Does Your Diet Need A Makeover?

Whether you want to drop a few pounds, lower your risk of heart disease, or decrease pain and inflammation in your body, certain foods can help you reach these goals. Here are the ones to add to your shopping list.
Nicole Egenberger, ND

Shopping List
You already know the basics of healthy eating: Shop the perimeter of the store and eat minimal processed foods and fats. But are you buying the foods that will help you reach your specific health goals? To help you do this, we paired three integrative practitioners with three readers who have different health concerns. One is trying to lose weight, another wants to lower her cholesterol without drugs, and another hopes to ease his osteoarthritis pain. Here’s what their grocery shopping lists looked like before they worked with our experts—and what they’re shopping for now.

Ambere St. Denis, 32
Home: San Francisco
Goal: Weight loss
Challenges: Cravings for sugar and bread, low energy, bloating

The Background
Being single in San Francisco with a demanding job in sales means Ambere does a lot of “grab-and-go” eating and dining out. While she knows she needs a hearty breakfast to keep her energy high all day, she often picks up an egg sandwich or a scone and coffee at a deli near her office and then goes out again for lunch. “It’s pretty typical for me to eat all three meals out at least a few times a week,” she says. “It’s just easier—and oftentimes, I’ll have client dinners.” When her energy flags, she typically reaches for something sweet or carb-heavy. Although these snacks give her a quick pick-me-up, Ambere knows they’re not helping her energy in the long run.

Ambere’s Typical Shopping List Ambere’s Typical Meals
White bread
White rice
Oil-packed tuna
Cheese (occasionally)
Vegetable oil
Olive oil
Breakfast Eggs, potatoes, toast
Lunch Tuna melt, french fries, fried chicken sandwich
Dinner Fried catfish or curry chicken with white rice, pot stickers, bread
Snacks Scones, chocolate, or other sweets

Nutrition Analysis
The first thing that jumped out at me is that Ambere is consuming wheat at almost every meal—in part because she craves it. Often, we crave the foods we have a hidden sensitivity to—and a food sensitivity can actually prevent weight loss. Why? When the body isn’t able to digest a food like it should, the immune system kicks into gear, essentially considering that food a foreign body that needs to be “fought.” This makes the immune system too busy to focus on the low-grade inflammation that happens as a result of stress, environmental toxins, and processed foods—and the result is illness and an inability to lose weight. By cutting wheat, Ambere should immediately see a change for the better in her energy level and digestion (read: no more bloating!). What’s more, in order to feel full, she’ll have to replace that bread, white rice, and pasta with fiber-filled whole grains, which will sustain her energy and reduce her calorie intake.

To figure out if you’ve got an underlying food sensitivity, visit for directions on how to follow an elimination diet.

Ambere’s To Do’s
In addition to ditching wheat, Ambere needs to scale back on the number of meals she eats out. The more she can get in the habit of cooking nutritious meals that can be reheated later in the week, the better. When she does cook at home, she should use coconut oil, which has been shown to decrease fat stores and stimulate metabolism. Ambere should also keep these three “R’s” in mind:

Remove processed and refined foods, white sugar, gluten, and trans fats. While I do not adhere strictly to the blood-type diet, it is important to note that many with blood type O (Ambere included) have difficulty digesting gluten, and the result can be weight gain.
Replace these “baddies” with nutrient-dense, easily digested foods, including dark leafy greens, high-quality protein such as seafood and grass-fed meats, flaxseeds, and gluten-free foods.
Repair a gut that’s been damaged by foods you’re sensitive or allergic to with the amino acid L-glutamine. Adding fermented foods, yogurt with live-active cultures, and nondairy probiotic drinks will also help repopulate the gut with the “good” bacteria it needs to function at its best.

Ambere’s New Shopping List The New Meal Plan
Fruits and vegetables
Dark leafy greens like kale, collard greens, and rainbow chard
Whole grains
Brown rice
Quinoa and quinoa noodles
100% buckwheat
soba noodles
Wild salmon (avoid farmed)
Pacific halibut
Mahi mahi
Black sea bass (avoid Chilean)
Free-range chicken
Grass-fed beef and buffalo
Thermogenic herbs like garlic, cayenne, and curry (they stimulate metabolism)
Fennel (removes excess fat from the intestinal tract)
Fenugreek (removes excess fat from the liver)
Cinnamon (stabilizes blood sugar)
Pasture-raised eggs
Raw nuts and seeds
Coconut oil
Goat’s milk yogurt
Almond milk
Gluten-free crackers and cookies
Green tea
Breakfast Omelet with spinach, peppers, and a pinch of cayenne
Lunch Grilled salmon salad with avocado, shredded carrots, and pumpkinseeds
Dinner Curry or grilled chicken with brown rice and steamed swiss chard or bok choy
Snacks Sliced strawberries in plain goat’s milkyogurt or cold quinoa salad with chopped veggies and fruit

The Expert
Catherine Ziegler,
HHC, holistic nutrition counselor in San Francisco

Quick tip! When a bread craving strikes, spread almond butter on a gluten-free cracker. If you’re jonesing for something sweet, drizzle a little agave nectar on top. The protein-carb combo will give you a boost and fill you up so you’re not reaching for something else later.

Carolyn Clay, 56
Home: Durham, North Carolina
Goal: Lower cholesterol without drugs
Challenges: Diagnosed with cardiovascular disease and has had two heart attacks and two cardiac stents in the past seven years

The Background
Most people are surprised when they learn that Carolyn, a cardiac nurse, has had two heart attacks and that her cholesterol was almost 300 at its highest. For Carolyn, however, her medical history makes sense. “When I had my heart attacks, I wasn’t really paying attention to me—I was taking care of everyone else,” she says. “I ate anything I wanted to eat,” including her husband’s high-fat, calorie-dense specialties and ice cream—Carolyn’s self-proclaimed weakness. Now on cholesterol-lowering drugs, Carolyn hopes to change her diet enough to eventually stop taking those prescriptions.

Carolyn’s Typical Shopping List Carolyn’s Typical Meals
Sweet snacks (like ice cream and cakes)
Crystal Light
Diet sodas
Breakfast Sausage, eggs, and grits,
with a large biscuit
Lunch Salads, sweet or baked potato, chicken, and ice cream
Dinner Chicken or ham, baked beans, salad, cake, and ice cream
Snacks Sweets, sweets, and more sweets!

Nutrition Analysis
The good news is that Carolyn’s husband is a culinary king and does all the cooking. The bad news is that he appears to be a meat-and-potatoes kind of guy. She needs a fisherman-farmer type for her goals, which include a plant-based diet that contains lean protein from seafood (preferably cold-water fish like wild sockeye salmon) and non-animal protein from legumes. Right now, Carolyn’s diet is too heavy in high-fat animal protein. If giving that up altogether is too much, she and her husband can get creative and mix beans with meat in, say, sloppy joes to get a taste of the meat with much less fat.

While eggs are often off-limits in cholesterol-lowering diets, Carolyn can have them in moderation—about five to seven per week, in fact—and she can make them go further by baking a frittata and adding grilled vegetables, baby spinach, and garlic. I also recommend cutting back the yolks and adding more egg white to the scramble.

Carolyn’s vegetable choices are currently limited to starchy potatoes and corn—not especially good for maintaining her blood-sugar level. High blood sugar contributes to inflammation (which we know contributes to heart disease). Carolyn also needs to up her fiber intake and heart-healthy fats, like those found in nuts, seeds, olives, avocados, ground flaxseeds, and oils such as olive and canola. She’s not getting enough omega-3 fats from cold-water fish and plant sources, and she needs more calcium and magnesium, which are essential for bone and cardiovascular health.

Carolyn’s To Do’s
The goal is to get Carolyn to eat nine to 12 servings of antioxidant-rich fruits and vegetables a day. That may sound like a lot, but a diet high in antioxidants helps reduce the LDL (“bad cholesterol”) that leads to heart disease. Adding more soluble fiber will also help improve Carolyn’s cholesterol profile and prevent heart attacks and strokes. Carolyn should follow these steps for lunch and dinner:

Step 1: Fill her plate with fruit (yes, even at dinner!), vegetables, and legumes. Ideally, these “side” dishes should take up half to three-quarters of her plate.
Step 2: Reach for whole grains (like brown rice, quinoa, and millet); these should take up no more than a quarter of her plate.
Step 3: Place a piece of fish or chicken no bigger than the size of her palm on the remaining quarter of her plate.

Carolyn’s New Shopping List The New Meal Plan
Fruits and vegetables
Frozen black cherries
Kale, collards, spinach, and other dark leafy greens
Sweet potatoes
Whole grains
Steel-cut oats
Brown rice
Cold-water fish(such as wild salmon)
Free-range chicken
Ground flaxseeds
Nuts and nut butters
Olive and canola oils
Nonfat or 1% milk,
yogurt, and cheese
Fresh-fruit sorbet
Green and black tea
Breakfast Egg-white omelet with two kinds of chopped veggies and a side of berries
Lunch Cold brown-rice pasta salad with three kinds of grilled or sautéed veggies, garlic, olive oil, chopped walnuts, and goat cheese crumbles
Dinner Grilled salmon or free-range chicken with sides of veggies, fruit, and beans
Snacks Edamame, fresh-fruit sorbet, frozen black cherries, or cinnamon applesauce

The Expert
Beth Reardon, RD,
integrative nutritionist at
Duke Integrative Medicine

Quick tip! Keep meal times consistent, and opt for five small meals rather than three squares if you’re trying to lower your cholesterol. Evidence shows that grazing throughout the day can stabilize blood-sugar levels, regulate metabolism, and help you lose weight.

Tom Rabbitt, 58
Home: Southold, New York
Goal: Ease arthritis pain in hips to prolong (or prevent) hip-replacement surgery
Challenges: Experiences pain during exercise; about 15 to 20 pounds overweight

The Background
For Tom, a former college soccer player, staying active is a way of life. During his 30s and 40s, he played racquetball twice a week, ran a few times a week, and golfed on the weekends. Now in his 50s, the effects of intense exercise are taking a toll in the form of osteoarthritis in both hips. “My doctor told me the cartilage is almost completely worn down in both joints, which means hip replacements are likely,” he says. “But since those don’t last forever—and I’m still pretty young—I’d like to put off surgery for as long as I can, and try to stay as pain-free as possible in the process.” While he now bikes for aerobic exercise (20- to 25-mile outdoor rides when the weather permits and spin classes during colder months), Tom experiences intense pain in his hips after walking long distances.

Tom’s Typical Shopping List Tom’s Typical Meals
Local, in-season veggies from the farmers' market, including salad greens, tomatoes, and carrots
Potatoes, broccoli, turnips, onions, garlic
Fresh fish, including tuna, trout, flounder, and sea bass
Farmed salmon
Filet mignon or other cuts of beef
Bananas, apples, watermelon, berries
White bread, pasta, and rice
Olive oil, pretzels, potato chips
Coffee, tea, beer
Breakfast Three cups of coffee and a banana
Lunch Cobb salad with ham and blue-cheese dressing or tuna salad on white bread
Dinner Grilled steak, steamed broccoli, and bread dipped in olive oil
Snacks Pretzels and potato chips; ice cream

Nutrition Analysis
Tom is taking great steps toward maintaining a healthy lifestyle. Biking is good because it gets him outside, which helps maintain healthy vitamin D levels (vitamin-D deficiency has been linked to osteoarthritis progression) and is both aerobic and low impact, so it won’t further damage his hips. Including a variety of vegetables from his local market is also a great move, since the fresher the food, the more nutrient-dense it tends to be.

There are two goals Tom should focus on. First, he needs to gradually lose weight. Along with a variety of other health benefits, weight loss has been shown to slow the degeneration of the hip and knee joints in osteoarthritis. To help him lose weight, Tom needs to decrease the amount of refined flour products and sugar in his diet and be mindful of portion sizes and the hidden calories in beverages. Second, Tom needs to decrease the level of inflammation in his body to slow the degeneration of his hip joints. Sugar, coffee, alcohol, and food sensitivities increase inflammation. One way Tom can avoid developing food sensitivities is to make sure he’s eating a wide variety of foods and isn’t eating any one food every day (most of us eat dairy and wheat three meals a day, every day). Tom should consider trying an elimination diet to see which foods may be increasing his joint pain.

Tom’s To Do's
Eliminate the nightshade family. Potatoes, tomatoes, eggplant, bell peppers, cayenne, and paprika contain solanine, a compound known to aggravate joint pain in many people.

Take 1 to 2 tablespoons of brewer’s yeast or rice bran daily. These provide a good range of B vitamins. Several studies demonstrate that these vitamins can help improve range of motion and decrease pain in osteoarthritis patients.
Consider red meat a treat. Eat beef no more than twice a month, since frequent consumption has been correlated with an increase in C-reactive protein (an inflammation indicator).
Snack smarter. Swap pretzels and potato chips for a handful of nuts or a tablespoon of nut butter and a piece of fruit. A half cup of sunflower seeds is also a great choice, since they contain a good amount of vitamin E, a prostaglandin inhibitor that helps reduce inflammation and protects joint cartilage.
Spice things up. Increase intake of turmeric, which has been shown to reduce inflammation. Adding black pepper to a recipe helps boost turmeric’s absorption.
Cut back on coffee and alcohol. Tom needs to limit himself to one cup of joe a day; more may increase inflammation. Alcohol is a source of hidden calories, so if Tom wants to indulge, he should opt for a glass of red wine. At about 80 cals per glass, it’s a better choice than beer (which can have a calorie count of 200 or more).

Carolyn’s Typical Shopping List The New Meal Plan
Tom’s New Shopping List
Fruits and vegetables
Low-glycemic fruits like berries, apples, and pears
Sweet potatoes
Dark leafy greens
Whole grains
Basmati and brown rice
Wild salmon and other smaller fish
(avoid tuna and swordfish, which tend to have higher heavy-metal contents)
Organic chicken
Brewer’s yeast
Flaxseed oil (use in homemade salad dressings, not as a high-heat oil)
Nonhydrogenated, olive oil–based spreads
Organic, grass-fed milk and yogurt
Nondairy alternatives (oat or almond milk)
Sunflower seeds
Ginger tea
Breakfast Steel-cut oatmeal with rice bran and flaxseeds, berries, and one cup of coffee (followed by green or ginger tea, if needed)
Lunch Salad with grilled salmon or chicken, ginger and flaxseed-oil dressing, and a side of baked sweet-potato “fries”
Dinner Lentil stew with brown rice, or grilled wild salmon with steamed veggies and a side of pureed cauliflower (instead of mashed potatoes)
Snacks Nuts, sunflower seeds, or almond butter on apple slices

The Expert
Nicole Egenberger, ND, a naturopathic physician in New York City