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Top 5 Misconceptions About Food: A Doctor’s Daily Experience

As a primary care doctor, I spend my days taking care of patients with diabetes, high blood pressure, high cholesterol, heart disease, and obesity. I also see “healthy” patients whose eating habits are starting them on the road to a future filled with doctor’s appointments and hospital visits.

I enjoy reminding my patients that their fork can be more powerful than my prescription pad when it comes to preventing and reversing chronic diseases. This conversation usually uncovers some common misconceptions about food and nutrition. Here are five myths that I hear almost every day, among patients and colleagues alike:

1. “I need to eat more protein.”

Many people don’t realize that the average American consumes more than twice the Recommended Dietary Allowance (RDA) of protein, most of it from animal products. 1,2 Unfortunately, animal-based proteins have been shown to promote faster growth, not only of normal cells but of cancer cells, and have been linked to a variety of cancers as well as heart disease, diabetes, Alzheimer’s disease, and kidney stones.3,4

Plant foods contain plenty of proteinand a well-planned whole-foods, plant-based diet can easily meet our protein requirements. And unlike animal proteins, plant proteins from whole foods are not associated with cancer or other chronic diseases. In fact, these foods actually prevent many of the diseases we see today!

2. “I need to drink milk to have strong bones.”

Many people equate dairy with calcium, strong bones, and the prevention of osteoporosis (low bone density). Generations of advertising slogans have perpetuated this idea. However, dairy isn’t the answer here. Studies show that dairy products may actually increase the risk of fractures related to osteoporosis!5-7

The biological purpose of cow’s milk is to support the rapid growth of a calf. Humans have no nutritional or medical need to consume the milk of cows or any other nonhuman species. Cow’s milk naturally contains female hormones, and can contain antibiotics, pesticides, saturated fat, and cholesterol -- substances that definitely do NOT do a body good! Dairy has been specifically linked with prostate, ovarian, and uterine cancer, as well as heart disease and early death.7-13

The best sources of calcium come from the earth, in foods such as kale, broccoli, bok choy, and Brussels sprouts. As a bonus, these vegetables are high in vitamin K, which is also important for strong bones. (Some greens, such as spinach and Swiss chard, are high in calcium but the calcium is not well absorbed due to the high oxalate content of these foods.) Fortified plant milks and calcium-set tofu are other good sources of calcium.

3. “Chicken, turkey, fish, and eggs are healthy sources of protein.”

Chicken, turkey, fish, and eggs contain significant amounts of cholesterol and saturated fat, in many cases as much as beef,14 so they are not “heart healthy” foods. Plant-based sources of protein contain zero cholesterol and far less saturated fat. Chicken and turkey usually contain antibiotics, pesticides, and fecal contaminants, and have been associated with salmonella, staph, and other infectious disease outbreaks. Chicken, fish, and eggs have been associated with an increased risk of diabetes.15-23 Almost all fish contain mercury, which can cause neurologic and cognitive problems; many also contain polychlorinated biphenyls (PCBs), a toxin associated with cancer.14 And a recent study showed that eggs cause intestinal bacteria to make a substance called TMAO, which can trigger heart attacks and other cardiovascular events.24

Whole plant foods can supply plenty of protein, and they don’t come packaged with cholesterol or high levels of saturated fat. Instead, their protein is bundled with fiber and many necessary nutrients! Great plant-based sources of protein include beans, peas, lentils, tofu or tempeh, whole grains, nuts, and seeds.

4. “I can’t eat carbs.”

Many people are mistakenly led to believe they should avoid carbohydrates, particularly for weight management and diabetes control. Instead, they focus on proteins—especially animal proteins—and fats. Sadly, this approach actually increases the risk of chronic disease and death,25-29 and it deprives people of the numerous nutrients found in carbohydrate-containing foods.

It is true, however, that not all carbohydrate-rich foods are created equal. Refined, highly processed carbohydrates can raise triglycerides, promote weight gain, and drive up blood sugar. On the other hand, starches that come from whole grains bring fiber, essential fatty acids, B vitamins, zinc, and protein, and other essential nutrients into our diets and provide an excellent source of energy. Beans, lentils, peas, starchy vegetables, and fruits are other healthy carbohydrate sources. Balancing these foods with non-starchy vegetables is an optimal way to eat for weight loss, diabetes control, and reversal of heart disease.

5. “Healthy food is too expensive.”

You don’t need to shop at a gourmet health food store to find nutritious foods. Actually, some of the healthiest foods are the least expensive, and they are readily available at most grocery stores and many local farmers’ markets. Beans, lentils, brown rice, and frozen vegetables are usually inexpensive, especially when bought dried and in bulk. (Organic fruits and vegetables can cost more, but eating nonorganic plant-based foods is still more nutritious than eating meat, chicken, fish, eggs, and dairy, organic or otherwise.)

Even when processed foods and animal products are sold cheaply, they are expensive in terms of the cost to your health. What you may save now, you could end up spending later in pharmacy co-payments and medical bills!

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References

1 Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press; 2002.
2 Rizzo NS, Jaceldo-Siegl K, Sabate J et al. Nutrient profiles of vegetarian and nonvegetarian dietary patterns. J Acad Nutr Diet 2013; 113(12):1610-9.
3Campbell TC, Campbell TM. The China Study: Startling Implications for Diet, Weight Loss, and Long-Term Health. Dallas: BenBella Books; 2006.
Barnard NB, Weissinger R, Jaster BJ, et al. Nutrition Guide for Clinicians, First Edition. Washington, DC: Physicians Committee for Responsible Medicine; 2007.
5 U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2004.
6 Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 2003; 77:504-11.
7 Michaëlsson K, Wolk A, Langenskiöld S, et al. Milk intake and risk of mortality and fractures in women and men: cohort studies. British Medical Journal2014;349:g6015.
8 Qin LQ, Xu JY, Wang PY, et al. Milk consumption is a risk factor for prostate cancer: Meta-analysis of case-control studies. Nutr Cancer 2004; 48(1):22-7.
9 Qin LQ, Xu JY, Wang, PY, et al. Milk consumption is a risk factor for prostate cancer in Western countries: Evidence from cohort studies. Asia Pac J Clin Nutr 2007; 16(3):467-76.
10 Chan JM, Stampfer MJ, Ma J, et al. Dairy products, calcium, and prostate cancer risk in the Physicians’ Health Study. Presentation, American Association for Cancer Research, San Francisco, April 2000.
11 Chan JM, Stampfer MJ, Giovannucci E, et al. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study. Science 1998; 279:563-565.
12 Genkinger JM, Hunter DJ, Spiegelman D, et al. Dairy products and ovarian cancer: a pooled analysis of 12 cohort studies. Cancer Epidemiol Biomarkers Prev 2006; 15:364–72.
13 . Ganmaa D, Sato A. The possible role of female sex hormones in milk from pregnant cows in the development of breast, ovarian, and corpus uteri cancers. Med Hypotheses 2005; 65:1028–37.
14 Simon, D. Meatonomics. San Francisco, Conari Press, 2013.
15Li Y, Zhou C, Zhou X, et al. Egg consumption and risk of cardiovascular diseases and diabetes: a meta-analysis. Atherosclerosis 2013; 229(2):524-30.
16 Djoussé L, Gaziano JM, Buring JE, et al. Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care 2009; 32(2):295-300.
17 Radzevičienė L1, Ostrauskas R. Egg consumption and the risk of type 2 diabetes mellitus: a case-control study. Public Health Nutr 2012; 15(8):1437-41.
18 Tonstad S, Butler T, Yan R, et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care 2009; 32(5):791–6.
19 Chiu TH, Huang H, Chiu Y. Taiwanese vegetarians and omnivores: dietary composition, prevalence of diabetes and impaired fasting glucose. PLoS One 2014; 9(2):e88547.
20 van Nielen M, Feskens EJ, Mensink M. Dietary protein intake and incidence of type 2 diabetes in Europe: the EPIC-InterAct Case-Cohort Study. Diabetes Care 2014; 37(7):1854-62.
21 van Woudenbergh GJ, van Ballegooijen AJ, Kuijsten A, et al. Eating fish and risk of type 2 diabetes: a population-based, prospective follow-up study. Diabetes Care 2009; 32:2021–6.
22 Kaushik M, Mozaffarian D, Spiegelman D, et al. Long-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus. Am J Clin Nutr 2009; 90:613–20.
23 Djoussé L, Gaziano JM, Buring JE, et al. Dietary omega-3 fatty acids and fish consumption and risk of type 2 diabetes. Am J Clin Nutr 2011; 93:143–50.
24 Tang WH, Wang Z, Levison BS. Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. N Engl J Med 2013; 368(17):1575-84.
25 Larsson SC, Orsini N. Red meat and processed meat consumption and all-cause mortality: a meta-analysis. Am J Epidemiol 2014; 179(3):282-9.
26 Lagiou P, Sandin S, Lof M, et al. Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study. British Medical Journal 2012; 344:e4026.
27 Fung TT, van Dam RM, Hankinson SE, et al. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann Intern Med 2010; 153(5):289-98.
28 Noto H, Goto A, Tsujimoto T, et al. Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies. PloS One 2013; 8(1):e55030.
29 de Koning L, Fung TT, Liao X, et al. Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr 2011; 93(4):844-50.

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About the Author

Headshot of Michelle McMacken, MD, FACP, DIPABLM

About the Author

Michelle McMacken, MD, FACP, DipABLM

Dr. Michelle McMacken is a board-certified internal medicine physician, executive director of Nutrition and Lifestyle Medicine at NYC Health + Hospitals, and an assistant professor of medicine at NYU School of Medicine. An honors graduate of Yale University and Columbia University College of Physicians and Surgeons, she has more than 14 years of experience practicing primary care, directing a medical weight-loss program, and teaching doctors-in-training. An enthusiastic supporter of plant-based nutrition, she is committed to educating patients, medical students, and doctors about the power of healthy eating and lifestyle modification. Follow her on Instagram and LinkedIn All opinions expressed by McMacken are her own and do not necessarily represent those of her hospital affiliations; neither she nor her affiliated hospitals have a financial relationship with Forks Over Knives.
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