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Ask Me Anything: Diets, cooking and healthy eating

In an Ask Me Anything, Michelle Hauser shares her expertise around all things food, diet and healthy cooking.

Between busy days in the office, kids' food aversions and cravings for sugary treats, healthy eating habits can be elusive for the whole family. In our latest Ask Me Anything, we ask Michelle Hauser, MD, a clinical associate professor of surgery who specializes in obesity medicine, to answer questions on everything food.

Can diet choices affect the health of your heart? Can it decrease inflammation? What foods are best for weight loss? And what about breakfast? Is it really the most important meal of the day?

Hauser, part doctor, part professionally trained chef, is a firm believer that healthy food can -- and should -- taste good. In this Ask Me Anything she weighs in on how to optimize your diet for the best health results and shares her insights as a chef in the kitchen and doctor in the clinic.

Are there certain diets to follow that are good for your heart?

There are a number of diets that are heart-healthy including Mediterranean; DASH; and other whole-food, plant-based diets. The bulk of these diets are made up of minimally processed plant foods, such as vegetables, fruits, whole grains, beans, nuts and seeds. Focusing on incorporating as many of these foods as possible and limiting excess sodium and highly processed carbohydrates (such as foods made with flours, especially white flours, and added sugars or sweeteners) will send you well on your way to heart health.

Michelle Hauser, MD, a physician-chef

For high-protein foods, opt for beans; tofu; tempeh; and lean proteins such as poultry without the skin, fish and seafood (not breaded or fried). Minimize or exclude red meat, processed meat (bacon, sausage, cold cuts) and alcohol. Fats in the diet should be primarily those that are liquid at room temperature or naturally occurring in the foods those oils would come from (olives, avocado, nuts, seeds).

Following this dietary pattern is also good for decreasing inflammation and lowering LDL cholesterol levels.

What does it mean to be a physician-chef?

Being a physician-chef literally means training in both fields and using the knowledge and skills learned in professional practice. The field combining these two things is more popularly called culinary medicine. The definition I use for culinary medicine is "an evidence-based field that brings together nutrition and culinary knowledge and skills to assist patients in maintaining health and treating food-related disease by choosing high-quality, healthy food in conjunction with appropriate medical care."

I use culinary medicine in my practice on a regular basis, whether that's talking to patients about food and nutrition or doing cooking classes with them in person or by video call. I love seeing people's faces light up when they try something that surprises them with how good it is or that they thought they wouldn't like. In my experience, everyone loves good food. Making healthful food taste delicious is the key to getting people to eat more of it. 

What are the best foods to eat (or avoid) to decrease fat deposits around the midsection?

The same dietary pattern that's best for a healthy heart applies here. I want to draw special attention to the limitation of highly processed carbohydrates. Eating too many foods with these ingredients, not maintaining a healthy weight and being physically inactive can lead to increased waist circumference.

I recommend frequently revisiting the question, "Could I eat this way forever?" in considering the sustainability of a dietary pattern. If yes, great! If maybe, keep trying and see if you move toward or away from yes. If no (or hell no), don't try to force it. Move on to the next dietary change you're contemplating and don't feel guilty about it!

How can I get my kids to eat more veggies?

The number one thing you can do to get kids to eat more veggies is to engage them in all aspects of food acquisition and preparation. Have them choose recipes, shop for and put away groceries, join you at the farmer's market, and plan and prepare meals. Most recipes have kid-appropriate steps for those of almost any age. Make meal planning and preparation a family activity. Talk about the good things that food does for the body. Avoid negative commentary or dieting comments. Avoid battles over food. Encourage trying one bite of new foods and then letting it go.

Lastly (although I could go on!), make it fun and delicious. Cut up lots of veggies and make food art. We do "bagel people" with small, whole-grain bagels. Add hummus and decorate with vegetables to create all sorts of creatures. It's difficult to make good food art without all the colors in produce. For lunches, using food cutters in fun shapes -- we have zoo animals -- can also increase the likelihood of veggies getting eaten.

What's your favorite easy weeknight recipe?

Salad night! We'll use a mix of the following ingredients for salad night:
Veggies: greens, cherry tomatoes, rainbow bell peppers, cucumbers, broccoli, snap peas, pickled red onions, carrots, celery, roasted sweet potatoes
Protein: roasted tofu, beans marinated in a vinaigrette, hummus, veggie chicken
Whole grain: quinoa, whole-grain toast or crackers
Healthy fats: dressings (see below), avocado, olives, seeds (chia, flax, hemp, pepitas), or nuts (sunflower seeds, pepitas, pecans, almonds...peanut allergy house, so no peanuts)
Fruit: dried or fresh fruit in the salad or on the side
Dressing: My fave is balsamic vinaigrette, my 5-year-old likes Cashew Ranch, my toddler likes either the balsamic vinaigrette or miso ginger dressing.

What was it like training at Chez Panisse?

It was transformational. I had grown up in the Midwest and largely experienced vegetables as a sad or soggy side dish that was an obligatory, but certainly not celebrated, part of each meal. In French cooking school (Le Cordon Bleu), I learned that vegetables could be incredibly delicious, but much of the preparation in my training included adding cream, butter, cheese, salt and bits of meat to flavor them. 

Chez Panisse built the foundation of what later became an "ah-ha" moment about healthy food being delicious. I never once heard anyone there say anything about the healthfulness of a dish. Yet most of the dishes were incredibly nutritious. While I was there, Gourmet magazine rated Chez Panisse the best restaurant in America. Clearly, healthy food can be delicious and crave-worthy. This lesson is what guides much of the work I do in culinary medicine to this day.

What's a common diet mistake or misconception?

The most common pattern that I see associated with weight gain, difficulty with appetite control, food cravings and weight-loss plateaus is skipping meals during the day and concentrating most of the caloric intake in the evenings. Fasting reduces metabolic rate, as does weight loss. When food does become available after a fast, our bodies often respond by activating processes that allow us to consume more food than normal.

When breakfast time rolls around, we're not hungry because we consumed so many calories the night before. After breakfast, we get busy and skip most food till dinner again, and the cycle repeats. What's worse is that this pattern of eating sets us up for craving calorie-dense food.

Is breakfast really necessary? And if so, what do you recommend?

While a full breakfast isn't a must, I wouldn't recommend skipping calories for the day. Instead, for those who don't like to eat breakfast, I recommend making a list of 100- to 250-calorie options that they can have in lieu of meals. Picking options that include fiber, protein and healthy fats helps the most with satiety and maintaining stable blood sugars, which in turn helps prevent overwhelming food cravings and insulin resistance, which can happen if you don't eat breakfast.

For example, you might opt for an apple or banana with peanut butter, a 1-ounce serving of nuts, avocado slices with whole grain crackers, roasted tofu, refried black beans (made with a small amount of oil or broth, not lard), or veggie sticks and hummus. Avoid flavored, presweetened yogurts and packets of oatmeal which can hide enormous amounts of sugar. It's better to add a teaspoon or two of your own sweetener if you feel you need it after adding other ingredients. Using spices associated with desserts, like cinnamon, ginger, nutmeg and cloves, can add an element of sweetness which helps reduce the perceived amount of sugar needed in a dish.

What advice would you give to someone who wants to make a healthy meal plan?

Try to structure meals on the following proportions: ½ produce, ¼ whole grains, ¼ protein foods. For those trying to lose weight, I recommend that the vegetable portion of the plate is made up of non-starchy vegetables. You can also substitute starchy vegetables for the whole grains. This allows you to fill up on fewer calories than a plate with multiple starchy components.

Think about the taste preference you or your family have. Try to incorporate those. Like smoky or savory flavors? Find a recipe or dish that incorporates those flavors in a healthy way. Like sweets? Include a fruit or very small portion of dessert with meals. Leaving cravings unsatisfied can cause you to focus on the item of interest or to snack because you feel unsatisfied.

Any advice for meal prep if you're on a busy schedule?

Find time during the week when you can do some meal prep. If you can chop all of the onions or garlic, cook whole grains, or chop veggies that will keep, do it then. Make a flavorful, healthy sauce or two (vinaigrette, romesco, pesto, etc.); freeze part of it for another time and use part that week. Doing this each week with sauces -- or even finished dishes -- will give you a stockpile of pre-made foods or items that you can turn to on busy evenings instead of relying on take-out or delivery.

For more Ask Me Anything content, visit our related Scope stories.

Photo by kerdkanno

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