analysis of what a nutritionist eats and hospital food

An article in Business Insider, A Nutritionist Shares Pictures of Everything She Eats in a Day, caught my eye recently.  I thought it would be interesting to run the numbers to see how the food diary logged by this nutritionist compared to the four hundred or so meals that I’ve analysed.

Check out the original article if you want to see the daily food log chronicled in photos by the popular and published “Registered Dietician”, who claims to specialise in diabetes and is “passionate about being a good role model.”[1]

The quantities and foods that I analysed in the recipe builder at SELFNutritionData are shown below.  Besides the fact that the only green things she ate during the day were M&M’s, the food log is not particularly divergent from mainstream dietary advice (i.e. no full-strength Coke or McDonald’s).  The nutritional analysis would be much worse if it was a diet full of junk food, which is pretty common for a lot of people these days in this fast-paced convenience-loving world.

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This dietician is a national media spokesperson for the Academy of Nutrition and Dietetics.  She has published books and written for several magazines.[2]  Like most nutritionists, she argues for less fat and more whole grains.[3]

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So, let’s see how her daily diet stacks up.  The analysis below shows that, when we compare this daily diet against mainstream dietary advice that nutritionists prescribe, it ticks the following boxes:

  1. avoids trans fats,
  2. is low in fat, and
  3. is low in cholesterol.

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However, even though the diet is fairly low in fat, it has 29g of saturated fat which is greater than the Heart Association’s recommendation for a maximum of 16g of saturated fat per day.[4]   Unfortunately, the recommended limit of saturated fat is actually quite hard to achieve without relying on low fat highly processed foods.

Ironically, due to the focus on avoiding fat and trying to incorporate more “heart healthy whole grains”, the food recommended by nutritionists ironically tends to be lacking in nutrients.  It makes no sense!

The registered nutritionist’s daily food log also contains more than 400 grams of carbohydrates which will be a massive challenge to someone who is insulin resistant, would likely generate insulin resistance and eventually diabetes in someone who isn’t there yet.

For comparison, check out the analysis shown below of one of my regular meals (stir-fry veggies with some butter and sardines) which has a much higher vitamin and mineral score (94 compared to 55) and better protein score (139 compared to 66).

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When it comes to nutrient density and being diabetic friendly, this nutritionist’s daily food log ends up at the bottom of the pile of the four hundred meals that I’ve analysed!

It’s sad that this myopic one-size-fits-all dietary advice is forced on anyone who asks what they should be eating, or anyone whose food is influenced by government nutritional guidelines (e.g. hospitals, schools, jails, nursing homes etc).

Then we are told that dieticians are the only ones that are qualified to give dietary advice, even though the dietary advice that they give revolves around avoidance of saturated fat and more “heart healthy whole grains” and does not actually lead to high levels of micronutrition.

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Where it gets even sadder is that this sort of short sighted advice is also given to the people who are the most vulnerable.  The photo below is of Lucy Smith in hospital after being diagnosed with Type 1 Diabetes.  The diet given to her, as a newly diagnosed Type 1 Diabetic, is Weet-Bix, low fat milk, bananas, low fat toast, orange juice, and peaches.

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The analysis for Lucy’s hospital-provided breakfast is shown below.

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This single meal contains more than 200 grams of carbohydrates (82% of calories).  This breakfast would require a ton of insulin to be injected into her little body, and she would be on a blood glucose / insulin rollercoaster for days to come.

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When it comes to nutrient density, this meal has an even lower score than the day in the life of the nutritionist’s own diet discussed above!  Ironically, this hospital prescribed meal ranks at the very bottom of the list of four hundred meals when ranked to identify the best recipes for people with diabetes!

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Unfortunately, things don’t seem to have changed much from thirty years ago when my wife Monica was diagnosed with Type 1 Diabetes.  In hospital, after diagnosis, she was given so many carbs that she hid the food in pot plants in her hospital ward room because she just couldn’t eat anymore!  Twenty-five years later, she learned about the low carb dietary approach and she was finally able to reduce the high levels of insulin required to cover her food.

I’ve witnessed firsthand the massive improvements in quality of life (body composition, inflammation, energy levels, dental health etc) when someone comes off the blood glucose/insulin roller coaster!

Monica has been able to halve her daily insulin dose since no longer ascribing to the dietary advice she has been given by the dieticians and diabetes educators.  Her blood glucose levels are now better than ever and when she goes to the dentist, podiatrist and optometrist they tell her she’s doing great and they wouldn’t even know she’s diabetic.  And I get to have my wife around for an extra decade or two!

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By the way, Lucy is doing well now too.  Her parents are some of the most knowledgeable people I know when it comes to optimal foods for diabetics and monitoring blood glucose (as shown in this video from her father Paul).

My friend, Troy Stapleton, is another example of someone living with Type 1 Diabetes who has benefited immensely from a low carbohydrate dietary approach that aligns with his metabolic health.  His story and approach has been an inspiration to me.  You can also check out the Standing on the Shoulders of Giants article for a few more encouraging stories of people with Type 1 who got their life back after going against nutritionists orders.

As detailed in the article How to optimise your diet for your insulin resistance, if you have the luxury of being more metabolically healthy (i.e. not diabetic) you can focus on more nutrient dense foods or lower energy density if you’re looking to lose some weight.

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It amazes me that dieticians can be so militant and belligerent when they are largely passing on the recommendations of the US Department of AGRICULTURE (i.e. the USDA, also known as “Big Ag”), whose mission it is to promote the economic opportunity and production of AGRICULTURE[5] (i.e. grains and seed oils).  Talk about putting the fox in charge of the hen house!

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Speaking of conflicts of interest, it’s worth noting that major nutritionist organisations funding ‘partners’ are big food manufacturers.[6]  Does this influence the recommendations they give?  They claim not.

It’s hard to believe their published research or dietary recommendations could be impartial when so heavily sponsored by the food industry.

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Despite these conflicts of interest and a poor track record of success over the past four decades, I don’t think we should be gagging the Accredited Dietitians from publishing poor nutritional advice.  Everyone should be entitled to their freedom of speech and freedom to choose what they eat.

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What I do find ironic is that dieticians can bring spurious cases of malpractice against doctors to their governing bodies when they are acting in line with latest research and their personal, professional and clinical observations (e.g. Tim Noakes in South Africa and Gary Fettke in Australia).  At the same time, the Registered Dieticians have no governing body to report to, only their board of directors[7] and their ‘partners’.

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While they purport to be protecting the public interest, one could be excused for thinking that the dieticians’ associations are another marketing arm for big food companies and are protecting commercial interest rather than acting on behalf of public health.

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Is it just a coincidence that Nestle’s Milo, which is half sugar, is prescribed by hospital dieticians for pregnant and breastfeeding mothers with diabetes?

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Unfortunately, the situation isn’t that much different with the diabetes associations.[8]  Why would these institutions ever make recommendations to their members that reduced the amount of medications they needed or reduce the amount of processed food when their financial partners are pharmaceutical companies who manufacture insulin and drugs for diabetes?

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What would happen to this financial structure if a significant amount of people started eating whole unprocessed food without a bar code?  The share price of these massive medical and pharmaceutical companies would tank!

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After battling cancer himself and studying the role of nutrition in metabolic and mitochondrial disease in depth, Gary Fettke now spends his days as an orthopaedic surgeon amputating limbs mainly due to the complications of diabetes.

No, it’s not pretty, but unfortunately it’s very very real.

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Each year Gary volunteers as an orthopaedic surgeon in Vanuatu.[9] [10]  The contrast between the native people living in their natural environment, eating their native foods, and their relatives in town, eating processed foods, is stark.

I took this photo in a traditional village during our holiday in Vanuatu a couple of years ago.  These people eat lots of coconuts (which contains plenty of saturated fat, one of the remaining nutrients that Registered Dieticians still say we should avoid) and fish. These Vanuatu natives are some of the most beautiful, healthiest and happiest people I have ever seen!

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Unfortunately, in the capital Port Vila, it’s not so pretty.  The diabetes rates are the third highest in the world.  One in fifty Vanuatu natives have had an amputation!

It is such a big problem. Their diet has changed quite rapidly over the years, so instead of eating their island’s food, they now eat very large quantities of white rice and of course all the liquid sugar, like Coca-Cola and Fanta, and it’s literally killing them.[11]

After seeing the impact of diet, Gary has been outspoken in Australia, bringing attention to the quality of food that people are eating, especially in hospitals.[12]

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Gary and his Nutrition for Life Centre also worked with Chef Pete Evans on the “Saving Australia Diet” on national TV with great results achieved.[13]

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Then, in return for his efforts, Gary has been reported by the certified dieticians to the Australian Health Practitioner Regulation Agency; and he has been told he can no longer tell his patients to limit sugar even if they have just had their leg amputated due to the complications of diabetes.

Similarly, Tim Noakes has developed a massive following after realising that he needed to go against his own previous publications and advice, when he found he was developing diabetes. The recipe book that he helped write, The Real Meal Revolution, is filled with nutrient dense low carb meals that help people with diabetes achieve normal blood glucose levels, has been massively popular.

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Despite his impressive track record of real results, which goes against the general trend of the explosion of diabetes and obesity in western society, Professor Noakes has been reported to the Health Professionals Council of South Africa (HPCSA) and charged with unprofessional conduct, after suggesting that a mother wean her baby on to whole foods rather than processed “baby food”.

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This has led to a long and expensive court case which really appears to be more about maintaining the status quo on the supermarket shelves rather than public health.[14]

I think most nutritionists believe that they are doing the right thing by advising their clients to prioritise the avoidance of fat, cholesterol and saturated fat, and eat “heart healthy whole grains”.  However, the foundation of this advice seems to be crumbling from underneath them with the most recent updates to the US Dietary Guidelines that now remove the upper limit on fat and removing cholesterol a nutrient of concern.[15] [16]

However, if we have to rely on Big Food to provide processed food products to achieve the reduced saturated fat aspirations of the dietary guidelines (and in so doing produce very otherwise nutrient poor foods), then perhaps we need to declare them broken and look for new ones?

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Makes you wonder how we survived (let alone thrived) with the food that were available to us before the highly-processed foods and the low fat dietary guidelines that came to dominate our food choices in the 1970s.

Unfortunately though, fear of saturated fat still dominates the majority of mainstream dietary recommendations out there and leads to nonsensical food rankings that only suit the grain based food industry.[17] [18]

For example, the simplistic Australian Health Star Rating is based on the energy, saturated fat, sodium, sugar content along with the amount of fruits and vegetables in a product.[19]  This avoidance-based process gives little consideration for the amount of essential nutrients in a product, regardless of where they came from, and hence often returns nonsensical results.

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It’s hard to tell whether the attacks on people like Fettke and Noakes are motivated by:

  1. Well-meaning nutritionists who earnestly believe that higher levels of fat and a lack of “heart healthy whole grains” is going to harm people,
  2. Nutritional institutions sensing that they are becoming irrelevant and making a last-ditch attack at their adversaries in an effort to hold onto their jobs,
  3. Processed food manufacturers (i.e. big food) using their “partner organisations” to attack these outspoken thought leaders so they can maintain their strangle hold on nutritional advice that suits them and sells more of their product (i.e. it’s not a conspiracy, it’s just business), or
  4. Some combination of each of these options.

To cut through the confusion and conflicts of interest, wouldn’t it be great if there was an unbiased quantitative way to judge whether a particular food or meal was optimal based its nutrient density?  Perhaps we could even tailor food choices based on blood glucose and metabolic health (i.e. using insulin load), or by manipulating energy density of someone who is insulin sensitive but just needs to lose weight.

If you’ve been following this blog, you may have seen the optimal food lists tailored to specific goals.  To this end, I have devised a system to identify foods for different goals and situations. The table below will help you choose your ideal dietary approach and optimal foods based on your blood glucose levels and waist to height ratio.

approach average glucose waist : height
(mg/dL) (mmol/L)
therapeutic ketosis > 140 > 7.8
diabetes and nutritional ketosis 108 to 140 6.0 to 7.8
weight loss (insulin resistant) 100 to 108 5.4 to 6.0 > 0.5
weight loss (insulin sensitive) < 97 < 5.4 > 0.5
nutrient dense maintenance < 97 < 5.4 < 0.5

The first step in improving your nutrition is to minimize processed food that is laced with sugar.  These food lists can help you further optimise your food choices to suit your goals whether they be blood glucose management, weight loss or just maintaining optimal health.

Once you normalise your blood glucose levels, you can then start to focus more on nutrient density.  If you still have weight to lose, then you can focus on foods with a lower energy density to force more energy to come from your body while still maximising nutrition.   You can also find the highest ranking of the four hundred meals that I have analysed listed here.

Several people recently have suggested that I turn the nutrient density ranking system into a mobile app for easy implementation of the ideas and theories outlined on the blog in the real word.

So, my current project is to develop a Nutrient Optimiser that would rank the foods you have eaten based on your current goals (e.g. therapeutic ketosis, diabetes management, weight loss or maximising nutrient density) and recommend new foods to try.  The Nutrient Optimiser would progressively retrain your eating patterns towards ideal by helping you to maximise the more optimal foods, and progressively eliminate the foods that don’t align with your goals.   Whether you are trying to eat less Maccas, or you are practicing Calorie Restriction with Optimal Nutrition (CRON) and trying to live to 120, the Nutrient Optimiser would push you forward to truly optimise your nutrition.

The idea is not to simply create another calorie counting app.  There are plenty of those out there already.  Rather, the Nutrient Optimiser will help you to maximise nutrient density as much as you can, while catering to your other goals.

Rather than being centred on outdated “science” and avoiding boogeymen such as cholesterol, fat and saturated fat, or serving the interest of “financial partners” (e.g. BigFood and BigPharma), the Nutrient Optimiser uses a quantitative algorithm that will help you maximise the nutritional value of the food you eat.

The Nutrient Optimiser, based on the foods logged in the past few weeks, helps you to identify foods that would provide the nutrients that you haven’t been getting as much of.  Rather than just tracking calories, the app will continually adapt to what you eat, ensure that you are getting a broad range of foods that contain the nutrients you need, and ensure you don’t get stuck in a nutritional rut.

For people just starting out, it will help them gently move forward, without the judgement of someone looking over their shoulder.  It will suggest foods they should buy more of, new foods to try, and maybe which foods they should bin and never buy again.

For people who are truly wanting optimal nutrition, it will hopefully be the ultimate tool to continue to refine their food choices to maximise nutrient density while optimising blood glucose, insulin and body fat levels.

As you continue to log your weight, blood glucose levels and whatever other metrics you want to track, the app will progressively prompt you to “level up” to a more optimal nutritional approach.  Then, with your nutritional deficiencies filled, the cravings will dissipate and you will naturally be satisfied with less food.[20] [21]

If something like this is of interest to you and you want to be an early adopter or just check it out the nutritional analysis of other people food logs that have been done so far then then take a look at the Nutrient Optimiser Facebook page and to stay posted as things develop.

references

[1] https://www.amazon.com/Ruth-Frechman/e/B007HDN5IW

[2] http://www.ruthfrechman.com/Meet_Ruth.html

[3] https://www.youtube.com/watch?v=LAugDpr16Jg

[4] http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Know-Your-Fats_UCM_305628_Article.jsp#

[5] https://www.usda.gov/documents/usda-strategic-plan-fy-2014-2018.pdf

[6] http://daa.asn.au/advertising-corporate-partners/program-partners/

[7] http://daa.asn.au/?page_id=136

[8] https://www.diabetesaustralia.com.au/corporate-partners

[9] http://www.hopeforhealthvanuatu.com/volunteers/

[10] https://www.facebook.com/permalink.php?story_fbid=857965770964542&id=393958287365295

[11] http://www.radionz.co.nz/international/programmes/datelinepacific/audio/201818486/hope-given-to-amputees-in-vanuatu

[12] http://www.nofructose.com/2014/12/19/hospital-food-is-crap-and-its-killing-my-patients-and-what-to-do-about-it/

[13] https://au.news.yahoo.com/sunday-night/features/a/31538041/the-saving-australia-diet/#page1

[14] http://foodmed.net/tag/tim-noakes/

[15] http://time.com/3705734/cholesterol-dietary-guidelines/

[16] https://therussells.crossfit.com/2017/01/05/big-food-vs-tim-noakes-the-final-crusade/

[17] http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/How-to-use-health-stars

[18] http://www.nuval.com/

[19] http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/excel-calculator

[20] http://sydney.edu.au/news/84.html?newsstoryid=12632

[21] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988700/

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steak, eggs, spinach, brazil nuts and hallouimi

This is another one of my dad’s nutrient dense moderate protein meals.  He’s in a bit of a groove with the diced steak ready to do with the eggs, spinach and halloumi in the pan as the first meal of the day at between 1.00-2.00pm.

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Add some avocado, cucumber brazil nuts, broccoli sprouts and dulse flakes, salt & pepper and he’s good to go.

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Again, the nutrient density is great and we still get a keto / LCHF / diabetes friendly 70% fat without actually adding too much fat.

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The table below shows the nutritional data per 500 calorie serving.

net carbs Insulin load carb insulin fat protein fibre
4g 19g 13% 72% 29g 5g

how to get more of the harder to find micronutrients per calorie

There’s a lot of talk about “nutrient density” and “superfoods”, but what do these terms really mean?  Which foods actually give the most nutritional bang for your calorie buck?  That is, which foods provide the most nutrients for the least number of calories?

Some approaches to quantifying nutrient density (e.g. Joel Fuhrman’s Aggregate Nutrient Density Index) have looked at vitamins and minerals (along with other parameters that are only available for fruits and vegetables) per calorie, but do not consider essential fatty acids and amino acids.

Meanwhile, Registered Dietitians’ recommendations and mainstream food ranking approaches revolve around avoiding nutrients such as saturated fat, cholesterol and salt.  Unfortunately, this avoidance based approach to ranking foods does nothing to increase beneficial nutrients.

Avoidance of these demonised food elements typically ends up ignoring the whole unprocessed foods that contain the most nutrients.  Instead, current ranking systems encourage prioritisation of processed foods that have been manufactured to be low in fat, saturated fat, salt or cholesterol.

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The resultant fat-free manufactured products are so nutrient poor that they must be fortified with a smattering of synthetic vitamins to prevent the malnutrition that would otherwise occur.  Food manufacturers also add sugar and synthetic flavours to make them palatable.  After a few decades, food scientists have now learned to optimise sweetness to target “bliss point”[1] which continues to drive upwards in sweetness.[2]

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With synthetic flavourings, we can make hyperpalatable food stuffs that taste so much more intense than real foods that are found in nature.  After a generation or two of fake food we have forgotten what real food, in its natural form, tastes or even looks like.  Unfortunately, at the same time our food production is becoming more reliant on fertilisers to grow crops bigger and faster but the end result is food that doesn’t naturally taste as good as they used to because they don’t contain the same number of nutrients.  Our senses of taste and smell don’t have a chance of being able to find real nutrients amongst the plethora of super sweet and unnaturally flavoured foods.   This industrialized chemical storm also taxes your liver, kidneys, and digestive system and encourages disease instead of leading to health.

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So, if we can’t trust our senses anymore to find the nutrients we need what can we do?

As much as food technology has got us into this mess, the good news is that by quantifying nutrient density we can identify the foods that contain the most nutrients.  Then after a period without the distraction of sweeteners and artificial flavours and we can re-learn trust our tongue, nose, appetite and cravings to find the real nutrients that our body need.

The chart below shows the nutrients contained in the eight thousand foods in the USDA database per 2000 calories.  While it’s easy to get the minimum levels of iron, vitamin C and several the amino acids (at the bottom of the chart), it’s harder to obtain adequate quantities of omega 3 fatty acids, vitamin D, choline, vitamin E and potassium (shown at the top of the list).

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Rather than trying to get more of all the essential micronutrients, we can prioritise the following nutrients that are harder to find:

  • alpha-Linolenic acid (Omega 3 fatty acids)
  • Vitamin D
  • Choline
  • Vitamin E
  • EPA + DHA (Omega 3 fatty acids)
  • Potassium
  • Calcium
  • Magnesium
  • Pantothenic acid
  • Tyrosine
  • Thiamin
  • Zinc

The chart below lists the nutrients provided by the average of all food in the USDA database (orange bars) compared to the nutrients provided by the most nutrient dense foods (blue bars).  But focusing on the most nutrient dense foods, not only do we get more of the harder-to-find nutrients, we also improve the quantity of all the essential nutrients!

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Macronutrient split

The chart below shows a comparison of the macronutrients in the most nutrient dense foods compared to the average of all foods in the USDA database.  Although we have prioritised for only one amino acid (Tyrosine), it appears that the food that contain the most essential fatty acids, vitamins and minerals are also higher in protein.

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The quantity of fibre also increases substantially.  Nutrient dense vegetables come with large amounts of fibre which makes these foods more filling and harder to overeat.

The most nutrient dense foods also have a much lower energy density.  This makes these nutrient dense foods harder to overeat.  As well as feeling physically full, your body is likely to feel satiated once it has obtained the nutrients it needs.[3] [4]

Notice the proportion of fat and non-fibre carbohydrates are lower in the most nutrient dense foods.  In a way, I think we need to consider foods as nutrients and fuel separately.  The initial goal is to eat the foods that contain the nutrients to live an awesome life and support your bodily functions.  The secondary goal is to get enough fuel from higher energy density foods to support your activity and maintain ideal body fat.  Too often we sacrifice essential nutrients and nutrient density and instead choose irresistibly tasty and high calorie food products for a “quick rush”.

The most nutrient dense foods

The most nutrient dense foods (i.e. the top 10% of the eight thousand foods in the USDA database) are listed below along with their nutrient density scores (ND) which is based on the harder to find nutrients.

If you’re interested in all the gory details of the nutrient density score is calculated you can check out the Building a Better Nutrient Density Index article.  But in short the system compared the nutrients per calorie across all the foods in the USDA database.  A score is given based on the standard deviation from the mean.  If a certain food contains a lot of a certain nutrient it gets a large score.  If it contains an average amount of a certain nutrient it gets a zero score.  If it contains a little bit or none it gets a negative score.  We then sum all these individual nutrients scores for the nutrients that are harder to find that we want to emphasise.

If you want to check whether a particular food is nutrient dense I recommend Googling “nutrient data self [insert your favourite food here]” to see how it ranks.  For example, the image below shows that spinach does exceptionally well in both the nutrient balance (vitamins and minerals) and protein quality score.

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Vegetables

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Fibrous green vegetables are the highest-ranking nutrient dense foods.  Few people argue with the idea that veggies are good for you.  The nutrient density analysis confirms this.

food ND
watercress 16
endive 16
spinach 16
broccoli (sulforaphane) 13
escarole 13
asparagus 13
chicory greens 13
coriander 13
parsley 13
okra 12
lettuce 12
arugula 12
zucchini 12
brown mushrooms 12
Chinese cabbage 12
beet greens 11
seaweed 11
chard 11
chives 10
dandelion greens 10
cauliflower 10
turnip greens 10
celery 10
summer squash 10
yeast extract spread 10
alfalfa 9
radicchio 9
spirulina 9
white mushroom 9
pickles 8
cucumber 8
cabbage 8
mung beans 8
portabella mushrooms 8
mustard greens 8
collards 8
edamame 8
shiitake mushroom 8
snap beans 8
peas 8
artichokes 7
banana pepper 7
onions 7
soybeans (sprouted) 7
radishes 7
sauerkraut 7
pumpkin 7
kale 6
red peppers 6
butternut squash 6
Brussel sprouts 6
shiitake mushrooms 6
chayote 6
eggplant 6
jalapeno peppers 6
bamboo shoots 6
winter squash 5
turnips 5
rhubarb 5

Herbs and spices

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Spices add flavour and nutrients and plenty of vitamins and minerals.

food ND
basil 14
dill 9
paprika 7
cloves 6
thyme 6
sage 6
curry powder 5
marjoram 5
tarragon 4
pepper 3

Seafood

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Seafood provides amino acids as well as Omega 3 fatty acids which are harder to get from other foods.

food ND
crab 12
lobster 11
fish roe 10
oyster 9
crayfish 9
caviar 8
salmon 8
cod 8
trout 8
halibut 8
pollock 8
rockfish 7
sturgeon 7
shrimp 7
white fish 7
flounder 7
octopus 7
haddock 6
perch 6
whiting 6
anchovy 6
clam 6
sardine 5
scallop 5
tuna 5

Dairy and eggs

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Only low fat cream cheese makes the list in terms of nutrients per calorie as other dairy products typically have more fat and not as many essential nutrients per calorie.

It’s true that eggs are a nutritional powerhouse of vitamins, minerals and protein.  However, when it comes to the harder to find nutrients per calorie non-starchy veggies still win out.

It’s a similar story for nuts which don’t make the list.  Full fat dairy and nuts can be a great source of energy and nutrition, particularly if you are insulin resistant or have diabetes, but if you’re just looking to maximise the harder to find nutrients per calorie the list of dairy and nuts isn’t that long.

food ND
cream cheese (fat free) 8
whole egg 6
egg yolk 5
cottage cheese (low fat) 4
egg white 2

Animal products

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Organ meats do well as well.

food ND
turkey liver 9
veal liver 9
chicken liver 8
lamb liver 8
lamb kidney 7
ham (lean only) 6
pork liver 6
chicken breast 5
pork chop 5
turkey drumstick 4
turkey meat 4
lamb heart 4
leg ham 4
chicken liver pate 4
pork shoulder 4
veal 4

Pros and cons of nutrient density

The most obvious benefits of eating the most nutrient dense foods are that they:

  • provide the most essential nutrients with the fewest calories,
  • assist to normalize body weight (both lean tissue and body fat),
  • minimise cravings and the binge eating relating to nutrient hunger[5],
  • provide the nutrients your body needs to thrive and optimise mitochondrial health, and
  • help achieve and maintain overall good health.

Maintaining a healthy weight with adequate protein and while avoiding excess energy intake will help you to avoid a lot of the diseases of aging.  These foods will also be quite filling and hard to overeat due to the low energy density and high fibre content.

At the same time, it will be hard to get enough energy if you just ate from the foods in this list.   If you are very active you will also find it hard to in down enough energy for a lot of intense activity.   If you are insulin resistant you may want to start out with higher fat foods that will still provide plenty of energy without raising causing blood sugar swings.

Nutrient density plus…

Eating exclusively from the list of the most nutrient dense foods may not be appropriate for everyone, particularly if you are just starting out on your health food journey.  The table below lists several nutritional approaches that are suitable for different people depending on their blood glucose levels / insulin resistance and weight goals.

approach average glucose waist : height
(mg/dL) (mmol/L)
therapeutic ketosis > 140 > 7.8
diabetes and nutritional ketosis 108 to 140 6.0 to 7.8
weight loss (insulin resistant) 100 to 108 5.4 to 6.0 > 0.5
weight loss (insulin sensitive) < 97 < 5.4 > 0.5
bulking < 97 < 5.4 < 0.5
nutrient dense maintenance < 97 < 5.4 < 0.5

Getting even more personal

If you’re interested in optimising your diet for nutrient density as well as tailoring it to your blood glucose and weight loss goals I would love you to check out an a new tool I’ve been developing, the Nutrient Optimiser.  It will review your food log and, rather than just tracking calories it will identify your biggest nutrient deficiencies and the most nutrient dense foods to fix them.  You can also tailor the insulin load of the food recommendations to help normalize blood sugars and then energy density if you still have weight to lose.  It’s still early days, but the future looks very exciting!

references

[1] https://www.amazon.com/Dorito-Effect-Surprising-Truth-Flavor/dp/1476724237

[2] http://www.nytimes.com/2013/02/24/magazine/the-extraordinary-science-of-junk-food.html

[3] http://sydney.edu.au/science/outreach/inspiring/news/cpc.shtml

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988700/

[5] https://books.google.com.au/books?id=gtQyAgAAQBAJ&pg=PA185&lpg=PA185&dq=%22nutrient+hunger%22&source=bl&ots=VMRPgGgALA&sig=bCs4K5AKbQdQadtSfIniBizMsQA&hl=en&sa=X&ved=0ahUKEwjL7d2eqYvSAhWRq5QKHaAjA9AQ6AEIJjAC#v=onepage&q=%22nutrient%20hunger%22&f=false

sardines, spinach, eggs and avocado

My dad has been working hard to craft nutrient dense moderate protein meals.  For a while he was pursuing ketosis with a higher amount of dietary fat and his Bulletproof teas with extra butter after I introduced him to Dave Asprey’s version of “intermittent fasting” .

After an initial period of success  he found he was putting on weight, becoming inflamed and his blood glucose levels were starting to drift back up.

He then started to go for a slightly higher amount of protein in line with the concepts described in Volek and Phinney’s four phases of a ketogenic diet chart.  That is, during weight loss some of the fat being burned each day should come from body fat.  Hence his meals needed to focus on getting adequate protein to support muscle maintenance and obtain other necessary nutrients, while significantly reducing dietary fat.

Once he did this he started losing weight and his ketones actually increased due to the body fat being burned.  With adequate protein in place he then dialed down the dietary fat to the place that still comfortably satisfied hunger.  From there he had some great results in terms of weight loss.

p1090716

This meal of sardines, eggs, spinach, garlic, broccoli sprouts, avocado, goat cheese and a few walnuts is an example of one of those meals.  The details are shown in the analysis below.  As you can see it does well in terms of both the vitamins and minerals and the protein score.  While there is not a lot of added fat in this meal (butter used for cooking) there is still 65% fat from whole foods.

2016-11-19-12

The table below shows the nutritional data per 500 calorie serving.

net carbs Insulin load carb insulin fat protein fibre
4g 23g 16% 65% 35g 5g