The Healthiest Way to Eat to Prevent Disease According to a Cardiologist

The best way to eat now is under much debate, as keto dieters line up against plant-based eaters, the low-fat camp has their studies to wave at the low-carb believers. So, we turned to Dr. Andrew Freeman, a well-respected cardiologist, for his expert advice on how to eat to be heart-healthy, avoid cancer, lose weight, and feel great. Dr. Freeman, who is in the Division of Cardiology and Department of Medicine at the National Jewish Health in Denver, says you have to try to eat the way our ancestors did: Mostly plant-based, avoiding processed foods and eat as many natural foods as possible. "They were hunter-gatherers, but mostly gatherers," Freeman explains.

When it comes to whether to try to follow a ketogenic diet and avoid carbs, his view is: "Avoid Carbage, which is the carbs that are garbage," or highly processed foods like white bread, white rice, packaged foods, and added sugar. When it comes to trying to lose weight and be healthy, he adds, rather than cut out an entire food group like carbs, take what he calls the Goldilocks approach: Not too many carbs and not too few, but just the right amount, and focus on legumes, whole grains, vegetables, and fruit, especially the kind you could pick.

First, it's important to analyze your lifestyle and dietary habits and cut out the processed food, the sodas, or the chips, packaged snacks, or sugary sweets. I would advise someone to look at the easy fixes first. When people realize they are consuming 1,000 calories a day in soda,  that's an easy one to cut out. I would encourage someone who wants to be heart-healthy to go as plant-based as possible. If you think about how our ancestors ate: Back then you ate what you found and it was mostly plant-based foods.

I would not say the modern ketogenic diet is terrible, but for most people, the implementation of keto is hardly healthful. It usually involves a lot of processed meat, like bacon. Plus, eliminating foods that we know are beneficial like vegetables and fruits–because they have carbohydrates–turns out not to be healthy either.

We know that processed meat contains carcinogens, and you want to stay away from carcinogens since they cause cancer. When it comes to keto dieting I have nothing against it specifically, but it's the way most people do it that does not make sense to me. They wrap scallops in bacon and eat lots of processed meat. They lose weight but eventually, their cholesterol goes up. We don't know enough about the ketogenic diet, long term, to say it is unhealthy in itself. But the foods that people eat on it have been studied, and there is plenty of research that shows processed meat leads to heart disease and a higher risk of cancer.

There are some people who don't do well with keto. Some end up with digestive issues. So while we don't have enough data to say keto itself is the problem, it's well known that a diet high in meat and dairy leads to diseases like heart disease and cancer. So it's great to be skinny but it's not great to be skinny and get cancer.

The data we have from some years ago shows that a lower carbohydrate diet is worse for you in terms of health outcomes. I tell people: Don't go too low in carbs, since it appears to be unhealthy to eat all that fat and protein. Take the Goldilocks approach to carbs, which is not too little... Not too much. Just the right amount. And make sure those carbs come from whole grains, from vegetables, fruit, and from legumes.

There are enormous health benefits from eating legumes, like lentils, beans, and pulses. The end of the day human physiology benefits from these types of natural foods, and we are rapidly moving toward recommending a diet that is plant-rich and low in processed food. I would also recommend that for weight loss, add bouts of intermittent fasting. That's how humans lived. Long ago, they had to survive in the natural world, and they ate things they could find in nature or they grew them. It turns out that beans are some of the healthiest foods you could eat, especially lentils. These are high in fiber, fill you up, and have plenty of protein.

Our ancestors lived the way we are supposed to live: from the food you could gather. The natural way to eat is plant-based, with a little intermittent fasting thrown in. It turns out this is how our ancestors ate and it works. They had to be hunter-gatherers but they were much more likely to be gatherers. If they did get a piece of meat it was a rarity and a small amount.

If you combine a mostly plant-based diet with intermittent fasting, you will be healthy and maintain a healthy weight. That's how I eat (though I don't quite do intermittent fasting). I'm up early and cranking all day but if I had a less demanding lifestyle I would do that every day. And I do make it a point to exercise and try to be mindful. But back to our ancestors: Back then, you ate what you found.

You need to get exercise every day. Think about this: We know that all-natural food looked different way back then. Try picking organic strawberries–they are tiny nothings. So we spent a lot of time and effort picking fruit. Things didn't look like they do today in the store. The natural food was smaller and had more nutrients. But it took energy to pick those berries and get enough calories to survive. So when you look at our ancestors they were using a lot of energy to get their food. Not like today when you walk into a store and it's all laid out for you.

When you look at the healthiest people in the Blue Zones [Dan Buettner's book about longevity patterns and what people who live long healthy lives have in common] they all are physically active, have strong social networks, enjoy quality sleep. If you look at their diet, the one commonality is that they don't drink too much alcohol and they eat mostly plants.