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Interviewer: If you've ever had the thought that eating healthy stresses you out there could be hope. We're going to talk about that next on The Scope.

Man: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Trying to eat healthy stresses me out. If this resonates with you, you're going to want to find out what Staci McIntosh, Registered Dietitian and Assistant Professor at the Department of Nutrition at the University of Utah, has to say.
I've experienced this personally where I've tried to eat what I consider healthier - fruits, vegetables, closer to the source type foods, combining protein and carbs in the right ratio, the correct quantity of food to eat. It takes forever to prepare food this way, it takes forever to eat food, and it stresses me out. Do you ever run into this?

Staci McIntosh: I do, I do. I think we all do.

Interviewer: Help!

Staci McIntosh: One of the things that I tell my patients is let's look at it this way. Whatever you normally ate, whatever you ate before you came into see me today, I'm not taking that off the plate, but I want half the plate to be a salad or other green vegetables.

Interviewer: Okay.

Staci McIntosh: Then, the other half you can eat what you normally eat. We'll work on that later. Right now all we want to do is try to get half of your plate to be leafy green vegetables.

Interviewer: Okay. You get half the plate to be leafy green vegetables, but eventually we're going to get to this place that I feel that I'm at where it takes forever to eat. Because in order to get the calories I need I'm eating a cup of broccoli, and a big salad, and a couple of pieces of fruit, and you've got to do that four or five times a day.

Staci McIntosh: Yeah, you do.

Interviewer: That's just the way.

Staci McIntosh: There are no shortcuts, and there have never been any shortcuts. There never will be any shortcuts. If you want to eat healthy and be healthy then you've got to do the work. No one expects to have big biceps if I don't do curls or whatever. If I don't do arm exercises, I don't expect to have big biceps. Why would I expect to be healthy if I don't eat healthy?

Interviewer: Yeah. Is it okay to get some of my calories from a few chips along with my freshly made salsa along with my chicken breast?

Staci McIntosh: Absolutely.

Interviewer: That's fine, even though it's a processed food. That stresses me out, too. I'm trying to eat the fewest processed foods I can.

Staci McIntosh: Eating is a basic enjoyment of life. The minute it becomes an obsession and it's stressing you out it can no longer be a basic enjoyment of life.
Eating healthy and taking pride in that, and knowing that you had your salad, you got that in first, you're going to take 30 minutes to eat this meal, you're not going to swallow it whole in five minutes flat, then you know that you got in the good stuff. You're giving your body time to digest that and the hormones to get to your brain to tell you whether or not you're full.
Then, yeah, I'm still going to eat my lasagna that's full of cheese or whatever else that is on your plate for that night, but there's no reason to feel guilty about that. You still need the nutrients.

Interviewer: What about fat? I feel guilty about eating fat as well, like nuts and seeds, but yet some people say that's what I should be incorporating.

Staci McIntosh: There are essential fatty acids that you have to get from your meal, and you don't get them from anywhere else unless you're relying on supplements for your life. You do need fat, and fat is a good stimulator of satiety. It triggers a couple of different hormones during the digestive process that tells your brain you're full. If you're eating a diet that's fat free, you're not getting in those hormones, you're not getting that early satiety, and you're getting hungry much quicker in between meals.

Interviewer: At the end of the day how do I know if I'm eating healthy enough? Is it a weight monitoring thing? If I start gaining weight then I go well maybe I should cut back a little bit? How do you make that judgment without getting out the food journal and writing all that down?

Staci McIntosh: How do you feel about it? Nutrition is not rocket science. You know if you ate well today. You know if you ate good, and if you were hungry all day, or if you're obsessing over your food all day, or if you feel really bad because you ate half of a birthday cake for lunch. You know that. You know if you ate well or not.

Interviewer: What's my takeaway here? How do I start to a less stressful eating lifestyle?

Staci McIntosh: Focus on whether or not you're getting in your fruits and vegetables. Don't worry so much about the other stuff that you're getting in, if you're getting in your meat, or chicken, or meat substitute, or carbohydrates. If I get in all of my fruits and vegetables for the day I'm feeling pretty good and I need other calories to support my lifestyle.
At the end of the day if I realized, you know, I think I only had one serving of vegetables today, well I'm not going to have ice cream before I go to bed. I'm going to have an apple or an orange. I'm going to have some other source of antioxidants and good vitamins and minerals.

Man: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: Chewing your food. Is it as important as your mom said it is? We're going to find out next on The Scope.

Man: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: How important is chewing your food well, really, and what does that even mean? We're with Staci McIntosh. She's a registered dietitian and Assistant Professor at the Department of Nutrition at the University of Utah. How important is chewing your food?

Staci McIntosh: Chewing your food is important. It's the first step of mechanical digestion. It's important for not getting choked when you swallow.

Interviewer: That is important.

Staci McIntosh: More importantly, though, is taking your time throughout the meal however you do that. If you want to swallow your food whole and then take five minutes before you eat another bite, or if you want to chew your food 100 times before you take another bite.

Interviewer: Oh, okay. So, take your time. Why would I take my time? What's the purpose behind that?

Staci McIntosh: Because it takes about 20 to 25 minutes for the hormones in your body to reach your brain to tell you that you're full. If I eat an entire Big Mac meal in five minutes, that's not enough time for my brain to register when I'm full, but if I take 30 minutes to eat my dinner, then my brain is going to know that I'm full well before I finished that same amount of food.

Interviewer: So, inhaling your food is bad because you will overeat every time, it sounds like.

Staci McIntosh: Mm-hmm.

Interviewer: Let's talk about chewing as far as digestion is concerned. I've heard 20, 25 times per bite? You kind of rolled your eyes a little bit there.

Staci McIntosh: Our digestive system is really amazing.

Interviewer: Yeah.

Staci McIntosh: Our stomach, our small intestine will continue to go through all the muscular motions of mechanical digestion. The enzymes are going to get in there and will break apart the food [inaudible 1:46] the surface area until it eventually digests it all. Food doesn't just go through the system without being digested, nor does it sit there forever without being digested. It will eventually be digested. The more you chew it up, the less mechanical work your gut has to do.

Interviewer: What about nutritional assimilation in the body? The more that you chew, do you get more nutritional value.

Staci McIntosh: No.

Interviewer: No, really?

Staci McIntosh: No.

Interviewer: That's a myth?

Staci McIntosh: That's a myth. You will liberate some of the B vitamins from fiber a little bit more, early on, but we have a pretty good record in our gut of absorbing 95-99% of all the macronutrients--carbs, fats, and protein--and, much to a lesser degree, for the micronutrients--the vitamins and minerals--but, whether or not you chew five times or 25 times is not going to make that much of a difference.

Interviewer: So, just chew enough to get it down is the minimum, and if you enjoy it do it more?

Staci McIntosh: Sure.

Interviewer: So then I don't need to swish soft foods around in my mouth, like a banana or something, to mix it with the saliva?

Staci McIntosh: No, no.

Interviewer: You didn't like that too much.

Staci McIntosh: No, I can't imagine swishing a banana around in my mouth.

Interviewer: So, at the end of the day, it sounds like the amount of times that I chew my steak doesn't matter too much.

Staci McIntosh: Again, there is a big difference and there is statistical significance in studies that show the longer you take to consume your meal overall will make a difference in your satiety and your overall amount of calories consumed.

Interviewer: Gotcha.

Staci McIntosh: Whether you do that by taking longer to chew your food or if you take longer just in between bites, it's not going to make that much of a difference. I would certainly recommend that people chew their food appropriately, but counting the number of times you chew your food is a little obsessive.

Interviewer: I'm glad to hear that. So, it's more about just caloric intake than anything else?

Staci McIntosh: Caloric intake and the time. Your time will affect your caloric intake overall, but when it comes down to it, it is the caloric intake.

Man: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: Sometimes when you start eating healthier, you feel worse at first. Today, common negative reactions, which are short-term, to eating healthier. Is it normal when someone goes from not eating to eating healthy to feel some negative side effects?

Staci McIntosh: It depends on where you're coming from and where you're going. What did you eat before and how much did you change that? The more you change your diet, the more adjustment time will be necessary

Interviewer: How about from not too healthy to really healthy?

Staci McIntosh: Expect a couple of weeks. It's going to take some adjustment for sure.

Interviewer: What about some specific symptoms?

Staci McIntosh: So a lot of times our gut is populated with bacteria . . . Well, it's always populated with bacteria, and it gets specific to the types of foods that we're eating. When you change that and you're eating more fruits or vegetables then the type of bacteria that populates your gut is going to change with it, and that takes an adjustment period, and that will result in gas, and bloating, and a change of the population of that bacteria.

Interviewer: If you already said this, I'm sorry, but so the bacteria probably helps you digest, and you need to get the right kind for the food.

Staci McIntosh: Exactly, we all have bacteria in our gut, and it's part of our happy gut flora, and there's a healthy population of a variety of bacteria, and then there's not so much of a healthy population.

Interviewer: So you've got to get rid of the fast food bacteria and get some fresh fruit bacteria in there?

Staci McIntosh: You're introducing the good bacteria as you eat more fruits and vegetables, and then that's going to start changing the whole flora.

Interviewer: What about constipation and diarrhea is that the same thing going on there?

Staci McIntosh: Some of it will be. Some of it may be that you've gone from a low fiber diet to a pretty high fiber diet without a transition period, and without enough water during that time. So I always recommend that if someone's going from a pretty low fiber diet, so the average American eats 13 grams of fiber a day, and the average recommendation is between 25 and 38 grams a day.

Interviewer: Wow so almost half.

Staci McIntosh: So we're a pretty low fiber community in general so if we're going from a low fiber diet to a high fiber diet, we need a little transition period, and we need to increase the amount of water and activity that we're doing so that it helps get things healthy and not result in constipation.

Interviewer: Is that another enzyme issue?

Staci McIntosh: It's not an enzyme issue. Because we don't digest fiber so there's no enzyme to digest fiber, but it's just a matter of the fiber sucks in water and that's what helps make an easier stool to pass, but if you don't have the extra water for it to suck in then it becomes constipation.

Interviewer: All right, what about like brain fog? I feel like when I start my new diet sometimes I get brain fog. I'm not as sharp as I used to be. What could be going on there?

Staci McIntosh: You know I would have to find out more about what you were eating before and then what you changed to. I would expect, I expect to hear those kind of questions sometimes when I have a patient who's going to a low carbohydrate diet, or going to a paleo diet, or going to some extreme diet where they don't have enough carbohydrates intake, and then it will make you feel like a brain fog because you don't have enough basic glucose in the brain.

Interviewer: So you can eliminate too many carbohydrates?

Staci McIntosh: Absolutely.

Interviewer: What about fatigue and low energy is that a carbohydrate issue again?

Staci McIntosh: Yeah your basic, your primary source of fuel for every cell in the body is glucose.

Interviewer: Could it be just more calories could be the solution for something like that or does it need to be carbs?

Staci McIntosh: It needs to be glucose, you're going to use glucose for your brain, you're going to use glucose for energy for every cell in the body, and you can get that glucose from breaking down glycerol from fatty acids, or from turning amino acids into glucose, but that's just another step that your body has to go through.

Interviewer: Got you.

Staci McIntosh: So if it has available glucose then you have available energy for the cells.

Interviewer: What about headaches what could cause that if you're changing from one philosophy of eating to another?

Staci McIntosh: A lot of different things. So sometimes if people are going into using a lot of non-nutritive sugar replacements, so saccharin, aspartame, all those type things. If you would normally drink soda and then you go to a diet soda that can give people headaches a lot of times, and also if you're going to a really low carbohydrate diet your brain uses glucose, and every cell in your brain uses glucose, and it wants glucose, and if you don't have enough glucose available if you're on either a very low calorie diet, you're not getting enough fluids, or you're not getting enough glucose regardless of the calorie amount that would be a typical recipe for a headache.

Interviewer: Okay, how about extreme cravings? Now all of a sudden I want everything that's not good for me anymore.

Staci McIntosh: That's human nature.

Interviewer: Is that what that is?

Staci McIntosh: Yeah that's human nature. As soon as you say you can never have chocolate again that's all you're going to think about.

Interviewer: Yeah, so that's why it's probably good to maybe allow yourself a little.

Staci McIntosh: That's why everything in moderation.

Interviewer: A little taste, all right. What about going through withdrawals of things like caffeine, or sugar, are there withdrawal symptoms to those types of things?

Staci McIntosh: Absolutely, when you look at someone's MRI scan, for example, and you look at the result that it has on the brain for sugar versus nicotine it's the same area of the brain that gets stimulated so it does trigger, certainly not an addiction like nicotine would, but it's triggering the same areas of the brain so you can experience those withdrawals.

Interviewer: All right and some headaches might be caused by getting rid of the bad stuff and you're actually going through withdrawals, like . . . wow.

Staci McIntosh: Sure.

Interviewer: When somebody goes on a new diet what words of advice do you have for them to get through this process, because I imagine some of these things actually stop people from eating better?

Staci McIntosh: Absolutely, I say one step at a time, don't change everything overnight, if you have gained excess weight you gained it one gram at a time let's think about losing it one gram at time not changing everything all at once, and keeping in mind that eating is a basic enjoyment of life. If you're changing to a diet that is really not that enjoyable then why do that? Why not just start on something that you plan to do the rest of your life because it's healthy, and it's enjoyable, and you and your entire family can do it?

updated: February 17, 2023
originally published: February 26, 2014