Dietary Adherence
Linda L. Isaacs, M.D.
For many patients, of the three aspects of the treatment plan, diet, supplements, and detoxification, it is hardest to adhere to the diet. I have been on this regimen since 1986, and this has certainly been true for me. Much of our environment is encouraging us to eat the food that is commonly available—the advertisements on television, the signs on the road, the ever-present fast food restaurants with their drive-through lanes. Social events, family get-togethers, meetings with friends, religious services, all may involve food, during or after the activity. People can get quite offended if the food they prepared is refused. And if I am hungry, I am more likely to eat what is readily available.
The scientific support for the importance of eating freshly prepared, nutritious food is persuasive and steadily growing. But in the heat of the moment, when I'm hungry and there's nothing suitable around, when that delicious-looking brownie is calling my name, theoretical arguments about long-term consequences may not work. What does?
Well, for one thing, not getting into the situation in the first place, by making provisions for good quality food to be available. A patient once told me that she had been compromising her diet because she traveled for work extensively. She bought a small suitcase and started packing cut-up vegetables to take with her. She lost 25 pounds and felt considerably better as a result. This is an extreme example, but planning ahead for food that can be available when hunger strikes, and packing snacks and lunches is key.
For myself, willpower at the level of the grocery store is also key, because once any food item is in the house, I will eat it. Avoiding food shopping when hungry helps, as does having the support and cooperation of family members, so that they will not bring home unhealthy foods. I have had a few patients tell me that their children would not have a normal childhood without junk food; a sad commentary, that such food has so permeated our society that some think it is normal and necessary for happiness.
To eat properly, you will need to plan your meals, to shop, and to prepare the food. All this takes time, so give this some serious thought before committing to this program. Many today are accustomed to eating meals from fast food restaurants or prepackaged convenience foods. Even if purchased in a health food store, even if organic, such foods may be made with poor quality materials, refined flour, sugar, and inflammatory oils. And they may not taste very good.
The prescribed diets can be very satisfying if you know how to prepare your own food. That may be daunting for some. An entire generation seems to have forgotten, or never knew, how to cook. You may need to ask some knowledgeable friends for help, or take a class. A class on knife skills helped me streamline food preparation. Here’s a link for a free one online: Complete Knife Skills with Brendan McDermott.
The website Cooksmarts has several videos about cooking techniques; though not everything on the site is ideal, there is a lot of useful information there. Expert chefs tell me that the most important skill is to learn how to use herbs and spices.
The most important motivation for me to follow my own recommendations for diet is this: I feel better when I do. If I eat something that I shouldn’t, I pay for it. That delicious looking brownie? Even a bite of that brownie? It might go down fine in the moment, but I get a low-grade headache, a depressed mood later that day. It isn’t worth it. People who continually compromise—a nibble here, a taste there, a little bit of their kid’s candy, a teeny sliver of pie at a social event—might be surprised at how much better they would feel if they would stop eating sugary junk for a month.
Ideally, our approach to food would be one of choices and consequences. We make choices about our food and accept the consequences of those choices. If we don’t like the consequences, we figure out a way to eat better, perhaps by carving out more time in the kitchen, learning to use herbs and spices so we enjoy our food more, finding ways to spend time with friends that don’t involve food, or planting a garden so that we can harvest organic vegetables.
For some people, though, issues around food are extremely emotional, with guilt, anger, and self-worth tied into the choices they make. One patient told me that as soon as she is told she can’t have something, that is all she wants. If diet becomes a battleground, it may be time to examine whether there is some unresolved emotional issue that needs to be addressed.
