• Not all calories are equal, Michael Greger, MD, FACLM, said in a Healio Community webinar.
• The best dietary changes a clinician can recommend are often the most basic, Greger said.

Clinicians should look for supporting evidence when answering questions about the latest nutrition trends or providing dietary recommendations, according to Michael Greger, MD, FACLM.

“You don’t want to change your clinical practice based on one study,” Greger said during a Healio Community webinar. “We want overwhelming evidence of benefit before we recommend it.”

In the webinar, Michelle Tollefson, MD, FACLM, an OB/GYN and professor in the department of health professions at Metropolitan State University of Denver, spoke with Greger, a founding member and fellow of the American College of Lifestyle Medicine, and physician author, about various nutritional questions that clinicians may hear when counseling patients.

When asked what physicians may underemphasize in obesity counseling, Greger said calorie counts are not just about what you eat, but how and when.

“One hundred calories of chickpeas has a different impact than 100 calories of chicken or chiclets based on their ... impacts on things like absorption, appetite [and] our microbiomes,” he said. “The same number of calories ... at a different time of day, in a different meal distribution, or even after different amounts of sleep can translate into different amounts of body fat.”

When considering ultraprocessed foods vs. plant-based choices and alternatives, clinicians should ask “compared to what,” Greger said.

“[It’s] the most important question in the field of nutrition,” Greger said. “Are plant-based milks and meats healthy? Well, compared to the animal products that they were designed to replace? Absolutely. Though whole plant foods would be even better.”

When making dietary decisions, a “single swap” can make a difference, Greger said.

“Swapping even just one serving of plant-based meat a day nationwide could prevent more than 100,000 cases [of] heart disease, stroke and cancer in the U.S. every year,” he said.

The best dietary changes to improve health and longevity are the simplest ones, according to Greger.

“One needn’t make drastic changes,” Greger said. “Even these basic, common sense lifestyle factors can mean literally living a decade longer. Not smoking, not being obese, regular exercise, more fruits and vegetables. Just those four — and it’s never too late.”

Tollefson and Greger also discussed studies and randomized controlled trials exploring how nutritional choices may impact cognitive health, mood and depression, and chronic pain. They also discuss how to personalize nutritional choices by focusing on specific markers, such as LDL, to move away from proinflammatory diets.

To catch future conversations like this with physician authors on Healio Community, register here or join the Healio Community Food is Medicine group.