• Dr. Todd Hurst, MD

5 Simple Rules of Healthy Eating

Welcome to Dr. Hurst's Healthy Questions Answered.

“Let food be thy medicine and medicine be thy food”


Monica is 42 years old and unhappy with her blood pressure. She’s had low blood pressure up until the last few years and doesn’t understand why it’s high now. She’s fairly active, spends 30 minutes on the treadmill each day and tries to watch her calories. Why is her blood pressure high and why can’t she lose weight?

I asked Monica to give me more details on her diet and, as it turns out, she was eating mostly “low-calorie” processed foods that were also high in sodium.

She was taken aback when I told her that I thought her diet was the problem.

Calories In and Calories Out

We have been told the balance between these two is key for a long time. Burn more calories than you eat and you will lose weight. Eat more than you burn, and squeezing into your tight jeans is going to be more difficult. While it’s true that calories in and calories out determine weight loss (there is no percentage in arguing with the First Law of Thermodynamics), the issue is tracking calories doesn’t work for most people. The problem is that focusing only on calories doesn’t take into account the quality of those calories.

There is a growing mountain of evidence that highly processed food (particularly those high in added fructose and refined grains) doesn’t have the same effect on our cues for hunger and fullness as more natural food. In other words, it appears that real food is better at filling you up for the same calories than processed food. One of the stronger examples of this was in a research study that associated various foods with weight gain or loss. Many of the findings were as expected, more vegetables were associated with weight loss and high calorie foods like potato chips were associated with weight gain. But the more surprising findings were that some high calorie foods (like nuts and yogurt) were associated with weight loss!

The main point that I made to Monica was that her focus on calories has led to a poor quality diet, high in sodium and this was contributing to her high blood pressure. I asked her to first try a healthy diet before we start medications.

She liked the idea, but wanted to know, “What do you mean by a healthy diet”?

A Healthy Diet

What is a healthy diet? Is it high protein or low carb? Low glycemic, low fat or balanced? Plant based, vegan, Mediterranean, Atkins, gluten free, Dash? The list goes on and on. And all seem to have researh."

Just like with Monica, I can understand when my patients say “I don’t know what to eat anymore.”

I also struggled with this question early in my career, but over time I’ve been able to simplify “healthy eating” to 5 rules.

5 Simple Rules of Healthy Eating

1. There is no one diet for every person

The beauty – and challenge – of medicine is how different we are and how different the response can be to the same treatment. A medication can save one person’s life and cause a life threatening side effect in another. The same principle applies to diet. While one person may have amazing results with a certain diet, that does not mean you will have those same results. And just because a diet doesn’t work for you, doesn’t mean you failed, it just means it wasn’t the right one for you.

2. You have to like it (even better if you love it)

If you’re eating food you don’t like, you’re setting yourself up to fail. We don’t do well when we feel deprived. There are too many options to settle for food you don’t like. Find a healthy eating style you love.

3. Avoid highly processed foods

If you only follow one of these 5 rules, make it this one. About 70% of the US diet is highly processed foods and it’s a major contributor to the obesity, diabetes and high blood pressure epidemics. What are highly processed foods? There are several definitions, but here is mine. Processed food is food that is manufactured and typically high in added sugars or refined grains (for example, white flour or white rice). These foods often contain many ingredients you would not recognize as food such as preservatives and other chemicals.

4. Include vegetables

Mom was right. Eat your vegetables. I haven’t met a reputable expert yet who doesn’t think vegetables should be a big part of your diet. This doesn’t mean you need to be vegetarian necessarily, but the simple act of getting vegetables in the majority of your meals can do wonders for your blood pressure and health.

5. Portion size

For some, eating real food is not enough to get their weight and blood pressure where they want it to be. Often it is because they are eating too much. Slowing down, eating mindfully and eating off smaller plates are all proven ways to decrease the amount you eat without feeling like you are going hungry.

Eating healthy is not one size fits all, nor is it written in stone. For most of us, it’s a constant process of trying new things and seeing how you respond. To make things easier, you can start with one of the major diets that makes the most sense to you (i.e. Mediterranean, vegan, Paleo, plant based, etc) and adapt it to your tastes and needs.

As long as you follow the 5 rules, you will be eating a healthy diet.

Side Effects Include…

If you watch TV commercials, you already know all medications have potential side effects. Typically, these ads end with a rapid fire, lengthy list of horrible side effects (sometimes unintentionally comical) that can make you wonder why any sane person would take them.

And the Beat Goes On,

R. Todd Hurst, MD, FCCC, FASE