Decoding Ultra-Processed Foods: How They Impact Your Health and Wellness

I just realized that my patients and friends may not know what I mean by processed food. I thought I was being clever when I explained it this way: eat food that came directly from the ground or survive by eating something that grew from the ground. I am up against a robust industry whose primary objective is to increase profits by using food science to manipulate our taste preferences and cravings, using news, media, and tainted research to confuse us.

Fortunately, I am not easily discouraged.

So, what is Processed Food?

Processed food is any food that has been altered from its original form. This change could be as simple as cutting, cooking, or freezing the food. However, the processed foods I am referring to have been altered from their natural state by adding preservatives, flavors, nutrients, salt, sugar, fats, or other chemicals.

But, did you know that the Academy of Nutrition and Dietetics ranks processed foods from “minimally processed” to “highly processed”? 

1. Minimally Processed 

1. Examples are bagged spinach or pre-cut fruits.

2. Process: These foods are cleaned, cut, or packaged for convenience but retain most of their natural form and nutritional value

2. Moderately Processed: 

1. Examples are foods that have been canned, frozen, or dried, such as canned beans or frozen vegetables. 

2. Process: some ingredients may be added but are generally close to their original state.

3. Heavily Processed (AKA Ultra-processed Foods - UPF)

1. Examples

• Drinks: Soda, energy drinks, sports drinks, and some alcoholic drinks 

• Snacks: Chips, cookies, crackers, and candy 

• Breakfast: Sweetened breakfast cereals and bars 

• Desserts: Ice cream, cakes, and cookies 

• Meat: Processed meats like lunch meats, hotdogs, bacon, sausage, and jerky 

• Bread: Packaged bread, hamburgers, and hot dog buns 

• Pasta: Premade pastas ready for the microwave 

• Other: Pastries, instant soups, and pre-prepared pizzas

2. Process: These foods usually have added sugars, salts, fats (in the form of seed oils), and artificial ingredients. They may also undergo multiple processes (extrusion, molding, milling, etc.), contain many added ingredients, and are highly manipulated.   

Ultra-processed foods should be avoided at all costs. Seed oils (Canola oil, Corn oil, Cottonseed oil, Grapeseed oil, Safflower oil, Soybean oil, Sunflower oil, Rice bran oil, Peanut oil, and Linseed oil) should be avoided at all costs. Anything with added sugar and salt should be avoided.  Unfortunately, more foods fall into this category than most people realize (additional examples of ultra-processed foods include biscuits, carbonated drinks, fruit-flavored yogurts, instant soups, and some alcoholic drinks, including whisky, gin, and rum).

Why does this matter?

The more ultra-processed foods we eat, the poorer the overall nutritional quality of our diet. A large study conducted over 19 years showed a 31% higher mortality rate for the highest versus lowest consumers of ultra-processed food from conditions including, but not limited to, Type 2 diabetes, cardiovascular disease, and dementia. Recent data also shows that 57% of caloric intake in adults comes from ultra-processed foods, and it's even higher for our children, with 67% of their daily calories coming from ultra-processed foods.

Ultra-processed foods are engineered to promote overconsumption, inevitably leading to weight gain. To add insult to injury, they also often contain harmful ingredients that accumulate over time and take a significant toll on our mental and physical health. Ultra-processed foods are linked to increased rates of Type 2 diabetes, cardiovascular disease, stroke, dementia, colon cancer (and some others), premature death, and shortened health span. 

How to Make Better Choices

If your food has a label, read it! Food manufacturers are counting on consumers not to turn over packages and look at the nutrition labels. Jump straight down to the ingredient list. If the list is long, then it is ultra-processed. It is ultra-processed if it contains ingredients you do not recognize, cannot pronounce, or would not find in a home-cooked kitchen.  

Cutting out all processed foods may not be feasible for most people reading this. So, instead of totally eliminating these foods, consider balancing your diet. Make sure there are minimally processed foods in there, too—eat fruit and vegetables with your meals and drink water instead of sugary drinks—and try to fit in time over the week for home cooking.

Cutting down on processed foods will make room for whole foods like fruit and vegetables, fish, unsaturated oils, nuts, and seeds. Here are some swaps to get you started: 

• Instead of flavored yogurts with added sugar or sweeteners, choose plain yogurt and add your chopped fresh, frozen, or dried fruit for sweetness.

• Instead of buying sauces or ready meals, cook your favorites in larger amounts at home and freeze the extra portions for another day.

• In the morning, have home-cooked oatmeal, overnight oats, or chia seed pudding with fruit and nuts instead of sugary, low-fiber breakfast cereals or oatmeal packets.

Be wary of deceptive food marketing and advertising. Ultra-processed foods are often marketed as “healthy,” “natural,” and “organic.” While these words may describe the original ingredients, they don’t refer to the process of how the food was made. So it’s buyer beware. Remember, an organic, natural cookie is still an ultra-processed cookie!

In summary, not all processed food is terrible, but choosing wisely for a healthier lifestyle is essential. If you are struggling with diabetes, PCOS, weight loss, anxiety, depression, inability to focus, body aches, inflamed joints, “IBS,” or fatigue (to name a “few” that can be attributed all or in part to diet), consider looking at your food choices before reaching for a new supplement or taking a new prescription medication.

Why (non-DPC) Doctor’s Visits Feel Rushed

Why Doctor's Visits Feel Rushed

If you’ve ever felt that your visit to the primary care doctor was rushed, you're not alone. Many patients are frustrated by medical appointments' increasingly brief and impersonal nature. Let's delve into the reasons behind this and what it means for patient care, acknowledging the shared frustration.

Mal-aligned Incentives

In recent years, the healthcare landscape has shifted significantly. Large corporate entities, aka healthcare systems, have bought out many independent practices. These healthcare systems emphasize profitability and efficiency more than patient-centered care. The predominant reimbursement model in the US Healthcare system is “Fee-For-Service”(FFS). This model incentivizes volume (seeing more patients) over the quality of care.  In this model, insurances reimburse for direct care or patient visits. Some systems will counteract this by tacking on additional metrics to incentivize providers to improve “quality of care” (i.e., financially rewarding those who achieve a specific target percentage of patients above predefined metrics annually). The metrics vary yearly, but commonly measured things include the percentages of patients with controlled diabetes, controlled blood pressure, or the percentage of your panel up to date on colon cancer screening.  You may think this sounds good until you consider that a doctor with a panel size of 3000 patients (or more) likely has much less influence on those numbers than expected.  Quality metrics, short patient visits, and large panel sizes are a recipe for failure.  Improving outcomes requires time and trust. 

There is a push to re-align incentives with patient outcomes more comprehensively; however, this, too, has its limitations.    “Value-based care” (VBC) is a newer payment model that incentivizes providers to focus on quality outcomes rather than the quantity of services rendered. In VBC, the emphasis is on the overall health of the patient, rather than the number of visits or procedures. The potential benefits of VBC include improved patient outcomes, reduced healthcare costs, and a shift towards a more patient-centered approach. “The Centers for Medicare and Medicaid Services (CMS) has set a goal to have 100% of all Medicare beneficiaries tied to quality or value by 2030. Yet 40% of Medicare payments are still tied to Fee-for-Service as of 2020.” (Ahmed) Implementing VBC requires significant upfront financial and technology investments. Though it does stand to lower overall healthcare costs, it partially does so by limiting patient choice. Kaiser Permanente is an example of a healthcare system that has implemented VBC.

The Impact on Patients

Most of my patients come from FFS-based systems, so they are accustomed to 15-minute face-to-face visits (regardless of the patient issue) and long appointment wait times.  When I left my healthcare system, I had a panel of 3000 plus patients and a 3-6 mo appointment wait time.  Most appointments are “limited to “ your top 2-3 concerns; otherwise, schedule another appointment. Don’t think about bringing up new or chronic issues during your annual physical either; you get slapped with another co-pay for that visit (which is not always the doctor’s doing). This rushed atmosphere can lead to mistrust, overlooked symptoms, and a feeling of being unheard. It certainly does not leave room for lifestyle counseling and education.

The Impact on Doctors

Systematic time constraints place significant pressure on doctors. Because schedules are booked so far in advance, there are few slots for acute or simple patient visits.  Thus, most doctor schedules are packed with chronic conditions, complex medical cases, or comprehensive physicals. These tight schedules leave little time during the “work day” for paperwork, patient correspondence, and administrative tasks. The result? Work spills over into the evenings and weekends, and despite sacrificing sleep and time with your family, the work never ends.  Doctors in these environments must adapt to becoming cogs in the wheel or face moral injury. 

Lack of Continuity and Personal Connection

Another significant downside of the corporate medicine model is the lack of continuity in care. Patients are effectively not assigned to doctors; they are assigned to an office with a team of doctors and providers. There is certainly room for teams in medicine, however, not at the expense of the doctor-patient relationship. Fragmented care, sparse visits with your doctor, and time constraints lead to a lack of personal connection, making patients feel like just another number. Doctors feel the pain of this, too.  

A Way Forward

Direct primary care and other forms of independent practices are unlikely to meet the primary care needs of the whole population. However, I hope that by pushing the envelope and setting a new standard for primary care—quality over quantity, longer appointment times, and prioritization of the doctor-patient relationships—healthcare systems will have no choice but to change their practices. Maybe, just maybe, more students will choose primary care. 

Perks of a Chosen Family

While biological families play a significant role, chosen families—those friends and companions we select to be part of our lives—offer unique and profound health benefits. Here’s a look at how these cherished relationships positively impact our well-being:

1. Enhanced Emotional Support

Chosen family members often provide a level of emotional support that complements or even surpasses that of biological relatives. They understand us deeply and are there during life's highs and lows, offering empathy, encouragement, and a listening ear. This unwavering support helps reduce stress and promotes emotional stability.

2. Improved Mental Health

The companionship and understanding from a chosen family can significantly improve mental health. These relationships offer a sense of belonging and validation, which are crucial for combating feelings of loneliness, anxiety, and depression. Knowing that we have people who genuinely care for us enhances our overall mental well-being.

3. Increased Life Satisfaction

Having a chosen family can increase our overall life satisfaction. These relationships are built on shared interests, values, and mutual respect, making our interactions more fulfilling. Engaging with our chosen family brings joy, laughter, and a sense of purpose, contributing to a happier and more satisfying life.

4. Stronger Coping Mechanisms

Life's challenges are inevitable, but with a strong chosen family, we can navigate these difficulties more effectively. Chosen family members provide practical help and emotional resilience, whether it’s through advice, companionship, or hands-on assistance. This support system strengthens our ability to cope with stress and adversity.

Conclusion

The health benefits of the chosen family are multifaceted. These relationships offer emotional support, enhance mental health, increase life satisfaction, and bolster our coping mechanisms. In a world where traditional family structures are evolving, nurturing our chosen family is essential for a balanced and healthy life.

So, let’s recognize and celebrate the incredible impact of our chosen families. Reach out to those special people in your life, cherish these bonds, and embrace the profound health benefits they bring.

Finding Purpose: A Key to Health and Well-Being

In the hustle and bustle of daily life, it’s easy to overlook one of the most vital elements of a fulfilling existence: having a sense of purpose. Research shows that a clear sense of purpose can lead to numerous health benefits, including lower stress levels, better sleep, and increased longevity. But what exactly is “PURPOSE,” and how can you find yours?

Understanding Purpose

Purpose is the feeling that your life has meaning and direction. It gets you out of bed in the morning and drives you to pursue your goals. Whether living out your faith, raising a family, excelling in your career, or volunteering for a cause you’re passionate about, purpose gives your life a sense of direction and motivation. Regardless of your purpose, I firmly believe your purpose should involve an act of service to others. 

Health Benefits of Having a Purpose

1. Reduced Stress: Knowing your purpose and worth can help you navigate life’s challenges more resiliently.

2. Improved Mental Health: A strong sense of purpose is linked to lower rates of depression and anxiety.

3. Physical Health: Purposeful individuals enjoy better overall health and are likelier to engage in healthy behaviors.

Finding Your Purpose

1. Self-Reflection: Take time to think about what matters most to you. What are your passions, values, and strengths? Reflect on activities that make you feel energized and fulfilled. Are you currently giving your time and energy to things that you value? Are you presently engaging in activities that leverage your areas of strength?

2. Set Goals: Establish short-term and long-term goals aligning with your strengths, interests, and values. Having clear objectives can provide a roadmap to finding and living your purpose.

3. Explore and Experiment: Don’t be afraid to try new things. Engage in different activities, volunteer, or take up hobbies that interest you. These experiences can help you discover what truly resonates with you. Also, don’t be afraid to let go of things that don’t align with your strengths and values. 

4. Seek Connections: Build relationships with others who share your interests and values. Community and support networks can provide inspiration and motivation on your journey.

5. Reflect and Adjust: Discovering your purpose is often an iterative process. Periodically reassess your goals and activities to align with your evolving strengths, interests, and values.

Remember, your purpose doesn’t have to be grand or life-changing. Even small, everyday actions that align with your values and passions can contribute to a meaningful life. Start your journey to finding purpose today, and enjoy the myriad health benefits that come with it. 

At Seeds of Health, discussions about purpose are as common as blood pressure checks. We know how much this matters to your health and well-being because it matters to us, too.

Break Free from Self-Labeling

For many years, I proudly called myself a runner. The rhythmic pounding of my feet on the pavement was a source of joy and accomplishment. However, over the past decade, I distanced myself from this identity. Somewhere along the way, I labeled myself a non-runner, convincing myself that running was not for me... Although this shift was triggered by the progressive deterioration of my back and knees, it was an unwilling, gradual acceptance that became a self-imposed limitation.

This change in self-perception became starkly apparent during a recent 5k race. My spouse, also formerly a runner, half-heartedly trained for the same race and outperformed me significantly. While impressed, I was also ignited with envy and determination. Moments after the River Bank Run 5k, I decided to reclaim my identity as a runner, not just to beat him but to break free from the limitations I had placed on myself. I signed both of us up for another 5k and set my intention to train with purpose - I would outperform him (or at least perform better).

My experience with running illustrates the dangers and power of self-labeling. By defining ourselves in such rigid terms—runner or non-runner, capable or incapable, healthy or unhealthy—we inadvertently set boundaries limiting our growth. This dichotomous thinking places specific aspirations out of our reach, not because we lack the ability but because we believe we do.

As a doctor, I understand the importance of mental and physical health. Yet, I overlooked how my perception of myself shaped my reality. The label of "non-runner" had become a self-fulfilling prophecy, dictating my actions and eroding my confidence. It wasn't until I challenged this label that I realized the things I loved about running before were still within me, waiting to be experienced again.

Returning to running is more than a quest to outperform my spouse. It's a testament to the importance of challenging the labels we assign ourselves. Doing so opens doors to new possibilities and allows us to rediscover passions we thought were lost. Embracing a growth mindset and abandoning all-or-nothing thinking will enable us to see beyond the binary labels and recognize the fluidity of our abilities and interests.

So, to anyone who has ever confined themselves within the boundaries of self-imposed labels, I urge you to reconsider. Don't let a label define your potential, whether running, drinking more water, cutting out sweets, making time for yourself, or any other pursuit. Break free from the dichotomy and explore the full spectrum of who you can be. You might surprise yourself with what you accomplish.

The Erosion of Primary Care

In the intricate web of healthcare, primary care stands as the cornerstone, the initial point of contact, and the nurturing hub for individuals seeking medical guidance. Yet, despite its pivotal role, primary care is experiencing a gradual but profound decline, eroding the very essence of what it means to care for patients.

At the heart of this decline lies the devaluation of relationships. In the rush to optimize efficiency and maximize profits, the once sacred bond between patient and primary care provider has been diminished to mere transactions. Patients are reduced to data points, and their ailments are reduced to checkboxes on a form. The pressure to see more patients in less time has overshadowed the art of listening, empathizing, and truly understanding the patient's needs.

Compounding this issue is the commoditization of medical care. Once revered for its holistic approach to health, primary care has been reduced to a conveyor belt of prescriptions and referrals. The focus has shifted from treating the whole person to targeting isolated symptoms. In this system, preventive care takes a back seat to reactionary medicine, with little room for addressing the root causes of illness.

Moreover, primary care has become a gateway to services with higher reimbursement rates. Instead of being a hub for comprehensive care, primary care providers are incentivized to churn out referrals to specialists who command higher fees. This not only fragments the continuity of care but also perpetuates a system where profit drives patient management decisions.

Inadequate time to focus on prevention further exacerbates the problem. Primary care providers are stretched thin, juggling administrative tasks, insurance paperwork, and a never-ending stream of patients. This leaves little room for proactive measures such as lifestyle counseling, health education, and early intervention — all of which are essential for preventing chronic diseases and improving overall well-being.

The current framework incentivizes pill-pushing and metric-driven medicine, where success is measured by meeting quotas rather than fostering meaningful patient outcomes. The true essence of caring for people — listening to their concerns, addressing their needs, and guiding them on their health journey — is lost in this sea of bureaucracy and profit-driven healthcare.

To reclaim the soul of primary care, we must shift our focus back to what truly matters: the patient-provider relationship. We must prioritize time for meaningful interactions, listen, focus on prevention, take the time to coach patients through lifestyle modification and resist the temptation to prioritize profit over people. Only then can we restore primary care to its rightful place as the cornerstone of a compassionate and effective healthcare system.  This is why Direct Primary Care exists! We strive to be the answer to a broken system.