What Should I Eat? Nutrition Principles Everyone Should Know | Dr. Jaime Schehr

Poor diet is one of the biggest drivers of chronic disease worldwide. 

In this episode of The Health Curve, we explore one of the most basic but most confusing questions in health: what should people actually eat?

Host Dr. Jason Arora is joined by Dr. Jaime Schehr - integrative medicine physician, naturopathic doctor, registered dietitian, and Peloton's official Nutritionist @OnePeloton 🚴 - to cut through the noise on food, wellness, and the diets people are constantly told to follow.

Together, they break down the nutrition principles that matter most: why whole, recognizable foods matter, why most people need more fiber, how to think about protein, carbohydrates, fats, dairy, and micronutrients, and why so much of the confusion around food comes from misinformation, overprocessing, and convenience-driven eating.

The conversation also gets practical. What does a healthy plate actually look like? How should people think about smoothies, sugar, seed oils, hidden fats, and ultra-processed foods? And how can someone eat well even on a tight budget?

At its core, this episode is about simplifying nutrition. Not fad diets. Not food fear. Just the core principles that help most people eat better, feel better, and reduce their long-term risk of disease.

Follow The Health Curve @thehealthcurve for evidence-based conversations that make it easier to navigate health with clarity.

Chapters:
00:00 Intro
00:23 Dr. Jaime Schehr's background
03:13 Wellness trends and what's changed
07:53 Where nutrition fits in health today
11:22 Why nutrition feels so confusing
13:03 What a healthy diet actually looks like
17:01 What changed in the food pyramid
18:31 Do people eat enough protein?
21:43 How to eat healthy on a budget
24:52 Seed oils and ultra-processed foods
30:53 Why fiber matters so much
35:03 Carbohydrates explained
37:39 Smoothies, fruit, and sugar
42:21 Dairy explained
44:21 What micronutrients are
46:27 Where nutrition needs to go next
47:44 Closing thoughts

Transcript

Meet Dr. Jamie Scherer

SPEAKER_00 0:04

Thank you so much for joining us for this episode of the Health Curve on nutrition-focused wellness. I'm very, very grateful to be joined by Dr. Jamie Scherer out of New York. Jamie, thanks so much for joining me.

SPEAKER_01 0:16

Yeah, I'm looking forward to being here. I think this is an exciting conversation and a needed one in wellness and health today.

SPEAKER_00 0:23

So let's start with your very interesting background. So I see you're a dietitian, a naturopathic doctor, and an expert in integrative nutrition and integrative medicine. Now that's a lot. Can you just help unpack what that all means?

SPEAKER_02 0:37

Absolutely. So my career started off in nutrition, and it was always going to be that. So I did the traditional route of bachelor's and then graduate school for nutrition and became a registered dietitian. That path has never changed. And I still today practice as a registered dietitian just with an elevated education around more of the holistic or integrative stuff. So 20 years ago, when I started, a lot of the things that exist today in the holistic or integrative space didn't exist. And so it took an additional education, if you will, and I can tell you that story really quickly about how that happened, for me to be able to bridge the gap between what I wanted to understand about food and how I can use it as medicine versus what I had learned.

SPEAKER_00 1:23

Got you. And I think there's this increasing awareness around the critical role of food and nutrition in one's health journey. What was it for you that encouraged you to kind of double-click on that?

SPEAKER_02 1:36

I grew up as an athlete and I grew up with parents who were just very conscious of health. So I think that was embedded there for me. And then going through my education, getting my registered dietitian license and practicing nutrition, I learned very quickly that there was a void there for me. So I was in the hospital. I was in the hospital in Queens, New York, and I was prescribed writing a diet for a patient, and it was a low-sodium diet, and they were responsible for bringing the tray. And long story short, I see what's on this tray, and it's like jello and it's some broth and it's a piece of whole wheat toast. And I had this moment where I was like, I don't believe that this food is gonna help this person heal faster. And very shortly after I had lunch with a friend and I sat down to lunch and she looked fantastic. And I said, What did you do? Your skin is glowing. And she said, I got so tired of going to the dermatologist and getting medicine. I went and saw a naturopath and they fixed my acne. And I had this moment where I was like, what is a naturopath? Like, what does that? I never even heard of that before. She's like, it's like this holistic doctor. Long short, long surgery. I went and looked it up. I said, Oh my gosh, this is a doctorate education in using food as medicine, understanding supplements, understanding how I can take the things that I've already learned and apply them so that I can help people heal and prevent illness. And that was it. And so it was took a combination of experiences for me to say, I still love nutrition and I still believe that nutrition is the foundation of our health, but I need to understand and learn a little bit more to be able to practice it in a way that I think is going

The Moment Food Became Medicine

SPEAKER_02 3:13

to make a difference.

SPEAKER_00 3:13

Yeah, and there's a lot to that phrase, you are what you eat, right? And I can relate to your story in that there were many times that I saw patients, whether they were in the emergency room or in clinic or otherwise, where I just thought you don't need a pill, you need something different in your lifestyle, particularly around diet, actually. It came up so much, yet hasn't really been a core part of how we practice medicine. It's called medicine for a reason, too, right? And not health enablement or whatever, but you know, we can we can talk about that too. So just to kind of ground this conversation in where trends are today, because obviously the kinds of people who are looking at nutrition and wellness are folks that generally already, hopefully the ones that are listening to this episode, are folks who are already interested in their health and are trying to do something different, potentially. Where do you feel wellness trends are today? And what's what's changed over the last few years?

SPEAKER_02 4:17

That answer has to have two questions based off of demographics. I think that wellness trends look very different in different socioeconomic classes, in different areas, in different places. We can say what those wellness trends look like generally from a perspective of food is medicine, longevity, biohacking, wearables, functional foods. There's concepts that are sort of thread throughout. But I do think that, and social media has changed that landscape drastically today than from what it was 20 years ago, where it was led more by media and maybe print and TV, versus now it's led more by the grassroots, if you will, the people. So the trends, I think, are all in the service of I need to find a way that I could change. For some people, that's changing body weight. For some people, that's changing illness. For some people, that's changing mental health. For some people, that's changing their fitness level. But there's this desire to change. And that desire then fuels the trend. Is it to understand your sleep better and your HRV and it's a wearable? And for some people, it's I don't want to eat so much fast food. I want to find a way to meal prep. And they're the ones following the meal prep trends. So I think trend is a way to say, what are people looking for to change in themselves or in their environment that will then have an outcome on how they feel?

SPEAKER_00 5:35

Yeah, and I feel for the for the first group in particular, we've had a rebranding of wellness and it's now called longevity, right, to some degree. But but the aim is to kind of achieve the same thing in many ways. What do you tend to see coming into your clinic these days? Has that changed over time?

SPEAKER_02 5:52

It definitely has. The introduction of the new position, if you will, on hormones for women has changed a tremendous amount. GLPs have changed the landscape in all across the board in all the populations that I treat. So I think both of those things, hormone replacement therapy for women and GLPs, within the past, I would say six to 12 months have been the biggest change. But I also think we've seen a political system that has pushed some change on the nutrition side and the food side. Recently, we saw the changes to the food pyramid, right? There was a lot of, a lot of chatter around that on both people pro and people against. And so we are seeing those things happen. We're seeing changes on the political front, on the medication, the pharmacy front that are making big waves in what we have historically thought about as nutrition and wellness.

SPEAKER_00 6:42

Right. So wellness is this multi-trillion dollar industry in theory that encompasses lots of things from supplements, cosmetics, exercise, healthy food. You can cut it in lots of different ways, but it is a massive and growing market globally. And then you've got the GLP1's, you know, the Ozempics market, which is in the many billions and growing very fast too. So there's lots of things around this concept of the wellness that we can see and feel. So how do you look? How do you feel? How well can you perform in life, in your work and in your personal life? And how is that going to play out over time? So if we think about that and we think about things people have access to now, not just in terms of tools, but information, where is nutrition landing within this at the moment? Because people can just go on Chat GPT or go on the internet and find out loads of things about food and nutrition now. Is that access to information or any of these new tools, especially for nutrition, which I'd love to hear what you're seeing people tell you they're using right now for their food and their diets? Any of these making positive changes

Wellness Trends And Information Overload

SPEAKER_00 7:52

for people?

SPEAKER_02 7:53

Yes. I believe education in itself as a whole is a positive. I believe that people are focusing on food, they're paying attention to food, they're learning about food more quickly through social media and things like that. And of course, there are nuances and there's misinformation, and there's a lot of people doling out information that maybe aren't doing it rooted in more of the science. But at the end of the day, what we're saying is that people are turning to learn more about food. And I inherently think that's a positive thing. I do think nutrition is the foundation of our health. I believe that we have spent a lot of time trying to understand nutrition to treat disease, and not nearly enough time trying to encourage nutrition to prevent disease. And we're now just working backwards against the clock so hard to say, what can we do to treat? What can we do to treat this? How can we address this differently? There's also an opportunity to say, yes, that's important, but what if nutrition was prevention? And so, nutrition to me, of course, I'm biased. I'm a dietitian and I have a doctorate in integrative nutrition. I'm biased in that sense, but I do believe nutrition is the foundation of how we become our healthiest self and also is a catalyst for our most diseased self.

SPEAKER_00 9:09

I came across a really interesting statistic from the World Health Organization that around 80% of the world's population use some form of traditional complementary or alternative medicine. So not traditional healthcare. So things like herbal therapies, for example, where we haven't necessarily generated the evidence in traditional forms to support it being part of formal healthcare. What's your reaction to that? That it's actually so, so common.

SPEAKER_02 9:35

It's not surprising to me at all. Because it's very rare for me to work with a patient who hasn't taken a vitamin, tried a food that may have been more in line with their illness or trying to treat something. And I think when you bring nutrition and food into it, of course you're going to get numbers of that are much higher than what we would expect. I also think that sometimes access to medicine is very challenging for a lot of populations. And they then turn to what they can do on their own. I've had many patients where they'll come in and they'll have gotten some berberine or some chromium to help with their diabetes because even though they're on medicine, they still have elevated blood sugar. Or people will go get a probiotic because they were given an antibiotic and they're worried about getting a yeast infection. And these are all considered integrative or holistic ways to add on to their what we might say is traditional or conventional wellness. There's such a huge pendulum that falls into that category, right? If we're looking at how many people use some sort of alternative, well, I believe that fiber is the most underutilized new food and nutrient in our diet. And I believe that if we, as patients and as physicians, used fiber more, we'd have a healthier population. If you ask people, do they use supplemental fiber, they're going to fall into that category of using some sort of alternative therapy because it's technically a supplement. But also, so how broad is that category? If we narrowed it down, we could probably identify what's happening there. But I think it's just showing us that people are interested in trying to do more, find a different way, add on to what they're doing. We're all here in our own bodies. And I think that that's why that happens.

SPEAKER_00 11:22

So let's get into nutrition and health. I'm happy to make the statement that we are really bad at this. I remember when I went to study public health, and the first question I had was do we know what people should eat and how it's going to impact their health in the short and the long term? Now we know bits, obviously, but it's such a poorly defined science. And that's one of the issues, I think, with people trying different diets, people cycling through diets, there being so much variability between people. What's your what's your kind of headline take on where the nutrition field is today and why?

SPEAKER_02 11:58

It has become a field of misinformation. There's a lot of noise there. People are very unclear about what's good and what's bad and what they should eat, what they can eat, what they can't eat, and also what they have access to. So it's problematic because it gets in the way of being able to make sound decisions, where I think nutrition is very simple. I think that we have to eat a diet, however you want to name it or call it, that is predominantly fibers. And then we also have to have adequate proteins and fats. Simplified, that means I don't think people are eating enough fruits and vegetables. I don't think that people have historically had enough protein to supplement their diet and their health. That doesn't necessarily mean protein supplements, but it just means protein on the plate. And if we just dial it back and we talk about what does eating healthy mean, it means recognizing the food on your plate. It means access to food on your plate that you recognize on a daily basis. It means prioritizing food over convenience, and most people don't do that.

SPEAKER_00 13:03

Right. We've done a couple of episodes on those topics, which people should definitely check out. Just honing in a bit here on specific foods and macronutrients, and I guess we can talk about micronutrients as well. So we do know that diet strongly influences the development of chronic disease, heart disease, diabetes, fatty liver, certain cancers, etc. But when we talk about what should individuals be eating and how often can they break the rules of a healthy diet, that sort of stuff, it starts to get a bit confusing. So can you tell us what a healthy diet looks like for the average lay person who may not necessarily know much about fiber, protein, carbohydrates, etc.? Like what in a typical day, what should the average person be looking to eat in terms of the construct of their diet?

SPEAKER_02 13:55

Feels like an impossible question to answer because I don't know who we're talking to. Are we talking to an athlete? Are we talking to someone who sits in a chair all day long and has 30 pounds to lose? Are we talking, right? What and how much they need to eat, the variability there is it makes that an impossible question. But I'll go back to the answer that I just had before. If you can think of the sum total of your day and what you ate in a day, and you can't recognize any of those foods as either a fruit or a vegetable in its original form, that's a problem. If you can't think of a protein that is in its original form, whether it's a tofu for somebody who doesn't do animal or chicken or fish or turkey or beef or pork or egg, if you can't identify a source of protein in its original form, meaning not like a protein powder, or you can't identify a fruit or a vegetable in original form, meaning not a greens powder, but the actual food, that to me is a problem because that means we're relying on heavily processed foods that are not recognizable to their original form. So to answer the question, I would say to anybody listening, what does your breakfast look like? Does it look like a breakfast cereal that you couldn't tell me where it came from? Or does it look like a yogurt with some fruit on top? What does your lunch look like? Does it look like something that you opened in a package on the train? Or does it look like a piece of bread with some meat in between it? Right. And so being able to recognize the food, the where the food came from, what the food is, is the simplest path to helping somebody understand how to eat well. From there, of course, we can make it more specific and talk about the nuances. We can talk about what's happening in the world today, right? The dietary guidelines just change. They want everybody eating more protein. Does that mean that we should be eating more processed proteins that are blown into some of our packaged foods? So there's nuances everywhere. Whole foods and eating foods that are recognizable is incredibly important. If you'll give me two seconds, I'd love to tell you a quick story. So one of my first, I'm in the same FQHC I've been in for 20 years. And one of the first patients that I had there, he had come in, he had very high blood sugar. And I said to him, Well, what's going on? Why is your blood sugar so high? And he's like, Well, I'm trying to be healthier. So instead of having rice krispies, I went and I got raisin bran. And instead of having whole milk, I went and I got skim milk. And by making those changes, the increased sugar from the raisin bran and the decreased fat from the skim milk and the consumption of how much he ate drove the sugar so much higher. It was such a misunderstanding for him, right? So what we did was we sat down, we pulled out the label, we talked about sugar, we talked about fat, we talked about how that impacts diabetes, so that he could then make informed decisions when he goes back to the store. Those things to me have legs. That's what's important.

unknown 16:38

Right.

SPEAKER_00 16:39

So that takes us nicely

What A Healthy Plate Looks Like

SPEAKER_00 16:40

onto the food pyramids, which is a topic of conversation at the moment and will continue to be. You know, we've had food pyramids, folks have tried to follow over the years. We've had diets to aspire to, like the Mediterranean diet. Can you just describe to the audience what has changed in the food pyramid and what your take on those changes is?

SPEAKER_02 17:01

There's a few significant, there's many changes. There's a few significant that are languaged for the populations at large to understand. One, instead of the alcohol being a certain recommended amount, it's have less alcohol. I couldn't agree with or support that more, right? For all of us to drink less alcohol. There's one that is to increase your plant-based fruits and vegetables, right? So that's an important one and reduce our sugars, right? There's a big emphasis on before it was a certain number or percentage of sugars, now it's have less of it. So that's also very important. The change that has the most people sort of up in arms and or pro is this idea of such an increase in the protein intake because we had such a low recommendation for protein previously. And now this seems to be like the thing that everybody's holding on to is how much higher the protein intake. And I'm not going to get into all the numbers, but what's happening there is it's like this idea that we are underfed in protein, which then contributes to overconsumption of carbohydrates and sugars, which is a big part of why we're looking at so much metabolic disease and cancer and disease as a whole related to nutrition. And then the other piece was the fat. So they took off this idea that saturated fats was bad, and they said you can have fats from many sources. If we really, really, really pull it back, it's not tremendously different from the previously existing one. Interesting. It's really not. It does have a little bit more protein. It does take a little bit of a different language on the fat, but it's still saying you have to eat less sugar, more fruits, more vegetables, less refined carbohydrates.

SPEAKER_00 18:31

Okay. Tell us a bit more about the protein, and then we'll tackle the other macronutrients. So do people eat enough protein? I know this varies across the world and across countries, but in general, what's your message to the audience about protein?

SPEAKER_02 18:46

People are very confused, right? We've spent so many years saying, like, don't eat red meat. And now everybody's like, no, go ahead and eat a lot of red meat and don't have protein powders. And now, no, go have protein powders. And that this plant-based community was really gaining a lot of momentum. I don't want to say vegan because some of them are not vegan. And then now it's sort of like, well, maybe that was bad. And so there's just so much confusion in this space. And protein is a nutrient that up until recently, now all the companies are filling everything with protein. But up until recently, it wasn't a prioritized nutrient in a lot of our convenience foods. So if somebody were to go and grab like a cup of soup or a cup of noodle soup or chicken soup, they would have very low protein intake, even though it was chicken noodle soup. Right now we're going to start to see that shift where we're going to see high protein versions of this. For me, I'm going to go back to what I said before because I really work hard to reduce all the noise. And I work hard to make sure that people can understand nutrition from a clear perspective. And I really have a foot in both worlds. I teach physicians in an FQHC how to talk about food to their patients. And I run a concierge private practice where I get to treat patients who have a very different life around their resources.

SPEAKER_00 20:00

And just very quickly, just explain to our listeners what an FTHQC is.

SPEAKER_02 20:05

Really, sure, the Federally Qualified Health Center. So we the underserved, right? So I have this incredible privilege of getting to work with patients who otherwise would not have access to get nutrition care and their physicians. So the physicians will come to me and say, hey, this person doesn't want to take a statin. Can you help us figure out how we can make changes in their lifestyle to reduce, you know, the impact of their cholesterol? Or they're not tolerating their medication for their blood pressure. They get a lot of IVD, right? A lot of patients who have inflammatory bowel disease and in an acute flair, they're told they can't have fiber, but then we have to do a lot of damage control around that's only a temporary. We really need to bring those healthy foods back. So on that side of things, it's an opportunity to bring in really incredible nutrition care to patients and populations that otherwise wouldn't have it, while simultaneously teaching the physicians who did not get this exposure in their schooling at the same time I'm teaching the patient. So that's the work in the FQHC, which is so fill, so, so filling. And then so to bring to circle back, right? Like if I have somebody, I did this really interesting grand rounds for the FQHC a few months back, where I said, How can you help a patient who has a $5 per day budget to eat? What can you do? Right. And we broke it down. Somebody who has a $5 a day budget, they don't get to have steak for protein. So it does come down to sort of what we're working with. But looking at your food, finding a source of protein, whether it's a yogurt is a great source of protein from someone who needs to find one that's a little bit less expensive. That is a great source of protein.

SPEAKER_00 21:43

So on this one, I think this is a good time to ask how does someone who has $5 a day construct a healthy diet? What does that look

Eating Well On Five Dollars

SPEAKER_00 21:50

like?

SPEAKER_02 21:50

So that's gonna look like they would have to then buy in bulk, and we would have to buy foods that we were conscious of the cost, right? So if it we Take the five dollars and we would multiply it by seven and we would have our $35 a week. And we would say, okay, can I buy a bulk bag of frozen broccoli for five dollars? Can I buy a bulk bag of brown rice or white rice for $7? Can I buy some ground meat for $11? And can I cook these foods? And can I package them out? And can I supplement that with things I might be able to get somewhere else? But instead of just going to noodle packages that are a dollar a package and they can get seven packages of noodles, we figure out how we can take that same allocation of resources and teach and implement that in a way that's going to have a significant impact on their health.

SPEAKER_00 22:41

So that's really interesting. So that there's some key principles there, right? So one is the diet, the aspirational diet doesn't change. Still go for fruits and veg first and supplement with protein as raw and as whole foods as you can get, minimally processed, use freezing as a technique. And it's hard to say this because everyone struggles with it, but you have to carve out more time to plan your meals based on that because it might require more food prep, it might require a little bit more creativity around how you combine things. But you know, you can already see with that method that you just described that it is doable with a little bit of planning.

SPEAKER_02 23:18

It absolutely requires more time. But you know what? I'm gonna counter that for my population who's not struggling with a budget and has an unlimited budget for food. It also time is also an issue for them, too, because it's so convenient to pick up foods from outside. And for every single one of us, we have a responsibility to spend a little bit of time paying attention to what we're gonna eat. Very often I see parents, more mothers than anything else, who will spend a lot of time on their children's meals, but then won't do that same thing for themselves. And I have a lot of patients who will say, I can't afford vegetables because the vegetables will go bad. And that's because they're buying expensive vegetables that are fresh. They don't eat them in time, they go bad. They can't afford to waste that money. We talk about frozen vegetables on sale being an incredible option. And simultaneously, in a population that is more affluent, they'll be the ones that say, I don't have time to cook the vegetables. And I'll say frozen vegetables are a great option for you. Throw it into your microwave or your food that you're eating. One of the things that I get a lot of pushback on is that this idea that like the diet is so different in different demographics and socioeconomic circles. But honestly, it's not. We all have a responsibility to try and figure out how we can feed our bodies best. It is going to require time and it's going to require us to pay attention to the things that we're around that we're consuming. That's universal. Food is a universal language, right? Whether we're arguing seed oils, because that's all the trend right now, or whether we're arguing to reduce the intake of ultra-processed food, which is ultimately reducing the intake of seed oil, we're saying the same thing.

SPEAKER_00 24:52

Right. But this is where it all gets very confusing because what do what do people know about seed oils, right?

Seed Oils And Hidden Ingredients

SPEAKER_00 24:57

Not a lot. So what's your take on seed oil since we're on the topic?

SPEAKER_02 25:00

It's an attempt to reduce ultra-processed foods, it's a good thing. If it's an attempt to create fear around a food, it's a bad thing. Seed oils are not inherently bad or toxic. It's that we have become, we have overconsumed them in a way that we've never seen before. And we don't counter that with antioxidants and fibers. So what happens when you have so many oils that are coming in from seed oils that are cheap, inexpensive, they don't have a taste to them, perfect food for companies to manufacture with and restaurants to cook with, when we're constantly eating those and then we don't have the fibers and the antioxidants to combat that, yes, of course we're gonna see increases in inflammation and oxidized reactions. So yeah, I understand it. I get why people take it and run. But really, if we stopped looking at the single ingredient and we start looking at the looking at the source, the source is the issue. It's ultra-processed, overprocessed, convenienced foods, and it's like a broken record. It's like we have to find a way to get back to foods that we recognize.

SPEAKER_00 26:00

And you can see, and you probably see this in your clinic, right? How this very quickly becomes a laundry list of questions about individual foods or individual things that people may have heard through popular media. Sticking on the food pyramid, though, so we we've talked about fruit and veg, we've talked about protein. What about different types of fat? You know, saturated fats. You see a steak at the top of the food pyramid now, you see an avocado in there somewhere as well. Like, what's your take on how should people think about the type of fat that they're eating and why?

SPEAKER_02 26:29

The easiest way for me to answer that would be if it's fat from a food source, it's better than it's than if it's fats that are hidden, right? If it's steak that has fat or olive oil that has fat or butter that you see the butter, that's going to be a better choice than the fat that is hidden in the croissant that you're not seeing, right? And I always try to make nutrition very easy for people. A lot of the fats that are the most problematic are the ones that are hidden in foods that we're unaware of, in the cookies, in the cakes, in the pastries, in the things like that.

SPEAKER_00 26:57

And that's it's also true for salt and sugar as well, right? Because people think it's the table salt that's the issue, but it's not. It's the salt that you that you don't know is already in the food in a very high amount.

SPEAKER_02 27:07

The amount of people who will come through and say, Well, I don't want to eat fruit because it's too high in sugar, right? Or and you're like, oh, we really missed the boat there. So it's the same thing for fat, for sugars, for salts. It's where you can't see them that they're the biggest problem. And when I have someone who comes in with hypertension and they tell me they don't want to eat vegetables because they don't like them without salt, and salt is the only thing that makes their taste good, but then they're going ahead and they're eating noodles. I'm like, hold on a second, I would rather you put salt on your vegetables than open that package because we're, it's the what you can't see that becomes the most problematic. I want to go back to something I said before. We talked about this idea of like the convenience and the quickness and and how much intention we have to put into thinking about our diet. I get a lot of people, it's a little bit of a tangent, but I think I'll circle it back to make it make sense. I have a lot of people who get upset in their primary care space because their doctors don't know about nutrition, right? And it's very important for me to say it's not your doctor's fault. They you cannot fault somebody for what they don't know if they weren't taught it. But what I will say for anyone who's listening that might be a provider on the call, we have as much responsibility as providers as the patients do as the patient to make sure that our language and our intention is really clear around food and nutrition. And so, an example of this that I would say is, you know, how many providers out there, and this is not pointing the finger, it's bringing awareness to it, how many providers out there will prescribe a PPI for reflux without having a single conversation about how they're eating?

SPEAKER_00 28:47

It's really bad, isn't it?

SPEAKER_02 28:48

And so we the provider doesn't have to talk about the diet. They might say, listen, I need you to go home and look this up. I need you to do some research. And I know insurance-based models, and we don't have enough time, and they're not paid for the nutrition and not like I understand the broken system, but we still sometimes have to behave outside the broken system.

SPEAKER_00 29:07

Yeah, and I will defend my NHS training actually again on this podcast and say that we always used to tell patients first, let's talk about your diet, fatty foods, spice, what time you're eating, and let's look at other things that might help you before we prescribe a drug. So it just seems to be it's a low-cost, very effective, first-line, low invasive method of helping the patient before you start giving them a pill. And again, the system in the US is not designed that way. The incentives are not designed that way. And and I feel for my peers here who are practicing medicine because I know that they want to do those things, they want to advise on those things, and they do know about them. They have a few minutes and the incentives are sort of very much to, if you don't solve this problem in this one appointment, the patient will be back again, then you have to prescribe the drug anyway. So it's tricky. But to your point, I think we're we're fortunate. We're at this moment in time where patients and people have access to information that they did not have before, and the doctor in the last few decades or any sort of medical practitioner has become the expert advisor now, not the controller of the person's care at large. We'll get back to this conversation in just a

Providers And The Nutrition Gap

SPEAKER_00 30:23

moment. But if you're finding this episode helpful, here's a quick ask. Take a second to follow or subscribe to the Healthcare Podcast wherever you're listening. And if someone else in your life would benefit from this episode or any of the others you've heard, please send it that way. Just to stay on the different food sources and food types, you mentioned fiber. Let's go back to your favorite fiber. Can you tell the audience what that means in practice? I know you said fruit and veg. Why is it important?

SPEAKER_02 30:53

Because fiber is probably the only nutrient across the board that is going to positively impact almost every single system in the body, from the brain to the heart to the gut, to like literally across the board. High cholesterol, fiber, heart disease, fiber, weight, appetite, you know, management, fiber, gut health, fiber, skin health, fiber, hormone health, fiber. We see the universal benefit of somebody or someone's health when they eat enough fiber and/or eat and supplement fiber. And I am not sitting here saying everybody needs to take supplements all the time. I actually don't believe that, but I think that eating fiber, especially if you're not used to it, can be tough, where we can bring in supplemental fiber. It is so important. And also, it is probably one of the things that will have the quickest impact and the person will feel it. So we can use fiber as a part of the diet to improve the diet across the board. The risk-benefit ratio in favor of benefit with zero to little risk across the board makes this undeniably the most important thing that we can do in our diet. Whether you get your fiber from fruits and vegetables, or whether you get your fiber from less refined carbohydrates, or whether you get your fiber from nuts and seeds, you see what I'm saying here. All of these foods are not packaged, processed, ultra-processed, because the minute we ultra-process something, we tend to strip the fiber from it. I believe that our health crisis right now is largely in part due to refined foods, refined carbohydrates, ultra-processed foods where we have stripped the fiber. Fiber makes us feel full, it makes us have a normal bowel movement, it makes our cholesterol healthier, it makes our blood pressure healthier, it makes our hormones detox better. Like all the trendy buzzwords and all the truth to kind of the foundation of what keeps us healthy. If there's one thing I think is deficient, if there's one thing I think people aren't getting enough of, it's fiber. If I could take every Muralax prescription that was ever written and cross it out and make it a fiber supplement, I think that we would see a lot of people with stomachs and guts and health that felt a lot better. And that's not to say there's anything wrong with Miralax, but I'm saying we're not fixing the root if we don't address the fiber.

SPEAKER_00 33:07

And in the end, these things are given to us by nature, right? So just quickly, let's talk through what these different words mean. So obviously, proteins, carbohydrates, and fats are broken down into molecules that are used by our body. Fiber's different though. Can you explain what fiber is exactly and how it works for the body?

SPEAKER_02 33:28

Well, fiber, there's forms of fiber, right? There's insoluble and there's soluble. Insoluble gets broken down and pulled into the bloodstream, and it can help I'll use the word clean, but that's a poor word to use, but it'll help sort of clean the blood and help us carry things through the blood, such as cholesterol. And then there's insoluble fiber, which we don't break down, but that's a good thing because then it in our stomach it helps us create a normal, a bigger stool that will help us have a normal bowel movement. So when we think about fiber, and it also is a volume thing, right? So we feel fuller from when we're eating fiber. So we look at it for in across the board stomach health, right? Prebiotic fibers are what feed the beneficial bacteria of the gut. Well, we know a lot about the microbiome. We don't know exactly everything we need to know about probiotics in the gut, but we do know that the health of the microbiome is dependent upon fiber in your body. Short chain fatty acids, butyrate, all of those, they are from prebiotic fiber, right? So from your stomach, your gut, your bowel movement, your cardiovascular health, your brain health, your appetite regulation. Like if you don't have a bowel movement every day, you tend to not feel as well. Fiber can help that without being laxative. So, yes, we know a lot about proteins, fats, and carbs. Fibers are in plants. If it came from a plant, it has fiber. If it was altered and manufactured very far down the line, they probably took the fiber out of it. But at its root, if it comes from a plant, it inherently has fiber.

SPEAKER_00 35:03

So

Fiber Explained And Why It Works

SPEAKER_00 35:04

let's move on to carbohydrates now. Our arch nemesis in food and nutrition. Can you can you just break down what carbs are? What are some examples of it? There are processed carbs and refined carbs, and there are complex carbohydrates that are that are healthy for us. Can you please clear that up for us?

SPEAKER_02 35:22

Absolutely. 30 years ago, fat was the villain. Then 15 years ago, carbohydrates became the villain. But we failed to identify carbohydrates that are very healthy and beneficial versus the carbohydrates when we eat too much of them are problematic. Carbohydrate is a sugar backbone, but that doesn't mean it's a sugar. Broccoli has carbohydrates and a bagel is a carbohydrate. Oatmeal is a carbohydrate and grapes are a carbohydrate. So carbohydrates are foods that have a sugar backbone to it. And I won't get into the heavy science of it because that's not what anyone is here for. But to understand carbohydrates means to understand that if you are eating fruit, you're eating carbs. And if you're eating a bagel, you're eating carbs. But if the if the carbohydrate does not have fiber, it is a simple carbohydrate. It has a high glycemic index. It's going to make your blood sugar higher. This has been a problem for people with metabolic syndrome and diabetes and elevated blood sugar. If the carbohydrate has fiber in it, it tends to keep your blood sugar lower or more regulated or rise more slowly, which is very positive. We need carbohydrates for energy. Some would argue, no, you don't. You can follow a new carbohydrate. Generally speaking, to the greater population, we need carbohydrates. Also, carbohydrates are delicious. They're cheap, they're easy to process, they're easy to make, they're stabilized for a long time. So you know what? It's really easy to do. It's really easy to get inexpensive carbohydrates on the go, such as a pastry, a muffin, anything like that, right? Those are all carbohydrates. And we grab and we go and we overeat them. Or we go to a restaurant and we get an American-sized plate of pasta, which is like the entire box. And that's all carbohydrates. What I always tell people is carbohydrates are not a problem. It's the amount of them that we eat. They should not be the largest portion of food on your plate. Your vegetables should be the largest portion, and your protein should be equal to and or right beneath that. And the carbohydrate should be the smallest portion on your plate. But for most people, it's quite the opposite. The rice is the highest, the pasta is the highest, the noodle is the highest, the bread is the highest, and that's a problem.

SPEAKER_00 37:39

So continuing on this theme, let's talk about fruits, vegetables, and smoothies. So when you eat a fruit in its natural form, it takes longer to eat. You're not going to have as many of them compared to if you were to have them in a smoothie. So is the problem there with how much of it you're consuming in a short space of time via liquid form?

SPEAKER_02 38:00

Yes, but so we would argue that then juice would be even more problematic, right? Because there's no fiber in juice where at least in a smoothie we keep the fiber in the fruit.

SPEAKER_00 38:12

Right.

SPEAKER_02 38:12

When someone comes and says I'm having a smoothie for breakfast, and unfortunately I have to course correct the smoothie very often, and they'll say, I have, I put a banana, I put raspberries, I put oat milk, I put sometimes a handful of spinach and water, right? And I'm like, oh, we've got to rework this. So I have a rule of five. If you're making a smoothie, the smoothie has to have one fruit, one vegetable, one fat, one protein, and one liquid. Because now I know that you have a complete meal. You have a protein, you have a fat, you have a carbohydrate, and no one of them is predominantly more than the other. That might look like somebody having a smoothie that's made from banana, spinach, peanut butter, water, and yogurt. And that would be a fantastic smoothie. Versus someone that comes in, it's bananas, it's raspberries, it's mangoes, it's water, and it's oat. So when you're looking at the food, we're gonna go back to the thing that I talked about earlier, is what is in front of you? If you're drinking that, but you took out each ingredient and put them in front of you, would it have that protein, fat, carb balance, or would it be predominantly carbohydrates? The problem with the smoothies is that most people don't really love the way that it tastes if it's not filled with sugar. Because what is sugar? It's delicious. But we also want to balance it. So you got to think about your smoothie. Is this just a way for me to feel healthy, but it's actually a bullet of sugar, or is this a way for me to get in nutrients that I really need and it's well balanced?

SPEAKER_00 39:41

Right. And and with juices, we know, right? Like typically, if you were to juice one orange, often people are surprised by how much juice that produces. It's not a lot, actually. So when you yeah, so when you have a glass of juice, just think, would you eat that many oranges in one sitting in that short space of time? And then you have the processed juices that have lots of added sugar in them. But with smoothies, most places you go, are they just putting loads of fruit in there and not following this rule of five, even on a very basic level?

SPEAKER_02 40:13

Yes, because they're making things to cater to people liking it and coming back and buying it again, right? True. So absolutely, but very rarely will you find a place that makes smoothies on site that won't make it the way you want them to. You know, you made an interesting argument about the fruit. A glass of orange juice can have the equivalent of, you know, anywhere from six to 13 oranges. Same can be said for a New York City bagel. If you put that New York City bagel on a full scale and then put slices of bread, you would need six slices of bread to get an even weight to the bagel. Most people wouldn't sit down to a breakfast plate with six slices of bread.

SPEAKER_00 40:53

Yeah, that's crazy. And and again, the the purpose on this podcast is not necessarily to just say, hey, we need to change the world, but it's it's more about just making people aware so that when they go and order that smoothie next time, they just stop for a second and think, maybe instead of ordering the one on the menu, I'm just gonna say, I'm gonna make my own. I'm gonna say, okay, look, I want one of each of these ingredients in it, and I only want like one apple in it, one orange. It's just really about trying to understand why some of these things may not be healthy, even though the marketing and the branding that has been perpetuated around these may directionally be healthy, but in the end, actually, it's it's not.

SPEAKER_02 41:34

You bring an important point to this conversation, which I reference all the time when I'm speaking with people, which is awareness is a superpower. We cannot change what we're unaware of. But once we have the awareness, we can then make a decision to behave it differently. So if I say to anyone who walks into my office and sits down, if I say, I'm gonna tell you one thing more important than anything else, and if everything I say, you can't remember a single thing, but this one thing, this one thing I want you to remember is that 50% of one meal a day has to be just vegetables. You have to eat half of a plate from vegetables. And if you do that every single day for seven days a week, for entire months, for years to come, your health is going to be in an exponentially better place than it is today. And that's just an awareness of it, might not happen every day, but that awareness is there and they're going to work more towards getting to that place.

Carbs Smoothies Dairy And Micronutrients

SPEAKER_00 42:21

And just to round this out, can we do dairy very quickly? What's your advice on dairy?

SPEAKER_02 42:26

Dairy is one of those groups that unfortunately got victimized by just the name, right? So there is a massive difference between an ice cream bowl and an unflavored Greek yogurt. But they all fall into the dairy category. So I like to separate them into there's the dairy and then there's the sugar dairy. If you have a yogurt in the morning that has 32 grams of sugar in it because it's the Oreo crunch mix-in flavored yogurt, that is not the same as a Greek yogurt that is just by itself with absolutely zero sugar and all protein. So it goes back to the understanding, it's the awareness of can you flip that yogurt around, look at the food label, and say, oh, there's six grams of sugar in here. This is fantastic. Or there's 26 grams of sugar in here. That's more than a Snickers bar. I probably should look for a different yogurt, right? So if we're talking about dairy without getting too into the weeds of, you know, there's skim milk, there's whole milk, there's this and that. Like the the more sugar that your dairy has, the more inflammatory the food. That's true for every food across the board that is processed. It is not true for fruit, it is true for processed foods. If your dairy, dairy does not have the excess amounts of sugar by itself, they're put in there. The ice creams, the yogurts. Cheese is a little different. We'll talk about cheese for a second. Cheese in over consumption is a problem. Cheese is a food in a normal consumption can be. Part of a healthy diet. You see, the theme and the pattern here is that we tend to overconsume a very particular type of food in this country. We've made it cheap, we've made it available, we've made it taste better, we've made it easy, we've made it convenient, and now we're in a big problem because now we really are seeing the ramifications of that in the office.

SPEAKER_00 44:21

What are micronutrients?

SPEAKER_02 44:23

So your macronutrients are your protein, your carbs, your fats, and actually fiber. Fiber is a macronutrient, even though it's confused often to be not, we think of macros as three. So carbs, fats, proteins, and fibers are macro. Your micro are all your vitamins, your calcium, your vitamin D, your B12, your B6, your choline, all the vitamins in the foods, those are your micronutrients. Your macronutrients are the ones we talked about before. And guess what? You need them both. If you eat a variety of foods of different colors, you're gonna get a lot of micronutrients. If you have fruits and vegetables and grains and meats and you're eating a rainbow of foods, those colors in the absence of food dye come from micronutrients. So instead of worrying about needing to get micronutrients in a particular way or a particular supplement, we can first start with am I eating colorful foods throughout the week that are contributing to micronutrients? Of course, there's always a need for specific micronutrients within some people in certain situations. That's not what we're talking about. Generally speaking, micronutrients in food come from a variety of colors. That is the easiest and fastest way for people to think about that.

SPEAKER_00 45:33

And then how do they play different roles in the body? I would love to talk about this all myself, but I love asking my experts to explain it from their perspective.

SPEAKER_02 45:41

Micronutrients play roles that have their accessory roles, if you will. So the macros are giving us the energy, the recovery, the bigger actions more quickly. The micronutrients are all the accessories that allow us to function and optimize our best, right? So, quick example might be like B12 is a micronutrient. That's really important for our energy levels. But it does not the same as getting energy from carbohydrates in our food. It's a different form of it. So we really have to think about all of these are a system. It's like traffic, right? That the macronutrients would be the highway, the parkway, the roadway, the micronutrients would be the stoplight, the stop sign, the yield sign. Like you need all of them there for the traffic to function. You need all of these here. They just serve different purposes.

SPEAKER_00 46:27

So this takes us nicely to the last question I have on nutrition principles that people need to know, which is where does the nutrition field need to go next?

SPEAKER_02 46:36

Okay, so where does the nutrition field need to go? That's a hard question because the nutrition field has exploded with social media. And unfortunately, there's a lot of misinformation around nutrition. I would think one of the most important, and we just saw this in August 2025, we saw the HHS and the Department of Education came out with a call to action for medical school to bring nutrition into the paradigm, which will be phenomenal. I mean, that will be game-changing for us to have nutrition education throughout medical education. Where does nutrition need to go? I think it needs to come back to a place of simplicity. If I was going to leave this podcast with three of the most important things that we talked about, it's that if you can recognize your foods, you can significantly improve the quality of your diet. If you can quiet the noise, you can be less confused about all the bads and the goods, and you can come back to a place of what am I eating and what feels good for me. And ultimately find ways to eat more fiber. That is inherently like make that happen. But nutrition education is going to be about not making it too complicated, but bringing it back to food.

SPEAKER_00 47:44

Dr. Jamie Cher, thank you so much for joining me. We've learned a lot on this episode, and I'm sure people will find it very useful.

SPEAKER_02 47:50

Thank you for having me.