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Making Healthy Food Choices: It’s More Complicated Than You Might Think

Making Healthy Food Choices: It’s More Complicated Than You Might Think

People use the phrase “healthy food choices” all the time these days.  When we first hear it, it sounds easy enough to understand.  It seems universal, a phrase that would mean the same thing to everyone.  But upon closer examination, we find that the phrase “healthy food choices” means something different to everyone.  It’s not nearly as standard as you might be tempted to think.  In this post, I am going to share 6 Reasons why making healthy food choices is a bit more complicated that you might think.

food choicesKatie Smith/ Unsplash.com

1.  Availability of Food

Not everyone has the same foods available to choose from.  In certain parts of the world, you won’t find super-sized grocery stores with lots of choices.  Actually, in some places, you may not find any stores at all, and all food needs to be homegrown.

In other situations, there may be plenty of food choices around, but a family does not have enough money to purchase high quality cuts of meat, seafood and organic fruits and vegetables.

As you can see, asking a financially strapped person in a third world country how they define healthy food is going to be quite different from a wealthy person in a first world country.  Sometimes it comes down to what you can get, what you can afford, and what’s not contaminated or what won’t hurt you.

2.  Health Needs Differ

Saying eat healthy to a diabetic patient is going to mean something different from saying make healthy food choices to a patient with kidney disease.  The diabetic needs to carefully watch sugar and carbohydrate intake.  Whereas, the patient with kidney disease needs to keep a very close eye on water, salt, and certain other nutrients.  What is healthy for one person, may not be healthy for another and vice versa.

I have a gastrointestinal condition known as gastroesophageal reflux disease (GERD).  This means the food and stomach contents in my stomach has a tendency to move back up into my esophagus, where it doesn’t belong.  This causes me to feel very uncomfortable at times, but it also has the potential to cause significant damage to my esophagus.  Some studies have even shown a link to cancer.  I have been cautioned to avoid certain foods and have also noticed that certain foods cause me more trouble than others.  So, even though something may be considered very healthy, for me it may be a big no-no!

3.  Preferences Vary

When it comes down to it, it doesn’t matter how healthy experts claim something to be, if you don’t like it you’re not going eat it.  Also certain cultures tend to eat foods that other ones would not even dream of eating.  Here is the US, we have olive bars in just about every grocery store.  Some people even include olives on the list of the world’s healthiest foods.  Although I have tried them on a few occasions, and realize they have many health benefits, I can’t stand them.  So, I’m not going to eat them by choice.  They would have to the only option and I would have to be famished for me to think they were a good option.

Preferences go beyond just what people like and don’t like. Preferences include major diet choices such as choosing to be vegetarian, vegan, paleo, or strictly organic.  Sometimes diet are chosen due to cultural or religious beliefs.  Other times they are chosen due to the perception that they are the healthiest way to go.  Nevertheless, as we can see a meat eater and a non-meat eater are not going to think the same thing about the health benefits of a turkey dinner.  One might think real turkey meat is awesome and the only way to go.  The other may be looking for the best soy substitute so that actual meat won’t ever touch their lips.  Neither is necessarily wrong, it’s just a matter of preference.

4.  Allergies & Food Sensitivities

If you look at the dietary recommendations from just about any authority they will tell you that you need a certain number of dairy portions for a healthy diet.  Well, that’s great unless of course you have an allergy to dairy.  The same goes for other food that frequently cause people allergic or sensitivity problems.  A few that I have come across in my nursing career are peanuts, shellfish, eggs, wheat, and strawberries.

While a food may in itself beneficial to the body, each of body’s respond to food differently.  I have a relative who loves ice cream but must be close to a restroom when he chooses to eat it.  Some people are sensitive to sulfites.  Sulfites are chemicals that are added to some foods to help preserve them.  A few examples are wine, bottled lemon juice, and dried fruit.  While these foods are not unhealthy in moderate amounts, they are not healthy food choices if they’re likely to make you sick.  WebMD notes that some sulfite sensitivities can be life threatening.

5.  Perceptions of What Healthy Means

Even if you are talking about people of equal financial means, in the same general location, and they tend to like similar thing and no one has allergies, healthy can still mean something different.  It has to do with what we perceive the word to mean.  Our perceptions come from personal experiences, what we have been taught, and the culture we live in.

Growing up in a middle class home, we tended to eat well-balanced meals that were moderately priced.  Feeding three kids on one full-time salary meant my parents had to spend wisely.  I don’t think I ever heard of organic foods and certainly never ate any.  I didn’t understand the benefits of organic foods and didn’t understand why someone would pay more money for ugly-looking food.  My perception was that only extreme health nuts ate organic foods.  Often these people were doing very well financially and could easily afford this extravagance.

Today, I know much more about the benefits of organic foods.  In fact, if you’d like to hear more about this topic, I invite you to listen to my podcast entitled E-Books, Personal Learning, and Organic Food Choices.  This brings me to another key point, perceptions change.  My income level has varied greatly over the last 30 years.  There were times when I had more than enough, and times when I have counted my pennies.  In the lean times, 3 boxes of pasta for a dollar sounded really healthy to me.  In times of abundance, I have purchased organic fruits, vegetables, and meats that I considered healthier choices at the time.

6.  Experts Disagree

In an article by Quealy & Sanger-Katz (2016) called “Is Sushi ‘Healthy’, What About Granola, Where Americans and Nutritionists Disagree”  these authors discuss a study of what different people consider healthy.  I would expect the public to have differences of opinion, since everyone has different experiences and levels of education.  However, I would not have expected so much variation among the experts.

There were some foods both the public and experts agreed were healthy.  This list included apples, oranges, oatmeal, chicken, and turkey.  Then there were some that both groups agreed were not healthy.  These included hamburgers, diet soda, beef jerky, white bread, and chocolate chip cookies.  But then there was a list that no one was quite sure about.  Items on this list included pop corn, pork chops, whole milk, steak, and cheddar cheese.  I have to say, it only adds to the confusion about what constitutes healthy food choices when the experts can’t even agree.

Reflection Questions

  1. How do you define healthy food?
  2. Do you have any strong preferences of foods you love or can’t bear the thought of?
  3. How do you handle other people’s food preferences if they’re different from your own?


Quealy, K. & Sanger-Katz, M (2016).  Is Sushi ‘Healthy’, What About Granola, Where Americans and Nutritionists Disagree.  The New York Times.

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Health Benefits of Tea, Randomized Controlled Trials (RCTs), & Schedule Your Checkups

Episode 11:   Show Notes

In today’s 3-part episode we will be discussing the types of tea that are available and how they benefit our health, randomized controlled trials, and the importance of scheduling routine checkups.

Part 1:  Health Benefits of Tea

When I began to watch the amount of calories I ate and drank throughout the day, one thing I did was to eliminate the majority of calories from beverages.  This opened my eyes to the world of tea drinking.  I don’t add sugar, milk or any type of sweeteners but instead enjoy the calorie free taste of the plain tea.

In addition to enjoying my tea, I have been reading a lot of information about the health benefits of tea too.  So, I thought this would be a good thing for us to explore together.

The Dangers of Free Radicals

According to WebMD, free radicals are atoms or molecules that have at least one unpaired electron.  This makes them more prone to react with certain chemicals and can cause cells unable to function normally.  Some experts who study older adult health believe in the Free Radical Theory of Aging, that states free radical damage is a factor in some age-related health conditions.  And as we get older, free radical damage in the body may increase.

How We Are Exposed to Free Radicals

There are many ways we can be exposed to free radicals and we can’t always avoid them.

  1. By-products of normal processes like digestion.
  2. When the body breaks down certain medications.
  3. Through pollutants such as heavy metal and smoke.

Fighting Free Radical Damage

Even though we can’t prevent being exposed to free radicals, we don’t have to sit by silently and do nothing.  Molecules called antioxidants can stabilize free radicals.  Antioxidants occur naturally in fruits and vegetables and they are available as supplements.  But, here’s the good news – they are also found in many teas!

General Benefits of Tea

According to the Tea Association of the USA. Inc, daily tea drinkers is over 158 million, about half the US population.  That’s a heck of a lot of tea drinkers!

Some of the general benefits of tea according to Registered Dietician, Neva Cochran drinking include:

  • Ability to soothe
  • Restores & refreshes
  • Heart health
  • Cancer prevention
  • Promotes healthy teeth
  • Aids weight loss
  • Often less caffeine than coffee

Types of Tea – Specific Benefits

I’ve always been curious about what different teas do for us.  We might have a tendency to like the taste of certain teas, but for health reasons are some choices better than other choices?  The Berkeley Wellness website posted a wonderful infographic spelling out some of the major benefits for us.  I’m going to share a few of the highlights with everyone today.


Least processed, least caffeine.  Thought to protect us against cancer.


Negligible amount of caffeine and a high concentration of antioxidants (fight against the free radicals).  This tea is thought to protect against many things including:

  • Cancer
  • Tooth decay
  • Diabetes
  • Heart disease
  • Stroke
  • Osteoporosis
  • Burning fat & promotes weight loss
  • Improving cholesterol levels

Although this one sounds great, I do want to throw in a word of caution.  Even though the caffeine in green tea is minimal, it does still have caffeine.  So certain diseases or disorders can be aggravated when drinking it, such as anxiety and hypertension. A best practice is always to make sure your primary care provider is aware of the types of tea you are drinking to make sure they won’t interfere with medications you are taking or any other conditions you have.


Less caffeine than black tea.  Thought to protect against tooth decay and may help cholesterol levels.


The most processed and most caffeinated.  Its taste is stronger than oolong or green tea.

Rooibos (Red Tea)

Not actually considered a true tea because it is made from a South African herb.  Regardless, it is thought to help protect against cancer and neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease.


This group of teas is made from herbs, fruits, seed, or roots stepped in hot water.  This category is also not considered true tea, but has shown some health benefits, most especially in chronic illnesses like diabetes.

Word of Caution

The authors of a WebMD post on this subject caution us to always check the label on products we purchase and ingest.  There are companies that place additives to the tea, especially instant teas.  Senna for example is laxative.  Therefore, it really should only be taken if recommended by a healthcare provider for clients with constipation issues.

Also, you don’t want to drink something you’re allergic to.  Often if a person has outdoor allergies, he/she may have may have a problem with herbal teas such as chamomile, a plant from the daisy family.

What Kind of Tea Should We Drink?

When it comes down to it, there is still much research being done on how teas are beneficial to us.  So I expect we will continue to learn more in the days ahead.  In the meanwhile, I always recommend people focus on the health area where they are most likely to have a problem or have a known problem.  If neurodegenerative diseases run in your family and you are otherwise healthy, then giving Rooibos a try might be a good thing.  Always check with your healthcare provider first to make sure it’s safe for you.

Personally, I like many different kinds of teas, so I like to mix it up and drink different things as different times of the day.  I keep my caffeinated drinks before mid-day and save the non-caffeinated ones for later in day and evening.

Dr. Terri’s Heath Tip & Challenge of the Week

This week my tip & challenge is to make sure that you have plans to have all your routine screening checkups done.  Frequency varies from person to person, so you should always go with what you have personally been told.  Some of the types of checkups I’m talking about are:

  1. Annual physical if your primary care provider has recommended you do that.  If not annual, making sure you go as often as recommended.  If you don’t happen to have a PCP, then it’s time to get one.
  2. Dental checkups – every 6 months.  If you don’t have dental insurance, check out what free or discount resources are available.  Often dental hygienic and dental schools offer such services.
  3.  Women – breast and pelvic exams.
  4.  Vision –  for most people 18 to 60 years of age the American Optometric Association recommends every 2-year exams.
  5.  Specialty appointments – this list could become very extensive.  To name a few, cardiologist (heart), pulmonologist (lung), nephrologist (kidney), endocrinologist (endocrine problems like diabetes), oncologist (cancer), hematologist (blood).

Make yourself a list right now and schedule them before the week is out.  Don’t let it slip, or you might wait too long.  Remember, the purpose of routine screenings and checkups is to prevent a problem if possible and if it can’t be prevented, to find it as soon as possible so it can be treated promptly.

Part 2:  Randomized Controlled Trials

I have done several podcasts now where I have discussed the topic of vaping.  My latest one spurred quite a discussion on Twitter about the benefits, the barriers, and what type of research is available or currently going on about vaping.

The topic of RCTs, or Randomized Controlled Trials came up and it was apparent to me that not everyone knows what these are, and why they are important.  As someone who has studied and performed research, I know a good deal about the various types of research methods that can be used.  For today though, I’m going to focus on just one kind Randomized Controlled Trials.  And I’m going to put it in plain English, so it’s easy to understand.  If any research experts are listening, this may seem watered down but I assure you I’m intentionally making it easy to understand.  More information is always available for those who want it.

RCT Definition

A Randomized controlled trial is a type of scientific experiment, which attempts to decrease prejudice, bias, or favoritism when testing a new treatment.  This is not always possible, but when it is, it is considered the “gold standard” for clinical trials.  Clinical trials are research studies done on human beings.  Generally, the purpose is to answer questions about new treatments such as vaccines, drugs, food choices, supplements, or medical devices.


In a nutshell random means that something is unknown ahead of time.  So if there was a study being done to see is Drug A took pain away better than Drug B and no drug at all, we could randomly assign participants to one of the three groups.  People can’t choose.  People don’t know (the term blind is used to indicate people don’t know).  And we use the term double-blind to indicate that neither the person giving or receiving the medication knows which group the person was assigned to.  So, it’s random, only the researcher knows.

Controlled Trial

This part means that the researchers are controlling what type of intervention or treatment people receive including no treatment (or a placebo).

Other Types of Research

Without getting into too much detail, I do want to point out that we can research just about anything.  We don’t have to randomize, we don’t have to control who gets what.  We could watch something happen, record, and analyze it.  But controlling things give us the best scientific evidence and allows healthcare providers to make recommendations that are based on something concrete.

Problems with RCTs

There are several problems with RCTs.

1.  For ethical reasons not all studies can be RCTs.  There are vulnerable populations such as pregnant women, prisoners, mentally disabled, and children that cannot responsibly agree to be studied.  We don’t force participation.

2.  They take a large amount of time and resources (money etc).

3.  They may be required to stop early.  If results are very good or very bad, the study may be completed.

4.  Can’t find enough participants.  May not be interested.  Offering payment may sway results.

Practical Application

Now that you know a little more about RCTs, the question is, how do they affect your life?  There are few things for you to consider.

1.  If you’re asked to participate in one, know that you’re participating in an important process which helps physicians and other healthcare providers make informed recommendations for treatments.  So the results could help you or a family member or friend one day.

2.  There are ethical guidelines in place that protect participants.

3.  Other types of research are valid or worthwhile too, but they just don’t give us results that are as strong.

4.  You may have to be patient for more results to come in; it takes time and a lot of resources.

5.  One thing I haven’t mentioned yet is that one research study cannot answer every question on a topic.  Every study has one or a few questions that it is designed to answer and that where the study is focused.  If we’re studying if something works, it’s not the same as asking if people liked it.  Spinach is very healthy for you, but not everyone likes it or is going to eat it.


Free Radicals.  WebMD.

Recommended Eye Examination Frequency for Pediatric Patients and Adults (2017).  American Optometric Association.

The Health Benefits of Tea (2017). Academy of Nutrition and Dietetics.

The Health Benefits of Tea (2016).  Berkeley Wellness.

Types of Tea and Their Health Benefits (2009).  WebMD.

Reflection Questions:

1.  Do you currently drink tea?  If so, what kind do you enjoy most?  If not, are you interested in giving it a try?

2.  What type of doctor appointments do you need to schedule?

Ways to Connect with Me:

Subscribe, rate, and review “Breaking Thru Health Barriers with Dr. Terri Wenner” in iTunes or your favorite podcast app so you never miss an episode. Always feel free to drop use the contact form on my website to send me your comments and questions.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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