Most of us already know we should eat ‘better’. The problem is that healthy eating feels impossibly complicated.
One minute, we’re being told to cut carbs, the next, it’s about eating more protein, avoiding seed oils, going paleo or adding some magic supplement. Open TikTok and there’s a new ‘wellness’ rule waiting for you before you’ve even finished your coffee, sorry, I mean matcha…
It’s exhausting, and according to Dr Ezekiel Emanuel – oncologist, bioethicist and author of Eat Your Ice Cream – most of these fads don’t work, and some are actually harmful.
Instead of obsessing over trends designed to keep you coming back for more powders, pills and ‘health’ products, Emanuel believes long-term health is much simpler than we’ve been led to believe: cut back and reduce the harmful health habits doing actual damage – from sugary drinks and ultra-processed foods to mindless snacking – and build realistic routines that fit into your life. And yes, that means you can still eat ice cream.
Because the healthiest habits, he argues, are the ones that you barely have to think about: woven into your daily routine rather than added to an endless wellness to-do list.
Here, he explains why most people are focusing on the wrong things when it comes to healthy eating – and the simple, realistic changes that matter way more than restrictive diets.
Most people are focusing on the wrong things
The most common mistake in healthy eating is overcomplicating your diet with small optimisations while ignoring the basics. People often fixate on small optimisations – what time to eat, which milk to choose, whether an ingredient is ‘clean’ – while failing to address negative habits and basic diet components that matter far more. This imbalance helps explain why most diets fail after a few weeks or months.
Highly restrictive and complicated plans may work for a few weeks, but they are rarely sustainable. They require huge amounts of willpower to cut out enjoyable foods or follow rigid rules that do not fit into everyday life. Because willpower easily fatigues and almost everyone eventually abandons these diets and returns to their previous eating patterns.
Lasting health comes from adopting habits you can stick with for years rather than short bursts of discipline. That means shifting your focus from fine-tuning to consistency – creating enduring and enjoyable habits.
Sugary drinks are one of the easiest ways to damage your health
Drinking a large amount of sugary drinks is responsible for so much of the harm to our diets. Those 330ml fizzy drinks contain 10 teaspoons of sugar without any nutrition. Cutting back on these drinks is one of the simplest ways to improve your diet. Fortunately, consumption has been declining, but it is still on average one can per day in the UK. And diet fizzy drinks are no better and may be worse. They keep you wanting sugary items and the artificial sweeteners seem to reduce the good bacteria in your gut.
Ultra-processed foods are designed to keep you eating
Obesity and overweight are rampant in the US and UK, with 73% and 64% of adults, respectively, obese or overweight. Many factors contribute, but the biggest one is ultra-processed foods (UPF) – those packaged cakes, biscuits, muffins, pretzels, frozen pizzas and the rest. They constitute 54% of energy intake overall in the UK and 66% for adolescents. That makes the British the second-highest UPF consumers in Europe after the Dutch.
UPFs are designed to be easy to eat and even addictive with the added sugars, salts, and fats. They are energy-dense, having more calories per ounce, which is why they lead to obesity. It is easy to consume huge amounts of these without realising it. Plus, they have low nutritional value.
Mindless snacking is adding more calories than people realise
Habitual snacking is an extremely important but frequently overlooked issue. Snacking is often mindless. It occurs in small increments throughout the day, which can lead you to consume huge amounts of calories without realising it. On average, snacks contribute about 500 calories per day – roughly 20 to 25 per cent of total daily calorie intake – to our diets.
The eating habits that actually matter
Only after reducing the harm should you focus on gradually incorporating and sustaining healthy foods. Here, there are two rules which go a long way toward healthy eating and they both involve focusing on improving your microbiome. The microbiome is the collection of bacteria in your gut. There are over 100 trillion bacteria in your gut – more than all the cells in your body – which are estimated to be under 40 trillion.
Eat more fermented foods: Fermented foods like yoghurt, cottage cheese, hard cheese like gruyere, kimchi, sauerkraut, miso, and sourdough are a great place to start. All of these enhance your microbiome with good bacteria.
Eat more fibre: While protein is all the rage, almost everyone gets enough protein. Yes, people over 60 and endurance athletes need slightly more protein per day. But a normal diet has enough protein – about 1 to 1.2 grams per kilogram of body weight.
The big problem is that few people get enough fibre. We don’t eat enough fruits and vegetables. Fibre is important for those good bacteria to grow on, blunts blood sugar spikes and crashes, and helps coat your gut to reduce damage. So, eat raspberries, kiwis, apples, Brussels sprouts, almonds, and oats, and leave the expensive prebiotic supplements at the pharmacy.
A few dietary suggestions. The easiest way to eat healthily is to have yoghurt with fruit and granola for breakfast. You get the fermented foods and fibre. Add a green salad to every dinner, and you have a lot of the fibre you need every day.
There are many other dietary habits that are good for you. For instance, eat more dairy. It makes people taller but also seems to reduce the risk of developing diabetes. So eating yoghurt or cottage cheese is a two-for-one – good for the probiotics and reducing the risk of diabetes. It is also why ice cream seems to reduce the risk of diabetes.
If you feel like snacking, reach for the nuts or hummus and carrots instead of the biscuits or crisps. They have protein, fibre, and good fats.
These changes are effective because they’re not extreme and they give you multiple options for how to incorporate them. Health improves when habits are repeated and palatable, not when they are perfect and painful.
You do not need a perfect diet to be healthy
One of the most damaging ideas in modern wellness culture is that you need to do everything right.
Trying to follow a perfect diet is exhausting, and it sets you up for failure. When people inevitably slip, they often abandon the effort entirely. You can eat well most of the time and still enjoy foods you love. You’ll find more success when you give space for flexibility.
Rather than breaking down from the pressures of perfection and bingeing on ultra-processed junk foods, let yourself consume real, tasty dessert foods in moderation, like ice cream, to celebrate or spend time with friends.
Occasional indulgence is part of a healthy, sustainable lifestyle and shouldn’t be viewed as a setback. In fact, allowing room for enjoyment makes it easier to maintain healthy habits consistently.
Health should fit into your life – not take it over
Good nutrition centres on patterns that support health without taking over your life.
Diet is only one part of wellness. Many people who obsess about diet neglect social relationships, physical activity, and sleep, all of which play a critical role in long-term wellness.
Food should support your health, but it should also fit into a life you enjoy. When eating becomes overly restrictive or stressful, it is no longer serving that purpose. The goal is to build good eating habits that work in real life. That means letting go of the idea that there is a perfect diet and focusing instead on one that is realistic, consistent, and sustainable.
Dr Ezekiel Emanuel is a Harvard- and Oxford-trained oncologist and bioethicist. His new book, Eat Your Ice Cream: Six Rules for a Longer, Healthier Life (Penguin), is out now.
