Lisa Doggett

FIVE servings a day of fruits and vegetables. MINUMUM. That's a pretty universal recommendation from nutrition experts. Yet, only one in 10 U.S. adults eats enough, according to the Centers for Disease Control. A plant-based diet, with lots of fruits and veggies, is one of the best ways to prevent cancer, heart disease, diabetes, and many other chronic diseases. Replacing less healthy options with fruit and vegetables can help people lose weight and keep it off. But it can be tricky to fit in those servings, especially if you're not used to it. Here are some ideas, especially to add more veggies to your diet:

1)      Eat more salad: These days salads are not just tasteless iceberg lettuce and tomatoes tossed with a store-bought dressing. With the right ingredients, salads can be exciting and make for a very satisfying entrée. Mix together different kinds of greens with whatever other veggies look fresh or in-season. Toss in nuts or beans. Add fruit – fresh or dried. Add a little olive oil and balsamic vinegar (no need to buy dressing), and voilà: you have a great meal with three to four servings of veggies.

2)      Choose veggie-centered soups and stews: With cooler weather coming, stews and soups can double as comfort food and healthy entrées or starters. When choosing a soup or stew in a restaurant or selecting a recipe to make at home, choose one with a lot of veggies. Go light on the cream and butter. Look for recipes with great combinations of colorful vegetables; you'll easily meet the serving recommendations and get lots of important vitamins and nutrients in the process.

3)      Grab a bowl: Bowls filled with veggies, sometimes with grains, beans, and/or an egg, have become popular over the last few years, and they are a great way to add veggies to the diet. Combinations like quinoa with roasted Brussel sprouts, broccoli, carrots and avocado, maybe sprinkled with toasted pumpkin seeds or pecans, can be a delicious way to get more veggies in the diet.

4)      Go vegetarian: You may not want to give up meat altogether, but choose at least one day a week to try out life as a vegetarian. Consider joining the movement for Meatless Mondays, for example.  It may help you shift your focus from seeing meat as the centerpiece of the meal and come up with more creative – and healthy – veggie-centered alternatives. Check out this great article from The Guardian on how a plant-based diet also helps the planet!

5)      Snack on veggies: Baby carrots, cucumber slices, or celery sticks make great snacks, and are much healthier than chips or cookies. Keep some handy in the refrigerator along with hummus or a healthy dip.

6)      Try baked sweet potatoes: Yams or sweet potatoes are far more nutritious that regular white potatoes. They also make a satisfying and healthy entrée, especially when stuffed or topped with other veggies like green peas, beans, or roasted peppers.

7)      Fill a tortilla with veggies: In my hometown of Austin, Texas, we live and breathe tacos. Tortillas filled with veggies are my favorite. Try black beans with sautéed spinach and mushrooms or carrots and broccoli. Pour on the salsa and add some guacamole for even more veggie goodness.

8)      Smoothies! I know this article is on veggies, but fruits are great too. A super easy way to get in three to four servings is by making smoothies in the blender at home. With frozen bananas as a base, add other in-season fruits and milk, juice, or a non-dairy alternative; mix; and you're left with a delicious healthy beverage, which can even work as an entrée for any meal. I sometimes throw in veggies with the fruit too: frozen kale stems (from my garden) are my favorite.

Share your ideas below. Adding more veggies to your diet is an excellent way to improve your health and feel better.

A trip with my 10-year-old, Clara, to Laguna Gloria Art Museum to make robots for Family Day; a stop by the community garden to pick carrots; dinner at a favorite neighborhood restaurant; a good movie with Don; and a morning Mother's Day bike right with my 13-year-old, Ella, and my mom have resulted in a pretty ideal weekend. Busy, but not overly so. Productive, but fun. Quality time with many of my favorite people. Now I'm ready for my afternoon Texas Physicians for Social Responsibility board meeting and a low-key family dinner. 

This all ties into self-care, and below is Part 2 of my blog about my recommendations and personal self-care strategy. These questions came from a reporter who was writing an article for the New York Times. She did not end up using my answers, but I wanted to share them anyway, in case they are helpful.

What dietary behaviors do you believe protect your health – do you practice what you preach to your patients?

I feel strongly that I can't advocate for good health habits effectively if I don't follow them myself. I am a long-time vegetarian except I occasionally eat fish. I also am one of few Americans who actually eat more than five servings a day of fruits and veggies. Having MS has made me even more careful with my diet. I also try to set a good example for my kids, though it's led to few heated discussions about why I won't buy them Doritos.

What do you advise patients to do?

I tell patients that there is no magic to a healthy diet or to weight loss, which is often the goal. To lose weight, cut calories and exercise. For everyone, I suggest avoiding sugar-sweetened beverages, making sure that each meal contains at least one serving of fruits and/or vegetables (aiming for at least five servings a day – and even more is better), and avoiding fried and highly-processed foods. Keeping salt intake to a minimum (less than two teaspoons) is another good rule of thumb. Limiting alcohol, too, is important.

Do you take vitamins or supplements?

I don't take vitamins or supplements, except for calcium (for bone health) and vitamin D (only because I have MS). Evidence supporting most vitamins and supplements is pretty poor for those with a well-balanced diet. 

What about exercise?

I'm obsessed with exercise. I started exercising nearly every day over twenty years ago as a medical student. Exercise in my stress-reliever, my antidepressant, and helps prevent anxiety. I run or do another aerobic activity every morning just after I get up. I think exercise if the most important thing I do for my health – by far.

What are your thoughts about elective medical procedures - eg.back surgery, knee/hip/shoulder replacements?
I really try to practice evidence-based medicine. Some procedures – such as knee surgery for meniscal tears – have not been shown to be better than nonsurgical care. I do not advocate these procedures that only add to soaring health care costs and subject patients to unnecessary risks.

Tell me your thoughts about incidentalomas?

Incidentalomas are extremely common and are one driver behind escalating health care costs. Patients – and even some health care providers – often think that more screening, more testing is better. The problem, of course, is that we find things we aren't expecting, that often will never become a problem, but also can't – with 100% certainty – be safely ignored. I experienced a scare years ago as a patient when my doctor thought she detected an ovarian mass on a bimanual pelvic exam (a type of exam that is no longer recommended by many authorities in those without symptoms). I ended up needing an uncomfortable pelvic ultrasound – to the tune of hundreds of dollars and significant personal anxiety – to prove that it was nothing.

Do you watch your weight?

Yes. I have been fortunate that I've always had a healthy weight, and I've never been on a diet (except for a couple weird ones that I tried to alleviate MS symptoms), but I still work to maintain my weight through healthy nutritional choices and daily exercise. I keep a scale in my closet and check my weight regularly.

What do you do in general to keep healthy?

I strive for a healthy diet, daily exercise, daily (short) meditation, and seven to eight hours of sleep each night – usually I can do this!

What do you think are the most important things people can do?

Exercise and a healthy diet are more important than any pills or tests that a doctor can offer. However, people can still get sick (I got MS!). Having a trusted physician who can help when symptoms develop and getting screening tests and immunizations as recommended are critical as well.  

What are your hopes for medical care in the future?

I hope that as a society we can take steps to better support healthy habits and to offer truly universal, affordable health care.