Dr. Mahesh Tipirneni likes to go grocery shopping with his patients.
There's no buying, other than the buying-in of people willing to change what they eat to improve their health. Tipirneni, partner in Vitality Medical and Wellness with his wife Dr. Deepali Rastogi, guides those patients on a label-reading, alternative-seeking tour of Albertson's at La Cholla and Ina, near his office.
"I like to be more hands on, and I find that anything that requires a lifestyle change requires more involvement from the health care provider," said Tipirneni, a member of the Healthiest Town in America committee. "It's not as simple as prescribing a pill."
Before you make any dietary changes, it's important to consult your physician. And if you're really interested in monitoring calories, fat, sodium, protein and everything else in food, you've got to become a more discerning label-reader.
Don't shop when you're hungry, Tipirneni recommends. He also suggests people shop the periphery of any grocery store, rather than the more processed middle aisles.
He goes to Albertson's, rather than a health food store, to demonstrate "people can go to any general store and realize there are healthy options there." For that matter, Tipirneni adds, "you can go to McDonald's and find healthy options."
Tipirneni starts the trip in the bread aisle, and a comparison of the relative virtues of white and wheat bread. Wheat wins, but not by much.
He points out "healthy fats," which are monounsaturated, not polyunsaturated, not trans fats, not saturated fats. Monounsaturated fats can contain the Omega 3 and Omega 9 essential fats, which can improve immunity and cell function.
Trans fats give products longer shelf lives. Trans fats can accelerate arthrosclerosis and inflammation.
He's an advocate for things that spoil quickly, be they fruits, vegetables or meats. "Unfortunately, processed foods tend to be less expensive," he said.
The fewer ingredients, the better. He picks up a jar of organic peanut butter. "Peanuts and salt, that's it," he said. The more ingredients, the more processing. Watch out for partially hydrogenated vegetable oil, high fructose corn syrup, and sugar substitutes. Too much of the latter may give you a headache. Beware of all these "fruit" juices, and what's in them. Go for extra virgin olive oil. Eat white cheese, not the colored cheese.
While each individual is different, in general terms Tipirneni recommends people not eat more than three to four grams of sodium a day. Watch those soups; they're high in salt.
Insoluble fiber is preferable to other fibers, aiding with regularity. It can help lower blood gluco se and cholesterol, too.
Many people look at total carbohydrates on a label. That's good. But it's important to know the source of carbohydrates. "Where's the quality of the calories coming from?" he asks. Sugar? Fiber? Remember from high school chemistry that starches turn to sugars.
When you eat carbs, couple them with a healthy protein and/or a healthy fat. An apple a day (with the skin) is great; an apple a day with a handful of nuts may be better. Nuts are "very energy-dense." They're great for you, but in moderation. People tend to eat more roasted nuts than unroasted, because of the taste. Just don't overdo it.
To keep blood sugar in check, fruits with skins are preferable to fruit without skins. Citrus is an exception to that rule. That means more berries, and less melon.
Do you enjoy canned fruit? Look at the volume of sugar in it. "Generally, stay away from anything that's canned," he suggests. He likes bags of tuna. Dried fruits are generally sugar-laden; apricots less so, in comparison to other dried fruits.
"Make sure you get a lot of different colors" from vegetables and fruits, he suggests.
"Organic" foods may be better for you, even if they "tend to not look as nice." Consider the processing, the application of pesticides and anti-fungals, and recognize that at least a little bit of those substances moves forward with that shiny, bright apple. He's also a believer in cage-free, free-range eggs.
Chocolate? Sure. "Dark chocolate, once in a while," he suggests.
Pop, soda, whatever it may be called, is "the biggest source of calories for so many people," Tipirneni said. If you must have a carbonated beverage, try carbonated bottled water with carbonic acid, not phosphoric acid.
Tipirneni is an advocate of a "free day" once a week, or even a free meal once a week. For that day, or that meal, a patient can eat whatever his or her heart desires. Eat a whole cake, if you'd like, one day a week, and be disciplined the other six. "Free days are very, very important," he said. "It's all about lifestyle change."
It often takes a few weeks to learn how to eat smart, and many patients do not feel it is overly restrictive, Tipirneni said. "We work closely with our clients to build a realistic, customized, healthy lifestyle. Our philosophy is to optimize health through good medicine. It's a partnership between patient and doctor."
Reactions to the grocery store begin with surprise that a doctor would go to such length, and end with gratitude. Tipirneni schedules close follow-up appointments to see how people are doing with their diet modifications.
"People feel they have to be accountable," the doctor said. "It also encourages that they stick on the program. They are very excited with the results."
At the end of the excursion, Tipirneni hands over a $5 gift card to the La Cholla and Ina Albertson's courtesy of Chris Duncan, one of the store managers.
Both Tipirneni and Rastogi may be reached for a "mini" consultation at 461-1717, and they both take patients to the grocery store. His office is located at 7448 N. La Cholla.
Fall Healthy Expo
Saturday, Oct. 23
9 a.m.-1 p.m.
Oro Valley Hospital
Free health screenings, exercise and activities, a healthy dog tent, activities for kids, dispose-a-med, free pedometers to the first 200 people, free health bags to the first 200 people.
Presented by Healthiest Town in America