Preventive Medicine Column

Dr. David L. Katz

I suspect I am known in many circles as “that nutrition guy,” and as such, among the last people you want to hear from just before Thanksgiving!   It’s true that the application of food as the best medicine we’ve got to advance the human condition is the focal point of my career.  But it’s equally true that I believe in a figurative spoon full of sugar to help the medicine go down.  I believe we should all get to love food, even as we make the necessary adjustments to make sure it loves us back.

It’s hard to imagine a Thanksgiving not centered around food.  However unreliable the Thanksgiving origin stories tend to be, the inspiration for the holiday clearly has much to do with sustenance and bounty.

Feasting figures prominently in most special occasions, and with good reason: it’s a big part of what makes them special.  The term holiday- which derives from “holy” day- refers to times when business as usual is suspended.  That means no work, for one thing.  For another, it means bountiful food.

Throughout the long human history of holiday celebrations, bountiful food was, indeed, a departure from everyday norms.  While aristocrats may have lived large every day, the masses- our predecessors- barely scraped by.  A holiday was, in principle at least, a chance for everyone to get a literal taste of the good life, before a harsh return to subsistence.

Given this long tradition, I would argue that Thanksgiving is, in general, a particularly bad time to practice dietary restraint.  It’s supposed to be about bounty, so bountiful indulgence pretty much belongs on the menu.

But the trouble is the context.  In modern society, business as usual does not entail a daily demand on our muscles and just enough fuel to get us through another day.  Whereas calories were scarce and hard to get and physical exertion unavoidable throughout most of human history, we now find ourselves in a modern environment of our own devising in which physical exertion is scarce and hard to get, and calories all but unavoidable.  Feasting on the holiday is a variation on the prevailing theme of over-eating every day.

A theme that is taking a toll familiar to us all: epidemic obesity, epidemic diabetes, and so on.  A toll measureable in both lives, and dollars.  A global toll, too; there are now more overweight than hungry people on the planet, by a margin of at least several hundred million.  And an ever-worsening toll.  The CDC projects that by mid-century, a stunning- and devastating- one in three of us will have diabetes.

But still, abandoning the abandon of holidays such as Thanksgiving is not a preferred solution.  There are better options.

First, take advantage of Thanksgiving to consider – between mouthfuls of food- what else you have to be thankful for.  People will figure prominently on this list for most if not all of us.  The health of those people- friends, family, our children, ourselves- is, in fact, a universal priority.  How we and they eat throughout the year will meaningfully and quite predictably influence their health.  So much of what we have to be thankful for on Thanksgiving does, in fact, become a reason to try to eat well every other day.

The holiday itself is a great opportunity for some pleasant recreation.  Get outdoors with your clan for a walk, or hike, or game of football.  The food will taste even better if you do.

Another product of Thanksgiving reflection might be a new way of thinking about indulgence.  If you eat whatever you want, whenever you want, as much as you want just because it tastes good, neither your weight nor your health will be what you wish them to be.  On the other hand, if you went to extremes to have the physique of an underwear model, there is a good chance your diet would be quite a long way from you would wish it to be.

The sweet spot is actually where the pleasure you get from food that tastes good, added to the pleasure you get from food you feel good about having eaten- equals the greatest possible sum.  This “point of preference” is not about sacrifice; it’s about getting the most net pleasure and quality in your life.  It’s where loving food, meet food that loves you back.

I’m pleased to say there are new and easier ways to get there from here than ever before.  The NuVal nutritional guidance system (, the development of which I oversaw, is now in Big Y supermarkets in our area.  On a scale from 1 to 100, the higher the number, the more nutritious the food.  Numbers appear on the supermarket shelf, right next to the price.

The NuVal system is like GPS; it does not tell you where to go, but it does make it easy to reach your destination.  In almost every food category and supermarket aisle, you can find highly nutritious foods that are as affordable and tasty as the less nutritious choices you may be making now.

I am thankful for our bountiful Thanksgiving feast.  But I am more thankful for the health of my mother who prepares it.  I am more thankful for the health of my wife, and kids, and family and friends who gather at our table.  Giving thanks helps highlight what matters.

So feast well.  Just leave a little room for some food for thought.  Happy holiday, and good health.




Dr. David L. Katz;