Hi Nancy. Thank you for your comment! I like your more intensive criteria versus Tufts, which uses an up to 10 to 1 carb to fiber ratio. The problem with it is that it doesn’t take into account processed/refined added fiber. Such requires a sleuth to look on the label for maltodextrin, polydextrose, inulin/chicory root extract, oat fiber, corn fiber, wheat fiber (all refined and distinct from oat bran, wheat bran and corn bran). Also, there is a way to assess meals more completely once educating a client or patient on the detective work needed to see if processed/refined fibers are added (which either this upcoming or your calculation would need anyway). It’s called PF10™. Calculation goes like this… Take the fiber grams (which for high quality PF10 “score” must be at least 2 g for every 100 cal - to avoid giving high quality scores to meals that are simply high in protein and devoid of Mich fiber) and add them to the protein grams. That sum (fiber grams plus protein grams) is then multiplied by 10 to give the PF10. It is the PF10/calorie ratio that is the target for final assessment. For a good quality meal, PF10/calorie ratio (longevity score) should be at least 75%. For high quality >=100% (for which virtually all beans or lentils meet, notably). If PF10 is low for a day’s worth of food (

@@DrTomMD Fiber + Protein then divide by 10. 75% or better. And back to the less ingredients the better. Amazingly I had lentils for lunch. Lol

Then multiply by 10..

@@nancyevans5176 love legumes!👍🏽🙏🏽

Processed added fiber doesn’t hurt. It may be a little bit better. But what we are concerned about is that people will believe that processed added fiber has the same level of data and benefit as naturally occurring fiber

I love good healthy things stuffed into a tortilla. Am I moving in a helpful direction if I use a high fiber/low-carb tortilla instead of a normal I realize it’s not health food, but is it better?

That’s a good question that requires some nuance. If by chips you mean a no salt added kettle chips cooked in low saturated fat oil, I’m not sure if fiber one bar is better. But is a fiber one bar lower risk than a whatchamacallit bar? I say yes. Lower saturated fat, and combination of naturally occurring fiber and processed added fiber which, again, isn’t harmful. Its problem is that it is advertised to be as good as naturally occurring fiber but isn’t. I like an occasional fiber one bar too … though fiber one cereal stands out as one of the healthiest cereals ever invented along with plain shredded wheat 🌾

Tx. Would be fascinating to you and me. But esoterica for most. In the same spirit of your comment regarding first world issues, less than 1% of the United States crop land is certified organic. So, to whom would we be speaking? Nevertheless, I have run just such clinical experiments in individuals doing one then switching. What happens every time would almost assuredly happen again in your experiment - though I would prefer to use a proper form of flexitarian (eg as described in my Masterclass DPM.DrTomRifai) - is insulin sensitivity would be great on both, while lipids would be better on plant predominant flexitarian and, presuming that organic doesn’t whatsoever rule out the typical high salt intake of keto, blood pressure also better on Flex5 (ie my) version of Flexitarian, which respects the principled Paleo perspective on sodium. Biomarkers to compare: accurate resting blood pressure, LDL particle concentration and insulin sensitivity using NMR Lipoprofile (see precisionhealthreports.com) blended with fasting insulin and fasting glucose as well as body composition analysis via DEXA scan. We could deep dive further but those are the core four markers I’d suggest to compare. Best

@@DrTomMD Interesting. As far as blood pressure is concerned I would prefer to add a CAC score. I would take issue regarding LDL. It's not LDL volume which is the issue, it's the particle size. Also, research suggests Lp(a) is a better indicator of cholesterol status. I think the TG:HDL ratio provides a good, simple indicator. (should be well below 1) Also, remnant cholesterol, total cholesterol minus HDL and LDL shows how much VLDL is hanging around the bloodstream which can increase Homocysteine levels. Non of these issues are due to injesting saturated fat (high quality of course). In fact, relatively high LDL (not hypercholesterolemia) has been shown to be cardio and immuno protective. Dave Feldman would make an interesting interviewee? I agree that a HOMA-IR Test and DEXA scan are also great.

@@anthonylawrence5842 coronary artery calcium scoring is a relatively fixed, slow moving issue. If one expects to measure the difference of an intervention over weeks, CAC score (of which mine is 0 despite very elevated Lipoprotein A, which is another critically important test - but like CAC does not change much if at all over time as it is largely driven by genetics) will not help you other than to know their baseline risk…Which, if CAC high, one better hope the intervention lowers risk as I know what I would suggest does since I have well over 20,000 hours of clinical experience in multidisciplinary care metabolic health doing so, otherwise one is betting on their subjects/patients lives. Homocystine has very little direct influence on arterial cardiovascular risk versus the numbers I provided and commonly correlated with them. More influential in terms of venous clotting. You are incorrect regarding lipids. What’s control for LDL particle concentration, LDL size has no direct influence on risk, only indirect. I would suggest you read the works of Otvos and Cromwell, former president of the national lipid association. LDL particle concentration is king over all of the indirect measures that you discuss, other than VLDL remnants which I will address in a moment. Once controlled for LDL particle number, LDL size has no direct impact on risk. Ie if someone has a high LDL particle number with large particle size the risk is higher than someone with small LDL particle whose total LDL particle concentration is low. It is notably less likely, but certainly still quite possible, that someone with a smaller LDL particles will have a lower LDL particle concentration (including me), but it happens all the time. I live and breathe it, professionally and personally. Not sure how many advanced lipid analyses you have ordered in your clinical career but for me it is on the order of thousands over decades. Regarding VLDL remnants, absolutely saturated fat has an influence. I’m not sure what you are reading but it is incorrect if you think saturated fat has no untoward affect on lipids or VLDL remnants as well as on fatty liver. Go back and recheck more than a few papers. Saturated fatty acids, certainly the ones commonly concerned, certainly do, as do CRRAHP (calorie Rich, refined and highly processed) carbohydrates. If you don’t mind me asking, what is your knowledge base based on? Are you a metabolic MD or PhD with any clinical experience? Sorry if I can’t continue this conversation today or the next few days. Very busy. But thanks for engaging. I appreciate a good and friendly joust :-)

​@@DrTomMDmasterful response. Very well said!

A non sequitur. We already know what they would turn to - The proof is before us along with the disease rates to come with it, of course blended with a massive increase in sedentary lifestyle as it’s not just food alone nor is there any silver bullet (is all about silver buckshot) and that’s the issue at hand. So I’m not sure of your point. That because people would choose to rely heavy on heavy dairy and fatty CFAO meat over legumes and tubers that they would be healthier for it?