Forget Macros — A Nutrition Expert Says This Matters More For Healthy Eating

We've all been there—standing in the aisles of the grocery store doing mental math on grams of protein versus carbs. This practice has become common place in the last couple of decades, but while Americans are consuming fewer calories, they are still gaining more weight. That's why nutrition expert and cardiologist Dariush Mozaffarian, M.D., DrPH, wants you to cut the counting.

As Director of the Food Is Medicine Institute at Tufts University, Mozaffarian took me back a century in nutrition science before we got to macros. Early nutrition science scored huge wins against vitamin-deficiency diseases like pellagra, rickets, and scurvy, and later helped solve global calorie shortages through the Green Revolution, when agricultural production increased dramatically, especially when it came to wheat and rice. He explained that those early victories came from isolating a single culprit like a missing vitamin or a lack of calories, and fixing it.

Instead of tracking macros, Mozaffarian sorts foods into three buckets based on how processed they are and what they do inside the body.

The first is protective foods that you can eat without limiting yourself. They are minimally processed1, fibrous, and nutrient-rich foods nurture the gut microbiome. This includes fruits, vegetables, minimally processed whole grains, nuts, seeds, beans, legumes, plant oils, fish, yogurt, and other fermented foods2. These are the foods generally found in a Mediterranean-style diet.

Next, are foods to eat in moderation, which are generally unprocessed or minimally processed animal foods. Mozaffarian puts cheese at the top of this group, which he said surprises people. "Cheese is not linked to higher risk of heart disease. It's not linked to weight gain. And in fact, it's pretty consistently linked in observational studies3 to lower risk of diabetes," he said, crediting its fermentation. Milk, poultry, eggs, and butter fall just below cheese, then unprocessed red meat and pork fall at the bottom of this middle tier.

Looking at this framework, I was curious how Mozaffarian suggests balancing food quality with the macros we have been counting for years. For example, I pointed out that a jar of organic peanut butter, fresh from the farmer, is super high quality, but eating the whole thing probably isn't a great idea from a calorie standpoint. On the flip side, a David protein bar has incredible macros at 100 or so calories, but it contains EPG (esterified propoxylated glycerol), an ingredient that essentially mimics fat.

For Mozaffarian, a food's effect on the body depends on the whole package: its fiber, how processed it is, and the thousands of bioactive compounds it carries. He isn't asking anyone to totally ignore macros, either. "We can't totally ignore protein or totally ignore fat or totally ignore calories," he said. But when one of those numbers becomes your North Star, like if you are picking a product solely because it's lower in calories or higher in protein, he warned that "we're gonna get Frankenfoods and mistakes and problems."

Mozaffarian's advice is simple: whenever you're at the grocery store or a restaurant, decide which bucket a food falls into, and aim to specifically stock up on the top tier. "Don't even worry about calories. Eat as much as you want of those good foods," he said. Moderate foods are fine a couple of times a week, and bottom-tier foods are best saved as an occasional treat.

For starches, his rule is about placement. Skip the dinner rolls that come out at a restaurant, since eating them on an empty stomach is bad for glucose and will fill you up before you get to the good stuff. "Don't make rice or pasta or bread the center of your plate or the most of your sandwich. Make it a side," he said, and eat it alongside other protective foods.