CORE FOOD PLAN
Comprehensive Guide
Version 3
Table of Contents
Why the Core Food Plan? ............... 3
Features of the Core Food Plan ...... 4
Touring Through the Food Plan ....... 8
Frequently Asked Questions ......... 18
Resources and Tools for Success .. 26
© 2016 The Institute for Functional Medicine
IFM
n
Core Food Plan Comprehensive Guide
3
Why the Core Food Plan?
© 2016 The Institute for Functional Medicine
The Core Food Plan (CFP) is designed for those who are interested in:
n
Core principles of healthy eating
n
Health maintenance
n
Disease prevention
n
Awareness of one’s relationship with food
The CFP is a rst step towards healthier eating and is designed to encourage eating in a way that will nourish and
energize the body. It is based on current research on what and how people should eat in order to live long, healthy
lives. It takes elements from the Mediterranean diet and the hunter-gatherer approach (sometimes referred to as the
“Paleo” diet), and encourages eating low-glycemic carbohydrates.
This food plan can be easily changed to suit personal preferences and health needs. It is available with vegetarian
and vegan modications, and can accommodate foods from virtually any culture. This Comprehensive Guide
provides tools and information that will make it easy to tailor the food plan based on individual needs. In addition
to plan details, this guide answers many questions that might arise when beginning a new food plan.
We call this a “core” food plan because it lays the foundations for eating well that will carry an individual
throughout life. The CFP uses the basic principles of “food as medicine” to support an individual’s health goals and
improve his or her relationship with food.
IFM
n
Core Food Plan Comprehensive Guide
4
Features of the Core Food Plan
© 2016 The Institute for Functional Medicine
This food plan was created by a team of Functional Medicine physicians and nutrition professionals to help
individuals learn to eat a balance of healthy, whole foods that support optimum health.
n
Foundational eating plan: This plan starts individuals on a journey to
better health. It allows people to meet daily needs for the macronutrients:
protein, fats, and carbohydrates. It also supplies all the necessary minerals,
vitamins, and phytonutrients, along with adequate ber and uids. On this
plan, individuals can choose from a wide variety of high-quality foods to
incorporate into meals each day. Healthy snacking is encouraged.
The CFP is appropriate for children, adults of all ages, and pregnant
women. The plan can also be easily adapted for meat eaters, vegetarians,
and vegans alike. It can also be modied to meet the needs of athletes,
achieve weight loss or gain, control blood pressure, and exclude dairy,
gluten, or any foods to which one is allergic, intolerant, or sensitive. Foods
are grouped into categories. In some cases, a practitioner may recommend
a number of servings to consume from each category every day. The
number of meals and snacks may be changed each day to help distribute the allotment of
food in a way that best meets individual needs.
n
Focus on whole foods: Whole, plant-based foods are an important source of ber and
phytonutrients. Dietary ber is critical for proper health and digestion. Fiber binds to
toxins and excess hormones and helps the body excrete them. Fiber is also the preferred
food of the cells that line the digestive tract. Phytonutrients are plant-based compounds
with a wide range of antioxidant and anti-inammatory health benets. These
compounds give fruits and vegetables their deep hues, and phytonutrient-rich foods can
often be identied by their color. (For example, the phytonutrient beta-carotene is found
in yellow-orange foods like carrots, winter squash, cantaloupe, and papapa.)
n
Promotes clean and organic: Eating “clean” food helps to reduce toxin
exposure. Our food supply has become compromised by the addition
of articial colorings, avorings, additives, and preservatives. Pesticides,
insecticides, and herbicides are also found in conventionally-grown
(non-organic) produce, whole grains, nuts, seeds, and legumes. One of
the biggest nutritional problems is the amount of synthetic sweeteners
in highly processed foods. Eating a “clean” diet—avoiding non-organic,
processed foods—can increase the liver’s ability to eliminate toxins and
lower the toxic burden in the body. For these reasons, the CFP promotes
eating organic foods.
IFM
n
Core Food Plan Comprehensive Guide
5
Features of the Core Food Plan
© 2016 The Institute for Functional Medicine
n
Adequate quality protein: Protein is necessary to repair cells and make
new ones, support muscle growth, maintain lean muscle mass, and
stabilize blood sugar and insulin levels (which also helps to control
hunger). Every cell in the human body contains proteins: they are the
building blocks of life. Choices for protein on the CFP are moderately
lean and include both animal and plant foods. Choosing protein from
grass-fed and free-range animals and poultry is encouraged for omnivores.
Such “clean” protein is not just lower in toxins but also higher in omega-3 fatty acids than is
protein from corn-fed and caged animals and poultry. Given its vital role in bodily functions,
protein should be included with every meal and snack.
n
Balanced quality fats: Balancing dietary fat intake is a rst-line approach to
minimizing inammation in the body. Anti-inammatory strategies include the
following: (1) eliminate trans fats (typically found in processed foods); (2) decrease
intake of saturated fats and omega-6 fats from animal sources; and (3) increase
intake of omega-3–rich fats from sh and plant sources. Dietary fats and oils play
a signicant role in the risk of many chronic diseases. The emphasis on fat-free
foods in the latter part of the 20th century led only to weight gain, because the
fat in processed products was replaced with rened sugar. Rened sugars also
convert to body fat and can increase levels of blood fats called triglycerides.
Our general guideline is that it is better to replace saturated fat with unsaturated
(liquid) fats rather than with rened carbohydrates. There are many types of
saturated fats, and they have dierent eects on the body. In the CFP, healthy
sources of saturated fat have been included, such as coconut oil and butter from
grass-fed cows. Anti-inammatory fats from foods like sh, leafy greens, nuts,
certain oils, and seeds are also featured in the CFP.
n
High in ber: The average individual living in a Western country who eats mostly
processed food gets only about one-third of the ber they need every day. Eating the
whole, unprocessed foods listed in the CFP will provide the body with more dietary
ber. Fiber is found in plant-based foods like whole grains, nuts, legumes, vegetables,
and fruits. It is a form of carbohydrate that the body doesn’t digest, so consuming it
makes the body feel more full without eating a lot of additional calories.
There are two types of dietary ber, each with dierent benets.
Insoluble ber can
be found in the bran (outer coat) of vegetables and whole grains. This type of ber
acts like a bulky “inner broom, sweeping out debris from the intestine and helping
the intestines move food along. The other type of ber, called
soluble ber, attracts
water and swells, creating a gel-like mass that slows down digestion. The gel helps trap
toxins and other undesirable substances (including cholesterol and other dietary fats)
so that the body can excrete them. It also provides “food” for healthy bacteria in the digestive tract.
Soluble ber is found in foods like oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and
vegetables. It is also found in supplements that contain psyllium. Individuals should aim to consume
at least 5 grams of ber per serving of food, or a total of 25 to 35 grams of dietary ber per day.
IFM
n
Core Food Plan Comprehensive Guide
6
Features of the Core Food Plan
© 2016 The Institute for Functional Medicine
n
Low in simple sugars: Sugars contribute a signicant portion of calories to the
American diet, particularly through sugar-sweetened beverages, rened grains, and
desserts. Added sweeteners are also present in processed foods such as salad dressings,
frozen meals, soups, and condiments. Sodas, fruit drinks, tea and coee when
sweeteners are added, energy/sports drinks, and avored milks are sources of empty
calories. The result of all these added sweeteners has been a substantial increase in the
incidence of type 2 diabetes (T2D) in younger people, laying the groundwork for
obesity and the development of heart disease.
The CFP limits added sweeteners to help reduce cravings for more sweets. Removing
sweeteners also helps to minimize inammation and prevent dramatic surges in blood
sugar and insulin, helping to stabilize blood sugar levels. Sweeteners do not all have
the same eect on the body. Some have a very gentle eect (low glycemic), while
others lead to cravings (higher glycemic). With this in mind, no more than 1 to 3
teaspoons of the following lower glycemic sweeteners should be used daily: barley malt, brown rice
syrup, blackstrap molasses, maple syrup, raw honey, coconut sugar, agave, lo han, fruit juice concentrate,
and erythritol. Stevia is also well tolerated by most people, but it is a high-intensity herbal sweetener
that requires no more than a pinch for maximum sweetness. Overall, most sweeteners perpetuate a
need for sweet-tasting food and make it dicult to enjoy the natural sweetness in all fruits and certain
vegetables. Thus, approved sweeteners should be enjoyed in moderation.
Label reading is necessary to detect added sugars. Natural and articial sweeteners to be avoided
appear on food labels as dierent names, including the following: aspartame, brown sugar, cane sugar,
caramel, confectioner’s sugar, corn syrup, corn syrup solids, date sugar, Demerara sugar, dextrose,
evaporated cane juice, fructose, fructose syrup, glucose, high fructose corn syrup, invert sugar,
NutraSweet
, maltitol, maltodextrin, maltose, mannitol, sorbitol, Splenda
, sucrose, and turbinado
sugar. Eating whole foods should be the focus when following the IFM Core Food Plan; removing
processed foods reduces the worry about exposure to added sugars and will make the natural
sweetness of a low-glycemic piece of fruit more enjoyable.
n
Phytonutrient diversity: Plant (“phyto”) foods contain thousands of compounds that communicate
with the cells in the body and change how it functions. At this time, about 10,000 of these
compounds have been identied, but many thousands of others haven't yet been fully identied or
classied. We may eat only a small amount of some every day, yet they can have dramatic eects in
the body. Several of them—like the bitter compounds in arugula and other green leafy vegetables,
the resveratrol in grapes and red wine, and the astringent compounds in green tea—appear to be
benecial for health. Some phytonutrients may help regulate blood sugar,
lower LDL cholesterol, and get blood pressure back into a healthier range.
Colorful plant foods should be included in each meal and snack to make
eating more appealing; while providing the body with an abundance of
critical nutrients and phytonutrients. The CFP encourages eating a variety of
phytonutrient-rich fruits and vegetables every day by challenging individuals
to eat six dierent colors of plant foods daily (red, orange, yellow, green, blue-
purple, and tan/white).
IFM
n
Core Food Plan Comprehensive Guide
7
Features of the Core Food Plan
© 2016 The Institute for Functional Medicine
IFM
n
Core Food Plan Comprehensive Guide
8
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
8
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
The CFP is a whole-foods way of eating that allows for balanced meals. The food list provides a “snapshot” of
healthy foods to choose every day. It suits all eating styles, with vegetarian or vegan options. Additionally, healthcare
providers may make other recommendations based on an individual’s specic dietary needs.
This section of the Comprehensive Guide is organized by category of food. In some cases, healthcare providers
may choose to recommend daily calorie amounts for an individual based on his or her age, gender, size, and activity
level. These amounts can be met by selecting specic foods within each of the dierent categories each day. Calorie
counting is usually only needed initially to help individuals understand portion sizes and learn how to balance
choices of protein, fat, and carbohydrate-rich foods. As one becomes more practiced in following the CFP, the
quality of foods—rather than calorie amounts—will become more of a priority. Once balancing quality protein, fat,
and carbohydrates in meals becomes intuitive, there will be no need to count calories.
Proteins: Plant and Animal Sources
The two key words to remember when choosing plant and animal proteins are
lean and clean. As Michael Pollan writes in his book, Food Rules,
“Eat animals
that have themselves been well fed.
Grass-fed and pasture-raised beef, wild-
caught sh, and meat and eggs from free-range poultry are all excellent sources
of protein and healthy fats. For plant proteins, the best choice is a complete
protein from organic sources. A complete protein is one that has all of the amino
acids that are essential to human health. Soy is a complete protein. However,
much of the domestically grown soy today is a genetically-modied organism
(GMO). Because the long-term eects of eating GMOs are not known, the CFP
recommends choosing soy that is 100% organic, which by denition includes no
GMO ingredients. High-quality organic soy foods like soybeans (edamame) and soy
sauce can be included in stir-fries, spreads, sauces and dips. Additionally, fermented
soy provides protein as well as benecial bacteria. Examples of fermented soy foods
are miso soup, tempeh, and natto. For those who avoid soy, alternative, non-soy plant
proteins include protein powders, legumes, nuts, seeds, dairy products, and dairy alternatives.
Core Food Plan
FATS & OILS Fats
Servings/day______
Minimally rened, cold pressed, organic,
non-GMO preferred
Avocado–2 T or
⅛ whole
Butter–1 t, 2 t
whipped
Chocolate, dark
(70% or higher
cocoa)–1 oz
Coconut milk,
regular (canned)
1½ T
Coconut milk, light
(canned)–3 T
Ghee/claried
butter–1 t
Half and half–2 T
Mayonnaise
(unsweetened)–1 t
Oils, cooking:
Avocado, butter,
coconut (virgin),
grapeseed, olive
(extra virgin), rice
bran, sesame–1 t
Oils, salad: Almond,
avocado, canola,
axseed, grapeseed,
hempseed, olive
(extra virgin),
pumpkin seed,
saower (high-
oleic), sesame,
sunower (high-
oleic), walnut–1 t
Olives: Black, green,
kalamata–8
Pesto (olive oil)–1 T
Salad dressing made
with quality oils–1 T
1 serving = 45 calories, 5 g fat
PROTEINS Proteins
Servings/day______
Lean, free-range, grass-fed, organically grown
animal protein; non-GMO, organic plant protein;
and wild-caught, low-mercury sh preferred.
Animal Protein:
Cheese (hard)–½ oz
Cheese (low-fat)–1 oz
Cottage cheese
(low-fat)–¼ c
Feta cheese
(low-fat)–1 oz
Parmesan cheese–2 T
Ricotta cheese
(low-fat)–¼ c
Egg–1; or 2 egg whites
Fish/Shellsh–1 oz
Meat: Beef, bualo,
elk, lamb, venison,
other wild game–1 oz
Poultry (skinless):
Chicken, Cornish
hen, duck, pheasant,
turkey, etc.–1 oz
Plant Protein:
Mung bean/
Edamame pasta–1 oz
Natto–1 oz
Nutritional yeast–2 T
Spirulina–2 T
Tempeh–1 oz
Tofu (rm/extra
rm)–1½-2 oz
Tofu (soft/silken)
3 oz
Protein Powder:
Check label for
# grams/scoop
(1 protein serving=7 g)
Egg, hemp, pea, rice,
soy, whey
1 serving as listed = 35–75 calories, 5–7 g protein, 3–5 g
fat, 0–4 g carbs
Average protein serving is 3–4 oz (size of palm of hand).
LEGUMES Proteins/Carbs
Servings/day______
Organic, non-GMO preferred
Bean soups–¾ c
Black soybeans
(cooked)–½ c
Dried beans, lentils,
peas (cooked)–½ c
Edamame (cooked)
½ c
Flour, legume–¼ c
Green peas
(cooked)–½ c
Hummus or other
bean dips–⅓ c
DAIRY & ALTERNATIVES Proteins/Carbs
Servings/day______
Unsweetened, organic preferred
Dairy:
Ker (plain)–6-8 oz
Milk: Cow, goat–8 oz
Yogurt, Greek
(plain)–6 oz
Dairy Alternatives:
Milk: Almond,
coconut, axseed,
hazelnut, hemp, oat,
rice, soy–8 oz
Yogurt: Coconut, soy
(cultured)–4-6 oz
Ker: Coconut,
soy–4-6 oz
1 dairy serving = 90–150 calories, 7–8 g protein, 12 g carbs
1 dairy alternative serving = 25–90 calories, 1–9 g protein,
1–4 g carbs (nutritional values vary)
NUTS & SEEDS Proteins/Fats
Servings/day______
Unsweetened, unsalted, organic preferred
Almonds–6
Brazil nuts–2
Cashews–6
Chia seeds–1 T
Coconut (dried)–3 T
Flaxseed (ground)–2 T
Hazelnuts–5
Hemp seed–1 T
Macadamias–2-3
Nut and seed
butter–½ T
Peanuts–10
Pecan halves–4
Pine nuts–1 T
Pistachios–16
Pumpkin seeds–1 T
Sesame seeds–1 T
Soy nuts–2 T
Sunower seeds–1 T
Walnut halves–4
1 serving = 45 calories, 5 g fat
Refried beans,
vegetarian–½ c
Veggie burger
(non-GMO)–1 patty
1 serving = 90–110 calories, 3–7 g protein, 0 fat, 15 g carbs
© 2016 The Institute for Functional Medicine
Notes: Nutritional amounts are based on average values for the
variety of foods within each food category.
Dietary prescription is subject to the discretion of the
health practitioner.
Version 11
VEGETABLES Non-starchy Carbs
Servings/day______
Artichoke
Arugula
Asparagus
Bamboo shoots
Beets (cubed)
Bok choy
Broccoower
Broccoli
Brussels sprouts
Cabbage
Carrots
Cauliower
Celeriac root
Celery
Chard/Swiss chard
Chervil
Chives
Cilantro
Cucumbers
Daikon radishes
Eggplant
Endive
Escarole
Fennel
Fermented
vegetables: Kimchi,
pickles, sauerkraut,
etc.
Garlic
Green beans
Greens: Beet, collard,
dandelion, kale,
mustard, turnip, etc.
Horseradish
Jicama
Kohlrabi
Leeks
Lettuce, all
Microgreens
Mushrooms
Okra
Onions
Parsley
Peppers, all
Radicchio
Radishes
Salsa
Scallions
Sea vegetables
Shallots
Snap peas/snow peas
Spinach
Sprouts, all
Squash: Delicata,
pumpkin, spaghetti,
yellow, zucchini, etc.
Tomato
Tomato juice–¾ c
Turnips
Vegetable juice–¾ c
Water chestnuts
Watercress
1 serving = ½ c, 1 c raw greens = 25 calories, 5 g carbs
VEGETABLES Starchy C arbs
Servings/day______
Acorn squash
(cubed)–1 c
Butternut squash
(cubed)–1 c
Plantain– ⅓ c or
½ whole
Potato: Purple, red,
sweet, yellow–½ med
Potatoes (mashed)
½ c
Root vegetables:
Parsnip, rutabaga–½ c
Yam–½ med
1 serving = 80 calories, 15 g carbs
FRUITS Carbs
Servings/day______
Unsweetened, no sugar added
Apple–1 sm
Applesauce–½ c
Apricots–4
Banana–½ med
Blackberries–¾ c
Blueberries–¾ c
Cherries–12
Cranberries–¾ c
Dates or gs–3
Dried fruit–2 T
Grapefruit–½
Grapes–15
Goji berries
(dried)–2 T
Kiwi–1 med
Mango–½ sm
Melon, all–1 c
Nectarine–1 sm
Orange–1 sm
Papaya–1 c
Peach–1 sm
Pear–1 sm
Persimmon–½
Pineapple–¾ c
Plums–2 sm
Pomegranate
seeds–½ c
Prunes–3 med
Raisins–2 T
Raspberries–1 c
Strawberries–1¼ c
Tangerines–2 sm
1 serving = 60 calories, 15 g carbs
WHOLE GRAINS (100%) Carbs
Servings/day______
Unsweetened, sprouted, organic preferred
Gluten Free:
Amaranth–⅓ c
Buckwheat/
kasha–½ c
Grits: Corn, soy–½ c
Millet–½ c
Oats: Rolled, steel-
cut–½ c
Quinoa– ½ c
Rice: Basmati, black,
brown, purple, red,
wild–⅓ c
Sorghum–⅛ c
Te –¾ c
All grain servings are for
cooked amounts.
Gluten Containing:
Barley–⅓ c
Bulgur–½ c
Cereal, whole
wheat–½ c
Couscous–⅓ c
Crackers, rye–4-7
Kamut–½ c
Spelt–⅓ c
Individual portions:
Bread–1 slice
Granola
(homemade)–3 T
Muesli–½ c
Pasta–⅓ c
Pita–½
Tortilla–1, 6 in
1 serving = 75–110 calories, 15 g carbs
BEVERAGES, SPICES & CONDIMENTS
Unsweetened, no sugar added
Filtered water
Sparkling/mineral
water
Fresh juiced fruits/
vegetables
Coconut water
Coee
Tea: Black, green,
herbal, etc.
Herbs and Spices, all
Condiments:
Lemon/lime juice,
miso, mustard,
tamari, vinegars,
etc.use sparingly,
suggest 1 T or less
per serving
Organic, non–GMO fruits, vegetables, herbs and spices preferred
© 2016 The Institute for Functional Medicine
IFM
n
Core Food Plan Comprehensive Guide
9
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
9
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
Quick Tip: Avoid GMO ingredients by choosing 100% organic for both plant and animal
proteins whenever possible. When choosing foods that may not be organic, look for ‘Non-
GMO’ on the label.
Rule of thumb for portions of protein: There are approximately 7 grams of protein per serving listed in the CFP (e.g.,
1 ounce of lean meats, sh, and cheese; 1 egg; ½ cup of tofu). A typical serving size of animal protein for a meal (3 to 4
ounces) is about the same size as the palm of an average-sized human hand. The size of a st (approximately ¾–1 cup) is
the serving size for plant-based proteins like tofu, tempeh, or edamame, as well as dairy proteins like cottage cheese.
Vegetarian options: The protein section of the Vegetarian CFP is divided into plant proteins
VE
V
as well as lacto
VL
,
ovo
VO
, and pescatarian
P
food options to accommodate individual preferences.
Tips for eating lean and clean protein sources include:
n
Eating lean animal protein at each meal and snack to promote satiety and keep
blood sugar stable
n
Consuming lean cuts of red meat (lean loin, tenderloin, and ank cuts) from
free-range sources
n
Using omega-3-rich eggs from free-range hens as a quick protein source for
meals or snacks
n
Using organic tofu or tempeh in a colorful vegetable stir-fry
Legumes
Legumes are considered a combination food on the CFP, as they contain hearty
amounts of both
protein and carbohydrates. These plant proteins have been a staple
food in many cultures for thousands of years and are often a key ingredient in delicious
ethnic dishes from around the world. Legumes contain quality protein and ber, yet
have very little fat. Additionally, they are rich in nutrients like B vitamins, potassium,
and magnesium. They are a perfect way to get both quality protein and complex
carbohydrates that will promote satiety and keep blood sugar stable.
Vegetarian or vegan eaters must understand that the protein content from legumes,
seeds, nuts, and grains usually lacks one or more of the essential amino acids. By
combining dierent foods (for example, legumes or seeds/nuts with rice or grains), a
complete set of amino acids can be obtained. It is preferred, but not necessary, to eat
these complementary foods at the same meal. However, complementary foods should
be consumed on the same day, if possible."
IFM
n
Core Food Plan Comprehensive Guide
10
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
10
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
Quick Tip: Most prepared hummus is made with simple ingredients (ground garbanzo beans,
sesame tahini, olive oil, garlic, and lemon) and is readily available at your grocery store.
However, it’s also easy to make from scratch using organic dried or canned garbanzo beans. If
using dried beans, soak the beans overnight to shorten the cooking process, soen the beans,
and decrease gas-producing carbohydrates. If using canned beans, rinse rst to reduce the
salt content before making hummus. You can also add canned beans to salads or soups.
Tips for eating more legumes include:
n
Spreading hummus on a tortilla, or in place of mayonnaise on a sandwich
n
Using hummus as a dip for vegetables or organic corn chips for a healthy snack
n
Adding black beans or red kidney beans to salads and soups
n
Eating edamame as a snack
n
Combining beans with quinoa or rice and a rainbow of vegetables for a tasty salad
Dairy and Dairy Alternatives
Dairy and dairy alternatives are considered a combination food on the CFP, as they contain all three
macronutrients:
protein, carbohydrate, and fat. Although milk and other dairy products have long been a staple of
Western diets, there is controversy as to whether dairy products are appropriate food for humans. Similarly, there’s
controversy as to whether modern processing decreases the digestibility and potential nutritional value of dairy
products; some argue that raw, unprocessed forms of dairy from cows, goats, or sheep raised on organic pastures
are more appropriate (but still should be consumed only in moderate amounts). There is also concern about the
potential for commercial dairy products to contain antibiotics, hormones, and residual pesticides and herbicides
from the foods the animals consume.
Some choose to avoid all dairy foods due to dairy sensitivities or ethical reasons.
For these individuals, the CFP provides a separate list of dairy alternatives.
The CFP
encourages choosing organic dairy products and organic dairy alternatives such as
organic soy, rice, almond, hemp and coconut milks, kers, and yogurts. Plain yogurt is
the healthiest form of dairy and provides extra protein. Only milk alternatives labeled
‘unsweetened’ should be used. The coconut milk in this category is generally the
boxed or watered variety. The coconut milk in the fats category of the CFP list is the
canned variety, which is much higher in fat. When buying any canned products, only
those labeled “BPA-free” should be purchased in order to avoid exposure to toxins.
Quick Tip: Yogurt and ker from fermented dairy and dairy alternatives are also a rich source of
benecial bacteria that support gastrointestinal health, and these foods should be consumed
oen. Organic, plain varieties of these products are the best choices to consider.
IFM
n
Core Food Plan Comprehensive Guide
11
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
11
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
Tips for incorporating healthy dairy/dairy alternatives into meals include:
n
Using almond, hemp, or coconut milk in smoothies and soups
n
Using plain yogurt and ker as a healthy base for dips and sauces, a topping for fruits, or a
standalone snack
Nuts & Seeds
Like legumes and dairy, nuts and seeds are also considered a combination food. They
are an excellent source of
healthy fat and protein—as long as they are not covered with
sugar or salt! They are also packed with ber, key minerals (like magnesium, selenium,
and zinc), and fat-soluble vitamins like vitamin E. Small amounts of raw or roasted nuts
and seeds added to meals and snacks can be a part of a healthy diet.
Quick Tip: Nuts and seeds are good plant sources of protein. Peanuts (technically a legume but
usually thought of as a nut) tend to be the most pesticide-laden, so it’s important to choose organic
peanuts and peanut butters whenever possible. In general, any nut butters consumed while
following the CFP should have no added sugars or fats. For vegetarians and vegans, nuts and seeds
need to be combined with complementary foods in order to provide a complete protein.
Caution: Individuals with nut allergies should avoid them entirely. Often those allergic to nuts can tolerate seeds as a source of
healthy fat, ber, and protein. Hemp, chia, sunower, and sesame seeds all provide a rich source of healthy fats and protein. Those with
diverticulitis should avoid all whole nuts and seeds, but might consider smooth nut and seed butters as listed on the CFP food lists.
Tips for incorporating nuts and seeds into meals and snacks include:
n
Consuming high-quality, low-heat-roasted nuts and seeds as a snack or sprinkled on top of
salads, soups, and smoothies
n
Spreading 1 to 2 tablespoons of nut or seed butters on celery or an apple
n
Adding 1 tablespoon of ground axseed or chia seeds to your favorite smoothie or
unsweetened applesauce
n
Spreading 1 to 2 tablespoons of nut or seed butter on a rice cake and topping with fresh fruit
n
Drizzling tahini (sesame seed butter) over vegetables or hummus as part of a savory meal or snack
Fats & Oils
Eating high-quality, minimally-processed, organic fat and oils is of utmost importance.
Fats are not only used for energy, but are needed in the membrane around every cell in
the body. A minimum of four servings per day of fats/oils with two servings of nuts is
suggested on the CFP.
Please note the serving sizes in this section; they are very small,
which may be challenging for some.
IFM
n
Core Food Plan Comprehensive Guide
12
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
12
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
People have become fearful of eating fats in general because they are known to be high in calories and, as such, are
thought to be fattening. A diet that is low in fat is not satisfying, and cravings can result in overeating. Fats stay in the
stomach longer, helping you to feel satised for a longer period of time. Current research is conrming that healthy
fat and cholesterol are not the cause for many of the diseases of inammation that are rampant in the Westernized
world; rather, the problem is too many processed fats and rened grains and sugars.
Quick Tip: Avoid overly rened forms of trans (hydrogenated) fats and oils found in margarine, store-
bought salad dressings, and other processed foods. If the label lists “partially hydrogenated fat” of
any type on the ingredient list, the food should not be eaten.
Oils listed on the CFP are anti-inammatory, minimally-processed, omega-3–rich, monounsaturated,
and benecial. These oils should be used in small amounts in meals and snacks, and should be
organic whenever possible. Look for “cold-pressed”,expeller-pressed”, “unrened” and extra
virgin on labels when purchasing olive oil. Use olive oil when cooking over low heat. Use unrened
sesame, grapeseed, sunower, or coconut oil for baking and cooking over medium to high heat.
Flax and walnut oils can be used for homemade salad dressings. Small amounts of butter from
grass-fed cows can provide a natural source of Vitamin K, which helps the body absorb Vitamin D
for strong bones and optimal immune function.
Tips for incorporating healthy fats into meals each day include:
n
Drizzling olive oil on a fresh salad or sautéed vegetables
n
Making fresh guacamole to spread on foods or use as a dip, or slicing ripened avocados over
eggs, salads, soups, or a turkey sandwich
n
Adding black, green, and purple olives to salads, or eating them as a snack (rinsed before
eating to reduce sodium content)
n
Limiting benecial saturated fats to approximately one or two servings per day
n
Choosing organic extra-virgin coconut oil and BPA-free canned coconut milk
n
Consuming a small amount of dark chocolate (at least 70% cacao)
Non-Starchy Vegetables
Healthy eating is not all about cutting back. Most people need to add more fruits and
vegetables
to their diet. A minimum of 5 to 9 servings of fruits and vegetables should be
consumed per day, with an emphasis on non-starchy vegetables. For every 2 to 3 fruits,
a total of 6 to 7 servings of non-starchy and green vegetables is the goal. Another goal is
to aim for variety and color by eating a rainbow of colorful foods each day. Emphasize
the cruciferous vegetables, such as kale, Brussels sprouts, broccoli, and cabbage, which
contain an abundance of phytonutrients. The thousands of healthful compounds in plants can lower the risk of cancer,
heart disease, diabetes, and other chronic diseases. Both the quality of vegetables (fresh and organic when possible) and
the method of preparation are important. Raw and lightly steamed is preferred, but vegetables can also be sautéed at
low or moderate temperatures, and stir-fried at higher temperatures. When cooking at higher temperatures, oils with
higher smoke points should be used. These oils include avocado oil, and sesame oil. When cooking at low or moderate
temperatures, those with low to medium smoke points (olive oil, butter, ghee, coconut oil) are more suitable.
IFM
n
Core Food Plan Comprehensive Guide
13
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
13
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
The CFP will help individuals formulate a strategy for eating 9 to 12 servings of vegetables per day. One serving of
non-starchy vegetables is equal to ½ cup cooked or raw vegetables. The exception is raw greens, for which one
serving is equal to 1 cup. The goal is to see how many dierent colors and varieties of vegetables a person can
incorporate into meals each day.
Quick Tip: Green leafy vegetables include kale, collards and other greens, as well as cabbage,
bok choy, Swiss chard, arugula, spinach, and the many varieties of lettuce. The deeper the color,
the more nutrients the greens contain.
Tips for incorporating non-starchy vegetables into meals include:
n
Adding greens to smoothies, egg dishes, and soups for avor and color
n
Using greens as alternatives to tortilla wraps or buns
n
Creating the base of a salad with a variety of greens and colorful vegetables, and topping it
with lean proteins and healthy fats
n
Taking time to clean and prep vegetables right after purchase, then storing them in glass
containers in the refrigerator so they are ready to eat at a moment’s notice
Starchy Vegetables
Starchy vegetables such as sweet potato, yam, winter squash, parsnips, pumpkin, and
beets are rich in colorful phytonutrients, but cause blood sugar to rise more rapidly
than the non-starchy vegetables do. Those with blood sugar imbalances (e.g., diabetics
or those with metabolic syndrome) must be particularly careful to limit intake of these
starchy foods. Only 1–2 servings per day from this category is recommended for these
individuals.
The CFP separates the starchy from the non-starchy vegetables so that
appropriate selections can be made for blood sugar balance.
Quick Tip: Starchy vegetables add nutrients and ber and are helpful in thickening soups and
stews. Purée all or some of the cooked starchy vegetables and stir back into soup for this purpose.
Starchy vegetables are tasty when drizzled with olive oil, tossed with garlic and various spices, and
roasted. Sweet potatoes or yams are delicious baked with no additional oils; beets can be roasted,
peeled, sliced, and drizzled with balsamic vinegar.
Fruits
Fresh raw fruit, ripe and in season, is an easy and delicious way to consume a variety of
important phytonutrients, antioxidants, vitamins, minerals and soluble ber. Most fruits
have a high water content (often 80–95 percent) so this may help with hydration. As
with starchy vegetables, many fruits can raise blood sugar rapidly and should be eaten in
moderation by those with metabolic issues. It is helpful to eat fruit with some form of
protein and fat, such as nuts, to help decrease any rise in blood sugar. When estimating
serving sizes, it is important to remember that one serving of fresh fruit is about the
size of a small st. The CFP suggests 2 to 3 servings of fruit per day.
IFM
n
Core Food Plan Comprehensive Guide
14
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
14
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
Quick Tip: Fresh raw or frozen fruit (no sugar added) can be included with breakfast, eaten as
a snack, added to smoothies, or made into healthy desserts.
Tips for eating a variety of fruits each day include:
n
Adding ½ cup of fresh blueberries to a bowl of warm steel-cut oats
n
Topping any smoothie or Greek yogurt cup with fresh fruit to add color and  avor
n
Pairing a serving of fruit with a small handful of nuts or seeds for a perfect portable snack
Grains
Whole grains provide protein, ber, and a host of essential vitamins and
minerals. A true whole grain has had hardly any mechanical processing.
As a result, it contains all the nutrient-rich parts of the grain, including
the bran, germ, and endosperm. Much of the  ber and protein is
removed when a grain is re ned, leaving only the endosperm and starch.
The starchy part of a grain is what raises blood sugar (i.e., has a higher
glycemic index). Some Functional Medicine practitioners  nd that their
patients have fewer symptoms when they go o grains or when they
switch to gluten-free grains (like rice, millet, and quinoa). The CFP
lists all whole grains as acceptable, but individuals should follow their
practitioners’ speci c recommendations for grain consumption. Some
argue that genetic modi cation of wheat, corn, and soybeans may impact
the health e ects of these grains. These claims have yet to be scienti cally
investigated, but individuals are advised to observe how any of the foods
included in this plan, including grains, make their bodies feel or react.
The CFP suggests minimizing grains in the daily diet, with no more than 1 to 2 servings per day for most
individuals (unless a practitioner states otherwise). The food plan also recommends eating only organically-
grown, non-GMO whole grains. For individuals who want to limit or avoid exposure to gluten, grains are
separated into two categories: gluten-free grains and gluten-containing grains.
Quinoa is an ancient gluten-free plant grown mainly for its seeds. It’s not technically a member of the grass
family like other grains; in fact, it is a relative of beet and spinach. Because it can be used much like rice and
cooked cereals, it’s commonly included as a grain for practical use. Quinoa is high in the minerals magnesium and
calcium, rich in  ber, and has each of the amino acids needed by humans for making proteins. It’s often described
as a “super food” because of its nutritional density.
(diagram source: www.elements4health.com)
IFM
n
Core Food Plan Comprehensive Guide
15
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
15
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
Quick Tip: A serving size of most cooked grains like pasta, oats, rice, or quinoa varies from ⅓ to ½
cup, about the size of a cupped hand. Explore the variety of ancient grains (millet, te, amaranth,
spelt, faro, or quinoa) that have been around for centuries and provide ber, protein, and essential
nutrients. Any of these grains can be used in combination with oats–or in place of oats—to make a
tasty hot cereal.
Tips for incorporating appropriate amounts of whole grains into meals include:
n
Dipping organic blue corn chips into hummus, guacamole, or fresh salsa
n
Substituting whole-wheat pasta with quinoa, brown rice, or corn pasta to avoid gluten
n
Topping a brown rice cake with almond butter and fresh fruit for a snack
n
Making hot cereals with quinoa and amaranth on cold mornings
Condiments, Herbs, and Spices
Most modern condiments, like teriyaki sauce, ketchup, barbeque sauce, and glazes,
have quite a bit of sugar, salt, and preservatives added. It is usually best to avoid them
entirely, as they provide no needed nutrients. However, total avoidance isn’t always
possible. Reading and understanding food labels can help people limit unwanted
additives. Additionally, additives can be avoided altogether when making healthier
versions of condiments at home using common ingredients like herbs and spices.
Herbs are the fresh leaves of edible plants. Common herbs include cilantro, parsley,
rosemary, oregano, and thyme. When herbs are dried, they are referred to as spices.
Spices are edible and aromatic, and can come from a plant’s root, stem, bark, bud,
leaves, ower, fruit, or seed. Spices provide high levels of phytonutrients that help
ght disease. When buying spices, llers (like sugar, maltodextrin, gluten, articial
colors, preservatives, or synthetic anti-caking agents) should be avoided. Ideally,
spices should be stored in glass containers, rather than plastic, to avoid exposure to
toxins. Organically-grown herbs and spices are preferred whenever possible.
Both herbs and spices can give meals a boost of avor, which will make it easier to
avoid additive-laden condiments. In addition to the avor and taste they provide,
herbs and spices are often medicinal, too.
IFM
n
Core Food Plan Comprehensive Guide
16
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
16
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
Preferred condiments:
n
Apple cider, rice, and balsamic vinegars
n
Bragg Liquid Aminos™
n
Coconut aminos
n
Herbamare™
n
Homemade or store-bought, low-sodium and
organic broths (vegetable, chicken, beef)
n
Kosher or unrened sea salts
n
Lemon/lime juice
n
Miso (if soy is tolerated)
n
Mustards
n
Organic ketchup
n
Peppercorns
n
Red chili paste
n
Salsa without added sugars
n
Tahini
n
Wasabi
n
Wheat-free tamari
Top Medicinal Herbs and Spices
Many herbs and spices have medicinal properties. Some common medicinal herbs and spices
include basil, cardamom, cayenne, cinnamon, cloves, cumin, dry mustard, fenugreek, garlic,
ginger, oregano, rosemary, thyme and turmeric. Additionally, healing properties have been
observed in black pepper, bay leaves, caraway, celery seed, cloves, ginger, green cardamom,
mustard seed, nutmeg and (dried) onion. Curry powder is a blend of spices that varies from
geographic region to region. Many of the components of curries are anti-inammatory,
with most blends containing coriander, cumin, fenugreek, red pepper, and turmeric.
When buying and storing herbs and spices, follow these tips:
n
Avoid buying large quantities in bulk; purchase only what you will use within a few months. Store
bulk herbs and spices in airtight glass or tin containers, and throw out old herbs and spices.
n
Buy herbs and spices in their fresh, dried, whole, cracked, coarsely ground, and nely ground forms.
n
Store herbs and spices in a cool, dark place. Exposure to heat, light, and moisture will accelerate the
loss of avor. High temperatures can also cause spices to cake or harden and change or lose color.
n
To increase shelf life, close containers tightly after using, and don’t store spices near the stove. With
proper storage, ground spices will keep for about a year and whole spices for up to 2 or 3 years.
n
To test for freshness, rub between ngers and sni for aroma.
IFM
n
Core Food Plan Comprehensive Guide
17
Frequently Asked Questions
© 2016 The Institute for Functional MedicineIFM
n
Core Food Plan Comprehensive Guide
17
Touring Through the Food Plan
© 2016 The Institute for Functional Medicine
Tips for including more herbs and spices in your meals include:
n
Adding brewed tea to smoothies
n
Making a simple salad dressing by combining extra-virgin olive oil, lemon juice,
nely chopped garlic, and basil
n
Adding dry or Dijon mustards to dishes for a avor boost
n
Topping salads or sandwiches with fresh herbs such as cilantro, chives,
basil, or mint
n
Sprinkling cumin or fennel seeds in soups or salads
n
Marinating lean meats in curry powder or curry pastes
n
Sprinkling cinnamon and nutmeg over oatmeal, whole grain toast, a cup
of steamed soymilk, or vegetables (e.g., green beans)
n
Adding fresh parsley or chives to scrambled eggs
n
Stewing fruits with a cinnamon stick and a vanilla pod
n
Steeping lemongrass, ginger, or mint in hot water
n
Adding freshly grated garlic to mayonnaise
n
Adding fresh or dried herbs to your favorite pasta dish
n
Adding spices to ghee (claried butter), honey, oils, or salt
Beverages
Staying hydrated helps rid the body of toxins, builds resilience to stress, enhances metabolism, and promotes
satiety. Everyone should drink clean, ltered water throughout the day, but an individual's recommended intake
will depend on his or her weight (see the Quick Tip below). In addition to water, broths, herbal teas, and other
decaeinated beverages are good choices. Alcohol, caeinated beverages, and sugary beverages should be limited,
as they tend to dehydrate the body and raise cortisol and blood sugar levels.
Quick Tip: To determine an individual’s hydration needs, calculate body weight in pounds and
divide in half. The resulting gure is the number of ounces of water to consume each day. For
example, an individual who weighs 128 pounds should consume at least 64 ounces of water
(8 eight-ounce cups) each day (128 ÷ 2 = 64). Note that fruits and vegetables count as an
additional source of water.
Tips for enhancing hydration status include:
n
Adding a slice of lemon or lime or a splash (about an ounce) of 100% natural pomegranate, cherry, or
cranberry juice to a 32–ounce water bottle twice a day, for a total of 64 ounces of liquid.
n
Keeping a variety of herbal and green teas available to provide variety in taste and nutrients. Studies
suggest that approximately 3 cups of green tea daily is good for metabolism and cardiovascular health.
n
Exploring kombucha teas, which are made by fermenting green or black tea. Be aware of the sugar
content, which can vary by recipe.
IFM
n
Core Food Plan Comprehensive Guide
18
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
What are the core principles of healthy eating?
Functional Medicine starts with food. Food is energy, medicine, and connection. The basic principle of this CFP
is that eating a wide variety of high-quality, whole, and mostly plant-based foods is truly powerful medicine that
improves health and hinders the development of disease.
How is food used as energy?
Foods give us calories, or fuel to perform the required work in
every cell of the body. Every cell, tissue, and organ needs fuel to
function. A person’s quality of life is largely based on how well
their body can work, move, and act. By providing the body with
fuel of the highest quality, we ensure that our bodies are able to
function well and keep all of the body systems optimized.
What does the body use for energy? Macronutrients—protein,
fats, and carbohydrates (known collectively as PFC)—and
micronutrients—minerals, vitamins, and phytonutrients (known
collectively as MVP)—all of which are derived from food and
help your body perform its best.
Carbohydrates and protein provide 4 calories of energy per gram, while fat yields more than double that at 9
calories per gram. Our bodies digest the food we eat by mixing it with uids (acids and enzymes) in the stomach.
When we eat, the carbohydrates (both simple sugars and complex starches) in that food break down into glucose.
The stomach and small intestines then absorb the glucose and release it into the bloodstream. Once in the
bloodstream, the glucose can be used immediately for energy or stored to be used later. Protein is a longer-lasting
form of energy because it is broken down more slowly. Protein is primarily used as energy when total calorie
intake is too low and energy cannot be immediately obtained from carbohydrates. Fat is primarily used to store
energy, held as a reserve in the body until needed.
How is food used as information?
Food is not just calories you take in; it is also a source of information for the body. With every bite taken, food
has the ability to turn on or o genes that control disease risk, lifespan, and metabolism. Certain foods can impact
blood sugar, or even trigger allergic reactions, inammation, or autoimmune responses. Food has the potential to
provide the body with what it needs to function at its best level. If the body isn’t given the right information, it
won’t work well, and an individual’s health may decline. If too much food is taken in—or if the food gives the
body the wrong instructions—a person can become simultaneously overweight and undernourished, and can
increase their risk of developing many dierent diseases.
For example, choosing to eat clean food that is organically grown and not sprayed with chemicals helps reduce the
number of toxic substances in the body and gives the body the best information to signal health. Fresh organic or
unsprayed food has many health benets, namely that it has more minerals, vitamins, and phytonutrients. For these
reasons, it’s important to focus on buying food at local farmers’ markets, and to look for the label, “organic” or
“locally grown” on produce.
IFM
n
Core Food Plan Comprehensive Guide
19
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
Improving food choices can have a signicant impact on health and disease:
n
Poor quality food can cause disease by not providing enough nutrients.
n
Foods with the right kinds of nutrients can help to heal and reverse the path
of chronic disease.
How is food used as connection?
Food is central to our social interactions: we typically share meals with our communities, and our ethnic
backgrounds determine what and how we eat. Food is used for celebration and ceremony, and to honor and enjoy
traditional cultures. Through the process of eating with others, we can also practice mindfulness and intention.
Eating mindfully involves the following:
n
Becoming knowledgeable about portion sizes, balancing
meals with healthy nutrients, and actively managing food
cravings through awareness
n
Developing an appreciation for the path of food—from
soil to table—and becoming aware of the benets of
plant-based foods
n
Eating a variety of colors and avors to get the full
spectrum of healthy compounds from food in every meal
n
Taking time to enjoy meals with others when possible,
and avoiding eating while working, commuting, or
watching TV
n
Chewing food thoroughly to improve digestion
n
Finding pleasure and joy in cooking, eating, and tasting
while making healthy choices
How is food used as medicine?
The Western diet has large nutritional gaps because of the abundance of food with poor nutritional quality. As a
result, chronic diseases are rampant. Healthy whole foods can be just the medicine the body needs to reverse many
of these diseases. Nutrigenomics, a new science that studies the impact of food choices on gene expression, is
proving that we truly are what we eat! The key is making an eort to choose nutrient-rich foods that send the right
healthy signals to the body for positive gene expression and optimal health. Eating high quality foods can have a
positive inuence on the body and may even help to reverse disease. Think of the CFP as a foundation for healthy
eating that lays out the principles for a healthy life.
IFM
n
Core Food Plan Comprehensive Guide
20
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
Are organically grown foods really that important to buy? They seem expensive.
The short answer is that eating high-quality food is a way to invest in and manage health now. Buying organic food is
less expensive than the inevitable health challenges that will arise from eating a nutrient-poor diet. Investing in health
now will help prevent the loss of time, money, and energy spent on drugs, surgery, and other procedures later. There
are thousands of man-made chemicals present in the environment; while scientists learn more about their association
with disease, it only makes good sense to minimize exposure to pesticides, insecticides, hormones, antibiotics,
irradiated food, herbicides, and GMOs. This can be done, in part, by consuming organically-grown food whenever
possible. While this may be more expensive, as noted above, the negative health eects from these toxins could be
more expensive in the long run. Scientists at the Environmental Working Group (EWG), a non-prot organization
focused on protecting public health and the environment, have suggested that even small doses of pesticides and other
chemicals can have long-term health consequences that begin during fetal development and early childhood.
Buying foods in season from local sources may keep the costs down. Make purchase decisions according to the annual
“Dirty Dozen” and “Clean 15” lists published annually by the EWG (www.ewg.org).
Nonorganic meats and dairy may be the sources most heavily contaminated with hormones, pesticides, and herbicides.
Organic beef, chicken, and poultry are raised on 100% organic feed and never given antibiotics or hormones; in
addition, their meat is never irradiated. Organic milk and eggs come from animals not given antibiotics or hormones
and fed 100% organic feed for the previous 12 months.
Less use of antibiotics may also help avoid the development of antibiotic resistance, a serious health problem today.
Free-range eggs come from hens that are allowed to roam, but they are not guaranteed to be organic.
The certied organic label on a food guarantees that there has been no usage of genetically modied crops or sewage
sludge as fertilizer. The latter is not only healthier but helps to reduce toxic runo into rivers and lakes and the
subsequent contamination of watersheds and drinking water.
IFM
n
Core Food Plan Comprehensive Guide
21
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
To further reduce the risk of pesticide intake:
n
Wash produce before you peel it, so dirt and bacteria aren’t
transferred from the knife onto the fruit or vegetable.
n
Peel the skin or remove outer layer of leaves of nonorganic
produce like lettuce or onions.
n
Remove surface pesticide residues, waxes, fungicides,
and fertilizers by soaking the food in a mild solution of
white vinegar or additive-free soap (pure Castile soap or
biodegradable cleanser).
n
Wash your hands for 20 seconds with warm water and soap
before and after preparing fresh produce.
n
Dry produce with a clean cloth or paper towel to further
reduce bacteria that may be present.
How much protein is best for me to eat?
Typically, most people need to eat about 3 to 4 ounces (about the size of an average human palm) of protein at each
meal, but people with higher energy needs (e.g., athletes and pregnant or nursing women) will need more protein
in each meal. Recommendations for protein vary according to body weight and activity level. The quality of the
protein is very important: lean, grass-fed, free-range, organically grown, non-GMO meat, poultry, and wild sh are
all recommended for omnivores. Vegetarians should choose organic sources of soy and other legumes when possible,
along with nuts and seeds.
How oen is it okay to eat eggs?
Eggs are a high-quality source of protein. There has been an ongoing debate about eggs, particularly when it comes
to heart disease, as originally it was thought that the cholesterol in eggs made blood cholesterol rise. We now know
that it is ne for most people to eat eggs every day. The only caution is that some preliminary research suggests it
may be better for those with type 2 diabetes to have fewer eggs (less than one egg per day). The CFP stresses variety,
so food routines should be changed daily. Instead of eating eggs every day for breakfast, choose alternatives that will
help supply the body with a diverse array of nutrients.
Are there vegetarian and vegan options for the Core Food Plan?
There are several variations of vegetarianism supported in this plan:
VO
Ovo-vegetarians include eggs, but avoid all meat, poultry, sh, and dairy products.
VL
Lacto-vegetarians include dairy products, but avoid all meat, poultry, sh, and eggs.
VOL
Ovo-lacto-vegetarians include eggs and dairy products, but avoid all meat, poultry, and sh.
P
Pescatarians add sh to any of the above variations.
VE
Vegans omit ALL animal products, including honey.
Additionally, the CFP includes separate food lists for vegetarians and vegans.
IFM
n
Core Food Plan Comprehensive Guide
22
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
How does a vegetarian get adequate protein?
By including adequate amounts of legumes, whole grains, green leafy vegetables, seeds, and nuts into meals, vegetarians
and vegans can easily eat enough quality protein. For vegetarians who eat eggs and dairy products, getting adequate
protein is even easier, because these foods provide complete proteins. For vegans, it is important to include some grains
for the essential amino acid methionine, which is missing from beans and peas (legumes).
High-quality protein choices for a vegetarian might include, 1 egg (7 grams of protein), a typical serving of green
vegetables (2 to 3 grams), ½ cup organic tofu or soy product (10 grams), legumes—such as lentils (9 grams), edamame
or green soybeans (6 grams)—and 1 cup of soy milk (7 grams). Vegans will have more of a challenge, but will still
be able to obtain adequate protein from food if they have a solid understanding of complementary plant protein
combinations as discussed in the protein and legume sections in this document.
I am a vegan and oen will use some type of soy or other
veggie burger for my protein source. What do I look for in a
quality veggie burger?
While the IFM food plans suggest the use of whole, fresh foods found in local
farmer’s markets or the outside aisles of the supermarket, there are times when
access to a quick and easy source of vegetarian protein will be necessary.
There are many healthy vegetarian burger recipes available on the internet, and
these vegetarian burger patties can be made from scratch with fresh ingredients
and stored for later use.
When buying a premade frozen veggie burger, look at the food label to be sure
that whole organic, non-GMO ingredients with minimal additives are used.
Many of the premade veggie burgers available in the grocery store contain
unsuitable ingredients for a healthy diet, but there are some with well-sourced,
high-quality ingredients. Here is the ingredient list for a quality vegetable
burger found in many grocery stores, made with all non-GMO ingredients:
“Carrots, onions, string beans, oat bran, soybeans, zucchini, peas, broccoli, corn, soy our, spinach,
expeller pressed canola oil, red peppers, arrowroot, corn starch, garlic, corn meal, salt, parsley,
black pepper.
What is natto?
Natto is fermented soy beans, often eaten for breakfast in Japan. Although very nutritious, some nd the odor and
texture of natto a bit foreign or unappealing at rst, making it an acquired taste. For added avor and variety, natto can
be added to dishes like brown rice bowls and miso soup.
IFM
n
Core Food Plan Comprehensive Guide
23
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
When do I eat plants raw and when do I cook them?
For the most part, a combination of raw and cooked foods in the diet is preferred, and the most appropriate method
of preparation will depend upon the desired benet (see below). Raw foods are typically better to eat in the summer
months, as they are more “cooling” to the body, while cooked foods are best in the winter months when it is cold
outside. People with digestive issues (e.g., lots of bloating, bowel movement problems, inammation, gas, and pain) will
often benet more from cooked plant foods.
Healthcare providers and Functional Nutritionists can provide important information about phytonutrients, as well as
instructional materials aimed at teaching individuals how best to prepare and cook fruits and vegetables. Here are some
general guidelines:
n
Steaming or waterless cooking methods help preserve the vitamins and other nutrients in
vegetables far better than high-heat cooking methods like boiling. Use as little water as possible
and cook to the point at which the color of the vegetable becomes brighter and more vivid.
n
Overall, steaming is the preferred method of cooking, as it
results in the biggest increase in antioxidant content.
n
Avoid boiling any cruciferous vegetable (broccoli, cabbage,
kale, arugula, etc.), as boiling may deactivate an enzyme
called myrosinase that produces anti-cancer compounds.
n
In general, cook only to the point of making the
vegetables tender, not soft.
n
The nutrient content of foods like seeds, nuts, and legumes
can be increased using certain preparation methods,
including heat, soaking, fermentation, germination, and
malting.
n
Cooking increases the benecial antioxidant content in
the following foods: carrots, spinach, mushrooms, asparagus,
broccoli, cabbage, red cabbage, green and red peppers,
potatoes, and tomatoes.
n
Peeling away the skins of apples and cucumbers reduces their antioxidant content signicantly,
but it does limit possible exposure to pesticides if the produce is not organically grown.
n
Don’t pre-soak vegetables before cooking to make them soft, as nutrients will be lost in the water.
Are frozen fruits and vegetables okay to eat?
While fresh fruits and vegetables are always preferable, frozen fruits and vegetables are acceptable when cost, time, or
availability is an issue. Freezing foods will reduce avor a bit, and the nal nutrient content will depend on the initial
quality of the food before it was frozen. If the food was initially considered to be of high quality (i.e., organically
grown and fairly fresh at the time of freezing), then the nal nutrient content will be mostly retained. Studies have
shown that some foods, like blueberries, can retain their phytonutrient content after freezing.
There are some concerns with freezing, because the blanching process during preparation may result in the loss of
some nutrients like vitamin C and B vitamins. Still, frozen foods are always preferable to canned foods.
IFM
n
Core Food Plan Comprehensive Guide
24
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
Nine servings of fruits and vegetables seem dicult to eat in one day. How can I do it?
Here is an example of how to include 9 servings in an 1800-calorie diet:
n
2 servings (1 cup or 2 fruits) of fruits (servings may vary with dierent fruits)
n
2 servings of leafy greens (2 cups)
n
4 servings (2 cups) of other non-starchy vegetables
n
1 serving of starchy vegetables (½–1 cup)
Why are coconut oil and coconut milk on the Core Food Plan?
I thought coconut was bad for my heart.
The goal of the CFP is variety—even in fat and oil choices. While extra-virgin
olive oil is more of a “staple” oil—one to be used most frequently for salad
dressings and low- to medium-heat cooking—coconut oil may also be used,
especially when cooking at a higher heat, such as when stir frying. In general,
though, it’s not best to use high heat for cooking. A better way to cook is to
steam the food and add the oil at the end. Coconut oil provides short- and
medium-chain fats that can be quickly used by the liver and the intestine as an
energy source. Additionally, the medium-chain fats are absorbed directly into
the lining of the small intestine, making them a good choice for people with
gastrointestinal issues. Coconut oil that is rened (like most other oils), however,
is not healthy. It is best to use no more than 3 teaspoons (or 1 tablespoon) of
coconut oil that is labeled virgin and organic. Coconut milk is also a wonderful
way to add avor to stir-fried foods, curries, and soups.
I don’t see any sweeteners on the Food List. What can I use on the CFP as a sweetener?
For optimal health, it is best to refrain from added sweeteners as much as possible. The damaging eects from
inammation that sugar can have on the blood vessels and brain are long-lasting. In addition, high-intensity sweeteners
can lead to blood sugar imbalances, increased calorie intake with subsequent weight gain, and continued cravings.
When craving something sweet, low- to moderate-glycemic index fruits on the CFP are the best choices. For example,
eating an apple or having a handful of fresh blueberries can help to quell sugar cravings.
The CFP doesn’t recommend processed foods, so the hidden sugars in those products are not a concern. There are
no added sugars in fresh vegetables or fruits (note that dried fruits often do contain added sugars). Stevia, an herbal
sweetener, may be used occasionally in small amounts (just a pinch), as it is an intensely sweet herb.
What do I eat when I am having cravings?
When avoiding very sweet foods, eating naturally sweet fruits like apples, berries, and oranges, can satisfy the cravings.
Even using apple juice concentrate in cooking and baking will help. It is best to avoid articial (synthetic) sweeteners
because they may have negative eects on metabolism and could lead food cravings. Articial sweeteners to avoid
include (but are not limited to) the following: aspartame (NutraSweet
®
), sucralose (Splenda
®
), acesulfame-K (Ace
K, Sweet One, Sunett
®
), and saccharin (Sweet N’ Low®). More information on sweeteners can be found in the
“Sweeteners” handout.
IFM
n
Core Food Plan Comprehensive Guide
25
Frequently Asked Questions
© 2016 The Institute for Functional Medicine
What about drinking alcohol?
Drinking modest amounts of red wine may reduce cardiovascular risk. Research
has suggested that alcohol can even improve blood ow to the brain by lowering
blood pressure and opening up blood vessels. The phytonutrients in red wine,
such as resveratrol, help to relax the blood vessels, increase good cholesterol, and
bring blood sugar into balance. However, red wine is also a form of sugar and
added calories and may not be good for everyone. A healthcare practitioner
familiar with an individual’s health history can help determine whether moderate
or occasional use of alcohol would be appropriate and consistent with health
goals. For a generally healthy man, 1 to 2 glasses (5 ounces, or ⅔ cup) of red wine
(depending upon body weight) may be perfectly acceptable within a mealtime
setting. Women may wish to have just one glass of wine no more than four
times a week, due to the association between breast cancer and increased alcohol
consumption. Another option is to eat foods high in resveratrol, such as red
grapes, dark chocolate, peanuts, and purple grape juice.
Do coee and tea have any benets?
Studies have shown that caeine tightens blood vessels, causing short-term, unfavorable changes in blood pressure. Also,
caeine increases cortisol, a stress hormone, which may lead to feeling more wired and “on edge. For those sensitive
to caeine (most people know if they are), it can cause a fast heart rate and abnormal heart rhythms. On the other
hand, coee contains important phytonutrients like chlorogenic acid and caeic acid, which may help the liver process
blood sugar. Also, moderate consumption of up to 3 eight-ounce cups daily has been shown to be associated with
lower rates of T2D. Needs, preferences, and sensitivities will vary from person to person, and healthcare practitioners
should discuss these factors with individuals when designing a new diet and lifestyle plan. For those who enjoy the
taste of coee, a solution might be switching from caeinated to decaeinated coee with no added sugar. A small
amount of caeine (5-50 milligrams) is found in decaeinated coee, so there would still be some eect. Another
option would be to combine 4 ounces of caeinated coee with 4 ounces of decaeinated coee for a period of two
weeks before switching entirely to decaeinated coee.
Coee may be a good choice for some, but green tea may be a better drink for most people. It contains caeine, but
not as much as a typical cup of coee, and it can be purchased in non-caeinated varieties. Green tea contains anti-
inammatory and antioxidant phytonutrients. Drinking both green and black teas has been associated with a reduction
in the risk of heart disease and stroke by 10 to 20 percent. Three cups per day appears to be the best amount for the
most benet overall.
Why is miso on the condiment list?
Miso is a traditional Japanese seasoning made by fermenting soybeans with other ingredients. While miso can be a soy
protein source, it doesn’t t the macronutrient prole of other soy foods. It is best used as a condiment, as only a few
tablespoons are considered to be a serving. Miso may be added to soups, salad dressings, or stir-fries.
IFM
n
Core Food Plan Comprehensive Guide
26
Resources and Tools for Success
© 2016 The Institute for Functional Medicine
The CFP represents a phytonutrient-dense and balanced approach to healthy eating. It is benecial for both health
maintenance and disease prevention. To make the transition to this way of eating easier, we oer a number of other
tools.
The following handouts are available from Functional Medicine healthcare practitioners to assist patients who are
implementing the IFM Core Food Plan:
n
Core Food Plan – Food List
n
Core Food Plan – Vegetarian Food List
n
Core Food Plan – Vegan Food List
n
Core Food Plan – Weekly Planner and Recipes
n
Phytonutrient Spectrum – Comprehensive Guide
n
Phytonutrient Spectrum Foods
The internet has many helpful websites that explore all avenues of healthy eating principles. There is also much
conicting information, so it is important to know what information is the most accurate. The World’s Healthiest
Foods website (www.whfoods.com) contains unbiased information about foods, nutrients, cooking for best
nutrient preservation, and many other topics. It may help to answer many of the questions not covered in this
Comprehensive Guide.
© 2016 The Institute for Functional Medicine