Chronic disease accounts for almost three quarters of worldwide deaths.[1] In the United States, six in ten adults have at least one chronic disease diagnosis.[2] Included under the umbrella of chronic disease are diagnoses such as diabetes mellitus, heart disease, cancer, obesity, stroke, Alzheimer’s disease, and autoimmune disease. Why are chronic diseases so prevalent in society? Excessive alcohol use, tobacco use, exposure to secondhand smoke, lack of physical activity, and poor nutrition are top contributing factors. Addictions are complicated and often very difficult to change. On the other hand, most individuals are capable of making small changes to increase daily body movement and dietary choices. Two to three (or more) times per day we select our choices for breakfast, lunch, dinner, snacks, drinks, and desserts. All food choices have the potential to be satiating, but not all food is ingrained with nutrient density. Whole foods – free from additives and artificial substances – are satiating, nutrient dense, and are the most beneficial foods for the microbiome.[6] 

What does nutrient density mean? 

Nutrient density refers to foods highest in macronutrients and micronutrients that are essential for healthy metabolism and energy. Nutrient dense foods have the added bonus of also being higher in phytonutrients, like bioflavonoids and polyphenols, which have anti-inflammatory and antioxidant actions in the body. 

Macronutrients refer to carbohydrates, protein, and fat. Simple carbohydrates are abundant in highly processed foods like baked goods, candy, soda, juice, and other food containing added sweeteners like syrups. Complex carbohydrates are found in whole foods such as fruits and vegetables which also contain fiber, a part of plant-based food that passes through the small intestine to the large intestine where it is fermented into short chain fatty acids (SCFAs) by the gut microbiota. SCFAs have been shown to have anti-inflammatory, anti-cancer, and anti-microbial effects. They are necessary for gut health and a balanced immune system.[3] Protein and fat can be obtained from a wide variety of food, including animal meat, dairy products, seafood, nuts, seeds, and legumes. Fats are also present in cooking oils such as avocado oil, coconut oil, and olive oil. Certain fats, like omega-3s, are necessary to obtain from dietary or supplemental sources. These essential fats are naturally present in flaxseed, soybean oil, chia seeds, walnuts, canola oil, fish, microalgae, and krill. 

Micronutrients refer to water soluble vitamins, fat soluble vitamins (e.g. B vitamins and vitamin C), and minerals (e.g. calcium, magnesium, and zinc). Deficiencies in these vitamins and minerals can contribute to a variety of chronic diseases. For example, zinc deficiency is associated with diseases such as diabetes, rheumatoid arthritis, and macular degeneration.[5] Long term calcium deficiency is associated with diseases such as osteopenia and osteoporosis. 

How do we obtain more nutrient dense foods? 

We can create a nutrient dense diet by changing our hourly to daily decisions concerning how we take care of ourselves. At least 90% of the time, we can choose to select foods that are nutrient dense and best fit our individual nutritional needs. For example, a person diagnosed with celiac disease should not consume gluten due to the damaging autoimmune mediated effect it has on the intestines. Food allergies and intolerances also factor into individual nutritional needs. For example, certain people are more genetically prone to lactose intolerance. Intestinal permeability and microbiome dysbiosis are contributing factors to the development of food intolerances. 

If you have difficulty making dietary changes because “healthy, nutrient-dense food does not taste good”, start with a 30-day elimination of added and artificial sugar. If your palate is conditioned to eating foods high in sugar, nothing else will taste as delicious in comparison. As your diet changes your palate will become more sensitive to the sweetness in whole foods such as clementines, cherries, and dates. 

Other methods to increase nutrient density includes shopping mostly around the perimeter of the supermarket, changing our mindset concerning what foods are acceptable for specific meals, and trying new foods or new styles of foods. Breakfast foods can include a berry/avocado/milk/pea protein powder smoothie, an omelet with bell peppers/onions/mushrooms/cheese, and a leftover burger with roasted vegetables and rice. Purchasing a farm share or a box from Misfits market can be an inspiring way to utilize whole foods straight from the garden. You could always grow your own produce as well. Spring is a great time to start seedlings. Seeds can be purchased from department stores like Home Depot or Lowes, the Co-op, or online. 

The connection between food and health is an ancient concept. Hippocrates, a Greek physician who lived from 460 to 375 BC, is credited with the phrase, ‘Let thy food be thy medicine and medicine be thy food’. As scientists and medical professionals further explore the intricacies of the microbiome, we are gaining a more elaborate understanding of why specific foods are essential and beneficial for healthy human life. If each of us starts to incorporate this knowledge into our daily lifestyle decisions, significant strides can be made towards the prevention and reversal of chronic disease. 


Laurel Erath, ND is a naturopathic doctor at Rutland Integrative Health. 



  1. World Health Organization. Noncommunicable diseases. Accessed April 2, 2021.
  2. Centers for Disease Control and Prevention. About Chronic Diseases.,disability%20in%20the%20United%20States. Accessed April 2, 2021.
  3. Lattimer JM, Haub MD. Effects of Dietary Fiber and Its Components on Metabolic Health. Nutrients. 2010 Dec; 2(12): 1266-1289. Doi: 10.3390/nu2121266 
  4. Drewnoswski, Adam. Nutrient density: addressing the challenge of obesity. Br J Nutr. 2018 Aug; 120(s1):S8-S14. Doi: 10.1017/S0007114517002240 
  5. Wessels I, Maywald M, Rink L. Zinc as a Gatekeeper of Immune Function. Nutrients. 2017 Dec; 9(12): 1286. Doi: 10.3390/nu9121286 
  6. Dietert, Rodney. The Human Superorganism. Narrated by Jonathan Todd Ross, Audible, 2016. Audiobook.