Are Superfoods Worthy of Their Title?

Sara Gottfried MD Women's Health Article | Superfoods | Are Superfoods Worthy of Their Title?

When I see an article on superfoods, it makes me slightly crazy. Is eating an açaí bowl the size of soccer ball really a good idea? Some can get away with it, but most women I know over 40 find that this so-called superfood jacks up their blood sugar. I wear a continuous glucose monitor, so I can tell you with certainty that açaí is not a superfood for me, and may not be for you. Let’s take a closer look at these superfoods, objectively assess their risks and benefits, and see what might be true for you.

I have been talking about the benefits of most of these superfoods since 2013, back when I published my first book THE HORMONE CURE.


Avocados are a fruit–a berry with a large central seed. This is one of the original superfoods that contain healthy fats. If you are doing keto or gluten-free, avocados probably feature weekly, if not daily, in your meals because it’s a food that checks all the boxes. This is why you will find avocados in so many of my recipes for shakes, salads, even desserts. Plus they are delicious.

Benefits of avocados:

  1. They are a source of healthy fat that stabilizes blood sugar. Keeping your blood sugar in a healthy range is one of THE most important steps you can take to increase your healthspan and keep your brain healthy as you age.
  2. Avocados are high in omega-3s and play a vital role in reducing neuroinflammation and anxiety. They are also good for your heart health because they are rich in monounsaturated fat, thought to be protective.
  3. This miracle food has also been shown to raise dopamine, the feel-good hormone in your brain. Yes, avocados make you happy. Avocados are rich in precursors to dopamine—amino acids named tyrosine and phenylalanine so adding this food to your diet as often as you can, may boost your mood.1

Are there risks to eating avocados? The main problem I see in women over 40 is that they eat too much of a good thing. Since avocado is a calorie-dense food, the appropriate serving is about ⅛ to ¼ per day. One California or Florida avocado has about 300 calories, and 24 grams of carbohydrates.

When I’m following the type of ketogenic diet that I feature in my new book Women, Food, and Hormones, eating too much guacamole will pull me out of ketosis, so I keep to a maximum of ¼ per day, about 2 to 3 times per week. For most of my patients, a well-formulated and modified Mediterranean ketogenic diet is the least inflammatory and the most likely to result in stable insulin levels and fat burning–and that means restricting carbs along with increasing healthy fat. (By corollary, the most inflammatory diet is the Standard American Diet, which is high in carbs and fat, and low in superfoods.)

Fermented Foods

Fermented foods are nothing new in many parts of the world, but for people in the US trying to improve their health, they are relatively unfamiliar. Fermentation is the breakdown of substances by the action of yeast or bacteria. Fermentation is how we end up with wine or beer. But it also provides us with fermented foods such as sauerkraut, kimchi, kefir, kombucha, miso, and tempeh. You might ask yourself, why do you want to eat foods full of bacteria in the first place? Good question. In most cases, eating food that’s so old it’s fermented would be a big no-no. But in the case of these traditional foods like sauerkraut or kimchi, fermentation yields major bonuses for your health.

Benefits of fermented foods:

  1. They contain plenty of the good bacteria that you need for a healthy gut. A healthy gut is a foundation for both body and brain health. Gut dysbiosis (a gut that is out of balance with too many bad bacteria) can be the cause of so many health problems including ones we typically think of as “mental health” such as anxiety and depression.
  2. Fermented foods are typically low in sugar and calories, but high in fiber, which makes them wonderfully filling.
  3. Fermented foods also help stabilize your blood sugar, which reduces food cravings, keeps insulin sensitivity high, and aids weight loss.2,3

What are the risks? I find that patients with small intestinal bacterial overgrowth (SIBO) have a difficult time tolerating fermented foods. I recommend healing the SIBO first, and gradually increase the dose, starting with ½ teaspoon of sauerkraut or kim chee. Ready to make your own superfood? Here are some of my favorite fermented foods that you can do at home.


Make 2020 the year you include this superfood in your diet on a regular basis. They are a major source of betalains, phytonutrients that counter inflammation, protect the liver, and have antioxidant activity.

Benefits of beets:

  1. Beets kick inflammation’s butt. Chronic inflammation is at the root cause of not only chronic diseases that we are familiar with such as heart disease, cancer, Alzheimer’s and diabetes but could well be behind the reason you are struggling to lose weight due to the effect of chronic inflammation on the thyroid.
  2. They are a potent detoxifier4: Betalain is that red pigment found in beets. Anyone who has ever peeled a beet with bare hands will know what a potent amount of this pigment the root vegetable contains. Betalains promote detoxification in the body by enabling the production of enzymes in the liver.
  3. Just like avocado, beets raise dopamine levels in your brain, which makes my Red Velvet Shake a mood-booster.

While I love the benefits of beets for cardiovascular disease, they are starchy if you are watching your carbs. One cup contains about 13 grams of carbohydrates, so I limit my consumption of beets to ½ serving, usually once per week.


For keto followers, MCT oil is a daily part of their diet helping them to get into ketosis. But for many, MCT oil is unfamiliar territory. MCT stands for medium-chain triglyceride. This oil is a very efficient type of oil derived from coconuts that gets rapidly converted into energy for your brain and body because it doesn’t require a stop at the liver for processing.

Benefits of MCT oil:

  1. It’s easy on your gut. You don’t need bile acids to digest it, so it puts less stress on your GI tract.
  2. Good for your brain: I often add a tablespoon to shakes after a workout
  3. MCTs help you feel more full than long-chain fatty acids found in vegetable oils and can help regulate the Fatso gene. The official name of the Fatso gene is the Fat mass and obesity associated gene. This gene is strongly associated with your body mass index and, consequently, your risk for obesity and diabetes. In my book, YOUNGER, I often recommend using MCT oil as a dressing for salads.

Green Tea and Matcha

I am a slow-metabolizer of caffeine so coffee makes me feel too jacked up and disrupts my sleep. A morning cup of matcha (ground up green tea leaves) not only energizes me without the rev of coffee, but it offers a whole host of other benefits.

Benefits of Green Tea and Matcha:

  1. Matcha provides a rich dose of polyphenols. These are antioxidants that prevent oxidative stress from making you old and sick. One of the shining stars of matcha’s cast of characters is epigallocatechin gallate (EGCG).5
  2. Green tea leaves, stems, and buds contain six types of anti-oxidants known as catechins (of which EGCG is one), and all six clear your body of free radicals and can weaken the cold virus. That means when you catch a cold, you’re less likely to get sick.
  3. Green tea has been shown to induce glutathione production and help liver enzymes involved in detoxification.


Turmeric is a spice used extensively in Asian cooking. It gives dishes like curry their characteristic yellow color.

Benefits of turmeric:

  1. Fights inflammation: spices like turmeric, ginger and garlic target inflammatory pathways, and thereby may prevent neurodegenerative diseases. Spice up your morning with my version of the Turmeric Latte
  2. Its anti-inflammatory properties make it one of my favorite spices to add to dishes like quinoa. Quinoa is an ancient seed that is a great source of zinc and folate, which may help prevent dementia. Turmeric plus quinoa is a mighty combination to improve your health and help you age well. If you can’t find turmeric root, use turmeric powder sprinkled on food.
  3. Raises dopamine: you will find turmeric on my list of food recommendations to help fight addiction in my latest book BRAIN BODY DIET



1. A. C. Araújo et al., “Table of Phenylalanine Content of Foods: Comparative Analysis of Data Compiled in Food Composition Tables,” JIMD Reports 34 (2016):87–961.

2. Jung, S. J., et al. “Beneficial effects of Korean traditional diets in hypertensive and type 2 diabetic patients.” Journal of Medicinal Food 17, no. 1 (2014): 161-171.3. Kim, E. K., et al. “Fermented kimchi reduces body weight and improves metabolic parameters in overweight and obese patients.” Nutrition Research 31, no. 6 (2011): 436-443.
4. Clifford T, Howatson G, West DJ, Stevenson EJ. The potential benefits of red beetroot supplementation in health and disease. Nutrients. 2015;7(4):2801–2822
5. H. K. Na et al., “Modulation of Nrf2-Mediated Antioxidant and Detoxifying Enzyme Induction by the Green Tea Polyphenol EGCG,” Food and Chemical Toxicology 46, no. 4 (2008): 1271–78