Staying fit once one reaches middle age doesn’t come as easily as it used to. However, adults in this age range should still persevere as doing so may prevent heart failure. This article from the Huffington Post has the details:

Middle Age Fitness


Getting fit in middle age not only could add years to your life through a variety of health benefits — it could also reduce your risk for heart failure, a new study suggests.

Researchers from the University of Texas Southwestern Medical Center ranked the fitness levels of 9,050 men and women (average age 48). Participants took two fitness tests — eight years apart — during midlife. After 18 years of follow-up, researchers compared the fitness information with Medicare claims for heart failure hospitalizations.

“People who weren’t fit at the start of the study were at higher risk for heart failure after age 65,” said Dr. Ambarish Pandey, M.D., lead author of the study, in a press release. “However, those who improved their fitness reduced their heart failure risk, compared to those who continued to have a low fitness level eight years later.”

To conduct the study, researchers relied on metabolic equivalents (METs), a measure of how people do on a treadmill test. For each MET improvement in fitness, partipants’ heart failure risk fell by 20 percent. For example, if a 40-year-old went from jogging 12 minutes per mile to running 10 minutes per mile — a jump of two METs — that person slashed their heart failure risk by 40 percent, Pandey said.

With improvements to medical care, more people are surviving heart attacks and living with heart disease. As a result, the number of people with heart failure is on the upswing. More than 5.1 million Americans live with heart failure, according to the American Heart Association, and by 2030, the prevalence of heart failure may increase 25 percent from 2013 estimates.

“Improving fitness is a good heart failure prevention strategy — along with controlling blood pressure and improving diet and lifestyle — that could be employed in midlife to decrease the risk of heart failure in later years,” Pandey said in a press release.

Previous studies on fitness have found that those who are the most fit in their 40s and 50s develop conditions such as cancer, diabetes and Alzheimer’s later in life than those who are less fit.

In addition, another study found that middle-aged people who have heart issues, such as high cholesterol and high blood pressure, may be at an increased risk of developing cognitive and memory problems.

Dr. Rachna Mehra specializes in age management techniques and regenerative medicine. Visit this website to learn more about her practice.


Scientists at the Spanish National Cancer Research Centre have successfully transformed a living tissue inside an animal back into an embryonic state, which could lead to new medical interventions for repairing the body, including the heart. The article below discusses more about this scientific breakthrough.

They believe it could lead to new ways of repairing the body, for example after a heart attack.

However, the study published in the journal Nature, showed the technique led to tumours forming in mice.

Stem cell experts said it was a “cool” study, but would need to be much more controlled before leading to therapies.

When an egg is first fertilised, it has the potential to develop into every tissue in the human body, from brain cells to skin.

That flexibility is lost as an embryo develops. However, transforming adult tissues back into an embryonic-like state may lead to treatments that can regenerate a weakened heart, or the light-sensing cells in the eye or even the brain after a stroke.

‘Thought impossible’

The transformation has been done in a laboratory, by treating skin samples with a mix of chemicals or genetic modification.

It will be a monumental task to prove this is safe as what you’re doing is innately dangerous, but it is exciting as it’s potentially a new strategy for regenerative medicine.”

Prof Robin AliInstitute of Ophthalmology

Now scientists at the Spanish National Cancer Research Centre in Madrid have achieved the same results inside an animal.

“It is a surprising result, this was not expected, most of us thought that it would be impossible,” lead researcher Prof Manuel Serrano told the BBC.

The research group used mice genetically modified to switch on, when they were given a specific drug, production of four chemicals shown to reverse a tissue’s destiny in the laboratory.

Tissues were successfully transformed back into an embryonic state, but without further direction they rapidly developed into tumours.

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Speaking on Science In Action on the BBC World Service, Prof Serrano said: “Of course this is not what we want for regenerative medicine.

“We want to turn back the clock in a controlled manner and this is something we have to work out in the future.

“We have to find conditions where we reprogramme only partially so that they acquire a plastic state and repair the tissue.”

‘Monumental task’

Prof Robin Ali, from the Institute of Ophthalmology in London, is using stem cell technology to rebuild the retina to restore sight. He said the “ultimate goal” would be some treatment that could regenerate the back of the eye, “but that is a long way off”.

He added: “This is a really elegant study with important implications for the field.

“It will be a monumental task to prove this is safe, as what you’re doing is innately dangerous, but it is exciting as it’s potentially a new strategy for regenerative medicine.”

Overall it’s very cool and potentially very exciting, but it has massive issues in terms of control”

Prof Chris MasonUniversity College London

The technique was able to turn the clock back further than any other stem cell technology, including stem cells taken from an embryo.

Previous techniques produce stem cells that make the tissues found in the body. This study could also make those needed to support an embryo in the womb, such as the placenta.

Prof Robin Lovell-Badge, from the MRC’s National Institute of Medical Research, told the BBC that he could not see this technique leading directly to therapies, but rather improving scientific understanding.

“To me the interesting thing was the evidence that the cells correspond to an earlier stage of development.

“If we can repeat that with human cells, it would be incredibly useful and could have important research implications, such as understanding the placenta and how to help maintain a pregnancy.”

Prof Chris Mason, a stem cell scientist at University College London, said: “Overall it’s very cool and potentially very exciting, but it has massive issues in terms of control.”

Instead he thought techniques that transformed cells in the body directly into the desired tissue would be better than going via stem cells.

“It’s like a tree, instead of going down from a branch to the root and back up to a different branch, maybe we’ll be able to jump from branch to branch.”

Dr. Rachna Mehra specializes in regenerative medicine, including stem cell treatments and prolotherapy. See this blog for the latest news on medicine and health care.

Mainstream, positivist medicine is warming up to alternative medicine techniques such as acupuncture, which may be effective in treating lingering pain. Alice Park writes about findings on alternative medicine in this article.

Some people swear that regular sessions of acupuncture help relieve their back pain and headaches. And now there’s evidence they may be right.

In a study published in the Archives of Internal Medicine, researchers led by Andrew Vickers, an epidemiologist and biostatistician at Memorial Sloan Kettering Cancer Center, report that acupuncture is effective in reducing people’s chronic pain — more so than standard pain treatment and slightly better than using sham needles, suggesting that the benefits of real acupuncture are due to something more than the placebo effect.

The findings counter those of the last large study on the subject, which found that the needle technique was no better than a fake acupuncture treatment — using random pricking with toothpicks — in reducing people’s pain. But Vickers says his meta-analysis of the data, in which researchers reviewed 29 previous studies involving 17,922 participants, does a few things the previous studies did not. For one, he and his colleagues began by looking at only the most rigorous trials involving acupuncture and pain relief — those that directly compared acupuncture treatment with some type of sham needle therapy in which needles were either inserted only superficially or placed in locations that are not known by acupuncture standards to be key treatment points in the body. The authors of the analysis contacted each of the researchers on the previous studies to discuss with them how they separated the two treatment groups. By limiting their review to the most robust studies published, the authors could assess with more confidence acupuncture’s true effect on participants’ reports of pain before and after treatment.

Next, rather than simply summing up the total effect of acupuncture reported by researchers in previous studies, Vickers’ team asked for their raw data on individual participants’ self-reports of pain. Not all scientists use the same scale for reporting results, which makes it difficult to compare and consider such measurements of pain as a whole. With the raw data, Vickers and his team were able to standardize the participants’ responses and compare them in a more meaningful way.

The result was a clear and “robust” effect of acupuncture in relieving chronic pain in the back, neck and shoulders, as well as pain due to osteoarthritis and headaches, Vickers’ team found. Compared with people undergoing sham needle treatments, those receiving acupuncture reported drops in back and neck pain of 0.23 standard deviations, and of 0.55 standard deviations compared with those not using acupuncture at all. On a pain scale of 0 to 100, that meant that among the participants, who started out with an average baseline pain score of 60, pain ratings fell to 30 on average for those who got acupuncture, 35 for those who received fake acupuncture, and 43 for people who got usual care and no acupuncture.

“The effects of acupuncture are statistically significant and different from those of sham or placebo treatments,” says Vickers. “So we conclude that the effects aren’t due merely to the placebo effect.”

Acupuncture is an ancient Chinese remedy for a curing a host of chronic ills, from headaches to back pain and menstrual cramps. The practice, like all medical traditions from the East, is built on the concept of maintaining the balance of various body elements — including blood and nutrients along with less measurable ones like the energy force known as chi. Inserting needles at designated point on the body is supposed to intercept or unblock the flow of such elements, and lies at the heart of the centuries-old therapy of acupuncture.

However, these theories are completely foreign, even weird, to Western medicine, which has a harder time accepting unquantifiable entities such as chi. That’s why Western researchers have struggled not only to document objective evidence of acupuncture’s effectiveness, but also to provide some hints about how it may work.

Some doctors say the needles may release endorphins, the pleasure-inducing, painkilling chemicals that saturate the brain and numb pain signals. But such theories can’t fully explain why acupuncture patients say their chronic pain episodes become less frequent and less intense over time, with regular, long-term sessions. Some say the benefits of acupuncture are purely in the mind, a psychological placebo effect. But either way, for many pain patients, acupuncture does provide palpable relief.

Asks Dr. Andrew Avins in a commentary accompanying the study, if the treatment works, does it really matter whether the effect is physiological or psychological? “At least in the case of acupuncture, Vickers et al have provided some robust evidence that acupuncture seems to provide modest benefits over usual care for patients with diverse sources of chronic pain,” he writes. “Perhaps a more productive strategy at this point would be to provide whatever benefits we can for our patients, while we continue to explore more carefully all mechanisms of healing.”

In other words, if it works and doesn’t seem to lead to any harms, getting stuck with needles may not be such a weird idea after all.

Dr. Rachna Mehra is a proponent of expanding recognized medical techniques to include methods that aid in alleviating pain. Visit this Facebook page for more of updates on her practice.

As the pop culture saying goes, “if it tastes bad it must be good for you.” According to Alexandra Sifferlin, there may be more truth in that statement than acknowledged. Broccoli, a vegetable usually thought to be universally despised by children and adults, is a good example. Read this article to know more about the health benefits of eating broccoli.

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Even if you’re not a fan of broccoli, your joints may be.

Nutritionists have rhapsodized about the various benefits of broccoli — the cruciferous vegetable is stuffed with vitamins A, B, K, C, as well as nutrients such as potassium, zinc and fiber — and arthritis sufferers may soon join them. Along with its cousins brussel sprouts, cauliflower and cabbage, broccoli contains sulfur compounds that can filter out carcinogens that promote tumor growth.

And the latest study, published in the journal Arthritis & Rheumatism, shows that those substances may also battle inflammation, which is at the root of osteoarthritis, a painful, degenerative joint disease in which cartilage that normally protects joints starts to wear away under the influence of the inflammatory factors. For the estimated 12.4 million people affected by arthritis in the U.S. these results are certainly welcome news.

Starting with studies in mice, the researchers found that animals that ate a diet high in the sulforaphane found in broccoli had significantly less cartilage damage and signs of osteoarthritis compared to mice who did not consume sulforaphane. The team then moved to human and cow cartilage cells, and found that the sulforaphane was equally effective in protecting these cells from damage. The sulfur-based compound, they say, may be blocking enzymes that contribute to inflammation in cartilage, and the scientists are starting a trial to see if broccoli can protect a small group of arthritis patients getting knee replacement surgery.

If that trial confirms these early results, that could help more people to avoid arthritis to begin with; although surgery can treat symptoms, protecting joints from irreversible damage would keep joints stronger for a longer period of time.

“Although surgery is very successful, it is not really an answer. Once you have osteoarthritis, being able to slow its progress and the progression to surgery is really important, study author Ian Clark, professor of musculoskeletal biology at the University of East Anglia said in a statement. “Prevention would be preferable and changes to lifestyle, like diet, may be the only way to do that.”

Not to mention that a broccoli-rich diet could lower risk of other chronic diseases like obesity, which prior studies have connected to…arthritis.

Dr. Rachna Mehra agrees with other health professionals that a healthy diet is the key to fighting off many diseases. Visit this page for more health and wellness trends.


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Those not entirely familiar with what genetically engineered organisms (GMO) may be unknowingly consuming them. Genetically engineered food items such as fruits and vegetables were introduced to the consuming public in the 1990s. These biotechnology products have had their DNAs altered through genetic engineering techniques to induce features such as growth, resistance to pathogens, extra nutrients, and other nutritional benefits.

Although the Federal Government and many scientists gave their approval on GMO consumption, some groups still doubt the safety of GMO foods. Even the World Health Organization cited potential health risks such as toxicity and allergic reactions that are currently under investigation. As the Grist’s Nathanael Johnson asks, in the GMO safety dance, “what’s rule and what’s real?”


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This is a question that restaurant food chain Chipotle had to face recently amid its disclosure that it has been using GM ingredients in its products, the first in its industry to do so. But in its desire to serve “food with integrity,” the chain has decided to start reducing the number of menu items with GM ingredients. Quite a difficult feat since the United States Department of Agriculture reported that the adoption of genetically engineered crops in the country has been widespread in recent years.

The debate on whether genetically engineered food items are safe or harmful for human consumption is expected to continue until solid evidence is presented and accepted by all. Until then, it is up to the public to exercise their right on what or what not to eat.


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Rachna Mehra, M.D. believes that proper nutrition is the basis for healthy living. More tips on health and wellness are available on this Facebook page.

Herbal remedies
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Many forms of traditional medicine and a few complementary medical practices have been found to have therapeutic effects by practitioners of modern medicine. Likewise, the United Nations’ World Health Organization (WHO) has understood the importance of traditional and complementary medicine in health care and is now encouraging the adoption and integration in healthcare systems throughout the world.


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However, the WHO also notes that, for the most part, traditional medicine has been largely unregulated, which allows more unscrupulous dealers to sell products that are either adulterated forms of genuine traditional medicine products or ineffective imitations. This pervasive market practice is a threat to both actual patients and genuine practitioners of traditional medicine.


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The WHO adds that adding regulatory standards to traditional and complementary medicine can help bring the informal world of traditional medicine to full acceptance by healthcare systems worldwide. By introducing standards and practices that would ensure effectiveness and safety of traditional medicine products and procedures, the WHO hopes to make traditional medicine a safe complementary option for patients while protecting the business interests of genuine practitioners, whose market is being negatively affected by fraudulent products.

The full article and further resources on the WHO’s stance on the regulation of traditional, complementary, and alternative medicines and practices can be accessed on this page.


Among the services that Dr. Rachna Mehra offers is holistic medicine services. Visit this website for more information.

Mark Bittman agrees that healthful fast food is possible.  But the famed food writer posed a legitimate query in his article for The New York Times Sunday Magazine. “Is healthful fast food edible?”

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When my daughter was a teenager, about a dozen years ago, she went through a vegetarian phase. Back then, the payoff for orthodontist visits was a trip to Taco Bell, where the only thing we could eat were bean burritos and tacos. It wasn’t my favorite meal, but the mushy beans in that soft tortilla or crisp shell were kind of soothing, and the sweet “hot” sauce made the experience decent enough. I usually polished off two or three.

I was thinking of those Taco Bell stops during a recent week of travel. I had determined, as a way of avoiding the pitfalls of airport food, to be vegan for the length of the trip. This isn’t easy. By the time I got to Terminal C at Dallas/Fort Worth, I couldn’t bear another Veggie Delite from Subway, a bad chopped salad on lousy bread. So I wandered up to the Taco Bell Express opposite Gate 14 and optimistically asked the cashier if I could get a bean burrito without cheese or sour cream. He pointed out a corner on the overhead display where the “fresco” menu offered pico de gallo in place of dairy, then upsold me on a multilayered “fresco” bean burrito for about 3 bucks. As he was talking, the customers to my right and left, both fit, suit-wearing people bearing expressions of hunger and resignation, perked up. They weren’t aware of the fresco menu, either. One was trying to “eat healthy on the road”; the other copped to “having vegan kids.” Like me, they were intrigued by a fast-food burrito with about 350 calories, or less than half as many as a Fiesta Taco Salad bowl. It wasn’t bad, either.

Twelve years after the publication of “Fast Food Nation” and nearly as long since Morgan Spurlock almost ate himself to death, our relationship with fast food has changed. We’ve gone from the whistle-blowing stage to the higher-expectations stage, and some of those expectations are being met. Various states have passed measures to limit the confinement of farm animals. In-N-Out Burger has demonstrated that you don’t have to underpay your employees to be profitable. There are dozens of plant-based alternatives to meat, with more on the way; increasingly, they’re pretty good.

The fulfillment of these expectations has led to higher ones. My experience at the airport only confirmed what I’d been hearing for years from analysts in the fast-food industry. After the success of companies like Whole Foods, and healthful (or theoretically healthful) brands like Annie’s and Kashi, there’s now a market for a fast-food chain that’s not only healthful itself, but vegetarian-friendly, sustainable and even humane. And, this being fast food: cheap. “It is significant, and I do believe it is coming from consumer desire to have choices and more balance,” says Andy Barish, a restaurant analyst at Jefferies LLC, the investment bank. “And it’s not just the coasts anymore.”

I’m not talking about token gestures, like McDonald’s fruit-and-yogurt parfait, whose calories are more than 50 percent sugar. And I don’t expect the prices to match those of Taco Bell or McDonald’s, where economies of scale and inexpensive ingredients make meals dirt cheap. What I’d like is a place that serves only good options, where you don’t have to resist the junk food to order well, and where the food is real — by which I mean dishes that generally contain few ingredients and are recognizable to everyone, not just food technologists. It’s a place where something like a black-bean burger piled with vegetables and baked sweet potato fries — and, hell, maybe even a vegan shake — is less than 10 bucks and 800 calories (and way fewer without the shake). If I could order and eat that in 15 minutes, I’d be happy, and I think a lot of others would be, too. You can try my recipes for a fast, low-calorie burger, fries and shake.

In recent years, the fast-food industry has started to heed these new demands. Billions of dollars have been invested in more healthful fast-food options, and the financial incentives justify these expenditures. About half of all the money spent on food in the United States is for meals eaten outside the home. And last year McDonald’s earned $5.5 billion in profits on $88 billion in sales. If a competitor offered a more healthful option that was able to capture just a single percent of that market share, it would make $55 million. Chipotle, the best newcomer of the last generation, has beaten that 1 percent handily. Last year, sales approached $3 billion. In the fourth quarter, they grew by 17 percent over the same period in the previous year.

Numbers are tricky to pin down for more healthful options because the fast food industry doesn’t yet have a category for “healthful.” The industry refers to McDonald’s and Burger King as “quick-serve restaurants”; Chipotle is “fast casual”; and restaurants where you order at the counter and the food is brought to you are sometimes called “premium fast casual.” Restaurants from these various sectors often deny these distinctions, but QSR, an industry trade magazine — “Limited-Service, Unlimited Possibilities” — spends a good deal of space dissecting them.

However, after decades of eating the stuff, I have my own. First, there are those places that serve junk, no matter what kind of veneer they present. Subway, Taco Bell (I may be partial to them, but really. . .), McDonald’s and their ilk make up the Junk Food sector. One step up are places with better ambience and perhaps better ingredients — Shake Shack, Five Guys, Starbucks, Pret a Manger — that also peddle unhealthful food but succeed in making diners feel better about eating it, either because it tastes better, is surrounded by some healthful options, the setting is groovier or they use some organic or sustainable ingredients. This is the Nouveau Junk sector.

Chipotle combines the best aspects of Nouveau Junk to create a new category that we might call Improved Fast Food. At Chipotle, the food is fresher and tastes much better than traditional fast food. The sourcing, production and cooking is generally of a higher level; and the overall experience is more pleasant. The guacamole really is made on premises, and the chicken (however tasteless) is cooked before your eyes. It’s fairly easy to eat vegan there, but those burritos can pack on the calories. As a competitor told me, “Several brands had a head start on [the Chipotle founder Steve] Ells, but he kicked their [expletive] with culture and quality. It’s not shabby for assembly-line steam-table Mexican food. It might be worth $10 billion right now.” (It is.)

Chipotle no longer stands alone in the Improved Fast Food world: Chop’t, Maoz, Freshii, Zoës Kitchen and several others all have their strong points. And — like Chipotle — they all have their limitations, starting with calories and fat. By offering fried chicken and fried onions in addition to organic tofu, Chop’t, a salad chain in New York and Washington, tempts customers to turn what might have been a healthful meal into a calorie bomb (to say nothing of the tasteless dressing), and often raises the price to $12 or more. The Netherlands-based Maoz isn’t bad, but it’s not as good as the mom-and-pop falafel trucks and shops that are all over Manhattan. There are barely any choices, nothing is cooked to order, the pita is a sponge and there is a messy serve-yourself setup that makes a $10 meal seem like a bit of a rip-off.

Despite its flaws, Improved Fast Food is the transitional step to a new category of fast-food restaurant whose practices should be even closer to sustainable and whose meals should be reasonably healthful and good-tasting and inexpensive. (Maybe not McDonald’s-inexpensive, but under $10.) This new category is, or will be, Good Fast Food, and there are already a few emerging contenders.

Veggie Grill is a six-year-old Los Angeles–based chain with 18 locations. Technically, it falls into the “premium fast casual” category. The restaurants are pleasantly designed and nicely lighted and offer limited service. The food is strictly vegan, though you might not know it at first.

Kevin Boylan and T. K. Pillan, the chain’s founders, are vegans themselves. They frequently refer to their food as “familiar” and “American,” but that’s debatable. The “chickin” in the “Santa Fe Crispy Chickin” sandwich is Gardein, a soy-based product that has become the default for fast-food operators looking for meat substitutes. Although there are better products in the pipeline, Gardein, especially when fried, tastes more or less like a McNugget (which isn’t entirely “real” chicken itself). The “cheese” is Daiya, which is tapioca-based and similar in taste to a pasteurized processed American cheese. The “steak,” “carne asada,” “crab cake” (my favorite) and “burger” are also soy, in combination with wheat and pea protein. In terms of animal welfare, environmental damage and resource usage, these products are huge steps in the right direction. They save animals, water, energy and land.

Boylan wanted to make clear to me that his chain isn’t about haute cuisine. “We’re not doing sautéed tempeh with a peach reduction da-da-da,” he said. “That may be a great menu item, but most people don’t know what it is. When we say ‘cheeseburger’ — or ‘fried chickin’ with mashed potatoes with gravy and steamed kale — everyone knows what we’re talking about.” He’s probably right, and the vegetables are pretty good, too. The mashed potatoes are cut with 40 percent cauliflower; the gravy is made from porcini mushrooms and you can get your entree on a bed of kale instead of a bun.

When I first entered a Veggie Grill, I expected a room full of skinny vegans talking about their vegan-ness. Instead, at locations in Hollywood, El Segundo and Westwood, the lines could have been anywhere, even an airport Taco Bell. The diners appeared mixed by class and weight, and sure looked like omnivores, which they mostly are. The company’s research shows that about 70 percent of its customers eat meat or fish, a fact that seems both reflected in its menu and its instant success. Veggie Grill won best American restaurant in the 2012 Los Angeles Times readers’ poll, and sales are up 16 percent in existing stores compared with last year. The plan is to double those 18 locations every 18 months for the foreseeable future — “fast enough to stay ahead of competitors, but not so fast as to lose our cultural DNA,” Boylan said. In 2011, the founders brought in a new C.E.O., Greg Dollarhyde, who helped Baja Fresh become a national chain before its sale to Wendy’s for nearly $300 million.

Veggie Grill is being underwritten partly by Brentwood Associates, a small private-equity firm that’s invested in various consumer businesses, including Zoës Kitchen, a chain that offers kebabs, braised beans and roasted vegetables. “For a firm like us to get involved with a concept like Veggie Grill, we have to believe it’s a profitable business model, and we do,” Brentwood’s managing director, Rahul Aggarwal, told me. “Ten years ago I would’ve said no vegan restaurant would be successful, but people are looking for different ways to eat and this is a great concept.”

I admire Veggie Grill, but while making “chickin” from soy is no crime, it’s still far from real food. I have a long-running argument with committed vegan friends, who say that Americans aren’t ready for rice and beans, or chickpea-and-spinach stew, and that places like Veggie Grill offer a transition to animal-and-environment-friendlier food. On one level, I agree. Why feed the grain to tortured animals to produce lousy meat when you can process the grain and produce it into “meat”? On another level, the goal should be fast food that’s real food, too.

Much of what I ate at Veggie Grill was fried and dense, and even when I didn’t overeat, I felt as heavy afterward as I do after eating at a Junk Food chain. And while that Santa Fe Crispy Chickin sandwich with lettuce, tomato, red onion, avocado and vegan mayo comes in at 550 calories, 200 fewer than Burger King’s Tendercrisp chicken sandwich, the “chickin” sandwich costs $9. The Tendercrisp costs $5, and that’s in Midtown Manhattan.

Future growth should allow Veggie Grill to lower prices, but it may never be possible to spend less than 10 dollars on a meal there. Part of that cost is service: at Veggie Grill, you order, get a number to put on your table and wait for a server. It’s a luxury compared with most chains, and a pleasant one, but the combination of the food’s being not quite real and the price’s being still too high means Veggie Grill hasn’t made the leap to Good Fast Food.
During my time in Los Angeles, I also ate at Native Foods Café, a vegan chain similar to Veggie Grill, where you can get a pretty good “meatball” sub (made of seitan, a form of wheat gluten), and at Tender Greens, which, though it is cafeteria-style (think Chipotle with a large Euro-Californian menu), flirts with the $20 mark for a meal. It can’t really be considered fast food, but it’s quite terrific and I’d love to see it put Applebee’s and Olive Garden out of business.

In Culver City, I visited Lyfe Kitchen (that’s “Love Your Food Everyday”; I know, but please keep reading). Lyfe has the pedigree, menu, financing, plan and ambition to take on the major chains. The company is trying to build 250 locations in the next five years, and QSR has already wondered whether it will become the “Whole Foods of fast food.”

At Lyfe, the cookies are dairy-free; the beef comes from grass-fed, humanely raised cows; nothing weighs in at more than 600 calories; and there’s no butter, cream, white sugar, white flour, high-fructose corn syrup or trans fats. The concept was the brainchild of the former Gardein executive and investment banker Stephen Sidwell, who quickly enlisted Mike Roberts, the former global president of McDonald’s, and Mike Donahue, McDonald’s U.S.A.’s chief of corporate communications. These three teamed up with Art Smith, Oprah’s former chef, and Tal Ronnen, who I believe to be among the most ambitious and talented vegan chefs in the country.

According to Roberts, Lyfe currently has more than 250 angel investors who “represent a group of people that are saying, ‘We’ve been waiting for something like this.’ ” The Culver City operation opened earlier this year, and two more California locations are scheduled to open before the year is out. New York locations are being actively scouted, and a Chicago franchise is in the works.

When I visited the Culver City operation, shortly before its official opening, I sampled across the menu and came away impressed. There are four small, creative flatbread pizzas under $10; one is vegan, two are vegetarian and one was done with chicken. I tasted terrific salads, like a beet-and-farro one ($9) that could easily pass for a starter at a good restaurant, and breakfast selections, like steel-cut oatmeal with yogurt and real maple syrup ($5) and a tofu wrap ($6.50), were actually delicious.

Lyfe, not unlike life, isn’t cheap. The owners claim that an average check is “around $15” but one entree (roast salmon, bok choy, shiitake mushrooms, miso, etc.) costs exactly $15. An “ancient grain” bowl with Gardein “beef tips” costs $12, which seems too much. Still, the salmon is good and the bowl is delicious, as is a squash risotto made with farro that costs $9 — or the price of a “chickin” sandwich at Veggie Grill or a couple of Tendercrisp sandwiches at Burger King.

How in the world, I asked Roberts and Donahue, can they expect to run 250 franchises serving that salmon dish or the risotto or their signature roasted brussels sprouts, which they hope to make into the French fries of the 21st century? Donahue acknowledged that it was going to be a challenge, but nothing that technology couldn’t solve. Lyfe will rely on digital order-taking, G.P.S. customer location — a coaster will tell your server where you’re sitting — online ordering and mobile apps. Programmable, state-of-the-art combination ovens store recipes, cook with moist or dry heat and really do take the guesswork out of cooking. An order-tracking system tells cooks when to start preparing various parts of dishes and requires their input only at the end of each order. Almost all activity is tracked in real time, which helps the managers run things smoothly.

Lyfe isn’t vegan, so much as protein-agnostic. You can get a Gardein burger or a grass-fed beef burger, “unfried” chicken or Gardein “chickin.” You can also get wine (biodynamic), beer (organic) or a better-than-it-sounds banana-kale smoothie. However, I fear that Lyfe’s ambition, and its diverse menu, will drive up equipment and labor costs, and that those costs are going to keep the chain from appealing to less-affluent Americans. You can get a lot done in a franchise system, but its main virtues are locating the most popular dishes, focusing on their preparation and streamlining the process. My hope is that Lyfe will evolve, as all businesses do, by a process of trial and error, and be successful enough that they have a real impact on the way we think of fast food.

Veggie Grill, Lyfe Kitchen, Tender Greens and others have solved the challenge of bringing formerly upscale, plant-based foods to more of a mass audience. But the industry seems to be focused on a niche group that you might call the health-aware sector of the population. (If you’re reading this article, you’re probably in it.) Whole Foods has proved that you can build a publicly traded business, with $16 billion in market capitalization, by appealing to this niche. But fast food is, at its core, a class issue. Many people rely on that Tendercrisp because they need to, and our country’s fast-food problem won’t be solved — no matter how much innovation in vegan options or high-tech ovens — until the prices come down and this niche sector is no longer niche.

It was this idea that led me, a few years ago, to try to start a fast-food chain of my own, modeled after Chipotle. I wanted to focus on Mediterranean food, largely on plant-based options like falafel, hummus, chopped salad, grilled vegetables and maybe a tagine or ratatouille. I wanted to prioritize sustainability, minimize meat and eliminate soda, and I’d treat and pay workers fairly. But after chatting with a few fast-food veterans, I soon recognized just how quixotic my ideas seemed. Anyone with industry experience would want to add more meat, sell Coke and take advantage of both workers and customers to maximize profits. I lost my stomach for the project before I even really began, but recent trends suggest that there may have been hope had I stuck to my guns. Soda consumption is down; meat consumption is down; sales of organic foods are up; more people are expressing concern about G.M.O.s, additives, pesticides and animal welfare. The lines out the door — first at Chipotle and now at Maoz, Chop’t, Tender Greens and Veggie Grill — don’t lie. According to a report in Advertising Age, McDonald’s no longer ranks in the top 10 favorite restaurants of Millennials, a group that comprises as many as 80 million people. Vegans looking for a quick fix after the orthodontist have plenty of choices.

Good Fast Food doesn’t need to be vegan or even vegetarian; it just ought to be real, whole food. The best word to describe a wise contemporary diet is flexitarian, which is nothing more than intelligent omnivorism. There are probably millions of people who now eat this way, including me. My own style, which has worked for me for six years, is to eat a vegan diet before 6 p.m. and then allow myself pretty much whatever I want for dinner. This flexibility avoids junk and emphasizes plants, and Lyfe Kitchen, which offers both “chickin” and chicken — plus beans, vegetables and grains in their whole forms (all for under 600 calories per dish) — comes closest to this ideal. But the menu offers too much, the service raises prices too high and speed is going to be an issue. My advice would be to skip the service and the wine, make a limited menu with big flavors and a few treats and keep it as cheap as you can. Of course, there are huge players who could do this almost instantaneously. But the best thing they seem able to come up with is the McWrap or the fresco menu.

In the meantime, I’m throwing out a few recipes to the entire fast-food world to help build a case that it’s possible use real ingredients to create relatively inexpensive, low-calorie, meat-free, protein-dense, inexpensive fast food. If anyone with the desire can produce this stuff in a home kitchen, then industry veterans financed by private equity firms should be able to produce it at scale in a fraction of the time and at a fraction of the price. You think people won’t eat it? There’s a lot of evidence that suggests otherwise.

Dr. Rachna Mehra believes in the importance of healthy living in order to age well. This website provides additional information on wellness and longevity.