My husband has to be careful about grains and what fruits he likes due to carbohydrates (he's diabetic).
Granted, the typical American diet does leave much to be desired in health terms, but I'm not sure how to juggle the necessary revisions within my husband's dietary needs and keep the grocery bill halfway sane, especially if we were to seriously cut meat and other animal products.
I do think individual judgment is involved to accommodate allergies or other dietary issues, though.
(The soft drink habits DH and I both have would be a side issue, and yeah, we need to work on that. Hard for one household member to make such adjustments if the other isn't on board.)
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