Last week, as my son and I tackled Glenn Pass, one of the highest points of the John Muir Trail in the Sierra Nevada Mountains, the food we brought was nutritious and tasty but above all lightweight. We had to carry our freeze-dried lasagna on our backs a good distance, and at almost 12,000 feet the air is thin. At home in Honolulu our family worries less about the weight of our food and, like most, more about health and cost, along with convenience and taste.

According to a recent study in the policy journal Health Affairs, most Americans would like to eat healthier but are limited by cost. Federal guidelines for healthy eating were revised in January with recommendations to include more vitamin D, calcium, potassium and dietary fiber. Fresh fruits and vegetables, especially organic produce, can be expensive. Not everyone can afford to shop at Whole Foods each week to stock up on blueberries and wild Atlantic salmon.

A recent documentary by Robert Kenner, "Food Inc.," explores a family of four in which dad, an overweight taxi driver, is diagnosed with diabetes. Counseled by his health provider on how to eat to trim down and get off his diabetes medication, the entire family undertakes a change in shopping and eating habits to help dad. Despite their best efforts on a modest budget, they reluctantly decide that it is more economical to return to eating fast food and to cover the co-pay charge for his diabetes medication.

The truth is that eating well is not a luxury limited to the wealthy and fat, and it is never a bargain. The personal and societal cost of a heart attack, stroke or cancer, especially early in life, is never justified by habitual expediency. More often than not, to minimize cost, the sacrifice is convenience and time.

For those without easy access to the aina at one’s home, community gardens are a great way to connect with others of like mind and to ensure fresh, local produce. It’s amazing how much can be grown even on the lanai of an apartment or condominium.

It also helps to stay low on the food chain. Red meat — organic, free-range, antibiotic and hormone-free or otherwise — is going to cost top dollar. A recent study showed that red meat from any source increases the risk of diabetes. Chicken or fish is usually less expensive per gram of protein, while plant sources of protein such as tofu or the correct combination of rice and beans are still more reasonable. Eating this way is not only good for the health of body and wallet, but it also reduces one’s carbon footprint to help stave off global warming.

Increasing dietary potassium can be expensive, but when on a budget, go for bananas, which is easy enough in Hawaii. Apart from dairy products, good sources of calcium include broccoli, leafy greens, tofu and legumes. A rich local source of vitamin D is ahi. Bear in mind that too much ahi can increase your mercury levels, so moderation is important. Remember that for most dietary sources of vitamin D, we also need sun on the skin, in judicious amounts, for conversion to its useful form.

To maintain adequate dietary fiber is easy and of prime importance. Fruit and vegetables are great, but whole grains such as brown rice also do the trick. Fiber binds cholesterol and toxins and carries them out of the bowel while ensuring that we remain regular. In doing so, we can help prevent colon cancer and cardiovascular disease.

Living in Hawaii we have ready access to food sources rich in nutrients such as fish and bananas, which the FDA suggests we increase. Despite the challenge we face in balancing health with cost and convenience, it is worth the investment. At least we don’t have to carry it all on our backs at high altitude.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.