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Saturday, Oct. 11, 2003
It's 6:45 p.m. after a bruising
day at the office and a hair-raising commute on the freeway,
you are standing
in the kitchen about to prepare a healthy, satisfying dinner
for your spouse, your two school-age children and yourself.
As usual, all they want to know is "What's for dinner?" and "When
do we eat?" You dump a box of thin spaghetti into a pot
of boiling water, zap 3 cups of green beans in the microwave,
pop a loaf of frozen garlic bread into the toaster oven and
pour a medium-size jar of marinara sauce into a saucepan to
simmer. While all that's bubbling, you chop up half a head
of iceberg lettuce and a couple of tomatoes for the salad,
which you'll sprinkle with a light dressing. Dessert will be
two scoops of frozen yogurt per person and a plate of assorted
low-fat cookies for the family to share. Sounds pretty healthy,
right?
Wrong. While this meal may be better than what most Americans
eat for dinner, it's enough food for a family twice the size
of yours. In addition, it contains some nutritional traps that
in the best-case scenario will make you fat and in the worst
will increase your chances of developing diabetes, heart disease
and certain types of cancer. Think you know the pitfalls? Read
on. You may discover some surprises.
Here are just a few of the problems:
* Most "light" salad dressings are too heavy on sugar
and salt and too light on nutrition. A better choice is a simple
oil-and-vinegar dressing, which — although packed with
calories — contains lots of heart-healthy mono-unsaturated
fatty acids and no saturated fat.
* You're serving your family too many highly processed foods.
The latest research shows that such foods won't keep them satisfied
for very long and may make them hungrier in the long run.
* Having different kinds of cookies to choose from makes it
more likely that your family will eat more cookies than they
should. The fewer our choices, the less we eat.
* Your portion sizes are far too generous. According to the
U.S. Food Guide Pyramid, you're giving each member of your
family 4 servings of spaghetti, 112 servings of marinara sauce
and 2 servings of frozen yogurt. The whole meal contains 1,500
calories per person, or 80% of the daily requirement for a
sedentary office worker.
* Let's not even get started on whether the tomatoes should
be cooked or raw, how much salt, sugar and trans fat there
is in the garlic bread, or how many calories are packed into
that marinara sauce. It just goes to show that it's hard to
eat healthy even when we try. We've all heard that fruits and
vegetables are good for us, that restaurant portions are too
big, that we should exercise more. But even a casual glance
at public-health statistics suggests that Americans don't know
how to put that information into practice. Two out of three
Americans are overweight or obese. The incidence of Type 2
diabetes among children is climbing. And any gains we've made
against heart disease by quitting smoking may be about to disappear.
Alarmed by the worsening trends, health experts have unleashed
a flood of nutritional advice for consumers — much of
it contradictory.
One expert says red meat is bad. Another says bacon keeps you
trim. Someone says skip the potatoes, and someone else says
eat the skin. And let's face it, controversy sells. Diet books
and magazine articles try to grab our attention by telling
us everything we thought we knew was wrong. (It's not.)
Even the government-approved labels on our food can lead us
astray. Serving sizes bear no relationship to the helpings
we usually eat. Low-fat products are not necessarily low in
calories. And now the Food and Drug Administration says we
should be on the lookout for trans fat — a lesser-known
type of fat that is every bit as bad for the heart as saturated
fat — though we won't learn which products are the worst
offenders until 2006. Meanwhile, the food pyramid, which serves
as the basis for all meals prepared in the federal school-lunch
program, is about to be changed. However, the next revision
won't be out until 2005.
"People can feel like a ping-pong ball," says Dr. David
Katz, head of the Yale School of Medicine Prevention Research
Center and author of The Way to Eat (Sourcebooks; 2002). "They
are being batted in one direction and then another." Not
that we necessarily mind. Being perplexed can ease our conscience.
As long as we can point to a general state of nutritional confusion,
we don't have to take responsibility for our ever expanding
waistlines.
The truth is that nutritionists have a fairly good idea about
what constitutes a healthy diet as well as plenty of solid
evidence to back that up. As a rule, they tell us, we should
eat lots of fruits and vegetables, favor whole grains over
highly processed cereals and make red meat an occasional treat
rather than the daily centerpiece of our evening meal. And
we shouldn't eat any more than our body needs.
The problem is that no matter how much we think we know about
what goes into a healthy meal, we often misjudge the results.
Some vegetable dishes, it turns out, are healthier than others,
some grain products are less processed than others, some fish
are safer than others. You may think you are eating right,
but by making subtle changes in what you eat and how you eat
it, you could start eating considerably healthier.
The rewards are worth the effort. Studies show that as much
as 80% of heart disease and 90% of diabetes can be tied to
unhealthy eating and lifestyle habits. Doctors have proved
that a diet emphasizing fruits and vegetables as well as small
amounts of nuts and dairy products can lower blood pressure
and "bad" cholesterol as effectively as many medications.
And evidence is growing that adding fiber to your diet and
avoiding highly refined foods can help prevent or delay the
onset of Type 2 diabetes.
You don't have to sacrifice flavor. You don't have to go hungry. "It
doesn't have to be an all-or-nothing thing," says Dr.
Donald Hensrud of the Mayo Clinic in Rochester, Minn. "That
attitude can actually make it harder." You do need to
put in some effort — much of it in the kitchen — and
accept that there really is no free lunch. But with a little
planning and a better understanding of some of the basic food
traps, we can all eat a whole lot better and smarter.
You need Less Food Than You Think
"Everything in moderation" is a great motto until you realize
that moderate means different things to different people. Better
to nail down some specifics and measure them using a tough-to-fudge
yardstick — the much dreaded but ultimately very helpful
concept of the calorie. Stop, don't turn the page just yet.
We're not going to get tediously obsessive about this. But
whether you, like most Americans, need to lose weight or you
just want to maintain the figure you already have, you've got
to know a little something about calories.
At its heart, the rule for losing weight is simple: eat fewer
calories than you burn. As anyone who has ever tried to shed
a couple of pounds knows all too well, that's often harder
than it sounds. Eat too little, and your body ratchets down
its metabolism so that it doesn't need as much energy and you
regain weight more easily. One way to counteract that is to
boost your level of physical activity to increase the number
of calories you burn.
But when it comes to weight control, exercise — though
necessary — can take you only so far. Think about it,
and you'll understand why. Food is so plentiful and so readily
available that you're always going to be able to eat more than
you can sweat off. The average American consumes 530 calories
more per day now than he or she did in 1970. That's roughly
what you'd get from eating 21/2 cups of cooked pasta. You would
have to walk an extra two hours a day to burn that off. That
doesn't mean you should forget about exercising — the
benefits to your heart, bones and peace of mind are just too
great.
It does mean you have to pay more attention to the "calories
in" side of the equation.
Few of us really get this message. "People don't understand
the most basic things about calories," says Marion Nestle,
chair of the department of nutrition, food studies and public
health at New York University. "Larger portions have more
calories. Eating more often means that you eat more calories.
Having food in front of you means you eat more calories."
Even if you're happy when you step on the scales, you can't
eat the way you did when you were a teenager — or even
just a decade ago. As you grow older, your body needs fewer
calories to keep going. Certain exercises — like yoga
or weight training — help counteract the trend because
they build muscle, which burns more calories than fat. But
at some
point, to avoid gaining weight, you will have to eat less.
The Secrets of Portion Control
So, what are some smart ways of cutting back? Start by fooling
both your eyes and your stomach. As you reduce the amount of
food you eat, use smaller plates to keep your meals from looking
skimpy. Begin a couple of meals each week with an apple or
a cup of soup. Either will help curb your appetite. The apple,
besides being nutritious and only 80 calories, is full of soluble
fiber, which keeps the stomach from emptying too quickly. And
there is something about the texture and consistency of soup
(broth-, not cream-based, low in sodium and not more than 150
calories) that is particularly satisfying to the stomach. Several
intriguing studies have found that other liquids, like fruit
juices or sodas — which are often high in calories — do
nothing to suppress the appetite.
Watch out for the portion-size trap. For reasons known only
to bureaucrats, the portion sizes provided in the U.S. government's
food pyramid can differ dramatically from those indicated on
a product's food label. (One set of figures is regulated by
the Department of Agriculture, and the other, which appears
on product labels, is regulated by the Food and Drug Administration.)
A single serving of pasta is 12 cup (cooked) according to the
usda, 1 cup according to the FDA and at least 2 cups according
to most families.
Eat a variety of fruits and vegetables, but limit your choices
of everything else, particularly snacks. Giving folks a wide
choice of foods in a single meal, scientists have shown, encourages
them to eat more. "It works for every species ever tested — humans,
rats, fish, cats," says Susan Roberts, professor of nutrition
at Tufts University in Boston. If there are two types of cookies
on a plate, the temptation is to eat one of each.
Eventually, you will have to become familiar with the calorie
count of your foods. Just a couple of days of measuring or
weighing what you eat and calculating the calories you consume
can be a real eye-opener. You don't have to do this for the
rest of your life, just long enough to get a feel for it. Many
nutritionists recommend eating healthy frozen dinners, whose
calorie counts are printed on the package, as a good way to
make the transition to smaller portion sizes. How many calories
you should eat in a day depends on whether you want to lose
or maintain weight. The American Heart Association's rule of
thumb is to multiply your weight in pounds by 13 (15 if you're
active). If you want to lose weight, subtract 250 calories.
All Fats Are Not Created Equal
for more than 30 years, most researchers agreed that the healthiest
diets were those low in percentage of calories attributable
to fat. Now they realize that just as there are good and bad
types of cholesterol, there are good and bad types of fat.
The good fats — found in foods like fish, olive oil,
avocados and walnuts — actually improve cholesterol levels
in the blood and significantly reduce the risk that the heart
will
suddenly stop. As for the bad fats, there are now two villains
instead of just one. Saturated fats — typically found
in red meat, butter and ice cream — are still champion
artery cloggers. But trans fats — found primarily in
processed foods, such as margarines and many commercially baked
or fried
foods but also in whole milk — may be even worse.
Good fats do more than help protect the heart. They also seem
to delay hunger pangs. "People on these high-starch, low-fat
diets are often hungry soon after they eat. They would be more
satisfied eating nuts or a salad with a full-fat dressing," says
Dr. Walter Willett, chairman of the department of nutrition
at the Harvard School of Public Health and author of Eat, Drink
and Be Healthy (Fireside; 2001). "And longer-term studies
are showing that people tend to be able to control their weight
better over the long run on a moderate or higher-fat diet than
on a low-fat diet."
Fats have more flavor — a fact that was not lost on the
editors of Cooking Light magazine. Since the mid-1990s, they
have slipped a modicum of butter into their recipes. "You
have to make food enjoyable," says Jill G. Melton, senior
editor of Cooking Light (which, like TIME, is owned by AOL
Time Warner). "If something tastes bad, you're not going
to want it again."
Just remember that there's a smart way to include fat in your
diet and lots of unhealthy ones. Good fats contain double the
calories (9 calories per gram) of either proteins or carbohydrates
(4 calories per gram). So there's little room for error. If
you eat nuts, you're going to have to eat less of something
else.
What about the Mediterranean diet? you ask. Researchers have
long been fascinated by the traditional Greek and Italian diets
of the 1960s, which contained as much as 40% fat but didn't
trigger a lot of heart attacks. Don't assume that what worked
for Greeks and Italians 40 years ago will work for you. After
all, they typically ate a pound of fruit a day (equal to four
medium apples) and little red meat, and many of them got lots
of exercise tilling fields and tending livestock. "The
Mediterranean diet works well in the Mediterranean," says
Yale's Katz. "My concern about it in the U.S. is that
people will continue to go to Burger King but just dump olive
oil over their French fries."
You can go overboard trying to avoid trans fat. Yes, there
is a small amount of trans fat in whole milk, but whole milk
is what most pediatricians recommend for children from the
age of 1 to 2. Their brains need all kinds of fats to develop
properly. After they reach age 2, you've got to be on the lookout
for saturated fats as well. "You don't want people to
think trans fats are the only bad guys," says Alice Lichtenstein,
a nutrition professor at Tufts University in Boston and a frequent
spokeswoman for the American Heart Association. "If a
cracker has 2% trans and 2% saturated fat, it's better than
7% saturated and 0% trans." Finally, no matter how low
McDonald's reduces the amount of trans fat in its French fries,
they are never going to be a health food. Which brings us to
...
The Potato Factor
It's not that spuds are so bad; it's that they're misunderstood — not
to mention deep-fried and drowned in sour cream and cheese.
America's much beloved tuber definitely has a dual personality.
A good source of potassium (particularly if you eat the skin)
and a great thickener for soups, the potato still doesn't have
all the benefits bestowed by more colorful produce like broccoli,
Brussels sprouts and green beans. v This problem of mistaken
identity extends to quite a few of the foods we commonly call
carbohydrates. First, a tiny rant about the word carbohydrate.
When nutritionists first advised us to replace some of the
fats in our diets with complex carbohydrates, what they had
in mind was beans, fruits, leafy green vegetables and whole
grains. What we loaded up on was pasta, white rice and French
fries. Technically, we were following the rules, but by focusing
on these highly processed or refined foods, we were missing
out on a lot of antioxidants and other important nutrients.
And we found out, much to the detriment of our waistlines,
that it's a whole lot easier to overeat pasta, rice and potatoes
than apples and broccoli.
O.K., so maybe the experts were a little naive about human
nature. But no one anticipated the enthusiasm with which the
food industry would jump on the low-fat bandwagon. Alas, it
mostly just replaced the fat with refined foods and sugars
and left consumers with the impression that they could eat
as much of this stuff as they wanted. As if that weren't bad
enough, it is becoming increasingly clear that some folks respond
to highly refined foods differently than the rest of the population.
All carbohydrates get broken down in the body into a simple
sugar called glucose. This is a good thing, since glucose is
the principal fuel that powers our bodies and brains. But about
a quarter of American adults — some 50 million men and
women — have trouble regulating their glucose levels.
The hallmarks of this condition, which nutritionists now call
metabolic
syndrome, include a big waist (40 in. or more for men; 35 in.
or more for women), high blood pressure (more than 130/85 mm
Hg), a predisposition toward diabetes and troubling cholesterol
levels in the blood.
Doctors aren't quite sure exactly why the body sometimes reacts
this way, though they know that metabolic syndrome is exacerbated
by a sedentary lifestyle. Hence their No. 1 recommendation
for patients with metabolic syndrome is to get more exercise
and build muscle mass. But they also now advise them to replace
at least some of the refined carbohydrates in their diets with
healthy fats, like those in nuts and olive oil. In 2000 the
American Heart Association, which has long touted the advantages
of a low-fat lifestyle, added an exception to its guidelines
for folks with this condition.
None of this means you should avoid eating fruits and vegetables.
(In their natural form, they are not highly refined.) Just
make sure that they are as colorful as possible — in
order to get a wide variety of nutrients and those ever important
antioxidants. Using spinach instead of iceberg lettuce in a
salad, for example, will double the dietary fiber consumed,
more than quadruple the calcium and potassium, more than triple
the folate and provide seven times as much vitamin C. If you
don't like spinach, try a more nutritious lettuce like romaine
or Boston.
Your goal should be to eat at least five 12-cup servings of
fruits and vegetables a day — and preferably more. (Nine
is divine, according to the latest nutritional research.) Don't
assume that fresh is the only game in town. "Frozen can
be just as good and occasionally better," says Lichtenstein
at Tufts. Because frozen fruits and vegetables are chilled
immediately after being picked, they often contain more nutrients
than produce that has been sitting on the shelf.
Sirloin, Salmon or Beans?
Protein from any number of sources can be part of a healthy
diet. But figuring out just how much or how little of each
to include can be tricky. We've known for some time that most
Americans need to cut back on their consumption of red meat
because of its high saturated-fat content. But now some health
experts are raising the possibility that eating too much fish — long
a staple of heart-healthy diets — may expose folks to
dangerous levels of mercury and other poisons. That's still
being debated.
A study published in August suggests that most of the mercury
found in fish is of a form that is not particularly toxic to
humans. So if your choice is between the third helping of swordfish
that week and a Big Mac, go for the swordfish.
Overall, how much protein do you need? Given the popularity
of high-protein diets, you may be surprised to learn that there
hasn't been much research on the long-term health benefits
and risks of eating lots of protein, though there is concern
that too much protein can lead to kidney and liver problems.
Scientists have calculated the minimum amount needed to keep
your muscles from breaking down — just under 70 grams,
or about 212 oz., a day for someone who weighs 150 lbs. (Food
is so plentiful that Americans rarely develop protein deficiencies.)
Whether high levels of protein are linked to an increased risk
of developing cancer or heart disease remains unclear. What
is known is that too much protein of any kind can leach calcium
out of your body and that eating lots of animal protein usually
means you're increasing your intake of saturated fat as well. "I
don't believe any nutritionist would argue that 30% protein
isn't a reasonable upper limit for long-term safety," says
Roberts at Tufts. But what is safe and what is ideal are two
different matters. Current federal guidelines suggest that
adults get 10% to 15% of their daily calories from protein.
If you're like most people, what interests you about high-protein
diets is the possibility that they might make it easier to
slim down. Preliminary evidence suggests this may be the case
over the short run, but in many ways, that is almost beside
the point. "People forget they should be eating a nutritious,
healthy diet for other reasons," says Barbara Rolls, professor
of nutrition at Pennsylvania State University. "They go
on these kooky weight-management fad diets, and they lose all
sight of bone and cardiovascular health." So remember,
a little protein goes a long way. Your muscles will not fall
apart if you don't eat protein at every meal. Stick with leaner
cuts of meat and give preference to beans, fish, chicken or
pork over red meat.
The basic rules for eating smarter couldn't be simpler. Watch
your total calorie intake. Burn off as many calories as you
take in. And be choosy about the foods you eat — not
just for a couple of weeks or months but for the rest of your
life. "It
takes work," says Dr. John Swartzberg, who chairs the
editorial board of the U.C. Berkeley Wellness Letter. "We
live in a fast-food world." The sooner we accept that
that is not the healthiest of environments for us, the better
off we'll be.
So, what's for dinner?
___________________________________
Reported by David Bjerklie and Amanda Bower/New
York, Laura Locke/San Francisco, Maggie Sieger/Chicago, Frank
Sikora/Birmingham and Cathy Booth Thomas/Dallas
Copyright © 2003
Time Inc.
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