Healthy Eating Guidelines

Eating is one of life’s greatest pleasures. Making unwise food choices, however, can increase your risk of a heart attack, stroke, diabetes, cancer, obesity, osteoporosis, high blood pressure, and a host of other serious health problems.

It’s obvious that if you want good health you need to choose foods that promote health and avoid those that promote disease. Fortunately, health and nutrition research has identified key guidelines that can help us make wise food choices. Here are 10 healthy eating guidelines to help you achieve optimum health.

1. Eat predominantly from whole, plant based foods. The U.S. Dietary Guidelines state1, “Eating a variety of whole grains, fruits, and vegetables is the basis of healthy eating.” These foods are packed with nutrients and phytochemicals that protect the body from heart disease, cancer, and high blood pressure. They are cholesterol free and low in calories. Emphasize plant-based foods in your diet.

2. Maintain a healthy weight. This is not an easy task for most people. Two out of three people today are either overweight or obese! If you don’t plan to maintain a healthy weight, chances are you will become overweight in time. Here are eating tips to consider:

• Learn to enjoy lower calorie foods
• Limit high calorie desserts and treats to special occasions only
• Drink water in place of soda pop, beer, and other high calorie drinks
• Limit fast food and high fat restaurant meals
• Keep portion sizes moderate and limit second helpings
• Eliminate junk foods and frequent snacking
• Eat slowly and enjoy your meals
• If you need help in losing weight, join a reliable program with a support group that meets regularly
• A healthy weight is defined as a body mass index (BMI) less than 25

3. Aim for 30-60 minutes of physical activity daily. Activity balances calorie intake to help you maintain a healthy weight. Choose moderate activities such as brisk walking, active gardening, mowing the lawn, aerobics to music, biking, and active sports.

Start at levels you can complete without undue strain or fatigue. Gradually increase your time and/or intensity until you can complete at least 30 minutes daily. Two 15-minute sessions per day is fine.

Keep it fun. Think of physical activity as play! Take time to play or be active every day. For best health, the Institute of Medicine² recommends up to 60 minutes of activity on most days, especially if weight control is a problem. If you have health problems, get your doctor’s guidance before starting to exercise.

4. Eat fresh fruits and vegetables in abundance. They help maintain your weight and promote good health. The new NIH DASH Diet3 for cardiovascular health recommends eating 8-10 servings of fruits and vegetables daily. These foods help lower blood pressure and cholesterol. They also add color, texture, taste, and enjoyment to any meal. Include:

• Citrus fruits
• Raw vegetables
• Salads and leafy greens
• Berries and melons
• Onions, scallions, leeks, and garlic
• Broccoli and cabbage
• Tomatoes and peppers
• Apples and bananas

5. Choose healthy fats. Not all fats are bad. Some are essential for health. You will live longer and have less heart disease if you eat some healthy fats every day. Include:

• Unhydrogenated vegetable oils such as Canola, olive, and soy
• Trans fat free margarine
• n-3 fatty acids (in flax meal, walnuts, soy foods, Canola, and fish)
• Olives, avocados, and nuts (good sources of healthy fats)

Limit the intake of saturated and trans fats. They clog arteries and cause heart attacks and strokes. The Institute of Medicine recommends as low an intake of trans fats and cholesterol as possible (zero is ideal)². The National Cholesterol Education Program (NCEP) recommends that less than 7% of calories eaten should come from saturated fat⁴. Most fat should come from unhydrogenated vegetable oils high in mono and polyunsaturated fats. These healthy fats lower cholesterol and the risk of heart disease.

The trans fat content in foods will soon be included on food labels along with saturated fat. Until it is included, look for “partially hydrogenated fat” on food labels. If it is listed, trans fat is present. Sources of trans fat include most margarines, shortening, and foods made with hydrogenated fats. Examples include most baked goods, pastry, cookies, cake, deep fried foods, and convenience and snack foods.

6. Choose whole grains. Nutrition studies show that whole wheat bread, brown rice, oatmeal, and other whole grains actually lower the risk of heart attacks, strokes, and certain cancers. In the Nurses Health Study⁵ non-smoking women who ate at least 3 servings of whole grains daily cut their risk of heart disease in half compared to those eating white bread! They were also significantly less likely to get diabetes.

When choosing breads and cereals, read the food label. Look for the phrase, “100% whole wheat” or other grain. When eating rice, choose brown rice. For breakfast try oatmeal, shredded wheat, and other whole grain foods.

7. Eat nuts/legumes daily. Nuts and legumes are rich in protein, are cholesterol free, high in fiber, and contain healthy fats. When eaten daily these foods help lower cholesterol and the risk of heart disease. In the Nurses Health Study⁶, women who ate nuts daily had 35% fewer heart attacks than those who seldom ate nuts.

Foods such as hummus and nut butters make healthy alternatives to butter or margarine.

8. Choose healthy protein foods. Limit red meats. They are high in protein but also high in saturated fat. Limit eggs to one in a day. Look for eggs high in omega-3 fats and from grain fed chickens. You need 0.8 g of protein/kg of body weight per day. A 130 lb women needs 47 g/day. A 200 lb man needs 73 g/day. Athletes need 1.0 to 1.2 g of protein/kg body weight.

Traditional protein foods in America (steak, bacon, hot dogs, hamburgers, cheese) are high in saturated fat and cholesterol. Healthier alternative sources of protein include foods such as tofu, soy burgers, garden burgers, nuts, legumes, and other vegetable protein foods. They are cholesterol free and low in saturated fat. Skinless poultry and fish are also healthier alternatives to red meat.

9. Limit high fat dairy. Dairy is a good source of protein and calcium but is often high in saturated fat and cholesterol. The DASH diet recommends low fat dairy products such as low fat milk or yogurt. These foods were helpful in lowering blood pressure in the DASH diet study. Limit butter, cream, ice cream, and high fat cheese.

Soymilk is a healthy alternative for those who prefer not to drink milk. Choose brands low in added sugar and with at least 7-8 grams of protein per cup. If you don’t drink milk, be sure you get adequate calcium and vitamin B-12 from other sources or take a supplement.

10. Choose healthy carbohydrates. Refined carbohydrates such as snack foods, sugar, soda pop, white bread, white rice, and potatoes are absorbed rapidly. This results in high blood sugar, high insulin levels, and increased risk for obesity, diabetes, and heart disease. Limit high glycemic foods. Choose unrefined carbohydrates high in dietary fiber.

Use the New Food Pyramid⁷ as a guide for making healthy food choices. This new food pyramid was developed primarily by Dr. Walter Willett from Harvard University and was published in the Scientific American. It also is in agreement with the governments DASH diet for cardiovascular health. Dr. Willett's research showed that the old USDA food guide pyramid did not provide enough information to help people prevent disease. The new pyramid puts special emphasis on:

• Limiting high saturated fat foods such as butter and red meat.
• Limiting high glycemic foods such as soda pop, white bread, white rice, potatoes, and refined carbohydrates.
• Using low fat dairy products or alternatives.
• Eating more fruits and vegetables in the diet. Notice that they are at the base of the food pyramid indicating they provide the foundation for healthy eating.
• Using plant oils or healthy fats in the diet.
• Eating more legumes and nuts. These foods are good sources of vegetable protein and are protective to the health.
• Eating more whole grain breads and cereals.
• Daily exercise and weight control.

Summary

References
1. HHS, Dietary Guidelines, 2000
2. NAS, Inst. of Medicine, DRIs, 2002
3. JAMA 289:2083-93, Apr 23/30, 2003
4. NIH, ATP3 Heart Report, 2000
5. Amer J of Clin Nutr 70:412-19, 1999
6. British Medical Journal, Nov 14, ‘98
7. Walter Willett, Scientific American, Rebuilding the Food Pyramid, Dec 17, 2002

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Health content in this article is general health information from evidence based research for healthy populations. Its purpose is not to treat disease or take the place of advice by your doctor but to promote healthy lifestyles. Persons with health problems should contact their physician for specific guidance.  Written by Don Hall, DrPH, CHES. Updated June 12, 2003 DRH LA