Healthy Eating: A General Nutrition Guide

Ting Wu, M.D. – Family Medicine

“An apple a day keeps the doctor away.” This age-old saying may not be literally true, but it is a helpful reminder as to how important good nutrition is to our health and well-being. Research studies show that healthy eating can prevent heart disease and diabetes and help ward off hypertension, osteoporosis, and some forms of cancer. While one cannot completely control illness and disease, one can control their diet. This article seeks to provide you with some guidelines for healthy eating.

The food pyramid many of us are familiar with was developed by the Unites States Department of Agriculture (USDA) in 1992. It sought to educate people about the importance of the major food groups and the portions that one should eat from each group. In 2005, Harvard University’s School of Public Health developed the Healthy Eating Pyramid and this is now widely promoted in the medical profession.

The Healthy Eating Pyramid

Image taken from the Harvard School of Public Health website: http://www.hsph.harvard.edu/nutritionsource/

The Harvard Healthy Eating Pyramid represents the latest nutritional science. The widest part at the bottom is for things that are most important. The foods at the narrow top are those that should be eaten sparingly, if at all. This Healthy Eating Pyramid shows daily exercise and weight control in the widest, most important category. Fats from healthy sources, such as plants, are in the wider part of the pyramid. Refined carbohydrates, such as white bread and white rice, are in the narrow top. Red meat should also be eaten sparingly, while fish, poultry and eggs are healthier choices.¹

In attempting to eat a balanced diet, it can become confusing as to how much of each category one should eat. Some general rules are:

Fats: 20% to 35% daily calories (no more 10% from saturated fats, and keep trans-fats as low as possible)

Protein: 10% to 35% of daily calories

Carbohydrates: 45% to 65% of daily calories (no more than 25% from added sugar)

Fiber:

• Age 50 and younger: men 38 grams/day, women 25 grams/day
• Age over 50: men 30 grams/day, women 21 grams/day

Cholesterol: less than 300mg

Salt: less than 2400mg

For patients with diabetes, hypertension, high cholesterol, and/or heart disease, these numbers may require adjustment. Be sure to speak with your doctor for further details.

Fats. There is a lot of focus on fats and it is important to know that not all fats are bad. What, then, are bad fats and good fats?

Bad fats refer to trans-fats and saturated fats. Trans-fats are partially hydrogenated oils and artificially created in the laboratory to provide less expensive alternatives to butter. They’re even worse than saturated fats. They increase your LDL cholesterol (the bad cholesterol) and reduce your beneficial HDL cholesterol. There is no safe level of trans-fat. One needs to avoid them as much as possible. They mainly come from packed baked products such as cookies, cakes, breads, crackers, fast foods and some dairy products. So read the labels of food before you buy them. Saturated fats are naturally found in butter, whole milk, cheese and animal meats, especially red meats. Saturated fats increase LDL cholesterol.

Good fats come mainly from vegetable and fish. There are two broad categories of beneficial fats-- polyunsaturated and monounsaturated. Polyunsaturated fats have two types: omega-3 fatty acids and omega-6 fatty acids. They both reduce LDL and triglycerides. Omega-3 mainly comes from fish (fatty fish such as salmon, mackerel and sardines are especially good sources) and also from flaxseed, walnuts and canola oil. Omega-6 fatty acids are rich in vegetable oils such as sunflower, soybean, corn and walnut. Monounsaturated fats sources are olive oil, peanut oil, canola oil, avocado, and most nuts.

Carbohydrates. There are also good and bad carbohydrates. Heavily processed foods like crackers, french fries, cookies, white bread, white rice and noodles, soft drinks or juice with added sugar are digested fast. This causes high spikes of blood sugar in the bloodstream and thus insulin surges. This is then followed by dips of blood sugar and makes one hungry. One is apt to overeat and possibly gain weight. Good carbohydrates come from whole grains. Brown rice, steel-cut oats (processed oatmeal reduces its benefit), whole-wheat, barley and multi-grain cereal. These foods also provide plenty of fiber and vitamins.

Proteins. Good sources of protein and alternatives to animal meats and milk are: fish, tofu, kidney beans, lentils, broccoli and peanuts.

Off-limits Food. Are there any foods you should never eat? Not really. It is important to keep one’s perspective and allow yourself treats now and then. Just try not to make it a daily event. The foods one might eat infrequently include red meat, dairy fat, doughnuts, muffins, croissants, crackers, bagels and other baked goods made with white flour or pastries topped or filled with butter cream or whipped cream

A practical suggestion is to focus on having a variety of colors on your plate. When you do this, you will be selecting lots of fruits and vegetables and healthier wheat and grains.

Exercise. In addition to developing a healthy diet, one can improve their overall health with a regular exercise program. It is important to do something you enjoy so that you are more likely to maintain it over time. Incorporate exercise into your day by choosing to take the stairs vs. the elevator, or parking further away from your destination. Walking is something that can be done anywhere and anytime and doesn’t require a gym membership. Regardless of the exercise you choose to do, be sure to wear suitable clothing and shoes. Check with your physician if you have any concerns or questions about what would be appropriate for you to pursue.

In closing, remember that “You are what you eat!” Making healthier selections in your diet and regularly exercising will improve your overall sense of well-being and could lower your risk for certain disease. Start slowly if this is new and overwhelming to you. Be patient and live well.

¹Adapted from Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating by Walter Willett, M.D. (Simon & Schuster, 2005)

Dr. Wu practices family medicine at Bay Valley Medical Group’s Hayward office. To schedule an appointment with her, please call (510) 785-5000.