Why is Good Nutrition Important

What’s Really Important in Nutrition?

Not all that many years ago, nutrition experts told us to avoid fattening sugar and starch. Now they’re telling us to load up on starch, but never, never eat fat. What, you might well ask, is going on here? And why should anyone bother paying attention?

The self-appointed “food police” can turn any meal into a minefield. We’re told to avoid Chinese, give up guacamole, eat our popcorn dry. But here’s the good news about all of this: None of it is invariably true. If you talk to an authentic nutritionist, you’ll find that there’s plenty of stuff you can eat at the Peking Garden, and a way to have your buttered popcorn too.

Despite the confusion, we really do know more about nutrition today than ever before—and the basic facts turn out to be surprisingly simple. Moderation and balance are crucial. Everything else is a detail. The rest of this discussion is given over to those details, sorting out what really matters in nutrition, and highlighting ways to upgrade your diet for a healthier life.

Proven Facts

The government has incorporated most of the nutritional facts we’re sure of into two excellent tools—the “Nutrition Facts” labels and the Food Guide Pyramid. The food labels are designed to pinpoint what’s really important for most Americans. Experts now agree that most of us eat too much fat, saturated fat, cholesterol, sodium, and sugar, and may not be getting enough starch and fiber—and these are what you’ll find highlighted on the labels.

These nutrients have been singled out not only because they are problem areas, but also because they are the focus of some of the strongest evidence available on the way food affects our health. We are as certain as science can be, for example, that, for many people, a high-fat, high-cholesterol diet can lead to heart disease and stroke. The nearby box, “Certain enough to be allowed on food labels,” lists health claims with enough evidence behind them for the U. S. Food and Drug Administration (FDA) to allow them on labels.

As part of the nutritional labeling, the government has set recommended Daily Values (DVs) for many of the nutrients considered most important (see the table nearby). It has also adopted the rule of thumb that about 60 percent of our food should be carbohydrates (bread, rice, pasta, fruits, and vegetables are mostly carbohydrates), 30 percent fat (including 10 percent saturated fat), and 10 percent protein. By law, food labels now tell you not only how many grams of fat a serving has, for example, but how much of your Daily Value of carbohydrates, fat, and protein it delivers. A food that packs 50 percent of your recommended daily fat allotment in one serving, for example, should give you pause. You don’t have to pass it up—but you may want to compensate for it by loading the rest of your menu with low-fat options.

THE FOOD GUIDE PYRAMID

The Food Guide Pyramid, issued by the U.S. Department of Agriculture, translates the 60 percent carbohydrates, 30 percent fat, 10 percent protein guideline into servings of specific types of food. The biggest difference between the pyramid and its predecessor, the Basic Four Food Groups, is that meat is no longer the centerpiece of a meal. Instead, rice, pasta, or other grains, along with fruits and vegetables, are supposed to account for the bulk of our food. This is because grains, fruits, and vegetables are high in fiber, carbohydrates, and needed vitamins and minerals, and gratifyingly low in fat. Meat has not been banished from a healthy diet, but most of us eat far more of it than we actually need, while short-changing ourselves on grains, fruits, and vegetables.

The pyramid was released in 1992, and polls indicate that most Americans are aware of it. The polls also show that we don’t follow it. An August 1994 survey of 372 households by Parade magazine found that those questioned ate an average of 3.4 servings from the grain group per day, although the pyramid calls for 6 to 11. Other reports show that, from day to day, most of us eat about half of the 2 to 4 servings of fruit and the 3 to 5 servings of vegetables the pyramid recommends. Many of us go all day without eating any fruits or vegetables. And, despite everything we’ve been told, most of us still eat too much meat, too many dairy products, and excessive amounts of all the other things the experts warn against.

The Five Basic Guidelines

Ironically, it’s now easier than ever to upgrade your diet if you’re so inclined. Food labels make it a cinch to tell what’s actually in the food you buy; and you don’t have to calculate each ingredient to the last calorie. Instead, just keep these five general guidelines firmly in mind.

1. Cut Back on Fat and Cholesterol

The experts recommend that we get _no more, and preferably less,_than 30 percent of our calories from fat. That 30 percent includes 10 percent from saturated fat and 10 percent from polyunsaturated fat. We also should limit cholesterol to 300 milligrams a day. Right now, most of us get 35 percent to 40 percent of our calories from fat.

In susceptible people (and there’s currently no way to tell whether or not you’re susceptible), fat is conclusively linked to heart disease and perhaps to cancer as well (for information about the possible cancer link, see the “Promising Theories” section below). A high-fat diet is also associated with stroke and high blood pressure. Excessive fat intake raises cholesterol levels, and high cholesterol leads to the clogged arteries found in victims of heart disease, heart attack, and stroke.

It’s especially important to eat less saturated fat. Meat (both red meat and poultry) and whole milk are the two main sources of saturated fat for most of us. Meat also accounts for 30 percent of the cholesterol in most people’s diets, and there is no good substitute for cutting down on cholesterol. Niacin, a B vitamin, has been shown to reduce cholesterol; but, when used in high doses, it has potentially dangerous side effects, including flushing, rashes, impaired liver function, higher blood sugar, and stomach and intestinal problems. Likewise, cholesterol-lowering drugs are reserved for serious cases and are available only by prescription.

In contrast, there are plenty of simple, relatively painless ways to cut the fat in your cooking. Here are five tips from Consumer Reports on Health.

Don’t use fat as a flavoring. Let’s face it—fat is tasty, and a pat of butter or margarine on your bread or vegetables may not seem like much. But nutritionists warn that these little extras add up quickly. As a substitute for butter or margarine, try baking garlic in the oven for 1 hour with a little bit of olive oil, then using it on bread or pasta. It comes out with a spreadable consistency. Herbs or lemon juice can season vegetables. If you must use fat, try olive oil instead of butter.

Eat less meat. Reducing or eliminating meat from recipes such as spaghetti sauce greatly lowers their fat content. Try using vegetables and herbs in casseroles and other combination recipes where you might once have used meat. Let pasta, rice, and fruits and vegetables step in as the mainstays of your meal. A serving of meat should be no more than 3 ounces—the size of a deck of cards or a woman’s palm. Remember that the pyramid recommends only 2 to 3 servings a day from a group that includes eggs, beans, nuts, poultry, and fish along with meat.

Thin out the meat you do eat. Look for meat that carries a nutrition label so you can make an informed decision about what to buy. Currently, nutritional labeling for meat is voluntary, but about sixty percent of the packaged meat and poultry sold in stores does come with this valuable information on the package. Buy leaner cuts of meat, trim the fat, eat poultry without skin, eat smaller portions, and don’t fry.

Substitute low-fat or non-fat versions of fatty foods. This means using skim milk instead of whole milk, low-fat or non-fat yogurt, and choices from the array of low-fat or non-fat mayonnaises, salad dressings, and other foods. See the box on “Painless Ways to Cut Fat” for additional ideas.

Replace fatty foods with produce. Try snacking on apples, grapes, carrots, and other fruits and vegetables instead of fat-filled chips and sweets. This not only cuts down on fat, but boosts your intake of many valuable nutrients.

You can also hold down fat by watching for certain code words on packages and menus (see the “Giveaways to Fatty Foods” box nearby). Remember, though, that you can’t always rely on labels saying “low-fat,” “diet,” or “sugar-free” when eating out. Laboratory analysis of 10 frozen desserts billed as low-fat, low-calorie in New York establishments revealed that most packed as many calories as ice cream. One exception was Haagen-Dazs frozen vanilla yogurt, which had 88 calories and 0.2 grams of fat in a 5-ounce cup. To make matters worse, advertised calories are often based on a 4-ounce serving, while the “small” size you buy varies from 5 to 11.3 fluid ounces.

The only conclusive way to determine how much fat you’re really eating is to keep a daily diary of everything (yes, everything) you eat, then check labels to count fat grams and percent of Daily Values.

2. Cut the Calories (If You’re Overweight)

Partly because so many of us eat more fat than we need, excess weight is relatively common in the U.S. Too many extra pounds increase your chances of developing high blood pressure and, therefore, of having a stroke. Being overweight is associated with the higher cholesterol levels that can lead to heart disease. And obesity is a factor in type II diabetes—the kind that usually develops in adulthood. (To learn your ideal weight, see “Setting a Healthy Goal.”)

How much you need to eat depends on your gender, age, and activity. Men need more than women, younger people need more than older adults, and active people need more than the inactive. The Daily Value information on food labels is based on a relatively modest 2,000-calorie diet unless otherwise specified.

When adding up your calories based on food labels, be careful about the definition of a serving. The FDA’s idea of a serving is surprisingly small and may not match yours. (Does your spaghetti dinner usually amount to half a cup?) See the nearby box “What Counts as a Serving” for the official numbers. It may be worth measuring what you actually eat for a few days to see how closely it mirrors the printed serving sizes.

If you are cutting back on fat, this will automatically help you cut calories. One gram of fat packs about 9 calories, more than double the 4 calories in a gram of protein or carbohydrates. A regular exercise program will also help. What you burn, as well as what you eat, affects how much weight actually stays on you. Finally, there’s the old stand-by:

Hold the sugar. Mom and your dentist were right—sugar is mostly empty calories that fill you up, leaving less room for food with other nutrients. And sticky sweets and soda can rot your teeth. So, when the FDA recommends getting 60 percent of our calories from carbohydrates, they are really talking about the complex carbohydrates in starch, not the simple ones in sugars.

Adding a teaspoon of sugar to your coffee or tea isn’t a problem for most of us. All table sweeteners combined contribute less than a fifth of our daily intake. The major sources of sugar to keep in mind include:

• Soft drinks—25%
• Packaged foods, dressings, and other—21%
• Table sugar, jams, syrups—18%
• Baked goods—13%
• Ice cream, dairy—10%
• Breakfast cereals—5%
• Candy—2%

The Sugar Association says that, when you add it up, more than half the sugar we eat comes from processed foods—another reason (along with sodium), to favor fresh products. When you do buy processed foods, watch the labels. Sugar can pop up in the oddest places—ketchup (11 percent sugar), salad dressing, frozen pizza, and nondairy creamer, for example. Don’t be fooled by sugar’s disguises on labels, either—it goes by 18 different names in various lists of ingredients (see nearby box.) And remember that the natural fructose in fruit does count towards your total sugar intake.

Sugary foods may seem like quick energy boosters, but the initial burst is followed by a slump. Complex carbohydrates work more slowly but are a better choice for longer-lasting energy.

3. Slow Down on the Salt

The FDA recommends that we get 2,400 milligrams a day of sodium, about the amount in 1 teaspoon of salt. But by one estimate, men actually eat 4,000 milligrams, or 2 teaspoons per day, while women get 3,000 milligrams a day, or one-and-a-third teaspoons daily.

Reducing the sodium you take in can be tougher than you’d expect, because 75 percent of the sodium we eat is hidden in processed foods. Only 15 percent of most people’s sodium intake comes from the salt shaker; about 10 percent is found naturally in food. Sodium also is not necessarily where your taste buds would lead you to believe. McDonald’s french fries have less salt than any McDonald’s sandwich, biscuit, or Danish. Some salad dressings have 200 milligrams of sodium per tablespoon.

To get your sodium intake down, you’ll need to cut back on most brands of frozen dinners or pizza (Healthy Choice is one exception); processed meats like hot dogs or bacon; processed American-style cheese; canned or dried soup; salad dressings; and canned meats, beans, vegetables, and tomato sauce. Choose fresh rather than canned foods, and look for items labeled “less sodium,” “sodium-free,” or “light-in-sodium.” Check the “Nutrition Facts” label. Products that list less than five percent of the Daily Value on the Nutrition Facts label are considered low-sodium, while those that contain more than twenty percent are considered high-sodium.

Instead of seasoning food with salt, try cooking with herbs, spices, and lemon juice, to broaden your palate’s taste sensations. Try recipes in cookbooks or magazines that emphasize healthy (low-fat, low-calorie, low-sodium) meals. Stop cooking with salt, or add only half the amount specified in the recipe—chances are you won’t notice the difference. And move gradually to lower-sodium products and cooking, so your taste buds can adjust.

Restaurant food and fast food are also notoriously high in sodium. Healthful dining choices include grilled or roasted entrees and baked potatoes. Use of oil and vinegar instead of a salad dressing will also help reduce your sodium intake. Don’t be shy about requesting that the chef refrain from adding salt while preparing the food.

The reason for all the concern over sodium is its link with high blood pressure. In certain “sodium-sensitive” individuals, too much salt can cause a sustained increase in blood pressure, and since there’s no way of telling in advance whether you’re among the sensitive ones, cutting back on salt is the only completely safe course. If you do develop high blood pressure, your chance of heart disease goes up. Optimal blood pressure is less than 120/80; high is 140/90; and anything above optimal raises the risk of heart disease. About 4 out of 5 people aged 35 or older have blood pressure above optimal levels; and even if your pressure is low now, it’s likely to increase with age. On average, the first number in the blood pressure measurement goes up 15 points between the ages of 25 and 55. If everyone lowered salt intake by 1 teaspoon a day, the thinking goes, the average increase with age could be pared back to 6 points.

High blood pressure isn’t the only problem with too much sodium. Because it causes your body to lose calcium, it can raise your chances of developing osteoporosis, the brittle-bone disease of old age. Losing calcium is all right if you eat enough to compensate, but most of us don’t.

4. Boost Your Carbohydrates

Getting more carbohydrates (the complex kind) means eating more bread, pasta, rice, and other grains as well as extra fruits and vegetables. The goal is to make carbohydrates 60 percent of your calories, compared with the 20 to 25 percent that most of us get today. Just as eating less fat and sodium can help cut the odds of heart disease and high blood pressure, eating more fiber-containing grains, fruits, and vegetables can help lower your chances of getting cancer and heart disease.

The facts about fiber. Fiber is found in fruits, vegetables, and grains, and you should get 25 grams of it per day. The food labels tell you how many grams of fiber a serving contains. However, because testing is not always accurate, some nutritional experts estimate that the amount on the label is often 5 to 25 percent higher than the actual content. What about unlabeled produce? The nearby box gives the numbers for some of our favorite fruits and vegetables. Juice counts as a serving of a fruit or vegetable, but won’t provide fiber. (Remember that only 100 percent pure juice counts—some products are mostly sweetened water.) Whole grains give you more fiber than refined products from which the fiber-containing husk is removed.

Fiber reduces your risk of the top two killers in this country—cancer and, in the case of soluble fiber, heart disease. Diets lacking in insoluble fiber have been linked to colon cancer. Diets high in fruit, vegetables, and fiber have been shown to reduce your chances of developing precancerous colon polyps. Try to get your fiber from food rather than supplements: Some benefits of a high fiber diet come from the food itself as well as the fiber.

Even with fiber, it is possible to get too much of a good thing. Fiber scoops up minerals such as calcium, iron, and zinc on its way out of the gastrointestinal tract, making it potentially unhealthy for people at risk of osteoporosis and iron deficiency. Additionally, eating too much fiber without drinking enough liquid can clog your intestines.

Fiber added to food, especially breads, is sometimes really cellulose, an altered substance not like whole foods. Cellulose is rarely listed on the label, but the presence of added soy fiber or vegetable fiber should arouse suspicion. Cellulose may fight constipation but it’s not as effective as an equal amount of wheat bran. To avoid cellulose, stick to whole wheat bread.

Added benefits from fruits and vegetables. In addition to boosting your fiber and carbohydrate intake, increasing the fruits and vegetables in your diet may possibly lower your risk of lung, prostate, bladder, esophageal, and stomach cancers—or so some researchers believe. Choose fresh fruits and vegetables, if possible, to avoid the sugar and salt that may lurk in frozen and canned products. If you can’t find fresh, look for products without—or with little—added sugar, heavy syrup, sweetened fruit juice, or sodium. Aim for a variety of fruits and vegetables, not just the same few all the time. That will help ensure that you get the nutrients you need—you may be surprised by some of the intriguing new flavors you discover.

5. Don’t Worry about Protein

You can probably get by with less of this nutrient. The average American eats twice the amount needed. For most of us, there’s no danger in eating too much protein itself—but a problem arises when it crowds out other foods with nutrients we need. People with diabetes are an exception to this rule—they should not exceed the recommended value for protein (50 grams per day). Pregnant women and nursing mothers need more protein—as much as 60 and 65 grams per day, respectively.

If you’re concerned about the fat in your diet, you might want to consider getting more of your protein from vegetable sources such as beans and nuts, rather than fattier meats, eggs, and dairy products.

Promising Theories

Many of the nutrition stories you see in the media are based on research that is, at best, inconclusive. The best of these stories contain important ideas for which evidence is accumulating, but for which there is not yet absolute proof. Some of these theories will eventually be confirmed; others will quietly disappear. In judging them, it’s important to remember that even in science, “proof” is a relative term. It simply means that many carefully planned studies have supported the idea. Theories that are promising rather than proven generally have fewer studies to back them up, or have some studies that contradict others. (See the box on “When to Believe a Media Report,” for details.) Here are some of today’s theories most likely to become tomorrow’s facts.

Is the “Mediterranean Diet” Better than the USDA Food Pyramid?

As eminent an authority as the chairman of Harvard University’s nutrition department says Yes, and he’s not alone. The Harvard School of Public Health, the European office of the World Health Organization, and Oldways Preservation & Exchange Trust, a nutrition think tank, also endorse the Mediterranean Diet as a tasty, nutritionally superior alternative to the USDA pyramid.

Which Pyramid For You?

Some experts have gone a step beyond the government and endorsed a nutrition plan called the "Mediterranean Diet," which comes complete with its own food pyramid. This plan shifts the emphasis further away from meat, focusing on fish, beans, nuts, cheese, and yogurt as alternative sources of protein. Small amounts of wine, considered good for the heart, are optional. Regular exercise is mandatory. Adapted from Mediterranean Diet Pyramid. Oldways Preservation and Exchange Trust Available at http://www.oldwayspt.org/html/p_med.htm. Accessed June 29, 1999.

The Mediterranean Diet is similar to—but more detailed than—the pyramid. It focuses on lowering animal fat, rather than all fat. It recommends little or no red meat (a few times a month), compared with the 2 to 3 servings a day from the catch-all “meat group” compiled by the USDA. It also puts vegetable protein (such as that in beans and nuts) into a separate category from meat. These differences yield a diet with less saturated fat than the government pyramid (7 to 8 percent of calories), but more fat overall (35 percent of calories).

In the Mediterranean Diet, vegetable fat in the form of olive oil is actually recommended in certain quantities. The reason: Olive oil and other monounsaturated fats increase “good,” artery-clearing HDL cholesterol, but not “bad,” artery-clogging LDL cholesterol. Remember, however, that if you’re trying to lose weight, you still need to limit your intake of all fats, including olive oil. (For more on oils, see “What to Do about Fat.”)

On the other hand, the Mediterranean Diet includes no more than 16 ounces of red meat per month. Indeed, Harvard’s chairman of nutrition says the optimum amount of red meat could well be zero, as (a) we can get its nutritional value elsewhere, (b) it is high in fat and cholesterol, which are linked to heart disease, and (c) some data link red meat to colon and prostate cancer.

Both the Mediterranean Diet program and the federal Dietary Guidelines for Americans recommend regular physical activity. The Mediterranean Diet program also includes the optional, daily moderate consumption of wine. The federal Dietary Guidelines recommend drinking moderately, if at all.

Interest in the Mediterranean Diet stems from observations more than 30 years ago that people on the Greek island of Crete got 40 percent of their calories from fat but were only about one twentieth as likely to die of heart disease as Americans. A key difference was that much of the fat came from olive oil rather than meat. Despite their high-fat diet, the people of Crete actually took in less cholesterol-raising saturated fat than did Americans.

Today, it’s generally agreed that the Mediterranean Diet won’t hurt you, and some nutritional authorities say it’s healthier than the USDA pyramid approach. It can be tasty, too. Spain, southern Italy, Greece, and the Provençal region of France, the historical havens of Mediterranean cooking, are well known for their culinary delights.

Is Fat Intake Linked to Breast, Colon, Lung, Prostate, and Bladder Cancer?

These cancers tend to be more common among people eating high-fat diets. Women in Japan eating the country’s traditional low-fat diet are less likely to develop breast cancer than women in the U.S. Even more telling, the granddaughters and great-granddaughters of Japanese women who moved to the U.S. and switched their families to a high-fat diet are almost as likely to develop breast cancer as anyone else.

Such evidence does not prove that a high-fat diet causes these types of cancer, however, because many other factors could be involved. For example, it could be that people who eat lots of fat simply don’t get enough of the fiber-containing fruits and vegetables that are known to reduce the risk of cancer. Moreover, most of the studies in this area have measured the incidence of cancer and the fat in diet, but not factors, such as family history of cancer. As they say, further studies are required.

Is Alcohol Linked to Cancer?

Chronic alcohol use is a risk factor for throat and liver cancer, and possibly for breast and colon cancer. Scientists have not yet figured out the exact role of alcohol in the development of cancer, or what amount of alcohol raises the risk. If you consume alcohol, experts recommend doing so in moderation.

Is Red Meat Linked to Colon and Prostate Cancer?

Several large, long-term studies have found that colon cancer—or the colon polyps that often precede cancer—is much more common among people who eat red meat frequently. And a similar, long-term study has found that prostate cancer is more than twice as common in the men who eat the greatest amounts of red meat. This research doesn’t prove that red meat is the cause of colon and prostate cancer. After all, most meat-eaters don’t get either disease. Still, it appears that cutting down on red meat improves your odds of escaping those diseases.

Can Grilling Meat at Very High Temperatures Create Cancer-Causing Compounds?

Some research says Yes; but the practical significance of this—if any—is still unknown. For details, see “Cut Back on These Foods to Cut Your Cancer Risk.”

Is Plant Protein Better than Animal Protein?

Maybe. If nothing else, switching from animal sources (red meat, poultry, fish, and dairy products) to plant sources (beans, grains, and nuts) will lower your fat and cholesterol intake. Americans get twice the protein they need as it is, and two-thirds of that comes from animal sources. Switching even half of your meat intake to plant protein can cut your cholesterol levels—by 13 percent in one study. That’s important, because if your cholesterol is more than 200, every 1 percent drop could diminish your heart disease risk by 2 percent. One caution: most research in this area uses soy protein. Wheat, rice, or other plant foods might not have the same effect. Also, the best results have been found in Italy and Switzerland, where other factors may be at work.

Is Salt Linked to Stomach Cancer?

Stomach cancer is rare in the U.S., but deadly when it strikes—and some evidence seems to show that avoiding very salty food can help reduce risk. Salt intake is higher among people with stomach cancer; and some research suggests that salt-cured, pickled, or nitrite-preserved foods may be responsible for the higher rates of stomach and esophageal cancer found in countries where these foods are common. The risk in the U.S. diet, however, appears to be small.

Where the Experts Disagree

Although we learn more about nutrition every year, there are still areas where the experts still don’t have an answer. Sometimes this is due to conflicting research, sometimes to conflicts in interpretation. Here’s a quick look at three of today’s biggest controversies.

Are Recommended Daily Allowances Too Low?

Experts have become increasingly convinced that they are. Originally established to prevent acute deficiency diseases like scurvy and rickets, the RDAs for vitamins and minerals are currently pegged at the level deemed “adequate” for most healthy people. They are not intended to reflect the ideal amount required to maintain health at its peak.

The National Academy of Sciences, a private, non-profit organization that provides health policy advice to government agencies, has been giving the old RDAs a major overhaul. No longer focusing on the use of nutrients to prevent vitamin deficiencies, the task force is reviewing the scientific literature to determine the best way to use vitamins, minerals, and plant extracts to promote optimal health and prevent chronic disease. The new guidelines they’re developing are called DRIs or “Dietary Reference Intakes.

The DRIs will not only recommend what the daily dose of a nutrient should be, they’ll also set upper limits beyond which a toxic reaction may set in. The National Academy of Sciences is midway through the revamping process. Once all the nutrients have been reviewed, the Food and Drug Administration will incorporate the new DRIs into food labeling and recalculate Daily Values.

Does Sodium Cause High Blood Pressure?

Some experts insist that response to sodium varies from one person to the next. According to some estimates, extra sodium increases blood pressure in about 5 to 15 percent of the population, and in 25 to 60 percent of those with high blood pressure. Sensitivity to sodium increases with age. Other authorities believe that sodium does affect blood pressure in most of us, though more in some than others.

To add to the confusion, experts disagree over the interpretation of what information we have available. Some say that research has not conclusively demonstrated a direct, strong link between sodium and high blood pressure. They suggest that large, sustained reductions in sodium are needed to affect blood pressure, or that not everyone’s blood pressure benefits from cutting sodium intake. Others, looking at the same studies, say they confirm the link.

If there is this much controversy, why does the government recommend limiting sodium? For starters, no one really knows how many people are sensitive to sodium’s blood pressure-elevating effects, nor is there any way of telling who’s sensitive and who’s not. Since almost all of us eat far more than required, cutting back won’t hurt, and could help reduce the risk of heart disease.

Does Fish Oil Help the Heart?

Hotly disputed research suggests that the omega-3 fatty acids in fish lower cholesterol levels, perhaps by reducing the amount of cholesterol manufactured by the body.

Less controversial is fish oil’s ability to increase the time it takes blood to clot. This may reduce the chance of a clot, blocking an artery and causing a heart attack, but it can also increase your risk of bleeding, bruising, and anemia. Accordingly, moderate amounts of fish oil are considered healthy, while the large quantities found in fish oil capsules should never be taken without medical supervision. Though the capsules have been shown to reduce triglyceride (blood fat) levels and are prescribed for that reason, they have not been shown to reduce “bad” LDL cholesterol.

Correcting Some Common Misconceptions

Nutrition is a vast area, often vulnerable to oversimplification and misinterpretation. And, once enshrined by the media, the resulting half-truths and outright errors take on a life of their own. Here is the truth about some of the misconceptions still making the rounds today.

Protein Does Not Promote Osteoporosis

Eating more protein, plant or animal, does pull more calcium from the body, but not as much as once was thought. Additionally, your body may adapt and stop losing calcium at some point. A 1980 study found less osteoporosis among vegetarians, but more recent studies have failed to confirm that.

Too Much Protein Does Not Cause Kidney Disease

There is no direct evidence of a problem here. Kidney disease is rare in this country despite our high protein intake. Only diabetics need to limit protein to the level specified in the RDAs (50 grams per day).

Too Much Protein Does Not Cause Cancer

There is little evidence that animal protein increases the risk of cancer. Researchers, including those at Dana-Farber Cancer Institute in Boston, have been unable to verify a strong link between protein and breast, colon, or kidney cancer. Researchers at Cornell University did find that feeding rats more protein, especially animal protein, made them more likely to develop liver cancer when given a substance known to cause the disease. But this could be unique to the cancer-causing substance used in the study, and to liver cancer, which is rare in the U.S. despite our high-protein diet. Most experts agree that this finding does not justify changing your diet.

Oat Bran Does Not Slash Cholesterol

There is a kernel of truth to oat bran’s cholesterol-lowering powers. Early studies did find that oatmeal or foods containing oat bran could lower cholesterol. In 1990, however, researchers failed to verify these findings in a study done on a group of young women. Analysis of data from several previous studies then revealed that oat bran lowers cholesterol by so small a percentage (5 percent or less) that its effects are insignificant for most of us.

Cutting your intake of saturated fat and cholesterol is clearly a more effective way of reducing your risk of heart disease. This doesn’t mean it’s bad to eat oat bran or oatmeal—grains provide fiber and should form the basis of our diet. It’s just that oats won’t have a major effect on your cholesterol.

Starchy Foods Are Not Fattening

It used to be conventional wisdom that dieting meant cutting down on starch—bread, potatoes, pasta, and rice. Now, for most people these foods are considered the basis of any good diet, including weight-loss programs. Starch has the same number of calories as protein—4 per gram—and many fewer than fat, which has 9 calories per gram.

Most starchy foods are nearly fat-free, as long as you forgo toppings like sour cream on potatoes or Alfredo sauce on pasta. The body uses more energy processing starch than it needs to burn fat; so starch not only gives you less fat and fewer calories than fatty foods, but also makes the body burn more calories—a good combination. In some overweight people with a problem called “insulin resistance,” excess carbohydrates do tend to add extra pounds. But for most of us, they remain the best source of needed energy.

YOUR INCENTIVES

What a “Balanced Diet” Means Today

Following the current guidelines for healthy nutrition doesn’t doom you to life with a calculator. The theoretical target is 60 percent carbohydrates, 30 percent fat, and 10 percent protein, but in daily life that simply means going heavier on fruits, vegetables, and grains, lighter on meat and dairy, and very light on oils, salad dressings, mayonnaise, and sweets.

A balanced diet means just that—balance. You don’t have to make sure every food, or even every meal, is exactly 30 percent fat—just balance a rich restaurant meal with a light vegetable-and-rice dinner the next day. Healthy eating does not have to mean giving up foods you like, feeling guilty when you have a big meal, or viewing every decision about what to eat as inherently “good” or “bad”—all or nothing. You can eat ice cream or chocolate cake—just watch how much, and how often, you do it. Here’s the bottom line on today’s balanced diet and how it differs from what most of us are used to.

Less meat

All the experts agree: Eat less meat. How much less? For most of us there’s so much room for improvement that it really doesn’t matter. Though statistics show that we are eating less red meat, most of us have switched to white meat rather than grains, fruits, and vegetables. We’re also still eating too much fat—33 percent of calories from fat, instead of the recommended 30 percent, and 11 percent from saturated fat, rather than the recommended 10 percent, according to a government report.

Fewer Eggs and Dairy Products

These foods are out of favor for the same reason as meat: many are high in fat and cholesterol, and most of us eat too much of them. You don’t have to cut back severely, however. Switching to low-fat or skim versions will go a long way towards balancing your diet with little pain. Moderation is the key. Avoid having eggs and bacon every day, but don’t hesitate to have an omelet on the weekend.

More Fruits, Vegetables, and Grains

Low in fat, full of fiber and vitamins, these are the foods we don’t get nearly enough of. Even if your fat intake is low, you probably need more rice, pasta, whole-grain bread, fruits, and vegetables.

Gain Without Pain

With so much evidence that a diet low in fat and high in fiber, fruits, and vegetables can help fend off the top two killers of Americans—heart disease and cancer—making a few sacrifices in your diet seems well worth the effort. Surprisingly, those sacrifices are much smaller and easier than you’d expect.

As the title of Dr. Dean Ornish’s popular book announces, you really can “eat more, weigh less.” It’s all in what you eat. Cutting way back on high-calorie fat leaves room in your diet for more food than before—with no increase in total calories. And trimming the fat shouldn’t leave you hungry, either. Your body is designed to signal you when carbohydrates drop, but not when fat intake goes down. On an “eat more, weigh less” diet, you’ll get plenty of carbohydrates to keep you feeling full.

Big benefits can come from minor changes. One small study at the University of Washington in Seattle showed that switching to skim milk from whole milk for 6 weeks reduced total cholesterol by 7 percent and “bad” (LDL) cholesterol by 11 percent without diminishing “good” HDL cholesterol. In a study at a Harvard University-affiliated hospital, women lost an average of 5 percent of their weight by making seven simple changes, including substituting skim for whole milk, non-fat frozen yogurt for ice cream, and fruit spread for margarine or butter.

Take advantage of foods reformulated as low-fat, low-calorie, and low-cholesterol. They can be a boon if you absolutely cannot pass up certain favorite dishes. They can also help you get past the mental block that healthy eating has to mean cutting out what you like. Just remember not to view the “fat-free” label as a license to eat extra amounts, or “reward” yourself for foregoing one fatty food by gobbling up another.

Keep fruits, vegetables, and grains ready to eat in the house. Don’t bring home as much meat and fatty food from the supermarket. If it’s not in the refrigerator when you get home for the day, you probably won’t run back out to buy it.

Above all, be patient with yourself. An overnight make-over isn’t all that important, as long as you keep making progress. If you eat a 10 ounce piece of meat for dinner every night, try cutting back to 8 ounces, then 6 ounces, gradually filling in with pasta, rice, vegetables, and fruit. Don’t let yourself go hungry. If it takes you a few years to get down to the USDA’s recommended 3 ounce serving, that’s better than never making it at all.

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