Health Center Home
By Michelle Meadows
Most Americans consume too many calories and not enough nutrients, according to the latest revision to the Dietary Guidelines for Americans.
In January 2005, two federal agencies--the Department of Health and Human Services and the Department of Agriculture (USDA)--released the guidelines
to help adults and children ages 2 and up live healthier lives.
Currently, the typical American diet is low in fruits, vegetables, and whole grains, and high in saturated fat, salt, and sugar. As a result,
more Americans than ever are overweight, obese, and at increased risk for chronic diseases such as heart disease, high blood pressure, diabetes,
and certain cancers.
Of course old habits are hard to break, and the notion of change can seem overwhelming. But it can be done with planning and a gradual approach,
says Dee Sandquist, a spokeswoman for the American Dietetic Association (ADA) and manager of nutrition and diabetes at the Southwest Washington
Medical Center in Vancouver, Wash.
"Some people can improve eating habits on their own, while others need a registered dietitian to guide them through the process," Sandquist says.
You may need a dietitian if you are trying to lose weight or if you have a health condition such as osteoporosis, high blood pressure, high cholesterol,
Sandquist says that many people she counsels have been used to eating a certain way and never thought about what they were actually putting into their
bodies. "Someone may tell me they drink six cans of regular soda every day," she says. "When they find out there are about nine teaspoons of sugar in
one can, it puts things in perspective. Then I work with the person to cut back to three cans a day, then to two and so on, and to start replacing some
of the soda with healthier options."
Others are eating a lot of food between mid-day and bedtime because they skip breakfast, Sandquist says. Another common scenario is when someone has
grown up thinking that meat should be the focus of every meal. "We may start by having the person try eating two-thirds of the meat they would normally
eat, and then decreasing the portion little by little," Sandquist says. Cutting portion size limits calories. So does eating lean cuts of meat and using
lower-fat methods of preparation such as broiling.
Sandquist says that when people strive for more balance in their diets, they tend to enjoy mixing up their food choices. "A lot of times, they've been
eating the same things over and over. So when they start trying new foods, they find out what they've been missing."
Barbara Schneeman, Ph.D., director of the Food and Drug Administration's Office of Nutritional Products, Labeling, and Dietary Supplements, encourages
consumers to make smart food choices from every food group. "The Nutrition Facts label is an important tool that gives guidance for making these choices,
" she says. The label shows how high or low a food is in various nutrients.
Experts say that once you start using the label to compare products, you'll find there is flexibility in creating a balanced diet and enjoying a variety
of foods in moderation. For example, you could eat a favorite food that's higher in fat for breakfast and have lower-fat foods for lunch and dinner.
You could have a full-fat dip on a low-fat cracker. "What matters is how all the food works together," Sandquist says.
Older people are most likely to improve their eating habits, but nutrition is important for people of all ages, says Walter Willet, M.D., chairman of
the nutrition department at the Harvard School of Public Health. "We know that when people have health problems or their friends become ill, these are
strong motivators of change," says Willet. "The more serious the health condition, the more serious the change. We'd rather people made changes early
and prevent health problems in the first place."
So what if you're feeling trapped by a diet full of fast-food burgers and cookies? You can work your way out slowly but surely. Here are tips to move
your eating habits in the right direction.
Look at What You Eat Now
Use food diaries for FREE and track what you eat for a few days. You will get a good picture of what you're taking in.
By looking at what you eat and how much you're eating, you can figure out what adjustments you need to make.
If you can also write down what you are feeling. Were you nervous, happy, or sad when you ate five slices of pizza in one sitting?
"The very nature of writing things down in a food diary can help patients make changes," says Cindy Moore, director of nutrition therapy at the Cleveland Clinic Foundation.
"Someone will tell me: I didn't want to have
to write that I ate nine cookies, so I ate two instead."
Start With Small Changes
You don't have to go cold turkey. In the end, you want to achieve a long-term healthy lifestyle. Small changes over time are the most likely to stick.
"If you want to eat more vegetables, then try to add one more serving by sneaking it in," Moore says. "Add bits of broccoli to something you already eat
like pizza or soup. If you need more whole grains, add barley, whole wheat pasta, or brown rice to your soup."
When you think about what you need to get more of, the other things tend to fall into place, Moore says. "If you have some baby carrots with lunch or
add a banana to your cereal in the morning, you're going to feel full longer." You won't need a food that's high in sugar or fat an hour later, she adds.
Also, look for healthier versions of what you like to eat. If you like luncheon meat sandwiches, try a reduced-fat version. If you like the convenience
of frozen dinners, look for ones with lower sodium. If you love fast-food meals, try a salad as your side dish instead of french fries.
"Pick one or two changes to start with," Moore says. "Once the changes have become habits, which usually happens in about two to four weeks, then try
adding one or two more. In six to 12 months, you'll find that you've made substantial changes."
Use the Nutrition Facts Label
To make smart food choices quickly and easily, compare the Nutrition Facts labels on products. Look at the percent Daily Value (%DV) column.
The general rule of thumb is that 5 percent or less of the Daily Value is considered low and 20 percent or more is high.
Keep saturated fat, trans fat, cholesterol, and sodium low, while keeping fiber, potassium, iron, calcium, and vitamins A and C high. Be sure
to look at the serving size and the number of servings per package. The serving size affects calories, amounts of each nutrient, and the percentage
of Daily Value.
The %DV is based on a 2,000-calorie diet, but recommended calorie intake differs for individuals based on age, gender, and activity level.
Some people need less than 2,000 calories a day. You can use the %DV as a frame of reference whether or not you consume more or less than 2,000
calories. The %DV makes it easy to compare the nutrients in each food product to see which ones are higher or lower. When comparing products,
just make sure the serving sizes are similar, especially the weight (grams, milligrams, or ounces) of each product.
Control Portion Sizes
Understanding the serving size on the Nutrition Facts label is important for controlling portions, Moore says. "Someone may have a large bottled drink,
assuming it's one serving," she says. "But if you look at the label, it's actually two servings. And if you consume two servings of a product, you have
to multiply all the numbers by two." When the servings go up, so do the calories, fat, sugar, and salt.
Moore also suggests dishing out a smaller amount on your plate or using smaller plates. "If you put more food in front of you, you'll eat it because
it's there," she says. According to the ADA, an average serving size of meat looks like a deck of cards. An average serving size of pasta or rice is
about the size of a tennis ball. Here are some other ways to limit portions: Split a meal or dessert with a friend at a restaurant, get a doggie bag
for half of your meal, get in the habit of having one helping, and ask for salad dressing, butter, and sauces on the side so you can control how much
Control Calories and Get the Most Nutrients
You want to stay within your daily calorie needs, especially if you're trying to lose weight, says Eric Hentges, Ph.D., director of the USDA Center
for Nutrition Policy and Promotion. "But you also want to get the most nutrients out of the calories, which means picking nutritionally rich foods,
" he says. Children and adults should pay particular attention to getting adequate calcium, potassium, fiber, magnesium, and vitamins A, C, and E.
According to the Dietary Guidelines, there is room for what's known as a discretionary calorie allowance. This is for when people meet their recommended
nutrient intake without using all their calories. Hentges compares the idea to a household budget. "You know you have to pay all the bills and then you
can use the leftover money for other things," he says. "The discretionary calorie allowance gives you some flexibility to have foods and beverages with
added fats and sugars, but you still want to make sure you're getting the nutrients you need."
For example, a 2,000-calorie diet has about 250 discretionary calories, according to the Dietary Guidelines.
Know Your Fats
Fat provides flavor and makes you feel full. It also provides energy, and essential fatty acids for healthy skin, and
helps the body absorb the fat-soluble vitamins A, D, E, and K. But fat also has nine calories per gram, compared to four
calories per gram in carbohydrates and protein. If you eat too much fat every day, you may get more calories than your body
needs, and too many calories can contribute to weight gain.
Too much saturated fat, trans fat, and cholesterol in the diet increases the risk of unhealthy blood cholesterol levels,
which may increase the risk of heart disease. "Consumers should lower all three, not just one or the other," says Schneeman.
Saturated fat is found mainly in foods from animals. Major sources of saturated fats are cheese, beef, and milk. Trans fat
results when manufacturers add hydrogen to vegetable oil to increase the food's shelf life and flavor. Trans fat can be found in
vegetable shortenings, some margarines, crackers, cookies, and other snack foods. Cholesterol is a fat-like substance in foods from
animal sources such as meat, poultry, egg yolks, milk, and milk products.
Most of your fats should come from polyunsaturated and monounsaturated fatty acids, such as those that occur in fish, nuts, soybean,
corn, canola, olive, and other vegetable oils. This type of fat does not raise the risk of heart disease and may be beneficial when
consumed in moderation.
Make Choices That Are Lean, Low-fat, or Fat-free
When buying meat, poultry, milk, or milk products, choose versions that are lean, low-fat, or fat-free. Choose lean meats like chicken
without the skin and lean beef or pork with the fat trimmed off.
If you frequently drink whole milk, switch to 1 percent milk or skim milk. Many people don't taste a difference. Some mix whole milk
with lower-fat milk for a while so the taste buds can adjust. This doesn't mean you can never eat or drink the full-fat versions, Schneeman says.
"That's where the discretionary calories come in."
Other tips to reduce saturated fat include cooking with non-stick sprays and using olive, safflower, or canola oils instead of lard or butter.
Eat more fish, which is usually lower in saturated fat than meat. Bake, grill, and broil food instead of frying it because more fat is absorbed
into the food when frying. You could also try more meatless entrees like veggie burgers and add flavor to food with low-fat beans instead of butter.
Focus on Fruit
The Dietary Guidelines recommend two cups of fruit per day at the 2,000-calorie reference diet. Fruit intake and recommended amounts of other food
groups vary at different calorie levels. An example of two cups of fruit includes: one small banana, one large orange, and one-fourth cup of dried
apricots or peaches.
Eat a variety of fruits--whether fresh, frozen, canned, or dried--rather than fruit juice for most of your fruit choices. "The whole fruit has more
fiber, it's more filling, and it's naturally sweet," says Marilyn Tanner, a pediatric dietitian at the Washington University School of Medicine in
St. Louis. Still, some juices, such as orange and prune, are a good source of potassium.
Ways to incorporate fruit in your diet include adding it to your cereal, eating it as a snack with low-fat yogurt or a low-fat dip, or making a fruit
smoothie for dessert by mixing low-fat milk with fresh or frozen fruit such as strawberries or peaches. Also, your family is more likely to eat fruit
if you put it out on the kitchen table.
Eat Your Veggies
The Dietary Guidelines recommend two and one-half cups of vegetables per day if you eat 2,000 calories each day.
Tanner suggests adding vegetables to foods such as meatloaf, lasagna, omelettes, stir-fry dishes, and casseroles. Frozen chopped greens
such as spinach, and peas, carrots, and corn are easy to add. Also, add dark leafy green lettuce to sandwiches. "Involve kids by letting
them help pick vegetables in different colors when you're shopping," Tanner suggests. Get a variety of dark green vegetables such as broccoli,
spinach, and greens; orange and deep yellow vegetables such as carrots, winter squash, and sweet potatoes; starchy vegetables like corn; legumes,
such as dry beans, peas, chickpeas, pinto beans, kidney beans, and tofu; and other vegetables, such as tomatoes and onions.
"Look for ways to make it convenient," Tanner says. "You can buy salad in a bag. Or buy a vegetable tray from the grocery store and put it in the
refrigerator. Everything's already cut up and you can just reach in and eat it throughout the week."
Make Half Your Grains Whole
Like fruits and vegetables, whole grains are a good source of vitamins, minerals, and fiber. The Dietary Guidelines recommend at least three ounces of
whole grains per day. One slice of bread, one cup of breakfast cereal, or one-half cup of cooked rice or pasta are each equivalent to about one ounce.
Tanner suggests baked whole-grain corn tortilla chips or whole-grain cereal with low-fat milk as good snacks.
In general, at least half the grains you consume should come from whole grains. For many, but not all, whole grain products, the words "whole" or
"whole grain" will appear before the grain ingredient's name. The whole grain must be the first ingredient listed in the ingredients list on the food
package. The following are some whole grains: whole wheat, whole oats or oatmeal, whole-grain corn, popcorn, wild rice, brown rice, buckwheat, whole rye,
bulgur or cracked wheat, whole-grain barley, and millet. Whole-grain foods cannot necessarily be identified by their color or by names such as brown bread,
nine-grain bread, hearty grains bread, or mixed grain bread.
Lower Sodium and Increase Potassium
Higher salt intake is linked to higher blood pressure, which can raise the risk of stroke, heart disease, and kidney disease.
The Dietary Guidelines recommend that people consume less than 2,300 milligrams of sodium per day (approximately one teaspoon of salt).
There are other recommendations for certain populations that tend to be more sensitive to salt. For example, people with high blood pressure,
blacks, and middle-aged and older adults should consume no more than 1,500 milligrams of sodium each day.
Most of the sodium people eat comes from processed foods. Use the Nutrition Facts label on food products: 5%DV or less for sodium means the food
is low in sodium and 20%DV or more means it's high. Compare similar products and choose the option with a lower amount of sodium. Most people won't
notice a taste difference. Consistently consuming lower-salt products will help taste buds adapt, and you will enjoy these foods as much or more than
Prepare foods with little salt. The DASH (Dietary Approaches to Stop Hypertension) eating plan from the National Heart, Lung, and Blood Institute
recommends giving flavor to food with herbs, spices, lemon, lime, vinegar, and salt-free seasoning blends. Consult with your physician before using
salt substitutes because their main ingredient, potassium chloride, can be harmful to some people with certain medical conditions.
Also, increase potassium-rich foods such as sweet potatoes, orange juice, bananas, spinach, winter squash, cantaloupe, and tomato puree. Potassium
counteracts some of sodium's effect on blood pressure.
Limit Added Sugars
The Dietary Guidelines recommend choosing and preparing food and beverages with little added sugars. Added sugars are sugars and syrups added to foods
and beverages in processing or preparation, not the naturally occurring sugars in fruits or milk. Major sources of added sugars in the American diet
include regular soft drinks, candy, cake, cookies, pies, and fruit drinks. In the ingredients list on food products, sugar may be listed as brown sugar,
corn syrup, glucose, sucrose, honey, or molasses. Be sure to check the sugar in low-fat and fat-free products, which sometimes contain a lot of sugar,
Instead of drinking regular soda and sugary fruit drinks, try diet soda, low-fat or fat-free milk, water, flavored water, or 100 percent fruit juice.
For snacks and desserts, try fruit. "People are often pleasantly surprised that fruit is great for satisfying a sweet tooth," Tanner says. "And if ice
cream is calling your name, don't have it in the freezer. Make it harder to get by having to go out for it. Then it can be an occasional treat."
Differences in Saturated
Fat and Calorie Content of Commonly Consumed Foods
Saturated Fat Content
? Regular cheddar
? Low-fat cheddar
? Regular (25% fat)
? Regular (5% fat)
3 oz. (cooked)
3 oz. (cooked)
? Whole (3.24%)
? Low-fat (1%)
? Croissant (medium)
? Bagel, oat bran (4")
? Regular ice cream
? Frozen yogurt, low-fat
? Soft margarine, zero trans fat
? Fried leg with skin
? Roasted breast with no skin
3 oz. (cooked)
3 oz. (cooked)
ARS Nutrient Database for
Standard Reference, Release 17
Some Nutrient Content Claims
than 0.5 grams of fat per serving
grams or less per serving (if the serving size is 30 grams or less or 2
tablespoons or less, no more than 3 grams of fat per 50 grams of the food)
fewer calories or half the fat of the "regular" version
milligrams or less per serving (if the serving size is 30 grams or less or 2
tablespoons or less, no more than 140 milligrams of sodium per 50 grams of
least 50 percent less sodium per serving than the "regular" version
describing fat, sodium, or calorie content, the food must have at least 25
percent less of these nutrients than the "regular" version
- Unsalted pretzels
- Low-fat yogurt with fruit
- Unbuttered and unsalted popcorn
- Broccoli, carrots, or cherry tomatoes with dip or low-fat yogurt
- Apple slices with peanut butter
- Graham crackers
- Gingersnap cookies
- Low- or reduced-fat string cheese
- Baked whole-grain tortilla chips with salsa
- Whole-grain cereal with low-fat milk
Source: FDA Consumer magazine, May-June 2005
Adapted by Editorial Staff,n July 2006
Last update, August 2008