Current Issue

A Guide to Eating Well

by Sue Radd
From the September 2013 Signs  

Diet is the single most important behavioral risk factor that you can use to improve your health. Research shows that a healthy diet can prevent more than one-third of all premature deaths from chronic diseases. Unfortunately, most popular diets simply provide a plan for rapid weight loss. They fail dismally when it comes to sustainable, long-term eating advice that will also keep you healthy and free of disease.

Every five years the American government calls for a review of the scientific literature and the creation of evidence-based judgments on diet from an independent panel of health experts. The result is practical advice in the form of dietary guidelines that can help you to both lose weight and benefit your overall health.

Experience has shown that the guidelines are used especially by health professionals, policy makers, and the food industry. However, the general public also needs to be aware of them. Following are some of the more important guidelines that can help you to develop and maintain optimal health.

Body weight

Being overweight is one of the most serious health risks in today’s Western society.

Body mass index

One scale that health professionals use to determine whether a person is overweight or obese is what is known as the body mass index (BMI). Briefly, BMI is the ratio of your weight to your height. A high BMI is recognized as an indicator of a significantly reduced life expectancy. Following are the normal and abnormal BMI indicators:

Less than 18.5 Underweight
18.5–24.9 Normal
25–29.9 Overweight
30 and over Obese
40 and over Grossly obese

A BMI of 30–35 reduces life expectancy by two to four years, and a BMI of 40–45 reduces life expectancy by eight to ten years. Being overweight or obese is a setup for most other chronic diseases, such as type 2 diabetes and heart disease.

Energy foods

International data show that it is the increased use of energy foods that, over time, will cause excessive weight gain. This is especially true of snack foods, sweet drinks, and fast foods. Even a small, persistent energy imbalance is enough to cause excessive weight gain. This is true whether you are a child or an adult, and over time it progressively increases your BMI.

Preventing overweight

Indulging in just two rich cookies for your morning coffee break once a week at work could tip you over the scales! Often, the weight gain may not be obvious for a decade, which is why people find it difficult to put their finger on what behaviors are making them fatter.

Prevention of overweight and obesity is important because weight loss is difficult to achieve and even more difficult to maintain. If you are already overweight, a sustainable and beneficial goal is to lose two to eight pounds per month, reaching a 10 percent loss of your initial weight in the short term and up to 20 percent loss over one to five years. What is actually considered to be realistic and achievable for sustained weight loss isn’t nearly what the rapid weight-loss diets promise. The problem is that most people will regain their lost weight and then some.

Exercise to lose weight

Newer research suggests 45–60 minutes of exercise a day is required to keep you from gaining back the weight you lost and people who’ve been obese need 60–90 minutes of moderately intense activity to avoid gaining it back. And those who include even some discretionary foods, such as cookies, candy, and chips, need even more physical activity in order to keep the pounds off.

Overweight in children

Overweight in children is increasing in Western culture. And overweight children grow up to be overweight adults. Studies have shown that children and adults who eat just one or more fast-food meals per week have an increased risk of gaining weight and of becoming overweight or obese.

A variety of nutritious foods

Most dietary guidelines recommend consuming a wide variety of nutritious foods from the five food groups, with an emphasis on plenty for the consumption of vegetables, fruits, and legumes. The reason why plant foods are important is that they contain many phytonutrients, such as flavonoids, carotenoids, and resveratrol, which are health-enhancing chemicals found in plant foods.

You should choose different types of fruits, vegetables, and legumes, including a variety of colors. It’s best to consume them whole, and fruits should be mainly fresh and raw. Whole foods are more effective in reducing the risk of cancer than are specific vitamin and mineral supplements. In fact, some supplements may actually increase the risk of cancer. So stick to whole foods!

Vegetables, fruits, and legumes are particularly beneficial for the prevention of coronary heart disease and stroke. Most nutritionists and dietitians acknowledge that all types of vegetarian diets, including vegan diets, are healthy and nutritionally adequate for all stages of life, provided they are appropriately planned.

Refined foods

Research shows that by avoiding refined foods, such as white rice, pizza, and burger buns, and adding whole grains, such as barley, traditional oats, and quinoa, into your meals, you can significantly lower your risk of cardiovascular disease, type 2 diabetes, and excess weight gain. And the good news is that you can easily incorporate these into delicious snacks and meals.

Not all carbohydrates are bad. The problems are associated with the highly refined ones, including many modern products made from white flour that come in packages rather than directly from a tree or plant.

Processed and cured meats should be relegated to the discretionary foods category, and even then only sometimes and in small amounts. Soda, butter, cream, ice cream, fast foods, and cookies should also be used in limited amounts, if at all. Eggs, legumes, nuts, and seeds are nutritious substitutes for red meat, which is a key risk factor for colorectal cancer.

People who are shorter, smaller, or sedentary are at a disadvantage and have little or no scope within their usual dietary pattern for discretionary foods since their calorie requirements are lower.

Foods to limit

The purpose of this guideline is to limit foods and drinks that have been associated with an increased risk of obesity and/or chronic disease, including cardiovascular disease, type 2 diabetes, and some cancers.

Foods with saturated fat

Foods that you should limit or avoid altogether include cookies, cakes, pastries, potato chips, savory snacks, and alcoholic beverages. It’s particularly important that you choose low-fat options when you eat food prepared outside the home, since saturated and trans fats often lurk in the background. And in order to achieve and maintain a healthy weight, people who do consume these foods need to greatly increase their physical activity in order to burn up the additional calories. But this is clearly not realistic for those who have low rates of physical activity.

Salty foods

Any reduction in dietary sodium will reduce blood pressure. A low-salt diet will also lower the risk of developing high blood pressure in those who don’t already have it. Some new evidence also suggests that people who have high blood pressure can reduce the risk of dying from stroke and heart disease by simply lowering their blood pressure. And reducing sodium may also be important for people who are genetically salt sensitive or for overweight people with certain medical conditions. The ratio of sodium to potassium can also influence blood pressure more strongly than the amount of sodium alone.

Added sugar

Sugary drinks are the most common source of sugars in the modern diet, with consumption being highest in children and adolescents. Fructose and high fructose corn syrups are commonly used as sweeteners in the United States, and these will also cause problems if they are consumed in excessive amounts. High-sugar foods also usually lack useful nutrients. Research shows that at any given level of calorie intake, as the proportion of added sugars in the diet increases, the nutrient density will fall.

Restricting added sugars will also reduce the risk of developing cavities in the teeth, and there is growing evidence showing a link between sugar-sweetened drinks and excess weight gain in both children and adults. Also, recent studies suggest that sugar-sweetened drinks may increase the risk of developing type 2 diabetes.


The evidence suggests that a limited use of alcohol may be beneficial for reducing cardiovascular disease, but it also increases the cancer risk. The consumption of even one to one and a half standard drinks per day is associated with an increased risk of cancers of the breast, colon, rectum, liver, oral cavity, pharynx, and larynx! Alcohol use by adolescents also has an especially harmful effect on their developing brains.

Limitations of the guidelines

Finally, it’s important to note that while dietary guidelines are helpful for most people in maintaining good health, they do not apply to those with medical conditions that require specialized dietary advice. This advice can be provided by a registered dietitian, who will take into account your medical history, current blood test, and the results of a genetic test.

You can download the full Dietary Guidelines for Americans at dietaryguidelines/.

Six Smart Eating and Lifestyle Tips for a Healthy Weight

  • Focus your meals on foundation foods from the five food groups: vegetables (including legumes), fruits, grains, nuts, and dairy or their alternatives.
  • Pay attention to your portion sizes.
  • Avoid sugar-sweetened drinks.
  • Drink plenty of water.
  • Include some whole grains and nuts each day.
  • Avoid fast foods