The Medical Minute: What to eat in 2008

March 25, 2008

By John Messmer

What’s on your plate – your dinner plate, that is? Too often we eat what we like from what is available without considering anything but taste. Or, eating out, we choose from a menu based on likes and dislikes rather than nutrition. The good news is it's OK to have entertainment foods from time to time as long as our basic diet is healthy.

Eating well is not hard with some basic knowledge. If your idea of a hearty meal is fried chicken, biscuits and gravy or a 16-ounce steak with fries and a side salad, your palate will need some re-education. It’s not that you can never eat fried food or steaks -- what counts is how often and how much.

Let's consider carbohydrates first. This group has been given a bad reputation in popular weight-loss programs, but the truth is we need carbohydrates for energy. All carbohydrates are composed of sugar, either plain sugar or sugar molecules joined together. The ones that break down quickly -- called "high-glycemic index" -- raise blood sugar levels fast and contribute to obesity. Others break down slowly -- "low-glycemic index." The latter are preferred since we can use the energy and feel as though we have had enough to eat without overdoing it.

We should eat less of the high-glycemic carbohydrates, including pastas, white flour, white rice, white bread, potatoes, corn, pretzels, cookies, cake, bagels, and low-fiber cereals and sugars. A teaspoon or two of sugar in coffee is fine, however. Problem sugars include regular soda, candy, syrups, honey, molasses and -- surprise -- fruit juices, including orange juice, grapefruit juice and others.

We should eat low-glycemic carbohydrates including: 1) grains such as brown rice, quinoa, barley and whole wheat; 2) beans, lentils and other legumes; 3) crunchy fruits such as apples, melons, berries and most vegetables, including sweet potatoes or yams.

Fats also come in good and bad forms. Oils are liquid fats and are generally better for us than solid ones. Oils or "good fats" are found in nuts, seeds, some vegetables such as olives and avocados, and many fish. "Bad fats" tend to be solid. They are also called "saturated" fats based on their chemical structure having more hydrogen. Examples of saturated fats are animal fats, palm and coconut oils (tropical oils) and partially hydrogenated oils found in some processed foods. The latter are the "trans" fats that manufacturers have been trying to eliminate since they tend to clog arteries. All fats, good or bad, have more than twice the calories of other foods.

Protein is found in meat, fish, milk and many plant sources. Fatty meats, such as ribs, should be eaten sparingly (pardon the pun). Organ meats (liver, kidney, brain, sweetbreads, and chitterlings) are so high in fat they should either be avoided or included only rarely. Breakfast meats such as bacon, sausage and scrapple should be limited as they are very high in fat.

A 3-ounce serving, about the size of a deck of cards, of lean meat (lean beef or pork, chicken or turkey) is fine. Beans and other legumes such as, lentils and chickpeas are excellent sources of protein with almost no fat and should be included in our diets frequently. Although nuts and seeds have fat, they have high quality protein and the fats are monounsaturated fats which are good for us in modest quantities.

Fish is very nutritious and a good alternative to red meat. Swordfish, mackerel, shark and tilefish tend to accumulate mercury, so these should be eaten less than twice a month, and pregnant women should avoid them altogether. Fish has EPA and DHA, known as omega-3 fatty acids, another kind of oil that reduces risks of heart disease.

One of the problems in eating properly is our busy lives get in the way of proper meals. Plan ahead to include five or more servings of vegetables and fruits daily. Mix different colors of stalky and leafy vegetables and different fruits each day and throughout the week. Choose from beans, lentils and grains in multiple servings.

One more thing to consider is sodium. Many otherwise highly nutritious foods have sodium added. Prepared foods, such as, soups and frozen dinners are major offenders and can risk the entire day's allotment of sodium in one or two servings. All herbs and spices are fine, but sodium can lead to high blood pressure and stresses weak hearts.

Maintaining good dietary habits doesn't require a nutrition degree. Healthy foods are plentiful and generally inexpensive. Recipes for beans, grains, vegetables and lean meats and fish are readily available on the Internet and in bookstores and libraries. You'll appreciate the variety and feel better, too.

John Messmer is associate professor of family and community medicine at Penn State College of Medicine and a staff physician at Penn State Milton S. Hershey Medical Center.


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Last Updated March 19, 2009