The Medical Minute: What to eat in 2004

January 21, 2004

By John Messmer, M.D.
Penn State Milton S. Hershey Medical Center

Hershey, Pa. -- What are your dinner plans -- a trip to South Beach? Supper in The Zone? Rice cakes and tofu? Too often we eat what we like or what is available without thinking much about it other than whether it tastes good. Then we eat to the point of being full and follow it with snacks and empty calories for entertainment. The result is that a third of us are overweight while another third are obese, and diabetes rates are climbing.

Eating well does not have to be hard, but you might have to rethink your menus a bit. If your idea of a hearty meal is fried chicken, biscuits and gravy or a 16-ounce steak with fries and a side salad, you are in for a new experience. It's not that you can never eat fried food or steaks -- what counts is how often and how much.

The good news is we can include a wide variety of foods in our meals.

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 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.

Low-glycemic carbohydrates, which we should eat, include 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. 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. Animal fats tend to be saturated. Palm and cocoanut (tropical oils) are saturated vegetable oils that are not good for us as are partially hydrogenated oils found in many processed foods. You may have heard of "trans" fats -- another chemical description. Many hydrogenated oils are "trans" fats, which can have harmful health effects if they are a big part of our diets. Whether you consume good or bad fats, they all have more than twice the calories of other foods.

Protein is found in meat, fish, milk and many plant sources. A 3-ounce serving of lean meat, about the size of a deck of cards, is fine. Fatty meats, such as ribs, should be eaten sparingly (pardon the pun). Organ meats are so high in fat they should either be avoided or included only rarely. As most people know, breakfast meats such as bacon, sausage and scrapple should be limited, as they are very high in fat. Beans and other legumes are excellent sources of protein with almost no fat. Lentils, chickpeas and beans should be included in our diets frequently. Although nuts and seeds have fat, they have high quality protein and the fats are "good" for us.

Fish is very nutritious and a good alternative to 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 the quick meals associated with our busy lives. 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. Condensed soups are a major offender 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, so try to limit a serving to 300 mg or so.

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

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Last Updated March 19, 2009