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Healthy Eating

PART 1: Introduction to Healthy Eating 

In 2018, almost half of Americans included healthy eating, weight loss, or getting into shape on their New Year’s resolution lists. Each year we pour money into the $60 billion dieting industry in the hopes of being healthier. We buy supplements, special formulas, and books to help guide us. Some scoff at these lose weight quick schemes, but those who purchase them really are trying to be the healthiest version of themselves. What we often forget though, is that weight that took a decade or more to put on, should take longer than 3 months to take off – in a safe, long-lasting way that is. As we undergo these fad diets we are often removing key nutrients, leading to possible weight loss, but not necessarily increased health. This year, let’s make nutritious, healthy eating the goal. Let’s focus on foods and nutrients we need to add back into our diets. Filling up on healthy foods may leave little room for the not-so-healthy ones and slowly, but surely, long-lasting health will follow. 

The Meaning of the term “diet”

When we think of the term “diet”, we tend to think of weight loss, food restriction, and let’s face it, being hungry. We think of popular diets on the market and what is deemed “rabbit food”. The term diet, however, stems from the Greek word “diaita”, meaning “way of life”. It referred to not only food and beverage consumption, but activity, healthy lifestyles, and an individual’s daily regimen. It was believed that citizens with healthy bodies and minds would result in healthy, thriving communities. In the Middle Ages, the understanding of the term shifted to mean a regimented way of eating that served a specific purpose. But, the word today means the food and drinks consumed on a regular basis. 

Dieting as we typically view it is not a new concept. One of the first fad diets noted in history was the British notion of “banting” in the 1860s. Individuals who banted, reduced their consumption of foods high in starch and sugar. You could almost compare it to modern-day popular low-carbohydrate diets, except that banters reduced their meat intake to 6 ounces a day as well.

A century and a half later, with thousands of diet marketed to make you healthy, we live in a country where the stereotypical diet is considered to be energy rich, but nutrient poor.

We exist in this paradoxical state where we have too much food, yet we are malnourished This is greatly in part due to our increasing intake of processed foods. These packaged or pre-prepared foods tend to have high amounts of saturated fats, refined grains, and sugars. This has led to a reduction in intake of nutrient dense foods coming from our basic food groups: vegetables, fruits, whole grains, dairy, and protein.


PART 2: What makes up a healthy diet

As we talk about healthy eating, we need to look beyond simple calories and quick fixes. This article will focus on nutrient dense foods that should be incorporated into our diets everyday.

Nutrient dense foods provide vitamins, minerals, and other substances that contribute to adequate nutrient intakes or may have positive health effects.

US Departments of Health and Human Services and Agriculture

These include foods within the food groups such as vegetables, fruits, whole grains, dairy, and proteins that have been prepared with little to no sodium, added sugars, and solid fats. Let’s take a look at the five different groups of food needed for health and what we should consider when selecting what to put on our plates. 

Fruit & Vegetables

I am going to group together fruits and vegetables in our healthy eating discussion. They have similar characteristics and health benefits. Before readers feel the need to remind me that tomatoes are technically a fruit, not a vegetable, it should be noted that we will be using the common language, culinary use of the term “fruit”, not the botanical definition.  From culinary perspective, fruits and vegetables are classified according to taste. Fruit typically refers to sweet tasting plants and vegetables are the savory or less sweet plants.

Fruits and vegetables can be grouped together a variety of different ways. Fruits are often categorized by physical characteristics. There are stone fruits, or those with a pit in the middle such as plums, cherries and peaches. Soft fruits include different berries and grapes. Hard fruits include apples and pears. And then citrus fruits such as lemons, limes, and oranges. Vegetables are categorized according to which part we typically eat, whether it be leaves, seeds, roots, bulbs, etc. Nutritionally speaking, we group fruits and vegetables according their color, dark-green, red and orange, purple and blue, and white. Each of these categories offers different nutrients, making variety important. 

Green Produce

Chlorophyll is the pigment that gives these fruits and vegetables their natural green color. They also contain carotenoids, however, the green pigment is more prominent. Green fruits and vegetables are sources of vitamin K, folic acid, and potassium. Vitamin K has a few major roles in the body. It is required for the formation of blood clots and deficiency can result in hemorrhage. Vitamin K is also necessary for the production of proteins involved in bone formation. The folic acid found in green produce is important in fetal neural tube development and red blood cell production.

Fruit Examples:

  • Avocado
  • Green apple
  • Green grapes
  • Lime
  • Kiwi
  • Honeydew melon

Vegetable Examples:

  • Spinach
  • Green Pepper
  • Zucchini
  • Green Beans
  • Broccoli
  • Brussels Sprouts
  • Asparagus
  • Cucumber
  • Leafy Greens
  • Okra
  • Arugula
  • Celery

Red and Orange Produce 

These fruits and vegetables get their vibrant colors from the pigment lycopene (red) and carotenoids (orange). Lycopene is an antioxidant and carotenoid that has shown to reduce certain types of cancer. Carotenoids are converted to active vitamin A in the body, which is important for eye and skin health. These fruits and vegetables also contain potassium, vitamin C and fiber. Vitamin C is important for immune function, growth and repair of tissue, and also functions as an antioxidant. Fiber plays a role in heart and gastrointestinal health. Potassium plays a large role in fluid balance and muscle contractions. 

Fruit Examples:

  • Raspberries
  • Strawberries
  • Watermelon
  • Red apples
  • Cherries
  • Cranberries
  • Red grapes
  • Grapefruit
  • Pomegranates
  • Cantaloupe
  • Mango
  • Oranges
  • Peaches
  • Pineapple
  • Lemon
  • Apricots
  • Yellow apple

Vegetable Examples:

  • Tomatoes
  • Red peppers
  • Beets
  • Radishes
  • Red onion
  • Radicchio
  • Carrots
  • Summer squash
  • Pumpkin
  • Butternut Squash
  • Sweet Potato

Blue and Purple Produce 

Anthocyanins are the antioxidants that give these fruits and vegetables their deep purple and blue color. These nutrients may play a role in reducing cancer risks and may have a positive impact on inflammation.

Fruit Examples:

  • Blueberries
  • Blackberries
  • Plums
  • Purple grapes
  • Raisins
  • Prunes

Vegetable Examples:

  • Eggplant
  • Purple potatoes
  • Purple carrots
  • Black olives.

White, Tan and Brown Produce

Garlic and onions found in this group contain allium, which has been shown to benefit heart health and lower blood pressure. Other fruits and vegetables in this group are sources of vitamin C, vitamin k, folate, potassium, and fiber

Fruit Examples:

  • Bananas
  • Dates
  • White peaches
  • Brown pears

Vegetables Examples:

  • Onion
  • Garlic
  • Cauliflower
  • Ginger
  • Mushrooms
  • Potatoes
  • Turnips
  • Kohlrabi

Researched Benefits

Research consistently shows the benefits of a diet high in fruits and vegetables. From heart health to gut health and weight management, fruits and vegetables are a major part of healthy eating. 

Both food groups contain potassium. Potassium is a mineral that works in the body to regulate fluid and reverse some of the negative effects of salt. It causes blood vessels to relax and the removal of salt from the blood stream. This in turn can reduce blood pressure. The DASH diet (or Dietary Approaches to Stop Hypertension), which encourages a diet high in fruits and vegetables, low fat dairy, and limited saturated and trans fats; has been shown to have a similar effect on blood pressure as prescribed medications in some patients. 

Diets high in fruits and vegetables lowers the risk of cardiovascular disease and stroke. Recent studies have shown that each serving of fruits and vegetables lowered risk by as much as 4%, with leafy greens having larger effects than other produce options.

Individuals who consumed the recommended five servings a day had a 20% stroke risk reduction compared to those who only at 3 servings per day.

Fruits and vegetables have a positive impact on gut health thanks to the insoluble fiber found in them. The insoluble fiber moves through the gastrointestinal tract undigested. It will absorb water as it moves along, resulting in bulkier stools that are easier to pass. This can help relieve and even prevent constipation issues. 

Fruits and vegetables are highly nutrient dense. They are packed with vitamins, minerals, antioxidants, and other healthy components with relatively few calories per serving. When prepared with little to no butter and/or sugar, and used to replaced higher calorie foods, eating fruits and vegetables can help control weight. 

Amount needed each day

Adults need 5 cups of fruits and vegetables each day, 1.5-2 cups of fruits and 2.5-3 cups of vegetables. While consuming this volume is important in obtaining the health benefits associated, consuming a variety is equally important in a healthy diet. Because the different colors offer different nutrients, no single fruit or vegetable will be able to get you the nutrients you need to obtain the health benefits of a diet high in plants. A variety should be eaten everyday. 

Fresh, frozen, canned, dried, and 100% juice all count towards your servings of fruits and vegetables. There are a few caveats to some of these. When choosing canned foods, look for low sodium vegetables. If you cannot find any, rinse your vegetables to remove the salt that is used as a preservative. Similar recommendations can be given for fruits. Look for canned fruit packed in natural juice instead of syrup. If this is not available, rinse the syrup off to remove the unnecessary added sugar. 100% juice is considered a fruit serving, however, some of the beneficial nutrients are lost during the processing making whole fruits the better choice.

Grains

Grains are the small, hard, dry seeds that are harvested from a variety of plants and used for consumption. They are relatively inexpensive and easy to store for long periods of time. Grains include, but are not limited to, wheat, rice, oats, barley, buckwheat, millet, quinoa, and sorghum. 

From a nutrition perspective, we divide our grains into two separate groups: whole and refined. Whole grains have undergone minimal processing and contain all three layers of the grain: the bran, endosperm, and the germ. The bran is the outermost layer that contains fiber. The middle and largest layer is the endosperm, which holds the plant’s energy stores primarily in the form of starch. The germ is the small innermost layer containing healthy oils, B vitamins, and minerals such as magnesium, selenium, and copper. Refined grains, on the other hand, have been milled to remove the bran and the germ, leaving only the energy containing endosperm. This creates a product that is finer in texture and can last longer on the shelf due to removal of fats that can go rancid. Refined grains used in baking creates fluffy products with lighter textures that are often preferred compared to the dense products when whole grains are used. 

Image by TefiM with istock photos.

Researched Benefits

Not all grains are created equal and the benefits of consuming grains in the diet come from whole grains, not refined. This is primarily due to the fiber left behind in the bran layer and the vitamins, minerals, and healthy oils found within the germ layer. 

Thanks to its fiber content, healthy eating with whole grains can help lower blood cholesterol levels. The soluble fiber found in whole grains moves through the gastrointestinal (GI) tract undigested. It will bind to bile in the small intestines and cause it to be removed from the body. The body must create more bile for proper fat digestion and uses cholesterol to do so. Over time, this may result in lower blood cholesterol levels and a healthier cardiovascular system.

The fiber also aids in weight management and blood sugar control. The fiber content will help you feel full for longer than refined grains, reducing food intake and helping individuals maintain or lose weight. Fiber and starch present in whole grains will also slow digestion and increase the time it takes for glucose to reach the bloodstream. This can help prevent spikes in blood sugar levels for diabetics and help patients keep blood sugar levels within proper ranges. 

The fiber content will help you feel full for longer than refined grains, reducing food intake and helping individuals maintain or lose weight.

Diets meeting and/or exceeding the recommended intake for whole grains can reduce their risk of death from cardiovascular disease and lower blood pressure

Amount needed each day

Dietary guidelines recommend 6 servings (or ounces) of grains each day. At least half of those servings should come from whole grain choices. Foods such as brown rice, oatmeal, cracked wheat, crushed wheat, barley, and corn are whole grain choices. When purchasing prepared grain foods, such as tortillas, bread, and pasta, look at the nutrition label for guidance. Product ingredients can be found underneath the nutrition facts and are listed in order of appearance from greatest to least. Look for products where the term “whole grain” is in the first or second ingredient. You can also look for the Whole Grains Council’s logo indicating that a product is made with 100% Whole Grains. 

Curtesy of the Whole Grains Council

If you are new to whole grains, texture can sometimes be an issue. Because of the presence of the bran in the grain, product texture is often more dense and can take some time to get used to. I recommend you start with pasta. Often sauces can mask some of the altered texture as you are adjusting. 

Individuals following a gluten free diet can still include healthy whole grains in their meals. Gluten is a protein found in wheat, barley, and rye. Other grains should not cause a reaction. These include brown rice, corn, amaranth, quinoa, millet, and sorghum. 

Protein

Protein foods come from both plants and animals sources. Beef, chicken, pork, seafood, and other animal meat contain 5-8 grams of protein per ounce, depending on the amount of fat present. One large egg contains roughly 5 grams and a cup of milk/dairy contains 8 grams. Proteins found in animal products are considered “complete” proteins because they contain all 9 essential amino acids.

Plant protein sources include soy, lentils, beans, quinoa, seeds, and nuts. Grains and some vegetables also contain a significant amount of protein. With the exception of soy products, plant based proteins are not complete and require proper combinations in order to create a meal that meets the requirements for all essential amino acids. For example, combining legumes and whole grains would supply all nine essential amino acids. This could mean a breakfast of peanut butter and whole grain toast or a dinner of rice and beans. Legumes can also be combined with nuts and seeds to create a complete protein. With proper thought and planning, individuals can obtain all of the nutrients they need, with the exception of vitamin B12, from an entirely plant-based diet. 

Protein content found in common foods. Foods presented from lowest to highest protein per serving. 100 grams is equivalent to roughly 3.5 ounces.
Illustration by newannyart with istock photos.

Role of Protein in the Body

Proteins are made up of amino acids. Each protein has a different number and order of amino acids. This results in a different structure and function of that protein. There are 20 amino acids that make up the different proteins found in our foods and our own bodies. Human bodies can make 11 of them, the remaining 9 must come from the foods we eat. When we eat foods that contain protein, the body breaks it down into individual amino acids that we can then use to create muscles and other proteins needed within the body. 

When we think of protein, most minds immediately go to muscle building.  While protein is used in muscle development, it has many other functions. Protein makes up our tissues, organs, and the red blood cells used to carry oxygen around the body. They make up the antibodies we need to stay well and the enzymes used to break down food. Proteins are also the hormones needed for proper growth and regulation of body activities. Proteins play a such a large role in many important functions of the body and it is essential that we eat the right amounts of high quality protein foods.

Amount needed each day

We measure protein in what is called “1-ounce equivalents”. This includes:

  • 1 ounce meat
  • 1/4 cooked beans
  • 1 egg
  • 1 tablespoon peanut or nut butter
  • 1/2 ounce nuts or seeds

The amount of protein needed each day varies depending on age and gender. Children need between 2 and 4 1-ounce equivalents, adolescents and adults need between 5-6.5. 

Though some may disagree, healthy eating can involve animal products. When selecting animal meats, choose options with less visible fat. Animal products have saturated fats which, if eaten in larger quantities, over time can increase risk of heart disease. Visible fat can be trimmed from raw meats and rinsed from browned ground meats. Seafood, especially fatty fish, contain omega-three fatty acids which benefit heart health and should be eaten 2-3 times per week. 

In addition to protein, plants also provide vitamins, minerals, fiber, and antioxidants. There is ample research that recommends diets that are primarily plant-based (note that this does not necessarily mean animal free, simply filled with plant foods). Diets high in plant foods tend to lower the risk of heart disease, obesity, diabetes, and some cancers.

Dairy

Dairy foods include milk from cows and goats and the foods made with that milk; including cheese, yogurt, and cottage cheese. These foods are a surprising high-quality protein source, containing more than an ounce meat. One serving also contains one third of daily calcium needs, 25% of vitamin D, phosphorus, and riboflavin needs, and 20% of daily vitamin B12 requirements. When compared to plant-based “milks”, dairy foods contain more protein and naturally occurring vitamins and minerals. The exception to this is soy milk. Calcium-fortified soy milk and soy products are considered a quality substitution for dairy foods.

Researched Benefits

The bulk of established research for dairy foods are in regards to bone health. During childhood, we are actively accruing bone mass, which requires calcium and vitamin D. In fact, by the time we reach 18, 90% of our bone has been developed. Optimizing bone health when reduce the risk of osteoporosis and other bone disease later in life. This involves daily, regular consumption of calcium and vitamin D. Dairy foods are a main source of these nutrients. 

Intake of low fat dairy foods has also been associated with lower blood pressure, reduced risk of cardiovascular disease and type-2 diabetes. Evidence is still growing in these areas.

Amount needed each day

Calcium does more than build bones in the body and your body works really hard to maintain calcium levels in the blood to perform all of these functions. If there is not enough calcium coming in from the diet on a regular basis, the body will pull calcium out of the bones and use it for other functions. Over time this will develop into osteoporosis. Bones will become weak and porous and will break or fracture easily. Daily, regular intake of calcium and vitamin D is needed to prevent the body from doing this. 

Bone spongy structure close-ups, normal and with osteoporosis.
Image by eranicle with istock photos.

Adults need 3 servings each day and children need 2.5. One serving is equal to 8 ounces of milk or yogurt, 1.5 ounces cheese, 2 ounces of processed cheese, and 2 cups of cottage cheese. Foods made from milk that do not maintain their calcium content are not considered appropriate sources from the dairy group. These include butter, cream, and cream cheese. Ice cream is technically considered a dairy food, but given the sugar content should be enjoyed on special occasions. 



PART 3: Using MyPlate as a guide for healthy eating

Since 1894,  the United States Department of Agriculture has been developing guidelines to help Americans to know and understand what to eat. These guides have changed overtime to reflect new discoveries in nutrition science. I grew up learning the food guide pyramid (developed in 1992) and MyPyramid (2005), both of which were not always clearcut and were difficult to explain to patients. The USDA introduced the current guidelines, MyPlate, in the 2010 Dietary Guidelines for Americans. Scientists in charge of development used the image of a dinner plate to guide Americans towards healthy eating. Simply put, if you prepare your plate similar to this visual, you will be consuming an overall, healthy diet. 

It is important to note that preparation of food matters as much as volume when it comes to healthy eating. Fried chicken is not equal to baked chicken as a protein source, and that is not necessarily clear in the image. Foods should be prepared with minimal saturated fats, added sodium, and added sugar. As stated in prior sections, vary your fruits and vegetables using different colors in the diet and make half of your grains whole grains. Modeling your plate after MyPlate graphic and following these additional suggestions can help you on your way to a healthy diet. 

It is easy to get mixed up with all of the nutrition information available. The MyPlate graphic is a fantastic, simple way to think about your meals and healthy eating in general. If you prepare your plate at each meal according to the image, you will be consuming the recommended five to six servings of fruits and vegetables, three servings of dairy, and appropriate amounts of protein and grains. If you are just beginning the journey to healthy eating, using this guide is a great way to start. 


PART 4: Adding back to your diet

As you think about your diet in the upcoming year, be sure to consider foods that need to be added as much as those that need omitting. Most of us first consider foods we need to stop eating, whether it’s candy, sweets, fast food, sodas, etc. While that is important, we also need a strong focus on the foods that should be included in our diets like more fruits and vegetables, more high fiber foods, dairy servings, seafood, etc. Make a plan to regularly fill your plate with foods that will help you with your health goals, while reducing disease risk and keeping you full. Focus on foods from the 5 food groups, using MyPlate to guide your proportions. Minimize fat, sugar, and sodium in the preparations as well. 

One thing we didn’t really focus on are the foods that shouldn’t be consumed on a regular basis. This is because it is okay to enjoy high fat or high sugar foods on occasion . If you have a deep love of ice cream, enjoy your ice cream on occasion without feeling guilty. If you’re a ribeye kind of guy or gal, enjoy your steak. The question I always ask my kids is whether or not a food will help them grow. If the answer is no, then we can still eat it and thoroughly enjoy it, but we don’t need it every day. Part of healthy eating is not feeling guilty about eating any food, but we do need a fundamental understanding of how food will affect our health. We should make it a point to know and understand which foods keep us healthy and which won’t. Obsessing about healthy eating is ironically not healthy (for non-nutrition reasons) and balance is important. Put forth the effort to eat mostly foods that help you develop and/or maintain a healthy life and minimize (but occasionally enjoy without guilt) the ones that don’t.


Check out some of these Village Table recipes that will help you and your family get started on your healthy eating journey:

Apple Cinnamon Baked Oatmeal
Easy Weeknight Italian Meatballs
One-Pot Hamburger Helper
Creamy Tomato Basil Soup
Rainbow Fruit Salad
Chicken Tortellini Soup

Jessica Barnes, PhD, RDN, LD

Dr. Jessica Barnes received her PhD in nutrition from Texas Woman's University. Her research focused on food preference development and creating materials to help preschoolers become familiar with healthy foods. She has worked with families and communities as a clinical and community Registered Dietitian Nutritionist.

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