What do We Eat Now? Finding your Way through the Swamp of Advice on Nutrition

Feb. 5, 2003

You‘d think that with thousands of scientists and dietitians studying nutrition over the past 100 years or so that we‘d be the most knowledgeable people of all time in terms of what makes for healthful dining.
But such is not the case. As noted in a recent Newsweek article on the collapse of the USDA‘s Food Pyramid, Americans are now fatter than ever -- and more inclined towards heart disease, diabetes, cancer and hypertension -- often as a direct result of their poor eating choices.
“Americans have grown fatter and sicker since the USDA Food Pyramid came out a decade ago. Is there a healthier, tastier diet?“ queried writer Geoffrey Cowley in the Newsweek article. To find out, the Express met with three local experts in health, exercise and nutrition to get their views on what constitutes good eating habits, including fitness specialist Doug Petersen and dietitian Jennifer May, R.D., both of the Fitness Center in Traverse City, and family practitioner Natalie Gray, M.D., of Brookside Family Medicine. In the following interview, they offer advice on how to find your way through the wilderness of fad diets and theories to develop healthful dining and exercise habits.

THE PYRAMID CRUMBLES
But first, a little background. In early January, federal health officials conceded that the USDA‘s Food Guide Pyramid released in 1992 has been flawed at best, if not a disaster.
The Food Pyramid divided nutrition into four basic food groups -- meat, dairy, produce and grains. Grain-based foods such as bread, cereal, pasta and rice formed the base of the pyramid, indicating the bulk of what one should eat. Next came produce, dairy products, and a small amount of meat balancing off the top of the pyramid.
According to Newsweek, the pyramid was devised in the late ‘80s at a time when most nutritionists were concerned about the high level of fats being consumed by Americans. Their reasoning went that if they could get people to eat less meat and more grain-based foods (carbohydrates), we‘d be a healthier nation.
But what the nutritionists didn‘t anticipate was the flood of high-carbohydrate processed foods which were created in response to the low-fat craze, “and that cereal grains had all the nutritional value of table sugar when milled into flour.“ Food makers flooded the grocery shelves with cookies, cakes, and Hamburger Helper-style meals which were packed with carbs, but low in fat.
Since that time, many best-selling books on nutrition have emerged, pointing out the hazards of high-carbohydrate diets, when tend to result in obesity, heart disease and other health hazards. Carbohydrates enter the body as blood sugars and are stored as fats; they also gunk up the arteries. Unfortunately, the Food Pyramid gurus never anticipated the boom in processed foods, and the message never got out to go easy on the sweets and carbs.
“We were trying to promote lean meats and low-fat dairy products,” said Marion Nestle in Newsweek, a nutritionist who advised the surgeon general in the late 1980s. “We never thought of Snackwell’s.”
A new “Healthy Eating Pyramid“ from the Harvard School of Public Health stands some of the old Food Pyramid‘s reasoning on its head (see illustration). In the Healthy Eating Pyramid, grain-based carbs such as bread, white rice and potatoes are at the top, to be eaten sparingly, and exercise forms the base for good health.

THE PROBLEM
So, what do we eat now?
“That‘s a question so many people are asking,“ says fitness trainer Doug Petersen. “It‘s amazing how many people don‘t know what to eat.“
Dr. Natalie Gray agrees. “There‘s so much confusing information out there that hasn‘t been updated. Even physicians aren‘t getting the kind of good information they need for their patients.“
“There‘s way too much focus on diets and not enough on health when it comes to eating,“ says dietitian Jennifer May. “If your primary focus is only on losing weight, then there are many unhealthy ideas out there on how to lose it.“
Speaking of weight, May adds that Americans have reached a state of crisis at the waistline. Some 61% of us are overweight now, and that percentage could jump to 75% in the next four-five years. Meanwhile, American children are the fattest in the world, owing to a diet wallowing in soft drinks, sweets, snacks and fast food.
Part of the problem is that Americans have hundreds of convenience foods to choose from, many of which are unhealthy.
“Thirty years ago, a typical dinner could take two or three hours to prepare,“ May notes. “Now it could take 15 minutes, and the big issue is over the quality of the processed foods we‘re eating.
“People need more education on what to eat,“ she adds. “I think there‘s a lack of education and good solid advice.“
The problem of course, is determining what the “correct“ education is, since there are hundreds of books on the market advocating different theories of nutrition, from the Atkins Diet and the Protein Power Plan to Weight Watchers and various fads advocating a diet heavy in foods like grapefruits. All of them advocate “the best“ course of action for nutrition, backed by persuasive anecdotes and scientific evidence.

COMMON SENSE
Yet it‘s possible to find your way through the swamp of skewed science and dietary advice by using the guides of moderation and common sense.
Dr. Gray says she has found good advice on nutrition in the works of author Andrew Weil, who penned “Eating Well for Optimum Health“ and other health-oriented books. The book allows you to literally have your cake and eat it too, only with an eye towards small portions.
As a simple guideline, Dr. Gray says she tells her patients to eat five servings of fruit and vegetables a day, along with more lean proteins such as chicken or fish, and less red meat. Sometimes people get overwhelmed by the idea of five servings of fruit or vegetables until they‘re informed that a serving can be as little as half a cup.
Petersen has some humorous advice relating to high-carbohydrate, processed foods. “I heard one theory that you shouldn‘t eat anything that didn‘t have a mother,“ he says. Nor should one eat “anything that comes in a bag or a box.“ It‘s the same advice given by advocates of unprocessed and organic foods, ranging from Weil to Ted Nugent.
May says one should dispense with the idea of diets altogether, which tend to come and go with limited success. “I‘ve seen such a negative impact from diets; I don‘t even like the word ‘diet‘ because they tend to lead to snack foods and binge eating.“
Instead, healthful eaters would be better served by getting back to the basics of eating smaller portions, dining on sensible foods, and adding more daily exercise.

EXERCISE FACTOR
Exercise is especially important when it comes to weight loss because when you build muscle mass, you ignite your body‘s natural furnace, burning calories 24/7.
“I always look at what my patients are doing for exercise,“ says Dr. Gray. “Exercise is one of the keys to weight loss, because the more you do, the less you have to cut calories.“
Petersen adds that it‘s relatively easy to figure out how many calories your exercise program can help you burn each day. Walking briskly for an hour, for instance, burns an average of 325 calories; running or cycling the same period burns 720.
Losing weight often gets down to simple common sense. If you drink a sugary Coke and don‘t exercise, you‘re in a weight gain situation; conversely, not drinking the Coke and exercising tips the scales towards slimness.
“Certain things work differently for different people, depending on their level of fitness,“ Petersen adds. “A marathon runner can eat white rice for energy and not gain weight because it‘s not being sucked into fat cells.“ For those of us who aren‘t as fit, however, white rice has been shown to enter the bloodstream as quickly as plain sugar.
“People who are overweight often have a history of a lot of dieting, but not much exercise,“ notes May. Unfortunately, many diets prompt the body to lose muscle tissue along with fat as a self-preservation mechanism. When the diet is over, people tend to blimp back up precisely because they no longer have much muscle mass available to help burn calories.

LOW CARB DIETS
All three experts agree that one should be wary of the extreme low-carb, high-protein fad diets.
“I have many concerns with the Atkins Diet,“ says Dr. Gray. “First of all, I don‘t think it fits in with our lifestyle as a way to eat for the long term. It‘s hard to follow for any length of time.“
Petersen agrees. “It‘s initially successful,“ he says of the Atkins. “You lose six or 10 pounds, but then people tend to gain it back.“ He adds that much of the weight loss in the Atkin‘s plan can be attributed to being simply dehydrated.
The Atkins Diet works by inducing the body into a fat-burning state called ketosis. Since the dieter is eating little or no carbohydrates, there is nothing available for the body to burn as fuel, so it relies on its own stores of fat.
But eating a diet heavy in meats and proteins in lieu of carbohydrates can result in health risks, including heart disease, cancer, kidney problems and osteoporosis.
“Undoubtably we eat too many carbohydrates, but I don‘t think the answer is to increase eating a lot of protein,“ says Dr. Gray. “Protein is a very complex molecule and the American diet is not lacking in protein whatsoever. If anything, we eat too much of it already and it‘s not a clean-burning fuel.“

So, what‘s best to eat? To summarize:
• Moderation: Eat smaller portions and smaller meals. You don‘t need to give up dessert -- just have a smaller serving.
• Common sense: Eat foods that you know are going to be good for you; five servings of fruit/vegetables per day along with lean meats. Go easy on foods heavy in carbs and sweets. Study the new Healthy Eating Pyramid.
• Education: Take time to find out what you‘re putting in your mouth each day and whether it‘s adding to your waistline and/or poor health. Think in terms of a lifetime eating strategy, rather than a temporary diet.
• Exercise: Building muscle mass can have a dramatic effect on weight loss since well-toned muscles burn calories even while you sleep. “Try to get at least three hours of exercise each week,“ says May.