Healthy Nutrition
Guidelines
Nutritiously Gourmet food is designed to be
optimally healthy. They will strive to meet the following guidelines for
health adapted from Walter Willett's Eat, Drink and Be Healthy
as well as providing vegetarian fare. The guidelines are prioritized in order
of importance. For example, it would be better to have a little variance in
carbohydrates than excessive calories or bad fats.
1) Calorie control:
Since each menu is a dinner or main meal menu, energy will range from 700 to
900 calories, about 1/3 to 1/2 an average person's daily requirement. It is
very important to pay attention to the designated portion sizes.
2) Unsaturated Fats
Saturated, hydrogenated and partially hudrogenated fats will be avoided
whenever possible. Fats used in cooking and added to recipes will be primarily
unsaturated. Mono- unsaturated oils -- canola and olive -- will be favored.
Nuts and seeds will be used regularly. Fish will be included as a source of
omega-3 fatty acids. Overall concern will focus more on the type of fat used
than on the quantity.
3) Healthy carbohydrates
Vegetables and fruits will be included liberally. Legumes, including dried
beans, lentils, split peas and peanuts will be chosen for both their healthy
carbohydrate as well as their healthy proteins. Whole grain foods, including
brown rice, whole wheat flour and pasta, rolled oats and other whole grains
such as quinoa, millet, barley, etc., will be favored over refined grains.
When sugars are used, they will be added as sparingly as possible.
4) Healthy sources and quantity of protein
Protein sources will be primarily plant foods such as legumes, nuts and seeds
as well as fish. Infrequently, small amounts of cheese and other dairy foods
will be used. Eggs will be used reasonably. The overall quantity of protein
will be in the 20 to 30 gram range, about 1/3 to 1/2 an average person's daily
requirement.
Eat, Drink and Be Healthy
Eat, Drink and Be Healthy
reflects the latest scientific research available as analyzed by Walter C.
Willett, M.D., Dr. P.H., Harvard School of Public Health. Dr. Willett has
spent years in research and public education. In his recently published book,
he aims "to offer straightforward, no-nonsense advice on nutrition, based on
the best information available." When Walter Willett speaks, it is worth
listening. I recommend his book to your reading.
I have summarized Dr. Willett's conclusions below. The following seven
guidelines are his healthiest nutritional strategy to date.
1) Maintaining a stable, healthy weight
"The number that stares up at you from the bathroom scale is the most
important measure of your future health." Control your weight: the lower and
more stable your weight, the better your chances of preventing disease. Low
Glycemic Index ** diets rather than lowfat diets are the best route to weight
loss. Exercise, more than merely a weight control measure, is essential to
health. "Too many calories, regardless of food source, are far more important
to the development of breast cancer than dietary fat." "The lowfat,
high-carbohydrate diet recommended by the...USDA Food Guide Pyramid may be
among the worst eating strategies for someone who is overweight and not
physically active."
2) Replacing saturated and trans fats with unsaturated fats
Eat MORE good fats: unsaturated fats such as canola oil, olive oil,
nuts, seeds and fish. Stay away from bad fats: saturated fats such as animal
and dairy fats and hydrogenated and partially hydrogenated fats. "It is
perfectly fine to get more than 30% of daily calories from fats as long as
most of those fats are unsaturated" ...AND total calories are controlled.
"If you balance the number of calories you eat with the number of calories you
burn,...you won't gain weight on a diet that has 35 or even 40 percent of
calories from fat." "The fat in your diet doesn't necessarily make you fat
...IF you keep your calories constant."
3) Substituting whole-grain carbohydrates for refined-grain
carbohydrates
Eat fewer refined-grain carbohydrates and more whole-grain carbohydrates.
Select whole grain carbohydrates such as whole grain breads, brown rice, oats,
other whole grains or beans. Potatoes should be an occasional food, consumed
in modest amounts. Eating lots of carbohydrates that are quickly digested and
absorbed -- white flour, white rice, potatoes, sugars, -- increases levels of
blood sugar and insulin, raises levels of triglycerides and lowers levels of
HDL cholesterol...leading to cardiovascular disease and diabetes. "A constant
and heavy demand on the pancreas to make insulin appears to be a key
ingredient for adult-onset diabetes, especially when paired with lack of
exercise." "Carbohydrates from whole grains, fruits and vegetables should
indeed give you the bulk of your calories." No longer is "simple" and
"complex" carbohydrate an adequate distinction; the Glycemic Index:** which
shows the effect of various carbohydrates on blood sugar levels, should be
used to sort "good" from "bad" carbohydrates. "High levels of blood sugar and
insulin surges are now implicated as part of the perilous pathway to heart
disease and diabetes."
4) Choosing healthier sources of proteins by trading red meat for nuts,
beans, chicken and fish
You need a minimum amount of protein every day; but don't overdo it.
Too much protein can draw calcium out of the bones and lead to kidney disease.
Choose healthy sources of protein. Plant proteins have advantages over animal
sources. "The best sources of protein are beans, nuts, fish, poultry and
eggs." Don't go overboard on soy.
5) Eating plenty of vegetables and fruits
...but hold the potatoes. A diet rich in fruits and vegetables protects
against heart disease, a variety of cancers, development of cataracts and
macular degeneration. Aim for a minimum of 5 servings a day; 7 to 9 servings
would be better
.
6) Using alcohol in moderation
"Alcohol, in moderation, is probably good for most people." Moderation means
one drink a day for women; one or two for men. Any alcohol-containing beverage
-- wines, beer, hard liquor --offers the same benefits. "People who have one
or two alcoholic drinks a day are less likely to have a heart attack or die
from heart disease than nondrinkers or heavy drinkers." "For women, 2 drinks a
day increase the chances of developing breast cancer by 20 to 25 percent."
Folic acid may help to reduce this.
Adequate fluid is important. Water is the best way to get the most important
nutrient, water. Regarding milk: "there are more reasons not to drink milk in
large amounts than there are to drink it. I don't recommend it as a beverage
for adults." "Coffee is a remarkably safe beverage." Tea also has some
benefits.
7) Taking a daily multivitamin for insurance
Supplement the hard-to-get-enough-of nutrients. There is not a calcium
emergency. "Too much calcium might be a bad thing." Elevated intakes of
calcium do not prevent broken bones in old age. Eating a lot of dairy products
may increase ovarian and prostate cancers.
** The Glycemic Index measures how a particular carbohydrate food affects the
blood sugar level. In general, refined sugar, potato, rice, and bread have a
greater effect on blood sugar and, therefore, insulin production, than
legumes, fruit, most vegetables and pasta.
Some of you may already be doing all of the
above. Congratulations. Most of us, however, continue to strive toward optimal
health. It is important to remember that the guidelines are listed in order of
importance. Work on the first ones first. And don't try to do it all at once.
You have a lifetime to perfect this, hopefully a long, healthy lifetime.
Introduction:
There are about 40 nutrients, substances
that the human body needs to consume on a regular basis to survive. The most
important nutrient is water. More than half of our body is water. It makes
sense, therefore, that daily replenishment of this essential component is
vital for health. Energy-yielding nutrients needed in large amounts --
protein, fat and carbohydrate -- are called macronutrients. The percentage of
total daily Calories supplied by each of these is a major determinant of
health. The remaining nutrients -- vitamins and minerals -- are needed in
small, in some cases minuscule, amounts. We call these micronutrients. Fiber,
the remaining essential substance, is not a true nutrient as it does not
actually enter the bloodstream, passing through the body via the
gastrointestinal tract.
Protein:
The body requires a fairly precise
amount of protein daily: that which is needed to maintain and repair bodily
tissues and to provide growth for infants, youth and pregnant women. This
amount depends on body size, averaging about 53 grams of protein per day for a
woman and about 63 grams for males. This level of protein intake represents
about 10% of daily Calories. Protein amounts eaten beyond requirements are
burned as energy or stored as fat.
Protein is available from both animal and plant foods. It used to be thought
that animal protein was superior to plant protein. The truth, however, is that
with a varied and balanced diet, complete protein can be obtained from plant
sources alone. Nutrition science verifies that plant protein is actually
healthier than animal protein. As animal protein amounts increase in the diet,
"diseases of nutritional extravagance" such as heart disease and many cancers
also increase. Plant protein, unlike animal protein, tends to be protective
and preventive of such diseases. As excess protein is consumed, urea nitrogen
levels rise in the blood; along with their rise, the rates of degenerative
diseases also increase.
Fat:
Fats are the current darling of the food
police. This is not without some justification, of course, but it is wise to
distinguish the various kinds of fats and keep the overall balance of the
entire diet in mind when thinking "nutrition and health." It is confusing to
recognize that fat is a nutrient, an essential food substance, and yet to
understand how much of which type or types of fat we really need to eat.
Fats
are either saturated or unsaturated, a chemical distinction referring to
stability. Saturates are stable; unsaturates are unstable. Simple, so far.
Foods with fat all contain a mix of saturates and unsaturates, yet we consider
them one or the other depending on which type predominates. For example,
examples of saturated fats include butter, margarine, vegetable shortening,
lard and palm and coconut oils. Unsaturates sort into two piles, depending on
whether they are primarily monounsaturated or polyunsaturated. Monounsaturates
include olive oil, canola oil and various nut oils. Polyunsaturates include
soy oil, cottonseed oil, safflower oil, corn oil and fish oil. Fats that
started out unsaturated can be saturated through a process of hydrogenation.
Hydrogenation or partial hydrogenation creates substances called trans fatty
acids which are unhealthful. Hydrogenated fats are found in margarines and
vegetabled shortenings and foods made with these products, including most
commercially baked goods.
As a
nutrient, we need only a small amount -- less than one teaspoonful -- of a
particular polyunsaturated fat. It has been suggested that we also require
another form of polyunsaturated fat called "omega-3 fatty acids." These
particular fats are found in fish oils, flax seed and, in small amounts, in
canola oil, soy oil and walnut oil. Omega-3s prevent heart arrthmias and
sudden cardiac death, a cause of half of all heart disease deaths. The
American Heart Association recommends eating at least 2 servings of seafood
weekly.
We have no need for saturates.
Since their consumption is related to elevations in serum cholesterol levels,
it is prudent to avoid saturates -- as well as trans fats from hydrogenation
-- whenever possible.
Since more than 80% of the oil
used commercially is soy oil, we probably get more polyunsaturates than we
need for a healthy fatty acid balance. It makes sense, therefore, to use
monounsaturates at home.
Since
we get a sense of completion of a meal or sense of satiety from fat, we all
enjoy eating more than a paltry teaspoonful across an entire day. We also like
the flavors carried by fats and the mouth feel. And, let's face it, some of
our favorite foods are just plain fat -- think cheese, chocolate, I could go
on. How much fat is too much?
Even
after fine tuning our diet to maximize the good fats and minimize the bad, we
still need to pay attention to the overall intake. Fats are very
calorie-dense. As long as our caloric intake is managed to maintain healthy
weight, we can include good fats necessary for palatability and to insure that
we eat the necessary vegetables, legumes and other nutrient-dense foods that
often accompany them.
Carbohydrates:
All carbohydrates ultimately convert to
glucose in the body. We consume them as complex carbohydrates: starches, or
simple carbohydrates: sugars. The nutritional difference is that starchy foods
provide other nutrients such as vitamins and minerals and are rich sources of
dietary fiber. Sugars, except for those in fruits, are usually empty calories,
devoid of extra dietary goodies. They digest more rapidly, assaulting blood
sugar levels and associated insulin responses.
Only
plant foods supply carbohydrates, with the exception of lactose, a sugar in
milk. And, since most of our calories need to come from carbohydrate (there
are no other sources after protein and fat except for alcohol), we are looking
at a vegetarian reality. Look on the bright side. Only unrefined plant foods
have fibers, those necessary cholesterol lowerers and stool softeners. There
is no cholesterol in any plant food; only animal foods have cholesterol. And,
only plant foods bring anti-oxidants into the diet. These are only some of the
reasons that "Five-A-Day," the campaign to increase fruit and vegetable
consumption, is so important for our health.
Vitamins and Minerals:
If one consumes a balanced diet as
described above -- appropriate protein, primarily from plant foods; good fats,
primarily monounsaturated and omega-3; and whole grains, legumes, and adequate
vegetables and fruits -- AND one has not restricted energy intake for extreme
weight loss AND one eats a variety of different foods, it is almost impossible
not to obtain adequate micronutrients.
A
vitamin B12 deficiency is possible with a very strict vegan diet. Other
possible nutrients of concern include vitamins B6, folic acid and E and
minerals iron, magnesium and zinc. Foods such as legumes, whole grains, dark
leafy greens, nuts and seeds are good sources of these micronutrients and make
a major contribution to a healthy diet. Supplements should be used to fill in
the gaps if the diet is not providing enough of these hard-to-get-enough-of
nutrients. They should not be utilized as a substitute for a healthy diet. The
Recommended Dietary Allowances (RDA) offer general guidelines for safe
supplement intakes.
Fiber:
Dietary fiber is found only in plant
foods. There are two general types of fibers, soluble and insoluble. The
soluble fibers aid the body in lowering levels of serum cholesterol. These
fibers are found in legumes, oat bran, the white, pithy part of citrus peel
and unripe fruits. Insoluble fibers are prevalent in wheat bran and most
vegetables. They act primarily in the large intestine, helping to prevent
diverticulosis and regulate bowel movement.
Conclusion:
Although nutrition science is a growing
body of research, there is still much to learn about the relationships between
foods and health and disease prevention.
Top
This ongoing nutrition research
project is the most comprehensive and most compelling study ever undertaken on
the relationships between what we eat and the risks of developing the chronic
degenerative diseases so prevalent in our culture. Once aware of this study,
it is hard to ignore its implications.
As a percentage of total
calories, the Chinese average 10% from protein, 15% from fat and the remainder
primarily from carbohydrate. (A small percentage derives from alcohol, the
only other energy source.) Based on this data and adjusting the fat toward a
more attainable goal, an optimal daily dietary balance of calories might be
10% from protein, 20% from fat, and 70% from carbohydrate.
The Chinese Diet:
The
average consumption of fat in China is 15% of total calories, less than half
that of the West. Their protein intake is about two-thirds that of the West,
but only 10% is animal-based whereas 70% of the Western protein intake comes
from animal foods. Depending upon the region of China, the diet may be based
on rice, wheat, corn, millet, sweet potatoes or other starches; they consume
far more vegetables than Westerners.
Dietary Guidelines Suggested
by the Study:
-
Use little or no added fats
or oils
-
Eliminate or cut down on
animal proteins of all types
-
Eat a generous amount of
plant-based foods
-
Be cautious regarding
supplements; they do not substitute for real foods
The Project:
Begun
in 1983, the China Project is a collaborative effort primarily between
nutrition scientists in America and China. The chief investigator is Dr. T.
Colin Campbell, a professor of nutrition and biochemistry who holds an endowed
chair at Cornell University. Dr. Chen Junshi of the Chinese Academy of
Preventive Medicine in Beijing works with Dr. Campbell. Scientists from
Oxford, England, and laboratories throughout the world have also collaborated
on the study.
China
was chosen as the site of the study as it offers a living laboratory unlike
anywhere else in the world. The genetically similar Chinese tend to spend
their entire lives in the same area, eating the same kinds of locally grown
foods throughout their lives. Their diets as well as their disease rates vary
considerably from one region to another. Because of the immensity of the
country, both "diseases of poverty" such as pneumonia, tuberculosis and
rheumatic heart disease and "diseases of affluence" such as diabetes, cancer
and coronary heart disease are found. The scientists wanted to find out if the
varying diets in different parts of China would correlate to varying death
rates from certain diseases.
Researchers collected data on how people live and die in 65 counties
throughout China. Some of the data gathering required days of travel across
rough terrain in order to reach nomads on the Soviet border or villagers in an
oasis near the Gobi desert. In the 1989 survey, more than 1000 items of
information were collected on each of the 10,200 Chinese and Taiwanese adults
that were observed, interviewed, measured and poked for several days. Every
piece of food they ate was noted; urine and blood samples were taken.
Truly, this is the most comprehensive epidemiological study ever undertaken on
the relationships of diet and disease. It is unique in that it looks at the
effect of overall diet and lifestyle on health, not just a single food or food
component relative to a single disease.
Results:
Cholesterol:
A
high blood level of cholesterol was consistently associated with many cancers,
including leukemia, liver, colon, rectum, lung and brain. The women in the
villages that had the highest cholesterol levels also had the highest levels
of cancers, heart disease and diabetes, while the women with the lowest
cholesterol levels had the lowest levels of these diseases. It is important to
note that the highest cholesterol levels in rural China were near the lowest
levels found in the U.S. In the U.S., cholesterol levels average 210 - 220
mg/dl. The rural Chinese average 125 - 130 mg/dl. The Chinese who had even
lower levels suffered significantly less cancer and heart disease than their
more "average" compatriots.
Animal protein and saturated fat cause cholesterol levels to rise. Metabolic
studies in humans show that animal protein raises blood cholesterol more than
does saturated fat. In effect, lean meats may be just as damaging to your
cholesterol levels as fatty bacon.
In
any group of men, seventeen times more American men will die of heart disease
than Chinese men. Dr. Richard Peto of Oxford University, a major researcher on
the project, says, "The Chinese experience shows that most Western coronary
heart disease is unnecessary."
Protein:
Urea
nitrogen, leftover after protein metabolizes in the body, is directly related
to chronic degenerative disease rates. As excess protein is consumed, urea
nitrogen levels rise in the blood; as urea nitrogen levels rise, so do
diseases of affluence. Not surprisingly, data gathered near the more affluent
cities of Beijing and Shanghai where diets are richer with animal products
showed higher rates of degenerative diseases associated with affluence. Even
small intakes of animal foods, such as meat, eggs and milk, are associated
with significant increases of cancer, heart disease and diabetes. Conversely,
the higher the percentage of plant foods in the diet, the less the chance of
getting these diseases.
Osteoporosis:
The
Chinese have a low rate of osteoporosis: they have only about one fifth the
number of hip fractures as in the West. They consume little if any dairy and
ingest low amounts of calcium. A different level of physical activity might
explain some of the difference. But, they also eat far less protein than
Westerners. High protein intakes, especially animal proteins, cause calcium to
be excreted in the urine. A person eating 142 grams of protein a day will
excrete twice as much calcium as a person eating 47 grams, the amount required
by an average woman. If more calcium is excreted than is eaten, the deficit is
made up by withdrawing calcium from the bones, weakening them over time.
Calories:
In
China, 30% more calories per kilogram of body weight are consumed than in the
U.S. Despite averaging 270 more calories per day, the average Chinese is
thinner than the average American. Could the source of the calories make a
difference? The Chinese eat 6 - 24% of their calories as fat; Americans
consume about 30-46% of calories as fat.
Antioxidants:
Antioxidants may help protect against cancers. The study found that the lower
the intakes of vitamin C and beta carotene, two antioxidants, the higher the
rate of esophageal and stomach cancers. Antioxidants are only found in plant
foods; they are not in animal foods.
Iron:
Most
of the iron in the Chinese diet comes from plant foods. While it is true that
the iron in vegetables and grains is less easily absorbed than heme iron which
is found in animal foods, the Chinese had normal blood levels of iron. The
added fiber in a plant-rich diet did not appear to interfere with
bioavailability of iron.
Breast Cancer:
In
China, high levels of breast cancer were associated with several things: high
intake of dietary fat; high blood levels of cholesterol, estrogen and
testosterone; and early age at first menstruation. We know that dietary fat
and blood cholesterol are related to diet. Estrogen and other reproductive
hormones increase in the blood as meat, milk and fat increase in the diet.
Testosterone also was high in those women who ate more fat and animal foods.
Even menarche is diet related: diets high in fat, calories and animal protein
lower the age of menarche by accelerating growth. The earlier the onset of
menstruation the greater the likelihood of developing cervical as well as
breast cancer.
Other Cancers:
Lung cancer
rates reflect the introduction and promotion of cigarettes in China. It is
estimated that around 50 million of the existing Chinese population will die
prematurely of lung diseases.
The relationship of
dietary fiber and colon cancer in the Chinese population reflects that
the higher the intake of a wide variety of fibers, the lower the rate of colon
cancer. The Chinese eat three times as much fiber as Americans. Fiber is only
found in plant foods.
People infected with
chronic viral hepatitis (type B and C) -- about 12-13% of the Chinese
population -- were more likely to get liver cancer. Among those people,
the ones with the highest cholesterols levels were most likely to develop
liver cancer.
People who have stomach ulcers or chronic stomach infections from Helicobacter
pylori bacteria are more likely to get stomach cancer. In the absence
of refrigeration, foods are preserved by salting and fermentation, possibly
contributing to this problem. Even in people predisposed to liver and stomach
cancers, a higher intake of plant foods led to fewer cases.
Carcinogenesis, the development of cancer, appears to be turned on by animal
protein and turned off by plant protein, even if cancer has already been
initiated. It appears that once the body has met its protein needs (about 8 -
10% of the daily calories), the excess protein begins to feed precancerous
lesions and tumors.
Other Findings:
Researchers found
that the higher the levels of copper in the blood, the higher the rate of
certain cancers.
There was a strong
but unexplained association between cadmium in the urine and primary liver
cancer.
There was an
intriguing correlation relationship between herpes simplex infections and
heart disease.
The shorter Chinese
stature was more likely related to early childhood infections that to lack of
protein or nutrients.
Chinese women report
fewer difficulties with symptoms of menopause. This may be related to overall
lower estrogen levels in Chinese women, higher intakes of magnesium and
vitamin B6 which appear to reduce symptoms of PMS, or higher intakes of
phytoestrogens such as genistein in soy foods which counter falling estrogen
levels at menopause.
Chinese men have the lowest advanced prostate cancer rates in the world: one
in every 100,000 men, while Chinese-American men living in San Francisco have
a rate 19 times higher. High levels of testosterone trigger rapid growth of
prostate cancer cells. Testosterone production is accelerated by an animal
protein diet, while a diet low in fat and high in fiber slows its production
and speeds its elimination. Furthermore, vegetables contain plant estrogens
that can help normalize the proportion of testosterone to estrogen in the
body. Several studies have shown that men eating diets high in phytoestrogen
containing foods, such as soybeans and peas, are less likely to develop
prostate cancer.