Why should I try to have a healthy diet?

Having a healthy diet is one of the most important things you can do to help your overall health. Along with physical activity, your diet is the key factor that affects your weight. Having a healthy weight for your height is important. Being overweight or obese increases your risk of heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), osteoarthritis, and some cancers. You can find out if you're overweight or obese by figuring out your body mass index (BMI). Women with a BMI of 25 to 29.9 are considered overweight, whereas women with a BMI of 30 or more are considered obese. All adults (aged 18 years or older) who have a BMI of 25 or more are considered at risk for premature death and disability from being overweight or obese. These health risks increase as the BMI rises. Your health care provider can help you figure out your body mass, or you can go to www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm.

Having a healthy diet is sometimes easier said than done. It is tempting to eat less healthy foods because they might be easier to get or prepare, or they satisfy a craving. Between family and work or school, you are probably balancing a hundred things at once. Taking time to buy the ingredients for and cooking a healthy meal sometimes falls last on your list. But you should know that it isn't hard to make simple changes to improve your diet. And you can make sense of the mounds of nutrition information out there. A little learning and planning can help you find a diet to fit your lifestyle, and maybe you can have some fun in the process!

How can I start planning a healthy diet for me and my family?

You can start planning a healthy diet by looking at the Dietary Guidelines for Americans 2005 (http://www.healthierus.gov/dietaryguidelines) by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS). The best way to give your body the balanced nutrition it needs is by eating a variety of nutrient-packed foods every day. Just be sure to stay within your daily calorie needs.

Mix up your choices within each food group
	Focus on fruits. Eat a variety of fruits – whether fresh, frozen, canned or dried – rather than fruit juice for most of your fruit choices. For a 2,000 calorie diet, you will need 2 cups of fruit each day (for example, 1 small banana, 1 large orange, and 1/4 cup of dried apricots or peaches).
	Vary your veggies. Eat more dark green veggies, such as broccoli, kale, and other dark leafy greens; orange veggies, such as carrots, sweetpotatoes, pumpkin, and winter squash; and beans and peas, such as pinto beans, kidney beans, black beans, garbanzo beans, split peas and lentils.
	Get your calcium-rich foods. Get 3 cups of low-fat or fat-free milk – or an equivalent amount of low-fat yogurt and/or low-fat cheese (1 1/2 ounces of cheese equals one cup of milk) – every day. For kids aged 2 to 8, it's 2 cups of milk. If you don't or can't consume milk, choose lactose-free milk products and/or calcium-fortified foods and beverages.
	Make half your grains whole. Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice, or pasta every day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of cooked rice or pasta. Look to see that grains such as wheat, rice, oats, or corn are referred to as 'whole' in the list of ingredients.
	Go lean with protein. Choose lean meats and poultry. Bake it, broil it, or grill it. And vary your protein choices – with more fish, beans, peas, nuts and seeds.
Know the limits on fats, salt and sugars. Read the Nutrition Facts label on foods. Look for foods low in saturated fats and trans fats. Chose and prepare foods and beverages with a little salt (sodium) and/or sugars (caloric sweeteners).

What are the most important steps to a healthy diet?

The basic steps to good nutrition come from a diet that:

• helps you either lose weight or keeps your BMI in the "healthy" range.

• is balanced overall, with foods from all food groups, with lots of delicious fruits, vegetables, whole-grains, and fat-free or low-fat milk and milk products.

• is low in saturated fat, trans fat, and cholesterol. Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.

• includes a variety of grains daily, especially whole-grains, a good source of fiber.

• includes a variety of fruits and vegetables (two cups of fruit and 2 1/2 cups of vegetables per day are recommended for a 2,000 calorie diet).

• has a small number of calories from added sugars (like in candy, cookies, and cakes).

• has foods prepared with less sodium or salt (aim for no more than 2,300 milligrams of sodium per day, or about one teaspoon of salt per day).

• does not include more than one drink per day (two drinks per day for men) if you drink alcoholic beverages.

I know a healthy diet means I should control my fat intake, but I'm confused by all the different kinds of fats in foods! How do I know which ones are ok and which ones to avoid?

There are different kinds of fats in our foods. Some can hurt our health, while others aren't so bad – some are even good for you! Here's what you need to know:

• Monounsaturated fats (canola, olive and peanut oils, and avocados) and polyunsaturated fats (safflower, sesame, sunflower seeds, and many other nuts and seeds) don't raise your LDL ("bad") cholesterol levels but can raise your HDL ("good") cholesterol levels. To keep healthy, it is best to choose foods with these fats.

• Saturated fat, trans fatty acids, and dietary cholesterol raise your LDL ("bad") blood cholesterol levels, which can lead to heart disease. Saturated fat is found mostly in food from animals, like beef, veal, lamb, pork, lard, poultry fat, butter, cream, whole milk dairy products, cheeses, and from some plants, such as tropical oils. Tropical oils include coconut, palm kernel, and palm oils that are found in commercial cakes, cookies, and salty snack foods. Unlike other plant oils, these oils have a lot of saturated fatty acids. Some processed foods (such as frozen dinners and canned foods) can be quite high in saturated fat — it' s best to check package labels before purchasing these types of foods.

• Trans fatty acids (TFAs) are formed during the process of making cooking oils, margarine, and shortening and are in commercially fried foods, baked goods, cookies, and crackers. Some are naturally found in small amounts in some animal products, such as beef, pork, lamb, and the butterfat in butter and milk. In studies, TFAs tend to raise our total blood cholesterol. TFAs also tend to raise LDL ("bad") cholesterol and lower HDL ("good") cholesterol. One study found that the four main sources of trans fatty acids in women's diets come from margarine, meat (beef, pork, or lamb), cookies, and white bread. At this time, TFAs are not listed on nutrition labels, but that will soon change. Although it might take a couple of years to begin seeing it, the Food and Drug Administration (FDA) is now asking food manufacturers to begin labeling TFA content. And some food manufacturers are announcing they are taking TFAs out of their food.

I'm concerned about heart disease. Is there a special diet to help prevent or control it?

Heart disease is the #1 killer of both women and men. Eating a heart-healthy diet is key to help reduce your risk factors for heart disease, like high blood pressure, high blood cholesterol, overweight, and obesity. It also will help you control these conditions if you already have them.

Here are some general guidelines for heart-healthy eating:

• Choose foods low in saturated and trans fats. Foods low in saturated fat include fruits, vegetables, whole grain foods, and low-fat or nonfat dairy products. Try to avoid commercially fried and baked goods such as crackers and cookies.

• Choose a diet moderate in total fat. Keep total fat intake between 20 to 35 percent of calories. You don't have to eliminate all fat from your diet! This will give you enough calories to satisfy your hunger, which can help you to eat fewer calories, stay at a healthy weight, and lower your blood cholesterol level. To keep your total fat intake moderate, try to substitute unsaturated fat for saturated fat.

• Choose foods low in cholesterol. Try to eat fruit, vegetables, whole grains, low-fat or nonfat dairy products, and moderate amounts of lean meats, skinless poultry, and fish. Eat plenty of soluble fiber, which may help lower your LDL ("bad") blood cholesterol. Good sources are oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, and strawberries. Insoluble fiber will not help your blood cholesterol level but is still good for healthy bowel function. Good sources of insoluble fiber are whole wheat breads, kidney beans, almonds, beets, carrots, brussel sprouts, broccoli, cauliflower, green beans, and apple skin.

• The American Heart Association also recommends that you try to eat at least two servings of fish per week (especially fatty fish like salmon and lake trout) because they are high in omega-3 fatty acids, which may help lower blood cholesterol. Some types of fish, such as swordfish, shark, or king mackerel, may contain high levels of mercury and other environmental contaminants that can damage the brain and nervous system, especially in developing fetuses. Children, pregnant, and breastfeeding women should limit how much fish they eat to no more than 12 ounces per week.

• You also can eat omega-3 fatty acids from plant sources, such as from tofu, soybeans, canola, walnuts, and flaxseed (these contain alpha-linolenic acid, a less potent form of omega-3 fatty acid).

• Cut down on sodium. If you have high blood pressure as well as high blood cholesterol — and many people do — your health care provider may tell you to cut down on sodium or salt. Even if you don't have high blood pressure or cholesterol, try to have no more than 2,300 milligrams of sodium each day. The DASH Diet also recommends a lower level of 1,500 mg of sodium a day. You can choose low-sodium foods, which will also help lower your cholesterol, such as fruits, vegetables, whole grains, low-fat or nonfat dairy products, and moderate amounts of lean meat. To flavor your food, reach for herbs and spices rather than high-sodium table salt. Be sure to read the labels of seasoning mixes because some contain salt.

• Watch your body weight. It is not uncommon for overweight people to have higher blood cholesterol than people who are not overweight. When you reduce the fat in your diet, you cut down not only on cholesterol and saturated fat but on calories as well. This will help you to lose weight and improve your blood cholesterol, both of which will reduce your risk for heart disease.

If you are healthy, but would like to keep your cholesterol low, you can follow this diet:
Heart Healthy Diet
http://nhlbisupport.com/cgi-bin/chd1/step1intro.cgi

If you currently have high cholesterol, here is a diet you can follow to help lower your LDL cholesterol:
Therapeutic Lifestyles Changes (TLC) Diet
http://nhlbisupport.com/chd1/tlc_lifestyles.htm

If you need to lower high blood pressure, you can follow:
The Dietary Approaches to Stop Hypertension (DASH) Diet
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/

Many diets say to limit my sodium to an amount measured in milligrams per day, but exactly how much salt is that?

Salt is also labeled as sodium chloride. Soda, sodium bicarbonate, and the symbol "Na" on food labels mean the product contains sodium. Here are some general guidelines:

1/4 teaspoon salt = 600 milligrams (mg) sodium
1/2 teaspoon salt = 1,200 mg sodium
3/4 teaspoon salt = 1,800 mg sodium
1 teaspoon salt = 2,300 mg sodium
1 teaspoon baking soda = 1,000 mg sodium

It's hard to know if my portions are too big or too small for a healthy diet. Do I have to measure everything I'm eating?

It can be hard to learn if your portions of food are putting you over amounts of things you're trying to control. It doesn't help that sizes for everything from bananas to soft drinks have gotten larger in the past 20 years. It's not enough to eat the right kinds of food to maintain a healthy weight or to lose weight. Eating the right amount of food at each meal is just as important. If you are a healthy eater, it is possible to sabotage your efforts by eating more than the recommended amount of food. A serving is a specific amount of food, and it might be smaller than you realize. Here are some examples:

• A serving of meat (boneless, cooked weight) is two to three ounces, or roughly the size of the palm of your hand, a deck of cards, or an audiocassette tape.
• A serving of chopped vegetables or fruit is 1/2 cup, or approximately half a baseball or a rounded handful.
• A serving of fresh fruit is one medium piece, or the size of a baseball.
• A serving of cooked pasta, rice, or cereal is 1/2 cup, or half a baseball or a rounded handful.
• A serving of cooked beans is 1/2 cup, or half a baseball or a rounded handful.
• A serving of nuts is 1/3 cup, or a level handful for an average adult.
• A serving of peanut butter is two tablespoons, about the size of a golf ball.

I'm confused by all of the labels I see on foods, like "fat free" and "low calorie." What do these terms mean?

Terms like these are on many food packages. Here are some definitions based on one serving of a food. If you eat more than one serving, you will go over these levels of calories, fat, cholesterol, and sodium.

Calorie-free: fewer than 5 calories
Low calorie: 40 calories or fewer
Reduced calorie: at least 25% fewer calories than the regular food item has
Fat free: less than ½ gram of fat
Low fat: 3 grams of fat or fewer
Reduced fat: at least 25% less fat than the regular food item has
Cholesterol free: fewer than 2 milligrams cholesterol and no more than 2 grams of saturated fat
Low cholesterol: 20 milligrams or fewer cholesterol and 2 grams or less saturated fat
Sodium free: fewer than 5 milligrams sodium
Very low sodium: fewer than 35 milligrams sodium
Low sodium: fewer than 140 milligrams sodium
High fiber: 5 grams or more fiber

How can I follow a healthy diet if I eat out a lot?

The American Heart Association gives these tips for a healthy diet, even when you aren't cooking at home:

• Ask the server to make substitutions, like having steamed vegetables instead of fries.
• Pick lean meat, fish, or skinless chicken.
• Make sure your entrée is broiled, baked, grilled, steamed, or poached instead of fried.
• Ask for baked, boiled, or roasted potatoes instead of fried.
• Order lots of vegetable side dishes and ask that any sauces or butter be left off.
• Ask for low-calorie salad dressing or a lemon to squeeze on your salad instead of dressing.
• Order fresh fruit or fruit sorbet in place of cake, pie, or ice cream desserts.

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