Diet and Health: The Big Picture

After teaching an undergraduate public health nutrition course (i.e., not a course for aspiring dietitians) for a couple of years, I realize that there are a few points that are most important. The first is that healthy is a very squishy word and must be defined when used. In fact, at this very minute the FDA is taking public comments as they consider whether food companies can continue to use the word on their products and what exactly it would mean if they did (same for the word natural). I define healthy in the spirit of the Dietary Guidelines for Americans. Therefore, a healthy food would be high in nutrients that we need and do not get too much of (e.g., we need sodium/salt but we easily get plenty, so a food high is sodium is not considered healthy), and low in calories and things we need less of (e.g., solid fats and added sugars). So healthy foods are usually whole foods (i.e., produce, whole grains), lean proteins (e.g., some fish, legumes), certain oils (e.g., olive oil, omega 3, flaxseed) and some low fat dairy products. Unhealthy foods would be ones likely found in a box or bottle (e.g., sugar sweetened beverages) with high calories, high sodium (e.g., 10% or more of the daily value on a food label), and added sugar. Unhealthy would also include whole foods that were prepared in a way that adds excess calories, sugar or sodium, and cooking with healthy oils instead of adding a small portion (less than a tablespoon) of raw oil after preparing the food.

The remaining points are these:

• Just because something is good for you (aka healthy) does not mean it is free of calories and that you can eat as much of it as you like.

• Just because something is bad for you (aka unhealthy) doesn't mean you should NEVER eat it (with a few exceptions, e.g., raw fish or unpasteurized milk).

• Calories matter no matter what you tell yourself and its important to have a general idea of how many you need and how many are in the foods and beverages (including alcohol) that you consume. On that note, the national calorie disclosure law for restaurant chains and vending companies has NOT BEEN REPEALED and is due to take effect in May.

Calorie Awareness While Traveling

I recently spent a week at a Residence Inn in Alabama. I attended a research methods workshop for obesity prevention and treatment. On several occasions, I was aware of the 'conspicuous' absence of calorie disclosures. The biggest one... the hotel 'free breakfast.' Except for the cartons of yogurt and milk, nothing was labeled. Considering that a slice of bread can have as little as 40 calories (if you search hard) and as many as 100+, that's a big deal. I imagine the range for the available muffins, bagels and waffles make them equally hard to 'estimate.' Sure a day or two of incidental over consumption should't have lasting effects on your health, but if you travel  - and eat away from home - often, the information will come in handy. 
When I travel, attend workshops, meetings and just go to work, I try to keep within the bounds of what is healthy for me. That is another observation I had while at the workshop. It is not enough for the planners to serve 'healthy' food, because healthy, especially these days, is a relevant term and a moving target. Healthy for me mostly meets with the updated recommendations from the Dietary Guidelines Advisory Committee: 

The overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat;i and low in sugar-sweetened foods and drinks and refined grains. Vegetables and fruit are the only characteristics of the diet that were consistently identified in every conclusion statement across the health outcomes.

*The fruits and vegetables are highlighted as being prepared with spices and without adding salt and saturated fat. See the full report here.

So for me, healthy is not about organic or 'all natural,' and healthy doesn't mean no artificial sweeteners, but that is exactly how some others might define healthy for themselves. My healthy diet includes mostly whole foods, minimally processed; no meats, lots of vegetables, soy based lean protein, fish, almond milk and no or low fat dairy (yogurt, cheese, ice cream), fruit, coffee, plenty of whole grains, like popcorn!, fiber and yup, alcohol and diet soda. So to eat the way I like, I usually bring my own food, and in Alabama, though I ate out a few nights, I went to the grocery store and prepared my lunch and dinner in the nice hotel room kitchen.  (The reason the workshop lunches weren't 'healthy' to me is because they were often sandwiches, pasta, or meat based. I did enjoy the fruit and diet soda though!)
Interestingly, my friends and I were out walking one evening and one or two got very excited when we passed the Insomnia Cookies store. (remember this was an obesity prevention workshop, and cookies can be part of a calorie controlled diet). So, my friend was more than a little excited as she went into the store - there was quite a line at the counter - but she came right back out, with a brochure (for me) and disgust. WHY? THEY POSTED THE CALORIE CONTENT!  HAHAHAHA, she said that seeing the calories took all the fun out of it. Hilarious. (BTW, we have one of these Insomnia Cookie food trucks at Temple University, and the shop in Alabama was within a mile of the UAB campus. Sense a theme?)

Notice the ranges, also on the right is ice cream