1. Shifting Eating Habits For Better Health

Ready to Shift?

You don’t have to overhaul your eating habits overnight or give up all of the foods you love to attain good health. Instead, think about making small shifts in your diet or eating pattern to incorporate heathier options. If you make small, positive changes in the way you’re currently eating—over the course of a week, a day, or even a meal—it marks important progress in working toward a healthy eating pattern that makes sense for you. This is an overarching message of the 2015–2020 Dietary Guidelines for Americans (see Box 1-1, “Make Small Shifts to Improve Habits”). For example, shift from potato chips to air-popped popcorn for a snack, or replace some of the meat in your chili with more beans. Throughout this report, watch for “Smart Shift” boxes, which will help you get started on this strategy.

Ultimately, it’s your eating pattern, or the foods and drinks you habitually eat over time, in addition to healthy lifestyle habits, such as regular physical activity, stress management, and adequate sleep, that impact your health and risk of chronic disease. A healthy eating pattern includes a variety of whole and minimally processed, nutritious foods such as vegetables, fruits, whole grains, legumes (beans, peas, and lentils), low-fat dairy, lean meats, poultry, fish, nuts, and seeds. Unfortunately, the eating pattern followed by about three-fourths of the U.S. population is low in vegetables, fruits, and dairy products (see Box 1-2, “Eating Habits Compared With Recommendations,” on page 7).

Although the majority of the population meets or exceeds recommendations for intake of grain and protein foods as a whole, we fall short on high-quality grain and protein foods. For example, we need to opt for whole grains and lean proteins, such as whole-wheat bread, seafood, and legumes, but instead we tend to eat too many processed foods within these categories, such as luncheon meat and bread and pastas made with refined white flour, which are not as nutritious.

Take Charge of Your Health

About half of all U.S. adults—that’s about 117 million people—have one or more preventable, chronic disease. Factors that you can control, including poor eating patterns, excess calorie intake, and physical inactivity, contribute to your risk of developing these diseases. By shifting to healthier eating patterns and adopting positive lifestyle practices such as regular exercise, you can turn this concerning statistic on its head. In fact, healthy eating is one of the most powerful tools you have to reduce your risk of developing chronic diseases. Improving your diet and lifestyle can potentially help you by:

• Reducing your risk of cardiovascular disease, type 2 diabetes, and some cancers
• Controlling your blood pressure and blood sugar
• Lowering your total and harmful LDL cholesterol, as well as triglycerides
• Improving your immune system’s capabilities
• Maintaining your bone density, mobility, and independence
• Reducing your need for some medications
• Maintaining normal bowel function
• Managing your weight
• Getting more restful sleep
• Improving your mood
• Reducing age-related loss of memory and eyesight
• Providing an overall better quality of life.

Healthy Eating Patterns

There is no single, perfect diet; fortunately, a healthy eating pattern can accommodate a range of food preferences, cultures, traditions, and budgets. Though there are some distinctions among healthy eating patterns, in the following pages you’ll find that they have many similarities.

Tufts’ MyPlate for Older Adults

Although most nutritional guidance is “ageless,” you do need to make some adjustments in your eating pattern to fit the changing needs of your body as you get older. Calorie requirements tend to decline with aging, but other nutritional needs do not. In fact, in some cases, nutritional needs increase with age. To address the special concerns of older Americans, nutrition scientists at Tufts’ Human Nutrition Research Center on Aging (HNRCA) created “MyPlate for Older Adults” (see Box 1-3, “Tufts’ MyPlate for Older Adults”), which was updated in 2016 with support from the AARP Foundation. An accompanying website is available at hnrca.tufts.edu/myplate. Although specific foods are shown on the graphic, they represent general categories of foods, and your choices shouldn’t be limited to the foods pictured. Here is an explanation of the key features of the graphic:

• Colorful fruits and vegetables, including fresh, frozen, and canned options, make up half of the MyPlate for Older Adults. Each of these foods provides a host of nutrients, and the frozen and canned varieties may be less expensive, simpler to prepare, and easier to keep on hand. Choose plain, packaged produce that is low in sodium and packed in its own juice rather than salty sauces and sugary syrups whenever possible. Alternately, you can rinse canned produce to help reduce sodium and remove syrup.
• Grains should make up one-fourth of your plate, especially whole grains, such as whole-wheat bread, oatmeal, brown rice, and whole-grain pasta. Like fruits and vegetables, grains provide fiber and many other health-promoting nutrients. Breakfast cereal and other fortified grains also provide important B vitamins, such as vitamin B12.
• Protein-rich foods also make up one-fourth of the plate and include foods such as lean meat, chicken, fish, eggs, tofu, beans, nuts, and nut butters. Dairy foods, which are also protein-rich, include items such as low-fat yogurt and cottage cheese.
• Healthy, plant-based oils, such as extra-virgin olive oil, and soft spreads free of trans fats are shown in a small section of the center of the plate, which indicates that they can be used in limited amounts (remember, fats and oils are high in calories) to help flavor and cook foods. Incorporating small amounts of plant-based oils supplies essential fats and supports your body’s absorption of fat-soluble vitamins.
• Fluids, including plenty of water, in addition to tea, coffee, milk, and small portions of 100-percent fruit juice are shown to remind you to stay hydrated. It’s important to pay attention to your fluid intake, just as you do your food intake. You also get fluids from foods with a high water content, especially fruits, vegetables, and soups.
• A reminder to stay physically active is included below the MyPlate graphic. Stay active by doing whatever you enjoy most, such as walking, swimming, or riding a bicycle. Regular physical activity is as essential to good health as smart food choices. Exercise helps reduce risk of chronic disease, aids in weight control, and helps you maintain strength and independence as you age.

DASH and Mediterranean-Style Diets

The DASH diet and Mediterranean-style diets are additional healthy eating patterns that provide special guidance for those at risk for cardiovascular disease. Although these are distinctly different diets, they share some common recommendations, such as emphasizing whole and minimally processed foods, especially fruits and vegetables, and limiting red meat. Both of these diets are discussed in detail in Chapter 2.

Plant-Powered Eating

Nutrition experts have been advising us for many years to eat our fruits and vegetables, and a plant-based eating pattern takes this recommendation to the next level. A healthful, plant-based diet encourages us to eat nutrient-rich, whole plant foods while minimizing processed foods, refined sugars and grains, and animal foods, especially processed and fatty meats. If eating a diet composed solely of plant foods is not for you, you can still include some animal foods in your eating plan while making the majority of what you eat whole vegetables (raw or cooked), fruits, beans, peas, lentils, and whole grains, as well as seeds and nuts (in smaller amounts).

A dietary approach that emphasizes more plant foods and fewer animal foods may help reduce risks of many common diseases, such as obesity, high blood pressure, heart disease, cancer, and diabetes, as well as increase longevity. If you’re hesitant to give up most animal foods due to concerns about nutrient deficiencies, be assured that it is possible to achieve a balanced, nutrient-rich diet while eating only plant-based foods (see Chapter 2, page 15, for more on vegetarian and vegan diets).

One easy step toward a more plant-based eating pattern is to participate in “Meatless Mondays,” an international campaign that encourages you to eat no meat one day a week. Reducing the amount of meat you eat may contribute to better personal health as well as the health of the planet by helping to conserve the earth’s water and energy resources used by the meat industry. Limiting meat also may help trim your grocery bill (for more money-saving tips, see Box 1-4, “Eat Right, Save Money,” on page 9).

Pay Attention to Portion Sizes

So far, our emphasis has been on healthy eating patterns. However, the amount of food you eat is just as important as what you eat. Too often, people ignore the portion sizes of their food, especially if they feel that the food is a healthy choice. Eating portions that are too large packs on the pounds because—healthy or not—all foods have calories, and consuming excess calories causes weight gain.

Calorie requirements depend on body composition (lean body mass burns more calories than fat), physical activity, lifestyle, age, gender, and genetic factors. Determining proper portion sizes for you depends on your calorie needs and your weight goal. For further guidance, see Box 1-5, “USDA-Recommended Food Patterns,” on page 10.

Since everyone’s calorie needs are different, the seven-day menus in Chapter 12 are just a guide. The foods and eating plans in that chapter are healthful and based on the Tufts’ MyPlate for Older Adults, as well as principles of the Mediterranean-style and DASH diets.

Strategies for Eating Out

You have the most control over what you eat when you cook whole and minimally processed foods at home. However, the reality is that Americans spend more money eating out at restaurants than they spend on food at the supermarket. Additionally, Americans consume about one-third of their calories from restaurants and takeout meals. A new law requiring calorie information to be posted on menus or menu boards at restaurants is scheduled to go into effect May 2017. However, non-chain restaurants and small chains with less than 20 locations won’t be required to provide calorie information—so it may be even easier to overdo it at such eating places (see Box 1-6, “Calorie Overload at Large and Small Restaurants”).

The large portions and flavorful dishes typically served at restaurants can hijack self-control and lead to overindulging, despite your best intentions. Although you might think you’ll compensate by eating less at other times, several studies suggest this generally doesn’t occur. Before you go out to eat, put some thought into how you can enjoy your meal while making optimal food choices for your health. Here are some strategies that may help:

• Limit meats and make lean protein choices. Protein foods should take up only one-fourth of the space on your plate, but they often dominate restaurant meals. A protein portion, such as a chicken breast half, sirloin steak, or salmon fillet, should be about the size (length, width, and thickness) of a deck of cards. Order a smaller option when it’s available, or plan to take the excess amount home to eat later. If you don’t like to prepare fish at home, enjoy it (baked or grilled) when you eat out.
• Make self-control easy. If the bread basket is too tempting, keep it out of arm’s reach, or, if your fellow diners are willing, ask the waiter not to bring bread to your table. If you’re offered free appetizers, politely decline them. Additionally, don’t wait until you’ve consumed half of your meal to box up the rest. Instead, box up half as soon as your waiter brings it so you’re not tempted to keep eating.
• Seek out vegetables. If an entrée comes with French fries, ask to swap them out for steamed broccoli, a garden salad, or any other healthy vegetable option you see on the menu.
• Keep it simple. Complex mixed dishes, such as “fiesta lime chicken topped with ranch dressing and melty cheese” or “cheese-stuffed ravioli,” are bound to be loaded with calories. Opt for simpler items, such as grilled chicken breast with asparagus.
• Consider preparation method. Higher-calorie options often are signaled by words such as breaded, battered, smothered, stuffed, and crispy. Lighter preparation methods are suggested by words such as blackened, broiled, grilled, baked, and steamed.
• Request condiments on the side so you can limit how much you use. For example, barbecue sauce and tartar sauce each have about 125 calories per one-fourth cup. One-fourth cup of ranch dressing has 260 calories, and one-fourth cup of reduced-fat French dressing has 145 calories. If you ate 100 extra calories every day for a year, you’d gain about 10 pounds.
• Keep leftovers safe. If you have to drive a good distance to a restaurant or won’t be going home right away after you eat, stow a small cooler in your car so you can protect restaurant leftovers from harmful bacteria that can cause food poisoning.
• Limit alcohol and avoid sodas. By drinking water with your meal, you’ll save calories and cash.

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