Top 10 Everyday Super Foods that Fight Disease

10 Everyday Super Foods

These easy-to-eat foods are packed with multiple nutrients to help you stay healthy.
By Kathleen M. Zelman, MPH

If only there were some kind of potion or pill that had everything you needed for weight loss and good health. Unfortunately, no such pill exists, but there is a solution -- something that not only promotes wellness and weight control but tastes good, too. These multitasking "super foods" provide multiple disease-fighting nutrients, fill you up so you can enjoy plenty of food without excess calories, and are easy to include in everyday meals. After all, what good is a super food that is hard to find, difficult to prepare, and the kids won't eat?

Eaten regularly, these foods will help you satisfy the recommendations of the U.S. government's 2005 Dietary Guideline, giving you nutrients that are typically missing from American diets. According to the Guidelines, Americans need to eat more fruits, vegetables, whole grains, and low-fat dairy products.

Of course, experts are quick to point out, this list of top 10 super foods by no means includes all the nutritious foods that should be part of a healthy diet.

"What is ultimately the most important to good health is a dietary pattern that includes all these foods, along with a wide variety of other nutritious foods and regular physical activity," says Tufts University researcher Alice Lichtenstein, DSc.

And don't forget that portion size matters, even when it comes to healthy foods. You can take more liberties when eating simply prepared vegetables, but you should take care to eat other super foods in sensible portions.

"Foods like nuts are nutrient rich, but if you overeat them you can pack on the pounds, and that defeats the purpose," says Elisa Zied, MS, RD, author of Feed Your Family Right!

Top 10 Multitasking Super Foods

Low fat or fat-free plain yogurt is higher in calcium than some other dairy products and contains a great package of other nutrients, including protein and potassium. It can also be enhanced with other good-for-you substances. "Yogurt is a vehicle food that can be enriched with probiotics for a healthy balance of bacteria in your gut, and beneficial, heart-healthy plant stanols," says Zied. "And lactose sensitive people may tolerate yogurt better than milk." Look for plain yogurt fortified with vitamin D, and add your own fruit to control sweetness and calories. Versatile yogurt can also be used in entree and bakery recipes, in dips for veggies, etc. Don't like yogurt? Skim milk is another super dairy food that has only 83 calories per cup and is easy to slip into coffee to help you get one of the recommended three servings of dairy each day. "Dairy foods contain practically every nutrient you need for total nutrition -- and in just the right balance," says bone health expert, Robert Heaney, MD. "No other food group in the diet is as complete or as economical."

Eggs make the list because they are nutritious, versatile, economical, and a great way to fill up on quality protein. "Studies show if you eat eggs at breakfast, you may eat fewer calories during the day and lose weight without significantly affecting cholesterol levels," says Elizabeth Ward, MS, RD, author of The Pocket Idiot's Guide to the New Food Pyramids. Eggs also contain 12 vitamins and minerals, including choline, which is good for brain development and memory. Enjoy them at any meal or hard-cooked as a portable snack.

Nuts have gotten a bad rap because of their high fat content. But their protein, heart-healthy fats, high fiber, and antioxidant content earn them a place on the top 10 list. The key to enjoying nuts, experts say, is portion control. "All nuts are healthful in small doses, and studies show they can help lower cholesterol levels and promote weight loss," says Today Show nutritionist Joy Bauer, MS, RD. "I like pistachio nuts because they also contain plant sterols and it takes longer to crack the shell and eat them, making it easier to control the portion. Whether you prefer pistachios, almonds, peanuts, walnuts, or pecans, an ounce a day of nuts help fill you up. Nuts add texture and flavor to salads, side dishes, baked goods, cereals, and entrees. They taste great alone, too. Zied recommends putting together your own "100-calorie packs" of nuts for easy and portable snacks.

Kiwis are among the most nutritionally dense fruits, full of antioxidants, says Ward. "One large kiwi supplies your daily requirement for vitamin C," says Ward. "It is also a good source of potassium, fiber, and a decent source of vitamin A and vitamin E, which is one of the missing nutrients, and kiwi is one of the only fruits that provides it." The sweet taste and colorful appearance of kiwis makes it easy to slice in half, scoop out with a spoon and enjoy alone, or slice it into desserts, salads, or side dishes. Kiwifruit can also have a mild laxative effect due to their high fiber content.

Quinoa is now readily available in many supermarkets and is one of the best whole grains you can eat, according to Zied. "It is an ancient grain, easy to make, interesting, high in protein (8 grams in 1 cup cooked), fiber (5 grams per cup) and a naturally good source of iron," she says. Quinoa (pronounced keen-wa) also has plenty of zinc, vitamin E, and selenium to help control your weight and lower your risk for heart disease and diabetes, she says. Quinoa is as easy to prepare as rice and can be eaten alone or mixed with vegetables, nuts, or lean protein for a whole-grain medley. Try to make at least half your daily grain servings whole grains. In addition to quinoa, try barley, oats, buckwheat, whole wheat, wild rice, and millet.

Beans, beans, good for your heart -- really! Beans are loaded with insoluble fiber, which helps lower cholesterol, as well as soluble fiber, which fills you up and helps rid your body of waste. They're also a good, low-fat source of protein, carbohydrates, magnesium, and potassium. Bauer favors edamame (whole soybeans) because they also contain heart-healthy omega-3 fatty acids. Beans can easily substitute for meat or poultry as the centerpiece of a meal, says Bauer, but they also work as a side dish, or tossed into soups, stews, or egg dishes. The U.S. Dietary Guidelines recommend 3 cups weekly.

Salmon is a super food because of its omega-3 fatty acid content. Studies show that omega-3 fatty acids help protect heart health. That's why the American Heart Association recommends eating fatty fish like salmon twice weekly. Salmon is low in calories (200 for 3 ounces) has lots of protein, is a good source of iron, and is very low in saturated fat. You can simply grill or bake it, top it with salsas or other low-fat sauces, or serve it on top of salad greens. If you don't like salmon, Lichtenstein recommends eating other kinds of fish, like canned tuna. And what about the mercury content? (Mercury is known to accumulate in fish.) "The benefits of eating salmon or other fatty fish twice weekly far outweigh any risks, but if you are concerned, check with your doctor," says Zied.

Broccoli is one of America's favorite vegetables because it tastes good and is available all year long. It's a rich source of vitamin A, vitamin C, and bone-building vitamin K, and has plenty of fiber to fill you up and help control your weight. "Some people think beta-carotene (vitamin A) is only found in orange and yellow vegetables, but broccoli is an excellent source," says Ward. You can eat broccoli raw, lightly steamed, stir-fried, roasted, or grilled. Eat it as a side dish, or toss into grains, egg dishes, soups, and salads.

Sweet potatoes are a delicious member of the dark orange vegetable family, which lead the pack in vitamin A content. Substitute a baked sweet potato (also loaded with vitamin C, calcium, and potassium) for a baked white potato. And before you add butter or sugar, taste the sweetness that develops when a sweet potato is cooked -- and think of all the calories you can save over that loaded baked potato. "If we eat more foods like sweet potatoes that are rich sources of potassium, and fewer high-sodium foods, we can blunt the effect of sodium on blood pressure and reduce bone loss," says Zied. Other dark orange vegetable standouts include pumpkin, carrots, butternut squash, and orange bell peppers.

Berries pack an incredible amount of nutritional goodness into a small package. They're loaded with antioxidants, phytonutrients, low in calories, and high in water and fiber to help control blood sugar and keep you full longer. And their flavors satisfy sweets cravings for a fraction of the calories in baked goods. Blueberries lead the pack because they are among the best source of antioxidants and are widely available. Cranberries are also widely available fresh, frozen, or dried. All can add flavor and nutrition to numerous dishes, from salads and cereals to baked goods and yogurt.

SOURCES: Robert P. Heaney, MD, John A. Creighton University Professor, Creighton University. Joy Bauer, MS, RD, author, Joy Bauer's Food Cures; nutritionist, the Today Show. Elizabeth Ward, MS, RD, author, The Pocket Idiot's Guide to the New Food Pyramid. Elisa Zied, MS, RD, spokeswoman, American Dietetic Association; author, Feed Your Family Right! U.S. Department of Agriculture's 2005 U.S. Dietary Guidelines. Alice Lichtenstein, DSc, Stanley N. Gershoff Professor of Nutrition Science and Policy, Friedman School of Nutrition Science, Tufts University. Asia Pacific Journal of Clinical Nutrition, June 2002; vol 11, issue 2: pp164-168.

Reviewed on December 04, 2008

Four Tricks to Cut the Salt

Low-Sodium Recipe and Cooking Tips

According to the U.S. government, Americans are supposed to eat no more than 2,300 milligrams -- about 1 teaspoon -- of salt a day. People with high blood pressure are told to limit salt even more, to just 1,500 milligrams. That's about a half teaspoon of salt daily.

Considering that salt is an ingredient in just about every type of processed food or restaurant meal, it's no wonder most Americans are getting double -- or triple -- the amount of sodium they need each day. Just 8 ounces of tomato soup can have 1,200 milligrams of sodium. Three ounces of ham can have more than 1,000 milligrams. And 1 ounce of pretzels or 2 tablespoons of salad dressing can pack upwards of 500 milligrams of sodium.

Salt may add flavor to your food, but getting too much of it can also cut years from your life. Studies have linked a high-salt diet to increased risk of high blood pressure, which increases the risk of stroke and heart disease. Research also has shown that reducing the salt in your diet may help lower those risks.

Low-Sodium Meals: How to Cut the Salt in Your Cooking
It is possible to limit the salt in your meals without sacrificing the flavor of your food. Here are three low-sodium cooking tips to help you make healthy, delicious meals that are good for your heart:

Keep it real. Processed foods are often loaded with extra salt. That's because salt acts as a preservative. Cooking your own meals from scratch is the best way to control how much sodium goes into your food. Cookbooks and the Internet are full of easy low-sodium recipes that take all of the guesswork out of cooking. Opt for fresh fruits or vegetables instead of canned. Choose fresh poultry, fish, and meat instead of processed or smoked varieties. For side dishes, make brown rice or whole baked potatoes instead of instant or flavored rice or mashed potatoes. If you have to use canned foods, such as tuna, rinse the contents beforehand to wash away some of the sodium.

Become a label reader. Scour every food label for sodium content. Look for products labeled "sodium-free" (less than 5 milligrams of sodium per serving), "very low sodium" (35 milligrams or less per serving), or "no salt added." Watch out for broths, dressings, soy sauce, bouillon cubes, meat tenderizers, seasoned salts, and condiments (mustard, ketchup, barbecue sauce), which are notoriously high in salt. Watch for additives such as monosodium glutamate (MSG), baking soda, baking powder, and sodium benzoate, which are all sodium compounds.
Don't follow directions. When a recipe calls for even a pinch of salt, replace it with another herb or spice. You can try rosemary, marjoram, thyme, tarragon, onion or garlic powder, curry powder, pepper, nutmeg, cumin, ginger, cilantro, bay leaf, oregano, dry mustard, or dill.

Spicing Up Your Low-Sodium Menu
Salt-free doesn't have to mean taste-free. You can substitute dozens of different seasonings and ingredients to spice up to your low-sodium meals. Here are just a few ideas:

Marinate chicken breasts or pork chops in lemon juice, orange juice, or red wine
Roll fish in sesame seeds before baking
Spice up beef with a mixture of onion, peppers, sage, and thyme
Toss in a few fruits and vegetables, such as dried apricots, raisins, red pepper, or yellow pepper for extra flavor
Simmer carrots in cinnamon and nutmeg
Sprinkle some dill and parsley onto potatoes before roasting
Add a dash of chili powder to corn
Toss your pasta with fresh chopped garlic
Replace salted butter with unsalted butter
When cooking with cheese, opt for fresh mozzarella or cheeses labeled "low-sodium"
Try a commercial salt-free seasoning blend (such as Mrs. Dash), or make your own mix with this recipe from the American Heart Association:
1/2 teaspoon cayenne pepper 1 teaspoon mace, ground

1 teaspoon basil, ground 1 teaspoon onion powder

1 tablespoon garlic powder 1 teaspoon black pepper, ground

1 teaspoon thyme, ground 1 teaspoon sage, ground

1 teaspoon parsley, dry flakes 1 teaspoon marjoram

1 teaspoon savory, ground

SOURCES:

USDA: "Dietary Guidelines for Americans -- 2005."

U.S. Department of Health and Human Services: "Your Guide to Lowering Your Blood Pressure with DASH."

Cook, N. BMJ, published online April 20, 2007.

Oklahoma Department of Human Services: "Tips for Managing Your Congestive Heart Failure."

National Heart, Lung, and Blood Institute: "Your Guide to Lowering High Blood Pressure."

How Do You Start Eating Healthy

Help Your Child Grow Up Healthy and Strong
Healthy Lifestyles: A Family Affair!

Give your children building blocks for a healthy lifestyle by teaching them the importance of good nutrition and regular physical activity. Eating well and being physically active every day are keys to your child's health and well-being. Eating too many high calorie foods and getting too little physical activity can lead to excessive weight gain and physical health problems, such as type 2 diabetes and high blood pressure, now being diagnosed in children. Obesity also is associated with an increased risk of other health problems such as depression.

You play an important role in helping your child, and the entire family, learn about healthy eating and regular physical activity. Parents have the power to set examples. Make healthy eating and daily physical activity fun, to help children learn good habits to last a lifetime. This brochure provides some tips on how you can promote healthy eating habits and encourage active lifestyles in your family.

Healthy Choices Start With You!
Help your children develop healthy eating habits at an early age. Nutritious food is something to enjoy. It helps children grow strong and gives them energy.


Set an example for active living by moving with your kids. Your kids pay attention to you, they really do!


Teach your children that good health depends on the right balance between what they eat and how much they move.
It's never too late! Small steps make a big difference.

Body Mass Index: A Useful Tool

Body Mass Index, or BMI, is used to assess overweight and risk for overweight. Children's body fatness changes over the years as they grow, and boys and girls differ as they mature, so it is important to use a BMI measure specifically designed for children. Many schools have begun routine BMI measurement for students as one tool to help identify those at risk of obesity. If you are concerned about your child's weight, ask your pediatrician or school clinic about the BMI for children. For more information on BMI for children, see www.cdc.gov/nccdphp/dnpa/bmi.

Keys to a Healthy Diet
The keys to healthy eating are variety, balance and moderation. Be sure your family eats a variety of foods, including plenty of vegetables, fruits and whole grain products. Also include low-fat and nonfat dairy products, lean meats, poultry, fish and legumes (lentils and beans). Drink water to quench your thirst, and go easy on the salt, sugar and saturated fat.

Good nutrition should be part of an overall healthy lifestyle that also includes regular physical activity. To maintain weight, both kids and adults must balance the calories they eat with the calories they burn through physical activity. If you eat more calories than you use up in physical activity, you gain weight. If you eat fewer calories than you use up, you lose weight. Make a commitment to helping your family eat sensibly and move more often.

Here are some tips for healthy eating to help you get started.

Try to keep track of your children's meal/snack and physical activity patterns so you can help them balance the amount and types of food they eat with the amount of physical activity they perform.


Encourage your family to eat at least 5 servings of brightly colored vegetables and fruits a day. You can start the day with 100% fruit or vegetable juice. Slice fruit on top of cereal. Serve salad with lunch and an apple as an afternoon snack. Include vegetables with dinner.


Leave the candy, soft drinks, chips and cookies at the store. Substitute them with fruits, vegetables, nuts, and low-fat or nonfat milk products. Your child will soon learn to make smart food choices outside your home as well.


Serve children child-sized portions, and let your child ask for more if still hungry. Don't force children to clean their plates. Try measuring food items to learn to estimate the amount of food on a plate.


Choose a variety of foods. No single food or food group supplies all the nutrients in the amounts that you need for good health. If you plan for pizza one night, balance your meal with salad, low-fat or nonfat milk and fruit.
Eat Smart!
Sharing meals is an ideal way for the family to spend time together. Whether you're eating at home or eating out on the go, it's important to eat smart.

Be consistent. Establish a family meal routine, and set times for breakfast, lunch, dinner and snacks. Eat together whenever possible.


Take charge of the foods your children eat. When you serve a meal, your child can choose to eat it or not; but don't offer to substitute an unhealthy alternative when your child refuses to eat what you've served.


Restrict children's access to the refrigerator and snack cupboards.


Turn off the TV during meals, and limit kids' snacking when watching TV.


Serve a vegetable or fruit with every meal and at snack time.


Reward your kids with praise and fun activities rather than with food.


Involve your children in meal planning and food preparation. They are more likely to eat what they help to make.


While shopping and cooking, teach your children about the food groups and the importance of a balanced diet. Throughout the day, choose the types and amounts of foods you need from the five food groups.


Teach your children how to read food labels and use the 5%-20% guide to Daily Values to make better food choices. See www.fns.usda.gov/tn/Resources/Nibbles/readit_session.pdf for more information.


Limit foods that are high in saturated fat, cholesterol, sodium, and added sugars, and make sure to get enough fiber and calcium.


Use low-fat cooking methods such as baking, roasting and grilling, and choose healthy fats when you use them, such as olive or canola oils.


Serve water, low-fat or nonfat milk with and between meals. Only children under two years always need to drink whole milk.


Teach your children how to make wise food choices away from home, at school cafeterias, restaurants, and vending machines. Teach them to pay attention to both the quality and quantity of their food choices. More food is not always better for them; appropriate portion sizes need to be understood.
Get Moving!
Physical activity is good for children and adults. It strengthens muscles, bones and joints, and it gives children the opportunity to gain confidence while having fun. Children need at least 60 minutes of physical activity every day. Playing hopscotch, tossing a ball back and forth, and dancing are some good ways for your child to be active. Some children are good athletes, but all need many opportunities to be active, including but not limited to sports.

Be a physically active role model and have fun with your kids. Adults need at least 30 minutes of daily physical activity.


Walk with your child at every available opportunity — if possible to school or to the store on errands. Take a family walk after dinner instead of watching TV or playing computer games.


Plan active weekends. Include biking, hiking, skating, walking or playing ball. Take a trip to the park, skating rink, zoo, or swimming pool.


Offer to join your child in his/her favorite physical activity, or enroll your child in a group exercise program.


Include children in active chores such as dog walking, house cleaning, car washing, and yard work.


Limit inactive behavior such as television watching and computer time. Do physical activity with your kids during commercials, such as marching in place or stretching. This helps reinforce the importance of movement in your child's life.


Avoid using TV as a child sitter or pacifier. Offer active alternatives to screen time — jumping rope, playing hide-and-seek or running an errand. Children love when you are active with them and involve them in what you do.


Keep TV's out of children's rooms.


Give your children gifts that encourage physical activity — active games, sporting equipment, or a Frisbee.


Take the President's Challenge as a family. You can track your individual physical activities together and earn awards for active lifestyles at www.presidentschallenge.org.


Talk with your schools about ways to incorporate noncompetitive physical activity during the day.
Money-Saving Ideas for Better Health
Good nutrition doesn't have to mean expensive grocery bills!

Plan ahead. Make a list of meal ideas for the coming week. Keep in mind the days you'll have time to cook from scratch and the days you'll be pressed for time. Then make a grocery list and stick to it.


Buy in-season fruits and vegetables. Use local farmers' markets when possible — the foods are fresher and tend to cost less.


Purchase canned (in water or in their own juice, not heavy syrup) and frozen fruits and vegetables when fresh ones are not available or affordable. They're healthy, too, and will last longer.


Never shop for food when you're hungry.


Review store ads and clip coupons before shopping.


Sign up for your grocer's bonus/discount card for additional savings.


Stock up on sale items you can use in a timely manner. Buy in bulk for quality and value, but serve healthy portions.


Look for items on the top and bottom shelves at the grocery store. The most costly brands are often placed at eye-level. Store brands that may be cheaper and just as good are often placed higher or lower.


Assemble snacks at home in small baggies and use foods such as nuts and seeds, low-fat cheese and fresh veggies and fruits, rather than buying less healthy and more expensive prepackaged and processed snacks.


Use your food budget wisely. For the price of a large bag of chips and a box of cookies, you can buy a lot of apples, bananas, carrots, potatoes, peppers and other healthy foods.
A Healthy Week-at-a-Glance
An easy and fun way to keep your family active and eating right is to create a weekly calendar of healthy lifestyle activities. Use some of the ideas below to get yourself started on building a healthy life that works for your family and your schedule.

Monday
Start a daily log of what your family eats and how they keep active; review it with them at the end of each week.

Tuesday
Go to your local community center and find out what physical activity or sports programs are available.

Wednesday
Make frozen juice pops instead of buying popsicles . They're healthier and cheaper!

Thursday
Encourage your family to use safe and accessible stairs as an active alternative to elevators and escalators.

Friday
Involve your kids in cooking and take a walk after dinner.

Saturday
Take your children food shopping and let them pick out a new fruit or vegetable to try.

Sunday
Review the coming week's school lunch menu with your kids, and talk about making healthy meal choices.

Chocolate Lovers Rejoice!

Chocolate Lovers Rejoice!

Don't feel too guilty if you like to sneak in a few bites of chocolate a day! Current research indicates that certain chemical compounds in chocolate are actually good for you. Not that you should overindulge in your appreciation for chocolate, but, nonetheless, it is still rather comforting to know that this food of the gods may have potent nutritional capabilities. "Recent evidence has shown that chocolate is a rich source of Antioxidant compounds and may confer protective effects on cardiovascular disease," explains Penny Kris-Etherton, Ph.D.,professor of nutrition at The Pennsylvania State University.

Chocolate & Catechins
In a study conducted by researchers at Holland's National Institute of Public Health and Environment, and published in The Lancet, scientists examined the chemical compounds in a range of foods and discovered that catechins, powerful flavonoids found in tea, are also found in chocolate. According to the study, chocolate appears to have more catechins than tea. As research on chocolate continues to be promising, it is important to note that methods used to analyze total dietary intake of flavonoids from any food item still need to be refined, and subtle bioactive differences in the composition of flavonoids, particularly in relation to their potential health benefits, remain undetermined.

Don't Go Chocolate Crazy Yet: Stearic Acid Controversy
The potential down-side to chocolate may lie within its stearic acid content. Stearic acid is a saturated fatty acid found in beef, some dairy foods, and chocolate. According to Frank Hu, M.D. professor, Harvard School of Public Health, "our study found that intake of stearic acid, like other saturated Fat, was associated with increased risk of heart disease. However, this does not necessarily mean that chocolate is bad because chocolate contains not only stearic acids, but also numerous other nutrients such as antioxidants." An editorial ("Harbingers of coronary heart disease: dietary saturated fatty acids and cholesterol, is chocolate benign because of its stearic acid content?") published in the American Journal of Clinical Nutrition conjectures that stearic acid poses a risk to cardiovascular health because it may be responsible for the promotion of thrombosis (blood clotting). Other sources imply that stearic acid confers positive effects upon plasma lipoproteins and cholesterol when it is metabolized into oleic acid. Clearly, more research on stearic acid is needed.

Chocolate Cravings: More Than Meets the Tongue
Along with dietary flavonoids, chocolate also contains several biologically active components (methylxanthines, biogenic amines, and cannabinoid-like fatty acids), all of which potentially cause psychological reactions that parallel those caused by addictive substances. Data from a study, "Chocolate: food or drug," published in the Journal of the American Dietetic Association by researchers at University of Arizona, College of Medicine, Tucson, suggests that chocolate may appeal to people who have addictive behavior by evoking psychopharmacologic and behavioral reactions in those who are susceptible.

Magnesium Deficiency, PMS & Chocolate
Needless to say, the combination of sensory characteristics, nutritional profile, and psychoactive compounds, contributes to a sound explanation of why chocolate is so appealing. Some theories suggest that craving chocolate is associated with fluctuations in hormonal changes that occur just before and during the menstrual cycle, which may be the key to why women tend to be the predominant devotees of chocolate. Chocolate cravings may also indicate certain dietary deficiencies such as magnesium. Chocolate as well as cocoa powder contain high amounts of magnesium (100mg/100g and 520mg/100g, respectively), and some studies have shown magnesium supplements to subdue symptoms of craving for chocolate.

Chocolate cravings may be a way of compensating for low levels of neurotransmitters (Serotonin and dopamine) involved in the regulation of mood and food intake. Studies have shown magnesium deficiency correlates with increased symptoms of premenstrual syndrome (PMS). Dopamine, a Neurotransmitter that relays signals of euphoria, well-being, and satisfaction to the brain, is depleted when magnesium deficiency occurs. This may lend some credence to the notion that magnesium deficiency contributes to the increase in chocolate cravings associated with PMS.

Whatever the scientific explanation, just remember, you aren't alone in your love of chocolate. According to recent statistics, more than one billion people worldwide consume some form of chocolate every day. Americans eat about 12 pounds of chocolate a year.




by Maureen Mulhern-White

Date Published: 2/14/2000
Date Reviewed: 9/25/2008

Busy B's: Good for your Heart?

Busy B's: Good for your Heart?

One of the most interesting new clues to heart disease is homocysteine. It's a substance that we all produce from an amino acid (a building block of protein) in food. The link between this substance and heart disease was discovered in 1969 by Dr. Kilmer McCully, then of Harvard and now at the Department of Veterans' Affairs Medical Center in Providence. Studying people with a rare genetic disorder called homocystinuria, Dr. McCully found that in addition to the high levels of homocysteine, these people also had premature hardening of the arteries. They died early from heart attack or stroke. He thought homocysteine was the cause.

In the normal course of events, the homocysteine that healthy people manufacture is converted into amino acids that do them no harm. This is accomplished by three B vitamins—B-6, B-12, and, probably most important, folacin (also called folate or, when used in a supplement or to fortify foods, folic acid). If the conversion does not take place rapidly enough, due to a genetic defect or vitamin deficiency, elevated levels of homocysteine may, the theory goes, damage arterial walls and promote the buildup of cholesterol, thus potentially leading to arterial blockage and a heart attack.

It took years for researchers to recognize the importance of Dr. McCully's finding. Homocysteine is now on its way to being a household word, like cholesterol. But doctors, as well as the public, are still unsure what they should do about it.

Many studies, no certainties

An impressive number of new homocysteine studies have appeared in the past decade, and some have found that a high level of homocysteine is an independent risk factor for heart disease, along with high blood pressure and high blood cholesterol. In 1992, for example, a large study found that men with homocysteine levels in the top 5% were at three times the risk for heart attack as those with lower levels. A study in 1997 showed that high levels increased the risk of death in those who already had heart disease. One study of 1,500 men and women in 19 European medical centers found that those who ranked in the top 20% for homocysteine levels had double the risk of heart disease, compared to those with low homocysteine—similar to the increased risk from smoking or high cholesterol. But people in the study who took supplements of folic acid, B-6, and B-12 cut their risk substantially. A study in Circulation found a link between heart disease and high homocysteine levels in young women—a group in which heart attacks are rare—particularly when the women were deficient in folacin. This is just a sample of the findings.

The evidence, however, is not consistent. One study conducted at the Harvard Medical School did not find that elevated homocysteine levels increased the risk of arterial narrowing. And other good studies have failed to identify high homocysteine levels as an independent risk factor for heart disease. Some people wonder if high levels might be the result, rather than the cause, of heart disease. It's apparent that low blood levels of folate and vitamin B-12 (and to a lesser extent B-6) are associated with high homocysteine levels and that increasing your intake of these vitamins can lower homocysteine. What's still unknown is whether consuming B vitamins also reduces your risk of heart disease. Evidence is mounting, and studies are now underway, but it will take time to come up with the answer.

Too early to be tested

You may be wondering whether you should have your homocysteine level measured. In fact, unless you have a family history of early heart attacks or have already had a heart attack and your doctor wants to check your level, you don't need to have it measured. The problem is that there's no clear definition of normal or desirable levels. Another problem: it remains to be proven that lowering high homocysteine levels will actually reduce the risk of heart attack and stroke (except in those with homocystinuria).

Thus homocysteine has not "replaced" cholesterol as a health concern. (Don't go back to cream and butter!) The homocysteine theory fills in some blanks in the puzzle. For example, many people with coronary artery disease don't have high blood cholesterol levels, but may have high homocysteine.

No need to wait for certainties

What you can do, without getting any test and without hesitation, is to increase your consumption of B vitamins. If you eat well, and particularly if you consume fortified foods, you can get all these vitamins from your diet. Folacin and B-6 present few problems: they are plentiful in leafy greens, whole grains, some fruits, and fortified breakfast cereals. Cereal grain and white flour (breads, pasta, grits, white rice, and cornmeal) are now fortified with folic acid—chiefly because folic acid is important in preventing certain birth defects. A good target is at least 400 micrograms daily, especially for women of child-bearing age. (No one knows if such levels of folic acid intake are enough to reduce the risk of heart disease, but they can't hurt.)

Vitamin B-12 does present some concerns: it is found chiefly in meat, organ meats, eggs, and other foods that tend to be high in cholesterol and saturated fat (definitely not good for the arteries). But fortified cereals, fish, lean meats, and milk do supply vitamin B-12. The chart at left will guide you.

If you don't eat at least five fruits and vegetables a day, as well as fortified cereals and small servings of lean meat, poultry, or fish, do consider taking a daily multivitamin supplement providing 100% of the RDA of these B vitamins.

The folic acid and B-12 in supplements and fortified foods are much better absorbed by the body than the folacin and B-12 found naturally in food. Thus, recent studies have shown that people who take folic acid supplements decrease their homocysteine levels more than those who get more folate from food.



Keep in mind: Only a comprehensive program can prevent heart disease: not smoking; eating a diet rich in fruits, whole grains, fortified foods, and vegetables, and low in animal fats; and regular exercise such as brisk walking. Regular checkups for blood pressure and blood cholesterol are important, too.

VITAMIN ADULT RDA SOURCES
Folacin 400 micro-
grams (mcg) Leafy greens, broccoli, wheat germ, beans, whole grains, fortified oatmeal. 1 cup cooked spinach has 260 mcg; 1 cup beans, 160 to 350 mcg.



B-6 1.3 milligrams (mg), women;
1.7 mg, men Whole grains, bananas, potatoes, beans, fish, meat, poultry. 1 medium potato (baked, with skin) or banana has 0.7 mg.



B-12 2.4 mcg Meat, poultry, liver, eggs, dairy, fish, fortified cereals and soy products. 3 oz beef has 2 mcg; 1 cup milk, 0.9 mcg.

Be Choosy About Carbs

Be Choosy About Carbs

Go to a dinner party these days and you'll probably meet both carbohydrate boosters and carbohydrate haters. For carbohydrates have once again become a battleground in debates about healthy eating. They're what you're supposed to fill up on when you cut down on fat, says one side of the table. Or they're what's making Americans fat, according to the other side. Yet most people don't really know what "carbs" are. Many of the boosters and haters talk as if all carbs were the same (not true). This refresher course on carbohydrates will help you out.

The basics

The three calorie-providing components of foods are carbohydrates, protein, and fat. Carbohydrates are found in an immense variety of foods. Which of these, for example, are rich sources of carbs: orange juice, table sugar, nonfat milk, pears, strawberries, whole-wheat bread, apple pie, popcorn, biscuits, green peas, muffin, honey, sweet potatoes? If you chose all of these foods, you're right. Carbohydrates (the word means carbon dioxide combined with water) include all the sugars, starches, and fiber we eat. Carbs (except for fiber) are transformed by the body into blood sugar (mostly glucose), the body's basic fuel.

Carbohydrates are the main energy source for the body, and they're the main source of calories in virtually every diet worldwide. They supply 4 calories per gram, the same as protein. Fat has more than twice as many calories (9 per gram)—one reason for its bad reputation. Fiber, however, has no calories, because it isn't absorbed by the body.

Since most carbohydrates are broken down into glucose, why does it matter which carbohydrates you consume? Why is the energy in a teaspoonful of sugar any better or worse than the equivalent amount of carbs in lima beans or whole-wheat bread or, for that matter, in a chocolate bar?

Not so simple, not so complex

Most carbohydrates come from plant-based foods—fruits, vegetables, grains, and legumes (beans, peas, and lentils). Dairy products are the only animal-derived foods with lots of carbs. There are two general types of carbohydrates:

• Simple carbohydrates are sugars—glucose and fructose from fruits and some vegetables, lactose from milk, sucrose from cane or beet sugar, and others. Table sugar is pure sucrose. Much of the simple carbs we eat are sugars added to processed foods such as sodas, cookies, etc. These added sugars are the main reason why sugar now accounts for 16% of all calories consumed by Americans; 20 years ago, it supplied 11%. Soda alone supplies about one-third of this added sugar.

• Complex carbohydrates, which are chains of simple sugars, consist primarily of starches as well as the fiber that occurs in all plant foods. Starch is the storage form of carbohydrates in plants. Foods rich in complex carbs include grains and grain products (such as bread and pasta), beans, potatoes, corn, and some other vegetables.

Are complex carbs preferable to sugars?

Usually, but not always. Many foods high in sugar (especially sucrose and other added sugars) supply "empty calories"—that is, they have few nutrients but lots of calories. By contrast, the calories in foods rich in complex carbs usually bring many nutritional extras with them. It depends on the food. Dairy products and fruit contain sugars, but are important parts of a healthy diet because of the other nutrients they contain.

Some foods rich in complex carbs are better than others. White bread and french fries contain complex carbs, for instance, but you can make better choices. Whole grains (such as oats, whole wheat, brown rice) are more nutritious than refined grains, since they retain the bran and the germ, which are rich in vitamins, minerals, fiber, and beneficial phytochemicals. Whole grains are digested more slowly, and thus have a more modest effect on blood sugar than refined carbs or sugars (see below). The same is true of vegetables and beans. The fiber in these foods has many health benefits. In particular, soluble fiber (found in oats, barley, and beans) may help lower LDL ("bad") cholesterol, triglycerides, and blood pressure. In fact, people whose diet is rich in whole grains and other high-fiber foods tend to have a lower risk of heart disease, diabetes, and some cancers.

Carb bottom line

The USDA's food pyramid is a good, practical place to start when choosing your high-carb foods. It shows 6 to 11 daily servings of grains, 2 to 4 servings of fruit, 3 to 5 servings of vegetables, and 2 to 3 servings of dairy products (along with small amounts of meat, poultry, or fish). The more calories you consume each day, the more servings you should consume in each category. Servings are small: just one slice of bread or a medium piece of fruit; half a cup of cooked rice, pasta, beans, or vegetables; a cup of raw leafy vegetables; or 3/4 cup of juice. A large apple or banana, a cup of broccoli, or a medium-size salad each counts as two servings.

Such a semi-vegetarian diet will derive more than half its calories from carbs. But be choosy about what kinds of carbs you pick—especially with those 6 to 11 grains. You should include as many whole grains as you can (at least 3 servings a day), according to the government's new dietary guidelines. Limit your intake of highly refined, low-fiber grain products such as white bread. It's much better to get simple carbs (sugars) from fruit, milk, and juice than from cake, cookies (even if low-fat), or soda. There's nothing wrong with small amounts of foods and beverages high in added sugar, but many Americans eat too much of them, adding lots of calories, leaving little room for more nutritious foods, and increasing the risk of chronic disease.

The glycemic index

Various high-carbohydrate foods have different effects on blood sugar. This effect is measured by the "glycemic index," which is mentioned in many of today's diet books. The index indicates how fast a food is digested into glucose and absorbed, and thus how much it causes blood glucose to rise. Some studies suggest that a diet rich in foods high on the glycemic index (meaning they have a strong effect on blood sugar) increases the risk of diabetes, at least in those pre-disposed to it, and lowers HDL ("good") cholesterol.

The index doesn't merely reflect whether the carbohydrates in a food are simple or complex. Many factors come into play, including the amount of fiber and fat in the food, how refined the ingredients are, and whether the food was cooked. Table sugar and honey are high on the glycemic index. But so are raisins, corn, potatoes, carrots, watermelon, doughnuts, white bread, instant rice, and most breakfast cereals. Apples, peaches, and ice cream, as well as most beans, grapefruit, and peanuts, are low on the index. Pasta is in the middle.

The glycemic index has little practical use, however. You shouldn't try to build your diet around it, as some well-known diet doctors (including Dr. Atkins) advise. The main problem: it deals with single foods eaten by themselves. Potatoes may be high on the index, but when eaten as part of a meal, they have much less of an effect on blood sugar. There is no reason to avoid foods high on the glycemic index—many are very nutritious. Even people predisposed to diabetes, or with the disease, can eat these foods in moderation.

Sweet Nothings: Carb Myths

Myth: Carbohydrates, especially sugars, are the leading cause of obesity.

Fact: Eating more calories than you burn causes weight gain—it's that simple. It doesn't matter where those calories come from, as far as weight is concerned. Many obese people get into trouble with excessive amounts of fat, not sugar or starch. In fact, many "sweets" (cakes, ice cream, cookies) actually get most of their calories from fat, not sugar. There's no evidence that eating carbs stimulates appetite or leads to more or easier fat storage and weight gain, as some carb-bashers claim.

Myth: Only refined sugar causes cavities.

Fact: Refined sugar remains the leading dietary cause of tooth decay, but sugars such as fructose in fruit and lactose in milk also promote decay, as do some foods high in fermentable carbohydrates, such as bread and rice. The most important factor: how sticky the food is, since the longer the food remains on the teeth, the more damage is done.

Myth: Sugar makes children hyperactive.

Fact: Though for years parents have been blaming a high sugar intake for their children's uncontrollable behavior, studies have found no evidence for this.

Myth: Sugar in fruit is good, sugar in candy is bad.

Fact: The sugar in most fruit is primarily fructose, which has few, if any, advantages over sucrose (the sugar in candy). So it doesn't matter, for instance, if your jam is sweetened with "sugar" or "fruit juice sweetener."

Myth: Honey and brown sugar are more healthful than table sugar (sucrose).

Fact: Neither offers significant nutritional advantages

13 Keys to a Healthy Diet

13 Keys to a Healthy Diet

Developing healthy eating habits isn't as confusing or as restrictive as many people imagine. The first principle of a healthy diet is simply to eat a wide variety of foods. This is important because different foods make different nutritional contributions.

Secondly, fruits, vegetables, grains, and legumes—foods high in complex carbohydrates, fiber, vitamins, and minerals, low in fat, and free of cholesterol—should make up the bulk of the calories you consume. The rest should come from low-fat dairy products, lean meat and poultry, and fish.

You should also try to maintain a balance between calorie intake and calorie expenditure—that is, don't eat more food than your body can utilize. Otherwise, you will gain weight. The more active you are, therefore, the more you can eat and still maintain this balance.

Following these three basic steps doesn't mean that you have to give up your favorite foods. As long as your overall diet is balanced and rich in nutrients and fiber, there is nothing wrong with an occasional cheeseburger. Just be sure to limit how frequently you eat such foods, and try to eat small portions of them.

You can also view healthy eating as an opportunity to expand your range of choices by trying foods—especially vegetables, whole grains, or fruits—that you don't normally eat. A healthy diet doesn't have to mean eating foods that are bland or unappealing.

The following basic guidelines are what you need to know to construct a healthy diet.

1 Eat plenty of high-fiber foods—that is, fruits, vegetables, beans, and whole grains. These are the "good" carbohydrates—nutritious, filling, and relatively low in calories. They should supply the 20 to 30 grams of dietary fiber you need each day, which slows the absorption of carbohydrates, so there’s less effect on insulin and blood sugar, and provides other health benefits as well. Such foods also provide important vitamins, minerals, and phytochemicals (plant chemicals essential to good health).

2 Make sure to include green, orange, and yellow fruits and vegetables—such as broccoli, carrots, cantaloupe, and citrus fruits. The antioxidants and other nutrients in these foods may help protect against developing certain types of cancer and other diseases. Eat five or more servings a day.

3 Limit your intake of sugary foods, refined-grain products such as white bread, and salty snack foods. Sugar, our No.1 additive, is added to a vast array of foods. Just one daily 12-ounce can of soda (160 calories) can add up to 16 pounds over the course of a year. Many sugary foods are also high in fat, so they’re calorie-dense.

4 Cut down on animal fat. It’s rich in saturated fat, which boosts blood cholesterol levels and has other adverse health effects. Choose lean meats, skinless poultry, and nonfat or low-fat or nonfat dairy products.

5 Cut way down on trans fats, supplied by hydrogenated vegetable oils used in most processed foods in the supermarket and in many fast foods.

6 Eat more fish and nuts, which contain healthy unsaturated fats. Substitute olive or canola oil for butter or stick margarine.

7 Keep portions moderate, especially of high-calorie foods. In recent years serving sizes have ballooned, particularly in restaurants. Choose a starter instead of an entrée, split a dish with a friend, and don’t order supersized anything.

8 Keep your cholesterol intake below 300 milligrams per day. Cholesterol is found only in animal products, such as meats, poultry, dairy products, and egg yolks.

9 Eat a variety of foods. Don't try to fill your nutrient requirements by eating the same foods day in, day out. It is possible that not every essential nutrient has been identified, and so eating a wide assortment of foods helps to ensure that you will get all the necessary nutrients. In addition, this will limit your exposure to any pesticides or toxic substances that may be present in one particular food.

10 Maintain an adequate calcium intake. Calcium is essential for strong bones and teeth. Get your calcium from low-fat sources, such as skim milk and low-fat yogurt. If you can't get the optimal amount from foods, take supplements.

11 Try to get your vitamins and minerals from foods, not from supplements. Supplements cannot substitute for a healthy diet, which supplies nutrients and other compounds besides vitamins and minerals. Foods also provide the "synergy" that many nutrients require to be efficiently used in the body.

12 Maintain a desirable weight. Balance energy (calorie) intake with energy output. Exercise and other physical activity are essential.

13 If you drink alcohol, do so in moderation. That is one drink a day for women, two a day for men. A drink is defined as 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of 80-proof spirits. Excess alcohol consumption leads to a variety of health problems. And alcoholic beverages can add many calories to your diet without supplying nutrients.