How to eat: 6 simple tips from a nutrition researcher

Dr. Marian Neuhouser, who helped create the new U.S. Dietary Guidelines, shares how she eats – and how you should, too
Fruits and vegetables
When it comes to eating for good health – and weight loss, for that matter – it’s all about real food, says Fred Hutch nutrition researcher Dr. Marian Neuhouser. Fred Hutch file

Every January, it’s the same thing.

After gorging our way through the holidays, we want to get healthy ASAP. So we go a little crazy and basically forget how to eat.  We skip breakfast, thinking we’ll save calories, and down a cup of low-fat yogurt at our desk, along with five times the sugar we want or need. We replace our mid-day apple and tuna sandwich with a processed frozen lunch that promises low calories but delivers 16 times the sodium, a mouthful of chemicals and little in the way of real food.  By dinner, we’re so hangry, we pick up a sausage and pepperoni pizza and wash it down with diet soda.

We want to be healthy. We want to be thin. But how do we go about it with good, bad and ugly diet advice coming at us from all sides?  

We tapped healthy-eating heavyweight Dr. Marian Neuhouser, a nutritional epidemiologist at Fred Hutchinson Cancer Research Center, for some simple answers. A long-time public health researcher, Neuhouser knows how grains, fats, dairy, fruits and veggies, processed meats, coffee, alcohol and everything else we put into our mouths impacts our health, particularly when it comes to obesity, cardiovascular disease, diabetes and cancer. She’s conducted hundreds of studies and recently served on the advisory committee that synthesized the latest nutritional science into a report used to create the 2015 U.S. Dietary Guidelines, which informs everything from food labels to school lunches.

Here are her tips on how to eat.

Dr. Marian Neuhouser
Dr. Marian Neuhouser Fred Hutch file

Forget the fads.

Yes, we know that Kelly Ripa swears by her high-alkaline cleanse, but like many get-thin-quick diet schemes, the idea of rebalancing your body’s alkaline and acid levels with food is junk science, said Neuhouser. Same goes for gimmicky diets that encourage people to eat one food almost exclusively – think kale, pomegranate juice, or cabbage soup – or avoid one food group, like grains, entirely.

“Fad diets that recommend you exclude entire food groups or types of foods – or emphasize any one particular food or nutrient [over others] should be avoided,” she said. “They’re not based on science.”

A better alternative: diets that encourage you to avoid added sugars, added fats (which are often artificial trans fats), and high amounts of processed ingredients. The just-published U.S. News & World Report’s 2016 Best Diets Rankings includes many of these, including the DASH, MIND, Ornish, and TLC diets.

“Don’t avoid anything, unless you’re avoiding white bread, white rice, chips, pop, added sugar, candy, and excess alcohol,” said Neuhouser, who said once we stop eating processed foods laden with extra fat, sugar, and salt, we won’t crave it as much.

“You’ll be surprised,” she said. “Your taste buds will adapt.”

Carbs are not evil.

Carbs are often targeted by post-holiday dieters (reeling from all those cookies, pies, and mashed potatoes, no doubt), but not all carbohydrates are created equal, Neuhouser stressed.

“When people hear ‘low-carb diet,’ they think they should eliminate everything, but really what should be reduced are highly refined carbohydrates like white rice, white flour, white sugar and things made with [them],” she said. “Whole grains offer tremendous nutrients and should never be avoided.”

Same goes for fruits and vegetables, which also contain carbohydrates.

“Every food has some carbohydrates,” Neuhouser said. “People have misconceptions. They think that meat is all protein, and vegetables are all vitamins and maybe some fiber. But nearly all foods have some amount of fat, carbohydrates and protein (also called macronutrients). It’s just that some are higher than others. If people eliminate all carbohydrates, including whole grains, they eliminate fiber, a major source of B vitamins and a number of other things that go into making a healthy dietary pattern.”

Think about your diet as a whole.

And it’s all about the overall dietary pattern.  

“This is the way the nutrition field is going,” she said. “It’s about dietary patterns, what you eat at every meal and eating occasion [i.e., snacks] – it all adds up.”

Case in point:  you eat a healthy breakfast (a whole grain hot cereal, some fruit, a little yogurt and coffee); opt for a not-so-healthy lunch (some fried chicken or a burger with soda); dig into a semi-healthy dinner (lasagna and a small salad) and enjoy a few too many cookies before bed.

“Is that an overall healthy dietary pattern? Probably not,” said Neuhouser. “You might think you’re eating healthy because of the breakfast but it’s what happens throughout the rest of the day. And the rest of the week. Having one day where you don’t eat particularly well or having pizza twice a month is not terrible. It doesn’t mean you can never eat these things. But it’s the whole dietary pattern over the course of one’s being that’s important.”

The good news: a holistic approach to food not only helps fend off disease, it will also help you drop pounds.

“Following a healthy overall dietary pattern is associated with weight loss, maintenance of a healthy weight and a lower risk of diabetes and cardiovascular disease and most likely cancer,” she said. 

Hot dogs
Neuhouser recommends limiting processed meats, such as hot dogs, to no more than once or twice a week. Stock photo by Feature Pics

Limit the usual suspects.

You know what we’re talking about here:  red meat, bacon, sodium, sugar-sweetened sodas and juices, fried foods, chips and other unhealthy choices. They’re fattening, they’re often devoid of nutrients and they’re ubiquitous – a huge part of the Western diet and the deadly health consequences that can come with it. 

Despite the proliferation of bacon-flavored everything – including vodka, chocolate and cupcakes --  Neuhouser said she “has to go with the evidence,” pointing to the recent World Health Organization report that labeled processed meats a known carcinogen and classified red meat as “probably carcinogenic.”

“Bacon, bologna, ham, sausage – basically anything that you’d get from the deli counter, including turkey and chicken – are processed meats,” she said. “That doesn’t mean never eat it. But lower your consumption to no more than once or twice a week. Especially for red meat.”

Sodium can jack up our blood pressure and put us at risk for heart disease and stroke if we consume too much. And we do. Currently, every single demographic in the U.S. – babies, adolescents, young women, middle aged men, you name it – consumes “about twice as much as the tolerable upper limit” of sodium, Neuhouser said.

Why? Because it’s everywhere.  

“It’s one of the major preservatives that we have,” she said. “Bacon is terribly high in sodium. But [sodium is] also in canned soup, crackers, cookies, breakfast cereals. Anything that has to remain shelf- stable probably has added salt and added sugar.”

As for sugar, too much of it causes obesity, diabetes and other health problems, and a just-published study indicates that fructose, found in table sugar and high-fructose corn syrup (a common sweetener in sodas and fruit-flavored drinks), fuels the growth of cancer in mice.

Further study is needed but Neuhouser said added sugar should be limited in a healthy dietary pattern, “making up no more than 10 percent of calories – and this includes all sources of added sugar.”

Food labels
The Food and Drug Administration’s new proposed Nutrition Facts label (right) highlights the calories, updates the serving size and folds in new information about added sugars. The current label is on the left.

Read labels. Ask questions.

How do you know if you’re getting added sodium and added sugar?

Read the label, especially if you eat any kind of convenience foods – in other words, anything that comes in a package or a box. That way you know exactly what’s going into your body.

When it comes to sodium, for instance, anything more than 400 to 500 milligrams per serving is considered high, Neuhouser said.

“Reading labels is one very important thing you can do,” she said. “A processed frozen dinner might be low in calories but very high in sodium, so it’s not necessary healthy.”

Boning up on our grocery ingredients might seem daunting, but help is on the way.

The Food and Drug Administration’s new proposed Nutrition Facts label highlights the calories, updates the serving size and folds in new information about added sugars. The FDA has also given food makers until 2018 to remove partially hydrogenated oils (the main source of unhealthy trans fats) from their products. Restaurant menus are getting into the better labeling act, as well. A new sodium warning requirement for New York restaurants just went into effect and the FDA has set a Dec. 1, 2016 deadline for restaurants to list calorie counts on their menus (information on ingredients such as trans fats, sodium and sugars must be provided upon request).

In keeping with this move toward better health, some restaurant chains and food manufacturers are removing artificial flavorings, colors and additives from their products. The Institute of Food Technologists predicts even more “healthification” of restaurant fare and grocery items.

“There are a lot of new lines of convenience foods out there that are pretty healthy,” Neuhouser said. “They use whole grains, have low sodium, use lean sources of meat and they don’t have a lot of added sugar in the sauces. Read the label and be judicious.”

What if you’re grabbing lunch from the supermarket salad bar or cafeteria and there is no label?

“You can always ask how it was prepared,” she said.

Stick to real foods as much as possible.

When it comes to eating for good health – and weight loss, for that matter – it’s all about real food: choices such as carrots, grapes, brown rice, avocado, eggs, cheese, apples, nuts, spinach and salmon. And the more you can purchase and prepare your own meals, the more control you will have over maintaining a healthy dietary pattern.

Food author and activist Michael Pollan boils it down to seven words in his book (and just-released PBS documentary) “In Defense of Food”:  Eat food. Not too much. Mostly plants.

This philosophy is very much in keeping with current nutritional science, including the overall healthy dietary pattern championed by Neuhouser and the 2015 U.S. Dietary Guidelines advisory committee.

How does the nutritional expert put this into practice for herself? 

For breakfast, she eats a whole grain cereal, nonfat milk, fruit and coffee. Lunch might be a sandwich or salad or a leftover fajita from the night before made of lean pork, grilled vegetables and a tortilla.

Neuhouser said eating the same thing day after day is fine, as long as it’s a healthy mix of ingredients.

“I try to have a variety of foods,” she said. “A good healthy dietary pattern. The whole is more than the sum of its parts.”

How do you keep your diet well-rounded and nutritious? Join the conversation on our Facebook page.

Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she also writes the breast cancer blog doublewhammied.com. Reach her at dmapes@fredhutch.org.

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