Wednesday, March 10, 2010

Only One Message

The following post is part of the Women's Health Blogfest 2010. Visit the links following the post to read different topics from a variety of Registered Dietitians participating in the Blogfest.

As a Registered Dietitian, if I could give only one message, what would that be?

Registered Dietitians serve an incredibly wide variety of clients and give many messages, often tailored to individuals with specific needs and life circumstances. Overall, we live in a nation experiencing the consequences of our poor dietary habits--

• More than 90 million Americans are affected by chronic diseases (HHS and USDA, Dietary Guidelines for Americans 2005, Message From the Secretaries).

• Type II diabetes is increasing in the adult population and has made a surprise appearance in children. 24 million Americans have diabetes and an estimated 57 million Americans have “pre-diabetes”, and the numbers are fast rising (pre-diabetes is also known by other names: hyperinsulinemia, insulin resistance, Metabolic Syndrome, Syndrome X). Unbelievably, 1 in 4.5 Americans have Syndrome X, a silent killer that can lead to a heart attack. Hypoglycemia, a related disorder, plagues the lives of countless millions more.

• About 12 million people in the United States have coronary heart diseases. Nearly one out of every two of us dies of cardiovascular disease (heart attack or stroke). Based on the Framingham Heart Study, 45% of all heart attacks occur in people under age 65. Stroke is the leading cause of serious disability in the United States, and 28% of the people who suffer a stroke in a given year are under age 65.

• Co-morbidities are no longer unusual.

• Sixty five percent of Americans are now either overweight or obese.

We are clearly in trouble. While billions of dollars have been allotted to battling the trend, the overall health of America continues to decline. For the most part, people are not just going to “get healthy” because they realize they should, even though they understand that there are benefits of being healthy and dire consequences of staying unhealthy. Certainly, a simple do-able message that people can readily apply would be helpful.

I wonder if most Americans even realize that it’s not normal to die of such long-term degenerative diseases which are the norm in America. There is a consistent theme taken from the overwhelming evidence in research and healthy cultures around the world which, simply and generally given, can set any American walking on the right path and able to make immediate dietary adjustments yielding immediate benefits. You don’t need one diet for cancer prevention, one diet for cardiovascular disease, one diet for diabetes. A diet based on 90% plant:10% animal helps prevent all of these “lifestyle” diseases, and more. The same diet also supports optimal energy and weight-loss. The highly-recommended DASH diet for hypertension and the widely popularized Mediterranean Diet are variations of the same theme. In fact, healthy cultures around the world eat a strikingly similar diet (in a wide variety of ways) based on 90% plant:10% animal food as I have pictured here:

50% whole grains, beans, nuts, seeds
30% vegetables
10% fruit
6% dairy
4% meat, fowl, fish

Copyright 2006

Compare this to the Standard American Diet which gets 70% of its calories from animal foods (meat and dairy)--WE HAVE FLIPPED THE TRIANGLE!!!

Is it any wonder we are is so much trouble? Furthermore, in America, the last 30% is made up largely of refined grains instead of whole grains, beans, nuts and seeds. And at the tippy bottom of the triangle are vegetables. If the only change we made was to eat more vegetables we would come a long way in preventing our lifestyle diseases. If we just ate more vegetables (like grandma said) we would increase the fiber in our diet (Americans eat only half of the recommended daily intake of fiber), decrease total fat, decrease saturated fat, increase vitamins, minerals, antioxidants and other phytochemicals, and decrease the excessive calories which contribute to an epidemic of obesity in our country. But if you ask all the people you know how many eat just one vegetable a day, about half would say “no”, and many more ask “Don’t McDonald’s french fries count as a vegetable”? The American diet is not just out-of-balance--we have flipped the triangle!!!

Even the wildly popular fad diets such as The South Beach Diet, when more clearly defined in years subsequent to its introduction, reflects the 90:10paradigm, and popular diet book recommendations such as those found in Eat Right 4 Your Type (a.k.a. “The Blood Type Diet”), when push comes to shove, do too. There really is no getting away from it, and evidence continues to confirm it is an optimal diet. There are a wide variety of cultural ways to eat a 90:10 diet. Also note that what always has been a healthy diet still is a healthy diet, and I venture to say it always will be a healthy diet--it’s not going to change. Political commentary aside, we are not “evolving” into some greater species as some philosophical diet book authors propose. Just take a look at the news.

Now the 2005 Dietary Guidelines for Americans recommend the following as the composition of a healthy diet:

45-65% calories from CARBOHYDRATES (<10% “simple”)
20-35% calories from FAT
10-35% calories from PROTEIN

This would be a big improvement over the Standard American Diet (S.A.D.):

42% calories from CARBOHYDRATES ( 1/2 “simple”)
37-42% calories from FAT (predominantly animal/saturated fat)
20-25% calories from PROTEIN (predominantly animal protein)

But experts agree that the current American dietary recommendations are not enough. An accumulating body of evidence supports the idea that a 90% plant:10% animal food diet is indeed optimal:

• According to “The China Study” conducted by T. Colin Campbell of Cornell University, the healthiest cultures in China also eat a 90% plant:10% animal food diet.

• Drs. Dean Ornish and John McDougall teach people how to eat a plant-centered diet with much success in reversing diseases such as heart disease, diabetes, and osteoporosis.

• Mediterranean countries follow a similar diet and suffer from reduced amounts of “lifestyle disease”.

• In 1993 the American Dietetic Association issued a position statement indicating that vegetarian diets are healthful and nutritionally adequate when appropriately planned.

In October 1992, ninety-four of the most widely respected nutrition professionals and scientists in the country were interviewed by Consumer Reports. They have served as members of federal advisory boards relating to nutrition, and on nutrition committees of professional organizations:

• Three-fifths of the experts agreed that no more than three 3-ounce servings of red meat a week should be consumed.

• More than half of the experts agreed that 7 or more servings of fruits and vegetables a day is ideal. Many others agreed that 7-9 a day is more optimal. The 2005 Dietary Guidelines for Americans recommends a minimum of 4 servings of fruit (2 cups) and 5 servings of vegetables (2 1/2 cups) for 2000-calorie individuals (that’s 9 servings fruit and vegetables daily), and up to 5 servings of fruit (2 1/2 cups) and 8 servings of vegetables (4 cups) for 3,200-calorie individuals (that’s 13 servings fruit and vegetables daily!)

A full 18 years after the Consumer Reports review, I rarely meet an individual who is eating this many servings of fruit and vegetables daily. The take-home message is this—eat just one more fruit or vegee daily this week—start with one that you like but are just not in the habit of eating. You will be surprised at how this small change begins to replace other foods that are eaten to excess (meat, fat, sugar). By focusing on what to “put in”, rather than on what to “cut out”, our bodies quickly change. In a surprisingly short amount of time, without any “all-or-nothing” change, people often say that they feel so much better and don’t feel good when they eat what they used to eat. That’s behavior change that will last!

And while you are adding that one more fruit or vegee this week, remember the triangles.

Please visit the following links for more information from fellow Registered Dietitians:

Beyond Prenatals (Debra) - Vitamin D in Pregnancy and Beyond

Wendy Reinhardt Kapsak, MS, RD - Can Dietitians Have Real I.M.P.A.C.T?

Sandra Meyerowitz, MPH, RD, LD - Changes Worth Making Take Time

Carrie Miller - What Nebraska Dietitians Are Saying

National Dairy Council- Nutrient-rich foods build a healthy diet

Janel Ovrut MS RD LDN - My Top Tips for Registered Dietitian Day!

Heather Pierce, MS, RD, CDE – Enjoy Food

Elizabeth Rahavi, RD - The Art of Nutrition Messaging

Shelley A. Rael, MS RD LD - Food Is LIFE, Nutrition is HEALTHY Life

Kerry Robinson, RD - A Food Safety Message with IMPACT

Marianne Smith-Edge, MS, RD - RDs are the Premiere Food and Health Communicators

Kris Sollid, RD - Unintended Consequences of Simple Messaging

Angie Tillman, RD, CDE, LDN- Take Time to Care for Yourself

Nurturing Notes--Registered Dietitian Blogfest


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