As a registered dietitian, people ask me all the time what to do to be healthy. Since I started practicing 20 years ago, I’ve seen all kinds of diet trends and patterns—some good, some bad—but most healthy habits remain the same. So when I teamed up with Women’s Health to write this book, we decided to join forces and give you our very best eat-right advice. On the following pages, you’ll find our top tips—all backed by real research—for optimizing health. Even better, they’re completely realistic, so you’ll actually be able to stick with them and feel great every day.
Nearly all experts stress the importance of eating frequently to keep your metabolism and energy up and to avoid becoming so ravenous that you overeat when you finally do sit down to a meal. The “three meals plus two snacks a day” approach appears to be the best one for weight loss and weight maintenance. In a study in the Journal of the Academy of Nutrition and Dietetics, researchers found that people who were at a healthy weight and those who had lost weight both regularly ate two snacks a day. Snacking also appears to prevent weight gain. In one study, researchers followed more than 2,300 girls for 10 years (from about age 10 to age 20). Those who ate less frequently had an average increase of 1 body mass index unit and ½ inch in waist size more than girls who ate six times a day.
How does eating often help? There’s really no evidence to support the belief that it keeps your metabolism humming, but the opposite is absolutely true. If you cut back too far on calories, you’re embarking on a self-defeating proposition: The lack of calories slows your metabolism. Plus, if you’re only eating three times a day and trying to be calorie conscious, there is a good chance that you won’t eat enough.
Probably the biggest benefit of eating often comes from the effect it has on blood sugar (glucose) levels and, therefore, insulin production. When glucose and insulin are in balance, your appetite is on an even keel. That not only helps reduce hunger but also simply makes you feel better. I know from personal experience that having small meals throughout the day (instead of three squares) keeps me energized. Some experts think that eating at regular intervals leads to less fat storage, too, because your body learns to recognize that food will be available relatively soon. And psychologically, knowing that your next meal isn’t far away helps you cope with the biggest fear of people trying to lose weight: the fear of being hungry.
Of course, what you put in your mouth matters. If your snacks consist of potato chips and cupcakes, you aren’t doing your health or your waistline any favors. As you’ll see, many of our snacks are more like mini-meals. That’s because we see snacking as the perfect opportunity to sneak more nutrients into your diet—and little portions of “real” foods are far more satisfying than the empty calories you’d get from chips and candy. In a study from the University of Illinois, women who had two snacks a day had a higher intake of fiber than those who noshed less often. Additionally, women who snacked in the afternoon had a higher intake of fruits and vegetables than those who snacked in the morning. But don’t worry, we’ve got your fruit and veggie intake covered with our delicious recipes.
Carbs are not evil. They’re essential fuel, and they’re your body’s preferred energy source. On top of that, foods that are classified as mostly carbs—whole grains, fruits, vegetables—come packed with vitamins, minerals, and phytochemicals that are important for disease prevention. They can also be high in fiber, which helps keep you feeling full and satisfied. However, when you eat carbs by themselves, your body converts them into glucose faster than it would if you were eating something that slowed digestion (such as protein or fat) at the same time. An elevated glucose level causes a spike in insulin, which leads to a crash in blood sugar, which then results in extreme hunger. If that happens on a regular basis, your body switches to starvation mode, slowing your metabolism to conserve energy. Translation: You burn fewer calories in everything you do.
When you do choose carbs, make them complex carbs whenever possible. That means whole grains instead of white refined ones for bread, pasta, and rice. That’s because refined carbs, like white flour and sugar, are chemically closer to glucose, and therefore they break down quickly. The fiber in whole grains and fruit slows this process somewhat, but the effect could be blunted even more if you combined your carbs with some protein or fat. (Beans and vegetables are a little different. Beans are mostly carbs, but they pack a hefty dose of protein, too. And except for potatoes, corn, and peas, the carbs in vegetables are comparatively minimal, even in those that are “sweet,” like beets, carrots, and winter squash.)
According to a survey from the International Food Information Council, just 20 percent of people think that all fats are equal when it comes to health, but 67 percent try to cut as far back on all fats as they can. That’s a mistake, because how much fat you eat doesn’t really have an impact on your weight or your risk for disease. It’s the type of fat and the total calories you take in that really matter.
There are four general categories of fat: polyunsaturated, monounsaturated, saturated, and trans. With the exception of trans fat, your body needs all of them. Fat is a major component of every cell in your body. It helps you absorb fat-soluble nutrients from low-fat foods, keeps your skin and hair healthy, and makes your brain work more efficiently. Some types of polyunsaturated and monounsaturated fats also protect against disease and control inflammation. Saturated fat raises cholesterol levels and also increases your odds of developing insulin resistance (which can lead to diabetes), but you still need some of it in your diet. Cholesterol, which is primarily made from saturated fat, is an important building block for hormones.
Trans fat should be avoided, period. Studies show that as little as 1 gram of trans fat a day increases your odds of developing heart disease. Steering clear of it is far easier when you follow a diet that contains few packaged foods. The biggest source of trans fat is partially hydrogenated vegetable oil, which is found in crackers, cookies, cakes, and other processed foods. Many manufacturers have cut it from their products, as evidenced by the labels screaming “Trans Fat Free!” Still, always read the ingredients list, looking for the words “partially hydrogenated.” Food manufacturers are allowed by law to say that something is trans fat free if it contains less than 1 gram of trans fat. When all it takes is 1 gram a day to put your health at risk, though, you can’t afford to “accidentally” eat three half-gram portions.
One big problem with low-fat diets is that people tend to replace the missing fat with carbs. A body of research done at Harvard University as well as other institutions has shown that this swap unfavorably changes cholesterol levels: “Bad” LDL rises and “good” HDL drops. Replace saturated fat with polys or monos, and you get the opposite outcome. Eating a diet relatively high in unsaturated fats also lowers blood pressure more than a diet relatively high in carbs does.
A study funded by the National Institutes of Health found that low-carb and low-GI (glycemic index) diets helped people who lost weight to keep it off. The participants ate three different diets for 4 weeks each. The low-carb diet supplied just 10 percent of calories from carbohydrates. The low-GI diet was similar to a traditional Mediterranean diet—40 percent of the calories came from fat, 20 percent from protein. In the low-fat diet about 20 percent of the calories came from fat. The results: The participants burned an average of 300 and 150 more calories a day on the low-carb and low-GI diets, respectively, than they did on the low-fat diet. This was probably because the low-carb and low-GI diets did a better job of keeping blood sugar levels stable and insulin spikes minimal.
You might be wondering why, if the low-carb diet revved calorie burn twofold, we don’t suggest you eat that way. Two reasons: Low-carb diets can be notoriously difficult to stick with for life—not for everyone, but for a lot of people. In addition, such a high-protein diet often means a lot of meat. Meat comes with saturated fat, so the impact on your heart health is problematic.
Here’s another important point to keep in mind: Fat makes food taste good. On the one hand, that can cause you to overeat, but on the other, it can help you eat more vegetables and other healthy foods that you should be getting in your diet. I’m pretty sure that even the most strident vegetable lover would admit that a little olive oil, Parmesan cheese, toasted nuts, or even—wait for it—butter on top of steamed asparagus likely makes the asparagus more flavorful.
Skip the morning meal and chances are good that you’ll end up consuming more calories overall simply because you are hungrier. Think about it: If you finish dinner at 7:00 p.m. and don’t eat again until noon the next day, you have gone without food for 17 hours. You think you’re helping yourself drop pounds because you’re cutting out calories, but you’re actually causing your body to store more fat because it doesn’t know when the next influx of energy is coming. In addition, eating breakfast has been associated with lower blood glucose and cholesterol levels, and skipping it is linked to constipation and menstrual pain. In children, breakfast helps boost attention span and learning. (It’s not clear if adults get the same benefit.) Studies have consistently shown that breakfast eaters weigh less than breakfast skippers. Some studies have found that people who have a high-protein meal, like eggs, are more satisfied, while others show that whole grain cereal is most filling. Some of the research suggests that you should have a lot of calories at breakfast, while some says a light meal is what’s called for. None of these studies is conclusive, so our advice is to just eat something, preferably a carb-fat or carb-protein combo.
At one point or another, we have all stood in front of the refrigerator with the door open, eating leftovers or ice cream right out of the container. And even if you aren’t guilty of this little healthy eating blooper, I’ll bet you’ve eaten a meal while doing something else—like watching TV or answering e-mail—that diverts your attention from what you’re putting in your mouth. It’s a habit that many of our experts have broken, because when you don’t concentrate on your food as you’re eating it, it doesn’t quite register in your body. You could call it calorie amnesia: You can’t really remember what you ate, so you don’t get as much satisfaction from it. As a result, you find yourself craving something else not long after your meal. The science bears this out. In a study in the American Journal of Clinical Nutrition, researchers had one group of participants eat a meal while playing computer solitaire and another group eat without any distractions. The solitaire group had a hard time remembering what they ate, and they felt less full. What’s more, they ate twice as much when cookies were offered half an hour later.
No matter how busy you are, you can afford to take 15 minutes to sit down and eat your meal. Focus on the food on your plate, and really notice the aromas, flavors, and textures. Eating your meal slowly helps too. Japanese researchers found that fast eaters have triple the risk of being obese as those who take their time.
Learning to cook changed my health for the better. I can control the nutritional quality and calorie counts of my meals. I also found that cooking with my son makes him more likely to try different foods—an observation backed up by a study from the University of Alberta, which found that children who helped with food prep were about 10 percent more inclined to like vegetables.
To say that restaurant portions tend to be large is an understatement. On average, the typical restaurant meal has 50 percent more calories than a home-cooked meal. But those calories aren’t the only worrisome things you’re being served: A survey of restaurant meals by the RAND Corporation uncovered the sad fact that 96 percent of the nearly 30,000 chain restaurant menu items tested exceeded daily saturated fat and sodium recommendations. And don’t think the local bistro is any healthier: Chefs use a lot of salt, oil, and butter in their cooking, and big portions are just as common in independent restaurants.
Cooking at home does not mean that you have to be the next Jacques Pépin or Rachael Ray. Home cooking can be super simple; in fact, tossing together a salad from fresh greens and vegetables with a little protein counts as home cooking!
That’s what the World Health Organization recommends, and it’s what most of our health pros do. It’s not difficult. A large apple, for instance, can easily be one-third of a pound. Tomato sauce counts. So do beans and lentils.
Studies show that people with a high intake of fruits and vegetables weigh less. They also get fiber, vitamins, minerals, and phytochemicals that protect against cancer and heart disease. “Eat the rainbow” has become a bit of a cliché, but it’s the best way to think about how to eat a balanced diet. The compounds that give plants their pigments—green, purple, blue, red, orange, yellow—aren’t just pretty. They’re powerful antioxidants, and you want to eat a variety of them. Even white vegetables are good for you: Every ounce of them you eat each day reduces your stroke risk by 9 percent.
Meatless Mondays, semi-vegetarian, vegivore, vegan until 6 o’clock, flexitarian—these are just some of the words used to describe a way of eating that emphasizes plant foods but doesn’t totally eschew dairy, meat, poultry, or fish. Maybe the best way to think about it is to consider yourself a vegetarian most of the time. In fact, one survey found that two out of three people who describe themselves as vegetarians actually eat this way. Most of the people in the Mediterranean (Italy, Greece, and Spain) follow this kind of diet, and study after study has shown that they have lower risks of chronic diseases. For instance, researchers at Loma Linda University School of Public Health in California found that the occurrence of diabetes in semi-vegetarians was about half that of people who ate a typical nonvegetarian diet. Harvard researchers found that limiting red meat intake to no more than 10½ ounces a week could prevent 1 in 10 early deaths in men and 1 in 13 early deaths in women. And cutting out one serving of red meat per day lowered the risk of premature death by 7 to 19 percent, depending on whether the meat being eliminated was a burger or a roast or processed red meat. Another study showed that semi-vegetarians live an average of 3.6 years longer.
Evidence that added sugar plays a role not just in weight gain but also in heart disease, diabetes, cancer—and even wrinkles!—is steadily mounting. The average person eats 22 teaspoons, or 88 grams, of sugar a day. (Each teaspoon weighs 4 grams.) That’s 352 calories’ worth. The American Heart Association recommends a maximum daily intake of just 5 teaspoons for women and 6 teaspoons for men, which means that if you have one soda, you’ve already exceeded your limit. Our meals use only natural sugar (and some use maple syrup as a sugar replacer) from real whole fruits so you’re not introducing extra sugar into your system.
Most of the sugar people eat isn’t added to food by the teaspoon, though—it’s in processed and packaged products. And separating added sugar from naturally occurring sugar in fruits, some vegetables, dairy products, and whole grains isn’t easy. The amount of sugar listed on food labels is the combination of both natural and added sugars in one serving of the food. Sugar has many names—high-fructose corn syrup, glucose, sucrose, honey, maple syrup, barley malt, beet sugar, cane juice, and cane sugar, to name a few—so reading the ingredients list can help. The best way to keep your added sugar intake low is to eat real foods.
Stress can ruin the best-laid diet plans. According to a survey by the American Psychological Association, 40 percent of respondents reported emotional eating—that is, eating for reasons other than hunger, such as feeling pressured, anxious, sad, or bored. (Interestingly, studies have found that being happy also causes people to eat more.) Stress appears to change the brain’s response to food, making appetizing food more enticing—and it affects where your body stores fat. When your stress hormones are high, you tend to have more abdominal fat, which is linked to an increased risk of heart disease and diabetes. The solution is three pronged. First, eat mindfully (see rule 5). Second, find an outlet for your stress. In a University of California, San Francisco, study, mindful eating and meditation helped women feel less stressed and reduced stress hormones. The women in the study lost belly fat, even though they did not change what they ate. Exercise is also a terrific stress reliever.
Finally, learn to distinguish true hunger from head hunger—the desire to eat because you think you deserve it, because it will make you feel better, or just because the food looks good. How can you do this? Tune in to your body. After you eat a meal, focus for a few minutes on your belly. You should feel satisfied but not stuffed, as though you could eat a few more bites, but you don’t need to. (Don’t check in too soon, though. Your brain needs 20 minutes to register that your stomach is full.) Once you become familiar with that feeling, ask yourself, “Am I hungry?” every time you want to eat. If the answer is yes, eat. If the answer is no, ask yourself what else is going on. Take 10 minutes to think about it—whatever you are craving will still be there—and then decide. Take a walk, read a book, call a friend—do anything you enjoy that will take your mind off of food. If that doesn’t work, have a small portion of the food you want. That’s often enough to make you feel satisfied. Whatever you do, though, don’t beat yourself up. Even the best eaters give in to head hunger sometimes.
Okay, this isn’t a diet tip, exactly, but exercise and diet are so closely linked that the connection can’t be ignored. You don’t need to do formal “exercise” every day, but whether it’s climbing the stairs or walking the dog, just move your body. Being physically active often leads you to eat better. Some of that may just be a natural side effect of wanting to be healthy, but some researchers believe that exercise actually changes your brain so you are better able to resist temptation or so that the hormones that control your appetite are more balanced. People who get 2½ hours of moderate activity a week have lower levels of inflammatory markers in their bloodstreams. And people who exercise are more sensitive to insulin (which lowers your risk for diabetes) and are less likely to develop dementia later in life. Exercise helps you sleep better, too, and people who get enough high-quality sleep are more likely to be slim.