What to Eat
The subject of proper diet is endlessly debated in nutrition circles. Controversy rages over many issues, such as the role (if any) of animal protein in the "ideal" diet. Such concerns sometimes move otherwise pacific vegetarians to fits of savage indignation.Here are some guidelines that can help virtually anyone form the basis of a healthy eating style. Remember, of course, that each of us is unique in food preference and biological makeup. There is no single "ultimate approach" to diet selection. What we're looking for is a diet that promotes optimal personal health, not rigid adherence to one dietary philosophy.Nutrient-Rich versus Calorie-DenseAn important basic principle in food selection is to prioritize foods that are rich in vitamins, minerals, fiber, and protein and packaged with minimal caloric accompaniment. An example of a nutrient-rich food is salmon. It's loaded with protein, vitamin A, vitamin D, selenium, and heart-healthy omega-3 oil. Another is broccoli, which is chock-full of fiber, vitamin C, the carotenoids, calcium, and cancer-preventive indoles (more on these later). The calorie-dense antithesis of these foods might be a rich dessert pastry, with little in the way of substantive nutritional value. A diet that emphasizes high-nutrient and low-calorie content is especially important as you age and your metabolism slows down.Low-Fat ManiaThese days, every major magazine is full of low-fat articles and recipes, many of them meatless for the sake of cholesterol and fat reduction. If you peruse the shelves of your local supermarket, you will also notice that nearly every item has a label boasting its absence of cholesterol, even foods like peanut butter and pita bread that never had cholesterol to begin with.Some people apply fuzzy logic to their reasons for not eating fats. It goes something like this: "Fat is the calorie stuff that makes you fat and has something to do with heart disease, so eliminate fat and you'll stay slim forever and never die." Right? Wrong! Taken to its extreme, low-fat mania results in the exaltation of poor-quality high-calorie foods like "low-fat" desserts, cookies, breakfast pastries, and pasta items made with refined flour. Don't fall for the low-fat hype.Oil ChangeThat's right -- get yourself an oil change. Some fats are healthy; others are not. Avoid margarine and hydrogenated fats used as shortening in cookies, breads, candies, and baked products. Cut down on butter and fried meats. Frying seals in fat and renders chemically unstable refined polyunsaturated vegetable oils rancid ("oxidized" is the formal biochemical term.) Oxidized cholesterol and fat may be the true culprits in heart disease.Though the fast-food giants advertise their "healthy" move from lard to polyunsaturated vegetable oil that is touted to have no cholesterol, remember that the vegetable oil is an unstable compound and oxidizes readily, especially with repeated heatings, producing free radicals that can cause all kinds of harm to the body. Like the move from butter to margarine, this switch does not deliver the health benefits it claims.Vegetarianism -- The Mantle of Virtue?A carefully planned and executed vegetarian diet has many proven health benefits. But all too frequently, junk-food eaters assume the virtuous mantle of vegetarianism and gorge on all manner of nonnutritious sweets, chips, and fried foods that they pick up in health food stores. The unbalanced eating styles of many vegetarians leave them prey to deficiencies of critical nutrients like protein, iron, zinc, B vitamins, and essential fatty acids. The paucity of protein options fosters inordinate carbohydrate cravings.While a vegetarian diet may be a good cleanser for people who have spent most of their lives on a diet heavy in foods from commercially raised animals, continuing a totally vegetarian diet for too long can often backfire, especially for women. The bottom line: vegetarianism is a boon for some, a bane for others.The Glycemic IndexPrioritize low glycemic index carbohydrates like tofu, beans, brown rice, and kasha. These foods slowly release their stored sugar without precipitating insulin surges, unlike dried fruit and fruit juice, cold cereal, flavored yogurt, pasta, breads, and most "natural desserts."Sitting down to eat a large plate of pasta, or eating other large portions of high glycemic index foods, can be especially risky. With a large portion, you are more likely to exceed the ability of your system to produce sufficient insulin. You're challenging the insulin response, which tends to induce high cholesterol levels and levels of fat-enhancing hormones.When to EatThis is almost as important a question as what to eat. A study of the eating habits of Japanese sumo wrestlers gives us a case study on how to put on massive amounts of weight. They eat relatively little during the day and start with a massive meal in the evening, followed by rest. Then they have a big midnight snack and go immediately to bed. The combination of gorging and sleeping gives them the desired massively heavy physique. To maintain a more normal body shape, do the opposite. Have a hearty breakfast to forestall craving for junk food later in the day. Eat moderate-size scheduled meals punctuated with complex carbohydrate and protein snacks.Protein AlternativesMost Americans are trying to cut down on their intake of the classic red meat protein sources of the past: steaks, hamburgers, chops, and stews, laden with saturated fat. Marine sources of protein are a desirable alternative for those who like them. It was once thought that seafood like lobster and shrimp were laden with cholesterol, but in fact, these foods do not raise cholesterol levels in humans. Bivalves (clams, oysters) actually have been shown to lower cholesterol in human experiments.Also consider eggs, which have been shown by many studies to be a reasonable protein source. The widespread notion that eggs boost cholesterol in people is the height of scientific absurdity. Only an insignificant minority of the population has this problem.Organic, free-range chicken, preferably baked or grilled, is also a good option for high-quality protein. Remember that how the chicken is prepared is as important as that it's chicken. Some people hear, "eat lean poultry" and say, "Oh, I'm at McDonald's so I'll have the chicken McNuggets or the chicken sandwich -- it's better than red meat." But this doesn't cut it. Those nuggets and ground chicken patties are saturated with oil, which may be vegetable oil but is easily oxidized with heat and full of dangerous free radicals.Vegetarians and the economy-minded can look to tofu, beans, lentils, split peas, and other legumes as excellent sources of protein that can also help them meet their fiber quotient. They are rich in phytochemicals, which have an anticancer effect, particularly against breast or prostate cancer. Individuals who are at higher risk for cancer of the breast, uterus, colon, or prostate do well on a vegetarian or semi-vegetarian diet.Eight ounces of yogurt a day not only will provide some of your protein but, more importantly, will boost your body's immune system, help fight off disease, reduce hay fever and allergy symptoms, provide you with plenty of calcium, and, if you're a woman, fend off recurrent episodes of vaginitis. Women are especially susceptible to vaginitis after a course of antibiotics, and yogurt will help restore the balance.Meat May Not Be All BadThe worst kind of saturated fat is the kind in the red meat and the processed sandwich meat that's available in our supermarkets. That meat now contains more fat than it does protein. Many people are wisely reducing their intake of meat. The 1950s' ideal dinner of steak and potatoes was a dietary aberration. As history always shows us, the pendulum has started to swing in the other direction. We are increasing our intake of plant foods and lowering our intake of animal foods. However, from a health perspective, this doesn't mean we should cut out animal foods altogether. Some meat (yes, even red meat), minus the drugs and hormones pumped in by modern farming techniques, might not be so bad for some of us after all. The move back to moderate meat consumption has begun. Some people, of course, never abandoned it.The important thing is that we are not talking about the commercially raised meat available in most supermarkets but about the organically fed animals that are given no antibiotics, hormones, or other drugs or chemicals. The newly available beefalo, bison, and wild game meats are a trend that I hope will spread. These meats are low-fat and hormone free; they have much more protein than domesticated meat and yet contain only one-sixth the amount of fat, a level that compares favorably with many beans and grains. This kind of organic meat is available in some supermarkets around the country and is supplied by mail-order companies as well.Fiber: It Works for MothsAs George Burns once quipped, "Fiber can't be all bad. Have you ever seen a fat moth?" Generally, fiber is consumed in inadequate amounts in this country. The average American eats 5 to 15 grams of fiber a day, but a more optimal amount would be 25 to 35 grams. It isn't hard to increase your fiber intake; you can get lots of fiber from broccoli or from applesauce. It's a very good idea to protect yourself by increasing your fiber intake in simple, sensible ways.Keep it Fresh and OrganicWhen selecting fruits, vegetables, and prepared foods like baby foods, insist on organic products. They are free of toxic residues that may render even the healthiest foods harmful or even deadly. Insist on freshness, too. Fresh foods are tastier because the nutrients they contain have not been degraded. With the current organic produce explosion, more fresh options are available year-round.Raw versus Cooked versus FrozenCarrying on an interminable debate, "raw-fooders" insist that subtle nutrient qualities are damaged by cooking, while the "cookers" reply that careful food preparation renders food more easily assimilated. The answer: choose both, selecting a mixture of raw and lightly steamed food items. Give boiled veggies a wide berth -- unless consumed in their broth in soup dishes, they are leached, lifeless remnants of their former selves. Frozen vegetables without additives or preservatives may be better than wilted fresh vegetables, but they are a bit of an unknown because of potential handling problems. Repeated cycles of thawing and refreezing, damage nutrients and flavor. Freezing your own fresh vegetables may be an alternative.Phyto-PharmaceuticalsScience is gradually discovering categories of food components that go beyond simple vitamins and minerals in their ability to prevent disease. Examples are the cancer-fighting indoles present in the cabbage family vegetables like brussels sprouts and kale; natural phyto-estrogens in soybeans and other legumes, which prevent breast cancer in women and prostate cancer in men; and polyphenols found in berries and green tea, which may combat heart disease as well as cancer.Natural versus SyntheticOur food is laced with far too many chemicals, the safety of which have not been tested over time. As a matter of fact, we as a population are being ruthlessly subjected to what amounts to wholesale scientific experimentation. Newly patented "designer chemicals" are permeating our diet as never before. We're absorbing multiple food additives that no humans have ever consumed before this century. The long-term effects of artificial sweeteners, hydrogenated oils, and artificial food colorings, flavorings, and preservatives are unknown. I recommend that you avoid them all.The Spice of LifeBecause of the availability of products from all over the world in our supermarkets, and because we can get fruits or vegetables that may not be in season here, Americans tend to think that we eat a varied diet. In fact, the American diet is extremely monotonous. Think over what you've eaten during the last four days, and it's almost certain that you've had wheat and dairy products daily, and probably eggs, corn, tomatoes, potatoes, and citrus fruits. Those are the most common allergenic foods, and it is known that repetition of a food can render you susceptible to food allergy. So make an effort to get variety in your diet -- not just wheat and corn, but other grains such as rye, buckwheat, spelt, amaranth, and quinoa. A wide variety of foods will provide you with more of the unique, healthful, disease-fighting nutrients that food alone can supply.Beware of PerfectionismDon't get caught up in dietary perfectionism. Perfectionism is self-abuse of the highest order. As in the Victorian era, the flip side of rectitude can be debauchery and unbridled hedonism. Learn to be steadfast but not rigid, and allow flexibility. The exception is when addiction to substances like sugar, caffeine, or alcohol makes total abstinence a preferable strategy. Learn to cheat playfully, without guilt or heavy self-recrimination. If you like, you can balance minor dietary lapses with a day of light eating or increased exercise.Portions of this column were excerpted from Dr. Hoffman's new book "Intelligent Medicine: A Guide to Optimizing Health and Preventing Illness for the Baby-Boomer Generation, " a Fireside Book published by Simon & Schuster.Dr. Ronald Hoffman is Medical Director of the Hoffman Center in New York City and is author of "Seven Weeks to a Settled Stomach" and "Tired All the Time," both available from Pocket Books.