This is the eighth blog in my series of blogs discussing Eating Disorders (ED's) - and in this blog I will continue to discuss recovery.
In the last two blogs (No.'s 6 and 7) I introduced the topic of recovery from ED's, and I made the point that recovery is a choice (nothing and no-one can help a sufferer of an ED to recover - until the sufferer chooses to 'get better' and engage in their own recovery); and recovery from an ED will almost always require help from others (a successful recovery is much more likely if a sufferer seeks help from others - especially professional help).
In this blog I will look at the third most important step in recovery from an ED: Never Diet Again.
Yes, you heard me correctly. Never. Diet. Again. Ever.
This is the mantra that I have lived by for the last 30 years, since I recovered from an ED:
'I will never diet again.'
And, the amazing thing is that I haven't needed to diet to remain exactly the same weight, which is in a healthy weight range (BMI: 19 − 25).
My weight has remained exactly the same (give or take 1- 2 kilograms) - even after 30 years; four children; eating whatever I want (including cakes and lollies and chocolates - pretty well everyday); not weighing myself more than once per year (at the most - and only if I think I look gaunt or out of curiosity); minimal or no exercise (other than an occasional swim or walk on week-ends); and after lots of stressful ups and downs in my life - like everyone else.
My point: Dieting is not ever necessary to maintain a stable and healthy weight.
However, there are things that do help to maintain a healthy weight - which I will discuss in this blog. But dieting is NOT one of those things. In fact diets are impractical, they don't work anyway, and they are counter-productive. They usually result in people gaining weight - and feeling stressed and miserable and self-critical.
In fact, a large part of why I have found it easy to maintain a healthy and stable weight for my entire adult life - is likely to be largely because I never diet - rather than being in spite of it.
These are the issues, relating to diets and dieting, which I will discuss in this blog.
1. Dieting is strongly linked to both the onset and relapse of ED's:
As I've mentioned in earlier blogs, dieting is the single most important risk factor for developing an ED.
A reminder of some statistics from blog 3 in this ED series:
- Studies have shown that among people 12 to 17 year old, 90% of females and 68% of males have been on a diet of some kind.
- At any given time, approximately 68% of 15 year old females are on a diet! Of these 8% are severely dieting.
- It is known that adolescent girls who diet only moderately are 5 times more likely to develop an ED than those who don't diet, and those who diet severely are 18 times more likely to develop an ED.
Studies show that 35% of 'normal dieters' progress to 'pathological dieting'. And, of those, 20 − 25% progress to partial or full-syndrome ED's.
* Dieting in the onset of ED's:
In my own case of developing anorexia nervosa, at the age of 13 years, I recall my best friend started a diet. So I did too. I copied my friend - as many teenage girls do. Strangely, when I look back, I was a skinny teenager even before the ED and before the diet. I don't think the diet was so much about losing weight, for me, as it was about being competitive with my friends and keeping up with their behaviour.
However, unlike any of my friends, I couldn't stop the diet - and then the ED took over and controlled me - fairly quickly - with that very first diet.
*
My daughter's ED also began at the age of 13 years - when she began a diet with her girlfriends at high-school.
At the time she didn't even know what a diet was - because through her entire childhood I never dieted, and she'd witnessed no-one discussing or engaging in dieting. At the time her girlfriends at school refused to eat their lunch and they discussed the calorie-content of many foods.
However, none of these other girls ever developed an ED. My daughter, presumably having a genetic predisposition for ED's, like me, developed a severe case of anorexia nervosa within four weeks of beginning that first diet. And, within 12 weeks, of beginning the diet, she was admitted to hospital, for the first of many subsequent admissions over the next three years, for resuscitation and stabilisation of her fluid and nutritional state.
*
This is likely to be similar to the situation where an individual, who is prone to becoming an alcoholic or a problem-gambler, may start innocently having a little drink, with friends, or a flutter at the casino, again with friends. The friends will probably never develop a problem with addiction, but the predisposed individual might quickly develops a serious disorder.
So, a common stepping-stone into ED's is dieting - especially in the genetically predisposed. And, the scary thing is that many people are not aware that they might be genetically predisposed. In my case, I knew no-one in my extended family who had an ED. In fact I knew almost nothing about ED's - and still my horrible ED began with that very first diet.
Avoiding diets - and teaching our children to avoid diets - is, therefore, a really important step to avoiding the establishment of ED's.
Prevention is always better than cure.
* Dieting during recovery from an ED:
It is important to avoid diets, of any kind, while working towards recovery from an ED.
Even if you are planning to lose weight - to get back down into a healthy weight range (BMI 19-25) - restricting your eating will stop you from making the changes necessary to recover from the ED.
During recovery - if you are restricting your food intake, frequently weighing yourself, focusing on your weight (numbers) and your body shape - as you attempt to lose weight again - you will not be able to change your thinking and behaviour in the ways necessary for recovery.
However, the good news is that your weight will very likely return to a normal healthy range - once you learn to listen to your hunger cues, eat regularly, consume healthy foods, use a smaller dinner plate, and start a little regular moderate exercise (Ideally 30 minutes per day. You may need to check with your local doctor first if you have any current health issues) .
Changes to your weight, when you stop dieting, will be slow and steady and sustainable. That will come. Be patient, and allow those things to follow naturally.
But don't diet. Not ever again. The mantra ...
But, for now, focus simply on giving up the ED - and establishing a healthy and happy and fulfilling life.
So, no more starving (dieting) and no more binge eating. Note that if no foods are off limits and you are never hungry - then you will be far less inclined to ever binge. Binging is generally a response to severe hunger and severe food restrictions.
Dieting precipitating relapse of an ED:
Relapse of an ED is always possible. Even years after you have recovered from the ED. To prevent this - decide now that you will never diet again. Make it your mantra. If you ever feel tempted to diet - just say to yourself:
'No! I will never diet again!'.
And take a deep breath and find something else to distract yourself with ( a bath, a walk, television and so on).
For example:
- You've put on 20 kilograms while pregnant (as I did - four times!) and none of your clothes fit, and all the other new mums are dieting. Say: 'No! I will never diet again!'
- You've had a stressful day and eaten half of the chocolate cake in the fridge - as well as a burger and chips for lunch, and cheese-cake for breakfast. I did that this week - it 's a long story involving a particularly stressful and rushed day. Let it go. Don't starve yourself to make up for it. Say 'No! I will never diet again!'. Not even for a few days. Your body will adjust to this and, without giving it any thought, you will likely feel a little less 'hungry' over the next day or so. I always know that in the long run - my weight stays the same. My appetite and my natural 'body weight' sorts things out if I 'pig-out' occasionally. A big party or a big dinner out would be the same thing.
- You realise that you favourite skirt doesn't fit. You must have put on some weight. (You're unsure about your 'actual' weight - because you no longer weigh yourself regularly) . Maybe eat less cake for a day or two. I'm not kidding. That's what I do. It's not a diet. It's just a reduction in 'extra snacks' for a day or two. You'll notice - that is all that's needed. The skirt will soon fit again - within a few days usually. This is being 'mindful' (rather that fanatical - as in an ED) with your weight. Keeping a mindful check on clothes fitting; a little like watching the speedo in your car to see you're roughly in the correct range. It is all that is necessary to maintain a stable and healthy weight - I've found.
* * *
2. Diets don't work anyway.
Here's a new fact - which you've probably secretly known all along:
Diets don't work.
Ok, so here's the scientific proof.
A psychologist, Traci Mann, teaching and researching at the University of Minnesota, has been studying eating habits, self control and dieting for more than 20 years.
Her research has demonstrated why dieting over the longer term is impossible.
Research has shown that there is a 'honeymoon' phase to dieting. Any diet. Even the 'crazy' ones. This 'honeymoon' phase generally lasts between 6 − 12 months from the start of dieting. During this time a dieter can lose about 10% of their starting weight. So, someone weighing 80kg could lose around 8kg - in the short run.
But, this early phase is not the whole story. People tend to focus on this early weight loss with dieting - as if it is the 'whole story'. But it is not the whole story. It is after this phase where the problems with diets begin. And, it is the weight gain, which occurs in 95% of dieters after this honeymoon phase, which people blame on the dieters - as failures in their 'will power' - rather than acknowledging that it is the 'diets' which don't work - in the long run.
In the long run - biological changes occur - as a result of dieting - and it is these biological changes which cause the dieter to regain all the weight lost - and possibly even gain more weight than before.
Note: While 95% of dieters regain any weight lost in the diet - in the long term - you may wonder how the other 5% of dieters manage the maintain the weight lost.
Answer: With great difficulty - and struggling for the rest of their lives. It will remain for them - a daily fight against their body's biology - forever.
People have a 'set range' of weight - based on their genes. This is a weight range that they were born to be. It is inherited. And, it is known that if you lose weight, through dieting, to achieve a weight lower than this 'set weight range' - then biological changes will kick in - and effectively try to 'defend' the 'set weight range'.
When your weight goes lower than your set weight range - your body adjusts biologically to bump you back into the set range again.
However, and this is a nice thing to appreciate, if your weight goes above the 'set weight range' then you body will also make changes to take you automatically back down to your set weight range.
So, your body will adjust your weight into a set weight range for you - without you needing to diet or weigh yourself or work at it.
As I've said, my weight has kept itself within 2 kg of the same number for all of my adult life. I never diet. Ever. And I weigh myself no more than annually. And, then it's only out of curiosity, or because I think that I look gaunt - and I want to see that I've not dropped my weight lower than what is a healthy weight range (BMI 19 − 25).
So, a realistic and easily 'do-able' goal would be to aim to be in the 'lower end' of your set weight range. That is the right place and the 'easiest' place for you to be.
So, the 5% of dieters who manage to maintain a weight below their set weight range would need to defy their own biological processes working to keep them in their set range. This means that they need to devote every minute of their lives to staying at that weight. They effectively spend their entire lives living like a starving person - which is what 'dieting' is. Dieting is a lot like starving - physically. Dieters are putting themselves into the exact same state that their body would be in if they were starving. And that is why their body fights them.
Three of the major biological changes which your body uses during dieting (starving) to regain any lost weight (especially if your weight drops below your set range):
A. Neurological:
While you are dieting (starving yourself) your brain actually changes to push you to want to eat more.
Your brain becomes overly responsive to food - especially calorie-dense food. You notice food more, and it becomes more appetising and tempting. So it becomes harder to resist food.
B. Hormonal changes:
As you lose body fat - the amounts of different hormones in your body changes. Specifically, the levels of the hormones which help you to feel full - decrease, and the levels of the hormones which make you feel hungry - increase.
One of the hormones which is reduced, when your body fat is lower, is called 'leptin'. Leptin is known to decrease appetite - via the hypothalamus in the brain.
So, as your body fat reduces - you really do begin to feel more hungry!
C. Metabolic changes:
As people lose weight, below their set weight range, their metabolism slows down. You body starts to use calories more efficiently - as if you were starving - and your life depended on this. So, your body manages to conserve more calories - and store these as fat.
So, diets don't work in the long run anyway. But, the good news is - you don't need to diet - to remain a stable and healthy weight. I will discuss healthy eating at the end of this blog. A healthy plan (not a diet) where you won't be hungry, you'll be well nourished, and you can maintain your weight in a healthy and stable range - easily.
3. A vegetarian diet - if its to control or reduce your weight - then abandon it:
My advice about whether or not a vegetarian diet will hinder your recovery from an ED depends on two things:
a. When you started the vegetarian diet: Before or after the onset of your ED.
b. Why you wish to be a vegetarian: Was it for weight loss or weight maintenance reasons or for non-weight related reasons (such as ethical or purely health-related reasons).
Studies have shown a link between a vegetarian diet and anorexia nervosa.
Research studies have shown that vegetarianism is linked to anorexia nervosa.
One study (published in J. Acad. Nutr Diet. 2012) showed that individuals with an ED history were significantly more likely to:
* Ever have been a vegetarian (52% vs 12%)
* To currently be a vegetarian (24% vs 6%), and
* To be primarily motivated by weight-related reasons (42% vs 0%)
Furthermore, research at the University of Carolina (published in the same journal) has shown the following association between a vegetarianism and anorexia nervosa:
* Most (68%) of the individuals with a history of anorexia nervosa said that they felt there was a link between their vegetarianism and their ED. They reported that being a vegetarian helped them to lose weight, maintain the ED, and it gave them a way to reduce calories and feel in control.
* Most (60%) of the individuals with a history of anorexia nervosa reported that the ED preceded the onset of the vegetarianism. This finding supports other research suggesting that vegetarian diets may be used to help ongoing food restriction rather than cause the ED.
So, the studies suggest that vegetarianism may be used by some individuals as a socially acceptable way to legitimise food avoidance, avoid certain eating situations, and mask more serious eating pathology.
The vegetarian lifestyle might also further simplify the lives of individuals with eating disorders with regards to establishing clear 'do's' and 'don'ts' of eating - which aids them in their efforts at food restriction.
With regards to recovery from an ED:
The research does not show that having been a vegetarian during an ED made recovery more or less likely.
However, continuing to follow a vegetarian diet was shown to be associated with a much higher chance of not recovering from anorexia nervosa.
In one study (J Acad. Nutr Diet. 2012) the association between ongoing vegetarianism and recovery from anorexia nervosa was as follows.
(Note: All three groups below - active or recovered ED's - had similar rates of 'ever having been' vegetarian in the past - during their ED's).
* In the 'active ED' group - 33% remained vegetarian
* In the 'partly recovered from an ED' group - 13% remained vegetarian, and
* In the 'fully recovered from an ED' group - only 5% remained vegetarian.
In summary, this research suggests that if you have an ED (especially anorexia nervosa) - then you may be using vegetarianism to continue your illness. That is - to control or reduce your weight. This is especially likely if you became a vegetarian after your ED started.
So, unless your vegetarianism preceded your ED, and you are a vegetarian for reasons which are completely unrelated to weight loss or weight control - then it would help you in your recovery from an ED - if you returned to a non-vegetarian diet.
4. Get rid of your diet rules.
Eating disorders are full of rules about eating. Restrictive rules relating to food and calories and weight and exercise. So many exhausting rules!
Rules will fuel the ED. So, it is important to get rid of them in order to recover.
Also, restrictive rules will result in you eventually failing them, anyway, and result in you feeling like a failure. A loser. And you are NOT a loser. It was the rules that were ridiculous and too hard for anyone to follow endlessly, and the rules are completely unnecessary. The rules need to be trashed!
Note: In cases of restrictive anorexia nervosa - more than 60% of sufferers will fail their restrictive calorie rules - and this will result in them 'binge - eating'.
You'll need to be brave and prepare yourself for change. You will be fine. You can do it. Start gradually - in tiny steps - with clear goals to work towards.
You might start with a list of your rules - and plan each week - in small steps - to ease up on each one of the rules.
* For a start, you could rename the 'rules' to 'guidelines'.
So, in this way, you won't feel that you've 'broken a rule' - as it was only a guideline. This allows your thinking to be less 'black and white' - and you'll feel less upset and self-critical if you don't follow the 'rule' - as it was only a 'guideline'. This small change is a healthy and positive start.
Black and white ('All or none thinking) can also lead to 'binge eating' in an ED - as an individual with this thinking style might consider that as they broke a 'rule' - then they may as well 'abandon all control' and binge. For example, they might think, 'Well I've blown it now, I may as well continue …'
This is especially likely if the individual feels bad and depressed about the broken rule - and they were starving hungry as well (on a very restrictive daily calorie intake).
This is all sounding very familiar I am sure - if you suffer with an ED. So, you will know, now, that you are not alone. Other people know how you feel and what the illness does to you. There is hope for recovery. You can get better. Just little steps and hope and asking for help. You can do it. Recovery is possible.
Rules in ED's are restrictive and punitive and unreasonable. They may include things like:
a. The number of calories eaten daily: Eat what you need to feel comfortably sated.
A universal ED rule would be to consume a very low number of calories each day. Much less than your body requires. This will result in many of your pathological eating behaviours and drive your constant hunger and endless thoughts about food.
This is the rule which should be abandoned.
As I have explained in the section above (why diets don't work) - if you eat less calories than your body needs - then you will struggle and fight against your own biology. This will be an endless struggle fought every minute of every day for the rest of your life.
But, if you eat when you're hungry - so that you are no longer 'hungry' - but not yet full (ie comfortably 'sated') - then your body will find your healthy 'set weight range'.
As I have explained earlier in this blog, you could always choose to sit at the lower end of your 'set weight range' - and that is a nice compromise to the ED.
In France there is a phrase: 'Je n'ai pas faim'.
This translates as: 'I do not have hunger.' So, it is perfectly healthy and fine to eat enough to no longer be hungry - but not yet full.
This will allow your body to find its way back to your set range - even if you are currently above the healthy recommended weight range (BMI: 19 − 25) - without 'dieting' or 'restricting your calorie intake' - which will hinder your recover from an ED.
Another detail here: Don't read the calories of the foods you eat. Don't count them up. Just stop. Trust that your body will find the correct 'set weight range' for you. And that included the fact that your body will pull you back down into the normal set weight range as well - if you happen to eat more than you need.
Learn to trust your body again. Listen to your hunger and eat regularly - as I will explain.
b. Eat regularly through the day: Three meals and three snacks.
Other ED rules often relate to how often you eat through the day.
Some ED sufferers starve themselves all day - and only eat when they get home at night. Others skip different meals through the day, avoid any snacks , or even fast for days at a time.
Whatever your ED diet rules are - relating to the frequency that you eat - I would advise that you toss them out - and resolve to eat three meals and three snacks per day. This equates to eating every two to three hours through the day.
It is worth noting that even fasting for as little as five hours will results in the physiological changes in your body to cope with 'starvation'. These changes include things like - slowing of your metabolic rate, feelings of hunger, light-headedness, finding it harder to concentration, and so on.
c. Eat a range of foods.
Other ED rules that you have may include lists of 'good' and 'bad' foods. In fact your list of foods which you allow yourself to eat - is probably a very short one. It is also very likely a list of very low calorie foods.
I will discuss the 'healthy eating' advice at the end of this blog. However, suffice to say that recovery from your ED will involve 'dumping' the list - and substituting it for a range of foods which will be nourishing, healthy and be more a 'guideline'. This means that some foods, while they may not be nourishing and they may not be terribly 'healthy' can become 'sometimes' foods.
By doing this - you'll be able to learn to enjoy food again - and 'crave' these foods less (because they're not banned), and socialise with your friends and family enjoying foods like pizza and burgers and chips and cake sometimes - without guilt and self loathing.
The key is 'moderation and balance' with less black and white thinking.
How to start?
You could start by adding a single extra food item to your list of 'OK' foods - each week. Initially you might add foods which don't scare you too much - healthier and lower calorie foods like different fruits and vegetables. Later, you might gradually add the foods which are harder for you to try - higher calorie and less healthy foods like cake or biscuits. You could remind yourself that these foods might just be eaten on weekends or only once per day and in a small amount.
So, the point is not to get you eating a regular junk food diet. The point is to get rid of 'rules'. Replace rules with flexible 'guidelines' and see less healthy foods as foods which are eaten only sometimes.
You can still be a healthy and stable weight - eating a diverse range of foods in a balanced and moderate way.
The trick is little steps and a clear goal to work towards. (See recommended food guide at the end of this blog: The 'Healthy Food Pyramid and Plate'.)
d. Eat with other people again.
ED rules often include do's and don'ts about who you can eat with - and where.
Many people with ED's choose to eat alone. This can be socially isolating and is another rule which should be abandoned.
You could, once again, plan how to start eating with other people gradually. Like introducing different foods into your diet - starting with the least scary ones; you could start to eat food with the people with whom you feel the most comfortable. It might be starting with something small and easy at first. Maybe having a glass of water with your mother or sister or someone you feel safe with. Maybe your psychologist or your GP. Gradually, in little steps, you could broaden this to other people and new situations.
Think of each little step as a very long journey to recovery - taken with a clear goal in mind. But each tiny step will make the next step easier. Ask for help and be kind to yourself along the way.
You could even precede each step with 'visualising' it first:
Imagine taking the next step in your head. Experience how you feel. Tell yourself that you are safe. This will make each actual step you take easier. Your brain will actually have changed with the thoughts. (This was discussed in the ED blog discussing neuroplasticity). Visualisation is a powerful tool which can help you to recover from your ED. But it can help you in other scary challenges you face in life later on. I used 'visualisation' to help me through some big medical specialty exams. And it worked! I felt so much more calm when I actually did those exams - and I passed them. There's some inspiration for you.
You can do this too. I recovered from my ED - as did my daughter. You can as well. Be patient and kind to yourself. And have a plan with a clear goal at the end.
e. Any other food rules you have.
No more rules. Only healthy and moderate guidelines.
Other rules might include things like:
Not sitting down to eat; only eating at home and when alone; eating less than everyone else; cutting your food into tiny pieces, and so on.
Write down any other rules you have and plan the little steps needed to live without them. Little steps. Slow. Be patient with yourself. Seek support and help - when you need it. Use visualisation to help you imagine calmly achieving each new step to recovery.
5. Don't weigh yourself. Or, if you feel that you must, limit how often.
I suffered with an ED for three years - over 30 years ago. I have never relapsed since then. My weight has remained the same.
I don't need to weigh myself. My clothes fit so I know I'm roughly the same weight. If my clothes feel a little tight - I just cut back on cake and chocolate for a couple of days. Also, note that I said: 'Cut back' on cake. Not: 'stop' cake.
My point: Don't be a slave to the scales. Don't be a slave to numbers.
ED's are filled with way too many numbers: calories, exercise repetitions, weight - kilograms and pounds …
Enough!
You don't need to know.
But, if you really must - I would suggest weighing yourself no more frequently than monthly.
As with all the other changes we've discussed, start weaning slowly.
Maybe reduce to alternate day weighs, if you had been weighing yourself daily. Slowly reduce with a goal in mind (ie goal to reduce weighs to fortnightly or monthly).
As time goes by - you might do my trick: Just see that your clothes fit - and leave it at that.
6. A healthy eating plan:
So far, in this blog, I've discussed many features of the ED which need to be tossed into the bin: the ED rules, the diets (including vegetarianism in most cases); the scales; the self-loathing ...
Now, I'll discuss something which can fill the void created by all this 'spring cleaning' : A healthy eating plan. (I'll discuss other lovely things to focus, away from the ED, in subsequent blogs: hobbies, achievable goals and challenges, spirituality, relaxation, and so on). But, as far as food goes - this is it:
Most people are familiar with the Food Guide Pyramid. This was designed nearly twenty years ago by the U.S. Department of Agriculture (USDA). The image demonstrated what the USDA said were the elements of a healthy diet.
Since then, there have been major advances in our understanding of the connection between diet and health.
The USDA retired the Food Guide Pyramid in 2005. There have been a few different revisions of it since then - but most recently the Harvard School of Public health created The Healthy Eating Pyramid (2008) and the companion Healthy Eating Plate (2011) - both based on the latest scientific research.
The plan is that the food recommendations, and modifications to the pyramid and the plate graphics, will be reviewed regularly (at least every five years) taking into consideration the very latest in scientific research.
* I have put the Healthy Eating Pyramid and the Healthy Eating Plate diagrams at the end of this blog.
You may even like to print them out - to put onto your fridge as a visual guide to healthy eating and healthy grocery shopping.
The Healthy Eating Pyramid and the Healthy Eating Plate are clear and simple schematic diagrams which give an instant guide to the recommended types of foods and proportions of those foods to be eaten each day in order to remain healthy and in the healthy weight range.
The healthy eating pyramid also addresses other aspects of a healthy lifestyle:
- exercise (half hour per day is recommended);
- weight control (in a stable and healthy range (BMI: 19 − 25));
- multi-vitamin tablet (with vitamin D: aim for 800 − 1000 IU (international units)).
The Healthy Eating Pyramid and Plate complement each other. Both emphasize food which promotes good health. Both encourage people to limit or avoid foods and drinks which are harmful, or provide a lot of empty calories (calorie dense but little nutrition).
The diagrams are not rigid guides. They don't dictate exact quantities of foods or which foods exactly you must eat. They are meant simply to be a flexible guide for you to create your own menus and grocery lists - based on the foods you enjoy - and how hungry you are - which will be determined by your size and activity levels.
Obviously, someone who is smaller and inactive will need less food (directed by their own 'hunger' - to decide how much to eat) than someone who is larger and very active. Alternatively, you may need to eat more on days when you are more physically active.
You'll know how much to eat because, as we've discussed, when you don't restrict your eating - and you re-learn how to listen to your own hunger and appetite cues - you'll eat what you like (directed I hope by the diagrams) and how much you need - until you are no longer hungry - but not yet full. In this way your weight will return to a stable level in your 'set weight range'.
The Healthy Eating diagrams can be used by vegetarians - as well as non-vegetarians.
Vegetarians can follow the plans by emphasizing - nuts, beans, other plant sources of protein. Plus non-dairy sources of calcium and vitamin D.
Non-vegetarians can choose, instead, fish or chicken for protein, with occasional red meat.
If you choose a variety of 'fresh', whole foods from all the food groups below the 'use sparingly' category you'll ensure that you get the nutrients you need, and you'll reduce your salt intake a lot. This is because 'processed' foods (ie. deli meats, chips, canned soups, frozen dinners) contain most of the salt in western diets.
The only truly 'off-limits' foods are foods which contain 'trans-fats' - from partially hydrogenated oils. These should be listed on labels in Australia, US and Canada.
The guidelines might result in your weekly grocery shop coming to resemble the diagrams:
vegetables, fruits, wholegrains, healthy oils, healthy proteins - like nuts, beans, fish, and chicken. Plus a little yogurt and milk - if you like. Ideally skip (or greatly reduce) - soft drinks, the snack-food aisle, the deli-counter, and, only occasionally, visit the butcher counter for steaks and chops.
A few extra details to explain further the Healthy Eating Pyramid and Plate:
1. Vegetables and fruit:
A diet rich in fruit and vegetables will have many benefits:
- It decreases the chance of having a heart attack or stroke.
- It may protect against some cancers
- It is associated with lower blood pressure
- It guards against cataracts and macular degeneration (the major causes of vision loss in people over 65 years).
Note: Potatoes don't count as a vegetable as they have a high glycemic index (GI).
* (High GI foods cause blood sugar and insulin levels to rise and fall quickly - resulting in increased hunger, weight gain and difficulty with weight-control, and the development of type 2 diabetes and heart disease).
2. Whole grains:
The body uses carbohydrates mainly for energy. It can get carbohydrates from many sources.
Healthy sources include: beans, vegetables, fruit, whole grains (oatmeal, whole wheat bread, brown rice).
Unhealthy sources: sugary drinks, sweets, refined grains.
Whole grains have a low GI - which, as discussed, causes slower, steadier increases in blood sugar - which is a good thing for your body and energy levels and weight control.
Conversely, refined grains should be eaten sparingly: white bread, white rice, white pasta, other refined grains, potatoes, sugary drinks and sweets.
The fast and large increases in blood sugar levels associated with these foods can lead to weight gain, diabetes, heart disease, and other chronic diseases.
3. Protein:
Fish, chicken and eggs are good sources of protein.
Fish: Research has shown that eating fish can reduce the risk of heart disease because it is a rich source of heart-healthy omega-3 fats. Ideally, fish should be eaten at least twice per week.
Chicken: This is a good source of protein and it can be low in fat.
Eggs: It is suggested that if you have diabetes or heart disease it is best to limit yourself to not more than three egg yolks per week. Egg whites, however, are fine - and these can substitute 'whole' eggs in omelettes and baking.
Red meat and processed meat: Red meat and processed meat contain a lot of saturated fats - so, like butter, these foods are at the top of the pyramid diagram - indicating that they should be eaten sparingly. Maybe, once per week.
High intakes of red meat, such as beef, pork, and lamb are associated with a higher risk of heart disease, diabetes, and colon cancer.
Processed meats (such as bacon, hot dogs, and deli meats) are also very high in added sodium. These meats are even more strongly linked to heart disease and diabetes.
4. Dairy (1 − 2 serves per day) or vitamin D/ calcium supplements:
It is advised that you don't consume too much dairy.
Building healthy bones requires calcium, vitamin D, exercise, and many other things.
Three glasses of milk (three serves dairy) provides more calcium than is needed each day, but not enough vitamin D.
However, high dairy intake is linked to prostate cancer and possibly ovarian cancer.
So, it is advised that only 1 − 2 serves of dairy/day should be consumed along with a multivitamin capsule with adequate vitamin D (800 − 1000 IU/day).
The multivitamin tablet can also fill any gaps in your diet.
The extra vitamin D has been shown to help lower the risk of colon and breast cancer.
5. Healthy fats and oils:
These fats are the key to a healthy heart and a lower risk of developing diabetes.
Good sources: Healthy unsaturated fats include:
- olive oil, canola, soy, corn, sunflower, peanut, and other vegetable oils;
- trans-fat - free margarine;
- nuts, seeds, avocado;
- fatty fish such as salmon.
These healthy fats not only improve cholesterol (when eaten in place of highly processed carbohydrates), but the fats in the fish can protect the heart from sudden and potentially fatal rhythm problems.
6. Minimise salt:
Most salt in our diet comes from processed foods - such as cheese, breads, deli meats, spaghetti with sauce, and food prepared away from home.
7. Drinks:
It is advisable to complete each meal with a glass of water. Or, if you prefer, a cup of tea or coffee. The latter drinks are low in calories and have additional health benefits.
But, as we've said, limit milk to 1-2 servings per day, limit juice to one small glass each day, and try to avoid sugary drinks.
Finally, some inspiring research findings about the benefits of a healthy diet:
1. The Harvard School of Public Health researchers looked at 100,000 female nurses and male health professionals taking part in a long-term study.
They collected information about their daily diets over 8 − 12 years. They found the following:
- Men whose diets most closely followed the Healthy Eating Pyramid guidelines were 20% less likely to have developed a major chronic disease, than those whose diet followed it the least, and almost 40% less likely to have developed cardiovascualr disease.
For women the reduction in major chronic disease was 11% less - for those whose diet most closely followed the Healthy Eating Pyramid compared to those whose diet follwed it the least, and almost 30% less likely to have developed cardiovascular disease.
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2. Another recent study which gives further evidence of the 'disease-prevention' benefits that result from following a diet similar to the Healthy Eating Pyramid.
The study tracked 7,319 British civil servants for 18 years and found that men and women whose diet most closely followed the Healthy Eating Pyramid had a 25% lower risk of dying of any cause, and a 42% lower risk of dying from heart disease - when compared to people whose diet followed the Healthy Eating Pyramid the least.
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