Diet
Better Health and You: Tips for Adult
Just Enough for You: About Food Portions
Very-Low-Calorie Diets
Better Health and You: Tips for Adult
The basis of a healthy diet is eating a wide variety of foods. Every day,
you should try to eat:*
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6 to 11 servings of bread, cereal, rice, or pasta. One serving equals
one slice of bread, about 1 cup of ready-to-eat cereal, or 1/2 cup cooked
cereal, rice, or pasta.
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3 to 5 servings of vegetables. One serving equals 1 cup of raw leafy vegetables,
or 1/2 cup of other vegetables, cooked or raw.
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2 to 4 servings of fruit. One serving equals one medium apple, banana,
or orange; 1/2 cup of chopped, cooked, or canned fruit; or 3/4 cup of fruit
juice.
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2 to 3 servings of milk, yogurt, or cheese. One serving equals 1 cup of
milk or yogurt, 1 1/2 ounces of natural cheese (such as Cheddar), or 2
ounces of processed cheese (such as American). Choose low-fat or fat-free
products most often.
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2 to 3 servings of meat, poultry, fish, dry beans, eggs, or nuts. One
serving equals 2 to 3 ounces of cooked lean meat, poultry without skin,
or fish. You should eat no more than 5 to 7 ounces per day. One half cup
of cooked dry beans, one egg, or 1/2 cup of tofu counts as 1 ounce of meat.
Two tablespoons of peanut butter or 1/3 cup of nuts counts as 1 ounce of
lean meat.
The larger number of servings is for active men. Eat a smaller number of servings
if you are a woman, inactive, or trying to lose weight.
* Servings and serving sizes are from the U.S. Department of Agriculture/Department
of Health and Human Services Food Guide Pyramid
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1/2 cup of rice or pasta = size of ice cream scoop
1 cup of salad greens = size of a baseball
1/2 cup of chopped fruit or vegetables = size of a lightbulb
1 1/2 ounces of cheese = size of four dice
3 ounces of meat or fish = size of a deck of cards or cassette
tape
2 tablespoons peanut butter = size of a ping pong ball
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- Eat breakfast every day. People who eat breakfast are less likely
to overeat later in the day. Breakfast also gives you energy and helps you
think and learn.
- Choose whole grains more often. Try whole wheat breads and pastas,
oatmeal, brown rice, or bulgur.
- Select a mix of colorful vegetables each day. Different colored
vegetables provide different nutrients. Choose dark, leafy greens such as
kale, collards, and mustard greens, and reds and oranges such as carrots,
sweet potatoes, red peppers, and tomatoes.
- Choose fresh or canned fruit more often than fruit juice. Fruit
juice has little or no fiber.
- Use fats and oils sparingly. Olive, canola, and peanut oils, avocados,
nuts and nut butters, olives, and fish provide heart-healthy fat as well
as vitamins and minerals.
- Eat sweets sparingly. Limit foods and beverages that are high in
added sugars.
- Eat three meals every day instead of skipping meals or eating a
snack instead of a meal.
- Have low-fat, low-sugar snacks on hand at home, at work, or on the
go, to combat hunger and prevent overeating.
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- low-fat yogurt sprinkled with low-fat granola
- oatmeal with low-fat or fat-free milk, or soy-based beverage
- whole wheat toast with thin spread of peanut butter
- fruit smoothie made with frozen fruit, low-fat yogurt, and juice
- low-sugar cereal with soy-based beverage
- low-fat or fat-free yogurt
- rice cakes
- fresh or canned fruits
- sliced vegetables or baby carrots
- dried fruit and nut mix (no more than a small handful)
- air-popped popcorn sprinkled with garlic powder or other spices
- low-sugar cereal
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Body mass index (BMI) is one way to tell whether you are at a healthy weight,
overweight, or obese. It measures your weight in relation to your height. A
BMI of 18.5 to 24.9 is in the healthy range. In the chart below, find your
height in the left-hand column and move across the row to find your weight.
If you are in the overweight or obese range on the chart, you are more likely
to have certain health problems.
*Without shoes **Without clothes
Another way to find out if you are at risk for health problems caused by overweight
and obesity is to measure your waist. If you are a woman and your waist is
more than 35 inches, or if you are a man and your waist is more than 40 inches,
your risk of disease is higher.
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Extra weight can put you at higher risk for:
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type 2 diabetes (high blood sugar)
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high blood pressure
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heart disease and stroke
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some types of cancer
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sleep apnea (when breathing stops for short periods during sleep)
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osteoarthritis (wearing away of the joints)
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gallbladder disease
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irregular periods
- problems with pregnancy such as high blood pressure or increased risk for
cesarean section (c-section)
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People gain weight when the number of calories they eat is more than the number
of calories their bodies use. Many factors can play a part in weight gain.
- Habits. Eating too many calories can become a habit. So can choosing
activities like watching TV instead of being physically active. Over time,
these habits can lead to weight gain.
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Genes. Overweight and obesity tend to run in families. Although
families often share diet and physical activity habits that can play a
role in obesity, their shared genes increase the chance that family members
will be overweight.
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Illness. Some diseases can lead to weight gain or obesity. These
include hypothyroidism, Cushing's syndrome, and depression. Talk to your
health care provider if you think you have a health problem that could
be causing you to gain weight.
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Medicine. Some medicines can lead to weight gain. Ask your
health care provider or pharmacist about the side effects of any medication
you are taking.
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The world around you. You can find food and messages about
food at home, at work, at shopping centers, on TV, and at family and social
events. People may eat too much just because food is always there. On top
of that, our modern world—with remote controlled televisions, drive-in
banks, and escalators—makes it easy to be physically inactive.
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Emotions. Many people eat when they are bored, sad, angry, or stressed,
even when they are not hungry.
Although you may not be able to control all the factors that lead to overweight,
you can change your eating and physical activity
habits.
Losing as little as 5 to 15 percent of your body weight over 6 months or longer
can do much to improve your health. For example, if you weigh 200 pounds, losing
5 percent of your body weight means losing 10 pounds. Losing 15 percent of
your body weight means losing 30 pounds. A safe rate of weight loss is 1/2
to 2 pounds per week.
Try some of these ideas to support your weight loss efforts:
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Shop from a list and shop when you are not hungry.
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Store foods out of sight.
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Dish up smaller servings. At restaurants, eat only half your meal and
take the rest home. See WIN's brochure Just Enough for You, About Food
Portions for more tips on controlling portion size.
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Eat at the table with the TV off.
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Be realistic about weight loss goals. Aim for a slow, modest weight loss.
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Seek support from family and friends.
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Expect setbacks and forgive yourself.
- Add physical activity to your weight-loss plan. Doing regular physical
activity can help you control your weight.
Write down all the food that you eat in a day. Also write down the time
you eat and your feelings at the time.
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You do not have to be an athlete to benefit from regular physical activity. Even
modest amounts of physical activity can improve your health. Start with small,
specific goals such as walking 10 minutes a day, 3 days a week and slowly build
up from there. Keep an activity log to track your progress.
Try these activities to add more movement to your daily life:
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Take the stairs instead of the elevator. Make sure the stairs are well
lit.
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Get off the bus one stop early if you are in an area safe for walking.
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Park the car farther away from entrances to stores, movie theatres, or
your home.
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Take a short walk around the block with family, friends, or coworkers.
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In bad weather, walk around a mall.
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Rake the leaves or wash the car.
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Visit museums, the zoo, or an aquarium. You and your family can walk for
hours and not realize it.
- Take a walk after dinner instead of watching TV.
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As you become more fit, slowly increase your pace, the length of time you
are active, and how often you are active. Before starting a vigorous physical
activity program, check with your health care provider if you are a man and
over age 40 or a woman and over age 50, or have chronic health problems.
For a well-rounded workout plan, combine aerobic activity, muscle-strengthening
exercises, and stretching. Do at least 30 minutes a day of moderate physical
activity on most or all days of the week. Add muscle-strengthening activities
to your aerobic workout two to three times a week.
To reduce the risk of injury, do a slow aerobic warm-up, then stretch before
aerobic or strengthening activities. Follow your workout with a few more minutes
of stretching. See WIN's brochure Walking-A Step in the Right Direction for
stretching exercises.
Aerobic activity is any activity that speeds up your heart and breathing
while moving your body at a regular pace. If you have been inactive for a while,
you may want to start with easier activities such as walking at a gentle pace.
This lets you build up to more intense activity without hurting your body.
Regular aerobic activity can help to:
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Control weight. Aerobic activity burns calories, which may help
you manage your weight..
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Prevent heart disease and stroke. Regular aerobic activity can
strengthen your heart muscle and lower your blood pressure. It may also
help lower cholesterol, a type of fat in your blood.
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Maintain strong bones. Weight-bearing aerobic activities that involve
lifting or pushing your own body weight, such as walking, jogging, or dancing,
help to maintain strong bones.
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Improve your outlook. Aerobic exercise relieves tension and decreases
stress. As you get fit, it can help to build confidence and improve your
self-image.
Choose aerobic activities that are fun. People are more likely
to be active if they like what they are doing. It also helps to get support
from a friend or a family member. Try one of these activities or others you
enjoy:
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brisk walking or jogging
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bicycling
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swimming
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aerobic exercise classes
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dancing (square dancing, salsa, African dance, swing)
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playing basketball or soccer
Strengthening activities include lifting weights, using resistance
bands, and doing push-ups or sit-ups. Besides building stronger muscles, strengthening
activities may help you to:
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Use more calories. Not only does the exercise burn calories, but
having more muscle means you will burn more calories-even when you are
sitting still.
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Reduce injury. Stronger muscles improve balance and support your
joints, lowering the risk of injury.
- Maintain strong bones. Doing strengthening exercises regularly helps
build bone and may prevent bone loss as you age.
Strengthening exercises should focus on working the major muscle groups of
the body, such as the chest, back, and legs. Do exercises for each muscle group
two or three times a week. Allow at least 1 day of rest for your muscles to
recover and rebuild before another strengthening workout. (It is safe to do
aerobic activity every day.)
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Many people feel stress in their daily lives. Stress can cause you to overeat,
feel tired, and not want to do anything. Regular physical activity can give
you more energy. Try some of these other ideas to help relieve stress and stay
on track with your fitness and nutrition goals:
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Get plenty of sleep.
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Practice deep breathing and relaxing your muscles one at a time.
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Take a break and go for a walk.
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Take short stretch breaks throughout the day.
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Try taking a yoga or tai chi class to energize yourself and reduce stress.
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Try a new hobby, like a pottery class or any activity that sparks your
interest.
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Surround yourself with people whose company you enjoy.
A balanced eating plan, regular physical activity, and stress relief can help
you stay healthy for life.
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- Eat breakfast every day. People who eat breakfast are less likely to overeat
later in the day.
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Choose whole grains more often. Try whole wheat breads and pastas, oatmeal,
brown rice, or bulgur.
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Select a mix of colorful vegetables each day. Different colored vegetables
provide different nutrients.
- Eat three meals every day instead of skipping meals or eating a snack instead
of a meal.
-
Have low-fat, low-sugar snacks on hand at home, at work, or on the go,
to combat hunger and prevent overeating.
- At restaurants, eat only half your meal and take the rest home.
- Visit museums, the zoo, or an aquarium. You and your family can walk for
hours and not realize it.
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Just Enough for You: About Food Portions
Have you noticed that the size of muffins, candy bars, and soft drinks has
grown over the years? How about portions of restaurant foods like pasta dishes,
steaks, and french fries? As portion sizes grow, people tend to eat more-often
more than they need to stay healthy.
Larger food portions have more calories. Eating more calories than you need
may lead to weight gain. Too much weight gain can put you at risk for weight-related
diseases like type 2 diabetes, heart disease, and some cancers.
Managing your weight calls for more than just choosing a healthful variety
of foods like vegetables, fruits, grains (especially whole grains), beans,
and low-fat meat, poultry, and dairy products. It also calls for looking at how
much and how often you eat. This brochure shows you how to use serving
sizes to help you eat just enough for you.
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A "portion" is how much food you choose to eat, whether in a restaurant, from
a package, or in your own kitchen. A "serving" is a standard amount set by
the U.S. Government, or sometimes by others for recipes, cookbooks, or diet
plans. There are two commonly used standards for serving sizes:
The United States Department of Agriculture (USDA) Food Guide
Pyramid is a healthy eating plan for people ages 2 and over. It shows
the recommended number of servings to eat from each of five food groups every
day to meet your nutrition needs, and it defines serving sizes. (For more
information, see The Food Guide Pyramid under Additional Reading.)
The Food and Drug Administration (FDA) Nutrition Facts Label is printed
on most packaged foods. It tells you how many calories and how much fat, carbohydrate,
sodium, and other nutrients are in one serving of the food. The serving size
is based on the amount of food people say they usually eat in one sitting.
This size is often different than the serving sizes in the Food Guide Pyramid.
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The
portion size that you are used to eating may be equal to two or three standard
servings. Take a look at this Nutrition Facts label for cookies. The serving
size is two cookies, but if you eat four cookies, you are eating two servings-and
double the calories, fat, and other nutrients in a standard serving.
To see how many servings a package contains, check the "servings per container" listed
on the Nutrition Facts label. You may be surprised to find that small containers
often have more than one serving inside.
Learning to recognize standard serving sizes can help you judge how much you
are eating. When cooking for yourself, use measuring cups and spoons to measure
your usual food portions and compare them to standard serving sizes from Nutrition
Facts labels for a week or so. Put the measured food on a plate before you
start eating. This will help you see what one standard serving of a food looks
like compared to how much you normally eat.
Another way to keep track of your portions is to use a food diary. Writing
down when, what, how much, where, and why you eat can help you be aware of
the amount of food you are eating and the times you tend to eat too much. The
chart below shows what 1 day of a person's food diary might look like.
After reading the food diary, you can see that this person chose sensible
portion sizes for breakfast and lunch-she ate to satisfy her hunger. She had
a large chocolate bar in the afternoon for emotional reasons-boredom, not in
response to hunger. If you tend to eat when you are not hungry, try doing
something else, like taking a break to walk around the block or call a friend,
instead of eating.
By 8 p.m., this person was very hungry and ate large portions of higher-fat,
higher-calorie foods. If she had made an early evening snack of fruit or pretzels,
she might have been less hungry at 8 p.m. and eaten less. She also may have
eaten more than she needed because she was at a social event, and was not paying
attention to how much she was eating. Through your diary, you can become
aware of the times and reasons you eat too much, and try to make different
choices in the future.
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You do not need to measure and count everything you eat for the rest of your
life-just long enough to recognize standard serving sizes. Try these other
ideas to help you control portions at home:
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Take a standard serving out of the package and eat it off a plate
instead of eating straight out of a large box or bag.
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Avoid eating in front of the TV or while busy with other activities. Pay
attention to what you are eating and fully enjoy the smell and taste of
your foods.
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Eat slowly so your brain can get the message that your stomach
is full.
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Take seconds of vegetables or salads instead of higher-fat, higher-calorie
parts of a meal such as meats or desserts.
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When cooking in large batches, freeze food that you will not serve
right away. This way, you won't be tempted to finish eating the whole
batch before the food goes bad. And you'll have ready-made food for another
day. Freeze in single-meal-sized containers.
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Try to eat three sensible meals at regular times throughout the
day. Skipping meals may lead you to eat larger portions of high-calorie,
high-fat foods at your next meal or snack. Eat breakfast every day.
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Keep snacking to a minimum. Eating many snacks throughout the day
may lead to weight gain.
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When you do have a treat like chips, cookies, or ice cream, eat
only one serving, eat it slowly, and enjoy it!
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Have you noticed that it only costs a few cents more to get a larger size
of fries or soft drink? Getting a larger portion of food for just a little
extra money may seem like a good value, but you end up with more food and calories
than you need.
Before you buy your next "value combo," be sure you are making the best choice
for your health and your wallet. If you are with someone else, share
the large-size meal. If you are eating alone, skip the special deal and just
order what you need.
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Research shows that the more often a person eats out, the more body fat he
or she has. Try to prepare more meals at home. Eat out and get take-out foods
less often. When you do eat away from home, try these tips to help you control
portions:
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Share your meal, order a half-portion, or order an appetizer as
a main meal.
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Take half or more of your meal home. You can even ask for your
half-meal to be boxed up before you begin eating so you will not be tempted
to eat more than you need.
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Stop eating when you begin to feel full. Focus on enjoying the
setting and your friends or family for the rest of the meal.
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Avoid large beverages, such as "supersize" soft drinks. They have
a large number of calories. Order the small size, choose a calorie-free
beverage, or drink water with a slice of lemon.
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When traveling, bring along nutritious foods that will not spoil
such as fresh fruit, small cans of fruit, peanut butter and jelly (spread
both thin) sandwiches, whole grain crackers, carrot sticks, air-popped
popcorn, and bottled water. If you stop at a fast food restaurant, choose
one that serves salads, or order the small burger with lettuce and tomato.
Have water or nonfat milk with your meal instead of a soft drink. If you
want french fries, order the small size.
The amount of calories you eat affects your weight and health. In addition
to selecting a healthful variety of foods, look at the size of the portions
you eat. Choosing nutritious foods and keeping portion sizes sensible may help
you reach and stay at a healthy weight.
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Very-Low-Calorie Diets
Obesity affects nearly one-third of adults in the United States, increasing
their risk for diabetes, high blood pressure, and heart disease. Traditional
weight loss methods include low-calorie diets from 800 to 1,500 calories a
day and regular physical activity. Health care providers sometimes consider
an alternative method for bringing about significant short-term weight loss
in patients who are moderately to extremely obese: the very-low-calorie diet.
VLCDs are commercially prepared formulas of about 800 calories that replace
all usual food intake for several weeks or months. VLCDs are not the same as
over-the-counter meal replacements, which are meant to substitute for one or
two meals a day. VLCDs, when used under proper medical supervision, effectively
produce significant short-term weight loss in patients who are moderately to
extremely obese.
Studies have shown that meal replacements at higher calorie levels (800 –
1000 calories) produce weight loss similar to that seen with much lower calorie
levels, probably due to better compliance with the diet. In addition, VLCDs
are usually part of weight-loss treatment programs that include other techniques
such as behavioral therapy, nutrition counseling, physical activity, and/or
drug treatment.
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VLCDs are intended to produce rapid weight loss at the start of a weight-loss
program in patients with a body mass index (BMI) greater than 30. BMI correlates
significantly with total body fat content. It is calculated by dividing weight
in kilograms by height in meters squared, or by dividing weight in pounds by
height in inches squared and multiplying by 703.
Use of VLCDs in patients with a BMI of 27 to 30 should be reserved for those
who have medical complications resulting from their overweight. VLCDs are not
recommended for pregnant or breastfeeding women. VLCDs are not appropriate
for children or adolescents, except in specialized treatment programs.
Very little information exists regarding the use of VLCDs in older people.
Because people over age 50 already experience normal depletion of lean body
mass, use of a VLCD may not be warranted. Also, people over 50 may not tolerate
the side effects associated with VLCDs because of preexisting medical conditions
or need for other medications. Physicians must evaluate on a case-by-case basis
the potential risks and benefits of rapid weight loss in older individuals,
as well as in people with significant medical problems or who are on medications.
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A VLCD may allow a patient who is moderately to extremely obese to lose about
3 to 5 pounds per week, for an average total weight loss of 44 pounds over
12 weeks. Such a weight loss can rapidly improve obesity-related medical conditions,
including diabetes, high blood pressure, and high cholesterol.
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Many patients on a VLCD for 4 to 16 weeks report minor side effects such as
fatigue, constipation, nausea, and diarrhea, but these conditions usually improve
within a few weeks and rarely prevent patients from completing the program.
The most common serious side effect is gallstone formation. Gallstones, which
often develop anyway in people who are obese, especially women, are even more
common during rapid weight loss. Research indicates that rapid weight loss
may increase cholesterol levels in the gallbladder and decrease its ability
to contract and expel bile. The drug ursodiol can prevent gallstone formation
during rapid weight loss, but is not often used for this purpose.
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Studies show that the long-term results of VLCDs vary widely, but weight regain
is common. Combining a VLCD with behavior therapy and physical activity may
help increase weight loss and slow weight regain. In the long term, however,
VLCDs are no more effective than more modest dietary restrictions.
For most people who are obese, obesity is a long-term condition that requires
a lifetime of attention even after formal weight loss treatment ends. Therefore,
health care providers should encourage patients who are obese to commit to
permanent changes of healthier eating, regular physical activity, and an improved
outlook about food.
Endnote: This fact sheet is an updated, modified version of a previously
published review article appearing in the August 25, 1993 issue of the Journal
of the American Medical Association. Both the review article and this fact
sheet were developed with the advice of the National Task Force on Prevention
and Treatment of Obesity.
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