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Nutrition & Weight Control

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Your Dietary Arsenal Against 8 Serious Disorders

Many people believe that dietary changes made later in life are of little consequence. In fact, changing dietary habits at mid-life or even later is a powerful weapon against several leading chronic diseases. The amount and types of food you eat may determine whether and when you develop a disorder that reduces your quality of life (such as osteoporosis) or a life-threatening disorder (such as cancer or coronary heart disease).

In surveys of nutrition habits, people cite a multitude of obstacles to practicing good nutrition: time constraints, the availability of packaged and processed foods, the perception that they will have to give up their favorite foods, and confusion over conflicting information on nutrition. The steps for dietary changes outlined here are simple and direct—and because many of these recommendations overlap, following even one or two can help protect against several disorders.

The recommendations for preventing coronary heart disease (CHD), hypertension (high blood pressure), diabetes, and osteoporosis are based on solid, consistent scientific findings. They also take into account recently revised guidelines for sodium and potassium intake. Although many of the recommendations for cancer prevention are less certain, a growing body of evidence suggests that they are protective. Experts estimate that about 35% of all cancers are related to dietary factors and that a high intake of fruits and vegetables can cut cancer risk in half.

CHD and Stroke

Limit saturated fat and trans fatty acids to less than 10% of calories (or less than 7% if you have high blood cholesterol levels). You can accomplish this by restricting your intake of the major sources of saturated fat (fatty meats, poultry skin, full-fat dairy products, and tropical oils) and by restricting your intake of hydrogenated fat (found in commercially prepared baked and fried foods and margarines), the major source of trans fatty acids.

Center your diet around fish, skinless poultry, and plant-based, unprocessed foods, such as whole grains, fruits, vegetables, legumes (such as beans), and nuts.

Eat at least two servings of fish per week, particularly fatty fish such as mackerel, salmon, and albacore tuna. Fatty fish contain omega-3 fatty acids, a fat believed to be “heart healthy.” To limit exposure to contaminants, restrict consumption of larger species such as shark, swordfish, king mackerel, and tile fish. Wild varieties tend to be less contaminated than those that are farmed.

Include soy foods in your diet—replace foods high in saturated fat and cholesterol with 25 grams of soy protein daily. This recommendation is particularly important for those with high levels of total and low density lipoprotein (LDL, or “bad”) cholesterol.

Opt for fat-free and low-fat dairy products and lean meats in place of higher-fat cuts. The leanest cuts of meat are loin, flank, and round.

Get at least 15% of total calories from monounsaturated fats such as olive oil. Choose unsaturated fats instead of saturated and trans fats.

Limit cholesterol to 300 mg daily. If you have high blood cholesterol levels, limit your intake to less than 200 mg daily.

Get 20 to 30 grams of fiber daily; include plenty of soluble fiber.

Consume at least 400 micrograms (mcg) of folate (folic acid) daily from fruits, vegetables, fortified grains, and/or a supplement.

Limit intake of refined carbohydrates, particularly white flour and sugar.

Maintain a desirable weight to prevent metabolic syndrome, a major risk factor for CHD.

Hypertension

Maintain a desirable weight.

Before age 50, limit daily sodium intake to 1,500 mg, the equivalent of about 2/3 teaspoon of table salt (sodium chloride). Since blood pressure rises with age, after age 50 strive for 1,300 mg daily; after age 70 reduce daily intake to 1,200 mg.

Increase intake of fruits and vegetables to get enough potassium. Aim for at least eight servings daily. Recently revised guidelines recommend consuming 4,700 mg daily, about double the current consumption.

Consume 2 to 4 servings of fat-free or low-fat dairy products daily for adequate calcium and protein.

Include plenty of whole grains, fish, and poultry.

Restrict intake of fat, red meat, and sugary foods and drinks.

Limit consumption of alcohol to no more than one drink daily for women and no more than two daily for men. One alcoholic drink equals one 12-oz. beer, one 5-oz. glass of wine, or one shot (1 1/2 oz.) of 80-proof spirits.

Type 2 Diabetes

Maintain a desirable weight.

Limit saturated fat intake to no more than 7% of total calories.

Get at least 15% of total fat calories from monounsaturated fat.

Limit dietary cholesterol to less than 200 mg daily, which requires restriction of all dietary sources of cholesterol, including eggs and shellfish.

Get at least 25 grams of fiber daily; include several servings of whole grains and plenty of soluble fiber.

Choose an overall balanced diet that emphasizes produce and whole grains. Aim for eight servings daily of a variety of fruits and vegetables.

Restrict intake of refined carbohydrates (white flour and sugar).

Osteoporosis

Consume 1,200 to 1,500 mg of calcium daily. Besides dairy products, good dietary sources include canned salmon and sardines, dark green leafy vegetables, shellfish, and some fortified cereals. Take calcium supplements if the calcium in your diet is low.

Get an adequate amount—400 to 800 IU daily—of vitamin D, which enhances calcium absorption from the intestine and also works within bones to strengthen them. Good sources of vitamin D include milk and fatty fish. Many people require a vitamin D supplement to achieve adequate intake.

Follow a dietary pattern that emphasizes fruits, vegetables, and whole grains.

Restrict caffeine consumption to less than 300 mg daily; consuming more than this may contribute to bone loss in some older women. An average cup (8 oz.) of coffee contains between 115 and 175 mg caffeine. The caffeine content of an average can of soda (12 oz.) is between 30 and 50 mg.

Prostate Cancer

Limit intake of fat from animal sources, especially meats and dairy products.

Limit your intake of red meat. Choose lean cuts and eat small portions (about 3 oz.).

Eat a diet rich in whole grains and have at least five servings daily of a variety of fruits and vegetables. Include plenty of cruciferous vegetables, such as broccoli, cauliflower, and cabbage; researchers in one study found that consuming three or more servings of cruciferous vegetables a week was associated with a 41% lower risk of prostate cancer than that associated with eating less than one serving per week.

Eat several servings of cooked tomato products (such as tomato sauce) per week. A high intake of lycopene, an antioxidant found in tomatoes and tomato products, is associated with a 16% to 21% reduced risk of prostate cancer.

Breast Cancer

Maintain a desirable weight.

Limit fat intake, especially saturated fats and trans fatty acids.

Get at least 25 grams of fiber daily. Be sure to include several servings of whole grains.

Eat at least five servings daily of a variety of fruits and vegetables.

Limit alcohol consumption to fewer than seven drinks per week.

Colon Cancer

Limit intake of red meat. Choose lean cuts and limit portions to about 3 oz.

Eat several servings of whole grains and at least five servings of fruits and vegetables daily. Include plenty of spinach, broccoli, tomatoes, oranges, berries, and carrots.

Get 1,200 mg of calcium daily from calcium-rich foods, such as 2 to 3 servings of low-fat or fat-free dairy products.

Weight Control Is Key

In addition to controlling your choice of specific foods, probably the most important aspect of diet for preventing disease is weight control, which means avoiding weight gain and reducing your caloric intake if you are overweight. In general, decreasing calorie consumption by 500 calories daily, especially in conjunction with a modest increase in exercise, can result in weight loss of 1 to 2 lbs. a week. Research shows that even modest weight loss decreases the risk of a wide range of obesity-related illnesses ranging from CHD and diabetes to some kinds of cancer.

 

Getting the Most Out of Antioxidants

Fruits and vegetables are included under virtually every disorder largely because they are rich in antioxidants, such as vitamins C and E, the mineral selenium, and plant pigments known as carotenoids (which include beta-carotene). Antioxidants are desirable because they help to counteract cell damage caused by free radicals, molecules that may contribute to many of the illnesses associated with aging. To get the most from the antioxidants you consume:

Rely mostly on diet. It’s possible that the beneficial effect of antioxidants occurs only when they are consumed in combination. Furthermore, the long-term effects of high-dose antioxidant supplements are unknown and may include increased lung cancer risk in smokers. A diet containing 5 to 9 servings of fruits and vegetables per day can easily provide an adequate amount of most antioxidants.

Color counts. Focus on dark green vegetables and orange, red, and yellow fruits and vegetables. Fruits and vegetables of these colors provide substantial amounts of antioxidants and vitamin C, as well as other beneficial nutrients.

Get enough vitamins C and E. The Recommended Dietary Allowance (RDA) for vitamin C is 75 mg for women and 90 mg for men. These amounts are easily obtained through diet. Good sources include citrus fruits and juices, strawberries, peppers, broccoli, cauliflower, and cantaloupe. The RDA for vitamin E is 10 mg. Good sources include nuts, seeds, vegetable oils, whole grains, and leafy greens. (Just keep in mind that the first three are high in fat and should be eaten in small amounts.)

Don’t take selenium supplements. The difference between an adequate and a toxic dose of selenium is quite small. People concerned that they are not getting enough selenium might consider a multivitamin-mineral supplement that contains no more than the RDA for selenium (55 mcg).

 

From The Johns Hopkins Medical Letter: Health After 50, May 2004


 


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2005
WHITE PAPERS
Nutrition & Weight Control

The Nutrition & Weight Control White Paper from The Johns Hopkins White Papers series is an annual, in-depth report written by Hopkins physicians.


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Johns Hopkins Medical Letter: Health After 50
Keep abreast of the latest medical news with the nation's leading health newsletter for people over 50.

 

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