Dr. Carolle Jean-Murat, M.D. -- Staying Healthy: Step 3

Staying Healthy: 10 Easy Steps for Women
An Online Guide

Step 3. Improve Your Nutrition and Diet.

Diet plays an important role in maintaining good health. The immune system, which helps the body fight infection, requires the nutrients found in a healthy, balanced diet. What is a healthy diet?

It should be low in fat, no more than 20 to 30 percent of the total amount of calories consumed, since a high fat content can be harmful to your health. Fats contain nine calories per gram.
It should be moderate in protein (meat, fish, eggs and nuts). Proteins contain four calories per gram.
The diet should also be rich in fiber -- complex carbohydrates like cereals, wheat flour, rice, corn, pasta, beans and vegetables. Carbohydrates also contain four calories per gram.

Obese people eat more calories than they need and they have metabolisms and habits that contribute to high cholesterol levels. Cholesterol is a type of fat found in animal-derived food sources, including meat, eggs and dairy products. The human body also synthesizes cholesterol as the first step towards producing various hormones and enzymes.

When cholesterol in the bloodstream is high, it sticks to the inside walls of the blood vessels, making them narrower and sometimes blocking them entirely. Cholesterol settles in the coronary arteries, endangering the heart. When it builds up in the arteries of the neck, it increases the chance of stroke, endangering the brain.

Obese people tend to have a higher-than-normal risk of high blood pressure, diabetes and gallstones. Obese women have a higher incidence of uterine, breast and colon cancers.

It is important to have the cholesterol level in your blood checked, starting right now and, if you're in your teens, around age 20. The first checkup should be even earlier if there is a family history of high cholesterol. If the level is normal, it should be re-checked every three to five years.

Fat isn't all bad for your health, by any means. It is the energy supply that the body needs in order to function. Women naturally have a higher percentage of fat in the body than men do. Women need a certain amount to maintain a healthy level of estrogen, the main female hormone that controls the menstrual cycle.

Daily Food Guide
For many years, foods were divided into four groups from which to choose a balanced diet. In the 1990s, the U.S. Department of Agriculture took the latest research, which emphasizes reduced amounts of fat and meat and large amounts of complex carbohydrates, and gave us the Food Guide Pyramid.

The Base of the Pyramid
Breads, Cereals, Rice and Pasta Group -- 6-11 servings each day. As examples, each serving consists of 1 slice of bread, 1/2 English muffin, 1 oz. of ready-to-eat cereal, 1/2 cup pasta, rice, grits or cooked cereal, and 1 tortilla, roll or muffin.

The Middle of the Pyramid
Vegetable Group -- 3-5 servings per day.
Examples include 3/4 cup of juice, 1/2 cup raw vegetables, 1 cup raw, leafy vegetable, 1/2 cup cooked vegetable, and 1 medium potato.

Fruit Group -- 2-4 servings daily.
Examples include 3/4 cup juice, 1/2 cup of raw, canned or cooked fruit, 1 medium apple, banana, orange or pear, 1/2 grapefruit, and 1/4 cantaloupe.

Milk, Yogurt and Cheese Group -- 2-3 servings a day.
Examples include 1 cup milk and yogurt, 1 1/2-2 oz. cheese, 1/2 cup cottage cheese, ice cream, ice milk or frozen yogurt.

Meat, Poultry, Fish, Dry Beans, Eggs and Nuts Group -- 2-3 servings a day.
Examples include 2-3 oz. cooked lean meat, poultry or fish, 1/2 cup cooked dry beans, 1 egg, 2 tablespoons peanut butter.

The Top of the Pyramid
Fats, Oils and Sweets.
USE SPARINGLY!

Antioxidants and Health
It has long been held by the medical community that proper nutrition is best achieved through good dietary habits, and there is no benefit in taking vitamin supplements in amounts greater than the recommended daily allowance (RDA). Ideally, we can get all the nutrients we need from the food we eat.

Unfortunately, the majority of people do not eat a balanced diet. For this reason, vitamin supplements have a place in the daily health routine. This is particularly true of supplements that contain cancer-fighting antioxidants like vitamin A, vitamin B, vitamin C, beta carotene and selenium, to name just some of them.

Many studies have shown that an adequate dietary intake of antioxidants may decrease your chance of developing coronary-artery disease, stroke and various kinds of cancer.

As your body uses the food you eat and the oxygen you breathe, a number of molecules (called "free radicals") are formed that damage healthy cells as they search for a component that will let them remain chemically independent. This process of oxidation -- the attempt to attach missing electrons -- wears down cell walls and alters the DNA (basic genetic material).

These changes can start the cell on the road to becoming cancerous.

Antioxidants are vitamins and minerals that neutralize free radicals by lending them electrons so they don't have a chance to damage the cells. Here are food sources of some antioxidants:

Vitamin A -- raw carrots, liver, kidney, egg yolk and spinach.

Beta carotene -- cantaloupe, peaches, broccoli and cauliflower.

Vitamin E -- though hard to get from standard diets, it is found in wheat germ, safflower and sunflower oils, and in smaller amounts in peaches and prunes.

Selenium -- deficiency of this mineral is rare; it is found in organ meats and seafood.

Zinc -- meat, grains, bread, eggs and lima beans.

It has been shown that people are not consuming enough fruits and vegetables to provide the necessary amounts of antioxidants. For this reason, I recommend taking the following supplements daily:

Vitamin C -- 200-300 mg
Vitamin E -- 300 mg
Beta carotene -- 20,000 IU
Selenium -- 50 mg
Copper -- 2 mg/dl
Manganese -- 5 mg
Zinc -- 15 mg

Calcium
Throughout life the body needs calcium to make strong, dense bones and for the heart, muscles and nervous system to work properly. The average American diet, even a healthy one, may not give you the amount of calcium you need. This is especially true if you are pregnant, nursing your baby, or a teenager.

Lack of calcium for a long period may cause osteoporosis ("porous bones"). In this condition, the bones become unusually thin, porous and brittle, and break easily. In women, bone density is linked to the female hormone estrogen.

Since this hormone's production is greatly reduced after menopause, the risk of osteoporosis increases greatly at that time. But the process begins earlier in life if you don't take adequate amounts of calcium. If you're of northern European extraction, your bones are thinner than others' and your risk of osteoporosis is greater.

The best assurance of strong, dense bones throughout life comes to those who eat adequate amounts of calcium and perform weight-bearing exercise such as walking, dancing, bicycling and jogging (beginning especially before age 35). Nevertheless, the diet-and-exercise plan may provide some help at any age.

Some of the best sources of calcium are dairy products, salmon, sardines and tofu. Whole, low-fat or fat-free (skim) milk is an especially good source. It has high levels of calcium. And it's fortified with Vitamin D, the "sunshine vitamin" that helps the body use calcium more efficiently. Many vegetables are also high in calcium, but it is bound to other substances so that most of it passes through the body unused.

Adult women of all ages should take 800-1200 mg of calcium daily. If you're pregnant, nursing or post-menopausal, the amount should be increased, in consultation with your health-care provider.

Thinness and the "Ideal" Image of Women
Television, magazines and newspapers depict very thin models who "represent" the ideal image of today's woman. In a recent survey, 40% of the men and 70% of the women admitted that they were not happy with their weight.

People who think they're overweight spend billions of dollars each year at spas and "fat farms" and on drinks and drugs in an attempt to become thinner. Unfortunately, after a year, more than 90% of these people have regained the weight they had lost and sometimes even more.

The old joke about "yo-yo" diets is as true today ever as it was: "I don't have any trouble losing 10 pounds. I've done it dozens of times."

Many adolescents and some women suffer from an illness called anorexia nervosa. These women have a distorted image of their bodies.

They think they are obese even if they weigh less than the adequate weight for their age and height. That is why they eat very little and exercise in an exaggerated manner. Because they cannot maintain the normal level of necessary estrogen, many anorexic women do not have a menstrual cycle.

Another disease is bulimia, or exaggerated appetite. In this case, the person eats large amounts of food and then forces herself to vomit in order not to gain weight. Some women have both illnesses. The combination of anorexia nervosa and bulimia can be life-endangering, and people who suffer from them require medical and psychiatric treatment.

Some people who gain weight deny overeating. In reality, they may be eating more than they think without even knowing it.

According to a report from Indiana University, their problem is caused by a multiple-personality disorder. They literally don't realize they are eating huge amounts of food.

Psychological investigation revealed that one personality was pushing them to eat without the "real" self (which was trying to lose weight) being aware of it.

The same scientists found other people who ate while they were asleep. When they woke up in the morning, their beds and night clothing were full of scraps from food that they couldn't remember eating at all. But these conditions are very rare.

Who Really Needs to Lose Weight?
According to the U.S. Department of Agriculture, the normal weights for Americans are those shown in Table 3.1.

**Table 3.1. Normal Weights for Americans**
Height (without clothes)	Weight (without clothes) age 19-34	Weight (without clothes) age 35 and older
5'0" 5'1" 5'2" 5'3" 5'4" 5'5" 5'6" 5'7" 5'8" 5'9" 5'10" 5'11" 6'0"	97-128 101-132 104-137 107-139 111-146 114-150 118-155 121-160 125-164 129-169 132-174 136-179 140-184	108-138 111-143 115-148 119-152 122-157 126-162 130-167 134-172 138-178 142-183 146-188 151-194 155-199
The higher weights apply to men; the lower to women.

Weight of 5-20% over the normal is considered "overweight." Greater than 20% above normal is considered "obese."

How to Lose Weight in a Healthy Manner
People have a difficult time changing habits they've had all their lives. Do you want to change the way you eat and the amount you weigh? The important thing is to make up your mind to change your eating habits and take small steps that are manageable one by one.

Trying to lose weight can be hard. Most social activities involve eating. Working with a doctor or nutritionist can help you design a program that fits you and your state of health. Sometimes it's nice to do it with a friend or relative so you can offer support to each other.

The best way to lose weight is to combine a low-fat diet with regular exercise. When a person is dieting, her metabolism slows down, making it harder to use up the calories in food. Metabolism is the way our bodies use what we eat, producing energy. Each person has a different metabolism. Even people who don't eat a lot can have a problem losing weight if they don't exercise.

The key to exercising is to develop the habit of regularly performing an activity you like. Exercise increases the metabolic rate, and aerobic exercise is the best kind for losing weight.

Watching the scale while trying to lose weight sometimes can be disappointing. While trimming the fat, muscle mass also increases, slowing the weight loss that shows up on the scale.

The healthiest kind of weight loss is slow, steady and permanent. Yo-yo diets can damage your body. Try to learn your own eating behavior and improve from there. When do you tend to overeat? Be prepared with healthy snacks like fruits, raw vegetables, air-popped popcorn and plain water. Drink lots of water, because consuming more than eight 8-ounce glasses of water can help decrease your appetite.

Simple Steps to Cut Fat From Your Diet

Meat

Remove the visible fat from your meat.
Remove the skin from poultry. Eat white meat like chicken breast and avoid the thighs.
Bake or barbecue meats instead of frying them.

Dairy Products

Consume low-fat milk products. Use yogurt instead of heavy creams.

Vegetables

Olives, avocado and coconut are very high in fat, so eat them sparingly.

Oils

Use vegetable oil, preferably monosaturated or polyunsaturated, rather than animal fats.

Mealtime

Serve food on smaller plates so less looks like more.
Eat more often with a family member. Socializing lets you eat more slowly, getting more enjoyment from less food.
Eat slowly. Put your fork down between mouthfuls.
Wait for twenty minutes before going for seconds. That's how long it takes your brain to sense that your stomach is full.

Don't go searching for a miracle. It has been proven that if you want to lose weight and keep it down, you need to have a diet that's low in fat. This means consuming more vegetables and complex carbohydrates. Prepare the food you like, but cut down on the fat.

It's normal for people to gain some weight with aging. That is why exercising regularly will help keep your weight down. You'll feel good and enjoy good health.