The National Cholesterol Education Program (NCEP) encourages physicians to prescribe stringent dietary therapy of hyper cholesterolemia for at least 6 months before initiating drug therapy. Physicians should also be cautioned about premature use of hypercholesterolemic medications: no known study has demonstrated decreased mortality in recipients of such medications. Dietary therapy should strongly be encouraged, and physicians should adopt mandatory referral to a registered dietitian or other qualified nutrition professional before dietary therapy is declared a failure and drug therapy is started.
Lowering cholesterol levels decreases the incidence of heart disease. In fact, several studies have convincingly shown that adequate hypercholesterolemic treatment can not only prevent CHD, but can also reverse it. [Kuo, P.T., Hayase, K., Kostis, J.B., and Moreyra, A.E.: Use of combined diet and colestipol in longterm treatment of patients with type II hyperlipoproteinemia. Circ 59:199, 1979. ] Recently these topics have been comprehensively reviewed. Dietary therapy is the cornerstone of all hypercholesterolemic therapy, and it has been estimated that 60 million adult Americans may be candidates for dietary instruction.
Findings suggest that blood lipid cholesterol levels predict subsequent mortality in men, especially those with preexisting cardiovascular disease. Those with high blood cholesterol levels have a risk of death from cardiovascular disease, including coronary heart disease, that was 3ï¿½ times higher than that for men with a “desirable” blood cholesterol level.
Familial hypercholesterolemia carries a marked increase in the risk of coronary heart disease (CHD), but there is considerable variation in susceptibility to CHD between individuals. Results indicate that an elevated level of lipoprotein is a strong risk factor for CHD in these individuals; the risk is independent of age, sex, smoking status, and serum levels of total cholesterol, triglyceride, or HDL-cholesterol. The higher level of lipoprotein observed in patients with CHD is the result of genetic influence. The New England Journal of Medicine: 322:1494, 1990.]
The efficacy of hypercholesterolemic diets lowering cholesterol and in some cases, in preventing CHD, has been convincingly demonstrated. Such efficacy does depend, however, on the vigour which the physician and dietitian support dietary therapy. Many physicians have declared dietary therapy a failure without providing their patients with real dietary advice and support.
Two factors that probably contribute to physicians disinterest in dietary therapy are extensive advertising of hypercholesterolemic drugs compared with the little advertisingof dietary therapy and patient reluctance to alter diet and life-style. Getting patients to alter their life-style is often a challenging task. A recent survey [Schucker, B., Bailey, K., Heimbach, J.T., Wittes, J.T., Cutler, J.A., Mackintosh, D.R., Gordon, D.J., Haines. C.M., Mattson, S.E., Goor, R.S., and Rifkind, B.M.: Change in public perspective on cholesterol & heart disease.JAMA 258:3527,1987] suggests, however, that the public is ready and able to embrace dietary therapy as the primary solution to hypercholesterolemia.
To further facilitate dietary therapy, recent research suggests that certain forms of fat (eg. fish and monounsaturated fatty acids) may be hypocholesterolemic, especially if they replace saturated fatty acids in the diet. Food technology is improving daily in palatably, removing fat from items like cheese, chips, and crackers. Frozen yogurt has become a popular replacement for ice cream. Fat substitutes, as they become available, may also facilitate compliance with a low-fat diet.
Psyllium is an especially attractive hybrid intervention in that it is well tolerated, lowers LDL-cholesterol by 10% to 20%, has no adverse effects on triglycerides, high-density-lipoprotein (HDL) cholesterol, or serum glucose, and is readily available and fairly inexpensive. It has a long history of use without any evidence of long-term adverse effects.
A recent article estimated that oat bran supplementation (90 gm per day) was a much more cost-effective method of lowering serum cholesterol than either cholestyramine or colestipol. [Kinosian, B.P., and Eisenberg, J.M.: Cutting into cholesterol: Cost-effective alternatives for treating hypercholesterolemia. JAMA 259:2249, 1988.] In addition, high-fibre diets may decrease risk of colon cancer, improve glucose tolerance, lower blood pressure, and assist in weight loss.
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“Nothing will benefit human health and increase chances for survival of life on Earth as much as the evolution to a vegetarian diet.”
- Albert Einstein
This site covers the nutritional and dietary guidelines presented by the mainstream to the general population. So when vegetarian diets have a direct effect on a persons state of health, it has been noted. For example in the Vitamins chapter there is mention of the fact that a strict vegetarian may need to supplement B12.
Although it is becoming more popular, either for moral or health reasons, a vegetarian diet still seems to have a strange stigma attached to it.
Hundreds of millions of people are vegetarian (eg. Hindus for religious reasons); more health professionals are discouraging the consumption of animal fats and red meats, that have been shown to increase the chance of obesity, cancer and other diseases; and the environmentalists who know that much of the limited resources, on Planet Earth, are wasted by converting them to meat.
It takes 2,500 gallons of water, 12 pounds of grain, 35 pounds of topsoil and the energy equivalent of one gallon of gasoline to produce one pound of feedlot beef.
70% of US grain production is fed to live stock.
5 million acres of rain forest are felled every year in South and Central America alone to create cattle pasture.
Roughly 20% of all currently threatened and endangered species in the US are harmed by livestock grazing
Animal agriculture is a chief contributor to water pollution. America’s farm animals produce 10 times the waste produced by the human population.
There are sound reasons for health, ethically, and ecologically to be vegetarian. There is nothing strange about being vegetarian.
Vegetarian, the belief in and practice of eating exclusively vegetable foods and abstaining from any form of animal food.
To what extent this definition applies, in reality varies, what it refers to is a strict vegetarian or a vegan. Lacto-vegetarians include milk and other dairy products in their diet. Lacto-ovovegetarians eat milk, dairy products and eggs. Those who eat fish are not vegetarian.
A vegan, excludes animal flesh (meat, poultry, fish and seafood), animal products (eggs, dairy and honey), and the wearing and use of animal products (eg. leather, silk, wool, lanolin, gelatin). The vegan diet consists totally of vegetables, vegetable oils, and seeds.
vegan ‘ve-gen also ‘ve-jen or -,jan\ n [by contr. fr. vegetarian] (1944) : a strict vegetarian who consumes no animal food or dairy products; also : one who abstains from using animal products (as leather) _ veganism ‘ve-ge-,ni-zem, ‘va-ge-, ‘ve-je-\ n .
Partial vegetarians exclude some groups of animal foods but not others. A diet that excludes red meat but includes fish is often adopted for health not moral reasons.
Zen macrobiotic diets. This is a Japanese way of eating based on the ‘Yin Yang’ theory. It aims to keep the balance between Yin and Yang (positive and negative) aspects of life for optimal spiritual, mental and physical welfare. Foods are divided into Yin and Yang, and a spiritual goal is aimed for by working through ten levels of diet. These gradually eliminate all animal produce, fruit and vegetables towards the final goal which is only cereal (brown rice). Fluids are also severely restricted. Many nutritional deficiencies may develop and death can result. Infants and children subject to these restrictions are particularly at risk [Thomas et al., 1988]
This is extreme, not all macrobiotic diets are so extreme and are often equivalent to a balanced vegan diet. It is important to eat as much variety of food as possible and not limit it to one group of foods.
If you are vegetarian or want to become one, start off by giving up one kind of animal food, the one that offends you most. Once you are used to supplementing this food with another of vegetable origin, tackle the next. Progressively reaching the level of vegetarianisim you desire, slowly over a period of time. This progressive vegetarian is one who changes their eating habits / lifestyle at a positive rate, by doing so you allow your body to adjust to the eating of new types of foods or foods that may have given you troubles before (beans). It also gives you time to learn more about nutrition and increase your pool of knowledge on the subject. Thus it is not a fad diet that you will give up the next day but a progressive change towards a healthy lifestyle.
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Marilyn Stephenson, a registered dietitian and director of the Office of Nutrition and Food Sciences in the FDA Centre for Food Safety and Applied Nutrition explains just exactly what a balanced diet is: [A How-To Guide to a Balanced Diet, FDA Consumer, Pg 23, October 1986]
Eating a balanced diet means eating a wide variety of foods. A traditional way of getting a balanced diet has been to eat a certain number of portions from certain food groups, as defined by the US Department of Agriculture.
The five basic groups are vegetables; fruit; bread and cereal; dairy; and meat, poultry, fish, and legumes (dry beans, lentils and peas).
It’s recommended that you have four servings from the fruit and vegetable group, and should include one good source of vitamin C each day, such as citrus fruit, and a good source of vitamin A, usually deep-yellow or dark-green vegetables. From the bread and cereals group, it is recommended that you get six basic servings including some whole-grain bread or cereals. The recommended servings from the milk and cheese group vary with age, the highest recommendations for teens and nursing mothers (four servings). Two basic servings from the meat, poultry, fish and bean group are recommended.
Then there’s the sixth group: fats, sweets, and alcohol. It’s a group you want to avoid getting too many servings from. Foods in this group have plenty of calories and not a fair balance of other nutrients.
Eggs, as a protein source, are included in the same group as meat, poultry, fish and beans. One egg is considered a serving in that group. So if you eat two eggs for breakfast you have obtained your recommendations from the protein group and should have no more egg, meat, poultry or fish that day.
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This is “A diet plan used by the Birmingham Alabama Hospital in their Cardiac Unit for patients who need to lose weight fast before having heart surgery. Up to 40 lbs a month could be lost using this plan!” This quote, published in a popular magazine, has been passed on with the diet for your informational purposes only — Please ask your doctor if it is safe based on your special needs before trying it.
“Do not vary or substitute any of the foods. Salt and pepper may be used but no other seasonings – use this diet 3 days at a time. In 3 days you will lose 10 lbs. After 3 days, you can eat your usual foods but don’t over eat! After 4 days of normal eating, repeat the 3-day plan.”
Black coffee or tea,
½ grapefruit or 4 oz of grapefruit juice
1 slice toast
1 Tbsp peanut butter
½ cup tuna or 1 slice cheese
1 slice toast
black coffee or tea
2 slices any type meat (3 oz)
1 cup string beans
1 small apple
1 cup vanilla Ice Cream
Black coffee or tea
1 slice toast
1 cup cottage cheese or ½ cup tuna
5 saltine crackers
black coffee or tea
1 or 2 hot dogs (no bun)
1 cup broccoli or cabbage
½ cup carrots or turnips
1 cup vanilla ice cream
Black coffee or tea
5 saltine crackers
1 slice cheddar cheese
1 small apple
1 boiled egg
1 slice toast
black coffee or tea
1 cup tuna
1 cup beets or carrots
1 cup cauliflower or greens
1 cup cantaloupe
½ cup vanilla ice cream
Testimonial: I lost an initial 10 pounds using this diet, then, by just moderating portions within a reasonably balanced diet over the following 15 weeks, continued to lose a pound a week for a total loss of 25lbs.
This above diet may be a little hard to follow for some people. I have included a link to another diet plan by a former body builder that works well for people looking to lose weigh more gradually and helps keep the weight off.
The guide is called “Burn the Fat, Feed the Muscle” and you can get more information by Clicking Here.
Diet Plan from – http://www.moreforyourhealth.com/free-diet-plan.html
The fact that more than 20% of the United States adult population is obese presents a major public health concern. However, the failure to follow through and maintain weight loss on their own, after termination of counselling, makes the long-term success of weight loss programs difficult to achieve.
Health professionals often assume that patients will dutifully comply with recommendations simply because they are urged to do so. The magnitude of noncompliance has been well documented. Adherence to dietary programs is thought to be poorer than to medication regimens. [Glanz, K.: Dietitians' effectiveness and patient compliance with dietary regimens. JADA 84:444, 1984.] Dietary regimens are often restrictive, require changes in life-style and behaviours, interfere with family habits and customs, and are of long duration.
Weight control methods are considered a success if weight loss is maintained without expense to overall health. A goal of any successful weight reduction program is to promote permanent life-style changes. The physical and psychological consequences of repeated weight fluctuations may be more harmful than maintaining some degree of overweight. [Rock, C.L., & Coulston, A.M.: Weight control approaches: A review by the California Dietetic Association. JADA 86:44, 1988] The ultimate goal of all weight loss programs is to reduce nutritional risk factors associated with chronic diseases by increasing consumer awareness of healthy food choices.
In 1992 over 49 million people were dieting. The National Council Against Fraud estimates that quackery costs consumers between $25 billion and $50 billion a year – and nutrition fraud is the most common type. [Legislative Highlights, Journal of the American Dietetic Association. Page 648 - 650. May 1990]
Therefore to identify a quality weight loss program, and not to be misled by a “fad diet”, the following indicators must be considered:
A variety of foods. Weight control programs should be individualized to fit people’s life-styles and food preferences. Individualization diminishes feelings of deprivation, which lead to discouragement, bingeing, and rebound weight gain – all hallmarks of the yo-yo diet syndrome.
Enough calories to maintain good health. Consuming less than 1200 kcal a day may result in loss of muscle instead of fat and may compromise nutritional status as a result of deficient nutrient intakes.
Realistic weight loss goals. To lose body fat and not just water, a maximum weight loss of 2 pounds per week is advised.
Regular exercise. Especially as we age, exercise can be the key to weight loss and maintenance of a desirable weight.
Behaviour modification. Registered dietitians counsel people to keep lost weight off by helping them alter their eating behavior and responses to foods for the rest of their lives.
Unfortunately, a current trend toward the view that a single food is either a panacea or a poison is being gradually adopted by major health associations. This “good food/bad food” dichotomy ignores the consensus among nutritionists that all foods can be compatible with health when used in moderation as part of a balanced, varied diet.
Over the past decade people have become obsessed with the nutritional value of the food they eat. Time and again, nutrition ranks high among consumer concerns, along with food safety, convenience, quality, and value. In the United States sales in the “healthy foods” category accounted for $65 billion in 1985, but are expected to reach $98 billion by 1995.
Consumers are asking for specific information about which foods and, in particular, which brands of packaged foods to choose from when they eat or purchase foods. For example the broad guideline to avoid to much fat, saturated fat and cholesterol require specific behaviour implementations that include:
Eat more fresh fruits and vegetables, whole grain breads and cereals, potatoes, rice noodles, dried beans, peas, and lentils.
Choose low fat dairy products, including skim, 1%, and 2% milk, low-fat cheeses, and low-fat yogurt.
Choose lean meats, fish, chicken and turkey.
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The importance of diet to health, especially in the prevention and cure of illness, is slowly becoming apparent. I endeavour to provide you with more than the basic, and usually inaccurate information on diet and nutrition. So whether you are a registered dietitian and want to brush up on the immense amount of information, or whether you just want to find out, for the first time what you should be eating, then this site is for you.
First I would like to talk about a very contentious word – diet. Many people don’t like using this word, when referring to their eating habits, because they feel that it is humiliating to be on a diet. I am the opposite, as I am always on diet. Whether underweight, overweight, sick or fit, diet, by its Greek definition means the food eaten by an animal to maintain its state of health. So, when I talk about a diet I don’t mean that you must necessarily lose weight, what I am referring to is the food that you should generally be eating, be it to build muscles, put on weight, lose weight or get rid of a cold.
This topic is as arguable as religion, politics and sex. There are always many different opinions relating to diet and nutrition. I am only going to present facts on the subject of nutrition as affirmed by the mainstream diet and nutrition world. The fallacies of the fringe will not be proposed, although they have been investigated by myself, so I know what the quacks are telling “Joe Public”.
It has become apparent that the overconsumption of certain dietary components is now a major concern to people in the Western World. Foremost among them is the disproportionate consumption of fats, sodium, and sugars, at the expense of foods that may be more conducive to good health, such as foods high in complex carbohydrates and fiber (vegetables, fruit, and whole grain products).
The usual approach of the orthodox medical circles, when dealing with a disease, is to treat the symptoms with a remedy rather than removing the cause. Yet, by following the dietary guidelines of the nutrition and health authorities, that have been proven with epidemiologic studies to be scientifically correct, it is possible to achieve and maintain good health.
Dietary factors play a prominent role in five out of the ten leading causes of death for Americans. Thus, it is important to emphasize the relationship of diet to the occurrence of chronic disease and to understand how wholesome food is necessary for good health.
Foods contain nutrients essential for normal metabolic function. An imbalance in nutrient intake or the consumption of harmful substances is the underlying factor in many chronic diseases, such as coronary heart disease, diabetes, obesity, and some cancers.
To acquire these nutrients we have to eat foods that contain them and make choices about what foods shouldn’t be eaten in excess. This is difficult and requires a comprehensive research base and much effort before it is possible to maintain good health.
Eating is a source of considerable pleasure and an important part of our lives. It is not necessary to lessen this pleasure by following a healthy diet plan. By knowing what nutrients are, how they relate to different diseases, and how to make choices in selecting and preparing foods, it is quite possible to feel good and enjoy life equally or more.
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With increasing consumer awareness of nutrition, and the influence of nutrients on dietary related diseases, the need for accurate and standardization of nutrition labeling is apparent.
The eating habits of Americans have changed extensively since the turn of the century. Changes have occurred in the composition of foods because of improved production methods, new varieties, and advances in food processing.
The primary changes in the past 70 years have been an increase in the percentage contributed by fats, oils, sugars, and sweeteners and a decrease in the percentage contributed by grain products. Although no change has occurred in the amount of protein consumed, a greater proportion now comes from animal sources. Dietary fiber is considerably below the recommended level. In general, intakes of vitamins and minerals are adequate in the United States today.
From a general marketing standpoint, it is readily apparent that nutrition “sells” to today’s consumer, making nutrition an integral part of product development and promotion. Consumer feedback is a powerful mechanism for manufacturers in developing new products that provide the health and nutrition characteristics sought by the public. Food marketers guard a product’s front panel with fervour for the purpose of promotion and competition, they oppose any labeling proposals that threaten their control of this part of food packages.
Americans are increasingly aware of health risks associated with sodium, fat, and cholesterol and report eating less salt, red meat, butter, whole milk, and eggs.
Studies on the use of food labels reveal that consumers want comprehensive nutrition information. About half of consumers report that labels fail to provide all the information they desire and that more information should be provided on caloric, fat, and sodium content.
Laboratory analysis provides quantitative nutrient information for nutrition labeling of food products. Considerable improvement is needed to validate and standardize analytical methods for use in nutrition labeling. Particular problems exist in the measurement of dietary fiber and many vitamins, and in databases used for foods for which direct laboratory analysis is impractical.
If consumers are to make the dietary adjustments recommended by health experts, they must be able to make informed choices in food selection, preparation, and consumption. Although about half of packaged foods currently carry nutrition labeling, the lack of relevant and consistent information on all food products is a major deterrent to consumers who wish to make informed choices.
The Committee on the Nutrition Components of Food Labeling, National Academy of Sciences, Washington D.C., recommends that nutrition labeling be made mandatory on most packaged foods. There is no longer a plausible excuse for packaged foods not to provide nutrient information.
Current dietary recommendations advise consumers to modify their intake of certain food constituents. In considering those dietary recommendations, the committee believed that more categories of food should be required to carry nutrition labeling. That nutrition labeling be provided at the point of purchase for produce, seafood, meats, and poultry. In addition restaurants should make information on the nutrient content of menu items available to consumers on request.
Growing public interest in nutrition has led manufacturers to characterize their products as nutritionally beneficial through widespread use of principal display descriptors; this practice has drawn considerable attention from regulatory bodies and groups concerned with health.
Despite the high popularity of terms such as “low-calorie”, “fat free”, “no cholesterol”, “fiber rich”, and “lite”, the potential for confusion, exaggeration, and deception has prompted proposals that these descriptors be prohibited. Although it may be truthful to label a food “no cholesterol”, that descriptor would mislead someone if the food also contains substantial amounts of total fat and saturated fatty acids.
Nutrition information on food labels is a mechanism to provide information and facilitate behavior modification. The government should allow the information to appear and regulate content, format, and placement. Although information campaigns to promote health are generally aimed at enhancing knowledge, changing attitudes, and improving skills, changes in consumer knowledge and attitudes do not directly result in adoption of health-promoting practices. Consumers need information to make long-term dietary changes, yet more than just information is necessary to achieve this goal.
Dietitians are the health professionals most involved in educating consumers about the use of food labels in selecting foods to meet dietary goals. Most diet-related health problems develop gradually, without immediate or dramatic symptoms. Risk factor reduction and disease prevention through dietary change require individuals to make long-term and often arduous changes in food habits.
For the food industry, health professionals, and consumer groups, it will be of interest in terms of their own objectives in promoting nutrition labeling changes that are in line with current dietary recommendations and in product development. [Earl, R., Porter, D.V., Wellman, N.S., Nutrition labeling: Issues and directions for the '90s. Institute of Medicine National Academy of Sciences. September 1990.]
The rules of labeling are set out by the Food and Drug Administration (FDA). The following are excerpts from comments presented to the Advisory Committee on the FDA’s Subcommittee on Food and Veterinary Medicine, on September 6, 1990, by Nancy S. Wellman, PhD, RD, President of The American Dietetic Association.
FDA needs independence from politics, particularly in regard to rulemaking. FDA autonomy is essential to its mission. It has been dismaying for dietitians to see rulemaking proposals stalled and/or overturned as has happened in the past for health claims, cholesterol, and various food safety issues such as food colors. Food labeling is an example where FDA suffers from the lack of overarching government-wide policy. FDA must be allowed to make decisions independent of current Administration bias.
Dietitians believe Americans want a stronger, yet reasonable FDA – an FDA in tune with the times, an FDA with the autonomy to fulfill its mandate. The FDA must take a more contemporary, broader role in not only safeguarding, but improving the nutritional status of Americans.
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