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Eating for Life

Battle of the bulge

Staving off middle-age spread requires portion control and plenty of exercise

Updated: 2008-03-19T17:41:17Z

By Jill Wendholt Silva

The Kansas City Star

Before last summer, playwright/actor Philip blue owl Hooser had the necessary girth to play Alfred Hitchcock in Late Night Theatre's "The Birds."

In theatrical reviews he's been described as "larger than life," "slow moving" and "physically imposing ... moving about the stage like a great ocean liner."

Hooser, a 41-year-old Choctaw Indian, weighed 335 pounds, and the slow, steady spread of middle age was only adding to his midsection. "I just kept buying bigger clothes," he says.

It's a refrain many baby boomers know. Sixty-five percent of American adults are considered overweight or obese, and the nation's expanding midsection cuts across gender, age, race and ethnicity.

Maintaining a healthy weight in the adult years can be an uphill battle. As the metabolism slows, the risk of becoming overweight continues to increase until age 60. A weight gain of more than 20 pounds increases the risk for heart disease, certain types of cancer, Type 2 diabetes, stroke, arthritis, breathing disorders and depression.

Health officials from the surgeon general on down are eager to get a handle on what many are calling a health crisis of epidemic proportions: 300,000 deaths each year are associated with obesity, and the economic cost in the United States has been estimated at between $93 billion and $117 billion a year.

Some experts are calling obesity "the next tobacco."

"In terms of health, health-care costs and quality of life, only nutrition and physical activity come close to the importance that tobacco does," says Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, a nutrition advocacy group based in Washington, D.C.

"If you want to prevent disease, you have to deal with diet, inactivity and tobacco, because they're responsible for two-thirds of all premature deaths."

Yet physicians and dietitians say a climate of political correctness has made it difficult to tell adults what they don't want to hear: It's time to take responsibility for what and how we eat.

"If you eat too much, you will get fat. It's an absolute equation," says K. Dun Gifford, executive director of Oldways & Preservation Exchange Trust, a Boston-based nonprofit nutrition think tank.

Achieving a healthy body mass index or BMI - a ratio of height to weight used to determine fitness - requires relearning restraint, rethinking portion sizes and removing the social barriers that keep us from nutritional balance.

But how?

Real people eat food. They don't eat nutrition. That's where researchers find lifestyle practices are frequently out of sync with our knowledge and beliefs about good nutrition.

As the pendulum swings
Eager to be cast in more varied roles, Hooser started a low-carbohydrate/high-protein diet last summer.

"I gotta tell you, the way I eat makes people mad. Some people say, 'It's just wrong,' " Hooser says during lunch as he laps up a decadent cream sauce with his spoon, carefully skirting a molded mound of rice at the center of his plate.

Wrong because he's indulging in meat and cream, which are high in saturated fat. Wrong because instead of eating six to 11 grain servings a day, as recommended by the USDA's Food Guide Pyramid, Hooser eats just two grain servings a week and limits his fruit intake.

A shift in focus from low-fat to low-carbohydrate diets has put the public and some experts in the nutrition community at odds.

"It's a very controversial topic," says Holly Wyatt, an assistant professor of medicine at the University of Colorado Center for Human Nutrition. "Most people feel strongly one way or another."

CU recently received a grant from the National Institutes of Health to study the Atkins diet, a low-carbohydrate/high-protein diet that has been around since the '70s but has never undergone rigorous scientific scrutiny.

Meanwhile, low-fat diet proponents insist that removing plant sources from the diet because they contain carbohydrates is encouraging people to eat more animal proteins. Animal products contain higher amounts of saturated fat, the "bad" fat, which has been linked to heart disease.

Which diet is the right diet?

The optimum diet probably lies somewhere between the '90s fat-free Snackwells and the '00s protein-rich T-bone steak. It also depends on a person's genetic predisposition for certain diseases and overall lifestyle habits.

Despite swings of the dietary pendulum, the truth is still this: There is no magic pill. At every age, good nutrition is about eating a wide variety of foods in moderation (especially more fruits and vegetables), avoiding high-fat and high-sodium foods and exercising daily.

"If nutrition guidelines have not seized public attention, it may be because they seem so obvious. Eat more fruit and vegetables. Nothing could be more self-evident," says Marion Nestle, a professor of human nutrition at the New York University and the author of Food Politics: How the Food Industry Influences Nutrition and Health (University of CaliforniaPress, 2002).

Flaws in the design
A simple, easily recognizable icon, the decade-old USDA Food Guide Pyramid is designed to give at-a-glance nutrition information. Food groups are arranged in a highly graphic, hierarchical structure with recommended servings listed under each.

But critics are quick to point out the pyramid's flaws. For instance, there is no explanation about what constitutes a serving size, nor does it differentiate between monounsaturated and polyunsaturated (the good fats) and saturated or trans fats (the bad fats). By encouraging people to eat from all the food groups every day, the message appears to be "eat more" when we should really be eating less.

"To put it bluntly, current conventional dietary guidelines and messages are a failure," Gifford says. "Eating and drinking behaviors at birth are instinctive in all living things. Healthy eating and drinking, however, is a choice. It is a learned behavior and must be taught."

In the past dietitians have been seen as finger-wagging naysayers. Perhaps understandably, people often tune out messages that do not fit their lifestyles or their tastes.

A 2002 American Dietetic Association survey found that 63 percent of consumers agreed with the statement: "It seems like I am always hearing information about what not to eat rather than what I should eat." Only 37 respondents agreed with the statement when posed two years earlier.

Basics of good nutrition
The average adult already knows quite a bit about health and nutrition. A study for Rodale Press found that nutrition news tops the list of subjects adults are interested in, rating higher than national, local and even sports news. Yet there are wide gaps and plenty of confusion to go around.

"You can eat the (USDA Food Guide) pyramid requirements and still have a bad diet if you choose five servings of white bread, a couple of eggs, some apples and corn," says Barbara Lohse Knous, associate professor at K-State Research and Extension. "Eating from the pyramid does not guarantee a healthy intake, but not following it pretty much guarantees you won't have a healthy intake."

So here are the basics:
Eat more fruits and vegetables - At 4.4 servings a day, most Americans are getting close to the recommended "5 a Day," a national program to increase fruit and vegetable consumption sponsored by the National Cancer Institute. But last fall the recommended servings went up - from five to nine.

The average Missouri male eats just 3.37 servings of fruits and vegetables a day. The average Kansas male eats 3.65 servings of fruits and vegetables a day.

A good rule of thumb is to "colorize" diet by choosing vividly colored fruits and vegetables that are rich in antioxidants. Filling up on large amounts of fruits and vegetables can help keep hunger pangs at bay.

Eat good fats - Since 1990 the Dietary Guidelines outlined by the USDA continue to recommend no more than 30 percent of calories from fat with no more than 10 percent from saturated fat, but it's important not to shun all fats. Some fat in the diet is essential to proper bodily functioning, and monounsaturated fats such as those found in foods such as avocados and nuts contain healthful phytochemicals.

Eat fewer carbohydrates - Americans have tended to overdose on "bad" carbohydrates in recent years. Refined and processed grain products make up the bulk of the American diet. Instead, eat more whole grains. Look for the words "whole grain" as the first ingredient on nutrition labels.

Moderate protein - The verdict is out on whether the Atkins diet is a useful tool for long-term weight maintenance. That said, few people can follow a true "diet" for the rest of their lives. Instead, most dietitians recommend consuming moderate amounts of protein. The protein source need not be meat. Try beans and legumes.

Portion control - Americans have super-sized their meals to the point they no longer know what an appropriate portion size is. A 2002 survey by the American Dietetic Association has found 68 percent of respondents overestimated the serving size of cooked vegetables, 55 percent overestimated a serving of pasta and 54 percent overestimated a serving of meat.

Learn to cook - The only way to really know what's in your food is to take control and prepare your own food.

Become a mindful eater - Eat slower. Eat at a table. Eat with seasons so food is at its peak of freshness.

Exercise - The link between diet and exercise is a crucial piece of the weight-management puzzle. Most experts are recommending at least an hour of brisk exercise a minimum of five times a week for optimum health, but health benefits accrue with as little as 30 minutes a day.

Detours on the road
Forty-year-old females who are educated are the most likely to consume the recommended five servings of fruit and vegetables each day. But when asked to define the appropriate serving size of raw, leafy vegetables, most adults surveyed by the American Dietetic Association overestimated the proper amount. (One cup of raw, leafy vegetables is considered a serving.)

NYU's Nestle uses an order of fast-food french fries to illustrate how portion sizes have become grossly inflated. From 1950 to 1970, the usual serving size was 2 ounces of french fries or 200 calories. By the 1980s the serving size had doubled. And by 2002, the serving size had ballooned to 6.1 ounces, tipping the scales at a whopping 610 calories.

But whether you're a soccer mom carpooling kids, a businessman between appointments or an actor juggling a frenzied schedule of rehearsals and performances, quick, inexpensive grab-and-go fare is often hard to resist.

In the last three decades, American families have increasingly relied on restaurants to cook for them. In 1970, 26 percent of food dollars were spent on restaurant meals and foods prepared away from home, according to CSPI. By 1993, 46 percent of our food dollars were spent outside the home for a total of one-third of our daily calories.

A restaurant entree can easily provide half a day's calories, saturated fat and trans fat, or sodium. Include an appetizer, drink and dessert, and you may consume a whole day's calories, saturated and trans fat, and sodium in a single meal.

Breaking down the barriers to better eating will require Americans to bypass the drive-through and make a detour to the kitchen. Even better if that detour includes a stop at the gym or a walk around the block.

Lifestyle changes
As a playwright, Hooser spends the bulk of each day sitting in front of a computer screen writing.

Last summer he began walking for exercise, shedding 90 pounds and dropping his waist size from 54 to 38 inches. Now he walks from his Westport apartment to his job at Crown Center four times a week and has begun looking for other exercises that will help him build lean body mass.

With a boost in energy, Hooser says his mood has improved.

"I can feel the health difference of not having to lug a friend around with me," he says.

Hooser chats online with others in the "low carb community" who urge him to "take it one bite at a time." He has begun cooking more. He even swaps recipes on the Internet with other dieters and boasts of making a "mean" gratin-style cauliflower dish that mimics the silky smooth taste of twice-baked potatoes.

Potatoes have long been a favorite of Hooser's. He still eats them, just not as often. As the potato vs. cauliflower swap illustrates, not all foods are created equal.

About one-third of Hooser's diet comes from carbohydrates, and he now consumes moderate amounts of protein (63 grams for men; 50 grams for women)in line with the USDA recommendation. But unless you're overweight or obese, many health experts say forget about counting carbohydrates and proteins. Focus on a diet heavy on fruits and vegetables instead.

Not only is color-rich produce high in fiber and low in fat, it's also loaded with health-giving phytonutrients high in antioxidants. Antioxidants are thought to protect against heart disease, cancer, age-related cognitive decline, cataracts and macular degeneration.

To get the maximum benefit, variety is the key. Eating apples and oranges is good, but over the long haul it won't provide the same protection as a diet that also includes blueberries, kale and sweet potatoes.

Meanwhile, Hooser's latest party trick - sucking in his gut until his pants fall down - is getting rave reviews. When he reaches "the century mark" he plans on throwing himself a party.

"I don't really advocate the way I eat to anybody, but it's working for me. I'm happy eating this way," he says.

As Hooser likes to say - "YMMV."

Your mileage may vary.

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