Eating right: A guide to good grub

Mapping out a healthy diet is as easy and straightforward as following Canada’s Food Guide, which is available through hospitals, government health services, doctors, dieticians, even some dentists and chiropractors.

The Guide is a model of clarity, spelling out daily dietary requirements from the four food groups — fruits and vegetables, bread and cereal products, dairy products, and meats and fish — with examples of proper serving sizes, and sample menus that provide the right combination of foods for good health. The Guide also recommends maintaining a healthy weight, getting regular exercise and limiting the amount of salt, alcohol and caffeine you ingest. Its philosophy, in short, can be summed up in three words: variety, moderation and balance.

Joe Schwarcz, Ph.D., and the editors of the 1996 Reader’s Digest bestseller Foods That Harm, Foods That Heal, point out that following the general concepts in Canada’s Food Guide “will result in a ‘nutritious diet.’ This means that energy needs will be fulfilled, micronutrient requirements (vitamins and minerals) will be met, and the macronutrients (proteins, fats, and carhydrates) will be consumed in an appropriate ratio… A truly balanced diet is one that provides all the essential nutrients while maintaining the ideal body weight.”

In her 1993 compendium, The Complete Canadian Health Guide, June Engel, Ph.D., notes that, “if food provides too little of any nutrient, the body cannot function properly. A lack of carbohydrate for fuel results in fatigue, poor mental and physical performance and ultimately starvation and death… [but nutrient] excesses can also undermine health. Too much vitamin A can cause nausea, headaches, irritability and skin and liver damage; excess vitamin D can damage brain, bone and liver function… Balance is the key.”

Canada’s Food Guide was first produced during World War II as Canada’s Food Rules, and it hasn’t changed substantially since, says Monica Vegelji, a registered dietician at The Toronto Hospital: “Sound nutrition advice remains as simple as the four food groups. The big change is that, in the latest revision, we’re not just talking about a basic diet to prevent deficiencies of disease — we’re talking about a diet to optimize health in such a way that excesses are prevented. In Canada, and really North America in general, one of the basic problems is not inadequate nutrition — a deficiency of nutrients — but rather diseases of excesses that plague us: too many nutrients and, in particular, too much fat.

Thus, the new Guide places a larger emphasis on two of the four food groups: grain products, and vegetables and fruits. Milk products are still important, but lower fat products are recommended, such as 1 per cent milk and yogurt, and skim-milk cheese. Meat and alternates are still an important group, “but that’s probably the smallest portion of the plate when you sit down to dinner,” Vegelji says. “If those recommendations are followed, then there are really no major nutrition concerns. You can’t go far wrong if you start with a basic healthy diet.”

To help her clients visualize appropriate Food Guide portions, Vegelji uses what she calls “the plate model”: “If you picture the surface of a dinner plate, and you want to fill it up in a healthy way, for most people that would be about one quarter with meat or alternates. You want to fill about half your plate with vegetables and fruit, emphasizing dark green or orange vegetables, such as broccoli and carrots. Fill the remaining quarter with a grain product, such as a potato or pasta, or bread or rice.

“For people with greater energy requirements, they might add something on the side — a glass of milk, another bread or dinner roll, maybe a piece of fruit for dessert. If you use that model, when you walk into a cafeteria or try to judge a healthy portion on your plate, you’ll have an instant way of recognizing it.”

For the average person, drafting up a healthy menu with the help of Canada’s Food Guide is pretty straightforward, but there are lots of good reasons to ask for professional help. If you suffer from food allergies or sensitivities or have a particular health condition, if you’re taking medications that impose dietary restrictions, or if you’re physically unable to shop for and prepare three meals a day, you may want to consult a specialist to ensure your diet is properly balanced. Leaving even one key food or food group out of your diet could mean you’re depriving yourself of an essential nutrient or vitamin.

If you’re concerned about your diet, ask your doctor for a referral to a registered professional dietician. Keep in mind doctors rarely have much training in diet and nutrition (dentists and chiropractors receive more), and, although there are well-trained nutritionists, they’re unregulated: Anyone can call him- or herself a nutritionist, whether they’ve had training or not (ask for his/her credentials); only dieticians have to meet strict educational requirements (a four-year university course, followed by a one-year internship and perhaps further specialization). For specific advice on drug-nutrient interactions, talk to your pharmacist.

A little professional advice can go a long way, given the number of factors that can have an impact on diet, especially as we age. “To talk to someone about diet simply as a bag of nutrients would be an oversimplification,” Vegelji asserts. Social issues, including reduced income, can play a major role in whether or not an elderly person is eating properly. “And, if someone’s lost a spouse and they’re lonely, depressed and isolated, that’s going to have a tremendous impact on that person’s ability to get an adequate diet. To only talk about nutrients at that point would be doing that person a disservice.”

Age isn’t simply a matter of chronology, Vegelji points out. A fit, active 70-year-old can be far “younger” physiologically than a 50-year-old, because exercise can affect feelings of wellness, appetite and cardiovascular capacity. However, there are physiological changes that accompany aging that can impose very specific nutritional concerns on seniors, no matter how fit they are. Chronic conditions may develop, such as elevated blood-lipid levels, high blood pressure, heart disease or osteoporosis, and anyone affected by such conditions, Vegelji says, “is probably concerned about dietary intervention strategies that will help to eliminate or bring those conditions under good control.”

There are age-related physiological changes that aren’t disease-specific, such as our sense of thirst. Among elderly people especially, Vegelji says, “often by the time their sensation of thirst kicks in, they’re already dehydrated. Taste acuity and sense of smell are also diminished in the elderly, and oftentimes this leads to excessive use of salt, and that may fuel a problem of high blood pressure or heart disease, or be a concern if someone is taking a particular medication where excess salt is contraindicated.”

Some people simply lose interest in food as they grow older. They may start to develop problems with their teeth, so that foods become hard to chew, or their digestive systems may slow down, causing constipation, heartburn and bloating, but with every food they consequently delete from the menu there’s a nutrient loss.

The Complete Canadian Health Guide points out that “the diets of many older people, especially women, are substandard, particularly low in protein and vitamins (especially vitamin D), not even providing half the essential nutrients. As people spend less time outdoors in the sunlight, vitamin D stores can be depleted, and some seniors need a supplement… Although overall food intake should be somewhat less with advancing years, the body’s actual nutrient needs remain similar or slightly increased, so it’s just the total calorie count that needs to go down with each successive decade.”

To calculate how much food you need to meet your nutritional requirements, consider that, per day, the average 23- to 50-year-old woman (162 cm/55 kg, or 5-foot-4/120 lb), requires 36 calories per kilogram (16 cals/lb) — that’s just under 2,000 cals/day. The average man (180 cm/77 kg, or 5-foot-11/170 lb), requires 44 cals/kg (20 cals/lb) — just under 3,400 cals/day. Now figure that, after age 40, calorie requirements drop by about five per cent per decade, so the average 60-year-old woman would require about 1900 cals/day, the average man about 3,200 cals/day.

Unless you’re an experienced calorie-counter, working out a appropriate, balanced diet to meet those guidelines could be a daunting task. Again, start with Canada’s Food Guide, but don’t be afraid to ask for help: That’s where a dietician or qualified nutritionist comes in. When Vegelji’s dealing with someone in a counselling setting, she tries to take everything into consideration — her client’s age, physical activity and wellness levels, any health conditions they may have, medications they’re taking and their caloric requirements — and then she goes to work with that individual to set up goals and devise strategies to meet those goals.

It’s a fairly complete approach. And rest assured that few dieticians will try to ram a diet of carob and cooked cabbage down your throat — despite the fact you can’t stomach either. It doesn’t matter how nutritious it is; if you won’t eat it, there’s no point putting it on your plate. Like much of what goes into diet and nutrition, that’s just common sense.