6 “Healthy” Eating Choices to Rethink

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If you’re committed to healthy eating, it’s time to start investigating whether your current food choices are as wholesome as you’ve been led to believe.

In the pursuit of optimal vitality, many health-motivated people reach for food they think is good for them. Unfortunately, many such so-called healthy choices turn out to be less beneficial than we assume. Because they often involve swapping fats and sugars for a slew of chemicals, they may actually undermine, rather than support, your health goals.

“When I see fat-free or sugar-free on the label, the alarm bells go off,” says Maggie Ward, RD, nutrition director at the UltraWellness Center in Lenox, Mass. “I immediately wonder, ‘What are they putting in its place?’”

Given the way food packages are designed, it’s hard to know. Labels are cluttered with claims about “heart health,” “zero trans-fat” and “low cholesterol.” You need a discerning eye to see through the hype. You also need a willingness to question both conventional wisdom and media messaging.

Not quite sure how well you’d score on a healthy-eating pop quiz? Here are the subjects on which many well-intended eaters remain confused, and a review of the often misunderstood gaps between hype and reality.

1. Artificial Sweeteners

Hype: In the 1960s, artificial sweeteners found their way into soft drinks and were marketed as a dieter’s dream: all the sweet and none of the sin. Today, saccharin (Sweet’N Low), aspartame (NutraSweet, Equal) and acesulfame-K and sucralose (Splenda) are ubiquitous parts of the American diet. Aspartame alone appears in more than 6,000 products and is gulped down by 54 percent of Americans. Because artificial sweeteners are low in calories and sugar-free, food makers market them to both dieters and people with diabetes (two groups with ever-expanding memberships). The sell is that calorie-free sweeteners are healthier than sugar and less likely to contribute to weight gain or blood-sugar disorders.

Reality: Research has shed light on the possibility that these sugar substitutes may hurt the very people they are purported to help. In a study of more than 3,600 people, published in 2008 in the journal Obesity, researchers at the University of Texas Health Science Center at San Antonio were stunned to discover that people who drank artificially sweetened beverages, such as diet sodas and artificially sweetened tea and coffee, gained 47 percent more weight during a seven- to eight-year follow-up period than people who avoided artificial sweeteners. These findings were based on long-term changes in individuals’ body mass index, or BMI, and all analyses were adjusted for each person’s BMI at the start of the study. Specifically, it found that consuming more than 21 artificially sweetened beverages per week (vs. none) was associated with an almost doubled risk of becoming overweight or obese among the 1,250 individuals who were normal weight at the study’s outset.

So what gives? Although the study didn’t investigate the underlying mechanisms of weight gain, lead investigator Sharon Fowler, MPH, suggests a couple of plausible scenarios: For starters, she says, “The brain is very good at counting calories.” Meaning, it likes to consume the same amount of calories every day. “So, if you switch from Coke to Diet Coke and cut out 400 calories a day from sugar, your body may try to compensate elsewhere.” The upshot is that you may end up eating all the calories you saved, and then some.

Then there’s a dynamic known as “taste distortion.” Artificial sweeteners, made to fit snugly into the mouth’s sweet-taste receptors, are up to 13,000 times sweeter than sugar. Fowler and her colleagues speculate that teasing the taste buds with noncaloric sweeteners may stimulate appetite without providing any of the calories that would produce satiety. Instead, she explains, “they create a craving for intensely sweet, highly caloric food.”

Other research suggests that noncaloric sweeteners may also trigger the body’s cephalic phase response, in which the brain responds to the taste of something sweet by releasing insulin (the body’s normal response to a rise in blood sugar) even though there’s no sugar for the insulin to process. The net result: disrupted blood sugar, sugar and carb cravings, and resultant weight gain.

If you’re svelte, it might take more than a fear of weight gain to pry that Diet Coke from your hand. But Fowler cautions people not to underestimate the other health risks of artificial sweeteners. “These drinks are just a slurry of chemicals, and we’ve not yet begun to understand their total health risks.” She is particularly leery of sucralose and aspartame, pointing to research and consumer experiences that indicate aspartame can trigger responses ranging from skin rashes to migraines — and worse. One possible culprit may be formaldehyde, an indirect metabolite of aspartame. “People who are highly sensitive to formaldehyde may be the canaries in the mineshaft,” she says. “I’m concerned that the long-term effect on other vulnerable individuals may be a slow, neurological toxicity.”

Better choice: First, strive to reduce your intake of sweets and sweetened beverages overall. If you are in the habit of enjoying several sweetened beverages a day (regardless of how they are sweetened), make it a priority to replace them with water or herbal tea.

When you do choose to enjoy a sweetened food or beverage, give preference to sweeteners closest to their natural state, such as honey, maple syrup, agave nectar or raw sugar. But remember, sugar is sugar, and most natural sweeteners digest as quickly as refined sugar — so don’t overdo it.

If an inflammatory disease, such as diabetes, heart disease, cancer or arthritis, has you cutting back on the sweet stuff, but you still crave the occasional treat, agave nectar is probably your best bet. Extracted from cactus sap (the same cactus used to make tequila), agave nectar is three times sweeter than white sugar but its glycemic index is four to five times lower than that of honey. That means it digests more slowly and, therefore, won’t spike blood-sugar levels.

Stevia is another option, but its calorie-free status raises some of the same concerns critics have noted about artificial sweeteners. While small amounts of Stevia (and its processed brand-name counterpart, Truvia) are not likely to pose any health risks, high doses of the herb have caused reproductive problems in rats, so consider it a second choice, and avoid commercial products that rely on Stevia as a sweetening ingredient.

No matter which sweetener you choose, keep in mind
that feeding a sweet tooth is simply going to increase your cravings for more sweets and refined carbs and will also reduce your ability to enjoy the natural sweetness of fruits, vegetables and whole grains. So, swap good sweeteners for bad, but use them in moderation.

LEARN MORE: Poor Substitutes” (December 2007), “Fighting Inflammation” (July/August 2004), “Sugar Breakdown” (July/August 2006)

2. Low-Fat Dressings

Hype: When studies in the early ’90s found that salad dressings were a surprisingly high source of fat in women’s diets, food makers rushed in to offer low-fat options. Today, dozens of low-fat and fat-free salad dressings crowd supermarket shelves, and one in three women (and one in five men) say they always opt for low-calorie dressings. The appeal of low-fat and fat-free dressings is the notion that they are in some way “heart healthy,” cholesterol reducing or helpful in supporting weight loss.

Reality: You’re better off making or buying salad dressings with a healthy dose of high-quality oils or natural fats such as olive oil or grape-seed oil, and even augmenting your salad with additional ingredients rich in healthy fats (think nuts, seeds and avocado). That’s because a well-built salad not only tastes great and satisfies longer, it’s a smorgasbord of vitamins, minerals and other micronutrients. Striving to keep your salad fat-free, or even low fat, not only reduces the pleasure you take in eating the salad, but it reduces your body’s ability to make use of those nutrients.

It turns out that the human gut simply can’t absorb key nutrients, such as carotenoids (organic pigments that give orange and red fruits and veggies their bright colors), without a dollop of fat. Researchers estimate that the gut needs roughly 6 grams of fat to wrestle carotenoids from their plant moorings and whisk them into the body.

Another reason to pass on low-fat and fat-free dressings? Peruse the ingredient list of most fat-free ones and you’ll likely see artificial flavors and a hefty glob of high-fructose corn syrup. The syrup is particularly hazardous, since studies suggest it lowers metabolism while shutting off the brain’s master switch for appetite control. Some low-fat salad dressings also contain hydrogenated oils (trans fats), which you want to avoid at all costs.

“Fat-free dressings rob you of the chance to integrate healthy fats into your diet,” says Michelle Babb, RD, a nutritionist at the Bastyr Center for Natural Health in Seattle. Moreover, she notes, “A salad with fat-free dressing will leave you hungry an hour later because you didn’t get the satiety that comes with eating fat.”

This last point is important, because a lack of eating satisfaction can lead directly to unhealthy snacking and overeating of sugars and refined carbs, both of which pose a larger threat to lipid profiles and healthy-weight maintenance than the fats found in most salad dressings.

Better choice: Give preference to dressings that have an olive oil or other healthy-oil base and that contain only natural, whole-food ingredients. It’s easy to make your own single-serving dressing. Start with a tablespoon of high-quality, extra-virgin olive oil and mix in a teaspoon of Dijon mustard. Add a couple teaspoons of your favorite vinegar, plus sea salt and fresh-ground pepper to taste. Prefer a creamy dressing? Add smaller amounts of the ingredients above to a base of plain, full-fat yogurt.

Not a fan of salad dressings? Get many of the same benefits (and then some) by adding avocado to your salad. At 115 calories and 10 grams of fat, one-half of an avocado will help your body absorb good stuff from the salad, as well as deliver vitamin B6, vitamin C, folate, potassium and omega-3 fats.

LEARN MORE:Big Fat Controversy” (January/February 2004), “Fat Chance” (January/February 2006), “All About Oils” (April 2007)

3. Whole-Grain Breads

Hype: Read the packages in the bread aisle and it’s easy to think you’ve hit the nutrient jackpot. Every label features words like “whole,” “multi-grain,” “oats,” “natural” and “fiber.” For generations raised on white bread, the mere hint of brownness and texture may be enough to signal wholesomeness.

Reality: When it comes to bread, you can’t judge a loaf by its wrapper — or its color. Nor can you assume that even a healthy bread is going to be healthy in any and all quantities.

First, read the fine print. Check the first few ingredients of most mass-market-brand breads and you’re likely to find “enriched flour,” meaning it’s made mostly of refined white flour — the same stuff in Wonder Bread.

“Just because it says ‘made with whole grain’ doesn’t mean it’s good for you,” says Michael Aziz, MD, author of The Perfect 10 Diet (Cumberland House, 2010). Also, make sure your whole-grain bread doesn’t contain added ingredients such as high-fructose corn syrup, molasses, artificial flavors, trans fats or industrial, unhealthy oils (soybean and cottonseed, for example, which are used because they are cheap, not healthy).

Keep in mind, too, that even the best whole-grain bread products require moderation. “Whole wheat has become a get-out-of-carb-jail-free card,” says John La Puma, MD, author of ChefMD’s Big Book of Culinary Medicine (Crown, 2008). People tend to think that when they choose a whole-wheat product, they can eat it with impunity. “Some whole-wheat bagels are the size of tricycle tires,” he notes.

La Puma suggests that people strive to replace some of their grains with nonstarchy vegetables and legumes. When we do choose whole grains, he recommends eating a moderate serving (one slice of regular-size bread, for example) and pairing it with a healthy protein, such as nut butter, to slow digestion. A healthy serving of whole grains equals one slice of whole-grain bread, 1 cup of whole-grain cereal or a half cup of brown rice.

Better choice: Although many nutrition experts recommend eating bread sparingly, you don’t have to give it up completely. If you want to stick with conventional products, look for a loaf with fewer than five ingredients. Look at fiber and protein next, Ward advises. “You want 4 to 5 grams of fiber and some protein in each slice.” If you’re willing to sacrifice smooth, fluffy texture for a heartier, chewier one, Ward suggests opting for specialty breads made with sprouted grains and seeds. She likes them because “the sprouting process makes them more digestible and higher in key nutrients, like protein, than other breads.” Breads containing seeds also tend to satisfy hunger longer.

LEARN MORE:Great Grains” (July/August 2005), “How Healthy People Decode Labels” (April 2009), “Role Reversals” (October 2006)

4. Egg Substitutes

Hype: Thanks to their fat- and cholesterol-rich yolks, eggs have gotten a bad rap. For decades, we’ve been told to steer clear of cholesterol-containing foods because diets high in cholesterol increase our risk of heart disease. So it’s no wonder that many health-minded people have turned to egg-replacement products as an easy substitution — especially since the tantalizing labels on these products promise “zero cholesterol.”

Reality: Dietary cholesterol is not a major culprit in contributing to heart disease and other health woes. Foods that incite inflammation in the body — sugars, refined grains, trans fats and other processed foods — not egg yolks, are the real problem. Egg yolks actually contain a variety of healthy fats and proteins and are full of vitamins and minerals that actually help support your body’s health.

Fake and yolk-free egg mixes, meanwhile, manage to reduce dietary cholesterol (and in some cases, calories) only by making some important nutritional compromises. To make up for removing the egg yolk, manufacturers often add polyunsaturated vegetable oil, a category of industrial fat known to stoke the fires of inflammation. “Heated polyunsaturated oils create free radicals that harm the arteries,” says Aziz. Other additives required to reintroduce flavor and texture add little or nothing in the way of nutrition and increase the daily burden of chemical compounds your body must deal with.

That’s why today’s well-informed nutrition experts are recommending that if you like real, whole eggs, you should go ahead and enjoy them. For starters, eggs are a good source of protein (about 6 grams in a large egg), and about half the protein resides in the yolk. The yolk also contains most of an egg’s minerals and vitamins, including vitamins A, D and E — not to mention micronutrients, such as lutein and zeaxanthin, that give the yolk its vibrant color. Free-range and flaxseed-fed chickens produce eggs especially high in omega-3 fats.

There may also be a variety of other nutritional cofactors built into whole eggs that science has yet to discover, but the upshot is that whole eggs taste great and satisfy well, and since they’ve now been exonerated as a cholesterol- and heart-disease-causing suspect, there’s no reason not to enjoy them as nature made them.

Better choice: Enjoy whole eggs, choosing those from pastured chickens (meaning they roam freely outdoors) whenever possible.

Ward advises her clients who love eggs to enjoy them soft boiled or poached. “Scrambling exposes them to heat, oxygen and light, which can oxidize cholesterol and other fats,” she says. “So protect the yolk as much as you can.”

While frequency recommendations vary, there’s no evidence that eating eggs even several times a week poses any health risk. Just make sure you’re building enough nutritional variety into your diet and complementing your egg breakfasts with vegetables and legumes (consider adding a side of sautéed tomatoes, dark greens, zucchinis, sweet potatoes or black beans) whenever you can.

LEARN MORE:Cholesterol Reconsidered” (June 2009), “Cholesterol Myths” (December 2005), “The Whole Thing” (March 2008)

5. High-Fiber Breakfast Cereals

Hype: Ads for adult cereals lead people to believe there is nothing more wholesome than starting the day with a heaping bowl of vitamin- and mineral-enriched flakes. Many fiber-rich cereals are emblazoned with health claims about cancer fighting, heart health and weight loss. But the truth may be a little harder to stomach.

Reality: Studies do show that a diet rich in whole grains and fiber can help thwart colon cancer, diabetes and heart disease, but it pays to be discerning. “In most whole-grain cereals, the grain is pulverized into a fine powder,” says La Puma. “And, once inside the body, it acts almost the same as a starch or sugar. The presence of ample fiber may help slow the release of all that sugar into your bloodstream and may also help you with regularity, but the cereal itself is unlikely to be a particularly nutritious day starter — even if it is fortified with a range of vitamins and minerals. Studies have shown that isolated nutrients, such as those added to many fortified cereals, don’t confer the same health benefits as eating whole foods.

In fact, one of the key problems with many high-fiber cereals is that they take a relatively unhealthy, conventional cereal product and then just add supplemental fiber and isolated nutrients to the mix. The product may still contain all kinds of other questionable ingredients and heavy doses of sugar.

Worse, relying on a cereal to fulfill daily fiber and nutritional requirements may discourage people from including more authentically nutritious whole foods (berries, nuts, seeds, proteins) in their breakfast regimens and may reduce their motivation to seek out vegetables, legumes and other fiber-rich foods throughout the day.

Better choice: Many dietitians prefer to see their clients eat breakfasts of yogurt with nuts and berries, eggs, steel-cut oatmeal, whole-food smoothies, or even leftovers, because these options are more naturally packed with nutrients as well as proteins, which help ward off hunger. If you enjoy having cereal for breakfast, however, just strive to have it a couple of times a week, rather than daily.

Take some time to select one or two truly nutritious cereal options. Most leading-brand products are heavily refined. Less-processed cereals, such as granolas and mueslis, may be more nutritious but can be surprisingly high in sugars and very dense in calories, so watch your serving sizes.

In choosing a fiber-rich product, select an unsweetened or minimally sweetened cereal that contains mostly whole-food, minimally processed ingredients and does not rely on “enriched” strategies for its nutritional merit. Make a point of topping whatever cereal you choose with nuts, berries, chopped apple, and ground flax or shelled hemp seed — or, better yet, start with a base of ingredients like these and then add a handful of cereal on top. Then add milk, yogurt or a milk alternative such as soy, hemp, rice or almond milk.

Avoid eating cereal plain out of the box for a snack. People tend to overeat cereal this way, getting a big infusion of fast-digesting sugars that can lead to hunger and cravings later. Instead, “toss cereal into a trail mix with nuts and seeds,” suggests Ward. Each of these options fuels the body with a steadier stream of energy and nets you more phytonutrients, fiber and healthy fats.

LEARN MORE:The Whole Thing” (March 2008), “Learning to Read Labels” (September 2007)

6. Meal-Replacement Drinks/Weight-Loss Shakes

Hype: Promoted as healthy, handy alternatives to eating actual meals, many weight-loss and meal-replacement drinks promise to get you a huge helping of vitamins and minerals in just a few gulps. Most advertise their low-cal and low-carb attributes.

Reality: Labels of weight-loss shakes reveal these concoctions are little more than skim milk, high- fructose corn syrup or artificial sweeteners, and artificial flavorings and colorings. Yes, they have supplemental nutrients thrown in, but as noted above, research has indicated that most nutrients are best absorbed when delivered by whole foods, not isolated and mixed with chemicals.

“Your body doesn’t know how to respond to new-to-nature molecules, like artificial colors and sweeteners,” says Babb. “We are learning that some of these chemicals, like high-fructose corn syrup, may trick your body into thinking it’s still hungry when it’s not.”

Another problem with these shakes is the chewing dilemma. “Weight-loss shakes don’t satisfy our need for chewing, for texture, for enjoying the sensory aspect of our food,” says Suzanne Havala Hobbs, DrPH, MS, a registered dietitian and professor of public health at the University of North Carolina at Chapel Hill. “Our body doesn’t properly register the calories we consume in beverages. So, if anything, they are counterproductive because they leave you wanting more.”

Finally, relying on prepackaged, processed food replacements for your sustenance establishes poor eating habits and may contribute to a sense of being “out of control” of your eating when you do attempt to enjoy regular food.

Better choice: Eat real food whenever you can, and commit to developing sustainable eating habits that support your health and vitality. Do not rely on liquid nourishment to support weight loss.

If you want to incorporate nutritional shakes as an energy-boosting snack during the day, make your own and take it with you. Babb advises her clients to start with a high-quality protein powder (for more on powder options, see page 36), add a cup of fresh or frozen fruit, pour in some milk or a milk substitute, and top it off with a tablespoon of ground flaxseed or hemp seed.

Want to feel even more virtuous? Add a handful of raw spinach leaves, a whole tomato or a scoop of a supergreen supplement, such as spirulina, to send your nutrient count skyrocketing.

LEARN MORE: Sizing Up Smoothies” (June 2004), “The Simple Way to Slim” and “The Fit Way to Weight Loss” (January/February 2008)

Getting past marketing hype to see the true health merits of foods requires mixing close label-reading skills with a practical dose of skepticism. It also requires a willingness to experiment with food options that no attractive celebrity sponsor may ever encourage you to try.

If you’ve grown accustomed to eating heavily processed so-called health foods, it may also take a little time for your tastes to adjust to the real thing. But if you start making these recommended shifts now, within just a few weeks you’ll find that you’re enjoying your food more and feeling more energized by the meals you’re putting in your body. Your cravings for less healthy foods will diminish, and you’ll reclaim the naturally healthy palate that is your birthright.

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Catherine Guthrie eats a mostly vegan, wheat-free and sugar-free diet in Bloomington, Ind.

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