Feeding Frenzy

Overwhelmed by conflicting advice, most Americans have thrown in the napkin on healthy eating. Here's how to cut through the controversy.

_I_ There's a new American way of living today ... Americans care about physical fitness and good nutrition now as never before ... We eat less red meat and more poultry and fish, more fresh vegetables and fruits, more whole grain cereals...._i_

-"Betty Crocker's Light and

Williams's approach to the bewildering world of food choices is a simple one: give up and hope for the best. It seems to be shared by millions. Assaulted by a blitz of nutrition advice in recent years-lower your cholesterol, eat more fiber, throw out the salt shaker, forget red meat, get more calcium, reduce your fat intake, use more olive oil, grill everything, avoid barbecuing, eat more fish, watch out for shellfish, choose margarine, beware of transfatty acids in margarine-many Americans have thrown up their hands. "Basically, I eat junk," says Sharon, a 53-year-old telephone-company employee, downing a hot dog at a Santa Monica, Calif., mall. "I don't listen to any of those claims that eggs are bad for you and everything else causes cancer. The next thing they'll be telling us is you can't drink water."

Nonsense! Of course you can drink water (as long as it's been tested for lead). But recently Americans woke up to some particularly discouraging headlines: the latest dietary bugaboo is food itself Or so it seemed. The basic four food groups, long touted as the healthiest organizing principle for American meals-two servings of meat a day, two of dairy products, six of grains and five of fruits and vegetables are under attack. The U.S. Department of Agriculture, along with many nutrition experts, wants to reconfigure t groups to emphasize the importance of grains, fruits and vegetables, with a corresponding de-emphasis on meat and dairy pr Meanwhile, the Physicians for Responsible Medicine, a based nonprofit group, wants to throw out the traditional groups entirely. PCRM favors what it calls the new four: fruits, vegetables, grains and legumes (which include peas and beans). Meat, poultry, fish, eggs and dairy would retire to the far fringes of the American diet.

Both these plans reflect a growing body of scientific evidence that American eating habits are killing us. Our rates of heart disease and some cancers, particularly of the breast and colon, are among the highest in the world. Many factors contribute to cancer and heart disease, including an individual's genetic inheritance, but when epidemiologists trace the course of diseases across the globe, the role of diet stands out sharply. Japan offers the starkest example. The traditional Japanese diet is the direct opposite of ours: typically they eat rice, vegetables and a little fish, while Americans put a big porn of meat in the center of plate and add a few french fries. Consuming only about a quarter as much fat as we do, and far more carbohydrates, the Japanese live longer than anybody else in the world. That is, until they move here. "The Japanese in Japan have one fifth or one sixth the rate of breast cancer that we do," says Dr. Peter Greenwald, director of the Division of Cancer Prevention and Control a Cancer Institute. "When they move to Hawaii, the rate goes up." In the last few decades, moreover, as hamburgers, ice cream and other high-fat foods have become popular in Japan, higher rates of cancer and heart disease have followed. Similar patterns are emerging all over the globe. "I've been in Mauritius, Cuba and Hungary, three completely different countries, advising their governments on nutrition education," says Marion Nestle, professor of nutrition at New York University. "People in all three countries are starting to imitate our diet, they're eating more animal fat and dairy products, and their rates of disease are skyrocketing."

Precisely how our diet fails us is a matter of continuing debate, but nutritionists agree that its proportions are all wrong. That half-pound sirloin in the center of the plate carries nearly one and a half times the amount of protein you need in a whole day (the excess can make you fat), and it's packed with saturated fat. True, many Americans know the bad news about meat by now and have cut down, but substituting chicken or fish doesn't go to the heart of the problem. What's missing from the plate is just as important as what's on it. According to recent dietary studies, nearly half of all Americans eat no fruit on a given day and nearly a quarter eat no vegetables. Eleven percent eat neither, and only 9 percent of us get the recommended five servings a day. "For a great many people, a day without meat is somehow inadequate," says Gladys Block, a nutritional epidemiologist at the National Cancer Institute. "That just isn't so for a day without fruits or vegetables." Block and other scientists are now convinced that fruits and vegetables actively protect against cancer, and new evidence suggests that they may also protect against heart disease.

The theory is that an excess of free radicals-oxygen compounds generated in the course of normal metabolism-can travel through the body doing damage to its cells, thus initiating both cancer and atherosclerosis (hardening of the arteries). The body's best defense against these marauding molecules are nutrients known as antioxidants-the mineral silenium, vitamins C and E, and betacarotene, which turns to vitamin A in the body. They're found in fruits, vegetables and grains. Antioxidants neutralize the free radicals, at once protecting the body against disease and vindicating generations of mothers, nutritionists and home-ec teachers.

"For years, the National Academy of Sciences and the National Cancer Institute have been telling Americans to eat more vegetables," says Bonnie Liebman, nutritionist at the Center for Science in the Public Interest, a Washington, D.C.based consumer group. "But we aren't eating fruits and vegetables. No one has succeeded in getting that message across."

That message is very much at the center of the current flap over the four food groups; unfortunately, the controversy seems more likely to end in public frustration than public enlightenment. Ever since 1956, when the USDA began promoting the food groups, they have reflected political reality as well as nutrition policy. "The standard four food groups are based on American agricultural lobbies," says NYU's Nestle. "Why do we have a milk group? Because we have a National Dairy Council. Why do we have a meat group? Because we have an extremely powerful [meat lobby]." As the science of nutrition grew more sophisticated, and the relative roles of fats and carbohydrates became better understood, the food groups came up for revision not in content but in graphic design. Rather than simply list the groups or show them on a pie chart, suggesting they are equals, the USDA created "The Eating Right Pyramid" with grains taking up the large space on the bottom, fruits and vegetables the next largest, meat and dairy products in a narrower slice above them and fats and sweets in a tiny space on top. Nutritionists applauded, but after the graphic had gone to the printer Agriculture Secretary Edward R. Madigan suspended its publication indefinitely. Meat and dairy representatives had objected to the new design for its purported slighting of their products. Madigan says the pyramid "was and is under review."

PCRM's far more radical proposal to dump the four food groups has received a great deal of publicity, but surprisingly little attention has been paid to its practical implications-or to the politics embodied by PCRM. The group has two stated purposes: to address nutrition issues and to work against the use of animals in medical experiments. Its president, Neal Barnard, is a psychiatrist; he has also served as a scientific adviser to People for the Ethical Treatment of Animals, an animal-rights group, although he says he has "no official role" with the organization. According to PCRM, some 3,000 of its members are medical doctors; more than 50,000 "associate members" are not. While PCRM's new four food groups purport simply to place fruits, vegetables, grains and legumes at the diet's center, leaving other foods as options, Barnard himself is a strict vegetarian who eschews all animal foods including dairy products. The menus and food lists that PCRM has circulated with its proposal are similarly extreme, eliminating even low-fat animal and dairy products.

Barnard says that his personal belief, and his work for animal rights, have nothing to do with PCRM's proposal. "The science is in," he says. "We felt that we had to say that the old four food groups were a prescription for disaster." But the American Medical Association has charged that a "close relationship" between PCRM and the animal-rights movement is behind the group's dietary recommendations. "They are neither responsible nor are they physicians," says Dr. M. Roy Schwarz, the AMA's senior vice president for science and medical education.

Barnard's recommendations will never sweep the nation on the basis of gastronomic appeal-his recipes get their zip from nutritional yeast and soy milk. But many nutrition scientists agree that a fundamental restructuring of the American diet is long overdue. "I want people to recognize that dinner should not be made up of a chicken breast and a little half cup of rice and some iceberg lettuce-that's not enough plant food," says CSPI's Liebman. "Most of the meal should be grains, vegetables and beans, and meat should be used as a condiment. " She sees no reason to give up low-fat dairy products or lean meats and fish in moderation, but "moderation" amounts to a lot less of these foods than many Americans now eat. About six ounces of meat a day should be the maximum; three ounces of meat is the size of a deck of cards.

For most Americans, even modest changes in a single meal are hard to accomplish, much less a complete dietary overhaul. "I do try to cut fats, and I've totally cut out red meat," says Frann Davis, 39, unpacking her lunch in the courtyard of a Los Angeles office building. "Let's see, I have a tuna sandwich, dolphin-safe of course, on whole wheat, and an apple. And a bag of Fritos. I know the Fritos aren't very healthy, but I don't believe in depriving myself." Many people faced with the continuing chaos of nutrition advice, seem to have cobbled together an ad hoc food plan that includes eating exactly what they want and redeeming themselves with a diet soda. "They say they want healthy food, but it probably represents the smallest part of our sales," says John Hawthorne, a food-systems specialist at Chicago's Amoco Oil Co. cafeteria, which serves 3,000 people a day. A few weeks ago the cafeteria manager moved the desserts to a new spot near the salad bar. Sales of pie shot up by 30 percent.

What's needed, even more than a whole new diet, is a whole new way of thinking about food. A fat-free pastry won't do it. A vitamin pill won't do it, either. Worst are the food myths we're carrying around in our heads, the legacy of years of nutrition mania. You've got to start fresh. Here's how:

Unless you're on a weight-loss diet, or you want to compute the percentage of fat from calories in a given dish, don't even think about calories. They're a distraction. A calorie count means nothing unless it's accompanied by a fat count.

Some people need to restrict salt for the sake of their blood pressure; according to recent studies, most do not. Warning: the jury is still out on this one. But if you stay away from heavily processed foods, you're not likely to overdose on sodium.

Unless your doctor tells you to. If you must worry about something in this category, worry about artificial sweeteners. Don't stuff your diet with junk food, but the sugar in a dessert won't hurt. Sugar's real problem is its frequent companion-fat.

Most of us get nearly twice as much as we need without even thinking about it. A cup of milk, a peanut-butter sandwich on whole wheat, and four ounces of fish with some peas will give you a day's protein. Studies show that the more protein people eat, the more calcium is excreted in their urine, which may be why countries with the highest protein consumption-like ours-also have the highest rates of osteoporosis.

Check with your own pediatrician, but most of them now advise that kids should be drinking low-fat milk from the age of 2. Research indicates that kids tend to eat the way their parents do, so if you're eating lots of fruits, vegetables and grains, low-fat dairy products and moderate amounts of animal protein, your kids will probably get the message.

The easiest way to make good choices when you walk into the supermarket or open the refrigerator is to remember just one fact: fat, especially the saturated fat found in animal products, is the biggest troublemaker in the American diet. If you know where the fat is-and isn't-your choices will be easy to make. Fruits, grains, vegetables and beans have little fat; they are always good choices. (Fresh produce is best, but canned or frozen varieties are fine.) If you can restructure your notion of dinner so that rice, pasta or beans are in the center of the plate, lots of vegetables are nearby and meat is added more for flavoring than substance, you're way ahead. If you can't go that far, choose lower-fat meats and fish in smaller portions than you're probably used to, and fill up on grains and vegetables. You shouldn't eliminate every drop of fat from your diet-polyunsaturated vegetable oil, for example, is a good source of vitamin E, and olive oil may protect against heart disease. Just keep the amounts modest, and watch out for such innocent looking foods as salad dressings and muffins-they're fat traps.

A diet centered on low-fat foods will be high in fiber, which may protect against colon cancer, and low in cholesterol. It's likely to provide adequate calcium, although your doctor may advise supplements. In general you'll be doing all the right things without paying attention to them. Should you give up potato chips? You know the answer to that (10 grams of fat per ounce), but if you're regularly choosing low-fat foods, a few potato chips don't matter. A hot dog and potato chips and a candy bar, every day for lunch-that matters, Should you give up barbecuing? In other words, should you try to change your life with every new, horrifying discovery that hits the headlines? Better to use a little common sense. Grilling has been highly recommended for years as a cooking method that produces great flavor with little added fat. But research now suggests that grilling any protein, fat or lean, at a high temperature for a long time produces carcinogenic substances on the skin or the outside of the meat. According to the NCI's Greenwald, if you first microwave the meat for a minute or two and then throw out the accumulated fluid, which is where the potential carcinogens collect, you throw out most of the problem. Grilling over moderate heat to the rare or medium stage, rather than well done, also cuts the risk; and so does removing any skin before serving.

Dr. Jeanne Goldberg, assistant professor of nutrition at Tufts University in Medford, Mass., has the simplest prescription of all. "What we need to do is exercise, and eat somewhat less," she says. "A lot of our problems would take care of themselves." Goldberg calls Americans a nation of "guilty gluttons:" we'll eat anything as long as we can apologize nervously for it. "If you want fried chicken once every few months, there's nothing wrong with that," she says. "When we start getting diet Thanksgiving and Christmas dinners, we've really lost it."

There is a pleasure principle in diet that's all too easily forgotten when one's attention is fixed on the relative calcium content of bok choy and cottage cheese. But indulging in so-called forbidden foods may not be the only way to find pleasure at the table. "There's the idea that you either lead a sensual, rich life and die young, or you avoid life and eat boring food," says Dr. Dean Ornish, the San Francisco-based heart specialist whose program of exercise, stress reduction and a very-low-fat diet has been shown to un-. clog his patient's arteries. "That isn't the choice at all. You can be sensually satisfied without abusing yourself." His patients eat sunflower sprouts dressed with papaya and lime, and crepes wrapped around a mixture of sweet potatoes, chickpeas, carrots and roasted onions, all prepared by chef Jean Marc Fullsack, formerly of New York's Lutece restaurant. As important as the food, however, is the way his patients learn to relish it, to feel better and to enjoy their lives. Rushing through a highfat meal in typical American fashion, notes Ornish, is no recipe for pleasure.

You don't need a personal chef and doctor to be able to taste the delights of beautifully prepared food that's good for you: a new wave of what used to be known as health-food restaurants is beginning to appear. "The minute I said this was healthier, people thought it was macrobiotic-tofu and brown food," says Steve Frankel, co-owner of New Yo King, which has been serving lavish and imaginative dishes made without beef or dairy products for almost two years. Fish and chicken appear frequently, but fresh, whenever possible, are the stars; they're radiant.

Food that gives real pleasure, most often, is food that tastes like itself, food that hasn't been processed beyond recognition or tortured into palatability with chemicals. Fast foods and packaged foods, for all their convenience, don't seem to have cured any of our ills, physical or otherwise. "I'm sure that kind of diet is what's making people sick and fat and unhappy," says Alice Waters, owner of Berkeley's Chez Panisse restaurant and a founding mother of California cuisine, with its devotion to impeccably raised ingredients. People who eat heavily processed foods get trapped by them, she feels. You keep eating and eating, she notes, but you're never satisfied.

Very often, the food that truly satisfies us is the food that comes from home. A diet centered on grains, vegetables and beans demands home cooking to a much greater extent than a diet centered on take-out chicken, and perhaps that's one of the less tangible reasons why people who make the change often feel better. But cooking, while not yet a lost art, is a dwindling one. Goldie Caughlan, nutrition educator for The Puget Consumers Coop stores, a supermarket chain in Seattle, directs a team of instructors who offer market tours emphasizing how to buy and use fresh and bulk foods. "If we can't show people how to have a good meal in a short time, they're going to keep buying out of the freezer," says Caughlan.

Home cooking is satisfying because it reminds us that food, as Waters likes to say, deserves respect. "It can't be treated as if it came from a factory, that's not what food is," says Waters. "People need to care a lot more about where their food comes from-the farms, the animals, the farmers. That's the missing link between us and what we eat." No, you don't have to raise your carrots in a window box or drive 200 miles to buy a politically correct free-range chicken. Just get to know food, get to know the flavors and textures of what you eat. Don't let a chain restaurant do it all for you, do it for yourself. That's the pleasure we've been missing, and we can find it in red meat and broccoli alike.

The basic four were devised in 1956 to promote the health of The new pyramid retains the four groups but emphasizes the all Americans-including the meat and dairy industries. importance of making fruits, vegetables and grains the basis of Cheese turns up twice; is it meat or milk? the diet. Meat and dairy groups aren't happy with their spot.

Hungry? Don't ask a scientist what to eat. Expert opinion on good nutrition seems to change daily. Here's the latest.

It used to be king; now we know that too much just makes you fat.

Eat up, they aren't fattening anymore. But watch the sauces.

The good news is you may need less calcium if you eat less protein.

Here's the real culprit. But there's life after croissants, honest.

Not everybody has to banish the salt shaker. Check with your doctor.

Fast food doesn't have to go straight to your arteries. Most places offer salads, baked potatoes and other life preservers. Less than 30 percent of calories should be fat.

Best: McLean Deluxe Sandwich. 320 cal.; 10 grams fat Worst: Filet-O-Fish Sandwich. 440 cal.; 26 grams fat

Best: BK Broiler Chicken Sandwich. 379 cal.; 18 grams fat Worst: Double Whopper w/Cheese. 935 cal.; 61 grams fat

Best: Grilled Chicken Sandwich. 340 cal.; 13 grams fat Worst: Wendy's Big Classic. 570 cal.; 33 grams fat

Best: Lite'n Crispy drumsticks (2). 242 cal.; 14 grams fat Worst: Chicken Sandwich. 482 cal.; 27 grams fat

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