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Healthy Shopping
Written by Dr. Teri Bilhartz, Preventive Medicine Department, Stony Brook Univ Med Center
AT THE SUPERMARKET

efore we go into detail about restaurant foods, let's start closer to home with the supermarkets. For many Americans, a trip to the store is a mundane, often unpleasant, chore. It is usually at the end of a long day when we are hungry and tired, or we're in a huge hurry and need to grab something fast and get out. Regardless, shopping for our food has become a mindless activity not much different than pumping gas. Supermarket chains have catered to our hurried, fast-paced lifestyles. This is evident upon entering most supermarkets, where bins of cheap, packaged food are lined up along the walls and at the registers, complete with SALE tags. This food is quick, easy, and convenient for the harried shopper to throw in the cart, and later, to shovel into the mouth. But this "convenient" food does not come without cost. There's no getting away from the inherent truth that if all you feed your body is junk, then all your body can give back is junk. You can't bloom a beautiful botanical garden if all you plant are weeds! We are paying for the bins of packaged food via our health bills, our larger clothes, and our physical and emotional pains. To live healthy, you must commit to mindful shopping and eating.

THE CONSCIOUS CART

hances are, whatever you purchase at the store is what you will consume at home, so your desire to eat healthy begins at the store. Your grocery cart should serve as a gatekeeper for what you buy, and therefore what goes in your mouth. If the food is an Earth food, then it can fly into the cart, no further delay! But if it's a packaged product, you should scrutinize the food a bit more before placing it in the cart. Keep in mind that foods "from the earth" have great nutritional worth. The further removed from nature a food becomes, the less the nutritional worth. If you're looking at a package that has an ingredient list as long as the box dimensions, with chemical names that you can't pronounce, then you can be relatively assured that the product is lacking in nutritional worth.

An easy rule of thumb is to count the number of ingredients listed on the box. The fewer the better! When choosing between two products, choose the one that has the least number of words in the ingredient list!

HEALTHY EATS: THE STAPLES

et's make supermarket shopping as painless as possible. If you aren't motivated to read ingredient lists yet, this next section will provide a list of healthy foods that can be found at any supermarket. These foods should be staples in your pantry. Add the following to your conscious cart without hesitation:

  • Fresh fruits of any kind: apples, bananas, peaches, grapes, kiwi, cantaloupe, honeydew, berries, pineapple, mangoes, papaya, pears, watermelon, and persimmons. Step out of the routine and buy fruit that you haven't had in awhile. Remember summer picnics with fondness? You can eat luscious, fresh fruit any time of the year. When stored in a refrigerator, most types of fruit will last a week or longer. Bananas overripe? Cut them in slices and freeze them for a popsicle-like treat!
  • Fresh vegetables: spinach, lettuce, chard, carrots, cauliflower, broccoli, squash, celery, zucchini, onions, tomatoes, avocado (actually a fruit!), mushrooms, bell peppers, corn on the cob, sweet potatoes, asparagus, green beans, sugar snap peas, lima beans, green peas, water chestnuts, and more!
  • Potatoes: Experiment with different yams and sweet potatoes. Potatoes serve as a healthy alternative to white flour carbohydrates. They can be paired with vegetables or a salad for a delicious meal, chocked full of fiber, potassium, vitamin C, and beta-carotene (in sweet potatoes).
  • Brown or multi-grain rice: the instant kind is fine, as long as it's whole grain
  • Oats: instant or slow-cooked. Steer clear of the flavored oatmeals that are full of sugar and artificial ingredients. Buy the real thing, and make your own tasty flavors!
  • Soymilk or low-fat/fat free milk
  • Nuts: cashews, almonds, walnuts, brazil nuts, pistachios, macadamias, pecans, filberts, pumpkin seeds. Make sure the nuts are unsalted, and preferably raw.
  • Nut butters: peanut butter, almond butter, cashew butter -be creative! Important: buy the freshly ground (if the store has a grinding machine) or the natural varieties that have one or two ingredients on the jar (peanuts or peanuts and salt). You will have to stir up the contents the first time, as the oil will separate at the top, but you'll avoid the hydrogenated fats and added sugar that the Jiffy and Skippy brands are loaded with.
  • Shredded wheat cereal: again, plain shredded wheat. Not frosted or sweetened! You can add a banana, cinnamon, fresh berries, and voila!
  • Frozen vegetables: This is a life-saver for the busy health-nut! Frozen fruits and veggies have been shown to retain their anti-oxidants and are just as healthy as fresh. They can be pulled out of the freezer, poured into a pot, and heated in 5 minutes to add to any dinner. They are already sliced and washed so there is no prep time!
  • Frozen fruit: This is especially useful for berries, as fresh berries are often hard to come by at certain times of year, and can be quite costly. Frozen blueberries, strawberries, blackberries, raspberries, and cherries can be added to oatmeal, shredded wheat, or thrown in a blender with soymilk and ice for a delicious antioxidant-rich smoothie!
  • Whole grain bread. Avoid the bread aisle, and instead find your bread at the supermarket bakery. Most supermarkets now bake their own fresh bread daily. The fresh variety has less chemicals, preservatives, and high fructose corn syrup, and tastes better! Once you switch over to fresh bread, you won't be able to stomach the artificial "wonderbread" any longer! Fresh bread should be kept in the refrigerator, as the shelf-life is reduced thanks to no preservatives! If it's not already sliced, just ask the deli to slice it for you.
  • Whole grain pitas, wraps, tortillas. For a change from the usual sandwich bread, experiment with other whole-grain carbohydrates. Fill a pita or tortilla with beans, avocado, and veggies for a delicious wrap. Or spread peanut butter in a wrap and add chopped celery for a not-so-ordinary PB&C! Hummus makes a great dip with whole grain pita bread for those that like the taste.
  • Beans: black, kidney, garbanzo, white, pinto. The more pigmented the bean, the greater the anti-oxidant value, but all beans are full of fiber and nutrients and will keep you full! Beans can be added to brown rice or a baked potato, mixed in with steamed veggies for a stir-fry, wrapped in a whole wheat tortilla for a fajita, or added to any (low-salt) vegetable broth for a hearty soup! You can buy them canned for convenience, just look for a no-salt variety. If "no-salt" is not available, drain the broth from the can before cooking---most of the salt will run down the drain and not into your dish!
HEALTHY SUBSTITUTES

ome less healthy items can easily be substituted for more healthy alternatives without much if any loss in taste. Use the following substiutions whenever possible:

  • Low-salt tomato sauce instead of ranch or cream-based dips: tomato sauce makes a great dip for carrots and veggies, yet it is low in fat and calories compared to the more popular ranch dips. It is also loaded with lycopene, a potent anti-oxidant. Read the ingredients to get a brand without sugar, and make sure the salt is reduced. When you eat this sauce, measure out a serving (1/4 cup) or less so that you don't overdo the portion.
  • Non-dairy "butter": There are several options of heart-healthy spreads that taste just as good as the real thing (seriously!). Look for Earth Balance brands. As with any sauce, make sure to measure out a small portion (1 TBS or less). This butter can make a tasty addition to a baked potato-just add plenty of veggies!
  • Salt-free spices: explore the spice aisle and remind yourself of the countless spices that will not wreck havoc on your blood pressure or cause your ankles to swell! Red and black pepper, oregano, cinnamon, all spice, dill, cilantro, parsley, garlic, thyme, basil, turmeric, and more!
  • Shredded wheat cereal instead of Frosted Mini-Wheats or the likes. Avoid packaged cereals with the exception of plain shredded wheat. Add your own cinnamon and berries and you have a delicious (but healthy) cereal.
  • Plain oats instead of packaged and flavored oatmeals (avoid maple spice, apple cinnamon, or peaches and cream). Use real fruits and spices to flavor your oats without the sugar and preservatives.
  • All-natural peanut butter (stir it up yourself) instead of the hydrogenated brands.
  • Brown rice and whole wheat pasta instead of the boxed meals. Avoid all of the packaged rice or pasta varieties. Add your own veggies, spices (other than salt), and a small amount of low-salt tomato sauce to plain rice or pasta, and you'll have a healthy alternative to the boxed items.
  • Soymilk instead of dairy milk (whenever possible). Dairy has cholesterol and added hormones, so it is not ideal for anyone watching their cholesterol or health. Soymilk has the added benefits of soy protein isoflavones, which has been shown to reduce the risk of heart disease and certain cancers. If you must drink dairy milk, stick to nonfat or 1%.
  • Whole grain (100% whole wheat) carbohydrates instead of refined, white flour. This means that you will likely eliminate "treats" that are found at supermarkets. Remember that most cakes, cookies, bagels, sweet rolls, hamburger buns, muffins, waffles, and pancakes are made with white flour. White flour has been refined to remove the nutrients that naturally occur in wheat germ. Why would you want to eat flour that doesn't have the nutrients that it should?! Refining flour also removes the fiber content. Fiber is important for lowering cholesterol, reducing sugar spikes in your bloodstream, and preventing many cancers. Fiber also keeps you feeling fuller longer so that you are less tempted to snack on unhealthy foods.
  • Fresh or frozen fruits and veggies instead of canned. When fruits are canned, syrupy sugar is usually added to the fruit, increasing the calorie content and the sugar in your bloodstream. Canned fruit has also usually been peeled so the fiber content is significantly reduced. Similarly, canned vegetables are usually sitting in a salt bath with preservatives, so it is best to avoid them as well.
MODERATION MANTRA

hen it comes to food, the mantra to remember is moderation. When it comes to meat, the less processed it is, the better the nutritional worth. For example, packaged frozen chicken nuggets and fish sticks are a stone age away from nature, and thus are low in nutritional worth. Plain chicken, on the other hand, devoid of sauces, salt, the deep fryer, and preservatives, comes out better in the nutritional contest than its processed counterpart. When it comes to nutritional worth of meat, not all selections are created equal. In general, the smaller (and leaner) the animal, the leaner (and healthier) the meat. Chicken and turkey come out far better than beef and pork. Fish trump all. If you have high cholesterol, heart disease, or diabetes, you should reduce your meat consumption and choose from fish, chicken, or turkey when you do eat meat.

As for methods of cooking, stick with grilling, steaming, and baking. Fried foods rank almost zilch on a nutrition scale, so avoid them. If you do eat a piece of meat, keep it as simple as possible. Refrain from covering the meat in gravy or sauce, and avoid marinating with salt or sugary sauces. By keeping these tips in mind, you can improve the nutritional worth of meat.

DAIRY

airy includes all foods derived from animal milk (most commonly cow's milk). Dairy includes milk, cheese, cottage cheese, butter, cream, sour cream, cream cheese, yogurt, ice cream, frozen yogurt, whipped cream, casein, and whey. With a list such as this, you can imagine why dairy is found in a plethora of foods, from packaged foods to sauces to protein powders to infant formulas.

Because dairy comes from an animal source, dairy products contain cholesterol. Milk is a naturally high-fat food, predominately saturated fat, which is the least heart-healthy of all fats. (Think about it: cow milk exists to nourish baby calves into adult cows and bulls. Just as human babies require fat for brain and nervous system development, baby calves require the intensified fat as well. But as human adults, eating such intensified saturated fat is not a healthy idea, nor what nature intended!) Even "low-fat" dairy products still contain higher amounts of saturated fat than most natural foods, and the cholesterol component is always present, even in skim milk.

For anyone with heart disease, high blood pressure, or diabetes (a risk factor for heart disease), a food that is concentrated in saturated fat and cholesterol per ounce is not the best choice. Thus, the more that dairy can be eliminated from the diet, the better for health.

If you are going to eat dairy, here a few health pointers:

  • Always choose the nonfat or low-fat option, whether it is milk, sour cream, cream cheese, or cottage cheese. This will reduce the amount of saturated fat and cholesterol as well.
  • Choose organic, low-fat cheeses. Part-skim mozzarella is lower in fat, as well as most string cheeses. Goat cheese naturally has less fat and calories than cow's milk varieties. Nearly every type of cheese is available in a low-fat variety. The key is to use as little as possible to get the job done. Also, keep it simple: choose one cheese and learn to appreciate the taste. Who said you need to have a three-cheese omelet or four topping pizza? One cheese per dish is more than enough.
  • Use nonfat milk instead of cream in your coffee.
  • Choose frozen yogurt (soft-serve) instead of ice cream. If you are going to partake in a dessert, frozen yogurt is a better option than ice cream.

Bottom line: Keep it simple! Even if you start small, benefits will be received. Choosing low-fat versus high-fat dairy is a great start. Asking for your salad or hamburger without cheese is another way to reduce fat and cholesterol consumption. Choosing only one cheese topping for a pizza or omelet will also benefit your health. Baby steps do count!

READING NUTRITION LABELS: AN ART, NOT A SCIENCE

nyone who so much as glances at a package before placing it in the grocery cart can attest to the mass confusion over labels. There are more words on a single food item than in a textbook! And with the advertising trend to market a "healthier" product, the labels only became more confusing.

The key to eating healthy is to know what labels are important and reliable, and what labels are trivial (at best) or misleading (at worst). The simplest advice is to eat whole, natural foods. That works when you're in the produce section. But all of us living in today's society, at some point or another, will find ourselves outside of the produce section. So here's where a little bit of knowledge can go a long way....

The Nutritional Labeling and Education Act of 1990 mandated that most packaged foods in the United States be labeled with a "Nutrition Facts" label. This label must include an ingredient list, serving size, calories, and the amounts of fat, cholesterol, sodium, carbohydrates, and protein in the food. The label must also list the percent daily values of vitamin A, vitamin C, calcium, and iron, based on a pre-set 2000 calorie diet. In 2006, the FDA added Trans fat to the "Nutrition Facts" labels, requiring that the amount of Trans fat per serving be listed. It is this "Nutrition Facts" label that you are familiar with, or perhaps not-so-familiar with. The label provides accurate factual information about the macronutrients of a food. Remember that foods are made up of macro- and micronutrients. The nutrition labels on our foods provide us with the needed information to make healthy choices based upon the macronutrients, but regulation falls short when it comes to the micronutrients (most of the vitamins, minerals, anti-oxidants, and other healthful compounds). The art to reading a nutrition label is making healthy macronutrient choices, but recognizing that the true nutritional worth of a food cannot be found on the Nutrition Facts label. Determining the nutritional worth of a food requires contemplation of how far removed the food is from its natural state. The more removed, in general, the less healthy.

Case in point: the Nutrition Facts label is excellent for sizing up the calories, fat, sodium, and sugar in a food, but it should not be used as the only means for choosing what foods to eat. Always remember that the most powerful information on a package is the ingredient list. If the ingredient list is long and/or full of chemicals, place the box right back on the shelf and move on!

(For more information regarding the regulation of nutrition labels, visit www.fda.gov)

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