Nutrition

Nutrition refers to the manner in which the body makes use of food. It not only includes eating the correct amounts and kinds of foods, but also the processes by which the body uses food substances for growth, repair, and maintenance of body activities. Nutrition also concerns the role that food plays in our lives and the many factors that determine our food choices.

Good nutrition during adolescence is very important for the achievement of full growth potential and optimal health as well as for the prevention of certain adult chronic (frequently recurring) diseases. Poor eating habits formed during childhood and the teen years may, in combination with other factors, increase the risk for chronic diseases later in life such as heart disease, osteoporosis (a disease that causes bones to become fragile), and some forms of cancer. Eating habits also affect the risk for immediate health problems including iron deficiency anemia (a blood disease), high blood pressure, and tooth decay.

Food is basic to survival, and people have built-in mechanisms in their bodies that work to control how much they eat, when they eat, and what they eat. In addition to these built-in mechanisms, there are many other factors that affect the way people eat. What, when, and how much people eat is greatly influenced by emotional, social, cultural, and economic factors. However, eating too much, too little, or not eating some of each type of food can make people unhealthy.

Good nutrition is a complex issue that not only has immediate benefits but also is an investment in a person's future health. Adolescence is a critical period for establishing the foundation for healthful eating patterns.

EATING WELL: WHY IT'S IMPORTANT

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Throughout history humans have written about food and its effect on the body. In recent years people have learned more and more about nutrition through laboratory studies conducted on animals and humans. The role of nutrition in health and disease has been recognized from research as early as 1900, although much remains to be learned.

By choosing healthy eating habits, people will gain many rewards. Eating healthy foods helps people maintain a healthy weight while also providing them with plenty of energy. Not only will people feel better and have more energy when eating well, but their skin, teeth, and hair will also reflect their good choices. The choices people make now can also affect their health later in life. People's risk for developing major health problems such as heart disease, stroke, diabetes, and cancer can be reduced if they make the right food choices a part of their lives. Good nutrition will help people to look and feel their best today and help prevent some of the deadliest health problems in the future. An unhealthy diet, lack of regular physical activity, smoking, and the over-consumption of alcohol are the leading contributors to premature death in the United States. It's important to eat well—good nutrition can save lives.

To better understand the diet link in health and disease, government agencies continue to study nutrition. Many controversies remain and a lot still needs to be explained; however, general guidelines have been developed to illustrate what Americans can do through proper diet to ensure good health.

Nutrients

Just as a car needs gasoline, a form of fuel, to run, people need food for fuel every day. Food is the source of all nutrients needed for life. Nutrients are substances used by the body for fuel, growth, and all body processes. The body needs more than fifty different nutrients every day to maintain proper health. Nutrient needs are higher in adolescence than any other time in the life cycle because the body is experiencing its biggest growth spurt at this time.

The nutrients people get from food are vitamins, minerals, carbohydrates, fats, protein, and water. People's bodies need all of these nutrients to remain healthy. Calories people eat come from fat, carbohydrates, and protein. Fat, carbohydrates, and protein are essential nutrients, which means people need them for good health. Vitamins and minerals are necessary for good health but have no calories. The body depends on good food choices to get all of these nutrients in the right amounts every day.

FAT. Fat provides the most concentrated source of energy in our diet. It also provides flavor and texture to foods. Fat in the body functions to insulate, cushion, and support vital organs and is a part of every cell membrane. Fat in our diet mainly comes from fatty meats, whole milk and whole milk dairy products (such as yogurt), butter, and baked goods. Fat can be saturated (solid at room temperature) or unsaturated (liquid at room temperature).

CARBOHYDRATES. Carbohydrates are the fuel the body needs to function. The brain primarily uses carbohydrates as its energy source. Most carbohydrates are plant-based from grains, fruits, and vegetables. There are three types of carbohydrates: sugar, starch, and fiber.

PROTEIN. Proteins act as the building blocks of the body. The body uses protein to make and maintain body tissue such as muscles and organs. It also functions as the key component of enzymes and hormones. Milk, eggs, cheese, meat, and fish are the most common sources of protein, although beans and nuts are good sources as well.

VITAMINS. Vitamins are needed in the right amounts by the body for normal growth, digestion, mental alertness, and resistance to infections. They enable the body to use fat, protein, and carbohydrates. There are thirteen different vitamins, four of which are stored in fat.

MINERALS. Like vitamins, minerals are needed in small amounts by the body. They help regulate cell function and provide structure for cells. There are fifteen minerals needed by the body; the most common ones are calcium, phosphorous, and magnesium.

WATER. Next to oxygen, water is most important to life. A person's body is 50 to 70 percent water. Although people can live for weeks without food, they can exist for only a few days without water. People need eight to ten cups of water each day.

Calories

Calories are units of energy contained in the foods people eat. The amount of calories a food has reflects how much energy it supplies to the body. The more calories a food has, the more energy it contains. The body needs energy to do everything from breathing and pumping blood to walking and running. If people eat more calories than their body burns, their body stores the excess energy as body fat.

Only the nutrients fat, protein, and carbohydrates contain calories and therefore provide energy. Vitamins and minerals don't actually supply calories but are vital in the processing of the energy-producing nutrients. Fat provides the most energy—nine calories per gram. Protein and carbohydrate both provide four calories per gram. A gram is roughly the same weight as a paper clip.

THE FOOD GUIDE PYRAMID

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Adolescents need a practical guide to help them make food choices to meet their nutritional needs. During the twentieth century and especially in recent years, several food guides have been developed by a number of government agencies. Currently, the Food Guide Pyramid is the most widely accepted food guide that incorporates the recommendations of the Dietary Guidelines for Americans.

The Food Guide Pyramid was created to help Americans choose a healthful diet. The guide addresses two main dietary problems: diet excesses and diet deficiencies. Several of the major causes of death in the United States are linked to diets that contain too much fat, saturated fat, cholesterol, or sodium. On the other hand, bodies need enough protein, vitamins, minerals, and fiber to grow and stay healthy. People who eat too many foods with a lot of calories but few or no nutrients, like soft drinks and candy, can develop nutrient deficiencies.

The food pyramid depicts six food categories and emphasizes that the American diet should include greater amounts of grain foods, fruits and vegetables, and lesser amounts of fats and sugars. Its shape is very important to its message, as it visually represents how much food people need from each of the six categories. Each group is equally important, but people need foods from the bottom in larger amounts than foods closer to the top of the pyramid. The food pyramid emphasizes the following key points:

• Eat a variety of foods every day.
• Choose foods with less fat and sugar.
• Eat plenty of whole grain foods, fruits and vegetables (preferably raw).

While the food pyramid divides foods into six categories, there are five major food groups. The food category at the tip of the pyramid is not considered a major food group since these foods should be used sparingly for good health. The food pyramid reminds people to eat a variety of foods to get all of the nutrients they need as well as the right amount of food to maintain

a healthy weight. The foods are grouped together according to the key nutrients they provide. Foods provide many more nutrients besides their key nutrients but by eating plenty of foods with key nutrients, people are more likely to get the correct balance of all nutrients.

The food pyramid also provides information on how much to eat from each group. It recommends a range of servings needed each day from each of the major food groups. The amount of calories and key nutrients people need determines how many servings they should have. A serving is a specific amount of food, which is different for each food category. The amount of calories or energy people need depends on how old they are, how active they are, and how much they weigh.

In general, boys need more energy than most girls and therefore more servings. This is due to the fact that boys have more muscle and bone growth during adolescence, which requires a higher consumption of protein, iron, calcium, and zinc. For girls, adolescence means a smaller increase in muscle mass and an increase in fatty tissue because the body is preparing for menstruation. This results in a lower need for girls than boys for certain nutrients. However, girls do need more iron and calcium because of the onset of menstruation.

As people age, they need fewer servings due to a decrease in activity level and other factors. To get all the nutrients and enough energy each day, almost everyone needs to eat at least the minimum number of servings for each group every day.

Bread, Cereal, Rice and Pasta Group

A healthy diet begins with plenty of foods from the bread, cereal, rice, and pasta group (which will be referred to as the grain group since all are made from grains such as wheat, oats, corn, or rice). It is recommended that people eat between six and eleven servings per day from this group. As such, this group is at the bottom of the pyramid and forms the base, or foundation, of a healthy diet. People need more servings each day from this group than from any other. The grain group of foods provides the nutrients complex carbohydrates (starch and fiber), vitamins, and minerals to the body.

The choices people make from this group are significant because carbohydrates, especially those from whole grain sources, can play an important part in healthful eating. Complex carbohydrates are the starches that come mainly from plant foods such as wheat, oats, and rice. Fruits and vegetables also provide complex carbohydrates. Complex carbohydrates provide your body with its preferred source of energy. There is a common misconception that the foods from this group are fattening. In fact, most grain group foods are low in fat and calories. Donuts, pastries, muffins and some crackers (butter or cheese flavored) can be quite high in fat and are the few exceptions. What can increase the amount of fat and calories is what people add to grain foods. For example, the butter or cream cheese people may use on a bagel can (depending on how much is used) nearly double the calories from this grain food.

Fiber is the tough or stringy part of plant foods like grains, fruits, and vegetables, therefore sometimes referred to as "roughage." People do not digest most dietary fiber, and so it gets pushed through the digestive tract helping the body rid of wastes. To get the fiber the body needs, the type of grain group foods people choose is very important. Grains high in fiber include whole wheat bread, brown rice, whole-wheat crackers, pasta, and whole grain cereals (like Cheerios, Raisin Bran, and Shredded Wheat).

Vegetable Group and Fruit Group

It is recommended that everyone eat at least five servings per day from this category. Fruits and vegetables—especially raw (or uncooked) fruits and vegetables—help reduce the risk for heart disease and some cancers by providing important vitamins and minerals as well as a good source of fiber. Fruits and vegetables are also naturally low in fat and calories, help maintain a healthy weight, and decrease the risk of diabetes and high blood pressure. Two of the vitamins that are particularly important to health that fruits and vegetables provide are Vitamins A and C.

Vitamin A is important for: night vision, healthy skin, gums and teeth. Good sources of Vitamin A are: carrots, sweet potatoes, spinach, grapefruit, cantaloupe, and nectarines. Vitamin C is important for healthy gums and teeth, healing cuts and scrapes, and strong bone development. Good sources of Vitamin C are: broccoli, tomatoes, green pepper, 100% orange juice, pineapple, and peaches.

Most Americans don't get enough servings of fruits and vegetables every day. The National Cancer Institute and Department of Health and Human Services has been promoting increased consumption of fruits and vegetables through a program called "5 A Day for Better Health." Research has suggested that people who eat lots of fruits and vegetables may have lower risks for some cancers than people who eat less. The fiber, vitamins, and other components in fruits and vegetables may be responsible for this lower risk.

Eating a variety of fruits and vegetables every day is important since they all don't provide the same vitamins and minerals in the same amounts. Besides the vast number of different fruits and vegetables, fruit juice and vegetable juice are also considered servings from these groups. Many beverages on the market today call themselves juice but are mostly based on a sugar-sweetened liquid with only a small amount of fruit juice added. Consumers should be sure to look for the words "100% fruit or vegetable juice" on the label of juices to be sure that they contain all of the benefits of a fruit or vegetable serving.

Milk and Milk Products Group

It is recommended that two to three servings from this group be consumed per day.

The milk and milk products group includes milk, yogurt, and cheese. The key nutrient supplied by this group is the mineral calcium, but milk and milk products also provide protein, carbohydrates, and other vitamins and minerals. Vitamin D is an important component in milk because a body needs vitamin D in order to properly absorb calcium. As a result, all milk sold in stores is fortified with Vitamin D.

There are many choices when it comes to buying milk at the grocery store or even in the school cafeteria. There are four types of milk, which differ only in the amount of fat and calories they contain. All four types of milk provide the same amount of calcium and other nutrients. Water is not added to low fat or nonfat milk, although people tend to think this because the

milk may seem "watery" if they are used to drinking milk with higher fat content (milk with higher fat content tends to be thicker or creamier than nonfat milk).

According to health experts, in order to get all of the nutrition milk has to offer without getting too much fat or calories, anyone above the age of two should be drinking low-fat milk. One cup of whole milk (4% fat) has the same amount of fat as three strips of bacon. Babies and children under two years of age need that extra fat in their diets for growth and development. Most adults, teens, and schoolage children should drink low fat or nonfat milk. Low-fat (1% fat) and nonfat milk (skim milk) are excellent sources of calcium without a lot of fat and calories.

Type of Milk	Fat (per 1 cup)	Calories (per 1 cup)
Whole milk (4%)	8 grams	150 calories
Reduced fat milk (2%)	5 grams	120 calories
Low-fat milk (1%)	2.5 grams	100 calories
Nonfat milk (skim)	0	80 calories

Experts recommend that if people find it difficult to adjust to drinking low-fat milk, they should try switching to reduced-fat milk (2%) first. Then, when they have adjusted to the change, they can make the healthy switch to low-fat or nonfat milk.

Meat and Meat Alternatives Group

The meat and meat alternatives group provides the key nutrients protein and iron. Protein is needed for maintaining muscles, and iron is needed for healthy blood. This is perhaps the most diverse food group of them all because it includes not only red meat, like steak or hamburger, but poultry, fish and seafood, eggs, beans, nuts, and peanut butter as well. These foods are considered alternatives or substitutes for meat because they are all good sources of the key nutrients protein and iron. It is recommended that two to three servings from this group be consumed each day.

In general, most Americans get enough protein each day, and usually more than they need. The foods in this group are often thought of as being high in fat and cholesterol. Some choices in this group are much higher in fat than others and should be chosen less often. Highest fat choices include bologna, salami, hot dogs, regular ground beef, fried chicken, and sausage. Lean meat, chicken and turkey without the skin, fish, and beans are the best to choose most often because they are lower in fat.

Individuals who follow a vegetarian (meatless) diet must take care to incorporate protein into their diets. People choose to be vegetarian for a variety of reasons: religion, culture, or love of animals. Whatever the reason, foods such as nuts, eggs, seeds, beans, peanut butter, tofu or possibly fish would replace meat or poultry as protein sources in their diet. If it is planned carefully to make sure important nutrients are not lacking, a vegetarian diet can be a healthy and adequate diet.

Fats, Oils, and Sweets

The small tip of the Food Guide Pyramid shows fats, oils, and sweets and is not considered a major food group. These foods provide fat, sugar, and calories but few nutrients and should be enjoyed as occasional extras, not in place of foods in the major food groups. The foods found in this group include salad dressing, butter, margarine, soda, candy, chips, and sweet desserts. Although fat is an essential nutrient needed for good health, there is no recommended number of servings provided for this group. Eating foods from the major food groups should provide all of the fat people need. The foods in this category should be used sparingly.

The Facts on Fat

Fat is an essential nutrient needed for good health. Most Americans, however, eat too much of it. Fat has been given a great deal of attention in recent years for two reasons. First, fat provides more calories than any other nutrient. Second, a fatty diet can promote heart disease, cancer, and obesity (being very overweight) and is the biggest nutrition concern among Americans. Not all fats are created equal, however. There are two major types of fat: saturated fat and unsaturated fat. There is also a substance known as cholesterol, but it is not the same as fat.

SATURATED FAT. Saturated fat is also referred to as the "bad" fat because it is the type that is responsible for clogging the arteries and raising blood cholesterol levels. Saturated fats are fats that are solid at room temperature, such as margarine, butter, lard, or the fats in and on meat. In comparison, unsaturated fats are liquids. Foods that contain a lot of saturated fat are ground beef, bacon, sausage, hot dogs, bologna, whole and 2% milk, cheese, ice cream, and butter. Many baked goods and snack foods are also high in saturated fats.

UNSATURATED FAT. Unsaturated fat is also known as the "good" fat because it does not clog arteries. But that does not mean people can eat all of the unsaturated fat they want. Too much fat of any kind can be unhealthy. Unsaturated fats are fats that are liquid at room temperature like vegetable oil.

CHOLESTEROL. Cholesterol, a cousin to fat, is a steroid found only in foods that come from animals, like egg yolks, organ meats, and cheese. Foods low in cholesterol are not necessarily low in fat. An example is vegetable oil; it is 100 percent fat but has no cholesterol because it comes from a plant and not an animal.

Saturated fat and cholesterol in food can raise the body's blood cholesterol level. A high blood cholesterol level is one of the risks for heart disease. Heart disease is the clogging of the arteries, and it happens over a long period of time. It starts in the teen years and can eventually lead to a heart attack or stroke if it goes unchecked. The American Heart Association recommends a diet that provides less than 30 percent of its calories from fat. People can slow down or stop the buildup of fat and cholesterol in their arteries by making good food choices now. On the other hand, people should remember that the body still needs some fat to be healthy. Following a completely fat-free diet is harmful to a person's overall health. A fat-free diet also won't guarantee that a person won't get heart disease.

Although people do need some fat in their diets, most people get too much, especially the saturated kind. For best health, people should try to eat fewer higher fat foods. If a person follows the guidelines of the food pyramid and eats plenty of whole grains, vegetables and fruits, it isn't difficult to eat the right amount of fat. In addition, one should select milk and dairy foods made from low-fat or skim milk as well as skinless poultry, fish, and lean cuts of meat. Higher fat food choices need to be balanced with lower fat ones so that it all evens out at the end of the day.

WHAT MAKES A HEALTHY DIET?

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For a healthy diet, one should:

• Eat more fruits and vegetables. Fruits and vegetables are naturally low in fat, are filling, and can help reduce cravings for higher fat snacks and treats.
• Use low-fat or nonfat milk and milk products. Milk, yogurt, cheese, and frozen desserts made from low-fat or nonfat milk will help to reduce the intake of fat.
• Eat lean meats that are baked, broiled, boiled or grilled instead of fried.
  

  Choose these more often:	Choose these less often:
  Tuna packed in water	Tuna in oil
  Baked fish and steamed seafood	Fried fish and seafood
  White meat chicken and turkey	Dark meat chicken and turkey
  Low-fat hot dogs	Regular hot dogs
  Turkey or lean ham	Bologna or salami lunchmeats
  Canadian bacon or lean ham	Bacon
  Turkey or low-fat sausage	Regular sausage
  Lean ground beef	Regular ground beef

• Try lower fat versions of some high-fat favorites:
  

  Try:	Instead of:
  Low-fat frozen yogurt	ice cream
  Low-fat salad dressing	regular salad dressing
  Low-fat mayonnaise	mayonnaise
  Baked tortilla chips	fried tortilla chips

  

  Flavored rice cakes	high-fat crackers
  Low-fat cream cheese	cream cheese
  Low-fat fruit yogurt	regular yogurt

• Add less fat to foods. Mayonnaise, butter, cream cheese, gravy and salad dressings can add a hefty amount of fat to a meal. Try to use less of these products or find a replacement (mustard instead of mayo, jam instead of butter, etc.) or try the low-fat version to cut back on fat.

JUNK FOOD

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Americans eat a lot of sugar. In fact, the average person in the United States consumes 130 pounds of sugar a year. This is the equivalent of 1/4 cup of sugar a day. Almost 25 percent of the calories the average person consumes each day comes from sugar. This far exceeds what health experts recommend—less than 10 percent.

Sugars are a form of carbohydrates. There are two types of carbohydrates, simple and complex. Simple refers to single units of sugar like table sugar. Complex carbohydrates are starches and fiber found in grain foods, fruits, and vegetables. During digestion, all carbohydrates are broken down to sugar. When most people think of sugar, they think only of white table sugar. However, sugars do occur naturally in many foods like milk, fruits, and vegetables. Less than 10 percent of the sugar that Americans consume is from natural sources. The rest is from "junk food," such as candy, soda, or processed foods.

The major nutritional concern about sugar is that it can displace other more nutritious foods in a person's diet. Sugar provides calories but no essential nutrients by itself. If people consume a lot of sugary foods, they may not have room for foods that provide vitamins, minerals, and other essential nutrients. A diet high in sugar does not cause hyperactivity as many people claim. Nor is it the cause of diabetes (a disease that disables the body from controlling the level of sugar in the blood). The only disease that sugar causes is tooth decay.

SNACKING

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People often think of snacking as something bad and unhealthy. As a result, they often try to prevent eating between meals. However, snacking can be an important part of a healthy diet depending on the choices people make. Many health experts recommend fueling up on several mini-meals throughout the day instead of eating three big meals. The right snacks can help boost energy levels and help people get the well-balanced variety of foods they need each day.

Snacking is not part of a healthy diet if a person fills up frequently on fatty, sugary foods. Snacks such as soda, chocolate candy, chips, cookies, cakes, doughnuts, and ice cream are not what a person should reach for first when looking for a snack. Filling up on these kinds of snacks leaves little room for the other foods people need. Even if people eat the foods they do need along with these snacks, they will probably end up with too much fat and calories in their diets. An excess of calories and fat can be harmful to a person's health. Snacks like soda, chips, chocolate and candy are okay in moderation, but snacks from one of the major food groups should be the first choice. Looking at food labels can also help a person make good snack choices. Good snack choices mean nutrient-dense snacks.

A nutrient-dense food is a food that provides a good source of nutrients in relation to its calories. For example, a cup of broccoli, a piece of custard pie, and a half-ounce of cheddar cheese all provide similar amounts of the mineral calcium. The pie by far has the most calories, the broccoli the least. The broccoli has the highest nutrient density for calcium because it provides the most calcium for the least amount of calories, which is most beneficial for the body's health. Healthy snacking means combining snacks from the different groups in the food pyramid, such as a banana with low-fat yogurt to meet a fruit and a milk serving. It's important to try to eat fewer snack foods that provide little in the way of nutrients. These snacks are usually high in calories, fat or sugar (or all three) and low in vitamins, minerals, and complex carbohydrates.

Moderation Is the Key

All foods can fit into a healthy diet. The key to healthy eating is balance, variety, and moderation. This means eating a variety of foods without getting too many calories or too much of any one nutrient, especially fat. If portion sizes are kept reasonable it's easy to eat the foods one wants and stay healthy. Favorite foods need only be reduced, not completely eliminated from the diet. Most people eat for pleasure as well as nutrition. If favorite foods are high in fat and/or sugar, the key is to moderate how much and how often they are eaten.

Not every food and every meal has to be perfect for a person to be healthy. When eating foods high in fat, salt, or sugar one should also choose foods that

aren't. If one food group is missed one day, it can be made up for the next. Food choices over several days should fit together into a healthy eating pattern.

Foods are not "good" or "bad," but a diet can be. People should not feel bad if they enjoy foods such as ice cream, candy, or chips. Favorite foods can be eaten in smaller quantities less frequently, balancing them with healthier choices to provide the variety and balance that is important in a healthy diet.

FOOD, WEIGHT, AND BODY SHAPE

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Most people believe that nutrition and food are closely connected to weight and body shape. While this is true to a certain extent, it certainly does not represent the whole picture. A person's weight and body shape are not solely determined by how much a person eats or exercises. In fact, a person's body shape is determined most by the body shape of his or her parents. In addition, experts recently began questioning the role of weight and fat in relation to disease and illness. More needs to be studied, but researchers believe now that it's possible to be fit and healthy even if a person appears to be over-weight. In other words, having excess fat on the body does not automatically make a person unhealthy.

A Lesson in Genetics

Nearly 55 percent of adults are considered overweight or obese in America today. It is believed that when people eat more calories than their body uses, they gain weight. Simple as it may seem, not all people who are over-weight overeat. Most overweight teens do not eat more than their healthy weight peers do. The difference appears to lie in the level of activity. Genetics also can play a part. Genes are responsible for much of the way a person looks and acts. To a certain degree, they can also influence whether a person will be overweight or not. Although people may be able to improve their health by eating well and exercising, their body type and weight is dictated mostly by genetics.

Body type seems to be related to body weight. In the 1940s, scientist William H. Sheldon proposed a theory to characterize three basic body types. An endomorph is characterized by an increased proportion of body fat; a mesomorph by a muscular build; and an ectomorph by lack of much fat or muscle. An endomorph would have difficulty losing weight, have a soft body and round shape. The mesomorph would have a hard, muscular body and could gain or lose weight easily. An ectomorph would have a thin, delicate build and trouble gaining weight. Not every person will fit exactly into one category.

Having an excess of body fat can carry with it some health risk factors. Not only the amount of excess fat but the location of fat on a person's body is of importance. Women typically gain weight in their hips and buttocks giving them a pear shape. Men usually build up body fat around their bellies giving them an apple shape. Although this is not a hard and fast rule, there is evidence that people with fat in their abdomen, men or women, are more likely to develop many of the health problems associated with being over-weight or obese, such as heart disease and type-II diabetes.

People whose parents are obese tend to be overweight as well. Having parents who are overweight will increase a person's chance of being over-weight by 25 to 30 percent. Heredity does not destine anyone to be fat, but it can influence the amount of body fat and where fat is distributed on a person's body. To avoid serious health risks, a person who is genetically predisposed to obesity should be consistently careful about eating healthfully and exercising regularly.

The Body's Set Point

The set point theory of weight control holds that the body will defend a certain weight regardless of external factors. In other words, no matter how healthfully a person eats or how much a person may exercise, he or she remains right around the same weight. Unfortunately, many people who are overweight tend to concentrate only on losing the pounds when their focus should be to improve their health. Ultimately, fitness is more important to health than what a person weighs or the amount of body fat one has. Some individuals may not be overweight even though their weight may seem high for their height. This can be due to differences in body composition. Athletes with a lot of muscle, such as Olympic skier Picaboo Street, may weigh more than they appear, but they would never be considered overweight because muscle weighs more than fat. Ultimately, a person who exercises and eats well will naturally fall to his or her set point. Trying to fight this set point may lead to frustration, depression, and unhealthy weight management practices, such as fasting and dieting.

Body Image

Looking in the mirror—what does one see? Is it everything or is the focus just on trouble spots? Body image is how one sees oneself, and how one believes what others see, too. Body image can say a lot about one's mental and physical well-being.

A negative body image is when one doesn't like or doesn't feel satisfied with their body. Having a negative body image can be related to low self-esteem, depression, poor health habits, or a psychological disorder. It can negatively affect feelings, behaviors, interpersonal relationships, decisionmaking ability, and day-to-day living. It takes practice to accept one's body and understand that all aspects of appearance can't be controlled. Much of a person's appearance is due to heredity.

If a person has a negative body image, that person should strive for self-improvement but be realistic. Seeking positive supportive relationships is

helpful as well as remembering that a person's sense of self-worth must come from within. Associating with people who accept themselves, recognizing that the body is only part of oneself, and focusing on positive aspects of one's personality are helpful. It's also important to practice positive self-talk often and give oneself credit for worthy accomplishments.

Food and Feelings

From the day people enter the world they have an emotional connection to food. Eating can be an emotional experience. Many people eat in response to their emotions—such as being stressed out, tired, or bored—rather than in response to internal cues that they are hungry. This is called emotional eating. People also eat in response to other external cues such as time of day, location, or social situations. People with whom we live or socialize, the places in which we carry on our lives, and our emotions largely control our eating.

"Normal" eating is defined as eating when real hunger is present and eating until one is satisfied, without feelings of guilt or becoming uncomfortably full. Normal eating is flexible and depends on internal cues to regulate it, but it also depends on good food choices to ensure good nutrition.

From birth many people are programmed to eat at certain times of the day, given food as rewards for good behavior or a job well done, or associate foods with certain holidays or social events. Many people associate eating with other behaviors such as watching television. They may find themselves frequently snacking while watching television even though they are not really hungry, because it's what they always do. And so eating "habits" are formed. Eating habits such as these can lead to overeating or eating the wrong foods. Many health experts agree that changing negative eating habits to healthier ones can help a person improve their health.

In order to begin to change a bad food habit, a person must recognize it first. The reason many overeat or eat more than they need is because they don't recognize negative food behaviors. Experts recommend that people identify their food behaviors by keeping a food diary. A food diary is a record of the food people eat, what they were doing at the time, and how they felt. This exercise will tell people about themselves, their temptations and the emotional states that encourage them to eat and otherwise ignore internal signs of hunger.

WEIGHT MANAGEMENT AND DIETING

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As stated earlier, people's body weight is mostly controlled by their bodies' set point. Weight is also somewhat affected by how often people exercise. Many people try to change their body weight through dieting, which usually involves eating less or a combination of eating less and exercising. Some people, in an effort to lose weight quickly, may take diet pills or engage in unhealthy weight management practices. Dieting is not a healthy way to control body weight. The best way to stay healthy is to eat properly and exercise regularly. With regular exercise and good nutrition, most people will naturally fall to the weight appropriate to them, that is, their set point. In fact, experts say that when people are exercising, they need more food in order to function.

Dieting can be dangerous because it often deprives the body of the nutrients it needs to function properly. In addition, dieting can also cause people to gain weight. This happens because the body's metabolism (the rate at which the body uses energy) lowers in response to not getting enough food. Any food the body does receive is then stored as fat. This is a survival method used by the body to get the food it needs. When people go off diets, their metabolism is still lower, which means when they start eating more, they will store even more food as fat. The result is more weight gain. Experts recommend that dieting be avoided at all times. Being healthy and fit is a lifestyle choice. It doesn't happen on a temporary diet, and it doesn't happen by denying the body food. It happens when a person eats nutritious food and exercises.

In addition, dieting can turn dangerous when a person engages in unhealthy behaviors, such as taking diet pills, fasting (not eating over a period of time), or purging (vomiting) the food. Many times, a diet can lead to a serious eating disorder. [See Chapter 13: Eating Disorders for more information.]

Weight Loss Programs and Products

Nearly 8 million Americans enroll in structured weight loss programs each year. While some programs do succeed for some individuals, unfortunately most people fail to lose the weight permanently. The problem is that most programs don't teach people how to change their eating habits and exercise regularly to promote good health. Frequently new diet books and plans appear, usually with some gimmick offering quick, painless weight loss. Many of these diets do nothing to change food behaviors permanently or create a weight maintenance program. Most are inappropriate for lifetime eating patterns, may be nutritionally inadequate, and possibly dangerous, especially for young people. For example:

Product/Program	How supposed to work	Concerns
Diet pills	Chemically decrease appetite or stimulate central nervous system	Increase blood pressure, can dehydrate, possible dependency
Special food or combinations	Grapefruit burns fat, special combinations fool your body into digesting differently and decreasing absorption of calories	Not based on scientific fact, limits choices, compromises nutrition, impossible and unhealthy to maintain
Liquid drinks or package foods	Control total calories eaten by replacing meals or snacks	Products alone do not help you lose weight, no flexibility

Any claims by weight loss programs or products that people can lose weight effortlessly are false and unhealthy. Fad diets or diet gimmicks rarely have any lasting effects since radical changes in eating habits and patterns are difficult to maintain over time. Crash diets often send a person into a cycle of quick weight loss followed by rebound weight gain.

Beware of pills and powders claiming to burn, block, or flush fat out of the body. If it sounds too good to be true, it probably is. Some diet pills may be able to control appetite but can have serious side effects. For example, amphetamines—a common appetite suppressant found in many diet pills—are highly addictive and can have damaging effects on the heart and nervous system. There are numerous weight loss programs available today. Some are schemes that come and go and others have stood the test of time. The main thing to remember is that these programs are a business like any other and aim to make money. If one plans to join a program, it pays to do some homework first. There are a few things to know before making any financial commitments to a program:

• Understand the program's format. Is it individual or group? Is it necessary to buy their food?
• Does the program offer one-on-one counseling? Does it reward or punish members based on the amount of weight lost?
• Does the program include all food groups every day? A well-balanced diet is important for good health. Beware of programs that have definitive "good" foods and "bad" foods or exclude any particular kinds of food.
• If a program utilizes its own prepackaged foods, taste them first. It would be a terrible shame to invest time and money and find the food inedible. More important, is the packaged food healthy? Check sugar and salt levels on the packages.
• Does the program fit into one's lifestyle? Is it affordable? Is it risky? Does the program help make positive behavior changes and encourage a safe personalized exercise program? These are the tools to help keep the weight off. If a program cannot provide these, then one should reconsider.
• Do the counselors in the program have an education in nutrition, psychology, and exercise?

BECOMING AN INDEPENDENT EATER

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As children grow older, they often become more independent in their eating patterns. During adolescence, other factors begin to influence what people eat. For example, playing sports or engaging in after-school activities can alter eating times. Going out with friends can turn eating into a social event. Unfortunately, busy schedules and busy lives can mean unhealthy eating and poor nutrition. Sometimes, a person decides to follow a special diet, such as vegetarian or vegan. When these choices are made, it's important to make sure that the body is getting all the nutrients it needs to grow and stay healthy.

VEGETARIAN AND VEGAN DIETS

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Most vegetarians don't eat meat, poultry, or fish. Their diets consist mainly of plant-based foods such as vegetables, fruits, grains, legumes (peas and beans), nuts, and seeds. Eggs and dairy products may also be excluded. Vegans (pronounced VEE-ghans) don't eat any animal products including eggs, dairy, or even honey. Others who occasionally eat meat (usually chicken or fish) may also call themselves vegetarians, although they are really only part-time vegetarians.

Only about one percent of the population in the United States is vegetarian. There are many reasons why a person may choose to be vegetarian. The most influential reason for adopting a vegetarian diet worldwide is food availability. In many parts of the world plant foods are abundant whereas animal foods are scarce or too expensive. In the United States, people have adopted a vegetarian lifestyle for one of several reasons. They may believe it is more healthful, their religious or ethical beliefs exclude meat, or they may be concerned for the environment or the treatment of animals raised for consumption. Research has shown that vegetarians have lower rates of some cancers, heart disease, high blood pressure and diabetes. Vegetarians are also less likely to have gall stones, kidney stones, and constipation.

Types of Vegetarian Diets

• Lacto-ovo vegetarian diet includes milk, milk products and eggs.
• Lacto-vegetarian diet includes milk and milk products.
• Vegan diet includes only plant foods.

Vegetarian diets can be healthy and adequate but may take a little more planning to ensure nutritional adequacy. This is particularly true of vegan diets. The more people restrict their diets, the more difficult it is to get all of the nutrients they need. Vegans have a difficult time getting vitamin B-12, calcium, vitamin D, and zinc because vegan diets exclude dairy and meat, both of which provide the primary sources for the aforementioned nutrients.

Becoming a vegetarian isn't as simple as some people think. It doesn't mean just excluding meat from the diet. Beginning a vegetarian diet in this manner may shortchange the body of essential nutrients important for growth and development. If one is considering a vegetarian diet for any reason, one should become educated about it and perhaps even speak with parents and doctors about a healthy eating plan. Common vegetarian foods include macaroni and cheese, spaghetti, pizza, eggplant parmesan, vegetable or bean soup, bean burritos, and peanut butter and jelly.

It's important to note, however, that growing children and pregnant or nursing women should proceed with a vegetarian diet with caution because of special nutrition needs. The key to a vegetarian diet—as with any other diet—is to eat a variety of foods and limit the amount of fats and sweets. One should be prepared with the right tools to get started and remember to eat the following foods to obtain these nutrients that could be lacking in a vegetarian diet that is not properly planned:

Protein: soy products, tofu, legumes (peas and beans), nuts, seeds. Calcium: milk, leafy dark green vegetables, legumes, fortified soy or rice milk, tofu. Iron: cereals and grains, leafy dark green vegetables. Vitamin B-12: dairy or eggs, supplements for vegans.

CREATING HEALTHY EATING HABITS

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Eating regular meals and snacks throughout the day is very important to meeting nutritional needs. It is nearly impossible to get all nutrient needs in only one or two meals each day. This way of eating may lead to overeating and poor food choices because people may get too hungry to think clearly about what and how much they are going to eat. Irregular meals may be one of the reasons many people struggle to maintain a healthy weight. In fact, skipping meals in an effort to lose weight it is a common mistake. Depriving oneself of a meal or particular food in order to lose weight may lead to bingeing (a period of uncontrolled eating) or poor eating later in the day.

Hunger usually wins out and irrational food choices can result. Smaller, more frequent meals or snacks is a sensible way to remain energized and get all of the servings needed from the five food groups each day.

Don't Forget Breakfast

The meal most often neglected by teenagers is breakfast. It is an easy meal to skip as people rush to get out the door to school or to work, but breakfast really is the most important meal of the day. Breakfast literally means to "break a fast" (a fast is a period where little or no food is eaten), in which the fasting period is the time that the person was sleeping. A person's body needs fuel in the morning to help spark metabolism. Breakfast fuels people up with enough energy to learn and be active throughout the day. It can help to keep concentration at a better level and energy high. Breakfast can make a difference in how a person feels all day. Quick and easy breakfast ideas include granola bars, bagels, English muffins, cereal, and frozen waffles. A glass of milk and juice or fruit balances it out.

Remembering the dietary guidelines' recommendations and utilizing the food pyramid is the key to a healthy diet. Spend lots of time at the bottom of the pyramid, less time at the top, and choose carefully from the middle. Drink plenty of water each day and balance food choices with exercise to help maintain a healthy weight.

FOR MORE INFORMATION

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Books

Herbert, Victor and Genell J. Subak-Sharpe, eds. Total Nutrition: The Only Guide You'll Ever Need. New York: St. Martin's Press, 1995.

Larson, Roberta. The American Dietetic Association's Complete Food and Nutrition Guide. Chicago: Chronimed Publishing, 1996.

Levchuck, Leslie. Fuel Up!: A Girl's Guide to Eating Well. New York: The Rosen Publishing Group, 1999.

Web sites

5 A Day for Better Health. [Online] http://www.5aday.com (Accessed October 29, 1999).

E Nutrition. [Online] http://www.enutrition.com (Accessed October 29, 1999).

Mayo Clinic Nutrition Center. [Online] http://www.mayohealth.org/mayo/common/htm/dietpage.htm (Accessed October 29, 1999).

The Vegetarian Resource Group. [Online] http://www.vrg.org (Accessed October 29, 1999).