For one thing, vis-a-vis their "wrinkled, sexless" counterparts, say back in the 1960s, today’s women who are beyond the big 5-0 are more conscious and open about their health and sexuality. They talk about the fluctuations in their estrogen levels as casually as they discuss the rise and fall of the peso. For another, there’s a new approach to women’s medical care, there are midlife women’s centers and there are books on women’s health concerns like menopause. Like this book What to Expect in Your Fifties by Judy Mandell (359 pp., available at Goodwill Bookstore). It answers questions women (especially those in their 50s and older) have always wanted to ask (but didn’t know who to ask). For now, let’s zero in on diet and the loaded topic of fats – separating fat from fiction:
What is good nutrition?
It’s defined as a state of optimal balance in the consumption and utilization of nutrients. But now, it’s more than that. It now includes body conditioning and exercise. It’s really having your body performing optimally by consuming the right foods and maintaining a balance in your energy metabolism through physical activity.
What is the Food Guide Pyramid all about?
Twenty years ago, the food intake recommendations were based on four major food groups – meat, dairy, fruits and vegetables, and grains. There was a lot more emphasis on meat and milk.
The Food Guide Pyramid is now focused more on fruits and vegetables, fiber, and grains, and it also suggests quantities. The USDA recommends three to five daily servings of vegetables and two to four servings of fruits. Six to 11 servings of breads, cereals, rice, and pasta per day are the base of the pyramid. Meat and dairy products are included but in limited amounts.
Why is the emphasis away from meats and dairy products?
The primary reason is because these foods are high in saturated fat.
What is bad about high intakes of saturated fat?
Many studies have shown that high intakes of saturated fat are related to risks of heart disease and possibly colon cancer.
How can women, especially women in their 50s, get enough calcium in their diet and keep saturated fats to a minimum?
Women should have three to five servings of dairy products a day. They can limit the high-fat dairy by drinking skim milk, a really good source of calcium, and eating low-fat yogurt. Another solution is acquiring a taste for skim milk and low-fat or nonfat yogurt. There are also low-fat cheeses in the grocery stores, although they are less popular. Nondairy sources of calcium include tofu, sardines, and some green leafy vegetables.
How does saturated fat increase the risk of heart disease?
A diet high in saturated fat can lead to an accumulation of plaque in the arteries. Plaque is a lipid (fat) material that collects on a lesion in the artery. It narrows the arteries and increases the formation of blood clots, which causes heart disease.
What about the link between saturated fat and colon cancer?
The colon cancer data are less clear. This link seems to be between high-fat intakes and slow transit time. The hypothesis is that if you’ve got a high-fat intake, the food sits in your intestine longer and interacts to form compounds that can negatively affect your colon.
Are you implying that chronic constipation is harmful to colonic health?
Yes. That’s another reason to eat a high-fiber diet – fruits and vegetables and grains with fiber. You want to keep things regular. Regularity can become a problem as we get older.
Tell us something about fiber.
There are two main types of fiber – soluble and insoluble fiber. Soluble fiber – found in oats, apples, and other fruits – gets into the blood and can protect against heart disease. Insoluble fiber – found in wheat bran – tends to protect against colon cancer. It is better to ingest fiber from food than from supplements.
What are trans fats?
Trans fats in our diets come largely from hydrogenated fats, which are oils that have been chemically altered to be more solid at room temperature. The chemical structure of hydrogenated fat is different from that of most naturally occurring fats. Margarine and shortening are examples of trans fats.
What about margarine?
With the movement away from saturated fats, nutritionists told people to use margarine. Margarine is made by hydrogenating polyunsaturated oils. Hydrogen is added to make them more saturated. Trans fats act like saturated fats, so new evidence suggests that you’re not doing much better by eating hard margarine. If you choose margarine, use the soft tub, which has less of the trans fats. The liquid margarines are even better. According to current recommendations, try to avoid both saturated fat and trans fat as much as possible.
Are there hidden trans fats that people might not realize?
Yes. French fries are an example of a hidden source of trans fats. Many, if not most, fast-food restaurants cook French fries in hydrogenated oil. Other hidden trans fats are in crackers and snack foods. Those could be problems when people are trying to cut their saturated fats.
Which and how much of that fat should we have in our diet?
The guideline is to stay below 30 percent of calories from total fat, to keep the saturated fats below 10 percent, and to balance polyunsaturated, monounsaturated, and saturated fats.
Some studies claim that monounsaturated fats such as olive oil are good for one’s health. Why is that?
Years ago, it was recommended that people avoid saturated fat by switching to highly polyunsaturated fats, such as safflower oil. However, research showed that while such fats lowered total cholesterol, they also lowered the HDL (the good cholesterol). It was observed that people in sections of Europe where the rates of heart disease were much lower than in the US, consumed much more olive oil than people in America. Studies done in the US and elsewhere revealed that higher proportions of olive oil reduce total cholesterol without such a reduction of HDL. Therefore, olive oil is more protective of the heart.
Should we then add olive oil to our diet?
Yes, it’s better to use olive oil in cooking, on vegetables, and in salad dressing. All of that is good in moderation, but you shouldn’t feel free to increase your total fat by adding olive oil. You still have to work on reducing your fat intake.
What about fake fats like Olestra?
Olestra is very controversial. We don’t know enough about it yet. There are side effects, such as bloating and abdominal pain. More serious, fat substitutes absorb and bind the fat-soluble nutrients in the diet, including the carotenoids and some other phytochemicals. Those are the very factors that may be protective against heart disease and cancer. Their loss is of great concern.
More than that, fat substitutes in the diet have been shown to help with weight loss. Some people believe that since they are nonfat, they can eat more of them. Replacing high-fat junk food with nonfat junk food doesn’t solve the problem. These are not nutrient-rich foods. They usually contain high amounts of sugar. They may be fat-free, but they may still have a lot of calories.
What about sugar in the diet?
There’s nothing wrong with sugar in itself. It’s a natural food. It’s fine in moderation. Sugar provides pure energy, but it doesn’t contribute other nutrients. If you eat lots of pastries, you’re getting fat and sugar, high calories and low nutrients. If you’re eating candy, you’re getting lots of sugar but essentially no other nutrients.
What about salt?
Studies on salt have been inconsistent, but it seems that salt intake contributes to high blood pressure in some, but not all, persons. If you have high blood pressure, limiting your salt is recommended. There is plenty of sodium already in our food supply so there’s no need to add salt from the salt shaker. Salty snacks and processed foods are other major sources to watch. Fortunately, sodium content is listed on food labels.
Are there bad foods?
There are no bad foods. Do not exclude any foods from your diet. The key is to practice portion control and to limit the frequency of use of high-fat, low-nutrient foods.
Is fish better than red meat?
Yes, fish is generally a better choice than red meat. Fish contains omega-3 fatty acids, which have been shown to reduce the clotting that leads to arterial plaque formation. But it’s fine to eat a little red meat, in small portions and limited frequency. Red meat provides iron, which you don’t get from fish.
How can vegetarians get a well-rounded diet?
It depends on the kind of vegetarian. Ovolacto vegetarians get complete protein from eggs, milk, and other dairy products. Iron is a nutrient to be concerned about, however.
Strict vegetarians, who do not consume any animal products, should be careful. The old recommendation for balancing the amino acids can help. Soy products, such as tofu, dried beans and peas, peanuts, and peanut butter, eaten with whole grains, can cover most protein requirements. Supplementation with iron, vitamin B-12, calcium, and vitamin D is important.
What about older vegetarians?
It’s important for older vegetarians to get adequate protein and vitamin B-12. With aging, protein requirements seem to go up. Both exercise and adequate protein are important to protect against loss of lean body mass.
What sort of diet protects a woman’s health?
• Eat a balanced diet.
• Eat a variety of foods.
• Limit intake of meat, high-fat desserts, high-fat dairy products, soft drinks, and candy, but don’t try to be extreme. Splurge occasionally with small portions of the foods you really love.
• The more fruits and vegetables and whole grains, the better for protection from heart disease and cancer.
• Use skim milk and low-fat dairy products. Include supplements like calcium and vitamin D vs. bone loss and osteoporosis, vitamin B-12 and vitamin E.
(More prescriptions next week)