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Eating for Life
Eat for life? Eat to improve your chances long and healthy
life? Yes, you can.
At a time when we seem to be overwhelmed by conflicting
diet and health messages, the National Cancer Institute (NCI)
and the National Heart, Lung, and Blood Institute (NHLBI)
have some good news: by making the right food choices, you
may reduce your risk of developing cardiovascular disease
These diseases take the lives of more Americans than all
other illnesses and causes of death combined. Each day, about
three out of every four deaths in the United States will occur
as a result of cardiovascular disease or heart disease (like
heart attacks and strokes) and cancer. This need not be. Although
no diet can ensure you won't get a heart attack,
stroke or cancer, what you eat can affect your health. This
has been shown by research of the National Cancer Institute
and the National Heart, Lung, and Blood Institute (two of
country's National Institutes of Health), along with the research
of other scientists.
How does a person eat for life? It's easier and more enjoyable
than you might think. The practical ideas in this booklet
show you how to make healthful, tasty, and appetizing
food choices at home and when you're eating out. They are
consistent with the Dietary Guidelines for Americans, published
by the U.S. Department of Agriculture and the U.S. Department
of Health and Human Services. These seven basic guidelines
* Eat a variety of foods.
* Maintain desirable weight.
* Avoid too much fat, saturated fat, and cholesterol.
* Eat foods with adequate starch and fiber.
* Avoid too much sugar.
* Avoid too much sodium.
* If you drink alcoholic beverages, do so in moderation.
The first two guidelines form the framework of a good diet:
eat a variety of foods so that you get enough of the essential
nutrients you need, and eat only enough calories to
maintain desirable weight. The next five guidelines describe
special characteristics of a good diet-getting adequate starch
and fiber and avoiding too much fat, sugar, sodium, and
alcohol. Although the guidelines are designed for healthy
adult Americans, these suggestions are considered especially
appropriate for people who may already have some of the risk
factors for chronic diseases. These risk factors include a
family history of obesity, premature heart disease, diabetes,
high blood pressure, or high blood cholesterol levels.
This pamphlet focuses on five guidelines that are particularly
related to the prevention of heart disease and/or cancer:
eat a variety of foods; maintain desirable weight;
avoid too much fat, saturated fat, and cholesterol; eat foods
with adequate starch and fiber; and avoid too much sodium.
Keep in mind that staying healthy requires more than just
good nutrition. Regular exercise, getting enough rest, learning
to cope with stress, and having regular physical checkups
important ways to help ensure good health. Checkups are especially
important for early detection of cancer and heart disease.
Another important way to reduce your risks of heart
disease and cancer is not to smoke or use tobacco in any form.
Controlling high blood pressure (hypertension) can also greatly
reduce your risk of heart disease and stroke. Remember, three
of the major risk factors for heart disease are largely under
your control. They are smoking, high blood pressure, and high
How Do the Foods We Eat Affect Our Chances of Getting Cancer
and Heart Disease?
There is much still to be learned about the relationship between
the foods we eat and our risk of getting cancer and heart
disease. The NHLBI and NCI are conducting a great deal of
research to find out more about this relationship. There is,
however, a lot that we know now. The relationship of diet
to cancer and the relationship of diet to risk factors for
disease are summarized below:
* We know that obesity is associated with high blood pressure,
high blood cholesterol, diabetes, heart disease, and stroke,
Extreme obesity has also been linked to
several cancers. This means that if you are obese, losing
weight may reduce your chances of developing these serious
diseases or conditions. If you already suffer from
hypertension and are overweight, weight loss alone can often
lower your blood pressure to normal levels. Because fat (both
saturated and unsaturated fat) provides more
than twice the number of calories provided by equal weights
of carbohydrate or protein, decreasing the fat in your diet
may help you lose weight as well as help reduce
your risk of cancer and heart disease. Today, most Americans
get about 37 percent of their daily calories from fat. Many
experts suggest that fat should be reduced
to 30 percent or less of calories.
* We know that high blood cholesterol increases your risk
of heart disease, especially as it rises above 200 mg/dl (milligrams
of cholesterol per deciliter of blood). The evidence is clear
that elevated cholesterol in the blood, resulting in part
from the foods we eat and in part from cholesterol made in
the body, contributes to the development of atherosclerosis,
a disorder of arteries that results in their narrowing and
in reduced blood circulation. This condition can lead to a
heart attack or
* We know that blood cholesterol levels are greatly influenced
by the amount of saturated fat and cholesterol found in many
of the foods we eat. These raise blood cholesterol levels.
(Of the two, saturated fat seems to be the major dietary factor
which affects blood cholesterol.)
To reduce your blood cholesterol level, it is important to
eat less saturated fat and cholesterol. Saturated fat and
cholesterol are often found together in foods. Saturated
fat in the U.S. diet is provided primarily by animal products
such as the fat in meat, butter, whole milk, cream, cheese,
and ice cream. There are a few vegetable fats--coconut oil,
cocoa butter, palm kernel and palm oils which are also high
in saturated fat. Cholesterol is found only in animal products
eggs, meat, poultry, fish and dairy products. Plant foods
such as vegetables, grains, cereals, nuts, and seeds do not
contain cholesterol. A few
foods are high in cholesterol but relatively low in fat--for
example, egg yolks and liver.
Watch out for items in the grocery store that are labeled
no cholesterol or, contains no animal fat." They may
still contain a large amount of fat or saturated fat. Examples
peanut butter, solid vegetable shortening, nondairy creamer,
and baked products like cookies, cakes, and crackers. For
people trying to lose blood cholesterol level, these foods
should be chosen less often.
* We know that substituting unsaturated fatty acids (which
are usually liquid and usually come from plant sources) for
saturated fats can help reduce high blood cholesterol.
Safflower, corn, soybean, olive, and canola oils are major
sources of unsaturated fats. The omega-3 fatty acids which
are found in fish and seafood, may have a favorable effect
on blood fat and reduce the risk of heart disease. No one
is sure yet.
* We know that there is an association between too much
sodium in the diet and high blood pressure in some individuals.
Sodium is a mineral that occurs naturally in some foods and
is added to many foods and beverages as salt or other additives.
Most sodium in the American diet comes from salt. One teaspoon
of salt contains about 2 grams of sodium. In countries where
people eat only small amounts of sodium, high blood pressure
is rare. We also
know that when some people with high blood pressure greatly
reduce their sodium intake, their blood pressure will fall.
Because Americans generally eat much more sodium than they
need, it is probably best for most people to reduce the amount
of sodium they eat. According to the National Academy of Sciences,
a safe and adequate amount
of sodium in the diet of the average adult is between 1 and
3.3 grams daily.
Some recent studies indicated that the substitution of monosaturated
fats, such as those saturated fats may lower blood cholesterol.
* The National Cancer Institute estimates that about 80 percent
of all cancers may be related to smoking, diet, and the environment.
* The National Cancer Institute estimates that about one-third
of all cancer deaths may be related to the foods we eat. Studies
at the National Cancer Institute suggest that eating foods
high in fiber may reduce risks of cancers of the colon and
rectum. Adult Americans now eat about 11 grams of fiber daily
according to NCI studies. NCI recommends that Americans increase
the daily amount of fiber they eat to between 20 and 30 grams,
with an upper limit of 35 grams. The NCI also emphasizes the
importance of choosing fiber rich foods, not supplements.
Good sources of fiber are whole grain breads and bran cereals,
vegetables, cooked dry peas and beans, and fruits.
* We know that diets high in fats of all kinds have been
linked to certain cancers, particularly those of the breast,
colon, lining of the uterus, and prostate gland. Some studies
have suggested that fat may act as a cancer promoter (an agent
that speeds up the development of cancer).
* There is some evidence that diets rich in vitamin A, vitamin
C, and beta-carotene (the plant form of vitamin A) may help
reduce the risk of certain cancers. The evidence we have about
vitamins A and C comes from studies of these vitamins as they
are found in foods. That is why NCI recommends that you eat
a variety of foods rich in vitamins rather than relying on
vitamin supplements. Good sources of vitamin A include yellow-orange
as carrots, winter squash, sweet potatoes and pumpkin; and
yellow-orange fruits such as peaches, cantaloupes and mangoes.
Sources of vitamin C include dark-green leafy
vegetables such as kale, spinach, and watercress; broccoli
and asparagus; and tomatoes. Some fruit sources of vitamin
C are oranges, lemons, grapefruit, peaches, berries, and
* There is some evidence that vegetables in the cabbage
family may help protect against cancer of the colon. These
vegetables are also good sources of fiber, vitamins, and
minerals. Cabbage family vegetables include cabbage, broccoli,
cauliflower, Brussels sprouts, collards, kale, turnips, mustard
greens, turnip greens, kohlrabi, watercress and radishes.
Reducing Your Risk of Heart Disease and Cancer
Based on what we know, the National Heart, Lung, and Blood
Institute and the National Cancer Institute have joined together
to suggest some ways you may reduce your risks of
heart disease and cancer. These suggestions emphasize the
need to eat a variety of foods each day. They also include
some "mealtime strategies" that you can use to plan
meals that avoid too much fat, saturated fat, cholesterol,
and sodium, and that help you to get adequate starch and fiber.
These strategies are consistent with the Department of Agriculture
and Department of Health and Human Services Dietary Guidelines
for Americans. These strategies should encourage you to think
about the foods you eat, how to prepare them, and what food
choices you can make when you go grocery shopping or eat away
The key is following a Choose More Often approach. It doesn't
mean giving up your favorite foods. It means taking steps
to choose more often foods that are low in fat and high
in fiber. For example, if you enjoy eating steak, choose a
low-fat cut such as round steak, trim off the excess fat,
broil it, and drain off the drippings. Pizza? To try a low-fat
version that is rich in fiber, use a whole-grain English muffin
or pita bread topped with part-skim mozzarella, fresh vegetables,
and tomato sauce. And cookies or other desserts? In
many recipes you can reduce the fat, and substitute vegetable
oils or margarine for butter. To increase fiber, use whole
wheat flour in place of white flour.
Here's how the Choose More Often approach works:
Choose More Often:
Low-fat meat, poultry, fish
Lean cuts of meat trimmed of fat (round tip roast, pork
tenderloin, loin lamb chop), poultry without skin, and fish,
cooked without breading or fat added.
Low-fat dairy products
1 percent or skim milk, buttermilk; low-fat or nonfat yogurt;
lower fat cheeses (part-skim ricotta, pot, and farmer); ice
Dry beans and peas
All beans, peas and lentils--the dry forms are higher in
Whole grain products
Breads, bagels, and English muffins made from whole wheat,
rye, bran, and corn flour or meal; whole grain or bran cereals;
whole wheat pasta; brown rice; bulgur.
Fruits and vegetables
All fruits and vegetables (except avocados, which are high
in fat, but that fat is primarily unsaturated). For example,
apples, pears, cantaloupe, oranges, grapefruit, pineapple,
peaches, bananas, carrots, broccoli, Brussels sprouts, cabbage,
kale, potatoes, tomatoes, sweet potatoes, spinach, cauliflower,
and turnips, and others.
Fats and oils high in unsaturates
Unsaturated vegetable oils, such as canola oil, corn oil,
cottonseed oil, olive oil, and soybean oil, and margarine;
reduced-calorie mayonnaise and salad dressings.
To assure an adequate diet, choose a variety of foods daily
including selections of vegetables; fruits; whole-grain breads
and cereals; low-fat dairy products; poultry, fish, and
lean meat, dry beans and peas. Here are some tips for following
the Choose More Often approach in three important areas: grocery
shopping, food preparation, and eating out.
Focus on variety. Choose a wide selection of low-fat foods
rich in fiber. Include whole grain breads and cereals, vegetables,
fruits, low-fat dairy products, and poultry, fish, and lean
meat. Although the goal is to reduce fat to 30 percent or
less of calories, when choosing foods that do contain fat,
try to choose ones that contain primarily unsaturated fats.
example, choose an unsaturated-rich margarine instead of butter;
choose vegetable oils.
Read food labels. To help you find foods that are low in
fat and cholesterol and high in fiber, get into the label-reading
habit. Many nutritional labels on packaged foods show the
amount of unsaturated and saturated fatty acids and the amount
of cholesterol and fiber they contain. Check the type of fat
on the ingredients list. Is it an animal fat, coconut or palm
kernel oil high in saturated fat? Or, is it corn or soybean
oil high in polyunsaturated fat? Choose a product with the
lowest proportion of saturated fat. The label also tells you
something else about a product. Ingredients are listed in
order of amount from most to least by weight. So, when you
buy a breakfast cereal, for example, choose one that has a
whole grain listed first (such as whole wheat or oatmeal).
Pay attention to sodium. Many processed, canned, and frozen
foods are high in sodium. Cured or processed meats, cheeses,
and condiments (soy sauce, mustard, tartar sauce) are also
high in sodium. Check for salt, onion or garlic salt, and
any ingredient with "sodium" on the label. If the
sodium content is given on the nutritional label, compare
choose the ones with lower levels.
Use small amounts of fat and fatty foods. There are lots of
ways to use less fat. For example, when you saute or stir-fry,
use only 1/2 teaspoon of fat per serving. When you
use margarine, mayonnaise, or salad dressing, use half as
much as usual. And, decrease portion sizes of other high fat
foods--rich desserts, untrimmed and fatty types of meat,
poultry with skin, and fried foods, especially breaded foods.
Use less saturated fat. While reducing your total fat intake,
substitute unsaturated fat and oils for saturated fat in food
preparation. For example, instead of butter, use margarine
or vegetable oil. One teaspoon of butter can be replaced with
equal portions (or less) of margarine or 3/4 teaspoon of vegetable
oil in many recipes without affecting the
quality. Saturated fat may be reduced even more if you want
to experiment with recipes. Poultry without skin and fish
are good choices because they are often lower in fat and saturated
fat than many meats.
Use low-fat alternatives. Substitute 1 percent, skim, or
reconstituted nonfat dry milk for whole milk. Use low-fat
yogurt, buttermilk, or evaporated skim milk in place of cream
or sour cream. Try reduced-calorie mayonnaise and salad dressing
in place of regular.
Choose lean meat. When you buy meat, choose lean cuts such
as beef round, pork tenderloin, and loin lamb chops. Be sure
to trim all visible fat from meat and poultry and remove poultry
Use low-fat cooking methods. Bake, steam, broil, microwave,
or boil foods rafter than frying. Skim fat from soups and
Increase fiber. Choose whole grain breads and cereals. Substitute
whole grain flour for white flour. Eat vegetables and fruits
more often and have generous servings. Whenever
possible, eat the edible fiber-rich skin as well as the rest
of the vegetable or fruit.
Use herbs, spices, and other flavorings. For a different
way to add flavor to meals, try lemon juice, basil, chives,
allspice, onion, and garlic in place of fats and sodium. Try
new recipes that use less fat or sodium-containing ingredients,
and adjust favorite recipes to reduce fat and sodium.
Choose the restaurant carefully. Are there low-fat as well
as high-fiber selections on the menu? Is there a salad bar?
How are the meat, chicken, and fish dishes cooked? Can you
have menu items broiled or baked without added fat instead
of fried? These are important things to know before you enter
a restaurant--fast food or otherwise. Seafood restaurants
usually offer broiled, baked, or poached fish, and you can
often request butter and sauces on the side. Many steak houses
offer small steaks and have salad bars.
Try ethnic cuisines. Italian and Asian restaurants often
feature low-fat dishes. though you must be selective and alert
to portion size. Try a small serving of pasta or fish in a
tomato sauce at an Italian restaurant. Many Chinese, Japanese,
and Thai dishes include plenty of steamed vegetables and a
high proportion of vegetables to meat. Steamed rice, steamed
noodle dishes, and vegetarian dishes are good choices too.
Ask that the chef cook your food without soy sauce or salt
to decrease sodium. Some Latin American restaurants feature
a variety of fish and chicken dishes that are low in fat.
Make sure you get what you want Here are just a few things
you can do to make sure you're in control when you eat out.
Ask how dishes are cooked. Don't hesitate to request that
one food be substituted for another. Order a green salad or
baked potato in place of french fries or order fruit, fruit
ice, or sherbet instead of ice cream. Request sauces and salad
dressings on the side and use only a small amount. Ask that
butter not be sent to the table with your rolls. If you're
not very hungry, order two low-fat appetizers rather than
an entire meal, split a menu item with a friend, get a doggie-bag
to take half of your meal home, or order a half-size portion.
When you have finished eating, have the waiter clear the dishes
away so that you can avoid postmeal nibbling.
We've given you some basic information on fat, fiber, and
sodium. And, we've provided some tips on decreasing fat, saturated
fat, cholesterol and sodium; and increasing fiber. But, how
do you put it all together when it comes to breakfast, lunch,
and dinner? These mealtime strategies should help.
Strategy #1--Choose fruit more often. Just a few great choices
in the fruit family are: cantaloupe, grapefruit, strawberries,
oranges, bananas, pears, and apples.
Strategy #2--Choose whole-grain cereals and products more
often. Examples are whole wheat or bran breads, bagels, and
Strategy #3--Try making pancakes and waffles with whole
wheat flour instead of white flour and one whole egg and one
egg white rafter than two whole eggs. For a low-fat topping
with fiber, try applesauce, apple butter and cinnamon, or
fruit and low-fat plain yogurt.
Strategy #4--Fruit juice and skim milk are familiar breakfast
drinks. For an extra boost in the morning, why not try a fruit
smoothie made from juice, fruit and nonfat plain yogurt blended
together. Other nonfat choices are seltzer water, coffee,
These breakfast choices are sound nutrition choices because
they are not only low in fat and cholesterol but also provide
fiber, vitamins, and minerals. Some foods that you should
choose less often are sausage, bacon, butter, whole milk and
cream (including commercial nondairy creamer). These foods
are high in saturated fat and cholesterol.
Strategy #1--Try a fiber-rich bean, split pea, vegetable,
or minestrone soup. Use commercially canned and frozen soups
and cream soups less often--they can be high in sodium and
fat. If you make your own soup, use broth or skim milk to
fat content low.
Strategy #2--Have a bean salad or mixed greens with plenty
of vegetables. For fiber include some vegetables like--carrots,
broccoli, cauliflower, and kidney or garbanzo beans. For a
low-fat dressing, try lemon juice or a reduced-calorie dressing.
If you use regular dressing, use only a very small amount.
Strategy #3--Try sandwiches made with water-packed tuna,
sliced chicken, turkey, lean meat, or low-fat cheese, and
use whole-grain bread or pita bread. To decrease fat, use
reduced-calorie mayonnaise, or just a small amount of regular
mayonnaise, or use mustard. Mustard contains no fat.
Strategy #4--For dessert, have fresh fruit, low-fat yogurt,
or a frozen fruit bar.
Strategy #5--Fruit juice and skim milk are good beverage
choices. Club soda with a twist of lemon or lime, hot or iced
tea with lemon, or coffee without cream are refreshing drinks.
At lunch, try to eat these foods less often: processed luncheon
meats, fried meat, chicken, or fish; creamy salads, french
fries and chips, richer creamy desserts, high-fat baked
goods, and high-fat cheeses such as Swiss, cheddar, American,
Strategy #1--Eat a variety of vegetables. To increase variety,
try some that might be new to you, such as those from the
cabbage family (broccoli, Brussels sprouts, cauliflower,
and cabbage), dark-green leafy vegetables (spinach and kale),
and yellow-orange vegetables (winter squash and sweet potatoes).
For old favorites, like peas and green beans, skip
the butter and sprinkle with lemon juice or herbs. Or, how
about a baked potato, with the skin, and topped with low-fat
yogurt and chives, tomato salsa, or a small amount of low-fat
Strategy #2--Try whole wheat pasta and casseroles made with
brown rice, bulgur, and other grains. If you are careful with
preparation, these dishes can be excellent sources of
fiber and low in fat. For example, when milk and eggs are
ingredients in a recipe, try using 1 percent or skim milk,
reduce the number of egg yolks and replace with egg whites.
Here are some ideas for grain-based dishes:
--Whole wheat spaghetti with fresh tomato sauce;
--Whole wheat macaroni and chickpea stew in tomato sauce;
--Tuna noodle casserole, using water-packed tuna (or rinsed,
oil-packed tuna), skim milk, and fresh mushrooms or sliced
--Turkey, broccoli and brown rice casserole using skim milk
and egg whites;
--Eggplant lasagna, made with broiled eggplant and part-skim
mozzarella or ricotta cheese.
Strategy #3--Substitute whole-grain breads and rolls for
Strategy #4--Choose main dishes that call for fish, chicken,
turkey or lean meat. Don't forget to remove the skin and visible
fat from poultry and trim the fat from meat. Some good low-fat
--Red snapper stew;
--Flounder or sole florentine (make the cream sauce with
--Salmon loaf (use skim milk, rolled oats, and egg whites);
--Baked white fish with lemon and fennel;
--Chicken cacciatore Italian-style (decrease the oil in
--Chicken curry served over steamed wild rice (choose a
recipe that requires little or no fat; "saute" the
onions in chicken broth instead of butter);
--Light beef stroganoff with well-trimmed beef round steak
and buttermilk served over noodles;
--Oriental pork made with lean pork loin, green peppers
and pineapple chunks served over rice.
Strategy #5--Choose desserts that give you fiber but little
fat such as:
--Baked apples or bananas, sprinkled with cinnamon;
--Fresh fruit cup;
--Brown bread or rice pudding made with skim milk;
--Oatmeal cookies (made with margarine or vegetable oil;
For many, the end of the workday, represents a time to relax,
and dinner can be a light meal and an opportunity to decrease
fat and cholesterol.
Strategy #1--Try a raw vegetable platter made with a variety
of vegetables. Include some good fiber choices: carrots, snow
peas, cauliflower, broccoli, green beans.
Strategy #2--Make sauces and dips with nonfat plain yogurt
as the base.
Strategy #3--Eat more fruit. Oranges, grapefruit, kiwi,
apples, pears, bananas, strawberries and cantaloupe are all
good fiber sources. Make a big fruit salad and keep it on
Strategy #4--Plain, air-popped popcorn is a great low-fat
snack with fiber. Watch out! Some prepackaged microwave popcorn
has fat added. Remember to go easy on the salt or use other
Strategy #5--Instead of chips, try one of these low-fat
alternatives that provide fiber: toasted shredded wheat Squares
sprinkled with a small amount of grated Parmesan cheese,
whole-grain English muffins, or toasted plain corn tortillas.
Strategy #6--When you are thirsty, try water, skim milk,
juice, or club soda with a twist of lime or lemon.
The National Heart, Lung, and Blood Institute and the National
Cancer Institute are committed to promoting good health and
reducing the loss of life from heart disease and
cancer. You can help. By using the ideas in this booklet,
trying recipes that have been modified to decrease fat and
sodium and increase fiber, and planning menus that are high
fiber and low in fat, especially saturated fat, you may reduce
the risk of these diseases for yourself and for those you
So Eat Well, Eat Healthy... And Eat For Life!
Free Printables that can help you with your diet: