Sensible Eating (Part I)

Some basic concepts

It is helpful to begin with some terms commonly used in discussing nutrition. This will be of assistance in understanding the recommendations contained in the rest of the chapter.

The components of food can be classified into three broad categories of macronutrients. These are protein, fat, and carbohydrate. All contain micronutrients. These are vitamins and minerals.

The energy content of food is now measured in kilojoules. Energy content used to be measured in kilocalories—commonly called, simply, Calories (with a capital C). One Calorie equals approximately 4.2 kilojoules.

Protein

Protein (from the Greek proteios, meaning ‘primary’), is made up of amino acids. There are nine essential amino acids (eleven for premature babies).

The proteins made up of these amino acids are the basic elements of:

• more than 50 000 enzymes (essential to all chemical reactions in our bodies);

• blood plasma; and

• the structural proteins (for example, collagen, part of connective tissue, and muscle proteins).

Foods supplying proteins include:

• meat, eggs, fish, and dairy products (these are high in proteins);

• legumes, such as beans and lentils (moderately high);

• whole grains (medium);

• vegetables and fruit (low, but still significant).

Women require about 50 grams of protein daily. Pregnant women need an extra 30 grams per day (80 grams in total), and lactating mothers require about 20 grams extra per day (70 grams per day). Men require approximately 75 grams daily. These intakes of protein must include the essential amino acids in proportions suitable for our bodies.

Protein contains approximately 16.8 kilojoules (4 Calories) of energy per gram.

Fat

Fat is comprised of fatty acids. Some fats are said to be saturated (for example, animal fats) and others are said to be unsaturated (for example, olive oil). These terms refer to their chemical structure.

Just as there are essential amino acids, there are also essential fatty acids (EFAs) that our bodies must have daily. These are used to make all other required fatty acids. Fats make up (in part):

• hormones;

• cell membranes;

• nerve sheaths; and

• cellular transport mechanisms.

They are therefore essential to life.

Our bodies are made mostly of protein and fat, with some minerals.

Because fat contains 37.8 kilojoules (9 Calories) per gram, it is a concentrated source of energy.

Carbohydrate

Carbohydrate is the preferred energy source for our bodies. All vegetables, fruit, and grains are sources of carbohydrate. They are usually classified as being simple carbohydrates (sugars) and complex carbohydrates (starches).

Gylcaemic index (GI) is a useful measure of carbohydrate activity in the body. This indicates how rapidly a food is converted to glucose and how quickly blood glucose, the body’s fuel, rises.

Carbohydrate, like protein, contains about 16.8 kilojoules (4 Calories) of energy per gram.

Micronutrients

The micronutrients are:

• vitamins (the absence of which leads to specific disease); and

• minerals (which are essential for chemical and metabolic processes).

Some vitamins are antioxidants. This means that they bond with free radicals—which are byproducts of oxygen reactions in the body, and harmful in excess. This bonding leads to elimination of the antioxidants from our bodies.

Taking a new look at food

The majority of articles on food tend to concentrate on the kilojoule (or Calorie) content of food. Because fats contain the most kilojoules, these articles therefore tend to concentrate on the fat content of food. This has serious limitations for pregnant and lactating women. It is better to think about food in terms of the combinations of foods that will provide optimal nutrition for you and your child.

Expectant women (indeed, any person interested in health!) should try to minimise or avoid less desirable foods and maximise desirable foods in their diet. Desirable foods maximise nutrition and thus provide kilojoules that are beneficial. Less desirable foods have high kilojoule density and low nutritional density. The term ‘nutritional density’ refers to the extent to which the fifty nutrients that are essential to life are found in a particular type of food.

Let us look at a few examples.

White bread is very dense in kilojoules. One slice of white bread has roughly the same number of kilojoules as more than three and a half cups of broccoli—but the broccoli contains a huge range of additional vitamins, minerals, and phytonutrients (see below for more on phytonutrients).

White sugar is rich in carbohydrate, but contains no other nutrients—in fact, its digestion removes various micronutrients from the body, and its kilojoule density is relatively high. In contrast, spinach is rich in a large variety of nutrients. However, because of its vegetable structure, it is low in kilojoules.

As far as possible, you should try to eat food that is relatively kilojoule sparse and relatively nutrition rich because this ensures that the amount of nutrition you get in each mouthful of food is optimised. In the process, you will be avoiding unwanted weight gain (body fat). The total amount of energy that you need will depend on your activity level.

Another way of understanding this is to say that if you eat more of your food from the list of ‘What to include’ (below), you can eat a greater amount of food to achieve your desired kilojoule total, and each mouthful is giving you more in terms of nutrition.

And remember that all foods eaten in excess of energy requirements are stored as fat.

When choosing food, it is helpful to know that some complex carbohydrates have a very high glycaemic index (GI). In general, lower GI foods are preferable to higher GI foods because foods with a lower GI provide energy over a longer period. Pure glucose is given the highest rating of 100 and is the benchmark against which other carbohydrates are measured. The basic GI of a food can be altered significantly by refinement. For example, a boiled new potato has a GI of 62, whereas instant potato from a packet has a GI of 83. Whole grains have low GIs (for example, crushed wheat used in Lebanese food is less than 50), but refined grain products (bread and biscuits) can be 90 or more. Although many grain products are described as ‘complex carbohydrates’, they can behave like a simple sugar once digested, so consideration of GI can be helpful.

Notice that many refined foods are found in the list of ‘What to minimise or exclude’ (below). The refining process generally increases carbohydrate density (the amount of carbohydrate in any volume of food). The refining processes also usually remove essential fatty acids and other highly reactive food substances. The result is a tendency to lower nutrient density. These substances are removed in refining to increase the food’s shelf life.

Therefore, if you are concerned with maximising nutrition, you should eat more unrefined food sources. Of course, some foods are nutritionally and relatively kilojoule dense (for example, meat).

Desirable foods

These lists are only a rough guide. They are designed to help you look at food a different way, and to assist you to choose food that is better for you.

High-quality protein and low-to-medium saturated fat

• lean meat (beef, lamb, pork, venison, game meats)

• chicken (remove skin)

• fish (especially salmon, tuna); fresh, smoked, or canned

Medium-quality protein and medium-density carbohydrates

• dried beans

• kidney beans

• lentils

• chick-peas

• cracked wheat

• brown rice

• soy beans (canned beans are OK)

• tofu

Medium-quality protein and beneficial fat; high nutrition

• brazil nuts

• pecan nuts

• almonds

• cashews

• hazel nuts

• avocado

Low-density carbohydrates; high nutrition (fruit with medium-to-high GI)

• grapes (black grapes best; but also green grapes)

• bananas

• oranges and other citrus fruits

• apples and pears

• figs (fresh)

• dates (fresh)

• cherries

Low-density carbohydrates; high nutrition (vegetables with relatively low GI)

• capsicum

• spinach

• broccoli

• cauliflower

• potatoes (boiled)

• celery

• zucchini

• Chinese vegetables

• onion

• garlic

• ginger

• peas

• beans

• carrots (raw)

• Brussels sprouts

• other sprouts (mung, soy, alfalfa)

Medium-high density carbohydrate; low-medium protein; good nutrition

• ‘heavy’ breads (dark rye, pumpernickel)

• slow-cooking oats

• whole-grain pasta

• skim milk

• skim-milk yoghurt

Less desirable foods

Medium-high GI carbohydrate; low protein; kilojoule-dense

• breakfast cereals (packaged)

• rice (white)

• bread (white; ‘light’)

• pasta

• potatoes (instant)

• rice (instant)

• fruit juices

• sugar (raw)

• honey

• potato chips

• biscuits

• cakes

• instant noodles

• soups (packaged)

• chocolate

• fruit (canned; versions with no added sugar better)

High saturated fat; trans-fatty acids; low-medium protein; kilojoule-dense

• ‘TV’ dinners (including ‘low-fat’)

• pizza

• hamburgers

• ‘fast’ or ‘junk’ food

Medium-low density carbohydrate; low protein; high GI

• carrots (cooked)

• potatoes (baked or fried)

• parsnips (cooked)

• broad beans

• dried apricots

• baked beans (canned)

Foods with no known nutritional value

• cordials

• sweet carbonated drinks

• white (refined) sugar

• sugar-coated food

Some suggestions for meals of the day

In the pages that follow is a list of what foods to include in a sensible eating plan (and what to minimise or avoid), followed by a discussion of the reasons for our recommendations.

What to include

Breakfast

• grain-based source (unrefined if possible);

• protein source, or health shake (recipe suggestions below);

• piece of fresh fruit.

Mid-morning snack

• piece of fruit plus piece of cheese; or

• closed handful of raw mixed nuts and piece of fruit; or

• two to three tablespoons of cottage cheese and fruit; or

• small tin of tuna or salmon and piece of fruit; or

• meal replacement (drink or bar).

Lunch

• palm-sized lean protein source;

• two-hand-sized salad; or

• hand-sized lightly cooked vegetables; or

• half-and-half salad and cooked vegetables (approximately two-hand-sized);

• piece of fruit (optional).

Afternoon snack

• same as mid-morning snack.

Dinner

• protein source;

• fresh vegetables (starchy and leafy);

• piece of fruit.

What to minimise or exclude

• recreational drugs;

• coffee and tea;

• refined packaged food sources;

• ‘fast’ food;

• fried food;

• foods that are kilojoule-rich and nutrient-sparse (high GI foods);

• excessive kilojoules;

• foods rich in saturated fats;

• sweet carbonated drinks and refined sugar;

• low-fat packaged foods; and

• ‘convenience’ food.

Reasons for recommendations

Breakfast

In our list of ‘What to include’ (above), the following recommendations were made for breakfast:

• grain-based source (unrefined if possible);

• protein source, or health shake (recipe suggestions below);

• piece of fresh fruit.

Some thoughts on each of these is included below.

Grain-based source

There are two traditional Australian breakfasts—which might be termed the ‘bacon-and-eggs approach’ and the ‘cereal (grain) approach’. Both have good aspects, and not-so-good aspects. (Cereals are considered immediately below; for bacon and eggs see under ‘Protein source’, below.)

The best grains for breakfast are ordinary oats. Not only are they a source of slow-release energy (low GI of around 40), but also they contain gamma linolenic acid. Indeed, oats are one of the very few plant sources of this desirable fatty acid. You can add some honey, fruit, and milk (dairy or soy) if you wish. Note that the more ‘instant’ forms of oats generally have a higher GI.

Less-desirable sources of carbohydrate are the more-refined breakfast cereals. Try to get organically sourced and wholegrain cereals if you can. The least desirable grain-based carbohydrate sources are the even more refined versions of these foods, and the worst ones have the individual flakes covered in sugar.

Other desirable sources of unrefined carbohydrates are the heavier (in weight) of the wholegrain breads, pumpernickel (dark rye) bread, and mixed-grain breads. Less desirable are the ordinary brown breads, and the least desirable is white bread—even if the label does say that it is fortified with extra fibre. If you are eating sensibly, fibre will not be a problem.

Protein source

There are many sources of protein.

If you eat animal protein, a couple of soft-boiled or poached eggs, or an omelette made of two or three eggs (with your favourite filling) is an excellent choice. If you are concerned about excess cholesterol intake, simply do not eat some of the yolks. (The yolk contains some cholesterol, but many nutritious substances too.) If you have two or three soft-boiled eggs for breakfast, you can choose to have the yolk of one and eat only the whites of the other two. (However, it is always a good idea to have at least one yolk.)

Bacon and eggs supply a good amount of protein—often missing in many modern breakfasts—but can supply significant amounts of saturated fat. Reserve for special occasions, and use lean bacon!

Other good protein sources are cheese and yoghurt (especially good with mixed raw nuts, fresh fruit, and/or honey for additional flavour).

Health shake

A health shake is a good way to ‘jump-start’ your morning with excellent quality nutrition.

The basic liquid into which the other ingredients is blended is a matter of choice. You can use 50:50 fruit juice and water, or you can use a low-fat high-calcium milk source (or a soy-milk equivalent). If you prefer, you can use whole milk. However, if you are adding yoghurt and other products to it, the end mixture can be quite thick and heavy.

To the basic liquid, add two or three generous tablespoons of yoghurt (flavoured or non-flavoured). The organic ones are best, or you can make your own. If you look at the contents of many of the brands of yoghurt that you find on the supermarket shelves, you will be amazed at how much sugar they contain. The best of the organic yoghurts are flavoured with real fruit and do not contain preservatives or any other extra chemicals. A raw egg or two can be added.

Add some fresh fruit. Bananas taste good, and they blend extremely well, but any ripe fruit can be used. Some people don’t like the idea of mixing citrus fruit with a milk-based drink (if you are using milk or similar as the base), but the resulting mixture has an excellent taste.

If you feel that you need additional protein at the beginning of the day, you can add about 10 grams (about a tablespoon or two) of a suitable protein powder. Whey protein powder is said to have the highest ‘biological value’. This means that more of the protein in the powder is taken up by the body than a similar amount of another protein source, but really any powdered protein will do. If you are on a budget, use two or three tablespoons of skim milk powder. Skim milk contains casein which is an excellent high-quality protein. Vegetarians can fortify their shakes with soy protein, available from a health food shop. If you need extra fibre, Psyllium husks (one or two teaspoons) can add the right kind of fibre—good insurance with no ‘down’ side, in any case.

The final part of the health shake is a tablespoon of an oil containing the essential fatty acids (EFAs). These are linolenic acid (LNA) and linoleic acid (LA). Research suggests that the average Western diet is low in LNA. The addition of oil to the basic mixture makes the resulting shake taste creamy and delicious, even if you haven’t used yoghurt. Flax seed oil is the best source of LNA, and is obtainable from a health food shop. It is stored in dark bottles and must be kept in the refrigerator.

This is a useful place to discuss the fats that everyone is afraid of. Cholesterol, a saturated fat, is an essential substance in the body, but does not need to be eaten. Cholesterol is produced by the liver and is a major fraction of brain tissue and the nerves of the body. High blood cholesterol is usually a result of genetics, but good dietary habits (increasing EFAs and fibre) and adopting the relaxation strategies described in Chapter 2 can be beneficial. Trans-fatty acids are toxins produced by heating and refining oils, and using oils to fry. In the pursuit of good health, these cooking practices need to be minimised. Sufficient EFAs and antioxidants (such as vitamins A, C, and E) should be included in your diet to help your body process transfatty acids.

LNA is also found in soy bean and walnut oils, and dark green leafy vegetables. The other essential fatty acid, LA, is found in safflower, sunflower, soy bean, sesame, and flax seed oil. Buy oils that contain EFAs from a health food shop, and choose coldpressed organic sources. These oils cannot be used for cooking.

A note for lactating mothers: the Nursing Mothers Association of Australia (NMAA) states that ‘if you are eating enough for your own energy requirements, the fatty acid pattern in your milk will resemble that of your diet’ (Carafellam ,1996). This is good reason for asking yourself if you have sufficient EFAs in your diet.

The breakfast is finished with an optional piece of fresh fruit (discussed below).

Mid-morning snack

In our list of ‘What to include’ (above), the following recommendations were made for mid-morning snack:

• piece of fruit plus piece of cheese; or

• closed handful of raw mixed nuts and piece of fruit; or

• two to three tablespoons of cottage cheese and fruit; or

• small tin of tuna or salmon and piece of fruit; or

• meal replacement (drink or bar).

Some thoughts on each of these are included below.

Piece of fruit plus piece of cheese

Any ripe fresh fruit is a good source of simple (and some complex) carbohydrates, minerals, vitamins, and fibre. Ripe bananas are especially good. The notion of complex carbohydrates can be a bit misleading however, because the bonds between the glucose molecules (that give rise to the term ‘complex’) are easily broken down. This process begins in your mouth (during chewing) and is normally completed in your stomach (during the first stage of digestion). Some complex carbohydrate sources can raise your blood sugar level quite quickly. However, because you are having only one piece of fruit and a small amount of protein together, this will not be a problem. Any cheese will do, but if you are concerned about your intake of cholesterol, consider a low-fat variety.

Closed handful of raw mixed nuts and piece of fruit

All nut varieties contain beneficial fatty acids. If the nuts are roasted, the chemical composition of some of the fatty acids can be changed, so it is probably best to eat nuts raw. Eating mixed raw nuts ensures that a greater variety of essential fatty acids is consumed. Nuts are also a good source of protein, contain no cholesterol, and have minimal amounts of saturated fats.

Two to three tablespoons of cottage (or ricotta) cheese and fruit

Cottage cheese is made from milk and contains casein, an excellent high-quality protein. It is also low in saturated fat. Add this to a piece of fresh fruit and you have an excellent snack.

Small tin of tuna/salmon and piece of fruit

Fish is a form of protein that cans very well. Two fatty acids found in the oils of coldwater fish are part of the same omega 3 fatty acid family that includes LNA. Salmon is a migratory fish, and it has a high oil content.

The oil found in fish is good for your body. Recent research suggests that increasing your consumption of these fatty acids can help prevent cardiovascular disease. The extent to which these fatty acids are changed by the canning process is unclear. A better source of these oils is sliced smoked salmon (found in supermarkets).

Together with a piece of fruit, you obtain a small amount of excellent-quality protein and a small amount of easily digested carbohydrate.

Meal replacement (drink or bar; check label for the 'extras')

There is an increasing variety of meal-replacement bars or powders on the market. Careful reading of the labels reveals an extraordinary variation in the proportions of carbohydrate, protein, and fat in these products. If you want to use a meal replacement, choose one in which these various nutrients are present in approximately equal amounts in terms of kilojoules. Many manufactured substances can be used to make the final product taste and feel like food. Check the labels!

Be aware that if you use low-fat or fat-free meal replacements, the rate at which the carbohydrate enters your bloodstream is faster than it would be if some fat is present in the product, and this can raise the blood sugar level of some people a bit too rapidly. For this reason, the bars that have some fat in them (depending on the kind of fat) are generally preferable to the ones with little or no fat.

Lunch

In our list of ‘What to include’ (above), the following recommendations were made for lunch:

• palm-sized lean protein source;

• two-hand-sized salad; or

• hand-sized lightly cooked vegetables; or

• half-and-half salad and cooked vegetables (approximately two-hand-sized);

• piece of fruit (optional).

Some thoughts on each of these are included below.

Palm-sized lean protein source

The basis of our sensible eating plan is to maximise the amount of nutrition in the food that we eat and minimise the number of ‘empty’ kilojoules (little or no nutrition). A quick way of assessing your diet is to consider it in terms of how much carbohydrate, protein, and fat are likely to be in it.

The various Zone books by Barry Sears, and Body of Life by Bill Phillips, both recommend an ‘eyeballing’ method for assessing protein and carbohydrate quantities. This is because the body can assimilate only about 25 grams of protein at any one sitting. The rest is excreted or stored. Accordingly, it is a good idea to have just the right amount of any nutrient. A palm-sized piece of lean protein will contain 25–40 grams of protein, depending on its thickness (and the size of your palm!). To help you assess, 100 grams of steak contains about 25 grams of protein. Vegetarians (vegans or lacto-ovo vegetarians) will need to give some thought as to how much protein (and what proportion of which amino acids) is being consumed in their favourite food sources.

Two-hand-sized salad

Have some raw vegetables at most main meals, before or during the rest of the meal. Raw vegetables contain many enzymes that the body can use to help digest proteins, carbohydrates, and fats in the food that you eat. To ensure the greatest variety of phytonutrients, try to have as many colours in the salad as you can.

Many vegetables can be added to salads. These include varieties of lettuce (common in many salads), beetroot and carrot (can be grated), beans and peas (added raw), and broccoli and other brassicas (lightly steamed before adding). There are, of course, many other vegetables that can be added.

Nuts can be added to salads to increase the protein and (beneficial) fat content.

If you use one of the recommended oils as part of your dressing, salads provide a very convenient way of getting some of the two essential fatty acids.

Eat roughly ‘hand-sized’ if you are having other vegetables; increase the salad serving size if not.

Because these foods are low in carbohydrate density, you can eat as much as you like.

Hand-sized lightly cooked vegetables

The recommendation of a ‘palm-sized’ piece of lean protein (above) provides a simple assessment of how much protein to eat at each meal. This also applies to the suggestion to have a hand-sized serving of lightly cooked vegetables. This amount provides a good balance to the palm-sized protein source that you are combining with this meal. Together, you will get an excellent source of carbohydrates, proteins, and fats.

In addition, the vegetables (raw or lightly cooked) will provide you with many of the vitamins and minerals that are needed in daily life. Your body requires nutrition ‘as needed’. This means that you need to have all of the fifty essential nutrients (discussed below) almost every day. This means, for example, that it is not good to have a big serving of spinach on Monday, and not eat any other dark-green leafy vegetables until Friday.

Food is cooked to make it more palatable, and some nutrients are released by the process. However, many enzymes are denatured or destroyed if food is cooked for too long or too hot. This is why we recommend lightly cooked vegetables.

The best way to cook vegetables is to use a non-stick pan, or to cook in a quarter of a teaspoon of butter or coconut oil. Add a quarter of a cup of water, fit a tight lid, and steam the vegetables. Add some of your favourite oil as a dressing after cooking. Recommended oils include virgin olive (Australia is making some wonderful olive oils now) or a mixture of the oils that will supply the essential fatty acids.

Half-and-half salad and cooked vegetables (approx. two-hand-sized)

An even better suggestion to increase enzyme and nutrient intake in the diet is to have a salad and some cooked vegetables which, together, form roughly a hand-sized serving. This is fiddly, however, and you might choose to have your cooked vegetables at lunch and your salad at dinner, or vice versa. Have a slice of a heavy bread, if you wish.

Piece of fruit (optional)

To finish lunch, you can have a piece of fruit. But this is optional, and you might simply be too full to eat another thing! If you do leave fruit out of your lunch, you can have it for an afternoon snack.

Afternoon snack

Same as for mid-morning snack.

Dinner

In our list of ‘What to include’ (above), the following recommendations were made for dinner:

• protein source;

• fresh vegetables (starchy and leafy);

• piece of fruit.

Some thoughts on each of these are included below.

Protein source

We need a protein source at dinner too. We have suggested using the palm of your hand as a rough assessment of the desired 25–30 grams of protein. But where does that leave someone who wants to eat spaghetti bolognese or similar for dinner? The answer is that the same ‘palm-sized’ vs ‘hand-sized’ proportion as a guide still applies, but consider a small kitchen ladle to be equivalent to a palm-sized serving. Assuming a sauce that contains protein and carbohydrate, consider the ladle volume to be the protein part, and have an equivalent amount of the pasta. Compared with vegetables, pasta is carbohydrate dense, so a smaller amount is required for balance. Have some additional low GI vegetables on the side.

A salad with many different kinds of vegetables is an excellent complement to this meal. However, starchy vegetables are denser carbohydrate sources and, if you choose a lean palm-sized protein source, you will probably want to include some of these starchy vegetables as well—to make sure that you are getting sufficient carbohydrates. (You might also have a slice of one of the heavy breads.) Starchy vegetables include the tubers (including potato, sweet potato, and pumpkin).

Avoid deep-frying these vegetables. Deep-frying in otherwise good vegetable oil changes the oil and creates substances called trans-fatty acids, which are no good for your body at all. It is far better to steam or boil the vegetables and add some sort of good oil at the serving stage.

If you wish, have a tasty ripe piece of fruit to finish the meal.

 

To Part II