Thursday, February 4, 2016

What to eat, what to avoid: CoxHealth endocrinologist discusses new dietary guidelines

In early January, new dietary guidelines were released. The guidelines are aimed at helping Americans improve their eating habits, reduce obesity and prevent chronic diseases, such as type 2 diabetes, hypertension and heart disease.

CoxHealth Endocrinologist Dr. James Bonucchi explained that in the past, the dietary guidelines emphasized a low-fat diet.

“What we’ve learn through more recent research is perhaps the low fat diet is not the ideal diet,” Dr. Bonucchi explains. “When you start to eliminate fats in your diet, the fats are often replaced with carbohydrates, whether it is simple sugars, such as candy, sodas and sweet teas, or even more complex sugars, such as a potato. The extra sugar in the diet, complex carbs included, have a big detriment on the body overall. Those carbohydrates end up leading to more obesity based on what we believe with current research, which ultimately relates to more diabetes.”

Dr. Bonucchi said 20 years ago, the obesity rate in the U.S. was only 10 to 15 percent. Today,  in Missouri, the obesity rate is now one in three adults, according to 2014 numbers and no state has an obesity rate less than 20 percent.

What’s to blame?

Dr. Bonucchi explained there are a couple of things believed to be contributing to the growing obesity problem – less active lifestyles and the foods being consumed today.

“It is not just about the calories consumed, but what makes up those calories, is what really plays into it,” he says.  “A lot of it also likely has to do with convenience foods. The average kitchen has shrunk in size in new houses. People are eating out, ordering in and getting take out. They are not spending time in their kitchen cooking from scratch the way our grandmothers did. When our grandmother made something, she knew every ingredient she put in there. With processed foods, we don’t know what foods we are putting in our bodies.”

When purchasing food, Dr. Bonucchi suggests purchasing items with no more than five ingredients listed on the label, if possible.

“Also, if you can’t pronounce an ingredient, you probably shouldn’t be buying it,” he said. 

Stick to a healthy eating pattern, not a diet
“You should really stick to a healthy eating pattern and not to a diet,” Dr. Bonucchi said. “Diets don’t work because diet implies it is short term. We are talking about healthy eating, something you are doing consistently, every single day. That healthy eating pattern should include a healthy, rich mixture of different vegetables including leafy, dark greens, as well as greens, reds and oranges.  All of those different fruits and vegetables are different colors for a reason because there are different nutrients in each one. Also, don’t forget about beans. Beans are very healthy and a great source of both protein and fiber.”

Selective with starches

“Some starchy vegetables are OK, if you are eating them whole,” Dr. Bonucchi says. “We are often told to avoid corn, but corn still has good nutrition in it, as long as it is not ground up into a corn tortilla. It is also OK to have a potato occasionally, as long as it is not the giant baked potato. If you have a baked potato, have a small baked potato that will fit in your hand and make sure you are eating the skin because that is where you find the good nutrients.”

Go for whole grains

“It is OK to have some carbohydrates, especially if they are in the form of whole grains because the body can handle whole grains over a longer period of time,” he says. “Whole grains are less refined and so the body is able to handle it more slowly and it allows your body to absorb the food in your body over a longer period of time, which is especially important for those who have diabetes. The key to whole grains is avoiding white. If it looks like it has little nuts and seeds in it, that is perfect.”

Add fish to your diet

“Don’t forget about seafood,” Dr. Bonucchi said. “We probably don’t eat enough seafood in this country. You should be having a serving of ocean fish at least once a week, not deep fried and battered, but baked or grilled. Also, go for lean meats, poultry, chicken, eggs, beans and soy.”

What to limit

“We should consume no more than 10 percent of our daily calories from added sugars,” explains Dr. Bonucchi. “We are not talking about sugars that naturally occur in fruit. Those don’t count because they are buried in that whole piece of fruit or corn. It is the sugars that are added to our diet that we really must limit to 10 percent of our calories. If the average person is on a 2,000 calorie diet, they should limit their intake to 50 grams of sugar. That is equivalent to about one can of regular soda or one glass of sweet tea. Also, be aware of hidden sugars, such as sugars added to salad dressings and sauces.”

The new guidelines also recommend limiting  sodium to 2,300 mg per day.

“The average American is consuming 4,000 mg each day,” Dr. Bonucchi said. “If you are going out to eat, you can easily get 2,000 mg of sodium in one appetizer, let alone the entire meal. Most processed food items are filled with sodium, including your frozen TV dinners. Sodium is an excellent preservative but the tradeoff is we are getting a lot of sodium in our diet from processed foods.”