Real-Life Food Choices

A nutritionist tells four "average" people what they're doing right -- and wrong

From the WebMD Archives

Eat nine servings of veggies a day, drink quarts of water, load up on fiber -- we all know what the doctors and nutritionists recommend. But in real life, of course, people don't always make the best fitness and food choices.

So just how does an "average" American's diet shape up from a nutritional standpoint?

WebMD asked four healthy people -- all college-educated, none following a specific health or weight-loss diet -- to keep a food diary for one day. Then, Molly Kimball, RD, a sports nutritionist at the Ochsner Clinic's Elmwood Center in New Orleans, gave them the verdict on what they're doing right -- and what they might want to re-think.

Our four volunteers, who asked that we refer to them by first name only, vowed to be completely honest about their food choices, whether good, bad, or ugly. Here's how their diets fared.

1. RACHELE

Bio: 36, magazine editor in Atlanta, husband, no kids

Body type: Think Olive Oyl

Exercise : Elliptical trainer in the evening

Food diary:

9:20 a.m.

  • Whole-grain bagel with margarine
  • 12-oz. fountain cola (she hates coffee)
  • 12-oz. calcium-fortified orange juice

Noon

  • Corndog (plain)
  • 35 French fries (half-order) with honey-mustard sauce
  • 1/2 cup field greens (mesclun), no dressing
  • Fried apple pie, fast food style, (you must eat these occasionally or leave Georgia, she claims)
  • 4 small slices honeydew melon (1/4 inch by 4 inches)
  • 1 similar-sized cantaloupe slice
  • 12-oz. cola

4 p.m.

  • Fast food fried chicken sandwich with two pickle slices
  • Half order of fries

6 p.m.

  • 12-oz. can of orange-flavored sparkling water
  • 3 large gulps of bottled water
  • 8-oz. of yet another type of sparkling water

8-8:30 p.m.

  • 2 large glasses of Chardonnay (8 oz. each)

10 p.m.

  • 12-oz. can of flavored water
  • Two fruit-flavored, chewable antacids (for calcium)
  • Medium banana

Nutritional tally:

  • Approximately 2,400 calories
  • 400 grams of carbohydrate
  • 55 g protein
  • 65 g fat
  • 44 ounces of hydrating fluids (not caffeinated or alcoholic)

(Needs depend on weight and level of activity, but half a gram to one gram of protein per pound of body weight and 30-50 grams of fat a day is ideal. All women, and men over 50, should get 1,500 mg calcium a day. For men under 50, 1,000 grams is a good target.)

Continued

Here's what Rachele is doing right, according to Kimball. She:

  • Eats frequently (every four hours or so), which helps keep her metabolism stoked and keeps hunger pangs away.
  • Has a good calcium intake, with calcium-fortified juice and supplements.
  • Has a good intake of fruits, both fresh fruits and juices.
  • Drinks plenty of sparkling waters with no calories or artificial sweeteners.

Here are some healthy changes Rachele could make, Kimball says:

  • Add protein to breakfast. With all those high-sugar carbs (soft drink, fruit juice) and even whole-grain carbs (bagel), but no protein, she's probably having a dip of energy mid-afternoon. She can help prevent this by having only half a bagel, along with a tablespoon of peanut butter or slice of cheese.
  • Decrease sugar intake. She could try more sparkling water in place of the soft drinks.
  • Eat fewer fried foods. She could try to limit them to once weekly, or every other day. This will decrease her intake of both saturated fat and the trans fats everyone is talking about, both of which have been linked to an increased risk of heart disease. Rachel could order a fast-food grilled chicken sandwich instead of a fried one, and have salads (with just a little dressing) in place of fries.
  • Eat more veggies. The mixed greens was the only serving Rachel had all day. She could try also dipping raw veggies (red peppers, carrots, broccoli, etc) into a dip while she enjoys her wine.
  • Cut back on alcohol. A serving of wine is 4 ounces, so Rachele actually had four "glasses" of wine. The recommended intake for "moderate alcohol consumption" for women is one drink a day. Rachel could mix her Chardonnay with sparkling water to create a wine spritzer.
  • Get more fiber. Rachel should have sandwiches on whole grain bread when possible, increase her fruit and veggie intake, and snack on whole grain crackers.

Next Up: "Teddy Bear" Jeff

2. JEFF

Bio: 46, owns insurance agency in Tempe, Ariz.; wife and two elementary school-age kids

Body type: Teddy bear: solid

Exercise: Used to hike a lot, before he got so busy running the kids around

Continued

Food diary:

7:30 a.m.

8:30-9 a.m.

  • 2 cups coffee

11:35 a.m.

  • 2 pieces of leftover fast-food chicken
  • Glass of skim milk

1 p.m.

  • Handful of son's fast-food French fries
  • 2 sips of cola

3:20 p.m.

  • Handful of jellybeans

7:30 p.m.

  • 2 helpings of beef Stroganoff
  • 2 glasses of water

8-9 p.m.

  • 2 bourbon-and-colas
  • Six pieces of cherry licorice

10:30 p.m.

  • Glass of water

Nutritional tally:

  • Approximately 2,200 calories
  • 260 grams carbohydrate
  • 110 grams protein
  • 80 grams fat
  • 60 ounces of fluid

Here's what Jeff is doing right, says Kimball:

  • Taking fish oil for cholesterol -- a good move!
  • Getting enough calcium, if he's using milk in his coffee as well as having it with lunch.
  • 2 drinks daily is fine for men -- keep in mind that a 'drink' is 1 ounce of bourbon. To keep the sugar low, try mixing it with ice and water instead of cola.

And what changes might he want to make? Here are Kimball's suggestions:

  • Cut back on saturated fats and trans fats (which are especially high in fried foods). Taking fish oil won't negate their effects on cholesterol. Simply taking the skin off of the fried chicken can lower its saturated fat content to that of a baked, skinless chicken breast! And snacking on a handful or two of walnuts (instead of the jellybeans) would be a great way to incorporate more heart-healthy omega-3 fats.
  • Cut back on sugar and refined carbs. Eating too much sugar can increase triglyceride levels, another risk factor for heart disease.
  • Get more fiber. This will keep him feeling full, keep him regular, and help lower cholesterol. Adding fruits and veggies is an easy way to increase fiber -- and he had none of either on this day! Frozen vegetables work just fine. Other easy ways Jeff could add fiber would be to have a packet of plain instant oatmeal for breakfast, snack on an apple with peanut butter, and use whole-wheat pastas and brown rice in place of the refined versions.

Continued

3. KATY

Bio: 30, social worker for child protective services in Phoenix; husband, 14-month-old son

Body type: Wants to lose a few

Exercise: Recently joined a gym

Food diary:

8 a.m.

  • Diet cola (she says it's too hot in Arizona to drink coffee)

9 a.m.

  • Half a fast-food breakfast sandwich (a co-worker snatched the other half)
  • Multivitamin

10:30 a.m.

  • Liter of water

Noon

  • Dinner salad with lettuce, tomato, cheese, croutons, and Italian dressing
  • Two diet colas

2:30 p.m.

4 p.m.

  • One liter of water
  • 7 woven wheat crackers

6 p.m.

  • 1/2 cup of corn chowder
  • 1 peanut butter and grape jelly sandwich
  • 1/4 of son's peanut butter and jelly sandwich
  • 2 cups skim milk

7 p.m.

  • 8-oz. of diet drink made from flavor crystals, diluted with 8 ounces water

9 p.m.

  • 2 light beers

Nutritional tally:

Approximately 1,550 calories
220 grams carbohydrates
43 grams protein
55 grams fat
3 liters, or 100 ounces, of hydrating fluids

Here's what Katy has in her favor, according to Kimball. She's:

  • Exercising!
  • Choosing high-fiber foods, such as the salad, whole-wheat crackers. Even better, she could have whole-grain toast for breakfast and add some fresh fruit.
  • Getting plenty of fluids.
  • Taking a multivitamin.
  • Eating frequently. She didn't go more than four hours without eating, which helps keep her metabolism up.
  • Getting enough calcium, with the milk and cheese.

And how might Katy improve her dietary habits? Kimball recommends that she:

  • Limit her alcoholic drinks to one a day, for general health as well as weight-loss purposes.
  • Add protein. This will keep her feeling full, and make her less likely to overeat. She had only 43 grams of protein on this day, less than the recommended minimum. She could have an egg with her whole-wheat toast for breakfast; add chicken or shrimp to her lunch salad; have lean fish, steak, or pork for dinner (a 3-5 ounce serving, about the size of her palm); and add a slice of cheese or tablespoon of peanut butter to the whole-grain crackers she had for a snack.
  • Limit the carbs at night to boost her weight-loss efforts. Since she doesn't need all those carbs at night for energy, she could try having just a serving of lean protein and a non-starchy vegetable.
  • Have just two chocolate kisses instead of six -- maybe one after lunch, and another after dinner.
  • Limit her diet drinks to one or two daily. Instead, she could try sparkling water or fruity herbal iced teas.

Continued

4. LINDA

Bio: 57, postmenopausal, homemaker in Glendale, Ariz., husband, grown children

Body type: Slender

Exercise: Former runner; since suffering an injury, she now walks an hour daily

Food diary:

7:15 a.m.

  • Soy shake with strawberries
  • 2 cups black coffee with chicory
  • 1/2 cup of sports drink
  • 24-oz bottle of water (those walks get HOT)

9 a.m.

  • 6 gulps of water from an iced jug kept on the counter

11:20 a.m.

  • 2 more big swigs of water

12:25 p.m. (Lunch in a restaurant)

  • 1/2 turkey sandwich with cranberry cream cheese on rye
  • 4 bites of coleslaw
  • 1 bite of chocolate cake
  • 1 1/2 fried Twinkies ("Elvis, I am coming to join you," she jokes)
  • 1 1/2 diet colas

3 p.m.

  • 1 cup water

4 p.m.

5:30 p.m.

  • 2 glasses nonalcoholic white Zinfandel
  • 1 square chocolate candy with caramel

6 p.m.

  • 1-oz. cold filet mignon

6:30 p.m.

  • 1 cup water

Nutritional tally:

Approximately 1,330 calories
180 grams carbohydrate
40 grams protein
50 grams fat (mainly from the fried Twinkies!)
60 ounces of fluid

Here are some things Linda is doing right, according to Kimball:

  • Those daily walks, which are "wonderful" for her health.
  • Getting plenty of water.
  • Having a snack in the afternoon. Eating frequently helps to maintain energy levels and metabolism.
  • Getting enough fresh fruit.
  • Limiting portions. Her choice of half a sandwich in the restaurant was a good one. And she did well to have just a bite of chocolate cake! Maybe she was holding out for the Twinkie?

And here are some areas where there's room for improvement. Kimball suggests that she:

  • Supplement her diet with a multivitamin plus 1,000 mg of calcium daily.
  • Add protein. Linda is well below the recommended minimum of 50 grams. She could add a scoop of soy protein powder to her shake, and increase her portion of lean meat at night to 3 ounces.
  • Add vegetables by having a salad with lunch and some cooked veggies at dinner.

Continued

So we see that in the real world, lots of people eat on the run and choose whatever is quickest or whatever they feel like. As Jeff put it, "Eating what we want is about our last freedom."

But that doesn't necessarily mean dietary disaster. The trick, as Kimball has shown, is to make a few, relatively painless changes that will help you approach perfection. And even if you have a fried Twinkie kind of day, you can always start over the next.

WebMD Weight Loss Clinic-Exclusive Feature Reviewed by Kathleen M. Zelman, MPH, RD, LD on January 20, 2004

Sources

SOURCES: Molly Kimball, RD, sports nutritionist, Ochsner Clinic's Elmwood Center, New Orleans. Food diaries submitted by four volunteers.

© 2007 WebMD, Inc. All rights reserved.

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