Healthy Living Messages

• Be Physically Active
• Eat Wisely
• Strive for a Healthy Weight
• Get Recommended Screening Tests & Immunizations
• Be Involved in Your Health Care
• Be Tobacco Free
• Limit Alcohol
• Manage Stress
• Be Safe
  

Key recommendations for eating wisely

• Vegetables & Fruit:
  • Eat enough vegetables and fruits (fresh, canned, or frozen) while staying within your energy needs. Aim for 5-9 servings of vegetables and fruits every day (two and one half cups of vegetables and two and one half cups of fruit per day). Fresh, canned or frozen fruit is preferred over fruit juice.
  • Choose a variety of vegetables and fruits each day. In particular, make selections from the different vegetable groups several times a week. Choices should include: dark green (i.e., broccoli, kale, spinach); orange (i.e., carrots, pumpkin, tomato); legumes (i.e., kidney, pinto and black beans, lentils, and peas), starchy vegetables (i.e., potato, corn, plantain) and other vegetables (i.e. beets, eggplant, artichokes, cabbage). Starchy vegetables contain more calories so choose these less often.
  • Canned, dried, and frozen fruits and vegetables are good options. Look for fruit without added sugar or syrups and vegetables without added salt, butter, or cream sauces.
• Whole Grains:
  • Eat 3 ounces or more of whole-grain cereals, breads, crackers, rice, or pasta per day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of cooked rice or pasta.
  • For many, but not all "whole-grain" food products, the words "whole" or "whole grain" may appear before the name (e.g., whole-wheat bread). But, because whole-grain foods cannot necessarily be identified by their color or name (brown bread, 9-grain bread, hearty grains bread, mixed grain bread, etc. are not always "whole-grain"), you need to look at the ingredient list. The whole grain should be the first ingredient listed. The following are some examples of how whole grains could be listed: whole wheat; brown rice; quinoa; buckwheat; whole oats/oatmeal; whole rye; bulgur (cracked wheat); sorghum; whole grain; barley; popcorn; millet; or wild rice.
• Salt (sodium and potassium):
  • Eat less than 1 teaspoon of salt (approximately 2,300 mg of sodium) per day.
  • Choose foods with little added salt and prepare foods without salt when possible. At the same time, eat potassium-rich foods, such as vegetables and fruits. Good potassium sources are: orange juice, beet greens, white beans, potatoes, tomatoes, tomato paste, and bananas.
  • People who are middle-aged or older, have high blood pressure, or who are African American should limit their sodium intake to 1,500 mg of sodium per day. They should also get the recommended potassium (4,700 mg/day) in what they eat and drink.

Additional recommendations for eating wisely

• General recommendations:
  • Eat a variety of foods and beverages selecting from the basic food groups. Choose foods that are: high in fiber (whole-grains); have little added salt or sugars; and are low in saturated and trans fats, and cholesterol. Limit alcohol consumption.
  • Get the nutrients you need in a healthy way by following a balanced eating pattern, such as those provided by using the USDA SuperTracker* and USDA ChooseMyPlate* food guidance.
  • Maintain (or aim for) a body weight in a healthy range. To achieve your weight goals, balance the calories you take in from what you eat and drink with the calories you burn through activity. For additional weight loss information, please see the Healthy Living Message: "Strive for a Healthy Weight."
  • Specific recommendations for calorie intake to maintain weight will vary depending on a persons age, sex, size, and level of physical activity. Recommended total energy intakes range from 2000 to 3000 calories per day for men and 1600 to 2400 calories per day for women.
• Key recommendations about dairy:
  • Consume 3 cups per day of fat-free or low-fat milk or milk products such as yogurt or soft white cheese (cottage) cheese. If you don't or can't consume milk, choose lactose-free milk products and/or calcium-fortified foods and beverages.
• Key recommendations about protein/meat:
  • Go lean with protein. Choose lean meats and poultry. Lean beef cuts include round steaks (top loin, top sirloin, and top round) and roasts (round eye, top round, bottom round, round tip, arm, and chuck shoulder).
  • When selecting beef, choose cuts labeled "Choice" or "Select" instead of "Prime". "Prime" usually has more fat. Choose cuts with the least amount of visible fat (marbling). Even then, trim any visible fat before preparing the beef. Choose extra lean ground beef. The label should say at least "90% lean", 93% or 95% is even better.
  • Vary your protein choices by including seafood more often. Choose a minimum of 8 ounces of seafood each week. Seafood is rich in heart healthy omega-3 fatty acids and includes fish, such as salmon, tuna, herring, trout, and tilapia, and shellfish, such as shrimp, crab, and oysters.
  • Choose dry beans or peas as a main dish or part of a meal. Consider including 2 or more meatless meals in your weekly menu. Some choices are: meatless chili with kidney or pinto beans; split pea, lentil, minestrone, or white bean soups; black bean enchiladas; rice and beans; veggie burgers or garden burgers, and chef salad with garbanzo or kidney beans.
  • Choose nuts as a snack, in salads, or in main dishes. Use nuts to replace meat or poultry, not in addition to meat or poultry (i.e. pine nuts in pesto sauce, slivered almonds on steamed vegetables, toasted peanuts or cashews in vegetable stir fry, add walnuts or pecans to salads instead of cheese or meat.
• Key recommendations about carbohydrates:
  • Choose fiber-rich vegetables, fruits, and whole grains often.
  • Choose and prepare foods and beverages with little added sugar or other sweeteners that contain calories.
• Key recommendations about fats:
  • When selecting and preparing meat, poultry, fish, dry beans, and milk or milk products, choose lean (skinless), low-fat or fat-free varieties and do not add fat when you cook them.
  • The best cooking methods to capture flavor and retain nutrients in your food without adding fat or salt are to bake, broil, braise, roast, steam, sauté, poach, grill, or stir-fry. Drain off any fat that appears during cooking.
  • Look for foods low in saturated fats, trans fats, and cholesterol by using the Nutrition Fact Labels on food products. Daily Value listed as 5% or less is low, where a Daily Value listed as 20% or more is high.
  • Most of the heart-healthy fats you eat should be polyunsaturated and monounsaturated fats such as those found in fish, nuts, and most vegetable oils. Limit saturated fats that are found in high-fat cheeses, high-fat cuts of meat, whole-fat milk, cream, butter, ice cream, palm kernel and coconut oils. Eat less than 10 percent of your total daily calories from saturated fats.
  • Avoid foods that contain trans fats. Trans fats are often found in commercial baked goods such as cookies, crackers, and pies. Some restaurants may also use oils with trans fats for frying.
  • Eat less than 300 mg of cholesterol each day. Cholesterol is found in animal based food such as meats, poultry, egg yolks, and whole milk. Limit egg yolks to 1 per day and choose egg whites or pasteurized egg white products as substitutes for additional whole eggs.
  • Keep your fat intake between 20 and 35 percent of your total calories.

Key recommendations for specific population groups

• People over age 50 should:
  • Get enough vitamin B12. Vitamin B12 is naturally found in animal products, such as fish, meat, poultry, eggs, milk or milk products. The best sources of vitamin B12 include: breakfast cereals fortified with 100% Daily Value of vitamin B12 per serving, fish/seafood (trout, salmon, sockeye, tuna, clams), and supplements.
  • Older adults often have trouble absorbing vitamin B12 from foods. However the type of vitamin B12 used in supplements and in fortified foods is absorbed the best.
• Older adults, people with dark skin, and people who do not get exposed to enough sunlight should:
  • Get extra vitamin D from vitamin D-fortified foods (cereal, breads, margarine, milk) and/or supplements. Foods naturally high in vitamin D are: fish liver oils (cod liver oil); fatty fish (salmon, mackerel, sardines, tuna, eel); shitake mushrooms, and eggs.
  • Most people's bodies are able to make enough vitamin D if they can be out in the sun without sunscreen for 10-15 minutes at least twice a week.
• Women of childbearing age and those in the first trimester of pregnancy should:
  • Eat foods high in heme-iron and/or consume iron-rich plant foods or iron-fortified foods along with vitamin C-rich foods which help iron absorption.
  • Vitamin C-rich foods include the following fruits: orange, orange juice, cantaloupe, strawberries, kiwi, guava, and mango; and vegetables: broccoli, asparagus, tomato, tomato juice, potato, and green and red peppers.
  • Heme-iron is iron found in animal sources (i.e. turkey, beef, mussels, shrimp, clams, and liver) and is absorbed best by the body.
  • Non-heme-iron is found in vegetable sources (i.e. enriched cereals, cooked beans, blackstrap molasses, and enriched pasta); it is not as easily absorbed.
  • Consume adequate folic acid daily (from fortified foods or supplements) in addition to the folate in foods from a varied diet.
  • Foods that are a good source of folate include: fortified breakfast cereals, whole wheat products, leafy green vegetables, asparagus, oranges, liver, eggs, beans (kidney, black, Lima), and sunflower seeds.

Key recommendations about alcoholic beverages

• If you choose to drink alcoholic beverages, drink moderate amounts. Women should limit themselves to one drink per day and men to two drinks per day. Alcohol adds calories to your diet without providing the nutrition you need.
• For additional information, please see the Healthy Living Message: "Limit Alcohol."

More Information

• U.S. National Institutes of Health (NIH), National Institute on Aging (NIA) health information www.nia.nih.gov/ including brochures such as: Healthy Eating After 50; Osteoporosis: The Bone Thief; High Blood Pressure*
• Guide for Making Better Food Choices
  www.ChoseMyPlate.gov*
• Office of Disease Prevention and Health Promotion, HHS
  www.health.gov/dietaryguidelines/*
• Healthfinder:A Quick Guide to Reliable Information on Healthy Eating and Other Topics, HHS
  www.healthfinder.gov/scripts/SearchContext.asp?topic=591*
• U.S. Department of Agriculture and U.S. Department of Health and Human Services (HHS)
  www.nutrition.gov*
• Centers for Disease Control and Prevention (CDC), HHS
  www.cdc.gov/nutrition/*
• Office on Women's Health (OWH), HHS
  www.womenshealth.gov/fitness-nutrition/nutrition-basics/*
• Healthfinder: Eat Healthy
  www.healthfinder.gov/prevention/ViewTopic.asp?topicId=21*

* Indicates that the link leads to a non-VA website. The VA is not responsible for the content that is on the site.

Supporting Information

Definitions

• Saturated fat**: Fat that consists of triglycerides containing only saturated fatty acid radicals. Often described as "solid" fats. Examples of foods containing a high proportion of saturated fat include dairy products (especially cream and cheese but also butter and ghee), animal fats such as suet, tallow, lard and fatty meat, coconut oil, cottonseed oil, palm kernel oil, chocolate, and some prepared foods.
• Trans fat**: Another name for trans fats is "partially hydrogenated oils."  Trans fats (or trans fatty acids) are created in an industrial process that adds hydrogen to liquid vegetable oils to make them more solida process called hydrogenation.  These partially-hydrogenated oils are inexpensive to produce and tend to keep food fresh longer. The consumption of trans fats increases the risk of coronary heart disease by raising levels of "bad" LDL cholesterol and lowering levels of "good" HDL cholesterol. Trans fats can be found in many foods—but especially in fried foods like French fries and doughnuts, and commercially-baked goods including pastries, pie crusts, biscuits, pizza dough, cookies, crackers, and stick margarines and shortenings.  Some commercial restaurants may also use partially-hydrogenated oils when frying their entrees and side items.
• Polyunsaturated**: Polyunsaturated fats are fats that have more than one double-bonded (unsaturated) carbon in the molecule.  Polyunsaturated fats are typically liquid at room temperature and when chilled. Polyunsaturated fats can have a beneficial effect on your health when eaten in moderation and when used to replace saturated fats or trans fats.  Polyunsaturated fats can help reduce the cholesterol levels in your blood and lower your risk of heart disease.  They also include essential fats that our body needs but can't produce itselfsuch as omega-6 and omega-3.  Foods high in polyunsaturated fat include  a number of vegetable oils, including soybean oil, corn oil and safflower oil, as well as fatty fish such as salmon, mackerel, herring and trout.  Other sources include some nuts and seeds such as walnuts and sunflower seeds.
• Monounsaturated**: Monounsaturated fats are fats that have one double-bonded (unsaturated) carbon in the molecule.  Monounsaturated fats are typically liquid at room temperature but start to turn solid when chilled.  Monounsaturated fats can have a beneficial effect on your health when eaten in moderation and when used to replace saturated fats or trans fats.  Monounsaturated fats can help reduce bad cholesterol levels in your blood and lower your risk of heart disease and stroke.  They also provide nutrients to help develop and maintain your bodys cells.  Examples of foods high in monounsaturated fats include vegetable oils such as olive oil, canola oil, peanut oil, sunflower oil and sesame oil.  Other sources include avocados, peanut butter, and many nuts and seeds.
• Cholesterol**: Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body's cells. Cholesterol is an important part of a healthy body because it's used for producing cell membranes and some hormones, and serves other needed bodily functions. Too much cholesterol in the blood is a major risk for coronary heart disease and for stroke. Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat. Cholesterol is found in animal based food such as meats, poultry, egg yolks, and whole milk.
• Dietary Guidelines for Americans 2010
  The Dietary Guidelines for Americans are the cornerstone of Federal nutrition policy and nutrition education activities. These guidelines are jointly issued and updated every 5 years by the Departments of Agriculture (USDA) and Health and Human Services (HHS). They provide authoritative advice for Americans ages 2 and older about consuming fewer calories, making informed food choices, and being physically active to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health.
  
  For more information please visit the USDA website: www.cnpp.usda.gov/dietaryguidelines.htm

**For more detailed definitions please visit the links embedded in the terms found in the definitions section.

VA Policies

• VHA National Health Promotion and Disease Prevention Program:
  Prevention Handbook 1120.02 (2012)

Source Documents

1. HHS. Healthfinder: A Quick Guide to Reliable Information on Healthy Eating and Other Topics.
   www.healthfinder.gov.
2. HHS. US Department of Aguiculture and US Department of Health and Human Services Nutrition website.
   www.nutrition.gov.
3. CDC. Centers for Disease Control and Prevention Nutrition website.
   www.cdc.gov/nutrition/.
4. The USDA ChooseMyPlate website.
   www.ChooseMyPlate.gov
5. Office of Disease Prevention and Health Promotion Dietary Guidelines website.
   www.health.gov/dietaryguidelines.
6. Office of Women's Health Fitness and Nutrition website.
   www.womenshealth.gov/fitness-nutrition/nutrition-basics/.
7. The Guide to Community Preventive Services-Nutrition - website.
   www.thecommunityguide.org/nutrition/index.html.
8. Behavioral Counseling in Primary Care to Promote a Healthy Diet website.
   www.ahrq.gov/clinic/uspstf/uspsdiet.htm#related.
9. Recommended Community Strategies and Measurements to prevent Obesity in the United States website.
   www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm?s_cid=rr5807a1_e*.
10. Agency for Healthcare Research and Quality (AHRQ) - Integrating Evidence-Based Clinical and Community Strategies to Improve Health.
    www.ahrq.gov/clinic/uspstf07/methods/tfmethods.htm.