ALLISON AUBREY, HOST:
Diet advice is complicated, but it doesn't have to be. These little preschoolers, they know what they should be eating...
UNIDENTIFIED PRESCHOOLER #1: Orange.
UNIDENTIFIED PRESCHOOLER #2: Bell pepper.
UNIDENTIFIED PRESCHOOLER #3: Cucumber.
AUBREY: ...And what they maybe shouldn't.
UNIDENTIFIED PRESCHOOLER #4: Cookies.
UNIDENTIFIED PRESCHOOLER #5: Cake.
UNIDENTIFIED PRESCHOOLER #6: Ice cream.
AUBREY: But when we grow up, we just kind of lose our way. We make things too complicated. We get distracted by trendy diets or so-called super foods. So today, we're going to go back to basics.
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AUBREY: This is your NPR LIFE KIT for healthy eating. You've probably heard the old saying let food be thy medicine. Well, there's a lot of truth to that. So whip yourself up a green smoothie, sit back and listen. And you may just relearn what you used to know as a little kid.
UNIDENTIFIED PRESCHOOLER #7: Healthy food is something that's good for your body, your whole body.
AUBREY: More in a minute.
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AUBREY: I'm Allison Aubrey, and I cover health and wellness for NPR. Have you ever noticed these days how everyone has their own pet theory about what healthy eating looks like?
DARIUSH MOZAFFARIAN: Right now in our country, food is so hot. People are so interested in it that everybody has an opinion. Everybody has an expert.
AUBREY: That's Dariush Mozaffarian. He's a big deal in the nutrition world. He's a cardiologist, and he's the dean of the nutrition school at Tufts University. Despite that, people sometimes treat him like he's just another guy with an opinion.
MOZAFFARIAN: If I were a rocket scientist and I go to a dinner party and tell people how I'm planning to get the next rocket ship to Mars, everybody would listen politely and maybe ask some questions. But they wouldn't tell me whether I was correct or incorrect about my rocket fuel calculations.
But as a cardiologist, as a nutrition scientist, if I have the same conversation with 10 smart folks in the room who this is not their background, they will all listen politely and ask questions. And then they'll all tell me what's really wrong with the food system and what they should eat and what they shouldn't eat. And it's a little bit of a challenge. Food is so personal.
AUBREY: But Dariush has more than experience. He's also got evidence. He and his colleagues published a big study in a major medical journal about how specific types of food influence our health.
MOZAFFARIAN: We estimated that almost half of all cardiovascular disease and diabetes deaths in the United States each year are due to just poor diet which is almost a thousand deaths every day.
AUBREY: Wow. That's a huge number...
MOZAFFARIAN: A huge number.
AUBREY: ...To stop and think about that.
MOZAFFARIAN: A huge number.
AUBREY: It's huge.
MOZAFFARIAN: So just imagine if any other part of our economy, our housing system, our phones, our cars was killing a thousand people per day, right? There would be outrage.
AUBREY: But it doesn't need to be this way. I mean, we know what to eat to keep people healthy. Dariush and his team have also identified foods that can help boost your health and maybe help you live longer. We're going to walk you through a cheat sheet with three types of foods you should be eating more of and three types of foods you probably want to cut back on.
So No. 1 on the eat more list is nuts and seeds. Dariush calls them life-giving foods.
MOZAFFARIAN: When people, say, ask me for a simple rule - should I be vegan? Should I be vegetarian? Should I be plant-based? - I say, you know, eat foods that give rise to life.
AUBREY: Think about what happens when you plant a seed. It sprouts. Nuts and seeds contain all the nutrients you need to kick-start the growth of new life.
MOZAFFARIAN: That's what our bodies need with aging. And so nuts and seeds have an incredibly powerful mixture of healthy fats, fiber and probably most importantly trace nutrients. These flavonols, these polyphenols have a range of effects on us, on our gut bacteria, on our livers, on our cellular functions that are incredibly beneficial as we age.
AUBREY: There really is a lot of evidence that eating nuts and seeds can pay off. For instance, a landmark study in Spain found that people who ate a handful of nuts a day as part of a healthy diet cut the risk of having a heart attack or stroke by about 30 percent.
And then there's this nugget. Researchers at Purdue University found people who snack on a handful of almonds each day ate less throughout the day. It almost works like an appetite suppressant.
ANGELA GINN-MEADOW: A handful a day keeps a doctor away.
AUBREY: That's Angela Ginn-Meadow. She's a registered dietitian, and she thinks about this stuff all day, every day. She's going to help us translate the advice Dariush gives us and put it into action.
GINN-MEADOW: It can be a wide variety of nuts. It could be from walnuts to pistachios to almonds, peanuts. I recommend pistachios you have to open for a lot of my clients that tend to overeat. If we are using something that we're opening up and taking our time, we slow down.
AUBREY: Next up on the eat more list - fruits and vegetables.
UNIDENTIFIED PRESCHOOLER #8: Plums.
UNIDENTIFIED PRESCHOOLER #9: Pears.
UNIDENTIFIED PRESCHOOLER #10: Broccoli.
AUBREY: Yeah. We knew you were predicting that one, but really this message has gotten a little confused lately. We got this question from a listener named Theresa Mansini (ph).
THERESA MANSINI: Growing up, we always had fruit in the house. We always ate fresh fruits and vegetables. Like, and now I feel like, you know, oh, I'm eating a clementine. And, oh, do you know if sugar's in that? And you're like, OK. Am I not supposed to have that? (Laughter) Like, I don't know. It's fresh, and, you know, it's not canned. So isn't that good?
MOZAFFARIAN: That listener highlighted so many key points in her short comments. You know, first, I think it's fresh should not be confused with healthy. And so if you get frozen fruits or vegetables, that's great. If you can get canned fruits or vegetables that don't have a lot of sodium or added sugar, that's fine. So we don't need to always have fresh.
Secondly, you know, there's growing recognition that one of the biggest problems in the modern food supply is all of the processed starch and sugar. And so that's what that listener is reacting to is that we get that sugar is bad in soda. But, you know, natural sugars that are still packaged in the food that they were intended to be in are good for us.
AUBREY: So that clementine has intrinsic sugar along with a lot of other good stuff, like fiber and micronutrients and vitamins. Is that right?
MOZAFFARIAN: Yeah. That's right. I mean, in long-term observational studies, people who eat more fruit gain less weight and have lower risk of diabetes.
AUBREY: By the way, we have a deep dive on good carbs and bad carbs in another episode of our guide. And to make sure you always have veggies on hand, Angela says the freezer's your friend.
GINN-MEADOW: It is super easy. I keep frozen veggies in the freezer. And even when my peppers are going - kind of going south, I will chop them up and put them in the freezer.
AUBREY: She uses them to make a quick breakfast frittata in little muffin tins.
GINN-MEADOW: I'll saute my broccoli with scallions or onions, depending on what I have, with some peppers. And I will whip up my egg mix with half-and-half, little salt and pepper and then pour it into muffin tins. Bake it till they're firm, and then I'll keep a couple in the frigerator (ph) for me to have for breakfast. The other ones, I put in the freezer. And so when I want one, I can just take one out of the freezer and microwave it.
AUBREY: So when I listen to what you're telling me, I'm realizing that you're kind of thinking about your breakfast tomorrow beginning tonight. That takes a little bit of preplanning, right?
GINN-MEADOW: It does. Planning is really the key for healthy eating habits. And I say that to my clients, and I say it to my friends. When we're not prepared, we get into trouble. And what I mean by that is we choose unhealthy options when we're on the go. So if we plan our meals ahead, we plan breakfast, we plan lunch - some people even like to meal prep on the weekend - you will be on the right track to living healthy.
AUBREY: And now for your third food rule - and this one might surprise you a little - don't be afraid of fat. Yes, fat because there are lots of healthy fats out there.
MOZAFFARIAN: I try not to describe the hierarchies in terms of the fats 'cause people don't eat fatsy foods. And so I try to tell people the foods they should eat - so nuts, great - fish, great - avocados, great. And then plant oils and extra virgin olive oil, soybean oil and canola oil seem to be the three with the best evidence.
AUBREY: But there is one type of fat that stands out for its health benefits.
UNIDENTIFIED PRESCHOOLER #11: Salmon.
AUBREY: Yes, she guessed it - the fats found in fish, otherwise known as omega-3 fatty acids. This might explain why grandma loved her cod liver oil.
MOZAFFARIAN: We just published a meta-analysis combining all available studies showing that in randomized trials, you know, babies who got more omega-3s in their diets either from formula or from their mothers taking supplements or having fish had better brain function. And so we know that optimal levels of omega-3s are crucial for kind of getting the baby's optimal brain development.
AUBREY: So when you hear that fish is brain food, there's some evidence behind that.
AUBREY: You know, most Americans don't eat that much fish. So Angela says try to add more in. And, yes, fish can be pricey, but frozen and canned fish can be pretty affordable.
GINN-MEADOW: From tuna to sardines to canned salmon. It could be a tuna salad, or it could be made into, like, salmon cakes.
AUBREY: And if you don't eat fish, well, you can get omega-3s from plants. Fish get theirs from the algae they eat. So you can try flax seeds, walnuts or even chia seeds.
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AUBREY: While we're talking about fats, we should probably talk about dairy...
UNIDENTIFIED PRESCHOOLER #12: What's your favorite food?
AUBREY: ...Because it's a big part of the American diet.
UNIDENTIFIED PRESCHOOLER #13: Cheese.
AUBREY: We got this question from another listener. Her name is Katherine Olecki (ph)
KATHERINE OLECKI: As a lifelong Midwesterner, dairy has always played a huge role in my family's meals and snacks. However, as plant-based milks and cheeses are hitting grocery stores at the same time as full-fat yogurts, I'm wondering how much of a healthy diet should contain dairy or if it's better off to just become entirely dairy-free.
MOZAFFARIAN: There's a lot of disagreement. There's, until recently, been very little empiric evidence on how dairy foods impact our health. And when we do study milk and yogurt and cheese, milk seems to be, on average, kind of neutral.
AUBREY: In other words, for most adults, milk just doesn't seem to play a big role in influencing our health. But what about all the other dairy products?
MOZAFFARIAN: We have published many papers now suggesting that people who eat more dairy fat actually have lower risk of diabetes. So what I recommend now, I suggest that people should have yogurt and cheese every day. And whether it's low-fat or whole-fat, there's initial early evidence that whole-fat dairy might actually be better than low-fat dairy. But that's not yet convincing.
AUBREY: As for butter, Dariush says it's neither angel nor devil.
MOZAFFARIAN: Butter is sort of middle-of-the-road. You know, remarkably butter only contributes to about 2 percent of saturated fat intake in this country, and yet we think of it as a major source of saturated fat. You know, the intake level is just so low, it probably doesn't make a big difference.
AUBREY: In other words, butter is just not that big of a deal because most of us don't eat that much of it. But to be clear, this is not your green light to go whole-hog on butter.
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AUBREY: So for a quick recap, we're going to eat more of those life-giving nuts and seeds, more fruits and vegetables and more healthy fat. Now - I'm sorry - it's time for some doom and gloom - foods we should be eating less of. And I'm sorry to start here, but we kind of have to talk about bacon.
UNIDENTIFIED PRESCHOOLER #14: I like bacon 'cause it's really crisp...
UNIDENTIFIED PRESCHOOLER #15: It's so crunchy.
UNIDENTIFIED PRESCHOOLER #14: ...And there's just a little bit of fat. And that really adds to, like, the flavor of the bacon.
AUBREY: But the science is pretty clear. It says eat less processed meat. What's - what's so bad about bacon?
MOZAFFARIAN: There are a few different ways that, you know, processed meats are processed. The most obvious one is sodium. There's about 400 percent more sodium in processed meats than in unprocessed meats. The second is nitrates.
AUBREY: So nitrates are used to cure meat. So there's a reason why they're in there. But there's some evidence that they can lead to the formation of compounds that are carcinogenic to us. In particular, eating lots of bacon is linked to a higher risk of colorectal cancer.
MOZAFFARIAN: And then thirdly, many of the processed meats are actually cooked. And they're cooked using high-temperature commercial cooking processes that could also introduce harmful products.
AUBREY: And it's not just bacon.
MOZAFFARIAN: But also processed deli meat, like bologna and roast beef.
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AUBREY: But if you do have a hankering for that smoky essence of bacon, Angela says try layering on other flavors, like caramelized onions.
GINN-MEADOW: Even a smoked Gouda can sometimes give it, you know, another layer of flavor to your eggs in the morning or smoked mozzarella.
AUBREY: And what if I were to say, you know, I don't eat it every day, but every Sunday I just love a nice, crispy piece of bacon? What do you say?
GINN-MEADOW: You can enjoy your crispy bacon on a Sunday. Keep it to two to four slices, max.
AUBREY: While we're talking guilty pleasures, let's move on to the second category of foods to cut back on.
UNIDENTIFIED PRESCHOOLER #16: I really wish my parents let me eat Oreo cookies.
UNIDENTIFIED PRESCHOOLER #17: (Chanting) Fruit snacks. Fruit snacks. Fruit snacks. Fruit snacks.
AUBREY: So by now, you've probably all heard the advice to cut back on sugar - you know, cookies, candy and especially sugary drinks.
MOZAFFARIAN: Liquid sugar from soda and energy drinks is, you know, the worst way to consume sugar.
AUBREY: Why? Well, for starters, it's all empty calories that don't even make you feel full.
MOZAFFARIAN: So, for example, there have been studies in children where if you give them Skittles or soda, they'll at least partially compensate for the Skittles in terms of what they consume. But they won't really notice the calories they're getting from the liquid sugar.
AUBREY: The bottom line here is that there's overwhelming evidence that sugary drinks can harm us. There was actually a study that found drinking just one sugary drink a day - just one - can increase the risk of getting Type 2 diabetes by about 20 percent.
And here's another point closely related, and listen up because this is a little bit tricky. It's not just sugar that harms us. Think about all the savory snacks we have, things like chips and pretzels. Well, a lot of these packaged foods that are full of refined starch are just one step away from becoming sugar in our bodies.
MOZAFFARIAN: There's not really a lot of difference between refined starch from potatoes or white bread or breakfast cereals and table sugar or candy. You get a rush of glucose and fructose into your bloodstream, and some of that free sugar gets taken up by the muscles - not very much. But the vast majority of it goes to the liver and gets turned into fat. It makes the liver fat. It makes your abdominal organs fat, and it leads to the body being fat. So what I try to remind people is that refined starch is the hidden added sugar.
AUBREY: So here's your takeaway. Cut back on sugar, and think twice before eating those starchy snacks like crackers and pretzels.
GINN-MEADOW: If you like pretzels with the added salt, I then would choose edamame.
AUBREY: Or if you have a sweet tooth...
GINN-MEADOW: If people like something sweet, I always go for something that is warm. So I enjoy baked apples. (Laughter) I've microwaved frozen peaches and sprinkled a little ginger snaps on top - just, like, one ginger snap on top. And once you have it warm, it's delicious.
AUBREY: So it makes you feel like you're having dessert, but really you're just finding a new way to get in more servings of fruit.
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AUBREY: Now the third and final thing to cut back on - salt. I know your study found that excessive sodium is strongly linked to death from these cardio-metabolic diseases. What is it about sodium that's so bad for us?
MOZAFFARIAN: Well, the most obvious and well-confirmed problem with too much salt is it raises your blood pressure. And high blood pressure is a clear risk factor for stroke and for heart attacks.
AUBREY: But cutting back on salt can be a little tricky. That's because it's often hidden in foods where you don't even suspect it.
MOZAFFARIAN: Bread is the single biggest source of sodium in the food supply. It's not what people think of as a salty food because it's needed to keep the bread from spoiling.
AUBREY: You know, that probably does surprise people. It doesn't taste salty necessarily, but I've been told that you can really only sense the salt externally. So potato chips, of course, taste salty 'cause all the salt's on the outside. With bread, it's sort of baked in there. We don't even have a sense that it's salty.
MOZAFFARIAN: It's amazing if you actually just look at labels, at milligrams of sodium in different foods. You know, nuts or potato chips, people that they think of as salty, don't really have that much salt in them per serving compared to something like sausage or bread or even some breakfast cereals have more salt in them than potato chips per serving.
AUBREY: So reading the nutrition labels to look for the sodium is the first thing you need to do.
GINN-MEADOW: When you're looking at a snack item, aim for no more than a hundred to 150 milligrams of sodium.
AUBREY: And here's another quick hack to cut back on salt. If you pick up a can of beans and it has a high sodium content...
GINN-MEADOW: You can just rinse and use a little tap water. And you would get rid of the extra sodium.
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AUBREY: So those are your simple food rules to follow. And here's a quick review. Based on all the best scientific evidence, you're likely to be healthier if you eat more of these three categories of foods - for starters, more nuts and seeds. Why nuts and seeds?
MOZAFFARIAN: Foods that give rise to life, packed with fiber, healthy fats and other nutrients.
AUBREY: More fruits and vegetables...
MOZAFFARIAN: Fruits and vegetables are a foundation of minimally processed foods packed with polyphenols, vitamins, fibers and slow carbs.
AUBREY: OK. Omega-3s - that's seafood and fish...
MOZAFFARIAN: Great for the brain, great for the heart, omega-3s pack a lot of punch by influencing multiple cellular processes.
AUBREY: And what to cut back on? Starting with processed meat.
MOZAFFARIAN: Not only bacon and sausage, but also processed deli meat like bologna and roast beef. The major factor seems to be all the preservatives and the processing. Those do not seem to be good for our body.
AUBREY: And something we've all heard but probably have a little bit harder time doing it, fewer sugary beverages and refined carbohydrates like pretzels and crackers.
MOZAFFARIAN: Absolutely. Refined starch is the hidden sugar. And whether you're getting your starch and sugar in bread or packaged foods or soda or energy drinks, it is not good for us.
AUBREY: And finally, watch out for salt.
MOZAFFARIAN: Sodium in packaged and processed foods raises blood pressure and may contribute to scarring of a lot of essential organs in the body.
UNIDENTIFIED PRESCHOOLER #18: So the healthiest foods are vegetables, fruits. Like vegetables, are carrots. Now, can they hear what we said?
AUBREY: If you like what you hear, make sure to check out our next episode about how to choose a diet. You can find other LIFE KIT guides at npr.org/lifekit. There, you'll find helpful information on all kinds of topics, like how to get more perks from your credit cards or how to build an exercise habit that sticks.
And while you're there, subscribe to our newsletter so you don't miss anything. We've got more guides coming out each month.
And here, as always, is a completely random tip, this time from Jenna Sterner of the NPR training team.
JENNA STERNER: If you get deodorant marks on your shirt or any fabric, you can actually use a dryer sheet and rub it right over where the deodorant mark is, and it will take it right out.
AUBREY: If you have a good tip or want to suggest a topic, we want to hear from you. Email us at email@example.com. I'm Allison Aubrey. Thanks for listening.
UNIDENTIFIED PRESCHOOLER #19: Cut. (Laughter).
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