The New American Diet: Can We Do It?


We can all be healthy, promise the new U.S. diet guidelines. Or can we?

Your father’s dinner plate featured a meat or fish entree. Vegetables were side items: something starchy, and something green — both, like the white dinner rolls, slathered with butter. Maybe there was a salad for starters. Almost certainly there was a dessert.

If this is what your dinner plate looks like, the U.S. health and agriculture departments now say, forget about it. The plate should be alive with colorful vegetables such as purple eggplant, dark green kale, and bright orange winter squash – all without butter. If there’s any meat at all on the plate, it will be no more than three lean ounces of beef, chicken, or much-preferred fish.

That’s not all. You’ll need five servings of vegetables, four servings of fruit, three cups of low-fat dairy foods, and 6 ounces of heart attack to motivate some people to change their diet. That’s altogether too true, says Roger S. Blumenthal, MD, director of the Johns Hopkins Ciccarone Preventive Cardiology Center and co-author of the Betty Crocker Healthy Cookbook.

“>heart attack –it may be a disabling stroke, the thing everybody fears,” Blumenthal tells WebMD. “The cornerstone of prevention is better diet and exercise. One’s eating habits when one is younger play a role, so what we eat influences our children’s health for the rest of their lives. We need to be more aware of this. And that it’s never too late to start a heart-healthy diet.”

The Guidelines Go Shopping

Dickinson points out that the guidelines are based on long-term studies that compared people who ate the most vegetables and fruits to those who ate the least. But, she says, the guidelines go far beyond what even the most voracious vegetable eaters ate in these studies.

“I do think this is more extreme — more extreme than we really have evidence for,” Dickinson says. “If we say that people who eat more vegetables and grains and fruits are more healthy, that is true. But even those people aren’t eating these quantities.

Dickinson has come up with a weekly shopping list based on the guidelines. It feeds just one person, so multiply it by the number of average-size people in your family:

Leslie Bonci, MPH, RD, director of sports nutrition at the University of Pittsburgh Medical Center and nutritional consultant to the Pittsburgh Steelers, also agrees with Dickinson — up to a point.

“If people really step up to their plates and are able to make changes and increase their whole fruits and vegetables and dairy foods, they won’t need supplements,” Bonci tells WebMD. “But because everybody isn’t going to be making this transition overnight, a multiple-vitamin-and-mineral supplement is fine.”

That said, Bonci and Zelman both stress that the body needs healthy food.

“All those things in the guidelines, those dark greens and deep oranges and so on — all those phytonutrients in the food — are not going to be in the supplement,” Bonci says. “You can take a Centrum, but you still have to eat your spinach.”

The Department of Health and Human Services, one of the agencies that released the guidelines, did not return calls seeking comment.

Getting the Most From the Guidelines

Here’s the problem: We Americans know we aren’t eating healthy enough. If the guidelines scare us, it’s only because we’ve become used to more unhealthy habits than most of us care to admit. Sure, the guidelines are a blueprint for building a healthy body. But Rome wasn’t built in a day.

“People truly have to think about where they are right now,” Bonci says. “People need to honestly ask themselves, ‘Am I even willing even to eat more fruits and vegetables?’ For some people, the idea of red, yellow, orange, purple, and green foods – well, if it’s not a gummy bear, they are going to say no. They just won’t do it.”

One way to get a handle on this is to think about how much food you’re going to eat over the course of the day. Think about what kinds of foods you’ll emphasize, and which ones you’ll have less of.

“So say, ‘OK, I am willing to change the look of my plate. I’m going toward half of that being fruits or vegetables and one quarter of it protein and one quarter starch,'” Bonci advises. “That is easier for people, to draw a line on the plate and go from there. In and of itself that is going to cut down calories, because the bulk of the plate is going to be foods with a lower energy density to it, without having to go into the rigors and logistics of counting calories.”

Does this still sound too hard? Hang in there. Don’t throw your hands in the air. Do not run to the nearest hamburger joint or fried chicken outlet.

“Start where you are today and look toward guidelines as goals,” Zelman says. “If you are eating one serving of vegetables, eat two or three. Don’t let the number intimidate you. If you are not exercising, 90 minutes a day is too much. Take baby steps. Make the changes in your lifestyle that help you incorporate some of these recommendations a little at a time. Don’t let it make you crazy.”

Eating, Bittman says, is one of the truly consistent pleasures. We can’t deny that. So we have to find ways to get our pleasure while keeping our health.

“Eating just two pieces of shrimp or a steak the size of a small McDonald’s hamburger — I think most people are going to find that an exercise in frustration,” Bittman says. “Those of us who eat meat really like to tuck in. You like to take a few good bites. So the thing is to do trades and figure you are going to eat a chunk of meat once a week instead of twice a day as a lot of people do.”

The Bittman plan: Set a rough limit for yourself. Be aware of the calories in different kinds of food, but don’t get obsessed with counting them. Get half your calories from plant foods — not counting the oils used to flavor them.

Is a Hamburger and Fries So Bad?

“If you get half of your food intake from vegetables and fruits and whole grains, the other half wouldn’t be that bad for you unless you were eating suet,” Bittman says. “Even if you get 600 calories from a Big Mac and 450 calories from a medium order of fries, if the rest of your day’s diet were broccoli and apples and bulgur, you wouldn’t be that bad off.”

Look on the positive side, Bittman says. It is satisfying to eat beautiful vegetables. It is satisfying to eat rich whole grains.

“Use a strategy of seeing the big picture. Say, ‘I am going to try to eat two cups each of vegetables and fruit every day, and a cup or two of whole grains every day,'” he advises. “I know that is going to leave me hungry. But at least I have eaten the stuff that has the fiber, that has the lack of fat, that has the omega-3 fatty acids. And then I am going to go ahead and put my olive oil on it and eat my meat and fish. I can eat smaller quantities. I just don’t have the willpower to go in any other direction.”

Bittman remembers the old days, when he and three friends would devour a four-pound pot roast. Last weekend, he cooked a 2 1/2 pound chuck roast for a five-person Super Bowl party — and there were leftovers.

“That never used to happen — everybody took just a small piece of meat,” he says. “We wound up eating five or six ounces. That is probably more than it should be, but I felt very restrained. It was a pack-of-cards-sized piece of meat. Now if I have to feel guilty about that — well, I don’t know that I can go there.”