Nutrition for Good Health

Malnutrition is a word often associated with famine and starvation, especially in developing countries. But another form of malnutrition, or poor nutrition, is prevalent in countries such as the United States and Canada and in areas with a similar diet. This is malnutrition caused by poor selection of foods and excessive food consumption.

To gain a better understanding of the nutritional problems representative of the industrialized nations, Awake! spoke with nutritionist Nilda Tirado, New York City coordinator for the Expanded Food Nutrition Education Program, which is administered by Cornell University, Cooperative Extension. The Cooperative Extension programs throughout the United States provide free information and help to the public in the proper selection and use of foods to maintain good health. The following are Nilda Tirado’s answers to questions of an Awake! representative.

What would you say are the major nutritionally related health problems in industrialized countries?

The most common nutrition-related problem would be dental caries, or tooth decay, affecting every age group. Obesity, or excessive weight, would be next, and iron-deficiency anemia, which is still prevalent in women, adolescents, and infants. However, of great concern are several chronic diseases or conditions, such as high blood pressure, arteriosclerosis, and gastrointestinal problems, which are directly related to overconsumption of high-calorie foods, fat, and salt, as well as insufficient fiber consumption. These conditions are all related to the many changes in our life-style and in our eating and food-preparation patterns.

You’ve mentioned the problem of too much food. Is this really of major concern?

Obesity is a major public-health problem in all age groups in many industrialized countries. Changes in life-style and greater availability of food contribute to this. In school-age children, we see it especially in grades one through three and notably in urban areas where opportunities for exercise are often limited. When a person is carrying more than 20 percent above normal body weight, he is said to be obese. An overfed infant can easily grow into an obese child, and then if steps aren’t taken to correct eating habits, the obese child becomes an obese adult—with risk of high blood pressure, diabetes, heart attack, and stroke.

What problems do you encounter with infant nutrition?

We often find that many mothers wean their infants too early and introduce solid foods too soon. They also tend to give more food than is really needed for the health of the child. Many mothers, pressured by family and friends, often try to wean babies at three months. Since babies’ tongues are conditioned to suck in liquids and not to push solid food back properly for swallowing, the baby will often spit out most of the food. Frustrated by this, mothers concoct a kind of baby-food milk shake by diluting the food in formula. Then they feed this through a baby bottle after enlarging the hole in the nipple. Besides the risk of the baby’s choking, this type of feeding increases the tendency toward an overweight baby and has also been related to a higher incidence of ear infection.

When is a good time to wean a baby?

Most infants do not need solid foods until they are about six months old, and even then they should not be introduced to high-protein food immediately. Their gastrointestinal system often cannot handle the protein, so there may be slight bleeding in the intestines, which the mother will not even notice. This can manifest itself as anemia. There may also be a problem with the development of allergies and skin problems. The American Academy of Pediatrics recommends that when weaning a baby, something easily digested, such as rice cereal, be given for the first two or three days. And whenever a new cereal is introduced to the infant, it is suggested that only that cereal be given for three days in a row to determine if there are any allergies to it.

Do you recommend breast-feeding?

Most certainly. By all means. Breast milk contains not only needed nutrients in the proper amounts for infants but also antibodies, which prevent many of the infections common in infancy. Breast-fed infants rarely become obese and generally have fewer allergies and gastrointestinal upsets. Unfortunately there is still the misconception among some women that if you can possibly afford it, baby formula is better. Although formula is nutritionally adequate, it doesn’t afford the antibodies and the perfect balance of nutrients that one finds in mother’s milk.

What about older children?

We see a twofold problem with toddlers. First, they are often overfed, and, second, they are not taught to eat a variety of foods.

Infants require numerous feedings throughout the day, and sometimes mothers keep up that routine as the child grows. But toddlers don’t require as much food per pound of body weight as infants do, and they should not be forced to eat all the time.

In addition, toddlers often go through food jags, preferring only one or two foods all the time. This can create problems if not handled properly. Children may have trouble adopting a well-balanced diet later. For example, much of the nutritious food incorporated into school-lunch programs gets thrown away because children have never been exposed to some of these foods prior to starting school. So it is important to encourage children to be open to new foods. Encouraging children to select, prepare, and even grow food are ways of making foods interesting and fun. Parents also need to serve as role models here. Some toddlers are not given the opportunity to feed themselves. In order to shorten their mealtime, or because mothers feel it’s their role, toddlers are often spoon-fed instead of letting them learn to eat by themselves.

Do adults have any particular nutritional problems?

Studies have shown that adults among all income groups consume too much fat and sodium (salt) and not enough fiber. Excess fat intake is often reflected by an overweight condition or by arteriosclerosis in some people. Preference for a high intake of meat, which is also high in fat, and snacking on empty calorie foods contribute to these conditions, as does a lack of adequate exercise. Sodium intake is high due to a heavy reliance on processed foods, which, because of today’s life-style, people find very convenient to use. Consumption of fiber, on the other hand, is lower because people eat less of the foods in which it is present, including legumes (beans, peas, lentils), fruits, vegetables, and whole-grain breads and cereals.

Americans especially eat larger portions of meat than is really needed. To meet the body’s daily requirement for protein, only about two to three ounces (57 to 85 g) of meat is necessary. But it’s common to see people consume six to eight ounces (170 to 230 g) of meat at supper alone. This is in addition to the protein in their breakfast ham, bacon, or sausage, and their hot dog or hamburger for lunch and the protein that is found in all the other foods they may eat. The individual who sits down and consumes half a chicken, for example, is really getting four times the amount of protein required for that day and many more calories than needed. By increasing our protein sources from animal foods, we also increase our intake of fat, since almost all are high in fat and cholesterol. The more animal products consumed, the more calories and fat. Sometimes people who want to lose weight cut out other foods and eat only meat, not realizing that meat has many more calories than does pasta or rice.

Do nutritional needs change with age?

Yes and no. We all need the same nutrients no matter what our age but in different amounts. As we age, we require fewer calories. This is because the energy needed to maintain the body decreases with age, although the activity and health may remain constant. If a person becomes less active, then even fewer calories are required. So the elderly need to eat fewer calories and exercise more or they will become overweight. Sugars, fats, oils, and alcohol should be limited as they are high in calories and lack essential nutrients.

Our nutritional needs also change during growth periods—childhood, adolescence, and pregnancy—and after illness or surgery. At these times, we do have to increase the availability of nutrients to our bodies by eating foods providing more calories and nutrients.

The most common nutritional problem in women still remains that of iron deficiency. The tendency among many women is to cut back on calories, which may be a good thing for their weight, but since iron is difficult to obtain in food, and because it occurs only in certain foods and in limited amounts, the amount of iron available is decreased even more. Iron supplements are often recommended as a safety measure.

Another increasing problem, especially in older women, is osteoporosis, caused by a loss of calcium in the bones. About 40 percent of all women who reach age 80 have this condition. This loss of calcium is actually a normal part of aging, but since women do not usually have a good store of calcium in their bodies—due to a calcium-poor diet and decreased activity throughout life—what would be normal is instead a serious problem. As the calcium comes out of the bones, they become less dense, and many times the person will shrink, appearing much shorter. Curvature of the spine is common along with fractures of the hipbones and spinal column. It is for this reason that calcium-rich foods should be part of the diet throughout life.

What recommendations do you give homemakers for healthier eating?

Besides doing what has already been mentioned, we encourage people to eat a variety of foods to assure that they receive all the nutrients they need. Also, since there seems to be a pattern today of opening packages and cans and eating frozen TV dinners, we urge people to look around and select from the wide variety of fresh foods available in the marketplace and then to learn to prepare these foods so that nutrients, taste, and color are preserved. Stir-frying, steaming, and baking are cooking methods that help to do this and are preferable to boiling and frying. It’s amazing just how many people have not learned to cook well or just don’t feel they have the time to do it.

We try to help people see that they can better control what they eat by doing their own cooking. Instead of falling back on, say frozen prepared chicken that is coated, has additives and extra fat, a homemaker can buy a fresh chicken, or frozen chicken parts, prepare it, add ingredients enjoyed by her family, and serve it attractively for all to enjoy.

We also encourage homemakers to limit the use of commercially prepared mixes, such as powdered soups, meat helpers, and cake mixes. These often contain high quantities of salt and other ingredients that may not be the best for our health. A homemaker can prepare some of these mixes herself and store them for later use. This will save time and money and allows for the creativity of the cook. In this way the homemaker can also control what goes into the food she feeds her family, and she can limit fat and salt if she wants. This is almost impossible to do if you use prepared mixes.

We urge, too, that homemakers become knowledgeable about what nutrients are needed for good health and become informed consumers by looking for ingredients listed on the labels of products before they buy. Since there are new food products and nutrition information in the media every day, homemakers should also get advice from reputable sources of nutrition information. Such reputable sources include health professionals in government agencies, in hospitals, and in local health agencies, and naturally Cooperative Extension, which operates nutrition programs in every state in the United States.