HE-411, Reprinted Nov 1998. Barbara Struempler,Extension Nutritionist, Professor, Nutrition and Food Science, Auburn University. Originally prepared by Yvonne Jackson, former Nutrition Specialist.

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Nutrition

For many years the emphasis in nutrition has been on preventing nutritional deficiency diseases. However, few people now have scurvy or pellagra; today we see another type of malnutrition. This is overnutrition, or getting too much to eat. It is becoming increasingly apparent that many of the major health problems in the United States are associated with overnutrition.

Research studies indicate that nutrition plays an important role in the development and treatment of five of the ten leading causes of death in the United States. These include coronary heart disease, some types of cancer, stroke, diabetes mellitus, and atherosclerosis. Another three--cirrhosis of the liver, accidents, and suicides--have been associated with excessive alcohol intake.

Dietary Fats

Dietary fats are the fats we see as well as some we do not see in the foods we eat everyday. They are necessary for the proper functioning of the body. But just like everything else, you can get too much of a good thing. Too much fat, saturated as well as unsaturated, can lead to problems.

Dietary Fats and Disease

One of the major health consequences of too much fat in the diet is an intake of an excessive amount of calories. This leads to obesity. Obesity is probably the most common and one of the most serious nutritional problems affecting Americans today. It is a risk factor for developing cardiovascular diseases, hypertension, atherosclerosis, gallbladder disease, diabetes mellitus, and liver diseases. A risk factor is one contributing factor in the development of a chronic disease.

Dietary fat has been found to be a risk factor for developing coronary heart diseases and cancers of the colon, breast, and uterus.

Heart Diseases. The leading cause of death in the western world is some form of cardiovascular disease such as stroke and atherosclerosis. Heart attacks are rare for people in countries that have lowfat diets. When people from these countries move to the United States and their dietary habits become "Americanized," deaths from heart attacks increase.

Diet was implicated as a cause of coronary heart diseases over 30 years ago when blood cholesterol levels were found to be high in persons suffering from atherosclerosis (hardening of the arteries). Much research has been done to find the exact cause of this relationship. Although we still do not have a total understanding of the relationship between diet and coronary heart disease, we can make the following statements:

• Hyperlipidemia, which is a high level of fat in the blood, greatly increases your chance of developing diseases of the heart and circulatory systems.
• The amounts and kinds of fat in your everyday diet may influence the fat levels in your blood.
• A diet high in saturated fat and cholesterol may raise the level of cholesterol in your blood.
• A diet low in total fat, saturated fat, and cholesterol but with some polyunsaturated fat and monounsaturated fat may lower the cholesterol level in your blood.

The cause of heart disease is not simple. There are many risk factors associated with its development. These include high blood cholesterol levels, high blood pressure, stress, smoking, obesity, heredity, poor diet, and lack of exercise!

 Table 1. Fat and Fatty Acid Content of Selected Foods

		Approximate Fatty Acid Content (as percentage of total fat*)
Food		Total Fat (grams)	Total Saturated Percentage	Total Polyunsaturated Percentage
Beef chuck, 3 oz., roasted		31	41	5
Pork loin, 3 oz., baked		24	36	7
Peanuts, 1/4 cup, roasted		18	19	30
Whole milk, 1 cup		9	54	-
Corn oil, 1 t.		5	13	58
Lard, 1 t.		5	40	12
Chicken, dark meat, no skin; 3 oz., baked		5	27	24
Lowfat milk, 1 cup		5	3	-
Corn oil margarine, 1 t.		4	16	21
Chicken, white meat, no skin; 3 oz., baked		2	32	31
* Percentages may not equal 100 since only saturated and polyunsaturated fatty acids are given.

Cancer. About 25 to 60 percent of all cancer in humans is related to diet and nutrition. However, we still know very little about its causes and prevention.

Cancer of the colon and cancer of the breast are thought to be related to dietary fat consumption. Again, countries that have lowfat diets have low incidence of breast cancer and colon cancer. Researchers are not sure what type of fat causes or promotes growth of cancerous tissues.

Diabetes. Dietary fat, by itself, has not been linked to the development of diabetes. However, a large number of diabetics are obese. And one contributing factor in the development of obesity is a diet high in fat.

Today, most people who become diabetic after they reach adulthood die prematurely of cardiovascular diseases. Dietary fat is definitely a risk factor in the development of cardiovascular diseases.

 Table 2. Cholesterol Content of Selected Foods

Foods	Milligrams Of Cholesterol (approximate)
Liver, 3 oz.	370
Egg yolk, 1 large	250
Shrimp, 1/2 cup	85
Turkey, dark meat, 3 oz.	85
Beef, 3 oz.	80
Pork, 3 oz.	75
Turkey, white meat, 3 oz.	65
Butter, 1 T.	35
Whole milk, 1 cup	35
Lowfat milk or buttermilk, 1 cup	5

What Can You Do?

As a good health measure, most of us should reduce the total amount of fat we eat. Select foods that are lower in fat such as poultry or fish in place of fatty meat; use nonfat milk in place of whole milk. Trim visible fat from meat, poultry, and fish. And reduce the use of fat during food preparation by roasting or broiling meats and steaming vegetables rather than frying.

Also, replace some saturated fats with polyunsaturated and monounsaturated fats. Saturated fats are usually solid animal fats; polyunsaturated and monounsaturated fats are primarily liquid vegetable oils. Most foods, however, contain all three fats. Select those that are lower in saturated fats such as fish, skinless poultry, lean meats, and lowfat dairy products.

Many people should eat less high-cholesterol food. Cholesterol is a fatlike compound that our bodies make. Animals also manufacture cholesterol in their bodies, so it is in meats and foods of animal origin. Plants do not contain cholesterol since they do not make it.

Sodium

Most Americans like salt--a lot of it! The average adult in the United States consumes the equivalent of 4 to 6 grams (2 to 3 teaspoons) of table salt a day. The average person needs 1 to 3 grams a day.

Table salt is made of two minerals: sodium and chloride. Sodium is needed by the body to help control fluid balance and to maintain proper pressure within the cells. In addition, sodium helps transmit nerve impulses so muscles can work.

Sodium and Hypertension

Twenty percent of the adult population and 40 percent of older Americans have hypertension. The occurrence is higher for black Americans (38 percent) than for white Americans (29 percent). Hypertension is another risk factor in cardiovascular disease. Research indicates that a moderate reduction in sodium intake might help in reducing hypertension for some people.

 Table 3. Sodium Content of Selected Foods

Food	Milligrams Of Sodium (approximate)
Salt, 1 t.	2000
Baking soda, 1 t.	1230
Baking powder, 1 t.	300
Bread, 1 slice	200
Bacon, 2 slices	170
Snap beans, 1/2 cup, commercially canned	125
Milk, 1 cup	120
Egg, 1 medium	70
Beef, 3 oz.	50
Snap beans, 1/2 cup, fresh	3

What Can You Do?

Most of the sodium in our diets is added to foods in the form of salt. Other sources of sodium in foods include baking soda, baking powder, soy sauce, monosodium glutamate, and seasoning mixtures such as lemon pepper and garlic salt. Processed foods high in sodium include cured meats (such as corned beef, hot dogs, sausage, and bacon), brined foods (such as olives, pickles, and sauerkraut), and salted snack foods. Convenience foods such as instant puddings and instant cereals contain sodium compounds. And sodium is a natural ingredient in some foods, including cheese and shellfish. Some medications, such as antacids, also contain sodium.

You can reduce sodium in the diet by limiting the amount of salt you add to food at home and by limiting consumption of processed foods high in sodium. Some people will need to make additional dietary adjustments. People with high blood pressure should consult their physician about restricting sodium intake.

People who exercise strenuously in hot weather may need supplements to replace sodium lost in perspiration. However, additional sodium is not needed unless a great deal of water is lost through perspiration.

Sugar

Sugars, as well as starches, are carbohydrates. Carbohydrates are one of the three classes of nutrients that provide calories, or energy, from the foods we eat. About 20 to 25 percent of a typical American's calories comes from sugar. This adds up to 100 to 125 pounds of sugar a year.

Sugar and Your Health

Recently sugar has been singled out as an "enemy" of good health. Unfortunately, much is still unknown about the impact of sugar consumption on health.

Obesity. Sugar has been blamed for one of the major health problems in our country--obesity. Although sugar often contributes to the problem, it is not the sole cause. Obesity is a complex problem and results when a person eats more calories than are needed by the body. No particular food is fattening by itself. It is the sum total of calories from all foods eaten that counts.

Diabetes. For many years sugar has been blamed for causing diabetes. We know that diabetes is inherited, but we don't know what triggers it. However, it is true that obesity is related to diabetes; therefore, sugar may be indirectly related through its relationship with obesity.

Heart Diseases. Both obesity and diabetes contribute to heart diseases. An excessive dietary intake of sugar contributes to obesity. But sugar, itself, is not directly linked to heart diseases.

Tooth Decay. Poor dental health is one of the most widespread and costly diseases directly related to nutrition in the United States. Over 98 percent of the people in this country have decayed teeth. Essentially, all dental disease is preventable.

Tooth decay starts with plaque, a sticky, colorless film of bacteria. Certain bacteria in the plaque make acids from the sugar that sticks to your teeth. The acids dissolve the enamel of the tooth which allows bacteria in to decay the tooth.

The problem is not simply the amount of sugar eaten. Of equal importance are the frequency of eating sugar-rich foods, the length of time the sugar stays in the mouth, and the stickiness of the sugar.

 Table 4. Sugar Content of Selected Foods

Food	Sugar Percentage (approximate)
Cane or beet sugar	100
Candies	55 to 99
Dried fruits	75 to 90
Honey	80
Syrups	75
Jams and jellies	65 to 70
Graham crackers	20
Pineapple, fresh	10
Carrots	10
Apples, fresh	5

What Can You Do?

Much of the sugar we eat is "hidden" in foods. Soft drinks are high in sugar; so are many cereals and bakery products.

Complex Carbohydrates and Dietary Fiber

Diets high in complex carbohydrates and dietary fiber tend to be lower in calories and fat, especially saturated fat and cholesterol. Populations that eat diets high in complex carbohydrates and dietary fiber have lower rates of diverticulosis and some types of cancer. Diverticulosis--a ballooning out of the intestinal wall--can occur when intestinal muscles become weak from lack of stimulation. This weakness, expecially in the colon where the fecal matter is solid, can make portions of the colon wall balloon out.

Complex carbohydrates are "starchy" foods such as whole grain foods, cereal products, vegetables (including dried beans and peas), and fruits. Diets high in vegetables and fruits, particularly dark green and deep yellow vegetables and cruciferous vegetables (such as cabbage and broccoli) may lower risk for some cancers and have antioxidant properties. Antioxidants may help to delay the aging process.

Dietary fiber, or roughage, is the part of plants that is not broken down in the digestive tract. Rather than being a single, uniform substance, fiber is a group of several related carbohydrate materials found in plants.

Fiber aids the movement of waste products through the intestine by absorbing and holding water. This makes the waste soft and less compact so it will move more easily.

The benefits of fiber have recently been praised by many people. Articles promoting high-fiber diets have appeared in magazines, and cookbooks featuring foods high in fiber are now popular.

Complex Carbohydrates, Dietary Fiber, and Digestive Disorders

Nutritionists agree that fiber can be useful in treating constipation and diverticular disease, but there is considerable disagreement on whether fiber has any value in preventing these disorders. Research is continuing on the possible role of dietary fiber in reducing blood cholesterol levels and prevention of such disorders as hemorrhoids, colon and rectal cancer, obesity, and many others.

 Table 5. Fiber Content of Selected Foods

Food	Dietary Fiber (grams)
Peanuts, 1/2 cup	7
All bran cereal, 3/4 cup	5
Corn, 1/2 cup, cooked	4
Apple, raw, without skin	4
Broccoli tips, 1/2 cup, cooked	3
Carrots, 1/2 cup, cooked	3
Whole wheat bread, 1 slice	2
Cabbage, 1/2 cup, cooked	2
White bread	trace

What Can You Do?

Whole grain foods, cereal products, vegetables (including dried beans and peas), and fruits are the primary sources of complex carbohydrates and fiber. Eat a lot of these foods. The type of fiber varies from one food to another. For example, cellulose is the major type of fiber in bran. Apples, grapes, and some other fruits are high in pectin, another type of fiber.

Summary

To maximize your health, eat a varied diet and keep your body weight normal by exercising and eating nutritious but limited-calorie foods. A good diet includes a variety of fruits and vegetables, enriched and whole grain breads and cereals, low-fat milk and other dairy products, and lean meat and other protein foods. The amounts of fat, salt, sugar, and alcohol in the diet should not be excessive.

References

Dietary Guidelines for Americans. 1990. U.S. Department of Agriculture, U.S. Department of Health and Human Services. Home and Garden Bulletin 232.

The Food Guide Pyramid. 1992. U.S. Department of Agriculture, U.S. Department of Health and Human Services. Home and Garden Bulletin 252.

Healthy People 2000: National Health Promotion and Disease Prevention. 1991. U.S. Department of Health and Human Services DHHS, (PHS) 91-50212.

Improving American's Diet and Health: From Recommendations to Action. 1991. National Academy Press, Washington, DC.

The Surgeon General's Report on Nutrition and Health. 1988. U.S. Department of Health and Human Services DHHS, (PHS) 88-50210.

For more information, contact your county Extension office. Look in your telephone directory under your county's name to find the number.