ANRED logo: eating disorders: anorexia nervosa, bulimia, binge eating disorder: information and resources

What does healthy eating look like?

If we were to believe advertising and commercials, we would think healthy, normal eating is either constant dieting or regular consumption of high-sugar, high-fat fast foods and snacks. Neither is true. Long-term caloric restriction can lead to an eating disorder, and a steady diet of sugary and fatty foods, especially in the absence of physical activity, can produce overweight, obesity, and the health problems associated with those conditions.

Some people have eaten in a disordered way for so long that they have forgotten what normal, healthy eating is. Basically, it is respecting your body so that you eat when you are hungry, and you eat what you are hungry for, and you stop eating when you are satisfied. This means that you do not use food to try to meet needs other than nourishment; for example, eating a box of donuts because you are lonely (or anxious, or angry, or bored, or sad). It also means never refusing to eat something your body is really hungry for. If you do, you make that forbidden food an object of obsession, and chances are you will binge on it later -- one chocolate truffle now, or a whole box later.

And lastly, eating normally means paying attention to your body so you will recognize when it is hungry for simple things like green beans and whole wheat bread, not just the sweet and fatty foods you routinely deny it.

But it's a big step from chronic restriction or frequent diet-binge-purge cycles to rule-free spontaneous eating. Most people need a few guidelines to provide reassurance when they begin the transition. The following suggestions are based on current recommendations made by the National Academy of Sciences. Best wishes as you begin to incorporate them into your life, one or two at a time so you don't feel overwhelmed and panicky.

Food choices and calories

  • Sufficient food and calories to achieve and maintain a medically healthy weight, neither overweight nor underweight. A sedentary woman might maintain healthy weight on 1800 calories per day while a very active woman might require 2800 calories per day. Male caloric requirements are correspondingly higher.

  • Note: Some people with anorexia nervosa think they can be healthy eating as little as 800-900 calories per day. That is simply not true. Children age one to two years require on average about 950 calories per day. Older, bigger people require far more as outlined above.

 

  • Eat 45-65% of your daily calories as carbohydrates. In other words, adults and children need at least 130 grams of carbohydrates (and that's a bare minimum) each day to provide nourishment to the brain. If you starve your body, you also starve your brain, and a starving brain cannot think clearly or perceive reality objectively. High quality carbohydrates include whole grain bread, crackers, and pasta; fruits, vegetables, potatoes, and beans. Avoid carbs with added sugar such as regular soft drinks, candy, cookies, and fruit beverages sweetened with sugar, sucrose, corn syrup, etc.

 

  • A healthy diet includes 10-25% fat calories (yes, that's really true), but choose the fats wisely. Limit saturated fats (red meat and whole-fat dairy products) and trans fats (found in most margarines, bakery items, and restaurant fried foods). Saturated fats and trans fats contribute to heart and blood vessel disease. Choose instead healthier mono- and polyunsaturated fats. They are found in nuts, avocados, olives, flax seeds, and canola, corn, sunflower, safflower, and olive oil. The oils found in fish such as salmon, tuna, and cod are also healthy, providing protection against cardiovascular disease. Note: these beneficial fats can't be manufactured by your body. You need to eat them every day to enjoy maximum health.

 

  • A healthy diet also includes 10-35% protein, which is used by the body to build and repair cells and tissues. Get quality protein from reduced-fat dairy products, fish, and lean meats such as skinless chicken and turkey breasts.

 

  • A healthy meal plan includes low-fat or non-fat milk or other dairy foods that provide calcium for strong bones: at least 1200 mg. per day for women who menstruate and 1500 mg. per day for those who don't. Men also need calcium for strong bones. If you are afraid of the calories in dairy products, new research (American Journal of Clinical Nutrition, 2003) suggests that calcium also helps control blood pressure and may aid in the breakdown of body fat and cause fat cells to make less fat.

 

  • Keep cholesterol consumption down. That means eating fewer animal foods and more fruits, vegetables, and whole grains (cereals, bread, pasta, etc.)

 

  • Fiber is important for regular elimination and bowel health. Men 50 and younger need at least 38 grams per day, and women the same age need 25 grams per day. Fruits, vegetables, and whole grains (especially whole-wheat bread, oatmeal, other whole grain cereals, and brown rice) are excellent sources of dietary fiber.

 

  • Note: After age 50, calorie requirements go down, about 10-20% lower than the values in the chart below. During childhood and adolescence, however, more calories and more protein are required to add muscle mass to the developing body. Pregnant women and nursing moms need more healthy calories as well.

Specific recommendations

  • Eat a variety of nutrient-rich food and beverages from the basic food groups (proteins, fats, and carbohydrates). Eating only a few "safe" foods day after day will deprive you of vitamins, minerals and micronutrients contained in greater or lesser amounts in a wide range of foods.
  • Limit intake of saturated (animal fat, coconut, and palm oil) and trans fats (from partially hydrogenated vegetable oil), which can contribute to heart and blood vessel disease.

  • Some dietary fat is necessary for health. Enjoy the fats and oils that come from vegetables (olive, canola, etc.), fish, and nuts.

  • Limit intake of sugar, salt, and alcohol, which carry health risks if consumed in excess. Avoid the sugar bowl. And the salt shaker. And processed foods that are heavily salted. Moderate alcohol usage is defined as no more than one five-ounce glass of wine, OR one 12-ounce can of beer, OR one ounce of distilled spirits per day for women. Because of differences in physiology, moderate alcohol usage for men is defined as two servings per day.

 

  • To lose weight (when appropriate), reduce portion sizes but still eat a variety of foods. To gain weight, increase portion sizes and enjoy a variety of different foods. If the idea of weight gain panics you, make the increase slowly, and if you get stuck, ask a dietitian (RD) to help you make a meal plan tailored for your specific needs.

 

  • Eat plenty of fruits and vegetables. Only now are we beginning to appreciate the role played in good health by the micronutrients they contain.

 

    • Consume two cups of fruit and two and one-half cups of vegetables daily. Include foods from all the vegetable subgroups (dark green, orange, legumes, starchy veggies, and others)

 

  • Eat three or more servings of whole-grain products daily

 

  • Use only fat-free or low-fat dairy products. Make sure you get at least 1200 to 1500 mg of calcium a day, depending on age and menstrual status (No periods? Then you need more calcium.) Make sure you also consume sufficient vitamin D and the supportive minerals that promote calcium absorption.

Note: The above suggestions were taken from guidelines issued by the Department of Health and Human Services on January 12, 2005.

Counting calories

Don't obsess by counting every calorie, but be aware that your body's emergy requirements are higher that what is provided by many diets. Use the following as a guideline. (From the University of California Wellness Letter. October 2002)

 Activity level

 Women

 Men
Very light

 1,910

  2,465
Light

  2,225

  3,020
Moderate

 2,350

  3,260
Heavy

2,800

  3,975

Healthy lifestyle choices

  • At least eight hours of sleep every night, more if you need it. Sleep deprivation seems to impair the way the human body uses insulin, which can lead to overweight and possible problems with blood sugar.

 

  • Thirty to sixty minutes of physical activity every day. It does not have to be done all at one time, and routine activities such as climbing stairs and yard maintenance count.

 

  • No smoking, ever, and if you use alcohol, no more than two standard servings per day for males and one standard serving per day for females.

  • A nutritious breakfast every morning. Ninety-six percent of everyone who loses weight and keeps it off eats breakfast every day, according to Ann Yelmokas McDermot, a nutrition scientist at Tufts University (USDA Nutrition Research Center)

 

  • Plus all the things your mother probably has nagged you about: Wear your seat belt when in a car. No unprotected sex unless you are in a strictly monogamous relationship. Insist on counseling or leave relationships if you are physically, sexually, or emotionally abused. If you are dependent on alcohol or other drugs, get treatment and get clean. Many people with eating disorders are also chemically dependent.

  In summary

  • For long-term health, eat minimal amounts of animal fats, trans fats, sugar, and junk food.

 

  • Choose healthy carbohydrates over refined carbs. For example, eat lots of whole grains, fruits, vegetables, beans, oatmeal, brown rice, etc. and stay away from white bread, white rice, snack-pack treats, regular soft drinks, processed stachy, sugary, and fatty foods, etc.

 

  • Choose lean protein: chicken breast, turkey breast (remove the skin), fish, and low- or non-fat dairy products over red meat and high-fat dairy foods.

 

  • Eat moderate portions. When eating out, mark a healthy-sized portion and put it on a separate plate. Leave the rest on the table or take it home for a second meal tomorrow.

 

  • Stay active and exercise regularly. Sixty minutes a day is ideal, but everything (even climbing stairs and walking to school or work) counts.

 

  • Above all, NEVER deny yourself a reasonable portion of something you really want. If you do, you set yourself up to binge on it later.

Postscript

  • Some people, especially in the beginning of recovery, find a structured meal plan more useful than the general guidelines we give above. If you are one of these people, we recommend you consider the DASH Diet (Dietary Approaches to Stop Hypertension). This meal plan was designed to lower high blood pressure, but it contains the elements of healthy eating: low in total fat, saturated fat, and cholesterol, and rich in fruits, vegetables, whole grains, and lowfat dairy products.

 

  • Download or order the DASH Diet at the National Heart, Lung, and Blood Institute's Web site. Single copies are free. If you already have low blood pressure, please check with your physician before you begin this diet plan.

Eating disorders are powerful foes. They can destroy something as basic as the ability to feed oneself, something babies to do learn in the first year of life. Getting back on track can be a struggle. If you can't make the above information work for you, ask your physician for a referral to a registered dietitian (R.D.) who can help you design a healthy meal plan and then provide support you as you learn to implement that plan.


 Warning! Please Note: ANRED information is not a substitute for medical or psychological evaluation and treatment. For help with the physical and emotional problems associated with eating disorders, talk to your physician and a mental health professional.


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