American dietetic associateion complete food and nutrition guide 2nd

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American Dietetic
Association
Complete Food and
Nutrition Guide
2ND EDITION

Roberta Larson Duyff
MS, RD, FADA, CFCS

J o h n Wi l e y & S o n s , I n c .

www.Ebook777.com


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Praise for the
American Dietetic Association Complete
Food and Nutrition Guide

“. . . jam-packed with practical eating and food safety tips.”
— USA Today

“It’s always refreshing to find a nutritionist interested in good taste!”
—Julia Child, author, culinary expert, TV personality

“[A] remarkable reference.”
—Graham Kerr

“[The book] may be the ultimate healthy-eating primer. How often can it be
said of a book that it may extend your life?”
— Fitness magazine

“. . . brimming with tips from baby food to eating for healthy aging.”
— Shape magazine

“Duyff really covers nutrition and healthy eating from all angles . . . without
overusing the ‘d’ word [‘don’t’].”
—Tufts University Health & Nutrition Letter

“Intelligent advice about sensible eating.”
—Washington Times

“Everything you ever wanted to know about everything you ever wanted to
eat is in this guide.”
— Food Management magazine

“. . . a must for everyone’s kitchen, from the teenager learning about food and
nutrition to adults changing their eating styles.”
— Cheri Svoboda, The Oregonian

fmatter.qxd 6/20/02 12:54 PM Page ii

“. . . in short, it’s a winner!”
—Washington Post

“. . . set out so anyone, even those not nutritionally inclined, can open the book
and find something interesting.”
— Janice Denham, food editor, St. Louis Journal Publications

“. . . covers everything from deciphering food labels to maintaining a familyfriendly kitchen to changing dietary needs as we age.”
— St. Louis Post-Dispatch

“An essential resource for consumers seeking to make healthy food choices,
and nutrition professionals requiring a science-based reference tool.”
—Susan Lerner Barr, M.S., R.D., contributing nutrition editor, Self magazine

“. . . solid all-around guide to nutrition that’s fun just to pick up and peruse . . .
sure to become dog-eared over time.”
— Environmental Nutrition

“Translates nutrition science into the everyday food advice people need to
make healthy choices when grocery shopping, cooking dinner, or ordering from
a restaurant menu.”
—Carolyn O’Neil, MS, RD, award-winning television food journalist,
former CNN nutrition news correspondent

“. . . tackles most of the nutritional issues that concern Americans today . . .
up-to-date and helpful.”
— Seattle Times

“Readable and timely. . . . Duyff gives sound advice.”
— Library Journal

“A wealth of practical information [to] refer to time and time again.”
—Journal of Nutrition Education

“Excellent and thorough . . . Includes solid, science-based content on many
nutrition topics, up-to-date healthy eating guidance, and ways to evaluate
current nutrition research.”
—Johanna Dwyer, DSc, RD, professor, School of Nutrition and Medicine, Tufts University,
and director of Frances Stern Nutrition Center


fmatter.qxd 6/20/02 12:54 PM Page iii

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American Dietetic
Association
Complete Food and
Nutrition Guide
2ND EDITION

Roberta Larson Duyff
MS, RD, FADA, CFCS

J o h n Wi l e y & S o n s , I n c .

www.Ebook777.com

fmatter.qxd 6/20/02 12:54 PM Page iv

About the ADA
The American Dietetic Association is the largest group of food and nutrition professionals in
the world. As the advocate of the profession, the ADA serves the public by promoting optimal
nutrition, health, and well-being.
For more information . . .
Visit the ADA’s Web site at . The American Dietetic Association’s Web
site offers nutrition information for consumers and health professionals, and the Find a Dietitian feature to locate a dietetics professional in your area. The ADA’s Consumer Nutrition Information line, at (800) 366-1655, also provides referrals to local registered dietitians as well as
recorded nutrition messages in English and Spanish.

This book is printed on acid-free paper.
Copyright © 2002 by The American Dietetic Association. All rights reserved
Illustrations on part and chapter openers and on pages 298, 372, 374, and 392 copyright © 2002 by
Jackie Aher.
Published by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
Design and production by Navta Associates, Inc.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,
electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108
of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization
through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers,
MA 01923, (978) 750-8400, fax (978) 750-4470, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ
07030, (201)748-6011, fax (201) 748-6008, email:
.
Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this
book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this
book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither
the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited

to special, incidental, consequential, or other damages.
Readers are advised to seek the guidance of a licensed physician or healthcare professional before making changes in
healthcare regimens, since each individual case or need may vary. This book is intended for informational purposes
only and is not for use as an alternative to appropriate medical care. While every effort has been made to ensure that the
information is the most current available, new research findings, being released with increasing frequency, may invalidate some data.

For general information about our other products and services, please contact our Customer Care
Department within the United States at (800) 762-2974, outside the United States at (317) 572-3993
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ISBN 0-471-44144-9
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1


Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

x

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

xi

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

PA RT I

Eat Smart, Live Well: It’s About You!

CHAPTER 1

Food Choices for Fitness . . . . . . . . . . . . . . . . . . . . . . . .

5

Fitness: Your Overall Health! . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
What’s Smart Eating? Guidelines for Americans . . . . . . . . . . . . .
Your Food Choices: The Inside Story . . . . . . . . . . . . . . . . . . . . . . .
Solutions for Healthful Eating, Active Living . . . . . . . . . . . . . . . .

5
7
14
16

PA RT I I

Healthful Eating: The Basics

CHAPTER 2

Your Healthy Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Body Basics: What’s Your Healthy Weight? . . . . . . . . . . . . . . . . . .
Energy Basics: Calorie Math . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Weighing the Risks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Weight Management: Strategies That Work! . . . . . . . . . . . . . . . . .

Too Thin—a Problem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disordered Eating: Problems, Signs, and Help . . . . . . . . . . . . . . .
“Diets” That Don’t Work! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
When You Need Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CHAPTER 3

21
25
29
31
43
44
47
50

Fat Facts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Fats Matter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

52


vi

CONTENTS

Cholesterol: Different from Fat . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Too Much of a Good Thing? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CHAPTER 4

64
67

Vitamins, Minerals, and Phytonutrients:
Variety on Your Plate! . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Vitamins and Minerals: Team Players! . . . . . . . . . . . . . . . . . . . . . . 74
Vitamins: The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Minerals—Not “Heavy Metal” . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Phytonutrients—a “Crop” for Good Health . . . . . . . . . . . . . . . . . . 107

CHAPTER 5

Sweet Talk: Sugar and Other Sweeteners . . . . . . . . . 112
Sugars: The Sweet Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sugars in Your Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Polyols: Sugar Replacers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Intense Sweeteners: Flavor without Calories . . . . . . . . . . . . . . . . .

CHAPTER 6

112
120
125
126

Fiber: Your Body’s Broom . . . . . . . . . . . . . . . . . . . . . . . 130
Fiber: An Important Nonnutrient . . . . . . . . . . . . . . . . . . . . . . . . . . 130
For Fiber—Variety! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136

CHAPTER 7

Sodium: A Salty Subject . . . . . . . . . . . . . . . . . . . . . . . . 143
Sodium and Your Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Sodium in Your Food Choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Flavor . . . with Less Salt and Sodium . . . . . . . . . . . . . . . . . . . . . . 148

CHAPTER 8

Fluids: Often Overlooked . . . . . . . . . . . . . . . . . . . . . . . 153
A Fluid Asset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
What’s to Drink? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

PA RT I I I

Smart Eating: The Consumer Marketplace

CHAPTER 9

What’s on Today’s Table? . . . . . . . . . . . . . . . . . . . . . . . 179
Food: What’s “in Store” for You? . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Ensuring Your Food Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

C H A P T E R 10

Planning to Eat Smart . . . . . . . . . . . . . . . . . . . . . . . . . . 210
The Food Guide Pyramid: Your Healthful Eating Guide . . . . . . . 210
What’s Inside the Pyramid? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
Health-Wise Eating Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226

C H A P T E R 11

Supermarket Smarts . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Today’s Food Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Supermarket Psychology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248


CONTENTS

Your Shopping Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Food Safety: Start at the Store . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
C H A P T E R 12

The Safe Kitchen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
Foodborne Illness: More Common than You Think! . . . . . . . . . . .
Checklist for a Clean Kitchen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Safekeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Safe Preparation and Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Quick Tips for Injury Prevention . . . . . . . . . . . . . . . . . . . . . . . . . .
The “Eco Kitchen” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

C H A P T E R 13

274
282
283
289
299
300

Kitchen Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301

“Resetting” Your Table . . . for Taste and Health . . . . . . . . . . . . . . 301
Simply Nutritious, Simply Delicious . . . . . . . . . . . . . . . . . . . . . . . 308
Add Life to Your Spices—and Herbs, Too! . . . . . . . . . . . . . . . . . . 326

C H A P T E R 14

Your Food Away from Home . . . . . . . . . . . . . . . . . . . . 332
Dining Out for Health and Pleasure . . . . . . . . . . . . . . . . . . . . . . . .
Eating Out Safely . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fast Food, Healthful Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Eating Out Ethnic Style . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Eating for Travelers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

332
339
340
349
358

PA RT I V

Food for Health: Every Age, Every Stage of Life

C H A P T E R 15

Off to a Healthy Start . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
Breast-Feeding Your Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
Another Healthful Option: Bottle-Feeding . . . . . . . . . . . . . . . . . . 377
Solid Advice on Solid Foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382

C H A P T E R 16

Food to Grow On . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393
Toddlers and Preschoolers: Food for the Early Years . . . . . . . . . . 393
Eating ABCs for School-Age Children . . . . . . . . . . . . . . . . . . . . . 404
Feeding the Teen Machine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420

C H A P T E R 17

For Women Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
Childbearing Years: Nutrition, Menstruation, and Prepregnancy
Congratulations! You’re Expecting! . . . . . . . . . . . . . . . . . . . . . . . .
For Those Who Breast-Feed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Now for Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

C H A P T E R 18

429
435
445
449

For Mature Adults: Healthful Eating! . . . . . . . . . . . . . . 452
Aged to Perfection! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452

vii


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viii

CONTENTS

When Lifestyles Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
Changes That Challenge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466

PA RT V

Healthful Eating: Special Issues

C H A P T E R 19

Athlete’s Guide: Winning Nutrition . . . . . . . . . . . . . . . 475
Nutrients for Active Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A High-Performance Diet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Making Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The Game Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ergogenic Aids: No Substitute for Training . . . . . . . . . . . . . . . . . .

C H A P T E R 20

The Vegetarian Way . . . . . . . . . . . . . . . . . . . . . . . . . . . . 498
Being Vegetarian . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Vegetarian Diets: Nutritionally Speaking . . . . . . . . . . . . . . . . . . . .
Throughout the Life Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
“Vegging Out” the Healthful Way! . . . . . . . . . . . . . . . . . . . . . . . . .

C H A P T E R 21

475

487
490
493
495

498
500
505
508

Sensitive about Food . . . . . . . . . . . . . . . . . . . . . . . . . . . 517
Food Intolerances and Other Adverse Food Reactions:
Copycat Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517
Food Allergies: Commonly Uncommon . . . . . . . . . . . . . . . . . . . . 526

C H A P T E R 22

Smart Eating to Prevent and Treat Disease . . . . . . . . 536
Your Healthy Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Blood Pressure: Under Control? . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cancer Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Diabetes: A Growing Health Concern . . . . . . . . . . . . . . . . . . . . . .
Osteoporosis: Reduce the Risks . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gastrointestinal Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Anemia: “Tired Blood” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Food and Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

C H A P T E R 23

536

546
552
558
568
572
575
577

Supplements: Use and Abuse . . . . . . . . . . . . . . . . . . . 582
Dietary Supplements: What Are They? . . . . . . . . . . . . . . . . . . . . . 582
Supplements: Safe? Effective? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595
If You Take a Supplement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600

PA RT V I

Resources: More about Healthful Eating

C H A P T E R 24

Well Informed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 609
Need Nutrition Advice? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 609

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CONTENTS

Be Your Own Judge! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 613
Case against Health Fraud . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619

Resources You Can Use . . . . . . . . . . . . . . . . . . . . . . . . 623
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 628
1997–2001 Dietary Reference Intakes . . . . . . . . . . . . . . . . . . . . . .
Protein: 1989 Recommended Dietary Allowances . . . . . . . . . . . .
Growth Charts: Body Mass Index for Children and Teens . . . . . .
Body Mass Index for Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Carbohydrates in Common Foods . . . . . . . . . . . . . . . . . . . . . . . . .
% Daily Values: What Are They Based On? . . . . . . . . . . . . . . . . .
Health Claims on Food Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Functions of Selected Additives . . . . . . . . . . . . . . . . . . . . . . . . . . .

628
628
633
633
635
637
637
639

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 641

ix


Foreword

F

ood nourishes us in many ways. Eating is one

of life’s pleasures. Food is tied to memories of
our youth and to social occasions, celebrations,
and other aspects of our culture. Food also
fuels our bodies. What we eat is a controllable factor
in keeping us as healthy and as fit as possible.
The fundamentals for fostering a healthy body
remain constant. A well-balanced approach to eating
and getting plenty of rest and physical activity are, and
always have been, keys to good health. Research about
nutrition and its impact on everything from childhood
development to disease control and prevention, however, shows that our knowledge about the role of nutrition in a healthful lifestyle is continually evolving.
Since the last published edition of this book, scientists have made exciting discoveries about nutrition
and how much it can affect our overall health. We now
know more about health-promoting substances in
fruits, vegetables, and grain products called phytonutrients. We have expanded the way we look at vitamins
and minerals. Consumers are increasingly turning to
“alternative” medicine and therapies to treat or prevent
disease. In addition, the impact of biotechnology on
the food supply is changing the way we think about
how our food is grown and processed.

All these important issues and more are discussed
in the second edition of the American Dietetic Association Complete Food and Nutrition Guide. Written
and reviewed by qualified nutrition practitioners—
registered dietitians and dietetic technicians, registered—the book is scientifically based. But more than
that, it is practical and easy to understand. Registered
dietitians counsel people to attain optimal health by
eating a variety of nutrient-rich foods with an emphasis on taste, quality, moderation, balance, and food
safety.
In the second edition of the American Dietetic

Association Complete Food and Nutrition Guide,
Roberta Duyff shows you how to maximize your
health while enjoying food. Her practical suggestions
are backed up by the latest scientific evidence, as
well as by her extensive experience as a registered
dietitian. Best of all, the book can serve as a reference
for your entire family’s health—and it’s right at your
fingertips.
Enjoy the book and optimize your health.
Julie O’Sullivan Maillet, RD, PhD, FADA
President, American Dietetic Association


Acknowledgments

A

t every phase in developing the American
Dietetic Association Complete Food and
Nutrition Guide, I’ve been grateful and
indebted to the many professionals, colleagues, and friends—in the fields of nutrition and
dietetics, health, family and consumer sciences, food
science, culinary arts, education, and communications—who have shared their knowledge, experience,
and expertise throughout my career. I’m especially
grateful to:
The American Dietetic Association, for the honor
of writing this book on behalf of the association’s more
than seventy thousand members.
Betsy Hornick, editor and registered dietitian, on
behalf of ADA Publications, for her nutrition expertise, editorial guidance, and commitment to excellence

at every phase in the development of this book in both
its first and second editions.
ADA staff: Diana Faulhaber, ADA director of book
publishing, who offered constant support and encouragement for a consumer-focused, healthy-eating book;
Sharon Denny and Lorri Fishman, ADA Knowledge
Center, for their quick, enthusiastic help in preparing
the manuscript; Saudia Muhammad and Alison
Loviska, publications department, who helped with
permissions; Anne Coghill, acquisitions editor, who
began the second-edition process; Michael Weitz,
ADA director of marketing, for the many promotional
efforts for the book; Lori Ferme, ADA media relations manager, for ADA’s publicity of the book; and
to those who work with them.

ADA members—with expertise as either a registered dietitian or a dietetic technician, registered—
who volunteered countless hours to review the
manuscript for content accuracy, clarity, and comprehensiveness:
ⅷ To those who reviewed this entire edition:
Sharon Denny, Lorri Fishman, and Lisa Kelly.
ⅷ To those who provided their unique expertise
for portions of the book: Keith-Thomas Ayoob,
Leila Beker, Felicia Busch, Maureen Callahan,
Beverly Clevidence, Mildred Cody, Eleese Cunningham, Connie Diekman, Robert Earl, Deborah Fillman, Susan Finn, Julie Fulton, Molly Gee,
Barbara Gollman, Dayle Hayes, Lenore Hodges,
Edith Hogan, Sherri Hoyt, Barbara Ivens, Judith
Jarvis, Cynthia Kupper, Linda McDonald, Elaine
McLaughlin, Julie O’Sullivan Maillet, Wendy
Marcason, Jacqueline Marcus, Mildred MattfeldtBeman, Libby Mills, Marlene Most, Tammie
Otterstein, Linda Rhodes Pauly, Anne Piatek,
Christine Polisena, Diane Quagliani, Christine

Rosenbloom, Allison Sarubin Fragakis, Lana
Shepek, and Joanne Slavin.
ⅷ To those who reviewed the first edition: Susan
Borra, Mary Carey, Dayle Hayes, Marsha Hudnall,
Nancy Schwartz, and Madeleine Sigman-Grant, as
well as Julie Burns, Suzanne Havala, Sue Murvich,
and Ann Semenske.
Sherri Hoyt, colleague and registered dietitian, for
her contributions on food sensitivity, infant and


xii

ACKNOWLEDGM ENTS

child feeding, nutrition during pregnancy, and breastfeeding.
Registered dietitians and other food, nutrition, and
health professionals who work in government agencies, the food industry, and educational institutions
throughout the country, and who served as resources
and experts.
Organizations who granted permission for the use
of supporting illustrations and graphics.
Dietetic students for their careful fact checking:
Sehr Jangda, Adrienne Kraemer, and Grace Lange.
The fine team of editors and staff at John Wiley
& Sons, especially Kitt Allan, Kellam Ayres, Tanya
Barone, Laura Cusack, Sabrina Eliasoph, Tom
Miller, John Simko, and Elizabeth Zack, who handled
the publication of this book; copyeditor William
Drennan; the design team at Navta Associates; as

well as the Chronimed Publishing team responsible
for its first edition.
Other friends and family who reviewed the manu-

script from their unique consumer and professional
perspectives: Ann Hagan Brickman, Linda Carpenter, Julie Duyff, Phil Duyff, Patty Fletcher, Karen Marshall, Patricia McKissack, and Linda Valiga.
Edith Syrjala Eash, Diva Sanjur, and Hazel Spitze,
who encouraged my early career as a registered dietitian and in nutrition education.
Anne Piatek, colleague and culinary dietitian, for
encouraging me to write this book.
My family, especially my mother, Jeane Larson,
and my friends, who shared their support, understanding, and encouragement for both editions.
My husband, Phil, who read every chapter for clarity and consumer friendliness . . . and who offered the
sensitivity and loving support I needed to write this
book.
Roberta Larson Duyff, MS, RD, FADA, CFCS
Author/Food Nutrition Consultant
Duyff Associates, St. Louis, Mo.

This book went to press prior to release of the 2002 Dietary Reference Intakes for
macronutrients and fiber; recommendations for these dietary components reflect previous guidelines.
Unless otherwise noted, the nutrient and calorie data in this book were derived from:
ⅷ

U.S. Department of Agriculture/Agricultural Research Service, Nutrient Data
Library, />ⅷ Jean A. T. Pennington, Bowes & Church’s Food Values of Portions Commonly
Used, 17th ed. (New York: J. B. Lippincott, 1998)
ⅷ Selected data from food manufacturers and fast-food chains

Introduction

T

he American Dietetic Association Complete
Food and Nutrition Guide has been created
for you as a practical, up-to-date resource
for healthful eating. From cover to cover,
you’ll see how smart eating—combined with physical activity—promotes fitness. As important, you’ll
learn how healthful eating and taste go hand in
hand!
To offer solutions for your everyday eating dilemmas, this book is filled with practical advice—whatever your lifestyle or needs. From weight control to
heart-healthy eating . . . supermarket shopping to eating out . . . food safety to kitchen nutrition . . . vegetarian eating to sports nutrition, you’ll find many tips
for ease, convenience, and good taste. Look for today’s
“hot” food issues, too: phytonutrients, functional
foods, dietary supplements, and food biotechnology,
among others.
As your complete resource on nutrition, you can
refer to this book again and again at every age and
stage of your life—from choosing the healthiest baby
food or feeding a child or teen, to dealing with unique
nutrition needs in a woman’s life or challenges of
aging. It’s also filled with advice for preventing, slowing, or dealing with heart disease, cancer, diabetes,
and other common health problems. This book is
meant for you, and for all those you care about . . .

perhaps a child, spouse, companion, aging parent,
or friend.
For your personal nutrition “checkup,” you’ll find
opportunities to assess your own everyday food

choices. Start in chapter 1 with “Looking for ‘Healthy
Solutions’?” to identify your personal eating challenges. For more information, each question refers
you to in-depth answers throughout the book. In fact,
in almost every chapter, “Your Nutrition Checkup”
gives you a close-up look at your own food decisions.
Whenever nutrition makes the news (print, television, radio, or online), this book can help you judge
the headlines and separate sound fact from fad.
Its food and nutrition advice comes from the American Dietetic Association, the authority the United
States turns to for food and nutrition advice, with
more than eighty-five years of nutrition expertise and
research.
With questions posed to nutrition experts—in part
through the American Dietetic Association’s Knowledge Center—thousands of consumers have helped
shape the focus and content of the American Dietetic
Association Complete Food and Nutrition Guide. We
hope the answers to their food and nutrition questions
will also answer many of yours!
Read, enjoy, be active, and eat healthy . . . for life!


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PART

I

Eat Smart, Live Well

I t ’ s A b o u t Yo u !


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CHAPTER

1

Food Choices for Fitness

Y

our life is filled with choices! Every day you
make thousands of choices, many related to
food. Some seem trivial. Others are important. A few may even set the course of your
life. But as insignificant as a single choice may seem,
made over and over, it can have a major impact on your
health—and your life!
This book is about choices—those you, your family, and your friends make every day about food, nutrition, and health. Within its pages, you’ll find reliable
nutrition information and sound advice, based on scientific evidence. It offers you practical ways to eat
healthfully in almost any situation and at every phase
of life. And it encourages you to enjoy the pleasures
of food. After all, taste is the number one reason most
people choose one food over another.
Most important, the practical tips and flexible
guidelines on its pages help you choose nutritious, flavorful foods to match your own needs, preferences,

and lifestyle—even as your life and family situation
change. Eating for health is one of the wisest decisions
you’ll ever make!

optimal health and overall well-being. Fitness is your
good health—at its very best.
Being fit defines every aspect of your health—not
only your physical health, but your emotional and
mental well-being, too. In fact, they’re interconnected.
Smart eating and active living are fundamental to all
three. When you’re fit, you have:
ⅷ Energy to do what’s important to you and to be
more productive
ⅷ Stamina and a positive outlook to handle the
mental challenges and emotional ups and downs
of everyday life, and to deal with stress
ⅷ Reduced risk for many health problems, including serious, often life-changing diseases, such as
heart disease, cancer, diabetes, and osteoporosis
ⅷ The chance to look and feel your best
ⅷ Physical strength and endurance to protect yourself in case of an emergency
ⅷ A better chance for a higher quality of life, and
perhaps a longer one, too

Fit Is Ageless

Fitness: Your Overall Health!
What does being fit mean to you? Perhaps, being free
of disease and other health problems? Or having
plenty of energy, or a trim or muscular body, or the
ability to finish a 10K run? Actually, “fitness” is far

broader and more personal. It refers to your own

Fitness at every age and stage in life depends on
healthful eating and active living. The sooner you
make them your priorities, the better your health.
That, too, is what this book is all about—how to
eat for health and stay physically active throughout the
cycle of life, and enjoy great-tasting food along the
way!


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Good nutrition and regular physical activity are two
lifestyle habits that promote fitness—but certainly not
the only ones. To stay fit, make other lifestyle choices
for good health, too: get adequate sleep, avoid smoking, manage stress, drink alcoholic beverages only in
moderation (if you drink), wear your seat belt, observe
good hygiene, get regular medical checkups, obtain
adequate health care—to name a few.

Smart Eating: Fuel for Fitness
What does it take to be fit? You don’t need special or
costly foods, or fancy exercise equipment or health
club membership. You don’t need to give up your

favorite foods, or set up a tedious system of eating
rules or calorie counting. And you don’t need to hit a
specific weight on the bathroom scale.
You’ve heard the term “nutrition” all your life. The
food-fitness connection is what it’s all about. In a nutshell, nutrition is how food nourishes your body. And

Your Nutrition Checkup
Ready for Healthier Eating?
Where do you fit on this “healthy eating” readiness test?
Check one.
□ “My food choices are okay as they are.” Okay, but
read on to find out why you might consider taking
a few steps in the future to eat for better health (and
perhaps move more, too).
□ “I’ll change my eating habits sometime, but I can’t
make myself do it now.” Good initial thought. Check
here for sensible, realistic ways to eat smarter (and
move more)—but now rather than later. The sooner
you start, the greater the benefits.
□ “I’m ready to eat smarter, starting now.” Good. Look
through these chapters for small steps to healthful
eating that you can take. As you achieve them, try a
few more. Be active, too.
□ “I’m already a ‘healthy eater.’” Great, keep it up! Flip
through this book for more practical ways to eat
smart. In fact, get adventuresome with your eating.
And take time for active living.
□ “Healthy eating and active living are second nature
to me.” Excellent! Share the practical advice here
and your own success with someone else!

being well nourished depends on getting enough of the
nutrients your body needs—but not too much.
At every stage in life, healthful eating fuels fitness.
Well-nourished infants, children, and teens grow,
develop, and learn better. Good nutrition helps ensure
a healthy pregnancy and successful breast-feeding.
And healthful eating and active living help people at
any age feel their best, work productively, and lower
their risks for some diseases.
Today’s understanding of nutrition is based on years
of scientific study. Interest in food and health actually
has a long history and was even recorded by the
ancient Greeks. But it wasn’t until the nineteenth century that the mysteries of nutrition began to be solved.
Since then, scientists have been able to answer many
nutrition questions. And research continues as scientists explore emerging questions about food, nutrients,
phytonutrients, and their role in health.
Today we know that healthful eating dramatically
lowers the risk for the main causes of disability and
death in the United States: heart disease, certain cancers, diabetes, stroke, and osteoporosis. Good nutrition and regular physical activity also can lower risks
for obesity, high blood pressure, and high blood cholesterol—all risk factors for serious disease.
Nutrition advice, with the consensus of today’s
nutrition experts, is supported by solid scientific evidence. So unlike the ancients, you have a valid basis for
choosing food for health. It’s up to you to apply nutrition principles and advice for your own well-being.
To make wise food choices, you need sciencebased nutrition information. What you know—and
don’t know—just may surprise you!

Smart Eating: Pleasure, Too!
Why do you choose one food over another? Besides
the nutrition benefits, food is a source of pleasure,

adventure, and great taste! It’s no surprise that people
entertain and celebrate with food, or look forward to
a special dish.
Your own food choices reflect you and what’s
important to you: your culture, your surroundings, the
people around you, your view of yourself, the foods
available to you, your emotions, and certainly what
you know about food and nutrition. To eat for health,
you don’t need to give up your food favorites. Simply

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FOOD CHOICES

learn how to fit them in. Good nutrition adds pleasure
to eating—especially as you eat a greater variety of
vegetables, fruits, grain products, and other nutrientrich foods.
Throughout this book, you’ll get plenty of guidance
to do just that! You’ll learn more about nutrition and
fitness—and how you can eat the foods you like, even
try new foods, in an eating plan that promotes your
personal fitness.

Source: The Dietary Guidelines Alliance, 1999; © Cattlemen’s
Beef Board and National Cattlemen’s Beef Association.

What’s Smart Eating?

Guidelines for Americans
Healthful eating: it’s one of your best personal investments! While your genes, age, surroundings, lifestyle,
healthcare, and culture strongly influence your health,

Go Online

FOR

FITNESS

7

C h e c k Yo u r “ E a t
Smart” Score!

Want a snapshot view of your food choices for the day?
Score the quality of your day’s meals and snacks online—
and see how your food choices match up to the Dietary
Guidelines for Americans and the Food Guide Pyramid.
Using the U.S. Department of Agriculture’s Interactive
Healthy Eating Index (IHEI), go online to compare the
types and amounts of food you consume with healthful eating advice from the Pyramid. This interactive Web
site also shows how much total fat, saturated fat, cholesterol, and sodium your day’s food choices contain.
Use it for one day to get a quick look, or up to twenty
days to check the quality of what you eat over time.
Access it through to the
Interactive Healthy Eating Index online.

what you eat and how much you move are key factors
in your fitness equation.

What’s the secret to healthful eating? It’s no secret
at all, just solid advice. In a nutshell, enjoy an overall
approach to eating, with most of your energy, or calories, coming from grain products, vegetables, fruits,
lower-fat milk products, lean meat, fish, poultry, and
legumes. Consume less energy, or calories, from fats
and sweets. Let’s explore just what that means—and
how to do it.
In ten statements, the Dietary Guidelines for Americans sum up the basics about eating and being active
for health. Follow their advice, and promote your
health for the long run, while reducing your risks for
many health problems, including some leading causes
of disability and death among Americans. By following the guidelines you may reduce risk factors (obesity, high blood pressure, and high blood cholesterol)
that lead to chronic disease. And you may lower your
chances for heart disease, some cancers, diabetes,
stroke, and osteoporosis.
So if you’re not following the Dietary Guidelines
already, why not? And why not start now?
Developed by the U.S. Department of Agriculture
and the U.S. Department of Health and Human Services, the Dietary Guidelines have been developed for
you—in fact, for all healthy Americans ages two and
over. Updated every five years, these guidelines offer
the most current, science-based advice, based on the
consensus of many nutrition experts.


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The Dietary Guidelines
are flexible, with plenty of
room for you to eat what
you enjoy and eat for health!
They’re sensible, too, recognizing that what you eat
over several days, rather
than for just one day, or one
meal or snack, is what really
counts!
The advice of the Dietary
Guidelines is summed up
with the ABCs for good
health:
ⅷ Aim for fitness . . .
with a healthy body
weight and active living.
ⅷ Build a healthy base
. . . with a variety of nutritious, health-promoting
foods, kept safe to eat.
ⅷ Choose sensibly . . . without overdoing on fat,
especially saturated fat; sugars; salt; and for adults
who choose to drink them, alcoholic beverages.

Aim for Fitness
When you focus on fitness, remember that two guidelines—aiming for a healthy weight and putting
physical activity into your everyday life—pay off:
helping you work productively, enjoy life, and feel
your best. These same guidelines help children and
teens thrive, develop, and succeed at school.

“Weight” for Health

Guideline 1: Aim for a healthy weight.
Are you at your healthy weight? Appearance or fitting into a clothes size are commonly cited reasons to
maintain a healthy weight. Yet, even a few pounds of
excess weight may be more risky to your health
than you think. Research shows that overweight and
obesity increase the risk factors for chronic disease,
including high blood pressure and high blood
cholesterol, and up the chances for developing serious health problems: heart disease, stroke, diabetes,
certain types of cancer, arthritis, and breathing prob-

lems, among others. Did you
know that premature death is
linked to excess body weight
as well? And that being overweight also can take a toll on
emotional health?
Despite the known risks,
overweight and obesity have
become a national and global
pandemic, and not just for
adults. The typical American
adult gains weight with every
decade. The risk for and the
actual incidence of overweight
among children and teens are
rising dramatically, too.
No matter what your age,
aim for a healthy weight. For
adult women, more than 35

inches around the waistline,
and for men, more than 40
inches around the waistline are quick markers for
excess abdominal fat and the potential risk for some
health problems. What’s your “measure” of fitness?
As an adult in a healthy weight range, set your goal
on maintaining your present weight. However, if
you’re overweight, and especially if you already have
one of these health problems, you’re wise to trim down
gradually. At the very least, manage your weight so
you don’t gain more. (Note: Being overweight is a
problem when extra pounds come from excess body
fat. Because strenuous workouts build muscle, extra
weight from muscle isn’t a problem.)
If children and teens can keep a healthy weight
while they’re growing, their chance of being overweight adults is lower. More active play, fewer sedentary activities (such as TV and video and computer
games), and healthful eating are their best strategies to
a healthy weight.
For children, teens, and adults of any age, a healthy
weight is key to a long, healthy, and productive life.
The smart way to achieve that goal? Eat mostly nutrient-rich foods such as vegetables, fruit, grain products,
lean meats, and low-fat dairy foods, choose sensible
food portions, and keep physically active. For more
about weight management and health, see chapter 2,
“Your Healthy Weight.”


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FOOD CHOICES

FOR

FITNESS

9

Move It: The Food-Activity Connection

Guideline 2: Be physically active each day.
Physical activity is essential for your health, yet
most Americans don’t get enough. For those reasons,
being active every day is its own Dietary Guideline!
Your healthy weight is one key reason for regular
physical activity. But the benefits extend much farther.
See “Ten Reasons to Make the ‘Right Moves’” later
in this chapter. Try to accumulate each day at least
thirty minutes of moderate physical activity if you’re
an adult, and sixty minutes for children and teens. For
examples of moderate physical activity, see “Moderate Activity: What Is It?” below.
Get active . . . stay active . . . or become even more
active. Spread out your activity, or do it all at once;
either way offers benefits. If you haven’t been active,

E x e r c i s e Yo u r O p t i o n s
For more about the benefits of physical activity and
about ways to be more physically active, check here:
ⅷ For most healthy people, including those managing

their body weight . . . “Get Physical!” in chapter 2

ⅷ For children . . . “Get Up and Move, Turn Off the

Tube!” in chapter 16
ⅷ For teens . . . “Move Your ‘Bod’” in chapter 16
ⅷ For older adults . . . “Never Too Late for Exercise” in

chapter 18
ⅷ For travelers . . . “When You’re on the Road” in chap-

ter 19
ⅷ For athletes . . . chapter 19, “Athlete’s Guide: Winning

Nutrition”

MODERATE ACTIVITY: WHAT IS IT?
If some activities use more energy than others, you may wonder: Just what does “moderate physical activity” really mean? It equates to the energy you need to walk 2 miles in 30 minutes.
Moderate physical activity uses about 150 calories a day, or about 1,000 calories a week.
For that amount of energy expenditure, you might spend more time on less vigorous activities,
such as brisk walking, or spend less time on more vigorous activities, such as running.
SPORTING ACTIVITIES

DURATION

Playing volleyball

45 min.

15–60 min.

Playing touch football

30–45 min.

30–45 min.

Walking

13⁄ 4

30–40 min.

Basketball (shooting baskets)

30 min.

30 min.

Bicycling 5 miles

30 min.

30 min.

Dancing fast (social)

30 min.

Walking 2 miles (15 min./mile) 30 min.

Water aerobics

30 min.

Shoveling snow

15 min.

Swimming laps

20 min.

Stairwalking

15 min.

Basketball (playing a game)

15–20 min.

Jumping rope

15 min.

COMMON CHORES

DURATION

Washing and waxing a car

45–60 min.

Washing windows or floors
Gardening
Wheeling self in wheelchair
Pushing a stroller
Raking leaves

11⁄ 2

miles

Less Vigorous,
More Time*

More
Vigorous, Less
Time

Running

11⁄ 2

miles (20 min./mile)

35 min

miles (15 min./mile) 15–20 min.

* Some activities can be performed at various intensities. The suggested durations correspond to the
expected intensity of effort.

Source: Practical Guide to the Identification, Evaluation and Treatment of Overweight and Obesity in Adults (Bethesda,
Md.: National Institutes of Health, 2001).


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Te n R e a s o n s t o M a k e t h e “ R i g h t M o v e s ”
hether you’re involved in sports or simply live
an active lifestyle, physical activity pays big
dividends. Physical activity is the “right move”
for fitness—for almost everyone, not just for athletes.
Consider just a few reasons why:

W

1. Trimmer body. If you’re physically active, you’ll have
an easier time maintaining a healthy weight, or losing weight and keeping it off if you’re overweight.
For more about the benefits of physical activity for
weight management, see chapter 2, “Your Healthy
Weight.”
2. Less risk for health problems. An active lifestyle—or
a sports regimen—can help protect you from many
ongoing health problems.
Studies show that regular physical activity helps
lower risk factors. For example, physical activity
lowers total and LDL (“bad”) cholesterol and triglyceride levels while boosting the HDL (“good”) cholesterol level, controls blood pressure, and improves

blood sugar levels. Your risks for heart disease, type
2 diabetes, and colon cancer also go down when
you fit physical activity into your everyday living.
Active living also may reduce or eliminate the
need for medication to lower blood lipids, lower
blood pressure, or manage diabetes.
3. Stronger bones. Regular, weight-bearing activities
such as walking, running, weight lifting, crosscountry skiing, and soccer help make your bones
stronger. If you’re past age thirty-five, weightbearing exercise helps maintain your bone strength
and reduce your chance of fractures.
4. Stronger muscles. Strength-training activities such
as lifting weights at least two times a week keep
your body strong for sports and everyday living.

start gradually. Work up to longer, more intense activities for more benefits. As you plan, try to fit in physical activities that are especially beneficial:
ⅷ For flexibility, try stretching, yoga, and dancing.
ⅷ For strength, try weight-bearing activities (walking, tennis) for bone strength, and carrying groceries or weight lifting to build muscles.
ⅷ For cardiovascular fitness, try aerobic activities
that increase your heart rate and breathing.

When you’re strong, it’s easier to move, carry, and lift
things. When you exercise your muscles, you also
give your heart a workout. Remember, it’s a muscle,
too. A strong heart pumps blood and nutrients
more easily through your 60,000 miles of blood
vessels.
5. More endurance. You won’t tire as easily when
you’re physically active. And you may have more
stamina during the rest of the day, too.
6. Better mental outlook. Active people describe feelings of psychological well-being and self-esteem

when they make active living a habit. It’s a great way
to reinforce that “can do” attitude.
7. Stress relief and better sleep. Research shows that
physical activity helps your body relax and release
emotional tension. That promotes longer, betterquality sleep, and you may fall asleep faster.
8. Better coordination and flexibility. Your body moves
with greater ease and range of motion when you
stay physically active.
9. Injury protection. When you’re in shape, you more
easily can catch yourself if you slip or trip . . . and
can move away from impending danger more
quickly.
10. Feel younger longer. Research suggests that physical activity slows some effects of aging. Active people have more strength and mobility, and fewer
limitations.
For more about the benefits of physical activity, see
“Active Play: Good Moves for Children” in chapter 16,
and for older adults, “The Reasons Are Many” in chapter 18.

Have You Ever Wondered
. . . if you set a safe pace for physical activity? Take
the “talk-sing test” to find out. If you can talk as
you move, you’re okay. If you’re too breathless to
talk, slow down. And if you can sing, step up your
pace!


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FOOD CHOICES

Unless you have a health problem, you probably
can start moving more now! Talk to your healthcare
provider first if you have an ongoing health problem—
including heart disease, high blood pressure, diabetes,
osteoporosis, arthritis, or obesity, if you’re at high risk
for heart disease, or if you’re over age forty for men, or
over age fifty for women.

Build a Healthy Base
Four more Dietary Guidelines establish your base for
healthful eating. The familiar Food Guide Pyramid is
an easy-to-use planning guide that helps you get the
nutrients you need from food each day. Vegetables,
fruits, and grains form the foundation of the Pyramid
for good reason: you need plenty of them for good
nutrition and health, and to reduce your health risks. In
fact, try new foods from these groups in place of highcalorie, less nutritious foods you may be used to eating. And always keep your food safe—wherever,
whatever you eat!

Food Guide P yramid
A Guide to Daily Food Choices

Fats, Oils, & Sweets
USE SPARINGLY

Milk, Yogurt,
& Cheese
Group
2–3 SERVINGS

FOR

FITNESS

11

Food Variety—a Priority!

Guideline 3: Let the Pyramid guide your food choices.
If variety is the “spice of life,” in your food choices
variety is key to enjoying food and to good nutrition
and health. Each day your body needs the nutrients
and other healthful substances that a variety of food
provides. Most foods and beverages have more than
one nutrient. But no one food or food category has
them all.
The Food Guide Pyramid is an easy guide for what
to eat each day: for variety, so you get a range of nutrients, and for adequacy, so you get enough without
overdoing on calories. In fact, it’s flexible enough to
fit any healthful way of eating and include any food,
even occasional fats and sweets. The Pyramid recommends a range of servings, and identifies serving sizes.
It acts as a guide for an appropriate amount of food
for you.
The Food Guide Pyramid translates nutrient recommendations from the Dietary Reference Intakes
(DRIs) and the Dietary Guidelines for Americans into
practical advice for all healthy people, ages two years
and over. In chapter 10 learn how
to use the Pyramid to plan meals
and snacks.

KEY

Fat (naturally occurring and added)
Sugars (added)

Meat, Poultry, Fish,
Dry Beans, Eggs,
& Nuts Group
2–3 SERVINGS

Vegetable
Group
3–5
SERVINGS

Fruit
Group
2–4 SERVINGS

Bread, Cereal,
Rice, & Pasta
Group
6–11
SERVINGS

Source: U.S. Department of Agriculture/U.S. Department of Health and Human Services

Grain Products, Fruits, and
Vegetables—Enjoy!

Guideline 4: Choose a variety of
grains daily, especially whole
grains.
Guideline 5: Choose a variety of
fruits and vegetables daily.
Grain products, fruits, and vegetables (including legumes)—you
need more of these foods than others. Just check the serving recommendations in the Food Guide
Pyramid.
Grain products belong at the
base of the Pyramid; their complex carbohydrates should supply
most of your food energy. These
same foods also supply a unique
array of vitamins, minerals, and