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Healthy Eating Habits

Developing healthy eating habits early is highly beneficial to promoting a long lasting and productive life. With the emergence of fast foods, processed foods, and other easy and cheap food options, the occurrence of obesity, diabetes, and other preventable diseases and disabilities have increased in nearly every country in the world, and especially in America. American culture has become used to the excessive abundance of inexpensive and readily accessible food supplies available all hours of the day. Such a culture has encouraged a gluttonous lifestyle prone to snacking and grazing with no established mealtimes. Several innovative policies to reduce overeating and improve dietary quality have been addressed and implemented, but a lot can also be done on an individual basis.

What consists a healthy diet?

Including a variety of colorful vegetables, including legumes (i.e. beans, peas), and several sources of protein including seafood, lean meats and poultry, eggs, nuts, and seeds, are key guidelines to sustaining a healthy diet and lifestyle. Additionally, Americans should aim at consuming less than 10% of calories per day from added sugars and saturated fats, and consume less than 2,300 mg of sodium. Currently, Americans get 13% of their calories from added sugars and children consume as much as 17%. Vitamins A, C, D, E, calcium, potassium, and fiber should also be consumed more regularly.

USDA Food Pyramid

Model countries

In several western European countries - France, Spain, Italy, maybe others - there is less disintegration of family structures around mealtimes. In these countries, meals seem to hold more importance than in the U.S. As a result there is significantly less disease and disability prevalent around eating habits. In France, for example, the obesity rate is exactly half of what it is in the U.S.

With the way American culture has evolved, becoming more efficient, so has the way Americans eat - efficiently. Since the Industrial Revolution, Americans' lives revolve around a stringent work schedule, 9am-5pm with little time for breaks and a healthy, balanced meal. The sandwiches we slap together and throw into a paper bag or the soup ladled into cardboard containers and balance on cafeteria trays - is a relic of the same shift: these quick, simple staples came to the rescue when the noontime feed assumed its new identity as an away-from-home routine. Cold staples that do not require utensils and no-frill, low-cost prepared foods at quick-service venues gained popularity largely for reasons of practicality. They were practical then, and they remain practical now.

A healthy meal

Looking at European cultures, the opposite is true. It is not unusual to take over an hour lunch break, with family and a home cooked meal. Snacking and grazing are almost non-existent, or there is a pre-determined time in the afternoon for a light snack; known as a merienda in Spain and Portugal, and a goûter in France for example.

The tradition of healthy eating in Southwestern and Mediterranean Europe consists of a high percentage of fruits, vegetables, cereal products, legumes, olive oil, and minimal amounts of animal products, with a focus on high quality products and produce freshness. It was already possible to demonstrate in the 50s that the Mediterranean countries have significantly less coronary heart disease than northern Europe and the USA and that this correlated closely with the diets of people in the Mediterranean region.

Improving Eating Habits

Early Education

Our eating habits are largely rooted in human behavior, and can be difficult to alter the longer we practice them; Food preferences have been shown to take shape early in life and track further on until adulthood. Early education of food habits in children begins as early as the weaning process in infants. During the weaning process, infants are introduced to different types of food from vegetables and fruits to grains, fish, and dairy. Essentially, weaning should supply essential macro and micronutrients for proper development and growth, taking care to avoid nutrients that may have negative health effects. Avoidance of such foods and beverages containing high amounts of sugar and salt for example can prevent the development of an over-dependency on such nutrients. Long term effects of such an over-dependency has lead to childhood obesity, hypertension, and cardiovascular disease.

Proper education of healthy eating habits in schools is also essential. Children spend a good part of their day in school, eating 47% of their daily calories through the National School Lunch Program, away from the supervision of parents who would otherwise have direct control over their meals. Schools in the U.S. are notoriously known for providing their students with low-nutrient, energy-dense foods. Several simple interventions can be made to promote a healthier diet in schools:

First Lady Michelle Obama, Sam Kass, Senior Policy Advisor for Healthy Food Initiatives, and Top Chef head judge Tom Colicchio, establish initiatives to provide healthier food to students. (Official White House Photo by Sonya N. Hebert)

• Modification of choice - pre-ordering lunch versus deciding in the cafeteria line made students more likely to choose more nutrient-dense foods.
• Behavior modification - token reward system for eating at least one-eighth cup of fruits and/or vegetables at lunch
• Marketing strategies - price reduction to encourage healthier food purchases at schools
• Time-efficiency strategies - express line offering healthier foods
• Fruit slicing - when slice fruit is offered, fruit consumption increases (from 5.5% to 16.2% in one example)

Individual Strategies

Although most people's eating habits were established early in life, shaped by sociological, economic, biological, and environmental factors, it does not mean it is too late to change them. It is also important to do so gradually. Making radical changes too quickly can result in short term weight loss, and are neither healthy nor a good idea, and won't be successful in the long run. A successful approach requires reflection, replacement and reinforcement.

Adult Obesity - CDC Vital Signs - August 2010

Reflect - review current eating habits both good and bad, and common triggers for unhealthy eating

• Keep a food diary listing what foods are eaten throughout the day at which times, and how much
• List common habits
  • eating too fast
  • always finishing the plate
  • eating when not hungry
  • eating standing up
  • eating dessert consistently
  • skipping meals

Replace - replace unhealthy eating habits with healthier ones

• limit calories from added sugars and saturated fats
• reduce sodium intake (> 2300 mg per day)
• focus on variety, nutrient density and amount
• shift to healthier food and beverage choices
• eat more slowly
• snack less

Reinforce - reinforce these new, healthier eating habits

• Be able to recognize and stop bad eating habits if they redevelop
• Be patient
• Be vigilant

Policy

World map of Female Obesity, 2016

As humans are quite vulnerable to making poor food choices, policies therefore play a highly important role in regulating those choices to best benefit a human life's longevity. These policies are evidence based and focus on identifying and setting interventions to limit exposures in the environment that can lead to negative health outcomes. Additionally, they are separated into six categories: mandates, restrictions, economic incentives, marketing limits, information provision, and environmental defaults.

Mandates

• New York City (NYC) Board of Health’s 2006 ordinance - prohibited restaurants from cooking with trans fats

Restrictions

• 2011 ban on the sale of SSBs from city property in Boston, Massachusetts
• SSB ban in all food establishments within a children’s hospital in Ohio (USA)
• Minimum legal age to purchase alcohol and tobacco
• In 2014 Lithuania became the first country in the European Union to ban energy drink sales to anyone under the age of 18 years
• Healthy, Hunger-Free Kids Act of 2010. Public Law 111-296, 111th Congress, enacted December 13, 2010 - the USA enacted a policy to update the federal nutrition standards for all foods and beverages in schools, requiring more servings of fruits and vegetables, limiting kilocalories (calories), saturated fat, and sodium, and restricting access to candy and SSBs

Economic incentives

• Implementation of taxes (1-7%)on foods of low nutritional value, including soda, junk food such as potato chips and candy, and high-fat items
• Berkeley, California, passed an excise tax on SSBs (US$0.01 per ounce [~30mL]) in 2014
• Mexico enacted a one peso (US$0.08) per liter excise tax on SSBs and an 8% sales tax on junk food (energy-dense, non-staple foods) in 2014

Marketing limits

• Australia has banned television advertisements aimed at children 13 years old and younger
• Sweden, Norway, and Quebec now ban all television advertising aimed at children, regardless of the product involved
• South Korea restricted television advertising of energy-dense and nutrient-poor foods targeting children in 2010

Information provision

• Patient Protection and Affordable Care Act. Public Law 111-148, 111th Congress, enacted March 23, 2010 - USA has passed a law requiring menu labeling in large chain restaurants
• In 2014 Ecuador passed a mandatory traffic light labeling policy for packaged foods
• Voluntary labeling schemes are used in countries such as Denmark, Norway, Sweden, and Singapore
• In the UK, some food manufacturers have adopted a multiple traffic light labeling system on packaged food and beverage products to signal whether products have low (green), moderate (yellow), or high (red) levels of sodium, sugar, and unhealthy fats
• Trans fats were reduced in some packaged foods following their mandatory inclusion on the nutrition facts label in the USA
• In 2014, the World Health Organization issued draft guidelines to limit sugars to 5% of total daily energy intake
• In 2015, the USA Dietary Guidelines Advisory Committee issued a scientific report recommending that the federal government limit added sugars to below 10% of total daily energy intake
• In 2008 the Australian government launched the ‘Measure-Up’ campaign to link waist circumference with chronic disease risk
• Los Angeles County Department of Public Health (California) launched the “Sugar Pack” health marketing campaign in 2011 to educate the public on reducing excess calorie intake from SSBs

Environmental defaults

• In 2015 major fast-food chains McDonald’s, Wendy’s, and Burger King all dropped soft drinks from their children’s menus
• Increasing access to healthy foods through farmers’ markets and mobile vendors of healthful foods
• Subtle environmental cues such as smaller plate size
• Pre-committing to healthier food choices by ordering food ahead of time