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O.K., so maybe the experts were a little naive about human nature. But no one anticipated the enthusiasm with which the food industry would jump on the low-fat bandwagon. Alas, it mostly just replaced the fat with refined foods and sugars and left consumers with the impression that they could eat as much of this stuff as they wanted.
As if that weren't bad enough, it is becoming increasingly clear that some folks respond to highly refined foods differently than the rest of the population. All carbohydrates get broken down in the body into a simple sugar called glucose. This is a good thing, since glucose is the principal fuel that powers our bodies and brains. But about a quarter of American adults--some 50 million men and women--have trouble regulating their glucose levels. The hallmarks of this condition, which nutritionists now call metabolic syndrome, include a big waist (40 in. or more for men; 35 in. or more for women), high blood pressure (more than 130/85 mm Hg), a predisposition toward diabetes and troubling cholesterol levels in the blood.
Doctors aren't quite sure exactly why the body sometimes reacts this way, though they know that metabolic syndrome is exacerbated by a sedentary lifestyle. Hence their No. 1 recommendation for patients with metabolic syndrome is to get more exercise and build muscle mass. But they also now advise them to replace at least some of the refined carbohydrates in their diets with healthy fats, like those in nuts and olive oil. In 2000 the American Heart Association, which has long touted the advantages of a low-fat lifestyle, added an exception to its guidelines for folks with this condition.
None of this means you should avoid eating fruits and vegetables. (In their natural form, they are not highly refined.) Just make sure that they are as colorful as possible--in order to get a wide variety of nutrients and those ever important antioxidants. Using spinach instead of iceberg lettuce in a salad, for example, will double the dietary fiber consumed, more than quadruple the calcium and potassium, more than triple the folate and provide seven times as much vitamin C. If you don't like spinach, try a more nutritious lettuce like romaine or Boston.
Your goal should be to eat at least five 1/2 cup servings of fruits and vegetables a day--and preferably more. (Nine is divine, according to the latest nutritional research.) Don't assume that fresh is the only game in town. "Frozen can be just as good and occasionally better," says Lichtenstein at Tufts. Because frozen fruits and vegetables are chilled immediately after being picked, they often contain more nutrients than produce that has been sitting on the shelf.
SIRLOIN, SALMON OR BEANS?