When I meet new people in social settings, sometimes I try to avoid the so-what-do-you-do-for-a-living conversation. That’s because I know what kind of questions I’m going to get after revealing that I’m a dietitian: “What do you think about the X diet?” “Is it good to eat Y?” “Is it bad to eat Z?” Even though I am passionate about food and nutrition, even dietitians need a break sometimes from assessing diets!

While it can be tedious to be asked these questions over and over, I’ve come to realize that the fact so many people are asking them reveals a couple of things. First of all, it shows a sincere interest in healthy eating in our society - which is great! However, among the interest I also hear a massive amount of confusion about how to eat healthfully, which is not so great. Not that I blame anyone who’s not in a nutrition-related field for feeling that way.

I genuinely have sympathy for people who want to learn about healthy eating. Unfortunately, there’s a lot of misinformation about nutrition that gets put online by people who are trying to sell a product and/or lack the credentials to be giving nutrition education to the public. I myself have seen tons of clickbait articles with titles like: “Why everything you thought you knew about nutrition is totally wrong” or “Never, ever - under any circumstances - eat these 5 vegetables” or “Always eat these 5 vegetables (which are the same vegetables from the last post)”. I get why people are confused! If you’re being bombarded by these sorts of messages, it makes sense why healthy eating seems like such an unclear concept.

Though the average person might not know where to turn for reliable nutrition information, as a registered dietitian, this is my forte. I’ve spent a lot of time reading up on the dietary guidelines released by Health Canada, the U.S. National Institutes of Health, and the U.K. National Health Service. Don’t worry, I got your back. I know how helpful it is to have clear, concrete recommendations to follow. That’s why I’ve summarized the latest healthy eating guidelines for you in this post. I’ve also provided a quick and simple tool routinely used by dietitians that you can use to assess your own diet.

For the general population, following these guidelines is a helpful way to ensure your nutrition needs are met. And completing the assessment tool below may reveal certain areas of your diet that can use improvement. However, this article is not intended to be a substitute for a consultation with a registered dietitian. If you have concerns about your nutrition status and/or have a medical condition that requires management with diet, please consult a healthcare professional.

Canada’s Food Guide Offers Easy-to-Follow Guidelines [1]

“Wait, I heard the latest food guide is no good. You’re saying you want me to follow it?” I know there was a lot of hubbub in the news and online when Canada’s Food Guide was updated in 2019. While there were legitimate criticisms made of the new guide, in my opinion, the flaws in the updated guidelines were blown out of proportion for clicks and views. You can read more about the latest food guide and my thoughts on it here.

The main reason why I like the 2019 Canada’s Food Guide is that it gives simple recommendations that can be easily followed in daily life. The use of the Plate Model is a good case in point.

The Food Guide is full of realistic recommendations that are easy to apply. Regardless of your eating style (vegetarian, gluten free, intermittent fasting, diabetes-friendly, etc), following these guidelines is a great way to ensure you’re eating a healthy diet: 

• use food labels:

  • limit foods high in sodium, refined sugars, and saturated fat. Check out the % Daily Value on the nutrition facts label. A good rule of thumb is 5% or less is a little, 15% or more is a lot.

  • take a look at the ingredient list. The ingredients in a food product will be listed by weight. That means the list will start with the ingredient that weighs the most and ends with the ingredient that weighs the least. The ingredients that show up first in the list will reveal whether a food product is a healthy choice. For example, if words like “corn syrup”, “fructose”, or “glucose” are listed near the beginning of the list, the food product is likely high in refined sugars and is a less healthy choice.

• cook more often:

  • plan your meals. Knowing what you’re going to make and having the ingredients for your healthy meal ready to go in your kitchen will set you up to make healthy decisions. 

  • when cooking, use herbs and seasonings to add flavour instead of salt and pre-made sauces. Try to limit the amount of saturated fat (ex: butter) and sweeteners (ex: honey, syrups) you add to your cooking and baking.

  • limit highly processed foods in your diet: sugary drinks, chocolate, candies, ice cream, frozen meals (ex: pizza), and processed meats (ie: sausage, deli meat)

• make water your drink of choice. Replace sugary drinks with water flavoured with fresh/frozen fruit, vegetables (like cucumber), or herbs (like mint).

• choose plant sources of protein more often: 

  • choose one day each week to be meatless (ex: Meatless Monday)  OR

  • have a meatless meal each day  OR

  • replace half the meat you would normally eat in a given meal with plant protein

• don’t forget the social aspect of food: cook and eat with others

• practice mindful eating: eat when you are hungry and stop eating when you are full. Read more about noticing your hunger and the Hunger Scale here.

A blast from the past:

My favourite recommendation from the 2007 food guide is to eat a green vegetable and an orange vegetable each day. 13 years later, I feel it’s still relevant. This guideline is easy to remember and will help you incorporate foods into your diet that are rich in B vitamins, vitamin A, iron, calcium, and potassium.

The Mediterranean Diet [2]

Before getting into the diet assessment tool, I need to give some background. The assessment tool is based on the Mediterranean diet. The Mediterranean diet is the name given to the dietary patterns practiced in Southern Italy, Greece, and Crete. Why is there so much buzz around this diet? A ton of research has been done on this style of eating and the data show that this diet produces excellent health outcomes. People who follow the Mediterranean diet tend to have a lower risk of heart disease, diabetes, stroke, Parkinson’s disease, Alzheimer’s disease, and depression. The diet is also used to improve heart health in people who have had a heart attack and it helps manage blood sugars in people with diabetes. 

Sounds like the diet to end all diets, doesn’t it? So how exactly does one practice the Mediterranean diet? Here are the details: 

Choose daily: fruit, vegetables, whole grains, legumes, olive oil, cheese & yogurt, herbs & spices

Choose weekly: fish, chicken, eggs, sweets

Choose monthly: red meat, processed meats, fast food

+ Drink wine with your meals, 3 or more times per week

Now, I’m not saying that everyone should drop their preferences, cultural/religious practices, etc to adopt this diet to a T. However, what the research on the Mediterranean diet ultimately shows is that there are certain general dietary practices that result in positive health outcomes. Studies have shown time and again that implementing these habits will improve the health of the people who practice them:

• eat a diet rich in fruit, vegetables, whole grains, unsaturated fats, fish (or other sources of omega-3 fatty acids), and legumes

• limit the amount of red meat, saturated fat, and processed foods in your diet

• cook from scratch often, using herbs and spices instead of salt to flavour foods

• practice portion control

• cook and eat with others

(You’ve probably noticed that these Mediterranean practices are very similar to the guidelines found in Canada’s new food guide. See, I told you the updated version is good stuff!) Regardless of your style of eating, try to incorporate as many of these characteristics into your diet as you can. To find out which areas of your diet can use improvement, try taking this short quiz. 

The Mediterranean Diet Score Tool [3]

Answer “yes” or “no” to each question. At the end, tally up the number of yeses. Research on this tool has shown that the higher the score, the better the health outcomes. Work towards a score of 10/14 or higher [2]. 

1) Is olive oil the main fat used in your cooking?

The Mediterranean diet is big on choosing healthier (ie: unsaturated) fats when preparing foods instead of saturated fats (like butter, lard, coconut oil, etc). Olive oil is specifically named in this assessment tool because that’s the main cooking oil used in the Mediterranean. However, in my professional opinion, you can answer “yes” to this question if you mainly use any oil that is high in unsaturated fats for cooking: canola, corn, olive, peanut, safflower, soybean, and/or sunflower [4].

2) Are 4 or more tablespoons of olive oil used on the average day?

Again, olive oil can be substituted for any of the oils listed above, which are rich in unsaturated fats. Though the recommended amount of oil might seem high to some, studies actually demonstrate that diets rich in healthy, unsaturated, fats are better at preventing heart disease than diets that are very low in fat. 

3) Do you eat 2 or more servings of vegetables on the average day? (1 serving = 1/2 cup cooked or 1 cup raw)

4) Do you eat 3 or more servings of fruit on the average day? (1 serving = 1/2 cup fresh, frozen, or canned)

The conventional wisdom of eating your fruits and vegetables is backed up by science. You can ensure your vitamin and mineral needs are met by eating a variety of fruits and vegetables each day. Eating a diet rich in produce also decreases the risk of heart disease and cancer. 

5) Do you eat less than one serving of red or processed meats on the average day? (1 serving = 2.5 ounces, or the size of a deck of playing cards)

Red and processed meats are high in saturated fats and processed meats are high in salt. Try replacing red and processed meats with poultry, fish, and plant-based sources of protein.

6) Do you eat less than 1 serving of butter, margarine, or cream on the average day? (1 serving = 1 tablespoon)

These foods are very high in saturated fats. Try using plant-based fats instead. 

7) Do you drink less than 1 serving of sugar-sweetened beverages (juice, pop, energy drinks, etc) on the average day? (1 serving = 330 mL or 1.5 cups)

Consuming excessive amounts of refined sugar increases the risk of diabetes and heart disease.

8) Do you drink 3 or more servings of wine each week? (1 serving = 1/2 cup)

Scientific studies suggest that moderate alcohol intake can be beneficial to your health. However, there is no evidence to show that it benefits non-drinkers to start drinking alcohol. So if you don’t drink due to religious, moral, or any other reason, keep doing what you’re doing. 

9) Do you eat 3 or more servings of legumes each week? (1 serving = 1 cup)

Legumes (ie: beans, lentils, and peas) are high in soluble fiber, which helps you feel full for longer after eating, decreases cholesterol levels in your blood, and feeds the microbes in your gut. They’re also a great source of nutrients, including protein, iron, zinc, and magnesium. 

10) Do you eat 3 or more servings of fish or seafood each week? (1 serving = 1/2 cup or 2.5 ounces or the size of a deck of playing cards) 

Seafood is rich in unsaturated fats, including omega-3 fatty acids. If you don’t eat fish or have an allergy, I recommend taking a supplement to meet your omega-3 needs. (Please consult a healthcare professional before taking a new supplement if you are on any medications and/or have any medical conditions.)

11) Do you eat less than 3 servings of sweets (candy, chocolate, pastries, store-bought baked goods, etc) each week? (Refer to the food label for serving size.)

Limiting processed foods is a major characteristic of the Mediterranean diet. This type of food tends to be high in refined sugars, saturated fat, and salt. Try replacing processed foods with produce, whole grains, and lean protein. 

12) Do you eat 3 or more servings of nuts per week? (1 serving = 2 tablespoons) 

Nuts (ex: walnuts, almonds, hazelnuts, peanuts) are a great source of unsaturated fat, fibre, vitamin E, and iron. Choose unsalted rather than salted nuts as often as possible.

13) Do you routinely eat white meats (chicken, turkey, rabbit) instead of veal, pork, ground beef, and sausage?

White meats are lower in saturated fat. When cooking meat, choose healthier cooking methods, like grilling, roasting, and stir frying. Side note: the skin on poultry is high in saturated fat. Removing the skin from poultry before eating it will decrease the amount of saturated fat in your meal. 

14) Are dishes flavoured with garlic, tomato sauce, or onion 2 or more times each week?

Using spices and herbs to flavour dishes instead of salt is a key feature of the Mediterranean diet.

What was your score? Which areas of your diet need improvement? Pick one area to work on over the next couple weeks!

References

[1] Health Canada. (2020) Canada’s Food Guide. Government of Canada. <https://food-guide.canada.ca/en/?wbdisable=true> Accessed June 29, 2020.

[2] Werstuck, M. & Kapuscinski, L. (2017) Eating Mediterranean? Assessing adherence to the Mediterranean diet to promote healthy eating. Nutrition Resource Centre. Powerpoint Presentation. <https://opha.on.ca/getmedia/3e87247a-bb14-40b6-a5fe-547cefb672e7/NRC-Webinar-Eating-Mediterranean.pdf.aspx> Accessed June 29, 2020.

[3] Homby, A. & Pateron, K. (2013) Mediterranean Diet Score Tool. British Heart Foundation. <http://www.cardiacrehabilitation.org.uk/docs/Mediterranean-Diet-Score.pdf> Accessed June 29, 2020.

[4] American Heart Association. (2018) Healthy Cooking Oils. <https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/healthy-cooking-oils> Accessed July 7, 2020.