Northwest Health Fall 2012

Become a Savvy Shopper

Making healthy food choices in the grocery store should be easy, right? Here's a handy reference to help you sort through product choices, complex labeling, and marketing hype.

Go to: Northwest Health Index

Walk into any grocery store and brace yourself. You'll be bombarded by thousands of items emblazoned with health claims, ingredient lists with mysterious words, and a whole lot of temptations. Not to mention widely conflicting serving sizes, confusing information about calories, and complex decisions about whether to buy organic produce and grass-fed beef, or the conventional varieties of both.

What's the average consumer supposed to do?  Group Health dietitians Eileen Paul, RD, and Jodi Augustine, RD, say that with just a bit of education, you can become a smart and efficient shopper while making healthy and economical choices the majority of the time. You can also learn what to pay attention to on a food label, and what to ignore as marketing hype.

Learn to Shop Smart

Follow these steps the next time you shop for groceries.

1.  Make a list. Divide it into categories such as fruits and vegetables, whole grains, lean meats, and so forth, to make shopping more efficient and ensure you buy the healthy foods you need. It will be immediately obvious if there's nothing listed under a given category, such as fruit. It's more difficult to catch this with a single long list of items.

2.  Shop the edges. The majority of healthy food is located around the edges of the store. That's where you'll find the largest selection of unprocessed, whole foods such as fruits and vegetables; dairy, soy milk, and similar products; and the fish and meat counters.

Obviously, there are some foods in this region to avoid or buy in moderation, such as fatty cuts of red meats, cured meats like bacon or salami, whole fat dairy products, and the bakery with its selection of highly processed, sugary pastries.

3.  Shop the aisles carefully.  Dive into a few selected inside aisles "so you can get whole grain bread, or go down the aisles for beans and grains and some of the other unprocessed foods there," Paul says. Other things to shop the aisles for: low-sugar, whole-grain cold breakfast cereals; oatmeal; and canned fruits and vegetables with lowered sodium levels and no added sugar, says Paul. You can reduce sodium and sugar in some canned foods, like beans or peaches, by rinsing them with water before eating.

4.  Don't forget the freezer section. The bags of broccoli, spinach, green beans, squash, carrots, peas, berries, and other fruits and vegetables are healthy choices. Most are flash frozen at their peak when nutrients are highest. Because of this, they may be more nutritious than fresh vegetables and they're usually more affordable.

5.  Use caution at the deli.  Sometimes prepared foods at the deli can be excellent choices, such as salads with plenty of veggies. But many deli foods contain high levels of sodium, like rotisserie chicken that has been soaked in a salty solution prior to roasting. Salads with dressings usually contain big doses of mayonnaise or oil — more than you might use if you made it from scratch.

Labeling: Marketing or Meaningful?

It's easy to get caught up in the latest food fad when the packaging screams at you with healthful-sounding words. A couple of current examples are "organic" and "gluten-free." The implication is that foods labeled this way are better for you. But that's often not the case.

It's important to educate yourself about foods you buy, even if you consider yourself a knowledgeable shopper, says Augustine. Here's what she says about some current labeling.

Organic. Produce with this label often isn't more nutritious. Studies show that certified organic produce has essentially the same amounts of vitamins, sugars, fats, and protein as conventional produce. The health benefit has more to do with the fact that pesticides and herbicides aren't used.

Non-produce foods that are labeled "organic" are even more suspect in terms of nutrition. "Choosing an organic food with lower nutritional value is not going to build a stronger body," Augustine says. "Is an organic cookie better than a conventionally raised apple? I would argue not."

Gluten-free.  Gluten-free foods are critical for anyone who has celiac disease or gluten sensitivity. But the percentage of people with such health conditions is low. Most gluten-free foods offer no health benefits for the majority of us. Avoiding whole grain products when gluten isn't a problem makes it more difficult to get important fiber and nutrients, says Augustine. There are many prepared gluten-free foods that aren't healthy. "Is a gluten-free cookie any healthier than a cookie with gluten? It's still junk food, low fiber, and sugary," she says. "There's no nutritional benefit to it." Both should be viewed as treats to be eaten in moderation.

All natural.  The claim "natural," as applied to most foods, is essentially meaningless. It does not mean organic and tells you nothing about what you're eating. A "natural" food like a granola or sports bar can be high in fat, sugar, or salt, and have little nutritional value.

Pasture-raised or grass-fed red meat.  Neither of these factors makes beef significantly healthier — and it often makes it more costly, Augustine says. "Yes, the fat is a little bit different in grass-fed beef in terms of saturated fat versus unsaturated fat, compared with regular beef," she says. "But it's still the overall quantity of fat that is going to make the biggest impact on your health." Look for the leanest cuts of meat to give you good quality protein with less of a nutritional downside. Then, if your budget allows, choose the organic or grass-fed version to limit pesticide and herbicide exposure.

Probiotics, omega-3, and added fiber. These are all good ingredients, but their presence alone doesn't make the food they're in healthy. Probiotics are strains of bacteria said to help digestive health. Omega-3 is a type of fatty acid that can boost heart health and lower triglycerides. Fiber is important for digestion.

"If you have a very high-fat food and it says it has added fiber or probiotics, that doesn't change the fact that it's a high-fat food," says Augustine. Eggs can have added omega-3, but you'd need to eat 20 in a week to get the recommended amount. You get more of the fatty acid by eating a small quantity of salmon.

Low fat.  "A low-fat food is not necessarily any lower in calories than a regular one," says Augustine. "The manufacturer may have replaced the fat with sugar and the calories are the same."

How to Read a Nutrition Facts Label

Labels are required for all prepared foods, though not for raw food. They are regulated by the U.S. Food and Drug Administration (FDA), which approves all health claims. Though they can be confusing at first, with a little practice you can build a comprehensive understanding about what foods to buy and what foods to avoid by reading the nutrition facts label, says Augustine.

A nutrition facts label tells you: What ingredients are in a product, some information about the quantity of those ingredients, the size of a serving, calories per serving, and nutritional content. It must include percentages of the following: total fat, trans fat, saturated fat, cholesterol, sodium, total carbohydrates, dietary fiber, sugars, protein, vitamin A, and calcium.

Begin by spending some time reading a lot of labels, especially those on the types of foods that you frequently consume. "You need to build up a knowledge base so you have some kind of a reference point," says Augustine. "For instance, if you eat cereal, by reading cereal labels you'll learn which ones have a lot of added sugar and which ones don't.  Eventually you'll know what cereal is best for you. It doesn't mean you'll have to read cereal labels every time you shop for the rest of your life."

Nutrition Information.  Limit sugar, fat, cholesterol, and sodium. "The recommended amount of sugar for someone on a 2,000 calories-a-day diet is 12 teaspoons. You could get half of that in one container of flavored yogurt — even one that's labeled low fat," says Paul.  Also avoid foods with added sweeteners such as high fructose corn syrup, sometimes rebranded as corn sugar. And remember that any sugar — whether in the form of corn syrup, honey, cane sugar, concentrated fruit juice, or brown rice syrup — is still sugar. It doesn't add appreciable nutrition to anyone's diet.

With fats, avoid foods high in trans and saturated fats and also fats described as hardened, hydrogenated, or partially hydrogenated. "These are red flags for fats that aren't good for you," says Paul. These fats are also tied to increased cholesterol.

The government recommendation for sodium is 2,400 milligrams (mg) a day for adults and only 1,500 mg for adults with some health conditions such as high blood pressure. A tablespoon of soy sauce may top out at 1,000 mg. Canned soup may contain 700 mg per serving. Even foods labeled "low sodium" may have several hundred milligrams of sodium.

If a food has a high percentage of fiber, that's a good thing. Many diets fall short on fiber, says Paul. "You want to get 25 to 30 grams of fiber a day. That pretty much means you need to include a high fiber cereal, grains, or beans in your daily diet." Foods with a high percentage of protein, vitamin A, and calcium are also usually good for you.

Order of ingredients. They are listed on the label by quantity from large to small. "If sugar is one of the first ingredients, or salt, you probably need to look at the serving size listed on the label and see how it fits in with your diet," says Paul.

Serving size.  Knowing serving size is perhaps the most critical part of analyzing a food label. A serving size is often much less than you would normally eat, so the nutritional information becomes deceptive. For instance, if the serving size on a can of reduced-sodium soup is half a can, ask yourself if that is realistic. Most people eat more — as much as the whole can. So instead of getting the promised low sodium, they get double the dose. "The whole can of low-sodium soup has about 500 mg of sodium, which may be about a third of your sodium for the day," says Paul.

Calories.  This ties closely to serving size. For instance, a serving of dried cereal may have only 120 calories, but that may be for a half cup of cereal.  Also pay attention to how many calories come from fat. It's generally a good idea to steer away from foods where a high percentage of the calories are from fat.

Percentage of daily value. This tells you how much of a particular nutrient is in one serving of food. For instance, a serving that has 10 percent protein means that it contains 10 percent of the recommended amount of protein for a day. But here's the catch. The percentages are usually based on a 2,000 calories-a-day diet. Many people — especially many women — don't need 2,000 calories a day. If they follow average label servings, they will eat more than they need. Meanwhile, those same 2,000 calories might be on the low side for an active younger man.

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