Tag Archives: calories

Fat still matters

Last week I wrote about some recent research suggesting that low-carbohydrate diets may be better for weight loss that low-fat diets. For many, this study reinforced the notion that traditional recommendations are wrong and that the key to good health is to eliminate carbohydrates from your diet. This couldn’t be further from the truth.

The recent study did show that people lost more weight and experienced beneficial changes in blood lipids when they followed a low-carbohydrate diet compared to those who ate a low-fat diet. However, this does not mean that low-fat diets aren’t effective for weight loss or that they are “unhealthy.”

In fact, low-fat diets have long been used effectively to promote weight loss, reduce heart disease risk, and lead to healthier eating in general. This is supported by the results of hundreds of research studies as well as the practical experience of health professionals and real people. Here are two reasons why fat still matters when it comes to health.

First, reduced-fat diets have been shown to improve blood cholesterol and lower the risk for heart disease. Eating a diet low in fat, especially saturated and trans fat, has been the foundation of nutrition recommendations for decades. The fact is that these diets are effective for weight loss, reducing cholesterol, and otherwise improving heart health.

One famous study demonstrated that following a low-fat diet contributed to a reduction in the severity of atherosclerosis, the narrowing of arteries that leads to many heart attacks. Literally hundreds of other studies have shown similar beneficial results.

This isn’t some magical effect of eating less fat, though. The health benefits are likely due to eating more vegetables, fruits, and whole grains as much as they are to reducing fat intake. The point is that adopting a low-fat diet can lead to better nutrition overall.

Second, reducing fat intake is a good way to reduce calories. This is true because fat contains nine calories per gram, more than twice that of carbohydrates and protein, so cutting fat is an effective way to cut calories. Limiting fat intake also reduces calories indirectly because many high fat foods are also high in sugar and calories (think of most desserts).

It is important to mention that simply reducing fat intake won’t always lead to weight loss; total calories must be lower, too. This is a mistake many make when they reduce fat intake, but increase the amount of calories from other sources, typically carbohydrates. Many low-fat foods are actually relatively high in calories due to added sugar or people tend to eat more of them (the SnackWell Effect).

The effectiveness of low-fat diets for weight loss has been demonstrated in research studies (like this one) and countless weight loss programs. In one notable study, a diet low in fat even led to weight loss in people who weren’t trying to lose weight. And don’t forget that in the recent study about low-carbohydrate diets, the subjects that followed the low-fat diet also lost weight.

For some people, cutting carbohydrates as a way to lose weight is reasonable; for others, reducing fat intake makes sense. For most people, though, doing both to some extent is the best option, but going to extremes is unnecessary.

Eating less added sugar and avoiding foods with added fats (such as French fries) are good recommendations for almost everyone. That said, there is little evidence for the benefit of limiting carbohydrates in the form of whole grains, legumes, vegetables, and fruits or the fat in meat and dairy.

The bottom line is that the quality of food we eat is more important than the specific amounts of the nutrients it contains. Eating low-carbohydrate or low-fat diets can help steer you toward making healthier choices, but so can avoiding processed foods in favor of wholesome, nutrient-dense “real” food.

Good sources of protein for your low-carb diet

Thanks to a recent study and media coverage (including me), low-carbohydrate diets are a popular topic of discussion. For many people, cutting back on carbohydrates is a good way to reduce calories to promote weight loss.

Most low-carbohydrate diets also emphasize protein intake. But finding healthy protein sources is important for promoting weight loss and good health.

This recent discussion about the best protein for optimal weight loss  on the Train Your Body show on RadioMD should help.

The diet wars continue

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best, you are forgiven. First we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better. And back and forth it has gone for years.

During this time, the prevailing recommendations have suggested that a diet low in fat and high in carbohydrates was best. But more and more research has supported the notion that cutting carbohydrates, not fat, would lead to greater weight loss. Although this has been supported by some research, critics pointed out that eating more fat would raise blood cholesterol and other risks for heart disease.

According to a recent study, though, low-carbohydrate diets seem to have benefits for promoting weight loss and improving some indicators of heart health over low-fat diets. But you should hold off on shunning fruits and vegetables in favor of cheeseburgers! Here is a practical interpretation of the research and some common sense recommendations, taken from my Health & Fitness column in the Aiken Standard this week.

The study, published last week in the Annals of Internal Medicine, reported on 150 men and women who either restricted the amount of carbohydrates or fat they ate. After one year, the group that ate a low carbohydrate diet lost over 7 pounds more than the subjects on the low-fat diet. Additionally, the low-carbohydrate diet promoted greater improvements in blood lipids than the low-fat diet.

This is important for two reasons. First, this wasn’t a weight loss study; the researchers were simply following the subjects to see what would happen as they followed either diet. The fact that the low-carbohydrate group lost more weight suggests that it is relatively easier to cut calories following this type of diet.

This is consistent with other research showing that eating more carbohydrates, especially refined carbohydrates and sugar, can actually make people feel hungrier and eat more. Indeed, other studies have shown low-carbohydrate diets to be more effective for weight loss than low-fat diets (although a more recent study suggests there isn’t such a difference).

Second, the greater decrease in triglycerides and “bad” LDL cholesterol and increase in “good” HDL cholesterol in the low-carbohydrate group were different from what might be expected. Conventional wisdom holds that a low-fat diet should have a greater effect on blood lipids. Since weight loss can have a big effect on blood lipids, the improvement in the low-carbohydrate group may be due to losing more weight, not a direct effect of the diet.

It is important to note that the low-fat diet also led to weight loss in this and numerous other studies. The critical component of any weight loss diet is that it is relatively low in calories, regardless of what nutrients supply those calories. Really, almost any diet will lead to weight loss as long as it contains less energy than what is expended, but a low-carbohydrate diet may be more effective for weight loss than the traditional low-fat diet.

The bottom line is that the best diet is one that emphasizes eating wholesome foods, not on cutting carbohydrates or fat. That said, limiting carbohydrates in the form of refined grains and added sugar is an excellent way to reduce calorie intake and improve the overall nutritional value of what you eat. And shifting toward more monounsaturated fats (think olive oil and nuts) rather than worrying about the total amount of fat you eat is also a good idea.

To make your diet healthier, add exercise.

The American diet is frequently blamed for the poor health of Americans and, increasingly, other countries. The quest for the healthiest way to eat can literally take people around the world to find the right foods eat.

Unfortunately, diets and supplements that include these “super foods” are rarely the answer to good health on their own. It turns out that the key getting the optimal health benefits from your diet isn’t the food itself—it’s exercise!

This is the topic of my Health & Fitness column in the Aiken Standard this week. It’s not to say that what you eat isn’t important (it is!). The point is that healthy eating will only get you part of the way to the goal of good health.

For decades scientists have tried to isolate the types of foods or individual nutrients that lead to good health by studying what healthy and unhealthy people eat around the world. In some studies eating more of a certain nutrient or food, like saturated fat or red meat, was associated with a higher risk of heart disease and people who ate more fish had better heart health.

This is how we arrived at the common guidelines that encourage us to eat more fish and less red meat. The assumption was that the saturated fat in red meat was the cause of more heart attacks in Americans while the beneficial oils in fish protected the Japanese from heart disease.

But these studies, or at least the interpretation of these studies, didn’t take into account the fact that the populations that had the higher heart attack risk were also less active than their healthier counterparts. Perhaps it was the physical activity that made the difference in health.

A good example of this is the popular Mediterranean diet, which is often touted as the healthiest diet in the world. It’s true that people in the Mediterranean region historically tended to have a lower risk of heart disease. This was thought to be due to their diet which emphasizes healthy fats from olive oil along with vegetables, whole grains, seafood instead of red meat, and red wine in moderation.

Unfortunately, eating more olive oil or drinking more red wine, both recommendations based on the Mediterranean diet, won’t necessarily make you any healthier. This is because health benefits are due to a complex interaction of what we eat and other lifestyle factors, including activity. And people in the Mediterranean region move a lot more than we do, a key to realizing the benefits of the local diet.

Another example is the Ornish diet, a low-fat, semi-vegetarian diet that has been credited with improving blood lipids and even reversing the process that clogs arteries in heart disease. This is part of the reason for the recommendation to avoid foods high in saturated fat and cholesterol and eat more vegetables. It’s true that this diet has been shown to improve heart health, but the subjects in the studies also exercised regularly. Achieving the full benefits of this diet requires exercise, too.

Even the typical American diet won’t necessarily be unhealthy when combined with enough exercise. The Olympic swimmer Michael Phelps famously revealed what he ate on a typically day. The amount and type of foods he consumed were not what you would expect from someone so fit and healthy! Without the hours of training he engaged in each day that diet would almost certainly have resulted in obesity and poor health.

So, as you work toward improving your diet, don’t forget about the importance of daily exercise or other activity in maximizing the health benefits. And when people ask your secret, you can tell them that the real key to a healthy diet is exercise.

Are fat-free and sugar-free foods healthy? Maybe not!

Have you ever felt confused by the health claims made about some foods? If so, you are not alone. Nutrition is isn’t always easy to understand and, unfortunately, misleading information on food labels only makes it worse.

There are a great many foods that seem as though they would be healthy choices for weight loss or good health in general. Surprisingly, some of these low-fat and low-sugar alternatives aren’t as healthy as you might think.

This is because, in many cases, the claims on the label only tell part of the story. This isn’t to say that the information is false, but it does require some interpretation to understand whether these foods are really a healthy choice.

My Health & Fitness column in the Aiken Standard this week includes two examples of label language that seems to indicate a healthier option, but may not necessarily be the case:

1. Fat-free

Cutting back on fat intake is a good way to reduce calories and is typically recommended for weight loss. It is also a major part of traditional recommendations to lower cholesterol and prevent heart disease, although recent research suggests this may not be so important.

In order to meet a demand for lower fat and lower calorie foods, manufacturers have long offered fat-free versions of popular items. Cookies, snack foods, and salad dressings are among the most popular fat-free foods, especially for people who are trying to lose weight.

However, the number of calories in the fat-free foods may be the same as the full-fat versions because manufacturers often add sugar to make these lower fat foods taste as good. This is often the case for cookies, cakes, and other fat-free baked goods.

In the end, these fat-free foods may not really be lower in calories. And common sense tells us that the best way to reduce calories is to eat fewer of these snack foods and dressings in the first place.

 2. Sugar-free

Reducing sugar intake is also a popular way to limit calories in many foods and beverages. Currently, sugar is viewed as a major contributor to obesity and poor health in general, so this also makes some foods appear to be healthier than they really are.

While it is true that sugar-free versions of desserts and snack foods do usually contain fewer calories, the alternative sweeteners used instead raise some concerns. While there is no good evidence that these sweeteners are harmful, they certainly don’t make these foods any healthier.

It is important to note that the concern is with foods that have added sugar, such as packaged or prepared desserts, baked goods, and snacks. Foods with naturally occurring sugars like fruits, fruit juices, milk, and some vegetables are not worth worrying about.

Again, the most reasonable approach to creating a healthy diet is to eat fewer foods with added sugar, not looking for foods that replace added sugar with artificial sweeteners.

The Bottom Line

The problem for most people isn’t that they are eating cookies with too much sugar or salad dressing with too much fat, it’s that they are eating too many cookies and using too much dressing in the first place. Lowering fat or sugar in these foods does little to make people healthier.

The only way to do that would be to limit the intake of these processed foods in favor of more “real” food. Indeed, fruits, vegetables, nuts, and natural oils (like olive oil) are widely thought to be healthful, certainly better than processed and modified alternatives.

Calories Still Count!

The debate about whether diet and exercise are the cause of or good treatments for obesity has been going for some time. A familiar point of argument is the role of total calories vs. the source of those calories.A new model of how obesity illustrates how calories in, calories out may not be the initial step in the cascade of physiological and behavioral factors that lead to significant fat gain. But this doesn’t change the fact modifying eating and activity behaviors are a key step in the development of obesity—and the key to weight loss.This is the topic of my Health & Fitness column in the Aiken Standard this week.


Eat less, exercise more. Calories in, calories out.

These phrases are probably familiar to you if you have tried to lose weight. This is because these concepts make up the traditional explanation for why people gain weight and the most common method of losing weight.

More and more research suggests that gaining and losing weight might involve more that the simple math of counting calories. It may be that the source of the calories matters as much as the total amount that you eat.

However, this doesn’t mean that you can ignore the calories you eat and expend through exercise and other activity. While it may be true that the quality of the food we eat is important, calories still count.

A recent article in the Journal of the American Medical Association proposes an alternative to the classic model of how weight gain occurs. Traditionally, an imbalance between calories in and calories out causes obesity. According to this model, eating too much and not being active enough results in increased fat storage.

The new model suggests that diet quality, especially the type and amount of carbohydrates, combined with genetics and lifestyle factors including getting enough sleep and excessive stress leads to fat accumulation. The excess fat alters levels of hormones and other factors that stimulate hunger and inhibit energy expenditure, including physical activity.

In the new model, increasing fat mass comes first and excessive food intake and inadequate activity follows. The end result is the same, though: a small increase in body fat turns into obesity.

This seems to suggest that carbohydrate intake, especially from refined grains and sugars, is the main culprit. This is good news for people who follow and promote low-carb diets! It also gives the impression that exercise isn’t as important as previously believed.

But a closer look at the new model shows that obesity—storage of excessive body fat—really is the result of too many calories in and too few calories out. The difference is that the eating and activity behaviors is driven by other factors.

The fact of the matter is that diet quality, genetics, and factors such as stress and sleep do play a role weight gain. Changes in hormones, sugars, and fats in the blood are real and powerful physiological signals that certainly contribute to obesity.

But so do changes in how much we eat and how active we are. It would be wrong to disregard these behavioral factors and the important role they play not only in body weight regulation, but in health in general.

Furthermore, the traditional calories in, calories out model of weight gain leads to a sensible treatment for obesity: Eat less, exercise more. Even though these simple recommendations can be challenging to implement, certainly in the long term, people who follow this advice do lose weight.

Even in the new model, calories in must be greater than calories out to lead to the significant fat gain that characterizes obesity. Additionally, the focus on the food quality is also consistent with this idea. People who get more of their calories from refined grains and sugars tend to consume more total calories.

As of now, the only treatments we have for obesity focus on changing energy intake and energy expenditure. This almost always involves altering eating and activity behaviors and frequently includes other lifestyle changes including stress management and getting enough sleep.

Given this new model of obesity, the best way to lose or maintain weight is not new at all: Eat less, move more, chill out!

Stealthy Healthy Eating

My Health & Fitness column in the Aiken Standard this week is about the many processed foods that include added nutrients, primarily vitamins, minerals, and fiber, to make them healthier. While this seems like a good thing—helping people get enough essential nutrients, even if they eat a poor diet—there are drawbacks to using these foods instead of eating actual food that contains these nutrients.


What if there was a way to get the benefits of eating vegetables without having to eat any vegetables? This may be a dream for millions of American children and adults who don’t eat enough vegetables.

Thanks to creative food processing, the healthy components of vegetables can be added to many foods, including soda, candy bars, and other sweets. Books and websites contain recipes for adding pureed vegetables to brownies and other baked goods. There is even a new line of prepackaged pureed vegetables to use!

The recommended intake of vegetables ranges from one cup per day for young children to 3 cups for adults. A simpler guideline is to fill half of your plate with fruits and vegetables at each meal. The goal should be to eat a variety of vegetables throughout the week.

There are plenty of good reasons for people to eat vegetables. Most vegetables are a low-calorie source of essential vitamins and minerals. The dietary fiber found in vegetables (and fruits and whole grains) plays a role in maintaining a healthy body weight, lowering cholesterol, and reducing the risk of some cancers.

Fiber is increasingly added to processed foods including granola bars and energy bars. It is possible to get up to half of your daily recommended intake of fiber by eating a single Fiber One bar. That is the equivalent of a cup or more of most vegetables! Considering that many of these snacks are essentially candy bars, they are a tasty way to get fiber.

Vitamins and minerals have long been available as supplements and added to certain foods, including products made from grains like pasta and bread. But now you can get vitamins in many soft drinks, many of which have as much sugar as soda. And calcium is added to a variety of foods from breakfast cereals to snacks.

There are, of course, some benefits of doing this. People who don’t eat a healthy diet can get enough essential nutrients through these products. Some of these foods are low in calories so they can help people who are trying to lose weight.

While these “hidden” nutrients may seem like a good solution for people who don’t eat enough vegetables, this form of stealthy healthy eating may have some negative consequences.

These processed foods may be high in sugar, fat, and calories which could contribute to weight gain. The fact that these foods are designed to taste good—many include chocolate—may lead people to overeat. Aside from excess calories, eating far too much fiber could cause GI discomfort or other health problems.

More concerning, though, is the fact that these foods set an expectation that healthy foods should be sweet. This is particularly problematic in children, who may avoid eating vegetables (and other healthy foods) in favor of sweet drinks and snacks that contain the same nutrients.

Additionally, getting vitamins, minerals, and fiber through processed foods keeps people from learning how to make healthy choices and prepare real food. This has consequences for developing healthy eating habits in both children and adults.

Focusing on getting individual nutrients over eating a variety of healthy foods is thought to be an important cause of the current obesity epidemic. Relying on processed foods with added vitamins, minerals, and fiber may be doing more harm than good to your health.

The bottom line is that you should get your nutrients from real food and balance what you eat with daily physical activity. Remember, good health comes from making smart choices, not from a bottle or a box!

How to win at losing: What to do when your diet ends.

In the past few weeks several community and fitness center-based weight loss programs have ended. Since many diets and exercise programs last 12–15 weeks, this time of year marks the end of many programs. During this time many people have met personal weight loss goals through individual diets and “biggest loser” type programs. (I have written about competition-type weight loss programs in the past here and elsewhere.)

One of these is the Team Lean program at the Y. This year over 1,600 people from the Aiken and Augusta area participated in this 12-week program that included weekly education sessions and weigh-ins, a strong group dynamic, and monitoring to prevent rapid, unhealthy weight loss. The average participant lost almost 10% of their body weight, which is sufficient to promote improvements in blood pressure, cholesterol, and diabetes.

This level of weight loss is common among people who participate in individual or group programs. But the real challenge is to maintain that weight loss after the program ends. Many people have successfully met their weight loss goal only to gain the weight back later. In fact, some people do it every year, losing and regaining the same 10 (or 20 or 30) pounds over and over.

Losing weight is challenging, to be sure. But maintaining weight loss can be even more challenging. Many people think that they are finished once their diet or weight loss program ends. The truth is that the end of the diet marks the beginning of the next phase: keeping the weight off. This is the topic of my Health & Fitness column in the Aiken Standard this week.

There is a practical reason why this happens. In order to lose weight and keep it off people need to learn a whole new lifestyle involving what, when, why, and how they eat as well as daily exercise. These lifestyle changes are difficult to make and can take months or years to fully adopt. In many cases, the weight loss program ends before people make lasting behavior changes and revert to their old habits.

While there are literally hundreds of diets and weight loss programs to choose from, “weight maintenance” programs are far less common. The good news is that following the advice of people who are successful at losing weight and keeping it off can help you maintain your weight loss.

The National Weight Control Registry (NWCR) is a collection of information submitted by individuals who have succeeded at long-term weight loss. These “successful losers” have lost an average of 66 pounds and kept it off for over five years, with some losing as much as 300 pounds! Best of all, they share the secrets of their success.

It turns out that they lost weight through a variety of diets and programs. Nearly half lost weight on their own and the other the other half followed of some type of program. Regardless, almost all of them increased their physical activity and modified their diet, suggesting that diet and exercise together are important for successful weight loss.

There is also variety in how NWCR members keep the weight off. Most report continuing to maintain a low-calorie, low-fat diet and doing high levels of activity. Almost 80% eat breakfast every day, 75% weigh themselves at least once a week, over 60% watch less than 10 hours of TV per week, and 90% exercise, on average, about 1 hour per day.

Many people worry whether they are following the “best” diet or weight loss program. The specific diet may not be as important as what you do when it ends. Notice that the majority of successful losers still control what they eat and nearly all exercise each day. This suggests that going back to the way you ate before you lost weight is unrealistic. And if you aren’t exercising, at least walking, every day already, now is a good time to start.

That’s NOT fruit!

Making healthy food choices is never easy. It is made more challenging by the fact that some foods that appear to be a smart choice may be less healthy than you think.

This is the topic of my Health & Fitness column in the Aiken Standard this week. It is a topic I have addressed in the past that is still relevant today. Specifically, regarding what my kids picked for breakfast this morning! This shouldn’t be a surprise, since many foods that look healthy, but aren’t are breakfast foods marketed to children.

Often, prepackaged fruits and vegetables contain added sugar, fat, or salt, making them less healthy than eating them fresh. Consumption these foods can also make it less likely that people—especially children—will eat fresh fruits and vegetables when they are available.

The problem is that these foods may look like fruit. They may even contain real fruit juice. But many drinks and snacks–especially for kids– that look like fruit are really candy in disguise.

Here are a couple of examples of foods that may appear to be healthy but, upon closer examination, turn out to be less nutritious than we might think.

Fruit snacks: These gummy fruit treats are a favorite among kids. If you check the package you will probably see that they contain real fruit or fruit juice, so they must be healthy, right? While there is variation among different brands, in most cases these snacks contain little, if any, actual fruit. If you read the ingredients you will see that they do contain lots of added sugar, meaning that many of these snacks are essentially candy. In fact, if you compare some brands of fruit snacks with something that is easily recognized as candy, such as gummy bears, you will see that they have a similar sugar content.

Fruit drinks: Not everything that looks like fruit juice is actually juice. Take Sunny D for example. This popular orange drink contains mostly sugar and water—and only 5% juice. By contrast, real orange juice contains fewer calories and more vitamins per serving. In fact, if you compare the ingredients and nutrition information, Sunny D is essentially orange soda without the bubbles!

There are two problems with this. First, some foods that appear to be healthy because they either claim to or actually do contain fruit are actually less healthy than we might believe. Considering that fruit snacks and fruit drinks are likely to be consumed as alternatives to real fruit juice or a piece of fruit as a snack, these foods could lead to poor nutrition. This is especially true in children.

Second, sweetness is one of the most important tastes we respond to. Consuming food and beverages that are flavored like fruit but are actually much sweeter may make real fruit less palatable. Again, this is especially true for children who may develop an expectation that strawberries should taste like strawberry-flavored fruit snacks or that orange juice should taste as sweet as Sunny D. These kids are likely to prefer the sugar-sweetened version over the real fruit. Since these sugar-sweetened “fruits” tend to be higher in calories, consumption of these foods is one contributor to childhood obesity.

This isn’t just the case with fruit. Adding salt and sauces to vegetables makes them more flavorful, to the point that many of us don’t eat plain vegetables very often. The majority of potatoes are consumed in the form of French fries, loaded with both fat and salt. This has changed how we expect potatoes to taste so that now we typically eat baked potatoes “loaded” with butter, sour cream, cheese or bacon. When was the last time you ate a plain baked potato?

But there are some simple steps you can take to get back to eating real fruit and vegetables. Look for 100% fruit juice or, better yet, a piece of fruit instead of fruit-flavored drinks. Instead of sugar-sweetened fruit snacks, try dehydrated fruit. Cut back on the salt, butter, and other toppings you add to vegetables or purchase frozen vegetables without added sauces.

Subway’s identity problem (and why it matters).

If you are looking for a healthy place to eat lunch, chances are you will think of Subway. More than any other fast food restaurant, Subway has developed a reputation for being a healthy choice, consistent with losing weight and an active lifestyle. While you can get healthy food at Subway, you may end up eating a meal that is similar to traditional fast food in terms of calories, fat, and sodium.

This “identity problem” — Is it a healthy option to regular fast food? Or just an alternative to fast food? —  is the topic of my Health & Fitness column in the Aiken Standard this week.  This matters, of course, because you may well be fooling yourself into thinking you are making healthy choices when you aren’t.

Subway has long been thought of a healthy alternative to traditional fast food. This is largely due to a menu that has fresh-looking sandwiches rather than burgers and fries. Food at Subway looks healthy. This image is enhanced by a marketing strategy that associates Subway with health and wellness, something they seem to do better than any other fast food chain. Advertisements featuring former Olympians were abundant during the winter Olympics television broadcasts and the continuing association with Jared Fogle, who lost nearly 250 pounds by drastically changing his diet—including eating at Subway—and becoming more active strengthen this image.

The Subway menu does include several sandwiches designated as Fresh Fit choices that are low in fat and calories and could contain a full serving of vegetables. If you read the fine print you will see that this is true if you order a 6-inch sandwich on plain bread with meat and veggies, but no condiments or cheese. Adding mayo, sauces, and cheese or substituting another bread will increase the calories and fat in the sandwich. But, if you make smart choices, select a healthy side such as apple slices, and have water, unsweet tea, or another calorie-free drink, you can get a healthy, low-calorie meal.

However, that does not mean that all of the sandwiches at Subway are good choices if you want limit calories or fat. One of the sandwiches featured currently is the Fritos chicken enchilada sandwich, which is served exactly as it sounds: shredded chicken topped with enchilada sauce and Fritos chips. But if it comes from Subway it must be healthy, right?

Wrong! If you look at the nutrition information you will find that this sandwich has 580 calories, 26 grams of fat (which account for 40% of the calories), and 1170 milligrams of sodium (nearly half of what you should get in a whole day). The best traditional fast food comparison is the Big Mac at McDonald’s, which has 550 calories, 29 grams of fat, and 970 milligrams of sodium. Considering that many people eat at Subway in an effort to avoid the fat and calories of fast food, this would not be a good choice.

The point is that while you can get a healthy meal at Subway, many menus items are as high in fat, calories, and sodium as food at other fast food restaurants. The image that Subway has carefully cultivated likely conceals this fact, leading people to think they are eating a healthy meal when, in reality, they are not. It is also possible to get a meal at McDonald’s and many other fast food restaurants that is nutritionally similar to the healthier sandwiches at Subway.

This is a good lesson, since menus at many restaurants include a “healthy choices” section. Keep in mind that food that appears to be healthy may not be and that a restaurant typically thought of as a poor choice may have healthy menu items. The trick is to check out the nutrition information and make smart choices.