Tag Archives: diet

The five pillars of good health

Posted on January 12, 2015 | 2 comments

What does it really take to live a healthy lifestyle? This is the topic of me Health & Fitness column in the Aiken Standard this week.

Confusing and conflicting information can make improving your health especially challenging. Some advice is straightforward—quit smoking, for example. But other recommendations, especially those regarding nutrition and exercise, are less clear. In an effort to stay focused on the “big picture” I have created what I call the Five Pillars of Good Health. These are five habits that are the basis for achieving and maintaining good health.

Don’t Smoke.

Smoking doubles your risk of heart attack and stroke and is the leading cause of lung cancer. Second-hand smoke can affect the health of others, so these risks are not limited to the smoker.

If you smoke, quit now…no excuses! Newer prescription medications and over-the-counter nicotine replacement products can help, but quitting will require dedication, effort, and support.

Eat Smart.

Good nutrition is essential for preventing and treating most chronic diseases including obesity, diabetes, and heart disease. Perhaps the best way to cut through the conflicting nutrition information and diet claims is to simplify healthy eating to it’s most basic form: Eat real food, not processed “food.”

This isn’t easy, of course. One sure way to make better choices is to limit added sugars and salt, which are almost always present in processed foods. Strive to eat more whole fruits and fruit juices, vegetables, whole grains, legumes (like beans), lean meat, dairy, and nuts. If weight loss is a goal for you, reducing portion sizes will absolutely help you cut calories.

Move More.

This is a three-step process. First, sit less. Limit sedentary time at work and home and make opportunities to get up and move. The health effects of prolonged sitting are similar to not exercising. If you find yourself in stuck a chair for an hour, at least get up and stretch for a minute.

Second, move more. Look for ways to add activity to your everyday routine. This can include yard work and house work as well as using the stairs and parking further away in parking lots. Every additional step counts!

Third, dedicate time to be active every day. This can include activity such as taking the dog for walk as well as more structured exercise that includes endurance, resistance, and flexibility training. Strive for 30 minutes per day, but know that more is better.

Chill Out.

Chronic stress can have a powerful effect on your health. While it is not possible to eliminate all stress from your life, you should dedicate yourself to identifying and modifying sources of stress at work and home and learning to control your stress response.

Much of the stress of life comes down to not having enough time. Good time management, planning carefully, and setting priorities will certainly help reduce both long and short-term stress. You should also know that inadequate sleep adds to the health effects of stress, so strive to get enough sleep.

Make It Work For You.

This is the tricky part—how to actually make these changes. The first step is to make good health a priority and dedicate time and energy to your efforts. No doubt you have tried some of these changes before, you probably have an idea of what does and doesn’t work for you. Try something different this time around. The support of others is essential, so don’t be afraid to ask for help. Get your friends and family involved, too. They will certainly benefit from joining you on your journey toward better health.

 

 

 

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Not sure where to begin to improve your health? A guide to taking the first step

Posted on December 15, 2014 | Leave a comment

If you are thinking about losing weight, becoming more active, or quitting smoking you are not alone. These are three of the most common health-related New Year’s resolutions. Considering that two-thirds of American adults are overweight, about half don’t meet minimum recommendations for physical activity, and one in five smoke, there are many people who need to change more than one of these behaviors.

Quitting smoking and changing eating and exercise habits to lose weight or improve fitness are among the most difficult behavior changes to make, especially at the same time. Some people focus on one change to begin with.

Obviously, changing all three of these behaviors is ideal, but if you are only willing to change one, which should you take on first to have the biggest impact on your overall health? This is the topic of my Health & Fitness column in the Aiken Standard this week.

You might think that quitting smoking would be the most important change to make initially. Smoking is the primary cause of lung cancer and other respiratory diseases such as emphysema and chronic bronchitis. Smoking also increases the risk of most other cancers and is a major contributor to heart attacks and strokes. Quitting smoking greatly reduces these risks with beneficial changes that begin within days of quitting. Despite this, if you only want to change one behavior, smoking isn’t the place to start.

Being overweight is a leading cause of diabetes, high blood pressure, heart disease, and some cancers. If you are overweight, losing just 10% of your body weight (20 lbs. for a 200 lb. person) can significantly reduce the severity of these conditions. Maintaining a healthy body weight can prevent many of these health problems. However, losing weight is not the first change you should make.

It turns out that becoming physically active is the most important change you can make to improve your overall health. Decades of research show that regular physical activity reduces the risk of most chronic diseases including diabetes, heart disease, and some cancers and can extend the lifespan by up to five years. In fact, the health risks of inactivity are equal to or greater than that of obesity or smoking. Regular activity also improves muscular strength, aerobic fitness, bone density, cognitive function, and memory. There is no other single intervention—drugs included—that has as many health benefits.

Research also shows that the negative health effects of being overweight and obesity are, in part, caused by inactivity and poor fitness. If you are overweight but physically fit, your risk of death is lower than if you are at a “healthy” weight but unfit. Regular exercise can reduce the risk of diabetes in people who are overweight, whether they lose weight or not. Furthermore, studies of “successful losers” show that daily exercise is a requirement for long-term weight loss, so becoming active now can help you lose weight later.

You should change all three of these behaviors to achieve optimal health. But if you are looking for an initial step that will have the biggest impact, start by becoming more active. A good initial goal is to reduce the time you spend being sedentary (sitting) and to get a minimum of 30 minutes of moderate-intensity activity, such as a brisk walk, each day. You can get greater benefits by participating in more intense exercise, including strength training, three or more days per week. And once you have established a routine of regular activity you will be ready to make other health changes.

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Take a lesson in healthy eating from your turkey this Thanksgiving.

Posted on November 24, 2014 | Leave a comment

My Health & Fitness column in the Aiken Standard this week is about Thanksgiving dinner. With all the talk about how to make it a “healthier” meal by replacing traditional dishes and modifying recipes, I think we may be missing an important lesson in healthy eating.

This is Thanksgiving week, and people throughout the country are planning a feast including traditional dishes and family favorites. Even though many of these are not the healthiest choices, they make an appearance on the dinner table each year. Combined with the common occurrence of over-indulging, Thanksgiving dinner can represent a day of poor nutrition choices.

In an effort to make Thanksgiving dinner healthier, recommendations for modifying or replacing traditional dishes are a common theme in magazines, on the morning TV shows, and on the web. While these suggestions are meant to be helpful, I’m not sure they actually serve to make a significant impact on health.

After all, Thanksgiving is one day, and if there was ever a day to give yourself license to indulge, this is it! Of course, trying new foods and cooking techniques is always good, but the impact of replacing the butter in your mashed potatoes with fat-free sour cream or taking the marshmallow topping off Granny’s famous sweet potato dish isn’t realistically going to make you any healthier in the long run.

The truth is that if you eat a healthy diet every day, or even most days, and you have an active lifestyle you can get away with a day—or weekend—of overeating. (Obviously, you should always follow dietary restrictions for any medical conditions you have.) The problem comes when Thanksgiving dinner is yet another unhealthy meal in addition to the others that week or month.

Some of these recommendations are worth trying, for sure. Making an alternative to a traditional dish can get your family to try new foods they might not otherwise consider. And cooking using different ingredients or techniques on Thanksgiving can give you ideas for other meals, too.

However, focusing on modifying your Thanksgiving dinner may distract you from appreciating the greatest potential health benefit of this meal. Given the current confusion about how much and what type of carbohydrates and fats we should eat, there is an increased push to get us to eat less processed food and more real food.

For many of us, Thanksgiving dinner is one of the only times we cook and eat real food. A real turkey, vegetables, and home-made dessert are a huge improvement over the processed foods most of us eat on a daily basis. While we eat turkey at other times, it is almost always in a processed form such as ground turkey or deli meat, which frequently includes other additives. Cooking and eating a whole turkey is, for most families, relatively rare. So is eating a meal that doesn’t come from a restaurant or is heated in a microwave.

Additionally, Thanksgiving dinner is shared simultaneously around a common table (and maybe a kids’ table, too). All too often, meals are consumed away from the family table, frequently at different times. The benefits of eating together as a family are well-known, and can impact nutrition, psychological well-being, and health in general. Maybe Thanksgiving dinner isn’t about the food as much as it is the company. Why not make this a habit at other meals?

This week, let’s all give thanks for family, friends, and a shared meal. Let’s also take a lesson from the day and try to prepare and eat more real food as a family. This may be the biggest benefit of Thanksgiving. That, and a second serving of pumpkin pie!

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Celebrate Food Day every day by eating real food

Posted on October 20, 2014 | 4 comments

This Friday is Food Day, an annual event that aims to raise awareness about the food we eat and the impact it has on our health, environment, and quality of life. It turns out that many of us don’t know much about our food including where it came from, the method of preparation, and the quality and nutritional value.

As I describe in my Health & Fitness column in the Aiken Standard this week, we are increasingly disconnected from our food, a fact that has implications for our health and the health of the environment.

Our lack of knowledge about the food we eat has been replaced by a heightened awareness about nutrients. In fact, many people follow diets that either emphasize or restrict certain nutrients in order to obtain health benefits. But the research to support the importance of these individual nutrients is often mixed or lacking altogether. Still, as we seek out sources of these nutrients we are led to supplements, such as fish oil, or processed foods with added nutrients, like fiber.

To be sure, fish oil and fiber are good for us. But does that mean that taking a fish oil supplement will have the same health benefits as actually eating fish instead of, say, fried chicken? Or is adding fiber to a chocolate breakfast bar equivalent to getting more fiber from fruits and vegetables? Both research and common sense suggest that the answer is no.

Beyond the individual nutrients, the food we eat has changed. Even the way food gets to our table has changed. Since nearly half of our meals are eaten outside the home, it’s not even “our” table anymore. And when we do eat at home, take-out and prepackaged heat-and-eat meals have become the norm. In fact, the idea of cooking meals from ingredients is so foreign that we have to be reminded about how and why we should do it.

Events like Food Day are an attempt to get us back to the basics of cooking and eating real food. This, of course, is how people ate for years before the obesity and diabetes epidemics we are dealing with now, so eating real food again is a step toward reducing these, and other, health problems.

In addition to the potential health benefits of focusing on food over nutrients, this approach is also good for the environment and the economy. It turns out that eating healthier food promotes sustainable agriculture and can support local farmers. Locally grown produce, which is picked at the peak of freshness, can be more nutritious and have a lower environmental impact than food from factory farms which is often shipped great distances. And most important, food from local farms usually tastes better!

This is the point of Food Day. We should make ourselves aware of where our food comes from and do our best to eat “real food” as opposed to processed and pre-packaged foods that tend to be high in calories, added sugar, salt, and unhealthy fats. When possible, we should buy foods that are grown locally to minimize the environmental impact and support local farmers who live, work, and pay taxes in our area.

It turns out that focusing on food, not nutrients, will have a positive impact on your health, the environment, and quality of life for you and others. And that is why it is called Food Day, not nutrient day. You can learn more about how you can celebrate Food Day every day at www.foodday.org.

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Don’t forget about breast cancer prevention!

Posted on October 13, 2014 | Leave a comment

October is National Breast Cancer Awareness Month and many local and national organizations are promoting breast cancer awareness, sharing information about the disease, and celebrating survivors. This month represents the most visible part of a year-round effort to educate about, screen for, and hopefully cure this devastating disease.

Of course, these are all worthy goals that deserve our attention and support. What is often missing are the steps women—especially young women—can take to reduce their risk for, or even prevent, breast cancer.

Approximately 1 in 8 women will develop breast cancer. The American Cancer Society estimates that around 300,000 new cases of breast cancer are diagnosed and nearly 40,000 women die from this disease each year. Breast cancer can occur in men, but these cases are rare, so the focus is rightfully on women.

Much attention is given to genetic factors that increase the risk of breast cancer. These include certain gene mutations, including BRCA1 and BRCA2, as well as family history. A woman who has a first-degree relative (mother, sister, or daughter) who has had breast cancer has nearly twice the risk of being diagnosed herself.

Considering that most women diagnosed with breast cancer have no family history, it is also important to try to reduce other modifiable risk factors. This involves making health behavior changes that are probably familiar to most people. The good news is that these changes can also reduce the risk of other cancers, cardiovascular disease, and most other chronic diseases.

Avoid tobacco use. While the results of studies of smoking and breast cancer are mixed, a conservative interpretation is that smoking may increase the risk. Smoking increases the risk of other cancers, especially lung cancer, as well as heart attack, stroke, and other lung diseases. Not smoking, or quitting now, is among the best health decisions a woman can make.

Consume alcohol in moderation. Women should limit their alcohol intake to one drink per day. Women who consume more than two drinks per day increase their risk of breast cancer by 20% over women who don’t drink.

Maintain a healthy body weight. Being overweight can increase the risk of breast cancer in post-menopausal women by 30–60%. Excess body fat can alter the levels of estrogen and other hormones. The good news is that losing as little as 10 pounds can reduce this risk.

Be physically active everyday. Regular activity and exercise can lower breast cancer risk by as much as 20%. In addition to helping with weight control, physical activity may lower the level of certain hormones that are associated with breast cancer. The biggest reduction in risk of breast cancer is seen in women who have been active their whole lives, but it is never too late to start.

Eat a healthy diet. The evidence from studies on the effect of diet on breast cancer risk is mixed, and more research is needed. In general, increasing fruit, vegetable, and whole grain intake and reducing red meat is associated with at least some decrease in breast cancer risk. These “healthy” foods are rich in vitamins, minerals, and other nutrients and eating more of these foods may lead to weight loss or prevent weight gain with age.

Every woman has a different breast cancer risk based on her unique family history, biology, and lifestyle. But by making some simple health behavior changes, all women can reduce their risk for, or even prevent, breast cancer and improve their overall health.

 

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When it comes to your health, don’t take the high road.

Posted on October 6, 2014 | 1 comment

When faced with challenging moral or ethical situations we are advised to do what is right, even if it is more difficult. “Taking the high road” is often synonymous with living a better life. When it comes to your health, though, taking the high road may lead you on a path to chronic disease, disability, and early death.

The high road I am referring to in this case has nothing to do with ethical decisions. It has to do with test results, specifically measurements your doctor makes of your weight and blood pressure as well as blood tests of cholesterol and glucose. This is the topic of my Health & Fitness column in the Aiken Standard this week.

These tests are indicators of your current health as well as risks to your health in the future. The results of these measures are used to classify you as having “normal” or “high” blood pressure, blood glucose, and blood cholesterol. For example, a fasting blood glucose between 70–100 mg/dl is normal but you are considered to have diabetes if your result is 126 mg/dl or higher.

Even if your blood glucose is above normal (100–125 mg/dl) but isn’t high enough for you to be classified as diabetic, it may still be too high. This condition is called prediabetes because without intervention most people in this category will eventually develop diabetes.

Considering that diabetes is a leading cause of heart attacks, blindness, and amputations, preventing your blood glucose from increasing should be a high priority.

The same is true for other measurements including blood pressure and body mass index (BMI), the most common assessment of obesity. Even if you aren’t considered obese or don’t have hypertension, the higher your BMI or blood pressure becomes puts you at increased risk of the condition getting worse over time or leading to other more serious health problems.

In fact, even within the normal range, a higher value is associated with increased health risks. Take blood cholesterol for example, where the risk of heart disease increases at total cholesterol levels above 150 mg/dl, well within the “normal” range of less than 200 mg/dl. At even higher levels, total cholesterol is associated with a much greater risk.

Clearly, having a high BMI, blood pressure, blood glucose, or cholesterol is concerning. But it is important not to be fooled into thinking that a value that is technically below the diagnostic criteria for “abnormal” is necessarily “normal.” For many, even slightly elevated levels of these variables now are likely to get worse over time.

The good news is that modest lifestyle changes including weight loss, regular moderate physical activity, and changes to what you eat can prevent conditions like prediabetes and prehypertension from getting worse. This can be achieved through losing as little as 10 pounds, walking or doing other activity for 30 minutes per day, and adding more fruits and vegetables to your diet.

To be sure, taking the “high road” with BMI, blood pressure, cholesterol, and glucose, even if your test results are within the normal range, can put you at increased health risk. For these conditions, you are far better off taking the low road and making the necessary lifestyle changes to stay there.

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Fat still matters

Posted on September 15, 2014 | Leave a comment

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.

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Good sources of protein for your low-carb diet

Posted on September 10, 2014 | 1 comment

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.

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The diet wars continue

Posted on September 8, 2014 | 2 comments

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.

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To make your diet healthier, add exercise.

Posted on August 25, 2014 | 2 comments

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.

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