Tag Archives: diet

Time to make your new school year resolutions

Today is the first day of school for my kids and the first official day back for me and my colleagues at USC Aiken. So, it seems like a perfect time to make and plan for New School Year resolutions. It’s also a good time to assess your progress on your New Year’s resolutions and restart (or finally get started) on your goals. This is the topic of my Health & Fitness column in the Aiken Standard this week.


It’s hard to believe, but summer is winding down and the start of a new school year is upon us. As teachers, students, and parents know, this is the real beginning of the new year. For those of us involved in education, the first day of school is a perfect time to make new goals for the upcoming year, whether they are related to school or not.

This is a lot like making New Year’s resolutions on January first. Hopefully, you are still on track with your resolution. Sadly, research suggests that only 8% of people actually achieve their goal (more data here).

There are a host of reasons for this. Some of the most common resolutions—quitting smoking, losing weight, and getting in shape—are also some of the most difficult behaviors to change because they require making significant lifestyle modifications. To make things worse, many people set unrealistic goals or try to take on too much at once.

Many people who fail to keep their New Year’s resolutions this year will recycle them next year and try again. In fact, most people who manage to successfully quit smoking or lose weight have tried many times in the past. Sometimes experience, even a bad experience, is the best way to learn what does and doesn’t work.

But there is no need to wait until 2015 to restart your stalled New Year’s resolution or finally get around to doing what you planned months ago. Setting a date to begin a behavior change is an important step in the process so, why not make a New School Year resolution and try again now?

Here is some advice to help make this second chance to start or restart your New Year’s resolutions successful.

Be realistic. Many people fail to keep their resolutions simply because they don’t set realistic goals or aren’t realistic about what it will take to meet those goals. For example, running a marathon is an ambitious goal for almost everyone, especially someone who doesn’t exercise at all. A resolution to work up to jogging five days per week, with a goal of completing a 5k run is more realistic and achievable.

Focus on learning. Making most health behavior changes involves learning as much as doing. Something as simple as eating a healthier meals requires learning about the nutrients that make some foods healthier than others, learning to read food labels to select healthy foods, and learning how to cook and prepare healthy meals. If your resolution is to learn about healthy meals you will be able to achieve that goal and be well on your way to eating a healthier diet.

Manage your time. Most health improvement projects require taking time to learn about, implement, and maintain those healthy behaviors. If you resolve to manage your time to include exercise or meal preparation in your daily schedule you will be much more likely to meet your goals. Trying to add these new activities as “extras” to your already busy day will inevitably lead to them getting squeezed out.

Plan ahead. Most people already know that changing health behaviors can be challenging, even under the best circumstances. It’s no wonder that holidays, travel, and other life events can complicate or even derail an otherwise successful diet or exercise program. Make it your resolution to think about what you can do before, during, and after these (and other) disruptions occur to keep yourself on track.

Hopefully these steps will help you keep your resolutions, achieve your goals, and make this a happy, healthy year. As a bonus, you can take January 1 off!

Don’t go into (health) debt!

We are all aware of the hazards of being in debt. Too many individuals and families have gotten themselves in a poor financial situation by spending too much and not saving enough. For most, this debt has developed over several years and will have an impact lasting years into the future.

Unfortunately, this is not the only debt we face. Many of us are also in a health debt crisis. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Poor eating habits and increasingly sedentary lifestyles have led to an obesity epidemic. This is important since the three leading causes of death among adults (heart disease, stroke, and cancer) are directly linked to poor diet, inactivity, and obesity.

Obesity, diabetes, heart disease, and cancer are among the conditions that make up our health debt. Even if we have not been diagnosed with these or other health conditions, our lifestyle has put us on that path.

Whether our doctors have told us or not, many of us are in poor health. And our overall health and potential complications get worse each year, so the longer we are overweight and inactive, the worse our health is likely to be in the future. That is our health debt crisis.

Another example of a health debt is smoking, the cause of nearly 90% of lung cancer cases. Lung cancer doesn’t develop after the first cigarette; it takes years of smoking to cause cancer. One estimate suggests that there is a 20 year time lag between smoking and lung cancer diagnosis.

During this time smoking is causing damage to the lungs that leads to cancer, but it is usually undetectable. The cancer process is underway long before it causes symptoms, and since smokers are unaware of it, they continue to smoke. Quitting smoking begins to erase this debt but former smokers suffer poor health even after they quit. In some cases, the debt can’t be completely paid back.

Aside from poor health and reduced quality of life, health debt carries a financial cost. The medical costs attributed to obesity alone are estimated to be $147 billion per year, and a typical obese patient spends over $1,000 more per year on their own medical care than someone at a healthy body weight. The financial burden is both collective and individual, meaning we all pay for it.

Just as financial debt is due to an difference between the money we save and what we spend, much of our health debt is due to an imbalance between the energy (calories) we save and spend.

We have been spending too little energy through activity and saving too much of the energy we eat in the form of fat. Each day we consume more calories than we burn, we store that extra energy as fat. Even a small difference each day adds up over time.

Putting it in these terms, the pathway out of health debt is clear—spend more energy by being more active and cutting back on the calories we eat. Like a financial debt, even though the solution is easy to identify, putting it into place requires making some difficult choices.

But it doesn’t have to be a painful process. Even small changes in activity and diet can lead to weight loss and improved health over time. Make it a priority to be active every day and try to spend less time sitting. Pass on second servings at meals and skip desert once in a while.

Remember, the health debt wasn’t created overnight. It was the result of small changes over time, some of which we may not have noticed. Fixing it will take time, too.

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!

When normal isn’t normal.

The typical American is overweight, doesn’t get enough exercise, eats too few vegetables and fruits, too much sugar, and too many calories. Unfortunately, we have come to consider this combination as “normal.” While this situation may be common, it is definitely not normal. This is the topic of my Health & Fitness column in the Aiken Standard this week.

For most measures of health, a normal value is consistent with good health. A “normal” blood pressure is in a range that is associated with a low risk of stroke, for example. Someone with LDL (bad) cholesterol that is considered “above normal” has a greater risk of heart attack than a person with a normal LDL value.

But for many health indicators, having a normal value is not the norm. According to the most recent recommendations, a normal blood pressure is less than 120/80 mmHg. However, nearly 60% of adults have a blood pressure that is above normal, meaning they have hypertension or prehypertension.

A person who has a body mass index (BMI) in the normal range, between 18.5 and 24.9 kg/m2, is considered to be at a healthy body weight. But two-thirds of adults are overweight, with a BMI above the normal range. Similarly, participating in regular exercise should be considered normal. But it’s not, since fewer than half of adults meet minimum recommendations for physical activity.

The problem is that the term “normal” is frequently used to refer to what is typical, rather than what is healthy. Obesity is so common that a person who is at a healthy weight may look out-of-place. So many people look for ways to avoid physical activity that a person who walks instead of drives is considered abnormal. The person who comes away from a buffet with a less-than-full plate or who has a salad for dinner often gets strange looks. One of the reasons that people get noticed for doing these things is because they stand out from the crowd.

In reality, though, many of the health behaviors we consider to be abnormal—regular exercise, a healthy diet, or a lean physique—are, historically, completely normal. Until relatively recently, most everyone was active much of the day and spent little time being sedentary. Likewise, the consumption of the processed foods that are such a big part of our current diet was rare even a few decades ago.

It is likely that, by considering unhealthy behaviors to be normal, we have created a situation that discourages people from adopting a healthy lifestyle. As anyone who has tried to change their health habits knows, it can be a challenge, especially if everyone else maintains their typical eating and activity pattern. It’s not easy to be “the one” who only eats healthy food or who takes time to exercise every day.

Maybe we need to redefine normal health behaviors to reflect what is healthy rather than what is most common. When walking or biking rather than driving becomes the norm there will be greater incentive to provide safe places for pedestrians and cyclists to travel. When a healthy diet is considered normal it is more likely that restaurants will offer more nutritious options.

In the end, we would all benefit from changing our definition of normal. And a normal diet and activity pattern will go a long way to promoting a normal BMI, blood pressure, and cholesterol.

Feeling the pressure

May is National High Blood Pressure Education Month, a time to raise awareness about the diagnosis, health effects, and treatment of high blood pressure, also called hypertension. This is important because approximately 70 million U.S. adults have hypertension. Of those, almost 40% don’t even know it, which means they are not seeking treatment.

Another 30% have prehypertension, blood pressure that is above normal but does not meet the criteria for hypertension. Prehypertension is appropriately named since most people with this diagnosis eventually develop hypertension—unless they take steps to lower their blood pressure.

High blood pressure is a contributing factor to many heart attacks and strokes and is associated with type 2 diabetes, heart failure, and kidney disease. Hypertension is called the “silent killer” because it often has no symptoms yet it leads to serious health outcomes.

Here are some steps to help you celebrate National High Blood Pressure Education Month:

1. Know your numbers

Your blood pressure includes two numbers, both measured in millimeters of mercury (mmHg). The top number, systolic, is the pressure in your arteries while your heart is contracting and pumping blood. The bottom number is the diastolic pressure, which occurs between beats when the heart is relaxed. Both numbers are important for assessing your risk of health problems.

Normal blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic. Blood pressure that is 140 mmHg and higher or 90 mmHg and higher is considered hypertension. If your blood pressure is between 120–139 mmHg systolic or 80–89 mmHg diastolic, you have prehypertension.

2. Get it down

If your blood pressure is above normal you should take treatment seriously. Lifestyle changes including eating a healthy diet, regular physical activity, weight control, and quitting smoking are all effective and essential for lowering blood pressure.

There are also several good medications that your doctor can prescribe to lower your blood pressure. Take them as directed and don’t forget that they are designed to work with healthy lifestyle habits.

3. Keep it down

The aim, of course, isn’t simply to reduce your blood pressure using drugs. Your ultimate goal should be to keep your blood pressure low without relying on medications, all of which have at least some negative side effects.

The best way to maintain a normal blood pressure is through daily exercise, eating a healthy diet, losing weight if you are overweight, and quitting smoking. A good place to start is the DASH diet, which is high in fruits, vegetables, and fiber and low in sodium and added sugar.

The DASH diet has been shown to lower blood pressure and lead to weight loss. It is also consistent with recommendations to prevent and treat many other health problems, including diabetes and high cholesterol.

Since blood pressure tends to increase with age, even if you have normal blood pressure you should take steps to prevent high blood pressure in the future. Adopting a lifestyle that includes daily physical activity, healthy eating habits, managing stress, and not smoking is essential for preventing high blood pressure.

Additionally, these same health habits will help you prevent most other chronic disease including diabetes, heart disease, and many cancers. It turns out that celebrating National High Blood Pressure Education Month can also help you celebrate good health in general.

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.