—Lucinda K. Porter, RN
of health, whether you have hepatitis C or not. We know that we “should
eat better,” but what we eat and what we should eat don’t always
match. Let’s face it, some of the less healthy foods are
mouth-watering, and when confronted with a choice between pizza and
tofu, pizza usually wins. As Mark Twain said, “The only way to keep
your health is to eat what you don’t want, drink what you don’t like,
and do what you’d rather not.”
and think that you would rather risk diabetes, heart disease, and
stroke than give up your favorite food? Or, do you use denial, thinking
about the taste rather than the consequences? What if you could have
it both ways, the ability to eat good food and still be healthy?
which simply means making less harmful choices. Harm reduction is
usually applied to behaviors that have potentially serious
consequences. Harm reduction began in the public health and drug policy
arena when it was clear that the war on drugs was not solving any
problems. Shame and punishment don’t help people change behaviors,
whereas harm is reduced when drug users are empowered with choices.
are examples of harm reduction. It works—not only is harm reduced, but
drug users are more likely to get help for substance use.
applied harm reduction concepts to eating? Dean Ornish, MD, Professor
of Medicine at the University of California, San Francisco uses this
approach. In the 1970’s, Ornish researched the effect of lifestyle
choices on coronary artery disease. Decades later, he has amassed a
body of research showing that diet, exercise, stress management, and
support can reverse heart disease, type 2 diabetes, and lower cancer
he writes, “Foods are neither good nor bad, but some are more
healthful for you than others. You have a spectrum of choices.” A dark
chocolate fan, Ornish endorses occasional indulgence. “Studies have
shown that the people who are most healthy overall are those who allow
themselves occasional indulgences.”
one of five groups—group 1 foods are the most healthful, group 3 are
intermediate, group 5 are the least healthful. To maximize health,
choose most of your foods from group 1 or 2, and minimize foods from
groups 4 and 5. Ornish never uses the word “should.”
foods, I need to say that diet plans vary widely. I am not endorsing a
particular diet, and I am only using Ornish’s Spectrum because it illustrates the concept of harm reduction. The Ornish Spectrum is
a mostly plant-based diet, and although meat-lovers can still eat meat
on this program, they may prefer something more like the South Beach Diet.
Both are liver-friendly. Pick the safe nutrition plan that works for
you. As Ornish points out—diets based on deprivation and sacrifice are
not sustainable; diets that include pleasure, feeling good, and freedom
of choice are more likely to last.
Since few of us can follow a diet perfectly, here are
strategies that will improve matters even if when you fall short of
your goals. It’s like having your cake and eating it too, although
you’d be better off having half a portion of cake, or eating an apple.
Eat smaller portions of less healthy foods.
For example: a large
McDonald’s fries has 500 calories, 25 grams of fat, 3.5 grams saturated
fat, 63 carbs, and 350 mg of sodium. Small fries cut that by more than
half to: 230 calories, 11 grams of fat, 1.5 grams saturated fat, 29
carbs, and 160 mg of sodium. Kids’ fries cut the small fries numbers by
more than half.
Reserve the least healthy foods for special occasions.
A doughnut on your birthday
is unlikely to kill you unless you choke on it. A doughnut every day
is risky. If you aren’t ready to give up doughnuts, half a doughnut or
one doughnut hole would be a better choice.
Be cautious about what constitutes a “special occasion.” Too many special occasions can sabotage the best intentions.
Make informed choices, not assumptions.
Sweet potato fries may
sound healthier than regular fries, but may not be. At Carl’s Jr., a
serving of sweet potato fries has more calories and fat than regular
Keep a log of what you eat. Food and exercise journals are highly effective tools for change.
Journals don’t lie.
Some people will skip a food rather than log it.
If you aren’t meeting your goals, diaries can show you areas that might be changed or strengthened.
Delay tactics – Skip the fries today or this week, or this month.
Make another choice altogether. Microwave apple slices with cinnamon rather than eating apple pie.
- Plan your splurges. I love Thanksgiving turkey.
Although I also like all the trimmings, I’d rather have two helpings of turkey and skip the rolls.
Although there is wide variation in nutrition
plans, nearly all experts agree on foods to avoid or limit. These are:
Sugar and unrefined carbohydrates
Soda, many fruit drinks, and sweetened energy drinks and teas
Most bakery goods such as pastries, donuts, cookies, white bread, white pasta
Trans-fats, saturated fats, and high-fat foods
Butter, cream, and full-fat cheese are on most diet hit lists
Bacon, beef, ham, lamb, sausage, organ meats
Trans fats are being phased
out, but check ingredients for partially hydrogenated oil in foods
such as microwave popcorn, frozen desserts, crackers, and stick
Processed food, frozen foods, canned foods, and deli-meats
Snack foods with empty calories (potato chips, candy, etc.)
harm reduction may be applied. A lean flank steak is healthier than
fatty prime rib. Orange juice is healthier than soda.
Most nutrition experts recommend eating vegetables, and lots of them.
Fruit and whole grains are healthy, but in moderate amounts.
Eat plant-based or lean protein choices, such as egg whites, nonfat yogurt or milk, beans, nuts, fish and poultry.
Choose healthy fats, such as canola and olive oil.
Be sure your diet is rich in fiber.
Reduce sodium intake. Go easy on processed foods, which are often high in sodium and other additives.
Don’t overdo it. A serving of nuts is healthy; a can of nuts is not.
health today and tomorrow. Food tastes good in the moment, but the
effects can be devastating. To me, few indulgences are worth a lifetime
of coronary artery diseases, fatty liver, diabetes, and so on. However,
I am not ready for a life without one of the unhealthiest foods of
all—movie popcorn. Even without extra butter it is packed with
sodium, carbs and saturated fat.
size and savor it. It is possible to eat well, enjoy life, and stay
Choose My Plate
Harvard’s Nutrition Source www.hsph.harvard.edu/nutritionsource
The South Beach Diet www.southbeachdiet.com
Lucinda K. Porter, RN, is a long-time contributor to the HCV Advocate and author of Free from Hepatitis C and Hepatitis C One Step at a Time. Her blog is www.LucindaPorterRN.com