The University of Michigan Integrative Medicine’s Healing Foods Pyramid was conceived by Monica Myklebust, MD, and Jenna Wunder, MPH, RD, in their passion for food in all of its beauty, variety, and healing benefits. The foods we choose to eat are essential to how we care for ourselves. In choosing the healing foods on this pyramid, each one of us contributes to our own health.

Click on the categories in the pyramid to access highlights for each food group

Healing Foods Pyramid

We emphasize:

Healing Foods
- Only foods known to have healing benefits or essential nutrients are included
Plant-based choices
- Plant foods create the base and may be accented by animal foods
Variety & balance
- Balance and variety of color, nutrients, and portion size celebrate abundance
Support of a healthful environment
- Our food, and we in turn, reflect the health of our earth
Mindful eating
- Truly savor, enjoy and focus on what you are eating

The pyramid shape was chosen due to its general familiarity. However, with the complexity of nutrition choices and concepts today, no two-dimensional model can fully convey all considerations. The categories and their placement on the pyramid generally support our intent, which is to emphasize the foundational role of Water, followed by the importance of a rainbow of Fruits and Vegetables. Grains emphasize whole grains and includes some starchy vegetables that act like grains in the body. Legumes are excellent sources of non-animal protein in this plant-based pyramid. Healthy Fats emphasizes monounsaturated oils and nuts. Eggs offer high quality protein and Dairy includes foods low in fat yet rich in calcium. Lean Meats complement other foods rather than playing the starring role. In Fish & Seafood, fish high in omega-3 fatty acids is emphasized. Seasonings include herbs, onions, garlic, pepper, salt and others that add flavor while contributing healing benefits. Dark Chocolate is a source of antioxidants and Alcohol, when used in moderation, has health benefits. Use of alcohol is to be guided by consideration of one’s personal health. Tea is recommended as a healthful beverage choice.

At the top of the pyramid is a personal space purposely left open. It is to be filled by you. What will make this Healing Foods Pyramid complete for you?

Facts About documents offer details of the recommendations. With the ever-changing ideas and research findings of food and nutrition, this Healing Foods Pyramid will be a continuous and dynamic work in progress.

High-fiber foods

Looking to add more fiber to your diet? Fiber moves quickly and relatively easily through your digestive tract and helps it function properly. A high-fiber diet may also help reduce the risk of heart disease and diabetes.

Here's a look at the fiber content of some common foods. Read nutrition labels to find out exactly how much fiber is in your favorite foods. Recommended fiber intake for women is 21 to 25 grams a day and for men is 30 to 38 grams a day.

Fruits	Serving size	Total fiber (grams)
Pear	1 medium	5.1
Figs, dried	2 medium	3.7
Blueberries	1 cup	3.5
Apple, with skin	1 medium	3.3
Strawberries	1 cup	3.3
Peaches, dried	3 halves	3.2
Orange	1 medium	3.1
Apricots, dried	10 halves	2.6
Raisins	1.5-ounce box	1.6
Grains, cereal & pasta	Serving size	Total fiber (grams)
Spaghetti, whole-wheat	1 cup	6.3
Bran flakes	3/4 cup	5.1
Oatmeal	1 cup	4.0
Bread, rye	1 slice	1.9
Bread, whole-wheat	1 slice	1.9
Bread, mixed-grain	1 slice	1.7
Bread, cracked-wheat	1 slice	1.4
Legumes, nuts & seeds	Serving size	Total fiber (grams)
Lentils	1 cup	15.6
Black beans	1 cup	15.0
Lima beans	1 cup	13.2
Baked beans, canned	1 cup	10.4
Almonds	24 nuts	3.3
Pistachio nuts	47 nuts	2.9
Peanuts	28 nuts	2.3
Cashews	18 nuts	0.9
Vegetables	Serving size	Total fiber (grams)
Peas	1 cup	8.8
Artichoke, cooked	1 medium	6.5
Brussels sprouts	1 cup	6.4
Turnip greens, boiled	1 cup	5.0
Potato, baked with skin	1 medium	4.4
Corn	1 cup	4.2
Popcorn, air-popped	3 cups	3.6
Tomato paste	1/4 cup	3.0
Carrot	1 medium	2.0

Grains and starchy vegetables

This Facts About explains and gives examples of grains and starchy vegetables. We list foods with a guide for selecting an appropriate portion size and provide recommendations for incorporating healthy changes into your diet.

What are the recommended servings of grains & starchy vegetables per day?

4 -11 servings per day. For optimal health, we recommend only whole grains versus milled, processed or refined grains.

What are whole grains?

Grains are the seeds of plants. Whole grains contain all parts of the grain, including the bran, endosperm and germ.

Bran. Forming the outer layer of the seed, the bran is a rich source of niacin, thiamin, riboflavin, magnesium, phosphorus, iron and zinc. The bran also contains the majority of the seed's fiber.
Germ. A concentrated source of niacin, thiamin, riboflavin, vitamin E, magnesium, phosphorus, iron and zinc. The germ also contains protein and fat.
Endosperm. Also called the kernel, the endosperm makes up the bulk of the seed. It contains most of the grain's protein and carbohydrate and has small amounts of vitamins and minerals.

What are milled, processed and refined grains?

Unlike whole grains that contain at least part of their bran and germ layers, milled, processed and refined grains have both the bran and germ removed during processing; therefore all of the nutrients in these layers are also removed.
They are often “enriched” which means nutrients that were lost during food processing are added back. For example, B vitamins, lost when wheat is refined, are added back to white flour during processing. However, even after enrichment, milled grains do not have as many nutrients as whole grains, and they do not provide as much fiber, if any.
While whole grains are preferred, adding fiber -rich foods to milled or processed grains can lower the glycemic impact and moderate fluctuations in blood sugar. Therefore, foods such as pasta and white rice can be part of a healthy diet when combined with high fiber foods such as vegetables or beans.
Examples of milled grains are white rice and white flour.

What are starchy vegetables?

Starchy vegetables include corn, potatoes (all kinds including sweet), winter squash, plantains, and yucca (cassava root)
These vegetables are higher in starch than other vegetables and are metabolized in your body more like a grain
They are often used as the central starchy part of a meal, for example: mashed potatoes or polenta (milled corn)
When used whole, they provide ample fiber and nutrients
Their primary function is to provide energy for the body, especially the brain and the nervous system. The body breaks down starches into glucose, which the body uses for energy.

Why choose whole grains and starchy vegetables?

They are rich sources of fiber and naturally low in fat
An important source of vitamins and minerals, such as B vitamins, Vitamin E, folate, selenium, zinc and iron
They contain a variety of phytochemicals and antioxidants
They help form the foundation of healthy eating
There is a wide variety to choose from
Tend to have a low glycemic index, which helps to regulate blood sugar levels
Associated with reduced risk of type 2 diabetes, constipation, diverticulitis, obesity, heart disease and some tyepes of cancer

Try replacing refined, processed and milled grains with a whole grain alternative

Choose Less Often		Choose More Often
Milled/Refined Grains & Starchy Vegetables	Serving Size	Whole Grains and Starchy Vegetables	Serving Size
White / wheat bread	1 slice (1oz)	Whole wheat / whole grain bread	1 slice (1 oz)
White Rice	1/3 cup	Brown rice, millet, quinoa, barley or polenta	1/3 cup
Couscous	1/3 cup	Whole wheat couscous	1/3 cup
Pasta	1/3 cup	Whole wheat / multi grain pasta	1/3 cup
Crackers and Pretzels	3/4 oz	Whole grain crackers and pretzels	3/4 oz
Potato chips	3/4 oz	Tortilla chips	3/4 oz
Potato without skin	1 med	Potato with skin	1 med
Bagel, 4oz	1/4	Whole wheat / whole grain bagel, 4 oz	1/4
Pancake or waffle, 4 inches across	1	Whole grain pancake or waffle, 4 inches across	1
Pita bread, 6 inches across	1/2	Whole wheat pita, 6 inches across	1/2
Corn flakes, sugary breakfast cereal	3/4 cup	Oatmeal, cereal based on oats, barley or bran	3/4 cup

Specific Considerations

What is the glycemic index (GI)?

The glycemic index measures how different types of carbohydrate foods affect blood glucose (blood sugar) levels. The higher a food ranks on the glycemic index, the faster it increases glucose in the blood. Eating more than the recommended servings of foods high on the glycemic index can lead to loss of sensitivity to insulin, the hormone needed to allow blood sugar to enter cells for use as fuel. This "insulin resistance" promotes weight gain and type 2 diabetes.

The glycemic index ranks carbohydrates on a scale from 0 to 100 according to the rate and extent that the sugars from these carbohydrates enter the blood and cause blood sugar levels to rise after eating
Carbohydrates that breakdown quickly have the highest glycemic indexes
Carbohydrates that breakdown slowly have low glycemic indexes

What is the glycemic load (GL)?

GL builds on the glycemic index concept to provide a measure of total glycemic response to a food or meal based on serving size
GL = GI (%) x grams of carbohydrate per serving

GI and GL Range Values

Glycemic Index (GI) Range	Glycemic Load (GL) Range	Glycemic Load per Day
Low GI = 55 or less	Low GL = 10 or less	Low GL <>
Medium GI = 56-69	Medium GL = 11-19	High GL > 120
High GI = 70 or more	High GL = 20 or more

Milled Grains and GI

When the fiber is removed from grains during the milling process, the refined carbohydrate that remains is converted to glucose by the body much more quickly during digestion. Therefore the milling process increases the GI of a particular grain, for example:

Grain	Glycemic Index (GI)	Glycemic Load (GL)
Milled - White rice, instant, 1 c	87 - High	36 - High
Whole - Brown rice, 1 c	50 - Low	16 - Medium

Fiber in the prevention of chronic disease

Constipation
Fiber adds bulk, aiding the movement of food through the gut, thus preventing constipation

Diverticulitis
Fiber also helps reduce the risk of diverticulitis, a condition in which small pouches in the colon wall may become infected

Type 2 Diabetes
Foods with a low glycemic index and high fiber, like many whole grains and starchy vegetables, do not raise blood sugar levels as quickly as milled and processed choices. Therefore, they are associated with a lower risk of type 2 diabetes. Low glycemic index foods are often high in fiber and include legumes, whole fruits, oats, bran and whole grain cereals.

Heart Disease
Fiber reduces fat and cholesterol absorption leading to lower total and LDL (bad) cholesterol levels

Obesity
Because insoluble fiber is indigestible and passes through the body virtually intact, it provides few calories. Since the digestive tract can handle only so much bulk at a time, and since fiber-rich foods are more filling than other foods, people on high fiber diets tend to eat less. Insoluble fiber also may hamper the absorption of calorie-dense dietary fat.

Cancer
Whole grains contain phytochemicals and antioxidants that can help lower your risk for cancer. Also, the fiber in whole grains can help move potential cancer- causing compounds through the intestines faster, reducing their chances of being reabsorbed into the body.

What are the health concerns associated with grains?

Gluten Intolerance

Celiac disease (CD) is also known as gluten intolerance. Gluten is the common name for the proteins in specific cereal grains that are not tolerated in persons with CD. These proteins are found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn, and faro), and related grains, rye, barley, and tritcale. When individuals with CD ingest gluten, the villi, tiny hair-like projections in the small intestine that absorb nutrients from food are damaged. This is due to an immune reaction to gluten. Damaged villi interfere with the body's ability to absorb basic nutrients - proteins, carbohydrates, fats, vitamins, minerals, and, in some cases, water and bile salts.

Pesticide Use

Pesticides are chemicals that are used to control pests that destroy crops. They are used in the production of most crops sold in the United States. These chemicals may increase your risk for cancer or other chronic diseases and should be limited in your diet.

Choose Organic

We recommend organic grains because they contain less pesticide residue. We believe they also provide better flavor and are a better nutritional choice than conventionally grown produce.

Organic food is produced by farmers who emphasize the use of renewable resources and the conservation of soil and water to enhance environmental quality for future generations. Organic food is produced without using most conventional pesticides, petroleum-based fertilizers, or sewage sludge-based fertilizers, bio-engineering, or ionizing radiation. Organic systems replenish and maintain soil fertility, eliminate the use of toxic and persistent pesticides and fertilizers, and build biologically diverse agriculture.

How can you get more fiber and whole grains into your diet?

Reduce the amount of refined grains you eat. A good way to be sure a food item contains whole grains is to look at the fiber content-3 or more grams of fiber per serving is recommended.
Use breakfast cereals based on oats, barley and bran for breakfast or a snack.
Use “grainy” breads made from whole seeds.
Eat brown rice instead of white rice.
Experiment with cooking various whole grains like quinoia, barley and millet.
When buying bread products, read the label. If you see the word enriched, the product probably does not contain whole grains.
Wheat flour and whole wheat flour are not the same! Look for whole grain, stone ground, whole ground, whole wheat flour, whole oat flour or whole barley flour.
When eating a milled or processed grain, add foods with plenty of fiber (fruits, vegetables, legumes or whole grains) to lower glycemic impact.
Many foods are now available in whole wheat / whole grain versions: pasta, couscous, frozen waffles, pancake mixes, crackers, bagels and pretzels.

This Facts About document is published by Monica Myklebust, MD, and Jenna Wunder, MPH, RD, at University of Michigan Integrative Medicine Clinical Services. Our mission is to care for people using an Integrative Medicine model that reaffirms the importance of relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches to achieve optimal health and healing.

Legumes

This Facts About reviews beans and lentils and gives examples of foods to choose from as well as foods to avoid. We provide a guide for selecting an appropriate portion size, and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per day?

1-3 servings per day

Why choose legumes?

Low in fat
Excellent source of protein
Good source of fiber
Contain iron, zinc, calcium, selenium, and folate
Rich in antioxidants
Provide a low glycemic index (GI) / glycemic load (GL)
May help reduce the risk of chronic diseases, such as, heart disease, diabetes mellitus,obesity and cancer

What are legumes?

Beans, peas, lentils, and peanuts are collectively known as legumes, which are plants that have pods with tidy rows of seeds inside. Various foods in this category metabolize differently and provide different nutrients. For example, peanuts, which are usually consumed in ways similar to tree nuts are actually in thelegume family and grow underground. They contain more fat and fewer carbohydrates than other legumes. Sugar snap peas contain fewer calories, carbohydrates, and protein per serving than other legumes and are used in cooking as a vegetable. Soy beans are unique for their high isoflavone and essential amino content. They are also used to make such a wide variety of foods unlike other beans in this category. For these reasons, we have listed peanuts in Healthy Fats, fresh green peas in Vegetables, and soy beans in Soy. Please read these individual Facts About sheets for more information.

Legumes have many of the nutrients recognized as important in preventing heart disease, cancer, obesity, and other chronic diseases. They are a vegetarian source of protein for the diet. For non vegetarians, they offer an alternative source of protein with less fat and more fiber.

Selected Food Sources with Serving Sizes, Protein, and Fiber Content

Selected Food Sources of Legumes
Types	Serving Size	Protein and Fiber Content
Beans: garbanzo beans (chickpeas), lima beans, fava beans, black beans, black-eyed peas, kidney beans, navy beans, great northern beans, pinto beans, adzuki beans, mung beans	1/2 cup canned or cooked 1/3 cup mashed	Provides approximately 8 grams of protein & 8 grams of fiber
Peas: split, yellow or green
Lentils: large or small; brown, green, red or black

Specific Considerations

Protein Complementation

Protein is made up of building blocks called amino acids and must be consumed in the diet for building new proteins in the body. Our bodies can make some amino acids from the protein we eat, but not others; the ones the body cannot make are considered essential amino acids because they must be consumed from the diet.

Dairy and meat usually contain all of the essential amino acids and are considered to provide complete proteins. However, they often contain saturated fat and cholesterol.
Grains, fruits and vegetables lack at least one of the essential amino acids and are considered to provide incomplete proteins. These items, when eaten in combination can fulfill requirements for essential amino acids in the diet.
For the most benefit from complimentary protein foods, plant sources of protein such as legumes, seeds and whole grains should be eaten in combination and during the same day, but do not necessarily need to be eaten during the same meal as once thought.
There are many examples of common plant-based dishes that contain adequate essential amino acids: brown rice and beans, peanut butter and whole wheat bread, cornbread and pinto beans and refried beans with wheat or corn tortillas.
Dairy products can also be added to a meatless dish to enhance the protein content of a meal.

Canned versus Dried Beans

Canned beans are fast and easy to use
Many canned beans are high in sodium. To avoid this, buy “no added salt” products or rinse thoroughly.
Dried beans have a fresher taste than canned beans and soaking times vary. Read product label for instruction.

Intestinal Gas

Many people who eat beans have a problem with intestinal gas. Humans are missing an enzyme required to break down raffinose sugars found in beans. The bacteria in our gut feast on these sugars, giving off hydrogen and carbon dioxide and causing intestinal gas. Some people avoid beans due to the intestinal gas or bloating they may produce. Gradually increasing the amount of beans you eat over several weeks can help in overcoming this.

Ideas to increase beans, peas & lentils

Choose beans as your protein choice instead of high fat meat or dairy products.
Keep pantry stocked with a variety of canned legumes for a quick meal or side dish.
If you're new to beans, start with a small amount and increase gradually.
Consider vegetarian days.
Change your favorite recipe by replacing half the meat with legumes.
Try a new legume each week.
Enjoy bean soups and a salad for lunch and / or dinner.

To decrease intestinal gas from beans, peas, & lentils

Mix 1/8 teaspoon of baking soda into the soaking water. It helps leach out raffinose sugars, reducing intestinal gas.
Drain and rinse canned beans. That will get rid of some of the gas-causing raffinose sugars (and almost half of the unwanted sodium).
Never cook beans in the water they've soaked in. It's loaded with the gas-causing raffinose sugars.

This Facts About document is published by Monica Myklebust, MD, and Jenna Wunder, MPH, RD, at University of Michigan Integrative Medicine Clinical Services. Our mission is to care for people using an Integrative Medicine model that reaffirms the importance of relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches to achieve optimal health and healing.

Fruits and Vegetables

This Facts About reviews fruits and vegetables and gives examples of foods to choose. We provide a guide for selecting an appropriate portion size, and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per day?

Overall: more than 7 servings
Vegetables: unlimited (minimum 5 servings)
Fruits: 2-4 servings

Why should you choose fruits & vegetables?

Excellent source of fiber
Rich in vitamins and minerals
Low in calories and most are fat-free
Provide a food source of water; fruits and vegetables are made up of more than 50% water
Abundant in phytochemicals and antioxidants
High consumption helps reduce risk of various diseases such as cancer, obesity, heart disease, arthritis, asthma, macular degeneration and diverticulosis

What is the threshold effect?

Research supports evidence of an inverse relationship of fruit and vegetable consumption with development of chronic disease. This means that the more fruits and vegetables you eat, the less likely you are to develop a chronic disease. The most significant reductions in risk of illness are seen when individuals consume 7-10 servings of fruits & vegetables per day (the threshold). Therefore, to get the most health benefits we recommend a minimum “threshold” of 7 servings of fruits & vegetables daily.

A limited selection of fruits and vegetables

Fruits		Vegetables
Apricots	Oranges	Asparagus	Parsnips
Blackberries	Papaya	Bell peppers	Radicchio
Blueberries	Passion fruit	Bok choy	Radishes
Cantaloupe	Peaches	Broccoli	Sorrel
Dates	Plums	Cabbage	Spinach
Guava	Pomegranate	Carrots	Swiss chard
Grapefruit	Raspberries	Cucumbers	Tomato
Honeydew melon	Star fruit	Green beans	Turnips
Kiwifruit	Tangelos	Kale	Watercress
Mango	Watermelon	Kohlrabi	Zucchini

Selected serving sizes of fruits & vegetables

Fruit or Vegetable	Serving Size
Raw leafy greens	1 cup
Baby carrots	6-7
Apple/Orange	Size of tennis ball
Banana	Medium
Grapes	17
Berries	¾ cup
Melon	chopped 1 cup
Raw, chopped fruit or vegetables	½ cup
Cooked vegetables	½ cup
Dried fruit	¼ cup

Specific Considerations

Phytochemicals

Phytochemicals (‘phyto’means plant) are naturally occurring plant chemicals
Phytochemicals are not yet classified as nutrients. Nutrients are substances necessary for sustaining life. Phytochemicals’ role in nutrition is still unfolding however, they have been identified as containing properties that aid in disease prevention
In the human body, some phytochemicals act as antioxidants, some protect and regenerate essential nutrients, while others work to deactivate cancer-causing substances
Thousands of phytochemicals have been identified in the plant foods we eat
One serving of fruit or vegetables may contain 100 different phytochemicals. Some are available when the vegetable is raw, and others when the vegetable is cooked. It is important to eat a mix of raw and cooked vegetables to gain the most benefit from phytochemicals.

Cooking method matters; steaming helps retain water soluble vitamins like B vitamins and vitamin C rather than boiling
High cooking temperature and long cooking times also destroy heat sensitive nutrients such as B vitamins, vitamin C, and folate, so keep cooking times short

Antioxidants

The most well known phytochemicals are the antioxidants

Antioxidants found in fruits and vegetables protect cells from damage caused by metabolic by-products (free radicals), as well as toxic substances from food and the environment. As our bodies use oxygen to produce energy, these free radicals are formed. They damage cells which may lead to cellular dysfunction and disease
Colorful plant foods are loaded with antioxidants so eating a variety of fruits and vegetables is a great way to protect the body from oxidation, and therefore reduces the risk of numerous health conditions

Examples of antioxidants:

Beta carotene - carrots, cantaloupe
Vitamin C - citrus, cantaloupe, mango, and kiwi
Vitamin E - dark leafy greens, broccoli
Selenium – mushrooms, cabbage

Rainbow of Color

Phytochemicals contribute to the pigments of fruits and vegetables:

Red - lycopene found in tomatoes, watermelon, & pink grapefruit
Orange - beta carotene found in carrots, mangoes, & cantaloupe
Yellow - beta cryptothanxin found in pineapple, oranges, & peaches
Green - indoles found in broccoli, cabbage, & kale
Purple - anthocyanins found in blueberries, grapes, & eggplant
White – allicin found in garlic, onions, & chives

Research tells us that the more phytochemical-rich foods eaten, the lower the risk for diseases such as cancer and heart disease. Therefore we recommend eating a rainbow of fruits and vegetables daily.

Pesticide Use

Wash all fruits and vegetables with water
Before eating apples, cucumbers, potatoes or other produce in which the outer skin or peeling is consumed, scrub with a brush
Throw away the outer leaves of leafy vegetables, such as lettuce and cabbage
Peel and cook when appropriate, although some nutrients and fiber may be lost when produce is peeled

Choose Organic

We recommend organic fruits and vegetables because they contain less pesticide residue. We believe they also provide better flavor and are a better nutritional choice than conventionally grown produce.

According to the Consumers Union and The Environmental Working Group, the top fruits and vegetables to buy organic because of potential pesticide residue are:

Peaches
Apples
Pears
Green beans
Grapes
Strawberries
Raspberries
Spinach
Tomatoes
Cantaloupe

Ways to Transition to Organic Fruits and Vegetables

Shop at farmers markets
Buy a share in a community supported agriculture (CSA) program
- For more information, check out http://www.nal.usda.gov/afsic/csa/
Join a food co-op
Buy organic produce in-season and freeze/preserve
Grow your own fruits and vegetables
Ease into buying organic produce

Ideas to Increase Fruits and Vegetable Consumption

Do it gradually.
Snack on raw vegetables instead of chips and crackers. To keep it interesting, try dipping vegetables in hummus, salsa or low-fat dip.
Add fruit to your cereal or yogurt at breakfast.
Order salads as an appetizer when out to dinner.
Get creative. Add vegetables to dishes that don’t always include them, like scrambled eggs, rice or pasta dishes, pizza and casseroles.
Drink your fruit (including fruit just past it’s prime) in the form of a fruit smoothie.
Choose salads as your main course for lunch or dinner. For variety, top your salads with dried cranberries, sunflower seeds or other nuts.
In hot weather, frozen fruit such as grapes, sliced kiwis, sliced peaches and strawberries are a refreshing snack.
Enjoy salad bars at restaurants or grocery stores.
When craving a sweet treat, try dried fruit.
Buy fresh fruits and vegetables in season.
Frozen fruit and vegetables are frozen soon after harvest and can be eaten during the off season as a nutritious alternative to fresh produce.
Watch local grocery advertisements for reduced prices on your favorite fruits and vegetables.
Try fruit for dessert.
Prepare fruits and vegetables ahead of time in a way you like to eat them so they are readily available and desirable to you when you are hungry.
Fill half of your plate with fruits and/or vegetables.
Choose a rainbow of fruits and vegetables daily.

Diary

This Facts About reviews low-fat/non-fat dairy and gives examples of foods to choose from as well as foods to avoid. We provide a guide for selecting an appropriate portion size, and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per day?

Optional: 1-3 servings per day

Why choose low-fat/non-fat dairy products?

Though many foods contain calcium, dairy foods are some of the richest sources of calcium
They are high in protein, vitamin B12 and other minerals the body needs, such as selenium, zinc, phosphorus, potassium and magnesium
Most milk is fortified with vitamin D, which helps the small intestine absorb calcium
Low-fat and fat-free milk are also typically fortified with vitamin A, which is lost in the removal of milk fat
Selecting low-fat/non-fat dairy products helps reduce total and saturated fat intake and calories
While low-fat and non-fat dairy products are made using 1%, ½%, or non-fat milk instead of using whole milk or cream, artificial ingredients may be added to enhance color, shelf-life, and texture. Read labels and avoid products if the ingredients are chemicals or names too long to pronounce.
Although recent research suggests that dairy product intake may be associated with lower body weight or body fat, definitive evidence is pending.

Why choose fermented/probiotic milk products such as yogurt?

Probiotic foods contain healthy living bacteria. Eating such foods can help re-establish a healthy bacteria balance in the digestive tract that may have been disrupted by poor diet or medications. Research has shown that the healthful bacteria in yogurt may provide many benefits, such as:

Offering a safe and effective means of treating acute infectious diarrhea in children
Preventing antibiotic-associated diarrhea
Protecting against tumor formation in the colon
Reducing intestinal transit time which helps prevent constipation
Improving the digestion of lactose in persons with lactose intolerance
Enhancing gut and systemic immune function by increasing IgA antibody production
Preventing allergic reactions by reducing hypersensitivity reactions
Helps reduce symptoms of inflammatory bowel disease (IBD) such as Crohn’s and ulcerative colitis
Increasing HDL (good) cholesterol and decreasing the ratio of LDL (bad) to HDL cholesterol with long-term, daily intake of yogurt; this may be due to the fatty acid distribution and the type of fats in the milk

Other fermented milk products, such as low-fat/non-fat sour cream, cottage cheese, and cheeses (Swiss and Cheddar), may have similar benefits.

Selected Food Sources with Serving Sizes

Selected Low-fat Dairy Sources

1-3 servings per day
Select from the following with less than 3g fat per serving

Low-fat/non-fat yogurt (1 cup)

Low-fat/non-fat frozen yogurt (1 cup)

Low-fat/non-fat cottage cheese (1/2 cup)

Low-fat/non-fat cream cheese (1 tbsp)

Low-fat/non-fat sour cream (2 tbsp)

Part-skim ricotta cheese (1 oz or 1/8 cup)

Part-skim mozzarella (1 oz)

Skim milk (non-fat), 1/2%, or 1% (1 cup)

Specific Considerations

Choosing low-fat/non-fat dairy products

Low-fat dairy products have less than 3 g of total fat per serving
Check expiration date on containers
Choose dairy products from "free-range", "grass-fed" or "organic" animals to minimize consumption of antibiotic residues and other toxins

Full-fat cheese

Although full-fat cheese is high in total fat and saturated fat, small amounts of natural, minimally processed cheese can be an important dietary component. The Mediterranean diet, known for its health benefits, includes small amounts of cheese almost daily. Full-fat cheese should be consumed in small portions.

Buy high-quality cheese made by local farmers or imported from reputable creameries. This decreases the chance of antibiotic and hormone residues and use of trans-fats/hydrogenated oils as a means of processing cheese to increase shelf-life. Avoid pre-packaged cheeses for the same reasons.

Examples of Full-fat Cheeses

Up to 1 serving per day Serving size 1-2 oz
Soft	Brie, Mascarpone
Semi-hard	Blue, Feta
Hard	Cheddar, Swiss
Very hard	Parmesan, Romano

Lactose Intolerance

Many people are lactose intolerant, meaning that they lack the enzyme lactase that breaks down the natural sugar (lactose) found in dairy products. Around the world, various ethnic groups have different proportions of those who are lactose intolerant; approximately 90% of Asians, 70% of African and Native Americans and 50% of Hispanics are lactose intolerant, versus only about 15% of people of Northern European descent.

Lactose intolerance can cause bloating, gas, and stomach aches after intake of dairy products. Symptoms may be avoided by choosing fermented dairy products such as yogurt or lactose free milk.

Casein Sensitivity

The milk protein casein, found in dairy products, stimulates the production of mucus in some people and can potentially aggravate conditions like auto-immune disease, asthma, bronchitis or sinusitis. Some studies suggest that casein may irritate the immune system which should be considered by people who have “overactive immune systems” – often manifested by chronic allergies, lupus and rheumatoid arthritis, for example.

Choose Organic

We recommend organic, free-range animal products because they contain less antibiotic or hormone residue and have a higher omega-3 and vitamin E content. These qualities make organic animal products a better nutritional choice. We believe they generally provide better flavor than conventionally raised animals.

Organic food is produced by farmers who emphasize the use of renewable resources and the conservation of soil and water to enhance environmental quality for future generations. Organic meat, poultry, eggs, and dairy products come from animals that are given no antibiotics or growth hormones. With the increase in incidence of hormone-related diseases such as breast and prostate cancer, it may be prudent to consume only organic dairy products.

Hormones and Antibiotics

Most commercial animal products contain residues from drugs, hormones, and chemicals used to keep modern dairy cows producing abundantly. These residues in food may increase the risk of breast cancer and other hormone-related cancers including prostate cancer.
Most commercially-raised animals may have been exposed to antibiotics. This practice contributes to the escalating problem of antibiotic-resistant bacteria throughout the world.

Know Your Limits for Fat

On a 2,000 calorie diet, about 30% or 600 calories (67g) should come from total fat per day
A ratio of 1:2:1 of saturated: monounsaturated: polyunsaturated (such as Omega-3s) fat should be the goal. 1:2:1 in calories equals 150:300:150 - no more than 150 calories or 7.5% (17g) of total calories should come from saturated fat
A low-fat dairy product has less than 3g of fat per serving

Ideas for your dairy consumption

Freeze yogurt for a frozen dessert. Research shows that probiotic bacteria can survive the freezing process, so freezing yogurt will not diminish its health benefits.
Plain yogurt, mixed with fresh fruit, makes a quick and easy snack. Since plain yogurt has no added sugars choosing it reduces your sugar and calorie intake. Additionally you get added fiber and antioxidants from the fresh fruit!
Use cottage cheese like a dip for raw vegetables and whole grain pretzels or pita chips.
Full-fat cheese has big flavor (and lots of fat). An ounce or two can be a satisfying treat.

Seasonings

This Facts About reviews spices and herbs and gives examples. We provide a guide for selecting an appropriate portion size, and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per day?

Use a variety of spices, herbs, and alliums in your daily food preparation. Experiment cautiously with hot peppers.

What are spices, herbs, alliums and hot peppers?

Herbs refer to leaves of low-growing shrubs. They can be used fresh or dried.
Spices may be the seeds, buds, berries, bark, root, or fruit of tropical plants and trees
Alliums are bulbous plants that are used as flavoring for foods and for their medicinal properties. They are found in most regions of the world except the tropics, New Zealand and Australia.
Hot peppers are edible, pungent fruits of the species Capsicum. They are used as spices and flavoring for foods and for their medicinal properties.

Why choose a variety of seasonings?

Seasonings are grown for their culinary and medicinal properties
They may be helpful in many medical conditions, such as:
- Nausea
- Infections
- Anti-inflammatory conditions
- Autoimmune disorders
- High blood pressure
- Cholesterol levels

Selected Food Sources - The following information is not meant to be an exhaustive list. Due to limited space, we have highlighted only a few of the many beneficial seasonings.

Selected Seasonings
Spices	curry, turmeric, cumin, chili pepper, fennel, cinnamon, ginger, cloves, nutmeg, allspice, mustard seed, black pepper, paprika, salt, cardamom, vanilla, horseradish, anise
Herbs	parsley, chives, thyme, sage, oregano, mint, rosemary, tarragon, basil, dill, cilantro, coriander, marjoram, caraway, savory
Alliums	green onions, onions, shallots, leeks, chives, garlic
Hot Peppers	cayenne, jalapeno, Anaheim , chipotle, habanero, Serrano, ancho

Special Considerations

Whole Turmeric in Powdered Form

Tumeric is the yellow spice most familiar in Indian cooking and American prepared mustard
Has antioxidant and anti-inflammatory properties
May decrease symptoms of autoimmune disorders, arthritis, tendonitis, and other disorders with inflammation
Curcumin is the part of turmeric that gives the yellow color

Fresh Ginger Root

Ginger is an underground stem or rhizome which sprouts large pink and orange flowers that look as if they have been carved out of wax
Has anti-inflammatory properties
Helps with nausea and motion sickness
Decreases symptoms of arthritis and bursitis
Reduces platelet aggregation

Fresh Garlic Cloves

Garlic cloves are the segments of a head or bulb of garlic
Natural antibiotic and antiviral agent as a result of sulfur-containing compounds
May help with infections: colds, sore throat, ear infections in children, fungal or yeast infections
May slow development of atherosclerosis, improve high blood pressure and decrease total and LDL (bad) cholesterol by reducing blood platelet stickiness and artery spasms
May decrease risk of developing colorectal, prostate, breast, liver, skin, and digestive tract cancers by inhibiting the growth of tumors and stimulating the immune system

Fresh or Dried Peppermint

Fresh or dried peppermint are the leaves from the peppermint plant
Used as a digestive remedy for relief of heartburn, indigestion, and nausea
May soothe the lower GI tract by decreasing spasms and gas formation
Contains antioxidants called flavonoids which stimulate bile and saliva production
Its soothing effect results from the stimulation of salivation, which increases the swallowing reflex and suppresses cough

Cayenne Pepper

A very pungent spice produced by drying and grinding the orange to deep-red fruits of small-fruited species of Capsicum
Capsicum is used to stimulate digestion
Eases toothache pain
Improves peripheral circulation
Reduces blood clotting tendencies
Decreases cholesterol
Helps to prevent arteriosclerosis and heart disease

Whole food vs. supplements

Whole foods are the best sources of vitamins, minerals, and other plant compounds that help you stay healthy and fight disease
We recommend these foods in their natural form. Taking them in supplement form may reduce their effectiveness and may increase the risk of side effects.

Interactions with medications and medical conditions

Because of their medicinal qualities, some spices and herbs may interact with medications. We advise individuals to contact their physician if taking medications.

How to use seasonings

Spices and herbs should be stored in a cool, dry place.
Green herbs should be protected against direct sunlight exposure.
Ground spices release flavor immediately, therefore add them at the end of the cooking period.
Whole spices should be added at the beginning of cooking so their full flavor can be extracted.
Crumbling whole herbs just before use helps to release their flavor.
Chopping or mashing garlic releases an active medicinal component, allicin.
To reduce the heat of hot peppers, remove the seeds.
Fresh herbs can be added to salads, soups and sauces.

Healthy Fats

This Facts About reviews healthy fats and gives examples of foods to choose from as well as foods to avoid. We provide a guide for selecting an appropriate portion size, and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per day?

3-9 servings per day (see serving sizes below)

What are the different types of healthy fats and oils?

Fats and oils are made up of basic units called fatty acids. Each type of fat or oil is a mixture of different fatty acids.
Monounsaturated Fatty Acids (MUFA) are found mainly in vegetable oils, nuts, seeds and some plant foods. They are liquid at room temperature.
Polyunsaturated Fatty Acids (PUFA) are found mainly in vegetable oils, fish and seafood. They are liquid or soft at room temperature. Omega-3 and omega-6 fatty acids are types of PUFA and are considered essential fatty acids because our bodies cannot make them, thus they must be obtained through the diet.
Saturated Fatty Acids are usually solid at room temperature and are found mainly in foods from animal sources like meat, dairy products and butter. Some vegetable oils such as coconut, palm kernel and palm oil are saturated.
Trans Fatty Acids are liquid vegetable oils that have been chemically processed to become solid at room temperature through the addition of hydrogen atoms. These hydrogenated and partially hydrogenated oils are used in some margarines and fried foods as well as to improve the flavor, texture and shelf-life of processed snack foods like cookies and crackers.

Which fats are recommended?

Emphasize consumption of monounsaturated and omega-3 fatty acids
Limit consumption of saturated and trans fats (listed as hydrogenated or partially hydrogenated vegetable oils on labels)
All foods containing fat have a mixture of polyunsaturated, monounsaturated, and saturated fatty acids. It is not feasible or desirable to completely eliminate one type of fatty acid from your diet.

Why choose healthy fats like MUFA and omega-3s?

They provide antioxidants such as vitamin E and selenium
Small amounts of healthy fats help the body absorb the vital nutrients from fruits and vegetables
Including healthy fatty acids in the diet in appropriate quantities can help prevent and treat: diabetes, heart disease, cancer, obesity, musculo-skeletal pain, inflammatory conditions
Some research suggests that diets including MUFA can have a positive effect on cholesterol, blood pressure, blood clotting and inflammation.
Omega-3 fatty acids are necessary for proper brain growth and development. They are anti-inflammatory and may be helpful in the prevention and treatment of heart disease, high blood pressure, inflammation, mental health disorders, diabetes, digestive disorders, autoimmune disease and cancer.

Why should I avoid saturated and trans fatty acids?

Saturated fat eaten in excessive amounts is the main culprit in raising total and LDL “bad” cholesterol, which can increase risk of heart disease.
Trans fatty acids may act like saturated fats in the body and raise LDL cholesterol levels. They may also lower HDL (“good”) cholesterol.
A food item may contain less than 0.5 grams of trans fat per serving but still reflect “0” grams of trans fat on its food label. To ensure that the foods you eat are actually free of trans fat, check that hydrogenated and partially hydrogenated vegetable oils are not listed as ingredients.

Selected food sources of MUFA with serving sizes (listed highest to lowest MUFA content)

Oils
(serving size is 1 teaspoon)

Nuts (serving size)

Seeds (serving size)

Butters (serving size)

Other (serving size)

Olive oil

Canola oil

Peanut oil

Sesame oil

Walnut oil

Soybean oil

Flaxseed oil (should be consumed raw and not used in cooking)

Grape seed oil

Macadamias (2-3)

Hazelnuts (5)

Pecans (5 halves)

Almonds (7)

Cashews (6)

Pistachios (17)

Brazil nuts (2)

Peanuts (9)

Pine nuts (50)

Walnuts (4 halves)

Sesame seeds
(1 Tbsp)

Pumpkin seeds
(47 seeds)

Ground flaxseed
(1 Tbsp)

Sunflower seeds
(3 Tbsp)

Almond butter
(½ Tbsp)

Cashew butter
(½ Tbsp)

Peanut butter (½ Tbsp)

Tahini/sesame paste (2 tsp)

Sunflower seed butter (2 tsp)

Avocado
(2 Tbsp or 1 oz)

Black olives(8)

Green olives (10)

Selected Plant Sources of Omega-3 Fatty Acids (listed highest to lowest omega-3 content)
Please visit the Fish & Seafood sections for more information about animal sources of omega-3 fatty acids.

Oils (serving size = 1 teaspoon)	Nuts and seeds (serving size)
Flaxseed oil*	Flaxseeds (1 Tbsp)
Walnut oil	Walnuts (4 halves)
Canola oil	Pecans (5 halves)
Soybean oil	Pine nuts (50)
*Should be consumed raw and not used in cooking.

Specific Considerations

Calorie-controlled high-MUFA diets:

Do not promote weight gain
Are more suitable than low-fat diets for weight loss in obese people
Are a substitute for low-fat diets for medical nutrition therapy in diabetes

Flaxseed Facts

Flaxseeds are an oilseed just like canola and sunflower are oilseeds. The seeds that come from flax provide excellent health benefits:

Rich source of omega-3 fatty acids, which are similar to the healthy fats found in fatty fish such as salmon
Good source of fiber
Contain other beneficial plant nutrients called lignans; research shows that a diet that contains lignans may reduce the risk of several types of cancer as well as heart disease and osteoporosis
Using ground flax meal or grinding flaxseeds in a coffee grinder is necessary to make MUFA available to our bodies.

What is the daily recommended intake of omega-3 fatty acids?

There are currently no established guidelines regarding optimal omega-3 intake. According to the Institute of Medicine, the Adequate Intake (AI) is 1.1g daily for women and 1.6 g daily for men. However, some experts believe that these recommendations might be too low to obtain the health benefits associated with omega-3s. Research shows benefits associated with higher intake of 2-3 g per day.

Why is the fat ratio important?

Two types of fatty acids that are essential for human health are omega-3 and omega-6. Studies suggest that decreasing the ratio of omega-6 (in vegetable oils) to omega-3 fatty acids (in fatty fish and some vegetable oils) is important to reduce risk of cancer and heart disease, inflammatory conditions, and depression.

Most people consume too many omega-6 fatty acids and consume too little omega-3 fatty acids. To reduce your risk of chronic disease, reduce your intake of omega-6 fatty acids and increase your intake of omega-3 fatty acids.

Avoid vegetable oils such as corn or safflower oil.
Eliminate highly processed foods.
Eat high omega-3 fish at least twice per week.

Know Your Limits for Fat

On a 2,000 calorie diet, about 30% or 600 calories (67g) should come from total fat per day
A ratio of 1:2:1 of saturated to monounsaturated to polyunsaturated (such as omega-3s) fat is recommended
1:2:1 in calories equals 150:300:150; no more than 150 calories or 7.5% (17g) of total calories from saturated fat
Most people consume too much saturated fat and not enough monounsaturated or omega-3 fatty acids.

Ideas to balance your fat consumption

Choose salad dressings that use olive, canola, or flaxseed oils as its base.
Add avocados, nuts, or olives to salads instead of high saturated fat animal foods like cheese, butter and meat.
For a snack, opt for a small handful of nuts/seeds each day in place of highly processed and high fat choices including chips, pastries, and cookies.
Use olive and canola oils for most cooking.
To increase plant sources of omega-3s, choose walnuts, ground flaxseed and uncooked flaxseed oil.
Never use oils, seeds or nuts after they begin to smell or taste rank or bitter. This is a sign that the oil has begun to turn rancid through a harmful oxidation process.
For high temperature sautéing or frying, use oils with a high smoke point, like canola or grape seed oils.
Limit/avoid consuming:
- Polyunsaturated vegetable oils like safflower, sunflower and corn oil
- Margarine, vegetable shortening, and all products made with partially hydrogenated oils
- Saturated vegetable oils such as coconut, palm kernel and palm oil
Use high-quality cold-pressed olive oil, flaxseed oil or sesame oil as an addition to cooked foods or salads before eating.
Add a tablespoon or two of ground flax seeds or flax meal to smoothies, muffins, bread or any other home-made baked item.
Choose white meat; in general, red meat (fatty beef, lamb, pork, ham, duck, and goose) has more saturated fat than white meat (turkey or chicken without skin) or fish
Be aware of any foods deep fried in restaurants. Deep fried foods may say “fried in vegetable oil”, but it is often hydrogenated vegetable oil.

Fish and Sea Food

This Facts About lists common fish & seafood with an emphasis on those choices with high omega-3 content. We make recommendations on how to avoid toxins and choose fish & seafood that support sustainable fisheries. We provide a guide for selecting appropriate portion sizes and recommendations for incorporating healthy choices into your diet.

What are the recommended servings of fish & seafood?

Optional: 2-4 servings per week, including at least 2 servings of fish with high omega-3 content
- Serving size 4-6 ounces

Why should you choose fish & seafood?

Low in saturated fat
Rich source of protein and iron
Contains B-12 vitamins
Richest source of omega-3 fatty acids may be helpful in the prevention and treatment of: heart disease, high blood pressure, inflammation, mental health disorders, diabetes, digestive disorders, autoimmune disease, and cancer

Selected Food Sources with Serving Size*

Selected Fish and their Omega-3 Fatty Acid Content (2.0 g and above per serving)

Finfish High in Omega-3s	Average grams of omega-3 fatty acids per 6 ounce portion
Anchovy, European, canned in oil	3.4 g
Wild Salmon	3.2 g
Pacific and Jack mackerel	3.2 g
Sable Fish	3.0 g
Whitefish	3.0 g
Pacific sardine	2.8 g
Bluefin tuna	2.8 g
Atlantic herring	2.4 g
Atlantic mackerel	2.0 g
Rainbow trout	2.0 g
Note: We recommend eating fish listed in this table at least twice per week*

Selected Fish and Seafood with Moderate-Low Omega-3 Fatty Acid Content (less than 2.0 g per serving)

Common Finfish	Grams of Omega-3's per 6 oz. portion	Common Seafood	Grams of Omega-3's per 6 oz. portion
Tuna, white albacore, canned in water	1.4 g	Mussel	1.4 g
Halibut	0.8 g	Wild Eastern Oyster	1.0 g
Pollock	0.8 g	Farmed Eastern Oyster	0.8 g
Ocean Perch	0.4 g	Blue crab or Alaska King crab	0.8 g
Tuna, light, canned in water	0.4 g	Shrimp	0.6 g
Yellowfin tuna	0.4 g	Scallop	0.6 g
Cod	0.2 g	Clam	0.4 g
.	.	Lobster	0.2 g
.	.	Crayfish	0.2 g
*Note: While the fish and seafood above do contain some omega-3s, other fish are richer sources (see High Omega-3 table above)*

* Omega-3 content of various fish and seafood sources are averages and may depend on factors such as time of year of harvest and body of water in which the animal resides. Values should be used for comparison of relative amounts in fish and seafood sources of omega-3 fatty acids.

Special Considerations

Choosing Fish & Seafood

Seafood should not smell "fishy" but rather like a "fresh ocean breeze"
Mollusks should always be alive when purchased with the shells. Shells should be tightly closed or close tightly when gently tapped.
Use fresh fish no later than 2 days after purchase
For long-term storage, fish must be frozen
Fish is fully cooked when the flakes separate easily; about 10 minutes of cooking time per 1 inch of thickness

What are omega-3 fatty acids?

Omega-3 fatty acids are a type of polyunsaturated fatty acid (PUFA). They are an essential component of the human diet because our bodies can not make them. These fats are necessary for proper brain growth and development. Omega-3s are most abundant in deep-water fatty fish and some plant foods. They are anti-inflammatory and may be helpful in the prevention and treatment of numerous conditions.

Which fish should you eat to get the greatest benefits of omega-3 fatty acids?

Omega-3 fatty acid content varies greatly among different species of fish. Cold-water fatty fish have the highest content of omega-3 fatty acids because their physiology, environment and diet promote omega-3 fatty acid production in their flesh.
All fish contain some amount of omega-3s, however quantities vary among species and within a species according to the same factors mentioned above, i.e. environment and diet.

What is the daily recommended intake of omega-3 fatty acids?

There are currently no established guidelines regarding optimal omega-3 intake. According to the Institute of Medicine, the Adequate Intake (AI) is 1.1g daily for women and 1.6 g daily for men. Although some experts believe that these recommendations might be too low to obtain the health benefits associated with omega-3s. Research shows benefits associated with higher intake of 2-3 g per day.

Why is the fat ratio important?

Two types of fatty acids that are essential for human health are omega-3 and omega-6. Studies suggest that decreasing the ratio of omega-6 (in vegetable oils) to omega-3 fatty acids (in fatty fish) is important to reduce risk of cancer and heart disease, inflammatory conditions, and depression.

Avoid vegetable oils such as corn or safflower oil.
Eliminate highly processed foods.
Eat high omega-3 fish at least twice per week.

Know Your Limits for Fat

On a 2,000 calorie diet, about 30% or 600 calories (67g) should come from total fat per day
A ratio of 1:2:1 of saturated: monounsaturated: polyunsaturated (such as Omega-3s) fat is recommended
1:2:1 in calories equals 150:300:150; no more than 150 calories or 7.5% (17g) of total calories from saturated fat

Potential Chemical Contaminants

Risk of Mercury Poisoning

Mercury is a toxic heavy metal that can accumulate in fish. Eating fish with high levels of mercury can negatively impact brain development in children and can affect learning and memory function in adults. Certain fish species are known to have higher mercury concentrations than others, sometimes due to polluted waters. The highest levels of mercury and contaminants tend to accumulate in the large predatory fish at the top of the food chain.

Avoid in pregnancy and in young children*

Shark

Swordfish

King mackerel

Tilefish

Limit intake in children as well as pregnant and nursing women**

Albacore tuna
Bass (Sea and Largemouth)
Bluefish
Grouper
Halibut
Lobster
Marlin
Red snapper
Pike
Orange roughy
Spanish mackerel
Walleye

Low levels of mercury-containing fish**

Anchovies
Atlantic mackerel
Catfish
Cod
Canned light tuna
Haddock
Herring
Mahi mahi
Pollock
Salmon
Sardine
Shad
Shrimp
Trout
Whitefish

Advice from the EPA for women who are pregnant, planning to become pregnant or nursing:

*Do not eat shark, swordfish, king mackerel, or tile fish because they contain high levels of mercury. Everyone else can eat up to 6 ounces of high-mercury fish per week.
** Eat up to 12 ounces per week (about 3 to 4 servings) of a variety of fish and shellfish that are lower in mercury
Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.
A commonly eaten fish, albacore ("white") tuna contains higher levels of mercury than canned light tuna because these fish are larger. Limit consumption to 6 ounces of albacore tuna per week.
For further information about the safety of locally caught fish and shellfish, visit the Environmental Protection Agency's Fish Advisory website www.epa.gov/ost/fish or contact your State or Local Health Department. A list of state or local health department contacts is available at www.epa.gov/ost/fish. If no advice is available, eat up to 6 ounces per week of fish you caught from local waters, but don't consume any other fish during that week.
Follow these same recommendations when feeding fish and shellfish to your young children, but serve smaller portions

Risk of PCB Exposure

PCBs (polychlorinated biphenyls) are industrial pollutants that find their way into fresh waters and oceans where they are absorbed by fish. A recent study reported unacceptable levels of PCBs in fish feed given to farmed salmon. The study reported that PCB levels in farmed salmon, especially those in Europe, were about seven times higher than in wild salmon. PCBs are potential human carcinogens, known to promote cancer in animals. Other potential health effects include impaired memory and learning, and adverse effects on the immune, reproductive and nervous systems. Until more research results are available, it may be prudent to choose wild salmon over farmed salmon and eat a wide variety of fish, along with plant sources of omega-3s. You can reduce PCB exposure from fish by removing the skin and visible fat as well as baking, broiling or grilling fish instead of frying.

Farmed vs. Wild

The old adage “you are what you eat” applies even if you are a fish. The location and living conditions where fish and seafood live can affect what they eat and their exposure to chemicals. In some studies, farm-raised fish have been shown to contain higher levels of contaminants compared to fish caught from the wild. However, there are some ethical fish farms that take good care of their fish and limit contaminant exposure. Recommendations have not yet been established for farmed vs. wild fish and seafood sources although the EPA has limited fish consumption in vulnerable populations such as children and women of childbearing age. Talk to the person you buy your fish and seafood from to better understand this issue.

Incorporating High Omega-3 Fish into Your Diet

Order a variety of fish in restaurants and avoid fish that is fried or dipped in batter.
Experiment with fish recipes to replace red meat and other high fat choices.
Look for wild salmon at your local health food stores.
Mix canned sardines with your own combination of chopped red onion, avocado, hard-cooked eggs, lemon juice, salt and/or pepper.
Add chopped anchovies to pasta sauce just after you sauté your onions and garlic; the fish will melt away while leaving a mild, subtle fishy taste to your sauce.
When buying canned products, look for fish packed in water or olive oil (preferably, extra-virgin).
Cook with either dry or moist heat methods; poached, steamed, grilled, baked, or broiled are preferred.
Avoid fish that is battered and fried, slathered in butter, or blanketed in creamy sauces to reduce saturated fat and calorie intake.

Lean Meats

This Facts About reviews lean meats and gives examples of foods to choose from as well as foods to avoid. We provide a guide for selecting an appropriate portion size and recommendations for incorporating healthy changes into your diet.

What are the recommended servings per week?

Optional* : 1-3 servings per week

*Optional - Those individuals choosing to not include animal foods in their diet need to be aware of important nutrients found in these foods. These nutrients can be obtained from a thoughtful and varied vegetarian diet. However, some individuals who avoid animal products may develop a vitamin B12 or iron deficiency and may also need to consider a calcium supplement. If you have questions regarding this, consult with your physician or registered dietitian regarding your individual needs.

Why choose lean meat?

High protein source
Rich iron source
Contains B-12 vitamins

Selected Food Sources with Serving Sizes

Selected Lean Meat Sources Lean Meat Portion size: 2-3 oz
Poultry	Beef	Pork	Lamb	Wild Game
Chicken	Flank steak	Centerloin	Chops	Venison
Cornish hen	Sirloin tip	Tenderloin	Leg roast	Bison
Turkey	Eye of Round	Canadian bacon	Tenderloin Shank	Elk
White meat, but not dark meat, without skin is considered lean.	Top Round			Ostrich
	Tenderloin			Emu
	Top Loin			Squab
	Rump roast			Wild duck
	Extra lean ground beef			Pheasant
	Extra lean ground beef			Rabbit

Special Considerations?

Choosing lean meats

Choose lean meat containing less than 3g of fat per 1 oz
Generally, the leanest cuts of meat contain round or loin in their name
Choose animal products that are labeled “organic,” “hormone-free,” “antibiotic-free,” “free-range,” “grass-fed, “ and / or “wild” whenever possible
Choose lean meat over higher fat choices to reduce total fat intake
Consume lean meat weekly rather than daily
Look for poultry with USDA Select grading of A and B
Look for beef with USDA Select or Choice grading
To lower the fat content of poultry and other meat, cut off skin and fat before cooking and/or eating it
While many grocery stores carry both ground chicken and ground turkey, it may contain as much fat as ground beef because it may include dark meat and skin. For lower fat, choose ground breast meat or look for low fat ground chicken or turkey.

Saturated Fat Content

Lean meat contains less than 3g of fat per 1 oz , which is less than higher fat choices, but still contains some saturated fat
The typical American diet is high in saturated fat, coming mostly from animal foods
Eating too many foods with saturated fat may increase blood levels of LDL and total cholesterol. High blood levels of LDL and total cholesterol are risk factors for heart disease.
Diets high in saturated fat promote obesity, cancer, heart disease, inflammatory arthritis, diabetes, and chronic pain

Use of Hormones and Antibiotics

Most commercial animal products contain residues from drugs, hormones, and chemicals used to keep modern dairy cows producing abundantly. These residues in food may increase the risk of breast cancer and other hormone-related cancers including prostate cancer.
Most commercially-raised animals may have been exposed to antibiotics. This practice contributes to the escalating problem of antibiotic-resistant bacteria throughout the world.

Choose Organic

We recommend organic, free-range animal products because they contain less antibiotic or hormone residue and have a higher omega-3 and vitamin E content. These qualities make organic animal products a better nutritional choice. We believe they generally provide better flavor than conventionally raised animals.

Organic food is produced by farmers who emphasize the use of renewable resources and the conservation of soil and water to enhance environmental quality for future generations. Organic meat, poultry, eggs, and dairy products come from animals that are given no antibiotics or growth hormones. Organic food is produced without using most conventional pesticides, petroleum-based fertilizers, or sewage sludge-based fertilizers, bio-engineering, or ionizing radiation. Organic systems replenish and maintain soil fertility, eliminate the use of toxic and persistent pesticides and fertilizers, and build biologically diverse agriculture.

Free-Range, Grass-fed, Pasture-raised

Some studies have shown that free-range, grass-fed and pasture-raised animals contain more omega-3 fatty acids and vitamin E. Free-range farming generally provides adequate room inside. To be certified by the USDA, producers must demonstrate to the Agency that the animal has been allowed access to the outside. These animals have fresh air, open space, and enjoy shelter. They also have the opportunity to forage for food.

Know Your Limits for Fat

On a 2,000 calorie diet, about 30% or 600 calories (67g) should come from total fat per day
A ratio of 1:2:1 of saturated: monounsaturated: polyunsaturated (such as Omega-3s) fat is recommended
1:2:1 in calories equals 150:300:150; no more than 150 calories or 7.5% (17g) of total calories from saturated fat

Ideas for your lean meat consumption

When ordering lean meat in restaurants make sure that it has been prepared with either dry or moist heat methods; poached, steamed, grilled, baked or broiled are preferred.
To reduce saturated fat and calorie intake, avoid meat that has been battered and fried, slathered in butter, or blanketed in creamy sauces.
Experiment with leaner cuts of meat in your favorite recipes to replace higher fat choices.
Choose lean meat up to 3 times per week rather than daily.
Use lean meat to flavor meals rather than as the main focus.
Be mindful of portion size for all meats – a 2-3 oz serving of lean meat is approximately the size of a deck of cards
To reduce the amount of meat in a recipe, replace half with beans, mushrooms or other vegetables.

Alcohol

This Facts About reviews the benefits and risks of alcohol consumption. It also provides a guide for selecting appropriate amounts.

What are the recommended servings per day?

Optional: 1-2 servings per day depending on age, gender, and history

Optional - Although there are some documented health benefits to moderate alcohol consumption, we do not encourage people to start drinking. As with other categories listed in this pyramid, there are potential health risks that must be weighed (see health concerns section).

What is moderate drinking?

One drink or less a day for women and people over 60
Two drinks or less a day for men (no more than one an hour)

This limit is based on the differences between men and women both in weight and the way they metabolize alcohol.

Is the risk-benefit balance for an individual drinker favorable or unfavorable?

Risk-benefit balance depends on the individual's age, gender, and history. We do not recommend alcohol consumption for:

Women who are pregnant or planning to become pregnant
People who plan to drive or engage in other activities that require attention or skill
People taking medications that interact with alcohol, including some over-the-counter medications
Individuals with a history of alcoholism or alcohol abuse
Those under the age of 21

Selected Alcohol Beverage Sources with Serving Sizes

Type of Drink	Serving Size	Typical % Alcohol	Total Amount of Alcohol
Beer	12 oz.	5 %	0.6 oz.
Wine	5 oz.	12 %	0.6 oz.
Hard liquor (whiskey, vodka, rum, gin, scotch)	1.5 oz.	40 %	0.6 oz.
The alcohol content of a beverage is dependent on its alcohol concentration, or % alcohol. The above examples contain approximately the same amount of alcohol.

What are the potential health benefits of moderate alcohol consumption?

May lower risk of coronary artery disease and heart attack
May decrease risk of stroke caused by blocked blood vessels
Decreases tension, anxiety, and self-consciousness
In the elderly, stimulates appetite and may promote regular bowel movement
May be associated with a decreased risk of gall bladder surgery in women

Red Wine

Moderate consumption may be associated with longevity
Contains tannins, which may raise HDL (good) cholesterol levels and inhibit platelet cells in the blood from clumping together
Contains resveratrol, an antioxidant compound found in grapes, which may decrease the development of some cancers
Resveratrol affects the immune system and inflammation in the body; both immune and inflammatory components are thought to be important in the development of plaque buildup in blood vessels, which often leads to heart disease
Significant source of saponins, antioxidants believed to promote heart health by binding to cholesterol in the blood and preventing its absorption
Saponins may play a role in decreasing inflammation, which could have beneficial effects in reducing heart disease and cancer risks

Liquor and Beer

Raises HDL (good) cholesterol levels
Inhibits platelet cells in the blood from clumping together

What are the health concerns of alcohol consumption?

Increases risk of accidents
Often a trigger for migraine headaches
Increases strokes caused by bleeding
Higher risk of fetal alcohol effect (FAE), low birth weight, and stillbirth
Increases physical, mental, and behavioral problems among the children of mothers who drink during pregnancy
Medication interactions - including non-prescription drugs
Increases the risk for cancers of the oral cavity, pharynx, esophagus, and larynx
Increases the risk for cancers of the stomach, colon, rectum, liver, and ovaries
Increases accumulation of fat in the liver, alcoholic hepatitis, and cirrhosis. This contributes to liver disease and sometimes liver failure.
Increases estrogen levels, a risk for breast cancer
Tobacco use enhances alcohol's effects on the risk for cancers of the upper digestive and respiratory tract
Liquor consumption (not beer or wine) may be associated with higher homocysteine levels in the blood which is associated with an increased risk of heart disease

Specific Considerations

Abstinent individuals should not begin to drink solely for health benefits
Some benefits can be achieved from whole foods instead of alcohol. Resveratrol contained in grape skins is available in whole grapes, grape juice or wine.
Ask your physician about potential benefit and harm of alcohol consumption in your individual case, considering your age, gender, medical history, and medications

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