EcoNutrition
A Semi-vegetarian Lifestyle is a Natural Way to be Optimally Healthy and Age Well, to Lose Weight and Cure Obesity and Prevent Cancer, Heart Disease, Diabetes, Alzheimer’s, Musculoskeletal Injuries & Similar Conditions.
Gerald N. Waagen, D.C., Ph.D.
Professor
Palmer College of Chiropractic
West Campus
San Jose, California
Caveat.
The information published in this book is for educational purposes only and must not be viewed as personal medical advice. The information herein published is not meant to replace, supplant, augment, or diminish the advice of a health professional in the medical care of the reader. Neither the author nor the publisher is responsible for any harm, real or imagined, that could take place using information herein contained. The author recommends seeing your doctor before engaging in a change of dietary habits or exercise.
Smashwords Edition
Copyright 2011 Gerald N. Waagen
License Notes
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Table of Contents
The food is really good but the way most modern people eat is not.
Part 1. Our role in the ecosystem is determined by a combination of culture and genes, both are important.
Chapter 1. All living organisms need energy.
Chapter 2. We have some unusual genetic appetites that cause health problems.
Chapter_3 There are difficulties with popular cultural solutions, vegetarianism, fad diets, and government agency plans. The New American Plate
Part 2. A modern semi-vegetarian lifestyle for optimal health.
Chapter 4. An ecologically appropriate and genetically satisfying semi-vegetarian diet is a practical and attractive lifestyle solution to the modern eating problem. Fifteen Eating Principles. Lowcost Lowcal 4 Meal Plan
Chapter 5. Basics. The Five Shopping Facts You Need to Know The KISSS Rule Equipment Difficulty Time etc French Terms Whole vs processed grains & potatoes
Part 3. Recipes and helpful info for preparing healthy semi-vegetarian cuisine.
Chapter 6. Breakfast Oatmeal Tostada Simplest French Toast Pancakes Granola Scones
Chapter 7. Lunch. Cottage Salad, Healthy Salad Dressings: Tzatziki, Raita, Peanut Sauce, Sesame Soy Vinaigrette, Homemade Cajun Spice, Thai Dipping Sauce, Sandwiches, Summer Soup, Potato Leek Soup, Ratatouille
Chapter 8. Enjoy a healthy 4-course semi-vegetarian main meal dinner of 700-800 calories with at least 2 vegetables.
Chapter 9. Stir-fry dinners. Three Stages of a Stirfry, Cajun Chicken, African Stew, Peppery Pork, Beef, with Tomato, Fried Rice, Coconut Curry Chicken, Curry Pastes. Thai Noodles or Pad Thai
Pasta dinners.. How to Cook Pasta. Spaghetti, MacNCheese, Roux, white sauce, & gravy, Sesame Chicken Noodles
Chapter 11. Mexican-style dinners. Enchilada Casserole, Tortilla Fiesta, Cornbread, Tamale Pie
Chapter 12. Legumes. How to Cook Beans, Chili, Dal, Split Pea Soup
Chapter 13. Rice. Steamed Rice, Mexican Rice, Dirty Rice, Coconut Rice
Chapter 14. Fish & meat entrées: Fish Tacos, Mango Salsa, Braised Trout, Baked Salmon, Moqueca, Thai Beef, Cajunstyle Sloppy Joes
Chapter 15. Fruits & vegetables. Green Papaya Salad or Som Tum, Simplest Steamed Vegetables, Cauliflower Puttanesca, Roasted Vegetables, Potato Caponata
Chapter 16. Snacks: Chips etc. Yogurt Fruit, Dried Fruits and Nuts, Granola and Salsa, Crudites etc, Peanut Butter Toast, Cheese and Crackers, Hummus
Chapter 17. Slow-cooker chicken stock.
Epilogue and the Six Factors of Wellness: nutrition, exercise, toxic chemical avoidance, psychosocial integration and stress management, early detection and prevention, financial stability.
Biography
The food is really good but the way most modern people eat is not.
“Spaceship Earth is so ingeniously designed that no one has a clue that we are on one, flying through the Universe at a million miles per hour with no need for seatbelts, lots of room in coach, and really good food,” R. Buckminster Fuller, quoted by Paul Hawken, Commencement Address, Univ. of Portland, ‘09.
In the post-war industrial world the quality of food has plummeted while the quantity has increased beyond the wildest dreams of our ancestors. Modern people eat too much and they eat too many ingredients that are preserved for storage and transportation and enhanced with artificial flavorings and colorings. Many preventable chronic diseases are caused by eating excessive quantities of processed foods.
I grew up in a small farming community in Utah. After my Master’s in biology I volunteered for the Peace Corps in Malaysia. In addition to living and traveling in Asia, Europe, and the Middle East, I completed a Ph.D. in ecology. I am a licensed physician and for many years taught a college nutrition course. When I was diagnosed with hypertension and then had a heart attack I was determined and confident that I could find a practical way to cope with my problem.
As a scientist and a doctor I am forced to accept certain truths. As much as we might wish we are not angels who are exempt from the limitations of human history and the biological world we live in. Therefore our plans must be realistically based on our genetic heritage and our role in the ecosystem. My ultimate goal was to thrive and be optimally healthy and age well and avoid preventable chronic diseases. That was the goal that I had for myself, and it seemed to me, as a socially responsible adult, that I needed to include my family and my community. I had 2 excellent reasons for including others. First, I have an immense warm loving kindness of wanting what is best for them (LOL by all who have met me); second, since we’re social beings if I want to be successful I need to include all who might affect my plans.
If you are reading this you are, in one sense or the other, a member of my community. Does that goal strike a responsive note in your core? Do you want, for yourself, your family, and your community, to “thrive and be optimally healthy and age well and avoid preventable diseases”?
In 1970, as a member of the local Sierra Club, I helped organize the first Earth Day at the University of Utah. The situation has worsened since then and the writing is on the wall in blazing red letters. We humans need to live more harmoniously. The continual increase in chronic diseases should be a clear sign to us that our current occupation of earth, which in my mind is similar to the way the Nazis occupied Norway during World War II, is not working. We need a better way.
There’s more to Life than Food
This book is about the food we eat. But if health is our concern we need to consider everything that affects it. The Milken Institute lists 5 wellness factors: 1. Nutrition, 2. Exercise, 3. Toxic chemical avoidance, 4. Psychosocial integration and stress management 5. Early detection and prevention. Report from the Milken Institute (DeVol R, et al., An Unhealthy America: The Economic Burden of Chronic Disease – Charting a New Course to save Lives and Increase Productivity and Economic Growth. Santa Monica, CA: Milken Institute; October 2007). I add a 6th factor, Financial security, because I think it’s important.
The way living organisms acquire energy from the environment is so important that the other issues are included. If we eat properly we are, for example, avoiding toxic substances (3), such as preservatives. Eating is, in general, a social event (4). Reducing weight and food additives has repeatedly been proven to prevent chronic diseases (5). And, last but possibly most important, an ecologically appropriate way of eating costs much less than processed or fast food alternatives which helps with financial security (6). Wellness factors that are mostly ignored when we focus on eating include exercise, early detection, and dangerous drugs, though proper nutrition can obviate the need for pharmaceuticals. And it goes without saying that no matter how well you eat you need to be physically active and don’t smoke or drink to excess.
I propose that a desirable social change, from pathological consumption to communities that encourage healthy behavior, includes a “modern semi-vegetarian lifestyle diet” and that such a diet is optimal for people in the modern world. The rationale for that argument is presented in part one. In part two the philosophy and basic features of a practical plan are described. The third part includes information and recipes that are helpful for preparing healthy cuisine. I did it, so can you; do it for yourself, your family, your community, and the environment. Wouldn’t you prefer to live in a healthy world with supportive people? Wouldn’t it be worth the bother?
Part One. Our role in the ecosystem is determined by a combination of genes and culture, both are important.
Chapter 1. All living organisms need energy.
Plants are producers or autotrophs that absorb the energy in sunlight to make organic tissue from water, air, and minerals. When plants ‘photosynthesize’ they produce or ‘synthesize’ organic matter. The amount of sunlight that strikes the earth each day is 1.3 sextillion calories. Plants absorb some of that energy and use it to convert carbon dioxide, water, and minerals into organic matter. Plant tissue includes proteins, fats and oils, simple carbohydrates (sugars), complex carbohydrates (starch and cellulose), vitamins, minerals, and gazillions of phytochemicals.
One gram of protein or carbohydrate contains 4 calories of energy. One gram of fat or oil has 9 calories. Fat contains over twice as much energy as an equal amount of protein or carbohydrate. A cup of oil has 2000 calories of energy; 1 cup of protein or carbohydrate has only 900 calories.
The Ecological Food Chain
Most organisms are plants or primary producers which are the most abundant organisms at the bottom of the food chain. Animals are heterotrophic consumers that lack chlorophyll and cannot photosynthesize sunlight into organic compounds. In the ecosystem plants are eaten and recycled by primary consumer animals. Secondary and tertiary consumers are animals that eat and recycle other animals.
Although animals eat plants or other animals this is not, as it might appear at first glance, exploitation. Both parties benefit from the interaction. It is, in that sense, like a good marriage. Plants need animals and vice versa. If there were no animals there would be no carbon dioxide and plants would not be able to grow. Animals produce carbon dioxide as a ‘waste by-product’ of metabolism. And the oxygen that animals breathe is a by-product of plant respiration. Animals and plants both need each other in a stable ecosystem.
When I was a child I worked in the fields. In the evening I would lie there and wonder what it would be like to be a big, peaceful, round, serene, green cabbage. If you could choose, gentle reader, what type of plant would you like to be? We can’t, of course, be plants, you and I, but we can dream. Would you like to be a banyan tree or a bamboo grove or a blueberry bush?
The cellulose problem.
The most common organic molecule in the world is cellulose, the structural component of plants. Look around you. Do you see any wood, paper, or grass? Wood and paper are primarily cellulose. A blade of grass is 98% cellulose molecules. Other terms for cellulose are ‘plant fiber,’ or ‘bran.’ Cellulose is a polysaccharide of glucose molecules that are connected by very strong bonds (β 1-4 glycosidic bonds in scientific terminology). Animals do not have the gene to make the enzyme cellulase that is required to break the bond between the glucose molecules in cellulose. Certain bacteria have the gene and make the enzyme cellulase. Herbivores are primary consumer animals that have acquired the ability to utilize that feature by growing those bacteria in special compartments in their digestive systems. Cows, chickens, elephants, termites, and other herbivores have two important adaptations so that they can use cellulose as food.
1) They have huge teeth or some other mechanism for grinding plant fiber. Human teeth lack large grinding surfaces and humans are not herbivores like cows and horses.
2) Herbivores have a special compartment in the digestive system for cellulose-digesting bacteria. Cows are ‘intestinal fermentation’ experts. The ‘rumen,’ ‘omasum,’ ‘abomasum,’ and ‘reticulum’ parts of the cow’s stomach contain special anaerobic bacteria that produce cellulase and are therefore capable of digesting plant fiber or cellulose which the cow uses for energy.
The Herbivorous Advantage
Plants are producers that grow wherever there is sunshine, air, water, and minerals. Herbivores are plant-eating animals that never have to worry about where their next meal is coming from if they can see the sun and breath the air and there’s water trickling someplace through soil; wherever there is sunlight, water, and soil there will be plants and the animals that eat them and breathe out carbon dioxide which the plants need.
Would you like to be a massive ox-like herbivore?
You can’t be an autotrophic plant with leaves and roots. I can’t be a cabbage and you can’t be a rose or whatever type of plant you would want to be if you wanted to be one. Would you like to be a herbivore like an agile deer or a graceful gazelle? I have always wanted to be a rhinoceros.
Sorry, Charlie, you can’t be a zebra or a goat.
I’m not a rhino and you aren’t a llama. You don’t, as a matter of fact, have the genes for it. You don’t have herbivorous teeth or the ability to ‘intestinally ferment’ plant fiber into digestible glucose molecules. Since you don’t have big flat teeth to grind cellulose, plant fibers pass through your body undigested and unabsorbed. And since you lack cellulose-digesting micro-organisms, even if you crushed the fibers you could not digest the cellulose into glucose molecules. And though your molars are tiny compared to those of a moose, they have a lot more surface area than the molar teeth of a typical carnivore like a cat, and you can digest about 2% of the ‘fiber’ you eat.
You could, theoretically, live on grass but it would wreck your teeth.
Since humans digest 2% of the cellulose we eat, you or I could live on grass. But we would have to eat 55 pounds or 25 kilograms a day to get 2000 calories. A 1000 pound cow only needs 25 pounds or 11.4 kilograms of grass daily because it has a special stomach with bacteria that digest cellulose (R. W. Bailey, Plant Chemistry Division. Dept of Scientific and Industrial Research. Palmerston, North New Zealand. Journal of the Science of Food and Agriculture, Vol 9, Issue 11, pp743-747. Published Online: 20 Sept 2006. Carbohydrates in pasture species. I. The starch content of clovers and rye-grass).
Carnivores
Herbivores are primary consumers, they eat plants; carnivores are secondary consumers, they eat herbivores. There are many more plants than animals that graze on them. The ecological ‘trophic’ ratio is about 10:1. It takes about 100 pounds of grass to make 10 pounds of grass-eating antelope. And it takes 10 pounds of kangaroo to make 1 pound of kangaroo-eating crocodile. Carnivores have two special adaptations for eating meat. First, they have sharp piercing and slicing teeth; second, they have simple digestive systems with an abundance of proteolytic enzymes. The dentition of a carnivorous cat includes piercing front canines and a rear-mounted scissors-action carnassial shear formed by an upper jaw premolar and a lower jaw molar.
Although we are not carnivores there is some evidence that about 2.4 million years ago humans acquired a genetic adaptation to eat meat. This ability, however, comes at a cost; the amount of meat we eat must be balanced by a corresponding increase in physical activity or there is increased risk of cardiovascular disease, cancer, and diabetes. Meat-adaptive genes and the evolution of slower aging in humans, Finch and Stanford, Quarterly Review of Biology79:1-56, 2004).
We are omnivores who can eat some meat but we shouldn’t eat too much or we will get sick. The arithmetic is simple, for every bite of meat you eat you should run once around the house.
Would you like to be a fuzzy adorable fast and ferocious carnivore?
You can’t be a plant. And you don’t have the teeth, or the stomach, to be a herbivore. I can understand the attraction; wandering around complacent in the sunshine eating when the mood strikes. And if you were rather large, like a water buffalo (or a rhinoceros), you wouldn’t even have to worry about predators.
Would you like to be a lion or a weasel? Would you like to be a cute snake, spider, or bat? My sleek cat and your furry dog are carnivores. Ponder the possibility, if I couldn’t be a cabbage or a rhinoceros, but I could choose, I would be a hawk, a red-tailed hawk, or a snapping turtle.
Too bad, Sheila, you can’t be a carnivore.
When I took anthropology in college the professor demonstrated the difficulty of eating a dead animal with human teeth. It’s almost impossible to bite through the skin; and if you’re trying to eat something bigger than a mouse, like an elephant or a hippopotamus, it’s virtually impossible unless you have a knife. And eating a lot of meat astronomically increases your risk of lifestyle diseases such as cancer, strokes, and heart attacks.
We can’t be plants, herbivores, or carnivores, what else is there?
Humans are in a special group, the omnivores. Human teeth don’t work well for grinding vegetation or for slicing meat. Your teeth are a lovely compromise of both functions. And you cannot digest cellulose; you are not a herbivore or “vegetarian.” We aren’t plant-eaters or animal-eaters, we are eaters of everything, like bears, pigs, and opossums.
Humans have a genetically-determined way of life in the ecosystem as ‘opportunistic omnivores’ that eat plants and animals. This is not a choice issue. You don’t get to choose your genes. We are not cellulose-digesting herbivores and we are not sharp-toothed meat-eaters. Genetically and ecologically humans are neither vegetarians nor carnivores.
Omnivorous teeth are not as good as the teeth of herbivores for grinding vegetation; and they are not specialized for slicing meat, like the teeth of carnivores. Omnivore teeth are semi-good for eating everything. The human is a beautiful compromise between a stand-in-the-sunshine grass-munching camel and a ferocious shark. Ecologically we’re semi-vegetarian or semi-carnivore “opportunistic omnivores.”
You, my friend and colleague, are an opportunistic omnivore.
As an opportunistic omnivore you can eat nuts, berries, lettuce, other kinds of vegetation, and meat. You can’t digest the cellulose in plants, but you need some indigestible plant fiber, about 2 ounces or 50 grams daily, which will, for example, help prevent colon cancer. And, although you can’t digest cellulose, you can digest plant starch, a polysaccharide of glucose molecules similar to cellulose but with the important distinction that it can be digested by an enzyme, amylase, produced by vertebrate digestive systems.
There isn’t as much plant starch in the world as cellulose, but there’s a lot. Cellulose is the structural building block of plants. Starch is plant energy storage tissue. It is a digestible complex carbohydrate. The ‘glycosidic’ bonds that connect the chains of glucose molecules in starch can be broken down or digested by the enzyme ‘amylase,’ produced by salivary glands and the pancreas. Plant starch is the white part of potato, rice, wheat, etc. The outer coverings of plants, e.g., potato skin and wheat bran, are primarily cellulose, but they are an important source of nutritious minerals, vitamins, and phytochemicals and you should eat them. Do you need iron and calcium? Eat brown rice and other whole grains; don’t peel carrots, cucumbers, or potatoes.
Chapter 2. We have some unusual genetic appetites that cause health problems in the modern environment. It’s not our fault; we inherited some ‘bad’ instincts. And industrial food is not as nutritious as it should be.
As opportunistic omnivores we can eat anything. This, however, is not necessarily a good thing; although we can eat anything and everything, it would be better if we didn’t. If you eat as much fried chicken, pizza, soda pop, French fries, BBQ ribs, and beer as you can, you will get sick. And if you eat too much junk food as a lifestyle you will suffer from chronic diseases. We have a problem because our DNA urges us to eat foods that are nutritionally inappropriate. When you eat too much fatty meat, simple sugars, and salt, you increase the risk of lifestyle diseases including obesity, cancer, heart attacks, diabetes, Alzheimer’s, and musculoskeletal injuries.
Human Genes, Nutrition, & Health
Every one of us burst into life with a genetic instruction manual. A few years ago (2006) the Human Genome Project found that our 46 chromosomes are organized into about 25,000 genes. We are hard-wired to use tools with our opposable thumbs, consciously manipulate abstract symbols as human language, and, apparently, build lots of roads. Our genes operate our livers, hearts, lungs, and billions of body cells to perform physiological metabolism without requiring any personal attention. Some of the instinctive behaviors that we inherit are, however, maladaptive in the modern world. They worked in years gone by but genes that made it possible for your ancestors to cross the Bering Strait in pursuit of greener pastures are now causing lifestyle diseases.
Shirley’s Question
We were about halfway through the nutrition course that I was teaching when one of the students, Shirley, a large young woman, jumped up, visibly agitated. “So,” she asked, “you’re teaching us that everything we like to eat is bad; and everything we don’t like is good?” I was taken aback because I had never thought about it that way before. What she liked was fried chicken, pizza, soda pop, and French fries. She didn’t like broccoli, carrots, or any kind of what she termed “plant food.”
She glumly confessed that her doctor had told her that she was obese and had diabetes and high blood pressure. Although she was a young woman she was taking an arsenal of medications. She was angry because people were telling her that the foods she liked were making her sick and this did not seem fair to her. I couldn’t think of a good answer and just stood there like an idiot. What would you have said?
Salt is an essential nutrient but there’s no “OFF” switch
If you are gainfully employed you receive a ‘salary,’ a Latin term that means money designated for the purchase of salt. For most of human history salt has been a rare and expensive commodity. We need to eat 1500 milligrams daily because it is a critical blood ion for nerve, brain, heart function, etc. You get that much in 1 teaspoon of table salt, 2 tablespoons of soy sauce or 1.2 tablespoons of fish sauce. Salt is used and then excreted by the kidneys.
In addition to being a requirement for human physiology, salt is also used in the marketplace; it is our best preservative, we can use salt to prevent our food from spoiling. Since most modern foods are processed and preserved, there is a lot of salt in the modern diet; this is good because it prevents our food from going rotten, but bad because there is too much salt in processed foods.
There is a problem which is caused by an odd, and unfortunate, feature of human physiology. Humans have a ‘positive-feedback’ appetite for salt that makes us want to eat more and more, rather than stop when we’ve had enough. Instead of an “enough” switch there is a “lowered suprathreshold sensitivity” which results in higher salt consumption. R. Shepherd, Sensory Influences on Salt, Sugar and Fat Intake, Nutrition Research Reviews (1988) I:125-144). When you eat some salt your appetite is stimulated so that you want to eat more. Since salt has historically been rare in our environment we have not developed an internal sense of how much we need; instead, we have an insatiable appetite for the nutrient. Our genes scream for us to eat as much salt as we can get. Since it has been so rare for most of human history, eating as much as we can get has, until modern times, barely been enough.
The consumption of excess salt causes high blood pressure. Salt is an essential nutrient that we need in small quantities; but commercialization of the food industry makes salt pervasive. Our appetite misleads us, we learn to like too much salt, food only tastes good when it is overly salty, and we develop high blood pressure and cardiovascular disease as a result.
Eat more fresh vegetables, less meat, and fewer processed foods, and you won’t have to worry about salt and you will reduce your risk of suffering from heart disease.
Sugar is an Essential Nutrient
Do you have a ‘sweet tooth’? Do you like chocolate? My cat doesn’t; if you are a relatively normal human, you do. If you were to wander into a forest or a desert or the Australian Outback in search of sweets you would have to forage far and wide to find a bit of honey or a succulent grub.
Simple sugars are good nutrients; they are readily digested and absorbed and are the best natural source of quick energy; this is especially useful if you have to go slay a ferocious wildebeest for Sunday dinner. If you don’t have too many arduous energy-demanding chores, if there are few tasks on your “to-do-today” list that involve hostile confrontation with a boar then too many simple sugars in your blood stream will increase your risk of diabetes. Simple sugars have been so rare in the human environment until recently in the modern industrial world that when we have found a small cache of sugars we have been inclined to consume as much as possible. We are genetically compelled to eat as much sweet sugary foods as we can find. Switch from the industrial diet of fast processed foods and lots of meat to a semi-vegetarian diet and you will automatically limit your simple sugar consumption, eat less, not be hungry all the time, and reduce your risk of diabetes and obesity.
Fats & Oils are Essential Nutrients
A simple sugar is a quick-energy food. You should eat some if you have to slaughter a rabid bandicoot to feed the family. But if you have to go for a month-long trek across the Polar icecap you need an endurance fuel, you need fats and oils, nature’s concentrated energy source. Pound for pound or gram for gram, plant oils and animal fats have more than twice as many calories (9 calories per gram) as sugars or proteins (4 calories per gram).
Like salt and sugar, fats and oils are rare in nature. And so we have developed an insatiable instinctive appetite for these tasty morsels. Fats and oils and the meats that are frequently attached to them are so enticing to the human palate that I have personally seen grown men cry real tears in foreign lands where they could not get real American meat. This is terrible, though it does indicate how desperately much we crave these red delights. Unfortunately, too much of the good thing increases the risk for heart disease, stroke, cancer, and diabetes.
Genetic Sabotage & Chronic Lifestyle Diseases
Shirley is being betrayed by her genes. She has inherited voracious appetites for meat, fat, salt, and sugar that are maladaptive in the modern environment and are the cause of serious health conditions.
Most adults (68%) in the U.S. are overweight (BMI > 25, 34%) or obese (BMI > 30, 34%) because we eat too much. People who do hard physical labor need to eat more that those of us with sedentary jobs. Average consumption in the U.S. is over 3700 calories per day and most people are not very active. Most of us are eating more than twice as much as we need so it is no surprise that too many of us are overweight.
Being too big is not the only problem. If it were just a matter of buying larger clothes and having wider seats on airplanes it would be a technological issue that we could manage. But the stress of excess ‘adipose tissue’ (i.e., ‘fat’) causes chronic lifestyle diseases including heart problems, diabetes, cancers, and musculoskeletal injuries. 36.3% have cardiovascular disease, 11.6% have diabetes, and 25.9% are ‘pre-diabetic.’ American Heart Association, 2009 update). Obesity is a contributing factor in the development of cancers of the colon, breast, uterus, kidney, gallbladder, ovaries, pancreas, and prostate. National Cancer Institute, Fact Sheet, 6 April 2011). Obesity has been implicated as a developmental cause of Alzheimer’s Disease.
The problem is made worse by the processing that is required to preserve food so that it can be stored or “safely” travel the average 1800 miles from where it is “manufactured” to the store or fast food joint where it is purchased. Pirog, R., and Benjamin, A. Checking the food odometer: comparing the food miles for local versus conventional produce sales to Iowa institutions. Leopold Center for Sustainable Agriculture, Ames, Iowa, July 2003).
The preservatives and taste enhancers that are used also contribute to life-style diseases. The most important preservative we have is sodium or table salt which is a primary cause of heart disease. Trans-fats are another food enhancer which improves flavor and preserves food but causes cancer and heart disease. The sugars added to soda pop, cereal, etc., cause diabetes.
Shirley was 5’ 8” and she weighed 180 pounds. Was she really ‘obese’ as her doctor said?
BMI (Body Mass Index)
We can use BMI to estimate healthy weight. BMI is calculated by dividing mass in kilograms by height in meters squared. Alternatively you can calculate your BMI by multiplying your weight in pounds by 703 and dividing that number by your height in inches squared. Shirley’s BMI is 180 x 703 divided by 72 x 72 = 27.36. Since ‘normal BMI is 18.5-25.0, we conclude that Shirley is ‘overweight.’ But, ‘obese’ people have body mass indexes greater than 30, so Shirley is not clinically obese, her doctor was wrong.
You can calculate your personal BMI by dividing your weight in kilograms by your height in meters squared or by multiplying your weight in pounds by 703 and dividing that number by your height in inches squared..
Find your BMI. If you are in the “normal” zone, congratulations! Read on so that you can continue being healthy and age well and prevent lifestyle diseases in the modern environment.
If you are in the “overweight,” “obese,” or “underweight” (BMI less than 18.5) zones, read on and improve your lifestyle so that you become a healthier person. Then stay healthy so that you age well and prevent lifestyle diseases in the modern environment.
Traditional food
Living organisms usually have to struggle and fight for every morsel they eat. Our ancestral hunters and gatherers spent most of their time scurrying around searching for roots, berries, and small animals for lunch. A 1300-year-old ancestral human was discovered in 1995 frozen in the ice in Switzerland. Examination of his stomach contents revealed that meat was 10% of his diet and that whole-grains were the foundation (The omnivorous Tyrolean iceman: colon contents, meat, cereals, pollen, moss and whipworm, and stable isotope analyses, James H. Dickson et al. Philosophical Transactions of the Royal Society of London, Series B, 355:1843-1849, Dec 29, 2000).
He was a hunter and gatherer ‘semi-vegetarian.’ Farming began when some clever chap discovered slash-and-burn agriculture so he wouldn’t have to spend so much time hunting for edible leaves. Later an even cleverer fellow or his wife learned to irrigate, which reduced the need to migrate from place to place every year. Unfortunately nobody has ever figured out how to grow crops and raise animals that doesn’t require a ridiculous amount of hard work.
When I was a child in a small farming community in Utah in the 50s our diet issues were rather different than the current ones. Dads had jobs outside, moms took care of the house and cooked and cleaned; the kids went to school and worked in the fields and orchards during the summer. Since we didn’t have much, we didn’t eat a lot of meat, processed salty snacks, or simple sugary sweets. We were “semi-vegetarians” not by choice but by necessity. And my biggest problem was finding enough to eat during the winter.
The Post-war Green Revolution and Modern food
Modernization began during the Green Revolution of the post-World-War-II era. The creation of high-yielding crops and livestock that respond to concentrated inputs of chemicals including fertilizers, hormones, and antibiotics is a proven scientific model that is supported by governments. We are currently producing about twice as much food as we need. To keep it from rotting the food is preserved. The commonest preservative used is salt, which causes high blood pressure and heart disease. Other preservatives include sugar, oil, and trans-fats which cause diabetes, heart disease, and cancers.
When opportunistic omnivores with insatiable appetites for salt, fat, sugar, and meat are living in an environment where they are encouraged if not coerced to eat those foods the results are predictable. The fast-food industry is based on the enthusiasm of people to buy foods with excessive amounts of salt, fat, sugar, and meat. Government subsidies make the food cheap and TV advertising media-hype encourages people to eat. The first Kentucky Fried Chicken franchise opened in Salt Lake City in 1952, shortly after the Green Revolution made chicken and beef affordable. Commercial TV began broadcasting throughout the US in 1954, the same year that Swanson introduced and sold more than 10 million TV dinners. The next year the first McDonald’s opened in the small Midwestern town of Des Plaines, Illinois. 50 years later home-cooked meals have been replaced by take-outs and TV-dinnerish products. The Green Revolution and TV have given us cheap food and something to do while we eat it. And it’s obvious that the profit-driven marketplace is exploiting our innate tendencies to eat unhealthy foods. You can’t change your genes; but you can modify the way you interact with people who want to take your money and sell you harmful junk. We can’t change our genetics; but we can change our behavior and our habits.
During the frenzy of post-war optimism the philosopher-architect R. B. Fuller predicted that technology would enable everybody in the future to live like royalty in geodesic domes. He envisioned common people enjoying high-tech culturally sophisticated leisure with plenty of free time and as many consumer products as they wanted.
We live in the world foreseen by Dr. Fuller. Machines do a lot of the heavy lifting though it seems that we’re working more and life has become much more stressful. He was wrong about cultural sophistication; leisure time is generally spent watching sports or sitcoms on TV.
And we obviously have more food than we know what to do with. When I was growing up our parents told us to clean our plates because there were starving children in India. Now the message seems to be to eat as much as possible because we need to do something with all this food. But modern cuisine is less healthy than the fruits and nuts harvested by our ancestors and the family farmers of my youth. Most of it is produced at massive factories and processed with enough preservatives and artificial ingredients to embalm a large city. As a result we now have diet and health problems. The modern lifestyle of too much processed food and abundant leisure time has not worked out well. As we eat more and do less these changes are causing epidemics of “lifestyle diseases” such as diabetes, cancer, musculoskeletal injuries, and heart attacks that are the inevitable result of being overweight and out of shape.
Since mom and dad both work in the marketplace, nobody has time or energy to prepare elaborate meals, but we do have money to buy ready-made food. We are being exploited by the fast-food industry and their political supporters. They appeal to our baser instincts to gorge ourselves on such items by selling big bags of fatty, salty meats and fried foods and sugary drinks and pocketing the profits. Average Americans consume more than 3700 calories per day, which is about twice as much as they need. Of course people are obese, they’re eating too much. Of course they suffer from chronic lifestyle diseases, they are consuming too many processing chemicals in their excessive food, and they spend most of their time sitting, in the car, watching TV, or working at a desk. And North Americans who typically eat their main meal in the evening have bad timing. We are genetically designed to have a big afternoon lunch and take a nap or siesta during the hottest time of the African day.
The Economic Cost
In the modern world lunch isn’t free but it’s cheap. There is a paradox because excess ‘cheap’ food causes serious damage to our health and our finances. The current annual cost of obesity in the U.S. is $7000 per person. David H. Freeman, How to fix the obesity crisis, Sci Amer, Feb 2011, p. 47). If people continue to eat ever-larger amounts of poorer quality food, they will soon be mainlining bright red, yellow, and blue HFCS (high fructose corn syrup) from big hoses directly through their mouths into enormous bodies while they take expensive pills to stay alive.
The economic cost of obesity was 147 billion dollars in 2009. In a report to the federal government the Samueli Institute has estimated that unless something is done we will have to spend 49% of income on health care for “avoidable” life-style diseases that include obesity, cardiovascular disease, diabetes, musculoskeletal injuries, and Alzheimer’s (Finkelstein, EA, Trogdon, JG, Cohen, JW, and Dietz, W. Annual medical spending attributable to obesity: Payer-and service-specific estimates. Health Affairs 2009; 28(5):W822-W831).
In 1960 health care represented 4.7% of total spending in the U.S. In 2007 the cost had increased to 14.9%. A report from the Congressional Budget Office projects that if spending for health care continues to increase at the current rate we will be spending 49% in 2052.
The people who are affected by the problem include those who are overweight or suffer from one of the “lifestyle” diseases, their immediate families and coworkers and the rest of the people in the community who have to pay for their care and support. Virtually everybody is harmed by the eating problem.
Cultural Considerations, People are Social, Values Change
Unlike bears, which are generally solitary and independent, people are social, like dogs and ants, we are herd creatures. Although we are hard-wired with genes, we have a unique ability in the biological world to adapt culturally to changes in the environment.
Social values and habits are influenced by the family and community we belong to. I can’t convince Bob that he doesn’t like pizza, BBQ ribs, beer, or soda pop or that he should only eat what he cooks himself if his friends and family are encouraging him to go grab take-out. This is especially difficult because we have inherited instincts to crave unhealthy nutrients. We need to create a proactive “Culture of Health” if Kathy and her kin are to prefer a reduced-calorie version of pizza with less meat, fat, and salt, and lots of veggies.
Creating a “Culture of Health” will require a “paradigm shift” in fundamental values. Is it possible to convince Randy to value home-cooking and shun fast foods and commercial meals that are ‘inedible’ from the perspective of good health? Family and friends can persuade people to spend their hard-earned dollars on fresh fruit and decrease the amount of salt and meat they eat if they internalize that as a value. And home-cooked food is healthier; I don’t think it would even be possible to make a pizza at home that would be as unhealthy as the typical commercial take-out type.
A Heart Attack is Very Motivating
I grew up as a semi-vegetarian because that’s what we had to eat. Later I became familiar with a different type of semi-vegetarian cuisine when I lived for some years in Malaysia as a U. S. Peace Corps Volunteer.
When I was older, but still as opportunistic an omnivore as any human, I ate the food that was available in mainstream American culture, burgers and fries, pizza, fried chicken, etc. I knew I wasn’t eating as well as I should but I was bike-commuting about 100 miles weekly and I felt healthy and there didn’t seem to be any urgency to change my diet. A few years later I quit biking to work and gained weight and was diagnosed with hypertension. Then I had a heart attack during a New Year’s Eve walk on the beach. The next day an angioplastic surgical procedure was performed and a stent was successfully installed in a blocked coronary artery.
On New Year’s Day as my wife was driving me home from the hospital I resolved to eat less, become more active, and lose weight. My New Year’s Resolution was, literally, a life-or-death issue.
Chapter 3. There are difficulties with popular solutions such as Vegetarianism, Fad Diets, and Government Agency Suggestions
The Vegetarian Option.
Maybe we should become vegetarians if we are concerned about our health. 2-3% of the population consider themselves “vegetarians” Vegetarianism in America,” a Harris Interactive Poll survey, published by Vegetarian Times, 2008) and don’t eat meat, poultry, fish, or seafood. This approach to food is confused by political and religious issues. “Vegans” consider it “wrong” to eat or use animal products of any kind including leather, honey, and dairy products. “Pollo vegetarians” don’t eat meat, fish, or seafood, but they do eat poultry. “Lacto ovo vegetarians” don’t eat meat, poultry, fish, or seafood, but they do eat dairy and egg products. “Lacto vegetarians” eat dairy products but they don’t eat meat, poultry, fish, seafood, or eggs. “Raw foodists” are vegans who only eat vegetation that has not been cooked. “Fruitarians” enjoy a diet of fruits, nuts, and seeds. “Piscatarians” eat fish and seafood but they don’t eat meat or poultry. These are arbitrary cultural distinctions that lack any real biological basis.
I include myself among the 10% of the U.S. population who are “vegetarian-inclined.” Biologically, humans are “opportunistic omnivores.” Other ways to accurately describe our feeding behavior include “semi-carnivore,” “partial herbivore,” “people who eat a lot of seafood,” etc. The terms “opportunistic omnivore” and “vegetarian-inclined” are very general and I prefer “semi-vegetarian.” Similar terms, “quasi-vegetarian” and “flexitarian,” have unfortunate connotations implying that such people lack the motivation or moral fiber to be decent vegetarians. The term semi-vegetarian seems more neutral and is the most commonly used. I’m not a semi-vegetarian because I lack the determination to be a vegetarian; I’m a semi-vegetarian because I consider it the best way to be healthy in the modern world. Being vegetarian is not the healthiest way to live; humans are not herbivores, we’re social opportunistic omnivores.
The Dieting Solution, consider going on a short-term fad diet to lose weight.
We need stable and sustainable lifestyles that include healthy habits. Dieting to lose many pounds quickly is not a healthy way to live. There is a hormone, leptin, that maintains your weight at a “set-point.” If you want to have a healthier weight you need to change the set-point, then the hormone will maintain it, but only if you keep your weight stable for a year or 2. Going on a diet to lose weight quickly is not a practical solution, the ‘set-point’ won’t change that fast.
Robert was Planning on Getting Married
One of my students, Robert, told us that when the wedding was scheduled 2 years in advance for a Sunday in early December he weighed over 300 pounds. He told his friends and family and the bride-to-be that it would be irresponsible for him to become a family man if he was ‘morbidly obese.’ So he made a decision to lose enough weight so that he was ‘normal’ (i.e., BMI less than 25) before the wedding. He enrolled in every weight-loss program and purchased every device and pill available to try to lose the weight. Nothing worked and he spent a lot of money. He guessed that his futile efforts cost him $15,000. He then took advantage of his employer-sponsored fitness club program and spent hours every day jogging and swimming and riding a bicycle and reduced his daily calorie consumption severely. When he got married as scheduled he had lost over a hundred pounds. His BMI had been reduced from ‘morbidly obese’ to ‘overweight’ and he was continuing his personal fitness program.
After telling his story he asked us what we thought he would have experienced as the most difficult part of the endeavor. We guessed the obvious, getting up early to exercise, sticking to his eating plan, etc. He told us that those issues were hard but he could deal with them. The biggest obstacle he experienced was a cultural obtuseness. His mother and other relatives told him that he wasn’t fat, he had “big bones.” His fiancée told him that she loved him as a big black man and didn’t want him to lose weight. His friends were offended when he refused to eat pizza with them and he lost most of his friends. The last time I saw Robert we were standing outside and one of the other students had bought a personal-size pizza from the luncheon truck. It was dripping with cheese and fat and he was eating it enthusiastically. Robert commented that he would never eat another slice of pizza. “You know,” he said, “I used to eat half of one of those big pizzas all by myself, but now it seems like it was somebody else who did that, not me.”
When I met him Robert was, according to him, happily married; his wife was expecting a baby and he was rather looking forward to their future together. “Dieting” didn’t work for Robert; in the long run, it doesn’t work for anyone. How you eat is a lifestyle issue, not a short-term fix-and-forget problem.
Authorities Recommend a Semi-vegetarian Diet
Let’s see what the authorities recommend, smarter people than us must have dealt with this problem before. We find that the governments of the world and virtually all legitimate health agencies, and this will come as a shock to most of us, actually want to help. Well, it makes sense, it’s in their best interests if we eat well and don’t get sick so that we can be productive workers and reduce the expense of health care. Nobody, not you, not your family, not your government, wants you to be sick. As opportunistic omnivores we can eat anything, but for our health’s sake and the health of the planet, we shouldn’t.
Credible authorities recommend a plant-based diet, with some meat. So this proposition for a semi-vegetarian cuisine is not revolutionary or radical. It is consistent with recommendations from the U. S. Department of Agriculture, the professors at Harvard University, and other legitimate agencies, who all want us to be as healthy as possible (so we can be compliant productive little workers, but that’s a different issue). They don’t use the term “semi-vegetarian” but they should.
The USDA & Other Authoritative Resources
Tax dollars pay the salaries at the U. S. Department of Agriculture (USDA). Use their MyPlate.gov website. It’s the most authoritative and accurate resource we have. Also look at the Canadian food pyramid and the “healthy eating pyramid” from the fine folks at Harvard University. The websites are useful resources. There are sample menus, tools for estimating activity and nutritional intake, recipes, etc. The USDA Food Guide Pyramid was replaced in 2011 by a graphic MyPlate. It is recommended that most of the calories in a standard meal come from vegetables, fruit, and whole grains, with a relatively small portion (i.e., 25% or less) of protein or meat.
The American Heart Association (AHA) has produced a series of cookbooks which are very useful. The Wellness Kitchen and the Berkeley Wellness Letter are sources of timely information about nutrition, exercise, and other health issues.
Maybe I’m too critical or demanding, but none of these work for me as well as they probably should. I was, therefore, quite thrilled to find a book that seemed to solve the problem.
The New American Plate
The modern eating issue is a social problem that affects us all because the number of people and the cost of lifestyle diseases like cancer and obesity is increasing. An excellent book, The New American Plate, was written by a team at the prestigious American Institute for Cancer Research.
“The traditional American plate … holds three items: a piece of red meat, poultry, or possibly fish; a sizeable helping of potato or white rice; and a small serving of some green vegetable – most often peas or green beans. The portion of meat is so large – usually 6-8 ounces – that it crowds everything else to the side. … The traditional American plate … was shaped by food-industry marketers and government agencies during the mid-twentieth century, and we have grown accustomed to it. … The proportion of foods on the plate is all wrong. Your plate should hold two-thirds (or more) vegetables, fruits, whole grains, and beans and one-third (or less) animal protein. That is the New American Plate. … Some members of the cookbook team felt strongly that one-pot meals are the ultimate New American Plate – foods in the right proportion blended to produce an enticing meal. They argued that these meals would facilitate the transition to healthier eating. People enjoying their complex flavors would not notice the reduction in animal protein.
“Other team members felt just as strongly that there is lingering prejudice against casseroles, stews, and chilis in America. During the last century, one-pot meals were too often concocted with leftovers and other ingredients that the cook wanted to disguise. Many of us still think of casseroles as yesterday’s chicken, noodles, and canned mushroom soup baked bone-dry in the oven. In many American homes, when guests arrive, the host serves meat, potatoes, and a vegetable, certainly not a casserole, chili, or stew. So the cookbook team decided to offer the meal with two vegetables, a whole grain, and a little meat as the prototypical New American Plate. Updated one-pot meals are offered as another option. In effect, the team decided to suggest two models for a healthy meal and let you choose whether to use one, the other, or quite sensibly, both.” J. R. Prince et al, The New American Plate, Univ of Calif Press, Berkeley, LA, London, 2005, pp 3-7).
Difficulties with the AICR New American Plate and the USDA MyPlate include workload and ‘the brother-in-law problem.’
The principles and basic approach of the AICR effort and the USDA MyPlate plan are excellent but there are some logistics difficulties. Since I have a full-time job I can’t plan, shop for, and prepare 4 separate dishes including a meat, two vegetables, and a starch, every night, and you probably can’t either. A 1-pot casserole or stir-fry entrée takes a lot less work than a New American Plate or the 4 parts of the USDA MyPlate. Since I’m not a 1950s stay-at-home mom I can’t spend 2 hours every day preparing meals. I generally have about 10-40 minutes to get dinner on the table. And those casseroles made with “yesterday’s chicken, noodles, and canned mushroom soup baked bone-dry in the oven” were dreadful. We ate them but they were not good and we didn’t like them.
Another difficulty occurs when you serve traditional people. If you put out 4 bowls, 1 with meat, 2 vegetable dishes, and a bowl of pasta or rice, they take the three items of the traditional American plate in traditional portions. How do you persuade your brother-in-law to eat a small amount of meat and a big helping of rice? What do you serve your guests so you don’t look like a cheapskate?
A Better Way
We need a better way to prepare healthy and satisfying food. Those of us who are at risk of lifestyle diseases need meals that are low in calories, sodium, refined sugars, fats, and meat and high in vitamins, minerals, vegetables, and fruits. My wife enjoys a good dinner that is arranged attractively. My brother-in-law is traditional in his ways but has a bad heart. There are others like Bruce and his children who will eat vegetables if there’s nothing else but may be diabetic or have serious weight problems. And being realistic we need to use ingredients that are readily available to make meals that taste better and cost less than fast food.
Since we have such a broad diversity of individual requirements this might seem like a hopeless task. But I didn’t think it would be impossible because, genetically and ecologically, we really are social opportunistic omnivores who will eat anything.
It took me about 4 years.
My proposed solution is a semi-vegetarian lifestyle that includes 4 meals daily, 3 mini-meals and dinner. Dinner is based on one-pot dishes, which can be prepared as, “foods in the right proportion blended to produce an enticing meal.” Healthy one-pot dishes do, however, have two serious limitations. First, they lack variety; a diet of casseroles, stews, and chilis gets intolerably boring and dreary very quickly. Second, even the best one-pot meal is too bleak. When that’s all you have on your plate it does not seem like a decent meal. I was able to improve the one-pot dish by adding easily-prepared embellishments that include a side-dish vegetable, “extras,” and fresh fruit for dessert, such that it becomes generally acceptable. And to solve the variety problem I alternate one-pot dishes with a semi-vegetarian entrée plus grain. If we have a casserole on Monday, there will be fish or a stir-fry on Tuesday.
I developed a strategy of including vegetables in the meal that makes it easy to eat healthy and awkward for anybody not to eat them. The main course includes protein and a vegetable and there is a vegetable side-dish. So the standard plate automatically includes a lot of low-calorie, high-nutrient vegetables and a relatively small amount of high-calorie low-nutrient meat and fat. For example, in the semi-vegetarian version of mac-n-cheese we add a veg such as peas or green beans to the pasta and serve it with a vegetable side-dish. My brother-in-law takes a serving of pasta garnished with Parmesan and a serving of side-dish vegetable. After dinner we bring out a bowl of fruit for dessert and he and his family are quite satisfied with their healthy low-cal dining experience.
Part Two. A modern semi-vegetarian lifestyle for optimal health
Chapter 4. An ecologically appropriate, genetically-satisfying semi-vegetarian diet is a practical and attractive lifestyle solution to the modern eating problem.
Fifteen Healthy Eating Principles and a Sustainable Daily ‘Diet’ Plan
1.You need a healthy lifestyle. If you eat too much you will suffer from chronic diseases. And yo-yoing , i.e., go on a diet, gorge, diet, gorge, etc., is a fundamentally unstable & unhealthy lifestyle. Eat 3 small meals (breakfast, lunch, evening snack) and a 4-course dinner daily.
2.Plan your meals. Get in the habit of making a menu and shopping for food once a week. Store enough common ingredients to eat for a month.
3.Eat a low-cost 300-400 calorie whole-grain breakfast with 2+ fruits.
4.Have a low-cal (300-400 calories) salad, sandwich, or soup for lunch.
5.Enjoy a decent 4-square semi-vegetarian dinner of 700-800 calories with 2 or more vegetables.
6.Have an evening snack mini-meal of 300-400 calories. Carbs are a snack “sometimes.” Usually eat fruit, veggies, non-fat yogurt, etc.
7.Value home-cooking; shun dastardly fast-foods and industrial meals.
8.Drink 8 cups or 2 liters of water daily, more is fine. All recreational drinks including soda pop, caffeinated and alcoholic beverages are ‘diuretics’ that dehydrate you. If you drink those you need extra water.
9.Eat a reasonable portion; use a smallish plate; don’t go back for ‘seconds.’ It’s easier if you don’t eat in the kitchen where the food is.
10.Don’t eat too much protein, 2 ounces or 50 grams daily is ample, eat fish twice a week.
11.Eat 5-9 or more servings of a variety of vegetables and fruits every day.
12.Whole-grain complex carbohydrates, e.g., brown rice and whole wheat bread, are our best source of energy. Eat enough but not too much.
13.Minimize fats and oils including fried foods, butter, margarine, eggs, lard, etc. Buy non-fat dairy products. Cook with small amounts of heart-healthy oils like canola and olive. Never buy or eat ‘trans-fats.’
14.Minimize salt and processed foods. You need about 1500 milligrams (mg) of sodium daily; you get that much in 1 teaspoon of table salt, 2 tablespoons of soy sauce, or 1.2 tablespoons of fish sauce. Read the label and buy low-sodium (300 mg or less per serving) ingredients. Take the salt shaker off the table.
15.The AHA (8/24/09) recommendation is to reduce daily refined sugar consumption to 100 calories for women and 150 calories for men. A typical 12-ounce soda pop contains 130 calories of sugar. Snack on fruits like grapes, carrots, and celery, instead of candy and chips.
Plan for a sustainable lifestyle ‘diet’ of 1600-2000 calories per day.
1.Breakfast. A low-cost 300-400 calorie whole-grain mini-meal (oatmeal, tostada, etc.) with 2+ fruits.
2.Lunch. A salad, sandwich, or soup, mini-meal of 300-400 calories.
3.Dinner. A 4-course semi-vegetarian main meal of 700-800 calories.
4.Evening Snack of 300-400 calories. Carbs are a snack “sometimes.” Usually eat fruit, veggies, non-fat yogurt, etc.
A Typical Semi-vegetarian Day. There’s more to life than Dinner.
There’s also breakfast, lunch and snacks. Both of my grandfathers lived to the age of 97. They ate mush with fruit for breakfast, as do I. It’s called oatmeal now, but it’s just mush.
Breakfast. Low-cost, low-cal whole-grain mini-meal w/ 2+ fruits (OJ, banana, cranberries, applesauce) (368 calories): Oats, 1/3 cup (150 calories); Flax, ground, 1 tsp (20 cals); Cranberries, dried, 1 Tb (40 cals); Milk, non-fat½ cup (43 cals); Applesauce, ¼ cup (25 cals); OJ, ½ cup (40 cals); Banana, ½ (50 cals)
Lunch. Low-cal Salad, Soup, or Sandwich (360 calories): Lettuce, 2 cups/serving, shredded (30 cals); Tomato, ½/serving, bite-size pieces (15 cals); Cottage cheese, ½ cup/serving (90 cals); Artichoke hearts, 3-4/serving (35 cals); Cucumber slices, 2-3 Tb (10 cals); Carrots, grated, 2-3 Tbs (20 cals); Red Cabbage, minced, 2-3 Tbs (20 cals); Cilantro, minced, 2-3 Tbs (10 cals); Salad Dressing, non-oil or low oil (30 cals); Fruit, ½ apple + ½ pear (100 cals)