Canned goods have an often undeserved bad reputation.  True, the sodium is often high, as can be the sugar, and some cans are lined with bisphenol A (BPA).  However, many low-sodium products are available, including vegetables and fish canned without added salt.  Similarly, fruits are available in juice, as opposed to heavy syrup, thereby sparing a considerable amount of sugar.  These days, perhaps due to the BPA concern, several traditionally canned products, such as soups and beans, are now available in boxes instead.

Beans are cheap protein sources that also provide plenty of fiber.  Garbanzo beans, for example, are available in boxes without any added salt, and many people enjoy them on top of a salad as a change of pace from grilled chicken, tuna, or other animal-based proteins.  Canned tuna, sardines, and salmon all provide protein and heart-healthy omega-3 fatty acids in a shelf-stable form that can conveniently wait in your pantry until you need them.  Because sardines and canned salmon often (but not always) contain edible bones, they are great sources of calcium as well.  For those who are concerned about potential BPA in the cans, salmon and tuna also come in packets.

I have seen patients of mine utilize canned/boxed soups in different ways.  One popular method of controlling calorie intake is to begin a meal with a broth-based soup such as minestrone, vegetable, or chicken.  Such soups are relatively low in calories and can help make one feel full without contributing much in the way of calories.  In other words, if someone has a smaller portion of his entrée and substitutes some broth-based soup instead, the overall meal will likely be lower in calories.  I also see patients who will mix together a broth-based soup with frozen vegetables, sprinkle in some nuts or beans for extra protein, add in some frozen brown rice, and bring the concoction to work as a healthy lunch that requires virtually no preparation and nothing but a microwave to heat.

My neighborhood store stocks oils in the canned goods aisle too.  Coincidentally, I write this at the same time as I am preparing for an upcoming guest appearance on Beyond Strong with Jessica R. on which I will be discussing fats.  I could write an entire blog series about fats, but for the sake of discussing them in the context of this blog entry, I will streamline the topic into just a few points.

1. Olive oil is not the only healthy oil on store shelves; there are plenty of others, too.
2. Opt for fats that are liquid at room temperature (e.g., olive, canola, soybean, corn) as they tend to have a healthier ratio of unsaturated-to-saturated fat in comparison to those that are solid at room temperature (e.g., coconut, palm, palm kernel).
3. Fats help the body absorb fat-soluble nutrients, such as vitamins A, D, E, and K, as well as the phytochemical lycopene, so consider skipping the fat-free salad dressing and instead choose one that has some fat in it.  Even better, choose a dressing high in monounsaturated fat (such as one made primarily with olive oil).  One research study I read found that it took just three grams of monounsaturated fat to achieve the same level of vitamin A absorption achieved with 20 grams of other fats.
4. Not all oils are meant for use at the same temperature, so check the bottle to make sure the one you are selecting fits your intended use.  For example, extra virgin olive oil, with a smoke point (the temperature at which oil begins to break down) of 320-375^o F, works well for low-heat cooking and salad dressings.  In contrast, canola oil has a higher smoke point of 468^o F, making it a better choice for sautéing and stir-frying.

Next installment, I will discuss the baking goods section . . .

What are you talking about?  The dairy section is on the perimeter, not in the interior!

Not necessarily.  At my neighborhood store, for example, the dairy section is in the exact middle of the store.  This further emphasizes what an oversimplification shopping just the perimeter is, as there is still no guarantee what you will encounter (and what you will avoid) if you do.

In the dairy section, the two options that immediately caught my eye were Greek yogurt and eggs.  Greek yogurt, which is higher in protein compared to standard yogurt, works well as a component of breakfast, a mid-morning or mid-afternoon snack, or a post-exercise recovery food.  Like yogurt, eggs can also be part of a healthy breakfast.  Some people enjoy hard boiling them and adding them to lunchtime salads.  Contrary to popular myth, eggs are not the cholesterol disaster some people believe them to be.  Furthermore, the yolks are great sources of fat-soluble vitamins and help one to stay satiated.

How could I discuss the dairy section without even mentioning milk, a great source of protein and calcium?  In addition to the typical ways in which people consume milk, its combination of protein, carbohydrate, and fluid make it a good post-workout recovery fuel.  Shelf-stable boxed milk is particularly convenient for this purpose.  Some of my patients who exercise after work will throw a box in their gym bags in the morning and drink it after an exercise session in the evening.  Parents also take them on outings with their kids without worrying about refrigeration, just the same as when they take juice boxes.

Although milk alternatives, such as almond, soy, rice, hemp, hazelnut, and oat, have different macronutrient compositions than cow’s milk (most are lower in protein, for example), people with lactose intolerance or milk protein allergies will find that these products often substitute well for traditional milk.  Oat milk, for example, has similar thickening properties to cow’s milk and can fill in quite well in a pudding mix, while almond milk is popular with cold cereal, and several of my patients like coconut creamer in their coffee.

Next installment, I will discuss the canned goods section . . .

The freezer section contains some great options for healthy eating.  The standouts to me are the frozen vegetables and fruits, many of which contain neither added salt nor sugar.  Some of my patients use frozen produce either as a cheaper alternative to, or as a supplement to, fresh fruits and vegetables.  For example, if somebody does his weekly shopping on a Sunday in order to prepare for the work week, some of the produce may start to wilt, rot, or mold by late in the week if simply left on the counter or in the refrigerator.  Rather than make do with a small amount, or even zero, fruits or vegetables for the latter part of the week and weekend, he may use frozen fruits and vegetables until his next Sunday shopping trip.

A barrier some of my patients face when it comes to eating whole grains is the time it takes to cook them.  Products like frozen brown rice and frozen quinoa can cut down on cooking time immensely.  Brown rice, for example, might take somewhere in the ballpark of 45 minutes to make from scratch on a stove top, while frozen brown rice is ready after just a couple of minutes in the microwave or on the stove.  Similarly, frozen, pre-cooked steel cut oats can fill a need for somebody who wants a healthy, hot cereal for breakfast, but is too busy getting ready for work or school to do any significant cooking.

I cannot tell you how many new patients with celiac disease have come to me feeling discouraged that they could not find any gluten-free bread at their grocery store.  However, many gluten-free baked products reside in the freezer section, not the bread aisle where people understandably often look.  I found a wide range of gluten-free products in the freezer including not just breads, but also English muffins, waffles, frozen meals, and cupcakes.

Other products marketed towards those with food allergies or intolerances often reside in the freezer section too.  For example, I found a pizza made with a milk-free cheese substitute that I expected to taste, well, horrible.  But I bought it, tried it, and get this: I liked it.

Next installment, I will discuss the dairy section . . .

Body Mass Index (BMI), or the relationship of one’s height and weight, is most often used by the medical community to determine someone’s health risk.  BMI is really meant to assess the health of populations, not individuals.  If a researcher wanted to assess the health of adults in Massachusetts, for example, BMI could work quite well.  The problem is that it is inappropriately applied to individuals, partly because it is easy to do so as opposed to monitoring other markers that require more expensive testing and/or equipment.

There are a number of examples that call the BMI’s accuracy and usefulness into question.  For instance, Tom Brady’s BMI of 27.4 and Paul Pierce’s BMI of 26.5 put them squarely in the “overweight” BMI category, which is associated with increased risk for heart disease, diabetes, and a number of other health problems. Obviously, both of these athletes have a great deal of muscle mass and are in top physical shape. Would you call them “overweight?”  Of course not!

On the flip side, there are numerous people who fall into the “normal weight” BMI category that can’t even climb a flight of stairs without getting winded and have high cholesterol or high blood pressure.  In other words, lack of muscle mass can contribute to somebody being labeled as “normal weight” even though they are actually pretty unhealthy.  Some individuals with eating disorders also have “normal” BMIs, as do some formerly overweight patients who have lost weight due to diseases such as cancer or AIDS.  So clearly being healthy is about more than just one’s BMI.

Instead of just focusing on one number, there are so many other factors we need to take into consideration. Measuring blood pressure, cholesterol levels, and waist-to-hip ratio are just a few ways to get a better picture of someone’s health status. Other things to look at could be an individual’s physical fitness, mental and emotional health, as well as feelings of well-being. I think it’s important for all of us to remember that one number cannot tell us everything about a person’s health and that there are many ways to define what health is.

A young couple passed by me in the grocery store the other day.  I heard the woman remind her partner, “Remember, we are only shopping the perimeter.”  You may have heard the same advice that she was presumably referencing, that purchasing foods only from the store’s perimeter is somehow healthier than including the interior aisles.  Like much of pop culture’s nutritional advice, this tip is an overgeneralization that, if followed, can cause people to unnecessarily skip plenty of healthy foods.

The stick-to-the-perimeter advice has some merit in that it encourages people to load up on fruits, vegetables, dairy, seafood, and poultry, which are traditionally located on a store’s borders.  The advice also tends to reduce the temptations to which people are exposed.  In other words, somebody who might buy Oreos on impulse is spared that temptation by entirely avoiding the cookie aisle.

Just because a food resides on the perimeter, however, does not mean it is one of the healthier foods in the store.  For example, guess what my neighborhood Whole Foods has on the perimeter: the bakery section!  Even on the perimeter, we are still subjected to temptations and less healthy foods mixed in with the rest.  In other words, the store’s perimeter is like the rest of life: we have to be able to make sensible and balanced food choices wherever we go.

As I considered what this woman said to her partner, I thought about some of the healthy foods they were missing, foods that not only would they never buy, but that they would never even see.  I went down the interior aisles a bit slower than usual, deliberately taking some time to explore the inventory and to consider some of the healthier options available and how one might choose to utilize them.

Following this entry will be a short blog series in which I am going to share some of my interior aisle reflections with you.  As I write, I will avoid singling out products by name, as I do not want anybody to mistake these musings as endorsements.  I invite you to post comments, including mentions of some of your favorite interior aisle foods and how you use them.

Next installment, we begin with the freezer aisle . . .

You may have read the blog entry that Joanne recently wrote in which she discusses the dangers of believing everything written about nutrition on the internet without considering the source.  One of the reliable sources of nutrition information online is the blog that Joan Salge Blake, MS, RD, LDN writes for boston.com.  In a recent post entitled “Do Sugar Substitutes Cause Cancer?” she discusses the widely-held belief that artificial sweeteners cause cancer, the historical roots of this belief, and the lack of any credible research whatsoever to support this belief.

Apologies to my former English professors who would frown at my decision to use “belief” three times in a single sentence, but I did so to emphasize my point: one of the main reasons that online nutrition information is often faulty is because the messages being conveyed are really just beliefs, theories, ideals, or hypotheses disguised as facts or well-supported conclusions.

Last month, I attended the Cardiometabolic Health Congress.  For four days, I sat in what might as well have been a series of statistics classes.  The presenters understood that the credibility of information rests on the quality and quantity of research supporting it.  Reliable information, like Joan Salge Blake writes about and Joanne and I use in our counseling, is founded on an evidence-based research approach.  The ethics of our profession demand it.

The authors of most website content, however, are bound to no such standards and are free to write whatever they please.  The result is that hypotheses are often misrepresented as conclusions despite the void of supporting data.  Remember this the next time you read about nutrition online.  Ask yourself who the author is, what his or her credentials are (if any), and be suspicious of claims that are not backed by reputable research.  If you get confused or have questions, ask one of us.  That’s what we are here for, and we are happy to help!

The internet is a wonderful tool.  I often wonder how in the world we were able to survive without it 20 odd years ago.  It provides a wealth of knowledge at our fingertips, and we can find the answer to almost any question with the stroke of a key.  Unfortunately, while the web has a lot of solid information about various topics, it also has a vast amount of bogus information.  This is markedly evident when looking for answers to nutrition questions.  I can’t tell you how many clients (as well as many of my friends and family), tell me about the latest diet or miracle food that they found out about online. Inevitably, there is very little truth to these food myths.

Here are some examples of the misinformation one can find online:

• Carbohydrates make you fat/gain weight.
• Bananas are not as nutritious as other fruits.
• Foods that are high in dietary cholesterol cause high blood cholesterol.
• Foods that contain fat will make you fat.

Given our thirst for immediate information, many of us turn to the web to help us figure out what is true and false.  The problem is that these diet myths are almost always written by individuals who are not nutrition professionals.  What is truly scary is that nutrition information is not policed on the internet.  Anyone can write almost anything and call it truth, and then millions of people can read it and be misinformed.

The moral of the story?  Don’t believe everything you read online about nutrition!  Unless the person writing it is a registered dietitian and has peer-reviewed, valid research to back it up, it is very likely that this nutrition information is false.  If you have questions about what foods will make you healthier, talk to your friendly registered dietitian, as he or she has been trained in nutrition and is qualified to answer your questions.  Be a savvy internet-user, and don’t believe the hype!

Earlier this week, I recorded a Podcast on cholesterol.  Stan Starsky, author of the snack cookbook “Peace, Love, and Snacks,” conducted the interview.  My apologies for the less than stellar sound quality; next time I will be sure to use a different phone.

If you have any questions about this topic, feel free to post them here or on our Facebook page.