Melanie Cole, MS (Host): How do you really know if you have unhealthy diet practices? And what are the effects on our bodies? Today, we're offering guidance and support in overcoming such challenges. Joining me is Jodi Dalyai. She's a dietician nutritionist for Henry Mayo Newhall Hospital. I'm Melanie Cole. And welcome to It's Your Health Radio with Henry Mayo Newhall Hospital.

Melanie Cole, MS: Jodi, I'm so glad that you could join us today. You and I always have such lively, spirited and informative conversations. So, let's just talk about an unhealthy diet in the long term. What do we even consider an unhealthy diet?

Jodi Dalyai, MS: I'd say in today's world, and certainly in the US maybe compared to some other countries, main problems with an unhealthy diet are just ultraprocessed foods. We know that more and more, the majority of adults, but children and teens especially, just get the majority of their calories from what are called ultraprocessed foods. These are foods in packages, cans, boxes, fast foods that really are highly processed. You wouldn't really recognize a lot of the ingredients and when these are providing the majority of calories we're missing out on what we really need from food. We're getting calories, but we're not really getting nutrition.

Melanie Cole, MS: Well, thank you for that. Now, people see their diets and maybe they don't really know what the ultraprocessed foods are. They don't really recognize. Are there any signs or indicators of an unhealthy diet? Do we feel differently? Or is food just food, and it'll kind of get us in the long run? But are there anything we would know about right now if we're eating all that processed food, fried food? I know I feel sick to my stomach. I love to have McDonald's and it goes down really well, but doesn't stay there that well. I kind of feel sick after.

Jodi Dalyai, MS: Yeah. A lot of people regularly feel like they have heartburn, they are bloated, they have constipation or diarrhea. And this could certainly be related to poor diet. But I think we know overall the biggest challenges we face are obesity and high weight related to poor dietary choices. I mean, I think it's something that we all struggle with based on what the culture of food is in our country. That poor quality food is often cheaper. It's easily accessible. It's on every corner. And whether it's a time crunch, a financial crunch, an inability to really know what to choose, that is our biggest challenge is how it affects our weight and then eventually, health issues like diabetes and heart disease, hypertension. So, those things can come up more quickly. It doesn't necessarily take a very long time, but many people struggle with symptoms that can definitely be related to diet.

Melanie Cole, MS: Well, I agree with you. Now, let's get right into what we can do to improve it. So, a lot of people don't want to hear from us, "Oh, just eat more salads." Because first of all, salads can be a pain in the ass to make unless you buy them pre-packaged or whatever. Let's give some real workable things people can do tonight that they can, if they're cooking for their families or themselves. What can we do right now, Jodi, to start breaking some of those habits, to make those steps to healthier diet choices?

Jodi Dalyai, MS: Generally speaking, in the first place, I tell people to look is if you're drinking any of your calories, right? We know that drinking sugar-sweetened beverages and we're getting clear information now that drinks that are flavored with artificial sweeteners are also detrimental to our health. So, that's often the first easy step people can take. You know, if I talk to someone who's having four sodas a day, then we talk about, "Could you do three? Could you have two?" Starting with that can often be the easiest in.

Melanie Cole, MS: Okay. So, we look at what we're drinking because I agree with you, and even including alcohol because that adds a lot of calories to our daily diets. But soda, sugary drinks, that's a great place to start. Looking at those kind of things and trying to limit those, cut those out, whatever it is you need to do. Now, foods, because this is where it can get pretty tough. People don't always know what to do with the fresh stuff or how to cook it or really what's considered unhealthy. If you take a frozen dinner, is that considered unhealthy? People wonder about all those things. So Jodi, go over some of the foods with us and ways to make the changes.

Jodi Dalyai, MS: Well, I think again, just as the easiest in, a lot of times we talk about how rather than thinking about what you need to remove, think about what you can add. So if I talk to someone and they're really not having a fruit every day, say, "Okay. Well, could you start adding in one fruit a day?" You know, most people can eat a banana or an apple, that's easy. You don't have to do anything with it and they're pretty inexpensive. So, sometimes that's just the best first step. If you can get a fruit, can we get a vegetable? Buying things like carrots, cucumbers, again, things you can eat, raw, things that you don't have to prepare, relatively inexpensive. If we can get at least one serving of each a day, that's a really good starting place. Once we do that, then I might try to think, "Okay. Can we get at least half our plate vegetables at one meal?" We need the vitamins and minerals that come in vegetables, we need those antioxidants, so that can be another first step. I like a lot of the visuals that come with that healthy plate. Whether it's the USDA Food plate, whether it's the Harvard School of Public Health Healthy Plate, that really guides you to that visual of half a plate of vegetables. It's simple and, for many people, can be a next good step.

Then, I'd often want to teach people about just comparing foods at the supermarket, right? There's easy ways to pick up a food and compare it to another and see which might be better, like you mentioned with frozen meals. Starting out by looking at the sodium, comparing and looking for ones that are lower, same with the fat. And then, looking at ingredients. If we see a long list of ingredients and we don't know what they are, and these are additives, you know, things like preservatives, colorants, we don't need those foods. We can choose a frozen meal that maybe has foods we recognize, right? Things like chicken or broccoli, grain, words we know, and not too many words that, again, are going to be those processed additives to food.

Melanie Cole, MS: A long time ago, I learned about the perimeter of the grocery store, and that that's where the healthier choices lie. And that processed things, boxed things, things with labels are in the inner aisles, but the outer aisles are where we're going to get the fresh fruit and the produce and the meats and the cheeses and the things along those lines, so out in the perimeter. But when we're looking at all of those and trying to think of our meal plans, what do you recommend as a dietician nutritionist, Jodi, when you're talking to people every single day? Any food groups that you want them to avoid or increase? Now, you've mentioned vegetables and fruits a little bit, but what about meats and cheeses and fish and those kinds of things versus pasta and canned foods and frozen vegetables? Kind of give us a little dietician advice here about the foods we should limit and increase.

Jodi Dalyai, MS: So I mean, we all need our macronutrients, right? We need carbohydrates, we need proteins and we need fats. Main parts of our carbohydrate foods, fruits and vegetables and grains, and those are good for all of us with very few limitations for most people. And that's where we get the fiber that fills us up and keeps our digestive tract healthy. So, we want to make choices there. Fresh is great, but there are plenty of healthy frozen fruits and vegetable options, and those can be used and even canned if you need to. We just would look for low sugar or take the syrup off or low sodium. But the main thing is to eat them. So, I don't want to ever say, you know, "Don't eat it that way," because if that's the way you have it, we want to consume it.

With our proteins, sure, we want to get our protein from a variety of sources, but we know more and more that having high amounts of animal foods isn't good for us, whether it's because of cancer risk or heart health. We definitely want to focus on plant proteins like beans and maybe have some fish, if you eat animal foods at all. But be much more conscientious about the amount of animal proteins we eat overall. And then, we certainly want to have, you know, just balance throughout the day and that can be complicated and look different for everyone. But we do need to get a variety of all the different food groups.

When we talk about limiting, I mean, it's just really limiting the portion sizes. You know, many people enjoy lots of different foods. You can probably prepare some foods. But often it just comes down to portions. So, we need to pay attention to our hunger and fullness and pay attention to what we're putting on our plate and how much of that, that's really the best way we can control taking in more than we need. But we need a variety of foods and we need all the different foods you can find. At the store, shopping the perimeter can be good advice. Stores really are set up quite differently depending on where you go these days.

Melanie Cole, MS: I know I'm old.

Jodi Dalyai, MS: It's not as clear cut as that anymore, but I think we know, again, choosing less things in boxes and bags, but I mean a bag salad, if that's the time and energy you have, I certainly want someone to choose a bag salad over no salad, right? I certainly want someone choosing canned peaches over no fruit. So, I think it's really about choosing foods that we know what they are and choosing less chips, cookies, things that have multiple ingredients that are mainly a sugar or a fat item.

Melanie Cole, MS: So back when my mother lost all of her weight and she did it via TOPS, so she would write down all of her food and portion control. And you mentioned portion control, and we're not talking about weight loss specifically here. That could be another podcast. Right now, we're talking about unhealthy practices. But I always remember that she said portion control was a little bit more difficult for weight loss because you have to be very disciplined if you're going to eat foods that you really love that may be unhealthy, but only a small amount to satisfy yourself, versus a larger amount of salad or pasta with marinara or something that isn't as damaging. What do you tell people when they say portion control is very hard and that they want bigger amounts, because that's what we've been trained to do?

Jodi Dalyai, MS: Yeah, I think it's practice. All of these things when we have habits that we just have learned over time or been exposed to over time are just things we've gotten used to. It's habits that we have to practice and work on. And I think it's not having an expectation, you know? Things that harm you with diet and health choices are usually things where we go to the extreme or we feel like we need a result immediately and we need to be able to take time with ourselves and be gentle and learn what works best for us. You know, we all have different food preferences. We all have different lives that require us to have more or less calories or more or less of certain foods and we need to listen to ourselves and take the time to figure out what works. So, I think, number, one is just is being patient and really reflecting on what you notice works for you.

 Overall, we know that when we include more of that healthy, low calorie, high fiber, high water food first, fruits, vegetables, we tend to eat less of the less healthy foods. So, filling up on those foods first, having that nice big salad, including fruit and vegetables at our meals generally can help us cut down on things like the mashed potatoes or the mac and cheese or the large piece of meat because we're filling up again on those lower calorie nutritious foods. But again, it's just working on how to change habits and that just takes time. Reflection, trying things out, reflecting back on how it worked and whether it worked or not, and then trying the next thing if it didn't.

Melanie Cole, MS: That's great advice, Jodi. You're always full of such great advice. And now, it's the season, the farmers markets are starting to pop up, and so you can go to those. And try a new vegetable, try something you've never tried before. And you can even ask the person, "What do you do with this kohlrabi or different foods?" So, you know, it's all about being creative, coming up with ways to use those whole foods, those non-processed foods, that's really the best way. And Jodi, thank you so much for reiterating that for us today and giving us some great ideas to change our unhealthy diet practices.

And for more information, you can visit henrymayo.com/classes for a list of Henry Mayo Community Education classes on nutrition. You can also visit our free health information library at library.henrymayo.com. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. I'm so glad that you could join us today.