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Melanie Cole (Host): Good nutrition is such an important part of leading a healthy lifestyle, and when combined with physical activity, your diet can help you to reach and maintain a healthy weight, reduce your risk of chronic diseases, and promote your overall health. Here to discuss this in this panel style discussion today are my guests; Emily Sylvester, she's a Registered Dietician, and Ardith Friday-Hamm, she's the Chief Clinical Dietician, both at Oroville Hospital. Ardith, I'd like to start with you. What does it even mean to eat healthy? People don't really understand what that means. Tell us.

Ardith Friday-Hamm, RD (Guest)): Well, it probably means different things to different people. So when someone hears that, what they should think of is eating a wide variety of food, a plant-based diet, which includes lots of fruits and vegetables, whole grains, beans, legumes, lean meats, lean poultry and lean seafood, and that's what they should be thinking of.

Melanie: Emily, what are the benefits of a healthy diet? Can it help to stave off some diseases like high blood pressure or heart disease or diabetes?

Emily Sylvester, RD (Guest): Oh, for sure. There are numerous health benefits to eating a healthy diet, some of which include giving you adequate energy, helping you maintain a healthy weight, reducing the risk of - like you said - chronic diseases such as diabetes and heart disease. And specifically, if you're looking at consuming a healthy diet, you can definitely lower your blood pressure and overall improve your heart health.

One of the most well-known dietary plans to reduce blood pressure is the DASH Diet, which it stands for Dietary Approaches to Stop Hypertension. This emphasizes healthy food sources while eliminating red meat, sodium, and added sugars such as sweets, cookies, candy, et cetera.

Melanie: Such an important aspect of a good diet, and Ardith, people hear 'healthy diet,' and as Emily has just said the DASH Diet, but how important is portion control to what it is we're looking at? And I know that that may concentrate a little bit more on weight loss, but how do you go about portioning food? How important is that?

Ardith: Well portion control is very critical because that controls calories, and calories obviously is what causes excess weight gain. So the best way to control portions is to use your plate as a measure of how much to eat. So a standard size plate- so a lot of people have probably heard of My Plate, which is put out by the government, and basically what My Plate is saying, is it's telling you to split your plate up and to eat a little bit of all sorts of different healthy foods, but what the My Plate also does, is it helps portion control because a fourth of your plate should be protein, a fourth of your plate should be starch, half of your plate should be fruits and vegetables. So you shouldn't be really using a plate over nine inches for an adult and over- it should be about seven inches for a child.

Melanie: Emily, what about some of the fad diets that people hear about? No carbohydrates, and not all carbohydrates are created equal, some are actually really good for us. But you know, there's a lot of controversy. People hear that word 'carbs,' and they go running for the hills. So tell us a little bit about carbohydrates, and what they do for us, and how we should be limiting them, or which types we should be concentrating on.

Emily: Okay, yeah. I hear the low carb / no carb diet, I think every day in my job. Somebody comes in saying, "I'm not eating any carbs, and I'm losing weight." Well of course, when we restrict a certain nutrient, we're going to lose weight. Typically 50% of all our calories that we consume are from carbohydrates, and yes, eating fewer ones might produce weight loss, but also including certain carbohydrates such as whole grains can promote a healthy weight and also produce weight loss.

Things that are higher in fiber, these types of foods are digested slower than refined grains, keeping us fuller, also promoting heart health, and just benefits as in keeping blood sugar controlled. So our body's first source of energy comes from glucose, which is what carbohydrates break down to the body. So when somebody is following a no carb or a low carb diet, there's no glucose to use, and their body relies strictly on the stored fat. When we're lacking the carbohydrates in our diet, we typically tend to go toward high saturated fat, like the way a lot of the fad diets do it. Especially red meat such as bacon, steak, things like that, that are also high in sodium. People have to be very, very cautious if they had kidney disease or any cardiovascular disease because it can worsen their condition, and it also can lead to deficiencies such as fiber, calcium, and vitamin D.

So when we're looking at- I like to say a high fiber grain, there are two types of fiber; soluble fiber and insoluble fiber. Both are very important for our overall health, and digestion, and preventing diseases. So when you look at it, I like to say whole grains, legumes, also some fruits are very high in fiber, and vegetables. Women need twenty-five grams per day, men need thirty-eight grams of fiber per day. So by doing those, you can also improve cholesterol as well.

Ardith: And I just wanted to add because so many people with diabetes feel like they have to restrict carbohydrates in order to control their blood sugar, that's very important to know that they can eat healthy carbohydrates, because there is a difference between healthy carbohydrates and unhealthy carbohydrates.

When I say 'unhealthy carbohydrates,' what I'm talking about is foods that have a high concentration or a high amount of sugar added, and also things that are processed white flour, those sorts of things. So you hear sometimes patients saying, "Well, I know I need to really watch my carbohydrates," so we need to emphasize that healthy carbohydrates are an important part of the diet, and yes, the portions should be controlled, and what you should really be restricting and watching the portions on are like sugary beverages, that includes coffee beverages, and then all the desserts. But it doesn't mean you have to avoid those completely, you can include those in just small portions.

Melanie: That's an excellent point, and Ardith, where does protein then fit into this picture, as there are healthy carbohydrates, and people look at these fad diets and things that Emily has discussed, they think, "Oh, let's just up the protein," and that's not always the best idea either. How do you sort it out and decide which are going to be the best proteins for you, and how much of each to include?

Ardith: That's a good question. So yes, there are a lot of people nowadays that are saying, "More protein, more protein." The Paleo Diet, which is primarily very high protein, very low carbohydrates. But you want to include a good protein source at every meal because your body needs to assimilate- it breaks down- your body breaks down the protein into components called amino acids, and you do use those to break down, to rebuild your muscle stores. Especially after you've exercised, it's good to get a good source of protein at the next meal that you eat.

So a good portion of protein would be, for example, about the size of a woman's palm is three ounces, and that's about the average size for a woman or a smaller man. A larger man might need more like four ounces, which would be a little larger than a woman's palm. And so you should include a good protein source at every meal because your body does need those amino acids. And at breakfast, a good protein source, you could do eggs, but if you don't want to use the yolk, where the yolk is high in cholesterol and saturated fat, you can just use the egg whites, which are very healthy and they don't contain the saturated fat.

Other sources of good protein would be Greek yogurt, especially the Greek yogurts because they're more concentrated in protein than your standard yogurt and they tend to be lower in sugar than your standard yogurt. Cheese, cheese sticks, especially like the mozzarella which is a little bit lower fat. So there's lots of different ways you can get your protein through vegetarian too with legumes, different types of beans, and that sort of thing. So you should try to include- and a serving of legumes is about a cup cooked. So yes, there's ways to incorporate that, but every meal should contain at least some portion of protein.

Emily: And I would like to add, there's also misconception that the more protein you eat, the bigger muscles you'll build. There's also some negative consequences such as dehydration and weight gain. If you're eating large portions of meat, you're also going to gain the weight, just like you'd gain eating large servings of carbohydrates.

Melanie: Emily, as Ardith has mentioned the big 'E' word - exercise - how does exercise combined with the healthy eating we've been discussing really help with that overall health, and what types of exercise do the experts recommend? The biggest question people always seem to have is how much do they need to do?

Emily: Well, exercise and nutrition go hand in hand. Obviously nutrition is- the majority, if someone is trying to lose weight, it's going to be focusing on nutrition first, and exercise is going to be a great weight maintenance tool after you've started losing the weight. About 3% to 5% of adults are meeting the exercise recommendations, where about 150 minutes of moderate intensity aerobic activity weekly. So that's something like a brisk walk, or anything that raises your heart rate and makes you break a little bit of a sweat, but you can still carry on a conversation. Or seventy-five minutes of vigorous intensity, so like jogging, swimming, something that your heart rate is really increased.

Children, when it comes to them, they're more likely to- the older they get, to meet the recommendations, is sixty minutes of physical activity a day, and only 42% between the ages of six and eleven are meeting those recommendations, and then when they become adulthood, obviously the percentage goes down.

Ardith: I just wanted to add about the exercise, is that the other component to exercise are the strengthening exercise. So at least maybe two or three times a week for adults, and the same actually for children, is doing some sort of resistance exercise. So that could be with exercise bands, that could be with free weights, that could be with weight machines. So something that is stressing your muscles so that they can rebuild or kind of build them up a little bit. So that's part of it, and another component to exercise would be the stretching. So a lot of us don't do very much stretching at all, and our muscles get pretty tense, so some amount of stretching once or twice a week.

Melanie: Emily, first last word to you. What would you like the listeners to know as a Registered Dietician about the combination of exercise and eating healthy, and all of the- they get so much information from so many different places. Kind of wrap it up for us with your best advice about what someone can do today, right now, to start on that road to healthy eating, good exercise, and better overall health.

Emily: Okay. You know, I like to tell people, keep it simple. Don't take all the information from your friends, from online. Go to a good source, and a balanced diet is truly the foundation of living a healthy life. So that new My Plate is a great visual. So looking at My Plate and filling your plate like that every single day, and then also realizing that we need exercise for not only to promote a healthy weight, but also cardiovascular health and other health issues to prevent, and also if you have them, to improve. So just make it simple, keep it easy and healthy.

Melanie: Ardith, your turn. Tell the listeners what you would like them to know about the link between disease state and healthy eating and exercise. Our immune systems, our mood, stress, heart disease; all of these things that come at us from all different angles, and how exercise and healthy eating can help stave some of those off.

Ardith: Well, as Emily said, overall a healthy diet and some exercise definitely contributes to your feelings of well-being, how good you're feeling. I mean, if you've ever had a day where you've eaten a lot of junk food, so to speak, or a lot of sugary foods, you can just definitely feel the difference versus eating a healthy diet. But overall, it's going to help prevent certain diseases such as cardiovascular disease, diabetes, and in fact, some people don't realize that pre-diabetes, which is a precursor to diabetes, is reversible. So a healthy diet and exercise can help prevent that from going into type II diabetes. Just overall, your general well-being. And exercise helps release those good chemicals called endorphins that help to relax you and make you feel better. And then there's the whole component of stress and excessive eating. So if you exercise, that helps bring down your stress level, and that prevents some of the over-eating that sometimes happens. So overall, the exercise and the healthy diet go hand in hand to bring down that stress level, which eventually brings down your risk for heart disease, certain cancers, and diabetes.

Melanie: Thank you so much, ladies, for joining us today. It's really great information. So important for listeners to hear from Registered Dieticians and Clinical Dieticians about the importance and how to eat healthy, because not everybody really knows what that means. Thank you so much for joining us today. You're listening to \Growing Health Together, a podcast by Oroville Hospital. For more information, please visit www.OrovilleHospital.com. That's www.OrovilleHospital.com. This is Melanie Cole, thanks so much for listening.