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2. Detailed information for those who want to know more - fine tuning your diet.

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There are many dietary regimens that are beneficial, based largely on the concept of getting more than 75% of daily food requirements from cereals (which have had limited or no refining), fruit and vegetables. The following are outlines of these diets along with links to the web sites that have the complete information on them.

The following diets will be shown:

A. The Mediterranean diet
B. The Australian diet (Department of Health and Aging and the National Health and Medical Research Council )
C. The American diet
D. The vegetarian pyramid

A.The Mediterranean diet.
This is the traditional diet from around the Mediterranean Sea from Spain to Turkey with regional variations mainly relating to the availability of sea foods. It has been extensively studied and many of the concepts of this diet which evolved over the past hundreds to thousands of years, have been incorporated into many other recommended diets.

The food pyramid based on the traditional Mediterranean diet showing the proportions of the various food types was developed by the Oldways organization (www.oldwayspt.org). This couldn't clearer: what you should eat least of is at the top of the pyramid and what you should consume most of is at the bottom. This diet is in harmony with the land and has stood the test of many centuries, being environmentally sustainable. Anyone who tells you that we as humans should return to the theoretical high meat diet of Palaeolithic times ignores the obvious: humans flourished on the Mediterranean diet. The great civilizations that form the foundation of much of our current western society consumed this type of low animal protein, largely plant-based diet.

B. The Australian diet. (Department of Health and Ageing and the National Health and Medical Research Council).

As can be seen only a small part of this diet is made up of animal-based foods, with the around 80% of food intake being in the form of fruit, vegetables, legumes and minimally or unprocessed cereal foods. The full details can be downloaded from the NHMRC web site at www.nhmrc.gov.au/publications/synopses/dietsyn.htm

C. The American diet (US Department of Agriculture)

This clearly shows that the majority of foods should be plant based, but gives a lot of more emphasis to dairy and other animal-based foods compared to other recommendations. This may reflect the intense lobbying of the producers of animal protein on various government agencies. While these recommendations will certainly maintain you in reasonable health, their effect on the environment is likely to be much worse. By accessing the MyPyramid site, tailored advice as to what a particular each individual should consume can be obtained (www.mypyramid.gov). For very detailed information on these recommendations download the full Dietary guidelines for Americans at www.health.gov/DietaryGuidelines.

D. The vegetarian pyramid.
This image is one of many available on the web and this particular one was originally developed by the New York Medical College. It can be downloaded from the web from numerous sites which give good background information on this.

Vegetarian diets are quite safe from a medical point of view provided that a wide range of foods are consumed. This pyramid encompasses all types of vegetarianism. The top most triangle is for vegans who are at risk of developing vitamin B12 and other deficiencies. An excellent guide can be downloaded from the Vegetarian Resource Group site: the Food Guide for North American Vegetarians (www.vrg.org) prepared by the American Dietetic Association and Dieticians of Canada (Messina 03). If you do begin a vegetarian diet it is important that you get reliable nutritional advice on your planned eating. Vegetarians are indistinguishable from other members of the community (apart from their better overall health) in that they have similar academic and athletic performance (Key 06). Their effect on the world's ecology is certainly very much better and it is a much more sustainable lifestyle.

Portion sizes and all that.

This table of portion sizes is taken from the Dietary guidelines for Australians which can be downloaded from www.nhmrc.gov.au/publications/synopses/dietsyn.htm. When used in conjunction with the next table which lists the number of portions for each age group and sex, it gives an indication of how much you should consume of these vital food types. If you base your eating pattern on a largely plant-based intake, then these tables become irrelevant; you will by default consume adequate amounts of these. If you have trouble knowing how much to eat of these food types, then you can use these as a guideline for the minimum consumption.

I have deliberately left out the portion sizes for animal-based foods since in our typical western diet we consume far too much of them anyway. My feeling is that giving portion sizes for such things as cheese and red meat may be taken by some to mean that we should eat that amount. My philosophy is that if you look after the plant-based foods, the other parts of your diet will fall into place. The best advice is don't make this a chore, be flexible and always keep in mind that the major part of your intake should be from these sources. Always eat the greatest number of food types possible.

Cereals, breads etc.
2 slices of bread	1 medium bread roll	1 cup cooked rice, pasta, noodles
1 cup of porridge	1 cup breakfast cereal flakes	1/2 cup of muesli
Vegetables and legumes (choose variety)
Starchy vegetables
1 Medium potato or yam	1/2 Medium sweet potato	1 Medium parsnip
Dark green leafy vegetables
1/2 cup cabbage, spinach, silverbeet, broccoli, cauliflower or Brussels sprouts.
Legumes and other vegetables
1 cup lettuce or salad vegetables	1/2 cup broad beans, lentils, green beans, zucchini, mushrooms, tomatoes, capsicum, cucumber, sweetcorn, turnips, sprouts, celery, eggplant etc.
Fruit
1 piece medium sized fruit, eg apple, orange, mango, mandarin, banana, pear, peach etc
2 pieces of smaller fruit eg apricot, kiwi fruit, plums figs etc		About 8 strawberries
1 cup diced pieces or canned fruit	1/2 cup of fruit juice	1/4 medium melon (rockmelon, honeydew)
Dried fruit eg 4 apricots	1&1/2 tablespoons of sultanas	About 20 grapes or cherries

The next table should be used in conjunction with the table above to show you how much of these foods you should consume. The reality is that most people fall far short of a healthy intake.
You know that you will be getting in right if you consume these amounts and as a consequence reduce the amounts of animal-based foods so that overall your weight remains stable, except of course if you are trying to loose weight. Remember that animal protein and carbohydrates have the same caloric value of 4 Kcal/g and if you eat too much carbohydrate from any source, plant or animal, you will become overweight.

Serves for various age groups	Cereals Breads	Vegetables, Legumes	Fruits
Children and teenagers
4-7 years	5-7	2	1
8-11 years	6-9	3	1
12-18 years	5-11	3	3
Women
19-60 years	4-9	5	2
60+ years	4-7	5	2
Pregnant	4-6	5-6	4
Breast feeding	5-7	7	5
Men
19-60 years	6-12	5	2
60+ years	4-9	5	2

Some very important points on eating.

First, the saturated fat story.
The problem that comes with most animal-based foods (excepting fish) is that they have a lot of saturated fat, particularly in the way that industrial production has adversely altered them. Many fast foods are fried in saturated vegetable oil because of it doesn't oxidize quickly, maintaining its taste. These are just as bad. Most authorities recommend a maximum of 10% of energy come from saturated fats. That might seem a lot, but you must remember that fat of all types has 9Kcal per gram (270Kcal/oz.) This means that to avoid going over that limit, you can only eat on average about 20-25g (less than 1oz) of saturated fat per day in a standard 2000Kcal diet. It is very easy to exceed this.

For medically fit people, the less saturated fat you consume the better, just because the recommended limit is 10% of your calories, it doesn't mean that you should approach this level. (A word of caution, however. If you have established coronary artery disease, known abnormal blood lipids or diabetes, the situation becomes very complex. Seek expert medical advice about fat content and type in your diet.)

Some web sites say that saturated fats are needed for your good health. The paper that is most quoted comes from the most reputable of reputable sources: Mozaffarian, American Journal of Clinical Nutrition 2004; 80:1175-1184 (Mozaffarian 04). It's use exemplifies some of the errors that are made in quoting the scientific literature to support narrow points of view. What it doesn't say is that saturated fat is good for you. What it does say is that in elderly post menopausal women who are overweight, who have a high rates of diabetes or the metabolic syndrome and who have established coronary artery disease with relatively low fat intakes, replacing saturated fat with carbohydrates leads to a greater progression of coronary artery disease. The reasons for this apparent paradoxical response are not well understood.

This is a very restricted scenario from which some have wrongly extrapolated to indicate that replacing saturated fat with carbohydrates leads to coronary artery disease as a general effect. The paper definitely doesn't say that. Another sin it demonstrates is that some people who quote this paper have taken other people's incorrect comments and have never read the paper themselves. If you haven't read it and/or don't understand the medicine, then you have no right to use it as evidence. It is highly misleading and downright dangerous to do so. Speaking without knowing is a common crime. To re-emphasize my previous word of caution, where there is pre-existing diabetes, metabolic syndrome, coronary artery disease or known dyslipidaemia seek competent medical advice.

Here is a list of notable saturated fat offenders (Saxelby 06):

Food
Saturated fat
in grams

Shortbread 2 fingers 4.6

Croissant 8.7

Cheddar 1 slice 20g 4.3

Processed cheese 1 slice 20g 3.7

Cheesecake 1 wedge 15.0

Chocolate mud cake 1 wedge 17.0

Butter 2 teaspoons 5.2

Full cream 1 tablespoon 5.7

Coconut cream 1/4 cup 11.4

Salami 2 slices 5.7

Sausage/hot dog 1 thick 6.2

Lean beef steak 100g 3.4

Potato crisps small pack 50g 7.1

Popcorn medium serve 15.2

If your limit is around 20-25g/day, then you don't have to eat much of the above to exceed this level. Remember also that commercially fried foods such as chicken and fish are often fried in saturated fats and one serve is likely to exceed your daily limit.

Second, try to avoid processed foods - eat low HI (human interference) foods .
They are usually full of simple sugars, fats - especially the most damaging of all, transfat - and salt. Avoid white bread, it may taste really good but it isn't good for you. Minimally or unprocessed foods such as fruit, vegetables and wholegrain cereal products have low glycaemic indexes (causing only a slow rise in blood sugar when consumed) are always to be preferred. It is these foods coupled with a low saturated fat intake that gives vegetarians good health and longer lives without obesity or diabetes. Most pre-prepared convenience foods are highly processed. Look on the ingredient list and if the food has a long list of ingredients, give it a miss.

Low HI foods (Tickell 04). Another good guide is choose food that has a low HI (human interference) value from the fruit, vegetable, cereal and legume types. A good example of a high HI cereal product is Coco Pops or muesli bars. Simply ask yourself, "How was this product made?" If the answer comes back that it was unlikely to have directly from the farm but rather from some big manufacturing facility, skip it. Save yourself some money, make your own and improve your health at the same time. An excellent review of this can be found in Marion Nestle's recently published book "What to Eat" (Nestle 06).

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References:

(Key 06) Timothy J. Key, Paul N. Appleby and Magdalena S. Rosell. Health effects of vegetarian and vegan diets. Proceedings of the Nutrition Society 2006;65:35–41

(Mozaffarian 04) Dariush Mozaffarian, Eric B Rimm, David M Herrington. Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women. American Journal of Clinical Nutrition 2004; 80:1175-1184.

(Nestle 06) Marion Nestle. What to eat. 2006, North Point Press.

(Saxelby 06) Catherine Saxelby. Nutrition for life. 2006 Hardie Grant Books

(Tickell 04) John Tickell. The Great Aussie Diet. 2004 Boomerang Books.