Public Health

9 diet questions patients should be asking their doctors

Sara Berg, MS , News Editor

Eating a healthy diet can help adults live longer and have a lower risk of obesity, heart disease, type 2 diabetes and certain cancers. Healthy eating can even help people with chronic disease manage those conditions and prevent further complications. However, most Americans are not eating a healthy diet and could benefit from asking their physicians key questions about nutrition and lifestyle changes.

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The AMA’s Diabetes Prevention Guide supports physicians and health care organizations in defining and implementing evidence-based diabetes prevention strategies. This comprehensive and customized approach helps clinical practices and health care organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring patients at risk to a National Diabetes Prevention Program lifestyle-change program based on their individual needs.

Here are some questions patients should be asking their physicians when it comes to their diets and lifestyle, along with the answers that doctors should be ready to share.

Most of the sodium in a person’s diet comes from packaged, processed foods with adults consuming more than 3,400 mg of sodium per day—more than the 2,300 mg limit recommended by the American Heart Association (AHA). Minimizing the consumption of these foods can reduce sodium intake, lower BP and prevent hypertension from developing in the first place. One way to help patients minimize their consumption of sodium is by identifying the different myths about salt.

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There are benefits to fish oil, but it should not replace eating fish. The AHA recommends eating fish at least two times a week because it is a good source of protein and, unlike fatty meat products, is not high in saturated fat. Fish is also a good source of omega-3 fatty acids, which may help to reduce the risk of heart disease and stroke.

Fatty fish such as salmon, mackerel, herring, lake trout, sardines and albacore tuna are high in omega-3 fatty acids. But some types of fish contain high levels of mercury and other environmental contaminants. These are highest in older, larger, predatory fish and marine mammals. Patients should avoid eating shark, swordfish, king mackerel or tilefish because of their high levels of mercury, according to the AHA.

The new research about red and processed meat does not explain how much is safe to eat. Higher consumption of red meat is associated with increased risk of chronic disease and mortality. Current recommendations from the AHA, American Cancer Society and U.S. dietary guidelines call for limiting red meats and processed meats. Patients should continue to follow those recommendations.

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Drinking diet sodas will not help a person lose weight. While diet soda is calorie-free, most cans still contain 40 mg of sodium. To add to that, diet sodas contain artificial sweeteners, which often confuse the body. When not consuming any liquid calories, it may be easier to justify that extra slice of pizza.

Most people should avoid artificial sweeteners completely because they stimulate appetite, encourage a sweet tooth and make people pack on the pounds. This places people at risk for obesity, type 2 diabetes, heart disease and fatty liver. There is one exception, though. For patients with type 2 diabetes, artificial sweeteners are preferable to real sugar and are regulated by the Food and Drug Administration as food additives.

A diet that is high in fat can lead to weight gain, but it takes more than limiting high-fat foods to lose weight. It is also important to watch how many calories a person eats. Extra calories, even from fat-free and low-fat foods, can get stored in the body as fat. Low-fat options can help reduce total caloric intake, but it is also important to pay attention to caloric intake from carbohydrates and proteins.

While nuts are high in fat and calories, they are incredibly healthy. Eating nuts is not associated with weight gain, which means patients should regularly eat nuts as part of a healthy diet. Nuts can even help with weight loss, but it is important to exercise portion control.

Physicians should provide recommendations for moderate consumption and what is defined as a drink. Over time, heavy drinking can damage a person’s heart. For healthy adults, women who have more than one drink a day and men who have more than two drinks a day can see an effect on blood pressure. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.