Healthy Eating Through the Day -- Elizabeth Ward, MS, RD -- 03/11/03

By Elizabeth Ward
WebMD Live Events Transcript

Now that we know what to eat, how do we pull it all together? What are good ideas for quick breakfasts, square meals for lunch? Can a family live on frozen-food meals alone? And are there any good takeout choices? Elizabeth Ward, MS, RD, joined us to answer these questions and more.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live. Our guest today is nutrition expert Elizabeth Ward, MS, RD. Hello again, Elizabeth. Thank you for joining us. Let's start with breakfast. Is it really the most important meal of the day?

Ward: Well it's not the most important meal of the day but it's critical for a number of reasons. Any meal is an opportunity to work in the nutrition that you need and breakfast is no exception. Plus, eating breakfast may actually help fight the battle of the bulge, and the reason for that is that skipping breakfast usually means that you're very hungry by 9 or 10 a.m. and usually go for the vending machines or run out to buy a pastry or even a bagel that's much too large. So, I think skipping breakfast sets the tone for the day and that tone is not usually healthy.

A lot of people say they don't have the time to eat breakfast, but it only takes between five and 10 minutes to sit down with a bowl of cereal that's high in fiber, topped with low-fat milk and fruit. Even if you don't have the time to eat at home, you can always bring food to the office or keep food at the office that would qualify as healthy breakfast fare. So you could, for example, have 8 ounces of yogurt and mix your cereal into that instead of fussing with milk and cereal at your desk at work.

The other complaint that I hear is people don't like "traditional" breakfast foods, such as eggs, toast, cereal, and milk, and that's OK. You don't need to eat the traditional breakfast foods in order to get the nutrition that you need. If you feel like eating a sandwich for breakfast, go ahead. Just make sure it's something fairly low fat, such as turkey on whole wheat, and include a serving of fruit and dairy and that qualifies as a healthy breakfast.

Moderator: In our family, our motto has always been, "If it's healthy for dinner, it's healthy for breakfast."

Member: My kids hate eggs. They'd rather have sugary cereal. Is it better to let them eat a bowl of Captain Crunch (with skim milk) if the alternative is no breakfast?

Ward: They learned how to like sugary cereals, and they can learn how to unlike them. By that, I mean, you can start weaning them off the high-sugar, low-fiber kid cereals by mixing those cereals with low-sugar cereals such as Cheerios. And gradually, children get used to eating less sugar. Also, you can make the cereal sweeter by adding fruit on top and it will become an entirely different bowl of cereal after you're done modifying it.

But to answer your original question, it is better for them to have a bowl of sugary cereal than no breakfast at all, and the reason for that is even though there's a lot of sugar in that cereal and very little fiber, sugary cereals are typically fortified with many vitamins and minerals that kids need. In addition, your child is getting a serving of milk by eating that cereal. So, because breakfast is very important to a child, I would say that any kind of cereal is better than no breakfast at all.

Member: My family likes hot foods for breakfast. For the ones who don't like eggs, are frozen waffles or pancakes OK if we use lite syrup? On weekdays they aren't going to get much more cooking out of me in the morning -- I work full-time!

Ward: I say hats off to you for doing that much cooking every morning. Pancakes and waffles are an excellent choice for breakfast and light syrup is a great idea; just make sure your child is including some sort of dairy product and some fruit as well.

Member: My husband loves eggs for breakfast. I poach them or cook them using spray, not butter. How many times a week is it all right for him to have eggs?

Ward: What a great question. The American Heart Association, who, in the past, has put the kabosh on eggs, recently stated that you can have an egg or more a day. It really doesn't matter how many eggs you consume, as long as your diet is low in fat. So as long as you are eating eggs and not pairing them up with high-fat meats such as sausage, or with hash browns and other high-fat foods, and as long as your blood-cholesterol levels are normal then go ahead and eat eggs.

Moderator: Scrambled eggs are a great way to use leftover veggies from dinner.

Member: I like to serve yogurt parfaits for breakfast. Layer yogurt with fruit and cereal in a pretty glass and kids love it. It's fast and easy to prepare. Is non-traditional breakfast like this OK?

Ward: It's actually not so non-traditional when you consider the elements that go into the parfait. The presentation sounds lovely and is not a traditional way to use these foods for breakfast, but it's a great breakfast, particularly because your kids are interested in it and they eat it. But I like it mostly for the fact that it combines three different food groups.

Moderator: Anything new in the news about breakfast?

Ward: The American Heart Association had a conference last week and there was evidence presented that suggested that when you don't eat breakfast you may be more prone to diabetes and obesity in the long run. I think that makes a lot of sense, partially because breakfast helps control your appetite and it helps to reduce the likelihood of overeating later in the day. And when you're overweight your chances of developing type 2 diabetes goes way up.

If you are one of those people who say they're just not hungry in the morning, you may want to consider eating less at night. In my experience, people who reduce the amount of food eaten between dinner and bedtime wake up very hungry and they are more likely to eat a healthy breakfast when they stop overeating at night.

Member: What's the best lettuce for my lunch sandwich? I know iceberg is basically useless, but between green leaf, romaine, and those dandelion-looking mixed greens, what should I buy for the best nutrition?

Ward: I'd go with romaine. It's dark green, which means it contains many more nutrients than other greens. Plus, I think it's easier to work with in a sandwich, because you can fold one piece in half and stick it between two slices of bread.

Member: My family is so tired of having the same old lunches day after day. What can I do differently rather than a sandwich, cookie, and fruit?

Ward: When you're stuck in a rut, you can try using different breads a change of pace, such as:

  • Pita
  • Tortillas
  • Colorful sandwich wraps

Also, vary sandwich fillings:

  • Add things like chopped celery or water chestnuts to tuna salad
  • Combine sliced chicken with grapes when making chicken salad
  • Dress up the sandwiches with fillings like cranberry sauce and different flavors of mustard

If you're totally tired of sandwiches, you can go for more non-traditional approach to lunch. Some ideas:

  • Combine whole wheat crackers with string cheese that comes in 1 ounce packages
  • Hummus
  • Yogurt and fruit
  • Hard-boiled eggs
  • Carrot sticks
  • Whole-grain roll
  • A fruit salad topped with yogurt and some whole grain crackers
  • A large salad with tuna fish or leftover chicken and different vegetables in the salad

Member: I am trying to lose weight and eat healthier. I work all day. I don't have time to pack much of a lunch. I tried to make extra food at dinner so that I can have leftovers for lunch, but with a teenage son, leftovers don't last. Sometimes he eats so much at dinner there are no leftovers. He is in a growth spurt and not overweight at all. I have tried the frozen low-cal lunches, but am concerned about the hydrogenated fats in them. Are they acceptable?

Ward: Generally speaking, low-fat foods are low in hydrogenated fat. So if you choose the frozen entrees that are geared to weight loss or weight control, I wouldn't really worry about the hydrogenated fat content, but I would add certain foods to make that meal more complete, including, a piece of fruit or a large green salad and a serving of low-fat dairy.

Member: What do you think about the guy who lost all that weight eating Subway sandwiches? Is that really a healthy diet?

Ward: I think it's great that he lost weight, but I think that he lost weight because he ate fewer calories and he probably could have achieved the same results just by cutting back on all the foods that he ate.

Member: How do you feel about diet drinks like SlimFast?

Ward: I don't think much of them, in the long run, because they don't teach you how to eat and they really help you avoid the real reason why you can't get your weight under control. So, they offer a jump-start to any diet, but they're a crutch that effectively produces weight loss, but never really solves your ultimate problem.

Member: If I have a whole navel orange for a snack, how many servings is that, and am I getting any fiber from it?

Ward: Yes, that's a great snack and you are getting about three to four grams of fiber, which is a good amount. But more importantly, you're getting the benefits of the hundreds of phytonutrients found in an orange, which may help to reduce chronic diseases such as heart disease and cancer in the long-run.

Member: I've been snacking throughout the day to avoid overeating. I eat things like non-fat yogurt, or raw veggies with a little low-fat dressing as a dip. Is this a healthy way to eat?

Ward: Eating small meals throughout the day is a fine way to eat, as long as you stay within your calorie requirements. And a snack such as raw vegetables with low-fat dressing is a great snack, but I would caution people to first understand that they have to determine how many calories they need, and then divide up the meals so that they don't exceed those calories.

Member: My daughter (age 7) has no taste for meat, other than the occasional chicken dish. She eats a lot of pasta and cheese pizza. She does love peanut butter, but that's not a great dinner choice. Should I worry about so many carbs and so little meat in her diet?

Ward: I'm chuckling because I have a 4-year-old who would fit the same description and I struggle to get her to eat poultry, never mind meat. I'm not sure I've come up with the perfect solution but I continue to offer chicken as much as possible and until she eats more foods with iron in them I give her a chewable multivitamin with iron every day to cover my bases.

Iron is really the major concern here. So a supplement may be just fine for a child that doesn't like meat. As long as she's eating dairy foods and peanut butter, I really don't have a problem with her protein intake. But I would be concerned about iron and other vitamins and minerals that she may not be getting without some meat or poultry every few days.

Member: Some vitamins say "with iron" Do I need to give her one of those, or the regular multi?

Ward: I think a regular multi-vitamin is fine.

Member: Do spices have any particular nutritional benefit?

Ward: It's a good question, and I don't have all of the answers. But I have read lots of interesting tidbits about spices and their health benefits coming from the American Institute for Cancer Research. So you might want to try their web site for more information.

Member: Back to my orange question: I'm still not sure what constitutes a "serving." I'd really love to know if there's more than one serving in a whole orange. I sure hope so!

Ward: No, it's one serving.

Moderator: Dinner can be tough for families with lots going on. How do frozen dinners stack up? Are they a viable alternative?

Ward: Frozen dinners are basically a last resort. I'd rather see you eat pizza than a frozen dinner that has a lot of added sodium and flavorings and food coloring and really lacks fiber. I think a bit of planning can help put off the urge to use frozen dinners more than once every couple of weeks. A simple meal that uses convenience foods could be roasted chicken from the supermarket and a bag of salad greens and a box of minute rice. You could have that on the table in the same time it takes to heat up a frozen meal.

Moderator: What things would you keep in the pantry so that you could always throw something quick on the dinner table?

Ward: Here's the bare minimum of what you can keep on hand to fix healthy, quick meals:

  • Pasta
  • Rice
  • Whole grain bread
  • Pancake mix
  • Fruit
  • A large bag of pre-washed salad greens
  • Milk
  • Cheese
  • Yogurt
  • Canned beans such as chick peas
  • Canned tuna fish
  • Peanut butter
  • Eggs
  • A bag or two of frozen vegetables

Member: You mentioned chickpeas; I love them and make a mean Indian masala dish with them, but sometimes they are a bit chalky and hard. Besides cooking them to death for hours, do you know how to make chickpeas as soft as they do in the restaurants?

Ward: I have to confess that I use the canned variety and mine are smooth. I think it depends on how old the beans are and how you cook them, but I am not an expert on cooking legumes.

Member: A stir-fry is one of the few things my family can agree to eat together. I use low-sodium soy sauce and as little oil as I can get away with (a canola blend), with plenty of veggies and white meat chicken. And I add raw peanuts when I have them on hand. Any other ideas for making this dish as healthy as possible?

Ward: I would say you're already there for the health qualification. You might try different kinds of nuts in the stir-fry, such as slivered almonds, maybe changing around the protein part by using pork or lean beef, and just varying the vegetables as much as possible.

Member: What big chain restaurant is best for having a nutritious meal? I'm thinking of the Friday's, Outback-type of places.

Ward: What happens in these large chain restaurants is they use a lot of convenience foods to speed up the preparation and to keep the cost lower. And that means that the diner loses control over how much salt is in their meal or how much added fat has gone into their meal. You lose control over that anyway by going to a restaurant, but at chain restaurants the situation is probably worse, because the chef can't cook to order as readily as they would in a smaller establishment. So you have to live by a few rules of thumb when dining out.

One is, if it sounds fattening, it is -- and you should avoid it. For example, a taco salad is deadly to your waistline because the taco shell can have more calories than the actual salad with the salad dressing on it. So try to eat food as plainly as possible and order sauces and dressings on the side and avoid things with cheese and fried foods and I think you'll do OK.

Portions are typically double what you would eat at home, so you may want to try what I call the preemptive doggy bag. Ask for a doggy bag up front, at the beginning of the meal, and not the end. That way, you won't be tempted to pick at the food throughout the meal.

Your other option is to share a meal. And if you must have dessert, order the desert and four forks and spread the calories around whenever possible.

Member: If you are going to eat out, is sushi a healthy choice?

Ward: Well yes, and no. Sushi is certainly low-fat and very low in saturated fat and cholesterol, but I am not a big fan of raw fish or raw seafood of any kind because of the food safety concerns I have. The second issue of eating a lot of seafood concerns mercury. Recently, the Food and Drug Administration has warned women in their childbearing years to avoid certain fish, including swordfish, shark, king mackerel, and tilefish. And other organizations have urged the FDA to target tuna as also being high in mercury and potentially harmful. So eating a lot of tuna of any kind, raw or canned, for women in their childbearing years might be a problem, because these fish that I've mentioned have concentrated levels of mercury in their flesh, which is the part that we eat, and mercury can harm a developing baby's nervous system.

I know that people who like sushi really like sushi, so they tend to eat a lot of it, and you may want to reconsider doing that. An occasional sushi meal is probably not a problem, however.

Moderator: We are out of time. I'm sorry we couldn't get to all of your great questions. Our thanks to Elizabeth Ward, and thank you class for joining us today.

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