Why all the fuss about diet and exercise?  The majority of adults in the United States are overweight or obese. The prevalence of overweight adults has increased from 31% to 64% in the last four decades. The prevalence of obesity has increased from 13% to 31% (JAMA 2002;288:1723-7). Adverse health consequences of obesity are well established and include increased risk of cardiovascular disease, type 2 diabetes, some types of cancer, and a reduced life expectancy.   Our "current" modern diet is clearly maladaptive as cardiovascular disease (heart attacks and strokes) is the main cause of death in Western societies (41% of all fatalities) (J Am Coll Card 2000;35:66-80B). Diabetes is another epidemic in modern society.  The lifetime risk of developing diabetes melitis for individuals born in 2000 is 32.8% for males and 38.5% for females AND a male who is diagnosed at age 40 years old will lose 11.6 life-years (14.3 if female) and 18.6 quality-adjusted life years (22 if female) (JAMA 2003;290:1884-90).   Cancer it the cause of 25% of the deaths in our society and can clearly be linked to certain environmental risks (80%).  Our cravings for sweets and fats gave us a survival advantage during times of famine.  In modern times with an abundance of inexpensive, calorie-dense foods, these cravings are working against us.  The basic "diet problem" with the average Western diet is..

Specific Recommendations for Healthy Living in the 21^st Century:

Topics:  Protein | Nuts | Oils | Carbohydrates | Vegetables | Dairy | Tips on Making Changes | Food to Avoid | Exercise | Weight Loss |  Dieting and Weight Loss | The Six Step Treatment of Obesity | Common Commercial Weight Loss Diet Plans |

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The 3 key elements are

(1) Healthy eating habits.

(2) Regular physical exercise.

(3) Reduce stress.

Who should be following these lifestyle and dietary guidelines?: most any and every healthy person from age 2 to 99+ years old including diabetics, and those with cardiac disease or hypertension.  These guidelines are designed from primary and secondary prevention of the diseases that kill the majority of Westerners (cardiac and cancer).   There will be slight modifications for those who are pregnant, have liver, kidney disease or other less common diseases. 

A 21^st Century Healthy Living Blocks:  

This is simply an outline of what to eat each day based on basic dietary guidelines, not a rigid or structured pan.  Now we emphasize a heart-smart diet, life-long, similar to the food pyramid with a slight modifications to allow more fat (so long as good such as mono-unsaturated).  We also combine the base (was pure carbs) to be fruits-vegetables (unlimited) with the carbohydrate group.  Foods such as grains, pasta, breads, and rice (3 to 5 servings but minimize refined sugars) are in the group at the foundation of the food building blocks along with vegetables (3 to 5 servings) and fruit with (3 to 5 servings).  This will comprise the base for any healthy diet.   Moving higher up the pyramid you'll find the meats, then daily and sweets.  A healthful diet will contain 2 to 3 servings of meat, poultry, fish, beans, eggs, or nuts (limiting saturated fats and avoiding trans fats).   It will also contain 2 to 3 servings of low-fat milk, yogurt, or cheese.  Most importantly we now emphasize exercise (daily or at least 20min 3x per week).

Balanced Diet:  Eat lots of .......................................

.

Focus on:  ..............................................

**Ref: (Diet and the prevention of cancer. BMHJ 1998;317:1636) (Mediterranean diet and the rate of cardiovascular complications. Circulation 1999;99:779) (Nutrition therapy for the cancer pt.  Hematol Oncol Clin North Am. 1996;10:221-34) (Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21^st century hunter gatherer. Mayo Clin Proc 2004;79:101-08)

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