HEALTHY DIET - Full extract 

Jason is 28 and captain of the local cricket team. He came in one morning complaining of several days abdominal pain, diarrhoea and a sore bottom. " I know I'm a bit unfit," he said. " But these pains in the guts are getting me down."

 Although his cramping abdominal pains were caused by a viral infection, a rectal examination revealed that his anal soreness was due to rather large haemorrhoids. At 170 cm and 88kg he was clearly overweight, especially around the abdomen. However, the rest of the examination was normal. 

Jason lives by himself and has a lot of take-aways. " I often grab a burger and chips on the way home from training," he said. " But I eat pretty healthy most of the time." 

I was far from convinced that he had a healthy diet, and the more questions I asked, the less healthy it sounded. I gave Jason some brief dietary advice and a brochure about high- fibre foods. I prescribed some ointment for his haemorrhoids and asked him to make a another appointment to discuss his diet and general health in more detail. To my surprise he was very enthusiastic. " Count me in," he said. " When things start interfering with my cricket, it's time to get serious." 

When it comes to diet, we are all at risk to some degree. There is so much tasty, delectable food around, and it's ready to go, 24 hours a day. If those goodies aren't in our fridge already, they are at the local supermarket just begging to be picked up. 

The long-term effects of a poor diet can be disastrous. Conditions like coronary artery disease, diabetes, high blood pressure, vascular disease, gout, bowel disorders like haemorrhoids and diverticular disease, and the many problems associated with obesity can often be directly related to diet. Even some types of cancer, for instance breast and bowel cancer, have been connected to dietary factors. 

Some of us may have an old aunt or uncle who ate plenty of rich, fatty foods and still lived to a ripe old age. The person may even have smoked for good measure. But these cases are few and far between; they were often from another era and usually had totally different lifestyles to us. The evidence has gathered steadily that a sensible diet is fundamental to keeping well. 

With a few exceptions the same dietary principles apply to us all, whether we are in good health or have illnesses like diabetes, high blood pressure or obesity. It is best to regard healthy eating as a different approach to food, rather than having to go onto a diet. It is just part of an overall package. And when we talk about keeping well we have to also include such things as regular exercise, losing excess weight, not smoking and minimizing stress. 

In general terms, plant foods should form the main part of our diet, for instance fruit, vegetables, complex carbohydrates like cereals and potatoes, and dietary fibre. An adequate intake of water is also essential. Meat and dairyfoods are fine as long as they are mainly low in fat content. Full-cream dairy products are recommended for growing children. Fresh fish is very suitable, provided it is not cooked in fat or heavily salted. The amount of carbohydrates and protein we require depends largely on factors like age, weight and level of physical activity. 

On the other side of the ledger, it is better to reduce the amount of fat in our diet, especially fatty meats and full- cream dairy products. These solid or semi-solid saturated animal fats are of greater concern than the amount of cholesterol in foods. If a small amount of fat for cooking is required it is better to use a monounsaturated fat like olive oil or a polyunsaturated preparation. The term saturated refers to the chemical structure of the fatty acids that comprise the various fats. The amount of salt we use should also be restricted. Unfortunately, fat and salt are a big component of many takeaway foods and snacks and seem to have special appeal with young people. 

The intake of refined carbohydrates such as sugar should be kept to a minimum. Although it is high in calories and provides energy, sugar has little nutrient content of its own. Complex carbohydrates like cereals, potatoes and wholemeal are more suitable because they are digested and absorbed more slowly. Of more concern is the company that sugar keeps. It is often in combination with fats, for instance in sweet biscuits, cakes and chocolate bars. Alcohol should be kept to less than two standard drinks per day and, wherever possible, artificial additives should be avoided. 

Many Australians have a diet where fats comprise 40% of the calorie intake or higher. More recent research suggests that the dietary fat content should be kept to 30% or lower. This is important to keep our blood cholesterol level at an acceptable level and thereby reduce the risk of vascular and coronary artery disease. 

As an alternative to butter the new margarines containing vegetable sterols are worth a try. Research has shown that regular use of these products can actually lower the blood cholesterol level.

Dietary fibre is present only in plant foods and should be a significant part of our diet. In the past we have made the mistake of removing as much fibre and roughage as possible from food, with the emphasis on white fluffy bread rather than wholegrain foods. Fibre helps to retain fluid in stools, increasing their bulk and preventing constipation. As a result it helps to prevent conditions like haemorrhoids and diverticular disease. High fibre foods are often complex carbohydrates and have nutrient quantities of their own. They also affect the absorption of various substances from the bowel and probably reduce the likelihood of conditions like bowel cancer. 

It is surprising how quickly the major food companies adapt to changing attitudes in the community. There is a whole range of lite-foods that have come onto the market. Likewise, most restaurants are happy to discuss how their food is prepared and will cater for those who prefer low-fat meals. 

Health Tips:
* Be positive about eating well. There is a wonderful range of tastes in fresh healthy food. 

* A variety of different foods from groups like cereals and vegetables is essential. 

* Grill instead of frying. If you need to use oil try a small amount of olive oil. 

* Read the labels on foods. Some foods that look healthy are far from it. 

* We all need a little treat at times. But get back on the bandwagon. It's what we do for most of the time that counts. 

* There are plenty of excellent books available. Contact the National Heart Foundation for more advice.

Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: August 18, 2001