Dietitian Ruth Frechman dishes up a lower-calorie version of a house favorite,… (Mel Melcon, Los Angeles…)
At first glance, Susan and Herb Eckerling's kitchen doesn't look that bad, food-wise. A bowl of fresh fruit graces the tan tile counter, there's leftover steamed cauliflower in the refrigerator and some quick-cooking oats in the pantry.
But scratch the surface and signs of poor choices and unnecessary deprivations emerge: Susan's diet is extremely short on whole grains, and neither eats much red meat — even though they like it — because they fear every cut is bad for their health. Herb is a late-night carb grazer who reads food labels selectively, ignoring essential information such as sodium content.
"I look for something that's low-sugar and low-calories and that's about it," he says.
The retired Agoura Hills couple, married 14 years, has some health issues that a better diet could improve. Herb, 74, is pre-diabetic and Susan, 64, is anemic and has high cholesterol. Although they dine home most of the time on fairly healthful foods, they don't eat enough fruits and vegetables, and Herb's favorite snack of rye bread with margarine isn't doing his blood sugar any favors.
Some of what guides the couple's dietary habits is dubious information, including bromides that date back decades. For instance, Susan has been avoiding most breads, cookies and pasta since a doctor told her in the 1970s that if she didn't lose the weight she gained during pregnancy by age 25 she never would. The petite woman took the news so much to heart that she steers clear of many grain-based carbs, including ones made from healthful whole grains.
Failing to adjust one's diet habits may be risky as people age because nutritional needs change. Older people may need fewer calories if they're not as active as they used to be, and they may have a tough time absorbing some types of vitamins and nutrients. They're also at higher risk for conditions such as cardiovascular disease, which diet can affect.
On a recent night at the Eckerlings' comfortable, antique-filled home, Burbank-based registered dietitian Ruth Frechman assesses the situation and is determined to modernize the couple's approach to eating. She lays down the law about carb intake, which is important for people at any stage of diabetes.
"A carb is a carb," she tells the Eckerlings. "It's all digested down to sugar, and once that gets into the bloodstream, your body doesn't know if you're eating chocolate or a bagel or an orange."
"Aren't there healthier ones?" Susan asks.
"Of course," says Frechman, who serves as a spokeswoman for the American Dietetic Assn. "You want oranges rather than chocolate to get the vitamins, minerals and fiber."
Simple carbs, such as bread, cookies and pasta, make their way into the bloodstream faster, which can cause blood sugar levels to spike. Complex carbs that have fiber, such as whole grains and vegetables, take longer to digest and help keep blood sugar steadier.
"If you're pre-diabetic you want to have some protein at every meal," Frechman says. "Protein and fiber will help level off your blood sugar."
Frechman recommends that Herb have 30 grams of carbs per meal and see if that raises his blood sugar levels, which he checks during the day. Based on the results, Herb can adjust his carb intake if needed.
She offers him an easy formula for figuring out how much to eat: 15 grams of carbohydrates are equal to one "carb," and he can have six carbs a day. Nutrition labels list carbohydrate content in grams, and carb values for fresh foods can be found online.
Although the Eckerlings look at nutrition labels, they're not seeing the whole picture. Frechman instructs them on how to analyze carb grams, saturated fat and serving sizes. For sodium, she says sedentary older adults may need considerably less than the 2,400 daily milligram ceiling recommended for the general population. And since Type 2 diabetes can cause high blood pressure, Frechman suggests sticking with only 1,500 milligrams a day.
The couple have been avoiding red meat for years, based on the assumption that all of it is unhealthful. Once again, Frechman has news for them. She presents a list of lean cuts low in saturated fat, such as top round, top sirloin and brisket, that they can eat on occasion.
"Beef is a very healthy food," she says. "It contains a lot of iron," something anemics lack.
"Does that mean that hamburger isn't that bad?" Herb asks, a note of optimism in his voice.
"As long as it's at least 90% fat free," Frechman replies.
Susan wonders whether it's OK to set aside the long-ago advice from her doctor about weight gain from breads, cookies and pasta. "If I could choose something that I really like that I've given up," she says, "I would prefer going back to rice and pasta rather than sweets."
Susan, meet whole grains.