For some people, buying fitness equipment for home use may be a good alternative, especially if it makes it more likely you’ll exercise. You can purchase low-cost stability balls, free weights (dumbbells), and resistance bands, as well as pricier equipment, such as home weight machines and cardiovascular workout equipment, such as treadmills and exercise bikes.

Some businesses rent exercise equipment, such as treadmills, rowers, elliptical machines, and weight equipment. Renting gives you a chance to try machines and determine how much you’d really use them.

If you already have an outdoor bicycle, consider buying a bike-trainer device, which allows you to ride your regular bike in place indoors. You’ll pay a fraction of the cost compared to a dedicated exercise bike.

Tips for At Home Success

It takes discipline and willpower, especially in the beginning, but once you experience how good it feels to live in a stronger, healthier body, the drive to keep it going will appear. Here are some ways to get started.

Make It a Habit. Getting into the exercise habit doesn’t happen overnight. Studies suggest it may take about 10 weeks of consistently repeating a desired behavior, such as fitness walking, to form a new habit. The more consistently you exercise, the easier it should get and the more likely it will become second nature, so that if you skip doing it, it will feel strange.

Anchor It. You are more likely to exercise if you make it a regular part of your day and anchor it to an existing habit, just as you might do for brushing your teeth before you go to bed. To anchor exercise to an existing habit, think about what time of day you’d like to exercise. For example, if you’d like to go for a walk in the evening after dinner, you might anchor your habit like this: After I do the dishes, I will go for a walk.

Find Joy. No matter what type of exercise you’re doing, it’s important to select activities you enjoy. Trying something new can boost motivation and having fun increases the odds you’ll do it again. In one study, women who were asked to use a hula hoop for 30 minutes reported significantly higher intentions of doing aerobic exercise in the next month compared with those who had walked on a treadmill for 30 minutes.

Track Progress. Setting clear, manageable goals can be motivational, and tracking your activity can help you assess your progress toward those goals. Record how much weight you lifted, the number of sets and reps, steps taken, distances run, or exercise classes attended. Seeing improvement may encourage you to keep going, and a lack of improvement could signal the need to change your approach. Missing a single day of exercise won’t necessarily derail your exercise habit, but missing a whole week could. Aim to be as consistent in your routine as you can, but don’t beat yourself up if you get off track. Every day is a new day to try to do a little bit better.

For more information on the benefits of exercise, purchase Eat Well and Exercise from University Health News.

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Academy of Nutrition and Dietetics
eatright.org
800-877-1600
120 South Riverside Plaza, Suite 2190
Chicago, IL 60606-6995

American Academy of Physical Medicine and Rehabilitation
aapmr.org
847-737-6000
9700 West Bryn Mawr Ave., Suite 200
Rosemont, IL 60018-5701

American Association of Retired Persons (AARP)
aarp.org
888-687-2277
601 E St., NW
Washington, DC 20049

American College of Sports Medicine
acsm.org
317-637-9200
401 W Michigan St.
Indianapolis, IN 46202-3233

American Diabetes Association
diabetes.org
800-342-2383
2451 Crystal Dr., Suite 900
Arlington, VA 22202

American Heart Association
heart.org
800-242-8721
7272 Greenville Ave.
Dallas, TX 75231

American Physical Therapy Association
apta.org or moveforwardpt.com
800-999-2782
1111 North Fairfax St.
Alexandria, VA 22314-1488

Arthritis Foundation
arthritis.org
404-872-7100
1330 W. Peachtree St. NW, Suite 600
Atlanta, GA 30309

Dietary Guidelines for Americans 2015‑2020
health.gov/dietaryguidelines
240-453-8280
Tower Building
1101 Wootton Pkwy., Suite LL100
Rockville, MD 20852

National Association of Area Agencies on Aging
n4a.org
202-872-0888
1730 Rhode Island Ave., NW,
Suite 1200
Washington, DC 20036

National Council on Aging
ncoa.org
571-527-3900
251 18th St. S, Suite 500
Arlington, VA 22202

National Heart, Lung and Blood Institute
nhlbi.nih.gov
301-592-8573
NHLBI Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105

National Institute of Diabetes and Digestive and Kidney Diseases
niddk.nih.gov
800-860-8747
National Institutes of Health
9000 Rockville Pike
Bethesda, MD 20892

National Institute on Aging
go4life.nia.nih.gov
800-222-2225
Bldg 31, Rm 5C27
31 Center Dr., MSC 2292
Bethesda, MD 20892

National Osteoporosis Foundation
nof.org
800-231-4222
251 18th St. S, Suite 630
Arlington, VA 22202

National Strength & Conditioning Association
www.nsca.com
800-815-6826
1885 Bob Johnson Dr.
Colorado Springs, CO 80906

Physical Activity Guidelines for Americans
health.gov/paguidelines/
240-453-8280
Office of Disease Prevention and Health Promotion
1101 Wootton Pkwy, Suite LL100
Rockville, MD 20852

President’s Council on Fitness, Sports & Nutrition
www.fitness.gov
240-276-9567
1101 Wootton Pkwy., Suite 560
Rockville, MD 20852

YMCA of the USA
ymca.net
800-872-9622
101 North Wacker Dr.
Chicago, IL 60606

U.S. Food and Drug Administration
fda.gov
888-463-6332
10903 New Hampshire Ave.
Silver Spring, MD 20993-0002

Cookbooks

Here are some cookbooks you might consider adding to your kitchen.

Better Homes and Gardens:
New Cook Book, 16th edition (Better Homes and Gardens, 2014)

The China Study Quick & Easy Cookbook: Cook Once, Eat All Week with Whole Food, Plant‑Based Recipes
by Del Sroufe (BenBella Books, 2015)

The Complete Month of Meals Collection
(American Diabetes Association, 2017)

Good and Cheap: Eat Well on $4 a Day
(Workman Publishing, 2015)

Grill It, Braise It, Broil It: And 9 Other Easy Techniques for Making Healthy Meals
by the American Heart Association (Harmony, 2015)

Joy of Cooking: 2019 Edition Fully Revised and Updated
by Irma S. Rombauer (Scribner, 2019)

Mark Bittman’s Kitchen Matrix: More Than 700 Simple Recipes and Techniques to Mix and Match for Endless Possibilities
by Mark Bittman (Clarkson Potter, 2015)

The New American Heart Association Cookbook, 9th Edition (American Heart Association, 2017)

You Can Have It! More than 125 Decadent, Diabetes-Friendly Recipes (American Diabetes Association, 2018)

Online Recipe Sources

If you don’t see a “recipes” link on the home page of these websites,
simply type “healthy recipes” in the search box.

American Diabetes Association My Food Advisor
diabetesfoodhub.org

American Heart Association
heart.org

American Institute for Cancer Research
aicr.org

Fruits & Veggies—More Matters, Produce for Better Health Foundation
fruitsandveggiesmorematters.org

National Heart Lung and Blood Institute
nhlbi.nih.gov

Oldways Traditional Diets
oldwayspt.org

Health & Nutrition Letter
by Tufts University
nutritionletter.tufts.edu

Whole Grains Council
wholegrainscouncil.org

Exercise Books

Choosing the StrongPath: Reversing the Downward Spiral of Aging
by Fred Bartlit, Steven Droullard, and Marni Boppart (Greenleaf Book Group Press, 2018)

Core Strength for 50+:
A Customized Program for Safely Toning Ab, Back, and Oblique Muscles
by Karl Knopf (Ulysses Press, 2012)

Empowered Aging: Expert Advice on Staying Healthy, Vital and Active
by Sharkie Zartman (Spoilers Press, 2018)

End Everyday Pain for 50+:
A 10-Minute-a-Day Program of Stretching, Strengthening and Movement to Break the Grip of Pain
by Dr. Joseph Tiere (Ulysses Press, 2016)

Younger Next Year: The Exercise Program: Use the Power of Exercise to Reverse Aging and Stay Strong, Fit and Sexy
by Chris Crowley and Henry S. Lodge M.D. (Workman Publishing, 2015)

Free Online Exercise and Nutrition Resources

choosemyplate.gov: Provides practical information to help consumers build healthier diets. Includes resources and tools for dietary assessment and nutrition education.

consumerlabs.com: Provides independent test results, reviews, ratings, and comparisons of vitamins, supplements, herbal and nutrition products.

doyogawithme.com: Hundreds of free streaming videos offering yoga for all levels.

fitnessblender.com: Hundreds of free, full-length workout videos.

go4life.nia.nih.gov: Offers free videos on strength, flexibility, and balance exercises for older adults that can be done in the home.

silversneakers.com: Free access to gyms, classes, and more.

sparkpeople.tv: Free workout videos of all types for all levels. Allows you to search for the length, type, and level you want.

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aerobic exercise: Physical activity that increases the intake and use of oxygen and improves the cardiovascular and respiratory systems. Sometimes called endurance exercise.

body mass index (BMI): A calculation that combines weight and height: Weight in pounds / (height in inches x height in inches) x 703. A BMI 18.5 to 24.9 is considered healthy weight; 25 to 29.9 is considered overweight, and 30 or higher is considered obese.

cardiovascular disease (CVD): A class of diseases that involve the heart or blood vessels. Includes coronary artery disease, heart attack, stroke, heart failure, and more.

cognition: Conscious intellectual activity, such as thinking and memory, orientation, language, judgment, and problem solving.

core muscles: The muscles of the abdomen, lower back, and hips.

coronary artery disease: Blockage of one or more arteries that supply blood to the heart, usually due to atherosclerosis (hardening of the arteries).

endurance exercise: Also called aerobic exercise.

free radical: A highly reactive atom or compound produced through normal metabolism or from environmental toxins, such as cigarette smoke and air pollutants. Free radicals damage cell membranes, DNA, and other molecules in the body. They are neutralized by antioxidants.

free weights: Dumbbells, barbells, or kettlebells, for example, used in resistance training.

glucose: A sugar used by the body as a source of energy. Carbohydrate is broken down in the digestive system into glucose.

glycemic index: A system that ranks foods on a scale from 1 to 100 based on their effect on blood-sugar levels.

glycogen: The form of glucose stored in the liver and muscles.

heart failure: A chronic, progressive disease in which the heart muscle weakens and can no longer pump blood well enough to meet the body’s needs.

heart rate: The number of times your heart beats in one minute (pulse).

high-impact aerobic exercise: Physical activity that results in a heart rate of approximately 80 to 85 percent of maximum, and in which there is a greater impact on bones and joints.

high-intensity interval training (HIIT): Involves short bursts of intense activity followed by brief recovery periods.

insulin: A hormone released by the pancreas that causes cells to take up sugar (glucose) from the bloodstream to use and store for energy. Insulin is important in carbohydrate, fat, and protein metabolism.

insulin resistance: The body’s inability to efficiently use the insulin it produces, which is linked to obesity and physical inactivity and occurs in type 2 diabetes.

ketones: A substance produced when the body breaks down fat for energy, such as when you don’t consume enough carbohydrate or when a person with diabetes does not have enough insulin to help the body use glucose for energy. High levels of ketones in diabetes, if not treated, can be life-threatening.

kyphosis: A curving of the spine that causes a bowing or rounding of the back, which leads to a hunchback or slouching posture.

lipid: A word used to encompass many different kinds of fat-soluble molecules, including cholesterol, triglycerides, and free fatty acids.

low-impact aerobic exercise: Physical activity in which there is a less-demanding cardiovascular effort and in which one foot is always in contact with the ground or surface.

maximum heart rate: The heart rate a person should not exceed for any extended length of time.

metabolic syndrome: Having three or more of these conditions: high triglycerides, low HDL (good) cholesterol, high blood pressure, elevated blood glucose, and a large waist circumference (abdominal obesity). Metabolic syndrome is associated with insulin resistance and an increased risk of diabetes and cardiovascular disease.

osteoarthritis: A disease characterized by the degeneration of cartilage and the underlying bone.

osteoporosis: A disease in which the bones become weak, brittle, and porous.

power: The ability to generate force as fast as possible (a product of strength and speed).

prediabetes: A condition in which blood sugar (glucose) levels are higher than normal but are not high enough for a diagnosis of diabetes. People with prediabetes are at increased risk for developing type 2 diabetes and for heart disease and stroke.

phytochemicals (also called phytonutrients): Compounds in plants that provide flavor, aroma, and color, and protect the plant from microbes and environmental damage. When consumed by humans, phytochemicals are believed to promote health and prevent disease. Many phytochemicals are antioxidants.

repetition (rep): The single act of lifting or moving a part of the body against resistance.

resistance bands: Elastic bands that act as resistance against movement during resistance training.

resistance training: A form of exercise that involves movement or attempted movement against resistance (or load). Also called strength training.

sarcopenia: Age-related loss of muscle mass and strength.

set: A group of consecutive repetitions (reps) of an exercise movement, without rest.

strength training: A form of exercise that involves movement or attempted movement against resistance (or load). Also called resistance training.

target heart rate zone: A heart rate range of approximately 50 to 75 percent of maximum heart rate, which is generally the target for aerobic conditioning.

triglycerides: A form of fat found in food, fat tissue, and the bloodstream. Elevated triglycerides in the bloodstream are a risk factor for heart disease.

type 1 diabetes: Occurs when the pancreas stops producing insulin. It is an autoimmune condition in which the body’s immune system attacks the insulin-producing beta cells in the pancreas and destroys them.

type 2 diabetes: Occurs when the pancreas does not produce enough insulin and/or the body’s cells become resistant to insulin.

vegan: A diet that eliminates all animal products, including dairy, eggs, and honey.

vegetarian: A diet that eliminates meat, but still may include dairy and eggs. Vegetarians who consume fish are called pescatarians.

weight training: Exercise in which a person lifts or moves weights to gain muscle strength or endurance. Also called resistance training or strength training.

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It’s prudent to properly eat and exercise according to any specific health issues you may have. In this chapter, we discuss some common conditions and various recommended adaptations. It’s always wise to discuss changes in dietary and exercise plans with your health-care provider. Your physician and health-care team are your allies and can help track progress and provide ideas for when you get stuck.

Joint Pain

Osteoarthritis is the most common form of arthritis. Achy joints, especially in your knees and hips, may keep you from wanting to move. But physical activity is highly recommended in these cases, and evidence indicates it can help prevent or slow osteoarthritis damage.

Just a few minutes of moving your body can relieve pain, and a dedicated longer-term program can help keep joints heathier. Some people especially benefit from simple stretches in the morning while still in bed. For example, opening and closing hands, bending and straightening the knees, and gently twisting the torso from side to side can be helpful. If you have rheumatoid arthritis, exercise can help to relieve symptoms and improve day-to-day functioning.

A recent study showed that activity trackers can help those with arthritis and other musculoskeletal issues increase physical activity (see “Trackers Can Motivate People to Exercise”).

The Arthritis Foundation recommends range-of-motion and flexibility exercises, coupled with aerobic and strength-training exercises. Walking and water exercises are particularly easy on the joints, and aquatic resistance training may be able to slow or even stop the progression of knee osteoarthritis. Other low-impact choices are cycling or using an elliptical machine.

High-impact activities like basketball should be limited and hard surfaces avoided. If you’re new to exercise or unsure what’s right for you, work with your doctor and/or a physical therapist to design an exercise plan for your needs.

Dietary changes may help control arthritis as well. A Mediterranean dietary pattern (see Chapter 3) is rich in foods that have been found to help control inflammation. The omega-3 fatty acids in fish and nuts, the antioxidants in fruits, vegetables, and beans, and the fiber in whole plant foods all have anti-inflammatory potential.

Some people report that nightshade vegetables (eggplant, tomatoes, peppers, and potatoes) make their arthritis pain worse. If you suspect this is the case for you, try cutting these foods out of your diet. If symptoms don’t improve after two to four weeks, add them back in.

Your Heart

If you have cardiovascular disease (CVD), such as atherosclerosis (hardening and narrowing of the arteries), heart failure, high blood pressure, or a history of a stroke or heart attack—diet and exercise can help improve or manage your condition.

Exercise can help control weight and improve cardiovascular disease (CVD) risk factors like high blood pressure and blood lipids (triglycerides and cholesterol). Regular physical activity also may reduce the need for medications. Exercise improves quality of life in CVD and makes it easier to perform ­self-care tasks.

Even so, there are precautions a person with CVD should take. In high-risk CVD, exercise may not be recommended. While most people with CVD may be able to exercise on their own after seeking their doctor’s guidance, your doctor may recommend you exercise under supervision of trained health personnel, such as at a cardiac-rehabilitation center if you are at a particularly high risk. Both aerobic and resistance training are generally recommended for people with CVD who have their doctor’s approval to exercise.

A cool-down session immediately after exercise is especially important if you have heart issues, since most problems associated with exercise in CVD occur after exercise. Your doctor can tell you if any health conditions or medications you are on could cause problems with exercise.

Diet is key to controlling high blood pressure, keeping your arteries clear, and controlling heart failure. While the diet advice offered in Chapter 3 is a good guideline, some additional recommendations apply to certain cardiovascular issues. Everyone should limit saturated fat, but if you have high cholesterol, you should be especially vigilant. A reduced-sodium, high plant-food diet, like the Dietary Approaches to Stop Hypertension (DASH) plan described in Chapter 3, has been proven to improve blood pressure. People with heart failure should follow their doctor’s or dietitian’s sodium and fluid recommendations as closely as possible.

Diabetes

If you have type 2 diabetes or prediabetes, exercising and eating well are the best things you can do to help improve blood-sugar control, enhance insulin sensitivity (which makes your body’s cells more responsive to insulin), and reduce cardiovascular disease risk factors.

A combination of resistance training and aerobic exercise may be especially helpful in improving A1C (a blood test for average blood sugar) in people with type 2 diabetes. In some cases, a regular exercise program may even lead to your doctor being able to reduce your diabetes medication.

New research suggests high-intensity interval training (HIIT) may be another exercise option useful in type 2 diabetes management or prevention (see Chapter 2). General physical activity recommendations in diabetes are described in “Physical Activity Recommendations in Diabetes.”

If you have type 1 diabetes, the American Diabetes Association considers exercise just as important for you as it is for the general population. Studies suggest many benefits of regular exercise in type 1 diabetes, such as improved cardiovascular health and improved insulin sensitivity, as well as reduced risk of long-term complications.

Effects on Blood Sugar

In the short term, exercise can help lower blood sugar because, in sustained moderate-exercise sessions, muscles take up glucose at almost 20 times the normal rate. Additionally, exercising muscle can absorb glucose on its own, without the use of insulin, and muscle cells also become more responsive to the effects of insulin with exercise. Just a single exercise session may increase insulin sensitivity for up to two or three days (and you should exercise regularly to maintain this effect). So, you’ll need less insulin to do the same job and you’ll reduce surges in insulin that can contribute to heart disease, high blood pressure, and other health concerns.

If you take insulin or sulfonylurea medications (such as glyburide and glipizide, which stimulate insulin release), you could experience hypoglycemia (low blood sugar) during exercise if adjustments aren’t made. Special precautions must be followed to ensure your blood sugar is in reasonable control before engaging in exercise, especially if you take insulin to control your blood sugar. Exercise performance seems to be best when blood sugar is maintained between 80 and 180 milligrams per deciliter.

Generally, experts don’t recommend starting an exercise session if your blood sugar is higher than 250 mg/dL and ketones are present (which can be checked with urine test strips sold at pharmacies). Ketones are a chemical compound produced when a person with diabetes doesn’t have enough insulin available to use glucose for energy.

Also note that short sessions of high-intensity activity may make your blood sugar go up (regardless of which type of diabetes you have), due to the body’s release of certain hormones that raise glucose to help fuel physical activity. This is usually temporary, and within a few hours after intense exercise your blood sugar will come back down as glucose is used to replenish glycogen (glucose stores) in your muscles. Typically, you shouldn’t increase (but rather will likely need to decrease) your post-workout insulin dose in this situation. If you don’t take insulin, just realize it may take a little time for your blood sugar to come down after intense exercise, or you can cool down with some less-intense exercise to help bring your blood sugar back to normal.

Diabetes Complications

The longer you have had diabetes, the more likely it is you have developed microvascular complications (diseases of the smallest blood vessels) that could impact your exercise program. If you have conditions like retinopathy (eye disease), peripheral neuropathy (nerve disease), and nephropathy (kidney disease), you may require certain precautions during exercise and/or the avoidance of certain kinds of physical activity. Your health-care team can assess your condition and determine what types of exercise are appropriate and whether any restrictions are needed. For more information, see “Exercising with Diabetes Complications” at the American Diabetes Association website, diabetes.org. Older adults may face additional complications, and guidelines have been adjusted accordingly (see “New Diabetes Guidelines for Older Adults”).

Osteoporosis

You can fight back against osteoporosis with good nutrition and physical activity and, in some cases, you may need to take bone-strengthening medications.

Bone Benefits of Exercise

In general, resistance training (two or three sessions per week) and weight-bearing aerobic activity (at least four sessions per week) are recommended to assist in maintaining and preventing bone loss. Resistance exercise causes muscle to contract against bone, and this stimulates the bone to become stronger and denser. In 1994, Miriam Nelson, PhD, and her colleagues at Tufts University published a ground-breaking study showing that postmenopausal women (ages 50 to 70) who lifted weights twice a week for a year gained an average of 1 percent of their bone mass, while those who didn’t exercise lost about 2 percent of their bone density, which is typical after menopause. Since then, other studies have confirmed that strength training is generally safe and can support bone health.

High-impact weight-bearing aerobic activity such as running or jumping rope may help improve bone mass more quickly compared with low-impact activity, such as a brisk walk. High-impact aerobic activity isn’t safe for everyone, though, so check with your health-care team first. Non-impact aerobic exercise, such as swimming, water aerobics, and bicycling, are good for your cardiovascular health, but don’t seem to place a sufficient load on the bone tissue to maintain or improve bone density.

Seek Expertise. If you have osteoporosis, get your health-care team’s guidance, including consulting a physical therapist experienced in osteoporosis, to discuss the best exercise program for you. A physical therapist also can assess kyphosis (an overly rounded back) and determine if there are exercises you should avoid. Expert instruction in correct technique for resistance training is especially important for those with poor bone health.

Eating for Better Bones

The National Osteoporosis Foundation recommends you get a well-balanced diet with plenty of dairy, fish, fruits, and vegetables. These foods are rich in calcium, vitamin D, and other nutrients that support bone health. For a list of bone-building foods and nutrients, see “Foods for Bone Health.”

Dietary Precautions

Beans contain calcium, magnesium, and other beneficial nutrients, but they also contain substances called phytates, which block the absorption of calcium. To reduce the phytate level, soak beans in water for several hours, then drain. Wheat bran also contains phytates.

Very high protein diets can cause the body to lose calcium.

High-sodium foods can cause your body to lose calcium and can lead to bone loss. Whole foods are naturally low in sodium. If you are eating packaged processed foods, check the Nutrition Facts label for sodium content. A food is considered high in sodium if a serving provides 20 percent or more for the percent Daily Value. Aim to get no more than 2,300 mg of sodium per day.

While foods like spinach, rhubarb, and beet greens do contain calcium, they also are high in oxalates, which bind with their calcium so it’s less available to you. These foods are healthy choices but not a good way to get calcium.

Caffeinated drinks (coffee, tea, colas) and too much alcohol can contribute to bone loss. (Note: Less than 3 cups of coffee a day does not seem to be a problem.)

Eating a healthy diet that includes plenty of calcium-rich foods can compensate for any negative effects from the calcium-depleting foods in your diet, so don’t hesitate to enjoy generally healthy choices, even if they are not the best for bone health.

Embrace a Healthy Lifestyle

Staying the course for the long run is among the most challenging aspects of embarking on lifestyle changes. That’s true whether or you have a chronic condition or not. Charting your progress can help you stay motivated, whether it’s with an online tracking program, a wearable digital fitness tracker, or simply logging in a notebook. Beyond just tracking what you eat, drink, and do; notice how you feel emotionally and how you are sleeping.

Eating well and exercising impacts your overall well-being, providing you with more energy, better health, and greater enthusiasm for living. Remember, it’s not about perfection. There’s room for treats and pauses. A healthy lifestyle is about making wise choices the rule rather than the exception. Give yourself a chance and enjoy the journey.

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Less obvious sensory changes include decreased sense of smell and taste, which can cause increased use of things like high-sodium hot sauce and table salt. The ability to sense thirst also declines, which can lead to dehydration. But knowing this may happen can help you overcome these issues. For example, choose herbs and spices instead of salt, and portion out containers of water and make sure you consume them by day’s end.

In addition, the body’s overall metabolism slows down with each passing decade. We lose muscle mass and gain more fat. That’s why food choices and physical activity become even more important as we get older. Remember, daily choices can mean the difference between feeling energized or fatigued.

Physical Activity Energizes

It’s easy to blame getting older as the primary reason for gaining weight and feeling less energized. While there is some truth to that, it’s
equally true that many older adults are quite sedentary—spending most of their days sitting. A study published in 2017 in the Annals of Internal Medicine showed that high sedentary time (12.5 or more hours daily) is associated with a greater risk of premature death. As you might guess, watching television is the most prevalent sedentary activity. Research shows that nearly 90 percent of older adults in the United States watch television on a given day, and they do this for an average of nearly five hours daily. Maybe television isn’t such a lure for you, but perhaps computer time, reading, or some other sedentary activity is. Regardless, it’s important to get up and get moving frequently throughout the day.

It’s counterintuitive, but exercise boosts energy. As the circulatory system is stimulated, more blood flows throughout the body and into the brain—energizing both with richly oxygenated blood. Exercise can reduce health-harming visceral fat, that deep layer of fat that surrounds organs and increases disease risk (see “Exercise Defends Against Deep Abdominal Fat”).

If you’ve been inactive for a while, start at a low level of activity and work your way up slowly over time. Some older adults avoid exercise and physical activity due to fear of injury, but the risks of being sedentary are far greater than any that might come with starting light activity. Your local Agency on Aging (n4a.org) may assist you in finding a physical activity program for older adults.

Remember that the social support of walking groups can help older adults increase physical activity, as well as improve health. That’s why many church groups and senior-living centers offer exercise programs, such as classes on tai chi, yoga, and tap dancing. See “Falls: Did You Know?”

Nutrient Needs for Aging

As you age, you need fewer calories but more vitamins and minerals. The absorption of nutrients in the digestive tract becomes less efficient, increasing requirements for certain nutrients as you age. A focus on eating more nutrient-dense foods is needed, as discussed in “Increasing Calories and Nutrition.”

According to the National Council on Aging, 16 percent of independent older adults are at high risk for malnutrition due to their dietary choices. Research shows that community-dwelling older adults in Western countries are prone to a low dietary intake of vitamin D, thiamin, riboflavin, calcium, magnesium, and selenium.

Older adults often consume too little protein for muscle strength and have low levels of vitamin B₁₂ (important to prevent neurological deterioration and for red blood cells) and vitamin D (essential for calcium absorption). They may also be iron-deficient.

Focus on eating the most nutrient-rich foods you can to meet your nutritional needs and remain within your calorie limit. Avoid empty calories. Nutrient deficiencies can impact both your health and your quality of life, but eating well can ensure you get everything you need.

Tufts’ MyPlate for Older Adults

The easiest way to ensure you are getting the nutrients you need is to follow a healthy dietary pattern. Tufts’ MyPlate for Older Adults is like MyPlate and the other healthy patterns described in Chapter 3, but it is adapted slightly to best meet the needs of older adults. This simple guide encourages you to choose several different categories of foods at every meal, which can help you take in a broader variety of vitamins, minerals, and other nutrients.

The Tufts’ MyPlate for Older Adults recommends vegetables and fruits make up half of every meal. These powerhouse foods are rich in vitamins, minerals, antioxidants, and other beneficial plant components that support health and activity.

• Protein-rich foods (fish, chicken, turkey, eggs, lean red meat, legumes, natural nut butter, tofu, and dairy products, such as low-fat Greek yogurt and reduced-fat cheese) should make up one-fourth of your meal.
• Whole grains should make up the final quarter. These foods—such as whole-wheat bread, brown rice, barley, rye crackers, and oatmeal—supply complex carbohydrates to help fuel your muscles, B vitamins to support metabolism, and fiber to help keep your digestive tract running smoothly. Smaller amounts of fortified refined grains, such as unsweetened fortified breakfast cereal, also can be included.
• Plant-based oils, such as soybean, corn, canola and olive oils, and soft spreads can be used in small amounts. They provide essential fatty acids (needed in small amounts) and some fat-soluble vitamins. Since the risk for high blood pressure increases with age, herbs and spices are recommended to enhance the flavor of foods instead of salt.
• Hydrating beverages should be included throughout the day. Top choices are water, tea, and low-fat (1 percent) milk. You can include small amounts of coffee and 100 percent fruit juice, if desired. Soup also makes a substantial contribution to your fluid intake.

Overcoming Food Issues

In addition to poor eating habits, there are a number of age-related factors that can impact food intake. The number of taste buds diminishes with age, decreasing the ability to taste sweet and salty, leaving foods tasting more sour or bitter. While it may be tempting to add salt and sugar to foods to compensate, both are linked to increased cardiovascular disease risk. Instead, experiment with the use of herbs and spices to boost flavor and enjoyment of foods.

Dental problems can make eating difficult. Get these issues addressed as soon as possible. If chewing is a problem, choose moist, soft foods, like stewed meats and tuna or egg salad for protein. Mash root vegetables (like potatoes, yams, squashes, and more exotic choices like rutabaga, parsnip, or turnip). Purée or cream vegetables like spinach and enjoy fruit and veggie smoothies. These moist foods, along with sauces and gravies, also help if medication side effects are causing dry mouth, but watch out for acidic foods like tomato sauce and citrus, as these may irritate a dry mouth.

Constipation and stomach upset are common due to medication side effects and naturally slowing digestion. Plenty of fiber-rich whole grains, fruits, and vegetables, along with increased fluid intake, can ease constipation. If a chronic upset stomach is making eating unappetizing, try multiple small meals a day, experiment with different foods to see which are best tolerated, and work with your doctor and a registered dietitian to be sure you are getting enough calories and nutrients.

Changes in stomach-acid secretion and changes in the metabolism of foods can lead to vitamin B₁₂ deficiency. Getting plenty of protein foods like dairy, eggs, meat, poultry, seafood, or fortified soy foods will provide your body with the B₁₂ it needs.

The amount of water in the body decreases by approximately 15 percent between the ages of 20 and 80. This puts an older person at greater risk of dehydration from small losses of water. The ability to register thirst often declines as well. With age, the body’s ability to concentrate urine decreases—and you may find yourself visiting the restroom more often. These changes increase the risk of dehydration in older adults. It’s essential to make sure you are drinking enough, even if you don’t feel thirsty. Carry a reusable water bottle with you wherever you go and drink from it throughout the day, keep water by your bedside to drink when you wake up, and make sure you drink with meals.

Bone Health

Strong bones help you to remain physically active and independent into old age, and resistance exercises help to keep bones strong, but a ready supply of bone-building minerals and vitamins is also essential. Most minerals in your body are contained in your bones. In general, the denser this network of minerals is, the stronger your bones are and the more protection you have against fractures. Physically active people generally have greater bone-mineral density than those who are sedentary.

People reach peak bone mass around age 30. After that, your goal is to minimize losing bone mass as you age. Although men and women are vulnerable to bone loss, hormonal changes in women speed up bone loss in the year or two before menopause and the five years or so after menopause.

Bone mass is greatly affected by nutrition. If you don’t consume adequate calcium, your body pulls this mineral from your bones to supply your nerves and muscles with what they need. Vitamins D and K are also important in bone formation. Following a healthy eating pattern can help you get enough of all of them.

Dairy products are well-known as good sources of bone-building calcium, although the mineral also can be obtained from broccoli, kale, almonds, and calcium-fortified foods, such as orange juice, tofu, and milk substitutes.

Supplements for Shortfalls

A study in the November 2017 issue of The Journal of Nutrition, Health & Aging showed that, at least in mobility-limited older adults, nutritional supplements don’t provide any benefit in the effectiveness of exercise. However, supplements can be important to aging adults to make up nutritional inadequacies that often result from a reduced intake of food.

Meal-replacement drinks like Boost or Ensure provide some fluids, vitamins, minerals, and protein. These drinks may be helpful to people too ill to prepare their own smoothie, but it’s better to get nutrients from whole foods (or puréed whole foods). Be aware that these meal-replacement drinks can help people eat less regular food.

Vitamin and mineral supplement pills like vitamin D, iron, or calcium may be necessary if you are unable to get enough from foods. Multi-vitamins are unnecessary unless there are serious gaps in your diet that can’t be addressed. Other supplements, such as herbal supplements, are largely unregulated, are not subject to FDA approval and testing, and could mix badly with medications. Be sure to tell your health-care providers about all supplements you take.

The post 8. Solutions for Age-Related Changes appeared first on University Health News.

Nonetheless, the reality of day-to-day demands can make exercise fall to the bottom of your to-do list. You must make physical activity a priority. The first step in becoming active, or increasing your activity level, is to remove any barriers that might exist. Lack of time is the most common excuse. Everyone gets overscheduled. Rain can ruin plans for an outdoor walk. And motivation to move can be difficult to find. Don’t let these happenings stop you. Be among those who choose to overcome such obstacles.

It takes discipline and willpower, especially in the beginning, but once you experience how good it feels to live in a stronger, healthier body, the drive to keep it going will appear. You may find yourself scheduling your day around when you can exercise, as opposed to trying to fit it into a packed schedule. That’s prioritizing your health.

Getting started can be the hardest part. Think smart. Commit to walking with a friend, schedule a workout with a personal trainer, or join a bike club. What you choose to do isn’t as important as consistently doing it.

Fitness as a Lifestyle

Dedicating yourself to being physically active for life is one of the best decisions you can make. It is the true fountain of youth. It helps keep the brain sharp and the body supple. For most people, fitness as a lifestyle requires making some changes to daily routines and habits. Behavior change can be challenging, but science offers ideas that have been proven to be helpful to many people. In a short time, you’ll be looking forward to exercise. At the very least, you’ll reap the benefits of physical activity and that can motivate you to stay the course.

Make It a Habit. Getting into the exercise habit doesn’t happen overnight. Studies suggest it may take about 10 weeks of consistently repeating a desired behavior, such as fitness walking, to form a new habit. The more consistently you exercise, the easier it should get and the more likely it will become second nature, so that if you skip doing it, it will feel strange.

Anchor It. You are more likely to exercise if you make it a regular part of your day and anchor it to an existing habit, just as you might do for brushing your teeth before you go to bed. To anchor exercise to an existing habit, think about what time of day you’d like to exercise. For example, if you’d like to go for a walk in the evening after dinner, you might anchor your habit like this: After I do the dishes, I will go for a walk.

The Buddy System. Many people find it motivating (and more fun!) if they exercise with someone else. Consider asking a friend, family member, coworker, or neighbor if they’d like to join you for a walk, hike, or a trip to the fitness center. You also can get peer support from virtual exercise communities using smartphone apps and websites, and many organizations can help you find a buddy or group to exercise with in person.

Find Joy. No matter what type of exercise you’re doing, it’s important to select activities you enjoy. Trying something new can boost motivation and having fun increases the odds you’ll do it again. In one study, women who were asked to use a hula hoop for 30 minutes reported significantly higher intentions of doing aerobic exercise in the next month compared with those who had walked on a treadmill for 30 minutes.

Maybe you’ve always wanted to try ballroom dancing or tap, or maybe there’s a local rec league for the sport you played in school. Join a bowling league, start a walking book club, try a yoga class, or see how it feels to hit a punching bag.

Track Progress. Setting clear, manageable goals can be motivational, and tracking your activity can help you assess your progress toward those goals. Record how much weight you lifted, the number of sets and reps, steps taken, distances run, or exercise classes attended. Seeing improvement may encourage you to keep going, and a lack of improvement could signal the need to change your approach.

Missing a single day of exercise won’t necessarily derail your exercise habit, but missing a whole week could. Aim to be as consistent in your routine as you can, but don’t beat yourself up if you get off track. Every day is a new day to try to do a little bit better.

Exercise Opportunities

Whether you choose to exercise at home; go to a local park, pool, or community center; join a Y or health club; or even hire a personal trainer, there is no wrong way to be physically active.

Fitness Centers

Fitness centers aren’t just for 20-somethings. In fact, a growing number of gyms are catering to those over age 50. Gyms, health clubs, and fitness centers house a lot of fitness equipment and exercise classes under one roof and provide an opportunity to socialize with others interested in physical activity. The local YMCA/YWCA is a great resource in many areas. You also can go to Gymsandfitnessclubs.com and put in your zip code to find clubs in your area.

Your insurance plan may qualify you for a discount at certain health clubs. The SilverSneakers program offers unlimited access to more than 14,000 participating gyms and fitness centers to people on Medicare. Visit the website silversneakers.com or call 866-584-7389 to find out more.

Conversely, if you can prove you go to a gym or health club regularly, you may qualify for a discount or incentive bonus on your health insurance. Before you choose a health-insurance plan or gym based on discounts, check which gyms in your area are included in the discount offer, and visit them to make sure they’re a facility you’d want to join. See “Choosing a Gym Checklist” for suggestions.

At-Home Exercise

You don’t need to leave home to get active. You can get your heart rate up at home by just getting chores done. Cleaning and yardwork can get your blood pumping, or you can walk up and down the stairs, dance during television commercials, use cans or milk jugs as weights, or follow an exercise video or DVD. If you have a video-game system, many excellent games are well designed to give you a workout, from dance games to virtual personal trainers.

For some people, buying fitness equipment for home use may be a good alternative to joining a gym, especially if it makes it more likely you’ll exercise. You can purchase low-cost stability balls, free weights (dumbbells), and resistance bands, as well as pricier equipment, such as home weight machines and cardiovascular workout equipment, such as treadmills and exercise bikes.

Some businesses rent exercise equipment, such as treadmills, rowers, elliptical machines, and weight equipment. Renting gives you a chance to try machines and determine how much you’d really use them. It also may be handy for temporary locations, such as a winter home. Joining a gym, however, most likely would be a lot more budget friendly.

If you already have an outdoor bicycle, consider buying a bike-trainer device, which allows you to ride your regular bike in place indoors. You’ll pay a fraction of the cost compared to a dedicated exercise bike.

Especially for larger purchases, be sure to try exercise equipment before you buy it. If you’ve never used an elliptical machine, for example, don’t buy one simply because your friend raves about hers. Stores typically have floor models you can try. To save money, check stores that sell second-hand exercise equipment. If you’re tired of the equipment you have and want something different, some exercise equipment stores pay cash for used equipment, although you may be able to make more money selling it on your own.

Clubs, Teams, and Other Options

Getting outside your home can shake up your routine and might make exercising more interesting and fun, but that doesn’t mean you have to join a gym or a health club. Walking, jogging, biking, golfing, bowling, playing basketball, or joining a softball team or biking club are all great ways to increase activity and improve your health. Other ideas for making the most of opportunities right outside your door include:

• Shopping malls are a great place to walk in all weather.
• Large community spaces, such as parks, zoos, and museums, provide space for walking.
• Faith-based organizations and churches sometimes offer exercise programs.
• Hospital-sponsored wellness and rehabilitation centers employ physical therapists and other experts to assist with recovery from injury and illness.
• Parks and recreation departments can provide information about indoor and outdoor activities, bike/walking trails, public swimming pools, and more.
• The StrongWomen Initiative, founded by Miriam Nelson, PhD, at Tufts University, targets women in midlife and older. StrongWomen programs include strength training and heart-disease prevention (aerobic activity) programs and are offered in at least 29 states. Visit www.strongwomen.com to find locations near you and to learn more.
• Active.com, an event registration website, helps you find physical activity events in your area, such as 5K races (walk or run), bicycling group events, and marathons. A related site, activeendurance.com, provides resources for helping organize a fun run and other race events.

Personal Trainer Benefits

Some people find that one-on-one attention can help them reach their goals. A personal trainer should assess your health and fitness level, design a program that meets your individual needs, teach you how to perform exercises safely, and motivate you to reach for a higher level of fitness. They are available at many health clubs and Ys, but there are also some who operate private businesses, offering training in storefronts or right in your own home. Personal trainers are typically paid by the hour.

Currently, there is no national standard or minimum requirement for personal trainers. Look for a personal trainer who is certified by a nationally recognized organization that is reputable, such as the American College of Sports Medicine (ACSM) or the National Strength and Conditioning Association (NSCA), and who has a four-year degree in exercise science, kinesiology, physical education, or a related health-and-fitness field. Be aware that some personal trainers offer nutrition counseling, but very few are trained nutrition professionals. Always be sure to ask.

For more information on specialists who can help you get on track and stay on track, see “Activity and Nutrition Specialists.”

Too Busy?

It can be challenging to fit in exercise. Some people find that exercising in the morning works best, before their schedules get too busy. Others prefer to exercise in the late afternoon to unwind and de-stress.

If you don’t have a 30-minute or longer time block to exercise, schedule exercise in 10-minute sessions during the day, such as morning, lunchtime, and as an afternoon break. The latest physical activity guidelines say that there is no minimum amount of time you need to reach in a single session to make activity valuable.

Regardless of when you plan to exercise, schedule exercise on a calendar, daily planner, smartphone, or wherever you keep your appointments. Treat exercise like an appointment that you must keep.

If you must take a break from exercise because you’re sick or injured, as soon as you’re able, pick up exercise again. Start at a lower level than where you left off, and gradually work back up to the level of activity you were previously doing.

When you’re outside your normal routine, such as when traveling or during holidays, it can be more challenging to exercise. It helps to set up your environment to support activity. For example, choose a hotel with a swimming pool or a fitness room and pack your exercise clothes or swimming suit. Alternately, take along an exercise DVD that you can play on your laptop computer or a hotel room DVD player. There are also online exercise videos you can view on your computer or smartphone.

As reminders to get moving, lay out your exercise clothes before you go to bed at night, and set your sneakers by the door. During the holidays, set a new tradition of going for a walk after a holiday meal. Plan an active get-together, such as a holiday bowling event, rather than a dinner party.

Overcoming Inclement Weather

If your activity of choice is done outside, bad weather can put a real damper on your exercise plans. That’s when you need to have a Plan B. Indoor exercise provides a great alternative for staying active year-round. Options you could consider include:

• Use a home exercise video.
• Clean your house on a bad-weather day, including more vigorous activities such as mopping the floor and vacuuming.
• Buy your own exercise equipment.
• Walk at a local mall or similar large public facility.
• Go to a local recreation center or community center.
• Take a dance class, such as ballroom dance, square dance, or tap.
• Go to a gym or health club. Some offer day passes so you may not have to commit to a long-term membership.

Keeping Track

Tracking your physical activity can help you see your progress, stay focused on your goals, and keep motivated. Research provides evidence that using an activity tracker can help with reaching weight-loss goals. Subjects in the study (mostly middle-age women) lost more weight when activity trackers were added to their weight-loss programs. There are many ways to track activity, from a low-cost, low-tech notebook to a smartphone app, online site, or fitness-tracker wristband.

Track It Yourself

If you prefer low-tech methods, you can use a notebook to record your progress. For aerobic exercise, record the date, activity, minutes, and distance. For resistance exercise, record the date and each exercise with sets, reps, and weight lifted. You can use these records to see how far you’ve come over time and plan your next step.

Activity Tracking Gadgets

Numerous step counters, activity trackers, fitness wristbands, and other gadgets are available to help you during exercise, track physical activity, and help keep you motivated to move your body. Sophisticated devices such as heart-rate monitors are available, too. In general, the best choice is whatever accurately gives you the information you need, is easy to use, and fits your budget.

A study published in the Journal of Sports Medicine in 2018 found 25 high-quality studies that addressed the efficacy of wearable activity devices used in a comprehensive weight-loss program. While not much benefit was seen in young adults, the study found middle age or older people lost more weight when activity trackers were added to short-term weight-loss interventions.

Step Trackers. If you walk, run, or jog, a pedometer can help you track your distance in terms of steps. One mile is about 2,000 steps (varies, according to your stride). Pedometers are small step-counting devices that can be strapped to your waistband or fit in your pocket and generally range in price from $20 to $50. Various smartphone apps are also available to track number of steps and distance covered.

If your goal is to decrease how sedentary you are throughout the day and walk more, you can use a pedometer to monitor your physical activity. Some people aim for 10,000 steps a day (which is about five miles), but that number may be too high or too low for you. You may want to wear the pedometer for several days to get your baseline before setting a steps-per-day goal. See “Assessing Activity Level by Daily Steps” for a general guide to classifying your activity level based on step counts.

To test the accuracy of a pedometer, attach it to your belt or waistband on either side of the front of your body so that it’s in line with the center of your kneecap and walk 50 steps at your typical walking pace. If it reads between 47 and 53 steps, it’s likely reasonably accurate and your placement is good. If the reading varies more than three steps above or below 50, reposition it on your waistband and repeat the test (try the opposite side of your waist, if necessary, too). If your waistband is loose, that can lead to undercounting steps. If no position is accurate, the device itself may not be good and you may need to return it for a refund. Keep in mind that most pedometers are fairly accurate at speeds of 2.5 mph and above; however, even some of the most accurate pedometers miscount steps at slower speeds, according to the American College of Sports Medicine.

If you carry your smartphone with you wherever you go, including during exercise, then a pedometer application (or “app”) may work well for you. A study that compared the accuracy of dedicated fitness trackers versus smartphone fitness apps for counting steps suggests smartphone apps can be a good choice.

If you walk or run for exercise and want to know more than just how many steps you’ve taken, there are countless free- or low-cost activity smartphone apps, which you can locate by checking the health and fitness category at your app store. Many allow you to track food intake as well as activity, if you’re trying to lose weight or eat healthier. Some even have built-in support groups.

The National Institute on Aging’s Go4Life internet site is another tool to make tracking physical activity easy and fun. This site has additional resources, fitness tracking logs, goal-setting tools, and other options to track your physical-activity progress.

High-Tech Bands and Watches. Many of these products track everything from steps, heart rate, and calories to sleep patterns, and some can even automatically recognize when you are performing some types of exercise. Some have screens that display data, while others require a smartphone to view your information. The latest high-end smartwatches have music storage and allow you to check messages, get calendar alerts, and even make purchases right from your watch.

Most of these products are meant to be worn around the clock, and some measure your quality of sleep. Some can be worn as a pendant instead of a wristband, and some come with interchangeable bands for the style-conscious.

Prices may range from $60 to well over $200. Such fitness bands typically have memory and download options, so you can store your physical activity data over time, as well as share it on social networking sites online, such as Facebook, if you would like to do so.

Choose a fitness tracker that fits your budget and your needs. If you swim, for example, a waterproof model would be the best choice. Because technology changes quickly, check for the latest reviews on whatever smartphone app, fitness band, smartwatch, or another device you are considering purchasing.

Heart-Rate Monitors. Heart rate is a measure of how fast your heart is beating. Measuring beats per minute during exercise is a shortcut to gauging exercise intensity. If your heart rate goes over your target, you’ll know it’s time to slow down, and seeing it below the target rate can motivate you to work a little harder.

A heart-rate monitor helps you keep tabs on your exercise intensity without the need to stop and take your pulse. These devices are available as chest straps, arm bands, or even earphones that track your workouts while you listen to music. Many fitness trackers and smartwatches include heart-rate monitors, so you may not need a second device if you choose to use one of those.

The latest models do more than just monitor heart rate. Features include counting reps during strength training, tracking your run, and sending data to smartphone apps. There are a variety of features and types of monitors on the market (including some better suited to cycling and waterproof models for swimmers), so choose the monitor best suited to your needs.

Sportswear

Special clothing is not needed for most exercise, but you should be comfortable and able to move easily. Clothing and socks that wick moisture can be helpful if you sweat a lot. If you plan to exercise outside, dress in layers so you can shed a layer as you warm up during exercise. If you plan to exercise outdoors in the early morning or evening when lighting is dim, wear bright or reflective clothing. If it’s raining or snowing, wear a waterproof coat or jacket.

If it is cold outside, wear several layers of loose clothing: Tight clothing can keep your blood from flowing freely and lead to loss of body heat, and the space between the layers traps warm air. Cover your extremities with a hat, scarf, and gloves. Warm up your muscles before you go outside.

Nutrition Supplements

Supplements and specialty sports foods, such as nutrition bars, energy gels, and protein shakes, are promoted to active people and athletes—and they’re big business with billions of dollars in sales.

Unless you’re an endurance athlete spending more than 60 to 90 minutes in exercise daily or competing in long-distance events, you most likely don’t need specialty sports products, such as sports gels, energy chews or gummies, and sports drinks. (For information on why endurance athletes may need quick carbohydrates, see “Hitting the Wall.”)

Many gyms and nutrition stores, as well as supermarkets, sell protein powder supplements that can be mixed into water, juice, milk, smoothies, or other beverages. Most physically active people easily can meet their protein needs with food. If you choose to use protein supplements, watch for added sugars, and remember that the body can only use so much protein—any extra is broken down for energy, and excesses can be stored as fat.

Although countless dietary supplements are promoted to athletes, few have been shown to enhance performance, and any benefits may be relatively small. Besides concerns about unproven benefits, some supplements have quality-control problems. For more guidance on dietary supplements, see “Safe Supplement Choices.”

The post 7. Get Physical appeared first on University Health News.

Small Changes, Big Benefits

The words “diet” and “lose weight” can seem overwhelming and demotivating. Think instead about how you’d like to feel. Better energy and a slimmer, stronger body can be created and maintained in great part through the foods you choose. Every journey starts with small doable steps. Assess where you are now and make a few adjustments. For example, swap a cookie for diced pineapple or peaches, ditch the crackers and eat baked spicy sweet potatoes or herbed grilled veggies instead. These choices alone may significantly reduce risk of heart disease. Switching from butter to vegetable oils, which are higher in heart-healthy unsaturated fats, is also a heart-healthy choice. Try eating meatless meals once or twice a week. Meatless Mondays is a nonprofit global campaign with a robust website filled with recipes, ideas, and meal plans. All these ideas are relatively small changes with potentially big health impacts.

Here are a few more inspiring ways to transition to a healthier dietary pattern:

• Enjoy whole grains. Make pasta, potatoes, and white rice less often, and replace them with brown rice, barley, bulgur, quinoa, wheat berries, Kamut, and other tasty whole grains. All grains are cooked the same way: Put them in a pan with water or broth, bring to a boil, then simmer until the grain becomes tender. Grains can be cooked ahead and stored in the refrigerator or freezer for convenience. The Whole Grains Council (wholegrainscouncil.org) is a great resource.
• Sweeten without added sugars. Choose breakfast cereals with less than 10 grams of sugar and try cooking oatmeal with grated apple or chopped dates, or top it with sliced bananas to sweeten without adding sugar. Replace sodas with water or unsweetened teas, or make a refreshing spritzer by adding a splash of 100 percent fruit juice to seltzer.
• Have fruit for dessert. Make fruit your go-to dessert for when you crave something sweet. Fruit is as packed with nutrients as vegetables, and its sweetness helps scratch that sugar itch without nutrition-empty calories. Bake apples or try topping grapefruit halves with jam and broiling them.
• Choose lean proteins. Serve poultry, fish, and meatless meals more often. When eating beef, look for leaner cuts (like flank steak, top loin, and sirloin tip), and trim any visible fat before cooking. Small quantities of nut butters (1 to 2 tablespoons), beans, tofu, and eggs make great protein choices.
• Explore legumes. Beans and legumes are nutritious and versatile proteins. You can throw them onto a salad, toss them into a grain dish, and stir them into soups and stews. Replace half the meat in your chili with beans, use bean dip or hummus on sandwiches instead of mayo, make lentil salad instead of pasta salad, and stir black beans into salsa to get a satisfying, heart-healthy, digestive-health promoting dish.

While you’re making small changes to the individual food choices you make, remember that what matters most is your overall dietary pattern—the total of all the foods you eat. There is no one superfood that will keep you healthy or give you all the energy you need to be active (and one treat will not ruin an otherwise healthful week). Consuming a wide variety of healthful foods is the way to go, provided you achieve the right balance and practice moderation.

Make a Plan

When you want to grab a snack or need to throw together a meal, having good choices on hand makes all the difference. Research shows that people who plan their meals are more likely to meet recommended dietary guidelines. Before you go to the grocery store, think about what you’ll eat during the week, and choose recipes you’d like to make. Make a shopping list to curb impulse buying. Plan to use fresh foods in the days immediately following your shopping trip and cook more pantry- and freezer-based meals (like whole-wheat pasta with cans of beans, tuna, and Italian-seasoned diced tomatoes, or brown rice with frozen edamame and mixed Asian-style vegetables) later in the week.

Batch cooking is a great way to ensure healthy, home-cooked choices when you’re short on time. Pick a couple of recipes and schedule a “cooking day,” then prep, package, and freeze meals for grab-and-go lunches or quick-defrost ready-made dinners.

Stock your pantry with canned beans and whole grains, fill your freezer with frozen fruits and vegetables, and pull yogurt and fresh veggies to the front of your refrigerator. Planning for healthy choices makes developing new habits much easier.

Preparing Healthy Dishes

Shifting to healthier food choices is important, but how you cook your food may affect its nutritional value. If you boil vegetables too long, you’ll be dumping their nutrients down the drain with the water. Fry your food in a lot of oil, and you’ll add loads of fat and calories to your meal. Try these healthy cooking techniques to get the most from your healthful food choices:

Marinating: Soaks in Flavors

Marinating simply means soaking food in a seasoned liquid before cooking. Marinating gives the food more flavor and helps tenderize meat and poultry. A typical marinade is one part acid (like vinegar, citrus juice, or wine), two parts oil (like canola), plenty of aromatics and seasonings (like onions, garlic, herbs, and spices), with salt and sugar to taste. Try ½ cup olive oil; ¼ cup vinegar, lemon juice, or wine; 2 cloves of garlic, crushed; and 2 teaspoons mixed dried herbs. Put all the ingredients in a gallon sealable bag for easy, no-mess storage and disposal.

The thinner or more delicate the food, the less time it should be marinated. Marinate seafood and tofu about 30 minutes; poultry pieces and vegetables, 30 minutes to two hours; and lean meats, 30 minutes to four hours. Use a third to half cup of marinade per pound of food, store food in the refrigerator while marinating, and dispose of the marinade promptly after use.

Broiling for Crisp and Juicy Dishes

Broiling involves cooking food about four to eight inches under the broiler heating element of an oven. You can broil meat, poultry, fish, vegetables, and even fruit. This method works best if you use a slotted broiler pan (or simply use a cooling rack with a cookie sheet underneath). Line the bottom of the pan with aluminum foil for easier cleanup.

Poaching: Delicately Cooks Food

Poaching involves cooking food on the stovetop in a saucepan in barely simmering liquid. Liquid is simmering when small bubbles rise slowly to the liquid’s surface. This technique works well for eggs, chicken breast, and firm fish.

Roasting: Enriches Flavors

Roasting means cooking food uncovered in the oven, typically without adding liquid. Roasting whole chicken, turkey, and beef is common, but this method works well for fish and vegetables as well. Try drizzling broccoli, cauliflower, or Brussels sprouts with olive oil, sprinkling with salt and pepper (or other seasonings you enjoy), and roasting them to bring out an appealing sweetness.

Sauté for Quick and Easy Dishes

Sautéing involves cooking smaller pieces of food quickly in a little oil in a skillet over medium-high heat, stirring often. Stir-frying is similar but uses high heat and is faster, requiring constant stirring. Sautéing is great for one-pot meals. Brown bite-sized chunks of meat or poultry in a little oil, but don’t cook them all the way through. Set the meat aside and put diced, non-leafy veggies in the pan (add onion first and let it soften before adding other vegetables). Add seasoning or sauce, then stir in any greens, and put the meat back into the pan to finish cooking. If you’re not starting with raw meat, add pre-cooked meat or beans to warm through near the end of cooking.

Steam for Flavorful, Crisp Cuisine

Often used for vegetables, steaming helps retain texture and nutrients. All you need is a saucepan with a lid and a steamer basket that fits in the pot to hold the vegetables out of the boiling water. Steamed vegetables should be “crisp-tender” when finished. Lift the lid occasionally to make sure the veggies are still brightly colored and aren’t getting mushy. String beans, peas, sliced or baby carrots, edamame, broccoli, and cauliflower are all delicious steamed.

Microwave: Speedy Meals

Microwave ovens aren’t just good for cooking pre-packaged frozen dinners. They are great for reheating leftovers, quickly defrosting frozen foods, and preparing frozen vegetables. Potatoes and yams can be ready in under 10 minutes in a microwave (just be sure to poke some holes in them first). The next time you’re looking for an easy breakfast, crack an egg into the bottom of a glass measuring cup, beat it, cover, and microwave 1 minute. (Grease the cup first for easier clean-up.) Toast a whole-grain English muffin and slice some tomato or greens for a quick, power-packed egg sandwich! You can even throw some leftover veggies or protein into the egg before cooking for added flavor and nutrients.

The Secret to Delicious

Herbs, spices, vinegars, and fruit juices are the secret to making good food taste great. They can help you cut back on salt, sugar, and fat in dishes while making nutritious foods. A 2018 study published in the Journal of Food Science showed that people are more likely to eat more seasoned vegetables and enjoy them more often compared to veggies that are not seasoned.

Herbs come from the leaves of plants (such as basil), while spices may come from the roots (such as ginger), bark (such as cinnamon), berries (such as peppercorns), dried seeds (such as cumin), or flowers/buds of plants (such as saffron and cloves). Compared with herbs, spices typically have stronger flavors, so they’re used in smaller amounts.

Carrots are delicious with basil, garlic, thyme, or oregano. Peas work well with tarragon or dill. Dress up green beans with thyme, mint, or tarragon. Try lemon and basil for asparagus, and rosemary and garlic are great with mushrooms. A wide variety of fresh or dried herbs pair well with beef and poultry. Try thyme, coriander, fennel, or rosemary with fish. If you like it hot, red-pepper flakes or a dash of cayenne work with just about any dish. Don’t add too many different flavors at a time. Smelling herbs and spices first may help you decide if they pair well with the dish you’re eating.

Vinegars (balsamic, apple cider, white wine, or even plain white) add a mouthwatering bite, but don’t overdo it with these strong flavors. Lemon, lime, and bitter orange juices added at the end of cooking or squeezed on at the table freshens up fish and vegetables. Try lime and fresh cilantro for a Mexican flair. Low-sodium soy sauce adds an Asian flavor, or experiment with a little fish sauce (which tastes much better than it smells!).

Herbs, spices, aromatics (like onion and garlic), and other flavor enhancers liven up food and add variety and can bring a dose of powerful antioxidant and anti-inflammatory compounds to your plate as well. Experiment by adding small amounts of these flavor enhancers to your foods.

Indulge in Plant‑Based Meals

A dietary pattern that emphasizes more plant foods and fewer animal foods may help reduce the risk of many common health problems, such as obesity, high blood pressure, heart disease, cancer, and diabetes, and it may help you live longer.

Cutting out animal products, however, removes a major source of protein in the Western diet. Fortunately, plant foods like beans, lentils, nuts, and even some grains can provide the protein you need. Although French fries, donuts, and soft drinks align with a plant-based diet, they’re far from healthy.

Adding a salad to your daily routine and snacking on nuts and hummus are steps in the right direction, but many non-Western diets offer an amazing array of fabulous flavors just waiting to be explored. Chinese vegetable stir-fries and tofu dishes may be familiar to many, but the fresh tastes of Vietnamese cooking, the lentil dal in Indian food, bean dishes in Mexican cooking, and the chickpea-based hummus and falafel from the Mediterranean region are just a few examples of plant-based options to explore. Try some ideas from a vegetarian or vegan cookbook that appeal to you or use the many free websites or the vegetarian sections of popular recipe resources on the internet.

Adding more plant foods at meals or snacks is a healthy choice, but you may want to consider working some animal-free meals like the ones suggested below into your repertoire. Remember to check the Meatless Mondays website for ideas on how to cut back on meat.

Breaking the Fast

Your body’s stores of fuel are depleted overnight, and your body doesn’t run well—physically or mentally—when you’re low on fuel. Eating breakfast may help prevent or minimize fatigue during exercise and during everyday activities as well. Breakfast, like all meals, should follow the MyPlate pattern, but typical American breakfasts—like pancakes or French toast slathered in syrup, cereal with milk, and eggs with breakfast meat and buttered bread—rarely do. And about 10 percent of Americans don’t eat breakfast at all. We’ve gathered up some ideas for plant-based breakfasts that are quick, easy, satisfying, and nutritionally head and shoulders above the typical American breakfast fare:

• For breakfast on the go, grab a whole-grain snack bar (look for higher fiber and lower sugar), a banana, and a hard-boiled egg or Greek yogurt.
• Plain yogurt with berries, granola, and nuts provides fruit, whole grains, protein, and dairy. Now that’s a power breakfast!
• Up the protein power of fashionable avocado toast by layering a sliced hard-boiled egg with the avocado on whole‑grain toast.
• Spread 1 or 2 tablespoons of nut butter on a whole-grain tortilla and wrap it around a banana. Apple slices, carrots, and celery are great with nut butters too.
• Eggs are a good high-protein breakfast choice, but firm tofu can be scrambled with veggies and spices as well. Try either one wrapped in a whole-wheat tortilla and topped with salsa.

Cereal with milk may seem like the perfect breakfast, but it fails the MyPlate test. Tossing a handful of nuts and some fruit into the bowl can help, but check the protein, fiber, and added sugars on the cereal box label.

For a warm, filling bowl of hot cereal, choose whole grains like oatmeal over processed cereals like Cream of Wheat or grits. Cooking with low-fat or nonfat milk instead of water adds protein and nutrients, and stirring in finely chopped fruit like apples, dates, or prunes at the start of cooking adds sweetness without the need for added sugars. You could also try a bowl of warm, protein-rich quinoa with fruit and nuts.

Remember, breakfast doesn’t have to be limited to traditional breakfast foods. Nobody says you can’t eat leftovers from dinner for breakfast.

Midday Meal

Whether you’re eating at the workplace or at home, you’ll want a lunch that helps you avoid late-afternoon doldrums. Even in plant-based eating, you can combine protein and whole-grain carbohydrates with fruits and vegetables for extra-energizing nutrients to help you stay satisfied and energized until dinner.

• Toss the grains and vegetables from dinner with salad greens, top with rinsed, drained canned beans, and dress. If you’re taking lunch to go, bring dressing in a separate container.
• Sandwich leftover grilled or roasted vegetables and a slice of cheese and/or some bean dip or hummus between two slices of whole-grain bread or roll it in a whole-grain wrap.
• Cook, package, and freeze meatless favorites ahead of time, so you’ll have ready-made meals that don’t even need an ice pack to stay cold.
• Try nut butter (like peanut or almond) on whole-grain bread but use fruit instead of jelly to decrease added sugars and increase flavor and texture. Mashed bananas and apple slices are delicious choices to add.
• Make a quick bean salad by tossing beans of your choice with salad dressing. Cut-up veggies and olives make this lunch more delicious and nutritious.
• Bean-based chili and lentil soups are great lunch choices, especially during colder weather.

Evening Dinner

When building a healthy evening meal, meatless or not, keep the MyPlate model in mind. Half of your meal should be fruits and vegetables, a quarter should be grain (preferably whole), and a quarter protein. Stews, soups, salads, stir-fries, and even pasta dishes can meet the MyPlate requirements, but keep the proportions in mind. A quarter plate of pasta may look small, but toss it with a generous helping of your favorite veggies and some beans or tofu (or poultry or lean meat), and you’ll have a sizable, satisfying meal low in calories and high in energizing, health-promoting nutrients.

Top a bowl of cooked whole grains with vegetables and egg, beans, or tofu. Top with sauce or seasonings of your choosing. Try brown rice with seasoned black beans and peppers, topped with some lettuce or collard greens and a sprinkling of shredded cheese. Or eat quinoa with diced apricots, slivered almonds, and spiced chickpeas. Stewed lentils (like Indian dal) over brown Basmati rice makes a rich and filling meal.

Mix leafy greens (the darker the better) with a variety of colorful vegetables and fruits, and at least one good protein source (like eggs, beans, meat substitute, or tofu, if you’re going meatless). To round out the meal, add whole-grain crackers, or warmed whole-wheat pita bread wedges.

If a green salad doesn’t sound like dinner to you, consider a taco salad: Start with a quarter of a plate’s worth of brown rice and seasoned meatless crumbles, and heap on shredded lettuce and veggies of your choice (such as corn, black olives, and bell or hot peppers). Top with salsa and sprinkle with crushed tortilla chips, cilantro, and reduced-fat shredded cheese.

Shredded cabbage tossed with edamame, whole-grain or buckwheat noodles, mandarin oranges, scallions, and peanuts makes a great Asian-style salad. Creamy salad dressings are a big source of bad fats, sodium, and calories. Stick to vinaigrettes and consider shaking up your own.

Make a frittata (an Italian egg-based dish, similar to an omelet or crustless quiche). A typical recipe starts with four eggs and adds ¼ cup of liquid (such as milk, tomato juice, or broth), ¼ teaspoon fresh or dried herbs, and 1 cup of whatever veggies, cheese, pasta, or grains you like. Cook in a hot, well-greased nonstick pan over medium heat for eight to 10 minutes.

It’s best to have dinner at a reasonable time. Eating late at night can increase LDL (bad) cholesterol (see “Nighttime Eating Increases Cholesterol Levels”).

It’s OK to Snack

A snack can be as simple as a piece of fruit or handful of dry-roasted nuts to tide you over in between meals. If you’re looking for snacks with a little more staying power, try combining a whole-food carbohydrate item with a food that provides some protein. Using the average 2,000-calorie diet as a guide, if meals average 500 calories apiece, that leaves 500 calories for snacks, so keep snacks to 200 to 250 calories or less. See “Snacks with Staying Power” for nutritious, delicious (meatless) snacks.

Small Batch Cooking

If you’re cooking for one or two people, it may seem a little challenging that recipes are typically geared to serve several people, packaged ingredients contain multiple servings, and produce may go bad in your refrigerator before you’ve had a chance to eat it. Fortunately, there are many strategies for shopping and storage that will make preparing healthy meals easier for small households.

Shop Smart

Go to the supermarket with a detailed list based on what you plan to eat that week. Try these shopping strategies:

Benefits of Bulk Bins. Bulk bins in grocery stores allow you to buy just the amount for you. This can be especially handy when you’re trying a new food—perhaps quinoa or lentils—and aren’t sure how much you’ll like it. Bulk bins for grains, legumes, nuts, dried fruits, and many other foods are often available in supermarkets, as well as most health-food stores.

Frozen Foods Last Longer. Frozen fruits and vegetables are at least as nutritious as fresh, if not more so. Choose packages without added salt, fat, or sugars. They will last a long time in the freezer and they’re already cut up, so it saves you prep time and effort. Simply portion out the amount you’d like to use and seal the bag tightly to prevent freezer burn until the next time. Try frozen vegetables as a side dish, or toss into soups, casseroles, and stir-fries.

Select Smaller Quantities. It can be difficult to finish large containers of fruit and vegetables before they spoil. Buy a couple of oranges or a few potatoes instead of a bag. It may seem more expensive, but you’ll save money in the long run by not throwing out rotten food. It’s generally acceptable to split up a bunch of bananas or put fewer grapes in a produce bag rather than buying the amount that’s pre-bagged.

Stages of Ripeness. When possible, buy produce in different stages of ripeness. For example, you often can find some ready-to-eat bananas, as well as some green bananas, at the same store. Buying a small amount of each will save you a trip to the supermarket later in the week. This strategy also can work for fresh tomatoes, avocados, apricots, peaches, nectarines, plums, kiwifruit, mangos, and pears.

Stock Up at the Salad Bar. For smaller amounts of produce, such as for a minor ingredient of a recipe, check the supermarket salad bar. In some cases, the produce will cost more on the salad bar, but you’ll save money because you’re able to buy only the amount you need. In other cases, the salad-bar produce may be less expensive than what you’ll find in the produce section. Compare the price per pound to be sure.

Fresh from the Meat Counter. If you just want one pork chop or chicken breast or a half pound of ground beef, the fresh meat counter is the place to get it. In most markets, you can ask for the portion to be cut that you want, and they will prepare it for you while you wait or shop.

Seafood That Doesn’t Spoil. Frozen and canned seafood provide easy, healthful protein choices that won’t spoil if you can’t cook them right away. Cans of tuna, salmon, and crab can be drained and tossed on salads, mixed with cooked grains, added to pasta or beans for a quick hearty meal, or made into a tasty sandwich.

Look for flavored packets of tuna and salmon for a change from mayonnaise-based preparations. Frozen peeled deveined shrimp can be boiled or sautéed quickly and easily, and individually wrapped frozen fish fillets thaw quickly in the refrigerator or under cool running water in a sink.

Freeze It

If you’re cooking for one or two people, why not make the full recipe and freeze extras? You also can use your freezer to store prepped ingredients and save time in the kitchen. For additional guidance, see “Freezer Food Tips.”

Make Your Own Entrées. Forget buying pre-made frozen dinners at the supermarket—you can make much healthier options at home. Dishes made with rice, beans, or pasta, such as casseroles, chili, and soup, typically freeze and reheat well. Meatballs, sliced meatloaf, and leftover roast beef freeze and reheat well, too. Freeze precooked meals in small Pyrex glass dishes so you can put them straight in the oven or microwave to reheat.

Precook and Freeze Chicken Breasts. Many recipes—such as chicken salad, tacos, wraps, and soup—call for precooked boneless, skinless chicken breast meat. Rather than buying salty precooked chicken, cook and freeze your own for later use. One simple method is to put boneless, skinless chicken breasts in a single layer in a baking dish with ¼ to ½ cup water (to prevent the chicken from drying out). Cover and bake in a 350ºF oven for 30 to 40 minutes or until completely cooked. Alternately, you can cook chicken breasts in a slow cooker with ½ cup water on low heat for five to six hours (or eight to nine hours if the chicken is frozen). If you must stack the chicken breasts, be sure to rearrange them once during cooking.

Ready-to-Go Ground Meat. Cook lean ground meat crumbles in one-pound batches and freeze for later use in recipes, such as sloppy Joes, taco salad, or meat sauce for pasta. Cool the ground meat in a shallow container in the refrigerator, then promptly transfer the meat to freezer bags supported by a flat surface, such as a metal pan, until frozen. Once the meat is frozen, you can remove the pan for more efficient stacking.

Fast Frozen Whole Grains. Brown rice, whole wheat berries (including ancient varieties such as farro and Kamut), oat groats, and other intact whole grains—ones that haven’t been ground into flour or flaked—take longer to cook. Cook extra and freeze (or refrigerate) them for later use. They can be used in soups, stews, casseroles, salads, pilafs, or simply as hot cereal.

Be sure you watch portions along with food choices, plan, don’t be afraid to try new things, and remember that eating healthy food should be delicious and satisfying—not a sacrifice. All these tips are meant to be guides in your journey to eating well. Try a few and integrate more strategies as you build your daily healthy-eating habits. After all, it’s not about dieting for a few weeks, it’s about eating healthfully for life.

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For women, the biggest increases usually occur during the first couple of years of menopause when the fat percentage increases and lean body mass decreases. By age 75, body fat percentage can be double what it was during young adulthood, if you’re not careful. You may not get your slim 20-year-old body back; however, you can create a weight-appropriate, more physically fit body at any age.

Body weight is mostly a function of what you eat. Exercise does help, but most people overestimate calories burned during exercise and underestimate calories consumed. One study compared people who only exercised to those who only dieted. The diet-only group lost more weight than the exercise-only group. The authors concluded that, while dietary interventions reduced body weight and improved body composition more than exercise alone, adding exercise reinforced the effect of dietary interventions.

Of course, exercise provides benefits beyond weight loss or maintenance. It reduces stress, is good for your heart and mind, and can reduce the risk of diseases like type 2 diabetes, heart disease, stroke, certain cancers, sleep apnea, osteoarthritis, fatty liver, and kidney disease. However, all the exercise in the world won’t undo the effects of too much body fat and poor nutritional choices, which are the greatest causes of disability as people age.

As the information in this report illustrates, good nutrition and an active lifestyle preserve physical function and help your body run properly, improving your overall metabolic health—blood pressure, cholesterol and triglyceride levels, and blood-sugar control, for example—at any weight. If weight loss is something you want to achieve, try to make health, not looks, your primary motivator. Losing 7 to 10 percent of your current body weight might not make you model-thin, but research shows it can have a major impact on your health.

Healthy Body Weight

The most commonly used gauge of healthy body weight is a body mass index (BMI), which is an indirect way of estimating how much body fat you have. Falling at the extreme ends of the BMI range—including extreme obesity and underweight—seems to pose the greatest risks for mortality.

When we burn more calories than we take in, we lose weight. Eating less and moving more is the best way to achieve this calorie deficit. To lose weight safely and to minimize loss of muscle and bone, it’s essential to make choices that keep you well-nourished and active.

Smart Way to Lose Weight

Weight loss is not rocket science, but it does require smart choices and dedication to a healthy lifestyle for life. Sure, you can have occasional indulgences, but the keyword is “occasional.” Following healthful dietary patterns like the ones outlined in Chapter 3 will make it more likely that weight loss is accompanied by good health.

There are no magic weight-loss foods, but there are ways of eating that will make weight loss easier, while ensuring you stay well-nourished and satisfied.

Control Your Portions

Research shows that people eat more when they are given larger portions. Unfortunately, portion sizes in the United States have grown tremendously. According to the CDC, the average restaurant meal today is more than four times larger than in the 1950s. Back then, a hamburger weighed 3.9 ounces, but the average burger today weighs in around 6.7 ounces. A serving of fries has grown from 2.5 ounces to 6.7 ounces.

And it’s not just restaurant food that’s adding to our waistlines. Bags are bigger, bowls are deeper, even the plates we eat from have increased in diameter! The plate depicted in MyPlate images is nine inches across; chances are the salad plates in your dish set are closer to that size than the dinner plates. Our brain is easily fooled: Eating food that fills a smaller plate is more satisfying than the same amount of food on a larger plate.

These tips will help you avoid some common portion-size pitfalls:

• When eating out: Many restaurants serve more food than one person needs at one meal. Consider splitting an entrée with a friend or ask the waitperson to wrap up half your meal before it’s brought to the table.
• When eating in: Serve food on individual plates instead of putting the serving dishes on the table. Keeping the excess food out of reach may discourage overeating.
• In front of the TV: When eating or snacking in front of the TV, put the amount that you plan to eat into a bowl or container. It’s easy to overeat when your attention is focused on something else.
• Don’t go hungry: If you feel hungry between meals, eat a healthy snack, like a piece of fruit or small salad, to avoid overeating at your next meal.
• Beware of large packages: The larger the package, the more people eat. Divide the contents of one large package into several smaller containers to help avoid over-consumption. Don’t eat straight from the package. Instead, serve the food in a small bowl or container.
• Out of sight, out of mind: People tend to consume more when they have easy access to food. Put healthier foods front-and-center, and they’ll get chosen more often. Keep a fruit bowl on the counter. If you must keep tempting foods like cookies, chips, or ice cream in the house, move them to a high shelf or the back of the freezer. Move the healthier foods to the front at eye level. When buying in bulk, store the excess in a place that’s not too easy to get to, such as a high cabinet or at the back of the pantry.

Choose Foods That Satisfy

The key to eating less lies in making the foods you eat fill you up (satiation) and keep you satisfied longer (satiety).

Over the years, carbohydrate, protein, and fat have all been suggested as the food component in control of making us feel satisfied and stay satisfied. While there is research to support each one, protein has risen to the top as the most satisfying nutrient, followed by carbohydrate, and then fat.

But these macronutrients are not alone in controlling our hungry/full signals. Micronutrients like calcium also play a role in control of appetite. This may be because the body is designed to make sure it gets what it needs. When you’re running low on an important nutrient like calcium, your body sends out a general signal that you’re hungry.

Even non-nutrient food components get in on the act. Fiber, for example, will help you feel full longer—even if you take in fewer calories. So, choosing naturally high-fiber foods like whole grains, vegetables, and fruits alongside your protein may allow you to eat more satisfying meals, while still cutting calories.

One key to staying satisfied and well-nourished while watching caloric intake is to consider the energy density of your food. Energy density is the calories per gram of food. Foods with high energy density provide more calories per bite than foods with low energy density. Choosing low energy density foods allows you to take in fewer calories while eating the same amount of food in a day (or maybe even more).

A great way to make meals more filling and satisfying without adding extra calories is to add vegetables. Toss an extra helping of your favorites into stir fries, stews, chili, pasta dishes, and salads. Pulses (beans, peas, and lentils), which provide both protein and fiber without a lot of calories, are a great addition to any meal. Pulses work well in chili, soup, or salad, or stirred into rice or pasta dishes to make them more nutritious and filling.

Thwart Cravings

Choosing reasonable-sized portions of satisfying, healthful food will help you cut calories in a safe and healthy way. Keep your appetite and food intake in check by trying:

Mindful Eating. We are born knowing when we are hungry and when we are full, but years of ignoring those signals can cause us to lose the ability to recognize them. Multiple studies have linked eating quickly to being overweight, perhaps because slower eating tends to result in eating less.

Mindful eating allows you to focus on what you are seeing, smelling, tasting, and feeling while you eat. This can improve food choices, support portion control, and increase enjoyment of food (see “Tips for Mindful Eating”).

Out with the Bad. It’s easier to make good food choices when you don’t have bad ones within reach. Stock your pantry and fridge with healthy choices; keep a bowl of fruit on the counter; change your route to work so you don’t pass the donut shop; get rid of the candy bowl at work; propose monthly or quarterly office birthday parties to limit cake-filled days; lobby for healthy vending-machine choices; and replace large plates and bowls with smaller options. Don’t feel you have to stock unhealthy snacks and desserts for children. Developing good habits at a young age is easier than breaking bad habits as an adult.

Weight-Loss Enemies. Some things that seem unrelated to food may be getting in the way of your weight-loss efforts. Feeling tired could cause a craving for fast energy—in the unhealthy form of sugar and refined grains—so getting enough sleep is important when you’re trying to control your appetite. Stay well-hydrated to prevent mistaking thirst for hunger. Be sure you don’t skip meals or eat too late at night to help control blood sugar peaks and valleys, potentially reducing cravings and the desire to binge. As you will see in the next section, choosing to be physically active also plays an important role in healthy long-term weight loss.

Trendy and Extreme Diets

Diets that recommend severely restricting or eliminating entire food or nutrient groups (like low-carb diets) help with weight loss in the short term, but they can be difficult to follow long term, so weight-loss results generally don’t last.

Without the recommended balance of carbohydrate, protein, and fat, it is difficult if not impossible to get all the nutrients you need. Cutting carbohydrates, for example, removes whole grains, calcium-rich dairy, fruits, and a wide variety of vegetables from your plate. Dietary patterns rich in these foods have been shown repeatedly to be associated with better health.

The best diet for health or weight loss is one that emphasizes plant foods and lean proteins in proportions that meet (but don’t exceed) your healthy body weight calorie needs. Putting these health-promoting choices on your plate automatically edges out foods high in health-damaging refined grains, saturated fats, added sugars, and sodium.

There are many ways to construct a dietary pattern that suits your tastes and can help you meet your health goals, so make sure you choose a healthful option you can follow long term. Use the proven dietary patterns discussed above as a guide and beware of trendy advice.

Superfoods

Some nutrient-rich foods are being called  “superfoods” and are believed to be especially good for your health. Advertisers seem to be pushing new superfoods every day—from avocado to acai berries, and chia seeds to dark chocolate.

Each of these foods is high in at least one component that has been associated with good health, but none of them is the secret to a healthy life. Rather than focus on eating a lot of one food, it’s better to take superfoods as representatives of health-promoting food categories.

For example, oats are a whole grain packed with fiber and nutrients, but other whole grains are nutrition powerhouses as well. Kale is a leafy green packed with vitamins, minerals, and health-promoting phytochemicals, but so are collard greens, chard, and spinach, to name just a few. Salmon is a great source of heart-healthy omega-3 fatty acids, but eating any fatty fish two times a week is associated with a lower risk for cardiovascular disease. Avocados are packed with healthy fats as well, but those fats come with a high calorie count.

A lot of research has been done on blueberries, linking them to such benefits as a lower risk of dementia, but other berries provide the same family of phytochemicals and should have the same health benefits.

Enjoy the occasional piece of dark chocolate, but not simply for its antioxidants. Following a dietary pattern rich in a variety of fruits, vegetables, whole grains, and lean proteins like fish is the truly super way to reduce disease risk.

Better with Exercise

Exercising while you’re cutting calories has benefits beyond burning calories. It’s good for your heart, reduces stress, and

helps muscles and bones stay strong. But many people believe that cutting calories alone will do the trick. Maybe. But you are better off adding that exercise component. Researchers in Taiwan (Menopause, March 2018) attempted to determine the effects of dietary or exercise interventions, alone or combined, on weight loss in overweight or obese women. Not surprisingly, the authors found that dietary interventions reduce body weight and improve body composition in women more than exercise alone, but adding exercise reinforces the effect of the dietary interventions.

Aerobics for Burning Calories

The basis of weight management is calories in versus calories out. Eat more calories than we burn, and we gain weight; burn more calories than we eat, and we lose weight. Aerobic exercise burns calories. The first step in building your exercise regimen is to aim for 150 minutes of moderate-intensity aerobic activity each week. To reach your weight goal, you may need to increase your activity beyond that. When it comes to maintaining weight loss and preventing weight regain over the long term, physical activity is needed.

Aerobic exercise can help you decrease body fat, including harmful abdominal fat. In fact, a weight-loss program that includes regular exercise preferentially reduces fat stored in the abdominal area, so if you’ve packed on excess fat around your middle, aerobic physical activity can help.

Many people overestimate how many calories they’ve burned during exercise and/or mistakenly think they need to refuel just because they’ve exercised.But both can interfere with your weight-control efforts.

Strong Bones and Muscles

When you lose weight, you can lose muscle and bone along with fat, but resistance (strength) training can help. The latest research makes a good argument for adding resistance training to your weight-loss efforts:

• A recent randomized controlled trial found that doing any kind of regular exercise while cutting calories helps you lose more fat, but resistance training is better than aerobic exercise in helping you hold on to muscle.
• A new analysis concluded that performing resistance training while you cut calories may help prevent bone loss better than aerobic training.
• A study conducted with older overweight or obese men and women found that resistance training alone did not lead to weight loss or improvement in health metrics like abdominal obesity, cholesterol, triglycerides, or blood pressure, but resistance training plus cutting calories did.

Preserving or adding muscle could make losing weight (or maintaining weight loss) easier. For every pound of muscle, you burn approximately six calories a day, while each pound of fat burns only two calories a day, so having more muscle makes it somewhat easier to manage your weight.

Be aware that muscle weighs more than fat, so if you’re gaining muscle while losing weight, the scale might not change as much as you’d like it to. The fit of your clothes is a better way to judge weight loss than the number on the scale.

Cleared for Exercise?

If you’re obese without other limiting disease conditions and your doctor has cleared you for exercise, standard exercise routines may be appropriate, although if it’s been a long time since you’ve exercised, you will need to ease into it. The Physical Activity Guidelines for Americans advise that obese individuals should work toward accumulating at least 300 minutes per week of moderate-intensity aerobic activity to help meet their weight goals. In some cases, two or more shorter sessions a day may be better tolerated and can help you reach this goal more easily.

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