WHAT'S FOR BREAKFAST

The best way to become nutritionally conscious is to read food labels when available. In addition, appendix 2 provides the nutritional content of common foods.

There are many breakfast foods that are consistent with the 10% solution. Here is a sample.

1. COLD CEREALS

The cereals below are low in fat, cholesterol, sugar, and sodium. Some of the cereals have more fiber content than others.

2. HOT CEREALS

The following grains can be cooked for a healthy hot cereal: barley, buckwheat, groats (kasha), bulgur, cornmeal, hominy grits, rice, rye.

3. SKIM OR 1 PERCENT MILK

4. BAGELS, ENGLISH MUFFINS, BAGUETTES, BREADS, RICE CAKES

5. OMELETTES made from egg whites or low-fat (or non-fat) egg substitutes

6. FAT-FREE EGG OMELET (see recipe for omelet in chapter 14)

7. FRENCH TOAST made with egg substitutes

8. LOW-FAT CREPES (see recipe for Fruit Crepes in chapter 14)

9. PANCAKES made with egg substitute and pancake mix (check the grams of fat; some pancake mixes are higher in fat than others)

10. CHEESE BLINTZES made with low-fat cottage cheese, skim milk, and egg whites

11. FRESH FRUIT

12. FRUIT JAMS, JELLIES, PRESERVES

13. VERY LOW FAT CHEESE

Check your store for other low-fat cheeses.

LETS HAVE LUNCH

The following is a sample of lunch foods that comply with the 10% solution. There is an increasing variety of non-fat and very low fat items available in your supermarket, so keep an eye out for healthy alternatives.

1. SALADS

2. SANDWICHES

MIXED WITH

BREAD

CONDIMENTS

3. STEAMED VEGETABLES with potato or with low-fat (1 percent) cottage cheese

4. PASTA (prepared without butter, margarine, or oil with a low-fat tomato or marinara sauce)

5. FRUIT PLATE

6. SOUP

7. THE SALAD BAR: low-fat or high-fat?

Salad bars contain nutritious vegetables, fruits, and grains, but avoid the following high-fat items:

• Bacon bits
• Butter, margarine
• Cream-based soups
• Croutons
• Cheese and processed meats
• Muffins
• Nuts and seeds
• Tuna, chicken, egg, potato, pasta salads smothered in high-fat oil, salad dressing, or mayonnaise
• Whole, hard-boiled eggs

IT'S TIME FOR DINNER

A small sampling of what you can eat.

1. MEAT

2. VEGETABLES (also see salad list for "Let's Have Lunch," above)

3. GRAINS

4. ANY FRUIT

5. PASTA

6. SALADS (see "Let's Have Lunch")

7. BREADS

8. SAUCES

SNACKIN' IT

Many low-fat snack items are appearing on supermarket shelves. Here is a small sample of nutritionally sound snack alternatives.

FROZEN FOODS

There is an increasing selection of low-fat items available in the frozen foods section of your supermarket. Remember to always check the number of fat grams because the words "low fat" on the package do not always guarantee that the product will comply with the 10% solution. Remember also to consider serving sizes. Some manufacturers will use artificially small serving sizes to make their products appear more nutritionally sound than they are. For example, if a package contains 6 servings, and you eat half the package, then you need to multiply all of the nutritional quantities (calories, fat, sodium, etc.) by 3 (servings).

It is also important to check on sodium content. Some low-fat products are still excessively high in sodium.

One brand that is worth noting is Healthy Choice. All of the Healthy Choice meals provide relatively low levels of fat, cholesterol, and sodium. There is an extensive selection, and the products have rated high in consumer taste surveys.

Here is a small sampling of frozen foods that are reasonably low in fat.

ENTREES AND DINNER

HEALTHY CHOICE

WEIGHT WATCHERS

Some of Weight Watchers' frozen entrees and dinners are reasonable in fat content, but others are too high. Check the fat grams on the label when choosing from their selection.

LEAN CUISINE

These are somewhat high in terms of sodium content.

VEGETABLES

BIRDS EYE

Birds Eye offers many frozen vegetables in small boxes or large bags.

GREEN GIANT

Green Giant also offers many frozen vegetables in small boxes or large bags. To decrease fat intake, buy Green Giant vegetables without added butter sauce.

Two examples of Green Giant vegetables:

GREEN GIANT AMERICAN MIXTURES

Green Giant offers several combinations of frozen vegetables.

DESSERTS

SARA LEE

PEPPERIDGE FARM

HOW THE OILS AND FATS COMPARE

In general, all added oils and fats should be avoided on the 10% solution. The primary guideline, however, is to limit fat to 10 percent of calories, so it is possible to use oil sparingly on the 10% solution as long as you count the fat grams. For example, if using a small amount of oil on your salad is important to you, you could use a teaspoon of olive oil, which adds 4.5 grams of fat. That will be a significant portion of your fat grams, but it is not out of the question (if you eat 2,000 calories per day, 10 percent calories from fat means eating 22 grams of fat per day). Other possible uses of oils include adding small amounts to recipes, such as tomato sauce, or using a very small amount when sautéing.

If you do plan on using oils, then I recommend extra virgin olive oil, which is the oil that is highest in monounsaturated fat, the "less bad" fat. Canola (or rapeseed) oil is also popular because it is very low in saturated fat although its polyunsaturated fat content is higher than that of olive oil. Also, some of the polyunsaturated fat in canola oil is omega-3 fat which is another "less bad" fat Otherwise, I do not recommend any of the other vegetable oils. I also do not recommend any of the meat fats, Crisco, butter, or margarine, all of which are included below for comparison.

The following chart compares these oils and fats in terms of the different types of fat. Eating an excessive level of saturated fat will raise cholesterol levels, which substantially increases the risk of heart disease and other conditions. Consuming polyunsaturated fat is also not healthy and is linked to increased cancer risk and decreased levels of HDL (the good cholesterol). Monounsaturated fat should still be avoided, but it is a "less bad" fat than saturated or polyunsaturated fat.

All amounts below are in teaspoons.

RECIPE CONVERSION

Many recipes can be converted to a low-fat equivalent, but use common sense since substituting every ingredient in a recipe may not work well.

Here are some suggested substitutions.

INSTEAD OF USE

Note: To thicken sauces, you can use non-fat milk powder, pureed cooked potatoes, pureed cooked vegetables, pureed cooked rice, pureed cooked kasha, and cornstarch.

The following are some samples of full recipe conversion.

TRADITIONAL LASAGNA (HIGH-FAT VERSION)

Serves 8

1. In a large frying pan, sauté the onion in oil until soft. Add beef and garlic and cook until the meat is crumbly. Optional: Add sausages to beef, garlic, and onion mixture for flavor.

2. Stir in tomato sauce, tomato paste, and water. Add salt, oregano, pepper, and sugar, stirring until mixed. Cover the pan and simmer for about 11/2 hours. Remove sausages, if used.

3. Cook the noodles in boiling salted water as directed on the package. Drain and rinse the noodles. Drain again.

4. Preheat oven to 350°.

5. Arrange 1/3 of the noodles on the bottom of a 9-by-13-inch shallow casserole dish. Spread 1/3 of the tomato sauce over the noodles. Top with 1/3 of the ricotta and mozzarella cheese.

6. Repeat layering two more times. Top with the Parmesan cheese.

7. Bake lasagna for 30 minutes. Remove from oven and cut into rectangles to serve.

Nutritional information per serving:

VEGETARIAN LASAGNA (LOW-FAT)

Serves 8

1. Preheat oven to 350°.

2. Using a non-stick skillet, sauté onion, garlic, and mushrooms. Add tomato sauce, basil, oregano, and pepper. Reduce heat.

3. In a bowl, stir cottage cheese, 3/4 spinach, and pureed broccoli together.

4. Cook noodles according to directions on package. Do not add salt.

5. Cover bottom of a l3-by-9-inch casserole dish with lasagna noodles. Add 1/2 of the spinach and broccoli mixtures. Add 1/3 of the tomato sauce and 1/3 of the mozzarella cheese. Repeat layers once.

6. Finish with noodles, the remaining sauce, and the remaining cheese.

7. Cover with aluminum foil. Bake for 35 minutes.

Nutritional information per serving:

TOMATO SALAD (HIGH-FAT)

Serves 4

1. Place sliced tomatoes and red onions in a medium serving bowl.

2. In a small mixing bowl, stir olive oil and pepper together. Pour onto tomatoes and red onions.

3. Sprinkle the tomatoes and red onions with pepper, parsley, and basil. Cover and refrigerate for 2 hours. Serve cold.

Nutritional information per serving:

TOMATO SALAD (LOW-FAT)

Serves 4

Follow steps for high-fat Tomato Salad.

Nutritional information per serving:

10% COOKING METHODS MADE SIMPLE

There are many healthy ways to cook food. Several methods are briefly explained below.

1. SAUTÉING

DEFINITION: Cooking or browning food at a high temperature in a small amount of hot liquid in a skillet, continuously stirring food during cooking. Sautéing is similar to stir frying.

Vegetables, fish, meat, and poultry are delicious when sautéed. Ten percent sautéing means replacing butter or oil with:

• Defatted chicken or fish stock
• Vegetable stock
• Wine
• Juices from other vegetables, such as finely chopped onions

Do not sauté vegetables in water. Sautéing in water produces tasteless vegetables.

EQUIPMENT FOR SAUTÉING

Teflon skillet or wok: Teflon skillets are useful because you need very little stock to sauté food.

TO SAUTÉ

1. Turn the burner to high.

2. Place a skillet or wok on the burner and add a small amount of the desired liquid.

3. Quickly add food.

4. Stir constantly, keeping heat on high. As the food cooks, you may need to add more liquid.

5. The length of time to sauté the food will depend on the quantity and kind of food cooked. Meats should be browned or golden; vegetables should be tender.

2. STEAMING

DEFINITION: Cooking food in steam given off by boiling water.

Steaming is an excellent way to cook most vegetables (except for large-root vegetables, such as potatoes and yams). Unlike vegetables that have been boiled, steamed vegetables maintain most of their nutritional value.

EQUIPMENT FOR STEAMING

Stainless-steel steamer basket: Different sizes of these inexpensive baskets can be used with different-size pots and are useful for steaming vegetables. However, moisture collects and drips on the metal and may make the food soggy.

Bamboo steamers stacked over a wok: These steamers are handy because several dishes can be steamed over a wok at the same time.

In a pinch: If you have neither bamboo nor stainless steamer baskets, use a metal colander or a wire rack over a pot.

TO STEAM

1. Bring water (no more than an inch) to boil.

2. Lower the heat to simmer.

3. Place steamer basket, colander, or wire rack over, but not touching, water.

4. Add food to the steam basket and cook to desired tenderness. Vegetables will take only a few minutes. Test vegetables to see that they are tender but not limp.

5. Drain food. You can save the water from vegetables, chicken, or fish for stock.

3. GRILLING

DEFINITION: Cooking food over a dry heat source.

Grilling offers a low-fat alternative for cooking poultry, lean meats, and fish that has been marinated. Marinated vegetables may also be grilled.

EQUIPMENT FOR GRILLING

Covered grills: Kettle- or wagon-shaped. These grills are fueled by charcoal, gas, or electricity.

Braisers: Uncovered shallow grills, used for direct-heat grilling only (grilling directly on top of the coals). Note that excessive charcoal grilling has been linked to stomach cancer.

Hibachis: Portable grills for small servings.

4. MICROWAVE COOKING

MICROWAVE COOKING is moisture producing and needs no added fats to cook foods: Adapt conventional recipes by reducing the cooking time given by one-third to one-quarter. Choose foods that cook well in moist heat: chicken, fish, ground meat, vegetables, sauces, and soups.

1. To help foods cook faster, cover them with dish lids or microwave-safe plastic wrap. If using microwave-safe plastic wrap, allow steam to escape by turning back one corner. (Always leave a gap in a container to allow steam to escape.)

2. Do not use paper plates or towels when cooking food for more than ten minutes.

3. Do not use any dish to microwave food in unless it fits in the microwave!

4. If the microwave doesn't have a turntable to spin food, turn or stir food throughout cooking.

OTHER HEALTHFUL COOKING METHODS

BAKING: Cooking food over a dry heat source, often using a covered container and adding liquid before cooking. Foods to bake: starchy vegetables (potatoes, yams, winter squash), chicken, fish, lean red meat, casseroles.

BROILING: Cooking underneath direct heat (usually in an oven) at high temperatures. Foods to broil: chicken, fish, lean red meat.

POACHING: Cooking by immersing food in simmering liquid. Foods to poach: chicken, fish.

ROASTING: Cooking food with a dry heat source in an uncovered pan. Foods to roast: chicken, lean red meat.

THE 10% PANTRY

The environment that you have the greatest control over is your home. Setting up your pantry to facilitate a low-fat diet is a key step to a successful commitment

Here are some items that the well-stocked "10% pantry" might include.

DAIRY

BEVERAGES

GRAINS

HERBS AND SPICES

CANNED MEAT AND FISH

• Unsalted tuna, packed in water
• Unsalted salmon, packed in water
• Unsalted chicken

CONDIMENTS

WHERE FAT LURKS

The fat content of food is not always apparent until you acquire some knowledge. One important source of this information is the nutritional breakdown provided on the label of prepared foods. When this is provided, always look at the number of grams of fat. In general, l gram of fat per 100 calories represents just slightly less than 10 percent calories from fat. Use appendix 2 of this book, "Nutritional Content of Food," as a further guide. Note that not every food needs to be under 10 percent calories from fat in order for your diet to average 10 percent. Note your overall fat budget. If you eat 2,000 calories per day, then 10 percent calories from fat represents 22 grams of fat.

Following are examples of foods that just don't make it on the 10% solution.

CONDIMENTS

RED MEAT, POULTRY, AND FISH

BAKED GOODS

DAIRY PRODUCTS

SNACKS, APPETIZERS

BEVERAGES

Piña coladas (contains coconut cream)

MISCELLANEOUS

• Vegetables prepared in butter or oil
• Fried vegetables and other foods
• Avocados
• Olives
• Cream substitutes and non-dairy creamers (some contain coconut oil, which is high in saturated fat) Sour cream substitutes
• Whipped toppings (contain coconut or palm-kernel oils)

DINING OUT

TIPS ON DINING OUT

• If possible, call the restaurant ahead of time to find out what's on the menu.
• Ask that food be prepared low-fat
• Ask if low-fat substitutions may be made for high-fat items.
• For appetizers, choose tomato- or vegetable-based soups. Order salads with low-fat dressing. Order dressing on the side.
• For an entree, order baked or broiled fish or chicken. Ask to have skin removed from chicken before it is cooked.
• For a drink, order skim milk, water, fruit juice, or herbal teas.
• Request that items be prepared without oil, butter, milk, cream, or cheese.

Avoid

• Creamy soups
• Fried appetizers
• Butter or margarine on bread or vegetables
• Food cooked "au gratin"
• Anything "Parmesan"
• Anything with cheese, cream, or hollandaise sauce
• Casseroles
• Red meat (except in very small quantities)
• Following are a number of suggestions of foods that you can order for each type of restaurant.

1. ITALIAN

• Vegetable- or tomato-based soup (e.g., minestrone)
• Salad with balsamic vinegar or lemon juice dressing
• Seafood and vegetables with fresh tomato sauce
• Fish or chicken entrees baked, broiled, or poached with wine
• Vegetarian platters
• Linguine with white or red clam sauce (but no oil)
• Pasta with tomato, Marsala, or marinara sauce
• Pasta primavera with low-fat sauce
• Italian ice for dessert
• Low-fat sauce on the side
• Pizza (no cheese or oil) with tomato sauce and vegetable topping

2. CHINESE

• Vegetable-based soup:
• Wonton
• Hot-and-sour soup (without egg)
• Boiled, steamed, or broiled appetizers
• Boiled, steamed, or broiled entrees, such as chicken with snow peas (ask that no oil be added)
• Stir-fried vegetables, chicken, fish, or noodle dish (made with a clean wok using soy sauce, chicken broth, or cornstarch)
• Steamed rice
• Soft noodles (no fried noodles)

3. JAPANESE

• Sushi
• Sashimi
• Miso soup
• Fish or chicken teriyaki
• Chicken sukiyaki
• Yosenabe (a seafood soup with vegetables and noodles)
• Oshitashi (spinach salad)
• Nabemono
• Yakimono (broiled foods)
• Steamed rice
• Sunomono (marinated fish salad)

4. FRENCH/PROVENÇAL

• Bread (no butter or margarine)
• Vegetable soup with chicken base
• Rice with parsley and herbs
• Roasted new potatoes with herbs
• Broiled, baked, or poached fish or steamed shellfish
• Foods cooked in wine sauces such as Bordelaise
• Provençal items (these are made with tomatoes, garlic, fish, and vegetables; ask the chef to eliminate the oil when cooking these dishes)
• Vegetables with low-fat sauce

5. GREEK

• Tzatziki (yogurt and cucumber appetizer)
• Pita bread
• Greek salad (without feta cheese, anchovies, and olives)
• Plaki (fish with tomatoes, onions, garlic)
• Shish kebob with fish, chicken, or small amount of red meat (no added oil)
• Rice with entree (no butter)
• Vegetarian dolmas or dolmades (grape leaves stuffed with rice and herbs)

6. MEXICAN

• Salsa with vegetables
• Bean salad
• Vegetable salads (without oil)
• Gazpacho
• Tomato-and-onion salad with lemon dressing
• Baked fish
• Steamed corn tortillas or flour tortillas (not fried)
• Steamed tacos or tostadas with vegetable or chicken fillings
• Meatless chili
• Enchiladas stuffed with chicken, crab, or vegetables
• Chicken fajitas (without guacamole; with low-fat sour cream)
• Rice and beans (not refried)
• Seviche

7. INDIAN

• Salad
• Chicken or vegetable curry
• Steamed rice
• Tandoori chicken or fish (cooked with Indian spices and roasted in a clay pot)
• Lentils/dal
• Breads: dried pulkas (unleavened white bread), naan (without butter)

8. MIDDLE EASTERN

• Appetizers: midya dolma (mussels stuffed with rice, pine nuts, and currants)
• Lentil soup
• Tabbouleh (made with a small amount of olive oil)
• Yalanji yaprak (grape leaves with chicken and rice)
• Vegetarian-stuffed grape leaves
• Imam bayildi (baked eggplant stuffed with vegetables)
• Vegetarian or chicken shish kebob
• Couscous or steamed bulgur topped with vegetables or chicken

9. CONTINENTAL

• Fish (swordfish, tuna, scallops, etc.) or chicken broiled, baked, or poached with no oil (wine is a good sauce)
• Baked potato
• Steamed vegetables

FAST-FOOD RESTAURANTS

The typical fast-food restaurant is not the ideal place to follow the 10% solution, but some offered items are better than others. The following items are lower in fat than most, and it would be possible to eat some of these items and still eat no more than 10 percent of your calories from fat (as long as you count your fat grams). Some of these items are excessively high in sodium, however (particularly those that exceed six hundred mg per serving).These items are listed here as foods that you might eat if necessary, but should be avoided on a regular basis.

On airplanes: at least twenty-four hours before your departure, order a special meal, either low-fat, low-cholesterol, or vegetarian (no egg, no dairy).

LACTOSE INTOLERANCE AND OTHER FOOD SENSITIVITIES

Do you suffer from excess gas, bloating, stomach cramps, nausea, or other symptoms of gastrointestinal distress (GID)? If so, you may have lactose intolerance. Although not related to the issues raised in this book, lactose intolerance and other food sensitivities are important nutritional issues because of the significant amount of discomfort they cause and the ease of treating these conditions once diagnosed.

At least 25 percent of all American adults are lactose intolerant but only a small fraction are aware of it. Certain ethnic groups are particularly susceptible. For example, 90 percent of Asians, 70 percent of North American blacks, 70 percent of Jews, 75 percent of Mexican Americans, and about 70 percent of Mediterraneans are lactose intolerant. The symptoms can be subtle, although still uncomfortable, and, thus, most instances of lactose intolerance remain undiagnosed.

Lactose intolerance is not an allergy and, consequently, will not respond to allergy medications. Lactose is a simple sugar found in milk and milk products. The body uses a natural enzyme called lactase to digest lactose and to convert it into other simple sugars. Lactose intolerance is caused simply by a lack of lactase. Because the production of lactase normally declines with age, the likelihood of being lactose intolerant increases as one gets older.

The most straightforward way to diagnose lactose intolerance is to stop eating milk and milk products for four to five days. If the symptoms subside, continue to stay away from products containing lactose for another week. If you continue not to have symptoms, then try reintroducing milk products and see if the symptoms return. If so, you are probably lactose intolerant.

Living with lactose intolerance need not be difficult. You can treat milk and other liquid milk products with the lactase enzyme (brand names include Lactaid, Lactogest, and Dairy Ease). For example, using Lactaid drops, you add five drops per quart of dairy product to remove 70 percent of the lactose, ten drops to remove 90 percent, and fifteen drops to remove 99 percent. After adding the lactase drops, gently shake the milk or milk product and wait twenty-four hours for the lactase to convert the lactose. The nutritional qualities of the milk or other dairy products are unaffected, although it may taste slightly sweeter because the lactose is converted into other, more digestible simple sugars. You can also purchase milk that has already been lactose reduced, although lactose-reduced milk is usually only 70 percent reduced in lactose. You can add additional drops of lactase to remove most of the remaining lactose.

You can also take caplets or capsules containing lactase when eating any product containing lactose, to help your system digest the lactose. You take the lactase just before eating the food containing lactose. You have to experiment with the dosage, as different people have different levels of sensitivity.

Yogurt, buttermilk, and other cultured milk products are already very low in lactose because the fermentation process has already predigested most of the lactose. Thus, most lactose intolerant people are able to eat yogurt. Frozen yogurt, however, is usually not made from pure yogurt, but also contains skim or low fat milk solids.

Although lactose intolerance is the most prevalent food sensitivity, there are many others. Food sensitivities may include reactions to wheat, gluten, onions, garlic, certain spices, nuts, certain fruits, vegetables or grains, beans, eggs, yeast, fructose .... The list is endless. Diagnosing a food sensitivity can be accomplished by removing the food or type of food causing the problem from your diet and then noting that the symptoms have subsided. However, because the number of possible offenders is so large and because many people with food sensitivities will react negatively to more than one category of food, making a successful identification can involve more than a little detective work.

A doctor who is familiar with food sensitivities can assist you in diagnosing this type of problem, but it is important that you choose a physician who is nutritionally oriented. Many cases of food sensitivity are often mislabeled as spastic colon, irritable bowel syndrome, or just a sensitive stomach.

If you have severe or very persistent symptoms, then it is important that you consult your doctor, because you may have an infection, ulcer, tumor, or other serious condition that requires medical attention.

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