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Colon cleansing is normally used as preparation for medical procedures such as a colonoscopy. However, some alternative medicine practitioners offer colon cleansing for other purposes, such as detoxification.

But colon cleansing also called a colonic or a colonic irrigation for such purposes isn't necessary. That's because your digestive system and bowel already eliminate waste material and bacteria from your body.

During a colon cleanse, large amounts of water sometimes up to 16 gallons (about 60 liters) and possibly other substances, such as herbs or coffee, are flushed through the colon. This is done using a tube that's inserted into the rectum. In some cases, smaller amounts of water are used and are left to sit in the colon for a short time before being removed.

Proponents of colon cleansing believe that toxins from your gastrointestinal tract can cause a variety of health problems, such as arthritis and high blood pressure. They believe that colon cleansing improves health by removing toxins, boosting your energy and enhancing your immune system. However, there's no evidence that colon cleansing produces these effects or is beneficial at all.

And colon cleansing can sometimes be harmful. In fact, coffee enemas sometimes used in colon cleansing have been linked to several deaths. Colon cleansing can also cause less serious side effects, such as cramping, bloating, diarrhea, nausea and vomiting.

Other potential concerns with colon cleansing include:

If you choose to try colon cleansing, take these precautions:

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Coeliac disease is usually treated by excluding foods that contain gluten from your diet.

This prevents damage to the lining of your intestines and the associated symptoms, such asdiarrhoea and stomach pain.

If you have coeliac disease, you must stop eating all sources of gluten for life. Your symptoms will return if you eat foods containing gluten, and it will cause long-term damage to your health.

This may sound difficult to do, but a GP can give you help and advice about ways to manage your diet. Your symptoms should improve considerably within weeks of starting a gluten-free diet. However, it may take up to 2 years for your digestive system to heal completely.

A GP will offer you an annualreviewduring which your height and weight will be measured and your symptoms reviewed. They'll also ask you about your diet and assess whether you need any further help or specialist nutritional advice.

When you're first diagnosed with coeliac disease, you'll be referred to adietitian tohelp you adjust to your new diet without gluten. They can also ensure your diet is balanced and contains all the nutrients you need.

If you have coeliac disease, you'll no longer be able to eat foods that contain any barley, rye orwheat, including farina, semolina, durum,cous cous and spelt.

Even if you only eat a small amount of gluten, such as a spoonful of pasta, you may have very unpleasant intestinal symptoms. If you keep eating gluten regularly, you'll also be at greater risk ofdeveloping complications, such as osteoporosis and some types ofcancer in later life.

Find out more about the complications of coeliac disease.

Gluten is not essential in your diet and it can be replaced by other foods. There are many gluten-free versions of common foods such as pasta, pizza bases and bread available in supermarkets and health food shops. Some GPs may providebread and bread mixes on prescription.

Many foods, such as meat, vegetables, cheese, potatoes and rice, are naturally free from gluten so you can still include them in your diet. A dietitian can help you identify which foods are safe to eat and which are not. If you're unsure, you can use the following lists as a general guide.

If you have coeliac disease, do not eat the following foods, unless they're labelled as gluten-free versions:

It's important to always check the labels on the foods you buy. Many foods (particularly processed foods) include additives which contain gluten, such as malt flavouring and modified food starch.

Gluten may also be found in some non-food products, including lipstick, postage stamps and some medicines.

Cross-contamination can happen if gluten-free foods and foods that contain gluten are prepared together or served with the same utensils.

If you have coeliac disease, you can eat the followingfoods, which naturally do not contain gluten:

By law, food labelled as gluten-free can contain no more than 20 parts per million (ppm) of gluten.

For most peoplewith coeliac disease, these trace amounts of gluten will not cause a problem. However, a small number of people are unable to tolerate even trace amounts of gluten and need to have a diet completely free from cereals.

The Coeliac UKwebsite has moreinformation about shopping for gluten-free foods, and advice about living a gluten-free lifestyle.

Oats do not contain gluten, but many people with coeliac disease avoid eating them because they can become contaminated with other cereals that contain gluten.

There's also some evidence to suggest that a very small number of people may still be sensitive to products that are gluten-free and do not contain contaminated oats. This is because oats contain a protein called avenin, which is suitable for most people with coeliac disease but may trigger symptoms in a few people.

If, after discussing this with your healthcare professional, you want to include oats in your diet, check the oats are pure and that there's no possibility of contamination with gluten.

You should avoid eating oats until your gluten-free diet has taken full effect and your symptoms have beenresolved. Once you're free of symptoms, gradually reintroduce oats into your diet.If you develop symptoms again, stop eating oats.

Do not introduce gluten intoyour baby's diet beforethey're6 months old. Breast milk is naturally gluten-free as are all infant milk formulas.

If you have coeliac disease, Coeliac UK recommends foods containing gluten areintroduced gradually when a child is 6 months old. This should becarefullymonitored.

The Coeliac UK website provides more information about feeding your baby.

As well as eliminating foods that contain gluten from your diet, there are other treatments available for coeliac disease.

In some people, coeliac disease can cause the spleen to work less effectively, making you more vulnerable to infection.

Youmay therefore need to have extra vaccinations, including:

However, if your spleen is unaffected by coeliac disease, these vaccinations are not usually necessary.

As well as cutting gluten out of your diet, a GP or dietitian may also recommend taking vitamin and mineral supplements, at least for the first 6 months after your diagnosis.

This will ensure you get all the nutrients you need while your digestive system repairs itself. Taking supplements can also help correct any deficiencies, such asiron deficiency anaemia.

If you have dermatitis herpetiformis (anitchy rash that can be caused by gluten intolerance), cutting gluten out of your dietshould help.

However, it can sometimes take longer for a gluten-free diet to clear the rash than it does to control your other symptoms, such as diarrhoea and stomach pain.

If this is the case, you may be prescribed medicine to speed up the healing of the rash. It's likely that this will be a medicine called dapsone, which usually comes as a tablet you swallow twice a day.

Dapsone can cause side effects, such as headaches and depression, so you'll always be prescribed the lowest effective dose.

You may need to take medicine for up to 2 years to control dermatitis herpetiformis. After this time, you should have been following a gluten-free diet long enough for the rash to be controlled without the need for medicine.

Refractory coeliac disease is a rarer type of coeliac disease where the symptoms continue, even after switching to a gluten-free diet. The reasons for this are unclear.

It's estimated that around 1 in every 140 people with coeliac disease will develop the refractory form of the condition.

If refractory coeliac disease is suspected, it's likely you'll be referred for a series of tests to make sure your symptoms are not being caused by another condition.

If no other cause can be found and the diagnosis is confirmed, you'll be referred to a specialist. Treatment options include steroid medicine, such as prednisolone, which help block the harmful effects of the immune system.

Page last reviewed: 03 December 2019Next review due: 03 December 2022

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A balanced diet gives your body the nutrients it needs to function correctly. To get the nutrition you need, most of your daily calories should come from:

The Dietary Guidelines for Americans explain how much of each nutrient you should consume daily.

The number of calories in a food refers to the amount of energy stored in that food. Your body uses calories from food for walking, thinking, breathing, and other important functions.

The average person needs about 2,000 calories every day to maintain their weight, but the amount will depend on their age, sex, and physical activity level.

Males tend to need more calories than females, and people who exercise need more calories than people who dont.

Current guidelines list the following calorie intakes for males and females of different ages:

The source of your daily calories are also important. Foods that provide mainly calories and very little nutrition are known as empty calories.

Examples of foods that provide empty calories include:

However, its not only the type of food but the ingredients that make it nutritious.

A homemade pizza with a wholemeal base and plenty of fresh veggies on top may be a healthy choice. In contrast, premade pizzas and other highly processed foods often contain empty calories.

To maintain good health, limit your consumption of empty calories and instead try to get your calories from foods that are rich in other nutrients.

Get some tips for curbing cravings of less nutritious foods.

Calories are a measure of energy that foods supply. The number of calories you need will depend on your sex, age, and activity level.

A balanced diet supplies the nutrients your body needs to work effectively. Without balanced nutrition, your body is more prone to disease, infection, fatigue, and low performance.

Children who dont get enough healthy foods may face growth and developmental problems, poor academic performance, and frequent infections.

They can also develop unhealthy eating habits that may persist into adulthood.

Without exercise, theyll also have a higher risk of obesity and various diseases that make up metabolic syndrome, such as type 2 diabetes and high blood pressure.

According to the Center for Science in the Public Interest, 4 of the top 10 leading causes of death in the United States are directly linked to diet.

These are:

Learn more about healthy meal plans for kids.

Your body needs nutrients to stay healthy, and food supplies essential nutrients that stop us from getting sick.

A healthy, balanced diet will usually include the following nutrients:

A balanced diet will include a variety of foods from the following groups:

Examples of protein foods include meat, eggs, fish, beans, nuts, and legumes.

People who follow a vegan diet will focus entirely on plant-based foods. They wont eat meat, fish, or dairy, but their diet will include other items that provide similar nutrients.

Tofu and beans, for example, are plant-based sources of protein. Some people are intolerant of dairy but can still build a balanced diet by choosing a variety of nutrient-rich replacements.

Foods to avoid or limit on a healthy diet include:

Whats healthy for one person may not be suitable for another.

Whole wheat flour can be a healthy ingredient for many people but isnt suitable for those with a gluten intolerance, for example.

Learn about 50 super healthy foods.

Fruits are nutritious, they make a tasty snack or dessert, and they can satisfy a sweet tooth.

Local fruits that are in season are fresher and provide more nutrients than imported fruits.

Fruits are high in sugar, but this sugar is natural. Unlike candies and many sweet desserts, fruits also provide fiber and other nutrients. This means theyre less likely to cause a sugar spike and theyll boost the bodys supply of essential vitamins, minerals, and antioxidants.

If you have diabetes, your doctor or dietitian can advise you on which fruits to choose, how much to eat, and when.

Learn about 11 low-sugar fruits.

Vegetables are a key source of essential vitamins, minerals, and antioxidants. Eat a variety of vegetables with different colors for a full range of nutrients.

Dark, leafy greens are an excellent source of many nutrients. They include:

Local, seasonal vegetables are often reasonable in price and easy to prepare. Use them in the following ways:

Refined white flour is featured in many breads and baked goods, but it has limited nutritional value. This is because much of the goodness is in the hull of the grain, or outer shell, which manufacturers remove during processing.

Whole grain products include the entire grain, including the hull. They provide additional vitamins, minerals, and fiber. Many people also find that whole grains add flavor and texture to a dish.

Try switching from white breads, pastas, and rice to whole grain options.

Meats and beans are primary sources of protein, which is essential for wound healing and muscle maintenance and development, among other functions.

Healthy animal-based options include:

Processed meats and red meats may increase the risk of cancer and other diseases, according to some research.

Some processed meats also contain a lot of added preservatives and salt. Fresh, unprocessed meat is the best option.

Nuts, beans, and soy products are good sources of protein, fiber, and other nutrients.

Examples include:

Tofu, tempeh, and other soy-based products are excellent sources of protein and are healthy alternatives to meat.

Shop for tofu and tempeh.

Dairy products provide essential nutrients, including:

They also contain fat. If youre seeking to limit your fat intake, reduced fat options might be best. Your doctor can help you decide.

For those following a vegan diet, many dairy-free milks and other dairy alternatives are now available, made from:

These are often fortified with calcium and other nutrients, making them excellent alternatives to dairy from cows. Some have added sugar, so read the label carefully when choosing.

Shop for almond and soy milk.

Fat is essential for energy and cell health, but too much fat can increase calories above what the body needs and may lead to weight gain.

In the past, guidelines have recommended avoiding saturated fats, due to concerns that they would raise cholesterol levels.

More recent research suggests that partially replacing with unsaturated fats lowers cardiovascular disease risk and that some saturated fat should remain in the diet about 10 percent or less of calories.

Trans fats, however, should still be avoided.

Recommendations on fats can sometimes be hard to follow, but one scientist has proposed the following guideline:

Most experts consider olive oil to be a healthy fat, and especially extra virgin olive oil, which is the least processed type.

Deep fried foods are often high in calories but low in nutritional value, so you should eat them sparingly.

Shop for olive oil.

A balanced diet contains foods from the following groups: fruits, vegetables, dairy, grains, and protein.

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A balanced diet includes foods from five groups and fulfills all of a persons nutritional needs. Eating a balanced diet helps people maintain good health and reduce their risk of disease.

Dietary guidelines evolve with scientific advances, so it can be challenging to stay on top of current recommendations and know what to eat.

In this article, we look at current dietary recommendations and describe how to build a balanced diet.

A balanced diet is one that fulfills all of a persons nutritional needs. Humans need a certain amount of calories and nutrients to stay healthy.

A balanced diet provides all the nutrients a person requires, without going over the recommended daily calorie intake.

By eating a balanced diet, people can get the nutrients and calories they need and avoid eating junk food, or food without nutritional value.

The United States Department of Agriculture (USDA) used to recommend following a food pyramid. However, as nutritional science has changed, they now recommend eating foods from the five groups and building a balanced plate.

According to the USDAs recommendations, half of a persons plate should consist of fruits and vegetables.

The other half should be made up of grains and protein. They recommend accompanying each meal with a serving of low-fat dairy or another source of the nutrients found in dairy.

A healthful, balanced diet includes foods from these five groups:

The vegetable group includes five subgroups:

To get enough nutrients and keep dietary boredom at bay, people should choose a variety of vegetables.

Additionally, the USDA recommend that people eat vegetables from each of the five subgroups every week.

People may enjoy vegetables raw or cooked. However, it is important to remember that cooking vegetables removes some of their nutritional value. Also, some methods, such as deep-frying, can add unhealthful fats to a dish.

A balanced diet also includes plenty of fruit. Instead of getting fruit from juice, nutrition experts recommend eating whole fruits.

Juice contains fewer nutrients. Also, the manufacturing process often adds empty calories due to added sugar. People should opt for fresh or frozen fruits, or fruits canned in water instead of syrup.

There are two subgroups: whole grains and refined grains.

Whole grains include all three parts of the grain, which are the bran, germ, and endosperm. The body breaks down whole grains slowly, so they have less effect on a persons blood sugar.

Additionally, whole grains tend to contain more fiber and protein than refined grains.

Refined grains are processed and do not contain the three original components. Refined grains also tend to have less protein and fiber, and they can cause blood sugar spikes.

Grains used to form the base of the government-approved food pyramid, meaning that most of a persons daily caloric intake came from grains. However, the updated guidelines suggest that grains should make up only a quarter of a persons plate.

At least half of the grains that a person eats daily should be whole grains. Healthful whole grains include:

The 20152020 Dietary Guidelines for Americans state that all people should include nutrient-dense protein as part of their regular diet.

The guidelines suggest that this protein should make up a quarter of a persons plate.

Nutritious protein choices include:

Dairy and fortified soy products are a vital source of calcium. The USDA recommend consuming low-fat versions whenever possible.

Low-fat dairy and soy products include:

People who are lactose intolerant can opt for low-lactose or lactose-free products, or choose soy-based sources of calcium and other nutrients.

A poor diet is a common reason why people struggle with weight loss.

When combined with a regular exercise routine, a balanced diet can help a person reduce their risk factors for obesity or gaining weight.

A balanced diet can help a person lose weight by:

People interested in losing weight should begin or enhance an exercise routine.

For some people, adding 30 minutes of walking each day and making minor changes, such as taking the stairs, can help them burn calories and lose weight.

For those that can, adding moderate exercise that includes cardio and resistance training will help speed weight loss.

Eating a balanced diet means eating foods from the five major groups.

Dietary guidelines change over time, as scientists discover new information about nutrition. Current recommendations suggest that a persons plate should contain primarily vegetables and fruits, some lean protein, some dairy, and soluble fiber.

People interested in weight loss should also consider introducing moderate exercise into their routines.

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healthy eating

Whether you're trying to prevent or control diabetes, your nutritional needs are virtually the same as everyone else, so no special foods are necessary. But you do need to pay attention to some of your food choicesmost notably the carbohydrates you eat. While following a Mediterranean or other heart-healthy diet can help with this, the most important thing you can do is to lose a little weight.

Losing just 5% to 10% of your total weight can help you lower your blood sugar, blood pressure, and cholesterol levels. Losing weight and eating healthier can also have a profound effect on your mood, energy, and sense of wellbeing. People with diabetes have nearly double the risk of heart disease and are at a greater risk of developing mental health disorders such as depression.

But most cases of type 2 diabetes are preventable and some can even be reversed. Even if youve already developed diabetes, its not too late to make a positive change. By eating healthier, being more physically active, and losing weight, you can reduce your symptoms. Taking steps to prevent or control diabetes doesnt mean living in deprivation; it means eating a tasty, balanced diet that will also boost your energy and improve your mood. You dont have to give up sweets entirely or resign yourself to a lifetime of bland food.

Being overweight or obese is the biggest risk factor for type 2 diabetes. However, your risk is higher if you tend to carry your weight around your abdomen as opposed to your hips and thighs. A lot of belly fat surrounds the abdominal organs and liver and is closely linked to insulin resistance. You are at an increased risk of developing diabetes if you are:

Calories obtained from fructose (found in sugary beverages such as soda, energy and sports drinks, coffee drinks, and processed foods like doughnuts, muffins, cereal, candy and granola bars) are more likely to add weight around your abdomen. Cutting back on sugary foods can mean a slimmer waistline as well as a lower risk of diabetes.

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A diabetic diet doesn't have to be complicated and you don't have to give up all your favorite foods. The first step to making smarter choices is to separate the myths from the facts about eating to prevent or control diabetes.

Fact: You can enjoy your favorite treats as long as you plan properly and limit hidden sugars. Dessert doesn't have to be off limits, as long as it's a part of a healthy meal plan.

Fact: The type of carbohydrates you eat as well as serving size is key. Focus on whole grain carbs instead of starchy carbs since they're high in fiber and digested slowly, keeping blood sugar levels more even.

Fact: The principles of healthy eating are the samewhether or not you're diabetic. Expensive diabetic foods generally offer no special benefit.

Fact: Studies have shown that eating too much protein, especially animal protein, may actually cause insulin resistance, a key factor in diabetes. A healthy diet includes protein, carbohydrates, and fats. Our bodies need all three to function properly. The key is a balanced diet.

As with any healthy eating program, a diabetic diet is more about your overall dietary pattern rather than obsessing over specific foods. Aim to eat more natural, unprocessed food and less packaged and convenience foods.

Carbohydrates have a big impact on your blood sugar levelsmore so than fats and proteinsso you need to be smart about what types of carbs you eat. Limit refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, packaged meals, and snack foods. Focus on high-fiber complex carbohydratesalso known as slow-release carbs. They are digested more slowly, thus preventing your body from producing too much insulin.

High glycemic index (GI) foods spike your blood sugar rapidly, while low GI foods have the least effect on blood sugar. While the GI has long been promoted as a tool to help manage blood sugar, there are some notable drawbacks.

Eating a diabetic diet doesn't mean eliminating sugar altogether, but like most of us, chances are you consume more sugar than is healthy. If you have diabetes, you can still enjoy a small serving of your favorite dessert now and then. The key is moderation.

Reduce your cravings for sweets by slowly reducing the sugar in your diet a little at a time to give your taste buds time to adjust.

Hold the bread (or rice or pasta) if you want dessert. Eating sweets at a meal adds extra carbohydrates so cut back on the other carb-heavy foods at the same meal.

Add some healthy fat to your dessert. Fat slows down the digestive process, meaning blood sugar levels don't spike as quickly. That doesn't mean you should reach for the donuts, though. Think healthy fats, such as peanut butter, ricotta cheese, yogurt, or nuts.

Eat sweets with a meal, rather than as a stand-alone snack. When eaten on their own, sweets cause your blood sugar to spike. But if you eat them along with other healthy foods as part of your meal, your blood sugar won't rise as rapidly.

When you eat dessert, truly savor each bite. How many times have you mindlessly eaten your way through a bag of cookies or a huge piece of cake? Can you really say that you enjoyed each bite? Make your indulgence count by eating slowly and paying attention to the flavors and textures. You'll enjoy it more, plus you're less likely to overeat.

Reduce soft drinks, soda, and juice. For each 12 oz. serving of a sugar-sweetened beverage you drink a day, your risk for diabetes increases by about 15%. Try sparkling water with a twist of lemon or lime instead. Cut down on creamers and sweeteners you add to tea and coffee.

Don't replace saturated fat with sugar. Many of us replace saturated fat such as whole milk dairy with refined carbs, thinking we're making a healthier choice. Low-fat doesn't mean healthy when the fat has been replaced by added sugar.

Sweeten foods yourself. Buy unsweetened iced tea, plain yogurt, or unflavored oatmeal, for example, and add sweetener (or fruit) yourself. You'll likely add far less sugar than the manufacturer.

Check labels and opt for low sugar products and use fresh or frozen ingredients instead of canned goods. Be especially aware of the sugar content of cereals and sugary drinks.

Avoid processed or packaged foods like canned soups, frozen dinners, or low-fat meals that often contain hidden sugar. Prepare more meals at home.

Reduce the amount of sugar in recipes by to . You can boost sweetness with mint, cinnamon, nutmeg, or vanilla extract instead of sugar.

Find healthy ways to satisfy your sweet tooth. Instead of ice cream, blend up frozen bananas for a creamy, frozen treat. Or enjoy a small chunk of dark chocolate, rather than a milk chocolate bar.

Start with half of the dessert you normally eat, and replace the other half with fruit.

It's easy to underestimate the calories and carbs in alcoholic drinks, including beer and wine. And cocktails mixed with soda and juice can be loaded with sugar. Choose calorie-free mixers, drink only with food, and monitor your blood glucose as alcohol can interfere with diabetes medication and insulin.

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Being smart about sweets is only part of the battle. Sugar is also hidden in many packaged foods, fast food meals, and grocery store staples such as bread, cereals, canned goods, pasta sauce, margarine, instant mashed potatoes, frozen dinners, low-fat meals, and ketchup. The first step is to spot hidden sugar on food labels, which can take some sleuthing:

Choose fats wisely

Some fats are unhealthy and others have enormous health benefits, so it's important to choose fats wisely.

Unhealthy (saturated) fats. Found mainly in tropical oils, red meat, and dairy, there's no need to completely eliminate saturated fat from your dietbut rather, enjoy in moderation. The American Diabetes Association recommends consuming no more than 10% of your daily calories from saturated fat.

Healthy (unsaturated) fats. The healthiest fats are unsaturated fats, which come from fish and plant sources such as olive oil, nuts, and avocados. Omega-3 fatty acids fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flaxseeds.

It's encouraging to know that you only have to lose 7% of your body weight to cut your risk of diabetes in half. And you don't have to obsessively count calories or starve yourself to do it. Two of the most helpful strategies involve following a regular eating schedule and recording what you eat.

Your body is better able to regulate blood sugar levelsand your weightwhen you maintain a regular meal schedule. Aim for moderate and consistent portion sizes for each meal.

Start your day off with a good breakfast. It will provide energy as well as steady blood sugar levels.

Eat regular small mealsup to 6 per day. Eating regularly will help you keep your portions in check.

Keep calorie intake the same. To regulate blood sugar levels, try to eat roughly the same amount every day, rather than overeating one day or at one meal, and then skimping the next.

A recent study found that people who kept a food diary lost twice as much weight as those who didn't. Why? A written record helps you identify problem areassuch as your afternoon snack or your morning lattewhere you're getting more calories than you realized. It also increases your awareness of what, why, and how much you're eating, which helps you cut back on mindless snacking. Keep a notebook handy or use an app to track your eating.

Exercise can help you manage your weight and may improve your insulin sensitivity. An easy way to start exercising is to walk for 30 minutes a day (or for three 10-minute sessions if that's easier). You can also try swimming, biking, or any other moderate-intensity activity that has you working up a light sweat and breathing harder.

Learn how to lose weight and keep it off. If your last diet attempt wasn't a success, or life events have caused you to gain weight, don't be discouraged. The key is to find a plan that works with your body's individual needs so that you can avoid common diet pitfalls and find long-term, weight loss success.

Authors: Jeanne Segal, Ph.D., Lawrence Robinson, and Melinda Smith, M.A.

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Hawton, K., Ferriday, D., Rogers, P., Toner, P., Brooks, J., Holly, J., Biernacka, K., Hamilton-Shield, J., & Hinton, E. (2018). Slow Down: Behavioural and Physiological Effects of Reducing Eating Rate. Nutrients, 11(1), 50. https://doi.org/10.3390/nu11010050

Holt, R. I. G., de Groot, M., & Golden, S. H. (2014). Diabetes and Depression. Current Diabetes Reports, 14(6), 491. https://doi.org/10.1007/s11892-014-0491-3

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Malik, V. S., Popkin, B. M., Bray, G. A., Desprs, J.-P., Willett, W. C., & Hu, F. B. (2010). Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes. Diabetes Care, 33(11), 24772483. https://doi.org/10.2337/dc10-1079

Martn-Pelez, S., Fito, M., & Castaner, O. (2020). Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review. Nutrients, 12(8), 2236. https://doi.org/10.3390/nu12082236

Omega-3 Fatty AcidsHealth Professional Fact Sheet. (n.d.). Retrieved March 8, 2022, from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/

Rietman, A., Schwarz, J., Tom, D., Kok, F. J., & Mensink, M. (2014). High dietary protein intake, reducing or eliciting insulin resistance? European Journal of Clinical Nutrition, 68(9), 973979. https://doi.org/10.1038/ejcn.2014.123

Ryan, D. H., & Yockey, S. R. (2017). Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Current Obesity Reports, 6(2), 187194. https://doi.org/10.1007/s13679-017-0262-y

Simple Steps to Preventing Diabetes | The Nutrition Source | Harvard T.H. Chan School of Public Health. (n.d.). Retrieved March 8, 2022, from https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/

Whole Grains | The Nutrition Source | Harvard T.H. Chan School of Public Health. (n.d.). Retrieved March 8, 2022, from https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/whole-grains/

Last updated: October 13, 2022

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Top row: escargots, sardines, and fava beans (Crete); naan in salty yak-milk tea (Afghanistan); fried geranium leaves (Crete); boiled crab (Malaysia); raw beetroot and oranges (Crete); chapati, yak butter, and rock salt (Pakistan). Middle row: dried-apricot soup (Pakistan); boiled plantains (Bolivia); fried coral reef fish (Malaysia); bulgur, boiled eggs, and parsley (Tajikistan); stewed-seaweed salad (Malaysia); boiled ptarmigan (Greenland). Bottom row: grilled tuna (Malaysia); cooked potatoes, tomatoes, and fava beans in olive oil (Crete); rice with melted yak butter (Afghanistan); fried fish with tamarind (Malaysia); dried apricots (Pakistan); grilled impala (Tanzania; photographers utensils shown).

Cultures around the world have centuries-old food traditions, as seen in these dishes from several different populations.

By Ann Gibbons

Photographs by Matthieu Paley

Some experts say modern humans should eat from a Stone Age menu. What's on it may surprise you.

Fundamental Feasts For some cultures, eating off the land isand always has beena way of life.

Its suppertime in the Amazon of lowland Bolivia, and Ana Cuata Maito is stirring a porridge of plantains and sweet manioc over a fire smoldering on the dirt floor of her thatched hut, listening for the voice of her husband as he returns from the forest with his scrawny hunting dog.

With an infant girl nursing at her breast and a seven-year-old boy tugging at her sleeve, she looks spent when she tells me that she hopes her husband, Deonicio Nate, will bring home meat tonight. The children are sad when there is no meat, Maito says through an interpreter, as she swats away mosquitoes.

Nate left before dawn on this day in January with his rifle and machete to get an early start on the two-hour trek to the old-growth forest. There he silently scanned the canopy for brown capuchin monkeys and raccoonlike coatis, while his dog sniffed the ground for the scent of piglike peccaries or reddish brown capybaras. If he was lucky, Nate would spot one of the biggest packets of meat in the foresttapirs, with long, prehensile snouts that rummage for buds and shoots among the damp ferns.

This evening, however, Nate emerges from the forest with no meat. At 39, hes an energetic guy who doesnt seem easily defeatedwhen he isnt hunting or fishing or weaving palm fronds into roof panels, hes in the woods carving a new canoe from a log. But when he finally sits down to eat his porridge from a metal bowl, he complains that its hard to get enough meat for his family: two wives (not uncommon in the tribe) and 12 children. Loggers are scaring away the animals. He cant fish on the river because a storm washed away his canoe.

The story is similar for each of the families I visit in Anachere, a community of about 90 members of the ancient Tsimane Indian tribe. Its the rainy season, when its hardest to hunt or fish. More than 15,000 Tsimane live in about a hundred villages along two rivers in the Amazon Basin near the main market town of San Borja, 225 miles from La Paz. But Anachere is a two-day trip from San Borja by motorized dugout canoe, so the Tsimane living there still get most of their food from the forest, the river, or their gardens.

Im traveling with Asher Rosinger, a doctoral candidate whos part of a team, co-led by biological anthropologist William Leonard of Northwestern University, studying the Tsimane to document what a rain forest diet looks like. Theyre particularly interested in how the Indians health changes as they move away from their traditional diet and active lifestyle and begin trading forest goods for sugar, salt, rice, oil, and increasingly, dried meat and canned sardines. This is not a purely academic inquiry. What anthropologists are learning about the diets of indigenous peoples like the Tsimane could inform what the rest of us should eat.

Rosinger introduces me to a villager named Jos Mayer Cunay, 78, who, with his son Felipe Mayer Lero, 39, has planted a lush garden by the river over the past 30 years. Jos leads us down a trail past trees laden with golden papayas and mangoes, clusters of green plantains, and orbs of grapefruit that dangle from branches like earrings. Vibrant red lobster claw heliconia flowers and wild ginger grow like weeds among stalks of corn and sugarcane. Joss family has more fruit than anyone, says Rosinger.

Yet in the familys open-air shelter Felipes wife, Catalina, is preparing the same bland porridge as other households. When I ask if the food in the garden can tide them over when theres little meat, Felipe shakes his head. Its not enough to live on, he says. I need to hunt and fish. My body doesnt want to eat just these plants.

The Tsimane of Bolivia get most of their food from the river, the forest, or fields and gardens carved out of the forest.

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As we look to 2050, when well need to feed two billion more people, the question of which diet is best has taken on new urgency. The foods we choose to eat in the coming decades will have dramatic ramifications for the planet. Simply put, a diet that revolves around meat and dairy, a way of eating thats on the rise throughout the developing world, will take a greater toll on the worlds resources than one that revolves around unrefined grains, nuts, fruits, and vegetables.

Until agriculture was developed around 10,000 years ago, all humans got their food by hunting, gathering, and fishing. As farming emerged, nomadic hunter-gatherers gradually were pushed off prime farmland, and eventually they became limited to the forests of the Amazon, the arid grasslands of Africa, the remote islands of Southeast Asia, and the tundra of the Arctic. Today only a few scattered tribes of hunter-gatherers remain on the planet.

Thats why scientists are intensifying efforts to learn what they can about an ancient diet and way of life before they disappear. Hunter-gatherers are not living fossils, says Alyssa Crittenden, a nutritional anthropologist at the University of Nevada, Las Vegas, who studies the diet of Tanzanias Hadza people, some of the last true hunter-gatherers. That being said, we have a small handful of foraging populations that remain on the planet. We are running out of time. If we want to glean any information on what a nomadic, foraging lifestyle looks like, we need to capture their diet now.

So far studies of foragers like the Tsimane, Arctic Inuit, and Hadza have found that these peoples traditionally didnt develop high blood pressure, atherosclerosis, or cardiovascular disease. A lot of people believe there is a discordance between what we eat today and what our ancestors evolved to eat, says paleoanthropologist Peter Ungar of the University of Arkansas. The notion that were trapped in Stone Age bodies in a fast-food world is driving the current craze for Paleolithic diets. The popularity of these so-called caveman or Stone Age diets is based on the idea that modern humans evolved to eat the way hunter-gatherers did during the Paleolithicthe period from about 2.6 million years ago to the start of the agricultural revolutionand that our genes havent had enough time to adapt to farmed foods.

A Stone Age diet is the one and only diet that ideally fits our genetic makeup, writes Loren Cordain, an evolutionary nutritionist at Colorado State University, in his book The Paleo Diet: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat. After studying the diets of living hunter-gatherers and concluding that 73 percent of these societies derived more than half their calories from meat, Cordain came up with his own Paleo prescription: Eat plenty of lean meat and fish but not dairy products, beans, or cereal grainsfoods introduced into our diet after the invention of cooking and agriculture. Paleo-diet advocates like Cordain say that if we stick to the foods our hunter-gatherer ancestors once ate, we can avoid the diseases of civilization, such as heart disease, high blood pressure, diabetes, cancer, even acne.

That sounds appealing. But is it true that we all evolved to eat a meat-centric diet? Both paleontologists studying the fossils of our ancestors and anthropologists documenting the diets of indigenous people today say the picture is a bit more complicated. The popular embrace of a Paleo diet, Ungar and others point out, is based on a stew of misconceptions.

The Hadza of Tanzania are the worlds last full-time hunter-gatherers. They live on what they find: game, honey, and plants, including tubers, berries, and baobab fruit.

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Meat has played a starring role in the evolution of the human diet. Raymond Dart, who in 1924 discovered the first fossil of a human ancestor in Africa, popularized the image of our early ancestors hunting meat to survive on the African savanna. Writing in the 1950s, he described those humans as carnivorous creatures, that seized living quarries by violence, battered them to death slaking their ravenous thirst with the hot blood of victims and greedily devouring livid writhing flesh.

Eating meat is thought by some scientists to have been crucial to the evolution of our ancestors larger brains about two million years ago. By starting to eat calorie-dense meat and marrow instead of the low-quality plant diet of apes, our direct ancestor, Homo erectus, took in enough extra energy at each meal to help fuel a bigger brain. Digesting a higher quality diet and less bulky plant fiber would have allowed these humans to have much smaller guts. The energy freed up as a result of smaller guts could be used by the greedy brain, according to Leslie Aiello, who first proposed the idea with paleoanthropologist Peter Wheeler. The brain requires 20 percent of a humans energy when resting; by comparison, an apes brain requires only 8 percent. This means that from the time of H. erectus, the human body has depended on a diet of energy-dense foodespecially meat.

Fast-forward a couple of million years to when the human diet took another major turn with the invention of agriculture. The domestication of grains such as sorghum, barley, wheat, corn, and rice created a plentiful and predictable food supply, allowing farmers wives to bear babies in rapid successionone every 2.5 years instead of one every 3.5 years for hunter-gatherers. A population explosion followed; before long, farmers outnumbered foragers.

Over the past decade anthropologists have struggled to answer key questions about this transition. Was agriculture a clear step forward for human health? Or in leaving behind our hunter-gatherer ways to grow crops and raise livestock, did we give up a healthier diet and stronger bodies in exchange for food security?

When biological anthropologist Clark Spencer Larsen of Ohio State University describes the dawn of agriculture, its a grim picture. As the earliest farmers became dependent on crops, their diets became far less nutritionally diverse than hunter-gatherers diets. Eating the same domesticated grain every day gave early farmers cavities and periodontal disease rarely found in hunter-gatherers, says Larsen. When farmers began domesticating animals, those cattle, sheep, and goats became sources of milk and meat but also of parasites and new infectious diseases. Farmers suffered from iron deficiency and developmental delays, and they shrank in stature.

Despite boosting population numbers, the lifestyle and diet of farmers were clearly not as healthy as the lifestyle and diet of hunter-gatherers. That farmers produced more babies, Larsen says, is simply evidence that you dont have to be disease free to have children.

The Inuit of Greenland survived for generations eating almost nothing but meat in a landscape too harsh for most plants. Today markets offer more variety, but a taste for meat persists.

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The real Paleolithic diet, though, wasnt all meat and marrow. Its true that hunter-gatherers around the world crave meat more than any other food and usually get around 30 percent of their annual calories from animals. But most also endure lean times when they eat less than a handful of meat each week. New studies suggest that more than a reliance on meat in ancient human diets fueled the brains expansion.

Year-round observations confirm that hunter-gatherers often have dismal success as hunters. The Hadza and Kung bushmen of Africa, for example, fail to get meat more than half the time when they venture forth with bows and arrows. This suggests it was even harder for our ancestors who didnt have these weapons. Everybody thinks you wander out into the savanna and there are antelopes everywhere, just waiting for you to bonk them on the head, says paleoanthropologist Alison Brooks of George Washington University, an expert on the Dobe Kung of Botswana. No one eats meat all that often, except in the Arctic, where Inuit and other groups traditionally got as much as 99 percent of their calories from seals, narwhals, and fish.

So how do hunter-gatherers get energy when theres no meat? It turns out that man the hunter is backed up by woman the forager, who, with some help from children, provides more calories during difficult times. When meat, fruit, or honey is scarce, foragers depend on fallback foods, says Brooks. The Hadza get almost 70 percent of their calories from plants. The Kung traditionally rely on tubers and mongongo nuts, the Aka and Baka Pygmies of the Congo River Basin on yams, the Tsimane and Yanomami Indians of the Amazon on plantains and manioc, the Australian Aboriginals on nut grass and water chestnuts.

Theres been a consistent story about hunting defining us and that meat made us human, says Amanda Henry, a paleobiologist at the Max Planck Institute for Evolutionary Anthropology in Leipzig. Frankly, I think that misses half of the story. They want meat, sure. But what they actually live on is plant foods. Whats more, she found starch granules from plants on fossil teeth and stone tools, which suggests humans may have been eating grains, as well as tubers, for at least 100,000 yearslong enough to have evolved the ability to tolerate them.

The notion that we stopped evolving in the Paleolithic period simply isnt true. Our teeth, jaws, and faces have gotten smaller, and our DNA has changed since the invention of agriculture. Are humans still evolving? Yes! says geneticist Sarah Tishkoff of the University of Pennsylvania.

One striking piece of evidence is lactose tolerance. All humans digest mothers milk as infants, but until cattle began being domesticated 10,000 years ago, weaned children no longer needed to digest milk. As a result, they stopped making the enzyme lactase, which breaks down the lactose into simple sugars. After humans began herding cattle, it became tremendously advantageous to digest milk, and lactose tolerance evolved independently among cattle herders in Europe, the Middle East, and Africa. Groups not dependent on cattle, such as the Chinese and Thai, the Pima Indians of the American Southwest, and the Bantu of West Africa, remain lactose intolerant.

Humans also vary in their ability to extract sugars from starchy foods as they chew them, depending on how many copies of a certain gene they inherit. Populations that traditionally ate more starchy foods, such as the Hadza, have more copies of the gene than the Yakut meat-eaters of Siberia, and their saliva helps break down starches before the food reaches their stomachs.

These examples suggest a twist on You are what you eat. More accurately, you are what your ancestors ate. There is tremendous variation in what foods humans can thrive on, depending on genetic inheritance. Traditional diets today include the vegetarian regimen of Indias Jains, the meat-intensive fare of Inuit, and the fish-heavy diet of Malaysias Bajau people. The Nochmani of the Nicobar Islands off the coast of India get by on protein from insects. What makes us human is our ability to find a meal in virtually any environment, says the Tsimane study co-leader Leonard.

Studies suggest that indigenous groups get into trouble when they abandon their traditional diets and active lifestyles for Western living. Diabetes was virtually unknown, for instance, among the Maya of Central America until the 1950s. As theyve switched to a Western diet high in sugars, the rate of diabetes has skyrocketed. Siberian nomads such as the Evenk reindeer herders and the Yakut ate diets heavy in meat, yet they had almost no heart disease until after the fall of the Soviet Union, when many settled in towns and began eating market foods. Today about half the Yakut living in villages are overweight, and almost a third have hypertension, says Leonard. And Tsimane people who eat market foods are more prone to diabetes than those who still rely on hunting and gathering.

For those of us whose ancestors were adapted to plant-based dietsand who have desk jobsit might be best not to eat as much meat as the Yakut. Recent studies confirm older findings that although humans have eaten red meat for two million years, heavy consumption increases atherosclerosis and cancer in most populationsand the culprit isnt just saturated fat or cholesterol. Our gut bacteria digest a nutrient in meat called L-carnitine. In one mouse study, digestion of L-carnitine boosted artery-clogging plaque. Research also has shown that the human immune system attacks a sugar in red meat thats called Neu5Gc, causing inflammation thats low level in the young but that eventually could cause cancer. Red meat is great, if you want to live to 45, says Ajit Varki of the University of California, San Diego, lead author of the Neu5Gc study.

Many paleoanthropologists say that although advocates of the modern Paleolithic diet urge us to stay away from unhealthy processed foods, the diets heavy focus on meat doesnt replicate the diversity of foods that our ancestors ateor take into account the active lifestyles that protected them from heart disease and diabetes. What bothers a lot of paleoanthropologists is that we actually didnt have just one caveman diet, says Leslie Aiello, president of the Wenner-Gren Foundation for Anthropological Research in New York City. The human diet goes back at least two million years. We had a lot of cavemen out there.

In other words, there is no one ideal human diet. Aiello and Leonard say the real hallmark of being human isnt our taste for meat but our ability to adapt to many habitatsand to be able to combine many different foods to create many healthy diets. Unfortunately the modern Western diet does not appear to be one of them.

The Bajau of Malaysia fish and dive for almost everything they eat. Some live in houses on the beach or on stilts; others have no homes but their boats.

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The latest clue as to why our modern diet may be making us sick comes from Harvard primatologist Richard Wrangham, who argues that the biggest revolution in the human diet came not when we started to eat meat but when we learned to cook. Our human ancestors who began cooking sometime between 1.8 million and 400,000 years ago probably had more children who thrived, Wrangham says. Pounding and heating food predigests it, so our guts spend less energy breaking it down, absorb more than if the food were raw, and thus extract more fuel for our brains. Cooking produces soft, energy-rich foods, says Wrangham. Today we cant survive on raw, unprocessed food alone, he says. We have evolved to depend upon cooked food.

To test his ideas, Wrangham and his students fed raw and cooked food to rats and mice. When I visited Wranghams lab at Harvard, his then graduate student, Rachel Carmody, opened the door of a small refrigerator to show me plastic bags filled with meat and sweet potatoes, some raw and some cooked. Mice raised on cooked foods gained 15 to 40 percent more weight than mice raised only on raw food.

If Wrangham is right, cooking not only gave early humans the energy they needed to build bigger brains but also helped them get more calories from food so that they could gain weight. In the modern context the flip side of his hypothesis is that we may be victims of our own success. We have gotten so good at processing foods that for the first time in human evolution, many humans are getting more calories than they burn in a day. Rough breads have given way to Twinkies, apples to apple juice, he writes. We need to become more aware of the calorie-raising consequences of a highly processed diet.

Its this shift to processed foods, taking place all over the world, thats contributing to a rising epidemic of obesity and related diseases. If most of the world ate more local fruits and vegetables, a little meat, fish, and some whole grains (as in the highly touted Mediterranean diet), and exercised an hour a day, that would be good news for our healthand for the planet.

The Kyrgyz of the Pamir Mountains in northern Afghanistan live at a high altitude where no crops grow. Survival depends on the animals that they milk, butcher, and barter.

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On my last afternoon visiting the Tsimane in Anachere, one of Deonicio Nates daughters, Albania, 13, tells us that her father and half-brother Alberto, 16, are back from hunting and that theyve got something. We follow her to the cooking hut and smell the animals before we see themthree raccoonlike coatis have been laid across the fire, fur and all. As the fire singes the coatis striped pelts, Albania and her sister, Emiliana, 12, scrape off fur until the animals flesh is bare. Then they take the carcasses to a stream to clean and prepare them for roasting.

Nates wives are cleaning two armadillos as well, preparing to cook them in a stew with shredded plantains. Nate sits by the fire, describing a good days hunt. First he shot the armadillos as they napped by a stream. Then his dog spotted a pack of coatis and chased them, killing two as the rest darted up a tree. Alberto fired his shotgun but missed. He fired again and hit a coati. Three coatis and two armadillos were enough, so father and son packed up and headed home.

As family members enjoy the feast, I watch their little boy, Alfonso, who had been sick all week. He is dancing around the fire, happily chewing on a cooked piece of coati tail. Nate looks pleased. Tonight in Anachere, far from the diet debates, there is meat, and that is good.

The people of Crete, the largest of the Greek islands, eat a rich variety of foods drawn from their groves and farms and the sea. They lived on a so-called Mediterranean diet long before it became a fad.

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Ann Gibbons is the author of The First Human: The Race to Discover Our Earliest Ancestors. Matthieu Paley photographed Afghanistans Kyrgyz for our February 2013 issue.

The magazine thanks The Rockefeller Foundation and members of the National Geographic Society for their generous support of this series of articles.

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The Evolution of Diet - National Geographic

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Oct 14th, 2022 | Filed under Diet Effectively
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