Departments Special Features — 18 April 2014
Reversing damage from years of poor eating

By Rebecca Cahilly

You’ve just celebrated the big 5-0, or 5-1, or 5-5. The candles have been blown out, the cake eaten, and suddenly words that previously went ignored – “coronary heart disease,” “stroke,” “fibromyalgia,” “diabetes,” “Crohn’s disease,” “arthritis” – have taken on new and very real meaning.

If you’re one of millions of Americans who have enjoyed a moderately sedentary lifestyle and less-than-healthy eating habits, these chronic conditions will be brought to your attention because they are likely connected to your lifestyle. Is it too late to reverse the effects of decades of poor choices? You will be happy to hear that changing course at any age will yield many more benefits than you think.

“It is never too late to begin healthier eating and lifestyle habits,” says Marilyn Gordon, registered dietitian and clinical assistant professor in the Department of Family Medicine at Nova Southeastern University.

Research indicates that changing poor eating habits mid-life can add as many as 14 years to one’s life. A five-year study by Dr. Dean Ornish published in The Journal of the American Medical Association (JAMA) in 1998 evaluated the effect of sustained positive lifestyle changes – without the involvement of lipid-lowering drugs – on the incidence of coronary heart disease.

The experimental group underwent an intensive program that included a 10 percent fat vegetarian diet, moderate aerobic exercise (walking), stress-management training, smoking cessation and group psychosocial support. These participants were encouraged to avoid simple sugars in favor of complex carbohydrates and other whole foods. After one year, the results were favorable and adherence to the new lifestyle was excellent, so the study continued for another four years.

Not only did the experimental group experience an average weight loss of 23.9 pounds by the end of year one, they sustained an average weight loss of 12.8 pounds after five years, whereas the control group participants’ average weight varied little from the program start. Cardiac events per patient in the control group were more than double those of the experimental group despite the prescription of lipid-lowering drugs to control group participants. The findings of this study supported the success of positive lifestyle changes in delaying, stopping and even reversing the progression of coronary artery disease over prolonged periods.

How to begin

Sitting down with a registered dietitian to discuss your concerns and formulate a plan for a diet and lifestyle change is a great step in the right direction. Start with achievable goals, says Ryann Smith, a nutrition therapist at The Renfrew Center in Coconut Creek.

“A simple place to start is to adopt this goal: Have a cup of fresh fruit or a cup of fresh vegetables with every meal,” she says. “This will increase your intake of fiber, vitamins and minerals, and it’s likely you will eat less processed foods because fruits and vegetables are filling.”

As president of the Julien Nutrition Institute in Aventura, nutritionist Ronni Litz Julien counsels parents on ways to instill healthy eating habits in their children.

“It is much easier to teach children healthy eating habits, but it is very possible to change habits at any age,” she says, adding that brain chemistry takes six to eight weeks to recognize a new habit.

When counseling adults and families on disease prevention and creating realistic nutrition lifestyle changes, Julien encourages clients to set reasonable goals.

“Be specific,” she says. “For example, ‘I will go one week without regular sodas’ or ‘I will go five days without excess snacking.’ ”

Gordon advises her clients to list the top five things they would like to change and to set a S.M.A.R.T. (specific, measurable, achievable, realistic and time-framed) goal for each change. If your goal is to eat less fast food for lunch, for example, bring your lunch to work from home three out of five days.

“The more specific the plan to change, the more likely someone will do it,” she says.

Gordon also recommends cleaning up your food environment to reflect the lifestyle change you desire.

“I can’t expect myself to stay out of the ice cream in the freezer if I just bought a fresh gallon. Do a pantry and fridge/freezer sweep,” she says. “Place the things that you want to be eating on the main shelves in the front. People usually become discouraged only because they set impossible or unrealistic goals. You can feel the difference with healthier eating within a few days.”

Where to shop,
what to buy, what to avoid

Adopting a healthy eating regime in no way means you have to start cruising health-food stores, foraging for seeds and enduring meals that are like chewing on the leg of a chair. Food that is good for you is the most natural and often the most delicious. Much of it is available at your local supermarket.

Emphasize unprocessed foods such as fruit, vegetables, lean protein and whole grains. Make sure you look for meat and dairy products that are hormone, additive and preservative free.

Read the label. “Organic” is always a good place to start, from fruits, vegetables and legumes to nuts, whole grains and animal proteins free of hormones and antibiotics. While not everything you purchase needs to be organic, there are 13 food items that should be purchased organic wherever possible: apples, dairy (beware of UHT or ultra pasteurized organic milk), strawberries, grapes, celery, peaches, spinach, bell peppers, nectarines, cucumbers, potatoes, cherry tomatoes and leafy greens.

The most important thing is to have fun with your new eating lifestyle. Visit a local farmer’s market on the weekend or sign up for an organic co-op and enjoy weekly or bi-weekly “mystery box” deliveries. These come with creative recipes, so you’ll soon find yourself cooking with food items you never would have thought to purchase at the grocery store.

“Now would also be the perfect time to take a raw-foods or vegetarian cooking class or a college-level nutrition course either in person or online,” Gordon suggests.

Be Active


aking the right lifestyle change isn’t only about diet modification.

“You must be willing to have a regular exercise program,” Litz says. “This is probably 60 to 70 percent of the emphasis, particularly after age 50.”

Keeping a record of calories, carbs and sugar intake will aid diet, and apps like, or are useful tools.”

“You’re never too old to start exercising,” says Dr. Sandra Frank, a South Florida dietitian nutritionist. “I belong to the SilverSneakers group, and I’m the baby at my gym.”

SilverSneakers ( is a benefit offered to members of many Medicare plans that cover gym or health-club membership.

“When it comes to exercising,” says Frank, “check with your doctor first and then go for it.”

Begin making simple lifestyle changes now, and by next year’s birthday you just might surprise yourself at how active, energetic and healthier you’ve become.

The study to prove it


s a disease that affects more than 20 million Americans, Type 2 diabetes is the most common form of diabetes. Environmental and genetic factors contribute to this disease, but obesity and lack of physical activity are the most common reasons Type 2 diabetes develops in those prone to it.

Diabetes had historically been considered a chronic, progressive and incurable condition, but research has shown that lifestyle changes in the form of diet and exercise can lead to remission and even eliminate the need for medication in some instances.

Research published in JAMA in 2012 analyzed data from the Look AHEAD (Action for Health for Diabetes) trial, which was originally intended to study the effects of long-term weight loss on the incidence of cardiovascular disease in individuals living with Type 2 diabetes.

Participants in the intensive lifestyle-based weight-loss intervention were asked to reduce their caloric intake to between 1,200 and 1,800 calories per day, to reduce total and saturated fat intake and to increase physical activity levels to a goal of 175 minutes per week. After one year 11.5 percent of these participants experienced diabetes remission – blood glucose levels returned either to pre-diabetes or non-diabetic levels – compared to only 2 percent of the control group participants who were asked not to change lifestyle but to attend three diabetes counseling sessions.



A report analyzing the results of studies on the prevention of cardiovascular disease (CVD) by Frank B. Hu published in The American Journal of Clinical Nutrition in 2003 determined that high consumption of plant-based foods such as fruits, vegetables, nuts and whole grains is associated with a significantly lower risk of coronary artery disease and stroke. The study also noted that while decades of research on the benefits of plant-based foods and eating patterns has pointed to CVD prevention, it has also uncovered that foods once deemed unhealthy due to their fat content – nuts, for example – are in fact important components of diets designed to lower blood pressure and cholesterol and control weight.

According to the study: “Although the conventional wisdom holds that a low-fat diet would reduce body weight, long-term clinical trials have provided no convincing evidence that reducing dietary fat can lead to substantial weight loss. Such absence of evidence, combined with the dramatic increase in the prevalence of obesity in the United States despite a decrease in percentage of energy from fat, leads us to believe that too much emphasis on reducing dietary fat as an effort to prevent obesity and CVD may have been counterproductive.”

So before you reach for the fat-free salad dressing, consider oil and vinegar with herbs as an alternative. You’ll enjoy the benefits of essential fatty acids as well as the taste.


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