It’s apples and pears

"People who carry extra weight around the midsection — abdomen and chest — are often called apple-shaped. When you have extra weight in these areas, it is linked with health problems such as coronary artery disease, diabetes, stroke, high blood pressure and gall bladder disease," says Lisa Grudzielanek, dietitian with Wheaton Franciscan’s Medical Weight Loss Program, Healthy Way.

The apple body shape is predominantly a male phenomenon; but women are prone to develop the shape in mid-life, particularly after menopause. At that point, female hormones are present in much smaller amounts. This body type is also more susceptible to the so-called "metabolic syndrome," which is characterized by a group of metabolic diseases such as high cholesterol, high blood pressure and diabetes.

Happy heart

"I tend to recommend the American Heart Association’s Heart Healthy Diet, which is low in saturated fat and sodium. There is more and more evidence that it is a generally healthy diet for everybody," says Jennifer Motl, clinical dietitian with Columbia St. Mary’s Hospitals. "If a person has diabetes, we take it one step further and modify the diet by dividing the carbohydrates throughout the day," she says.

Those with a pear shape may not be at the same type of risk for disease. "We don’t tend to get as worried when we see extra weight around the hip and thigh area because it is somewhat normal for fat pockets to develop in those areas in women. You don’t see too many pear-shaped men," Grudzielanek says. "A lower fat diet is still a good idea or the pear shape can become an apple."

DASH to diet

Motl recommends the DASH (Dietary Approaches to Stop Hypertension) eating plan, which is recommended by the National Institutes of Health for lowering blood pressure. "The DASH plan favors fruits, vegetables, whole grains, low-fat milk and plant-based protein over meat," she says. "Research has shown that this kind of diet can help prevent high blood pressure and cholesterol, both of which lead to heart attacks."

Now, there’s even more reason to follow the DASH eating plan. Results of a study released this past April that followed more than 88,000 healthy women for almost 25 years shows those who maintained the best health had eating habits similar to those recommended by the DASH eating plan. And, although the study only followed women, men would probably get similar benefits, according to experts. For more on the DASH Diet, go to www.nhlbi.nih.gov/hbp/prevent/h-eating/h-e-dash.htm.

Thinking ahead

Despite all of the solid data backing them up, nutritionists still face obstacles in their quest to get people to eat healthy. "People often think that it is too expensive to eat well, but that doesn’t have to be true," Motl says. "Fresh fruits and vegetables probably don’t cost as much as some processed frozen foods if you eat what’s in season and look for sales."

Another common complaint is the time factor involved in preparing fresh foods. "People are busy and whole foods can take a little more time to prepare, but they are so much better for you. If you can learn to plan your menus and prepare some things ahead of time, you will be much better off," Motl says.

The biggest problem is simply convincing people that they need to eat better for a better life. "People might think, ‘I don’t have high blood pressure, so I don’t have to follow this diet,’ but even healthy people should be on a healthy diet," Motl says.

What’s your type?

If you aren’t sure about your body type, your waist-to-hip ratio will tell you if you are pear-shaped, apple-shaped or avocado-shaped, which is somewhere in between the apple and pear. There are several sites on the Internet that can calculate it for you, such as www.healthcalculators.org/calculators/waist_hip.asp. Use a measuring tape to measure your waist and hips, plug in the numbers and the online calculator will figure your ratio.

"A waist-to-hip ratio of around 0.80 or more seems to indicate a greater chance of getting coronary disease," Grudzielanek says. This is based on the Nurses Health Study, which involved 45,000 women aged 40 to 65. The study revealed a remarkable link between waist-to-hip ratios and serious health problems. For example, if you’re under the age of 60 and your ratio is between 0.76 and 0.88, you have more than twice the chance of getting coronary disease as women whose ratios are 0.72 and less. Over 60, the risk falls to about one-and-one-half times that of women with a ratio of 0.72 and less.

Balanced meals

Motl offers this easy meal planning tip. "I encourage people to try and fill half their plate with non-starchy vegetables, one-quarter of the plate with lean protein and one-quarter starch. It’s balanced and tends to be pretty low calorie," she says.

Even healthy choices can be overdone, however. A little bit of a bad thing once in a while can keep someone on track when they have a craving, Motl says. "You can work in a small single serving of Cheetos once in a while. You have to honor those cravings," she says. "People perceive that as a much bigger barrier than it is."

"If you avoid processed foods, sweets and junk food and drink lots of water, you won’t have to restrict your eating," Grudzielanek says. Make exercise a regular part of your life in some way — walking, swimming, aerobics or whatever appeals to you. A greater emphasis on lifestyle changes can make the difference.

Five ‘super foods’

To be healthy, nutritionists recommend eating a variety of "super foods" that pack an extra punch in the fight against disease. "The specific foods tend to change a bit from time to time, but they tend to belong to the same categories, such as fish, leafy greens, grains and berries," says Lisa Grudzielanek, a registered dietician with Wheaton Franciscan’s Medical Weight Loss Program, Healthy Way. The following are some super food choices to add to your own diet.

1. Berries. "Berries like blueberries contain a lot of antioxidants that work to reduce the buildup of ‘bad’ (LDL) cholesterol in artery walls that contributes to cardiovascular disease and stroke," Grudzielanek explains. Antioxidants also help neutralize harmful byproducts of metabolism called free radicals that can lead to cancer and other age-related diseases. One cup a day of blueberries, blackberries, black raspberries, black currants or red grapes should do it.

2. Fish. "Studies show that eating seafood rich in omega-3 fatty acids at least twice a week could reduce your risk of heart disease and some inflammatory diseases like arthritis," Motl says. However, recent reports indicate that people should avoid eating fish containing high levels of mercury, limiting albacore tuna to no more than 6 ounces in one week.

3. Soy protein — Soybeans, soy nuts, soy milk, energy bars, cereal or tofu. Rich in omega-3 fatty acids, protein, vitamins and minerals, soy protein is a good alternative for red meat. Soy protein is also lower in fat and higher in fiber than many meat choices. One ounce of soy protein per day is recommended.

4. Oatmeal. "Whole grains like oatmeal may prevent disease and help lower bad cholesterol," Motl says. One half-cup of oatmeal is desirable, but you can get your whole grains in other forms besides oatmeal, including whole grain breads and pastas.

5. Spinach. "It’s loaded with nutrients that can help prevent things like heart disease and cancer," Grudzielanek says. Other leafy greens like broccoli and kale are close seconds. A cup a day is perfect, and the deeper the color, the greater the benefits.