A recent study published in Food Technology reports that Americans are too busy to make time for nutrition. The irony is that the busiest bodies absolutely need proper nutrition to maintain their on-the-go lifestyles.

With statistics like these, it's difficult to believe that Americans are receiving adequate nutrition in their daily diets. America is certainly a busy place, but those who must resort to a take-out menu more often than they would like don't have to sacrifice their health and nutrition for mere convenience.

Among the excuses Americans give for neglecting their health and opting for faster food options, the one that tops the list has to be, "I don't have time to eat well." When Nancy Clark, MS, RD, an international sports nutritionist and nutrition author, hears this from patients, she such as work, study or exercise instead of eat [well]."² Clark doesn't urge patients to choose their health and the care of their bodies over work, study or exercise; instead, the idea is that proper nutrition is more than worthy of their time. After all, without a healthy body, no one can keep up with the daily hustle and bustle for long.

Start Simple

When we're hungry, we eat. The equation seems simple enough, but unfortunately, Americans don't exist in a vacuum. In this country, where a new fad diet is born each week and new potential causes of cancer, heart disease, and diabetes are uncovered every day, the simplicity that once was becomes cluttered with variables that make the pursuit of health and wellness as complex as quantum physics. If dwelled upon, these variables tend to polarize attitudes toward foods, creating categories of "good" and "bad" that then go on to affect how people feel about certain foods.³

"Twenty-two percent of restaurant meals, which most often consisted of hamburgers and French fries were purchased from a car in 2005. And coffee was the top breakfast food! With statistics like these, it's difficult to believe that Americans are receiving adequate nutrition in their daily diets."

If Americans claim they "don't have time" to choose fresh foods over fried, for example, they certainly don't have time to consider all the clutter in their lives. And the truth is, the equation really is simple: Hunger is a signal that the body needs nutrients,³ not an annoyance to be ignored or lessened with whatever pre-made, processed items are nearby. An infant's cry is an indication of an unarticulated need. Parents don't use earplugs or cover the child's mouth to lessen the noise; they see to it that the child's needs – whether food, drink or sleep – are met. Adults ought to view their nutritional needs in the same way.

Dietary Guidelines

Last year, the U.S. Department of Agriculture (USDA), together with the U.S. Department of Health and Human Services, updated and reissued the Dietary Guidelines for Americans and food pyramid to help consumers choose adequate nutrients within their caloric or energy needs. The USDA offers a user-friendly, interactive Web site, www.mypyramid.gov, that includes a breakdown of the new dietary guidelines and food pyramid, tips and resources, and even "MyPyramid Tracker," which illustrates a link between good nutrition and regular physical activity by calculating a person's energy expended through exercise, and the energy taken in from food.⁴ Americans can take comfort in the fact that following the guidelines is different from diving into the next fad diet, because the guidelines emphasize consumption of appropriate foods and nutrients, instead of deprivation or avoidance of particular foods or food groups. The guidelines promote health consciousness, rather than obsession. Once your patients are informed about the recommended foods and nutrients, here are a few thoughts to pass along that will make their healthy food choices more gratifying.

Take Time to Taste Food and Feel Full

The rich tastes and smells of so many nutrient-rich foods offer ample reward for a person's health-driven efforts. However, without slowing down long enough to really taste a meal, it's impossible to enjoy it. Linda Feingold, MEd, MS, RD, a nutritionist and exercise physiologist in New York, urges her patients to sit down, make each mealtime a dining experience, and savor each bite of food.⁵ It makes nutrition, which might otherwise seem tedious, much more exciting.

Feingold also stresses the importance of taking at least 20 minutes to enjoy food, which helps her patients avoid overeating. "It takes about [20 minutes] for your brain to receive signals from the stomach that you have ingested a sufficient amount of energy and nutrition, and are no longer hungry. Taking fewer than 20 minutes to eat may make you feel pressured to inhale anything and everything you can."⁵ And because today's food portions are so large, the likelihood that rushed eaters will take in more than they can comfortably digest is quite high.

Armor for the Drive-Thru

Despite a fresh perspective and a plan to slow down for nutrition, the fact remains: Americans are still busy people. No one, not even the USDA, can expect those who follow the new dietary guidelines to abstain from fast food altogether – nor does anyone have to. It is possible to make nutrition a priority when dining out. Again, time is key! Taking time to look over a menu, skipping "the usual" for healthier fare, and adding variety to daily meals can help keep your patients on track nutritionally. It seems America is already making wiser decisions at the drive-thru. In 2004, diet soft drinks, main-dish salads, bottled water, milk, and fruit made the top 10 list of restaurants' fastest-growing orders, joining burgers, fries, coffee and chicken sandwiches. In 2005, main and side-dish salads were among the top 10 foods ordered by men, women and young adults.¹ Feingold encourages her patients to start the day with meals in mind, "If you don't plan out when and what you'll be eating throughout the day, you are setting yourself up for disaster."⁵

Popular Fast-Food Items Ordered in 2005
	McDonald's		Carl's Jr.		Jack in the Box		Pizza Hut
	Big Mac®	French Fries (lg.)	Super Star® w/cheese	CrissCut Fries® (lg.)	Jumbo Jack® w/ cheese	Seasoned Curly Fries (lg.)	Pepperoni Lover's® Pizza (2 slices)	Meat Lover's® Pizza (2 slices)
Calories	560	520	920	410	686	550	560	560
Fat (g)	30	25	57	24	41	31	26	26
Fiber (g)	3	7	3	4	2	6	4	4
Protein (g)	25	6	48	5	23	8	28	28

Healthier Options Available on the Same Menus
	McDonald's		Carl's Jr.		Jack in the Box		Pizza Hut
	Grilled Chicken Classic Sandwich	Cobb Salad w/ Grilled Chicken*	Charbroiled BBQ Chicken Sandwich	Charbroiled Chicken Salad-To-Go*	Chicken Fajita Pita	Asian Chicken Salad*	Fit n' Delicious Veggie Pizza (2 slices)	Spaghetti w/ Marinara Sauce
Calories	420	280	370	330	300	140	260	490
Fat (g)	9	11	4	7	10	1	7	8
Fiber (g)	3	4	4	5	3	5	2	10
Protein (g)	32	35	35	34	23	14	10	14
*Nutritional data is for a salad without any dressing. (Low-fat and nonfat dressings are available for all salads listed.)

For mealtime guidance, The Mississippi Department of Health Web site offers a fairly exhaustive list of tips to help fast-food frequenters make wise food choices away from home. A few hints for those in a hurry include:

• Order the regular or kid-sized portion. Mega-sized servings are more than anyone needs.
• Boost the nutrients in all kinds of sandwiches by adding tomato, peppers and other vegetables.
• Go easy on condiments, special sauces and dressings on sandwiches and salads. Ask for mustard, catsup, salsa, or low-fat spreads and dressings.
• A baked potato offers more fiber and fewer calories than French fries; just tell your patients to go easy on the sour cream and butter. The potato can be topped with broccoli, a small amount of cheese, or salsa.

Making Progress

Despite many startling statistics, the January 2006 Food Technology report did include some admittedly encouraging details. After a 14-year slump, fresh fruit consumption has risen by 4 percent since 2002, with young adults ages 18-37 and those with children under age 6 posting the largest gains in fruit intake last year.¹ And apparently, Americans are paying more attention to portion control: 61 percent say simply that they are motivated to cut back on the amount of food they eat, and 62 percent of consumers feel that there are not enough small portions in restaurants. Moreover, full-service and fast-casual restaurants have seen a continual drop in appetizer and dessert sales over the past four years.

Many popular fast-food restaurants are getting wise to these healthy trends. The same menus that offer double cheeseburgers, deep fried chicken nuggets, and pepperoni pizza, also include more nutritional meal-time options – if you choose to look for them. At the risk of frightening patients, it's important that they know what they are putting in their bodies. The truth might even provide a little motivation.

Often, healthy menu options are far less aggressively marketed than the fat-laden favorites. The healthy menu items contain less fat and fewer calories, are packed with protein, and share the same menu with some of the "old standbys." Compare the charts above.

More extensive nutritional information for these and other menu items are readily available on the listed restaurants' Web sites. Your patients can better plan the meals they will be eating throughout the day if they are familiar with their options before visiting their favorite or most-frequented restaurants. Clearly, America isn't slowing down, and the days aren't getting any longer. But with education and increased awareness, there's no excuse for your patients and their families not making time for nutrition.

Written by Julie Engebretson