Food Frauds That Can Wreck Your Diet

Food Fraud: Caesar Salad

Some foods that we think are healthy can be sneaky little diet wreckers. University of Pittsburgh nutritionist Leslie Bonci, MPH, RD, shares a few of these "food frauds," starting with Caesar salad. Just a small bowl has 300-400 calories and 30 grams of fat, thanks to loads of dressing.

Food Fix: Use only 1 Tbs. dressing and 2 Tbs. tangy, Parmesan cheese.

Food Fraud: Fresh Smoothies

That "healthy" berry blend at a smoothie shop can have a whopping 80 grams of sugar, 350 calories, no protein, and often, no fresh fruit. Fruit "concentrates" are often used instead of fresh fruit. And sorbet, ice cream, and sweeteners can make these no better than a milkshake.

Food Fix: Get the "small" cup. Ask for fresh fruit, low-fat yogurt, milk, or protein powder to blend in good nutrition

Food Fraud: Energy Bars

Many of these are simply enhanced candy bars with more calories (up to 500) and a higher price tag. Their compact size also leaves many people unsatisfied. "Three bites and it's gone," says Bonci, who advises hungry athletes and dancers.

Food Fix: Choose bars that have 200 calories or less, at least 5 grams of fiber, and some protein, which helps provide energy when the sugar rush fades.

Food Fraud: Chicken Burrito

With healthy beans and no red meat, what's the problem? About 1,000 calories and plenty of saturated fat. Cheese, sour cream, and the fat in the jumbo flour tortilla all contribute. And when the burrito is as big as your forearm, the serving is just too big.

Food Fix: Share one. Or try a soft taco with fajita-style grilled meats and veggies on a corn tortilla with tasty low-calorie salsa.

Food Fraud? A Sugar-Free Dilemma

Sugar-free foods sound like a no-brainer for weight loss. But a problem arises when we choose an artificially sweetened food or drink, then feel that we deserve a large order of fries or a jumbo dessert. Upsizing the fries adds nearly 300 calories to your meal. If your calorie intake exceeds what you burn off, you'll still gain weight -- and you can't blame the sugar-free foods.

Food Fix: Watch your total calorie intake..

Food Fraud: Enhanced Water

Vitamins are commonly added to bottled water and advertised on the front label. But some brands also add sugar, taking water from zero calories to as much as 125. "Often the vitamins don't contribute much," Bonci says, "but the calories can contribute a lot."

Food Fix: Refrigerating tap water may make it more appealing to family members. Or try packets of crystallized lemon to add flavor without calories.

Food Fraud: 2% Milk

Two percent milk sounds healthier than "whole" milk. But it still has more than half the saturated fat of whole milk. Here's what's in a cup of milk:

Whole Milk (3.25%) = 150 cal., 8g fat, 5g sat. fat
Reduced-fat (2%) = 130 cal., 5g fat, 3g sat. fat
Skim (nonfat) = 80 cal., 0g fat, 0g sat. fat

Food Fix: If you like whole milk, blend it with 2% for a while, then 1%, then skim, until you get used to the taste of nonfat milk.

Food Fraud: 2% Milk Latte

It's tempting to choose "reduced-fat" milk in a latte and reward yourself with whipped cream on top. Sadly, this trade-off still adds up to 580 calories and 15 grams of saturated fat in a 20 ounce white chocolate mocha. That's worse than a quarter-pound burger with cheese.

Food Fix: A sweetened, frothy beverage is a diet splurge. Limit the damage with nonfat (skim) milk and no whipped cream. You'll avoid 130 calories and two-thirds of the bad fat.

Food Fraud: Turkey Hot Dogs

The nutritional content of turkey hot dogs varies from brand to brand -- and some are real turkeys when it comes to health. It may say "less fat" on the front label, but when you check the fine print on the back, you find there's still plenty of fat left in each sausage.

Food Fix: Compare nutrition labels for the lowest fat content; there are some really good choices now available. Or only eat them a few times a year.

Food Fraud: Breakfast Muffins

Muffins masquerade as a healthy choice for breakfast. They beat doughnuts, they're still mainly sugary little cakes of refined flour. One store-bought muffin can hit 500 calories with 11 teaspoons of sugar.

Food Fix: Go no larger than 2 1/2 inches in diameter. Or look for 100-calorie muffins at the store. They limit calories, and some brands are a surprisingly good source of whole grains and fiber.

Food Fraud: Low-Fat Granola

The low-fat version of this crunchy cereal has only 10% fewer calories and is still full of sugar. Plus, the low-fat label can easily lead you to overeat. A study at Cornell University found that people ate 49% more granola when they thought it was low fat -- easily blowing past the measly 10% calorie savings.

Food Fix: Look for low-sugar, whole-grain cereal, and sweeten it with fresh fruit.

Food Fraud: Low-Fat Yogurt

Too often this nutritional superstar � rich in protein and calcium � contains shocking amounts of added sugar. Some brands add 30 or more grams of fructose, sucrose, or other sweeteners.

Food Fix: Six ounces should be 90-130 calories and under 20 grams of sugar. Avoid sugary "fruit on the bottom," or blend sweetened yogurt with plain, nonfat yogurt.

Food Fraud: Multigrain

When you see "multigrain" or "seven grain" on bread, pasta, or waffles, flip the package over and check the nutrition label. Even with more than one type of grain, the product could be made largely from refined grains � such as white flour � which have been stripped of fiber and many nutrients.

Food Fix: Look for "100% whole grain" as the first ingredient. Or choose the brand with more fiber.

Food Fraud: Light Olive Oil

Anything labeled "light" is enticing when you're watching your weight. But often the food is not what you expect. Light olive oil, for instance, has the same calorie and fat content as other types � it's just lighter in color and taste.

Food Fix: Some light foods do provide significant calorie savings. Compare the labels in the store.

Food Fraud: Added Omega-3

Some yogurt, milk, eggs, cereal, and other foods boast of added omega-3. But most don't contain the kinds of omega-3 best known to help your heart � EPA and DHA. Or there's only a smidgen � about as much as in one bite of salmon. Instead, they contain ALA from vegetable sources. It's not clear if omega-3 from ALA is as beneficial as DHA/EPA.

Food Fix: Try 6 ounces of salmon. It has 100 times more omega-3 than is in a serving of fortified yogurt. Vegetarians could consider algae-derived omega-3 supplements.

Food Fraud: Iced Tea

The antioxidants in iced tea don't make it a health food. Too much added sugar can turn a tall glass into a health hazard. A 20-ounce bottle can have more than 200 calories and 59 grams of sugar.

Food Fix: Skip "sweet tea" in favor of unsweetened iced tea. Lemon or artificial sweeteners add zing without calories. Herbal and berry teas taste mildly sweet without sugar.

Food Fraud: Microwave Popcorn

The word "snack" can be a little misleading on microwave popcorn. One popular brand packs 9 grams of bad fat, including 6 grams of trans fat, into each "snack size" bag.

Food Fix: Compare nutrition labels and get a lower-fat popcorn that has no trans fat at all. Sprinkle with Parmesan cheese or low-salt spice blends for added flavor without a lot of fat.

Food Fraud: Iceberg Lettuce

This popular lettuce is big on crunch but a big "zero" when it comes to vitamins and flavor. And its boring taste leads many people to overdo it on the dressing.

Food Fix: Add spinach or arugula to the mix. Crumble 2 tablespoons (100 calories) of blue cheese or feta on top. Then splash the salad with a little oil and vinegar to spread flavor without a lot of calories.

Food Fraud: Salty Toppings

Processed artichoke hearts, chickpeas, and olives are just a few of the salt shockers lurking on the salad bar. To avoid an unhealthy amount of sodium, limit anything that comes out of a can. Also pass up cured meats. Choose beans or tuna, but not both.

Food Fix: Radishes, bell peppers, cucumbers, and other fresh vegetables are low in sodium. Rinse canned beans to remove a lot of the salt.

Food Fraud: Cole Slaw

Cabbage can be dandy for weight loss, but cole slaw can be a diet disaster. At one popular restaurant, a small cup (4.5 ounces) has 260 calories and 21 grams of fat � a third of most people's daily limit � thanks to copious mayonnaise.

Food Fix: Some places make a healthier slaw, so ask for nutrition information. At home, try low-fat mayonnaise or mix with nonfat yogurt.

Food Fraud: A Little Trans Fat

One cinnamon roll can have 2 grams of trans fat � hitting the daily limit for this unhealthy type of fat before you have the second one. Pastries, cookies, and crackers often contain trans fat � and have ridiculously small serving sizes. And in a trick of labeling, less than 0.5 grams per serving can be labeled "trans-fat free." Eating too many servings may add up to too much trans fat when you think you're not getting any.

Food Fix: Check the back label for trans fat per serving. Don't eat out of the bag or box. Doing so leads to overeating.

Food Fraud: Banana Chips

Deep-fried bananas are probably not what the doctor envisioned when she told you to eat more fruits and veggies. These don't look greasy, but just one ounce has 145 calories, 9 grams of fat, and 8 grams of saturated fat � about the same as a fast food hamburger.

Food Fix: Try a fresh banana: four times more food, 0 grams of fat, all for about 100 calories.

Food Fraud: Cracker Sandwiches

Some cracker sandwiches now say "whole grain" � a step in the right direction. But what you see on the front label may be only a tiny portion of what you eat. When a whole grain does not appear in the first three ingredients, there's not much of it. "Wheat flour" is usually just a different name for refined, white flour � a name intended to sound healthier than it is and fool customers.

Food Fix: Limit portions. Or keep a low-fat cracker like a crisp bread and peanut butter in your desk drawer.

Photos of the Best and Worst

Sorting Out the Healthiest Options

While plenty of high-fat and high-calorie breakfast choices abound at fast-food restaurants, most chains offer at least one or two items that are healthier. Here are some of the worst menu items at several major chains and suggested substitutes to consider if you find yourself at the drive-through. WebMD doesn't endorse these "better bets"; some still may be too high in sodium or calories for your diet.

McDonald's: Worst Choices

Pass on the Deluxe Breakfast with a regular or large biscuit and the Big Breakfast because they can set you back a minimum of 790 calories, 51 g fat, and 18 g saturated fat.

McDonald's: Better Bet

Your better alternative under the golden arches is the Egg McMuffin (300 calories, 12 g fat, 5 g saturated fat, 2 g fiber, 820 mg sodium). To help make the healthiest choices at McDonald's or any other fast-food chain, ask for a nutrition information brochure at the counter or check out the web site. Look for items that contain some fiber and protein that will keep you feeling satisfied for hours and don't have too much sugar, sodium, or saturated or total fat.

Burger King: Worst Choice

Skip the Enormous Omelet Sandwich (730 calories, 45 g fat, 16 g saturated fat, and 1,949 mg sodium) containing an omelet on a specialty bun topped with bacon, sausage, and cheese -- a high-calorie, high-fat, high-sodium sandwich containing almost a day's worth of fat and sodium.

Burger King: Better Bet

Choose the Ham Omelet Sandwich (290 calories, 13 g fat, 4.5 g saturated fat, 870 mg sodium, and 1 g fiber) for a breakfast that will help keep you feeling full until lunch.

Jack in the Box: Worst Choice

Even though it sounds healthy, the Sirloin Steak & Egg Burrito with Fire Roasted Tomato Salsa has a whopping 790 calories, 48 g fat, and 5 g saturated fat along with 6 g fiber.

Jack in the Box: Better Bets

Take your pick and enjoy a Breakfast Jack (290 calories, 12 g fat, 4.5 g saturated fat, 760 mg sodium and 1 g fiber) sandwich with a slice of ham, cheese and an egg, or for a few more fat calories, make it a Bacon Breakfast Jack (300 calories, 14 g fat, 5 g saturated fat, 728 mg sodium, and 1 g fiber).

Skip Carl's Junior for Breakfast

French Toast Dips with syrup are the better bet but hardly healthy. Worst bets include the Breakfast Burger loaded with a burger, egg, bacon, cheese, and hash brown nuggets (830 calories, 47 g fat, 15 g saturated fat, 1,580 mg sodium, and 3 g fiber) or the hard-to-hold Loaded Breakfast Burrito bursting with scrambled eggs, sausage, bacon, 2 cheeses, and salsa wrapped in a tortilla (820 calories, 51 g fat, 16 g saturated fat, 1,530 mg sodium, and 2 grams fiber).

Dunkin' Donuts: Worst Choices

Stay away from the decadent, more like over-the-top desserts, Triple Chocolate Muffin (660 calories, 33 g fat, 7 g saturated fat, 4 g fiber) or Peanut Butter Cup Cookie (590 calories, 29 g fat, 13 g saturated fat, and 3 g fiber).

Dunkin' Donuts: Better Bets

Pair your favorite coffee with a wheat bagel (330 calories, 4 g fat, 1 g saturated fat, 12 g protein, 4 g fiber) or a multigrain bagel (380 calories, 6 g fat, 1 g saturated fat, 14 g protein, 5 g fiber) high in satisfying fiber and protein that will keep you going strong. Or eat half of a high-fiber Honey Bran Raisin Muffin.

Starbucks: Worst Choices

Worst bets on the Starbucks menu include pretty much all the other high-fat, high-sugar options that won't keep you full until lunch. This includes Starbucks Classic Coffee Cake (570 calories, 28 g fat, 10 g sat fat, 7 g protein).

Starbucks: Better Bets

Starbucks is a popular morning stop for coffee and a quick treat. Breakfast items vary by region, featuring both indulgent and healthy choices. Better bets include the Spinach Roasted Tomato, Feta & Egg Wrap (240 calories, 10 g fat, 3.5 g saturated fat, 13 g protein, 7 g fiber), the fruit and cheese platter, and any of the low-fat bran muffins, scones, and coffee cake.

Subway: Worst Choice

You won't lose weight if you opt for our pick for the worst choice, the 6 inch Chipotle Steak & Cheese Breakfast Sandwich (600 calories, 32 g fat, 11 g saturated fat, 1,470 mg sodium, 6 g fiber).

Subway: Better Bets

Enjoy a Cheese Breakfast Sandwich (410 calories, 18 g fat, 8 g saturated fat, 23 g protein, 1,010 mg sodium, 5 g fiber) on a 6 inch whole grain roll piled high with veggies for a healthy high-protein, high-fiber portable meal.

Benefits of a Healthy Morning Meal

Breakfast really is the most important meal of the day -- it gives you energy to start the day and is linked to many health benefits. Studies show that eating a healthy breakfast can help give you a nutritionally complete diet, higher in nutrients, vitamins, and minerals; better weight control; improved concentration and performance in the classroom or the boardroom; more strength and energy to engage in physical activity; and lower cholesterol levels.

Bottom Line on Breakfast

If you find yourself at a fast-food chain in the morning, always opt for the healthiest breakfast options, or eat a smaller portion and save the other half. You can eat out healthfully, but nothing compares to the numerous breakfast options at home, from an egg and whole-wheat toast to a whole-grain breakfast parfait with fruit and yogurt. Short on time? Pack it the night before and take it along with you.

An Overview and Visual Guide to OA

Osteoarthritis: What Is It?

Also called "wear and tear" arthritis or degenerative joint disease, osteoarthritis (OA) is the progressive breakdown of the joints' natural shock absorbers. This can cause discomfort when you use the affected joints � perhaps an ache when you bend at the hips or knees, or sore fingers when you type. Most people over 60 have some degree of OA, but it also affects people in their 20s and 30s.

Osteoarthritis: Symptoms

The symptoms of osteoarthritis tend to develop slowly. You may notice pain or soreness when you move certain joints or when you've been inactive for a prolonged period. The affected joints may also be stiff or creaky. Typically, osteoarthritis leads to morning stiffness that resolves in 30 minutes. When osteoarthritis affects the hands, some people develop bony enlargements in the fingers, which may or may not cause pain.

Osteoarthritis: Where Does It Hurt?

In most cases, osteoarthritis develops in the weight-bearing joints of the knees, hips, or spine. It's also common in the fingers, thumb, neck, and big toe. Other joints are usually not affected, unless an injury is involved.

Osteoarthritis: What Causes It?

Every joint comes with a natural shock absorber in the form of cartilage. This firm, rubbery material cushions the ends of the bones and reduces friction in healthy joints. As we age, joints become stiffer and cartilage is more vulnerable to wear and tear. At the same time, repetitive use of the joints over the years irritates the cartilage. If it deteriorates enough, bone rubs against bone, causing pain and reducing range of motion.

Risk Factors You Can't Control

One of the major risk factors for osteoarthritis is something none of us can control � getting older. Gender also plays a role. Over age 50, more women than men develop osteoarthritis. In most cases, the condition results from normal wear and tear over the years. But some people have a genetic defect or joint abnormality that makes them more vulnerable.

Risk Factors You Can Control

Because injured joints are more vulnerable to osteoarthritis, doing anything that damages the joints can raise your risk. This includes sports that have a high rate of injury and jobs that require repetitive motion, such as bending the knees to install flooring. Obesity is another risk factor � it has been linked specifically to osteoarthritis of the knees and hips.

Impact on Daily Life

Osteoarthritis affects each person differently. Some people have few symptoms despite the deterioration of their joints. Others experience pain and stiffness that may interfere with daily activities. If bony knobs develop in the small joints of the fingers, tasks such as buttoning a shirt can become difficult. Osteoarthritis of the knees or hips can lead to a limp. And osteoarthritis of the spine can cause debilitating pain and/or numbness

Diagnosing Osteoarthritis

To help your doctor make an accurate diagnosis, you'll need to describe your symptoms in detail, including the location and frequency of any pain. Your doctor will examine the affected joints and may order X-rays or other imaging studies to see how much damage there is, and to rule out other joint conditions. In many cases, blood tests are used to rule out other forms of arthritis.

Long-Term Complications

Unlike rheumatoid arthritis, osteoarthritis does not affect the body's organs or cause illness. But it can lead to deformities that take a toll on mobility. Severe loss of cartilage in the knee joints can cause the knees to curve out, creating a bow-legged appearance (shown on the left). Bony spurs along the spine (shown on the right) can irritate nerves, leading to pain, numbness, or tingling in some parts of the body.

Treatment: Physical Therapy

There is no treatment to stop the erosion of cartilage in the joints, but there are ways to improve joint function. One of these is physical therapy to increase flexibility and strengthen the muscles around the affected joints. The therapist may also apply hot or cold therapies such as compresses to relieve pain.

Supportive Devices

Supportive devices, such as finger splints or knee braces, can reduce stress on the joints and ease pain. If walking is difficult, canes, crutches, or walkers may be helpful. People with osteoarthritis of the spine may benefit from switching to a firmer mattress and wearing a back brace or neck collar.

Medication for OA

When osteoarthritis flares up, many patients find relief with over-the-counter pain and anti-inflammatory medication, such as aspirin, ibuprofen, or acetaminophen. Pain-relieving creams or sprays can also help when applied directly to the sore area. If pain persists despite the use of pills or creams, your doctor may suggest an injection of steroids or hyaluronans directly into the joint.

Supplements

Overall studies suggest no benefits of glucosamine and chondroitin � supplements available at pharmacies and health food stores touted for relieving pain and stiffness for people with osteoarthritis. Check with your doctor before using chondroitin, especially if you take blood-thinners.

Osteoarthritis and Weight

If you're overweight, one of the most effective ways to relieve pain in the knee or hip joints is to shed a few pounds. Even modest weight loss has been shown to reduce symptoms of osteoarthritis by easing the strain on weight-bearing joints. Losing weight not only cuts down on pain, but may also reduce long-term joint damage.

Osteoarthritis and Exercise

People with osteoarthritis may avoid exercise out of concern that it will cause pain. But low-impact activities such as swimming, walking, or bicycling can improve mobility and increase strength. Training with light weights can help by strengthening the muscles that surround your joints. For example, strengthening the quadriceps can reduce pain in the knees. Ask your doctor or physical therapist which exercises are best for you.

Is Surgery for You?

If osteoarthritis interferes significantly with everyday life and the symptoms don't improve with physical therapy or medication, joint replacement surgery is an option. This procedure is used on those with severe OA and replaces a damaged joint with an artificial one. The knee and hip are the joints that are replaced most often.

Preventing Osteoarthritis

The most important thing you can do to ward off osteoarthritis is keep your weight in check. Over the years, extra weight puts stress on the joints and may even alter the normal joint structure. Preventing injuries is also important. Take precautions to avoid repetitive motion injuries on the job. If you play a sport, use proper equipment and observe safety guidelines.