At my most recent visit to the rheumatologist, I was instructed to eat as much as 11 servings of fruits and vegetables per day. I said, "wow, that sounds like a lot" My doctor’s response was that it was not as much as you might think when 1/2 cup counts as a serving.
Counting full and half cups of fruits and vegetables is part of a new campaign "Fruits and Veggies-More Matters" launched by the CDC. Lots of information, including tips and recipes, can be found at FruitsandVeggiesMatter.gov. When visualizing amounts of food, it may be easier to picture kitchen measuring cups, rather than guessing whether a large piece of fruit counts as one or two servings.
On the homepage of Fruits and Veggies Matter is an interactive tool which tells you how many cups of fruits and vegetables are recommended based on age and gender. For a 42 year old female who engages in a low level of physical activity, the recommendation is 1.5 cups of fruit and 2.5 cups of vegetables every day, based on an average 1800 calories/day diet.
What counts as one cup of fruit or vegetables?
Examples of one cup servings of fruit or vegetables include:
- 2 clementines, 1 large orange, 1 medium grapefruit, 1 small apple, 1 medium pear, 1 large banana, 2 large plums, 8 large strawberries, 1 cup of blueberries, 8 oz of 100% fruit juice, 2 small boxes of raisins or 2 snack containers of applesauce
- 1 large sweet potato, 1 medium potato, 1 large ear of corn, 2 large stalks of celery, 2 large carrots or 12 baby carrots, 10 broccoli florets, 1 cup of green beans, 1 cup cooked greens or 2 cups raw greens (lettuce, spinach, or other leafy greens), 1 cup dried beans*
*Note: I frequently forget that beans are not just a good source of protein, but that they are a vegetable. Extra bonus is that they are also a great source of dietary fiber.
Fiber and Digestive Health
In addition to thinking about nutrition and weight matters lately, I am learning firsthand about the health benefits of fiber. Whole grains, fresh fruits and vegetables, legumes and nuts provide excellent sources of fiber. Not only are these foods good for overall nutrition, they also protect against developing certain digestive disorders.
Although I’m only 42 years old, I underwent my very first colonoscopy as a grandparent had colon cancer. We wanted to rule out more serious causes of my periodic bouts of digestive problems. While no polyps or other suspicious tissue was seen, I did receive a new diagnosis…diverticulosis.
Diverticulosis is a condition characterized by small pouches in the large intestines often caused by chronically increased pressure or strain on the colon wall such as from chronic constipation. The pouches can become inflamed and cause significant complications. A high-fiber diet helps to protect against diverticulosis and just like many Americans, I have not been eating enough fiber.
For an introductory discussion of diverticulosis, please come read Digestive Health and Complications of a Low-Fiber Diet: What is Diverticulosis?
How much fiber should we eat daily?
The Institute of Medicine recommends that children and adults should eat 14 grams of fiber per every 1000 calories of food eaten each day, according to Harvard Health. With an average 1800 calorie/day diet, we should eat at least 25 grams of fiber daily.
There are two types of fiber: soluble fiber which dissolves in water and insoluble fiber which passes through the digestive tract primarily unchanged. Each type is important to consume. In general, fiber from grain sources is more effective in preventing constipation than fiber from fruits and vegetables.
Sources of soluble fiber include oatmeal, oat bran, nuts and seeds, legumes, beans, dried peas, lentils, apples, pears, strawberries, and blueberries. Sources of insoluble fiber include whole wheat bread, barley, couscous, brown rice, bulgur, whole grain breakfast cereals, wheat bran, seeds, carrots, cucumbers, zucchini, celery, and tomatoes. For an extensive list of foods and their fiber content, consult the Fiber Content Chart found on New York’s Continuum Health Partners website.
Variety, Vitamins, and Supplementation
While Cheryl Koch and the Johns Hopkins Arthritis Center suggest that no particular dietary approach has been proven effective in treating arthritis, it is important that we eat in a balanced way. Koch states that patients living with rheumatoid arthritis are at increased risk of malnutrition and vitamin deficiencies.
"The most commonly observed vitamin and mineral deficiencies in patients with RA, are folic acid, vitamin C, vitamin D, vitamin B6, vitamin B12, vitamin E, folic acid, calcium, magnesium, zinc and selenium. Although, food is always the preferred source for vitamins and minerals, it may be essential to use supplementation to assist in counterbalancing the outlined deficiencies and improving nutritional status for patients with RA."
It seems even more important that we eat a wide variety of foods in addition to supplementing for vitamin deficiencies. Have you had your vitamin D levels checked recently? This would be something good to discuss with your doctor at your next visit. No matter how much milk you may drink, it is possible to be deficient in vitamin D or if you are like me, you might not be able to drink milk at all.
Bottom line - Make a conscious decision to provide your body with all it needs. Fruits and vegetables really do matter, as does fiber and protein. As the year will be coming to an end very soon, I am preparing to look back at some accomplishments and step forward into the new year. In the meantime, check out these excellent tips on how to incorporate foods into your diet.
- Fruit & Vegetable of the Month
- Tips to help you eat vegetables
- Tips to help you eat fruits
- Tips to help you eat whole grains
- Searchable Recipe Database
Nutrition for Everyone (CDC)
Lisa Emrich is a patient advocate, accomplished speaker, author of the award-winning blog Brass and Ivory: Life with MS and RA, and founder of the Carnival of MS Bloggers. Lisa uses her experience to educate patients, raise disease awareness, encourage self-advocacy, and support patient-centered research. Lisa frequently works with non-profit organizations and has brought the patient voice to health care conferences and meetings worldwide. Follow Lisa on Facebook, Twitter, and Pinterest.