Dear Doctor: We're often told we can consume alcohol, sweets, or burgers and fries "in moderation." My sister and I had a conversation about that sort of recommendation just the other day. What does moderation actually mean? Is it one beer a day? One burger a month? Ten french fries once a week?
Dear Reader: You're right -- moderation is a term that makes a lot of sense in theory but turns out to be somewhat slippery when it comes to actual practice. That's because moderation is relative and varies from person to person. What amounts to a moderate amount of a certain food or beverage for one person may actually be a binge for someone else. And moderation isn't only about the amount or the type of food or beverage -- it's linked to an individual's patterns of consumption as well.
Let's look at alcohol, for example. The current guidelines, put forth by the National Institute of Alcohol Abuse and Alcoholism, define low-risk drinking for women as no more than seven drinks per week, with no more than three drinks on any single day. For men, that number is no more than 14 drinks per week, and no more than four on any one day. (One drink is further defined as 5 ounces of wine, one 12-ounce bottle or can of beer, and 1 ounce of hard liquor.) A man who abstains from drinking during the week, but then downs four drinks per night over the weekend, is technically within the safe drinking guidelines. However, that pattern, which goes from zero to the edge of a binge, doesn't exactly say moderation.
When it comes to sweets, snacks and splurge foods like the burger and fries you mention in your letter, things get a bit murkier. For patients in our practices, we start with the advice to set a baseline with a healthful, balanced diet. In our opinion, that's lean proteins and fish, whole grains and legumes, and a wide variety of fresh fruits and vegetables. When it comes to sweets and treats, whether it's a foray into the potato chip aisle of the grocery store, a visit to the ice cream shop or dinner at your favorite burger joint, make them a fraction of your weekly -- or monthly -- calories. For our patients who are in ideal health, we advise a split of 80 percent being good about diet, and 20 percent "cheat." For those with diabetes, hypertension or any cardiac issues, the ratio changes to 90 percent good and 10 percent cheat.
One of the best guides to figuring out moderation is how the cheat or binge made you feel after it was over. A hangover after a few cocktails or a headache the morning after a chocolate spree, and your body may be asking you to please take a step back and reconsider. That doesn't mean you have to give up on splurges. Indulge in your pleasures, but in quantities and at a frequency that don't require the word "guilty."
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