Dear DOCTOR Owen:

I hear over and over again about eating plenty of fruits and vegetables. I try to promote this to my family, but they whine so much that I just quit trying. When I do fix vegetables, they won’t eat them unless they are creamed or swimming in butter and fat. Any suggestions?

Vege Mom

Dear “Vege”:

You are correct about plant foods and good health. Countless studies have looked at the amount of plant intake and the risk of certain diseases. Many of these same studies also correlate plant intake with body weight. Not surprisingly, the groups with the highest plant intake have the lowest incidence of heart disease, cancer, and obesity-related conditions.

Health Management Resources (HMR®) of Boston recently evaluated fruit and vegetable intake among patients who had just finished the weight-loss phase of their diet program and were starting the maintenance part with supervision and counseling. HMR® uses a Triple Imperative® promotion for maintenance patients:

• Minimum of 35 servings of fruit and vegetables/week.
• 35 or more meal replacement products/week.
• At least 2000 calories of exercise/week.

The group using more than 70 servings of fruit and vegetables/week had continued weight loss, used the most meal replacements, and exercised the most. The group using 35 servings of fruit and vegetables/week maintained or lost slightly more weight. All of the people in the group using less than 14 servings/week had some weight re-gain. These findings were duplicated in several clinics.

Here are three reasons for the success of the Triple Imperative®:

• Requires much conscious effort to consume products that frequently. The conscious-raising effort is likely to raise the need for other healthy behaviors—such as exercise.
• Fruit and vegetables are mostly fiber and water when they are not refined or squeezed; therefore, they are filling.
• Buying these foods and putting them in highly frequented areas around the household requires some planning. A fresh Delicious apple doesn’t just “happen” to be in a fruit bowl on the table next to the couch in the TV room, for example. Just as cakes and doughnuts are placed on the tables in break rooms, so can fresh fruits and vegetables end up in your family’s favorite places—with some planning on your part.

Health benefits ensue from replacing high-fat foods with low-fat foods, from the decrease in cancer-causing fats entering the body, and from the increase of flow through the gut. While the antioxidants might provide some protection, my guess is that benefits come as much from what is not eaten. (Antioxidants are substances that bind to or “clean up” free oxygen molecules formed in all living tissue. The free oxygen is very toxic to cells and causes cell damage.)

As for your family’s “whining,” you obviously do not know, nor do you believe in, the power of replacing high-fat foods with low-fat foods. I also doubt whether you truly believe in the risks inherent in our current eating styles. Otherwise, you would spend time and energy to promote fruits and vegetables and discourage fats and refined sugars.

You discourage drug use among your family, don’t you? Well, would you buy food products that are made of harmful chemicals and stock them in your kitchen? You discourage foul language and dangerous behavior in your household, right? Well, making high-fat foods available shows a lack of respect for your family’s health needs, and is a dangerous behavior. You buy toothpaste and floss for healthy family dental hygiene, don’t you? Well, why not take the same good care of the rest of your body by purchasing healthy foods? These are not silly analogies. You are in the position to enforce these behaviors proactively—even if they cause some whining.

I find that there is little stress in households where there was a slow, deliberate, conscious change in the food environment. For example, make healthy food items (fruits and vegetables) available in bowls on the kitchen counter, in the pantry, and on the table at mealtime—and slowly decrease your purchases of other items. This will be hardly noticeable to the household. It may take a year or two to replace whole milk with low-fat milk, and then low-fat milk with skim milk. And, purchasing and using a fruit-squeezing device and not relying on pre-packaged juice will offer a learning process for everyone: Let them find out how many oranges need to be squeezed for one glass.

Tell your family what you are doing and explain why. Ask for their input and advice. Act on their healthful advice and explain your position on their not-so-healthful opinions. Acknowledge their whining, but hold firm to the principles of good health. Tell them that outside of your domain and economic support, they can choose any lifestyle they desire.

I am certain that you wish your family a long and prosperous life. But, do more than simply wish or hope. Be a role model, not a rollover model.