Adventures in Cyber-Dining

Adventures in Cyber-Dining

One woman's lighthearted look at not-so-forbidden fruits (and vegetables!)

I should have scurvy. Or some other really scary boat-with-no-oranges-disease. According to a website hosted by the University of Michigan Cancer Center that tells you how many servings of fruit and veggies you need per day, I don’t get enough. Nearly enough. According to this site, I don’t consume enough fruit and veggies in a week to satisfy the recommended daily allotment for one day. So much for feeling smug about my healthy eating habits. I used to eat healthily —I really did. But somewhere along the way I got too busy, spread too thin to shop properly (insert your own excuse here), and simply .… forgot.

The good news is, although one needs at least five servings of fruit or veggies a day, a serving is really quite small, says Ed Saunders, deputy director of the Center for Health Communications Research at the UM Cancer Center, who developed the website tool. The center is jointly funded by the UM School of Public Health and the Cancer Center.

The web tool is a very small part of a very large multi-institution research study called “MENU Choices,” which was designed to show whether HMO members will use an interactive website with tailored recipes and eat more healthfully as a result. Victor Strecher, professor at SPH, is the lead UM researcher on the project. Saunders said researchers extracted the web recipe portion of the study as an easy, free service for anyone to use.

The website is called Cancer Center Recipes Just for You. It focuses only on fruits and vegetables, and features dozens of tailored recipes by famed Galloping Gourmet Graham Kerr. They began initially with fruits and vegetables because they are so important in fighting disease and cancer.

So one day I tried it. The first step was to create a login, then I was taken to a page where I listened to a video introduction by Kerr. Then, I was instructed to create my profile. This consisted of rating fruits and vegetables on a scale ranging from “won’t eat at all” to “like very much.” I was surprised at how many vegetables I haven’t tried.

The site also asked me for dietary limitations; for instance, did I want low sodium, low carbohydrate, low fat recipes, etc. (One tip: the fewer limitations you include, the greater number of personalized recipes you get. I learned this the hard way.)

After finishing the ratings and dietary limitations, I was given a personal-ized menu. Not one recipe returned under the limitations I chose. So, I clicked on the “change preferences” options and removed high protein, and voilà! Dozens of recipes popped up.

Next, I tried to figure out how I could cheat. For instance, what if I ate 20 servings of fruit or vegetables in one day? Could I roll that over to the rest of the week? No, says Shannon E. Considine-Dunn, MPH ’05, MSW, with the Center for Health Communications Research.

“There’s no such thing as eating too many servings of fruit and veggies in one day, unless you’re on calorie restriction,” Considine-Dunn says. “But, the recommendations that we give are on a daily basis. If you exceed one day, that doesn’t mean you get to roll those servings into the next day. Each day has a new recommendation.”

Can I drink my fruit in, say, orange juice (or perhaps a Bloody Mary I thought, hopefully, but did not specifically ask that question)?

It depends, she says. Only 100 percent fruit juice counts as a serving, Considine-Dunn said. Or, you can take a banana, a handful of strawberries and a few blueberries and throw them into a blender with a bit of skim milk, and the smoothie that you make has the same nutrients as if you had eaten the banana, strawberries, and blueberries plain.

What if I only like strawberries? “While it is recommended to eat a variety of fruit and vegetables, one kind is better than nothing,” she says. “But, we do stress trying things you’ve never had before, especially since you get different vitamins and nutrients in different kinds of fruit and vegetables.”

Do fruit rollups, fruit-flavored candy, chewy fruit snacks count? Not really, she says.

“We ask people to stay away from fruit products such as fruit rollups or those chewy fruit snacks. Those typically have next to zero nutritional value and don’t count as a serving of fruit,” she says. “However, there are some 100 percent fruit snacks available. People just have to be careful to read labels.”

So I’m back on the wagon, eating a blend of fruits and vegetables and feeling good about my choices. The recipes look great, but I don’t cook, so slightly burnt grilled veggies is about the best I can do. And the occasional Bloody Mary must have 100 percent vegetable juice.

This link gives various fruit-serving sizes: http://www.cancer.med.umich.edu/support/nutrfruits.shtml.

computer image Can a website make you healthy? A few years ago, health officials recommended that everyone eat five servings of fruits and vegetables a day. Today they say you should eat at least five servings daily, but the precise number depends on lots of factors, including your gender, weight, and age.

By Laura Bailey; illustrations by Don Hammond.

Just for You

An individually tailored program that can help millions of people eat better? It’s a click away. The large multi-institutional MENU Choices study (Making Effective Nutritional Choices) is an attempt to solve one of public health’s biggest challenges: communicating individually tailored health messages to large populations.

“We’ve got very tailored programs that are effective, but don’t reach many people and are very costly,” says Ed Saunders, deputy director of the Center for Health Communications Research. For example, individual counseling. “Then you have broad messages that reach lots of people fairy cheaply but aren’t effective at all,” Say, a billboard or a brochure.

Saunders says dozens of studies have shown that tailoring to individual needs is by far the most effective public health intervention.

The tailored recipe program that UM extracted from the larger MENU study and placed on the UM Cancer Center web site (see main story) is a small portion of a comprehensive interactive web intervention that researchers developed for MENU.
The focus of the recipe program is on fruits and vegetables, but in the larger MENU study, participants were asked dozens of questions in addition to their fruit and vegetable preferences. The idea was that researchers wanted to learn as much about each individual as possible: learning styles, motivation, barriers to change, support systems, etc. Anything and everything that could possibly influence the user was used to shape the tailored program delivered to that participant.

One argument against a web approach is that lower income populations don’t have access to the Internet. Saunders says that may have been true once, but it improves every year.

“Currently 74 percent of all adults use the Internet. In households earning less than $30,000 annually, usage is 57 percent,” said Saunders. “And of all Internet users, 75 percent look for health or medical information online.” < —L.B.