Healthful eating is not hard; it's a matter of choice. So, how do you get started? The first step is to become an educated consumer. This means knowing how to use the Food Guide Pyramid, how to read product labels to determine what to buy, and how to avoid fat traps at home and when eating out. Educated consumers also know that "diet" is not a dirty word. It simply refers to the pattern of food choices that people make.

Eating healthy foods isn't just about changing your diet; it's about changing your lifestyle. It's changing your focus to improving your overall health. What we eat has been connected to many diseases, including cancer and heart disease. And for women with disabilities, eating well can help reduce or prevent chronic diseases that all women are at risk for as well as complications of disability.

A healthy diet
One very good pattern that we can follow for health is the Food Guide Pyramid (See article, The USDA Food Guide Pyramid). The Food Pyramid reflects current thinking about a healthy diet, one with fewer fatty foods and more vegetables and fruits. For each food group, a range of servings is recommended. Most women, children, and some older adults need the lowest number of servings shown for each food group. Teen girls, active women and most men need servings somewhere in the middle of those shown. Teen boys, active men and very active women need the highest number of servings shown.

Eating the suggested number of servings in each group will provide the right amount of protein, starches, and fats and will provide a healthy balance to the diet. It can also ensure that you get the nutrients you need daily and can help you control your weight. A good rule of thumb is to eat five servings of fruits or vegetables daily. Remember: Five a Day, The Easy Way.

Try three meals and two snacks a day. Studies show that the body handles food better when it comes in smaller, regular amounts than in one or two huge meals. Most people should try to make dinner a lighter meal because they don't need as many calories for energy in the evening. You might consider eating four to six small meals during the day.

A disability may result in special dietary needs as well. The nature of the disability can affect the number of calories a woman needs in her diet. Women with disabilities that increase muscle activity and/or muscle tone may need more calories to maintain healthy weight. Women with disabilities that decrease muscle activity and/or lower muscle tone may need fewer than average. One way to tell your calorie needs is to look at your weight. If you are underweight, you might need more calories; if you are overweight, you might need fewer calories.

Are you label conscious?
The healthiest diets use more fresh foods than packaged foods. But the convenience and ease of preparation of packaged foods is often a boon for the busy woman and even more so for the woman with a disability. And when you understand what you're getting, you can be sure of making the best choices.

Food labeling has improved in recent years. Certain information such as total calories, total fat, protein and carbohydrate is required on the nutrient label. The percent of daily values must also be included so that the numbers associated with each nutrient are not misleading. For example, if a food item has 140 mg of sodium, that may sound high. But that is actually only 6 percent of the daily recommended amount (2,400 mg of sodium).

Another good source of information about packaged foods is the list of ingredients. Ingredients are always listed in order of prominence by weight. So check what you're paying for. Do you really want the packaged product whose first ingredient is food starch, sugar or salt?

Some other terms on packages that can be confusing are words like "reduced," "light," "less" and "low." The Food and Drug Administration has specific definitions for each of these.

While it's often a good choice to choose "low" or "reduced" foods, the benefits will diminish if you double the portion size.

Building bones
Women need strong bones to prevent osteoporosis. Key bone-builders include diet, exercise and hormones. For women who can't do weight-bearing exercise and for those on certain medications, diet is doubly important to prevent osteoporosis. Diets rich in calcium and vitamin D help build bone mass and slow bone loss that occurs with aging. Dairy foods have the highest amounts of calcium. Lower-fat dairy foods such as skim milk, lower-fat yogurt and cheese are the best choices.

Other foods that are good sources of calcium include sardines, canned salmon with bones, dried beans, almonds, broccoli, kale, collards, mustard greens, and fortified fruit juices.

Protect your heart
An important factor in preventing heart disease is your diet. Using the Food Pyramid helps you tailor a diet that protects you from heart disease. Saturated fat and cholesterol are the two biggest threats to your heart. Choosing lean meats, low-fat dairy foods and small amounts of spreads, fats and oils helps reduce these threats. Sodium, which is found in salt, can lead to high blood pressure in some people.

Meals with plenty of vegetables and limited packaged foods usually are lower in sodium and provide fiber that can help lower high blood cholesterol. According to several studies, the B-vitamin folic acid may help fight heart disease and can protect against birth defects in infants when taken before and during pregnancy. Women should get .4 mg folic acid daily and a total of .8 mg a day during pregnancy. The FDA recommends no more than 1 mg of folic acid a day.

Reduce cancer risk
Diet is also linked to cancer. According to the Massachusetts Medical Society, diet is responsible for about 30 percent of all cancers. Many studies have shown that diets high in fruits and vegetables can help reduce the risk of almost all cancers. High-fat diets, long associated with heart disease, may also increase the risk of developing certain cancers, including colon and breast cancer. Again, the Food Pyramid can come to the rescue in helping to reduce the risk of cancer.

Up with fiber
Getting enough fiber can help prevent constipation that may occur with limited mobility or decreased muscle tone. To increase fiber, choose mainly whole-grain bread products and cereals, emphasize fresh fruits over juices and eat more vegetables. Fiber intake should be at least 20-25 grams per day. Fiber amount should be listed on the labels of packaged foods.

Getting Started
So take a look at what you eat every day and compare it to the recommended servings in the Food Pyramid. It might be helpful to keep a food journal of what and when you eat. You don't have to radically change your diet overnight. Start by making small changes that you're comfortable with. Drink an extra glass of water in the morning. Take an apple to eat during your work break. Try leaving the mayonnaise off your deli sandwich. You'll find that eating a healthy diet is easier than you think; and you'll feel better for it, too!

[By Casey Czaplinski, registered dietician, Women's Health Branch of the NC Division of Public Health, and Sally McCormick, writer, Woodward Communications.]