You go to Mom's for some good, old-fashioned home cooking. You sit up to the table, mouth watering, and she serves you a plate with a heaping pile of white sugar, another of pile bleached flour, a scoop of lard and a meatball between a couple chunks of diced tomato.

Yum, yum! Eat up!

Proportionally, that wouldn't be too far off what most Americans are eating nowadays, even in Mom's good home cooking.

Very often today, the discussion about what we eat and how it's affecting our health revolves around the massive portions we receive in our restaurant meals and the high-fat, high-sugar foods and snacks we consume that someone else prepares for us.

But research shows that even when we re actively feeding ourselves, most of us are not doing a very good job of it. We've gotten used to those cheap and gigantic restaurant servings, so we're using the super scoop at home more often. We're busier, so we're buying more quick-and-easy processed items and less fresh food. We're eating in front of the TV more, so we're cramming down more food unconsciously while we're distracted by our shows.

In fact, you could argue that a lot of the problems Americans have with their eating habits are due to unconscious habits, rather than that they've made conscious choices in spite of their better dietary judgment. Really, how often have you said to yourself, "Hmmm, I guess I'll have a big, syrupy waffle and bacon to add to my high cholesterol and weight problem."

More than likely, that just seemed like a yummy choice at the time. By the time people start being aware of how poorly they've been eating and start thinking, "Oh, I really shouldn't," most are already overweight.

And when it comes to what we eat at home, those automatic, unconscious habits start in the grocery store. What we choose at the store limits what we can choose at home, so it's important to make those grocery shopping choices steer our eating habits in a healthy direction.

Grocery store marketing is a fine science of rigorous research and trial and error. You can bet that if you ve suddenly come across a product you haven't thought about purchasing before, it's no accident. Placement, signage, lighting and positioning all play a role in how likely you are to buy a product.

While they're all a little different, grocery stores are set up in particular ways to encourage sales of certain kinds of foods, usually those foods that are high-profit items. And that usually means poor nutritional values, because the most highly processed foods are the cheapest to mass produce and have the longest shelf lives.

Think about it. Your fresh produce, dairy and meat products are almost always situated around the perimeter of the store, while there's aisle after aisle of packaged, processed and frozen foods right in the middle, and on every endcap and on display tables near the checkouts, with candy and other treats on little shelves by the registers. That's good for grocers, but not necessarily for you.

So even though these foods are placed in the most prominent areas of the store, you don't have to buy in. By thinking of yourself as a discriminating shopper and being more conscious when you re food shopping, your choices at the store can begin to make a big difference in your diet and your health.

Start by eating well before you shop. If your body is already satisfied, physical hunger won't be compounding the psychological appeals that will be thrown at you off every shelf and display.

And make a list before you go. It's the rare shopper indeed who can stick exclusively to the shopping list; there's always something you forgot to put on the list but having one can be a great guide and will help limit spontaneous selections of unnecessary treats.

(That said, if you're in the produce section and you're struck by an impulse to try swiss chard or a pumelo or and acorn squash, you should probably go for it. Americans simply don't eat enough fresh fruits and vegetables and trying to find more ways to enjoy fresh produce can't be a bad thing.)

And here are some questions to help you assess your choices. You can use them to review your list before you go, and then again to review your cart before you check out. You may find that you want to edit your grocery selections before you get in that line.

Fruits and veggies:
-Are your canned fruits packed in fruit juice or high-calorie syrup?
-Are your frozen veggies packaged without added fat and sauces, including butter, cream or cheese?
-Is at least one of your vegetable choices dark green, yellow or orange?
-Is at least one of your choices a good source of Vitamin C, like citrus, peppers, tomatoes, broccoli, cantaloupe, kiwi or strawberries?
-Are you careful to limit high-starch vegetables such as potatoes, corn and peas?

Dairy foods:
-Is your milk non-fat (skim)?
-Are your cheeses low-fat, part-skim or reduced fat?
-Are your yogurts non-fat?
-Have you chosen lower-fat margarines?
-Have you chosen reduced-fat or fat-free cream cheese?
-Is your cottage cheese 1%, rather than 2% or 4%?
-Have you tried a high-protein kefir drink? It s like a drinkable yogurt, but with more protein and less sugar than commercial smoothies.

Meats and seafood:
-Are your deli meats marked 95 percent or more fat-free?
-Are the fresh meats you chose lean cuts, e.g. beef round steak, pork tenderloins; veal cutlets; lamb leg shanks; or skinless poultry?
-Are the meats you chose graded select? It s a better, lower-fat grade than choice or prime.
-Is your fish, meat and poultry free of added fat? (Did you even know that additional fats can be added to help flavor and preserve meats?)
-Are your canned fish and chicken packed in water rather than oil?

Bread and grain products:
-Are your cereals made without added fat or sugar?
-Are your cereals whole grains?
-Are your breads made from whole grains?
-Are your grain selections whole grains, such as brown rice and whole wheat pasta?

One more tip: If you're very familiar with your store, consider grouping your list by location and changing the physical route of your shopping. Don t go down aisles where you don't know you ll need something. Sure, there might be something you d want to try, but don't set yourself up for needless temptation among the snacks and frozen goodies and pre-packaged, high-processed insta-foods.

Save your spontaneity for the kefir and pumelos and acorn squash.

Through Thick & Thin

You could think of grocery shopping as a good-natured battle of wits, with grocers trying to get you to buy, and you being vigilant and aware of the methods used to tempt you and steer your buying habits toward the foods you neither want nor need. Stick to the fresh foods on the perimeter and avoid purchasing processed goodies. You'll have healthier meals at home if you have healthier foods at home.

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Caroline J. Cederquist, M.D. is a board certified Family Physician and a board certified Bariatric Physicians (the medical specialty of weight management). She specializes in lifetime weight management at the Cederquist Medical Wellness Center, her Naples, FL private practice, you can also get more information about Dr Cederquist and her weight management plan by visiting www.DietToYourDoor.com. She is the author of Helping Your Overweight Child - A Family Guide, which is available at, DrCederquist.com, Amazon.com, or by calling toll-free 1-800-431-1579.

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