A lot of us can seem pretty smug about our nutrition knowledge and eating habits. After all, we know researchers have found lots of health benefits in nuts, olive oil is heart healthy, and whole wheat bread is loaded with fiber. And we want those protective phytochemicals in fruit so we’ve switched from soft drinks to big glasses of grape and orange juice. Eating out? We turn down the "bad" foods like French fries and pepperoni pizza and opt for the veggie-loaded salad instead.

Problem is, all our supposed healthy eating hasn’t automatically translated into lean and trim bodies, and far too many of us are fatter than ever.

What is going on here? Nutritionists say the problem is two pronged -- hidden calories in what we think are healthy foods and a lack of attention to portion control.

Here’s an example of a diet downfall that has both of those problems: a nice, big, restaurant salad. After all, what could be healthier than "rabbit food" with some lean meat? But a little detective work shows a typical Caesar salad with chicken entree at a national restaurant chain racks up 1,100 calories and a whopping 96 grams of fat.

That makes a typical fast-food salad seem like diet food. One of these salads is typically far smaller than the restaurant choice, weighing in at only 410 calories. But before you congratulate yourself by selecting the grilled chicken salad at the drive-through window instead of a quarter pounder, consider this: the salad has about 24 grams of fat and the burger has about the same calorie count but less fat.

The skinny on healthy eating

How do you identify -- and avoid -- the biggest pitfalls that have you taking in far more calories and fat than you realize while trying to eat healthy?

"People frequently don’t consider hidden calories, such as calories in sauces or dressings," says Nancy L. Cohen, Ph.D., who heads the Department of Nutrition at the University of Massachusetts.

For example, a salad can have lots of veggies, but it can also sabotage your healthy-eating lifestyle if you aren’t aware that half the calories in many salads come from the salad dressing, including those hyped as "all natural" and healthy. If you insist on a low-fat vinaigrette instead of other varieties, you’ll avoid adding 15 grams of fat and over 150 calories to your meal.

Another food choice that sounds healthy but can pack on pounds -- so-called "energy" or nutrition bars. Cohen points out they can have as many calories as an entire meal, but too many people eat them as a snack between meals. A better choice for the waistline if you are hungry, and it isn’t time for lunch or dinner, is to simply reach for a piece of fruit like an apple or a handful of grapes.

Cohen, a spokesperson for the Institute of Food Technologists, also advises doing some homework instead of assuming you know what the healthiest choices are when you eat on-the-go. "Many fast food restaurants have the nutritional content of their menus online or posted, so you can check to find the foods you typically order, and see if you can find ones you like with lower fat and calories," she says.

But what about restaurants where calories aren’t included on the menu? Don’t automatically assume that a healthy food like fish is always the healthiest choice. It’s how the fish or other food is prepared and served that makes the difference. "Your best bet is to order the most simply prepared foods you can, without cream sauces or added fats," says Cohen. "Try tomato sauces instead. And always choose broiled meats, poultry, and fish instead of fried." It may be a no-brainer to go for the all natural baked potato instead of French fries, but not if you add butter, sour cream, and bacon bits.

Another healthy food that can bust your diet plan in excess is olive oil. As part of the highly researched and known to be heart-healthy Mediterranean style of eating, olive oil is a great choice for cooking and salad dressings. But many restaurants are now serving it with whole wheat bread as an appetizer. It may sound healthy, but consider this -- the bread acts like a sponge soaking up the oil and a mere tablespoon of olive oil has 40 calories. A few dips of olive oil and bread can add hundreds of extra calories to your meal.

Diet dangers of healthy drinks

You’d never overindulge in beer, so why do you have what looks like a beer belly? Unfortunately, those healthy drinks you imbibe could be expanding your waistline. According to Jennifer Nelson, director of clinical dietetics at the Mayo Clinic, too many of us ignore all the liquid calories we take in, even if we are making healthy choices like low-fat milk and juice instead of soda or a six-pack of beer. And health smoothies, like nutrition bars, can contain the calorie equivalent of an entire meal.

"Take a look at the glass size that our grandparents used for juice. Remember those little jelly jar glasses? Juice used to be too expensive and was too uncommon, especially in winter, to drink in huge glasses. It was valued and served in small amounts," says Nelson. "Now juice is everywhere and we’re bombarded with larger glassware and even huge paper cups and cartons. A so-called single serving of juice isn’t really what a single serving should be. You should drink only 4 to 6 ounces of juice a day. If you are going to drink that big 12 ounces of orange or apple juice, don’t do it every day. The calories add up."

Scientists have linked moderate red wine consumption to a reduced risk of a host of health problems, from heart disease to dementia. But drinking wine in excess not only can contribute to health problems like liver damage, it contributes excess calories to your meals, too.

The problem once again with drinking "healthy" red wine, Nelson says, is the popular conception of what constitutes a moderate amount. "When we talk about red wine being healthy, we are talking about a serving of daily wine that is pretty small, about 5 ounces," she says. "Take out a measuring cup and see what that amount looks like. It’s a little more than half a cup, not a big snifter glass full of wine."

A glass of low- or non-fat milk with your meals may sound harmless but routinely adding those calories when you sit down to eat can mean adding unwanted pounds. Instead, drink water or unsweetened ice tea with meals.

A healthy eating plan that works

You’ve heard it over and over: "read labels." But that doesn’t mean stopping at the "Low-Fat" or " Non-Fat" part. "Don’t assume that if something says ‘low fat’ it is healthy," says Mayo Clinic nutrition expert Nelson. "Always check the calories and also the amount of salt. Excessive sodium is unhealthy, especially if you have high blood pressure. And when food manufacturers lower the fat content, be aware they usually up the carbohydrate or sugar or salt."

Portion control is also one of your best strategies for healthy eating. "Our lifestyle keeps getting bigger and bigger. It’s super-sized, and so are we. It’s about quantity. Just because something is healthy doesn’t give you free reign to eat massive quantities," says Nelson. "In fact, this is the most common issue we find when we work with patients who appear to be eating a healthy diet but need to lose weight. The key is to get into the mindset that you probably need about half of what you think you need to eat."

For example, she points out that it’s common for people to drink the equivalent of about 6 to 8 cups of milk a day when adults need half or less of that amount of dairy products daily. Another diet downfall are nuts. Yes, nuts are healthy but not when eaten by the handful. "Nuts are loaded with calories and you need to stop at five almonds, or just 20 peanuts, "Nelson says. "So spread that bowl full of nuts you love over many days, and you’ll get the health benefits without too many calories."

More common sense ways to eat healthy foods in a healthy way:

• Don’t beat yourself up if you had a huge glass of grape juice one day. Just cut down the rest of the week. Even better, eat a whole piece of fruit instead of juice, and you’ll get the same or more nutritional value plus fiber that will help you feel full.
• When you eat out, even when you order healthy, eat slowly and mindfully. Nelson suggests sharing an entree with a friend -- you’ll save calories and money. "You don’t have to eat that mammoth salad, either. Just ask for a box and take it home," she says.
• Use this technique to eat healthy foods in a healthy way. "When you look at your plate, half of what you see should be plant based, comprised of vegetables or fruit," says Nelson. "Only a quarter should be starchy -- even it if is a healthy choice like brown rice or baked potato -- and the other quarter should be a serving of protein no larger than a deck of cards."

Sherry Baker is a writer from Altanta, Georgia. She also wrote "Dangers of Mixing Prescription (and OTC) Drugs" for this issue of Synergy. Sherry can be reached at featuredstories@adamcorp.com.