Food Games: Do you Play?

Chess pieces on chessboardAre you a master at deception? Are you always having a conversation with yourself that manages to sabotage your newest efforts to finally lose weight?  If so, chances are pretty good that you have a dialogue in your head that needs to change.  If you are having the following self conversations, it’s best to redirect your dialogue to help you win at weight loss.

The Clean-Plate Game.  You know this game:  eat it all up because some people are starving!  If you eat up all the food when not hungry, you are not helping anyone that is starving!  Or, you paid for it so you must eat it.  At home, put less food on your plate.  In a restaurant, ask for the people box prior to digging into the large plate of food, and acknowledge that while you still paid for it, you now have food for another meal so you doubled your value.

Skipping Breakfast Game:  You think you will eat less overall calories by limiting what you consume in the morning. Many studies indicate that when people do this, they manage to consume more total calories in a given day.  Other studies show that when people consume substantial calories in the morning, they use those calories to meet energy requirements more efficiently, and store less of that energy in fat cells.  Consuming the bulk of your calories at the tail end of the day is less productive for your body weight and energy levels.  You will just be hungry and crabby all day, and may over indulge at night.

Dining and Taking Out Food Game.  Do you really know what is happening in the kitchen of your favorite restaurant and take-out place?  I would venture to guess that this food has much more fat, calories, and sodium than you would find in your own kitchen.  Try to limit relying on outside sources for your food unless you are able to confirm with nutrition labels that it is a healthy option.

It’s for Company Mantra Game! There are many variations to this one: there is also “It’s for the kids.”  Do the M & Ms really need to be in a bowl for your grandchildren and shouting to you all the time? I have grandchildren too, but I would not have a candy bowl sitting out all the time, because I certainly like the chocolate at well.  Get the treats for kids, grandchildren, and company, but keep a limited stock that is purchased just prior to their arrival or hidden away with little access.  Better yet, get a treat that does not pose a high temptation threat to you!

The Game of Willpower.  I don’t feel that most people successful at weight loss can use the power of willpower.  Over the long haul, they should instead think “smart” on eating strategies:  keep a clean kitchen free of high temptation foods, keep small amounts or portion controlled foods that you conceptualize as treats, or if food is just too tempting to avoid once in your kitchen, just don’t put it into your grocery cart in the first place.  Willpower, in my book, is a short-term bandage fix that doesn’t really last long enough to help you achieve weight loss.

Taking a step back to evaluate the games you play in life will help you be successful at weight management.

Do you play any other games? Care to share your strategies for helping to “win”?

The Fat in Your Blood Your Doctor Doesn’t Talk About, but Your Dietitian Will!

Blood SampleAccording to a recent airing of the Dr. Oz show, triglyceride levels are the orphan fat that is not readily discussed during your doctor’s appointment. If your triglyceride value is elevated, your blood is thick like motor oil, which can contribute to deadly plaque formation and heart disease.  If you are in need of taming your triglycerides, here are some simple and effective steps:

  • Limit Alcohol— For some people, cutting out alcohol can elicit a marked decrease in their triglyceride levels.  While you may like it if your doctor tells you red wine is good for you, your dietitian knows alcohol can increase your triglyceride levels and I tell patients to eat grapes instead.
  • Choose Fats Wisely— Replace butter with equivalent amounts of olive oil, but don’t forget to swap the fats for each other. Simply adding olive oil to your diet on top of your usual butter intake will not assist you in improving your cholesterol or triglyceride numbers!
  • Cut Down on Simple Carbs—Carbohydrates are basically divided into two categories: simple and complex. Simple carbohydrates tend to be sweet, such as soft drinks, desserts, candies, and syrup. Complex carbohydrates are found in bread, pasta, rice, fruits, and vegetables.  It is generally recommended that people with high triglycerides avoid simple carbohydrates. Some people are so sensitive to sweets that their triglyceride levels increase drastically when they eat too much sugar. In any healthful diet, complex carbohydrates should be in the 45-65% of overall calorie intake, but even too much high-fiber, nutrient-dense complex carbohydrates can aggravate triglyceride levels when eaten in amounts exceeding 60% of total calorie intake.
  • Eat More omega-3 fatty acids— Omega-3 fatty acids are found in most fish, but are more abundant in fatty fish like salmon, sardines, and herring.  Other good sources of omega-3 fatty acids include tofu, soybeans, flaxseed, nuts, and green leafy vegetables.
  • Increase Physical Activity—Aerobic exercise can help with weight loss and can decrease triglyceride levels at the same time. In fact, both short bouts of aerobic exercise as well as long-term repetitive exercise have been shown to decrease triglyceride levels. Most studies find that the best bet is to do 30-45 minutes of moderately intensive exercise five times a week. First, get your doctor’s approval if you’re not accustomed to exercise.
  • Maintain or Get to a Healthy Weight—Studies have shown losing weight and maintaining an ideal weight to be associated with decreased levels of blood fats-including both triglycerides and cholesterol.

Do you have a success story about how you lowered your triglyceride numbers?

5 Weight Control Tips for December Damage Control

Woman Stepping onto ScaleWeight loss in December is not usually the objective for my clients.  Most of my clients simply hope to hold the line on their weight.  The challenges of the holidays are numerous:  shopping which leads to more frequent fast grab lunches at the mall, office parties, stress-related eating, and family or friend gatherings during the holidays.  Here are 5 tips to help you manage the tipping point on the scale:

  • Try to eat a healthy meal before hitting the mall.  If your shopping period is an all day affair, then plan your restaurant meal in advance.  Use the Internet to preplan your options at your mall restaurant by reviewing the nutrition information online.
  • For office parties and gatherings, try to have a healthy snack of fruit or veggies prior to the festivities.  If you are feeling a sense of fullness, it will be easier to resist some of those high temptation goodies which are sure to be available.  If you are having lunch catered in, see if you can find out the menu so you can preplan how you will handle the meal to meet your health and weight objectives.
  • You can help your stress-related eating by simply controlling your eating environment at home.  Make sure your kitchen is full of healthy food options which are easy to prepare as opposed to a kitchen full of high temptation baked goods and candy.  If you must bake for the holidays, keep those baked treats where you cannot easily get to them.  Better yet, store them at skinny friend’s house.
  • For gatherings with family and friends, contribute something to a potluck which meets your dietary objectives.  Make it something healthy, but something you can enjoy as well.  Fresh shrimp, a fruit platter, or crackers with reduced fat cheese spreads are good options.
  • Watch those alcohol calories!

An ounce of prevention is probably worth much more than a pound of cure.  It is much easier to avoid weight gain, than to undo those unwanted December pounds come January.

Wishing my readers a happy and healthy holiday season and 2013.

How to Halt Your Hearburn!

Recently a student in a college nutrition class I teach raised her hand to contribute to a discussion on heartburn.  She indicated that her doctor told her to drink whole milk to help her heartburn.  She stressed that the doctor noted it HAD to be whole milk.  Since she was not interested in drinking whole milk, this recommendation was not followed through on by the student.  The recommendation was neither realistic for her, and probably not really the best advice to take anyway with regard to managing heartburn.

You know if you have suffered from heartburn.  You may actually have a burning sensation in either your chest, mouth, or both areas.  You may have a constant sore throat.  You may even bring up vomit.

Common factors contributing to heartburn include: pregnancy, smoking, certain medications, obesity, and alcohol.

Food Factors.  Certain foods are known to aggravate heartburn.  Consider the following list of foods and evaluate if your symptoms are worse when you eat these foods.

  • Citrus fruits (limes, lemons, oranges, grapefruit)
  • Spicy foods
  • Chocolate
  • Caffeinated food (coffee, soda pop, tea)
  • High fat foods (salad dressing, oil, butter, margarine, fried foods, rich desserts)
  • Raw onions and garlic
  • Tomato based foods
  • Peppermint or spearmint oils (sometimes recommended for irritable bowel syndrome)

Lifestyle Factors.  By manipulating your daily habits, you can help to decrease your heartburn symptoms.

  • Make sure you eat a low fat diet
  • Avoid alcohol
  • Mange your weight and lose weight if you are overweight.
  • Avoid overly large meals-instead eat smaller meals more frequently.
  • If necessary, prop your head up with multiple pillows at night.  This makes it a bit more difficult for the acid to back up into your esophagus.
  • Drink liquids between meals, instead of with your meals.
  • Wear loose clothes.
  • Wait several hours to lie down after a larger meal.

Taking these first steps to halting heartburn can be very effective.  You can always consult with a dietitian as well.  If your symptoms persist even after diet and lifestyle adjustments, you should see your physician for medical management of your problem.

 

Weighing in on Doctor Refusing 200 Pound Patients

As I turned on the morning news the other day, the attention grabbing “teaser” headliner was about a physician in Shrewsbury, Massachusetts who refused to treat anyone weighing more than 200 pounds (link below).  If you haven’t heard it, the recap is that an internal medicine physician has decided to reject all new patients weighing over 200 pounds. She indicates that her staff has been “hurt” by handling these heavier people (not sure what she means by this), and that those patients already in her practice and weighing 200 pounds were grandfathered in.  She further notes that some of these grandfathered patients proceeded to lose weight after her office policy was implemented. The physician further states that there is an excellent university affiliated medical facility nearby which is much better suited to being able to handle very large patients. This scenario seems to beg the question, “is this a new trend in the medical profession?”  Will the United States evolve to medically managed weight loss centers for all people classified as obese?

Mayor Bloomberg restricts soda pop, Michelle Obama encourages us to plant vegetable gardens, but what can individuals and society really do to take responsibility?  This will become even more pressing of a concern to individuals if primary care physicians begin to refuse treating heavier patients on a wider scale.  If those heavier people are required to find access to health care in settings equipped to handle their special needs, this could also potentially handicap the weight loss process even more-if possible.  Right now, we are failing in managing our weight as a nation, just as we are failing at balancing our national budget.  We did not come to this point because of one problem.  We are a society that is not generally inclined to move:  we stay inside for safety reasons (like dodging bullets), we sit in front of computers all day, we play video games rather than dodge ball, and we eat out constantly.  While eating out is a great treat, doing so too often really insures your energy intake is too high which translates to weight gain.  Unless you are training for a marathon or triathlon, you still need to critically manage your energy intake if you are going to manage your weight.  All too often, those that workout regularly still forget the energy content (meaning calories) of the food they consume.  So, again, what are some solutions?

I do not have a simple solution because there is not necessarily a simple solution to a laundry list of factors causing this national crisis.  Our current societal complexities seem to set us up for obesity at this point.  Both physicians and patients need to take responsibility for slimming down the nation.  Apparently, it is perfectly legal for this physician to screen her patients according to weight limits.  If this is her prerogative (and it’s her practice), she should make a point of offering some other options to her patients.  While she was relying on a nearby medical facility affiliated with a teaching hospital, she and other physicians should have business cards of dietitians, therapists, and trainers and refer to those professionals!  And, patients need to take responsibility as well.  There is no magic solution here.  The message to move more and eat less is perceived as “boring” by many.  And to many, this simple message is not really simple.  After all, how much should one really eat and move in order to both prevent and manage obesity?

What can we do as a nation?  Please provide input to this question directly on my blog.  I look forward to your comments.

http://www.wcvb.com/health/Doctor-refuses-to-treat-overweight-Shrewsbury-patient/-/9848730/16255838/-/79l2ctz/-/index.html#ixzz24s3sKDno

 

 

6 Starter Steps to Tame Your Triglycerides

I recently had a client come to a nutrition consultation for a severely elevated triglyceride level.  While his elevated triglyceride level was a challenging and depressing situation for him personally, it was what his cardiologist told him to eat which was really depressing!  His physician actually told him to “eat grass and cardboard.”  Obviously, this doctor was being sarcastic, but the comment implied that the diet needed to be overly restrictive.  As is often the case with nutrition advice, this particular advice was misleading, incomplete, and inappropriate in terms of helping the patient improve his medical outcome.

Here are 6 simpler alternatives to eating cardboard and grass:

  • Maintain or Get to a Healthy Weight—Studies have shown losing weight and maintaining an ideal weight to be associated with decreased levels of blood fats-including both triglycerides and cholesterol.
  • Increase Physical Activity—Aerobic exercise can help with weight loss and can decrease triglyceride levels at the same time. In fact, both short bouts of aerobic exercise as well as long-term repetitive exercise have been shown to decrease triglyceride levels. Most studies find that the best bet is to do 30-45 minutes of moderately intensive exercise five times a week. First, get your doctor’s approval if you’re not accustomed to exercise.
  • Cut Down on Carbs—Carbohydrates are basically divided into two categories: simple and complex. Simple carbohydrates tend to be sweet, such as soft drinks, desserts, candies, and syrup. Complex carbohydrates are found in bread, pasta, rice, fruits, and vegetables.  It is generally recommended that people with high triglycerides avoid simple carbohydrates. Some people are so sensitive to sweets that their triglyceride levels increase drastically when they eat too much sugar. In any healthful diet, complex carbohydrates should be in the 45-65% of overall calorie intake, but even too much high-fiber, nutrient-dense complex carbohydrates can aggravate triglyceride levels when eaten in amounts exceeding 60% of total calorie intake.
  • Limit Alcohol—According to the American Heart Association (AHA), even small amounts of alcohol can increase triglyceride levels. For some people, cutting out alcohol can elicit a marked decrease in their triglyceride levels.  In the case of my patient, his triglyceride decreased a whopping 90%.
  • Choose Fats Wisely—The AHA also recommends that up to 30% of the calories you get from fat come from foods containing more monounsaturated and polyunsaturated fatty acids.
  • Eat More Fish—Most health experts also recommend eating more fish because of the omega-3 fatty acids found in fish, which have been associated with decreased triglyceride levels. Omega-3 fatty acids also help make the blood less sticky, so it is less likely to forms clots that contribute to heart attacks. Omega-3 fatty acids are found in all types of fish, but are more abundant in fatty fish like salmon, sardines, and herring. Other good sources of omega-3 fatty acids include tofu, soybeans, flaxseed, nuts, and green leafy vegetables.

While these are some steps to start you off, a licensed dietitian can help personalize your food plan to meet your goals, and do so effectively and palatably so you too can avoid eating grass and cardboard!

What’s on your plate to lower triglyceride levels?

Confused About Healthy Eating? 5 Easy Tips to Start!

We are a society on ”nutrition” overload. Messages reach us each time we turn on the ten o’ clock news or boot up the computer. Eat eggs, don’t eat eggs, do this, don’t do that-and consumers feel messages conflict and constantly spin a one-eighty every other week. No wonder the public is unsure about what to eat or who to take advice from! With that in mind, here are 5 tips I feel can help most people improve their overall health status:

  • Decrease your animal protein consumption. This will decrease your saturated fat intake, keep your calories in line, AND decrease your carbon footprint on our dear planet earth.
  • Eat more plant-based foods. The upside of this, is simply, more anti-oxidants, more fiber, fewer calories, and less of a carbon footprint on planet earth.
  • Try to focus on unprocessed foods as much as possible. The less processed the food, the more nutrient dense the food. When the food is molded, distorted, manipulated, or redesigned, the nutrition composition is most likely altered, and not usually for the better!
  • Don’t be afraid of bread! Whole grain breads are a rich source of B vitamins, iron, magnesium, zinc, and fiber.
  • Cast a wide net on the variety of foods you eat. No single food is a magic health bullet. Eating a variety of foods keeps your taste buds happy and also increases the likelihood that you are getting more and varied nutrients into your diet.

While some people should not follow these suggestions due to specific medical concerns, for most people this is a good start to up shifting to a better quality of diet. If you need to omit food groups or implement special diet therapy, consider consulting with a Registered/Licensed Dietitian to design a food plan that works for your health goals. Bon Appetit!

 

Is There a Weight Loss Bullet?

Actually, there are three weight loss bullets-food documentation, limiting restaurant food, and regular eating.  Dietitians have been aware of this information for decades, and a new study out this month supports these tried and true tactics for successful weight loss. 

Here are my thoughts on the subject:

  • Food documentation:  Food documentation can happen on a smart phone with numerous apps, desktop computer, or iPad.  I have clients who also mix it up a bit and even revert back to an old-fashioned small notebook and pen which is easy to carry around.  It does not matter how you document, because the fact that you document your food means you are not shoving food into your mouth without paying attention. You cannot “run and hide” from your calorie consumption, and the sheer act of “facing” those calories gives you a winning edge on successful weight loss because pretending you did not eat those calories is accomplishing nothing!
  •  Limit Restaurant Food:  Chances are pretty good that the meal you ate out for lunch or dinner contained many more calories than had you eaten at home.  Making a conscious choice to dine at home rather than away from home will increase the likelihood you will succeed at weight loss. Those that think otherwise are either in denial about the calorie content of standard restaurant cuisine or uninformed.  Remember the greasy bun you did not expect to come with your overly large burger or the really large serving of fries you probably would not have eaten at home? And, the cocktail and desserts typically not available at home but that you consumed while dining out are not helping your waistline either.  Try as you may, it is an extreme challenge to constantly dine out and manage your weight.  It is the first lifestyle change I recommend with new weight loss clients!
  • Eat Regularly: Even a hungry dietitian can walk into the kitchen and want to eat everything in sight if she or he went too long without eating! Eating on a regular schedule keeps your blood sugar up and your hunger down.  Going for very long periods between meals and snacks paves the way for a binge.  Intentional stockpiling of calories to save for later in the day usually backfires as well.  You will, in all likelihood, be so ravenous your guard will be down and you will overdo those calories and do so in a hurry as soon as you can eat.

No one ever said losing weight was easy.  But facing your eating and lifestyle behavior are half the battle in this process.  Being accountable, calorie savvy, and nourishing yourself on a timely basis will help make the weight loss process happen. 

What tools do you use?

Got Gas? 10 Tips to Fight Flatulence!

We all have gas production which is a normal bodily function.  For some, however, gas production can seem excessive and uncomfortable, not to mention embarrassing. Some people are so bothered by excessive gas that they bring up the topic to their physicians.  While it is very important to rule out diseases, often the gas symptoms result from how and what one eats! In fact, once a gastroenterologist referred a healthy patient to me simply to help the patient minimize gas, or flatulence, with specific eating strategies.  Some helpful strategies to minimize flatulence include:

  • Don’t go long periods without eating.  It is very common to have more gas discomfort if you skip food all day and then gorge on a large meal at the end of the day.
  • Avoid drinking beverages quickly.  Using a straw may lessen the amount of air swallowed.
  • Do not wolf down your meals.  Eating too rapidly will also introduce extra air into your digestive tract.  After all, what goes in must come out!
  • Steer clear of carbonated beverages, particularly without eating.
  • Stop chewing gum as this may also be a source of swallowed air.
  • Try decreasing or eliminating lactose in from your diet.  Lactose is a natural sugar found in dairy products.  As we age,  we start making less of the enzyme necessary to break down the lactose.  Lactose-free milk is readily available at grocery stores for those who want to continue drinking milk.
  • Certain vegetables are known culprits for causing gas.  Healthy vegetables such as cauliflower, asparagus, brussels sprouts, and cabbage all contain a natural sugar which some people have trouble digesting without an over-the-counter enzyme supplement such as Beano.  Beano provides the necessary amounts of enzymes to break down the natural sugar from these vegetables.  Or, simply consider eating smaller amounts of these foods!
  • Certain fruits such as apples, pears, prunes, and bananas may also be problematic due to the natural sugars fructose and sorbitol. No need to cut these fruits and the vegetables out, just try to pinpoint with food tracking which fruits and vegetables seem to be the gas culprits.
  • Many dietetic goodies also contain a lot of sorbitol which is used as a sweetener. If you consume a lot of dietetic foods, consider decreasing your intake to decrease your sorbitol intake and symptoms.
  • High fiber grains can also be gas culprits due to the soluble fiber.  Fiber is important for over-all health, so if you are having trouble with fiber rich grains, just increase these foods gradually.  Most people adapt to a higher fiber intake within a few weeks.

The best way to determine your dietary gas culprits is to track your food and your symptoms. As everyone is different, some food eliminations work for some and not for others.  Being aware of how you respond to your dietary adjustments is key to less gas discomfort.  If symptoms persist and your physician has ruled out any medical conditions, seeing a dietitian can help you sort through the best eating strategies in order to both minimize gas and keep you healthy!

 

Maybe Getting Too Much Iron? Then, Pick These Cereals and Not Those Cereals!

Iron consumption is critical for the health of all-especially women of childbearing age, infants, and children.  Iron deficiency can cause a range of symptoms from energy draining anemia to disruptive behavior in children.  Because adequate dietary iron is so critical to health, many of our foods are fortified with iron to lessen the public health risk of too little iron.

Cereals are probably the most widely iron fortified food in this country.  For infants, iron fortified baby cereal is an excellent way for babies to get the iron they need to grow.  For older children and adults, a single serving of cereal can provide 100% of the recommendation for iron.

But what happens if a lot of this highly fortified cereal is eaten by men and older women who have significantly lower iron requirements than younger women and children?  Women of childbearing age need 18 mg of iron, but men and  women in menopause need only 8 mg of iron.  While a healthy body can actually exert some control over absorbing too much iron, once in the body, it can be problematic to excrete. If too much iron is absorbed on an ongoing basis, it can cause a range of symptoms from increased infection to organ failure in susceptible individuals.

If you walk down the cereal aisle and start looking at the Nutrition Fact Label on cereal boxes, you will see that some of the most popular cereals-including some of the healthier high fiber whole grain varieties- are often packed with 50 to nearly 100% of the recommended 18 mg suitable for younger women.  So, what about a man or older woman who chooses to eat multiple servings of a these cereals in a given day?  They would be ingesting much more iron than they need, potentially placing themselves at medical risk over the long run.

Let’s look at how some popular cereals stack up per serving with regard to the 18 mg iron requirement:

  • Cheerios have 6.3 mg
  • Special K has 6.3 mg
  • Corn Chex has 9 mg
  • Corn Flakes have 9 mg
  • Raisin Bran has 6.3-10.8 mg (depends on the brand)
  • Wheat Chex has 14.4 mg
  • Frosted Mini Wheats have 16.2 mg
  • Multi-Bran Chex has 16.2 mg
  • Total has 18 mg

For those who love their cereal, but need less iron, there are some lower iron choices such as:

  • Kashi cereals range from virtually no iron up to 2 mg depending on the variety selected
  • Puffins have less than 1 mg
  • Cooked oatmeal has less than 2 mg
  • Fiber One has 4.5 mg
  • Frosted Cheerios have 4.5 mg
  • Basic 4 has 4.5 mg
  • Flax Plus Multibran Flakes has less than 2 mg

Given that many people eat more than the standard  ½-1 cup serving size, there is little doubt that some of you are consuming very large amounts of iron from cereal.  Couple large serving sizes of iron fortified cereal with a glass of orange juice, and the iron absorption triples from the vitamin C in that orange juice!

Should you change your cereal choice based on your iron requirements?