The Real Skinny on Fat Habits

I’m excited to announce that two nutrition experts, whom I hold in high esteem, have jointly written a book entitled The Real Skinny: Appetite for Health’s 101 Fat Habits & Slim Solutions (Penguin). Julie Upton, MS, RDN, CSSD and Katherine Brooking, MS, RDN run the a great website and blog called Appetite For Health which is loaded with great information on health, nutrition and features new products and great deals that are health related.

Now on to their book. Truth be told, I’m not much of a fan of diet books in general. I guess that’s why I haven’t written one yet …don’t hold me to that, though! Ha! But The Real Skinny isn’t really a diet book, per say. It’s more of a book of solutions to common “fat traps” that we all fall into. Sure, there’s some neat recipes and a 14-day menu plan tucked inside, but what I liked most were the 101 Fat Habits and the Slim Solutions that Julie and Katherine offer. Take Fat Habit #61 for example. I’m a nighttime nosher, for sure. I have a degree in nutrition and should know better but as I always say, when it comes to lifestyle, knowledge is great but it’s what you do that counts! Nighttime nibbling, especially the just-open-a-bag-of-anything-and-start-eating habit is the worse. Eating late at night can really ratchet up the number of calories that your mind doesn’t even register because it’s not a “sit-down” meal. But it’s not just eating late at night that’s the problem. According to Upton and Brooking, “Studies show that distracted eaters gobble up more calories compared to non-distracted eaters, and those who watch TV and eat consume 20-100% more calories compared to individuals who eat without distractions. Even worse, distracted eaters reported being less satisfied.”

People who tend to eat late at night are at more risk of being overweight, having sleep disorders and the list goes on. So what’s the Real Skinny solution? Well Julie and Katherine give you eight to choose from including eating a fiber-rich dinner and eating dinner a little later so you are full and satisfied until bedtime. My favorite tip is keeping yourself busy. Think about it. Most of us just want to unwind – which translates to zoning out in front of the tube and keeping our hands and mouths busy by filling them with food. And of course, your ability to monitor what you eat and cut off eating when you are actually full goes out the window when watching TV. Find things to do or hit the hay early and get up earlier!

Julie and Katherine also offered some insight to their book that I thought I’d share with you.

Do you need diet foods to lose weight?

There are no “special” or “manufactured” foods required to lose and maintain a healthy weight. In fact, good-for-you unprocessed foods like fruits, veggies, whole grains and lean proteins are probably the best foods to help you lose weight.

Many dieters get stuck on using pricey unhealthy “health” foods: diet foods, sugar substitutes, diet sodas and other calorie-reduced items that aren’t necessary and they aren’t always associated with diet success. Some studies even suggest sugar substitutes interfere with the body’s natural mechanisms to regulate caloric intake. Use diet foods and beverages sparingly and be mindful that they alone, will not equal diet success. A recent statement from health organizations say that if you use sugar substitutes as a replacement for foods and beverages with added sugars, they can help you cut calories. We suggest using sugar substitutes sparingly and limiting diet beverages.

How do you recover when you totally blow your diet?

Chronic dieters often adhere to strict all-or-nothing diets that are too restrictive and unrealistic. It’s like trying to walk on a tightrope for life, which explains their lack of success. We all will eventually fall off. Instead of thinking of a strict eating plan that doesn’t fit your lifestyle, focus on strategies that you can, with a little work, realistically live with.
You need to expect slip-ups to happen when you’re losing weight, so how you deal with a bad day, week or month helps predict success. Individuals who can lose and maintain weight loss can be flexible enough with themselves to bounce back to healthy eating. Think: Life Happens or as I like to say, #$%! Happens! And start fresh tomorrow.
of meals and snacks, you need to only eat. When the brain is distracted, it takes significantly more calories to get the same level of satiety.

Is there a difference between food calories and liquid calories?

New research shows that we’re drinking a great proportion of our calories than ever before. In fact, one-quarter of the population drinks nearly 300 calories a day from sugary drinks like soda, fruit drinks, energy drinks, flavored water and gourmet coffee drinks. The problem with drinking our calories is that they’re less satisfying than when we eat foods, so we’re unlikely to eat less when we drink more calories. In addition, most beverages with calories get their calories from nothing other than sugar. This sugar is rapidly absorbed by the body and may increase risk for metabolic syndrome, type II diabetes and may increase hunger and cravings. It’s important to think before you drink.

You can purchase a copy of The Real Skinny and find out more about Appetite for Health by visiting Julie and Katherine’s website, http://www.AppforHealth.com .

Would you like to win a copy?? Hit me up in the comment section and tell me why you need this book! Most compelling story wins!!

Dietary Supplement Advice That’s Not Hard to Swallow

If you haven’t received the memo yet, we are a far cry from meeting the nutrition and healthy eating objectives of the 2010 Dietary Guidelines for Americans (DGAs), according to studies. The DGA committee identified that many fall short of reaching minimal healthy levels of key nutrients including vitamins A, C, and E, calcium, magnesium, potassium, and fiber. One study showed that less than 5% of adult workers meet dietary fiber recommendations. This may explain why irritable bowel syndrome and sales of laxatives are on the rise.

In my new book, The Best Things You Can Eat, I talk about what foods can help bridge these short-gaps in nutrients. I’m sure this information will be helpful for many of my readers but I’m also a realist. Even those who follow a healthy diet (including myself) or have all the best intentions to do so, don’t always eat perfectly…everyday. That is one of the reasons I included information on dietary supplements in the new book and have always recommended dietary supplements for my patients, family and even myself.

Even if you are on a great supplement program, if you don’t take them, they aren’t going to do you much good. So what are some of the roadblocks to taking supplements? I asked Judy Blatman, senior vice president or communications from the Council of Responsible Nutrition (CRN), for her thoughts on why people either don’t take dietary supplements or why those who do may have a hard time sticking to their regimen. She mentioned that CRN conducted a consumer survey this year that investigated supplement habits of consumers and health professionals alike. “We did ask those who indicated that they didn’t always comply with their daily supplement routine, to select the main reasons why they didn’t,” says Blatman.  The top three answers were: 

1. I get busy and forget to take them
2. If they’re not in plain sight, I forget to take them
3. Some days, I just don’t feel like taking them.

These all make perfect sense to me. Even I forget to take my supplements for all the very same reasons! And to spin off the last reason of “Some days I just don’t feel like taking them”, swallowing huge capsules or tablets are a physical impossibility for me. Have you ever had a tablet or capsule get stuck in your throat? Owww! It’s painful and the most uncomfortable feeling I can possibly imagine. My solution? I chew EVERYTHING! Yup…that includes my fish oil capsules, too! Not pleasant, eh? So, it’s not surprising that even the espousers of dietary supplements don’t always take them if their own advice is literally “hard to swallow”!

Good news. I was approached earlier this year by the folks at Nature Made who clairvoyantly knew of my supplement plight. They were excited to announce that they created new lines of dietary supplements with the sole purpose of making the task of taking supplements doable if not downright pleasurable! I was all ears. Long story short, they sent a variety of products for the whole family to try out that included adult gummies, full strength minis and a new type of small tablets called vita melts that literally melt in your mouth! They were amazing and really solved my swallowing challenge. I liked them so much that I started working with Nature Made to spread the good news! So I thought I’d share what the Grottos are taking as a core program as a result of trying the new products. Of course, I would be remiss if I didn’t thow in a bit of advice to seek out a qualified health professional for dietary supplement guidance. Okay? Do it! I also provided links in the photos in case you want to know more about the supplements.

My three daughters, who are all in their teens, take the full strength minis. So does my wife Sharon.

This is my base program. I take the men’s full strength mini’s multiple plus two of the the smaller omega 3 supplement. I also take an additional 1000i.u. of vitamin D in the vita melt series. They taste GREAT!

Lastly, I wanted to share some cool gizmos and apps that address the first two reasons that folks don’t take supplements from the CRN survey.

I forgot:
CRN’s Life Supplemented campaign also designed a cool iphone app that can be used on your ipad as well. Besides reminding you to take your supplements, it eve has a restock reminder to tell you if you are getting low.

They don’t have an android version out yet but rumor has it that there may be one available in 2013. Meanwhile, I ran across another app that works great for android devices.

Having them visible.

“Having your supplements out on your kitchen counter, on your desk, in your pocketbook so they’re visible can really help,” says Blatman.  
Even for those times when your supplements aren’t in a direct line of sight, here’s a great carrier for them that will sounds an alarm when its time to take them. Cool eh?

I hope that helps break down some barriers to taking your supplements regularly. Have you found any supplements, apps or supplement carriers that you would recommend that make taking supplements easier? I’d love to hear from you!

Thank you to my intern, Jamie Digiovanni, who helped me with this story.

1. Kachan D, Lewis JE, Davila EP, Arheart KL, LeBlanc WG, Fleming LE,
Cabán-Martinez AJ, Lee DJ. Nutrient intake and adherence to dietary
recommendations among US workers. J Occup Environ Med. 2012 Jan;54(1):101-5.

2. J Am Coll Nutr February 2009 vol. 28 no. Supplement 1 69S-72S

Take Heart: This is One ER Doc You Don’t Want to See (except on television)

 

 

 

 

 

As featured today on WebMD Real Life Nutrition

By David Grotto, RD

Wow! That Giants – Patriots game last night sure was enough to make your heart skip a beat, eh?! Patriots fans may have felt a twinge in their chest at the end of the 4th quarter with that disappointing loss. And believe it or not, getting caught up in the excitement of an action-packed Super Bowl game might be enough to land you in the emergency room!

Doctors in the ER see their fair share of chest discomfort come through their doors. According to the Centers for Disease Control, every year about 785,000 Americans have a first heart attack. Many don’t even know they are having one, and depending on where in the heart the attack occurs, some won’t live to experience a second one. Heart disease is the number one killer of both men and women, accounting for nearly 600,000 deaths in the U.S. in 2009, according to the CDC, with an estimated declining figure for 2010 of 400,000 deaths, according to the World Health Organization. Slightly more than half of those deaths occur in men. And unfortunately, women are closing that gap.

Many women wouldn’t mind seeing the doc I interviewed for this post in the ER. You may know him from his appearance on The Bachelor or as “Dr. Travis” from the award-winning talk show, The Doctors. He doesn’t just play a doctor on TV – he actually is a highly trained emergency room doctor by profession. Dr. Travis Stork, MD graduated Magna Cum Laude from Duke University and earned his MD with honors from the University of Virginia. He works as an emergency room doctor and brings his real life experiences to the show he co-hosts and to his bestselling books: The Lean Belly Prescription and The Doctor Is In: A 7-Step Prescription for Optimal Wellness. But Dr. Stork would prefer never to see his fans in the ER. “You can’t reverse the effects of dead heart muscle once you’ve had a heart attack,” he says. “So don’t wait until you have one to start following a healthy lifestyle. You don’t want to come to the ER and hear me say ‘it’s too late.’” So with an eye on prevention, I asked Dr. Travis Stork to share his thoughts on our current battle against heart disease and his best advice on how to avoid ever seeing him in the ER.

Are we making any progress in the war against heart disease?

Dr. Stork. The numbers are still alarming. It’s still the #1 killer of both men and women. Death rates are declining, which is good, so yes, we are making headway. But in some respects, we are doing worse. We’ve made advances in diagnosis. [Many] women most likely died of heart disease years ago but we might have thought it was from something else because we didn’t think of heart disease as a “woman’s disease”. In the last decade or so, there has been a new focus on women and heart disease and more progress is being made. But time is so limited with your doctor, so conversation is also limited and heart disease messages don’t always get out there. Media is doing a better job and I think our show is getting the word out. However, I’m concerned that if we don’t reverse our current obesity trend, it won’t matter how great our technology is — we won’t make the headway needed to continue to curb heart disease.

Let’s start with the doctor-patient relationship. What can be done to foster better communications there?

Dr. Stork. Feel empowered. Talk with your doctor about steps to improve your health. Ask him/her, “What are the steps I can take?” So much education has to take place outside of the doc’s office – there’s simply not enough time during a visit to cover everything. Knowledge is power. When you visit your doctor to discuss treatment strategies, bring information with you so he/she can tailor a program more to your needs. The doc will know where you’re coming from and can better gage your motivation to make lifestyle changes. What lab tests/technologies are the best indicators that we are at risk for heart disease? Dr. Stork. Cholesterol is a good baseline test. Just like what leads to glucose and blood pressure problems, heart disease starts early in life. Your cholesterol may be perfect at age 20 — at least you know where you are at, if you have it tested. If it is elevated, you need to take extra precautions. Having your blood pressure, glucose, and cholesterol tests done as recommended are the best ways to get a snapshot of your health and they are fairly cheap to have performed. Know your numbers! For example, 64 slice CT scans are often advertised to detect heart disease, but most insurance companies don’t pay for them. Why? Is it worth the out-of-pocket investment? Are they accurate? We have more and more tech that can detect heart disease earlier. But whether the CT scan shows or doesn’t show disease, you should live every day to maximize heart health regardless of the results. Why would you want to wait until you have a problem to act?

What dietary and lifestyle advice do you recommend for your patients and fans?

Dr. Stork. Be wary of some new food that gets positive press — the #1 food that is supposed to be the be all and end all when it comes to fighting heart or any other disease. Consumers tend to latch on to the next big headline. Our show checks out how valid the information is about a food or product before jumping on the bandwagon. People don’t need to get distracted by the headlines – keep it simple. Soluble fiber from oats can lower cholesterol. Ordering salads without the creamy dressings and instead using olive oil and vinegar is a simple thing to do. Don’t focus on can’t do, focus on can dos. I ride my bike to work every day, rain or shine. It’s important to do physical activity that you enjoy doing. I feel when we talk about physical activity in a clinical setting, it sounds so boring. Getting active can be as simple as just getting on your feet more and not about going to the gym more. Getting on your feet doesn’t have to be one of the things you hate. In fact, it can reduce C-reactive protein (a marker for inflammation). Try getting on your feet when you’re on the phone. Most say, “I can do that!” Those are the kinds of messages that people relate to – 30 more minutes of activity versus watching more TV. Try to view health as a hobby rather than something you dread. You will get more enjoyment out of life and have a more positive attitude.

Can you lower your cholesterol without drugs? Are their dietary supplements that you recommend for lowering cholesterol?

Dr. Stork. Be careful with dietary supplements. I believe that eating whole foods has the best benefit for your health. Beans, oats, nuts, olive oil in place of butter, and fatty fish are all heart-healthy foods. More docs are recommending Omega 3 supplements for helping to control triglycerides. My #1 advice: treat a supplement like you would a medicine and talk to your doc. Tell your doctor what you are taking so that it can be entered into the electronic medical record. That way he or she will know what supplements you are taking in addition to your meds and will have a better idea of what you are doing. There is a role for supplements but be cautious about how they are used.

We hear inflammation is tied to heart disease. What can we do to reduce inflammation?

Dr. Stork. Believe it or not, flossing your teeth everyday helps control inflammation and inflammation is connected to heart disease. Data on flossing and longevity is quite interesting – decreasing your bacterial load in your mouth is good for your gums and may be good for your heart. Eating fruits and veggies can also help reduce inflammation.

Are statins safe? Any concerns with them?

Dr. Stork. Meds are patient specific. Statins can raise liver enzymes and possibly cause myopathies. But they can be very effective in lowering cholesterol. I take a two-pronged approach – just popping a pill is the wrong mindset. Meds are important. No matter what some people do to take care of themselves, they may be predisposed to heart disease, so meds might be appropriate for them. Yes, there are docs who are “meds first” and there are docs that are “lifestyle first”. We are getting better and better at offering lifestyle but some are still just giving meds – it’s easier. We probably do, as a profession, lean too much on meds because of the grim stats. It is difficult for many patients to make the necessary lifestyle changes.

How often should you see your doctor?

Dr. Stork. See your doc annually and have your cholesterol checked annually as well. Seeing your doctor should be tailored to your needs. The good news is if you take good care of yourself, then you don’t need to go to the doc as much. View health care as a check-up. The better choices you make, the longer time you can go between checkups. For example, if your blood pressure is elevated, you might have to see doc more frequently to make sure it is under control.

Final thoughts?

Dr. Stork. My personal belief is all of us should live our lives as if we have heart disease. Don’t wait until you have a diagnosis or a bad lab value to make the necessary lifestyle changes to lower your risk. Diagnostic tools are great, but why wait? Assume you will have heart disease unless you make the right choices. Control the risk factors: Smoking, high blood pressure, high cholesterol, high triglycerides, untreated diabetes, obesity, stress, and lack of regular exercise. What’s interesting is there are really three simple things you need to do – get active, eat better, and stop smoking. Concentrating on these three risk factors leads to all the others.

Thanks to Travis Stork, MD for sharing his wonderful advice. Next week I’ll offer some of my own advice on the best foods for fighting heart disease along with some yummy recipes! Stay tuned and have a great week!

Grapefruit: Not Just a “Chick Fruit”

As featured in Real Life Nutrition, WebMD

By David Grotto, RD, LDN

One of my fondest memories as a kid was sharing ruby red grapefruits with my big sister for breakfast. She would slice one in half, cut all the segments for me, and sprinkle just a little sugar on top. I would scoop out each segment and then, when they were all gone, tilt my head back and squeeze the remaining juice from the skin into my mouth. It was fantastic…sometimes I ate two halves because they were so tasty! Gosh…that was probably 40 years ago and I’d be lying if I told you that I’ve done that more than five times ever since!

I can’t for the life of me figure out why I abandoned something I enjoyed so much as a kid. Sure, I’ve had grapefruit and grapefruit juice a handful of times since then, but it has never become a regular part of my dietary routine. This is surprising to me, especially since I deemed grapefruit a worthy member of my book 101 Foods That Could Save Your Life. When I was doing a literature review on grapefruit, I discovered that one-half of a medium grapefruit delivered quite an array of nutrients and health benefits:

• It’s only 60 calories and supplies 100 percent of the recommended daily value of vitamin C.
• Pink or red grapefruit contain more than 50 times the amount of carotenoids of white grapefruit.
• Grapefruit contains more than 150 phytonutrients, mostly flavonoids, which have been found to help the body fight against aging, allergies, infection, cancer, ulcers and heart disease, to name a few challenges.

So why don’t I eat it more routinely?

Back in the mid 1700’s, the grapefruit was referred to as the “forbidden fruit of Barbados.” I don’t really know why it was called that, but I have observed that not a lot of my guy patients eat grapefruit. Maybe they think it’s forbidden to them? I do think it has a lot to do with the image of the grapefruit as being a “dieter’s fruit.” And if you look at how the fruit is marketed today, it’s definitely targeted towards women. Check out this website and you’ll see what I mean. I rest my case.

So why am I writing about grapefruit if it’s such a chick fruit? I’m on a mission. My friend and colleague, Dawn Jackson Blatner, RD, reminded me that grapefruit is a perfect fruit for guys, too. I remembered that one of the carotenoids that pink and red grapefruit contain is lycopene, which benefits the heart and those special parts—like the prostate gland—which often comes back to haunt guys later in life if we don’t feed it right. Grapefruit also contains the citrus flavinoid naringenin which was found to help repair damaged DNA in human prostate cancer cells. And speaking of the heart, I also found a study where researchers fed one grapefruit a day to 57 patients who had high cholesterol, triglycerides and went through bypass surgery. After 30 days those who consumed one red grapefruit a day showed a better lowering in total cholesterol, bad cholesterol (LDL) and triglycerides compared to those who didn’t. Check out this video interview I just did with Dawn on why guys should eat grapefruit.

 

Grapefruit Salsa Photo and recipe courtesy of gofloridagrapefruit.com

Here’re some tips on adding grapefruit to your dining routine:

• When choosing the perfect grapefruit, choose those that are firm and heavy for their size but slightly springy to the touch of light pressure.
• Taste quality is not affected by skin discoloration, scratches or scales but avoid those with overly rough or wrinkled skin.
• Also avoid those that appear to have water-soaked areas or have an overly soft spot at the stem.
• Grapefruit are juicier when served warm rather than cool, but I think they taste better served cold.
• If you plan to consume grapefruit within one week of purchase, store them at room temperature. Keep them fresh by storing them in the refrigerator crisper for up to 2-3 weeks.
• Eat fresh by slicing the fruit in half, separating the flesh from the membrane and scooping out each section with a spoon. Not sweet enough? Just a sprinkle of sugar will do the trick.
• Special curved-blade “grapefruit” knives or serrated grapefruit spoons can be purchased, too.
• Lastly, guys, don’t care about all that health business unless the food also tastes great. Once again, grapefruit delivers.

Here’s a recipe you might want to bust out on Superbowl Sunday (by the way, next week’s post is all about “super bowls” for the superbowl).

Grapefruit Salsa

Yields: 1-1/2 cups.

Ingredients:

2 TBSP. lime juice

1 TBSP. olive oil

1 tsp. minced jalapeno

1/2 red bell pepper, minced

2 TBSP. minced red onion

1 large Florida grapefruit, peeled, membrane removed, sectioned, chopped

1/4 tsp. ground cardamom

2 TBSP. chopped fresh cilantro leaves

Directions: Toss all together. Serve chilled as side dish to barbecued meat, seafood and nachos.

For women only: Shhhhh. We both agree that YOU are the true caretakers of guys—no surprise here. As you know, sometimes guys just need a little direction and a big push. But I have an added incentive for all you ladies to serve grapefruit to that special guy in your life. Check out this research… Thirty-seven men and women were asked to estimate the age of a series of models in photographs while wearing masks that were infused with the various aromas and then again while wearing a regular surgical mask. When women wore the mask infused with grapefruit, they were closer to the correct age. But when guys inhaled the smell of grapefruit, it made them guess that the models were six years younger than they actually were. Hey, just wanted you to be prepared. Please, no need to thank me…all in a day’s work for the Guyatitian.

Is It Too Late?

Photo courtesy of www.fatbellyexercises.com As featured in the Real Nutrition section on WebMD By David Grotto, RD, LDN As promised, I offer you  part deux of  Houston, I Don’t Think I Have a Problem…yet… Some of you were kind  enough to share a bit of your own weight management struggles with me last  week, and I really appreciate that. But I couldn’t help but sense that there   are those of you who are still quietly waiting in the wings, hovering between   pre-contemplation and contemplation, trying to figure out if you even have a  problem or not. And if you do realize that you have health problems, many of   you might be figuring out what your problems might be and then pondering what  you can realistically do about them. All of this can be quite a pain and   perhaps you are feeling one of those big “why bother?” moments coming on.   You’ve been down this path before and the odds seem like they are always   stacked against you. You lose a pound only to gain back two. I get it…totally   frustrating. Is it even worth trying anymore? Do we have a hope of ever  getting back to the glory days state of health we once enjoyed? If you read The Fat Trap by Tara Parker-Pope in the New York Times, you may have come away with the feeling that when it comes to losing weight   for many of us, the only real “losing” that will be happening in your future  will be that of hope…a total downer for sure. But thankfully, in come the  cavalry of science, common sense and hopefulness. I read a very eloquent   retort to Jessica Parker-Rope’s article from David Katz, MD, MPH featured in  the Huffington Post in which he pointed out that when we ask: “Our bodies: with us or against us?” we are asking the wrong question. I asked the   optimistic yet pragmatic Dr. Katz to weigh in on our ‘health state of the  nation’ and to also expound upon some of the challenges and solutions that he  discussed in his article. Have we thrown in the proverbial towel? Are we in the right mindset to make serious changes at this  time? What will it take before we act? Dr. Katz: The one word answer is passion.  When enough of us are passionate about this cause, we will turn the tide. I’m  not sure we’re there yet – but I think we’re getting there. You spoke of an  “optimal environment that works with our natural traits and tendencies” in  your rebuttal to the Fat Trap featured in the Huffington Post. Describe what  you mean by an “optimal environment.” Dr. Katz: Up to a point, we might contend that a Stone Age environment is optimal for our native traits. But that point   would be a life span of about 40 years, MAX! One of the problems with invoking our native Paleolithic environment is that Stone Age humans died at 20 on average, and rarely made it past 40. Still, that is the environment to which we are adapted – so it’s a starting point. The true optimal is a   modified Stone Age environment: one in which food is direct from nature,  there’s routine physical exertion, clean air and water – enhanced by  protection from the elements and predators and pathogens. In essence, we need wholesome food close to nature, the conditioning daily exercise native to our animal vitality, adequate sleep, avoidance of toxins, control of stress and loving relationships in our lives. These are our native tonics. How do we go about achieving this environment? Dr. Katz: Incrementally – one paving stone,  sandbag, program practice, and policy at a time. We don’t need a Stone Age  environment to get exercise every day – but we need incremental modifications  of the built environment and daily routine to move us in that direction. We don’t need mammoth meat or Stone Age plants to chew on – but we do need to eat more plants and foods closer to nature in general. We have the means at our disposal to do that—we just need to apply them. Do you feel our present dietary guidelines are appropriate? What would happen if we actually followed them re: rates of obesity, heart disease, diabetes, longevity, etc.? Dr. Katz: They are appropriate – although not optimal. Let’s acknowledge that they are devised by government agencies with a need to keep large corporate interests placated. The Dietary Guidelines are openly a blend of science and politics, not pure public health science. But despite their limitations, they are much better than the typical American Diet. So yes, were we to better approximate them, rates of heart disease, cancer, stroke, diabetes, sleep apnea, arthritis and so on would come down substantially. If we got to truly optimal diets, exercised routinely, and avoided tobacco – we could eliminate fully 80% of the entire chronic disease burden.  ‘Tis a consummation devoutly to be wished! Do you feel that the food industry is doing enough to change the environmental landscape? If not, what needs to change here? They are not doing nearly enough. What needs to change is that they must take responsibility for creating the prevailing preferences for copious additions of sugar and salt and fat. As is, they tend to throw up their hands and argue they are just trying to keep the customer satisfied. But they had a hand in creating the palate that prevails in the USA—in essence, they cultivated the addictions and now provide the fixes! They should work a whole lot harder to help cure the addictions. They should stop using marketing to distort accepted truths about nutrition (what on earth is “enhanced” water?). And they should embrace measures of nutritional quality developed by objective 3rd parties, not their own hired guns. What changes would you like to see to promote more physical activity? Dr. Katz: Programming adapted to every setting and ability level. Programs that fit into every school and work day.  Ways to be active all at once; in small doses; in planes, trains and automobiles. We are not going back to the Stone Age, so we have to engineer solutions that fit into the modern world as it is. Our ‘abe’ for fitness   program is an example of what I mean. So is our school program, ABC for   Fitness. Is there enough consumer awareness to drive change? Is it out of our hands at this point? Have we reached the point where we can no longer decide for ourselves what’s best for us? Dr. Katz: Consumer awareness is not enough – but consumer passion is [enough to drive change]. It is not out of our hands. Demand trumps supply and if every loving parent and grandparent in the country came together around causes devoted to protecting the health of children, no special interest group could withstand our collective might. We have the power – but we need common cause. It begins with common understanding – so we professionals have our work cut out for us. We must   cultivate the common will so we come together to pave the way. I think what Dr. Katz  proposes will take nothing short of a massive collective effort requiring many intricate wheels to turn simultaneously to work. I agree that we do have many of the tools, the power, and the knowhow at our disposal to make real change for the better happen. But I do wonder, as Dr. Katz mentioned, if we have enough passion to pull it off. Your thoughts? Do we have what it takes to turn the boat around?

Now THAT’S Healthy!

"Shelvic Exam"

Congrats to Lauren Harris-Pincus, MS RD, aka “Nutrition Babe”  who submitted a picture of her healthy refrigerator as part of my Sears FitStudio Shelvic Exam chat contest. These chats are held every Wednesday evening throughout November from 7:30-8:30pm CST on Twitter at #FitStudio as part of my Healthy Kitchen Makeover project.

What made Lauren’s fridge a winner? Take a peek below!

Where do I begin? Look at all of the yellow arrows of goodness!

Produce: Lauren has plenty starting from the bottom up. I like to see those crispers jammed packed with fruits and veggies. It’s hard to make half your plate fruits and veggies unless you have plenty in the fridge.

Dairy: From Greek yogurt, to low-fat milk, to cottage and cheese wedges, Lauren has plenty of calcium rich-dairy to build healthy bones. She even has an almond beverage as a change of pace – not super high in protein but it does have at least 30% DV of calcium, depending on the product.

Eggs: Lauren has both egg replacers and the real deal. Both are healthy but I always recommend whole eggs for their nutrients such as choline (good for brain health) and Lutien ( a nutrient that’s great for the eyes).

Others: She also has calcium fortified 100% orange juice, low sodium chicken broth, fun snack packs of hummus and some jarred white fish for a quick source of great protein.

What’s NOT there! Lauren still could have had some goodies in there from chocolate, a few cans of soda, and so on and I would have still awarded her 1st prize. But there is no doubt that Lauren has her eye on the prize -not just the lovely Yoga Mat she won courtesy of Sears and yours truly – but more importantly, her health!  Take one look at Lauren’s photo here on the Nutrition Babes website and you can see she is one RD who practices what she preaches! Great job, Lauren – congrats!!

Join me this Wednesday at 7:30pm CST on Twitter for more great Kitchen Makeover information and terrific prizes from Sears and the Guyatitian!

Male Call!

Just in time for Father’s Day, here’s some great advice from the AMERICAN DIETETIC ASSOCIATION on how to encourage the men in your life to take ownership of their health and nutrition.

When was the last time your father, brother, husband or partner cooked a meal, asked for a second helping of vegetables or did the grocery shopping? If recent trends are a guide, it happened recently, according to the American Dietetic Association.

“More than ever, men are playing a role in buying and preparing the food that is eaten in their household,” says registered dietitian Martin M. Yadrick, past president of the American Dietetic Association. “Not only is budgeting finances important, but men are also realizing the need for healthy calorie budgeting, too.

“Think of eating in terms of contributing to your 401k. Doing the right thing over time will make a huge difference down the road,” Yadrick says. “My advice is: Guys, take ownership of all your personal health needs.”

Registered dietitians say men’s questions, interests and needs regarding food and nutrition tend to focus on such areas as being healthier; looking good; performing at their best; having more energy; recovering from injuries and
learning how they can excel through healthy eating and activity habits.

For men of all ages and all stages of life, eating right and being physically active are as important to health as annual physical exams and visits to the dentist, Yadrick says.

“For men as well as women, good nutrition is vital, but a man’s nutrient needs are unique due to higher muscle mass, larger body size and hormonal differences.”

Men can serve as an example of healthful eating – at work or at home – by making smart foods choices when they’re around colleagues, children and spouses.

“Cut down on meat portions and fill up the extra space with fruits, vegetables, whole grains, beans, nuts and seeds,” Yadrick says. By including these foods on your plate every day, men can benefit their health and potentially stave off obesity, heart disease, type 2 diabetes, certain cancers and dementia.

“You can stay healthy and active longer – and that includes your sex life and fertility – if you make good choices when you eat,” says Yadrick.

With research showing that making small dietary and lifestyle changes every day goes a long way toward improving your overall health picture for life, Yadrick encourages all men to jump aboard the eating right bandwagon.

“Adding nutrient-rich foods like fresh fruits and vegetables at every meal is a great step in the right direction. Cutting down on portion sizes can make a huge difference in your overall calorie intake,” Yadrick says.

“It’s the results that matter to men, and our taste buds and health can provide the proof that eating right pays off.”

To find a registered dietitian in your area and to learn more about men’s health and nutrition, visit http://www.eatright.org/menshealth/.

10 Best Superfoods for Men

You’ve heard that the way to a man’s heart is through his stomach — so is the way to a healthier body. In light of June being Men’s Health Month, here’s a list of 10 superfoods he should eat daily.

1. Tomatoes are an excellent source of vitamin C, potassium, and the plant substance known as lycopene — great for heart and prostate health.

2. Broccoli is rich in natural cancer-fighting chemicals and loaded with heart-healthy, immunity-building nutrients such as vitamins A, C and folate — a B vitamin found to protect against heart disease. Preparation tip: Steam broccoli to help preserve vital antioxidants.

3. Salmon — whether smoked, canned, fresh-caught or frozen — is an excellent source of omega-3 fats, which help reduce inflammation and improve cholesterol.

4. Berries are “berry” good sources of nutrients such as vitamin C, potassium and anthocyanins, which are known to fight heart disease, cancer and diabetes. Rich in fiber and low in calories, berries taste great in salads or over breakfast cereal. Pick a color, any color!

5. Soy may boost prostate and bone health, research reveals. The Food and Drug Administration has also approved a claim that products made from soybeans, including meat substitutes and beverages, help improve heart health.

6. Olive oil is rich in oleic acid, a type of monounsaturated fatty acid that boosts heart health. It also enhances the absorption of lycopene (found in tomatoes), which may be helpful in reducing the risk of heart disease and prostate cancer.

7. Nuts contain fiber, healthy fats and plant nutrients called phytosterols, which are known to reduce LDL (bad) cholesterol and increase HDL (good) cholesterol. In a study featured in the medical journal Circulation, researchers found that eating a handful of almonds (about 1 ounce) daily reduced LDL by about three percent.

8. Green tea packs a group of antioxidants called polyphenols. These compounds may decrease plaque formation in the arteries and help fight prostate cancer cells.

9. Red wine contains a super antioxidant called resveratrol, found in the skins and seeds of grapes. Experts claim resveratrol assists in reducing LDL cholesterol and also helps in keeping the inside lining of the arteries that feed the heart more resistant to atherosclerosis, a.k.a. hardening of the arteries. Enjoy up to two 5-ounce servings a day, the American Heart Association suggests.

10. Whole grains, such as brown rice, oats, whole-grain breads and cereals may enhance immunity, reduce cholesterol and protect against a variety of cancers. The 2010 dietary guidelines recommend adult men consume six to eight one-ounce servings daily, with at least half of the grains being whole.

Food should be your primary source of nutrients, but most guys don’t eat an optimal diet every day. Your backup plan: take a multivitamin. Choose one designed for men’s needs. It should pack eleven milligrams of zinc and 600 IUs of vitamin D, two important players in prostate health. Since guys don’t menstruate, don’t worry about iron.

For more tailored advice on proper diet and supplementation, see a registered dietitian. All men may not be created equal — but they all have the potential to be super!

Author David Grotto is a FitStudio advisory board member, registered dietitian and the founder and president of Nutrition Housecall. He is the author of 101 Foods That Could Save Your Life and 101 Optimal Life Foods. He served as a national spokesperson for the American Dietetic Association for more than six years.

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Type 2 Diabetes and Pre-Diabetes: The Real Deal

 

The Centers for Disease Control and Prevention recently released stats that are downright scary!
· 26 million Americans have diabetes (90%+ have type 2)
· 79 million (35% of American adults) have pre-diabetes (

What is true in both scenarios is that many don’t even know they have it: seven million who have diabetes don’t yet know it and only eight percent of people with pre-diabetes know they have it. The good news is if pre-diabetes is diagnosed and managed from the outset, the progression to type 2 diabetes can be greatly reduced if not prevented entirely.

Research shows the keys are: losing five to seven percent of your body weight (10 – 20 pounds for someone starting at 200) and getting in 150 minutes of activity at least five days a week. People with type 2 diabetes can also lead a very healthy life (if they take their diabetes seriously starting day one, follow a healthful eating plan, get and stay physically active and, work with their health care provider to take the appropriate medications as their type 2 progresses over time. But unfortunately, there’s lots of misinformation out there and many don’t know where to turn to get the straight scoop on diabetes.

To help me sort out the myriad of information and get the “un-sugar-coated” facts about diabetes, I turned to expert Hope Warshaw, registered dietitian, certified diabetes educator and author of several books about healthy eating for diabetes.

Tell us Hope why you have dedicated your career to diabetes management?

Thanks for asking! Diabetes actually found me. My first job, way back (ouch, I hate to say it) in 1979, was in a unique diabetes program at Grady Hospital in Atlanta. I have stayed engaged in the diabetes field over these 30 years. Unfortunately over time, diabetes, especially type 2, has grown exponentially world-wide. Because food choices and eating habits are so integral to managing diabetes, it’s a great place for an RD to do good work. I am hopefully reaching people far and wide indirectly as the author of several books for American Diabetes Association and author of articles in Diabetic Living.

What are the most common misunderstandings about Type 2 diabetes?

Many assume that type 2 diabetes isn’t the “serious” type and that it’s typically diagnosed later on in life. Many also assume that people who are diagnosed with type 2 diabetes just need to follow a healthy eating plan, lose a few pounds and perhaps over the years, they’ll need a “diabetes” pill.

Research, which has been accumulating over the last two decades, underscores that type 2 is a progressive disease and the progression is typically kicked off nearly a decade before diagnosis. Insulin resistance, due to excess weight mixed with a positive family history, are common culprits. Type 2 diabetes is now being diagnosed in younger adults and even children. By the time of diagnosis, most people have already lost half to three-quarters of their insulin making pancreatic beta cells. Expert guidelines now recommend starting individuals on a blood glucose lowering medication to treat the insulin resistance right out of the starting gate, most commonly metformin. It’s now known that insulin production will dwindle further over time. Most people will need a progression of blood glucose lowering medicines over the years. The good news: research shows early and aggressive management to control blood glucose can slow this progression. Healthy eating, losing a few pounds, and being physically active will always offer an assist.

Is controlling blood glucose goal number one?

Having type 2 diabetes carries a risk factor equivalent to having had a heart attack or stroke. The most common complication of type 2 is heart and blood vessel diseases, not eye or kidney disease, as is often thought. Research has shown that to get and stay healthy over time, people with type 2 need to focus squarely on their ABCs: A for glucose control (both the daily glucose numbers and the two to three month A1C result), B for blood pressure and C for cholesterol (more correctly blood lipids – LDL, HDL, triglycerides). Studies show that when people think diabetes, they think glucose. They don’t make the link between diabetes and circulatory problems. Yet, three-quarters of people with diabetes have high blood pressure.

Isn’t losing weight the key to controlling blood glucose?

Research shows that the greatest impact of weight loss on blood glucose is in the first few years after diagnosis – as early on as possible. In fact, the biggest bang per pound is in the pre-diabetes phase. With a loss of 5-7% of body weight and 150 minutes of physical activity, research has shown people can prevent or delay the progression to type 2. Once insulin production is on a dwindling course, weight loss will have less impact on glucose control. So, five, ten years after diagnosis, losing weight is unlikely to correct high glucose numbers. Reality is if blood glucose is out of control, it’s time for medication.

What about carbohydrate? Is it best to eat a low carbohydrate diet?

Nutrition recommendations for people with type 2 diabetes from the American Diabetes Association and other health authorities echo the recently unveiled U.S. 2010 Dietary Guidelines for carbohydrate consumption: about 45 to 65% of our daily calories should come from carbohydrates. (Americans currently eat about 45- 50% of their calories as carbohydrates.) Countless research studies do not show long term benefit of low carb diets on blood glucose, weight control or blood fats. People with type 2 diabetes, like the general public, should lighten up on added sugars and sweets (they’re mainly carbohydrate with minimal nutrition). They should eat sufficient amounts of fruits, vegetables, whole grains and low fat dairy foods — all healthy, nutrient-packed sources of carbohydrate.

What do people with type 2 diabetes need to do to get and stay healthy?

First is facing the diagnosis promptly and taking action immediately and continuously tracking and controlling blood glucose, blood pressure and blood cholesterol – those ABCs. Type 2 diabetes is such an easy disease to deny because nothing typically hurts. And what we’re learning is that it doesn’t take years to develop the diabetes complications, most commonly for type 2 heart and blood vessel disease. These can predate the diagnosis or occur shortly thereafter. But don’t let anyone tell you this is all easy….losing weight, eating healthfully, being active is tough to do in our culture. Find yourself some support. It will come in handy!

What resources do you recommend that are credible and the most help to those with either pre-diabetes or Type 2 diabetes?

Well, of course, my books which can be found wherever books are sold and conveniently at www.hopewarshaw.com. If people want to get straight facts all about type 2 diabetes in bite size snippets, I recommend Real Life Guide to Diabetes. If they want to dig into what to eat, how to frame in a healthy eating pattern for themselves and how to address making those challenging lifestyle changes, I recommend Diabetes Meal Planning Made Easy. Both books are published by American Diabetes Association and can be easily purchased via my website www.hopewarshaw.com or ADA’s www.shopdiabetes.org.

New Dietary Guidelines Suggest Getting “Real”…Food That Is!

Eat less calories, sodium, sugar, sat and trans fat and eat more plants and drink water instead of sugary sodas. Oh yeah…and Move! That’s basically the new Dietary Guidelines for Americans distilled down to a sound-bite. So, for those of you who just wanted the “low-down”, you are free to bail on me now. For all others, behold! For here they are in all of their glory…

Enjoy your food, but eat less.

Avoid oversized portions.

Make half your plate fruits and vegetables.

Switch to fat-free or low-fat (1%) milk.

Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.

Drink water instead of sugary drinks.

This may surprise you but I embrace these new guidelines…I really do. In fact, I also believe they are based on good science and NOT the result of special interest lobby groups’ efforts (oh how we love a juicy conspiracy story!).

Take the dairy message for example; I’m not too sure how the dairy folks feel about “Switch to fat-free or low-fat (1%) milk” as part of the new guidelines. I know I’m thinking “How many people are getting in too much saturated fat and calories because they are drinking 2% or whole milk?”  According to 2005-2006 NHANES data, only 60% of Americans consume the recommended amount of milk and milk products. And out of all milk products consumed, only 1/3 is consumed as a milk beverage. So it seems that whole milk as an ingredient may be more at issue and not because people are buying too much 2% and whole milk. Anyhow, I digress…a little…

What I really like about the Dietary Guidelines for Americans is that it establishes dietary goals for better health. Who can’t get behind “Make 1/2 Your Plate Fruits and Vegetables”? But what I really loathe about the guidelines is that in their history, the majority of the population has never achieved all of the recommendations! Yet every 5 years, we are compelled to “raise (or lower in the case of “nutrients of concern”, i.e. sodium, sat and trans fat, cholesterol) the bar” despite how successful we as a society were in achieving the prior guidelines. Ah, but should we shoot the messenger? Is it the guidelines that I loathe or our inabilities to achieve them?

Guidelines without real teeth for implementation will always be just “guidelines”. It’s how we tackle them as a society that will change lofty guidelines into a roadmap for health. So I want to present for discussion how we might just go about making these guidelines “real” for everyone concerned. And I like approaching health “one delicious bite at a time” so let’s tackle what I consider the most important guideline of them all.

Task:. Make Half of Your Plate Fruits and Vegetables.

Solution?

I turned to blogger friend Jenna Pepper for some help on this one. You see, Jenna is a mommy blogger who has a kid-focused blog called Food with Kid Appeal. She already has been working on this project for as long as her kids could eat solid foods. What’s more is that Jenna also has taken her mission from the family kitchen table to the school cafeteria in the “Eat to Learn” program at Sherwood Elementary School in Houston Texas. She shared with me how this program is really making a difference in her community.

Q. What is the Eat to Learn Program?

Jenna: Eat to Learn is a year-long food education program that strives to make a connection with kids between food and learning, as well as increase consumption of fruits and vegetables in the school cafeteria. The program is not only for students at school, but also involves parents in several events. Eat to Learn was a grant proposal submitted to National Parent Teacher Association for a $1,000 grant award.  Sherwood did not receive a grant award.  We were able to fund the program with parent and community donations.  Events in the program include: 

• daily morning announcements that connects 21 fruits and vegetables served in the cafeteria to learning
• a parent meeting to educate parents on the nutrients a learning brain needs
• Turkey Trot that links physical activity to improved learning
• Lunch tray evaluations – students get to grade their lunch tray or lunch box selections
• Taste Off – a campus wide food tasting competition
• Monthly Eat to Learn flyers sent home with students for parents to read the content contained in the morning announcements.

Q. Why Sherwood Elementary?

Jenna: My sons both attend Sherwood Elementary.  Our school principal, Stefanie Noble, is supportive of building better eating habits in the student body as well as increasing student success by way of real food. Without a principal who believes in educating the whole child; including academics and wellness, the students at Sherwood would not be receiving education about real food and how it helps them succeed at school.  Ms Noble was receptive to the program from the beginning. 

Q. Tell me about the “Taste Off” competition.

Jenna: The Taste off Competition was a campus wide event, where each Sherwood student received a punch card with 9 foods listed: celery, cucumber, carrots, green beans, pears, oranges, beans, broccoli and spinach.  Each child was offered 9 types of produce and given an opportunity to taste them.  Tasters received a punch on their card.  After the tastings, students got to decide their favorite and least favorite item tasted by placing a sticker on a poster to build two Decision Charts for each grade.  After the tastings, students got to jump rope, dance, hula hoop or play soccer.   In the weeks following the taste off, each class room will receive their punch cards to build graphs and interpret the tasting data. They will also be writing journal entries and essays about the Eat to Learn program. The Eat to Learn program was designed to tie into math and language arts curriculum. 

Q. Of the 400 kids, how many tried the various produce offerings?

Jenna: 82% of the students tried all 9 items.  I saw a couple of punch cards with 3 tastes (the lowest), but of the 18% who didn’t taste all the foods, most tasted 7-8 items.   Surprisingly, raw spinach and broccoli were tasted by 95% of kids.

Q. What were the results?

Jenna: 48% selected one of the vegetables as favorite, 52% selected a fruit as their favorite.  25% preferred a green vegetable out of all nine foods offered.

Q. How do the results of this project apply to kids across America?

Jenna: Many kids do not eat vegetables, and many kids do not prefer vegetables.  Liking a vegetable and preferring a vegetable are two different things. Many kids never learn to eat items they don’t prefer. The vast majority of their diet on a daily basis is made up of various preferred items. Training taste buds starts with mindset.  If mom believes that her kiddo can learn to like vegetables, and she follows up that belief with similar thoughts (jr tasted broccoli today, that’s progress.) and actions (serving vegetables on a regular basis) and expectations (I expect that my child will learn to eat vegetables because we value food that nourishes the body) then in most cases a child will learn to eat vegetables.  What happens with mom’s mindset is more like this “Picky eaters don’t usually like vegetables.”  What do her thoughts, actions and expectations look like?  What are the results? I’m not saying that an open mindset enables every kid to eat every vegetable, but that mindset sets kids up for success with healthy eating habits.

Studies have shown that kids have more taste buds than adults.  This means they taste “bitter” much more intensely than adults do.  Some bitter vegetables are often unloved by kids until they are older and have lost some of their taste buds.  If a child has a strong reaction to a bitter vegetable at age 3, that broccoli or leafy green may forever be labeled as “unacceptable” by the child. When in reality, that same flavor could be adopted with practice or in time, as taste buds decrease, become palatable. Another issue is mindset.  How many parents would end up with literate kids if we doubted our child’s ability to learn to read?  Kids learn to read because we know they are capable of it, we expect it and our actions are in agreement with our mindset. The results (literacy or adventurous eating) fall out of the mindset.

• Mindset matters.  Believe that your child will learn to like vegetables the same way he learns to ride a bike, read or write.  With lots of practice, with parents who believe he can.
• Control of the menu.  Remove processed food from the menu, and see what kids eat.  When crisp steamed broccoli sits next to boxed macaroni and cheese, it’s hard for a palate to appreciate the broccoli.
• Make vegetables relevant to kids.  Kids want to eat foods that help them grow, learn and move.  What is it that your kids do with their mind and body?  Make sure they know that vegetables help them do what they love.
• Be consistent with your actions. Offer a variety of veggies often and in a variety of ways on a regular basis.  Some kids will eat raw spinach vs. cooked spinach.  Some kids prefer carrots cooked to raw.  Try lots of veggie salads, lots of veggies sides, roast veggies, steam them, and serve raw veggies with dips like salad dressing or hummus.  If you don’t cook, make sure you expose your child to lots raw veggies in their lunch box and select vegetables in restaurants.  Menus are full of delicious salads and side vegetable items.
• Communicate your expectations to your kids. Let kids know that nourishing their body is a value your family holds.  Let them know you expect them to nourish their body with plenty of wholesome food. Teach kids they don’t have to love vegetables or prefer them to eat them.  They can just be “acceptable”, or “not yucky.”  With so many processed foods that are chemically engineered to taste amazing, it’s hard for young eaters to accept a food item that doesn’t create a party in their mouth. 

Q. I heard a poem was written about the health benefits of eating produce and was shared with the kids at Sherwood Elementary. Can you share it with us?

Jenna: Sure!

Spinach makes memorizing math facts a breeze,
B vitamins bring oxygen to the brain helping it breath.
Antioxidants prevent brain cell death by the hour,
more brain cells = more spelling power.
Folic acid has the brain instruct your face to smile
while you put facts and figures in a huge brain file.
The iron in spinach will fuel you with energy,
run, swing, climb, slide and be done with lethargy.
Eat the spinach sitting there on your lunch tray
you’ll grow a big brain the Sherwood way.

Thanks Jenna! I like the “…and be done with lethargy” part. Hopefully this new set of Dietary Guidelines for Americans will inspire all to work together to improve the health of our nation. And maybe we will finally be done with apathy, too!

I’d love your thoughts about the new guidelines and want to hear about your efforts on the home front, at schools, in industry, etc. to make them come alive deliciously on the plate. Comment away!