Meal Plans

When discussing weight loss, I am often asked for a meal plan for the person to follow. I really do not like meal plans. There are two kinds of meal plans. The first lists specific foods in specific quantities that you should eat. The other lists food groups in specific amounts such as 3 oz of protein and 1/2 cup of vegetables but you can choose the protein and the vegetable.


Yes, meal plans are easy as you are told exactly what to eat but they also have a number of drawbacks. First, the meal plan may include food you do not like. Do you really want to waste your calories eating food you do not enjoy? Also, there are many healthy foods that may not be listed on the meal plan. Just because it is not listed does not mean that you should not eat the food (if you like cherries which are very healthy but the meal plan does not list them, don't stop eating them!). Even 30 days worth of meal plans may not cover all of your favorite foods. What if the meal plan lists a food you cannot find? Do you know what you can substitute in its place? If you just use the meal plan for a guide (for instance, 3 oz of protein, 1/2 cup of vegetables rather than 3 oz of grilled salmon and 1/2 cup of broccoli), it can still be very limiting especially when you go out to eat. Restaurants meals will rarely follow your meal plan.


"But then", I'm asked, "how do I know what to eat?" I recommend you calculate the calories of everything you eat for at least three days (at least one day should be a Monday - Friday day and one day should be a weekend day). The easiest way to do this is to enter every bite of food that goes into your mouth into a program or website that will tabulate the calories. Some people enter the information throughout the day. Others will write down everything they eat and then enter it all at once. There are several sites that do this. I have used http://www.caloriecount.about.com/. Do not make any changes to your diet during this time.


Now that you have an analysis of what you typically eat, do you see any food that has a surprising amount of calories? Is there a particular meal of the day that has the most calories? Do more than 200 calories come from each snack? These are the parts of your diet that you need to work on.


For food that has a surprising amount of calories, try to find a healthier version or variety. It may be as simple as switching ingredients such as swapping low fat milk for whole milk or a lite mayo for regular mayo. You may just need to make a healthier food choice such as an apple in place of a cookie or a lite popcorn in place of chips. Does a large number of calories come from beverages such as soda or juice? Try sparkling water with a splash of juice or a flavored water (check the label for calories). You can even make your own refreshing water by adding lemons and cucumbers to water. If you really do not want to give up that food, try eating a smaller portion. You may need to add in some healthier food to fill you up. For example, one burrito with a vegetable rather than two burritos.


Do your dinners have twice the calories of your lunch? Try eating a little larger lunch or a healthy snack before dinner to reduce hunger at dinner time. If you are not as hungry, you should eat less.


Are your snacks too large? I usually recommend keeping snacks to less than 200 calories each. See a previous blog for some lower calorie snacks.


Go to http://www.mypyramid.gov/ to find out how many servings of each food group you should have per day. Do you meet the recommendations or exceed them? Are your vegetable or fruit servings low? Adding fruits and vegetables to the diet will help make you full so that you eat less of teh higher calorie food.

Once you are able to get your calorie intake to meet your recommended calorie level and have been able to meet your pyramid recommendations, you can try to tweak your food to make it more healthy. Substitute whole grain bread for "wheat" bread, try a whole grain cereal (ex Shredded Wheat) rather than a sugary cereal (ex Captain Crunch). Try to choose fruits and vegetables in a variety of colors (red, green, orange, purple/blue). Bake rather than fry. If you do fry, use a vegetable oil rather than butter.

In this way, you can keep many of your favorite foods and add foods that you like. Sticking to a "diet" of food you choose and like is much easier than adhering to a diet someone else chose for you.

Ever have one of those days where you feel that you cannot get enough to eat? Ever wonder why? Sometimes, we know we are extra hungry because we did not eat much the day before or because we did more physical activity than usual. Other times, there appears to be no reason for it. One possible explanation has to do not so much with how much we ate but with what we ate the day before.

A study was recently published in the Journal of Clinical Investigation looking at the effects of different types of fat on appetite. Some mice were given palmitic fat for three days in a row. Palmitic fat is a saturated fat found in butter and beef. The rest of the mice were given oleic fat which is an unsaturated fat (healthier than saturated fat) normally found in nuts, olive oil and fish. After 3 days, the mice on the palmitic fat became resistant to the appetite suppressing hormones leptin and insulin. This means that the mice did not feel full and stop eating as early as they did before the palmitic fat. This led to increased calorie intake which will lead to weight gain if continued. Studies in humans have had similar results showing increased calorie intake the day after a fast food meal.

What to do? It would be easy to say, "don't eat saturated fats" but that is not always possible or desirable (ever have a craving for a cheeseburger and fries?). Now that we are aware of the effect of a high saturated fat meal, we can take steps to help prevent overeating.

• Keep this phenomena in mind and make a conscious effort to eat healthy the next day
• Do not let yourself become too hungry. Have a snack between meals.
• Start off the meal with a salad to help fill you up with minimal calories
• Eat slower than usual to allow your body the time to feel full.

No Weight Loss Support Group Meetings in July and August

We had our last weight loss support group last Tuesday. Unfortunately, our guest speaker was unable to make the group. Marcia did a great job reviewing the speaker's weight loss success story which consisted of eating healthy and exercising. We will try to arrange for other guest speakers when we resume the support group. If you know anyone who has lost weight on their own and kept it off, please pass them on to us!

We will be starting the weight loss support group again in either September or October. We will post the dates and times on this blog and in the Schweinfurt Dispatch. In the meantime, this blog will continue bringing you the latest on weight loss research and tips. If you click the "Followers" button, the blog will be delivered to your email so you do not have to remember to check this site.

We hope to see you in a couple of months!

Tips for Writing a Diet Book

One of the nutrition blogs I subscribe to had a great tongue-in-cheek article this week on how to write a diet book. http://www.diet-blog.com/10/write_your_own_diet_book_heres_how.php


Once you read the article, you realize how much all diet books are alike. It reminds me of a time several years ago when my best friend, also a dietitian, and I decided to write a diet book in which the diet is based on your hair color. We were going to make up a diet for each hair color and type (straight hair, curly hair). We also decided that a special diet would be needed for permed hair or color treated hair. There is absolutely no science behind this but my friend's husband, who has a masters degree is biochemistry, was going to write the science portion for us using enough scientific jargon to confuse even the most scholarly among us. Being dietitians, all of the diets were all going to be healthy but just slightly varied. This was all in fun due to the vast number of diet books that were popping up on the market at the time.


The article does bring up some very good points to watch out for when reading about any nutrition information. The most important point is the person giving the information. Just because the person is a celebrity or is a psychologist does not mean they know anything about nutrition. Beware of the term "nutritionist". This term does not have a legal definition. Anyone can call themselves a "nutritionist" whether or not they have studied nutrition. In order to use the term "dietitian", the person must have a degree in nutrition or dietetics, have completed an internship and passed a test. Doctors and nurses may or may not have nutrition knowledge. Marcia, the RN for our weight loss support group, has extensive nutrition knowledge but much of it was learned on her own time due to her own interest, not from nursing school.


Beware of any product that is "revolutionary", a "miracle", or something "your doctor won't tell you about". If it is that great because it really works, your doctor will tell you about it. Definitely watch out for supplements sold on the same site as weight loss information. Why do you need their supplements? Is their diet so unbalanced or restrictive that you are not getting some important nutrients from the food?

Speaking of unbalanced and restrictive, watch out for diets that limit your food choices either by cutting out specific foods or whole food groups or tell you to only eat "unprocessed" or organic food. Diets that have these "rules" can be very difficult, if not impossible, to follow. If you have a lot of weight to lose, you might have to follow this diet for months. Can you really not eat any grains for 10-12 months or longer? Can you afford to only eat organic foods? I have seen organic potato chips. Are they healthy just because they are organic? No, they have the same calories and fat as the non-organic varieties. Do you really want to restrict yourself to only unprocessed foods - fruits and vegetables? Even meat is minimally processed. Anything that has been changed even slightly or pasturized would not be considered unprocessed. Eggs are pasturized. Milk and cheese would have to be avoided. Think of all the vitamins and minerals you would be missing if you followed any of these "rules".


Another point that stood out to me is "there is a single or simple cause as to why you are fat." More than likely, there is more than one cause for being overweight and it is not the same for every person. It may be from eating too much junk food. Or eating too much food period. This is probably in combination with not burning enough calories. It may be genetic or a hormone disorder. Depending on the causes of the weight gain, the method to lose weight may be different.


"...tell people calories don't matter, and then design meal plans that are precisely 1200-1300 calories". Calories do matter per recent weight loss studies comparing different diet patterns. The Atkins diet is a great example of this. Although they do not count calories, their sample meal plans are lower calorie which is what causes the weight loss, not the "no carb" philosophy.


I hope this gives you some guidelines to follow when searching for nutrition information. Some great reliable sources of nutrition information include: the government (http://www.nutrition.gov/, http://www.mypyramid.gov/), the American Heart Association(http://www.heart.org/HEARTORG/), the American Dietetic Association (http://www.eatright.org/), and the American Diabetes Association (http://www.diabetes.org/).

Snacking

A few blogs ago, I mentioned that Americans are eating more calories now than 30 years ago. I recently found an article that gives more specific numbers on how our calroie intake has changed since the 1970's.


In the mid-1970's, the average American ate 2,090 calories per day which increased to 2,400 calories per day in the mid-1990's which increased again to 2,500 calories per day during the period of 2003-2006. That is over a 400 calorie increase per day.


Snacks went from 200 calories/day in the 1970's to 420 calories per day in the 1990's to a whopping 500 calories per day from 2003-2006. Five hundred calories is close to a small meal. Between eating more at meals and snacks, no wonder we are gaining weight. Snacks can be great tool to stave off hunger until our next meal. They can even prevent us from overeating at the meal but a snack should not be a meal itself. A snack should be just that - a snack. Merriam-Webster defines a snacks as "a light meal : food eaten between regular meals". I usually recommend not more than 200 calories for a snack.


Not only do we eat more, we eat more often than we used to. Time between eating occasions shrank by 1 hour. It follows logically that if we eat more often, we probably eat more calories. Another reason to watch your snacking calories.

Here are some 200 calorie or less snacking ideas:
8 oz nonfat fruited or plain yogurt8 oz nonfat yogurt with ½ cup mixed berries
8 oz nonfat yogurt with 1 Tbsp slivered almonds, ground flax or wheat germ
4 oz nonfat or 1% fat cottage cheese with
½ cup canned fruit in own juice
4 oz nonfat or 1% fat cottage cheese on 1 slice whole grain bread or English muffin
½ cup nonfat pudding
1 oz part-skim mozzarella string cheese and 1 medium apple
6 oz skim or reduced fat milk and 2 graham crackers
8 oz skim milk or reduced fat milk and 1 piece of fruit

1 oz nuts

2 Tbsp peanut butter on 2 celery sticks1 medium pear with 1 oz of cheese

2 oz smoked salmon with 1 oz of nonfat cream cheese on 1/2 medium bagel

1 trail mix bar

I'm sure you can make your own 200 calorie inventions to add to this list. If you have any ideas, please pass them along for others.

An Hour A Day

Summer is finally here. Now is a great time to get outside and get some exercise. With sunset coming after 9:00pm, we even have more hours in the day to be outside. Does exercising have to be running, biking, or basketball? No, of course not. Gardening is a great exercise. Walking is another very underestimated exercise. There is also hiking, swimming, golfing (walk, not drive, the course), playing with your kids, roller blading, walking your dog, and soccer to name a few.

How much is enough? The government recommends at least 150 minutes of moderate exercise per week. This amounts to 30 minutes of exercise 5 days/week. But what if you are trying to lose weight or trying to prevent weight gain? A recent study originally published in the Journal of the American Medical Association indicated that it may take an hour a day to avoid weight gain. Researchers tracked more than 34,000 women for 13 years. By the end of the study, the average woman had gained 6 pounds. The 4,540 women who gained less than 5 pounds during the study reported walking briskly or doing similar moderate exercise for roughly one hour a day throughout the study. Women who exercised for less than an hour a day were roughly 10 percent more likely to gain at least 5 pounds within about three years.

An important note: Exercise was not related to weight gain or loss in women who were overweight or obese when the study began. This suggests that preventing weight gain is critical.

Whether you are at a good weight, overweight or obese, and are in good medical condition, exercise can only help. If 30 minutes is too much, try 3 10 minutes walks spread throughout the day. Or do 20 minutes of exercise 7 days per week. One lap around Sennfeld lake is 1 mile (approximately 20 minutes). If you have several errands to run on Ledward, park your car in one spot and walk to each errand rather than drive. Make extra trips up and down the stairs. Exercise does not have to be a once a day shot. Just try to move more throughout the day.

For more information on the government's exercise recommendations, please go to http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html

A great site to see how many calories you are burning is: http://www.caloriesperhour.com/index_burn.php. Click on activity calculator and then enter your weight and time and click on the activity. This site has more activities than any others I found.

Hope to see you outside!

Dieting for Dollars?

How much money would it take to get you to lose weight? $100? $1,000? Or does money not matter? Due to the increasing health care costs related to treating obesity and obesity related illnesses (diabetes, high blood pressure, high cholesterol), many companies are coming up with cash incentives to motivate overweight employees to lose weight.

These motivation strategies come in a variety of flavors. The first is providing dollars for weight lost. Some companies reward employees for simply having a health evaluation or enrolling in a weight loss or nutrition class. The reward is granted even if the person does not attend the class. Others require actual weight loss before providing a reward. Still other companies have tried a "Biggest Loser" type contest. Refunding the cost of a weight loss program such as "Weight Watchers" or "Jenny Craig" or reducing health insurance premiums for weight loss are another way employees may benefit attempting to lose weight.

For some, other people's money may not be enough of an incentive. A recent study found that employees lose more weight (okay, it was only a pound more on average, but it was still more) if they put their own money on the line. Either an employer or an independent contract provide refundable bond contracts. An individual will put up his own money into the bond and set a weight loss goal. If the person reaches the weight loss goal, the money is returned to him. If not, the company keeps the money. One company called StickK.com sends the money from those who fail to a company the person despises as an extra incentive.

Being a dietitian, I am interested in any program to motivate people to lose weight. For some, that motivating factor may be money and that is fine if it works for them. The part I do have an issue with is that some people may resort to unhealthy measures just to lose the weight . Some people may choose to starve themselves or go on an unhealthy weight loss diet such as the grapefruit diet or the maple syrup diet. These weight loss techniques are not only deficient in nutrients and calories, they are also impossible to continue which sets the person up for failure.

It does not have to be this way though. The program can be designed along with weight loss and/or fitness classes. Providing education for healthy lifestyle choices that one can continue for life is the key for weight loss.

I think a good example of this is the TV show "The Biggest Loser". Although I do have issues with this program, the participants are taught about nutrition and physical fitness. By the time they leave, they do have the tools they need to continue the program at home.

For more information on this topic, please see the article at: http://news.yahoo.com/s/ap/20100602/ap_on_he_me/us_med_dieting_for_dollars