Go Slow and Don't Yo-Yo! (When it comes to weight loss)

It’s the beginning of a New Year, and we all know that means tons of New Year’s resolutions, which typically revolve around losing weight, starting an exercise program, and/or trying to eliminate unhealthy habits. Too many people give up on healthy eating and exercise during December and give themselves the freedom to gain a few pounds during the holidays. Many think: “Oh I will just lose the weight in January.” While you may be the type of person that knows you will be successful at losing the weight come January, you are also probably like the majority of people that end up gaining back that weight by the following December (since you know for a fact you can lose it- you must have lost, regained, and lost before, right?). If you think a few pound weight fluctuation isn’t a big deal, think again! A new study out of Wake Forest found that post-menopausal women who lose weight and gain some (even just a mere 5 lbs!) of it back increase their risk for heart disease and diabetes.

In the study, 80 obese women lost 25 pounds on average over 5 months, which significantly improved their cardiovascular disease (CVD) and diabetes risk factors. A year later, 2/3 of the women had regained at least 4 lbs, with most of them regaining over 17 pounds. The researchers found that for women who regained just some weight returned to their baseline level of risk factors for CVD, and specifically, diabetes risk factors got worse- and they didn’t even regain ALL the weight they initially lost! Daniel Beavers, one of the researchers for the study stated:

Women who regained 4.4 pounds or more in the year following the weight-loss intervention had several worsened cardiovascular and diabetes risk factors [. . .] What was striking about the women who regained weight was that although they did not return to their full baseline weight on average -- women only regained about 70 percent of lost weight -- several chronic disease risk factors were right back at baseline values and in some cases, particularly for the diabetic risk factors, slightly worse than baseline values [. . .] Meanwhile, women who maintained their weight loss a year later managed to preserve most of the benefits.

So, the message is clear: if you are going to lose weight, you better be 100% motivated to stick with that lifestyle forever. You need to change your eating and exercise habits to keep the weight off for good, or you may end up just hurting yourself in the end (by getting diabetes or having a heart attack!). There are even studies showing that when people lose and regain, more of that weight gained back is fat as compared to the baseline level.This is yet more proof why diets don’t work!

My recommendation: Vow never to give yourself permission to gain weight or to go on “a diet” again. You must be committed to following a healthy lifestyle and keeping the weight off for good. Try to maintain your weight during holidays and vacations, and do not lose weight if you are not 100% devoted to keeping it off. If you think rationally, it just doesn’t make sense that it would be okay to overindulge and be sedentary for a period of time, then soon after to go on a strict diet and exercise regime. Extremes are never healthy, so practice “everything in moderation” and ask yourself whether you are really motivated to change your lifestyle FOR GOOD!

References:

Daniel Beavers, Ph.D., assistant professor, department of biostatistics, Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, N.C.; Gregg Fonarow, M.D., spokesman, American Heart Association, and professor, cardiology, University of California, Los Angeles; Samantha Heller, M.S., R.D., exercise physiologist and clinical nutrition coordinator, Center for Cancer Care, Griffin Hospital, Derby, Conn.; Dec. 13, 2012,Journal of Gerontology: Medical Sciences, online

Reinberg, Stephen. "Yo-Yo Dieting Can Hurt the Heart, Study Finds." Yo-Yo Dieting Can Hurt the Heart, Study Finds. HealthDay, 13 Dec. 2012. Web. 20 Dec. 2012.

Choose your Holiday Cocktails Wisely!

One thing about the holidays is that there are countless parties and family gatherings. Besides tacking on extra calories from mindlessly eating, alcohol can contribute hundreds of barely noticeable calories. Below I list the average calorie content of the average drink. Take a look at the booze you like to choose, and then also notice the serving size. Now think about how much (compared to the serving size) and how many you may consume at a party… then do the calorie math. You could tack on 500+ calories to that 1200 calorie appetizer, dinner & dessert depending on how much of a boozehound you are.

NUTRITIONAL AVERAGES OF SELECT ALCOHOLIC BEVERAGES

MY RECOMMENDATIONS:

If you don’t drink alcohol: that is fantastic and your liver thanks you! Be sure to drink non-caloric items such as water, unsweetened iced tea, club soda, or diet soda.

 If you do drink alcohol: I recommend drinking water WITH each drink and IN BETWEEN each drink (hydration is key to preventing hangovers… and important to decrease calorie consumption). Stick with light beers, use non-caloric mixers like Diet Coke or club soda (tonic has calories!!!), and AVOID holiday punches and especially egg nog (see nutritional info above!!!).

Good News! Most Kids Outgrow Food Allergies

Picture Source: Food Allergy Foundation

Many children nowadays have very limited diets due to their food allergies. It is a challenge for even a dietitian to get in all the nutrients when working with someone who is allergic to soy, milk, and wheat. However, there is hope! It is estimated that 85% of children who are allergic to milk and eggs will outgrow that, and most allergic to soy and wheat will outgrow that by 10 years of age, many by 5 years. Peanuts are less common to outgrow, with only about 20% of those kids being able to safely consume peanuts later in life. Only about 9% of children with tree-nut allergies ever outgrow them.

Instead of just assuming that your child will always be allergic to a food or foods and never allowing them to consume them, have them re-tested with the IgE antibody test, especially if they haven’t had any reactions recently. If your child shows up as no longer allergic it will make their life (and yours!) much easier and more enjoyable. There are many health benefits in all the major allergens (soy, wheat, tree-nuts, milk, fish, shellfish, peanuts), so it is a shame to unnecessarily avoid a food if a child (or even adult) has outgrown it. 

On a similar note, many of my clients have recently invested in “food intolerance” panel testing, and find that they are intolerant to dozens of foods (gluten, oats, buckwheat, soy, milk, most fruit, eggs, many vegetables, garlic, onions, etc). At that point, it is important to speak with a doctor about whether you are actually having any negative reactions to eating that food and if avoiding it is completely necessary. If you just go by what the "intolerance panel" shows you possibly intolerant to, you could be risking malnutrition. Try eating a healthy diet that eliminates most grains, fruits, veggies, and dairy- it cannot be done! I do always encourage my clients to try going at least 2 weeks without a food that they think is the source of a problem. For example, if a client thinks dairy is causing them stomach problems, I have them go on a dairy-free diet for 2 weeks. If nothing improves, bring back dairy, because that most likely isn't the culprit.

References: American Academy of Allergy, Asthma & Immunology;  The Food Allergy & Anaphylaxis Network

Suppress Your Appetite With Exercise!

For years, researchers have known that hard exercise suppresses appetite, known as “exercise-induced anorexia” (anorexia= lack of appetite). You may recall this after running sprints or after a killer plyometric training session. Many runners know that they are not very hungry for hours after a race if they ran it at maximal intensity. A recent study showed that those who did aerobic training for 12 weeks had a higher perceived fullness after both fasting and eating compared to those that did resistance training for the same time duration. So, in addition to torching calories during an intense aerobic exercise, your body triggers changes in the hunger hormones which can potentially cause you to eat less afterwards. Just weight lifting and other forms of resistance training didn’t seem to have the same benefit in this study, although resistance training is VERY important for boosting your metabolism (by adding muscle), preventing osteoporosis, and keeping you strong as you age. Another study out of BYU showed that women who walked vigorously on the treadmill for 45 minutes in the morning had less interest in food than on days they didn’t.

My recommendation:  In addition to burning lots of calories, aerobic exercise such as spin, plyometrics classes, and running have the added benefit of decreasing your appetite afterwards. The problem lies in the fact that you may be less hungry than you are normally, but you still probably eat (which is important to replenish glycogen stores in the muscles). Most people have a skewed estimate of how many calories they actually burn during exercise, and may tend to overcompensate and eat more calories after a workout than they actually burned- which is why most of us who exercise are not losing weight. Just know that when an exercise instructor tells a class they are burning "600 calories/hour!" that may not necessarily be for you... especially if you are a small woman (you might only be burning 300). Calorie burn depends on your size, muscle mass, and the effort you put in. If you want the most bang-for-your buck, make sure you incorporate interval training into your workout routine regularly to burn calories, reduce abdominal fat, and get the most benefit out of the appetite-suppression. I recommend investing in a heart-rate monitor (X-mas present request???) to give you a better idea of how hard you are actually working and to give you a better estimate of how many calories YOU are actually burning.

References: http://news.byu.edu/archive12-sep-foodmotivation.aspx

Beneficial effects of 12 weeks of aerobic compared with resistance exercise training on perceived appetite in previously sedentary overweight and obese men. Kym J. Guelfi, Cheyne E. Donges, Rob Duffield

Skip Breakfast and Pay For it Later (with Calories!)

Do you think that by skipping breakfast you can “save” your calories for that fancy dinner or holiday party you’re going to tonight? Think again! While some people do succeed at not overeating later, most people find that they are extremely hungry once they get to a party, and will have a tendency toward the least healthy dishes served. 

Everyone has heard that breakfast is the “most important meal of the day” and there are countless studies showing that people who eat breakfast have lower body weights and kids who eat breakfast perform better in school. Through my own experience working with clients, I have found that those who don’t eat a healthy breakfast tend to have problems with binge eating or nighttime snacking. 

A recent study presented at the Neuroscience 2012 Conference did indeed find that when people skip breakfast, they are more likely to seek out calorie-dense foods and overeat later in the day compared to when they eat breakfast.The researchers did brain scans on 21 normal weight people and found that the part of the brain involved in food appeal became activated when subjects were shown high calorie foods, but not low calorie foods, on days they weren’t fed breakfast. Subjects also consumed larger lunches on days they were not fed breakfast. The take-home message from this study was that eating breakfast takes the edge of your appetite, so that you are less likely to be tempted by high calorie foods, and will end up eating fewer calories later in the day.

I know during the holiday party season people are tempted to fast throughout the day and “save” their calories for later. This study suggests, and most health experts would advise against that mentality: you will probably end up making healthier choices at the parties if you do eat a nice breakfast and don’t starve yourself early-on. If you fast throughout the day, chances are that eggnog, artichoke dip, and cookies are going to look even more delicious, and you will probably end up consuming more calories than if you had a simple, healthy, breakfast. It only takes a mere 15 minutes out of your 24 hour day to make and eat a healthy breakfast, and it can potentially save you the hassle (and health consequences of gaining weight and needing to lose it ;-)

Reference: Society for Neuroscience, news release, Oct. 16, 2012

Tip of the Week: Make Sure You're Getting 6-8 hours of ZZZZZZZZZ's Each Night!

More and more research shows that your body needs a precise timeframe of sleep (6-8 hours) each night in order to work properly and have the most efficient metabolism. Over 35% of Americans are classified as obese (BMI >30 kg/m²), with an estimated 28% of those getting <6 hours of sleep per night. There are several studies linking sleep deprivation and childhood/adolescent obesity, which has been attributed to increased daily screen time and calorie consumption. In one recent study [done by well-qualified PSU professors ;-)], researchers found that people who were sleep deprived have increases in the hormone ghrelin (hunger-stimulator), decreases in leptin (regulates energy intake, energy expenditure, and signals satiety/fullness to the brain), and reduced insulin sensitivity.

Another study I blogged about on April 12^th linked lack of sleep and altered sleep patterns in night-shift workers to an increased risk for diabetes and obesity due to disruption of the natural circadian rhythm of the body. We all knew sleep was important for feeling alert, concentrating, and for keeping ourselves healthy, but now we have even more motivation to make sleep a priority- to keep our bodies thin and svelt!

My recommendation:  Do whatever you can to make sure you get between 6-8 hours of sleep each night.  Make sure you block out this time to at least lie in your bed if you have real trouble sleeping- don’t stay up watching TV or going on the computer! Practicing meditation and exercising daily should help you sleep, but talk to your doc if you still have issues falling or staying asleep. Don’t go without this issue being addressed! Lack of sleep can wreak havoc on your body and potentially make you gain weight- which will cause a slew of other health issues for you!

References:
"Partial Sleep Deprivation and Energy Balance in Adults: An Emerging Issue for Consideration by Dietetics Practitioners," Julie D. Shlisky, PhD; Terryl J. Hartman, PhD, MPH, RD; Penny M. Kris-Etherton, PhD, RD; Connie J. Rogers, PhD, MPH; Neil A. Sharkey, PhD; Sharon M. Nickols-Richardson, PhD, RD. Journal of the Academy of Nutrition and Dietetics, Volume 112/Issue 11 (November 2012), DOI:10.1016/j.jand.2012.07.032, published by Elsevier.

TIP OF WEEK: Natural & Organic Foods Don’t Necessarily Mean “Healthy” Foods

Recently there has been a big push to purchase “natural” and “organic” food products. I think the consumer demand for these products has been great, and the food manufacturers are responding. We are seeing a lot less additives added to these types of foods, but there is still a lot of work to be done. Both the terms natural and organic are not regulated by the FDA, but the USDA does certify foods as “organic”, but that term has different regulations depending if the food is a crop, livestock, or a mixed-ingredient food. Natural has no standard definition.

I caution you to assume that a natural cookie or donut is an okay food choice, or that organic potato chips are a healthy treat. As with every food, look to the ingredients to learn what is actually in the product, and check out the nutrition facts before biting in. Just because the chocolate chip cookie is organic and from Whole Foods doesn’t mean that it is good for you. Natural and organic junk food usually contains just as many calories and grams of saturated fat… and they aren’t whole grain unless that is listed as the main ingredient. So, they are still junk food even if they are an organic junk food.

My recommendation:  Personally, I wouldn’t even bother buying super expensive organic or natural cookies and treats. By purchasing the cheaper versions, you know that they are loaded with all sorts of junk, so you probably won’t be inclined to eat as much as if you had purchased the natural version. If you buy the organic and/or natural versions, you might be more inclined to overeat. However, if your kids eat lots of snack foods, then it might be worth the investment, but always look to the ingredients and nutrition facts… and watch the amounts the kiddies are eating!!!

The Best 'Cleanse' or 'Detox' is a Healthy Diet!

Picture Source: drugstore.com

You have probably heard the saying “Diets Don’t Work”, which is because most of them have you completely eliminate foods, and thus, nutrients that have a vital function in maintaining health and your happiness. There are diets that eliminate “carbs”, low-fat diets, gluten-free fad diets, and hundreds of others. The truth is that Americans are very good at following diets for a limited period of time and are champs when it comes to losing weight. The problem is that the majority of people are not able to follow that strict lifestyle for extended periods of time, and therefore, end up regaining the lost weight, and sometimes gaining even more. So, if food-based diet plans fail to show long-term success in weight loss, then why on earth would a short term liquid based diet, cleanse, or “detox” work?

Detox diets and cleanses have been around for many decades and the main idea behind them is to get people into a “healthy” frame of mind. If you can trick yourself into thinking that your body is being cleared of toxins, perhaps you will be more inclined to eat healthier when you do introduce real food and start an exercise regime. However, most often, people will do a detox for 5-7 days, lose weight, may feel better, and may “clear out” their system… and therefore, think the detox is working! The reality is you are losing weight because you are consuming very few calories and taking in much more fiber than your body is used to- which will get things “moving” and cause you to lose weight quickly due to lost water. Most people don’t eat anywhere near the recommendation for fiber (>30 grams/day), so, of course adding lots of fiber (as long as you are drinking liquids- which cleanses are!) will get things moving no matter how you do it. It’s not the magic of the cleanse diet; you experience more regularity because you are increasing your fiber and liquid intake.

Once you lose the initial amount of weight and try to transition back to a normal diet, you will mostly likely have a difficult time continuing to lose weight. The only way you will be successful at losing weight and maintaining your goal weight is if you have completely changed the way you think about food. In order to be successful, you need to break your old habits that led to weight gain in the first place. You must  have a good grasp on what healthy foods and food groups you need to include in your diet, exercise regularly, and be mentally strong (this is incredibly important for keeping up a healthy diet & exercise routine).

The Kelly Cleanse Diet: If you really have the urge to get into a healthy frame of mind, here is my cleansing plan for you: Pick a week where all you eat is fresh fruits, TONS of vegetables, plain whole grains (buckwheat, brown rice, quinoa, amaranth, oats, etc), and lean natural sources of protein (fish, eggs, soybeans, nuts, seeds, etc). Once you do this for a week you should feel like you have been “cleansed” of processed foods, and can slowly begin to add back sauces, non-fat and low-fat dairy or dairy-alternatives, and more processed foods like whole wheat bread, tofu, yogurt, kefir, etc.

My recommendation: The best cleanse is healthy eating. If you are eating fruits, vegetables, whole grains, minimally processed dairy and dairy alternatives, and lean sources of protein, there is no reason why you would ever need to “cleanse.” If you are sticking to appropriate portions and including physical activity every day, there is also no need to “go on a diet.” You should think of healthy eating as what you do, not a limited time installment in your life. As far as “detox” diets go- your liver is the best “detoxifier” there is! Your liver can get rid of ethanol (alcohol), which is toxic to the human body. If it can get rid of that, it can pretty much rid the body of any minor toxins that you may come across in your mostly healthy diet. Here are a few of my healthy diet rules:

1.    Eat whole, natural foods as often as possible.

2.    Eat as many non-starchy veggies as possible.

3.    Don’t eliminate any food group, especially grains!

4.    Don’t restrict foods you love, just eat them rarely and in an appropriate portion.

5.    Stick to proper portion sizes (schedule an appointment with me to find out what your individual portion sizes should look like! ;-)

6.    Get Moving!!!!!!

Don't Be Fooled by "Reduced, Low, or Free" Junk Foods!

Manufacturers have learned how to label junk food so that consumers think that they are "healthy" (or at least healthier) food items. However, reduced calories just means that a food has at least 25% fewer calories than the original. So, with "reduced fat" hot dogs, they can still have 12 grams of unhealthy fat (highly saturated, processed, etc.), but just be lower than the original that has 16 grams. Low-fat doesn't mean fewer calories, and oftentimes, low fat or fat free products contain close to the same amount of calories as the original because sugar has been added to replace the fat. With sugar-free products, they add fat and artificial ingredients to replace the sugar. Finally, "trans fat free" doesn't mean that the product is fat-free. Furthermore, it doesn't mean that the product has no trans fat. It simply means the product has <0.5 g/serving, so a 1 tbsp of flavored coffee creamer may have 0.4 g/tbsp (from the partially hydrogenated oils), but it can legally be labeled trans fat free. So, if you consume 5 tbsp of this stuff a day, you are above the recommended <2 gram limit for trans fat. 

My recommendation: Stick to foods that you know are naturally healthy (fruit, vegetables, whole-grains, nuts, etc.), and if you must indulge, take a little bite of a treat and don't overdo it. It’s all about portion size. It's better to taste a little of something really good, rather than eating a lot of something that tastes "okay" and is full of calories and artificial additives. You'll end up eating fewer calories in the end if you eat one fresh baked chocolate chip cookie as opposed to several sugar free or low fat cookies.

Didn't Think That Was a "Magic" Brownie? Think Again!

Those brownies need not be “special” and those cakes need not be “space” cakes for you to get pleasurable feelings from them….new research shows that foods can act just like drugs in the body.

Many people find that they crave certain foods, and when given access to that food, they just can’t seem to manage eating one measly portion. For years, I’ve been telling my clients to try to think of “trigger foods” as drugs, to really think about the consequences before you bite into that cookie or take a French fry. My goal has always been to make people more mindful of what they’re eating, but I didn’t realize how accurate I was with the drug analogy. You’ll notice that foods people crave don’t tend to be naturally occurring in nature. I would guess you don’t find someone craving a cucumber, but rather, a pickle. No one craves a cup of corn or oats, but rather, tortilla chips and oatmeal cookies. The theme amongst foods people crave is the fact that they tend to be highly processed and high in fat, sugar, and/or salt. Research now shows that these heavily processed foods can act in the body just like drugs, and make it difficult to resist a food at all, or stop at just one serving size.

Oregon Research Institute published a study earlier this year that had young children look at pictures of chocolate milkshakes, and then consume them later. Children who had consumed the most milkshakes over the course of the study showed a lower response in the reward centers of the brain when given the milkshakes at the research site. One researcher said: "Over consumption of these foods down regulates reward processes [. . .] that may, in turn, make you eat more. You could be continually tying to match the earlier experience.” The result of this down-regulation can cause you to consume larger and larger portions whenever exposed to the treat, which could cause you to gain weight if exposed frequently enough. As the body becomes more accustomed to the “drug”, you need more to get the same pleasurable feeling you got the first time you tried it.

Another study showing the similarities in processed foods and drugs showed that rats go through withdrawal symptoms when sugar was taken away, and consumed 23% more once allowed to consume it again. Last year, studies done in California and Italy showed that rats who consumed a fatty liquid diet started producing endocannabinoids, which are compounds similar to those produced by marijuana. Another study from the University of Michigan recently studied neuronal cues when rats were exposed to chocolate M & M’s. The researchers identified a link between a part of the brain called the stratium and an endorphin called enkephalin which is known as a pain-relieving peptide. They found that when they synthetically injected the rats with enkephalin, the rats ate faster and consumed double the amount they did without the enkephalin. When the rats ate the M & M’s on their own, the levels of natural enkephalin increased.

MY RECOMMENDATIONS: When changing people’s diets, I always encourage them to try to stick to the most natural of foods: real fruit instead of fruit juice, old-fashioned oats instead of gluten-free dry cereal, a baked potato instead of French Fries. One reason I have for this is not just the research on the drug effects of processed foods, but processed foods also seem to be metabolized differently and can cause you to gain weight easier. Whole foods also contain much higher levels of antioxidants, phytonutrients, and fiber than their processed counterparts. I recommend you try to cut out the heavily processed foods, and try to find alternatives to your “guilty pleasures.” Try to wean yourself off of ice cream by making smoothies with yogurt, make your own egg sandwich by using whole grain English muffins with a poached egg, and drink coffee with milk and sugar (or honey!) instead of the flavored creamers. By eating more naturally, you will find that you don’t crave the things you once did, sugared foods are too sweet, salty foods are way too salty, and having one bite of a cookie is enough to get the gist- you don’t need to eat the whole box to understand the flavor and texture.

References:

1.         http://bodyodd.nbcnews.com/_news/2012/02/23/10480896-can-you-get-addicted-to-ice-cream-maybe-study-shows?lite

2.         http://well.blogs.nytimes.com/2012/09/20/craving-an-ice-cream-fix/?ref=health

3.         http://www.latimes.com/news/science/sciencenow/la-sci-sn-craving-chocolate-brain-activity-20120920,0,1049260.story?track=rss

4.         2004 Mar;12(3):461-72. PubMed PMID: 15044663. 12: Stice E, Spoor S, Ng J, Zald DH. Relation of obesity to consummatory and anticipatory food reward.

5.         Enkephalin Surges in Dorsal Neostriatum as a Signal to Eat

Alexandra G. DiFeliceantonio, Omar S. Mabrouk, Robert T. Kennedy, Kent C. Berridge

Current Biology - 20 September 2012

6.         Rossmeisl M, Macek Jilkova Z, Kuda O, Jelenik T, Medrikova D, et al. (2012) Metabolic Effects of n-3 PUFA as Phospholipids Are Superior to Triglycerides in Mice Fed a High-Fat Diet: Possible Role of Endocannabinoids. PLoS ONE 7(6): e38834. doi:10.1371/journal.pone.0038834

7.         Starowicz, K. M., Cristino, L., Matias, I., Capasso, R., Racioppi, A., Izzo, A. A. and Di Marzo, V. (2008), Endocannabinoid Dysregulation in the Pancreas and Adipose Tissue of Mice Fed With a High-fat Diet. Obesity, 16: 553–565. doi: 10.1038/oby.2007.106

Tip of the Week: Get “WHOLE-ly” with Grains!

 

            This week, only allow yourself to eat grains that are 100% WHOLE GRAIN. Many are convinced the gluten-free diet sheds weight, when the reality is that most people are probably just cutting out things they used to overeat (pasta, crackers, cookies, etc). Whole grains are vital for weight loss and maintenance, as well as overall health, so they are important to include in your diet. By challenging yourself to only eat whole grain products; you will have to say no to those Stacy’s Pita chips, a hoagie on a plain roll, regular pizza, or pasta at a restaurant. You will learn to seek out whole grains, and when eating out, you will automatically be making healthier choices by skipping the pasta-based dishes altogether and hopefully ordering the fish that comes with a side of vegetables and red quinoa! Whole grains can include: whole wheat flour, brown rice, quinoa, amaranth, bulgur, barley, buckwheat, popcorn, wild rice, whole grain corn, oats, and other more exotic grains.

          Note: This is just a one week exercise. You should never go on a diet that completely prevents you from eating things you enjoy (unless specified by a medical doctor). However, this activity will train you to think about the grains you’re about to eat and whether they are helpful (whole grain) or harmful (refined grains). The goal is to learn to eat primarily whole grain products for the rest of your life!

Nutrition counseling reimbursement may be available for the following insurance plans:

Guest Blog Post: Nutrition for Drug & Alcohol Addiction

The following blog was written by a guest blogger, Paige Taylor:

How Nutrition Can Help With Drug and Alcohol Addiction

Drug and alcohol abuse have two major negative effects on health: Not only do the alcohol and drugs affect the body itself, but they can cause adverse lifestyle changes like poor dietary habits.

A woman who drinks while pregnant may give birth to a child with physical or mental defects. As the American Pregnancy Association explains, the alcohol a pregnant woman consumes permeates the placenta to reach the baby and can cause major developmental problems that might be irreversible. Since alcoholism is “one of the major causes of nutritional deficiency in the United States,” according to Medline Plus, normal growth and development of the baby is harmed even more.

High levels of alcohol consumption changes gut permeability.  The gut absorbs endotoxins released by bacteria, and these endotoxins impair the liver.  When the liver can no longer detoxify, Kupffer cells release free radicals, increasing oxidative damage.  This could result in a hypermetabolic state, which causes a negative nitrogen balance in the body and increased peripheral insulin resistance.  People suffering from hypermetabolism often experience symptoms such as weight loss, anemia, shortness of breath, and rapid heart rate.

Substance abuse has other negative effects on the body, especially, when trying to recover. Abusing drugs and alcohol slows the body’s metabolism, impedes the proper functioning of the organs, and adversely affects mental health. Eating a diet full of the proper nutrients during recovery can help the body to heal.

How Certain Drugs Affect the Body

Different drugs have different bearing on nutrition, according to Medline Plus.

• Opiates like heroin, morphine, and codeine can harm the gastrointestinal system, causing symptoms like nausea, diarrhea, and vomiting during withdrawal from the drug. Each one of these symptoms can result in the body losing valuable nutrients. The proper levels of electrolytes like sodium, potassium and chloride can also be thrown off balance. Eating foods high in fiber and complex carbohydrates during recovery from an addiction to opiates is suggested.

• Regular alcohol use, especially amongst alcoholics, can cause severe nutritional deficiencies. Those nutrients that are most commonly depleted due to alcoholism are vitamin B6, folic acid, and thiamine. The result of these deficiencies is often depression, fatigue, and problems with the nervous system.

Alcohol abuse is also harmful to the liver and the pancreas, which are both important for nutrition and metabolism. If these two organs are damaged, there can be an imbalance of electrolytes, protein, calories, and fluids in the body.

Other side effects of alcoholism are diabetes, malnutrition, cirrhosis of the liver, high blood pressure, and seizures.

• Using cocaine, crack, and methamphetamine reduces the appetite, which can lead to poor nutrition and weight loss. These stimulants also cause electrolyte imbalances and dehydration. Problems with memory can be a side effect of stimulant use.

• Marijuana stimulates the appetite and long-term use can lead to weight gain, according to a study published by John Hopkins University.

Nutrition and the Mental Aspects of Substance Abuse Recovery

A nutritionally balanced diet is known to improve not just overall health but mood as well. That is why it is so important for those in recovery to maintain a healthy diet. Generally, when people feel healthy the chances of a relapse are less. The University of Maryland Medical Center suggests guidelines that those in recovery should follow:

• Have a regular meal schedule
• Eat foods low in fat
• Eat plenty of foods with protein, fiber, and complex carbohydrates
• Take vitamin and mineral supplements
• Make sure all snacks are nutritious
• Stop smoking
• Cut down on caffeine
• Incorporate physical activity

For any questions or comments regarding this article, please contact Paige Taylor at: pgtaylor8@gmail.com 

Save a bunch, and pack your and/or your child's lunch(es)!

It’s that time of year again… back to school! (I used to hate that commercial!). Anyway, back to school means back to routine, which for many, can be a very positive thing when it comes to diet quality. In addition to making sure your child eats breakfast, has healthy snacks, and a well-balanced dinner, make sure they have a healthy lunch! One of my biggest tips to both children and adults is to PACK YOUR LUNCH.

I recommend you make buying lunch a special treat for your child, just as eating out should be a treat for adults and NOT the norm. If your child is old enough, teach them how to prepare a healthy lunch, so that way you do have the excuse that YOU are too busy to make it. Packing lunch will create autonomy for your child, while also teaching them how to prepare food for themselves. Furthermore, if your child makes their own lunch, they will be way more inclined to eat it!!! I have been packing my lunch since I was seven years old (my mom will confirm) and I can tell you, I have packed my lunch and snacks almost everyday since! Another benefit of packing lunch is the amount of money you will save. If your child gets just the school lunch everyday, you are only spending $2.35-$4/day… but if they buy a-la-carte items, those prices can add up very quickly. Some of my adult clients estimate they spend up to $2,000/year on eating out for just lunch!

By law, school lunches (just the meal of the day- NOT a-la-carte items!) have to offer 1/3 of the daily recommendation for calories, protein, vitamin A, vitamin C, iron, and calcium, and <30% of calories from fat (<10% from saturated) on average for the week. However, a survey from 2004-05 showed that fewer than 30% of schools met the fat standard. A fruit and vegetable have to be offered each day, half of the grains must be whole, and only low-fat milk products are to be offered. On average, a school lunch in elementary school will provide 550-650 calories, and 450-600 calories for high-school.

While the school lunch is beneficial for students that don’t get much to eat outside of school, it may set up some students for weight gain if they are eating substantial amounts outside of their school lunch meal. Just look at your child’s school lunch menu, most of the items aren’t what I would consider “healthy” meals (e.g: nachos w/ beef, cheese & salsa, individual pizza, and a meatball sandwich, served with corn and canned fruit) since they are loaded with saturated fat and sodium. If you do allow your child to buy lunch, look at the menu and identify healthy options for them to select, ensure that they are eating the fruits, veggies, and dairy, or have them choose healthy a-la-carte items such as a sandwich on whole grain bread or a salad. 

The National School Lunch Program is incredibly valuable for underprivileged children and I am happy to see they are making significant improvements regarding the nutritional value of the meals. However, having your child pack his/her own lunch has incredible benefits and sets the stage for a good habit to last for life. If your child does pack lunch, just make sure you only have healthy options available, otherwise, their Lunchable, juice, and cookie meal will be comparable to eating pizza, canned fruit, and French fries. I recommend packing low-sodium lunch meat on whole grain bread, a low-fat yogurt, whole grain pretzels, and piece of fruit and/or veggies. You can also mix it up and have your child eat leftovers from dinner, create shish kabobs with veggies and chicken, use cookie cutters to cut out fun shaped tea sandwiches, or make wraps. The creativity of school lunch is endless!

Sources: www.fns.usda.gov/cnd/lunch/  School Nutrition Dietary Assessment Study III: Summary of Findings

Participate in MEATLESS MONDAY!

The overarching theme in the development of the 2010 Dietary Guidelines was the push for a “mostly plant-based diet”. In fact, the executive guidelines specifically state:

“Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts, and seeds. In addition, increase the intake of seafood and fat-free and low-fat milk and milk products and consume only moderate amounts of lean meats, poultry, and eggs.”

The mostly plant-based diet recommendation comes from a panel of experts who have come to a consensus regarding reputable studies that show people who eat this way tend to be healthier and have the lowest prevalence and risk of certain diseases such as diabetes, heart disease, and certain cancers. Additionally, by decreasing animal meat in your diet, you will save money (meat is expensive, beans are not!), and definitely help the environment. Livestock, particularly cattle, are not good for the environment due to methane emissions from the animals, waste, and grazing lands. It is estimated that just livestock contribute 18% to the world greenhouse gases, which is more than that of livestock transport. If everyone in the U.S. gave up meat one day a week, it’s estimated that would be the equivalent of not driving 555 billion miles- not bad, eh?

Contrary to popular belief, you can survive without eating meat. You can get complete proteins (those that contain ALL of the essential amino acids) by eating soy, hemp, amaranth, and quinoa. You can get all your essential nutrients and proteins by eating a well-balanced diet full of whole grains, fruits, veggies, nuts, seeds, beans, and other natural plant-based foods. Also, giving up animal meat doesn't necessarily mean you have to give up all animal products, you can certainly indulge in milk, eggs, and fish if you choose to. For those that eat red meat (ground beef, steaks) regularly, instead of making meatless Monday the one day you don't eat red meat, try to switch that around to picking one day once a week that you will have one (4 oz.) serving of red meat... and even less frequently if possible.

My recommendations:

Have your family participate in Meatless Monday (or any day!) every week. Get creative with beans, nuts, seeds, quinoa, tofu, edamame, and other healthy sources of vegetarian protein! Be sure to stock those veggies high too, most people don’t come anywhere close to the recommended 2 ½ cups per day!

Sources: USDA 2010 Dietary Guidelines for Americans

U.S. Agriculture and Forestry Greenhouse Gas Inventory: 1990-2005

FAO. “Livestock Impacts on the Environment.” 2006

The Environmental Working Group

Latest post on PHILLY HEALTH WATCH: Coping with Stress Eating

Read my latest post on PHILLY HEALTH WATCH, "Coping with Stress Eating":
http://phillyhealthwatch.com/2012/08/09/coping-with-stress-eating/

Learn why you tend to gain weight easier when stressed, and what you can do about it!

SIT LESS, MOVE MORE!

Summertime presents as a fantastic opportunity to become more active throughout the day. Everyday, I am sent the latest nutrition and exercise news, and over the past few months, I have been bombarded by studies suggesting that sitting is terrible for your health. I have clients that (understandably so), think that they are active enough because they do a 1 hour spin or cardio class each day. While this is commendable, and much more exercise than most Americans do, it is not enough. In order to lose weight, keep weight off, and prevent disease you must be moving AS MUCH AS POSSIBLE throughout the day!

One hour of cardio does not make up for the other 23 hours of other inactivity during the day. A study released by the British Medical Journal in July pooled data from 5 studies with 167,000 adults and evaluated sitting, TV watching, disease, and mortality risk. By reducing sitting time to <3 hours per day, you can raise your life expectancy by 2 years, and cutting sitting down to <2 hours/day can increase your life by another 1.4 years. The average American sits and watches TV for 5 hours a day, which is associated with an increased risk of diabetes (↑ 20%), heart disease (↑ 15%) and premature death (↑ 13%). By eating and not using your muscles, the sugar is not cleared from the bloodstream, and eventually builds up and destroys cell membranes- therefore increasing your risk of death and disease. Keeping sugar in the bloodstream also keeps insulin levels high, which can put you at risk for diabetes, and also, increased fat storage.

My recommendation: Move as much as you can throughout the day! Try to stand up and move around (at least) every 20 minutes. Walk before you eat and definitely get moving after you eat so the muscles can suck up all that extra sugar in your bloodstream. When you exercise, do so intensely to get the most benefit out of our workout (i.e.: not just a walk or steady-state on the elliptical- add intervals!). Also, don’t let your kids sit and watch TV for long periods of time. Another study published in July linked TV watching when children are 2-4 years old to larger waists and weaker leg strength just by the time they are in 3^rd and 4^th grades. Early sedentary behaviors and TV watching can set your child up for diabetes and obesity in the not-to-far-off future. If your family wants to watch TV, try to be active while doing so. Have a stationary bike or a mini-trampoline available so that you can move and watch at the same time!

Sources:

Katzmarzyk PT, I-Min L. Sedentary behaviour and life expectancy in the USA: a cause-deleted life table analysis. BMJ Open. Published online June 9 2012.

AMA. 2011 Jun 15;305(23):2448-55.“Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis.” Grøntved A, Hu FB. Institute of Sport Science and Clinical Biomechanics, Department of Exercise Epidemiology, Center of Research in Childhood Health, University of Southern Denmark, Odense.

Dr. Gabe Mirkin

International Journal of Behavioral Nutrition and Physical Activity 2012, 9:87 doi:10.1186/1479-5868-9-87

Published: 16 July 2012

The July Issue of Philly Health Watch is Here: How to Stay Healthy on Vacay!

Going away this summer? Want to know how you can go away, relax, and still eat healthy, exercise and not gain weight? Read my latest article in the July issue of Philly Health Watch:

Vacation Should Leave You Feeling Refreshed- Not Fat and Unhealthy!!!

What To Order During Hoagiefest at Wawa

Read my latest interview and tips for eating healthy at Wawa during Hoagiefest with Be Well Philly!
http://blogs.phillymag.com/bewellphilly/2012/07/05/order-wawas-hoagiefest/

Minimizing Hangovers

This weekend really marks the beginning of summer party season- barbecue’s, heading to the Princeton Friday and the Springfield on Saturday, having friends over for tropical drinks, and/or enjoying a nice cold beer (or two) after a long work week. For some people, all of these events are fun at the time, but the next day proves to be a dreadful experience due to the loathed HANGOVER.

A hangover occurs after the blood alcohol has returned to zero after excessive alcohol consumption. Alcohol is toxic to the body, so it makes sense that drinking large quantities would wreak havoc on the body. Symptoms of a hangover can include, but are not limited to, headache, weakness, inability to concentrate, decreased activity, fatigue, thirst, dizziness, sensitivity to light and sound, diarrhea, vomiting, sweating, chills, and shaking.

There are many reasons people experience hangovers including dehydration, changes in immune and endocrine metabolite production, build up of toxins (e.g: acetylaldehyde), gastritis, decreased sleep quality and duration, fatty liver, hypoglycemia, congener content of drinks (metabolites that flavor, scent, and color alcoholic beverages), alcohol withdrawal, and due to the obvious fact that alcohol is absolutely toxic to the human body. Alcohol is poison, so it makes sense that you wouldn’t feel that great after drinking it!

If you do choose to drink more than one to two drinks in a day, there are certain measures you can take to minimize the risk of a hangover and to ameliorate the symptoms once you experience them. While there is not a ton of research on hangovers, a few studies have been done in which I draw my recommendations from.

         

Recommendations to minimize hangovers:

1. Abstain from alcohol!!! (duhh)

2. Drink small, non-intoxicating amounts

…or…. If you must indulge:

3. Consume alcohol that has few congeners (pure ethanol, vodka, and gin)

4. Consume water with and between drinks

5. Consume alcohol with fructose-containing foods such as fruit and fruit juice

6. Consume solid foods that contain carbohydrates with and after drinks (such as bread)

7. Be sure to get a good nights sleep

8. Eat bland cracker-type foods to help with nausea and hypoglycemia

9. Antacids may help with nausea and gastritis

10. Ibuprofen may help with headache symptoms, just be sure not to consume until the next day since your liver cannot process both the alcohol and drugs at the same time!

11. Make sure you have a folate-rich diet which is needed to metabolize ethanol. Folate is found primarily in leafy greens and whole grains.

12. Exercise!

If the thought of a hangover isn’t reason enough to discourage you from drinking, here is some approximate calorie information on some popular alcoholic beverages:

Alcohol and Calorie Content

Alcohol Name	Serving size	Estimated Calories
Blue Moon Belgian White Beer	12 fl oz	164
Wine- red or white	5 fl oz	125
Cosmopolitan	Martini glass	200
Bloody Mary	4 fl oz	220
Shot of liquor (vodka, rum, gin, etc)	1.5 fl oz	100
Long Island Iced Tea	12 fl oz	790
Pina Colada	6 fl oz	300
Rum & Coke	10 fl oz	355
Old Fashioned	4 fl oz	180

If you get a hangover, you most likely didn’t just have one of these drinks. Do the math to see how many hundreds of calories you consume in just a short period from having “a few” drinks. If you start with a Pina Colada, but ease up and just have two light beers afterwards, you’ve already tacked on almost 550 calories to your daily totals. If you are the type that can down a bottle of wine in a night… try to think of it as soda. Most people wouldn’t drink more than a liter of soda in one sitting, so why is alcohol any different?

So at your parties or weddings this weekend I want you to THINK before you DRINK. Think about whether the alcohol is worth the calories and the consequences. Do not drink in excess no matter how high of a tolerance you think you may have- alcohol is toxic, so too much can easily kill you. Have fun, drink responsibly, and Happy 4th of July!

References:

Chapman, LF. Experimental induction of hangover. Quarterly Journal of Studies on Alcohol 5(Suppl. 5):67–86, 1970.

"Liver and Alcohol Breakdown." MyDr.com.au. UBM Medica Australia, 21 Sept. 2009. Web. 26 June 2012. <http://www.mydr.com.au/gastrointestinal-health/liver-and-alcohol-breakdown>.

Pawan, GL. Alcoholic drinks and hangover effects. Proceedings of the Nutrition Society 32(1):15A, 1973.

Swift R, Davidson D. Alcohol hangover: mechanisms and mediators. Alcohol Health Res World 1998; 22:54–60.

Verster, J. C. (2008). "The alcohol hangover-a puzzling phenomenon". Alcohol and Alcoholism 43 (2): 124–126