Friday, May 24, 2013

If you want to be healthy (and save some $$$), limit eating out!!!

            My number one recommendation to people who are trying to lose weight is try to limit eating out as much as possible. Not only will you save a ton of money, but you will most likely be eating a lot healthier if you make your own food. Many people pride themselves on that they don’t eat fast food, which is great, but those mom and pop restaurants can pack on just as much, if not more, fat, calories, and sodium than a McDonald’s cheeseburger with fries. Three recent studies show concerning figures about the amount of calories found in restaurant meals and how people tend to underestimate the calories they are consuming. 

A study from the University of Toronto found that the average calorie content of 19 different restaurant chain meals contained 1,128 calories, and most of those meals exceeded 50% of the daily value for fat, saturated fat, and sodium. Tufts University did a similar study, except they evaluated small chains and independent eateries (your mom and pop restaurants) and found the average meal contained 1,327 calories. The new calorie labeling laws in major cities only apply to restaurants with more than 15 locations. However, an important thing to keep in mind is that the person making your meal probably isn’t using the exact measurements as the standard recipe, so you may be getting more (or less) than you bargained for. Most chefs don’t measure the oil they squirt on the grill pan, or measuring the butter they throw in mashed potatoes, so that is where calories can really add up (1 tbsp, on average, is more than 100 calories for any fat).

In theme with restaurants containing more calories than one would think, a recent study out of Harvard Medical School confirms that people tend to underestimate how many calories they are eating. The study found that teens, parents of school-aged children, and adults under-estimate the amount of calories in fast food meals by 34%, 23%, and 20% respectively. Similar to previous studies, people tend to really under-estimate the calories in meals coming from commonly thought of “healthier” restaurants. For example, even the “Lighter Side” Grilled Chicken TBM at Cosi still has 527 calories, 17 g of fat, close to 1/3 of your daily value for saturated fat (7 g) and 18% daily value for sodium, which is not much of an improvement from their regular Grilled Chicken TBM which has only 157 calories more, only 1 more gram of saturated fat, and is lower in sodium at 15% of your daily value.

            Another concern is that many of the chains make you think you are choosing healthy options, when they really aren’t that great. For example, Panera’s “whole grain” breads do contain whole grains, but the first flour ingredient is “unbleached enriched wheat flour”, which is refined grain. Same is true of Subway’s “9-Grain Wheat” and Wawa’s Wheat rolls. However, if you must eat at these places, those breads are definitely better options than the completely white breads, since you will at least be getting in some whole grains and fiber! If you think you are better off getting a wrap when you go out, just note that the typical wrap contains over 300 calories and 600 mg sodium for just the tortilla itself! For example, at Subway you are definitely better off getting the 9-Grain 6” roll for 210 calories, 240 mg sodium, and 40 g carb versus the wrap for 310 calories, 610 mg sodium, and 51 g of carb.

            One final thought is with regards to sodium. Many restaurants now have lower calorie offerings, which is great. The problem is that the sodium is still through the roof. For example, Season’s 52 offers a Sesame Crusted Tuna entrée for only 473 calories, 15 grams of fat, but a whopping 2062 mg of sodium (<2300 mg per DAY is the recommendation). Most of their items (salads, soups, and entrees) contain close to 50% your daily value of sodium. At Chipotle, if you add any salsa, you will be adding more than 400 mg of sodium to your meal (unless you choose the green tomatillo), which is in addition to the sodium found in the meats, fajita vegetables, rice, beans, and whatever else you add to that…. It is hard to build a bowl with less than 1,000 mg sodium.

My recommendations: So what is one to do since even “healthier” choices don’t seem to be so healthy? Since there are so many unknowns when eating out, it is always best to just make the food yourself. Did you know that most restaurants will butter and grill the bread they put sandwiches on? That butter can easily add 100 extra calories to your Ahi tuna sandwich, not to mention the calories and fat from the wasabi mayo. At most restaurants, especially fancy and “really good” restaurants, the chefs add tons of butter. Butter makes everything taste better. If you want to impress your dinner guests, add extra pats of butter to your salmon and vegetables, and I guarantee people will be raving. As a dietitian, I do not advocate this… but it is true… the trick to being a good cook is butter. Butter is fat and salt, two things human taste buds crave. If you must eat out, go for basic salads with grilled chicken or fish, dressings on the side. If you want an entrée, I always recommend going for the fish, but be aware that butter and salt are most likely added to the fish and the side of vegetables. You can always special request, so don’t be afraid to do so. You are the paying customer and this is your health!!! Keep in mind that alcohol will add on even more calories, and don’t even touch the desserts. You have already had an indulgent meal and are full, so why waste extra money on unnecessary calories? Skip the dessert and you will feel so much better tomorrow morning. Use that $7 you would have spent on flourless chocolate cake to buy some extra produce for the week ;-)


1. Scourboutakos MJ, Semnani-Azad Z, L’Abbe MR. Restaurant Meals: Almost a Full Day's Worth of Calories, Fats, and Sodium.JAMA Intern Med. 2013;():1-2.
2. Urban LE, Lichtenstein AH, Gary CE, et al. The Energy Content of Restaurant Foods Without Stated Calorie Information. JAMA Intern Med. 2013;():1-8. 
3. BMJ 2013;346:f2907 

Friday, May 17, 2013

Don't Go Nuts for CocoNUT Oil & Milk

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Google the health benefits of coconut oil and you will come across tens of thousands of results about how coconut oil prevents heart disease, can make you lose weight, improves insulin sensitivity, improves digestion, and zillions of other reasons why this is an oil you must be incorporating into your diet. However, do not jump on the bandwagon so quickly! Most of the “research” behind these claims is from testimonials as opposed to actual clinical research. Furthermore, no major health organization (WHO, Academy of Nutrition & Dietetics, FDA, American Heart Assoc., etc), recommends consuming high levels of any form of saturated fat.

Coconut oil is 92% saturated, but about 64% of that is medium chain triglycerides (MCTs), which are metabolized differently the other triglycerides, which are normally found in other saturated fats. The majority of claims that coconut oil confers major heart health benefits comes from studies using pure MCT’s, not coconut oil itself (keep in mind, coconut oil is only about 64% MCTs). Many other studies are just lab-based or animal studies, not from actual human trials. Don’t be fooled by coconut milk either. Coconut milk contains 5 grams of fat per cup, of which 100% is saturated. Coconut milk also contains very little protein (0 g vs. 8 g in milk) and only 10% of your daily value for calcium (vs. 30%), so it is not a good substitute for cow’s milk.

My Recommendations: Coconut oil may provide more benefit compared to butter or ground beef since the saturated fat is plant-based, so it does contain more antioxidants. Populations with low levels of heart disease have been consuming coconut for centuries, but they also tend to consume more seafood, fruits, and vegetables. Thus we don’t know if it is the actual coconut that leads to low-levels of heart disease, or more likely, their low-intake of animal-based fats and high intake of natural produce and seafood. Either way, it is still recommended to limit your intake of ALL saturated fats. The research is still inconclusive about the actual health benefits or harms of coconut oil. I recommend sticking to what we have lots of evidence to support, such as getting your fats from healthy, unsaturated, plant-based food sources like almonds, seeds, walnuts, avocados, and salmon.

Friday, May 10, 2013

Stop the Juicing- EAT your food!

Lots of people are into “juicing” these days, and almost on a daily basis someone tells me they bought a VitaMix or are thinking about buying one. While I do like the idea of making homemade smoothies as a substitute for something unhealthy like ice cream, I find the idea of juicing completely unnecessary. It is always better to eat your fruits and vegetables instead of blending them together and gulping it down. If you actually use a juicer (appliance), you will be missing out on a lot of the fibers that are so important for disease prevention and weight management. Furthermore, by eating the actual fruits and vegetables, you will most likely consume fewer calories throughout the day because they take longer to eat, and will be more filling in solid form rather than liquid (many studies show that the calories in beverages are not registered the same in the brain in terms of satiety compared to real food).

My Recommendation: I only recommend juicing for those people that absolutely refuse to eat vegetables. However, if you like spinach and broccoli, eat them, don’t juice them. Solid vegetables add a lot of bulk and volume to meals, which aids in feeling more satisfied at meals- both visually (mentally) and physically. Some juices can also be quite calorie dense, since you can fit an entire pear, bunch of spinach, banana, and avocado in such a small volume of liquid. If you were to actually eat all of those separately I guarantee you would be super full and probably not able to do it. If you are using juices as meal replacements, you will also be missing out on many key vitamins and minerals that come from other food groups like grains, dairy, and the meat and beans groups. The goal for most people should be to eat over 2 cups of solid non-starchy vegetables (as many as you’d like!) and 1 ½ cups of fruit each day.
Appliance Recommendation: Even though I don't recommend juicing, and would prefer you eat food than drink it, I do recommend that my clients do invest in something like the "Magic Bullet." These are great for blending frozen bananas as an alternative to ice cream, for making soups, chopping vegetables, nuts, etc. And if you are going to have a dessert, blending up a smoothie with frozen mango, almond milk, and yogurt is not a bad way to go ;-)