Remember, It's a Lot Easier to Eat 100 Calories than it is to Burn it Off!

This blog may seem pretty blunt and harsh, but it's important to read if you are not seeing results in losing weight. Hard work= hard body!

Most people overestimate how active they actually are. With my clients I am a stickler when it comes to activity. I want them to get in their recommended 10,000 steps (~5 miles/day) WITHOUT including their planned exercise in that. So, even if you take a spin class or run for an hour, I want you walking 10,000 steps too. People nowadays are MUCH more sedentary than they were even a few decades ago. If you went to a big college, you hopefully walked everywhere you had to go, and it was no big deal. Now that you are out of that environment, it's like you have to plan a walk as your exercise. That shouldn't be. If you are able, and it is a safe environment, you should definitely walk anywhere you need to go if it is <1 mile away (I would argue even 2 miles away isn't bad). A 1 mile walk will take you less than 20 minutes, so if you have the time, don't be lazy, and walk! You'll benefit too for the fact that you'll be saving gas $$$ and not contributing to pollution.

As I have posted about before, people who "go to the gym" but are sedentary the rest of the day may not be any healthier than someone who doesn't do a planned workout but has a job that they are at least up and moving. Sitting is bad for you, so try to avoid it, especially after meals.

No matter how active you are, you still need to be conscious of your food choices and realize it is much easier to eat calories than burn them off. Even if weight isn't your concern, or you are trying to gain weight, focus on healthy foods so that you can keep your energy levels high and your body in good health. I may burn 130 calories on my 1.33 mile walk to work, but I usually eat a KIND bar on the way home... so that's 200 calories- net gain of 70 calories. If people who are trying to lose weight partake in similar actions, just that 70 extra calories per day can theoretically lead to slightly less than 1 pound gained per month. So, if you are the type of person who rewards yourself after a hard workout like spin with a 400 calorie smoothie, you are probably offsetting the calories you burned during that workout.

My point is, I want you to be active, but I don't want you to think that your activity level is permission to eat whatever you want. Plus, machines and instructor generalizations about calories burned during a workout tend to be an overestimate for most people. Most of those estimations would be for a large man who is working very hard. If you are barely breaking a sweat and not out of breath for the majority of a one-hour class, I doubt you burned anywhere near 500 calories.

Keep in mind one average-sized homemade chocolate chip cookie is about 100 calories, so just think about running at least a mile to burn that off. When you are at a Superb owl party this weekend, think about each item before you consume it:

One regular beer= 150 calories
8 oz wine= 200 calories
1 hot chicken wing= 100 calories
10 potato chips= 100 calories
2 tbsp hummus= 80 calories
6 wheat thins= >50 calories

So again, think before you eat and sit less, move more!

Picture Source: http://isagenixhealth.net/wp-content/uploads/2013/07/Workout-while-eating640x400.jpg

One Positive of the Cold Weather: It Might Help You Lose Weight!

Source: Philly.com

The past week I have not been walking to work due to the frigid temperatures and frostbite warnings. However, I normally do walk most days of the throughout the winter (on days it is >20˚F). People think I am crazy, but I say it is no different than when I was in college at Penn State- walking over a mile to class on a day it was below freezing was no big deal, it was actually the norm for PSU students. I remember some days by the time to get to class I would want to cry because I was so cold that my face hurt and eyelashes were frozen. Or, we would be tailgating then sitting on the metal bleachers for four hours at night with temperatures in the teens and twenties. Ahhh the glory days! But hey, it was fun and it made me tougher!

Walking in the cold certainly makes me appreciate heat and being comfortable. Just as with exercise, being uncomfortable isn't necessarily a bad thing, it can make you stronger (mentally and physically!). I actually have found that now that I am not living up in Happy Valley and don't have long periods of exposure to the cold anymore, I am more of a wuss when it comes to cold temperatures. I really think I could tolerate the cold better when I was in college than I do now... so perhaps I had more brown fat back then? 

Researchers have long known that shivering is a protective function of the body and works to increase the body’s temperature by burning more calories. Some estimate that the metabolic rate can increase almost 5x when shivering, leading the body to potentially expend over 400 calories an hour. New research suggests that exposure to just slightly less than comfortable temperatures really can boost your calorie burn through Non-Shivering Thermogenesis (NST). NST is when the body increases its temperature (without shivering) in cool, but not frigid conditions. Research has shown that people gradually adapt and build up more brown fat when exposed to cold regularly. Brown fat is metabolically active fat and burns calories to produce heat, rather than storing calories like the standard white fat. Some estimate that brown fat can account for 30% of the calories one burns in a day.

In one Japanese study, subjects sat in a cooler room (62.6˚F) for 2 hours a day for six weeks. After the six weeks, the test subjects had decreased their body fat by 5% compared to those exposed to traditional room temperature settings. Furthermore, test subjects burned more calories when exposed to cold than the control subjects. In a new study, researchers had subjects sit in a room at 59˚F for six hours each day over 10 days. At the end of the 10 days, subjects had an increase in their brown fat and noticed they could tolerate cold better than they previously could.

My Recommendations: Experts still are not sure how long you need to be in a cold setting to burn x amount of calories, but the studies are showing that slightly cooler than comfortable temperatures can make a difference in your levels of brown fat and calorie burn. So, next time you are tempted to stay inside on a cold day, get outside for a bit and go for a walk (unless there is a frostbite warning!). Maybe learn to appreciate your freezing cold office and realize it may actually be benefitting you. My motto is that you never experience the joys in life (i.e: heat) without first experiencing the pains (i.e: cold). However, if you are an elderly person or have significant health problems like a heart condition, exposing yourself to cold may be something you want to talk to your doctor about.

References:

1. J Clin Invest. 2013;123(8):3404–3408. doi:10.1172/JCI67803.
2. Trends in Endocrinology & Metabolism, van Marken Lichtenbelt et al.: "Cold exposure – an approach to increasing energy expenditure in humans."
3. Picture- Philly.com
4. http://woodburygazette.com/burn-more-calories-in-the-winter-or-summer-months-p552-106.htm

You Can Tolerate More Alcohol if you are of a Certain Genetic Makeup and In Good Shape!

This blog is dedicated to my good friend Christine, who does not have a favorable experience with alcohol. She finds that when she just has one drink she becomes flushed, feels bad, and will become sick if she drinks more than two drinks within a few hours. I, on the other hand, (not that I have ever tried this), can consume a large quantity of alcohol in a short period of time and not experience any symptoms of being drunk. People are often amazed by this phenomenon, considering I am a small female who doesn’t drink a lot; so one would assume I cannot handle my alcohol.

WARNING: Super Sciency terms for the following paragraph:

Did you know that your genetics may play a huge role in how quickly you get drunk and how you metabolize alcohol? There is some truth to those college kids who say “I’m Irish so I can drink a lot!” Certain Asian populations, specifically East Asians such as the Han Chinese, Taiwanese and Japanese, have polymorphisms of the alleles involved in the enzymes used to metabolize alcohol. For alcohol to be metabolized, it must be converted from ethanol (alcohol) to acetylaldehyde, then acetylaldehyde to acetic acid. Alcohol dehydrogenase(ADH)  is the enzyme used for ethanol -> acetylaldehyde and acetylaldehyde dehydrogenase (ALDH) is the enzyme used for the second step. About 50% of people with Asian ancestry experience a mutated ALDH enzyme, which leads to an accumulation of acetylaldehyde. This build up causes facial flushing, increased heart rate, and an increased skin temperature after alcohol is ingested.

In addition to the specific mutations common in Asians that limit their ability to consume alcohol, certain populations have higher rates of alcohol elimination, which allows for more alcohol to be consumed without experiencing immediate negative consequences. Certain countries in Europe, such as Ireland, England, Germany, and Russia drink more than other countries, and some experts believe that is due to their normal ALDH enzymes and higher rates of alcohol elimination and metabolism.

Besides ancestry, body water percentage tends to play a huge role in the ability to metabolize alcohol. Body fat has low water content, whereas lean muscle is mostly water. Women tend to have “lower” tolerances because they have, on average, more body fat than men. Older people tend to have lower tolerances because they have less water (due to decreased muscle mass).  So, you theoretically will have the highest tolerance if you are a young and very lean man who is well hydrated.

My recommendations:  No alcohol is good for you; in fact, it is toxic to the body. Alcohol is very calorie dense (7 cal/gram compared to 4 cal/gram for fat and carbs), and is an easy way to add hundreds of useless calories to your daily intake. However, this blog was meant to be more entertaining and informative....so, if you’re looking to increase your alcohol metabolism perhaps you should hit the gym and start eating healthy! ;-)

My conclusion about why I can drink more is because I am of Eastern European and Irish heritage, I am pretty lean, still relatively young, and am always well hydrated. 

References:

1.     http://www.bettyfordcenter.org/treatment/announcements/are-some-countries-more-prone-to-alcoholism.php

2.     http://www.intox.com/t-physiology.aspx

3.     Edenberg HJ, Jerome RE & Li M (1999) Polymorphism of the human alcohol dehydrogenase 4 (ADH4) promoter affects gene expression. Pharmacogenetics 9, 25–30.

4.     Proceedings of the Nutrition Society (2004), 63, 49–63

Try My Dietitian Approved Entree at Ella's American Bistro in Wayne, PA!

I've partnered with the chef at Ella's American Bistro to create a healthy and delicious meal for patrons to order for dinner. The dish is called "fish (of the day- fill in name here- examples: salmon, swordfish) a la maison" and will be 450- 600 calories on average (depending on the type of fish used). The fish is limited to a 5 oz serving, 1/2 cup of barley cooked with homemade no-sodium added broth, and wilted Swiss Chard with <2 tsp sesame oil.

The nutrition information for the entire dish is available upon request at the restaurant, but keep in mind the nutrients and calories will vary slightly for each fish. As far as healthy menu options go (especially for not being a salad!) this is a sure crowd-pleaser. This dish is very low in calories, sodium, calories, and fat compared to most out there. Be sure to order it and let me know what you think!

Note: The picture  shows an optionalside of Sriracha hot chili sauce which does not come with the meal- this will add about 5 calories and 100 mg of sodium per teaspoon to the dish.

Intermittent Fasting Can be a Good Way to Lose Weight & Improve Health

If you read health magazines or watch shows that discuss weight loss, you have probably heard the new craze of Intermittent Fasting (IF). Basically, there is no real definition for IF, and many health experts, doctors, and book authors define it differently. I, personally,  define fasting as not eating or drinking anything besides water for at least 24 hours.

I am okay with people fasting since I think it is a natural process that the human body is meant to deal with.  A lot of how our body stores fat and how the metabolism works is attributed to our genetic makeup tracing it back to our ancestors. These people typically went through days where they consumed adequate calories, then some days where they had very few calories. Therefore, the need to store fat and conserve energy was important for survival. So, IF seems like a sensible thing for dieters to try since we seem to be going against our own genetic makeup by eating all day 24/7. I also think it is good for people to experience hunger, and have your body go through all the anabolic and catabolic metabolic pathways (glycolysis, gluconeogenesis, lipolysis, etc.).

According to some studies, IF may accelerate weight loss, decrease inflammation, blood pressure, cholesterol, and decrease the risk for cognitive decline, heart disease, and certain cancers. However, improving insulin sensitivity seems to be a benefit that is seen across most of the IF study subjects.

My Recommendation: I only recommend IF for those people that don’t have diabetes, hypoglycemia, or any health condition that would contraindicate IF. I basically only recommend IF to those people that know they do not exercise 2 days out of the week and are unwilling to, and know that they can go long periods of time without eating and not pass out. I would rather people exercise every single day (yes, even on "off" days go for a brisk walk or do yoga!) and eat normally than be sedentary and only eat a few hundred calories. But, if you know you will not exercise on certain days, use those days for IF.

Furthermore, I only recommend IF for people who have strong willpower- the last thing I want is someone binging at night because they haven't eaten during the day and have such strong cravings that they end up eating a tub of Ben & Jerry's at night. I also don't encourage people to use IF as an excuse to eat crap during the days they are not fasting, because you will most likely not see the health or weight loss results you want. 

I, personally do not practice IF due to the fact that I am very active and it would be unwise/unhealthy to limit my calories to <600 on any given day. However, IF can be a great tool if you are trying to lose weight and have good self control. I recommend Dr. Michael Moseley’s approach which requires you to consume <600 calories two days out of the  week. If you are trying to lose weight and stick to a well-balanced 1500 calorie diet the other 5 days/week, you should technically lose about an extra half pound per week. On the days that you are eating <600 calories, I recommend loading up on fruits and vegetables since you can eat a high volume for few calories. It is also important to include lean proteins and whole grains and drink TONS of water. 600 calories can be a substantial amount of food if you are choosing the right foods! 

So, again, I don't really define this as fasting, I would say it is more Intermittent Extreme Calorie Deficit (IECD- you heard it hear first!). You can choose any two days out of the week you want, but those are the ONLY 2 days out of the week that you aren't getting a good workout in (being physically active is CRUCIAL to living healthy!).

References:

Proc Natl Acad Sci U S A. 2003 May 13;100(10):6216-20. Epub 2003 Apr 30.; http://www.bbc.co.uk/programmes/b01lxyzc

 Med Hypotheses. 2006;67(2):209-11. Epub 2006 Mar 10.

 J Nutr. 2003 Jun;133(6):1921-9.

Learn Where Extra Calories Are Sneaking Into Your Diet!

You don’t need to go on a radical diet to lose weight. I encourage people to eat more vegetables, eat only whole grains (i.e: not refined grains), nonfat or low-fat dairy, fresh fruit, and lean sources of protein, and incorporate exercise into your daily routine. However, if that is too overwhelming for you at this point in your life, just cutting out a few things from your diet can have a huge impact. It is estimated that 3,500 fewer calories will cause you to lose 1 pound. So, if you cut out 250 mindless calories each day, you can theoretically lose a pound in 2 weeks. If you consciously change your eating to healthier choices and add on exercise, you will lose weight much quicker. Below are some common food items I see that contribute tons of calories to people’s diets without them even knowing:

·         Oils & Fats

o   1 tbsp of olive oil has 130 calories- so go easy on the oil and add water to help sauté foods

o   1 tbsp of peanut or almond butter has about 100 calories. These are healthy fats but not fantastic sources of protein, so if you are eating nuts you can probably do without nut butters in your diet.

o   1 tbsp of mayo has 100 calories

o   1 tbsp of butter has 100 calories

·         Alcohol

o   5 fl oz of wine has 130 calories- if your serving size is slightly larger than that and you decide to have 2 glasses each night that could be contributing 300 extra calories each day!

·         Juices

o   I always say it is better to eat a fruit than drink the juice. Whole fruit is more filling and you will get more antioxidants, phytonutrients, and fiber through eating the real thing. 1 cup of fruit juice typically has 100-140 calories… even if it is 100% fruit juice and “no sugar added”, it will still be loaded with sugar and calories.

 ·         Cheese

o   1 oz or 1 slice of cheese, on average, has 100 calories. If you put 2 slices of cheese on your sandwich for lunch, that can be adding 200 calories each day to your diet. Also be conscious of those cheese cubes at cocktail parties- each 1” cube is 100 calories too! Monitor your cheese consumption!

·         Nuts

o   Yes, nuts are very healthy. However, the calories add up quickly. 3 tbsp of peanuts has about 200 calories, and ½ c almonds have about 260 calories. Nuts are definitely a snack you don’t want to just grab handfuls of, because you could be adding hundreds of calories to your diet without even thinking about it.

·         Calorie-dense cereals

o   Many people think granola is a healthy choice for breakfast. While it may contain whole grains and nuts and seeds, it typically contains a lot of added sugar and oils. One cup of granola can easily pack 400-500 calories per cup. Similarly, cereals like muesli or any mixed cereal with dried fruits and nuts will typically be very calorie dense. Always read the label and watch your portion size!

·         Proteins

o   For some reason, many people believe they can eat as much “protein” as they want and it won’t make them gain weight. Extra protein calories will just be converted to fat if not used, so you need to watch your protein intake just as you do carbs. A standard “serving” is 3 oz of boneless skinless chicken breast, which contains only 140 calories. However, most people eat larger than 3 oz servings, and the meat will typically be fattier than boneless skinless chicken breast, and/or fat will be added, contributing many more calories, especially in a restaurant setting. Also be conscious of protein powders… if 1 scoop is 100 calories and your body doesn’t need that extra protein, those extra calories will basically just be adding to your waistline ;-)

If you want to be successful at losing weight, the best thing you can do is be aware of the foods and calories you are consuming! If you can decrease the quantity of some of the foods above, you should lose weight (as long as you don't replace those calories with something else...)

Picture Source: http://allieatfood.files.wordpress.com/2011/02/048.jpg

Information on Insurance reimbursement for Nutrition Counseling:

INDEPENDENCE BLUE CROSS and AMERIHEALTH Members: Personal Choice, Keystone Health Plan East, AmeriHealth, or Independence Administrators members may receive 6 free nutritional counseling sessions each year with Kelly!

*Note: Medicare and Blue Cross/Blue Shield plans are not covered & specific IBC plans may not be covered

AETNA Members: Aetna reimbursement depends upon your specific policy. Many plans do offer 100% coverage for up to 10 visits per year!