Posts Tagged ‘Weight management’

Parents, remember these numbers: 5210

July 29, 2012

Five-two-one-zero (5210) is a reminder of what our children need each day in order to be healthy. Here is the breakdown:

5    = Five or more servings of fruits and vegetables

2    = No more than two hours of recreational screen time (no screen time under 2 yrs old)

1    = At least one hour of physical activity

0    = Zero servings of sugary drinks (drink water and fat-free or 1% milk instead)

[To remember the numbers I think “five to ten”]

For more information see http://www.letsgo.org

Here is a short video to use as a teaching tool for children: http://youtu.be/TluNJeM6HAI

Here is a more detailed video for help in designing a 5210 program in a community: https://vimeo.com/29985972

Advertisements

Diet advice for 2012 – from Cleveland Clinic

January 5, 2012

It’s  a new year and I resolve to write more blog posts this year than last. So, I’ll start with what is on many people’s minds now: which diet should I choose? Here is the latest from a respected source – Cleveland Clinic.

This New Year’s, losing weight will undoubtedly top many Americans’ list of resolutions – and it’s an important one. One reason? Heart disease is the main health threat caused by obesity. Make your efforts to slim down more successful this year by becoming wise to the “secret of calories!”  …

Just follow these 5 rules:

1. Understand the basic principal of dieting for weight loss. With all of the opposing diet plans forbidding carbohydrates or preaching against fat, it’s easy to see why confusion prevails. But, Cleveland Clinic experts say, recent studies comparing these different diets have found that the proportion of carbohydrates, proteins and fats in your diet do not influence weight loss. 

This means, in a nutshell, you can lose weight with any diet as long as you burn more calories than you take in. That’s the secret.

2. Know how many calories you need. Would you believe that of the half of Americans who are dieting at any given time, only 12 percent know how many calories they should consume daily? This number, which for adults ranges from 1,600 to 3,000 a day, depends on your age, gender and activity level. [Here is a useful daily calorie calculator]

3. Change your calorie intake to lose weight. If you want to lose weight, eat fewer calories than you burn. Eat 500 to 1,000 fewer calories per day and you will lose weight, often one to two pounds per week. But don’t be discouraged when weight loss begins to slow after a few weeks of dieting – this is a normal event as your body adjusts to your new diet. Keep watching calories and exercising and you will keep heading toward your weight loss goal!

4. Don’t be fooled by fad diets. More isn’t always better. In fact, it can be harmful. Any loss of more than two pounds a week is usually just water weight. Studies also show that the faster weight comes off, the quicker it is regained. Stick to a diet that has a goal of only one to two pounds weight loss a week [even better, in the long run, would be one pound per month].

5. Choose a diet you can live with. For your weight loss and weight maintenance efforts to succeed, you must continually manage your calories. No one diet is better than another. Studies show dieters tend to lose five to 10 pounds over the course of a year, regardless which diet they pick. What’s important is to pick a diet that works for you and that you can stick with. And if you’re not successful, pick a different diet next time.

Do you know a fat person?

July 20, 2010

Call them obese, huge or fat — the stigma won’t go away. And I’m not sure it should.  Obesity is bad for a person’s health, bad for the planet, bad for fellow airline passengers, and even bad for babies born to obese mothers (which, in turn, is bad for the economy; see NYTimes article).  When something causes this many personal and social problems we usually assume it is not a good thing to have or be.

“But,” some say, “we mustn’t blame the victim.  Obesity isn’t a weakness or a fault; it’s genetic. When we stigmatize people, they suffer even more, and may even avoid seeking help.” There is a kernel of truth to this concern, but it distracts us from the main point: obesity can and should be eliminated over time, through more research, and through attacking many known contributing factors (factors such as the  marketing and subsidizing of unhealthy foods).

The most active researchers who advocate against “weight bias” and “weight stigma” (Kelly Brownell and Rebecca Puhl at Yale, for example) also tell us that the obesity epidemic is growing and the health consequences are horrible.  They do not claim the problem is due to a change in genetics.  People can do a lot to prevent and even treat obesity, without altering genes (see many of my posts in this blog).

An anti-obesity program in Singapore that targeted overweight children was discontinued because of concern about stigma, even though the program was effective (reducing the percentage of overweight children from 14% to 9.5% in fourteen years — 1992 – 2006; click here for more information). I don’t know what should have been done in this case; there are no easy answers.

Outright discrimination against people based on appearance is generally wrong, and fat people should be treated sensitively and humanely, no matter what caused their affliction.  (Many equate stigma with discrimination, but I see a difference between the two concepts.)

Whether or not it reduces stigma, television has recently upped its focus on obesity by producing such shows as “Drop Dead Diva,” “Huge,” “Mike and Molly,” and, of course, “The Biggest Loser.”  A new series starts next month, “Too Fat for Fifteen: Fighting Back,” and at least one other obesity-related series is in the works. See this article for a discussion of how obesity is being addressed on TV.

[The photo at the top of this post is from ABC Family’s series “Huge”]

How many times a day should we eat?

May 26, 2010

I stated in my last post that we cannot trust “hunger” as a cue for when to eat. But how do we know when it IS time to eat?  For me, and I suspect for many others, the three-meals-a-day “rule” works well.  In fact, I believe that for most people who struggle with weight control, eating more often, “grazing,” or snacking between meals only adds to the problem.

Now, many of you believe that six or more small meals per day, or three meals plus two or three snacks, is best (e.g., see comment by Personal Trainer on my last post).  And for some people there is a medical reason for eating more often than three times per day (e.g., people with dyspepsia, GERD, hypoglycemia, etc.).  Some of these medical indications are valid, and some are not.  I won’t get into that here.  What I do know is that the more we snack, the more likely we are to consume excess calories (see this research report).

A survey reported this year in the American Journal of Clinical Nutrition found that in the thirty years between the 1970s to the early 2000s, for adults and children, the average time between eating occasions shrank by one hour (most recently, 3 hours apart for adults and 3.5 hours apart for children).  Daily calories for both groups increased from roughly 2,090 in the 1970s to 2500 in the 2003 – 2006 period.

Calories from snacks more than doubled: for adults, from 200 calories per day in the 1970s to 470 calories in the recent time period; for children, from 240 to 500.  A significant portion of snack calories came from beverages.  It can be assumed that these numbers are underestimates, since surveys usually under-report the number of calories consumed.  [The above research was described in the May 2010 issue of Nutrition Action Health Letter]

It makes sense to me that the more often one eats, the more one is exposed to temptation and calories.  Also, we know that “willpower fatigue” occurs, so that the more often we have to decide what and how much to eat, the less “willpower” we are left with by the end of the day.

One known cause of overeating, which is also closely related to snacking, is “emotional eating.”  The solution to that problem is mindful eating, plus tending to emotional issues in a more appropriate way.

Personally, one of the most effective things I have done over the years to maintain my weight in a healthy range is to eliminate snacking.  It takes some getting used to — for example, eating dessert just before bed was a long time habit for me — but it really makes a difference.  And I haven’t developed hypoglycemia, insomnia, or any other health problem as a result.

If eating three daily meals (assuming the portions are reasonable and the food is mostly “healthy”) works to maintain weight, would two meals be even better?  Apparently not, according to several studies.  People who skip breakfast, for example, tend to weigh more than people who don’t.

Looking your best in 2009

January 1, 2009

090105_r18091_p233

For my first post in 2009, I am passing along to you a sure-fire 9-step program to help you lose weight and/or accept yourself. It is straight from the January 5 issue of The New Yorker (by Amy Ozols):

People say that obesity is an epidemic in America, but I’m determined not to become part of the problem. That’s why I’ve spent years perfecting the secret to a trim and attractive physique. My foolproof system involves just nine easy steps.

Step 1: Avoid what psychologists refer to as “emotional eating.” This is hard, because many people have a tendency to experience emotions. To solve this problem, consume increasing dosages of psychotropic medications until you cease to feel emotions of any kind.

Step 2: Visualize yourself as a thin person. This is very important, because the body often takes its signals from the brain. Each time you take a bite of food, imagine that you are a thin person taking a bite of food, chewing the food, then spitting the food into a napkin, then tucking the napkin into your backpack or purse. After you’re done visualizing these things, start doing them.

Step 3: Get rid of your “fat clothes.” Keeping your closet stocked with unflattering garments will only distract you from your quest for a slender body. To complete this step, shred or burn everything in your closet, including any hangers or shelving that a fat person may have touched. Refrain from donating anything to charity, as this could cause underprivileged people to become obese, which would be unsavory and possibly even illegal.

Step 4: Refrain from consuming food.

Step 5: Surround yourself with thin people. This will naturally encourage you to emulate their healthy habits. Weigh your friends on a regular basis, then weigh yourself. Do you have a friend who weighs less than you? If so, consider gastric bypass surgery.

Step 6: Drink plenty of water. As you’ve probably heard, water functions as a natural lubricant in the body, flushing toxins and fat cells from the digestive tract. Water is also a delicious replacement for higher-fat liquids, such as milk. Try pouring water on your cereal or in your coffee. If you’re a baby, try pouring water into your mother’s breasts.

Step 7: Buy a pet. Having a pet will force you to take walks, which are a form of exercise. This is true unless you make the mistake that I made, which was buying an iguana. Iguanas walk very slowly and smell strongly of turds. I really cannot dissuade you strongly enough from buying an iguana.

Step 8: Vigorous sexual intercourse burns up to two hundred calories per hour. Therefore, if you are not currently promiscuous, it is essential that you begin “boning” immediately. Start by having sex with every person you know. Then have sex with numerous people you have never met. Continue doing this until you are thin.

Step 9: Self-confidence is the most attractive trait a person can have. For this reason, strive to love yourself and accept yourself exactly as you are. This will be difficult if you are overweight, on account of your loathsome physical appearance and compromised value system, but do your best. And, if the going gets tough, remind yourself: every person is beautiful on the inside, provided that they are also extremely attractive on the outside.

Please, don’t Resolve to “get healthy” in the new year!

December 31, 2008

ist2_1141718_desk_calendar_january_1st_with_clipping_path1

There is nothing wrong with setting a goal to walk 30 minutes a day, or to stop buying fat-and-sugar-laden snack foods to keep in the pantry. The problem with New Year’s Resolutions is that they are usually reactive and rarely work.  By reactive, I mean they tend to be the result of a feeling that “I have overindulged” or “been bad” in December, so I will make amends next year.  This kind of thinking is self-defeating.  Diets don’t work, and Resolutions don’t work.  What does work is a full time commitment to practicing specific, realistic behaviors.  The idea of an annual review and re-commitment is not bad, but I suggest the best time to do this might be December 1 — certainly not January 1.

Here is an excerpt from Weight Management for Your Life that may give you some idea why I think December, with all of its “special occasions,” would be a good time to review and renew your healthy-living plan:

If you have been successfully working on changing your eating and exercise patterns for some time, you will encounter situations where someone will say to you “This is a special occasion, so go ahead and eat that cake!” The cake is not the issue, but the implication behind the statement is. People observing your healthier lifestyle will assume you are in a constant state of self-deprivation, and will want to see you “loosen up.” It is important to them to feel okay about
their own “indulgences.” The problem with your buying into that theory is that it discounts the fact that you already are eating (and exercising) the way you want to. You are not depriving yourself – in fact, by doing what you want, you are indulging yourself. Your ongoing healthy lifestyle is its own reward.
Another problem with going back to old unhealthy habits, even temporarily, is that such “special occasions” come up frequently: out-of-town trips, weddings, graduations, birthdays, holidays, cruises, office parties, etc. etc. Add the special occasions with their special “indulgences” or “rewards” up over the course of a year and you have put on an unwanted five to ten pounds. … Special occasions are even more special when they don’t throw you off your chosen path.

Happy new year!

What can we learn from the latest major “diet” study?

July 18, 2008

A major, well-designed research study of the effectiveness of various “diets” on weight loss and health has been published in the current issue of the New England Journal of Medicine. The researchers carefully followed 322 moderately obese people (mostly middle-aged men) for two years in a workplace setting where a lot of support and education was given along with a controlled diet. The research subjects were divided into three groups who ate one of the following: a low-fat, restricted-calorie diet; a Mediterranean, restricted-calorie diet; or a low-carbohydrate, non–restricted-calorie diet.  In the final analysis, all three groups lost weight (mostly in the first six months) and had health benefits, but the Mediterranean and low-carb groups had the best outcomes. Overall, 85% of subjects stuck to their diet for the full 2 years.

What we can learn is that education, structure and support are important in maintaining a consistent eating pattern (this study took place in Israel where the mid-day meal is traditionally the main meal, so the impact of the workplace is significant).  We also learned that the two diets with the best outcomes (in terms of weight loss maintenance, reduction in waist circumference, and some health measures) were the Mediterranean and low-carb. Finally, as written in the original article, we learned:

Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. … The low-carbohydrate and Mediterranean diets had some beneficial metabolic effects, a result suggesting that these dietary strategies might be considered in clinical practice and that diets might be individualized according to personal preferences and metabolic needs [e.g., diabetics might do better on the Mediterranean diet; people with lipid problems might choose the low-carb diet]. The similar caloric deficit achieved in all diet groups suggests that a low-carbohydrate, non–restricted-calorie diet may be optimal for those who will not follow a restricted-calorie dietary regimen. The increasing improvement in levels of some biomarkers [health indicators] over time up to the 24-month point, despite the achievement of maximum weight loss by 6 months, suggests that a diet with a healthful composition has benefits beyond weight reduction.

One limitation of the study is the fact that most of the subjects were middle-aged men (only 16% were women).

Diet research is hard to do, and this study benefited from having a relatively controlled setting (workplace with main meal being served there). This is also a weakness, because few in the real world have that much structure and support.

The take home message for me is that even with almost ideal conditions it is hard to lose much weight, but weight can be maintained after the initial six months and the health benefits continue in the maintenance phase. Also, the study does help us (a little) choose what kinds of foods to add or subtract from our permanent diet (lifestyle), as opposed to a temporary “weight loss” diet. So, for example, I may decide to add more fish and chicken (and less red meat), more Tabouli (I love it), and less sugar and starch (if I cut way down on these, I won’t have to count Calories so much). Nothing we didn’t already kind of know, but this is reinforcement for that.

For a more detailed summary of the research see this site.

Weight loss strategies

July 16, 2008

This research report appeared in the current news summary from medscape.com. The study only shows associations and not cause and effect, but is worth noting because of the large number of people surveyed.  Though not conclusive, the report reinforces the advice to self-weigh regularly, eat breakfast daily, and avoid fast-food.

July 8, 2008 — Overweight or obese adult patients with type 2 diabetes who followed various weight-loss interventions had lower body mass indexes (BMIs), according to the results of the Action for Health in Diabetes (Look AHEAD) clinical trial reported in the July issue of Diabetes Care [2008;31:1299-1304].

This is a cross-sectional study within an ethnically diverse population with type 2 diabetes from 16 US centers (the Look AHEAD study) to correlate eating patterns with BMI and to describe the most common weight-control strategies in patients with type 2 diabetes.

“Intentional weight loss is recommended for those with type 2 diabetes, but the strategies patients attempt and their effectiveness for weight management are unknown,” write Hollie A. Raynor, PhD, RD, from the Brown Medical School/The Miriam Hospital in Providence, Rhode Island, and colleagues from the Look AHEAD Research Group. “In this investigation we describe intentional weight loss strategies used and those related to BMI in a diverse sample of overweight participants with type 2 diabetes at enrollment in the Look AHEAD. . . clinical trial.”

Study Highlights

  • The Look AHEAD study included 5145 patients aged 45 to 74 years with type 2 diabetes with a BMI of 25 kg/m2 or more (or 27 kg/m2 or more for those receiving insulin), with 33% of participants from ethnic minority groups.
  • Excluded from this analysis were those with inadequate control of diabetes and with underlying diseases that influenced lifespan.
  • Weight-control practices included a list of 23 behaviors that participants chose from, expressed as a percentage of participants using each practice and duration of use of each practice, up to 52 weeks.
  • Those who self-weighed weekly had a lower BMI (35.3 kg/m2) vs those who weighed themselves once a month.
  • Those who consumed 6 or more breakfasts weekly had a lower BMI of 35.6 kg/m2 vs those who consumed 3 to 6 days per week (36.7 kg/m2).
  • Overall, participants consumed 1.9 fast-food meals per week.
  • BMI was 35.1 kg/m2 for those reporting no fast food per week vs 36.9 for those reporting 3 or more fast-food meals per week.
  • The 3 most prevalent weight-control practices by duration of use were increasing fruit and vegetable intake, cutting out sweets and junk foods, and reducing consumption of high-carbohydrate foods, with duration of practice from 20.3 to 26.5 weeks.
  • Overall, a larger amount of intentional weight loss, self-weighing less than once weekly, and more fast-food meals consumed were associated with a higher BMI, whereas consuming more breakfasts was associated with a lower BMI.

What does 200 Calories look like?

July 9, 2008

Click here to see many examples of what 200 Calories looks like. This is a great set of photos, thanks to Joe AverageFor another set of amazing photos, click here (you won’t forget these).

Taking a “vacation” from healthy eating

June 27, 2008

I am on vacation – several weeks of sharing a beach house with friends and family – and I am eating (and drinking) very well! People often say to me “Have some more of this [fill in the blank: junk food, fried food, rich desert, Bloody Mary], you are on vacation!”  For many people who succumb to this kind of peer pressure, the result is unwanted weight gain that is very difficult to reverse. They rationalize: “As soon as I get home, I am going on a strict diet, and will work out twice a day!”  The diet doesn’t work and the rigorous workout routine rarely lasts a full week.

Fortunately, my eating and drinking patterns do not change when I am on vacation or having a “special occasion” because I have figured out a way to eat and drink very well ALL the time.  In that sense, I am always on vacation when it comes to healthy behavior and good eating.  True, I may overeat (or drink) for one meal or event, but easily compensate by eating and drinking less for two or three other meals. Here is some advice for coping with vacations and other special occasions (from Weight Management for Your Life):

If you have been successfully working on changing your eating and exercise patterns for some time, you will encounter situations where someone will say to you “This is a special occasion, so go ahead and eat that cake!” The cake is not the issue, but the implication behind the statement is. People observing your healthier lifestyle will assume you are in a constant state of self-deprivation, and will want to see you “loosen up.” It is important to them to feel okay about their own “indulgences.” The problem with your buying into that theory is that it discounts the fact that you already are eating (and exercising) the way you want to. You are not depriving yourself – in fact, by doing what you want, you are indulging yourself. Your ongoing healthy lifestyle is its own reward. Another problem with going back to old unhealthy habits, even temporarily, is that such “special occasions” come up frequently: out-of-town trips, weddings, graduations, birthdays, holidays, cruises, office parties, etc. etc. Add the special occasions with their special “indulgences” or “rewards” up over the course of a year and you have put on an unwanted five to ten pounds.