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Considering All Options for a Better Approach to Weight Management

The journal Obesity recently published an expert panel report reviewing what could be the most effective obesity treatment guidelines. The panel’s report intends to settle some of the arguments among health care providers in terms of what exactly is the best evidence-based approach to weight management.

freedigitalphotos.net

freedigitalphotos.net

While many enjoy arguing over the “best diet”, the panel concluded that there are many approaches to obesity and weight management (including referral for bariatric surgery in specific cases), insisting that it is time to stop arguing about various approaches. The panel addressed these key questions:

  • Who needs to lose weight?
  • What is the optimum level of weight loss?
  • Which diet is the most effective for weight loss?
  • Is diet and exercise the best way to lose weight?
  • How can weight loss be maintained?
  • Who should receive bariatric surgery?

When individuals consider weight loss, they are often lured in by the quick fix diet, or elimination diet (think: gluten-free) that appear simple to follow. We know however, that without long-term behavior change, these types of plans are only short-term fixes. We also seem to be a society obsessed with perfection, or at least the idea of it – toned bodies, smooth skin, and super-white teeth. This, while aesthetically appealing, does not always equate to “healthy”, and just as there is no one measure for beauty, there is also no one measure for “healthy”.

A person’s weight, while a huge factor in health and disease risk, is not a simple assessment. For this reason, physicians are wise to bring in the registered dietitian to evaluate an appropriate weight goal for individual patients. While BMI (body mass index) and weight charts can be useful, positive metabolic changes can occur with small amounts of weight loss.

As far as effective “diet”, the ability and motivation of an individual to maintain an eating style should be considered in addition to the basic dietary framework that is supported by evidence to reduce or prevent disease (the DASH Diet, vegetarian diets, and the Mediterranean diet all fit this bill).

The expert panel realized that while face to face counseling is very beneficial, other individuals can also benefit from telehealth options and online approaches. Hopefully this expert review will help improve the reimbursement for a variety of nutrition service approaches from qualified professionals.

If there is one thing we should agree on, it is that no one diet fits all, and neither does one lifestyle approach. Individuals need encouragement from professionals they can relate to, and need programs that are individualized to fit their lifestyle for long-term success.

 

 

 

Paleo or Vegan? Meet me in the middle

healthy-foodIn my 28 years of practice in the field of food and nutrition, I don’t remember a time when food and diet were so controversial. The Internet and social media have provided a platform for everyone – regardless of whether or not they have any background in nutrition or diet therapy – and, they want to tell you what to eat. As a registered dietitian-nutritionist whose charge is to clarify the science behind the claims for consumers, all of the published pseudoscience on the Internet keeps me busy.

Interestingly it seems that the extreme ends of the diet spectrum are the most passionate. Let’s take a look at the Paleolithic diet and the Vegan diet.

Paleo Basics:

  • Eat as your Paleolithic ancestors did, 12,000 years ago
  • Focus on lots of protein from grass fed meats, fish
  • Non-starchy Vegetables (claiming potatoes are bad)
  • Avoid most grains, including wheat (no breads, cereals, pasta, rice)
  • Avoid vegetable cooking oils
  • Limit fruits
  • Limit added sugar and fats

Vegan Basics

  • Avoid all animal products – all meat, fish, seafood, eggs, dairy, and products derived from them (which may include bees – no honey)
  • Include vegetable protein, soy, nuts, and seeds
  • Pure vegans also avoid other animal products (leather, wool) and are usually vocal proponents of animal welfare.

I can advocate a vegan diet (when planned properly) for health, but I can’t advocate the Paleo lifestyle for long-term health. The only benefit to a Paleo diet is, perhaps, short-term weight loss. A vegan diet is a very healthy way to eat, but for some, it may not always be the most enjoyable choice. There’s no question that plants are more medicinal than meats, but I like to help people improve their health by choosing a diet they enjoy, and can sustain. If Vegan is that choice for them, great, but many people can achieve good health and prevent disease, meeting somewhere in the middle: Less meat, and more plants.

Many proponents of both the Paleo and Vegan diets and lifestyles however, support their choices as if it were a religion, and in some cases are using diet as a political statement. We are blessed with a wide variety of food to eat in our country. I encourage everyone to also consider the environmental impact your diet may have, and do your best to conserve energy in general, but it’s not an all or nothing proposition. You can meet halfway.

The DASH and the Mediterranean Diets are the dietary middle ground. Both of these diets promote a good dose of vegetables and fruit, and small amounts of animal protein. The DASH diet also includes 3 servings of low fat dairy, since the research trials showed that the groups who included the dairy daily lowered blood pressure more than the groups who did not. A wide variety of foods can be included with both diets, and the diets are sustainable and evidence-based.

In terms of overall public health, there’s not one meal plan for all. Everyone has individual food preferences, and some people may be intolerant to certain foods or beverages. Yet everyone can choose to eat a healthy diet – and would especially benefit by meeting with a nutrition counselor. A registered dietitian can help you make choices that are going to based on what you enjoy eating, your health, and what your body tolerates, among other things (culture, traditions, budget, region, availability of various foods, medical nutrition needs).

If you choose to “go on a diet”, or subscribe to a restrictive lifestyle, that’s your choice. I don’t think it’s appropriate to convince everyone that your choice is the best choice for everyone. What is clear (and supported by science) is that everyone benefits from adding more vegetables to their diet, and science does back up a plant-based diet. Let’s just agree on that, and leave the rest to personal preference.

The Health Food Aisle’s Halo

ChipsphotoAll natural. Clean.

What do these terms mean to you? For a few years now, food manufacturers like to use the word “natural” on product labels since consumers seem to gravitate toward it. Unfortunately, from a food labeling standpoint, there is no clear definition of “natural”, so products labeled as such can intermingle with some “not-as-natural” products, and that the label alone doesn’t always mean much.

So what is a natural food? Well, an easy definition could be foods that are available as they are found in nature. A green bean that’s snipped off the vine, and apple plucked off the tree, a walnut from its shell, and a fresh egg straight from the hen house.

But what about all of the packaged foods on the market that make the “natural” claim? For instance, during a recent trip to the store, I noticed a company called Rice Works makes snack chips that are made from brown rice. So you may think: “Brown rice is better for me and higher in fiber” and that’s true. But do you benefit from getting your daily dose of fiber from a packaged snack food? And are these types of snacks really better than the old-fashioned potato chips (which they apparently aim to be replacements for)? Well, basically, no.

Take a close look at the bottom line on the Nutrition Facts label.

One ounce of the Rice Works chips provide:

140 calories

6 grams of fat

120 milligrams of sodium (up to 200 mg in some flavors)

1 gram of fiber

The Rice Works chips contain brown rice and up to 20 other ingredients 

Compare this to an ounce of Cape Cod Original potato chips:

140 calories

8 grams of fat

150 milligrams of sodium

<1-gram fiber

The potato chips contain potatoes, oil and salt.

So which is “healthier”?

This is the dilemma that many consumers have, although it’s really not a dilemma at all. The answer? Neither product is healthy if consumed in large quantities, every day. They aren’t “every day” foods, they are both “sometimes” foods. I recommend eating the one you enjoy more, but not putting the health halo on the brown rice chip.

It’s not about which snack you choose, it’s about how often you choose them and the size of the portion you consume. But, it is interesting that the Rice Chip tries to act like a health food, and yet the good ‘ole potato chip has simply three ingredients and a very similar calorie, fat and sodium profile.

Remember this as you check out new products in the “health food section” of the grocery store. Take a close look at them, and don’t assume that just because they are packaged in healthy-looking wrappers, they are automatically healthier than the original or alternative. A packaged treat is just that – a treat.

 

Side Note – My Healthy Snack On the Go

Almonds are one of our favorite snacks. We keep a large jar in the van for road trips, and I keep a small tin of them in my purse for times when I’m late for a meal and hungry. The purpose of snack time is to offer you some nutrition and energy to hold you over until the next meal, so snacks can play an important role in your diet. Stick to the basic food groups for snacks – fresh fruits and veggies, nuts – and enjoy packaged snacks only as a treat on occasion, or perhaps when traveling (some packaged snacks are particularly conducive to picnicking, hiking, biking and similar activities).

The Path to Wellville is full of Snakes

You may be familiar with the term snake oil salesman. This term refers to someone who tries to sell a fraudulent health product that is unproven. They say history repeats itself, well here we are, believing the snake oil salesmen again.

There’s the Fed Up Movie mantra:

“Everything you’ve been told about diet and exercise is dead wrong”

Actually, almost everything you’ve heard for the past 20 or 30 years about diet and exercise IS true. Fresh vegetables and fruits are good for you. Don’t eat too much cake or candy. Choose leaner cuts of meat. Use butter in moderation. Add some real fiber to your diet (nuts, beans, whole grain). Eat more home-cooked meals. Grow a vegetable garden.

But guess what? Some people just plain don’t want to do it!

Others are just overwhelmed with other priorities, or confused about the nutrition information they hear.

From my perspective, and that of many of my dietitian colleagues, the misconception that the dietary advice (meaning the therapeutic use of food as medicine) that RDs have been preaching for decades is “dead wrong”, is just that – a misconception and misperception.

For those of us who have been working in the field of food and nutrition for decades – there is no mystery here. But the media, and a few self-proclaimed experts (i.e. no formal education in the science of nutrition) continue to make it more and more confusing.

Another example is the book Sugar Savvy, recently reviewed by an RDN. Written by Kathy Dulgin (aka High Voltage). While I support Kathy’s efforts (and Dr. Oz’s) to engage people in pursuing a healthier lifestyle, I can’t support engaging them with false statement about food, sugar, and nutrition science in general. Tell people to cut back on sugar. Give them ideas about how they can do it. But don’t tell them sugar is “killing us” and that people have no responsibility or control over what they choose to eat.

The Draw of the Wizard

I guess everyone just wants to wish their troubles away. Twenty years ago, most doctors were not paying any attention at all to how therapeutic diets or a referral to a registered dietitian or certified diabetes educator could help their patients. Now everyone is suddenly interested. Shall we call this another aspect of the “Oz effect” ?

The recent Oz commentary during his Senate hearings included this:

“I actually do personally believe in the items I talk about on the show. I passionately study them. I recognize that oftentimes they don’t have the scientific muster to present as fact. Nevertheless, I would give my audience the same advice I give my family, and I have given my family these products.”

snakeoilsalesmanSo in other words, Oz doesn’t care if there is any science to support the claims he makes on stage, he just “believes” in it and feels good recommending it to his audience (which he seems to think is only the people actually in the studio, not the millions watching).

This is not what medicine is supposed to be like. The Practice of Medicine (and registered dietitians practice under the umbrella) is supposed to be evidence-based. Peer-reviewed. Shown to do no harm.

Between Dr. Oz and so many unscience-based diet books on the market, I have to ask: How did we get here?

It’s time for America to show the snake oil salesmen what you’re made of. Make better choices at the grocery store, cook at home more often, buy less packaged food. Sorry, I won’t lie – it’s not going to be easy, it never has been. Losing weight is hard (which is why it is worth working on preventing weight gain in the first place). It’s not easy to eat right and exercise. But your health and happiness is worth it.

 

 

Cooking: A Strategy to Better Health

This really isn’t news to many, but cooking at home is good for your health. Cooking at home through the week will likely result in better food, more nutrients, less calories and less sodium than eating out too often. It also can heighten the family’s awareness about where food comes from and tune you into your body’s hunger cues.

These key points lead to healthier eating:

  1. Eat more vegetables
  2. Consume ‘good fats’ (olive oil, canola oil, peanut oil, nuts, olives, avocados)
  3. Consume ‘good carbs’ (limit refined sugar and white flours, and add more whole grain carbohydrates: oats, barley, brown rice, whole grain breads and cereals)
  4. Eat Mindfully (be aware of what, how much, and when you are eating)

Most people need to include more vegetables in their diet, and keep in mind that food should taste good. If you think you or a family member doesn’t like vegetables, it’s probably because you have never prepared them properly (or have never had them prepared properly for you). Just steamed? Boring.

Try these simple cooking techniques to add some zing to your diet:

  • Use your grill. And not just for meats, chicken, seafood, and vegetables. You can even grill fruit. Grilled peaches or pineapple make delicious accompaniments to meats. Grilling veggies this season, and toss them into pasta (hot or cold) for a great side dish or meal. Slice zucchini, onions, eggplant, and bell peppers and toss together in an oven safe glass dish. Drizzle with good olive oil and sprinkle with sea salt. Roast in the oven for about an hour. The result: a sweet, tender, delicious taste sensation.
  • Don’t be afraid to pan sauté. It may sound difficult, but it’s easy and a great-tasting alternative to deep-frying, and it’s a way to add ‘good fat’ to a tasty meal. And it’s quick, and won’t heat up your kitchen. Try breading thin cuts of chicken breast or pork loin. Heat 2 tablespoons of olive or peanut oil in a six to ten inch sauté pan, place meat into hot oil and cook until lightly browned, about 4-5 minutes per side.
  • Add carbohydrate; don’t remove it from your diet, but balance it through the day. If you think you are going to get fat, or stay fat, by eating a bagel in the morning, or a roll with your salad, or a bowl of rice, think again. These foods are enjoyable to most people – the key thing here is portions, and balance. If you have a bagel for breakfast, try soup and salad for lunch and skip the roll. If you have oatmeal in the morning, enjoy a sandwich for lunch. Balance and variety and moderation – the foundation of a healthy diet.
  • Change the focus. Instead of the pasta being the main focus of a “pasta salad”, how about making the veggies the main attraction? Just add 2/3 veggies to 1/3 pasta or barley or couscous!

What will undo your weight loss plan: too much junk food, candy, processed cakes and cookies, sugary drinks, tubs of icing, too many granola bars, and not moving your body enough. Or in general, too much of anything is not a good thing.

Be mindful. Do you even know what you ate today? Were you hungry? Do you know how small or large your portion was? Did you count the handful of candy you took from your coworker’s desk? Being aware of what and how much you eat is important when it comes to changing behaviors for the better. Consider keeping a food journal.

Use the summertime to start preparing more healthful food that your family will enjoy. Share some links to some favorite recipes!

What Dad Really Wants

Summer has arrived. For many, a cold beer never tastes as good as it does in summertime. It’s Father’s Day weekend, and there’s are a lot of articles about what to get dad, or what kind of special dinner you can cook him, but what do dads really want? 

Most likely: Peace, quiet, and beer.

My husband and I love beer. As with food, moderation is important. Health authorities recommend that while binge-drinking (defined as 5 or more drinks on one occasion) is an unhealthy habit, moderate intake (women can have no more than 1 drink per day, and men no more than 2 drinks per day) seems to have no harmful effects. In fact, a moderate intake of alcohol may even have some benefit.

To keep in mind -

  • Guidelines. You may choose to have 3 beers one day when celebrating a special occasion, and not have any on other days, and that’s probably okay.

“The code is more what you’d call guidelines than actual rules.” ~ Captain Barbossa, Pirates of the Caribbean

  • Calories count too. Calories in beer come from its alcohol content, so a higher the alcohol content, yields a higher calorie count. I personally would rather just have one good beer, than three light beers, but that’s up to you. Just don’t overdo it too often.

Sure, I want all dads to be as healthy as they can be, but I also want them to be happy. This means eating food you enjoy, but balancing it out with moderation and exercise. While you enjoy a healthy spread of food this Sunday (perhaps some grilled vegetables and a nice lean steak), allow yourself to enjoy a cold brew with it.

Here’s a review of some of our (me and the dad in the house) favorite picks (including % abv – alcohol by volume) for adventurous beer drinkers to try out:

  • Sierra Nevada IPA. We fell in love with this beer in 1991 when we went to visit a friend in Reno, Nevada. Nobody I knew in the East was drinking IPA then. It’s still one of my all-time favorite IPAs. We also love that it comes in cans, which is great for picnics, poolside or boat docks. It’s 5.6% abv.
  • Dogfish Head 60-minute IPA. I’ll admit right now, I’m partial to IPAs. We visited the Dogfish Head pub in Rehoboth Beach around 1999 and have been enjoying this beer ever since. Maybe the 6% abv does it?
  • Southern Tier 2xIPA. Let’s just say one’s enough. At 8.2% abv, this is darker, and complex than their standard IPA
  • Founder’s Centennial IPA. Founder’s brews some great beers. This IPA is piney and floral, with a lot of other complex flavors I can’t describe. 7.2% abv
  • Southern Tier Goat Boy. Another confession: We’re partial to goats. Sort of. Well, we don’t like them actually. My husband is a cyclist and has also competed in triathlons. Two summers ago he was out riding on country roads of Maryland, and a goat ran straight out into the road in front of him, putting him head over tin cup. He got scraped up pretty good, and hurt his shoulder. Ever since, he’s had a love-hate relationship with goats. So we admit, even before tasting a beer called Goat Boy – we liked it. To boot, they put their goat on a bicycle when creating the logo, so what’s not to love? (“Ein bock” is German for billy goat – for that reason bock beers often have goat references.)  This is a German style bock beer – an imperial weizenbok. Dark and malty.

I admit, I’m what some folks call a beer snob. Please don’t take offense. For folks who really don’t like “beer”, but like to drink beer, these may be good summertime picks: 

  • Bud Light Lime. Beer Advocate rates this as “awful”, but if you’re not a serious beer drinker, you don’t like microbrews, and are just looking for something refreshing to drink on a hot day – this may be the beer for you. It’s only 4.2% abv, and has a light hint of lime
  • Amstel Light. This is a light, 100 calorie lager-style beer. 3.5% abv
  • Stella Artois. Belgium beers are nice in the summertime, and Stella practically got the whole “beer can be poured into a cool glass” thing going (The “chalice”). 5.0% abv

We are very fortunate to have a couple of fantastic breweries in town:

Voodoo Brewery

  • Big Black Voodoo Daddy. If you like stout, check it out. It has coffee and chocolate flavors, and is exceptionally smooth. Packs a punch at 12.5% abv
  • Pilzilla is a lighter tasting beer. 7% abv
  • Good Vibes is a hoppy beer, with some fruit in the background. 7.3% abv
  • Love Child. This smooth Belgium-style beer is brewed with Passion fruit. Raspberry, cherry and spices. Word in town is that if you drink too many of these, you may indeed have a love child. 10.5% abv 

Timber Creek

  • Liberty Blond – a refreshing, malted, golden ale that has mass appeal
  • Fresh Squeezed IPA – hoppy and delicious
  • Werkzeug Stadt – a German style beer with a nice balance of malt and hops
  • Black Bear – a dark stout, full-bodied with hints of coffee and chocolate. My husband loves a good stout anytime, I prefer mine for dessert

Drink responsibly, and Happy Father’s Day.

The Obsession with Sugar

As a nutrition communication consultant I occasionally write about topics related to the food industry clients I may serve, but my thoughts and opinions are my own. This post is on behalf of the Calorie Control Council.

 

I recently read an article claiming that crystalline fructose was different than the fructose in fruit because it’s “stripped” of fiber. Fact: Fructose is fructose.

Unless you are slurping up clear liquid fructose concoctions all day long (which don’t exist), the sugars you consume are most likely consumed with other foods/meals, which likely includes some fiber.

Fructose has been in the news quite a bit recently, and the movie Fed Up has stirred up some controversial ideas. The movie sends a message that the food industry and government could be a factor in the cause of obesity, particularly pediatric obesity. The movie claims that food companies market products to children, which causes poor eating habits.

Early years

Unfortunately simply looking for a one-ingredient-cause, or the promotion of extreme dietary change, won’t address the real problem: A lack of education and a lack of understanding the true importance of proper nutrition and eating habits. In children, the early years are very important in terms of feeding. Eating isn’t just about food choices, it’s also very much about behavior and habits. Good eating habits begin early – right at birth – as mother’s nurse or bottle feed their infants. Taking cues from the infant early in life (for instance stopping bottle or breast when the infant turns away) helps the connection to his natural satiety cues develop. A breastfed newborn does not require “the food industry” – only his mother. The mother however has to learn how to eat properly to fuel her baby, and then begin to set a good example as the baby grows. Early, and proper, introduction of food at the age of 4-6 months also helps an infant learn about healthy eating habits.

Feeding Your Family a Balanced Diet

So why does the media insist that sugar or fructose is the big universal problem? All of this focus on sugars may indeed backfire. The goal is to get people to learn more about nutrition basics, cook more meals at home, even if some packaged food is used along with whole food.

If most people would worry less about getting a magnifying glass out to read ingredient labels and worry more about planning 3 balanced meals, there’d be no issue balancing your diet. Sugar helps make some foods palatable, and in some cases it simply enhances the flavors of food. Instead of obsessing over every gram of sugar, focus on what you should be adding to your diet and the sugars will automatically be reduced.

  • Eat real food first – lean protein, vegetables, fruit, nuts, seeds, bread, and grains.
  • It’s okay to use some packaged foods for convenience, just balance it out. Sitting down with your family at the table for supper is a great goal.
  • Learn some simple cooking techniques and cook as a family. Start with 5 go-to recipes. A vegetable recipe can really give you a whole new appreciation for how good food can taste!
  • If you are a new parent, learn more about feeding children. Buy a good book, or find a dietitian. Young children need foods from the 5 food groups to grow, they need smaller portions than older children, teens or adults. Toddlers shouldn’t drink soda at all, but as children approach school age, you can provide sweet drinks occasionally as a treat as you teach your child about moderation. By the teen years, they’ll understand how to choose healthy food first then allow for the treats.
  • Don’t worry about the sugars on ingredient labels of products that only have <1 to 2 grams of sugar per serving (items such as tortilla chips, salsa, bottled salad dressing, whole grain crackers).
  • Buy more fresh produce.
  • Consider the other nutrients provided by a food that may have added sugars. For instance – the calcium and protein in yogurt or chocolate milk; or the fiber and vitamins from the oatmeal you add 2 teaspoons of sugar to; or the particular sweet and sour dressing that allows you to really enjoy a large veggie-packed salad.
  • Enjoy sweets in moderation and on special occasions.

Don’t Put Your Eggs all in One Basket – There’s More than One Way to a Healthy Diet and Nutrition Counseling is Key

There seems to be a bit of a turf war going on – who should you trust to give you nutrition advice? A newscaster? A doctor? A scientist? A magazine? An herbalist? A babe or some other self-proclaimed nutrition expert? 

People generally believe what they want to believe, but I believe in science-based nutrition recommendations, and also the fact that eating should be a nourishing and enjoyable activity. I also happen to be a registered dietitian. Dietitians certainly aren’t the only ones who are qualified to provide accurate diet and nutrition information (key word is qualified – I’d expect at least an undergraduate degree in nutrition, and the RDN credential indicates just that, plus field experience and credentialing). Yet why do you see so many television shows featuring “nutrition expert” panels, that are void of the RDN? These television panels or interviews include MDs, activists, or policy makers, but not the input of the most widely recognized nutrition professional? To me this is unfairly balanced. Sure, seek an “alternative opinion”, but that opinion should also be weighed against that of the credentialed RD who represents a huge portion of the nutrition science profession.

Every week the media prints something about the new “evil food” or “poisonous ingredient” that will destroy your body. On the other hand, you’ll also hear about the “healthiest superfood you can eat!”.  I’d like to know what the authors of these columns really have in their refrigerators and pantry cabinets, and why they may feel that an RDN has nothing to add to the conversation.

While I do firmly believe that a plant-based diet is important (along with regular physical activity) – and science supports a basic healthy diet “framework” – I don’t believe that everyone has to eat the same foods. Some may choose a vegetarian lifestyle, others may avoid alcohol, some may avoid sweets, but others may include meat, alcohol and sugar among those plant products in their diet, and not have long-term health consequences from it.

If some of you feel that there’s only one set of foods and beverages that can result in health, you are missing the boat to improving public health. Or perhaps you don’t understand how different people are. There are too many different types of people, from different backgrounds, with different means, living in different areas for a “single diet prescription” to work.

Our food system has become a political issue, with some feeling that processed foods have no place in a healthy diet, or that only a plant-based, “whole food”, or vegan diet can result in health. Or, that if you just eliminate sugar for ten days, you’ll be home free to a healthy life and healthy weight and your eating habits will suddenly reach nirvana. Why so judgey (and funny, some people judging aren’t real nutrition experts)?

In addition, it seems that so many people are getting into activism. This isn’t a bad thing, but sometimes it’s misplaced. Chefs are using their celebrity clout to make statements about everything from food to water (caring about safe water is one thing, a chef claiming to have any expert knowledge of geoscience is absurd). Political activism may have its place to get food policy changed (such as labeling guidelines, or school lunch guidelines, or food safety guidelines), but using politics to try to change individual eating behaviors, or to control well educated nutrition professionals, or to micromanage the manufacture and delivery of food in every school, institution, grocery store or home in America? That is counterproductive and will backfire.

Trust me, as someone who has actually spoken to thousands of people about what they eat – they don’t want to be told what to eat! They want guided. They want options. They want to make their own decisions, and the opportunity to meet with a registered dietitian can help them do just that.

The fact is, everyone can’t eat the same thing. I’ve been a dietitian for 28 years. While I still do some nutrition coaching, I now primarily work as a nutrition communications writer and author. The 10 of my first 28 years of experience however included counseling and entering food record data for research studies. I’ve seen and listened to many people from many walks of life tell me about what they eat on a daily basis. Real life is usually not the way you read about it in the media.

I’ve counseled moms who worked full time and had 3 kids; dads who worked 15 hour days or the night shift; young women who struggled with eating disorders; pregnant women who smoked and ate chips and a cola for lunch; people who skipped breakfast daily, ate fast food for lunch, and a bowl of cereal for dinner; 380 pound men with diabetes who drank 4 liters of soda daily; 40 year old women who ate oatmeal, fish, and carrots by the pound (orthorexia); 50 year old obese women who have been dieting all their lives.

Do you think each of these people could follow the same dietary advice? No, I individualized their advice. I met them halfway when necessary. I understood their complex medical and social history. I got them started on the right track.

Somehow, we have to get people to understand that they have some control over their own wellness, and that feeding yourself well is your number one priority. Somehow we also need insurance companies to also cover nutrition counseling from qualified counselors, but we also need people to feel it’s important to invest in this help as well.

Many would rather argue that there is no amount of toaster strudels or fast food that can fit into a healthy diet, in lieu of getting these people referred to a registered dietitian-nutritionist for counseling. An RDN can teach a busy mother of 2 how to plan 3 healthy meals each day. The healthy food you eat in addition to the proverbial toaster strudel is far more important, as is the manner in which you eat.

Do you want to feed your family better? Then seek help from a qualified nutrition professional.

One Dietitian’s Pantry

Proper eating is about valuing your own health, and the health of those you care for, so in my work, I try to help people set realistic goals (i.e. easy and doable) for themselves. Cooking from scratch is a step in the right direction. Whether you are using a few processed foods, or canned vegetables to get dinner on the table, or cooking from basic or gourmet recipes – cooking at home is a good habit.

But how many times do I have to say it? There is no one-size-fits-all diet.

I believe people should enjoy the food they eat, and nurture their body with the nutrition that it needs. I also believe eating is influenced by important cultural aspects, and people certainly have different food preferences. Of course in addition, physical activity is also vital to health, which is why I go to the gym twice a week, and run, walk or use a cardio machine 3-4 times a week (but I mostly enjoy getting outside for walks or runs).

The easiest way for me to share my thoughts on balance and enjoyment of food, is to tell you what my pantry looks like. Some may want to judge me, but I’ve always said – I practice what I preach. Rather than tell you what you should eat, and what you should avoid, I think it’s better to show you how you can balance out healthy foods with treats.

I don’t expect you to replicate my pantry, I expect you to work towards healthier eating, and get advice from a professional if you need it.

Staples in my ‘fridge:

  • Fresh eggs (although they don’t require refrigeration, we put them in there anyhow). These are from the hens we raise in the backyard henhouse (aka ‘chicken tractor’ – hand built using recycled materials.) We recycle any rotten produce or moldy bread to the hens to eat in addition to their feed and water.
  • Fresh vegetables. In season – from the summer garden planted in raised beds using the recycled composite decking material that was left after we tore our deck down (asparagus, tomatoes, herbs, eggplant, variety of peppers, onion, squash, beans, peas). We also buy vegetables at the store, and not organic-exclusive.
  • Fresh fruit (we buy this at the store, but also have apple, pear, peach trees; grapes, blueberry, raspberry bushes) Right now there are apples, grapes, strawberries, blackberries, one kiwifruit, one grapefruit, lemons, limes, and an avocado in the fridge.
  • 1% milk, low fat or nonfat Greek yogurt, half and half
  • Coffee (hence the half and half – for our daily coffee habit)
  • Romaine lettuce (I won’t lie – some of it goes to the bearded dragon), spring greens, carrots, asparagus, assorted mini sweet peppers, celery, sugar snap peas
  • Lunchmeat drawer: baked ham, turkey, hot dogs (it’s summer), Laura’s fresh ground beef, cheddar cheese (3 blocks of different variety), American cheese deli slices, grated Romano, Feta, goat cheese, hummus, a package of shredded taco-blend cheese.
  • Freezer – pork loin, shrimp, sirloin or beef roast, frozen bell pepper strips, spinach, ice cream
  • Brummel and Brown® spread, Philadelphia® cream cheese spread, Tops® Strawberry cream cheese
  • Salsa from the deli, grape jelly, peach jam, seedless blackberry preserves (I love toast)
  • Orange juice
  • Nestle’s cookie dough (my 16 year old son enjoys baking these on occasion, but I also bake from scratch)
  • A variety of condiments (Heinz Ketchup, mustards, pickles, relishes, mayonnaise, salad dressings)

My pantry:

  • About 12 varieties of pasta (none of them whole wheat at the moment)
  • Uncle Ben’s Instant Brown Rice (hey, sometimes I am in a hurry to get dinner on the table before we get “hangry” or right after Track practice)
  • Quinoa, Barley, boxed Pilaf
  • Applesauce, canned peaches (lunchbox)
  • Oreo cookies (again, the hyper metabolic 16 year old)
  • Tortilla chips, pretzels, potato chips (unopened, for crowds)
  • Cereals – At least 4 types of ready-to-eat breakfast cereal (with 3-9 grams of sugar/serving), and oats. 
  • Canned tomato puree, 2 jars tomato sauce
  • Almonds, pistachios
  • Kind bars, Nutrigrain Bars (again, 16 year old who runs out the house in the morning 1 minute before the bus comes)
  • Crackers – Nabisco® Triscuits and Wheat Thins
  • Jiff Peanut Butter (son’s favorite)
  • Marshmallows, Hershey Bars, Graham Crackers (yep, it’s s’more season and we love family time at our fire pit to enjoy this sweet treat – one each, plus a marshmallow or 2 on the side)

“Other” Refrigerator

courtesy of freedigitalphotos.net

We have a second small refrigerator where we keep soda pop and extra food (the back-up gallon of milk, half and half, or large platters or bags of produce when entertaining). Since soda, lemonade, or iced tea are “occasional beverages” it’s not front and center in the kitchen where the milk and water are. I feel this helps maintain the message that soda (like beer) isn’t something you drink every day.

We also follow these guidelines in my home:

  • Don’t skip meals. At a minimum, have a glass of milk in the morning before school or work.
  • Include all food groups when packing a simple lunch – protein, bread/grain, fruit/vegetable, milk/yogurt
  • Enjoy a home-cooked meal for dinner, even it’s simply meat from the grill with a vegetable or fruit.
  • Eat out less than 3 times a week.
  • Encourage the kids to eat fast food no more than once per week, or less. Choose small portions when there.
  • Only drink soda or sugary drink with meal sometimes when dining out, but not every time (have water or milk sometimes).
  • Limit between meal eating. If you’re hungry, plan a snack  of fruit, veggies, cheese, or nuts.
  • Eat chips, crackers or cookies only after you’ve eaten a healthy meal or snack.
  • Get some exercise.

So what’s in your refrigerator and pantry?

As my mother used to say: Cook what they like. As a parent it’s your job to expose children to a variety of foods, and their job to eat it. If children are exposed early on to vegetables, they will eat them, but they will not like every one. If your family doesn’t like kale or spinach, then don’t try to shove them down their throats! Offer broccoli or carrots or snap peas or whatever vegetables they enjoy.

The same goes for other meals. Take breakfast cereals. If my son likes to add 2 teaspoons of sugar to oatmeal, I think that’s okay. Oats are good for him. If he likes ready-to-eat cereal for breakfast that has 9 grams of sugar per serving, I don’t have a problem with that either, because I’m not serving cereal for dinner, and I know he’ll eat the veggie and meat that we have.

When I counsel people, I don’t expect them to recreate my pantry, I help coach them into figuring out how to create the healthiest pantry that they can, and to modify habits that may lead them to poor choices. There are as many ways to create a healthy diet (one that’s full of fruits and vegetables, low in sodium and saturated fat, and moderate in sugar) as there are people.

 

 

Fed Up with Pseudoscience

If you haven’t heard, a new movie about the potential causes of childhood obesity opened this past weekend. In the likes of Supersize Me, King Korn, and Food Inc (which claims that for “the average American, the ideal meal is fast, cheap and tasty”), this movie sensationalized the way some people choose to eat, and blames the food industry for essentially making it too difficult for them to choose otherwise.

I haven’t seen the movie yet. But the trailer and synopsis seem to place a lot of pressure on the food industry in general for marketing unhealthy foods exclusively to children (think: sugary cereals, yogurt), which they believe to be the cause of excessive weight gain leading to obesity. I think they take a few unjustified stabs at the National School Lunch Program too.

The movie will no doubt stir up a bunch of heated conversation and fist pumping (Yeah! Stick it to the man!), but will not solve any problems, just as previous movies have not. More importantly, the movie may feed into the misinformed notion that sugar causes obesity. I served on a Children’s Task Force about 12-14 years ago, when “competitive foods” such as soda, chips and other vending machine items, were identified as problematic to overall nutrition and weight in students. They’ve since been removed from schools. While calcium intake may have gone up, the action didn’t “solve obesity” (and many parents pack soda and sugary drinks in their children’s lunch boxes anyhow).

Take the Fed Up Facts Quiz.

Those who subscribe to the theory that it is the food industry’s fault that our citizens are fat and unhealthy believe that this industry markets unhealthy food to children, and saturates the grocery stores and markets with junk – and people are too weak to handle avoiding it. 

The other part of the theory is that sugary foods create an addiction in some people (rat studies have attempted to claim sugar is as addictive as cocaine). This puts you in the awkward position of having to walk by the potato chips and candy bars without buying them, or saying “No, not today” when your child asks you to buy a candy bar, sugary cereal, or blue yogurt. 

Now I’ll admit, I bought blue yogurt a couple of times when my children were small, even though I had made secret pact with myself not to give into it. Guess what? Sometimes you have to pick your battles. Raising children is difficult, and seemingly endless, work. Parents have to realize that sometimes giving in to small stuff is okay, as long as you hold your ground in other instances, to ensure the small stuff doesn’t become big stuff. Teaching a child about healthy eating is as important as teaching them about safely crossing the street, or teaching them about the dangers of drugs and alcohol, and how to set other limits in their lives.

“Healthy eating” does not mean that you must only eat healthy food all of the time, it means that you understand that fueling your body properly is the priority, while learning to take your body’s cues for hunger and satiety, and at the same time, balancing the healthy food with treats.

A child needs help learning these skills, and sometimes as a parent you have to be strong and say “No, you can’t have that.”. And when the going gets rough, you really put your foot down with the tried and true, “Because I said so, that’s why!”.

Some people do have addictive personalities, and may indeed have more trouble abstaining from certain foods, or consuming them in moderate amounts. These people need counseling; because even if Coca Cola took all of their products off the shelves, a true addict will find what he needs elsewhere.

Pseudoscience

While I’m sure there are many science-based facts in the Fed Up movie, I’m also sure that many who watch it will walk away with distorted facts. I was recently quite amused by the Jimmy Kimmel bit where he asked “people on the street” who are following a gluten-free diet – “What is gluten?” Most people could not define it, or provided completely inaccurate information. They’ve just “heard” that “gluten is bad” so they avoid it (this was confirmed in my own reality when a friend recently asked a health food store owner what gluten was and he truly had no idea but tried to fake it).

Sugar isn’t “bad” unless you let it overtake your daily intake. The dose makes the poison. What is bad, is having poor eating habits and not being able to reconcile your behavior. There’s been quite a bit of research on the ideas of using simple behavioral techniques to help yourself avoid unnecessary snacking, or correct other types of problem eating behaviors. I often suggest using smaller bowls, for instance, for your ice cream. It fools the eye, and a little bit of something sweet is often satisfying enough (and won’t poison or kill you). So rather than banning caloric sweeteners, how about learning how to enjoy them in moderation?

Facts are facts. There are certain aspects of biochemistry and human physiology that are pretty well understood by scientists. Obesity that occurs in a 10 year old is also very different than fat accumulated later in life.  While there are likely biochemical differences among people in terms of their appetite/satiety hormones, behavioral issues are at the crux of the problem. An attempt to ban sugar or a singular nutrient, while demonizing the food processing industry, is not going to reduce the incidence of obesity. Obesity is a very complex problem involving behavior, and an imbalance of energy. It’s very difficult to lose weight, but it is up to the individual to put in the effort. It’s not easy, it never has been, which is why prevention is the best cure. Don’t ban foods, let’s teach children how to eat properly.