Informative: New Nutrition Labels

Do you use nutrition labels?  You should!  And the FDA is finally making it easier to do.

Nutrition labels have been notoriously difficult to interpret and most individuals report not regularly checking nutrition labels when they purchase packaged foods.  However, this is changing and nutrition labels are changing.  The nation as a whole is becoming much more conscious about nutrition and what we put in our bodies.  This is a large reason why rates of obesity at least appear as though they are starting to level off for adults (and even declining in very young children).

With this comes the first significant change in nutrition labels in 20 years!

nutrition labels

There are 3 major changes, all of them good:

1. Serving sizes are going to be adjusted to reflect what people normally consume. So you’ll see nutrition info for a full 20oz bottle of soda instead of just 40% of it (note a few companies did this voluntarily already- good job) and a cup of ice cream instead of 1/2 cup.

2. Calories are being made much more prominent. Hands down the most important thing an individual can pay attention to with regard to diet is the number of calories consumed. That’s not to say that other things aren’t important but, plane and simple, calories determine our body weight.

3. ‘Added Sugars’ has been added. Therefore, manufacturers now need to report just how much (and it’s often an insane amount) of sugar they dump into your food and drinks. Hopefully this will not only help people to become aware of just how much added sugar they are ingesting (a can of soda has 8 teaspoons, while the RDA for women is only 6!!), but also get manufacturers to start lowering the amount of added sugars.

Several other minor changes have been proposed but those are the big ones.  These are GREAT changes, and the FDA should be commended.  But…  it’s still going to be a couple years till we actually see the new labels on food products on the shelves.

Click here to see Dr. Ochner talk about the new nutrition labels on ABC News Digital.

Practical Tips: For Doctors to Address Obesity

Addres3b25a39sing overweight and obesity can be a daunting task for doctors. Below are practical tips based on the scientific literature that physicians can use in their practices.

 

Proactively address prevention with overweight patients. Being overweight is the #1 risk factor for obesity which, once present, may be more challenging to address. Therefore, doctors should not wait until patients develop obesity to address the importance of proper nutrition and physical activity.

Implement a multi-factorial intervention strategy. Physicians should construct an individualized treatment plan involving different treatment modalities. These may include highly structured diets (e.g., partial or full meal replacement), increases in physical activity, medications for appropriate candidates, and surgery for treatment resistant patients with clinically severe obesity.

Inform patients with obesity of the challenges to weight loss maintenance. Help patients understand that they may become more metabolically efficient with behavioral weight loss getty_rf_photo_of_doctor_giving_patient_second_opinionand have to ingest up to 300 fewer (or burn 300 more) calories as someone of the same weight who never had obesity just to maintain that weight. It may also be necessary to discuss the fact that dieting may be insufficient once they have had obesity for an extended period of time, and that the use of biologically-based treatments (e.g., medication or surgery) is not a reflection of weak will.

Continue to monitor progress and adjust treatment strategy as necessary. Address and provide resources for weight loss maintenance to patients who are able to achieve weight loss via lifestyle modification. A clinical weight management strategy should be ongoing and take into account the fact that weight loss maintenance is more difficult than weight loss. For example, medication may be considered at the point that behavioral weight loss efforts wane, prior to typical weight regain.

Recommend surgery when appropriate. Currently, bariatric surgery is the only effective long-term unimodal treatment for obesity. Attempt highly structured lifestyle modification and discuss pharmacotherapy first. Patients, particularly patients with clinically severe obesity, for whom this is not successful should be informed about the risks and potential benefits of bariatric surgery and provided with or referred for further information so an informed decision can be made.

Why Diets Don’t Work

A new scientific article explains why even the most state-of-the-art weight loss programs result in only modest short-term weight loss and little to no long-term weight loss. Even of the obese people who are able to be successful in losing weight on a diet (usually 5-10% of initial body weight), about 98% of them put the weight right back on.  This article is a big step in explaining why that happens.  The article, “Biological Mechanisms that Promote Weight Regain Following Weight Loss in Obese Humans” is available online and published in the August 2013 issue of the journal Physiology & Behavior.

yoyo yoMost weight loss programs are based on a restrictive model that tries to use will-power to overcome powerful biological drives, which is a losing proposition.  It’s no wonder so many obese individuals are frustrated and feel like failures when it comes to weight loss dieting.  They’re doing it completely wrong but that’s exactly what we, the supposed experts, keep telling them to do.  Conventional weight loss programs assume that obese individuals lack sufficient willpower and/or knowledge, and assume that providing motivation and knowledge will fix the issue.  This article sharply challenges this notion.

Food scarcity was one of the largest threats to survival for millions of years.  Over time, humans developed multiple biological mechanisms to help prevent starvation.  For example, someone at risk of starvation would experience a shift in their neural responsivity and hormonal profile to encourage caloric intake, as well as a reduction in fat metabolism in order to conserve energy stores.  This article discusses evidence that this happens not only at the brink of starvation but also when a 400lb individual loses 20 lbs.  The body reacts the same way whether you are on the verge of starving to death or a morbidly obese individual trying to lose weight in order to improve health.  Your body- your very own biology- will fight vehemently against weight loss, regardless of how much you weigh.  And, chances are, it’s eventually going to win.

The article explains that the body adopts an individual’s highest sustained body weight and will then defend that weight in the exact same way it would in order to prevent death from starvation. The authors also discuss evidence that these mechanisms cause notable changes in biological functioning within hours of caloric restriction.  The article goes on to explain that even the best “lifestyle change” diets do nothing to address these biological changes and are, therefore, doomed for failure.  The authors note that bariatric surgery, particularly Roux-en-Y gastric bypass surgery, has been shown to reverse some of these changes, which may help explain why it is currently the only obesity treatment with long-term effectiveness.  Overall, the evidence presented in this article suggests that the approach taken by current weight loss diet programs is fundamentally flawed and that a more biological approach is required to achieve sustainable weight loss.

For a free PDF copy of the article, email Dr. Ochner at christopher.ochner@mountsinai.org

Eating Out: Healthy Fast Food

Is there such thing as healthy fast food?  Can I maintain a healthy diet and beach-ready body while still eating McDonald’s every once in a while?

Everything is relative but, for the most part, the answer to both is “yes.” Below are The_Golden_Arches_(2495820931)3 relatively healthy items from menus of the most popular fast food restaurants.  In fact, to prove that it is still possible to eat a healthy diet amidst a toxic food environment, I myself at McDonald’s every day for two months.  I lost 1 lb and 0.5% body fat.  How?  By sticking to the items listed below!

 

Restaurant Item   Cal Tot Fat (g) Sat Fat (g) Protein (g) Carbs (g)
McDonald’s
Grilled Chicken Sandwich (no mayo) 300 3.5 1 27 41
Grilled Chicken Snack Wrap 250 8 3.5 16 27
Side Salad, Low Fat Dressing 70 2.5 0.5 2 11
Cal Tot Fat Sat Fat Protein Carbs
Wendy’s
Ultimate Grilled Chicken Sandwich (no mayo) 320 4 1 32 39
Chili (Large) 310 9 3.5 26 31
Caesar Side Salad (no croutons, fat-free dressing instead of Caesar) 110 3.5 2.5 4 17
Cal Tot Fat Sat Fat Protein Carbs
Burger King
TENDERGRILL Chicken Sandwich 360 6 1.5 36 39
Breakfast Muffin Sandwich: Ham, Egg and Cheese 250 9 4 18 23
Whopper Jr. (no mayo) 260 9 4 14 32

More healthy fast food restaurant menu items to come!

Informative: Is Obesity a Disease?

American Medical Association Classifies Obesity a Disease

Tobese manhe classification of obesity as a disease is well-justified, as we are finding out that obesity actually has more to do with hormone levels and neural responsivity than willpower. That is not to say that individual choice is not important or that people are not responsible for what they put into their bodies. However, it is much easier for some people than others to stay thin, based on both genetics and prior lifestyle. Once someone becomes obese, and is obese for some time, it is almost physically impossible for them to regain a normal body weight without surgery. The body adopts the obese weight as if it needed to be that weight to survive and enacts biological mechanisms that defend against any weight loss literally as if the person were starving to death. The fact that obesity is now officially recognized as a disease will allow for more research to be done to create treatments that circumvent the biological mechanisms that prevent weight loss. Up until now, these mechanisms have been largely ignored.

Some obese individuals are concerned that they’re being called “diseased.” However, this is a major step forward in the fight against obesity and win for obese people in general. Until the American Medical Association classifies something as a disease (or the American Psychiatric Association classifies it as a mental disorder), very few insurance companies will reimburse for its treatment. That means that, until now, only the wealthy (who have the lowest rates of obesity) have been able to afford obesity treatment, which is typically quite expensive. We now expect obesity treatments that have been proven to be effective to be reimbursed by insurance companies. These include commercial behavioral weight loss programs (such as Jenny Craig & Weight Watchers), meal replacement programs (such as Slim Fast, MediFast and Optifast) and weight loss counseling from qualified individuals practicing validated lifestyle change (cognitive behavioral therapy based) treatments. Further, we would expect more of these programs to be offered now that hospitals and treatment centers know that the people who really need them can actually afford them.

512px-PET-imageFinally, the classification may help reduce the false stigma that obese people are simply lazy and lack willpower. It will be interesting to see whether the American Psychiatric Association will look to include obesity as a mental disorder in the next iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM), as there is growing evidence that obesity may be causally related to maladaptive patterns of neural responsivity in the brain.

Summary: Treatment, access to treatment, and the stigma surrounding obesity will all be improved considerably by this commendable move by the AMA.

Practical Tips: Make Small Changes

I just did the math and wrote this into a grant proposal for the National Institutes of Health. How big of an impact small changes can have over time…

2 friench fries“An obesity prevention program that was successful in getting its participants to lower their caloric intake by only 25 calories (e.g., 1.75 peanut M&Ms, 2 Doritos or 2.5 French fries) per day would effectively halt unhealthy weight gain in the majority of overweight individuals.”

Point is, you would never notice two fries missing from your extra value meal but that is exactly what is making America fat- consuming just a tiny bit more than what we need to.  Think about it- very few people get fat overnight.  In fact, it’s such a gradual process that most barely even realize it until they have to buy a bigger pant size.  I say, if you’re going to get fat, you should at least enjoy the journey.  Tragedy is people don’t.  We call it passive overconsumption.  Don’t live in denial until you are looking for a dress in a 12 and don’t starve yourself.  Start now, all you have to do is cut out a few calories each day- just the ones you won’t miss!

Healthy Conversion: Pepperoni & Sweet Pepper Pizza

Pepperoni and Sweet Pepper Pizza

We HIGHLY encourage you to read the below DJD post on dieting to get the ‘big picture’ perspective on how these recipes may just save your waistline and health.  As promised, here is the first installment of Delicious Health.  Who doesn’t love pizza?

  • 1 Flatbread from Trader Joe’s*
  • 12 slices turkey pepperoni
  • ½ cup tomato sauce (no sugar added)
  • 5 small sweet peppers sliced thin
  • ½ cup fat free mozzarella cheese
  • ¼ cup mix of oregano, parsley, basil, black pepper, and crushed red pepper

Flatbread_Pizza_Peppers_LoRes

Note: This is not a prop.  Last night’s dinner and it was unbelievably delicious!

Regular Pepperoni Pizza Flatbread Pepperoni Pizza
Serving size 2 slices 1 flatbread pizza
Calories 814 390
Total fat 36 g 4 g
Saturated fat 16 g 1 g
Carbohydrates 86 g 48 g
Sugar 8 g 6 g
Glycemic index 51 30
Glycemic load 43 14

* If you are not fortunate enough to have a Trader Joe’s by you, your local supermarket may have flatbreads but beware of regular pre-made pizza crusts that often have upwards of 1,000 calories (compared to only 220 for these!).  Bake in the oven (right on the rack) at 350 for around 10min until you can see brown around the edges for a nice crisp.  Enjoy!

Stay tuned and stay healthy!

Relevant Musings: Big Soda Ban in NY Blocked… Win or Loss for New Yorkers?

Justice Milton A. Tingling Jr. of State Supreme Court in Manhattan blocks New York City’s ban on big sugary drinks.

Picture this…  Your child’s school superintendent holds a meeting for parents and informs you that the school cafeterias have been stocked with junk food, and that the kids are consuming mainly cookies and doughnuts and soda. That’s making them fat and giving them diabetes and will likely kill them at an early age. Therefore, the superintendent is going to be making some changes to have less garbage and more healthy stuff available to them. In other words, the superintendent wants to improve the food environment.

NY was about to take a step toward that but that was prevented at the last minute.  Several sources are speculating about how deeply and exactly who reached into the pockets of the beverage industry. Bloomberg appears to be taking it in stride and vows to appeal.

graphic portion sizes- burger fries sodaMany people were up in arms claiming the ban would ‘rob us of our freedom to choose.’ Proponents of the ban assume this voice chiefly reflects the propaganda promoted by the beverage industry to continue to make money by killing their customers, much like the accusations against big tobacco. I will not comment on these accusations but I will share some factual information based on empirical evidence…

People tend to eat whatever is in front of us. That means the kind of food or drink and the amount of food or drink.  Basically, we eat and drink tons more of what is easily accessible, and we eat and drink however much we have in front of us.  There is tons of data proving this. No coincidence that portion sizes and waistlines have expanded in almost perfect parallel in recent decades.  Sugary beverages such as regular soda are a source of tons of (at best) completely empty calories.  Excess calories make us fat and unhealthy.  If 16oz bottles are readily available, we’ll drink 16oz and be satisfied with that.  If 20oz bottles are readily available, we’ll drink USObesityRate1960-200420oz and be no more satisfied but get an extra 47 calories (and 13g of sugar).  Doesn’t sound like much?  Let’s say a person typically gets a 20oz soda with lunch (1 soda per day).  Compared to a person who drinks a 16oz soda every day (I wouldn’t recommend either), a person who drinks a 20oz soda will ingest an extra 17,155 calories over one year, which is an extra 4.9 pounds!!!!! 

Check my math: 47 calories in 4oz of soda.  47 x 365 = 17,155.  3,500 calories = 1lb.  17,155 / 3,500 = 4.9.  Yep, for someone who drinks a soda per day, keeping the extra 4oz that they wouldn’t miss anyway gives them an extra 5lbs of flab every year.

The big soda ban was about making way too much soda less readily available in a form that promotes immediate consumption. It was a small change toward a less toxic food environment. It was going to benefit the health of literally millions of people. The cost? Some restaurants have to buy new glasses and 16oz instead of 20oz bottles of coke in NY. Some speculate that beverage industry would have lost some money and may have invested in an attempt to have the ban blocked.  We may never know for sure why the ban was blocked but we do know for sure it was not the best outcome in terms of our health and that of our children.

Healthy Conversion: Hot Fudge Sundae

Hot Fudge Sundae

  • I cup Frozen Vanilla Greek Fat Free Yogurt
  • 4 tablespoons calorie-free fudge topping
  • 3 tablespoons fat-free whipped cream

healthy hot fudge sundae

With the nutritional breakdown below, this hot fudge sundae may be healthier than some commercial weight loss program meals!!

Regular Hot Fudge Sundae Healthy Hot Fudge Sundae
Serving size 1 sundae 1 sundae
Calories 480 215
Total fat 26 g 0 g
Saturated fat 18 g 0 g
Carbohydrates 55 g 18 g
Sugar 42 g 17 g
Protein 1 g 12 g

Notes on the ingredients

Frozen Greek yogurt: Key is to get a quality GREEK frozen yogurt b/c of its low calorie and high protein content.  Beware of ones that say ‘Greek’ but have the same poor/mediocre nutritional content as regular frozen yogurt.  Trader Joe’s carries a good one but it does taste like yogurt.  Adonia makes one that is almost as healthy and tastes like ice cream but costs a little more.  Many regular supermarkets and most specialty food stores now carry it.

Calorie-free topping: Not only does this exist but it actually tastes good.  The brand I use is Walden Farms (they also make a calorie free strawberry syrup that I will feature on a killer strawberry crunch sundae).  Check specialty food stores and even some regular supermarkets- refrigerated section.  Note- it’s sweetened with sucralose (Splenda).

Enjoy and stay healthy!

Diets: The Carbohydrate Controversy

truth         The truth about carbohydrates…

Quick oversimplification of the concept behind low-carb diets:

Physiologically speaking, carbs are the body’s (and brain’s) preferred energy source, meaning that they will be metabolized (burnt) first to provide fuel.  When you deprive the body of carbohydrates, it needs to turn to another source of fuel to keep it running.  It may try burning muscle but quickly realizes that muscle is important and so then turns to fat.  You may get where this is going…

 

128px-Urination_maleAs the body starts burning fat, it simultaneously softens up the fat depots in the body and starts producing compounds called ketone bodies.  Some of these ketone bodies can be used for fuel in the heart and brain but others are excreted from the body carrying fat.  So, basically, a low-carb diet is supposed to get you to this state called “ketosis,” where you are primarily burning fat (as opposed to carbs) for energy and peeing out even more fat.

 

222px-Ketogenic_diets_pieDoes it work?  Yes and no.  With pretty extreme carbohydrate deprivation (definitely don’t try w/o taking to your physician first), people can reach dietary ketosis and lose weight.  Studies of low-carb diets show short-term weight loss on par with most ‘lifestyle change’ diets.  However, most people do not reach or maintain ketosis when on low-carb diets.  Why?  Ketogenic diets are very restrictive, as carbs are very difficult to avoid.  So why do people lose weight on low-carb diets if it’s not because of this quasi-magical ketogenic state?  Pretty much guaranteed that the weight loss stems from eating fewer calories.  Carbs are super easy to overeat and typically account for a large proportion of the calories derived from meals.  If you cut 75% of those carbs out (pretty decent dietary compliance), chances are you won’t reach ketosis but you will be cutting a ton of calories out of your meal.

 

So, yes low-carb diets are generally as effective for weight loss as other diets, just not for the reason intended.  Likely it wouldn’t be that much different than going on a diet where you cut out all white food from your diet.  Would be pretty simple to remember and likely just as effective due to caloric reduction.  However, I wouldn’t recommend it.  Most docs (and I) would prefer to see people go for a healthy lifestyle change diet largely b/c of the high amount of saturated fat typically ingested with low-carb diets.

 

128px-Havana_Fashion_WeekThe low-carbohydrate diet isn’t quite completely out of fashion yet but it is pretty 2009. Seems the masses have realized that it’s not the magic bullet they hoped it would be and are desperately seeking the next eventual disappointment.  For most people, low-glycemic and gluten-free diets will be no better or worse (sans Crohn’s sufferers and people w/gluten allergies).  Stay tuned for postings on those…

 

Hope this helps clear up some of the confusion about low-carb diets. Please feel free to ask questions and I’ll do my best to address them.  Thanks and stay healthy!

Healthy Conversion: Big Mac

Big Mac

Like McDonald’s but concerned about nutrition?  Try this healthy Big Mac recipe               by Don’t Just Diet:

  • 1 whole-grain bun (sometimes I indulge in a potato roll b/c they’re just so delicious)
  • 1 Boca burger patty (note: contains large amounts of gluten)*
  • ¼ cup shredded lettuce
  • 1 slice fat-free American cheese
  • 2 slices dill pickles
  • 2 tbsp healthily adapted special sauce (1/8 recipe below):
  •         1/2 cup fat-free mayonnaise
  •         3 tablespoons fat-free French salad dressing
  •         2 tablespoons sweet pickle relish (no sugar added)
  •         1 teaspoon sugar substitute (e.g., stevia)
  •         1 teaspoon dried, minced onion
  •         1 teaspoon white vinegar
  •         1 teaspoon ketchup

Boca Big Mac

McDonald’s Big Mac DJD Healthy Big Mac
Serving size 1 burger 1 burger
Calories 550 295
Total fat 29 g 2 g
Saturated fat 10 g 0 g
Carbohydrates 46 g 34 g
Sugar 9 g 6 g
Glycemic index 51  38
Glycemic load 23 13

* I happen to like Boca burgers b/c they are very low-fat, low-calorie and high-protein, but MorningStar Farms also makes a decent healthy burger.  These are also great with extra lean ground beef or turkey but, with a very tight schedule, I appreciate the convenience of pre-made burger patties.  Find what works best for you but be careful when selecting a burger patty- many turkey and veggie burgers contain just as much fat and as many calories as regular ground beef!

Informative: Sucralose (Splenda)- Good or Bad?

sucraloseThe concerns about sucralose (Splenda) are very reminiscent of the concerns about aspartame several years back, most of which were not based on even anecdotal evidence, but completely made up:

 

See aspartame made up story 1 and aspartame made up story 2

Sucralose was supposed to be better for the body because it was ‘made from sugar.’ Now, a number of people who consider themselves experts believe that stevia is better than sucralose ‘because it’s natural.’ Yes, stevia is *naturally derived* and might turn out to be better for the body than sucralose but it is still processed and my guess is I will be posting to address concerns about potential dangers of stevia in 5 or 10 years. The fact of the matter is we just don’t yet know whether there are any long-term effects of any of these nonnutritive sweeteners.

We do, however, know that there are immediate harmful effects of sugar overconsumption and obesity, which is why I personally continue to use these (even Splenda) in moderation. I love sweet things but I know that sweet things are usually high in calories and if I ingest too many calories I will get fat. Period. Therefore, I make the conscious decision to accept whatever risk may or may not be associated with artificial sweeteners to avoid becoming obese (which has clear health effects) because I refuse to stop eating the foods I love to eat. To this point, however, everyone needs to make their own decision.

I have been reading the studies connecting sucralose to ill effects and am personally not yet convinced because, to my knowledge, there have been no high-quality (randomized placebo-controlled trials) or long-term studies published. The ‘evidence’ raised to this point has been largely anecdotal and correlational at best. Let me be very clear- that does not mean that sucralose (or any other nonnutritive sweetener) is necessarily safe; it just means that, in my opinion, there is not yet compelling evidence to suggest that it is not. Please please let me know if you know of any scientific study that is not just correlational (eg, there is a relationship between drinking diet soda and obesity- no kidding, there is a relationship between dieting and obesity- doesn’t mean that dieting causes obesity- likely the opposite).

In sum, you should be suspicious of anyone who says that sucralose (or any other FDA-approved nonnutritive sweetener) definitely does or does not have any long term effects because that data simply does not exist. Anyone who says it does, clearly does not know how to properly interpret the scientific literature so I would be very hesitant to buy anything they were selling.

I welcome and will try to respond to comments. Stay tuned and stay healthy!

Healthy Conversion: Spicy Rotini Bolognese

Delicious healthy Italian that even grandma will love!

Spicy Rotini Bolognese

  • Whole wheat pasta (serving = 2 cups cooked)
  • Shredded fat free mozzarella cheese (serving = ¼ cup)
  • Bolognese sauce (serving = 1/16 below)
    • 64 oz Regular pasta sauce
    • 1.5 lbs extra lean (99%) ground turkey
    • ½ cup diced sweet onion
    • 2 Tbsp red wine
    • 2 Tbsp sweet BBQ sauce
    • 2 Tsp balsamic vinegar
    • ½ cup mix equal parts Italian seasoning, crushed red pepper, ground black pepper

pasta

The sweet elements work with the spiciness of the red and black pepper to create an almost addictive flavor.  For the sauce base, obviously use your own if you have time to cook, otherwise just use your preferred jarred sauce.  Prego is good if you like it a little sweeter.  Francesco Rinaldi is good if you like it less sweet.  Both come in large containers from warehouse stores and some local supermarkets.  Trader Joe’s carries the extra lean ground turkey at a very good price.

Here’s the key: most recipes will tell you to cook the meat first and then add the sauce.  Totally silly b/c you wind up double cooking the meat and it winds up dry even sitting in a vat of sauce.  Particularly when using lean meat, be cautions about overcooking.  I add everything at the same time and slow cook the sauce with a low flame over an hour or so- the meat is always plenty cooked but still moist.

As most people, I’m busy so I usually make 2lbs of pasta and store that and the sauce in an air-tight containers in the fridge.  This way, I have a delicious and super healthy meal in minutes anytime I want for the rest of the week!

NUTRITION FACTS

Restaurant Rotini Bolognese Healthy Rotini Bolognese
Serving size 275 g 275 g
Calories 460 320
Total fat 22 g 2 g
Saturated fat 10 g 1 g
Trans fat 1 g 0 g
Cholesterol 70 mg 10 mg
Fiber 5 g 12 g
Protein 22 g 26 g

Stay tuned and stay healthy!

Informative: Not So Fun Facts About Obesity

Some Not So Fun Facts About Obesity:

  1. Today, the most commonly purchased fountain drink is 1 liter, which has 30 teaspoons full of sugar.
  2. It is now statistically normal to be overweight.
  3. Obesity costs the Unites States somewhere between $100 and $200 BILLION annually
  4. For 7 million years, we have been fighting starvation. In the last hundred years we obese factssucceeded in killing more people from too much than too little food.
  5. Worldwide, 2.8 million people die each year as a result of being overweight or obese.
  6. A child who is obese at age 11 has a 70% chance of being an obese adult.
  7. The average child spends more time per year watching television than attending school.
  8. One in three children born after the year 2000 will develop diabetes.
  9. Childhood obesity is strongly correlated with increased rates of premature death.
  10. Children today have a shorter life expectancy than their parents for the first time in 100 years.

Here’s another great one: we are the first generation not expected to live longer than our parents.  Anybody have a guess as to why that might be?

Relevant Musings: Children on Diets?

FatKidWhy All Children should be on Diets: Response to Backlash over The Heavy by Dara-Lynn Weiss

Listened to radio show this morn where people were freaking out, aghast that a mother (Dara-Lynn Weiss) put her 7-year old daughter on a diet & then wrote book about it (The Heavy).  Over and over parents vehemently defended the position that we shouldn’t restrict our children’s eating.  Really???

When did ‘diet’ become a four letter word?  I was never good at math by the way.  What about ‘proper diet’ or ‘healthy diet’?  Diet does not mean starvation!  It should mean healthy nutrition.  Ever go into McDonald’s and see a morbidly obese person scarfing down a portion sufficient for 3?  Most people have and a lot think something like “and they probably wonder why they’re fat.”  Somehow, these are the same parents that would just as soon push clergy in front of traffic for suggesting that they should restrict what their child eats.

Newsflash: The habits you model and teach your children are likely to be maintained into adulthood, including and especially dietary habits.  If you teach them it’s OK to overeat hamburgers and ice cream at every meal as children, why would you expect them to ‘spontaneously’ adopt healthy eating habits as they advance into adulthood?

Wanna hear something else scary?   Once someone is obese for a while, the body adapts and that becomes the body weight that their biology will defend as necessary for survival.  Physiologically speaking, the body then literally reacts as if the person is starving to death when they try to return to a healthy body weight.  This one of the main reasons why diets typically don’t work and we say ‘don’t just diet.’  Unfortunately, surgery has become the only long term effective option once someone (even a child) is obese for an extended period of time.  Point is, don’t contribute to your kids getting to the point where surgery is the only option they have of being healthy.  Please!!

Causes: Why Even the Best Diets Don’t Work

There are two main reasons why diets fail:

#1: The body has extremely potent anti-starvation mechanisms, developed over millions of years of food scarcity.  The body and brain will do everything they can to slow metabolism, retain fat and get you to eat more.  Thing is, the last 200-300 years have brought worldwide industrialization and the new problem of food excess, which ironically now threatens our health as much as starvation has for the past 6 or 7 million years.

Here’s the rub- true biological adaptation to our environment is a sloooooow process.  300evolution years is nothing in terms of biological adaptation (what some might call ‘evolution’).  Our bodies and brains are still wired to protect against weight loss (starvation), which appears to be regardless of how much we weigh.  This point bears repeating- no matter how much we weigh, our bodies have extremely powerful anti-starvation mechanisms that will kick in immediately when we try to lose weight.

There is a caveat; these anti-starvation mechanisms kick in for obese people immediately (literally minutes) upon restricting caloric intake if and only if the individual has been obese for an extended period of time.  That means that people who gain a lot of weight rapidly (eg, pregnant women) and then lose it rapidly will be able to do so with relative ease.  After a while (likely 1y + but depends on individual), however, these anti-starvation mechanism get “reset” to the higher body weight and are triggered immediately when the individual begins to diet.  Once that happens, weight loss becomes the perpetual struggle that most obese people are familiar with.  It is not impossible but individuals in this situation must be prepared to work very hard and change habits for lifeChanging habits for a little while and losing a little weight in this scenario will not work because the body will do everything it can to assist in regaining that weight.

#2: This brings us to the 2nd reason why diets fail.  Almost all diets have something in common- one way or another, they tell people not to eat certain things and encourage eating more of other things.  The problem is, the certain things most diets tell us not to eat are the really delicious things that we love (pepperoni pizza, cheeseburgers, fries, hot fudge sundaes, etc) and the certain things most diets tell us to eat more of are typically not what we scientists would refer to as “hedonically pleasurable.”  Look at some diet recipes.  When was the last time you heard anyone say, “I am dying for some zucchini casserole right now!”?  And who wants to eat quinoa and chia seeds instead of pizza every day for the rest of their lives???

This is the concept behind Don’t Just Diet.  Through cutting edge research on how the Crack_Crackbrain controls food intake, we have learned that palatable (delicious) food can be as rewarding to the brain as drugs and sex.  Go find a crack addict and see if you can get him to substitute kale for crack from now on.  Not going to work!  In order for people to maintain particular dietary habits for the rest of their lives, the diet foods must be as pleasurable to eat as the foods they are replacing.

Our mantra is that if the belly is not happy, the diet won’t last.  Period.  What we actually mean is that if people adopt a diet that doesn’t activate the same pleasure centers in the brain as does eating the foods they love, the diet will not last.  No need to worry about neural activation in response to food- that’s our bag.  All you need to worry about is making the foods you love more healthy and we’re going to help!

Most diets, good or bad, catch on because of some anecdotal evidence (actually an oxymoron).  Like the coconut oil for Alzheimer’s or Jared from Subway or Jennifer Hudson for Weight Watchers, Don’t Just Diet has been followed successfully by it’s creator, Dr. Christopher Ochner.

Dr. Ochner:

Anyone who knows me has said on at least several occasions that they can’t believe I’m not obese with the amount of food that I eat.  Frankly, I’m amazed also.  I have the taste buds of a 5-year old boy.  I eat almost nothing but pizza, fries, burgers, ice cream sundaes, chili dogs, burritos… you get the point.  I developed this diet out of my out-and-out refusal to stop eating these foods that I love but desire to be and look healthy at the same time.  I came to find out years later that there is actually neurological evidence supporting the use of this diet! 

Does it work?  Not only am I not obese but I have maintained about 5% body fat* for the past five years after being heavier all through college and graduate school (10 years worth).  Are both my parents thin so maybe I have ‘thin genes?’  Nope.  Do I work out incessantly?  No, only about 30min per week and taking the stairs to my 3rd floor apt.  Am I one of those people who doesn’t really care about food?  No way, Jose; I loooove food and would consider myself a foodie despite my ‘unsophisticated palate.’  Am I one of those people who can just eat what they want and doesn’t gain weight?  Nope, trust me, my weight fluctuates easily.  Give me $10M for a leading movie role playing an obese person and I’ll be obese in a month, no problem (of course, I’d have to lose it right away otherwise my body would adapt to that weight and then I’d have to work twice as hard).  

So what’s the big secret?  Don’t Just Diet.  Literally, don’t just ‘go on a diet’ to lose weight because it’s not going to work.  In fact, don’t go on any diet where you don’t enjoy eating just as much as you did before because it’s not going to work.  Trick is to turn the foods you love into healthy foods without making them less fun to eat.  In essence, make sure you keep the belly happy while eating foods that help instead of hurt your body.  How?  That’s why we’re doing this.  Our goal over the next several months and years is to help everyone do just that.  Literally everyone and anyone can and should do it- it’s a healthy way to eat whether you’re too skinny, lean, overweight or obese!

*minimum essential amount of body fat for healthy functioning

As you can see throughout the blog, we mix essential information with simple and practical transformations of foods we all love to eat.   Our recipes emphasize taste, time and $- we know people are busy and don’t want to take out a 2nd mortgage to eat a healthy diet.  Most of all, we know people need to enjoy their food!  The Pepperoni and Sweet Pepper Pizza above may quite literally be the best pizza you will ever eat and has less than half the calories and 1/16 the saturated fat of normal pizza!  The Hot Fudge Sundae below tastes just as sinfully indulgent as a normal sundae but has less than half the calories, 0 vs. 26 grams of fat and 12X the protein!  We hope you enjoy, stay tuned and stay healthy!

Myth Busting: Disappearing Chicken in McNuggets

In our first of hopefully many fun segments, we’re going to test the myth that the chicken in McDonald’s Chicken McNuggets disappears when not consumed for 10 days.

mcnuggetcollage1

mrshappyhomemaker.com

click here for the original story

 

Quick Summary: Mrs. Happy Homemaker claims she put McNuggets in her fridge for 10 days and then examined them to find that they were all completely hollow shells of fried whatever and no remnants of white stuff (chicken or other) inside.

Could be true; could be bogus…

 

Set up for our experiment:

I purchased a 6-piece Chicken McNuggets from McDonald’s on June 27th at approximately 5pm. Following the methodology in the original story, I simply placed the McNuggets in my refrigerator and waited 10 days. On July 7th at approximately 7pm, I pushed my thumb into one of the McNuggets as described in the original story.

And…

BOGUS!

10 d nuggets

McNuggets day 10

Real Chicken 10 days

Real Chicken day 10

Maybe that’s not fair- maybe it happened for Mrs. Happy Homemaker like she said and it just didn’t work for us.  I doubt it, but it’s possible.  Truth be told, I was a little disappointed b/c, if there are two things that I love, they are experiments that work and bashing fast food manufacturers.

As grossed out as I am by Chicken McNuggets, that is more/less what I would expect to happen with real chicken.  This, however, only proves that the white substance in McNuggets doesn’t magically disappear after 10 days in the fridge.

2-WEEK UPDATE:

2 wk nugget

McNugget day 14

Real Chicken day 14

Real Chicken day 14

 

Hopefully the next experiment will turn out better… I am always on the lookout for any reason to warn people off fast food aside from the should-be-obvious it’s terrible for you, will make you fat, give you diabetes and kill you unless consumed in extreme moderation.  However, the idea that the white chicken-like substance in McNuggets magically disappears is not one of them.  Be careful what you believe on the internet. Unfortunately, there is more crap than truth out there.  Stay tuned for a full story on McNuggets on livestrong.com I will update with the link when it’s up.  Enjoy and stay healthy!

Practical Tips: Top 10 Tips for Avoiding Holiday Weight Gain

party-buffet-table-small-100x150Let’s be honest, nobody likes restricting themselves from eating delicious foods, particularly during the holidays.   Problem is, nobody likes the excess weight gain associated with the holidays either.  Even more alarming is the fact that overweight and obese individuals gain more weight over the holidays than do lean individuals.  If the laws of physics are correct, something has to give here.  Trick is to cut the excess calories we don’t even notice or enjoy.  Below are a few tips for keeping the belly happy during the holidays without feeling guilty and expanding your waistline after.

  1. Watch calorically-dense appetizers.  Limit creamy/cheesy dips, fried anything, frozen hors d’oeuvre, (eg, pigs in a blanket, mini quiches) pretzels and chips. Instead, go for nuts, salsa, shrimp cocktail, veggies, and fruit.  The more you eat of the good stuff, the less you will eat of the bad stuff.  It works.  Plus, there is usually so much good food floating around on the holidays, do you really want to waste the calories on chips?
  2. Load up on turkey and ham.  These are relatively lean meats that will deliver a lot turkey1of protein with very little fat and few calories.  Eat more of this and less sides such as potatoes, stuffing, and cranberry sauce.  Think about it, this is the most expensive component to a meal (when you order Chinese, notice they sometimes load it down with vegetables and skimp on the chicken, beef or shrimp?) and the best for you.  Added bonus- protein makes you feel fuller and fuller longer so load up on the lean protein and you will eat less of the much more waistline expanding bad stuff.
  3. Don’t unbutton your pants unless you are going to the bathroom or changing.  What we really mean here is don’t eat to the point that you are uncomfortably full.  Think about it- why should being uncomfortable be a part of holiday enjoyment?  For most of us living in the US, nobody is going to steal the food; it will be there all night so pace yourself.  You continue to get fuller after you stop eating.  So, if you stop eating when you are 3/4 full, you will be perfectly satisfied but if you stop eating when you are full, you will likely become uncomfortably full in a little while.
  4. Take smaller portions and go back if you are still hungry.  Studies show that we eat pretty much whatever is in front of us so loading up two heaping plates is going to result in tons more calories than eating more smaller portions.  We get full over time so, again, pace yourself.  Also, people tend not to go back for 4ths and 5ths and the belly is already plenty satisfied.  Using this technique, you can eat as much as you want (within reason of course) and still usually ingest fewer calories than you would if you loaded down two heaping plates.
  5. Watch salad dressings and sauces.  Unless you’re going to a health conscious household, these will typically be full fat and full calorie versions.  These are as bad or worse than the triple chocolate cake dessert.  No kidding.  Opt for fat free versions or extra virgin olive oil and vinegar instead.  The same is true for any mayonnaise or cream based sauces.  Mustard is actually a very healthy option and a very under appreciated condiment in our humble opinion.
  6. 116591-dmn-wine-glass-evans-2011-thumb-820x1024-116590Limit alcohol.  It’s the holidays, we’re off from work, a lot of us tend to have a few drinks.  Some times more, especially if you have to put up with the in-laws all night.  Just be aware that alcohol increases hunger and decreases dietary restraint so you’re more likely to pack in the calories and pack on the pounds the more you drink.  Try red wine instead of hard liquor or beer.  Also, be aware that alcohol itself contains a ton of calories (about 100 calories for a glass of wine, light beer or shot of alcohol) and this does not include mixers!
  7. Wait to eat desserts.  Give some time after dinner before diving into the desserts.  If you cram everything into your belly at once, you’re going to load down too many calories.  The body can only metabolize (burn) so many calories at one time and then the rest basically get stored as fat.  That is why eating more smaller meals is better.  Use this trick during the holidays and beyond!  Also, as mentioned earlier, fullness increases over time so, even though you may be tempted by the pecan pie right after dinner, you probably won’t want it as much 10 minutes later.
  8. Keep desserts to a reasonable level and avoid “a slice of everything.”  Yes, icecream-pie-su-1816277-lmost desserts are loaded down with fat, sugar and calories, and have little if any nutritional value.  That’s why they are desserts.  Even things that may seem benign like fruit tarts are often in the same category of butt bulgers.  Enjoy in moderation and avoid having a slice of several different things- the brain will allow us to force even more into an already full stomach when the flavors vary a lot.  Ever notice that you can be painfully full and then see the dessert tray and feel like you could maybe just try a slice of whatever?  You can eat more of different things- we call that sensory specific satiety.
  9. Limit soda and other caloric beverages.  Most people forget that caloric beverages can and will make you just as fat as food.  Even worse, unless it’s 100% fruit juice (which still has a lot of calories), it’s likely delivering zero nutritional value and won’t do much to reduce appetite.  So overloading on caloric drinks and food during the holidays is a double-whammy.  If you’re going to indulge, make it with delicious foods- you can have a glass of soda anytime.
  10. Be conscious of where you’re spending calories.  It’s a fact, unless you’re a marathon runner or Olympic athlete, you can only pour so many calories into your body until they show up where you don’t want them to.  No need to carry a note pad and estimate calories and do complex fractions.  Just use your brain- eat more healthy stuff than unhealthy stuff and be aware of hidden calories frequently found in the potatoes (butter, sour cream, oil), vegetables (oil) and sauces (saturated fat).  By all means, enjoy the food and eat some unhealthy stuff, just balance it out with healthy stuff!

Quick Tips: Healthy Eating Out

Brief practical advice for healthy eating on the go:

SKIP THE HOTDOG PIZZA.

hotdog pizza small

Yes, a little satire but you would be amazed how many of us shovel things that are not necessarily great tasting and definitely not healthy in to our mouths.  At the very least, make sure you’re getting one of those things- some less healthy things are worth if if you absolutely love those things and eating them brings you immense joy.  Sans joy in eating something, why not make at least make it healthy??

The overall point is that we are happier when we enjoy our diets.  Things that can get in the way of our happiness are not eating foods we enjoy eating and being unhappy with our bodies.  Things like hotdog pizzas and cold leftover restaurant meals don’t provide much in terms of eating pleasure  but contribute heavily to our waistlines.  These foods should be the first to go!

Causes: Why do diets fail?

Obesity is still on the rise, particularly in our children.  Unfortunately, most diets don’t work.  In fact, of the obese people who successfully lose weight, over 95% of them put the weight back on.  Why?  Don’t Just Diet will cut through the ridiculous mess of [mis]information out there and discuss why diets fail and what can be done to lose weight and keep it off.

Why do diets fail? Two main reasons:

1. Biologically speaking, we are designed to get fat in today’s food environment.

the_evolution_of_manEvolutionarily, humans had the best chance for survival if they ate and stored as many calories as possible when calorically dense foods were available in order to survive periods of famine.  This is a large part of the reason that, for most of us, pizza is more hedonically pleasing (delicious) than brussels sprouts- it is a survival advantage to prefer pizza.

Problem is, in most industrialized nations, calorically dense food is always available and famine is rare.

 

2. Biology changes when a person is severely obese for a long period of time.

The body and brain both act as if the person needs to be at that weight to survive.  For example, the number and size of fat cells both increase with obesity.  With weight loss diet, fat cell size decreases but fat cell numbers never decrease.

Conventional dieting almost immediately sets of survival (anti-starvation) mechanisms that undermine weight loss efforts and can actually make us want to eat “forbidden” foods even more.  When we deprive ourselves of something pleasurable, the perceived reward value of that thing actually increases.  In other words, that unhealthy food sounds even more delicious when it’s “off limits.”

Human biology is a powerful thing and difficult to overcome. Conventional dieting pits efforts to resist temptation directly against human biology- a losing proposition 9 out of 10 times.  Don’t Just Diet will get to what can and should be done to change this.  Stay tuned, I look forward to speaking with you again.