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Archive for December, 2010

It was reportedly Albert Einstein who defined insanity as doing the same thing over and over but expecting different results.  How many of us do this with resolutions?  We make the same list over an over, maybe we add something new about spending less money, and never accomplish anything on it.  Statistically, by February 15th, 90% of us will have fallen back to our old habits.

So if getting healthy or losing weight are on your list this year, here’s how to make it stick:

1. Change your mindset. You have to plan to eat differently and to keep exercising the whole rest of your life.  This isn’t about a diet; diets don’t work except in the short run.  Yes you can lose weight on diets but as soon as you stop dieting, you pack on more than you lost.  Diets are unsustainable.  What you really have to do is change your relationship with food.  Food gives you the energy to do what you want in your life—it nurtures you.  Many regular dieters have an adversarial relationship with food.  You have to learn that you eat when you aren’t hungry and why.  Most of us eat when we’re bored, angry, lonely, hurt or happy rather than just when we’re hungry.  Figure out your triggers and deal directly with them – stop using food as medication or therapy.  Don’t forget about exercise.  You can’t be healthy just by eating “right” or just by exercising.  You have to do both.

2. Develop a specific plan. Psychologists have documents that people who set very specific and measurable goals are much more likely to succeed.  So a plan that says “I’m going to lose 20 lbs in the next 2 years by eating at least 5 servings of vegetables, 1500 calories and 25 grams of fiber every day” is going to help you much more than simply thinking “I need to lose 20 lbs”.  When you plan your exercise, make sure to schedule it on your calendar just like any other appointment.  Again, “I will spend 1 hour at the gym every Monday, Wednesday and Friday at 6 pm” is a much better plan than “I need more exercise”.  Make sure your plan includes getting support from loved ones and friends, and make your goals public— you are less likely to fold if you’ve told everyone you’re going to do it.

3. Track your progress and results. Weigh and measure yourself once a week and only once.  At first you might find you will gain weight, especially if you are lifting weights at a gym.  That’s OK as muscle really does weigh more than fat—but you’ll probably also find you’ve lost inches at the same time and your clothes are a little looser.  Write down everything you eat every day in a food diary journal.  There are lots of great ways to track your calories intake online.  I do recommend:  http://www.sparkpeople.com which as a very good databases of foods plus you can add in your own if they aren’t available yet.  That way you don’t have to check the calorie counts and nutritional value of everything you eat.  Both of these programs also let you track your exercise at the same time.  There are also a few smart phone applications that have been well reviewed: LoseIt! (free for iPhone); Calorie Counter (free for Android and Blackberry); and Livestrong’s Calorie Tracker ($3 for iPhone, Andriod or Blackberry).  This kind of tracking will let you make adjustments as you go along.

So here’s the plan: understand that you need to make changes for a healthier lifestyle, make a plan, measure and track your progress toward your goals. If you need nutritional and fitness counseling, feel free to send me an email.

Good luck making 2011 your healthiest year yet!

 

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Diabetes and Obesity

Diabetes and obesity are frequently in the news today—various studies and reports declare diabetes a public health crisis, and the medical community, researchers and educators agree that obesity is a chronic disease. Citizens today need to practice healthy living to address a situation that will severely impact the quality of life for future generations.
Diabetes and obesity are not new issues. However, they have been on the rise over the past 30 years in most industrialized countries. The bodily harm attributed to each has become more prominent, especially in the U.S., as more and more young people are diagnosed. An acceptable worldwide definition for diabetes states that diabetes is a pancreatic disorder that impairs the way the body uses glucose, protein and fat. Type 1 diabetic individuals are always insulin dependent because they produce too little or no insulin at all. Type 2 diabetes is more common, associated with obesity, and can be reversible. Type 2 diabetes may be diet-controlled or controlled with oral medication, but if left untreated, may progress to become insulin dependent. 

In a clinical setting, overweight is diagnosed as having a body mass index (BMI) between 24.5 kg/m2 and 29.9 kg/m2 and obesity is diagnosed as having a body mass index (BMI) greater than 30 kg/m2. According to the Center for Disease Control (CDC), “overweight” and “obesity” are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems.

Some Statistics

  • In 2007, there was an estimate of 3.6 million children and adults in the United States—7.8% of the population—have diabetes.
  • About 1 in every 400 to 600 children and adolescents has type 1 diabetes and about 2 million adolescents aged 12-19 are on the verge of diabetes.
  • Diabetes was the seventh leading cause of death listed on U.S. death certificates in 2006. This ranking is based on the 72,507 death certificates in 2006 in which diabetes was listed as the underlying cause of death.
  • According to death certificate reports, diabetes contributed to a total of 233,619 deaths in 2005, the latest year for which data on contributing causes of death are available.

So who’s at Risk?
Children between the ages of 6 and 14 are showing the fastest-growing signs of weight-related diabetes. Diabetic children also carry other health risks for a longer portion of their lives. Health problems formerly associated with adulthood or advanced age such as high cholesterol, elevated levels of triglycerides, sleep apnea, and respiratory problems, become apparent much earlier. In addition, the overweight, diabetic child must face the social stigma of being obese. As a result, schools, parents, social agencies and individuals have begun to seek advice from fitness and nutrition professionals.

The Risks of Inactivity
A sedentary lifestyle is far more common among many Americans now than it was 25 years ago. The ADA reports that Americans are getting overweight as they become more inactive—unused calories show up as excess weight. While dieting has long been the focus of health improvement, the realization that combined elements of proper nutrition and exercise are the most effective tools for long-term health promotion is supported throughout studies.

Exercise and the Weight-Challenged Diabetic
Regular exercise, according to the American Diabetes Association, allows better glycemic control, prevents cardiovascular disease, reduces triglycerides, and prevents type 2 diabetes through weight reduction. However, weight-challenged diabetics are more likely to avoid unnecessary strenuous physical activity. The ADA asserts that preparing the diabetic individual for a safe and enjoyable physical activity program is as important as physical activity itself because the person’s mindset and/or physical limitations may present obstacles to participating in such efforts on a regular basis.  Walking, jogging, bicycling, playing tennis, cross country skiing, dancing, water exercise, Tai Chi or yoga may be suggested in addition to organized sports. For those who view exercise as a formidable task, approach physical activity in terms of what these people have to do every day. For example, taking stairs instead of an elevator, parking farther from work, getting off the bus one stop earlier, gardening, vacuuming, mowing the lawn and walking the dog.

Precautions
Be aware that diabetics should monitor their blood sugar before and after exercising to avoid hypoglycemia. Certain activities that increase pressure in the blood vessels of the eyes should be avoided. Most fitness professionals know that a combination of cardiovascular conditioning, along with flexibility and strength training, constitutes a total fitness program. But diabetics must use caution when engaging in high-intensity activities because of the effect on insulin levels in their bodies; make sure that they have a snack before exercising.

It is recommended that all diabetic clients wear an identification bracelet or some other form of identification stating their name, address, phone number, physician’s name and phone number, type and dose of insulin or other medicine they take. It is essential for diabetics to carry a blood glucose meter and their medicine at all times. In addition to water, they also need a source of carbohydrates such as glucose tablets or hard candy available for an emergency.

In Conclusion
Attaining good health requires a commitment to healthy behaviors. These behaviors must emphasize activity consistency and enjoyment of eating. Given our current sedentary lifestyle and fast food culture, significant change will require a concerted effort by the public, the government and the individual to address the broad issues that contribute to childhood and adult obesity and diabetes. In the meantime, nutrition professionals, fitness experts and ancillary healthcare providers can complement medical teams in helping weight-challenged, at-risk and diabetic clients achieve optimal health.

For more information, visit http://www.diabetes.org

 

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For more than a decade, the Food Guide Pyramid has taken a one size-fits-most approach to outlining healthy eating. But with MyPyramid, the new food guidance system based on the Dietary Guidelines for Americans 2005 by the United States Department of Agriculture and Health and Human Services, a new way to individualize eating is introduced. Some additions include emphasizing weight control and the importance of physical activity, increasing fruit and vegetable recommendations, whole grain intake, keeping total fat intake to 20-35 percent of calories, and minimizing trans fat intake.

Unlike the old food guide, MyPyramid personalizes dietary and physical activity recommendations by including a variety of pyramids designed to fit an individual’s unique needs. MyPyramid has six major points:

  1. Be Active. The recently updated Dietary Guidelines recommend physical activity on most—preferably all—days of the week. In order to maintain weight, one must exercise at least 30 to 60 minutes a day. For weight loss, 60 to 90 minutes of daily exercise is recommended.
  2. Moderation. This concept focuses on the importance of limiting the consumption of foods high in saturated fats, trans fats, sodium and sugar. This translates to a decreased intake of full-fat meats, processed foods and sweets.
  3. A Personalized Approach. Personalization is a major feature of MyPyramid. To meet an individual’s unique dietary and physical activity needs, 12 different pyramids are created. Caloric and food group recommendations are based on gender, current activity level and age.
  4. Portion Control. By basing food recommendations on standard household measurements and ounces, it is hoped that people will maintain better portion control.
  5. Variety. Including all of the food groups daily and choosing a variety of foods within those groups will help achieve the nutrient recommendations. Numerous colors, flavors and textures should be included in order to get a diverse supply of nutrients.
  6. Make Gradual Improvements. Fitness professionals need to help individuals formulate an exercise and diet plan that will sustain behavioral change. Helping clients set measurable and realistic goals can do this. For example, if someone only exercises once a week, have him or her increase their frequency to two times a week, gradually working up to five to six days a week within four to six months. Goals should be behavior-based, as opposed to weight loss only.

BUILDING A PERSONALIZED PYRAMID
Determine Activity Level

The caloric recommendations for adults are highly influenced by the amount, intensity and duration of physical activity. According to MyPyramid, sedentary is considered less than 30 minutes of daily physical activity. Physical activity routines that average 30 to 60 minutes every day are considered moderately active. Sixty to 90 minutes of exercise every day is considered active.

Establish Appropriate Caloric Level
Activity level, age, and gender determine caloric needs. Depending on an individual’s weight management goal, recommendations can be increased or decreased by 200 to 500 calories daily.

The next chart illustrates how much of each food group is required daily for common calorie levels (from http://www.mypyramid.gov/downloads/MyPyramid_Calorie_Levels.pdf).

Calorie Level 1,800 2,000 2,200 2,400 2,800 3,000
Fruits 1 1/2 cups 2 cups 2 cups 2 cups 2 1/2 cups 2 1/2 cups
Vegetables 2 1/2 cups 2 1/2 cups 3 cups 3 cups 3 1/2 cups 4 cups
Grains 6 oz 6 oz 7 oz 8 oz 10 oz 10 oz
Meat and Beans 5 oz 5 1/2 oz 6 oz 6 1/2 oz 7 oz 7 oz
Milk 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups
Oils 5 tsp 6 tsp 6 tsp 7 tsp 8 tsp 10 tsp
Discretionary calorie allowance 195 267 290 362 426 512

Fruits and Vegetables
Nutrients can be met by consuming fruits and vegetables of various colors. Canned, frozen, dried and fresh fruits and vegetables all count toward intake goals. Recommendations were increased to meet dietary fiber needs and reduce the risk of chronic diseases. Increased fruit and vegetable recommendations encourage a diet rich in potassium, which may help to maintain a healthy blood pressure. Fruits and vegetables high in potassium include potatoes, spinach, winter squash, bananas, melons, oranges and plantains. To provide a variety of nutrients and fiber, at least one leafy green and an orange fruit or vegetable should be eaten daily. Choices range from red leaf lettuce, broccoli, carrots, sweet potatoes and cantaloupe.

Grains
One-half to two-thirds of total grain intake should come from whole grain foods. These are good sources of fiber and complex carbohydrates, while being low in fat. Beyond that, they are a good source of antioxidants, iron and B vitamins. Breads, cereals and other grain-based foods that name whole grain ingredients first are the best choices. These include wheat, rye, corn, millet and barley.

Meat and Beans
For those who eat meat, low-fat or lean meat products are preferred to keep saturated fat and cholesterol intakes low. Lean meats, poultry, fish, eggs, beans, nuts, seeds and tofu all count in the meat and bean group.

Dairy
Dairy recommendations are based on the need to provide nutrients for bone health. Fat-free or low-fat milk, yogurt or cheese is preferred in order to keep saturated fat and cholesterol intakes low. Good alternatives for those who avoid dairy products are soymilk, soy yogurt, fortified beverages and leafy greens.

Fats and Oils
Fat is a major fuel source for working muscles and it is the most concentrated energy source available. The fat and oil recommendations are designed to provide essential fatty acids and vitamin E. The type of fat chosen is a major determinant of disease prevention. Solid or saturated fats can be limited by choosing low-fat dairy products and lean meats while avoiding many fast foods. Limiting hydrogenated and partially hydrogenated vegetable oils and commercially prepared foods (e.g. cookies, crackers and chips) will help limit trans fat intake.

As part of a healthy diet, unsaturated fatty acids (e.g. canola oil, olive oil, nuts, seeds and avocado) should account for the majority of fat intake. Including fatty fish like salmon and tuna, as well as nuts and flaxseed oil at least four to five times a week, will contribute to the omega-3 fatty acid intake which can reduce blood clotting in the arteries.

Include Daily Physical Activity
More than 60 percent of adults do not achieve the recommended amount of regular physical activity. Physical activity is key in preventing chronic disease and maintenance of a healthy body weight. To reduce the risk of chronic disease, it is recommended that adults engage in at least 30 minutes of exercise most everyday. To maintain body weight and prevent gradual weight gain, 60 minutes of moderate-to-vigorous-intensity activity most days of the week is recommended. In order to sustain weight loss, one must get 60 to 90 minutes of moderate-intensity activity every day. Make sure you consult your physician before a fitness professional can design a safe and effective program.

Discretionary Calorie Allowance
The discretionary calorie allowance is designed to help people limit foods not considered nutrient-dense. Think of these as “fun foods” so clients can treat themselves to foods such as sodas, sweeteners, alcohol, candy, sweetened cereals and baked goods—among others.

So what is the IDEAL meal?
When designing a meal plan, try to include multiple food groups in meals and snacks. When making the ideal meal, keep in mind that it should consists of: two to three ounces of grains, one to one-and-a-half cups of fruits, one to one-and-a-half cups of vegetables, two to three ounces of protein, and one cup of milk or other low-fat dairy product. For those avoiding dairy, substitute with soymilk or soy yogurt and add plenty of leafy greens.

For detailed information, visit http://www.mypyramid.gov

 

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There’s no denying that everyone, at one time or another, has had a snack attack. Views on snacking differ: some of us feel that snacking is bad and that eating between meals leads to weight gain. Others believe that eating many small meals and snacks throughout the day is healthy for maintaining energy levels and optimal weight. If there were one way of snacking that was right for everyone, we would all be doing it! 

To lighten the snack attack guilt, try to understand why you are snacking and what snacks work best for your body. Perhaps you snack because your daily diet is missing nutrition, or because you are eating too little at meals. You might be snacking to soothe nerves when you are emotional, or to entertain yourself when you are bored. Whatever your reason might be, acknowledge it and start thinking about how to create a life that is nourishing and truly satisfies.

Although snacks are no substitute for loving your life, they can be great energy boosters, mood lifters and a healthy and fun way to keep your body fully nourished, as long as you use a little common sense. So many convenient snack foods are highly processed and full of chemicals, additives, damaging fats, and refined sugars. When a snack attack hits you, try foods that are filling and satisfying, but also nutritious. Snack on things that don’t come in a plastic wrapper or a box, like fresh or frozen fruit, leftover vegetables or rice cakes with almond butter and fruit spread. Make your own signature trail mix, organic hot chocolate made with almond milk, or blue corn chips with hummus.

You can also try “upgrading.” If you are craving something crunchy, upgrade from potato chips to raw carrots, apples or whole grain crackers; if you are craving a candy bar, upgrade to a handful of nuts and dried fruit; instead of a cup of coffee, upgrade to green tea; instead of ice cream, upgrade to applesauce with cinnamon. Upgraded snacks are high in nutrition and give you a greater sense of satiety and satisfaction; you won’t feel physically or psychologically deprived, and you’ll have plenty of energy to sustain your activities for hours.

Snacking is enjoyable and there are a wide variety of healthful goodies for whatever you’re craving, be it sweet, crunchy, salty, creamy or spicy. Dive in, be creative and enjoy your snack attack.

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So you made it though Halloween and Thanksgiving relatively unscathed, but now Christmas is looming.  The average American eats something like 5000 calories just at a holiday dinner – that’s almost 3 day’s worth of food.  And who can pass up dessert, I mean, really?  Here are some tips on getting through the day with your waistline and arteries unscathed.

For the cook(s):

1) Make LOTS of vegetables, and not just squash drenched in sugar.  Make sure there is a variety on the table – multiple colors are a great strategy: green, red, purple, orange, and white.  Try to avoid packaged or processed ingredients in favor of fresh ones, especially in the sauces for the veggies. 

2) Try substituting sweet potatoes for white ones – they have more nutrition and are naturally sweet.  Mash them just like white potatoes. 

3) For root vegetable mashes such as potatoes, turnips, parsnips and squash, try mashing them with low fat buttermilk or plain yogurt rather than cream and tons of butter.  You can still add butter, for that great smooth and creamy feel in your mouth, but you can usually use about 1/4 of the normal amount to keep fat and calories lower without losing the effects.

4) Be aware of how much salt you use in each dish – it can add up fast.  Add it last just before serving and you’ll use less but still get the flavor boost.

5) Serve on small plates – many studies have shown that people fill up their plates, so smaller plates mean smaller portions and fewer calories, and everyone will still get full, I promise!

For the eaters:

1) Practice portion control – take very small samples of everything you want to eat so you can get a taste and not miss anything.  You can always get more of whatever tastes good enough that you don’t care about the calories.  Do you really need 2 cups of stuffing AND 2 cups of mashed potatoes?  No. Try starting with a 1/4 cup of each.

2) Don’t eat mindlessly: wait 15 minutes before getting a second helping; it takes your brain that long to get the signal that you are full.  If you still want more after a wait, go ahead.

3) For most foods it’s the first taste that’s the best.  Once that craving has been satisfied with one bite, check in with yourself and make sure you are still enjoying it rather than trying to re-create the feeling of the first bite.  If you manage #1 correctly, this won’t be as much of a problem.

4) Don’t miss breakfast or lunch to “save room” for dinner; you’ll be so hungry by the time dinner is served you WILL overeat.

5) Go ahead and have desert – just make the pieces small. 

6) Savor each bite and be sure to thank the chef.

Have a wonderful holiday everyone!

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Every time people go on a fad or crash diet, they usually need to give up something in return. More often than not, it’s the classic ‘standby’ food —bread. I have lectured every client how I am not big on fad diets, but what if you’re just trying to eat better? Is there any reason to actually eliminate bread?

The pro-bread side says: bread is a great way to get the complex carbs we need. If you’re pursuing a balanced diet, you can’t eliminate carbohydrates. In fact, you should be eating a good amount of them, as they do tons of things that keep our bodies running properly, and those things aren’t easy to replace with something else. Bread is one of the easiest ways to get those carbs — it’s widely available, and delicious.

The no-bread side says: not all carbs are the same. White bread is digested far faster than other carbs, and thus heads right into the bloodstream as sugar. Just like white rice, there’s nothing very nutritious inside the food to slow the digestion down, and hunger levels rise much faster because of the increased levels of insulin that come with such an infusion of sugars.

This leads us towards a larger debate about carbohydrates in general, and whether low-carb diets are actually healthful, sustainable, and good for our bodies. Remember — you can find scientific (and nutritionist) evidence for just about anything, if you look hard enough.

With that in mind, what are we supposed to do?

Eat “good” bread instead. Don’t bother eating white bread at all. If you’re following any kind of ‘whole foods’ or ‘eating clean’ program in the first place, white bread should already be off the list. It’s usually full of sugar (or high-fructose corn syrup) and a ridiculous, unnecessary amount of salt. The more you can eat whole-wheat bread, or rye bread, or pita bread, or basically anything but white bread, the better.

Follow the bakery-or-nothing rule. This one is simple, and it’s exactly how many French & Italians continue to eat bread. If you’re thinking about cutting out bread but don’t want to make such a huge effort, just put your effort towards buying bread from a real bakery instead. Not only does it taste far better, but you won’t worry about useless added sugars or unnecessary ingredients.

Oh, and one more important thing: this counts for all bread. Just because a Subway sandwich seems to have a healthy calorie count doesn’t mean the bread isn’t full of preservatives and unnecessary additions. Same goes for any hot dog bun or dinner roll. Ever tried to buy, say, a hamburger bun that doesn’t contain sugar? It’s harder than you think — so let the bakery-or-nothing rule sort this all out for you. If it hasn’t been made, by a baker, in the last 2 or 3 days — skip it.

Don’t buy sliced or bagged bread. This is an easy-to-remember variation on the ‘bakery’ rule. Obviously it will have some exceptions (good pita bread is almost always in bags), but if you need a super-simple rule to remember, this is one. Only buy freshly-baked loaves and cut off what you need. Bread lasts longer when it’s not pre-sliced, and proper European-style crusty loaves keep air out far longer thanks to their thick crusts.

Don’t eat too much of it. If there’s anything you should be watching your portion sizes with, it’s bread. Take it easy, savor it, and don’t make it the main protagonist of any meal. If you do this, and stick with the bakery-or-nothing rule, you’ll be set.

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Gloomy weather can be one of the main reasons that someone might put off exercising.  It is also known that gloomy weather leads to depression.  Small basic tips to kick the procrastination habit can be found in the Fitness Tips section of this blog.

It is great walking into the gym in the middle of winter and seeing people exercising on a regular basis, and having that exercise have a really positive effect on their depression or anxiety.

The Science Behind It

I did some research, and while there is no super-set-in-stone link between alleviating depression and exercise, there are a bunch of factors that point to reasons why exercise might help.

Endorphins — the chemicals our brain releases when we work out, go for a run, or get physically active. This is the chemistry behind the “natural high” people talk about experiencing after a workout.

Body Temperature — this one isn’t as clear as the endorphins, but (as everyone knows), when you exercise, your body temperature can go up, and for some people, this can alleviate anxiety.

Pure Emotion—The other big thing about exercise is just the fact that any physical activity you do, especially when you’ve really made a positive change in your life and are working out consistently, is something you know is fundamentally good for you. And being able to stick with that — to know in your heart that you’re really pursuing something that’s great for your mind, body, and well-being — that can often make a real difference in combating some of the symptoms of both depression and anxiety.

More to Come: Keep a lookout for Getting Started on a daily routine and daily basis article especially if fitness-procrastination is a problem for you.

On those days when you seem to be able to find every reason not to exercise, what’s the one single trick that gets you moving? It can be mental, physical, a trigger, a song — whatever works for you, and only you!

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