Extra Calories, Low Protein Are Culprits in Weight Gain

Recent research reinforces the fact that consuming too many calories causes weight gain.  And, when calories are in excess of needs, eating inadequate amounts of protein contributes more to fat gain than when eating adequate protein.   

In the study, 25 healthy participants followed diets containing different levels of protein -- plus nearly 1,000 extra calories -- for eight weeks. The researchers looked at how the level of protein in the diets affected body composition, weight gain and energy expenditure in an inpatient setting  where all of their food intake and activity could be monitored.  The diets varied in the amount of calories derived from protein. The low-protein diet had 5% of calories from protein, the normal-protein diet had 15% of calories from protein and the high-protein diet had 25% of its calories as protein. All three diets included the same amount of carbohydrates, and fat made up the difference in the calories.

Not surprisingly, researchers found that everyone gained weight during the overeating period. However, people in the low-protein diet lost 2.2 lbs. in muscle mass, while those in the normal- or high-protein groups gained muscle mass during the overeating period. Muscle weighs more than fat, which is why they gained more weight. So, those on a low protein diet had a more unhealthy pattern of weight gain as it came from an increase in body fat and a decrease in lean tissue. In contrast, the high-protein diets led to increases in lean body mass and lower increases in fat.

What to do:  To prevent weight gain eat a calorie-controlled diet with ample lean proteins such as fish, chicken, egg whites, lowfat dairy, and beans.  Try to limit intake of excess fat and nutritionally poor carbohydrates including refined (white) grain products and high sugar foods.  Replace these foods with a variety of healthy fruits and non-starchy vegetables to help fill you up and improve the quality of your diet. 

SOURCE: Redman L, Diekman C.  Journal of the American Medical Association.  Jan. 4, 2012.

Adapted from article found at http://www.nlm.nih.gov/medlineplus/news/fullstory_120378.html

MEDITERRANEAN DIET GOOD FOR IMPROVING DIABETES, HEART HEALTH & FERTILITY

The Mediterranean diet is rich in fruits, vegetables, fish, legumes, olives, and whole grains.  It has limited meat and dairy.  Following this type of diet has been found to have many positive health effects including increased longevity and reduced heart disease.   A new study offers further evidence that a Mediterranean-style diet is good for improving heart health and diabetes.  Interestingly, this study found that even when following the diet does not result in weight loss, adopting the diet still promotes improved heart health and diabetes. 

Researchers examined how three different types of balanced diets influenced the body’s capacity to respond to insulin and lower blood sugar levels. One diet treatment was rich in carbohydrates (grains & starches), another treatment rich in protein (animal-based foods), and the third rich in unsaturated fats (olive oil, nuts, avocado).  The participants were assigned to each diet for six weeks. The diet rich in unsaturated fats improved insulin sensitivity and blood sugar levels significantly more than the high-carbohydrate diet.  Researchers found that unsaturated fats from foods such as avocados, olive oil and nuts increase the body's ability to regulate blood sugar and decreases the risk and progression of heart disease and diabetes.  This beneficial effect occurred even though the participants did not lose weight.

Another recent study may be helpful to women who are having difficulty getting pregnant.  It found that women who eat a Mediterranean-style diet are less likely to have fertility problems than those following a typical Western-style diet.

Researchers looked at nearly 500 women with fertility problems and more than 1,600 women of the same age who had no fertility problems. Based on questionnaires, they measured how closely women followed a Western-style diet rich in sugary foods, refined carbohydrates (white-flour based foods), meat, and dairy or a Mediterranean-style diet rich.  Researchers found that women following a Mediterranean-type diet were significantly less likely to have fertility problems.

What to do:  The Mediterranean style diet is rich in plant foods including whole grains, fruits and vegetables, and beans.  Its primary protein source is fish and its fats mostly come from unsaturated fat sources including olives, nuts, avocado, and oily fish.  To improve your heart health and diabetes or to prevent problems, following a Mediterranean type diet is a healthy choice.  Still, make sure your caloric intake is controlled to promote weight loss which is also very good for these conditions.  If you are diabetic, you also want to keep in mind that whole grains, though better than refined grains, still raise blood sugar.   For women who are thinking about getting pregnant, adopting a Mediterranean diet is also a wise choice.  Just make sure to choose fish options low in mercury such as salmon and include nonfat or lowfat dairy sources to ensure you are consuming a diet rich in calcium and vitamin D.

Adapted from articles found at http://www.nlm.nih.gov/medlineplus/news/fullstory_117966.html & http://www.nlm.nih.gov/medlineplus/news/fullstory_119099.html

SOURCES: http://bit.ly/puuLP3 Fertility and Sterility, September 22, 2011 & Johns Hopkins Medicine, news release, Nov. 16, 2011

HEALTHY HEART HABITS ALSO REDUCE CANCER RISK

People who are diligent about keeping their heart healthy have a good chance of staving off cancer as well, researchers report.  A recent study found that individuals who don't smoke,  maintain a healthy weight, normal blood pressure, as well as other lifestyle factors that influence heart health, have a 38% lower risk of developing cancer.

"People generally know that healthy behaviors prevent heart disease and cancer, but to relate risk factors such as cholesterol to cancer is novel," Sometimes I talk to patients about lowering their cholesterol and exercising, and they get very fatalistic saying that, in my family, cancer is the problem. But, these findings indicate that the same healthy habits that reduce risk for heart disease also lower the risk for cancer, stated lead researcher Laura Rasmussen-Torvik.

For this study, researchers followed more than 13,000 healthy individuals for 13 years, measuring seven indicators of heart health at the study’s outset and then tracked if participants developed cancer. The seven heart health indicators they assessed were: not smoking, healthy weight, regular physical activity, healthy diet, and healthy levels of blood cholesterol, blood pressure, and fasting blood glucose.  Researchers found that the more heart healthy characteristics people had, the less likely they were to develop cancer.  Compared to people who had none of the seven factors, having just one reduced the risk of cancer by 20%. Having 5-7 heart healthy factors lowered the risk of cancer by 38%.

It's not clear why these associations exist, but researchers hypothesize that levels of  inflammation that are increased by heart health risk factors also contribute to the development of cancer.  

Another recent article corroborated existing evidence that a diet rich in plant-based foods not only helps to prevent heart disease but also cancer.  These findings were from an ongoing study that has been tracking the health and lifestyle characteristics of 86,000 U.S. nurses for over 26 years.

In this study, researchers found that women with diets rich in vegetables, fruit and legumes and diets low in red meat, sodium, and processed carbohydrates have a decreased risk of developing breast cancer.  The risk was lowest among women whose diet resembled that of the Dietary Approaches to Stop Hypertension (DASH) diet -- an eating plan that helps to lower blood pressure. It emphasizes vegetables, fruit, fiber-rich grains, legumes and nuts, and low-fat dairy.  Women following a diet similar to DASH had a 20% reduced risk of developing breast cancer.  High fruit and vegetable intake were most strongly predictive of lower breast cancer rates.  Even after researchers accounted for factors like weight, exercise habits and smoking, the link between plant-rich diets and lower breast cancer risk still held.

What to do:  Practice heart healthy habits! Control your heart health risk factors with regular activity, a healthy diet, and taking medication when indicated.  It is also very important for heart health and cancer prevention not to smoke or quit if you do.

Adapted from articles found at  http://www.nlm.nih.gov/medlineplus/news/fullstory_116242.html and http://www.nlm.nih.gov/medlineplus/news/fullstory_118784.html.

HAVE A RESOLUTION TO LOSE WEIGHT IN THE NEW YEAR? FOLLOW THESE TIPS TO TURN YOUR GOALS INTO REALITY.

It takes more than simply making a New Year's resolution to fulfill your weight loss goals.  To make your resolution plan realistic, first try to identify exactly what you want to accomplish.  Once you know your goals, then consider how you are going to get to where you want to be.  Try to make your plan as specific as possible.  Small changes are usually easier to stick with than dramatic changes. 

 

Keep track. One of the most effective ways to follow through on dietary changes and lose weight is to write down everything you eat and drink.  Dieters who keep track of everything they eat lose twice as much weight as those who don't, research shows.  When you keep a food journal, you think twice about your eating decisions and have a clearer understanding of your intake and food patterns.  You can write down what you eat in a notebook, or track your intake online or on your smartphone/Blackberry/Ipad.  The apps provide you with a weight loss calorie goal and count your caloric intake so you can know how much you can eat to stay within your calorie goal.  Here are some of the most common apps along with my rating of their quality.

 

·         Calorie Counter & Diet Tracker by MyFitness Pal (free) - Tracks a combination of fitness goals and nutrition analysis to help you lose weight. If you choose, this application allows your nutritionist or friends to view your diary.  This is the app NYCC’s nutritionist recommends for tracking intake.  RD Rating: 4.5 stars

·         Calorie Counter (free) - Tracks food, exercise, weight and all the nutrients listed on a Nutrition Facts label. Includes daily inspirational articles, healthy recipes and an easy-to-understand help section. RD Rating: 4 stars

·         Calorie Counter by MyNetDiary (free, enhanced version $3.99)- Allows user to personalize a calorie limit for weight loss, gain or maintenance. RD Rating: 3 stars

·         Calorie Counter: Diets & Activities (free) - Features a classic food diary that tracks calories, water, fitness and the time each food item is consumed and an option to create your own diet and physical activity plan and an Integrated Body Tracker. RD Rating: 4 stars

·         Calorie Tracker by Livestrong.com ($2.99) - Food and fitness diary designed to help you achieve your diet and nutrition goals, whether you want to lose, maintain or gain weight. RD Rating: 4 stars

·         Daily Burn (free, enhanced version for fee) - Keep track of calories consumed and track workouts to see how much energy is burned. RD rating: 2 stars

·         Lose it! (free)- Keeps track of foods you eat with its detailed food database. RD Rating: 3 stars

·         Sparkpeople Food and Fitness Tracker (free) Fitness and food tracker for people looking to lose a half-pound to 2 pounds per week or to maintain weight. Includes menus you can personalize.  RD Rating: 4 stars

·         Weight Watchers Mobile (free)- Follows the Weight Watchers plan step by step, using interactive tools, RD Rating: 2 stars

 

HERE ARE 25 USEFUL TIPS FOR WEIGHT LOSS IN THE NEW YEAR

·         Check- in with your reasons for wanting to lose weight.  Try making a list of the specific reasons you want to lose weight.  Whenever you feel your motivation waning, look back at the list to renew your resolve.

·         Set a realistic weight-loss goal. Most experts recommend aiming for half a pound to 2 pounds a week.

·         Motivate yourself. Get out a pair of pants that are too tight and hang them in the kitchen instead of the closet to keep yourself inspired.

·         Get help from family and friends. Dieters who have support from a partner at home lose more weight than those who don't, studies show.

·         Move it to lose it. Research shows that people who do physical activities such as walking or biking for two to four hours a week during weight-loss efforts lose an extra 3 to 5 pounds over a year.

·         Pay attention to portions. A 3-ounce portion of meat, poultry or fish is about the size of the palm of your hand or a deck of cards; 1 teaspoon of butter or margarine, a standard postage stamp; a cup of cold cereal, berries or popcorn, a baseball; 4-inch pancake or waffle, the diameter of a CD.

·         Clean out your pantry and refrigerator. Get rid of the foods that sabotage your weight loss.

·         Create "a dinner deck." This would include 10 favorite quick and healthful dinners written on index cards.

·         Avoid hunger. Eat regular meals and snacks. Make sure you have some protein foods such as yogurt, tuna, beans or chicken for most meals. Research indicates protein helps you feel full longer.

·         Keep produce on hand. Place a bowl of vegetables such as broccoli, snap peas, cucumbers or carrot sticks in the refrigerator. You can eat them as a snack or when preparing meals to take the edge off your hunger.

·         Stock up on "impulse fruits." Keep things like grapes, Clementines, small apples, small bananas and pears around the house. These foods are easy to eat without having to do much cutting and slicing.

·         Make some stealth changes. That will get everyone in the family eating healthier. Buy lowfat/nonfat dairy products and lean cuts of meat. Use them to cut the fat and calories.

·         Cut out liquid calories. Eliminate high calorie sweet drinks such as soda, sweetened iced tea, sports drinks, juice, and alcoholic beverages. Liven up the taste of water by adding lemon, cucumber, mint and/or carbonation. Choose skim/1% milk.

·         Practice the "Rule of One." When it comes to high-calorie foods, you won't go wrong if you allow one small treat a day. That might be one cookie or a fun-sized candy bar.

·         Pace, don't race. Aim to eat more slowly and savor each bite to consume less and increase satisfaction.

·         Hydrate before meals. Drinking 16 ounces, or two glasses, of water before meals may help you eat less.

·         Downsize plates, bowls, glasses, silverware. Using smaller versions will help you eat less food naturally.

·         Adopt the motto "after 8 is too late" for snacks after dinner.

·         Buy a pedometer. Health experts recommend taking at least 10,000 steps a day, which is roughly 4 to 5 miles, depending on your stride length.

·         Treat yourself occasionally. If your chocolate craving is getting to you, try diet hot-chocolate packets. If you need a treat, go out for it or buy small prepackaged portions. If you love chocolate, consider keeping bite-size pieces in the freezer.

·         Dine at a table. Eat from a plate while seated at a table. Don't eat while driving, lounging on the couch or standing at the fridge.

·         Dine out without pigging out. Figure out what you are going to eat in advance. Get salad dressing on the side. Dip your fork into the dressing and then into the salad.  Pack up half of large portions for another meal.

·         Get plenty of sleep. Insufficient sleep increases levels of hunger hormones and carbohydrate cravings.

·         Weigh yourself regularly. That's what successful dieters and those who manage to maintain weight loss do. Some step on the scales once a week. Others do so daily.

·         Reward yourself. When you meet your incremental weight loss goals, say losing 5 pounds, treat yourself to something — but not food.

Cutting Carbohydrate Intake Just 2 Days a Week Can Accelerate Weight Loss

Dieters who can’t stomach the idea of limiting carbohydrates 7 days a week just got good news: You might be able to drop more weight if you cut back on carbs just 2 days a week.

British researchers found that women who limited their carbohydrate intake to 50g (approximately the amount of carbohydrate in 1 cup of cereal or rice) for two days and ate a reasonable diet on the other days of the week dropped about 9 pounds on average, as compared to the 5 pounds lost by women who cut back to around 1,500 calories every day, according to a report presented at the CTRC-AACR San Antonio Breast Cancer Symposium.

“We came up with the idea of an intermittent low-carb diet because it enables people to still have foods that are very satiating,” said the study’s lead author Michelle Harvie, a research dietitian at the Genesis Prevention Center at the University Hospital in South Manchester, England. Harvie and her colleagues were spurred to find a diet that would be easier for women to follow because research has shown that obesity and the changes it causes in the body increase the risk for breast cancer. “We know from our research in animal models that losing weight has the potential for reducing breast cancer risk,” Harvie said.

The researchers followed 88 women for four months. All the women were at high risk for breast cancer based on their family histories. One third of the women were put on a Mediterranean-type diet that restricted calories to about 1,500 per day. A second group was told to eat normally most of the time, but two days a week to cut carbs and also calories to about 650 on those two days. The third group was also to cut carbs two days a week, but there was no calorie restriction on those days. At the end of four weeks women in both of the intermittent dieting groups had lost more weight — about 9 pounds — than the women who ate low calorie meals every day of the week — about 5 pounds. Women in the intermittent dieting groups also had better improvement than daily dieters in the levels of hormones — insulin and leptin — that have been linked with breast cancer risk, Harvie said.

What to do:  To follow this diet, you need to significantly cut back carbohydrates two days a week and try to eat sensibly the rest of the time. What that means is that you can eat protein, healthy fats, green vegetables, and 1 fruit on the two low carb days, but skip bread, pasta, and starchy vegetables like (potatoes & plantains), and sweets to stay under the 50g carbohydrate limit.

Adapted from article by L. Carroll for msnbc.com accessed at http://today.msnbc.msn.com/id/45587821/ns/today-today_health/t/cutting-carbs-just-days-week-can-spur-weight-loss/

Drinking 3 or More Drinks per Week Raises Risk of Breast Cancer

Corroborating prior studies, a recent study on 106,000 women, found women who drank the equivalent of 3-6 glasses (4 oz. each) of wine per week were 15% more likely to develop breast cancer than women who never or rarely drank. Women who consumed much more alcohol -- about two glasses of wine or the equivalent of beer (12 oz.) or liquor (1.5 oz.) a day -- had a 51% increased chance of being diagnosed with breast cancer during nearly three decades of follow-up.  This study also found that even as few as three alcoholic drinks (a drink is defined as 4 oz. wine/12 oz. beer/1.5 oz. spirits) a month were associated with a slightly increased risk of breast cancer.  The risk was similar whether women drank wine, liquor or beer.

Prior research has also found an association between alcohol consumption and breast cancer. One reason for the connection may be that alcohol raises levels of circulating estrogen, and high levels of estrogen are linked to breast cancer.  What made this study unusual is that information was provided about women's alcohol consumption over several decades. Many other studies have asked about alcohol consumption at a single point in time, but drinking patterns may change over a lifetime. 

Another recent study looking at the relationship between drinking and breast cancer found that drinking alcohol may be especially risky for young women who have a family history of breast cancer (including having a mother, grandmothers or aunts with the disease).  In this study, researchers examined data on more than 9,000 girls from 1996 (when they were aged 9 to 15) through 2007.  They focused on 67 participants who were later diagnosed between the ages of 18 and 27 with benign breast disease, a large class of conditions that can cause breast lumps or pain and can be a risk factor for breast cancer.

The researchers found that women who have a family history of breast cancer or breast disease were about twice as likely to develop both benign breast disease and breast cancer than women with no family history of the disease.  Risk of benign breast disease rose along with how much alcohol the young women consumed.

What to do:  Breast cancer risk appears to increase with cumulative alcohol consumption.  Therefore, women who occasionally over-imbibe on vacation or at a holiday party shouldn't be alarmed.  And women who drink 1-2 drinks per week are likely not substantially raising their risk for breast cancer.  However for those who are drinking 6-10 or more drinks per week, risk of breast cancer is significantly increased.  Persons with a family history of breast cancer should be especially aware of their alcohol intake.  For all women, it is likely best to limit intake to no more than 3-4 drinks total per week.  Remember a drink is defined as 4 oz. of wine, 12 oz. of beer, or 1.5 oz. of spirits.  Many portions are larger than this and could count as 2 drinks even if they are served in one glass.  It is also true that previous studies have suggested a glass of red wine daily has significant cardiovascular benefits, so this has to be weighed against the breast cancer risk.  For cardiovascular benefits, among types of alcohol, red wine appears to be most beneficial.  Still, it is not recommended that women who do not drink should start consuming wine daily for its cardiovascular benefits.

SOURCES: Wendy Y. Chen, M.D., M.P.H., assistant professor, medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass; Steven A. Narod, M.D., professor, Dalla Lana School of Public Health, University of Toronto, and research chair, breast cancer, Women's College Research Institute, Toronto, Canada; Nov. 2, 2011, Journal of the American Medical Association.

Anees Chagpar, M.D., M.P.H., director, The Breast Center at Smilow Cancer Hospital at Yale-New Haven, and associate professor, department of surgery, Yale School of Medicine, New Haven, Conn.; Nov. 14, 2011, Washington University School of Medicine news release.

Adapted from articles at:  http://www.nlm.nih.gov/medlineplus/news/fullstory_118685.html and http://www.nlm.nih.gov/medlineplus/news/fullstory_118204.html

Research Finds Vitamin D May Be Crucial in Preventing Cardiovascular Disease and Fighting Infections

A growing body of evidence is finding that adequate levels of Vitamin D are important not only in maintaining healthy bones but also in reducing risk for cancer, heart disease, stroke, diabetes, autoimmune diseases, and infections.  Unlike other essential vitamins, Vitamin D is a hormone your body can make when skin is exposed to the sun. Vitamin D is not present in most foods but is found in fortified milk and fatty fish.  However these sources do not provide adequate Vitamin D for many people, especially for persons who are older, obese, have darker skin, or live in colder climates like New York.   An estimated 40%-75% of people in the U.S. are deficient in Vitamin D. 

Here are some highlights of recent studies revealing the importance of Vitamin D to heart health.   It is believed Vitamin D reduces blood vessel inflammation and therefore is an important ingredient in the prevention of heart disease.  A recent review of 75 research studies on Vitamin D and heart disease concluded there is evidence low Vitamin D levels are associated with unhealthy blood pressure & blood sugar levels, and the development of coronary artery disease.  Several recent studies add to these conclusions. One study found that post-menopausal women with low Vitamin D levels have more risk factors for heart disease than those with adequate Vitamin D levels.  Another recent study found that people who took 4,000 IU of Vitamin D daily for five days following a severe heart event had less inflammation than patients who didn't take the supplement.  Another recent study found that among patients with chest pain, those with low Vitamin D levels were more likely to die during the next two years than those with adequate levels of the nutrient.  While an association between low Vitamin D and cardiovascular disease risk is now clear, it is not known if taking Vitamin D can prevent these health problems. 

Researchers have also recently made progress in understanding how Vitamin D is important to the body’s capacity to fight infection.  For example, a recent study found Vitamin D plays a critical role in the body's ability to combat tuberculosis (TB) infection, a potentially fatal infection of the lungs. Investigators examined how the body tries to stop the growth of M. tuberculosis, the bacterium that causes TB. They found the white blood cells, or T-cells, that are critical to the body's ability to fight off infections, cannot function properly without adequate levels of Vitamin D.  The research report noted that the connection between low Vitamin D and infection may explain why darker skinned persons (whose skin is less effective at generating Vitamin D when exposed to the sun) are more susceptible to TB. 

How Much Vitamin D Do You Need?  This is still being debated by the medical community.  Recently, daily Vitamin D recommendations were increased.  For adults up to age 69 it is advised to take in 600 IU/day, and for those who are 70 or more the recommended intake is 800 IU/day. A level of 4,000 IU has been set as the maximum amount that is safe to consume daily, unless directed otherwise by your doctor.

Vitamin D Sources:  Vitamin D is naturally present in only a few foods.  Mushrooms, particularly those dried in the sun (containing approx. 400 IU per 3 oz. serving), and fatty fish such as salmon (approx. 800 IU in 3 oz.) and sardines are natural sources of Vitamin D.   Also, in the U.S. the milk supply is fortified with 100 IU of vitamin D per 1 cup of milk. Food manufacturers are also fortifying other foods such as yogurt, cereal, and orange juice.  The sun is an effective source of Vitamin D, but dermatologists recommend using sunscreen (which blocks vitamin D production) and getting vitamin D from food and supplements rather than risk exposure to the sun, which is associated with greater risk of skin cancer.  Supplements are also a useful way to boost your Vitamin D intake. 

What to do:  Consume food sources rich in Vitamin D such as lowfat/nonfat milk and oily fish such as salmon.  Also, next time you get blood work with your regular doctor, you can request your Vitamin D level be checked.   This way you can know if you are deficient or not and how much to supplement with.  At our clinic we usually recommend patients take 800-1000 IU of Vitamin D3 (another form, vitamin D2, is less well used by the body).  Vitamin D3 is widely available in multivitamins, combined calcium and vitamin D supplements, and in stand-alone Vitamin D supplements.  To maximize bone health benefits, it is best to take Vitamin D along with Calcium.  Persons with some conditions such as sarcoidosis should not supplement with Vitamin D so it is always best to check with your doctor before starting supplementation.

Adapted from information found at http://www.nlm.nih.gov/medlineplus/news/fullstory_118730.html & http://yourlife.usatoday.com/health/story/2011-10-03/Is-the-sunshine-vitamin-good-for-the-heart/50647202/1  and from news releases from University of California, Los Angeles (Oct. 12, 2011) & American Heart Association (November 15, 2011).