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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Friday, December 28, 2012

HOW TO PUT NEW YEAR’S WEIGHT LOSS RESOLUTIONS INTO ACTION

While the year changes overnight people usually do not, especially when it comes to habits developed over a lifetime.  Studies show that most New Year’s resolutions to lose weight do not last.  Why is this?  One problem is that most resolutions do not include a realistic action plan.  Many people plan to lose an unrealistic amount of weight and aim for drastic changes to their diet and exercise pattern.  When they fail to stick with the extreme changes they envisioned making, they throw in the towel.  But, you can succeed in lasting weight loss.  Follow these 5 essential guidelines to put your weight loss goals into action. 

#1 – Be in it for the long haul.  The only way to achieve lasting weight loss is to adopt a food and activity lifestyle change – something you can live with over the long-term.  When people adopt a very restrictive diet, they lose weight but they usually do not stay on the diet.  When we lose weight, we still have the extra fat cells we had at our heavier weight, they are just smaller.  So, it is more challenging for someone who has gained and lost than someone who has never gained, to maintain their weight.  Chances are, once you lose weight, if you return to your pre-diet intake, the lost weight will come back on.  So, recognize that sustaining loss demands long-term changes, not crash diets.   

#2 - 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 what they consume lose twice as much weight as those who do not, 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.  Websites and “apps” provide you with a weight loss calorie goal and count your caloric intake helping you to budget your intake and stay under your calorie limit.  At NYCC, we like the “app” and online site Calorie Counter & Activity Tracker at MyFitnessPal.com.  It is free, and, if you choose, this application allows your nutritionist or friends to view your diary. 

It is also useful to track your weight either weekly or daily.  Day-to-day weight will always fluctuate but the scale can help you to stay focused.  Tracking your weight also gives you great feedback on whether the changes you have made are working or if you need to make additional changes to achieve weight loss. 

#3 Get physical. Research demonstrates that activity helps with weight loss not only because it increases the total calories we burn but also because it helps individuals focus on their health goals.  Working out also helps to improve mood, self-image, and appetite sensitivity.  Armed with a positive perspective we are much better at following through on challenges.  Both cardiovascular and resistance training are useful.  Cardio (exercises that increase your heart rate) especially helps to burn calories and improve mood.  Resistance activity helps to build muscle and increase metabolism.  The best activity is the one that you will do.  Research shows that when you exercise with a friend you are much more likely to stick with your goals.  Sometimes working out at home with an exercise DVD or video game or going for a brisk walk is easier to work into your routine than going to a gym. No matter what activity you do, always increase your activity slowly and, if you have health problems, talk to your doctor before starting a new exercise plan.

#4 Learn from slip-ups. Making changes to diet and activity is hard work.  Sometimes you are going to make a decision that is not in line with your health goals.  This is O.K.  Instead of deciding you are a failure, forgive yourself and then review the set-back and how you could reduce the likelihood of having the same problem in the future.  By learning from your experience, you can improve your ability to stick with a healthy diet and active lifestyle.

#5 Build social support.  Making dietary and lifestyle changes is easier with the support of family, friends, and colleagues.  Try to communicate the changes you are trying to make to the persons in your household.  Let them know specific measures they can take to help you such as giving you space to exercise or keeping tempting foods out of the house.  Friends can also be useful allies.  Having an exercise buddy is ideal but friends can also help by calling to encourage you to make your workouts.  It can also be motivating to note your progress with your online social network.  The myfitnesspal.com site and “app” also allows you to “friend” other dieters who can help you problem-solve and offer support.     

Thursday, December 13, 2012

THINKING YOU ATE A LOT MAY HELP YOU FEEL FULL LATER

 When it comes to our perceptions of fullness and food satisfaction, our minds play a central role.  For example, in numerous studies it has been found that when people are lead to believe what they are eating is decadent they like the item better than when they are told the item is healthy.  And, when people visualize eating an item, not just having a passing thought about a food, but going through the mental process of the action of consuming the food, their perceived hunger and cravings for the item are diminished.  Adding to these findings, a new study has demonstrated that when people believe they have consumed a large portion, even when the actual portion is small, they feel less hungry hours after the meal.

This study included volunteers who were given what appeared to be either a small or large portion of soup for lunch. The researchers, however, manipulated the amount of soup the volunteers actually consumed by using a hidden pump that could refill or empty a soup bowl without the eater noticing.

They found that immediately after they ate, the volunteers' level of hunger matched the amount of soup they had eaten, not the amount they had seen just before eating. But two to three hours after lunch, those who had seen a larger portion of soup had significantly lower levels of hunger than those who had seen a smaller portion.  And, 24-hours after eating the soup, more of the volunteers who had seen a larger portion of soup (but had in fact consumed a smaller portion) believed that the portion they had consumed would satisfy their hunger
Lead researcher Dr. Jeffrey Brunstrom and his colleagues said their results demonstrate the independent contribution of memory processes to feelings of satiety after a meal.  "This study is exciting because it exposes a role for cognition in the control of hunger - appetite isn't governed solely by the physical size and composition of the meals we consume,” said Burnstrom.

What to do:  To help you reduce your portions while feeling satisfied, serve your meals on dishes that make the portion look bigger such as shallow bowls, small plates, and glasses that are tall and thin (rather than short and wide).  Engage your mind in the process of eating.  Remove distractions such as television and phones and eat your food slowly, savoring each bite. 

Adapted from articles available at:

http://www.foodnavigator-usa.com/Science/All-in-the-mind-Meal-memories-may-influence-later-feelings-of-satiety

Source:
Brunstrom JM, Burn JF, Sell NR, Collingwood JM, Rogers PJ, et al. (2012) Episodic Memory and Appetite Regulation in Humans. PLoS ONE 7(12): e50707.doi:10.1371/journal.pone.0050707

Tuesday, December 4, 2012

SKIPPING BREAKFAST INCREASES APPEAL OF HIGH CALORIE FOOD CHOICES

Your mother was right!  A mounting body of research has found that breakfast may indeed be the most important meal of the day.  For example, those who eat breakfast are less likely to become overweight/obese and more likely to maintain weight loss.  And, when people eat breakfast they have more balanced blood sugar levels throughout the day and are less likely to overeat at the end of the day. 
An interesting recent study examined brain scans when individuals had and had not eaten breakfast.  21 healthy weight individuals were shown pictures of foods while having an MRI taken of their brain.  On one day they were given no breakfast before the scans and on a different day they were fed breakfast an hour and a half before the scans.  In response to low calorie foods, there was no difference between the level of activity in the participants’ orbitofrontal cortex (the area of the brain believed to be involved with food appeal).  However, the brain response to high calorie items was much greater among those who had missed breakfast than those who had eaten.    The researchers said skipping breakfast created a "bias" in the brain in favor of high calorie foods, making it much more difficult for the individual to make a healthy choice.  When the researchers offered the participants lunch at the end of the study, people ate 20% more calories and chose less healthy items if they had missed breakfast.  
What to do:  Eat a healthy breakfast!  A healthy breakfast should contain a combination of nutrient-rich carbohydrates such as whole grains; fruits and/or veggies; some lean dairy or other protein source such as eggwhites; not too much fat.
Adapted from article available at:  http://www.bbc.co.uk/news/health-19962588.

CALCIUM SUPPLEMENTATION FOUND NOT TO INCREASE RISK OF HEART DISEASE


New findings conclude that calcium supplements, widely prescribed for bone health in women, do not appear to be associated with increased cardiovascular risk.  This study offers strong support against a link between calcium supplementation and cardiovascular problems.

The potential for calcium supplementation to increase heart disease risk in women has been a subject of intense scrutiny in recent years after some studies uncovered an apparent association between calcium supplements and heart disease.  However the results of this most recent study, based on a landmark 20-year study that tracked more than 75,000 women found no link between calcium supplementation and heart disease, and that supplementation with calcium, if anything, slightly reduces the risk of heart disease.
 
In this study, Dr. Julie Paik from Harvard Medical School analyzed data from the Nurses' Health Study in the U.S., which began enrolling women in 1976 at ages 30-55.  Over the next 24 years participants’ lifestyle, diet, supplement intake, and medical records were tracked.  Researchers took into account other factors that are known to affect heart health risk including diet, weight, activity, smoking, family history, smoking, alcohol intake, and aspirin use as well as other patient characteristics.  Their analysis indicated that among participants who supplemented with 1,000 mg or more of calcium, risk of getting heart disease overall was slightly reduced.  And, participants’ risk of having a fatal heart attack or stroke appeared unaffected by supplementation.

The main previous work pointing to a possible link between calcium supplementation and heart health risk tracked more than 24,000 Swiss women over an 11-year period.  This research found that participants whose calcium intake from all sources was moderate -- 820 mg a day -- had a lower risk of heart attack than those whose intake was less than 820 or more than 1,100 mg.   And, when the researchers singled out those who supplemented with calcium, they found a significantly increased risk of heart disease. 

The researchers in the Swiss study postulated that unlike many dietary sources with small amounts of calcium, supplements could cause greater fluctuations in blood calcium and possibly contribute to hardening of the arteries.  Still, many experts felt that such an effect was unlikely because the body can only absorb about 500-600mg of calcium at a time.  And, supplements typically contain about 500mg, equivalent to the amount of calcium in 1 cup of milk plus 1 oz. of cheese.  There are other experts who advise that when calcium supplements are combined with vitamin D they are better utilized and therefore less likely to lead to a potential high blood calcium level.  This study did not address whether individuals were taking calcium alone or in combination with vitamin D.  In response to the findings from the Swiss study, Dr. Robert Recker, director of the Osteoporosis Research Center at Creighton University stated, "It's hard to understand why calcium in the diet can reduce the risk of heart attack, but supplements increase the risk."  He stated that he felt these findings could reflect a bias where those already at risk for heart attacks took supplements in hopes of reducing the risk, but some had heart attacks nonetheless.  Because the results of this study seem contradictory and the recent findings by Paik and colleagues found no association between supplementation and heart disease, most experts continue to recommend that adolescent girls and women over 50 who do not consume a diet rich in calcium take ~500 mg of calcium combined with ~200-600 IU of Vitamin D two times per day.

What to do:  Consume a diet rich in calcium as calcium rich diets have consistently been found to be good for bone health and blood pressure as well as other aspects of health.  Dairy products and fish that contain bones (such as sardines) are the richest food sources of calcium.  When choosing dairy always opt for nonfat or lowfat to avoid unhealthy saturated fats.  Dark green vegetables also have significant calcium but it is harder for the body to absorb the calcium they contain.  Many products such as soy milk, cereal, and orange juice are fortified with added calcium. During adolescence, when bone is built most rapidly, adequate calcium intake is essential to life-long bone health.  Talk with your doctor to determine if calcium with vitamin D supplementation is right for you.

Adapted from articles available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_125506.html
http://www.consumer.healthday.com/Article.asp?AID=665054

Sources:
Paik J, et al "A prospective study of calcium supplement intake and risk of cardiovascular disease in women" ASBMR 2012; Abstract 1135.


Li K et al. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg). Heart 2012 Jun; 98:920. 

Tuesday, November 20, 2012

PORTION CONTROL AND PLANNING CAN KEEP AWAY THOSE HOLIDAY POUNDS

From Thanksgiving to the New Year’s Eve toast, the opportunities to overindulge are nearly endless. There is a common misconception that holidays are so infrequent that eating done only on special occasions doesn't matter. But, the celebrations can add up with parties, work events and family gatherings.  And several high calorie days can significantly derail your weight management goals.  For example, on Thanksgiving, the average American consumes 4,500 calories and 229 grams of fat. That's at least 2-3 times what one needs to eat in one day.  The average holiday weight gain according to a 2000 study by the National Institutes of Health is 1-2 lbs.   A pound is not so much, but people tend to not lose the weight when the holidays are over so it adds up over time.  Also, while the average for the general population is just 1 pound gain, for those who are obese, average weight gain is 4-6 lbs.
Enjoying the food is a big part of enjoying the holidays, but it doesn’t have to add inches to your waistline. It is possible to eat foods traditionally associated with holiday celebrations and to stick with a weight-loss plan.  Try to maintain a clear idea about your weight goals during the holiday season and don't let small setbacks completely derail progress.  The following tips can also help to prevent holiday weight gain.
1.      Minimize mindless munching. Nibbling before and after a big holiday meal is a sure way to add significant calories. Between the eggnog, cheese ball, homemade cookies and candy, it’s easy to top 1,000 calories before sitting down to dinner. The same goes for the goody trays in the break room at work. What to do? Survey the culinary landscape and decide what you really want. Keep the portion reasonable and then leave the food table.

2.      Enjoy the turkey, but don’t gobble. This isn’t an eating contest, so slow down! Truly enjoy the rich pleasure of the foods you don’t get every day. Let the food linger on your tongue. You may discover a sense of satisfaction with half your typical portions when you take time to slow down and enjoy the food you’re eating.

3.      Portion control, portion control, portion control:  Make those special, holiday-only foods manageable by savoring them slowly in limited portion sizes.  Skip the items that you do not really care about.  It can also be helpful plan ahead for a dinnertime celebration by having a lighter breakfast and lunch that day, but do not skip meals as that often leads to overeating later.  To control daily calories in the face of frequent celebrations, some people find it helpful to substitute a calorie-controlled meal replacement for 1-2 meals per day during the holiday season.

4.      Plan ahead & make wise choices:  Plan ahead before heading to a holiday gathering or party.  Know what will be served and figure out what it is you really want and if it’s worth the calories.  If you can live without your mother’s pumpkin pie but not her sausage stuffing, then have some stuffing.  The same goes for a holiday buffet: scan the table first before filling your plate and decide which foods you can live without. Choose small portions of the foods you want to enjoy, filling your plate once.  If you’re asked to bring something to a gathering, try bringing something healthy, like veggies and low-fat dip, instead of cookies.  That way, if there are leftovers, you will go home with a healthy option rather than problem treat.

5.      Use high-protein and high-fiber foods to your advantage. Lean meats, poultry, fish and green vegetables can help you feel full when you’re hungry without adding a burdensome load of calories. To avoid going to a holiday party too hungry — eat something high in fiber and/or protein before heading out.  Have ready-to-eat veggies with hummus, a cheese stick with fruit, a Greek yogurt cup, or a small portion of fiber rich cereal to help curb your hunger. 

6.      Beware of liquid calories. Being aware of the calories you’re drinking during the holiday season is also important to maintain a healthy weight. A cup of regular eggnog can have up to 500 calories and that Starbucks white hot chocolate with whipped cream will cost you even more calories. Factor in alcohol, sugar-loaded punch drinks, hot cider and more and see how liquid calories add up. What to do? Choose “light” or “diet” drinks and drink lots of water. Choose hot tea or coffee in place of hot chocolate or cider.  And, if you really must indulge in Eggnog, the “light” eggnogs being sold are a significantly better calorie deal.  Alcohol not only provides empty calories but it decreases one's resolve to stick to an eating plan, so use moderation when it comes to drinking. Diluting wine with club soda can make a tasty wine spritzer that has less alcohol and less calories. 

7.      Channel your inner-Santa in non-food ways.  It can also be helpful to channel your holiday spirit in ways that are not focused on food.  For example, too add activity, consider celebrating the season by going skating or going for a holiday lights walk.  Decorating, crafts, and gift giving can also satisfy the homemaker in you without running the risk of exposing to more homemade treats. And, if you are determined to bake consider giving friends with dogs homemade pet biscuits rather than items you might be tempted to sample. 

8.      Get moving.  Don't slow down or stop physical activity during the busy holiday months. Instead, try to maintain or even increase activity and exercise levels to compensate for additional caloric intake.  On holidays with big meals, try to get active in the morning.  Go outside with the kids to toss the football around, grab your music and take a brisk walk, or prepare for your mall shopping by doing some determined walking laps around the space first. Simply moving more can help burn off extra calories, tone your muscles, and work off some of the holiday stress.

Tuesday, November 13, 2012

HEALTHY FATS: PART OF A BALANCED DIET

Think you need to take fat out of your diet in order to be healthier and lose weight?  Not so.  To lose weight, you have to use more energy than you take in.  Calories are the measure of the energy in foods.   If you consume too many calories, whether from protein, fat, or carbohydrates, the body will store the extra energy as fat.   With more than double the calories of proteins and carbohydrates, fat calories can add up quickly and lead to weight gain, but, when consumed in moderation, healthy fats are an essential part of balanced, heart healthy diet.  
Fat is needed for the absorption of the essential fat soluble vitamins A, D, E and K that help protect vision, immune system function, and bone health. Moreover, fat is needed for the manufacture of hormones in the body, the membrane lining in every cell, and the sheath surrounding every nerve cell.
GOOD VS. BAD FATS
Fish and plant sources of fat are good for health while meat and dairy sources are detrimental.  To incorporate good fats into the diet without gaining weight, use them in place of less nutritious calories such as those in cream and meat fats, sugary snacks, and refined grain products.
The “Bad” Fats
Modern diets tend to be high in the unhealthy fats found in meat and dairy, and hydrogenated oils.  These fats increase your risk of heart disease and clogged arteries by increasing blood cholesterol and inflammation in the body. 
x Saturated fats - Limit intake of products high in saturated fat including meat, lard, chicken skin, coconut and palm kernel oil, shortening, butter, cheese, cream, and other full-fat dairy products. It is recommended that no more than 7% of your calories come from saturated fat, so for an 1800 calorie diet that would be less than 14g of saturated fat.  This can be challenging when you consider 4 oz. of prime ribs has this much saturated fat. Look at the nutritional facts labels to choose products low (less than 5% of the Daily Value listed on food labels) in saturated fat. 
x Trans fats.  Completely eliminate trans fat from your diet.  This is an artificial fat added to products such as pre-made frosting, margarines, baked goods, and snack foods.  Check labels to make sure the trans fat is 0g.  If a product contains “hydrogenated” or “partially hydrogenated” oil, than it contains trans fat.
The “Good” Fats
When consumed in moderation, healthy plant- and fish-based sources of fats help to reduce inflammation in the body and lower blood cholesterol and triglycerides. How much is enough? Recommended fat intake is 20-35% of calories.  For an 1800 calorie diet, this would be the equivalent of 3-5 tablespoons of oil.
R Monounsaturated and polyunsaturated fats.  These are found in plant foods that contain fat such as nuts, seeds, avocados, olives, soy beans, and vegetable oils. 
R Omega-3 fats.  These, found in naturally oily fish such as salmon, tuna, herring, and mackerel, are particularly beneficial for the heart & help to lower blood triglycerides. Because our body is unable to make omega-3 fats, it is important to regularly consume fatty fish.
THE SKINNY ON FAT:  10 TIPS FOR MAKING HEALTHY CHOICES
1.      Choose Oily Fish Twice a Week or More.  Eat seafood in place of meat or poultry at least twice a week.  Tuna, salmon, trout, herring, sardines, halibut, rainbow trout, and scallops are excellent sources of heart healthy omega-3 fats.  Prepare your fish without butter, which contains 7g of saturated fat in each tablespoon.

2.      Have Meat Less Often. Try reducing intake of saturated fat by replacing some of the meat you eat with beans, skinless chicken, or fish.

3.      Choose Lowfat & Nonfat Dairy Products. Dairy is naturally high in saturated fat.  Each cup of whole milk contains 5g of saturated fat, so concentrated sources of dairy fat like cream, butter, and cheese are especially artery clogging.  Still, dairy contains many healthy nutrients including protein, calcium, and potassium, so include dairy but choose low or nonfat options. 

4.      Make Meat & Poultry Lowfat.  Choose lean or low-fat cuts of meat like round or sirloin and ground beef that is at least 90% lean. Trim or drain fat from meat and remove poultry skin. 

5.      Use Oil or Margarine Instead of Butter.  Use liquid vegetable oils such as olive or canola instead of lard, shortening, or butter.  Try topping bread, cooked vegetables and popcorn with olive oil and a little salt. When baking muffins, cookies, sweet breads, and moist cakes, try canola or vegetable oil in place of butter.  For every ¼ th cup of butter called for, substitute 2 ½  -3 tablespoons of oil.  For a more butter-like substitute than oil, look for margarines low in saturated fat (i.e. 1.5g or less per tablespoon) with no partially hydrogenated oil.

6.      Add Avocado. Try them in sandwiches or salads or make guacamole. Also, a healthy alternative to mayonnaise for moistening sandwiches and tuna salad.

7.      Go for Nuts.  Have ¼th cup of nuts or seeds for a healthy snack or add them to stir-fries, vegetable dishes, salads, yogurt, and cereal.  Use them instead of breadcrumbs on chicken or fish.  Blend them into smoothies.  Stay away from salted and sugary nuts - these are less healthy and easy to overdo. 

8.      Dress Your Own Salad. Commercial salad dressings are often high in saturated fat or made with damaged trans fat oils. Create your own healthy and flavorful dressings with olive, flaxseed, walnut, or sesame oil.

9.      Watch Out for Fat-free Junk Food. A “fat-free” label doesn’t mean you can eat all you want without consequences to your waistline. Many fat-free foods are high in sugar, refined carbohydrates, and calories. 

10.  Don't Spoil Your Oil.  A good fat can become bad if heat, light, or oxygen damages it. Oils such as flaxseed, soy, corn, and vegetable are rich in polyunsaturated fats, which are most susceptible to damage. To best preserve these oils keep them refrigerated in an opaque container.  When cooking over the grill or stovetop with oil, avoid heating the oil so much that it changes color or begins to smoke. When this happens, the oil has degraded, producing possible carcinogens and off-tastes.  Oils smoke at different temperatures.  Filtered/light/refined olive oil is one of the best choices for cooking at high heat.  Never use oils, seeds, or nuts after they begin to smell or taste rank or bitter.   

Wednesday, October 31, 2012

OVEREATING CAUSES BRAIN INSULIN RESISTANCE, INCREASING DIABETES RISK



New research suggests that chronic overeating can lead to insulin resistance within brain cells, and when the brain becomes insulin resistant it fails to properly regulate the breakdown of fat stored in the body as well as the production of glucose by the liver.

While stored fats are important energy sources during fasting, their release into the bloodstream when the body is in a fed state, leads to multiple metabolic problems including elevated blood sugar and blood cholesterol, and increased levels of inflammation throughout the body. Previously it was believed that insulin's ability to suppress fat breakdown in healthy persons was entirely mediated through the fat tissue cells but recent findings suggest that brain cells’ response to insulin is a key regulator of fat breakdown. 

In this most recent study, Dr. Christophe Buettner and his research team at Mt. Sinai School of Medicine demonstrated, at least in rats, that overeating drives brain insulin resistance. For 10 days researchers fed one group of rats their usual weight- maintenance diet while they fed another group a diet with 150% of their caloric needs. The researchers then infused a tiny amount of insulin into the brains of both groups of rats. Unlike in the control diet group, in the overfed group, the addition of insulin to the brain failed to suppress the release of glucose from the liver and fatty acids from fat tissue. While this study was not conducted in humans, it is probable that a similar process of brain insulin resistance occurs in humans.  Certainly human studies have demonstrated that temporary overeating produces similar patterns of metabolic dysfunction in the liver and fat tissue. 

What to do: These findings remind us that not only excess weight but that overfeeding itself also drives insulin resistance and the metabolic problems that lead to diabetes and heart disease. Certainly, maintaining a healthy weight by following a healthy diet moderate in calories and getting regular activity minimizes the risk of diabetes.  But, even among persons with excess weight, avoiding overeating (even when weight loss is not achieved) can help to moderate insulin resistance and the processes that drive the development of diabetes.

Adapted from article available at: http://www.sciencedaily.com/releases/2012/10/121017153911.htm & http://www.sciencedaily.com/releases/2011/02/110216123547.htm

Sources:
T. Scherer, C. Lindtner, E. Zielinski, J. O'Hare, N. Filatova, C. Buettner. Short Term Voluntary Overfeeding Disrupts Brain Insulin Control of Adipose Tissue Lipolysis. Journal of Biological Chemistry, 2012; 287 (39): 33061 DOI: 10.1074/jbc.M111.307348.

Thomas Scherer, James O'Hare, Kelly Diggs-Andrews, Martina Schweiger, Bob Cheng, Claudia Lindtner, Elizabeth Zielinski, Prashant Vempati, Kai Su, Shveta Dighe. Brain Insulin Controls Adipose Tissue Lipolysis and Lipogenesis. Cell Metabolism, 2011; 13 (2): 183 DOI: 10.1016/j.cmet.2011.01.008

TRICKS FOR KEEPING HALLOWEEN HEALTHY


According to a recent study, the average child gains 2.2 lbs of extra weight from eating Halloween candy.  Because many children are overweight or at risk of becoming overweight, this Halloween weight gain can have serious health consequences. Here are some tips for how trick-or-treaters can enjoy a healthier, lighter Halloween. Here are tips for kids and on the reverse, for adults.

For Kids
·    Try providing a moderately sized trick-or-treat basket and establishing that no more treats than can fit in the basket can be collected.  Also consider offering non-food treats or small sums of money that they can trade the treats in for.

·    A good meal prior to parties and trick-or-treating.  By filling up on healthy choices, everyone will feel less of an urge to splurge on sweets after trick-or-treating is over. It is also a good idea to provide healthy alternatives for you and your kids. Keep a ready supply of nuts, reduced-fat cheese sticks, and fresh fruit on hand.

·    Set an example.  If children see you taking handfuls of candy they are likely to follow suit.  Try to emphasize quality over quantity.  Eat candy slowly and teach your children to savor it.  Have a contest to see who can eat a piece of candy the slowest.

·    Try to ration treats for the days following Halloween.  One way to ration the candy and encourage moderation is to number small pieces of paper from one to five and place them into a hat. Every day for two weeks, have your children pick a number and whatever they choose, that's the amount of candy they may have for the day.

·    It may not be easy but try shaping at least part of your kid's Halloween experience around something other than candy.  This could be making seasonally themed art projects such as masks or carving pumpkins and/or attending seasonal events such as haunted houses, hay rides, pumpkin patches, or corn mazes.

·    Sugary foods like candy, especially carmel-type candy that sticks to the teeth and sour candies that are acidic, promote tooth decay.  To minimize damage to the teeth, rather than spreading candy intake throughout the day, try to limit intake to occurring at the end of 1-2 meals per day.  Dentists recommend rinsing with water after eating candy and then waiting about 20 minutes before brushing because the acidic environment created by many candies can actually make the teeth vulnerable to damage when brushed. 

For Adults
·    Establish a "no leftovers" rule at the office for yourself. For all your careful preparation at home, it's sometimes hard to avoid the leftover candy colleagues bring to work. Stashing healthy snacks in your desk drawer or keeping chewing gum on hand to keep your mouth busy may help to stave off temptation.

·    Don't get taken in by clearance sales.  After Halloween, stores will try to move leftover candy as quickly as possible. By avoiding the candy aisle altogether, you won't be tempted to take advantage of the lower prices.

·    Allow yourself a treat so you don't feel deprived. No one said you shouldn’t enjoy a little splurge on Halloween. It is, after all, an occasion that comes but once a year. Treat yourself to one or two small pieces of dark chocolate (with nuts, if you like).

·    Before you pop that innocent looking fun-sized Snickers bar into your mouth it may help to put the calorie count in perspective. A 150-pound person burns about 60 calories during a 15-minute, moderately paced walk.  That means you'll have to stroll for at least 30 minutes to cancel out two of those tiny treats. Before you start, ask yourself if you can you really stop at a couple and is the calorie cost really worth it to you.

·    For the trick-or-treaters that come to your home, buy candy you don't like to limit the temptation. For example, if you're a chocoholic, give out Smarties instead.  Or, if you know all candy is dangerous, consider handing out something non-edible but cool.  Items like glow necklaces, mini crayon packs, stickers, or temporary tattoos are often appreciated, especially as kids will have plenty of candy from other sources.

·    Also, to minimize the risk of having candy in the house, buy your trick or treat candy at the last possible minute and get rid of any leftover candy as soon as possible. 

Saturday, September 8, 2012

WEIGHT LOSS AFTER WEIGHT GAIN LEAVES BEHIND EXTRA FAT CELLS AND WEIGHT IN THE LOWER BODY

If you temporarily gain - and then lose - even a small amount of fat, does your body return to how it was before gaining?  A recent study by researchers at the Mayo clinic found that in fact the body does not return to its pre-gain composition and that weight is not lost in the same pattern that it was gained.  For this study, researchers had 15 men and 8 women in their 20’s and 30’s increase their weight by 5%.  Depending on energy needs, subjects were given one, two, or three of the following each day: a 400-calorie ice-cream shake, a 510-calorie king size Snickers bar, or a 360-calorie cup of Boost Plus.
After eight weeks of being overfed, the body composition of subjects was assessed.  Subjects averaged a gain of about seven pounds of fat and one pound of muscle.  61% of the extra fat, on average, was upper-body subcutaneous (fat just below the skin), 12% was visceral (fat deposited around the internal abdominal organs), and 27% was lower-body (primarily hips and buttocks).
Next the subjects were prescribed calorie restricted diets and additional exercise to lose the weight gained.  After eight weeks, subjects had lost an average of five pounds.  Thus, subjects were able to gain weight faster than they were able to lose it.  Also, weight that was put on in the lower body decreased less than abdominal weight, so that the process of weight gain and then weight loss caused subjects to retain more weight in the lower body.
Consistent with previous studies, the researchers found that when participants gained weight the number of fat cells in their body increased.  However, when they lost weight, the additional fat cells decreased in size but remained at increased numbers.  One disadvantage of having additional fat cells, especially when they lose stores, is that each cell produces hormonal signals that increase hunger levels.  This study points to the fact that once weight is gained, even if it is eventually lost, the body does not return to its original leaner state. 
What to do:  Aim to prevent weight gain by consuming a healthy diet, getting regular activity, and monitoring your weight.  Because after weight loss we retain extra fat cells that produce hunger signals, it is more challenging to maintain lost weight than it is to maintain a healthy weight.  This does not mean maintaining loss is impossible but that sticking with the healthy behaviors you have acquired during weight loss is key to long-term weight loss maintenance. 
Adapted from article in Nutrition Action Healthletter, Sept. 1, 2012, pg 8.
Source:  Singh P, Somers V, Romero-Corral, et al.  Effects of weight gain and weight loss on regional fat distribution. Am J Clin Nutr; July 3, 2012, doi: 10.3945/ajcn.111.033829 available at http://ajcn.nutrition.org/content/early/2012/06/28/ajcn.111.033829.full.pdf

Wednesday, September 5, 2012

CHRONIC 'BUTTER FLAVORING' EXPOSURE LINKED TO HARMFUL BRAIN PROCESSES ASSOCIATED WITH ALZHEIMER'S DISEASE

Diacetyl is used to give a buttery taste and aroma to common food items such as microwave popcorn, margarines, snack foods, candy, baked goods, and other products.  Previous studies have linked diacetyl to severe respiratory disease (so-called “popcorn-lung”) among workers at microwave popcorn and food-flavoring plants.  Cases of frequent consumers of microwave popcorn also suffering related lung problems have been reported as well.  Now researchers at the University of Minnesota have uncovered yet another reason to steer clear of this common flavor additive.  The chemical structure of diacetyl is similar to a substance that makes beta-amyloid proteins clump together in the brain. This clumping is a hallmark of Alzheimer's disease.
The recent research linking diacetyl with Alzheimer’s disease processes was conducted in a lab using cell cultures not living organisms but their findings of how the additive influences physiologic processes is cause for concern none the less.  Previous experiments have revealed that diacetyl crosses the "blood-brain barrier," which helps protect the brain from dangerous substances.  This means that when inhaled or ingested, diacetyl can potentially reach the brain.  The current research found that when brain cell cultures were exposed to levels of diacetyl similar to that experienced by popcorn factory workers, the diacetyl increased the amount of beta-amyloid clumping and that diacetyl also prevented a beneficial protein from protecting the brain cells.
What to do:  While this was only a laboratory study, the fact that chronic diacetyl exposure has been linked to lung disease, justifies minimizing exposure to the additive.  To spare your lungs, reduce your salt intake, and save money, make your own microwave popcorn.  Add ½ cup of popcorn kernels (optional: toss kernels with ½ tsp oil, salt, and/or spices) to a sack lunch paper bag. Shape the bag so that it can sit up and fold the top of the bag over just once and put one staple in the middle (this will not cause sparking).    Cook at full power for 2 ½-3 minutes, or until you hear pauses of about 2 seconds between pops. Carefully open the bag to avoid steam.  Enjoy!
Information adapted from article available at: 
http://www.cdc.gov/niosh/topics/flavorings/
SOURCE: American Chemical Society, news release, Aug. 1, 2012

Tuesday, September 4, 2012

BREAD WINNERS: MAKING A HEALTHY CHOICE IN THE BREAD AISLE

BREAD WINNERS:  MAKING A HEALTHY CHOICE IN THE BREAD AISLE
Bread remains a staple in the American diet with the average American consuming 53 pounds of bread each year.  Because we eat bread so often, it is particularly important that we select a nutritious choice.  However, with the array of products labeled with healthy sounding phrases like “wheat”, “cracked”, “stone-ground”, and “multi-grain”, it can be quite challenging to determine which products are the most nutritious.   Here’s what you need to know to be a savvy bread shopper.
GRAIN BASICS
Before it is processed, a wheat kernel is a whole grain comprised of the outer layer known as the bran, the inner bulk called the endosperm, and the grain’s core, called the germ. The outer sheath, the bran, is rich in fiber, B-vitamins, and minerals. The germ is the portion of the grain that sprouts to generate a new plant. It is full of B-vitamins, antioxidants, and vitamin E.  The endosperm, making up the volume of the grain, is comprised of starch and some protein. 
To process whole grain flour into refined white flour, the nutrient-rich bran and germ are removed, leaving behind only the starchy endosperm.  
SELECTING A HEALTHY BREAD PRODUCT:  UNDERSTANDING THE FRONT OF THE PACKAGE
-Choose 100% whole: If the packaging says “100% whole grain” or “100% whole wheat” this is your guarantee that the bread contains no white flour.
-Whole vs. 100% whole:  If the packaging says “whole grain” or “whole wheat” this means that the product is comprised of 51% or more whole grains.  So, beware, these products may contain nearly as much white (refined) flour as whole grain flour. Ingredients are listed in descending order based on how much they weigh in the product. This means that the first ingredient is the most prevalent ingredient.  To determine if a product is mostly whole grain check to see where the whole grains appear in the ingredient list.    
-Multi-grain does not mean whole:  When the package says “multi-grain”, this simply means that there are different kinds of grains (i.e. oat, wheat, rye, barley, etc.) in the product.  Whether these are whole or refined grains has nothing to do with number of different grain sources.
-Other names for white flour:  Do not fall for deceitful terms such as “wheat flour,” “unbleached wheat flour,” “multigrain,” “enriched,” or “stone-ground wheat flour” on the package or ingredients list.  These are just sneaky ways of saying the product contains refined white flour. 
-White flour vs. white whole wheat:  Regular whole wheat flour is made from a variety of wheat known as red wheat. White whole wheat breads are made from a special variety of albino wheat. White whole wheat flour is as nutritious as regular whole wheat flour, but bread made with white whole wheat flour has a milder taste and texture due to the characteristics of that particular type of wheat.  For picky eaters (including kids) who don’t like the taste of regular whole wheat bread, white whole wheat bread could be a good option.
SELECTING A HEALTHY BREAD PRODUCT:  SIZING UP THE NUTRITIONAL LABEL
-Calories:  Aim to choose slices that have no more than 100 calories.  With bread, if it is thinner, it generally has fewer calories.  Pita and “thins” or “flats” (that offer a svelte sandwich top & bottom for 100 calories) have about half the calories of regular slices.  Another calorie conscious option are the breads labeled “light”, “diet”, or “low-carb”.  These are formulated to contain less of the digestible grain carbohydrate than regular slices. 
-Sodium:  Bread is the leading source of salt in the American diet.  Because salt is baked into the bread rather than being on the surface (such as with chips) it does not necessarily taste that salty but a typical slice has 220mg sodium.  This means 2 typical slices can have around a third of the advised 1500 mg daily sodium limit. Try to make choices with less than 120mg of sodium per slice.  
-Fiber:  Most Americans get much less than the recommended 25-30g of dietary fiber.  Whole grain options contain the grains’ bran making them naturally high in fiber.  Many breads are also formulated with added fiber, though this may not have all the benefits of the naturally occurring fibers.  Look for a 100% whole grain slice with 2g or more of fiber. 

Saturday, August 25, 2012

WATCHING YOUR WEIGHT? SERIOUSLY, WATCH OUT FOR RESTAURANT MEALS.

The more you eat out, the more likely you are to be overweight or obese. A mounting body of evidence clearly links eating out with obesity, hypertension, and heart disease.  Two new studies bring to light just how bad for our health eating at restaurants is. 

In one study researchers compared the caloric intake of subjects’ meals at home and at restaurants.  More than 1,000 men and women were asked to record everything they ate at home and at restaurants for one week. People of normal weight averaged 550 calories per meal at home while their average restaurant meal intake increased to 825 calories. For people who were overweight or obese, a typical meal at home had 625 calories while at restaurants their meals increased to 900 calories.  Researchers also found that meals out contained less whole grains and less vegetables than meals at home.

A second new study quantified just how many calories, sodium, and unhealthy saturated fat were in the menu offerings of more than 28,000 dishes served at 245 different restaurant chains nationwide. Surprisingly, they found that the average appetizer contained 700 calories and included more fat, saturated fat, and sodium than other menu categories.  A quarter of the appetizer offerings had more than 1,145 calories.  They also found that entrees had an average 590 calories not including the typical side dish with 210 calories, dressed salad with 560 calories, non-alcoholic beverage with 360 calories, and bread offerings with 355 calories.  Fewer than 3% of entrĂ©e offerings were within the USDA guidelines for sodium and unhealthy saturated fat. 

The high calorie cost of restaurant food has been shown to substantially influence weight outcomes.  Lisa Mancino, a food economist for the USDA, has found that for the average consumer, eating one meal away from home each week translates to roughly two extra pounds a year.  Given that more than half adults eat out three or more times per week and 12% eat out more than seven times per week, the poor nutritional profile of restaurant meals is impacting a large percentage of Americans and has been cited as one of the major factors contributing to the obesity epidemic.

What to do: Eat out less often.  To make it easier to eat at home, plan meals ahead of time and batch cook and freeze selections so that you always have healthy food options available at home. When you do eat out, select healthier menu items.  To control calories, ask for high calorie sauces and dressing on the side and, at chain restaurants, utilize the calorie counts to select lower calorie items.  To limit the size of your meal, choose between having a caloric beverage, a dessert, or an appetizer and, when served large portions, have half your food boxed to-go before eating.  

Sources: 
-latimes.com/health/os-restaurants-obesity-20110704,0,7026226.story
-Appetite 59: 204, 2012.
-Public Health Nutr. DOI: 10.1017/S136898001200122X.
-Nutrition Action Healthletter, July/August, pg. 8.