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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.

Tuesday, November 24, 2015

THE SKINNY ON HOLIDAY WEIGHT GAIN

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 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.

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. What to do? Survey the culinary landscape and decide what you really want. Keep the portion reasonable and then leave the food table.  Also, beware the baskets, tins and trays of treats that frequently appear in the workplace around this time of year.  Try to see these foods as not yours and avoid them altogether.  Or, save one treat from the selections for the end of the day.  Be mindful of your choices and honest with yourself about your decisions.

Enjoy the turkey, but don’t gobble - Life is so full of rushing, we forget that we can slow down and enjoy our food.  Truly savor 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.

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 to 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.

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.

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. 

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. 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.  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. 

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, to 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 you 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.  


Keep 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, moderate some of the negative metabolic effects of overeating, tone your muscles, and work off some of the holiday stress.

TREATING INSULIN RESISTANCE MAY IMPROVE DEPRESSION

In a new small experimental trial, researchers found that the diabetes drug pioglitazone (Actos), which makes the body more sensitive to insulin, helped relieve symptoms of chronic depression in people with insulin resistance.  These results add to growing evidence of a connection between insulin resistance — the body’s inability to efficiently process glucose, even with adequate insulin production in the pancreas — and mood disorders.  Insulin’s important role in brain function is well-documented.  Brain cells, unlike many other cells, can only use glucose for fuel and the brain accounts for one-fifth of all glucose use in an active human being.   So, it makes sense that impaired glucose uptake due to insulin resistance would affect many pivotal processes in the brain.

Insulin resistance is often a precursor to type 2 diabetes.  Normally, when food is consumed, blood sugar levels in the body increase, and, in response, insulin is released by the pancreas, signaling the cells to take up the glucose and use it for food.  However, the cells of people with insulin resistance fail to take up glucose adequately, causing blood sugar to stay elevated longer than normal.  This increases inflammation in the body and, if unchecked, leads to type 2 diabetes. 

The 12-week study involved both insulin sensitive and insulin resistant patients whose symptoms of depression had failed to improve substantially, despite treatment.  Half the participants were randomly selected to receive treatment with pioglitazone while the other half received a placebo.  Throughout the study, patients’ levels of depression and insulin resistance were monitored. Researchers found the insulin resistant patients on pioglitazone showed significantly improved depressive symptoms while those on the placebo did not.  Also, the more insulin resistant a participant was at the beginning of the study, the better the drug’s antidepressant effect.

What to do:  Excess weight and inactivity are potent risk factors for insulin resistance.  Even though your fasting glucose may be normal you may still have insulin resistance.  Discuss being screened for insulin resistance with your healthcare provider.  Checking hemoglobin A1C in bloodwork is one way to screen for the presence of insulin resistance.  Whether drugs for insulin resistance are a safe, effective way to treat depression in insulin resistant individuals remains to be seen but, in the meantime, weight loss and regular cardiovascular activity are two sure fire means of reducing insulin resistance.  And, there is also plenty of evidence that healthier weight and activity are both supportive of mood.   

Source:
Lin KW, Wroolie TE, Robakis T, & Rasgon NL.  Adjuvant pioglitazone for unremitted depression: Clinical correlates of treatment response.  Psychiatry Research. Published online ahead of print October 12, 2015. DOI: http://dx.doi.org/10.1016/j.psychres.2015.10.013

Adapted from articles available at:
http://med.stanford.edu/news/all-news/2015/11/insulin-sensitizing-drug-relieves-symptoms-of-chronic-depression.html
https://www.nlm.nih.gov/medlineplus/news/fullstory_155792.html