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Fiber for Weight Loss

Chances are you are missing out on a great (and easy) way to lose weight or maintain your healthy weight. On average, women only get about 50% of their recommended fiber intake (25 grams a day). We just do not eat enough fiber-rich foods on a daily basis. While many think of fiber in terms of digestive health or cholesterol reduction, fiber is also a great weight loss and healthy weight maintenance aid. In one study, researchers found that not only were fiber-rich whole grain foods related to a lower weight in women, but that the women who ate higher fiber diets gained half the weight of those eating mostly refined carbs over a 12 year period. Also, overweight and obese women benefited the most from eating fiber-rich whole grains. Fiber increases satiety, so you stay satisfied longer and it decreases the amount of sugar and insulin released into the blood stream. This helps decrease fat storage in your body. Here is the good news, it is easy to eat more fiber. A new study shows just how easy it is to increase your daily fiber significantly by eating a couple bowls of cereal. In the study they used All Bran as one of the test cereals, just 1/2 cup has 10 grams of fiber. Here are some recommendations for starting off the day in a fiber-rich way:
-Try eating a high fiber cereal like All Bran with low-fat (or non-fat) milk -- you may like it.
-If high fiber (at least 5 grams) cereals are not your style, pick a whole grain cereal and sprinkle in a higher fiber cereal such as All Bran Bran Buds (1/3 cup has 13 g fiber) with low-fat milk.
- Now add an apple (3 more grams of fiber) and you are now almost half way there (depending on which cereal you picked, you may be over half way to meeting your goal of 25 g of fiber).
Let's complete the day to get you to your fiber goal. After having your fiber-rich breakfast, eating the following foods throughout the day will help you reach 25 g.
- eat a medium sized pear with lunch for 5 grams and a slice of whole wheat bread 2 grams
- eat 1/2 cup beans or lentils with dinner for another 5-10 grams depending on the bean or lentil
- eat another high fiber bowl of cereal with low-fat milk as a snack if you are hungry after dinner for another 5 grams.
Total fiber -- 25 grams or more

Mom's diet may make for fat babies

A new study from the Journal of Neuroscience found that what you eat while pregnant can result in overeating and obesity in the child. The study was done on rats, however, it does seem to make sense that exposure to a high-fat diet in utero can lead to changes in brain development in the fetus, which create an appetite for fat. The offspring from those fed the high fat diet ate more throughout life, began puberty earlier (a common issue with overweight children as well) and weighed more as compared to those offspring from animals fed a balanced diet.
Bottomline eating a balanced, healthy diet during pregnancy offers advantages to you and your children:

• it will help you gain the right amount of weight so taking it off post-pregnancy is easier
• it helps to keep your child's weight down and him healthy throughout his life

While I would be the last person to tell you not to enjoy a some indulgences during pregnancy - chocolate was part of my diet everyday for all of my pregnancies - just make sure you balance it out with lots of nutritious fruits, veggies and whole grains.

Tactics to keep the weight off

While losing weight is certainly a feat, keeping the pounds off seems to be a bigger challenge for most people. Why? As you lose weight your calorie needs decrease because you're carrying around less mass and therefore, to keep losing weight or even to just stay at your present weight, you have to take in less and less calories over time or increase the number of calories you're burning. Here are some proven tactics to keep those lost pounds, lost:

• Exercise. A new study found that exercise and not the type of diet you follow is the real key to keeping off the weight. Researchers found that regardless of which diet was followed, low-fat or moderate fat, some weight regain was inevitable; they say increasing exercise is a more effective approach.
• Eat breakfast. One study found that women who eat breakfast have lower BMIs, a measure of overweight, than women who skip breakfast. And you should include some milk or yogurt in that breakfast, too.
• Drink milk. A new study found that eating three servings of dairy each day helped people maintain weight loss while eating more calories than the people that only had one serving of dairy each day. Both groups successfully kept off the 10 percent of body weight they'd lost (for the 6 months of the study) however the 3-a-day dairy eaters had about 150 more calories each day than the 1-a-day. This suggests drinking milk or eating yogurt may allow someone trying to maintain weight loss to eat a little more and still keep all the weight off.

Are bananas a magic diet food?

There's a diet craze going on in Japan called the Morning Banana diet that's been all over the TV and web sites. Check out this article on WebMD. Your first thought may be "why is there a diet craze in Japan? Aren't they a pretty lean population?" It was my first reaction but I guess it's a good indication that the issue of overweight has gone global.
Essentially the diet says that in the morning if you eat only bananas and water, have no dairy products, alcohol, or food after 8 PM then you will lose weight. It allows any food for lunch, dinner and snacks. Sound ridiculous? Well, much of it is - there's nothing magical about bananas that make it a diet superfood moreso than any other fruit - but there are some principles in the plan that (when tweaked a bit) can help in losing weight and keeping it off which we talk about in the Baby Fat Diet.
1. They say: Drink only room temperature water. We say: Stick primarily to non caloric drinks; water is an excellent choice, but tea and coffee are okay too and have lots of disease-fighting antioxidants.
2. They say: Don't eat after 8 PM. We say: Stop eating 2-3 hours before bed; late night eating is usually mindless munching of empty calories.
3. They say: Have only bananas and water for breakfast. We say: Eat a fiber-filled, well balanced breakfast. Have as many colorful fruits and vegetables as you can in your day, aiming for at least 5; they are filling for few calories and have tons of nutrients.
4. They say: Exercise only if you want to. We say: Incorporate movement into your day as much as possible by actively playing with your kids and make an effort to work up to 30 minutes a day of deliberate exercise; it's very important to helping take the weight off, keep it off and keep you healthy for life.
As for the Japanese, they traditionally eat lots of fish, brown rice and vegetables, foods that are certainly healthful and relatively low in calories. I'm thinking just go back to that eating plan and overweight won't be a problem.

School lunches - are they healthy?

Most children love buying lunch at school -- it is a very big step towards Independence once they begin Elementary school. (That is unless you have a very picky eater and send them to school with their lunch every day - as a dietitian, I find that sometimes allowing picky eaters to buy lunch at school once a week can help them break bad habits.) A study was recently conducted that looked at the healthfulness of school lunches. When comparing the nutritional intake of those who bought school lunch to those who brought their lunch, the results were surprising. Those purchasing lunch actually had higher vit A, C, B6, folate, calcium, thiamin, iron and phosphorus intakes. They also drank more milk and ate more vegetables and had fewer sweets, sweetened beverages, and snacks. On the flip side, although the number of calories were similar the amount of fat and saturated (bad) fat as well as sodium were higher for those purchasing lunch. So, the schools still have some work to do in improving their lunches. Bottom line: It is a good idea to balance bringing lunch and buying lunch. Let your children pick two days a week to buy their lunch and prohibit a la carte items (in many schools you can put a block on this). On the other days, pack a healthy lunch and have your child buy milk at school. Here is an example of a healthy sack lunch--
- whole wheat bread with either cheese and all natural lunch meat without preservatives or all natural peanut, almond or sunflower butter with all natural jelly.
- a fruit or two
- trail mix with high fiber cereal, almonds and semisweet choco chips
- milk - buy at school

Dieting causes excess pregnancy weight gain

A new study in the Journal of the American Dietetic Association reports that dieters and restrained eaters tend to gain more weight than recommended during pregnancy. Many who diet or have restrained eating habits may feel "free" to eat the foods that they typically stay away from. The deprivation felt before pregnancy can cause overeating during the pregnancy. The result is gaining excess weight. This extra weight can put you at risk for delivering a large baby, a c-section, and a shorter time spent breastfeeding as well as being overweight after having the baby. Interestingly and also alarming is that research shows that excess weight gain during your pregnancy puts your baby at risk of being overweight by age 7. So, what can you do? Look at your pre-pregnancy eating habits, do you jump from diet to diet, do you feel deprived in what you allow yourself to eat, do you tend to feel guilty when you eat something you enjoy? If your answer to these types of questions is yes, then you may be at risk of gaining too much weight during your pregnancy. The good news is once you have identified yourself as at risk, you can deal with it -- try the following to help yourself.
- Visit MyPyramid for pregnancy and breastfeeding and estimate how many calories and servings of foods from each food group you need to have a healthy pregnancy
- Ask your doctor to recommend a dietitian to help you plan your meals and calories needs.
- Get a subscription to a healthy pregnancy magazine to support your healthy living behaviors
- Make sure and stay active to keep the feel good hormones circulating (with your doc's permission)
- Get at least 7 hours of sleep to help curb your cravings
- Eat every 2-3 hours to keep yourself from overeating

Great lunchbox addition

There's a great product that I've been putting in my kids' lunchboxes - it's called Wateroos. Not only are they healthy - they're really just water with a touch of flavor but no sugar or calories - but the kids love them b/c they look just like juice boxes and have cute characters on the front. Starting kids off early and teaching them to enjoy the pure, natural taste of water is extremely beneficial - developing this good habit avoids the need to drink sweet or flavored beverages and in most cases lots of sugar or artificial sweeteners. It can be really hard to break the habit of overconsuming sugary sweet or diet drinks once you're an adult and realize it's best to stick to water. Drinking too many calories is a very common habit that I see in my patients who need to lose weight. The first thing we cut out are coffee drinks, juices, sodas and smoothies; it's much more satisfying to eat your calories than to drink them. Even diet drinks can be overdone and aren't really good for your teeth. So, the earlier you can develop the water habit, the better.
There's also a good website, www.drinklesssugar.com, which compares different lunchbox drinks so you can see how much sugar is in various beverages.

Eat to lose weight

I just had a conversation with the nursing staff at my doctor's office yesterday concerning weight loss. They had been trying to lose weight and had successfully lost some weight but were now at a plateau. These women are educated and know what they should be eating, but they were not aware of how much and when they should be eating. This became obvious when I dug a little further and found that both went the whole work day without eating, so from 8-6pm they did not eat a thing. Additionally, one of them had not eaten yet, and it was already noon. This nurse in particular even made the comment that she used Weight Watchers to successfully lose the bulk of her weight and they made her eat all the time. After speaking with them the possible problem became clear -- in response to their baffling question of "why am I not losing weight" I was able to provide a simple answer...YOU MUST EAT TO LOSE WEIGHT! Going all day without eating will only sabotage your efforts at losing weight (and staying energetic and happy and let's not forget, healthy). In fact, the US weight loss registry shows that those who lose weight successfully eat breakfast at the same time every day. So, what does that tell us? We need to eat on a schedule. The body needs to know when to expect food, so that it does not try to conserve energy. We want the body to feel free to burn calories. Another important factor are all of the nutrients that are missing from their diets because of their limited food intake during the week. You also need key nutrients to help your body burn energy efficiently. Additional problems with not eating all day can also include overeating at other meals, feeling as if it is okay to eat higher fat foods since you did not eat all day, etc. (You know all the inner talking we do to rationalize unhealthy eating.) So, here is my advice...
1. Eat breakfast at the same time everyday to break your overnight fast -- make your body confident, so that it will burn energy efficiently.
2. If you do not have time for a sit down lunch during the day, that is okay, just make sure to bring healthy snacks with you and eat every 2-3 hours during the day.
For example,
-- if you eat breakfast at 7 am, by 10 am make sure and have a piece (or two) of fruit.
-- by 12 pm make sure and have an all natural peanut butter (2tbsp) sandwich with no added sugar jelly (1 tbsp) and whole wheat bread
-- by 2 or 3 pm have a homemade trail mix (high fiber cereal, handful of almonds, raisins and a few semisweet chocolate chips) and another piece of fruit
3. Make sure and eat a healthy dinner with at least two vegetables if you did not eat any veggies during the day.
4. If you are hungry before you go to bed, eat a high fiber cereal and skim milk as a snack.

Dinner dilemma solved

I hear time and time again from my friends and patients with young babies or children at home - most of whom are trying to lose a few pounds - that making a healthy dinner is an insurmountable chore. With all else there is to do, finding time to make a balanced meal gets pushed to the wayside. I feel their pain. When I'm done with work and shuttling the boys to and from activities, grabbing takeout just seems so much easier. But while it's quick and easy, eating takeout certainly won't help with keeping your health or weight in check. Cooking a homemade meal means you know exactly how much salt and fat was added into your food. Enter the slow cooker (or Crock Pot, as your mom used to call it). Toss in some chicken breasts, frozen veggies, a can of crushed tomatoes and a half pound of whole wheat pasta, let it simmer all day and you have a delicious, ready-to-eat meal when it's time to collapse into your chairs. You can use just about any lean protein (seafood, turkey, lean beef, pork tenderloin), vegetables, starch and source of liquid for a well-balanced, all in one meal.
While I'm not a slow cooker queen, like some, every few months I rediscover my slow cooker and love how easy it is to get dinner on the table. The meal is nutritious, low in fat and simple to prepare. I can pretty much use ingredients I have lying around. So go ahead, rediscover your slow cooker, too.

Paltrow exercised away the baby fat

Did you catch Gwyneth Paltrow on Oprah this week? I missed the episode but I did see an article yesterday with her comments on how she got her body back after baby number 2. It was refreshing to hear that not only did it take her 2 years to lose the baby weight, but it took hard work to take off the pounds. She credits lots of exercise for helping her lose the weight. While she worked with a celebrity trainer, there's nothing she did that regular people can't do themselves. It's really about motivation and sticking with it. I know for myself, taking off the baby weight and then maintaining my weight long term requires that I exercise daily - in addition to eating right most of the time (chocolate daily is a must have). I have some equipment in my basement and when I put the kids to bed at night, I go down there and enjoy an hour of Jeopardy and Wheel of Fortune while I work out. No nannies, celebrity trainers or state-of-the-art gym needed. You can do it, too. Buy a jumprope or an exercise video and get started. You'll be looking like Gwyneth in no time - or at least the best, fittest version of you (which is even better).

More kudos for the Mediterranean diet

A new study came out showing the Mediterranean diet prevents numerous diseases, like heart disease, cancer, Alzheimer's and even Parkinson's. While the Mediterranean diet is not new and we've known that it's a healthy eating pattern, this study analyzed the diets of more than 1.5 million people - so it's conclusive.

Eating like our Greek and Italian friends means loading up on fruits, vegetables, whole grains, nuts, beans, fish and even olive oil and cutting back on red meat, dairy products and processed foods. The good news is that most of the those foods will also help you to lose weight since they are rich in nutrients and fiber so they fill you up without filling you out. The diet is really about eating whole foods that are either naturally low in all fats or high in only healthy fats, which keep your blood flowing smoothly.

To get yourself started on a Mediterranean style of eating, cut back your red meat intake to only once or twice a week and replace with a nice, healthy piece of fish, like tilapia or salmon, and a side of lentils. Get rid of the butter from your fridge and replace with olive and canola oil. You can order pre-filled olive and canola oil spray bottles that make portion control easy from Gourme Mist. This ensures you're not overdoing it on the added fat because even if it's the healthy kind, too much fat means too many calories.

Eating high protein breakfast sustains your diet

A new study out of Purdue University finds that eating a high protein breakfast - participants had eggs and Canadian bacon - leads to a sustained feeling of fullness throughout the day. Feeling satiated can lead to eating less at subsequent meals or going for a longer time without getting hungry again, making weight loss easier. Another study found that having two eggs for breakfast helped overweight adults lose more weight than those who ate a bagel with the same number of calories. Again, it's likely due to that feeling of satiety. Fiber and protein, because they take longer to digest, are the two nutrients that promote longer lasting feelings of fullness.
While having an egg or lean meat at breakfast can be a good high protein choice, low fat dairy can serve the same purpose. A high fiber cereal or oatmeal with skim milk or yogurt are also satiating breakfasts.
While I'm on this topic, I came across a new product, called Lightfull, which promotes itself as a satiating snack. It's a yogurt-like drink that has 5 grams of fiber and 5 grams of protein for only 90 calories. The company sent me some samples so I gave it a try and you know what, it was pretty true to its claims. I had one for breakfast with half an English muffin and really didn't feel hungry again until after noon. Normally, I need a mid-morning snack to tide me over til lunch. I'm going to give some samples to my weight loss patients and see how it works for them too. Check it out and see if it works for you.

Holidays and weekends could be sabotaging your weight loss

Came across a great article that hit home. It's about a new study that found that dieters regularly comsume more calories on the weekends than during the weekdays and those extra calories were making weight loss impossible. The reason it hit home for me is that one of my patients is having that exact issue. The scale won't budge, yet Monday through Friday his diet is pristine. The weekends are sabotaging all of his great eating during the week. Alcohol, eating out and less physical activity are all culprits. Interestingly, according to the study people who are extremely strict about their diet and do not give themselves breaks to cheat - like weekends or holidays - are 1 1/2 times more likely to keep off the pounds.
So, as we go into this Labor Day holiday weekend - keep your diet on track and do not allow those extra calories to sneak in. Here are some tips to help you:

• Eat a high-fiber breakfast with some protein (eg. oatmeal w/skim milk, egg whites and whole wheat toast + a piece of fruit) --make sure to eat enough to keep yourself satisfied, skimping on breakfast can backfire; I find about 400 calories at breakfast is right for most women
• At BBQs fill up your plate with salad, veggies, whole grains if there are any, and a small piece of lean protein; skip anything with mayonnaise
• If you want a drink, have one and make it a glass of wine or light beer; those fruity cocktails are really high in calories
• Exercise, at least 30 minutes each and every day - even holidays and weekends
• Keep a food journal and write down what you eat each day of the weekend; it holds you accountable
• Weigh yourself on Monday mornings; knowing you'll have to face the scale may help you to stay on track

Look for many more great tips to help you lose the baby weight and keep your diet on track in our new book The Baby Fat Diet -- available for preorder and on bookshelves this December.

Back to school healthy lunchbox ideas

As the lazy days of summer wind down and kids head back to school, you may start thinking about what to pack in the lunchbox. This is something I struggle with every week of the school year: getting my kids to eat a nutritious lunch that can be prepped fast. Here's an article I wrote with 8 easy, healthy lunch options. By the way, these are great lunches for yourself, as well. They are all nutrient packed and have less than 500 calories, so can help you stay (or get back) on track with your diet this fall. Since they are full of fiber and protein, feeling satisfied through the afternoon is a guarantee. So once again, eating like your kids is beneficial to your health and your waistline!
Tip: For me the quickest way to get through the grocery store with healthy food in my cart is to make a list ahead.

New Quick and Easy Recipe

I have another recipe to share with you that I created with ingredients found in my fridge and pantry -- my family really liked it and so it passed the test for blogging!

1 lb cooked chicken breast -- you can boil or bake it (I boiled the chicken the night before)
1/2 cup low-fat ricotta cheese
1/2 cup no-fat sour cream
1/2 cup low-fat Monterey Jack cheese
1/2 cup finely chopped red onion (I used my small chopper)
1/4 cup finely chopped green onions (I used the small chopper again)
1/4 cup wheat germ
1 cup organic, low sodium tomato sauce
Whole wheat tortillas (or use corn for a lower calorie option)
1 tbsp olive oil

1. Chop the cooked chicken breast in a chopper (I cut up the chicken and used my small chopper since it is easy to clean) and place into pan with olive oil
2. Add all ingredients (except tortillas) and cook on medium heat for about 10 minutes (you may want to adjust some of the ingredients based on your desired consistency)
3. Using a tablespoon, place mixture in center of tortilla, spread and roll tortilla - repeat until all mixture is used up (or you run out of tortillas).
4. Place tortillas in baking dish and drizzle more tomato sauce over top if desired and cover with foil.
5. Bake at 425 for an additional 10 minutes.
6. Enjoy with brown rice and small red kidney beans
Nutrition info for two tortillas --
340 calories (made with 2 whole wheat tortillas) or 180 calories (made with 2 corn tortillas)
13 grams protein and 5 grams fat (with either the whole wheat or corn)

Amazing Olympians and their diets

Are you watching the Olympics? I'm addicted to it. In fact, I've been up every night well past my bedtime watching the swimmers, divers, gymnasts and volleyball players. It's so inspiring to see these athletes performing such amazing feats. The other day I was on the treadmill jogging and watching the 100 meter runners racing. I felt like we were running together - of course, I was going about 1/100th the pace they were going.
Watching all of these extremely fit individuals led me to think about the diets they follow to fuel the record breaking performances. I found some articles talking about the diets of amazing gold medal swimmer, Michael Phelps and his teammate, Ryan Lochte. You have to see what they are eating - it's mind boggling! While their calorie needs are really high because they're burning tons of calories, I would think their diets would be pretty pristine. Not so, for some of the athletes - filled with fast food! Gymnasts seem to be a little more conscious since maintaining a sleek physique is part of the deal - and they don't burn quite as many calories.
So, enjoy reading about what the athletes are eating but I wouldn't follow their lead - when it comes to diet, anyway. Let them inspire you to get off the couch and go for a run or a bike ride, instead. Enjoy the games!

New moms are drained

A new report confirms what all new moms already know -- having a newborn is demanding and stressful. In addition to trouble sleeping (3 AM feedings, anyone?), the report found that 40% of the women had trouble taking off the baby fat and 24% experienced chronic backaches. I'm guessing they're related - it can be challenging to exercise if your back is injured. They also found that a large percentage of the women were back at work by 12 weeks postpartum, which adds another challenge.

So, to all you new moms out there it's important to cut yourself a little slack. Just like you wouldn't expect your newborn to start crawling or walking immediately after entering this new world, you shouldn't expect that you'll immediately be able to spring right back into your old body or prior energy level. Take baby steps. Set small, realistic goals for yourself. For this week, try this goal: each day eat 1 more fruit and 1 more vegetable than you currently do. Go for a walk this weekend with the baby in the stroller.

And know this, there is a light at the end of tunnel - life does get easier. I always say that as a new mom, it's all about finding your groove -- getting used to the new norm. And by making small healthy lifestyle changes along the way, before you know it, you'll be movin and groovin right back into your skinny jeans!

Restaurants posting calorie counts

If you found out there were way more calories in your favorite soup and sandwich combo than you thought, would you start ordering differently? That's what is happening at my husband's office. He works in New York City and about a year ago the city passed legislation requiring labeling on menu boards for chain restaurants. (Since then a number of other cities have passed similar legislation.) When my husband and his co-workers recently saw that several of their favorite lunch eateries started posting the calorie contents for the items on the menu board and they were significantly higher than they thought, their orders changed. One of his colleague's favorite soups was astoundingly high in calories and quickly dropped off the list for ordering a "light" lunch. This is a good reason why labeling of foods at restaurants is so important - it's extremely hard to guess the number of calories in a dish prepared by someone else and we can be underestimating by hundreds of calories.
So, while it's always a question as to whether people will change their eating habits by just knowing how many calories are in the foods they enjoy, this has clearly been the case in my husband's office. I know that I would have a hard time ordering anything with a huge number of calories staring back at me on the board. Luckily, I live in the suburbs and can blissfully (and ignorantly) enjoy my favorite foods - for now. I'm kidding, of course. My hope is that menu labeling will spread throughout the country and perhaps make a real impact on the public's health and waistline. Because, obviously for my husband, this is making a real difference in the foods he's choosing and I know I have a definite interest in him living a long and healthy life. Do you think it would be helpful to see the calories right on the menu or board at your favorite eating establishments?

Yummy (healthy) salmon patty recipe

Here is a recipe that I adapted from the Chicken of the Sea Salmon Pouch. The kids loved it – they dipped the patties in ketchup.

Ingredients (makes about 10 patties)
2- 7 ounce Pink Salmon pouches (skinless and boneless) or you can used the canned Salmon (skinless and boneless)
¼ cup omega-3 fortified light mayo
2 eggs
1 ½ cups whole wheat bread crumbs (divided)
½ cup wheat germ (divided)
¼ tsp garlic salt
1 tbsp lemon juice
Optional - finely chopped onions 1 cup and finely chopped red bell pepper 1 cup

-- Combine Mayo, optional ingredients, lemon juice, garlic salt and stir in salmon, egg and 1/2 cup of bread crumbs and ¼ cup wheat germ – mix until well blended.
-- Form mixture into balls and roll in remaining bread crumb/wheat germ mix and flatten into cakes about ½ inch thick.
-- Add patties to skillet with 2 tbsp olive oil and cook. Or you can bake at 425, just spray baking sheet with either olive oil or canola or vegetable oil and spray the salmon cakes with the oil as well and cook about 30 minutes.

Let me know what you think.

Smell the coffee to melt away stress

A brand new study in lab rats shows that coffee may help relieve stress from not sleeping. After inhaling the aroma of coffee, more than a dozen stress-relieving genes turned on in the brains of sleep deprived rats. What is interesting, is that the smell of something can have such an effect on our brains, well in this case, rats. These types of studies are useful to set up human studies, but are not necessarily appropriate for making human recommendations. But, for now, it would not hurt to to inhale deeply while enjoying your cup of Java after a rough-night's sleep. Or, for those of you that do not drink coffee, breath deeply while purchasing your yogurt parfaits at Starbucks.

Are diet drinks making you fat?

A study out of the University of Texas Health Science Center, San Antonio found a positive relationship between diet drinks and weight gain. After following 1550 residents of San Antonio for 8 years, they found that for every can (12oz) of diet soda consumed a day a person's risk of becoming obese went up by 41%. Now, this does not mean that diet soda causes obesity, but there does seem to be a link. Some believe that the sweetness in diet soda causes a person to crave more sweet foods. Or, it could be that someone switching to diet soda is already gaining weight and is trying to balance the calories by drinking no calorie drinks. Whatever the answer may be, the best drink to quench your thirst is still water (if you must drink diet soda, try to keep it to no more than one a day). Or, as I just posted, try iced green tea, but brew your own and stay away from the green tea drinks that are full of sugar.

Drink Your Tea

A new study out of Athens Greece shows that drinking 3-4 cups of green tea a day will keep your vascular system healthy. This is extremely important as your vessels impact almost all aspects of your health. Now, I have heard it before -- you do not like green tea. Fortunately, there are flavored green teas that are great for brewing. (Or if you prefer it cold, brew it then add some ice and cool it down). I personally do not like regular green tea, but have found one that I have been able to get used to and now enjoy -- Republic of China Pomegranate Green Tea. I had to try several before I found one that I liked. By the way, there are also studies that show green tea to have a weight loss benefit -- although, the jury is still out on this one. So, schedule in some tea breaks throughout the day, and better yet, add a piece of fruit or some nuts to your tea break.

Junky diet and tv for kids = overweight adults

Imagine yourself looking in a mirror at age 10 catching a glimpse of your 30 or 40 year old body. Would you be horrified or just slightly freaked out? Dr. Oz used this interesting tactic on yesterday's Oprah to drive home the importance of getting kids to eat healthfully from the get go. He showed a 10 year old boy his 400 pound body at 40 if he continued to eat junk and live a sedentary life for the next 30 years.
As a dietitian, I work with children and parents to help families start implementing healthier lifestyle habits. (Having a video depiction to show them the consequences of not making these changes would help tremendously in compliance, I imagine.) I've found the most important key to success is making changes the whole family follows. So, while you're working on getting your own 30 or 40 year old body (or at any age really) into the shape you would've been proud to see in that mirror at age 10, make sure the rest of the family follows suit. And while the choices available to kids -- check out this article in U.S. News and World Report on unhealthy foods available in schools -- is a critical component (read:buy lots of fruits and vegetables), educating your children, no matter how young, that eating nutritious foods make the body strong and healthy is just as important. Even my two year old knows that fruits are good for him, while donuts are only a once-in-a-while dessert.

Does a junky diet in pregnancy mean permanent damage for baby?

According to headlines in Forbes, Science Daily and several other publications on Monday and Tuesday, a new study from the UK came out that showed a diet full of junk food while pregnant can lead to irreversible, long-term health consequences to the child, such as obesity or high cholesterol and blood sugar into adolescence and even adulthood. So, if you're a pregnant woman who's been overindulging in chips and donuts lately, the guilt may be piling on. I'm here to tell you to relax and stop panicking -- headlines can be misleading. First of all, the study was done in rats, so the results may or may not hold true in humans. Secondly, you can absolutely start eating a better diet today --don't worry about what you've done up til now. Commit to eating at least 5 fruits and vegetables each day and making your bread/pasta selections whole grain. These filling foods leave little room for junk. Lastly, even the researchers comment that whether a mom ate poorly or not during pregnancy, a person needs to take responsibility to live a healthy lifestyle -- these health conditions are not inevitable and can be altered by making good diet and exercise choices throughout life.
So, as a dietitian I encourage you to eat a well-rounded, nutritious diet most of the time - allow yourself small treats here and there - and keep exercising (with your doctor's okay) during pregnancy, because it's good for you and for your baby. I didn't really need a study in rats to tell me that!

Gain the right amount for your baby's sake

Not only does gaining the right amount of weight during pregnancy lead to better health outcomes (eg. less chance of C-section, reduced risk of gestational diabetes, healthier birth weight of the baby, etc) and a higher likelihood that you'll get back in your skinny jeans, but new research suggests that it's important to your child's future weight, too. A recent study from the University of Pennsylvania on over 10,000 women showed that gaining more than the recommended amounts during pregnancy (25-35 pounds for normal wt, 15-25 pounds if overweight) can increase the child's chances of becoming overweight in the future. They followed the children until the age of 7 and found that for every 2 pounds over the recommended guidelines that the mom gained, the odds of the child becoming overweight increased by 3%. The scientists speculate that excess weight during pregnancy can trigger certain physical processes like high blood sugar levels causing overproduction of insulin in the baby while in the womb. To gain within the guidelines, remember that you don't need to eat for two -- just have about 300-400 calories more than you normally eat during the second and third trimesters. This is equal to a PB&J or a yogurt and a banana. With your doctor's okay, either continue to or start exercising -- walking is a great option for beginners or even those who are already fit. Pregnancy is the perfect time to focus on eating right and exercising -- it will keep you and your baby on the longterm road to good health.

Walking off the baby fat

Do you know the most popular form of exercise? It's walking and it's no surprise --it can be done anywhere, has no learning curve, needs no special equipment and can be done at any level of fitness. Walking helps take off the fat because it burns a decent number of calories (approx 80-100 per mile, more on hills) and tones the major muscles of the legs.
The best way to start walking more is to measure the number of steps you take with a pedometer and then add on whenever you can. By keeping track it becomes a competition with yourself to increase the number of steps you can take in a day. Several years ago we tried this at the office where I was working. Many were shocked by the small number of steps they were taking. It led to many people going out for a walk after lunch just to up that number.
While I am pretty active during the week - taking aerobics, lifting weights, spinning and doing the elliptical trainer at the gym - walking is my favorite weekend activity because the whole family participates. My husband and I put the kids in strollers and walk about 3 miles to a playground and then back again. The path we take is wooded and serene. While 6 miles of walking may be too much if you're not currently active, keep track of your steps using our new walker tracker page and you'll see the amount of walking you can do jump in no time. (It's about 2000 steps per mile.) Finding a great destination and beautiful surroundings helps, too.

Stress affects eating

People handle stress in different ways but one fairly universal manifestation of stress is an impact on eating. For some it may mean skipping meals, for others it may be overconsuming junk, but however it's handled, stress inevitably leads to an imbalance in eating behavior. One way I know that I've had a stressful, overscheduled week is to look back at what I ate. For example, last week on Thursday I had a bag of popcorn as my lunch. I was juggling a bunch of projects at once and couldn't stop to take a break so grabbed a bag of popcorn (luckily it was light) and it ended up being my lunch. It was pretty much the caloric equivalent at 500 calories so I didn't do major damage, which could've happened if I'd grabbed chips or cookies instead. Most of my week was similar with grabbing this or that and failing to sit down to enjoy any meal at all. I could probably count the number of vegetables I had the whole week on one hand, which is really unusual for me. Luckily, things got back on track by the weekend and I had more acceptable meals that included some fruits and veggies.
Thinking about my week, it's easy to see how stress and "having too much on your plate" so to speak can lead to a downward spiral of overeating and weight gain. It's important to address stress and time management issues and find ways to "lighten the load, as in stuff to do" as we try to address eating and how to "lighten the load, as in pounds." Becoming aware of what you're putting in your mouth, how that's affected by everything else going on in your life, and a strategy for managing the stress is a good step towards a more healthful lifestyle. I've found just telling others about what's happening and how you're feeling can help in finding a creative solution to time crunches. Someone else may volunteer to watch your kids or run an errand for you, for example.
This week I have a plan so it doesn't happen again. I'm going to take a set 20 minute lunch break each day sometime between 12 and 1 - as a mom, I've learned I've got to be a little flexible with the schedule - and I have the whole wheat bread, turkey breast and baby carrots all ready to go. I'll let you know how it goes.

Update on "finding the middle ground" dieter

I talked to the patient yesterday who was having trouble finding how to live in the middle ground -- he tends to only live in extremes. I'm very happy to say that we are successfully moving to the middle, even if by baby steps! At our first meeting he was skipping eating all day long, "saving up his calories" just to binge at night and thus make up for every last calorie -- laying down to go to bed on all of that food wreaks havoc on the body as well. Now he's eating something small every few hours and he said he feels so much better. His choices are getting a little bit better too. He's having cereal in the morning with yogurt and a banana instead of his old habit of a bagel or white roll with butter at the deli. And at dinner his portions have been significantly reduced. This week he's working on trying to include more than one food group at each eating occasion. For example, his chosen morning snack has been 3 cheese sticks but it would be better to have one cheese stick and a handful of almonds or an apple. Variety and including all food groups ensures a distribution of healthful nutrients rather than just loading up on certain ones. Next week we're going to the grocery store so I can show him good choices aisle by aisle. I'll let you know the shopping list we come up with!

Not eating for Two

Pregnancy for many means, "yippee, I can eat what I want." For the sake of our waistlines, we need to change this thinking. Did you know that many women keep as much as 11 pounds from each pregnancy and some even more? I teach a prenatal nutrition class and I love the expressions I get when I tell everyone that in the first trimester you do not need any extra calories, you just need to make sure and eat really, really healthy** and take your prenatal vitamins. I also enjoy the looks of disbelief when I let the women know that in the second trimester they only need about 300-340 more calories. This is equivalent to about a bowl of Honey Nut Cheerios with 1/2 cup skim milk and an ounce of almonds. In the last trimester, the number jumps to an extra 450 calories total -- so, add a piece of whole wheat toast and jelly to your bowl of cereal and almonds and you are now at 450 calories. By making sure you eat healthy** during your pregnancy, you can set yourself up for easier weight loss after you have your bundle of joy.
**healthy defined -- to learn more about how many servings of foods from each food group you should be eating during your pregnancy, go to mypyramid.com and enter your information.

Oprah going vegan

Did you hear that Oprah announced she's going vegan? For 21 days, that is. This means she's cutting out all meat, eggs, dairy -- any animal foods or foods associated with animals for three weeks. Interestingly, a vegan diet can be very healthy if it's done properly -- meaning you get all the necessary nutrients from plant sources. There are certainly some vitamins and minerals that can be in short supply (B12, iron, calcium) on a diet like this if not careful. Oprah, of course, has a chef preparing all the meals - many of which are based on soy and tofu with an abundance of fruits, vegetables and grains. Check out what she's eating -- it seems pretty time-consuming to make all of the foods everyday if you're doing it yourself, although I admit I didn't try the recipes yet. But, even without going fully vegan, adding a few meatless recipes to your repertoire is beneficial both to your health and to the environment's, so it's worth checking out.

I'm glad to see that Oprah is interested and gets her tremendous audience interested in following a healthy lifestyle. I just hope anyone out there thinking of jumping on the bandwagon (longterm, especially) thinks to consult a dietitian before trying a diet that could potentially cut out many important nutrients.

Find the fiber to take off the weight

I've been noticing a significant lack of fiber in client's diets lately, which surprises me because of the prevalence of so many new products that have fiber and whole grains added to them. (Fiber One seems to come out with a new product every week - have you tried the yogurt?) Fiber is a very important part of weight control and overall health since it makes you feel full and keeps things moving nicely through the digestive system. The problem is with all the great new products out there, restaurants haven't been as quick to get on board. Eating out or taking in too often leaves a significant shortfall in the fiber arena. If you can find these choices at your local eateries, take advantage:
- whole grain pizza crust
- whole wheat buns or sub rolls
- whole wheat pasta
- spinach and other dark green leafy veggies (iceberg lettuce has very little fiber)
- brown rice or beans
I ran across this article that has some other good suggestions.
In the meanwhile, when you're at the store here are some of our high fiber favorites:
- Plumsweet cherry essence dried plums (store in the fridge, they taste much better cold)
- All Bran multigrain crackers
- Fiber One granola bars
- Roman Meal cereal bars
- Kashi Good Friends cereal
- Kashi GoLean frozen waffles
- Martin's whole wheat potato bread

Healthy snacking idea for you and the kids

I love my pediatrician! He was mine as a child and now he takes care of my children. The other day we were discussing healthy snacking for the kids and he had a great idea -- put several healthy snacks in a plastic container with each child's name on it and after school let them go and choose their snack from their container. I love it! My kids are always trying to be more independent (they are 7 and 4), so this is right up their alley. Now, I have taken this a step further -- in an effort to increase my (and my husband's) fruit and nut consumption, we now also have a container in the fridge. Believe it or not, this little trick has increased my fruit consumption by two fruits a day. By the way, here is what is currently in our containers - it changes each week.
Baggies of pistachios, almonds with semi-sweet chocolate chips, apple slices, strawberries, cherries, and whole wheat crackers with all natural peanut butter.
Next week I will probably include, pretzels with hummus, banana slices with choco syrup, high fiber cereal trail mix (I just mix all bran with low fat granola, honey roasted sunflower seeds and dried cranberries or raisins), watermelon slices and (for the kids) whole wheat crackers with cheese slices.
Try it and let me know how it goes.

Healthy Fish Sticks

A friend asked me to include more healthy fish recipes and this one immediately came to mind. Most kids love fish sticks, and I must admit, I like them too. So, I decided to find a way to make healthier fish sticks. Here are two versions of my fish sticks recipe that stuck.
The amounts that I will share are approximate, I actually think I make it a little different every time -- you may have to tweak it until you find what works for your family.
1st version --
1-1.5 pounds tilapia
2 cups whole wheat bread crumbs
1 cup flax meal
1/2 tsp salt (you can also add garlic salt, onion powder, etc for flavor)
2 eggs lightly beaten
1 tbsp skim milk
Slice the tilapia (to a fish stick size). Then lightly beat the two eggs with the milk. In a separate bowl mix all the dry ingredients. Now just dip the tilapia slices in the eggs mixture, then coat with the dry mixture and put on an olive oil sprayed pan. Heat oven to 350 degrees (I try not to preheat for too long, so I typically turn on the oven when I am almost done). When all the fish sticks are on the pan, I lightly spray then with olive oil -- I love the Mazola Olive oil spray. Then cook for about 15-20 minutes -- keep an eye on them and when they turn golden, they should be done.
2nd version --
Everything above just add sweet potato puree to the egg mixture. I guess I typically add about 1 cup. Poke a few holes in 1-2 sweet potatoes (depending on their size) and microwave until mushy. Remove peel and put in food processor until smooth. Then add to the egg mixture above and dip away! I love this recipe with the sweet potato it not only add nutrition but it adds sweetness to the fish sticks. They are a big hit with my kids and my husband. Try it!

The psychology of weight loss: Finding the middle ground

I was recently talking to a patient who needs to take off a significant amount of weight. He was contemplating having the LapBand surgery but wanted to give good old fashioned diet and exercise one more try first. He's yo-yoed for years, trying various diets that have worked for short periods of time but always regained the weight and more. Each time, his efforts involved a weight loss program where you have to buy prepackaged meals or cut out whole food groups and he said it just got boring after a while so he always went back to old eating habits. Once we started delving into why he gravitated toward those programs and talked about why they haven't worked over the long haul, it became clear that his underlying state of mind plays a huge role in his weight. While it wasn't that surprising to me, as psychology plays a huge role in just about anyone's weight problem, it was certainly an aha moment for him. Talking it out for over an hour and half I came to understand what might be going on and how we might start to address his issues. He's very much an all or nothing kind of dieter. He either eats bacon double cheeseburgers with fries or he has a salad with no dressing. There's really no middle ground in his eating habits. And over the past several years, he has just decided, consciously or subconsciously, that he'll eat what he wants and worry about it another day. But the added pounds have been weighing on his mind and he's starting to physically feel the effects of the weight. So, we started talking about finding that middle ground -- you know, the place where you can be comfortable eating for the long haul and take care of your health without feeling deprived. After a number of suggestions, such as ordering the grilled chicken sandwich with barbecue sauce rather than the one with melted cheese and bacon, he seemed confident that he could make some healthy changes that he could live with for the long term. I'm anxious to see his food diary next week. Hopefully we've taken a baby step toward the middle ground. I'll keep you posted.

Get your partner on board to take off pounds

If you want to successfully take off the baby fat, you've got to get your hubby on board. We know that it's easier to lose weight when you have support for your efforts and you make healthy lifestyle changes for the entire household. In other words, clean out your cupboards of the junk and stock up on fruits and veggies (that means for everyone)!
Interestingly, a new study finds that the amount of support a significant other provides when the partner is trying to lose weight may be a reflection of the strength of the relationship. Researchers from Ryerson University in Toronto asked couples whether their non-dieting spouse was supportive of their efforts to follow a healthy diet and not surprisingly, those who described their relationship as supportive felt that the spouse was, in fact, helpful. Supporting a healthy lifestyle change isn't just about encouragement but really needs to include sharing in changes in shopping and eating habits. The researchers found that partners who put up obstacles - eating junk foods or making negative comments - for the well-intentioned healthy eater were often unaware that they were doing so.
Bottomline: Speak up and get your spouse on board with making changes toward a healthy lifestyle. Chances are, he could stand to take off a few too!

Sleep to lose weight

Are you getting at least 8 hours of sleep a night? If not, here is your excuse to get more zzz's. Studies show that people who sleep at least 8 hours tend to weigh less. Why? Because, sleeping actually helps your body produce less of the hunger hormone ghrelin and produce more of the fullness hormone leptin. Also, not sleeping enough may cause cortisol levels to go up which increase appetite and may even help add belly fat. In fact, a study from the University of Chicago showed that it only took a few sleepless nights to drop leptin levels by 18% and increase ghrelin by 28% causing cravings for starchy foods and sweets to jump by as much as 45%. So, mom's, for the sake of your figure...go to sleep.

Nutrition bars are convenient but whole foods still best

I was recently talking to a couple of new patients interested in eating healthier, feeling more energetic and taking off a few pounds. Both had the issue of little time and a constant eating on the run situation. (We moms tend to have the lack of time problem as well.) As with most people, I first discussed the need to eat small amounts every few hours to avoid a binge once the starving signals do kick in. The obvious response to me was, "what am I supposed to eat since I'm always on the go?" I mentioned a bunch of different ideas, including nutrition bars, and they were on their way. (Bellybars were a favorite to throw in my carry-on when I was pregnant and had to fly for work.) The next week when I got their food diaries back, a slew of nutrition and energy bars showed up on their logs, sometimes twice a day!
Whoa, Nelly. While eating nutrition bars is certainly acceptable as a few-times-a-week fill in, one for every snack will leave a gaping hole in a well-rounded diet. Study after study shows that foods, especially whole plant foods, contain nutrients that work together to promote good health and just cannot be accounted for with the fortification in an energy bar. I had to remind my patients that nature makes some pretty convenient foods: apples, bananas, pears, peaches, plums, nectarines. Adding a cheese stick and a bag of nuts makes that snack well-balanced (carbs, protein and healthy fat) and chock full of natural nutrients. It took a tiny bit more planning for them than grabbing a prepackaged energy bar but the benefits make it well worth it. Luckily the next week I saw a lot more whole foods on their food records and just an occasional bar here and there. Next time I'll clarify the frequency for my snack suggestions!

Can how much you eat influence your baby's gender?

A new study came out this week that's been getting buzz all over the internet, papers, magazines, and tv. The study from the UK found that women who ate breakfast and a higher quality diet with more vitamins and minerals were more likely to conceive boys than those who skipped the most-important-meal-of-the-day. They also ate more calories overall prior to conceiving - 2413 for boy mamas vs 2283 for girl mamas. (The boy moms were more likely to be exercising to use up the excess calories because there were no differences in weight or body size between the groups.) Of the 740 British women in the study, about 56% of the women in the highest third for calorie intake had boys versus about 45% of the women in the lowest third for calorie intake. Some researchers say that this makes sense as boys are more likely to be conceived in times of plenty because it takes more calories and nutrients to support the male embryo.
When I read these articles, I seriously thought it might be April 1st and it was all a big joke -- I mean it's the male sperm that determines the gender so why would the mom's diet make a difference? (After looking it up on the National Institutes of Health, it turns out the study is real and was just published.) But, maybe the mom's diet plays a role in which sperm gets to nab the coveted egg. Thinking about my own experience, I have 2 boys and know that I always eat breakfast and exercise regularly, so could it be true? Does this theory hold up for your experience?
Before you jump on the bandwagon and start eating more or less in the hopes of choosing the gender you want (if you're trying to conceive), there are definitely a few flaws I can see in the theory: 1) In developed countries, like the UK and US, there's always plenty -- in fact most of us eat too much -- so it would make sense that there should be more boys than girls, but that's not the case 2) the researchers site that women on diets are the reason for the trend that girl births outnumber boys in the last 40 years, yet calorie intake has increased for everyone (2283 calories for the moms of girl babies is more than anyone was eating 30 or 40 years ago -- doesn't seem like they were dieting. Calorie intake has been steadily increasing over time - women eat about 350 more calories per day on average than they did in 1970).
The bottomline is that more research is needed to confirm whether a mom's pre-conception diet can influence her baby's gender. The one thing we know for sure is adequate nutrition before and during pregnancy does increase the odds of having a well baby, regardless of the gender. So, eat breakfast and a balanced diet since a happy, healthy bundle of joy is the most important outcome of all.

Easy and Healthy Snack for you (and the kids)

On August 7th of last year, I shared with you a healthy and fun snack that my daughter and I discovered (see that post for the recipe). Well, we have added onto the original idea and thought I would share the enhanced version with you. What is great about this snack -- is that it's great for moms and dads! (As well as the kids).
1. Slice some fruit, any kind will do -- apples, strawberries, bananas, pineapples, cantaloupes, grapes (no slicing necessary), etc
2. In separate bowls put yogurt and all natural peanut butter -- this could get messy, but it is fun.
3. In a few more bowls add colored sprinkles, semisweet choco chips, granola, chopped nuts (find in baking section or chop yourself), colored sugar, etc.
4. Now, dip, dip and dip away. You may have to use a spoon or finger to smear the peanut butter if it does not stick.
5. Make sure to leave some for the kids.
I usually have everything sitting out and ready to eat and share when the kiddos get home from school. Try it!

Chocolate to help you lose weight

There's a great, delicious product that I would recommend to anyone who's been trying to eat well balanced, feel satisfied and keep the calories down - and guess what? - it's chocolate, real melt-in-your-mouth chocolate. Surprised to hear a dietitian say so? Nope, studies show that including small amounts of really satisfying treats in a balanced diet helps people stick to those diets and take off weight for the long term. But my suggestion is not just any run-of-the-mill chocolate, however. I am a big fan of Hershey's Extra Dark portion-controlled, packaged squares. At 45 calories each, you can have one or two without any concern for blowing your diet and believe me you will feel satisfied.
I'm sure you've heard that chocolate, especially dark chocolate, is rich in antioxidants and can have real health benefits, such as decreasing blood pressure. (In fact, studies show just a small amount everyday can have this effect.) The Extra Dark squares contain a hefty dose of the antioxidant flavanols thanks to being 60% cocoa and even have nice amounts of fiber and iron. And if you're worried about the fat and saturated fat in them, don't. Most of it is a kind called stearic acid, which has been shown to have no effect on cholesterol levels, the main concern with saturated fats. Plus, if you're losing weight, which is easier if you can have calorie-controlled, yet satisfying treats, your cholesterol will come down as the pounds come off.
I can practically feel my blood pressure lowering, as I enjoy two squares every day at 3 o'clock with a cup of antioxidant-rich pomegranate flavored white tea. It's such a flavorful and satisfying afternoon lift, it's all I need to hold me to dinner. If I could describe to you how luscious they are - well, you should really just get a bag and give them a try.

Easy and Healthy Meal

I made a spaghetti meal the other night that my children loved and was very healthy for them -- I want to share it with you.
Add mashed or pureed sweet potatoes (microwave on high for 10-12 minutes) to ground beef with some crushed garlic. Make whole wheat spaghetti and serve with the cooked sweet potato ground beef mixture.
The sweet potato made the ground beef sweet -- one child ate it with tomato sauce and my other child ate it alone without the sauce. Try it -- it is a great way to add nutrition to a kid's favorite meal. By the way, the sweet potato has been ranked as a highly nutritious food. See the stats for yourself below --
Sweet Potato Nutrition Facts
(for one medium size sweet potato)
Calories 130
Fat 0 g
Protein 2.15 g
Net Carbs 31.56 g
Dietary Fiber 3.9 g
Calcium 28.6 mg
Sodium 16.9 mg
Potassium 265.2 mg
Folate 18.2 mcg
Vitamin C 29.51 mg
Vitamin A 26081.9 IU
Source: US Department of Agriculture

Vitamin D and your health

I just recently returned from a trip to Boston where I heard a lecture by Dr. Michael Hollick, MD, PhD (means he is both a clinical doctor and a scientist) from the Boston University Medical Center. He is world-renown for his research in vit D. Click here to see his website as well as his latest review in the New England Journal of Medicine. He not only sees patients but he also conducts research on vitamin D status and health. In his studies, he has found that low levels of vit D may be partly responsible for many of the illnesses we suffer from today. Aside from bone problems, other health problems such as arthritis, autoimmune disorders, heart disease, unexplained bone and muscle pain as well as certain cancers may be affected by not getting enough vit D. Given our aversion to the sun because of the risk of cancer and the increase use of sunblock, he argues that most people are probably either vit D deficient or insufficient. Here are some recommendations to make sure you are getting enough vit D --
-- get your and your family's blood levels checked next time you get lab work done, ask for your 25 (OH) D levels to be checked as this is the major circulating form of the vitamin. You want your level to be above 30 ng/ml.
-- next, make sure and allow your legs and arms to receive 10-15 minutes of sunlight a day. Sunblock blocks the vit D producing rays, so do not add the sunblock to your arms and legs until they have been exposed to the sun for 10-15 minutes.
-- take a vit D supplement with 400-1000IU of vit D -- depending on your lab results your doctor may want to increase the amount of your supplement.
-- enough vit D is hard to get from foods alone --

• Cod Liver Oil, 1 Tbs: 1,360 IU
• Salmon, cooked, 3 1/2 oz: 360 IU
• Mackerel, cooked, 3 1/2 oz: 345 IU
• Sardines, canned in oil, drained, 3 1/2 oz: 270 IU
• Milk, nonfat, reduced fat, and whole, vitamin D fortified, 1 c: 98 IU
• Margarine, fortified, 1 Tbs: 60 IU
• Pudding, 1/2 c prepared from mix and made with vitamin D fortified milk: 50 IU
• Dry cereal, Vitamin D fortified w/10% of the recommended daily value, 3/4 c: 40-50 IU (other cereals may be fortified with more or less vitamin D)
• Liver, beef, cooked, 3 1/2 oz: 30 IU
• Egg, 1 whole (vitamin D is present in the yolk): 25 IU

Source: National Institute of Health
For example, one cup of milk supplies half of your daily need (200 IU adults, 400 IU pregnant or lactating). However, we are finding that our daily need may be higher than originally thought. So, although, I do not normally recommend supplements, in this case, a supplement may be necessary -- make sure and talk to your doctor first.

Speed a sluggish metabolism

The term “metabolism,” especially in terms of weight loss and gain, gets kicked around a lot. For many, this is an ambiguous term that is either blamed for weight gain (as in, “I have a slow metabolism”) or blamed for the ability of skinny people to eat all they want and stay skinny (as in they have a “fast metabolism”)! We all have a metabolism and what we want to do is keep it stoked so that it’s using fuel (food) at a good rate. Here are ways to actually “work out” and strengthen your metabolism to aim for the highly coveted “fast metabolism.”
- Eat every 3-4 hours (doesn't have to be a full meal but something)
- Aerobically exercise 30 minutes on most days (high enough intensity to break a sweat) and strength train 2-3 days a week (hard enough so your muscles feel fatigued)
- Increase the amount of protein and fiber in your diet -- beans and other legumes accomplish both
Other foods that may help boost metabolism:
- Green and oolong teas have been found to increase energy burned by about 3% and decrease body fat by 14%. Recommendation: 5 cups a day is the goal and it can be decaf.
- Spicy foods, like cayenne and hot peppers, have capsaicin thought to raise metabolic rate slightly. Recommendation: Whenever you can handle the heat.
- Caffeine in coffee, colas and energy drinks, is a stimulant and may increase metabolism slightly. Recommendation: Don't start downing a lot of caffeine but a cup of joe, especially before a workout, has been shown to increase endurance and make it feel less strenuous.

A Hint of flavored hydration

Discovered a new product that can help you stay hydrated, especially important now that the weather is getting warmer and exercising outside is a good option for taking off the baby fat. It's called HINT and it's basically water with just a hint (hence the name) of flavor at the end of your swig. It has no calories, no artificial sweeteners or sugar and it's in the loveliest bottle. You can throw it in the bottom of the jogging stroller and take sips as you go. The only drawback is it's on the expensive side at $1.79 per 16 ouncer. For a similar at home experience slice oranges, lemons, limes or kiwi into a pitcher of water and put in your fridge.

Lose the Baby Fat with Sleep

There is new research to show that moms do need to sleep, especially if you want to lose your baby fat. A new study in the American Journal of Epidemiology showed that women who slept less than 5 hours a night were 3x's as likely to keep at least 11 extra pounds from their pregnancy. This just adds to what we already know -- that not sleeping enough can release hormones that can lead to overeating. So, for the sake of losing weight, take those naps and get at least 8 hours a night

Healthier takeout

The last two times we've tried to take the kids out to dinner - they're ages 2 and almost 5 - it's been a disaster. My husband and I ended up tag teaming, where one of us shovels the food in while the other keeps the toddler from standing up on his seat and the preschooler from going under the table. Then we switch so the other can eat. Really not an enjoyable experience. So, our answer has been to do takeout as our treat instead. Since I'm a dietitian, I of course have to think about ways to make the meal the best it can be while still enjoying a night off from cooking. Here are some of my tips:
1) Supplement the meal with a bagged salad or frozen veggies. Minimal work but boosts the nutrients.
2) Customize your order. (Bonus: you won't get the dirty looks from the waiter if you call it in.) "Steamed, with sauce on the side" is my regular catchphrase.
3) Tell them you don't want the bread, fried noodles or chips that are usually mindlessly eaten while waiting for your order in the restaurant - they'll be no waiting since the food will be ready to eat as soon as you get it home.
4) Box up leftovers as soon as everyone fills their plate. No need to leave it out, just tempts picking.

I'm glad to know I'm not alone in my homebound eating situation. A survey from the Food Marketing Institute found that 28% of people with children aged zero to six orders in, takes out or drives through at least once a week compared to only 17% of parents with children aged seven to seventeen. Looks like it may get easier to get out in a few more years.

Two super easy fish recipes

Now that you know how good fish is for you (omega-3s, lean protein) - here are my two favorite fish recipes:
Honey Mustard Salmon (serves 4)
Mix 1 Tbs of dijon mustard with 2 Tbs of honey. Pour over 1 lb salmon fillet. Bake at 450 for 10-20 minutes until opaque.

Garlicky Tilapia (serves 4)
Stir together 1-2 cloves of miced garlic with 1 tsp lemon juice and 1 Tbs olive oil. Pour over 1 lb tilapia. Sprinkle with 1/2 cup of breadcrumbs and 1 Tbs dried oregano. Bake at 450 for 10 minutes.

These are so quick and use few ingredients. They are in my regular rotation of dinners for a busy day.

Fish is Fast Food

Eating fish two-three times a week has tremendous health benefits. What most people do not realize is that fish is actually a fast food. See below for different ways of cooking fish and the cooking times, you will be amazed at how little time it takes fish to cook (5-20 minutes depending on the fish). So, go ahead and plan for fish on your busy nights and you will have an easy, healthy meal in minutes.

There are multiple ways to cook fish.

Boil: Shellfish, such as lobster, lobster tails, crab, crab legs and shrimp, can easily be
cooked in boiling water. Once the shells turn bright orange or red, test the meat to make
sure the temperature has reached 140 degrees F. If so, your food is ready – this only
takes about 3-8 minutes depending on the size of your shell fish, so make sure to keep a
close eye on the color change.

Steam: This cooking method is great for more delicate fish. Just place seafood on a rack or steamer basket over a shallow amount of boiling water (you can even use your rice cooker if it has a steaming basket). Then cover tightly and cook shrimp for 2 to 5 minutes and other fish, including crab and lobster for 10 to 15 minutes (again make sure the internal temperature has reached at least 130 degrees F, see below for FDA recommended temps).

Sauté (Pan Fry): Use this method to cook fish fillets or steaks. Start by heating 3 tablespoons of olive or canola oil in a non-stick skillet over Medium to Medium-High heat. Once the oil is hot, add the fish and cook 6 to 8 minutes until light brown, turning once halfway through cooking. Be careful, since this is a fast cooking method it is very easy to get the oil too hot or to over-cook the fish. A great option is to dip the fish in non-fat milk or beaten egg and dip in a mixture of whole wheat bread crumbs and flaxseed meal before cooking.

Poach: This method uses liquid to gently cook fish. First heat the liquid, such as wine,
water, fish stock or milk (add just enough to cover the fish). Then, cover the pan tightly
and cook fillets just below the boiling point. Cook fillets 8 to 10 minutes and whole fish 15
to 20 minutes. You can then use the leftover poaching liquid as the base for a sauce.

Microwave : You can cook almost any boneless fish fillet or steak in the microwave. First,
place fish in a single layer in a shallow dish with a small amount of liquid (any of the above
recommendations will do). Then cover with plastic wrap with a few vent holes. Lastly, cook
fish 3 minutes per pound on high power, turning fish over once during cooking. If you want to add salt do so after cooking (or try lemon pepper or garlic salt for more flavor).

Additional Fish Tips -

• Resist the temptation to over-cook fish until it "flakes." Flaky fish is actually a sign that your fish is becoming dry. The best way to tell if your fish is done is to notice the color change from translucent to opaque (usually white).
• The U.S. Food and Drug Administration (FDA) suggests cooking fish to an internal temperature of 145 degrees F. The optimal temperature to enjoy various types of fish may vary (130-145 degrees F) according to individual preference for texture and taste.
• Use fresh seafood the day you purchase or freeze within two days. If frozen, thaw in the refrigerator overnight. Rinse in cold water, drain and pat dry.

Get outside - Spring is almost here

Spring is almost here in the Northeast. Every March, the weather goes back and forth between nice and yuck. We've had some gorgeous 60 degree sunny days, followed by a few dreadfully gloomy days in the 30s, then it goes back up again. I've been taking advantage of the nice ones by going powerwalking outside with my toddler in the stroller and taking the kids to the playground after preschool. It definitely lifts my spirits. For some of the most durable and reliable strollers designed to get out and get active, check out babyjogger.com. They are versatile, comfy for your little one and even fold up pretty easily. My jogger helped me take off the baby weight from 2 kids. And it's lasted from infancy to age 4 and still going with my younger one.
Here's to spring, springing (for good) anyday now!

The fat you need

If you're pregnant, nursing or had a baby in the last several years, hopefully your doctor recommended that you eat foods with DHA, and take a DHA supplement or a prenatal vitamin with DHA in it. DHA is one of those healthy omega-3 fats that has been shown to help with developing eye and brain function in babies - in the womb and out. It's passed along from the mom to baby in utero and in breastmilk. Many infant formulas are also fortified with the nutrient.
After sampling many products on the market, we've found a couple of decent-tasting ones that make it easier to choke down all the extra DHA you need during these critical times. Bellybar Chews are chocolate and citrus flavored supplements - similar in texture and taste to Viactiv - that have 50 mg of DHA in each (they also have calcium and vitamin D, which women tend to fall short on as well). While you need 200-300 mg of DHA each day, popping a couple here and there while including other foods with DHA (Eggland's Best fortified eggs have 100 mg each) may be more enjoyable than swallowing a DHA horse pill. Another good choice that gives you all of your DHA in one shot is Coromega liquid supplements. They taste good straight or you can mix one into your OJ.

Salt may be making us fat

If your family has been packing on the pounds, the culprit could be too much sodium. An interesting new study from London just came out in the journal Hypertension that showed a higher salt intake in kids was linked to a greater likelihood of becoming overweight and obese. The reason? Researchers speculate that all that salt makes the kids thirsty and they end up drinking loads of calories from soda and other drinks. While switching everyone in your family to water instead of all the liquid calories is one solution, reducing the amount of sodium you eat is beneficial for lowering blood pressure and heart disease risk as well.
Bottomline: when you're shopping keep an eye on the sodium too. While sodium is found in many of the obvious places like snack foods and fast food, lunch meats, cheeses and breads are often also full of salt. Look for lower sodium versions of these (Alpine Lace, Boar's Head, Ezekiel bread).
Luckily many food companies are on board with getting the salt down. I've noticed many new varieties of lower sodium soups on the grocery store shelves lately and Campbell's just announced they'd be lowering the sodium level in 12 of their condensed soups marketed to children. There's also good research showing that eating broth-based soups before meals helps to lower the number of calories you eat at that meal; so soup can be a great diet tool.

Are you really hungry?

If it is not your typical meal time or if it is after dinner and you should not be hungry but find yourself wanting food, then you are probably not truly hungry. For most, we are no longer in tune with our hunger signals. We eat for all kinds of reasons beyond true physiological hunger. So, let's start today to identify if we are truly hungry. Start by asking yourself the following questions --

• Am I thirsty? -- If so, have a glass of water
  
• Tired? -- this can lead to craving carbs, instead take a nap or take an energizing walk
  
• Bored? -- find something to do other than eating
• When was the last time I ate – was it less than 3 hours ago? -- If not, you should not be hungry
  
• Can I wait 15 minutes before I eat again? Until the next meal? -- If so, leave the kitchen or put down the treat you picked up from the check out line and distract yourself until your next meal.
  
• On a scale from 1 to 10, what is my hunger? One represents not very hungry while 10 represents extremely hungry. If you rate yourself an 8, 9 or 10, it’s time to eat.

You may be surprised at how many "false" hunger signals we experience throughout the day.

The link between clutter and overweight

Just caught a really interesting episode of Oprah with Peter Walsh, the de-clutter expert and author of "Does this clutter make my butt look fat?" The show was about an overweight family and the link between all of the excess stuff and the excess weight. There were some really good points Peter made:

• eating healthfully is impossible in an overcluttered kitchen (many people resort to takeout or eating out when their sink, refrigerator or cabinets are a mess)
• children model the behavior of their parents, including all of the excess

It served as a good reminder that environment plays a huge role in a child's healthy development. If we want kids to move freely in their surroundings and learn appropriate amounts of everything, we need to do our best to resist excess. If we want our children to eat right and exercise, we better eat right and exercise. Sometimes it's easy to forget that those little ones are watching all of our healthy or unhealthy habits. Here are some tips from Peter for tackling the excess:

• stop buying "stuff" - de-cluttering is first and foremost
• choose what's good and not what's easy (in other words, nourish yourself with a homemade meal and give the takeout menus a leave of absence)

With these points in mind, I think I'll go do the dishes and then get dinner started!

Eating for Energy

We could all use some extra energy - well, maybe not if you are under10 years of age. For those of us that are not bursting at the seams and running and skipping to everywhere we go, there are some healthy ways to feel more energetic. Besides exercising, which actually increases your energy level, there are certain eating habits that can also help. Ask yourself the following questions to see if your lack of energy is diet related --
-- first, have you eaten in the past 3-4 hours?
-- Are you eating healthy foods, that contain carbohydrates, such as fruits, veggies, low-fat yogurt and whole grain carbs?
-- Are you getting enough iron in your diet (you need 18 mg/day)? You can find iron in whole grain foods, beans, lentils, leafy greens, blackstrap molasses, iron-fortified cereals and beef and dark cuts of chicken. Vit C will help you absorb iron, so eat an orange or drink some orange juice with your iron-containing food.
-- How many glasses of liquid have you drank today? Make sure you stay hydrated -- drink your water.

Coffee is good for you?

You may have heard reports that coffee is the next miracle food. From decreasing the risk of developing diabetes to decreasing the risk of Parkinsons and even preventing cavities -- there is a new-found love of coffee. Starbucks, get ready! Here is a list of what drinking coffee might do for you --
decrease diabetes risk
decrease Parkinson's risk
cure your headache
improve your mood
help your workouts
make you more alert
help you on tests
decrease your cavities
(click here for more on the health benefits of coffee)
Coffee is a plant based food and thus contains antioxidants and other nutrients as well as caffeine that may provide health benefits. But before you go ahead and up your java intake or start the java habit, you need to be aware of the down-sides and how coffee may affect you as an individual. There are studies that show that coffee may increase your cholesterol levels. Also, a new study out of Duke University Medical school found that caffeine increased blood sugar levels in those with type 2 diabetes. Caffeine has also been shown to increase nervousness, anxiety and sleeplessness. So, bottom line -- if you currently drink coffee and do not experience any of the negative effects listed, then you are probably okay. For those of you who do not personally know "Joe"; drink it early in the day and take it slow to make sure you and "Joe" can be friends. Coffee is not necessarily for everyone -- if you have made it this far without coffee -- you are probably okay without it. You can get the health benefits listed above (and more) by eating your fruit (3), vegetables (3) and legumes (1/2 cup) daily.

Race ya!

Think you need to join an expensive gym or buy lots of pricey equipment to get yourself in shape? Not according to a new study from the Journal of the American Medical Association (JAMA). Wearing a pedometer - a basic one usually costs under $10 - may be all you need. In the study, participants increased the amount of physical activity by 27% when they started wearing one and better yet, they experienced significant health gains. They lost body weight and lowered their blood pressure. Setting a goal of 10,000 steps per day was helpful; even if they didn't acheive the goal, they were more likely to increase their activity somewhat.
Try this: Go get a pedometer for everyone in the family. (You can make them your Valentine's Day presents.) Start a contest to see who can get the most steps by the end of each day.
I'm going to try this with my family and I'll keep you posted how we're doing. My four year old is obsessed with races and who can "win" at anything and everything (fastest getting dressed, brushing teeth, etc). He's going to love this challenge!

Seamless "diet" recipe

Just read an article that reiterates our mantra: diet tips that work are those that fit into your life seamlessly. Here's a recipe makeover that I made for dinner last night that defines what we mean. It's a classic: delicious, easy, fast and you'll never notice how much healthier it is!
Ingredients (for 6 servings):
12 oz whole wheat spaghetti
26 oz jar tomato sauce (low sodium is better but your favorite is fine)
1.3 lb ground turkey (breast is better)
Parmesan cheese

Cook the spaghetti according to directions. Meanwhile brown the ground turkey in a skillet. Drain the excess fat if you use 93% lean ground turkey - if you use breast there won't be any excess fat. Pour the tomato sauce over the cooked meat; heat through. Top the pasta with the meat sauce. Sprinkle with parmesan if desired. Serve with a side salad.

How easy is that. Dinner in about 15 minutes. You can make over any of your favorite dinners by substituting ingredients that are lower in fat, calories and contain more nutrients than the old standbys.

Support for your New Year Resolutions

Hopefully you are still going strong with your health resolutions. At this point, it may make sense to enlist some help and support. Studies show that snail mail reminders and tips help people reach their health and wellness goals, as well as support from family and friends. So, to help support your goals get a subscription to a good magazine. Some of my favorites are Prevention, Self, Health, and Natural Health. Each month you will get new tips and strategies as well as information that can help support your efforts. Also, tell your family and friends about what you are trying to achieve and ask them to ask you how you are doing. Believe it or not, just knowing that you will be asked about your progress can help. To help spread the word and get additional support -- you can use a new (and free) online program from Wellfolio.com (CarrotMe!). It not only allows you to set goals and track your progress; but you get to share your progress with your supporters while they cheer you on and provide incentives to keep you motivated.

Family meals promote children's healthy eating

Eating with your kids is very important to their long term health. A new study found that when families ate together 5 or more times a week, children were more likely to establish healthy eating habits and less likely to participate in unhealthy eating and dieting behaviors. The researchers looked at adolescents, ages 13-16. Specifically, they found a strong relationship related to girls; the less a family ate together, the greater the potential for disordered eating and extreme weight loss measures (diet pills, laxatives, bulimia).

While my children are still quite young, I recognize the strong messages and eating behaviors that are established when you sit down together for a meal. Children look to adults for cues about what they should be eating and are certainly more likely to try new foods and eat vegetables if they see you do it. I know this is how my 4 year old started eating salmon; he saw us doing it. Lately, we've had a tough time sitting down to dinner as a family since my husband doesn't get home from work until after the kids' bedtimes. But, it's important for many reasons to eat together; so, we've come up with a few solutions that may work for you, too, if you have the same dilemma:

• on the weekend have family meals several times, including lunch or breakfast; make sure to have a variety of healthy foods (even when eating out)
• during the week, eat together as much as possible - breakfast may work better on some days; perhaps schedules can be altered to go to the office earlier one or two days to come home earlier for dinner
• resist over scheduling children with activities so they are always eating on the run; set a rule for the number of days participating in extra-curricular activities and get all of your kids on the same schedule
• if every member of the family can't join for dinner, that's okay; still sit down and eat a balanced meal with those that can

Mealtime is so important to the well being of your children. Besides establishing good eating habits and offering greater nutrition, it's a time to catch up on events of the day or week and unwind together. In the hectic race through life, slowing down and eating together are the times you will cherish and remember, and so will your kids.

2008 New Year Resolutions

Here is a quick list to add to your 2008 Healthier Eating New Year Resolutions.
-- Eat 1/2 cup serving of beans (eat all kinds including soy beans) and lentils every day - do not add any fat, instead add some garlic or other spices for seasoning.
-- Eat a handful, just a handful (1.5 ounces) of nuts a day. That is about 30 almonds, 21 walnuts, 42 peanuts, 67 pistachios, 27 pecans and 15 macadamias.
-- Eat at least 5 fruits and vegetables a day (or try for 10, which has been shown to decrease the risk for several cancers) -- count at the end of the day to make sure you hit your goal.
-- Drink water instead of calorie-laden drinks or drinks full of artificial sugars and colors. Or, at least swap water for another beverage twice a day.
-- Exercise, do something everyday. Even if it is just jumping in place to your favorite music. You can exercise in spurts - research shows that three 10 minute sessions of exercise a day can provide health benefits (and, not to mention, will help you maintain a healthy weight)!
Cheers to a healthy 2008!

The smell of weight loss?

I ran across a blurb in the latest edition of Health Magazine about a research study that showed participants experienced reduced cravings for sweets and subsequent weight loss by wearing a vanilla-scented arm patch. I looked up the study and while it was done in 2000, it does seem that perhaps there's some validity to the notion that the scent of vanilla may curb cravings for sweets. Here's another article that reported on the study. Lighting up a vanilla-scented candle or wearing a vanilla-scented spray is a pretty low cost way to potentially help you pass up that basket of leftover holiday treats. And even if it doesn't work you and your house will smell really nice.