Tuesday, August 30, 2011

Common Challenges: Top culprits that can squash your weight loss

Most of my blogs are based off of current research or are responses to questions asked by people in and outside of the Kindred Community.  For today, though, let’s change it up a bit and discuss constraints or obstacles I see in my current practice. My clients are very motivated and for the most part are very successful but when analyzing each client there are specific culprits that challenge every client’s success.  I figured if it’s happening within the Kindred Community it's most likely happening outside of it. Let's discuss the white elephant in the room, shall we?
1.        Foregoing the food diary:
Let’s face it.  Keeping a food diary is a complete drag.  It’s time consuming and it holds you accountable to all those little morsels you drank or ate that are easily forgotten.  Unfortunately, this is exactly why I recommend keeping a food diary.  You can’t get to where you want to go without knowing where you came from.  Once you keep a journal and are able to assess your intake it’s easier to implement changes.  I suggest working with myfitnesspal.com.  This is a great tool that allows you to see calorie ranges for an enormous amount of food.    I also recommend working with a Registered Dietitian, of course.  Only a Registered Dietitian is qualified to look at your current intake, physical activity, and co-morbidities to define the appropriate calorie goal.    The proof is in the pudding with this one.  Research completed by Kaiser Permante showed that people who kept food diaries lost up to DOUBLE the amount of weight than those who didn’t keep food diaries. 

2.        Expecting exercise to be the magic bullet:
Let me say this loud and clear.  It’s not that I don’t think exercise is extremely beneficial and important, but the thing is, exercise should primarily be thought of as an activity geared towards heart health rather than an answer to weight loss.  Exercise has many benefits which include increasing HDL (the good cholesterol), producing endorphins that can combat depression, anxiety, and stress, and assisting to control blood glucose levels but if you don’t change what you are eating, your exercise may only help you maintain weight.  On average most individuals burn approximately 100 calories per mile of exercise.  If you walk two miles in thirty minutes you are only burning 200 calories.   Even if you are eating the exact calories your body needs to function, burning 200 calories a day will only yield a .4 pound weight loss a week.  How many of you feel confident that you are eating the exact calories recommended for you?  Exercise can supplement weight loss, but it is not the sole answer.  You still need to look at your diet.

3.        Buddy Up:
This is something I stress with all my clients.  Changing your lifestyle is a hard feat and it only gets harder the older you are.  Habits are strong and the longer they’ve been intact the harder they may be to change.  It’s important that this is acknowledged and understood in order to move forward.  It’s also important to accept the fact that since this is a large feat, it is hard to do it alone.  My most successful clients are those who have their family and friends on board.  Research shows that those who work with others with a good support system such as Jenny Craig lose 10% of weight loss the first year and 8% the second year.  The University of Pennsylvania completed a research study that showed that 95% of people who buddied up during weight loss stuck with the program verse 76% who attempted alone and that 66% maintained weight loss verse 24% who did not have the support or buddy. Be vocal, get support, and be successful.

Changing your lifestyle is a big deal.  Congratulations on making the commitment and avoid these pitfalls that could squash your success.  Good luck and be well.
The keys to success

Friday, August 19, 2011

Miraculous Misconceptions: Obese and Healthy?

A study published in Applied Physiology, Nutrition and Metabolism this week concluded that obese people who are otherwise considered healthy, live as long as their “skinny” peers.   The study also suggests that healthy obese individuals are less likely to die from cardiovascular complications than their lean counterparts.

I silently laughed as the media got a hold of this study with titles such as, “Fat and Healthy? Study finds Slim isn’t always Superior”, or “Being fat isn’t a death sentence at all”, or my favorite “Obesity Police busted? Study says fat people can be healthy.”

The study monitored 6,000 obese Americans over 16 years and compared them to the death rate of lean individuals.  Once compared, the conclusion was found that the mortality rate of obese individuals who had none or minor co-morbidities were no higher than that of lean people.

CBS interviewed Dr. Kulk who stated "I think this is a common notion, that if you are overweight you are unhealthy and that if you are skinny you are healthy. What people need to realize is that normal-weight people can have diabetes, high blood pressure, and other cardiovascular problems."

I echo what Dr. Kulk says and because of that, this study wasn’t so mind blowing for me.  Basically a lean person with Diabetes, and Hypertension, especially that is uncontrolled, will absolutely have a higher mortality risk than the obese person with no co-morbidities. 

I wonder what the ages were of the individuals who were monitored and I also ask myself, is sixteen years a long enough time span to monitor?  I’m not sure, especially when I think about the overweight college student that doesn’t find out they have Type 2 Diabetes, high cholesterol, or hypertension until their mid thirties. 

After reading clips from this study, at the end of the day I think it’s important to always look at the whole picture. Do I think you can look at someone’s weight and assess their health status?  Absolutely not and this is why I don’t put too much merit on BMI and weight alone in my practice.  It’s important to address family history, diet, physical activity, and co-morbidities.  Always remember, just because you do not have any co-morbidities now, no matter what your weight, does not mean you will not develop them later.  Focus on a healthy diet and physical activity for heart health and don’t skip your yearly physicals.  

Monday, August 15, 2011

Guest Post: Coming Out of Hiding - A blog post from a client..

As Sarah continues to make her way to progress to recovery from Anorexia, she has found it helpful to express her thoughts and feelings by writing guest blog posts.  If you've ever known anyone who struggles with Anorexia, have struggled with eating disorders in the past, or just want to educate yourself some more read below.  We are all cheering for Sarah as she works her way to recovery.

One of the hardest things for me to do is to come out of hiding. To stop hiding what I do not eat, stop hiding behind clothing, to not hide my emotions, and most of all to not hide the fact that yes I do indeed have an eating disorder. The biggest step for anyone with an eating disorder to take is to admit they have a problem and to seek help.  For me, it took almost 22 years.  There are days when I wish I would never have opened my mouth as it was so much easier to hide.

Coming out of hiding means confiding in friends and family and let me tell you, in my situation, not everyone is supportive.  Some friends have shut me out because they can not look at me in my current state.   Some ask “are you sure you have a problem and it isn't medical because you always ate?”   Some just ignore it because they have no idea how to be supportive. 

It is very difficult to explain to someone not familiar with eating disorders that everyone with an eating disorder does it differently. In my honest opinion there is no textbook way to do an eating disorder. I remember in my high school's ninth grade health class we had to do a report on a disease or disorder. I chose Anorexia. The information I found was not very informative, it pretty much defined anorexia as someone who didn't eat, or binged, or purged, and didn't approve of their body image. Nowhere in the resource material did it ever mention the words relapse or recovery.  It was a textbook with definitions and no wonder I didn't think I had a problem because to me I ate.

I would eat an apple or a salad for lunch then do an hour and a half or more of team practice and finally go home and eat a small dinner. I would eat candy like there was no tomorrow because I knew I would be running it off in practice. In my mind there wasn't a problem and I am learning that in my family and friends minds there wasn't one either because to them I ate.

One of the other comments I hear now from the people closest to me is “you were just active and had a high metabolism.” Yes I was active. I competed on a varsity team, won state titles, was a straight A student, and was involved in at least seven clubs in high school. I also had two jobs and still managed to find time to be with friends and a boy friend. When I think about this, I realize that it was easy to move eating to the lowest point on my priority list.  I am also learning now when I look back it was never about what I ate but more about what I didn't eat. I surely did not consume enough calories on a daily basis to sustain the exercise I was doing and I never really lost weight growing up but I tried really hard not to gain it either.

 My anorexia is not about the food, believe it or not.  It is a coping mechanism, a way to deal with my emotions and most importantly to maintain control. Trying to be the perfect student, perfect athlete, and a perfect kid isn't easy. I felt out of control like nothing I did was good enough.  I never felt fully accepted, but always tried to make sure everyone around me was happy and cared for.  All of these feelings and emotions followed me into adulthood because I never knew how to deal with them as a child. 

Having control of what I eat feels safe to me, it is the one thing I will always have control over. I am slowly learning, through therapy, healthier ways to express my emotions and deal with everyday life. I have agreed to do this blog to help others understand what eating disorders are about and to also help others who are going through similar situations.   Yes recovery is a hard and emotional process but it is possible. Currently right now I am trying to get to a state of recovery.   There are good days and bad days and I never know what the next day is going to bring, but for now I need to remind myself that tomorrow is always a new day and a fresh start.

Thursday, August 4, 2011

Miraculous Misconceptions: Oh brother: Healthy eating privilege of the rich?

I just love when I get questions or blog ideas from my Kindred Community and have to give my husband kudos for forwarding this study to me and asking me what I think.  Today a study was mentioned on Yahoo titled “Healthy Eating Privilege of the Rich?”  The study focuses on the food pyramid changes in 2010 recommending an increase in consumption of potassium, dietary fiber, vitamin D, and calcium rich foods.  Two thousand individuals in the state of Washington participated in a telephone survey which then led to the request for a printed survey to be completed.  Only 1300 of the printed surveys were returned.  The information provided in this article states that the printed survey focused on food eaten.  Nutrients were then analyzed and estimated in cost. 

Conclusions from this study state that the more money spent on food, the closer the people were to meeting the food pyramid guidelines of potassium, dietary fiber, vitamin D, and calcium which then led to a request for the government to do more to help consumers eat healthier. 

I have a lot of questions regarding this study since I could not get my hands on it, but I’ll keep those to myself.  I agree with Parke Wilde, Associate Professor at Friedman School of Nutritional Science and Policy at Tufts University who states it is not expensive to get all nutrients and that diets get more expensive with the more rules they have.  I also love a comment I saw from a reader stating “A multipack box of Twinkies costs $3. A bunch of bananas or a pound of apples can be had for half of that. So cost isn't the issue, choice is.”

There are many less expensive foods that are affordable for most. When I look at potassium one can focus on pinto beans and lentils, bananas, raisins, oranges or orange juice, baked sweet potatoes, canned peas, and mushrooms.  You can receive vitamin D from fortified cereal, dairy products, eggs, and mushrooms.  If you are looking for calcium rich foods focus on yogurt, fortified OJ, milk, and kale.  Fiber is provided in most fruits and vegetables, fortified cereals, beans and legumes. 

Most of these items are relatively inexpensive and can even be grown in a home garden or purchased at farmers markets.  If you don’t have access to either of these, you can most likely utilize sales and specials to purchase the most economic products towards your weekly budget with a little planning and forethought. This article focuses on food stamps not allowing the purchase of potatoes.  I agree that is unfortunate, however do they allow for the purchase of fortified cereals, bananas, and milk?  This just was not that great of an argument for me.

My recommendation is if you are on a limited budget but you want to get your nutrients in, I say gat an egg in for breakfast with ¾ cup of a high fiber fortified cereal and ½ cup of milk.  Try adding bananas, raisins, oranges, baked sweet potatoes and mushrooms throughout the day and also, sunlight is free.  Just ten minutes a day in the sun can help with your vitamin D recommendations. 

What do you think about this study?  I’d love to hear your thoughts.

Tuesday, August 2, 2011

Food Trends: McDonalds is changing it's Weighs...

I was wondering what we’d start seeing as the National Calorie Labeling Law comes into effect and I have to say I’ve been quite impressed with multiple restaurants attempting reformulations or portion size changes.  For instance, this week I read that the Cheesecake Factory is going to create a Skinnylicious menu where entrees would be less than 590 calories.  Of course I love this idea, the name not so much. 

Of all the changes I’ve seen so far, McDonalds seems to have the most in depth plan to date.  On July 26, 2011, the President of McDonalds announced the following commitment to offer improved nutrition choices. 

1)       To automatically include produce or low fat dairy products in happy meals by the end of Q1 2012.  This will provide a 20% reduction in calories.

2)       To reduce added sugars, saturated fat and calories by 2020 and reduce sodium by 15% by the year 2015.

3)      To offer increased access to nutrition information.  McDonalds will even be launching their own mobile application for McDonalds providing nutrition information on all products.

McDonald’s has already reduced sodium by 10% in all their chicken menu items and will be rolling out the new happy meal in September 2011.  The new happy meal will reduce french fries to a serving size of 1.1 ounce and also provide ¼ cup of apples in every meal.  There will also be a choice of fat free chocolate milk and 1% low fat milk. 

In addition to the changes that are already underway, look out for McDonald’s “listening tour” which will be a national venue for parents and nutrition experts to express their ideas on how McDonald’s can initiate healthier options.  McDonald’s will also be working with a third party joining a Kids Food and Nutrition Advisory Board which will help promote nutrition and lifestyle marketing messages for kids.

In my eyes, all of these changes are great but my message still remains the same.  Parents still have the primary role to educate children on healthy nutrition choices by limiting high calorie, sodium, and saturated fats to name a few.  Just because McDonald’s is making some changes, this doesn’t mean it’s appropriate to increase visits to Ronald McDonald. 

Here’s to your health!  Be well.


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