Recently, I was visiting with a client regarding her food diary. Although my client had been keeping a food diary, it was incomplete, lacking serving sizes and macronutrient information. As we began discussing her record keeping, I noticed that she had recorded "almonds" several times per day, over the course of the week in question. I asked her to tell me exactly how many almonds was in each serving on her food record. Her response was something like, "I'm not exactly sure, but probably a handful each time" (which was occurring 4-6 times day).
So what is the BIG deal about eating almonds? The package even says that they are "smart eating" and an "irresistible snack", and they are also whole and natural. The package also highlights that they have no cholesterol, they are a good source of fiber, and contain no artificial ingredients. It is true that most of the fatty acid content of almonds comes from monounsaturated fatty acids (~61% of the fat content) and polyunsaturated fatty acids (~25% of the fat content). These are considered to be the "good" fats as compared to saturated fatty acids which are more prevalent in high fat animal products, such as whole milk, standard beef products, and chicken with skin. These buzz words had been a selling point on her choice of "snack".
After some "investigating", it was clear that my client was eating more than the serving size of almond that we had discussed in her nutrition counseling session. (Please note that portion sizes and serving sizes are inconsistent depending on which entity is being used). For example, I had provided my client with serving sizes based on the Exchange System, developed by the American Diabetes Association and the Academy of Nutrition and Dietetics, which classifies foods into groups based solely on their calorie content. In the Exchange System, 6 almonds is a serving of fat and contains 45 calories per serving. On the label of her bag of almonds, a serving was defined as 24 nuts and contains 160 calories per serving. Although my client could not exactly tell me how many almonds she was consuming per day, she could tell me that she was consuming one 12 ounce bag every week, as she was having to re-purchase them routinely in her weekly trip to the store. (This is the small bag up from the canister, but not the largest bag generally found at most grocery stores).
Here comes the "almond (math) problem"....If I look at the label on the almonds she is purchasing, it indicates that there are 12 servings in a bag, each containing 160 calories, with 130 calories derived from fat. If she eats the entire bag in 1 week, the caloric cost of those almonds is 1920 calories per week (or 275 calories per day on average) of primarily fat.
Based on her past and current behavior, let's pretend that my client eats one 12 ounce bag of almonds every week for the next calendar year. That would be a total of 99,840 calories from almonds. Just for the fun, I am going to apply the Wishnotsky (1958) model of 1 pound of fat = 3500 calories (which by the way has been recently deemed mathematically inaccurate and over simplified manner of estimating weight loss, but at risk of putting you sleep with mathematical formulas, I am going to use this method to illustrate my point).
If my client consumes an extra 99, 840 calories from almonds in a year (from consuming one 12 ounce bag per week), the math would be calculated as follows:
99, 840 calories/year = ~ 28 pounds expected weight GAIN/year
3500 calories/lb of fat
As I mentioned before, every pound of fat does not contain exactly 3500 calories and multiple regression analysis have shown this to be true, I am using this method to illustrate a point.
My client certainly does NOT want to gain 28 pounds in a year from almonds. And as she replied. "There not even that good! I thought that I was making a healthy choice". Generally, we think it is the "BIG" things in our diet that are causing our "BIG" butts and bellies, but more often than not, it is the "little" snacks and bites that we enjoy that are the culprits! As I mentioned previously, almonds are a great source of monounsaturated fats, however, it is most important to watch the serving size and the calories respectively! Happy Eating!
Sunday, April 30, 2017
Friday, March 3, 2017
Iron Deficiency is the MOST Common Deficiency-Are YOU at Risk?
Iron deficiency is the most common deficiency in the United States and world-wide, with approximately 10% of Americans and 30% of the world's population exhibiting iron deficiency anemia. Although anyone can be diagnosed with iron deficiency, certain populations are at a very high risk.
Heme in blood cells contain iron; and hemoglobin carries oxygen to our cells and helps excrete carbon dioxide. When hemoglobin levels become decreased, deficiency symptoms began to present.
Symptoms of iron deficiency include fatigue (despite adequate sleep), poor temperature regulation, decreased appetite, and pale skin. In populations with darker skin tones, clinical paleness can be observed in the gum tissue. Side effects as a result of iron deficiency anemia include low attention span, difficulty concentrating,and low immune response resulting in opportunistic infections and illness.
1. Women of Childbearing Age:
Females that experience menses have increased blood losses each month, making them at higher risk for low serum iron levels, particularly if periods are extremely heavy or long in duration.
2. Infants, Children, and Adolescents:
The common denominator in infants, children, and adolescent iron deficiency is an expanding blood supply due to high periods of growth. Infancy is the most rapid period of growth demonstrated from birth to 1 year of age. Ideally, a term infant should triple their birth weight by their first birthday. As adults, it would be most frightening if our weight tripled in a year! It is recommended by the American Academy of Pediatrics that infants from 9-12 months be screened for iron deficiency, as it can cause growth and developmental issues, as well as, decreased immune system. Infants at the highest risk are those that are breast fed without the inclusion of iron fortified cereal or good sources of iron from age appropriate foods.
Growth in children continues at a steady rate, and the blood supply increases accordingly. Children should be monitored to insure iron needs are adequately met. Like infancy, adolescence represents another period of high growth and expanding blood supply. In addition, females have the onset of menses, further increasing iron needs.
Interestingly, the USDA school Lunch and Breakfast Programs are in place to minimize iron deficiency in at risk populations. Adequate iron intake has been shown to improve attention span, concentration, and learning ability. This is why parents often receive a friendly reminder encouraging breakfast during standardized testing periods and low income school often offer free breakfast to all students.
3. Pregnancy:
During pregnancy, women also have another period of rapidly increasing blood supply. Not only does this increase in blood volume affect the iron status of the expectant mother, it also affects the iron store of the growing fetus. Babies born with low hemoglobin levels can have low APGAR score and difficulty breathing after birth. Iron stores are best maintained during pregnancy by choosing a diet rich in iron and vitamin C, in addition to taking prescribed prenatal vitamins.
4. Athletes:
Iron depletion is a relatively common occurrence among athletes, ranging between 30% and 50%, especially among female athletes and both male and female athletes who participate in endurance sports. Because female athletes often do not consume proper amounts of dietary iron ( as a result of lower calorie consumption and/or reduction in meat in the diet), coupled with increased iron losses in sweat, gastrointestinal bleeding, muscle stress/trauma, and menstruation, health and optimal performance may be compromised. Decreased exercise performance is related not only to anemia, and decreased aerobic capacity, but also to tissue iron depletion and diminished exercise endurance.
The Best Foods to Prevent Iron Deficiency:
Iron is found in a variety of foods including:
-Oysters
-Liver
-Lean red meats
-Iron fortified cereals
-Peanuts
-Almonds
-Barley
Consuming vitamin C rich foods in the presence of iron rich foods (particularly meat sources) will help increase the absorption of the iron. An example of a meal might be to have a steak (great source of heme iron) with broccoli (excellent source of Vitamin C).
Calcium and antacids can reduce iron absorption and should be taken at opposite times to prevent decreased iron absorption. If iron deficiency persists, iron supplementation should be considered. Taking supplements with heme or animal sources of iron and vitamin C will also enhance iron absorption.
If you are in a high risk group, you should consider asking your health care provider to check your iron status at your annual exam. Iron deficiency is easily prevented and treated and can have a great impact on your health, physical performance, and cognitive ability.
Now, go pump some iron!
For more information, please contact Leslie Goudarzi, MS, RD, LD, Wellness Dietitian at the Institute for Healthy Living, at 903-239-1551.
Heme in blood cells contain iron; and hemoglobin carries oxygen to our cells and helps excrete carbon dioxide. When hemoglobin levels become decreased, deficiency symptoms began to present.
Symptoms of iron deficiency include fatigue (despite adequate sleep), poor temperature regulation, decreased appetite, and pale skin. In populations with darker skin tones, clinical paleness can be observed in the gum tissue. Side effects as a result of iron deficiency anemia include low attention span, difficulty concentrating,and low immune response resulting in opportunistic infections and illness.
1. Women of Childbearing Age:
Females that experience menses have increased blood losses each month, making them at higher risk for low serum iron levels, particularly if periods are extremely heavy or long in duration.
2. Infants, Children, and Adolescents:
The common denominator in infants, children, and adolescent iron deficiency is an expanding blood supply due to high periods of growth. Infancy is the most rapid period of growth demonstrated from birth to 1 year of age. Ideally, a term infant should triple their birth weight by their first birthday. As adults, it would be most frightening if our weight tripled in a year! It is recommended by the American Academy of Pediatrics that infants from 9-12 months be screened for iron deficiency, as it can cause growth and developmental issues, as well as, decreased immune system. Infants at the highest risk are those that are breast fed without the inclusion of iron fortified cereal or good sources of iron from age appropriate foods.
Growth in children continues at a steady rate, and the blood supply increases accordingly. Children should be monitored to insure iron needs are adequately met. Like infancy, adolescence represents another period of high growth and expanding blood supply. In addition, females have the onset of menses, further increasing iron needs.
Interestingly, the USDA school Lunch and Breakfast Programs are in place to minimize iron deficiency in at risk populations. Adequate iron intake has been shown to improve attention span, concentration, and learning ability. This is why parents often receive a friendly reminder encouraging breakfast during standardized testing periods and low income school often offer free breakfast to all students.
3. Pregnancy:
During pregnancy, women also have another period of rapidly increasing blood supply. Not only does this increase in blood volume affect the iron status of the expectant mother, it also affects the iron store of the growing fetus. Babies born with low hemoglobin levels can have low APGAR score and difficulty breathing after birth. Iron stores are best maintained during pregnancy by choosing a diet rich in iron and vitamin C, in addition to taking prescribed prenatal vitamins.
4. Athletes:
Iron depletion is a relatively common occurrence among athletes, ranging between 30% and 50%, especially among female athletes and both male and female athletes who participate in endurance sports. Because female athletes often do not consume proper amounts of dietary iron ( as a result of lower calorie consumption and/or reduction in meat in the diet), coupled with increased iron losses in sweat, gastrointestinal bleeding, muscle stress/trauma, and menstruation, health and optimal performance may be compromised. Decreased exercise performance is related not only to anemia, and decreased aerobic capacity, but also to tissue iron depletion and diminished exercise endurance.
The Best Foods to Prevent Iron Deficiency:
Iron is found in a variety of foods including:
-Oysters
-Liver
-Lean red meats
-Iron fortified cereals
-Peanuts
-Almonds
-Barley
Consuming vitamin C rich foods in the presence of iron rich foods (particularly meat sources) will help increase the absorption of the iron. An example of a meal might be to have a steak (great source of heme iron) with broccoli (excellent source of Vitamin C).
Calcium and antacids can reduce iron absorption and should be taken at opposite times to prevent decreased iron absorption. If iron deficiency persists, iron supplementation should be considered. Taking supplements with heme or animal sources of iron and vitamin C will also enhance iron absorption.
If you are in a high risk group, you should consider asking your health care provider to check your iron status at your annual exam. Iron deficiency is easily prevented and treated and can have a great impact on your health, physical performance, and cognitive ability.
Now, go pump some iron!
For more information, please contact Leslie Goudarzi, MS, RD, LD, Wellness Dietitian at the Institute for Healthy Living, at 903-239-1551.
Monday, February 20, 2017
Febuary is Heart Health Month! Are You at Risk?
February highlights heart health focusing on the prevention of heart disease. Heart disease continues to be the number 1 killer of both men and women in the United States, accounting for about 28% of total deaths per year.
No one single factor "causes" heart disease, however, predictive risk factors that can help identify individuals at the highest risk for a cardiac event, including heart attack, stroke, or atherosclerosis. Some of our risk factors are inherited or can result from aging, however, the majority of risk factors are a result of our lifestyle choices.
There are some risk factors that are inherited. These include being male at age 45 and greater (Being male doesn't cause heart disease, but increase cardiac risk at an earlier age than females. Females have an elevated risk after age 55), being African American increases risk for hypertension and stroke, while Caucasians are at a higher risk for myocardial infarction. Family history is also important in assessing heart disease risk.
The good news is that most of our risk factors are daily choices that we make!
What Are The Risk Factors for Heart Disease That I Can Control?
1. Tobacco Use: Smoking cigarettes or using smokeless tobacco products cause vasoconstriction of blood vessels, contributing to hypertension or high blood pressure. It also lowers the levels of oxygen that reach our cells and also contributes to lung disease. Smoking is a choice that definitely increases heart disease risk.
2. Uncontrolled Hypertension: High blood pressure is associated with increased occurrence of cardiac events. The good news is that hypertension can be controlled with one or more of the following treatments, including lowering sodium intake to 1500 mg per day, weight management, exercise, stress management techniques, and sometimes prescription medications. As a Registered Dietitian, I recommend the least invasive strategies first such as a therapeutic nutrition program as well as an exercise regimen. If elevated blood pressure continues to persist, it may be time to consider a more aggressive approach, such as medication. The most important factor to consider with your health care professional is the most effective way to control your blood pressure.
3. Elevated Blood Cholesterol: Like the other risk factors, high cholesterol does not cause heart disease, but it is a significant risk factor and predictor of future disease. More that 100 million Americans have increased cholesterol, or roughly half of the US population. Cholesterol can only be assessed by obtaining a blood sample, typically at your doctor's office or clinic. Total blood cholesterol levels should be less that 200 mg/dL. Individuals with cholesterol levels more that 240 mg/dL are at twice the risk of a heart attack. The most effective ways to lower blood cholesterol levels is by maintaining calorie control (not consuming more calories than you need to maintain a healthy weight), decreasing sugar consumption, and controlling fat intake. It is important to note that we make cholesterol in the body. In fact, approximately one third of our serum cholesterol is contributed to our liver's ability to produce it's own cholesterol from fatty acids. Some individuals are highly "efficient" cholesterol producers and actually produce more cholesterol in the liver than what is normally expected. Like hypertension, it is important to control hyperlipidemia and sometimes it is necessary to include the use of statin medications to help lower cholesterol. Your best option to decrease your cholesterol should be discussed with your health care provider. Generally, a combination of treatments is most effective.
4. Physical Inactivity: It has been said that "Sitting is the new smoking", Exercise is very important to the prevention of heart disease. It has been shown to be a vasodilator (opens up blood vessels), lowers blood pressure, lowers stress levels, lowers cholesterol, and contributes to the maintenance of a healthy weight. All types of exercise are beneficial and should be included in a healthy regimen including aerobic activity, strength training, and flexibility and stretching. There is really no downside to exercise.
5. Being overweight or obese: Having an elevated BMI (greater than 25) is indicative of being overweight or obese. Excess body weight is also a risk factor for the development of heart disease, especially if it is centered around the trunk of the body (imagine an "apple" shape versus a "pear" shaped individual). Typically, individuals with a "big belly" are at higher risk than those with a "big bottom. Exercise, diet, and stress management can all be helpful in achieving a healthy weight.
6. Having Diabetes: Diabetes mellitus also increases the chances of having a cardiac event. Type 2 Diabetes Mellitus (adult onset) is typically associated with high BMI, obesity, low levels of physical activity, increased insulin resistance, and poor carbohydrate metabolism. Controlling blood sugar levels, exercise, and weight management are all priorities in helping to manage this risk factor.
7. Uncontrolled Stress: Stress is a factor in everyone's life. Some people handle stress better than others. There are many effective strategies to deal with stress including yoga, meditation, and exercise. Poor ways of dealing with stress including "eating your feelings", internalizing feelings, and self medicating with drugs or alcohol. Sometimes counseling or therapy may be helpful.
8. Alcohol Usage: Alcohol intake above a moderate level (one drink for a female and two for a male) increases cardiac risk, particularly increased hypertension leading to higher risk for stroke. Alcohol also is a significant calorie source and can increase body weight and body fat.
Managing your risk factors for heart disease is the most important thing you can do to prevent this devastating disease. The best part is that your heart health can be managed by your daily choices!
For more information regarding Heart Healthy Nutrition, please contact Leslie Goudarzi, Wellness Dietitian at the Institute for Healthy Living, at 903-239-1551.
No one single factor "causes" heart disease, however, predictive risk factors that can help identify individuals at the highest risk for a cardiac event, including heart attack, stroke, or atherosclerosis. Some of our risk factors are inherited or can result from aging, however, the majority of risk factors are a result of our lifestyle choices.
There are some risk factors that are inherited. These include being male at age 45 and greater (Being male doesn't cause heart disease, but increase cardiac risk at an earlier age than females. Females have an elevated risk after age 55), being African American increases risk for hypertension and stroke, while Caucasians are at a higher risk for myocardial infarction. Family history is also important in assessing heart disease risk.
The good news is that most of our risk factors are daily choices that we make!
What Are The Risk Factors for Heart Disease That I Can Control?
1. Tobacco Use: Smoking cigarettes or using smokeless tobacco products cause vasoconstriction of blood vessels, contributing to hypertension or high blood pressure. It also lowers the levels of oxygen that reach our cells and also contributes to lung disease. Smoking is a choice that definitely increases heart disease risk.
2. Uncontrolled Hypertension: High blood pressure is associated with increased occurrence of cardiac events. The good news is that hypertension can be controlled with one or more of the following treatments, including lowering sodium intake to 1500 mg per day, weight management, exercise, stress management techniques, and sometimes prescription medications. As a Registered Dietitian, I recommend the least invasive strategies first such as a therapeutic nutrition program as well as an exercise regimen. If elevated blood pressure continues to persist, it may be time to consider a more aggressive approach, such as medication. The most important factor to consider with your health care professional is the most effective way to control your blood pressure.
3. Elevated Blood Cholesterol: Like the other risk factors, high cholesterol does not cause heart disease, but it is a significant risk factor and predictor of future disease. More that 100 million Americans have increased cholesterol, or roughly half of the US population. Cholesterol can only be assessed by obtaining a blood sample, typically at your doctor's office or clinic. Total blood cholesterol levels should be less that 200 mg/dL. Individuals with cholesterol levels more that 240 mg/dL are at twice the risk of a heart attack. The most effective ways to lower blood cholesterol levels is by maintaining calorie control (not consuming more calories than you need to maintain a healthy weight), decreasing sugar consumption, and controlling fat intake. It is important to note that we make cholesterol in the body. In fact, approximately one third of our serum cholesterol is contributed to our liver's ability to produce it's own cholesterol from fatty acids. Some individuals are highly "efficient" cholesterol producers and actually produce more cholesterol in the liver than what is normally expected. Like hypertension, it is important to control hyperlipidemia and sometimes it is necessary to include the use of statin medications to help lower cholesterol. Your best option to decrease your cholesterol should be discussed with your health care provider. Generally, a combination of treatments is most effective.
4. Physical Inactivity: It has been said that "Sitting is the new smoking", Exercise is very important to the prevention of heart disease. It has been shown to be a vasodilator (opens up blood vessels), lowers blood pressure, lowers stress levels, lowers cholesterol, and contributes to the maintenance of a healthy weight. All types of exercise are beneficial and should be included in a healthy regimen including aerobic activity, strength training, and flexibility and stretching. There is really no downside to exercise.
5. Being overweight or obese: Having an elevated BMI (greater than 25) is indicative of being overweight or obese. Excess body weight is also a risk factor for the development of heart disease, especially if it is centered around the trunk of the body (imagine an "apple" shape versus a "pear" shaped individual). Typically, individuals with a "big belly" are at higher risk than those with a "big bottom. Exercise, diet, and stress management can all be helpful in achieving a healthy weight.
6. Having Diabetes: Diabetes mellitus also increases the chances of having a cardiac event. Type 2 Diabetes Mellitus (adult onset) is typically associated with high BMI, obesity, low levels of physical activity, increased insulin resistance, and poor carbohydrate metabolism. Controlling blood sugar levels, exercise, and weight management are all priorities in helping to manage this risk factor.
7. Uncontrolled Stress: Stress is a factor in everyone's life. Some people handle stress better than others. There are many effective strategies to deal with stress including yoga, meditation, and exercise. Poor ways of dealing with stress including "eating your feelings", internalizing feelings, and self medicating with drugs or alcohol. Sometimes counseling or therapy may be helpful.
8. Alcohol Usage: Alcohol intake above a moderate level (one drink for a female and two for a male) increases cardiac risk, particularly increased hypertension leading to higher risk for stroke. Alcohol also is a significant calorie source and can increase body weight and body fat.
Managing your risk factors for heart disease is the most important thing you can do to prevent this devastating disease. The best part is that your heart health can be managed by your daily choices!
For more information regarding Heart Healthy Nutrition, please contact Leslie Goudarzi, Wellness Dietitian at the Institute for Healthy Living, at 903-239-1551.
Monday, January 23, 2017
Are These Yoga Pants Making Me FAT?
Weight gain happens slowly, creeping up, like a monster in a horror movie. Sometimes, it is barely noticeable until you have hit a new 5-10 pound increase. How does this happen? Our yoga pants (or other comfortable clothes) may be to blame.
When it comes to food intake, there are 2 basic factors that regulate our consumption. These are our internal and external cues. Internal cues, are those signs that your body is physically no longer hungry and you can continue on with your daily activities. Our external cues, however, can positively (meaning encouraging you to eat more) or negatively (meaning you eat less) influence your intake greatly.
Internal cues, in my opinion, is how our relationship with food was "meant to be", The best example of a human following their internal cues is a typical 4 year old. The child is presented with a full meal, including dessert. He is allowed to eat how much of each item he wants (not forced or coerced). Lunch time is over and he is done. Now as adults, we may look at his plate, and think, "Hmm, I don't think he ate enough". Or maybe, "There are children starving in Africa and he is so wasteful" (By the way, I have never understood how someone eating excess calories in America solves world hunger on another continent). Or perhaps, a million other things that our brains have been programmed to tell our gastrointestinal tract in order to manipulate it into consuming more. Simply put, internal cues are noticing when your body is hungry and eating until it is comfortably satisified.
External cues, in contrast, are all of the outside influences that affect our food choices, including how much we eat. These can vary from time of day, how many people we are eating with, mood, portion sizes, cost of the food, and even what we are wearing!
In his book Mindless Eating by Brian Wansick, Ph. D., he cites an observation that occurred in county jails:
"The food served in county jails is not typically awarded any Michelin Stars. In fact, complaining about the food is one of the great inmate pastimes. This is why a sheriff at one Midwestern jail was puzzled when he noticed an odd trend: The inmates, with an average sentence of six moths, were mysteriously gaining 20-25 'prison pounds' during the course of their 'visit'. It wasn't because the food was great. Nor did it seem to be because they hadn't exercised or because they were lonely or bored. They generally had access to exercise facilities and to daily visitors.
In fact, upon release, no inmate blamed the food, the exercise machines, or the visitation hours for their weight gain. They blamed their jailhouse fat on the baggy orange jumpsuits they had to wear for six months. Because these orange coveralls were so loose-fitting, most of them didn't realize they had progressively gained weight-about a pound a week-until they were release and had to try and squeeze back into their own clothes".
Hopefully, you are not in county jail and wearing orange coveralls. However, we can all benefit from these jail house subjects because we practice similar behaviors, such as wearing stretchy yoga pants in lieu of jeans or fitted pants, pull on shorts, or loose dresses. All of these types of clothing are known for their comfort value, however, when our calorie intake starts increasing and affecting our waist line, it may go unnoticed if our pants aren't talking back!
Our clothes do communicate with us if we tune in and listen. The notch in the belt is let out or taken in. Our pants only zip half way or are too loose entirely. Researches in Dr. Wansick's lab reported these 8 signals that indicated weight loss to them more often than just the number on the scale.
-"When my jeans feel comfortable again."
-"When I have to start wearing a belt".
-"When I suck in my stomach, and I can see some definition, like a four pack".
-"When my belt notch moves back to where it used to be".
-"When I don't get tired walking up two flights of stairs to my office".
-"When I can see my cheekbones".
-"When I don't have to inhale to button my pants".
-"When friends or colleagues ask me if I've lost weight".
So, a few take home messages:
1) Wear some "fitted clothing", at least some of the time for a REAL gut check!
2) Be mindful of your eating, when your actually hungry and when you are actually satisfied. I like to encourage my clients to close their eyes, take a deep breath and exhale, and ask themselves to rate their hunger before a meal on a scale of 1-10. After assessing their hunger, make sure that the food intake matches their hunger level. During their meal, eat slowly, noticing what the foods taste like, how their body feels. About half way through the meal, reassess the hunger and respond accordingly until satiety is achieved, and get back to your four year old self!
Happy and healthy eating!
For more information on nutrition or counseling services, please contact Leslie Goudarzi, MS, RD, LD at 903-239-1551.
When it comes to food intake, there are 2 basic factors that regulate our consumption. These are our internal and external cues. Internal cues, are those signs that your body is physically no longer hungry and you can continue on with your daily activities. Our external cues, however, can positively (meaning encouraging you to eat more) or negatively (meaning you eat less) influence your intake greatly.
Internal cues, in my opinion, is how our relationship with food was "meant to be", The best example of a human following their internal cues is a typical 4 year old. The child is presented with a full meal, including dessert. He is allowed to eat how much of each item he wants (not forced or coerced). Lunch time is over and he is done. Now as adults, we may look at his plate, and think, "Hmm, I don't think he ate enough". Or maybe, "There are children starving in Africa and he is so wasteful" (By the way, I have never understood how someone eating excess calories in America solves world hunger on another continent). Or perhaps, a million other things that our brains have been programmed to tell our gastrointestinal tract in order to manipulate it into consuming more. Simply put, internal cues are noticing when your body is hungry and eating until it is comfortably satisified.
External cues, in contrast, are all of the outside influences that affect our food choices, including how much we eat. These can vary from time of day, how many people we are eating with, mood, portion sizes, cost of the food, and even what we are wearing!
In his book Mindless Eating by Brian Wansick, Ph. D., he cites an observation that occurred in county jails:
"The food served in county jails is not typically awarded any Michelin Stars. In fact, complaining about the food is one of the great inmate pastimes. This is why a sheriff at one Midwestern jail was puzzled when he noticed an odd trend: The inmates, with an average sentence of six moths, were mysteriously gaining 20-25 'prison pounds' during the course of their 'visit'. It wasn't because the food was great. Nor did it seem to be because they hadn't exercised or because they were lonely or bored. They generally had access to exercise facilities and to daily visitors.
In fact, upon release, no inmate blamed the food, the exercise machines, or the visitation hours for their weight gain. They blamed their jailhouse fat on the baggy orange jumpsuits they had to wear for six months. Because these orange coveralls were so loose-fitting, most of them didn't realize they had progressively gained weight-about a pound a week-until they were release and had to try and squeeze back into their own clothes".
Hopefully, you are not in county jail and wearing orange coveralls. However, we can all benefit from these jail house subjects because we practice similar behaviors, such as wearing stretchy yoga pants in lieu of jeans or fitted pants, pull on shorts, or loose dresses. All of these types of clothing are known for their comfort value, however, when our calorie intake starts increasing and affecting our waist line, it may go unnoticed if our pants aren't talking back!
Our clothes do communicate with us if we tune in and listen. The notch in the belt is let out or taken in. Our pants only zip half way or are too loose entirely. Researches in Dr. Wansick's lab reported these 8 signals that indicated weight loss to them more often than just the number on the scale.
-"When my jeans feel comfortable again."
-"When I have to start wearing a belt".
-"When I suck in my stomach, and I can see some definition, like a four pack".
-"When my belt notch moves back to where it used to be".
-"When I don't get tired walking up two flights of stairs to my office".
-"When I can see my cheekbones".
-"When I don't have to inhale to button my pants".
-"When friends or colleagues ask me if I've lost weight".
So, a few take home messages:
1) Wear some "fitted clothing", at least some of the time for a REAL gut check!
2) Be mindful of your eating, when your actually hungry and when you are actually satisfied. I like to encourage my clients to close their eyes, take a deep breath and exhale, and ask themselves to rate their hunger before a meal on a scale of 1-10. After assessing their hunger, make sure that the food intake matches their hunger level. During their meal, eat slowly, noticing what the foods taste like, how their body feels. About half way through the meal, reassess the hunger and respond accordingly until satiety is achieved, and get back to your four year old self!
Happy and healthy eating!
For more information on nutrition or counseling services, please contact Leslie Goudarzi, MS, RD, LD at 903-239-1551.
Thursday, January 19, 2017
Cheers! The Ups and Downs of Alcohol Intake
The average American consumes 6-10% of their calories as alcohol. The average represents those who never drink, those that drink socially (those who prefer an alcoholic beverage over water, tea, milk, etc.. with a meal or social engagement), binge drinkers (those who drink 4 or more drinks in a short period), and problem drinkers (those who prefer to become intoxicated as often as possible; may be due to psychological and physiological issues).
Moderate drinking is defined by one drink per day for a woman and two drinks per day for men. This does not mean that a female can abstain from alcohol for 6 days, and on day 7 enjoy seven alcoholic beverages (this would be considered binge drinking as describe above).
An alcoholic drink is defined as 1 ounce of hard liquor, 12 ounce beer, or 3.5 ounces of wine. The amount of calories in alcoholic beverages can be significant ranging from 90-600 calories per beverage, depending on the mixers in which the alcohol is combined.
We have all heard that we should not drink on an empty stomach (and some of my readers may have actually participated in their own "scientific experiment" with regard to this). When alcohol is consumed without food, the alcohol can be absorbed directly from the stomach into the blood stream, where it travels quickly to the brain, lowering inhibitions and limiting judgement ability. The alcohol in the blood will eventually make it's way to the liver for metabolism or break down. The liver views alcohol as a toxin and the main goal of to dismantle the alcohol and excrete it from the body. When alcohol is consume with or after food intake, alcohol absorption is slowed and the intoxication effects are lessened.
An enzyme, alcohol dehydrogenase (ADH), is secreted n the liver when alcohol is present. A nondrinker will have a smaller amount of ADH available as compared to a binge drinker or a problem drinker. Alcohol dehydrogenase is the enzyme that is typically associated with what the average person refers to as "tolerance", meaning the more an individual drinks, the more alcohol dehydrogenase the individual will produce in anticipation of needing it to break down future alcoholic beverages. This explains why some people can be 'drunk' on 2 drinks, while others can tolerate a case of beer or a fifth of hard liquor in a single day.
Once alcohol dehydrogenase has been activated, it will begin a cascade of physiological processes to rid the body of the toxin. First, antidiuretic hormone (controls fluid balance in the body by regulating urine output) is deactivated resulting in increased urine output in order to rid the body of the alcohol . This explains why it is much easier to find an empty bathroom stall at a school that in it is at a concert or bar. This excessive urine output will dehydrate the body, leading to increased thirst, and if followed up with additional alcohol intake, will further dehydrate the body. The eventual result of this dehydration will cause many of the symptoms associated with the hangover including headache, nausea, and muscle weakness and lack of coordination. if the alcohol consumption continues to an excessive amount, vomiting is likely to occur, furthering the dehydration.
The dehydration process will continue until the alcohol is completely metabolized. The body will also attempt to use the excessive calories from alcohol for energy. If more calories are consumed than can be utilized, those excessive calories will be converted into fat. In fact, drinkers have increased body fat compositions compared to nondrinkers. Excessive body fat and dehydration may be especially contraindicated for athletic performance, decreasing cardiac output, lessen ability to perform for long durations, and fatigue more quickly.
Over the long term, drinkers are more likely to suffer from more conditions than nondrinkers including
`cirrhosis and liver disease
`bladder, kidney, pancreas, and prostate damage,
`bone deterioration and osteoporosis
`brain disease, central nervous system damage, and stroke
`deterioration of the testicles
`type 2 diabetes
`heart disease
sexual impotence in men
`impaired immune response
`impaired memory and balance
`malnutrition
`nonviral hepatitis
`severe psychological depression
`skin rashes and sores
`ulcers and inflammation of the stomach and intestines
It should be noted that there are populations that SHOULD NOT consume alcohol including:
`children and adolescents
`individuals that cannot restrict intake
`women who may become pregnant, women that are pregnant or breastfeeding
`people that are driving
`people that are taking medication that can interact with alcohol
`people with medical conditions worsened by alcohol, such as liver disease
So is there an upside to drinking? Yes, in some situations.
1. Drinking alcohol (in moderation) decreases inhibitions. This can be a particularly positive for individuals that experience social anxiety or generalized anxiety disorder.
2. Drinking alcohol increases appetite. Appetite is the psychological need for food, meaning that food looks good, sounds good, and smells good. In fact, we generally eat about 15-20% more after consuming 1 cocktail before dinner. In addition, the cocktail drinkers rank the food quality and enjoyment of the meal higher than nondrinkers at the same meal. For individuals with decreased appetite, such as cancer patients, HIV/AIDS patients, and nursing home residents, alcohol may be helpful in increasing oral intake. However, if you are trying to lose weight, it is important to remember that alcohol intake will likely result in eating more calories as well as drinking them.
3. In individuals over 65 (that have been moderate drinkers during adulthood), switching their alcohol choice to red wine may be cardio-protective.
So when evaluating your food and beverage choices, be sure to include your alcohol intake. It may be beneficial in moderation for you, however, it could increase your body fatness, negatively impact you athletic performance, or even harm your health. Remember, like all of our dietary choices, moderation is key with alcohol intake!
Happy eating (and drinking)!
For more information or to schedule an appointment with Leslie Goudarzi, MS, RD, LD, call 903-239-1551.
Moderate drinking is defined by one drink per day for a woman and two drinks per day for men. This does not mean that a female can abstain from alcohol for 6 days, and on day 7 enjoy seven alcoholic beverages (this would be considered binge drinking as describe above).
An alcoholic drink is defined as 1 ounce of hard liquor, 12 ounce beer, or 3.5 ounces of wine. The amount of calories in alcoholic beverages can be significant ranging from 90-600 calories per beverage, depending on the mixers in which the alcohol is combined.
We have all heard that we should not drink on an empty stomach (and some of my readers may have actually participated in their own "scientific experiment" with regard to this). When alcohol is consumed without food, the alcohol can be absorbed directly from the stomach into the blood stream, where it travels quickly to the brain, lowering inhibitions and limiting judgement ability. The alcohol in the blood will eventually make it's way to the liver for metabolism or break down. The liver views alcohol as a toxin and the main goal of to dismantle the alcohol and excrete it from the body. When alcohol is consume with or after food intake, alcohol absorption is slowed and the intoxication effects are lessened.
An enzyme, alcohol dehydrogenase (ADH), is secreted n the liver when alcohol is present. A nondrinker will have a smaller amount of ADH available as compared to a binge drinker or a problem drinker. Alcohol dehydrogenase is the enzyme that is typically associated with what the average person refers to as "tolerance", meaning the more an individual drinks, the more alcohol dehydrogenase the individual will produce in anticipation of needing it to break down future alcoholic beverages. This explains why some people can be 'drunk' on 2 drinks, while others can tolerate a case of beer or a fifth of hard liquor in a single day.
Once alcohol dehydrogenase has been activated, it will begin a cascade of physiological processes to rid the body of the toxin. First, antidiuretic hormone (controls fluid balance in the body by regulating urine output) is deactivated resulting in increased urine output in order to rid the body of the alcohol . This explains why it is much easier to find an empty bathroom stall at a school that in it is at a concert or bar. This excessive urine output will dehydrate the body, leading to increased thirst, and if followed up with additional alcohol intake, will further dehydrate the body. The eventual result of this dehydration will cause many of the symptoms associated with the hangover including headache, nausea, and muscle weakness and lack of coordination. if the alcohol consumption continues to an excessive amount, vomiting is likely to occur, furthering the dehydration.
The dehydration process will continue until the alcohol is completely metabolized. The body will also attempt to use the excessive calories from alcohol for energy. If more calories are consumed than can be utilized, those excessive calories will be converted into fat. In fact, drinkers have increased body fat compositions compared to nondrinkers. Excessive body fat and dehydration may be especially contraindicated for athletic performance, decreasing cardiac output, lessen ability to perform for long durations, and fatigue more quickly.
Over the long term, drinkers are more likely to suffer from more conditions than nondrinkers including
`cirrhosis and liver disease
`bladder, kidney, pancreas, and prostate damage,
`bone deterioration and osteoporosis
`brain disease, central nervous system damage, and stroke
`deterioration of the testicles
`type 2 diabetes
`heart disease
sexual impotence in men
`impaired immune response
`impaired memory and balance
`malnutrition
`nonviral hepatitis
`severe psychological depression
`skin rashes and sores
`ulcers and inflammation of the stomach and intestines
It should be noted that there are populations that SHOULD NOT consume alcohol including:
`children and adolescents
`individuals that cannot restrict intake
`women who may become pregnant, women that are pregnant or breastfeeding
`people that are driving
`people that are taking medication that can interact with alcohol
`people with medical conditions worsened by alcohol, such as liver disease
So is there an upside to drinking? Yes, in some situations.
1. Drinking alcohol (in moderation) decreases inhibitions. This can be a particularly positive for individuals that experience social anxiety or generalized anxiety disorder.
2. Drinking alcohol increases appetite. Appetite is the psychological need for food, meaning that food looks good, sounds good, and smells good. In fact, we generally eat about 15-20% more after consuming 1 cocktail before dinner. In addition, the cocktail drinkers rank the food quality and enjoyment of the meal higher than nondrinkers at the same meal. For individuals with decreased appetite, such as cancer patients, HIV/AIDS patients, and nursing home residents, alcohol may be helpful in increasing oral intake. However, if you are trying to lose weight, it is important to remember that alcohol intake will likely result in eating more calories as well as drinking them.
3. In individuals over 65 (that have been moderate drinkers during adulthood), switching their alcohol choice to red wine may be cardio-protective.
So when evaluating your food and beverage choices, be sure to include your alcohol intake. It may be beneficial in moderation for you, however, it could increase your body fatness, negatively impact you athletic performance, or even harm your health. Remember, like all of our dietary choices, moderation is key with alcohol intake!
Happy eating (and drinking)!
For more information or to schedule an appointment with Leslie Goudarzi, MS, RD, LD, call 903-239-1551.
Monday, January 2, 2017
The Upside of Making SMARTER New Years Resolutions
Millions of us have made lofty "New Year's Resolutions" as part of the tradition of self improvement that occurs each January. The most popular proclamations include losing weight, quitting smoking, or to cut out junk food. Although these are all great aspirations, our approach may need some improvement. Stating the goal in a positive manner may actually help achieve those desired positive results. For example, instead of a goal of losing weight, perhaps we should focus on improving eating habits or increasing our fitness abilities. Psychologically, we are in a happier place to think of our goals as gaining something instead of giving something up.
Once you have goal in mind (aka resolution), increase your success rate by following the SMARTER method.
S-Specific:
Be clear about what you want as you set a positive specific goal. Instead of saying "I am going to eat better, state specifically how you are going to improve your eating habits. For example, "I am going to follow a 1400 Calorie balanced eating plan to improve my nutrition habits and promote weight.
M-Measurable:
The goal should be measurable. Using the example above, you could track the number of clories you consume to know whether you are meeting your goal.
A-Achievable:
Focus on behaviors that you can control. For instance, you can't directly control how much weight you will lose this week, because you may retain fluid one day or hit a plateau one month. However, you can control the behaviors that lead to weight loss, such as eating a set number of calories and doing physical activity. So, instead of setting a goal of "losing 2 pounds this week", phrase your goal to "this week I will consume 1400 calories per day".
R-Realistic:
I see advertisements, especially this time of year, promising quick, rapid weight loss, such as "Lose 10 pounds in 2 weeks". These types of unrealistic expectations can be incredibly devastating emotionally and sabotage your goals. Being realistic means setting a goal that is challenging but not overwhelming, so you can experience success and build confidence in your ability to conquer bigger challenges.
T-Time bound:
Setting specific start and end times for your goal will help you commit to a time frame and to avoid restarting each Monday!
E-Evaluated:
It is important to look at your goals and see how you are progressing. In the example above, did you consume the 1400 calories per day? If not, what happened? Were there certain challenges or problems with meals or certain days? Evaluation of your own behavior can help you to plan for possible diversions and learn how to have a positive plan when problems occur.
R-Rewarded:
Celebrate your success!! Acknowledge your progress by rewarding your achievements with non-food treats! We are more likely to achieve goals when there are both intrinsic and extrinsic rewards.
Making a positive goal and following through with these steps can help turn those resolutions into a reality! Wishing you all a happy and healthy New Year!
For more information on healthy eating, weight management, or to make an appointment with Leslie Goudarzi, Wellness Dietitian at the GSMC Institute for Healthy Living, call 903-239-1551.
Once you have goal in mind (aka resolution), increase your success rate by following the SMARTER method.
S-Specific:
Be clear about what you want as you set a positive specific goal. Instead of saying "I am going to eat better, state specifically how you are going to improve your eating habits. For example, "I am going to follow a 1400 Calorie balanced eating plan to improve my nutrition habits and promote weight.
M-Measurable:
The goal should be measurable. Using the example above, you could track the number of clories you consume to know whether you are meeting your goal.
A-Achievable:
Focus on behaviors that you can control. For instance, you can't directly control how much weight you will lose this week, because you may retain fluid one day or hit a plateau one month. However, you can control the behaviors that lead to weight loss, such as eating a set number of calories and doing physical activity. So, instead of setting a goal of "losing 2 pounds this week", phrase your goal to "this week I will consume 1400 calories per day".
R-Realistic:
I see advertisements, especially this time of year, promising quick, rapid weight loss, such as "Lose 10 pounds in 2 weeks". These types of unrealistic expectations can be incredibly devastating emotionally and sabotage your goals. Being realistic means setting a goal that is challenging but not overwhelming, so you can experience success and build confidence in your ability to conquer bigger challenges.
T-Time bound:
Setting specific start and end times for your goal will help you commit to a time frame and to avoid restarting each Monday!
E-Evaluated:
It is important to look at your goals and see how you are progressing. In the example above, did you consume the 1400 calories per day? If not, what happened? Were there certain challenges or problems with meals or certain days? Evaluation of your own behavior can help you to plan for possible diversions and learn how to have a positive plan when problems occur.
R-Rewarded:
Celebrate your success!! Acknowledge your progress by rewarding your achievements with non-food treats! We are more likely to achieve goals when there are both intrinsic and extrinsic rewards.
Making a positive goal and following through with these steps can help turn those resolutions into a reality! Wishing you all a happy and healthy New Year!
For more information on healthy eating, weight management, or to make an appointment with Leslie Goudarzi, Wellness Dietitian at the GSMC Institute for Healthy Living, call 903-239-1551.
Thursday, November 17, 2016
Food, Family, and Foodborne Illness-How to Prevent Code Brown This Thanksgiving!
Thanksgiving is time of family, friends, and fellowship. Most of us are concerned with the massive caloric content of our favorite Thanksgiving foods, however there may be a bigger concern. The schedule for this beloved American holiday is often food and football, but unfortunately can be followed by a bad case of foodborne illness if food safety is overlooked. Foodborne illness often manifests itself with moderate to severe gastrointestinal symptoms including nausea, vomiting, and diarrhea, or "Code Brown". The Centers for Disease Control and Prevention (CDC) estimates that 48 million, or 1 out every 6 of us, will get sick each year from foodborne illness. Infants, adolescent children, elderly, and those with compromised immune systems are especially at high risk.
According to the CDC, the two leading causes of food borne illnesses are eating raw or undercooked foods such as meat, poultry, seafood, and eggs; and allowing food to remain at unsafe temperatures too long. It is important to make sure that you keep your food safe this Thanksgiving by remembering a few simple rules. Food safety begins with the purchase of food and continues until the food is discarded. Proper handling of food is most important and can be summarized by the tips below:
1) Purchase foods that have been stored at the appropriate temperatures. If you are buying frozen food, it should be thoroughly frozen in the store. If you buying a ready to eat product, make sure it is at the proper temperature. Cold foods should be held at 40 degrees or below and hot foods should be held at 140 degrees or above. The danger zone for high microbial growth in food is 60 degrees to 120 degrees (where we also find "room temperature".
3) Check expiration dates on cartons and cans. Make sure that you are using safe and fresh ingredients. Old or expired products can taint dishes before the holiday even begans.
3) Avoid buying dented or bulging cans. These can be signs of foods affected with the toxin, Cl. botulinum, which can be life threatening or deadly.
4) Plan ahead to thaw raw meats and poultry properly. It is important to keep in mind that it may take several days to safely thaw a frozen turkey. It is unsafe to set a turkey or meat out on the counter to thaw, as the exterior portion of the meat will be exposed to the "Danger Zone" temperatures, while the interior of the meat will remain at freezing for some time. Thawing the meat in the refrigerator on a bottom shelf is the optimal method to use (bottom shelf is preferred to prevent uncooked poultry drippings from contaminating other ready to eat foods).
5) Cook meat, poultry, and other dishes to safe internal temperatures. Properly using a meat thermometer can assure that your food is at a lower risk for contamination. The thermometer should be inserted in to the middle of the interior to check for doneness.
6) Keep cold foods refrigerated below 40 degrees and hot foods at 165 degrees until ready to serve. This can be done by keeping the food in the oven, using heating elements to keep food warm, and warm or cold packs for insulated casserole dishes.
7) Most families serve Thanksgiving in a buffet style where there are no sneeze guards, hand washing police, or heating and cooling elements to keep foods at their preferred temperature settings. All of these factors can contribute to your risk. To maximize food safety, encourage hand washing, help children with their plates to prevent little fingers contaminating entire dishes. Keep food completely covered to minimize unsafe sampling and to prevent germs from sneezing or coughing to infiltrate the food. Cover foods quickly after serving and refrigerate as soon as possible.
8) No double dipping! Provide serving spoons for each dish. Never put a "personal" utensil in a "public" dish!
9) Fill your plate with foods that have lower microbial growth potential such as fresh fruit, plain vegetables, whole grains, and appropriately heated meats (as opposed to creamy or protein based casseroles).
10) Risks for illness increase dramatically when the Thanksgiving feast is left out at room temperature for hours, sometimes until the next meal. Remember, bacteria thrive at room temperature and many bacteria are introduced during the serving of the holiday dinner. When in doubt, throw it out.
Following these guidelines can help you have a safe and enjoyable Thanksgiving day and extended weekend. Do your part to encourage friends and family to prevent having a Code Brown Turkey Day! Happy and Healthy Eating!
For more information on healthy eating, contact Leslie Goudarzi, MS, RD, LD, at the GSMC Institute for Healthy Living at 903-239-1551.
According to the CDC, the two leading causes of food borne illnesses are eating raw or undercooked foods such as meat, poultry, seafood, and eggs; and allowing food to remain at unsafe temperatures too long. It is important to make sure that you keep your food safe this Thanksgiving by remembering a few simple rules. Food safety begins with the purchase of food and continues until the food is discarded. Proper handling of food is most important and can be summarized by the tips below:
1) Purchase foods that have been stored at the appropriate temperatures. If you are buying frozen food, it should be thoroughly frozen in the store. If you buying a ready to eat product, make sure it is at the proper temperature. Cold foods should be held at 40 degrees or below and hot foods should be held at 140 degrees or above. The danger zone for high microbial growth in food is 60 degrees to 120 degrees (where we also find "room temperature".
3) Check expiration dates on cartons and cans. Make sure that you are using safe and fresh ingredients. Old or expired products can taint dishes before the holiday even begans.
3) Avoid buying dented or bulging cans. These can be signs of foods affected with the toxin, Cl. botulinum, which can be life threatening or deadly.
4) Plan ahead to thaw raw meats and poultry properly. It is important to keep in mind that it may take several days to safely thaw a frozen turkey. It is unsafe to set a turkey or meat out on the counter to thaw, as the exterior portion of the meat will be exposed to the "Danger Zone" temperatures, while the interior of the meat will remain at freezing for some time. Thawing the meat in the refrigerator on a bottom shelf is the optimal method to use (bottom shelf is preferred to prevent uncooked poultry drippings from contaminating other ready to eat foods).
5) Cook meat, poultry, and other dishes to safe internal temperatures. Properly using a meat thermometer can assure that your food is at a lower risk for contamination. The thermometer should be inserted in to the middle of the interior to check for doneness.
6) Keep cold foods refrigerated below 40 degrees and hot foods at 165 degrees until ready to serve. This can be done by keeping the food in the oven, using heating elements to keep food warm, and warm or cold packs for insulated casserole dishes.
7) Most families serve Thanksgiving in a buffet style where there are no sneeze guards, hand washing police, or heating and cooling elements to keep foods at their preferred temperature settings. All of these factors can contribute to your risk. To maximize food safety, encourage hand washing, help children with their plates to prevent little fingers contaminating entire dishes. Keep food completely covered to minimize unsafe sampling and to prevent germs from sneezing or coughing to infiltrate the food. Cover foods quickly after serving and refrigerate as soon as possible.
8) No double dipping! Provide serving spoons for each dish. Never put a "personal" utensil in a "public" dish!
9) Fill your plate with foods that have lower microbial growth potential such as fresh fruit, plain vegetables, whole grains, and appropriately heated meats (as opposed to creamy or protein based casseroles).
10) Risks for illness increase dramatically when the Thanksgiving feast is left out at room temperature for hours, sometimes until the next meal. Remember, bacteria thrive at room temperature and many bacteria are introduced during the serving of the holiday dinner. When in doubt, throw it out.
Following these guidelines can help you have a safe and enjoyable Thanksgiving day and extended weekend. Do your part to encourage friends and family to prevent having a Code Brown Turkey Day! Happy and Healthy Eating!
For more information on healthy eating, contact Leslie Goudarzi, MS, RD, LD, at the GSMC Institute for Healthy Living at 903-239-1551.
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