Healthy Holiday Recipes for the New Year

Invest in Your Health

A recent radio newscaster used the word, “capitulation,” when describing today’s investor in the stock market. Capitulation, in the stock market, is when the investor gives up and pulls out entirely. He or she does not ride out the economic waves, but is gun-shy about investing further in a volatile instrument. My first reaction to this news spot was, “What better time but to invest in yourself?” When everything else feels like it is failing you, you have the most control over your body and mind. Make it as healthy and sharp as possible.

In thinking about the theme of this article, an old cartoon popped in my head. In this cartoon, an out of shape and not so healthy looking individual sits on an examination table, while the physician stands directly across from and converses with this patient. The physician says, “You can consult with a registered dietitian and learn about nutrition and weight loss to help your condition, but this is most-likely not covered by your insurance.” The physician continues to tell the patient, “Or, you can undergo radical surgery, and that is most-likely covered completely by your insurance.” The patient quickly responds, “I’ll take the surgery.”

Funny as it sounds, it is pretty sad. Our politicians have plenty of ideas for fixing our healthcare system, but no one has ever entertained a tax or penalty for those who do not take care of their mental or physical health. Even “preventive” health plans give very little incentive for undergoing nutritional care and mental health services as a means to avoiding unnecessary visits to the doctor, expensive medications and radical surgeries.

Dr. Dean Ornish pioneered the heart reversal diet, low in fat and low on the food chain. Heart Reversal programs began to pop up around the country, costing a few thousand dollars in exchange for longevity. Initially, his approach was criticized and labeled as “radical” by other healthcare providers and the media. Dr. Ornish regularly posed the question, in his presentations, “What is more radical: drugs and surgery or eating healthy?”

For more than 40 years, T. Colin Campbell, Ph.D. has been at the forefront of nutrition research. His legacy, the China Study, is the most comprehensive study of health and nutrition ever conducted. In The China Study, Dr. Campbell outlines the connection between nutrition and heart disease, diabetes, and cancer, and also its ability to reduce or reverse the risk or effects of these deadly illnesses. The study was the culmination of a 20-year partnership of Cornell University, Oxford University and the Chinese Academy of Preventive Medicine.

The findings of this study showed that individuals who ate the most animal-based foods developed the most chronic disease. Individuals who ate the most plant-based foods were the healthiest and tended to avoid chronic disease. The problem that most people find in eating healthy is the increase in their grocery bills. What if you looked at your increase in grocery bills as saving money later on your bill of health?

Some corporations, such as Johnson and Johnson, have developed incentive based health plans, where employees get certain bonuses for regular check ups, and penalties for ignoring their health. Other employer groups have carved out nutrition and exercise coverage in their health plans.

On the other hand, we spend thousands of dollars on education and activities for our children, but ignore the necessity of addressing prevention and treatment of destructive behaviors. In my eating disorder practice, I see bright individuals who have achieved academic honors, but yet will never be able to function on a job unless they take their recovery seriously. And then there are those families who choose to brush these illnesses under the carpet, ignoring the value of addressing one’s mental health.

So, if you are thinking about a special gift this holiday season, for you or someone you love, spend it on the gift of health. If you are looking to make a serious renovation to your house, renovate your inner house. Happy holidays!

Nutrition: October 2008

Have you ever wondered why many “health conscious” individuals think of foods such as diet soda, artificial sweeteners, and TV dinners – with names like “Health” or “Lean” as a part of their brand name – to be “healthy foods” despite their ingredient panel containing a long list of unnatural or artificial ingredients?

Since the 1950’s, America has seen a tremendous growth in its food supply. In the mid 1980’s, this country saw an enormous increase in the number of available diet and artificial foods, intended to promote weight loss and “health”. However, since then, our country’s population has been getting heavier and increasingly wrought with chronic disease. We are consuming food that truly is not food, and our bodies do not know how to process these many foreign substances!

Slow Food is a breath of fresh air. Slow Food is a non-profit, eco-gastronomic member-supported organization that was founded in 1989 to counteract fast food and fast life, the disappearance of local food traditions and people’s dwindling interest in the food they eat: where it comes from, how it tastes and how our food choices affect the rest of the world.

Slow Food members around the world work to build relationships with producers, campaign to protect traditional foods, organize tasting and seminars, encourage chefs to source locally, nominate producers to participate in international events and work to bring taste education into schools. Most importantly, they cultivate the appreciation of pleasure and quality in daily life.

Slow Food is good, clean and fair food. Slow Food members believe that the food you eat should taste good; that it should be produced in a clean way that does not harm the environment, animal welfare or your health; and that food producers should receive fair compensation for their work.

Carlo Petrini, an Italian journalist dismayed by the opening of a McDonald’s in Rome, stated, “Pleasure is a way of being at one with yourself and others.” Slow Food recognizes that the best place to preserve biological and cultural diversity is not in museums or zoos but on our plates.

Slow Food is a great adjunct to Mindful Eating, which you may have heard about recently as a way to slow down and appreciate what you are eating. Mindfulness is being aware of what is present for you physically, emotionally and spiritually in each moment. Mindful Eating is:

• Allowing yourself to become aware of the positive and nurturing opportunities that are available through food preparation and consumption by respecting your own inner wisdom.

• Choosing to eat food that is both pleasing to you and nourishing to your body by using all your senses to explore, savor and taste.

• Learning to be aware of physical hunger and satiety cues to guide your decision to begin eating and to stop eating.

If weight management is primarily your interest, bringing awareness and attention to how and what you are eating can help you eat when you are hungry and stop when you are full. If everyone in this country practiced this rule, weight loss diets would be obsolete! Here are some other ways to practice mindful eating:

• Bring the palms of your hands over your food, and notice if you feel anything from it. With your palms here, give thanks for the food and the experience.

• Journal what is coming up for you at this moment

• Begin to eat. Again, appreciate the food with all five senses. Chew slowly and completely, keep your eyes closed. Can you chew each mouthful 30 or 50 or even 100 times? Explore the full flavor and the variety of tastes that make up this food.

• Explore the food with all of your senses:

Sound – Does the food have a vibration or sound?

Smell – Odors, familiar smells that bring up memories, feelings

Visual – Color, presentation

Taste – Describe taste

Texture – Describe all sensations

How can you support the Slow Food movement?

• Reduce your intake of processed foods

• Eat lower on the food chain

• Eat locally grown and organic produce as much as possible

• Cook more meals from scratch vs. dining out

• If cooking is not your forte’, try the “meals to go” in whole and organic food stores

A “slow” approach to dietary changes will pave the way to long-term changes. The “slow” approach to making life long dietary changes involves a comprehensive nutrition assessment. This assessment is an important first step in order to peel back the layers and pave the way for a successful nutrition counseling experience.

Many individuals expect to transform themselves in one meeting with a registered dietitian. They want to learn and internalize everything in less than an hour of time. Just like any other credible healthcare profession, you are not healed in one visit to your healthcare provider, whether it be your physician, psychotherapist, physical therapist, occupational or speech therapist.

Learning how to make healthy and wholesome food choices, over time, will give you much more clarity vs. loading up on sugar and junk food. This is how you create balance and move away from the “all” or “nothing” approach.

Fighting the Battle of Childhood Obesity

by Heidi Press

When family challenges and overeating created health issues for 12-year-old Kylee Gallero of Waterford, her family decided it was time to take action. They signed up for Shapedown.

Phil (dad), 48, Lori (mom), 40, and Kylee joined the University of California-developed weight loss program through the Community Programs department of St. Joseph Mercy Oakland (SJMO) in Pontiac. Based on family involvement, Shapedown is aimed at ending childhood and adolescent obesity through a curriculum that emphasizes healthy eating, exercise and communication. By-products of the 10-week program include increased self-esteem, decreased depression, improved diet and exercise habits and weight management knowledge.

For the Galleros, enrollment in the program came in the nick of time. Phil had suffered failure of one kidney and a heart attack. Mom, Lori, who works midnights was “sleeping on everything I ate.” Daughter Kylee had developed high blood pressure and diabetes.

With Gallero’s illnesses already causing stress, the family also had experienced deaths of family members in recent months, including Lori’s father, with whom 12-year-old Kylee was particularly close. She was so broken up when he died, she started eating for comfort and “that’s when I started gaining weight.” “We were so stressed out with things that happened to us, we just started eating,” Lori explains. Thanks to Shapedown, the Galleros learned how to deal with death and other life challenges.

They learned about Shapedown at SJMO, when Phil was being treated for his heart attack. The hospital connected them with a nutritionist who directed them to Shapedown. The Galleros attend the program at the North Oakland YMCA in Auburn Hills.

Currently, five families are participating, but there’s room for eight in each session. The program costs $500 per family, and each member receives a workbook in which he/she can keep track of the foods intake, exercise and communications activities. And it is loaded with information.

The program doesn’t offer a diet, just a plan to make healthy choices when it comes to food. In one class, the Galleros learned how to make healthy sandwich wraps and season and prepare food. They also learned how to scale down proportions. Each used to eat a bowl of ice cream; now it’s just a cup.

According to the Centers for Disease Control and Prevention (CDC), about 17 percent of children and adolescents ages 2-19 are overweight. In Michigan, 12 percent are overweight, and 15 percent are at risk for becoming overweight. This extra weight can lead to all kinds of health issues, the Michigan Department of Community Health reports, including cardiovascular disease, Type 2 diabetes, some types of cancer as well as social and emotional difficulties.

Since enrolling in the program, the Galleros say their communications skills have increased. “If anything is bothering us, we now talk to each other, rather than holding it in,” Lori says. “The program made us more aware of each other,” she adds. “We’re supporting each other.”

They also learned how to relax with breathing exercises accompanied by mellow music.

In the exercise track, the program provides the children and teens with Theraballs, Therabands and water bottles. Other recommended exercises include walking, swimming, Rollerblading, bike riding and ball exercises.

Each of the Galleros has experienced some results from the program after only a couple of sessions. Phil says it has helped with his recovery. Lori finds that it boosts her self-confidence in addition to motivating the family to get moving. And, their daughter Kylee says that her “pants are getting bigger, which I’m happy about.” She also likes the fun element, and that “you’re not going through this alone.”

Phil says he likes the program because it gives him the tools to help him eat right and “ideas for exercise that won’t put stress or strain on you.”

SJMO’s program is directed by Julie Esparsa, coordinator for weight management programs. Classes are taught by licensed professionals, including an exercise physiologist; nutritionist; and social worker.

According to Esparsa, Shapedown was started in response to the increase in childhood obesity, especially in Pontiac, which is served by SJMO. The program is supported by donors and SJMO’s Community Benefit mission. Scholarships are available.

The Galleros like the supportive nature of the program. “We interact with other families,” Lori says. Since joining the program, the Galleros have met other families with whom they are planning to stay in touch.

For Phil, Lori and Kylee, Shapedown was a great find. “This program is the best way to go,” says Gallero. “It works. If you follow the program and do the exercises, you actually lose the weight.”

Heidi Press is the public relations specialist for Trinity Health’s St. Joseph Mercy Oakland in Pontiac, MI. She holds a Bachelors of Arts degree from Wayne State University in English and Journalism.  She has an extensive background in the communications field.

Nutrition: Shedding Heavy Foods for the Summer

Summer is a great time to think about eating lighter meals. A growing amount of individuals are interested in experimenting with a vegetarian diet or eating more vegetarian meals during their week. Just like any food plan, the key to a healthy vegetarian diet is simple—eat a variety of foods, which are nutrient dense, and limit junk foods. If you base your diet around junk food, whether you are a carnivore or a vegetarian, you will be missing out on many key nutrients.

What should individuals be concerned about regarding proper nutrition if contemplating a vegetarian diet? Iron deficiency anemia is still a widespread problem. However, studies show that anemia is no more prevalent in vegetarians than in carnivores. Although the iron in meat products is more readily absorbed, good non-meat sources of iron include beans, green leafy vegetables, fortified cereals and dried fruit.

On the other hand, a vegetarian diet may be useful in treating heart disease and diabetes. Over 50% of individuals with diabetes develop heart disease at some point in their lives, which can be prevented or abated by prudent food choices. Dr. Dean Ornish has done groundbreaking research in the area of lifestyle and heart disease prevention. He has demonstrated that the blockage of arteries can actually be reversed without surgery or drugs using a low-fat, vegetarian diet in conjunction with exercise and stress management. Since even small improvements in arterial blockages can significantly improve blood flow to the heart, this is a wonderful option for anyone who has considered surgery to be the only choice.

In addition to heart disease, meat is a contributing factor in the development of kidney failure due to it’s high protein content, along with stroke, and increased vulnerability to infectious diseases. Too much fat is also a problem in the diet of women. Dietary fat, mainly of animal origin, influences levels of various hormones in the body, thereby increasing one’s risk of cancer.

Calcium is another concern in terms of osteoporosis prevention. In the first few years of menopause, women can lose up to 30% of their bone mass. However, osteoporosis is not a disease of calcium deficiency—but a disease of calcium loss. Many women are routinely on diets or are on the go, guzzling down caffeine and/or diet pop, both which cause calcium loss from bone. Caffeinated soft drinks enhance this bone loss. The issue may not be that women are not taking in enough dairy products, but consuming products that are leaching their calcium stores.

Americans, vegetarians included, eat four times as much protein than they actually need. High protein diets promote calcium loss from the bones. Although dairy products contain large amounts of calcium, they also contain a large amount of protein, which causes calcium to be excreted from the body. Non-animal sources of calcium, which would be lower in protein and therefore better retained by the body include green leafy vegetables, beans, tofu and other soy products.

For anyone contemplating a vegetarian diet, you don’t have to embark on the “all or nothing” approach. Finding what works for YOU is the key to any successful diet and lifestyle change. Any change is a step in the direction to feeling healthy.

Here are some steps you can take:

• Eat less red meat and switch to chicken or fish.

• Reduce poultry and fish consumption to three times per week or less, while having at least two to three meatless meals per week emphasizing legumes, soy products, whole grains, and vegetables.

• Don’t worry about “complementing” your proteins. Many people feel that eating vegetarian is “hard work.” This misconception may exist because it was once thought that in order to derive high quality protein from grains and vegetables, proteins needed to be “complemented” (i.e., legumes with seeds, seeds with grains, grains with legumes, etc.) at the same meal. It is now known that you do not have to combine foods in a special way at the same meal to obtain all of the amino acids together. This is usually done naturally during the course of the day with the meals normally eaten.

• Decrease or eliminate consumption of dairy foods. Substitute soy or rice products for milk, yogurt, cheese, and ice cream.

• Limit refined grains such as white rice, white bread, and white pasta. Choose instead brown rice, whole grain breads and other whole grains.

• Increase your intake of fruit and vegetables to load up on antioxidant vitamin and minerals. Have at least three pieces of fruit a day and try a variety of colorful salad greens such as romaine, green and red leaf, spinach, and bibb, not just iceberg or head lettuce.

• Eat more foods rich in omega-3 fatty acids, which are good for your heart, bones and help fight depression. Vegetarian sources of omega-3 fatty acids include flax seeds, wheat germ, tofu, walnuts, and green, leafy vegetables.

Women & Heart Disease: Here are the Facts

By Dr. Gail Dawson, MD, MS, FAAEP

About eight million American women live with heart disease, the #1 killer of women (and men) in the United States today!

Studies show the following:

• One in three women will die of heart disease.

• Women are less likely to survive a heart attack than men.

• About 38 percent of women will die within one year of a first recognized heart attack.

• About 35 percent of women heart attack survivors will have another heart attack within six years.

• Two thirds of women who have a heart attack fail to make a full recovery.

• Women tend to underestimate the symptoms of heart disease and are less likely to seek treatment.

• Heart disease is a lifelong condition – once you are diagnosed with it, you will always have it.

The very positive news is that women easily can change these statistics! Most risk factors of heart disease are controllable. Research shows that women can lower their heart disease risk enormously – by 82 percent – if they lead a healthy lifestyle.

What is heart disease?

The most common cause of coronary artery disease – commonly known as heart disease – is a narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart muscle. This process happens slowly over time, and is the major reason people have acute myocardial infarction (heart attack).

What are the warning signs of a heart attack?

Heart disease often has no symptoms, however, there are a few signs to watch for, and the signs in women may be different than those men experience. Women may feel pain in the center of the chest; in the ear, jaw or neck; or in the back or shoulder area. (Men tend to have crushing pain in the center of the chest that extends down the arm.) Other signs can be unusual tiredness or sudden extreme fatigue, problems with breathing, indigestion, or anxiety.

Heart disease symptoms may be milder in women than men. About 1/3 of women experience no chest pain at all when having a heart attack, and 71 percent report flu-like symptoms for two weeks to a month prior to having more obvious signs of a heart attack.

Can I reduce my risk of heart disease?

Making relatively simple changes in your daily eating habits will pay off quickly. By following this advice, you can reduce your chance of heart disease significantly:

• Control your blood pressure. Blood pressure is considered high when it reaches 140/90.

• Stop smoking. More than half of the heart attacks in women under age 50 are related to smoking. Women who smoke are at risk of dying 19 years sooner than non-smokers. Women who stop smoking for three years have the same risk as women who have never smoked.

• Get tested for diabetes. This medical condition is considered one of the major factors contributing to heart disease. Women with diabetes are two to three times more likely to have a heart attack. Controlling sugar makes a big difference in the development of coronary artery disease, as well as renal failure and stroke.

• Control your cholesterol levels. Too much cholesterol in your blood can build up (plaque) in your arteries and cause a narrowing of the arteries, which causes heart disease. Good cholesterol (HDL above 50 for women) helps remove bad cholesterol (LDL) from the blood. LDL levels should be at least under 140 for women, and the lower the better. Eating healthy helps maintain the good levels of cholesterol in your blood.

• Eat a heart healthy diet. Keep fat calories to less than 30 percent of the total calories you eat each day, and choose foods low in saturated fats, which raise your LDL. Avoid animal meats, butter, whole milk dairy products, cheese, and tropical oils (coconut, palm). Also limit trans fats, which are found in margarine, donuts, muffins and other processed foods. Choose foods with mono or polyunsaturated fats instead. Wise food choices include vegetables, whole grain foods, and low fat or nonfat dairy products. Some processed foods – frozen dinners and canned foods – can be high in saturated fats. When in doubt, read labels. Also remember to limit sodium to no more than 2.4 grams a day.

• Maintain a healthy weight.

• Try to exercise 30 minutes a day, a minimum of three to four times a week. Remember, your heart is a muscle. It needs regular exercise to stay in shape. At midlife, women can benefit from weight-bearing activities that keep bones healthier – walking, lifting hand weights, and even carrying groceries.

• If you drink alcohol, limit it to no more than one drink (12 ounce beer, five ounce glass of wine, one shot of hard liquor) a day.

• Do not take hormone replacement therapy to prevent coronary artery disease. It actually does more harm than good. Research now shows that estrogen plus progestin therapy increases the chance of developing heart disease, stroke, blood clots and breast cancer. If you need to take hormones, use the lowest possible dose for the shortest time needed.

Only two risk factors for heart disease are not controllable – these are your family history and age. If your father or brother had a heart attack before age 55, or if your mother had one before age 65, you’re more likely to develop heart disease. This does not mean you will have a heart attack; but it means you are at a higher risk.

To protect your heart health, be aware that every risk factor counts. If you have even one risk factor, you are more likely to develop heart disease.

What tests are conducted to determine if a person has heart disease?

If you are worried that you have signs or symptoms of heart disease, check with your physician right away. A physical exam may be all that is needed, but sometimes, more testing is necessary.

Imaging studies such as a stress echo or nuclear test will show the reaction of the heart muscle under stress. Patients walk on a treadmill or receive a drug to dilate the blood vessels or make the heart beat faster. In a stress echo, the cardiologist looks for abnormal heart movement under stress. A nuclear study tracks the flow of blood. If it can’t get to the heart muscle under stress because of a blockage, the heart will appear lighter in some areas on the scan.

A CT scan and cardiac catheterization provide a view of the inside of the coronary arteries, which supply blood to the heart muscle. If there is a blockage, it will show up as a narrow part in the blood vessel. A CT scan takes X-rays very rapidly. Patients lie in a machine while dye is injected. The heart rate needs to be slow enough to obtain clear images of the coronary arteries. During a cardiac catheterization, the cardiologist injects dye through a catheter that enters the leg and goes up into the coronary arteries, and then takes pictures. If an artery is blocked, the physician can open it during the procedure. Often a stent is placed to keep the artery open. A stent looks like a skinny tube made of metallic meshwork.

What should I do if I think I am having a heart attack?

Fast treatment can limit heart damage. Get to the hospital as fast as possible. Do not drive yourself. Chew an uncoated aspirin if you have one. This can reduce damage to the heart muscle. Once you arrive at the hospital, an electrocardiogram (EKG) and blood work will be ordered to help determine if you’ve had a heart attack. Even if the EKG is normal, you still may have had a heart attack, and more testing will take place.

Remember: the good news is that women can make a lot of simple changes in their daily routine to greatly reduce their risk of heart disease. It is never too late to start making these changes!

Dr. Gail Dawson is on the medical staff at Genesys Regional Medical Center in Grand Blanc and practices at Regional Cardiology Associates.  She obtained her medical degree from the University of Michigan and earned a fellowship in Cardiology at the Detroit Medical Center through Wayne State University.  She is board certified in cardiovascular disease, internal medicine, nuclear medicine, echocardiography, and coronary CT interpretation.

Fitness: It’s the (Not So) Little Things That Count

So here we are, a couple months into 2008. You made that New Years Resolution to get in shape. You’re hitting the gym like a madman and following all the workout advise that you read about in some magazine by some insane personal trainer/physical therapist who thinks he knows what he is talking about; you even bought this crazy kettlebell thing he kept saying is so great. So why isn’t the weight pouring off? Why don’t you still have enough strength to lift yourself off the couch or the energy to even care. What is going on here?

Now, let me preface what I am about to say by stating clearly that I am not a nutritionist or registered dietician; nor do I have any special training in analyzing sleep patterns. But, I am aware of many of the problems out there that people have and I am going to attempt to make you more aware, too.

Fitness is like a love triangle with constant battles between the exercise component, the rest/sleep element, and the nutrition/diet factor. If one is out of balance, none of it will fit together right. I always talk about exercise, so now we are going to focus on the other two.

Sleep/Rest

The National Sleep Foundation reports that while exact sleep requirements differ among people, the general rule of thumb is:

Adults = 8 hours

Teens = 9 hours

Younger = more

You need to realize that working out hard is great, but muscles don’t grow or get stronger when you work out, it is the recovery process where muscles repair themselves from the workout and can become bigger and/or stronger. The National Sleep Foundation further notes other areas that are affected by improper sleep:

• Memory and learning – Sleep seems to organize memories, as well as help you to recover memories. After you learn something new, sleep may solidify the learning in your brain.

• Mood enhancement and social behaviors – The parts of the brain that control emotions, decision-making, and social interactions slow down dramatically during sleep, allowing optimal performance when awake. REM sleep seems especially important for a good mood during the day. Tired people are often cranky and easily frustrated.

• Nervous system – Some sleep experts suggest that neurons used during the day repair themselves during sleep. When we experience sleep deprivation, neurons are unable to perform effectively and the nervous system is impaired.

• Immune system – Without adequate sleep the immune system becomes weak and the body becomes more vulnerable to infection and disease.

• Growth and development – Growth hormones are released during sleep and sleep is vital to proper physical and mental development.

There is more to sleeping properly than just getting in the required number of hours. Proper sleep actually involves 4 stages ranging from light sleep to deep and dreaming stages. A person cycles through these stages throughout their sleep time. To insure that all stages are achieved, and achieved enough, consistency is needed. It is important to generally go to sleep and wake up at roughly the same time each day (straying every now and then won’t kill you). If there are any factors that are limiting your ability to fall asleep at a consistent time, you need to address them. Things like eating too soon before bed, watching TV while falling asleep, and participating in physically or mentally stressful activities too close to bedtime are common disrupters of sleep (although not for everyone). My advice is to keep a sleep log for one month. A sleep log is fairly simple and should include information such as: bedtime, time you actually fell asleep, time you woke up, number of times you awoke during the night, how well you slept, how you felt when you woke up, and how you felt the rest of that day. Try it and see how you feel.

Nutrition/Diet

So, is anyone confused about what the heck they are supposed to eat? With all the diets out there it’s enough to drive a person absolutely crazy. It would be nice to think that all of the diets were created in an attempt to truly improve a person’s life in terms of weight loss, energy, control of diseases like diabetes, etc; but while some of that may be true, a lot of the diets are only improving the bank accounts of the diet “creators.” For most people, it is not hard to know how to eat right; it is doing it that’s the problem. Let’s face facts, many people cannot lose weight via diet because either they just eat too much or what they eat is garbage. You don’t have to be a rocket scientist to know that eating pizza, cheeseburgers and drinking beer daily is not a staple for proper nutrition. Many of the diet programs out there do work and the reason people do not have success is because they do not do them correctly.

All that being said, there are many others who do not overeat, and eat what they think is healthy and still have problems. Before I let you know some details, let me first say again, that if you are using weight loss as the benchmark of proper diet, you must consider whether the other areas are balanced (exercise and rest). Assuming they are, here are some things to consider:

1) Calories: 3500 calories = 1 lb. (an excess 3500 calories = gaining 1 lb., a deficit of 3500 calories = losing 1 lb); 1 gram of protein and/or carbohydrates = 4 calories, 1 gram of fat = 9 calories, 1 gram of alcohol = 7 calories

Sounds simple right? Wrong. It is not just about total calories you eat or do not eat, but how you utilize those calories.

2) Metabolism: The number of calories used by your body during various activities, including rest.

Example: 2000 calorie per day diet – 500 calories burned during exercise = 1500 calories left to use for the rest of daily activities. If 2000 calories are required for daily activities, then there is a deficit of 500 calories. Therefore, in 7 days one pound of body weight will be lost (500 x 7 = 3500); however, if only 1000 calories are required for daily activities, then there is an excess 500 calories. Therefore you would gain 1 lb. in 7 days. This is metabolism – the higher the metabolism, the more calories burned. Factors that affect metabolism include: body size/weight (heavier = more calories used, although this mostly refers to calories used during activity vs. rest), body composition (greater lean body mass/muscle = higher metabolism), age (metabolism decreases with age), sex (sorry ladies, men burn more calories), drugs (don’t do drugs!), heredity, hormones, stress/anxiety, and temperature (good news for Michiganders – more calories are used in colder temperatures). To calculate your metabolic rate, use these formulas:

Women = 655 + (4.36 x W) + (4.32 x H) – (4.7 x A)

Men = 66 + (6.22 x W) + (12.7 x H) – (6.8 x A)

* W = weight (lbs.) H = height (inches) A = age (years)

3) Food quality: These days everything is about being quick and convenient – welcome to fast food. Not only do we have to deal with fast food, but in an attempt for certain industries to make money, things like preservatives, chemicals, and basic “fake food” are rampant. It is very difficult to look at an ingredient label and see less than a dozen ingredients, half of which you need a degree in biochemistry or nutrition to even know what it is. Last, just because the calorie count may be low (such as with carbohydrates), your body only uses so much before it gets stored as excess, generally as fat.

So with all this information, now which diet should you choose? Realize that weight loss will not happen overnight, and even with proper diet, the loss may not always be consistent.You may even experience some weight gain at certain points, especially if you are exercising.

The best thing I can tell people is to start keeping a food log. Record everything you put in your mouth, how much of it, and what time you did it. Be as specific as possible. For example: turkey sandwich with whole wheat bread (2 slices), 5 slices of lean turkey, lettuce, tomato, mustard at 11:15 a.m.; 16 ounces of water at 1:33 p.m.; 3 jellybeans at 10:42 p.m.

Doing this may make some things more obvious. I had a client who thought she was eating healthy, and then via her food log, discovered she was eating Oreos every hour! It was only one or two at a time, but it adds up. Eventually what you want to see is about six small meals per day, spaced fairly equally. No eating right before bed. Try to balance carbs and protein – most people are excessive with their carbs (most of your snacks/munchies – the things you throw a handful of in your mouth without thinking are either carbs or fat) and the body only uses so much at a time. Eat a lot of vegetables and a decent amount of fruit. Try to have real food.

These are very basic rules for a difficult task. Unlike exercise, which only takes about an hour, you have to think about what you eat the whole time you are awake (which should only be 16 hours – see above). Two excellent resources for nutritional information are: The Metabolism Advantage by John Berardi, and The Anti-Estrogenic Diet by Ori Hofmekler (for both men and women).

Rest and nutrition are two areas that are all too often neglected, and just as important (if not more so) than anything else. Put some time into focusing on these areas if you truly are looking for improved fitness and life quality.

For more information regarding rest/sleep, and nutrition/diet; as well as to download sleep and food logs – contact Bob at bob@functional-strength-training.com, or visit his website at www.functional-strength-training.com.

Choosing to Lose…

As Mary White, 48 of Clarkston, begins her cardio warm-up with her personal trainer Peggy Staycoff, the inspiration of what her body is now capable of doing mitigates her profound dislike of the next 12 minutes she will spend running on the treadmill.

In March of 2007, Mary underwent gastric bypass surgery, a form of bariatric or weight loss surgery that alters the anatomy of your digestive system by limiting the amount of food you can eat and digest.

“Even though I’ve been overweight my whole life, I’ve always considered myself a healthy person. I’ve always believed in the power of exercise and a healthy diet,” says White.

At 5 foot two inches tall, White’s heaviest weight was 234 pounds.

“For years, I had tried every diet, exercise routine, and diet pill that came onto the market. Nothing worked for me. I finally realized that I could not achieve my optimal weight goal alone,” says Mary.

The decision to have gastric bypass surgery is a weighty one loaded with many concerns, questions and even dangers. For Mary, her decision took many years of investigative work where she educated herself on what the surgery involves, its risk factor and its long-term prognosis for sustained weight loss.

During gastric bypass surgery or Roux En Y, the kind of surgery Mary had, the stomach is reduced to the size of a walnut and food is allowed to bypass part of the small intestine. Not only is the stomach’s capacity diminished thereby resulting in feeling full more quickly but fewer calories are absorbed as food is bypassed from the small intestine. Generally, individuals with a Body Mass Index (BMI) of 40 or higher or individuals who have a life-threatening disability due to obesity can be considered as candidates for the procedure.

In the spring of 2006, Mary thought she had her decision made and surgery was scheduled for April. But her family, fearful for her safety and survival, sat Mary down and discussed with her their concerns over the operation. During her family’s intervention, she decided against having the procedure and cancelled her surgery date.

That year, she gave herself the freedom to eat whatever she wanted. Much to her surprise, she only gained six pounds.

“But I was constantly tired. At the beginning of 2007, I decided to give the procedure more thought once again, said Mary.”

This time, she teamed up with Dr. Mark Pleatman, a general surgeon specializing in bariatric surgery at St. Joseph Mercy Hospital in Pontiac. Dr. Pleatman provided Mary with not just the scientific and medical answers she was still searching but also the comfort in addressing her and her family’s concerns. After a few consultations with him, she and her family members changed their minds and set a date for Mary’s surgery.

Mary knew that having the surgery was just part of the change that could eventually result in her reaching her weight goal. Once the surgery was complete, the onus was on her to make the additional changes in her lifestyle.

If bariatric surgery is accompanied by sustained behavioral changes such as a healthy and balanced diet, and exercise, it can provide a long-term solution to weight loss, says Dr. Pleatman.

During the next few months, with the procedure always present in her mind, she tried to lose some extra weight in an effort to put less stress on her liver during the time of surgery. And, she spent many sleepless nights terrified over the uncertain outcome of her decision to have this life-changing procedure.

The operation, which took about 4 hours, was a success. For the next six weeks, Mary would have to follow a strict diet: two weeks of liquids, two weeks of pureed foods and two weeks of soft foods. After six weeks, regular food was gradually added back into her diet as her stomach began to heal.

She also worked with a nutrition counselor who advised her on what to eat, how much to eat and how to appropriately balance her foods so that she was meeting her nutritional requirements.

“I realized that for years, I was eating wrong. I wouldn’t eat the whole day and then I would consume way too much because I was so famished. I was eating so fast that my brain could not receive the signal that I was full,” says Mary.

With her current weight at 124 pounds, Mary has lost almost over hundred pounds since her surgery last spring. She also exercises with a personal trainer three days a week.

In addition to her physical appearance, her eating patterns have also changed significantly. Mary eats six small meals every day and she can only eat about one cup of food at a time due to the reduced size of her stomach. If she tries to eat more, her body will reject it and pain and vomiting will consequently and unfortunately follow. She also takes a cocktail of vitamins, which are specifically designed, for bariatric patients and will have to take them for the rest of her life. But for her, these lifestyle changes are worth every ounce of weight that has vanished from her body.

“I can finally walk the talk I’ve been trying to walk. Having this procedure was the best and most difficult decision I have made so far in my life. It has made a life-long dream of mine come true,” Mary says.

Our Get Fit Challenge Winner Shares Her Success

Several months ago we offered the chance for our readers to tell us why they wanted to get in shape. We received many submissions from people across Southeast Michigan. Some had never exercised and wanted to get started, others had once been fit but over the years had let themselves “slip.” Even more were concerned about their health and their abilities to enjoy the every day things in life.

The person we would select would have the opportunity to workout at Bally Total Fitness for three months with a personal trainer.

We selected 28-year old Elizabeth Schmaltz whose story reflected her battles with diets, working out and losing unwanted pounds. Elizabeth was like many people who struggle with obesity, she knew she needed to lose weight, but didn’t know how to go about it. Even though she had a gym membership, she was too intimidated by the equipment to get an effective workout.

As our winner, Elizabeth has spent the last three months working out at the Bally Total Fitness in Troy with certified personal trainer Brian Gambino. Brian put Elizabeth on a workout plan and gave her nutrition guidance, beginning with a food diary to monitor what she was eating. A disciplined workout combining cardio and weight training and Elizabeth was on her way.

We are happy to report that Elizabeth has lost 25 pounds since she started.

So, how does she feel now?

“I feel great, fantastic, to the point where people are starting to notice. I had a co-worker who said, ‘Oh, I can see your collarbones,’” Elizabeth candidly shares with us.

Great attributes to Elizabeth all through this process have been her humor, optimism and motivation. She has never pretended that her weight hasn’t been a struggle, yet she is comfortable with who she is. Her primary goal was to be a thinner, healthier, Elizabeth.

Although getting started was difficult, she is now a natural around Bally Total Fitness.

“I’m pretty familiar with all of the machines in the weight area and I’m increasing my own intensity in cardio,” says Elizabeth. “I’m doing some jogging and that is going really well. I really like it, it’s a challenge; but it’s a good one.”

She has also been able to change her outlook on her past eating habits. By keeping a food diary, she was able to monitor what she was eating, how much, and how many calories she was consuming.

“It was tough doing the food diary. I was trying to justify eating a muffin in the morning every day, I’d say; ‘It’s okay to eat a 400 calorie muffin.’ But now to look back, I ask myself, ‘Why was I doing that?’ It was awful to do at first, but there was no way I was going to write down 12 potato chips,” says Elizabeth. She has since changed that attitude and consistently logs in what she eats throughout every day.

Elizabeth is very positive about her experience and her success at losing weight. “I think I thank you every time I talk to you, but this has been enlightening and has been such a good experience. I’m so glad I took the opportunity to do it,” she says.

She also recommends that others in her situation take the opportunity to get into a gym, and even hire a personal trainer.

“I would say it is a worthy investment even if you do it for two or three sessions, just get an idea on what to do, and what machines to use. There is a ton of information online that is helpful. But, you really just have to try and find a way to stick with it,” she suggests.

Elizabeth credits her personal trainer, Brian Gambino, of Bally Total Fitness for getting her on the right track. “Working out with Brian was fantastic! He increases the intensity of what we do every week and there were a lot of exercises I was doing and I wondered what I was doing to myself? But once I got used to it, I just figured out that this (workout) was how it was going to be and I embraced what was given to me,” says Elizabeth.

She adds that working out with Brian was “fun” and that he continually supported and motivated her throughout their time together.

Elizabeth is well on her way to improving her health as she continues to work out on her own. She still gets to the gym 5-6 times each week, despite working a full-time job and earning her second bachelor’s degree in business at Oakland University.

She has not quite set a final weight loss goal for herself, but is taking things “one day at a time.”

“As a person who has never been thin, I have no idea of what anything less than 200 lbs. looks like, so once I get there, I will decide how far I want to go,” says Elizabeth.

Somehow, I think whatever goals she sets, she will reach.

Editor’s note: Be sure to watch for our January issue when we wrap up this series with Elizabeth’s personal trainer, Brian Gambino, share her workout with you, as well as excerpts from her food diary.

Fitness: Gut Check Time

So here we are, the end of beach season. Many people are sorry to see it end, others say, “Thank goodness I don’t have to wear a swim suit for another 9 months!” Most people’s New Years or Memorial Day resolutions to get in shape did not turn out the way they wanted. Oh well, better luck next year, right? It doesn’t have to be that way.

Before deciding which of the thousand new fad diets or exercise programs you may look into in the next 12 months, first look inside and do a “gut check” as to why things have not worked out thus far. As you read this article, be true to yourself about how much any of this applies to you. If you are happy with your physical self, then great! If not, stop doing the same thing you have been doing, but hoping for different results, and make the change.

DIET

Before addressing what my clients SHOULD eat, I always first look at what they ARE eating. There are a number of diets out there, and most of them do work for some people, but none of them work for everyone. We are not going to compare and contrast the differences, let’s point out why many people cannot succeed with their diets.

1. Right idea, but missing the point. “I don’t know why I’m overweight, I pretty much just eat salad all the time”, or “my diet is healthy, I eat high protein which is low in fat”. Let’s examine a typical salad – iceberg lettuce (almost no nutritional value), cheese (take your pick which kind, they are generally processed with lots of chemicals and fat), bacon bits (not a good source of protein, but plenty of fat and sodium), croutons (sodium and fat), maybe a little bit of cucumbers and a tomato (the only redeeming value of the salad), and plenty of dressing (even most of the low fat alternatives are not exactly healthy). Or the protein eater – what was it cooked in (butter, oil, etc?), what did you eat with it (that wonderful salad, or maybe a good creamy sauce). Don’t get me wrong, I like salad and protein, and they can be extremely healthy, but just because you eat salad and chicken does not automatically make you a healthy eater.

2. The old standard: “just don’t eat anything.” Super-low calorie diets have been a staple for people looking to lose weight forever. Fortunately some very smart people have figured out that eating a cracker and a diet coke all day is not the healthy alternative. Starving your body will cause it to feed on areas you do not want to lose, like muscle tissue; and affect overall functioning throughout your body. Furthermore, these types of diets basically destroy a person’s metabolism, causing your body to burn very few calories on its own.

3. Think before you stuff: the people who do actually eat healthy, and then some. It is amazing to me how generous people can be. As a physical therapist, I am often blessed with thank you gifts from my patients. I cannot accept money or other similar gifts, and people know this. So what do they give: food. This is the case in most office settings, the thank you gift, or it could be leftovers from someone’s party – brought in for the office to share. While it usually tastes good, the food is rarely good for you, but instead some sort of “sugary” treat. When sweets appear, or maybe it is a bag of chips lying around, people often will shovel it in without thinking. So while someone may eat healthy meals, it is the unhealthy snacking that gets them.

I have found that the best first step towards eating right is to keep a food journal – a pain in the butt, but effective. There are only a few requirements, write down everything you put in your mouth (and I mean everything), how much of it, and what time you did it. Try to be as specific as possible – don’t just write “salad” or “sandwich”; write down everything in it. If you have water, write down “1 glass (8 oz.) of water at 9:17 a.m.”.

This task helps in multiple ways. First it makes you actually think before you eat, and decide if putting that cookie in your mouth is worth having to write it down. Second, it makes you aware of your current eating habits and what needs to change. Third, if someone else is helping you with your eating (a personal trainer, dietician, etc.) they can have the facts vs. what you tell them (which is often less than accurate).

EXERCISE

1. “I belong to a gym”, or “I have a great gym in my house.” This may be true, but indicates being in shape about as much as a person who owns a lot of books claiming to be an intellectual. Many of the big, expensive gyms are losing members to the cheaper, more basic gyms. People’s philosophy, why waste $100 per month on a membership I don’t use, when I can just waste $20 per month – can’t argue with that logic.

2. “I am at the gym 3 hours a day.” I actually had a woman say this to me once in an attempt to brag about what great shape she was in. After taking one look at her, I thought, “then you are wasting 2 1/2 hours per day.”

I estimate (and this comes from observing many people) that for every hour the average person “works out,” they get about 20-30 minutes of work done. The rest of the time is spent chatting, taking unnecessary breaks, or just standing around not having a clue.

The other end of the spectrum is the person who actually does spend hours working out. Unless someone is training for a specific endurance event, these people usually are sacrificing quality for quantity, and are risking overworking their bodies, which can be a serious condition.

3. “The lazy exerciser”: the person who does quality exercise on a regular basis, but is lazy the rest of the time. These are the people who drive around a parking lot for 10 minutes looking for the closest spot to the door so they don’t have to walk too far, the first in line to take the elevator to the second floor, or the person who comes home and plops down on the couch, because they are tired from sitting all day at work. Let’s get real, 60 minutes of exercise does not compete with 1380 minutes of laziness.

4. “My job is physical enough.” The truth is, most of the time, no it isn’t.

5. “I don’t have time.” It’s understandable – people need to spend time at work, driving, sleeping, eating, watching TV for four hours, “working” on the computer for two hours, etc. It’s not my place to tell people how to prioritize their lives, but everyone needs to prioritize their own life.

6. “I got off schedule when I went on vacation.” People like to claim that they have specific days that they work out, and specific things they work on those days. For example, Saturdays they work chest and shoulders, Tuesdays are legs (men usually skip that day), Thursdays are back and arms. While all of this probably sounded good in the Muscle and Fitness article where it came from, it gives people the excuse that since they missed the Saturday workout, their schedule was off and that’s why a month has gone by without being able to “get back on.”

There is a simple solution. Schedules will be thrown off; unless you are competing for Mr. Olympia in the next week, start back today. You don’t need to wait for New Years, Christmas, or Rosh Hashanah – be like Nike, “just do it.”

7. “I don’t know what I am supposed to do, or how to do it.” So, instead they do nothing. Here’s the deal: LEARN, or if you don’t want to learn, find someone to tell you what to do. If none of that works, use common sense – you know you should not just be sitting around all the time, start walking every day (and don’t say you walk all day at work).

8. My favorite: “I workout with a personal trainer 3 days per week.” Refer back to number 1 – talking to your trainer for an hour about what they did over the weekend, how their week is going, and what their weekend plans are, does not constitute working out. Obviously, as a trainer myself, I think having a personal trainer is a great way to go, but only if you are doing it for what it is meant.

As I said, this article is meant for everyone’s personal use. It may seem harsh at times, but reality often is. I don’t want to make light of legitimate reasons for not being in the kind of shape you want, because there are many. The point is to examine if you are in the kind of shape you want to be in, look at what may be contributing to it, and make necessary changes. If you try something and it doesn’t work, make another change and keep trying until you find what works for you. Remember, “the only place where success comes before work is in the dictionary” – unknown.

Bob can be reached by email at bob@functional-strength-training.com or visit his website at www.functional-strength-training.com

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