A recent study came out in the Diabetes Care journal that explored what strategies worked best for weight loss in patients with Type 2 Diabetes. 

Most people have heard how important breakfast is, however, this article really proves it.  The people who were most successful at losing weight were those who ate breakfast at least six times per week.  I always encourage patients to eat 3 meals per day (at the least).  This almost always helps avoid the ‘pitfall’ of overeating at night.  When we don’t listen to our body’s hunger and ‘put it off’ until later, it’s impossible to make good food decisions and know when we are full.  This study showed that eating more frequently also helped patients take the weight off.

The other two strategies that helped take the weight off were limiting fast food consumption, and weighing themselves. 

Fast food generally isn’t healthy, so it wouldn’t be a surprise that eating less fast food contributes to weight loss.  However, if you are in the situation where there’s not many chocies except for fast food, remember that you can always get something healthy.  There’s always a healthy choice wherever you go.  More and more restaurants are encouraging healthy food choices. 

Many people try to avoid the scale like the plague.  I agree that the scale doesn’t tell us everything.  However, I always encourage people to weigh themselves at least once a week or every other week.  It’s easier to lose 2 pounds than wait for it to increase to ten or twenty pounds. 

I have always heard that it’s better to be ‘fit and fat’ rather than ‘thin and sedentary’.  However, we also know that being overweight is not healthy and does increase the risk for medical conditions….so what’s the truth?  I think we still don’t know.

 Last week a report came out from the Archives of Internal Medicine which researched whether or not there is a correlation between overweight, obesity and cardiovascular risk factors.  The researchers investigated over 5000 individuals who were examined and filled out questionairres for the National Health and Nutrition Examination Surveys between 1999 and 2004.  What they found was that over 51 percent of those who were considered overweight and 31.7 percent of those who are considered obese had normal cholesterol, blood sugar, blood pressure and other measures of labs linked to heart disease. 

The researchers noted that you can be obese and be healthy.  They also examined the area of the body where these people carry their extra fat.  Thirty six percent of those who had waist circumfrences in the ‘danger zone’ for heart disease, didn’t have any abnormal blood tests. 

Does this mean that being overweight or obese is healthy?  No, it just tells us that we can have normal indicators for heart disease risk.  It doesn’t tell us about all of the other medical conditions associated with obesity such as joint problems.  It also doesn’t tell us anything about the subject’s physical fitness levels.  If someone is overweight, it means that they have to carry more weight to do any type of physical fitness and puts more stress on the body. 

One thing we have to keep in mind.  Research is valuable, and we learn so much from it, however, sometimes we need more information than what the media is telling us.

As of July 1, 2008, all restaurants in New York City are required, by law, to remove all trans fats in their foods.  I find this very interesting to watch as the food laws in NYC unfold.  A recent law was also passed to require chain restaurants to post nutrition information on their menus. 

The question that many people are asking is whether these rulings will make a difference in obesity rates, or heart disease rates. 

Trans fats are used in a variety of foods, especially baked goods, to lengthen shelf life.  Unfortunately, they are helpful for the food industry, but not for our health.  Trans fats are just as bad as saturated fats for our heart heath. 

Will this ban on trans fats make a difference?  I tend to think it won’t- primarily because the foods that trans fats are typically used in are baked goods and foods that need shelf life.  These are not generally healthy foods in the first place.  In most cases, trans fats are just a cheaper replacement for saturated fats like butter. 

When I was a child, I grew up in a kosher home.  I’ll never forget that when I was young, I was never allowed to eat Oreos because they had lard in them.  Lard is a saturated fat.  I was only allowed to eat Hydrox (wonder if there is a reason they are called ‘hydrox’ as in ‘hydrogenated’) cookies because they weren’t made with lard.  They were made with partially hydrogenated oils (trans fats) instead of lard.   I grew up reading food labels to look for ingredients that we weren’t allowed to have in a kosher home.  Years later, I was reading a package of oreos and noticed that there was no longer any lard in them.  Surprise- the companies switched lard to partially hydrogenated oils.  HMMM-so what are we going to switch the hydrogenated oils to when trans fats are taken out of these baked goods?  I predict that these products will be back to having lard instead of hydrogenated oils.  What’s healthier????  Neither!  Needless to say, baked goods and packaged goods aren’t necessarily ‘health foods’, so if we are trying to make these healthy, I think we’re spending a lot of time and money in the wrong area. 

This ban on trans fats isn’t a bad thing, however, I’m not convinced that it’s going to make a difference in our heath.  The bottom line is: fried foods with or without trans fats still aren’t healthy. 

The news is out-Michael Phelps eats 12000 calories per day. The question is:  how much of what the media is telling us is actually true?   According to WebMd, he reportedly eats 8000-10000 calories per day.  According to the Wall Street Journal, it’s up to 12000 calories per day.  Yes, he is a competitive swimmer and he is Michael Phelps, however, 12000 really does seem like a lot. 

If he’s swimming 6 days per week for 5 hours per day, and he weighs 190 pounds and is 6′4" I think that 12000 calories may be a little high, however, it’s still possible.  My guess is that he may eat a little closer to 8000-10000 calories.   I would estimate  his resting metabolic rate including a factor for daily activites to be approximately  3600 calories, and he’s probably burning about 4000-5000 calories swimming.  This equals about 8600 calories per day. He may need a little more for training outside of the pool, however, training enough to bring he needs up to 12000 calories would be quite a bit. 

I also hope that the media has made a mistake saying that he is drinking ‘energy drinks’ instead of ’sports drinks’ that have electrolytes and are properly formulated for athletes.  11 cans of Red Bull per day — for an olympic athlete — I hope none of our high school and college athletes are using this as a model for good nutrition for athletes.

All I can say is that 12000 calories is a LOT of food for anyone.  It’s definitely hard work to get in those calories.

Last week, I attended the annual American Association of Diabetes Educators conference in Washington DC.  There are hundreds of exhibitors at these conferences, and can range from food companies to insulin pump companies and anything in between.

One of my favorite booths was the sugar booth.  I had to laugh as I passed by.  I was actually happy to see that the sugar industry was there to show people that it’s OK to eat a little sugar once in a while.  Many health professionals feel it’s their duty to be the ‘food police.’  The comments that I heard as I stood at the booth were both hilarious as well as a little concerning.

I don’t like to be the ‘food police.’  I want to educate people on a healthy diet without telling them what to eat and what not to eat.  I’ve found that the more peple cut out of their diet, the more they want it.  Sometimes, just being able to eat a treat in moderation (moderation being the key word) is really the best way to have a healthy diet and not feel like you’re being deprived of everything you love.

As I stood at the sugar booth, I remember hearing someone ask “is this ‘like’ real sugar?”  The woman working for the sugar industry was telling me all of the unbelievable comments she had been hearing.  What’s in this sugar?  Is this real?  Why is a sugar booth at a diabetes conference?  Is this a new type of sweetener?   All of this makes me a little scared that we have forgotten that a little bit of moderation can be ok.  Sugar has 15 calories per teaspoon. Of course, I would rather my patients avoid adding sugar to their coffee and on top of their cereal in the morning.  It’s the excess that really is the problem in our diets.

Visit the American Association of Diabetes Educators’ website

Weight loss and healthy eating is such a hot topic. Unfortunately, there are so many diets out there that it can make your head spin. What’s healthy, what’s not healthy, what’s going to make me lose weight really quickly, what’s going to help me keep the weight off in the long run, what can I afford? These are all questions that the overweight person has to think about before embarking on a change in lifestyle and diet.

Anyone who knows me will tell you how I work as a dietitian. I am not the person who will give someone a ‘diet’ and send them out the door. Losing weight is a difficult battle and it takes a lot of hard work and isn’t going to happen overnight. We learn unhealthy habits during our life and need to change those habits. It’s not something that’s easy. I tell my patients this when I see them. Some get angry that I don’t like to give out a menu plan (you can get that on the internet). I give out medical nutrition therapy, not diets. I discuss food and feelings and other things that are going on in one’s life and help the patient find trends in their eating habits. I also refer most of my patients to psychotherapists because if it was ‘just about the food’ and it was easy to change eating habits, I would just be handing out menus everyday.

I have this discussion with my patients daily. Honestly, anything that cuts calories and helps you expend more calories than you take in will help you lose weight. If my patients feel that whatever they are doing helps them lose weight and the scale goes down, I think it’s great. However, what are they going to be able to continue to do for a lifetime?

There are so many fads out there. I hate to call them fads because the majority of them work to help people lose weight. However, the question is how long can they continue to change their eating habits before they fall into the same habits that they had before they started?

I always tell my patients ‘restriction leads to overeating’, the trick is to not restrict so much that you end up overdoing it in the end. Finding balance in one’s diet is extremely important. There are many quick fixes, liquid diets, and meal plans. We have to remember what’s really important……changing behavior. Until behavior changes, weight isn’t going to.