Archive for the ‘balanced diets’ Category

Chocolate: a new medicine? Part One

Tuesday, March 27th, 2012

Dark chocolate, in small amounts, is good for youI was reading The Wall Street Journal this morning and came across an article titled "A Chocolate a Day to Get Slimmer?" I'm not a major chocolate eater, but had heard something on NPR about this study yesterday, so ate eight small pieces of dark chocolate at a board meeting last evening. Then, when I weighed myself before breakfast today, I realized I was down 2.8 pounds.

Should I continue this increased chocolate consumption or was that, as I of course knew, just "water weight" I'd lost? The previous night I'd eaten a prolonged meal with friends at our favorite Thai restaurant and the next morning had gained over three pounds.

Let me digress a bit. Whenever I mention water weight I'm really referring to fluid that the body keeps because of dietary salt excess. I normally don't use table salt, as I have a family history of high blood pressure and was aware that most of us, eating a typical American diet, were ingesting far too much sodium, the crucial element in table salt. When I eat out I expect my weight to bounce up a few pounds and don't worry about that short-term increase. The salt in the food causes me to retain fluid and therefore to gain weight temporarily. Many diet plans that advertise losing five or more pounds in the first week are really helping people get rid of water weight.

Okay, back to chocolate. The article I mentioned is important, but the message it's carrying is nothing new. In 1973 I saw Woody Allen's movie, "Sleeper" in which he plays a nerdish store owner who is revived out of cryostasis (a form of preservation using ultra-cold temperatures) after 200 years. In that future world science has shown chocolate to be good for you.

Two prominent food gurus, Andrew Weil and Den Ornish, mention health benefits of chocolate. I found Dr. Ornish's 2007 Newsweek article,"Chocolate to Live For," in which he mentions a host of medical studies showing dark chocolate, which has higher amounts of beneficial chemicals called flavinoids, may lower blood pressure and and improve blood flow to your brain and heart. White chocolate and milk chocolate have very small amounts of flavinoids and bitter dark chocolate has the most.

Eat a small bite of dark chocolate and meditate

The phrase "moderation in all things" dates back more than two thousand years to a Roman "comic dramatist." It certainly applies here. None of the articles I read were about eating a lot of extra calories in the form of chocolate. Dr. Ornish's approach made sense to me; he very slowly eats a bite of dark chocolate, meditates while doing so by focusing on the experience with all of his senses, and regards the very first bite as being the most pleasurable.

What a great way to eat something he regards as a special treat as well as a health food.

I've never tried that with chocolate, but having read his magazine piece, I'll try that approach.

I'll continue with more medical background on chocolate in my next post, but to whet your appetite will give you a link to today's article in WSJ.

Happy chocolating.

 

 

 

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Adulthood: when your BMI is more important than your IBM (stock)

Thursday, February 9th, 2012

I do this at home, without clothes

In my last post I wrote about our upcoming generations and their obesity issues. Unfortunately, as you might have easily been able to predict, that carries over into adulthood. The same issue  (Feb 1, 2012)  of the Journal of the American Medical Association (usually called JAMA) had several articles on adults also. To begin with the National Health and Nutrition Survey (NHANES) looked at the body mass index (BMI) of men and women from 1999 through 2010.

"AARRGGHH" you say, "Why the hell should I care about whatever BMI is enough to try to understand it?"

Well, that's a tough question, I admit. But BMI is the standard way of deciding if a person is too thin, normal, overweight or obese. So let's give it a try.

Your BMI is a number calculated using your height and weight.  If you weight 250 pounds and you're a seven-foot tall basketball professional center player, you're unlikely to be obese. But if you're five foot, six inches tall, and don't exercise at all, like the adolescent I was reading about recently, you're far too heavy. In the first case, the athlete has a lot of muscle, whereas the youngster is almost certain to be carrying around a lot of excess fat.

For a long time physicians just weighed their patients. That plus eyeballing their bodies in an exam room works for most people. Then along came the BMI as one way of getting a little more scientific. I looked online for the history of the use of body mass index as I suspected it was "invented" by a European (it was). It certainly seems to me to favor the metric system. There it's easy to figure out your BMI; you divide your weight in kilos by your height in meters. It's much more complicated using pounds and inches (BMI = weight in pounds divided by height in inches squared and that number is multiplied by 703) The CDC explanation of BMI is helpful and also supplies a "widget" you can download and a calculator if you just want to bookmark the website.

height counts, for adults too

So now you've (hopefully) figured out your own BMI; What does it mean and how reliable is it?

First the numbers: most people with a BMI under 18.5 are skinny, underweight. That probably excludes a whole passle of long-distance runners. Most people with a BMI over 18.5 and under 25 are in the "normal" weight category. I used the CDC calculator and my number is 20.5. Most whose magic number is 25+ and less than 30 are overweight and almost anyone whose BMI is over 30 is obese. The teenager I mentioned above has a BMI of 40.

Okay, you say. Now what do I need to do once I know what category I'm in.

I'd start with the eyeball test. Do you have a roll around the middle? In early 2009, weighing only three pounds more than I had for twenty years, I clearly did. I made up my mind to do something about that excess flab, knowing that fat in the belly also implies arteries that are narrowing down.

After losing thirty pounds and keeping it off, I bounced up after the Superbowl and went back on my diet, i.e., consuming fewer calories. I went to a meeting last evening; there were lots of goodies, but I ate only carrots and cucumbers. This morning I'm at 148.2 pounds, smack dab in the middle of the three-pound "ideal weight" range I decided on.

Harvard Medical School just published a piece titled "Choosing the diet that will work for you." The central theme is cutting calories.

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The very high-priced spread

Saturday, February 4th, 2012

This obese teenager could be headed for trouble

I've been concerned about our burgeoning problem of excessive weight, so when the Journal of the American Medical Association for February 1, 2012 arrived, I was intrigued by the variety of articles touching on the subject. Let me start with a disclaimer: I have no clear-cut special competence, no magic bullet for preventing or treating obesity in our children. I do think it's a major threat to the upcoming generations here and elsewhere in the world. I am also very aware that its opposite numbers, hunger and even starvation, threaten whole populations around the globe.

But my own background, both as a physician and as someone who has successfully fought weight issues (I weighed 218 in 1969 and 148 this morning), has made me concentrate on the American epidemic of eating to excess as a major area of my interest.

The first article dealt with kids and adolescents. A group of CDC researchers reported an update on obesity in American kids, giving data from 199 to 2010. The newest statistics show nearly ten percent of our infants and toddlers are obese and close to 17% of our kids ages two to nineteen. As the kids got older, more boys than girls were obese in this survey with over 4,000 participants.

Then there was an article titled "Weight Loss Stratagies for Adolescents," based on a Boston Children's Hospital Conference roughly a year ago. The MD, PhD Harvard Professor of pediatrics who discussed the issue began with the case history of a particular obese girl, a fourteen-year-old who was five foot six and weighed nearly 250 pounds (giving her a body mass index,BMI, of 40). Her adoptive parents were overweight themselves, but had to learn to "back off" in their attempts to control her diet. There is some early data that suggests that parents can help by providing health food choices in the home and facilitating enjoyable physical activity throughout the day (versus a fixed "exercise time).

I had seen an example of that with some former neighbors whose boys, in order to have their one hour of "screen time," had to be outside playing for several hours at a time. Both youngsters were lean.

One critical point to be made is avoiding focusing on obese kids only. A large Danish study, published in the New England Journal of Medicine in December, 2007,  followed over a quarter million children born in the 1930 to 1976 time period. Denmark established a national civil register of "vital statistics" in 1968 and enrolled everyone in the country, giving them a unique number, ironically termed their CPR number. Although that had nothing to do, I gather, with cardiopulmonary resuscitation, which is what I think CPR means, the study did look at risk factors for coronary heart disease.

When your heart's on fire, it may not be from love

The results are impressive and threatening: every one point increase in BMI across the spectrum was associated with an increased risk of coronary artery disease. A child didn't have to be fat to be at risk later on. One calculation estimated that a 13-year-old boy weighing 25 pounds more than the average had a one-third increase in the likelihood of having a heart attack before the age of sixty.

It's time to start helping our kids live leaner and longer, healthier lives.

 

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Vindication? Part 1

Thursday, January 5th, 2012

One way to get lots of protein

Since the late 1990s when I invented a diet, or perhaps I should say an eating pattern, I've relied on one principal concept: Eat Less; Do More. I came upon this simple idea after listening to a group of medical professionals who were discussing which diet they should go on while they were simultaneously consuming huge portions at our hospital cafeteria.

One of them, I recalled, had tried a high-carb, low-protein diet the past year; losing nearly twenty pounds, then regained it all and more in a few months. Now she was going to attempt  to lose twenty-five pounds with a different approach, this one with an emphasis on protein. I had seen weight-loss plans come and go and didn't believe any of them were the answer, at least not for everyone. I remember coming home and saying to my wife, "Lynn, I've invented a new diet"

I explained it was simply, "Never finish anything; No snacks between (meals); Nothing after eight." I added, "Get lots of exercise."

I lost the seven pounds I had gained on a two-week vacation and didn't need my strategy again until early in 2009. Then I weighed 177 one morning, up three pounds from my normal weight since 1991. I attributed that to eating out four times in the prior week. But when I tried on a pair of good suit slacks, I realized the weight hadn't changed much, but the distribution sure had.

I went back to my eating plan, lost five pounds easily, then coasted a while before resuming the diet. Lynn bought me a digital scale and I weighed myself daily. I also started going to our gym six days a week. Eventually I shed thirty pounds and five inches off my waistline. At 147 pounds I was twenty-five under my usual high school weight. This morning, nearly two years later, I weighed 148.

I allow myself a three-pound zone of weight fluctuation, thinking that would account for fluid shifts and the occasional big splurge. Whenever I exceed 150 pounds I go back on my plan.

Then I read a Wall Street Journal article titled "New Ways Calories Can Add Up to Weight Gain: Study Challenges Idea That Varying Amounts Of Fat, Protein and Carbohydrates Are Key to Weight Loss." It quoted the Journal of the American Medical Association, AKA: JAMA. I went online and found the JAMA article and an accompanying editorial.

I read both pieces in detail, even finding a wild typo, "...their diets were returned to baseline energy levels and diet compositions (15% from protein, 35% from fat and 60% from carbohydrate)." I called the AMA and suggested they correct the numbers since they added to 110%.

Is a high-carb, low-protein diet safer?

But the basic premise of the study's data intrigued me. It's something I've believed for years, calories count, as opposed to what form those calories come in. But there's one extra facet: low-protein diets can be dangerous.

I'll analyze that in detail in my next post.

 

 

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Eating our way across Portugal

Thursday, October 6th, 2011

 

 

We started just west of Lisbon

 

 

We're on a three and a half week trip, almost all in Portugal. I wasn't planning to add any posts, but brought my iPad2 and realized I could find Wi-Fi connections in many places. So now we're on a two-day farm stay in the Duoro Valley, heart of the Port wine grape industry and we're eating well, perhaps too well.

I'm not normally a chocolate eater but the Mousse de Chocolata" here has been wonderful. I realized today that I've eaten more desserts and more bread (freshly made) than usual, but my slacks still fit and I' using the same belt notch.

So what's keeping me from gaining a significant amount of weight?

To begin with we're often eating one main meal, one smaller one and a fruit or yogurt snack. Breakfasts here have freshly squeezed orange juice, rolls that don't need butter and some cheese. Our lunches have often been eaten in transit and, more often than not, have been light.

Then too we're walking 45 minutes to two hours a day, often up and down hills.

Today for lunch we returned to the same wonderful gourmet restaurant we'd been to last night. As in the previous meal portions were smaller than we get at home. We ate slowly savoring each bite and drank a third of a glass of a late harvest wine the chef had sent us. My wife had a fruit and vegetable salad, while I ate a fish fillet. We really dawdled for an hour and forty minutes, talking, putting our forks down between smaller-than-usual bites and talking...a lot.

I realized we'd spent two and a half hours over dinner the previous evening. This was a European way of dining I noticed as I looked around. Nobody was in a hurry and, tellingly, nobody seemed significantly overweight.

So I've learned a lesson or two on this trip and, in doing so, have enjoyed my food more.

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Let us eat lettuce...and more

Wednesday, July 27th, 2011

I want more to a salad than just iceberg lettuce

Some years back I told my wife, "I'm tired of the same old salad; could you make a different one?"

We both cook, though she does more of of daily cooking than I do, but salad making is my least favorite part of cooking.

Over the next six weeks she never made a salad I had tasted before; her mix and match approach led to some surprises, but I'm always happy to try new dishes and almost all of them were successes. She added edamame, sunflower seeds, unusual greens; I ate them all. I finally told her, "I didn't mean an entirely new salad every time, just less of the iceberg lettuce, store-bought tomatoes and cucumber with familiar dressing.

We still eat salads at least once a day, sometimes as our main dish with chicken or fish added for protein. Sometimes we'll have a brand new mixture; sometimes I can recognize we've had this blend before and put it on the "keeper list."

Today I read about food companies attempts to get more Americans on the same dietary pathway. The Wall Street Journal had an article titled "The Salad Is in the Bag." I was amazed to read that the typical US adult eats salad with a meal only 36 times a years, roughly once every ten days. Less than half of Americans eat even one "leaf salad" in meals they serve at home in a two-week period.

The two of us are clearly on the far end of that scale when it comes to salad making. Our share of this weeks' vegetables from Grant Family Farms, our CSA, included summer squash, English peas, cabbage, carrots, kohlrabi, cilantro, parsley, green onions, a little broccoli, cylindra beets (new to us) and romaine lettuce. All of those veggies will find their way into salad

I've even gotten more enthusiastic about preparing some of the new salad combinations myself.

So what's going on with the "store-bought" salad concept?

A market research group reported the biggest issue is making salads. Apparently people don't want to take the time to wash produce, inspect it, cut it and come up with mixtures the family will eat (we won't even get into those who abhor greenery).

So some of the major food companies are responding by making salad preparation easier. One concept being explored is adding more kinds of vegetables to bagged lettuce or spinach. That way all you have to do is buy a bag, bring it home, open it before a meal and pour the contents into a salad bowl.

Well that sounds easy, but it turns out to be a bit more complicated than the simple version. One company found wheatberries absorbed moisture; their research director spent six months resolving that issue. Then there's the price issue; bagged salads cost more. Past history and the view of CPSI says there's more risk of pathogen growth and therefore of food-bourne illness.

But pre-washing with newer chemical mixtures, eliminating the need for a second wash at home, may help.

A new and improved version

Salad, anyone?

 

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