More fruit and vegetables, please

October 27, 2009 by  
Filed under OBESITY

fresh_vegetablesLast week, I reported on the latest IOM recommendations to revamp the 14-year old Nutrition Standards and Meal Requirements. Another report, this time from the Centers for Disease Control and Prevention (CDC) indicates that the recommendations, which call for more fruit and vegetables in US school lunches, are really necessary should be implemented as soon as possible.

According to the CDC report, Americans of all ages are not eating enough fruit and vegetables to meet their dietary requirements. This is especially evident among teenagers. This comes 9 years after Healthy People 2010 which set a target that 75% of the population would eat at least 2 servings of fruit each day and 50% would eat at least 3 vegetable servings daily. Well, 2010 is just a few months away but the target is still as far away as ever. The CDC State Indicator Report on Fruits and Vegetables 2009 reveal:

  • Not one state is meeting the targets for fruit and vegetable consumption.
  • 32% teens (high school students) eat the recommended daily servings of fruit and 13% for vegetables.
  • Only 33% of adults eat the daily fruit consumption recommendation and 27% of vegetables.
  • Only 1 in 5 (21%t) middle and high schools offer fruits and non–fried vegetables in vending machines, school stores or snack bars.

Fruit and vegetables are important for optimal growth, weight management, and prevention of chronic diseases. With children obesity an all time high, health experts are urging for better nutrition among the younger generation – in school and at home.

fruits1Can fruit and vegetables help in weight management? The few studies done on this topic indicate that the answer is yes. Food may be classified based on energy density which is the relationship of calories to the weight of food (calories per gram).

  • High energy density foods (4 to 9 calories/g): Examples are high fat foods like butter, bacon, and cookies.
  • Medium energy density foods 1.5 to 4 calories/g):  Examples are hard-boiled eggs, dried fruit, lean sirloin steak, and whole wheat bread
  • Low energy (0.7 to 1.5 calories/g) and very low energy density foods (0 to 0.6 calories/g): Examples are fruit and vegetables and fat-free yoghurt or cheese.

Several studies show that consumption of low energy foods “promoted feelings of being full, reduced hunger, and decreased energy intake regardless of how the food was changed to lower the energy density.”

On the CDC site, the brochure How to use fruits and vegetables to help manage your weight is available for those who might be interested. The brochure especially gives useful tips on

  • How to combine foods of different energy density to get a tasty dish with acceptable amount of calories.
  • Using low energy substitutes
  • Preparing fruit and vegetables without increasing calories (e.g. no frying, whole fruit vs. juices)

Why Wait?

June 16, 2008 by  
Filed under DIABETES

June 12, 2008, Reuters Health: Diabetic Weight Loss Plan Yields Long Term Success. One year later. The findings of the follow up of the Joslin Diabetes Center, Why Wait? program show that the participants of the 12-week program for Type 2 diabetics resulted in an average weight loss of 24.6 pounds and good control of blood glucose levels and blood pressure.

What is Why Wait?

The 12-week program involves exercise, dietary changes, education, counseling and adjustment of diabetes medications. Participants meet weekly and the program is insurance reimbursable. There is a monthly support session fee of $25 out of pocket.

Program components per the Joslin Why Wait? site:

  • Intensive and interactive medication adjustments
  • Structured modified dietary intervention
  • Graded, balanced and individualized exercise intervention
  • Cognitive behavioral intervention
  • Group education

The dietary component portion of the Joslin Why Wait? program includes meal replacement shakes for breakfast and lunch. Snacks between meals. Dinners are from 14 menu selections from the Joslin Nutrition Guidelines. Nutritional breakdown of the meals are about 40% carbohydrate, 30% fat and 30% protein.

Additional Joslin weight notes per Why Wait? site:

  • A modest weight loss of one pound every one to two weeks is advised.
  • Reducing daily calories should be by 250 to 500 calories; total daily calories should not be less than 1,000 to 1,200 for women and 1,200 to 1,600 for men.
  • Weight loss is different for each person and should be continued until a person reaches a target body mass index, or BMI.

Calculating target body mass index or BMI:

The exercise component portion of the Joslin Why Wait? program recommends ” A minimum of 150 to 175 minutes of moderate intensity physical activity is recommended. A target of 60 to 90 minutes most days of the week is encouraged.”

The medication component portion includes working with a diabetologist to reduce or eliminate medications that interfere with weight loss. It is includes more frequent glucose monitoring. Medications are adjusted weekly based on your personal results.

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Proper Weight Management

October 17, 2007 by  
Filed under OBESITY

Proper weight management is about much more than simply focusing on a single number, your weight. There are other, very important, objective measurements to add to your intellectual toolkit – BMI, waist circumference, body fat percentage, muscle-to-fat ratio and others – in order to achieve a physical result.

That physical result, too, should be more than just reducing a number. Your fundamental goals are to look attractive and optimize your health. Everything else is a means to those ends.

The first step to achieving those interlocking twin goals is to recognize that there are no short cuts, no easy and safe ‘miracle cures’. There are aids that modern nutritional and exercise science can supply. By all means, take advantage of them.

But along with proper nutritional supplements, appetite suppressants and the like, it’s still essential to have a proper diet and adequate daily exercise. Some appetite suppressants, when used under a reputable doctor’s guidance, can be a helpful short-term addition to the overall program.

But when you stop taking them, in the overwhelming majority of cases, the weight will quickly return unless they are only part of an overall strategy. That strategy has to include good nutrition and proper exercise.

There are hundreds of fad diets around. The ‘low carb, high protein’ diet is one of the latest. People following them often experience rapid weight loss, initially. But the long term benefits are few and the costs are high.

Carbohydrates are the primary source of energy for the body. When the body has a shortage of available carbohydrates (chiefly glucose) to use to produce energy, it turns to other sources. One result of that, though, is often muscle loss and not just fat consumption.

Low carbohydrate diets reduce the amount of glucose available in the muscles and liver. That leads to muscle fatigue and less tone. At the same time, that fatigue also makes exercise more difficult and less pleasant. It also leads to a lower basal metabolic rate, which means fewer calories will be consumed per hour than would otherwise be the case.

That’s an unhealthy trade off for a rapid, short-term weight loss.

What’s needed instead is a disciplined, long-term commitment to lifestyle change. That, admittedly, is much more difficult than simply changing a few things on the menu. It requires learning more about nutrition, and more care in the selection of things to eat. It may mean substituting whole grain brown rice for potatoes. It means substituting fruits for ice cream and candy as dessert.

At the same time a person is struggling to change eating habits, something very difficult to do when the body is urging a return to the old items, another hurdle needs to be overcome: beginning a regular exercise program. Regular exercise is the second factor essential to proper weight management.

It isn’t necessary to become a fitness fanatic, but a regular series of vigorous running or weight lifting or other form of age-appropriate exercise is critical. That requires great willpower, to be sure. Most people give up too soon, because they try too hard at first. That results in injury and abandoning the program.

Think long term, make changes slowly but permanently, and you’ll find that weight is the last thing you have to think about. Your general appearance and health will improve. Those are the ends to keep in mind.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.