Week 6: Recommend reading on diet and nutrition, March 21, 2010

Cathy and I just got back from a relaxing 4 days on vacation from spring break. In addition to sleeping in, walks and exercise, watching movies and basketball, going out to eat and shopping, we each brought a project or two that we want to do but have trouble doing at home. My project was some reading on diet and nutrition.

I last researched this topic of nutrition over 5 years ago. At the time, the best book I could find on the topic was Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating (EDBH) by Harvard professor of epidemiology and nutrition Walter Willett. I also benefited by a book called Eat to Live: The Revolutionary Formula for Fast and Sustained Weight Loss by Joel Fuhrman.  These are still books I would recommend as good reading on the topic.

But, noting that EDBH was published almost 10 years ago, I recently decided to take a bit of time to again briefly survey what is available on the topic to make sure I am getting the best advice today. Additionally, this time around I wanted more help implementing change, rather than focusing on increased understanding.

My search was not exhaustive; I am sure there are other good books out there. I went to see if Willett had done anything more recent than EDBH, I checked out recommendations of my nutritionist friend, I looked at some of Amazon’s recommendations, and I make a trip to the public library to see the books for myself. After looking them over during spring break, below is a very brief summary of those I am purchasing. You will hear more from these books and resources later.

I was encouraged to find there is a significant consensus on what a good diet is (of course I stayed away from fad diets). I was even more encouraged that there are increasingly a number of well written books to help us implement what the science is saying and that the diets include great and satisfying foods.

What I am purchasing (links to Amazon):

• Eat, Drink, and Weigh Less: A Flexible and Delicious Way to Shrink Your Waist Without Going Hungry by Mollie Katzen and Walter Willett – The book includes a very readable summary of what science is saying in nine “turning points” for good nutrition (you will get this list on a subsequent post), a way to track your “body score” to encourage you to improve your diet habits, and 3 weeks worth of meal plans to lose weight with enjoyable and doable recipes. There is also 1 week worth of menu plans that are easier to do, help eating out, etc. Highly recommended.
• The Volumetrics Weight-Control Plan by Barbara Rolls and Robert Barnett. Recommended by my nutritionist friend and the American Dietetic Association. It is another good book on basics of good nutrition and helping you to implement those ideas. What is new here, that I have not seen elsewhere, is a focus on being satisfied with the quantity of food you are getting. They do this by helping you to make good choices and modifying recipes to reduce calorie density. By doing so, you can eat more, are more satisfied, and yet can control or lose weight. The results are surprisingly satisfying and doable.  More later.
• The EatingWell Diet: The University-Tested VTrim Weight-Loss Program by Dr. Jean Harvey-Berino – This book again includes very good nutritional information and a solid plan for implementing it. We do not plan to follow  their plan per se but will use some of the recipes. They are very attractively laid out in the book. In doing a bit more research, I found that the recipes are taken from Eating Well Magazine. So I am subscribing to it as well. You might check out their web site!

Recommended web sites:

• American Dietetic Association – http://www.eatright.org/
• Eating Well Magazine – http://www.eatingwell.com/
• WedMD’s healthy eating and diet
• Mayo’s healthy lifestyle

Week 5: Getting active, March 14, 2010

This week I will focus on the up and downs on my efforts to get more active, concluding with what is working for me now.

Back in 2006, the last time I decided to get in shape, I joined the YWCA near my work. It was great to exercise over lunch as it provided a nice break in the day and I was able to do it with some regularly when I was in town. For much of the first 5-6 months, I found my weight bouncing up and down: when I was in town, I lost weight; when I was on the road, I seemed to gain it back. So I did not make any real progress. But I enjoyed getting in better shape physically, esp. the weight training, which I had never done before, always thinking that aerobics was the chief exercise objective.

In early 2007, I got tired of the lack of progress on losing weight and decided to do some more study on the topic, and esp. to learn more about the calories in food when I was traveling.  One handy reference I found was Nutrition in the Fast Lane, which lists nutritional information on 59 fast-food and casual dinners.

During that time, I also learned more about the value of weight training. It helps with weight loss as it raise your base metabolism and is something that we need, esp. as we age.

With more attention to my diet, esp. we traveling, and more consistency in my exercise regime, I finally made some consistent progress.

Then in June 2007, I was promoted to chief engineer of the Division of Water Resources and my dedication to exercise went out the window, my travel increased, and slowly I regained some, but not all, of the weight I had lost.

Over the next two years, I have tried to re-start my trips to the YWCA but never succeeded with any consistency; there is always too much pressing on me in this challenging new work position. I finally got tired of paying for a membership that I did not used, so I dropped the membership.

Another reason for my inconsistency at the YWCA which led to a new exercise routine: our new dog, Bingley. He is an English Setter . As it turns out, this bred is one that requires regular, daily exercise.  Otherwise, he becomes bored and creates his own activity in a way we do not appreciate. So I give him a 1 mile walk in the morning and another mile walk in the evening, every day, in virtually all weather. It is good for both of us. Yes, it takes time, but the health rewards are worth it.

Lately I have been trying to figure out how to add strengthening exercise to my routine. My problem is time. Morning is the best time but it is also the most limiting. Doing it at home is the most convenient.

I have recently found an exercise video that is working for me for the moment: The FIRM’s Slim Without a Gym. It is a 45 minute routine that is broken into 4 segments (cardio, core, upper body, gluts). It came with a jump rope, toning cord, and resistance loop. I can do 2 segments on one day with my walk; and then the other two segments on the next day with my walk. On a third day, I do a longer walk (or a bit of a walk/jog). I repeat these three days once again, and then take a day of rest for all but walk with the dog.  It is working for me so far.  The nice thing about this routine, is I can do it on the road as well.

[Note: the paragraph below was amended 3/29/2010 based on advice from Mary Elizabeth, my nutritionist friend]

My original posting encouraged morning exercise with a recommendation to exercise before eating any calories and then delay breakfast a bit. My thought was that if I do not have any significant amount of blood sugar in bloodstream, when I exercise, my body will have to go to my fat stores to get its energy.

However, on reading it, Mary Elizabeth gave me the following encouragement: “I suggest you eat breakfast before you exercise in the morning.  After all night of not eating, your body is in it’s fasting or “starvation” mode.  In this mode, your body works to expend as little energy as possible to hold on to fat and calories.  So, if you’re working out before eating, you’re body isn’t expending as much energy or burning as much fat as it could if you provide it a little energy before your workout to kickstart your metabolism.  Also, people tend to overeat at the next meal if they skip meals or don’t eat when they wake up in the morning.  You don’t have to eat a large breakfast, but something that has a little carb and a little protein is a good breakfast before workout to get your metabolism going for the day.  I like to do a piece of fruit and yogurt cup.  Think of it more like a snack in the morning.  Then, after your workout when you get to work, you can have a breakfast as well.”

Background: Much of what I will share over the coming months is from research on nutrition I did in 2005. But I have been doing a bit of additional research on the topic. I happened upon a program called “The Diet Solution”. While much of it was consistent with my nutritional reading, other parts left me wondering. Fortunately for me, at church we have a young women who has earned her B.S. in Human Nutrition, Foods and Exercise and is here in Kansas doing her dietetic internship on her way to becoming a registered dietitian. Below is my email of questions to her and her answers in italics. It is a long post but worth it, I think.

And I have posted one new recipeon Cathy and my web site at: http://dcbarfield.org/recipes/. The new recipes is for Red Beans and Rice. I got it from one a workmate who grew up in New Orleans and brought it for Mardi gras.  I have enjoyed it very much.

Mary Elizabeth,

I have a confession to make. I normally do not succumb to infomercials but I did this time. In my recent nutrition research, I happened upon an infomercial that kept my interest as what it espoused was consistent with what I knew of good nutrition.

I bought the $ 49 program. Below are key points of the program and some questions, which are bolded.

1)  Metabolic typing – The program talks about metabolic typing and crafts meal plans to a degree accordingly. The metabolic types are “protein”, “carbs” and “mixed”. Based on the type, there are various the rations of protein, carbs and fats in the meal plans.

a.       Mixed type: 50% carbs, 40% protein; 10% fats
b.      Carb type: 70% carbs, 20% protein; 10% fats;
c.       Protein type: 35% carbs, 45% protein; 20% fats.

That is quite a difference between types. Have heard anything that says there is any validity to this?

Cathy and I were both typed as “Mixed” and the program is built around this (with adjustments for the other types. The diet has more protein in it than I am used to including protein with every meal. For example, usually for breakfast I have oatmeal. It includes nuts (but not much) as well as ground flax.

Somewhere in between the “mixed” and “carbohydrate” diets is what most nutritionists consider the “ideal” diet.  50-65% of calories coming from carbs, 15-20% from protein, and around 25-35% from fat (hopefully more of the unsaturated fats).  This breakdown isn’t exact, but it’s a good thing to strive for…our bodies need all 3 as different fuel sources and to do different things.  The only “diet” in those listed I don’t agree with is the protein one.

Overall, Americans really eat too much protein, especially protein from meats.  We really only need about 5-7 oz. of protein a day.  Eating protein at meals can help you feel full much longer, but other than that, it doesn’t really provide any benefit.  Over time, too much protein can be hard on the kidneys and liver to take care of and can result in some health problems with those organs.

Keep in mind that all the protein from beans, peas, nuts counts, too (you mentioned nuts with your oatmeal).  I don’t know if you’ve heard this before, but pairing a bean or nut source with a grain source is just as good (well, almost just as good) as protein from meats.  I’m a big advocate for using these protein sources rather than meats for at least one or two meals a day because they have a lot of fiber and other nutrients that typical American diets lack.

2)  Smaller, more frequent eating – The program’s plan has smaller, more frequent meals.

Small meals is definitely a good option, if you care to reorganize your day around those meals…that can be somewhat of a challenge.  The idea behind multiple small meals is to keep your stomach feeling satisfied throughout the day rather than becoming ravenous between meals.  Often times, when we get too hungry between meals, we tend to overeat.  With small meals, you should still be consuming the same amount of food that you normally do (if you don’t overeat at meals), but you just consume a small amount at a time.

3) Choosing good foods, organic food, etc. – The program places an emphasis on choosing good foods – avoiding processed foods, choosing organic foods, etc  This includes stressing the use of range feed beef and chicken, eggs. Of course, all this cost more so I need to figure out what is most important and worth it. 

If her “good foods” means fresher foods like fresh fruits and vegetables, I agree absolutely.

So far, there’s not a whole lot of research about organic foods being better for you than the regular, but some claim that organic foods have more nutrients in them than the regular products.  Personally, I think organic food, and locally-grown food–especially  eggs and produce–tastes a lot better than the regular grocery store options, but cost is something to watch.  A lot of small farmers raise their livestock without hormones and antibiotics, but to be called “organic,” they have to pay a pretty hefty fee that some farms just can’t pay.  So, if you’re considering going the organic route, remember you can look into some products that don’t necessarily have that organic sticker on them.

4) Counting calories vs choosing the right foods and serving sizes – The program states that while calories matter they are not the entire story – eating the right foods in the right proportion is also important. So eating the right foods and serving side is more of how she advocates dieting, not counting calories.

I agree with this one.  Overall, calories are still calories, but we should focus on eating fresh, less processed foods in good portion sizes rather than keep an exact calorie count.

5) The use of sugar leading to fat storage – The program stresses that high glycemic foods trigger an insulin reaction which signals your body to store fat rather than burn it. So the program says to quit sugar.   I did a bit of research and it seems this may be right for people whose diets are heavy in high glycemic foods. We do not eat foods that are highly glycimic so I doubt the changes will change us into “fat-burning machines” as the program says. Any evidence that sugar, etc. cause us to store fat?

Increased intake of sugar/carbohydrates can increase fat storage.  The body will use its carbohydrate/sugar stores before fat stores if carbohydrate/sugars are available.  Increased sugar/carbohydrate intake causes increased glucose in the blood.  Consequently, insulin is produced to pull glucose into cells for metabolism and increases storage of fat.  However, insulin secretion is proportionate to the amount of glucose in your blood (unless you have glucose intolerance or diabetes).  Continued high levels of blood sugar (like in diabetes) can result in an increase in triglycerides (aka stored fat).  Making changes to your diet won’t really make you more “fat-burning.”  Overall, the biggest culprit of increased fat storage is increased calorie intake, particularly from saturated and trans fats.

6)   Omega-3s –  The program strongly encourages increasing Omega-3s. How much do we need? I am not excited about fish oils. Any suggestions?

Omega-3’s:  They are one type of unsaturated fat that our American diet typically does not get enough of.  We should be getting somewhere around 1.6 g/d but most of us get a lot less.  Fish oil is really just one way of getting omega-3…really, it’s for all of us Americans that like to fix our health problems with a pill.  If you like fish, it’s recommended that you eat fish about 2 times a week, if you can–the fatty fish like tuna, salmon, mackerel.  You can also get omega-3s from nuts, particularly walnuts.  If you like walnuts, try adding them to you morning oatmeal.  The flax seed you eat also contains omega-3s.

7)  Water – The program says to drink lots of it and to get a water filter. I don’t drink as much as she recommends. What do you think?

We should be consuming about 8 glasses of water a day, but we can get it from the foods we eat, too, not just drinking water.  The more water you can drink, the better hydrated you will be and probably the better you will feel.  I think everyone needs to drink more, but it doesn’t necessarily have to be the filtered kind.  I don’t know of any research or anything that shows filtered water to be better for us.

8)  Sea salt vs. table salt. The program is down on table salt but indicates sea salt does not have the problems of table salt and provides many benefits. Any thoughts here?

Salt is salt.  Technically, sea salt contains less sodium than regular table salt, but it’s not really enough to make a difference.  Just eliminating the salt shaker at the table and reducing our consumption of prepackaged, processed foods can eliminate a lot of salt from our diets.  I’m not sure about the benefits of sea salt; I haven’t read anything or heard anything about that.  I think I will have to look into that!

9)  Stevia as a sweetener? The program is down on sugar and artificial sweeteners but instead suggests the use of Stevia. Any thoughts?

Stevia is from a plant, so it is natural, unlike all the other sweeteners.  Personally, I think sugar is no problem, as long as it is in moderation; the problem is when we drink 2-3 cans of regular soda pop a day.  A lot of research has been done on artificial sweeteners, and none have been found to cause cancer or any other health problems.  (The only one was saccharin causing bladder cancer in rats…but they were given astronomically high doses.)  Using an artificial sweetener or stevia won’t cause any health problems, but sugar in moderation isn’t bad either.  For me, I think a small amount of cake made with regular sugar is a whole lot more satisfying that a huge piece of cake made with Splenda.

10) Any other advice?

I really encourage anyone who is seeking to change his/her diet or lifestyle to consult a registered dietitian to ensure accurate information based on sound research.  I’m not very familiar with dietitians in this area, but if you go to www.eatright.org, you can click on the “Find a Dietitian” button and search for a dietitian that deals specifically with weight loss/weight management located in this area.  Most likely, your insurance will not cover this type of dietitian consultation, unless it’s related to a specific disease.  I’m not exactly sure how much it would cost, but likely around $50-75.  While not an inexpensive investment, but it is well worth in that you will get good research-based help and good knowledge to help you make decisions in the future.  Depending on your needs, you may need to schedule a follow-up appointment, which would probably cost around the same amount. Some dietitians offer group classes, some do only one-on-one counseling, and some have programs you can go through…it just depends on the individual dietitian.

Additionally, on www.eatright.org there are some great tips and information about weight management.

As far as books go:  Volumetrics by Barbara Rolls is a pretty good book dealing mostly with portion sizes of foods; it’s a pretty good read, and Barbara is a dietitian.  I generally encourage people to go with books written by registered dietitians; overall, they tend to give the best, most comprehensive explanations for the way our body and metabolism works so that you can make good decisions for yourself, rather than the “eat this, don’t eat that” method of a lot of nutrition programs out there.

While there is a lot of nutrition knowledge out there and a lot of nutritionists understand different aspects of it, dietitians really have a better mastery of it and can help you put it all together.