The ABCs of Eating Right & Exercising

Depsite the advancements in medical therapy for diseases like hypertension (high blood pressure), high cholesterol, and diabetes, very few treatments are as effective, or as longlasting, as weight loss, exercise and proper nutrition - and of course, smoking cessation in those that smoke. However, I also realize that exercising every day and eating "right" can be challenging on many levels, not the least of which is understanding how to eat right and what type of exercise is best. These type of lifestyle changes also require us to change our habits, our schedules, and most frustratingly, the comfort-giving routines that we have been entrenched in for weeks, months and sometimes years.

The DASH diet. DASH actually stands for Dietary Approach to Stop Hypertension. The basics: eat lots of fruits, vegetables, whole grain, low-fat dairy foods, as well as poultry, fish, meat, nuts and beans. The amounts of added fats, red meat, and sugary drinks and foods are limited - as is salt.
So how good is this diet? the NIH studied patients on the DASH diet as if they were studying a new medicine and found that:

• Patients with pre-hypertension who followed the DASH eating plan experienced an average drop of 6 mm Hg in systolic blood pressure and 3 mm Hg in diastolic blood pressure.
• Patients with hypertension experienced reductions of 11 mm Hg in systolic blood pressure and 6 mm Hg in diastolic blood pressure.

Not too shabby for changing the food that you eat. Most pharmaceutical companies would brag about this type of data if they could reliably produce it.

Furthermore, a recent study published in Circulation: Cardiovascular Quality and Outcomes pointed out that the DASH diet decreases the 10-year risk of heart attack..

You need more reasons you say? How about the fact that U.S. News & World Report just ranked the DASH diet as Best Overall Diet. A panel of experts in diet, nutrition, obesity, heart disease, diabetes and food psychology reviewed 29 diets and ranked them according to safety, short-term and long-term weight loss, how easy they were to follow, nutritional completeness, diabetes prevention and management, and heart disease prevention.

The diets were ranked according to a star system, with five stars being the best score. Below are the diets which ranked best:

• DASH diet - 4.1 stars. Nutritionally complete, safe, can prevent and control diabetes, also promotes heart health.
  
• TLC diet - 4 stars. TLC stands for Therapeutic Lifestyle Changes. This diet was created by the National Institutes of Health (NIH) to reduce levels of cholesterol. The panel said it is a healthy, well rounded diet. However, the dieter is left very much on his/her own.
  
• Mayo Clinic diet - 3.9 stars. Experts say it is safe and nutritious, and moderately effective for those aiming to lose weight. How can you go wrong with the Mayo?
  
• Mediterranean diet - 3.9 stars. The diet is rich in vegetables, fruits, olive oil, and other healthy nutrients. It was criticized for being too different to what Americans are used to and may consequently be hard to keep up.
  
• Weight Watchers - 3.9 stars. This diet was praised for the emotional support dieters receive, as well as being an easy one to stick to.

Above you will find links to where you can find and download the DASH Diet (YOU DO NOT HAVE TO BUY THE BOOK BECAUSE ALL THE INFO IS PUBLISHED FREE HERE) and all the other Top 5 diets. The best of them are free but others come with a fee and for some, that is a motivating factor, i.e. 'I payed for it, I better do it' phenomenon.  Each of the above diets are good for you and often times the one that seems most appealing and realistic for you will be the best one. At the very least, if you are not a structured diet person, here's a few simple tips on how to lose weight:

1. Limit your portion size. A good rule of thumb is that each portion should be no bigger than your fist.
2. Limit your intake of rice, pasta, potatoes and bread. These complex carbohydrates are heavy in calories, low in protein, and all eventually are converted to sugars. Replace the starchy sides with vegetables, e.g. curry roasted or pureed cauliflower (tastes like mashed potatoes), quinoa, string beans, etc
3. Eliminate all sugary drinks from your diet - particularly sodas. Empty calories with no nutritional benefit.
4. Exercise 4-6 days per week. Even 30 mins of walking on the treadmill with a modest incline would be greatly beneficial to you in the longterm. '

Here's to a healthier, thinner, you in 2013!

Super Goal Monday

With the big game on Sunday, and the big food that goes along with it, many of us (or maybe just me) are still  on our "Holiday" will-power hiatus and looking for an excuse to start serious food restriction.

Well, the gig is up and thanks to my awesome office staff, I have an excuse to get my BMI closer to where it should be. The women have initiated a Super Goal Monday Weight Loss Challenge.

After gorging on offensively hot wings, a plastic football full of pretzels and (hopefully) the sweet taste of a Giants victory, we will begin a 3 month competition to see who can best reverse the damage of the above. Weekly weigh-ins and a financial incentive will keep us honest and aqt the end of 90 days, we will all be better for it.

For privacy and safety reasons (mine in particular), I am not allowed to post results of any of the weigh-ins although I'd really like to. Unfortuantely, I'll just have to give vague, non-numerical updates. These types of weight loss challenges are wonderful ways to help you and your colleagues/friends/neighbors/family members to get healthier, using a team approach and exchanging ideas about what works and what doesnt. There are also several online options to facilitate a group weight loss challenge and I've provided a few below. Check it out if you feel so inspired. And fo course, GO GIANTS!!!

Ideas for a Weight Loss Challenge at LiveStrong

WeightLossWars

Healthier School Lunches Are on the Menu

After 15 years, the school lunch ladies will be dishing over some healthier grub to our children, says the National School Lunch Program.

With an additional six cents per meal, the schools could hardly figure out where to spend first. Fortunately, most of the improvements come in the form of omissions, including smaller portions, calorie limits, less fats and zero trans fat. There are some increases too, such as those in "dark green vegetables", whole grains, and fruits.

Despite an attempt to discount tomato paste (and thus pizza) as a vegetable Congress was able to successfully reverse that and maintain its status as equal to one veggie serving.

"It was a bit unfortunate that some groups had powerful friends in Congress and basically tried to sort of short-change [kids] and create some confusion with these standards," said Agriculture Secretary Tom Vilsack.

"Our response was to set up minimum requirements. You have to have a minimum level of dark green vegetables, you've got to have a minimum level of red or orange or yellow vegetables."

And coming on the heels of these changes will be laws affecting school vending machines.

Here are the quick bullet points:

• Offer a minimum of 8 to 10 ounces of whole grains. No more than two desserts a week may be used to meet this minimum
• Offer at least a half cup per week of dark green vegetables
• Offer at least 3/4 cup red/orange vegetables for grades K-8, and at least 1 1/4 cups in grades 9-12
• Offer at least a half cup of beans or peas
• Offer at least a half cup of starchy vegetables. There is no limit on starchy vegetables
• Offer at least a half cup of fruit in grades K-8 and at least 1 cup of fruit in grades 9-12
• Offer at least a half cup (grades K-8) or 3/4 cup (grades 9-12) of "other vegetables," which may be met with any of the above vegetables except for starchy vegetables
• Allow tofu as a meat alternative
• Get federal reimbursement only if they offer at least a half cup of a fruit or vegetable
• Contain no fewer than 550 calories for grades K-5, 600 calories for grades 6-8, and 750 calories for grades 9-12
• Contain no more than 650 calories for grades K-5, 700 calories for grades 6-8, and 850 calories for grades 9-12
• Obtain less than 10% of total calories from saturated fat
• Have zero trans fat
• Limit salt according to grade level
• Offer at least a cup of low-fat or skim milk

Read the whole article on WebMD 

Disney: Let the Memories (and the diet) Begin



Longingly wishing that their dad would just buy them ice cream


I just returned from Disney World and while it was super packed, very hot, and kind of expensive, it was also awesome. The parks are immaculate, the staff is patient beyond what normal people should be, and despite the waiting (and a little whining), all 3 of my children thoroughly enjoyed it.

But as I schlepped my 5, 3 and 2 year old children along sun-baked paths, through crowds and onto various rides, I noticed that I was one of the younger (and thankfully thinner) child-schleppers out there. The percentage of obese grandparents, parents, and children that populate Disney World was somehwhat disheartening but not as much as the remarkably limited food options for the Disney goers.

It first hit me when I saw an elderly couple dividing up their pill box contents at lunch. I thought that many of these generous and loving grandparents were likely diabetic and hypertensive. And what would they eat? Finding healthy food options in Disney is harder than getting seats at the Princess Breakfast. I am certainly no Disney expert and this is just an opinion, but the vast majority of nourishment options were of the hamburger/hot dog/fried variety. There was a definite lack of fresh fruit and vegetables but you couldn't spit without hitting an ice cream/candy/frozen sugary concoction stand.

I know, I know. What should I expect? It's an amusement park, not a wellness center. But it also is supposed to be a magical place and it is indeed a family-oriented destination that prides itslef on making memories. It would be my hope that in the future they begin to provide healthier options for those grandparents and parents who may not want to bring their own food and stay healthy. There is a a movement afoot in this country to get healhtier and greener and our children are learning this in school. So where better than Disney World to set the example and begin providing healthier lunch, dinner and snack options to all those millions of people who love to make memories.

If any of you have differing opinions, or similar ones, we always love to hear from you! Comment below...

Cholesterol-Lowering Foods: They Do Exist

So, we've talked about the No-brainer bad foods, and the High-cholesterol surprises,  but there are rumors out there that all foods are not created equal and that you can actually improve your LDL by eating more of certain food items. It's true! Some of them decrease your LDL (should be <100 mg/dL), some increase your HDL (should be >35 mg/dL), and some do both.

"These foods may not be magic, but they're close to it," says Ruth Frechman, RD, a spokeswoman for the American Dietetic Association.

1. Nuts - Let's not get crazy here, only some nuts and in their healthiest form are good for you. Summarily discount anything that is honey-roasted, salted, or candied. The raw versions, and to a lesser extent, the dry roasted are your best bets. Believe it or not, the esteemed cardiac journal Circulation published a study
demonstrating that people who had two handfuls of almonds, lowered their LDL by more than 9%!
Along with almonds and walnuts, the FDA gave its qualified health claim to peanuts, hazelnuts, pecans, some pine nuts, and pistachios. Another study, published in the Journal of Nutrition, examined a standard low fat/low cholesterol diet with a diet that replaced one-fifth of the calories with pecans. When compared to the standard diet, the pecan diet lowered bad LDL cholesterol by 10.4% and decreased triglycerides by 11.1%. It also raised the levels of good HDL cholesterol by 5.6%.

2. Oatmeal - Yes, those annoying breakfast commercials are partially true. Oatmeal actually decreases the bad cholesterol (LDL) without affecting HDL. It is also a recipient of the illustrious FDA's "health claim" status, granted in 1997. Most adults should get at least 25 grams of fiber a day.There are 3 grams of soluble fiber in 1.5 cups of oatmeal -- enough to lower your cholesterol, according to the American Dietetic Association. It may be a bit much for breakfast, so just add in oatmeal or bran to dishes at other times of the day.

3. Plant sterols - "Eating sterol and stanol-containing foods is an easy way to lower your LDL cholesterol, which helps reduce the risk of heart disease," says Ruth Frechman, RD, a spokeswoman for the American Dietetic Association (ADA). A more recent study from the University of California Davis Medical Center looked at the effects of sterol-fortified orange juice. Of 72 adults, half received regular orange juice and half the fortified OJ. After just two weeks, the people who drank the stanol-fortified juice had a 12.4% drop in their LDL levels. The results were published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology. Ok, that's easy enough, but what are they? And where do I find them? Many of the butter, or better even, margarines that you smear on bread have sterols added - check the labels! Sterols and stanols are also found in some cooking oils, salad dressings, milk, yogurt, and juices.

4. Fish - Because of the high levels of the oft praised Omega-3 fatty acids, which have been shown to reduce the risk of heart disease and stroke while helping to reduce symptoms of hypertension, the American Heart Association recommends eating a variety of types of fatty fish (such as salmon, tuna, and mackerel) at least twice a week. You should be grilling or baking that fish though and not eating out of a can, covered in oil, or frying it!

5. Olive Oil - The cholesterol-lowering effects of this Mediterranean Diet staple is most effective when it is the extra virgin variety, meaning the oil is less processed, thereby leaving many of the beneficial nutrients. Careful though, the caloric content is high so only use the recommended amount.

Heart Healthy Diet

Patients are often asking us how to eat right and improve their diet. Well, the government (the National Institute of Health, really) actually provides some great answers. The NIH website offers a lot of great information about how to keep you and your family healthy and this is juts one part of it.

Here are some highlights:

Heart Healthy Diet Guidelines -- you should eat:

• 8-10% of the day's total calories from saturated fat.
• 30 percent or less of the day’s total calories from fat.
• Less than 300 milligrams of dietary cholesterol a day.
• Limit sodium intake to 2400 milligrams a day.
• Just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level. (Ask your doctor or registered dietitian what is a reasonable calorie level for you.)

For the whole article, go here:
http://www.nhlbisupport.com/cgi-bin/chd1/step1intro.cgi

And pass this blog along to your friends....