Keeping Extra Pounds off your Holiday List

Although by now you’ve hopefully now finished the last of the Thanksgiving turkey and pumpkin pie, the holiday eating season has just begun. And, as a result, over the next month, the average American will gain one or two pounds. While that might not sound like much, the annual weight gain adds up from year to year and can lead to significant gains as the years goes by.

So, if the seams on your favorite holiday outfit are already bursting ahead of the onslaught of holiday parties, all-you-can-eat buffets, peppermint bark and eggnog, now’s the time to consider strategies to maintain your current weight and still enjoy the season.

At this time of year, most of us are bombarded with food. High calorie treats appear everywhere you look. Tables are filled with home-made cookies, gingerbread, hot apple cider, and irresistible savory appetizers. But resist you must, says Amy Moore, Ph.D., assistant professor of nutrition and dietetics at Saint Louis University.  Here’s her advice to keep you lean this holiday season:

Be picky about your splurges. You can eat crackers and cheese any time, but the holidays are a time to sample special seasonal treats that people have spent a lot of energy preparing. So, if you’re at a holiday buffet, browse before you graze to size up your best options. If that delectable chocolate dessert beckons, enjoy a slice but pass on the brownies or soda. Allow yourself to indulge, just choose where you want to spend your calories.

Be mindful. When there’s a bowl of chips right in front of you, you are more likely to keep munching without really thinking about it. So pay attention to what you’re eating. Slow down and savor every bite, taking the time to appreciate what you’re putting into your mouth. Watch your portion size.

Plan ahead. If you know you are going to a party in the evening, eat a healthy breakfast and lunch. Don’t starve yourself; in fact, consider eating a snack to take the edge off of your hunger. Bring something healthy to potlucks so at least you can count on one healthy option being offered. Seasonal fruit such as pomegranates, clementines and cranberries are terrific holiday dishes because they are pretty, festive and, best of all, guilt free.

Conversation is calorie-free. Once you’ve taken a plate of food at a holiday gathering, step away from the table. Find a comfy space where you can talk to others. Fill up on fellowship, which is calorie-free!

Water is calorie-free, too. So, drink up. Alternate a glass of water with every alcoholic beverage to pace yourself as you celebrate and prevent a next day hang-over. Consider creating a wine spritzer by adding flavored sparkling water to your wine. Instead of drinking lemonade or soda with a meal, choose water. Not only does water fill you up, it’s also good for your digestive system, skin, muscles and kidneys.

In addition to watching what you eat and drink, you should offset holiday calories by becoming more active. Saint Louis University associate professor of physical therapy and athletic training, Ethel Frese, DPT, offers the following tips:

Be realistic.  Becoming more active is a great way to mitigate a few extra calories, but it is not license to add massively to your diet. So, suppose you splurged and ate a 350 calorie pastry, on top of your normal daily calories. If you want to burn off all of the excess, you’ll need nearly an hour of intense exercise. While it’s not necessary to count every calorie, it is good to have a rough idea of how your calorie intake corresponds to your exercise, and know that it can take more exercise than you might think to balance out your food intake.

Everything counts. That said, don’t be discouraged. Exercise offers many overall health benefits, and burning off even an extra hundred calories a day makes a significant difference. In some cases, extra activity may be a natural part of your routine this season. Walking from the back of a packed parking lot at the mall and scouring stores for the perfect gift provides good exercise. House cleaning for company can burn calories, as can shoveling snow, playing with children and putting up decorations.

Fight the urge to hibernate. If rainy or snowy days tempt you to stay at home watching movies and reading books, be sure you don’t make a habit of avoiding outings. Bundle up and get out for fresh air and exercise. Run errands, stop by to see friends and neighbors, drop off canned goods at a food pantry, check out an exhibit at a museum or build a snowman!

Be consistent. The secret to success is to add a little bit of exercise each day. The effort really does add up, and you’ll find that daily activity makes you feel healthier, more alert, and happier in general. You’ll enjoy the season more without the sluggish feeling brought on by too many sedentary hours. Even if you don’t burn off all of the extra calories through exercise, you’ll limit the damage and in January, you’ll appreciate having only one pound to lose, instead of five.

Remember that the secret to controlling your weight is balancing the calories you take in (food) with the calories you burn. “Even the healthiest eaters need to exercise and the best exercisers need nutrition,” says Moore. “Nutrition and exercise provides the one-two punch of holiday weight management.”

Make your weight management mantra for the season to maintain not gain.

Dying for an energy drink?

As someone who gets up at 4:30 am most days to go to the gym and who rarely, if ever, eats carbs, I know there is no easy way to stay fit and healthy.  But, there are others who may be tempted to look for an easier or quicker way…and to them we say- beware!

Before you reach for a weight loss supplement, or energy drink, you may want to think again. According to four separate case reports just presented at the American College of Gastroenterology’s 78th Annual Scientific Meeting in San Diego, consumption of some of these can lead to hepatitis, severe liver damage, liver failure and even death.

Use of herbal and dietary supplements is widespread for a variety of reasons. But many patients don’t disclose supplement use to their physicians, and as such important drug side effects can be missed.

The first case report documented a case over liver toxicity and fulminant liver failure associated with the use of SlimQuick™, a weight loss supplement containing green tea extract.

A 52-year old female patient was admitted to the emergency room after one week of vomiting and progressive jaundice. The patient reported she had ingested SlimQuick™ for two days, while fasting three weeks prior to admission. Her liver biopsy was consistent with hepatic necrosis She was started on steroids but these were discontinued after two days, as liver function worsened and mental status deteriorated to the point she needed to undergo liver transplantation two days later.

In the second paper, Khadija Haroon Chaudrey, MD, presented a rare case of black cohosh-induced hepatotoxicity leading to early cirrhosis. Black cohash is often used by menopausal women to control hot flashes and other associated symptons

A 44-year-old female had developed jaundice for one month, and initial lab work revealed elevated liver function tests (LFTs). The patient had no history of alcohol intake, IV drug use, unprotected sex, recent travel outside the United States, NSAID ingestion or blood transfusions. After an unsuccessful outpatient trial of steroids, she was referred for inpatient evaluation because of gradual progression of her symptoms.

The patient then reported she had started taking black cohosh about one month prior. “Her ultrasound abdomen showed nodular contour of liver consistent with cirrhosis,” said Dr. Chaudrey. “Given patient’s history of black cohosh use and the timing of her abnormal liver chemistries, it was clinically evident the culprit agent was black cohosh.”

Once the patient stopped taking black cohosh, her symptoms improved and her LFTs normalized.

The third case described acute liver failure following consumption of Rockstar® Sugar Free energy drink.

Brian Huang M.D., Chief Resident of the Internal Medicine Residency Program at Cedars Sinai Medical Center, presented a case involving a 36-year-old male without prior medical history. He sought medical attention after symptoms of right upper quadrant abdominal pain, jaundice and fatigue. After abnormal lab work, he was brought to the hospital. The patient admitted to binge drinking (10 beers in a three-hour period) prior to symptom onset. He denied consuming herbal supplements, but admitted to having three Rockstar® Sugar Free energy drinks, on a daily basis for the past year. He too, required a liver transplant.

According to Dr. Huang, “The patients’ pathology reports showed massive hepatocellular necrosis and parenchymal collapse consistent with drug-induced liver injury. We believe his prior history of binge drinking may have provided initial damage on his liver, making him more susceptible to develop liver failure. Although the patient had a history of weekend binge drinking, his liver biopsy was not consistent with alcoholic hepatitis. Thus, they determined that the liver failure was linked to the long-term energy drink consumption.

A fourth case of drug-induced liver injury was found to be associated with the advanced weight loss supplement, Ripped Fuel®. This supplement contains herbal extract with 60% flavinoids, caffeine and cacao.

A 36-year old female with history of depression and no prior liver disease was seen after having one week of abdominal pain, anorexia and nausea. On physical examination, she had jaundice and yellowing of her eyes. The patient had started to take Ripped Fuel® three weeks prior to developing these symptoms, to lose weight. She denied use of other herbal medicine, supplements or acetaminophen. There had been no recent changes in her depression medication.

“There is a lack of knowledge about the status of Food and Drug Administration regulation of dietary supplements,” said Dr. Halegoua-De Marzio, author of the first paper. “Currently, dietary supplements are not required to have safety or efficacy studies before they are marketed to the public, and they remain popular among consumers despite reports of hepatotoxicity. 

These cases serve as a reminder of how even minimal use of dietary supplements can lead to liver failure and liver transplant. It is important that patients talk with their doctors before starting any new dietary supplements.

Or better yet, stick with the old fashioned way of healthy diet and exercise.  So who wants to join me in the gym at 5am tomorrow?

A Call to End Religious Nutrition

Q: “How can you tell if a friend is on a gluten-free diet?”

A: “They’ll tell you.”

Again and again and again… Same joke goes for paleo, low-carb, vegan and pretty much any organized dietary strategy that has a defining name and movement behind it.

Along with politics, gun rights, religion and abortion, is one of those areas where people feel comfortable not only sharing their views but do so with incredible conviction, passion and certainty. And yet, nutrition is anything but certain.  Sure, we know there are patterns of eating that help in minimizing the risk of various chronic diseases, but those patterns are far broader and less drilled down than most nutrition gurus and zealots believe.

So, we were very interested in fellow blogger –Yoni Freedhoff’s – recent blog in which he calls for an end of nutrition as religion.  More so, because Yoni is not just another disillusioned dieter. No siree!  He is the Medical Director of the Bariatric Medical Institute and assistant professor of family medicine at the University of Ottawa.  Dr. Freedhoff has also been called Canada’s most outspoken obesity expert and his award winning blog, Weighty Matters, has at times been ranked the world’s top health blog by blog ranking service Technorati.

So what does Dr Freedhoff have to say?

First, he suggests that practitioners of dietary religion risk alienating friends through strict adherence to their religious commandments.  Second, he states that diet adherents tend to use their online platform to frown upon any and all dietary strategies beyond their house of worship. To question their program or guru’s plans is akin to questioning their religious beliefs; and yet, unlike actual religious questioning (which would almost certainly lead to a thoughtful discussion), question dietary dogma online, and you can bet it will lead to a highly heated debate where anger and indignation can easily descend into name calling and personal attacks.

And even if you religiously avoid all cyber nutrition nuts, you may still be at risk. According to Freedhoff, although you may not have a stranger’s zealous scrutiny to watch out for, you’ve still got yourself. Dietary dogma, almost by definition, dictates blind faith and absolute loyalty, where breaking a dietary commandment is akin to committing a sin. And with sin, comes guilt. And if you feel guilt often enough, you might well decide to abandon your entire healthier-living, guilt-inducing effort.

Nutrition as religion demands perfection, yet perfection is an impossible goal. Remember, food is not simply fuel. Since the dawn of humankind, food has been used for comfort and celebration, and if your newly found dietary religion forbids foods you enjoy, my bet is you’re not long for that diet.

So what’s the solution?  Freedhoff advises : the easiest question to evaluate any dietary plan or religion is simply, “Could I happily live like this for the rest of my life?” where the most important word in that question is “happily.” If the answer’s “No,” you’ve either got to get comfortable with adding in some sinning, or find another way to go.

Add in some sinning in the form of thoughtful, “worth-it,” dietary imperfections, and suddenly new lifestyles may transform from the merely tolerable to the actually enjoyable. Enjoy your lifestyle, albeit imperfectly, and maybe you’ll even stick with it.

Nutrition isn’t religion. Eat the healthiest diet that you can enjoy, because if you’re not enjoying it, it isn’t going to last, and tolerable isn’t good enough.

Go on, sin a little, on us. The good doctor will forgive you enough to forgive yourself.

Battling Broccoli

If you’re a parent, you’ve more than likely experienced your little darlings crisis and tantrums at the dinner table. And you’ve probably asked yourself, more than once, “why won’t my kids eat their vegetables?”

Perhaps you were once one of those kids yourself.  I know I was!  My mother is still baffled how years later her child who would rather go hungry than eat a single green thing, became a strict vegetarian.

Maybe now I can give her an answer.  Research has found that about more than two thirds of children have sensitivity to bitterness. Dislike of the bitterness may stem from the TAS2R38 gene, which influences how we perceive bitter tastes.

The  study, published in the Journal of the American Dietetic Association found that 70% of kids tested were bitter-sensitive, meaning bitter foods, such as broccoli and cucumber, can have a very unpleasant taste to them.

The study did provide some hope, though: Bitter-sensitive kids who were offered ranch dip with their greens, ate 8% percent more vegetables than kids who weren’t given the dip. The findings held true regardless of the fat content of the dip, with kids consuming as many vegetables with low-fat ranch dressing as they did with a full fat version.  At the end of the 7 week study, the number of children who said broccoli tasted “yummy” also increased by 18 percent.

“I’ve never met a parent who’s not familiar with the daily struggle to get their kids to eat better,” said veggie expert and registered dietitian Jodie Shield. “It’s helpful for parents to know that there is a reason why their kids might not eat vegetables and exciting to see that simple actions like offering a dip can have a profound difference in a child’s eating habits.”

So what if your kids don’t like ranch dressing either?  Don’t fear, SRxA’s Word on Health has a number of other viable veggie solutions!

• Grow Your Own: Children love to plant things and watch them grow.  Besides, home-grown veggies taste so much better
• Get Your Kids Involved in the Process:  children who help to prepare and cook their own food are more likely to eat those foods and even ask for seconds
• Making Veggie’s Fun: Teach your kids about vegetables. Make up stories about Peter the pea and Charlie the cucumber. Make veggies their friends.
• Make Eating Fun: Get creative with serving and decorating their plates. Making veggies part of a familiar shape such as a smiley face or an animal, will get them eating in no time

For more great ideas why not check out www.LoveYourVeggies.com

Falling for Pumpkins

Here in the nation’s capital, the cooler temperatures and brilliant colors of Fall are upon us. Pumpkin patches are opening everywhere and among the neighborhood kids, the countdown to Halloween has begun. This year, rather than throwing out the pumpkin seeds after carving lanterns or making pie, nutritionists are suggesting that we eat them. Pumpkin and its seeds provide many nutritional benefits including:

• Vitamins: vitamin C, E, iron, zinc, magnesium, potassium, both beta & alpha carotenoids (anti-oxidants which help prevent cell damage), and lutein (to support healthy eyes)

• Protein: pumpkin seeds are high in protein

• Essential fatty acid oils: to help maintain healthy blood vessels, nerves, tissues and hair

 Snack on a quarter-cup of pumpkin seeds and you will receive 46% of the daily value for magnesium, 29% for iron, 52% for manganese, 24% for copper, 16.9% for protein, and 17% for zinc.

It’s claimed that pumpkins can also support kidney, bladder and prostate health; minimize osteoporosis, help get rid of parasites & tapeworms, and lower cholesterol due to the high levels of phytosterol.  Pumpkin seeds may also alleviate symptoms of depression as they contain L-tryptophan.

Dr. Helen Lee of ChicagoHealers.com recommends four ways to incorporate pumpkin into your everyday diet.

1.  A handful of raw pumpkin seeds as a snack or mixed with trail mix, on top of cereal
2. Pumpkin seed butter spread on toast
3. Pumpkin pie/desserts/pancakes/waffles
4. Pumpkin baked or browned with spices in risotto, chili, rice, spaghetti

SRxA‘s Word on Health’s personal favorite is pumpkin seed oil, a wonderful thick, green- oil that is produced from roasted pumpkin seeds. Try it drizzled on pumpkin soup or mixed with balsamic on salads. If you’re feeling adventurous you can even do as the Viennese, and add a few drops on vanilla ice cream.

Go on, share your favorite pumpkin recipe with us!

Middle Age Spread Linked to Later Life Dementia

Need a new and compelling reason to lose weight?  Word on Health thinks we’ve found one of the best ones. 

According to a new study, published in Neurology, being overweight or obese during middle age may increase the risk of certain dementias such as Alzheimer’s Disease.

Researchers from the Karolinska Institutet in Stockholm, Sweden, studied information from the Swedish Twin Registry on 8,534 twins age 65 or older. Of those, 350 were diagnosed with dementia and 114 had possible dementia.

Information on participant’s height and weight had been taken 30 years earlier. Participants were classified as either underweight, normal weight, overweight or obese according to their body mass index (BMI). Nearly 30% (2,541) of the twins, were either overweight or obese during middle age. Researchers learned that this group had an 80% higher risk of developing dementia, Alzheimer’s disease or vascular dementia in later life compared to people with normal BMI.

The results remained the same after considering other factors, such as education, diabetes and vascular disease. A total of 26% of those with no dementia had been overweight in midlife, compared to 36% of those with questionable dementia and 39% of those with diagnosed dementia.

Three percent of those with no dementia had been obese in midlife, compared to 5% of those with questionable dementia and 7% of those with diagnosed dementia.

In twin pairs where one twin had dementia and one twin did not, there was no significant relationship between weight and dementia in midlife suggesting that genetic and early life environmental factors may contribute to the link.

“Currently, 1.6 billion adults are overweight or obese worldwide and over 50% of adults in the United States and Europe fit into this category,” said study author Weili Xu, MD, PhD. “Our results contribute to the growing evidence that controlling body weight or losing weight in middle age could reduce your risk of dementia.”

For us – the diet really does start today, before we’re no longer able to remember our resolution.