Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

Better Than Your Mother’s Workout DVD?

March 7th, 2012 at 12:34 pm by timigustafson
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The so-called “active video games” that run on Microsoft’s Xbox or Nintendo Wii were supposed to make a big difference in the way people, especially kids, exercise at home and, hopefully, lose weight and get back in shape. That hasn’t happened yet, at least not on a large scale, according to researchers who studied the impact of these relatively recent innovations on children’s health.

Active video games offer virtual tennis, track and field or dancing experiences, which are meant to encourage consumers to get off the couch and move their bodies. In areas where opportunities for outdoor activities are sorely missing, where going to the gym requires a long drive, or where schools don’t offer physical education (PE), health advocates had hoped for an alternative tool to fill the gap. That expectation has so far been frustrated.

For the study, a research team from Baylor College of Medicine in Houston, distributed free active as well as inactive video games among a group of 9 to 12 year olds who were all above average weight. As it turned out, the children who played the active games lost no more weight than those who stuck to the inactive versions, like sing-alongs.

“We expected that playing the [active] video games would in fact lead to a substantial increase in physical activity in the children,” said Dr. Tom Baranowski, one of the researchers at Baylor in an interview with Reuters Health. “Frankly, we were shocked by the complete lack of difference.”

Over a time period of roughly 3 months, the children were tracked and monitored for their physical activity levels through a motion-measuring device called an accelerometer. The results showed an average of 25 to 28 minutes of moderate to vigorous physical activity among the kids who played active videos and 26 to 29 minutes for those who only played inactive ones.

Active video games “might increase caloric expenditure a bit more than a traditional sedentary video game, and if you do that on a daily basis that could have a cumulative effect that might be beneficial,” said Dr. Jacob Barkley, an exercise scientist from Kent State University who was not involved in the study. [But it] isn’t going to increase physical activity a whole heck of a lot,” he added.

In the meantime, sales of traditional workout DVDs remain strong, and not just among the Jane Fonda fans from decades ago. According to Reuters, 18 to 34 year olds account for 35 percent of fitness DVD buyers, followed by 35 to 50 year olds at 33 percent and people 55 and older at 20 percent.

Only lately has the weight loss and fitness industry begun focusing on children due to the ever-growing childhood obesity rates in the U.S. and much of the world. Workout DVDs can be cheaply produced and are easy to use, which makes them a viable alternative to more sophisticated and more expensive formats.

Still, health experts warn that we should not expect too much from the low-impact exercises you can do in front of your TV screen. All this virtual jumping, throwing and dancing or even the pushups people do on the living room floor do not compare to the impact you get from running in the park, swimming laps in an Olympic-size pool or working out in a well-equipped gym. But, I agree, it’s better than nothing.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Why Is Gaining Weight So Much Easier Than Losing Weight?

March 4th, 2012 at 1:40 pm by timigustafson
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One of the hardest things about weight gain is that it can happen so easily. Losing weight, on the other hand, can be a never-ending struggle. Some people say they put on a pound or two merely by looking at food. But no matter how much they deprive themselves or how hard they exercise, the numbers on the scale only seem to go up.

This experience is as common as it is counterintuitive. If you eat more calories than your body burns off, you will gain weight. The same should be true the other way around. Use up more than your intake and you will lose weight.

One pound of body fat represents 3,500 calories. You can increase or reduce that amount – it would seem – by equal measures. But that is not necessarily so. A great number of additional factors must be taken into consideration to understand the difference between weight gain and weight loss.

For example, your actual weight determines how many calories you burn. The heavier you are, the more calories your body requires to function properly. If you are overweight or obese, you need more calories to maintain your weight and, paradoxically, you can also lose some faster than if you were normal-weight – but only to a certain extent.

Dr. David Ludwig, director of the “Optimal Weight for Life” program at Children’s Hospital Boston and co-author of a commentary on the subject of weight gain versus weight loss in the Journal of the American Medical Association (JAMA), explained the difference like this:

“Our bodies don’t gain or lose weight indefinitely. Eventually, a cascade of biological changes kicks in to help the body maintain a new weight. A person who eats an extra cookie a day will gain some weight, but over time, an increasing proportion of the cookie’s calories also goes to taking care of the extra body weight. Similar factors come into play when you skip the extra cookie. You may lose a little weight at first, but soon the body adjusts to the new weight and requires fewer calories. Regrettably, however, the body is more resistant to weight loss than weight gain. Hormones and brain chemicals that regulate your unconscious drive to eat and how your body responds to exercise can make it more difficult to lose weight. You may skip the cookie but unknowingly compensate by eating a bagel later on or an extra serving of pasta at dinner.”

Unconscious or “mindless” eating, as Dr. Brian Wansink called it in his landmark book, “Mindless Eating – Why We Eat More Than We Think,” can contribute substantially to unwanted weight gain or the inability to lose weight. Indulging in some tasty but less-than-healthy snacks or downing a few sodas or alcoholic beverages on the side can add on unaccounted calories real quick. But burning those off can take a lot longer and require serious efforts.

Another issue is whether your weight gain was rapid due to some exceptional occasion or event (e.g. a party or a vacation) or whether you put on more pounds over time. The former can usually be undone by returning to your healthier eating and lifestyle habits. The latter is a different story. In that case, some self-evaluation may in order. Did your eating pattern change for any particular reason such as stress at work, a move, financial issues or domestic problems? Did you stop exercising? Age may also be a factor. As you get older, your metabolism slows down and you require less food than you used to – but your habits have not kept up with your biological changes.

One of the greatest frustrations people with weight problems can go through is the so-called weight cycling or yo-yo dieting – losing weight successfully, only to gain it all back. Unfortunately, this phenomenon is quite common. Over 80 percent of dieters regain some or all of their former weight back within two years and two-thirds of once successful dieters end up heavier than they were before their initial weight loss, according to a study by the University of California at Los Angeles (UCLA).

Yo-Yo dieting is not only emotionally frustrating, it can also have serious consequences for a person’s physical well-being. “The more diets you’ve been on, the harder it becomes to lose weight,” said Dr. Kelly Brownwell, director of the Rudd Center for Food Policy and Obesity at Yale University.

Even on a sensible diet, your body is reluctant to let go of some of its mass. When you are dieting, it may perceive it as impending starvation and a threat to its survival. In cases of rapid weight loss (e.g. crash diets), a metabolic overcompensation can kick in, resulting in a slower metabolism and greater difficulty to lose additional weight.

Weight cycling can actually change your physiology, according to Dr. Brownwell. One of the reasons for this is that through dieting a hunger hormone called ghrelin increases, and a fullness hormone called leptin decreases, so you feel hungrier and less satiated every time around. Also, frequent yo-yo dieting lets you lose muscle mass and replaces it with fat as you regain weight. Because muscle burns many more calories than fat does, your metabolism slows down even further.

“Losing and regaining weight regularly takes a huge toll on your body,” said Dr. Keith Ayoob, professor at Einstein College of Medicine at Yeshiva University in New York, not just aesthetically by loss of skin elasticity but, more importantly, by the damage being done to the inner organs, the arteries and the skeletal system, and by a host of potentially life-threatening illnesses resulting from unhealthy weight gain like diabetes, heart disease, high blood pressure and cancer.

Of course, there are cases where the body is resistant to weight loss because of an underactive thyroid or other disorders. But those are relatively rare by comparison to diet- and lifestyle-induced weight fluctuations. In the absence of such medical conditions, the best way to prevent weight gain and promote weight loss (if necessary) is, as always, healthy eating, regular exercise, managing stress and getting enough sleep – in other words, opting for an all-around healthy lifestyle.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Obesity and Diabetes – The Plague of Our Time

February 28th, 2012 at 6:00 pm by timigustafson
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When Michelle Obama announced “Let’s Move,” her signature initiative to combat childhood obesity, she emphasized that major diet and lifestyle changes were not required in her view to turn this growing health crisis around. “Small changes add up,” she said. “We don’t need to totally evaporate our way of being as we know it today.” In other words, if we just cut a few calories here and there and exercise a bit more, things will be fine before long. A comforting thought.

But that may be wishful thinking, according to Mark Hyman, MD, chairman of the Institute for Functional Medicine and medical director of the UltraWellness Center in Lenox, Massachusetts, and author of several bestselling health books, including his latest, titled “The Blood Sugar Solution.” The way he sees it, we are in the middle of an explosive epidemic of obesity and type 2 diabetes that will touch almost everyone in one way or another. He does not hesitate to call it “the modern plague.”

Obesity, insulin resistance, metabolic syndrome, pre-diabetes, type 2 diabetes, heart disease, dementia and cancer are ultimately all rooted in one and the same problem: Our dismal diet- and lifestyle choices. Diagnosing and treating these diseases separately as if they were not interconnected misses the whole picture. Instead, Dr. Hyman proposes using a more comprehensive term to describe the continuum of which all these health problems are part of: “Diabesity.”

Diabesity can range from slight weight problems and mild insulin resistance to morbid obesity and severe diabetes. Because the disease is not well understood as a continuum, millions of those affected by it remain undiagnosed and untreated. As a consequence, more people all over the world die now from chronic illnesses than from infectious diseases. The real tragedy is that the causes are almost always environmental and lifestyle-related, which would make them perfectly preventable or curable through public education and enough political will to implement the necessary changes.

“This is a lifestyle and environmental disease and won’t be cured by medications,” Dr. Hyman writes. “Billions and billions have been wasted trying to find the ‘drug cure,’ while the solution lies right under our nose. Shouldn’t the main question we ask be why is this happening? Instead of what new drug can we find to treat it?

Since most of our modern-day ailments are primarily caused by poor diet choices, chronic stress and sedentary lifestyles, as well as toxins and allergens in the environment, we must address these problems from the ground up (literally). Instead of looking for quick fixes through medication and surgical procedures, we can make many important corrections by ourselves and without delay by using the right ingredients that make us healthy again, including whole, fresh food, vitamins and minerals, water, fresh air, exercise, stress reduction, etc. “When we take out the bad stuff and put in the good stuff, the body knows what to do and creates health and disease goes away,” writes Dr. Hyman. Care for the environment is part of that, too. Here, he strongly agrees with Sir Albert Howard, who is by many considered the founder of the organic agriculture movement, when he wrote in his landmark book, “The Soil and Health,” that we must “treat the whole problem of health in soil, plant, animal and man as one great subject.”

Finding our way back to wholesome nutrition is one of the greatest challenges we face today. “In America, we eat more than we ever have, yet we are nutritionally depleted,” writes Dr. Hyman. The epidemic of diabesity and other chronic illnesses is paralleled by an epidemic of nutritional deficiencies. Most of us don’t eat enough the kind of food that protects us from diseases and too much of the kind that makes us sick.

“Food literally speaks to our genes,” he writes in a chapter titled “Nutrigenomics.” “The information your body receives from the foods you eat turns your genes on and off.” Whole-foods and plant-based diets have been shown in clinical studies to be able to turn off cancer-causing genes or turn on cancer-protective genes. No medication can do this. “What you put on your fork is the most powerful medicine you can take to correct the root causes of chronic disease and diabesity,” he writes.

“The Blood Sugar Solution” is a highly informative but, thankfully, also a very accessible book for both professionals and the laypersons. Some readers may find Dr. Hyman’s positions to be somewhat radical, if not utopian, especially where he seeks to offer hands-on solutions. Admittedly, he writes with passion and a sense of urgency – and rightly so. The obesity crisis keeps growing unabatedly worldwide and the time for “small steps” may have passed. Something has to change on a fundamental level. Unfortunately, that makes it so much less likely that we will see significant successes in the near future, if ever.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

A Renewed Effort to Fight Alzheimer’s Disease

February 25th, 2012 at 5:12 pm by timigustafson
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The Obama administration has tasked the science community with finding some effective treatments for Alzheimer’s disease by 2025. Experts consider the quest as ambitious. Still, health advocates applaud the government’s initiative, calling it an important step towards prevention, delay and, eventually, cure of the disorder.

Alzheimer’s disease is one of the most feared health conditions among Baby Boomers, second only to cancer, according to a survey conducted by the Alzheimer’s Association and the Harvard School of Public Health, which was first published at an international conference in Paris, France, last year. However, because of stigma and misinformation about Alzheimer’s and other forms of dementia, too many cases still remain undiagnosed. As a first step, the government has announced a major campaign to better educate both the medical community and the public at large about the disease.

“Alzheimer’s is the most significant social and health crisis of the 21st century,” said Dr. William Thies, the Chief Medical and Scientific Officer of the Alzheimer’s Association. “The overwhelming numbers of people whose lives will be altered by the disease, combined with the staggering economic burden on families and nations, make Alzheimer’s the defining disease of this generation. However, if governments act urgently to develop national research and care strategies with appropriate smart investments, the impact of Alzheimer’s and dementia can be managed,” he added.

Currently, over five million Americans suffer from Alzheimer’s and other forms of dementias, a toll that is expected to triple by 2050. The numbers may be much higher yet because as many as half of those affected have not been formally diagnosed. According to the American Health Assistance Foundation (AHAF), almost half a million new cases are added annually. Over 80,000 patients die from the disease every year, making Alzheimer’s the sixth leading cause of death in the U.S.

The annual costs for treatments and care of Alzheimer’s patients in the U.S. amounted approximately to $183 billion in 2011; they are expected to reach over one trillion dollars by 2050. The vast majority of people with Alzheimer’s receive home care by relatives, which is not covered by Medicare and most health insurance plans. For this reason, the new government initiative also aims at providing some form of relief for overwhelmed families who carry the burden of caring for loved ones, although the details hereto are still unclear.

Alzheimer’s is the most common form of dementia. The disease worsens as it progresses and leads to death within four to seven years on average, although 20 years are not unheard of. It was first described in 1906 by the German psychiatrist and neuropathologist, Alois Alzheimer, and was named after him.

Early symptoms are often overlooked or misinterpreted as age- or stress-related phenomena such as forgetfulness or confusion. Since the disease affects each individual differently, predicting its course is difficult.

What causes Alzheimer’s in the first place is not yet fully understood. Currently available treatments can only help with its symptomatic effects but are not able to halt or reverse progression. Some have suggested that diet, exercise and mental stimulation can have a positive impact, however, there is no clinically proven evidence that such measures have a real effect in terms of prevention.

Still, most experts agree that healthy diet and lifestyle choices are the best weapons we currently have against all age-related diseases, including Alzheimer’s and dementia.

If you liked this article, you may also enjoy reading “The Right Food for Your Brain” and “Reducing Risk Factors for Alzheimer’s Disease.”

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Your Eating Habits – What Makes Them, What Breaks Them

February 22nd, 2012 at 2:08 pm by timigustafson
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Charles Duhigg wanted to lose weight. Luckily for him, he was well-equipped to achieve his goal. As a journalist writing for the New York Times and author of an upcoming book on the science of habit formation, he is an expert on the subject of self-control. What he found out through his research and how he managed to turn his findings into action for the benefit of his own health is remarkable and may have significant implications for millions of people struggling with weight issues.

Getting his weight under control was not the original purpose of studying the inner workings of habit building. Duhigg’s first interest was to report on how today’s marketing researchers examine the behavior of consumers and influence their decision-making processes. He found that the success, if not the survival, of entire industries depends on increasingly detailed analysis of the behavior patterns of their clientele. “The push to understand how daily habits influence our decisions has become one of the most exciting topics in research,” he says, quoting from a study conducted at Duke University, which estimated that habits, rather than conscious decision-making, shape almost half of the choices we make on a daily basis. This view may change the way we think about dieting to how doctors conceive treatments for a variety of illnesses, including emotional stress and addictions.

Clinical lab tests have shown that, as we encounter an unfamiliar territory or try to learn new skills, our brain activity first increases dramatically and then decreases gradually as we begin to find our way around. We become familiar with the tasks at hand and our actions and reactions become more automatic. Eventually, many of them turn into habits.

The process in which the brain converts certain actions into an automatic routine is known to neuroscientists as “chunking.” There can be hundreds of behavioral chunks we rely on every day, from brushing our teeth to backing our car out of the driveway. And there is good reason for that. “Left to its own devices, the brain will try to make almost any repeated behavior into a habit, because habits allow our minds to conserve effort,” Duhigg explains. In other words, we form habits and routines for the brain to keep functioning. It would crash if kept in perpetual overdrive.

Unfortunately, there is a downside to all that too. If brain activity is reduced to conserve energy too soon or at the wrong moment, we can miss out on something important or fail to re-examine our actions when necessary. Old habits, even counter-productive ones, can be persistent and difficult to change.

Exploring the intricacies of habit-forming is also the specialty of a team of neuroscientists at the Massachusetts Institute of Technology (M.I.T.). According to their research, the habit creating process in the brain can be seen as a “three-step loop.” The forming of a new habit requires (1) a cue that triggers the brain to go into automatic mode, (2) a routine or automatic reaction that follows in response, and (3) a reward, which also helps the brain to decide whether a particular experience is worth remembering for the future. Over time, this loop – cue, routine, reward – becomes more and more automatic and neurologically intertwined. The results can reach from a simple tendency to cravings to a full-blown addiction.

What exactly turns an event into a cue and what constitutes a reward depends on the individual as well as on the situation. Both, cues and rewards, can be obvious or subtle, they can take place quickly and be barely noticeable, we may not even realize their presence at all, but our neural system registers and uses them to form automatic behaviors.

I remember a good example from my own practice as a health counselor. One of my clients who tried hard to get her weight under control described herself as addicted to sweet pastries, especially donuts. On her way to my office for our bi-weekly appointments, she had to pass by a bakery, which she had often patronized in the past and which she now had a hard time to avoid.

Needless to say, the cue (bakery) was still there every time she approached the area. Her old routine would have made her stop without question to satisfy her cravings. The rewards were obvious. Now that she was on weight loss regimen, she had to find a way to interrupt what the M.I.T. scientists identified as her “loop.” Instead of exposing herself any longer to the cue that would inevitably trigger her routine response, she had to a take a different route to see me. It took her several months until she was able to come near that bakery again without going in – but eventually she succeeded. How? Her cue was still there, but she developed a different routine in response, and the awards were for the world to see when she eventually lost over 50 pounds.

This is the good news. “Habits aren’t destiny,” says Duhigg. “They can be ignored, changed or replaced.” Still, old habits die hard. Actually, they never fully disappear. Once a habit is established, it will rear its head at any chance it gets. “Unless you deliberately fight a habit – unless you find new cues and rewards – the old pattern will unfold automatically,” he cautions.

In the end, Mr. Duhigg was successful in his quest for weight loss. He knew that his habit of eating a chocolate-chip cookie during his daily afternoon break caused him to put on the extra pounds. So he looked into his cues: Was it the place (he liked going to the cafeteria where the cookies were), the time (during the afternoon doldrums), his emotional state (he was tired or bored), other people (he liked chatting with his colleagues) or was it something that happened (right before he started craving a cookie)? Eventually, he found that the strongest cue was his desire for company. Once his needs for socializing were satisfied, the cookie monster disappeared.

We are obviously still at the beginning of our understanding of habits and how they develop, but the implications are potentially enormous, especially in the field of dietetics. In order to get the growing obesity crisis under control, we have to look far beyond calorie counts and portion sizes. Based on what we now know about our habits and how they drive our behavior, we need to work toward a much deeper understanding of who we are and what makes us act the way we do.

Charles Duhigg is the author of “The Power of Habit: Why We Do What We Do in Life and Business.” The quotes used for this article are taken from a piece he wrote in the New York Times Magazine (2/19/2012).

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Americans Prefer Eating at Home But Still Don’t Cook and Don’t Eat More Healthily

February 19th, 2012 at 12:55 pm by timigustafson
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The average American family eats at home on most days but is too rushed to make meals from scratch, according to a survey by Gallup-Healthways. In terms of nutritional quality, overall eating habits in America are not improving and have in some ways become even worse.

Fewer Americans reported eating healthily by including fruits and vegetables on a weekly basis last year than the year before. Produce consumption is down especially among young adults, seniors, women and Hispanics, according to the Gallup poll.

“The trend has been toward eating more meals at home. It’s just that we’ve been getting more and more of those meals we’ve been eating at restaurants to eat at home,” said Harry Balzer, a vice president at The NPD Group, a consumer market research firm. “Frozen and pre-prepared foods have gotten more popular. [People] want to spend as little time as possible preparing meals and that’s the driving force in the way we’re eating right now,” he added.

The results of the Gallup survey have been largely confirmed by another recent study, this one conducted by the U.S. Department of Agriculture’s Economic Research Service (ERS), titled “How Much Time Do Americans Spend on Food?” While many of the ERS’s findings came as no surprise – Americans like to eat quickly, tend to skip breakfast, take shorter lunch breaks, don’t spend much time on preparing and enjoying elaborate meals, make spontaneous food shopping choices, etc. – what stands out is the growing dominance of what the study calls “secondary eating patterns,” that is eating and drinking while simultaneously doing other things. Just focusing on your meals and enjoying them is becoming a thing of the past, especially among the younger generations, according to the report.

“On an average day [in 2006 to 2008 – the time period the survey took place], Americans age 15 and older spent about 2.5 hours daily eating or drinking. Slightly less than half of that time was spent eating and drinking as a primary or main activity, while the remaining time was spent eating and drinking while doing something else such as watching television, driving or working and waiting to eat or traveling to meal destinations,” said the report.

The ERS study also found that Americans who adhered predominantly to “secondary eating patterns” had on average a higher Body Mass Index (BMI) than those who kept mostly to “primary eating patterns” by setting time aside for their meals.

In his landmark book, “Mindless Eating,” Dr. Brian Wansink, a professor for marketing and nutritional science at Cornell University, pointed out that the average American makes well over 200 decisions about food every day, although when asked, most people initially believe they make only about 15 food-related decisions daily. Many of these decisions are made more or less unconsciously and even inexplicably. The reason is that we are often too distracted to pay attention to our eating. “If we knew why we ate the way we do, we could eat a little less, eat a little healthier, and enjoy it a lot more,” said Dr. Wansink.

Needless to say that this would not be an easy exercise. In a world where we all are constantly surrounded by a thousand things competing for our attention, it is hard to shut everything down and focus only on what we eat, when we eat, where we eat, how much we eat and how fast we eat. Yet, these are the quintessential elements of healthful eating habits.

As a dietitian and health counselor I’m often asked by my clients what changes they should make in their way of eating. There are many possibilities, of course, but much comes down to paying closer attention to your actions.

For instance, you can start by making grocery shopping lists and sticking to them once you’re at the store. Don’t buy food items spontaneously. For this reason, you should not go food shopping when you’re hungry.

Lay out a meal plan for a few days or an entire week if you have enough storage space. Prepare your meals as much as possible from scratch using fresh ingredients and lean cooking techniques. If you don’t have enough time to cook every day, prepare what you can in advance over the weekend or whenever you have the time.

Eat only in your dining room or whichever part of your home is set up for eating. Before you sit down, make sure to switch off your television, cellphone, computer, everything that can interfere with the enjoyment of your meal.

If possible, try to keep conversations light. Sharing a meal with loved ones should be a pleasurable experience. If the atmosphere around the dinner table is tense and stressful, it will affect everyone’s nutritional benefits as well.

Use food to celebrate. Although Thanksgiving is only once a year, there are plenty more opportunities to be grateful throughout the year. Having good food available itself is a cause for gratitude, being able to share it with others even more so.

There is little chance that we Americans will ever become quite like the French, the Greeks or the Italians, sitting down for hours on end over multi-course meals and wine in midday. And there is no reason why we should adopt other people’s lifestyles. But we should make ours as healthful as we can. And there we have plenty of room for improvement.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Despite of Recommendations for Total Ban, Trans Fats Stick Around

February 15th, 2012 at 3:29 pm by timigustafson
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Just as you thought it was safe to indulge again in your favorite pastries, crackers and chips because you were told that trans fats have been all but eliminated by food manufacturers under the mounting pressure from health advocates and lawmakers, you may have to realize that you exhaled too soon.

“Despite all the bad press these artificial, man-made fats have gotten over the years and an increasingly large body of science linking them to health issues from heart disease to ovarian cancer, trans fats are still hiding in processed foods and offerings on restaurant menus,” says Emily Main, a contributing writer and editor for Rodale (rodale.com), an online magazine specializing in issues of health, nutrition and environmental protection.

The use of trans fats in some restaurant chains and school cafeterias has officially been banned in several states and cities across the United States. Colorado state legislators are currently debating a bill that would entirely ban trans fats in school lunches as well as in snacks from vending machines and any other food outlets available on campus. Indiana and New York are considering similar measures.

There is no reason why we could not keep at least the food environment of school children trans fat free, insists Ann Cooper, head of food services at Colorado’s Boulder Valley school district and author of the “Renegade Lunch Lady” blog. “We don’t serve convenience food, we don’t serve junk food,” she says. “That’s where the trans fat is. You cook from scratch, it’s not a problem cutting all the trans fat.”

Trans fats are mostly used in processed foods, although they can naturally occur in small amounts in milk and certain meats. The by far largest quantities eaten by consumers, however, are created in a process called “partial hydrogenation” of unsaturated plant fats or vegetable oils. Partially hydrogenated fats, or trans fats, have become so popular with food manufacturers because they are much cheaper to make than other fat sources. They also extend the shelf life of the foods they are added to and require less refrigeration. Trans fats are commonly applied to fast food items, baked goods and snack foods. They are also utilized for deep-frying in restaurants because they can be used longer than conventional oils before turning rancid.

Over the years, the National Academy of Sciences (NAS) has released a number of recommendations for limiting the use of trans fats for health reasons. One of its contentions is that “trans fatty acids are not [nutritionally] essential and provide no known benefit to human health.” Another, more significant, reason for restricting their use is that trans fats are known to cause LDL (bad) cholesterol levels to increase and HDL (good) cholesterol levels to decrease, thereby contributing to heart disease and other health risks. These findings by the NAS are supported by a comprehensive scientific review of studies on trans fats published in 2006 in the New England Journal of Medicine (NEJM), which also concluded that “from a nutritional standpoint, the consumption of trans fatty acids results in considerable potential harm but no apparent benefit.” The study report also confirms the NAS position that there is “no safe level of trans fat consumption.”

According to the NEJM study, between 30,000 and 100,000 deaths can be attributed to trans fats in the diets of Americans every year.

Other studies have suggested that the detriments caused by trans fats reach beyond cardiovascular disease. A study report published in the Archives of Neurology (2/2003) suggested that the consumption of trans fats and saturated fats might promote the development of Alzheimer’s disease. The American Cancer Society has stated that, while a direct relationship between trans fats and cancer has not been determined, there are indications for a “positive connection between trans fats and prostate cancer.” A high intake of trans fatty acids may also substantially increase the risk of breast cancer, according to one study from France titled the “European Prospective Investigation Into Cancer and Nutrition.” Researchers from around the world have also expressed concern that the widespread consumption of trans fats may be partially responsible for the ever-growing obesity and type 2 diabetes crisis, especially among children and adolescents.

Even in the face of an abundance of scientific evidence and repeated warnings by health experts, consumer advocacy groups and legislators, so far the only way people can completely banish trans fats from their diets is by careful label reading, says Emily Main. Unfortunately, the U.S. Food and Drug Administration (FDA) lets food manufacturers hide the true content of trans fats by allowing them to call their products “trans fats free” as long as the actual amount is 0.5 gram or less per serving. Instead of falling for these false advertisements, says Main, consumers should look for “partially hydrogenated oils” on the ingredients lists posted on the packaging. Or better yet, eat only fresh foods.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Too Much Salt in Our Bread, U.S. Government Study Finds

February 12th, 2012 at 3:35 pm by timigustafson
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The highest amount of salt Americans eat comes from bread, according to a study by the Centers for Disease Control and Prevention (CDC). Nearly 50 percent of the salt consumed in the U.S. is linked to popular foods such as baked goods, cold cuts, cured meats, pizza, poultry, soups, sandwiches, cheese, pasta and snacks like pretzels and potato chips. Many items loaded with salt don’t even taste salty.

The study, which involved over 7,000 participants, found that bread accounted for an average of seven percent of daily sodium intake, more than any other individual food item. Bread may not contain the highest amount of salt per serving, but the fact that people eat it more often and in larger quantities than most other foods makes it a leading contributor to high blood pressure, heart disease and stroke.

The average American consumes about 3,250 milligrams of salt per day, far more than what’s recommended by the government’s Dietary Guidelines, which is 2,300 milligrams for healthy adults and 1,500 milligrams for high blood pressure and heart disease patients. Over 30 percent of the adult population suffer from high blood pressure, according to the CDC.

Most consumers are not aware that they are getting too much salt. What makes matters worse is that they could not easily change that even if they wanted to. “Most sodium comes from common grocery store and restaurant items and only a very small portion from the shaker at the table,” Dr. Thomas R. Frieden, the Director of the CDC, told reporters. “People can choose how much salt they add to their food at the table,” he said, “but they can’t take it out once it’s there.”

In fact, over 60 percent of the salt consumed by Americans is found in processed foods, about 25 percent in restaurant meals and the remainder from other sources such as vending machines and extra salt added at home, according to CDC statistics.

Dr. Frieden called for food manufacturers and restaurant owners to reduce the amount of salt they apply to their products. It is estimated that a 25 percent reduction in salt content in the most popular food items could save tens of thousands of lives every year.

Food industry representatives have responded by saying that reducing sodium would adversely affect taste and may also violate food safety standards because salt is commonly used as a preservative.

The CDC study report was released in the February edition of the journal “Vital Signs,” just in time to coincide with “Heart Health Month.” Sodium is well known to raise blood pressure, which is a major risk factor for heart disease and stroke. More than 800,000 Americans die each year from these diseases.

Health experts have long advised that people with heart problems should avoid processed and packaged foods as much as possible and eat more fresh produce instead. With regards to bread, it is important to read the Nutrition Facts labels. Sodium content in different breads can considerably vary between 80 and well over 200 milligrams. Other items like canned soups can have a wide sodium range from 100 to well over 900 milligrams, depending on the brand. Many fast food choices and TV dinners contain astronomical amounts of salt, often more than the recommended daily values in just one serving.

Asking food manufacturers and restaurants to voluntarily change the ways they use salt has not been very effective, although there are exceptions. Other than through legislation, the only promising approach would be consumer demand. If grocery store owners found that customers prefer low-sodium products and restaurant patrons asked to have salt reduced or eliminated in their dishes, we could see some positive changes over time.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Heart Health Month – An Important Reminder

February 8th, 2012 at 1:38 pm by timigustafson
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February is “Heart Health Month.” Health advocacy groups and organizations like the American Heart Association (AHA), the National Heart Lung and Blood Institute (NHLBI) and the Centers for Disease Control and Prevention (CDC) want to remind us that heart disease is the most common cause of death in America and deserves more of our attention.

Sadly, heart disease has become nothing short of a national crisis in this country. “Heart disease takes the lives of far too many people in this country,” said Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. “With more than two million heart attacks and strokes a year, and 800,000 deaths, just about all of us have been touched by someone who has had heart disease, a heart attack, or a stroke.”

Heart disease is also very expensive to treat. Cardiovascular disease and stroke hospitalizations have cost nearly $450 billion in health care expenses and lost productivity in 2010 alone.

“The sad truth is that these ailments are usually preventable, and in a perfect world I would be out of a job,” said Mehmet Oz, MD, a cardiothoracic surgeon and host of “The Dr. Oz Show.” “Unfortunately, I’m busier than ever,” he added.

Raising awareness is a crucial way to fight back against the spreading disease. In 2011, the HHS, in collaboration with the CDC and other government agencies as well as private organizations, has launched a program named “Million Hearts,” a nationwide initiative aimed at preventing one million heart attacks and strokes over the next five years. Among its many goals, the program wants to “empower Americans to make healthy choices,” such as avoiding tobacco use and reducing the amount of sodium and trans fat they eat, and to “improve care for people who need treatment” by encouraging them to take steps to better control their blood pressure, cholesterol levels and other major risk factors for cardiovascular disease and stroke.

“Million Hearts” is not the only awareness movement in the country. “Go Red for Women” is a nationwide program by AHA “to fight heart disease as the number one killer of women in America.” Observers can express their support by wearing red clothing or pins. “Choose to Move” is another AHA project dedicated to women’s heart health through physical exercise.

Sending the right messages is vitally important, especially for women, said Dr. Oz. “Many women and their health care providers believe that heart disease is less serious in women than in men. This is simply not true. Studies show that more women than men die within a year of having a first heart attack. Women are two to three times more likely than men to die following heart-bypass surgery, and more women than men die each year from congestive heart failure.

In fact, women may suffer from a completely different type of heart disease than men, according to Noel Bairey Merz, MD, director of the Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles, which is not yet fully understood and harder to detect, and therefore can often remain undiagnosed until it is too late.

The good news is that there are only a few causes of heart disease that are out of our control, such as genetic predisposition, family history and aging. The rest is a matter of choice. Even small lifestyle improvements can make a significant difference. Weight control, good nutrition, regular exercise and stress reduction are all part of that. Each one of these is fully achievable for everyone with enough commitment and willingness to make the necessary efforts. Raising awareness is a good start, but it doesn’t end there.

For more information on heart-healthy living, please go to the “Eating Smart for a Healthy Heart“  section of the “Food and Health with Timi Gustafson R.D.” blog.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

The Perfect Body

February 8th, 2012 at 1:22 pm by timigustafson
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Whether we admit it or not, we all are concerned about our physical appearance. Being attractive is an important issue for most people – and for many good reasons. Statistics show that having the right look has many advantages in society.

According to the Social Issues Research Center (SIRC), a non-profit institute specializing in global socio-cultural trends, attractive children are more popular with classmates and teachers and on average do better in school. Attractive applicants have better job opportunities and get promoted faster. One study found that in America taller men earned about $600 more per inch than their shorter peers. Attractive people are convicted of crimes less often or receive shorter prison sentences. The list goes on and on. So, it is not at all surprising that good looks play such a big role in our lives.

When you ask people what characteristics make someone attractive, most will say that a good-looking person is slender and fit. This applies to both sexes but in particular to women. Slimness and beauty are so much identified with one another that it seems almost natural to think this way. Historically speaking, it is not. In fact, today’s beauty ideals are relatively new.

Prior to the 20th century, attractive women were quite curvy. A classical Renaissance painting, titled “Three Graces” by Raffael (1505), reflects the beauty ideal of that time. By our standards, those ladies look rather overweight. The same goes for the so-called “Rubens figures,” named after the famous Dutch artist’s many paintings of nude, fleshy women.

Historians have pointed out that for our ancestors being well fed was a sign of wealth and status because only the well-off could afford an abundance of food, while the poor had little to eat and looked thin and haggard. Today, the situation is reversed: Weight problems mostly affect the lower class, while the upper crust spends millions on diets and fitness programs to stay slim and look youthful.

It is quite fascinating to see how the perception of attractiveness has changed over time. One common denominator, however, seems that beauty ideals were never attainable for most people because they were so unrealistic. Especially women have nearly always faced the impossible: Whether the fashion of the day called for a classical “hourglass” figure (equal size of hip and bust, narrow waist), an athletic look (muscular, tight pelvis, big bust) or “Barbie” type body (slim, big bust, tight pelvis, long legs), the vast majority of women was never able to measure up.

Today’s demands seem higher than ever. “Thanks to the media, we have become accustomed to extremely rigid and uniform standards of beauty,” says Kate Fox who writes for SIRC. “The current media ideal of thinness for women is achievable by less than 5 percent of the female population.” Because TV ads, billboards, magazines, etc. bombard us with images of beautiful people all the time, “they make exceptional good looks seem real, normal and attainable,” she says. But that’s an illusion and it makes people terribly insecure about their appearance.

And even attractive folks can be insecure about their looks and feel pressed to maintain or enhance what nature has given them. Studies have shown that beauty and self-esteem don’t always correlate.

Statistically, women tend to be more critical of their appearance than men. Most females don’t seem to be satisfied with what they see in the mirror, at least not without makeup. Men have a better self-image and even tend to over-estimate their attractiveness. Gay men are more concerned about how they look than straight men, but lesbians seem to be less worried than heterosexual women, according to the SIRC study.

What’s considered beautiful may differ from country to country and culture to culture, but increasingly there is a global trend to follow the Western standards. In one study that involved young women from around the world, almost all participants named celebrities from Hollywood as their role models for attractiveness. Being skinny, tall, with long hair and perfect teeth and elegantly dressed in Western-style clothing ranked highest on the list of beauty ideals. “The ideals of the ‘beauty culture’ in the industrialized world are rapidly spreading through the remotest areas, affecting the way of life and the sensibility of all, regardless of skin, religious beliefs, or cultural heritage,” says Julian Robinson, fashion designer and author of “The Quest for Human Beauty” (W. W. Norton & Co Inc., 1998).

The downside is that people who don’t live up to these standards (the vast majority) are judged – and often judge themselves – as a failure. For example, prejudices against overweight people can cause especially women to develop very low self-esteem, which can leave them socially isolated and emotionally depressed. These problems are not generated by the weight problems themselves but by the widely accepted association of beauty and thinness. Struggling with weight issues from a health perspective can be hard enough. Having a social stigma attached to it makes it much worse.

While we cannot ignore the cultural standards around us, we can decide for ourselves how we respond to them. The attraction to physical beauty will always be part of our socio-cultural landscape with implications on status, acceptance and suitability as a mate. But that doesn’t mean we have to surrender to it like an oppressive force that prevents us from accepting ourselves as we are in every shape or form.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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