Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

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.

For Weight Loss, Cutting Back on Calories Matters Most

February 5th, 2012 at 3:22 pm by timigustafson
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People who swear by a particular diet to lose weight may be fooling themselves, according to a recent study by scientists at Pennington Biomedical Research Center in Baton Rouge, Louisiana. There is no real evidence that low-carb, low-fat or high-protein diets make as big a difference as overall calorie reduction when it comes to weight loss, according to Dr. George Bray who worked on the study.

“Earlier research had found that certain diets – in particular those with very little carbohydrate – work better than others. Diet books also often guide consumers to adopt a particular type of meal plan. But there hasn’t been a consensus among scientists,” Dr. Bray said in an interview with Reuters Health (1/30/2012).

For the study, several hundred overweight and obese people were assigned in equal groups to four different diets: (1) Average protein, low fat and higher carbs; (2) high protein, low fat and higher carbs; (3) average protein, high fat and lower carbs; (4) and high protein, high fat and lower carbs. All diet styles were designed to allow for an energy deficit of about 750 calories per day.

The participants were weighed after six months and again after two years. The researchers found that, although most lost weight and managed to keep at least a few pounds off for two years, “there were no differences in weight loss or fat reductions between the diets.”

The study, which was published in the American Journal of Clinical Nutrition, also determined that stick-to-itiveness was a crucial factor for the success of any of the diet regimens – but also one of the hardest to achieve. “The major predictor for weight loss was adherence,” said Dr. Bray. “Those participants who adhered better, lost more weight than those who did not.”

While these study results should not come as a major surprise, they are not necessarily welcome news for the diet- and weight loss industry. After all, Americans spend billions of dollars annually in a highly competitive market of weight loss programs and dieting ideas. Could the ultimate solution be as simple as eating less and burning off more calories for the rest of your life?

Not quite, according to Dr. Scott Olson, a practitioner of alternative medicine and author of “Runner’s Soul.” “Using calories as a way to measure what you should be eating can only take you so far,” he says. The reason is that you are not a calorimeter, you are a living being and not some laboratory tool. Something happens when you consume carbohydrates that is different from what happens when you eat protein or fats – regardless of calories.”

Dr. Olson sees focusing exclusively on calories regardless of their source as a misguided approach because it misses out on other important issues. “Calories don’t matter as much as blood sugar, especially when you are talking about weight loss. To lose weight, yes, you need to burn more calories than you are consuming, but you also have to keep your blood sugar from spiking too high and causing your body to store that extra energy as fat,” he said.

Dr. Bray and his fellow-researchers would agree that not all diets offer the same health benefits, even if they are comparatively effective in terms of weight loss. For that matter, Dr. Bray favors the DASH diet (Dietary Approaches to Stop Hypertension), which is endorsed by the National Institute of Health (NIH).

In my own practice as a dietitian and health counselor, I have always preached that calorie restriction for weight loss must go hand in hand with high quality nutrition. That may require cutting back on portion sizes but also loading up on important nutrients. In the end, I want my clients not just to be thinner but all around healthier. And that’s why I also want to know where their calories come from.

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.

Can’t Lose Weight? It Could Be Stress

February 2nd, 2012 at 11:39 am by timigustafson
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People who fail to lose weight, routinely name stress as one of the greatest obstacles they face when trying to diet and eat more healthily. As a health counselor, I’ve heard it a thousand times: When I’m stressed out, I almost automatically reach for food. I can’t resist, I just need something to help me cope.

Excessive snacking and overeating are common responses to stress. When feelings of anxiety and discomfort persist, food can offer much needed relief – especially the kind we call ‘comfort food.’ Scientists believe, however, that there is more to the stress-food connection than a simple inability to stay away from the munchies.

Stress itself is not necessarily the problem. In fact, experiencing stress is a natural response without which we would not have survived as a species for long. Stress is our body’s way to protect us from danger. In emergency situations, the release of stress hormones such as adrenaline and cortisol allow us to focus better, react faster and work harder than we normally would be able to. In extreme cases, stress hormones can enable us to react almost without thinking as if on autopilot, a process also known as “fight-or-flight” response, which can be a lifesaver.

But these mechanisms are only designed to deal effectively with short-term events. If the perception of danger continues unabatedly, our own natural defenses can eventually turn against us. Especially in situations where neither fight nor flight responses are possible, enduring continuously high levels of stress can cause serious damage to our physical and mental well-being in multiple ways. Over time, this can lead to a dangerous form of chronic stress, a condition so widespread and so severe, it has become one of the greatest health threats of our time.

“Stress can mean facing each day ravenously hungry, adding weight gain to [people’s] list of worries,” says Dr. Elissa Epel, a professor of the Department of Psychiatry at the University of California, San Francisco. “While the immediate response to acute stress can be a temporary loss of appetite, […] for some people, chronic stress can be tied to an increase in appetite and stress-induced weight gain. The problem,” she says, “lies within our neuroendocrine system, a brain-to-body connection that harkens to evolutionary times and which helped our distant ancestors to survive. This system still activates a series of hormones whenever we feel threatened.”

For instance, the stress hormone, cortisol, is responsible for replenishing the body with nutrients even after the stress-inducing causes have passed. As cortisol levels rise, our appetite for food increases. While the hormone itself does not make fat, chronically elevated cortisol levels can have a variety of negative health effects, including a decrease in insulin sensitivity, growing insulin resistance, reduced kidney function, hypertension and weakening of the immune system.

“The fuel our muscles need during fight or flight is sugar – one reason we crave carbohydrates when we are stressed,” says Dr. Riccardo Perfetti, an endocrinologist and director of the outpatient diabetes program at Cedars Sinai Medical Center in Los Angeles. “To move the sugar from our blood to our muscles requires insulin, the hormone that opens the gates to the cells and lets the sugar in. And high levels of sugar and insulin set the stage for the body to store fat,” he explains.

To better control these negative effects from stress responses, experts recommend regular exercise, not only to burn calories but also to enhance the body’s production of biochemicals that can counterbalance the concentration of stress hormones.

In times of heightened stress, the worst thing people can do is “sit and stew in frustration and anger without expending any of the calories or food stores that would be used in a physical fight out of stress or danger,” says Dr. Shawn Talbott, professor in the Department of Nutrition at the University of Utah and author of “The Cortisol Connection.”

The best de-stressors are eating a balanced diet, getting sufficient amounts of sleep, taking breaks for relaxation and rejuvenation, avoiding stimulants like caffeine, tobacco and alcohol, and spending time with supportive family members and friends.

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.

School Lunches Will Improve, But More Work Needs to Be Done

January 30th, 2012 at 2:33 pm by timigustafson
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School children will find more fruits, vegetables and whole-grain products on their lunch plates under the new nutritional guidelines for the National School Lunch Program issued by the U.S. Department of Agriculture (USDA). The guidelines also seek to reduce or eliminate high contents of sodium, saturated fat and trans fats. For the first time, food and beverages sold in vending machines on campus will have to meet certain nutritional standards as well.

The newly adopted nutrition standards are largely based on recommendations by the Institute of Medicine (IOM) of the National Academies and are designed to help in the fight against childhood obesity, which is now affecting 17 percent of children living in the U.S.

Under the revised rules, all meals served in school cafeterias will have upper and lower limits of calories, which vary with each age group. Kindergarteners to fifth-graders will receive 550 to 650 calories per meal, 6th to 8th graders about 700 calories, and 12th graders up to 850 calories.

The extra costs for better nutritional quality come to about $6.8 billion over the next five years, according to government estimates. “Schools are definitely going to be challenged by the additional costs of meeting the new rules,” says Dianne Pratt-Heaver, a spokesperson for the School Nutrition Association (SNA), a non-profit organization that represents school cafeteria vendors and operators. The government will pay schools six cents per meal on top of the current rate, which is not nearly enough to cover expenses, according to the SNA. The school lunch program provides daily meals to about 32 million students, often for free or at a reduced price.

Regardless, Ms. Pratt-Heaver says, her organization approves of the new policies. The Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) has also signaled its support. “Given the realities of federal, state and local budgets, the Academy of Nutrition and Dietetics is committed to leading the creative collaborations that will be needed to implement changes in the school food program,” said Sylvia A. Escott-Stump, a Registered Dietitian and President of the Academy in an official statement by the organization.

The new regulations mark the first overhaul of the school lunch program since the 1990s and will gradually be phased in over the next three year. It was not an easy task, considering the oftentimes vehement opposition from food manufacturers, which culminated in last year’s controversy over whether pizza (or rather the tomato paste topping) should qualify as a vegetable serving. So far, it does, at least legally.

Also somewhat unresolved remains a dispute over the nutritional benefits of potatoes. The National Potato Council (NPC) has voiced strong objections to any attempts to limit servings of potatoes in school lunches, including French fries. “We still feel like the potato is downplayed in favor of other vegetables in the new guidelines,” said Mark Szymanski, a spokesperson for the NPC. “It seems the department still considers the potato a second-class vegetable.”

There is some reason for that. According to a study by the Harvard School of Public Health, which followed over 120,000 people for up to 20 years to find out what kinds of food affected their weight, potatoes were found to rank among the greatest weight boosters.

There is a very strong hypothesis that potatoes in particular lead to weight gain, says Professor Walter Willett, an Epidemiologist at Harvard and lead author of the study report. The reason is that potatoes are consumed fully cooked and rapidly broken down into sugar. Sugar is quickly absorbed into the bloodstream and eliminated by insulin, which leaves us hungry again after just a few hours. Particularly problematic, Dr. Willett says, are potatoes made into French fries and potato chips, “because they’re designed to make us overeat.”

Fried potatoes are also much higher in calorie and fat content than the steamed or baked varieties because of the oil used in the process. While one baked medium-size potato carries about 110 calories and virtually no fat, a medium-size serving of French fries has about 380 calories and 19 grams of fat.

Calories and fat, of course, are not the only issues. High levels of sodium are of equally great concern. While a medium-size potato contains about 10 mg of sodium (without added salt), a medium-size order of French fries comes with a whopping 270 mg.

Worries about sodium content have also fueled the debate over tomato paste on pizza. While tomatoes in their natural form are almost sodium-free, processed tomatoes like tomato paste, canned tomato sauce and ketchup can have over 1000 mg of sodium per serving (100g). High levels of sodium are known to cause a number of negative health effects, including heart disease and high blood pressure.

As a dietitian and grandmother of kindergarteners and gradeschoolers, I obviously support the changes the new guidelines are trying to achieve. However, much work remains to be done before all school children can receive the quality nutrition they need to grow up healthy and succeed at learning.

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.

Unrealistic Expectations Can Sabotage Weight Loss Goals

January 25th, 2012 at 7:32 am by timigustafson
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Resolution season is in full swing or perhaps already winding down. If you have given up by now on this year’s weight loss efforts and old habits start creeping back in – you’re not alone. About 90 percent of all the promises we make to ourselves are quickly forgotten, according to Tom Connellan, author of the “1 Percent Solution – How to Make Your Next 30 Days the Best Ever.”

“Some people’s New Year’s resolutions are so broad that they’re often unattainable,” says Leslie Fink, a Registered Dietitian and contributing writer for Weight Watchers. “When expectations are set too high, it doesn’t take much to throw a person off.” Instead of aiming for a perfect score, she advises, people should be content with 80 percent of their initial objectives. That by itself would qualify as a great success.

How we manage our aspirations in pursuit of our goals is critical either way. In fact, there are physiological reasons why we feel gratified or disappointed when we succeed or fall short of our expectations. A release of a neurotransmitter, called dopamine, is triggered in our brain when our intentions are fulfilled, causing a pleasant sensation of satisfaction and well-being, according to Dr. David Rock, Director of the NeuroLeadership Institute and author of “Your Brain at Work.”

Unfortunately, this mechanism works also in the other direction, and even more so: “When our expectations are not met, […] our negative feelings are much stronger than the good feelings we get when expectations are exceeded,” says Dr. Rock. “When we don’t hit our expectations, our brain doesn’t just get slightly unhappy, it sends out a message of danger and threat.”

In other words, as humans we generally tend to be optimistic (and oftentimes overoptimistic) about our prospects but are more afflicted when they end up in failure. The trick is not to get stuck in the negative emotions, even if they initially dominate.

Being able to build on the successes you already had is crucial for staying motivated. Take your cues from what worked and what didn’t and find out what made the difference. Then, if you fail or are about to fail, put a plan into action you may call “resolution revival,” suggests Dawn Jackson Blatner, a Registered Dietitian at Northwestern Memorial Wellness Institute. “Evaluate where you’ve been and where you want to go,” she says, “and make sure your initial goal was realistic.”

If you expected too much of yourself, “chop up your resolution into little pieces,” as Blatner puts it. Small steps are much more manageable and they eventually add up to greater achievements. If you are continuously able to meet your (somewhat scaled back) expectations, you will gain more confidence over time and can set the bar higher as you go.

Being realistic about your abilities and limitations also includes to learn from your past mistakes. Don’t make the same resolutions year after year, says Blatner. Rather, ask yourself what you can do differently from hereon in. Also, keep your eye on the larger picture: You are not trying to perform a quick fix (at least, you shouldn’t) but to make lasting lifestyle changes.

Last but not least, do not expect that losing weight, getting back in shape and looking more attractive is going to solve every other issue you may be dealing with in your life. Being thinner does not necessarily turn you into the person you idealize in your fantasies. Don’t listen to all the “testimonials” from people on TV claiming their entire lives have been turned around after they lost weight.

“People expect a lot from weight loss, things that weight loss alone can’t deliver,” warns Dr. Lee Kern, Clinical Director of Structure House, a residential weight management facility in Durham, North Carolina. “And then they learn the hard way that success and happiness aren’t linked to a number on a scale,” he says.

Identifying your real goals and pursuing them in realistic ways will make it much more likely for you to stay on track. If your motives are misguided, the messages you give your body will be equally confusing.

“The first thing I always ask people is why is this the right time for you to lose weight,” says Dr. Madelyn Fernstrom, Professor of Psychiatry and Epidemiology at the University of Pittsburgh School of Medicine and author of “The Real You Diet.” If they say they’re happy with their lives but have hypertension – great. If they’re losing weight just to be happier, then we’ve got to talk. Happiness isn’t a size 2.”

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.

One Out of Five Americans Found to Be Mentally Ill

January 25th, 2012 at 7:28 am by timigustafson
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Nearly 50 million Americans suffered from one or another form of mental illness in 2010, according to a report by the Substance Abuse and Mental Health Service Administration (SAMHSA), a federal government agency founded in 1992 to survey and reduce the impact of substance abuse and mental illness on communities throughout the country.

The survey found that young adults and especially young women were susceptible to mental illness to a degree that it substantially interfered with their lives. SAMHSA defines mental illness as “diagnosable mental, behavioral or emotional disorders.”

For the study, SAMHSA surveyed over 67,500 participants aged 12 and older in all parts of the United States. The results showed that almost 2 million teenagers experienced at least one bout of depression, which is defined as a period lasting at least two weeks. Nearly 9 million adult Americans had serious thoughts of suicide, with 2.5 million making suicide plans and 1.1 million making an actual attempt.

The study results came as a surprise, according to Peter Delany, Director of SAMHSA’s Office of Applied Studies. “We all know people who have had a depression or anxiety disorder,” he said, “but this is a pretty big number.” He said he was somewhat reluctant to speculate on the reasons for these developments, which are not easy to pinpoint. “The recent economic downturn may be a factor for some, but these conditions are multifactorial – there are biological issues, there are social issues and also personal issues.”

Delany thinks that many people who are struggling don’t seek treatment because of the stigma that is often attached to mental illness. Many also lack insurance coverage to pay for their care. According to SAMHSA, less than 40 percent of those with a mental illness receive health services. That’s extremely unfortunate, said Delany. “We know with the appropriate use of medication and with good treatment people can recover and go on to lead very healthy and productive lives,” he said.

Other experts agree. “Mental illness is a treatable problem,” according to Dr. Ihsan Salloum, Director of the Addiction Psychiatry and Psychiatric Comorbidity Programs at the University of Miami School of Medicine. “[But] there is a gap between the need and how many people reach treatment,” he added.

SAMHSA also investigated connections between mental illness and substance abuse such as use of cocaine, hallucinogens, inhalants and heroin. In its report, the agency concluded that people who abused drugs or alcohol showed substantially higher rates of mental illness than those who did not – 20 percent versus 6 percent. Teenagers who suffered from extended periods of depression were twice as likely to develop drug problems than their peers who did not have such experiences.

As alarming as the SAMHSA report sounds, it is also somewhat vague because it compiles a number of different issues that may be connected but are by no means identical. For instance, thoughts of suicide may not always be symptoms of mental illness but can result from deep despair. Hopelessness is not necessarily a mental dysfunction but can be a conceivable reaction in the face of extraordinarily dire situations. Alcohol and drug abuse are far too widespread among the general population to label them as symptoms of actual mental illness. People use them for recreational purposes and often, of course, to numb themselves in times of heightened stress and anxiety.

Still, the report should give us pause and have us ask how dysfunctional our lives must have become to cause so much suffering especially among the young who are supposed to look to the future with optimism and confidence. Hardly a promising picture for all of us.

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.

Fighting Childhood Obesity in a Complex Environment

January 22nd, 2012 at 4:52 pm by timigustafson
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With one in three children in the United States struggling with weight problems, the fight against childhood obesity is becoming ever more desperate. Some of the new health care provisions that are going into effect this year include insurance coverage for screening, counseling and other preventive care measures for obese children.

While the need for more programs for preventing and treating childhood obesity is obvious, experts say that creating them poses considerable challenges. “Few proven models exist for helping children and adolescents to achieve and maintain a healthier weight, and researchers do not even fully understand the factors that contributed to the rapid rise in childhood obesity in recent years,” writes Reed Abelson in an article for the New York Times, titled “Learning to be Lean” (1/17/2012).

Insurance companies are developing new policies to determine treatment coverage of childhood obesity. One insurer, Wellpoint, is working with pediatricians by offering training in obesity treatment and connecting them with dietitians. And Weight Watchers has announced an upcoming program specifically designed to meet the needs of overweight children and teenagers.
Experts agree that for the fight against childhood obesity to be successful, the focus must be on the greater environment today’s children live in, including families, the media, schools and communities.

The home is the place where children first learn and develop their eating and lifestyle habits. Parents decide what kind of food is being brought into the house, how it is prepared and how much is served at the dinner table. Parents influence through their own behavior what lifestyles their kids adopt, how physically active they are, how much time they spend watching TV, and how much sleep they get.

For these reasons and others, diet- and lifestyle counseling and education should first be directed towards the parents, according to Dr. Adam P. Knowlden and Dr. Manoj Sharma, both pediatricians at the University of Cincinnati and co-authors of a systematic review of clinical studies of pediatric obesity. Unfortunately, the need for educating parents of overweight children is often difficult to meet. Even those who seek counseling (and by far too few do) don’t always have access to the right resources.

Parents are oftentimes defenseless against outside influences, especially the daily onslaught of advertising by food companies that spend billions on TV ads and product placements geared towards children, according to Dr. Victor Strasburger, a professor of pediatrics at the University of New Mexico School of Medicine and lead author of a study report by the American Academy of Pediatrics (AAP), titled “Children, Adolescents and Advertising.”

“It’s not that easy when you are up against Ronald McDonald,” says Dr. Strasburger, referring to McDonald’s iconic clown character that is popular with many kids. “In fact, it is inherently unfair and deceptive to advertise to children who are too young and too impressionable to distinguish between advertising and factual reporting,” he says.

On average, children watch up to 10,000 food and snack commercials every year, according to the AAP. The best thing parents can hope for is limiting the time their kids are exposed to television and other advertising outlets, which, of course, is easier said than done.

In response to the AAP report, the Federal Trade Commission (FTC) has asked food manufacturers to regulate their marketing efforts to children but has stopped short of asking for any binding policies. Critics say that calling for voluntary self-regulation by the industry is not sufficient to change the existing advertising practices.

Despite of the government’s more recent efforts to improve the National School Lunch Program with “The Healthy, Hunger-Free Kids Act of 2010,” many schools across the country still don’t have the necessary resources for facilities and personnel to meet the nutritional needs of their students. Due to the downturn of the economy in years past, millions of children depend on the free or subsidized meals they receive at their schools, which in many cases is the only food source available to them. School officials say the increase of federal reimbursement for school lunches by 6 cents per meal does not nearly cover the costs for the growing demand.

So, vending machines filled with sodas and snack foods will not disappear from campuses as long as schools depend on corporate funding for many of their programs and services. And physical Education (PE) is still not available in all schools because of budget limits. The bottom line is that too many schools continue to fail doing their part in the fight against childhood obesity.

When Michelle Obama started the “Let’s Move” initiative, she put much emphasis on the role of communities. In general, the response was strong and countless grassroots movements have been brought to life all over the country ever since. What is sorely lacking, however, are important changes in our infrastructure. Due to budget crunches, more public parks and playgrounds are being closed than opened. Many cities don’t have bike paths or safe areas to run. Low-income neighborhoods are often too dangerous to let kids play outside or even walk to and from school. In a nutshell: Too many communal environments are not designed to allow kids to be physically active and stay healthy and fit.

Of course, there are many more factors to be considered if we are to deal with the childhood obesity crisis effectively. But these are some of the central issues in this complex task. Education of the public, regulation of industry, funding of school lunch programs and other health services for the young as well as building community support systems and infrastructure are all crucial elements in this fight. Addressing all of them in a comprehensive manner might get us somewhere, hopefully sooner rather than later.

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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