Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

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.

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.

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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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