Timi Gustafson, R.D.

Helping people to live healthy and fulfilling lives.

Include Mindfulness in Your Meals

December 28th, 2013 at 4:24 pm by timigustafson
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If you have any interest at all in healthy eating, you probably have come across Brian Wansink’s book, “Mindless Eating – Why We Eat More Than We Think.” In a nutshell, the author, a professor of marketing and nutritional science at Cornell University, wants us to pay more attention to our eating habits, something that may be easier said than done. But if mindless eating is such a central component of the ongoing obesity epidemic, as the professor suggests, what would its opposite – mindful eating – entail?

There has been increasing interest in the subject in recent years, and a growing movement that connects eating with meditation and other calming exercises has emerged. Even Google now offers mindful eating lunches on its headquarter campus in Mountain View, California.

“Mindful eating is not a diet. There are no menus or recipes. It is being more aware of your eating habits, the sensations you experience when you eat, and the thoughts and emotions that you have about food. It is more about how you eat than what you eat,” says Dr. Susan Albers, a psychologist at the Cleveland Clinic and author of five books on the practice of mindful eating.

Our hectic lives usually don’t leave us much time for paying attention to the foods we consume. And when it comes to food preparation, efficiency and convenience trump almost all other aspects. So we never really become aware of the taste, smell and mouth feel of our edibles, let alone cultivate positive emotions like comfort and gratitude we could derive from eating.

Instead, Dr. Albers says, we regularly overeat, graze all day, skip meals, or do a thousand other things while munching on something or other that has little meaning for us. That kind of mindless relationship to food then can easily lead to overeating and unwanted weight gain or worse.

“The fundamental reason for our imbalance with food and eating is that we’ve forgotten how to be present as we eat,” says Dr. Jan Chozen Bays, a pediatrician and Zen teacher in Clatskanie, Oregon, who has written a guidebook on mindful eating. “Mindful eating helps us learn to hear what our body is telling us about hunger and satisfaction,” he says.

As we pay more attention to our food, we begin to better understand our need for being nurtured, not just for the benefit of the body but the mind as well. We notice how eating affects our moods and how our emotions such as joy, anxiety, or boredom influence our eating habits.

Especially the holidays are a time when we should pay more attention to our eating behavior. When we get stressed out over all the shopping and preparations ahead of us, and festive meals and treats are offered everywhere, we would be well-advised to stop once in a while and take time to relax and reflect a bit. That’s when mindful eating can play an important role, says Dr. Lilian Cheung, a lecturer on nutrition at Harvard School of Public Health who co-wrote a book on the subject with Buddhist Zen master Thich Nhat Hanh, titled “Savor: Mindful Eating, Mindful Life.” “We need to be coming back to ourselves and say: Does my body need this? Why am I eating this? Is this just because I’m so sad or stressed out?”

Thankfully, engaging in mindful eating does not require lots of practice or training. You can begin at any time and without further ado. Just settle down and become quiet for a moment. Focus on something edible in front of you. It can be a three-course meal or a single raisin. Make yourself aware of aromas, tastes and textures, and also your responses, both physical and emotional. Eat in silence. Eat slowly. Chew with your eyes closed. Try not to let your mind drift elsewhere. If it does, bring yourself gently back to the present experience without judging.

It also helps to create an environment that is comfortable and keeps you safe from interruptions. Make sure your phone is off and you cannot be disturbed. You may like sharing the experience with others, or you may prefer to be alone.

In any case, you will be making progress simply by finding yourself slowing down and becoming better aware of your actions. Your body will take care of everything else.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Researchers from Harvard University found that eating healthily costs more than sticking to junk food. While this shouldn’t come as a great surprise, it is the first time anyone has tried to put an exact price tag on what it takes to follow nutritional recommendations.

On average, a person who wants to maintain a diet rich in fruits, vegetables, whole grains, and lean protein sources must cough up an extra $1.50 per day, or about $550 a year, based on a daily intake of 2,000 calories, as recommended for adults by the Dietary Guidelines for Americans.

“People often say that healthier foods are more expensive, and that such costs strongly limit better diet habits. But until now, the scientific evidence for this idea has not been systematically evaluated, nor have the actual differences in cost been characterized,” said Mayuree Rao, a junior research fellow in the Department of Epidemiology at Harvard School of Public Health and lead author of the study report.

Less than two dollars a day difference doesn’t sound too prohibitive, but even these small amounts add up over time, and low-income families may be hard pressed to make consistently costlier, albeit healthier, choices.

According to the U.S. Department of Agriculture (USDA), most Americans adhere to diets that do not meet its proposed standards. Whether food costs are a decisive factor is not always evident in the view of the agency, noting that some highly processed foods are not necessarily cheaper than many fresh varieties but may be preferred by consumers because of greater convenience.

Also, food prices can vary considerably depending on location and season, making it difficult to set clear measuring standards. And it is not always apparent which foods are truly healthy and which are not. For instance, are items like apples acceptable, which are certainly nutritious but may contain traces of pesticides? Or should they be eaten only when organically-grown, making them much more expensive?

Geographic variations also play a significant role, not only in terms of the neighborhoods people live in but also in which part of the country they are. Larger cities may be better served but tend to be more pricey, while rural areas typically require longer driving distances to outlets, adding expenditures for gas or public transportation.

The government’s Dietary Guidelines would benefit from a reality check, says Dr. Adam Drewnowski, director of the Center for Public Health Nutrition at the University of Washington in Seattle and co-author of a study on the effects of food prices on consumers’ behavior. He warns that dietary guidance often overlooks the issue of affordability when making recommendations about food choices.

“Unrealistic advice is useless. People eat the foods they can afford,” he said to Food Navigator USA. “Given current food preferences and eating habits, more nutrient-rich diets do cost more,” he added.

Of course, for those who are able and willing to spend more money at the grocery store, higher quality foods have many advantages. Eating healthily makes it easier to control weight and avoid diet-related illnesses like diabetes, heart disease, and hypertension, all of which affect millions of Americans. Reducing some of these afflictions would make a huge difference in healthcare spending and people’s quality of life.

Poor eating habits of individuals, however, are not the only cause of our current health crisis. Our food policies that give subsidies to producers of commodities like corn, soy and sugar, but nothing to fresh produce farmers, will only perpetuate the existing unbalance between food prices, very much to the detriment of consumers who would love to eat better.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Fighting the Cold Season More Effectively

December 14th, 2013 at 3:24 pm by timigustafson
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You’ve had your flu shot, you wash your hands more often, you avoid crowded areas, and still there is no guarantee that you will escape the common cold or worse this year or any other. One reason why there is no ironclad protection against the cold is that over 200 different viruses can cause cold symptoms, according to the National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institute of Health (NIH). Most of these are relatively harmless in terms of lasting health effects, but some can lead to serious respiratory infections, especially among the elderly and the very young. Complications include bronchitis, pneumonia, sinusitis, and ear infections.

Over one billion colds are counted in the United States every year, meaning that most Americans get hit more than once throughout the season. Children are particularly prone to spreading cold viruses in schools, playgrounds and homes. But office spaces, shopping malls, restaurants, and public transportation means can be equally as hazardous.

Most common are the so-called Rhinoviruses (from the Greek word rhin, meaning “nose”), which are responsible for up to half of all colds. Over 100 different types of this strand have been identified so far, and more seem to emerge every year. Researchers believe that between 20 and 30 percent of all causes of colds remain unidentified.

The reason why there is such a thing as a cold season is not necessarily a drop in temperatures but rather human behavior. When the weather turns nasty outside, people tend to spend more time indoors and in closer proximity to one another, which gives the viruses a better chance to spread from person to person. Breathing dry, cold air may also play a role since this dries out the inside lining of the nose, making it more vulnerable to viral infections. Paradoxically, fewer people who stay physically active outdoors in the wintery weather seem to get sick than their hibernating counterparts, perhaps because exercising helps strengthen their immune system.

Boosting your natural defenses may be the most effective way to fend off cold threats. Eating lots of nutrient-dense foods such as fruits, vegetables, whole grains, and lean protein sources will help, as will managing stress, getting enough rest, and abstaining from smoking and alcohol/drug abuse.

If it’s already too late and you’ve come down with a cold, it is important to get you back on your feet as quickly as possible. For this, you should stay in bed and drink lots of fluids, not only to keep hydrated but also to thin mucus and ease congestion.

Warm liquids can soothe a sore throat and help you get some sleep. Fruit juices may sound right because of their vitamin C content, but be careful not to put too much sugar into your system because excessively high sugar levels can hinder white blood cells from fighting infections. Soups and stews are also a good provider of fluids. When made from scratch, a vegetable soup is a nutritional powerhouse, and it goes down more easily than solid foods.

If you take cold medications, make sure you follow instructions and don’t overdose in an attempt to speed things up. Don’t drive or operate machinery while under the influence, and don’t mix with alcohol.

Besides following these recommendations, getting enough rest and letting your body do its job is the most important measure you can take. Patience is a necessary part of the healing process and should not be overlooked.

Best of luck for this year’s season.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Obesity and Health Don’t Go Together, Study Finds

December 7th, 2013 at 3:32 pm by timigustafson
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For quite a while some experts believed that a little extra body fat would not necessarily trigger health problems like metabolic syndrome, a cluster of diseases that often accompanies weight gain. There was even talk of an “obesity paradox,” meaning that some people could derive certain benefits from being obese. But all that may just be fantasy, according to a recent study from Canada.

“Obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight,” wrote Dr. Caroline K. Kramer of Mount Sinai Hospital’s Lunenfeld-Tanenbaum Research Institute in Toronto and lead author of the study report.

Whether being overweight is immediately harmful depends on a number of factors, including a person’s genes, activity level, hormonal functions, and the source of calories, said Dr. David L. Katz, founder and director of the Yale University Prevention Research Center, to HealthDay. Fat accumulation, especially when it affects inner organs like the liver, can do serious damage even at low levels, he warned.

The notion that fat and fit are not necessarily exclusive of one another stems in part from studies that found overweight but physically active people to be healthier than normal-weight folks who never exercised.

Also, judging someone’s health status based on body-mass index (BMI) alone has been widely criticized as an inaccurate measure in terms of overall health. Instead, most healthcare providers now prefer waist circumference as an indicator for weight-related health issues.

According to guidelines published by the National Institutes of Health (NIH), overweight people can be considered healthy if their waist size does not exceed 40 inches for men, or 35 inches for women, and if they don’t have high blood pressure, high blood sugar, or high cholesterol.

However, when it comes to obesity (BMI of 30 and above), almost all studies agree that even being relatively fit cannot offset the health risks.

The issue is not so much the extra weight itself but what is called “metabolic health.” For any person – obese, overweight, or normal-weight – to be metabolically healthy, his or her blood pressure must be less than 130/85 mmHg, triglycerides under 150 mg/dL, fasting blood sugar equal to or lower than 100 mg/dL, and HDL (“good”) cholesterol above 40 mg/dL in men and 50 mg/dL in women.

But what about the so-called “obesity paradox,” a finding that overweight and moderately obese patients who suffer from chronic conditions like diabetes or heart disease sometimes outlive their normal-weight counterparts with the same disease? There may be a number of explanations for this, including genetic differences and access to treatment options. Either way, the fact remains that both weight management and fitness are important factors for good health, as is dietary quality.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Healthy Aging: To Stay Physically Active, Better Start Early

December 4th, 2013 at 1:32 pm by timigustafson
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Unlike their predecessors, baby boomers will remain as physically and mentally active as ever, even as they retire from their day jobs. 60 and 70-year-olds will continue to push boundaries, explore and experiment, travel the world, play sports, and stay healthy and fit far longer than what has been considered possible only a generation or two ago – or so we are told by an onslaught of literature, advertisements and workshops for active retirement, declaring the twilight years as the best of all times.

The truth is that many retirees find it hard to stay active at all after having lived sedentary lifestyles for most of their lives.

How active people will continue to be largely depends on the kind of jobs they are retiring from, according to Dr. Stephen Kritchevsky, a professor of gerontology and geriatric medicine and director of the Sticht Center of Aging at Wake Forest Medical Center in Winston-Salem, North Carolina.

For most people, retirement is a very important change in life, which can bring about new opportunities but also pitfalls. Retirees have more time on their hands to take care of their health needs, which can yield important dividends long-term, he said to Reuters Health. But it’s not a given that everyone will begin a healthy exercise regimen if he or she has not done so before.

study from England examined differences in physical activity habits between working and retired participants and found that most of those who lead a sedentary life continued to do so after retiring, and that those who were more active in their younger years usually kept to their routines after they stopped working.

Although it seems that sedentary working conditions and lifestyles prime many people for lack of movement as they grow older, the slower pace of retirement can also be a “critical window” for encouraging older adults to become more active, according to Dr. Alan Godfrey, a researcher at the Institute for Ageing and Health at Newcastle University and lead author of the study report.

One of the most important things retiring people must do is to plan carefully how they intend to fill their days. Pursuing old dreams, developing new interests, taking up new sports and other activities may sound wonderful, but some of those projects may be unrealistic for a number of reasons, including physical limitations and other health concerns.

Naturally, the healthier and fitter you are by the time you get to your golden years, the more you will be able to accomplish. But acting age-appropriately should also be a consideration, no matter how well you have (or think you have) been able to preserve your vigor.

But regardless of personal history, physical exercise is a crucial component of healthy aging. Whether you just want to feel better and have more energy, or whether longevity is your goal, age-appropriate exercise can be beneficial on multiple levels. It helps you control your weight, strengthens your immune system, enhances mobility, promotes better sleep, keeps your sex life going, and may even protect you against age-related memory loss and dementia. But the earlier you start a regular program and stick with it, the better your chances will be that it will do you a lot of good.

If you liked this article, you may also enjoy reading “Adjusting Diet and Exercise to a Slowing Metabolism” and “Healthy Aging: Exercising the Body Benefits the Mind, Too.”

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Walking, a Simple Yet Highly Effective Health Measure

November 30th, 2013 at 5:33 pm by timigustafson
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At a time when extreme sports are all the hype, mundane activities like walking don’t get much attention. It’s just too basic, too boring to even think about it. Yet walking can be a great indicator of both physical and mental wellbeing. In addition, walking is considered by health experts as one of the most effective ways to stay fit and fend off illnesses like high blood pressure, heart disease, and even dementia.

A recent study from England found that taking a long walk every day can help decrease the risk of stroke, especially in older men. It doesn’t seem to matter as much how fast someone walks, just how often and for how long.

“Our study suggests that maintaining an active lifestyle, specifically by spending more time on all forms of walking, could be an important part of stroke prevention strategies in older people,” said Dr. Barbara J. Jefferis, a epidemiologist from University College London and lead author of the study, in an interview with Reuters.

According to her findings, men who walked four to seven hours each week were 11 percent less likely to suffer a stroke than those who walked three hours or less. Participants in the study who walked the most – more than three hours daily – had a 60 percent lower risk than those who spent the least amount of time walking.

Although this particular study included only men, there is no reason to assume that walking wouldn’t benefit women in similar ways.

Walking seems to provide other advantages as well. A number of studies have found that losing the ability to walk at a reasonably brisk pace can be an indication not just for physical but also mental decline. Researchers at the Mayo Clinic looked at stride length, cadence and velocity of older adults and concluded that gait changes and slowing pace can be early signs of Alzheimer’s disease and other forms of age-related dementia. Some of these effects may be delayed, if not prevented, in people who maintain a regular walking regimen.

Of course, there is no need to wait until old age to take up walking as a form of exercise. At any time in life, going on hikes or just strolls around the block can help with overall fitness, weight management, bone and muscle strength, balance and flexibility, and also stress management, sleep, and emotional wellbeing.

Unfortunately, according to the Centers for Disease Control and Prevention (CDC), Americans are notoriously averse to walking and prefer driving even for short distances. This is especially true in rural areas and cities that lack a walkable infrastructure. Nevertheless, in its recommendations for greater public health, the agency urges everyone to get a minimum of two and a half hours moderate exercise per week. It may take some creativity and rethinking of lifestyle, but the sooner you start, the better the results will be, now and long-term.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Don’t Go All Nuts Just Yet

November 27th, 2013 at 5:31 pm by timigustafson
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Once in a while there’s some good news for people who want to eat right and keep their weight in check but are also tired of hearing about all the foods they can or should no longer enjoy because of health concerns. What’s the good news? Nuts! Consuming all sorts of nuts, including peanuts, which are actually legumes, is good for you, according to a study that was recently published in the New England Journal of Medicine.

For the study, scientists analyzed data from two big research projects, namely the Nurses’ Health Study, with120,000 participants, and the Health Professionals Follow-Up Study, involving more than 50,000. Both have been started decades ago and are still ongoing.

What the scientists found was that participants who ate nuts several times a week tended to be healthier, thinner and longer living. They were less likely to develop diabetes, high blood pressure, heart disease, and certain forms of cancer. Even if taking into account other factors like diet and exercise, the nut-eaters seemed better off in almost every category.

It also didn’t seem to matter what kind of nuts people preferred. The benefits apparently spanned across all varieties. The most decisive factor was the frequency of nut consumption.

For full disclosure, it deserves to be mentioned that the study was sponsored in part by the International Tree Nut Council, a trade group that represents nut growers, but no undue influence was exerted, the scientists involved assured.

Somewhat counterintuitive is the notion that eating nuts could help with weight control. While nuts have many important nutrients and other biological benefits like anti-inflammatory effects, they are also rather caloric and contain substantial amounts of fat.

It’s not altogether clear yet what makes nuts so beneficial, said Dr. Charles Fuchs of the Dana-Farber Cancer Institute in Boston, one of the study leaders. The scientists are still trying to understand the bioactive compounds in nuts.

That is also the position of Dr. David L. Katz, the founding director of the Prevention Research Center at Yale University who was not involved in the study. He cautioned that the study, which is only observational, meaning it cannot prove cause and effect, provides no proof that the consumption of nuts will keep people healthier or let them live longer. Still, he says, the findings are “healthy food for thought.”

“One potentially important reason why nuts reduce disease and death risk is what they add to the diet, another is what they remove from the diet. People who eat more nuts are likely eating them instead of other foods, perhaps snack foods apt to be far less nutritious,” he said to ABC News.

As for the downside of nuts, it is common knowledge that many varieties carry a substantial fat content. Granted that it is the heart-healthy mono- and polyunsaturated kinds, they still can add to your waistline if you don’t restrict portion sizes. Nuts range from 160 to 200 calories per ounce, depending on the variety of your choosing. Also, like most snack foods, nuts invite “mindless eating,” meaning they tend to disappear in your mouth without you noticing. So, overeating is a clear and present danger.

To avoid these pitfalls, I recommend that you take the exact amount you wish to eat out of the bag, jar or can and put it on a plate in front of you. This way, you can focus on your movie or whatever else you do while munching away – and you won’t exceed your limit.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

No Such Thing as a “Natural Diet” for Humans, Scientists Say

November 23rd, 2013 at 4:36 pm by timigustafson
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Diet plans like to make all sorts of claims in terms of their effectiveness for weight loss and better health. Most emphasize certain food groups while eliminating others. Almost all assert their guidelines work best because they reflect how we should eat.

One of the regimens that has been growing in popularity in recent years is called the paleo diet, a.k.a. the caveman-, stone age-, or warrior diet. Its premise is that we ought to return to the eating styles of our ancestors from way back – because it’s more in keeping with our genetic makeup.

The underlying theory is that civilization has corrupted our food supply through unsound food production and manipulation, which has lead to the onslaught of diet-related illnesses like obesity, diabetes and heart disease we are facing today. The only way out of this misery, proponents say, is to mimic the eating behavior that once ensured the survival of our species for many thousand years.

For humans, ancient or modern, the paleo diet is the optimum diet, says Dr. Loren Cordain, a professor in the health department of Colorado State University and author of “The Paleo Diet,” who calls himself the “world’s foremost authority on the evolutionary basis of diet and disease.”

Genetically we have not been able to adapt to our modern food choices, i.e. the so-called Western diet, which is largely based on processed foods and laden with fat, salt and sugar, he says. Consequently, we are now plagued with diseases that are caused by our acting against our nature.

The solution would be to dispense with most, if not all, man-made foods, especially carbohydrates and dairy products. Instead, followers are encouraged to eat meats, seafood (wild caught) as well as certain vegetables and fruits, as long as they can be found in their original, unmodified state. Intermittent fasting is also recommended.

Some nutrition experts and biologists, however, are skeptical of these restrictions.

The paleo diet is basically a fantasy, according to Dr. Marlene Zuk, a professor of ecology, evolution and behavioral science at the University of Michigan, who gave an interview on the subject to the German news magazine Der Spiegel.

“Its supporters assume that, at a certain point in time, our ancestors were perfectly adapted to their environment. But those conditions presumably never existed,” she said.

Other scientists agree.

“Scientists find it appalling that a number of proponents of the supposed stone-age diet claim to be knowledgeable about a period of time that lasted around 2.5 million years and ended in about 8,000 B.C.,” said Dr. Alexander Ströhle, a nutrition physiologist at the University of Hannover, Germany. “On the whole, the feeding behavior of prehistoric man […] was very flexible.”

Besides that, “our modern food products are well removed from their wild ancestors. They have been extremely modified and, as a result, are more calorie-rich, easier to ship, or simply better-tasting than the original. So, even if we wanted to, we couldn’t live exactly the way our ancestors did,” said Dr. Zuk.

As far as the health benefits of the paleo diet are concerned, they are so far undetermined. Some studies have linked the regimen to reducing blood pressure, LDL (bad) cholesterol, and triglycerides (a fatty substance in the arteries that can increase the risk of heart disease and stroke). But the strong emphasis on eating meat, including red meat, has its own well-known disadvantages. Also, followers of vegetarian eating styles (for religious, cultural or other reasons) will not easily be able to adhere to this diet.

That doesn’t mean there are no benefits to be had from the paleo diet. For those who are interested, there are plenty of food guides available on the Internet, like the Ultimate Paleo Guide, to name just one. More importantly, however, dieters should still focus on the healthiest food choices, no matter what philosophy appeals to them.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Lion Share of Medical Spending Goes to Services and Treating Chronic Diseases

November 19th, 2013 at 4:39 pm by timigustafson
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It is a widespread belief that the aging baby boomer generation is going to break the bank when it comes to medical costs. But while it is true that the elderly on average have greater healthcare needs than younger people, it is not where the bulk of the money goes, according to a recent study published in the Journal of the American Medical Association.

There are mainly two factors that make the American healthcare system more expensive, albeit not more efficient, than any other in the world, the study found. One is that the costs of medical and administrative services as well as drugs and devices have risen astronomically over the last decade or so. The other is that treating patients with chronic diseases like diabetes and heart disease is expensive, no matter what their age is. In fact, the majority of those suffering from these illnesses is under 65.

Paradoxically, today’s healthcare consumers pay a much smaller percentage of the actual costs to the system than they did 30 or 40 years ago – about 11 percent compared to 23 percent in the 1980s. That also means that most people don’t have the slightest idea how expensive medical services are because they never see 90 percent of the bills, says Dr. Hamilton Moses, chairman of the Alerion Institute, a consulting firm in Virginia, and a professor of neurology at Johns Hopkins University who wrote the study report.

The other issue is the sharp increase in diet and lifestyle-related diseases, which are now affecting ever-larger parts of the population. In 2011 (the year of the most recent numbers available), treating chronic illnesses absorbed 84 percent of all medical spending, two-thirds of which went to patients younger than 65 years of age.

“Chronic illness is a problem for everyone, not just the elderly,” says Dr. Moses. “That’s another reminder to follow a healthy lifestyle to reduce your chances of developing common health problems like high blood pressure, high cholesterol and diabetes.”

Unfortunately, our current system with its almost exclusive focus on treating existing health problems instead of preventing them is not well equipped to address these challenges.

“There are lessons to be learned from other countries,” says Dr. Moses. Chronic illness is where the misery is, it is where the money is, and it is where the greatest opportunity lies.”

A recent memo issued by the Centers for Medicare and Medicaid Services (CMS) points in that direction. In it, the agency urges doctors to include “intensive behavioral therapy” for obese patients in their treatment, meaning more screening for weight problems, nutritional assessment, and counseling on diet and exercise. Unlike in the past, the CMS says it will authorize reimbursement for this kind of counseling sessions from here on.

Similarly, the American Heart Association (AHA) has called for medical service providers to evaluate their patients’ physical activity habits as routinely as they check blood pressure and other risk factors for cardiovascular diseases.

Recommending measures like these are geared towards prevention and that can be a good first step, acknowledges Dr. David L. Katz, director of the Yale University Prevention Research Center. Unfortunately, most doctors are not well versed in weight management counseling, partly because it is still not a subject matter that medical schools spend much time on.

“Bad counseling can be worse than none at all,” he writes in an opinion piece in the Huffington Post.

Still, enlisting doctors in the fight against the obesity epidemic can be a good start if it leads to a comprehensive solution that goes beyond their practice. In any case, it is better to make the current system part of the solution instead of the problem.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Who Wants to Be Called an “Inner Beauty”?

November 16th, 2013 at 2:58 pm by timigustafson
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When the singer and actress Beyonce was named the “World’s Most Beautiful Woman” by People Magazine in 2012, she responded that it was in fact “inner beauty” she valued the most. Whatever she meant by that, it’s safe to say that she and celebrities like her can easily afford such displays of humility. To the rest of us mere mortals, being beautiful only on the inside doesn’t sound especially appealing.

According to a survey by Glamour magazine, 97 percent of women who were asked about their body image declared they were less than satisfied with the way they looked. “Too fat,” “too thin,” “ugly,” “gross,” and other descriptions to that effect revealed a widespread sense of low self-esteem among women when it comes to their bodies.

“I’m not totally surprised [about the survey results],” says Dr. Ann Kearney-Cooke, a psychologist specializing in issues of body image and self-esteem, who was involved in the design of the survey. “It’s become such an accepted norm to put yourself down that if someone says she likes her body, she’s the odd woman out,” she says. “It’s actually more acceptable to insult your body than to praise it.”

It’s not just outside pressure by the media and the beauty ideals women are constantly bombarded with, we do it also to ourselves, she explains. Whatever we focus on, it eventually shapes our perception. If we keep having all these negative thoughts about the way we look, those thoughts become habitual. We actually can train ourselves to be this way.

A negative self-image often develops very early in life. It’s not just women who go through pregnancies, gain weight, or see their skin wrinkle as they get older. Even children and adolescents can be uncomfortable with their looks, especially if they get teased or bullied by their peers, or if they don’t feel they measure up to the fashion and show biz icons of the day.

The diet and health industry is also not beyond reproach when it comes to creating unrealistic expectations, thereby setting their clients up for disappointment. Weight loss companies defend themselves by saying they don’t have much of a choice if they want to stay in business.

“I regularly find myself tip-toeing around the issue of body image because I’ve been told that women want to hear one thing, and one thing only on a sales call: I can make you thin,” says Isabel Foxen Duke, a health coach and emotional eating expert and author of “How Not to Eat Chocolate Cake.”

Health experts know full well that acceptance of one’s body as it is in all its frailty and with all its imperfections is an important part of the healing process. Whether someone is obsessed with false beauty ideals or with self-loathing doesn’t matter. Both attitudes are equally self-destructive. By contrast, understanding and appreciating the body’s value, no matter how it looks, is a first step in the right direction.

Don’t get lost in all the details of what and what not you must do to get or stay in shape, what you can eat and what you must avoid, how often and how much you must exercise, etc. etc. “I want you to listen to and trust your body’s needs. I want you to get a big old life outside of food. That’s what I’m really trying to do,” says Foxen Duke.

Being your own whole person in body and mind, that would be truly beautiful – from the inside out.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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About timigustafson

About Timi Gustafson, R.D. As a clinical dietitian, health counselor, book author, syndicated newspaper columnist and, as of late, blogger, she has been able to reach millions of people, addressing their concerns about issues of health, lifestyle and nutrition. As Co-founder and Director of Nutrition Services for Cyberdiet.com (now Mediconsult.com), she created the first nutrition-related interactive website on the Internet in 1995. Many of the features you find on her blog, www.timigustafson.com, are based on the pioneering work of those days. Today, her goals remain the same: Helping people to achieve optimal health of body and mind. She received a Bachelor of Science degree in Clinical Nutrition and Dietetics from San José State University in California and completed a Clinical Dietetic Internship at the University of California Medical Center in San Francisco. She is a registered dietitian and Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Academy of Nutrition and Dietetics, a member of the Diabetes Care and Education, Dietitians in Business and Communications, Healthy Aging, Sports, Cardiovascular and Wellness Nutrition, and the Vegetarian Nutrition Practice Groups. For more information about Timi Gustafson R.D. please visit: www.timigustafson.com

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