Posts Tagged ‘Dieting’

When Choosing a Diet Plan, Separate the Wheat from the Chaff

October 20th, 2013 at 7:22 am by timigustafson

If your goal is to lose weight, almost any diet that restricts calorie intake will do the trick, at least for a while. What should be met with suspicion are weight loss plans and programs that promise quick results and lasting success with little effort. In the real world, no such thing exists.

So-called “fad diets” hit the market almost daily. In essence, they all make the same claims: You will see positive changes almost immediately, you don’t have to forego your favorite foods, you won’t feel hungry, and, best of all, you don’t have to exercise.

What they also have in common is that it’s nearly impossible to follow them over time. According to a study by the University of Massachusetts, even the most popular diet plans have low long-term adherence. But, as any health expert will tell you, stick-to-itiveness is a central component of successful weight loss.

According to the Academy of Nutrition and Dietetics (AND), the world’s largest organization of food and nutrition professionals, there are no foods or pills that let you magically burn fat and lose weight. There are no super foods that can alter your genetic code. Worse yet, some ingredients in weight loss products can be outright dangerous and even deadly. The bottom line, the AND says, is that “if a diet or product sounds too good to be true, it probably is.”

Rapid weight loss, which is what most commercial plans aim for, is not even a desirable goal. A slow but steady loss of ½ to 1 pound per week is an appropriate pace, according to the AND. If you lose weight more quickly, it will not only affect your body fat but also your muscles, bones and water balance.

Moreover, sudden weight fluctuations make weight loss less sustainable. So-called yo-yo dieting, where lost weight is gained back time and again, can put enormous stress on inner organs and is linked to high blood pressure, heart disease and diabetes.

While calorie restriction is an intricate part of dieting, deprivation of essential nutrients by withholding certain foods or entire food groups – e.g. carbohydrates – is not recommended. Also, the ADA says, there is no scientific evidence that certain food combinations or eating particular foods at specific times can support weight loss, as some diet programs advertise.

Unfortunately, the word “diet,” as it is most commonly used, is almost exclusively associated with “eating less” or “not eating at all.” That by itself may lead to the wrong approach. In its original form, diet means simply “the way someone eats.”

And indeed there are diet plans that don’t focus on weight loss at all, but rather on eating highly nutritious foods, keeping portion sizes in check, and also encourage an all-around health-promoting lifestyle. For example, the Mediterranean diet, which is based on the culinary traditions of countries bordering on the Mediterranean Sea and is thought of as one of the healthiest dietary guidelines anywhere, or the DASH diet (acronym for Dietary Approaches to Stop Hypertension), developed for heart health, both emphasize healthy eating habits from which weight loss and permanent weight control can follow.

Neither of these, shall we call them “inclusive” diets (as opposed to “exclusive” regimens that eliminate foods in both quantity and quality), will let you shed massive amounts of weight in a hurry, but you will be better off for the rest of your life.

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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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More Realistic Goals, Longer Lasting Results

January 16th, 2013 at 10:58 am by timigustafson

The NBC hit show, “The Biggest Loser,” now in its 14th season, is well known for its rigorous (to put it mildly) workout sessions where contestants are regularly driven to the brink of collapse in the pursuit of rapid weight loss. Of course, all the huffing and puffing during the exercising also adds drama and entertainment without which the show would probably not have lasted this long.

Although the participants come from all age groups, this year’s focus is on obesity among children and adolescents, which is a good idea considering that 17 percent (12.5 million) of Americans age 2 to 19 are now diagnosed as obese, according to the Centers for Disease Control and Prevention (CDC). Since 1980, obesity rates among the young have tripled, and the latest data show only slight improvements despite of stepped-up efforts by government agencies and advocacy groups to curb the trend.

While it is disheartening to see how much damage the obesity crisis is doing to all generations, programs like “The Biggest Loser” can help convey the message that it is never too early or too late to make positive changes, provided one is willing to put in the hard work. For that they should be applauded. Still, there are some disconcerting elements at play here.

With progressive success in their weight loss efforts, many of the contestants develop a high, if not inflated confidence level. Naturally, a certain amount of faith in one’s abilities is necessary just to stay motivated. However, when I hear a candidate who has still a long way to go to a healthy weight range talk about her plans for running a complete marathon in the near future, I wonder how expectations of what’s possible can sometimes spin so much out of control. Yes, it would be a headline-grabbing sensation if a once morbidly obese person could pull off one of the most challenging athletic performances known to man after just a few month of training – but is that a healthy, even desirable prospect? Why this tendency to swing from one extreme to another?

It is no secret that radical weight loss bouts over short periods of time don’t last in most cases. So-called yo-yo dieting is a well-known phenomenon in the weight loss industry. Many former “The Biggest Loser” contestants have gained at least some of their old weight back. What seems feasible within a controlled environment often doesn’t hold up when people resume their own daily routines.

And there is also no need for that. The intensity and rigor of a concentrated weight loss program cannot and should not continue indefinitely. Studies have shown that most people reap the greatest benefits from light to moderate but consistent exercise such as resistance training, fast walking or jogging for limited distances (up to 20 miles per week). More than that does not produce significantly greater advantages for physical health or longevity, according to Dr. Carl Lavie, medical director of cardiac rehabilitation and prevention at the Ochsner Medical Center in New Orleans who conducted extensive research on the subject. “If anything,” he says, “it appears that less running is associated with the best protection from mortality risk. More is not better, and actually, more could be worse.”

His colleague and study report co-author, Dr. James H. O’Keefe, a specialist in preventive cardiovascular medicine, agrees. “In general, it appears that exercise, like any therapy, results in a bell-shaped curve in terms of response and benefits. To date, the data suggest that walking and light jogging are almost uniformly beneficial for health and do increase life span. But with more vigorous or prolonged exercise, the benefits can become questionable,” he said in an interview with the New York Times.

So, instead of going from years of overeating and doing no exercise whatsoever to competitive running, I suggest that the young lady in question finds some middle ground where she can manage her weight and engage in an overall health-promoting lifestyle that can make life so much better for her for the rest of her life. The same goes for the rest of us.

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, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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Instead of Dieting, Build a Healthy Lifestyle

January 9th, 2013 at 12:00 pm by timigustafson

Just in time for resolution season when many Americans try hard to lose the extra weight they gained over the holidays, a surprising study by the Centers for Disease Control and Prevention (CDC) has come out, seemingly suggesting that a few additional pounds may not do too much harm after all, and being a bit overweight may even reduce a person’s mortality risk. The findings, which were widely publicized in the press, quickly proved controversial and evoked some strong reactions from health experts and the public. Is this the end of the need for weight control?

“Not all weight is the same,” said Dr. Thomas Frieden, director of the CDC department that conducted the study, in an interview with USA TODAY. “If you work out and build muscle mass, you may increase weight and that’s healthy.”

Whether a few extra pounds matter much or not depends on how someone has acquired them, said Dr. Walter Willet, professor at Harvard School of Public Health, in the same interview. “If someone has always been muscular and is active and strong, and their blood pressure and levels of blood glucose and cholesterol are fine, then their health risks are probably minimal. However, if someone has gotten to this weight by putting on 10 pounds or more, has increased their waistline by more than two inches, or has elevations in blood pressure, glucose or cholesterol, then this weight can be a serious health risk.”

The problem is that the large majority of overweight people develop metabolic abnormalities such as high blood pressure, diabetes and many other conditions. That’s why most will benefit from losing weight, even if it’s only a modest amount, he added.

Even those who are still within a healthy weight range should take proactive steps to avoid weight increase by eating right and exercising regularly. Obviously, it is much easier to prevent any damage than to repair it.

Either way, successful weight management does not come in form of quick and temporary fixes but with a firm commitment to your overall health and well-being that lasts a lifetime. This may entail paying careful attention to your eating habits and, if necessary, making some changes, which can range from cutting back on portion sizes to learning entirely different eating styles. It can require going on more walks or making the gym your new obsession.

Those who are significantly overweight and face health threats because of that may have to take some immediate action. Even losing relatively small amounts of weight can be a lifesaver. In extreme cases, more drastic measures under medical supervision may be necessary.

Unfortunately, most dieters still focus too much on calorie reduction, in spite of the fact that deprivation rarely works. That’s why so many encounter a so-called ‘yo-yo’ effect, where they regain the weight they’ve lost and sometimes add more once the dieting is over.

No matter how extensive your efforts will need to be, they don’t have to be complicated. Most experts recommend to start small and set more ambitious goals over time. Aim for balance, variety and moderation in your eating pattern. Develop an exercise regimen that matches your needs and that you enjoy enough to stick with it.

Don’t try changing everything all at once. Allow for occasional treats, count on lapses, but don’t lose sight of your long-term goals. Ask for support from loved ones or seek professional help when the going gets too tough. In the end, what matters most is that you own your new and improved lifestyle and that it becomes part of who you are. And it will, if you try long and hard enough.

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, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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Making Your Resolutions Last

January 2nd, 2013 at 4:47 pm by timigustafson

New Year’s resolutions are a popular annual tradition in spite of their notoriously high failing rates. According to surveys, almost half of Americans will again vow to change something or other in their lives this month. Losing weight usually ranks at the top of the list, followed by getting better organized, saving money, taking more time off, improving physical fitness, and quitting or reducing alcohol and tobacco use.

The percentage of people who say they regularly achieve all of their goals is a measly eight percent. Almost half report partial success, while a quarter admits to complete failure year after year.

Making resolutions has a great deal to do with the belief that we can reinvent ourselves at our choosing, according to Ray Williams, author of “Breaking Bad Habits.” It can also be a form of procrastination. It’s a way to motivate ourselves to make long overdue changes, if not right away, then at least in the near future.

However, if resolutions are too unrealistic and insufficiently aligned with our actual circumstances, they are doomed from the start. “When you make positive affirmations about yourself that you don’t really believe, the positive affirmations not only don’t work, they can be damaging to your self-esteem,” he writes. “You may think that if you lose weight, or reduce your debts, or exercise more, your entire life will change, and when it doesn’t, you may get discouraged and then you revert to old behaviors.”

There may be a multitude of good reasons why we don’t follow through with our good intentions but in the end, it all comes down to energy, or lack thereof, says Dr. Carolyn Anderson, a surgeon and wellness expert. “All resolutions require extra energy, and if your day-to-day life already leaves you exhausted, you’ll never get around to fulfilling your plans,” she says.

Lack of sufficient energy to make lifestyle changes often gets confused with lack of time, which is one of the most common excuses. Energy comes from discipline, she says, discipline to follow proven strategies like eating right, exercising and getting enough sleep. These are the necessary foundations other improvements can be built upon.

Another potential cause for failure is the size and scope of the goals we set for ourselves. The bar may be impossibly high, the target too far away. It may also be a matter of lacking confidence. “[The] problem isn’t that we shouldn’t think big, but that we consider ourselves too small of a player in the quest for our own goals,” says Kristi Hedges, an executive coach and author of “The Power of Presence.” “We set all-or-nothing New Year’s resolutions that we can’t possibly keep, and frankly don’t expect ourselves to.”

Many resolutions, she says, are not only unrealistic but also too general and vague to be turned into concrete steps. Failure then becomes an almost inevitable consequence, allowing us to return to our familiar excuses.

So, before you make another resolution, consider first how you will pursue your goals differently from last time when you failed, says Chrissy Scivicque, a lifestyle and career coach. Perhaps you didn’t plan ahead carefully enough. Or you didn’t plan for setbacks and were ill equipped to deal with them when they occurred. You may have lost motivation along the way or forgot why you went on a particular journey to begin with. Maybe you didn’t get enough support to keep you going. Or you are prone to sabotaging yourself as you approach success.

Besides setting only specific goals that are realistically achievable, you should only focus on one resolution at a time, advises Ray Williams. Don’t wait for New Year’s Day to get started. There is no need for artificial timetables. Begin by taking small steps. Pace yourself. Have an “accountability buddy” who helps you keep track of your progress and encourages you when the going gets tough. Don’t be too hard on yourself if you advance too slowly or fall back. Celebrate small successes. Be conscious that changing your behavior and mindset is no easy task and takes time. But it’s all worth it and, hopefully, will spare you another frustrating resolution season. Happy New Year!

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, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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Don’t Start Dieting Just Yet

December 26th, 2012 at 7:56 am by timigustafson

The holidays are nearly over. It’s time to assess the damage caused by delicious treats, fun cocktail parties and festive dinners that made us feel so good but now give us a sense of regret. It’s time to repent, shed quickly the extra pounds we gained and return to the path of nutritional righteousness. Or is it?

In fact, no. I don’t recommend dieting after the holidays. Going on a diet right after putting on more weight may be the worst thing you can do. Why?

Numerous studies have shown that starving yourself after periods of overindulging can be highly counterproductive. One study from the University of CaliforniaLos Angeles (UCLA) found that people who diet not only regain the weight they lost but actually tend to add more.

“We found that the average percentage of people who gained back more weight than they lost on diets was 41 percent, says Dr. Traci Mann, a professor at the University of Minnesota who specializes in psychology of eating disorders, in an interview with WebMD. She believes these numbers are conservative and the statistics may be even bleaker because the study’s data are based on self-reporting, which notoriously skews the results.

One of the reasons why diets don’t work, especially after a time of overeating, is that it’s hard for most people to change even recently acquired habits. If you can’t continue with something that provides you with so much gratification, it feels like cruel deprivation. It can be difficult to overcome that sudden void.

And even if you initially succeed at losing some weight, the returns inevitably diminish over time, says Dr. Mann. “When you keep to a reduced-calorie diet, your body makes metabolic adjustments that make it harder and harder for you to lose weight. Your body becomes very efficient, and you have to eat less and less to continue to lose weight. If you had the will to go on a diet, the fact that it steadily becomes less and less effective makes it even harder to stick to it,” she says.

People often underestimate how difficult it is to change their lifestyle, says Dr. Robert M. van Dam, a professor of medicine at Harvard Medical School who specializes in obesity studies. “People think diets are something you do for a little while before going back to your old lifestyle. But if you do a crash diet, you will only regain the weight,” he warns.

So what is the right way to get us out of the holiday spirit and let us down gently?

“People who want to achieve and maintain a healthy weight should start working at lifestyle changes they can maintain, even if it means not losing weight but just staying at the same weight,” says Dr. Madelyn Fernstrom, a professor for psychiatry and epidemiology and director the Weight Management Center at the University of Pittsburgh. In other words, instead of jumping on another fad diet that promises quick results, it is better to gradually ease back into your regular routine and go from there if additional weight loss measures are needed.

This is not just a physical exercise but a mental one as well. If the holidays caused you to engage in some bouts of emotional eating – meaning you ate for reasons other than hunger – you must find ways to cope with those issues as well. Just because the season is over doesn’t mean those needs go away.

Lifestyle changes that produce lasting results include a number of different elements, says Dr. Fernstrom, including moderation of food intake, increasing physical activity, managing stress and, if necessary, getting counseling and treatment for depression and other illnesses that may get in the way.

If you enjoyed this article, you may also enjoy reading “How Damaging Is Yo-Yo Dieting?.”

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, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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Weight Gain During the Holidays Is Hard to Undo

November 14th, 2012 at 2:51 pm by timigustafson

Millions of Americans will again become heavier over the holidays. For many it’s an experience as reoccurring as the Season itself. It seems almost inevitable that we overeat too often and exercise too little this time of the year. While the resulting weight gain is not always dramatic, getting rid off the extra pounds afterwards can be a real challenge.

“Americans probably gain only a pound during the winter holiday season, but this extra weight accumulates through the years and may be a major contributor to obesity later,” finds one study conducted by the National Institutes of Health (NIH).

In other words, even a little uptick in body weight each holiday season can add up over time until it becomes a potential health problem. For people who are already overweight or obese, the situation can be worse. Research by the National Center for Biotechnology Information (NCBI) found that the average weight increase in this group was as much as five times higher. “These results suggest that holiday weight gain may be an important contributor to the rising prevalence of obesity,” the NCBI study concluded.

Most Americans who gain weight between Thanksgiving and New Year’s Eve generally don’t lose that weight ever again, says also Dr. Mehmet Oz, a cardiologist and talk show host on ABC. Some meals people eat during the holidays can add up to 2,000 calories or more, according to Dr. Oz, so they could actually put on an extra pound every day if they keep indulging like this. Once they become used to the higher calorie intake, it may seem like normal and they continue on that level.

So what can be done to prevent us from falling into the same trap year after year? While the holiday season is no time to start dieting because of all the temptations around us, there are a few tricks you can apply, says Registered Dietitian Marisa Moore. She suggests to keep tempting treats as much out of sight as possible. “Just seeing food can trigger the desire to eat,” she warns.

Especially beware of calorie-laden drinks like eggnog, which can have 450 calories or more per glass. When you attend a party where lots of food will be served, “ruin your appetite” before you get there, Moore advises. Rather than arriving ravenous, grab a handful of protein and carbohydrate-rich snacks like nuts or cheese with some fruit. It will leave you less inclined to overload on heavier foods later.

Also, don’t forget to maintain your exercise schedule between your partying. In fact, you may want to increase your workout efforts a bit for counterbalance.

Last but not least, don’t forget to get enough sleep. Your full social calendar can wreak havoc on your body, says Moore. Lack of sleep and resulting exhaustion can contribute to weight gain as well because you are less likely to exercise restraint and keep your eating habits under control.

The more you are aware of your inclinations (some call it weaknesses), the easier it will be to work around them. Always have a plan ready for how much you are willing and able to consume without having to deal with dire consequences later.

Remember that the holidays are primarily there to reconnect with family and friends and to celebrate good times. Enjoying delicious food is certainly part of that, but it shouldn’t be the main focus. Instead of standing around the buffet, you can hit the dance floor, or simply enjoy a good conversation with old and new friends that doesn’t require more than you being your lovely self.

If you enjoyed this article, you may also enjoy reading “‘Tis the Season for Weight Gain – And What (Not) to Do When Celebrating the Holidays

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, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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What Do You Really Know About Healthy Eating?

September 12th, 2012 at 7:07 am by timigustafson

Most Americans think they’re healthier than they actually are. Considering that well over 60 percent of the U.S. population is struggling with weight problems, that is quite surprising. Yet 80 percent of participants in a recent survey identified themselves as “extremely healthy” or “very healthy.” But only 20 percent claimed to have what is considered an all-around healthy diet, according to the NPD group, a leading market research company that conducted the study.

Despite of the overly positive self-assessment, about half of the almost 2,000 adults who were interviewed agreed that their existing diet could use some help. Roughly half of those said that changing their eating habits would require some exclusion of certain foods (presumably of lesser nutritional quality) as well as inclusion of others (presumably of higher nutritional quality). 26 percent saw the need to add more healthy foods, and only 19 percent thought they needed to cut back on what they usually ate. There were slightly fewer respondents claiming to be on a weight loss diet than in previous years when similar research was done.

Other studies have found that it is not rare for people who are overweight or obese to misjudge their size, sometimes considerably. Researchers from the University of Illinois at Urbana-Champaign found in a study on weight problems among young Hispanics that only a minority of overweight or obese participants judged their body size accurately. Nearly 60 percent of those whose BMI identified them as overweight described themselves as normal weight, while 75 percent of those who were obese thought they were merely overweight. One in three women does not realize when she gains five pounds and 15 percent aren’t aware of weight increases of more then 10 pounds, according to a survey by the University of Texas in Galveston.

Even for Americans who are interested in eating better and keeping their waistline from expanding, maintaining a healthier lifestyle remains an uphill battle. Food prices, especially for fresh produce, are high and keep rising. Contradictory messages like a recent study that questioned the benefits of buying organic add more uncertainty. Many consumers either give up altogether or make inconsistent dietary decisions. “There’s complete confusion,” said Maria Mogelonsky, a food analyst for a global marketing firm in an interview with the New York Times on the subject. “Most people have a randomly arranged set of diet principles. They buy organics sometimes. They buy based on price sometimes. Very few people are completely committed to one cause,” she said.

So what advice is there to give?

• The first thing I tell my clients is not to make their dietary improvements too complicated. If your new regimen doesn’t fit your lifestyle, it won’t stick, no matter how hard you try.

• Learn a few basic facts about nutrition (your body needs over 40 different nutrients every day), and how you can achieve and maintain balance in your diet.

• Don’t start controlling your food intake by counting calories. Rather, watch your portion sizes. Your stomach’s size is roughly equivalent to the size of your fist. Your servings should not exceed that.

• Gradually increase your consumption of healthy foods like fruits and vegetables. At the same time, decrease your intake of processed and packaged foods.

• Buy fresh produce as much and as often as it fits your budget. To save costs, choose locally grown, seasonal items whenever possible. Farmers markets can offer better quality at lower prices than supermarkets.

• Prepare most of your meals from scratch. Eating out or grabbing some take-out on the way home should be the exception, not the rule.

• Make water your primary beverage. Avoid sodas and keep caffeine and alcohol to a minimum.

• Get enough exercise to burn off calories your body doesn’t need.

If all or some of this is too challenging for you right now, take the steps you can manage and work toward the rest as you go.

If you enjoyed this article, you may also be interested in “Will Rising Food Prices Change America’s Eating Habits.”

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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The K-E Diet – Quick and Potentially Dangerous

April 25th, 2012 at 2:19 pm by timigustafson

Shedding pounds in a hurry is never easy and it’s certainly not without health concerns. Yet, the so-called “crash diets” rank among the most popular weight loss programs in America. In our culture of instant gratification, getting fast results is what seems to matter most.

Now a new program is making headlines that elevates the meaning of ‘radical weight loss’ to a whole new level. The K-E diet, abbreviation for Ketogenic Enteral Nutrition, promises astounding short-term success without hunger pangs or the need for exercise.

And it’s radical alright, even by the looks of it. Instead of following a specific meal plan, dieters have a feeding tube inserted through their nose into their stomach to facilitate a constant drip of a protein and fat solution mixed with water that can lower their daily calorie intake to about 800. Although this equals a near-starvation scenario, those who have tried the procedure say they never felt hungry.

“It’s a hunger-free, effective way of dieting,” said Dr. Oliver Di Pietro of Bay Harbor Islands, Florida, who offers the program in his clinic. “Within a few hours, your hunger and appetite go away completely, so patients are actually not hungry at all for the whole 10 days [the program lasts]. That’s what’s so amazing about this diet.”

Although the K-E diet is not entirely new and has been in use in Europe for some time, it has suddenly attracted wide attention over here ever since Jessica Schnaider, a soon-to-be bride, has been wearing the feeding device in public for over a week so she could slim down enough to fit into her wedding gown.

“I don’t have all the time on the planet just to focus an hour and a half a day on exercise, so I came to the doctor, I saw the diet and I said, ‘You know what? Why not? Let me try it. So I decided to go ahead and give it a shot,” she said in an interview with ABC News.

Dr. Di Pietro asserts that his approach is perfectly safe. He says body fat is burned off through a process called ketosis that leaves muscle tissue intact. Although exercise is not required during the short diet period to ensure weight loss, Dr. Di Pietro agrees that exercising to maintain muscles may still be a good idea.

When the K-E diet first made the news, many nutrition experts responded with skepticism and a few were downright outraged. “Any extreme low-calorie diet is associated with side effects [such as] kidney stones, dehydration, headaches,” said Dr. Louis Aronne, director of the Comprehensive Weight Control Program at New York Presbyterian/Weill Cornell Medical Center. “Nutrition should probably be included in that. If you lose muscle mass and water, what’s the point of that.”

That is a problem with most crash diets. The quick success in weight loss rarely lasts. As soon as people go back to their normal eating habits, they regain their lost pounds and sometimes add even more. This can result in the notorious ‘yo-yo’ effect when body weight fluctuates considerably within relatively short periods of time.

Another potential danger is the development of eating disorders in connection with crash dieting, warns Dr. David L. Katz, director of the Prevention Research Center at Yale University and founder of the Integrative Medicine Center at Griffin Hospital in Derby, Connecticut. He has little patience with concepts like the K-E diet and compares them to disorders like bulimia. “This ‘diet’ is little short of lunacy,” he wrote in a recent article published in the Huffington Post. “If self-induced vomiting after meals constitutes an eating disorder, what exactly is infusing a liquid formula through a tube into the duodenum without medical indication? It has nothing at all to do with health and basically endorses the notion that weight loss by any means is acceptable.”

Dr. Di Pietro argues that his method applies mostly to people who are in need of a quick fix and not to those who have large amounts of weight to lose or deal with weight-related illnesses, such as diabetes or heart problems. “I get a lot of brides, nervous eaters,” he said. But that may not be enough justification for resorting to such radical measures, according to Dr. Jodi Krumholz, director of Nutrition at the Renfew Center in Philadelphia, who specializes in the treatment of eating disorders. “Even though they might do this one time for the wedding, I think there can be addictive qualities to these diets, and I think that someone might continue to do something like this. And it could put them in a really dangerous low weight place,” she said.

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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Why Is Gaining Weight So Much Easier Than Losing Weight?

March 4th, 2012 at 1:40 pm by timigustafson

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Your Eating Habits – What Makes Them, What Breaks Them

February 22nd, 2012 at 2:08 pm by timigustafson

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.

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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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