Very Low Calorie Diets and Aging

October 2nd, 2009

There has been talk of very low calorie diets and the benefits in terms of living longer and healthier. There is some evidence from people in one area of Japan who eat much less than we are all used to eating and have tremendous longevity, living over 100 years in many cases. There have been small research studies using very low calorie diets claiming benefits including improved memory, lower cholesterol, and lower blood pressure. Some folks have made the leap from this to recommending extremely low calorie diets.

While this diet may have such benefits for certain people,  I would recommend caution if considering adopting this as a life plan. It is an extreme diet.

First of all, it is hard enough to eat right on an average calorie diet, and much harder to get adequate nutrition on an extreme diet, so I would not do this without medical nutrition advice.  The only real experience that is currently valid is in medical treatment of obesity with very low calorie diets, and these are only in medical centers with very close observation of the individual on the diet. This is so the people do not put their bodies into starvation- a life threatening situation.

Second, it is not clear what the effect on your body will be from this big change. The people who are the basis of this theory are different from us in many ways other than food intake, and we cannot be sure what gives them their longevity. Many factors may play a role- genetics, stress, environment, culture…

Third and most important- it is not fun to eat next to nothing!!!  Yes, most Americans eat too much and not always the best quality. But you can eat less, eat well, and enjoy your food while at the same time improving your health by preventing disease and ultimately living longer without starving!!

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Calcium and Vitamin D

September 22nd, 2009

Most of us know that calcium is important for healthy bones, but there is increasing evidence that vitamin D is equally or more important. Vitamin D is helpful in many aspects of metabolism and body function, including heart health and improved blood pressure, and may help reduce cancer.  New evidence suggests that calcium and vitamin D together reduce death rates. Sources of calcium include dairy products, soy, and sardines(strange but true!). Vitamin D is less available through foods, is made in sun exposed skin ( it is difficult to get enough, and even harder to recommend) so most experts recommend a supplement. The easiest solution is to get a calcium supplement which contains vitamin D and take two per day, separately, with food.  Or if you eat enough calcium, take vitamin D as a supplement- 800-1000 units per day.

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Eggs

August 31st, 2009

I like and recommend eggs! The bad reputation given to eggs(well, mostly yolks), took all the pleasure away from eggs.  I never learned to like egg whites- no flavor, no color, what’s the point?? But good news!! Eggs have lots of good nutrients, mostly in the yolk. One egg has approximately 75 calories, 6 grams protein, 5 grams fat- 1.5g of which is saturated, 2g monounsaturated, and 1g polyunsaturated. This is high quality protein, mostly “good” fat, and less than one tenth the amount of saturated fat recommended in 1500 cal diet (a low calorie diet).  There are also other nutrients in eggs, such as choline and lutein. While eggs do have cholesterol in them, eating cholesterol has no significant effect on blood cholesterol levels for most people.

Eggs, because of their protein and fat content, keep you satisfied longer (higher satiety). This is especially important to remember at breakfast, and particularly for children. Including eggs in your and/or your child’s breakfast means you will last much longer before you get hungry again (and be less cranky, have more brain power, have more energy). Plus, eggs are not expensive, are easy to cook, and can be cooked in many different ways to keep things interesting. Eggs taste better and have more nutrition when they are fresh, so look for local eggs if possible.

So try some eggs for breakfast again! Fried, scrambled, poached, boiled, frittatas, egg sandwich, burrito, in your pancake batter, the list goes on and on…

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Cooking

August 23rd, 2009

Healthy eating, whether for weight loss or other health reasons s easier to achieve when you make your own food. There are many reasons for this, one is that you select your own food and know (or can find out) where it came from and what the quality is. It is important to choose the highest quality of food you can afford so that you get the most nutrition with the least concern for harmful chemicals or hormones. This need not mean fancy gourmet foods, but does mean fresh fruits and vegetables, as local as possible, meats and dairy as chemical and hormone free as posible, and fresh fish. Food chosen this way is healthier in that it is free of excess sugar, salt, and is not processed.

Now for the cooking part!

Many peple feel that they do not have the time to cook anymore. Americans now spend less than 30 minutes per day preparing food. Consider finding that time again- not to make elaborate meals, but to make your own food – more nutritious, healthy food that makes you feel better. Here are some tips to make this possible:

1. Make a list for food shopping! and stick to it-

2. Create a meal plan for the week ahead, factoring in when you plan to eat out, and making the most of your time- make double meals or portions of meals that can be used over the week. Prepare salad ingredients once- wash and dry lettuce, tear it , and put it in a clean bag, cut up carrots, cucumbers, peppers and other veggies and put in containers- so making a salad is a simple task during a busy week. Chicken can be grilled, eaten for dinner, and what is left can be put in the fridge for lunches or another dinner.

3. Use your freezer- steel cut oats can be made in a large batch and frozen in individual containers. Lasagne can be frozen in meal sized portions. Berries can be washed and frozen for use in smoothies, pancakes, muffins…

4. Make it an event- cook together with family or friends- cooking is a social enterprise and can be fun – there is a task for everyone, whether it is simple as washing fruits and veggies, or chopping them up. Children love to help in the kitchen- start them when they are young, it is a great life skill.

So give it try- pick a week, and plan your meals and see how it goes- you’ll find it is easier that you think, and fun!!

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Why Vineyard Vitality?

August 9th, 2009

You may wonder why a physician would decide to offer nutrition and lifestyle counseling. Well, if you have read or watched the news on healthcare lately, you know that primary care is a specialty in trouble. Few graduating medical students are deciding to pursue a career in primary care these days, sadly with good reason. What used to be a great job – taking care of the whole patient, not just their parts- practicing preventive health, diagnosing problems, treating chronic illnesses- keeping people as healthy as possible — has devolved slowly over the past ten or fifteen years into what I call factory medicine. Remember I Love Lucy when she works in the chocolate factory and the conveyor goes faster and faster until she is stuffing chocolates into her mouth and pockets? Hysterical, right? Well, not so funny with people.

My goal is and always has been to provide the highest quality care possible to my patients, but that requires taking time to talk to them, listen to them, get to know them. I simply can’t spend that time anymore.  So, I spent a lot of time looking around, trying to find a way to help people without the frustrations of the time constraints, referrals, denials, prior approvals, and changing vagaries of insurance coverage.  I found some great training for physicians in nutrition, lifestyle, and mind/ body medicine, and realized that I could get back to the reason I became a physician in the first place- helping people.  So here I am, with a great opportunity- I can focus on the person, learn about what their goals are, and work with them to achieve those goals.

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Artificial sweeteners – good or bad?

July 31st, 2009

There is considerable controversy over health effects and possible harm from artificial sweeteners. There are basically 4 types available: saccharin (sweet’n low/sugar twin), aspartame (equal/nutrasweet), sucralose (splenda), and stevia (truvia, purevia, sweetleaf). The first three are chemically made, the last is an extract from plant leaves.

All are hundreds of times sweeter than table sugar, or sucrose.  This is likely the biggest issue with these compounds. When used in a drink such as diet soda, the effect on a person is to provide a powerful burst of sweetness to their taste buds, which is theorized to create a craving for more sweet foods. So, simply put, overweight people who drink  a lot of diet soda stay overweight because  they are eating sugary things to meet their craving for sweets.

The other concern is whether these compounds cause cancer or other diseases. This has never been proven, despite some good medical research, but doubts linger. And some of these products have not been around long enough to say for sure whether there may be problems.

So what is the solution? Well, if you are a purist, I would say don’t use artificial sweeteners.  If you are diabetic or simply like sweet drinks but don’t want sugar calories, use the sweeteners, but as little as possible. If you want to take the healthiest approach, I would recommend avoiding artificial sweeteners, and eating limited sweets. Also consider using natural sweeteners other than sucrose, which causes a rapid rise in blood sugar , then another rise in insulin, which over time can decrease your body’s insulin and result in diabetes. (This also occurs with processed carbohydrates such as white flour) Alternative sweeteners include molasses, honey and agave extract- particularly appealing as you need very little, and it does not produce much of a rise in blood sugar or insulin. Lastly, consider using unrefined cane sugar, or turbinado sugar, instead of processed white cane sugar.

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Breakfast – Cereals

July 21st, 2009

A good example of a balanced cereal is Kashi Go Lean. This particular Kashi product is high in protein and fiber and low in sugar. Many granolas are a good balance, but some have excess sugars. A good choice is Bear Naked Fit.  Both are great with some fruit for a complete breakfast.

An excellent choice is oatmeal, but it needs to be the old fashioned steel cut oats- the kind that takes 30 minutes to cook. Instant oatmeals are processed and thus have lost much of their fiber as well as some of their nutrients.  To limit the hassle of the long cooking time, old fashioned oatmeal can be made in large batches, put into small freezer containers, and warmed up in the morning. Add a pinch of brown sugar, a few walnut halves, some dried fruit or a bowl of fresh fruit, and you have the ideal breakfast!

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Breakfast

July 14th, 2009

While breakfast may or may not be the most important meal of the day, it is important to eat in the morning. Breakfast eaters have more energy, do better with weight loss, and children and adolescents are less likely to be obese. A healthy breakfast can be simple, but should contain protein and fruit and/or vegetable in addition to the typical carbohydrate.

The key is to read labels on breads if that is what you usually eat, as quality varies tremendously. Ingredients you want to see: 100% whole wheat (not just wheat, that is misleading) or other whole grain, fiber- more is better, as most people don’t get enough-, amount of  protein (if any, many breads have little to none), and sugars- look for high fructose corn syrup and stay away, but often other sweeteners are added and can lead to a high sugar content .

An example of a complete breakfast is 1 or 2 slices of whole wheat toast spread with a thin layer of a nut butter(peanut, almond, cashew) and piece of fruit or bowl of berries. Tasty and easy!

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Low fat diets- good or bad?

July 7th, 2009

A new research study shows that either a low carb or a Mediterranean type diet is better than a low fat diet for both weight loss and lowering cholesterol.  There is increasing evidence that low fat diets promoted over the last 20 years led to epidemic levels of obesity in the US, which also has resulted in medical problems from obesity such as high cholesterol, diabetes, heart disease and high blood pressure. It important when considering your own diet to get good advice about the best types of foods for your particular health concerns.

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Summer Vegetables

July 2nd, 2009

Summer is an easy time to add vegetables to your diet.  If you have a farm stand near you, go regularly and choose what is fresh and ideally locally grown. If not, often times grocery stores carry local produce, or you can choose what looks freshest.  For those who like to grill, a great way to make a vegetable dish is to cut up a mixture of vegetables and grill them. For example, take squash and zucchini, cut in quarters lengthwise, then into about 2 inch lengths, cut out the seedy part, roughly chop some onions, perhaps some peppers, and toss with olive oil and a little sea salt and pepper. Put into a grill basket and toss until browned. You can grill a nice piece of fish at the same time, have some whole wheat bread or brown rice and you have an excellent summer meal! When serving, the ideal proportions on the plate are 1/2 vegetable, 1/4 fish, and 1/4 rice or bread.  Enjoy!!

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