Kare about Health

On Monday, November 2, 2009 the Arizona Daily Star published an article, “Alternative-healing instruction in medical schools is questioned.” Right up front before the article, the following was seen: EDITOR’S NOTE: Ten years and $2.5 billion in research have found no cures from alternative medicine. Yet these mostly unproven treatments are now mainstream and used by more than a third of all Americans. This is one part of an occasional Associated Press series on their use and potential risks.

I was perplexed to say the least, since I have done medical writing and have been involved with some alternative therapy research that was shown to be highly effective.

Then, the next day an article “More insurers are covering alternative healing, at a cost,” with the same editor’s note staring you in the face before you read the article.

I am currently with no institutional backing to be able to do thorough research into recent clinical trials, but I was able to spend a few hours and find many clinical research journal articles that showed alternative therapies to be statistically significantly effective over either controls or conventional therapy. What bothers me is the technicality in that editor’s note about finding “cures.” That editor’s note has been worded to be manipulative through sensationalism. It shows obvious bias (which is why it is an editor’s note, I suppose) and is expressing that bias before the reader even gets a chance to read the article. You will not find a lot of “cures” in conventional medicine clinical trials either! Taking Lipitor for high cholesterol does not “cure” high cholesterol. Taking blood pressure meds does not “cure” hypertension.

So what predicts who will use alternative therapy? NCCAM (National Center for Complementary and Alternative Medicine – see below) found that predictors were: more education, poorer health, holistic orientation to health, had a transformational experience that changed their worldview, or classification in a cultural group identifiable by their commitment to environmentalism, feminisim, and interest in spirituality and personal growth psychology. Hmmm… now that’s a mouthful! A person is also more likely to seek alternative therapies for back problems, chronic pain and urinary tract problems. Interesting.

The bottom line is consumers are demanding alternatives to conventional medicine. In their annual survey, the NCCAM found that a full 38% of American adults used some form of alternative medicine in 2007. And it seems to be growing. Is is possible that we are not getting satisfactory results from conventional therapies and are searching for answers?

Alternative therapies like acupuncture are being used more and more.

Ten years ago the National Center for Complementary and Alternative Medicine (NCCAM) was established. The National Center for Complementary and Alternative Medicine’s mission is to explore complementary and alternative medical practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals. It is housed by the National Institutes of Health (NIH)—The Nation’s Medical Research Agency—which includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.

It made merging alternative and mainstream medicine “a central and overarching goal” and gave $22.5 million to 12 medical schools, two nursing schools and the American Medical Student Association to develop curriculum plans.

“Consumers are demanding it,” and more research is needed to see what works, said Mary Jo Kreitzer, who directs the Minnesota school’s alternative-medicine curriculum. “Ultimately, we need to align policy” so that insurers pay for these therapies, she said.

“Complementary and alternative medicine (CAM), more recently known as integrative health or integrative medicine, is a diverse field comprising numerous treatments and practitioners of various levels of training. This review defines several of the main CAM modalities and reviews some of the research relevant to their clinical application. The goal is to provide healthcare providers with a basic understanding of CAM to start the incorporation of proven treatments into their clinical practice as well as guide them to working with CAM providers; ultimately, such knowledge is a fundamental part of a collaborative approach to optimal patient health and wellness.”

How anyone can say that medical doctors and nurses should not be made aware of CAM, is ludicrous. The last I read, knowledge is defined as acquaintance with facts, truths, or principles, as from study or investigation; the body of truths or facts accumulated in the course of time.  The number of visits per year of Americans to practitioners of CAM has risen to over 600 million in 2007. That exceeds the total visits to all US primary care physicians!  I sure want my doctor to know what other options are out there for me when he or she is unable to help me. Or just to know what other therapies may actually be better for my particular ailment.

Basically, there is no “alternative medicine.” There is scientifically proven, evidence-based medicine and there is unproven medicine for which scientific evidence may be lacking. Whether a therapeutic practice is traditional or unconventional is irrelevant (except for cultural interest). There are vast differences in skills, knowledge and capabilities of both “Western” practitioners and “alternative” practitioners. Bottom line is that we need to focus on the fundamental issues here — namely the patient and the target disease or condition — and what is the best way to restore health. Let’s not forget preventative medicine, which is a much larger component to health care than conventional medicine allows. CAM seems to address prevention on a much larger scale if practiced appropriately.

Please do not shout out that there have been no “cures” found even after 10 years and billions of dollars spent. Find the facts and present them scientifically. Let us make up our own minds as to whether we deem them worth trying or not. And please don’t limit the education of our doctors and nurses who are struggling within this health care “system” we are currently dealing with as much as we are.

Dear Editor,

Here are just a few studies I found in a quick search of the literature. They are all well-designed studies appearing in peer-reviewed journals. Some show statistically significant effectiveness, some do not. This is the kind of solid research that is needed to differentiate between what is evidence-based good medicine and what is not. The evidence is mounting.

1. Meta-analysis: acupuncture for low back pain.  Ann Intern Med. 2005 Apr 19;142(8):651-63.

The 33 randomized, controlled trials that met inclusion criteria were subgrouped according to acute or chronic pain, style of acupuncture, and type of control group used. CONCLUSIONS: Acupuncture effectively relieves chronic low back pain. No evidence suggests that acupuncture is more effective than other active therapies.

2. A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain. Archives of Internal Medicine. 2009;169[9]:858–866.

People suffering from chronic low back pain who received acupuncture or simulated acupuncture treatments fared better than those receiving only conventional care according to a recent study published in the Archives of Internal Medicine. The study highlights central questions about the mechanisms of benefit seen in acupuncture studies.

3. Meta-analysis on acupuncture for treatment of depression in patients of poststroke

CONCLUSION: The therapeutic effect of acupuncture for treatment of the depression in patients of poststroke is superior to other common medicine with safety, but it still needs more large sample RCTs to verify.

4. Acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective complement to standard care. This landmark study was funded by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), both components of the National Institutes of Health. The findings of the study—the longest and largest randomized, controlled phase III clinical trial of acupuncture ever conducted—were published in the December 21, 2004, issue of the Annals of Internal Medicine.

5. NCCAM-funded researchers recently analyzed the use of prescription drugs and dietary supplements in a sample of 3,070 people aged 75 and older. Nearly 75 percent of the GEM study participants took at least one prescription drug and one dietary supplement. Approximately 33 percent used three or more prescription drugs and three or more supplements. Furthermore, 10 percent of the participants combined five or more prescription drugs with five or more dietary supplements. If this is happening, isnt it better for our doctors to know what the ramifications are?

The dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer’s disease in older people, according to a study published in the Journal of the American Medical Association

Also, the use of St. John’s Wort for depression was not found to be any more effective than placebo.

But the use of Red Yeast Rice was found to be effective for lowering bad cholesterol (LDLs) in the blood compared to a placebo.

Studies have been completed, but no results posted yet from NCCAM, for the use of laser light therapy for various disorders. Light energy therapies have been in practice for decades and much research has been published especially in the last 10 years or so. I look forward to the NCCAM’s clinical trial results so that this important adjunct therapy may become more recognized.

For additional information, call NCCAM’s Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site at nccam.nih.gov. NCCAM 1999–2009: Celebrating 10 years of rigorous research.

Vitamin D has been getting lot of press lately. It seems that deficiency in this vitamin can cause more problems than just rickets. Vitamin D is one of the oldest hormones, having been produced by life forms for over 750 million years. Phytoplankton, zooplankton, and most plants and animals that are exposed to sunlight have the capacity to make vitamin D. In humans, vitamin D is critically important for the development, growth, and maintenance of a healthy body, from birth until death. To give you an idea of how the sun helps us in this regard, a light-skinned person will synthesize 20,000 IU of vitamin D in 20 minutes sunbathing on a tropical beach, at which point vitamin D synthesis shuts down for the day (it takes a dark-skinned person 6 to 10 times longer to make this amount). Also to give you an idea of how far off the Recommended Daily Allowances (RDAs) are; recommended doses are from 200-600 IU depending on age. Intake reference values for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies (formerly National Academy of Sciences). In 2008, the American Academy of Pediatrics (AAP) issued recommended intakes for vitamin D that exceed those of FNB. The FNB established an expert committee in 2008 to review the DRIs for vitamin D (and calcium). The current DRIs for this nutrient were established in 1997, and since that time substantial new research has been published to justify a reevaluation of adequate vitamin D intakes for healthy populations. Determinations of DRIs are based on indicators of adequacy or hazard; dose-response curves; health outcomes; life-stage groups; and relations between intakes, biomarkers, and outcomes. For vitamin D, the FNB committee will focus on (1) effects of circulating concentrations of 25(OH)D on health outcomes, (2) effects of vitamin D intakes on circulating 25(OH)D and on health outcomes, and (3) levels of intake associated with adverse effects [21]. The FNB expects to issue its report, updating as appropriate the DRIs for vitamin D and calcium, by May 2010.

Very few foods in nature contain vitamin D. The flesh of fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks. Vitamin D in these foods is primarily in the form of vitamin D3 (cholecalciferol) and its metabolite 25(OH)D3]. Some mushrooms provide vitamin D2 (ergocalciferol) in variable amounts. Mushrooms with enhanced levels of vitamin D2 from being exposed to ultraviolet light under controlled conditions are also available. Fortified foods provide most of the vitamin D in the American diet.

A growing body of evidence suggests that Vitamin D deficiency is involved in a multitude of diseases and syndromes. From Alzheimer’s to autoimmune diseases, cancer and even the flu, it seems there is a connection with Vitamin D levels. There is good evidence that Vitamin D deficiency is a causal factor in some 15 different common cancers. (NEJM 2007;357:266–81.)

When scientists at the Australian Institute of Sport recently decided to check the Vitamin D status of some of that country’s elite female gymnasts, their findings were fairly alarming. Of the 18 gymnasts tested, 15 had levels that were “below current recommended guidelines for optimal bone health, the study’s authors report. Six of these had Vitamin D levels that would qualify as medically deficient. Unlike other nutrients, Vitamin D can be obtained by exposure to ultraviolet radiation from sunlight, as well as through foods or supplements. Of course, female gymnasts are not known for the quality or quantity of their diets, or for getting outside much.

But in another study presented at a conference earlier this year, researchers found that many of a group of distance runners also had poor Vitamin D status. Forty percent of the runners, who trained outdoors in sunny Baton Rouge, Louisiana, had insufficient Vitamin D. “It was something of a surprise,” says D. Enette Larson-Meyer, an assistant professor in the Department of Family and Consumer Sciences at the University of Wyoming and one of the authors of the study.

Vitamin D once was thought to be primarily involved in bone development. But a growing body of research suggests that it’s vital in multiple different bodily functions, including allowing body cells to utilize calcium (which is essential for cell metabolism), muscle fibers to develop and grow normally, and the immune system to function properly. Almost every cell in the body seems to have receptors for Vitamin D. “It can up-regulate and down-regulate hundreds, maybe even thousands of genes,” Larson-Meyer says. “We’re only at the start of understanding how important it is.”

But many of us, it seems, no matter how active and diligent we are about health, don’t get enough Vitamin D. Nowadays, many people aren’t going outside very much, and most of us apply sunscreen and take other precautions when we do. The Baton Rouge runners, for instance, most likely “ran early in the morning or late in the day,” Larson-Meyer says, reducing their chances of heat stroke or sunburn, but also reducing their exposure to sunlight.

Meanwhile, as suggested above, dietary sources of Vitamin D are meager. Cod-liver oil provides a whopping dose. But a glass of fortified milk provides a fraction of what scientists now think we need per day.  A major study published online in the journal Pediatrics last year concluded that more than 60 percent of American children, or almost 51 million kids, have “insufficient” levels of Vitamin D and another 9 percent, or 7.6 million children, are clinically “deficient,” a serious condition. Cases of childhood rickets, a bone disease caused by lack of Vitamin D, have been rising in the U.S. in recent years.

Although few studies have looked closely at the issue of Vitamin D and athletic performance, those that have are suggestive. A series of strange and evocative studies undertaken decades ago in Russia and Germany, for instance, suggest that the Eastern Bloc nations may have depended in part on sunlamps and Vitamin D to produce their preternaturally well-muscled and world-beating athletes. In one of the studies, four Russian sprinters were doused with artificial, ultraviolet light. Another group wasn’t. Both trained identically for the 100-meter dash. The control group lowered their sprint times by 1.7 percent. The radiated runners, in comparison, improved by an impressive 7.4 percent.

How much is safe?

So, maybe this is one area where supplements may be in order, but how much to take? “1,000 IU a day and much more for people who are deficient” is probably close to ideal, Larson-Meyer says. This, by the way, is about double the current

Most supplements are not adequate!

recommended daily allowance. Most experts anticipate that this allowance will be revised upward soon. “Well adults and adolescents should take 5,000 IU per day. Two months later have a 25-hydroxyvitamin D blood test, either through ZRT (see below*) or your doctor”, says John Jacob Cannell MD Executive Director, Vitamin D Council.

“National recommendations from the Food and Nutrition Board are 400 to 600 International Units (IU) a day,” Neil Binkley, MD, an Associate Professor in Geriatrics and Endocrinology at the University of Wisconsin said. “That’s simply not enough. Experts recommend somewhere between 1500 to 2600 IU daily. It’s considered a very safe vitamin. One would need daily doses of 40,000 IU or higher before seeing negative side effects.”

Vitamin D is essential for bone health, but Binkley discussed its role in improving muscle function. “One of the primary killers among older adults is falls,” Binkley said. “A sufficient amount of Vitamin D not only enhances bone strength but also improves muscle function thereby reducing the risk of fractures.”

Vitamin D receptors have been discovered in many tissues throughout the body. “There’s a lot that is unknown about vitamin D right now,” Dr. Binkley said. “But there is one certainty – its importance is widespread.” The ubiquitous effects of the “sunshine vitamin” are demonstrated by research studies associating lower circulating vitamin D levels with cancer, type 1 diabetes and cardiovascular disease.

No matter what the experts are saying, the current recommendation seems to be a far cry from what is ideal. Consult with your doctor before beginning supplements. Overdoses of Vitamin D are rare, but can occur.

Flu prevention?

Another side to this that has been getting not nearly enough press is that Vitamin D levels in the blood fall to their lowest point during flu seasons. Unable to be protected by the body’s own antibiotics (antimicrobial peptides) that this gene-expresser engineers, a person with a low vitamin D blood level is more vulnerable to contracting colds, influenza, and other respiratory infections, says Dr. Donald W. Miller, a cardiac surgeon and Professor of Surgery at the University of Washington in Seattle, and former head of cardiac surgery at the VA hospital in Seattle. (His web site is www.donaldmiller.com). There seems to be an interesting correlation between Vitamin D levels and immunity.Why is flu season when sunshine is at it’s lowest level in both hemispheres? Something that scientists are finally zooming in on.

Other things you can do to prevent the flu, according to Dr. Miller: “Avoid sugar. It suppresses immunity. Avoid Omega-6 vegetable oils (corn, safflower, sunflower, peanut, canola, and soybean oil). Americans consume 50 times more of these oils than are necessary for good health. In this amount they are powerful immune suppressants. Take a well-balanced multivitamin/mineral capsule on a daily basis. Eat garlic. Manage stress. Exercise. Get enough rest. And wash your hands. Viruses spread most often from touching contaminated objects, like doorknobs, phones, shared computer keyboards, and shaking hands.”  Hmmm… flu protection in a vitamin? So much safer and cheaper than flu shots, yes?

What can you do?

Get tested for your Vitamin D levels. The only blood test that can diagnose vitamin D deficiency is a 25-hydroxyvitamin D. Dr. Cannell, Dr. Miller, and others (including my MD colleagues at Canyon Ranch) agree that levels should be above 50 ng/ml year-round. Your doctor may try to tell you that anything above 30ng/ml is normal. But it seems that “normal” is not ideal. It can take 2-3 months for the right amount of supplementation to show up in the blood levels, so leave enough time before being re-tested.

* The Vitamin D Council has partnered with ZRT Labs to make a discounted take-home Vitamin D Test Kit that you can order on the Internet. A portion of the proceeds from the sale of each test will be donated to the Vitamin D Council by ZRT to help in their mission to end the worldwide epidemic of vitamin D deficiency. The tests will be available to order in either a quantity of one (1) or four (4). I checked the website today and the one-test kit was $65 and the 4-test kit $220. The 4 test kit is $10 less expensive per test. If you have insurance, you may just want to ask your doctor for a test. Make sure it tests for 25-hydroxyvitamin D.

So, the bottom-line (as I always like to give)… There seems to be balance and moderation in the amount of sunlight exposure (unprotected) that we need for our body to synthesize Vitamin D, and not to stimulate cancer cell growth. Gosh, that moderation thing just keeps showing up, over and over again!

How many of you have had your Vitamin D levels checked? Are (were) you deficient?  Do you care?

Sunshine and good health to all of you!

*** Remember… this is not meant to be a substitute for medical advice. Please discuss your individual situation with your doctor.

It’s Friday! Happy Halloween! Time to check in with our healthy behavior goals.

I maintain my beautiful weight this week. I am trying to look at it from that perspective right now. I am not gaining!  After 5 weeks of trying, I am only 2 lbs. down! Frustrating! Right now, I have been restricted in my physical activity and that, in turn, has caused me to have more nights at home not doing much physical activity and with more access to food! It has been a difficult struggle, but I am not giving up!

What I thought I would focus on this week, is healthy living in general. If you are familiar with Dr. Oz, he made these 5 simple recommendations on the Oprah Show a while back (before he got his own show). Not sure I completely agree with them all, but I think it is a good place to start. I took the liberty (forgive me Dr. Oz) of re-prioritizing them. But, it doesn’t matter what order they are in. If you pay attention to all 5 you will live a healthier life.

1. 

   Getting enough sleep is more important than you think!

   Sleep and Sex. I put this one first because you can do everything else, but you won’t feel good or be healthy if you don’t get enough sleep. Research has shown, that no matter what you think you have trained yourself to “get away with” sleep-wise, MOST adults need 7-8 hours of sleep a night.  There are very few exceptions. It is amazing what goes on in your body when you sleep.  Dr. Oz also recommends that you have sex 2-3 times a week (to garner all those health benefits I mentioned in an earlier article.)

2. Food. He recommends adding the following to your diet;  foods high in anti-oxidants (5-7 servings a day),  At
   

   Eat 5-7 servings of foods rich in anti-oxidants

   least 25g of fiber, 3g/day of omega-3’s (walnuts, flax seed, salmon), red wine or grape juice (1 glass a day), and 4 cups of green or white tea.

3. Exercise. Dr. Oz’s recommendations are for at least 30 minutes a week of strength-training and at least 3 times a week getting your heart rate up with aerobic exercise (60 minutes a week). He also recommends walking every day.
4. Meditate. Trying to reduce stress is important to keep healthy. Dr. Oz suggests that even 5 minutes a day of focused relaxation (meditation) can help you to reduce stress.
5. Vitamins. This is where Dr. Oz and I may differ. Vitamin crazes have come and gone so many times in my career as a health educator.  Does anyone remember Dr. Kenneth Cooper’s “Antioxidant Revolution”? Since his extreme vitamin recommendations back in 1995, we have found that it is not possible to get all of the benefits of these antioxidants in a pill form. There are too many other factors in the whole foods that require a balanced diet to be healthy. You can’t maintain your health by eating poorly and popping vitamins. However, a decent multi-vitamin supplement should suffice if you are maintaining that healthy diet. Some populations may require additional calcium and Vit D as well.

That’s it! Five things!  How many of them are you currently practicing?

Reminder: Please consult with your doctor or health practitioner for medical advice and treatment before starting any new program.

This morning on the Today Show, I watched an update that Matt Lauer did with David Zinczenko who has co-written the books and spearheaded the movement, called “Eat This, Not That”.

Some of the national chain restaurants that were targeted in the past, but have improved their menus in response to this (and a consumer movement) are Red Lobster, Romano’s Macaroni Grill, Starbucks, Jamba Juice, and Ruby Tuesdays.

The good news is that restaurants are responding! Since the first book in 2007, Eat This, Not That has helped call attention to restaurants that serve meals with trans-fatty oils, calorie-and sodium-counts reaching into the thousands, or are low in nutritional value but saturated (pardon the reiteration) with saturated fat.

Since the first published list of the 20 Worst Foods in America over two years ago, a full 10 of those dishes have either disappeared or have been altered significantly. The following items have disappeared from menus:

Baskin-Robbins Chocolate Oreo Shake (Large)
2,600 calories
135 g fat (59 g saturated, 2.5 g trans)
263 g sugars
1,700 mg sodium

Romano’s Macaroni Grill Kids’ Double Macaroni ‘N’ Cheese
1,210 calories
62 g fat
3,450 mg sodium

Ruby Tuesday Colossal Burger
2,014 calories
141 g fat
95 g carbohydrates

The Seared Sea Scallops Salad from Macaroni Grill, a “leafy abomination packed in 1,170 calories, 27 grams of saturated fat, and 2,680 milligrams of sodium” has undergone a 64 percent reduction in calories and an 85% reduction in saturated fat, making it the Most Improved Meal in America.

Eat This at Romano’s Macaroni Grill:

Scallops and Spinach Salad
420 calories
4 g saturated fat
1,510 mg sodium

Then there are the restaurants that refused to disclose (Chipotle comes to mind for me). Red Lobster was one of a handful of restaurant chains that refused to share their food’s nutrition information.  Hmmm… if you won’t talk, you must be hiding something. Fast-forward two years, and in their newest book, “Eat This, Not That! 2010,” Red Lobster has a score of A-. That’s the highest grade for any restaurant in America! It’s largely due to a host of incredibly lean seafood dishes, very few fried foods on the menu, and excellent, low-calorie sides. When at Red Lobster, they recommend you choose an item from the Wood-Grilled menu, and ask for a baked potato with pico de gallo on the side. You’ll consume around 500 calories for an entire meal!

Red Lobster is unique in that it’s a sit-down restaurant that offers nutritious and light sides. Unfortunately, most other restaurants don’t.

Starbucks has expanded its food menu recently and the Egg White, Spinach, and Feta Wrap has just 280 calories and 9 grams of fat, but it’s absolutely packed with 19 grams of protein and 8 grams of fiber. Both slow your digestion, which means you’re eating a light, low-calorie meal, but you won’t feel hungry again for hours. Exactly what you want for breakfast.

Eat This at Starbucks:

Egg White, Spinach, and Feta Wrap
280 calories

9 g fat (3.5 g saturated)

1,140 mg sodium

Here are 5 restaurant survival tips recommended by the authors:

Check the company’s website before you go out
Many of them are now listing the calorie counts, and you’ll know what you’re ordering when you go. If that information isn’t available, you’re at an enormous disadvantage and you may want to consider other options. ** My note: Frequent the restaurants that give that information. It will encourage others to follow suit!

Avoid anything with the word “crispy” or “crisper” in its name
That just means breaded, fried and loaded with bad-for-you fats.

Be careful what you drink
We now drink twice as many calories as we did 30 years ago — more than 400 calories a day! Switch to low-calorie options and you can lose a lot of weight without changing what you eat at all. Or, if you must have that full-calorie drink, order the small size. You might feel as if you’re not getting your money’s worth, but new research from Duke University shows that’s not actually the case. See, the researchers discovered that some fast-food chains are encouraging customers to buy larger soft drinks — which justifies higher prices — by increasing the number of ounces in all sizes of drinks. They know what you may not: Most people subconsciously pick the middle option without considering the actual amount.

Avoid combo meals
The average “value” meal packs 1,200 calories! You might be saving more money than if you had ordered all items in the meal separately, but that’s NOT a deal you want to make.

Remember that the waiter is a salesperson
It’s his job to get you to open your wallet. A 2005 study from the Journal of Retailing and Consumer Services found that you’re more likely to order a side dish when the server verbally prompts you. Remember this the next time you hear, “Do you want fries with that?”

Bottom line… Tucson Restaurants LISTEN UP!!  There is a growing contingent of customers who will greatly appreciate being able to make informed choices when it comes to eating out. I beg you, PLEASE, let us know what we are getting into! We may not make the healthiest choices, but at least we will know what we are doing!

Side Note: I have to give a plug here for Pastiche. I tend to go there more often and recommend it to others for several reasons; they offer “bistro portions” so that I can get a smaller serving, they are very community-minded; they are open till midnight; and they are becoming more “green” in their operations.  My plea to other Tucson Originals: Please offer smaller, healthier offerings and give us nutritional information! I will love you forever!

Oh… and Chipotle... give me nutritional information (at least online the way your previous parent company McDonalds does) and I will frequent and recommend your restaurant much more often! Love the food! Yes, you recycle, don’t serve artificial ingredients, and ad negligible trans fats, but that doesn’t help me know how many calories are in my favorite burrito (even if I get it without the tortilla!) And can’t we make those burritos half the size?

We are all trying to live a little bit more frugally these days.  But we can’t ruin our health and the environment in the process! I am here to tell you that you don’t have to!

Here is Part Two of my socio-economic experiment on whether it is cheaper to eat poorly.

Today… Home-cooked meals.

In putting this together, I made all the grocery purchases, calculated the costs and determined the nutritional value (using nutritional software) of several family meals. Costs were calculated as precisely as possible, but I erred on the side of more when in doubt. For example, if I paid $5 for a jar of spices and I used one teaspoon, I estimated I used about 1/20th of the jar so it cost 25 cents. I used some ingredients that people on a budget may think are expensive (such as olive oil rather than vegetable oil), but I felt the nutritional value was important. Even though I may have spent $15 for a liter of olive oil, each tablespoon costs only 23 cents. So, if used judiciously, olive oil is not so expensive. I also prepared all the meals and timed myself doing it. Here are my results.

I adhered to the following criteria for compiling the meals:

1. All meals needed to provide the recommended values of percent fat, protein and carbohydrates as well as fiber and sodium levels.
2. All meals needed to cost less than $20 for a family of four (excluding drinks).
3. All meals should take about 30-45 minutes to prepare (or less).
4. Meals should not require any fancy ingredients that you cannot find at your local grocery store.

I am happy to report that it was not very difficult to do. I was able to come up with many recipes that easily fit this criteria. Very healthy, low-cost, easy-to-prepare meals are numerous! Two of the meals were under $11 and one meal (since I splurged on fresh berries) came in under $18. All home-cooked meals were cheaper than fast food! And MUCH more nutritious! I will provide three recipes here today and offer several more in the next coming weeks that all meet the criteria. My hope is that you will be inspired to create great home-cooked meals more often and boost your immunity for the upcoming flu season!

There is one thing that I forgot to mention in my post on fast food. With very little fruits and vegetables (if any) on those menus, it is basically empty calories that will not boost your health and immunity the way these meals will.

There is one caveat, of course. That is that you have to do a little planning and grocery shopping and

Cooking as a family can be a fun activity!

then it will require a little extra time on your part for preparation. But if a meal takes 45 minutes to get on the table, that is really only an extra 25-30 minutes (it would take you about 15-20 minutes extra to stop at the fast food place). Also, it can become a family affair with bonding time and pride in the preparation if you solicit help from family members. Eating healthy does not have to be time-consuming or costly.

Comparison bottom-line:

• Home-cooked meals were cheaper ($11-$18 vs $18-$20 for fast food)
• Home-cooked meals had fewer Calories (453-671 Calories per serving vs. 490-940 Calories per meal for fast food) – I decided to look at Calories per dollar for those that claim they just need to get as many Calories for their family as they can for their money. My home-cooked meals ranged from 146-252 Calories per dollar vs. 136-167 Calories per dollar for fast food.  There is no argument there. You not only get as many Calories per dollar, but so much more nutrition! And so much better for long-term health.
• Home-cooked meals had less fat ( 23-25% of Calories vs. 43-47% for fast food)
• Home-cooked meals had more protein (19-29% of Calories vs. 13-23% for fast food), this was actually surprising.
• Home-cooked meals had more fiber (12-19 g per serving vs. 3-6g per meal for fast food)
• Home-cooked meals had less sodium (326-781 mg per serving vs. 915-2240mg per meal for fast food)

(See my article on fast food)

As a reminder… Dietary recommendations are as follows:

Fat – 20-35% of daily Calories (less than 20% for heart-healthy recomendations)

Protein – 10-20% of daily Calories (recommendations vary depending on size, gender, physical activity – 50-80 g/day)

Carbohydrates – 55-65% of daily Calories (I did not include carbohydrate info since if fat, protein and fiber recommendations are met, carbs will follow). Whole grains plus lots of fruits and vegetables are the best carbs.

Fiber – Recommendations vary depending on gender and age, but in general, women should get at least 25g of fiber per day and men should get about 38g per day.

Sodium – Maximum recommendations are no more than 2,300 mg sodium/day.

Tips for cooking on a budget:

• Cut protein (meat or tofu) into smaller pieces before cooking. It goes a lot further.
• Use less of expensive items like cheese. If you cut back slowly over time, you may find you only need half as much as you thought.
• Add beans or lentils or brown rice or whole wheat pasta to your recipes as nutritious fillers. Then you need less of the more expensive items like meat.
• Utilize leftovers. Search for recipes with ingredients you have in your house already. Don’t let food go bad. The most expensive food is what you throw away.
• Eat produce that is in season. It is less expensive and it doesn’t have to travel as far to get to you, which means it is better for the environment.
• Get to know prices. Read grocery ads and plan your weekly menus based on sales.  Get to know what things cost, and what a good deal is.
• Use your freezer. Freeze leftovers to use in a pinch when time is not on your side.

Meal Number One

Healthy meal in no time!

Cajun Sausage, Beans and Rice

Serves 6 Prep time:  40 minutes.

Cost for entire recipe: $10.79 ($12.78 with bread and butter)

This recipe used andouille sausage, but could be made even healthier with turkey kielbasa or Canadian bacon. The smoky chipotle flavor adds just the right kick. You can use red pepper flakes instead if you can’t find the dried chipotle. Fast, easy one pot meal.

You may want to add a piece of whole grain bread (and a small pat of butter) for each person. That would add about $1.99 to the total cost and 116 calories per serving (2.8g fat, 3.2g protein, 2g fiber, 30 mg sodium).  Still very much within our guidelines!

Ingredients:

• 4-6 cups water, divided
• 1 cup brown rice (yields about 3-1/2  cups prepared)
• 1 T olive oil
• 4 andouille sausage links (Aidells brand) – 12 oz., sliced
• 1-1/2 cups chopped potatoes (with skin on)
• 1-1/2 cups chopped carrots
• 1 onion, chopped
• 4 cloves garlic, chopped
• bay leaf, some dried herbs of choice, black pepper, to taste
• 1 tsp dried chipotle pepper (optional)
• 1 tsp (or less) of cayenne pepper, to taste
• 1 can kidney beans (15 oz), drained and rinsed
• 1 can garbanzo beans (15 oz), drained and rinsed
• 1 can diced tomatoes (15 oz)
• 1 cup fresh spinach

Directions:

Prepare rice according to package directions.

While rice is cooking, heat olive oil in large skillet or pot and brown the sausage. Add the vegetables to the pot and saute for about 5 minutes, stirring frequently. Add spices, beans and tomatoes along with a cup or two of water and cook for 15-20 minutes or until the vegetables are cooked to your liking.  Add extra water as necessary to make it as soupy as you wish. Add the spinach at the last minute and serve immediately. You can either add the rice to the bean mixture, or serve the beans and vegetables over the rice.

This recipe makes great leftovers (I included 2 extra servings). It tends to get sticky, so you may need to add a little more water when reheating it. Perfect to take for lunch the next day.

Nutritional Info:

Per serving:

453 Calories,  12.3g fat (25% of Cal),  21.4g protein (20% of Cal),   11.8 g fiber (31-47% daily req.),  781 mg sodium (34% of daily max).

Meal Number Two/Three

Veggies are cooking before adding chicken, beans and pasta

This is two meals in one. You buy a roasted deli chicken and use about 2/3 of it for one meal and the leftovers (including the bones) to make a second meal. The same vegetables can be used for both recipes. You can substitute any vegetables you happen to have in your fridge. I will report them separately.

Chicken Pasta and Veggies

This is a very easy, very high protein and fiber meal with generous serving sizes. This makes a very hearty meal for four people. You may have some leftovers if you have lighter eaters in your family.

Serves 4        Prep time: 30 minutes       Total Cost: $10.81

Ingredients:

• 3 cups cooked whole wheat pasta (I used half a box of Barilla whole grain penne)
  
• 2 tablespoons olive oil
• 2 cloves garlic, chopped
• 1 onion, chopped
• 1 cup chopped bell peppers (I used red)
• 2 cups chopped carrots
• 2 cups cut green beans
• 1-1/2 cups frozen corn (can use fresh if you like)
• 2/3 of deli-roasted chicken (about 3 cups chopped meat) – you can use fresh chicken breasts you cook yourself
  
• 1 cup vegetable broth (can use lower sodium chicken broth)
• 2 cups cooked black beans (can use canned)
• 1 cup fresh spinach (optional)
  

Directions:

While cooking pasta, heat 1 T olive oil in a large skillet. Add garlic and onions and saute for a few minutes. Add peppers, carrots and green beans and saute a few minutes more. Add the second tablespoon of olive oil and add corn and chicken and brown everything very lightly. Add broth and black beans and cook for about 5-10 minutes or until vegetables are tender as per your preference.  Add pasta to the skillet, if large enough, or pour skillet contents over pasta in a large serving bowl. Use a bit of reserved pasta water to add liquid if needed. Add spinach at the last minute, if desired, toss and serve.

Note: Don’t forget to take all the meat off off the bones and save 1/3 of it or so for tomorrow’s soup. Simmer the bones in a pot of water while eating dinner to use for tomorrow as well.

Nutritional Info:

Per serving:  671 Calories,  17g fat (23% of Cal),  48.5g protein (29% of Cal),  19g fiber (50-76% of rec),  466 mg sodium (20% of daily max)

Chicken Vegetable Soup

Since the vegetable soup is so low in Calories, I have included a dessert. I splurged on the fresh berries, but you can cut costs if you used fresh peaches or bananas instead.  The soup can be as quick as 30 minutes if you use store-bought vegetable (or chicken broth) or a bit longer is you are making your own broth from the chicken bones above. Hopefully, you simmered the bones in water while eating dinner last night and now you are just reheating and simmering a bit longer. Then strain and follow recipe.

Serves 4, generously      Prep time: 30-45 minutes     Total Cost (including bread and dessert):  $17.59

Ingredients:

Soup:

• 8 cups chicken broth (pre-made from deli-roasted chicken bones)
• 2 cups vegetable broth
• 1 cup chopped onion
  
• 2 cups chopped carrots
• 2 cups cut green beans
• 1 cup chopped broccoli
• 1 cup frozen corn
• 1 cup chopped chicken meat
• Spices (bay leaves, herbes de provence, black pepper, etc)
• 2 cups cooked whole wheat pasta

4 large slices whole grain bread

4 small pats of butter

Dessert:

• 2 cups vanilla ice cream
• 2 cups mixed fresh berries

Directions:

Cook pasta according to package directions. Meanwhile, cut up all vegetables. Add vegetables and spices to a pot with the broth. Bring to a boil, then reduce heat and simmer until vegetables are cooked.  Serve over 1/2 cup pasta for each bowl.  Use bread for dipping if you like.

After dinner, scoop out 1/2 cup ice cream in each bowl and top with 1/2 cup fresh berries.

Nutritional Info (for entire meal, including bread and dessert):

Per serving:  644 Calories,  14.5g fat (20% of Cal),  31 g protein (19% of Cal),  13g fiber (34-52% of daily rec), 326 mg sodium (14% of daily max)
I hope you can see more clearly now that you don’t have to eat poorly to eat cheaply. All it will cost you is a little extra time.

Let me do one last calculation. If you eat 7 meals per week of fast food (for a family of four) at almost $20 per time, you spend $140 a week. By cooking low-budget meals at home for $12 per meal for four people as I have shown here is possible, you will save $63 a week, $252 a month and more than $3,000 a year!! Wow! Even if you only replace 3 meals a week with home-cooked meals, you will save $1,152 in a year. Imagine what  struggling family could do with eleven hundred dollars!

Have fun with it! I hope you find my recipes helpful. I’d love to hear your feedback. There was a lot of time and detail in putting this together, so please let me know what you think, one way or the other.

Happy meals to all of you!!

Happy Friday! Healthy Behaviors check-in day!

I am struggling. I felt I was so much better this week with my portion control and still no weight loss! I am still only 1.5 lbs down after 4 weeks! Yikes! I am not a very good example. I need help and encouragement from some of you!

I can try to blame a lot of it on my exercise restrictions. I am in the “healing” phase (hopefully) with my achilles and I am not able to run, walk, dance, play tennis at this time. I am restricted to the exercise bike and the pool. Neither of which I feel like I can get my heart rate up well enough. Plus they are very boring to me at this point! Oh well… I cannot make excuses! Onward! At least I can still do my weight training.

In the meantime, I need to get this done and get to the gym.

Keep up your healthy dreams!

Today, I decided to continue with the dietary thoughts from yesterdays post on fast food. We were discussing recommendations, so I thought these new guidelines might be worth reading.

New dietary guidelines from the U.S. Departments of Health and Human Services (HHS) and Agriculture (USDA) recommend fewer calories and smarter food choices.

Some of the key recommendations:

• Follow a balanced diet that is low in saturated and trans fats, cholesterol, added sugars, salt, and alcohol, such as the Dietary Approaches to Stop Hypertension (DASH) Eating Plan.
• Balance your calorie intake with exercise. Slowly decrease the amount of calories you take in while increasing exercise to prevent gradual weight gain over time. Exercise regularly and reduce activities in which you sit (such as watching TV).
• Eat 2 cups (4 servings) of fruit and 2 1/2 cups of vegetables (5 servings) per day for an average 2,000-calorie per day diet.
• Eat 3 or more ounces of whole-grain products per day.
• Consume 3 cups per day of fat-free or low-fat milk or milk products.
• Get fewer than 10% of calories from saturated fatty acids.
• Avoid trans fatty acids.
• Limit cholesterol intake to less than 300 mg/day.
• Make total fat intake no more than 20 – 35% of calories. Choose “good” fats such as fish, nuts, and vegetable oils containing polyunsaturated and monounsaturated fatty acids. Lean, low-fat, or fat-free meats, poultry, dry beans, and milk or milk products are preferable. Total fat intake can approach 35% if most of the fats are “good” fats.
• Stay away from added sugars.
• Consume fewer than 2,300 mg (approximately one teaspoon of salt) of sodium daily, and limit added salt when you prepare food.
• Do not consume more than 1 alcoholic drink per day for women, 2 per day for men. Certain people should not drink any alcohol.

So, there you have it. How many of these guidelines do you follow? Is any of this helpful to you? Are you surprised about any of the guidelines?

And most of all, how are you doing on your healthy behavior goals?  It’s not to late to begin, or start again! Till next week… keep fit, keep healthy.

Burlington, Vermont… #1 city to raise a family.

One of the criteria for why this city was chosen was that they have the lowest obesity rate of any city in the nation, and guess what? Burlington also has the the lowest number of fast food restaurants per capita! Hmmmm…

Speaking of fast food restaurants, I am finally going to submit my first entry in the socio-economic experiment. Fast food meals. I visited McDonald’s restaurants and Burger King restaurants in two different areas of Tucson to see what it costs for a family of four to eat at these convenience restaurants.  Prices were very similar except for the tax amount in the city of South Tucson is 8.1% vs. 6.1% in Pima County. I used the lowest prices for my comparison. Here are the criteria that I used:

• I tried to order both frugally and picking “better” choices when possible.
• I ordered for a typical family of four with two adults and one younger child and one older child.
• I did not include drinks unless they were part of a “Value Meal” that would have been more expensive to do separately. Drinks were only included in calorie counts for kid’s meals (since they came as part of it).
• Price totals include 6.1% tax.

Here are the details:

Burger King

"Have it your way"

1 Grilled chicken sandwich and small fries  –  $6.68

830 Cal, 38 g Fat, 30 g Pro, 95 g Carbs

1 Steakhouse Burger and medium fries  –  $6.58

1,430 Cal, 82 g Fat, 45 g Pro, 156 Carbs

1 Whopper Jr. and Value fries  –  $2.00

590 Cal, 32 g Fat, 21 g Pro, 59 g Carbs

1 Kid’s Meal (4 piece chicken tenders, value fries and milk)  –  $3.49

490 Cal, 23.5 g Fat, 15.5 g Pro, 57 g Carbs

Total Bill (including tax)  –  $19.89

Total Nutrition — 3,340 Calories, 175.5 g Fat (47%), 111 g Protein (13%), 367 g Carbohydrates (44%)

McDonald’s

"I'm Likin' It"

1 Angus Deluxe with side salad and ranch dressing   –  $ 5.98

940 Cal, 54 g Fat, 47 g Pro, 74 g Carbs

1 Southwest Salad with crispy chicken (low-fat Italian dressing)  –  $5.19          490 Cal, 22 g fat, 27 g pro, 38 g Carbs

1 McChicken sandwich with fruit and yogurt parfait –  $2.00

520 Cal, 18 g Fat, 18 g Pro, 71 g Carbs

1 Happy Meal (4 piece chicken nuggets, small fries,  milk) — $3.99

520 Cal, 25 g Fat, 20 g Pro, 52 g Carbs

Total bill (including tax) –  $18.21

Total Nutrition — 2,470 Calories, 119 g Fat (43%), 139 g Protein (23%), 235 g Carbohydrates (38%)

While we are looking at nutrition, let’s examine what percentages are considered healthy and appropriate for the various foods we eat.

It is widely recommended that a well-balanced diet will contain about 20-35% of total Calories from fat (heart-healthy diets are recommended to be 10-20%). As you can see, the meals from the fast food restaurants averaged between 43 and 47% Calories from fat. That is well above even the highest end of what is recommended. And more than double what would be prudent for heart health.  But we all know this, don’t we?And don’t even get me started on saturated fat. We should consume no more than 7% of our Calories from saturated fat. The above menus contain about 15% Calories from saturated fat. More than double.

Protein recommendations are a bit more complicated. It is recommended that we consume about 1 gram of protein for every pound of body weight. This is sometimes looked at as 0.8g per pound of muscle mass and of course athletes and body builders try to consume about 1.5g per pound of muscle mass. We will keep it simple. About 10-20% of your calories (no more than 30%) should come from protein. The meals above meet this requirement. The problem is the protein in these meals comes from non-lean sources as indicated by the total fat and saturated fat content. Most protein should come from lean sources (such as poultry, low-fat dairy, soy, egg whites, beans, lean beef and pork tenderloin).

It is recommended that 55-65% of Calories come from carbohydrates.  The meals above are lower in carbs than recommended, but it is due to the high fat content rather than protein sources. And once again, the source of carbohydrates is very important. Whole grain sources as well as fruits and vegetables should make up the bulk of your carbohydrate intake. Very little, if any, such sources found above.

Let’s not forget about vitamins, minerals and fiber. Three VERY important components that are sorely lacking in the fast food diet. Research is finding that you cannot get all the same benefits of whole foods vitamins and minerals from a pill. And If you do not eat foods which contain enough fiber you might end up with problems of the colon and rectum and will not be helping your cholesterol and heart health any. It is recommended that you consume 14g of fiber for every 1000 Calories.  To give an example, the Angus Deluxe and side salad above has 940 Calories and only 5g of fiber. That many Calories should have 13g of fiber. That’s not even half of what is recommended.

And don’t even get me started on the sodium!

If you’re looking at the Dollar Menu in terms of how much food (and Calories) you get it really appears as a good bargain.  But if you’re looking at it as how many nutrients are you getting for a dollar, it is the LEAST economical!

McDonald’s says it seeks to provide options for its customers, at both low and higher prices. “We’re proud of the choices we offer customers,” said Bill Lamar, chief marketing officer for McDonald’s United States business. “You can come in and order Apple Dippers, salads with low-fat dressing, yogurt, or you can order an Egg McMuffin, which is a very nutritious sandwich. People can make the decisions about how to eat for themselves.”

Two comments I have here. Even if you choose the lowest fat salad meal (that has protein) which is the Southwest Salad with Grilled Chicken and a low-fat dressing, you are still over the highest recommendation for fat (35%) since the salad and dressing come to 37% fat.  And we all know, very few people actually order the grilled chicken salad. Actually, since McDonald’s started advertising the Dollar Menu nationally, the double cheeseburger has become the chain’s most ordered item. The double cheeseburger weighs in at 47% fat. Almost half of the Calories are from fat!

The other comment is that in order to make “healthier” choices, it costs more.  At Burger King, in order to switch out the Value fries for Apple fries in a Kid’s Meal, it will cost you 79 cents more (that’s 23% more).  A budget-conscious family is going to order mostly from the Dollar Menu which has almost no healthy choices. The Fruit and Yogurt Parfait is the only exception. All in all, the high fat and low nutrition on the Dollar Menu is a recipe for disaster for the health of our community.

Bottom line, you can feed a family of four for under $20, quickly and easily. But at what health costs to you and your children? At what cost to your child’s development and future health? Not to mention the costs to our environment (see my article on The Cost of Eating Cheaply). I understand the convenience and ease of feeding your family this way when couples (or single parents) are working full-time and exhausted at the end of the day. And when kid’s activities pull you away from the kitchen. My hope is that with this information and armed with my recipes and tips in the next week or so, you will make this a rare event, rather than a regular one.

So, my job is to find easy, healthy, budget-conscious meals for a family of four for under $20. I think I can do it! Stay-tuned… the best is yet to come!

Okay, let’s face it. We all have a lot of excuses as to why or how we cannot bring new, healthy behaviors into our lives. Most of the excuses revolve around time. Between work, and children and living companions and animals and house maintenance, etc. there are a million excuses. So, I thought it might be nice to suggest some simple ways to sneak healthy behaviors into our lives. Here are my top 10 (as of today!):

1. Commit to 15 minutes! I spent a lot of time, while consulting at a premier spa, helping people find time to exercise. These were busy people, sometimes very famous people, who had a hard time fitting exercise into their lives, especially if their looks were not a factor in their fame. But the great thing about most of these people is that they usually had, or could easily get, access to wonderful exercise equipment. Many of them had treadmills, or exercise bikes or elliptical trainers in their homes, but they never used them. One way I was able to get people started into a more active lifestyle was to suggest they only do 15 minutes (actually in some cases, I only required 10 minutes, but that’s another story). No matter how busy your life is, you can usually find 15 lousy minutes to get on the bike or treadmill or elliptical, or, for those of us without the equipment, go for a walk or jog or swim.  If you tell yourself you only have to do 15 minutes (or 10 minutes!) then it is a much easier commitment. Some days that is all you will do and that is better than nothing. But most times, you will find that after 10 or 15 minutes you are starting to feel good and it will be just fine to do 5 more minutes or 5 more minutes after that. But the bottom line is you have my permission to do only 15 minutes!
2. 

   An exercise ball at your desk forces you to sit with good posture

   Practice good posture. Have you ever seen an unhealthy person with good posture? Not usually. On the other hand, have you ever seen a healthy person with bad posture? Of course you have!  Our whole inner being and happiness and health is reflected in how we carry ourselves.  The only way to have and maintain good posture is to practice it.   Set an alarm on your phone. Wear a ribbon or rubber band around your wrist. Put a sign in your work area. Something to remind you to straighten up. The more times you can do this in a day, the better your posture will be without thinking. Another thing you can do is bring an exercise ball to your desk. One of those large balls that you can sit on while you work at your desk. The act of sitting on these balls automatically puts you in good posture. And you can burn a few more calories by bouncing around on it!

3. If you have a sweet tooth, choose fruit. When you have that craving for something sweet, try a piece of fruit and see what happens before you indulge in the candy bar or piece of cake. You may be surprised how well it works if you give it a chance.
4. Practice portion control. This is more difficult than it sounds, but try very hard to cut your portions in half for a week and see what happens. Put half of that restaurant meal away before you even start or take only half of what you usually do at home and see if you really want more when you are done.
5. Add vegetables to frozen/saved meals. There are quite a few healthy frozen dinners out there these days. Part of the problem is that the portions and calories can be quite small and leave us feeling unsatisfied which can lead to overeating things that may not be so good for us! What I like to do is just throw in some fresh cut veggies to bulk up the meal without adding a lot of empty calories. I sometimes cut up a bunch and keep them in a zip-loc bag in the fridge to use during the week.  You can do this with saved meals from a restaurant as well.
6. 

   Exercise during TV commercial breaks!

   Exercise in front of the TV. Even if it is only during the commercials, get down on the floor or on your exercise ball and do a few sit-ups, pushups, planks (or other core body work as I demonstrated in an earlier post). Or just do your stretching while watching TV. You will feel so much better about indulging in your favorite TV show!

7. Drink more water. Try to drink at least one 8-ounce glass of water with each meal and one in between each meal. And try to drink a glass of water in between each alcoholic drink when you imbibe. You will eat a slightly smaller amount of calories and possibly drink less alcohol which can be a big calorie addition.
8. Get up and walk around in the office. Get up whenever possible. Walk to the rest room that is farther away rather than the closest. Take stairs to go to floors that are only 2 or 3 flights. But avoid the areas where temptations may lie (like a co-worker that always has goodies on their desk or the break room where treats may lurk). Or go for a walk during your “smoke” break. Smokers tend to take their 10 minutes breaks every hour or two, why can’t you?
9. Eat meat as a condiment. Use vegetables as your main course and meat as a smaller side. Just a different way of thinking of things. Remember that quarter rule – one quarter lean protein, one quarter whole grains and two quarters vegetables (or fruits).
10. Plan to be healthy! Pack healthy meals when going to work and cook ahead and freeze meals for those nights when you don’t have time to cook.  Yes, it takes a little work, but it is so worth it for the convenience and healthier habits you will ingrain. Bring fruit and leftovers to work for lunch. Pack carrot sticks or healthy nuts for snacks. If you have these things with you, you will not be as tempted by unhealthy foods. Also, plan for some activity. Take along exercise clothes and shoes so that there is no excuse to go home first!

I hope you find this list helpful and can implement a few into your life. Interestingly, not everyone agrees with this approach. Associate professor at the NYU School of Medicine, Marc Siegal, MD, told WebMD that the idea of stealth health is, “a small, gimmicky idea to target people with very unhealthy lifestyles,” and that these small actions are like “using a Band-aid to stop a hemorrhage.” In other words, he feels stealth health isn’t a long-term answer for the very people who need to make the most drastic changes to save their health. I can understand his point – to a point. Some health conditions are dire and require immediate, sometimes drastic, changes, but getting started is sometimes the hardest part, yes?  I think many people are overwhelmed by what it takes to get healthy, lose weight, or start exercising. Overhauling your diet, lifestyle, and exercise routine (or lack thereof) overnight is overwhelming! This can set many people up for failure, causing them to give up before they even try. But starting with small tasks is manageable. If walking for 10 minutes or just adding one piece of fruit to each day is all you can manage for right now, it is better than nothing, yes? And in my opinion, it often leads to more healthy behaviors as you adapt.
What do you think? Do you think stealth health works? What are some of the ways you sneak small bits of health, fitness or good nutrition into your days?

There has been mounting evidence in the last few years that the spread of obesity — not just in our country, but around the developed world — may be much more than availability of unhealthy food and lack of exercise. Although, these are important factors, we humans are so much more complicated than that!

In 2007, researchers from Harvard and the University of California, San Diego, reviewed a database of 12,067 densely interconnected people — that is, a group that included many families and friends — who had all participated in a major American heart study (Framingham Heart Study) between 1971 and 2003. The participants met with heart researchers every two to four years. To facilitate study follow-up, the researchers asked participants to name family members and at least one friend who could be called on if the participant changed addresses.

Is obesity contagious? (Bing Images)

According to their analysis, when a study participant’s friend became obese, that first participant had a 57% greater chance of becoming obese himself. In pairs of people in which each identified the other as a close friend, when one person became obese the other had a 171% greater chance of following suit. Wow.

Geographic distance between friends in the study seemed to have no impact: friends who lived a 5-hour drive apart and saw each other infrequently were just as influenced by each other’s weight gains as those who lived close enough to share meals and social events. The obvious question is, Why? Spouses share meals and a home, but the researchers found a much smaller risk of gaining weight — a 37% increase — when one spouse became obese. Siblings share genes, but their influence, too, was much smaller, increasing each other’s risk 40%. Maybe the effect has much more to do with social norms: whom we look to when considering appropriate social behavior. Having fat friends makes being fat seem more acceptable. Your spouse may not be the person you look to when you’re deciding what kind of body image is appropriate. But why do we not necessarily compare ourselves to our siblings? I guess that old saying rings true here, “You can choose your friends, you cannot choose your family.”

Socializing with overweight people can change what we perceive as the norm; it raises our tolerance for obesity both in others and in ourselves. It’s about being comfortable. Past research has shown that adults tend to eat more around friends and family than they do with strangers. Are overweight diners more likely to tone down how much they eat in front of skinny people to avoid the stigma of overeating?

Do you eat less with the opposite sex? (Bing Image)

When it comes to holding back, there’s nothing like the opposite sex to curb our appetites, at least when we’re single and female. In a study to be published in the October issue of Appetite, researchers at Montreal’s McGill University secretly observed 460 college students eating in the campus cafeterias. They found that when a woman was with a man, she ate about 100 calories less than when she was with a woman. The more men that were present in the eating groups, the fewer calories a woman had on her tray. Women ate roughly 100 fewer calories for each man at the table! But there was no such effect on men! Wish that worked for me!

A study published in the August issue of the American Journal of Clinical Nutrition finds that how much tweens and teens eat can be influenced by how much their friends weigh. In the study, 130 kids ages 9 to 15 were allowed to snack as much as they wanted while hanging out with a friend or with a peer they did not know. All the kids ate more when they were with a friend than with a stranger. But the overweight children ate the most when paired with an overweight friend — an average of 300 more calories than when they spent time with leaner friends. The research also found that friendship itself makes the appetite grow stronger: when overweight kids ate with similar-weight kids who were already their pals, they threw back an extra 250 calories than when they ate with chubby kids they had just met. Lead researcher and clinical psychologist Sarah-Jeanne Salvy says her research demonstrates an eye-opening social theory: obesity can be contagious. But that is socially contagious.

To take it a step further, there is accumulating evidence that certain viruses may cause obesity.

A study in the January 2006 issue of the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology published by the American Physiological Society suggests that obesity isn’t just spreading; rather, it may be contagious between people, like a common cold.

More recently, Nikhil Dhurandhar, an associate professor at The Pennington Biomedical Research Center, in Baton Rouge, La., said the virus, known as adenovirus-36 or AD-36, infects the lungs then finds its way around the body, forcing fat cells to multiply. “When this virus goes to fat tissue it replicates, making more copies of itself and in the process increases the number of new fat cells, which may explain why the fat tissue expands and why people get fat when they are infected with this virus,” Dhurandhar said.

In one test, a third of obese people had the rare and highly contagious virus compared to just 11 percent of thinner people. Weight gain can last three months until the body has built up resistance to the bug. Researchers are now trying to figure out why some people seem to become obese after Ad-36 infection while others don’t.

So, what do we learn from all this? The answer isn’t to ditch our fat friends. Social isolation is a much worse place to be. Some research has found that overweight people eat an average of 400 calories more when they’re alone, compared with when they’re in the company of friends of any weight group. You do not stop seeing people because they are fat, but you might be able to influence them into leading a healthier lifestyle by living a healthier life yourself. If you are in the habit of only eating and doing sedentary social activities with your overweight friends, then change that. Invite them to join you in healthier meals at home or recreational activities.

I feel it may be the idea of misery wanting company. If we are trying to eat better and exercise more, we don’t want to push that on someone else. We don’t want to appear high and mighty over them and their choices, so we slip into their lifestyle. There is no reason why this phenomenon cannot work the other way around. If you are overweight, make a point to hang out with thinner people and see if normal weight can be contagious, too!

How do you feel about this?

Do you eat more with certain friends?

Do you eat less around the opposite sex?

Since I just returned from a long business/pleasure trip, it occurred to me that our diet and fitness is greatly compromised while we are away from our normal routines.  I have developed some tricks over the years to help keep that compromise to a minimum. Please feel free to print and save this article for future reference when you are planning your next trip.

Vacations are for unwinding and recharging. But just because you’re relaxing your mind and body doesn’t mean your health should be put on hold. Here are some tips to help you maintain your health while you’re away.

Before you leave…

Walking and snorkeling in Mexico

Shop for your hotel.

Before you book your lodging, ask if the location has a fitness center or scheduled group classes. If you’re traveling with a friend or family member, invite them to join you for a workout.

Plan an active vacation.

Take the first steps before you even leave home: Prepare to have a healthy and active vacation. Take along your walking shoes, bicycle shorts, swim wear, or any special exercise or recreation equipment. Plan physical activities into your trip; like hikes, bike rides, cross-country skiing, snorkeling, etc.

Getting there…

Be selective while at the airport.

Most food found in airports is fast and unhealthy. But, more and more airports are beginning to offer more healthful options. You must be discriminating. Look for salads and sandwiches where you can request special orders. Ask for dressings, toppings and condiments on the side (or skip them altogether) so that you can determine how much is used. Lean turkey on whole wheat with lettuce, tomatoes and cucumbers is a better choice than pizza or burgers. And you have the bonus of being able to share easier or save half for later!

Avoid airplane food

Pasta or re-heated meat smothered in heavy sauces, greasy potato chips, chocolate-chip cookies — this starchy, high-carb junk food is not only unhealthy, it also can make you feel bad.  Bring your own food when you fly and drink plenty of water.  Throw some nutrition/energy bars and a few pieces of fruit in your carryon. Or pack nuts and carrot sticks. Even if the flight is short, there can be unplanned time on the tarmac or in the terminal.

Drink up.

You might think hunger is nagging at you, but in reality, water may be the only refreshment you need. Ask for water alongside any other drink you get on the plane. Take water in the car. Carry a water bottle during the day and drink from it often—especially if it’s hot or humid.

Limit alcohol.

I know what you are thinking. The health nut is preaching! Well, believe me, I am not telling you to avoid it completely if you enjoy a drink now and then. But, a single fruity alcoholic drink poolside can add 600-plus calories to your daily intake. If you must have an alcoholic beverage, avoid anything that has more than one or two ingredients. Ask for a glass of water at the same time and alternate sips, or just alternate drinks. Smarter alcoholic choices include wine, light beers, vodka and tonic or rum and diet cola (although I would avoid diet drinks if you can). Of course, I will be having my glass of wine with some sparkling water on the side!

Get off your butt

The best way to see a city is to walk it. Sure, you can save time riding a bus or subway, but just think how many calories you’ll burn if you walk to all those museums and restaurants. Make it an adventure: get a map and scope out a great route through the city’s best sights.

Get an exercise wake-up call.

Sleeping in is a lot of what a vacation is about, but carving out 30 minutes in the morning for the treadmill or lifting weights will boost your calorie burn for the whole day. Not a morning person? Take 30 minutes before you hit the showers for dinner. You’ll be so glad you did.

Find the gym!

Most hotels these days have fitness rooms, whether you’re in Dubai, Dublin or Dallas. True, the gym might be a smelly room with really old machines, but you’ll benefit from paying a visit. What’s more, many lodgings offer free passes or discount fees for nearby gyms. Ask the concierge.

Do like the (active) locals do

Hiking in Italy

On vacation try things the active locals do. When in Paris, San Francisco, or Santa Monica; bike or rollerblade. When in Vancouver, rig a sail. In Buenos Aires, take a tango class, and if you’re in the Caribbean, learn windsurfing or diving/snorkeling.
I’ve taken yoga classes in Mexico, aerobics classes in Switzerland… not only for the exercise. It is a great way to meet people and get a peek at local life.

Mealtime…

Don’t skip breakfast

Every day eat a healthy and energizing breakfast. If you stay at a hotel offering a free breakfast buffet, choose oatmeal, eggs, and fruit along with your tea or coffee. Limit use of sweeteners. Skip the sweet rolls or  pastries. If you order in a sit-down restaurant, order oatmeal and eggs rather than pancakes or French toast. If oatmeal is not available, a whole-grain bagel or true whole-grain bread or toast is the next best choice with your egg. A good breakfast will give you energy for your active day.

Let’s do lunch!

To avoid vacation weight gain, try eating one big meal each day in the middle of the day, followed by a light dinner. You’ll save money too, as lunch is always cheaper than dinner.
Don’t make the mistake of skipping lunch and running out of energy. But if you don’t eat two huge cooked meals at home, don’t do it on vacation, either. If you are planning a big dinner, choose a simple salad, soup, or wrap for lunch with unsweetened iced tea or water. Emphasize raw foods as much as you can, and ask for dressings on the side. You will probably only need a small fraction of what you are served. If you know servings are huge, consider splitting a meal with your travel partner.

Do a walk-by.

Buffet tables are great but not if you’re trying to watch what you eat. Assess the entire table before you get in line so you can select items that you really want. And don’t be afraid to serve yourself. Chefs are trained to pile it on. Ask for smaller portions.

Stay away from the familiar

McDonald’s, Burger King, Wendy’s — this junk food is found everywhere, so why would you eat it on vacation? Use your precious time in London, Moscow, or Honolulu to seek out local restaurants and cuisine.

Be a detective.

Choose wisely. Eat fresh and local.

Don’t be embarrassed to ask your server about portions and ingredients. For example, inquire about how many eggs the chef uses in the omelet, and whether or not a sauce is made with cream or butter.

Share and share alike.

Split a meal if portions are huge, and in any case skip the greasy appetizer. Go for lean meats, poultry, or fish, salad, and steamed vegetables. Go easy on the bread and potatoes. Dressings and sauces should be on the side. A single restaurant dessert is designed for between two and four people. Don’t eat an entire desert by yourself. Instead, get one serving for the table. Fill up on veggies and protein at dinner and make dessert what it is: a treat. And not every night!

Either/or but not both

When dining, plan your indulgences carefully. Yes, you can have the marzipan crépe with strawberry glaze, but not if you’ve also ordered the pasta special. Since you are on vacation, you can have a drink or split a dessert a few times in a week, but don’t have both at the same meal.

After hours!

After dinner enjoy more activity, a show, a walk, or conversation (or activity?) in your room. This way, you are less likely to eat as well.

Try not to have food in your room. If you will be too tempted to raid the honor bar, make sure you have healthful snacks such as fruit, and don’t even let chips into your room.

If you follow these steps, you will be just as active as at home and will not have sabotaged your healthy diet . You may even return slimmer than when you left (or at least no heavier) and a little healthier! Enjoy your vacation!