Source: USA TODAY

Americans need to lower their excessive salt intake for their health’s sake, but it may be harmful to cut back too far, says a new report out today.

Adults in the USA consume an average of 3,400 milligrams (about 1½ teaspoons) of sodium a day, mostly from processed foods and restaurant fare.

The government’s dietary guidelines recommend that most adults reduce daily sodium intake to less than 2,300 milligrams. People who are 51 and older and those of any age who are African American or have hypertension, diabetes or chronic kidney failure are advised to further reduce intake to 1,500 milligrams a day. The American Heart Association recommends that everyone consume less than 1,500 milligrams a day.

An expert committee, convened by the Institute of Medicine, reviewed the recent research on sodium consumption’s impact on heart disease and health. The committee’s report says that evidence links excessive dietary sodium to cardiac events such as heart attacks and strokes. That was expected based on prior data on high blood pressure, a well-established marker for cardiovascular disease, stroke and cardiac-related mortality.

The report also found:

• Studies are “inconsistent and insufficient” to conclude whether lowering sodium intake below 2,300 milligrams a day either increases or decreases the risk of heart disease, stroke or death from all causes.

• Low sodium intake may have adverse health effects in those with mid- to late-stage heart failure.

• The scientific evidence doesn’t support the 1,500 milligram recommendation for people who are 51 and older and those of any age who are African American or have hypertension, diabetes or chronic kidney failure. More research is needed to explore this recommendation.

“This is a two-sided message: We endorse public health efforts to lower excessive salt intake, but we raise questions about harm from too little salt,” says IOM committee chairman Brian Strom, executive vice dean of the Perelman School of Medicine at the University of Pennsylvania.

The committee did not define “excessive” sodium or set a recommended limit for sodium, he says. Another committee will do that in a few years, he says. But eating a diet that contains only 1,500 milligrams of sodium a day is “extremely hard,” he says.

“When you look at subgroups, there are suggestions that as you go to lower dietary sodium, the health risks begin to increase, but there are methodological limitations to that research,” Strom says.

Elliott Antman, a spokesman for the American Heart Association and a professor of medicine at Harvard Medical School, says there were flaws in the studies that were reviewed by the IOM committee. Some of the research was conducted in sick patients and was not designed to study the impact of sodium intake on cardiovascular health, he says. The heart association reviewed many of the same studies and found that substantial methodological concerns limited their usefulness in setting public health recommendations, he says.

The heart association’s sodium recommendation is “based on the strength of evidence relating excess sodium intake to high blood pressure, cardiovascular disease and stroke. We have evidence that reduced intake of sodium can prevent and treat hypertension and reduce the risk of adverse cardiovascular disease and stroke events,” Antman says.

In some people, sodium increases blood pressure because it holds excess fluid in the body, placing an added burden on the heart, the heart association says.

The group “is not going to change its position on sodium, and it stands with many other major health organizations,” Antman says. “We don’t want people to be distracted from the important health message that there is benefit in aggressively lowering sodium from the current levels in the American diet.”

Morton Satin, vice president of science and research for the Salt Institute, an industry group, says, “The report challenges the radical viewpoint of cutting sodium to 1,500 milligrams or below a day. This low amount has been shown to increase the health risks for some people.

“The report’s recognition that more research is needed marks a positive approach toward a more objective discussion about the complex effects of sodium reduction on overall health.”

Copyright © 2013 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

Mika Brzezinski, co-host of MSNBC’s Morning Joe, knows that the fact she has written a book about her obsession with food may rub some people the wrong way.

After all, at 5-foot-6½, she weighs about 132 pounds and wears a size 6 dress. That’s up from her usual 118 pounds and size 2.

Many people may not want to hear about a “skinny girl” with food issues, but Brzezinski, 46, says she has paid a high price for being thin. For years, she has maintained a cycle of overeating, starving, binging, running. She has struggled with multiple eating disorders, including a brief bout with bulimia, binging and purging, and a type of exercise bulimia where she would gorge then run for 10 miles. And one psychologist said she had an unhealthy obsession with eating healthful foods, which some call orthorexia nervosa.

“I know I’m not going to be a likable character to everybody. I can tell by the way people are responding, but if it gets the conversation going about food obsessions, I’ll take the hit,” says Brzezinski, author of Obsessed: America’s Food Addiction — and My Own, written with Diane Smith.

Her disordered eating patterns started in high school when she says she would scarf down two or three Big Macs at a time. In college, she would eat a large pizza, and starve herself for three to five days eating no food and going for 10-mile runs. About four months ago, in a sleeping-pill-induced trance, she wolfed down a jar of Nutella with her bare hands.

She comes from a family of overachievers; her father, Zbigniew Brzezinski, was the national security adviser to former president Jimmy Carter. In her family, intellect was valued, and she didn’t think she measured up. But, she says, “I don’t want to blame this on anyone. I think everybody gets to that place of having these problems in their own way.”

In her career, being thin and fit is celebrated. One time she was turned down for a job as TV host for weighing too much. “It’s hard to come to terms with this, but every time I am 120 pounds, I seem to have success. People tell me how good I look, that I look like a model, that I look amazing.”

But when her weight creeps up and she’s at a healthier level, those positive messages don’t come as often, she says.

Brzezinski decided to address her own eating issues after she confronted her friend Diane Smith, also a TV journalist, about being too heavy. “I was worried about her health and her future. We had shared all the things two friends could share, except one. Neither of us ever broached the subject of how we battled with food.”

Then, over Labor Day weekend in 2011, when there was an opening to discuss her friend’s weight, Brzezinski took it. At 5-foot-8, Smith weighed more than 250 pounds at the time. Brzezinski told her, “Diane, you have a problem we need to talk about.” Then she proceeded to use the words fat and obese.

“Diane looked stunned. Her eyes widened. It’s almost like she didn’t know it. I did get scared, and my heart started beating faster and I started sweating. I thought I had lost her friendship forever.”

Smith remembers it that way, too: “At first it felt like a slap. But then Mika said, ‘Your weight is killing you, and I love you too much to let that happen.’ She said, “You need to change your life, and I’ll help you.’”

Smith told Brzezinski she knew nothing about food and weight issues. Then Brzezinski broke down and told her the “ugly truth” about her “fight with food” every day. “I am obsessed by food. I’m tortured by it.”

At the time, Brzezinski’s weight was hovering around 120 pounds. “Diane’s situation was obvious. Mine is this hidden issue, this hidden secret, this hidden shame.”

The two made a deal. Smith would try to lose 75 pounds, and Brzezinski would gain 10 pounds. They decided to write a book about their experience.

Since then, Smith has lost 75 pounds and “she looks beautiful,” Brzezinski says. “I paid her a large chunk of the book advance. I put money where my mouth is. You don’t call someone fat and walk away. I gave her a lifeline, and she took it.”

Says Smith: “I used the book-advance money to hire a personal trainer and to join a hospital-based outpatient weight-loss program because I felt like I needed a lot of help. I’ve always been an emotional eater, and what I learned in behavior modification is there are other ways to handle emotions besides just eating.

“Mika really gave me my life back. She really woke me up,” says Smith, who now weighs about 180. “I have gone from size 20 to size 14. I still want to lose another 25 pounds.”

Brzezinski sought help from a psychologist and a nutritionist. The latter evaluated her diet and found she was eating about 1,200 calories a day, not nearly enough for someone who exercises and is trying to maintain her weight.

Brzezinski has gained 10 pounds and thinks she’s getting better. Her biggest victory is going to bed at night without weighing herself first and beating herself up about what she ate during the day.

She says her TV co-host, Joe Scarborough, supported her efforts. He has gotten healthier himself by losing weight “and looks really good.”

She wants to be healthier for her two teenage daughters, ages 14 and 17. “I would love for them not to have an obsessed life. I’d like them to be as happy and healthy as they are right now. I want them to enjoy their lives more than anything else.”

Copyright © 2013 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

The cost of feeding a family of four a healthy diet can run $146 to $289 a week, according to the latest numbers from the U.S. Department of Agriculture.

That’s based on preparing all the meals and snacks at home for a couple with two school-aged children. It doesn’t include one-dollar deals at fast-food restaurants or splurges at pricey restaurants.

The USDA uses national food intake data and grocery price information to calculate different costs for a healthy diet at home. The latest numbers for a four-member family: a thrifty food plan, $146 a week; a low-cost food plan, $191 a week; a moderate-cost plan, $239; a liberal plan, $289 a week. Some food waste is built into these costs.

“We constantly hear the claim that you can’t eat healthy on a budget, and to us that’s a myth because a family can eat a healthy diet with fruits and vegetables that meets the Dietary Guidelines for Americans,” says Robert Post, associate executive director of the USDA’s Center for Nutrition Policy and Promotion.

Costs today are up from 10 years ago, when a thrifty-cost food plan for a family of four was $108; a low-cost food plan, $139; moderate-cost plan, $173; a liberal plan, $208 a week.

The price of a moderate-cost healthy plan went up 38% between 2003 and 2013, says Mark Lino, a USDA economist. The cost of food in general went up 32%, he says. During that time period, inflation was about 26%, he says.

But you do have to use “smart shopping strategies” like the ones on www.choosemyplate.gov, Post says.

The thrifty plan is used as the basis of SNAP, the Supplemental Nutrition Assistance Program, formerly known as food stamps. Eating a healthy diet on that amount of money means buying the lowest-cost fruits and vegetables such as bananas, apples, carrots, potatoes and greens, says Lino. People who spend the higher amounts on food can buy more expensive fruits and vegetables and even pre-cut and pre-washed ones, he says.

The liberal plan allows for more expensive cuts of meat and types of seafood. It does not allow more desserts such as chocolate cake or cheesecake because it represents a nutritious diet, Lino says. The limit for calories from solid fats and added sugars is the same in all the plans.

Registered dietitians who work with families and dieters say how much people spend on food depends on their income, how much they budget for groceries, where they live and a number of other factors.

It is possible to eat healthfully on $146 a week, but you can’t do it without planning, says Bethany Thayer of Detroit, a registered dietitian and spokeswoman for the Academy of Nutrition and Dietetics. You have to shop sales, buy produce in season, purchase store brands and buy canned and frozen vegetables when they are on sale. Buying store brands instead of national brands can save you up to 30%, she says.

To eat cheaply at home you have to make an investment of time to plan meals, grocery shop, cook and prepare the food, says Tami Ross, a nutrition expert in Lexington, Ky., and co-author of Diabetes Meals on $7 a Day — or Less!, written with Patti Geil.

She advises her patients to plan for five evening meals a week and then have a night or two to clear out the refrigerator of leftovers or incorporate what she calls planned-overs.

Planned-overs are taking one main food, such as chicken, and using it several different ways throughout the week. You can serve it as an entree one night and then other nights put it on top of a green salad or incorporate it in soups, wraps, casseroles or chicken salad. That way you aren’t eating the exact same thing but you don’t waste food, she says. “Throwing food away is like throwing money in the trash can.”

Ross also tells patients to think of meat as the side dish, not the centerpiece of their meal, because it’s often the most costly part of the meal.

Thayer points out that there are many inexpensive protein choices — beans, eggs, peanut butter and other nut butters, she says. And when it comes to inexpensive whole grains, you can eat store-brand old-fashioned oatmeal for 9 cents a serving, she says.

“People spend a lot of money in the grocery store on their beverages,” Thayer says. To save money, your beverages should be tap water and low-fat or fat-free milk, she says.

Elizabeth Ward, a registered dietitian in Boston and author of MyPlate for Moms, says you can save both time and money with simple meals. An omelet with vegetables, whole-grain toast, fruit and milk is a relatively low-cost meal. So is a grilled cheese sandwich on whole-grain bread, green salad and fruit.

Make a list to take to the store to cut costs, but it’s OK to deviate from it for sale items that you know you will use.

To avoid waste, take leftovers for lunch the next day, Ward says. “For me, that’s the best part of cooking dinner — you get lunch, too.”

Thayer adds that people also can eat inexpensively on value meals and fast-food fare, but there’s a tradeoff. “Processed food and fast food offer a lot of calories for the dollar but not a lot of nutrients. That’s one reason we have people who are overweight but undernourished.”

Copyright © 2013 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

The trends are moving in the right direction: People are downing less added sugar in their diets, but health experts say Americans still consume too much.

About 13% of adults’ daily calories come from added sugars in things like cake and regular soda, according to government statistics, out today. Men consume about 335 calories a day from added sugars; women, 239 calories. These are sugars added to processed and prepared foods but not sugar added at the table.

About two-thirds (67%) of added sugars come from food; the other third (33%) from beverages.

“These results may underestimate the actual sugar intake because people may add sugar to cereal in the morning and to beverages such as coffee and tea,” says the study’s lead author Bethene Ervin, a nutritional epidemiologist with the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

A similar study by Ervin and colleagues, out last year, showed that kids and teens are downing about 16% of their daily calories (322 calories) from added sugars. Boys consume 362 calories a day from them; girls, 282 calories.

On the plus side, an analysis of CDC data by other scientists shows that added sugar intake has declined in people, ages 2 and older, from about 18% of total calories in 1999-2000 to 14.6% of total calories in 2007-2008, Ervin says. That’s mostly because of a decrease in regular soda, which is the single biggest contributor of added sugars to the diet for all age groups, she says.

The current intake of added sugars is far more than the amount recommended by the American Heart Association. The group advises that men consume no more than 150 calories a day from added sugars, or about 9 teaspoons. For women, it’s no more than 100 calories a day, or about 6 teaspoons of added sugars.

The heart association says that research has linked a high intake of added sugars to many poor health conditions, including obesity, high blood pressure, type 2 diabetes and other risk factors for heart disease and stroke.

“Most of us don’t have room in our diets for this many calories from added sugars,” says Rachel Johnson, a spokeswoman for the heart association and a nutrition professor at the University of Vermont. “There is a small glimmer of hope that added sugar consumption is declining modestly due to the reduction in full-calorie soft drinks, but the amount people are consuming is still substantially higher than it should be.”

STORY: Nutritionists go sour on sugar

The latest findings are from the National Health and Nutrition Examination Survey, which is considered the gold standard for evaluating food and beverage habits because the data come from in-person interviews about dietary habits. These results are from interviews with about 15,700 adults, ages 20 and older, conducted from 2005 to 2010.

Added sugars include white sugar, brown sugar, high-fructose corn syrup, maple syrup, honey, molasses and other caloric sweeteners.

Added sugars include all sugars used as ingredients in prepared and processed foods and beverages, such as cakes, candy, cookies, muffins, jams, chocolates, ice cream, sodas, fruit drinks, sports drinks, energy drinks, coffee, tea, flavored milk and alcoholic beverages.

Other findings:

– The percentage of total calories from added sugars decreases with age. Men and women ages 20 to 39 consume the most calories from added sugars, 397 and 275 respectively.

– Black men and women consume about 15% of their daily calories from added sugars compared with 13% of whites and Mexican-Americans.

– People with the lowest incomes consumed about 15% of their daily calories from added sugars compared with those at the highest incomes, who consumed about 11.5%.

– About two-thirds (67%) of the added sugars from foods were consumed at home. That is consistent with the fact that two-thirds of total calories were consumed at home.

Copyright © 2013 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

Comedian Sherri Shepherd, co-host of The View, says type 2 diabetes could have killed her, but instead it saved her life.

“If I didn’t have diabetes, I would probably be at the International House of Pancakes eating a stack of pancakes with butter and syrup,” says Shepherd, 46. “I would probably be 250 pounds. I would not be going to the doctor. I probably wouldn’t be married to my husband, Lamar Sally. I wouldn’t be healthy for my son, Jeffrey.”

At 5-foot-1, she now weighs 157 pounds, down from 197 pounds several years ago. Once she was taking three medications for diabetes, but now that she’s eating healthier, exercising regularly and keeping her blood sugar in the right range, the doctor has taken her off all medications for the disease.

Shepherd details her struggles with diabetes and the changes she made in her life in her new book, Plan D: How to Lose Weight and Beat Diabetes (Even If You Don’t Have It), written with Billie Fitzpatrick.

Almost 26 million U.S. adults and children have diabetes, in which the body does not make enough of the hormone insulin, or doesn’t use it properly. Insulin helps glucose (sugar) get into cells, where it is used for energy. If there’s an insulin problem, sugar builds up in the blood, damaging nerves and blood vessels. There are two major forms: type 1 and type 2. In adults, type 2 diabetes accounts for 90% to 95% of all diagnosed cases.

Symptoms of type 2 diabetes include thirst, hunger, tiredness, blurry vision, tingling and numbness in the hands and feet, healing problems and frequent urination. The disease may lead to heart disease, stroke, kidney failure, foot and leg amputations and blindness.

Shepherd has a family history of type 2 diabetes — both of her sisters have it and her mother died at age 41 from complications of the disease.

Shepherd says she was in denial after she was diagnosed with pre-diabetes. “That said to me I’m not diabetic so I can eat the way I want” including barbecue, mac and cheese, pasta, pancakes and waffles, she says.

But then in 2007, she was formally diagnosed. At the time, she says, she had no energy, had numbness in her feet, had blurred vision, was thirsty all the time and had to go to the bathroom frequently. Her blood sugar was way too high.

She says her doctor was blunt. “She said, ‘Sherri, you love wearing those shoes, don’t you?’ I said, ‘Yes, I do’. She said, ‘You won’t be wearing them with your foot cut off, because if you keep eating the way you are eating, that’s where you’re headed.’ “

But even after she was diagnosed with what she calls “the big D,” Shepherd went out and had a stack of pancakes and enough “pesto pasta to feed a family of four people. I can down some food. I love food. Girl, it was complete denial. I figured if I didn’t talk about it, it was going to go away.”

The doctor put Shepherd on medication. “I was scared,” she says.

Then she realized that she had to turn her life around or she might not live to raise her son. “I was going through a nasty divorce at the time, and I thought, I’ll be damned if my husband’s girlfriend is going to raise my son.”

A friend, the Oscar-winning actress and comedian Mo’Nique, said to her, “We keep saying we would die for the people we love. Are you willing to live for the people you love?”

She says she remade her eating and exercise habits and changed her relationship with food. “I learned how to eat. I learned how to get rid of the white foods — the pasta, pancakes, cereal, anything loaded with sugar.”

She began to enjoy grilled fish and chicken, instead of fried. She started reading food labels. She started eating more vegetables — those “green, yellow and red lovelies” that make your body happy.

“I never liked vegetables before. Now I’m a kale freak because one day we got kale and my husband sauteed it with green peppers, olive oil and garlic.” Her husband does most of the cooking, she says: “He’s my personal chef, but I gotta sleep with him.”

Shepherd exercises regularly, going to a boot-camp workout classes (intense cardio and weight training) three days a week and then to the gym a couple of times a week, often working out on the elliptical.

“I do have a trainer who teaches me stuff that I can do on my own at home. And when I have the time, I will go work out with her to have someone hold me accountable, but for the most part I do it on my own.”

She also works exercise into her everyday life. “I have learned to turn my house into a gym. I do lunges when going to the laundry with my basket. When cooking, I do push-ups against the kitchen counter. I do toilet squats. My behind has not touched a toilet seat in years. I am an Olympic squatter.”

She says she runs races with her son and even climbs the monkey bars with him. She loves dancing and does the salsa at home with her husband or son.

“I feel really healthy,” she says. “I have so much energy. I want to live and I’m going to beat this thing. I feel so blessed.”

Risk factors for diabetes:

According to the Centers for Disease Control and Prevention, people with the following risk factors are more likely to develop prediabetes and type 2 diabetes:

• 45 years of age or older.

• Overweight.

• Have a parent with diabetes.

• Have a sister or brother with diabetes.

• Family background is African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander.

• Developed diabetes while pregnant (gestational diabetes), or gave birth to a baby weighing 9 pounds or more.

• Physically active less than three times a week.

Copyright © 2013 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

Montgomery, Ala., resident Ashley Stewart and her family have made drastic changes over the past three months, going from being almost completely sedentary to preparing to run a 5K, from eating fried foods and fast food to planting their own organic vegetable garden, from putting their health on the back burner to making it a priority.

Five family members have lost a total of 113 pounds since mid-January and made vast improvements in their overall fitness. “To know that we’re able to jog and run now is crazy,” Ashley says. “I don’t think I had ever seen my mom work out before this, and now she’s doing some kind of workout almost every day. It’s nice to see.”

The Stewarts and five other families have been participating in USA TODAY’s Family Fitness Challenge — an initiative to help people across the country get more active and lose weight. The project is being produced in partnership with USA WEEKEND Magazine and The Doctors TV show. The families were paired with a fitness expert from the American College of Sports Medicine and a registered dietitian from the Academy of Nutrition and Dietetics.

The family includes Ashley Stewart, 25, and her husband, Jared, 25; her parents, Ed, 46, and Lenora Cochran, 45; and her mother-in-law, Debra Stewart, 52. At the beginning of the challenge, Ed had the most weight-related health issues, including type 2 diabetes, gout, high blood pressure and sleep apnea, a disorder in which breathing is briefly and repeatedly interrupted during sleep. But he has made dramatic health improvements over the past three months.

Ashley offers her assessment of the family’s accomplishments:

Biggest loser: “My dad. He lost 36 pounds. He looks like a million bucks. His face has slimmed down a lot, and even his tummy looks smaller. He weighed 241 pounds at the beginning of the challenge and now weighs 205. He’s 5-foot-8. He exercises every day, and dare I say it — he’s becoming a gym rat. He can run 55 minutes without stopping. My dad and Jared have lost so much weight, they need new clothes.”

Biggest health improvement: “Not only is my dad the biggest loser, but he also has had the biggest health improvement. He is no longer taking insulin shots to control his diabetes, and the dosage of his diabetic medication has been reduced. He is able to sleep without snoring, and he has had no flare-ups from gout since embarking on this healthy journey.”

Biggest fitness accomplishment: “We run. I have never imagined myself getting on the treadmill at the gym or going outside for a jog or run. As a family, we’re able to jog/run together, and as individuals, we jog/run for exercise. It’s a good way to get our heart rate up, and I’m so proud that we’re able to do it.

“Debra did 12 push-ups at the start of the challenge, and she could 40 push-ups six weeks into it. Jared has lost 25 pounds. He goes to the gym every day. He is jogging on the treadmill now, where before, he could only walk. He’s lifting weights. You can see the weight loss in his face and his neck.”

Biggest diet change: “Consuming less sugar. Sometimes when people think of eating sugar, they think about cookies and cakes. Of course, we liked those, but we also added sugar to foods that were otherwise healthy, such as peas, carrots, collard greens, even spaghetti. Down south, everything tastes better fried and with a little sugar.

“We’ve learned to enjoy the natural tastes of vegetables without unnecessary additives. Instead of a hunk of red velvet cake for dessert, we enjoy the natural sweetness of fruit. On special occasions, we may still have cake, but always smaller portions and lower-sugar and lower-fat recipes. It’s amazing the swaps you can make in your regular recipes to lighten food up.”

Biggest fitness change: “We now move. Before we moved only when we had to. Now we move because we want to. When I miss a group fitness class at the gym, I actually feel like I missed out on something. We now find fitness time enjoyable; before, it was a chore. I always wondered what it would feel like to enjoy working out, and now I get it.”

Hardest obstacle to overcome: “Controlling our personal environments. The gym serves pizza once a month, work parties happen often, and we have other family members and friends who eat lots of great-tasting food that isn’t good for us. We began taking lunch and snacks to work. I even put snacks in my car so I’m not tempted to stop for fast food. When going to gatherings where there will be food, we offer to bring a dish that’s healthy and delicious. When going out to eat, we review the menu and nutrition facts in advance to make meal decisions ahead of time. This is real life, and we can’t hide from food, but we can control what we eat and how much.”

Best lesson learned: “That healthy living is a way of life. So many times, we tried miracle diets to lose weight, but the weight always returns. This time, with making healthy choices and exercise, the weight is gone and it’s not coming back. The only regret we have is that we didn’t do it this way sooner.”

Best advice to others: “Never give up. I have had my days where I felt like I will never lose the amount of weight that I want to because I ate peanut-butter cups at snack time. Peanut-butter cups will absolutely ruin a diet, but not a lifestyle. I had to remind myself that tomorrow is a new day and I could start fresh. Giving up is how I got to an unhealthy lifestyle in the first place, so I constantly remind myself that I don’t want to go back to that life.”

How they are going to stick with it: “Our family will continue our healthy lifestyle by continuing to have Sunday Funday, where we get together and try new healthy recipes and work out together. We are planting an organic fruit and vegetable garden so that we can have access to fresh fruits and vegetables at a fraction of the normal costs. We will also stick to planning meals in advance and once-a-week weigh-ins to keep us on track.”

The Doctors is an Emmy-winning daytime TV show. Check local listings.

Copyright © 2013 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

Folks who want to get in better shape and eat healthier are often encouraged to make one change at a time, but a new study finds that people are the most successful when they tackle their diet and exercise habits simultaneously.

“It comes down to making them both priorities and thinking about both throughout the day,” says lead researcher Abby King, professor at the Stanford (University) Prevention Research Center.

King and colleagues worked with 200 inactive, mostly overweight people, 45 years and older, who had relatively unhealthy diets that didn’t include enough fruits and vegetables and contained too much saturated (animal) fat.

Published online in Annals of Behavioral Medicine, the study shows participants were divided into four groups: One learned to make diet and exercise changes at the same time; another learned to make diet changes first and then a few months later began working on their exercise habits. A third group changed their exercise habits first, then their diet later. And the fourth group learned stress-management techniques but did not get diet and exercise guidance.

Participants weren’t trying to lose weight, just live healthier lifestyles. Health educators met with them at the beginning of the year and then called them once a month to provide advice and support.

The goals were for participants to meet the government’s physical activity guidelines of doing at least 150 minutes a week of moderate-intensity physical activity, such as walking, eat five to nine servings of fruits and vegetables a day and keep their saturated fat intake to 10% or less of daily calories.

The findings after one year: Those who made changes in their diet and exercise habits at the same time did the best at meeting all three goals — eating enough fruits and vegetables, limiting saturated fat and exercising enough to meet the government’s guidelines.

Participants who started with exercise first also did pretty well at meeting diet and exercise goals, but not quite as well as the group that did both at the same time, King says. Those who started with diet first managed to meet dietary goals but not their exercise goals.

She says the results were surprising, because doctors and nutritionists often encourage people to make one change at a time. “For some people, that may be the best approach, but we found that you may get the most bang for your buck by making these changes together.”

This was not a weight-loss study, and participants were not taught portion control and other strategies important for weight loss, King says. However, some people did drop pounds, and researchers are studying those results now.

Tim Church, director of preventive medicine research at Pennington Biomedical Research Center in Baton Rouge, says, “This provides really strong evidence that you might as well do both from the beginning of your program.”

Felicia Stoler, a registered dietitian and exercise physiologist in Holmdel, N.J., says when she works with patients she gives them both a nutrition plan and a physical-activity plan. Many people would rather change the foods they eat than their physical activity, she says. “But when people become more physically active they feel better about themselves, and they often no longer want to put bad food in their system.”

Copyright © 2013 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

Folks who want to get in better shape and eat healthier are often encouraged to make one change at a time, but a new study finds that people are the most successful when they tackle their diet and exercise habits simultaneously.

“It comes down to making them both priorities and thinking about both throughout the day,” says lead researcher Abby King, professor at the Stanford (University) Prevention Research Center.

King and colleagues worked with 200 inactive, mostly overweight people, 45 years and older, who had relatively unhealthy diets that didn’t include enough fruits and vegetables and contained too much saturated (animal) fat.

Published online in Annals of Behavioral Medicine, the study shows participants were divided into four groups: One learned to make diet and exercise changes at the same time; another learned to make diet changes first and then a few months later began working on their exercise habits. A third group changed their exercise habits first, then their diet later. And the fourth group learned stress-management techniques but did not get diet and exercise guidance.

Participants weren’t trying to lose weight, just live healthier lifestyles. Health educators met with them at the beginning of the year and then called them once a month to provide advice and support.

The goals were for participants to meet the government’s physical activity guidelines of doing at least 150 minutes a week of moderate-intensity physical activity, such as walking, eat five to nine servings of fruits and vegetables a day and keep their saturated fat intake to 10% or less of daily calories.

The findings after one year: Those who made changes in their diet and exercise habits at the same time did the best at meeting all three goals — eating enough fruits and vegetables, limiting saturated fat and exercising enough to meet the government’s guidelines.

Participants who started with exercise first also did pretty well at meeting diet and exercise goals, but not quite as well as the group that did both at the same time, King says. Those who started with diet first managed to meet dietary goals but not their exercise goals.

She says the results were surprising, because doctors and nutritionists often encourage people to make one change at a time. “For some people, that may be the best approach, but we found that you may get the most bang for your buck by making these changes together.”

This was not a weight-loss study, and participants were not taught portion control and other strategies important for weight loss, King says. However, some people did drop pounds, and researchers are studying those results now.

Tim Church, director of preventive medicine research at Pennington Biomedical Research Center in Baton Rouge, says, “This provides really strong evidence that you might as well do both from the beginning of your program.”

Felicia Stoler, a registered dietitian and exercise physiologist in Holmdel, N.J., says when she works with patients she gives them both a nutrition plan and a physical-activity plan. Many people would rather change the foods they eat than their physical activity, she says. “But when people become more physically active they feel better about themselves, and they often no longer want to put bad food in their system.”

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