An article was published today in The New York Times Magazine entitled "The Fat Trap." It discusses the trials and tribulations that people face while trying to maintain weight loss. Long story short, many people attempt to lose weight but few manage to keep the pounds off. There are a few studies that have researched why it seems only a few people are able to maintain weight loss.
The National Weight Control Registry currently tracks over 10,000 people who have maintained a 30-pound weight loss or greater for at least a year. Surprisingly, there was no one way people initially took the weight off. The ways people lost weight ranged from joining weight-loss support groups to popular diets to weight-loss surgery. One of the most widely recognized ways people lose weight is through the help of support groups such as Weight Watchers or Jenny Craig.
Even if people in the weight control registry did not lose the weight the same way, they did have similar behaviors that assisted in maintaining their new weight. Ninety-eight percent of registry members have modified their food intake in some way. For physical activity, 94% have increased their activity with 90% exercising about one hour a day. Other common behaviors of those that have maintained weight loss included keeping a food diary and weighing themselves frequently.
The USDA recommends for losing weight and maintaining weight loss people should get 150 minutes of moderate activity each week, although some cases may need up to 300 minutes a week. Three hundred minutes is equal to five hours. It is recommended that this time is spread out throughout the week rather than all in one shot. The registry found that the average member does a four-mile walk 7 days a week. This means that if the person averages a 15-minute mile, they are getting 420 minutes of moderate exercise per week. This is well above what the USDA suggests for weight loss and maintenance.
Researchers have found that a person who has lost weight needs fewer calories to maintain their lower weight than a person naturally the same weight. It is still unclear as to why this occurs. One study found that the muscle fibers of people who lost weight burn 20- 25% fewer calories during everyday activity and moderate exercise than people naturally that weight. This means the number of calories the treadmill tells that person they burned is substantially higher than what they actually burned.
It is unknown how long people who lose weight need to restrict energy intake and/ or increase their activity level for. Early research from Columbia University suggests it could last six years, but potentially may be for the rest of that person's life. Obesity is a newer epidemic and it will take time to gather information for long-term weight maintenance. It may also be hard to find people who are able to maintain their new weight for a substantial amount of time, such as their life span. The average registry member has maintained a 66 pound weight loss for 5.5 years.
The picture of weight maintenance after weight loss may be looking a little bleak to you (to put it mildly). Do not despair just yet; I have a few tools for you that can help.
Log It If you put it in your mouth or do it, write it down. This will help you recognize how much you are actually eating and moving. You can use your logs to help you see where you're doing well and where your downfalls are. After comparing notes these logs can help you to create a plan to get you over your hurdles. Logs can be kept with a pen and paper, on a website, or on a smart phone app.
Know Your Numbers Learn to appreciate your scale and not loathe it. Numbers may fluctuate weekly, if not daily. Even the time of day you weigh yourself may make a difference. Pick a time of day, once a day, to weigh yourself. Using your weight along with your food and activity logs will help give a basis as to how you are doing. Do not weigh yourself pre- and post-workout and consider weight loss there as fat loss. Weight loss during a workout is from sweating, so grab your water bottle and rehydrate!
Partner Up Get your family, get your friends, get everybody on board! Studies show time and time again that support groups help in weight loss and weight maintenance. If you have the help of others you are less likely to backtrack. If you have the people you spend the most time with on board they can help keep you accountable. Keep an eye out for those who may try to sabotage you. For example, the person who says "Just try one cookie, it won't hurt." or "After a day like today, you deserve Happy Hour." Cheating on your new lifestyle only cheats yourself.
Weight gain doesn't happen overnight, nor does taking it off and maintaining it. As with most things in life, losing weight and learning to maintain it will take time. But the health, and the more apparent physical, benefits are well worth the work. Remember to keep focused and modify your plan as necessary to achieve your weight loss goals.
Wednesday, December 28, 2011
Thursday, December 22, 2011
YourPlate
In the beginning of June this year the United States Department of Agriculture released MyPlate, the replacement for the difficult to interpret MyPyramid. The plate is divided into four sections of the various types of food you should be consuming at each meal with a circle (equating to a glass) representing dairy on the side. Pretty self explanatory, right? Half of your plate should be fruit and vegetables, the other half should have a slightly smaller portion of protein in comparison to grains.
As it turns out, making your plate into MyPlate is pretty hard. Americans eat as MyPlate instructs 2% of the time. That's about one week of the year or 21 meals a year. Twenty one of the 1,095 meals we potentially eat each year. NPD deducted this number from the days people reached at least 70% of the daily recommendation of all of the food groups and considered those days to be MyPlate days.
The NPD group reported their finding based off of their National Eating Trends (NET) research. NET research has tracked the eating and drinking habits of US consumers for 30 years by examining two-week food diaries of 5,000 people. There is the potential for error when it comes to self-reported food diaries. Judging by the fact that this research was carried out by a private organization and not done in a clinical setting, people may be less likely to lie about what they eat. However, participants may still underreport how much they eat.
These findings are not all that surprising. The typical American dinner has a vegetable, a grain, and protein. Not only does the typical dinner not include fruit, but it does not include dairy either. It is also uncommon to have vegetables with breakfast. Making the need for following MyPlate more apparent, 65% of the participants in NPD's research are classified as overweight or obese.
On the days that people had a MyPlate day, they were more likely to consume more than 3 meals a day and to weigh less. This shows that following the MyPlate guidelines can help in leading a healthy lifestyle. They also found that people who snacked on fruit, vegetables, and yogurt also tended to have a lower body mass index.
Additionally, there are a few healthy diet tips that are not explicit on the MyPlate diagram. Americans should replace solid fats with oils. You should also try to make half of your grains whole-grains. The goal of MyPlate is for you to enjoy your meals, while eating less and still getting a high nutritional value.
Knowing how little of the time Americans follow MyPlate shows that education is needed. Americans need to be educated on what MyPlate is and how to apply it to their everyday life. With the number of obese and overweight Americans on the rise, education as a tool for intervention has never been more necessary.
Now that you've seen MyPlate try to make it YourPlate. Hopefully it lasts longer than a week.
Monday, December 12, 2011
Call to Arms
Dear Naughty Nutrition Reader,
This a plea that you will help the nation in the fight against obesity by allowing Medicare and Medicaid recipients to be covered to see medical professionals who are truly qualified and focused on treating their condition rather than their primary care giver alone. Recently, Centers for Medicare and Medicaid Services decided that Intensive Behavioral Therapy for Obesity could only be furnished by primary-care providers in the primary-care setting. Meaning medical professionals, such as registered dietitians and clinical psychologists, can no longer be reimbursed by Medicaid or Medicare for providing these services to obese Medicare/ Medicaid recipients. Primary-care providers, who have significantly less training on obesity counseling, are now being asked to show positive outcomes in treatment of obesity. Interestingly, a recent survey of primary-care physicians showed that 78 percent said they had no prior training on weight-related issues. Of those, 72 percent said no one in their office had weight-loss training. This hardly justifies what Centers for Medicare and Medicaid Services has done.
Many states in this nation are afflicted by the obesity epidemic and the numbers are continuing to rise. According to the CDC one-third of U.S. adults are considered obese. An even gloomier outlook, 12.5 million children and teens (or 17 percent) from age 2 to 19 are considered obese. This is a large number of people whose options for treatment are down to one person who may have little to no training in that area.
Obesity can lead to numerous chronic conditions including type 2 diabetes, hypertension, coronary heart disease, and cancer. The results of these conditions are not pretty, nor are they inexpensive. Take type 2 diabetes for example, in 2003 researchers performed a study to find out how much it will cost to treat an obese person with type 2 diabetes. In 2003 it cost $1,700 dollars for white men and $2,100 dollars for white women. This amount is minus the cost of what it would be to treat complications of diabetes. Obviously, not all patients with type 2 diabetes are white, but for the sake of this example and the lack of research concerning the cost of type 2 diabetes, I'll assume that treatment for blacks, hispanics, and asians would cost about the same. Coincidentally, most people with type 2 diabetes are not white but are black, hispanic or asian.
Now for a little math, shall we? According to the American Diabetes Association there are 25.8 million people in the US with some form of diabetes. Of that, 5 percent have type 1 diabetes. That knocks us down to 24.51 million people with type 2 diabetes. For the sake of trying to guess how many of each sex has diabetes, I'll average the costs to $1,900 a person to treat type 2 diabetes without any complications.
I failed to mention something, the $1,900 cost I used was just using diet therapy. Not many primary-care givers automatically recommend diet alone. I say this because someone near and dear to me was recently diagnosed with type 2 diabetes. He was told, "No white bread, no regular soda, and take this pill before every meal. I'll see you 3 months." Not what I wanted to hear. I wonder what advice that primary care doctor will give an obese patient. I am fairly certain it will include "take this pill."
Multiplying $1,900 by 24.51 million patients we get $46.569 billion to treat type 2 diabetes. These costs and patient numbers are from 2003 and 2007. Inflation since 2003 has likely increased how much it costs to treat diabetes. The number of people with type 2 diabetes has also increased. In actuality this number is a little low. The cost of treatment per person increased 10-90% depending on if drugs or other diseases related to diabetes occurred. If their diabetes lead to kidney failure and they required dialysis the cost increased 11-fold. Those are some big jumps in cost and these costs are passed on us, the tax payers, for Medicare and Medicaid recipients.
Type 2 diabetes is just one example of a chronic condition that can stem from obesity. Keep in the mind there are ten health conditions related to obesity. All of them requiring different types of treatments and therapies. All of these conditions can cost an astronomical amount of money, whether it be for the treatment or the economic loss of an individual being unable to work and needing assistance. All of these chronic health conditions may be prevented if proper and adequate action is taken to treat obesity.
This is the first year there are no blue states on the map. Welcome to the club Colorado.
We can have an impact on these chronic conditions by stomping out obesity. Tell Centers for Medicare and Medicaid Services that medical professionals such as RDs and clinical psychologists can help people with obesity in conjunction with (and maybe even better than) their primary care giver. If you or someone you know has been diagnosed as being obese and has benefited from the help of a RD you owe to yourself, that family member/friend, and that RD. You can sign the petition here: http://wh.gov/DWX.
Thank you and good night.
This a plea that you will help the nation in the fight against obesity by allowing Medicare and Medicaid recipients to be covered to see medical professionals who are truly qualified and focused on treating their condition rather than their primary care giver alone. Recently, Centers for Medicare and Medicaid Services decided that Intensive Behavioral Therapy for Obesity could only be furnished by primary-care providers in the primary-care setting. Meaning medical professionals, such as registered dietitians and clinical psychologists, can no longer be reimbursed by Medicaid or Medicare for providing these services to obese Medicare/ Medicaid recipients. Primary-care providers, who have significantly less training on obesity counseling, are now being asked to show positive outcomes in treatment of obesity. Interestingly, a recent survey of primary-care physicians showed that 78 percent said they had no prior training on weight-related issues. Of those, 72 percent said no one in their office had weight-loss training. This hardly justifies what Centers for Medicare and Medicaid Services has done.
Many states in this nation are afflicted by the obesity epidemic and the numbers are continuing to rise. According to the CDC one-third of U.S. adults are considered obese. An even gloomier outlook, 12.5 million children and teens (or 17 percent) from age 2 to 19 are considered obese. This is a large number of people whose options for treatment are down to one person who may have little to no training in that area. Obesity can lead to numerous chronic conditions including type 2 diabetes, hypertension, coronary heart disease, and cancer. The results of these conditions are not pretty, nor are they inexpensive. Take type 2 diabetes for example, in 2003 researchers performed a study to find out how much it will cost to treat an obese person with type 2 diabetes. In 2003 it cost $1,700 dollars for white men and $2,100 dollars for white women. This amount is minus the cost of what it would be to treat complications of diabetes. Obviously, not all patients with type 2 diabetes are white, but for the sake of this example and the lack of research concerning the cost of type 2 diabetes, I'll assume that treatment for blacks, hispanics, and asians would cost about the same. Coincidentally, most people with type 2 diabetes are not white but are black, hispanic or asian.
Now for a little math, shall we? According to the American Diabetes Association there are 25.8 million people in the US with some form of diabetes. Of that, 5 percent have type 1 diabetes. That knocks us down to 24.51 million people with type 2 diabetes. For the sake of trying to guess how many of each sex has diabetes, I'll average the costs to $1,900 a person to treat type 2 diabetes without any complications.
I failed to mention something, the $1,900 cost I used was just using diet therapy. Not many primary-care givers automatically recommend diet alone. I say this because someone near and dear to me was recently diagnosed with type 2 diabetes. He was told, "No white bread, no regular soda, and take this pill before every meal. I'll see you 3 months." Not what I wanted to hear. I wonder what advice that primary care doctor will give an obese patient. I am fairly certain it will include "take this pill."
Multiplying $1,900 by 24.51 million patients we get $46.569 billion to treat type 2 diabetes. These costs and patient numbers are from 2003 and 2007. Inflation since 2003 has likely increased how much it costs to treat diabetes. The number of people with type 2 diabetes has also increased. In actuality this number is a little low. The cost of treatment per person increased 10-90% depending on if drugs or other diseases related to diabetes occurred. If their diabetes lead to kidney failure and they required dialysis the cost increased 11-fold. Those are some big jumps in cost and these costs are passed on us, the tax payers, for Medicare and Medicaid recipients.
Type 2 diabetes is just one example of a chronic condition that can stem from obesity. Keep in the mind there are ten health conditions related to obesity. All of them requiring different types of treatments and therapies. All of these conditions can cost an astronomical amount of money, whether it be for the treatment or the economic loss of an individual being unable to work and needing assistance. All of these chronic health conditions may be prevented if proper and adequate action is taken to treat obesity.
This is the first year there are no blue states on the map. Welcome to the club Colorado.
We can have an impact on these chronic conditions by stomping out obesity. Tell Centers for Medicare and Medicaid Services that medical professionals such as RDs and clinical psychologists can help people with obesity in conjunction with (and maybe even better than) their primary care giver. If you or someone you know has been diagnosed as being obese and has benefited from the help of a RD you owe to yourself, that family member/friend, and that RD. You can sign the petition here: http://wh.gov/DWX.
Thank you and good night.
Monday, December 5, 2011
Read What You Eat
The Food and Drug Administration recently warned Alexia Foods about misleading food labels. Most of the Alexia Food products have "All Natural" on the front of the package right above their name. As it turns out, however, not everything they produce is as natural as it claims to be.
For instance, their Roasted Red Potatoes and Baby Portabella Mushrooms contain disodium dihydrogen pyrophosphate (DDP), a synthetic chemical preservative. This product was deemed misbranded by the FDA under legislation that states a food is misbranded if its labeling is false or misleading. The DDP in this product is used to keep cut potatoes from turning brown due to oxidation. DDP can also be used as buffer, leaven, quality modifier, ferment agent, emulsifier, nutriment, and adhesive in foods.
Image taken from: http://mywoodenspoon.com/
While doing some research I came across another product that contained DDP. Once again the product contained potatoes. The FDA noted that the product in their initial warning might not be the only offender in Alexia's product line and suggested they ensure other products are not misbranded as well.
Currently, the FDA does not a formal definition of what is considered 'natural.' The FDA considers use of the term 'natural' on a food label to be non-misleading when nothing artificial or synthetic has been included in, or added to, a food that would not normally be expected to be in the food.
The FDA typically has definitions for the terms commonly seen on food labels. For instance take the term 'fresh.' 'Fresh' can be used on a label to suggest that a food is unprocessed or in a raw state, that has never been frozen, nor has it underwent any thermal processing or form of preservation.
You may have encountered labels that have 'fresh frozen' or 'frozen fresh' on them. This means that the food was gathered and quickly frozen, all the way to the center of the food, by the use of freezing system in order that no deterioration of the food could have taken place between harvest and freezing. In this case, blanching the food is considered okay prior to freezing. Other foods that can have the label 'fresh' include the addition of waxes and coatings, post-harvest approved pesticides, or foods that have been treated with a ionizing radiation (that does not exceed a specific dose).
The specific definition for 'fresh' was created in 1993. It is likely that this definition was created during a time when consumers were putting down canned vegetables and opting for the produce section instead. With the ever growing trend of consumers wanting to purchase 'all natural' products, it is the likely the FDA will have to create a formal definition for 'natural' in the near future.
Alexia Foods has 15 business days to respond to the FDA with the actions they will take to correct this problem.
A link to the actual warning letter sent to Alexia Foods can be found here.
For instance, their Roasted Red Potatoes and Baby Portabella Mushrooms contain disodium dihydrogen pyrophosphate (DDP), a synthetic chemical preservative. This product was deemed misbranded by the FDA under legislation that states a food is misbranded if its labeling is false or misleading. The DDP in this product is used to keep cut potatoes from turning brown due to oxidation. DDP can also be used as buffer, leaven, quality modifier, ferment agent, emulsifier, nutriment, and adhesive in foods.
Image taken from: http://mywoodenspoon.com/
While doing some research I came across another product that contained DDP. Once again the product contained potatoes. The FDA noted that the product in their initial warning might not be the only offender in Alexia's product line and suggested they ensure other products are not misbranded as well.
Currently, the FDA does not a formal definition of what is considered 'natural.' The FDA considers use of the term 'natural' on a food label to be non-misleading when nothing artificial or synthetic has been included in, or added to, a food that would not normally be expected to be in the food.
The FDA typically has definitions for the terms commonly seen on food labels. For instance take the term 'fresh.' 'Fresh' can be used on a label to suggest that a food is unprocessed or in a raw state, that has never been frozen, nor has it underwent any thermal processing or form of preservation.
You may have encountered labels that have 'fresh frozen' or 'frozen fresh' on them. This means that the food was gathered and quickly frozen, all the way to the center of the food, by the use of freezing system in order that no deterioration of the food could have taken place between harvest and freezing. In this case, blanching the food is considered okay prior to freezing. Other foods that can have the label 'fresh' include the addition of waxes and coatings, post-harvest approved pesticides, or foods that have been treated with a ionizing radiation (that does not exceed a specific dose).
The specific definition for 'fresh' was created in 1993. It is likely that this definition was created during a time when consumers were putting down canned vegetables and opting for the produce section instead. With the ever growing trend of consumers wanting to purchase 'all natural' products, it is the likely the FDA will have to create a formal definition for 'natural' in the near future.
Alexia Foods has 15 business days to respond to the FDA with the actions they will take to correct this problem.
A link to the actual warning letter sent to Alexia Foods can be found here.
Thursday, December 1, 2011
Tantrum Meal
Like many cities, San Francisco is looking for ways to make their public healthier. Starting today it is illegal to give away a free toy with a kids meal if it does not meet certain nutritional standards. McDonalds being the geniuses they are, are now charging 10 cents for the toy with the purchase of a Happy Meal. Did I mention that all the proceeds from the toy go to the Ronald McDonald House of San Francisco? Very clever. Not only does a kid still get a cheap toy (literally and figuratively) but an ill child has the opportunity to have their family around.
Way to tug at those heart strings Mickey D's.
Charging for the toy was not the immediate response that McDonalds had to the new ordinance going into affect. In fact, they initially attempted to make their Happy Meals healthier. They offered low-fat milk and fresh sliced apples; eventually they want to add another vegetable option. The portion of fries was cut by more than half. They did a few other things too, but I'll let their gifted PR team explain it themselves. Even with these changes the kids meals were still not up to San Fran's new guidelines.
So McDonalds did the next best thing. Asked you for some change.
If you're like me, you may be starting to wonder what these new guidelines were and how this whole thing started. Back in 2004 the California's Congress passed a resolution to curb unhealthy marketing to children. As you can imagine, giving away free toys with kids meal purchases was deemed to be unhealthy marketing.
This makes sense. Remember the Beanie Baby craze back in the 90s. McDonalds would release a new Teenie Beanie each week and I was there. You know those hunks of fabric filled with foam and beads were going to be so valuable I might be able to pay for my college once I sold them off (at peak price nonetheless). This is a lesson on why you save, and not spend, money. Here was the caveat to obtaining a Teenie Beanie, I knew you could purchase the toy without having to get the meal. (Editor's note: That is not my collection pictured above. I'm pretty sure it didn't survive long after I left for college with zero beanie baby scholarship money.)
Can you imagine people going into McDonalds just to buy the toys on a regular basis? (Besides the collectors with rooms dedicated to the junk?) That probably doesn't happen. People get the kids meal because their kids require food, it's made especially for them, and the kid gets a hunk of plastic to entertain them for the afternoon with. Happy Meal sounds a lot better than Tantrum Meal.
Under the new ordinance, for restaurants to offer the free toy they must meet certain nutrition requirements for the kids meal. These kids meals have to have fewer than 600 calories and less than 640 milligrams of sodium. These meals also must have one serving of fruit and one and a half servings of vegetables (in non-breakfast meals). The drinks offered must have less than 10 percent of their calories from added sugars. Looking at the breakdown, this isn't too far off from what school lunches need to provide as sides under the National School Lunch Program.
Playing around on the meal builder I created what I thought most kids would eat. Chicken nuggets with BBQ sauce, french fries, and orange drink. (Because some adults are responsible and know their kids need their vitamin C.) This meal came in at 460 calories and 690 milligrams of sodium. McDonalds misses the new requirements because its higher in sodium and you have a fruit or fries option. Once McDonalds has a fresh vegetable option, adds another side item to the meal, and drops the sodium content in it they would qualify to hand out free toys again.
These healthier kids meals McDonalds has currently are set to be out across the United States by April. But will McDonalds add those healthier options at a higher price to them and possibly consumers to qualify to give out free toys? Or will they add a cape to Ronald McDonald's costume to illustrate how McDonalds helps sick kids by playing by their own rules?
Way to tug at those heart strings Mickey D's.
Charging for the toy was not the immediate response that McDonalds had to the new ordinance going into affect. In fact, they initially attempted to make their Happy Meals healthier. They offered low-fat milk and fresh sliced apples; eventually they want to add another vegetable option. The portion of fries was cut by more than half. They did a few other things too, but I'll let their gifted PR team explain it themselves. Even with these changes the kids meals were still not up to San Fran's new guidelines.
So McDonalds did the next best thing. Asked you for some change.
If you're like me, you may be starting to wonder what these new guidelines were and how this whole thing started. Back in 2004 the California's Congress passed a resolution to curb unhealthy marketing to children. As you can imagine, giving away free toys with kids meal purchases was deemed to be unhealthy marketing.
This makes sense. Remember the Beanie Baby craze back in the 90s. McDonalds would release a new Teenie Beanie each week and I was there. You know those hunks of fabric filled with foam and beads were going to be so valuable I might be able to pay for my college once I sold them off (at peak price nonetheless). This is a lesson on why you save, and not spend, money. Here was the caveat to obtaining a Teenie Beanie, I knew you could purchase the toy without having to get the meal. (Editor's note: That is not my collection pictured above. I'm pretty sure it didn't survive long after I left for college with zero beanie baby scholarship money.) Can you imagine people going into McDonalds just to buy the toys on a regular basis? (Besides the collectors with rooms dedicated to the junk?) That probably doesn't happen. People get the kids meal because their kids require food, it's made especially for them, and the kid gets a hunk of plastic to entertain them for the afternoon with. Happy Meal sounds a lot better than Tantrum Meal.
Under the new ordinance, for restaurants to offer the free toy they must meet certain nutrition requirements for the kids meal. These kids meals have to have fewer than 600 calories and less than 640 milligrams of sodium. These meals also must have one serving of fruit and one and a half servings of vegetables (in non-breakfast meals). The drinks offered must have less than 10 percent of their calories from added sugars. Looking at the breakdown, this isn't too far off from what school lunches need to provide as sides under the National School Lunch Program.
Playing around on the meal builder I created what I thought most kids would eat. Chicken nuggets with BBQ sauce, french fries, and orange drink. (Because some adults are responsible and know their kids need their vitamin C.) This meal came in at 460 calories and 690 milligrams of sodium. McDonalds misses the new requirements because its higher in sodium and you have a fruit or fries option. Once McDonalds has a fresh vegetable option, adds another side item to the meal, and drops the sodium content in it they would qualify to hand out free toys again.
These healthier kids meals McDonalds has currently are set to be out across the United States by April. But will McDonalds add those healthier options at a higher price to them and possibly consumers to qualify to give out free toys? Or will they add a cape to Ronald McDonald's costume to illustrate how McDonalds helps sick kids by playing by their own rules?
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