Judith J. Wurtman, PhD2013-06-20T08:36:04-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/author/index.php?author=judith-j-wurtman-phdCopyright 2008, HuffingtonPost.com, Inc.HuffingtonPost Blogger Feed for Judith J. Wurtman, PhDGood old fashioned elbow grease.Renewable Energy at 4 p.m.tag:www.huffingtonpost.com,2013:/theblog//3.33964482013-06-11T14:30:55-04:002013-06-11T14:31:07-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
"Looks like everyone needs a carbo fix," I remarked to my companion. "They all look worn out from a day on the beach and fretting over what T-shirt to buy as a souvenir."
Many people, not just the passengers on the ferry, experience an afternoon energy slump. This 4 p.m. energy leakage seems to take over our physical and mental state. Our bodies feel heavy and inert. It is hard to concentrate, to take on new tasks, to be patient and upbeat. The energy drain is worse in the winter when 4 p.m. means dusk or even darkness. But even in the brightness of a late spring afternoon, we may feel less active than we should with the sun still high.
What is curious about this energy drain is that it is rarely physical, even though it feels that way. Indeed, and this may be hard to believe, exercise, simply moving, is an excellent way to restore energy. When people engage even in trivial physical activity, they are energized. During a ferry trip last summer, the pilot announced that there was a whale and its pup on the starboard side of the boat. Passengers who had been slumped in a semi-stupor popped up from their seats and raced over to the right side of the ferry. Where was their exhaustion? It disappeared.
If muscle fatigue were the cause of late afternoon tiredness, exercise would only make it worse. But the brain, not the muscles, generates the cause of the afternoon fatigue. And one reason we feel more vigorous after exercise is that it increases blood flow through our brains, bringing more oxygen and nutrients.
Perhaps one solution for the afternoon mental slump is recess. If there were some way people could leave their cubicles and conference rooms and retail counters to take a fast walk, or a quick spin on a stationary bike, they would feel renewed and ready to continue to work.
There are two other suggested causes for late afternoon fatigue: lack of caffeine and inactive serotonin.
By mid-to-late afternoon, any caffeine we may have consumed in the morning has long disappeared from our bloodstream. Caffeine is a known stimulant, and like any stimulant we take into our body, when it is no longer active we feel tired. It is possible to recharge our mental energy by consuming more caffeine, but doing so comes with a cost, namely a sleepless night. However, that caffeine therapy works and may be an option for those whose sleep is not later effected It should be noted, by the way, that energy drinks are simply overpackaged flashier versions of highly caffeinated beverages.
The other reason for late afternoon fatigue affects everyone, including caffeine users, alike. The neurotransmitter serotonin seems to become less active in the afternoon and the result is a cluster of changes in mental focus, emotional well-being and appetite. Fatigue, lack of concentration, distractibility, impatience, grumpiness and a need to snack may be experienced. Years ago, at MIT, we found that volunteers needed to eat carbohydrates late in the afternoon and this need was always preceeded with some change in their energy, focus and mood. Further studies revealed that when serotonin became more active, these symptoms abate.
Restoring serotonin activity does not require drugs, herbs or supplements. It requires only eating certain foods that, after they are digested, allow tryptophan to get into the brain. Serotonin is made from tryptophan and as soon as this amino acid gets into the brain, it is converted into more serotonin. Enter: pretzels.
The foods that allow tryptophan to get into the brain are any carbohydrates with the exception of fruit. The best carbohydrates are fat-free because they will be digested rapidly and set off the process that gets tryptophan into the brain cells. (They also have the fewest calories.) Fruit sugar does not promote this process. Not much carbohydrate is needed, about 25-30 grams. Protein-containing foods, although they contain tryptophan, do not allow this amino acid to enter the brain because other amino acids in the protein prevent tryptophan access to the "gateway" into the brain. And unfortunately, beer and other alcoholic beverages don't contain enough carbohydrate to allow new serotonin to be made, although they certainly promote afternoon relaxation.
Why does serotonin activity drop in the late afternoon? In all the decades since we discovered its role in afternoon fatigue, we have never found an answer to this. But then again, there are many changes in our daily rhythms such as body temperature, cortisol levels, sleepiness and even hunger. Who is really hungry at 3 a.m. unless supper was skipped?
Afternoon fatigue is natural. So is the solution, which is eating and exercise. Pretzels and running to watch whales seems like a perfect combination.
For more on personal health, click here.]]>Time for Ice Cream in Your Diet!tag:www.huffingtonpost.com,2013:/theblog//3.33361392013-05-29T14:01:32-04:002013-05-29T14:01:38-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
Eating ice cream -- or its close cousins gelato, frozen yogurt, sorbet or soft serve -- is a seasonal treat (like buying the first bunch of daffodils or tulips), and as such should not be denied just because one is on a diet. And unless the dieter is following a program that forbids eating any sweet, creamy food that is cold on the tongue, it should be possible to fold the calories from one of these frozen delights into the day's calorie count without inhibiting weight loss. The key seems to be sticking to a half-cup serving size and avoiding the tempting but truly fattening sundaes and added high-fat ingredients.
Should you choose gelato over ice cream? Frozen yogurt, be it Greek or not, over ice cream? Perhaps soft serve versus hard ice cream? It turns out that the calorie count for all of these products hovers around 200 for a half-cup. Unless you are eating a fat-free, sugar-free item that is mostly air and filler, the difference is really in taste and texture.
Gelato is the Italian version of ice cream. It is sweet and creamy, and if you find a gelato store, you will be dazzled by the array of colors and flavors. Gelato has somewhat fewer calories than ice cream; an average half-cup serving has 150 calories versus 200 from regular ice cream because it contains less butterfat. However, it actually tastes creamier. The reason is that much less air is beaten into the mixture, giving it a denser mouth feel. In fact, it is so dense, it is impossible to eat quickly, thus extending the enjoyable experience of eating it.
What about frozen yogurt instead of ice cream? Or Greek frozen yogurt? Although it seems reasonable to assume that the frozen yogurts are less caloric, the caloric difference between them and ice cream may be unimportant. Ben & Jerry's Cherry Garcia Ice Cream (half-cup) is 240 calories, while the company's Raspberry Fudge Chunk Greek Frozen Yogurt (half-cup) is also 200 calories and its Fudge Brownie Frozen (non-Greek) Yogurt (half-cup) is 180 calories. If your frozen Greek yogurt scoop drips while you are eating it, the calories may end up the same.
Sorbet has fewer calories, around 150 per cup, and most flavors are fat-free. However, chocolate and coconut sorbet do contain some fat and are higher in calories. The calorie contents of soft-serve ice cream that comes out of a nozzle and can be whirled into a tower with a little comma on the top may vary much more. For example, soft-serve JP Licks has 150 calories for a half-cup, while Tasti D-Lite is considerably less, mainly because it contains very little fat but lots of gum and other thickening agents. But, if you add hot fudge topping and whipped cream to even light soft-serve ice cream, the calories bounce up to well over 300 a half-cup serving.
The problem with all these calculations is the serving size. The calorie counts depend on the size of the scoop, and also on whether a cone or cup is dipped in a fudge coating and/or cookies, nuts and candy are added into the mixture.
It is hard to imagine how the six-inch-high ice cream lapped up by the man in the suit could fit into a half-cup serving. A half a cup is not a very large measure. Indeed, even so-called kiddie cones seem to come in larger sizes than a half-cup. A few years ago, Good Housekeepingsurveyed serving sizes of ice cream around New York City and found no consistency in the amount scooped. Maybe it depends on how tired the wrist of the server is so that by the end of the day, less is put into the cone or cup than when the server comes to work.
Perhaps the most strategic approach to indulging in ice cream or other frozen delights while dieting, is to be cautious in what you choose. Kiddie-size cones or cups will approximate the half-cup serving size, and if you choose low-fat ice cream or frozen yogurt, you should be eating no more than 200 calories, more or less. Avoid waffle cones; they have 120 calories compared to 17 in a regular cone and 20 in a sugar cone. As yummy and tempting as they are, don't pick ice cream stuffed with chocolate, caramel, nuts, cookie dough and peanut butter -- and no hot fudge sauce.
The pleasure of an ice cream in the summer should come from the combination of warm sun on your skin and cold ice cream on your tongue. And that should be enough.
For more on diet and nutrition, click here.]]>Could Having a Valet Be Bad for Your Heart?tag:www.huffingtonpost.com,2013:/theblog//3.32157342013-05-06T16:54:14-04:002013-05-06T16:54:30-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
The answer was an overwhelming, "No!"
I thought of this while scanning a summary of a major study looking at the impact of running and walking on various measures of health such as blood pressure, cholesterol, diabetes, and heart disease. The study, recently released online in the journal of Arteriosclerosis, Thrombosis and Vascular Biology, reported the same health benefits for walkers and runners if they expended the same amount of energy while exercising. [1] This study, which lasted six years, enrolled 33,060 runners and 15,045 walkers who were dedicated to exercising. Records were kept of the amount of metabolic energy ("MET") expended by the volunteers when they were running or briskly walking, and then comparatively analyzed.
The results of the study are good and bad news for those of us who wonder what type of exercise is best for our health. Runners and walkers whose exercise used up the same METs had the low risk of developing diabetes and cardiovascular problems. That is the good news. But the sort of bad news is that runners expended more energy per unit mile they ran than walkers covering the same distance, and this translated into better health outcomes.
The reason for this discrepancy is that running is a less efficient way of moving, and so mile for mile, the runner burns up more energy than the walker. (Unless the walker is dragging a Great Dane or stubborn dachshund on a leash.) According to one of the authors, Paul Williams, a walker would have to cover 4.3 miles at a brisk pace to use the same amount of METs as a person running three miles.
What this study seems to say is that if your exercise of choice is walking, it has to be more than a stroll around the block if substantial health benefits are to be achieved. Indeed, the walk ought to be fast and long for the exercise to produce, over time, a substantial decrease in the risk of cardiovascular problems or diabetes.
But who is going to spend two or three hours a day walking? Obviously even the dedicated walkers in the study did not spend the extra time walking necessary to use up as much energy as the runners did in a shorter amount of time.
And what about those who would not even consider walking more than a block or two to their destination? Those, who like many residents of Los Angeles, for example, insist on having a valet drive their cars to the parking garage so they don't have to walk. Or people all over the country that pull up to the door of the restaurant, or the mall to avoid more steps than necessary? I see this even with well-meaning friends who always offer me a ride home after a lecture or meeting and are surprised when I refuse, saying that it is only a 10 or 15 minute walk.
The results of this major study are compelling as predictors of health risk. Yet how can they be translated into behavioral change? There has to be a cultural shift away from instant convenience, e.g., the valet, or saving a few minutes of time (the ride rather than the walk) or comfort. Rather than being annoyed at having to walk a few blocks because you couldn't park your car next to the door of the restaurant, be pleased at yet another opportunity to rack up a higher MET and consequently burn a few calories.
Moreover, if we are going to suggest dedicated walking as the exercise of choice for health benefits, then it has to have some pleasurable aspects to it. Otherwise it will be abandoned as a passing fancy. Here are some ways of making walking tolerable, and perhaps even enjoyable:
1. Map out your route using Google map or other GPS supported directions. Know how far you are going and when it is time to go further, use your GPS or map to plan another longer route. You are not a goldfish restricted to moving around in the equivalent of a glass bowl.
2. Consider buying walking sticks. They should come with rubber bottoms so they hit the pavement softly and give you support. The length has to be adjustable and the hand holds comfortable. Walking sticks, aka hiking poles, make your arms move as well as your legs, are useful for going up and down hills (this is why hikers use them), and for older walkers help with balance. Also, they make you look athletic.
3. Triumph over walking boredom by walking with a friend, chatting on the phone with people whom you otherwise do not have time to call during the work day, or listening to lectures or books on your iPod. (I listened to an excellent lecture course on the history of the Civil War while dragging the aforementioned dachshund on his daily rounds.)
4. Activate a pedometer on your phone, iPod or wrist device so you really know how many miles you have covered.
5. Remind yourself to keep up the pace... for a healthy heart you must walk briskly.
6. Take water and dress appropriately. A small knapsack is useful for holding layers that you take off as you get warm or put on if the weather should suddenly change.
Or simply enjoy. Turn off your phone and enjoy the fresh air.
Reference:
[1] http://atvb.ahajournals.org/content/early/2013/04/04/ATVBAHA.112.300878.abstract]]>Are You Reducing Your Bones While You Lose Weight?tag:www.huffingtonpost.com,2013:/theblog//3.31025302013-05-01T08:19:17-04:002013-05-01T08:19:25-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
A few years ago, a study from Rutgers University revealed some worrisome findings on bone health. After only six weeks, the bones of the women on a weight-loss diet were not absorbing as much calcium as women who were not dieting, even though the dieting women were taking an additional 1,000-mg calcium supplement. Since these women were post-menopausal, the researchers suggested that dieting itself might make older women more vulnerable to fragile and easily breakable bones.
Since many weight-loss plans don't emphasize the need to consume calcium-rich dairy products (Weight Watchers is an exception), the obvious answer to the prevention of weakening bones is taking a calcium supplement. After all, haven't women been told for years that supplements are a reliable source of calcium, especially for people who may not eat dairy products (like vegans or people who don't like foods that come from milk)?
Now it looks like calcium supplements are out, and calcium-rich foods are in.
Jane Brody recently discussed the latest information about the benefits and risks of calcium supplementation in the New York Times Science Section. She reported that the United States Preventive Services Task Force reviewed over 130 studies on whether calcium and vitamin D supplements prevent bone fractures. Their conclusion: They don't. It turns out that calcium from food is substantially more effective in promoting bone health than calcium taken as a supplement. Moreover, some reports have now pointed to a significant link between calcium supplements and an increased risk of heart attacks.
This information that calcium supplements are not as reliable as food in maintaining bone health removes the safety net that many women depend on. This is especially true for dieters because knowing that you, the dieter, could swallow a couple of calcium pills made you confident that you were getting enough of this vital mineral, even if you stopped eating dairy products to save some calories.
So now what do you do?
The first thing is to know how much calcium you should be taking into your body every day.
Women and men under 51 need 1,000 mg a day. Women need 200 more mg over 51, so their daily intake should be 1,200 mg. No one yet knows why weight loss should increase the need for calcium, but there is useful information about the best way to get your bones to absorb this mineral:
You should not eat more than 500 mg of calcium at any one time, because that seems to be the maximum amount that a body can process per ingestion;
Sunshine, or other sources of vitamin D, are necessary for calcium absorption. If your skin is not exposed to vitamin-D-enhancing sunshine, do take a supplement or eat vitamin-D-fortified foods (cod liver oil, of course the worst-tasting, is probably the best source);
Caffeine in coffee and chocolate, as well as caffeinated energy drinks and sodas, increase the loss of calcium from the body. Don't overdo it on the caffeine or else your bones may become too weak to support your energized body;
Just because a food contains calcium doesn't mean it will be absorbed by your body. Whole grains, peanuts, soybeans and most leafy green vegetables like spinach contain compounds that stick to calcium and prevent the mineral from entering your body.[1] Kale, mustard greens and collard greens are exceptions, as they don't contain the calcium-grabbing compounds. (Tofu, which is made from soy, will yield up calcium if it is processed with calcium sulfate and nigari. FYI: Nigari is the Japanese name for magnesium chloride. Both compounds are responsible for the formation of the solid part or block or the tofu.)
Read food labels. How else can you decide between cow, soy, almond, and rice milk? They all vary in calcium content and calories, and some of these dairy milk-like beverages are now fortified with more calcium than they were just a few years ago. Many foods that normally are calcium-free, such as orange juice and Total cereal, are also now calcium-fortified. If you put orange juice on your cereal in the morning (as my lactose-intolerant friend does), you may consume most of your calcium needs at breakfast; and to conclude,
Convenience and calcium needs may conflict. Not all calcium-rich foods fit into your lifestyle, and dieting further limits what you can eat. Boiled kale and tofu burgers may not be foods you are going to prepare when you return from work at 8 p.m., so have alternatives available. Cottage cheese, yogurt and part-skim ricotta cheese are all low-calorie calcium sources, and can be blended into smoothies, pasta, soups, or used as toppings for calcium-fortified toaster waffles. Milk-based fish chowders are an excellent source of calcium, and if made with fat-free or low-fat milk, can easily fit into a dieter's menu plan. Lasagna layered with low-fat ricotta cheese or cottage cheese and steamed kale can be made ahead of time, frozen in mealtime portions, and then heated up for a quick dinner. And if you can spare the calories, one-half cup of frozen Greek yogurt provides 15 percent of your daily calcium requirement (about 150 mg of calcium) and tastes good, too.
Even though dieting may make you vulnerable to bone loss if you don't take these dietary precautions, remember that diets often have a beneficial effect on bone strength. Exercise, that other component of weight-loss programs, is essential in strengthening bones. Indeed, physical activity is essential to prevent, as well as reverse, bone loss. And if you do burn off enough calories, you really can eat that frozen Greek yogurt without guilt.
References:
[1] Weaver, Connie & Proulx Heaney, Robert. Calcium in Human Health pp. 135-136
For more on personal health, click here.]]>If You Lead a Student to Vegetables, Will They Eat Them?tag:www.huffingtonpost.com,2013:/theblog//3.30398682013-04-09T14:02:14-04:002013-06-09T05:12:01-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
My 22-year-old cousin then forked up a micro-piece of the vegetable and tasted it. "Not bad... maybe I will eat it."
I thought of this scenario when reading about the struggle schools are going through to get their students to eat vegetables from the school lunch menu. As part of a campaign to reduce childhood obesity, the federal government established new guidelines for school lunches. Corndogs and other deep-fried foods are now replaced by lean protein, and students are asked to eat a vegetable or fruit and drink fat-free milk rather than sodas and sugar-filled juices.
An article in the Miami Herald described the resistance and dismay of many students at seeing their beloved Pop-Tarts, potato chips and French fries replaced with salad bars, apple slices and brown rice. It is not clear who or what is getting filled up with these healthier choices of vegetables and fruits: the students or the trash cans. A student journalist from a high school in north Miami, for example, reported that the kids are eating the main course, but dumping the vegetables and fruits in the trash. As quoted in the newspaper, the student claimed that these foods are thrown away because they don't look appealing.
Not surprisingly, it is the older students who reject the vegetable and fruit. Perhaps, like my cousin, they once ate some of these vegetables and found the texture and the taste at best boring, and more likely revolting. One taste of an overcooked, under-seasoned vegetable will eliminate any desire to try it again; it is easier simply to throw it away. Indeed, according to the newspaper report, the younger students are the ones most willing to try the foods on the new school menu. Perhaps because they have never tried them before? Who knows? But what seems to work with them is to allow them to sample the salads, fruits and vegetables at the beginning of the school year.
It is important that at some point, before any of these kids grow up and have families of their own, vegetables and fruits become a basic component of their daily food intake. And if they are not eating these foods at home (many teens don't even eat meals at home, preferring to get their meals from fast-food franchises), then school is the first and last resort.
Could the solution be to develop school lunch menus in which vegetables are concealed, or given more prominence and more taste? Concealing vegetables and indeed fruit is easy; every mother with a child who won't eat carrots or peas knows how to cook these and other vegetables in a spaghetti sauce or pureed soup or slow-cooked stew. Muffins and breads are wonderful foods in which to hide vegetables and fruit. Carrot, apple, pumpkin, cranberry, zucchini bread or muffins could be added to the school lunch menu to meet the grain and vegetable or fruit requirements. Meatloaf and sloppy joes make good hiding places for vegetables, and smoothies are perfect for concealing any fruit that can be blended into yogurt. At home, my son used to call my baked breakfast treats Wonder Muffins, as he and his sister would wonder aloud what I concealed in the batter. I never told.
It is not always necessary to hide these essential food groups. If kids won't eat fresh fruit, they might eat it frozen. Frozen blueberries, thinly-sliced apples, pears, strawberries and peaches have a cold, crunchy, sweet flavor and are fun to eat. Bananas dipped in a fat-free chocolate sauce and then frozen are nutritious substitutes for ice cream, and frozen orange wedges taste as good as an orange popsicle.
Increasing the chances that vegetables will be eaten and not thrown away, it's important that they both taste good and are fun to eat. Here are some suggestions to make this goal a consumable reality, in that your teens might actually make the Herculean effort to try:
Lettuce wrapped around a mixture of well-seasoned chicken, or beef and vegetables;
Thai or Chinese vegetables, meat, noodle vegetable dishes with appropriate spices;
Spicy dipping sauces (low-calorie) for vegetables normally ignored such as string beans, carrot sticks, and cauliflower;
Lasagna made with spinach and low-fat ricotta cheese;
Thin slivers of roasted sweet potatoes will taste like French fries without the fat and with more vitamins; and
Roasted cauliflower, broccoli, carrots, peppers and/or winter squash, when sprinkled with a small amount of melted cheese, are infinitely more appealing than the steamed or boiled variety. Indeed, almost every vegetable improves from roasting, including, I have been told, kale.
One device to improve the odds of a new vegetable dish being consumed and not thrown away is to have someone serve tiny samples of a new dish before the students go through the line. One look at the sample tables in the warehouse bulk stores reveals that tasting a tiny amount of anything hooks a prospective consumer far more than having it plopped on a plate. Perhaps the school lunch ladies will be willing to multitask in the name of vitamins and good health, cajoling with samples in an effort to improve a vegetable's chances of being eaten.
These techniques will hopefully work to change the food habits of many students. But even if a few students can stop eating Doritos for lunch and eat a lettuce wrap of chicken and vegetables instead, success will be achieved, one green at a time.
What have you, the reader, done to provide produce to a reluctant someone you love?
For more on diet and nutrition, click here.]]>Must You Give Up Your Day Job to Lose Weight?tag:www.huffingtonpost.com,2013:/theblog//3.28912662013-03-19T16:18:24-04:002013-05-19T05:12:01-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
"What about working out at lunchtime?" I suggested. I knew her company had a well-equipped gym.
"I can't do that either," she replied. "We are urged to work out, but in reality, if we are away from our desks for more than 15 or 20 minutes, we are viewed as not pulling our weight."
"So you also can't leave your desk to get a hot lunch?" I knew the answer but had to ask. We had just finished discussing how important it was for her to eat healthy protein, a large salad and some whole-grain bread or crackers at lunch.
"I must eat at my desk. I know on the diet I am supposed to eat a regular meal, but I only have time to eat some crackers or maybe a protein bar and a diet soda," she told me. "No one goes to the cafeteria to eat there. We just buy something and take it back to our cubicle. Sometimes, if I am really tired, I go to the vending machines and get candy bars or an ice cream sandwich for lunch."
Of course she was tired. Who wouldn't be, chained to a desk all day after a long commute in traffic, and then faced with another long commute home? I bet she isn't getting enough sleep either, I thought to myself. When I asked her whether she felt she slept enough, she laughed and said of course not. She had so little time at home that she could not bring herself to go to bed three hours after she returned, and instead stayed up late to take care of household tasks, paying bills and communicating with her friends on the computer. Weekends were no better because her boss expected her to be available via email and cell phone in case she was needed for some unexpected task. She considered herself lucky if she could get to the supermarket and gym before Monday came around.
"I often think that if I were in prison, I would have a better chance of losing weight," she laughed ruefully. "Prisoners get prepared meals and an hour of exercise every day."
Giving up her day job to lose weight wasn't an option, nor was waiting until retirement to get healthy. Plus, the employment statistics in her field of work were too discouraging for her to risk challenging her boss over workplace demands. A compromise was the only solution if she was to lose the 40 pounds between her and a healthy weight.
We did find a compromise. Forcing herself to go to bed earlier meant she could get up and leave for work early enough to get in a workout in the company gym three times a week. Bringing the protein portion of lunch from home (usually leftovers) and adding a salad, bread, and fruit purchased at the company cafeteria gave her a more substantial meal than the protein bar and diet soda she was eating. And she agreed that taking 20 minutes to eat would probably not be considered "slacking off" by her team.
I suggested that she have a carbohydrate snack like a bag of pretzels during her evening commute to dull her appetite (by making more serotonin). This would take away her tendency to eat several hundred calories while preparing dinner. And when not at the beck and call of her workplace during the weekends, I suggested that she try to get to the gym in her apartment building, order groceries to be delivered (saving time and gas money) and spend one afternoon preparing several meals for the week ahead. On a good weekend, she might have time left over for her social life and relaxation. Her weight loss would be slowed by the demands of her work, but with these suggestions in place, she would lose a pound or so each week.
But why should she have to make all these concessions? Why do we as a society wring our hands over the country's rapidly increasing obesity, lack of fitness, increased stress and chronic sleeplessness, and yet make demands on employees of all levels and salaries that leave them vulnerable to these problems? My client did not have to take care of children, aging parents, or even spend time with a partner or spouse. But many people juggle these commitments that erode time and energy, and can even take over control of healthy food intake.
So many advertisements promote all sorts of gimmicky diets, weight-loss pills and supplements that supposedly melt fat and increase fitness. What good do these diet plans and weight-loss programs do if they are incompatible with work/life demands? We should stop denying that for many, the workplace culture is an obstacle to a healthy lifestyle and may even exacerbate weight gain and unfitness. If we don't, we should not be surprised at the continual rise in health care costs and the simultaneous decline of our health. Healthy employees are better employees, after all.
For more on weight loss, click here.]]>Is Food Entertainment?tag:www.huffingtonpost.com,2013:/theblog//3.28227112013-03-12T11:44:55-04:002013-05-12T05:12:01-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/recent interview reported in the Miami Herald, Paula Deen was asked if her new, moderate way of eating would be reflected in her cooking shows. Her answer was that she doesn't expect people to eat fried chicken and biscuits every day, but if she were to prepare only salads, who would watch? She characterized her cooking shows as entertainment.
Julia Child, don't roll over in your grave.
I thought cooking shows were about cooking, but I guess that I'm wrong. Presumably the lip-smacking and oohing and ahhing over a finished product that oozes butter, cream, egg yolks and/or bacon or chocolate seen by viewers of her show is just for show. Yet while Deen may take a tiny bite (does she spit it out off-camera?), characterizing the show as entertainment implies that the viewer should not run to their kitchen to reproduce the dish.
If we are to believe Paula Deen, and others like her, people are not really intending to eat those luscious foods that she swoons over when she tastes them on air. That is only entertainment.
It begs the question: Is food entertainment?
Yes, otherwise we would not have endless varieties of restaurants, or magazines that seduce us with their cover pictures of multilayered cakes and lasagnas bubbling with melted cheese. Buffets would not exist, and cruises would get away with serving one menu item at every meal rather than tempting the passenger with multiple dishes and restaurants. Food is the basic ingredient in festivities and celebrations, and as an inducement to get people to come to meetings or lectures, is definitely entertainment.
Is there any risk to preferring or rejecting foods based on their entertainment value? A few weeks ago, the New York Times Sunday magazine ran an article on how food chemists manipulate the tastes of foods to increase their hedonic-pleasurable qualities. Thousands of people join focus groups that taste and test combinations of ingredients and textures of products ranging from soft drinks to snack foods. Their responses are analyzed using complicated computer-driven programs to generate the perfect foods for various age groups and gender. Unfortunately, this tweaking of ingredients to alter taste and texture is rarely applied to foods that we should be eating but don't, at least not in sufficient quantities. Would we all fall in love with steamed kale or stir-fried tofu or brown rice if care and attention were made to making these foods excessively palatable?
Most of us do not know what it is like to be hungry and not have enough to eat. When we eat, the palatability of our food is not associated with our relief at finally being able to remedy our excessive hunger. Unfortunately, this is not the case in too many parts of the world.
Have we forgotten, or perhaps never learned, why we eat? An infant crying for milk wants to be fed. His or her contentment while being fed is not affected by the fact that the milk tastes the same at each feeding, day after day, week after week. Mothers don't have to produce flavored milk to satisfy the hunger needs of an infant.
Yet by the time the child is on solid food, taste and texture are already factors in acceptance and rejection. It is hard to resist the temptation to offer rewards if the toddler will just try one spoonful of strained glop. And what about the child who is given a plastic tub of Cheerios to keep him still? We all learn young that food is more than nourishment, and can become entertainment. As an adult, I witnessed this behavior last evening at a fundraising dinner, for every time a speaker became repetitious and dull, people at our table pulled their dessert plates closer to them and finished the cake they had probably resolved to leave only partially eaten. The cake was certainly more entertaining than the speakers. (Dinner speakers beware: If you hear forks clanging on plates, wind up your talk.)
Posing the concept of food as entertainment leaves one to ponder, would food programs that focused on sensible rather than extravagant dishes (poached pears or baked apples for dessert rather than fat and sugar-filled pastries) be unpopular? If so, is that because people are only entertained by watching someone make foods on TV that they, the viewer, have no intention of ever making or eating? Or is the need to eat as entertainment the reason that so many people fail to reach their weight-loss goals, or revert back to a pre-dieting weight?
Perhaps so. The other night we were guests at the home of a dieting hostess, and her meal was not entertaining; indeed it tasted (it actually had no taste) like diet food. Despite that, the company was splendid, but even the most dedicated dieter and accommodating guest might wish for more entertainment value in a dinner party meal.
Maybe it will take a truly innovative chef to bring us healthy foods that allow us to lose weight or maintain a healthy weight, yet still feel entertained by what we are eating. Watching the foods made by this mythical chef on television could be as compelling as following the series Downton Abbey. When we then re-enact preparing such recipes ourselves, we will be entertained, excited and enthusiastic about what we are eating. It's a dietary win-win.
For more on diet and nutrition, click here.]]>The Pleasure and Perils of Exercise Classtag:www.huffingtonpost.com,2013:/theblog//3.27615052013-02-27T11:09:32-05:002013-04-29T05:12:01-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
So I went, finally figured out after almost an hour how to swing my arms, legs and hips to somewhat resemble what the instructor was doing, sweated as if I had run a race in the Sahara desert and had fun. But I woke up the next morning wondering why my arms ached and my feet were giving forth with little yelps of pain.
I flashed back to the gym again and the advice from friends: "You have to wear lighter shoes, not your running shoes. They won't allow you to pivot easily. Be careful of your knees on some of the squats. Warm up your arms and stretch before taking the class. And if it hurts, stop."
None of this information came from the instructor and anyway, the music was so loud (half the class wore earplugs) that I could not have heard her advice had she given any. I went back to the class because it was fun and, after the proper precautions, I no longer hurt afterwards. But being on the verge of injury was hardly unique.
Scores of articles have been written on the hazards of exercise classes of all types. Not because the techniques, moves, positions, and pace are themselves hazardous, but because the participants have different body types, levels of stamina, histories of past injuries and/or fragile backs, knees and necks. Even if warnings and advice are given out at the beginning of an exercise to "go at your own pace " or "don't do this if you have problems with your back, knees, etc.," some members of the class may realize they have these problems only after they experience pain or injury.
Maybe someday gyms and other facilities giving classes will first administer body scans so that areas of orthopedic and muscle vulnerabilities will be noted, and people told which exercise classes to take or which to avoid. But now, unless you have been told by a physical therapist or a personal trainer to be careful of physical activities because of the risk of injury, there really is no way of assessing the safety of group activities, be they folk dancing or kickboxing. On the other hand, you don't want to be restricted to sitting in a chair and waving your arms around.
You can do a couple of things to help decide whether the exercise class will be more pleasure than pain. Watch the class and speak to the instructor before taking it. For example, you might want to take a yoga class, but your back is rather dicey and you are not sure how good your knees are. Some of the moves will be excellent for these problems, but others might exacerbate them. If, after seeing the class, you are concerned that some of the positions might be injurious, go to the instructor afterwards and ask for advice.
If a class in which you are considering participation is crowded, and there is no one (the instructor or an assistant) to walk around to check posture and position, consider looking for a smaller, more personalized class in which you will be assisted and avoid doing something that might injure you. And if the instructor simply tells you to do what you feel uncomfortable doing, look for something else. After all, if you are not familiar with the moves, how will you know what to avoid until it is too late? (Of course, the downside of this is the teacher stopping the class to help you -- usually me -- put legs and arms in the right position with everyone patiently waiting to get on with the next move.)
Also consider your stamina, balance and flexibility. If you are starting out on an exercise routine, don't go to a class that will make you out of breath and even dizzy in the first 10 minutes. Wait until you have built up some endurance on exercise machines, perhaps under the guidance of a trainer.
Take beginner classes and note which moves are difficult, such as standing on one foot or reaching your toes when sitting on the floor. Ask the instructor for suggestions of what you can do outside the class to make the moves or positions easier.
Don't be afraid to walk out of class that doesn't not feel right for your body. And if you are the competitive sort, don't allow this trait to make you stick with something that is wrong for your body or push your endurance when you feel dizzy, are out of breath or hurt a lot.
The final argument for taking or avoiding a class is: Are you having fun? Do you enjoy what you are doing, or are you watching the clock?
Unlike solitary exercise on a machine or weight lifting, taking classes often makes going to a health club a social event. You get to know the other participants, develop friendships that travel beyond the gym or, at the very least, you can complain together in the locker room after the class.
For more on fitness and exercise, click here.]]>Will Keeping a Food Record Help You Lose Weight?tag:www.huffingtonpost.com,2013:/theblog//3.26890872013-02-17T10:19:03-05:002013-04-19T05:12:02-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
One diet program in the l970s insisted its members keep daily food logs for the duration of the program. Members were to come to a clinic daily for a weigh-in, and at that time turn in the food record of the previous day. A woman I knew who participated in this program told me she used to sit in her car in the parking lot of the clinic to fill out her record. "I made up what I had eaten. Who can be bothered remembering and measuring and writing it down?" She was far from original in utilizing this strategy.
Who can be bothered, indeed? Even now, with the support of digital devices that range from a notation on a smartphone to an immense database that will analyze the ingredients and calories in (almost) every food known to mankind, who wants to be bothered? Imagine going to a wedding reception buffet and before you start to eat from the multiple selections on your plate, you must first take out your phone and punch in the names of your food choices. Or imagine that you are debating whether you can indulge in an after-dinner treat of frozen yogurt while watching your favorite TV show, but you can't really pay attention to the show because you are counting spoonfuls of Ben and Jerry's? Perhaps you are in a supermarket and a lady is handing out crackers with some sort of spread. You take two samples, gobble them down, and realize you don't know what you just ate. How does one record that without looking foolish?
Why do diet programs suggest or even insist on food records? It is generally assumed that people who track their calorie consumption will do better on a diet, and some research has shown this to be the case. The reason is pretty obvious -- because anyone who is committed to writing down what has been eaten is committed to following a diet. Moreover, in order to make the recordkeeping reflect as accurately as possible what has been eaten, food choices are often severely limited to items whose composition is known (grilled chicken breast rather than chicken pot pie) and foods that must be counted, like cookies or peanuts, are avoided. Who is going to stop eating M&Ms because he couldn't remember if he had just eaten 11 or 12? It's better not to eat them at all.
The catch is that a weakening of resolve to keep a food record is often an early symptom of loss of commitment to the diet. Excuses for forgetting to keep an accurate, up-to-date record are even more numerous than excuses for not exercising. Again, who can be bothered?
But there are times when keeping track of what is being eaten is useful:
If you have been on a diet for several weeks and weight loss stalls, keep track of what you are eating and drinking for five days -- three weekdays and the weekend. You don't have to be precise about measurements, but notice what you are mindlessly nibbling, how many courses you ate at an extravagant Sunday brunch, and/or how a skipped lunch turned into a gargantuan supper. Note alcohol intake, because those calories add up fast, or;
Several months or a year or more after a diet, you notice that your "thin" clothes are not fitting. The scale confirms that this is due to weight gain, not a bad dry cleaner. Keep track of what you are eating for seven or eight days. Do this before even thinking of starting a diet. It is important to know from where those extra calories are coming. Are you back to eating large portion sizes, adding too much salad dressing to your salads or butter to your rolls? Are you treating yourself to too many high-calorie snacks, or too much beer or wine? It may be none of the above. The cause could be a change in exercise. But if it is a change in eating, then you may be able to modify what you eat and lose weight without going on a formal diet; or perhaps
You are developing the early symptoms of scurvy. Just kidding. But you have a vague sense of not eating from most of the food groups most of the time. Has it been days since you ate a green vegetable or a red fruit (strawberry, watermelon, apple, cherry or red grapefruit)? Was your last dairy product an ice cream cone? Are you hoping that tortilla chips are high in fiber? Write down what you are typically eating for two to three days during the week and on the weekend. Compare your list with the recommended foods for good nutrition (fruits and vegetables, whole-grain carbohydrates, low-fat dairy products, lean protein). Then go to the supermarket. And lastly;
Despite following a weight-loss program exactly, you are not losing weight. No one is sympathetic because frankly, they don't believe you. Write down exactly what you are eating for two weeks and then show it to your physician. You may have a metabolic problem that is preventing you from losing weight, and your food record is proof that something might be wrong.
Always keep your old records. A hundred years from now, someone might find them and marvel at what you were eating early in the 21st century.
For more on weight loss, click here.]]>Cell Phones at Meals: Might They Help Us Eat Less?tag:www.huffingtonpost.com,2013:/theblog//3.25811932013-01-30T09:42:48-05:002013-04-01T05:12:01-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
As a non-smoker (like a famous president, I never learned to inhale), I watched these smokers with envy. Not for them was an internal debate over having dessert. The cigarette was their dessert, and seemingly took away the urge to continue to eat. Moreover, it was something to do with their hands and mouth if others were still eating, because etiquette dictates staying at the table until everyone has finished. We, the non-smokers, would have to sit on our hands to prevent ourselves from nibbling, or often asked for seconds to have something to do until the slowest eater among us finally finished.
The rapid rise in obesity may be due, in part, to the decline in smoking. Nicotine does dampen appetite and, by taking away the temptation to eat seconds and/or dessert, could decrease calorie consumption. But perhaps something has come along to replace the cigarette as a signal to stop eating. It is called the cell phone.
The cell phone is the new cigarette. It is taken out and looked at as soon as the fork has been put down. Anyone who has eaten in a restaurant has probably seen tables full of diners all using their cell phones, oblivious to the presence of others at the table and also oblivious to the food on the plate. If messages on the phone require responses, both hands are on the phone, texting or emailing away. This means that neither hand is holding food or bringing the food into the mouth.
The end-of-the-meal cell phone scrutiny not only stops eating of the main course, it may also decrease eating dessert. After all, to consume another course means paying attention to what is being offered, and then having to put the phone away in order to eat the cake, pie or soufflé. And presumably, the calorie-conscious diner could use the phone to calculate how many calories were already consumed to see whether eating dessert was calorically justified.
Playing with the cell phone also solves other dining problems, like what to you do when you have finished your meal and others are still eating -- or how do you prevent yourself from eating dessert when others are doing so? How do you keep your fingers and fork from putting food in your mouth when people are sitting around a table just talking, or you are listening to a boring after-dinner speaker?
"I hate dinner parties where we all sit around the table for an hour or more after the meal," a weight-loss client told me. " Invariably, the host [hostess] will bring out nuts, candy, small cookies or fruit in case we should, by some miracle, still be hungry. No one is, of course, but it is really hard to not to nibble while talking, especially if you are bored or can't get a word in edgewise." She went on to tell me that this has all changed with the cell phone. No one apparently simply sits at the table to talk; they look at their phones and often leave the table to make a phone call.
We probably have not begun to expand the use of cell phones as a way of halting eating. Maybe sometime in the near future, a camera will take pictures of us stuffing potato chips or cookies in our mouths, or a picture of what is on our plate. This will be instantly transmitted and turned into calories and fat grams, and a message or perhaps mild electric shock will stop us from eating any more. Perhaps the phone will ring and some disembodied voice will tell us to get up, clean up the kitchen and get rid of the leftovers. Or we will be told that the cheesecake we are considering ordering for dessert will demand four hours in the gym the next day.
But on a basic level, the simple act of not eating for 15 or 20 minutes because we are engrossed in our cell phone communications will be sufficient to control portion size. We have all experienced the feeling of fullness if the meal is interrupted by a phone call, and we then return to our not-yet-empty plates 15 minutes later. Enough food has been digested to take away our hunger, and we don't feel the need to resume our meal. A cell phone as a meal terminator is not something an etiquette expert might allow, but on the other hand, unlike cigarettes, the only side effect is a run-down battery.
For more on personal health, click here.]]>Will Taking Away Your Stomach Stop the Hunger in Your Head?tag:www.huffingtonpost.com,2013:/theblog//3.24736802013-01-14T18:05:57-05:002013-03-16T05:12:02-04:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/reverse Type 2 diabetes. What's troubling is that the newest surgical procedure to reduce food intake, a sleeve gastrectomy, makes sure that very little food gets through the stomach by removing about 85 percent of the pouch. [1] This procedure is irreversible; patients are left with a long, banana-shaped stomach that gets filled up after only an ounce or two of mushy food is consumed.
A distant relative alerted me to this new weight reduction procedure, as he was interested in having the operation. Half-hearted dieting attempts and erratic exercise made him doubt that he would lose weight following a conventional weight loss program. His excess 200 pounds made him fearful of not living a long and healthy life. As he told me, the operation was usually done laparoscopically, and since no muscle was cut, recovery was much faster and less complicated.
But the newness of this procedure meant that no information on long-term weight loss was available. Could a determined overeater eventually stretch the "banana" shape of the stomach into an "apple" shape by eating larger and larger quantities of food? This is, of course, how so many recipients of other bariatric surgeries managed to gain back their weight and sadly experience a recurrence of their Type 2 diabetes. [2]
My relative was like so many others struggling with obesity, an emotional overeater. His job only added to the predictable sources of stress (family illness, financial worries, three small children, a sick parent), as there were times when he worked for weeks without any time off. I pointed out to him that finding the correct foods to eat post-surgery and scheduling time for regular exercise would be very difficult, given his demanding work schedule. And just as important, how was he going to deal with his tendency to turn to food to decrease emotional distress? If food made it possible for him to cope with his many problems, what would take its place? Indeed, anecdotal reports from patients who had bariatric surgery confirmed to me that the procedures changed only the ability of the stomach to receive food. It did not change the need of one's mind to use food for emotional comfort.
Ideally, prospective candidates for bariatric surgery ought to spend a year learning why they overeat and with professional help, see whether they can deflect these triggers from making them eat excessively. Indeed, a more basic goal might even be: Are they even willing to change their eating behavior?
Years ago, I had a client who insisted on going to a food court for lunch every day and eating two immense meals, one right after the other. He never was hungry for the second lunch and never could articulate why he needed to eat it. But he became agitated at the thought of eating only one lunch, even on a diet. (He lost no weight, of course.) He is an example of someone who probably would not benefit from bariatric surgery, since eventually he would find a way to stretch his stomach to receive large quantities of food that he felt he had to consume.
We have moved so far from eating only to sustain life that sometimes it is hard to remember that food's basic purpose is to keep us alive, allow us to reproduce, and maintain us in good health. And if we stopped eating the instant we were no longer hungry, none of us would be overweight or obese. Our minds seem to have taken over from our stomachs, however, when it comes to determining how much, what and when we eat. We pore over menus to see what item might entice us, we accept food at social gatherings because it is polite to do so, we nibble our way through frustration, boredom, anger, and exhaustion, and make food the surrogate for lonely evenings and failed companionships.
There is no surgery, no drug, nor herbal remedies or diets that surrender total control of our eating to the stomach. Our minds are always involved. Surgery to make the stomach look like a banana rather than an apple will be the answer to permanent weight loss only when we understand why we are overeating.
Ideally, then, if the mind and stomach can get together to figure out how to stop it, the surgery might succeed.
For more on personal health, click here.]]>Get Thee to the Gym!tag:www.huffingtonpost.com,2013:/theblog//3.23968052013-01-03T14:45:29-05:002013-03-05T05:12:01-05:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
Maybe that is what it will take to start the exercise-averse moving again? Perhaps sofa and chair manufacturers will put alarms in the seat that go off when one's bottom is compressing the surface of the cushion for more than an hour. The alarm will be a signal to get up and move, something by the way, my physical therapist told me to do in order to minimize a recurrence of back pain I had a few years back.
This time of year, as every year, exercise equipment and devices to measure activity are promoted as gifts, although I suspect they are about as welcome to the chronic couch potato as a set of expensive knives are to someone who never cooks. Have you noticed that people seem divided into those who do and those who don't exercise? This division is not necessarily along weight lines, because there are many thin people who would rather have root canal than get on a treadmill and lots of obese folk who exercise consistently. A considerably-overweight woman usually sits next to me on the exercise bike in my gym and outdoes me by miles. And then, when I stagger off to the locker room, she spends another hour lifting weights.
But before I continue, understand that this is not really another plea to join a gym. Indeed, the expense, coupled with the inconvenience of having to go "somewhere" to exercise, and for some, the alien nature of a large room with people sweating and grunting on machines, is off-putting. So if the gym is not where you want to exercise, consider other options: exercise equipment at home, community center exercise classes, facilities devoted to yoga and/or pilates, "meet up" groups who hike, bike or play competitive sports together, and parent-toddler exercise classes. But of course, like an antibiotic for a strep throat, all these options will not work unless you take them.
What will it take to get a non-exerciser to convert to the exercise committed? Waiting until some scary medical event takes place? The perception that climbing stairs or even climbing out of a chair is difficult? Being mistaken for someone much older? Learning that health clubs are a great way to meet people? A gift of a treadmill? Reading about a formerly-obese individual who just completed his first marathon? Certainly the thousands of articles, like this one, usually convince only the convinced.
It may turn out that the non-exerciser becomes dedicated to routine physical activity simply because it feels good to do so. Anyone who does exercise on a regular basis knows the feeling. The increase in energy, both mental and physical, the release of tension, increase in muscle flexibility, the sense of well-being is dramatic. This won't happen immediately and may not occur during the exercise session itself, but rather after it is over. But it does happen, and the corollary is also true. Stop exercising for a while and the energy decreases, stress and tension increase and the brain seems a bit foggy.
But exercise is not a magic pill. It does not bring about these benefits immediately. At first, you may feel only annoyance at having to do something you don't want to do, and pain because your muscles would rather be inert than working hard. Several weeks of routinely exercising may pass before you become aware of its psychological benefits. But benefiting from routine exercise is similar to benefiting from anything that has to be learned and practiced, such as playing the violin or speaking French. The screeching of the bow on the strings or mixing up grammar and mangled pronunciation have to be endured before one has more success and enjoyment than frustration. So it is with gym workouts or yoga class or jogging. But soon (much sooner than playing the violin) your muscles will remember and perform without protest, you will notice that your breathing is no longer labored, and your posture would make your mother proud. Someone will say to you "looking good," and you will finish the exercise feeling good.
Some people avoid exercise because they fear they are no longer good at it. The same goes for taking up the violin after not playing for 25 years. A friend who was the star of her yoga class before three babies and a job made it impossible to attend told me she would never go back, even when she had time. "Then I could do anything as well as or even better than the instructor. But now I am so clumsy and stiff, I am embarrassed to take a class." This friend was honest about her avoidance of yoga; many are not so honest about why they no longer play basketball, swim, run, or lift weights.
Fortunately, the exercise industry continually comes up with new ways to make us move: new classes, new types of equipment, even new sports.
My friend finally went back to the gym and takes Zumba classes and kick boxing. So even if you no longer can swim laps as you did on your high school swim team or outspin everyone in your spin class, you will find some activity compatible with your current muscle and cardiovascular strength.
Just stay out of the recliner, and get thee to exercise!
For more on fitness, click here.]]>Are the Holidays the Right Time to Call a Diet Truce?tag:www.huffingtonpost.com,2012:/theblog//3.22317492012-12-04T13:00:43-05:002013-02-03T05:12:01-05:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
This volunteer in a year-long weight loss program was adamant about taking a break from dieting from Thanksgiving through New Year 's Day. When I asked how she could justify gaining back weight she had tried so hard to lose, she shrugged and said that holiday parties and family dinners were more important than watching what she ate and taking time to exercise.
She did gain weight, about seven pounds, and annoyed the research team trying to develop effective weight loss strategies. One is not allowed to put into a research publication that a subject failed to reach her weight loss goal because she insisted on eating Eggs Benedict on Christmas morning and her sister's pecan pie on New Year's Eve. But now, years after the study concluded, I think she her attitude may have been partially correct.
Dieting during the holiday season is difficult. It is hard to shake your head and decline every time you are offered something indulgent to eat or drink during the six or so weeks between Thanksgiving and the end of the year. It is a challenge to:
• Go to a Hanukkah party and announce to the person holding the plate of sizzling potato pancakes that you don't eat carbs;
• Limit yourself to celery sticks and seltzer water at your church's Christmas potluck dinner;
• Not even sip your uncle's homemade glogg or take a bite of your aunt's special ricotta cheesecake during a family holiday gathering;
• Force yourself to get up at the crack of dawn after a late night because you must go to your 6:30 a.m. spin class;
• Put the gingerbread man your preschooler made for you in a drawer so you won't be tempted to bite off the foot; or
• Reject the Christmas ham or Hanukkah brisket because you only eat raw foods.
Life usually interferes with dieting, but during the holidays the diet may interfere with your life. There is a middle ground between rigidly adhering to the diet program and abandoning all efforts to maintain previous weight loss. Rebrand it as a diet truce, a time when you will not be losing weight but trying to prevent more than a negligible weight gain, and it is not that hard to do.
There are only two rules to follow: Pay attention to what you are eating and what you are drinking. No one is going to force-feed you sugar cookies or withhold liquids until you are willing to drink a quart of eggnog. You do need, however, to be acutely aware of what you are eating and drinking. Every time you take an appetizer at a party, accept a drink, or reach for a handful of nuts or chocolates, take a few milliseconds to look at what your caloric intake. Temporary amnesia about what you are consuming does not make the calories disappear.
Eat what you really want to eat, drink what you want to drink, but don't stuff yourself, because in two weeks you will be going back on your diet. Food and drink do not become more tasty or desirable as more and more is consumed. The contrary is the case. Second or third helpings rarely taste as good as the first bite. Alcohol has more negative than positive effects as one or two drinks lead to more. Moreover, you are not going into hibernation, only going on a diet.
Workouts can be adjusted to allow for more time with celebrations, relatives, travel and entertainment, but they should not be abandoned. Short bouts of exercise releases tension and stress, improves sleep and even cognitive function (so you can remember the names of your relatives). And, of course, exercise uses of some of the extra calories you are consuming. Make appointments with yourself to exercise so you will be beeped or alarmed when it is time to go for a walk or do some stretches.
This is a dieting truce, not an all-out war against your previous weight loss. Be mindful of what you consume and persistent in doing some physical activity and your weight should emerge undamaged after the diet holiday is over.
Taking a holiday from dieting during the holidays has benefits that go beyond eating once-a-year delicacies and indulging in extra sleep rather than going to the gym. It tests your ability to maintain your weight loss in the midst of real life. And a diet truce also offers you the opportunity to enjoy an authentic higher quality of life, albeit in a smaller size.
For more on weight loss, click here.]]>'Tis Almost the Season, or the Backstory to the Bingetag:www.huffingtonpost.com,2012:/theblog//3.20883262012-11-14T10:49:37-05:002013-01-14T05:12:01-05:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
This time it was a binge lasting a couple of days followed by a total avoidance of any food with nutritional value. "I don't know what happened," she told me. "I was doing so well, felt great, was thinking of buying new clothes in a smaller size, and then I blew it. Maybe it was the oatmeal I started eating for breakfast, or the veggie patties I have been having for lunch. There was something in the food that set me off. After that, I could not control my eating."
But a few minutes later, she admitted that it wasn't the food at all that started her binges. She was extremely stressed because she had to go to major family event six weeks and was embarrassed about her appearance. She had been in one of her thinner phases the last time the relatives saw her and now, despite her weight loss a few weeks earlier, she still weighed about 60 pounds more than at that previous occasion. Her rational self should have stayed on the diet but as she admitted, her irrational self said, "What's the use? I still look fat and they will all talk about me."
So she binged.
My job was to convince her that her present and future health was more important than this family event and to go back on her diet. Just as important was our conversation about recognizing that there is always a backstory to a binge. Binges never happen in an emotional vacuum, even though we can pretend that they do. Often someone claims that she was in perfect control of her eating until she ate that first doughnut or piece of chocolate. "It was the sugar that set off my binge," is usually the explanation, followed by the "carbohydrates are evil" mantra.
My response is to ask why was the doughnut or piece of chocolate was eaten in the first place. The backstory, if the response is insightful and honest, usually involves a stressful event, exhaustion, a desire to give oneself a treat following a period of meeting the obligations of others or an unwillingness to follow the self-denial of a diet any longer. In short, the trigger to the binge had nothing to do with the doughnut or chocolate; the doughnut or chocolate were the foods at hand to make the binge happen.
But binges can be stopped. As with seemingly endless thirst after a period of water deprivation, there comes a time when enough water or enough food has been consumed to cause the brain to say, "No more." The fastest way to stop a binge (other than covering the mouth with duct tape) is to eat a food that rapidly increases the synthesis of serotonin, which is the neurotransmitter in the brain that halts eating. When enough of it is active, people will actually take food out of their mouths because eating becomes aversive and unpleasant.
Often an exceedingly sweet carbohydrate, like Marshmallow Fluff or honey right from the jar, will not only set in motion the synthesis of serotonin; its sweetness will be unpleasant and shock the binge eater into stopping even before new serotonin is made.
Yet preventing the binge from starting is much harder. This is because the question "Why did I eat like that?" is rarely answered by the person who feels guilty, contrite and bewildered once the binge is over. It is hard to look at the antecedents of any impulsive behavior, whether it is buying an unwanted item on sale, texting an ex-boyfriend, or eating too much. Sometimes there are things that we rather keep hidden even from ourselves.
The answer to the question is this: Get help.
Find someone who knows you, is non-judgmental and wise, and is willing to talk with you about why you may have lost control over your diet (or resolution never to contact that boyfriend). The story behind the binge is usually easily accessible. Edna readily admitted her anxiety over the family event, her hidden anger over the nerve of her family to comment on her appearance and her simultaneous frustration with her weight and self-perceived unattractiveness.
Once the reasons behind impulsive overeating are brought into the open, then the binger can seek the appropriate help to diminish the likelihood of future bingeing. Sometimes the solutions are pragmatic. Edna decided to stay only a short time at the event because she had another (fictitious) commitment that day. Often the solutions require therapy and/or changes in diet. For example, binges may be more likely to occur when lack of carbohydrate decreases serotonin levels in the brain, thus decreasing serotonin's power to halt eating.
Once the backstory is known, the sequel's outcome can be positive. Control over bingeing and effective weight loss can begin, and you will find yourself with tools to curb emotional overindulgence, aka the winter holidays.
For more on weight loss, click here.]]>Choosing Between Good Mood and Bad Weighttag:www.huffingtonpost.com,2012:/theblog//3.19290442012-10-03T12:37:20-04:002012-12-03T05:12:02-05:00Judith J. Wurtman, PhDhttp://www.huffingtonpost.com/judith-j-wurtman-phd/
"I have resigned myself to needing treatment possibly for the rest of my life" she told me. "But what I cannot accept is the weight gain. I know it is caused by the drugs because as soon as I stop taking them, the weight comes off. But then I get depressed."
This woman -- let us call her Joanne -- is experiencing one of the more common side effects of antidepressants: weight gain. She is one of the lucky ones, as she rarely gains more than 30 pounds each time she starts on the drug. Some medications, such as those used for bipolar disorder or schizophrenia, can cause 100 or more pounds to be gained in a year. The mood disorders may be under control, but the subsequent weight gain produces its own constellation of problems such as diabetes, high blood pressure, orthopedic pain, and an increased risk of infection.
People who become obese in association with their antidepressant or bipolar disorder treatment are not like others who struggle with eating issues all their adult life. Many of them had been thin before drug treatment; they ate healthy diets, and never had problems with cravings, controlling portion sizes, or exercising on a regular basis. When we saw such patients at our psychiatric hospital-based weight loss clinic, we often had to explain to them how to follow a diet, since many had never previously dieted in their lives.
There are no data on what percentage of people taking these medications become obese. But surveys from the Centers for Disease Control and Prevention have reported an astonishing large number of Americans 12 years of age and older who are taking antidepressant medications. Data from the National Health and Nutrition Examination Surveys conducted from 2005 to 2008 found that 11 percent of Americans are on these medications and of this group, more than 60 percent have been taking the antidepressants for two or more years. Apparently antidepressants are the third most common prescription drug taken by Americans of all ages during this timeframe. However, until surveys on the health of Americans inquire about a link between weight gain and antidepressant and related drug treatment, we can only speculate if these drugs are contributing to the obesity "epidemic."
But for Joanne and others whose weight gain is directly linked to antidepressant treatment, help should not have to wait until they become a statistic for help. The 11 percent of Americans who are on antidepressant medication, mood stabilizers and antipsychotic drugs may represent a sub-group within the population at risk for obesity. They are on these medications because of their illness, but they should not have to choose between weight gain and a stable mood.
Programs dealing with the special dieting needs of this population are not common. Perhaps it is, sadly, because they are viewed as obese individuals who simply have to stop eating fried cookies, bacon cheeseburgers, and 64-ounce sodas, and instead start a vigorous exercise program to lose weight. This simplistic approach works for no one, because the causes of obesity are complex. But those formerly thin individuals who now weigh 60 or 100 pounds more than they used to because of their medication need dietary advice that is compatible with their drug's effect on their brain neurotransmitters. Often the advice is non-existent, the individual is told to sign up for a generic weight-loss program, or given the wrong dietary advice. Several years ago, after our book The Serotonin Power Diet was published, I received a frantic phone call from a woman in the Midwest. She suffered from severe depression but responded to antidepressants. Unfortunately, she had gained over 50 pounds, and her doctor told her to lose weight by cutting out carbohydrates. "I read your book, the doctor told me and I know that my brain won't make any serotonin unless I eat carbohydrates. And my drugs need serotonin in my brain in order to work. But the doctor insisted and so I went on the Atkins diet. " Two weeks later, she told me, her depression increased and she was still unable to control her food intake.
Although some research has pointed to a possible interaction of some of these drugs with cells sites that normally control food intake, there is still remarkably little information as to why these drugs remove satiety and normal meal termination (jargon for not eating any more once you are full). Our approach has been to attempt to increase the brain's control of satiety through diet. Consuming small amounts of carbohydrates such as oatmeal, pasta, and/or bread eaten with little or no protein and fat, results in an increase in brain serotonin. And it is established that one of the functions of brain serotonin is to halt food intake.
We developed a food plan that increases serotonin at intervals through the day and found that patients at our weight management center were able to lose weight. Many of them were on two or three medications, each one of which caused weight gain, so their weight loss was significant. But to be effective, weight loss programs for the antidepressant user must also include exercise recommendations that are sensitive to the embarrassment many expressed at taking their suddenly overweight bodies to the gym.
Finally, support groups or workshops should be available so people who have suddenly moved from a normal weight to overweight or obese can share their experiences and give each other support. No one should have to choose between a good mood and a good weight.