Allison J. Cleary http://www.eatingwell.com/taxonomy/term/884/all en Walking the Talk http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/walking_the_talk <h3>An interview with James Levine, M.D.</h3> <p>On the fourth floor of the Mayo Clinic in Rochester, Minnesota, the staff are all on their feet. Researchers, lab technicians and physicians type on computers that are positioned at eye level over softly humming treadmills; they take meetings standing up or walking calmly at a zenlike one mile per hour; wear mobile phones on their belts; and regularly go home at the end of the day hundreds of calories lighter.</p><div class="field field-type-content-taxonomy field-field-author"> <div class="field-items"> <div class="field-item odd"> Allison J. Cleary </div> </div> </div> <div class="field field-type-text field-field-subtitle"> <div class="field-items"> <div class="field-item odd"> If James Levine has his way, your next desk could be a treadmill. </div> </div> </div> <div class="field field-type-filefield field-field-image-standard"> <div class="field-items"> <div class="field-item odd"> <img class="imagefield imagefield-field_image_standard" width="310" height="310" alt="" src="http://bed56888308e93972c04-0dfc23b7b97881dee012a129d9518bae.r34.cf1.rackcdn.com/sites/default/files/James Levine.jpg?1303160742" /> </div> </div> </div> <div class="field field-type-text field-field-body"> <div class="field-items"> <div class="field-item odd"> <p>An interview with James Levine, M.D.</p> <p>On the fourth floor of the Mayo Clinic in Rochester, Minnesota, the staff are all on their feet. Researchers, lab technicians and physicians type on computers that are positioned at eye level over softly humming treadmills; they take meetings standing up or walking calmly at a zenlike one mile per hour; wear mobile phones on their belts; and regularly go home at the end of the day hundreds of calories lighter.</p> <p>This is the office of the future, says innovator James Levine, and it may well save the nation from a future of chronic obesity. Levine, an endocrinologist who has built his data and hypotheses around the importance of the ordinary movements of daily life rather than deliberate exercise, had his “aha” moment when one of his studies revealed that lean people are on their feet 152 more minutes a day than obese people. The data quickly translated into an office makeover that encourages people in traditionally sedentary settings to get up and move throughout the workday.</p> <p>With his keen sense of humor, British accent and unstoppable enthusiasm, Levine now travels the globe to persuade governments, corporations and individuals to turn offices, schools and other environments upside down, maximizing daily activity with creative solutions like treadmill desks and indoor walking tracks.</p> <p>Q: You’ve said your research has convinced you that everyday movement may be more important to a person’s health than deliberate exercise. How is this possible?</p> <p>The key is the calories you burn throughout your day through normal activity, predominantly comprised of the walking you do and the mooching around that is life. You do it for many hours every single day, rendering it more important than something you do very intensively yet very infrequently.</p> <p>Q: How can an office worker who uses his or her lunch break to go to the gym get as much exercise simply walking down the hallways?</p> <p>What does it really mean when you spend an hour at lunchtime going to the gym? You get the keys, go down the elevator, get to the car, drive to the gym and about 20 minutes later check in, go down to the locker room, change and get on the exercise bike. With no warm up you pound away for 20 minutes, look down at the little readout, see 64 calories, and jump off the exercise bike now stressed-out rather than calmed. You jump into the shower, take another 5 minutes for your hair, jump back into the car, arrive at work, and you don’t feel great. For all of that you achieve 20 minutes of real exercise. You do it three times a week and you’re talking about burning cumulatively 192 calories.</p> <p>Now, take a different scenario. Let’s say every day you have two one-hour meetings and instead of having those meetings sitting down opposite your supervisor at a desk, you walk. That’s two hours of very slow (1 mph) walking every day. Each of those walks will burn 100 calories—that’s 200 calories per day. So already in one day of meetings, without rushing, without stretching or even changing your clothes, you’ve burned more calories than the person who went to the gym three times. It’s the idea of lots of low-intensity movement being more powerful than short bursts of high intensity.</p> <p>Q: That’s sounds a bit unlikely for most office settings.</p> <p>If every office had treadmill desks, it would be possible. It takes less than 10 minutes to get used to working this way, and of some 300 people who’ve tried treadmill desks, we have had no failures. We recommend that you spend 30 minutes out of the hour walking.</p> <p>Q: Some would argue that it comes down to willpower rather than environment.</p> <p>People make this horrendous mistake, all the time, of assuming heavy people are not intelligent. We have innate drives; some people’s drives are to be active. For example, I just got off the plane in Washington, D.C., and I’ve got work to do, but for the last three hours, I’ve been walking around the city. I had the drive to do it. But others get off the plane and say, “Fantastic, I’ve got four hours with no interruptions and I can work now.” They’ll sit on their bottoms for four hours.</p> <p>Similarly, when dessert comes around, some say, “I fancy I’m full,” and pass on the offer while others wait for a second piece. I don’t call those people lazy or gluttonous, they simply have a different biology.</p> <p>Q: It’s probably safe to assume that not every worker will convince her colleagues to walk at meetings. And there won’t be treadmills on the sidelines of kids’ soccer games for the parents, which is my fantasy. So what other steps can people take to increase their everyday movements?</p> <p>I’ll give you real examples from a study we did to discover whether it was feasible to have normal people stand and walk around for two and a half more hours a day when given the directive. All of them succeeded.</p> <p>One woman moved the television to a room with her treadmill and never watched TV unless she was walking. Another lady created three 50-minute walking sessions she takes before work, in the evening, and at lunchtime after she eats her sandwich in five minutes. I’m not necessarily sure that I would do that, but people do what they want to do and that’s the point.</p> <p>At the government website <a href="http://www.small" title="www.small">www.small</a> step.gov, by the way, one suggestion for improving health is to walk the sidelines at your child’s soccer game.</p> <p>Q: What could a single mom with toddlers do?</p> <p>Well, we in fact worked with just such a woman. She had a 9-to-3 job and after work she collected her 4- and 2-year-olds, put them into a double stroller and walked the mall for an hour. Then, because the 4-year-old went to bed consistently at 7:30 but the 2-year-old bounced around until 9 p.m., she put on music and danced with the baby.</p> <p>My personal theory is that people are incredibly smart and creative. You provide them with good information and they will come up with an answer.</p> <p>Q: Are you still standing for this phone interview?</p> <p>Of course, I’m walking around. Portable phones are great, but the extra-long cords you can get for $5 are also fabulous. I’ve been walking at a shopping pace (1 mph) for the last hour, and I’ve burned 100 calories. If I’d stood still I would have burned 10 calories. If I’d sat I would have burned 5.</p> <p>What really inspires our patients, when we show them their numbers, is that at a shopping pace, you double your metabolic rate. At two miles per hour, you triple it. When you see yourself burning an extra 100 calories an hour, just by mooching around, why would you ever sit down?</p> <p>Q: You’ve suggested that we must completely revolutionize the office environment to include treadmill desks and walking tracks for meetings. Has anyone accused you of being just a little bit wacky?</p> <p>I’ve had scientists call me delusional, questioning how any researcher, based on data on relatively few people, could suggest that we need to completely uplift how we live. Science doesn’t normally speak in such large brushstrokes. We’re talking about societal change in a way that most of us can’t even contemplate yet. Most colleagues are very receptive; there’s a global recognition that this is really, really important information.</p> <p>If you perform the work, look at the data and believe it, you can’t help but respond and advocate for people. In fact, it’s the dream of every scientist to influence how people think and behave.</p> <p>Q: How has your research changed your own patterns?</p> <p>I used to walk for an hour at lunchtime every single day. It didn’t matter if I had a meeting, if it was minus-60 outside (as it often is in Minnesota). Now I don’t because I spend my entire day on a treadmill. I have a pair of black running shoes in my office, and as soon as I get to work I put them on. I don’t go home feeling like a sloth, or like I’ve been cheated of my walk.</p> <p>Q: Until someone manufactures these treadmill desks, can people make their own?</p> <p>We’ve heard that IKEA is going to market a model soon, and the Pentagon is ordering them from IKEA. But for $50 of wood and screws I built a unit at home. It took two hours and I’m not a whiz.</p> <p>The way you position the computer is crucial. If you position it at your hip so you have to stoop over it, you go home with back pain. Positioned at eye level, you don’t get back pain, foot pain, you don’t sweat, you don’t have to change your clothes.</p> <p>Q: You’ve said that “pervasive mechanization” may cost an individual 100-200 calories per day, a deficit that could potentially account for the entire obesity epidemic. But no one will go back to washing clothing by hand.</p> <p>I’m not advocating that we regress. Humans go forward, we develop. Yet we never move. I see an office building across the street and I know in the middle of the day that they’re all sitting in there. This lack of movement is pervasive, and the most pervasive thing of all is the computer and other screens, nothing but bland workspace. People go home, sit in front of the TV and Internet.</p> <p>Q: You’re not telling people “Leave your screen,” just make the activity come to your screen?</p> <p>Right, or associate the screen with the activity. In other words, make it a positive loop. The key thing is that it’s got to be fun, dynamic and make us feel good about ourselves. That’s why it’s going to work, by the way. Put a computer or TV on top of the treadmill, and people will enjoy working and watching TV more while they’re walking.</p> <p>Q: What about the argument that to be active in this world you need a certain comfort in income?</p> <p>You don’t need money to walk to church rather than drive, or get off the bus a little bit earlier; you don’t need money to take your boss for a walk—it’s not money related. It’s “Let’s do it.”</p> <p>Q: Any concerns about future generations?</p> <p>It’s more than hard to stay healthy in our environment. It’s pretty close to impossible. Sixty percent of us are overweight, and we’re not even warmed up yet, because the kids coming behind this generation are heavier than we were as kids.</p> <p>It is really necessary that we think completely differently about how we work, go to school and about how we spend our time at home. I am absolutely convinced that it is possible to do this. It has to happen—if it doesn’t the consequences are catastrophic.</p> <p>Q: At the end of the day, what do you hope to have contributed to public health?</p> <p>An active, happy world. People think I’m about activity, health, controlling health-care costs and so on. But to me the real excitement is that this is a path for happiness. People who are active are happy, and that to me is the real sell. ew</p> <p>Sources:</p> <p>Treadmills<br /> For a quiet, reliable treadmill suited to office walking, Dr. Levine recommends a Pacemaster Bronze (very quiet) or True Classic:<br /> <a href="http://www.pacemaster.com" title="www.pacemaster.com">www.pacemaster.com</a><br /> <a href="http://www.truefitness.com" title="www.truefitness.com">www.truefitness.com</a></p> <p>Standup Desks<br /> A number of companies make desks that can be adapted to use with a treadmill:<br /> <a href="http://www.standupdesks.com" title="www.standupdesks.com">www.standupdesks.com</a><br /> <a href="http://www.anthro.com" title="www.anthro.com">www.anthro.com</a><br /> <a href="http://www.hardwoodfurniture.com" title="www.hardwoodfurniture.com">www.hardwoodfurniture.com</a></p> <p>Further Information<br /> Details about the Mayo Clinic’s Office of the Future, including images of their own facility:<br /> <a href="http://www.mayoclinic.org/news2005-rst/2836.html" title="www.mayoclinic.org/news2005-rst/2836.html">www.mayoclinic.org/news2005-rst/2836.html</a></p> </div> </div> </div> http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/walking_the_talk#comments Allison J. Cleary Weight Loss/Diet Diet, Nutrition & Health - Weight Loss & Diet Plans Fri, 21 Aug 2009 14:58:23 +0000 Nifer 10199 at http://www.eatingwell.com Mind Over Appetite http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/mind_over_appetite <p>Pull up to Amarillo’s Big Texan Steak Ranch (“Home of the free 72-ounce steak”) and you step into a microcosm of modern American eating.</p> <p>Here, if you can down a 72-ounce sirloin (41⁄2 pounds!), complete with baked potato, salad, shrimp cocktail and a dinner roll within an hour, the meal is yours free, compliments of the house. Some 30,000 people have tried the feat, and almost 4,800, including a 69-year-old grandmother, have won the free meal.</p> <div class="field field-type-content-taxonomy field-field-author"> <div class="field-items"> <div class="field-item odd"> Allison J. Cleary </div> </div> </div> <div class="field field-type-text field-field-subtitle"> <div class="field-items"> <div class="field-item odd"> EatingWell interviews John Foreyt </div> </div> </div> <div class="field field-type-text field-field-body"> <div class="field-items"> <div class="field-item odd"> <p>Pull up to Amarillo’s Big Texan Steak Ranch (“Home of the free 72-ounce steak”) and you step into a microcosm of modern American eating.</p> <p>Here, if you can down a 72-ounce sirloin (41⁄2 pounds!), complete with baked potato, salad, shrimp cocktail and a dinner roll within an hour, the meal is yours free, compliments of the house. Some 30,000 people have tried the feat, and almost 4,800, including a 69-year-old grandmother, have won the free meal.</p> <p>“The youngest winner was an 11-year-old boy,” bemoans behavioral psychologist John Foreyt, who for 30 years has watched the eating patterns in this country change. In his own home state, serious eaters throng to the Big Texan, and a quick look at the recent winners of free 72-ounce steaks shows them to be, on average, 34-year-old males, standing six feet tall and weighing in at 264. The body mass index of these diners is 35.8. Obese. Foreyt, a nationally known expert on eating habits and weight loss, says they are far from alone in a country where bigger portions, fast food, fewer meals at home and more lonely eating are contributing to a national health emergency.</p> <p>At Baylor College of Medicine in Houston, Foreyt has helped thousands of patients lose weight, published hundreds of research studies and helped to revolutionize the field of behavior modification to sustain weight loss. He has taken the field from focusing purely on dropping pounds to focusing on lifestyle intervention, in which the total person, with all of his or her individual quirks and challenges, is considered and given a sense of empowerment to help themselves.</p> <p>Q: You warn that with the path we are taking, by the year 2040, 100 percent of Americans will be overweight; by 2100, 100 percent will be obese. Do you truly believe that?</p> <p>Yes, I do. I just projected out from the NHANES data [National Health and Nutrition Examination Survey], which records real heights and weights of a random sample of the United States adult population. They show that we’re getting fatter, one percentage point a year. There’s always going to be a small group of people who are protected genetically, but that number will be quite small and not significant. Remember, two-thirds of us are already overweight.</p> <p>Q: How much extra weight is unhealthy?</p> <p>Physiologically, with just 15 pounds of extra weight your blood pressure begins to go up, your cholesterol goes up, your good cholesterol, the HDL, goes down, your blood glucose starts going up. By the time you get up to 30 pounds overweight, most people will have either hypertension, hyperlipidemia or type 2 diabetes.</p> <p>Psychologically, you’re definitely in trouble by 15 pounds overweight, especially women. The damage comes in poor self-esteem, which can lead to anxiety, depression and stress. Your work is affected by it, and you may have a lower quality of life and that’s very serious. Men sometimes aren’t as aware of weight gain. They can get really heavy and deny it, or they don’t even notice.</p> <p>Q: How does psychology factor into obesity and weight loss?</p> <p>It’s not that people just eat because they’re hungry, but they eat for so many other reasons: stress, tension, anxiety, loneliness, depression, anger, boredom. So in order to lose weight you have to focus on diet, but you also have to deal with those emotional factors. Following a healthy diet and an exercise program is all motivation and behavior.</p> <p>Q: How can someone who has been eating the same way for 30 years make changes to lose weight?</p> <p>The problem is that most of us want to lose weight tomorrow. So you have this cognitive dissonance between what is practical and possible versus what you really want to do. All of us want to be skinny, but the way to achieve that is not overnight.</p> <p>If people make big changes they can lose weight, but the rebound tends to be quite quick. We counsel people to make small changes they can live with—start with a little less salad dressing or a little less mayonnaise or butter on your bread, and add a little bit of physical activity.</p> <p>Q: Many people are claiming they’ve found success on the low-carbohydrate Atkins diet, but it entails rather large changes.</p> <p>I’m just a data person so if you say that you like this or that diet, just show me the data. There’s no evidence to support that radical changes make a long-term benefit.</p> <p>I think that we’ll see data within the next couple of years that these diets are probably not very healthy long-term. But we don’t know yet. Until then, I certainly wouldn’t recommend that anyone stay on one of these diets long-term.</p> <p>Q: Sometimes, when people want to quit smoking, it helps if they change their environment as much as possible. Does this also apply to successful weight loss?</p> <p>It can help. I always tell people when they’re making changes with their weight to keep their old friends but find new friends who didn’t know you when you were heavy. A different environment, of course, would be ideal for all of us. But the practicality of it all is that we have to go back to day-to-day existence. Environmentally you can make some changes to make the job easier—don’t drive past the doughnut shop on your way to work.</p> <p>Q: You claim small changes are the key to successful diet changes, but many of those small changes take significant effort, using an entirely different way of thinking.</p> <p>If it were easy, everyone would be skinny.</p> <p>Q: I just saw an appealing ad with sizzling shrimp tumbling out of a pan onto a plate, and an all-you-can-eat-message for a local restaurant. We know it’s unhealthy to gorge: what is the appeal?</p> <p>Americans want to get their money’s worth. What better way to get your money’s worth than a bottomless shrimp bar or a buffet?</p> <p>We teach people to stay away from places where they’ll be tempted. It’s like the addicted gambler who goes to Las Vegas for the buffet—not a good idea.</p> <p>Q: You place more importance on “lifestyle intervention” rather than simple weight loss. Where do they differ?</p> <p>There are a million ways to lose weight—but the focus for most of us should be on a healthy lifestyle. To me that means eating healthy all the time—or nearly all the time—exercising regularly and dealing with the stresses of daily living. The way to do that is through behavioral strategies: self-monitoring, stimulus control, cognitive restructuring, stress management, social support.</p> <p>Q: What does socializing do?</p> <p>Meals are part of the whole ritual of rebuilding relationships with family and friends. It’s a critical element to health. You feel better about yourself when you’re around other people and you tend to pace yourself at a much better rate. You won’t overeat, gobbling down food, when the person next to you is not. And food becomes less salient than when you eat alone. We’ve lost that here in America. We eat for the food itself, not for the family or friends.</p> <p>Q: What if your friends overeat?</p> <p>Well, make new friends. I had a patient who had made changes and was losing weight successfully but her husband was afraid she would leave him if she kept losing weight. So he would bring home her favorite loaded pizza and plop it on the table in front of her. We see that kind of sabotage regularly. You try to deal with the sabotage. If not, change your lifestyle. Get rid of the jerk. That’s what she did, by the way. You make choices.</p> <p>Q: How important is it to get on a scale every day, and to count calories?</p> <p>Self-monitoring is the most critical element in this whole business of managing one’s lifestyle. For someone to change what they eat, they’ve got to know what they’re eating—it raises awareness.The ideal would be to carry a food diary, a notebook, write down everything you eat, look up the calories (one of those little paperbacks would be fine) and make adjustments.</p> <p>You can argue the validity of this business. You’re not going to get the right portion size, so precision doesn’t matter, and you’re going to underreport your calories by a third. I don’t really care about whether it’s true or not. It’s just raising awareness that I’m interested in.</p> <p>Now, along with self-monitoring, of course, is weighing yourself daily and keeping track of minutes of exercise, or using a pedometer.</p> <p>Q: Do you wear a pedometer?</p> <p>I have one on right now. I aim for 10,000 steps a day for weight maintenance. Ideally, 10,000 additional steps would lead to a pound-a-week weight loss—50 pounds a year. Ten thousand steps is equal to about 5 miles, and you burn about 100 calories a mile.</p> <p>Most people tend not to get more than 3,000 steps per day. Most of my steps happen in the morning when I jog for 45 minutes. I’m a slow jogger, I’m not a runner. And I don’t always do it—the goal is I try.</p> <p>Q: You say that while people generally underreport calories by one-third, they also overreport physical activity by one-half. Is that an active deception?</p> <p>Most of us are just not aware of how much we’re eating or how inactive we really are.</p> <p>Q: What other behavior strategies help individuals keep control of their weight?</p> <p>The next step in weight control is controlling the stimuli that are associated with overeating or underexercising. It’s laying out exercise clothes or putting that sign on the refrigerator door to remind you to stick to a regular schedule. I have one on my refrigerator, a picture of a pig, that says, “You back again?” It’s just to remind me, do I really want to take out that yogurt?</p> <p>Also, you can change the way you think about yourself and set realistic goals. In a study by nutrition researcher Gary Foster at the University of Pennsylvania, most people said they wanted to lose 36 percent of their weight when in reality they could lose 8 to 10 percent. Aim to lose a pound a week rather than three, and give yourself positive encouragement, telling yourself: I can do this today, I will do this today.</p> <p>Q: You claim that the true secret to weight loss and maintenance is “eternal vigilance.” What does it mean?</p> <p>Eternal vigilance is constant awareness of what you eat, of when you exercise. Our most successful patients watch themselves from the minute they get up in the morning.</p> <p>Q: That seems exhausting.</p> <p>Managing weight is exhausting. Part of the challenge is the way we’ve all chosen to live—we’re all too busy, we’ve all taken on too much.</p> <p>Q: How much does stress factor into weight?</p> <p>Stress is the number one predictor of relapse. But there are lots of ways to reduce stress, including physical activity, meditation and progressive muscle relaxation, which is tensing and relaxing different muscle groups. Practicing stress-reducers in two 15-minute sessions a day can really help.</p> <p>Q: Over the many years you’ve been helping people lose weight, what are some of the lasting philosophies you’ve put together?</p> <p>Make small changes, one day at a time, and be realistic. There is no magic, but all of us have the power, within ourselves, to be healthy, to focus on eating correctly and being active.</p> <p>The real issue today is the low activity level for all of us, but especially our children. Remember, when you’re exercising or being more active you feel good about yourself, and people who feel good about themselves have an easier time eating healthfully than people who don’t. Even if you don’t lose a single pound, it’s still important to exercise for the psychological state of well-being.</p> <p>Finally, we’re all human. Your weight is important but there are things that are even more important—loving your family and getting on with living.</p> <p>Foreyt’s Menu</p> <p>Breakfast: When I’m home and I have time I’ll make oatmeal and orange juice. If I don’t have time I’ll drink Slim-Fast. Meal replacements work like a charm—there are 10 years of published data to support that. You know precisely what you put into your body. When I drink a Slim-Fast I know I’ve taken in exactly 220 calories.</p> <p>Lunch: When I have time, I’ll have a sandwich.<br /> I have no problem with carbohydrates—I love them.</p> <p>Dinner: I make pasta or a Healthy Choice meal. Over the day I’ll take in about 20 percent of calories from protein. I’m not a fanatic, by a long shot.<br /> -By Allison J. Cleary</p> </div> </div> </div> http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/mind_over_appetite#comments Allison J. Cleary Weight Loss/Diet Diet, Nutrition & Health - Weight Loss & Diet Plans Wed, 19 Aug 2009 17:43:54 +0000 Nifer 9813 at http://www.eatingwell.com Eat Well, Lose Well http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/eat_well_lose_well <p>To hear what Kathy McManus has to say, you find yourself awake at dawn and scrambling to keep up as she takes her regular five-mile morning run. The pace never lags as she breakfasts, meets with patients in Boston’s Brigham and Women’s Hospital obesity clinic, brainstorms with a team of Harvard researchers, and teaches dietetic students about the role of nutrition in weight loss.</p> <div class="field field-type-content-taxonomy field-field-author"> <div class="field-items"> <div class="field-item odd"> Allison J. Cleary </div> </div> </div> <div class="field field-type-filefield field-field-image-standard"> <div class="field-items"> <div class="field-item odd"> <img class="imagefield imagefield-field_image_standard" width="160" height="160" alt="" src="http://bed56888308e93972c04-0dfc23b7b97881dee012a129d9518bae.r34.cf1.rackcdn.com/sites/default/files/2475eat_well_lose_well_160.jpg?1250701818" /> </div> </div> </div> <div class="field field-type-text field-field-body"> <div class="field-items"> <div class="field-item odd"> <p>To hear what Kathy McManus has to say, you find yourself awake at dawn and scrambling to keep up as she takes her regular five-mile morning run. The pace never lags as she breakfasts, meets with patients in Boston’s Brigham and Women’s Hospital obesity clinic, brainstorms with a team of Harvard researchers, and teaches dietetic students about the role of nutrition in weight loss.</p> <p>One of the architects of a landmark study on the importance of healthy fat in a weight-loss diet, McManus has witnessed time and again the fruitless efforts of motivated people who simply cannot lose weight and keep it off. She has also watched diet after trendy diet come and go, leaving behind a wake of frustration.</p> <p>The experience has forged two basic principles for McManus: Unless food tastes good and satisfies, most people will abandon their diets; and an individual’s future weight and health depend on healthy weight loss, rather than on simply losing pounds.</p> <p>In line with these precepts, she emphasizes the importance of individualizing diets. Counting calories and eating celery may work for some, she says, but not for everyone. In her own life, McManus is a vegetarian who strikes a balance between exercise and diet for maximum health. She loves good food, but approaches a five-course meal at an expensive French restaurant in the same way she does eating at the airport: seeking whole foods and reasonable portion sizes.</p> <p>Q: You’re famous for a study in which fat became the key for people trying to lose weight. How was this groundbreaking?</p> <p>For so long the presumed way to lose weight was to cut back on fat, an idea that took hold without much data to support the premise, especially in the long term. Our study helped demonstrate that people could eat healthy fat and still lose weight. In fact, the fat was what helped them stick with the regimen. Half of the volunteers spent 18 months on a typical low-fat diet (20 percent calories from fat). The other half followed a Mediterranean-style diet (35 percent calories from fat) in which monounsaturated fats (olive and canola oils and almonds, for example) were featured.</p> <p>People lost weight on both diets, but after six months those in the low-fat group dropped out of the study at a greater rate because they couldn’t tolerate the restrictions. By the end of the study, even after we offered them $100 to come in simply to be weighed, many of them had completely abandoned us. In contrast, the Mediterranean group found the diet enjoyable, and many of them stuck with it after the study ended.</p> <p>Food has to taste good. People who came into the study had been struggling unsuccessfully with their weight for a long time and had not eaten a nut or peanut butter in years. In the Mediterranean diet they could eat nuts, they could eat full-fat salad dressings, they could eat avocados—healthy, high-calorie foods they had been denying themselves. The key to their weight loss and follow-through was in portion control and including healthy fats.</p> <p>Q: The Mediterranean diet is a far cry from the currently popular Atkins diet, another regimen in which fats get a green light. What can the Mediterranean diet do that a low-carb diet like Atkins cannot?</p> <p>The Mediterranean diet can be used for healthy weight loss rather than simple weight loss. It cuts back on refined carbohydrates but makes room for healthy carbs from whole-grain sources, along with an abundance of fruits and vegetables. The Atkins diet may invite a little bit of fruit and vegetables back in, but it’s still low in the fiber and nutrients these provide. Also, saturated fat on the Atkins diet can be quite high, whereas on the Mediterranean diet it’s closer to 7 percent of calories. The average American’s intake of saturated fat is 12 to 13 percent—almost double.</p> <p>Q: Atkins dieters hear this and say, “So what? I’m losing weight and to me that’s healthy.”</p> <p>The problem is that we don’t know that the weight can stay off long-term. And we don’t know the implications of eating that way for the rest of your life: we have limited data on what the Atkins diet can do over a lifetime. Whereas we have more than 2,000 years of data that the Mediterranean diet can support health and long life.</p> <p>Q: If someone is used to eating lots of processed foods, it must take a while for the palate to adjust to foods that fit into a healthy weight-loss diet.</p> <p>Absolutely. This is not a quick fix. Rather it’s about biting the bullet and beginning to change eating patterns and build skills that are necessary to support them. In our study, the people on the Mediterranean diet began enjoying more vegetables and more fiber, two healthy results.</p> <p>Q: Is that because on the Mediterranean diet they could use fats to make vegetables more flavorful?</p> <p>Exactly. Instead of having simple steamed broccoli, they could stir-fry it with a little garlic and olive oil. With salad, a lot of people don’t like fat-free or low-fat salad dressings, but good olive oil enhances the flavor of salad. Even ranch dressing fits, as long as it uses a healthy fat like canola or olive oil as a base. If you eat fat-free salad dressings, you miss out on the beneficial linoleic acids in the oils. You can also sprinkle nuts on salad, instead of croutons, for crunch.</p> <p>Q: Portion sizes are a top problem for your patients. Without measuring, how can I know whether I’ve chosen an appropriate portion?</p> <p>Take a plate and divide it in half. Half of it should be vegetables, one-quarter should be lean protein, one-quarter should be whole grains.</p> <p>Q: But there are different sizes of plates out there.</p> <p>Yes, there are. But depending upon whether you are trying to lose weight or to maintain it, there are different approaches. To lose weight, take a smaller plate, but make sure the vegetables drape over the sides.</p> <p>Q: What about snacking? How do I determine how many crackers are too many?</p> <p>Pay attention to the serving size on the side of the package. Oftentimes what’s helpful is to combine a little bit of lean protein with the whole grain or the fruit: for example, have a little bit of low-fat tasty cheese, like string-cheese mozzarella, with an apple and a couple of whole-grain crackers; or have a little peanut butter or hummus on either fruits or vegetables or whole-grain crackers. Nuts also have protein, fiber and healthy fat.</p> <p>Q: What does the combination of protein, whole grain and fat achieve?</p> <p>It helps people, when they have that energy dip at 4:00 in the afternoon, to bring blood sugar up a little bit, but it’s not going to spike it—that’s good in the long run. If<br /> you have more-refined snacks you’re good for a half hour<br /> or hour but then you’re hungry again—you’re on that vicious cycle.</p> <p>Q: Do you recommend supplements?</p> <p>People who are trying to lose weight and who are cutting their calories should take a multivitamin, especially until they can get into healthy eating patterns. I also recommend that women take calcium with vitamin D.</p> <p>Q: Do you think most people can lose weight healthfully and keep it off?</p> <p>Oh yes. Call me Pollyanna but I do believe that people can make a difference in their lives and work toward goals. We do that every day in lots of different ways—and what better goal to work toward than health.</p> <p>A day’s menu for Kathy McManus</p> <p>Breakfast:<br /> Oatmeal or cold cereal (Kashi GoLEAN), with 1% milk, often a<br /> few almonds, pecans or walnuts, and I always add fruit (strawberries, melon, oranges, banana). Sometimes whole-grain toast with peanut butter, but<br /> no butter. Two cups of tea and at least six 8-ounce glasses of water (throughout the day).</p> <p>Lunch:<br /> A large salad of spinach leaves, vegetables, cottage cheese or a hard-boiled egg, dressed with oil and vinegar, with nuts sprinkled on top. Yogurt for calcium, and a piece of fruit, usually an apple.<br /> Snack: An ounce of peanuts (28 peanuts).</p> <p>Dinner:<br /> A big stir-fry of veggies, frozen and fresh, with tofu and olive oil. Whole-grain pita, bread<br /> or brown rice, and maybe another salad. I also make a lot of soups. In the summer it may be a cold squash soup or a gazpacho. I may have a glass of milk.</p> <p>Dessert: A few times a week I’ll have some ice cream or a piece of dark chocolate.</p> <p>Bookshelf<br /> Kathy McManus recommends:<br /> "Eat, Drink, and Be Healthy" by Walter Willett<br /> "Mediterranean Light" by Martha Rose Shulman</p> </div> </div> </div> http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/eat_well_lose_well#comments Allison J. Cleary Weight Loss/Diet Wed, 19 Aug 2009 17:11:16 +0000 Nifer 9799 at http://www.eatingwell.com Campaigning to Lose http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/campaigning_to_lose <p>At 4:30, in the blue dark of early morning, you can hear the steady beat of a man’s running footsteps skirting the 9-acre grounds of the Governor’s mansion in Little Rock, Arkansas. It is Mike Huckabee’s sweatiest hour of the day.</p> <p>Five years ago the Governor of Arkansas wouldn’t have dreamed of taking a run. In fact, he might not have survived it. At age 47, Huckabee had aching knee joints, lost his breath walking up porch stairs and, according to his physician, was on his way to an early grave.</p> <div class="field field-type-content-taxonomy field-field-author"> <div class="field-items"> <div class="field-item odd"> Allison J. Cleary </div> </div> </div> <div class="field field-type-text field-field-subtitle"> <div class="field-items"> <div class="field-item odd"> Mike Huckabee – How He Won by Losing. </div> </div> </div> <div class="field field-type-filefield field-field-image-standard"> <div class="field-items"> <div class="field-item odd"> <img class="imagefield imagefield-field_image_standard" width="225" height="172" alt="" src="http://bed56888308e93972c04-0dfc23b7b97881dee012a129d9518bae.r34.cf1.rackcdn.com/sites/default/files/2471mike_huckabee.jpg?1250700728" /> </div> </div> </div> <fieldset class="fieldgroup group-related1"><div class="field field-type-text field-field-relatedtitle1"> <div class="field-label">Related Content Title 1:&nbsp;</div> <div class="field-items"> <div class="field-item odd"> Related Article </div> </div> </div> <div class="field field-type-nodereference field-field-relatedlinks1"> <div class="field-items"> <div class="field-item odd"> <a href="/food_news_origins/food_news/dennis_kucinich_vegan_on_the_campaign_trail">Dennis Kucinich - Vegan on the Campaign Trail</a> </div> </div> </div> </fieldset> <div class="field field-type-text field-field-body"> <div class="field-items"> <div class="field-item odd"> <p>At 4:30, in the blue dark of early morning, you can hear the steady beat of a man’s running footsteps skirting the 9-acre grounds of the Governor’s mansion in Little Rock, Arkansas. It is Mike Huckabee’s sweatiest hour of the day.</p> <p>Five years ago the Governor of Arkansas wouldn’t have dreamed of taking a run. In fact, he might not have survived it. At age 47, Huckabee had aching knee joints, lost his breath walking up porch stairs and, according to his physician, was on his way to an early grave.</p> <p>The 280-pound Huckabee had a history of dieting, losing weight and gaining it back. But he took note when his doctor sat him down during an annual checkup, gave him a diagnosis of type 2 diabetes, and told him, “At the rate you’re going, you’ve got another 10 years left.”</p> <p>Skeletons in the Closet<br /> “I had parents and grandparents with type 2 diabetes,” Huckabee says. “I knew that I was predisposed and that I was moving in that direction, but I kept thinking, ‘Well, that will happen to me when I’m in my sixties. By then there’ll be some sort of magic medicine that will take care of this and I won’t even feel the consequences.’</p> <p>“I was shocked that it happened to me instead at age 47. Like so many people, I lived with denial.”</p> <p>So between gubernatorial events and legislative meetings, Huckabee attempted to take back his health. Modest changes like eating fewer pastries and walking when he had time didn’t take him far. “I was still struggling with weight and the reality that I had to exercise regularly.” Then Huckabee had another wake-up call. A good friend, former Governor Frank White, died of a heart attack a week after he stood in Huckabee’s office telling the younger man how much he was looking forward to retirement.</p> <p>Ultimately, says Huckabee, “I just finally got sick and tired of being sick and tired.”</p> <p>Facing the impossibility of making real progress on his own, Huckabee sought help at the University of Arkansas for Medical Sciences Weight Control Program. There doctors prescribed meal-replacement shakes that totaled 800 daily calories. Three months later and 40 pounds lighter, he graduated to 1,600-calorie meals loaded with vegetables and lean proteins like chicken and fish, and he earned the green light to walk for exercise. As the weight came off and his health improved, Huckabee found walking too slow and began to run. In the spring of 2005, he completed the Little Rock Marathon in just over 41⁄2 hours.</p> <p>Unlearning Bad Habits<br /> The same man who ate deep-fried Twinkies and gravy-drenched fries at the State Fair switched to a cooler filled with apples, string cheese and lean turkey as he travels from one event to the next. “Instead of doughnuts, I now crave apples.” His daily diet and exercise regimens have become routine. “This morning, I had some hard-boiled eggs, tomatoes and some melon,” Huckabee recalls, explaining that he typically eats a high-protein breakfast. For a midmorning snack, he’ll chomp on an apple, a handful of nuts or a bowl of strawberries. “I’ve made the practice of not going long periods of time without eating something,” Huckabee says, citing his doctor’s explanation that metabolism improves when you eat small portions regularly throughout the day rather than eating large meals three times a day.</p> <p>In Arkansas, where 25 percent of the population is classified as obese, avoiding fried, fatty foods takes constant vigilance. The cuisine is born in part from long traditions of poverty in the South, Huckabee says. “I grew up in a home in which we were just a few pockets full of change above the poverty level. We ate foods that stretched our food dollars but were not necessarily nutritious. Potatoes added bulk so you could serve more people; gravy added volume to a meal. We also ate a lot of foods that had a long shelf life, which meant they were probably loaded with partially hydrogenated vegetable oil. It preserved the food, but took from my shelf life.”</p> <p>As an adult, Huckabee consequently sought out fried chicken, chicken-fried steak, fried anything—zucchini, okra, potatoes. He ate burgers on the run because of the ease that drive-thru allowed. “My motto is that if it comes through the car window, it isn’t food. If what you eat creates a greasy sack, eat the sack and throw the food out,” he laughs. “At least the sack has some fiber.”</p> <p>The New Regime<br /> Huckabee cooks many of his own meals when home, but more often than not he’s on the road. At events he declines meals, depending instead upon his cooler. At restaurants he requests lean meats, heaps of steamed vegetables and salads with salsa rather than dressing.</p> <p>Just as he had to rethink food, Huckabee changed his attitude toward physical activity. “The very thought of health and fitness added guilt to an already frustrated life.” Put off early during grade school by “sadistic football coaches who didn’t want to teach P.E.,” Huckabee’s attitude continued to deteriorate in adulthood until he convinced himself that exercise was something he was physically unable to do with bad knees and joints. Besides, he reasoned, as Governor he couldn’t find the time.</p> <p>“Now, instead of finding the time I make time,” Huckabee says. “My life is as important as a speech, so I book exercise into my schedule.” If he isn’t running, he may put 35 minutes into a cardiovascular workout on the recumbent bike (where he can also catch up on the newspapers) and spends another 30 minutes training with weights.</p> <p>The results have been tremendous. Over two years, Huckabee, at 5'11" dropped 110 pounds—but even more telling, his blood sugar now registers in the normal zone. “My doctor says it’s almost as if I never had diabetes. I no longer need medication, but not everyone will be able to get to that point.”</p> <p>Inspiration Trickles Down<br /> His transformation has inspired changes in others at the statehouse. Sneakers are tucked under desks for walking breaks around the capital, a ritual Huckabee started because he was disturbed by unhealthy smoking breaks. Instead of doughnuts and pastries, staff often bring fruit to share as treats. And dinner events at the Governor’s mansion now feature vegetables, lean proteins and sugar-free desserts.</p> <p>Arkansas’s health-care policies have changed as well. “Government shouldn’t be the grease police, but it should create incentives,” Huckabee says. In his newfound evangelism Huckabee has built 24 new diabetes-education centers and the state now offers employees who take health assessments a discount on their health insurance.</p> <p>When people tell Huckabee they are going on a diet he wishes them luck but warns them they’ll probably fail. Diets, he says, by their very nature stop when a weight-loss goal has been met. Instead of weight loss, Huckabee says, set a goal in life span. “Health and fitness take the rest of my life. There’s never a point at which I can say, ‘Boy, I’ve gotten healthy, now I can coast,’ anymore than I can say, ‘I’ve been breathing for quite a while, I can stop now.’ My life depends upon the next breath, and I have to look at health and fitness in the same way.”</p> <p>-Allison J. Cleary</p> <p>A Governor’s Tips for Changing Lifestyle</p> <p> * You won’t find time for exercise, you must make it.<br /> * Start small. “You ate the elephant one bite at a time, you’ll have to get rid of it one bite at a time.”<br /> * Rewarding yourself with food is a “great cultural bugaboo.” Instead, reward yourself with a CD or go to the movies.<br /> * Don’t let others determine what you eat.<br /> * Don’t put off starting a healthy routine.</p> <p>The Governor’s book about his experiences has just been published: Quit Digging Your Grave with a Knife and Fork: A 12-STOP Program to End Bad Habits and Begin a Healthy Lifestyle (Center Street).</p> </div> </div> </div> http://www.eatingwell.com/nutrition_health/weight_loss_diet_plans/diet_reports_information/campaigning_to_lose#comments Allison J. Cleary Weight Loss/Diet Diet, Nutrition & Health - Weight Loss & Diet Plans Wed, 19 Aug 2009 16:54:10 +0000 Nifer 9793 at http://www.eatingwell.com Hip:Heart Ratio—Bumping out the BMI http://www.eatingwell.com/nutrition_health/heart_health/hipheart_ratio_bumping_out_the_bmi <div class="field field-type-content-taxonomy field-field-author"> <div class="field-items"> <div class="field-item odd"> Allison J. Cleary </div> </div> </div> <div class="field field-type-text field-field-subtitle"> <div class="field-items"> <div class="field-item odd"> A new way to assess risk of heart attack. </div> </div> </div> <div class="field field-type-text field-field-body"> <div class="field-items"> <div class="field-item odd"> <p>Just when you’ve gotten used to the BMI, or Body Mass Index, as the most cutting edge way of assessing your health risks, research raises a new finger of hesitation.</p> <p>It turns out that, at least when it comes to assessing the risk of heart attacks, the ratio between your waist and hip measurements is a much stronger indicator than that of the BMI, according to a study from Canada’s McMaster University on more than 27,000 people worldwide. A higher ratio may indicate more abdominal fat while a lower one may indicate more lower-body muscle.</p> <p>To determine your waist-to-hip ratio, measure your waist and hip circumferences with a snug tape measure, then divide the former number by the latter. Women with a ratio of 0.85 and above and men with a ratio of 0.90 or above are at increased risk of heart attack at some point in their lives and should seek advice from their physician.</p> </div> </div> </div> http://www.eatingwell.com/nutrition_health/heart_health/hipheart_ratio_bumping_out_the_bmi#comments Allison J. Cleary June/July 2006 Heart Healthy Diet Diet, Nutrition & Health - Heart Health Tue, 18 Aug 2009 20:17:35 +0000 Penelope Wall 9725 at http://www.eatingwell.com On the Spice Trail: Cinnamon to thwart diabetes and heart disease http://www.eatingwell.com/nutrition_health/diabetes/on_the_spice_trail_cinnamon_to_thwart_diabetes_and_heart_disease <p>Once traded like gold, cinnamon is proving its worth all over again in the world of medicine and prevention. A study from 2004 has linked the spice to health benefits for people with type 2 diabetes and anyone vulnerable to heart disease. </p> <p>Researchers at the Beltsville Human Nutrition Research Center in Maryland found that when people with type 2 diabetes consumed between 1⁄2 teaspoon and 3 teaspoons of cinnamon a day, they experienced significant improvements in blood glucose (sugar), triglycerides (fats) and cholesterol after only 40 days.</p> <div class="field field-type-content-taxonomy field-field-author"> <div class="field-items"> <div class="field-item odd"> Allison J. Cleary </div> </div> </div> <div class="field field-type-text field-field-subtitle"> <div class="field-items"> <div class="field-item odd"> Once traded like gold, cinnamon is proving its worth all over again in the world of medicine and prevention. </div> </div> </div> <div class="field field-type-text field-field-body"> <div class="field-items"> <div class="field-item odd"> <p>Once traded like gold, cinnamon is proving its worth all over again in the world of medicine and prevention. A study from 2004 has linked the spice to health benefits for people with type 2 diabetes and anyone vulnerable to heart disease. </p> <p>Researchers at the Beltsville Human Nutrition Research Center in Maryland found that when people with type 2 diabetes consumed between 1⁄2 teaspoon and 3 teaspoons of cinnamon a day, they experienced significant improvements in blood glucose (sugar), triglycerides (fats) and cholesterol after only 40 days.</p> <p>“When you get diabetes, your risk of cardiovascular disease goes up two- to fivefold,” says Richard Anderson, lead scientist at the Center. Blood glucose, triglycerides and cholesterol, risk factors for heart disease, are all controlled by insulin, the hormone that is jeopardized by diabetes. “Because cinnamon can improve the functioning of insulin, it works to improve these three risk factors,” Anderson concludes.</p> <p>“We think it is the polyphenols in the cinnamon that are at work. Polyphenols are natural products in plants that are used for protection,” Anderson says. In humans they also act as protective agents.</p> <p>Even people without diabetes can benefit from the spice. “Typically, the older we get, the worse our blood glucose profile becomes—but it doesn’t have to,” says Anderson. “If you fortify your body’s ability to produce and regulate insulin, you decrease your risk of long-term chronic disease like diabetes and cardiovascular disease.” </p> <p>Anderson himself shakes cinnamon on his morning orange juice every day. “A lot of people like to brew it with their coffee. And you can shake it on salads or meats, or on oatmeal, which is already good for you.</p> <p>“But you have to think of your whole diet,” Anderson warns. “Some people hear this news and think, ‘Great! I can eat more apple pie because of the cinnamon in it.’ But apple pie has a lot of other ingredients that can be detrimental to your health.”</p> </div> </div> </div> http://www.eatingwell.com/nutrition_health/diabetes/on_the_spice_trail_cinnamon_to_thwart_diabetes_and_heart_disease#comments Allison J. Cleary Diabetic Diet Heart Healthy Diet Recipes & Menus - Spices Diet, Nutrition & Health - Diabetes Mon, 17 Aug 2009 17:41:45 +0000 Penelope Wall 9589 at http://www.eatingwell.com