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Lifestyle intervention beats diet for weight loss: 6 changes to make

Here is my latest blog post for Huffington Post “Lifestyle intervention beats diet for weight loss: 6 changes to make today.”
You can also read it HERE.

As a nutritionist, for years I’ve seen the pendulum swing back and forth as to which “diet” works best for weight loss: low-carb, high-carb, low-fat, the fill-in-the-blank diet (rice diet, grapefruit diet, peanut butter diet), you name it. The diet rage of the day just leaves overweight individuals confused as to the best way to lose weight and keep unwanted pounds off. It turns out that we may just be better off forgetting the word “diet” altogether, according to an editorial published last week in the Journal of the American Medical Association (JAMA).

Two researchers, Sherry Pagoto of the University of Massachusetts Medical and Bradley Appelhans of the Rush University Medical Center, call for an end to the diet wars, because they write that they are all equally as good, or bad, in helping lose weight. In the report, “A Call for an End to the Diet Debates,” they make the case that lifestyle changes trump diet in fighting the battle of the bulge.

As a nutritionist recommending lifestyle changes over diet, I couldn’t be happier with this report. I’ve seen clients try different diets over an over, just to fall off the wagon, get discouraged, and then try a different diet. Which is why I am more concerned helping clients stick with a plan they can follow while incorporating lifestyle changes they can stick with. One of the major problems with diets is adherence, which is so hard for so many overweight people struggling to shed unwanted pounds.

Indeed, as the authors write in the report:

The only consistent finding among the trials is that adherence — the degree to which participants continued in the program or met program goals for diet and physical activity — was most strongly associated with weight loss and improvement in disease-related outcomes.

As reported in Fox News:

In the end, patients only get confused thinking that one diet is superior to another, they said, when in fact changes in lifestyle, not diet types, are the true ways to prevent weight gain and the associated ills of diabetes and circulatory disease.

Lifestyle interventions involve a three pronged approach: making dietary changes, exercising more, and incorporating behavior modification techniques.

Here are six simple lifestyle changes you can make to get you on the road to permanent weight loss. I have used these techniques, along with others, with much success in my private practice helping clients lose weight and keep it off.

1. Practice portion control.
As an advocate for portion control, watching how much you eat is one of the best ways to lose weight. I have been counseling clients for years, and I have seen in my private practice that when clients watch the sizes of their portions (aka eat less), they shave hundreds of calories daily, and lose weight effortlessly. While it may seem obvious that larger portions have more calories than smaller portions, most people don’t recognize just how many more calories a large portion contains.

Another advantage to practicing portion control is that you do not have to cut out entire food groups to get thin and you get to indulge in your favorite treat every now and then. No dieting and no deprivation.

For tips on portion control, click here for my blog post “Rightsize your waist and your plate.”

2. Think positive.
Instead of dwelling on the foods you cannot eat, try instead to focus on what you can have. I tell my clients that there is no restaurant that is completely off limits. You can always find something healthy to eat. For example, when going to an Italian restaurant, instead of dwelling on the fact that you shouldn’t eat fettuccine alfredo, called a “heart attack on a plate” by the Center of Science for the Public Interest, think instead of what you can eat: whole wheat pasta with veggies and fresh tomato sauce or fresh grilled fish with sautéed spinach.

3. Keep food records.
There is no better way to get a handle on what and how much you eat than by keeping food records. And, for the good news you do not have to keep records forever. People who keep records are generally more aware of the mistakes they make and are then able to make corrections. Food records help you see your patterns, both positive and negative ones. For example, are you nibbling in front of the TV without realizing it, are you famished when you get home from work so you eat whatever is on the counter. By identifying your bad habits, you can easily find substitutes for new habits.

4. Eat structured meals and snacks.
Speaking of nibbling and mindless munching, one advantage to eating structured meals and snacks is that you tend to get famished less often. And when we are famished, we tend to just grab whatever food is in sight. And, we also often end up grabbing junk food. Planning in advance is also important. Keep healthy foods at arms reach and bring along a fruit and yogurt if you know that it will be hard to buy something healthy midafternoon.

5. Move more.
All exercise helps. The key is to do what you enjoy and follow an exercise program you can stick with. You do not have to spend thousands of dollars on a fancy gym. Lifestyle activities also add up. For example, take the stairs and walk around the block at lunch. I also advise taking advantage of different exercises you enjoy during the different seasons: swimming outdoors in the summer, taking a walk on the beach, and skiing in winter. The key is to follow an exercise program that you can stick with for the long haul.

6. Cut yourself some slack.
I am a big advocate of focusing on progress, not perfection. It is important to take stock of the changes you’ve made so far and look at the big picture. For example, if you need to lose 50 pounds, and already lost 10 pounds, recognize your accomplishment, instead of complaining that you have 40 more pounds to lose. One way to recognize your progress is to try on some old clothes. Seeing that they are too loose can help you actually see your accomplishment.

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Buyer Beware: Five Ways to Steer Clear of Health Haloes

Below is my blog post for Huffington Post “Buyer Beware: Five Ways to Steer Clear of Health Halos.”

You can also read it HERE.

New research soon to be published in the International Journal of Obesity by researchers at University of Ulster in Northern Ireland found that subjects eat more when food is labeled with a term perceived as healthy such as “reduced fat.”

Nearly 200 adult subjects were presented with pairs of foods, one food labeled with a “healthy”-sounding term such as “reduced fat” and the other food a regular brand item. The pairs of items had the same number of calories per 100-gram portions. Foods studied were reduced-fat and luxury coleslaw, semi-skimmed milk and Sprite, and Frosties and Special K cereals.

The subjects served themselves a larger portion of the healthy-sounding foods. This translates into the fact that they actually ate more calories from the products perceived as healthy. The subjects also underestimated how many calories were in these portions.

I have seen this phenomenon quite a bit in my private practice. Clients often think that if a food is labeled with a healthy-sounding term, they can eat more. For example, just because cookies are labeled reduced-fat, organic or gluten-free, people often think that somehow the calories do not count. But after all, cookies are cookies, regardless of whether they are reduced-fat, organic, gluten-free, or labeled some other way. And usually, when products are labeled as “reduced-fat,” manufacturers compensate by adding sugar. When products often marketed for diabetics are labeled as sugar-free, they may contain added fats or sodium.

At the end of the day, it is important to remember that very often marketing is at play here. As reported in Reuters:

“Foods are marketed as being healthier for a reason, because food producers believe, and they correctly believe, that those labels will influence us to eat their products and perhaps eat more of their products,” said Dr. Cliodhna Foley Nolan the director of Human Health and Nutrition at Safefood, a government agency in Ireland.

The takeaway message: Don’t be fooled by food label traps. Here are several ways to avoid such pitfalls.

1. Read food labels. Look at the calories per serving along with the other nutrients, such as fat, sodium, and sugar. The order of ingredients matters, too. Ingredients are listed in descending order by weight. If the first few ingredient contain unhealthy ingredients, regardless of the promise made on label, I’d suggest limiting this product or skipping it entirely.

2. Pay attention to your serving size. Be mindful as to how much you actually eat. For example, if you must indulge in a cookie, go for one cookie instead of two cookies, regardless of how they are labeled. Reduced-fat, sugar-free, or gluten-free cookies still have calories. Reduced-fat or reduced-sugar coleslaw, for example, may still have the same number of calories as the regular version. And the more you eat, the more calories you will be taking in. It is that simple.

3. Eat more whole food. This includes unprocessed foods such as fresh fruits and vegetables — which do not have food labels touting these products as healthy, low-fat, reduced-fat, gluten-free, or some other “healthy”-sounding term.

4. Cook more. By preparing your own food, you are able to know exactly what ingredients, and how much of each, is going into the final product.

5. Avoid “diet” food. Oftentimes, diet foods such as baked goods labeled low-fat, reduced-calorie, or fat-free do not taste great. And you may end up eating more to compensate for the mediocre taste. My advice: Stick to the real thing, and eat a smaller portion of a food you really enjoy.

Finally, always remember that there is no free lunch.

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Holiday tip: mini-size it!

Here is my latest blog post for Huffington Post. You can also read it here.

Happy holidays!

Holiday tip: mini-size it!

Mini-size it! A great way—perhaps the best way—to cut calories is to trim your portion sizes. Especially of foods that are high in calories. That would include many treats you would find at holiday parties and events such as eggnog, specialty hot chocolates, fancy chocolates, and cakes. The good news about using portion control as a way to trim calories is that you do not have to entirely ban your favorite treats and traditional holiday foods. The key to success, especially during the holiday season is “moderation.” If you crave a fattening food, it is ok to treat yourself to a small serving.

A few healthy holiday tips:

  • If you are baking a pie for guests, try cutting it into 10-12 slices instead of 8 slices.
  • If you are baking holiday cookies, bake smaller ones.
  • Buy mini muffin pans so you have them handy so that you can bake mini muffins.
  • If you are cooking potato latkes for Chanukah, make smaller ones, and use less oil.
  • Eat off of smaller plates.
  • Drink out of smaller glasses. Sip wine, for example, out of a smaller wine glass when possible (if entertaining at home, for example) and limit refills. Liquid calories add up quickly.
  • Eyeball serving sizes using common visuals. Three ounces of meat look like a deck of cards, 1/4 cup nuts looks like a golf ball, and two tablespoons of salad dressing fills a shot glass.
  • Use your hand as a guide.  Stick with a portion of meat the size of your palm and your starch (potato or rice) should be around the size of your fist. (Of course healthy veggies, without dressing, can be consumed in generous portions.)

As the quote goes: “If you can half-it, you can have it.” Or, as I write in my book, The Portion Teller Plan, “What kind of sandwich isn’t fattening?: The answer: “a half sandwich.”

Happy holidays!

Enjoy family, friends, and of course moderate portions of your favorite foods.

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Diet industry supports Mayor Bloomberg’s proposal to limit oversized beverages.

Here is my latest post for Huffington Post.

You can also read it below.

One week before the Board of Health is schedule to vote on Mayor Bloomberg’s proposal to limit the sizes of oversized drinks, Weight Watchers and other diet companies including The South Beach Diet, Jenny Craig and Bob Greene of The Best Life Diet are supporting the proposal.

I have previously written about my support for the proposal and also testified at the hearing.

As reported in the New York Times, David Burwick, the president of Weight Watchers North America said, “There’s been a lot of hand-wringing about obesity but very little action.”

As reported in Metro NY, Mayor Bloomberg said “As the size of sugary drinks has grown, so have our waistlines, and so have diabetes and heart disease.” And, Commissioner Dr. Thomas Farley added that “In a city with large sizes of high-calorie snack foods and beverages at your fingertips around the clock, it is no wonder many New Yorkers struggle to maintain a healthy weight.”

I could not agree more!

Here are 5 good reasons:

1. Portion sizes have exploded in recent years.

2. Large portions contain more calories than small portions.

3. Large portions encourage us to eat more.

4. Large portions encourage us to underestimate how much we are eating.

5. Sugary sweetened beverages are empty calories and have no nutrition benefits to offer.
The Board of Health is scheduled to vote on the ban on Thursday, Sept. 13 and would go into effect six months after, on March 13.

Stay tuned!

Your thoughts?!

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Healthy holiday tips: Happy 4th!

Below is my latest blog post for Huffington Post to help you have a happy and healthy holiday!
Here is the link. http://www.huffingtonpost.com/dr-lisa-young/health-tips_b_1644929.html

Happy 4th!

Holiday Eating Tips: 10 Ways to Enjoy a Healthy Holiday Season

With summer season upon us and the Fourth of July around the corner, I’ve been helping clients struggle with issues surrounding holiday eating. With Independence Day falling in the middle of the week this year, and not sure which weekend to celebrate (license to overindulge), so many people that I have spoken to have decided to make it a 10-day holiday. Holidays are a time for pleasure and enjoyment, family and friends, and food should be enjoyed during this time. Whether you are going out of town, attending a summer barbecue, having a party on the beach, or just staying at home with your family, follow the principles of moderation.

Here are some tips and tricks so that you can have a healthy holiday season. Enjoy!!

1. Watch portion sizes.

  • Enjoy your favorite holiday treats, but take a small portion.
  • Avoid portion distortion: Moderation is key.
  • Fill up on more fresh fruits and veggies. Follow USDA’s MyPlate guidelines by filling half of your plate with fruits and veggies.

2. Banish your membership in the “clean plate club.”
Leave a few bites over. Ask yourself: Am I hungry?

3. Be realistic about weight loss during the holidays.
Don’t try to diet during the holidays. Try to maintain your current weight. At the very least, now is not a time to begin a diet.

4. Don’t go to a holiday party starving.
Eat before you eat: Enjoy a healthy snack — yogurt, fruit, veggie soup, salad — before your event.

5. Balance party eating with other meals.

6. Don’t skip meals. Make a plan.

7. Make only one trip to the buffet table.
Choose only the foods you really want, and keep your portions moderate.

The good news about buffets is that there will usually be some healthy choices. And so often, there will be a wide variety of fruits and vegetables. My rule of thumb: Do a lap around the buffet and sample the choices before making your selection. Take one plate of food (not five mini-plates), and make sure your plate is not piled so high that food is ready to fall off the plate. Eat until you are comfortably satisfied (and it’s okay to leave a little room for your favorite dessert), and enjoy the company.

And finally, move away from the buffet table when socializing.

8. Eat your calories instead of drinking them.
Choose your beverages wisely. Remember that soda, iced tea, and lemonade all have lots of sugar and calories. Flavored seltzer, water, and unsweetened iced herbal tea are great choices.
And remember that alcohol is also high in calories. Moderation is key. Go for a white wine spritzer or a light beer.

9. Be a healthy host.
When you are the host, include nutritious and lower-calorie foods like fruits, vegetables, and lean meats. Reduce the fat in holiday recipes.

10. Continue a regular exercise program.
Swim, take a bike ride, or even walk on the beach. Take advantage of being outdoors and choose an exercise you like. What matters most is that you move!

Finally, enjoy good friends and family.

Happy holidays!

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Eat more with Ultimate Volumetrics

I have been a fan of Barbara Rolls’ work for years. Through her many research experiments, she has shown that the more food you give people, the more they eat. And they don’t report feeling any more full. Her solution is simple yet brilliant: choose foods low in calorie density (CD). Dr. Rolls is a professor of nutritional sciences at Pennsylvania  State University and has spent 20 years studying the science of satiety and how it affects obesity. She is the author of more than 250 research articles and several books, including The Volumetrics Eating Plan which I keep on my book shelf.

In her new book written with registered dietitian Mindy Hermann, Ultimate Volumetrics Diet (William Morrow, $27.50), Dr. Rolls shows you how to manage your weight. The book is based on solid research and is armed with solutions to give readers a guide as to how to control hunger and manage their weight. This book offers over a hundred new recipes as well as user-friendly tools to help you on our way to successful weight loss.

Unlike the many fad diet books on the shelves which make countless promises, and work mostly just for the short term, this book provides time tested tools and strategies to help you lose weight and keep it off. With the Ultimate Volumetrics Diet, you do not have to give up your favorite foods and you do not have to avoid entire food groups as many diet plans advise. Here you will get time-saving tips to lose weight for you and your family, a guide to eating out healthfully, and a grocery store guide which reviews shopping strategies. And better yet, you can eat MORE. As a nutritionist counseling clients on weight loss, this is a dieters dream!

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Want to lose weight? Eat Less.

Two thirds of Americans are overweight and succeeding at weight loss is quite a challenge for many dieters. A new study just published in the American Journal of Preventive Medicine (AJPM) reported that eating less, exercising more, and switching to healthier food worked best.

The researchers were from Beth Israel Deaconess Medical Center in Boston and looked at data collected as part of the dietary intake survey  National Health and Nutrition Examination Survey (NHANES). The authors wrote in the  study published online that “Liquid diets, nonprescription diet pills and popular diets showed no association with successful weight loss.”

The Los Angeles Times summarized what worked and what did not work for the dieters.

Here’s what the dieters tried that worked:

* 65% ate less food

* 44% ate less fat

* 41% switched to foods with fewer calories

* 4% took weight-loss medications that were prescribed by a doctor

* Joining a weight loss program was also helpful perhaps because of “the structure of being in a program.”

Here’s what the dieters tried that didn’t work:

* 41% drank more water

* 14% ate “diet foods or products”

* 10% used nonprescription diet pills, including herbal remedies

* 7% adopted a “liquid-diet formula.”

I was glad to see this study as I’ve been advocating eating less and moving more for years. While this old fashioned advice may not seem as sexy as some fad diets and supplements, it works for the long haul. And, it will save you money—no need to buy unneeded supplements.

Take home messages:

*  Skip the fad diets and practice portion control instead.

* Go out and exercise. Pick something you enjoy and stick to it.

*  Choose healthier and more nutrient dense foods. A good place to start is by eating more fruits and vegetables!

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Why Calories Count

Want to know more about calories? Most dieters are obsessed with calories, often counting them meticulously and incorrectly. They have no idea what a calorie actually is or how many calories they require.  My NYU colleague Dr. Marion Nestle and Cornell professor emeritus Dr. Malden Nesheim have just written a terrific new book Why Calories Count: From Science to Politics.

While the book isn’t officially out until April, it has already received wonderful write ups. Last week, two articles on the book were written for the New York Times, one by Jane Brody and the other by Mark Bittman. I’ve had a chance to read my copy and here are some excellent points worth sharing.

This is not another fad diet book telling you exactly what to eat or not eat. It also does not advise you to count calories. On the contrary, Marion and Mal dissuade readers from counting calories. It is a well-researched guide (with over 30 pages of references) on what you need to know about the “mysterious” calorie, the science behind the calorie, and the social implications of living in a society surrounded by too much food.

Marion and Mal begin by defining a calorie, reviewing its history, and discussing how scientists count and measure calories. They review some of the confusion surrounding the calorie and the struggle we have to estimate our intake. As a nutritionist researching portion sizes and counseling overweight individuals, what I found particularly important in the book is the discussions on obesity (two thirds of us are overweight or obese), weight gain, diets, and an in-depth look at the politics of calories, Marion and Mal tackle our “eat more” society, the role of the food industry, and the issues surrounding calorie labeling. They help readers understand the calorie in terms of food labeling, fad diets, and calorie myths. One such example is the concept of negative calories– which is wishful thinking, they write, unless of course you are drinking ice cold water!

Finally, the book concludes with a section on how to cope with our current calorie environment. Some simple and practical take away messages from the book: “Get organized. Eat less. Eat better. Move more. And, get political.”

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Rightsize your waist and your plate

Rightsize your Plate and your Waist: Portion control for the New Year.

Practicing portion control is one of the most difficult tasks facing anyone who eats out or even eats in these days. Look around you and everything is supersized. And not just fast food. Bagels, muffins, steaks, even frozen dinners have grown in size. I tracked the history of portion sizes increasing since the 20th century and found that portions are much much bigger than they were in the past, 2-5 times bigger to be exact. And so are people! No surprise. As I wrote in The Portion Teller Plan and in numerous articles, large portions contribute to weight gain because large portions contain more calories than small portions. Simple as it sounds, so many clients that I counsel don’t seem to apply logic to the equation. We know that if a 64-oz double Gulp soda is eight times bigger than a standard 100 calorie 8-oz soda, it should contain 8 times the calories. Yes, the Double Gulp contains 800 calories. Simple math?  Yes. But… if WE drink it, we think, how can a soda possibly have so many calories?

Our plates have increased, so have our mugs, glasses, and wine goblets. Our cabinets and  dishwashers are now larger to accommodate our satellite-sized dishes. And, car seats for our kids, who are now pudgier than ever, have also increased. And even caskets have become supersized!

Many of us don’t understand what a healthy portion is, and for good reason. A pasta portion in a restaurant is easily 3 cups, and many steaks are at least a pound. That is much too much food. The problem is that we’ve gotten used to these jumbo portion sizes and we think that a “portion” is whatever is put in front of us.

Getting used to normal-sized portions is not an easy task. Here are some tips:

Practice plate control. For starters, try eating off of plates your grandmother used. Next, change your expectation. Restaurants are in business to sell food, and lots of it. It is time to shift our perspective on what a reasonable amount of food is. If you use a smaller plate, you will probably begin to scale back on your portion.

Fill up on fruits and veggies. We want to scale back on our meat and potato portions and increase our intake of veggies. An easy trick is to fill half your plate with veggies. One quarter of your plate protein (meat, fish, poultry, tofu) and one quarter healthy starch (brown rice, quinoa, barley).

Buy single-servings when possible. Steer clear of the jumbo bags of chips, cookies, and nuts sold at price warehouse clubs such as Costco. We all love a good bargain, but beware when it comes to buying food. While you may want to stock up on toilet paper or paper towels, when it comes to food, buy smaller servings. Single-serve bags of chips will really help you practice portion control while snacking.

Order a small. In many cases you have a choice between a small, medium, or large. Order the small size whenever possible.

Avoid your triggers. If you can’t stop at one serving of chips, then don’t even start. Choose a treat you CAN control.

Don’t snack out of the bag. Familiarize yourself with the serving size on the food label, pour  yourself one serving, and put the bag away. Practice this for chips, nuts, pretzels and other treats.

Don’t be fooled by health halos. Just because a food is labeled organic or trans fat free doesn’t mean you can eat as much as you want. Calories are still calories.

Skip all-you-can-eat buffets. They may be a bargain for your pocketbook, but not for your health. If you must visit a buffet, do a full lap around the buffet before choosing your selection and wear tight fitting clothes (you’ll probably eat less.)

Share, share, and share. Restaurant portion sizes are huge. Order one main dish and an extra veggie dish or salad and share both. And order one dessert for two or three people and you will still feel satisfied.

Eat like a Parisian. Eat slowly, savor your food, and enjoy your company.

Enjoy! Bon Appetit.

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To cut calories, try cutting food in half!

New research reported in the May issue of the Journal of the American Dietetic Association found what I have been preaching for years and in my book The Portion Teller Plan : to cut back on how many calories you eat, try eating a smaller portion! In this study, which looked at candy size, the researchers found that slicing candies in half caused subjects to eat less of the snacks, and ultimately fewer calories.

Subjects–college students–were put in one of 2 groups: in one, 20 pieces of candy were served whole. In another, the 20 candies were cut in half. During both tests, people ate about the same number of pieces.  Those who ate the larger pieces, however, consumed about 60 calories more than those who ate the smaller pieces.

Interestingly, no substantial differences were found in the groups regarding hunger, how much the test subjects liked the candies, and whether they ate candy on a regular basis.

Here is the take home message:  if you want to eat fewer calories, try cutting your portion. And, skip the over sized packages of candy, chips, and soda. Say no to the jumbo king size candy bar, or split it with several friends.

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