You Are What You (and Your Friends) Eat

By now most of you have read the headlines of yet another factor associated with the increasing obesity epidemic in our country: Blame overeating on your friends.

What? The fundamental findings in this study of 12,000 people take a look at factors that were associated with excess weight:

1. Heavy people had heavy friends
2. People with heavy friends, became heavier themselves

Now, before you start evaluating your friends based on their body size, and how they might be sabotaging your own weight loss effort, I'd like to put these results in the context of the society in which we live. The idea that obesity is "socially contagious" is really a no-brainer, at least in this country. We're a country who likes to eat, and food is everywhere, 24/7. Every study out there shows that the more food that's available, the more we eat.

The one thing this study clearly points out is that overweight and obesity are related to BOTH biology and behavior. This is particularly important to emphasize now, in light of the abundance of information reporting the biological causes of obesity (as it the other, non-biological factors are less important!).

We are social beings, and in America, food is a major part of socializing. How much YOU choose to make food a part of your social network is a personal choice, with this study implying that if food is a major part of your social network, you'll tend to find friends who feel the same way—and support each other in overeating. This is not a negative judgment of people who like to eat—it's just a good reminder that our own eating behaviors have a large "learned" component, and we are able to "unlearn" some of our overeating patterns. It doesn't matter what size package you come in, it's hard to limit calories in our eating environment.

Consider what we know from a variety of studies:

1. Americans spend a lot of time eating in restaurants (many more than at home)
2. Portions are huge
3. People eat more in a group than alone
4. Family celebrations involve an abundance of food
5. Eating is a very popular social activity
6. Alcoholic beverage consumption is a highly popular social activity
7. No one, heavy or thin, estimates calories accurately in food

So, is there any surprise that people are getting heavier? I think there are many ways to empower ourselves, no matter what size we are, to be more mindful eaters. Eating is social, and pleasant, but how can we support each other in positive ways, no matter what our size? This extends to both food and non-food related activities?

Here are some of my favorites:

1. Share an entree with a friend, and order a light soup or salad first
2. Order a variety of appetizers to share with a friend for dinner
3. Split a dessert among 4 people
4. Take a walk instead of meeting for a coffee
5. Buy yourself and your friend a pedometer, and catch up with a walk after dinner

While the causes of obesity are a jigsaw puzzle, we can try to put the pieces together in our own way. Friends are part of this effort. Maybe we also need to start to make friends with food—the first step in successful weight management.

I'd love to know your thoughts on this!

Soda and Heart Health

Are you a soda drinker? If so, read on! There's a lot of confusion and controversy over a recent medical study, and picked up by newspapers and TV alike, linking soda - diet and regular - with an increase in risk factors for heart disease. To me, this is a prime example of reading the headlines, and not checking out the fine print.

Obesity-related illness is on the rise. One big way to save calories, and help avoid overweight to begin with, is to substitute that 150 calorie 12 ounce can for a sugar-free diet soda with practically no calories. Just making that substitution once a day will produce a 10 pound weight loss in a year.

This article compared soda drinking - and did not differentiate between diet soda and regular soda, and lumped them together. When making their comparisons for risk factors, they found that "soda drinking" was associated with more of these risk factors.

But who are the people they studied? 9000 middle aged Americans, including diabetics. Plus, two thirds of the US population is already overweight or obese. So, many of the group already had some health/weight problems, which would more likely contribute to the increase in risk factors, not the soda.

Plus, diabetics (already are at a higher risk for heart problems) would choose diet soda as a positive lifestyle change. In fact, when the results were recalculated with diabetics in the group excluded from the study, there was a much weaker association of soda and heart risk.

Another important factor: A diet soda is a natural choice for many overweight and obese people - many of whom have increased risk factors for heart health. With this in mind, comparing the "soda" link in this group just doesn't add up to me.

While diet soda has been criticized for a variety of reasons - none of which have been scientifically confirmed - it can have a role in weight management. Diet soda consumption should not be encouraged as the first choice of a non-calorie liquid (think water as the number one choice), as an alternative to regular soda, it's a calorie saver that can support a weight loss effort; and weight loss is a key factor in improving heart health.

What do you think about this recent report? Confused or enlightened?

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More from Madelyn:

• Diet Soda as Health Food?
• Are Liquid Calories Packing on the Pounds?

Fruits, Vegetables and Breast Cancer

I was quite interested in the recent study from JAMA (Journal of the American Medical Association), talking about the lack of a connection between mega-consumption of fruits and vegetables and breast cancer recurrence. I read both the scientific article and the newspaper reports and have some information to share. I'm always troubled when I see the words "no cancer benefit found" coupled with healthy eating—in this case, lots of fruits and vegetables daily.

Despite the headlines, no one should feel discouraged that eating fruits and vegetables are just "not worth it." Research studies are not designed to be absolute; they demonstrate trends in large populations, and work to establish connections between disease, disease risk, and other factors (like food). While this study did not show a specific benefit of increasing fruit and vegetable intake on breast cancer recurrence, this does not mean that we should all just abandon the overall health benefits of produce and say, "What's the use?"

We must read beyond the headlines, and check out the fine print. It is important to emphasize that no single factor can account for the onset of disease. I think it's time to address the overall aspects of a healthy lifestyle, not just eating, as the focus of fighting both existing disease and disease risk.

We all need and want a sense of control in our health destiny. It's important for both physical and mental well-being, and truly affects our quality of life. Here are some easy lifestyle tips that you can aim for every day, that really can help promote your health. What are some of yours?

5 Everyday Tips to a Healthy Lifestyle

• Choose colorful foods at each meal
• Look for lean protein and consider soy or other vegetable proteins
• Walk 20-30 minutes daily
• Address your stress and work on reducing it
• Get 7-8 hours of sleep (or support with power naps)

Update on Health Claims for Food

Have you noticed the variety of health claims made for particular foods, and food groups? It seems like everything we eat has some value added, and "good for __________" [fill in the blank of heart, brain, digestion, aging, and more]. What you may not know is that the Food and Drug Administration is cracking down on a lot of these health claims, with new regulations that require approval from the FDA prior to making them.

Just this week, the FDA rejected the petitions asking for a health claim for tomatoes and lycopene (the nutrient thought to be most active) in reducing cancer risk. We've all heard so much about lycopene (a type of carotenoid in the Vitamin A family) in supposedly helping to reduce the risk of many types of cancer. But where is the evidence? It seems the FDA, after a comprehensive review of the medical literature on tomatoes/lycopene for reducing cancer risk, just did NOT support this specific health claim.

What does this mean to consumers? Tomatoes are full of nutrients, and an important part of the "Five A Day" recommendation for fruits and vegetables and part of a balanced diet. While no one can say FOR SURE that there is not some connection between eating tomatoes and somehow reducing disease risk (including cancer), there is not yet enough medical evidence to say this on a label or in advertising.

Other foods have been put to the test. You may notice that oatmeal DOES have the labeling as being good for heart health, as enough studies convinced the FDA that this is so. Green tea, while a healthful choice for many reasons, CANNOT carry a disease-specific prevention label.

New medical research continues to identify additional health promoters in different foods that we already know are healthful - think fruits and vegetables, whole grains, nuts, and fish. This supports the "value added" of consuming a healthful diet. The advice I give my patients, and follow myself is to aim for unprocessed foods. The basics of healthy eating do not change:

1. Eat an abundance of colorful fruits and vegetables


2. Choose fiber rich whole grains


3. Select lean protein (animal and plant sources)


4. Include heart healthy fats

Healthy eating is the best "health claim" of all. What do you think?

Related information on iVillage:

Cereals Step Up to Better Nutrition

Food Nutrition Labels a Puzzle? Here's Help

Fruits and Vegetables: How to Get Your 5 a Day!

Are You Overdosing on Vitamins?

There's not a day that goes by in the newspaper, magazines, or on-line that we're not reading about a so-called "new" action of all kinds of vitamins and minerals. It's getting scary out there, because we're crossing over into a mindset that started with vitamins as "supplements"—taken to supplement what we are eating—to large doses to either prevent or cure a whole host of disease states. When it comes to vitamin and mineral supplements, a small amount is a very good thing. More is not better, and in fact, can be harmful to your health.

We had an interesting discussion on my TODAY show segment about this very topic: The right way to use vitamins and minerals to improve health, and what to look out for when it comes to supplementation.

Are we a nation of vitamin pill poppers? Here are some interesting facts:

• More than 100 million of us, in the United States, regularly use vitamins.
• Consumer spending on vitamins has doubled in the past 6 years to a whopping $6.5 billion.
• 70% of households in the US purchase vitamins.

Are you a vitamin consumer? I'd love to know what supplements you take—and why you take them. The health benefits of vitamins and minerals can be fantastic, as long as there is some critical thinking on balancing the right amounts. When it comes to vitamin supplements, where and how you get your information can make all the difference between health promotion and health damage.

Vitamins and minerals play a critical role in our bodies. Used in all kinds of metabolic reactions, they serve an essential role in every body system. With the exception of Vitamin D (which our skin can produce with the help of direct sunlight), we need to consume vitamins and minerals in our food—they are essential nutrients that our bodies cannot produce, and so we must get from the outside.

While food is the preferred source of vitamins and minerals, we live in such busy times—restricting calories for weight loss, eating more processed foods, skimping on fruits and vegetables—that most of us would benefit from a daily multivitamin/mineral tablet.

Choosing a daily supplement means looking for "one stop shopping." Look for a complete pill containing 100% of the recommended daily intake (determined by scientific groups reviewing the medical literature). These numbers are reasonable estimates for most people—but diseases, dietary restrictions, and medications—can modify these requirements. Check with your doctor or pharmacist to see if your needs have to be adjusted.

Here's a brief vitamin/mineral primer for you, that explains why vitamin ingestion has to be monitored:

• Vitamins are grouped as either "fat" or "water" soluble, based on how they dissolve in the body.
• The fat solublevitamins (A, D, E, and K) dissolve in body fat, and are accumulated and retained by the body over time.

  If too much is taken, and the body has no extra need for them, they are stored, mostly in the liver and also circulate around in the bloodstream. Extra fat soluble vitamins can lead to hypervitaminoses—too much of a vitamin that can be damaging to a whole variety of body activities—and are reflected as malaise, stomach upset, diarrhea, nerve damage, headache, among other symptoms.

• Water soluble vitamins (B1, B2, B3, B6, B12, folic acid, C) dissolve in water, and are typically eliminated in urine if there is an excess amount in the body. These are not risk free, as excess Vitamin B6 can produce negative effects on the nervous system. Plus, too much folic acid can mask a Vitamin B12 deficiency, and too much Vitamin C can block the absorption of vitamin B12 by the body.
• Vitamins and minerals don't act separately, and are all part of the body's metabolic activity. When the body "sees" more than a small amount, it it handled more like a medicine, which is not nature's intended way. This puts the vitamin and mineral in a whole other category, with safety risks.
• There are upper levels of safety for most vitamins and minerals. The FDA regulates these, and while no one wants to be deficient, we also have to pay attention to NOT exceeding the upper level for safety.
• It's easy to get a lot of extra supplements - since in addition to fortified foods, you find them in diet soda, juices, and energy drinks. Plus, certain supplements, like calcium, have added Vitamin D for improved absorption.

Confused by all of this? Don't be. Rely on the FDA recommendations for daily vitamin and mineral intake.

Here are 5 easy steps to optimizing your vitamin and mineral intake:

• Review your present diet, including dairy consumption and particularly of fruits and vegetables. Make a note of any medications you take, and whether there is an indication for special supplement increase or decrease. Check with your doctor or pharmacist for further advice.
• Look for a supplement with 100% RDI for all (or most) nutrients. Avoid products with names like "thera", "mega" or "super."
• Choose a well known brand (or store generic) for greater purity. While the FDA regulates vitamins and minerals to some degree, much of this is determined by the company. While organic and "all natural" vitamins are an option, they can be quite costly, without greater efficacy.
• Take the supplement every day. If you're a regular consumer of fruits and veggies (7-9 servings a day), you might take it 3 days a weekly, for extra "insurance."
• Keep track of your calcium intake. Aim for 1000 mg per day, with at least one third (one serving) coming from a dairy product. Avoid consuming more than 500 mg at a dose. And, watch out for vitamin D intake; while absorption of calcium is enhanced with vitamin D, it is fat soluble, and too much should be avoided.

I've tried to "hit the high points" of vitamin and mineral supplementation. By the way, I take a daily multivitamin/mineral supplement myself—100% of the RDI. I aim for two servings of dairy, but also take 500mg of calcium (plus D) once daily. What about you?

Related information on iVillage:

Test Your Supplement Savvy

iVillage Symptom Solver

Multivitamins: Now Recommended for All Adults

"Lighten Up" Your Summer BBQs

One of the best and worst things about summertime eating is a backyard barbecue. Worst thing? What could be bad about casual, outside eating in nice weather with family and friends? I hear from people all the time that while the whole idea of a BBQ is fun, they really dread the eating part, because they are overwhelmed with all of the choices and abundance of the, literally, hours of eating.

Whether it's burgers, roasted corn slathered in butter, potato salad or super-rich brownies, we all need an eating plan at a barbecue to enjoy, but still maintain control

I've got 10 simple strategies that are reality based (Just stick with fruit for dessert? WAY too hard for mostly everyone, including me!), letting your taste buds dance, but also keeping an eye on your waistline!

While we all know the basics - skip the foot long hot dog! - here are some of my (and my patients') favorites for backyard barbecues. What are some of your favorite ways to trim calories at a BBQ? I'd love to know!

1. Check out the food before filling your plate; pick and choose to be a "taster." (The first bite is always the best!)
2. Avoid grazing. Structure your eating for one complete meal: Appetizer, main dish, dessert. You can keep your mouth busy with non-calorie beverages when you've completed your meal.
3. Choose alcohol carefully, if at all. Stick with light beer and avoid juice-based drinks and wine coolers. Try a white wine "spritzer" - wine with some club soda.
4. Barter foods to stretch your calories. Choose your favorites, and don't eat others. You are not obligated to try every dish on the buffet.
5. Watch out for condiments. Mustard, salsa, and ketchup are basics. Limit mayonnaise and guacamole.
6. Jump into the backyard games, even if you're not a badminton expert. Anything beats sitting.
7. Stick with non-calorie beverages to fill you up, and offset the calories of alcoholic drinks.
8. Pick one dessert and share with someone, or just start with a small piece. Add some fresh fruit, instead of going "a la mode."
9. Bring a dish YOU can eat as a free food. Think raw veggies; fruit platter; grilled portobello mushrooms, green salad with light dressing.
10. Don't announce you're watching your calories. That's one of the fastest ways to get people to offer you food!

With a little pre-planning, you CAN enjoy your holiday BBQs with good taste, and no guilt.

Cookouts are one of my favorite parts of summer eating, and I hope they will be for you too!