Top Tips for Guilt-Free Thanksgiving Eating

At this time of year, when thoughts focus on family and food, I'd like to "weigh in" (sorry!) with a few thoughts of my own.

Along with this, I'd like to wish all of you and your families a very happy and healthy Thanksgiving and upcoming holiday season. I thought I'd share my top five ways to enjoy Thanksgiving without deprivation. They work for me, and perhaps for you, too! Let me know your own ideas.

For more practical ideas, check out our iVillage slide show on Thanksgiving: Is It Worth the Splurge?

1. Make a mental adjustment: focus on the social part of Thanksgiving, and the pleasure of seeing friends and family, and look at the food as an enjoyable and important part of the day - but not the main event.
2. Take a look at all the foods you can choose from before serving yourself: Barter carefully, and select those of most "taste value" to you. You're not obligated to consume everything on the table!
3. Be a taster: Just a spoonful is usually enough. It's the first bite or two that gives us the most pleasure.
4. Don't starve yourself all day in preparation for a giant meal: This plan always backfires. We all think we're saving calories for the "big dinner", but truly, we just fuel a larger appetite. It's our biology - after a period of food restriction (like all day without eating), when we finally get food, we are "overhungry" to make up for the deficit, and actually have a stimulated appetite. So, eat modestly, at least once (if your meal is in the early or mid afternoon) or twice (eating in the later afternoon, or evening).
5. Take a 30 Minute Walk Before or After the Meal: Now 30 minutes isn't going to burn off a slab of pecan pie, but what it WILL do is keep you connected to a plan of moderation. Best is a walk after the meal, to help digestion, and get some closure to the meal, but any time is great.

Happy Thanksgiving!

Diet for a Healthy Heart

Can what we eat contribute to a healthy heart? Can our diet support heart health after a heart attack? If you've asked yourself these questions, read on. The foods you eat can be a part of a heart healthy lifestyle, if you make some smart choices and stick with them. That's the topic of my Today Show segment about diet and heart disease.

Click to watch the segment

What we eat can make a difference in heart health – both positive and negative. That said, while diet can influence heart health, it’s only one of the important factors involved in the variety of illnesses we commonly think about related to the catch-all term “heart health” – which include high blood pressure, stroke, heart attack, atherosclerosis (plaque-clogged arteries), and high cholesterol. Genetics (family predisposition), physical activity, stress management, and smoking are all important contributors as well.

I'd love to hear what you think about nutritional contributions to heart health. How does healthy eating fit into your lifestyle? Do you think the other factors are more important (like exercise and stress management)???

The lifelong goal is to seek a stable weight AND a heart healthy lifestyle – from childhood on. For many women (and men!), healthy eating and weight maintenance have come at the expense of caring for other family members. So many people approaching age 40 or older consume diets contributing to high cholesterol and artery-clogging, have a lack of physical activity, can’t manage stress, and smoke. Oftentimes, a heart attack is the unexpected outcome of poor diet, genetic tendencies, and inactivity (people often know their lifestyles are not heart healthy, but don’t know what to do!). This occurs after years of poor eating habits – not the occasional piece of cheesecake!

Food is not medicine, and will not replace medical care for the treatment of heart disease. Healthy eating can help lower the risk of heart disease for many people, if done consistently over time.

While we hope that the “wake up call” of eating for a healthy heart does NOT come after a heart attack, there are thousands of people needing this information. In reality, the diet to lower risk factors to prevent a heart attack is just about the same as the best diet to consume after heart attack.

So, what to eat for a healthy heart? I have an easy plan that starts with what I call the “3 Cs”, all supported my recent medical studies: Calorie Counting; Cholesterol/Saturated Fat Reductions; and Compliance.

Calorie Counting: Maintain a stable weight, or lose weight if you’re willing to. Even not gaining is a help. If you monitor calories, you’ll naturally lower your fat intake as well. Plus, you won’t tend to consume to much of “heart healthy” foods that are highly caloric – like nuts and olive oil.

Cholesterol/Saturated Fat Reductions: Cholesterol comes from two sources: the diet and our own livers, that make it. We can’t control the amount of cholesterol our livers produce (that’s genetic), but we CAN limit the cholesterol we eat in foods. While reductions in dietary cholesterol and saturated fat (artery-clogging) can often help lower blood cholesterol, and limit plaque formation, it is not always the case, and medications must often be used when lifestyle alone is insufficient. Cholesterol is a waxy, fatty substance that our bodies need a small amount of. Saturated fats come from animal fats (in contrast to vegetable fats), and contribute to plaque formation. This is a big area of improvement for many people – and the single biggest area of focus when it comes to heart health.

Compliance: While we use the word diet, that’s really wrong – because you can always go “off” a diet, but I like the term lifestyle, because that indicates “forever”. For the diet changes to have any influence on long term heart-health, it must be done DAILY, not “when I remember”. This is the hardest part of the heart-healthy diet for many.

There are two very similar eating plans: The American Heart Association’s TLC (Therapeutic Lifestyle Changes is the gold standard, while some studies have compared this with the Mediterranian-style diet (the main difference here is that there’s almost no red meat), and found similar effects.

HERE IS THE SIMPLE LIST OF FOOD GROUPS TO CONSUME:

Generous fruits and vegetables (all colors) Healthy Fats: fish, nuts, olive/canola oil Protein: LEAN meat, fish, poultry Fish (2 x/wk; skinless white meat poultry, very lean cuts of meat, including red meat; limited amounts of nuts, soy proteins Fiber rich starches (20-25 grams/day); up to 4 whole eggs a week (whites ok) Not fat or lowfat dairy products

REQUIREMENTS:

Total Calories (vary): To maintain: Take your present weight, multiply by 12- a rough idea…., so, 150 pound person needs 1800 cal; a 200 pounder is 2400 cal).
The calorie distribution is an example of someone who needs 1800 calories/day.

Total Fat: 25% - 35% of calories (450 - 600 calories per day)

Protein: about 15% (270 calories per day)

Carbohydrates (fiber rich): 50% - 60% of calories (900 – 1100 per day)
This means fruits, veggies, and starchy CHO – like bread, rice, potatoes, cereals

Cholesterol: Less than 200 mg per day (if no heart disease, or heart attack, this is 300 mg per day).

If the total fat intake for the day is 25% - 35% of calories, it can be divided into the following calories: best rule of thumb, keep saturated as low as possible…

Fat is broken down into saturated (bad) and unsaturated (good). Within the healthy, unsaturated group there is “mono” and “poly”

Saturated: less than 7% of daily calories (125 calories or less)
(This is 10% of calories if no heart disease: 180 calories)

Monounsaturated (like olive oil): up to 20% of calories (up to 360 calories daily)

Polyunsaturated: up to 10% of calories (180 calories)

An important reference point: a tablespoon of ALL fat has about 120 calories!

What about salt intake? 2500 mg or less per day (heart healthy) is the goal; 2000 mg or less per day with heart disease (check with your doctor!).

Other dietary strategies which might be helpful:

Plant stanols (or sterols) can be included, at 2 grams per day. These are often found in functional foods like PROMISE active yogurt (nothing to do with dairy, but 2 grams plant stanols); Cocoa Via chocolate bars; Benecol margarine.

A final thought on red wine and chocolate, that always come up in discussions of heart healthy eating. While these products do have antioxidants, so do many other foods. I suggest using these foods as part of your daily indulgence calories - 100-200 calories daily - which is part of a deprivation-free lifestyle. Use these "free" 200 calories wisely. If you like chocolate, go for it. A glass of wine, fine! Don't start eating candy or drinking alcohol is you don't already do it, for the perceived health benefit. It's just not true!

Your thoughts on this?

Top Nutrition Concerns of Baby Boomers

We all know that “50 is the new 40” and “40 is the new 30,” etc., etc., but what does that mean for your nutrition needs as the years click along?
Looking good inside and out–that’s the topic of my Today show segment this week. (Check back later for the video!)

I’d like to address some of the primary nutritional concerns many of my patients raise in mid-life. I face a lot of them myself! Health promotion is a multi-faceted effort, and healthy eating is certainly one part–but not the only one. Regular activity, stress reduction, and smoking cessation are all part of the good health equation.

I’ve selected some of the top nutritional concerns for baby boomer women. (And their significant others!) Some people come with the ailments already occurring, while others want to put out their best effort at prevention. I’m all for the lifestyle effort to maximize the control we have over our bodies, but bear in mind, there are genetic issues that can trump even the healthiest lifestyle. Make your doctor your health care partner.

That said, check out these eating strategies, and let me know some of your own. Small eating changes made consistently really can improve your health!

Fiber. Many boomer complain of “irregularity” and constipation. Why? Lack of dietary fiber. It’s really hard to get to the lowest recommended intake–about 20-25 grams every day. Before you run out to buy a fiber supplement, look for foods that naturally are fiber rich, and give you the biggest bang for your fiber buck! Try some fiber-rich cereals (Fiber 1 cereal, with Honey Nut Clusters, All Bran Flakes, Grape Nuts) mixed alone or mixed with other cereal favorites to get up to 50% of your fiber needs in a single serving.

Fiber 1 makes some very tasty bars–with almost 50% of your fiber needs in a single serving. Plus, the calories are quite modest. In addition to fruits and veggies (4-5 servings give you enough fiber for the day), look for fiber fortified foods, including yogurt. You can boost your fiber intake without expanding your waistline. Do it gradually–a few grams extra a day, to allow your digestive track to adjust.

Protein. Protein needs increase over age 40. Always select lean cuts of meat, and opt for fish, and skinless poultry more often. Try vegetable proteins, like lentils, chick peas, and black beans, or purchase some ready made soy-based items resembling chicken, and beef. Think about nuts (almonds and walnuts are great to toss in a salad), legumes, and soy sources of protein, which are all excellent source of complete protein Tofu is a favorite for many. (When a variety of these are eaten regularly; it’s not necessary to “combine” these for a complete source.)

Dairy can do double duty for protein and calcium. Make sure you choose non-fat or low-fat dairy, to minimize artery clogging fats. Think of eggs, which are nature’s most easily digestible protein. (The higher priced reduced cholesterol eggs might be worth the cost to you, or look for egg substitutes, which are egg whites only.)

Calcium. To offset bone loss, which starts at about age 30, maintaining calcium intake is key. While estrogen and exercise both help maintain dense bones, after menopause, there is typically a big drop in bone density. Aim for three servings a day of calcium-rich dairy foods–getting to about 1000 mg per day (aim for 1200 mg per day after menopause). Not a dairy consumer? Soy based products are calcium fortified, as well as other products. Plus, dark green veggies, like broccoli, provide a very well absorbed source of calcium.

Cholesterol/Fats. It’s a must-do to reduce your intake of saturated fats–that is, fats coming from all animal sources. Low and non-fat dairy are a plus. Heart healthy fats should be used for cooking–olive oil, safflower oil, flaxseed oil–but monitor carefully to minimize extra calories. Looking for omega-three fats? Flax seed oil and walnut oil are great sources for this heart healthy oil. Remember that heart healthy oils have the same calories are artery clogging ones!

Salt. Cutting down your salt intake can help lower blood pressure for many people–it’s the one thing we can control in our environment. First lose the salt shaker, and reduce the amount of processed (boxed and canned) foods that you eat–all are packed with sodium. (That’s the problem part of salt!). Use low-sodium condiments, like soy sauce as well. Aim for less than 2500 mg of salt every day. Many people consume upwards of 5000 mg daily. A little attention to this can really lower your salt intake, and contribute to better heart health.

Antioxidants. We hear so much about these–from cancer prevention to heart health, to anti-aging. First, I’d discourage you from taking a supplement for this, as simple as it may seem. A synthetic compound won’t provide all the nutrients in food (...just some of them!).

The best advice? Choose a colorful plate. That’s right: All the colors of fruits and vegetables are chocked full of antioxidants (and vitamins and minerals). A variety of colors in your diet–even “white” (think cauliflower, and garlic) provide a full spectrum of nature’s antioxidants. Avoid canned products, and look for fresh or frozen. Seasonal products are most nutritious and economical; look for locally grown products when possible.

What about supplements? The best choice here is a single, multivitamin/mineral supplement. This should contain the RDI (recommended daily intake) of all vitamins and minerals. Before menopause, look for one with iron. After menopause, choose one that is iron free. The only other supplement most people need is calcium.

Look for 500 mg per tablet/capsule/chew, with added Vitamin D to aid absorption. One daily, or two is important–and depends on your daily dietary calcium intake. Aim for 1000 mg per day (pre-menopause), or 1200-1500 mg daily (post-menopause).