Pay More If You Weigh More?

With the summer travel season in full swing, I'd like to "weigh in" on a topic that has been hotly debated over the past year or so: should a person be required to buy an extra airline seat if they're obese?

Southwest Airlines has a policy in place requiring passengers whose size prevents lowering of the armrest between the seats to purchase a second ticket. This apparently applies only to full flights, as a flight that is not full qualifies them for a refund.

Canada adds a new twist to this: for a degree of obesity that is considered "disbabling", an extra seat can be requested, but the passenger does not have to pay the charge, the government does. This seems to put obesity into the realm of a disability, which is a whole other topic of discussion!

What do you think about this ongoing controversy? With airline ticket prices on the rise, and flight cutbacks, an increasing number of flights are completely full. With added seats seemingly packed on each plane, all travelers are feeling the space crunch on the airlines.

Is Southwest doing the right thing? What about the Canadian policy?

I'm not sure of the answers, but I do know that we must address the issue of weight loss at a MUCH earlier point of intervention, so this topic is not even an issue. In fact, I have a number of patients who've made a commitment to a long term weight loss plan (no quick fixes here!), when they had to request a seat belt extender on the airplane.

Many others opt for car travel for most trips, short of a cross-country flight.

What do you think?

Superfoods for Menopause

I'm getting pretty tired of reading all about the "super cures" for menopause, ranging from foods to creams to supplements and beyond. A "cure" for menopause, like it's some kind of disease? It's a natural part of life that we need to accept and manage in a productive way. Menopause causes a big change in our hormonal profile—the huge drop in estrogen over a period of several years—that can give many women some problematic symptoms including sleep disturbances, sweating, bloating and mood changes. Plus, there are the "silent" changes that occur to our bodies' biology. These include a slowing of metabolism (easier weight gain), and an increase in the risk of heart disease (that protective effect that estrogen had goes away, when estrogen does!).

I'd like to set the record straight with some real advantages that a healthy diet and lifestyle can contribute to this mid-life change. A healthy and active lifestyle can certainly contribute to managing menopause, but if the strategies I've laid out don't help, it's important to see your doctor. You're not "sick," but all of us respond differently to individual hormonal changes.

Watch the segment from TODAY

Managing menopause with foods relates to two different areas:

1. Symptoms
2. Long-term Health

Here are some of my guidelines for managing your health during menopause. What are yours? I'd love to hear more of how you're managing these years with diet and lifestyle.

FOODS FOR MENOPAUSAL SYMPTOMS
(bloating, sweating, sleep disturbances)

Soy: Richest source of plant estrogens
A diet rich in soy has been documented to help reduce symptoms, but it's not just an occasional glass of soy milk or handful of soy nuts! Soy is very rich in a type of plant estrogen, termed isoflavone, that serves the same role as our body's natural estrogen. So, it helps to replace some of that estrogen that our bodies no longer make. To make an impact, you need at least 20 grams of soy protein daily. Most Asian cultures ingest this daily, without even a thought, but in the U.S., we're not soy-protein-based eaters. Think about "dairy" versions of soy (milk, cheese, yogurt), meat replacements (garden burgers and Boca Burgers), edamame pods and roasted soy nuts. For some, it's an acquired taste, but there is solid evidence that soy can help the symptoms. A note of caution: If you are soy sensitive, or have been advised to limit soy intake for medical reasons—this is not a strategy for you. Always check with your doctor before making a significant change in your diet.

Other foods with plant estrogens
While not as rich in plant estrogens (phytoestrogens) as soy, incorporating some of these other sources might help: beans, seaweed, and apples.

Foods you might want to limit
While there is not much hard evidence to support excluding certain foods to reduce menopausal symptoms, here's a few that many women report triggering hot flashes: caffeine, alcohol and spicy foods. Plus, if you're having trouble sleeping, limiting your caffeine intake from all sources (coffee, tea, colas, energy drinks) can sometimes help. Cutting down on your salt (limiting processed and packaged foods, losing the salt shaker) can also help reduce short-term water retention.

FOODS FOR LONG-TERM HEALTH
(for menopause and beyond)

Not surprisingly, at least to me, the basics of a healthy diet at menopause are similar to those for all other body parts and times of life: an abundance of colorful fruits and veggies, lean protein, low-fat dairy and fiber-rich starches. With menopause, dietary requirements do change. We need to do more to protect our hearts and our bones. Here are a few basics you don't want to miss:

For heart health
Increase your omega-3 fat intake. Eat "oily" fish (like wild salmon and mackerel) regularly—or take a daily fish oil capsule (1,500-2,000 mg/day). Think about flax seeds/oil and walnuts for non-fish sources.

For bone health
Keep your calcium intake up to 1,200-1,500 mg every day. Don't rely only on supplements! Choose low-fat, calcium-rich foods and deep green vegetables as an alternate source. Limit your supplement to 500 mg at a time to maximize absorption.

For weight management
Weight gain is easier, so make sure you balance your food intake with an increase in physical activity. Get a pedometer and keep track of your steps (2,500 steps is about 100 calories) and keep track of your daily calories eaten. Get some support to keep you on track!

One last word about a "must-do": physical activity. This is as important to maintaining mid-life health as what you eat. A minimum of a 30-minute walk daily helps your heart, your bones, your weight and your mood. If that's at the bottom of your list, the first thing to do is move it to the top!

UPDATE: You all have been leaving such great comments, and I have decided to respond to some of them. Click here to read my follow up blog entry on menopause relief.

Dieting In Secret?

Please take a moment to vote in our poll! The results may be used in an upcoming segment for the Today show.
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More on Budget Dieting

I see that I just scratched the surface with ways to slim down on a budget. You wrote in an amazing number of really helpful suggestions to slim down while watching your dollars. Here's a summary of some of the top responses. Others you'd like to add? Please post away!

1. Start a vegetable garden. Many people suggested growing your own vegetables. Whether in your yard, or some pots, from seeds or plants - it's really easy. No green thumb necessary! Most popular choices for this season are tomatoes, green beans, and zucchini.

2. Cook some one-pot meals in bulk. Making a large pot of a chicken and vegetable stew and dividing into several meals is a big money AND time saver.

3. Use dried beans and other vegetable proteins to replace meat. Whether it's a one pot meal, or a stew, many people save lot of money by going the vegetable protein route. A low cost and low fat option, for sure.

4. Select plain grains and season on your own. Whether it's plain oatmeal, rice, or pasta, you liked the idea of cooking the basic product (a very economical pick!), and adding your own seasonings. For oatmeal, additions from raisins to cinnamon to apples doll up a simple cereal. Rice can have seasonings, veggies, or anything else you feel like adding (even leftover ingredients from another meal!).

5. Pack a lunch: Lots of folks choose this option. The extra time saves money. Whether it's leftovers, or an intentional supermarket purchase, it's a sure way to save money. A major plus if you bring your own beverage.

More on tap water........

A lot of people were up in arms with my suggestion of drinking tap water. Of course, the quality of water varies in many parts of the country. But I still stand by my original view that once you've tested your tap water for safety, it's a major money saver. Get rid of juices and sodas, and stick with water. If you don't want to use a water filter on your tap, use a filter pitcher. Both are very economical. If you're not comfortable with tap water under any circumstance, then look for the cheapest store brand around, or stock up on your favorite when it's on sale. Sometimes a 24-pack is marked down to around $4!

I'd love to hear more!

10 Tips For Slimming Down On A Budget

Is the high cost of food getting you down? Do you think trimming your food budget means an expanding waistline? My weight loss clinic is filled with patients who want to eat healthy, but believe it's just too expensive. Do you feel the same way?

Food prices continue to rise - everything from produce to pantry items. Plus, with such busy schedules, many of us look for "convenience" when food shopping, which adds up to a lot of extra money.

Watch the segment from TODAY A few pointers before you even get to the store:

• Avoid shopping on an empty stomach! Go after a meal, or have a snack - to help resist temptation.
• Make a list and stick to it. That helps to avoid impulse buying.
• Shop once a week and pre-plan your meals.
• Use coupons for foods you regularly use.

Here are 10 tips to trim your waistline on a slim budget:

1. Drink tap water. No bottled water, or other low-calorie drinks. Good for your wallet and the environment. If you have concerns about your tap water, get it tested, and add a filter to the tap, or a pitcher if needed.

2. Shop seasonally and locally. If it's local, and in-season, the shipping costs are largely reduced, with the savings passed on to you.

3. Look for frozen foods (fruits, veggies, poultry, fish) without any added sauces. The same nutritional quality as fresh products.

4. Make your own "single-serving" snacks. Portion control is great, but you don't need to pay more for it. Buy some snack size, re-sealable plastic bags, and be creative. From cereal, to fruit, to chips, you produce a double duty snack - calorie and cost controlled.

5. Avoid the exotic. Stick with standard colors of fruits and vegetables. Green peppers don't seem as fancy as yellow or orange, but are a fraction of the cost.

6. Cut up your own produce. The shelves are filled with pre-cut vegetables and fruits. Don't waste money for this "convenience" - which only saves a minute or two at home.

7. Look for sale items - but read the label first! A variety of foods are in the "sale" sections - and can include fresh meats and poultry, dairy products, and produce. Check the expiration dates - often the markdowns occur with a date that's closing in to "use by" or "sell by". it's a great savings if you can use the food in the right time frame. Think ahead.

8. Buy store brands These are often produced by the "name brand" companies.

9. Be flexible with "in-store" specials. Planning a fish dinner, but chicken breasts are a great buy? Change your menu!

10. Purchase foods in larger bags from your local supermarket, or even the "big box" stores like Sam's Club and Costco. Go in with a friend or two, to save money and reduce spoilage. You might not need 18 pears, but 6 or 9 would be perfect. The bag of small apples might not look at gorgeous as the giant single fruits priced per pound, but the nutrition content is the same.

One BIG money waster: Driving from store to store for all the "best" bargains. You'll spend extra gas money, for small savings, and lose the frequent shopper advantages. Pick one major market, and become a mindful shopper there. Plus, when you get a "store card', you'll get coupons for frequently purchased foods, and other money-saving perks for your loyalty.

What are some of your money-saving diet tips? We need all the help we can get!!

UPDATE: Thank you for all the comments on losing weight on a budget! I have addressed some of your questions and concerns so take a look and leave any other comments you may have.