Madelyn Fernstrom

Poll: Healthy Barbecue?

2008-05-09T17:53:17Z

Barbecue season is almost here. Madelyn Fernstrom will be on the Today Show next week to talk about things you can do to make healthy choices at a barbecue.

What is your favorite food to barbecue? Take the poll below!

What's your favorite food to barbecue?

Losing Weight on a Budget

2008-05-01T14:47:29Z

Is the high cost of food getting you down? Do you think trimming your food budget means an expanding waistline?

We are all aware of the bad news that ALL food prices continue to rise. This is especially true for fruits and vegetables - the basics of lower calorie eating.

Here are some of my favorite ways to stay on track with your diet without breaking the bank:

Drink tap water: No bottled water, or other low-calorie drinks. Good for your wallet and the environment.

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

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

Buy store brands (private labels): These are often produced by the "name brand" companies.

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

Purchase foods in bulk from 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.

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?

Are You "Caffeine Sensitive"?

2008-04-28T14:30:39Z

A report from England's Daily Mail came across my desk recently:

A 40-year-old man, a daily user of an energy drink, consuming 320 mg daily, collapsed at the end of his work shift in a supermarket.

Is this a high dose of caffeine? No, not for the average person, where in the US, the recommended daily intake is around 300 mg per day. This is about 2-3 cups of coffee or about 6 cups of tea. "Energy" drinks vary in their caffeine content - from about 80 mg per serving to about 300 mg in a serving.

It turns out, after an autopsy, that he had an enlarged heart. The pathologist on the case suggested that his higher-than-average caffeine consumption might have contributed to his heart attack, although for the vast majority of people this amount of caffeine is readily tolerable. While it's hard to say whether his caffeine consumption was a direct contributor to his cardiac problems, it's a good time, I think, to point out, that it's important to know your own sensitivities to even "natural" stimulants.

I've written before about the "pros and cons" , and "myths and facts" related to caffeine. Among the major buzzwords for those choosing to consume caffeine is that of the "caffeine sensitive" person. What does that mean, and does it really make any difference?

Caffeine is a central nervous system stimulant, and produces the familiar and desired effects of a stimulant - improved mental focus, arousal, and alertness, for example. The related biological effects also occur as part of this arousal mechanism - increased heart rate and increase in blood pressure. Here's where the caffeine sensitive part comes in. If you have a biological sensitivity to these effects, it's possible your body can "over-respond" to the metabolic signals from caffeine, and cause some potential health damage.

If you're a caffeine consumer, pay attention to how much caffeine you consume in a day. Watch out for terms like "turbo" or "super-caffeinated", and read the label on those energy drinks, to determine how much you're consuming at one time.

While caffeine is one of nature's stimulants, with many positives, now that caffeine is put in every product from cold remedies to diet pills, to energy boosters, it can often be too much of a good thing. How much caffeine do you consume?

When do you drink caffeinated beverages?

What do you think? Leave a comment below.

Calorie Counts for Fast Food - A Good Idea?

2008-04-21T15:36:47Z

There's been a lot of buzz about the importance of having "in your face" calorie counts for fast foods. I'm wondering if seeing a calorie label posted by the food - in the same size font as the price - will be a factor in consumer choice. I'd like to think so, but I'm not so sure. Would it be a factor in your decision?

While I strongly believe in consumer education, there doesn't seem to be any convincing scientific evidence that this kind of labeling will be a deterrent to high-calorie choices. However, research doesn't always readily translate into real world food choices.

There is the common sense factor. I think seeing 540 calories listed beside a Big Mac might make people think twice. Or, an 8-piece bucket of KFC chicken (original recipe) with 1700 calories might help you re-do the math of how many people that bucket should feed.

Would knowing a giant soda contains nearly 1000 calories steer you to a diet soda, or just to a smaller regular soda?

It gets more complicated when you look at items like Taco Salads - a great choice without the edible fried bowl, but a caloric overload when the bowl is included. Or, how about added condiments? Sometimes simply deleting the mayo or special sauce is enough improvement.

When it comes to fast food choices (whether you've chosen to go there, or dragged along!), my recommendation to my patients is one I follow myself: stick with a kid's meal. Real food in small portions. With a water or diet drink, you're consuming around 500 calories, no matter which kind of restaurant you're in.

A lot of food for thought here... there are no easy answers. Let me know what you're thinking and take this survey!

Do you think fast food restaurants should be required to list calorie counts on their menu?

Weight Loss Battle of the Sexes

2008-04-13T20:10:51Z

When it comes to weight loss, it often seems like men and women are from different planets. That’s the topic of my Today Show segment. Does gender really make a difference in your ability to lose weight and keep it off? Read on, as I answer some questions I’m often asked. The answers are both biological and behavioral – not a surprise when it comes to Mother Nature. Do you have others? Let me know what you’re thinking!

Watch the segment from TODAY

Is it easier for men to lose weight than women?
It often can be. Men have more testosterone, which does two things: (1)supports greater muscle mass (so resting metabolism is usually higher); and (2) promotes more muscle mass with exercise – both which burn greater numbers of calories.

Plus, women have a biological “yo-yo” – childbearing, where excursions of weight are normal, and it’s often a struggle to get exactly back to the same pre-pregnancy weight. Monthly changes in hormonal status (up to and including menopause) also can stimulate appetite.

Do men and women accumulate different kinds of fat?
The fat is the same, but it’s distributed differently. Men typically have “belly” fat – around the middle, and women tend to have lower body fat, around the hips, thighs, and buttocks.

Is one kind of fat harder to lose than another?
Belly fat, most common in men, actually is targeted first during exercise. So, if you’re an exerciser, the biggest changes first seen will be in abdominal fat. The lower body fat is often deposited during the child-bearing years – where it is meant to be used when the baby is born to nourish (via breastfeeding). There are female hormones that target this fat at that time.

Do men and women eat differently for comfort?
In general, women are greater consumers of fruits and vegetables than men. When it comes to comfort, women seek out sweet/fat foods – think ice cream, baked goods, candy and chocolate, while men tend to look for savory and salty/fat foods – think pizza and cheeseburgers.

What about keeping weight off?
Weight maintenance is the great equalizer! Both women and men struggle with long term weight maintenance. Both sexes are “yo-yo” dieters. It appears that the same strategies for long term weight changes are the same for both men and women. One thing for sure, no matter how it comes off, we all need social support as a key strategy to keep it off!!

What do you think about this?

Small Changes DO Lead to Weight Loss!

2008-04-11T15:26:42Z

I've been checking out the recent iVillage challenge about small changes that can make a big difference in your weight loss effort. We all have to fight the urge to do "all or nothing" when it comes to losing weight.

What I LOVE about the iVillage community is the interest and support that keeps people connected. A must-have when it comes to weight management. Here are some of the top changes YOU have found helpful, and I'd like to "weigh in" on those! Let me know more of what you're doing!

CHOOSE LOW-FAT DAIRY PRODUCTS.
Switching from full fat to reduced/low fat products can save hundreds of calories each day, without much of a change in taste. It's not necessary to select fat free dairy - many people don't like the taste or texture of the foods. When it comes to dairy foods, it's not all or nothing - think low fat milk, cheese, and yogurt!

BUY PRE-CUT FRUITS/VEGGIES/SALADS
A BIG reason many of us don't get enough fruits and veggies is lack of convenience. While a little more expensive, it's often worth the convenience to pull out some carrot sticks from the fridge, or some cut-up melon. A bagged salad is ready-to-use, with a little waste and a lot of variety.

SELECT WHOLE GRAINS
The extra fiber in whole grains - from rice to pasta to breads and cereals - helps to keep you more content and full on a smaller serving (and a major calorie saver!). Look for a combo of fiber rich/low calorie products - like the 100 calorie english muffins with 8 grams of fiber (that's a third of your daily requirement!). Aim for 25 grams of fiber a day.

SIT DOWN WHEN YOU EAT
Walking around, and doing other things when you eat is a major cause of mindless overeating. When you make it a point to sit down - even when you're not at home in your kitchen - before you eat, you're more aware of what you're eating, and will often stop and think before you eat.

READ FOOD LABELS
While it seems the package labels are like reading an encyclopedia, there's a two-step process that will help you save hundreds of calories:

Step 1: check out the calories per serving.

Step 2: check out the serving size. Don't be fooled by something that looks like it's a serving for one; it's often 2-4 servings so the "calories per serving" can appear low!

There are dozens of other great ideas. Check out the message board for more!

Smart Splurges in the Frozen Food Aisle

2008-03-31T19:00:00Z

We all need to indulge now and then to avoid deprivation and overeating. Frozen foods can be a great way to treat ourselves - not only for taste and convenience, but for built in portion control. As the frozen food aisles continue to expand, there are many fabulous new options. That's the topic of my Today Show segment (scroll down for the video).

Here are some tips for some smart indulgences in the frozen food aisle:

Check out the box size - avoid those that say "hungry man"; "hearty portions" and similar large-size hints
Look for labels that include words like "lean","light", "healthy", and "smart"
Read the label to make sure of the serving size - it might look like a serving for one, but the calories listed are for 2 or more
Don't be confused by labels saying "sugar free" or "fat free" which don't mean "calorie free"
Feel free to eat LESS than the serving size - you don't need to eat four bagel bites listed as a serving; if you just want a taste pizza, stick with one or two!

We all have our frozen favorites, and it's a good idea to have some items in the freezer to turn to now and then for a special treat. Almost all frozen foods are available in single-serving portions - so great for getting the satisfaction of eating the "whole thing". The built-in portion control is a plus for a splurge, and can save hundreds of calories when compared to a restaurant take-out.

Watch the segment from TODAY

Here are some smart splurges in four popular frozen sections. What are your own favorites?

PIZZA
Lean Cuisine French Bread Pizza 290 calories; 8 gm fat
Lean Pockets Pepperoni Pizza 280 calories 7 gm fat
Bagel Bites (4) 220 calories 7 gm fat

FROZEN ENTREES
"Asian": Lean Cuisine Sweet and Sour Chicken (10 oz) 300 cal; 3 gm fat
"Meat and Potatoes": South Beach meatloaf 210 cal; 9 gm fat
"italian": Michelina's Lean Gourmet Chicken Parmigiano 250 calories 4.5 gm fat

SNACKS
Home Bistro shrimp cocktail 130 cal
Tyson Grilled Chicken Strips 110 cal
Lean Pocket Whole Grain Stuffed Sandwiches 210 cal

ICE CREAM / DESSERTS
Slim-a-Bear ice cream sandwich 100 cal
Luigi's Italian Ice (lemon or cherry) - 6 ounce cups 120 cal
Skinny Cow - ice cream bars 160 cal
Fudgsicle 70 cal
Sugar Free Fudgsicle 35 cal
Sugar Free Popsicles 10 cal
Smart Ones Cheesecake 150 cal
Smart Ones Eclair 140 cal

Indulge wisely and enjoy!

More on this topic from Madelyn Fernstrom:

Is It Worth the Splurge? Fabulous Frozen Food Finds

The Truth About Chocolate

2008-03-24T19:14:46Z

If you’re confused when it comes to chocolate, you’re not alone. A health food? A tasty indulgence? Maybe a little of both? That’s the topic of my Today Show segment. I hope you’ll find the answers to your questions, and also post a note with your own thoughts!

Watch the segment from TODAY

Some basic chocolate “truths”:

Chocolate comes from a plant – it’s the seeds (within the pods) of the cacao tree. It’s naturally very bitter; if you munched on a cacao bean, you would find a very harsh and bitter taste, nothing like chocolate as we know it.
Chocolate varies in its preparation. There are government regulations of what can be called “chocolate”, depending on its ratio of: cocoa solids, cocoa butter, sugar, and milk. Ranging from baking chocolate (almost no added sugars), to dark chocolate (limited sugar and abundant cocoa solids), to milk chocolate (lots of sugar, added milk, and less cocoa solids), to “white” chocolate (NOT classified as chocolate at all, because it has no cocoa solids!)
A special type of antioxidant is found in cocoa solids, called “flavanols”, which are where the health-promoting heart healthy claims of chocolate come from. This is dose related, meaning the more you eat, the more flavanols you consume. As a comparison, it takes nearly four ounces (that’s 3-4 regular size dark chocolate bars), consumed every day to promote a reduction in blood pressure! That’s 500 calories and 42 grams of fat!
The new “super cocoas” are the wave of the future to harness the health benefits associated with the flavanols. The first of these is a Flavanol Rich Chocolate (containing 200 mg per serving – that’s a lot!), produced by the company, Cocoa Via. It’s the active ingredient, without the sugar and fat of a regular chocolate bar.
Chocolate is also a “carrier” for other nutrients, which are unrelated to the activity of the flavanols. Calcium fortified chocolates (in milk and dark varieties) provide ½ the daily calcium requirement in one disk (at 30 calories), plus vitamin D. Plus, phytosterols (plant chemicals) are added to some chocolates to boost the cholesterol lowering ability of the product (Cocoa Via bars with 80-100 calories each). Again, any potential health benefits come from regular – daily – consumption.

Bottom line? Enjoy a modest serving of chocolate IF you enjoy it. Don’t start consuming chocolate as an addition to a “healthy diet”. Calories count, so monitor your portions, and allow a small indulgence. You don’t need to justify a chocolate treat for the health benefits of chocolate. While there are some health benefits to flavanols, they’re also present in a variety of other foods, including apples, grapes, wine (fermented grapes!), and tea.

As with all things eaten, moderation is key! What are your thoughts?

Hidden Reasons You Can't Lose Weight

2008-03-16T19:00:00Z

Every day I hear from people who try really hard, and just can't seem to lose weight. There are a number of "hidden" reasons this might be happening to you. That's the topic of my Today Show segment.

Watch the segment from TODAY

I've found these can pop up in four different areas: your eating, your activity, your behavior, and your biology (body). Let me know if you agree - or have other hidden reasons you've discovered!

YOUR EATING

Confusing “heart-healthy fat” or “fat free” with low calorie. Switching to olive oil from butter is a heart healthy choice, but won't save you any calories. To lose weight, it's important to cut the amount (instead of a tablespoon at 120 calories, try a teaspoon at 40 calories, since it's so flavorful). Fiber rich, whole grains are a great choice, and fat-free, but the calories add up we don’t stop with ½ - 1 cup serving. The only solution to this is label reading for calories per serving; when you see that reduced-fat peanut butter has just about the same calories as regular peanut butter, you won't be fooled by clever ads.

Poor calorie “eyeballing” (studies show 50% too low). We all feel we’re good at estimating portion size, but the cues to do so set us up for failure. Studies show we are at least 50% too LOW in our estimates – even when professionals do it.

Skipping Meals. Too busy, or choosing to skip a meal to save calories? The problem with meal skipping is you get over-hungry for the next meal – “I didn’t realize I was so hungry”, once you start eating.

]]> YOUR PHYSICAL ACTIVITY

Too much exercise is a biological stimulant for hunger. This is very common for dieters who only want to focus on exercise as a way to cut calories.. Rigorous exercise stimulates appetite to “refuel” for metabolic balance. I'm talking 2 hours of more intense activity. Plus, like the poor "eyeballing" of food, most of us aren't skilled at estimating how many calories are used for activity. Just remember it can take 5 minutes to eat a 500 calorie piece of pie, and nearly 2 hours to exercise it away!

On the other end of things, no exercise is a diet disaster. Whether it's lack of time, or lack of interest - only 100 cal a day – a 20 minute walk – helps you lose 10 pounds in a year! Even a small drop in physical activity (that people ignore) packs on the pounds. Here's an example I recently heard from a patient of mine: “I used to park blocks away in a cheaper parking lot. I got promoted, and get the corporate lot. I’ve gained 5 pounds in 3 months.”

YOUR BEHAVIOR

Lack of sleep is a huge problem – when we're tired, we eat for energy. When we're tired, we lose our focus, and discipline, and lose the mental control needed to stay on track. Between-meal snacks to “wake up” are the solution when a power nap would be better. Our body's have 24-hour rhythms in many hormones and pathways - like body temperature - that don’t “reset” and get out of balance with lack of sleep.

Poor stress management - a lof of mindless eating comes from the lack of focus due to mental stress. We often confuse business with poor stress management. "I feel overwhelmed" say many patients. We eat to soothe, to reward ourselves, and to indulge in extra calories. Food DOES make us feel better, but we have to learn to self-soothe in other, non-food ways as well.

Lack of consistency (5 days on, 2 days off). “I’m trying but lifestyle isn’t working”. Some general awareness every day is needed to avoid what I call “weight creep”. It takes only 100 calories extra a day to gain 10 pounds in a year. Most often, people “relax” their lifestyle on the weekend, and can easily pack on a couple of pounds a month – 7000 calories (that’s 2 pounds) – over 8 weekend days – only about 850 calories more a day.

YOUR BIOLOGY (BODY):

Medications can cause weight gain as a side effect, when they are started. Some stimulate appetite, and others slow your metabolism. A range of medications from antidepressants; antipsychotics some antihistamines, as well as insulin and blood sugar drugs, some blood pressure medicines, and anti-inflammatory drugs can pack on the pounds. Check with your doctor when starting a new medication, and always ask if weight gain is a reported side effect - there may be another medication you can take without this side effect. This happens only at the beginning of a new medicine. If you’re started a new medicine, and gained 4 pounds or more in a month, check with your doctor…..It’s NOT the cause if you’ve been taking a medicine, and then find suddenly you’re gaining weight, months after you’ve started.

Undiagnosed Mood Disorders. Undiagnosed depression or anxiety is both behavioral and biological. While many think depressive symptoms are only the “classics”: loss of appetite, insomnia, and weight loss, a large subgroup sleeps more and eats more. Oftentimes thyroid gland problems are linked to mood disorders (see below), and can result in weight gain.

Thyroid Function – The thyroid gland is your body’s “furnace” and sets the thermostat. This is regulated by a signal from the brain to release thyroid hormone into the system. Either resting or stimulated thyroid gland activity can be a problem, and result in slow, steady weight gain.

Elevated fasting insulin. This is known as "insulin resistance" or " metabolic syndrome" and often found in people with an "apple" shape (weight accumulates in the middle). It's invisible unless you get a blood test. Blood insulin levels can be high, with blood sugar levels being normal (everyone knows that number). It does not mean diabetes (where blood sugar is high), but is a sign of pre-diabetes. This can greatly sabotage a solid weight loss effort - and correcting the problem (with medication for starters) makes that weight loss effort easier. A further plus - more weight loss alone can help lower your fasting insulin - getting you off the medication to correct the original problem!

What do you think? Leave a comment below!

When Food and Medicine Don't Mix

2008-03-13T19:00:00Z

Did you ever wonder about those labels on your prescription bottles?

"do not take with food"
"avoid dairy products"
"take with food"
"avoid grapefruit juice"
"take with water"

There's actually a strong biological basis of food and medicine interactions that can really affect how your medicines work. That's the topic of my Today Show segment.

Watch the segment from TODAY

Foods interact with medicines in three different ways:

interfering with how the drug is absorbed and digested by the body.
blocking the breakdown of the medicine in the digestive track ( intestines or the liver).
Mimicking the effect of the medicine (acts like the medicine in the body.)

So, what about specific foods and medicines that don't mix? Always check with your doctor and/or pharmacist for advice on your specific medications.

Avoid GRAPEFRUIT JUICE If you take a cholesterol lowering agent (statins), some heart medicines, some immune system drugs, and some antihistamines.

Avoid VITAMIN K RICH FOODS (like dark green vegetables) if you take a blood thinner, like coumadin. Don't eliminate dark green veggies, but monitor your vitamin K intake carefully.

Avoid HIGH FIBER FOODS at the same time you take certain antibiotics and iron supplements.

Avoid HARD CHEESE and RED WINE if you are taking certain antidepressant medications, called monoamine oxidase inhibitors (MAOIs).

Avoid ALCOHOL with any medications affecting the brain. This includes, antidepressants, sleeping pills, sedatives, and antihistamines.

Avoid COFFEE and CAFFEINATED DRINKS if you take anti-anxiety medication or asthma medications. The stimulant action of caffeine can be a problem.

Need more information? Read the package insert, look on-line, or ask your pharmacist or doctor. It's important to know if you need to avoid the food altogether, or only a little before or after taking your medicine.

Let me know your own experiences with food and medicine!

Cocktails: Is It Worth the Splurge?

2008-03-06T19:00:00Z

Many of us enjoy a cocktail now and then, but when you're watching your weight, this can become a huge personal debate. We must all ask ourselves: "Is It Worth The Splurge?". This is a VERY individual choice. Check out the tips on how to make a better cocktail choice in my Today Show segment below. It's a biological fact that humans do not register the calories we drink - alcoholic or any other - as effectively as the calories we eat. Many studies demonstrate this point: when we drink calories, along with eating food, we don't account for those liquid calories, and eat as much as if we didn't have any extra calories at all.

When it comes to alcohol, the calories are all over the place, and can range from 64 calories for an ultra-light beer to 800 calories for a giant frozen margarita. They sure can add up quickly.

Bottom line: Americans drink a lot more calories than we used to - and alcoholic beverages are a major part of this problem - as drinks have gotten fancier (with multiple kinds of spirits, liqueurs, and flavorings) and larger (20 ounce margarita, anyone?). Plus, alcoholic drinks have the "double whammy" of high calories and the inhibition-reducing effects of alcohol, which can easily lead to overeating (fried zucchini IS a vegetable, right? fried mozzarella sticks - calcium and protein, right? You get the picture!).

It's time to "size up" our alcoholic beverage choices to support our weight management effort, as well as a healthy lifestyle.

Watch the segment from TODAY

Let me know what you think of the drink options I've suggested. No need for deprivation. Control is the goal.

More from Madelyn:

Be Careful What You Drink

2008-03-02T19:00:00Z

We are a nation of "supersizers" and often don't pay attention to the calories we're drinking. For most people, when we're home, we have "normal" size glasses, and pay attention to the serving size we're drinking (or at least most of the time!). Studies show that we ALL drink what's put in front of us. If a small serving is provided, we drink that... If a large one is there, we usually drink the whole thing (or much more than if we were just offered a small size). Bottom line: whatever size we're given is "one serving".

And, restaurants - whether chains, or fast-food types - lure us with amazing looking drinks in very cool glasses (sometimes we get to keep them as a souvenir! - or buy them in the "gift shop"). Most restaurants offer free refills, and we can always "supersize" for just pennies.

We all accept that eating away from home can add more calories. But most of us don't think about the calories from our drinks - which add up quickly. We also, biologically, don't compensate for these calories when we eat. Translation? We basically add on all the liquid calories to what we're eating.

While no drinks are "off limits", paying attention to the servings and what's in these drinks is a definite plus for your waistline. Check out my Today Show segment for some easy solutions to this problem.

Watch the segment from TODAY

How do you cope with liquid calories?

"Alternative Medicine" and Weight Loss

2008-02-22T19:00:00Z

I'm often asked about weight loss options that can help support the lifestyle effort of reducing calories, managing stress, and being more physically active (so familiar to all of us!). Many people ask about "alternative medicine." I prefer the terms "integrative" or "complementary" medicine, which is the new name of this category, since this supports, but does not replace a lifestyle effort. That's the topic of my Today Show segment (scroll down for the video).

The mind-body connection is key to long term weight loss, and any way to support that connection is a plus, as long as there is no potential for health risk. So, choose wisely, and seek out certified and credentialed practitioners (including many MDs) for techniques like hypnosis, acupuncture/acupressure, and meditation. These treatments have some growing evidence that can help some people, and could be worth a try.

Ingesting compounds can put you at risk, as the herbal supplements are not tested nor regulated by the FDA, and can interact with other medications you are taking. There is no guarantee of safety, purity, or efficacy for most of these products. Always check with your doctor before trying any other these. Plus, avoid products claiming weight loss without lifestyle change, and look for a website and 800 number to call for further information about purity of the compound. Be an informed consumer!

Also, fasts and extreme food restrictions can be health damaging if done without medical supervision. The "detox" described for many products can lead to fatigue, cramping, and dehydration. The body has natural "detox" organs - including the liver, skin, and lungs!

I'll be talking about:

hypnosis
acupuncture
meditation
herbal supplements
detoxification plans

Check out the video and let me know what you think!

Watch the segment from TODAY

Obesity and Fertility Problems

2008-02-17T20:00:00Z

Among the top reasons patients in their 20s and 30s seek my help in losing weight is the desire to have a baby. Some women have had irregular periods for years (a tip off for conception problems), with their doctors telling them it’s weight-related. For others, they’ve had regular periods for years, but just don’t seem to conceive, whether the old fashioned way, or with fertility-drug treatment. What’s the connection between obesity and fertility, and how can your diet and lifestyle influence fertility? That’s the topic of my TODAY segment (check back for the video clip).

First, let’s look to Mother Nature: Women on both the very thin and very heavy ends of the weight spectrum have trouble getting pregnant. While the absolute science is not yet here to tell us why, there are a number of scientific observations that point us in a direction of how to manage this problem, and marry both lifestyle and medical treatments to treat fertility problems not related to anatomical issues (liked blocked fallopian tubes).

I’d like to give you some strategies for optimizing what you can control in your lifestyle – of healthier eating, weight, and activity – to help resolve fertility issues.

Abundant studies show that overweight and obesity clearly promote infertility – and the heavier a woman is, the lower the rates of fertility. A study from this past December in the journal Human Reproduction showed that a woman roughly 50lbs overweight was about 25% less likely to achieve a regular pregnancy (without medical help.) Those with about 100lbs to lose were about 45% less likely to conceive easily.

While we don’t know the reasons for this, it appears that excess weight hampers a woman’s fertility, even when her ovulation is fine, and she has no weight-related health problems (like diabetes or high blood pressure). In addition, those women undergoing fertility treatment, typically need more hormones and adjusted dosing, compared with healthy weight woman. Translation: if you’ve been trying to conceive and have not – check with your doctor, and revisit your lifestyle for the first step in this fertility pathway: healthier eating, weight loss, and a physical activity plan to optimize the factors you can control.

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Know your Body Mass Index If it’s over 25, aim to lose 10% of your starting weight (if you’re at 150, that’s 15 pounds). The good news is that just a 10% reduction of starting weight loss can often make the difference in ability to conceive. Click here to find out your Body Mass Index.

Discuss your reproductive health with your primary care doctor or obstetrician. You need to rule out a biological basis for your fertility, particularly anatomical blockages, which will not be resolved by dietary and lifestyle changes.

Cut way back on processed foods, particularly carbohydrates. Aim for whole grains. When we think of “carbs” many of us don’t think of whole grains. If you consume a lot of processed products – white flour and pasta products, carb/fat/salt combinations (think chips) or carb/fat/sugar combinations (think cookies and cake) – downsize those servings, and up your intake of whole grains. You’re not limited to whole wheat – look for products like couscous, quinoa, flax, and spelt – all of which provide abundant B vitamins, fiber, and plant protein.

Increase your intake of fruits and vegetables to at least 5 a day. We often don’t think of fruits and veggies as carbohydrates. These are nature’s perfect food – fiber and water rich, with abundant vitamins and minerals that vary with the color of the food. Fruit is often referred to as “nature’s candy”. Plan a colorful plate.

Substitute some plant proteins for animal proteins. Plant proteins, (in contrast to animal proteins – like chicken or beef) are a good way to pack in protein with the added balance of fiber, and multiple vitamins and minerals. Don’t eliminate concentrated lean proteins, but aim to substitute these as a dish in a soup or stew. You’ll feel content on fewer calories, which can help your weight loss effort.

Keep a balance of carbohydrates, fats, and proteins. Don’t eat for nutrients alone, and think of the whole food content. Choose real foods – simply prepared and unprocessed as possible. Aim for a balance of ALL the major nutrients – carbohydrates, protein, and heart healthy fat. Balance is key to fueling your body for conception. When certain foods and groups are eliminated, that imbalance might have consequences in nutritional adequacy, which might contribute to fertility. Skip the high protein, low-carb diets, or ultra-low protein diet (say goodbye to juice fasts) – even to lose weight (more on that later).

Take a daily vitamin/mineral supplement at least 6 months prior to trying to conceive. A vitamin is good insurance to meet nutritional needs. They’re called supplement for a reason – they ADD to, but do not replace a balanced diet. Choose a supplement of 100% RDI, or a prenatal version. Check with your doctor or pharmacist to optimize your choice.

Get 30 minutes of physical activity most days. The metabolic stimulus of exercise goes back to cavewoman days. We were foragers for food, and were forced to be physically active. Activity positively influences brain chemistry, joint and bone function, balance, heart function, hormonal activity, and many other body functions. You don’t have to run a marathon, but aim for 30 minutes of walking each day. Get a pedometer to monitor your steps, with 10,000 daily steps an optimal goal. If you can, mix in some strength training to support muscle tone.

Practice stress management. We live in such a stressful world. Learn to address and manage your stressors, to help prevent overeating and weight gain, as well as interference with body hormone secretion, which can be strongly affected by stress.

Avoid the quick fix for weight loss. Using the changes above, you should anticipate a weight loss of about ½ to 2lbs a week, depending on your starting weight. You can do this in two ways:

-Count calories from the start: Most women will fall into this rate of loss when consuming anywhere from 1400-1600 calories each day or-

-Multiply your PRESENT weight by 15, to determine calories to maintain your present weight. If you reduce that by 500 calories daily, you’ll lose 1 pound a week; reduce it by 250 calories a day, you’ll lose 2 pounds a month. It’s up to you. (So, if you weigh 150lbs, you’ll need about 2250 calories to maintain. To lose a pound a week, you’ll need roughly 1750 calories). Quick weight loss always fails.

Make the mental adjustment to change your lifestyle for the long term. It’s the perfect time to make this commitment to yourself and your family to lifelong health. A healthy lifestyle is its own reward.

What do you think?

The Truth About Fruit

2008-02-14T19:00:00Z

This is the first in a series of "truth about....", based on our new Today Show series. Do you have questions about fruit and fruit products? Take a look at the TV segment (check back later for the video), and let me know what you think.

Some of the basics:

1. Eat your fruits ... Don't drink them.
Look for added fiber and fewer calories with whole fruits.

2. Is organic fruit really a better choice?
Is it always better to buy organic? The price is a big deterrent for many, and the nutrient content is pretty similar. What about pesticides? A good rule of thumb is to buy organic for fruits with thin skins - particularly if you consume them regularly - for many people that's apples and grapes. The thin skin is more prone to absorb residues than thick skinned fruits, like bananas and oranges.

3. Look for 100% fruit leathers and snacks.
Fruit on the package doesn't mean it's in the product. A great snack can be "fruit leather" - but look for 100% fruit, running about 40-60 calories per whole wrapped bar. While some packaged roll-ups, strings, and pieces can have all fruit, many have juice and extra sugars, which are a waste of calories. The tip off are the calories: if it's 80-100 calories per serving (instead of 40-60), it's got some unneeded extras, compared to 100%.

4. Dried fruit is so "fattening" - are there other choices?.
Fresh fruits are a calorie bargain, since all the water fills you up. Dried fruits take out some of the water, but are still "squishy" and it's easy to eat 4 or 5 fruits very quickly. While nutrient-packed, it's also calorie-packed. A great choice are the new "freeze dried fruits". ALL the water is removed, and are so dry, you have to re-hydrate them in your mouth. Intensely sweet, sort of nature's candy, they take a long time to eat, and are a calorie bargain. Also, quite portable and available in all fruit varieties in most supermarkets.

5. How do frozen fruits stack up to fresh?
Frozen fruits, without added sugar, are a GREAT substitute when you're looking for out of season choices. Frozen berries are great, and while squishier than fresh, can be added to cereals and fruit salads - and eaten right out of the bag, frozen. Economical and great taste.

Madelyn shares the truth about fruit and nutrition

What are your thoughts on fruit???