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    Archive for the ‘glycemic index’ Category

    Who Said It?: Reveal

    perricone_oprah_5-300x230“Coffee has organic acids that raise your blood sugar, raise insulin. Insulin puts a lock on body fat. When you switch over to green tea, you get your caffeine, you’re all set, but you will drop your insulin levels and body fat will fall very rapidly. [You will lose] 10 pounds in six weeks [if you replace coffee with green tea], I will guarantee it.”

    This quote comes from Dr. Nicholas Perricone, specifically from a 2004 appearance on Oprah Winfrey’s talk show.

    As with other doctors who are a staple on the media mogul’s program, Dr. Perricone is a source of nutrition soundbites that are TV-friendly, albeit not entirely accurate.  Never mind, of course, that Dr. Perricone is a dermatologist who for many years was invited to sit on Oprah’s couch to dispense nutrition advice.

    Let’s examine Dr. Perricone’s statements piece by piece.

    “Coffee has organic acids that raise your blood sugar.”

    True, coffee raises blood sugar levels ever so slightly.  The same can be said about plenty of healthful foods — nuts, seeds, beans, fresh fruit, whole grains, and root vegetables.  This concept of “raising blood sugar”, by the way, is nothing more than the glycemic index.

    Additionally, if Dr. Perricone is so concerned about coffee’s glycemic index, why is he such a fan of wild blueberries, which raise blood sugar levels more?

    “When you switch over to green tea, you get your caffeine, you’re all set, but you will drop your insulin levels and body fat will fall very rapidly.”

    This, of course, assumes you are drinking coffee and green tea on their own, without any milk — dairy or otherwise — or sweetener.  Add dairy, almond, soy, oat, or any other milk to your tea and your blood sugar will rise to some degree.

    If you like your tea plain but accompany it with food (whether it’s oatmeal or a chocolate chip cookie), this talk of “dropping insulin levels” also becomes a moot point.

    The above statement also makes the erroneous assumption that weight loss is simply about dropping insulin levels, rather than lowering caloric intake.

    It is absolutely possible to lose weight while eating foods with high glycemic indeces, provided that calories are also being lowered.

    Allow me to clarify.  It is true that plenty of fiberless and overly processed foods — white flour, white sugar, refined grains — raise blood sugar levels significantly.

    However, fruits are far from low-glycemic.  In fact, ice cream has a lower glycemic index than watermelon.  If weight loss was your goal, would you consider a cup of watermelon or a cup of Ben & Jerry’s to be the wiser choice?  Not to mention — have you ever heard of anyone gaining weight as a result of drinking unsweetened black coffee?

    Remember, too, that a food’s glycemic index can be altered by a variety of factors.  A potato’s glycemic index, for instance, is different if you eat it with its skin and top it with olive oil than if you peel and mash it.

    “[You will lose] 10 pounds in six weeks [if you replace coffee with green tea], I will guarantee it.”

    If this were a money-back guarantee, Dr. Perricone would have to file for bankruptcy.

    The notion that all it takes to lose 10 pounds — in six weeks, no less! — is a switch from coffee to green tea is not only science fiction, it is also infuriatingly misleading.  Talk about setting people up for failure.

    Of course, this “promise” wasn’t met with an ounce of skepticism.  Oprah vouched that she would give this a try, and the audience responded with applause.  Because, as we all know, if “a doctor on TV” says something, then it MUST be true (even though sixty percent of doctors in the US don’t have a single nutrition course built into their medical school curriculum, and thirty-five percent can take one course as an elective).

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    “But That Lady on TV Said It!”

    3716_GoodMorningAmerica_logoLast weekend, Good Morning America did a segment titled “What To Eat When.” For it, they booked Kimberly Snyder, a self-proclaimed nutrition expert who, in this particular instance, spouted off a variety of inaccurate facts and misleading information.

    Even more disturbingly, several magazines have recently turned to Miss Snyder for nutrition tips.  SOS!!

    Watch the video (linked above) first, and then read my detailed response below.

    Protein bars are unhealthy because they contain soy protein isolate, a heavily processed ingredient than can impair thyroid function.

    Yes, soy protein isolate is processed, but the main reason to limit protein bar consumption is because they are high in added sugars, generally low in fiber, and do not offer the same amount of nutrition real foods do.  While soy can exacerbate already-existing thyroid problems, it does not cause them.

    100% fruit snacks are not the best choice for children because they are too dense.

    I agree that 100% fruit snacks are not as healthy as they sound (they are basically pure sugar), but what on Earth does her critique of “it’s too much density” mean?  The problem isn’t that fruit snacks are calorically dense, it’s that they offer very little nutrition.

    “Peanut butter has a lot of sugar.”

    WRONG. You can find plenty of peanut butter brands that do not add sugar.  Additionally, even the ones that do add sugar do not add a lot (two grams, or half a teaspoon, per serving is the average).

    Almonds are better than peanuts because they have vitamin E and protein.

    Absolutely misleading.  Peanuts have just as much protein and vitamin E.  Besides, both almonds and peanuts contain heart-healthy monounsaturated fats and plenty of mineral and phytonutrients.

    Artificial sweeteners score high on the glycemic index.

    Wow.  Absolutely incorrect.

    Besides, if this ‘expert’ is so worried about the glycemic index of foods, why does she then recommend watermelon, which has a very high glycemic index?

    “An acidic body tends to hold on to more weight.”

    Oh, no — not that school of thought!

    No fruit after dinner — it sits in your stomach on top of what you ate and bloats you.

    Pardon me while I repeatedly smack my head on my desk.  This is absolutely false.  The human digestive system can handle a piece of fruit at any time of day.

    Good Morning America producers, you’ve got some ‘splaining to do!

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    You Ask, I Answer: Potatoes/Walter Willett’s Healthy Eating Pyramid

    I don’t really know anything about the science of nutrition, so I won’t state an opinion either way on the potato issue. But have you read Willett’s book, Eat, Drink, and Be Healthy?

    I think the pyramid is misleading by placing potatoes up there without an asterisk or something, but he does go into detail in Eat, Drink and Be Healthy about studies showing that potatoes cause a spike in blood sugar in the same way that refined grains do.

    Again, not a scientist so I can’t evaluate the merit of the studies and whatnot, but I’d suggest you check it out so you can decide if you agree.

    Personally, I like potatoes a lot…but I mostly like them in less healthy ways (not crazy about the skin, like them mashed, etc), so I try to limit them.

    Working at Harvard School of Public Health as I do, it’s easy to feel a bit oppressed by the pervasiveness of Willett and the Healthy Eating Pyramid, though!

    — Daphne (last name unknown)
    Via the blog

    Your question brings up several issues worth mentioning (by the way, I realize you are not in favor of the “potatoes are just as bad as sugar” argument, so this is not a “response” to you).

    I agree with Dr. Willett on many nutrition standpoints, but the potato issue is one I see completely differently.

    I have not read Eat, Drink, and Be Healthy, but am familiar with his reasoning for placing potatoes at the top of his Healthy Eating Pyramid along with white flour, sugar, and candy.

    Willett bases that decision on potatoes’ high glycemic index (basically, the degree to which they raise your blood sugar upon consumption).

    The problem with that reasoning is that it only truly applies if a potato is eaten entirely by itself.

    Have it as a side dish to a high-protein food (salmon, chicken, tempeh, etc.), top it with a little fat, and the glycemic index decreases.

    Since a potato’s skin is a good source of fiber, eating it helps lower the glycemic index.

    As I have mentioned before, a potato is not a potato is not a potato.

    Dehydrated potato flakes from a box that turn into instant mashed potatoes are very different from French fries, which are very different to a baked potato cooked in its skin, topped with olive oil, and eaten in conjuction with grilled salmon.

    Besides, the glycemic index is not a very accurate way to determine what foods are healthy.

    If you go by it, ice cream is a “better” snack than watermelon.

    While it is helpful for people living with diabetes, I don’t see it as the most useful tool for weight loss — it leaves calories out of the equation!

    If you were looking to cut calories, would you have half a cup of ice cream as a post-dinner snack or a cup of watermelon?

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    In The News: The "C" Word

    The glycemic index is fortunately starting to take a backseat in the realm of weight loss.

    The potato board is, of course, gleefully promoting the findings of a recent study published in the September 2007 issue of the American Journal of Clinical Nutrition concluded what dietitians have been saying for decades: when it comes to losing weight, it is calories — not the glycemic index of foods — that ultimately makes the difference.

    Researchers from Harvard and the State University of Rio de Janeiro in Brazil who worked independently from any food industry sponsors, sought to determine if a low GI diet would be more effective than a high GI diet for long-term weight loss in 203 overweight and obese women.

    Both diets included a mild energy restriction (i.e., 100-300 fewer calories per day) and had similar macronutrient distributions (i.e., carbohydrate, protein and fat); all that distinguished the two diets were the GIs of the foods.

    The high GI diet contained a hefty dose of… commonly identified high GI foods (e.g., [potatoes], bananas, watermelon, rice and white bread) while the low GI diet contained large amounts of beans and other low GI foods (e.g., apples, pears, oats, and sweet potatoes).

    At the end of the 18-month period both groups had lost weight and there were no significant differences in weight loss between the two groups.

    Some people might think, “So if it’s all about calories, why do you and other nutritionists always talk about how important is to eat whole grains, vegetables, fruits, and legumes? Why not just tell people to eat whatever they want as long as they are reducing calories?”

    Simple — nutrition isn’t just about weight loss.

    Eating healthy is about feeding our bodies adequate amounts of vitamins, minerals, and other nutrients.

    Someone consuming 2,000 calories a day would certainly lose weight eating 1,500 calories’ worth of ice cream, soda, and Doritos.

    However, they would be deficient in a plethora of vitamins and minerals, as well as fiber, Omega-3 fatty acids, and high-quality protein.

    The advantage of low-glycemic foods, though, is that, for the most part, they help stabilize our blood sugar and energy levels.

    They also tend to satiate us faster than foods with higher numbers, thereby making it easier to consume less calories.

    The one instance in which the glycemic index plays a major role is when planning the diet of someone living with diabetes, as keeping accurate track of blood sugar levels is key for successful maintenance.

    It’s a shame to eliminate nutritious and delicious foods like potatoes, bananas, and watermelon out of your diet only because of their ranking in the glycemic index.

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    You "Ask", I Answer: Evaporated Cane Juice

    [Evaporated cane juice] has the same energy content [as sugar] but its glycemic index is lower, meaning it won’t spike your blood sugar as much. It is healthier.

    — Paul (last name unknown)
    Via the blog

    The glycemic index is the Paris Hilton of nutrition — it gets way more press and attention than it really deserves.

    Firstly, the difference between sugar and evaporated cane juice’s glycemic index number isn’t too drastically different.

    Besides, relying on the glycemic index to determine what foods are healthy (the lower the number, “the better”) is not entirely accurate.

    If you go by that criteria, potato chips (with a GI number of 51) are a better food than watermelon (72), unsweetened oatmeal (58), lentils (52), or kidney beans (52).

    The glycemic index is an important tool for people living with diabetes, whose blood sugar needs to be meticulously controlled.

    However, it should not be used to determine the healthfulness of foods.

    Remember, too, that the glycemic index of a food is affected by how it is consumed.  Al dente pasta, for example, has a lower glycemic index than overcooked pasta.  Similarly, a potato topped with olive oil and eaten with a food high in protein has a lower glycemic effect than one sprayed with fat-free artificial butter and unaccompanied by any other food.

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    In The News: New Nutrition Labels

    Get ready for the Overall Nutritional Quality Index, coming to some supermarkets near you in 2008!

    This new labeling system, developed by a panel of leading nutritionists (including Yale’s Dr. David Katz, who I interviewed for this blog) scores foods from 1 to 100 (1 being absolute junk, 100 being perfection) based on several different factors.

    I applaud the motives behind this initiative (helping consumers quickly identify healthy foods), but a few questions come to mind.

    First — does this address the issue at hand?

    Most people know the basics — that fruits, vegetables, whole grains, and legumes are healthy.

    Similarly, I don’t think anyone considers Doritos, Coke, Haagen Dazs, and Oreos to be staples of a nutritious diet. Whether they choose to ignore that and snack on Ruffles and Pepsi every day because “they taste good” is a separate topic.

    I don’t think too many people will be surprised to learn that raisins score higher than M&M’s, or that Trix and Grapenuts are several numbers apart.

    Are consumers not buying healthy foods due to a lack of knowledge on their behalf, or the vastly different marketing budgets of food companies? After all, Nabisco certainly has more money to throw around for a cookie advertising campaign than the Avocado Board.

    Additionally, many healthy snack options are developed by smaller companies who are more concerned with getting their products on store shelves than on an American Idol commercial break.

    Many people who would love the taste of a nutritious product like Lara bars have no idea they exist. No wonder — when was the last time you saw a magazine or television ad for one?

    My main hope is that this system stays far away from the glycemic index. After all, if you swear by that ranking, ice cream is a better choice than a potato!

    I’m also curious to know how the issue of vitamins and minerals will be dealt with. Will a processed food like a Luna Bar injected with synthetic vitamins and minerals score just as high as an orange or apple (which, despite lacking added sugar or sodium, offer a lower variety of nutrients?)

    I’m looking forward to seeing how ONQI resonates with the public. If anything, I love the discourse it will bring up, and I sincerely appreciate the desire to make shopping for healthy foods that much easier.

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    Diets, Deconstructed: The Boys’ Club

    This marks the first installment of “Diets, Deconstructed”, where NYU clinical nutrition professor Lisa Sasson gives Small Bites the lowdown on today’s best-selling diets.

    Today, representing the gentlemen, we have The Abs Diet, created and co-written by David Zinczenko, editor of Men’s Health magazine.

    The premise of the Abs Diet is rather simple. Eat mostly foods from the following groups:

    Almonds and other nuts
    Beans and other legumes
    Spinach and other green vegetables

    Dairy (fat-free/low-fat milk, yogurt, cheese)
    Instant Oatmeal (unsweetened, unflavored)
    Eggs
    Turkey and other lean meats

    Peanut butter
    Olive oil
    Whole grains
    Extra whey protein powder
    Raspberries and other berries

    The book also asks readers to incorporate weight-lifting routines to their day with a special focus on exercises targeting the abdominal muscles.

    Here is Professor Sasson’s take on this best-selling diet:

    What I liked:

    I think the focus on exercise and fitness is really good, because a lot of diet books sometimes forget to stress the importance of adding physical activity to a healthy way of eating. This diet is also not unnecessarily restrictive. At no point are you told to completely cut out an entire food group.”

    What I’m not so sure of:

    “I do feel, though, that dedicating so much of the book to abs exercises is just part of the “abs” gimmick. I would have liked to see some more emphasis on aerobic activity. Someone who hasn’t done a sit-up in ten years can easily get discouraged by all this heavy fitness talk. Also, there’s too much emphasis on the glycemic index. A healthy meal does not lose this property if it’s accompanied by white rice instead of brown rice.”

    What I don’t like:

    This book suggests men need to have whey protein shakes every day, which is ridiculous since the average American gets more than enough protein. I don’t like the focus on one nutrient — protein — as if it is the magic answer to weight loss. Also, some of the studies the book cites are just preliminary research, but they are presented as tried and true facts. I especially took issue with one passage that makes a link between carbohydrate intake and the development of diabetes!

    My take? I think the Abs Diet has a solid idea behind it. I like the “groups” of food it recommends people make staples of their diet, and am glad they explain why low-calories, low-carb and low-fat diets are not effective for weight loss.

    Also, as Professor Sasson says, this is not a restricted diet. Eating dessert once in a while is fine, and enjoying the occassional junk food is not seen as weakness or a breaking of the rules.

    I also appreciated the miscellaneous tips sprinkled throughout (ie: “Five Ways to Add More Fiber To Your Diet”).

    I have a few issues with it, though:

    1) It makes no mention of portions or amount of food eaten. Yes, almonds and olive oil are healthy. But, adding four tablespoons of olive oil to your salad add up to 480 extra calories, and two ounces of almonds contribute 330 calories to your day. Unless you are working out heavily, these extra calories will contribute to weight gain.

    2) I absolutely agree with Professor Sasson that the emphasis on extra protein powder is overkill. As I explained in the sixth installment of the Small Bites newsletter, bulking up and adding mass to your frame is about eating more calories, not protein.

    3) Branding calcium a “fat fighter” is a bit of a stretch.

    4) The chapter titled “A Six-pack in Six Weeks” is too optimistic. I have a feeling most of the people who follow this diet might certainly shed pounds and eat in a more healthful way, but will not be displaying a six-pack in a month and a half. The fitness model shown on the very last page is obviously a man who has devoted much of his life to looking as buff and cut as he does, not a regular person who did the Abs diet for two weeks.

    I would certainly not refer to the Abs Diet as a ridiculous or unhealthy one. I think its intentions are good and, for the most part, it dispenses practical and healthy advice. However, in order for it to make the grade, it needs to rely less on preliminary research (as Professor Sasson noted) and protein as the key to weight loss.

    In my grade book, The Abs Diet receives a solid B.

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    Speaking With…: Lisa Sasson

    Lisa Sasson has been a clinical assistant professor at New York University’s Department of Nutrition, Food Studies, and Public Health for 15 years, and has almost twenty years’ experience counseling clients in New York City with their weight management goals.

    She is also co-director of NYU’s Food, Nutrition and Culture summer study abroad program in Florence, Italy. It’s only appropriate, then, that one of her specialties is The Mediterranean Diet.

    Her knowledge of nutrition and outspoken, affable personality led to appearances on Queer Eye for the Straight Guy and A& E as well as a one-on-one nutrition counseling session with supermodel Claudia Schiffer in 2004.

    Ms. Sasson is currently Nickelodeon’s nutrition consultant and has been featured in The New York Times, Reader’s Digest, Self, Time, Fitness, and was Allure Magazine’s nutrition makeover coach in 2005 and 2006.

    I sat down with Ms. Sasson and picked her brain regarding the latest fad diets. The result was a candid and insightful chat.

    Small Bites: How have diet fads evolved over the past few decades?

    Lisa Sasson: Nutrition reminds me of fashion. If you wait long enough, a certain diet will be in vogue again.

    For instance, when you look back 25 years ago, you see low-carb, high protein diets like Atkins and Scarsdale being advocated. These exact same diets resurfaced in 2003.

    Then, in the 90’s, diets were advocating counting grams of fat and eliminating it from your diet. In turn, people ate lots of carbs.

    Well, carbs, like all nutrients, have calories. Fat-free does not mean calorie-free.

    So, people ate lots of carbs and gained a lot of weight.

    SB: What themes do the most recent diet books have in common?

    LS: The glycemic index is back, and so is this idea of “good” versus “bad” carbs. Whole grains are also a focus of the newest diet books.

    Luckily, fat is becoming a component of most weight loss diets. Instead of calling for its elimination, the current books suggest eating healthy fats like olive oil, salmon, avocados, and nuts, which is a good push.

    SB: What’s your take on “good” versus “bad” carbs?

    LS: The problem I have with it is that there is no good scientific research demonstrating the importance of the glycemic index and “good” or “bad” carbs. So many factors affect the glycemic index of a food as it is. For example, the glycemic index of a potato varies depending on what you ate before, what you are eating with it, and how you prepare it.

    People take it out of context. A lot of these books focus on it because it’s a catch. It makes people think, “Oh! If I eat this I am going to lose weight.” It is a great way to draw someone into believing your book is special.

    SB: Which would you say is the best of the current diets?

    LS: Walter Willett’s book (Eat, Drink, and Weigh Less: A Flexible and Delicious Way to Shrink Your Waist Without Going Hungry) is one of the better ones.

    I liked it because he has a realistic approach. I wish he wasn’t so fixated on whole grains and the glycemic index, but he allows other carbs that may not be whole grains or “good” in the glycemic index to be incorporated.

    He also recommends healthy fats, and the meals featured in the book are simple to prepare.

    I liked Bob Greene’s book (The Best Life Diet) in the sense that it is done in increments and he goes into the psychological implications behind weight management.

    He also stresses the importance of exercise and being more physically active.

    You can’t talk about weight loss and not mention being more physically active. Not necessarily lifting weights, but just moving more. That’s the key to a healthy lifestyle.

    Exercising allows you to eat more, utilize glucose better, have more muscle mass and lose weight more quickly.

    SB: Are there any new diet books you aren’t too fond of?

    LS: Yes, The Sonoma Diet! The woman who wrote it, Connie Guttersen, is a registered dietitian. She should be ashamed! Do you know what her first “rule” is? “Throw out anything in your house that has white flour or sugar in it”!

    I mean, she takes pride in the fact that her diet mimics the Mediterranean Diet and then has the audacity to say, “Never eat pasta.”

    And then she has all these phases, or “waves”, as she refers to them. The first wave is VERY restricted. There is a whole list of foods you can’t have. You can only have certain veggies, certain nuts, and certain grains.

    There are also all these recipes that are so complicated. I was leafing through it and thinking, “Is someone really going to get home after a busy day and make these dishes?”

    The author also makes some outrageous statements. For example, she says you can’t eat fruit during phase one because of “the carbs”.

    That’s ridiculous because fruits are chock full of nutrients and fiber. Besides, they are delicious and sweet. There is absolutely no reason why people should not be allowed to eat fruit.

    Should you have limits? Of course. But to restrict a natural food makes no sense. I can’t accept that anything as natural as fruit should be eliminated from a diet.

    For someone to say, “I can’t eat an apple, I’m on a diet,” is just laughable.

    Oh, and throughout the whole diet you can only have Barilla Plus multigrain pasta, but not regular pasta. What bothers me is that Italians aren’t eating whole grain pasta.

    What matters more is what they’re putting on their pasta.

    SB: What do you mean?

    LS: In Italy, pasta has very little sauce on it. It’s eaten with beans and lots of vegetables, and it’s usually a side dish, not a huge meal. It is not a huge portion.

    SB: What would you say to someone who critiques nutritionists as being too objective when analyzing diets? It’s easy to look at the science, but what about the personal experience?

    LS: Funny you should ask that. I was looking at all these diets and thought to myself, “What does it feel like to go on these diets?” I wanted to really experience it “from the other side”, so to speak, so I decided to go on South Beach for 2 weeks. I followed it very strictly.

    The good thing was that while I was on it, I had very little freedom, so I was not tempted to just pick or snack mindlessly.

    So, it was easy in the sense that there wasn’t much choice. I was so hungry that whatever I ate, I enjoyed.

    The bad thing is that, while dieting, I continued living my normal life. It was very difficult to exercise during these two weeks. Yoga was particularly taxing.

    I was so low on carbs that I was glycogen-deprived, and glycogen is the main source of fuel. I felt light-headed, had terrible headaches, and was very moody.

    It was also hard for me to look forward to the social aspect of a meal. The joy and pleasure of food was taken out.

    After five days I couldn’t look at another egg because every morning I had one for breakfast. I also found it frustrating that I couldn’t just have a glass of wine with dinner.

    SB: So, psychologically, it was difficult.

    LS: Yeah, and what I hate about all these diet books is that none acknowledge that losing weight is not always easy.

    They talk about how delicious their recipes are and all the variety they offer and how you wake up and get to eat delicious things like ricotta cheese with Sweet and Low and Cocoa powder, which, ugh, I don’t know how anyone can find that tasty. It’s disgusting.

    And, again, none of these books mention fatigue or boredom. They dismiss it. All they talk about is how you’re going to lose all this weight in two weeks, and how you have so much choice, and how with each phase you can eat more. Please. I wanted to search the index for “headaches” and “moodiness” to make sure I wasn’t going crazy.

    SB: What about food shopping?

    LS: Oh, God! I would go to the supermarket and put all these artificial food products into my cart. I had diet gellatin, diet popsicles, diet ice cream, and all these products with fifty ingredients.

    Diet Jello became my best friend because I would make 2 boxes a day and make it when I was hungry. I would eat eggs, diet Jello, sugar-free pops, sugar free this, sugar free that. Meanwhile, I’m thinking, “This is expensive and I can’t have fresh fruits in my cart!”

    SB: What are some common pitfalls dieters make?

    LS: Setting unrealistic expectations. Rather than think of this as a change of their lifestyle, people just think of it as “I need to lose 40 pounds by my birthday.”

    Healthy eating goes hand in hand with living healthfully. So, apart from eating well, people should exercise and sleep enough. All these things affect your eating habits.

    Don’t look at weight loss as “I need to eat more blueberries and less salmon” or some mathematical equation.

    Also, learn to listen to your body. It lets you know when you are hungry, full, or satisfied. A lot of times people can’t differentiate between hunger and boredom. You shouldn’t feel stuffed after you eat.

    Also, it’s a good idea to eat BEFORE you feel famished. This will reduce your chances of overeating or choosing unhealthy foods to immediately curb hunger.

    SB: How should people who want to lose weight prepare themselves psychologically?

    LS: First of all, have realistic expectations. Healthy weight loss is approximately 1 pound a week. So, for twenty pounds, you are looking at four to five months.

    The key is to think of this as lifestyle changes. You want to lose this weight forever, not just so you
    can show off your body at the beach and then not worry about it because in the winter you hide under baggy sweaters and jackets.

    When you lose weight quickly and go on these ridiculous restricted diets, you slowly start breaking the rules and then ease into your normal eating habits. So, what you need to change is your eating habits, and that’s going to take time.

    When you make long term commitment, you will forever have a healthier relationship with food. Weight loss will not be at the forefront, it’s going to be changing the way you eat. Eating healthfully, physical activity.

    It doesn’t – and shouldn’t — mean you can’t have desserts two times a week or pepperoni pizza a few times a month. The idea is that these foods should play less of a role. Healthy eating is not about one meal or one food, it’s about dietary patterns.

    People don’t succeed on overly restrictive diets because they focus on specific nutrients instead of changing their lifestyle. People get stuck on eating less of this, more of that, and it becomes difficult to sustain socially, culturally, physically, and emotionally.

    SB: Say someone is reading this and wants to start losing weight today. What would you recommend as a good starting point?

    LS: The first thing I tell my clients is to get rid of liquid calories. Liquids do not satiate the way food does, so it ultimately leaves room to consume more calories.

    Also, these can easily be substituted with lower calorie healthy beverages. So I would begin by replacing sodas, juices, high fat milk, beer, alcoholic beverages, cocktails, and sugary iced teas with flavored sparkling water, diluted juices, unsweetened teas, and low or non-fat milk.

    Then, each day try to do more physical movement than what you currently do. It can just be an extra ten minutes of walking every day. Then, two or three weeks later, add ten more minutes. Build it up slowly.

    Don’t focus on how little you are doing. Whatever you do — even if it’s a five minute jog — is positive.

    People just see the long-term goal and lose sight of the small steps in between. They say, “I can’t get to the gym tonight. I might as well eat a whole pizza.” Well, if you can’t go to the gym, walk for 10 or 15 minutes in your neighborhood.

    Also, pay attention to what you feel when you eat. Before you put something in your mouth, ask yourself, “am I hungry? Or bored?” Rate your hunger. When you feel satisfied, try to stop.

    Don’t buy things that make you feel vulnerable. If potato chips are irresistible, don’t have them in your house. If you have to buy them for other family members, put them somewhere out of your way so you have some time to think before reaching for them.

    Focus on fresh fruits and vegetables. Don’t get hung up on this fruit, this vegetable. If you eat close to nature, if you are eating less processed food, you are already doing a really good job. Don’t think about eliminating plums and then eating watermelon only after the third week. Fruit is healthy!

    SB: How can people spot a well-rounded “diet” book versus one that is unrealistic to follow?

    LS: I don’t like books that tell you, “throw out everything that has white flour or sugar! Don’t eat these foods for six weeks!” It’s so ridiculous. Telling someone to ban 30 different foods does not mean they will stick to it or lose weight.

    Also, these super strict rules are unnecessary. You don’t have to subsist on whole grain pasta or brown rice to lose weight. It’s OK to eat normal pasta as long as it is cooked healthily and you aren’t having three cups of it for dinner.

    If you don’t like whole grain pasta, it’s OK. It’s not the magic weight loss solution. If you’re drowing your pasta in alfredo sauce, it doesn’t matter if it’s whole grain or not.

    I like books that talk about making healthy changes rather than eliminate foods.

    I like books that aren’t about just seeing the top of the mountain, but rather about the steps you need to take to get there. Looking at that tall mountain can seem overwhelming and defeating. People should be encouraged to concentrate on small, continuous steps. That’s a much healthier, more realistic approach.

    I also think a good plan incorporates cultural sensitivity. Not everyone drinks milk, so to tell people to get calcium from dairy, that’s very shallow. Some cultures don’t drink milk and their calcium intake is just fine.

    Thanks again to Lisa Sasson for a fun and thorough interview!

    Over the next few weeks, Ms. Sasson will be analyzing some of today’s hottest diets. Come back to find out which ones make the honor roll and which make the hall of shame.

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    You Ask, I Answer: The Glycemic Index

    What’s your take on the glycemic index as a way to monitor “good” and “bad” foods?
    — Anonymous

    Thirty years after it was first researched and introduced to mainstream nutrition, the glycemic index is making a comeback.

    The glycemix index (GI) is a ranking that lists foods based on their effect on our blood sugar levels. Foods that spike up our blood sugar following consumption are ranked higher, while those that help maintain blood glucose levels receive a lower number.

    Many low-carbers constantly refer to the GI, and will make statements like, “I don’t eat potatoes. They’re way up there on the glycemic index!”

    Oh, the horror! If anyone ever tells you that, your nutrition BS alarms should go off.

    Yes, it is true that foods largely composed of carbohydrates (especially refined ones) will raise our blood sugar more than those that mostly consist of fats and/or protein. That doesn’t necessarily make them less healthy, though.

    For instance, according to the glycemic index, a croissant, ketchup, and ice cream are a better choice than cooked carrots. Thus, this tool does not take into account that ice cream and croissants have high levels of cholesterol-raising saturated fat and not a trace of fiber, ketchup is a high-sodium condiment, and cooked carrots offer a wealth of nutrients.

    Additionally, I’m of the thought that the glycemic index oversimplifies foods. For instance, a baked potato scores high on this chart because the assumption is that you are eating it by itself. Have it as a side dish to accompany any protein (whether animal or vegetable), and the glycemic index of that potato becomes lower!

    Similarly, cooking methods affect foods’ GI numbers. Pasta scores lower when al dente, and potatoes result in a lower number if they are refrigerated prior to being eaten.

    Remember, when it comes to weight management, the main thing you truly need to keep tabs on is your caloric intake. Three thousand calories of food will make you gain weight, whether they come from lettuce leaves or ice cream (obviously, because lettuce leaves offer practically no calories, you would need to eat a LOT of them to even get 100 calories).

    Although the glycemic index is definitely helpful for people living with diabetes (who need to closely monitor their blood sugar levels throughout the day), I don’t consider it an effective weight management tool for the average person.

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