Goodbye Processed, Hello Paleo!

by Laura Burton

Well, I decided to give it a go. After several weekends of weddings, new cities, and social events, each boasting an array of culinary treats (that this foodie gladly took advantage of), I could tell my body was seeking a respite from some of the processed, high-sugar foods I had been so graciously feeding it.

I stumbled across a blog where the author announced she was starting “Whole30” that day. I was curious, so I looked into it. Whole30 is pretty much a 30-day “Paleo Diet.” This plan requires that you eliminate certain food groups that could be having a negative impact on your health and fitness. What’s allowed? Meat, seafood, eggs, vegetables, fruit, and good fats from fruits, oils, nuts and seeds. What’s NOT allowed? Added sugar, artificial sugar, alcohol, grains, legumes, dairy, carrageenan, MSG, sulfites, and white potatoes. Oh, and no paleo-fying dessert or junk food choices, which means no paleo pancakes…(sigh). The idea is to focus on making good food choices for 30 days with the purpose of feeling and performing better. The dietitian in me was intrigued! The food lover in me was terrified.

Today is Day 20. 

My body began to feel differently from day 1. The first few days I had a mild headache, which I attributed to my body mourning the absence of its regular pick-me-up: sugar.  I immediately felt that my energy level was not only higher, but more consistent throughout the day. No more ups and downs based on my blood sugar. I began sleeping better and feeling more hydrated within days. To my excitement, my stomach felt more full after eating since my intake mainly consisted of high-volume foods: fruits and vegetables. Pleasantly surprised, I forged on with a sense of confidence that I might actually be able to do this!  

Mentally, I realized that this would be no easy feat. First, I longed for those foods I couldn’t have – and not just sugary treats. I remember at one point standing in front of my pantry, staring at the Fiber One box (Fiber One of all things!) nearly in tears as I realized I would spend the next twenty-something days eating eggs and fruit for breakfast.  [Confession: I might have an unhealthy attachment to cereals of all kind.] Second, I quickly learned that planning ahead was essential. I had to thoughtfully plan every meal and every snack to be sure I was getting the nutrients and energy I needed. 

It quickly became evident that my thought processes regarding food were really changing. I became more aware of impulses to eat throughout the day, and rather than feeding my ‘cravings,’ I analyzed them. I was becoming a more mindful eater! I noticed that the complete removal of large food groups really works to my advantage since it eliminates the option of coming up with creative excuses to eat this or that, thus making food choices easier and helping me achieve compliance. Furthermore, the paleo diet got me out of my food comfort zone and forced me to experiment with different foods that I have come to love. Spaghetti squash has surprised me – I feel like I am enjoying a big bowl of pasta! Crunchy carrot chips with “Wholly Guacamole” is my new snack of choice. The other day I tried my hand at homemade slaw made with beautiful red cabbage, julienned carrots, cilantro, and a delicious, simple dressing of canola oil and lime juice. I have actually started to enjoy the process of preparing my foods because there is such purpose behind it. Sure, it takes more time. But I'm doing something good for myself.

From a dietitian’s standpoint, I have some reservations about the paleo diet. Vegetable protein sources like soy and legumes, which are off-limits on the paleo diet, are a heart-healthy way to get protein. In addition, whole grains can be a very beneficial part of a healthy diet when eaten in moderation. I question how realistic and healthful this type of plan would be long-term. But I can say with confidence that the past 20 days have shaped my relationship with food for the better, and that this experience will foster a more thoughtful approach to feeding my body for years to come.

I'll check back in in another 20 days to let you know how things are going post-Paleo...

Running from Tigers and Bears

At least 75% of our patients identify stress as a major factor in causing weight gain for them. Dealing with stress effectively can make a huge difference in your ability to manage your eating behaviors and your weight. A lot of the solution boils down to being able to self-soothe without food.

Why does stress lead to weight gain? The basic explanation is that we are hard-wired to respond to stressful situations in a way that makes us ready to defend our lives. Back in the day, our stressors were things like tigers and bears. Nowadays, our stressors are unreasonable bosses and crazy family members. While we don’t have to outrun them or get into physical fights (or least we try not to), our bodies still respond in a way that makes us feel like we need to be prepared for that possibility. To be prepared, our bodies get signals from hormones and chemicals that we synthesize to fuel up for the impending danger. However, we our access to food is ever-present and much more calorically dense than when we were running from tigers and bears. So instead of foraging for nuts and berries, we forage at the vending machine, choosing the 650 calorie honey bun and the 200 calorie soda to get through the afternoon.

Another part of the explanation of how stress leads to weight gain is the behavioral reinforcement to which we unknowingly fall a victim.  Remember when you had a bad day at school and your mother offered you a piece of cake to “make it all better”? That type of experience conditioned you to associate feelings of comfort and solace with cake. The cake didn’t necessarily have anything in it that was a mood altering substance—I don’t think she would have slipped you some Prozac; however, your mother’s comfort and concern for you were linked to the cake. We have the ability to associate memories and emotions with inanimate objects like food. This is especially true for food because the sight, smell, and taste can be an incredibly powerful stimulus.  So now as an adult 40 years later, you’re still looking for a piece of cake when you get home from a tough day at work or after arguing with your significant other.

So if we know all of this, why can’t we simply change how we respond to stress and stop eating? This is a central question to why obesity is so challenging to treat effectively. Food is powerfully consistent in its effects on your brain. Part of this is due to the fact that a lot of our manufactured food is designed to be exactly the same bite after bite. So you know that the last bag of candy you ate is going to taste just like the next one. Even though you intellectually understand that you shouldn’t go for the chocolate just because you are upset, you still do it because you can count on it making you feel a certain way, even if only temporarily. Until you can identify something that helps you soothe yourself and relieve stress as reliably and immediately as food, it’s hard to beat the feeling you get from that food.

All hope is not forsaken though… 

Things you learn in the grocery store: 3 common mistakes made in the gym

I have a knack for choosing the longest, slowest line at the grocery store (please tell me I’m not alone in this feat).  This rainy, dreary afternoon was no different, but I did overhear a couple discussing their frustration with weight loss and how exercise just "doesn't work."  I tried not to eavesdrop, but honestly I was hanging onto every word they said.  I wasn't getting any closer to checking out, so we stood in line, they discussed, and I listened. 

There are several different directions to go with this topic, but I chose to tackle (in my own head of course) the top three mistakes people make in the gym with exercise.  First, the body responds to change, and it is all too common (and easy) to start an exercise program and the next thing you know time has elapsed and you are doing the exact same thing over and over again.  Not only is this monotonous and mundane, but you won’t be optimizing the many benefits of physical activity.  There is a term in exercise world referred to as the 'overload principal' that simply states you have to be constantly thinking ahead and looking for the next step.  Take for example, walking for 30 minutes on a treadmill.  You will get a lot more out of this activity if you give yourself permission to push buttons.  Try mixing up the speed/grade/intensity.  Try a different exercise all together.  You may find you can decrease your time while increasing intensity, and who wouldn’t want more time on their hands. 

Second, one of my favorite adapted sayings in the gym has become “you have to straighten before you can strengthen.”  I find this especially true of people beginning an exercise program.  Keep in mind we learn to crawl before we walk and walk before we run; the same holds true with focusing on proper form and technique.  This statement encompasses a broad spectrum, but if you are not completing full range of motion on a bicep curl or maintaining proper posture on the elliptical machine you may be in fact setting yourself up for injury.  Maybe even more common, I run into a lot of people with back and neck pain.  There could be a lot of reasons for this, but if you are not addressing the potential postural problems with flexibility, and proper weight training, you could end up aggravating a problem.

Third, when I finally made it out of the grocery store, I hear my new friends say, “I want to get rid of these love handles and I do over 100 sit-ups every day.”  Wow, where do I start?  They have the strongest abs of anyone I know but it’s all behind a layer of fat.  We all know what love handles are, and we all want to get rid of them.  The question is how do we do it?  The ‘love handle’ is basically a build up of fat around the waist, and all the crunches, twists, and sit-ups in the world won’t get rid of them.  The answer to getting rid of fat throughout the body requires a combination of cardio, resistance training and a solid diet plan that leads to a calorie deficit. 

While exercise is something that feels natural (at least to some), there is a right way and a wrong way to approach it. Set yourself up for success by staying informed. Let’s get moving together!

Is that ALL I lost this week?!!!

If you have tried to lose weight before, you probably uttered the dreaded "P" word-- PLATEAU. A plateau, otherwise known as the lack of weight loss after doing a plan for a period of time, is not inevitable, if you're working with someone who knows how to guide you.

But this post really isn't about how to beat the plateau. It's more about how to not freak out if you think your weight loss is slowing down. Many of my patients anxiously compare week to week weight loss numbers, calculating every ounce of lost weight since the last encounter with the scale. I encourage everyone to weigh themselves regularly, especially if you are attempting to lose weight. Once weekly is good enough in my opinion. However, I don't want my patients to get overly concerned about the week to week difference.

Why not? The patient's job is to focus on implementing the weekly plan; my job is to focus on making sure we have the right plan that gets results. Try as you might, you can't control the number on the scale. Even if you do the same thing every day from one week to the next, the weekly weight loss will be different. This is due to a number of factors that are out of your control like how much water you retained that day, various hormonal levels, and metabolic changes occurring as a result of your ongoing weight loss. Unfortunately, losing weight is not a linear process.

As long as the average weight loss remains good, you know you're doing the right things. And those are the things you should continue to focus on-- daily food journal, consistently meeting your exercise goals, and achieving a good eating structure.

Smoke and Mirrors

Ok, the third week of our program is here. Now it's time to talk about food.

You've completed a food journal on a daily basis for the past 2 weeks and are starting to recognize some patterns by now. You understand that for every ACTION you take, your body responds with a REACTION that should be fairly predictable, now that you have some data. If you skip breakfast, you're starving by 1 pm. If you wait too long to eat, you make poorer choices. If you're really tired, you graze to keep yourself awake.

So what should you be eating? I'm going to suggest that for now, we ignore the number of calories that you should eat. Again, I'm not crazy, just evil. Here's the rationale for ignoring calories for now. I want you to focus on how to fix the structure of your eating, and this is NOT dependent on calories. As you may have noticed, the days that you consumed fewer calories and didn't starve yourself, you were more regular in the timing and spacing of your meals. Your portions were probably more consistent, and you likely avoided extremes of hunger and fullness.

We've become so calorie focused in our efforts to lose weight that we lose focus on what's important. We begin to implement smoke and mirror tricks to say we can eat whatever we want as long as we don't go over the calorie limit for the day. We trick ourselves into saying that we're "saving up" calories like we're about to make a down payment on a new car. As a numbers game, it may work for a while. Then the weight loss stops and no amount of manipulating those calories from the candy and ice cream will work to get it going again.

Rather than give you a calorie target to manipulate, I want you to use a simple method to get started with your plan of what to eat. Start by adding fruits and vegetables to your day based on the table below. 

Current number of fruits and vegetables per day	Number to add per day
< 2	2
2-4	3
5+	4

Add the fruits and vegetables in place of the highest calorie items you consume (for most of us, it's fried potatoes, juices and other sugar beverages, and desserts). Ideally you should have 5 eating episodes per day. If you have spaces in your day where you were not eating, add the fruits and vegetables there as well.

If you start here, this will naturally lower your caloric intake and keep you more satisfied throughout the day. You are simply swapping higher energy dense foods for lower energy dense foods, reducing calories without trying to cut the amount of food you are eating. Simple how it works...almost like magic!


Keep journaling to see the results...

Never Enough to Lose Weight

Routinely, I ask my patients what they need to be successful with losing weight. Invariably the responses include two things you will never have enough of—motivation and willpower. If you're banking on this to help you make a lifestyle change, you're setting yourself up to fail.
Why do I feel this way? Motivation can be misplaced and fleeting. Willpower by its very nature is inconsistent at best. When these two factors are the things you call upon to help you make better decisions and make changes in your lifestyle consistently, you will find that consistency is hard to achieve.

Let's deal with willpower first. The battle of willpower is something you will always lose. It's like gambling…you may get on a good roll, but if you do it long enough you lose. A misperception I hear all the time is that some people must have incredible willpower to stay thin or not eat certain foods. More likely is that these individuals manage their environment and avoid tempting themselves repeatedly with the things they are trying to limit. If I like to eat chocolate cake (and I do), and I only want to allow myself the option to eat it once a week, it makes no sense for me to bake a cake and leave it sitting on my counter top all week. Every time I walk past the cake, I'm going to think about it and have to expend mental energy to not have some. I may be able to do this when I'm at my best, but the next time I'm upset or really hungry or tired from working all day, I'll probably give in and make an exception. However, as soon as I finish that last bite, I'll resolve to NEVER DO THAT AGAIN.

Motivation is necessary, but only as a means to get you to reorder your priority list. Your motivation becomes sustained when you can recognize how the benefits of your lifestyle change outweigh the benefits of doing your default. When this happens, you make time for meal planning or exercise. You find ways to pack your exercise clothes for the business trip. You spend your time and effort doing the things that you care about most. If doing the things that are needed to make a lifestyle change and lose weight isn't important enough, you won't do it. The key phrase here is that you need to care about DOING THE THINGS. You have to care about the PROCESS just as much as you do the OUTCOME.
Losing weight is a challenging proposition for many, but very doable. Set yourself up for success by valuing the benefits of the small lifestyle changes you make (walking, eating better choices, journaling, good sleep) and by managing your environment.

 

A Case for Cooking

-Laura S. Burton, RD

As a dietitian, I have noticed that the number of people I see who cook regularly is dwindling rapidly. When individuals disclose how often they eat out, immediately a long list of excuses as to why cooking is not an option for them ensues. The top 5 reasons are as follows: 

1. “I can’t cook”
2. “I don’t have time to cook”
3. “I don’t know what to cook”
4. “Planning meals is overwhelming”
5. “It’s hard to plan healthy meals that will please everyone in my family”

I can relate!  Now although there are tips, shortcuts and resources that can make cooking much easier and more enjoyable (which I’ll share with you in a minute), I won’t argue that the drive-thru isn't still the easiest, quickest option. So what are the benefits of cooking and are they enough to get Americans back in the kitchen? Is cooking really worth it?

Cooking allows you to take control of what goes into your body. When we eat out, our health is at the mercy of food manufacturers, and all they’re concerned with is achieving maximum flavor and maximum shelf-life at minimum cost. Even grilled fish and chicken at restaurants can be loaded with sodium and smothered in high-fat sauces. We must start caring more about what goes into our food, especially when it comes to weight and disease management. Has your physician or dietitian recommended a reduced-sodium meal plan? With cooking, you can easily limit the amount of salt in your foods. Do you have trouble with high blood sugar? Cooking allows you to easily half the amount of rice or pasta in a casserole…and double the amount of vegetables! Heart disease or high cholesterol? You can still enjoy a burger when it’s made at home from extra lean ground turkey breast.  And the best part is that you can customize it based on your taste! Give it some Greek flair by mixing in breadcrumbs, red onions, reduced-fat feta cheese and dill. Be creative!

Set a good example for your family. The kitchen can be such a fun place to bond with your spouse or kids. Children who help their parents in the kitchen will not only develop cooking skills to carry into adulthood; they’ll learn about choosing healthy foods, learn to follow instructions, and realize that putting a little time and energy toward something often results in a great outcome. Cooking will likely foster a child's appreciation of teamwork, as well as give them a sense of ownership over the meal (which may make them more willing to eat it!)

It’s clear that cooking can be beneficial for a multitude of reasons.  But let me also suggest that cooking doesn’t have to be as daunting a task as we make it out to be. In fact, here are a few tips that might just change the way you think about cooking. 

1.  If you can read and follow directions, you can cook! Sure, cooking requires some basic knowledge of measuring, mixing, and heating techniques, but your faithful friends Google and SIRI are always there and willing to help. Simply type in those terms you don’t quite understand, or ask them how to “fold in the egg whites,” for example. Like any new practice, this may require a little extra time in the beginning, but you’ll find that once you understand the basics and get some practice under your belt, cooking will begin to come naturally for even the most anxious beginner chefs.

2. It may be worth it to spend a little extra money on shortcuts. If you’re low on time, purchase the pre-chopped onions rather than a whole onion (it’ll save you time and tears!). Or instead of buying the boxed rice that requires boiling, save time by purchasing the 90-second microwave brown rice in-a-bag.

3. Short on good, healthy recipes? Explore EatRight by UAB’s Nutrition Guidance System. With lots of healthy, easy, and kitchen-tested meals, our recipe collection won’t disappoint. In addition, the Nutrition Guidance System has teamed up with Piggly Wiggly to offer nutrition guidance as you shop! Watch a short promotional video here. Or sign up for one of EatRight by UAB's monthly cooking classes to learn new recipes as well as healthy cooking techniques.

What will you fix for dinner this week?

Self...Meet Self

Most of my patients have a pretty good idea of the issues that have contributed to their weight gain or inability to keep it off after losing it a few times over. One of the biggest reasons they often identify is themselves.

The first step I recommend that you take in your plan to get to a healthier weight is to learn more about yourself. Why is that you ask? Because despite all of the suggestions about genetic predisposition or the influence of the environment, we have to look at ourselves as the final decision maker in the choice between having seconds or putting the food away; between taking the walk (even when it's cold outside) or watching television and snacking. If you don't understand your own tendencies and inclinations, you won't be able to critically address the issues that plague you. For most of us, we are creatures of habit and respond to a stimulus in a fairly predictable way. That response may be programmed by years of conditioning (if I say "birthday" you think "cake") or naturally selected because it brings a survival advantage (the taste of sweetness signals us to eat more-- a useful trait when you're a caveman, not so much when you go to Krispy Kreme).

What does any of this have to do with your weight? Everything.

The key is to stop approaching your weight as simply a function of the number of calories you eat and how many minutes you can get in on the treadmill. You need to understand why you eat, when you eat, and how you  eat to be a healthier person. You need to understand if you move, when you have time to move, and how you move to be a healthier person. These issues represent your habits and tendencies that will either need to be overcome/modified or propel you on your way to a healthier lifestyle.

Week 1: Keep a journal for the next week, recording everything that goes in your mouth. Don't record calories (that's right, I said it)! However, do record the time you ate, what you were doing while you ate, where you ate, and your portions. Also make note of your mood and your mental and physical appetite [your mind is saying you could go for something to eat vs. your stomach is saying you need something to eat]. Think about your activity level as well. If you don't have a pedometer, now is the time to buy one.

This is your work for week one. As you jump in, we'll start to talk about some of the patterns that emerge and approaches to change your lifestyle.