How do we lose weight?  This magic question seems to elude and allure us to weight loss programs and gimmicks.   Water cooler conversations focus on the person who lost weight – how they did it, what are they eating, how long did it take?

I’ve thought about and wrestled with both the question and answer to weight loss since I was a little girl, which is the reason I became a dietitian.  I was a little round as young as second grade and always wanting the second ding-dong or ho-ho after school (who knew what a trans fat was in the 70’s?).  Why was I was always hungrier and bigger than my skinny friends - was it just that I needed to eat less calories or exercise a bit more?

Both the Los Angeles and New York Times have written about restaurant calorie counts, begging the question whether counting calories is the answer.  Health writer Jeannie Stein from the LA Times wrote several informative articles last week, one which asked “Does menu labeling really alter Habits?” 

New York Times article “In the Obesity Epidemic, What’s One Cookie?” discussed Michelle Obama’s strategy of “small changes add up,” in which one eats either 100 calories less or burns 100 calories more.

Is that enough? The challenge of weight loss is unique in that we are genetically diverse as human beings with different metabolisms and lifestyles.  And our food supply and large restaurant portions does not play to our advantage.

It might be time to stop looking for a simple answer and come up with a solution tailor made to your needs.  Ask yourself:

1.  Where do I store my weight?  If you have a lot of belly fat you may be eating too many carbohydrates (processed and starchy) and need more lean protein and good fats to keep your appetite under control.

2.  Instead of focusing on calories, think about how much food your body requires to be NO LONGER HUNGRY versus full.  Studies show when we shift into mindful eating it actually starts re-wiring our brains to be satisfied with less food.

3.  Exercise and activity are not really an “option” if health and weight loss are your goals.  Make exercise like brushing your teeth every day– something you do to keep all the systems in your body – including your metabolism- working at full capacity.

Think about what will work for you and focus on the REWARDS of what you want rather than the limitations.  That is how I found my answer.  Although I needed to look like my job, my driving force was to feel comfortable and healthy in my body.  Finding the path and answer to your water cooler question becomes the recipe for weight loss. Your recipe is the key to prevention and not prescription.

What are the most important things to buy organic if you are on a budget and/or short on time?

1.  Dairy – cows are fed hormones to produce higher quantities of milk and so best to purchase organic milk, cheese and yogurt.

2.  Meat – when you consume meat fed hormones, it is possible to increase the level of inflammation in the body.  In addition, if you are a meat eater and can afford it grass-fed meat (versus corn/grain fed) has higher levels of omega 3 fats which anti-inflammatory versus pro-inflammatory in the body.

3.  Fruits – the most important fruits to buy organic are:

           1.  Apples and Pears

           2. Stone fruits such as peaches

              and nectarines

           3.  Strawberries and cherries

           4.  Grapes

4.  Vegetables - the most important vegetables to buy organic are:

            1.  Carrots and Celery

            2.  Sweet Bell Peppers

            3.  Tomatoes

            4.  Lettuce    

Feed your family the organic and/or local produce and foods you can afford within reason.  Visit the farmer’s markets on the weekends.  You might be surprised how fresh and clean the air feels around the fragrant produce and how delicious healthy food feels on your body!

Current research is focusing on the beneficial properties of Curcumin.  Curcumin has been studied for its role in prevention of both Alzheimer’s disease and cancer since it is a powerful antioxidant with strong anti-inflammatory benefits.  It is now thought that one of the keys to lowering risk of cancer, diabetes or heart disease is to lower inflammation in the body.

A few epidemiological studies (ones in which an association exists between two things) revealed that individuals consuming foods with turmeric or curry a few times a month has less incidence of Alzheimer’s disease and cognitive problems than those who ate the spices less than once a month. 

UCLA Neurologist John Ringman studied Curcumin supplements in Alzheimer’s patients.  The study results showed no differences in patients treated with Curcumin supplements versus a placebo.  However, this study and others do show Curcumin has poor or uncertain absorption when taken in supplement form versus used as a food spice.

Research does show the supplement Curcumin has the potential to interact with blood thinning agents, NSAIDS (i.e. Motrin/Advil) and prescription medications metabolized by the liver.  In addition, this supplement is not recommended for those with liver or gallbladder disease.

Still to this day in India turmeric is referred to as “holy powder” for its health benefits.  Since turmeric has anti-inflammatory properties, why not include it in your regular diet? However, instead of grabbing a supplement, reach inside your spice cabinet and create a tasty recipe using turmeric or curry, which has the potential to benefit your health and possibly lower risk of Alzheimer’s and cancer.  That sure beats visiting a medicine doctor.

Last month a topic of discussion at the American Diabetes Association conference was children and heart disease.  Artery autopsies done on children who had fatal accidents showed the presence of fatty streaks.

Although I had knowledge of this phenomenon it still came as a shock to fathom children having fatty streaks and blockages in the arteries.  Isn’t that only supposed to happen to older adults?

I hear from parents – “they only wants pizza, burgers and fries.”  Who’s controlling the food?  When I was growing up I ate what was served without too many questions.  If I did not like a particular item served I was encouraged to have a few “no thank you” bites.  I know things have changed but I have to wonder if the current philosophy of feeding our youth needs an adjustment.

This week’s LA times article “A Sticking Issue with Kids” discusses the Center for Disease Control report which showed that cholesterol abnormalities – i.e. high bad cholesterol and low good cholesterol values – are far more common in children than in past times, particularly overweight children.  The article questioned whether we should start checking children’s cholesterol panels.  Pediatrician’s views are mixed.

Where does the solution start?  Will pediatricians start prescribing statin drugs for children to fix the problem of unbalanced eating and inactivity like we do in adults?

When do we start looking at the cause rather than the symptom?  Taking control of our youth’s health and happiness is having time for family dinners, cooking at home, and making meals from whole unprocessed foods.  Our bodies are happy to get rid of bad cholesterol and avoid making plaque when we feed them “clean’ foods in their natural forms.  Running around on the weekend with our kids and engaging them in outdoor activities is essential to keeping their little arteries supple and healthy.

It’s not too late to start now.  Even if your child is overweight and has high cholesterol studies show a turnaround is possible in as little as 2 weeks.  The body responds quickly to dietary changes.  Act now and start those “no thank you” bites of healthy foods.  Remember, it’s prevention not prescription.

One of the questions I hear most frequently in lectures and with my clients is “which oil should I be cooking with?”  This question turns out to be more complicated than you would think.  Years ago, most of the population ate butter. Then, experts reported that vegetable oils were a much healthier alternative, and many people switched to corn or vegetable oils.  This advice did not turn out to be true since weight, heart disease and diabetes have been rapidly increasingly.  The good news is that research on which oils are healthy has become clearer during the last year.  Choosing which oil to buy depends on the purpose – i.e. cooking versus using in salad dressing or baking. 

Olive oil is a monounsaturated fat that is useful in making salad dressing and marinating vegetables and meats.  If you are cooking with olive oil, only use it in recipes where the smoke point is between 200 to less than 400 degrees.  The best olive oil is cold-pressed, extra virgin since it contains both the good monounsaturated fat and powerful antioxidants known as Polyphenols.  This type of olive oil means the olives are processed within 24 hours of picking, which aids in retaining a higher quality product.  It is slightly cloudy due to the small particles of olive flesh in the oil.  Olive oil which is clear still contains the monounsaturated fat but is devoid of the Polyphenols.  “Lite” olive oil is a marketing gimmick that just refers to a milder flavor, rather than less fat and calories.

Coconut oil is a safe oil to cook with at high temperatures since it is saturated and the molecules cannot be damaged.  Organic coconut oil is best since it is free of pesticides.  Avoid high omega-6 oils such as safflower, sunflower, corn, and soybean oil. 

Canola oil, although high in omega-3 fatty acids, has a high sulfur content and can quickly become rancid.  It has been reported that baked goods made with canola oil can quickly develop mold. Due to the high level of rancidity, canola oil must be deodorized, and this process can increase the amount of trans fatty acids in canola oil, which negates the benefits of the omega-3 fatty acids that are present.  In addition, since canola is the result of irradiated seeds from the oilseed rape, 80-85 percent of canola is GMO (genetically modified organism) and best to avoid.

The best oils to buy are cold pressed extra virgin olive oil, organic coconut oil, and to a lesser extent flax seed oil and other nut oils such as walnut, peanut or grapeseed.

Two buzz words in nutrition and supplement research – quercetin and resveratrol.  What is the lowdown?  Should you take a supplement or just eat the food?

The simple answer is unclear.  Quercetin is a type of antioxidant known as a polyphenol.  Two categories of polyphenols are flavonoids and non-flavonoids.  A flavonoid is a pigment in food that has important health benefits.  Besides antioxidant activity, flavonoids are known for their prevention of heart disease and cancer, since they can lower cholesterol levels and inflammation in the body.

Quercetin is found in the greatest concentration in apple skins, but can also be found in red grapes, green tea and buckwheat.  Several positive studies were done with animals, including one in which quercetin supplemented mice were less likely to get the flu.  Human studies to date have been inconclusive on supplement usage.

Resveratrol is a non-flavonoid polyphenol that is found in grapes and grape skins.  It has strong anti-inflammatory effects in the body which can be helpful in the prevention of atherosclerosis.  Wine drinkers tout they are getting their resveratrol for the day.  However, you would have to consume 180 glasses of wine per day to obtain the amount necessary for health.  Studies are also inconclusive on supplement usage.  More importantly, many supplements tested do not contain the amount of resveratrol that is stated on the bottle.

Bottom line?  Until more research is in, eat apples and grapes, and drink green tea.  You will be receiving the quercetin and resveratrol your body can readily use and absorb and there is nothing to lose except bad health…and maybe the flu.

Last week’s blog regarding the New York Times article citing bypass surgery for children set off a raw nerve with readers.  Childhood obesity is multi-factorial but can it actually start with the first bottle of formula?

One ingredient to avoid on food labels is high fructose corn syrup or corn syrup.  Many infant formulas list this ingredient as second or third.  Dr. Robert Lustig, a pediatric endocrinologist at UCSF, gave an elaborate lecture on u-tube regarding the consequences of sugar and high fructose corn syrup.  He blew the whistle on the obesity epidemic starting with corn syrup in infant formulas.

Many women are unable to breastfeed for multiple reasons.  A few years ago some of my female clients turned to me for help in selecting an appropriate formula.  After spending many hours online and in the store I only found one or two formulas that came close to something I would recommend.

Besides corn syrup in cow-based formulas there even more issues with soy formulas since they are made with soy protein isolate (SPI).  To make SPI, manufactures take soybeans that are about 90 percent genetically modified, and mix them with a solution to remove the fiber.  This fiber-less soybean is then dried at high temperatures which denature the quality of the protein.  In addition, soy acts like a pseudo-estrogen in the body and it is estimated that an infant fed soy formula receives the amount of estrogen per day in at least 5 birth control pills – not such a great start to life.

Formula makers are now supplementing with the important omega-3 fats DHA and EPA to help the baby’s brain development.  However, the sources of these essential fats can be poor or contain inadequate amounts.

It might be time to demand infant formula makers to make a change-maybe the first step needed in Michelle Obama's campaign against childhood obesity.  Women receive cases of these formulas free in the hospital to encourage usage, unknowingly feeding their babies something which could influence their future health.  It’s time we started preventing obesity from the beginning – rather than prescriptions later.

One of the sweetest parts of writing A Recipe for Life had to be the section on dark chocolate and all its incredible health benefits.  This mornings beauty section of the Los Angeles Times has an interesting read on dark chocolate's health AND beauty benefits so of course I had to get the scoop.

Dr. Steven Pratt, a physician at Scripps Memorial Hospital in La Jolla, discusses why dark chocolate is a super food.  Dark chocolate contains nutrients known as flavonoids that can actually relax your blood vessels which lower blood pressure and in turn lower your risk of a heart attack.  Sounds like a no brainer to me.  Eat dark chocolate and lower your risk of heart disease?  One catch is that is it doesn't take all that much to achieve the effect - only a couple squares of greater than 70% cocoa a few times a week - not a license for eating a whole chocolate bar every day.

The article goes on explain how eating small amounts of dark chocolate provides your body with natural essential fatty acids and "skin-friendly" minerals that can help with decreasing wrinkles and sun damage.  It also contains a compound called theobromine which can increase circulation in the skin and reduce cellulite.  Sounds a little too good to be true, but what do you have to lose?  I think having one or two squares a day of dark chocolate gives me the little treat I need each day.  I can forego the extra bread at a restaurant or the cookie at the office as long as I can come home to a good cup of tea and my 2 squares of dark chocolate...and...I'm keeping the doctor away.

Since our book A Recipe for Life by the Doctor’s Dietitian came out my clients have been asking about the process we took with creating recipes.

Successful recipes are simple and easy to prepare besides having a great taste and nutritional profile.

Over the next few months some blogs will be dedicated to the process of creating recipes that are not only healthy and tasty but easy on the wallet.  I welcome your thoughts and ideas along the way.

A client came in for her appointment last week raving about the White Chicken Chili she looks forward to and savors once a year at a friend’s holiday gathering.  We have 2 chili recipes in the book – a vegetarian and spicy meat chili but I was intrigued by another type of chili.

How do you come up with a white chili that is not high fat and has a good protein to carbohydrate ratio for those with insulin resistance and/or diabetes?  I discussed the idea with Jeffrey that night and he researched some recipes and came up with a possible list of ingredients.

Our process is for Jeffrey to come up with an idea and I alter the ingredients based on health and nutrition.  I will then put the recipe into my analysis program and tweak it based on my findings.  If the recipe is an entrée it has to contain enough protein for blood glucose balance, a healthy source of reasonable amounts of carbohydrate and some fat for flavor and balance.  Having fiber and keeping the sodium intake to a minimum is important as well.

This recipe has a little more carbohydrate and less protein than I would usually want, but lots of fiber and flavor.  I wanted to increase the chicken and decrease the beans but as we are working on saving money and time, it is easier to measure 1 pound of beans and 1 pound of chicken than other amounts.

Our final result is a White Chicken Chili with a mild, spicy initial bite developing into a light flavorful ending. Bon appétit!

White Chicken Chili

Servings:       10 one-cup servings

Prep Time:    30 mins (not including bean soak 4 hours)

Cook Time:   90-120 mins

Ingredients:

1 pound-2 ½ cups white/pinto beans

32 ounces low sodium chicken broth

1 tablespoon butter

1 tablespoon olive oil

1 large yellow onion, chopped

2 cloves minced garlic

1 tablespoon oregano

1 tablespoon cumin

½ tsp chili powder

8 ounce can chopped green chilies

1 cup water

1 pound chicken breast, chopped

10 tablespoons white grass-fed cheddar cheese (topping)

Preparation:

Soak beans for a minimum of 4 hours with at least one change of the water.

Rinse and drain beans.  Place beans and chicken stock in a large pot and bring to a boil.

In a large, heavy skillet sauté chopped onion in butter and oil until golden brown, about 2-4 minutes.  Add in garlic and dry spices and stir for an additional 1-2 minutes.  Add in green chilies and if necessary deglaze the pan with some additional water.

Add chicken to onion mixture and brown, 4-6 minutes.  Add chicken/onion mixture to beans and add remaining water.  Bring to boil, and reduce to simmer, covering the pot.  If chili becomes too thick, continue to add small portions of water

Continue simmering for 1 ½ to 2 hours or until desired doneness. 

Portion into 1 cup servings and top each with 1 tablespoon of cheese.

Per Serving

Calories                                    325

Protein                             27 grams

Total Carbohydrates        33 grams

Total Fat                            8 grams

Fiber                                 12 grams

Sodium                               275 mg.

Our food supply is toxic; for convenience we feed our children processed packaged foods; we don’t have time to cook, and by the way – let’s operate to fix this problem.

Our nation needs a big wake-up call.  First Lady Michelle Obama launched her anti-obesity campaign for children and it comes not a moment too soon.  How can we help the children in America live a long healthy life?

There needs to be a direct correlation with the government incorporating policies to subsidize fruits and vegetables (versus corn that causes the problem) along with parents who model that practice in the home environment.

A great first step is addressing how you shop.  Shopping around the perimeter of grocery store allows you to buy foods that are fresh and wholesome, rather than processed and refined.  Eating real whole foods means you don’t have to read a label, since apples and broccoli are label-free. 

Foods you buy with a label should have less than 5 or 6 ingredients.  The more ingredients a food has the more processed it becomes.

Does the label contain any ingredients you can’t recognize or pronounce?  Answering this question may be a clue the food is not the healthiest choice.

Besides food choices, exercise and activity are non negotiable for children.  The American Diabetes Association encourages a minimum of 300 minutes of activity or exercise per week for health.  Currently children get 700 less activity calories per day than a decade ago – potentially a 72 pound weight gain per year. 

Studies show cooking and eating at home is a huge component combating childhood obesity.  It is up to us to provide our children healthy meals and activities to decrease their risks – otherwise we may out-live our children.  Our youth is faced with enough obstacles without having to have a major surgery.  Remember, it’s prevention not prescription.