Study finds restrictive diets and nutrition advice for elderly may not apply

Are Special Diets and Nutrition Guidelines Forever?

This post was originally written during my 2 1/2 year tenure as a blogger for Family Goes Strong. The site was deactivated on July 1, 2013, but you can read my original blog here.

STUDY FINDS RESTRICTIVE DIETS AND NUTRITION ADVICE FOR ELDERLY MAY NOT APPLY

Have you ever wondered what the upper age limit is for dietary advice? I’m not talking about headline grabbing food fads, but the diet and nutrition guidelines issued periodically by the government and health organizations that tell us what we should be eating more of and what we should eat less of to maintain health and prevent disease.

It’s something worth thinking about if you’re approaching the upper age limit for advice on nutrition.

Food intake requirements are based on several age categories for those younger than 19 years to address the special nutritional needs of growing infants, children and adolescents. The only other special categories are for pregnant and lactating women. The rest of us are lumped into three big groups for anyone 19-30, 31-50 and 51 -70 years of age.

But what about all those people living into their 80s and beyond? Could they possibly expect the same benefits from following a therapeutic diet as a 55 year old? New research suggests the answer is no. In fact, there may actually be survival benefits to being overweight or slightly obese as we age.

Be prepared to take back some of the dietary do’s and don’ts you may have issued to your aging parents.

Researchers at Penn State University and the Geisinger Healthcare System have been tracking the diet and health outcomes of more than 20,000 older people for more than a decade. The findings published in the January issue of the Journal of Nutrition Health and Aging focused on 449 individuals who were 76 years of age or older at the start of the study and followed for five years.

Using information collected in a series of 24-hour diet recalls obtained by telephone, the participants were categorized as having one of three different dietary patterns:

  • Sweets and Dairy – largest proportion of energy from baked goods, milk, sweetened coffee and tea, and dairy-based desserts, and the lowest intakes of poultry
  • Health-Conscious – higher intakes of pasta, rice, whole fruit, poultry, nuts, fish and vegetables, with lower intakes of fried vegetables, processed meats and soft drinks
  • Western – higher intakes of breads, eggs, fats, fried vegetables, alcohol and soft drinks, with the lowest intakes of milk and whole fruit

The researchers then used the subjects’ electronic medical records to identify whether they developed cardiovascular disease, diabetes, hypertension and metabolic syndrome during the five year period. They found no relationship between any of the dietary patterns and cardiovascular disease, diabetes, metabolic syndrome or mortality, but did see an increased risk of hypertension among those with the Sweets and Dairy pattern of eating.

Gordon Jensen, one of the authors and Head of Nutritional Science at Penn State University, said, “The results suggest that if you live to be this old, then there may be little to support the use of overly restrictive dietary prescriptions, especially where food intake may already be inadequate.”

This does not mean that people who have been following all the right diet rules can now abandon them. They can actually look forward to the best health outcomes of all. But for the rest of the over 70 crowd whose diets and nutrition habits have not been perfect, there may be no need to keep worrying about what you eat.

Visit donation centers to make blood bank donations during National Blood Donor Month

Blood Bank Donations Needed: Donate Now!

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can read the original blog here.

VISIT DONATION CENTERS TO MAKE BLOOD BANK DONATION DURING NATIONAL BLOOD DONOR MONTH

There’s a joke told in blood donation centers about a pick-up line a man uses to attract a pretty woman. It starts out, “Hi, I’m O-negative, so I can donate to anyone.” I can’t remember the rest of the joke, but you may be able to hear it if you donate now during National Blood Donor Month!

Blood bank donations are needed every day of the year to supply the more than 40,000 units (pints) needed. People undergoing cancer treatments, organ transplants and other medical procedures may be able to get family and friends to donate in advance for them, but who is prepared for an accident? Someone with burns over most of her body may need 20 or more pints of blood while a person in a serious automobile accident can require more than 50 pints of blood.

During the winter months, blood donations are down due to the holidays, more inclement weather keeping people at home or interfering with blood drives, and more illnesses making people unable to donate. At the same time, bad weather conditions increase the number of highway accidents and the use of portable heaters that can cause house fires.

Only 38% of the population is eligible to give blood, so it’s important that those of us who can, do. Unfortunately, less than 5% actually make blood bank donations. The most frequent donors visit donation centers 5 times a year, or once every 56 days. The unit of blood we give represents 10% of the blood in our body, but within two weeks it is completely replaced in a healthy donor.

Requirements to Donate Now:

  • At least 17 years of age, with no upper age limit. Younger people can give in some states with parental consent.
  • Weight at least 110 pounds
  • In good health on day of donation

Reasons You Can’t Donate Now:

  • Low hematocrit (see explanation below)
  • High or low blood pressure
  • Recent Body piercing or tattoo
  • Hepatitis
  • HIV/AIDS
  • Recent travel within certain countries
  • Organ or tissue transplants
  • Pregnancy
  • Sexually transmitted disease
  • Recent vaccinations
  • Chagas disease (rare disease spread by a parasite found in Latin America)

Build Up Your Blood Before You Donate

Having a low hematocrit or hemoglobin level is the most common reason for being temporarily deferred from donating, and accounts for 10% of female donors being unable to donate. The Food and Drug Administration requires a hematocrit of 38% for everyone who donates blood. For most males, a hematocrit below that level indicates they may be anemic, so they are disqualified. But females can have normal, healthy blood with a hematocrit between 36%-38%, so have to boost their level even higher in order to qualify.

To avoid a wasted trip to the donation center, take these steps before giving blood:

  • For at least 3 days before you plan to donate, include plenty of iron-rich foods in your meals. Lean beef, dark green vegetables, enriched breads and cereals, and canned or bagged beans are great choices.
  • The day of your donation drink an extra 16 ounces or more of caffeine-free and alcohol-free fluids to increase your blood volume
  • Avoid eating too much fat before your donation so it won’t interferes with your blood tests

To learn more about the risks of anemia, read here.

 

Controversy over eating too many eggs continues with recent study

Is Eating Too Many Eggs Bad For You?

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

CONTROVERSY OVER EATING TOO MANY EGGS CONTINUES WITH RECENT STUDY

If your neck got sore last week after hearing the report that eating too many eggs might be bad for your arteries, blame it on whiplash. The reemergence of bad news about good foods always leaves me feeling like I’ve been hit from behind, too.

Fortunately, there’s relief in the facts.

The Hard Boiled Truth

First, I want to disclose that I’m a big fan of eggs. Chicken eggs in the shell are a 100% natural, nutrient-dense, low cost food that are widely available and highly versatile in the culinary world. I cannot think of another food that delivers so much value for just $0.20 apiece.

I will come to the defense of eggs whenever they are under attack because I know we have a lot to lose if we let this fragile but mighty food get knocked out of our diets without good cause.

Headlines Scramble the Details

The latest study linking eggs to clogged arteries was done at Western University in Ontario, Canada and published online Monday in the journal Atherosclerosis. The headlines covering the research said eating too many egg yolks was as bad for your heart as smoking cigarettes. That really got me riled because I really don’t like tobacco products.

So I looked into the details of the study, not just the news coverage about it. Here are the facts that once again back up my defense of eggs.

  • The study was observational, not designed to prove cause and effect.
  • The subjects were people at risk for heart disease and smokers, not a random, healthy population.
  • Subjects answered questions about how many eggs they ate, smoking history, and some other lifestyle factors, but none about the rest of their diet, exercise habits, or alcohol use.
  • Plaque build-up was similar between those who ate the most egg yolks and those who smoked the most, but the egg eaters did not have higher total cholesterol and bad (LDL) cholesterol or lower good (HDL) cholesterol levels compared to those who ate fewer eggs.

Sunny Side of the Story

What this means is that the researchers did not ask enough questions to be able to explain why the people who enjoyed eggs the most had more plaque in their carotid arteries. It could be they ate their eggs with other foods high in saturated fat, like bacon and sausage, which do clog arteries. Maybe they did not eat many fruits and vegetables rich in protective antioxidants. Or it’s possible they did a poor job of estimating the number of eggs they actually ate in their lifetime. Do you know how many eggs you’ve ever eaten?

What the research did show is that eating eggs improves the overall blood cholesterol profile, but that was nowhere to be found in the headline.

My take-away is this retrospective study of 1262 people based on survey data does not outweigh the results of a prospective study done at Harvard with more than 100,000 subjects. It found no significant difference in cardiovascular risk between those consuming one egg per week and those eating an egg a day.

That means eggs will remain a regular part of my diet, how about yours?

Research finds getting regular exercise cannot protect you from the danger of sitting too much

Danger of Sitting Too Much is Getting Worse

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

RESEARCH FINDS GETTING REGULAR EXERCISE CANNOT PROTECT YOU FROM THE DANGER OF SITTING TOO MUCH

If you’re sitting while reading this, you may want to stand up. That advice goes for anything else you now do seated in a chair or on a couch. Research published this month in the Journal of the Academy of Nutrition and Dietetics placed the danger of sitting too much right up there with cigarette smoking.

Are you up out of your chair yet?

I’ve written about the “sitting disease” before, but the evidence is mounting that the hazards of sitting for long periods of time are a bigger problem than originally believed. It has even acquired a new term: Sedentarism.

What is Sedentarism and How Do You Get It?

The most important thing researchers have to say about sedentarism is that it is not the opposite of being physically active. That is what sedentary means. People who do not regularly engage in physical activityare sedentary.

Sedentarism is a condition that affects even the most committed exercisers. It occurs when you spend prolonged periods of time sitting or lying down, whether commuting, working at a desk, watchingtelevision, reading or sleeping. If that is how you spend more than half your day, you cannot escape sedentarism by meeting the recommended daily guidelines for exercise.

This unique disease of sustained inactivity is a result of the many changes in what we do at work and in our leisure time.

Since the 1950’s there has been a steady decline in jobs requiring moderate physical activity in the U.S. By 2008, more than 80% of all jobs were considered light activity or sedentary, meaning they are done while seated.

Things have gotten less physically demanding when we’re not at work, too. Washing machines, clothes dryers, frost-free refrigerators, self-cleaning ovens, dish washers and dozens of other work-saving appliances and products have lightened the load at home. The new-found free time has given us more time to sit down and watch television or search the Internet, and endure longer commutes to and from work.

The only problem is all that non-stop sitting is killing us.

What Can We Do to Avoid Sedentarism?

As I said in the beginning of this article, it helps to stand up more often. You don’t have to do jumping jacks, just get out of your chair. The goal is to build more standing time into your day to break-up the long stretches of sitting.

Some people are mounting their computers on treadmills so they can slowly walk while working. If that isn’t likely to go over too well in your cubicle, try some of these ideas.

You can stand at work:

  • Talking on the phone
  • Speaking to someone in the office/work space
  • Reading documents
  • Taking meal and drink breaks
  • During meetings
  • Waiting for appointments

You can stand more at home:

  • During television commercials
  • Text messaging
  • Following friends on Facebook
  • Waiting to pick up the kids
  • In line (at the bank, pharmacy, Dunkin Donuts) instead of using the drive-through
  • Reading mail, newspaper, school/community bulletins

If you’re still sitting, you haven’t been paying attention. This time stand up and read it again!

Use these checklists to see if you are developing diabetes

Are You Developing Diabetes?

This post was written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, but you can read the original post here.

USE THESE CHECKLISTS TO SEE IF YOU ARE DEVELOPING DIABETES

One of the biggest threats of gaining 20 pounds is the increased risk of developing diabetes. Twenty pounds is all it takes to go from a healthy body mass index (BMI) of 21 to an unhealthy one of 25. That is the point on the BMI chart when you are considered overweight.

Being overweight is a risk factor for developing type 2 diabetes in both children and adults.

Why the Disconnect Between Overweight and Diabetes?

When I was in private practice, many of my new clients who had gained 20 pounds came in saying they didn’t like the way they looked or how their clothes fit — as if that was all that was at stake. When I was writing The Wedding Dress Diet, many of the brides-to-be I talked to admitted they would probably gain 20 pounds after they got married — as if it didn’t matter.

Obviously, the connection between being overweight and diabetes had not hit home because whenever I asked anyone how they felt about getting diabetes, they shuddered. Being a little pudgy was one thing, having diabetes was quite another.

Sadly, the message still has not sunk in. Nearly 26 million Americans now have diabetes and three times that many are pre-diabetic – people with elevated blood glucose levels that are not quite high enough to be diagnosed as diabetes. That’s 75 million people who almost have diabetes!

If you or someone you know is concerned about developing diabetes, use the checklists below recognize the risks and warning signs, then get the help you need to prevent or treat it.

Who is At Risk of Developing Diabetes?

  • Overweight or obese with a BMI of 25 or higher
  • Waist circumference greater than 35 inches in men and 32 inches in women
  • Woman who had gestational diabetes or gave birth to a baby weighting more than 9 pounds
  • Low HLD cholesterol of 35 mg/dL or less
  • High triglyceride level of 250 mg/dL or more
  • High blood pressure of 140/90 mmHg or greater
  • Family history of diabetes in parents or siblings
  • Low physical activity level of exercising less than 3 times a week

Early Warning Signs of Diabetes

  • Blurry, clouded vision – once blood sugar is lowered, vision returns to normal
  • Increased thirst and hunger – not satisfied after drinking or eating
  • Frequent urination – 20 or more times a day
  • Always tired, weak, fatigued – even after sleeping since cells can’t get the energy they need
  • Sudden, unexplained weight loss –the body is breaking down muscle and fat for energy

Tests Used to Diagnose Diabetes

  • Fasting blood glucose: 126 mg/dL or greater on 2 separate tests. Blood sample is taken after not eating or drinking anything for at least 8 hours, but not more than 16 hours
  • Casual blood glucose: 200 mg/dL or greater. Blood sample used is taken at any time regardless of last meal
  • Glucose tolerance test: 200 mg/dL at the 2-hour reading. Blood glucose is tested after fasting, then a sweet liquid containing a known amount of sugar is consumed and blood glucose is tested periodically for up to two hours.
  • Glycated hemoglobin (A1C): 6.5% or greater. Used to tell blood glucose control over the previous 2-3 months.

Goals for Treating Diabetes

  • Maintain blood glucose levels as close to normal as possible with changes in diet and exercise and, if needed, medication
  • Lose at least 10% of body weight to improve symptoms, maintain a BMI of 25 or less to eliminate diabetes

Dietary Objectives for Diabetes

  • Eat meals and snack at the same times every day
  • Distribute total calories evenly among meals, don’t skip meals or eat just one or two big meals
  • Increase soluble fiber content in meals from oatmeal, oat bran, beans, lentils, barley, flax seed, nuts, apples, pears, oranges celery, and carrots.
  • Control the type of carbohydrates eaten by choosing “whole grain” breads and cereals over refined grains, raw and cooked vegetables and whole fruits instead of juice.
  • Limit the amount of carbohydrate to 45-60 grams per meal, including carbohydrates from added sugars
  • Pay attention to all of the ingredients in “sugar free” foods and those made with sugar substitutes
  • Use healthier fats and oils, such as olive and canola oil, and limit saturated fat and trans fat to reduce heart disease risk

See these related stories on diabetes.

  • Fast Eaters Have Greater Risk of Diabetes Than Slow Eaters
  • A Secret Weapon to Help Control Diabetes: Barley
  • Tired All the Time? 11 Reasons Why (Besides Lack of Sleep)
Older people have an added danger of dehydration when symptoms are misdiagnosed

Hidden Danger of Dehydration for the Elderly

OLDER PEOPLE HAVE AN ADDED DANGER OF DEHYDRATION WHEN SYMPTOMS ARE MISDIAGNOSED

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can read the post here.

Staying properly hydrated in hot weather is important for everyone, but the danger of dehydration in the elderly is of special concern. Not only do older adults become dehydrated more easily than younger people, the warning signs are often mistaken for something more serious.

Anyone who lives alone and has limited mobility is at risk of dehydration. The use of multiple medications increases the risk. Now add all those people being cared for by others who cannot communicate clearly and the count gets higher.

Why? They simply don’t drink enough. The primary causes of dehydration for the general population are vomiting, diarrhea, heavy sweating, uncontrolled or undiagnosed diabetes, infections, high fevers, and burns. But for those who can’t, won’t or don’t drink all that they should, dehydration is a dark secret.

Why Some Seniors Don’t Drink Enough

  • Fear of incontinence, especially if taking diuretics
  • Unable to get up out of a chair or bed alone
  • Too difficult or exhausting to walk to the bathroom
  • Difficulty toileting alone – undressing, sitting on commode, cleaning themself, redressing
  • Inability to get food or beverages for themselves or get enough
  • Don’t feel thirsty, especially if inactive
  • Trouble holding a glass or cup to drink for themself
  • Unable or unwilling to ask for help
  • Depression

The danger of dehydration for the elderly is heightened when the symptoms are not addressed because they are so similar to age-related dementia or senility and Alzheimer’s disease. Instead of getting the fluids and assistance with using the bathroom that they need, they may be viewed as incompetent. That is why it is important to monitor fluid intake and excretion in someone with the symptoms below before taking other steps.

Mental Signs of Dehydration

  • Headache
  • Dizziness, especially upon standing
  • Light-headedness
  • Confusion
  • Disorientation
  • Irritability
  • Forgetfulness

Physical Signs of Dehydration

  • Dry or sticky mouth
  • Thick saliva
  • Dry, inelastic skin – doesn’t relax if pinched
  • Rapid breathing
  • Increased heart rate
  • Low tear production
  • Low sweat production
  • Unexplained weight loss

Functional Signs of Dehydration

  • Muscle weakness or cramps
  • Fatigue or lethargy
  • Tired or sleepy
  • Nauseas
  • Constipated
  • Infrequent urination
  • Dark-colored urine

Both foods and beverages can provide the fluids our bodies need each day. Fruits and vegetables are very high in moisture and may be easier for some people to consume than another glass of water, juice or tea. You can also rely on flavored gelatin, pudding, yogurt, ice pops, sherbet, and soup for added fluids.

Catch up on more news about aging and hydration with these other posts:

Follow these guidelines to enjoy grilled meats safely

Is It OK to Eat Grilled Meats?

This post was written as a guest blog for Family Goes Strong. You can read the original post here.

FOLLOW THESE GUIDELINES TO ENJOY GRILLED MEATS SAFELY

Now that another barbecue season is about to begin, are you worried about the dangers of eating grilled meats? Should you panic if you mindlessly eat that severely burned hot dog the kids wouldn’t touch? Is the risk of ordering a well-done burger worse than making yours extra rare?

Like most health alerts, the issues surrounding meat cooked on the grill are a long story that has been reduced to sensationalized headlines. There is no reason to abandon this summertime ritual, but there are some things you need to know to make your cookouts healthier for everyone.

What Happens When You Grill Meat?

Protein-rich foods, like meat muscle, contain amino acids, creatine and some sugars that can react under certain conditions. Depending on the type of meat (it could be beef, pork, poultry or fish) and the cooking time (longer is more problematic), temperature (usually over 300 degrees F) and method being used (grill or stove-top frying pan), a chemical reaction can occur that causes the formation of compounds called heterocyclic amines (HCAs).

Other compounds called polycyclic aromatic hydrocarbons (PAHs) are found in the flames that flare up when fats and juices from meats being cooked over an open grill drip into the fire. These PAHs can adhere to the surface of the foods being cooked above the flames. They are also formed during food preparation processes, such as smoking of meats, and are found in cigarette smoke and exhaust fumes.

What Does the Research Say About Eating Grilled Meats?

Now here comes the troubling part. Research found laboratory animals exposed to large amounts of HCAs and PAHs developed cancer. In the studies rodent diets were supplemented with very high levels to HCAs and PAHs – thousands of times greater than a person would consume in a normal diet. Also worth noting is the lab animals were not actually fed grilled meats because it is too difficult to measure the exact amount of these compounds in them. The rat chow was fortified with the stuff.

No population studies – the kind that look at a group of individuals who share common traits – have established a definitive link between exposure to HCAs and PAHs from cooked meats and cancer in humans. However, epidemiological studies have found an association. These studies gather information from large groups of people who have nothing in common and look for common traits. What they found was the people who reported eating the most well-done, fried or barbecued meats had the greatest risk of colorectal, pancreatic, and prostate cancer. That is not evidence of causation. Many other factors could have increased their risk, including environmental exposure to PAHs from air pollution.

What Are the Guidelines for Eating Grilled Meats?

The World Cancer Research Fund and American Institute for Cancer Research issued a report in 2007 that recommended limiting the consumption of red and processed meats, including smoked meats, but made no recommendations about the HCA and PAH levels in meat. There are currently no federal guidelines on the consumption of grilled meats or HCAs and PAHs.

Advice for Grilling Meats

  • Raise the grill rack away from the heat source
  • Wait until flames die down so they won’t burn meat surfaces
  • Place aluminum foil on the grill to reduce exposure to flames
  • Cut meat into smaller pieces and skewer so it cooks faster
  • Select thinner steaks and chops that will cook faster
  • Buy leaner cuts of meat so there is less fat to cause flare ups
  • Precook meats to reduce the cooking time on the grill
  • Marinate to help lower HCA production
  • Turn meat frequently so surfaces don’t char
  • Scrape off charred areas
Eating too fast is an independent risk factor for type 2 diabetes

Fast Eaters Have Greater Risk of Diabetes Than Slow Eaters

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you read the blog here.

EATING TOO FAST WAS FOUND TO BE AN INDEPENDENT RISK FACTOR FOR TYPE 2 DIABETES

If you are among the fast eaters at the table you are at risk of becoming overweight. Part of the problem is you are first in line for seconds while everyone else is still nibbling on their first portion. Another is you miss the signal that tells you when you’ve had enough because your plate is empty before the food reaches your stomach and has a chance to send it to your brain.

Now research indicates fast eaters have 2.5-times higher risk of developing type 2 diabetes compared to slow eaters.

Eating Too Fast is an Independent Risk Factor

We already know being overweight or obese increases your odds of developing diabetes, but this study found eating too fast was an independent indicator of who might get diabetes.

The findings were presented at the joint International Congress of Endocrinology and European Congress of Endocrinology in Florence, Italy earlier this month. The researchers collected information about possible diabetes risk factors from 234 people with newly diagnosed type 2 diabetes and 468 people who did not have the disease. After adjusting the data for known risk factors, such as family history, body mass index, and waist circumference, the researchers found a more than two-fold increase in the risk of type 2 diabetes associated with those who reported faster eating habits.

The scientists could not explain why wolfing down your food was linked to type 2 diabetes, but that doesn’t mean you can’t take action while waiting for one. The importance of this study is that it identifies a risk factor that people can modify, while genetic predisposition to diabetes and some environmental factors that contribute to it are beyond our control.

Ways to Slow Down How Fast Your Eat

  • Eat with chop sticks (if not your usual utensil)
  • Use your non-dominant hand
  • Use a cocktail fork or other small cutlery
  • Wear a dental appliance (like a retainer)
  • Pace yourself with a slow eater
  • Put your fork or hand-held food down between bites
  • Count how long you chew each mouthful (shoot for at least 20 chews)
  • Swallow everything in your mouth before taking another bite
  • Don’t take seconds until everyone at the table has finished eating, or wait at least 10 minutes
  • Take a sip of water between each bite of food
  • Cut your food into very small pieces
  • Play background music with a slow tempo
  • Turn off any other distractions, like TV, so you can pay attention to your food

Engage in conversation, but never with food in your mouth

There are many ways to substitute whole grains for refined grains

15 Stealth Health Tips With Whole Grains

This blog was written as a guest post for the Bell Institute for Nutrition and health. You can read the original post here.

The message to eat more whole grains is now a familiar piece of nutrition advice to most Americans. It has been reinforced in each update of the Dietary Guidelines for Americans since the year 2000 and is prominently featured in the new MyPlate food plan. The food industry has also done its part by offering a wide assortment of whole grains choices to cover everything from cereals to snacks and side dishes.

The only challenge left is helping consumers incorporate more of these whole grain foods into their everyday meals.

The top 3 reasons I have heard from my clients for not eating enough whole grains are:

  • They’re not always available when eating out
  • I don’t always have a grain food with my meals
  • I don’t like the taste and texture of whole grains foods

While nothing could be easier than eating a serving of whole grain cereal for breakfast, a sandwich made on whole wheat bread for lunch and a stir fry over brown rice for dinner to get 4-5 servings of whole grains in one day, that menu doesn’t work every day of the week.

For those situations, some stealth solutions are needed. That means making simple substitutions in how food is prepared at home to make whole grains available at every meal and snack to increase their consumption throughout the week. What makes them stealth solutions is that they look and taste as good as the foods they’re replacing and can save money, too!

15 Stealth Solutions to Boost Whole Grain Intake

  1. Cube whole wheat or rye bread, brush with olive oil, season, and bake for crunchy croutons
  2. Crumble stale cornbread to make a country-style poultry stuffing
  3. Save whole wheat bread crusts and ends in the freezer, then use to make bread crumbs
  4. Slice day-old whole wheat baguettes, spray with olive oil, and bake for use with hummus and other spreads
  5. Prepare individualized pizzas using whole wheat pitas as the crust
  6. Cut corn tortillas into 6 pieces and crisp in a hot oven to enjoy with salsa
  7. Replace bread crumbs with rolled oats in meatloaf and meatballs
  8. Crush leftover whole grain cereal flakes and nuggets to stir into muffin batters instead of some flour or nuts
  9. Combine whole grain pretzel and cracker crumbs to use as a coating for fish and poultry
  10. Use white whole wheat bread to make French toast, and make extra to freeze
  11. Stretch tuna and chicken salad by adding some chilled brown rice
  12. Create a mixed-grain pilaf using brown rice, barley, and wild rice
  13. Use whole wheat couscous in place of noodles in soups
  14. Make risotto from barley instead of short-grained round rice for its creamy, chewy texture
  15. Mix cornmeal or oat flour into pancake batter for added flavor

Reflections on Obesity and the Weight of the Nation

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

A REGISTERED DIETITIAN’S VIEW OF OBESITY CONTRASTS WITH HBO’S WEIGHT OF THE NATION

While awaiting the heavily promoted premier of the HBO documentary, Weight of the Nation, I took the time to reflect on what I have learned about obesity in my 35 years of experience treating people who are overweight or obese. It just so happens my career spans the same trajectory as the epidemic, but I’m pretty sure I am not to blame!

Much has changed in this country since the mid-1970’s when obesity rates began to soar, and it all matters. But it is also true that no one thing is more important than any other in bringing about this unprecedented weight gain among Americans of every race, class and region.

I cannot offer all the mind-numbing statistics, frightening graphics, and challenging expert opinions of a high-tech television production, but I can tell you some things that need to be said.

What Obesity Is Not

All obesity is not same. Every person who reaches the benchmark to be classified as obese got there in his or her own way. It’s the result of a complex interplay of personal biology, environment, and lifestyle, where no two situations are exactly the same because no two people are exactly the same. This becomes even more apparent as the epidemic spreads around the world.

Obesity is not curable. There are many different factors that play a causal role in developing obesity and there no cure for it. Once you become obese, you must spend the rest of your life treating it or risk becoming even fatter or dying of the chronic diseases that accompany it.

 

Obesity is not easy to diagnose. Weighing a person and measuring their height is easy. Using those figures to calculate body mass index (BMI) is also easy. But deciding if someone is obese based on their BMI is not. More sophisticated measurements are needed to determine what the percentage of fat is in the body and where it is located to fully understand whether someone is at risk due to their body size and composition.

 

Obesity is not easy to prevent or treat. The best advice medical science has to offer as a means to prevent obesity is to maintain a state of “energy balance.” That advice is difficult to follow. It requires knowing precisely how many calories you consume every day (over a lifetime) and how much energy you expend every day to offset them. These are intangible values. Once you become obese, you are expected to create an energy imbalance by expending more calories than you take in. Only at this point, your body has a whole new way of dealing with energy that defies the mathematics of using calorie control to achieve weight control.

Obesity is not a plague. Obesity spread very quickly in the last three decades, but it is not a scourge that must be routed out by any means possible. Drastic measures have been proposed to “fix” the way we grow, distribute, and sell food in this country, while the obese have been scrutinized, marginalized, and penalized for their weight. In the panic to find a solution we have lost sight of the fact individuals become obese and it is individuals who need help dealing with it.

I hope I can look back 35 years from now and reflect on all that we learned about obesity to lift this weight from our nation.