Thirsty Thoughts

I’m sitting here drinking my morning coffee. I’m also sitting here looking at the following diagram. 

The image brings about two separate thoughts.

First Thought:

I am a lover of all coffeehouses. Including the chic, clean Starbucks’ that have capitalized our world. All 5mill of them.

Not to be confused with 5mL-clearly, that’s only 1/6^th the size of one fluid ounce OR 1/183.2^nd the size of the TRENTA!

I just don’t know how coffeehouses became the suburban McDonalds. Only with far less judgment.

Not taking into consideration this new size, a Venti Cinnamon Dolce Crème Frappuccino Blended Beverage (made with whole milk and whipped cream) is 450kcal with 11g of saturated fat. The kind of fat you don’t want to saturate your diet with. Take that down to their smallest 12oz size, still trumping the 8oz (1 cup) portion, and you almost cut calories and saturated fat in half.

Portion recognition is key here.

Second Thought:

I am reminded of a conversation I had with a friend over coffee. Actually he was drinking beer and I was drinking decaf and Baileys while sitting at a bar. My recall of the conversation went as follows (although my recollection is subject to mere decaf):

Me:…well if someone cannot eat orally due to injury, disease, unresponsiveness, or whatnot they are fed through a tube. And there are different types of tubes and formulas depending on where you’re feeding someone in their body.

Friend: So like, you feed into the stomach through a tube?

M: Yea, or like sometimes you feed straight into their vein (TPN) and the food/formula has to be in the most elemental form since you surpass the stomach and intestines which digests food. (ie: amino acids instead of intact protein).

F: So wait, where does it go?

M: In your vein. And then you’ve received nutrition.

F: But like how have you gotten nutrition? How are you full?

M: (This is where my epiphany on how differently we thought about nutrition occurred) Well your cells take in the food and your organs utilize the nutrition. And if you overfeed, your cells store excess fat in adipose tissue making you fatter.

F: (baffled) I thought your stomach got fat because you put food into it and it sat there until you pooped.

The conversation continued but the shock never stopped. For either of us.

Yes, 916mL of fluid is a lot but liquids do not just hang out in a stomach all day. Your stomach moves liquids/food into the small intestines where absorption can occur. And the more liquefied and broken down the components, the faster this process occurs. So sure it is a lot of fluid, certainly 3.81 servings of the recommended 1 cup portion, but it’s not necessarily the problem until you throw refined sugar, saturated fat, and copious amounts of caffeine into that 916mL that creates an absorption worthy problem. 

Not to mention, scarily caffeinated suburbanites running around.

Stop Acting like a Big Baby, Already.

It interests me that people throw money at “diet pills” not dietitians-not terribly surprising considering the promise of instant pound shedding products. People think of dietitians as “Food Police” but then choose an HCG + 500 calorie a day diet? Straight confusing.

And so is one’s body.

A body is an incredibly smart machine. It adapts to your needs and helps you fight disease. I mean, it creates life. A terrifically complicated process. It’s not like women desire the side effects of pregnancy when they aren’t pregnant…so why do some want to “fool” their machine into thinking otherwise? And men, you too?

If you are unaware, HCG (Human Chorionic Gonadotropin) is a hormone produced by the placenta during pregnancy. It helps ensure that the fetus receives enough nutrients to grow and develop normally. I recall doctors recommending increased nutrition intake and weight gain when HCG is present in a woman’s body. 

The 26 day diet kit from hcgdiet.com is $250 when combined with a calorie restriction diet. Meaning, you’re out $250 dollars, are hungry, and still haven’t invested money into long term nutrition education…but remember, it WORKS!! And saves you so much money on food that it’s kind of like a FREE diet!!

How about this: EFFECTIVE NUTRITION COUNSELING? Does that help? There's nothing wrong with a body until you confuse the machine-why not clear a mind?

Food and Drug Administration Officials claim this heavily promoted weight-loss product is fraudulent and illegal. And, Samuel Klein of Washington University School of Medicine in St. Louis states that "data from most randomized controlled trials show that HCG is no better than placebo in achieving weight loss or reducing hunger” (USA Today).

That’s placebo not placenta.

It seems the same people who try and alter their machine by using HCG are also those altering their bodies with crappy food (aka weight gain). Most likely the people who order pizza and fast food. Dare I say, "quick fix" types.

I wonder how long these quick fix types restrict their calories to 500/day, take HCG and believe it's blocking hunger wonder powers. Of course appetites are suppressed with a slowed metabolism and muscle wasting (our metabolic furnaces).

It seems there is a lot more belief in fraudulence than the belief that a dietitian possesses any real knowledge about nutritional science. Is it because dietitians aren’t speaking up or are they silent because it would be incorrect to generalize nutrition needs to everyone?

Either way, I can honestly say that 500 kcal a day is inappropriate for any healthy person. Except for maybe a healthy person at “birth to one week” of life which requires 8-12 bottle/breast feedings of 30-90 ml per serving each day equating to 400 kcal on average. Look at that. Just 100 kcal less than the alleged overweight adult HCG user. Tell me how that makes sense. Tricking your machine into pregnancy does not mean eating like a one week old.

You can’t tell me that these people who have “tried every diet out there to lose weight without success” have actually spent their money wisely on individualized nutrition education, counseling, and coaching from a registered dietitian. And another thing, stop crying and whining, that’s left to those who are truly infants and pregnant.

The Strong Economics in Reinforcement

Positive vs. negative reinforcement. which holds more “strength?”

Personally, negative reinforcement can be so defeating. Sure it works great for some things, like the old “don’t put your hand on the stove” when you’re 4 years old, or in my case, “don’t lick the birthday candles when they still have wax running down them…” Completely true and traumatizing story. I never again brought my mouth to fire preemptively. It was a sad day when I crossed ‘Fire Blowing Lady in the circus’ off my Prospective Careers Choices list-did I forget to add that in my ‘Icing at the Top’ blog?

But in all seriousness, I tend to work a lot harder when I feel like I’m doing well at something or receive recognition. When those who don’t work out start exercising they experience both negative and positive reinforcement. The next day they swing their legs to the side of their bed and attempt to stand up like a stiff plank (insert image of Grandpa Joe from Charlie and the Chocolate Factory) while pretty much crying as they waddle to the mirror…this is considered Negative Reinforcement. Fire burning muscles are not far from the 4 year old stove story. That thought of “Why on earth would I do this to myself again?” comes into their mind and then they look in the mirror. You know the one, shirt half way up on their body, standing to the side, shoulders back, head cocked…and here is where positive reinforcement comes in. Also sometimes a fist pump or two. 

Speeding when there is no police around is fine and dandy but getting a fine from speeding is not so dandy. So what do we respond better to? Is it personal or universal? I feel Econ 103 creeping up in the back of my brain: Cost vs. Benefit Ratio Curve circa sophomore year of college. Certain weight management programs are funded by negative reinforcement. You’re charged a fine if you don’t lose a pound at each weekly weigh in. These programs have strong reinforcements, unless participants gain lean body mass and tip the scale positively and get charged (negatively) but that’s a whole other blog. 

The idea behind Gym-Pact is to keep members committed to their workouts by charging $10/day for each missed workout planned. This could either be the most expensive gym membership I’ve ever heard of or the cheapest..? When I brought this up to a certain police officer (the dear) his response was “why not give members free work out gear or gym perks for showing up to their scheduled workouts instead?” 

I like this thought of positive reinforcement. When counseling, clients are often happier and more successful when I’m proud of their weight loss accomplishment. But I wonder, when it comes to Gym-Pact, who is profiting more in their scenario: The gym owners or the members? I wonder if the business plan, developed by Harvard grads who were inspired by behavioral economics, is really the business of healthy-committed members or simply business. 
Maybe a certain kind of person does respond better to negative reinforcement or maybe the member who enrolls is taking full advantage of "taking care of business" and changing negativity into positivity-on their own cost vs. benefit ratio curve. 

No More Childish Games

Dun dun dun dun dundundundun dun dun dun dun daaa daaa. Too bad I don’t have an audio feature on this thing because you’d know this exact tune. It’s what streamed through my head as I intensely watched my toaster today. Nothing’s scarier than zoning out in your kitchen, yet to have fulfilled the morning caffeine ritual, only to be jolted to life by the jack-in-the-box-toaster-popping situation. Am I alone here?

It got me thinking about everything from easy bake ovens to kids’ nutrition. As a little girl my parents bought me toys such as baby dolls and Fischer Price Kitchen Sets. It was a teaching method I suppose. It’s like the child version of the mandated high school class called Consumer Education. I was in love with the kitchen set. 

As I got older, unbeknown to my mother, I dragged strainers and pans out to our backyard sandbox to host my very own fabulous cooking show to the imaginary audience. (I wish the [applause] audio was working for me back then...too) 

And a little older, I started helping my mom peel potatoes and make banana bread. AKA licking the beaters.

I distinctly remember the day when my best friend’s mom walked into her house only to witness two 4^th graders making pancakes in her kitchen, unsupervised. I had no idea what the “F” word was before that day. And I didn’t understand the need for that word. I mean, what’s so wrong with using the stove unattended. Clearly, I felt like it was commonplace.

The presence of food developed into my interest in food. My Interest in food developed into my awareness of nutrition- instilled by the mere presence of food and food preparation. During my nutrition educations, I was amazed to discover that 4^th graders in inner-city St. Louis schools believed food came from McDonalds or the grocery store. They had no concept of tomato plants or licking beaters, for that matter. 

I am, of course, pro females in the work place. Clearly. But I am also pro-getting back to basics. With women in the workforce begins a new era of convenience foods and with convenience foods comes diabetes and heart disease. Many concerned moms (and dads!) do express difficulty feeding their children home cooked meals. The answer is presence. Forcing a child to eat vegetables is threatening. The child will resist. However, placing healthy foods on the table or on the child’s plate without forcing them to eat these foods promotes presence = awareness. Eventually, after enough encounters, the child will try the food. 

Parents often hide healthy foods in unhealthy foods to “trick” their children into adequate nutrition. Although this is good for nutrition, it confirms the child’s belief that “healthy foods are icky foods." These blank slates are not afraid of the vegetables until you reward them with candy and hide cauliflower in their mashed potatoes. Exposure is key.

Junk food ads are like the manufacturers and marketers way of dietary exposure. The U.N. health agency plans to discuss clamping down on junk food marketing to children when they meet in New York in September. Maybe it was my upbringing or maybe it was my upbringing in Chicago, where Jack-and-the-Boxes are nonexistent, but when I’m scared of the toaster pop I don’t think of the fast food chain. Just the terrifying toy-and that, my friends, is why I stuck with the Fischer Price Kitchen Set. 

Outcome of my Interview with Sean Kelly

With New Year's Resolutions, Mayor Leads By Example

 

For resident looking to shape up and slim down, they need to look no further than to Rock Hill's mayor.

By Sean Kelly

Rock Hill Mayor Daniel DiPlacido had a problem.

It was a common problem, and one many Americans become aware of every New Year’s Day: he wasn’t in the sort of shape he wanted to be.

“Ironically, it was my profession of physical therapist that caused me to veer off course with my own personal fitness,” DiPlacido said.

The mayor accepted a very demanding position as a therapist in a sports medicine clinic that required 10-12 hour days minimum on a regular basis.

"I was so tired when I got home that I frequently didn’t have the energy to even make supper, much less head for the gym for a workout," DiPlacido said. "That job lasted for two years, but my absence from the gym lasted until this past summer, nearly ten years.”

This year, DiPlacido re-engaged with the idea of personal fitness with a vengeance, losing 52 pounds in 12 weeks.  “I exercised, and still do, every day - a good brisk cardiovascular workout on (an elliptical machine) for at least 35 minutes.”

Obesity is a significant problem in the United States, according to statistics from the Center for Disease Control. As of 2009, 24.5 percent of people in the state of Missouri are obese, with an additional portion being overweight.  Obesity increases the risk of cardiovascular and other health problems and can shorten a person's lifespan.

In addition to burning calories, people should be conscious of what they're putting into their bodies, according to Margaret Murphy, a registered and licensed dietitian who is certified by the American College of Sports Medicine as a health fitness specialist with a pending Masters in Science from Saint Louis University.

“Just like a checkbook, food diaries are good tools to help people budget their eating habits,” Murphy said.

A helpful food diary, according to Murphy, has the type of food, the amount eaten, the time the food was eaten, where, if you were alone or with someone, if you were doing another activity while eating, the reason you ate, your mood and if you planned the food or not.

“Some of these questions can help you determine overall trends that are sabotaging your healthy eating plans,” Murphy said, “For example, you may find out that you’re eating far more alone at your desk when you’re stressed out than you thought. Then you have a better way to target the behavior and set goals to change that particular pattern.”

DiPlacido agrees that overeating is a significant problem in American society.

“With our huge meal servings, our comfort foods, our snack foods and the popularity of fast foods and the all-you-can-eat buffets, (overeating) was a real problem for me," the mayor said, adding that it's more of a challenge to eat healthfully than it is to work out every day.

Once you’ve started monitoring your eating, the next step is to plan ahead.

“There are tons of little hints and tricks to reduce calories, but the main suggestions for lifestyle changes are to do more of your own food preparation and plan out your meals in advance," Murphy said. "With these two suggestions you can avoid hunger while meeting your goals.”

Preplanned, healthy meals and snacks will help you stay on track without using convenience and hunger to guide food choices, according to Murphy.

“If you’re committed to losing weight, it is important to take the time to commit to packing lunches, grocery shopping or batch cooking and freezing. You can then portion out foods for the week and know where you stand."

The important thing, is to think of the value of your health and your goals instead of the "value meal," Murphy said, adding that you should put more valuable foods into meals. 

“Once you start losing weight, it becomes fun,” DiPlacido said.  “On the one hand it was a very difficult thing to do, but on the other hand, I was surprised how easy it was once I got started.”

 

Digital Short: "I Will Do Whatever You Say"

Click Below to view this blog

Movie: I Will Do Whatever You Say

Synopsis: The motivation to change behaviors for realistic goals is side tracked by immediate gratification of an unrealistic desire. 

Characters: An RD wearing a nurses hat (c'mon there are only so many characters to choose from that could represent a healthcare professional) and a client.

Director: mcmurph
Created: January 6, Twenty11
Producer: Xtranormal

Adding Variety to Your Diet (From 8 to infinity, which diet holds more weight?)

Posted originally on TribLocal.com

While we welcome 2009 and perhaps a resolution or two to eat healthier and lose weight, marketing professionals have descended upon us with a plethora of commercials touting the amazing effects of everything from weight loss supplements to free gym memberships.

My interest in nutrition back in high school naturally led me to a career as a registered dietitian. It also led me from reading unaccredited magazine articles and listening to poor media messages to learning far more about clinical practice, food service management and health promotion for a wide range of diseased patients, age ranges and cultural preferences than I would ever have guessed.

All I knew in my high school days was that a registered dietitian could help me gain a competitive edge in gymnastics or at the least, look slammin’ in a two piece at Centennial Beach. As I engaged in the latest diet news from my “credible” tabloid of choice most likely with one hand on a mocha whole milk double whip frappuccino, hold the whipped cream though, I found a diet that struck my fancy. It was The Only Eat Eight Items a Day of Any Kind of Food Diet.

Bingo. If I limited myself to just eight foods, how couldn’t I look lean and lovely by the time spring break arrived? Not that my March high school trip to Paris had me baring my midriff…so I decided to give it a go just to see the outcome. Needless to say the results weren’t impressive.

There are so many things wrong with this diet but of that long list that now runs through my dietetic intern head, I came upon four main problems. First, what are the portion sizes of these so-called eight foods? Secondly, how is one satisfied with only eight foods? Thirdly, how is health improved when you opt out of several varieties of fruits, vegetables and whole grains?

And fourthly, does the diet account for calorie dense versus nutrient rich foods? In other words, say you need 1,800 calories a day to support a lean weight. To keep your calories around this figure, you can either eat a little amount of high calorie foods or a large amount of low calorie foods that are high in nutrients. Examples of nutrient rich food include fruits, vegetables, whole grain which help you maintain a high metabolism speed when you start with breakfast and munch on them throughout the day.
By switching out some of the ingredients in your high calorie foods for low calorie options you can have your cake and eat it too! Consider making cookies, quick breads, or box cakes by replacing oil, butter, and eggs with applesauce, diet club soda, or low fat yogurt. You can make your favorites with healthier ingredients to give your foods more variety and you’ll be able to enjoy larger portions since the calories per portion will be in your favor. If you’re not ready for big changes just remember there’s no law that says you can’t use half 2% milk and half skim milk in your cereal or half white noodles and half whole grain noodles in your spaghetti.

So fast forward about six and a half years and compare my old New Year’s resolution to abide by a strict eight-foods-a-day-diet to my ’09 resolution which is to incorporate one or more new foods a week, which will have me reaping more health benefits, taste bud experiences, and knowledge to offer patients.

It is my personal, and now professional, opinion that people should seek to enrich their lives rather than limit themselves. Now if you’re reading this and saying, “ok, more ice cream it is!” I strongly suggest you explore alternatives to desserts high in saturated fat. Two, not-sinfully good, reduced fat dessert products you could try are No Pudge! Fudge Brownie Mixes or low fat yogurts topped with a bit of sweetness.

Unless allergies or other medical advice prohibits you from doing so, I would highly recommend lingering a little longer in the produce section, incorporating one new exercise/machine into your work out, taking the time to reevaluate your staple foods’ fact labels, or checking out the nutrition facts of your favorite restaurant entrees online.

A great and, not to mention, credible book that encourages the idea of including food into a diet rather than limiting food is "101 Foods That Could Save Your Life" by David Grotto, a registered dietitian. The book’s introduction will have you evaluating your lifestyle eating habits in a whole new way while staying true to balance, moderation and, most importantly, variety.