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FNCE 2012 Recap, Part 1: When Bigger Portions Can Be Better

Veggies Galore

Veggies Galore
Image: Michelle Meiklejohn, FreeDigitalPhotos.net

Session Speakers:
– Dr. Barbara Rolls, researcher for Penn State University
– Ellie Krieger, Registered Dietitian and Food Network star

Take Action & Respond: Try one of the many tips listed below and tell us how it goes.  What worked and what didn’t?  Did anything unexpected happen?

As I prepared to return home from this year’s Food & Nutrition Conference and Expo (FNCE) in Philadelphia, I started reflecting on all of the new research and tips I learned over the past 4 days.  And I figured what better way to reflect than to write!  So I’ll be writing a series of blog posts summarizing the take-home points from a number of the sessions I attended (at least the interesting ones).  First up, a topic near and dear to my heart: improving our eating habits by focusing on having more of the good stuff (fruits and veggies), rather than less of the bad stuff (pastries and fried foods).

Dr. Rolls has performed a number of studies focusing on how offering more fruits and vegetables at meals and snacks impacts our calorie consumption both at those meals and throughout the entire day. Her goal is to find ways to cut the amount of calories we eat by lowering the “energy density” of the meal rather than restrict portion size.

Energy density is defined as the amount of calories contained within a given volume of food.  In other words, you can eat half a pound of carrots and consume far fewer calories than if you ate half a pound of macaroni and cheese.  Therefore, carrots have a lower energy density than macaroni and cheese.  So why do carrots fill us up even though they have less calories?  Two reasons: fiber and water.  Do note, however, that it is likely the natural occurrence of water and fiber in these foods that lead to fullness, not the other way around.  In other words, don’t go drinking a big glass of Metamucil (fiber and water) right before a meal and expect the same effects.  In fact, you’ll probably get a quite different, less pleasant effect.

I personally like this “eat better, not less” approach, because no one likes to feel restricted.  In fact, research shows the vast majority of us can’t maintain a set of eating habits in the long-term if we feel that we’re in a restricted state.  That’s why most radical, restrictive diets ultimately fail.  Who really wants to eat two grapefruits for lunch and dinner the rest of their lives?  So instead, let’s look at what approaches Dr. Roll suggests we can take to lower the energy density (and ultimately the total calories) of our meals/snacks while keeping the amount of food we eat the same (or even more):

Serve large portions of veggies and fruit with meals – Make veggies “the entree”.  Have them on the largest serving dish.  Think about your grains and lean protein as the “sides.”  Stack your plate with those salads and veggies.  Fill half of your cereal bowl with berries.  The more on your plate, the more you’ll eat.

Make fruits and veggies your “go-to” foods when hungry – Have veggies and fruit available when you’re hungry without competing foods around. You’ll be more likely to eat them and enjoy it.  For example, have carrots/celery and hummus or an apple with peanut butter as a snack.  Or start your dinner with a salad or vegetable soup course before serving anything else.

Get stealthy – Choose foods and recipes that can easily integrate veggies and fruits as ingredients.  For example, zucchini or carrot bread, veggie soups/stews, using sliced zucchini or eggplant in place of layers of pasta in lasagna, add fruit to your oatmeal or cereal or build a salad in your sandwich by topping with lettuce, tomato, onion, pepper, cucumber, sprouts and more.

Use multiple strategies – If the ideas above sound like good ones, try all of them.  The more opportunities you give yourself to have fruits and veggies, the more likely you are to eat them.  And the more high-nutrient, low-calorie produce you eat, the less you will be tempted to overeat higher calorie foods.

On the culinary side of things Ellie Krieger discussed how we can take some established recipes and look to “healthify” them while still keeping the taste and flavor.  Healthy does not have to equal cardboard.  While she discussed a number of the “fixes” she made to comfort foods in her new cookbook, Comfort Food Fix, some of her best information was focused on easy ways to quickly, easily incorporate fruits and veggies as ingredients in recipes:

“Zero-step” additions – Purchase ready-to-go fruit purees (including applesauce) and veggie soups to use as bases for sauces/dips and baking substitutions.

“One-step” additions – Use a blender on a jar of drained roasted red peppers or olives to make a tapinade or blend up fresh herbs such as parsley, cilantro or arugula to flavor sauces, dressings, soups and stews.

“Two-step” additions – Boil and mash cauliflower, turnips, carrots or potatoes.  Or toss veggies with a little bit of olive oil and roast in the oven for 30-35 minutes.  You can use them as a side dish or blend them with a little liquid to make a fresh soup!

**Take Action & Respond: Try one of the many tips listed and tell us how it goes.  What worked and what didn’t?  Did anything unexpected happen?

Destination Thailand: A Healthy Honeymoon? (Part 2)

Best Green Curry Ever: I Made It!

Best Green Curry Ever: I Made It!
And a Snazzy Apron to Boot.

I’ve been back from Thailand for almost two weeks now (time flies, sheesh!).  Here’s the second installation of my lessons learned from staying healthy when traveling to the other side of the world.  This post focuses on tips to stay healthy and happy while enjoying your vacation destination:

Indulge in local treats rather than “usual” ones

Thailand had many of the usual indulgences available, from ice cream to Oreos.  But unlike the U.S., Thailand had some awesomely flavorful tropical fruits, so I chose to indulge in those instead (coconuts, mango shakes, rambutan, mangosteen, pineapple, guava, bananas [much better than what I get in NJ], etc.).  In contrast, when I was in Italy, I did have gelato just about every day.  Moderation was key: one scoop, which is actually one small scoop in Italy (vs. two heaping scoops for the “small” in most U.S. ice cream parlors).  If you want to indulge, seek out foods or desserts that you can’t get anywhere else (or not as good anywhere else).

Try new things (or old things in a new place)

When going to Thailand I knew there would be a number of foods that I never had before and I made it a point to try them: fruits (mangosteen, rambutan, fresh guava), veggies (baby eggplants, fresh(!) baby corn) and even raw peanuts!  I just never brought myself to trying the insects (though I’ve heard they are very good, per an 8 year old Thai boy).  When traveling, check out what’s new, different and possibly tasty.  Who knows, you may have a new favorite food to look for when you get back home (it’s amazing what’s actually available when you’re looking for it).

Of course I also had to try all of the usual dishes I have at my local Thai restaurants: papaya salad, pad thai, green curry, panang curry and more.  I can tell you one thing: it’s spicier in Thailand; and in many cases, much more flavorful.  The coconut milk and curry flavors were fantastic and better than most that I’ve had stateside.  At the same time, I decided to try some dishes that I’ve never been a fan of in the U.S. Many of the noodle dishes in Thailand (pad see ew, pad thai, etc.) were less greasy than I’m used to dealing with, which is a welcomed change.  In fact, some of the best dishes I ate were the ones Becca and I made ourselves in a cooking class in Chiang Mai.  When in doubt, make it yourself!

*Note: When traveling to other countries, if you’re trying some new foods be aware that your digestive system may not always be adapted yet.  Also, be aware how safe the water system is (we only drank bottled water in Thailand just in case, but we brushed our teeth with the tap water without issue).  A few days of GI upset can happen in any radically new eating environment and honestly it’s not the worst thing in the world compared to the experiences we got for it.  Worse comes to worse you can always go to a pharmacy (or bring with you from home).  Thailand is very hospitable in helping you find solutions to any GI problems.

Look for alternative ways to stay active

None of our hotels had gyms, so my usual workouts were out of the question.  But you always have your body, so running/jogging/walking, pushups, squats, pullups, lunges are always fair game.  I actually brought along a Pinky ball, mini band and super band for some extra options (under one pound in the baggage).  In addition we did a number of activities that are not in my usual routine such as paddle ball, kayaking, rock climbing, jungle hiking, snorkeling and walking everywhere.  Here’s some tips:

  • Take a look at your surroundings to see how you can be active (any unique opportunities to go sightseeing and be active?)
  • Remember you always have your body weight
  • Consider bringing some light workout equipment like mini-bands, Therabands, super bands, etc.  Even a TRX can work well.
  • Walk everywhere.

Stay in touch with your body’s hunger signals

Often we’re so busy and rushed in our daily lives that we lose touch with when we’re actually hungry and full.  As a result we’re usually alternating between ravenously hungry and totally stuffed.  Use your vacation as an opportunity to listen to, and get back in touch with your body’s satiety signals.  Your body usually takes at least 15 to 20 minutes to know when it’s full, so take your time when eating meals on vacation.  Eat slowly and savor the local foods (where else do you have to be?!?).  Stop when you’re satisfied, not stuffed.  Unless you’re hiking the Sahara, odds are there will be lots of food available everywhere you go.  When you’re hungry, have a small snack (choose a local flavor) to tide you over until meal time.  At meals, don’t feel compelled to buy a three-course meal every time.  Get what looks good and unique; split dishes with others when possible.  If you have a big day of sightseeing or evening out, you may even want to focus on eating “light” so you don’t run into a sluggish period when you’re trying to be your most energetic.  Taking the time to get back in touch with your hunger and satiety signals during vacation can help recalibrate your system for when you return if you make it a point to eat slower and listen to when your body is actually hungry upon your return.

I decided to weigh myself on the last night of my vacation (mainly because it was the only hotel room that had a scale) just to see if my weight changed since my eating and physical activity habits were very different than my usual habits.  Turns out my weight was exactly the same.  What I noticed was I ate when I was hungry but did not force dessert or extra foods on myself when I was full.  I just waited until I was hungry again (at the next snack/meal) to have them.  I think I only felt “stuffed” once during the entire 14 days (I ordered a whole fish one night to try it and Becca’s a vegetarian…and the fish was really good!).

Stay hydrated

Thailand was hot and muggy.  I think I had water bottles in my hand most of the day.  And the days I didn’t drink enough water, I started to get a headache by the end of the afternoon.  So I would pound back some H2O and was right as rain.

Many of us fail to stay hydrated even in day-to-day life, let alone when on vacation.  There are many opportunities to become even more dehydrated on vacation, from lengthy flights to long days sightseeing/sunbathing in hot weather.  Regardless of the health effects, becoming dehydrated can be a huge drag on our vacation because it can make us feel lethargic, headache-y, irritable and even hungry (when we’re actually thirsty).

Start hydrating as soon as you get to the airport and drink throughout the flight.  Either bring your own big water bottle on board or just keep getting up for more water (makes for a good stretch too).  If you’re brazen like me, you can even ask a flight attendant for a whole bottle of water.  Once at your destination, aim to drink at least half your body weight in ounces of water per day.  I’m 170 pounds, so that’s 85 oz. of water, or about 5 regular Poland Spring bottles of water. Add in more if you’re spending a lot of time out in the sun.  If you ever start to feel tired or a headache during a busy day, make water and shade a go-to first intervention.

Hope you found some of these tips helpful for the next time you travel (if you do, tell me which!).  And as they say in Thailand, lah gorn kop! (see you later).

Destination Thailand: A Healthy Honeymoon? (Part 1)

Kayaking in Railay Bay

Kayaking in Railay Bay

Howdy everyone, I just returned from beautiful (and sometimes rainy) Thailand!  Two weeks of amazing fun with the woman that I love, and am now married to!  We spent one week trekking around, exploring a friendly, welcoming country full of history and nature (including monkeys and elephants).  The other week was spent relaxing (and climbing, kayaking, etc.) on the confines of a pristine beach surrounded by natural limestone cliffs.

Needless to say, I was very much out of my usual “routine” of both physical activity and eating.  While reviewing the photos of my trip, I decided to also review what lessons I learned in the pursuit of staying healthy when traveling to the other side of the world.  Turns out I wrote a lot on this topic (surprise!), so I’m splitting it into two posts.  This post will discuss tips for getting to/from your destination (particularly, long flights) feeling great and how to re-acclimate upon your return.  My second post, in a week or so, will review tips to stay healthy, and happy, at your destination.

1. On the Plane (To & From)

Getting from New York to Bangkok required two flights, one 14 hours and the other 4 hours.  A long time to be sitting in a tight space (ahhh, coach).  Here are three ways you can prepare yourself for long flights:

  • Drink water

From the moment you get to the airport, start drinking water.  An airplane can be a very dehydrating place, between the dry air and difficulty in getting access to fluids during the trip (unless you’re like me who asks the flight attendant for an entire liter of water a few hours into the flight, with a smile of course).  In fact, I recommend bringing your own water bottle (empty first to get through security) and then go to the food area to refill it regularly during the flight.

Dehydration could contribute to physical discomfort during the flight including headaches and even upset stomach.   I’ve also talked to people who said being dehydrated prolonged their jet lag, so if you want to enjoy your trip, stay hydrated!  Try to avoid alcohol on long flights as well, as it becomes another stressor on the body and can have a dehydrating effect too.

  • Bring some of your own food

Food, of course, does depend on the airline.  Even if you know you’ll love the food on your flight, most of the time you’re going at least 8 to 10 hours between meal services on long flights.  Having some non-perishable, healthy snacks (i.e. nut/fruit trail mix, fruit, Kashi/Lara bars) can go a long way in keeping you satisfied and avoiding hunger pangs/crashing.  And if you don’t like the food, be sure to bring your own meal (from home or the airport) on-board.  Just be careful how long you hold onto the for, since perishable foods like dairy and meat can start to spoil after 4 hours.  If you want simpler food options on the flight, consider booking your meal preference as a “vegetarian”, even if you aren’t one.  Becca’s vegetarian meals actually looked better than mine on the flights (I was surprised…and jealous!).

  • Get up and move around regularly

Moving during the flight is essential to prevent you from feeling stiff for the first few days of your trip, keep your GI tract happy during the flight  (prolonged sitting could lead to indigestion or cramping) and to ensure you avoid a rare, but serious condition called deep vein thrombosis (DVT) which involves developing blood clots in your leg.   Areas that tend to get tightest during long flights are calves/hamstrings, hip flexors, quads and chest.

If you’re drinking a lot of water, you’ll have to get up often to go to the bathroom, so that’s a great start.  Stand up in the aisle or go to the back of the cabin and run through a 5-minute series of stretches starting from your toes to your head (calf raises, quad stretch, hamstring stretch, chest stretch against a wall/ledge, shoulder/arm circles, wrist folding, marching in place, mini-squats, wall pushups, lunges).  If you don’t want to get up you can still do a few of these in your seat.  In fact, the airline I was on had a seat-based, 10-minute exercise video that they played towards the end of our flight.  Doing this even a couple times during the flight can pay significant dividends both during the flight (more relaxed) and when you step off the plane.

2. Getting Back Home

  • Avoid Injury by Gradually Returning to Your Workout Routine

When I went to Thailand, I stayed quite active, doing hiking, rock climbing, kayaking, swimming, etc.  But these activities were very different from my usual training routine.  Missing just two weeks of exercise can result in strength and endurance losses.  Therefore I am not planning on immediately running the same distances and lifting the same weights as I did when I left.  To avoid injury, I plan on giving myself a week at 50% intensity followed by a week of 80% intensity to ramp myself back up into my training regimen.  I may add an additional “recovery” day of foam rolling, dynamic warm-up and core stability training as well after having to sit for that long flight back home.  On the other hand, if you maintained your usual training routine during vacation, then feel free to continue as is (i.e. you’re a runner and have were able to log similar mileage and intensity to your home training regimen while traveling).

  • Review Your Habits

Did you pick up any new, healthy habits while you were away?  Would you like to continue them?  Take a few minutes to review those new habits and how you could potentially fit them into your current routine at home.  Did you eat more fruit because you were in a tropical place?  Were you more physically active because you had more time?   Did you try some new foods that you’d like to work into your routine?  Did you walk more?  Were you able to regulate your appetite better during your vacation because you could eat slower? To make room for these habits, consider any “usual” habits that you didn’t need to do while traveling, and don’t need to resume now that you’re back at homey (you probably have to go back to work, but maybe you don’t need to watch 2 hours of TV every night).

On the flipside, consider if you started any unwanted habits that you can make sure to stop doing once you’ve returned.  When I went to Italy for a week a few years ago, I had a scoop or two of gelato every day (it’s really good there!).  So when I came home, I made sure to avoid the ice cream shop for a week or so to allow my body to forget the ice cream habit.

Do you have any healthy travel tips?  Please share by commenting below!

How Do You Deal with Game Changers?

Getting Married: A Game Changer?

Getting Married: A Game Changer?
Image: FreeDigitalPhotos.net

I’m getting married on Sunday, yay!  I’ll be away for the next few weeks (will be back end of Sept.) but wanted to leave you with a post that’s relevant to my current situation and applicable to us all during many other times in life.  Are you prepared for game changers?

Imagine you’ve started eating healthier (soup and salads a few days per week at lunch, cooking healthy dinners at home, preparing snacks on Sunday evening) and exercising more (getting to the gym 3-4 days per week).  You’ve hit a good groove and you’re starting to see results.  Then, BAM.  You get a new job or you move in with your boyfriend or girlfriend.  Your entire routine and schedule are blown to bits.  You can’t find the time to workout anymore and Sunday evenings are no longer a good time for prepping healthy snacks.  And without those healthy snacks, you find yourself getting ravenous during the day and opting for the cheeseburger and fries at lunch instead of the soup and salad.  Your results are slowing down and possibly stopping.  Yikes!  What to do?

First, an important point to remember: All results are based on habits.  Habits are the actions we perform consistently, day-in and day-out.  If you go on vacation for three weeks and gain a few pounds, it shouldn’t matter because when you get back (if you return to your usual habits) those pounds will go away.  Just as long as none of those less healthy habits from the vacation stick.

On the other hand game changers, whether good or bad, are times in life when there is a permanent, radical shift in our schedule or demands that can, in turn, have a significant impact on our physical activity or eating habits.  Some game changers are planned, while others are not.  The better we can prepare and plan for a game changer, the easier the transition will be, but sometimes it becomes a series of educated trial-and-error (that’s fine, it’s how we learn and improve).  Here’s an example for getting married:

Weddings – Wedding planning can often become a full-time job on its own, so time that you once had for preparing meals or exercising might be replaced with meeting florists and photographers.  However, getting married can be a strong motivator for people to look their best, so investing in a “Bride/Groom-to-be” exercise or nutrition program can be worth it.  Or you can review your schedule and reserve time for a few “mini” 30 minute workouts since something is always better than nothing.  Or make the choice to buy more healthy, prepared meals that you can keep in the fridge/freezer and reheat as needed when you’ve had a busy day (Fresh Direct does this very well in the NYC area, but you can find lots of decent options across the country like Amy’s Kitchen or The Organic Bistro frozen foods).  A little extra effort or money spent now may mean a lot more happiness on your wedding day.  And if getting married means moving in with your spouse, you may also have to deal with a change in living arrangements (snoring at night or shared fridge?) and schedules (different commute times?).

Some other common game changers include: moving, changing jobs or having a kid.  Here are a few ideas and strategies you can use in any of these situations to maximize your ability to stick to your healthy eating and physical activity habits:

  • Plan ahead – Write down your current schedule and how you go about maintaining your current habits and results (all of those good eating habits and physical activities).  Next, create a new “proposed” schedule that will likely reflect the changes you are anticipating to your lifestyle. Then determine how you can best “shift” your current habits to your new schedule.  Sunday evening gone for preparing healthy snacks?  Can you purchase the healthy snacks daily at a grocery store near your new job?  Or maybe you can prepare them another day and time?  Or with your significant other whom you just moved in with?
  • Get guidance and support – Speak to someone who successfully navigated a similar change to the one you’re facing.  Ask some friends or family members to be a cooking or workout buddy during the time you’re transitioning.  If you really want to make sure you don’t fall off the wagon, consider hiring a qualified dietitian (nutrition) or trainer (fitness) to guide you through the process until you feel comfortable handling the new routine on your own.
  • Look for positive replacements/substitutions – As Monty Python says, “Always look on the bright side of life.”  While some of your existing habits may be difficult to maintain, see if you can replace them with equal or better ones.  Starting a new job with long hours?  Speak to your employer and see if you can go during lunch.  Or if you moved to a new area, is there a closer gym or park that makes exercising more convenient?  If you’re moving in with a significant other or a new set of roommates, see if you can all take turns cooking healthy meals or preparing snacks.  Or make an agreement to not keep certain tempting foods in the house/apartment.  For me, moving in with my fiancee (soon to be wife) led to me having more green smoothies and salads.

What game changers have you dealt with and how were you able to handle them?  (Or what problems are you facing?).  Let me know.

Who Should Eat a Gluten-Free Diet?

Whole Wheat: Friend or Foe?

Whole Wheat: Friend or Foe?
Image: FreeDigitalPhotos.net

*Warning: A long post, but please stick with me here and let me know what you think.

Gluten-free foods have become all the rage the past five years, from quinoa pasta to rice-based crackers.  Many people swear by eating gluten-free: more focus, weight loss, greater energy, you name it.  But do you really need to give up gluten entirely?  Understanding the causes of and differences (or lack thereof) between gluten intolerance, wheat/gluten allergy, gluten sensitivity and celiac disease is crucial, and that’s what this article sets out to explain, in laymen’s terms.  I will be citing a few references, but will also be providing a few personal “logical extensions” of what we currently know.  If you agree with me, great.  If you don’t, I’d love to know why (with appropriate competing references and rationale) because it helps me learn more.  But before we delve in too deeply I want to know: do you know what gluten is?

According to Wikipedia (they have a good definition!), “gluten is a protein composite found in foods processed from wheat and related grain species, including barley and rye” (and kamut).  So, gluten is one of the primary proteins in wheat.  Sometimes you will see oats on the “avoid” list for gluten-free diets as well because many grain-processing facilities in the U.S. process wheat and oats in/near similar machines, so cross contamination can occur.  However oats themselves do not contain the gluten protein that those with gluten intolerances are sensitive to.

On the Internet and throughout the media these days the words “gluten sensitivity,” “gluten intolerance” and “wheat/gluten allergy” are used quite interchangeably.  Researchers, on the other hand, use these terms to refer to specific reactions and levels of severity.

Wheat/gluten allergy: Creates a systemic allergic reaction similar to other food allergies like hives, nausea, congestion and even anaphylactic shock in severe cases.  Low prevalence, only about 1% of children (many grow out of it) and a few adults.

Celiac Disease: A severe form of gluten sensitivity. When someone with true celiac disease eats a food with gluten, the body’s immune system attacks the gluten in their digestive tract and causes the destruction of many of the cells that are responsible for food and nutrient absorption into the body (properly called villi/microvilli).  The resulting inflammation and gastro-intestinal distress (i.e. diarrhea, bloating, cramps, etc.) is largely dependent on the severity of the celiac disease. Other symptoms may include malnutrition and increased risk of osteoporosis and cancer.  There are specific tests to determine whether you have celiac disease, and those with the diagnosis require gluten-free diets to remain symptom-free.

Considering how many people out there are swearing by gluten-free diets, you’d think that a huge portion of the population has celiac disease.  What percent of the American population do you think has celiac disease?  20%?  10%?  5%?  According to a recent study of nearly 7,800 people in the American Journal of Gastroenterology in July 2012, the prevalence of celiac disease in the U.S. is 0.71%.  Less than three quarters of one percent.  Interestingly, 29 of the 35 people who had celiac disease were undiagnosed until the study!  Non-Hispanic whites were the highest sub-group with a rate of 1.01%.

And this is not limited to the U.S.  In Europe here are some percentages (people 30-64 years old):

  • In total, across 29,212 participants: 1%
  • 2.4% in Finland
  • 0.3% in Germany
  • 0.7% in Italy

Interestingly, another study showed that prevalence of celiac disease has increased four-fold in the past 50 years, from 0.2% to 0.8%.  However, is this a result of changes to our diets or more sophisticated detection processes?  Either way, celiac disease is relatively uncommon.  The conclusion of the first study says it all: “Most persons who were following a gluten-free diet did not have a diagnosis of celiac disease.”

So why are so many people eating gluten-free diets?  Are there other types of people sensitive to gluten that do not have celiac disease?  It seems like there may be.

Undefined/Un-diagnosable Gluten Sensitivity: According to an interesting article in the Wall Street Journal, about 6% of the U.S. population may suffer from “gluten sensitivity,” resulting in stomach discomfort, headaches/migraines, balance problems and more.  But these sensitivities cannot currently be diagnosed.  So how can we tell the difference between this kind of gluten sensitivity and celiac disease?  The author of the article provides a great distinction:

“Their immune reactions were different, too. In the gluten-sensitive group, the response came from innate immunity, a primitive system with which the body sets up barriers to repel invaders. The subjects with celiac disease rallied adaptive immunity, a more sophisticated system that develops specific cells to fight foreign bodies.”

In other words, gluten-sensitive people have a more generalized inflammatory response to deal with the presence of gluten (i.e. the entire body gets pissed off) compared to those with celiac disease, where the body specifically attacks the gluten and the parts of the body immediately surrounding it (i.e. the body attacks the GI tract where the gluten is located).

Here’s my breakdown of the current information/research:

The body is designed to protect against foreign invaders.  Those invaders typically carry particularly identifiable “proteins” that our body can sense.  In celiac disease, there is a very specific auto-immune response (there is a direct, measurable cause-and-effect of eating gluten and getting sick) where a person’s body attacks itself when they consume gluten.  Therefore they should follow a gluten-free diet.

For gluten sensitivity, however, the issue is much more murky. There’s no particular measurable antibody response, although people do tend to feel better when they no longer eat gluten-based foods.  This “primitive immunity” results in an increase in general inflammatory proteins, that are impacted by many other factors besides gluten (to be discussed below). So what’s going on?  Maybe we’re just getting too much of a good thing?

This is where I take a logical leap, follow me for a minute and let me know your thoughts:

About 40 years ago the U.S. (and in some ways the world) went on a HUGE whole-grain kick when people realized that eating white bread and white rice all day wasn’t the best thing.  The fiber, vitamins and minerals from the bran and germ portions of the grain were important.  So we started eating more whole grains.  And what type of grain did the U.S. have an abundance of?  Wheat!  Fields and fields of wheat (points if you got the Woody Allen reference!).

So we started having wheat cereal for breakfast, wheat-bread with our sandwiches at lunch, wheat crackers as a part of our snacks and eventually whole wheat pasta for dinner.  We couldn’t get enough wheat.  In general, the more we expose our bodies to a particular stimulus without giving it a chance to recover (even good stimuli), the more potential we have for a negative response from the body.

Take running, for example.  Going for a run a couple times a week is good.  Our body gets the stimulus, recovers and then is ready for the next run.  Now imagine going for two or three runs a day, every day for half your life.  Do you think your body will wear out and get pissed off and inflamed?  Now consider how often we eat wheat each day.

Is it just possible that we’ve eaten too much wheat and need to reduce how much of it we’re eating?  This is the essence of most food sensitivities.  Your body gets pissed off because you’ve had too much of a particular food over and over again (consider dairy as another one).  If you’ve eaten a ton of it you may need to greatly reduce or cut it out to allow your body to “calm down.”  But then you can probably add it back in reasonable portions.  How much you have is up to you and your body’s reaction, but you could probably have it at least a few times a week, maybe even once a day.  Just not three times a day.

I would also like to mention that since the inflammatory response in gluten sensitivity is non-specific, it is affected by many other factors such as stress (mental or physical), exercise, consumption of other inflammatory foods, drinking alcohol, heat and more.

Non-specific inflammation (which is what occurs in non-celiac gluten sensitivity) is very much like a pool filling with water.  There’s a drain at the bottom of the pool which is our body’s natural ability to process and deal with inflammation.  However, causes of this inflammation (i.e. non-specific gluten sensitivity, stress, etc.) are streams of water pouring in.  The body is able to handle a certain amount of inflammation based on our ability to process it.  Healthier habits such as sleep, staying active, drinking water and stress management tend to slow the flow of water in and increase the size of the drain allowing water to flow out.  On the other hand, unhealthy habits tend to make the water flow in faster and make the drain smaller.  We only show symptoms when the pool reaches a critical point where the water is filling in so fast that it begins to spill over the edges, since the drain cannot clear it out fast enough.

In those with gluten sensitivity, gluten is one of the things that causes the water to flow into the pool faster.  So unless you want to go the rest of your life without pasta or bread, the key is to determine how much gluten you can eat without having your pool spill over (a tip: do lots of other things that help increase the size of the drain at the bottom of the pool to keep inflammation levels down).

If you have celiac disease or a true wheat allergy, then you should consult a Registered Dietitian and doctor for nutrition counseling before making any significant changes to your diet.

References:

Beck, M. (2011). Clues to gluten sensitivity.  Wall St. Journal, Health Journal, March 15, 2011.  Accessed on 8/16/12 at: http://online.wsj.com/article/SB10001424052748704893604576200393522456636.html#

Hadjivassiliou, M. et al. (2010). Gluten sensitivity: from gut to brain.  The Lancet: Neurology.  9, 318-330.

Mustalahti, K. et al. (2010). The prevalence of celiac disease in Europe: Results of a centralized, international mass screening project.  Annals of Medicine.  42(8), 587-595.  Accessed on 8/16/12 at: http://informahealthcare.com/doi/abs/10.3109/07853890.2010.505931

Rubio-Tapia, A. et al. (2009). Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 137(1), 88-93.  Accessed on 8/16/12 at: http://www.gastrojournal.org/article/S0016-5085%2809%2900523-X/abstract?referrer=http%3A%2F%2Fscholar.google.com%2Fscholar%3Fq%3Dceliac+disease+prevalence

Rubio-Tapia, A. et al. (2012). The prevalence of celiac disease in the United States.  American Journal of Gastroenterology. July 31, 2012 edition.  Accessed on 8/16/12 at: http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg2012219a.html

Sapone, A. et al. (2011). Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity.  BMC Medicine.  9(23).  Accessed on 8/16/12 at: charlotteceliacconnection.com/files/Divergence_of_Gut_Permeability_and_Mucosal_Immune_Gene_Expression_in_Two_Gluten_Associated_conditions_-_BMC_Medicine_-_March_2011.pdf

Inside the Trainer’s Brain, Part 1: My Training Philosophy

The Brain Behind the Blog

The Brain Behind the Blog

Over a series of posts in the coming months, I want to provide you with a look into what’s going on in my brain (scary!) when I’m creating training programs for my clients.  Because if you can learn and  understand the basic tenets of creating effective workouts and exercise routines, the more empowered you will be to stay active, healthy and most importantly, injury-free!

Today’s post is focused on my general training philosophy.  While this post is a bit more directed towards trainers, I hope it rings a bell with all fitness enthusiasts.

Training Philosophy Thought #1: Maximize Results while Minimizing Injury Risk

Inspired by Mike Boyle’s quote and my own experiences with clients, my philosophy of training is: Maximize performance or results while minimizing injury risk.  Sounds simple, but it’s not so easy to do.  Because the terms “maximizing” and “minimizing” means doing the absolute best we can for someone.  And the only way we can be our best is if we always strive to get better.  As a trainer that means continuing education workshops, reading books, watching DVD’s and practice!  If you train yourself, that means doing much of the same, striving to learn as much as you can about your own body and training regimen.  Or you can hire a trainer who has a similar philosophy to you.

Training Philosophy Thought #2: First Do No Harm

I feel that, just like any other healthcare practitioner, personal trainers (and dietitians) need to abide by the Hippocratic oath: “First do no harm.”  In other words trainers, myself included, should only train someone to the limits of our own abilities, and if we cannot help someone (or if we do not know how to), we need to either learn more and become able, or refer to another trainer, physical therapist or doctor who does.  It’s not about us, it’s about the client.

Training Philosophy Thought #3: Striving to Understand Our Clients, Or Ourselves

We must always strive to become better at understanding our clients, their daily movement patterns (i.e. sitting all day), their injury/medical history, baseline (and re-assessed) fitness levels and most importantly, their goals and motivations to change and improve.  We can only help someone if we meet them where they are at both mentally, and physically.  For example, there’s no point in having someone do box jumps if they can’t squat correctly.  Or doing kettlebell swings with a client who can’t deadlift or move through their hips.  Or asking them to train five days per week if they just got off the couch.  It’s like giving a brand new car to a baby. Great tool, just not right now.  We need to find what drives someone, and then equip them with the tools they need to get themselves there.

Training Philosophy Thought #4: Understanding Clients Change and Getting Feedback

We must be aware that our clients change, so even if we understand them initially, things can happen.  Jobs/schedules change, people get stronger (or weaker), family life can become more stressful, new deadlines can lead to poor sleep patterns (and less recovery), or any combination thereof.  And all of them can have a real impact on someone’s ability to train on a day-to-day and week-to-week basis.  Dealing with all of the things going on in my clients’ lives is a challenge for even the best of trainers.  Why?  Because we’re not mindreaders.  So we shouldn’t act like it.  Instead, we should get feedback from our clients to make our jobs easier and get them better results.

The only way I truly know I’m doing a good job for my clients is if I ask them!  So every couple of weeks I usually ask my clients how hard their most recent workout(s) felt to them, on a scale of 1 to 10.  My goal is to usually hear around an 8, particularly for clients that I train once or twice per week.  Too little means that they aren’t being challenged.  But too high means that we might be overdoing it.  Pushing to a 10, while rewarding on occasion, often has more pitfalls than benefits.  There’s no point in kicking the crap out of yourself if you can’t workout for the next four days (since you can’t move).  I’d rather see someone workout to an 8, but feel good the next day and be ready to do their next workout or cardio a day or two later.  Also, pushing to a 10 usually comes with an increased risk for injury due to loss of form and fatigue.  And being injured for a few weeks or months is the last thing we want when we’re trying to become more active.

A pseudo-summary for the non-trainers:

  • Maximize Performance while Minimizing Injury Risk by gradually increasing the intensity of your workouts.  If you’re completely new, push yourself to a 5 or 6 and build to a 7 or 8.  If you choose to push yourself to a 9 or 10, do it when you know you’ll have adequate opportunity to recover and if you feel any joint pain during the workout, dial back the intensity or stop.  It sure as heck beats getting injured.
  • Become aware of yourself, your schedule, your abilities and your tendencies.  What are your goals?  Are you happy with your current results?  If not, do you need to increase the number of days you’re active?    If so, how and when will you do it?  Do you need to learn any new exercises?  Remember, you can be active without going to the gym (i.e. sports).  Do you foresee a change coming in your schedule that may make it easier or harder for you to stay active?  Can you prepare for it?

Since I’m going to be creating a series of these posts I need to know whether this one was too random and ramble-y, or was it ok?  Did you learn something new about yourself or your training style?  What would you like to learn about?  My next couple of “Trainer’s Brain” posts will be focused on creating “balanced” workouts and understanding training intensity.

Let me know your thoughts by leaving a comment!  As I said earlier, I love feedback!

Weight Loss Drugs: Help or Hype?

A Pill a Day?  Or How About Just Eat Better and Exercise?

A Pill a Day? Or Eat Better and Exercise? Image: FreeDigitalPhotos.net

With the recent FDA approval of two new weight-loss drugs, Qsymia and Belviq, I wanted to briefly discuss the potential benefits and risks of the existing FDA-approved weight loss medications (yes, by prescription) which are:

  1. Qsymia
  2. Belviq
  3. Xenical (Orlistat) and its smaller-dosed, over-the-counter (OTC) equivalent: Alli.

Yep, until about two months ago, the only other weight-loss drug on the market was approved thirteen years ago.  And here’s an article I wrote for Nutrition411.com that discusses the benefits and risks of the OTC version, Alli.  Xenical is just a higher dose of the same medication.

While three are currently on the market, there have been a number of others in the past, now banned by the FDA due to life-threatening side effects such as heart attack, pulmonary hypertension and stroke: ephedra (Chinese herb), Fenfluramine (the “Fen” of Fen-Phen), Aminorex, Sibutramine (Meridia).

Now, let’s get to the two new players soon to be on the market:

Qsymia

  1. A combination of two drugs: Phentermine (the “Phen” of Fen-Phen) and Topiramate (an anti-seizure/migraine medication).  The medications are “designed” to suppress appetite, increase fullness, make food taste less appealing (nothing like avoiding chocolate by making it taste lousy!) and increase caloric expenditure.
  2. A federally “controlled substance” due to the use of phentermine.  In other words, too much is not safe so they need to restrict it so people take too much and have serious side effects.
  3. Currently designed to be “taken forever, or until you develop a side effect or have other reasons to stop.”

Belviq

  1. Increases levels of serotonin in the brain, which is known to suppress appetite.  Unfortunately it also does a lot of other things, such as act as a hallucinogen (LSD) when used in too high of a dose.
  2. A federally “controlled substance” due to the fact that taken in too high of a dose, it’s effects could be similar to a hallucinogen (so the DEA is involved).
  3. Currently designed to be “taken forever, or until you develop a side effect or have other reasons to stop.”

Both have a laundry list of precautions, a summary of which can be found at the WebMD article that served as the inspiration for this summary:

So how did these new drugs perform?  Anywhere from about 4% to 8% more results than placebo over the course of a year.  How much is that?  Well, for a 150 pound person, that’s an extra 6 to 12 pounds in one year.  Not shabby, but not earth shattering.  And there’s a catch to getting those results (it’s at the end of this article).

Despite these potential results, consider at what cost: the potential side effects such as increased heart rate, suicidal thoughts, glaucoma, attention/concentration deficits, hand/feet tingling, change in taste, trouble sleeping, constipation, etc.  You can check out full lists of precautions and side effects for Qsymia (http://www.drugs.com/qsymia.html) and Belviq (http://www.drugs.com/belviq.html) at the links listed.  And here as well, for Qsymia.

So what’s the catch?  The final line question from the WebMD article says it all:

If I take Belviq or Qsymia, do I still have to diet and exercise?

Absolutely. In clinical trials, the drugs were effective only when given along with a balanced diet and exercise.”

In other words, diet drugs only help if you live healthfully to begin with.  Otherwise, it’s just another pill that you have to take forever, until you develop side effects or choose to stop taking it.  So why not make some gradual, permanent changes to your eating and physical activity habits and allow your weight loss to take a couple months longer, without the potential for hallucinations or constipation?