Sugar Love

For my fellow sugar lovers, there is more to the story of sugary goodness than just feelings of happiness. There are different types of sugar in our diet. Sugars can be naturally occurring or added. Naturally occurring sugars are found in foods such as fruit (fructose) and milk (lactose). Added sugars are sugars and syrups put in foods during preparation or processing, or added at the table. Currently, many of the foods and beverages Americans eat and drink contain empty calories (add calories to the food but few or no nutrients) – calories from solid fats and/or added sugars. Foods that are high in empty calories (especially added sugars) include but are not limited to- cakes, cookies, pastries, and donuts, sodas, energy drinks, sports drinks, and fruit drinks, chocolate and Ice cream. Quite the list, isn’t it? We need to think before indulging into these sweet pleasures because we add a lot of calories to our diet by taking these empty calories. A small amount of empty calories is okay, but most people eat far more than is healthy. It is important to limit empty calories to the amount that fits our calorie and nutrient needs. It is super hard when it comes to ice cream or chocolate, correct? But it is the truth and we need to be mindful of what we eat.

Sweet Statistics- According to the data from the National Health and Nutrition Examination Survey, 2005–2010, approximately 13% of adults' total caloric intakes came from added sugars between 2005 and 2010. Men consumed a larger absolute amount of calories from added sugars than women. It was also highlighted that among adults, one-third of calories from added sugars (33%) came from beverages. In children and adolescents, 40% of calories from added sugars came from beverages.

How much is too much?- The American Heart Association (AHA) recommends limiting the amount of added sugars we consume to no more than half of our daily empty calories allowance. For most American women, that’s no more than 100 calories per day, or about 6 teaspoons of sugar. For men, it’s 150 calories per day, or about 9 teaspoons. Take a random health bar off the rack the next time you go to a supermarket and look at the label. Use the calculation below to find out how many tea spoons of sugar one serving contains. You don’t live off of one bar a day, do you? If you can only have 6 tsp of sugar per day and the bar gives you 4, how do you spread the other 2 tsp over the span of 24 hours? Something to think about. Think natural sugars and you will feel less guilty, I promise.

Say bye to sugar completely? – Of course not! A good first step is to cut the usual amount of sugar you add by half. Cut back on the table sugar (white and brown), syrup, honey, molasses etc. added to things you eat or drink regularly like cereal, pancakes, coffee or tea. Add fruits and nuts instead of adding sugar. Replacing soda with milk, water or freshly squeezed fruit juice is always a plus! Eating fresh, frozen, dried or canned fruits (good sources of natural sugars) and avoiding fruit canned in syrup, especially heavy syrup is another way of cutting down excess sugar.

 Compare food labels and choose products with the lowest amounts of added sugars. You can use this formula: 1 tsp= 4g of added sugar and calculate the number of tsp from a particular food. Added sugars can be identified in the ingredients list e.g. high fructose corn syrup (HFCS). Reduce the amount of portions eaten. Read about portion control elsewhere on this blog.  When baking cookies, brownies or cakes, cut the sugar called for in your recipe by one-third to one-half. Instead of adding sugar in recipes, use extracts like almond, vanilla, orange or lemon. You can also switch out sugar with unsweetened applesauce in recipes (use equal amounts).

Try non-nutritive sweeteners (approved by the FDA) such as aspartame, sucralose or saccharin in moderation. Non-nutritive sweeteners may be a way to satisfy your sweet tooth without adding more calories to your diet. 

This blog is written by Sharmin Hossain, a student intern of Valley Nutrition Counseling  with a PhD major in Nutrition at the University of Massachusetts Amherst

Sticky Superstar Starch

Judging by the very scientific term for carbohydrate rich foods like potatoes, carrots, yams, cassava, rice, etc. I wonder how many people actually use the term ‘Starch’. Not too many- is my answer and that’s probably because the concept of starch is less familiar than regular carbs. Starch is the major energy reserve for plants; it is located mainly in the seeds, roots or tubers, stem pith, and fruit. In home cooking and in commercial food processing native starches are used for their thickening properties. In other words, when your pancake batter is too watery and you add more flour to it to thicken it up a little, that’s where our key player ‘starch’ comes into action.

Where do we get them from? The total carbohydrate content of a food includes starches, or complex carbohydrates, which provide energy for your body. They constitute an important source of calories in grains, such as bread, rice and oatmeal; legumes; and some vegetables, such as potatoes, yams, green peas and corn. Each gram of starch provides 4 calories, just like sugar.  The predominant commercial starches are those from field corn (maize), potato, cassava (tapioca), wheat, rice, and arrowroot. The nutritional value of uncooked starchy foods (cereal grains, potato, peas, and beans) is relatively poor. In other words, eating them raw is not as beneficial as one might think, even though for most fruits and vegetables, that’s the way to go! Therefore, we need some form of cooking- baking, frying, boiling etc. to make the starch more available biologically than its raw form.

Calculating starch from a label-

·       Locate the amount of total carbohydrates on the nutrition facts label on the food packaging

·       Subtract the fiber from the total carbohydrate count. This gives you the net carbohydrates per serving.

·       Subtract the sugars from net carbohydrates. This will give you total starch content per serving.

Recommendations - The 2010 Dietary Guidelines for Americans recommend getting 45 to 65 percent of your daily calories from carbohydrates, which include both starches and sugars. Because a gram of sugar or starch provides 4 calories, this broad range corresponds to 180 to 358 grams of total carbohydrates a day, based on a 1,600- to 2,200-calorie diet. Just to give you a point of reference, each 1/3-cup serving of rice, sweet potato or pasta each provides approximately 15 grams of starches.

Weight loss goal- Reduce your intake of starchy carbohydrates, including bread, rice and potatoes, to a minimum until you start losing weight at a healthy pace of 1 to 2 pounds a week. Add more fiber to your diet to increase your sense of fullness.

Physical activity- If you are physically active, getting in enough starchy carbohydrates, especially in the post-workout period, can help you replenish your glycogen stores to better fuel your next workout. It, however, varies with the individual’s age, gender and weight and intake of starch should be adjusted accordingly.

Because starch and sugar both give us 4 cal per serving, it is important to choose wisely from a wide variety of foods to not exceed the daily limit. Inclusion of lots of fresh fruits and vegetables are a good way balancing the total carbohydrate intake with minimal portions coming from sugar and/or starch.

This blog is written by Sharmin Hossain, a student intern of Valley Nutrition Counseling  with a PhD major in Nutrition at the University of Massachusetts Amherst

Be Prudent with Portions

Weight management is all about energy balance, but what does this mean? In order to lose weight we need to eat less calories and burn more. Taking in the right portions of food is very critical in weight management. Unfortunately, in today's day and age portion sizes have doubled and even tripled in size. For example, a plain bagel 20 years ago used to be 150 calories, but now it's 350 calories. Today a small fries are 7 ounces with 610 calories, but 20 years ago it was only 2.4 ounces with 210 calories. Even the popcorn you get at the movies is 630 calories, but it used to be 270 calories. These numbers are shocking! How can 500 calories be consumed with just a bagel and coffee? Instead of refusing to go out to eat, it's better to enjoy the foods you love with modifications.

It's important to remember that you don't have to avoid eating bagels, popcorn, or french fries; just remember to eat in moderation. Instead of eating a whole bagel lathered with cream cheese, eat half of the bagel and a bowl of fruit. At the movies, ask for a small popcorn with no salt or butter. Try making your own french fries by cutting up potatoes and baking them in the oven. These alternatives make it possible to enjoy the foods you love while trimming down your waist line.

Another important aspect of weight loss is mindful eating. Try this trick... take a piece of food from your pantry and hold it in your hand. For this example a raisin will be used. Look and feel the texture of the raisin. Smell it and allow yourself to be completely absorbed in this experience. Put the raisin in your mouth without chewing it, focus on what it feels like with your tongue. When you're ready, take a bite and savor the taste. Take note of its chewiness. Taste its incredible sweetness. Clear all thoughts from your head and focus on that one raisin in your mouth. Keep chewing as long as you can, savoring the taste bit by bit. When you're ready you can swallow.

How do you feel after that? Did you notice anything about the raisin that you didn't realize before? How did it compare to your normal raisin experience? Eating mindfully helps you appreciate and savor your meals more. You'll find yourself eating less, but enjoying it more. This will create the negative energy balance we discussed before and ultimately weight loss. So the next bite you take make sure to savor it like it's your last and the pounds will certainly melt away.

This blog is written by Etana Matatia, a student intern of Valley Nutrition Counseling with a major in Nutrition at the University of Massachusetts Amherst

Get Thin With Fiber

Most Americans do not get enough fiber in their diets. After a hard day at work, you may come home feeling sad, annoyed, and hungry. Your first instinct is probably not to eat an apple, but something sweet and processed. Comfort foods like cake and candy may ease the pain temporarily, but they do not benefit your body and health in any way. These particular foods leave you feeling unsatisfied, empty, and even more hungry. Foods rich in fiber like whole grains, fruits, and vegetabes have the opposite effect.

Compare a piece of broccoli to a piece of cake. The piece of cake takes roughly 30 seconds to eat. It's common to eat sweets mindlessly and in large quantities. Taking second and third helpings is unresistable. On the other hand, the piece of broccoli takes over a minute to chew. The broccoli head is filled with nutrients that support optimal body health. This allows you to eat slower and savor your food longer. It's crunchy and satisfying, requiring many bites to break it down. Broccoli is filling and  it's rare for someone to go for a second and third helping of it. Fiber rich foods like broccoli will benefit your health and weight, but how does this occur? What properties are in broccoli that are not in a piece of cake?

 Why is Fiber Important?

Fiber is the part of plant foods that the body can’t digest. If the body can't digest fiber, why is it so important to include in our diet? Fiber is essential in regulating bowel movement by adding “bulk” to stool; this prevents constipation. Eating a diet rich in fiber can also prevent high blood pressure, high cholesterol, and weight gain. Fiber helps you feel full longer because it stays in your gut for longer periods of time. This helps prevent overeating because you are less hungry. High fiber diets are also typically lower in calories and fat.

 How Much Fiber Do You Need?

You're probably thinking okay so fiber is great and everything, but how much do I need to eat? Adult males need about 38 grams a day and females need 25 grams a day, but what does this mean? What does 10 grams of fiber look like? For example, a breakfast of ¼ cup oatmeal, 1 cup nonfat greek yogurt, ½ cup fresh blueberries would contain 10 grams of fiber, almost half a woman's daily recommendation! In comparison, a breakfast of 2 pancakes and glass of orange juice would only contain 2 grams of fiber. It's easy to modify your fiber intake by adding fruits and vegetables to your diet.

 What Foods are Major Sources of Fiber?

It's surprisingly easy to increase fiber intake. The major sources of fiber in our diet are whole grains, fruits, vegetables, beans, nuts and seeds. Three simple tricks to increase fiber intake are as follows. One is to swap your white bread for whole wheat. Two, try eating the whole form of a food rather than the juice counterpart. For example, eat an orange instead of drinking orange juice. Lastly, make sure to leave the skin on the fruit or vegetable (when possible) to increase fiber. Apples and cucumbers are crunchy and delicious with their skin left on. Make sure to wash them though! Incorporating fiber into your diet isn't hard and the health benefits are immense. Be prepared to get thin with fiber!

  This blog is written by Etana Matatia, a student intern of Valley Nutrition Counseling with a major in Nutrition at the University of Massachusetts Amherst

How Much Salt Is Too Much?

The American Heart Association recommends intake of less than 1500 mg of sodium per day for adults but on average we take more than twice the recommended amount. The recommendation translates to about 2/3 teaspoon of salt per day. Salt is made up of sodium and chloride but salt is not the only ingredient in our food that contains sodium. Other sources of sodium in our diet are baking soda, and food additives like MSG, sodium nitrite, and sodium benzoate. Only about 11% of our sodium comes from table salt and salt added to our cooking. The rest usually comes from processed foods high in additives. The best way to cut down on salt is cooking with fresh ingredients. On the other hand, physical activity and sweating increases your sodium needs.

Sodium is an important nutrient in controlling blood pressure, blood volume and electrolyte balance in our body. We only need 180 mg to 500 mg sodium per day equivalent to only ¼ teaspoon of salt to support all body functions that requite sodium.

High sodium intake has been associated with higher risk of high blood pressure, stroke, heart disease and kidney problems. People older than 51, African-Americans and people with high blood pressure, diabetes and kidney disease are high-risk populations who need to watch their sodium intake. Women’s average sodium intake is less than men’s therefore men are usually more at risk.

Like sugar, sodium is a common ingredient in most processed foods. It is also used as a flavor and color enhancer. Baked goods usually contain a lot of sodium because self-rising flour has leavening with lots of sodium in it. Baked goods add about 354 mg per day of sodium to the average American diet. Other high sodium products are dairy, canned products and cured meats. All types of salts including sea salt and kosher salt has the same amount of sodium as the regular salt so their differences are not the sodium content rather texture, taste and other components.

Watch for how much sodium you take by reading food labels to see how much is in one serving of each food. Even the sodium free products have up to 5 mg of sodium in them. “Low sodium” on the labels means up to 140mg of sodium per serving. Cooking with less salt or no salt and using spices and herbs for flavor in food are also great strategies to reduce sodium in diet. It usually takes 8 to 12 weeks to get used to the taste of low salt foods especially if you have been eating salty foods for a long time. 

Simple Weight Loss Rules: Eat Less and Move More

When I asked my grandfather how to lose weight, he always told me these simple words: eat less and move more. My grandfather passed away 20 years ago and I am now a registered dietitian with a PhD in nutrition, counseling many patients who badly need to lose weight. I ask myself: what am I saying different than what my old grandfather used to say? What are my rules?

Am I saying the same thing?

The difference between what I say to my clients and what my grandfather used to say to me is that I show them how to do it. Most people know they have to eat less and move more to take in less or lose more calories but they do not know how to do it successfully.

My six weight loss rules for short are:

1. Cut on Fat
2. Cut on Sugar
3. Cut on Starch
4. Cut on Portions
5. More Fruits & Vegetables
6. Exercise

My grandfather summarized my six weight loss rules in five words. I agree with him completely but I do not agree with the fact that it is simple especially when life is so stressful and everywhere we turn to, there are plenty of comfort foods with easy access. How can we not search for sugary, fatty and salty foods when stressed, hungry or bored? What makes it so difficult to follow rules? Is it our genetics, our age, food habits, time of the day or simply mindless practices that make us fail again and again? The reasons can be different for different people but we know for sure that we are losing touch with our bodies and hunger cues.

These are ten brief suggestions to how to follow my grandfather’s or my own rules:

1. Practice mindful eating
2. Listen to your hunger cues
3. Eat slow and chew well
4. Don’t skip meals
5. Plan meals and snacks ahead of time
6. Keep a food and mood diary to know your trigger situations
7. Find alternatives to food when bored or stressed
8. Make baby steps to change bad food habits
9. Make time for yourself
10. Manage stress

As general my rules and suggestions seem to look, they are keys to successful weight loss. Let’s listen to our bodies and become conscious about our lifestyle. Let’s solve this puzzle with the help of a professional and friends and family support. Let’s learn how to eat right and exercise for better health without obsessive behaviors. Let’s manage our weight naturally and comfortably for life. We all deserve a healthy nice body and why not starting to make a change now!!!

Are You an Emotional Eater?

If you are an emotional eater or stress eater, you don’t eat only when you are hungry rather you eat when you are stressed, anxious, lonely, bored or depressed. Food is comforting you for a short time but does not solve your problems. Emotional eating is a common cause for overweight and obesity and if not addressed correctly can get out of control. Emotional eating is more common in women than men and can negatively impact long-term weight maintenance after weight loss.

The problem is that most emotional eaters turn to fatty, sugary and high calorie foods because they have low energy. The reason can also be explained by hormonal imbalance when chronic stress will cause over production of hormones like cortisol. When cortisol and insulin are off balance, they make you feel like you need to eat more of the energy dense foods. Replacing healthier foods like high fiber, high protein, low calorie foods can also help you crave less for high calorie, fatty and sugary foods.

Emotional eaters can also become binge eaters. When one consumes large amounts of food in a relatively short period of time and when eating gets out of control, there is enough warning signs that the individual may have binge eating disorder.

Keeping a mood and food diary for a week can help you see how much of your eating is stress related.  Reflect on your diary and think about strategies that can help you cope with emotional-eating trigger situations without food. For example if you are lonely and bored during a weekend day, try to call a friend, take a walk or read your favorite book instead of turning to food.

Stress management techniques are highly recommended for emotional eaters. Exercise is still the best way to enhance your mood and feel more energy. Exercises like yoga, deep breathing, massage and meditation are great ways to distress. Planning what you do or eat when a trigger situation comes up ahead of time is also an effective plan to avoid eating when you want to eat for comfort not for hunger. In summary, you need to learn how to be in control of your emotions rather than being controlled by them.

IBS? Help Is Available!

Irritable Bowel Syndrome or IBS is a common disease of the large intestine or colon. Its symptoms include abdominal pain, cramps, bloating, gas, and change in the frequency and form of stool. About 7% of the US population is affected by IBS with more prevalence among women than men.

Treatment includes antidiarrheal and/or antispasmodic medications, stress management and diet. Food intolerances and/or food sensitivities are common triggers of IBS symptoms. Several elimination diets like low FODMAPs and LEAP have helped many IBS patients to recover from or improve symptoms for long term. However registered dietitians should supervise elimination diets to ensure adequacy of all nutrients in them.

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols, which are short chain carbohydrates, and sugar alcohols that are poorly absorbed in small intestine and will pass through large intestine. FODMAPs are fermentable by gut bacteria and therefore cause bloating, gas, abdominal pain and cramping. They are also highly osmotic and attract water into the colon and cause constipation or diarrhea. Following a low FODMAPs diet is usually done for 6 to 8 weeks. Eliminated foods will then be added one a day in order to identify trigger and non-trigger foods.

Another effective elimination diet is LEAP which stands for Lifestyle Eating And Performance. LEAP is an ImmunoCalm elimination diet based on a blood test called MRT which stands for Mediated Release Test. MRT checks the immune response to 150 commonly eaten foods and chemicals. LEAP dietary program should also be supervised by Certified LEAP Therapists (CLT) who are also specially trained registered dietitians.

Elimination diets are effective treatments to improve and control IBS symptoms and can replace medications if followed strictly under expert supervision.

How Much Water Do I Need?

Water is an important nutrient in our diet since without it we cannot survive more than a few days. About 75% of body weight in infants and 55% of body weight in elderly are water. We get water through variety of sources including food and beverages like milk, soups, fruits and juices. Dehydration by all means should be prevented since water is constantly a requirement for metabolism, human performance and overall health. There are many studies on the role water plays in chronic diseases and overall health but not enough studies on determining the water requirements of individuals on daily basis. The US Dietary Recommendations for water are based on the median intakes and not on measurements of hydration status of the US population.

Thirst is a physiological control mechanism to maintain body water and fluid. Our kidneys have an amazing ability to regulate water balance by eliminating excess intake or conserving water by reducing urine excretion. Our kidneys are critical in body’s water regulation and they function better when we drink enough water and take less salt and toxins. In fact, we do not always drink because we are thirsty. We drink in social occasions and for pleasure specially when the water is not in its pure form and is a vehicle to carry alcohol or sugar. This type of drinking is mediated through the taste buds. The fluid consumption among the US adults has been increased in the past decades mainly due to consuming more high calorie beverages not just pure water.

High levels of activity and heat can cause sweating and experiencing more thirst. The cells shrink because water leaves from inside the cells to the extracellular compartments. The sodium ion also is lost through sweat and therefore people prefer drinks that are high in salt. In elderly, this can lead to hypotension, stroke or abnormal fatigue and even death. Elderly population is more at risk of dehydration since they do not experience thirst like younger counterparts. Hypo-hydration can cause loss of electrolytes, increase blood viscosity and increase the body temperature. On the other hand, children are also more at risk of dehydration stress on their body since they have higher ratio of surface area to weight and are susceptible to more heat related diseases.

Even though there is no study supporting that drinking additional water in adequately hydrated individuals is beneficial but when it comes to physical activity and athletic performance especially during endurance exercises like running, extra water intake can prevent fatigue and improve motivation. Exercise especially in hot climates is associated with hyperthermia, reduced stroke volume and cardiac output, hypotension and lower blood flow to muscles. Both children and adults should drink water above their hydration status before starting athletic activities in hot climates.

Among other impacts of dehydration on physical and mental health are delirium among older adults, constipation, stress on kidneys, impaired cognitive performance like on short-term memory, frequency and intensity of headaches, skin health, urinary tract infections and blood pressure. However there is a need for more studies to confirm associations between dehydration and other chronic diseases like bladder or colon cancer or neurological disorders. There is also no study to confirm that drinking water alone is more beneficial than water containing other components like sweeteners and or caffeine. On the other hand, studies have shown that when people drink pure water, they generally have lower caloric intake than those who drink high calorie drinks.

Given the huge variability of water requirements based on variability in metabolism, weather conditions and physical activity, an adequate intake (AI) is established for the US population.  According to the Institute of medicine, an adequate intake of water for men is roughly 3 liters about 13 cups and for women is 2.2 liters about 9 cups. The recommendation of eight 8 oz-glasses of water is roughly 1.9 liters which is a close approximation. 

Understanding Bulimia

Bulimia Nervosa is a type of eating disorder when an individual gets rid of the excess food intake (i.e. binge eating) by different methods of purging like vomiting or laxative use. The purging behavior usually goes unnoticed by family and friends for a long time till the person’s health and nutrition status become severely compromised. Bulimia can lead to low self-esteem, social isolation and negative feelings of guilt and shame or vice versa.

Both binging and purging behaviors relate to positive and negative feelings for those individuals who specially have misperceptions of good and bad body size and shape. When they feel bad after binging, they think they look bad and to feel better they should purge the food. The bad and good feelings and bad and good body weights and shape create a vicious cycle which has to be broken by professionals who have expertise in the field of eating disorder. Food is usually a tool to solve feelings associated with life problems.

Bulimia occurs more in women than men where rates are also higher among adolescents and college students. Bulimics usually binge different amounts of high fat and high sugar foods that are usually soft, easy to digest and regurgitate. Often times, stress and anxiety perceptions lead to binging and feelings of guilt and shame.

Self-induced vomiting can cause electrolyte imbalance that can lead to death and disability if severe. Bulimic symptoms also include water balance disorders like dehydration, multiple GI disorders, poor bone and dental health and menstruation irregularities. Therapy should be individualized and performed by a team consisting of a primary health provider, a dietitian and a psychotherapist.