Author: Nadea S. Minet MS, RD, LDN

Week of April 2, 2012

8 Healthy Foods that Keep you Full

There’s nothing worse than walking away from the table and still feeling hungry. However, there is a way to put an end to this feeling. Certain edibles can leave you satisfied longer, which is a key element to losing weight. Eating foods that fill you up and satiate your appetite without giving you a dose of fattening calories is the way to go.  So try to remember the magic trio of protein, healthy fats and fiber is the best recipe to weight loss and maintenance.  Here are some favorite healthy filler-uppers.

1.  Eggs- They are a great source of hunger-quelling protein (about 6 grams per egg).  One study found that women who ate eggs for breakfast lost more weight than those who had bagels with the same number of calories, possibly because all the protein in the egg kept their hunger in check.  They are low in calories (about 70 calories per egg), and egg eaters report they have more energy!!

2.  Soup- Since soup is mostly liquid; your brain perceives it as filling.  Studies show foods containing a lot of water can keep you feeling full longer. When you start a meal with soup, you activate brain signals that begin to tell you you’ve had enough to eat.  By the time you finish your second course, you’ll be satisfied. Go for a broth-based bowl with fiber-rich veggies like celery and spinach.

3.  Avocados- Avocados are so misunderstood.  So many people avoid them because they think they’re fattening.  While they do contain fat, it’s the “good” fat (monounsaturated fatty acids) and avocados contain protein that will fill you up.  They are loaded with vitamins and minerals such as potassium, Vitamin E, and folate.  Not only can you add avocados to salads, but they’re also great as a spread on sandwiches, by themselves with a little lime juice or in a smoothie.

4. L0w-Fat Greek Yogurt- Going Greek is in.  Both Greek and regular yogurt can be part of a healthy diet.  They’re both low in calories and packed with calcium and live bacterial cultures, However, our Mediterranean friend is packed with protein (almost double the amount of regular yogurt) since it is strained extensively to remove much of the liquid whey, lactose and sugar, giving it a thick consistency.  For someone who wants a creamier texture, a little bit of a protein edge and a sugar decrease, Greek is definitely the way to go.

5.  Oatmeal- Oatmeal is the food weight loss dreams are made of.  It contains high amounts of soluble fiber, which slows digestion and keeps you full for hours.  Whole grains, like oatmeal, are bulky so it doesn’t take much to make you feel satisfied.  It also provides a surprising 4-7 grams of protein and that’s before you add milk.  It’s a great super food because it’s low in sugar and it’s so easy and quick to prepare. It’s only takes 5-10 minutes to cook and you can let your creativity run wild, topping your oatmeal with pretty much anything!

6.  Apples- Apples are full of fiber. With only 80 calories, one can be as filling as a meal because of the 4 grams of fiber and high water content.  There is a reason why your mother told you repeatedly that “one apple a day keeps the doctor away”. It might sound clichéd, but packing an apple for your daily snack will not only add one fruit/vegetable portion to your daily recommended intake (which can be difficult to achieve post-op), but the fiber will fill up your stomach and you won’t be so preoccupied with food.

7.  Beans and Lentils- These protein-packed little gems are full of fiber and water — two ingredients that make you feel fuller faster.  And eating them may help you eat less of everything else.  They’re high in protein (about 7 grams per half cup) and high in complex carbohydrates, the type that take longer to digest. Studies show people who eat legumes are slimmer than those who don’t. Beans also stabilize blood sugar levels, which suppresses hunger longer. Add beans such as kidney, black, or pintos to your salads, pasta, soups, and whole grains.

8.  Nuts- Nuts are tasty and some varieties contain the healthy monounsaturated fatty acids, good for you fats, that keep you full for hours.  Research has found that dieters who snack on nuts lose more weight than those who don’t, however they’re not exactly calorie-free. Stick with the natural kind because they’re lower in added sugars and salt, and watch your portion size.  Choose 1 ounce (about 27 nuts or 170 calories) or less to avoid calorie overload. The dietitian favorites? Walnuts, almonds and pistachios.

In your quest to lose weight, you can decrease your portion sizes at every meal and snack, without feeling hungry by filling up on these low calories foods.  Eating fiber-rich, low-calorie foods will help you lose weight without suffering through the pangs of hunger and then you can Celebrate your success at last.

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Author: Heather K. Mackie, MS, RD, LD

Week of March 26, 2012

Examining Sugar Alcohols

Do you consume low-calorie, sugar-free foods and beverages to aid in your weight loss success?  If so, you most likely consume sugar alcohols, also termed polyols. Sugar alcohols are not sugar.  They are not alcohol.  So what are they?  What are the benefits of sugar alcohols?  Should you consume them?

Common Sugar Alcohols. Sugar alcohols have been used in food for quite some time.  Some common sugar alcohols you might see are: sorbitol, xylitol, maltitol, malitol, lactitol, mannitol, erythritol, isomalt, and polyglycitol (hydrogenated starch hydrolysates).  They are commonly listed on the Nutrition Facts Panel as sugar alcohols under the carbohydrates section or they may be listed by their specific names.

Defining Sugar Alcohols. Sugar alcohols are a group of low-digestible, low-calorie, carbohydrate-based sweeteners.  They are developed by hydrogenating (adding a hydrogen atom) their sugar or syrup (i.e., lactitol from lactose).  These sweeteners taste like sugar, but have some advantages, which we will discuss.  Sugar alcohols may be beneficial in terms of oral health, aid in weight loss or maintenance, and/or reduce overall dietary glycemic load (basically reduce the amount that blood sugar might rise from the total meal/beverage or combination).

Safety of Sugar Alcohols. According to the Joint Expert Committee on Food Additives of the World Health Organization and the Food and Drug Administration (FDA), sugar alcohols are safe to use for people of all ages (including children) and individuals with certain health concerns, such as diabetes and obesity.

Why Use Sugar Alcohols?  Where Do You Find Sugar Alcohols? The main reason that sugar alcohols are used in many foods and beverages is their ability to deliver the taste and texture of sugar and/or sugar syrups with only about half the calories.  Sugar alcohols are commonly used in chewing gums, candies, ice cream, baked goods, jams/jellies, fillings, frostings, canned fruit, beverages, yogurt, and tabletop sweeteners.  They are also commonly found in many bariatric-specific supplements.  You may also find them in toothpastes, mouthwashes, cough syrup, and throat lozenges.

Oral Health and Sugar Alcohols. Sugar alcohols have been shown to not promote and may slow or prevent the formation of dental cavities.  Also, their sweet flavor stimulates the production of saliva, which may further reduce plaque formation and increase mineralization of tooth surfaces.  In fact, the FDA has allowed a health claim for sugar-free products sweetened with sugar alcohols: “does not promote tooth decay.”

Glycemic Control & Sugar Alcohols. Sugar alcohols may reduce the overall glycemic load, which benefits blood sugar control.  This is especially important for individuals with diabetes or those at risk for diabetes.  Sugar alcohols have low glycemic responses and do not induce a rapid increase in blood sugar or insulin levels after consumption due to their slow and partial digestion in the small intestine.  Changes in blood sugar will vary among different types of sugar alcohols.  For example, blood sugar doesn’t increase as much with xylitol, sorbitol, and lactitol when compared to other types of sugar alcohols.

Carb Counting & Sugar Alcohols. Many individuals who have had weight loss surgery also previously or currently have diabetes and are familiar with a form of dieting called “carb counting” that is used to help control blood sugar.  Some experts in diabetes management advise that if all of a food’s carbohydrates are from sugar alcohols and the total carbohydrate count is less than 10 grams, then a serving is considered a “free food.”  If there are more than 10 grams of sugar alcohols, subtract one-half of sugar alcohols from the total carbohydrates and then calculate your exchange.

Weight Loss, Weight Maintenance, & Sugar Alcohols. For years, food manufacturers have created foods with sugar alcohols to improve the variety of great-tasting, low-calorie products.  Since sugar alcohols are only partially digested, they provide less than the traditional 4 calories/gram generally assigned to carbohydrates.  Below are the FDA-approved caloric values of various sugar alcohols and sugar:

• Sugar/Sucrose – 4 calories/gram
• Polyglycitols – 3 calories/gram
• Malitol – 3 calories/gram
• Sorbitol – 2.6 calories/gram
• Xylitol – 2.4 calories/gram
• Maltitol – 2.1 calories/gram
• Isomalt – 2 calories/gram
• Lactitol – 2 calories/gram
• Mannitol – 1.6 calories/gram
• Erythritol – 0.2 calories/gram

Sugar alcohols may help individuals maintain a lower-calorie intake overall.  But just like anything, they the solution to weight loss.  It still takes more than just incorporating sugar alcohols into your eating plan to lose weight, such as exercise, physical activity, and eating a well-balanced diet.

Gastrointestinal Health & Sugar Alcohols. Since sugar alcohols are digested differently than sugar, it is understandable that there might be side effects associated with sugar alcohols.  Please keep in mind this information is in general and every individual reacts differently to sugar alcohols.  Some people can tolerate certain sugar alcohols or certain levels of sugar alcohols.  But why is this the case?

Sugar alcohols are not absorbed completely.  The absorbed portion is either metabolized or excreted via urine.  A large portion of the unabsorbed part is metabolized to short-chain fatty acids and gases by bacteria in the large intestine.  There are cells lining the gastrointestinal (GI) tract that use these short-chain fatty acids for energy, while the acids contribute to the formation of an acidic environment.  This promotes the growth of beneficial bacteria such as Bifidobacteria and Lactobacilli. Therefore, many sugar alcohols are considered prebiotics because of their ability to stimulate the production of probiotics.

The lower digestibility of sugar alcohols is similar to high-fiber foods.  For some individuals, the overconsumption of sugar alcohol-containing foods may cause undesirable GI symptoms similar to the reactions you may get from overconsumption of high-fiber foods.  The degree of the symptoms is associated with a person’s sensitivity and the type of foods eaten or type of sugar alcohol.  GI symptoms may include a feeling of fullness, gas, or a laxative effect.  These symptoms are typically mild and temporary if they occur at all.  Some individuals may adapt to sugar alcohols after a few days.  Therefore, it is recommended to gradually increase the use of sugar alcohols into your eating plan if you are currently not consuming any at all.

The absorption rate varies among sugar alcohols.  For example, 0% of lactitol is absorbed, 60% of mannitol is absorbed, 80-90% of sorbitol is absorbed, and 90% of xylitol is absorbed.  As the rate of absorption increases (closer to 100%), it is theorized that the likelihood of gas production is minimized.  For example, xylitol and sorbitol are less gas producing than lactitol.

In general, sugar alcohols consumed at an amount less than 10 grams/day are less likely to cause GI disturbance (gas, bloating, diarrhea, cramping, etc.).  Sorbitol and xylitol appear to be to of the more tolerable forms of sugar alcohols.  But again, keep in mind every person is different – some may be able to tolerate as much sugar alcohol as they could possibly consume in a day, while someone else may not even be able to tolerate 1 gram of sugar alcohol.

We hope this helps to explain how sugar alcohols came about in the food and beverage industry, why they are used, that they are considered a safe alternative to sugar, and may actually have some benefit.  However, you have to decide what is right for you – read the facts and make the best decision you can for yourself regarding sugar alcohols.

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Author: Nadea S. Minet MS, RD, LDN

Week of March 19, 2012

10 Healthy Foods to Reduce Stress

Foods can soothe, reduce anxiety, and boost your mood.  These are well known to anyone who has kept a vise grip on a pint of Chunky Monkey at midnight or dived into the deep end of a party pack of chips at the end of a day gone awry.  Ice cream and chips do represent a fast track to happiness.

A load of simple carbohydrates provides an instant lift because carbohydrates trigger the rapid release of serotonin, the mood elevating “happy hormone”.  When the brain produces serotonin, we experience a calming effect.

The problem with a simple carb overload is that it sets off a physiological chain reaction that wreaks havoc on the body. It also taxes the adrenals, suppresses the immune system for hours after intake and generally leaves a person feeling sluggish and off-kilter.

When it comes to eating to reduce stress, you need to focus on 2 things: 1) boost the happy hormones (serotonin and dopamine) and 2) reduce the stress hormones (cortisol and adrenaline), which take a toll on the body over time.  The next time you feel under pressure, under the weather or just too close to the breaking point, try reaching for one of these ten stress-free foods that will help pull you back into the game.

Oranges.  A German study found that vitamin C rich foods, such as citrus fruits, help reduce stress and return blood pressure and cortisol to normal levels after a stressful situation. Prolonged periods of stress deplete levels of vitamin C in the adrenal glands, so it’s important to consume foods that contain high levels of it.  Vitamin C is also well known for boosting your immune system, which is often compromised when we are under a lot of stress.

Sweet Potatoes.  Sweet potatoes can be particularly stress-reducing because they can satisfy the urge you get for carbohydrates and sweets when you are under a great deal of stress. They are packed full of beta-carotene and other vitamins, and the fiber helps your body to process the carbohydrates in a slow and steady manner.

Dried Apricots. Apricots are rich in magnesium, which are a stress-buster and a natural muscle relaxant as well.  Apricots are also high in fiber and vitamin C, but don’t eat too many of them at one time, because they also contain quite a bit of fructose, the sugar found in many fruits, which can elevate blood sugars quickly.

Blueberries. These little blue miracle workers are jam-packed with antioxidants and vitamin C, which are potent stress busters. They are low in calories and a good source of fiber, which gives it an added bonus and can help relieve the cramps and constipation that can occur in times of stress.  Try mixing them with cottage cheese or plain Greek yogurt or eat them on their own as a snack or dessert.

Almonds, Pistachios, and Walnuts.  Pistachios as well as other nuts and seeds, are a great source of omega-3 fatty acids.  Eating a handful of pistachios, almonds, or walnuts every day may help lower your cholesterol, reduce inflammation in the arteries of the heart, lower the risk of diabetes, and protect you against stress. Almonds are packed with B and E vitamins, zinc, and magnesium, which help boost your immune system and regulate your mood.  Also, walnuts and pistachios may help lower blood pressure.

Turkey.  Turkey contains an amino acid called L-tryptophan. This amino acid triggers the release of serotonin, which is a feel-good brain chemical. This is the reason why many people who eat turkey feel relaxed, or even tired, after eating it. L-tryptophan has a documented calming effect, which could help to reduce stress levels.  Chicken also contains high amounts of this amino acid.  Try eating it baked or broiled (not fried) to obtain all the benefits this food has to offer.

Spinach.  Popeye never lets stress get the best of him; maybe it’s because of all the magnesium in his spinach?  A deficiency in magnesium can cause migraine headaches and feelings of fatigue, compounding the effects of stress. One cup of spinach provides 40 percent of your daily needs for magnesium, which goes a long way toward replenishing magnesium stores.  Green leafy vegetables are a rich source of magnesium.

Salmon.  Foods high in omega-3-fatty-acids help control unhealthy surges in stress hormones; they are also protective against mood disorders such as depression and they are important for proper brain function, and reducing your risk of heart disease. A study from Diabetes & Metabolism found that omega-3s keep the stress hormones cortisol and adrenaline from peaking.  Try a tuna salad or sandwich (with light mayo) for lunch or grilled salmon or mackerel with a side of leafy greens for dinner.

Avocados. One of the best ways to reduce high blood pressure is to get enough potassium; ½ an avocado has more potassium than a medium-size banana.  The monounsaturated fats and potassium, both found in avocados help to lower blood pressure.  As we know, one of the best ways to lower blood pressure is to consume enough potassium.

Green Vegetables.  Broccoli, kale, and other dark green vegetables are powerhouses of vitamins that help replenish our bodies in times of stress.  Folic acid, which is found in many green vegetables, helps relieve stress, anxiety, panic, and even depression. Crunchy raw vegetables can help fight stress in a purely mechanical way. Munching celery or broccoli helps release a clenched jaw, and that can ward off tension.  Try to incorporate green vegetables as a simple accompaniment to fish or chicken, or toss them into a stir-fry along with other vegetables and some beef or shrimp.

Eat the right combinations of real food at the right time, and your body will be less taxed. It will also be better able to handle stress so you can Celebrate your success each and every day.

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Author: Heather K. Mackie, MS, RD, LD

Week of March 12, 2012

Oatmeal: Healthy or Not?

Following weight loss surgery, many patients choose to consume oatmeal, especially during the softer food phase of their healthy eating plan.  While oatmeal is touted as being a wonderfully, healthy, great-tasting food, is that always the case?  More and more fast food establishments are adding oatmeal to their breakfast menus, but is it a better choice than other options?

Oatmeal Basics. Including oats in your regular eating plan will provide a wide range of important health benefits.  Oatmeal is a significant source of dietary fiber, both soluble and insoluble.  Soluble fiber has been proven to be effective in lowering blood cholesterol.  The best benefit is seen when ½ – 1 cup of oatmeal is consumed daily.  Soluble fiber has also been shown to reduce dramatic changes in blood sugar levels.  Soluble fiber may also reduce blood pressure levels and reduce one’s risk of cancer.  Fiber is also well known to relieve constipation.  Fiber also keeps one feeling full for a longer period of time, which helps with weight loss.

One-cup of cooked oats (plain) provides 148 calories, 2.4 g fat, 0.4 g saturated fats, 0 mg of cholesterol, 25.2 g carbohydrates, 4 g fiber, 0.6 g sugar, and 6 g of protein. The Perfect Oatmeal (Starbuck’s version) plain comes in at 140 calories, 2.5 g fat, 25 g carbs, and 5 g of protein.

Oatmeal Add-Ins. As you can see oatmeal by itself isn’t that bad.  As with many other foods, it is the add-ins that can take a healthy food and turn it into an unhealthy option.

• Brown Sugar Topping. For example, Starbuck’s offers a brown sugar topping to be served with its Perfect Oatmeal.  By choosing to mix this in with your healthy oatmeal, you add another 50 calories and 13 g sugar.
• Dried Fruit Topping. Sprinkle dried fruit (raisins, craisins, etc.) into your oatmeal to tally up more calories.  The packet Starbuck’s offers will tack on another 100 calories, 24 g carbs, 20 g sugar, and <1 g protein.  While you get some nutrients from the dried fruit, adding real fruit might be a better option.
• Nut Medley. This add-in provides an additional 100 calories, 9 g fat, 2 g carbs, and 2 g protein.  This does include some healthy fats, but still may not be the best bet to start your day.
• Add all 3 of the above and you are looking at 390 calories, 11.5 g fat, 64 g carbohydrates, and less than 7 g protein.  For many weight loss surgery patients, this is more than one-third of their calorie recommendation for the day and only one-tenth of the necessary protein intake (based on general recommendations of ~ 1000-1200 calories/day and 60-90 g protein/day).

How to Ensure Your Oatmeal is Healthy. There are many alternative add-ins that you can use to make tasty oatmeal and a nutritious start to your day.  Just because your favorite fast food joint now has oatmeal, doesn’t mean that should be your breakfast of champions.  For example, McDonald’s Fruit & Maple Oatmeal has about as many calories as the Egg McMuffin, but far less protein (5 g vs. 18 g protein).  It has more sugar than a Snicker’s bar!  So do your homework and know your choices so you can make the best choice for you!

Some alternative add-ins might include:

• Splenda Brown Sugar Blend – while this is half brown sugar, half splenda it will save you about half the calories of regular brown sugar.
• Consider choosing a smaller portion of dried fruit and/or nuts.  Or consider using fresh fruit only.
• Some patients I used to work with added liquid egg whites as they were heating up their oatmeal in the microwave (stir while heating) to increase protein content of their oatmeal.  3 Tbsp of liquid egg whites provides about 25 calories and adds 5 g protein!
• You can also consider adding protein powder to “beef up” your oatmeal making it more weight loss surgery friendly.  Consider adding protein powders that would mix well with oatmeal, such as cinnamon roll protein powder, cappuccino protein powder, vanilla protein powder, etc.  An average serving will provide about 90-110 calories and 20 g protein.

Oatmeal is a great and easy-to-fix breakfast, but just like any other food, it can be modified and become a not-so-healthy food.  I hope you enjoy your healthy oatmeal as you continue your journey to wellness.  Please share with us ways that you incorporate oatmeal into your healthy eating plan.

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Author: Nadea S. Minet, MS, RD, LDN

Week of March 5, 2012

National Nutrition Month

March is National Nutrition Month® (NNM) and the theme for this year is “Get Your Plate in Shape.” NNM is a nutrition education and information campaign created annually during the month of March by the Academy of Nutrition and Dietetics (AND). The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits.

Before you eat, think about what and how much goes onto your plate.  Fruits, vegetables, whole grains, low-fat dairy products and lean protein foods contain the nutrients our bodies need without too many calories and extra fat.  You should try to include foods from all the food groups on a daily basis, and follow these great tips to “Get Your Plate in Shape”.

Make Half Your Plate Fruits and Vegetables. Eating a variety of fruits and vegetables especially those dark in color (dark green, red and orange vegetables) will provide you with the vitamins/minerals your body needs.  Fresh, frozen, and canned fruits and vegetables all count.  Make sure to choose “reduced sodium” or “no-salt-added” canned vegetables and “no sugar added” canned fruits.  As a weight loss surgery patient, you may not reach the previously recommended 5-9 fruits and veggies, per day, but don’t focus on that.  Focus on including fruits and veggies as you can and making them about half of your plate (and using a small plate as a weight loss surgery patient is important too).

Make at Least Half Your Grains Whole.  Check the ingredients list on food packages to find whole-grain foods and choose 100% whole-grain breads, cereals, crackers, pasta, and brown rice.

Vary Your Protein Choices. Lean protein is an important part of any healthy diet and can help you with your weight-loss efforts.  Lean protein provides you with a sense of satiety and can help prevent overeating. Try eating a variety of foods from the protein food group each week. Lean sources of protein include fish, chicken and turkey (white meat), beef (round, loin), eggs, as well as nuts and beans, edamame, and tofu.

Switch to Fat-Free or Low-Fat Milk (Dairy Products). Fat-free and low-fat milk have the same amount of calcium as whole milk, but with less calories and fat without the loss of flavor.  If you are lactose intolerant, try a lactose-free milk or calcium-fortified soymilk.  Try including low-fat cheese and yogurt to your healthy eating plan.  Both are good sources of calcium, vitamin D, protein and potassium.

Cut Back on Sodium. Look out for sodium in the foods you purchase.  You will be surprised what foods have sodium in them and they don’t even taste salty (yogurt anyone?).  Compare sodium in foods by reading the labels and choose the products with the lesser amounts.  Prepare food using little or no salt, for example skip using salt in cooking pasta, rice, cereals, beans, and vegetables.  Taste your food before reaching for the shaker; this may seem obvious, but it can make a huge difference in the amount of sodium you consume on a daily basis.  If you feel your food needs salt, lightly add a tiny bit as needed, not as a habit.  You might find your food tastes better without using added extra table salt.  Using salt-free seasoning blends, spices, and herbs to add flavor without adding salt is also a great way to spice up your food. This can help you wean yourself from a salt craving. In a short time, you won’t even miss it.

Find Your Balance Between Food and Physical Activity. Regular physical activity is imperative for your overall health and fitness—plus, it helps control body weight, stimulates a feeling of happiness and reduces the risk of chronic diseases. Try choosing activities you enjoy and do each for at least 10 minutes at a time. Aim for a total of 2 ½ hours of moderate physical activity per week. If you are just starting out, check with your doctor concerning increased physical activity.

Reaching and maintaining a healthier weight contributes to your overall health and well-being.  Focus on the big picture:  achieving overall good health.  You are more likely to succeed in reaching realistic goals when you make changes step-by-step. Start with one or two specific, small changes at a time. Track your progress by keeping a food and/or activity log and Celebrate your success every step of the way.

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