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Archive for January, 2009

About Exercise

The main obstacle – or excuse – for people who don’t exercise regularly is a lack of time. That’s a shame. Physical activity should never be considered as expendable but should rather be given a high priority in one’s daily routine. It doesn’t matter what exercise program or sport you choose, as long as you do something you enjoy. Focus on three areas: Aerobics, strength and flexibity. You can benefit from low-impact activities, such as walking, Yoga  or Tai Chi – or you can advance to more strenuous exercises, such as running, swimming, bicycling, weight lifting etc. Whatever you decide on doing, do it for at least half an hour every day.

Some Basic Information About Exercise
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Making Time For Exercise
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Calculating Your Target Heart Rate
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Young Bodies Need To Exercise
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Fitness Exercise For The Aging Mind
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Lifestyle Changes Matter More Than Dieting

Americans love to diet. Nearly 40 percent of women and 25 percent of men in America are on a weight-loss diet at any given time. Nationwide, we spend over 15 billion dollars annually on dieting-related products and services. And yet, we have the highest rates of obesity, heart disease and diabetes anywhere in the world. It is the sad truth that the vast majority of dieters eventually fail, despite their earnest efforts to control their weight.

Quick fixes are naturally more attractive than long term strategies. Diets that promise immediate results and don’t require too much effort enjoy the highest popularity. The problem is that fast results are rarely sustainable over time. The word “diet” itself suggests an only “temporary” break from one’s regular lifestyle. There is the implicit assumption that the diet will end as soon as the intended goals (i.e. weight loss, lower blood pressure, etc.) are accomplished. Dieting may be hard, but at least it’s not permanent. It is needless to say that this kind of attitude makes relapsing into old habits almost inevitable.

Of course, dieting is not altogether to be dismissed as futile because of lousy success rates. If the goal is to lose a few pounds in a hurry for swimsuit season, almost any weight loss program will do the trick. However, instead of looking for a magic bullet that does the job as quickly and as efficiently as possible, I think, it would be more beneficial to have a long-term strategy that goes beyond instantly gratifying results. In other words, instead of focusing on dieting for the single purpose of weight loss, I would rather favor a systematic development of (and permanent adherence to) an overall healthy lifestyle.

A diet plan I’m particularly fond of is called the Mediterranean diet, especially since it is rather a “lifestyle” than a “diet.” Read more »

Too Much Salt in Our Food Creates Serious Health Hazards

The typical American diet contains way too much salt, according to clinical studies recently published in the New England Journal of Medicine (1/22/2010; NEJM.org). This is not exactly news; however, the negative consequences for our health from the widespread overuse of salt in our food are more evident than ever before.

Clinical research has long shown the existence of direct links between increased salt consumption and hypertension (high blood pressure) as well as cardiovascular disease. Yet, salt consumption remains on the rise. The bulk of our salt intake, however, does not primarily come from excessive usage of salt in the kitchen or at the dinner table, but rather from many of the food products we eat every day. In fact, almost 80 percent of our salt intake is derived from processed foods, not from salt added during preparation or consumption. In particular breads, processed and canned meats and vegetables as well as soups, sauces and many spices contain high amounts of salt, mostly in the form of sodium chloride. Sodium is used in food manufacturing and packaging to add flavor and as a preservative to prevent spoilage and add shelf life. More surprisingly, many medications and vitamin supplements also contain elevated levels of sodium.

The Department of Agriculture (USDA) and the Department for Health and Human Services (HHS) recommends keeping our daily salt consumption at a maximum of 2,300 milligrams of sodium, roughly the equivalent of a teaspoon of salt, depending on health status and age. That’s far below the 4,160 milligrams most Americans eat on average every day.

As widely reported in the press, the Health Department of New York City has now begun campaigning for a voluntary reduction of salt use by food manufacturers and restaurant chefs who operate within its jurisdiction. New York’s initiative is laudable, especially if it leads to a widespread following elsewhere. On an individual basis, however, behavioral changes will be harder to come by. So far, there has been little progress in public awareness about the potential health risks from excessive salt intake. Some experts have pointed out that behavioral modifications in the larger population take time, as we have seen with public health campaigns about tobacco or cholesterol. Stepping up regulatory measures would be helpful as well, considering that the Food and Drug Administration (FDA) officially still regards salt as a “generally safe” food additive.

Limiting the use of dietary salt in our food supply through educational as well as regulatory efforts, even if only to a modest degree, could potentially make a significant difference in the fight against coronary heart disease and hypertension. Foreseeable benefits are not only measurable in terms of saved lives, but also in terms of actionable preventive measures to reduce health care costs.

As always, there is resistance to be counted on, not only from the food industry but also the public. After all, dietary preferences are perceived by most of us as a very private matter that should not be scrutinized by others. Manufacturers will claim that new regulations are either not feasible or too expensive. However, I think we should be hopeful. Business always knows how to turn an obstacle into another asset. Have you noticed how many food items now post big “NO TRANS FATS” signs on their labels? That too was rejected as an unreasonable burden only a short time ago. Before we know it, items with “NO ADDED SALT” will get the most shelf space. And what about the restrictions on our personal choices? Well, we hardly can remember when smoking in restaurants and other public places was considered a “private matter.”

Most of these things change over time, often insidiously and unnoticeable. Only when we look back, we can recognize that some changes, indeed, have been for the better. Besides, we don’t have to wait for others to take action. Don’t be afraid to speak your “health-conscious mind”! Before you buy, take a moment to read carefully the Nutrition Facts labels on your packaged foods, and then pick the brands with the lowest sodium content. This way, you can influence both business and public policy right now, and even more so in the future.

Making the “Bucket List”

In an upcoming movie, Jack Nicholson and Morgan Freeman play two characters with vastly different social backgrounds who find themselves both diagnosed with cancer. They decide to forego the less than promising medical treatment and, instead, live their last days to the fullest hoping to go out with a blast. The movie is titled the “Bucket List,” a choice of words that suggests that we make a list of things to do (and/or see) before we inevitably “kick the bucket.” Despite its ultimately dire prospects, the message of the movie is supposedly positive and even funny.

The idea of “get-it-before-it’s-too-late,” of course, is by no means new. There’s already a best-selling book series (with a follow-up TV reality show) out there that urges us to see at least 1000 places around the globe before death will stop us in our tracks.

The obvious purpose of these messages is to promote a rapidly growing market that is opening up with the retiring Baby Boomers in mind, the generation that has dominated America demographically for the last forty plus years. “Active retirement” is the new fad. Although that sounds like an oxymoron, it’s supposedly the next place to be. And for good reasons. Due to increasing longevity and overall higher quality of life of today’s older generation, it is only logical that traditional retirement is rapidly becoming a thing of the past. There’s talk about a “second spring,” or even a “second adolescence” that mature adults revisit when their grown kids leave the nest. Read more »

I’m Trying to Lose Weight, But I’m Not Getting the Support I Need

 

Dear Timi,
I have gone on a fitness and weight loss program and have already had some success. The problem is that my husband, who also could lose a few pounds, has no interest in joining me and does not want to change the ways he likes to eat. At this point, I’m cooking different meals for him and myself. Should I try harder to convince him that better eating habits would be beneficial for him as well?

Dear Reader,
First of all, congratulations to your success! You are right to pursue your health goals with or without the cooperation of your husband. Your experience is actually not uncommon. I have counseled a number of patients who have felt, at least initially, unsupported and even opposed by loved ones in their efforts to improve their health.

There can be several reasons for these negative responses. Some spouses simply don’t want to be inconvenienced by any lifestyle changes that may be introduced in their household. They may tolerate your actions, but only as long as they don’t affect them.

On more than one occasion, I have witnessed tensions arising between spouses as soon as the effects of weight became visible. Others may notice your physical changes and pay you compliments. You may be getting a kind of attention that can make any husband uncomfortable, if not outright jealous. Sabotaging your progress is a possible reaction. In cases such as these, couples should deal with their issues sooner rather than later by communicating openly and clearly with one another.

If your husband is not ready to join you in a weight loss regimen, you should probably not push the agenda right now. Most people don’t like the thought of dieting unless they have to. The fact that you feel forced to do double duty in the kitchen is more worrisome. If your adherence to a health-conscious diet turns out to be too much of a burden for you, you will not stick to it either.

So, here’s what I suggest that you do: Instead of serving a kind of food your husband really doesn’t like, you can work on improving the nutritional value of meals you both enjoy, for example by making better ingredient choices and using smarter cooking methods. I tell all my clients that the best way to diet is to improve the quality and taste of your food.

In addition, the two of you may find common ground by working out together or by going on walks and bike rides. Who knows, before long, you both may have reasons to be jealous of each others good looks…  Read more about Getting Support »

Strictly Vegetarian, Too Radical?

Dear Timi,
As a “Vegan,” I adhere to a strictly vegetarian diet. My friends and even my doctor keep telling me that my eating habits should be more balanced since I won’t get a sufficient amount of protein from plant food alone. Am I too radical in my approach to healthful eating?

Dear Reader,
All diets, including strictly vegetarian diets, should strive for balance. There are, of course, variations of vegetarian preferences, such as Semi-vegetarian (includes fish, poultry, eggs and dairy products), Lacto-vegetarian (includes dairy products), Ovo-vegetarian (includes eggs) and Vegan (includes only plant food and omits all animal products). Vegans, such as yourself, may indeed run the risk of some nutritional deficiencies, not only because of the absence of animal protein, but also because of the lack of vitamin B-12 which is only available in animal food products.

When certain foods are excluded, missing key nutrients must be replaced by other sources. For instance, when no meat, fish or poultry is consumed over extended periods of time, Protein, Thiamine, Iron, Zinc, Vitamin B-12 and Folate must be provided by other food items that can substitute these nutrients. Those could be milk, dairy products, eggs, grains, nuts, seeds, legumes and fortified soy milk. If some of these are excluded from a strictly plant-based vegetarian diet as well, access to “complete” high quality protein can be a challenge. Only animal and soy proteins are considered “complete” – meaning they contain all the essential amino acids (the building blocks which make up protein) the human body requires. Plant foods provide only “incomplete” proteins since they lack one or more essential amino acids.

The good news is that Vegans can make up for missing nutrients by a mix and match approach. For example, grains consumed with legumes (beans, peas) make “complete” proteins. So do other combinations of plant-based foods. Fortunately, complementary proteins don’t have to be consumed all at once and their intake can be distributed over the course of an entire day.

The Message of Good Health – Keep Paying it Forward

I love Gladys. Gladys is one of my greatest success stories in a personal mission of mine that began in the year 2000. You may remember the movie with Kevin Spacey and Helen Hunt that tells the story of a young boy, Trevor McKinney, played by Haley Joel Osment, who tries to make a positive difference in the lives of three complete strangers in response to a school assignment named “Pay It Forward.” According to the story, it was Trevor’s teacher who had come up with the idea that if each and everyone of us committed ourselves to help only three other people, and they would in turn do the same for three more and so on, it would eventually lead to an ever widening circle of benefactors and beneficiaries, which could eventually improve many people’s lives. Read more »

Where Does Your Food Come From – Should You Care?

A few years ago, I was about to have a book published. Everything was ready to go when my publisher called with bad news. The agency in charge of the printing process had given the print job to a new company overseas. Originally, we were supposed to print in Korea, but now my book was to be printed in Hong Kong instead. No big deal, one would think. The problem was that we had already put “Printed in Korea” on the back, and now the expensive book covers had to be completely redone, which delayed the date of release and added considerable costs. We had no choice. The law requires that all books available in the United States must indicate clearly and truthfully the name of the country where they were printed – no exceptions. Read more »

Scary Statistics of the Diabetes Epidemic

The online journal, BioMed Central, has recently published a nationwide survey on diabetes in the United States that includes a detailed state-by-state breakdown. The results are not surprising and confirm more or less what researchers have known for quite some time: Diabetes continues to be on the rise everywhere in America, and the situation is the worst in the southern parts of the country. Read more »

New Year’s Resolutions – Count on Failure

It is the time of the year again when many people think of changing their “evil ways.” The Holidays are over and regrets abound. Too many indulgences have left their ugly marks, mostly around the waistline. For us dietitians business is good but, unfortunately, we also get plenty of “repeat customers” – patients we have seen before. I never look forward to these reunions. Read more »

Your Health – A Larger Picture

People have great expectations when they visit a dietitian for the first time. They are motivated and ready to make real changes in their lives. I have seen many clients with serious health problems – often caused by reckless, addictive or otherwise dysfunctional lifestyles. Naturally, I talk about the importance of sound nutrition, the need to exercise and the dangers of alcohol and nicotine. That is what gets discussed on the surface. In most cases, it doesn’t address the real issues. It’s only the tip of the iceberg.

Unhealthy lifestyles are typically symptomatic for ailments that lie much deeper. People who have otherwise happy and fulfilling lives don’t normally exhibit self-destructive behavior. Consequently, I don’t believe in treatments that deal only with the symptoms and don’t go to the root of the problem at hand. Prescribing a weight loss and exercise program may be a good and even necessary first step, but it can only go so far – like kicking tires when buying a used car: you don’t learn much about the other parts that may need fixing. The picture has to be much larger.

As a rule of thumb, I tell my clients that their health and well-being rests essentially on three pillars: A balanced diet, physical fitness and peace of mind. Neglect one of them over time and things will start falling apart.

Developing a healthy lifestyle is a complex undertaking. We’re not born with the instinctive knowledge of how to take care of ourselves. Despite of the relentless onslaught of health and fitness advice generated by multi-billion dollar industries, we seem more confused than enlightened. Even the experts are unable to agree for long on one theory or another. We have to learn what works for us as individuals – often by trial and error. There is no single “right” path to achieve this, as there’s no “right way” to live. However, there’s a way that’s right for you and me. And to find that way is what matters. The question is where do we start looking.

Here’s my proposal: Before you enroll in another weight loss or fitness program, think about what went wrong last time – and the time before. What is it that tempts you to reach for that donut, that extra glass of wine, that cigarette. Is it hunger for food or for comfort? Is it because you haven’t eaten or because you’re bored and frustrated with your day? Are alcohol or cigarettes your remedies of choice whenever you’re stressed out? Do cookies and ice cream make you feel less lonely? It may be far less important to pay attention to what you’re actually doing than to understand the underlying motives that lead to your actions.

When things go wrong despite your best intentions, don’t blame it all on your weakness and lack of determination. It’s easy to give up and let the chips fall in your mouth. However, resigning yourself to the idea that a healthy lifestyle is just too hard to maintain is not a solution. Especially when negative health effects begin to show up. You’re not bound to fail forever – unless you want to. Don’t allow yourself to make excuses that keep you from succeeding. Ultimately, it is up to you to make the decision and choose to be healthy. Yes, it requires a commitment – but not a commitment to a program that has been designed and packaged in a one-fits-all format for sale. Rather, it requires a commitment to yourself. Take ownership of your well-being! Before I start working with new clients, I make a point of asking them a very important question: What do you want your life to be? Then act upon your answer.

So, when you feel next time that things are getting off balance, don’t make another resolution. Make a choice instead. Choose to make your life what you want it to be. Instead of dwelling on regrets, start over by setting realistic goals and building clear strategies. Then implement and execute your plan. You will know how to.

Staying Healthy in Tough Economic Times

Some time ago, I saw a patient who had become unemployed at an age where finding another job wasn’t going to be easy. He had been struggling with weight issues on and off for years past, but now he was facing some serious health problems. The stress from his job search and the increasing anxiety about his financial situation made it difficult for him to maintain a healthful lifestyle. Instead, he found himself drawn to eating more snacks and comfort food. Substantial alcohol consumption added to the damage. Before long, the results became all too obvious. Read more »