Obesity or being overweight typically refers to one who has a high proportion of body fat. The clinical definition of obesity is a body mass index (BMI) of 30.0 or higher, which can be calculated as your weight in kilograms divided by your height in meters squared (BMI = [kg/m²]). If your BMI is between 18.0 and 24.9, you are considered to be normal weight. If your BMI is 25.0 and 29.9, you may be considered overweight. But does your weight always indicate whether you are healthy or at risk of disease? Can you have a “normal” weight and be fat at the same time?

A recent study from the Mayo clinic published in the European Heart Journal analyzed over 6,000 Americans with normal body weight, as measured by BMI, but who also had a high percentage of body fat. Based on the 9 year study, these individuals were at a greater risk of heart disease relative to those with low to normal percentage of body fat. A similar study published in the journal Circulation, also indicated similar results when examining 17,000 middle-aged men from Sweden. Overall people with a higher ratio of fat to muscle tissue, but not considered overweight may have an increased risk of heart disease.

The fat in our bodies is not stagnant or inactive. In fact, fat is a tissue with unhealthy properties which releases inflammatory agents that increases one risk of diabetes and heart disease. Although research is needed to determine whether a reduction in percentage of body fat can lower one’s risk of heart disease, we do know a little extra weight around the middle can increase your risk of heart disease regardless of whether you are normal- or over-weight. Based on the American College of Sports Medicine and the American Council on Exercise, body fat percentages between 25-31% for women and 18 to 26% for men are “acceptable”.

Eating a healthy diet is important to reducing body fat, however if you just restrict calories you are at risk of losing both body fat and lean muscle. Incorporating weight training as part of an intense regular exercise program can assist with building and maintaining lean muscle tissue. So don’t be fixated on weight or BMI, it doesn’t always provide the total picture on health.

• Try not to be too hungry when attending holiday parties and dinners so that you set yourself up to over-eat. Plan your daily intake wisely.  
• When attending holiday parties, fill your plate up with fruits, vegetables and salad before consuming entrees and desserts.
• Use smaller plates and be mindful of portion sizes.
• Try to not “nibble” excessively on appetizers. These calories count too!
• Try to mingle with others and enjoy conversation away from the buffet table. The closer you are, the greater your chance of continuing to go back for more.
• Eat slowly and try to savor each bite. Before going back for seconds, wait at least 10 minutes to see if you are truly hungry.
• Remember calories are calories whether they are coming from food or beverages. Be mindful of calories coming from beverages, particularly alcohol. A beer can provide approximately 150 calories per 12 oz and 3. 5 ounces of wine can provide approximately 85 calories. Consuming alcohol frequently throughout the holidays can easily pack on the pounds.
• We all splurge but choose wisely. If you do overindulge, try to cut calories at other times during the holiday and/or increase your physical activity during this time-frame.
• Don’t forget to exercise during the holiday season. Your body does not know the difference between calories coming from holiday treats and non-holiday related calories, therefore make sure you burn some of those calories by increasing your physical activity.
• Dont forget about the true meaning of the holidays. Yes the food can be incredible this time of year but the holidays are truly meant for time with friends and family, personal reflection, gift-giving and outdoor activities.

Merry Christmas and Happy New Year!

You may be wondering what supplements are typically recommended. Of course, this can be highly individualized depending on one’s diet; but a new report looking at what Americans eat and the nutrients that are obtained through their diet provided an interesting perspective on a few key nutrients (http://www.ars.usda.gov/SP2UserFiles/Place/12355000/pdf/0506/usual_nutrient_intake_vitD_ca_phos_mg_2005-06.pdf). The report showed that only 31% and 36% of the total population is getting adequate vitamin D and calcium respectively, through their diet. It also showed that 9% of those ages 1 through 21 have vitamin D levels so low they could be considered deficient. Calcium levels were also particularly low in adolescents, particularly females. What is clear from this report is that many people are not getting sufficient vitamin D and calcium through their diet.

Vitamin D is found abundantly in only a few foods, such as fortified milk or juices, fatty fish and fish oils, eggs, and margarine. Also, vitamin D can be produced in your body when your skin is exposed to sunlight. Calcium is obtain primarily through dairy products as well as green leafy vegetables and fortified foods. Calcium enhances vitamin D absorption and this partnership of nutrients is essential in building and protecting bone. While various health conditions have been associated with low levels of calcium and vitamin D, evidence is the strongest in the area of bone health. However, continued emerging research indicates vitamin D and calcium are two nutrients that may lower the risk of chronic diseases, such as heart disease and certain types of cancer.

Because calcium is required in relatively large amounts and vitamin D in products is limited, getting these two key nutrients from the diet alone remains difficult for many individuals. With this in mind, when your doctor or nurse recommends any type of supplement, you may want to consider a calcium and vitamin D supplement. Typically calcium and vitamin D come as one supplement, which makes it even easier to ensure you are receiving adequate levels.

Popcorn is a source of whole grains. Incorporating whole grains into the diet to meet the recommended 3 servings a day can play an important role in your overall health.  Two cups of popped popcorn provides one serving of whole grains . However up until now popcorn was never considered to be a source of antioxidants. New research presented at the recent annual meeting of the American Chemical Society indicates popcorn provides a substantial amount of antioxidants called polyphenols.

I recently had the opportunity to speak with Dr. Joe Vinson from the University of Scranton in Pennsylvania. He shared some of his research findings with me. “Early researchers thought the fiber was the active ingredient for these benefits in whole grains, the reason why they may reduce the risk of cancer and coronary heart disease.” Dr. Vinson’s research also indicated hot and cold breakfast cereals also contain substantial amount of antioxidants. ” Recently, polyphenols emerged as potentially more important. Breakfast cereals, pasta, crackers, and salty snacks, including popcorn constitute over 66% of whole grain intake in the U.S. diet.”

Based on equal weight, the levels found in these products are comparable to those found in fruits and vegetables. Cereals had a higher antioxidant than snack items but of the snack items tested, popcorn contained the highest amounts. Among cereals, those made with wheat contained the highest antioxidant content followed by corn, oats and rice. He also found that cold cereals typically contain more antioxidants than hot cereals. For additional antioxidants, add raisins and spices such as cinnamon to your cereal. Keep in mind, the antioxidant testing only measures the antioxidant or polyphenol content of the various products. This test does not measure how effective these antioxidants are in your body.

There are over 8,000 known polyphenols which have various mechanisms or actions in the body. All antioxidants are not created equal therefore, it is important to consume an array of these antioxidants through consumption of fruits, vegetables, cereals, and snack items like popcorn to ensure your body is receiving adequate amounts as well as a variety. Popcorn can be now be another option to getting some of those antioxidants, so pop yourself up a bag the next time you need a snack.

 A few rules of thumb for snacking include:

• Limit snacks to no more than 200 calories per serving size or portion. The Institute of Medicine recommends this caloric amount for snacks available in school.
•  If you think you want a snack, you may want to ask yourself: Am I just feeling bored, stressed or emotional?  If the answer is no and you are truly hungry, go for it! If you answer yes, then don’t snack now and save your appetite.
• Do I have a craving for a certain taste, such as salty or sweet, or do I crave a particular texture, such as crunchy or creamy? Choose a snack that will not only curb your hunger and stay within your daily caloric needs but also satisfy that craving.
•  Read the Nutrition Facts Panel, as well as other label information. To prevent overeating, note the serving size/servings per container.
• Look for products that have little to no saturated fat and trans fat and instead contain polyunsaturated and monounsaturated fats.
• Look for products that provide the most nutrients for the least calories. Nutritionists refer to this as “nutrient dense” products.

Below are a few ideas for snacks you may want to choose.

• An 8 oz glass of 100% orange juice provides 110 calories and delivers a full days supply of vitamin C, a good source of folic acid, and as much potassium as a banana.
• Fruits and Vegetables are always good snack options particularly because most of them are high in nutrients and high in water content with minimal calories.
• Chips and crackers, such as those that contain whole grains, can provide fiber and important B vitamins, as well as healthier oils. Try pairing those chips with Salsa which typically only provides 15 calories per serving
• Nuts, Seed and Popcorn can provide essential minerals as well as fiber. New research indicates that popcorn, nuts and seeds are great sources of antioxidants too!
• Low-fat, low-sugar yogurts provide protein, calcium and vitamin D

Snacking can be apart of a healthy diet and incorporate important nutrients into your diet. Learning to snack healthy is one way to take charge of your diet.

 While you work-out, the rate at which you burn calories rises and a great deal of heat is created. Fortunately, the evaporation of sweat off the skin helps remove excess heat to stabilize your body temperature. During exercise, blood flows to the skin however blood must also flow to those muscles working hard. Keeping well hydrated ensures that blood flow and volume are sufficient to satisfy your needs.

You may be asking what beverage(s) would be ideal to consume during exercise. Ideally, during extensive or intense exercise, a beverage should contain both carbohydrates and electrolytes. The carbs help to fuel our bodies and the electrolytes, such as sodium, helps to maintain blood volume to satisfy muscular and sweat needs. Ideally a sports beverage should contain about 6% carbohydrate and 50 to 150 mg of sodium per serving.

 The recommendation from the Institute of Medicine for daily fluid intake is approximately 11 cups for healthy women and approximately 15 cups for healthy men. These numbers can change though, as the need for fluid intake increases with factors such as physical activity, or living in hot and cold temperature extremes, or some illnesses. Keep in mind fluids, such as juices, sports drinks, milk, soft drinks, coffee, tea and watery foods (fruits and vegetables) contribute toward hydration. Typically 80 percent of water intake is provided from beverages and 20 percent from foods.

 A few easy hydration tips include:

• Drink before, during, and after exercising.
• Monitor your weight after a workout. For every pound lost drink16-24 fluid ounces.
• Pick a drink with great taste appeal.
• Keep a beverage handy. You may want to keep your favorite beverage easily accessible to ensure you don’t forget to stay hydrated.
• Eat plenty of fruits and vegetables. Not only do these foods provide essential nutrients and antioxidants, they help contribute to your fluid needs.

 Staying well hydrated can step up your game for optimal performance!

Traditional interventions for obesity typically target a reduction in energy intake and an increase in physical activity.  Although this is critical, over-time maintaining weight loss is not so easy. Therefore, exploration around alternative factors have begun. Eating in response to a negative and sometimes happy mood or emotion is quite a common behaviour  and may provide an emotional relief for individuals. Studies indicate that those who decrease their emotional eating are more likely to succeed at weight reduction.

“Mindful eating” describes a nonjudgmental approach to physical and emotional sensations associated with eating. Mindfulness can be defined as an astute, nonjudgmental awareness of the present moment.   Mindfulness is a learned skill that is linked to many positive health outcomes. For example, mindful eating skills could help folks recognize and respond to feeling hungry or to recognize but not respond to eating from cues such as stress or unhappiness.

For instance, one recent study indicated that regular yoga practices was associated with a decrease of weight gain in middle-aged adults.  The researchers hypothesized that yoga may have led to less weight gain because of the mindfulness skills that are taught, such as focusing on breathing, conscious movement, and meditation.

In this particular study the researchers looked at 5 factors of behaviour that comprises mindful eating which may be effective:

1) Disinhibition – Meaning stopping when you are full and taking note of how much you ate. Being mindful of portion sizes and quantities served, particularly when dining at a restaurant. We all know that most restaruants serve portion sizes that are too large, which we typically consume at one-sitting.

2) Awareness – Paying attention and enjoying the food you are eating.  Attempting to notice your reactions to every bite of your food

3) External cues – What situations trigger a craving? A commercial or advertisement? Be aware of what drives these eating cues.

4) Emotional response – This entails recognizing what mind set we are in when we are eating. Yikes. Now we are getting personal! I know I like to eat when I am feeling sad.

5) Distraction – What are you thinking about when you are eating? Be mindful of your thoughts when eating.

All these items are factors we should consider when eating. To put it bluntly…

• eat slow
• enjoy your food
• pay attention to what and how much you are eating
• don’t fall for all those compelling advertisements and other external ploys
• don’t give into your emotions – they tend to pass

All these skills can be learned with time so be patient and in the mean-time start practicing mindful eating.

What initiated the interest was a commentary published in the American Journal of Clinical Nutrition which linked HFCS with obesity. Many claim the obesity rate has increased due to HFCS replacing table sugar (sucrose) in products commonly consumed. Since then, controversy surrounds the use of this sweetener in many products particularly in sweetened beverages.

 The composition of HFCS is similar to table sugar which are both made up equally of two sugars,  glucose and fructose. HFCS and other common sugars such as table sugar are handled by the body  in very similar fashions. Studies have indicated no difference in the way the body digests or metabolizes sucrose and HFCS. In a recent study conducted with liquids, there was no significant difference found between sucrose and HFCS sweetened colas in hunger, perceived sweetness or feelings of fullness (satiety).

At present, there are very few scientific studies analyzing a direct relationship between HFCS consumption and increased weight gain or obesity. Keep in mind, obesity is a disease that has many factors which contribute to the development including dietary, genetic and environmental factors. All these factors need to be considered before attributing this disease to any one factor or ingredient, such as HFCS or table sugar.

Recently the Center for Food, Nutrition and Agriculture Policy brought together an expert panel of highly regarded scientists to examine the relationship between weight gain and HFCS consumption. They concluded that based on current evidence HFCS does not appear to contribute to obesity or even weight gain any differently than other caloric sources.

Intake of HFCS through various food and beverages must be put into the overall context of the diet and physical activity. No one single factor, such as HFCS can contribute to obesity. It is necessary to watch total caloric intake and take appropriate measures to prevent weight gain.

• Protein – consuming protein after a work-out helps build muscles as well as reduce muscle breakdown.
• Carbohydrates – our bodies need to refuel after physical activity. Carbs helps to refuel our muscles.
• Electrolytes – nutrients provided in milk such as calcium, potassium and magnesium can replenish what we lose when we sweat.
• Fluids – rehydrates our bodies particularly after intense sweating.
• Calcium and vitamin D – these essential nutrients strengthen our bones and can reduce the risk of fractures.
• B vitamins – these essential nutrients helps support energy production by helping to convert food  into energy.
• Nine other essential nutrients – to further assist our bodies in performing at its best!

Research studies have begun to compile multiple ways milk (regular and flavored milk) provides benefits as a post-exercise beverage. These documented benefits would include chocolate milk helping athletes refuel muscles after a workout; regular and chocolate milk building muscles after exercise and the impact it provides on reducing muscle damage that results from exercise; and how milk compares to other drinks for hydration after exercise, particularly replenishment of electrolytes and fluids. Studies have indicated that milk and/or chocolate milk may be as effective as commercial sports drinks.

The evidence is promising regarding milk and its impact on the body after a work-out. Overall milk contains protein, carbohydrates, fluids and electrolytes like many commercial sports drinks. Keep in mind, milk is relatively inexpensive compared to some sports drinks and most people are already in the habit of consuming milk. So next time after you work-out consume a glass of milk, it’s a winning combination!

FDA commissioners Margaret Hamburg, MD and Joshua Sharfstein, MD published a persepctive online in the New England Journal Medicine concerning the strategy the FDA will take to become a leading, trustworthy agency for the public. As such they stated it is the FDA’s job to support access to safe and nutritious food and a safe and effective drug supply to ultimately promote health, prevent illness, and prolong life. The ultimate success of the agency will not be depedent upon the number of facilities inspected or drugs approved.

The commissioners pointed out that collaboration with other federal agencies and external partners is necessary to ensure  successful outcome of the advancement of science and any threats to the safety of the food or drug supply. Moving forward the FDA will work closely with the Centers for Disease Control and Prevention (CDC) to identify areas of action, such as outbreaks of food-borne illness.  The FDA will partner with the National Institutes of Health (NIH), academic medical centers, and universities to find solutions to medical problems. In addition, the FDA proposed they will work with the Centers for Medicare and Medicaid Services to explore ways to shorten the time from approval to reimbursement. Other partnerships will need to exist including one with the Department of Agriculture to establish a modern and up-to-date food safety system to prevent contamination and outbreaks from food-borne illness.  With regard to nutrition, the FDA will support efforts to educate the public about nutrition and promote healthy foods.

In the U.S., there are over 200,000 companies selling food, cosmetics and medical products. This indeed presents a challenge to manage. The FDA has propsed to access imported products for any potential negative impact. Safety standards must be put in place where none currently exist, which include assessing the country of origin, the importer, the importing country, and the final company in the supply chain.

Minimizing risk through education, regulation and enforcement will be part of the FDA’s ongoing role. Risks and benefits will need to be clearly communicated to the public. However for this to be effective, the public and congressional leaders will have to begin trusting the FDA as a credible source. Establishing the FDA as a public health agency will require the public interest being served and not be self-serving or compromising. Transparency will be key in order to begin building that trust with the public once again.  The commissioners stated, “Whenever possible, the FDA should provide the data on which it bases its regulatory decisions and other guidance and explain its decision-making processes to the public.”

In closing it was noted “Succeeding will require respecting the tradition of the FDA and its mission of public health.” We will have to wait and see if these intended plans will make an impact on the safety and well-being of the American public. For now, the FDA has come to terms with their past mistakes and has willingly began to open their doors to create partnerships and collaborations which will better serve the public.