Lead Us Not Into Temptation

Original Content, The Washington Post

Don’t count on willpower! Instead, make things easy on yourself and your family by controlling your environment. To increase the likelihood of eating healthfully, make your food tasty, accessible and convenient:

• Clean, chop and store fruits and vegetables in plastic containers next to healthful dips. For the kids, keep them at eye level in the fridge so they’re easy to grab. (Or, if you’re pressed for time, buy fruits and vegetables already cleaned and chopped at the salad bar.)

• Make several-serving batches of delicious entrees, soups and salads, store them in plastic serving-sized containers in your fridge or freezer to prevent that stop for fast food on the way home.

• Weigh and measure foods before cooking or portioning at the dinner table. You can’t overeat it if you haven’t cooked it. Avoid serving “family style.”

• Eat, then shop! Don’t go grocery shopping hungry and always go with a list to prevent impulse purchasing.

• Minesweep for calorie bombs! If you can’t have just one cookie or one chip, keep them out of the house to avoid temptations.

• Quality, not quantity. Splurge on smaller amounts of your favorite expensive healthy delicacies such as raspberries, hearts of palm, wild salmon or crab meat instead of buying supersized but lower quality foods; those extra calories get stored as excess body fat.

• Buy the gadgets you’ll need: nonstick pans, a heavy-duty stock pot, food scale, measuring cups and spoons, plastic baggies of all sizes and plastic containers that go from freezer to microwave.

• Each healthful and delicious meal deserves your entire attention: Overeating is inevitable if you’re distracted by reading, working or watching TV. Sit at your dining or kitchen table without distractions and make eye contact and conversation with your family members while you eat. — Katherine Tallmadge

© 2004 The Washington Post Company

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Whose Fault is Fat?

Original Content, The Washington Post

Trying to lose weight and stay fit seems daunting at times. The proof of our universal difficulties is evident when you consider that most of us — two-thirds of the U.S. population — tip the scales with numbers higher than medical authorities say is healthful.

When my clients occasionally express hardships, I remind them that in our personal struggles to be slender and healthy, we face two fierce, unforgiving forces: our genetics and our environment. The origin of the frustrations we’re facing today can be traced back 100,000 or more years. By then, our genetic code reflected millions of years of evolution, and it hasn’t changed much since. But our environment has changed dramatically in the last several generations — too quickly for our genetics to adjust.

Our genetics guide us toward certain behaviors that we once needed to survive, according to S. Boyd Eaton, professor of radiology and anthropology at Emory University in Atlanta. But in the relative affluence of modern life, these behaviors now may cause us grief — and girth. “There is a dissonance between ‘stone age’ genes and ‘space age’ circumstances,” says Eaton.

So does the mismatch mean it’s impossible to be slim and fit?

We evolved in an environment where food was scarce; we faced regular famines and our food was obtained with great physical exertion through hunting and gathering. To overcome these obstacles, we developed certain characteristics that enabled us to survive.

For one, we feasted when food was available. Those who demurred when there was food around with, “No thanks, I’m not hungry,” probably didn’t survive.

We also became very efficient at storing body fat, according to Eaton, a trait that kept us alive through lean times. And the most concentrated sources of calories — sugar and fat — were most appealing to us. For millions of years, we survived mainly on fruit, according to Eaton, and that created a natural attraction to sweetness; fat tasted good to us because when food was scarce it was an efficient way of getting calories.

On top of that, our ancestors, in their struggle to survive, burned 3,000 to 3,500 calories a day (compared to the average adult rate today of 2,000).

So take these genetic predispositions that have been in place for millions of years and put them into modern life, particularly into the last half century, during which we have created an environment and culture of abundance without precedent. The U.S. agricultural system produces 3,800 calories per person per day, double what most people need — and we barely have to lift a finger to get any of it. Moreover, the marketing, availability, flavor and abundance of that food — much of it high-calorie, low-nutrient processed foods (which earn the most profit) — make healthful eating a challenge for everyone.

“Because of the deadly combination of the availability of fattening foods and our natural desire to eat it, we live in a toxic environment which is a perfect recipe for creating obesity,” says Kelly Brownell, Director of the Yale Center for Eating and Weight Disorders. “If you were starting a society from scratch to maximize the likelihood of people being overweight, it’s hard to imagine doing it much better.”

Brownell, the author of “Food Fight” (McGraw Hill, 2004) lists factors in the environment that make unhealthful eating more likely. Among them:

• Accessibility Studies show we’re more likely to eat whatever is in our environment. And our environment is chock-full of unhealthy, high-calorie foods. Vending machines and drive-in restaurants are open 24/7, fast foods and snack food are abundant in schools, and even places like gas stations and drugstores have become opportunities to buy food.

• Convenience For people in a hurry (and who isn’t today?), unhealthful foods are easier to acquire, whether from drive-in windows or local convenience stores on every corner.

• Taste It’s easy and cheap to make foods tasty by adding fat, sugar or salt. And most people prefer Haagen-Dazs to Brussels sprouts and Big Macs to broccoli.

“Human beings becoming increasingly obese in a world awash in tasty calories and convenience devices is as easy to understand as polar bears, with their thick white coats, overheating under the Sahara sun,” said David Katz, director of the prevention research center, Yale School of Medicine, at the Time/ABC News Summit on Obesity in May. “While it’s true that we have no native defenses against caloric excess or the lure of the couch, we do have one great asset to fix our weight problem: we’re smarter than the average bear.”

Katz, author of “The Way to Eat” (Sourcebooks, 2002), believes in “skill” power rather than will power. “Overcoming an obstacle begins with identifying it. Then we can apply skills and strategies to all of the obstacles we encounter in our efforts to be thin and healthy,” said Katz. We may not be able to change our genes, but we can change our personal environments. And research confirms the most successful long-term weight losers work at avoiding temptations.

Most of your craving and uncontrolled overeating will be conquered when you feed your body the healthful food it needs regularly during the day and you have the food at your fingertips when you need it.

“With the right dose of skill power, rather than will power, we can navigate safely around the nutritional hazards of the modern landscape,” said Katz.

© 2004 The Washington Post Company

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Grains of Truth

Original Content, The Washington Post

In the world of nutrition there seems to be no shortage of complexity and confusion. But I’ve found that simple and straightforward solutions are often strikingly successful. In no area is this more true than the remarkable power of whole grains.

Over the years, countless clients of mine have struggled with various gastrointestinal complaints such as constipation or irritable bowel syndrome. Many have come to me after trying costly medications, usually with little relief.

In most cases, symptoms disappeared once they began increasing their fiber intake by eating adequate amounts of whole-grain foods. Some of my clients even teasingly call these foods their wonder drug.

But while it’s true that whole grains are valuable for their fiber content, their benefits are much more vast. Whole grains play a profound role in health. A growing body of research shows whole grains — wheat, oats, rice, rye and corn, for example, may help keep body weight down and prevent diabetes, heart disease and some cancers.

The importance of whole grains in health came to light in the 19th century, when refining grains became popular — and its negative consequences were learned. In Asia, chickens were cured of symptoms of a human illness called beriberi, characterized by muscle wasting and nerve degeneration, when they were fed the discarded part of polished white rice. It was later found that the parts discarded during the refining process contain the essential nutrient, thiamin (a B vitamin) necessary to prevent beriberi.

In 1975, researchers Dennis Burkitt and Hugh Trowell published a book of scientific observations comparing the diet of Africans eating their native whole grains versus North Americans and British eating their diet of highly refined carbohydrates. The researchers described for the first time the role that whole, unrefined foods play in reducing coronary heart disease, diabetes and cancer. Since then, numerous other research studies have chronicled the effects of whole grains on human health.

A whole grain has three parts: bran, germ and endosperm. The bran and germ contain fiber, Vitamin E, B vitamins (thiamin, niacin, riboflavin and pantothenic acid) minerals (calcium, magnesium, potassium, phosphorous, sodium, selenium and iron), protein, essential oils, antioxidants and phytochemicals (plant substances that may protect health). The endosperm contains mostly starch with a little protein and very few nutrients. When a grain is refined, turning whole wheat flour into white flour or brown rice into white rice, only the nutrient-poor endosperm is left. The riches found in the bran and germ are lost.

Food manufacturers attempt to make up for the loss in nutrients by enriching refined grains (those found in breads, pasta, rice and cereals, for instance) with some essential nutrients, such as B vitamins and iron.

But overwhelming scientific evidence has found major health differences in people who eat more whole grains compared with people who eat refined grains, proving enrichment doesn’t make up for the difference:

• Whole grains are our major source of fiber. The grain’s outer layer (the bran) keeps us regular and helps prevent hemorrhoids, diverticulitis, and reduces risk for ulcerative colitis (Crohn’s disease).

• Whole-grain intake is strongly correlated with reduced cardiovascular disease. This is partly explained by the soluble fiber in grains (oats, rye and barley have the highest levels), which is associated with cholesterol lowering. But other substances in grains, such as antioxidants like Vitamin E, also play a role.

• People who eat more whole grains also have lower body weights, according to epidemiological research. This is attributed to the fiber, which promotes feelings of fullness in foods that are generally low in calories.

• Many studies have shown a strong link between whole-grain intake and reduced incidence of type II diabetes. This may be partly because the fiber in whole grains slows down stomach emptying, causing a lower rise in blood glucose and insulin. Also, whole grains contain nutrients such as Vitamin E and magnesium, which may help improve insulin sensitivity.

• This research is less consistent, but whole grains may also help prevent cancers, especially of the intestinal tract and maybe even breast cancer. Several theories have been put forth explaining the mechanisms. For one, the fiber speeds intestinal transit, which reduces exposure to potential carcinogens. Also, antioxidants enter the circulation through colon cells, providing long-term antioxidant protection through the entire digestive tract, according to Joanne Slavin, a professor in the department of food science and nutrition at the University of Minnesota in St. Paul. Ninety percent of a grain’s antioxidants aren’t released until they get to the colon, the last stage of digestion, where they may provide maximum protection against cancer.

Interestingly, grains are still a mystery to researchers. They are so complex and full of a multitude of different compounds, scientists are largely unsure of what components of the grain are responsible for the benefits.

“We’re not sure if the benefits are from the fiber or the phytochemicals,” says Simin Liu, assistant professor of medicine and epidemiology at Harvard. “In my opinion, it’s the thousands of phytochemicals in whole grains which produce most of the benefits.”

To prove his point, Liu points to a four-year National Cancer Institute-funded study of high-fiber cereals in which wheat bran was added in the processing as opposed to naturally occurring in a whole grain. Researchers were surprised to find the high-bran diet did not prevent colon polyps, often a precursor to cancer.

“The data doesn’t support the claim that added bran fiber or fiber supplements make a positive difference in colon cancer, which is why I like to use the term ‘whole grain foods’ instead of fiber. The data only point to whole foods,” says Liu.

But while whole grains provide this wide array of health benefits, most Americans don’t take advantage of them.

“American adults eat six to seven servings of refined grains but only one serving of whole grains a day, with children eating less than one serving — well below U.S. Dietary Guideline recommendations of at least three servings,” says Slavin.

While science continues its search for the answers, I recommend you switch from refined-grain products to whole-grain products. Instead of white bread or crackers, choose whole wheat, whole rye or whole grain breads and crackers. Instead of white pasta or white rice, choose whole wheat pasta or brown rice or cereals made with whole oats or whole corn. Try unusual grains such as bulgur (cracked whole wheat), whole wheat couscous or exotic grain-like substances such as quinoa and amaranth.

But looking for whole-grain foods in your supermarket can be challenging. Many “whole wheat” or “multi-grain” breads, for instance, are made predominantly of white flour, even though the label may say “wheat flour.” Be sure the first ingredient on the nutrition label of your pasta, cereal, crackers or bread is a “whole” grain such as whole wheat, whole oats or whole rye. Also look for a whole-grain product containing three or four grams of fiber per one ounce (28 grams) or per 80- to 100-calorie serving. That signifies that the grain is likely in its most natural state.

Katherine Tallmadge is a Washington nutritionist and author of “Diet Simple” (Lifeline Press, 2004). Send e-mails to her at food@washpost.com.

Grain Guide

The grain family includes barley, bulgur, corn, millet, oats, rice, rye and wheat. Amaranth, buckwheat, and quinoa belong to a different botanical family. But they all contain protein, B vitamins, minerals and fiber, as well as antioxidants. Though corn, oats, rice, rye and wheat are relatively easy to find and cook, other of these healthful ingredients may require a search and some guidance before cooking:

AMARANTH This tiny seed, often found in health food stores, can be used to make flour or pasta. Add the seeds to your bowl of cereal, rice or stir-fry.

BARLEY This versatile grain makes a great pilaf or risotto; use the cooked leftovers in a salad, stir-fry or tuna salad.

BUCKWHEAT The seeds of the plant are used to make buckwheat flour, the basis of blini. Buckwheat groats are the hulled and crushed kernels of the seed and are usually cooked in a manner similar to rice. When the groats are toasted, they are called kasha. Add buckwheat to soups, stew, meatloafs or hamburgers. Cook buckwheat groats for a hot breakfast cereal.

BULGUR (also BULGHUR) Made from whole-wheat berries that are steamed, partially de-branned, dried and crushed or cracked, bulgur wheat is available in coarse, medium and fine grinds. A staple of the Middle Eastern diet, it is seen in salads such as tabbouleh or stews. It can also be cooked like a rice pilaf.

MILLET Cracked millet can be cooked like couscous; another variation, pearl millet, can be cooked like rice or a hot breakfast cereal. Millet flour is used in roti, an Indian flatbread.

QUINOA Pronounced “KEEN-wah,” this grainlike product is often found in health food stores. The grain, which must be simmered, has a delicious roasted flavor and can be added to vegetable dishes or rice. Quinoa flakes, a hot cereal similar to oatmeal, make a hearty breakfast.

— Katherine Tallmadge

© 2004 The Washington Post Company

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After Atkins

photo by ADA

Original Content, The Washington Post

A new client shared a familiar story with me: This man, who has struggled with his weight for years, went on the Atkins low-carbohydrate diet, and the pounds seemed to melt away. But after a few months, they started to creep back on. Another woman on Atkins lost only part of her desired weight and then hit a plateau. Still others find that after success with Atkins, their cholesterol levels soar, a potential danger to their health. They all came to me fearful that going off the Atkins diet would mean gaining their weight back. But they knew they had to figure out a different way to achieve their goals permanently.

Their fears are well-founded and point to a central dilemma in weight loss: While losing weight is exhilarating and energizing, it also can be fleeting.

“Unless people transition, they’re going to fail, because the Atkins diet produces weight loss but not weight maintenance,” says James Hill, director of the Center for Human Nutrition at the University of Colorado in Denver. “If people lose weight with the Atkins diet, they need to consider their weight loss as Phase 1 and be prepared to keep it off differently, which would be Phase 2.” Hill was co-author of the Atkins diet study published in the New England Journal of Medicine last year. It found that those in the Atkins diet group had a greater weight loss after three and after six months compared with those on a low-calorie, low-fat diet. After one year, though, there was no difference between the two diet groups.

But weight regain is not a problem unique to the Atkins diet. The struggle has been going on for as long as people have been looking for quick-fix, formulaic diets. In the 1970s, people lost weight by cutting carbohydrates with Atkins or Scarsdale. The ’80s brought us high-protein, modified fasts (remember Oprah and Optifast?). In the ’90s, low-fat diets were the rage. Now we’ve come full circle with low-carb diets. All these diets work because they dramatically lower your calorie intake. But the challenge is the same no matter what diet you follow: At some point, you must transition from the diet to a healthy, everyday eating plan that will maintain your weight and enhance your health.

In 1994, Hill and others founded the National Weight Control Registry to study the characteristics of people who successfully maintain their weight losses (known as “maintainers”). People in the registry have lost an average of about 70 pounds and have kept it off for an average of seven years.

The registry and other studies have found many factors that separate successful weight-loss maintainers from unsuccessful regainers:

• Diet: The registry found maintainers eat a low-fat diet with 24 percent of their calories coming from fat, 19 percent from protein and 56 percent from carbohydrates (much of it low-calorie, complex carbohydrates). Only 1 percent eat a low-carbohydrate diet (with less than 24 percent of their calories from carbohydrates).

The registry and other studies have found that maintainers eat more vegetables and fewer calorie-dense foods, such as fried food, fats, fatty meats and sweets, and they often substitute low-fat for high-fat foods.

Maintainers reduce portion sizes, reduce frequency of snacking, and they eat foods such as cheese, butter, high-fat snacks, fried foods and desserts less than once a week. They become satisfied with smaller portions and are less attracted to sweet or fatty foods.

Regainers increase their fat intake while maintainers keep it consistently low. But maintainers don’t completely deny themselves. They changed their basic food patterns, but they allowed themselves fewer but more meaningful indulgences. Regainers, on the other hand, went on very restrictive diets not permitting themselves any room for favorite foods. They felt deprived and easily fell back into old patterns.

• Eating style: The registry found successful maintainers prepare and eat the majority of their food at home, dining out about once a week, which is less often than the general population. The registry and another study found maintainers are more likely to eat five times a day, while regainers are more likely to skip meals, snacking on candies and chocolates more often. The registry found that a strikingly high number of maintainers eat breakfast.

• Self-monitoring: The registry reported that 75 percent of maintainers weigh themselves at least weekly or daily. This helps them nip any minor weight gains in the bud. On the other hand, regainers either accept larger weight gains or don’t notice their weight creeping up until they gain a large amount. One study found that successful maintainers develop a “healthy narcissism” about their appearance and physical condition. The registry and numerous studies have found that maintainers monitor their eating by occasionally keeping food diaries to increase awareness.

• Physical activity: Nine out of ten of the registry participants engage in regular physical activity. “During weight loss, diet is the driver. But during weight maintenance, physical activity becomes the key,” says Hill, whose new book, “The Step Diet” (Workman, 2004), incorporates elements from registry findings.

• Coping skills: Most people have comparable levels of stress and unpredictability in their lives, but some are able to handle it more effectively than others. Maintainers are more likely to face their problems, while regainers react emotionally or avoid problems by sleeping, drinking or eating. Maintainers are also more likely to seek support from friends, family and professionals.

• Lifestyle: Many maintain weight loss only upon making major lifestyle adjustments. One study found when home-bound women became more involved in activities outside of their homes, they were more likely to maintain weight loss. They became more confident and took responsibility for their lives and their size. The activities you choose to engage in and the people you spend time with influence weight-maintenance success. Often this means making new, healthier friends and including spouses in your lifestyle changes. Spousal support is necessary for long-term success, even if it may not be necessary short term.

• Goals and expectations: Maintainers are more likely to be patient, setting small, reachable goals. They accept dietary change as part of their lives rather than as part of a temporary diet. They realize they need to be continually conscious of their food and activity levels and work at staying in shape.

The evidence is clear: The battle of the bulge is won at the margins. Sweeping dietary overhauls are impractical and don’t work over time. Shrewd, small, concrete changes that can be easily incorporated into your daily routine lead to success.

Katherine Tallmadge is a Washington nutritionist and author of “Diet Simple” (Lifeline Press, 2004). Send e-mails to her at food@washpost.com.

© 2004 The Washington Post Company

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Accept No Substitutes: Dangerous Supplements?


Original Content, The Washington Post

Taking multivitamins, Vitamin B-6, Folic Acid, Magnesium, Zinc, Copper, and particularly Iron, may increase death rates, according to a recent study published in the Annals of Internal Medicine. Only Calcium and Vitamin D were correlated with positive benefits.

Let me explain…

Many of us want to include nutrients, the right vitamins and minerals in our diet. But we often don’t want to eat all the foods and calories required to get this balance. What we’re looking for is a magic supplement that will give us more energy, improve the quality and length of life and prevent the chronic diseases of today such as heart disease, cancer and diabetes.

While we know that certain foods have been shown to provide these benefits, can the right supplement do the same?

Leading researchers are increasingly convinced that while supplements can serve many positive purposes, they cannot take the place of a well-balanced diet, and may even be dangerous.

The Importance of Food

“The thousands of vitamins, minerals and phytochemicals [beneficial plant compounds] in whole foods act synergistically together to create a more powerful effect than the sum of their parts, producing a result which cannot be recreated by supplements,” says Jeff Prince, vice president for education at the American Institute for Cancer Research.

Over the past century, nutrition experts gained a fuller appreciation of the need for a plant-based diet. Research began to show in the 1970s that certain patterns of eating, beyond vitamin and mineral intake, were influencing illnesses.

By the 1980s, they found that populations that ate more fruits, vegetables and high-fiber foods experienced lower rates of cancer, heart disease and diabetes. Also, by that time, discoveries had been made that newly discovered phytochemicals and certain vitamins and minerals acted as antioxidants and might prevent chronic diseases such as cancer and heart disease. After all, it had been found that people with high blood levels of two antioxidant vitamins (a form of vitamin A called beta carotene and vitamin E) had reduced lung cancer rates. It had also been observed that people who ate more dark-green leafy vegetables (high in beta carotene) experienced less lung cancer, even if they smoked.

Sensing a major breakthrough, the National Institutes of Health funded one of the biggest studies ever conducted. Known as the ATBC (Alpha-Tocopherol, Beta Carotene) Cancer Prevention Study, published in the New England Journal of Medicine in 1994, it tested the theory that the antioxidant vitamins beta carotene and alpha-tocopherol (vitamin E) would prevent lung cancer in smokers, the highest-risk population. After following 29,000 male smokers for six years, the stunned researchers found “a higher incidence of lung cancer among the men who received beta carotene supplements than among those who did not. In fact, this trial raises the possibility that these supplements may actually have harmful as well as beneficial effects.”

Needless to say, these revelations sent shock waves through the scientific community. “This study was a turning point in the nutrition field, especially when multiple studies kept confirming that supplements didn’t work at preventing cancers and heart disease,” says David Klurfeld, national program leader for human nutrition at the USDA’s Agricultural Research Service. “People think that we can pull out the fiber, pull out the antioxidants. But research does not back that up. Study after study says you gain the most benefit from whole foods.”

That is not to say that supplements are of no use. They can be of great benefit, when taken based on individualized needs. This study, and others like it, stress the importance of personalizing your supplement needs by reviewing your medical, family and personal history, your food intake, THEN and only THEN, decide what you might be lacking and make an educated decision, preferably with the help of a registered dietitian and your doctor. Supplements simply can’t compete with better food choices. Consider these findings:

• When the ATBC Cancer Prevention study data was re-analyzed years later for consumption of fruits and vegetables, researchers found that while supplements did not prevent lung cancer, eating fruits and vegetables high in beta carotene (e.g., carrots, sweet potatoes), lycopene (e.g., tomatoes) and lutein/zeaxanthin (deep-green leafy vegetables such as spinach and kale) reduced lung cancer risk.

• A diet high in cereal and vegetable fiber (35 grams versus 15 grams) reduces the risk of colon cancer by 40 percent, according to recent findings in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. But studies of fiber supplements have failed to find any benefits and some have found an adverse effect.

• A diet high in fruit reduces lung cancer risk by 40 percent, also according to new EPIC study findings. Another study found subjects with a high fruit intake had a 44 percent lower risk of lung cancer compared with subjects eating the least amount of fruit. But when subjects added beta-carotene supplements, there was no benefit from the fruit.

• Men who ate 10 servings of tomato products weekly reduced their risk of prostate cancer by 35 percent compared with men who ate fewer than 1.5 servings, according to a Harvard Health Professional study. While the benefit is largely attributed to the phytochemical lycopene, trials of lycopene so far have found it is less potent than the tomato.

• A diet high in fruits and vegetables reduced stroke risk by 28 percent, and fruit alone reduced the risk by 40 percent, according to a study published in the American Journal of Clinical Nutrition in 2003. No dietary supplements have been found that significantly reduce stroke risk.

• People who ate collard greens or spinach two to four times per week had a 46 percent decrease in risk for age-related macular degeneration (the leading cause of blindness) compared with those who ate these vegetables less than once per month, according to a study published in the Journal of the American Medical Association this year. No studies have found supplements prevent or improve macular degeneration.

• People who eat more soy have a decreased risk for coronary heart disease, breast cancer and prostate cancer. But when various components of soy foods have been isolated and studied, these finding have not been replicated, and some have found adverse effects.

• A diet high in antioxidant-rich foods helps prevent cardiovascular disease, but the studies of individual antioxidant supplements have been so inconclusive that the American Heart Association recently issued an advisory against taking them to reduce cardiovascular disease

“Researchers are working as fast as we can to find the most effective components in foods,” says Janet Novotny, research physiologist at USDA’s Human Nutrition Research Center in Beltsville. “But so far, studies have shown that while fruits and vegetables are associated with decreased risk of chronic disease, studies of the isolated compounds in fruits and vegetables haven’t shown an effect.”

Food and dietary patterns are complicated and expensive to study, and can defy the brightest minds and best intentions. In the meantime, the best advice is to eat a plant-based diet with at least five to nine servings of fruits and vegetables (you’ll get the most benefit with the higher amount), at least three to four servings of whole grains and regularly eat legumes as a side dish or occasionally as your protein source.

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Have Your Fill

Original Content, The Washington Post

It’s not rocket science: Eat fewer calories than you burn and you’ll lose weight.

But somehow it seems almost impossible to do. How could something so simple be so hard? The dilemma we all face is how to eat less without feeling hungry and deprived. The solution, while not as important for short-term weight loss, is essential to weight maintenance. Any diet that keeps us hungry is doomed to fail over the long haul.

For decades, scientists have been digging for clues about what influences the decisions to start and stop eating. They have found that our bodies have a complex physiological signaling system that tells us when we’re hungry and when we’ve had enough. When you’re eating, nerves in the stomach wall detect your stomach is stretching. They send satiation messages to the brain and you start to feel full. When food is sensed in the intestines, several substances are activated there as well, including nerve regulators and hormones such as cholecystokinin (CCK).

The physiological sensation of hunger has been more difficult for researchers to pin down. Emerging research points to ghrelin (pronounced GRELL-in), a hormone sent into your bloodstream by the stomach when it is empty.

The level of ghrelin “goes up before meals — making you hungry — while the other satiating hormones go up after eating [with ghrelin going down], causing you to stop,” says David E. Cummings, associate professor of medicine at the University of Washington and the Veterans Affairs Puget Sound Health Care System. “With these two systems, you have physiological control over pre-meal hunger and post-meal satiety.”

Of course, we’re not automatons governed strictly by physiology. The decision to eat is also governed by things we can control.

“In humans, ghrelin may not be the only driver. Initiation of meals is a complex process that deals with social cues, smells, sights and more,” says Phil Smith, co-director of the Office of Obesity Research at the National Institute of Diabetes & Digestive & Kidney Diseases.

Evidence suggests that many factors are related to your satisfaction with a meal and ultimately, your ability to lose and maintain weight:

Portion size In a series of widely known experiments over the past five years, researchers found that the amount of food you are served will affect how full you feel and how much you eat. In the studies, people were given varying amounts of macaroni and cheese, submarine sandwiches and bags of popcorn or chips. In each case, when they were served smaller portions, they ate those portions and felt satisfied. But when they were given larger portions, without realizing it, the subjects (including children, in other similar studies) ate significantly more — sometimes 50 percent more.

This effect persisted. Over two days, when portions were 50 percent larger at each meal, subjects ate 16 percent more (328 extra calories in women and 522 extra calories in men per day). When the portions were 100 percent larger, subjects ate 26 percent more (531 extra calories in women and 806 extra calories in men).

Those extra calories, added daily over the course of a year, would pack 50 pounds more on women and 80 pounds more on men.

“This is a case where physiological satiety cues are overridden by environmental cues such as large portions and the easy availability of food,” says Barbara Rolls, co-author of the studies and a professor of nutritional sciences at Pennsylvania State University in University Park. “When served larger portions, people adjust their level of satiety to accommodate greater calorie intakes.”

Fortunately, studies also have found that the reverse is true. When good-tasting, lower-calorie foods or portion-controlled meals are available, people will eat those and feel just as satisfied. In fact, studies of successful weight loss maintainers find they easily adjust to smaller, more appropriate portions of higher-calorie foods.

An interesting study showed that preschool-age girls who regularly overeat can be taught how to change their behavior by learning to pay attention to their natural hunger and satiety signals.

Water and air content Rolls and colleagues found that as long as the volume of the food is high, people can feel full with fewer calories. In a study published in 2000, participants who drank milkshakes blended with more air (compared with the same shakes containing less air) ate 12 percent less at the next meal without realizing it.

In the most recent experiment, which will be published in the Journal of the American Dietetic Association in October, the researchers served salads of various sizes and calorie levels before a main course to determine the effect on the calorie intake of the whole meal. Participants consumed the fewest overall calories — 100 calories fewer — when they were served the largest, lowest-calorie salad before a meal.

Researchers surmise that a large food volume caused by water or air, even without added calories, influences satiety in a variety of ways. It causes stomach stretching and slows stomach emptying, stimulating the nerves and hormones that tell you when it’s time to put down the fork. Also, seeing a large volume of food can increase your ability to feel satisfied by it.

Finally, the larger a meal is and the longer a meal goes on, studies show, your satisfaction declines and you lose interest in completing it.

“Water is the component in food which has the largest influence on how much you eat,” says Rolls, who co-authored “The Volumetrics Weight-Control Plan” (HarperTorch, 2003). “These studies show eating a high-water-content, low-calorie first course enhances satiety and reduces calorie intake at the next course.”

Type of diet New research on ghrelin reveals it can work against weight loss. Apparently, losing weight under most conditions — low-calorie diets, anorexia, binge-purging and high levels of exercise — can increase ghrelin that’s circulating in the bloodstream and cause hunger. This is the body’s evolutionary way of holding on to body fat and surviving during the famines that threatened our ancestors, according to Cummings. But his research found one diet in which weight loss did not increase ghrelin levels: a low-fat one. After three months, people on a 15-percent-fat diet lost significant weight. But their ghrelin levels stayed the same.

Cummings cautioned that levels of fat higher than 15 percent — say, 20 or 25 percent — as well as other diet methods, may also prevent rises in ghrelin; not every situation has been tested.

But these results help explain studies of successful weight loss maintainers, most of whom eat a low-fat (less than 24 percent of calories) diet.

There’s a lot more to learn about why we eat. Researchers are studying types of foods, diets, meal timing, meal patterns, habits learned from childhood, genetics and sensory factors. But in the meantime, there is plenty that we do know to help us eat the right number of calories but still feel full and satisfied.

Katherine Tallmadge is a Washington nutritionist and author of “Diet Simple” (Lifeline Press, 2004). Send e-mails to her at food@washpost.com.

Pump It Up

Get back to basics and listen to your body signals. Start by rating your hunger on a five-point scale:

0 = ravenous

1 = hungry

2 = could eat, could wait

3 = satisfied, no longer

hungry

4 = uncomfortably full

5 = stuffed

Give yourself a rating before you start eating and another rating when you finish. You should eat when you’re hungry (1) and stop when you’re no longer hungry (3)*.

To feel full with fewer calories, try these tips from Barbara Rolls, co-author of “The Volumetrics Weight-Control Plan” (HarperTorch, 2003), whose research shows that people have greater success with weight loss when they eat larger servings of foods that have a high water content, such as cooked grains, vegetables, fruits, soups and stews:

• To lower the calories and increase the portion size of a favorite recipe, pump up the volume by adding vegetables as often as you can. This way, you can eat your usual portion for fewer calories.

• Choose fresh fruits over dried fruits or juices. For 100 calories, you could eat 1/4 cup of raisins or two cups of grapes. (You’re more likely to fill up on the grapes.)

• Whip air into your yogurt and fruit snack by putting it into a blender and turning it into a smoothie.

• Try air-popped popcorn (3 cups is only 90 calories) or flaky or puffed cereals.

• Start lunch or dinner with a bowl of broth-based vegetable soup or a big vegetable salad with low-calorie dressing.

• Turn main courses into soups or salads by adding water or vegetables.

— Katherine Tallmadge

*Adapted from “Eating Awareness Training” by Molly Groger (Summit Books, 1983)

© 2004 The Washington Post Company

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In the Night Kitchen

Original Content: Washington Post

Does this sound familiar? You get home from work, stressed and ravenous. You head straight for the kitchen, grab a bowl of nuts or a plate of cheese and crackers. You nibble as you’re preparing dinner.

After dinner, you settle on the couch, most likely in front of the television, and zone out with some favorite snacks, such as popcorn, chips, nuts, ice cream, peanut butter or sweets — whatever that’s tasty and easy to grab.

Welcome to the typical American evening! For many people, it’s an endless graze that doesn’t stop until they go to bed.

Evening overeating is an issue that contributes to many peoples’ weight problems. I’ve been surprised at just how many people struggle with this. I used to myself. Even disciplined people who carefully watch their intake during the day break down at night. I can’t count how many times I’ve heard these refrains: “I’m fine during the day, my problem’s at night,” or “If I could control my eating at night, my weight problem would probably disappear. . . . ” It’s become clear to me that evening overeating is not just an isolated problem but the convergence of a host of lifestyle issues — stress, exhaustion, loneliness, disorganized eating and hunger.

In today’s fast-paced world, many people are constantly hopping from meeting to meeting or from chore to chore during the day and don’t have time to sit down and eat a decent meal. So we become ravenous.

In the evening, there’s more time for eating, so we eat not only larger meals, but continuous ones. Those who are tired or stressed find that food is an easy way to reward themselves at the end of the day. Food can provide a little companionship for the lonely or depressed. Researchers who have identified “night eating syndrome,” the most severe form of evening overeating that affects about 5 percent of people who seek obesity treatment, say it is stress-related.

“We believe the night eating syndrome is a stress disorder. One of the characteristics of the syndrome is that sufferers eat at least one-third of their calories after the evening meal,” says obesity researcher Albert J. Stunkard, who has studied nighttime overeaters since the 1950s. He recently co-authored “Overcoming Night Eating Syndrome: A Step-by-Step Guide to Breaking the Cycle” (New Harbinger Publications, 2004).

Evening overeating is an important problem to solve because Americans who eat most of their daily intake of food at night eat more overall calories, according to a study reported in the Journal of Nutrition in June. And that makes them more susceptible to weight problems.

“The late-night period was when the highest-density foods were eaten. Eating a high proportion of daily intake in the late evening, compared to earlier in the day, was associated with higher overall intake,” researcher John M. de Castro concluded in the study, which analyzed food diaries of about 900 men and women.

De Castro, professor and chair of the department of psychology at the University of Texas at El Paso, also found that evening eating was less satisfying for people, which may help explain why they eat more.

In the evening, you get lower satiety. People tend to eat very large meals but then eat again shortly afterward, de Castro said.

For those who succumb to nighttime overeating, I recommend you attack this problem by assessing why this may be happening to you, and then devise personalized strategies for eating lighter at night. Some points to consider:

Breakfast: De Castro’s study found that a “high proportional intake in the morning is associated with low overall daily intake.” This finding confirms my experience of 20 years: Eating a bigger breakfast is the single most effective way of curbing evening overeating. Other studies have confirmed the importance of breakfast for maintaining weight loss.

I advise my clients to eat one-third of their daily calories in the morning. For most people, that’s at least 600 calories, much more than they’re used to consuming.

While solving other issues such as end-of-day stress and exhaustion is important, too, I’ve found that nothing works unless morning eating is beefed up first. Eating more in the morning is a scary proposition for many people who fear that they’ll continue their evening overeating on top of the bigger breakfast. But my clients who bite the bullet and give it a try are amazed to find that it reduces cravings and gives them a sense of control, so that it is easier to eat more moderately later in the day.

Interestingly, de Castro found that people are more sated with the food they eat in the morning. “If they eat a large breakfast, they’ll wait a long time before eating again. They get a lot of bang for the buck,” says de Castro.

Organized eating: Researchers have found that most people with the more severe “night-eating syndrome” don’t have regular meal and snack times. I have also found this is true for evening overeaters. Most overeating is due simply to undereating throughout the day and poor planning. I hear so many people say “I have no will power,” or “I hate myself because I have no discipline.” But they somehow regain their discipline and will power by simply planning and eating regular daytime meals and snacks.

That’s why I advocate cooking in large batches and regular grocery shopping so that you have healthy and delicious foods at your fingertips when you get home from work in the evenings.

Trigger foods: Many people who overeat in the evenings have “trigger” foods, specific foods they crave and are more likely to overeat, such as chips, chocolate or peanut butter. The experts find the avoidance of trigger foods can reduce evening overeating.

Assessing hunger: Your body lets you know what it needs. One key to lasting weight management is being in touch with your body and its signals. In the evening, before you eat, get rid of distractions. Take a few deep breaths and stop to think if you’re physically hungry. If you’re hungry, eat. If you’re not, or if you’re not sure, you shouldn’t eat.

Stress management: Many people overeat in the evenings as a way to cope with the stress and exhaustion they may feel or to reward themselves at the end of a hard day. But this is a self-defeating response either way. When you come home, never head straight for the kitchen. Instead, hop in the shower or tub to decompress, take a walk or stretch. Once relaxed, then decide what you’d like for dinner.

Of course, these actions are only possible if you’ve fed yourself properly during the day and you’re not ravenous.

Reducing behavioral associations: Like Russian scientist Ivan Pavlov’s famous dogs, we can train ourselves to salivate and crave food in connection with just about any activity. Playing cards, eat. Watching a movie, eat. Going to the mall, eat. Talking on the phone, eat. Reading in bed, eat. Watching TV, eat.

The experts recommend that you eat only when you are seated at the dining or kitchen table, without distractions, so that you don’t develop an association between eating and any activity, place or person. The only stimulus for eating should be hunger. Distractions tend to reduce inhibitions to overeating.

When to eat: There is no hard-and-fast rule governing the timing of your last meal in the evening. I recommend that evening calories don’t exceed lunch or breakfast calories and that you eat at least two-thirds of your day’s calories before dinner. It’s important to go to bed feeling light, not full. This way, you awake hungry for a big breakfast.

Katherine Tallmadge is a Washington nutritionist and author of “Diet Simple” (Lifeline Press, 2004). Send e-mails to her at food@washpost.com.

© 2004 The Washington Post Company

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Coping With Food Pushers

Original Content: Washington Post

One of my clients, who came to me to lose about 30 pounds, has a real problem. He loves to eat, and he loves to please people. In fact, he said pleasing people is the main reason he overeats. This tendency becomes especially troublesome during the holidays when friends, family and colleagues invite him for meals. My kind-hearted client literally cannot say no.

As a result, he says holidays are a time of joy but also frustration, because his need to be polite is in stark conflict with his goal of trimming down.

Many of us can appreciate his dilemma. Holiday delicacies can be difficult to navigate, especially if you’re trying to avoid gaining weight from Thanksgiving to the New Year. And that can bring out the best and the worst in people.

We all know hosts who aren’t satisfied until they convince us, beg us, to eat more, more, more. Their entreaties are hard to resist, if only because we want to be polite.

To be fair, “food pushers,” as I call them, aren’t necessarily bad people. Your mom, your spouse, your friends — they just want to please you. They are people who think they have your best interests at heart and know more than you do about what and how much food (and drink) you should be consuming.

My clients and I have tried various tactics through the years, most of them utter failures. I’ve tried explaining that I wasn’t hungry. I even went through a phase of telling people I was allergic to this or that. That didn’t work, either. And I learned that the worst thing you can say to a food pusher is, “No thanks, I’m on a diet” or “Thanks, I’m watching it.”

You might as well say, “Talk me into it!” Your excuse is giving the food pusher a double signal — that you really want it but have to refuse. It might also sound insulting, implying that the food isn’t good enough for your refined tastes. And finally your response might make the pusher feel guilty, as if he or she should be “watching it,” too. All of these things challenge the food pusher to seduce you.

But I finally began to make headway when I learned the most basic rule of all: Never give excuses. I’m delighted to say that one of the foremost authorities on etiquette told me that this approach is both appropriate and wise.

“The best answer is a simple but firm ‘No thank you,’” declared Judith Martin, the syndicated columnist who writes as Miss Manners. “Once you give an excuse, you open yourself to argument.”

Martin also offered clear advice in her column to food pushers, and their “endless patter of coercion — ‘Oh, come on, one won’t hurt you . . . I made this especially for you . . . it doesn’t have any calories . . . you’re too thin anyway . . . it’s good for you . . . you’re not going to make me eat leftovers tomorrow.’ Miss Manners asks them to cut it out.”

“To offer and provide food is lovely, but to badger people into eating it isn’t pleasant,” Martin told me. “Politeness consists of offering food and drink without cajoling or embarrassing people into taking it.”

While “no thank you” is fine for hosts, I learned I had to use a different tactic with my family.

During visits to my grandparents in Sweden, for instance, every day I felt overstuffed from too many fattening (and, yes, delicious) Swedish meatballs, cheeses and cakes. Inevitably with each visit I came home several pounds heavier.

I decided I’d drop subtle hints and compliments to guide them into serving me food that wasn’t going to make me look and feel like a Swedish meatball.

This technique of continued positive reinforcement took several years (in psychology, it’s called “shaping”), but it eventually worked. When they served seafood, salads, fruits — food I wanted more of — I complimented lavishly. “Sweden has the best fish in the world!” or “I just love your salads!” (which was all true, by the way). Over time, whenever I’d visit, they’d feed me what they learned I loved: seafood, salads and fruits. (Yes, I also loved the fattening stuff, but that was easily obtained, and I wanted to limit my indulgences without announcing it.)

The same technique can work with your colleagues, friends and family, and it doesn’t have to take years. At Thanksgiving or during the holidays, instead of focusing on what you don’t want or can’t have, and using turn-off words such as “healthy” or “diet,” simply compliment your hosts and stay positive. Instead of saying “I can’t have dessert, I’m watching it,” say “The meal was so satisfying, I can’t have another bite!”

When given a choice at, say, the Thanksgiving meal, a work party, a potluck, or in restaurants, instead of, “I don’t eat mashed potatoes and gravy,” say: “The green beans look fabulous!”

My client tried these tactics with his family and friends and has been losing weight ever since. He was surprised at how a simple compliment could stop food pushers in their tracks.

Even Miss Manners agrees that this approach is okay as long as you don’t go into too much detail. In the end, no food pusher can resist a happy guest.

Of course, as a guest, you have obligations, too, which I’ll discuss in my next column.

Katherine Tallmadge is a Washington nutritionist and the author of “Diet Simple” (Lifeline Press, 2004). Send e-mails to her at food@washpost.com.

© 2004 The Washington Post Company

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Just Say No

Original Content: Washington Post

My client Julie used to fight every holiday with her family. She would unwittingly start the argument at the dinner table by mentioning that she was on some sort of diet and couldn’t eat this or that. Then other guests would chime in with their own dietary viewpoints. This would cause the host to worry whether her guests were really complaining about the lavish spread she had slaved over. And the negativity didn’t help Julie; she would feel so frustrated that she would just give up on her dieting goals.

I’m afraid this is a familiar scene. As the party season begins, many of us are fearful of the delicious yet fattening holiday foods offered at countless gatherings. Although we want to enjoy ourselves and be appreciative guests, there’s the little (or not so little) issue of the weight we don’t want to gain.

Our fears are well founded. Studies show we are susceptible to weight gain at this time of year. Just about every party revolves around food. And when there is a variety of tasty foods in the vicinity, many of us simply can’t resist them. In fact, the more food that is available, the more we tend to eat. You could say the holidays, with all these temptations — plus the pressure of wanting to please our friends and family — provide the perfect environment for overeating and weight gain.

So, the challenge is how to be a gracious guest yet navigate the minefield of delicacies.

Our first obligation as guests is visiting friends and loved ones with a generous spirit. If offered food that we don’t want or can’t have, a simple “no thank you” is perfectly acceptable. Forcing your likes, dislikes and preferences for certain foods on the host or other guests can be downright unappetizing.

“It’s important not to treat private hospitality as a restaurant and announce what you want or don’t want,” said Judith Martin, the syndicated columnist who writes as Miss Manners, via telephone.

Today it seems almost impossible to escape people on this diet or that, freely espousing their views and theories. Worse, some guests expect their hosts to cater to their particular dietary requirements: no carbohydrates, no fat, no white flour, no sugar, no dairy, ad nauseam. Although it is fine to be following a diet, and may even be essential for your health, expecting the host to be a short-order cook is unfair. And discussing dietary views at the table is a no-no.

“This attitude that other people haven’t seen the light and you have to make them see the light makes the experience of eating unpleasant,” Martin told me. “Cooking has improved enormously over the decades, but the experience of eating has gone downhill because people are so self-righteous and willing to boss other people around.”

Martin also warned against bringing your own food or drink to a party, even if you have a serious dietary need or allergy, unless that is requested by the host. It is commonly mistaken as a lack of confidence in your hosts’ culinary tastes.

“Your family and intimate friends should know your condition, but if you are eating with hosts who do not, fortify yourself with food before going so that you are not starving, and then simply avoid dangerous foods,” said Martin. “This does not require an explanation.”

With family or close friends on extended visits, though, it’s perfectly acceptable to offer to contribute by going grocery shopping or providing food for everyone (not just yourself), while at the same time fulfilling your dietary needs. When I stay the night at friends’ or families’ homes, I’ll often bring a large basket of fruit, for instance, for everyone to enjoy. On an extended visit, I might offer to go grocery shopping or to make dinner for everyone.

This is a way to be generous but also to help myself have foods I feel comfortable with. However, it is important that this be done graciously, in the spirit of thanks and not as an obvious rejection of your hosts’ food or hospitality.

How did Julie solve her holiday eating problem? She and I decided she would drop the drama of the dieting daughter and assume the role of the gracious guest instead. She would not initiate or participate in any conversations about dieting or food during her visits.

Her strategy worked, and there were no more arguments during the holidays about her weight, dieting or food. Everyone, including Julie, enjoyed the holidays so much more. She has since lost 40 pounds.

TIPS (original content: Wednesday, December 1, 2004; Page F04)

To enjoy the holidays without tipping the scales, and to maintain the role of a gracious guest:

• Give away fattening leftovers. One splurge won’t interfere with your goals, but multiple indulgences will.

• If you’re afraid there won’t be foods you would like, or you would like to control your intake at a party, eat a snack or a meal before going.

• Don’t starve yourself the day of the party, or you may overeat once you get there.

• After you’ve arrived at the party, sip some sparkling water and wait at least 15 to 30 minutes before making a food choice. This gives you time to relax and to scope out the offerings.

• Prioritize your favorite holiday foods. Splurge on two or three special delicacies you can get only once a year.

• Wear close-fitting clothes to help remind you when you’ve had enough.

— Katherine Tallmadge

Katherine Tallmadge is a Washington nutritionist and author of “Diet Simple” (Lifeline Press, 2004). Send e-mails to her at food@washpost.com.

© 2004 The Washington Post Company

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Rough It

 

Cranberry, Orange, Walnut Whole Grain Muffins (in Diet SImple: Farm to Table Recipes)

Cranberry, Orange, Walnut Whole Grain Muffins (in Diet SImple: Farm to Table Recipes)

Original Content: The Washington Post

Our grandmothers have been extolling the virtues of “roughage” for generations. Turns out, they were right. But the benefits of roughage, aka fiber, are far more vast than grandmother ever realized.

High fiber diets have been shown to reduce the occurrence of several chronic diseases. Because of this, in 2002 the expert scientists on the National Academy of Sciences’ Food and Nutrition Board, the group which issues periodic dietary recommendations for Americans, for the first time recommended Americans double their daily fiber intake to 38 grams for men and 25 grams for women. That’s the level they found is protective against heart disease.

Fiber is mainly carbohydrate, the undigestible part of plant foods (fruits, vegetables, whole grains, legumes, and nuts)– it travels unchanged through the intestines. Fiber comes in many different forms in food. It is concentrated, for instance, in the skin of fruits and vegetables, such as apples, corn, and legumes, the seeds of vegetables and fruits such as berries and cucumbers, and the germ and bran or coating which surrounds wheat kernels and other grains. These essential parts of the grain are removed to create white flour and other refined grains.

Americans eat very little fiber – half of what is recommended, eating a highly refined diet, instead. And if you’re on a low carb diet, you’re lucky to be eating any. There are plenty of great reasons to increase your intake of fiber. My clients who do discover multiple benefits.

Easier Weight Loss

Not eating enough fiber may be one reason why people are getting fatter.

A study published in the American Journal of Clinical Nutrition last year found that women with the highest fiber intake had a 49 percent lower risk of major weight gain compared with women eating less fiber.

High fiber diets are usually lower in calories. Though fiber is mainly carbohydrate, very little of it, if any, is actually digested. So, with foods high in fiber, you’re actually eating food which only partially counts as calories (and you thought that was only in your dreams!).

High fiber foods are also bulky, and often watery foods, which means they fill you up for fewer calories. Studies have shown adding high fiber foods, such as vegetables, before or during a meal decreases the overall calorie content of the meal by about 100. While saving 100 calories a day may not sound like much, it translates into losing ten pounds in one year.

Another factor which helps you feel satisfied with fewer calories is the “chew” factor, High fiber foods require more chewing and take longer to eat, which leads to more physical and psychological satisfaction with your meals.

Improve Intestinal Function

Digestive disorders are on the rise and a main reason may be the dearth of fiber in our diets. For most digestive disorders such as reflux disease, constipation, diarrhea, hemmorhoids, diverticulitis, ulcerative colitis, Crohn’s disease and irritable bowel syndrome, a higher fiber diet relieves symptoms and can even prevent the disorder in the first place.

Many people with these disorders, particularly Crohn’s disease or diarrhea, think they should avoid fiber, but that’s a mistake for most. Fiber increases bulk and motility and this relieves pressure, keeps everything regular and more comfortable for the whole gammit of intestinal disorders.

Imagine fiber as a dry sponge in your intestinal tract. Fiber pulls water into the system, keeping everything larger, softer and moving more quickly and easily.

Lower Diabetes Risk

Numerous studies have shown that high fiber diets improve diabetes control and may even prevent diabetes. In fact, it’s been estimated that fiber, especially cereal fiber from whole grains, reduces diabetes risk by about 35 percent.

There are several theories explaining why this may be true. First, high fiber foods tend to have a lower glycemic index. This means that after eating, blood sugar levels rise less (diabetes is characterized by high blood sugar). And studies confirm that people eating high fiber diets usually have lower fasting insulin levels, an indicator of overall lower blood sugar levels.

Also, high fiber foods contain many nutrients which may improve diabetes. For one, magnesium, a nutrient found in whole grains, legumes, tofu and some vegetables, improves insulin resistance, a cause of Diabetes Type II, the most prevalent type of diabetes. Vitamin E, found in whole grains and nuts, may also improve insulin resistance.

Prevent Heart Disease

Fiber helps prevent heart disease in a variety of ways. Lower circulating insulin caused by a high fiber diet reduces heart disease risk and heart attacks. Also, research shows viscous fiber found in legumes, oats, rye, barley and some fruits and vegetables, reduces LDL cholesterol (the bad kind which correlates with heart attack). In fact, it has been estimated by the NAS expert panel that for every gram of soluble fiber you eat, you’ll reduce heart disease risk by 2.4 percent.

High fiber diets reduce triglycerides, or blood fat, another heart disease risk factor. New evidence shows fiber intake is linked to lower C-reactive protein, an indicator of inflammation, which is an emerging heart disease risk factor.

Whole grains and some legumes contain many beneficial healthful substances, including phytoestrogens, which affect circulating hormone levels and may impact heart disease positively. Diets high in fruits and vegetables, containing high levels of the nutrient potassium, also significantly lower blood pressure and stroke.

High fiber foods such as dark green vegetables, legumes and fortified cereals contain the nutrient, Folate (or folic acid). Researchers have found that low blood levels of folate are linked to heart disease.

Reduce Cancer Risk

In populations eating low dietary fiber, doubling fiber intake from foods could reduce the risk of colorectal cancer by forty percent, according to recent findings in the EPIC study (European Prospective Investigation into Cancer and Nutrition), an on-going study of 500,000 people in 10 European countries.

In fact, the majority of studies suggest that dietary fiber is protective against colon cancer, according to the NAS expert panel’s report on fiber. But, a few important studies have not found a link so the issue remains to be resolved, concluded the report.

Several mechanisms have been proposed for this beneficial effect. First, because it pulls water into the intestinal tract, fiber dilutes carcinogens and other tumor-promoters, and causes a more rapid transit, thus causing less exposure of your body to potentially damaging substances. Fiber also causes other beneficial chemical reactions, such as lowering the ph. And lower insulin levels caused by high fiber diets are correlated with lower colon cancer risk. The EPIC researchers stressed that foods supplying fiber also contribute many other nutrients and phytochemcials (beneficial plant chemicals) that have been linked to cancer protection, according to the study reported in The Lancet last year.

Reasons given for some disappointing results connecting fiber to cancer prevention are that the benefits of dietary fiber may not occur until fiber intake is sufficiently high, and Americans eat very low levels, compared with Europeans, so it’s hard for scientists to measure an effect in American diets. Also, some studies tested fiber supplements, as opposed to fiber in food, and researchers say that’s a completely different animal.

Human studies specifically looking at fiber supplements haven’t shown good results and did not find a lower incidence of colon polyps, a precursor to colon cancer. In fact animal studies suggest fiber supplements might increase cell proliferation, which suggests a negative effect, increasing one’s risk of developing cancer rather than reducing the risk.

Scientists believe that fiber supplements will probably not produce most of the health benefits found with high fiber foods (regardless of what the commercials on TV say), except for improved gastrointestinal function and slightly lower LDL, if the supplement is made from viscous fibers such as guar gum or psyllium. But fiber supplements’ role in chronic disease prevention remains unproven. It’s best to get fiber from whole foods in your diet.

Supplemental Evidence

Adding Fiber To Your Diet

The key to adding fiber while preventing gas or cramps sometimes associated with increased fiber intake, is eating fiber consistently, adding it slowly, and drinking plenty of fluids. If you eat a low fiber diet and suddenly at a party scarf down a large bowl of baked beans, you may suffer negative side effects. To prevent this, Leslie Bonci, author of “The American Dietetic Association Guide to Better Digestion,” recommends adding fiber by just five gram increments each week until you get to the recommended daily intake of 25 grams for women and 38 grams for men. Then, it’s important that you consistently eat regular amounts of fiber throughout each day.

Fiber content of selected foods:

Grains

Whole grains and are the largest source of fiber in your diet.

Grains              Grams fiber

whole wheat bread, 1 slice (1 oz) 1.4

whole wheat spaghetti, 1/2 cup cooked 2

Bulghur, ½ cup cooked  4

Brown Rice, ½ cup cooked 2

Wasa Sourdough Rye Crispbread, 2 slices 4

air popped popcorn, 1 cup  1.0

Oats, ½ cup dry 4

Swiss Muesli, ½ cup 4

Post Great Grains Cereral, ½ cup 4

Kashi Good Friends Cereal, ½ cup 6

Fruits

Fruits contain about 2 grams per 4 ounce serving, but they vary.

Fruits     Grams fiber

apple  3.5

apricot  1.8

banana  2.4

blueberries, 1/2cup 2.05

cantaloupe, 1/4 melon 1.0

cherries, 10 1.2

grapefruit, 1/2 1.6

grapes, 10 0.3

grapes, 1 lb. 2.7

mango  3.7

orange  2.6

peach  1.9

pineapple, 1/2 cup 1.1

strawberries, 1 cup 3.0

kiwifruit  2.6

Vegetables

Vegetables contain 1 – 2 grams per serving, or 1/2 cup cooked or 1 cup raw.

Vegetables, 1/2 cup cooked      Grams fiber

asparagus  1.0

beans, green  1.6

beets  2.0

broccoli  2.2

Brussels sprouts  2.3

Cabbage  1.4

carrots  2.3

cauliflower  1.13

cucumbers, sliced 1 cup 0.8

eggplant  1.2

greens  2.0

mushrooms  2

onions  1.5

zucchini squash  1.3

pepper  1.0

tomato  1.0

Starchy Vegetables, 1/2 cup cooked Grams fiber

corn   2.9

green peas  3.6

parsnip   2.7

potato, with skin  2.5

Legumes

Legumes are a great protein source and can substitute for meat. They average 6 grams of fiber per 1/2 cup cooked serving.

Legumes, 1/2 cup cooked  Grams fiber

kidney beans  7.3

lima beans  4.5

navy beans  6.0

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