Tag Archives: healthy eating

The truth about restaurant salads

If you are looking for a healthy option for lunch or dinner at a restaurant, especially if you are trying to lose weight, chances are you will consider a salad. It turns out that at most fast-food and casual dining restaurants, salads may not be the low-calorie or low-fat choice you were expecting. However, ordering a salad can still be a healthy option, as I explain in my Health & Fitness column in the Aiken Standard this week.

Big salad


We think of salads as being a healthy choice because they contain lots of vegetables which are low in calories and high in vitamins, minerals, and fiber. But most restaurant salads are more than just vegetables. At a minimum, you would add salad dressing and many salads also include nuts, fruit, chicken, bacon, or cheese, all of which add fat and calories.

Salad dressing alone can add hundreds of calories. Creamy dressings like ranch and blue cheese tend to be higher in both calories and fat than vinaigrettes. In many cases the salad has more calories than the sandwich or entree you would have ordered instead.

As an example, consider the Premium Bacon Ranch Salad with Crispy Chicken at McDonald’s. This popular salad contains 490 calories and 29 grams of fat. Compared to a Big Mac, which has 540 calories and 29 grams of fat, this salad doesn’t seem like such a healthy option. You could improve the salad by switching from fried chicken to grilled chicken and save 180 calories and 15 grams of fat.

The real problem is the ranch dressing—one packet contains 200 calories and 17 grams of fat. You could skip the dressing altogether, but a more reasonable approach is to switch to the Low-Fat Balsamic Vinaigrette, with only 35 calories and 1.5 grams of fat. Want to really cut calories? The salad with the vinaigrette dressing and no chicken has only 230 calories, almost 300 fewer than the version with crispy chicken with ranch dressing or the Big Mac!

Despite the fact that many restaurant salads have calorie and fat content similar to burgers and other entrees, it doesn’t make them a bad choice. The salad does contain several cups of vegetables, which means it is higher in vitamins, minerals, and fiber than a burger. The salads at McDonalds have about twice as much fiber as most sandwiches.

Think of it this way: the salad may be equivalent to a burger as far as fat and calories go, but it comes with a serving (or more) of vegetables. And the salad is even healthier when you consider that the sandwich would undoubtedly come with fries! One more point: I use McDonald’s as an example here, but the same holds true for salads at other fast food and casual dining chain restaurants.

What if you are at a restaurant and want to order a salad? What can you do to make it healthier? You could order a side salad. Given the huge portions at most restaurants, this smaller serving might be enough. You can also limit the toppings, especially meat and cheese, and choose a lower-calorie dressing. Another tried and true option is to ask for the dressing on the side so you can add just as much as you want. And don’t forget, you can always share one of the large salads with a friend or save half for another meal.

The bottom line is that salads at restaurants can be as high in calories and fat as other “unhealthy” menu items, but they do provide a serving of vegetables you might otherwise miss. And by making a few choices, you can create a salad that is a healthy, low-calorie option.


Nutrition, exercise, and health information can be confusing. 
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Are the additives in your food safe?

Making healthier food choices is something that you should be thinking about every day. Since November 4 is National Eating Healthy Day, this seems like a good opportunity to revisit some advice to help you make smart decisions. Eating more fruits and vegetables, limiting added sugar, and focusing on “real food” instead of processed, prepackaged meals and snacks are always good ideas. One reason for this is to avoid food additives, some of which may be harmful.

food additives


If you have ever read the ingredients on a food package you no doubt realized that much of what we eat isn’t really food. Chemical additives are common in packaged foods as preservatives, coloring agents, flavor enhancers, and even vitamins and minerals. This isn’t necessarily a bad thing, since these chemicals allow food to last longer, look and taste more appealing, and provide essential nutrients. The assumption is that these additives have been tested and proven safe for us to consume. Unfortunately, that is not the case for many commonly used additives.

This may be surprising, but it isn’t new. In the late 1950s Congress required that new food additives must be proven safe before they could be used. That raised the question of what to do with additives that were already widely in use. Since people had been eating these additives with no apparent ill effects the decision was made to classify them as safe, and the “generally recognized as safe” (GRAS) list was created.

Now additives may be approved as GRAS by an expert panel without rigorous testing and FDA approval. One study found that in every case these reviewers worked directly for or had financial ties to the companies that manufactured the additives. This raises serious questions about the process and whether or not the chemicals added to our foods really are safe.

So, are the additives in our food safe? There is no good answer to that question, mostly because the safety studies haven’t been done. However, it is rare that a food additive is removed from the market for health reasons. Most research showing that a food additive may be unhealthy is conducted in animals. These studies often test amounts that are far higher than people would reasonably consume, so they may not predict the health effects in humans. And some additives, such as iron added to cereal or vitamin D added to milk, for example, are widely thought to be beneficial.

To be sure, there are some chemicals in our food that we should avoid, but it isn’t fair to say that all food additives are bad. Even so, eating foods that are free from additives is probably a good idea. Even though each individual additives may not be hazardous, it is possible that exposure to small amounts of several of these chemicals could be dangerous.

Much of our exposure to food additives comes in the form of processed, prepackaged foods, including many restaurant meals. Getting back to basics and cooking using “real” food— fresh fruits, vegetables, and meats—is one way to avoid processed foods. Reading food labels can help, too. Look for ingredients that you recognize as food and avoid additives that clearly aren’t.

Avoiding all food additives is almost impossible. Even foods that don’t come in packages, such as fruits and vegetables, may contain coatings that prevent damage or preserve freshness. Even canned fruits and vegetables will likely have added salt or sugar, so even apparently healthy foods can contain additives. The best way to limit them is to select as many fresh foods as possible and make an effort to check labels for additives.


Nutrition, exercise, and health information can be confusing. 
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New reasons why it is so easy to gain weight. And what you can do to stop it.

If you have been gaining weight or find it more and more difficult to maintain your weight, you are not alone. According to current statistics, one-third of U.S. adults are obese and two-thirds are considered overweight. Being overweight is now the norm in America, since only about 3 in 10 people are at a healthy body weight.

This is consistent with other reports that show that the waistlines of Americans are expanding. One recent study looked at the percentage of adults who had a high waist circumference (over 35 inches for women and over 40 inches for men). Overall, the average American added over one inch to their waist circumference over the past decade. As of 2012, over half of U.S. adults meet the criteria for abdominal obesity. This is bad news, since excess fat, especially around the waist, increases the risk of type 2 diabetes, hypertension, and heart disease.

It wasn’t always this way. As recently as the 1980s the prevalence of obesity was much lower, around 15%. There has been much interest in figuring out why this widespread weight gain has occurred. While there is no single cause, there are a host of factors that contribute to the obesity epidemic. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Obesity


Among the forces that seem to be working against you are your genetics and our environment, specifically as it relates to eating and activity behaviors.  Over the past several decades our “food environment” has changed so that now low-quality, high-calorie food is readily accessible and more nutritious food is harder to find and more expensive. Our “activity environment” has changed, too. For most of us, the physical activity that was common at work and home years ago has been replaced by lots of sitting. While there are genes that influence our eating and activity behaviors, these genes have not changed enough over time to explain the obesity epidemic.

A practical explanation for weight gain, both for individuals and the population as a whole, is that we are eating more and expending less energy through activity. Indeed, even small changes in energy balance can add up to increased weight over time . A new study, however, suggests that there may be other factors that may have contributed to the rise in obesity beyond eating and activity.

Among these factors are exposure to certain chemicals in the environment, the use of prescription drugs that cause weight gain, and how our current diet has changed the bacteria in our intestines, that we now know regulate our physiology in surprising ways. For example, bisphenol A (BPA), still found in some plastics, food containers, and receipts, alters normal hormone activity in a way that may increase fat storage.

There is some good news, though. Eating a healthy diet and being active everyday can help you lose weight and maintain a healthy weight. This is true whether your concern is changes in your own eating and activity habits or these other potential causes of weight gain. Indeed, regular exercise may help treat many conditions, like depression, for which prescription medications that may cause weight gain are often used. And a diet rich in fruits, vegetables, and whole grains and low in added sugar may help restore more normal gut bacteria which might help with weight control.

Until we know otherwise, eating smart and moving more is still your best approach to weight control and good health.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
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How low should you go?

When it comes to your health, making even small changes can lead to big improvements. Whether you are trying to eat a healthier diet, get in shape, or lose weight, a little effort can go a long way. But doing more can produce even more meaningful changes.

The same is true for risk factors including blood pressure, cholesterol, and glucose. For example, if you have high blood pressure, you can reduce your risk of having a heart attack or stroke by lowering it, even if it doesn’t get into the “normal” range. This is often a goal for patients with high cholesterol or diabetes, too.

According to recent news reports, a major study suggests that treating risk factors—specifically, hypertension—to bring them well below previous targets has even greater benefits. This study, and how it applies to other health indicators, is the topic of my Health & Fitness column in the Aiken Standard this week.

blood pressure


The study, which examined the effect of lowering blood pressure on heart attack and stroke risk, produced such remarkable findings that the results will be published two years ahead of schedule. The researchers found that lowering systolic blood pressure (the top number) to less than 120 mmHg resulted in a risk of heart attack or stroke that was significantly lower than that of treating blood pressure to a typical goal of below 140 mmHg.

This suggests that getting your blood pressure out of the “high” category isn’t enough and that lowering it more is beneficial. Not only is this is good news for people with hypertension, but it also likely applies to other conditions as well. For example, the goal for people with type 2 diabetes is to get blood glucose level, frequently determined by the “A1c” number, as low as possible to prevent complications like blindness, kidney failure, and amputations. And it seems that the risk of heart problems are reduced proportionally to how low LDL cholesterol gets.

This concept can also be applied to health behaviors. For people who are mostly sedentary, something as simple as a 30 minute walk each day can lead to big improvements in fitness. And simply swapping high-calorie drinks like soda or sweet tea for water or other calorie-free beverages can result in noticeable weight loss for many people. And overweight individuals can reduce their risk of diabetes by losing as little as 10% of their excess weight.

But greater changes to activity level or diet almost always have even bigger benefits. Cutting back on calories from drinks is a good start, but losing significant weight almost always requires making other changes in what you eat and how active you are. Walking is an excellent exercise, but greater improvements can be achieved by doing more, either longer duration or a higher intensity. And building muscle will require doing some form of resistance training—walking typically isn’t enough.

It’s true that every pound of weight loss matters, and many people notice changes in how they feel or how their clothes fit after losing as few as 10 pounds. But real transformations in appearance or health require more significant weight loss, especially for people with greater obesity.

Although the SPRINT study focused on only one factor, blood pressure, we shouldn’t limit ourselves to making only one change when it comes to our health. Indeed, the benefits of increasing activity, losing weight, and eating healthier together far exceed doing only one. And, while even small changes make a difference, doing more will almost always result in bigger benefits.

Forget about low-carb, go smart carb.

Nutrition advice tends to be complicated and contradictory, making simple answers to the question, “What should I eat?” anything but simple (but you still need to do it!). This is particularly true when it comes to carbohydrates. On one hand, current recommendations call for carbohydrates to be the major part of your diet. On the other hand, low-carbohydrate diets are at odds with these recommendations but are still very popular.

For example, the Atkins diet restricts all carbohydrates, including refined grains and sugars. The Paleolithic diet emphasizes minimally processed foods that may have been consumed by our ancient ancestors including lean meat, eggs, fruit, and vegetables while restricting the consumption of grains and added sugars. Both have been shown to promote weight loss better than traditional low-fat diets.

Proponents of low-carbohydrate diets claim that restricting carbohydrates promotes fat loss and eating carbohydrates leads to fat storage and weight gain. It is also likely that people who follow low-carbohydrate diets find them easier to stick to than other diets, so they may actually end up eating fewer calories.

But the problem may not be carbohydrates in general, it might be eating too few of the right carbohydrates. Given that September is Whole Grains Month, this seems like a good time to explore the benefits of going smart-carb instead of low-carb. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Food grains


Sources of carbohydrates include whole grains (such as whole wheat bread), refined grains (white bread), and sugars. Both refined grains and sugars tend to raise blood glucose rapidly, called the glycemic index, which leads to an increase in certain hormones, including insulin. Insulin stimulates the uptake of nutrients into cells, including the storage of fat in adipose tissue. This is one reason why carbohydrates are linked to fat gain and why restricting carbohydrates leads to fat loss.

But carbohydrates from whole grains don’t raise either blood glucose or insulin as much. This “low and slow” response has several benefits, including improved blood glucose regulation, lower triglycerides, and, potentially, reduced fat storage. For these reasons, complex carbohydrates from whole grains are called “good carbs,” in contrast to refined grains and sugars, known as “bad carbs.”

Considering that the typical American diet contains too much carbohydrate from sugars and refined grains and not enough whole grains, restricting carbohydrates may have some benefits. But there is another approach: be smart about your carbohydrate choices. Instead of cutting out all carbohydrates, focus on reducing refined grains and sugars and emphasizing whole grains.

You can meet this goal by limiting your intake of sugars, especially added sugars, and refined grains while increasing your consumption of whole grains, fruits, and vegetables that are high in fiber. When comparing food labels, look for foods that contain whole grains (the first ingredient should be something like “whole wheat flour”) and higher levels of fiber. But be aware that some foods, like many breakfast cereals, contain whole grains but are also high in added sugar. The best advice is to get the majority of your carbohydrates from real food, including vegetables, fruits, whole grains, and legumes, rather than from processed foods.

Something to keep in mind is that although low-carbohydrate diets are associated with weight loss and good health, they are not the only way to achieve these benefits. Indeed, people who are considered to be fit and healthy have a wide range of eating patterns, from vegetarian and low-fat diets to extreme low-carbohydrate diets and everything in between. The one factor they have in common is that they are active. It may be that regular exercise is just as important as what you eat when it comes to promoting health.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

It’s not your fault, but it is your responsibility.

Eating well and being physically active are two of the most important things you can do to promote good health. But knowing you should do these things does not always mean it is easy to actually do them.

Despite the simplicity of the message “eat healthy and exercise,” many people struggle with knowing exactly what to do and how to do it. This is largely due to the complicated and ever-changing nature of nutrition and exercise information and the fact that most people receive no education in these areas.

You may even feel like the information you read and hear is designed to confuse you. That may be true, considering that much of the nutrition information we get comes from food companies that are trying to convince us to buy their products. Even scientific research can yield conflicting results, challenging even the most knowledgeable professionals, myself included, to make sense of it. And even if you do decide to make eating or activity changes, the “best” diet or exercise program claims may make you wonder if you made the right choice.

Given this, it’s not your fault if you struggle to understand basic health information and recommendations. But it is your responsibility to learn as much as you can to make the best choices for you and your family.

This is the topic of my Health & Fitness column in the Aiken Standard this week

Man shopping in supermarket

This won’t be easy, of course. The popular media, as well as social media, promote confusion and false promises about nutrition by making claims that some foods are “toxic” while others are “superfoods.” The old good carb, bad carb or good fat, bad fat arguments have been given a new life as eat this, not that lists. The problem is that many of these claims are not supported by science. The research that is done often yields complicated or conflicting results that aren’t explained in a way that actually helps people make good decisions.

The same is true for exercise. No one doubts that exercise and physical activity are essential for good health, but there are conflicting claims about specific benefits of exercise and what the best form of exercise really is. This can lead to the idea that if you aren’t doing the right exercise, it doesn’t count. Nothing could be further from the truth! While there are reasons why some athletes might want specific types of training, the majority of people can benefit from simply spending less time sitting and going for a walk each day.

So, what can you do? Given the confusing and changing nutrition recommendations it’s best to focus on what hasn’t changed. That is, to focus on eating real food rather than processed, prepackaged foods. Planning meals and snacks to include fruits, vegetables, whole grains, nuts, legumes, lean meat, eggs, and dairy should give you plenty of healthy fats, carbohydrates, and proteins.

Instead of worrying about the “perfect” exercise, make it your goal to do something active for at least 30 minutes every day.  Beyond that, dedicating time for aerobic, strength, and flexibility exercise will bring greater benefits. Remember, the best exercise for you is the one you will do! Seek advice from people you trust and credible professionals, but remember that if it sounds too good to be true, it probably is.

Your responsibility isn’t to understand all of the nutrition, exercise, and health information you hear. It’s to make an effort to make a few simple, healthy choices despite that confusing information: Sit less, move more, and eat real food.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

How much protein do you need?

Recently I wrote about carbohydrates, fats, and protein, the major sources of energy in our diet. Getting sufficient amounts of these nutrients is essential to promote good health and exercise performance. Given the current trend of low-carbohydrate diets and an emphasis on protein for everything from fitness to weight loss, many people have wondered about how much protein they should eat. This is the topic of my Health & Fitness column in the Aiken Standard this week.


Good food display

As you might expect, protein needs vary from person to person for a variety of reasons. For example, an athlete who is working out to add muscle or training for a triathlon needs more protein than a person who does less strenuous exercise. Despite these individualized protein needs, there are some broad recommendations that apply to most people.

There are two ways to estimate the amount of protein a person needs, both of which you may be familiar with. One is to recommend a certain amount of protein, in grams, based on body weight. The RDA, the amount that meets the needs of almost all healthy adults, is 0.8 grams of protein per kilogram of body weight (g/kg) per day. You can calculate your protein requirement by multiplying your body weight by 0.4, so a 200 lb. person would require about 80 g protein per day. (You can also use an online calculator, like this one)

Meeting this protein requirement isn’t very difficult. A four-ounce serving of meat contains about 30 grams of protein, an egg has 6 grams, and a cup of milk has 8 grams. Plants contain protein, too—whole grain bread and cereal has about 4 grams per serving, and one cup of cooked beans contains about 15 g. Getting enough protein is important, but there is little benefit to eating more protein than you need and excessive intake could cause health problems.

In general, most adults get enough protein but children, women who are pregnant, and older adults should make an extra effort to eat protein-rich foods. Vegetarians and vegans, especially athletes, need to carefully plan meals to get enough protein and the right balance of amino acids to meet health and performance requirements.

The other way to estimate protein needs is based on the number of calories you eat. According to the Institute of Medicine, the acceptable range for protein is between 10–35% of total calories. If you eat 2,000 calories each day, this would equal 50 to 175 grams of protein each day. For someone who weighs 200 lbs, this would be between 0.5 and 2.0 grams of protein per kilogram. Notice that the RDA fits within this range, which accounts for the protein requirements of nearly everyone, including people who have very high protein needs.

While the RDA is sufficient for most healthy people, even those who exercise regularly, it may be too low for athletes engaged in strenuous endurance or strength training. The protein requirement for endurance athletes, including runners, cyclists, and triathletes, is 1.2–1.4 g/kg per day. Athletes who are training to add muscle mass and strength—think football players in the offseason—need even more protein: 1.2–1.7 g/kg per day. This should meet both energy needs to fuel training sessions and provide adequate protein for muscle repair and growth.

For most of us, though, the focus should not be on eating more protein but to get our protein from healthy sources. For starters, several servings of protein-rich lean meat, eggs, and dairy as well as whole grains, legumes, and vegetables should meet protein needs. The emphasis should be on real food rather than processed foods with added protein. After all, no amount of granola bars with added protein will make you healthier!


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr