Sunday, June 29, 2014

Protein Requirements

I’ve had a little more free-time as of recent and with some of that free-time I’ve been reading.  Some books that I’m reading are just for pleasure and some are related to work, nutrition-related.  I just finished reading, 10% Happier:  How I Tamed the Voice in My Head, Reduced Stress Without Losing My Edge, and Found Self-Help That Actually Works—A True Story by Dan Harris.  It’s an easy read and definitely something that everyone can relate to.  If you’ve ever thought about meditation and still been unsure of its benefits, here’s a good example of a person that doubted and then believed.  Harris says, “Meditation isn’t about achieving some special state; you just need to be as aware as possible of whatever’s happening right then.  It’s what the Buddhists means by “letting go” – better translated “letting be.”  He gives tips at the end of the book to help someone begin meditating.  Meditation takes practice; it’s training our brain’s muscles to become stronger each time we practice.  Consistency is key. 

The next book that I just finished reading was by George Saunders, Congratulations, by the way.  I finished the book in under an hour; it might have only been 15 minutes.  It was that quick and short.  Saunders gave a convocation address at Syracuse University and a transcript of the speech was posted on The New York Times website.  Within days, it had been shared more than one million times.  They published it in a book for all to read and be able to share his uplifting message. 
“Here’s something I know to be true, although it’s a little corny, and I don’t quite know what to do with it:  What I regret most in my life are failures of kindness.”

He shares that kindness it turns out is hard.  We all have in each of us a bit of selfishness.  Instead of learning this as we age, he challenges us to start now, become kinder and more loving.  Always “err in the direction of kindness.”

The next book that I stumbled across as a recommendation to read is, “The Opposite of Loneliness” by Marina Keegan.  5 days after her graduation in 2012, she died in a car crash.  Her last essay that she wrote for the Yale Daily News, “The Opposite of Loneliness,” went viral.  Her family and friends compiled her essays and stories together in this book.  I’m still in the middle of reading the book; however, I know that she was super talented and taken far too young.
I request books at the library and when they come in I always get excited.  Mainly because the waiting list is so long I often forget what I’ve requested.  Yesterday, it was VB6 Eat Vegan Before 6:00 by Mark Bittman. I’m always looking for books within the field of nutrition to see what might be the latest craze. It’s important to keep up on the “latest” information circulating in the field of nutrition.  Nutrition is a science and it is ever evolving as new research is being done.  With so much information circulating related to these studies that’s where confusion sets in.  I requested this book because Bittman lays out a 28-day eating plan that would allow one to “go vegan.”  He shows you how to stock your pantry, gives you strategies for when you are eating away from home, and even provides you with 60 recipes that would allow you to embrace this vegetable- and grain-forward diet.  If he was making it sound this easy and also giving the scientific background as to what the benefits were I thought it was a definite book I needed to check out.  I wanted to see if it was practical and based on actual research or if it was just another one of those books that people would deem to be a “fad” diet.  Ironically yesterday a friend posted a link on Facebook to an article about a 78-year old vegan bodybuilder.  He only became vegan within the last 12 years.  By looking at him you’d think he ate meat – and hence the reason this article was written, to dispel the protein myth that commonly plagues vegans and vegetarians.  Can you get enough protein from plant sources?  The article stated that, “this 78-year old vegan bodybuilder might make you reconsider your diet.”  My friend said he’d give it a try, BUT if he saw a little piggy coming his way, he might attack.
As a dietitian (or as I prefer to think of myself, a Medical Nutrition Therapist) and practicing pescatarian I’m here to tell you, “YES!”  Eating a plant-based diet can give you enough protein.  Many of you are out there thinking, “I like a good steak every now and then.  I don’t think I could give up meat.”  I always tell people to keep things in perspective.  No one ever said to give it up completely (at least I never tell clients that).  But what I do encourage is for people to take a step back and look at the amounts that they’re consuming.  We’re consuming WAY too much protein in this country and more specifically the kind of protein that’s harmful to our health.  Many people choose to go vegetarian or vegan for health-related reasons.  The research shows that people who follow a vegetarian diet are at a lower risk for obesity, cardiovascular disease, hypertension, type 2 diabetes, diverticulosis, renal disease, some cancers, and gallstones.  Vegetarian diets have also been show to benefit people who already have type 2 diabetes.  In one study, 43% of the people with type 2 diabetes who ate a low-fat vegan diet reduced their need for diabetes medications.  The reason for these health benefits comes from the lower intakes of saturated fat and cholesterol and the higher intakes of complex carbohydrates, dietary fiber, certain minerals, and phytochemicals. 

First, let’s take a look at how much protein one needs and then see how easy it is to get too much protein.  Again, my challenge to you is this, check to see how much protein you’re ingesting during the day.  Check to see if you can alter not only the amount of protein but also the source, substituting plant based protein for some of the animal protein.  Minimally I tell people to cut back on the amount that they’re doing.   And if you are one of the few that actually isn’t getting enough protein, make sure that you are – eliminating animal protein is one thing, but regardless you still need to make sure you’re receiving a sufficient amount.

I’ll make up a typical day’s diet and analyze the amount of protein in each food.  (These are just rough estimates, there may be less or even more).  The average American needs just a gram/kg of protein/day.  There are certain circumstances that may require more (if you’re working out a lot, pregnancy, etc.) but the maximum amount I’ve suggested is 1.5 grams/kg.  If we used someone my size that would mean my protein needs are minimally 58 grams/day and maximum 87 grams/day.  So let’s take a look at how quickly the protein can add up:

1 cup of milk - 8 grams of protein                                                                   2 slices of whole wheat bread - 8 grams of protein                                           2 eggs - 14 grams of protein
Total:  30 grams of protein              

1 cup white rice - 4 grams of protein                                                           4-ounce chicken breast - 28 grams of protein                                                  1 cup stir-fried vegetables - 2 grams of protein
Total:  34 grams of protein

4-ounce ground beef, lean – 28 grams of protein                                             1 cup of pasta - 8 grams of protein                                                                1 cup of spinach - 2 grams of protein                                                             1 slice of garlic bread - 2 grams of protein                                                       
Total:     40 grams of protein       

For the whole day:  104 grams of protein, well exceeding the daily needs of a person my size (and I didn’t even include snacks in this day’s example).  If I had this person in my office and was counseling them on how to make changes, I’d encourage them to eat a smaller portion of the animal protein.  Just by cutting back an ounce or two at each meal you’d cut back ~28 grams of protein and that’d put you within the recommended amounts.  If you’re cutting back on the protein at your meal that’s where utilizing vegetables as part of your meal will help to fill you up but also provide more fiber and vitamins and minerals that often times are lacking.  If you were to switch out the animal protein and utilize plant protein as your protein source, it’s a little easier to cut back on total protein amounts.  In a ½ cup of beans there are 5 grams of protein (some beans have less, some have more – this is the average).  In an ounce of nuts there are 6 grams of protein.  You’d still be able to obtain the protein you need during the day but the protein source is from a plant and is overall healthier – and you don’t have to concern yourself with saturated fat or cholesterol.                

Here are some plant-based food choices if you’re wondering how to switch from animal based protein to plant-based protein:

-Soy milk (plain or unsweetened)                                                               -Soy-based cheeses                                                                                     -Soy-based yogurts                                                                                  -Tofu (silken, firm, or extra-firm curds)                                                           -Tempeh (fermented soy)                                                                            -Seitan (wheat protein)                                                                               -Beans                                                                                                      -High-protein grains (millet, quinoa, etc.)                                                         -Nuts/nut butters (They should be natural & not have added oils like palm oil or sugar for that matter.)
The research shows that plan-based diets are associated with:
-Lower levels of triglycerides                                                                       -Lower concentrations of inflammatory markers such as C-reactive protein      -Decreased body weight and body mass index                                                 -Decreased risk of death from any cause, including heart disease                      -Improved insulin sensitivity                                                                        -Better blood sugar control in patients with diabetes

Where should one start in this whole protein debate?  My recommendation:  check to see how much protein you’re getting daily, regardless of the source.  It’s always good to put things in perspective.  Are you getting what your daily requirements are?  Are you getting double or triple what the recommendations are?  Or maybe you’ve been switching over to becoming vegan and actually aren’t getting enough?  If you choose to go the vegetarian/vegan route and obtain your protein from plant sources, know that you CAN get a sufficient amount of daily protein from plant sources.  Whichever source of protein you choose to include, animal or plant, follow the recommended guidelines.  Extra protein will not help you build more muscle or make you stronger. 



Sunday, June 8, 2014

How to Get a Gut

How to Get a Gut

Why do people gain weight?  And more importantly, why do people gain weight in their abdomen?  Research is constantly going on to help identify the reasons why.  As a dietitian I try and help my clients clue in on habits or trends in the things that they’re doing that might be contributing to their weight gain.  One of the things that I’ll do is obtain a diet recall from people.  Truth be told I don’t think they’re effective in my sessions.  Why you ask?  Just the other day it took me 15 minutes just to get an idea of what a “typical” day was for this patient.  She had a hard time telling me what she does daily because every day is different.  Not to mention that she omitted what it was that she was drinking because she didn’t consider that food (she got a little perturbed at me that I even asked her about her drinks – yes, she was drinking lots of sugary drinks  that she knew she shouldn’t be.)  Diet recalls can be effective if the patient is willing to be honest.  I let the patients know that weight gain doesn’t happen all at once.  It actually can creep up on you.  The 1st place you’ll start to notice it is with your clothes – you can’t seem to fasten your skirt, your pants feel snug.  Guess what?  I let them know that they’re NOT alone.  The average adult American gains about a pound a year.  And if you gain weight around your waist, that’s the worst one for your health, because it raises the risk of heart disease, diabetes, and possibly dementia.  If you’re not sure how you’re gaining weight (that’s why my patients come to see me sometimes), here are some of the things we’re doing that make us gain weight…and more specifically, expand our waists.

Don’t bother getting up.

We sit in the car, at the office, at our computers, and in front of the TV.  Why should we move when we can work, e-mail, shop, and talk on the phone without so much as standing up? Unless of course you have to walk to the bathroom or kitchen.  I used to have a 3-hour commute.  I was the queen of sitting.  And the worst part of it all is that when I’d get home I’d want to go for a walk but all that driving made me a zombie.  I’d end up sitting on the couch till I went to bed just to do it all over again the next day.  Moving our limbs is becoming obsolete.

Researchers are looking at whether inactivity can drive the body to make new fat cells.  We know that stem cells can become bone cells, muscle cells, or a fat cell.  The question is whether the mechanical signals from exercise can alter the decision of cells to end up as fat.  The research shows that even if you don’t see dramatic weight loss, exercise reduces overall body fat and hidden intra-abdominal fat, which is the most dangerous type. 

Remember we’re gaining one to two pounds on average a year (and that’s being conservative).  Over time that adds up to dangerous levels over a lifetime.  Regular, moderate-intensity exercise can help you keep the weight from creeping on, and that can translate to a lower risk of diabetes, cardiovascular disease, or cancer in the long run.

We keep eating as much as we did in our 20s.

We always have chips with our sandwich, always clean our plate when we have mom’s Italian, always order egg rolls when we have Chinese, always get a pastry with our coffee.  It’s never been a problem, so why should we change now?

The reason why:  As we get older, calorie requirements go down.  We need fewer calories as we age because our metabolic rate is falling, because we’re burning fewer calories to process the food we eat, and because we’re making fewer spontaneous movements.  You’ll use fewer calories per year, even if you keep up the same activity level – but let’s be honest with ourselves – are we as active as we were in our 20s?  (For those that are and are exercising a lot more than they used to, this is not the reason you are gaining weight – head to my next tip).  Even if you put in the same hours exercising, your ability to transport and use oxygen drops with age, so it feels harder to get the same workout. 

For the most part people realize that they have to cut calories as they age, they just don’t realize how many.  When you’re in your 20s there’s a lot more room for discretionary foods like cake, brownies, chips, whatever.  But as we enter our 60s, there’s no room for any of that stuff.  It’s going to require a profound shift in what we’re eating.  Most are willing to make small cuts, many just don’t realize that they may need to eat 1,000 less calories at age 60 versus 20.

Bump up your calories per bite.

Chocolate.  Butter.  Cream.  Cake.  Who says you can’t have your cake and eat it too?  Foods like cake, cookies, pies, doughnuts are calorie-dense.  What that means is they pack a lot of calories into each bite, so more calories reach your still-room-for-more fat depots. 

There have been studies done that restrict the calorie density and people don’t even notice.  When people are eating the same number of spoonfuls, they don’t notice if each one has fewer calories.  They’re eating a consistent weight or volume of food.  It’s just a natural response.

If we cut the calorie density it’s been shown to help people lose weight.  How do you lower calorie density?  The biggest influence is the water content of foods.  You can eat more fruits and vegetables, broth-like soups, lean protein foods and whole grains, which absorb water.  Cutting back on fat also helps.  I’m not meaning to say that you should eat a low-fat diet.  However, cutting back on the unhealthy fats that you don’t need is important.



Drink Your Calories.                                                                                                                                    

Thirsty?  Have a glass of juice with breakfast.  A fresh-pressed juice would go well with that sandwich.  And wouldn’t a nice White Chocolate Mocha warm you up on your way to work?  Only one problem.

Our hunger goes down after we eat and stays at a lower level after we eat a solid more so than after we drink a liquid.  And whether you eat or drink your calories also affects your next meal.  Studies show that when people eat 100 calories of solid food, on average they consume about 65 fewer calories at their next meal.  When they eat 100 calories of semisolid food, they eat 21 fewer calories at their next meal.  But when they drink 100 calories of liquid, they don’t cut back at all later.

Why are liquid calories different?  The data suggests that some of the hormones that control appetite respond differently when calories hit you as liquid versus solid.  The solution is really simple – think your drink!!  And of course, water, water, water.  Water is capable of not only hydrating you but also you’re less likely to overconsume it because your thirst response gets turned off.  (With the sweetness or flavors in other drinks, that might not happen.)

Diet sodas might create other problems.  Some studies suggest that artificial sweeteners may mess up the body’s internal sensing of when it’s getting calories, which could lead to overconsumption of calories.

The bottom line:  don’t ignore the calories in your glass.  Those calories need to be included in your total calories for the day.  When you have the choice between a glass of apple juice and an apple, pick the apple.

Eat out more often.                                                                                                                                       

Why dine in when you can go out or get take-out?  It’s less work, and it’s usually less boring.  It’s also a great way to get a gut.

The calories in restaurant foods are obscene.  At many of the restaurants you can spend 1,000 calories on the main entrĂ©e, an entire appetizer can plaster another 1,000 calories, and then you can wrap the meal up with a 1,000 calorie dessert.  Not to mention that their portion sizes are completely out of control.  And huge portions don’t just matter when you eat out, they warp your expectations of what’s normal at other times.   Let’s be honest, after you eat an eight-ounce hamburger at a restaurant, a four-ounce hamburger at home seems puny. 

Giving up restaurants completely is unnecessary.  I understand it’s part of our lives.  But what I do challenge people to do is to check the frequency with which they are eating out.  How many times do you eat out per week?  Be honest with yourself.  You might be doing it more often than you realize.  Eating out less frequently is one of the easiest things you can do to keep your gut from growing.

Look for trans fat.                                                                                                                                                   

While many companies are removing the trans fat from their products it is still buried inside some pie crusts, pastries, microwave popcorns, frozen pizzas, and biscuits.  You can also get it in restaurant foods (unless you’re eating out in New York City, Philadelphia, or a few other cities where trans fats are virtually banned).

What does trans fat have to do with your waist and gaining weight?  Researchers have found that those that eat more trans fat are more likely to gain waist circumference.  And not only do they gain weight they also had higher post-meal blood insulin levels, suggesting that they had become insulin-resistant, which could raise the risk of diabetes and heart disease.

Trans fat could be interfering with the ability to send signals through cell membranes.  And that could interrupt normal fat storage and fat burning.  Guidelines from the American Heart Association recommend limiting the amount of trans fats to less than 1 percent of your total daily calories.  What does that translate to?  If you need 2,000 calories a day, no more than 20 of those calories should come from trans fats.  That’s less than 2 grams a day.  That means there’s no room at all for industrially manufactured trans fats.

Surround yourself with food.                                                                                                                              

Someone offers you something yummy so you oblige.  I mean you don’t want to be rude.  And even if it’s not a person, but, say, you’re at the grocery store and they’re offering out samples, why not go for it?  Maybe you are hungrier than you realize.

There are people who take food opportunities.  These are the people that take a slice of birthday cake even though it’s 2 p.m. and they’re still full from lunch (I admit it, I’ve done this!)  Disinhibition isn’t just a matter of willpower.  Another example is the person that goes in to buy coffee and looks at the pastries and 30 seconds later they’re hungry.  Whether you buy the pastry or not, that’s the person that probably eats more overall, because the pastries have stimulated their hunger.  (Having willpower is closer to what scientists call restraint.  But being restrained is different than being disinhibited). 

Surrounding yourself with food at home or at work is a recipe for gut expansion.  An example is secretaries ate more candy if a bowl sat on their desk rather than six feet away, and they ate more if the bowl was clear than they did if it was opaque.  The solution:  keep your distance.  Don’t go into that coffee shop and try to tough it out with the pastries if they tempt you.  Instead, just don’t go in.

Get less sleep.                                                                                                                                                             
So what if you stay up late again?  You’ll just do the usual and drag yourself out of bed and double the caffeine tomorrow morning.  No one gets a good night’s sleep these days anyway.  Roughly one out of three men and women aged 30 to 64 reported sleeping less than six hours a night in 2004. (Experts recommend at least seven hours of sleep a night.)  What on earth does sleep have to do with your belly?

Many studies have found a relationship between short sleep duration and obesity.  When you’re deprived of sleep, your appetite can go way up.  And not only your appetite, but they’ve found that the cravings for sweets and carbs went up in particular.

Sleep might have gotten linked to eating during human evolution, when summer meant longer days – and less sleep – than winter for people who lived away from the equator.  This short sleep duration during the summer may have been a signal to the body that it was the time to build up fat reserves to endure the winter.  This intra-abdominal fat is more adaptive to protect our internal organs in winter.  But the genes that helped us survive those winters or adapt to famine are not helping us now.  Our ancestors would’ve burned that fat over the winter.  We on the other hand are just piling it on.

In a recent report obesity rates appear to have leveled off since 2005, after having doubled in adults—and tripled in kids—since 1980.  Before we can start celebrating this we need to keep in mind that one out of three children or teens—and two out of three adults—still weigh enough to put their health at risk.  Here’s another staggering statistic:  0 children in 1980 were diagnosed with type 2 diabetes, 30+ years later, there are 57,638 kids with the disease (statistic taken from the movie Fed Up.)  We are a nation in crisis.  We’ve identified reasons why we gain weight but we still need to work on changing these habits/trends.  Otherwise we WILL continue to see a rise in the diagnoses of diabetes and other health related diseases.