New Dietary Guidelines Promote Healthy Lifestyles

On January 31, 2011, the federal government released the latest Dietary Guidelines for Americans, providing information on healthy nutrition. With more than two-thirds of U.S. adults considered overweight, the guidelines encourage reducing caloric intake and increasing physical activity to promote health lifestyles, lower the risk of chronic disease and decrease the prevalence of obesity.

Here are the highlights from the latest Dietary Guidelines for Americans:

• Enjoy food but eat less.
  
• Participate in regular physical activity.
• Increase intake of whole grains, vegetables, fruits, low-fat or fat-free dairy or fortified soy beverages, vegetable oils and seafood.
• Decrease intake of added sugars, solid fats and refined grains.
• Drink water instead of sugary drinks.
• Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.
• Reduce daily consumption of sodium to less than 2300 mg. For African Americans, people with hypertension, diabetes or chronic kidney disease and those over 50, daily consumption should be less than 1500 mg. This number has been reduced from previous years.
• Consume less than 10 percent of calories from saturated fats. Replace them with calories from unsaturated fats.

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Kicking Off Your Exercise Routine

Robin Stott-McNulty, MPT, member of the Penn Metabolic and Bariatric Surgery team, provides recommendations for starting an exercise program.

Regular exercise produces many health benefits including weight control, improved mood, better sleep and prevention of chronic disease. Finding the time and motivation can be a challenge, so make exercise a part of your daily routine by planning ahead and sticking to your routine.

Follow these recommendations to start incorporating regular exercise into your everyday life.

Start slowly and set simple, reasonable goals. If you set the bar too high, you may give up on exercise before giving it a fair chance.

• Goal 1: Walk for 10 minutes twice a day.
• Goal 2: Walk for 30 minutes five days a week and add 10 minutes of resistance training.
• Goal 3: Walk for 40 minutes five days per week and add 20 minutes of resistance training.
• Goal 4: Once you are up to 40 minutes a day, increase your pace and not your time. (Example – if you walk one mile in 40 minutes, increase your pace so you walk 1.2 miles in 40 minutes).

Create a schedule that works for you. Every minute of exercise counts!

• Wake up 20 minutes early and take a brisk walk to start the day off on the right foot.
• Use 10 minutes of your lunch break to go up and down the stairs or walk outside.
• Park in the furthest spot in the parking lot.

Make exercise enjoyable.

• Put on music and dance around the house. Dance is a great form of exercise!
• Take an exercise class with a friend.
• Lift hand weights or stretch while watching your favorite television program.
• Go for a walk with your family. If you cannot walk outdoors, walk in the mall or do an exercise video.

Make exercise a habit.

• Schedule a regular time to exercise just as you would an appointment or meeting and hold yourself to it.
• Record your daily activities in a journal.
  

Remember to check with your doctor before starting an exercise program and drink plenty of water during your workout.

– Robin Stott-McNulty, MPT

Healthy Snacking on Super Bowl Sunday

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides tips for healthy eating during the Super Bowl.

Are you planning to watch the Pittsburgh Steelers battle the Green Bay Packers in the Super Bowl this year? The average football fan consumes an entire day’s worth of calories during the Super Bowl game.

Avoid taking a time-out from healthy eating during the festivities by following these easy tips:

• If you are hosting a party, provide healthy foods for you and your guests to enjoy. If you are going to a party, offer to bring a healthy snack like one of those listed below.
• Use a small bowl or plate. Eating from a small plate helps limit portion sizes and reduces overall intake.
• Designate half-time as the only time to eat. Grazing during the game can lead to mindless eating.
• Avoid high calorie beverages. Drink calories can add up quickly, especially if they contain alcohol. Instead, opt for low-calorie beverages such as coffee, tea, water with lemon or sugar-free soft drinks with fresh fruit slices. For low-calorie alcoholic beverages, choose light beer or a mixed drink with a sugar-free mixer.
• If you do overindulge, stay positive and get back on track the next day.

These healthy and tasty snack ideas can help you stay on track.

• Cottage cheese and lemon pepper dip with fresh vegetables
• Whole-grain crackers and hummus
• Oven-fried chicken tenders with light ranch dip
• Baked tortilla chips with bean dip and salsa
• Thin-crust, whole-wheat pizza loaded with vegetables

Many more healthy snacks and recipes can also be found online.

- Cara Stewart, RD, LDN

Avoiding Added Sugar

Added sugar can derail any diet, but it can be especially harmful for patients who have had bariatric surgery.

Many prepared foods contain added sugar, including yogurts, cereals, granola bars, jams, canned fruit, and sweetened beverages. Natural sugar occurs in healthy and unprocessed foods, including milk, fruit and vegetables. Added sugar is introduced into food in the processing or preparation stage and lacks nutritional value. High intake of added sugar is linked to increased risk for obesity, high blood pressure, high triglycerides, heart disease and stroke.

After bariatric surgery, it is essential to limit intake of added sugars for continued and maintained weight loss. The best option is to avoid food and beverages that are high in added sugar, or consume only small portions.

In addition, for people who had gastric bypass surgery, consuming too much added sugar can also lead to dumping syndrome.

Added sugar is often disguised under a variety of names. It is important to carefully review the nutrition facts of food and beverage products before consuming them. If any of the following ingredients appears near the beginning of the nutrition facts, the food or beverage may be high in added sugar:

• Beet sugar
• Brown sugar
• Brown rice syrup
• Cane sugar
• Cane juice or evaporated cane juice
• Confectioner's sugar
• Corn syrup or high fructose corn syrup
• Corn syrup solids
• Crystallized cane juice
• Fruit juice concentrate
• Honey
• Ingredients ending in "ose" including dextrose, glucose, maltose and sucrose
• Invert sugar
• Maltodextrin or dextrin
• Maple syrup
• Molasses
• Palm sugar
• Raw sugar
• Turbinado

To find the added sugar content in many common foods, visit the U.S. Department of Agriculture’s Database for the Added Sugars Content of Selected Foods.

New Year, New You Patient Open House

It is a new year and Penn Medicine is hosting a special open house for patients who are interested in living a healthier life in 2011.

From 10 am until noon on Saturday, January 22, Penn Medicine will host a health and wellness open house at the Ruth and Raymond Center for Advanced Medicine. Physicians, nurses, therapists, dietitians, and staff members from Penn Medicine will answer questions and provide information about diabetes management, weight loss/bariatric surgery, nutrition, exercise and smoking cessation. This event will be especially informative for patients who are considering weight loss/bariatric surgery.

The event is free, but registration is required. Please call 800-789-PENN (7366) for more information or to register.

FDA recommends Extending Weight-Loss Surgery Eligibility

A recent front-page article in the Philadelphia Inquirer highlighted an FDA advisory panel recommendation to allow doctors to use the adjustable gastric band – a less invasive form of weight-loss surgery – in patients with milder obesity.

Under the new guidelines, people with a body mass index (BMI) of 30 to 35 and weight-related medical complications of obesity would qualify. Currently the device is only approved for people with BMIs of 40 and higher, or 35 to 40 with other medical complications.

The article includes comments from Penn Metabolic and Bariatric Surgery Program faculty Noel Williams, MD, FRCSI, David Sarwer, PhD, and Thomas Wadden, PhD.

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Dear Diary: Today I ate…

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the benefits of keeping a food diary.

Keeping a food diary is an important first step when losing weight. Awareness and accountability are critical components of healthful eating and weight loss. Keeping a food diary raises your awareness of your diet, gives you control of your eating habits and helps you lose weight.

When starting a food diary, it is important to find a format that works well for you. Some options include a notebook, smart phone application or website, such as Lose It!, MyFitnessPal or SparkPeople. Many cell phone applications and websites have a database of nutrition values to help you accurately record and track your intake.

Tracking what you eat works best if you record your food and beverage intake as you go. Write down what, when, where and the quantity that you eat. Make sure to include all snacks and beverages even if you grab just one cracker on your way out the door.

Preparing food at home also gives you better control and knowledge of what you are eating. The more accurate your food diary, the better it can guide you to make healthy dietary choices and ultimately achieve successful weight loss.

Finally, be sure to review your journal weekly to assess if changes are needed.

Sample entry: