Friday, August 28, 2015

Summer Stress Syndrome Part 1: Sugar, Fat, and Alcohol Can Make Us Feel Out of Control

Summer Stress Syndrome Part 1: Sugar, fat, and alcohol can make us feel out of control - time to recover!

Many of us look forward to the long, lazy days of summer.  We hope we will be relaxed, yet active, eat lots of fresh healthful foods, catch up on sleep, and share good times with friends.

Unfortunately, along with all the good things, summer can bring some stressful changes and challenges to our healthy lifestyle, too!  We sometimes call it "Summer Stress Syndrome”.  Visitors from out of town, parties, eating out at restaurants, road trips and vacations, late nights - while all of these can be fun, they can also mean loss of our healthy routines.  Constant temptations of ice cream, sweet treats,  alcohol, fried food, chips, side dishes full of mayo, etc, can trigger "addictive" responses in our brains - and leave us feeling out-of-control, tired, overwhelmed.  We may find it tough to preplan for healthy eating, tough to fit in regular exercise, tough to get enough quality sleep.  The combination of  “addictive”  treats, such as food and drink full of sugar/carbs, saturated fat, and alcohol, PLUS our fatigue, can lead us to make unhealthy choices.   Too much of this fun, and we can feel fried!  

Why is it so darn hard to control ourselves around certain foods, especially those full of sugar, and saturated fat?  Why can't we "just stop at one"? Are we just weak-willed, or is there a biological basis that is driving  addiction-like cravings?  

Seems like my patients are not the only ones asking these questions - there has been much research into the effects fat and sugar can have on our brains.  Here is a great article, with an interview with Dr. Louis Aronne: After analyzing a variety of weight loss diets, they determined that "a diet high in saturated fat and simple carbohydrates sets in motion a chain reaction of “metabolic dysfunction” involving the appetite  regulating hormones." Two particular hormones were affected by high fat diets: leptin and ghrelin. Leptin and ghrelin normally work to regulate our appetite to our bodies' needs, but these hormones malfunction when people eat high fat/high carb diets. A single high fat meal may make us feel "extra hungry" for up to 3 days! But even more concerning than the short term appetite problem - it turns out there may be long term damage in our brains. High fat/high carb diets may lead to “alterations in structural plasticity” - damage to nerve function in areas of the brain including the hypothalamus. According to Dr. Aronne in the article, "The evidence is quite convincing - eating fattening foods causes inflammatory cells to go into the hypothalamus…It's like your gas gauge points to empty all the time, whether or not the tank is full."
In other words, eating too much saturated fat and simple carbs can cause our brains to malfunction, so we never feel full and satisfied.  

For a more technical explanation, read the British Medical Journal article: "Excessive intake of certain macronutrients, such as simple carbohydrates and SFA (Saturated Fatty Acids) can lead to obesity and attendant metabolic dysfunction, also reflected in alterations in structural plasticity, and, intriguingly, neurogenesis, in some of these brain regions...appetite-related mediators, including circulating hormones, such as leptin and ghrelin, pro-inflammatory cytokines and the endocannabinoid intracellular messengers, are also being examined for their potential role in mediating neurogenic responses to macronutrients. "   We have called this the "Ice Cream Brain" effect, since ice cream is high in both saturated fat and sugar. Our appetites may be out of control up to three days after one very high fat meal - and knowing that may be enough to help us hold off on over indulging. And as bad as it is to feel out of control for three days after one splurge, it is even worse if we eat that way on a regular basis, since the damage can be more severe. This is serious, but the good news is that the damage may be reversible, if we make major dietary changes.

And it's not just fat - sugar by itself can be addictive as well.  Last fall the the New York Times ran an Op-Ed article called:  "Sugar Season.  It's Everywhere, and Addictive".
The story discusses the theory that humans, until recently, faced food scarcity, and those who were 'wired' to like, love, or REALLY love sweets, tended to be those who survived - and passed those genes along to us 'moderns'.  

Unfortunately these genes - which can turn our brains into carb-craving machines - can really backfire in the modern world, where we are surrounded by an abundance (overabundance?) of super-delicious, 'hyper-palatable' treats.

The constant temptation of sweets everywhere - easy to reach, easy to eat -  can really 'light the fire' of cravings, and set that fire blazing.  The more we see/smell/eat, the more we want of the same.  And it's all there, in our neurochemistry.

This review article ( states that "Based on the observed behavioral and neurochemical similarities between the effects of intermittent sugar access and drugs of abuse, we suggest that sugar, as common as it is, nonetheless meets the criteria for a substance of abuse and may be “addictive” for some individuals when consumed in a “binge-like” manner. This conclusion is reinforced by the changes in limbic system neurochemistry that are similar for the drugs and for sugar. "

This more recent  2013 review study ( ) states that "evidence in humans shows that sugar and sweetness can induce reward and craving that are comparable in magnitude to those induced by addictive drugs."  Furthermore, "At the neurobiological level, the neural substrates of sugar and sweet reward appear to be more robust than those of cocaine."  Yes, you read that correctly, more addictive than cocaine!  And it concludes that the "biological robustness in the neural substrates of sugar and sweet reward may be sufficient to explain why many people can have difficultly to control the consumption of foods high in sugar when continuously exposed to them."  I'd say so!

And then there is alcohol. In addition to "non-nutritive" (empty) calories, alcohol can have a profound effect on us both psychologically and physically. Alcohol can decrease our inhibition (lead to loss of control and poor food choices), act as an appetite stimulant, AND promote fat storage and block fat oxidation (block fat-burning.) According to Dr. Arya Sharma and Dr. Yoni Freedhoff, in their book "Best Weight", "At 7 kcal per gram, one large glass of wine a night adds up to 65,700 kcal per year (the equivalent of nearly 9 kg [20 lbs] in weight gain)." It's all about choices, and how you are personally affected, so choose carefully, and know what you're up against.

So, what to do to control cravings?  The answer is not a simple, single trick - as much as we would love that - but the good news is that there ARE strategies to control cravings.  We employ a strategy we call “REMOVE AND REPLACE” to conquer cravings.  First it's important to identify what our individual 'triggers" are.  We need to know how WE respond as individuals to certain foods - know and accept our own ‘history’ with certain foods.    Next it's important to REMOVE these triggers from our immediate environment  (you can't eat something if it's not there).  And finally  we must REPLACE those treats with healthier, but still tasty, treats.  You can't take something away, without putting something else back!  If you REMOVE but don’t REPLACE,  the change simply won't be sustainable. We help our patients come up with specific ways to do this, every day.   Our goal is to help patients create - and SUSTAIN - successful healthy lifestyles.

There are additional strategies that can be very effective to help control cravings,  which are beyond the scope of today's blog.   And the best success comes from the creation of individualized strategies to address each person's unique needs.  Lifestyle change can be tough - be we can make it easier, and help improve success -  through education, problem-solving, coaching, and support.  

Weight management medications can also sometimes be helpful when ESTABLISHING new, healthy habits, and can even be useful to help SUSTAIN healthy lifestyle (more on this in future blogs, including using a modified Finnish Sinclair Method of intermittent medication to help control addictive responses to triggers.)  But again, that is too much to discuss in today's blog!

If you are struggling with cravings, and would like help, we'd love to help you!  Give us a call at (603) 379-6500, and read more about our program and strategies at . We can offer help in person with our fun and supportive team of nutrition and lifestyle experts, and can also offer help on the phone, or online, via Skype. Check out our recent blog on getting back on track:;postID=3248554749533813515;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=1;src=postname

(Watch for Summer Stress Syndrome Part 2: When summer expectations don't match reality - should we beat ourselves up, or is there a better way?!)

Tuesday, August 18, 2015

Summer Recipes: To Grill, or Without a Grill!

Summer Recipes:  To Grill OR Not to Grill!  

Grilling can be a healthy and fun way to cook tasty foods in the summer and get friends and family together. Let others join in and see how enjoyable grilling can be.  Read on for tips and tricks to grill safely, and healthfully.  We’ve also included recipes - both for the GRILL and GRILL-FREE recipes, for those who aren’t grillers!

High intake of smoked or grilled meat was found in one study to lead to a 47 percent increased risk of developing breast cancer postmenopausal women with lower fruit and vegetable intakes. Researchers believe some of the higher risk may be due to carcinogens known as PAHs (polycyclic aromatic hydrocarbons) and HCAs (heterocyclic amines).  These molecules are created when meat is cooked at high temperature, and well-done.

There may be risk, but you also may be able to reduce that risk by following some simple grilling strategies.  The carcinogenic (potentially cancer-causing) PAH’s and HCA’s are formed in the charred parts of grilled meat, especially charred meat fat.  Avoid direct contact with high flame or intense heat when grilling, or even when using other cooking methods like broiling and frying (which can  also form these chemicals).
Grilling tips to reduce carcinogens:
  • Choose low-fat, flavorful and nutrient-packed foods. Trim excess fat from meat, since fat is a main culprit in carginogen formation. Choose lots of fresh vegetables.
  • Microwave meat before grilling. In some studies, it was shown that microwaving meats for around 2 min. before grilling decreased HCA content by as much as 90 percent! Extra tip: pouring off the liquid that’s formed during microwaving reduces HCA’s even further.
  • Try to avoid flare-ups during grilling. Flare-ups cause foods to burn, increasing the formation of HCAs.
  • Avoid overcooking foods. Carcinogens begin to form at an internal temperature above 212 degrees, so it is helpful to use a meat thermometer to check the temp. Ground beef should be cooked to internal temperature of at least 160 degrees and chicken or turkey breast to 170 degrees.
  • Avoid Charring. The fatty parts that are charred are where there is the largest formation of HCAs and PAHs; so, if there are charred spots, it is advisable to trim them off!
  • Marinades! Marinades containing honey, lemon, garlic, or onion may help reduce the formation of HCAs. Researchers believe sulfur compounds and antioxidants in these ingredients slow formation of HCAs. Marinating meat also adds moisture, which may help reduce burning and HCA formation.  And besides, they taste great!

Mastering the Art of Grilling

Additional tips for cooking yummy food on your grill:

  • Prep grill by rubbing the grates with cooking oil on a paper towel.  This will help keep food from sticking to the cooking area. Plus, clean up is far less messy and stressful.
  • Preheat the grill, bringing it up to the required cooking temperature, before putting meat on the grates. Gas grills need to be turned on at least 5 minutes prior to cooking. If using a charcoal grill, it is better to allow the coals to burn for at least a ½ hour before cooking.
  • 2 grill zones – a warm and a hot zone. If using a gas grill, see that one side is on high, while the other is at low. If using a charcoal grill, push most of the briquettes toward one side. This will help you cook the pieces of meat evenly by moving them from low to high heat periodically.
  • Never layer on sauce that contains sugar (BBQ sauce!), until the end stages of grilling.   High temperature will cause sugar to burn, and spoil the taste. Instead, baste the meat with a marinade or vinegar sauce, then let your guests add sauces at the table!
  • Always use a spatula or tongs when handling meat in the grill. Using a fork to pierce meat while it is cooking is not a good idea, as all the yummy juices will escape, making the meat too dry.
  • If pre-cooking partially in the microwave or in a cooking range, bring food immediately to the gril to finish cooking. Do not allow it to stand in room temperature or refrigerate before grilling.
  • Soon after you finish cooking, scrape and clean the grates. It is easier to clean it while still warm.  If you use a wire brush, BE CAREFUL to make sure no bristles get stuck to the grates - you don’t want to eat those later! You might want to try some new alternative methods, such as a wood scraping tool, a grillstone cleaning block, a nylon bristle brush, a "grillfloss" device, or an old trick, the 'onion method' - using the cut side of an onion to clean the grill:

Grilling Recipes
Grilled Scallop Spinach Salad
¾ lb scallops
Olive oil
Lemon pepper seasoning
Salt and Pepper (to taste)

Pat scallops dry.  drizzle olive oil, lemon pepper, salt and pepper,  covering all sides.  Grill 2-3 minutes each side.  Serve on top of spinach salad.  Makes 2 servings.
Teriyaki Shrimp Kabobs
¼ c low-sodium teriyaki sauce
1 tbsp. toasted sesame seeds
1 ½ lbs large shrimp (peeled and deveined)
¾ lb  fresh pineapple, cubed
1 medium red onion, cut into wedges
Cooking spray

First, prepare grill.  To prepare sauce, in a small bowl, combine teriyaki sauce and sesame seeds.  To prepare kabobs, alternate sticking shrimp, pineapple, and onion onto skewers.  Brush kabobs with teriyaki mixture.  Place kabobs on grill coated with cooking spray for 8 minutes, or until shrimp is opaque, turning once.  Makes 4 servings.

Chicken Satay with Red Grapes and Mango Chutney

Serves 4 (2 skewers per serving, with 3/4 cup chutney)
8 bamboo skewers, soaked in water at least two hours       
1 1/2 pounds skinless boneless chicken breast
1 tablespoon extra virgin olive oil
1/2 cup orange juice
2 tablespoons lime juice
3 tablespoons clover honey
1/2 teaspoon salt
2 tablespoons finely minced onion
1 teaspoon Dijon mustard
1 garlic clove, peeled and minced

Mango Chutney

1 ripe mango, peeled and diced
1 1/2 cups halved red grapes
1 teaspoon brown sugar
2 teaspoons balsamic vinegar
3 tablespoons chopped peppermint leaves
1 thinly sliced lime and grapes, for garnish

1. Slice the chicken into thin, long strips, less than 1/2 inch thick.
2. Prepare the marinade: Combine oil, orange juice, lime juice, honey, salt, onion, mustard, and garlic in a medium bowl. Reserve 1/2 cup of marinade to brush on the chicken. Add chicken, cover, and refrigerate for at least two hours.
3. Make the chutney: Place mango in a medium bowl. Grill grapes in a grill wok or pan until lightly browned and skins are soft, about 10 minutes; add the grapes to the mango and stir. In asmall bowl, dissolve the brown sugar in vinegar, and add to the fruit mixture. Stir in the peppermint, and set aside.
4. Stick chicken strips onto the soaked skewers and add slices of lime. Spray grill with fat-free nonstick cooking spray, and cook chicken over medium heat for about 15 minutes, turning often and brushing with reserved marinade every few minutes until marinade is used up. Serve right away, with 3/4 cup chutney. Garnish with whole grapes if desired.
Nutritional Analysis per serving : 363 calories, 40.4 g of protein, 37.9 g carobohydrates, 5.8 g total fat, 1.1g saturated fat, 1.8g fiber, 436mg sodium

Grill-Free Summer Recipes

Light Tuna Melts
1 pouch light tuna or salmon in water
Light, high fiber English muffin, sandwich thin or flatbread (such as Thomas’s, Fiber One, Josephs, etc)
1 tomato sliced
Reduced-fat or fat-free cheese (Kraft fat-free mozarella or cheddar, or Cabot 75% fat-free)
Lightly toast muffin/flatbread.  Layer tuna, tomato slices, and cheese on each half.  Broil until cheese is melted.
Chicken Quesadillas

3 oz. grilled white meat chicken, sliced or cubed (fresh or frozen, ex. Perdue Simply Smart Original Grilled Chicken Strips - prepare per package)

Joseph’s low carb oat bran and flax tortillas
Fat-free shredded cheese (fat-free Kraft shredded mozarella or cheddar, or Cabot 75% fat-free cheddar)
Lightly spray frying pan with non-stick cooking spray.  Place chicken, salsa, and cheese on one half of tortilla and fold over.  Keep in pan until the outside is crispy and cheese is melted.  (Note: Can substitute grilled shrimp for chicken)

Mini Salmon Snack Melts
1 pouch skinless and boneless pink salmon
½ cup chunky salsa
1 cup fat-free shredded cheddar cheese (Kraft, Cabot, etc)
Whole wheat crackers
Preheat oven to 350.  Combine salmon and salsa in a bowl.  Spoon onto crackers with cheese.  Bake on foil-lined cookie sheet for 5-7 minutes or until cheese is melted.
Crab Salad
2 6 oz pouches of crabmeat                                      1 medium ripe avocado, peeled, seeded and diced
¼ cup onion, chopped                                               1 medium ripe mango, peeled, seeded, and diced
¼ cup red bell pepper, chopped                                2 tbsp orange marmalade
¼ cup fresh squeezed lime juice                               ¼ cup almonds
2 tbsp olive oil                                                           Salt and pepper to taste
¼ tsp ground allspice
Blend crabmeat, onion, bell peppers, lime juice, olive oil, allspice, orange marmalade,  salt and pepper. Fold in avocado, mango, and almonds.  Serve over salad greens.  (292 calories, 4 servings)

Tuna Casserole
1 can condensed light cream of mushroom soup                   ½ cup fat-free sour cream or greek yogurt
1 package frozen chopped broccoli or mixed stir fry vegetables, thawed
½ lb sliced fresh mushrooms                                                   2 bags drained and rinsed tofu shiritaki fettucini
½ cup onion, chopped                                                             2 6 oz. pouches chunk light tuna in water
½ cup celery, chopped                                                            ½ cup toasted sliced almonds
Blend sour cream with soup mix until smooth.  Add to pasta and veggies.  Fold in tuna.  Bake in a lightly greased 1 ½ quart baking dish at 350 degrees topped with almonds for 25 minutes.

This blog was a team effort by Amy Buzzell, Beth Almstrom, and Jennifer Warren, MD
Read more about us, and our program at
Call any time at (603) 379-6500
  1. Steck, SE, Gaudet, MM, Eng SM, Britton, JA, Teitelbaum, SL, Neugut, AI, Santella, RM, Gammon, MD, 2007, Cooked meat and risk of breast cancer--lifetime versus recent dietary intake.  Epidemiology. 2007 May;18(3):373-82.

  2. Putatunda, Rita, Grilling Tips: Ideas and techniques on grilling, from

Sunday, August 16, 2015

Lose Weight Fast and Safely: A Strategy to Simplify and Get Back on Track

"Doc, how can I lose weight as quickly as possible, but still do it safely?!"
I've been hearing this call for help a lot lately, and I get it! While we all know it's important to establish sustainable healthy habits for nutrition, exercise, stress management, and a balanced life, we also can feel out of control right now, and desperate to get back on track as quickly as possible!

Research actually shows that rapid initial weight loss on a program is a good predictor of future success - so we are not wrong in wanting to "pull things together quickly". But we want to do this in a way that helps us preserve our muscle, our metabolism, our energy level, and our health - we do not want to go on silly starvation regimens which leave us feeling weak, shaky, foggy-brained, and our muscles starved for protein. We want to not only get on track quickly, we also want to set ourselves up for long term success. "Collectively, findings indicate both short- and long-term advantages to fast initial weight loss. Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers."

We also want to do this as simply as possible. Although some of us have dreams of cooking like Martha Stewart, few of us actually have the time in our lives to do that. Many of us suffer from something known as "decision fatigue" - we are so busy, so stressed, making so many decisions in our own lives, and taking care of others, that we have no energy left to make healthy decisions for ourselves. Simplifying our decisions can help decrease our stress, give us time to breath and think, and relax a bit. I've blogged about decision fatigue back in October:

If you are pressed for time, and need to simplify your life, one strategy is to simplify food choices. This can be done through regular grocery store or farmer's market foods, with careful planning to ensure the proper calories, protein, carbohydrates and fats, for your needs. This takes some time and planning, and we help patients set up their plans every day, in our clinic, or even on the phone or with virtual visits. Another strategy, which many find even easier when starting out, is to use a something we call the Rapid Reboot Fast Track.

Studies have shown more rapid weight loss success with medical meal replacements. "All methods of analysis indicated a significantly greater weight loss in subjects receiving the PMR (Partial Meal Replacement)  plan compared to the RCD (Reduced Calorie Diet)  group." Simply put, high quality protein meal replacements not only simplify your planning, but are likely to improve your success. After you develop a new eating routine, and gain a sense of control, you can transition back to grocery store foods, with all the support you need for continued success. The Rapid Reboot Fast Track Protein Supplements are medically designed to trigger a sense of fullness or "satiety", provide you with superior nutrition, and make it simple to control your calorie intake.

The Fast Track program may be particularly helpful for people who have trouble with portion control, very busy people, and those who are challenged by hunger and cravings. This program may also be ideal for people who are not candidates for appetite controlling medication, but have large appetites.

The foods, shakes, snacks and bars are delicious and affordable. We have evaluated and selected the "best of the best". Because we are independent, we are able to pick and choose the top products from all manufacturers, unlike programs which are bound by contract to offer products from only a single company. We have done the research - and the taste testing - for you.

You may choose to get a rapid "jump start" on weight loss by using the Fast Track for a few weeks, or, if you would like to lose a large amount of weight, you may choose to use the Fast Track throughout the entire weight loss phase of your program. Some people use the Fast Track intermittently - you can start and stop anytime, and start again when you need to get through a plateau. 

Below we have included an outline of how the program works, plus recipes for healthy protein shakes, snacks, fruit and vegetable list, and Six Minute Meals. We can help you select the best options for you - we enjoy getting to know people personally, and helping them make the best choices to fit their needs and preferences.  Feel free to give us a call: (603) 379-6500

Call us any time, and read more about our program here:, and our products here:

Below is a sample outline, keeping the calories above 1000 per day.  Your calorie needs may vary depending on your activity level, age, sex, and weight, and other factors.   We also recommend calling us for more personalized guidance.   

It is always a good idea before starting any program to consult with your primary care provider, and we recommend that you do this. This is particularly important if you have medical conditions or medications which can be affected by your diet. We have had excellent results in patients with a wide variety of medical conditions, including diabetes, and we have seen rapid improvements in blood glucose numbers so that patients have quickly found the need to decrease medications for their blood sugar. Please be aware that you may need a decrease in these medications, and please consult your medical caregiver. Our patients are obviously quite pleased when they decrease their need for medication!   

 Rapid Reboot: Phase One Fast Track Program  
No need to count calories.  It’s already done for your convenience.

Breakfast                                                   VHP Shake (plus fruit)
Morning Snack              1-High Protein Soup or Juice or Hot Chocolate or Oatmeal or protein bar
Lunch                                                        VHP Shake (plus fruit)    
Afternoon Snack           1-High Protein Soup or Juice or Hot Chocolate or Oatmeal or protein bar                          
Dinner                                  Lean Protein/Entree  &  Garden Salad/veg with low calorie dressing
                                                               (See Six Minute Meal Recipes)
Evening snack              1-High Protein Soup or Juice or Hot Chocolate or Oatmeal or protein bar                              

Eat: 6 x a day.  Do not skip a meal or snack.  No need to count calories. If you feel hungry on a particular day, you can simply have an extra healthy snack.

Dinner: 3-4 oz. lean protein (chicken or turkey breast without skin; seafood such as salmon, flounder, haddock, scallops, shrimp; grass-fed lean beef, buffalo/bison; pork tenderloin. Cooking methods: broiled, grilled, baked (avoid fried, or stuffed).
Vegetarian protein sources: fat free or 1% dairy (such as 0% Greek yogurt, fat-free or 1% cheese of all types), tofu, tempeh.

*See supplemental fruits and vegetable list for sides to have with dinner protein.
*See Six Minute Meals for dinner recipes.

It’s okay to switch lunch with dinner to meet your schedule and personal preferences.  Eat at regular intervals.  Consume all specified Phase One Fast Track High Protein meals and snacks as directed to maintain optimum nutritional intake for support of lean muscle and to curb hunger.

Below is the average daily nutritional breakdown for Phase One Fast Track Program:
Calories                    Carbs                    Fat                    Protein                    Dietary Fiber
1000-1200                 100 g                   10 g                     135 g                            16 g

Supplemental Fruit and Vegetable List

Lower-calorie fruits: Use in moderation.  ½ cup of berries (strawberries, blueberries, raspberries, etc), small clementine,  ½ orange,  ½ banana, small apple, ½ cup melon, grapes.  

Low-calorie vegetables: these can be eaten raw, as a large plate of salad, or may be steamed or roasted.  Try a large plate of greens (Romaine lettuce, spinach, radicchio, kale, swiss chard, beet greens, bok choy, endive).  Use any leafy greens you would like, and remember, the darker the color, the more rich in nutrients and vitamins it will be.

Try grape/cherry tomatoes, cucumbers, snow peas, green beans, broccoli, cauliflower, peppers (green, red, yellow), mushrooms, onions (red, yellow, white), zucchini, summer squash, spaghetti squash, brussels sprouts, shredded carrots, asparagus, eggplant, radish, turnip, celery, leeks, scallions, sprouts, water chestnuts, bamboo shoots, jicama, artichoke hearts (in water), roasted vegetables (asparagus), fiddleheads, sprouts, fresh herbs.

Additional salad veggies/fruits to use in moderation:    apple slices,  beets, pepperoncini peppers (watch the sodium),  black olives, baby corn
Cheese: use sparingly!  Try 1-2 Tbs of fat-free or 1% shredded cheese on salad (Kraft, Cabot)

You can create “zoodles” by using a device such as Veggetti, to create ‘noodles’ out of zucchini, summer squash, and spaghetti squash!  

Herbal toppings, low calorie dressing spritzes (such as Wishbone Spritzers), low/no calorie dressings (such as Walden Farms, maple grove farms), flavored vinegars may be used on salad or steamed vegetables.

Low sodium chicken or vegetable broth may be enjoyed alone, or low calorie vegetables may be added.  Look for boxes of low sodium organic broth (Trader Joe’s, Pacific Organic, Imagine Brand)

Ingredients to use sparingly, with CAUTION (they are calorie-dense, with a lot of calories per bite): avocado, nuts, seeds, craisins, raisins, full fat cheeses, bacon bits, no croutons

Recipes for Meal Replacement VHP (Very High Protein) Shakes
Coffee and Cream Frozen Delight
1 packet Vanilla V.H.P.
1 cup water
1 cup brewed coffee (Regular or Decaf)
5 ice cubes
Mix all ingredients together in blender until smooth.
Nutrition Facts (per serving): Calories 260, Fat 3 g, Carbohydrate 21 g, Protein 35 g

Mocha Latte Frozen Delight
1 packet Chocolate V.H.P.
1 cup water
1 cup brewed coffee (Regular or Decaf)
5 ice cubes
Mix all ingredients together in blender until smooth.
Nutrition Facts (per serving): Calories 260, Fat 3 g, Carbohydrate 21 g, Protein 35 g

Chocolate Dipped Strawberry Smoothie
1 packet Chocolate V.H.P.
15 oz of cold water
1/2 cup of Fresh or Frozen Strawberries
4 ice cubes (not needed if using frozen strawberries)
1 pkt of splenda or stevia to taste
Mix all ingredients together in blender until smooth.
Nutrition Facts (per serving): Calories 286, Fat 3 g, Carbohydrate 27 g, Protein 35 g

Orange Cream Smoothie
1 packet Vanilla V.H.P.
8 oz of Diet Orange Soda
8 oz of Cold Water, 4 ice cubes
Mix all ingredients in a blender on high speed until smooth.
Nutrition Facts (per serving): Calories 260, Fat 3 g, Carbohydrate 21g, Protein 35 g

Root Beer Float Smoothie
1 packet Vanilla V.H.P.
8 oz of Diet Root Beer
8 oz of Cold Water, 4 ice cubes
Mix all ingredients in a blender on high speed until smooth.
Nutrition Facts (per serving): Calories 260, Fat 3 g, Carbohydrate 21g, Protein 35 g

Your Favorite Flavor Smoothie
1 packet vanilla V.H.P.
8 oz of your favorite diet soda ( Cherry, Lemon Lime, Coke, etc)
8 oz of cold water, 4 ice cubes
Mix all ingredients together in a blender until smooth.
Nutrition Facts (per serving): Calories 260, Fat 3g, Carbohydrate 21g, Protein 35 g

Peach Smoothie
1 packet Vanilla V.H.P.
1 medium peach, peeled and sliced
8 oz of diet cream soda
8 oz of cold water, 5 ice cubes
Mix all ingredients in a blender on high speed until smooth.
Nutrition Facts (per serving): Calories 300, Fat 3g, Carbohydrate 34g, Protein 35 g

Fun Recipes for snacks and mini meals supplemented with High Protein Products

Protein hot chocolate or Protein vanilla cappuccino: (Instead of high calorie/high fat/high sugar coffee)  
  1. Mix the PROTEIN HOT CHOCOLATE/VANILLA CAPPUCCINO  into COFFEE (decaf or regular) to replace fatty/sugary creamers with a delicious healthy PROTEIN  burst!
  2. Add different flavor extracts TO the hot chocolate (try mint, almond, caramel, etc).
  3. Sprinkle the hot chocolate powder on top of fat-free Greek yogurt - you double the protein, and make it a ‘rocky road’ yogurt!

Protein bars:
  1. Cut bars into small sections to savor and nibble slowly (my favorite are the choc-mint bars).
  1. Cut and sprinkle bars on top of Greek yogurt for a delicious topping with a protein boost.
  2. Heat bars briefly in the microwave, and eating with a fork (try Cinnamon Raisin and Lemon Meringue)
  3. Try freezing bars for a cool treat (Caramel Nut turns into a ‘Turtle’ Treat!)

Protein oatmeal:
  1. Sprinkle  slivered almonds or chopped walnuts on top.
  2. Top protein oatmeal  with fruit, such as blueberries, apple slices and cinnamon.
  3. Spice things up with flavor extracts (vanilla, caramel, etc) or sugar-free syrup (such as Maple Grove Farms).

High protein Cinnamon swirls with chocolate bite:
  1. Use as topping on Greek yogurt.
  2. Try  as a cereal!
Protein chips:
  1. Have with lunch to replace salty carby chips.
  2. Take to the movie theater instead of fatty, high calorie popcorn.
  3. Eat as a snack alone, or with a simple, high-protein dip:  mix  non-fat greek yogurt with ranch dip powder flavoring!

Protein soups:
  1. top with fat-free mozarella cheese for a cheesy melty treat
  2. top with a few protein chips, for a fun, tasty, healthy crunch!

Six Minute Meals

Lettuce Wraps with Choice of Fish
One 4-6 ounce pouch of light tuna or salmon (packed in water)
4 large lettuce leaves - hearts of Romaine, or butter lettuce work well
1-2 Tbs chopped onion (red or Vidalia)  
¼ cup chopped tomato (fresh whole, cherry or grape tomatoes)
1 tbsp. finely chopped cilantro (fresh is best)

1/8 tsp. chili powder
1/8 tsp. garlic powder
1/8 tsp. cumin
Low sodium seasong (optional)

Empty tuna or salmon into a bowl, and stir in all dry seasonings.  
Next stir in the cilantro, tomato, and onion.   
Spoon onto the lettuce leaves, roll up and enjoy!
Makes 1 serving: 200 calories, 5g carb, 1g fiber, 36 g protein

Alfredo Broccoli Slaw with Chicken
4 oz precooked chicken skinless breast
2 Laughing Cow Light cheese wedges
12 oz steamable bag broccoli slaw
2 T fat free sour cream
Garlic Powder

Steam broccoli slaw until tender.  Stir in Laughing Cow cheese wedges and sour cream.  Microwave until melted, stir, and add in chicken.  Season with garlic powder and paprika.
Makes 1 serving:  315 calories, 18g carb, 8g fiber, 39g protein

Deluxe Turkey Sandwich and Salad
4 oz low sodium turkey breast
1 whole wheat sandwich thin, such as Arnold’s or Joseph’s
2 tsp light mayo or hummus
2 cups side salad (lettuce, tomato, mushrooms, veggies - can pick up pre-made or at salad bar at grocery store)
2.5 tsp vinegar
½ tsp oil
Put turkey, lite mayo, lettuce, tomato on sandwich thin.  Add oil and vinegar to side salad
Makes 1 serving:  306 calories, 26g carb, 6g fiber, 30g protein, 9g fat  
Southwest Chicken and Vegetables
4 oz precooked skinless chicken breast
2 cups frozen stir fry-style vegetables
1.5 cups frozen broccoli florets
1 tsp olive oil
2 T southwestern style sauce (such as Lawry’s Santa Fe Chili Marinade)

Microwave stir fry veggies and broccoli.  Add chicken, southwestern sauce, and oil.  Mix together, heat, and enjoy!
Makes 1 serving: 290 calories, 24g carb, 8g fiber, 29g protein

Snap Pea Tuna Salad
5 oz pouch low sodium tuna or salmon in water
16 oz bag mixed lettuce (Romaine, baby spinach, etc)
1 cup sugar snap peas
1 cup sliced mushrooms
¼  cup black beans (can use canned)
1.5 T vinegar
1 tsp olive oil

Drain tuna and rinse beans.  Toss with lettuce, veggies, oil, and vinegar.  Ready to eat!
Makes 1 serving: 360 calories, 32g carb, 15g fiber, 51g protein, 6g fat

Quiche in a Cup!
½ c liquid egg whites
1 wedge LIGHT Laughing Cow Swiss Cheese
½ c chopped fresh spinach
2 Tbs diced tomatoes
2 Tbs diced avocado
May add ½ c chopped peppers (red or green) and ½ c sliced mushrooms
Nonstick spray
Spray microwavable cup with nonstick spray, then add spinach/peppers/mushrooms and microwave until soft (about 1 minute).  Pour off or blot excess water.
Pour eggwhites into cup, stir, and microwave 1 minute.
Add Laughing Cow wedge and tomatoe, and microwave 1 minute.
Top with cool avocado, and enjoy!  
Makes 1 serving: 140 calories,  7g carb, 2g fiber, 16g protein


 2003 May;27(5):537-49.

Weight management using a meal replacement strategy: meta and pooling analysis from six studies.

"All methods of analysis indicated a significantly greater weight loss in subjects receiving the PMR (Partial Meal Replacement)  plan compared to the RCD (Reduced Calorie Diet)  group….Conclusion:  This first systematic evaluation of randomized controlled trials utilizing PMR plans for weight management suggests that these types of interventions can safely and effectively produce significant sustainable weight loss and improve weight-related risk factors of disease."
International Journal of Behavioral Medicine, Volume 17, Issue 3, pp 161-167

The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?  "Collectively, findings indicate both short- and long-term advantages to fast initial weight loss. Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers."

Personalized weight loss strategies—the role of macronutrient distribution 
Nature Reviews Endocrinology 14 October 2014
"Restriction of energy intake is the primary method of producing a negative energy balance leading to weight loss. However, owing to the different metabolic roles of proteins, carbohydrates and lipids in energy homeostasis, diets of similar overall energy content but with different macronutrient distribution can differentially affect metabolism, appetite and thermogenesis."