Thursday, September 22, 2016

"Will a FitBit Fitness Tracker Make Me GAIN Weight?"

"Will my FitBit make me GAIN weight?" A patient asked me this today after reading several articles which seemed to suggest that people who are trying to lose weight with fitness trackers actually do worse than those who don't use them.  She was referring to this article:  http://www.today.com/health/your-activity-tracker-may-actually-keep-you-losing-weight-t103046 which states, "A new study finds that people using a fitness tracker lose fewer pounds than those who don’t use the tech.”  


She had also read this article: http://www.today.com/health/fitness-band-frustration-users-complain-weight-gain-trackers-t66146 which says, "some wearers are experiencing fitness band frustration. They find that their Fitbit actually moves the scale in the wrong direction — making them pack on the pounds, as opposed to maintaining or shedding unwanted weight."


What is going on here?  What does the research really say?  The actual study was published in JAMA (Journal af the American Medical Association) on September 20. Researchers studied 471 people and concluded:  “Among young adults with a BMI between 25 and less than 40, the addition of a wearable technology device to a standard behavioral intervention resulted in less weight loss over 24 months. “ In other words, no, fitness trackers did not make people gain weight, but somewhat surprisingly, those who used them lost less weight than those who did not.  http://jama.jamanetwork.com/article.aspx?articleid=2553448  

Why could this be?  There has been some interesting speculation. “For some people these types of things are extremely motivating and might be exactly what they need; for other people they may be ineffective,” said John Jakicic, chair of the health and physical activity department at the University of Pittsburgh, and an author of the study.”  Sports Medicine physician Dr. David Geier, who wasn’t involved in the study, speculates, “Activity trackers … may give some people a false sense of how active they are. ‘Look how active I was today I can eat this cupcake.’”  In other words, people may get excited about the extra exercise they are doing, and then make the mistake of “rewarding” themselves with extra calories - too many calories for their actual goals and needs.  http://www.today.com/health/your-activity-tracker-may-actually-keep-you-losing-weight-t103046

Another problem - the trackers try to estimate the number of calories burned, but this number may not be accurate for a particular person.  Individuals may have “faster” or “slower” metabolisms than the average person their age, gender, and weight - and the tracker simply does not know that.  Basal metabolic rate (also called BMR, or REE for Resting Energy Expenditure) can vary by 30% from one person to another!   The device cannot possibly know you as an individual, and may be overestimating the number of calories you are burning for a given amount of activity.  http://ajcn.nutrition.org/content/82/5/941.full

What else could be going on?  While it is easy to understand that people might eat extra calories they think they’ve “earned” with exercise, and trackers themselves may be overestimating the number of calories burned, we need to remember that weight loss is not just a matter of “calories in versus calories out” - not all calories are equal!  From the second article: “So many people get fixated on the number of calories they are getting every day,” Wertheim explained, “and don’t think about ...the kind of calorie you are consuming...sugar and refined carbohydrates have a higher glycemic index, causing the body to produce insulin and store fat.”  Dr. Holly F. Lofton, director of the NYU Langone medical weight management program, presents more possible problems: “Hormones, sleep and the time you eat can play key roles in weight loss, too.”  Again, trackers cannot accurately measure the role these factors have on weight.  http://www.today.com/health/fitness-band-frustration-users-complain-weight-gain-trackers-t66146

Can too much exercise itself lead to weight gain?  Some experts note that extreme exercise (such as marathon training) can backfire, and ironically slow metabolism down. “The surprising result could be related to a dynamic that some runners have encountered during training, particularly when following demanding workout schedules like marathon programs. The so-called “train gain” effect occurs when the strain of workouts leads to overeating, rewarding yourself with food or stress-induced changes to metabolism.” Too much of anything is unhealthy, and can put excess stress on our bodies. http://running.competitor.com/2016/09/news/new-study-suggests-wearing-fitness-tracker-may-impede-weight-loss_155780

So, what is the bottom line - should we use fitness trackers to lose weight?  Not by themselves!  Fitness trackers can be EXCELLENT tools to help motivate us to move more, and monitor our progress in fitness and health, but unless we also journal our food intake, we are not going to lose weight. Exercise by itself is not a great way to lose weight anyway - the research shows that proper diet is key (along with support, accountability, and behavioral/lifestyle strategies, quality sleep, relaxation, and more.) http://www.nwcr.ws/research/published%20research.htm

Combine a fitness tracker with a good food journal  - such as the free smartphone app MyFitnessPal https://www.myfitnesspal.com/ (there are other food journals out there, but this is the most popular, and is easy to use.)  Make sure the food journal you choose does more than track calories - it also should calculate your protein, carbs, fat, and “macro ratio” to make sure your meals and snacks are balanced properly.  Do you need help determing how many calories, how much protein, how much carb, etc, you need?  The automated devices can help you try to figure things out on your own, but if you’d like extra help, and want to make sure you are doing things correctly, give us a call!  We offer 1:1 counseling in person, online, or via phone/Skype.  We are here to help if you need it!  Give us a ring:  (603) 379-6500.  Read more about our program:  healthyweightcenter.com

Tuesday, September 20, 2016

Food Journaling for Weight Loss: What Would Nancy Drew Do?

Some people think food journaling can be a 'drag', but it can be a GREAT tool for awareness, accountability, and problem-solving! Think of it as your own “Sherlock Holmes/Nancy Drew” strategy, or detective tool!  Once we see what we are actually eating, and what challenges we are facing in our daily lives, it becomes much easier to take charge and create simple solutions.  We use this tool in our clinic every day, and we are now offering online and phone/Skype counseling and journal analysis for convenience for people who would like help from a distance.  Research including the National Weight Control Registry shows that those who use a journal are far more likely to be successful both in losing weight, and keeping it off for the long term.


How does a journal work?  It’s one thing to know what to do - and another to thing to make it happen!  Journaling helps us see what challenges might be “tripping us up” - and analysis helps us come up with simple solutions for problems.  Journaling can be done with a free smartphone app such as “MyFitnessPal” (with a little tweaking of the app - we show people how to set to protein goals properly, for example), or even on paper (“old school” pen-and-paper notebooks are still popular, and they work too!)  Research has shown that those who use smartphone apps tend to be the most successful,  since they are simple to use once they are set up, they have a vast library of calorie, protein and other nutrient information at your fingertips, and they allow  in-depth analysis, and instant problem-solving.  But good news for those who like old-fashioned pen-and-paper - handwritten  journals come in a close second place for success.  Choose whichever feels most comfortable and natural for you, and you are most likely to actually use it!  


What should we record in a journal?  Food (what we ate and when) and calories, to start.   It is useful to also include exercise, other daily physical activity (chores, etc), sleep (quality and quantity), and stresses or other challenges in life that might be making it tough to stay on track with our healthy lifestyle. Most smartphone apps will instantly enter calories for you (and will automatically calculate other information for you, such as protein, fiber, carbohydrate, sodium, and macronutrient balance - all very helpful information), and have a way to record your exercise.  They also have a note section where you can record your sleep, challenge or stress you faced, and ideas and thoughts on your journey.  If you choose to use a written journal, it may be easiet to record just food (type, amount, calories, and time),  but it might be too much to try to record protein, carbs or other nutrients (unless you like to write a lot!)  Our nutritionists can review a written record and quickly calculate the protein amount (they are really good at their jobs!)  Also jot down activity,  exercise, sleep, and stress/challenges you faced, and other thoughts you might have about your health journey, and we’ll give you insight, feedback, and ideas to make your healthy lifestyle more simple, tasty, and fun!

Sometimes we realize, after looking at our journal, that we are doing really well 90% of the day, but have a “trouble spot” that keeps tripping us up, day after day, despite our best intentions. Intentions are good - but a concrete, realistic plan is even better!  For example, if you start out with a great breakfast and lunch, but then overeat in the afternoon or evening, a quick review of a journal can help identify what the problem might be (it might be a breakfast too low in protein, a lunch too high in carbohydrate, or a lack of a high-protein snack in the early afternoon, for example).  Another example: we THINK we are eating the right amount of calories for our needs, but are gaining weight (or not losing the weight we want).  A journal analysis can identify hidden calories (and  we can provide tasty alternatives for food that is too calorie-dense, for example).  Or perhaps a journal analysis may reveal an imbalance in our protein-to-carbohydrate ratio (known as “macronutrient ratio”); we can easily rebalance your meals and snacks. These are simple problems to solve, if we analyze them, and create a solution.


What does the research say about journaling ? Do we really need to journal, or can we just learn about nutrition, and try to stay motivated on our own? Studies have found that an individual’s motivation to lose weight combined with nutrition knowledge are NOT enough to maintain healthy weight long-term. Weight loss is very difficult and regain is very common; the most powerful predictor of long term weight loss was the amount of journaling done each week! Journaling enhances accountability and awareness of current behavior - it keeps us on top of our game. Journaling also helps us preplan our meals and exercise, set small attainable goals, and overcome resistance and challenges we face when trying to establish and maintain healthy behaviors.    2,3.
One study evaluating self-monitoring behaviors related to weight loss found those who journal the most  over a 6 months period lost significantly more weight than those that journal the least.  Individuals counting calories and/or measuring food most days of the week also experienced greater weight loss.  


Another key finding: the amount of journaling done in the first 18 weeks of a program was directly associated with amount of weight lost.  It makes sense that getting off on the right foot - and solving problems early and assertively - leads to better success.  New habits are tough to set up, and establish, and can take time to “solidify” so they become “second nature”.   Journaling and analysis can help this process.  Our Nancy Drew team can help!

If you would like help journaling, setting up simple strategies for success, and would love some extra support and problem-solving with our expert team, you can call us at (603) 379-6500.  Read more about our program: healthyweightcenter.com


References
1.       Kong, A., Beresford, S., Imayama, I., Duggan, C., Alfano, C., Foster-Schubert, K., Neuhouser, M., Johnson, D., Wang, C., Xiao, L., Bain, C., McTiernan, A. Adoption of diet-related self-monitoring behaviors varies by race/ethnicity, education, and baseline binge eating score among overweight-to-obese postmenopausal women in a 12-month dietary weight loss intervention. Nutr Res. 2012 Apr; 32(4): 260-265 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350640/
2.       Snetselaar, Linda (2007) Nutrition Counseling for Lifestyle Change, Boca Raton, FL, CRC Press, Taylor and Francis Group, chapters 9-14
3.      Bronner, F. (2006) Nutritional and Clinical Management of Chronic Conditions and Diseases. Boca Raton, FL, Taylor and Francis Group
4.       Khokhar, B., Jones, J., Ronksley, P., Armstrong, M., Caird, J., Rabi, D. Effectiveness of mobile electronic devices in weight loss among overweight and obese populations: a systematic review and meta-analysis. BMC Obesity 2014, 1:22
5.       Kong, A., Beresford, S., Alfano, C., Foster-Schubert, K., Neuhouser, M., Johnson, D., Duggan, C., Wang, C., Xiao, L., Jeffery, R., Bain, C., Tiernan, A. Self-monitoring and eating-related behaviors associated with 12 month weight loss in postmenopausal overweight-to-obese women. J Acad Nutr Diet. 2012 Sep; 112(9):1428-1435http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432675/
Dina Aronson, 2007, High-Tech Counseling: An untapped market for today’s dietitian? http://www.todaysdietitian.com/newarchives/tdmar2007pg46.shtml

Thursday, September 15, 2016

Healthy Frozen Dinners for Busy People!

Do you need quick, healthy dinners to fit your busy life? No time to cook? When life is crazy, you need to simplify wherever you can, stock up, and be prepared. It can seem daunting, but healthy frozen meals do exist, if you know where to look. We've compiled a list of tasty meals containing fewer than 400 calories, with good quality protein, balanced with a proper amount of carbohydrate, without excess sodium.

Our meal goals: fewer than 400 caloriesat least 10-15g of protein, balanced protein:carb ratio (ideally 1:1, no higher than 1:2), less than 40g of carbohydrate, less than 10g of saturated fat,  and ideally less than 600mg sodium.

Some delicious examples:




Name
Calories
Protein
Carbs.
Sodium
Kashi Chicken Florentine
290
22g
38g
550mg
Kashi Mayan Harvest Bake
340
9g
18g
390mg
Kashi Chicken Pasta Pomodoro
280
19g
40g
470mg
Kashi Chicken Enchilada
280
12g
24g
620mg
Boca Meatless Chili
150
19g
25g
650mg
Amy’s Tofu Scramble
320
22g
19g
580mg
Healthy Choice Cafe Steamers Chicken
w/Marinara and Parmesan
320
22g
19g
580mg
Healthy Choice Cafe Steamers Chicken
And Noodles
270
19g
29g
590mg
Healthy Choice Cafe Steamers Lemon Herb Chicken
260
20g
33g
550mg
Healthy Choice Cafe Steamers Grilled Basil Chicken
240
17g
30g
550mg
Healthy Choice Cafe Steamers Grilled Chicken Pesto w/Vegetables
200
27g
11g
600mg
Healthy Choice Cafe Steamers Roasted Chicked Marsala w/Mushrooms
250
18g
29g
640mg
Healthy Choice Cafe Steamers Chicken and Vegetable Stir Fry
190
22g
15g
500mg
Healthy Choice Cafe Steamers Roasted Beef Merlot (GF)
180
15g
20f
600mg
Healthy Choice Grilled Chicken and Broccoli Alfredo
190
27g
8g
600mg
Healthy Choice Beef and Broccoli
220
20g
34g
580mg
Lean Cuisine Herb Roasted Chicken
170
16g
18g
510mg
Lean Cuisine Salmon with Basil
250
19g
38g
500mg
Smart Ones Homestyle Beef Pot Roast
180
18g
18g
690mg
Smart Ones Chicken Mesquite
250
22g
33g
670mg
Tomato Basil Chicken with Spinach
160
18g
13g
600mg
Asian-Style Beef and Broccoli
160
14g
16g
640mg
Morningstar Farms Garden Veggie Burger (for 1 Burger)
110
10g
9g
350mg
Morningstar Farms Grillers Prime Veggie Burgers (for 1 Burger)
170
17g
4g
360mg
Applegate Naturals Chicken Nuggets (for 7 Nuggets)
180
12g
12g
210mg
Applegate Naturals Chicken Patty (for 1 patty)
180
12g
12g
200mg
Applegate Naturals Chicken Tenders (for 2 tenders)
150
12g
14g
230mg
Earth’s Best Chicken Nuggets (for 4 nuggets)
120
11g
10g
270mg


                                                                                     

Frozen Pizza:  Palermo and Kashi are higher in protein, lower in carbohydrate (choose “thin crust” versions)

These meals can make dinner just a little bit easier, when life gets really busy! If you'd like to simplify further, you can try our "Fast Track" to make your life even easier (and healthier): http://www.seacoastnutrition.com/phase-one-2-week-quot-fast-trackquot-pla2.html We love to help people set up sustainable, realistic nutrition, exercise, and lifestyle plans - we're here to help! Learn more at healthyweightcenter.com, or call (603) 379-6500, any time!