Monday, November 21, 2011

Thankful for Special Holiday Dishes

Getting ready for Thanksgiving? I know I am. Today I was searching for my mother-in-law's fabulous fresh yam and green bean recipes, so I can begin to make some of "her" dishes. However, I am SO grateful that she is still here on earth to be on hand as I prepare them, because her quantities are usually measured by phrases such as "just enough", and "till it looks right", and "well, it depends!"

Isn't it amazing how dependent we've become on prepared mixes or at a minimum, google'd recipes? Truthfully, in the kitchen I tend to alter the vast majority of recipes that I use, even the first time. I substitute apple sauce for oil, or change up flours to make things gluten-free, or create some other "healthy" modification. When it comes to family traditions, though, I usually defer to the high-fat, full calorie version, which is FINE. Not EVERYTHING we eat needs to be pure nutrition! It's perfectly fine within the confines of healthy living to splurge on treats now and then. The trick is to remember that every day or week should not be "that" special occasion!

I have learned from my patients (by doing 24 hour dietary recalls) that what people believe is an unusual day is often a frequent occurrence. Do you grab fast food before every soccer practice or music lesson? Well, I'm guessing that is EVERY Tuesday (or whatever day or dayS your kids have that activity.) Look at your schedule now, and recognize those days that present a challenge every week, and then PLAN AHEAD. Sandwiches, slow cooked meals, and even "breakfast for dinner" might be healthier choices.

BOTTOM LINE: Enjoy your traditional holiday treats this season, but recognize patterns of unhealthy choices in your everyday schedule and make pro-active changes to improve your health!

Sunday, November 13, 2011

Women's Breast Friend!

Today I was totally inspired by the Susan G. Komen Race for the Cure. Our daughters and I were part of a cheering squad at the two mile marker of a 5K race. What an amazing site to behold! Thousands of pink-bedazzled runners, joggers, walkers, strollers and even a few wheelchairs happily plowed through downtown Austin early this morning. The costumes are reasons enough to come and cheer on these participants- pink boas, tutu's galore, crazy headwear and hilarious t-shirts top the list.

The slogans ranged from "Big or Small, Save them All!" to "Save Second Base" and many versions of "Save the Ta-Ta's". Breast cancer survivors wore special dark pink shirts emblazoned with "survivor" down the front- and I can't begin to guess how many hundreds of survivors were sprinkled within the throngs of racers. Every survivor wore a large smile and a fierce, triumphant spirit that made all of us stand up a little straighter and appreciate our own measure of health.

Perhaps the most touching scenes were the families and groups of friends carrying pictures and banners of their dear ones who couldn't beat breast cancer. "Gone but never forgotten", and "You're our Angel" signs and shirts unified these participants, many clearly still keenly bearing their loss. How amazing that they are honoring these angels by helping raise money for breast cancer research to spare others the pain they know too well.

Race for the Cure is one of several foundations that hold races around the country to raise money for medical research. If you are looking for a way to start exercising, I promise you that signing up to WALK in races like these (where the time doesn't matter, so you don't have to be up to running to participate) will make exercise fly by as you surround yourself with such positive energy and zest for life.

BOTTOM LINE: Congratulations to all the participants in the Susan G. Komen Race for the Cure, and let's continue to support all cancer research!

Friday, November 11, 2011

What is BMI?

Yesterday, I mentioned that discussing your BMI with your doctor might be a less emotionally charged way to discuss your weight. Terms like "overweight" and "obese" tend to make us all shut down and stop listening, but it is really important to understand whether or not your weight is becoming a medical issue. The BMI is your "Body Mass Index", and it is a reflection of your relative body fat. Note that I said "reflection"- the BMI is NOT a precise measure of your body fat percentage.

BMI is simply calculated by using a person's weight and height. Specifically, BMI equals your weight in pounds multiplied by 4.88, divided by the square of your height in feet. There are charts to look at and on line calculators as well. Click on this link to the U.S Dept. of Health & Human Services' BMI calculator to see what YOUR BMI is today.

Now that you've got your number, what does it mean? Well, if you are less than 20, you are underweight. If you are between 20-25, you are considered healthy, or "normal" weight. Please pay attention if you are in the 25-29 segment, because you are overweight! If you are >30, you fall into the medical definition of obesity.

Why did I bold face that 25-29 segment? Because in my clinical experience, no one with a BMI of 30 or more is surprised that they weigh too much. However, I would estimate that over HALF of my patients who fall in the "overweight" category are shocked that they have a medical issue with their weight. After college, people often put on a couple pounds per year, very slowly creeping that scale. During that time, they may only go up a size or two in clothing, especially if they are buying more expensive clothes (which tend to run larger and larger.) Before they realize it, they weigh 20 or 30 pounds more than is healthy, yet they don't "feel fat". I don't care very much about cosmetic issues with weight, but I care deeply about increased risk of diabetes, heart disease, low back and joint pain, all of which come into play when your weight goes up.

BMI's are not flawless. If you are an "ARNOLD" with tons of huge muscles, your BMI will be falsely elevated. If you are elderly and frail, chances are good that your BMI underestimates your body fat. In general, however, the BMI is a great tool to assess your weight.

BOTTOM LINE: Take a moment and calculate your BMI, and take an honest look at your weight: 1/3 of Americans are overweight, 1/3 are obese, and only 1/3 are normal or underweight, so the odds are stacked against you.

Thursday, November 10, 2011

Why Don't Doctors Talk about Weight?

I have often heard people complain that their doctor did not tell their spouse to lose weight. (While I could do a side blog on why it is that people have this complaint more about their spouse than themselves, I will pass on that aspect today.) The CDC reported that in a recent Disease Control and Prevention survey, only 42% of obese patients were advised by their health care providers to lose weight. Interestingly, those who WERE counseled to lose weight were more likely to be actively trying to do so.

Why don't doctors tackle this more often? Obviously, there are many reasons, but let me list the top ones that immediately come to mind.

1. TIME- Doctors are all frustrated with less and less time with our patients. Weight loss conversations are rarely brief (and often loaded with emotional baggage) so doctors may avoid the topic purely from lack of time.

2. FEELINGS- Doctors are human (mostly) too, and we don't want to insult or hurt people's feelings. No one seems to be offended by high cholesterol or blood pressure, but universally people are defensive and/or hurt when say they are overweight or obese. Certainly, our society has made fat a four letter word.

3. MIRRORS- If your doctor is overweight, he or she may consciously avoid discussions of weight (why can't you lose your weight, doc?) or subconsciously avoid the topic because of their own frustration with the issue.

4. EXPERTISE- Not all physicians receive equal training in nutrition, so we have different comfort levels in direct counseling. Having said that, know that we can refer to our wonderful colleagues- our registered dietitians- who specialize in nutrition.

So, on your next office visit, why not ask your doctor about your weight? I think the least stigmatized way is to ask about your BMI- your body mass index. What's a BMI? More on that tomorrow...

BOTTOM LINE: Obesity should not fall into the "don't ask, don't tell" category- ask your doctor if you are at a healthy weight!

Wednesday, November 9, 2011

Holiday Weight Gain...Again!

Click! Step away from the Halloween candy. I repeat, step AWAY from the Halloween candy!

Okay, how many times have you walked past the leftover candy and snagged an extra treat today? It is so easy to keep it around just to "finish it off". I'll bet you're even down to the candy you don't even really like, yet you pop one in your mouth because, well, it's there. How do I know? Because I just ate a mini-Snickers, which is my least favorite candy. The Reese's cups were gone last week.

All kidding aside, please take stock of your health TODAY. We are already well into November, which is the heart of "stuff yourself silly" season. Treats and sweets abound, as well as extra adult beverages at every celebration- and those pack on the calories as much, if not more than the edible delicacies! At the office, we are already seeing the extra weight creeping up. The average American gains nearly 10 POUNDS during the holidays. And then what does everyone do? We make a New Year's Resolution to lose weight.

This year, let's be PROACTIVE! Start on that new exercise program right NOW! Take the stairs instead of the elevator. Park a little further away when you go to work or shop. Fill your party plate with healthy choices and eat them first before you head to the dessert buffet. Every bit you do now will make those New Year's Resolutions much easier.

BOTTOM LINE: Do not wait for New Year's to start thinking about improving your health!