Say NO to Delivery Food!

Have your kids reached the "I'm bored" stage of summer yet? If so, why not spend some quality time together in the kitchen? Our family is challenged with one vegetarian and one GF (gluten-free) dieters, but we have found multiple menus that still please everyone. Today's meal (pictured above) was made by our younger teenage daughter, proving that 14 year-olds can definitely do more than order pizza!

Nutrition studies have found that kids are far more willing to expand their palate when they are involved in preparing the food. Fruit smoothies are probably the easiest and most delicious way to engage your child in the kitchen. Grab some frozen fruit, a banana, and some plain or vanilla yogurt. Toss the ingredients together in a blender and voila- healthy breakfast you can drink on the run as you dash off to dance camp!

My next favorite is today's dish-stir fry. This meal is simple to make vegetarian by adding your beans of choice, but can also be protein-enhanced with chicken, fish or other meats. Supervise your kids as they learn to chop up squash, zucchini, mushrooms, onions and carrots, then toss them in a large wok or pan and stir fry with olive oil. You can also add some garlic and other seasonings as they expand their palate. We serve this over rice (using the" toss in the microwave for one minute" super-fast option) or pasta or even simply over lettuce for an extra veggie load.

BOTTOM LINE: Break the pizza/burger/nachos summer habit, and substitute some healthy dishes and family fun in the kitchen!

Pop Tart and Candy Diets

Ready to lose weight? Step up to the newest diet craze- the Peanut M&M diet! Can you imagine a diet that will let you eat this delicious candy and still lose weight? Okay, hold on right here. I could go on and actually give you details of how my new Peanut M&M diet will work- but be prepared to hear something like eat ONLY the green ones- then clip on your pedometer and don't eat the yellow ones till you've walked 2500 steps. So what's my point?

Last week, I was at a wonderful talk by registered dietitian, Daniela Knight, and one of the participants asked what she thought about the "Pop Tart Diet". (BTW, for fun, I googled pop tart diet and sure enough, came up with not only a diet but a youtube video explaining the supposed health benefits of pop tarts.) I loved her response- "Oooh, doesn't that sound enticing? Wow! A diet where you eat pop tarts! Way more fun than eating more fruits and vegetables, right?" But the audience was hooked, and all wanted to know details of the "diet". So here's the thing- ANY weight loss program CAN include pop tarts (or donuts, or peanut M&Ms), but if that is the mainstay of the calories in the diet, you are not going to feel so great. Your body (obviously) needs a balance of nutrients and vitamins that ideally comes from multiple colors of produce plus a protein source. Weight loss occurs when you consume fewer calories than you burn off. Period. So yes, you COULD eat six strawberry pop tarts per day, with as much water and diet sodas as you can hold, and you would be on a 1200 calorie per day diet. For most people, that would result in weight loss- BUT- you would be seriously lacking in protein, fiber, calcium, B Vitamins, Vitamin C...get the picture? No energy. None!

Am I saying NEVER eat a pop tart? No! Daniela (my favorite dietitian) would tell you immediately that NO food is "bad". Treats like pop tarts and M&Ms we need to limit, not ban. What IS a healthy way to lose weight? Fruits & veggies galore, with enough protein (eggs, meat, chicken, fish or nuts) at each meal to equal a daily total of roughly one gram per kg of your body weight.

Now, if I wanted to get RICH, I'd go back to my color-coded peanut M&M diet...but don't forget walking the mile in between color changes...

BOTTOM LINE: Yummy treats like pop tarts or peanut M&M's can be INCLUDED in any healthy diet- but should be the occasional bonus, not the mainstay!

7 Ways to Leave Your Cigarettes

SEVEN seems to be the magic number for habits of successful people, right? SO...smokers, step on up to the SEVEN choices to help with QUITTING SMOKING! QUITTING SMOKING is the single most important thing you can do to improve your health. In alphabetical order, here they are:

1. Bupropion SR (Wellbutrin SR)- this is an antidepressant that works via unknown mechanisms to decrease your desire for smoking; you start it a week or two before your quit date, and it significantly shuts down that craving for a cigarette.
Common side effects- insomnia and dry mouth.
2. NIcotine gum- do NOT chomp it like regular gum! It's chew, chew, stash it.
3. Nicotine inhaler- used every hour or two during the day; may cause throat/mouth irritation and cough
4. Nicotine nasal spray- 2-4 sprays per waking hour as needed; may cause local irritation in nose and throat
5. Nicotine patch (now OTC, but ask your doctor which dose)- may cause skin irritation; remove at night so no sleep issues
6. Nicotine lozenge- may cause mouth soreness and nausea
7. Varenicline (Zyban)- blocks nicotinic receptors and sharply decreases cravings; Common side effects: very vivid dreams and nausea.

Are they expensive? Puh-lease! Are cigarettes expensive? YES! These aids are money well spent, and will pretty much equal what you are already spending on your habit.

BOTTOM LINE: If you think you've tried everything to quit, double check the list and head to your doctor for a new cessation aid!

Separation of Religion and Medicine? I Hope NOT!

Lately there has been quite a buzz about the separation of church and state, but I'd like to share what I enjoy about COMBINING religion and medicine. In particular, I LOVE the season of LENT! Yesterday, we had Ash Wednesday, which marks the beginning of a 40 day (or 47 day, if you count Sundays) beautiful time of reflection, growth, and personal discipline in the Christian faith. Many people, particularly Catholics, have a tradition of giving up a dietary luxury of some sort- often chocolate, alcohol, desserts, or sodas. Today that list has expanded beyond dietary items, and many give up electronic activities such as Facebook, Twiiter, iPad, apps, or- gasp!- all non-school or work-related computer-based activities. How does this affect me as a family physician?

If I ask/suggest for a patient to give up, say, caffeine or alcohol- because it is causing him or her heartburn- patients are only moderately invested in committing to this change. Truthfully, they'd typically rather have a prescription for a pill to fix their symptoms, and not make any difficult lifestyle changes. If, however, this same conversation occurs after a Mardi Gras excessive celebration, and the patient CHOOSES to eliminate one of these substances from their diet as a form of religious discipline and self-sacrifice, the success rate skyrockets! I can't adequately express how often a Lenten "observance" has been an excellent kick-off for weight loss programs for my patients. Whether it is giving up a high calorie dietary staple, or freeing up time to exercise by giving up electronic play time, all of these changes work in a positive forward spiral, with the added benefit of personal religious fulfillment as well.

Of course, Lenten commitments aren't all about "giving up" treats, and I do not in any way want to minimize the religious implications of spiritual discipline. My point is simply that when we make positive health choices augmented with a higher purpose behind them, we can amplify our results.

BOTTOM LINE: Our personal religious beliefs can be a powerful source of motivation to make positive health changes- let's use them this Lent!

New Year's Resolutions- a WEIGHTy Issue

Happy New Year! Welcome to 2012, the year that holds the potential to be your HEALTHIEST yet! Virtually every list of top 10 New Year's Resolutions leads off with the battle of the bulge- whether it is "lose weight", "get fit", "eat healthy", "join weight watchers", "join a gym" or some other variation. With the vast majority of Americans falling into the "OVERWEIGHT" or "OBESE" categories, these resolutions certainly make sense. Unfortunately, many of us fight the SAME 10, 20, or even 30-plus pounds over and over again. We get motivated, make healthy changes, lose weight...and then gain it back. Ugh. What might we do differently this year?
Here is some food for thought...

1. Figure out the WHY of your eating behaviors, and learn to eat MINDFULLY. Dr. Michelle May's book "Eat What You Love, Love What You Eat" is a FABULOUS start- buy it today. Her focus is how to break the "eat, repent, repeat cycle". AMEN.

2. Speaking of buying- let's put our money where our mouth is- literally! I have heard over and over again that it's too expensive to meet with a dietician, join a gym, or eat fresh fruits & vegetables, or take up a new sport, yet these same people are spending far more discretionary money on their daily Starbucks, hair highlights or a round of golf. Seriously, we need to prioritize our health and be willing to pay for it!

3. Commit to ONE small permanent change each month. Experts say it takes 21 days to cement a new habit, so why not make 2012 the year to develop 12 new healthy habits? Start with something simple, like making sure you eat breakfast every day OR (assuming this was not part of your routine already.) In this case, it can be a granola bar or a cup of yogurt. Remember to keep it simple. If you try to make a change from no breakfast to cooking a veggie omelette and drinking freshly squeezed grapefruit juice- well, I'm not optimistic it will stick!

Whatever you choose, find a way to make yourself accountable. Make a deal with a friend, tell your co-workers, announce it to your family (if you have teens, they will HAPPILY hold you accountable), or simply record it on your smart phone, computer or an old fashioned piece of paper.

BOTTOM LINE: Make 2012 the year you make your New Year's Resolutions last beyond Janaury, and choose GOOD HEALTH!

Does Your Holiday Travel Include a Flight?

As the holidays are upon us and travel plans are ramping up, I thought I’d share some health-related flying tips. Since flu season is under way, I’d be remiss not to start with the basic advice that you should NOT fly if you have a fever or a productive cough (or other flu symptoms such as headache, sore throat, and body aches.) That being said, there are many times that you may need to fly when you have mild cold or allergy symptoms, and there are a few tricks that may be helpful.

The one time that I actually recommend over-the-counter nose sprays (like Afrin) is if you have a stuffy head/nose/ears and need to fly. Make sure to put it in ziplock bag to take it through security, but then use it when you are seated on the plane to reduce ear discomfort upon takeoff. Gum, mints or any beverage will help clear your ears as well- whatever helps you to swallow repeatedly.

I also suggest sucking on the zinc lozenges- any variety- I happen to like the ones combined with vitamin C. Zinc oral dissolvable products have been shown to reduce acquisition of respiratory viruses. Unfortunately, simply taking a zinc supplement that you swallow has not been shown to provide equal benefit.

If you have no contraindication to taking aspirin, a baby aspirin taken the day of your flight will reduce your risk for blood clots that can occur with prolonged sitting. Try to get up every hour or two and walk to the bathroom- that will help, too.

Nervous about flying? Talk to your doctor about a short-acting mild sedative or sleep aid (if the flight is long enough.) No need for embarrassment, as fear of flying is very common. I’d estimate I get this request close to once per week (and much more often this time of year!)

Should you wear a mask? I suppose if either YOU have a cough or your seatmate does, that is reasonable.

BOTTOM LINE: If your travel plans include flying, create your own "flying first aid" kit to take with you!

Gifts that Keep On Giving

'Tis the season of giving, and many of us are trying to find the perfect gifts for our friends and families. Before you choose gift baskets loaded with wine, chocolate, and other delicious goodies, though, stop and think. Is this the right gift for your friend who is struggling with her weight or your brother who has high cholesterol and "borderline" diabetes? Well, maybe not, but hey, it's the holidays, right? Doesn't everyone deserve a little treat? And they LOVE chocolate...

Well, yes, I agree that everyone deserves a treat, but is it really a treat if we're giving them something that harms their bodies or works against their health goals? If your friend is fit and healthy, knock yourself out with edible treats with a clear conscience. BUT... if they are NOT, why not focus on gifts that encourage health? Mind you, I'm not suggesting sticking a bow on a bag of carrots, either. How about fun workout socks or a new top? Buy matching pedometers for you and a buddy or two for some friendly competition or at least mutual encouragement. How about a gift certificate for a massage or manicure or pedicure? Or a new healthy cookbook? Out of money (and who isn't?) Make a gift certificate for a outing to a park or walk around the lake or a bike ride. Be creative!

I would be remiss if I also didn't put in a pitch for charitable giving this year. In this tough economy, our non-profits are struggling, too, so consider them as an alternative if you have friends or business associates with whom you typically exchange gift baskets. Our local Hospice, for example, has a program where you can purchase an angel ornament for $25- your gift recipient gets the ornament, Hospice gets the funds, and everyone gets the spiritual health gift of helping others! (http://www.hospiceaustin.org/site/pp.asp?c=bdJPITMyA&b=1556229) Or Meals on Wheels, where $25 provides ten meals plus services. There are so many wonderful charities who can stretch your donation dollars!

BOTTOM LINE: Think twice before sending out edible treats to ALL your friends and family this year, and show you really care by giving gifts that promote physical, mental or spiritual health! Happy Holidays!

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!

How Do You KEEP the WEIGHT Off?

Many people lose the SAME 10, 20, or even 50 pounds over and over again. How frustrating is that? What can you do to PERMANENTLY lose weight, so you're not fighting that same battle? The first answer is obvious- stop DIETING. When you go on a super restrictive DIET, certainly you will lose weight, but if you never really look at your eating patterns and exercise habits, you are doomed to repeat the cycle.

I always encourage my patients to make changes they can live with for the REST of their lives. Typically this does not involve permanently eliminating ANY particular item from their diet- whether it's chocolate, butter, or even soda. Should you limit these high calorie items? Sure! But really, if you focus on MORE fruits and vegetables and water, then truly, you'll begin to notice you ARE eating less of these higher ticket items.

There is a wonderful website dedicated to people who have not only lost more than 30 pounds, but KEPT THOSE POUNDS OFF for at least a year- the National Weight Control Registry. In fact, the average weight loss is 66 pounds, and they have kept it off an average of 5.5 years! Both men and women are enrolled, with the average ages being 49 and 45, respectively. About half lost the weight on their own, while the other half joined programs. What do they have in COMMON?

1. 94% INCREASED their activity level, most commonly by WALKING
2. 78% EAT BREAKFAST daily.
3. 75% WEIGH themselves once per week
4. 62% Watch less than 10 hours of TV per week
5. 90% EXERCISE DAILY

BOTTOM LINE: If you want to stop battling the same pounds, take a look at the success stories of people who have KEPT their weight OFF, and see what simple changes you might be able to make to keep YOUR weight off.

Mother's Day Gifts- Get Ready!

Mother's Day is coming this weekend, just as we are polishing off the last chocolate eggs from the Easter basket. Hmm...sounds a bit like Halloween and also Valentine's Day, right? Why is it that most of our American holidays focus on CANDY? Mind you, I love chocolate, but the truth is that I have been popping beautiful pastel peanut M&M's into my mouth each time I pass through my kitchen and hear the Easter candy bowl calling my name.

At the same time that we are fretting about trying on swimsuits and fitting into summer clothing, we are working to "finish up" the Easter candy. Kind of counter productive, isn't it? So, first of all, let's give away the rest of the candy (if it's still sitting around.) Secondly, let's pamper Mom with gifts she'll enjoy that promote her health- physical, mental or spiritual.

So, what do moms like? Are you feeling rich? Offer her spa certificates or maybe a gym membership. Not quite so loaded? How about a simple manicure (usually around $15) or a lovely smelling candle or body lotion, or a new exercise outfit? Totally broke? No worries- go for HOME MADE; a simple meal (that MOM does NOT have to prepare OR clean up), cleaning her car inside and out, or jumping in and doing "her" jobs for the day, like a load of laundry or walking the dog.

If you REALLY want to touch your Mom's heart, check back tomorrow see what my guest blogger, psychologist David Palmiter,PhD, thinks is the PERFECT gift for Mom or anyone you truly love...

BOTTOM LINE: Skip the chocolate this year and celebrate MOTHER's DAY with a health-promoting gift!

What Works for Weight Loss? MORE!

MORE, MORE, MORE! That is chant I want you to hear in your head as you focus on FITNESS. Yesterday I talked about MORE fruit and vegetable servings- 5-10 per day. Today let's shift to MORE MOVEMENT.

Many of my patients started 2011 with the resolution to go to the gym EVERY DAY after work. Guess what percentage are still doing that? Hmm...not too many. Why is that? It is a setup for failure. While exercising EVERY DAY is absolutely possible, and indeed, what I do and what I encourage everyone to make a life habit, exercising in a specific place outside your home- like the gym- is very difficult. Say today you wake up and your child has a fever, so you can't leave the house. Tomorrow you have a business meeting in the evening (no time to workout, shower and clean up between work and that meeting) and boom, then it snows/rains/floods...you get the picture!

I think planning a day or two per week at the gym (or the track, or walking the mall) is wonderful, but please, set yourself up for success by having backup plans AT HOME. I am a big fan of exercise bikes and DVDs for this reason. Grab your tunes and/or your dog and head out the front door. Set a timer for 30 minutes, turn on some music, and dance! OR- I got this idea from another woman physician last October- set the timer for 30 minutes, turn on music, and CLEAN YOUR HOUSE- actively! Vigorously scrub the counters, alternate hands, squat up and down unloading the dishes, mop quickly, whatever it takes to keep your heart rate up. Which exercise is best? The one you will DO.
The main idea is to MOVE MORE. Check out my blog on PEDOMETERS- they work great, too!

BOTTOM LINE: Switch your focus to MORE: MORE movement, MORE fruits & veggies!

Thankful for My Mother-In-Law...Seriously!

Getting ready for Thanksgiving? I know I am. Today my mother-in-law was sharing her fabulous fresh yam and green bean recipes with me, 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 as I was dutifully typing them into a word document, her quantities were "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!

BYOB Until You Get One of THESE New Machines!

Yea! Let's here it for vending machines selling...brace yourself... HEALTHY SNACKS! I was delighted to see "The Great Banana Challenge: How to dispense healthy snacks from a vending machine: design a fruit elevator" in the Wall Street Journal this week. It's hard to imagine walking up to a vending machine and expecting food to be, well, FRESH- but that's exactly what happens in these new machines.

Apparently, they've developed technology that allows for different refrigeration temperature zones as well as gentle "elevators" to lower the food and padded retrieval bins to avoid bruising. New packaging for the fruit itself extends the shelf life to nearly double its life outside of the wrapping.
For all of us who do not have these delightful new machines yet, don't worry! When in doubt, BYOB...Bring Your Own BANANA, that is!

BOTTOM LINE: The MORE we demand fresh fruits, vegetables and healthy snacks, the more innovative solutions our free market will create!

But It's Too EXPENSIVE to Eat Fruits & Veggies!

Okay, this is one of the top excuses I get from patients when we start talking about improving their diet, and getting them to focus on MORE fruits and vegetables. (Keep in mind, our goal is 5-10 servings per day, and a serving is what you can hold in your hand.) So back to the discussion- is the perimeter of the grocery store really more expensive than the boxed, processed junk in the middle?

Of course, if you look at the BIG picture, it's easy to see that no matter what, you are better off buying the fruits and vegetables. Diabetes, blood pressure and cholesterol medicines cost a small fortune, even if you are "only" paying the co-payments. Part of the incentive to improve your health (and yes, lose weight in the process) is that MANY people can reduce or even eliminate these medications, which will save them a very significant amount of money!

In the short term, though, what is the cost? Obviously it depends on what you choose. My friend and excellent dietician, Daniela Knight, RD, recommends that her patients check out the weekly ads. "If bananas are on sale, load up on those and skip the $5 per carton blueberries that week." Lettuce, carrots, onions, apples, oranges and potatoes are typically inexpensive year-round. Frozen fruits and vegetables are packed with the same nutrients as fresh ones, yet often cost much less. Additionally, there is nothing wrong with canned vegetables or fruit, either, despite the incorrect notion that they are vastly inferior. Yes, watch for sodium in canned goods, but the nutrients are fine!

Daniela also reminds her patients that you can buy an entire BAG of potatoes for less than the cost of a bag of potato chips, which are up to $3-$4. Pre-washed, packaged vegetables like broccoli and green beans are simple to pop in the microwave, and now you've got quick AND reasonably priced veggies.

BOTTOM LINE: Fruits and vegetables are worth every penny for your health, and can save you money in BOTH the short and long term if you buy frozen, canned and seasonal fresh produce!