Weight Loss Success: Make New Habits or Break the Old?

Which works better for weight loss: creating new healthy habits or getting rid of bad ones? 

A small but clinically significant study was recently published in the International Journal of Obesity that addressed this question. The good news is that BOTH interventions produced sustained weight loss at one year, with the 21 adults who created new habits having a 6.2% weight loss (roughly 12.5 lbs) and the 22 adults who worked on breaking unhealthy habits having a 4.8% (10.1 lbs) weight loss. 


The intervention group that tried new habits followed the researcher's "Top Ten Tips" which included fairly predictable weight loss strategies such as walking 10,000 steps/day; reading labels, watching portion size and reducing fat content; packing snacks and sticking to a meal routine; choose water over other drinks; slow down and be mindful while eating; and of course, my standard preach of at LEAST 5 servings of fruits and veggies per day.

Interestingly, the bad habit breaking group was called "Do Something Different" (DSD). The concept was to "increase behavioral flexibility" by being assigned a different task to perform each day during the 9 week initial intervention. Tasks could include choosing a different route to work or wearing a new outfit, or even writing a short story.

I love the focus on all-around behavioral flexibility that includes new healthy habits. Consider challenging yourself (or better yet, share a challenge with a friend or family member to increase your accountability) to "Do Something Different" each day on your path to a healthier you. My challenge today? Substitute water for my recently "snuck back in" habit of having a soda with my lunch. 

New Years' Resolutions: Take 2

Greek Salad at the Stash

Well, here we are at the end of January already...and how are you doing with your New Year's Resolutions? From the number of FitBits and step counts that I am seeing and hearing, I believe many people are enjoying being more active (or at least enjoying "competing" with themselves or friends over their numbers.) Perhaps the two most common health related resolutions are to increase exercise and to eat "better". What does that really mean?

First let's tackle "increase exercise". Please, focus on the INCREASE. If you are honestly doing nothing, start with walking. Consider a "FitBit" or a smart phone or a simple $10 pedometer, and start charting how many steps you take each day. Next, challenge yourself to up that number each day by 100 steps. We as a society seem to be very motivated by video-game-like challenges, so we know what it takes to "pass" each level, right? Let's apply that to our daily steps. For years, we have been pushing the "10,000" steps per day, which is approximately equal to 4 miles. My encouragement today is simply to see YOUR personal baseline, and push it up by SMALL increments each day.

Eating "better". Okay, I have blogged before about the "unhealthy vegetarian", but for those who have not yet heard my rant...here it goes. "Vegetarian" does NOT equal "HEALTHY". It certainly CAN, and even SHOULD- if that person is concentrating their food choices on- wait for it- VEGETABLES. However, especially in my current patient population of college students, "vegetarian" can mean diets of granola bars, chips, nachos, and cheese pizza. Hmm...let's count the fruits and veggies there- anyone have a calculator? LOL.

BOTTOM LINE: My 2016 Gift to you is that the last day of EVERY month, I wish for you a clean slate- a "do-over" for your NYE Resolutions. On this January 31st, why not pick a simple FEBRUARY healthy resolution? And feel free to share with us your success!

It's BA-ACK! Halloween Candy

Despite the 90 degree days we are still having in Texas, the calendar tells me it is already OCTOBER. Of course, the grocery stores have been featuring HALLOWEEN CANDY for nearly a month already! Did you resist? Or are you tossing in a bag of bite-sized candy on impulse as you check out?

If so, it's high time to realize that we are now officially in what I call the "treat yourself" season, as we hit the trifecta of food oriented holidays: Halloween, Thanksgiving and Christmas/Hanukkah. We tend to celebrate with nonstop EATING, and then what do we do every January? That's right, make New Year's resolutions where LOSING WEIGHT tops the list!
This year, let's THINK AHEAD...

Let's SAVE THE HALLOWEEN CANDY for...yes, HALLOWEEN! Start in the grocery store. Do NOT BUY the candy till the DAY BEFORE Halloween. It's way easier not to eat it when it is still sitting on the shelf in the grocery store, rather than sitting on your desk at work or your kitchen counter top. We all grab a small handful of treats when they are openly displayed in front of us.

Do the calories add up? You bet. Here are some of my favorites: Snack Size Butterfinger: 170 kcal, Fun Size Kit Kat- 50 kcal, and ONE single, plain M&M-4 kcal. Now, if you stop at ONE, it's really no big deal. but if you eat a handful of M&Ms each DAY for the next few weeks, or grab a couple fun size chocolate treats, BOOM-you will gain a pound right there. (Remember one pound is 3600 kcal- do the math.)

BOTTOM LINE: Don't wait for NEW YEARS to make a resolution for better health- start NOW by limiting Halloween CANDY to HALLOWEEN DAY!

PS. It's a new month, so CHANGE THOSE AIR FILTERS!

2013- A Year for YOU!

Happy New Year! I love new beginnings- who doesn't? Whether it is the first of the month, your birthday, an anniversary, or yes, the NEW YEAR- give yourself the precious gift of a new start!
Since this is my blog about all things healthy, I wish for you specifically to give yourself the gift of a new start for health...whatever is most important to YOU.
90% of us struggle with our weight. Whether it is fighting that same darn 10-20 pounds that we battle every year, or perhaps the first time that our metabolism packed its bags and deserted us, Americans have big issues with weight (no pun intended.) What will you do this year?
Let me say right now, if you are not exercising at all, and eating out over half your meals, please do not commit to exercise every day & a brilliant, gourmet, healthy home-cooked meal three times per day! Whatever you choose, set yourself up for SUCCESS!
For 2013, I'd like to encourage you to pick ONE thing today to improve your health. Is it a goal of five servings of fruits and/or vegetables per day? Hooray! Choose it! Is it parking your car at the back of the lot? Awesome! Walking the stairs instead of taking the escalator or elevator? Buying a pedometer? Meditating 5 minutes each morning before you get out of bed? Amen!
My wish for each and every one of you is better health- spiritual, mental, and physical health. I am in the process of finalizing tough decisions in my own life to optimize not only my health, but my family's collaborative "health".
BOTTOM LINE: Start off 2013 with ONE simple step towards better health- choose it today!

Doctor, How Do YOU Stay Thin? My Not-So-Secret Revealed...

"But Dr. Grimes, YOU don't have to worry about YOUR weight- you're tiny! You don't know what it is like to struggle with your weight." 

Every time I hear this from a patient, I am not sure if I should laugh or cry. While yes, there are some people out there who seem to be able to eat whatever they want and never exercise, and yet stay thin, healthy, gorgeous, rich and let's throw in perfect in every way (ha!), MOST people who appear healthy make very conscious choices to keep themselves there. As my close friends can attest, I love to eat delicious foods of all categories- nutritious or not.

Unfortunately, after having an exceptionally active metabolism up until age 25, I am now (& have been for over two decades) fully capable of packing on the pounds with the best of them. In my first pregnancy, despite delivering a month early and enduring over seven months of morning sickness that lasted day and night, I was mortified to gain forty pounds. I'm sure eating nonstop pizza & burgers (because nothing else appealed to me) might have had something to do with that...but I digress. The point is that if I do not keep a close eye on my weight, I gain more than I would like. I can lay the blame wherever I would like- blame medications, injuries, stress, or whatever- but that doesn't change the end result. If I gain weight, I have to lose it the same way everyone else does, by burning more calories than I consume. So what exactly do I do?

1. RECOGNIZE THE PROBLEM- I try to weigh every morning, aware that everyone has a natural up and down flux of a couple pounds. When I hit 3 pounds higher than my average, that's my ceiling and it's time to get serious before it gets out of hand. (This may be the most important step. When I skip this step, it's 5-10 pounds up, which is much tougher!)

2. START WITH A SEVERAL DAY "CLEANSE"- I'm not talking about an enema here! I simply go back to basics and eat ONLY fruits, veggies, and a simple protein (nuts, beans, fish, chicken or lean meat.) I also drink as much water as I can stand (about 6 glasses in a day), and no other beverages. The picture above is my lunch- large portioned, delicious and 90% veggies.

3. RAMP UP MY EXERCISE- for the record, I walk our dogs around two miles per day every day. This is both for the dogs & for me to MAINTAIN my weight. If I need to lose, this is not enough, because this is my baseline- I need "MORE". I typically add in a second walk or get on the exercise bike for 30 minutes in addition to the daily walk.

4. TRY TO HAVE REALISTIC EXPECTATIONS- good weight loss is 1/2-1 pound per week. I am as guilty as the next person that after two days of being "perfect", I am disappointed when my weight has not miraculously jumped back two or three pounds to baseline. By the end of a week (Mon-Friday) I have typically seen the scale budge at least a half pound, and once I know I am headed back in the right direction, I start to loosen up the diet by allowing some processed foods back in, but at restricted portions. Truth be told, I let in dessert first- but make healthy choices such as some whip cream on strawberries or chocolate syrup on a banana. Next I might bring back corn chips (I'm gluten-free, so less likely to choose cereal, breads, or crackers). I very slowly add in other foods until I am back to my healthy baseline, which includes some high calorie treats ONCE I am back where I want to be.

BOTTOM LINE: Virtually EVERYONE needs to be conscious about their weight and health choices for nutrition and exercise- don't assume thin people are just "lucky".

Is it a New or Old Weight Loss Drug?

This month I am talking about obesity & weight loss. By our human (and American) nature, we would all like a quick fix to solve our weight issues. This summer, the FDA approved not one, but TWO new weight loss drugs.  My last blog addressed lorcaserin (Belviq), and today's focus is really something old in a new package.

Qsymia was FDA approved in July 2012, and it is a combination of two older drugs that have been used independently to help with weight loss: phentermine and topiramate. Phentermine is an appetite suppressant, and was half of the infamous fen-fen (a diet pill combo that was removed from the market once its use was associated with the development of pulmonary hypertension (a damaging condition in the lungs) and heart valve issues. Phentermine by itself is still approved for "short term" use- a few weeks- as an appetite suppressant, but there is limited efficacy and safety data available. Topiramate was originally classified as an anti-seizure medication, but indications now also include migraine prevention. Physicians and patients were generally pleased to see that a side effect of topiramate is weight loss (to the point where I have had patients without frequent migraines ask if I will prescribe this drug "just in case"!)

Qsymia combines these two drugs, and showed significant weight loss at one year- an average of 8.9%.
Both drug components are  at much lower doses than the individual drugs are typically prescribed, which hopefully will limit side effects. Indications for this new drug are for patients who have a BMI>30 (defined as obese) OR if they are overweight (BMI>27) AND have high blood pressure, diabetes, or high cholesterol.

If you meet those qualifications and are interested in trying this new drug, don't rush to your doctor quite yet! Qsymia is not yet in pharmacies, though it is anticipated to be in "certified pharmacies" next month (September 2012).

BOTTOM LINE: The newly approved weight loss medication, Qsymia, combines two older medications and may prove to be significantly effective in helping treat obesity, but it is not available quite yet. 

A New Weight Loss Drug!

Have you heard that the FDA approved not one, but TWO new weight loss drugs this summer? Hooray! Our problems are solved, right? Are there still overweight doctors out there? Well...yes, there are, so that should give you a clue that these new drugs are not miracle workers.

Today I will focus on the first drug approved. Locaserin, brand name Belviq, came out in June 2012. This drug will decrease your hunger and increase your feelings of satiety (feeling full after a meal). Locaserin works within the serotonin system (like the antidepressants such as Prozac) but targets a specific receptor that is key in the appetite game, rather than mood. Fenfluramine, an older drug with a similar mode of action, was removed from the market in 1997 due to concerns of its detrimental affect on heart valves. The selling point of locaserin is that it targets a different, very specific receptor that is not linked to these deleterious valve changes.

In the studies necessary to get approved by the FDA, patients on this drug lost an average of 12 pounds in one year. Let me remind you that good steady weight loss is a pound or two per month (not the 30 pounds in 30 days we all would like), so this is reasonable weight loss. However, from my standpoint, I'd like to see a drug produce better results before risking the side effects. In this case,  side effects of lorcaserin include headache, dizziness & nausea. So at this point, I am not impressed enough to prescribe this drug.

BOTTOM LINE: Lorcaserin (Belviq) may provide obese patients help with decreasing their appetite & increasing satiety, but does not provide dramatic weight loss results.

Which Diet is Best for Weight Loss?

Now there is the million dollar question, right? Interestingly, despite billions of health care dollars being spent on "diets", there are not recent high level studies in the medical literature to support touting one weight loss diet highly above all the rest. In 2001, there was a scientific review of popular diets by Freedman, King, & Kennedy, that concluded "low fat, low calorie diets are the most successful in maintaining weight loss." Note- this is in MAINTAINING weight loss, not LOSING weight. Ultimately, as should come as little or no surprise, CALORIC BALANCE is the major determinant of weight loss, regardless of the composition.

So...which diet? HIGH protein, LOW carb diets have a very high satiety effect- you are simply not as HUNGRY when you restrict calories if there is a high protein content. Several studies have demonstrated that the less hungry (more satiated) people are, the higher their compliance rate with a calorie restricted diet. This sounds rather obvious- if you are not hungry, you won't "cheat"- BUT...remember most of us do not eat because we are hungry. We eat because we are happy, sad, mad, bored, distracted- you name it. (See related post "Break the Eat, Repent, Repeat Cycle").

Are high protein diets safe for the kidneys?  A 2012 study at the Indiana School of Medicine confirmed that low carb, high protein diets do NOT cause any harm to the kidney function in obese patients who had healthy kidneys at the start.

What about the heart? A very large study this year in Sweeden (>40,000 women) did show that women do develop an increased risk of cardiovascular disease (heart attacks & stroke) if they stay on a low carb/ high protein diet long-term.  However, in the short term (at one year), low carb/high protein diets are more effective in weight loss and reducing cardiovascular disease risk.

BOTTOM LINE: Low carb/ high protein diets may help you lose weight in the short term (~ a year), but for long-term weight maintenance or continued weight loss, go for what you know to be healthy- MORE fruits & vegetables & a lean protein source. 

You're "Obese"- Now What?

Yesterday's WAKE UP blog entry referred to the USPSTF recommendation that all patients who have a BMI >30 should be referred to an "intensive, multicomponent behavioral intervention" in order to lose weight and therefore decrease their health risk. These recommendations are evidence-based, focusing on patient outcomes (disease states, not purely lab numbers).

What is "intensive"? 

• 12-26 sessions per year (often weekly to begin, then monthly.)

What is "multicomponent"?

• Individual or group sessions with physicians, dietitians, and other trained providers
• Include physical activity
• Address issues that keep people from changing behaviors
• Encourage self-monitering of nutrition and exercise

What results can be expected? 

• Weight loss typically ranges from 8.8-15.4 pounds in the first year
• Glucose tolerance is greatly improved- in fact,  that there is a 50% decrease in new diabetes diagnoses in only 2-3 years 
• Cardiovascular risk factors are improved (lower cholesterol & lower blood pressures)

If your BMI is >30, you are more likely to develop heart disease, strokes, high blood pressure, diabetes, certain cancers (esophagus, breast, uterine, colon, kidney, thyroid,  and gall bladder). It doesn't matter if you LOOK "okay"- this is NOT a cosmetic issue! While 15 pounds may not be all you need to lose, often that is enough weight loss to make a very significant positive impact on your health

BOTTOM LINE: Talk with your doctor about your BMI at this year's annual physical, and prioritize a healthier lifestyle starting today.

WAKE UP America- Courtesy of Colorado!

This summer I had the pleasure of spending some time in the gorgeous mountains of Colorado, a state which has long been one of the "healthiest" state in the nation- especially as measured by weight. Colorado has "only" 20.7% of the population with a BMI (body mass index) that indicates obesity, compared with 35.7% of overall American adults who are obese. That's ONE in THREE American adults who are obese! But I digress...my point was going to be that as our family watched some of the Olympics on tv, we saw a Colorado health-awareness commercial that I thought was extremely well done. The commercial shows people waking up in bed, challenging the Colorado population to actually "WAKE UP" and look in the mirror and see their true reflection- not the image in their head. The point is that obesity is "not as extreme as you think", and certainly my clinical experience echoes that thought.

Most adults are so comfortable with the notion that they "will never look like/ weigh what they did in high school" to the point that as they carry around an extra 20-30 pounds, it doesn't occur to them that they are jeopardizing their health in any way. And their physicians (who are not immune to the same beliefs for both themselves AND their patients) are along for that joy ride.

In June of this year, the  United States Preventative Service Task Force issued an update to physicians regarding screening for obesity. We are called to screen EVERY adult (which means get a weight & height & determine a BMI) and then for every patient who is obese- meaning a BMI >30- we should direct them to an "intensive, multi-component behavioral intervention". What is that and why? More on this tomorrow...

BOTTOM LINE: "WAKE UP", step on a scale & check your BMI today- don't assume weight is not an issue if you don't "look" or "feel" obese. 

PS. It's the FIRST of the month- change those air filters!

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.

The Secret to a Successful Exercise Program

Here in Austin, the temperature is already climbing into the upper 80's, so our swimsuit season has officially arrived. Unfortunately, most of us still have a bit of "winter fat" on us that we'd like to shed. If you have kids, it's easy to get caught up in the end of school year rush and push aside your own health priorities. After all, who's got the time?

Let me encourage you to MAKE the time. Make exercise a DAILY habit- just like brushing your teeth. Take away the whole "am I going to exercise today" dilemma. If you got out of bed, YES, some form of exercise will happen today. Period. You don't have to have an elaborate work out plan that consumes an extra hour simply to get to and from the gym! If you have the time, grab that gym bag, but if not, START MOVING. The "BEST" exercise is the plan you will follow every day. Extend that dog walk and make it two miles in a half hour; pull the clothes off the treadmill or exercise bike and hop on it to watch your favorite show; pull out your favorite exercise DVD or flip channels till you find a new one.

What's the secret to exercising every day? Do it FIRST THING in the morning, and don't give yourself a "choice" to hit snooze. Let me assure you, when my alarm goes off at 5:00am, I do NOT leap out of bed with a smile on my lips and a song in my heart! I grumble to myself, moaning and groaning a bit while I throw on weather appropriate clothes, leash the dog, and head out the door. That being said, by the time I reach the top of the first hill, I'm pleased with myself for getting out there, and I feel energized and ready to take on the day by the time I hit the shower.

BOTTOM LINE: START EVERY DAY with 30 minutes of exercise, and you'll stop worrying about whether or not you can "fit" exercise into your schedule!

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!

MORE Ways to Lose Weight in 2011

As promised, in keeping with the new USDA guidelines, I am returning to talk about my MORE philosophy that has helped many patients lose weight. When people decide they want to lose weight, what is the first thing that pops into their mind? DIET, right? So what's next- which foods am I going to cut out of my diet? Followed closely by feelings of deprivation, and then frustration and disappointment when they give in to a craving for that off-limits food.
What if, instead of focusing on LESS, you focus on MORE? I encourage my patients to simply INCREASE their fruit and vegetable servings. The goal is 5-10 servings per day, total, of either veggies or fruit. A serving is what comfortably fits in your cupped hand. Therefore, a salad like the one pictured here is roughly four servings- 2 handfuls of lettuce, one of shredded carrots and one of tomato. Easy, right?

What happens when you focus on MORE vegetables & fruit servings is no secret. You FILL UP on "nutrient dense" foods that are GOOD for you, and eat less of, well, everything else! It tends to be the complex carbs (think breads, crackers, muffins, cookies, chips) that pile on the calories, NOT the fruits, vegetables and protein.
Does this mean you are not "allowed" to eat those complex carbs? Absolutely not! What it means is that you will be focusing on MORE quality in your diet by pushing up those F&V servings, and that typically will automatically decrease your total calorie intake, which POOF- "magically" helps you lose weight.
BOTTOM LINE: It's not rocket science, my friends- simply consume less calories than you burn, and yes, you will lose weight. But do it RIGHT, and make sure you are not skipping any meals, and that you ARE eating foods packed full of vitamins and fiber...our friends, the fruits and veggies.

Do-Over! New Year's Resolutions: Take 2

Welcome to the second Monday in January! Have you "blown" your New Year's resolutions already? If so, you are not alone, and better yet: take a "Do-Over"! Why not let January 10th be another January 1st?

Quite honestly, I'd rather you start over EVERY Monday than simply chunk your resolutions. However, this time, really focus on something SIMPLE and CONCRETE that you can definitely attain. If you have been inactive, for example, don't commit to heading to the gym 5 days per week! Instead, if you have joined a gym, commit to going "on Wednesday mornings, with your buddy, who joined with you." Mind you, I'm not saying to AVOID the gym the other days, but make sure your resolution is something that is possible to keep, so you can feed on your success.

If weight loss is your goal, make sure that you have set realistic goals. It takes a negative 500 calories per day (either eating less or burning off more) to lose ONE POUND PER WEEK. And that is excellent weight loss! I can't tell you how many of my patients feel dejected if they "only" lose 2 or 3 pounds in a month, despite the fact that medically, this is terrific weight loss. Shows like "The Biggest Loser" are motivational, but realize that those participants are more than 100 pounds overweight to begin with, and have chefs and trainers round the clock. If you are only 20 or 30 pounds overweight, plan to lose that in ONE YEAR.

BOTTOM LINE: Keep prioritizing healthy food choices (MORE Fruits and Veggies) and MORE exercise, and 2011 will be a year of success and good health!

MORE Dieting Tips!

As we launch into 2011, many people are motivated to work on weight loss. Yesterday I mentioned a few simple dietary changes that can add up to BIG RESULTS when they become a permanent change. Today, I'd like to focus on my "MORE" concept. I have found that the majority of my patients (and friends and family) have an easier time improving the quality of their diet by focusing on INCREASING the amount of veggies and fruit they consume, rather than focusing on eliminating "bad" food.

Here is my specific recommendation:
Aim to eat 5 to 10 SERVINGS (what you can comfortably hold in your cupped hand) of vegetables and/or fruit per day.

That's it! Really, it's that simple. Don't freak out that there is "no way" to eat that many servings per day. I promise you that even young kids can easily follow this rule. Add in a banana or a handful of berries to your breakfast. Have your morning or afternoon snack include a serving (think an apple, carrots, raisins, etc.)
At lunch or dinner, include a generously portioned salad. If you have two handfuls of lettuce, plus one more handful of either tomato, shredded carrots, avocado slices, peppers, or your favorite vegetable, you've already got 5 SERVINGS! If you layer up the salad or simply add some vegetables to another meal (think yams, green beans, applesauce) then you are up to ten before you know it.

Ultimately, you'll begin to recognize that each meal should contain "color"- at least half the plate filled with vegetables and fruit. You end up filling up on these healthy choices, and eating less of all the extras (such as pasta, rice, bread) that have a much higher calorie count.

BOTTOM LINE: Focus on INCREASING your fruit and vegetable servings for a healthier 2011!