Have you been trying to lose weight unsuccessfully? Have you reached a weight loss plateau? If you are frustrated from dieting and exercising without seeing results, a Vitamin D deficiency could be to blame.

Recent studies have shown deficient levels of Vitamin D to be related to increased body fat, including visceral fat - or the fat around the abdomen. The exact mechanism is still not fully understood, but studies have established a correlation between rising rates of obesity and vitamin D deficiency.

What is Vitamin D?
Vitamin D is one of four fat soluble vitamins. It is made naturally in our skin when exposed to sunlight (UV rays). At first, this form of Vitamin D is not biologically active. It is converted in the liver and then in the kidney, to the active form of Vitamin D, calcitriol. Vitamin D helps the gut absorb calcium and phosphorus from food, promotes health of bone and teeth, and helps our immune function.  In addition to these benefits, newer research shows adequate amounts of Vitamin D can help you lose weight and lower body fat percentages.

How much do you need?
If you have had trouble losing weight and keeping the pounds off, you may want to consider having your doctor check your Vitamin D level.  Optimal levels are 32-55 ng/ml. Levels below 30 ng/ml are considered deficient. The DRIs for Vitamin D are 200 IU for adults under age 50. The DRIs increase to 400 IU/day for adults 51-70 and 600 IU/day for those over 70. Information regarding Vitamin D on nutrition labels is based on the recommended daily intake of 400 IU per day.  If your vitamin D level is low, you may want to increase your daily intake above the DRI for your age.  *Some experts are even recommending higher intakes of Vitamin D … so stay tuned!

Where can you get it?
Vitamin D status is influenced by both exposure to sunlight and Vitamin D in the diet. Unfortunately, very few foods contain Vitamin D naturally. The Vitamin D which most Americans get from their diet comes from fortified foods, such as milk. Milk is generally fortified with about 100 IU per cup. Other good sources of Vitamin D include fish, egg yolks, and fortified cereals. Don’t forget UV rays, which trigger your body’s natural production of Vitamin D in the skin. Sun exposure, without sunscreen, for 15-25 minutes a few days per week will allow for adequate synthesis of Vitamin D. But be safe and apply sunscreen after that! The table below lists some foods that provide Vitamin D in the diet.

Food Sources of  Vit D (in IU’s)
Salmon (~3.5 oz) = 360
Mackerel (~3.5 oz) = 345
Cannned Tuna fish (~3 oz) = 200
1 egg = 20
Swiss Cheese (1 oz) = 12
Fortified breakfast cereals (3/4-1 c)  = ~  40 (varies)
Sardines (1 3/4 oz) =  240
Fortified margarine = 40
Pure cod liver oil (1 tbsp) = 1360

 
What about supplements?
Vitamin D is supplementally available in two forms: D2 (or ergocalciferol), and D3 (or cholecalciferol). Both forms are regarded as effective, however, D3 may be more effective at raising serum levels.  If taking a supplement, chose one that contains a Vitamin D dose of 400-800 IU. Most multivitamins contain at least 400 IU. Also, calcium supplements, such as Calcium carbonate and Calcium citrate contain adequate amounts of Vitamin D.

There is no doubt that Vitamin D is important to your health and nutrition. Aside from helping with your diet, some evidence suggests that Vitamin D can help prevent osteoporosis, heart disease, some cancers and even depression. Ask for a blood test and make sure you are getting enough!

Check out this link for more info on Vitamin D and weight loss

 
I would like to thank Despina Hyde, RD at NYU Medical Center, NYC  for writing this article. Despina also helped me to write the Lunch Survival Guide - so make sure you download it if you haven’t already done so!

I often get asked by my clients  “Can I fit alcohol into my weight loss plan?” My answer would be yes - as long as you are accounting for your calories from alcohol and are drinking in moderation. So for example, let’s say that your weight loss calorie goal is 1300 and you choose to drink a 5 oz glass of wine a night for 100 calories. This would mean that you had 1200 calories left from food. You should be able to lose weight as long as you stick to your total calorie goal.

Here is a real life example of how you can fit alcohol into your weight loss eating plan and still lose weight. Esther, from “Esther’s Weight Loss Journey” is a NY city girl who lost 20 pounds by following a 1500 calorie diet. She had an active social life and incorporated alcohol into her eating plan several times week.  (See pic of Esther, second from the right) But she also was quite careful with what she ate and exercised at least 4 days a week.

But what if you are drinking alcohol in moderation and are not losing weight? I have come across some people who have a very difficult time losing weight, despite being diligent with their caloric intake and exercise regimen. Here is an example:

Comment from CGB reader Liz (in response to my previous post on dieting and drinking):
“I have been counting calories and working out regularly for about 6 months
If I drink, I have been keeping track of the additional calories so I never went over my calorie goals. The weight has been really difficult to drop. Like almost won’t come off difficult. I looked in my food diary one day and noticed I have been having a drink or two almost everynight. It frightened me not only because it is something I never payed attention to but also the fact that it became so routine, I never even recognized the cycle. I have stopped drinking and in a matter of a week, my clothes feel looser, I feel better and skinnier. My stomach started shrinking. I read some people have a trigger to alcohol that actually does make them retain or gain weight. It effects insulin and other chemicals in the body. My advise is just don’t drink it. You will notice an immediate difference within the first week.” 

What does the research say? As with many areas of nutrition, the research in this area is controversial. Some studies demonstrate a link between alcohol and weight gain, especially when alcohol is combined with a high calorie meal. This is likely due to the fact that alcohol acts as an appetite stimulant.

But not all studies support this link. Some clinical research indicates that replacing dietary carbohydrates with alcohol causes body weight loss, and adding a moderate amount of alcohol to an adequate diet causes little weight gain, according to Richard Mattes, Ph.D., R.D., associate professor at Purdue University.

So as we can see from the above studies, alcohol does not affect everyone in the same way. In my experience, I find that some of my clients experience more difficulty losing weight if they are consuming alcohol (or at least more than a few drinks a week).

My advice: If you are diligent with watching what you eat and are exercising on a regular basis and are still not losing weight, you will need to evaluate if alcohol is having a negative impact on your weight. Consider…

• How many calories are you consuming from alcohol? From my experience, many of us underestimate the amount of calories we consume from alcohol. We assume a glass of wine is ~ 100  calories (5 oz). But what if it is an 8 oz glass of wine? And what about your martini? Sure, a martini with 1 1/2 oz of vodka or gin may have 120 calories. But who has a martini this size? Most restaurants pour at least 3 - 4  oz. (Pic is of citygirls enjoying martinis)
  Check out my previous post on calories in alcohol.
• Does alcohol decrease your willpower to watch what you eat or increase your hunger at the meal when you are drinking?
• Does alcohol increase your hunger later on in the evening after you have had a few drinks? (dialing for Chinese food at 1 am, stopping in at the diner after a night out with the girls or late night snacking?)
• Do you have increased cravings the day after drinking or decreased energy levels for your workout?

If you are still having trouble losing weight despite being careful with your food intake, I would recommend that you experiment and avoid alcohol totally for 2-4 weeks like Liz did.  If you see your weight drop by a pound or two on the scale, you will know that alcohol is having an effect on your weight!

Are you in the mood for a crunchy snack that isn’t loaded with calories and doesn’t taste like cardboard? And one that comes in an portion controlled bag so you don’t scarf done the entire 6 servings in the package? I am always on the lookout for new snacks - preferably something that has some redeeming nutritional value. Here are my 2 finds this week:

 Orville Redenbachers 100 Calorie Mini Bags:
Most of us are aware that popcorn comes in 100 calorie mini bags. This is helpful for people who have problems with portion control. I recently discovered the Kettle Korn mini bags. These are great because the satisfy both the craving for sweet and salty.

Nutritional content:
Serving size: whole bag
Calories: 100
Fat grams: 1.5
Trans fat: 0
Carb grams: 21
Fiber grams: 3
Protein grams: 3

Smartfood Popcorn Clusters  Being a nutritionist, I often get food products mailed to me to sample. A few weeks ago at work, I was craving a sweet snack. Suddenly the mailman handed me a case of Smartfood Popcorn Clusters. Right on cue! I found them to be absolutely delicious (and had a difficult time eating only one of the mini bags….).

Here are the flavors: Chocolate Cookie Caramel Pecan, Crunchy Cranberry Almond Flavored, Honey Multigrain. You have to check out their website … very cute! Videos and lot’s of downloadable cartoons.

Nutritonal content
Serving size: whole bag
Calories: 120
Fat grams: 1 - 2 (depends on the flavor)
Trans fat: 0
Carb grams: 24-25
Fiber grams: 5
Protein grams: 1 gm or less
* Also contains 200 mg of calcium - great

Enjoy! And please send in any new tasty (and healthy!) snacks that you have found.

  If you recently purchased a box of cereal, yogurt, ice cream or a granola bar and took a glance at the ingredient list, you may have noticed the strange little word “inulin.”  What is this ingredient? Is it safe? Healthy? A natural component of plant foods, inulin is a type of dietary fiber that is often added to increase the fiber content of a product without increasing the caloric value.  Inulin is found naturally in a number of vegetables and plants including wheat, onion, bananas, garlic and chicory.  Most of the inulin that is added to commercial products is either synthesized from sucrose or extracted from chicory roots. (pic is of chicory roots)

Inulin is often added to replace fat or sugar and decrease the caloric value of foods such as ice cream, dairy products and baked goods.  With the addition of inulin, the modified product contains fewer calories and higher fiber content.  As a dietary fiber, inulin influences intestinal function by increasing stool frequency and weight, as well as decreasing serum triglycerides and blood cholesterol levels.  Perhaps the most well-known effect of inulin, however, is its action of stimulating bifidobacteria growth in the intestine.  Some of these bacteria, such as Lactobacilli, are thought to promote positive shifts in the microflora and promote intestinal health.  Due to the beneficial effects of inulin on these health-stimulating bacteria, it has been termed a “prebiotic.”

Considered an important component of many functional foods, inulin displays nutritional properties and plays a crucial role in bifidus stimulation.  However, keep in mind that inulin comes from purified powders, not the kind of fiber found in whole grains, beans, vegetables and fruits. These foods have been shown to lower cholesterol, reduce the risk of diabetes and heart disease and may cut the risk of colon cancer. But there isn’t much evidence that “isolated” fibers like inulin have the same effect.  That being said, inulin still has some health benefits.   So the next time you notice that strange little word in the ingredient list, be assured that you’ve made a good choice!

Source: Niness, KR. Inulin and Oligofructose: What Are They? J. Nutr. 129: 1402S–1406S, 1999.

I would like to thank  Jinan Banna, PhD, Dietetic Intern
 at New York Presbyterian Hospital for writing this article.

Mmmm … who doesn’t love the taste of raw cookie dough? I even know some people (not me) who buy the tollhouse cookie dough and eat it before they can make it into cookies. Well, now Federal health officials are warning consumers to throw out packages of Nestlé Toll House refrigerated cookie dough because of risks of an E. coli infection. Nestle has recalled it’s Nestlé Toll House refrigerated cookie-dough products, ranging from chocolate-chip bars to tubs of gingerbread cookie dough.  The U.S. Food and Drug Administration said since March, 65 people in 29 states have fallen ill with symptoms caused by e. coli bacteria after eating Nestle Toll House dough raw.  Check out this link for the full list of products to avoid.

In the past we seen numerous contaminated foods, including ground beef, peanuts, pistachios, spinach, and now cookie dough.  If this continues, what will be left to eat?

Check out this link for the full article.

For those of you who missed my post last month about entering a contest to win a free gym membership, I am going to post it again! The contest ends Tues, June 20 … so get going if you want to enter it.

If you have an inspiring lifestyle change story to share, all you have to do is to send it in email or video format Jared’s blog and you’ll be entered to win a free membership to a health club of your choice ($600 value). Ok - so maybe it won’t cover the whole cost of Equinox or Reebok Sports Club, but it can help!  (pic is of me and Jared)

Fresh n’ Fit sweepstakes is hosted by Subway and Jared Fogle. For those of you who don’t know Jared, he is the guy who has been featured on Subway commercials for losing 262 pounds eating Subway sandwiches. I had brunch with him a few months ago and heard his “weight loss story”. Check out the post on My Breakfast with Jared.

The contest is being held now through the end of June. Check out Jared’s blog for more details and the contest rules.

I would encourage all of you to who have a lifestyle story to enter the contest. Not only can you help to inspire others, you can win a free health club membership. This will encourage you to continue your healthy habits. Win - win situation.

Good luck to those who enter the contest!  YOU MUST POST YOUR STORY ON JARED’S BLOG IN ORDER TO ENTER.   SEVERAL OF YOU SENT IT TO CGB LAST MONTH, BUT YOU MUST SEND IT TO JARED. Feel free to post your story on CGB as well. We would love to hear your story - but the judging takes place on Jared’s blog.

Good luck to all who enter the contest!

You made a healthy dinner choice in one of your favorite restaurants and are feeling rather proud that you bypassed the bread, got  salad dressing on the side and ordered grilled fish and veggies (instead of that steak you really wanted).  Suddenly the waiter appears with the most decadent dessert you have ever seen saying  ”compliments of the chef”. What should you do?

Possible thoughts going through your head…
Give me that fork - asap!
Maybe just one bite
I was really “good” at dinner so I deserve to have a few bites
I will just take a few bites - no sense being rude to the chef / waiter
It is free, why not!
I’m not going to have even one bite as that will set me off as sweets are a trigger food and I won’t be able to stop
I’ll do 30 minutes extra on the treadmill tomorrow to burn it off

My personal dessert story
This scenerio actually happened to me last weekend at The Orchard in NYC - except that my meal wasn’t quite as virtuous as the one I described above. While I am generally on the careful side when I order in a restaurant, that night  I decided to let loose (somewhat!). Three of us shared a  mushroom flatbread (See pic- sauteed seasonal mushrooms, polenta, mushrooon puree and fresh herbs) and pasta (fresh cavatelli, crispy pancetta, parmigiano-reggiano and a tomato cream sauce).  Both dishes were excellent … not too dietetic though. We  also ordered the tuna tartare. However the taste was  “off”, so we sent it back. No big deal. As we were getting ready to ask for the check, the waiter came over with some spoons and said “more things would be coming”.  Yikes! Two jumbo desserts were soon placed on the table in front of us.Warm flourless chocolate cake with vanilla gelato and an Apple Crumble made with baked apple-pecan crumble, carmelized apples, brown sugar crumbs and vanilla gelato.

So what did I do? I took bites of each … many many bites.  For those of you who have been following CGB, you know I have a problem with control when it comes to chocolate. And after a few glasses of wine, my willpower gets even worse!

How to recover from a dessert episode:
1. Don’t beat yourself up. One episode of overindulging won’t affect your weight. Remember it takes an extra 3500 calories to promote a one pound weight gain. Unless you ate 2 pints of Ben & Jerry’s ice cream, you didn’t consume 3500 calories!

2. If this is happening to you fairly frequently, you will need to evaluate the situation. I have some clients who frequent the same restaurant (s) and are friendly with the staff. They almost always get complimentary desserts sent over to the table. This can definitely be a problem. If that is the case,  you may want to tell them you appreciate the gesture, but that you are really trying to watch your weight (or that you have high blood sugar or cholesterol).

3. Engage in some extra exercise the next day. However keep in mind that you have to run at least 6 miles (or the equivalent) to burn off what you just ate. Unless you are a major athlete, don’t start rationalizing that you can burn off the calories from frequent splurges with exercise. You would have to spend hours a day in the gym. In addition, the calories that the machines in the gym say that you burn can be overestimated by at least 30%.

4. Cut back a bit on what you eat the next day. However don’t go too low as this can create a starve/binge mentality. Eat healthy but carefully.

Check out my previous posts on:

Getting back on track after a holiday splurge

Recover from your superbowl splurge

You know strawberry season is here when you see the boxes stacked on the street vendor carts or when you see the prices drop in your local expensive gourmet market. I’m always so happy when the warm weather comes because you know along with it comes the summer fruits. They are low in calories, delicious and full of nutrients. And so many good ones to choose from (unlike the rather boring winter choices … in my opinion!). Strawberries happen to be one of my favorite fruits. I recently found out that they are America’s favorite fruit as well. I had the opportunity to meet with the California Strawberry Commission a few weeks ago. They presented me with  nutritional info on strawberries, a great book called 101 Foods That Could Save Your Life  by David Grotto, RD, LDN  as well as a huge basket of the best tasting strawberries I have ever tasted. My people in my office couldn’t keep their hands away from it. (Pic is of me and Chris Christian from the California Strawberry Commission)

Here are some  Strawberry Facts:
- America’s favorite fruit
- Available year-round
- Enjoyed by the vast majority (94 percent) of Americans
- Have more vitamin C per serving than an orange
- Naturally low in sugar - only eight grams per serving
- Rank second among the top ten fruits in antioxidant capacity (TAC)
- May help reduce the risk of heart disease, fight some types of cancer and lower blood pressure
- Only 50 calories for 8 medium sized strawberries

My favorite ways to eat strawberries:
1. Sliced into Greek yogurt (my obsession!)
2. Made into a smoothie, with ice and yogurt
3. Dipped in a little dark chocolate (yes, I need my chocolate fix)
4. Sliced strawberries with a splash of high quality balsamic vinegar (may sound a little strange … but delicious)
5. Strawberries with a little low fat whipped cream
6. Strawberries with champagne!

Tips on using strawberries
- Wash prior to eating
- When strawberries aren’t in season, I buy frozen berries and add to yogurt. Frozen are nearly as nutritious as fresh as they are frozen soon after picking. This preserves the nutrients.
- If you live in NYC and buy them from street fruit cart, eat them soon as they go bad quickly! I often get overly ambitious my quest to eat strawberries and end up throwing moldy boxes out!

The California Strawberry Commission has a great website - check it out.
- For recipes, check out this link Warning: they are not all dietetic! 

- Strawberryville (for kids or maybe some adults … ) Fun, Facts, Recipes and Downloads. Very  cute!

- For more scientific studies on the health benefits of strawberries, check out this link

Looking for that extra edge to make your healthy diet even healthier? Most of us know the basics as to what is a healthy diet ….  eat a lot of fruits and vegetables, whole grains versus refined grains,  choose the good fats such as olive oil and nuts/seeds, low fat dairy versus whole milk dair and so on. However you can take it a step further. Read on for 8 ways to make healthy foods even healthier.

1. Sprinkle turmeric powder in marinade when grilling or baking chicken
Turmeric is a powerful anti-inflammatory with numerous proven healing properties.  It is one of the main ingredients in curry powder which gives food that yellowish color.

2. Chop up fresh garlic for your vegetable stir fry
Garlic acts as an anti-inflammatory and antioxidant with cardiovascular benefits and it can also help with acne.

3. Place sliced pineapple on your lean ground beef or turkey burger
Pineapple is high in vitamin C and bromelain, a natural anti-inflammatory that encourages healing and promotes digestion.

4. Throw some blueberries into your oatmeal
Blueberries are low calorie, have lots of flavor and are high in vitamins and minerals, especially vitamin C. Research shows they are great for the mind too. Buy them fresh or frozen!

5. Top off low fat frozen yogurt with chopped pistachios or almonds.
Both are high in vitamins and minerals, fiber and can be a great source of protein.  Protein and fiber help stabilize blood sugar, keeping you satisfied for longer periods of time. Nuts are also a great snack if you’re in a hurry or on the run.

6. Use low fat Greek yogurt instead of mayonnaise in tuna salad
Low fat Greek yogurt provides fewer calories and fat without sacrificing the taste. Yogurt is an excellent source of calcium, protein and probiotics which promotes digestive health. Studies show it can also aid in weight loss.  Look for live and active cultures and stick with low or non fat brands.

7. Stick with hummus as your “go to” spread for whole grain toast.
Not only is hummus low in calories and fat compared with butter but the chickpea and oil puree is packed with blood sugar stabilizing protein, fiber and not to mention heart healthy monounsaturated fats. Try experimenting with different flavors or make it yourself at home!

8. Slice up some avocado to put in your mixed green salad.
Avocado is another great source of monounsaturated fat plus vitamin E and potassium.  It is also great for your complexion and can add shine and moisture to your hair and nails.

I would like to thank Lisa Moskovitz, dietetic intern at New York Presbyterian Hospital for writing this article. Lisa received her B.S. in nutrition from Syracuse University.  After gaining experience as a clinical dietitian in a hospital for a few years, Lisa aspires to gradually build her own private practice, specializing primarily in sports nutrition and gastrointestinal disorders.

What do these three people have in common:  a chef from Butter (a hot NYC restaurant), a cardiologist and myself? No, we weren’t trying to raise cholesterol levels cooking with butter! We were presenting “Recipes for Hypertension Management” for Novartis last night in Tarrytown, NY at the Westchester Marriot. “Recipes for Hypertension Management” is a program designed to educate physicians on ways to help their patients better control hypertension through diet, lifestyle, medication and healthy cooking.

The event consisted of an open bar, appetizers, a full meal (cauliflower soup with roasted tomatoes, swordfish, steak - lean of course - roasted veggies and potatoes),  2 lectures and a cooking demonstration.We started off the program with a lecture from Dr. Meagher. I followed with a lecture on lifestyle tips for hypertension management.  But of course, the highlight of the evening was the cooking demonstration by Chef Alex.

I have done numerous “Recipes for Hypertension Managment” with Novartis, but I must say this one was the most entertaining. Chef Alex had the audiences in stitches during the entire cooking demonstration with her stories. All the while she was preparing a delicious and healthy Cauliflower Soup with Roasted Tomatoes. Who ever thought cauliflower could taste so good! I would have thought it was loaded with cream it was so rich -  but of course it wasn’t! I will post the recipe in the next day or so. (pic is of Chef Alex and myself).

Questions from the audience:
1. For Dr. Meagher: Do omega 3’s, calcium, garlic and Co Q 10 lower blood pressure?
Answer: omega 3 and calcium do, the others do not.

2. For Chef Alex(this question was from me!): How much oil do you add to grilled fish or chicken? And do you “top off” steak with butter?
Answer: about ½ Tablespoon. No, we do not top off steak with butter.

3. For chef: Do you cook a lot at home on your free time?
Answer: absolutely! I will go to the green market, buy fresh organic fruit and make a lattice pie!! Wrong….. the last thing I want to do is cook when I get home. Would a cab driver want to drive his cab around on his day off? (See what I mean – Chef Alex was hysterical!)

4. For Martha: How difficult is it for the average person to follow the DASH (stands for Dietary Approaches to Stop Hypertension) ?
Answer: Very difficult. Only about 20% of people with hypertension actually follow the DASH diet. (I will talk more about this diet in a later post). However it can be done with a lot of effort and planning. Eat yogurt and fruit for snacks. Eat big salads with a lot of veggies for lunch. Lean protein, veggies and whole grains for dinner. Whole grain cereal, nonfat milk and fruit for breakfast.

* Be sure to check out Chef Alex’s cooking at Butter if you live in the NYC area! And BTW - the restaurant, although named Butter, does not cook with butter!

Kudos to Novartis for presenting these informative programs to help educate physician on diet and lifestyle tips to help control blood pressure. Many other pharmaceutical companies just discuss medication options.

Check out my previous lectures for Novartis on “Recipes for Hypertension” with other great chefs:
Brooklyn, NY with Chef Bellanco

Greenwich, CT. with Chef Tramante

NYC with Chef Rippert

Chicago with Chef Tramonte