The guys have entered into the second half of the competition and some of them are going strong …while other appear to be struggling. 4 of the guys have lost between 10-20 pounds in the past  7 weeks. Excellent progress! Unfortunately several of the guys have gained a little weight since the beginning of the competition. Losing weight is not easy!

 Tomorrow, I will post some tips on how to break a weight loss plateau.

Results for week 6  

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Irregular periods? Trouble losing weight? Weight gain in the abdominal area? Hair growth on your face and/or body (where hair shouldn’t be growing)? Experiencing hair loss? If you are experiencing some of these symptoms, you may have a common hormone abnormality called polycystic ovarian syndrome (PCOS). It affects between 7-10% of women. Many women don’t even know they have it. If you have any of the above symptoms, take this PCOS quiz.

I have been working with women with PCOS for the past 10 years. Approximately 10-15% of my clients have PCOS. Check out my previous post for more info on PCOS. Through my experiences in working with these women, I have found the following lifestyle recommendations to be helpful to women with PCOS.

Lifestyle recommendations for PCOS:

 • No one diet works for everyone. Each plan must be tailored to suit the individual. In my experience, I have found that women with PCOS who are very insulin resistant, especially if they are obese, often have an easier time losing weight and feel better on a lower carb diet. However this doesn’t mean that every women with PCOS needs to be on a very low carb diet.  (Pic on the right is of me lecturing on Diet and PCOS to staff members at Reproductive Medical Associates - RMA- in NYC).

• Do not think of this as a short-term diet but rather a healthy eating plan to be followed for the long term. I don’t even like to use the word “diet” as it implies deprivation and something short- term.

• A priority in treating insulin resistance is weight loss. This is more important than the macronutrient composition of the diet. Even losing 5-10% of body weight will help decrease symptoms of PCOS.

• Exercise is a key factor in decreasing insulin resistance. The ideal program includes an aerobic and resistance training component. The resistance training component should focus on light weights and more repetition. 

• All calories count – whether from protein, fat or carbohydrate. This must be emphasized as it is common to see women who feel they can eat unlimited amounts of protein and fat as long as they keep the carbohydrate intake low. A hypo caloric diet must be adhered to if weight loss is to occur.

Use the following formula to determine your caloric needs:

For weight maintenance
- 10 calories per pound for women who are obese, very inactive, or chronic dieters 
- 13 calories per pound for women over age 55 who are very active
- 15 calories per pound for very active women
- If you tend to have a difficult time losing weight and are obese, very inactive, or a chronic dieter, it is possible that you may need to use 8 or 9 calories per pound.

For weight loss 
- To lose 1 lb a week, subtract 500 from maintenance caloric level
- So if your maintenance caloric needs are 2000, you should consume 1500 calories a day to promote a one pound weight loss a week.

• Select lower glycemic index carbohydrates (ie. whole grains, fruit, vegetables, legumes, milk) instead of higher glycemic index carbohydrates such as rice, potato, white bread.

• Consume balanced meals that contain protein/fat and carbs. This will help to control blood sugar, keep you feeling full longer and ward of carbohydrate cravings. For example, a slice of whole grain toast with some natural peanut butter may be a better choice for breakfast as compared to a bowl of cereal with fat free milk for some women. The higher fat and protein content of the peanut butter may satiate you more than the higher carbohydrate content of the cereal.

• Very low fat diets are not recommended as they can lead to increased cravings. In addition, they can worsen insulin resistance. On the other hand, you should not go overboard with your consumption of fats as they are high in calories. For example, 1 T. of olive oil contains 120 calories.

• Select healthy fats. Limit saturated and trans fats as these fats can increase risk of heart disease by raising LDL cholesterol. Substitute unsaturated fat for saturated fat and trans fats. Monounsaturated fats found in found in nuts and nut butters, avocado, olive and canola oil are especially healthy. Include omega 3 fats (found in fatty fish, canola oil, leafy greens and walnuts) in the diet to decrease risk of heart disease. These fats may also improve insulin resistance.  
• Identify problem behaviors and work on making permanent behavior changes. Make small changes at a time. Food records have proven to be a very useful tool in identifying problem behaviors as well as helping you to limit your calories. Who wants to write down that they had 5 chocolate chip cookies? Check out this link for more info on food records.

• Pay attention to how your body feels after eating various foods. Which foods set off cravings or decrease energy levels? Which foods make you feel energized? This is very important to help you determine what kind of eating plan will work best for you.

• Suggested vitamin / mineral supplements: B complex if you are taking metformin,  multivitamin with minerals,  calcium 1000 mg – 1500 mg  (if unable to consume enough from the diet). I would also recommend 1-2 grams of omega 3 fatty acids from a supplement if you are not eating fatty fish at least 3 times a week.

• Practice stress management. Being stressed can raise cortisol levels, which in turn, can worsen insulin resistance. I’m sure we have all heard of high cortisol levels linked to “belly fat”. And, no - those pills such as cortislim don’t lower cortisol levels nor do they get rid of belly fat!

• Get adequate sleep. Being sleep deprived can worsen insulin resistance, make weight loss more difficult and can intensify your carb cravings.

For more helpful info on PCOS, check out this book:  A Patient’s Guide to PCOS: Understanding–and Reversing–Polycystic Ovary Syndrome by Walter Futterweit 
I wrote the 2 chapters on diet and PCOS. Numerous meal plans are included.  

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Question from Joe: Excellent article on wine.  Are there any “low carb” wines?  After all they have light beers.

Answer from Martha: Glad you enjoyed the wine article! You asked a good question. Many people assume that wine is high in carbs because it is made from grapes. However, in the process of making the wine, yeast is used to ferment the grapes. Much of the yeast “eats up” the carbs in the grapes, leaving the wine with a minimal carb content. This fermentation produces alcohol. In general, a dry wine has little residual sugar (or carbs), whereas a sweet wine can have quite a bit.

While the carb content will vary somewhat when it comes to specific wines, on average, 4 oz of a dry white and dry red wine has ~ 1-2 grams of carbs, whereas 4 oz of a sweet dessert wine, sweet sherry or port will have 8-12 grams. Most distilled spirits such as vodka, gin, tequilla, etc. have negligible amounts of carbs. The carb content will be increased with mixers such as sour mix, regular soda, etc.

Of course, as I had mentioned in my recent post on wine, you need to pay attention to the portion size of the wine. Many bars and restaurants double this “4 oz” size therefore the carb content as well as the calorie content may double. For most people, the calorie content of wine and other types of alcohol is more of a concern than the carb content - at least when it comes to weight control.

 Of note, not only is  most alcohol low in carbs, it can actually cause hypoglycemia (low blood sugar) in diabetics. So therefore it is important for a diabetic to eat a little food along with the alcoholic drink. Actually, this is not a bad thing for all of us to do!

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Making permanent changes in behaviors are difficult - whether the changes are in your eating, exercise, drinking, or even shopping habits. For example, I am sure you know that eating a candy bar in the afternoon is not the healthiest habit, but how do you go about stopping yourself from doing it if you are an emotional eater when your boss assigns you another project at 4 pm … to be completed by the end of the day?

I’d like to share an email I received from a client whom I had worked with in July 07  for several months on a weight loss eating plan. She has been successful in making behavior changes.

Here is some background info on the client:

K.N. is a 23 year old women who weighed 162 pounds and was 5′10. She wanted to get to a goal weight of 150 pounds. K.N.  had a busy work and social schedule, frequently having business dinners during the week and eating out with her boyfriend on weekends.  She usually skipped dinner but “grazed” most of the night on peanut butter, apples and cheese. This grazing dinner frequently came to 1000 calories. She was really hungry at that time because her lunch often didn’t include enough protein nor did she have an appropriate afternoon snack. Her afternoon snacks tended to be something like granola bars.  She was a carb craver but had omitted most bread during the day in an attempt to lose weight. However, when the bread basket came with dinner, her “no bread” rule went out the window due to her hunger.  She usually exercised 3 times a week.

 Here is an email I recently received from K.N:

Dear Martha,
You may not remember me- I very unfortunately was unable to continue meeting with you beginning this past fall because of various family emergencies that limited my ability to meet with you on a regular basis, but I hope to be able to begin with you again soon.
In any case, I wanted to tell you how very much you have helped me with my eating habits and my attempts at weight loss.  I have lost 7 lbs over the last few months and could not be more pleased!!! I feel very much in control of my eating and feel I have found a ‘happy medium.

Few things that have helped me in particular: your great advice to keep hard boiled eggs in my refrigerator at all times– I eat the egg whites only (unless I feel I need a little extra ’something’ and have part of the yolk) and often have two egg whites for breakfast with some fruit, which I really love!  I also keep string cheese in my fridge at all times and find both are great things to have to snack on when needed. I have focused on having a piece of fruit as my ’snack’ mid morning and mid afternoon- (instead of a granola bar or something sweet) and this has made a huge difference in my control of cravings and energy levels.  I really love fruit and had sworn off it in attempts to limit my sugar in previous years, but ended up eating too much cheese or wayyy too many nuts to make up for it!

I also followed your advice on having more broth-based soups before meals and find they really help fill me up with relatively little calories (Also very welcome in the winter months in particular!)  I also got over my ‘fear’ of sandwhiches which you were great to point out are not necessarily the enemy–and have found that a small turkey sandwich on whole wheat toast with tomato / cucumber /lettuce and either a tiny bit of light mayo or mustard (from Lenny’s) for lunch fills me up, is very satisfying and yet ends up being a whole let less total than a large salad where I mix in all sorts of things that add up- and still inevitably leaves me feeling hungry afterwards!

I found that when going out to dinner, if you focus- you really can avoid indulging in the bread basket- and it only becomes more of a habit the more you do it- until you hardly think of it anymore!.. I have continued to be disciplined at going to the gym 4 times a week- and it continues to lift my mood and give me lots of energy.

Thank you so much for all your help- you have truly helped me so much.
 
P.S. I recently bought a new product that I was curious to see what you thought of- the Planters ‘Nutrition- Digestive Health Mix’ they recently came out with. It is super super yummy and I think is a nice change from nuts alone (so long as you can portion control of course) but I don’t know if I am just falling in their marketing trap. It is a combo of pistachios, almonds, cranberries, granola and cherries-  they say serving size is 1/4 cup (8 servings per container) with 150 cal, 70 from fat- 8 grams of Fat, 17 grams of carbs, 3 grams of dietary fiber, 11 grams of sugar and 4 grams of Protein. 
Also- is there much cholesterol in egg whites? Is it a problem if I have them everyday?
 
Thanks again for your help!

My answer to K.N:
1. That Planters product you described sounds fine as long as you can control your portion.

2. Egg whites don’t contain any cholesterol or fat and are very low in calories (only about 15 calories per egg white). You can definitely eat them daily!

Check out my other ideas for breakfast choices,  snack tips and crunchy snacks.

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If you’ve been having difficulty losing weight, will changing from diet soda back to regular actually help you lose weight?  Or putting a few packets of sugar into your coffee instead of the artificial sweetener?

A new study that came out this week suggests that consuming artificially sweetened foods/ beverages will somehow trigger your brain to consume more calories later in the day. So while you may initially save the 30 calories from 2 packets of sugar or 120 calories from a can of regular soda, you will more that make up for it with extra calories later in the day. Their theory is that when you (actually rats which were used in the study) eat something sweet, the body actually gears up to start digesting this sweet food/drink. When it doesn’t actually receive something caloric, the body will actually consume more calories later on or expand fewer calories in the form of activity.

Here is the actual study:

Artificial sweeteners linked to weight gain

Cutting the connection between sweets and calories may confuse the body, making it harder to regulate intake.

WASHINGTON — Want to lose weight? It might help to pour that diet soda down the drain. Researchers have laboratory evidence that the widespread use of no-calorie sweeteners may actually make it harder for people to control their intake and body weight. The findings appear in the February issue of Behavioral Neuroscience, which is published by the American Psychological Association (APA).

Psychologists at Purdue University’s Ingestive Behavior Research Center reported that relative to rats that ate yogurt sweetened with glucose (a simple sugar with 15 calories/teaspoon, the same as table sugar), rats given yogurt sweetened with zero-calorie saccharin later consumed more calories, gained more weight, put on more body fat, and didn’t make up for it by cutting back later, all at levels of statistical significance.

Authors Susan Swithers, PhD, and Terry Davidson, PhD, surmised that by breaking the connection between a sweet sensation and high-calorie food, the use of saccharin changes the body’s ability to regulate intake. That change depends on experience. Problems with self-regulation might explain in part why obesity has risen in parallel with the use of artificial sweeteners. It also might explain why, says Swithers, scientific consensus on human use of artificial sweeteners isinconclusive, with various studies finding evidence of weight loss,weight gain or little effect. Because people may have different experiences with artificial and natural sweeteners, human studies that don’t take into account prior consumption may produce a variety of outcomes.

Three different experiments explored whether saccharin changed lab
animals’ ability to regulate their intake, using different assessments
–the most obvious being caloric intake, weight gain, and compensating by cutting back.

The experimenters also measured changes in core body temperature, a physiological assessment. Normally when we prepare to eat, the metabolic engine revs up. However, rats that had been trained to respond using accharin (which broke the link between sweetness and calories), relative to rats trained on glucose, showed a smaller rise in core body temperate after eating a novel, sweet-tasting, high-calorie meal. The authors think this blunted response both led to overeating and made it harder to burn off sweet-tasting calories.

“The data clearly indicate that consuming a food sweetened with
no-calorie saccharin can lead to greater body-weight gain and adiposity than would consuming the same food sweetened with a higher-calorie sugar,” the authors wrote.

The authors acknowledge that this outcome may seem counterintuitive and might not come as welcome news to human clinical researchers and health-care practitioners, who have long recommended low- or no-calorie sweeteners. What’s more, the data come from rats, not humans. However, they noted that their findings match emerging evidence that people who drink more diet drinks are at higher risk for obesity and metabolic syndrome, a collection of medical problems such as abdominal fat, high blood pressure and insulin resistance that put people at risk for heart disease and diabetes.

Why would a sugar substitute backfire? Swithers and Davidson wrote that sweet foods provide a “salient orosensory stimulus” that strongly
predicts someone is about to take in a lot of calories. Ingestive and
digestive reflexes gear up for that intake but when false sweetness
isn’t followed by lots of calories, the system gets confused. Thus,
people may eat more or expend less energy than they otherwise would.

The good news, Swithers says, is that people can still count calories to
regulate intake and body weight. However, she sympathizes with the
dieter’s lament that counting calories requires more conscious effort
than consuming low-calorie foods.

Swithers adds that based on the lab’s hypothesis, other artificial
sweeteners such as aspartame, sucralose and acesulfame K, which also taste sweet but do not predict the delivery of calories, could have
similar effects. Finally, although the results are consistent with the
idea that humans would show similar effects, human study is required for further demonstration.

In  my opinion…

1. This study brings up an interesting concept that clearly needs more research.  It has similar findings as a previous study that found a link between diet soda and increased of metabolic syndrome in children - so there possibly could be a connection between artificial sweeteners and appetite control. However further studies need to be done before the results can be called conclusive.

2. This study was done on rats (while the one with diet soda was done on humans).  Do humans have the same physiological mechanisms as rats?

3. I am not a fan of artificial sweeteners -  especially when consumed in excess. However, until further research is done, I wouldn’t recommend that you omit the lower calorie foods containing artificial sweeteners that you may be consuming and revert back to the higher caloric foods/drinks if you are trying to watch you weight.  For example, a nonfat light fruit yogurt has 90 calories or less while its “regular” counterpart has ~ 250 calories. A diet soda has no calories while the regular one has 120 calories.  On the other hand, if you want to consume the regular product, just be aware of the calories and work them into your eating plan.

4. You should pay attention to how your body feels as well as hunger levels after consuming these diet products. Perhaps you don’t feel satisfied after consuming them or have the mentality that “I can eat a little more because at least I saved some calories with this diet soda”. Have you ever seen people at McDonalds loading up with the Big Mac and large fries but still consuming a diet soda? You want to avoid this mentality!

4. In my private practice, I have noticed that sweet foods, whether artificially sweetened or sweetened with real sugar,  often trigger cravings in people. If this is the case with you, you should try to limit all refined sweets and focus more on natural foods such as fruit, nuts, nut butter on crackers, cottage cheese and fruit, whole grains, legumes, etc. Adding protein and/or a little fat to the carbs should help to control your cravings.

5. If you have been having trouble losing weight despite being careful with your calories and are exercising on a regular basis AND are consuming a fair amount of artificial sweeteners, it may worth it to try to avoid them as much as possible for a month or so to see if your weight changes.  Just an experiment!

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Question from Lyn: I work with the guys in the N.H. Biggest Loser Competition. Many of them dropped weight so quickly. I was wondering why guys seem to lose weight quicker than women?

Answer from Martha:  You are not the first person to ask me that question. I actually see this “sceniero” occuring in my private practice in NYC. For example, I frequently work with both the husband and wife on a weight loss eating plan. The guy often ends up losing weight significantly faster than the woman. It is quite frustrating for the woman as she is trying just as hard (if not harder!) than her husband to follow the eating plan. So why do men frequently lose weight more quickly than women? 

Here are some of the reasons:
1. Guys tend to weigh more than women. The more you weigh, the quicker you can lose.

2. Guys tend to have more muscle mass than women. More muscle means a faster metabolism and a faster metabolism usually means quicker weight loss. For example, if you had a man and a woman who both weighed 180 pounds and ate the same amount of calories and performed the same amount of exercise, it is likely the man would still lose weight more quickly.   

3. Women go through hormonal changes that can make it difficult for them to release stored body fat. Menopause is one of those times. In addition, some women also get significant PMS which can exacerbate cravings for high calorie foods (usually sweets or salty foods). While this is not an “excuse” for eating, it can occur!

4. Since guys tend weigh more than women, they can eat more and still lose weight. For example, a 200 pound guy who is exercising a few time a week can probably eat 2000 calories a day and still lose 1 1/2 - 2 pounds a week, while a 150 pound woman would who was also exercising a few time a week would need to eat only 1400 calories to lose 1 1/2 - 2 pounds a week. 1400 calories is a lot less than 2000!

Bottom line, women should pay special attention to the weight training component of their exercise program (along with cardio). This will help to build muscle mass which will speed your metabolism. And remember, slow and steady wins the race!  Some of the guys  in the New Hampshire Biggest Loser Competition who initially lost a lot of weight have put much of that weight back on. So quicker results don’t necessarily mean permanent results.

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Happy Valentines Day! I thought today was the perfect day to talk about if certain foods can help put us “in the mood”. We often hear that certain foods, such as oysters and chocolate have aphrodiasiac qualities.  I’ve also polled some city girls and guys to ask what gets them “in the mood”.

Tips to get in the mood

1. While a romantic dinner can be a great way to start the night, try not to overeat. This might not be the best night to try out the five course meal your local restuarant.  There is nothing worse than a bloated belly to kill the mood!

2. Avoid gassy foods such as legumes, cruciferous vegetables. I don’t need to say anything else in this topic…

3. Alcohol in moderation may lower inhibitions and help to set the mood.  However, when consumed in excess,  it definitely impairs sexual performance. Would the guy on the right get you in the mood?

4. You may have heard that oysters fuel sexual desire/performance. Oysters, along with other seafood, meats, seafood and liver are rich sources of zinc. Zinc is essential for production of testosterone . Healthy zinc levels are also vital to maintain sperm counts. However,  there is no evidence that proves oysters - or any other zinc rich food - will live up to its claims of enhancing libido.

5. Chocolate has been called an aphrodisiac throughout history.  Check out this link from WebMD for the full chocolate story. The following excerpt was taken from this story:  ”Chocolate contains small amounts of a chemical called phenylethylamine (PEA), a.k.a. the “love drug,” and it’s been linked to the regulation of physical energy, mood, and attention. A tiny amount of PEA is released at moments of emotional euphoria, elevating blood pressure and heart rate. There is no evidence that PEA found in foods increases PEA in the brain – although many chocolate lovers may beg to differ!”

While I am a huge chocolate fan, I must say that when I was devoring that chocolate cake, I don’t think I had thoughts of “love” on my mind … except for love of the chocolate cake!

I polled city girls and guys to see what would get them in the mood. Here are some of their answers:

- Champagne and strawberries

- Candles

- Lingerie (this was obviously from a guy!)

- “It doesn’ t take much!”

- A massage

- Working out together (ever try taking a bikram yoga class?)

- The smell of fresh paint (hmm… keep in mind we are in NYC -you can’t expect total normalcy!)

Bottom line -  maintain a healthy lifestyle with regards to your diet and exercise. Keeping fit and healthy is the best way to boost your libido!

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Checking out the results from last weeks weigh-in, I think Superbowl Sunday may have had a negative impact on the guys progress. As I had predicted, the New England guys may have drown their sorrows in food and booze  (as evidenced by some of the weight gain).  In NYC, we were also engaging in some celebratory eating and drinking (check out my Super Bowl Splurge post).  Goes to show, all emotions, whether happy or sad, as well as social situations,  can trigger eating.

Moving on to the progress of the contestants … one of the co-workers of the contestants (pic on the right -identity withheld in fear of retribution) summed it up best, saying “The competition has started to take it’s toll on a few participants.  As you’ll see, there were a few “heavy” gainers this week.  In fact, some people seem to be frighteningly out of control…” 

Results of week 5: 

 Guys, all is not lost, despite the fact that some of you now weigh more than when you started. You still have 7 more weeks left. Just get refocused and buckle down! I will put up a post this week giving tips on staying motivated.

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So you only had 2 glasses of wine last night?  Ok, so what does “a glass” of wine mean? One serving of wine is technically 5 ounces. When was the last time you were served 5 oz of wine in a restaurant or bar? Probably not recently. Most places tend to serve portions that are significantly larger than 5 ounces  (unless you are in a really expensive restaurant where they actually do pour a 5 oz glass of wine for $15!).

 Here is an example. I went out with several of my girlfriends to a bar/restaurant called Peter’s on the upper west side. I ordered a cabernet. I actually like drinking red wine from a larger glass. But this glass was the size of a fish bowl and it was almost filled with wine. It had to have been almost 12 ounces. Of course, it’s nice to get good value for your money.

On the other hand, there are a few “cons” to this jumbo glass of wine.

- More calories than you think. This is not a 80 calorie glass of wine, but close to 160 to 200 (if it was 10-12 ounces)
- You may feel compelled psychologically to have another glass … because after all, so far you’ve only had one glass of wine. But if we are talking in standard serving sizes, that one jumbo glass of wine was really 2 or more glasses.  
- The guys around you suddenly start looking cuter than they really are…

More alcohol is consumed from larger wider glasses
Studies have shown that we consistently drink more when served from larger wider wine glasses, such as those used for red wine as compared to a smaller slender glass used for white wine.  Dr. Brian Wansink, in his book Mindless Eating, has done numerous experiments on people showing how we eat and drink more than we think.  Check out this link for details on these studies. These particular studies were done with with college students and professional bartenders showing that we pour more and drink more from wider larger glasses. 

Bottom line:
1. All glasses of wine are not created equal (and I’m not just talking about taste!)  A “glass”  is not necessarily the standard serving size of 5 ounces.

2. When drinking at home, use smaller more narrow glasses rather than shorter wider glasses. You will drink less whether it be alcohol, milk, juice, etc.

3. Or if you have your heart set on drinking from your jumbo red wine glasses, just be aware of how much wine you are pouring!

Check out these previous posts:

Calories in alcohol
Does alcohol cause weight gain?
Tips to deal with the dreaded hangover

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My apologies to Laura Cipullo, the author, for the error in the version sent out by email yesterday. Her article is correct now! I was having a little trouble with word press yesterday…

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