You’ve probably heard the word organic a lot lately and perhaps you are wondering what organic actually means and if it’s really worth the hefty price tag.  First, let’s make one thing clear, in the food world, organic and natural are not synonyms and neither of them independently mean that a product is healthy.  The word “natural” is over-used when it comes to food so read the ingredients label to decide if a product really is natural.  Cookies, chips and other snack foods may contain organic ingredients, but that alone does not make them a healthy option.

So, what does the term organic actually mean?  The United States Department of Agriculture (USDA) is responsible for the certification of organic foods.  The USDA defines organics as products produced “using materials and practices that enhance the ecological balance of natural systems to minimize pollution from air, soil and water”.  This means that organic food is not genetically modified and is produced with minimal use of fertilizers, herbicides and pesticides and in the case of animals without antibiotics or growth hormones.  In order for a product to have a USDA organic seal, it must be at least 95% organic.  100% organic products will usually be labeled as such.  A product labeled with the statement “made with organic ingredients” must contain at least 70% organic ingredients; these products will not have an organic seal.
 
Benefits of eating organic foods
Two known benefits of eating organic are: reducing environmental pollution and limiting your exposure to pesticides, herbicides, chemicals, antibiotics and growth hormones.  None of the evidence against pesticides, growth hormones or other chemicals used in agriculture is significant enough for their use to be banned in the United States, however reported dangers associated with the use of these products include: genetic damage, nervous system damage, disrupted hormone function, infertility, cancer cell growth and harm to the skin, eyes and lungs.  There are studies that show increased vitamin and mineral concentrations in organic produce but there is not sufficient evidence to support a statement from the Department of Agriculture affirming that organic food is nutritionally superior to its conventional counterpart.

Is organic worth the cost?
The reason organic food is typically more expensive than conventional food is that organic farming practices are more expensive and organic farming results in lower crop yield. So, is ingesting fewer chemicals and reducing your carbon footprint worth the cost?  I like the idea, but I guess it’s ultimately a personal decision.  To help you out the Environmental Working Group have named the “dirty dozen” of produce; tests show that these foods have the most pesticide residue.  So if you do make the decision to try organics, these foods are a good start:

The “Dirty Dozen” include: apples, bell peppers, celery, cherries, imported grapes, nectarines, peaches, pears, potatoes, red raspberries, spinach and strawberries. Check out this previous post for more info on the most and least contaminated fruits and veggies - and how to clean them.

Organic meats, poultry and baby food
Organic meat and poultry products are also an important consideration.  Organic meat and poultry products cannot be given antibiotics or growth hormones, are able to roam outdoors, and eat only organic feed with no animal byproducts.  Additionally, for parents out there, organic baby food might be the way to go since smaller systems are more vulnerable to the toxic effects of pesticides and fertilizers.  (Again, there are no official recommendations to this effect).

Where to find organic foods
One of the many benefits of living in New York City is that organic foods are quite accessible.  Many branches of Food Emporium carry a good selection of organic foods.  Most specialty stores like Gourmet Garage and Whole Foods Market carry organic foods. You are almost always guaranteed a great selection of organic foods at any New York City Greenmarket.   For added convenience, Fresh Direct offers a myriad of organic foods as part of their delivery service.  If you need some help getting started, Healthy Living NY  offers lists of grocery stores, markets and even restaurants that serve organic foods.  Check it out, perhaps its easier being green than you think.
 

I would like to thank Allison Arnett, Dietetic Intern at New York       
               Presbyterian Hospital for writing this article. 

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Talk about losing weight… this guy from my gym lost 240 pounds! If you were to see him, it is hard to believe that he once weighed 445 pounds. He is one of the fittest guys I have ever seen. I had noticed him a few months ago because of his intense workout sessions on the eliptical trainer. I don’t think I had ever seen anyone workout that intense for such a long period of time.  When one of my friends at the gym told me this guy lost 240 pounds (yes - LOST 240 pounds!) , I had to introduce myself and find out the whole story. (Pic on the right is L.P when he weighed 450 pounds)

Here is my interview with “L.P”… This is probably the one of the most inspirational stories you’ll ever hear.

Martha: What is your current age, height and weight?
L.P: I am 46 years old, 5′9 and weigh 205 pounds. (Martha’s comment - while 205 pounds may sound a lot for someone who is 5′9 - L.P. does not appear to have an ounce of fat on him. I bet his body fat is 8% or less.) Pic on the right is L.P’s “after” pic

Martha: How much weight have you lost?
L.P:   240 pounds

Martha: How long did it take you to lose this weight?
L.P:  18 months

Martha: How did you lose the weight - did you count calories, follow any special diet, enlist support from anyone such as Weight Watchers, a nutritionist, doctor, etc.?
L.P:  I changed my eating habits and started paying close attention to sugars, carbs, fats as well as calories. I also did 2 hours of intense cardio a day.

Martha: Did you have a weight problem for most of your life?
L.P: No, I didn’t always have a weight problem. However, as I got older, I was exposed more to “bad ” food including fried foods, high sugar desserts and eating late at night.

Martha: What were your major problem areas when you were overweight?
L.P: I love desserts, used to eat late at night, ate really large portions and got no exercise.

Martha: I am very curious to know what triggered you to lose weight and how you stayed so motivated…
L.P: I was losing close relatives to high blood pressure, diabetes and cancer. I also had low self esteem, was self-conscious and was afraid of dying young.

 Martha: When did you first start to exercise (how long ago) and what did you first start to do for exercise?
L.P: I started to exercise about 11 years ago at a fitness center that was free to employees of my workplace. I started doing the treadmill for about 30 minutes.

Martha: You appear in great shape. What do you do for your current exercise program: (how many times a week, how many times do you weight train and perform cardio)?
L.P: My exercise regimen is 4-5 days a week of weight training and 7 days of cardio (winter time on the eliptical machine and summer time running outdoors). 5 of the 7 days, I do cardio in the morning and evening (for a total of 2 hours of cardio)

Martha: Can you tell us what you eat on a typical day for breakfast, lunch and dinner and snacks?
L.P:
Breakfast: oatmeal with banana and a protein drink (low carb, low sugar and high protein)
Lunch: 2 all-natural peanut butter and jelly sandwiches
Dinner: salmon or chicken and a sweet potato
Snacks throughout the day: rice cakes, oranges, protein bar, sugar-free pudding, yogurt with fruit. I also drink a gallon of water during the day.

Martha: Do you ever go off your “diet”?
L.P: Yes …without any guilt because I work out religiously on a regular basis.

Martha: How do you stay so motivated??????
L.P: It it helps me to stay motivated when other members of the gym come approach me and comment on my progress and body structure. I also like to help motivate other people and to see their progress.

Martha: Well, there you have it! For those city girls and guys who think losing 10 pounds is hard work, imagine what it would be like to lose 240 pounds! BTW - L.P has been approached to appear on various televsion talk shows to discuss his amazing feat. He declined all interviews. I would like to thank him very much for allowing me to interview him. I think he will be very inspirational to readers of citygirlbites who are trying to lose weight. It goes to show that you can lose weight and keep it off …with hard work! It also goes to show the importance of exercise when it comes to maintaining weight loss. Not only does exercise burn calories, it also will build/preserve muscle mass which will help to speed your  metabolism. I am certainly not saying that everyone has to exercise 7 days a week for 2 hours per session. But somehow you will need to make exercise a priority if you want to lose weight and keep it off!

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The Biggest Loser competition  in New Hampshire started today, January 2nd. I will be following the progress of the participants on a weekly basis.  I want everyone to meet the participants. At this point, none of the guys are interested in having their pictures taken! Maybe as they lose the pounds, they’ll change their minds.

 Meet the Participants:

What are your stats?

Participant #1   R.C:   Age 34, Height 6’1”, Starting Weight 202.1, Weight loss goal: lose 30 lbs.
Participant #2    R.G:   Age 34, Height 5’9”, Starting Weight 229.6, Weight loss goal: lose 24 pounds 
Participant #3   GenX’ er:   Age 38, Height 5’ 7”, Starting Weight 195.6, Weight loss goal: lose 23 pounds 
Participant #4   J.C:   Age 40, Height: 6′1  Starting Weight 195.7 pounds  Weight loss goal: lose 20 pounds
Participant #5:  John Ingemi   Age 43, Height 5’ 10, Starting Weight 233.3 lb, Weight loss goal: lose 42 pounds
Participant #6 T.L:   Age 37,  Height; 6’ 2’’, Starting Weight 234.9 lb  Weight loss goal: lose 30lbs 
Participant #7 :  no info available except Starting Weight: 202.1 lb

Briefly describe your current exercise routine:

R.C:    I have not been exercising since this summer.
R.G:    Up until 3 weeks ago I was running 10 to 15 miles a week. Some weight training. Spinning class an hour one night a week
GenX’er:   Not much at all.
J.C:     2-3 days a week, aerobic treadmill or bike, P/U basketball
John Ingemi:   On average I currently work out 5x per/week for 60 to 120 minutes per workout using a  combination of running, cycling, weight-lifting & most recently boxing.
T.L:    Running

What kind of exercise routine do you plan on doing for this competition?

R.C:   I plan to run and do light weight work at the gym.
R.G:    A lot of treadmill, elliptical, some bike, light weight training.
GenX’er:      Aerobic and anaerobic.
J.C:    Same but more of it and some weight training.
John Ingemi:   I plan on doing all the above, but more of it. Example: On several days I will do multiple workouts in one day. Perhaps stationary bike cycling before work, followed by lunch hour work-out, and on occasion an evening workout.  (This photo is not one of the participants!)
T.L:    Running

List what you eat now on a typical day (breakfast, lunch, dinner and typical snacks). 

R.C:   Typically, I have toast and peanut butter, banana, or yogurt for breakfast.  For lunch, I’ll have either a salad or sandwich.  Dinner consists of chicken, pasta or beef. 
R.G:    Breakfast – Egg and bagel or oatmeal, maybe some yogurt. Lunch – Roast Beef or Turkey Wrap with apple or banana Dinner –  It Varies; Steak, potato, other veggies (broccoli or corn); Chicken with veggies; Spaghetti, Try to have fish at least once a week
GenX’er:    Breakfast (coffee w/cream, bagels, breakfast sandwiches from DD, oatmeal, cereal) – anything really
Lunch (pizza, subs, Wendy’s) Ginger Ale
Dinner (anything my wife makes – spaghetti, pork roast, rice & bean, pizza)
Snacks (chips, granola bars, peanut M&M)
 J.C:    Coffee, breakfast sandwich,  sandwich w/chips and gatoraide. Usually some type of pasta and meat for dinner and ice cream
John Imgemi:  I eat & drink whatever I want. It’s awful…I am probably consuming in the range of 3,500 to 4,000 calories p/day, and usually overdo my evening intake significantly.
T.L:  No Breakfast, Light Lunch (soup, meat and small amount vegetable. Dinner meat and vegetables.

How alcohol do you typically drink in a week?

R.C:     I seldom drink alcohol. 
R.G:     6 beers.
GenX’er:  Two drinks a month if that…
J.C:   Not much, 2-4 drinks per week.
John Ingemi:   Too much. Probably on average 16 beers or drinks ( scotch or wine) per week.
T.L: 30 drinks

How long have you had a weight problem for?

R.C.:   About 6 years
R.G:    All my life, Type 2 Diabetes.
GenX’er:    Good question.
J.C:   I wouldn’t say I have one.
John Ingemi:   I started to put on extra weight in my late 20’s, when my body’s chemistry started to change, and my activity levels went down ( I also got married around this time…)
T.L:   Since I was 8
 
What are the biggest problem area that you have with regards to eating healthy and/or controlling your weight (i.e.  not enough exercise, too much booze, too much snacking, huge appetite, too much snacking,  eat out too much, etc.)?

R.C:  My biggest problem is laziness and lack of motivation.  Once I stop exercising, I do absolutely nothing!  Additionally, I’m a late-night grazer with sweets and cakes.  I eat when I’m full.
R.G:    Not  enough exercise, ,too much snacking, huge appetite,  like fattening foods, etc.
GenX’er:   Eating big portions, not enough exercise.
J.C:    Bad food choices, not enough exercise.
John Ingemi:   Not  enough exercise, too much booze, too much snacking, huge appetite, too much snacking, like fattening foods, eat out too much, etc.  I have a naturally slow metabolism. This, coupled with a giant appetite and an enjoyment for alcohol, is a recipe ( excuse the pun) for disaster. Especially for a 43 Y/O male.  One of the secrets to me winning this contest ( and I will win) is that I will track every calorie and every work-out, on every day.
T.L: too much booze, too much snacking, huge appetite, too much snacking, like fattening foods, eat out too much.

Have you participated in these competitions before? How much weight did you lose? How much did you keep off?
 
R.C: I am a past weight loss champion, but have struggled to regain my “winning ways”!  I lost over 30 pounds and did a pretty good job of keeping it off through a proper diet and exercise.   Once I stopped exercising most of the weight came back on.
R.G:    2003 – Started: 270 Ended: 246
2006 – Started: 228 Ended: 206
2007 – Started: 238 Ended: 213
GenX’er:  Yes, last year. I lost 12 lbs without exercising, just cutting my portions and watching my intake.  I kept 6 to 8 lbs off until Thanksgiving.
J.C:     Yes..I’ve lost around 15 lbs and generally indulge too much over the holidays and put it back on.  For most of the year I weigh around 185.
John Ingemi:   I am the original founder of this contest, having started it almost 10 years ago. I “won” that contest, losing a whopping 7 lbs…  Two years ago I really, really applied myself and came in second, losing 36.6 lbs. Started at 224 and finished at 187.4. 
Uhm… Well I kept most of it off for almost a year. I was motivated to do so cuz I was training for triathlons. After the season ended I took a break and gained weight. Then, last January, I started to compete in the annual weight loss contest, but trained too hard, too fast and injured myself. I am now back to above where I started when I came in second last time. 
T.L:  Yes, I have participated before. I lost 25 pounds and kept off  ½ of that weight.

Do you think you will be able to keep the weight off that you will lose in this competition?

R.C:    I hope so!
R.G:   I hope so. I want to make sure I stay under 220 at least.
GenX’er :   Yes, if I continue to exercise regularly.
J.C:    Yes, as long as I don’t slip back in to the junk food routine.
John Ingemi:    Yes, at least most of it. I have learned from my mistakes.
T.L:  No

Other info:
J.C:    I live on a farm w/my family and we have a number of horses, so I get quite a bit or exercise doing chores as well
John Ingemi:   I am no longer married so there’s added incentive to stay lean and fit… 

Best of luck to the participants.  BTW - we would love some pics of you!!!  Please post any diet questions that come up as you are going through the competition.

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What citygirl doesn’t enjoy a cocktail now and then? Meeting friends for drinks is the way many of us socialize. While consuming alcohol in moderation can actually be good for your heart, drinking alcohol in excess, especially in the form of binge drinking, can increase your risk of breast cancer.

What is binge drinking?
The generally accepted definition of binge drinking in the United States is the consumption of five or more drinks in a row by men — or four or more drinks in a row by women — at least once in the previous 2 weeks. Heavy binge drinking includes three or more such episodes in 2 weeks. 

-The frequency of binge drinking is up on college campuses across America, especially among women. Roughly 40 percent of college women who were surveyed binge drank at least once a month compared with roughly 50 percent of men, according to the Harvard School of Public Health’s College Alcohol Study which was set up to examine drinking behavior among men and women in college.  

-And more disturbing is that high school kids also have a high rate of binge drinking. One study showed that 28.8% of high school students reported binge drinking in the past 30 days.

- I haven’t come across any data on binge drinking in adult women. However from my personal experience of listening to what people eat and drink, I can say that binge drinking is still fairly common, even in adults. Binge drinking doesn’t have to mean getting sloppy drunk. A martini (this equals 2 drinks - or more) before dinner and 1/2 bottle of wine with dinner could count as a “binge” for a woman. I must admit that my friends and I have had nights where we have consumed more than 4 drinks…of course not on a regular basis!

Study shows connection between binge drinking and breast cancer
Researchers at the Center for Alcohol Research in Denmark tracked 17,647 women for 8 years. Those women who reported having 1-3 drinks a week versus non-drinkers had a small increase in breast cancer risk - about 2% per additional drink each week. Women who had 4- 5 drinks at a time once a week had increased their breast cancer risk by 55% relative to the women having one drink per occasion. Lina Morch from the Center for Alcohol Research says alcohol raises blood levels of estrogen, which is associated with breast cancer. Blood alcohol levels peak when binge drinking occurs. This may lead to a greater buildup of cancer-causing toxins than repeated low level exposure.

Bottom line, while alcohol in moderation (moderation = one drink a day for women and two for men) can fit into a healthy lifestyle, binge drinking is risky for many reasons, not the least being an increased risk of breast cancer. I would caution women to be especially careful with their alcohol intake if they have a family history of breast cancer.

 FYI - Check out these pics to see the difference in the brain activity of someone who drinks versus someone who doesn’t  (scroll down the page)

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Has anyone read the article titled in the Oct 1 issue of New York Magazine (unfortunately I don’t have a link to the article) titled “Why Most of Us Believe That Exercise Makes Us Thinner- And Why They Are Wrong” by Gary Taubes (here is more info on Gary Taubes) According to Mr. Taubes, we do not need to exercise in order to lose weight or prevent weight gain. On the contrary, he says, exercise can make you gain weight. So throw out your running shoes and cancel your gym membership. Yipee – more time for city girls to shop and party!

Mr.Taubes cites numerous studies that supposedly prove exercise plays no role in losing or maintaining weight … however something just doesn’t sound right with this theory. He agrees that exercise has health benefits, however it just doesn’t play a role in weight control.

Here is what I agree with re: the article: 
1. Often times, exercise does make us hungrier. I am actually working with several people who will be running the NYC marathon in 11/07 who have gained weight in the past few months while training. Heavy training can really increase your appetite. You would think that with all the calories you have burned while running, you would be able to eat significantly more food. However, many people overcompensate for the increased exercise by eating more than they burn off (they are actually eating more than they think).

2. I personally can attest to this. I normally exercise at least 5 days a week (was training for triathalons 2 years ago). However last year when I couldn’t exercise much at all due to multiple injuries, I lost about 8 pounds. Part of this was due to muscle loss from not exercising. My appetite was also greatly decreased. Now that I am working out again, my appetite is back and I regained the 8 pounds within a few months.

3. Many people feel they are entitled to grab an extra piece of bread or second helping of food because they are exercising. For example, an average woman might burn 100 calories per mile of running. So let’s say she ran 4 miles and burned 400 calories. The energy bar she had prior to exercise and the banana and yogurt she had for a snack after her run totally negates the calories she burned off in her run - but of course she still received the health benefits from running. Keep in mind that exercise can cause you to build muscle and lose body fat. This initially can cause you to gain weight on the scale - or at least experience a slower weight loss. However you should at least see a difference in the way your clothes fit. So if you are exercising on a regular basis and don’t see any changes at all in your body, you will need to scrutinize your diet as you may be consuming more calories than you think. CALL ME for a Nutrition Consultation!

What I don’t agree with…
1. While I don’t have “studies” on hand to back up what I am saying, I have 25 years experience working with people trying to lose weight. While many people are able to lose weight without exercise - at least initially - there often comes a time when a plateau occurs. Exercise can help to break this plateau.

2. The majority of people, especially those people with slow metabolisms and/or menopausal women, need to exercise to lose weight, and even more importantly, to maintain the weight loss. Take a look at the study done by the National Control Registry . It has been following over 5000 people who have lost over 50 pounds and kept it off for 5 years or more. Successful long-term weight loss maintainers share common behavioral strategies, including eating a diet low in fat, frequent self-monitoring of body weight and food intake, and high levels of regular physical activity.

3. The majority of lean people you see walking around likely exercise on a regular basis.

4. I have had clients on moderately low calorie diets who were having great difficulty losing weight (especially my clients with PCOS). Once we added in regular exercise, the weight loss increased.

As we all know, exercise has numerous health benefits, including decreasing risk of heart disease, diabetes, cancer and osteoporosis, lowering blood pressure, providing stress management, etc. From an aesthetic point of view, exercise also makes us look more toned and attractive. What is more appealing - a normal weight “doughy” man or a toned athletic appearing man? Some thin women look great in clothes, but a totally different story in a bathing suit. A women who is a few pounds overweight yet toned from exercise, in my opinion, looks much more attractive than the thin flabby woman.

So bottom line, I know some of you out there are looking for an excuse not to exercise. Do not let the article in the NY Magazine add fuel to the fire!

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I often hear my clients say “I am working on improving my diet - I gave up coffee” or “Is coffee really that bad? Can I have one cup a day?”  Coffee somehow has the reputation of being unhealthy. I am not exactly sure where it can from. On the contrary, research is showing that a  cup of coffee can not only help wake you up, it may have health benefits as well.

Coffee Perks

• Lowers risk of diabetes: A review of 15 studies on coffee and type 2 diabetes published in The Journal of the American Medical Association found that people who regularly drank coffee had lower risk of type 2 diabetes. Most people in the studies drank coffee prepared with the drip method. Decaffeinated coffee was not always identified, but in two of the studies, the decaf drinkers had a lower risk of type 2 diabetes. So how does coffee have this effect of decreasing risk? Here is the potential mechanism… coffee contains many beneficial substances including chlorogenic acid, a compound in the antioxidant family that may improve glucose (sugar) metabolism.  Coffee also contains magnesium, a mineral that can also improve insulin sensitivity and enhance glucose tolerance
• May lower risk of liver cancer, Parkinson’s disease, and possibly colon cancer.  At least six studies indicate that people who drink coffee on a regular basis are up to 80% less likely to develop Parkinson’s, with three showing the more they drink, the lower the risk. Other research shows that compared to not drinking coffee, at least two cups daily can translate to a 25% reduced risk of colon cancer, an 80% drop in liver cirrhosis risk, and nearly half the risk of gallstones
• Drinking coffee and exercising may prevent cancer in sun-damaged skin cells by spurring production of a tumor-blocking protein in the body, a study found. Exercise and caffeine, used in combination, doubled levels of a tumor-suppressing protein called phospho-p53, researchers found. Exercise alone spurred an 18 percent increase, and drinking the equivalent of two cups of coffee daily caused a 27 percent rise. The research was done in mice - obviously more research needs to be done on humans. ( Bloomberg News August 5, 2007)
• Can increase energy levels, elevate mood and help decrease headaches
• Italian researchers credit another compound called trigonelline, which gives coffee its aroma and bitter taste, for having both antibacterial and anti-adhesive properties to help prevent dental cavities from forming
• Can enhance athletic performance and endurance
•  Contains soluble fiber. This is the type of fiber that dissolves in water and helps prevent cholesterol from being absorbed by the intestines. As a registered dietitian, it never would have occurred to me that coffee has more soluble fiber than some fruits and vegetables. I associate higher fiber foods with foods that have more bulk. But in doing research for this post, I found the soluble fiber content of the following foods:  
  espresso (per cup)  has 1.5 grams
  filtered coffee (per cup)  contained 1.1 grams
  instant coffee (per cup) contained the most — about 1.8 grams:
  cooked cauliflower 1/2 cup for 1 gm
  small banana for .6 grams
  cubed melon (1 cup) for .3 grams.
  For more info on this study, check out this link. Keep in mind the just because coffee contains soluble fiber, I am not suggesting that you substitute coffee for fruits and vegetables as they contain numerous other healthy components.
• Can contribute towards fluid needs. In the past, it was believed that coffee dehydrated you. More recent studies show that coffee does not dehydrate habitual drinkers and can count toward your daily fluid quota.
• Coffee is naturally calorie-free…unless you are loading it up with cream and sugar or drinking some of the high calorie coffee drinks (see my post on calories in starbucks drinks).

So What Has the Health Benefits - a Substance in the Coffee or the Caffeine? Actually both the caffeine and other substances found in coffee are responsible for health benefits.

- Substances in the coffee: Coffee contains large amounts of antioxidants - even more than many fruits and vegetables.  Antioxidants are found naturally in many foods and beverages and are thought to provide health benefits in preventing diseases such as heart disease and cancer by fighting cellular damage caused by free radicals in the body. Free radicals are damaging substances that are produced through normal bodily processes.  The antioxidants may help in decreasing risk of diabetes.

- Caffeine content: Some of coffee’s reported benefits are a direct result of its caffeine content. For example, experts believe the evidence is very strong that regular coffee consumption reduces risk of Parkinson’s disease. In fact, Parkinson’s drugs are now being developed that contain a derivative of caffeine based on this evidence.  Caffeine is also what helps in treating asthma and headaches. This is one of the reasons why pain relievers such as Anacin or Excedrin contains up to 120 milligrams of caffeine. This is the same amount of caffeine found in a large cup of coffee. 

Is There a Down Side to Coffee? While coffee has many perks, health experts are not recommending we substitute our water bottles for coffee cups. Here are some of the potential downsides:

• Too much coffee (or any product that contains caffeine) can make some people jittery or increase irritability. (your boss always has a coffee cup in hand… hmm …that might explain a few things).
• In my practice, I commonly see people who skip meals or go too long without eating and drink coffee all day long in atttempts to increase energy levels or ward off hunger. The has a negative health effect on your nutritional intake. While coffee can give you a quick energy boost, food is what provides you with more sustained energy levels.
• While it can contribute towards your fluid needs, it does not replace water. I often see people who only drink coffee or diet soda during the day. Water is the preferred source of fluid.
• Can cause rapid heartrate in some people. This actually happens to me. I used to love drinking several large cups of coffee a day, but after several episodes of a prolonged rapid heart rate, my doctor told me to limit regular coffee. I now drink 1/4 real coffee mixed with 3/4 decaf.
• Can some people’s abiliity to sleep if consumed too close to bedtime (again, that would be me!)
• Can stain your teeth (especially for you city girls who have invested in teeth whitening!)
• Can aggravate certain stomach problems. Some reports claim that coffee can induce stomach ulcers and impair digestion by raising stomach acidity levels. Some also experience heartburn but there is no proof directly linking any of the aforementioned problems to coffee. Regardless, many individuals experience stomach problems after drinking coffee. And decaffeinated brews have the same effect as regular blends in that regard. I actually have GERD and when it “flares up”, I find both coffee and decaf to be irritants.
• Some studies show a link between moderate to heavy consumption of coffee and increased inflammation and heart disease risk. Not all studies show this same link. 
• Again, some studies show that decaffeinated coffee can elevate fatty acids and raise LDL.
• Pregnant women should limit their intake of coffee

Bottom line, if you are a coffee drinker, no need to cut it out (unless you have been told to do so by your doctor) as it may actually have some health benefits. However you still need to make an effort to eat a healthy diet and exercise. There are no set guidelines as to what is the maximum amount of coffee you should drink a day. My opinion is moderation… 2 cups a day might be a good guideline. Just my opinion!

Ok - so I was a spokesperson for the National Coffee Association a few years ago and lectured to editors on Food and Mood at the New York Academy of Science in Oct. 04…however this did not make me “pro-coffee” for that reason. My data is based on reseach!  

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Polycystic ovarian sydrome (PCOS) is the most common abnormal hormonal condition of women of reproductive age and is the number one cause of infertility. It affects 7-10% of all women. Unfortunately, many women who have it do not know they have it. The diagnosis often slips by physicians as the condition can be tricky to diagnose. I have been specializing in PCOS for the past 8 years and often have the opportunity to help a woman get diagnosed with this condition. This will enable them to get the proper treatment.

Allison was a 30 year old female who came to my office seeking help in losing weight. She had experienced a rapid 30 pound weight gain in college which she has still not been able to lose. Allison reported sugar cravings, mood swings and carbohydrate cravings. She has tried many different diets but none have worked for her.

I obtained Allison’s diet history. Her diet was very low in fat and fairly high in carbs. She indulged her sugar cravings at least once a day. Her caloric intake was approximately 1700 calories a day. She was trying to exercise 2-3 times a week…when she was not too tired.

I frequently ask women who are overweight (especially in the abdominal area) about their menstrual history. It turns out the Allison had irregular periods and was put on the birth control pill in college. I also asked her if she had any symtoms of excessive hair growth - which she did. She said she thought the hair was due to her Italian ethnicity. Irregular periods, rapid weight gain and excessive hair growth (hirsuitism) can be symptoms of PCOS.

Problems:

1. I suspected Allison had PCOS. This could contribute towards her weight gain and difficulty losing weight, carb cravings and mood swings. It can also increase risk of diabetes, heart disease and endometrial cancer if not treated. I had Allison take a PCOS quiz. While this is not a “diagnositic” test, it is a useful tool to suggest a diagnosis of pcos.

2. Allison’s diet was too high in processed carbs and too low in protein and heart healthy fats and fiber.

3. She often went too long without eating. This contributed towards low energy levels, carb cravings and overeating at the next meal.

4. Allison was not exercising on a regular basis.

Solutions:

1. I gave Allison the names of several endocrinologists who specialize in PCOS. She met with one of them and was diagnosed with PCOS. She was relieved to know there was a reason for her difficulty losing weight, excessive hair growth and low energy levels / carb cravings.

2. I provided her with information on PCOS and insulin resistance. I also discussed the importance of a healthy diet in treating PCOS.

3. I explained that she would likely feel better and have more success in losing weight if she moderated her carbohydrate intake, selected lower glycemic index carbs and ate more frequent mini meals that included a high fiber carb, protein and fat. For example, snack on peanut butter and whole grain crackers rather than 2 hundred calorie packs of fat free cookies.

4. Increase her exercise to 4 times a week. In addition, I recommended that she walk to work (2 miles) at least 3 times a week. I explained the benefits of increasing physical activity: burning calories, speeding metabolism, stress management, lowering insulin levels, etc.

5. Keep a food record recording what she ate, the time she ate and how she felt. In additon to helping her keep track of her calories, this also showed her which meals made her feel better.

6. I also stressed the importance of calorie control. I often see people who think they can eat almost unlimited food as long as their carb intake is low. I recommended 1400 calories a day for Allison.

The good news, I have been meeting with Allison for follow-up appointments every 2 weeks. She has been able to lose 8 pounds in 7 weeks. She feels much more energetic and had fewer carb cravings. She has been meeting her exercise goals and says she feels like a new person.

Check out my website for more references on PCOS

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This was a crazy week. Monday I was interviewed for the cancer video. Tuesday I was interviewed by Katherine Chan from NBC: Your Total Health for a “mini-makeover” segment. The story is about how cholesterol can be lowered through diet and exercise rather than medications. I selected one of my “star” patients, Indra, to appear with me on the show. She was able to significantly lower her cholesterol through diet and exercise in the past 4 months. She is one of the most motivated patients I have had! I will tell you more about her story in Real Problems, Real Solutions.  Indra and I were filmed in a counseling session together as well as interviewed separately.

The show will air sometime in May.

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This was a busy week from a media standpoint… not my typical week. The New York Presbyterian Hospital is making a video on Diet and Cancer. I was videotaped along with several other registered dietitians on various topics on nutrition for cancer patients. While I have many tapes of my various media appearances, this will be the first “professional” video I have been on. It will be out in a few months. I will post the segment I did when it to comes out.

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