Just wanted to say Happy Thanksgiving to everyone. And as I have been telling my clients, enjoy your meal…but not too much! Seriously, Thanksgiving is not a day to be on a strict diet. The delicious food served on this day only comes around once a year. Keep in mind that overeating one day will not wreak havoc with your diet. The real problem can occur if you have tons of leftovers in your house  - or if your Thanksgiving day hosts end up giving you a doggie bag full of all the fattening foods that they are trying to get out of their house!

 So while I discourage “dieting” on Thanksgiving, I am not encouraging you to totally overdo it.  If one slice of pecan tasted good, why do you need to have two slices?

Here are some last minute tips to avoid getting stuffed on Thanksgiving:

1. Don’t go into the Thanksgiving meal being ravenous. This will only lead to consumption of massive amounts of food. Have your normal (hopefully healthy!) breakfast and perhaps a light snack - depending upon what time the meal is served. (Pic is of city man consuming massive amounts of food - perhaps went all day without eating and was overly hungry at dinner)

2. Be careful with the appetizers. They often contain almost as many calories as the meal. Check out my previous post on calories in holiday foods to see the caloric content of appetizers. While waiting for the meal to be served, don’t plop yourself down next to the candied walnuts or bowl of chips and dip!

3. When the serving bowls are passed around the table, be descriminating. Don’t feel like you need to sample every dish. Stick to moderate portions of your favorite foods. Why take the creamed spinach made by your Aunt Betty if you don’t even like spinach? Why take a dinner roll when you can get one of these any day of the week? (pic is of young city girl consuming a moderate amount of food)

4. Eat really slow and drink a lot of water. Try to be the slowest eater at the table. That way you might feel gluttonish is you go back for seconds if everyone else is done eating.

5. If you are a guest in someone else’s home, avoid taking home goodie bags of desserts or other fattening dishes (i.e. stuffing, gravy, any vegetable with cream sauce, candied sweet potato). Instead, askfor turkey. If you feel it would be rude to refuse these leftovers, I hate to say it … but … there is always your doorman or trash can. (Sorry Aunt Betty!).

6. Get out and take a walk after dinner.

Stay tuned for tips on how to deal with post-Thanksgiving day bloat!

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Most of us have our favorite foods we can’t live without. As a nutritionist, I get a lot of people asking me what I eat. While I enjoy eating a lot of different foods (most healthy, some not so healthy), there are a few foods that I always have to have in my apartment. I thought it would be interesting to see what types of foods other nutritionists can’t live without. Here are replies from some of my co-workers - registered dietitians and dietetic interns -  at New York Presbyterian Hospital. (Pics are of “nutritionists night out” … suprised I didn’t see wine listed as a favorite food/drink!)

Four foods nutritionists can’t live without:

C.S:    Non-fat yogurt, bananas, frozen vegetables (all kinds), almonds

D.H:    Oatmeal, whole wheat pasta, frozen broccoli, and chocolate 

B.O:    Smuckers Natural Peanut Butter, cherry tomatoes, grapefruits, rice and beans

M.Z:    Avocados, Sarabeth’s Fig Jam, cherry tomatoes, Laughing Cow Cheese; French Onion
Pheww that was hard because I can’t go without eating sushi for a week but I don’t keep it in my home; actually I don’t keep very much at home.

T.K:    Meusli - I mix my own, dried soba, canned fish, eggs

J.B:    Greek Yogurt 0% Fat, unsalted matzo, Swiss Miss Hot choc (50 calories), plaintain or fresh apple

J.H:    Dried cranberries, high fiber (4-5 g) bread,  cheese (usually cheddar, or sliced havarti), oranges, strawberries or apples
 
J.H:    Hummus, peanut butter, bread (always a loaf whole wheat sliced bread but a french baguette or challah is usally around too!!)
apples

R.W:    Natural chunky peanut butter, garlic lovers hummus, philadelphia fat free cream cheese, and chunky spicy salsa. I find that these spreads are an easy/cheap way to get me to eat my vegetables and make for healthy snacking. 

C.G:    Vanilla almond milk, Fiber One cereal, celery and hummus, dark chocolate

G.W:    Two foods I NEED to have are reduced fat peanut butter and sliced american cheese (reduced fat also). 

S.T:    Salad supplies- lettuce, tomatoes, cukes, mushrooms, fat free cheese slices/string cheese, some kind of sugar free candy/treats for my sweet tooth such as jello sugar free puddings and jellos, Fiber One cereal  

S.Z:    Fage 0% Greek Yogurt, soy nuggets, Puffins peanut butter cereal, part skim string cheese 

A.A:    Apples, carrots, almonds, chocolate 

T.C:    Skim milk, yogurt, cereal - Quaker Oatmeal Squares, whole wheat bread

G.A:    Bread, milk, cereal and fruit juice. That’s mostly because of  my children.

M.N:    Granola, cheese, tomatoes, peppers 

C.D:    Almonds, unsweetened apple sauce, oatmeal, chocolate    

M.M. (me!):   Fage 2% yogurt, blueberries (fresh or frozen), All Bran or Fiber One cereal, eggs.

 Well, there you have it. Most of our favorite foods are on the healthy side. Common favorites include almonds, peanut butter, whole grain bread, yogurt and various fruits and veggies. This doesn’t mean we don’t eat junk food on occasion!

What are the foods/drinks that you can’t live without?

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Martha McKittrick, RD, CDN, CDE is a registered dietitian and certified diabetes educator. She specializes in weight control, cardiovascular health, polycystic ovarian syndrome, diabetes, sports nutrition and preventative nutrition. A staff dietitian at The New York Presbyterian Hospital for the past 22 years, she also counsels clients privately and is a consultant to physicians, corporations and health clubs. She was the nutritionist for the 1998 NYC Marathon. She was an exercise instructor in NYC health clubs for 15 years.

Martha has appeared on numerous television, radio and web cast programs. She lectures on a regular basis and has been interviewed and written for publications including The Journal of The American Dietetic Association, Dietitian’s Edge, Nutrition Today, Allure, Self, Family Circle, New York Newsday and Cooking Light. Martha is known for giving practical nutrition advice, both in her individual counseling sessions as well as group lectures. Two of her most popular lecture topics include “Healthy Eating on the Run” and “Tame Your Carbohydrate Cravings”.

Martha was a health expert on WebMD™s Diet and Nutrition Message Board for the past 7 years. She also developed and led Find Your Ideal Weight:12 Weeks to a New You weight control program on WebMD (with 42,000 registrants) for the past 7 years. In her free time, Martha is an avid cyclist, runner … and now a blogger.

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Have you ever felt like your diet was controlling you? Have you ever avoided going out with friends because you didn’t want to miss your workouts or didn’t feel comfortable eating out in a restaurant? I see this happening with some of my clients. I’d like to thank my colleague, Laura Cipullo, RD, for contributing this article. Laura and I worked together at the New York Presbyterian Hospital for quite a few years. Laura now has her own practice (as well as a husband and baby) and specializes in eating disorders. (Pic is of Laura and I at a holiday party at NYPH).
 
When it’s No Longer a Diet
    by Laura Cipullo, RD, CDE

What starts as a simple effort to lose weight can become a catastrophe if you are not careful. Many women start and stop diets, gain and lose weight on a regular basis. What happens when someone doesn’t go off a diet? It is possible that what was once a diet is now disordered eating or potentially an eating disorder? Diets and weight loss can trigger a domino effect thereby causing disordered eating or an eating disorder. It is important that women know the signs and symptoms of a diet gone awry. Your eating and metabolism can be normalized if you get help.

A diet gone disordered…
Take this scenario of a diet gone disordered. Perhaps all the women in your office lost their holiday weight gain by cutting carbohydrates. Sounds easy enough, so you decide to cut carbs too. Little did you know the other women only reduced their carbohydrates for the initial two weeks of their diet. Now, 6 months later you have continued to restrict carbohydrates even fruit. Everyone says you look great and all the guys are commenting on how thin you are. You never miss a day at the gym and have memorized the nutrition labels of every food in your shopping cart. From an outsiders perspective, people think you are super healthy and in control.

Your diet starts to take control of your life
However, you feel just the opposite! You feel out of control of your life. You are afraid to eat anything for fear of weight gain. Chicken and broccoli are your safe foods! You have lost more weight than you had hoped, but you feel worse now. You have lost your self esteem. You missed your best friend’s birthday dinner to get to your favorite gym class. Besides - you stopped drinking alcohol for fear of the extra calories and wouldn’t dare to take a bite of the birthday cake.

These feelings and concerns are unhealthy and unnecessary. Women do not need to feel guilty for eating real food. When calorie thoughts consume your day, you know your diet is no longer a diet. Another scenario you may identify with is when your diet becomes a trigger for a binge or an episode of overeating. Perhaps you are counting points for your diet program. However, if you go above your allotted points, you feel like a failure and sabotage yourself. You eat whatever you can. This is not because you are hungry but because you are punishing yourself. You feel out of control with life and your eating. Your refrigerator is your enemy and your friend. The next day you wake up and hate yourself. You vow not to eat the rest of the day to make up for the extra calories you consumed last night. But you just can’t refrain from eating and you end up ordering Chinese food for dinner and eating a box of cereal for dessert. If you can identify with these thoughts and or behaviors, your diet is no longer a diet! 

Signs of disordered eating
Other signs that may signify your eating is becoming disordered include: eating the same foods every meal every day; only eating foods with nutrition facts/labels; refusing to eat/drink the full fat version of a food if the fat free version is not available; working out to compensate for the food you ate; working out despite having a cold; restricting all day in fear of what you may consume at night; feeling out of control in the presence of your “fear” foods; eating food in large quantities despite not feeling hunger; punishing yourself because you “cheated” on your diet; weighing yourself multiple times a day; the scale’s result determine your emotions for the day; feeling sad and moody all day if the scale goes up a pound; feeling powerful and in control for the day the scale goes down a pound; skipping social engagements involving food, skipping social engagements to exercise; claiming you have food allergies to prevent others from questioning your lack of food intake. Theses are a just a few examples of signs/symptoms to bring awareness to a possible eating issue.

You don’t fail at diets, rather diets fail you
Many women feel or behave in the above manner, but such discomfort with eating and our body is not necessary. You don’t fail at diets, rather diets fail you. You can empower change with the right help. Consider this: eating and exercise can and should be fun, nutritious and stress free. Eating is social and not perfect! Eating is not about being good or bad but rather an act of self care!  Self esteem and confidence come from internal self worth, not a number on the scale. Portions are determined by internal cues rather than external diets. Restrictions cause overeating. Diets don’t work. Making the decision to choose realistic life long nutrition practices like moderation can set you on a journey of happiness and health.

You can be free of diets, and diets gone badly. If food, exercise and or body thoughts consume your day, reach out and get help from a professional. Overcome your disordered eating before it becomes an eating disorder. A Registered Dietitian and a therapist specializing in eating disorders can help to normalize your eating and balance your life not just the scale.

 Resources:
 www.bulimia.com  
www.edreferral.com
www.LauraCipulloLLC.com   (Pic of Laura on the right)

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I often receive emails and letters from nutrition students who are interested in observing a nutritionist in private practice “in action”. I also train dietetic interns at the hospital where I work (New York Presbyterian Hospital) and enjoy helping students gain experience for their future careers as registered dietitians.

I received a letter from Allison Scheinfeld,  a Health and Nutrition Science major at Brooklyn College, asking for the opportunity to observe me counsel a patient with PCOS.   She will be graduating in May 2008, and is looking for internships in the NYC area. She has a special interest in PCOS since she has this condition. I suggested Allison write an article on her experience with PCOS … and here it is! 

My diagnosis of PCOS
At 19, after suddenly gaining 25 lbs, I was diagnosed with Polycystic Ovary Syndrome.  I then finally knew the cause for all the effects of my mind and body.  It explained why I gained weight, why my skin had constant little red bumps, the uncontrollable hair on my neck, why I hadn’t gotten a menstrual period in over 8 months and why I always felt slightly anixous.  It was still not an easy diagnosis,  I had to take many tests for other syndromes/diseases.  My many endronologists thought maybe I had Cushings Syndrome or Diabetes.  Knowing the cause was only half the battle.  Then came all the questions. What treatment is right for me?  Can I conceive a child?  Will the acne disappear?  The main question for me was would I ever be 100% happy despite all my  obstacles?  I have found that the correlation between food and symptoms is the key.  Nutrition is the basic component of controlling PCOS and has led me to become a R.D student.   My endocrinologist recommended Ms. Kittrick as a R.D and I soon googled her website.  She has given me the opportunity to sit in on her counseling sessions with PCOS clients, and now an opportunity to share my store, and hopefully some tips to help any girls that have this syndrome.

 The following carbs work best for me
The question of carbohydrates is one that many PCOS women have.  The answer?  Good carbs.  Only whole grains, complex carbs.  The best bet for carbohydrates is sprouted whole grain.  It has a very low glycemic index, which slowly raises your blood sugar. They have sprouted whole grain bread, pasta, bagels, cereal, English muffins, etc.  I start every morning with a piece of sprouted grain toast with melted cheese.  I am still able to enjoy carbs without worrying that my skin will break out or my mood and energy will drop.   Other good options of whole grains are Wasa multigrain crackers and Kashi products (their Go Lean bars are great to carry in your bag for the middle of the day.)  You should note, it is still best to watch your portion sizes.  Even the “healthy” food can add weight and negative effects if eaten in large amounts.

 How to incorporate fruit into the diet
I am a big fan of fruit and fruit salad, but many fruits have high sugar content, which does not have positive effects on symptoms.  Green apples have the lowest sugar content of a fruit and I find that the crunch and the sweetness satisfy my sweet tooth.  Other good choices for fruit are grapefruits, oranges, peaches and pears.   As far as melons go, they should be consumed in moderation, due to their high glycemic index.  You can still enjoy watermelon, but just like the carbs, know good portion sizes.  I find that dried fruit (raisins, apricots, prunes) set off my cravings for other sweets.  So I only have those once in a while. It is best to have fresh fruit, I prefer organic, but it just personal preference.

 The sweet tooth
If I have a binge night where I eat way too much chocolate or a large amount of chocolate cake (it’s a love/hate relationship), my skin will react the very next morning.  When I do not keep things under control, not just the acne reacts.  The hirsutism, hair loss, bloating and the low “down in the dumps” moods all come into play.  There are many other options than bingeing on the seven-layer cake.  Tasti D Lite is close to being my savior, along with Skinny cow products which are great to keep in the freezer for those nights when you need that something.

 Other good choices
 Hummus (my favorite brand is Tribe, but my sister is more partial to Sabra) is a great choice for girls with PCOS.  It is low calorie, low carb and low sugar.  I put it on the Wasa crackers and it’s delicious.  I make lots of stir frys with olive oil and pepper.  Sometimes I use salad dressings to mix in.  Mushrooms, peppers, onions, bok choy, beets, etc.  Veggies are a great way to fill up without any reason to feel guilty.  Sweet potatoes have a low GI and are a good alternative to the “evil” white potato (which I 100% steer clear of.)

 Importance of exercise for women with pcos
Exercise is also extremely important when dealing with PCOS.  I could not live without my treadmill.  Since I took up running 3 years ago, my body and mind have definitely improved (and I lost the PCOS related 25 lbs.)  I recommend starting out with 1 or 2 miles like I did, and then slowly adding distance.  I can now run 6 miles straight which is a huge accomplishment for me, considering I could not even run a half a mile a couple of years ago.  As far as the hirsutism goes, I have tried all types of hair removal, and my conclusion is that threading (ancient Indian technique) is amazing.  It is less rough on the skin than wax, and lasts longer.

 Make good choices and get good results
To have Polycystic Ovary Syndrome is to constantly have an extra obstacle to deal with in life.  No one in the outside world, except for women who suffer from PCOS can know the difficulty and pain that goes along with this syndrome.   It is a physical, as well as emotional.   It is nice to know that you have the power to control many of your symptoms with a little self-control and planning of your meals.

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The following is an excerpt from the book titled Eat, Drink and Be Gorgeous, from one my colleagues, Esther Blum, Registered Dietitian. Her book contains the secrets to beautiful skin, a fantastic figure, and peace of mind—all while living the good life.
“I am blessed to live and work in New York City. It is one of the most romantic and fabulous places to date. Restaurants are a dime a dozen, and each one has its own special atmosphere and succulent treasure trove of food. Nomatter what you’re craving—Thai, Japanese, oodles of noodles, or a fat, juicy steak—you’ll find it here. Upscale restaurants are still catering to the low-carb dieting sector, and even fast-food chains are catching on to the idea that weight loss can sell even when a girl is on the go. But no matter how fabulous the food is, and how much we are enjoying ourselves, one question still remains: What should a Gorgeous Girl eat on a date?

I can’t tell you how many times I hear from my clients that they’re more stressed about what to order on the date than going on the date itself! If you are trying to eat carefully and the process of eating out seems daunting, take the pressure off yourself by figuring out what you want to eat. Feel free to suggest a restaurant that appeals to you ahead of time. Your date will appreciate your initiative, and you’ll get to sit back and enjoy yourself. Isn’t five minutes of planning worth an evening’s peace of mind?

Before we even cover that territory, let me give you the single most important rule for going out in the evenings: Do not starve yourself during the day. You must eat during the day, especially if you’ve got a date that night. Eat your breakfast, eat your lunch, and eat one or two snacks in between meals. Nobody likes a party pooper, and if you go all day without meals your blood sugar will plummet, making you a cranky cookie and a very unappealing mood swinger (this is not to be confused with a wild swinger). Whether it’s a party or a date, plan ahead of time and make sure you don’t neglect yourself during the daytime hours because you’re worried about overeating at the big event or trying to keep your tummy flat. If you’ve taken care of yourself during the day, you will be less hungry by the time nighttime rolls around and less likely to overeat.

Game-Day Strategies
The day of your date, keep everything as routine as possible. Don’t skip meals or let your hunger get to the point of no return, or your body will attack you warrior-princess-style and you will end up bingeing at dinner to quell your pangs of hunger. You will go to bed with an uncomfortably full stomach, forcing your body to digest during what should otherwise be a time of rest. It’s just dinner you’re going to, not the Last Supper. Grazing and snacking is truly the way to go, rather than saving up all your calories for one giant blowout.

I’ve listed below some sample lunch and dinner meal plans that should serve as guideposts for you. Ultimately, you’ll need to check in with yourself and decide what foods on the menu are going to make your taste buds tingle and make the meal that much more enjoyable for you. You should also ask yourself how hungry you truly are when you start to eat; ask again at midmeal to prevent yourself from overeating. In a world where stress is abundant and our pleasures are booked within time slots, wouldn’t it be wonderful to at least have the knowledge that we’re treating ourselves with some level of gentle loving-kindness by giving ourselves what we really need? You’re welcome.

If you are going to be consuming alcohol on the date, it is crucial to have food in your stomach beforehand to absorb and metabolize the booze properly. Alcohol initially raises your blood sugar, then lowers it, wreaking havoc on your blood sugar balance, energy levels, sugar cravings, and mood swings. It also loosens up even the best nutritional intentions, making your stomach an unrelenting food whore that just won’t quit until it gets paid. Remember, there are peanuts at the bar for a reason, so eat up!

Ideally, you’ll know ahead of time exactly which restaurant you’ll be eating at. That way, you can look up the menu online or have it faxed to you so you can look it over and make sure it appeals to you. (Wouldn’t it be a complete disaster to go to an Indian restaurant for the chana saag, only to discover it isn’t on the menu?) But what do you do if that option is not available?

Here are a few important guidelines:

Eating Right on Date Night
Keep in mind that this info doesn’t just apply to date nights. These guidelines work whenever you find yourself in a restaurant:

• Figure out how hungry you are before you start eating. Rate your hunger on a scale of 1 to 10, where a 1 is ravenous and a 10 is overstuffed. Ideally you should start eating at a 2 or 3 and stop somewhere near 5, when you are satisfied. Don’t let yourself get too hungry or too full. Somewhere in between is just right.

• Look over the menu and figure out what appeals to you. Do you want something sweet? Salty? Crunchy? Chewy? If you’re worried about eating healthfully but just know you won’t be truly satisfied until you have the mac and cheese, then just order it and commit to stopping when you’re full. Divide the portion in half and see if you are still hungry after the first half is gone. We live in a world where food is abundant; try to remember that you can always come back to it later, when you are hungry.

• Order a meal that has some protein in it: Lamb, chicken, fish, turkey, ostrich, buffalo, venison, Rock Cornish hen, rabbit, and steak are all excellent choices. When your meal arrives, start by eating the protein first. Protein is the only nutrient that turns off your body’s hunger mechanism and will therefore prevent you from overeating.

• Order foods the way you want them cooked. Specify to your waiter whether you’d like something broiled or grilled, if you’d like sauces on the side, or if you’d like substitutions made. Learn to decipher jargon on the menu, or ask the waiter. Crackling or crispy means something is fried, grilled means it is grilled (but usually brushed with oil or marinated beforehand), sautéed means that the chef has cooked the food in oil—and usually a fair amount at that—and poached means a food is cooked in boiling water or steam. When in doubt, ask.

• If low-carb eating is your bag, then send the bread basket back. Substitute a second vegetable for the starch, and start off with a salad or vegetable-based soup for an appetizer. Did you know that people who eat soup before a meal lose more weight than people who don’t? Soups are very filling and low in calories, so you can feel full quickly without eating too much.

• Make sure that you get some fat in your meal as well. Fat will slow down the absorption of foods in your stomach, making you feel fuller longer and turning off your hunger signals, so that ultimately you will end up eating less. Slowing down your digestion will also slow down your absorption of any alcohol you’ve consumed too quickly, keeping you relaxed enough to enjoy yourself, yet respectable enough to get a second date. The healthiest fat you can find in a restaurant is olive oil. Commercial salad dressings are loaded with thickeners, sugars, and poor-quality oils, so try to stay away from them. Order oil-and vinegar-based dressings, or get a shot of olive oil and vinegar on the side. Feel free to order any salads or appetizers containing avocados, olives, almonds, pecans, sunflower seeds, tahini dressing, or any other nut or seed combo to get a dose of healthy fats as well.”

                                          Check out Esther’s book!

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Check out Martha’s quote in Womansday.com        

Snack Off the Pounds
How to fit mini-meals into your weight-loss plan

Trying to lose weight? Snacking doesn’t have to be your downfall. In fact, having small, frequent meals can actually help you shed pounds. Not only does it rev up your metabolism so your body burns slightly more calories than it does when you eat less frequently, snacking also helps you stay in control so you’re less likely to overeat at lunch or dinner.

Don’t forget to keep calories in mind, however. “Many women who struggle with weight eat too many calories between meals, often without even realizing it,” explains Dawn Jackson, R.D., a Chicago-based registered dietitian and spokeswoman for the American Dietetic Association. “In some cases, snacks may pack in more calories than meals.”

How Many, How Big?
One midmorning snack and one afternoon snack, each containing up to 200 calories, will satisfy most people, suggests weight-loss expert Barbara Rolls, Ph.D., professor of nutrition at Penn State University and author of The Volumetrics Weight-Control Plan. Dr. Rolls says a daily diet containing about 1,600 calories, with about 400 for breakfast, 500 for lunch, 500 for dinner and two 100-calorie snacks, will promote weight loss among most overweight women.

“Snacks should also be planned,” adds Dr. Rolls. “Too often, snacking is mindless nibbling on whatever you have readily accessible in the refrigerator or cupboard. Before you know it, you’ve eaten five hundred calories’ worth of chips.” Instead, pay attention when you’re eating and don’t allow yourself to eat and read or eat and watch TV. When you’re eating, that’s all you should be doing.

The Right Snacks
The best snacks are those that are high in bulk and low in calories—essentially, foods that fill you up with the fewest calories. Ideally, a snack should contain carbohydrates, fiber and protein, with perhaps a small amount of fat.

Fruits and vegetables are among the best snacks of all because they’re rich in nutrients and fiber and low in calories. When you snack on most non-starchy vegetables, you don’t even have to account for them in your diet, says Dr. Rolls. Some vegetables that contain significant calories are potatoes, corn, beans, peas, lentils and winter squash.
Fresh fruit is a great option, too, because most women can have two or three pieces of fruit daily without worrying about gaining weight. Fruit juice and canned fruit in syrup are less filling and these should be limited.

Snack Attacks: Reality or Not?
Afternoon and after dinner are the times when most people have problems controlling what they eat, says Martha McKittrick, R.D., C.D.E., a registered dietitian and weight-loss counselor at the New York-Presbyterian Hospital in New York City. “Afternoon snacks are usually a good idea if there’s a long time between lunch and dinner, but most people can go without an evening snack. They’re eating more out of habit than because they’re physically hungry.”
Often, the desire for a snack comes from another emotion or from habit, not hunger, says McKittrick. Here’s what she has her patients do when they have a snack attack. Before grabbing something to eat, answer these questions: “Am I really hungry? Do I feel hunger pangs?” If the answers are yes, plan and eat an appropriate snack of up to 200 calories.

If not, you may be bored, stressed, frustrated, mad, worried or tired. If you can identify an emotion that is causing you to want to eat, find an appropriate way to deal with that emotion. Eating a snack cannot do anything to beat boredom or solve a conflict. Take a break, call a supportive friend, stretch or do something positive for yourself.
 

See my post on basic tips for snacks and suggestions for crunchy snacks (more ideas for snacks will be coming soon!)
 

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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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Question from Linda (Registered Dietitian): What about the concern of parasites with suishi? Are your calculations for pieces or rolls?

Answer from Martha:
First question: You have brought an excellent point about the concerns of parasites with eating raw fish. This is always a concern when you are eating any kind of raw fish. The Food and Drug Administration stipulates that all fish to be eaten raw (with the exception of tuna) must be frozen first, in order to kill parasites. Are we guaranteed that our favorite Japanese restaurant is freezing the fish?

The following information was obtained from an article on sushi  from Web MD: (Brace yourself… the information can be hard to swallow).   
 
How risky is the raw fish in sushi? California Health Services researchers recently studied seven risky foods that can carry infections, and what should appear on their list? You guessed it: raw fresh fish.

Properly prepared and handled sushi fish is safer than other raw fish, but it’s obviously not as safe as cooked fish, says Erica Weis, a research scientist with the California Department of Health Services.

The good news: According to Phillip Spiller, former director of the Food and Drug Administration’s Office of Seafood, generally, seafood is very safe to eat. He says that on a pound-for-pound basis, seafood is at least as safe as other meat sources. But he adds that no food is completely safe.

The bad: If you do encounter raw fish parasites, the effects can range from mild discomfort to severe illness, depending on the type of worm you ingest, according to the Environmental Nutrition newsletter. If the culprit is a tapeworm, fluke, or flatworm, you may not even know it until it passes out in your stool. Or you might experience nausea, cramps, and diarrhea.

And the ugly: If the worm you swallow is the roundworm (Anisakis simplex), it may tickle your throat as it is swallowed, causing you to cough or vomit it up. Or it can bore into your stomach or gut lining, causing severe abdominal inflammation and pain that mimics appendicitis or an ulcer, often within an hour of eating. Getting the worm out at this point is no simple matter - it requires an endoscope or surgery.

The cure: Commercial freezing for at least 72 hours at 4 degrees Fahrenheit kills the parasitic worms and their larvae. Please note, though, that home freezers usually can’t reach temperatures this low.

So what’s a sushi lover to do?
- Order sushi from reputable restaurants, where the restaurant and  fish provider follow food safety standards. You can ask if the fish has been previously frozen.

- Completely cooked is always the safest way to eat fish

- The FDA recommends that you don’t risk eating raw fish if you’re pregnant or have a compromised immune system.

- Don’t make your own sushi with raw fish unless you can freeze the fish for more than 72 hours at 4 degrees Fahrenheit. Instead, use cooked fish or vegetables. For example, California roll (see recipe below) is made with avocado and cooked crabmeat.

 Second Question: My calorie calculations in my original post on sushi included calculations for both pieces of sushi and sashimi as well as for rolls. The top section gives information on pieces and the bottom section has info on rolls. The calories in the bottom section were for the entire roll (usually 6 pieces). I got my calories from weighing and measuring sushi purchased in my neighborhood as well as from this website.

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Many clients come into my office confiding in me that they can’t control their intake of certain foods, often times sweets. Frequently they are embarrassed with their lack of control.  They are seeking my guidance in learning how to control their intake of these foods. While I can give some behavior modification tips, I am not a poster child for controlling intake of sweets!

I have a really difficult time controlling my intake of certain foods,  especially sweets. If they are in my apartment, I will likely polish off the box. One year, a friend gave me a box of really good chocolates for Christmas (kind of a weird gift to give a nutritionist… but it was the thought that counts!). A little voice inside me said to immediately give the unopened box to my doorman. The other little voice said - no just have one or two and then give the doorman the box. Well, as you can imagine, once the box was opened, it did not make it out of my apartment (unless you count the empty box being thrown into the garbage). I have just admitted that I have no control over certain foods. End of story.

I was curious as to whether other “food experts” (aka registered dietitians) have the same issues. So I decided to poll the nutritionists at the hospital where I work - New York Presbyterian Hospital in NYC - to see how they would handle a box of chocolates or cookies being in their apartment. These are the women in the photos. I was curious to see whether nutritionists would be able to control their intake of these foods.

Here are some of the responses:

Nutritionists who WOULD have a problem controlling their intake said:
- I would likely polish off the box
- This would be really tough to control, especially if they were
   homemade
- Initially, I could eat 1-2 a day, but then I would lose control and eat
   most of the box
- The box would be gone in a few days, especially if I were stressed
   out
- I would eat the whole box if it were in my apartment
- I would polish a box of chocolates off right away — that is why I
   never buy them.   (I eat when I am tired and I am tired a lot of the
   time)
- I will not be able to control my intake of sweets - that is why I leave
   them out of the house. I eat them only as needed when I’m out of
   the house.
- I can not control my intake of anything
- Can control intake using certain “tactics”: I keep my problem foods
   in the freezer - chocolate, cookies, nuts. You are less likely to eat
   foods from the freezer quickly. This helps me to control my intake
- I would freeze them and eat 1-2 a day
- Can usually control intake, unless very stressed/PMS
- I can generally control my intake of sweets - however if I were
   having a bad day or having PMS, I would have a hard time
   controlling what I eat
- I can definitely control myself most of the times…but it really is
   sometimes depends on the mood… (after a long stressful
   day…hoi…)    Also, some sweets are harder to control than
   others…when it comes to ice cream…now that’s a different story…

Nutritionists who WOULD NOT have a problem controlling their intake said:
- I definitely could have 1-2 a day
- I could have just one little piece a day
- I am not really a sweets person, so I would be able to control my
   intake
- In response to your question, I definitely can eat just one or two
   chocolates a day. That’s what I do currently. I don’t feel deprived
   that way and it’s just enough for a daily treat.
- I could eat 1-2 then stop
- I would have 3-4, but not the whole box
- I can control my intake of sweets. I keep boxes of dark chocolate in
   my apartment. My medical condition (IBS) actually helps me  
   control my intake. If I overindulge, “it is not a pretty sight”.
- I hate chocolate and cookies
- I can have just one or two; a bar of chocolate lasts me about 5 days
   to one week I’m actually never tempted to eat the whole box/bar,
   it would make me sick.

So as you can see, we nutritionists are human too! Just because we know we “should” consume sweets in moderation, doesn’t mean that we always do it. Morale of the story, if you have a problem controlling your intake of certain foods, you are not alone! Just come up with a plan as to how you will deal with them. Check out my post on trigger foods to see more suggestions.
 

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