Halloween … you know it’s that time of the year when you see stores filled with sugary treats of all kinds. A sugar addicts worst nightmare! Halloween is associated with “treats” -  candy in your office, candy that you buy for trick or treaters or candy that your kids bring home. In my private practice, Halloween is a problem for many of my clients. I see people who buy candy a few weeks in advance in anticipation of Halloween.  Of course, the bag doesn’t stay unopened for long…  many of my clients food logs reveal consumption of mini candies all day long for several days prior to and after Halloween. Or they find themselves getting into their kids stash of goodies late at night.

Here are a few problems I see:

1. Buying candy for trick or treaters too early. The longer it sits in your apartment, the greater the chances are that you will open the bag. Even nutritionists know how hard it can be to resist eating candy when it is in your apartment!

2. Candy everywhere in your office. Again, very difficult to resist when you are bored or stressed. 

3. Candy that your children bring home. How many times have you found yourself getting into their stash? You may be thinking all that sugar isn’t healthy for them, but it isn’t good for you - or your hips - either!  

 Here are the calorie contents of some popular Halloween candies:

Tips to control your intake of Halloween candy:

1. Don’t buy candy too early for trick or treaters. Try to buy it the day of Halloween or the day before.

2. Don’t buy your favorite candy. Instead, buy something you don’t love. For example, I would buy mini twizzlers instead of anything that contains chocolate (since I am a chocoholic!). You always buy something healthy like mini boxes of raisins. One of my clients asked her child what kind of treat he wanted her to buy for the trick or treaters. Luckily he said “Smarties”. This was one of the few candies she doesn’t like!

3. Consider leaving the candy in a basket outside of your apartment. The less you see of it, the less you will eat.

4. Dispose of any leftover Halloween candy that you don’t give out.

5. If you have candy at work, try to limit yourself to 100 calories or so of candy a day. Check out the above chart for calorie content. If you find that you lose control once you have even one piece of candy, DON’T even start with it! Bring in a more “appropriate” snack.

6. Decide how you will handle your child’s Halloween candy. Perhaps allow your child 2 mini candies a day for a week. Throw the rest out if you find you can’t control yourself if it is around.

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So Esther made it through week 2 with flying colors! She met 100% of her goals. She kept her eating out and alcohol intake to a minium. She handled the Sex in the City party admirably. Esther lost another pound this week. Starting weight: 146  Weight May 30: 144

Here were Esther’s goals for week two:

Friday May 30th 
Breakfast  
coffee  
1 hard boilled egg 
4 oz 2 1/2 % cottage cheese
Lunch  
sushi 1 1/2 rolls 
( spicy tuna, tuna, california)
iced tea  
Dinner  
tuna tartare 
vodka w/ club soda 
martini w/3 olives 
1 pretzel stick  

Wednesday:   
Breakfast   
2 hard boiled eggs   
4 oz 2% cottage cheese   
Lunch   
1 chicken cutlet   
1 cup brown rice   
sm can of zucchini in tomato sauce   
1 orange   
Dinner   
1 hamburger
roasted cauliflower & broccoli
shirataki noodles
water
1 orange

Tuesday May 27th    
Breakfast    
banana    
1 cup coffee    
water    
1/4 orange    
Lunch    
green salad w/ fresh turkey    
little cheese, olive oil vinegarette    
Dinner    
2 chicken cutlets w/ panko bread crumbs sauteed in grape seed oil    
1 cup of brown rice w/ lemon    

My observations on Esthers food records:
1. Your caloric intake averaged ~ 1300 calories. Excellent!
2. Try to have an afternoon snack daily. If possible, make it something nutritious like fruit or yogurt.
3. Increase your intake of vegetables at night when you eat at home.
4. Glad to see that you are eating Shirataki noodles as they are a great low cal replacement for pasta.
5. Continue have salads frequently for lunch, but make sure you limit your oil to one Tablespoon.

My interview with Esther:
 1. Martha: Overall, how do you feel you did this week? Still as motivated?
Esther: I thought I did extremely well this week.  I am more motivated as I go on and getting a lot of support from friends and family helps.

2. Martha: Any tricky social situations?
Esther: This week I only went out once so it wasn’t difficult.  I have two occassions I will be out next week not including the week-end.  The limit of two drinks per week is hard when going out but not difficult when I am home.

3. Martha: Any barriers to meeting your exercise goals?
Esther: I am trying to schedule the workouts into my daily routine.

4. Martha: Any other thoughts?
Esther: Probably just that I had expected to lose more then just one pound this past week as I stuck to the plan 100%  Martha:  Losing one pound a week is right on track.  Losing slower means that you are losing more body fat. Losing more than 2 pounds a week means that you are losing more water and some muscle. Remember, “slow and steady” wins the race!

Esther’s goals for next week:
1. Continue food records
2. Plan healthy afternoon snacks
3. Exercise program the same as last week (2 training sessions, 3-4 cardio and 1 pilates)
4. 2 alcoholic drinks a week
5. Be very careful with choices eating out
6. An average of 1300-1400 calories a day.

Keep up the great work!

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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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When I went to Starbucks today to get my afternoon jolt, I noticed the calories listed on the menu. I think this is great! I wonder if it will really affect what people order. I have been taking an informal poll with my clients today to see if it would affect what would order. They all said yes… (maybe because they were talking to their nutritionist!)  One client told me “her friend” didn’t order the banana loaf in Starbucks based on the calories it contained. Another client told me she changed what she was going to order in Chipoltes based on the calories.

The other chain restaurants have until June 3 to post their calories. Working midtown, I’ll be waiting to see the calories posted on Hale and Hearty, Pax, Metro Cafe, Au Bon Pain, etc.

If anyone spots calories posted in their favorite lunch spots, let us know!

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For those of you who are regular readers of my blog, you know that I have a chocolate obsession. Since I don’t keep it around, I am generally in control of my intake. I allow myself small amounts here and there (like the 25 cent mini chocolates found in deli’s). This satisfies my chocolate urges. However, if someone were to give me a box of chocolates or bake me a cake (like my stepmother did - check out this post), I would be in trouble due to my lack of control.

A box of chocolates appeared on my desk
This week I was working with a client who also has trouble controlling her intake of sweets, especially cookies and chocolates. She had been keeping boxes of chocolates in her apartment and had been able to stay away from it …. until recently when she started to eat them. At our last session, I strongly advised her to get rid of the chocolates in any way she could - give it her doorman, a homeless person or just throw them out. I hadn’t expected she would bring the boxes of chocolates to MY OFFICE at our next session. While I was very pleased with her ability to part with the chocolates, I was a bit nervous how I would handle this delicious box of truffles (that was already opened) sitting in my office.

How I handled the situation
After the client left, my “nutritionist” side won over the “chocoholic” side. I immediately gave the box to another woman who works in my office and told her to hide them. My plan was to bring in my camera the next day to take a picture of them for this blog as I thought it was an amusing story. So the next day, I brought in my camera, took the above pics, ate TWO of the truffles and gave the box away to my co-worker to take home.

Tips to handle your problem foods  (taken from my previous post on trigger foods)
1. The first step is to acknowledge that you have a control problem with certain foods. It is unlikely that you will suddenly learn how to moderate your intake of these foods. I have had many clients come to my office and ask me “How can I learn to have just one?”  Unfortunately, I do not have the answer! It is quite likely that you will never be able to have just one.

2. Do not keep these foods in your house - or office - if possible. How many times have you bought this particular food telling yourself that it was for your husband or if company dropped by, but deep inside you knew it was for you?  So rule number one is not to keep it in your environment. If you need to buy desserts or snacks for your family, buy something that does not trigger cravings or uncontrolled eating.

3. If you feel you can handle your trigger food if it is in packaged into an individual serving size, try buying 100 calorie packs, individually wrapped ice cream products, etc. The question is…. can you have just one 100 calorie pack?  If not, do not buy them.

4.  Since everyone is different, you will need to consider whether it would be best if you totally avoided your trigger food OR allowed yourself a moderate portion in a controlled environment. For example, if you love pasta but can not stop eating it if you make it at home, consider allowing yourself a pasta entree in a restaurant several times a month. Or allow yourself a real dessert on occasion in a restaurant, but do not keep sweets at home

5. Pay attention to how your body feels after eating the trigger food in the above controlled environment. If it still sets off cravings into the night or the next day, you are likely better off totally avoiding the food.

 6. If you feel really out of control with your eating, you should seek counseling as it can be a sign of an eating disorder.

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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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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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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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Question from Linda: I have PCOS (polycystic ovarian sydrome) and am trying to follow a lower carb diet. However, I’m having trouble finding something low carb to eat for breakfast. My favorite breakfast foods - cereal and bagels - are loaded with carbs. Help!

Answer from Martha: You are right - most breakfast foods are high in carbs. However with a little creativity, you can find lower carb breakfast choices. But first, here is a little info on diet and PCOS.

Low glycemic index diet and PCOS
Many of the symptoms of PCOS (irregular periods, hair growth, hair loss, acne, etc.) may be caused by high levels of insulin. Eating foods that rapidly turn to sugar will increase blood levels of insulin. So I often recommend that women with PCOS follow a lower glycemic index diet to help lower insulin levels. In addition, many women with PCOS find that they feel better and have an easier time losing weight when they follow a diet plan that has a lower glycemic index. 

So what is a low glycemic index diet?
Basically, this type of diet contains  meals and snacks that include moderate amounts of higher fiber carbs as well as protein and a little fat. This combination of nutrients allows for a slower rise of glucose, less insulin secretion and then a slower drop of glucose. It can help you feel full longer, have fewer cravings and sustained energy levels.

Even if you don’t have PCOS, you might want to try some of the following suggestions for breakfast. They are a lot healthier and lower in calories than a jumbo bagel, a donut or a giant cup of oatmeal loaded with granola, brown sugar and raisins.

Suggestions for low glycemic index calorie controlled breakfast choices:

* These breakfast choices were taken from the chapters I wrote on diet and pcos for Dr. Walter Futterweit’s book: A Patient’s Guide to PCOS.

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Well, it’s the time of year when the chocolates and holiday gift baskets of food have started to appear in offices. Last week it began for me … a Harry and David Chocolate Tower was sent to the doctors office where I have my nutrition practice. Has anyone ever seen this tower? It is unbelievable - contains Moose Munch, Chocolate Truffles, Chocolate Covered Cherries, etc. For those of you who have been reading my blog for a while, you know I am a chocoholic. And the same thing is happening at the hospital where I work … cookies, chocolates, candy, etc. are at all the nurses stations. You try to control yourself, but everywhere you go, you see some kind of tempting goody. I bet many of you are faced with the same challenge.

 Tips to Handle Tempting Goodies or Gifts of Food:
1. In your office, keep them in another room out of your sight. Try to avoid the room where they are kept as much as possible. The more you see them, the more you will want to eat them!  For example, if I know there is a box of my favorite chocolates at the 5th floor nurses station, I try to avoid this area of the hospital.

2. At home, keep them in a container (not a see through one) and put them out of sight. Studies have shown that we eat significantly more candy/sweets if they are placed in a clear container versus an opaque container.

3. Allow yourself 1-2 of your favorite holiday goodies a day (maybe 150 calories). Choose what you really want, eat it slow and enjoy it. Then stop!

4. If eating these goodies opens the floodgates and leads to uncontrolled eating, then you will really need to avoid them. Check out my interview with Christy the Sugar Addict. Don’t even start with foods that “get you going”. Bring in healthy snacks from home to have when everyone else is munching on fattening cookies.

5.  Think about all the calories your co-workers will be consuming!

6. If you do overindulge, get back on track at the next meal or next day. Don’t beat yourself up or let the overindulgence fuel thoughts of “Well, I blew it, so I might as well keep on eating”.

7. If you get a tempting gift of food , consider giving it away - perhaps to your doorman or let your significant other bring it in to their office. Better to have the calories on someone else’s hips!  I’ve been given holiday gifts of cookies and chocolate and have learned the hard way that I’m not very  good at controlling my intake of these foods, so I now know to give them away before I even open the package.  Check out my previous post called “Can Nutritionists Control Their Intake of Sweets?” to get ideas of how other nutritionists deal with problem foods.

So the next time your neighbor (pictured at the right) shows up at your apartment with a fresh baked batch of cookies or another food basket arrives in your office, plan ahead as to how you will handle it.

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