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So you’ve  finally gotten serious with your exercise program. You’re exercising more days a week and have increased the intensity and duration of your sessions.  But you’re gaining weight!  What is happening? One of the reasons you increased your exercise program was to lose weight - not gain weight!

In my private practice, I’ve seen some of my clients gain weight as they increase their exercise. (Luckily they are seeing me … so I can reverse this problem!). There are several reasons as to why this weight gain can occur.

Reasons for weight gain while exercising:
1. Certain forms of exercise build muscle mass. Muscle weighs more than fat, which can show up as weight gain on the scale. If this is the case, you are likely losing body fat while gaining muscle. How do you know if you are gaining muscle and losing fat? You should see a change in the way your clothes fit despite the scale not budging or even going up. Your jeans may become loser around the hips or your skirt may zip easier.

 2. The second reason for weight gain is that you have increased your calories - either consciously or unconsciously. Exercise can actually make you hungrier or you may feel you “deserve” a little extra food since you have increased your exercise.

Overestimating calories burned in exercise 
Keep in mind that your exercise session is probably not burning as many calories as you think. Have you ever checked out what the cardio machines at your gym say you burn when you exercise? (Make sure you plug your weight into the gym machine) It is probably less than what you might have thought you would have burned off. In addition, these machines often times overestimate what you burn (especially the eliptical machine). More on this at another post!

Let’s say you burn 300 calories in your 45 minute treadmill session. Since you started your exercise program, you’ve added a 200 calorie energy bar (which you weren’t eating before) prior to exercising to boost your energy levels for your workout. In addition, you drink 100 calories of gatorade at the gym. And then after dinner, allow yourself a cookie (for 100 calories) because after all - you exercised and deserve a little treat. So while you burned off 300 calories in exercise, you increased your caloric intake by 400. There is a net increase of 100 calories. An extra 100 calories a day can promote a 10 pound weight gain a year!   

Tips to combat weight gain from exercising:
1.  If you are trying to lose weight, really try to stop the mentality of “I exercised, so I deserve a little treat”. Remember, the goal is to have a caloric deficit in order to lose weight.
2. Make sure you consume adequate protein at your meals. Focus on lean protein such as fish, skinless poultry, lean meats, egg whites, low fat cottage cheese and yogurt (the Greek yogurt is especially high in protein), and soy products.  Consuming adequate protein will help to control hunger.
3. If you find exercise increases your hunger, fill up on more veggies rather than carbs (or large portions of protein).
4. Make sure you are hydrated. Sometimes we think we are hungry when we are really thirsty.
5. If you exercising for 60 minutes or less, water is the ideal fluid replacement. Save a sports drink for exercising 60-9o minutes or more. You don’t need the extra calories.
6. Use your calories wisely. I usually recommend a pre-exercise snack(100-150 calories depending upon your caloric needs) to raise blood sugar levels if it has been 4 hours or more since your last meal. This may mean adding in a snack that you usually didn’t have.  Therefore, you will need to take the calories for this snack away from something else in the day. Suggestions: cut back on a glass of wine, piece of bread, slice of cheese in your sandwich, use low cal salad dressing, etc.  Keep in mind that this 100-150 calorie snack is for someone who will be performing moderate exercise. If you plan on running 8 miles or going for a 2 hour fast bike ride, you will need more calories. More on this in a later post.
7. Keeping a food record will really help to make you aware of everything you eat and drink.

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You spend hours in the gym pumping iron and eat a healthy diet… yet you aren’t getting the results you want. Building muscle mass involves a lot more than downing a protein shake or loading up on protein at meals. Assuming you are on track with your workout regimen, your lack of progress likely has something to do with your diet. New research has shown that what you eat and when you eat plays a major role in the development of muscle mass.

A little info about our muscles
Our bodies tend to be in a state of “negative protein balance”. This means that we are breaking down more protein than what we are building. This occurs while we are at rest and even after weight training. In order to build muscle mass, we need to be in positive protein balance. Our bodies need nutrients in order to become in “positive balance”. So what nutrients do we need?

Nutrients needed to build muscle mass
Protein is the major nutrient that builds muscle mass. Strength training increases your protein needs. Check out my previous post on the amount of protein you need a day in order to build muscle mass. This post also contains a chart that lists the protein content of foods. The average active person can easily meet their protein needs, assuming they are taking in an adequate amount of calories. However, they may not be consuming their protein at the right times (more on this later!).

In addition to protein,  you’ll also need to consume an adequate amount of calories. If you aren’t consuming adequate calories, your body will use the protein for energy, instead of using it to build muscle mass.

Last, but not least,  your body needs an adequate amount of carbohydrate. Not only is carbohydrate needed for energy, it also promotes the secretion of insulin. Elevated levels of insulin stimulate the growth of muscle as well as decrease the breakdown of muscle tissue following a workout.

Problems with the typical diet
Most of us have busy schedules and may not consume the optimal diet. Spending a good part of my day listening to what people eat, I have come across 4 common problem areas that can interfere with optimal developement of muscle mass:

1. Going too long without eating. Do you grab a bagel at 9 am,  a sandwich at noon, an apple at 5 pm, hit the gym at 6 pm and then grab dinner at 9 pm? Not good.  Your body is going too long without nutrients. The longer you go without eating, the greater the chances are that you’ll be in negative protein balance.
 
2. Not eating the right kind of foods before or after a workout. Do you eat just a piece of fruit or just a protein shake (without any carbs) or just a bag of nuts? Not the right kind of snack for muscle growth.

3. Following a really low carb diet. Again, not good! While I recommend limiting “bad” carbs, limiting all carbs can hinder your muscle growth as well as decrease your energy levels. Focus on eating moderate amounts of healthy carbs including fruit, whole grains, legumes and vegetables.

4. Not consuming adequate amounts of protein on a daily basis. I find this is more common in my female clients as compared to my male clients. Check out the chart in my previous protein post to see if you are meeting your protein needs.

Recommendations to maximize muscle growth
1. Eat more “mini-meals” containing carbs and protein versus 1-2 larger meals. Consumption of smaller meals containing protein seems to be superior over consuming the same amount of protein at one time. The ideal pattern would be breakfast, a small mid morning snack(if desired), lunch, a pre-workout snack, and a small post workout out snack if dinner will be more than 1-2 hours after your workout, then dinner. You can skip the post-workout out snack if you will be eating dinner soon after your workout. Of course, you may need to decrease the size of your meals if you are adding in more snacks. If you consume too many calories, you’ll gain weight!

2. Consuming a mixed snack containing carbs and protein immediately after exercise can facilitate the replenishment of energy stores as well as promote muscle development.

3. New research has shown that the pre workout meal/snack is even more important than the post workout meal when it comes to building muscle mass. This was news to me as I always focused more on the post workout meal with my clients looking to build muscle mass.

While the exact size and protein and calorie content of these pre and post workout “feedings” will vary depending upon the individual, it has been suggested that 15 grams of protein would be adequate. I would also suggest approximately 150 calories of a carb. Again, this is an estimation as the exact amounts will depend upon the individual persons needs.

Examples of pre / post workout snacks and meals
Protein shake with a cup of berries or a banana
Cottage cheese and fruit
Yogurt (try the higher protein yogurts such as Greek Fage - also called Total) and fruit
2 eggs (or several egg whites) and 1-2 slices of whole grain toast
Glass of low fat chocolate milk
Energy bar containing at least 10 grams of protein and 20 grams of carbs (check out my post on energy bars)
Grilled chicken, fish or lean meat, about one cup of a whole grain and veggies
Turkey or grilled chicken sandwich on whole grain bread

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Frequent headaches? Irritable or depressed? Feeling more tired than usual? Bloated? Craving fatty/sugary foods?  Is it almost “that time of the month”?  You are likely suffering from the effects of premenstrual syndrome (more commonly referred to as PMS).

PMS is a disorder defined as the physical and emotional symptoms that occur repetitively during the second half of your menstrual cycle. For every woman the length, type and onset of symptoms is different. The question is what can you change about your lifestyle to help minimize these discomforts?

You’ve probably heard or read at some point about the PMS diet, the Cycle Diet or that you should take certain vitamins to prevent PMS. The truth is there are hundreds if not thousands of theories about the relationship between nutrition and PMS.  A popular theory is that vitamin and mineral deficiencies can cause PMS and/or exacerbate the effects of PMS. In actuality there is no scientific evidence to support a link between nutrient deficiencies and premenstrual syndrome.  However, there have been some recent studies that show supplementing your diet with certain vitamins and minerals can help reduce the severity of PMS symptoms. 

Vitamin E has been suggested by a few studies as a helpful supplement, though how it works is still not completely understood.  Another recent study indicated that taking Vitamin B6 can help reduce premenstrual weight gain and emotional symptoms.  Due to the way that vitamin B6 is absorbed by your body, it should be taken as part of the B-complex, which is a balanced combination of all the B vitamins.  It is also thought that vitamin B6 should be taken with magnesium to help ease PMS symptoms.  Magnesium has also been studied recently for its possible role in reducing PMS symptoms such as tension and anxiety. Below is a list of foods high in these nutrients. It’s important to remember that taking MORE of a vitamin and mineral is NOT always better.  Talk to your doctor before making any dramatic changes to the type and amount supplements you take.  If you’re not sure if you are getting enough vitamins/minerals from your diet, you can always take a multivitamin as a backup.

Here is the Vitamin E, Vitamin B6 and Magnesium content of various foods:

With all the information out there, it’s hard to know what guidelines you can really follow while still maintaining a healthy lifestyle. The best thing you can do is recognize and manage your own individual symptoms.  To help you make the right decisions, The American Dietetic Association recommends the following dietary tips for controlling PMS:
 
- According to recent studies, the intake of calcium can help regulate mood-related brain chemicals as well as the retention of fluid.  Calcium can then work double-duty as it is a necessary mineral for maintaining bone health.  All women should consume at least 1200 mg of calcium per day by eating dairy products and other calcium rich foods.
 
- Phytoestrogens have also been indicated as helpful in relieving PMS symptoms as well as providing other health benefits.  These naturally occurring plant estrogens can be found in foods such as tofu, soy and tempeh.  However, the total amount needed on a daily basis is still not known due to a lack of knowledge about the interactions of phytoestrogens and hormones in the body.
 
- Limiting sodium to a heart healthy intake of 2400 mg per day can help reduce fluid retention, which is what causes that bloated feeling.  It is important to remember that even if you feel bloated you should not limit your intake of fluid throughout the day.

So ultimately what can you do? The most important thing for managing PMS symptoms as with anything else is to follow general healthy lifestyle guidelines.
1. Consume a well-rounded diet including plenty of complex carbohydrates, fiber and protein but avoid sugary/fatty foods.  Carbohydrates help the body release serotonin – a brain chemical that gives feelings of “well-being.” 
2. Simple carbs like cookies/cake/chips are a quick fix for stimulating serotonin but they can make other PMS symptoms like bloating and weight gain worse – so make a conscious choice to pick whole grain breads and pastas.
3. Also, eat several small meals throughout the day to help manage “food cravings” and increased hunger. 
4. Be physically active and maintain a regular schedule including plenty of sleep.

**************************************************

I would like to thank Teri Chaffman, Dietetic Intern New York Presbyterian Hospital for writing this article.
 

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How many times have your overindulgences caused the scale to jump up by several pounds? Perhaps the cause was your Thursday night “drinks with the girls” which turned into midnight munchies. Or the weekend with your family which ended up in a food fest. Perhaps you had 3 business dinners out this week. Whatever the cause, the result is the same … the scale is now 2 pounds higher.

Gaining a pound or two is not a big deal as you can should be able to take it off rather easily. The problem occurs when you don’t make an effort to take it off immediately and 1-2 pounds turns into 5-10 pounds. Here is an example of “creeping weight gain”.  Let’s say you gained 2 pounds over the December holiday season. You weren’ t that concerned as you figured you could get it off easily. Then your work schedule got really busy in January and exercise fell by the wayside … 2 more pounds appeared. Your February cruise vacation packed on another 2 pounds. Before you knew it, your weight was up 6 pounds. 6 pounds is a lot more difficult to get off than 2 pounds! Now if you had tried to get those 2 pounds off immediately, you probably wouldn’t be in this predicament.

I often suggest “recovery” meals to my clients who have gained a pound or two from overindulging. The “recovery meal” (preferably at dinner) should be low in calories, carbs and sodium to help you drop several pounds quickly. This will get you back to your baseline weight. At that point, you can go back to your more normal way of eating (which hopefully is healthy!)

 Suggestions for “recovery dinners” (many of these suggestions are for take-out foods as city girls tend not to spend too much time in the kitchen!)

1. Steamed Chinese food (protein and veggies) with 4 T. sauce on the side  (375 calories)

2. Middle Eastern chicken kabob (6 0z) over salad, add your own low fat dressing (375 calories)

3. Turkey burger (no bun) with steamed veggies* or salad with low fat dressing (450 calories)

4. 6 oz cold cooked shrimp with lemon and cocktail sauce, salad with low fat dressing or veggies* (360 calories)

5. 1/4 rotissere chicken (remove skin) with steamed veggies* or salad with low fat dressing (400 calories)

6. Edamame, miso soup and 6 pieces sashimi  (Ok - so this one is not so low in sodium… but I had to include it as city girls love sushi!). Check out my previous post on calories in sushi. (400 calories)

7. Frozen dinner for 350 calories or less. Check out my previous post on frozen dinners. Try to select one that is lower in sodium. Add steamed veggies* or salad with low fat dressing.  (400 calories)

8. Egg white omelet (at only 15 calories per egg white,use as many as you want!) made with Pam and a lot of veggies. (175 calories for an omelet made with 6 egg whites)

Other tips: 

1. *The veggies can be fresh or frozen, steamed, grilled, roasted or sauteed with Pam or a little olive oil (about 1-2 tsp). Be careful of buying prepared grilled or sauteed veggies found in many gourmet stores as they tend to be loaded with oil. If you are having a salad, look for a salad dressing with 75 calories or less. Check out my previous post on salad dressings.

2. Avoid alcohol on these “recovery days”.

3. If you have a snack after dinner, make sure it is 75 calories or less. Suggestions: fruit, diet jello/pudding, diet ice pop, nonfat yogurt.

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Are you diligent with your diet and exercise program but still not losing weight? It’s possible that you are a little too diligent! Most of you have probably heard that eating too few calories can slow your metabolism, thereby making weight loss more difficult. This is true. Studies have shown that your body can slow its metabolism by as much as 30% when you undereat.

What is “undereating”?
This will depend upon your age, sex, weight, height, activity level as well your individual metabolism. For the average woman, consuming fewer than 1200 calories would be too low. The fewer calories you consume, the greater the impact on your metabolism. Consuming 800 calories or less on a daily basis has the greatest effect of slowing your metabolism. Not only does consuming too few calories slow your metabolism while you are dieting, it will also cause your metabolism to stay in “slow-down” mode for a period of time even after you go off the strict diet. This contributes to weight regain.

Typical sceniero
Let’s say you want to drop 20 pounds somewhat quickly for a special occasion - so you follow a strict 1000 calorie diet. You initially lose 10 pounds  in the first month, however your weight plateaus for the next two months. The scale doesn’t budge. You get frustrated and go off the diet and revert back to your old eating habits (which weren’t so bad to start with!) and find yourself regaining the weight you lost. In the past, your eating habits maintained your weight. The fact that you are now gaining has to do with the fact that your metabolism has slowed from strict dieting.

How can you increase your metabolism from eating too few calories?
1. Continue to exercise regularly. This will help to rev up your metabolism. Weight training is especially important to build muscle mass. The more muscle you have, the faster your metabolism will be. However, this does not mean you should “over-exercise”.  Exercising too much, along with undereating, will slow your metabolism even more!

2. Slowly increase your caloric intake. This will help to speed your metabolism. Everyone is different, however I have found that many of my clients do well with increasing their calories by approximately 100-200 a month. So for example, if you are currently consuming 800 calories a day, get up to 900 for 2 weeks or so, then increase to 1000. This will give your body time to adjust to the higher caloric intake without causing weight gain. Your eventual goal will likely be a minimum of 1200-1500 calories a day. Make sure you are adding in calories in a balanced manner - protein, fat and healthy carbs.  Continue to exercise as you are increasing the calories, however don’t increase your exercise. This will only offset your increased caloric intake.

Very few people actually consume too few calories!
I frequently have people come into my office claiming they hardly eat anything and are still not able to lose weight. In my experience, once these people keep a food record for a few weeks, they find they are actually eating more than they think. However, there are definitely some people who are eating too few calories. I would recommend you keep a food record for a week or two to see which category you fit into.

Bottom line, while we all have days where we might consume too few calories, doing so on a regular basis is self-defeating as it will only slow your weight loss and make weight gain more likely once you have gone back to your normal eating patterns. The best way to lose weight is to follow a moderate calorie restricted diet and engage in a regular exercise program that includes weight training and cardiovascular exercise.

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

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

Lifestyle recommendations for PCOS:

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

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

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

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

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

Use the following formula to determine your caloric needs:

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

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

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

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

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

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

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

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

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

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

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

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

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

Here is the actual study:

Artificial sweeteners linked to weight gain

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

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

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

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

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

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

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

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

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

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

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

In  my opinion…

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

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

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

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

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

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

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

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

Results of week 5: 

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

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

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

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

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

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

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

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

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

Check out these previous posts:

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

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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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