Weight Management & Satiety

Today’s blog post comes from Mary Donkersloot, a registered dietitian and nutrition consultant with a private nutrition practice in Beverly Hills, California. Donkersloot has helped individuals dealing with diabetes, heart disease, weight management and eating disorders for more than 20 years. She is also one of ENC’s Health Professional Advisors.

A new study of more than 7000 U.S. children by Emory Health Sciences has found that a third of children who were overweight in kindergarten were obese by the eighth grade, and almost every child who was obese remained that way (1). With this new information, it is paramount that parents and caregivers learn the basics of how to help kids develop an eating style that will prevent weight issues. Here are five steps that may be helpful:

#1 Provide meal and snack structure.

Kids need a routine with predictable meal times, which generally best works out to be comprised of 3 meals and 3 snacks — breakfast, lunch, dinner, with a snack in between each and perhaps one at bedtime. Feeding toddlers whatever they want, whenever they want, may interfere with their ability to self-regulate their appetite and is a formula for overeating and weight gain.

#2  Limit processed foods high in sugar, fat and salt.

These may interfere with the child’s ability to eat in response to hunger, rather than impulse or reward (2). Instead of sugary cereals at breakfast, serve an egg and a slice of whole grain toast. Instead of crackers or cookies for snacks, make a snack a mini-meal, like almond butter on a small amount of whole grain bread with a glass of milk.

#3  Avoid sugary beverages.

Soda is an obvious issue, given its high calorie, low nutrient content. But juice should be limited as well, since when we drink calories, we don’t cut back as much, if at all, at the next meal, which can lead to overeating. (3,4) Choose water or milk instead of sugary beverages.

#4  Serve a fruit or vegetable each time you feed your child. 

Including fruit in milkshakes or smoothies and adding vegetables to soups and sandwiches can help increase the nutrient and fiber content of children’s meals. Fiber is particularly important. Not only does their fiber help to give a sense of fullness, vegetables and fruits also provide vital phytochemicals that protect the health of the child and promote healthy growth and development.

#5  Eat more home-cooked meals.

Many of the typical “kid’s meals” in restaurants add up to 1000 calories or more, especially those with pasta and sauce, or burgers, fries and soda. Kids who dine out soon suffer from “portion distortion,” or unrealistic expectations of what is a normal portion size. This may result in them feeling cheated when they are served a smaller portion of pasta at home.

While these changes may not be feasible overnight, remember baby steps can go a long way in developing a healthier routine for your child.

Mary Donkersloot, RD

References

1. Cunningham SA, Kramer MR, Venkat Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med 2014; 370:403-411.
2. Johnson SL, Taylor-Holloway LA. Non-Hispanic white and Hispanic elementary school children’s self-regulation of energy intake. Am J Clin Nutr 2006; 83(6):1276-82.
3. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity. Lancet 2001; 357:505-8.
4. Mrdjenovic G, Levitsky DA. Nutritional and energetic consequences of sweetened drink consumption in 6- to 13-year-old children.  J Pediatr 2003; 142:604-10.

January. A new year. A clean slate. No matter what happened in 2013, no matter what kind of health and nutrition goals were set (and perhaps never accomplished), in 2014 everyone gets a fresh start.

The first month of the year always results in lofty New Year’s resolutions, many of which involve personal and family health goals. As a health professional, you know how difficult it can be to help clients change their lifestyle habits, so this year, guide them toward incremental, achievable goals that will encourage them to gradually, but continuously, see results. When it comes to healthy eating goals, one idea is to suggest that clients start small, by focusing on just one meal, like breakfast.

The importance of eating breakfast for physical and mental health has been well established, and eggs are a perfect choice as part of a nutritious breakfast. The protein in eggs provides steady and sustained energy because it does not cause a surge in blood sugar or insulin levels, which can lead to a rebound effect or energy “crash” as blood sugar levels drop (1). Also, several scientific studies have examined the cognitive benefits of eating breakfast, such as improved memory recall time, improved grades and higher test scores (2,3). Even kids know that breakfast is the most important meal of the day. In one study, the majority of children surveyed agreed that eating breakfast helped them pay attention and stay energized throughout the day (4). Moreover, research shows that eating breakfast is a marker for overall health and good behavior in school children. Breakfast eaters are less likely to miss school due to illness or other issues, and are less likely to be tardy to class. (5)

It is no secret that a large portion of individuals’ New Year’s resolutions are goals for weight loss. The great news is that weight loss goals coincide directly with eating breakfast and eggs, in particular. In a study published in the International Journal of Obesity, eating eggs for breakfast as part of a reduced-calorie diet helped overweight dieters feel more energetic than dieters who ate a bagel breakfast of equal calories and volume (6). This is a crucial point for clients who want to lose weight because eating plans that leave a person feeling hungry are not sustainable and will be quickly abandoned.

If your clients are looking for a delicious way to follow your advice, lead them to the incredibleegg.orgrecipe page for quick and delicious egg recipes like these Mini Breakfast Egg, Tomato & Spinach Flatbread Pizzas.

What other nutrition resolutions are you suggesting to your clients this year? Add to the list of goals and advice in the comments section below!

References

1. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. JACN 2004; 23(6): 631S-636S.
2. Rampersaud G, et al. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. JADA 2005; 105:743-760.
3. Pollitt E, et al. Fasting and cognition in well- and undernourished school children: a review of three experimental studies. AJCN 1998; 67:779S-784S.
4. Reddan J, et al. Children’s perceived benefits and barriers in relation to eating breakfast in schools with or without Universal School Breakfast. J Nutr Education Behav 2002; 34(1):47-52.
5. Murphy JM, et al. The relationship of school breakfast to psychosocial and academic functioning: cross-sectional and longitudinal observations in an inner-city school sample. Arch Pediatr Adolesc Med 1998; 152:899-907.
6. Vander Wal JS et al , et al. Egg breakfast enhances weight loss. Int J of Obesity 2008: 32(10):1545-1551.

Keeping the Fun in Holiday Fun 

It’s mid-December, and the holidays are upon us! Exciting, right? Hopefully you and your clients are already enjoying the festivities of the season, but for many people, the next few weeks bring along added stress that can dampen spirits and make the season a little less bright. From making travel plans to buying gifts to making the house guest-ready, the holidays add to-dos on top of schedules that are busy enough during the other months of the year. While some stressors might be inevitable, it is possible to take steps to minimize any unpleasantness. This really should be “the most wonderful time of the year,” so help your clients employ strategies to make it that way.

We know stress isn’t fun by any means, but the physiological effects of stress can have dire consequences – more so than simply ruining a good time. Faced with stress, the body automatically enacts coping mechanisms that, once upon a time, helped humans survive potentially life-threatening situations. While this can be helpful in the short term, putting the body in a constant stressed state does cause harm over time. It can diminish immune system functioning, hampering a person’s ability to fend off illness. This is not ideal during the winter months when people tend to come down with colds or the flu more frequently (1,2). Moreover, prolonged psychological trauma has been associated with higher risk of cardiovascular events and all-cause mortality (3).

Psychological unrest and physical harm should not be part of your clients’ holiday season. Instead, help them stay happy and healthy by providing a few simple stress-reducing strategies that can make the holidays run more smoothly. Holidays are about family, love and giving, but they call for a little selfishness too!

• Plan ahead.
  • Make lists. This doesn’t refer to the naughty-or-nice list or your gift list for Santa. Rather, make lists of things that need to get done this month, this week and this day, in terms of holiday prep.
  • Prioritize. At the end of the day, what is most important? Accomplish high priority items first, and then move onto other items if there’s time.
  • Be realistic. Don’t put so many things on your list for each day that you can’t physically accomplish what needs to get done. Remember to leave room for relaxation and holiday festivities too!
  • Take time for yourself.
    • Rest. With a solid night’s sleep, you’ll be able to think more clearly, check off those holiday to-dos more efficiently and have more time for holiday fun!
    • Exercise. It does wonders for the body and the mind. Whether it’s in the form of physical activity, meditation or simple reflection, stepping away from the distractions of the holiday season can relax you and help you remember the joy that the holidays are meant to bring.
    • Eat and drink mindfully.
      • Fuel yourself wisely. Both mental and physical wellness find their roots in nutrition. Counteract stress’s negative impact on health by choosing wholesome foods like eggs, which provide 13 essential vitamins and minerals to help you stay in tip top shape, physically and mentally. For example, the choline in eggs has been shown to aid in memory and neurotransmitter synthesis, as well as decrease risk for neurological disorders (4). This is great news because we all need a little sanity during the holidays! Check out the Egg Nutrition Center handout on the Nutrient Content of One Large Egg for a full listing of egg nutrients (5).
      • Prepare Grab-n-Go choices. Make healthy meals and snacks ahead of time, so that you’re ready when guests arrive or when you need something as you run out the door for that unexpected errand. Try this Italian Vegetable Custard for a make-ahead “heat-and-eat” meal, and be sure to have Basic Hard-Boiled Eggs on hand for a quick snack (6,7).

While a person can’t possibly anticipate every hiccup or stressor during the holiday season, you can help your clients manage stress levels by providing these simple preparation and coping strategies. By keeping in mind what is truly important as we round out 2013, you and your clients will be able to minimize stress and assure that the joys of the season are truly enjoyable!

References

1. Hall JM et al. Chronic psychological stress suppresses contact hypersensitivity: Potential roles of dysregulated cell trafficking and decreased IFN-y production. Brain Behav Immun. 2013; Epub ahead of print.  http://www.ncbi.nlm.nih.gov/pubmed/24184400. Accessed Dec 9, 2013.
2. Neuzil KM, Hohlbein C, and Zhu Yuwei. Illness among schoolchildren during influenza season. Arch Pediatr Adolesc Med. 2002; 156(10):986-991. http://archpedi.jamanetwork.com/article.aspx?articleid=204004#ref-poa20122-1. Accessed Dec 11, 2013.
3. Hendrickson CM et al. Lifetime trauma exposure and prospective cardiovascular events and all-cause mortality: findings from the heart and soul study. Psychosom Med. 2013; 75(9):849-55.http://www.ncbi.nlm.nih.gov/pubmed/24149074. Accessed Dec 9, 2013.
4. Zeisel SH and Da Costa KA. Choline: an essential nutrient for public health. Nutrition Reviews. 2009; 67:615-623. http://onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.2009.00246.x/abstract;jsessionid=92C92C947F8962BD71C762AF787868E8.f03t01?deniedAccessCustomisedMessage=&userIsAuthenticated=false. Accessed Dec 9, 2013.
5. Nutrient content of one large egg. Egg Nutrition Center. https://www.eggnutritioncenter.org/wp-content/uploads/2012/04/Nutrient-Content-of-1-Large-Egg.pdf. Accessed Dec 11, 2013.
6. Italian vegetable custard. American Egg Board, 2013.http://www.incredibleegg.org/recipes/recipe/italian-vegetable-custard?from=/recipes/collection/brunch/baked. Accessed Dec 12, 2013.
7. Basic hard-boiled eggs. American Egg Board, 2013.http://www.incredibleegg.org/recipes/recipe/basic-hard-boiled-eggs?from=/recipes/collection/simply-eggs/hard-boiled-eggs. Accessed Dec 12, 2013.

Here’s what we’ve been reading here at ENC regarding protein the past couple of weeks! Check the articles out!

Heart-Healthy Holidays

Every year, the holiday season brings feelings of joy, giving and love. Along with these, of course, come holiday parties and gatherings that overflow with delightfully tempting food and drink, from cookies and pies to eggnog and mulled cider. Occasional treats are part of a healthy lifestyle, and the holidays are certainly an occasion to enjoy traditional favorites. But how do we help clients make it all fit and maintain a healthy balance? This year, advise clients and patients to treat themselves with nutritious meals and snacks and to balance out the season’s festive indulgences with physical activity. After all, what is more heartwarming than a healthy heart?

Having been to quite a few holiday parties in the past, you know what to expect: a banquet table piled high with food and drink, including both old favorites and new delights. Help your clients avoid falling into this overconsumption trap by employing these simple, balanced nutrition strategies leading up to the events of the season:

1)      Eat regularly throughout the day.

Parties and holiday gatherings often fall in the evening, but even though we know they’ll be stocked with treats, it is not a good idea to “save up” calories by eating less or not eating at all beforehand. The body naturally reacts to prolonged periods of inadequate caloric intake by prompting it to eat more than it normally would. Advise clients to eat regular meals and snacks throughout the day so as to avoid overindulging in the evening.

2)      Don’t skimp on breakfast!

Research clearly indicates that starting the day with a solid breakfast can help keep hunger at manageable levels, which makes it easier not to overeat and may help in maintaining a healthy weight (1). Advise clients to forego the holiday cinnamon roll if possible, in favor of some fruits or vegetables and a good source of protein, like eggs or nonfat Greek yogurt.

Suggest clients try this recipe for Easy Eggs Florentine with Baby Spinach and Goat Cheese (2).

3)      Portion out your plate.

Whether it’s a meal, a snack or a tasting of items from a holiday spread, advise clients to put together a reasonably portioned plate. At least half of a balanced plate is covered by fruits and vegetables, a quarter by a protein source and the remaining quarter by carbohydrate sources like whole grain bread, brown rice or potatoes.

4)      Keep healthy snacks within arm’s reach.

During the holidays, cookies and candies have a propensity to accumulate on the office desk and the kitchen counter, ready for easy grazing. To counter this tendency, advise clients to keep healthy snack options on hand at all times. Some great options include:

• Trail mix with nuts, popcorn and dried fruit
• Whole grain crackers with low-fat cheese and apples or grapes
• Veggies and hummus or spinach dip

Even with the perfect nutrition plan, holiday indulgences can add up. Help clients stay balanced despite holiday treats by recommending they include daily physical activity in their holiday schedules. Remind clients that exercise does not have to be at the gym; it can also be part of the holiday fun! Family and friends can stay active together by going for a walk to scope out the neighborhood’s holiday decorations, playing in the snow, organizing a pick-up football game or anything else that gets the group moving. There will be plenty of time for sitting by the fire, so advise clients to get up and be active every day, as it invigorates the body while also keeping it in energy balance.

Do you have other great tips for clients and patients around the holidays?

What do you do to manage the treats and temptations around every corner at this time of year?

We’d love to hear from you, so please share your thoughts in the comment section below!

References

1. Jacubowicz D et al. Meal time and composition influence ghrelin levels, appetite scores and weight loss maintenance in overweight and obese adults. Steroids. 2012; 77(4):323-31. http://www.ncbi.nlm.nih.gov/pubmed/22178258. Accessed December 2, 2013.
2. Easy eggs Florentine with baby spinach and goat cheese. Martha Stewart web site. http://www.marthastewart.com/315483/easy-eggs-florentine-with-baby-spinach-a?czone=entertaining%2Fholiday-entertaining%2Fholidaycenter-menus&gallery=275554&slide=281592&center=1009062. Updated 2013. Accessed November 26, 2013.