Holiday ideas to ‘maintain, not gain’

181431584I’ve lost 30 pounds this year. During the holidays, I want to make sure I “maintain, not gain.” Any hints? 

First, congratulations on your weight loss. You should be proud.

You probably already know this, but it’s not easy to keep weight off once you do lose it. Experts continue to examine why that is. Some cite a lack of emphasis on maintenance in weight-loss programs; others believe biology plays a stronger role, blaming significant changes in metabolism during and after weight loss. Those changes often make battling weight regain a Herculean task.

Despite the challenges, there’s hope. Here are some ideas that could help you attain your no-weight-gain goal during the holidays:

  • Be aware that you’re going to encounter a lot of cues that will tempt you to indulge in special treats. Try to counter the temptation by keeping reminders of the positive results when you resist the urge. For example, post photos of your new, svelte self on your refrigerator, inside your pantry and even on your office desk, especially if your workplace tends to be generous with holiday goodies. Another idea: Buy some healthy-living magazines and place them in spots where you know they’ll catch your eye.
  • Know your trigger foods and the times of day when you run into trouble, and ask for help. If you know you have trouble resisting nacho chips at holiday parties, ask a friend to help you keep yourself under control. If you tend to have difficulty when you’re home alone in the evenings, ask someone to call or text you each night for the next few weeks with a gentle reminder to stay the course. Such support can go a long way.
  • Think about tactics you’ve used in the past and renew those efforts: Keep a stash of celery sticks in the refrigerator to fill up on before going to a party. Brush your teeth after every meal. Park at the farthest parking space to help you add steps to your day. Think about what works for you, and make the decision to do it.
  • Be vigilant about sticking with your regular healthy routine: eating a healthy breakfast, drinking plenty of water, getting a good night’s rest and engaging in some type of physical activity every day. Keep yourself accountable by keeping a daily record.
  • Give yourself permission to enjoy the foods of the holiday season, but in moderation. Go ahead and savor a few bites of your favorite treat, but realize you don’t need to eat the whole portion. And, look for ways to be kind to yourself that don’t involve food, such as going to a mind-body class like yoga or Pilates. The rewards are great — and you’ll begin the new year on the right track.

Give thanks for great leftovers

152538549I think the best part of Thanksgiving is the leftovers, but last year our leftover turkey didn’t last very long, and we had to throw a lot of it away. What’s the best way to make leftovers last? 

Generally, leftovers stored in the refrigerator last only three or four days. That surprises a lot of people, who think they might be good for a week or longer.

This year, refrigerate only the turkey you think you’ll use in the next few days and store the rest in the freezer, where it should be fine for two to six months.

Here are some detailed leftover and storage tips for holiday foods from the U.S. Department of Agriculture’s Food Safety and Inspection Service:

  • Make sure perishable foods are left at room temperature for no longer than two hours before you refrigerate or freeze them. Bacteria can multiply rapidly between 40 degrees F and 140 degrees F, so limit the amount of time food is in that “danger zone.”
  • If the leftovers you’re storing are very hot, take steps so they’ll cool rapidly to reach the safe temperature of 40 degrees or below as quickly as possible. For example, divide large amounts of food into shallow containers. Slice turkey off the bone into smaller pieces.
  • After cooling, wrap leftovers well, in airtight packaging or in sealed storage containers. Not only will it keep bacteria out, but it helps the leftovers retain moisture, whether they’re stored in the refrigerator or the freezer. It also prevents leftovers from picking up odors from other foods in the refrigerator.
  • When freezing leftovers, mark the package with a date. Although freezing temperatures of 0 degrees F or below cause microbes to become dormant, preventing the growth of microorganisms that cause both food spoilage and foodborne illness, keeping foods frozen for too long can affect their quality. If your home freezer has a “quick freeze” option, use it, as rapidly freezing foods prevents undesirable large ice crystals from forming. If you have a free-standing freezer in addition to your refrigerator-freezer, use it, as it likely stays colder because it’s not opened as often.
  • When reheating leftovers, be sure they reach an internal temperature of 165 degrees F. Use a food thermometer.

For more, see the website with the USDA’s Safe Food Handling Fact Sheets at Scroll down to “Leftovers and Food Safety.”

Public policies can help fight obesity

159171619I’ve always thought that maintaining a healthy weight is a personal responsibility, but I hear some people talk about what the public should do about the issue. How can that make a difference? 

You might be surprised. Researchers have learned that people’s health behaviors are often influenced at multiple levels, so it makes sense to use multiple strategies to combat the nation’s weight problem.

The idea is this: It is not enough for people to know they should eat nutritious foods or become more physically active if the social or physical environment that surrounds them doesn’t support that knowledge. For example, requiring school lunches to include more fruits and vegetables is the type of public policy that is aimed at improving the environment to help kids make healthier choices.

It’s an important concern. Today, about one-third of the U.S. population is classified as obese and another one-third is overweight. That has implications not only for an individual’s health and well-being, but for public health costs due to the related increased risks of heart disease, stroke, diabetes and other conditions.

The Centers for Disease Control and Prevention offers resources on what local governments, schools, communities and other groups can do to help prevent obesity on its website at Ideas of what can be done to encourage more physical activity, for example, include:

  • Community-wide campaigns encouraging physical activity. Research indicates such campaigns result in an average of about a 4 percent increase in the percentage of people engaging in physical activity. Even more people increase the amount of physical activity they already do during such campaigns.
  • Point-of-decision prompts to use the stairs, including motivational signs and making physical improvements to stairwells to make the experience more pleasant. Such efforts result in an average increase of 50 percent more people choosing the stairs over the elevator.
  • Creating or enhancing access to places for physical activity. It shouldn’t be surprising that people who live in neighborhoods without sidewalks or walking paths, bike paths, or easy access to a fitness center spend less time in physical activity. While community-wide solutions like these can be challenging to implement, they can provide long-lasting benefits once in place.

Grapefruit affects more medications

grapefruitI know you’re not supposed to eat grapefruit or drink grapefruit juice with some types of medication. Which ones do I need to be concerned about? 

Actually, there’s quite a long list, according to the researchers who first discovered the interactions more than 20 years ago. In a review published earlier this year in the Canadian Medical Association Journal, the same researchers report there are now more than 85 drugs that are known to or are predicted to react with grapefruit. And, they said, the number of medications that can cause serious adverse effects increased from 17 to 43 between 2008 and 2012.

The Berkeley Wellness Letter provides a link to the list of interacting drugs that researchers included in their review, and you
can see it online here: The most common ones are some statin drugs used to lower cholesterol, such as simvastatin (Lipitor) and pravastatin (Pravachol), and some blood-pressure medications, such as nifedipine (Nifediac and Afeditab).

In a February 2012 Consumer Update report, the U.S. Food and Drug Administration explained why grapefruit is so problematic. Apparently, many drugs are broken down, or metabolized, with the help of an enzyme called CYP3A4 found in the small intestine. But grapefruit juice has certain substances that block this enzyme, so instead of being broken down, potentially dangerous levels of the drug could enter the bloodstream and remain active longer than anticipated.

The FDA update also explained that, surprisingly, grapefruit juice can have the opposite effect with some drugs. For example, a common over-the-counter allergy relief medication, fexofenadine (Allegra), can be less effective when taken with grapefruit, orange or apple juice, because they block the action of proteins that help move the drug into cells for absorption.

What should you do?

  • Read all prescription and over-the-counter medication labels for warnings about reactions with grapefruit. Non-prescription medications will have that information on the Drug Facts label. Asking your doctor, pharmacist or other health care professional is also a good idea.
  • If there is a warning about grapefruit, also avoid tangelos (a cross between tangerines and grapefruit) and Seville oranges (often used in orange marmalade), and check the ingredients listings on fruit juice to make sure it doesn’t contain juices from those fruits.

Details important in breakfast study

121682410I heard something about research showing that eating a big breakfast is good for people with diabetes. Can you tell me details? 

You probably saw some news coverage of a relatively small study reported at the European Association for the Study of Diabetes annual meeting in late September.

The findings were intriguing. Participants in the study’s “big breakfast” group ended up with blood sugar level reductions three times greater than those in the “small breakfast” group. About one-third of the big breakfast participants were able to reduce their daily diabetic medication within the study period of three months.

However, it’s important to remember some key facts: The study hasn’t yet been published in a peer-reviewed journal, so its findings are considered preliminary. Reports were based solely on the presentation and a press release from the association.

Also, the study involved just 59 people, was relatively brief and appeared to have a high dropout rate. So scientists are anxious to see if the results can be reproduced in more robust studies.

Finally, the big breakfasts in this study also had a higher percentage of protein and fat, which rules out high-carbohydrate morning fare such as a tall stack of pancakes with syrup.

In the study, participants who were in the big breakfast group ate 33 percent of their total daily calories at breakfast time, compared to 12.5 percent of total calories for the small breakfast group.

That means that for participants who consumed 1,800 calories a day, their “big breakfast” would have consisted of 600 calories. It’s not clear what the study participants actually ate, but an example of a 600-calorie breakfast that’s higher in protein and fat would be two extra-large eggs (160 calories); an ounce of cheddar cheese (115 calories); a whole-wheat honey English muffin (130 calories); a tablespoon of peanut butter (95 calories); and a cup of 1 percent milk (100 calories).

In comparison, people in the “small breakfast” group consuming the same 1,800 calories in a day would be limited to 225 calories for breakfast, with a lower proportion of protein and fat. Again, it’s not clear what was on their menu, but they might have had cereal with low-fat milk, for example, or a slice of toast with jam and orange juice.

While results are preliminary, consistently eating breakfast — especially one with lean protein — is associated with better weight management and lower blood sugar levels. Talk with your doctor or nutritionist for more information.