Posts Tagged ‘Nutrition’

Weight Loss Drugs: Worth the Hype?

Tuesday, January 4th, 2011

Dominique Adair, MS, RD

*courtesy of HFPN.com*

Weight loss drugs, referred to as pharmacotherapy, have been popularly used since the 1950s, though long before that there were products available claiming to contain sanitized tapeworms available for purchase. Following several drugs such as dinitrophenol and the amphetamine-like compounds that posed serious side effects, the weight-loss drugs most commonly used today are appetite suppressants and nutrient absorption blockers.

While lifestyle measures remain the cornerstone of prevention and treatment of obesity, adding anti-obesity agents is considered by some physicians for obese patients who did not achieve sufficient weight loss after lifestyle modifications. Often positioned as an adjunct to diet and exercise, weight loss drugs are meant to supplement these behavior interventions and not to replace them. This article will review these classes of drugs, how they work, and the criteria with which physicians prescribe them to their patients.

Classes of Drugs

Today, most commonly prescribed weight loss drugs are either appetite suppressants or fat absorption blockers. For both, the goal of pharmacological intervention is to decrease feeding behavior and reduce weight. Appetite suppressants facilitate weight loss by tricking the body into believing that it is not hungry or that it is full. Most of them decrease appetite by increasing serotonin or catecholamine — two brain chemicals that affect mood and appetite. For example, the drug Subutrimine acts by increasing noradrenaline and serotonin levels in the hypothalamus, nucleus accumbens and the brainstem, all regions associated with energy homeostasis (1). Other centrally acting drugs that also work through the modification of neurotransmitters are presently being aggressively researched to determine if these novel approaches lead to clinically meaningful weight loss and improvements in comorbid conditions such as diabetes and cardiovascular disorders.

Clinical experience data on the success of these drugs suggests that weight loss produced by any one agent is limited and rarely exceeds 10% of the starting weight (2). This initial drop also plateaus. The ‘ceiling effect’ observed is probably due to adaptive changes as the body continues to maintain a balance in favor of energy conservation or the body’s metabolic “slow-down” in response to chronic underfeeding. One approach that some weight loss specialists have adopted to overcome this issue is to develop combination therapies that tackle the problem through more than one mechanism in an effort to minimize the impact of these adaptive changes.

Fat absorption inhibitors work by preventing the body from breaking down and absorbing ingested fat. These medications act on the gastrointestinal system and work by blocking the action of lipase, the fat-digesting enzyme, thereby reducing fat absorption in the gut. The non-absorbed fat is then eliminated in bowel movements. It also blocks the availability of fat-soluble vitamins (vitamins A, D, E, and K), so patients may also take a vitamin supplement (3).

The most commonly prescribed fat absorption blocker is the prescription drug Orlistat (brand name Xenical). Research has explored the effectiveness of Orlistat compared to other drug treatments, placebo, or behavior-focused interventions. Avenell et al. carried out a systematic review of trials involving a combination of diets, drug therapy, exercise, and behavior therapy and concluded that adding Orlistat to a dietary intervention improved weight loss by 3.26kg up to 24 months (4). Research also indicates that Orlistat reduces cholesterol and blood pressure levels and improves glycemic control when compared to placebo (5).

As of 2007, Orlistat became available over-the-counter (OTC). Sold as the brand name “Alli,” which is half the strength (60mg versus 120mg) of the prescription drug, Orlistat was the first clinically-proven OTC product to be combined with a comprehensive support program. Research indicates that both Orlistat and Alli can improve weight loss if used alongside behavioral and lifestyle interventions, however due to unpleasant side effects (urgent bowel movements, diarrhea, and gas with oily spotting/anal leakage) there remain problems with adherence and much variability in patient outcomes.

The Best Candidates

While each physician develops their own specific criteria for prescribing weight loss drugs, guidelines do exist. The National Heart Lung and Blood Institute’s evidence statement on pharmacotherapy for weight loss asserts:

“Weight loss drugs approved by the FDA may only be used as part of a comprehensive weight loss program, including dietary therapy and physical activity, for patients with a BMI of 30 with no concomitant obesity-related risk factors or diseases, and for patients with a BMI of 27 with concomitant obesity-related risk factors or diseases. Weight loss drugs should never be used without concomitant lifestyle modifications. Concomitant assessment of drug therapy for efficacy and safety is necessary. If the drug is efficacious in helping the patient lose and/or maintain weight loss and there are no serious adverse effects, it can be continued. If not, it should be discontinued” (6).

Before selecting a medication(s), physicians will also consider health history, possible side effects, and potential interaction of weight-loss drugs with other prescribed and OTC medications.

It is extremely important for physicians to emphasize to their patients that weight-loss drugs don’t replace the need for changes in eating habits and activity level. In fact, several studies on drug intervention alone demonstrate that once patients stop taking the drug, they may have a higher rate of regain compared with people who also have some behavior modification support (7).

Weight-Loss Drugs and the Fitness Professional

When combined with a low-calorie diet and regular exercise, weight-loss drugs produce an average weight loss of 5% to 10% of total body weight within a year, a typical initial goal for any weight-loss effort. Losing 5% to 10% of total weight may not seem like much, but even modest weight loss can improve health by:

* Decreasing blood pressure
* Decreasing lipid levels
* Decreasing blood glucose levels
* Increasing insulin sensitivity

With interventions that combine lifestyle behavior change and pharmacotherapy, it is difficult to determine how much of weight loss success can be attributed to each. Regardless, both during drug intervention and after, lifestyle behaviors, as supported by fitness professionals, remain an exceptionally important part of the success equation.

References:

(1) Sargent B and Moore, NA. New central targets for the treatment of obesity. Br J Clin Pharmacol. 2009 December; 68(6): 852–860.
(2) Tziomalos K, Krassas GE, Tzotzas T. The use of sibutramine in the management of obesity and related disorders: an update. Vasc Health Risk Manag. 2009; 5: 441–452.
(3) Hollywood A, Ogden J. Taking Orlistat: Predicting Weight Loss over 6 MonthsObes. 2011;2011:806896. Epub 2010 Nov 11.
(4) Avenell A, Brown TJ, McGee MA, et al. What interventions should we add to weight reducing diets in adults with obesity? A systematic review of randomized controlled trials of adding drug therapy, exercise, behaviour therapy or combinations of these interventions. Journal of Human Nutrition and Dietetics. 2004;17(4):293–316
(5) Padwal R, Li SK, Lau DCW. Long-term pharmacotherapy for overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. International Journal of Obesity. 2003;27(12):1437–1446
(6) http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/txgd/4325.htm last accessed 12.12.10.
(7) Warziski Turk, M Randomized Clinical Trials of Weight-Loss Maintenance: A Review. J Cardiovasc Nurs. 2009; 24(1): 58–80.

Selecting Produce – What Are the Clues to Quality?

Thursday, October 28th, 2010

Courtesy of HFPN.com

Jonathan Ashe

The most important aspect of shopping for produce is finding clean, delicious, and nutritious fruit and vegetables for you and your family. You work hard towards health for you and your clients, so decisions regarding produce are as important as planning an exercise program. But how do you select quality produce?

We have all stood there—under the hum of fluorescent lights and fixed upon freshly moistened produce—trying to select a piece of fruit or a vegetable. Do you tap on a banana or a watermelon? Do you smell a potato or a tomato? And what do the answers to these tests reveal to us about the produce? “If you are a farmer that knocks on thousands of melons a year you probably know what you are listening for,” shared Kyle Tator. Kyle is the Extension County Program Director for New Mexico State University in Valencia County, New Mexico and helps run a local farmers market.

But what about us, those who want to pick the right produce but don’t have years of education to back our choices?

Experts advise that we become our own produce expert. Start by learning some general tips on selecting fresh and ripe produce.

Timing Is Everything

Look at where you buy your produce and find out the best time to buy your fruits and vegetables at that location.

Laura Bittner, and Extension Agent helping to run the Valencia County Nutrition Program advises, “there are days of the week…when produce comes in to the grocery store and I would ask whoever is working in the produce section what days those are and how quickly they get the produce out [on the floor]…that would be the day that I would go and purchase produce.”

Here are some general tips to help you and your client selecting the best produce:

* Fruits are either ripened on the plant or non-climatically ripened (berries, citrus, cherries, dates, and grapes) or still ripen off of the plant or climatically ripened (peaches, bananas, apples, melons, plums, and tropical fruits)
* Remember that buying under ripe produce isn’t always the best option. Peaches, cantaloupe and nectarines are examples of fruits that may soften during storage, but they won’t ripen.
* Tropical fruits such as mangoes and kiwis will grow sweeter off the plant, but not develop their aroma (developed on the plant)
* Avocados must be picked in order to ripen (so hard is okay)
* Look for produce that is average in size and shape for the best taste. Large produce rarely tastes as good, usually has tough flesh, and takes up too much space (does anyone really eat the state fair produce winners?)

Distance Matters

The estimates of miles traveled for produce varies with each season and each piece of fruit or vegetable.

If you live in New York and buy California table grapes, that produce traveled over 3000 miles to get to your plate.

For most fruits and vegetables, quality increases—in freshness, taste, or nutrition—as the distance decreases between the farmer and consumer. Know where the produce originated. Kyle and Laura suggest adding “distance traveled” on your list of clues to select quality produce. Further, they advise to segment distance to determine your top-down list of choices for produce:

The first choice is seasonally fresh produce that are usually found at your local farmers market, Community Supported Agriculture (CSA) groups, and grocery cooperatives—you will usually need a membership to the CSAs or co-ops to enjoy their benefits. Visit the Local Harvest website (http://www.localharvest.org/) to find farms, farmers markets, and CSAs in your area. You can also search for a farmers market through the USDA Agriculture Marketing Service website (http://apps.ams.usda.gov/FarmersMarkets/).

Eat local produce at the peak of freshness during their growing season and you will notice the difference. The more experience you gain from buying local foods, the more you will know the “season” for each produce selection.

When visiting your local farmers market or speaking with a CSA representative, Kyle suggests asking the following questions to help you decide if the produce is right for you:

If the booth displays “Grown Organically”, ask the farmer if they are registered or certified with the USDA. The answers will help you determine if they have gone through the application and approval steps or are misusing the label.

If the booth displays “Grown Naturally” or without an organic display, ask the farmer what type of inputs (fertilizer, insecticide, herbicide, etc.), varieties (heirloom, hybrid, genetically modified, etc.), water supply, and other practices to determine if you want to eat their produce.

Labels are Important

Buying produce—as every product in the grocery store—requires an understanding of labels. Use the labels attached to produce to help determine source and potential quality:

* Organic – The easy part is that produce is either organic or it is not. There is no such thing as 95% or 70% of organic ingredients when it comes to produce. For your best quality organic produce, select products with the USDA organic seal. To reduce the mystery of certification from international sources, select products with the USDA organic seal that were produced in the United States.

* Natural – This label means nothing regarding a certification process and there is no guarantee of what “natural” means.

* Universal Product Code (UPC) – The 12 digit number on the barcode will tell you a lot about the produce, including its origin. Use a UPC look-up service (such as http://upcdata.info/) to help find information. The UPC code is for fixed weight or volume items which is a trend with organic produce with larger companies (such as a package of organic carrots)

* Price Look-Up Code (PLU) – While that little sticker on loose produce is annoying to remove, they do provide information to help you decide on selection. The 4 or 5 digit PLU code aids checkout with specific codes for specific items and their prices per weight. The PLU provides you information such as:

o Produce that starts with the number 9 are organically grown
o Produce that starts with the numbers 3 or 4 are conventionally grown
o Produce that starts with the number 8 are genetically modified organisms (GMOs)

Make sure to clarify with the produce clerks when you find bulk produce that are without the PLU code or have a store made label above their bin. This will make sure the label is correct and aid you in making your produce selection.

If you are unsure of any produce at any venue, don’t hesitate to ask questions of the farmer, produce clerk, or anyone in charge of the selection. Even their responses will help you decide on what is best for you.

Further Reading:

To learn more about your local seasons for fruits and vegetables, visit About.com’s comprehensive state-by-state or regional listing of seasonal fruits and vegetables:

(http://localfoods.about.com/od/findlocalfoodsbystate/u/stateguides.htm).

To start building a knowledgeable foundation in produce selection, you can review numerous websites that identify clues of ripeness for specific produce.

Here are a few sites to get started:

* USA Pear Council Produce Guide  – http://www.usapears.com/en/Recipes%20And%20Lifestyle/Culinary%20Corner/Produce-Guide.aspx

* Purdue University Extension Program – http://www.cfs.purdue.edu/extension/food_health/nutrition/produce.html

* The Center for Disease Control provides a good monthly fruit or vegetable highlight – http://www.fruitsandveggiesmatter.gov/month/index.html

Client Solutions: 10 Commonly Asked Questions

Friday, October 1st, 2010

Courtesy of HFPN.com

HFPN Editorial Team

Personal Training

Question 1: Are you supposed to gain weight first before you lose weight?

Question 2:What exercises can I do to lose weight—for instance, to get rid of my stomach—and gain definition?

Question 3:I have been told that high fat meals lack food volume. What does that mean?

Question 4:How much protein does an “off-season” bodybuilder need?

Question 5:Which is better for recovery after a workout, carbohydrates or protein?

Question 6:How do I know my daily caloric needs?

Question 7:How many Calories do I need to burn to lose a pound?

Question 8:Is it safe to use supplements during pregnancy?

Question 9:I have a really hard time gaining weight! Any suggestions?

Question 10:What are some sources of lean protein?

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Q: Are you supposed to gain weight first before you lose weight?

A: That depends on your goal. If you are looking to add a few pounds of muscle mass before leaning up, you may want to try gaining some weight first. If you are gaining weight while trying to lose weight, then your caloric intake is greater than your energy expenditure. Take a close look at how much you are actually eating (i.e. weighing and measuring food, and tracking it in a food journal).

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Q: What exercises can I do to lose weight—for instance, to get rid of my stomach—and gain definition?

A: Any exercise can increase energy expenditure and contribute to fat loss. However, spot reducing—eliminating fat from certain places on the body by using particular muscles—is not possible. Instead, focus on controlling your food intake and increasing your exercise to create a need for your body to pull fat from your fat stores. As the fat under the skin is being consumed, your muscles will become more defined. But you can’t choose where on your body the fat is lost.

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Q: I have been told that high fat meals lack food volume. What does that mean?

A: One gram of fat represents 9 Calories, whereas one gram of carbohydrates or protein represents only 4 Calories. Since fat is a denser source of Calories, the amount of food is much smaller for a comparable number of Calories.

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Q: How much protein does an “off-season” bodybuilder need?

A: Protein requirements for an “off season” bodybuilder range from 1.6 to 2.0 g/kg/day. Research shows that excessive protein intake does not increase total body protein synthesis (LBM gain) if caloric needs are met.

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Q: Which is better for recovery after a workout, carbohydrates or protein?

A: A high carbohydrate drink with moderate protein is optimal, assuming it is within your caloric recommendations. Considering that your primary energy source for resistance training is glycogen (from carbohydrate intake), replacing glycogen enhances recovery by initiating an anabolic (muscle building) environment.

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Q: How do I know my daily caloric needs?

A: Daily caloric needs (sometimes called maintenance Calories) refers to the number of Calories you require for basic physiological functions, combined with the number of Calories you need for specific daily activities. The sum of these two numbers equals your daily caloric needs.

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Q: How many Calories do I need to burn to lose a pound?

A: You must burn an extra 3500 Calories (in excess of what you eat) to lose a pound.

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Q: Is it safe to use supplements during pregnancy?

A: A pre-natal multivitamin is a safe supplement and should be used through pregnancy and lactation. In addition, calcium and/or iron supplements can be safely utilized if nutrient needs are not being met through food, and your physician prescribes them.

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Q: I have a really hard time gaining weight! Any suggestions?

A: In contrast to fat loss, you must consume more Calories than you expend to gain weight. One way to do that is to find foods that are low in volume and high in Calories. Meal replacement bars and drinks are great for getting extra Calories when eaten in addition to your regular meals.

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Q: What are some sources of lean protein?

A: Chicken, fish, low-fat cottage cheese, egg whites, and turkey are just a few sources of lean protein.

Trans-Fat-Free Foods

Thursday, March 25th, 2010

Trans-Fat-Free Food: What’s the Truth?

The skinny on labels, calories, and what trans fat means to your diet.

WebMD Feature   

By Kathleen M. Zelman, MPH, RD, LD   

Reviewed by Brunilda Nazario, MD

We’ve made great progress since January 2006, when Congress required that trans fat content be listed on food labels. Food manufacturers and restaurants that used the unhealthy fats have scrambled to find alternatives so they can boast of their “trans-fat-free” foods. Bills to limit or ban trans fats in restaurants or school cafeterias have been introduced in many states.

Artery-clogging trans fats have been made out to be the bad guy in American diets — and there’s good reason for that. But the truth is that just because something is trans-fat-free, that doesn’t necessarily mean it’s healthy. Experts agree that using healthy fats, such as canola oil, olive oil, and plant sterols is better than using the artery-clogging trans or saturated fats. Yet all fats are loaded with calories — and so need to be limited in our diet.

To make it even more confusing, labels boasting “zero trans fat” don’t always mean a food is completely trans-fat-free. By law, such foods can contain small amounts of trans fats per serving. You’ll still need to turn over the package and look at the list of ingredients and the nutrition facts panel.

So just what are trans fats? There are two types — the naturally occurring type, found in small amounts in dairy and meat, and the artificial kind that results when liquid oils are hardened into “partially hydrogenated” fats.  Natural trans fats are not the ones of concern, especially if you usually choose low-fat dairy and lean meats. The real worry in the American diet is the artificial trans fats, which are used extensively in fried foods, baked goods, cookies, icings, crackers, packaged snack foods, microwave popcorn, and some stick margarines.

These artificial trans fats started getting lots of attention after research showed that they could increase the risk for heart disease by increasing “bad” LDL cholesterol and decreasing “good” HDL cholesterol.

The American Heart Association (AHA) recommends limiting trans fat to less than 2 grams per day (a figure that includes the naturally occurring trans fats).  The 2005 U.S. Dietary Guidelines simply recommend keeping trans-fats consumption as low as possible.

The Real Meaning of ‘Zero Trans Fats’

In any grocery, you’ll see many products boasting “zero trans fats.” Yet this does not necessarily mean there is absolutely no trans fat in the product. 

“Even though the label states “zero trans fats,” one serving of the food can contain up to 0.5 grams of trans fat, according to the law, and still be labeled trans-fat-free,” explains Elizabeth Ward, MS, RD.

The same guideline exists for saturated fats.  Only when the food label states “no trans fats” does it really mean there are none.

The problem is that small amounts of these artery-clogging fats can add up quickly, especially if you eat several servings each day of foods that contain up to 0.5 grams per serving.

For example, popcorn can be an excellent source of fiber, is a whole grain, and can be low in calories. But if you eat several cups of microwave popcorn, the trans fat can really add up.

“Most people eat three cups at a sitting, which is three times the serving size and can have as much as 1.5 grams of trans fats,” says Ward, author of The Pocket Idiot’s Guide to the New Food Pyramids. “The same goes for trans-fat-free cookies that are easy to eat by the handful and add up quickly.”

How to Find Trans Fats on Labels

The only way to be sure you’re getting a truly trans-fat-free food is to check the list of ingredients on the label. Avoid products containing “partially hydrogenated fats or oils” (the main source of trans fats) or “shortening.” Also keep in mind that some manufacturers are listing components of food ingredients separately so they can move trans fats lower on the list of ingredients.

Michael Jacobson, executive director for the watchdog group Center for Science in the Public Interest, suggests looking beyond trans fats when you’re reading labels.

“There is a frozen ice cream snack that claims zero trans fat, yet has 20 grams of saturated fat in one serving,” he says. “So even though it has no trans fats, it contains a day’s worth of saturated fat and is anything but healthy.

“Trans fats are the worst fats, even more so than saturated fats, but you must evaluate a food on the entire profile, including calories, total fat, saturated fat, vitamins, mineral, sodium, sugar, and fiber.”

Trans Fat Substitutes

If a label says trans-fat-free, what else might the food item have in it?  Food chemists are experimenting with different fats and oils that are suitable replacements and don’t alter taste or texture.

“Most of the fast-food restaurants have done a very good job switching to a vegetable oil like soybean oil to deep-fry their foods,” says Jacobson. 

Using heart-healthier monounsaturated or polyunsaturated oils, such as olive, canola, or corn oil, is a great option for some products, but doesn’t work when you need a solid fat to make a food. Replacing trans fat with saturated fat is better, but not ideal.

“Trans fats are worse than any other fat, including butter or lard, so look for foods that use the least amount of trans fats,” says Jacobson. “Even if it contains a little saturated fat, it is better than consuming the trans fat.”

Adds Ward: “Tropical oils such as palm, palm kernel, and coconut may not contain trans fats, but they contain unhealthy saturated fats that are almost as bad for you as partially hydrogenated fats.”

Trans Fats When You’re Eating Out

But what about foods in restaurants, or from outside the U.S. where trans fat labeling may not be required? When restaurants and state fairs boast that their oils are trans-fat-free, some consumers may be misled into believing fried foods are good for them.

“Using trans-fat-free cooking oil to fry foods is certainly better,” says Ward. “But the food is still fried, and fried food is high in fat and calories and generally not recommended for the heart or the waistline.”

Wendy’s, Taco Bell, Dunkin’ Donuts, Baskin Robbins, Denny’s, IHOP, KFC, Pizza Hut, and Starbucks are among the food companies that have replaced trans fats or are committed to doing so. Yet plenty of restaurants still use them.

“Avoiding fried foods and cakes, cookies, and pastries is the easiest way to reduce trans fat consumption when you eat out,” says Jacobsen. 

You can also ask about the type of fat used for frying, baking, and in salad dressings. Even if the menu boasts that items are “cooked in vegetable oil,” that doesn’t necessarily mean they’re trans- fat-free foods. They may contain some partially hydrogenated vegetable oil.

Beyond Trans Fats

While eliminating trans fats is important, it’s only one piece of the puzzle when it comes to protecting your heart and health.

“Trans fat is getting lots of bad press but it is important to keep in mind the ‘big’ fat picture, which includes total fat, saturated fat, and a healthy lifestyle,” says cardiologist Robert Eckel, MD.

“Limiting trans fats is … only one component of a healthy dietary pattern that includes eating a wide variety of nutritious foods such as fruits, vegetables, and whole grains; limiting total fats [and] saturated fats; getting regular physical activity; and being at a healthy weight,” says Tufts University researcher Alice Lichtenstein,DSc. Eckel, past president of the AHA, adds not smoking to that healthy lifestyle list.

To help educate consumers about trans fats and other fats, the AHA has launched a “Face the Fats” campaign, enlisting the help of Eckel as well as The Food Network’s Alton Brown, known for his scientific approach to cooking. Brown uses his knowledge of food to help consumers learn to make low-fat substitutions that are nutritious and still delicious.

“I look at recipes and see how I can make it healthier by reducing the amount or type of fat, using a replacement ingredient, or altering the cooking method,” says Brown. “But sometimes, none of these work and the answer is to simply eat a smaller portion.”

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Nutrition & Food Labels

Thursday, March 25th, 2010

All About Food Labels

Ever wonder what you’re really eating in that buttery snack cracker, sugary canned fruit, or slice of processed cheese? It’s easy to find out. Just read the Nutrition Facts on the product’s food label.

What Are the ‘Nutrition Facts’ on the Food Label?

The Nutrition Facts section is located on the outside of the package and is easy to read. This section of the food label gives you information about specific nutrients in the product, including:

  • Calories
  • Fats
  • Protein
  • Fiber
  • Specific vitamins and minerals

 

Serving Size: An Important Part of Food Labels

At the top of the Nutrition Facts section, you’ll see the serving size (such as 1/2 cup, five crackers, or 10 chips) and servings per container (such as two, four, six). The food label then lists the number of calories, and the amount of calories from fat, per serving.  

These numbers are important, especially if you aim to eat a diet lower in calories and fat. For example, having five Ritz crackers at 80 calories per serving is not bad for a snack. But who eats just five crackers? If you had 15 crackers, you’d consume 240 calories — which is probably too many, especially for teens who are watching their weight.

You’ll notice different units of measurement on food labels. Many of the nutrients are measured in grams or “g,” while others are measured in milligrams or “mg.” Some information is given in percentages (%).

Fats and Other Nutrients

Along with calories per serving and calories from fat, the Nutrition Facts gives you the amount of other nutrients and total fat. It then breaks the total fat number down into saturated fat and trans fat — the unhealthy fats that can increase the risk of heart disease.

The total fat number is also broken down into polyunsaturated fat and monounsaturated fat, which are healthy fats more beneficial to your health. Keep in mind that it’s always good to limit the total amount of fats you eat, especially “bad” fats.

Let’s look at what these terms mean:

  • Cholesterol is found mainly in meat, poultry, fish, and dairy products. The cholesterol found in food can increase the cholesterol in your blood, but saturated fats have a greater impact than dietary cholesterol.
  • Saturated fat comes primarily from foods of animal origin such as dairy products, meat, butter, cheeses, poultry, and luncheon meats. It is also found in tropical oils such as coconut oil and palm oil. Choose nonfat or low-fat dairy, lean meats, and skinless poultry to reduce saturated fat intake. Too much saturated fat can raise the cholesterol level in the blood and increase the risk of heart disease.
  • Trans fats are formed during the process of “hydrogenation,” a manufacturing technique that turns liquid oils into partially solid products. These fats are in vegetable shortening, some margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, salad dressings, and other processed foods. Eating too many trans fats raises the cholesterol level in the blood.
  • Polyunsaturated fat comes from many plant foods, nuts, seeds, some plant oils (sunflower, corn, soybean), some seafood (herring, salmon, mackerel, halibut), and soybeans. Polyunsaturated fat is a healthy fat and includes heart-healthy omega-3 fatty acids.
  • Monounsaturated fat comes from some plant foods, including olives and olive oil, canola oil, peanuts, and avocados. New research suggests that these fats help reduce your risk of heart disease.

After fats, carbohydrates, dietary fiber, sugars, and protein are listed on the food label. These items are followed by specific nutrients in the food, such as vitamin A, vitamin C, calcium, and iron. Last, the food label lists the ingredients in the product.

What Are ‘Daily Values’ on a Food Label?

To the right of the “Nutrition Facts” are the Daily Value percentages. The Percent (%) Daily Value indicates how much of a certain nutrient one serving of the food contains, compared to the recommended amount of that nutrient you should have for the entire day.

The percentages next to each nutrient — such as fat, sodium, fiber, protein — can help you determine whether a food is “high” or “low” in that nutrient. And 5% or less is considered to be “low,” while 20% or higher is “high.” For example, the Dietary Fiber is 0%, or “low,” in Ritz crackers.

Sample Nutrition Facts

Here is a sample Nutrition Facts label (for Ritz Crackers):

Ingredients: Enriched flour (wheat flour, niacin, reduced iron, thiamine mononitrate [vitamin B1], riboflavin [vitamin B2], folic acid), soybean oil, sugar, partially hydrogenated cottonseed oil, salt, leavening (baking soda, calcium phosphate), high fructose corn syrup, soy lecithin (emulsifier), natural flavor, cornstarch.

Nutrition Facts

Serving Size: 5 Crackers (16g)

Servings Per Container: About 28

Amount per Serving

Calories: 80 Calories From Fat: 40

% Daily Value*

Total Fat:4.5g 7%

Saturated Fat: 1g 5%

Trans Fat: 0g

Polyunsaturated Fat: 2g

Monounsaturated Fat: 1g

Cholesterol: 0mg 0%

Sodium: 135 mg 6%

Total Carbohydrate:10g 3%

Dietary Fiber: 0g 0%

Sugars: 1g

Protein: 1g 

Vitamin A: 0%* Vitamin C 0%

Calcium: 2%* Iron 2%

 *Percent Daily Values are based on a 2,000-calorie diet. Your daily values may be higher or lower, depending on your calorie needs.

Avoiding Marketing Hype

As you get used to reading food labels, you’ll realize that some manufacturers try to fool consumers.

Some packages say “all natural.” But if the products are high in sugar or saturated fat, “all natural” means nothing! If a food label says “low-fat,” read the Nutrition Facts to see if it’s really a healthy choice. Many times, a low-fat food is still high in sugar or calories.

Boosting Key Nutrients

It’s important to choose foods that are nutrient-dense. That means food with:

  • Substantial levels of vitamins and minerals.
  • Few calories.
  • Limited saturated and trans fats.
  • Low levels of cholesterol, sodium, and sugar.

Limit these nutrients: total fat, saturated fat, trans fat, cholesterol, and sodium. Eating too many of these may increase your risk of heart disease, high blood pressure, and some types of cancer. No more than 1/3 of your total daily calories should be from fat. And most of it should be mono- or polyunsaturated.

Get plenty of these nutrients: fiber, Vitamin A, Vitamin C, calcium, and iron. Eating plenty of these nutrients can boost your immune function and overall health. Fiber is important to promote healthy bowel function, while calcium builds strong bones and prevents fractures. Vitamin A and C are important for staying well, preventing infection, and reducing the risk of diseases.

By reading the Nutrition Facts, you can be sure you’re getting the nutrients you need each day. For instance, if a food has 30% of the Daily Value of calcium, you know you will need to eat a few more food sources of calcium (like milk, cheese, and yogurt) to reach 100% daily value of calcium for the day. If a food provides 20% of the Daily Value of protein, you’ll need to make other protein selections during the day to ensure 100% of the Daily Value of protein.

Words of Warning About Food Labels

Food labels must state if the product contains ingredients that contain protein from the eight main allergenic foods. These include:

  • Milk
  • Eggs
  • Fish
  • Crustacean shellfish
  • Tree nuts
  • Peanuts
  • Wheat
  • Soybeans

The label might say “Contains milk” or “Contains peanuts.” This is lifesaving information for people allergic to these foods.

The bottom line: read the Nutrition Facts on your food labels. Let food labels work for you as you establish healthful eating habits.

WebMD Medical Reference

View Article Sources

SOURCES: American Diabetes Association website: “Nutrient Content Claims & Percent (%) Daily Value.United States FDA/CVSAN website: “How to Understand and Use the Nutrition Facts Label.”

Make Grocery Shopping a Healthy Habit

Monday, March 22nd, 2010

TIPS FOR HEALTHY GROCERY SHOPPING

Read the labels, and fill your cart with the most nutritious foods

By Sylvia Davis
WebMD Weight Loss Clinic – Feature

Reviewed by Louise Chang, MD

It all starts in the grocery store. The foods you choose to stock your pantry, refrigerator, and freezer are the foundation for your diet.

Grocery shopping can be daunting. It can be overwhelming to try to choose the healthiest foods from among all the options that line every aisle. And new trends and choices pop up every day, from fortified foods to upscale gourmet.

To help you navigate the supermarket, here are some expert tips to help you read food labels and choose healthy products. We’ve also got a top 10 list of nutritious foods to add to your grocery cart.

Label Reading Tips

The first thing you’ll see is the label on the front of the food package. Manufacturers can say most anything they want on the front label (to get the real story, see the Nutrition Facts panel on the back). Here are some terms you may see there, and what they really mean:

  • Fortified, enriched, added, extra, and plus. This means nutrients such as minerals and fiber have been removed and vitamins added in processing. Look for 100% whole-wheat bread and high-fiber, low-sugar cereals.
  • Fruit drink. This means there’s probably little or no real fruit, and lots of sugar. Look for products that say “100% Fruit Juice.”
  • Made with wheat, rye, or multigrain. These products may have very little whole grain. Look for the word “whole” before the grain to ensure you’re getting a 100% whole-grain product.
  • Natural. The manufacturer started with a natural source, but once it’s processed the food may not resemble anything natural. Look for “100% All Natural” and “No Preservatives.”
  • Organically grown, pesticide-free, or no artificial ingredients. Trust only labels that say “Certified Organically Grown.”
  • Sugar-free or fat-free. Don’t assume the product is low-calorie. The manufacturer may have compensated with unhealthy ingredients that don’t taste very good — and have no fewer calories than the real thing.

Here are some key phrases you’ll see on the Nutrition Facts panel on the back of the package:

  • Serving Size. Portion control is important for weight management, but don’t expect manufacturers to make it easy for you. Pop-Tarts, for instance, come two to a package. The label says one serving is 200 calories — for “one pastry.”
  • Calories and Calories From Fat. This tells you how many calories are in a serving, and how many of those calories come from fat. Remember that this information is for one serving as defined on the label.
  • Nutrients by Weight and Percentage of Daily Value (%DV). This shows how much of each nutrient is in one serving, by weight in grams and by %DV. This symbol refers to the recommended daily allowance for a nutrient based on a 2,000-calorie diet (some nutrients, such as sugar and protein, don’t have a %DV). Fats are listed as “Total Fat” and also broken down so you can see how much is unhealthy saturated fat and trans fat.
  • Vitamins and Minerals. Vitamins and minerals are listed by %DV only. Pay particular attention to vitamin A, vitamin C, calcium, and iron; most Americans don’t get enough in their diets.
  • Ingredients. They’re listed in order from the greatest amount to the least. Experts offer a rule of thumb: the fewer the ingredients, the better.

Top 10 Foods to Put on Your Grocery List

Here are some foods that experts say should be on any health-conscious shopper’s grocery list:

  • Tomatoes. These juicy, red fruits are loaded with the antioxidant lycopene, which has been shown to reduce the risk of cardiovascular disease in women.
  • Low-fat proteins. Good sources of lean protein include seafood, skinless white-meat poultry, eggs, lean beef (tenderloin, sirloin, eye of round), and skim or low-fat yogurts, milk, and cheeses. Some research has indicated that a diet moderately high in protein can keep hunger at bay, and thus help you lose weight.
  • Whole grains, oats, and fibrous foods. Fiber helps your digestive tract work properly and lowers cholesterol levels while keeping your belly feeling full. Whole grains also contain antioxidants, are fat free, and are easy to fit into your diet.
  • Berries (red and blue), including grapes. Berries are loaded with vitamins and minerals, as well as phytochemicals with cancer-fighting properties. Red grapes, in the form of one glass of red wine daily, may even reduce the risk of heart disease, according to the American Heart Association. (If you’re a nondrinker, check with a doctor before starting.)
  • Nuts. A handful of almonds, cashews, pecans, or walnuts provides fiber, vitamin E, and healthful, monounsaturated fats. Just watch your portion size; these nutritious nuggets are high in calories.
  • Fish and fish oil contain omega-3 fatty acids that can reduce the risk of heart disease by protecting the heart against inflammation. The American Heart Association recommends eating fatty fish such as salmon, mackerel, tuna, or sardines at least twice a week.
  • Unsaturated fats such as olive, canola, and soybean oils are the best kind of fats.
  • Low-fat dairy products provide plenty of calcium to help keep bones and teeth strong, are a great source of protein, and may even enhance weight loss, according to some research.
  • Vegetables are a healthful eater’s best friend. All veggies, except avocadoes, are fat-free and loaded with disease-fighting phytochemicals.
  • Legumes (like pinto, garbanzo, kidney and black beans and lentils) are underrated. The lowly bean is naturally fat free and loaded with protein, fiber, vitamins, and minerals, especially iron. They add few calories, but keep you feeling full.

For additional information read 10 Tips for Healthy Grocery Shopping.

Heat & Dehydration

Thursday, March 11th, 2010

Experienced athletes generally have no trouble properly hydrating while exercising or training.  In fact, most athletes are aware of the role hydration plays in their performance and will take all measures to insure proper hydration before, during and after activity including acclimating to the environment in which they will be competing.  However, many clients and beginning athletes are unaware of the dangers lurking outdoors in the elements.

Heat adaptation

It is well-known that exercising in a hot environment accelerates muscle fatigue, challenging the body to regulate its core temperature and dissipate heat. However, did you know that as the core temperature rises, a change in muscle metabolism takes place?  Oxygen uptake, heart rates and blood lactate concentrations increase during exercise in the heat.  In addition, muscle glycogen utilization per hour is significantly in hot conditions.

An acute episode of hyperthermia starts off relatively mildly with symptoms like headache and nausea. If activity continues and hydration and temperature regulation are not addressed, symptoms can progress to cramps, heat exhaustion (with dizziness, profuse sweating and weak/rapid pulse), and ultimately heat stroke which can cause a loss of consciousness or even in extreme instances, death.

When exercising intensely for prolonged periods and/or in hot, humid conditions, keeping a watchful eye on hydration is crucial for optimal performance and health. Steps in preventing dehydration or heat stroke include

  • Adequate fluid intake before and throughout practice or competition
  • Monitoring of heart rate (any significant change in HR to constant activity shows a poor response to the demands of that activity)
  • Monitoring of weight, replacing weight losses with fluid. Remember, a pint weighs a pound

Fortunately, continued exposure to training in warm environments leads to adaptations that make it easier to perform in the heat. These adaptations include an increased capacity to sweat, reduced salt losses in sweat and a lower body temperature and heart rate response during activity. Excitingly, these adaptations can take place in a little as 7-14 days.

The primary mechanism for the body’s heat loss at high levels of work in both normal and hot environments is the evaporation of sweat which releases heat from the body. Sweat rates increase linearly with increased exercise intensity, and in hot weather sweat losses can reach close to 3.0 liters/hr.  

Fluids and performance

Without proper hydration, athletes cannot reach peak performance, even if exercise is only a few minutes long. The longer an athlete remains with inadequate hydration, the less desirable performance they will exhibit.  

Among US high school athletes, heat illness is the third leading cause of death. It doesn’t help that many distance running races, triathlons and football games occur in warmer times of the year.

Many athletes and exercisers mistakenly think that their thirst will guide them to ideal hydration. Thirst typically occurs when the one’s water deficit is approximately two percent of body mass. Performance begins to be impaired with a fluid loss of as little as 1%, suggesting our natural thirst mechanisms cannot keep up with exercise-induced fluid losses. In other words, by the time we register we are thirsty, performance may be in decline.

How can performance be affected by such small fluid deficits? It may be due in part to the decrease in plasma volume (any decrease in fluids will automatically decrease blood/plasma levels), impairing the delivery of oxygen and nutrients in and out of muscles. Along with the loss of fluids, especially during prolonged exercise and profuse sweating, we also lose electrolytes that are involved in muscle and nerve function. In addition, prolonged exercise can create a significant decrease in muscle and liver glycogen, the body’s main energy sources. Replacing fluid, electrolytes and glucose is the formula for performance success, especially in longer duration exercise (more than 60 minutes) in hot environments.

Children and Older Exercisers/Athletes

In young children, adolescents and in older (40+) athletes, we find natural hydration mechanisms (thirst triggers, taste) and heat dissipation functions (skin blood flow and sweat rates) are underdeveloped or diminished, making proper hydration strategies a bigger concern. In these populations monitoring is generally required.  Follow the hydration guidelines below to keep your athletes at peak performance levels before, during and after the game or exercise session.

Hydration Guidelines

Pre-workout Guidelines During Exercise Post workout Guidelines
  • Drink approximately 16 ounces of fluid two hours before activity, and an additional 8-16 ounces 30-60 minutes prior to training on warm and/or humid days.
  • Water may be adequate for activities lasting less than an hour.
  • If you are participating in endurance events, repeated bouts of exercise greater than 60 minutes, or multiple practices a day, use a sports drink containing 6-8% carbohydrate.
  • Depending on your sport, consume 6-12 ounces of water or sports drink every 15-20 minutes. This equates to approximately 32 ounces per hour.
  • For prolonged exercise greater than four hours, choose a sports drink with small amounts of electrolytes.
  • Immediately following activity, consume at least 16 ounces of fluid for every pound of weight lost to ensure proper rehydration.
  • A liquid shake with high carbohydrate content, minimal protein and fat can maximize recovery if muscle glycogen levels have been depleted.
  • Drink an additional 16 ounces with your post-workout snack and/or meal. Weigh yourself each morning. A stable weight generally indicates proper fluid balance.

 

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Hydration for Athletes

Thursday, March 11th, 2010

 Possibly the most  underemphasized aspect of sports nutrition, hydration can make or break an athlete’s performance.  While fuel depletion during exercise can impair performance, inadequate water not only impairs exercise capacity, but can create life threatening disturbances in fluid balances and core temperature.  With as little as 1% of body weight lost in fluid, athletes can experience thirst, fatigue, and weakness.(1)  Thirst drives a person to drink, but it can actually lag behind the body’s need.  When too much water is lost from the body and not replaced, dehydration develops.  Dehydration refers to an imbalance in fluid dynamics when fluid intake does not replenish water lost.  On the flip side, water intoxication occurs with excessive water intake or kidney disorders that can reduce urine output.  In healthy individuals, dehydration is more common than water intoxication, but appropriate water balance is crucial to optimal performance and ultimately survival.  

Water and Body Fluids

Water constitutes about 60 percent of an adult’s weight and it is the medium in which all life processes occur, including:

  • Carrying nutrients and waste products through the body
  • Maintaining the structure of large molecules
  • Acting as a solvent for minerals (i.e., sodium and potassium) and other small molecules
  • Acting as a lubricant and cushion
  • Maintaining blood volume
  • Helping the body regulate temperature

Every cell in the body contains fluid specific for that cell called intracellular fluid, and around it is extracellular fluid.  These fluids continually lose and replace their components, but the composition of each compartment remains remarkably constant.

Because an imbalance can be devastating, the body continually adjusts water intake and excretion as needed.  This type of balance is referred to as homeostasis.  

The body must excrete a minimum of about 500ml (about 2 cups) of water each day as urine to eliminate waste products that the body makes through metabolism.  Above this amount, the body adjusts by excreting excesses to balance intake.  In addition to water lost in the urine, the body also loses water from the lungs as vapor and the skin as sweat.  The amount of fluid lost depends on the environment (heat and humidity), and physical conditions such as activity. On average, the body loses about 2.5 liter/day.

Fluid maintains blood volume, which influences blood pressure. The homeostatic balance of fluids and solutes in the body is carefully regulated by the kidneys with assistance from several hormones including antidiuretic hormone (ADH) and aldosterone.  The primary solutes that are involved in maintaining fluid balance are sodium, potassium, proteins, and glucose.  Adequate intakes of water and electrolytes maintain hydration levels and regulate fluid shifts between the intra- and extra-cellular compartments.

To maintain water balance, intake from liquids, foods, and metabolism must equal losses from the kidneys, skin, lungs, and GI tract.

The Needs of the Athlete

One of the primary functions of water for all individuals, especially athletes, is thermoregulation.  A person can tolerate a drop in body temperature of 10 degrees (c), but an increase of only 5 degrees (c).  Heat generated by active muscles can raise core temperature to levels that would incapacitate a person if caused by heat stress alone.(2)

The body uses three mechanisms to dissipate heat: 

  • circulation
  • evaporation
  • hormonal adjustment. 

The circulatory system works to deliver warm blood to the body’s shell.  This produces the typical “flushed face.”  Sweating begins within several seconds of the start of vigorous exercise and this evaporative cooling controls heat dissipation during exercise.  Lastly, because sweat contains water and electrolytes, the body makes hormonal adjustments to help prevent the loss of salts and fluid.

When the fluid lost in thermoregulation results in dehydration and a drop in blood volume, the end result produces circulatory failure and core temperature levels can increase to lethal levels.

Water Replacement

Total water intake at the reference level of 3.7 liters for adult men and 2.7 liters for adult women per day covers the expected needs of healthy, sedentary people in temperate climates. 

The obvious dietary sources of water are water itself and other beverages, but most foods contain some water as well.  Most fruits and vegetables are almost 90% water, and many other foods like meats and cheese are approximately 50% water.  The body also makes water during metabolism, when energy-yielding nutrients break down and their carbons, hydrogens, and oxygens combine to make carbon dioxide (CO2) and water (H2O). 

According to the Dietary Reference Intakes: The Essential Guide to Nutrient Requirements, published by the Institute of Medicine (3), most people get adequate fluids by drinking when they’re thirsty.  However, the report does add that prolonged physical activity and heat exposure will increase water losses and therefore may raise daily fluid needs.  Very active individuals, who are continually exposed to hot weather, often have daily total water needs of six liters or more.   Both heat acclimatization as well as nutrition intervention are indicated for this population.  

According to the American College of Sports Medicine, general guidelines for fluid replacement are as follows: (5)

Consume a nutritionally-balanced diet and drink adequate fluids during the 24-hr period before an event.

Drink about 500 ml (about 17 ounces) of fluid about 2 hours before exercise to promote adequate hydration and allow time for excretion of excess ingested water.

  • During exercise, athletes should start drinking early and at regular intervals in an attempt to consume fluids at a rate sufficient to replace all the water lost through sweating or consume the maximal amount that can be tolerated.
  • It is recommended that ingested fluids be cooler than ambient temperature [between 15 degrees and 22 degrees C (59 degrees and 72 degrees F])] to enhance palatability and promote fluid replacement.
  • Addition of proper amounts of carbohydrates and/or electrolytes to a fluid replacement solution is recommended for exercise events of duration greater than 1 h since it does not significantly impair water delivery to the body and may enhance performance.

Water loss by sweating peaks at about 3L per hour during intense exercise in heat.  However, just about any degree of dehydration can impair performance.  Adequate fluid replacement sustains the body’s potential for evaporative cooling.  Rehydration protocols are often based on water lost as measured either by urine color, urine specific gravity, or changes in body weight.(4) If collecting urine is not feasible, sweat loss as reflected by weight loss can be used.  An athlete’s pre and post workout (or event) weights are takenand whole body sweat rate can be calculated by dividing the sweat loss by the time period of collection. The following equation can be used to determine volume of fluid lost: (5)

Sweat loss = (body weight before – body weight after) + amount of fluid intake – toilet loss.   

Alternatively, taking a simple measure of body weight each morning after emptying the bladder can show a pattern of hydration over time, provided gains or losses of fat and muscle tissue are not also taking place.

Fluid balance, electrolyte homeostasis, cardiovascular function, and thermoregulatory control are intimately linked to fluid consumption and each has a major impact on health and performance.  Fluid replacement helps maintain hydration and, therefore, promotes the health, safety, and optimal physical performance of individuals participating in regular physical activity.  Athletes and their coaches should be aware of fluid replacement needs, and develop strategies and protocols to insure athletes drink enough to keep pace with sweat loss.

Learn More About The Author

Drinking the Right Amount of Water: Important Part of Your Exercise Routine

Wednesday, February 24th, 2010

Possibly the most underemphasized aspect of sports nutrition, hydration can make or break an athlete’s performance.  While fuel depletion during exercise can impair performance, inadequate water not only impairs exercise capacity, but can create life threatening disturbances in fluid balances and core temperature.  With as little as 1% of body weight lost in fluid, athletes can experience thirst, fatigue, and weakness.(1)  Thirst drives a person to drink, but it can actually lag behind the body’s need.  When too much water is lost from the body and not replaced, dehydration develops.  Dehydration refers to an imbalance in fluid dynamics when fluid intake does not replenish water lost.  On the flip side, water intoxication occurs with excessive water intake or kidney disorders that can reduce urine output.  In healthy individuals, dehydration is more common than water intoxication, but appropriate water balance is crucial to optimal performance and ultimately survival.  

Water and Body Fluids

Water constitutes about 60 percent of an adult’s weight and it is the medium in which all life processes occur, including:

  • Carrying nutrients and waste products through the body
  • Maintaining the structure of large molecules
  • Acting as a solvent for minerals (i.e., sodium and potassium) and other small molecules
  • Acting as a lubricant and cushion
  • Maintaining blood volume
  • Helping the body regulate temperature

Every cell in the body contains fluid specific for that cell called intracellular fluid, and around it is extracellular fluid.  These fluids continually lose and replace their components, but the composition of each compartment remains remarkably constant.

Because an imbalance can be devastating, the body continually adjusts water intake and excretion as needed.  This type of balance is referred to as homeostasis.  

Fluid maintains blood volume, which influences blood pressure. The homeostatic balance of fluids and solutes in the body is carefully regulated by the kidneys with assistance from several hormones including antidiuretic hormone (ADH) and aldosterone.  The primary solutes that are involved in maintaining fluid balance are sodium, potassium, proteins, and glucose.  Adequate intakes of water and electrolytes maintain hydration levels and regulate fluid shifts between the intra- and extra-cellular compartments.

Nutrition and Poor Sleeping Habits

Friday, December 18th, 2009
Resting

Resting

Many of us don’t get the sleep our bodies require.  Several studies have confirmed that poor nutrition leads to inadequate sleep.  The average American sleeps 5 to 6 hours a night.  To wake-up feeling energized, you would need to sleep 7 to 8 hours without interruption.  Falling short an hour can leave you feeling like you’re spending your entire day in a daze.

 

 

 

 

Several factors affect your sleep, such as:

  • What and when you consume food
  • How you unwind from the day

Eating an hour before bed is definitely a no, no.  Not only will it affect your sleep, but it may even cause more serious problems down the road with acid reflux disease and GERD.  Stop eating at least 3 hours before you decide to call it a night.  If you’re dealing with a rumbling tummy, consider a 4 oz glass of hot chocolate or a few saltines to settle your stomach.  The lighter the food: the better it is for your body.

Stay away from high caffeine treats and drinks.  A cup of coffee or bottle of one of those power drinks can affect your sleep.  The caffeine is a stimulate and even though your body wants to sleep often your mind can’t shut off.

Although water consumption is considered a good thing, consuming too much of it late in the evening causes more frequent visits to the bathroom.  If you’re one that wakes up through the night because you have that urge, eliminate the consumption of liquids at least 4 hours before bed.

Some foods can be better when it comes to encouraging sleep, for instance “MILK”.  Milk has a substance called “tryptophan” that promotes sleep.  This amino acid is what the body uses to make serotonin, which slows down the brain nerve traffic so you can sleep into a blissful sleep.

Tuna, poultry, beans, whole grains, sunflower seeds, peanut butter, bananas, rice, and other dairy products other promote good sleeping habits.  All of which are nutritionally sound foods to consume.  Take some time to evaluate your nutrition and sleep pattern, then decide if making a few changes in when and what you eat is beneficial for you.