Kathy Jordan, MS, RD

By Kathy Jordan, MS, RD, LDN, CPT

• The # 1 key is making permanent changes¹- Realize that losing weight and keeping it off is a lifelong commitment and is very challenging. It requires the willingness to make major lifestyle changes and enthusiasm in accepting these changes.

• ENVISION YOURSELF THE WAY YOU WANT TO BE – “What will my life be like when….” Having a clear vision is paramount to success.

• Use visualization to picture yourself once you reach your goals. Practice in your mind how you will look and feel.

• You will need strong, compelling reasons to make these major lifestyle changes. Make a list (and post where you’ll see it several times throughout your day) of all the benefits of achieving a healthier weight and keep your focus on those benefits. Here are some examples of some benefits you will most likely experience with permanent weight loss: climbing stairs with ease, having more energy, improved health, more self-confidence, better mood, more fun shopping for clothes, overall enjoyment of life, better feeling about yourself, and so on.

• Sometimes negative reinforcement can be very effective; therefore, I suggest you also make a list of what your life will be like, what your health will be like, and how you will look and feel if you don’t make lasting lifestyle changes to achieve your weight loss goals and maintain your success. In other words “What will my life be like if I continue on this same path?”

• Use Visualization to see yourself behaving in ways that are in concert with your vision. Rehearse in your mind how you will handle certain situations ahead of time so you will be prepared and have a plan.

• Mindset – Having the right mind set or a can-do attitude is achieved by acknowledging that you and only you control your thoughts and feelings. Thoughts control your actions. Feeling empowered leads to success.

• Use Positive thinking – become aware of and garner the ability to change negative thoughts and negative self talk into positive, more productive thoughts.

• Be Flexible – You need to be prepared for setbacks and obstacles. Make contingency plans and know when and how to modify goals to fit your situation.

• Avoid trying to be perfect, acknowledge your weaknesses, accept your mistakes and setbacks and be able to continue moving forward, toward your vision.

• Focus on becoming healthy and making healthy choices

• Make it a priority and make the time to do whatever it takes to achieve your goals. For example, you need to set aside time to exercise, plan and prepare meals and snacks and grocery shopping so you have the right foods in your house. And stay away from FAST FOOD.²

• Set Realistic Goals that are in concert with your vision.

•Accountability:

• Studies have found that regularly meeting with a Registered Dietitian or joining a formal weight management program improves your success.³

• Hire a weight coach or personal trainer to help you get started, but eventually you will need to become you own coach and hold yourself accountable.

• Keeping a food and an exercise journal helps keep you honest and is a strong motivator to stay on track. ⁴

• Support system – surround yourself with people who have similar goals and/or support your efforts to reach your goals. This allows you to share ideas, experiences and strategies that help you stay on track. Choose a buddy that you can rely on when you need a little emotional support, or just to join you for a walk.

• Get Moving The National Weight Loss Registry studies found that people who maintained their weight loss, exercise for at least one hour per day.⁵

• Strength Training. Not only do you burn calories while you’re doing it, you also continue to burn more calories all day long, even while you’re sleeping. Muscle tissue is more metabolically active than fat tissue, so it revs up your metabolism – a very important factor in keeping the weight off.

• Get Adequate Sleep – Several recent studies have found that the quantity and quality of sleep affects hormones that regulate appetite and satiety (feeling of fullness). People who don’t get enough sleep have increased appetites, don’t feel satisfied after eating and tend to crave high carbohydrate, calorie dense foods. Emerging science indicates hormone changes due to lack of sleep may also result in higher blood sugar levels. High blood sugar results in storage of excess body fat. If you are not getting seven to nine hours of good quality sleep, set a goal to get more sleep. Eating a healthier diet and getting regular exercise may be just the things to help you get a better night’s sleep.

• Modify your environment to make it conducive to a healthier diet and lifestyle.

• Consider taking dietary supplements that enhance your nutrition and aid your weight loss and maintenance. Studies have found that those who take dietary supplements regularly are less likely to be overweight. ⁶

References:
1. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. 1997;66:239-246
2. Phelan, S., Wyatt, H., Hill, J., Wing, R.R. (2006) Are the Eating and Exercise Habits of Successful Weight Losers Changing? Obesity Research, April;14(4):710-716
3. Raatz, SA, ET, al, Perspectives in Practice: Intensive Diet Instruction by Registered Dietitian Improves Weight Loss Success.(2008) JADA 108: 1, 110-113.
4. Diane L. Helsel, John M. Jakicic, Amy D. Otto. Comparison of Techniques for Self-Monitoring Eating and Exercise Behaviors on Weight Loss in a Correspondence-Based Intervention. Journal of the American Dietetic Association October 2007 (Vol. 107, Issue 10, Pages 1807-1810).
5. win.niddk.nih.gov/notes/SprSum97/1artcl3.htm National Weight loss Registry
6. Association of Ten-Year Weight Change with Use of Supplements Marketed for Weight Management,” conducted by M.C. Nachtigal, ND, Emily White, PhD, and Ruth Patterson PhD, all of the Fred Hutchinson Cancer Research Center in Seattle. American Association of Naturopathic Physicians (AANP) 19th Annual Convention & Exposition, being held September 8-11, 2004, at the Washington State Convention & Trade Center, Seattle, WA.

By Kathy Jordan, MS, RD, LDN, CPT

For years we have been told to diet and do aerobic exercise to lose weight. Current research, however, finds that this formula may help you lose some weight, but not the right kind. And 98 percent of people gain it back. According to Wayne Wescott, PhD, only 10 percent of those who do aerobic exercise do enough to impact their weight. Let’s look at the facts to see why we gain weight over the years, and the role dieting and exercise play in successful weight loss.

The average American gains 30 pounds between the ages of 20 and 50. Over the same period of time, we lose 15 pounds of muscle. Theoretically, that means we end up with 45 more pounds of fat on our bodies at age 50 than we had at 20. This creates a weight loss/weight management dilemma because the amount of muscle we have largely determines our resting metabolic rate (RMR) or the amount of calories we burn at rest. RMR accounts for 65-70% of the calories we burn each day. Fat tissue is not very metabolically active, but muscle is. So the more muscle we have, the more calories we burn.

When you go on a weight loss diet without the right kind of exercise, it sets you up for difficulty in keeping that weight off (Am Psych Journal). Why? First, cutting calories enough to result in lost pounds reduces muscle mass. This, in turn, reduces your RMR which means you are burning far fewer calories after your weight loss than before. If you don’t lower the amount of calories you eat during the “maintenance” stage of your diet, you won’t maintain the lower weight.

What should you do to successfully lose weight and keep it off?

• Do not overly restrict calories or you will lose too much muscle. Instead, focus on eating a healthy mix of fruits, vegetables and whole grains and plenty of lean protein such as fish, poultry, non-fat dairy products and protein drinks.
• Eat a protein-rich diet combined with regular exercise to preserve lean body mass and maximize weight loss that comes mainly from fat.
• Add strength training to build muscle. Although strength training and brisk walking each burn 7 calories per minute, in the hour following your strength training session you burn another 25 percent, or 40 extra calories. This may not seem like much, but it’s cumulative. And the more muscles you condition, the more you increase your RMR and the more calories you burn all day long, even while you are sleeping.
• In addition to strength training at least 2-3 times per week, do some aerobic exercise such as walking or something else you may enjoy for 3060 minutes several days per week. Aerobic exercise will burn some extra calories, but the other benefits such as improved cardiovascular fitness really make it worthwhile.
• Dietary supplements may be important for overall health when you are cutting back on calories so you don’t miss needed vitamins or minerals. Although there is no pill that will do what strength training can do for your metabolism, there are some supplements that will help you burn more calories during and after weight loss.

Other benefits of combining strength training with a healthy diet and aerobic exercise include a stronger, sleeker, more toned body, more lean body mass and better balance. In other words, you’ll look and feel great!

By Kathy Jordan, MS, RD, LDN, CPT

Remember Thanksgivings as a child when you ate so much your tummy hurt and the rest of the afternoon was spent laying on the couch? You can probably recall a number of other occasions when you’ve asked yourself, “why did I eat so much?” There are many factors that influence overeating, many of which are learned behaviors. There are also different types of overeating, from occasional excess related to a holiday or social event to more chronic issues with over consumption.

The Risks
While eating too much once in a while is not likely to be a big issue unless you have certain medical conditions, chronic overeating can lead to excessive weight gain. This can have psychological, physiological and medical consequences. Chronic overeating is associated with depression, low self-esteem, a lack of energy and compromised quality of life. A number of other medical conditions are linked to and/or exacerbated by being overweight. Most of us want to lead a long, healthy life, so why would we do something, such as overeating, when we know it could negatively affect our health and well-being?

The Why

• Medical – While there are a few medications and medical conditions that contribute to being overweight (such as Prader-Willis syndrome and hypothyroidism), the majority of overeating and weight gain occur as a result of psychosocial reasons.
• Psychological Reasons – many people eat in response to emotions rather than true hunger.
• Restrictive dieting can cause cravings for foods the diet suggests avoiding. We often dwell on what we “can’t have.” If you give in and eat the “forbidden” foods, it may generate feelings of failure and guilt, which often lead to more overeating.
• Boredom
• Procrastination
• Fatigue
• Learned behaviors/habits
• Coping mechanism
• Comfort
• Anxiety/ feeling overwhelmed
• Feeling upset or hurt
• Stress
• Loneliness
• Eating as a reward
• Mindless eating
• Social Factors – Food is all around us. It seems that everywhere you go, whether it be the movies, the ball game, the office or even the hardware store, we are surrounded by food cues (triggers which result in the desire to eat). There is even pressure to eat in many social situations. Some examples of social factors that may lead to overeating include:
• Portion distortion
• TV
• Special occasions
• Specific places (associations)
• Friends, family, co-workers
• Visual cues
• Disordered Eating – below are a few forms of disordered eating that are associated with overeating:

Compulsive overeating, also called binge eating disorder, is characterized by recurring episodes of uncontrollable eating as a coping mechanism, and usually results in weight gain. It is accompanied by a feeling of lack of control in which the individual believes they are unable to stop eating.

According to the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, these binge-eating episodes are associated with some of the following:
• rapid eating
• eating past a sense of fullness to a point of pain
• eating large portions even when not hungry
• eating alone to hide the episode
• experiencing embarrassment or shame over the episode
• feeling depressed, guilty, or disgusted with oneself after overeating

Treatment for this type of eating disorder may include self monitoring, cognitive restructuring (forming alternative views of a situation and challenging beliefs that interfere with positive change), goal setting, stimulus control and working with a dietitian and/or support group.

Bulimia, also called bulimia nervosa, is an eating disorder characterized by the consumption of large quantities of food followed by some form of purging, fasting or excessive exercise. Professional help is recommended for managing this condition. It is best treated with a multi-disciplinary approach involving a physician, psychologist or other behavioral therapist, registered dietitian, and in some cases, additional allied health professionals. In order to make the most out of your weight management efforts, it is important to recognize any behavioral or psychological factors that may be affecting your eating patterns and discuss them with your doctor.

By Kathy Jordan, MS, RD, LDN, CPT

I am not a big fan of diets with lists of forbidden foods. They usually instill a lot of guilt and don’t work in the long run. Instead, I promote adopting a healthy lifestyle that includes healthy food choices that maximize your nutritional intake, strength training, aerobic exercise, adequate sleep and stress/time management. HOWEVER, the research is piling up that certain types of foods contribute to obesity, type-2 diabetes, non-alcohol related fatty liver and a number of other debilitating lifestyle-related conditions.

Consuming foods that are fast, convenient, and calorically dense while low in nutrients on a regular basis is not in your best interest if you want to avoid obesity, lose weight and have a long healthy life. The biggest culprits are refined flours, FAST FOOD and sugars.

The Stats and Studies:
The USDA Dietary Guidelines for Americans describe a healthy diet as one that is low in saturated fats, trans fats, cholesterol, salt and added sugars^1. This is consistent with the 2002 position paper on weight management by the American Dietetic Association that blames a sedentary life coupled with access to an abundance of energy-dense foods for the epidemic of obesity, chronic disease, and escalating national health care costs². A 2006 study conducted by the National Weight Control Registry found that weight re-gain was associated with several factors including high calorie and high fat intake, and fast food consumption. Factors associated with long-term weight loss included limiting fast food consumption³.

Why pick on fast food? A typical fast food meal is high in calories from fat, refined starches, salt and sugar. It is energy dense, supplying an average of 150% more calories than a traditional meal. It increases the risk of obesity and related health issues by encouraging inadvertent over consumption of calories. And supersizing compounds the issue. A supersized fast food meal often exceeds 1,600 calories, more than many people should eat in an entire day. These meals are woefully low in fiber, but pack in plenty of unhealthy fat, sugar and sodium. And it’s not just the fare at fast food restaurants we should be concerned about; ready-to-eat and other convenient meal solutions offered at supermarkets and convenience stores may have similar nutrient profiles.

Not all carbs are created equal. Sugar and refined flour or other refined starches (grains such as: cereals, breads, pasta, white rice and crackers, made from grains that have been processed to remove the husk also removing most of the fiber, vitamins and minerals along with it) are more rapidly digested into glucose – causing blood sugar levels to rise. This stimulates insulin production, which signals the body to convert more of the excess energy into: body fat, fatty lipids that circulate in the blood and deposits of fat in the liver⁴.

In 2001, the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) called for a drastic reduction in sugar consumption, citing that poor diet contributes to 60% of the 56 million annual reported deaths worldwide. Americans consume over 100 pounds of sugar per year. High sugar foods and beverages are usually high in calories and low in or completely void of nutrients. Soda and other sweetened soft drinks, such as sports drinks, fruit drinks, sweetened ice tea and lemonade are the leading sources of sugar in the American diet. Researchers from Children’s Hospital in Boston and the Harvard School of Public Health report that sugar-sweetened beverage consumption increases the incidence of obesity⁵.

As our consumption of sugars, refined starches and fast food has risen, so has the incidence of overweight and obesity. The average male and female American adult weighs approximately 25 pounds more today than we did 45 years ago, and the incidence of overweight and obesity among our youth has tripled since the 1960’s and 70’s. To win the fight against fat, we will have to choose foods that contribute to health over those that contribute to health decline.

¹ U.S. Department of Agriculture: Dietary Guidelines for Americans 2005, 6th ed.
² American Dietetic Association. Position of the American Dietetic Association: weight management. J Am Diet Assoc 2002;102(8):1145-55.
³ Phelan S, et al. Are the eating and exercise habits of successful weight losers changing? Obesity 2006;14(4):710-16.
⁴ Ludwig DS. Dietary glycemic index and obesity. J Nutr 2000;130(2S Suppl):280S-283S.
⁵ Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001;357(9255)505-8.

By: Kathy Jordan, MS, RD, LDN, CPT

Fact: The verdict is still out on this one. There are about 3,500 calories in a pound of body weight. Technically, it would take a calorie deficit of 500 calories per day to lose one pound in a week. However several studies have indicated that diets high in protein and low in carbohydrates may improve weight loss¹. They also result in a greater loss of fat while preserving more lean body mass². And the extra protein adds to the satiety factor making adherence easier³.

So what’s an athlete to do? Keep in mind that carbohydrates are the primary and preferred source of energy for athletes. Endurance athletes and even body builders need carbohydrates to fuel their muscles during workouts. Adequate carbohydrates are also needed during recovery to spare protein so it can do its job of helping repair muscles.

So, although cutting carbs may give a slight edge for fat loss, it would not be the weight loss formula of choice for endurance athletes. For maximum performance, endurance athletes generally need 60-65% of calories from carbohydrates. It would likely work better for strength training athletes provided the diet contains enough carbohydrate that work out stamina is not compromised.

<sup>1. Int J Obes Relat Metab Disord 1999, 23(5):528-53
2. Ann Intern Med. 2004 May 18;140(10):769-77. & Metabolism. 1994 Dec;43(12):1481-7
3. J Nutr. 2004 Mar;134(3):586-91</sup>

By: Kathy Jordan, MS, RD, LDN, CPT

Fact: Carbs have gotten a bad rap over the past few years but the reality is without carbohydrates, your body will have to burn protein for energy - a very inefficient way to stay fueled and pumped. Carbohydrates are the chief source of fuel for your muscles (and your brain) during workouts. Sure endurance athletes need more carbohydrate than body builders, but you still need at least 45% of your calories coming from carbs to have the energy you need to not only to get through your workout but to maximize strength and muscle gains.1 Carbohydrates provides energy and spares protein to do its job of supplying amino acids to build and repair muscles. The average active adult female needs about 2,000 to 2,200 calories per day and the average active adult male needs around 2,400 - 3,000.2 So that means 900 - 980 calories from carbohydrate or 225 - 250 grams per day for women who weight train. Similarly men would need 1080 - 1350 calories from carbohydrate or 270 - 240 grams per day. These amounts will vary based on a number of factors including: your height, weight, body composition, age, intensity and frequency of workouts and level of conditioning.

Food Item Serving size Carbohydrate Protein calories
Starchy Foods: bread, oatmeal, rice, starchy vegetables such as potato, corn 1 slice, 1/2 roll or small bagel, ½ cup rice potato 15 g 3 g 80
Fruits ½ - ¾ cup or one small fruit 15 g 0 g 60
Vegetables ½ cup cooked, 1 cup raw 5 g 2 g 25
Non Fat Milk 8 oz. 12 g 8 g 90
Meats, cheese, eggs 1 oz, I whole egg or 2 egg whites 0 g 6-7 g 35-100 depending on fat content
Fats: butter, mayo, oils, salad dressings 1 oz, I whole egg or 2 egg whites 0-2 0-2 45-100

For a more complete guide to carbohydrates and protein contents of foods by category go to http://www.med.umich.edu/1libr/aha/aha_exchlisa_crs.htm. Check labels of processed foods such as flavored yogurt, granola bars, boxed cereals as fiber, sugar and total carbohydrate contents vary widely.

1 Benardot, D. Advanced Sports Nutrition. Human Kinetics. Champaign, IL USA. 2006 p 13.

2 Institute of Medicine. Dietary Reference Intakes. Food and Nutrition Board, Washington DC, National Academy Press, 2002.

By Kathy Jordan, MS, RD, LDN, CPT

Life is a precious gift and most of us want to live each day to the fullest. Unfortunately, as we get older, suboptimal health and fitness can affect our quality of life by limiting our ability to do our favorite activities. Many of us blame this on age. But actually, much of what we consider a result of aging is actually due to a gradual decline in muscle mass. According to the American Council on exercise, we lose 3-5% of muscle mass per decade after we turn 30. The rate of muscle loss accelerates after 50, particularly for postmenopausal women. This results in a loss of stamina, strength, and balance. According to the American College of Sports Medicine (ASCM), we can slow these losses by doing things that maintain – or even improve – muscular strength and power.

You don’t have to feel old before your time. Adopting a better diet and fitness plan will help you have the energy and stamina to continue an active lifestyle as well as prevent age-related illnesses. Attaining the best possible state of fitness requires a life-long commitment to healthy lifestyle habits. If you want to transform your body into what it was 10 or 20 years ago, consume a well balanced diet that contains plenty of lean protein, fruits, vegetables and whole grains – but that’s just the first step. A balanced exercise plan, like the one detailed below, helps complete the transformation.

There are four components of an exercise program to optimize health and slow the aging process. First and foremost is strength training. Adequate strength is needed to more easily perform daily activities such as cleaning, yard work and playing with the grandchildren, as well as enjoying your favorite pasttimes (golf, skiing, etc). The others include: balance, flexibility and cardiovascular or aerobic exercise. These are not mutually exclusive; for example, you will likely have gains in cardiovascular health and improvements in balance from resistance exercises. And you can gain some strength while working on balance or from aerobic exercises that rely on the larger muscle groups.

Strength Training
Maintaining your weight over time does not mean muscle isn't vanishing, notes Steven B. Heymsfield of St. Luke's-Roosevelt Hospital Center in New York. Muscle loss usually goes unnoticed for decades. In fact, the body hides its loss by subtly padding affected areas with extra fat. This change in body composition in favor of fat can be slowed or reversed by coupling a healthy diet with exercise that incorporates resistance training.

The American Heart Association and the American College of Sports Medicine (2007) recommend doing 10-15 repetitions of 8-10 exercises using weights or other resistance equipment two or more times per week. If you have limited time, focus on the larger muscle groups or exercises that work a combination of muscle groups at one time.

Added benefits include increased bone density and a faster metabolism, which means you’ll burn more calories throughout the day.

Here are some suggestions for maximizing your time and activating the most muscles:

1. Focus on the large muscle groups including Quadriceps and Hamstrings.
   Your quadriceps is the large group of muscles on the front of the upper leg. These muscles run along the front of the thigh, starting at the hip joint and ending at the knee joint. Hamstrings run along the back of your leg from the knee to the hip. Together, their primary function is to flex the hip and extend/bend the knee, motions needed for walking, running, jumping, climbing stairs and pedaling. Squats and lunges target these muscles. Both can be done with or without weights.
2. Large muscles/combination: Lat pull downs. You can do these on a lat machine or using resistance bands. This exercise uses several groups of muscles in your back as well as arms and abs if you focus on your from and posture. Other suggestions include assisted pull-ups and push-ups.

For additional exercises and demos go to the website of Georgia State University, Department of Kinesiology and Health.

Aerobics
While this is not the exercise of choice for adding muscle, if you are now sedentary you will add a little muscle by doing aerobic activity. The real benefits of aerobic exercise include improved circulation and emotional well-being. Low impact activities such as brisk walking, bicycling, swimming and hiking are not only easy on your joints, but also have been shown to improve cardiovascular and cognitive health. If your goal is heart health, then track your steps with a pedometer and aim for 10,000 per day. If your goal is weight loss, you may have to work up to 12,000 steps or more per day. Weight loss will be of higher quality and easier to maintain if you couple your aerobic exercise with a couple bouts of strength training every week.

Balance
Balance is “the ability to maintain the body's center of mass over its base of support against the forces of gravity and acceleration” (Shumway-Cook, 2001). If you are just turning 50, you probably aren’t overly concerned with balance. However, as the years slip by this will become more and more important for maintaining quality of life. Believe it or not, strength training, particularly with free weights, is one of the best ways to maintain balance. Other exercises that focus specifically on balance, such as step ups on a Bosu Balance ball (looks like half an exercise ball with a flat bottom) or single leg squats, can be included in your strength training routine.

Flexibility
Have you noticed how much more difficult it is now to reach back and get that seatbelt? Our flexibility declines as we age, resulting in restricted range of motion. Stretching after you’ve warmed up your muscles, or doing yoga and Pilates, are good ways to build flexibility. Pilates and yoga can also help you develop core strength and balance.

To build muscle and maintain overall health and fitness:

• Weight train at least 30 minutes, 2-3 times per week, making sure you have at least 48 hours rest before working out the same muscle groups.
• Warm up for at least 5 minutes before you start your workout.
• A rowing machine or elliptical with the handles will warm up upper and lower body simultaneously.
• Include at least 30 minutes of aerobic exercise 3 or more times per week. Vary your workouts to prevent overuse of the same muscles and joints.
• Take a yoga or Pilates class once a week.

If you want to do weight training and aerobics on the same day, I recommend a 5 minute warm-up followed by 30-60 minutes of strength training, finishing with a half hour of aerobic activity such as walking, cycling or swimming.

Remember to stretch at the end of your workout when your muscles are warm and more pliable.
If you get really serious about building strength and muscle, you will need to adjust your diet. I recommend whey protein drinks before your workout and again about 10 minutes after you complete your strength training. Proper supplementation can optimize performance.

If you find you enjoy aerobic activity and want to participate in events of longer duration, you may need to include some supplements to provide extra “fuel” to maintain your energy and maximize recovery.
Regular physical activity that includes these 4 basic components – strength, aerobics, balance and flexibility – not only helps you look and feel younger; it also lowers your risk for a variety of conditions.

<sup>1. Janet Raloff. “Vanishing Flesh.” Science News online, Aug 10,1996.
2. Steven B. Heymsfield, Obesity Research Center, St. Luke's-Roosevelt Hospital Center.</sup>