Protein: The New Black

There’s a halo hanging around all things high protein, these days. In fact, even foods not high in protein are labeled as if they are—simply to convince you to buy them! Case in point: which is lowest in protein— Starbuck’s Protein Bistro Box, Chicken and Hummus Bistro Box or their Turkey and Swiss on wheat bread? 

The winner is? Their Protein Bistro Box! Yes, in spite of containing egg, cheddar cheese and peanut butter—a rather disgusting combination, I might add—it comes out the lowest at 13 grams, compared to its competitors at 16 grams and 34 grams of protein, respectively. 

If you are selecting the Protein Bistro because you think all that protein (which doesn’t exist anyway) is going to help with weight management, let me break the news—it’s among their higher calorie meals! And for the record, it's the calories that make the difference. Personally, I’d rather have the lower cal sandwich and add on a mini whoopee pie or cupcake. Maybe that’s just me.

I could have kept this secret to myself. I mean, if you are underweight and struggling to eat more, and protein feels safe, what’s it to me? But here’s the thing. I believe you need to be well informed, that if you are striving to eat better you should have the facts. That goes for those of you who are trying to increase your intake and gain some weight, and it applies to everyone else too. If you are overweight and struggling to lose weight, it’s only fair that you, too, be well-informed. Being well-informed, well-equipped to handle misinformation, allows you to be in control.

So let me set the record straight—there’s nothing magical about protein, about any one nutrient, in fact, that’s going to resolve your weight struggle. And we don’t eat protein. Rather, we eat foods, not nutrients. In those foods there may be protein, but there will also be other macro (large) nutrients, such as fats or carbohydrate. If you assume that protein is good, or safe, it implies that carbs and fats are bad. And you know what I think about these descriptions of good and bad! We need all three macronutrients for health. And no one nutrient will cause weight gain—or weight loss. If only it were that simple.

Adequate protein intake without adequate total calories will still result in loss of muscle mass. Not a good thing! Loss of muscle mass decreases metabolic rate, necessitating fewer calories to maintain your weight.

Excess calories over and above your need for maintenance, regardless of their source—protein, fat, or carbohydrate—will help contribute to an increase in weight.

Yes, it really is about energy balance.

Take it from Harriet

Harriet, an overweight woman, came to see me last week for guidance on weight loss. She’d been working with a trainer recently, at her gym. And given his extensive training in nutritional science (you know, men’s work out magazines and the like) he guided her to do the following: eat virtually no carbs, but push protein—you know, to build muscle and increase metabolism. She was eating as he instructed, whole avocados without the crackers, and limiting her fruit to only grapefruits (3 times per day). Reminds me of the Scarsdale Diet I followed in my teens for no good reason and with no good outcome!

Her energy level plummeted, making her workouts quite the challenge. She reported feeling deprived following her current regimen, and she spent a great deal of time thinking about food, preoccupied with when and what she’d get to eat next. And so she wisely sought out more sensible guidance.

When she presented at her initial session with me, she left with a grin from ear to ear. “Now I can have starches? And other fruits?” She was so excited. At her one week follow up visit, she reported feeling great—greater energy, and so much happier, being able to enjoy foods she badly missed. And, her weight was down. In fact, I had to recommend she further increase her intake to slow the rate of weight loss. It certainly proved the point that carbs weren’t harmful, and large amounts of protein are hardly helpful!

Regardless of your eating struggles, trust that all nutrients are necessary, and safe to eat. Be flexible, to avoid deprivation, allowing you to sustain healthy dietary changes. And please don’t be misled by poorly trained trainers, or misleading food packaging! 

Healthy Food = A Healthy Diet? Not Necessarily.

My lunch on a hike in Switzerland

Organic, whole grain, natural, unprocessed. These words carry visions of ideal diets, of pure and clean eating, of good health.  US News and World Report’s recent article  summarized the healthiest diets, from The DASH diet at the top of the list to The Paleo near the bottom. A panel of experts reviewed each plan for safety and nutritional value—then ranked the best down to the worst plans for health and weight control.

Here’s a brief summary of a few of their findings—with my interpretation added. You didn’t think I’d let this pass without putting in my two cents, did you?

DASH diet

Never heard of it? Not surprising, unless you, like me, have high blood pressure. DASH, an acronym for Dietary Approaches to Stop Hypertension is shown to be as effective against hypertension as medication, when compared side by side in studies. Its key elements are large quantities of fruits and vegetables, and inclusion of three low fat dairy products daily. It also includes lots of grains, and adequate amounts of lean protein sources. It recommends limiting sodium intake and being physically active as well.

What does this expert think? While it hasn’t normalized my blood pressure, the studies on DASH are quite impressive in demonstrating an improvement in blood pressure. And that’s what it was designed for. And it’s one step you can take to be healthier, if you have high blood pressure. I like its positive focus—on eating more fruits and more vegetables than most individuals consume, and on inclusion of three low fat dairy servings daily. Watching sodium generally necessitates eating less processed foods, which may lead to greater fullness—think apple versus juice.

Paleo diet

The theory, according to US News, is as follows:

Our highly processed, carb-obsessed eating pattern is the culprit behind many of our biggest health ills, so why not go back—way back—to the Paleolithic period of more than 10,000 years ago, when our diet wasn’t full of junk food and pasta? Paleo advocates say we should eat the way we ate when we were hunting and gathering: animal protein and plants.

The diet includes meat, fish, and other protein sources, as well as fruits and veggies, but omits dairy, grains and starchy vegetables, and several oils. Yes, even protein-rich, high fiber, satisfying legumes (think beans and lentils) are out of the question. As are root vegetables, such as sweet potato. (Imagine Thanksgiving at the Paleo family’s home!) Apparently these are omitted because they needed to be cooked. And say goodbye not only to milk, but also to those gut-beneficial probiotics we consume from yogurts with active culture. Never mind the lack of evidence that supports eliminating these foods.

If I have to give something up, there darn well better be a good reason for it. Unless there were some life altering evidence in favor of a Paleo, I say let’s be thankful we’ve evolved since then. And how fortunate we are to be able to consume legumes and grains—those carbohydrate rich foods, full of minerals and energy, as well as rich in fiber—given that we can cook them. Most of you, I suspect have a stovetop?

If you are not living in a year-round warm climate—rich in sunshine used to produce vitamin D, or you choose to prevent skin cancer by using sunscreen—you’ll be missing out on the foods necessary to obtain all the Vitamin D that you need following the Paleo diet. By the way, why use a Paleolithic period diet as some ideal, anyway? Their lifestyle was a bit different, I believe (I haven’t had to chase my dinner), and our lifespan has only increased over the years.

As for Atkins?

The lack of carbohydrate through many stages of this diet, and the saturated fat-rich intake flies in the face of all that we know about disease prevention. Review the 2010 Dietary Guidelines For Americans for an evidence-based review of these recommendations. Is anyone really taking this diet seriously anymore?

And Ornish?

Generally pretty extreme in it’s limitation of fats, which research confirms is not the cause of us getting fat; weight loss at the 12-month mark was no greater with a low fat diet, compared with many other popular diets. And any differences in weight loss between various diets (containing the same calorie level) was obliterated at the later follow up date. No, fats don’t make you fat. And a super low fat diet does not appear to be necessary to improve your lipid profile; very low fat diets may increase triglyceride level, an independent risk factor for heart disease. In the Ornish diet, meat, poultry and fish are not recommended, as well as all oils, nuts, seeds, and refined carbohydrate. It has its merits for reversing heart disease, but his studies showing this reversal focused not solely on dietary changes, but included a comprehensive stress reduction and exercise component.

Mediterranean Diet

My only beef with it is not its lack of meat, but its limited dairy. There’s no support for restricting dairy, particularly low fat varieties, for good health and weight management. I do like their inclusion of moderate amounts of wine, with meals, for those who are able to limit their alcohol. This diet is much higher in fats and carbohydrate than most, but includes, for the most part, less processed varieties. That said, they do not urge extremes, such as no bread or white potatoes.

The U Diet: The best diet you've never heard of

What was unfortunately left off the list of healthy diets was the U diet. Missing is consideration for the individual, because what’s healthy for one person is not necessarily healthy for another. Eating healthy, for many of you, should mean not trying to beat the system and eat less (like the Volumetrics Diet, for instance). Even those 2010 Guidelines for Americans act as if we are all obese and unhealthy and needing to eat less. It’s a challenge, for sure, when the rest of the universe is struggling to drop a few pounds or kilos and you are working, somewhat reluctantly, to gain them, or even to maintain them!

The U diet is truly the answer. It means, first and foremost, including an appropriate intake of calories. Ideally, if you are healthy enough to do so, this is done through better self-regulating (read the 100 or so posts in which I’ve addressed this already. Then re-read them!). It involves more mindful eating, and distinguishing hunger from other eating triggers. You know what I mean. 


But it also means releasing yourself from the rules which prevent you from eating when you are hungry, regardless of whether its only been two hours, or if it’s after 8 PM.

As I’ve mentioned previously, for many of my readers it requires the “just do it approach”—eating in spite of not thinking or feeling you need to eat.  It may defy all the healthy recommendations you’ve read above. Yes, you may be among those that need to decrease your vegetable intake, if they are displacing the calories and nutrients your body desperately needs to function.

Let's take Brian, whose diet was chock full of such wholesome ingredients, as recommended by DASH, Volumetrics, Mediterranean, and some dieticians' model diet.

Breakfast

Old Fashioned rolled oats with soy milk

Snacks

Fresh fruits and vegetables, both orange and green ones

Lunch

Brown rice and veggies

Dinner

Beans and a vegetable soup

Pretty good? Not at all. At 6'1" Brian struggles to function. His determination to select what he considers healthy foods has made him anything but healthy. His energy level is low, as is his testosterone level, impacting a range of quality of life activities. Let's just say, it impacts more than just the frequency of his shaving. His weight, while I will omit mention of numbers, is unhealthily low.

Or let me tell you about Sarah's recent diet. Her move away from "junk" food to a more wholesome diet landed her with a low heart rate and a plummeting weight, now below the 5th percentile. Never one to struggle with her weight in either direction, she now teeters on the need for a hospitalization. Her diet is low sodium, making it more challenging to keep her blood pressure in a healthy range given her unhealthy weight, contributing to her lightheadedness with posture change, from lying, to sitting, to standing.

And then there was Amy, who never intended to lose weight. Really. She gradually moved toward less processed foods, leaving her favorite items behind. Who needs Pop Tarts anyway? Her biggest concern, besides her hair loss, is that she is constantly freezing, even with the record warm temperatures we have had this fall in New England. This is what is motivating her to break from her "healthy" diet.

Diane was also concerned that her daughter wasn't eating healthy enough. Review of her intake revealed the following—she consumed a variety of foods, but would benefit from additional sources of dairy or an alternative. She included meals, but was somewhat picky about what she liked to eat -- pasta was high on her list, as well as several other choices. And for snacks, she responded to her hunger with what appeared to be reasonable quantities of items like Chips Ahoy cookies -- or fruit, or cereal.  She certainly could use to increase her intake of fruit or vegetables, for the variety of nutrients they provide, and for the fiber. But she eats enough to maintain a healthy weight with healthy body function. Her diet supports her need for energy, for fuel, to engage in the activities she enjoys.

Ahh, all butter pump cookies!

The Chips Ahoy? Those processed, refined carbohydrate and sugar containing cookies fit just fine, in the context of her diet. As long as she is getting all the nutrients she needs from a variety of foods, and she needed the calories from the amount of food she consumed, if Chips Ahoy was here snack of choice, why should I try to make it "healthier"?

Healthy eating, to me, is not just about healthy foods. It is about getting enough of what you need--enough calories--from protein, fat and carbohydrate to fuel your body and allow for repair and normal function. It includes a range of vitamins and minerals, as well as all the nutrients, such as phytochemicals, that we are learning contribute to disease prevention (think about selecting colors -- deep orange and yellows as well as deep green, and reds and blues in vegetables and fruits). It includes whole grains, and refined, low fiber foods as well (think French bread or my much photographed challah—white flour and delicious!)—because in our world we also need to balance our need for convenience with our busy lives. And, our interest in eating foods we enjoy.

Follow the U diet, and you, too will rest
peacefully!

Besides needing to meet our physical need, we cannot dismiss food's other benefits. There's the pleasure factor, the enjoyment of the taste and texture, the sensory experience of eating. I'm not saying we should simply eat for pleasure. Rather, that we need to consider these aspects of eating when we are hungry and seeking food. What do we feel like eating? What would we enjoy eating? Not simply what should we be choosing.

Consider the U diet. It may not be a best seller, but it’s a sensible, and healthy diet for your body and your mind.

This Time It’s Simply About The Calories

Piedmont: Great Wine, Great Challenges

I’m a snob. I admit it. When it comes to food, it’s got to taste good. Because I intend to really taste it. To enjoy it. To savor it. Every bite of it.

But Thursday, after many long, hot hours biking the grueling hills of the Piedmont region of Italy, we were hungry. Really hungry. The hills took us much longer than expected; we had no idea what it really means to be in shape for riding hills!  And the snacks we carried? We downed those within the first couple of hours.

So we rolled into a tiny town, known for its hazelnut production. Now give me a dessert with hazelnuts and chocolate and I would’ve been just fine. But that didn’t happen—no bakeries in sight. But it didn’t take us long to identify the only eating establishment around. Think retro, stale, cigarette-smoke-filled air luncheonette before it turned quaint and chic.

In our broken Italian we ordered the only Panini that sounded acceptable. Oh, and a salad.  What comes to your mind when you think salad? Fresh, crisp vegetables? A brilliant assortment of colors, flavors, and shapes? Think again. They offered what is known as Russian salad—a heaping mass of mayonnaise, containing diced potatoes, peas and a speck of carrot.  We had it along with the white bread sandwich packed generously with cheese. And I neglected to mention (how could I forget?)—that there were two rolled up sardines with olives. At least they added some color.

Well, I ate at least 90% of this lovely meal. And I hated every bite. (Although given my sweating from the unseasonable heat, the sodium rich sardines and olives were much appreciated.) This was so far from the fabulous cuisine I had heard so much about and had begun to enjoy my first day in the Piedmont (more posts about those meals to follow). The Piedmont, after all, is know for the Slow Food movement http://www.slowfood.com/international/6/faqs, amazing wines (Barolo, Barbaresco and Barbera) and white truffles (these are intense mushroom like fungus, not chocolates, my friends), with their distinctive flavor which embellishes foods with a mere drop of a truffle infused oil.

At this point, exhausted and overheated, depleted of energy, it was strictly about the calories, the fuel. I wasn’t going anywhere without eating this awful meal. I had no other options. I couldn’t find my voice in this language I barely spoke, and I suspect there were no other options, given the appearance of this place. Yes, mayonnaise-laden salad with a bland cheese sandwich was the only answer. Simply non-negotiable. There was nothing else to do but eat it.

Provence, not Piedmont!

What’s the meaning of this post? It’s not about my disappointment, of things not going as planned—that could be a whole other post. It’s not about adjusting expectations, because who could have expected this? Never mind that the biking was a total drag, nothing like our fantasy rides through Provence with climbs we could manage and stunning varied vistas to distract along the way.

No, the meaning is much more literal. Sometimes it comes down to Nike’s message—Just Do It.

For those of you who undereat—I know there are times when you are not hungry, and eating seems totally unnecessary. And when a fat-containing food may overwhelm. Or you question why you have to eat more than everyone else around you. Or the uncertainty of a meal’s content leads you to want to choose the safest route—food aversion. Or the allure of not eating, or restricting, promises a pleasant disconnect which might be so welcomed at this moment.

As for the overeaters and binge eaters (and anorexics, too)—skipping meals or snacks certainly sounds promising. Why take in those extra calories when a coffee will suffice? Because sometimes, you need to just do it. And when you’re feeling hungry even if no one else is, you need to just eat—because you need to begin to listen, to trust your body and its signals. Because you so deserve to be well nourished. Because your size has nothing to do with your need for nourishment in the moment. Yes, you too, need to trust it’s okay, it’s necessary to eat. And that you deserve to eat, regardless of what others’ glances may suggest, in spite of the messages from family members you hear or replay in your head, regarding your need to lose weight. Be in the moment, and trust that you should eat.

A cool drink after a long day of unmanageable hills and bad food!

I won’t be heading back for another Russian salad-filled lunch in the Piedmont. But I’m pleased I was able to fuel up for the challenging ride back. In the end, we enjoyed a lovely meal at dinner, and a refreshing drink just after unclipping from our pedals.

Time to Clear My Plate. Before You Get Triggered by My Plate, Read This.

Oh, Michelle, I so appreciate your honest and passionate concern for improving the health of our nation, particularly our kids. Really I do! But quite frankly, the subtle messages conveyed through the new USDA My Plate set us way back in our progress.

That’s not to say that I find nothing favorable about it. I do like the bright colors (they make me feel like a kid again), and the concept of half the plate as fruits and vegetables is truly a helpful, and reasonable teaching visual. And, a message I can support. But here’s where we part.

Where are the fats?

Ok, I realize that in the written food group description fats get mentioned, but not encouraged. And let’s face it—it’s the visual image that makes the biggest impact. And in that regard, fats are absent. Yes, in spite of the latest Dietary Guidelines for Americans summarizing the enormous body of research and declaring that increasing (unsaturated) fats should be a goal, comprising up to 30% of all our calories, this message is lost in My Plate.

In fact, in the description accompanying the image, it even sheds a negative light, saying “oils are not a food group”. And by oils they really mean fats, because avocado, for instance is not oil. Funny, in past pyramids, such as 2005, fats were a distinct part of the pyramid and were scattered around as a component of the other food groups. And if fats are not a food group, why is protein? If I remember my basic nutrition way back the three macronutritent groups making up all foods are protein, fats and carbohydrate. Yet My Plate places the nutrient protein on the plate, a component of foods, as if it’s a food, yet states that fats have no place? I don’t get it.

Where’s my favorite food group?

But perhaps the biggest problem I have is the omission of those “empty calorie” villains, the “sweets”. Past health messages from the American Dietetics Association and the recent aforementioned Dietary Guidelines for Americans 2010 instructs us to “find balance between food and physical activity.” At no point do they suggest we should eliminate sweets to prevent obesity.

And speaking of those additional calories, why make such an overreaching statement like “Enjoy your food, but eat less”? Should I suggest this to my normal weight sons? To the healthy growing kids I see? To the many I work with struggling with trusting their hunger, many of whom are working hard to increase their calories by appropriately eating more? Should I be eating less as I’m training for a biking event this month? Such an unnecessary and detrimental generalization! Would it take an eating disordered child for Michelle to be more sensitive to such absurd health recommendations?

This dietitian endorses a health-promoting message to include junk food!

Here’s the scoop. Black and white messages about good foods to eat and bad foods to avoid are damaging. They contribute to society being misinformed about weight management, and about eating in a healthy, balanced and pleasurable way. In life kids and adults are going to eat cupcakes and chocolate and ice cream in all flavors. The problem won’t be that we’re eating these foods. It’s that we view them as bad, feel guilty, and end up overeating them, because we have been convinced that we have done wrong by consuming them—in any amount. Rigid rules and clear omissions teach us nothing. They reinforce the wrong messages. It’s time to get with the times.

Why the beef about dairy?

And to the critics of inclusion of a dairy serving, like Walter Willet at Harvard (who says there’s no evidence to support including a dairy requirement), I’d like to ask you this—are you thinking we’re going to meet our requirement for calcium and Vitamin D from sardines, canned salmon, almonds and broccoli? I don’t think so. Perhaps the USDA could have done better by broadening that category to say “milk and fortified soy milk”; no other non-dairy alternative provides as much protein as well as calcium and Vit D. Yes, there is evidence that we need an adequate intake of these two nutrients, and practical, economical, acceptable sources are few and far between outside of dairy products.

As for the interactive resources, I would love to share my thoughts. But after signing in, the program failed to work when I tried to explore the physical activity section.

Time to go eat. 

My plate will include some homemade waffles this morning, fruit, yogurt, and real Vermont, full sugar maple syrup. And I just might decide to include a piece of pastry for my afternoon snack. And in spite of what My Plate urges, I have no intentions of reducing my portions from their usual level!

Thanks for reading! Enjoy your sweets today.