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Weight Loss Counseling, Vegetarian, Vegan, & Sports Nutrition, plus Fitness Training Services and Body Fat Assessments

Archive for January, 2015

What I Like and Dislike about MyPlate

Jan 29

Posted by Joey Gochnour, BS, BS, MEd, RDN, CSSD, CSOWM, LD, NASM-CPT in Personal Experiences and Opinions | No Comments

choosemyplate.gov

Nutrition Education Tool 2011

Most people I discuss nutrition with have heard of the Food Guide Pyramid, possibly MyPyramid, but even fewer have heard about MyPlate, which is the current national nutrition education tool for general population nutrition guidance.  This post discusses my criticism of MyPlate after a brief criticism of the other nutrition teaching tools.

Eleven Grains a Day, What?!

Nutrition Education Tool 1992 Eleven Grains a Day while I sit at my desk, lolwut!

The Food Guide Pyramid was criticized for overemphasizing grains and not putting enough emphasis on fats, among other things.  It also had a hierarchy of importance of food groups, even though clearly protein and vegetables probably should be higher up on that hierarchy.  That said, all food groups are important for their own reasons.

MyPyramid attempted to divide the base of the pyramid into all food groups and had a base of physical activity as well, showing that all food groups are important.  A criticism of MyPyramid was that it was too hard to understand.

Nutrition Education Tool 2005

All food groups are important, but this image was too hard and too busy to understand for most. If you get to the top of the pyramid, I guess you get less food.

MyPlate came out in 2011.  It was set on a plate, which was supposed to make it easy for people to understand since most people eat off of a plate.  While I personally eat all of my meals out of bowls, plates are still easy to understand and can be thought of more as a pie chart.  Most people understand pie charts.  This is a good part about the current educational model.

MyPlate emphasizes vegetables and is the first teaching model to recognize that you just need “protein,” not necessarily meat, which accomodates vegetarian eating.

What I dislike about MyPlate is that there is no mention of healthy fats on there.  Where do the nuts and seeds go?  I guess in the protein spot.  I always point this out to my clients who don’t need a lot of carbohydrate in their diet due to low activity.  I also think that MyPlate makes you think you need a fruit at every meal, which I do not promote.  If you want to fit a fruit in every meal, you can, but I don’t think it is necessary.

MyPlate mentions dairy as the source of calcium in your diet.  While I have nothing against dairy and promote it as a great way to get high quality protein, vitamins, and minerals, you could just have soymilk, almond milk, or plenty of vegetables that provide calcium.  No one is forcing you to have dairy.  However, if you do have almond milk, realize you’re not getting protein and are basically having a fat-sugar fortified beverage.  If you can fit that in your diet, then enjoy.  (diet used loosely as eating habits)

MyPlate doesn’t work very well for certain segments of the population.  For athletes, for example, I decrease the size of the vegetables portion to increase the size of the grains portion.  Yes, you Paleo fans can make MyPlate work if you use potatoes and sweet potatoes, but not everyone is going to go Paleo, ok?  🙂  For weight loss clients, I sometimes decrease the size of the grains part of the plate to enlarge the vegetables part.  For some people who eat tons of fruit who have certain goals, I may decrease the size of that for them.

Harvard Nutrition Education Tool

Harvard’s attempt to compete with the government recommendations. Drab and requires IQ over 100.

The Harvard Plate shows that calcium doesn’t have to come from dairy, and it also cautions against getting too much calcium due to association studies for higher morbidity risks, such as elevated risk of prostate cancer in men.  The evidence is far from conclusive on that, so I caution even mentioning it.

Harvard also puts oils under nuts and seeds, which is interesting considering oils are processed from nuts and seeds.  Which is a more nutrient-dense source of unsaturated fat?  Nuts and seeds.  Vegetables and fruits are grouped together.  Someone could run with that and not eat vegetables then.  Fruits and vegetables were not created equal.  There is too much going on in this pyramid to critique it all in this blog post.  In short, it isn’t perfect either.

When I work with clients, I tailor a message to them.  I may reference MyPlate to jump start a conversation, but I actually use a different teaching method, one I developed myself, that I feel is more effective for clients.  If you’re interested, you’ll just have to book an appointment with me to learn about that 🙂

Please comment and share!



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Paradigm Shift: Weight Regained After Dieting Is Not Failure

Jan 26

Posted by Joey Gochnour, BS, BS, MEd, RDN, CSSD, CSOWM, LD, NASM-CPT in Diet or Exercise?, Personal Experiences and Opinions | No Comments

I am often surprised by the number of people who claim that diets don’t work.  Perhaps there is a miscommunication on what they mean by that.  If anyone would clarify that for me in the comments, I would love to have a discussion on that.

All diets work.  You will lose weight if you change what you are eating to something with fewer calories.  All diets are rules of eating that get you to change what you are doing from an eating standpoint so as to consume fewer calories in the end than before.  Whether you want to do it with a fancy sounding trending word like a “cleanse,” a “detox,” or “paleo,” or if you want to add fasting into it (such as intermittent fasting), or if you want to do it less radically, the diet will work.  At the end of the week, you ate fewer calories than you did last week.

Not all diets are created equal.  When cutting calories, it is more important to make sure that the calories left that you ARE eating are actually doing something for your health.  You want them to be highly nutrient dense per calorie.  Otherwise, theoretically, you could deplete yourself of some nutrients and develop malnutrition during the process.  Then, how healthy will that diet actually be for you?  If you deplete yourself of nutrients involved in energy metabolism, maybe your body won’t want to lose weight as efficiently at that point.  It’s possible.

This is why it is important to work with someone who knows how nutrients affect your physiology so as to recommend diets that are healthy.  Shameless plug here for registered dietitians, a medically recognized profession that works with nutrition on a daily basis.  These are people to consult if you are planning on changing your eating habits for a goal.  Anyone can call himself or herself a nutritionist and set up shop.

To the main point of this article, however, a criticism of diets is that people gain the weight back.

My response to this?  So what?  Hear me out:

You still lost the weight for some time and learned from the experience.  This isn’t an all or none success thing.  Let’s not throw the baby out with the bathwater.  Diet failure is a highly pessimistic view of the experience.

Yes, it is important to view nutrition changes as things you should accept as long-term, but let’s say you are overweight or obese enough that it affects your ability to perform exercise at a level that you need to maintain your weight.  You will HAVE to go on a diet until you reach a weight at which you can start working out intensely without it killing your joints.

People who say that diets don’t work or that they fail do not understand the behaviors you must do to maintain your weight after you lost it.  The great part about finishing a diet is that you get to eat more food.  You also get to start working out more/harder because you have more energy from all that food you are now eating.

People who regain ALL their weight after a weight loss experience tend to not be progressing in their fitness level while going back to the habits and mindset that brought them to their original weight.  Weight loss requires cognitive restructuring of thoughts on how you view food and your relationship with it.  This is why cognitive behavioral therapy should be a part of the process.  The awesome part about exercise and fitness is that it is EXCELLENT for helping you maintain your weight post weight loss even if the way you view food psychologically hasn’t changed completely.

weight loss maintenance with exercise post diet

Exercise is excellent for maintaining weight lost post-diet.

You know when people plateau with exercise?  Their body has adapted to the stimulus.  This means that their body requires fewer calories during exercise and recovery because there is less breakdown of existing body tissue from that exercise because they are performing it more skillfully.  To get out of that plateau, you have to increase the intensity and get better at what you are doing by adding weight or reps so as to reach an eventual ultimate plateau where your hunger matches your energy expenditure–ie you are able to workout at a level that allows you to eat what you want.  This is the “nirvana” or “enlightenment” of nutrition and fitness, your ultimate goal of having maximized your physical fitness capacity while being at peace with the food required for that body.

If you DO regain all your weight back post diet and made good effort with progression in exercise, then you will just have to diet again and figure out what you were doing last time that didn’t work.  If you think about times of surplus and famine in history, dieting has happened for a long time.   There are times of the year you will be heavier and times you will be lighter.  There is always something you can do about it, so seriously, let’s just not say dumb things like “dieting doesn’t work” anymore.  At least be more articulate about what you really mean.

I get angry when I hear the idea that regained weight means it is a failure, which is stated even in scientific literature.  Yea, if you resume eating exactly like you did before without a change in your exercise habits, of course you will gain all your weight back.  That doesn’t mean the diet didn’t work.  It means you didn’t change the way you view and use food in respect to your activity and lifestyle.  Psychology is a huge part of the process.  Are you adaptable, and do you have grit?

You’re not going to get the weight off though initially without some form of a diet unless you are ok with extremely slow progress.  It is currently thought that achieving weight loss progress quickly builds adherence to the program (link to PDF).

So in short, dieting DOES work, and exercise is what you must progress with after dieting in order to maintain your weight.  Don’t use exercise as a means for weight loss because that doesn’t work, as shown in previous posts.  Use it to maintain your new weight!

Please comment and share!  If you would like to work with me personally, send me an email.

Edit: This article was featured on CureJoy on 02/24/15.  I encourage you to check out their site.  Disclosure: I do not have any financial or other incentive through the company.



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Calorie Recommendations, Dieting, and Exercise

Jan 22

Posted by Joey Gochnour, BS, BS, MEd, RDN, CSSD, CSOWM, LD, NASM-CPT in Diet or Exercise?, Personal Experiences and Opinions, Science Analysis | 2 Comments

Preface

When you’re trying to lose weight, how many calories is too low?  This question seems simple up front, but upon researching for “the correct” answer, I found that it comes down to what is called “clinical judgement.”

There are a variety of ways to assess how many calories you should be eating, called calorimetry, the measurement of calories.  The current best way to find it during one point in time is indirect calorimetry, where an estimate is taken based off of carbon dioxide to oxygen ratio per gas volume.  Direct calorimetry, or where changes in heat are observed in a closed environment, is not practical for humans.

Without indirect calorimetry, the next best way is to look at what you typically eat for a long period of time and find the average caloric intake from food journaling.  Food journaling is one of the best ways to assess your diet and look at what is working and what isn’t and serves a number of purposes beyond just finding the calories you typically eat.

Unless you walk around with an indirect calorimeter on all the time, the device is only so useful because it only looks at your needs based off of one data point in time.

Then we are left with predictive equations like the Mifflin-St. Jeor equation, which is the current most popular equation for predictive energy needs (1, 2).  These give you an estimate for your resting metabolism.  Then you must add an estimate of energy expenditure based on your activity, which honestly is an educated guess.

Predictive equations are great for a population but may not be as accurate for any particular individual.  You can assess your caloric intake on this website or use any online calculator you want.

What is Formally Recommended for Weight Loss

The simple answer is this one-size fits all calorie recommendation found in the Evidence Analysis Library (EAL) of the Academy of Nutrition and Dietetics.  For women, 1200-1500 Calories are recommended for weight loss along with physical activity.  For men, 1500-1800 Calories are recommended for weight loss along with physical activity.

Having completed the Commission on Dietetic Registration’s Self-Study Module for Adult Weight Management, as well as having seen evidence of this during my master’s and seen this in the EAL, we know that exercise is not an effective way to lose weight from a physiological standpoint.  Perhaps from a psychological or sociological standpoint, exercise is helpful because of reinforcement of good habits, including dietary habits.

Granted, we all know someone who has lost some weight with exercise, but having not followed them around to see how exercising changed their diet habits, I am still skeptical.  Some of my clients are very sure that they have lost weight with exercise alone and no diet change, so perhaps the research isn’t as sensitive to this or the particular people it has that effect on.

Exercise calorie deficits vary widely depending on how fit you are and what you do.  It is possible that some populations may be able to achieve weight loss from exercise, but it is a small percentage in the big picture, according to the research.

Below is a graph from some pooled evidence on whether diet or exercise is more effective for weight loss.  Notice how old the study is, yet people are still trying to exercise off their weight.

Diet beats exercise on weight loss

Not a significant difference on weight loss with diet vs diet and exercise.

Very Low Calorie Diets (VLCDs)

According to the 2009 Position Paper of the Academy of Nutrition and Dietetics on Weight Management, a very low energy (calorie = energy) diet (VLCD henceforth), is defined as “800 Calories (or 6-10 kcal/kg) or less per day” and is typically in the form of liquid meal replacement supplements that are fortified with 100% of vitamin and mineral needs.

These are prescribed under the supervision of an MD for people who are obese by BMI or overweight with comorbidities (like diabetes, cardiovascular disease, etc.).  They are supposed to result in rapid weight loss and can help provide encouragement to individuals with the fast results.  They are not recommended without a healthcare professional’s supervision because you REALLY have to make sure you make your calories count in terms of maximizing the nutrition density per calorie.

Some nutrients are of concern.  When you are not consuming a lot of food, electrolytes such as sodium and potassium, which aid in nerve impulse conduction and heart contractions (mainly calcium) can lead to heart arrhythmias.  Gallstone formation is another complication possibly due to less fat in the diet, and bile can concentrate with less gall bladder contractions.

If you are 250 lbs, a VLCD could be as low as 682 Calories or as high as 1136 Calories.  The 800 Calorie number is open to clinical judgment.  If you are 140 lbs, a VLCD could be as low as 382 Calories or as high as 636 Calories.  That said, you probably would not need to be on a VLCD at 140 lbs.

Since a VLCD starts at 800 Calories and requires medical supervision, beware of any diet that asks you to go to 800 or below calories.  The cabbage soup diet is a medically unsupervised, VLCD that does not provide the array of nutrients for meeting nutrition needs, yet people go on it often considering how popular it is.  I haven’t heard of anyone dying on it, but if you have, please let me know in the comments.

The calorie range of 800-1200 Calories seems to be a range of numbers where not much guidance is given in terms of recommendations for healthcare practitioners.  Many physicians fear going below 1200 Calories with patients, but unfortunately, some people just won’t lose weight at that level of calories.

That said, physician education on nutrition is limited to an elective or two during medical school, should they decide to take it and is not standardized across medical schools.  “On average, [medical] students received 23.9 contact hours of nutrition instruction during medical school (range: 2–70 h).”  So asking your doctor how many calories you need may not be the right question unless they actually studied nutrition.

Does this mean a recommendation of 850 Calories is too low?  It isn’t a VLCD, by definition, and would not require physician supervision.  It depends on who is recommending it and for whom.  A smaller person needs fewer calories than a larger person, so 850 may be very low for someone very large while it may be just low calories for someone smaller.

Registered dietitians are trained to make sure the calories count in your diet to avoid health risks while dieting.  Most of us will not even recommend something that low unless the patient has unsuccessfully tried other levels.

Summary

The take away from all this is that figuring out how many calories you need takes some effort.  We can estimate with equations and calorimetry.  Food journaling is the best way to figure out how to make changes to your diet and see where you can improve.

Very low calorie diets (VLCDs) are generally considered to start at 800 Calories and are not recommended unless you are speaking with someone who studied nutrition and have worked with them unsuccessfully trying other less extreme approaches.

Exercise is not considered a good way to lose weight unless it makes you make better food choices.  It will make you fitter and healthier though so should be encouraged.

If you like this post, please comment and share.  If you don’t like this post, please let me know why in the comments.



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Mind-Body Foods and Health: Alcohol, Chocolate, Tea

Jan 21

Posted by Joey Gochnour, BS, BS, MEd, RDN, CSSD, CSOWM, LD, NASM-CPT in Personal Experiences and Opinions, Science Analysis | No Comments

According to research, drinking moderately may reduce risk of disease and mortality.  This week, it is linked to a reduced risk of heart failure.  Not drinking or drinking too much is supposed to be worse than moderate drinking in terms of risk of disease.  This is often shown in association studies (observational studies).  Not cause and effect studies.

Chocolate is also supposed to be good for you.  Scientific opinion states that 200 mg daily has a cause-effect relationship on endothelial cell-dependent vasodilation (widening) of blood vessels.  Observational studies show it can affect memory, heart disease, stroke, and cholesterol levels.

Drinking tea has been associated with anticancer properties and blood pressure reduction.

I have issues with all of these topics, so this post is going to give you my personal opinion on all of them.

I stay up to date reading the news releases of the latest studies through various channels.  It can sometimes take me 2-3 hours a day to get through it all.  Combine this with my nine years of nutrition and exercise education and training as well as professional practice, I have developed some pretty opinionated thoughts when I hear news on alcohol being good for you or chocolate being good for you.

Here’re my thoughts on these topics:

Alcohol

Nutrition biochemistry says that alcohol can impair B-vitamin absorption and enhance pro-oxidant absorption since it messes with the integrity of the epithelium of the intestines.  Alcoholics are often deficient in thiamine, which is vitamin B1.  Pro-oxidants are the opposite of antioxidants.  One gives an electron and the other receives an electron.

Alcohol forces the liver to detoxify it immediately.  This is one of the few cases I will actually use the word ‘detox’ because it is appropriately used.

Alcohol is empty calories.  It does absolutely no good for your body as a chemical itself.  It is not a necessary nutrient.  It probably isn’t helping you control your weight.  Yet we make it harder on ourselves because some consider you weird if you don’t drink alcohol.

People can become alcoholics from alcohol.  It is used as a way to deal with their issues.  This is so common it is shown in movies and on TV.  You can get withdrawal from it.  It can cause liver cirrhosis, or liver scarring.

Because 71% of people drink alcohol, it is expected in most social gatherings.  It is a socially acceptable drug to use publicly.  Conversely, it is often perceived as socially unacceptable to not be drinking alcohol.

So, with all these things we know about how negative alcohol is to humans, SOMEHOW the studies show that moderate drinking could be good for us, NOT drinking is bad for us, and drinking too much is very bad for us.  There is a J-curve with alcohol consumption.  How does this add up?

The explanation I assert is that it isn’t the alcohol that is making people healthier.  It is the socialization, which is not controlled for in observational (association) studies because MOST people drink with other people at dinner parties or out on the town.

Think about it.  People who drink are out on the town having fun.  Being out on the town involves walking, which is physical activity that counts.  They aren’t depressed and sitting at home being sedentary.  Depressed and sitting at home is often associated with other negative behaviors in itself, such as overeating or drinking alone, and feeling left out.

People who don’t drink can feel pressured to defend their abstinence in social situations, depending on the person.  It can make for a very uncomfortable social experience to be assailed with questions on why someone isn’t drinking when being out.  A Google search of “why is not drinking weird” brings up many posts that can explain the mentality of those who choose not to drink and how it affects their life and other people’s perceptions of it.  Ovik Banerjee wrote a nice post on not drinking’s downstream social effects that got some great comments.

Having fun, laughing, and bonding with others relaxes blood vessels on its own because stress is low so the nervous system is less likely to be constricting your blood vessels.

Perhaps the small amount of alcohol that people feel is necessary for them to have in order to have fun, laugh, and bond with others doesn’t negatively outweigh the benefits of having fun, laughing, and bonding with others.  It may not outweigh the excitement of meeting someone new, being on a date, or being with people you like.

Alcohol is supposed to ward off cognitive decline, magically somehow.  I say this is because people who are drinking alcohol are socializing, which is actually a complex phenomenon of listening to other people, interpreting what they say, reflecting on it based on your own experience, and responding with empathy.  The alternative, sitting alone home by yourself, is probably associated with depression and boredom, which are not very stimulating states compared to socializing.  In my opinion, cognitive decline follows the ‘use it or lose it’ mantra.

People who don’t drink at all are missing out on the benefits of having fun, laughing, and bonding with others, but they also aren’t getting the negative effects of alcohol either.  After all, it does destroy the integrity of your intestinal mucosa and inhibit ion channels in nerve cells, which leads you to the popular mental effects of drinking alcohol.

People who binge drink, you know, those who in college are holding each others hair over the toilet or being propped up on their sides so as to not die in their own vomit, have the worst health effects.  Maybe they are drinking too much because they have other issues they are escaping, trying to fit in too hard, or just hate themselves and take it out on their bodies.

Chocolate

Most people know that it is dark chocolate that is supposed to be better than milk chocolate because it has a higher percentage of cocoa.  Well if that’s the case, then why don’t we just all save some money, leave the candy aisle, and just go to the cooking aisle and buy pure cocoa powder and start using it?

Oh right, it doesn’t taste that good by itself without all the fat and sugar surrounding the cocoa that makes what we know chocolate.  Milk chocolate tastes way better.  Let’s not kid ourselves.

Because I’m scientific and experiment sometimes, I have been purchasing cocoa powder from the cooking aisle ever since I heard about the benefits of chocolate.  I didn’t see the need to get all the extra saturated fat and empty sugar calories from having the candy form because, personally, I don’t need that stuff.  Maybe you do, but I don’t.

Based on the article linked above on the observational benefits of chocolate, I might experience lower cholesterol, heart disease, stroke, memory decline, and relaxation of blood vessels.  I had been adding it to my porridge in the morning, which makes it change color and look like chocolate porridge.  It is an…acquired taste…one that I actually enjoy after doing it for a while.

That said, I honestly don’t think it is doing much for my physiology.  Part of this reason is because I don’t derive the same sense of subjective relaxation and joy most people associate with chocolate, which can lead to the cardiovascular and memory benefits.

Some women say that chocolate stimulates the same area in their brain as sex.  Well, for me, I am not experiencing any orgasm from my cocoa powder in my porridge.  Therefore, it probably isn’t having the same effect on my brain and blood vessels as people who subjectively experience pure, better-than-sex bliss from eating this food.

This gets me to the subject of subjective experience from food.  There are people who will read a study or news release and make a behavior change based upon that study.  If chocolate is found to be good for you, they will start eating it because of the possible, yet mechanism unexplained, health benefits.  They will eat it like medicine.

I have worked with clients like this and probably am this type of person.  These types like to eat chocolate daily because the news releases have said that it is good for you.  Maybe it is good for THEM.  I’m not denying that.  But if you really don’t enjoy eating it, it probably is not giving you the health benefits the article says because people experience food differently.

The same thing goes for tea.

Tea

Compare the experience someone has who enjoys drinking tea vs drinking tea for the health benefits.

Having tea involves taking time out from your day to make the tea, wait for it to cool (or scald your mouth, whichever you do), and slowly sip it while reciting whatever pleasant mantra you have in your mind that relaxes you.  I choose “serenity now.”  Tea is an experience that promotes the flow of chi.  I imagine hearing the rolling waves of the ocean and the pleasant sound of water flowing while pouring tea into my self-crafted colorful pottery mug with its appropriately matching saucer.  Miraculously, I do not have to pee with all these water sounds.  I am spiritually centered and feeling warm zen as I slowly consume my hot water flavored with the leaves of the Camellia sinensis plant.

Now let’s look at another situation.

I boiled or microwaved water and poured it into my tea-stained reused white mug that has a tea bag that I purchased because it has health benefits.  I make sure the water is hot enough to disinfect any bacteria from the last time I used it.  Later, I forgot I poured the tea only come back to it two hours later in a rush as I’m leaving the house, so I quaff down the whole cup of flavored cool water.  It is kind of gross at this point, but I drink it anyway because it is good for me.

Which situation do you think lowered your blood pressure?  Obviously quaffing the stuff down as fast as possible in a rush out the door probably won’t have the same health benefits as sipping soothing flavored water slowly.

I can’t speak to the anticancer effects.  Maybe both situations benefit from just having the phytochemicals in tea.  Many health behaviors and foods are associated with a reduced risk of cancer, but there is not strong enough evidence to say that doing these things all the time will completely prevent cancer.  I would think that scalding your mouth with the tea may increase the risk of mouth cancer due to the turnover of epithelial cells in your mouth, but I can’t say for sure.

Summary

Sometimes the food itself has nothing to do with the reported health benefits associated with a food.  Perhaps some health benefits are chemically related to the foods themselves in some cases, but when association studies come out to promote certain foods, I like to examine things in contexts that people often don’t think about.

Alcohol, tea, and chocolate are good examples of the point that certain foods can have subjective effects on the mind that can confer health benefits for some people.  Others who do not get the same subjective experience from these foods are not weird but socially ostracized, which can have negative health effects if care is not taken to rationalize the whole situation and find other ways to achieve the health benefits.

If you like this post, please tell me why in the comments below and share.  If you don’t like this post, please let me know why in the comments below and share.



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Don’t Tell Others About Your New Year’s Resolutions

Jan 2

Posted by Joey Gochnour, BS, BS, MEd, RDN, CSSD, CSOWM, LD, NASM-CPT in Media Quotes | No Comments

For those of you who have lofty goals of personal change this year, I say keep it to yourself.  Behavior change experts agree.

Unless you are in an environment that is full of supportive people who wouldn’t think of undermining your endeavors because they challenge their status quo and comfort zones (not yours), just don’t tell them!  Some environments are just toxic.  Put up your antenna and scope out the situation, people, and environment before you go disclosing your change goals to people who may influence your ability to achieve them.

Kelsey Dallas did some nice research on this subject, so I would encourage my blog readers to have a read of her article in Deseret News.  Some behavior change experts even say that positive reinforcement of goals makes it less likely for you to achieve them.  Really, just don’t tell people your goals!  It’s between you and your goal!



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