The Menu Coach

Do You Have Diabetes?

noreply@blogger.com (Diana Young, RD, LD, CDE) — Thu, 05 Nov 2009 15:07:00 +0000

For blood sugar and weight management sign up for the free program at IChange.com

Should I get an Insulin Pump?

noreply@blogger.com (Diana Young, RD, LD, CDE) — Thu, 29 Oct 2009 14:47:00 +0000

Insulin Pump users have increased from 70,000 to 300,000 since 1998 in the United States. Only 5% discontinue use for various reasons.

If you are considering an insulin pump to manage your blood sugars you must be able to:

work with your dietitian, diabetes educator and physician to pursue mutually agreed upon goals of therapy
assess the nutrient value of meals, specifically, grams of carbohydrate per amount consumed
give more than 3 daily insulin injections in the event of pump interruption
monitor blood glucose daily at least 4 times per day, preferably 6 - 8 times
check ketone levels
keep a food, exercise, blood sugar and medication log

Contact your Diabetes Educator for Diabetes Self Management Education to delay the onset and slow the progression of diabetes complications.

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Diabetes Drugs: Exercise :: Diabetes Self-Management

noreply@blogger.com (Diana Young, RD, LD, CDE) — Sat, 24 Oct 2009 22:05:00 +0000

Diabetes Drugs: Exercise :: Diabetes Self-Management

Medingo Introduces Solo(TM) MicroPump Insulin Delivery System at the American Association of Diabetes Educators Meeting After Receiving FDA Clearance - With Photos

noreply@blogger.com (Diana Young, RD, LD, CDE) — Tue, 20 Oct 2009 17:56:00 +0000

Medingo Introduces Solo(TM) MicroPump Insulin Delivery System at the American Association of Diabetes Educators Meeting After Receiving FDA Clearance - With Photos

Nutrient Rich Food Ideas, Tips and Tools

noreply@blogger.com (Diana Young, RD, LD, CDE) — Fri, 16 Oct 2009 16:39:00 +0000

Easy ideas, tips and tools to help you apply the NRF approach

Returning to school can be a hectic time of year for both children and adults, and focusing on eating nutritious foods may seem like a difficult task while also getting back to set bed times, alarm clocks and carpools. But eating the nutrient-rich way can be delicious, easy, and affordable, whether at home, in school or on the go. Share some of these simple tips to help families eat well and learn to incorporate nutrient-rich foods into their routine for the school year:

Eating breakfast is crucial to children's performance in school, so start strong by including nutrient-rich foods in their morning meal:
- Add scrambled eggs and two slices of lean meat to a toasted whole grain English muffin
- Blend orange juice and ice with your favorite fruit, such as blueberries and strawberries, for an on-the-go morning boost
- Create a breakfast parfait by layering whole grain cereal, fresh berries, kiwi or melon slices and low-fat yogurt
For busy weeknight dinner ideas, visit the NRFC's recipe database , which offers fun, nutrient-rich, school lunch-friendly ideas on how to spice up children's mid-day meal, such as Grilled Potato Planks and Pasta Salad Nicoise.
Encourage children to make smart choices when selecting foods in their school cafeterias:
- Instead of potato chips, choose whole grain crackers as a more nutritious side option
- In the beverage line, opt for nutrient-rich, low-fat chocolate milk, which is a great choice for kids, since it offers the same package of nine essential nutrients as white milk
- Teach them to build their lunch by choosing foods from each of the five food groups
Make snacking smarter by packing nutrient-rich, grab-and-go items in a small cooler to take wherever you go, such as:
- Trail mix with whole grain cereal or crackers, almonds and dried fruit
- Drinkable or spoon-free low-fat yogurt, reduced-fat string cheese and hard-boiled eggs
- Snack-able cherry tomatoes, carrot sticks, slices of avocado, orange, kiwi or melon
Source: www.NutrientRichFoods.org

Are you Willing to Start an Activity Program?

noreply@blogger.com (Diana Young, RD, LD, CDE) — Sat, 29 Aug 2009 01:06:00 +0000

According to The American Dietetic Association, physical activity should be part of a comprehensive weight management program. Physical activity should include 30 minutes or more of moderate intensity activity on most, and preferably, all days of the week, unless medically contraindicated. Activity contributes to weight loss, may decrease abdominal fat, and may help with weight maintenance.

To get started, print this list and circle the activities you enjoy doing.

Only the ones you really enjoy.

Once you have determined your favorite activities:

Put an F next to the activities you can do for free.

Put a T next to the activities you can do today.

Put a $ next to the activities that cost money and use the Latte Factor® to put aside a few dollars a day for your favorite activity.

Put a NO next to the activities that you are unable to do, because of an illness or disease.

Put a C next to the activities that burn the most calories.

If it’s free and you can do it today, what are you waiting for? Schedule your favorite activities into your Day Planner and keep your appointment as if it’s paying you money. The benefits are priceless:

Better mood
Increases longevity and manages disease
Manages your weight
Strengthens your heart and lungs
Deepens your sleep

Activity does a body good. Start today.

Affordable Nutrient Rich Foods

noreply@blogger.com (Diana Young, RD, LD, CDE) — Mon, 24 Aug 2009 14:06:00 +0000

Milk/Cheese

2% milk
cheddar, mozzarella cheese
lowfat yogurt, plain or flavored

Meat/Fish/Eggs

lean ground beef
dark meat chicken
canned fish
eggs

Beans/Legumes

(dry/canned)
pinto
calico
red Mexican
black
brown

Nuts/Seeds

peanut butter
sunflower seeds
almonds

Cereals/Grains

whole wheat bread and rolls
corn or wheat tortilla
rice

Fruits

bananas
apples
orange juice (frozen concentrate)
100% fruit juice

Vegetables

potatoes
tomatoes (canned)
corn (canned)
100% vegetable juice

Can You Say No to Unhealthy Food Choices?

noreply@blogger.com (Diana Young, RD, LD, CDE) — Fri, 21 Aug 2009 00:16:00 +0000

Yes, you can.

Clearly define the results you want
Make a choice
Take Action
Whether you feel like it or not

Clearly define the results you want.

You can’t make the right choices unless you have clearly defined goals/results.

Making a Choice:

Making a choice is the mental process of thinking involved with the process of judging the merits of multiple options and selecting one of them for action.

Everything is a choice. Choice equals results.

Good Choice = Good Results
Bad Choice = Bad Results

Take Action:

Once we make a choice the mind automatically goes into action. “What action do I need to take in order to achieve the results I desire?”

Whether we feel like it or not

When you make a choice to take action for a result, then how you feel does not enter into the equation. How many times do you do what you do, when you do not feel like it? If you have children, how many times do you get up in the middle of the night to take care of your child when you did not feel like it?

Dean Briggs asked a student why he failed to complete an assignment. The student answered, "I wasn't feeling very well, sir." "Well, Mr. Smith," said Dean Briggs, whose own health was marginal, "in time you may find that most of the work of the world is done by people who weren’t feeling very well."

Of course, incapacitating illnesses can eclipse our work—and at times we must protect our health with rest. Dean Briggs' point for this student was to learn to master his own moods and feelings. The responsible person does not need to "feel like it" to obtain the results they desire.

Are You Ready to Lose Weight?

noreply@blogger.com (Diana Young, RD, LD, CDE) — Tue, 18 Aug 2009 23:12:00 +0000

Most will say an unequivocal "YES".

But, have you answered the hard questions?

Can you say no to unhealthy food choices?

Are you willing to start an activity program?

Will you stop mindless eating?

Can you devote the time and effort to lose weight?

Are you willing to ask for help when you get stuck?

Will you get back up when you slip?

If you answered yes to all 6 questions, you are ready. If you answered no to any of the questions, don't worry, during the next month I will be offering solutions to these challenges.

Stay Tuned . . .

RDs Bring Food and Nutrition Expertise to the Table

noreply@blogger.com (Diana Young, RD, LD, CDE) — Wed, 20 May 2009 22:51:00 +0000

Who is a Registered Dietitian?

Registered dietitians are food and nutrition experts, translating the science of nutrition into practical solutions for healthy living. The expertise, training and credentials that back a registered dietitian are vital for promoting positive lifestyle choices

Trust a Registered Dietitian

When you need food and nutrition information based on fact or need to know how a healthy diet improves health and fights disease— rely on qualified professionals in the field. Registered dietitians draw on their experience to develop a personalized nutrition plan for individuals of all ages. They are able to separate facts from fads and translate nutritional science into information you can use. A registered dietitian can put you on the path to lowering weight, eating healthfully and reducing your risk of chronic disease.

RD=Expert

Registered dietitians know the science of nutrition. They have degrees in nutrition, dietetics, public health or a related field from well-respected, accredited colleges and universities.

Looking for a Registered Dietitian?

When you need trusted, accurate, timely and practical nutrition advice, seek the services of a registered dietitian.

Healthy Food Choices

noreply@blogger.com (Diana Young, RD, LD, CDE) — Fri, 15 May 2009 23:24:00 +0000

Instead of…	Replace with…
*Milk Group* Sweetened fruit yogurt Whole milk Natural or processed cheese	Plain fat-free yogurt with fresh fruit Lowfat or fat-free milk Lowfat or reduced- fat cheese
*Meat Group* Beef (chuck, rib, brisket) Chicken with skin Lunch meats (such as bologna) Hot dogs (regular) Bacon or sausage Refried beans	Beef (loin, round), fat trimmed off Chicken without skin Lowfat lunch meats (95% to 97% fat free) Hot dogs (lower fat) Canadian bacon or lean ham Cooked or canned kidney or pinto beans
*Grain Group* Granola Sweetened cereals Pasta with cheese sauce Pasta with white sauce (alfredo) Croissants or pastries	Reduced fat granola Unsweetened cereals with cut-up fruit Pasta with vegetables (primavera) Pasta with red sauce (marinara) Toast or bread (try whole grain types)
*Fruit Group* Apple or berry pie Sweetened applesauce Canned fruit packed in syrup	Fresh apple or berries Unsweetened applesauce Canned fruit packed in juice or "lite" syrup
*Vegetable Group* Deep-fried french fries Baked potato with cheese sauce Fried vegetables	Oven-baked “french fries” Baked potato with salsa Steamed or roasted vegetables
*Solid Fats* Cream cheese Sour cream Regular margarine or butter	Light or fat-free cream cheese Plain lowfat or fat-free yogurt Light-spread margarines, diet margarine
*Added Sugars* Sugar-sweetened soft drinks Sweetened tea or drinks Syrup on pancakes or french toast Candy, cookies, cake, or pastry Sugar in recipes	Seltzer mixed with 100% fruit juice Unsweetened tea or water Unsweetened applesauce or berries as a topping Fresh or dried fruit Experiment with reducing amount and adding spices (cinnamon, nutmeg, etc.)

brought to you by: http://mypyramid.gov/STEPS/nutrientdensefoods.html

Eating your Way to a Healthier You

noreply@blogger.com (Diana Young, RD, LD, CDE) — Sun, 10 May 2009 03:24:00 +0000

Check out this SlideShare Presentation:

Eating your Way to a Healthier You

View more presentations from menucoach.

Mother's Day - Don't Let It Sabotage Your Weight Loss Success

noreply@blogger.com (Constance Brown-Riggs, MSEd, RD, CDE, CDN) — Tue, 05 May 2009 21:37:00 +0000

Much has been written about weight gain during the holiday season. Some experts say as much as 5 pounds can be gained between Thanksgiving and New Year's Day. Other experts believe that for most people the bigger challenge is the weight gain between New Year's Day and Thanksgiving, which also includes Mother's Day.

Whatever the holiday, everyone can agree that the holidays bring many more opportunities to over indulge. The following tips are designed to help you get through Mother's Day sensibly -with everything in tact-blood pressure, cholesterol, and blood sugar. Oh, and of course your weight!

Do have the traditional Mother's Day foods you've enjoyed since childhood - but remember to enjoy moderate portions.

Concentrate on eating slowly - by putting the fork down between bites, and savoring the taste and companionship during the meal.

Choose to eat new foods or traditional family favorites rather than waste calories on everyday foods, like mashed potatoes or broccoli.

Eat a small snack about 1 hour before you go to dinner so you don't arrive too hungry. Upon arrival at dinner, place appetizers on a plate instead of picking on foods here and there. You'll be less likely to overindulge!

Scan the entire buffet table before you make your food choices. Choose small portions of food you really, really want.

Remember to enjoy other aspects of the holiday, such as socialization with family and friends.

Look your best! When you look good, you feel good. And when you feel good, you're less likely to seek comfort in food.

For more great expert tips check out Confessions of the Food Police in the May/June issue of VIV Magazine.

Constance Brown-Riggs, National Spokesperson for The American Dietetic Association and Author of "Eating Soulfully and Healthfully with Diabetes"

Flat Belly Diet reviewed by a Dietitian

noreply@blogger.com (Diana Young, RD, LD, CDE) — Mon, 04 May 2009 17:09:00 +0000

Flat Belly Diet
By Liz Vaccariello with Cynthia Sass, MPH, RD
Rodale (2008)

Reviewed by: Constance Brown-Riggs, MSEd, RD, CDE, CDN

Claims:

The Flat Belly Diet claims you can lose up to 15 pounds in 32 days and flatten your belly – all without a single crunch. The editors claim the Flat Belly Diet is grounded in cutting-edge science that has found a link between monounsaturated fatty acids (MUFAs) and the accumulation of belly fat and is the safest, most satisfying way to lose weight. On the Flat Belly Diet you get to eat satisfying, healthful foods and lose the weight you want.

Synopsis of the Diet Plan:

The Flat Belly Diet consists of two parts: a four-day anti-bloat jumpstart and the four-week eating plan.

The jumpstart is designed to flush out fluid, reduce water retention and relieve digestive problems. Dieters are told to avoid the salt shaker, salt-based seasonings, highly processed foods, excess carbohydrates foods (pasta, bananas, bagels and pretzels), bulky raw foods, gassy foods (legumes, cauliflower, broccoli, Brussels sprouts, cabbage, onions, peppers and citrus fruits), chewing gum, sugar alcohols, fried food, spicy foods, carbonated drinks, alcohol, coffee, tea, hot cocoa and acidic fruit juice. Dieters must also drink two liters daily of “sassy water”: a blend of ginger root, cucumber, lemon and mint leaves. The jumpstart meal plan provides 1,200 calories daily and a four-day shopping list and sample menus are provided.

The four-week eating plan has three basic rules:

• Eat 400 calories per meal.
• Never go more than four hours without eating.
• Eat a MUFA at every meal.

This phase of the diet provides 1,600 calories daily from three meals and one snack. (Men are instructed to go to flatbellydiet.com to customize their calorie counts.) The book includes 28 sample breakfast, lunch and dinner and snack options of 400 calories each; a chart of MUFA foods; charts listing Flat Belly meal replacements, frozen meals and fast foods; and more than 80 recipes with nutrient analysis for calories, protein, carbohydrates, total fat, saturated fat, cholesterol, sodium and fiber.

The diet is based on a healthy, Mediterranean-style meal plan with menus and recipes provided to support the reader. Recognizing many dieters are eating on the run, there are also options for fast-food dining as well as meal replacements. And although the books claims “not a single crunch required,” there is an illustrated chapter touting the health benefits of cardio, strength training and core-focused exercises. Success stories with before-and-after pictures serve as strong motivators for weight change. However, there are only two calorie levels provided -- 1,200 calories for the jumpstart phase and 1,600 calories for weight-loss phase -- but no adjustments for calorie levels based on gender, height, weight, activity level or any other pertinent variables.

Nutritional Pros and Cons:

Despite having a relatively healthy eating plan, there are components of the book that are indicative of a fad diet, including:

• The jumpstart phase requires dieters to suddenly stop consuming caffeine, which can
cause severe headaches as well as other symptoms associated with withdrawal.
• Dieters are led to believe MUFAs are the “silver bullet” for weight loss.
• The book claims to be “grounded in cutting-edge science” but the authors fail to provide any scientific rational for “sassy water.”
• Rapid weight loss may result from being on this diet, but most of the weight will be water weight.

Bottom Line:

Based on the Mediterranean style of eating, the diet portion of this book is healthy. For individuals who require a 1,600-calorie plan, this book is great. Those requiring other calorie levels will need to work with their registered dietitian to individualize the meal plan.

purchase Flat Belly Diet

"The Engine 2 Diet" reviewed by a Dietitian

noreply@blogger.com (Diana Young, RD, LD, CDE) — Sun, 03 May 2009 15:15:00 +0000

The Engine 2 Diet: The Texas Firefighter’s 28-Day Save-Your-Life Plan That Lowers Cholesterol and Burns Away the Pounds
By Rip Esselstyn
Wellness Central (2009)

Reviewed by Jim White, RD, ACSM/HFI

Claims:

Written by Austin firefighter and former professional tri-athlete Rip Esselstyn, this plan focuses on lowering total cholesterol and LDLs (called “lethal cholesterol”) while improving HDL (or“healthy cholesterol”) through a plant-based diet. Weight loss is the inevitable result from a lowfat, high-fiber diet.

Diet Plan:

This book recommends readers keep a plant-based diet of whole grains, vegetables, fruits,legumes, tofu and soy products while “abstaining from all animal-based products and refined foods” -- and the author does mean ALL. In short, this is a vegan diet. The 28 days are broken into weeks in which the reader progressively purges from his or her diet processed foods, dairy, meats, eggs and oil (including olive and canola oils). For those readers who may need to “wean themselves off of unhealthy foods,” there is a modified Fire Cadet version. The book includes a weekly menu planner and more than 100 pages of recipes; lists of “E2-Approved foods” with brand names; a particularly good chapter on nutrition label reading as well as an exercise program with directions and photographs.

Nutritional Pros and Cons:

The author appropriately addresses the seriousness of cardiovascular disease and Type 2 diabetes and correctly points to some lifestyle choices that can lead to them. However, the Engine 2 Diet recommends the following macronutrient configuration:

Protein: 2 ½ percent to 6 percent
Fat: 9 percent to 15 percent
Carb: plant-based carbohydrates make up the rest of the diet (75 percent)

This extremely low fat intake would explain why the pounds “burn away” and the protein recommendations are well below 2005 Dietary Guidelines recommendations of 10 percent to 35 percent. The author also suggests a direct cause/effect of eating dairy products and Type 1 diabetes, which has not been proven. Nonetheless, he acknowledges eliminating the dairy food group may cause a decrease in calcium and addresses this by recommending plant-based foods that are good sources of this important nutrient. He promises the reader the palate will change over the course of the month so the desire for the unhealthy foods will decline, which may be optimistic.

Bottom Line:

I would recommend the book as a resource for vegetarians who are looking for interesting recipes, to a vegetarian wanting to progress to a vegan diet or to a self-proclaimed food “purist” wanting to decrease serum cholesterol with radical dietary changes to avoid the use of statins. The claim to decrease cholesterol and pounds if all the recommendations are followed is a foregone conclusion…but that is a big if because it will be difficult for the average reader to successfully sustain such extreme dietary changes. But the author’s friendly, positive and emphatic approach may motivate readers to take a stern look at their food intake and try to at least incorporate some plant-based meals into their diets.

Medifast - What Your Physician Should Know

noreply@blogger.com (Diana Young, RD, LD, CDE) — Thu, 30 Apr 2009 13:07:00 +0000

Medifast has been providing a clinically proven approach to weight loss and nutrition since 1980.

Medifast nutritional products are formulated with only the highest quality ingredients. Patients should work closely with a physician prior to starting and while following the Medifast Program.

Why have so many people been successful with Medifast?

The Medifast Program is a lifestyle plan that includes three phases: weight-loss, transition, and maintenance. Medifast uses nutritionally balanced meal replacements to help your patient lose weight safely and quickly. Medifast products are formulated with the right balance of protein, carbohydrates, fat, vitamins, and minerals. Your patient will appreciate Medifast’s “no-counting” approach to weight loss, which provides structure and simplicity while meeting all of the body’s nutritional needs.

Why does Medifast work?

Medifast is designed to safely create a gap between caloric intake and caloric expenditure without sacrificing nutritional needs. Each Medifast Meal is formulated with a proven balance of carbohydrates and protein for improved satiety and program adherence. The key to success on Medifast is the nutrient-dense, low-calorie Medifast Meals that promote mild dietary ketosis, helping the body achieve fast weight loss while preserving muscle tissue. This fat-burning
state also helps eliminate physical hunger while providing sufficient levels of energy.

The Medifast 5 & 1 Plan
5 Medifast Meals (any combination) + 1 Lean & Green Meal of lean protein (or meatless options) and vegetables

The 5 & 1 Plan provides 800 to 1,000 calories and 80 to 100 grams of carbohydrates daily through pre-portioned, vitamin- and mineral-fortified meal replacements. We encourage patients to eat every 2 to 3 hours to maintain proper nutrition, energy, and blood sugar control, and to avoid hunger. Protein and vegetables from the Lean & Green Meal should be weighed and measured with a food scale or measuring cup before eating. The 5 & 1 Plan is a low-sodium, low-fat meal plan with adequate protein (less than 30% of the calories). The Lean & Green Meal is comprised of 5 to 7 ounces of lean protein (or meatless options), 0 to 2 healthy fat servings (depending on protein choice), and 3 servings of vegetables. This meal may be consumed at any time during the day.

Recommendations:

Drink a minimum of 64 ounces of non-caloric fluids daily. Water is recommended. Medifast provides additional meal plans for your patients with special dietary needs, including:

Type 2 diabetes mellitus
Seniors – ages 70+
Teens – ages 13-18
Nursing moms

Medifast suggests that patients who already have an exercise program in place decrease the intensity of the exercise the first 2 to 3 weeks of starting the Medifast Program as their bodies adjust to the 5 & 1 Plan. Once they have adjusted to the fat burning state, activity can be gradually increased back to the normal level. Patients new to exercise can start a low- to moderate-intensity exercise program with physician approval 2 to 3 weeks after starting the 5 & 1 Plan. To improve compliance and promote long-term commitment, Medifast recommends incorporating activities patients will enjoy. No more than 45 minutes of vigorous exercise per day for patients on the 5 & 1 Plan.

Patients with diabetes

Prior to beginning the program, Medifast recommends that all patients with diabetes consult with their physician about the program and current medication dosages. For patients on insulin, sulfonylureas, thiazolidinedoines, and other medications, Medifast suggests that they check their blood a minimum of 2 to 3 times daily, especially at the beginning of the Medifast Program. As blood glucose levels improve with weight loss, continual physican monitoring is necessary to determine proper therapeutic levels of medications.

Concerns for women

Because estrogen is stored in adipose tissue, fast weight loss may cause an increase in the level of blood serum estrogen. Increased estrogen levels can affect the regularity of menstrual cycles and possibly increase PMS symptoms. Fast weight loss, along with higher estrogen levels, can also increase fertility. If a patient becomes pregnant, she should discontinue the 5 & 1 Plan immediately due to the low calorie level. Lactating women who need a higher calorie intake are advised against using the Medifast 5 & 1 Plan.

Contraindications to the 5 & 1 Plan

Significant medical conditions and certain medications may prohibit patients from using the Medifast Program. In some cases, patients may be able to use Medifast Meals as an occasional meal replacement. It’s recommended that physicians screen patients for the following conditions:

Heart attack within the past 3 months; recent or recurrent
strokes or mini-strokes; unstable angina; severe liver or kidney
disease; clotting disorders; active cancers; eating disorders;
severe psychiatric disturbances; current use of steroids over 20
mg/day; current use of lithium; or type 1 diabetes.

Patients over 70 years of age

Patients over age 70 can use the 5 & 1 Plan with close supervision. Some physicians have recommended a higher caloric intake based on individual needs. Medifast offers higher-calorie meal plans (1,000 to 1,500 calories per day) for this population.

Potential side effects

Most patients feel great on the Medifast Program. However, some patients may experience:

• Constipation
• Diarrhea
• Dizziness, lightheadedness, fatigue (in first week)
• Feeling cold
• Dry skin and hair

Medifast and lactose intolerance

Medifast offers a variety of low-lactose and lactose-free products.

Medifast and prescription medications

Most prescription medications will not interfere with the Medifast Program. However, as patients lose weight, medication dosages may need to be adjusted.

• Medications for depression, thyroid or hormone
deficiency, etc., may be continued while on Medifast.
• Medications for arthritis, such as Indocin® or naproxen,
should be avoided due to potential stomach irritation.
• Medications for blood pressure usually need to be
adjusted as patients progress on the program.
We do not recommend the 5 & 1 Plan for patients using over
20 mg of steroids, such as cortisone or prednisone, per day.

Medifast Program Phases

Weight-Loss Phase:

Patients follow the 5 & 1 Plan designed to induce mild dietary ketosis for safe and effective weight loss.

Transition Phase:

Designed to reintroduce healthy foods (including fruits, low-fat dairy products, and whole grains) into the calorie- and carbohydrate-balanced meal plan. Transition phase duration is a minimum of four weeks.

Maintenance Phase:

Designed to provide nutritionally-balanced and energy-appropriate meal plans to patients for successful lifelong weight management.

For more information:

Diana Young, RD, LD/N, CDE provides complimentary coaching to assist your patient in obtaining their goals.
www.DianaYoung.TSFL.com

5 Emotional Eating Triggers

noreply@blogger.com (Diana Young, RD, LD, CDE) — Tue, 28 Apr 2009 13:02:00 +0000

Food is used to satisfy our feelings, and that’s when the cycle of emotional eating takes over.

Eating to suppress negative feelings can sabotage your efforts to lose weight.

Top 5 Emotional Eating Triggers:

Anger
Hopelessness
Lack of Control
Feeling Unappreciated
Boredom

So, how do you regain control of your eating habits?

Keep a food journal and rank your hunger from 1-10. You will become aware of how often you eat and how hungry you feel. Getting to know your triggers will help combat your feelings associated with foods. In your food journal, write what you are thinking. It may help determine your mood and make you more aware of your emotional eating habits.

Make a list of things you enjoy doing and carry the list with you. When you feel the urge to eat, take out the list and begin doing an enjoyable activity instead.

Activity example: Tweet me and I'll tweet you back.

Stay away from your normal comfort foods and instead indulge in a pickle, celery sticks or a cup of bouillon. The trick is to keep healthy snacks around for when you have trouble overcoming your trigger points.

Until next time,
Diana Young

Need a Dietitian?

noreply@blogger.com (Diana Young, RD, LD, CDE) — Mon, 27 Apr 2009 22:34:00 +0000

Clinical Research Using Medifast Products

noreply@blogger.com (Diana Young, RD, LD, CDE) — Sun, 26 Apr 2009 17:27:00 +0000

Clinical Research Using Medifast Products

Medifast uses both clinical research studies and retrospective analysis data from its Medifast clinics as the basis of its claim, "clinically proven". An overview of Medifast clinical research is provided below.

STUDY 1

REFERENCE: Crowell, M.D. & Cheskin L.J, The Johns Hopkins University School of Medicine. Multicenter Evaluation of Health Benefits and Weight Loss on the Medifast Weight Management Program.
PURPOSE: The purpose of this study was to retrospectively evaluate the efficacy of a medically supervised, protein-supplemented modified fasting program (Medifast) for weight reduction and to evaluate the impact of weight reduction on coexisting health problems.
RESULTS: The results of the study concluded that medically-supervised, protein-sparing modified fasts offer a safe and effective means of weight reduction and are accompanied by significant improvements in coexisting health problems. Of samples taken, males lost an average of 67 lbs and females lost an average of 47 lbs during fasting. The study found significant reductions in systolic and diastolic blood pressure, total cholesterol and triglycerides, as well as the normalizing of blood pressure and hypertensive patients.

STUDY 2

REFERENCE: Cheskin, MD, FACP, Mitchell, MS, Lewis, BA, Jhaveri, MD Yep, BS. Johns Hopkins University School of Bloomberg Public Health. Efficacy of 2 Diet Plans Designed for People with Type 2 Diabetes on Weight and Health Measures.
PURPOSE: The purpose of this study was to evaluate the efficacy of the standard ADA (American Diabetic Association) self-selected diet (SD) vs. a portion controlled diabetic food diet (PCD) in obese patients with NIDDM. The study also evaluated not only the metabolic effects in the long term, but also compliance and any consequent medication changes in patients of the two weight loss regimens. (16-34 weeks of active weight loss, 52 weeks of maintenance) The meal replacements (Medifast) used in this study are soy-based products (bars, shakes, soups) that are considerably lower in sugar than their non-diabetic counterparts and other popular diet products on the market.
RESULTS: The results discussion is as follows. Significantly greater results were achieved after the initial 34-weeks of weight loss by participants in the PCD group in pounds and percent weight loss, insulin level and hemoglobin A1c. The PCD group also saw significant improvements within group in BMI, systolic BP, diastolic BP, waist/hip measurements, cholesterol, HDL triglycerides, glucose and percent body fat. Dropout rates were less in the PCD in both weight loss and weight maintenance. During weight loss, participants in the PCD group significantly decreased their use of medications to treat Type 2 DM. Participants in the PCD group also self-reported higher ease of compliance with the diet compared to the SD group (64.2% vs. 56.0%).

Researchers recommended that a PCD be considered for type 2 diabetics desiring weight loss, but that periodic use of SD during weight maintenance will not adversely affect weight loss efforts. The research supports that using a portion-controlled diet will produce comparable if not better outcomes in type 2 diabetics attempting to control their weight.

The study was published in the 2008 January/February issue of 'The Diabetes Educator'. The peer-reviewed journal is the official journal of the American Association of Diabetes Educators. The study was also presented at American Diabetes Association's 65th Annual Scientific Session in San Diego, CA, June 11, 2005.

STUDY 3

REFERENCE: Lawrence J. Cheskin, Lisa M. Davis, Andrea Hanlon-Mitola, Amy Mitchell, Ami Jhaveri, Mary Yep, Vanessa Mitchell. Johns Hopkins Bloomberg School of Public Health, Center for Human Nutrition, Department of International Health, Baltimore, MD 21205. Efficacy of Parent-Child Dieting Plans Incorporating Medifast Meal Replacements for Weight Loss. RCT Comparing Balanced Energy Deficit Diets With or Without Meal Replacements for Weight Loss and Maintenance Among Children Dieting Alone or With a Parent.
PURPOSE: The study compared the safety and efficacy of supplemental Medifast portion-controlled meal replacements (MRs) with a USDA Food Guide Pyramid-based diet. Both weight loss diets were 20% energy-restricted (~500 kcal deficit). 80, 8-15yo children, BMI>95th%ile, were screened and 40 randomized to either a MR diet (3 MRs/d during active weight loss and 2 MRs/d during maintenance) or to the food-based diet. Subjects were further randomized to dieting alone or with a parent.
RESULTS: By ITT analysis, dieting with a parent, or food vs MR, made no difference in weight outcome. However, following initial weight loss (6mos) and 1yr maintenance (18mos), significant (p less than or equal to 0.05) benefits were seen in the MR group in BMI%ile (0 mos=98.8 Â± 1.0, 6 mos=96.6 Â± 3.2, 18 mos=96.4 Â± 3.4); body fat (↓5.9%@6 mos, 5.3%@ 18 mos), total cholesterol (↓6.7%, 5.6%), LDL (↓19.8%, 7.9%) and triglycerides (↓23.6%, 22.3%). No significant between-group differences, differences in growth rates, or adverse events were observed. Conclusions: Among overweight 8-15yo children, dieting with or without a parent, meal replacements were as safe and effective as a food-based diet for weight loss and maintenance. (Supported by Medifast Inc., MD)

STUDY 4

REFERENCE: Drs. Walker S.C. Poston, C. Keith Haddock, Jennifer E. Taylor, John Foreyt. Effectiveness of Medifast Supplements Combined with Obesity Pharmacotherapy: A Clinical Program Evaluation.
PURPOSE: The purpose of the study is to evaluate the long-term impact of Medifast meal-replacement supplements combined with appetite suppressant medication (ASM) among participants who received a minimum of 12-weeks of treatment.
RESULTS: Results of this study were presented at the American Society of Bariatric Physicians annual meeting in May 2007 and the study is pending publication in a medical journal.

STUDY 5

REFERENCE: National Institutes of Health: Impaired Capacity to Lose Visceral Adipose Tissue During Weight Reduction in Obese Postmenopausal Women With the Trp64Arg B3- Adrenoceptor Gene Variant.
PURPOSE: This study examined whether women on a weight loss program who are carriers of a genetic variant (Trp64Arg) lose less visceral fat than women who do not have this gene. Participants entered a medically supervised weight loss program aimed at reducing body weight to less than 120% of ideal value. Food was self selected with dietitian supervision, with or without the inclusion of the TakeShapeTM, a Medifast brand modified fasting supplement.
RESULTS: Results from the study showed that reductions in body weight, BMI, total fat mass and fat-free mass were not significantly different between carriers and non-carriers of the variant. Both groups experienced weight reduction of 31-36.1 pounds, which the study identified as a significant weight loss effect.

STUDY 6

REFERENCE: Vivienne Matalon, M.D. The Bariatrician Summer 2000. An Evaluation of Weight Loss following a Carbohydrate and Fat Restricted Diet with Appetite Suppressant and Dietary Supplementation.
PURPOSE: This was an open label trial designed to assess the safety and effectiveness of a weight loss regimen consisting of a carbohydrate and fat restricted diet, supplemented with an appetite suppressant, a dietary supplement and a liquid protein drink (Medifast). At baseline, evaluations included a history and physical, and measurements of total body weight (lbs), body fat (%), BMI, lean body mass, water weight and blood pressure. Patients were then see weekly for 6 months. At each weekly visit, total weight, % body fat, BMI, lean body mass, water weight and BP were noted. At the end of the study statistically significant differences from baseline to final value were noted for body weight (P<.001), percent body fat (P<.001), BMI (P<.001), lean body mass (P<.001), water weight (P=.01) and body systolic (P=.003) and diastolic (P<.001) blood pressure.
RESULTS: Of 47 patients enrolled, 24 (51%) completed six months using the dietary regimen prescribed. Data was analyzed for all patients who were treated with the diet, as well as for the subset of patients who completed the entire study period. The dietary regimen showed that a carbohydrate and fat restricted program supplemented by a natural appetite suppressant can lead to progressive weight loss of comparable value to prescribed pharmacologic agents at the time of study. Patients in the study experienced statistically significant decreases in overall body weight, percent body fat, BMI, lean body mass, total body water and both systolic and diastolic blood pressure.

STUDY 7

REFERENCE: L. M. Davis, C. D. Coleman1, W. S. Andersen, L. J. Cheskin. The Effect of Metabolism-Boosting Beverages on 24-hr Energy Expenditure. The Open Nutrition Journal 2008; 2: 37-41.
PURPOSE: The effect of thermogenic meal replacement beverages (TMRB) containing 90 mg EGCG and 100 mg of caffeine on resting energy expenditure (REE) was tested. Thirty adults (19 women, 11 men) were stratified into 3 groups: lean (n=10, BMI 21.5 ± 2.1); overweight/obese (OW) (n=10, BMI 29.8 ± 2.7); or weight maintainers (WM) (n=10, BMI 28.8 ± 4.0). Following an overnight fast, baseline measurements, including REE via indirect calorimetry, were performed. REE was repeated at 30, 60, 90, and 120 minutes after consuming a TMRB. Appetite was assessed via visual analogue scale at baseline, 30 minutes and 120 minutes after the TMRB.
RESULTS: Mean 24-hour REE was increased 5.9 ± 2.5% overall (p=0.000), 5.7 ± 3.1% among lean subjects (p=0.0002), 5.3 ± 1.4% among OW subjects (p=0.000), and 6.8 ± 2.7% among WM (p=0.0007). Appetite was significantly reduced 30 minutes after the TMRB (p=0.0002). TMRB appear to be a promising weight control tool.

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Setting Weight Loss Goals

noreply@blogger.com (Diana Young, RD, LD, CDE) — Fri, 24 Apr 2009 14:28:00 +0000

A goal is your vision. It is what you desire; what you aim to achieve. Goals should be personal and meaningful. We can give you ideas and suggestions, but unless the goals feel right, it will be difficult for you to make a lasting commitment to them. Commitment is the key to success.

There are two types of goals: outcome goals, which are the "prize" for all your hard work, and behavior change goals, which are strategic plans you make to help you reach your outcome goal.

Setting specific behavior change goals will help you achieve your outcome goals. These may include shedding excess weight, improving your nutrition and getting into good physical shape. Your behavior change goals should be realistic and have a measurable outcome.

Examples of behavior change goals include:

I eat 5 Medifast Meals and 1 Lean & Green meal per day.
I walk briskly during my lunch hour for 20 minutes each day during the week.
I drink 8 glasses of water daily.

At times you will need to make adjustments, or change your goals, based on unforeseen obstacles that get in your way. This doesn't mean you give up on the goal; rather it means that you need to set up a contingency plan. We all lead busy lives, and sometimes we may fall behind on the important things - like exercise - and will have to make up for it by making sure we are still eating all the right foods. Stress is often an obstacle that can make us fall into bad habits, so taking time to relax and do things you enjoy could be just the thing you need to stay on track.

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Journal For Weight Loss

noreply@blogger.com (Diana Young, RD, LD, CDE) — Thu, 23 Apr 2009 13:08:00 +0000

Keeping a journal can help you learn a lot about yourself in terms of what you eat, how much you exercise and why you engage in various activities.

Journaling the meals that you eat helps you to avoid "unconscious eating" - eating that leads to consumption of excess calories, beyond what you may have ever intended to consume. In fact, research actually shows that keeping a food journal will help you lose weight! In addition, journaling your meals will help you keep the weight off once it's gone.

In addition to keeping track of your foods, journaling your moods, such as stress, boredom or anger, can help you pinpoint problem areas during your day, which in some cases may serve as triggers to overeating. Once you understand the problem, you can find a solution that does not involve opening the box of cookies or the jar of jellybeans.

And last but certainly not least, remember to log your exercise. The more often you log your exercise, the clearer it will be to see how exercise affects the bottom line when it comes to weight loss.

Need help with weight loss? contact Diana Young, RD, LD/N, CDE

Catch that Carrot - Setting a Reward System

noreply@blogger.com (Diana Young, RD, LD, CDE) — Wed, 22 Apr 2009 12:01:00 +0000

When beginning a weight-loss program, it is important that you set weight-loss and fitness goals to monitor your progress along the way. Once you have short-term goals, set up a reward system as positive reinforcement for your efforts.

We are familiar with reward systems from others, such as employee of the month, sports trophies and scholastic achievement awards. Weight-loss achievements are unique because you are the only one who really knows how hard it was to reach your goal! And so you must reward yourself!

Here are some guidelines for setting up a reward system:

Before losing any weight, plan the reward system so that the further along you go, the larger the rewards. For example, reaching the first goal could be a CD, the second goal a bottle of perfume/cologne, the third goal a facial, weekend trip with friends, etc.
Never use food as a part of your reward system.
Make sure you set up reasonable goals. Do not push yourself too hard - take the time to do this right!
You can set up the system by the number of pounds lost, clothing sizes lost, adherence to your exercise program or anything that you feel deserves recognition on your way to success.
Remember that losing the weight isn't the final goal, it's maintaining your lower weight. Use the reward system for maintaining the weight for a certain number of months until your accomplishments become habits.

For more information

Portion Control Just Got Easy

noreply@blogger.com (Diana Young, RD, LD, CDE) — Tue, 21 Apr 2009 12:55:00 +0000

Dear MFers,

Medifast teaches you portion control.

Since you will be eating Medifast Meals five times a day, you will only consume the amounts of food that we provide. In addition, our Lean & Green meal is very easy to follow, and has been mapped out for you when you start the plan. The My Plan section knows what you are supposed to be eating, and will give you suggestions for all of your meals. For more information on proper portioning, see our Quick Start Guide included with your first Medifast order.

Keep the serving sizes below in your head at all times, in order to better estimate your portions:

1/2 cup of cooked vegetables = scoop of ice cream
1 ounce of cheese = a pair of dice
3 ounces of chicken or fish = 1 deck of cards
1 tablespoon of salad dressing = 1/2 of a ping pong ball
1 teaspoon oil or butter = tip of your thumb

Good Luck! And if you need more support, contact me

Diana Young, RD, LD/N, CDE

Benefits of a Low Carbohydrate Diet

noreply@blogger.com (Diana Young, RD, LD, CDE) — Mon, 20 Apr 2009 03:51:00 +0000

ABSTRACT

The persistence of an epidemic of obesity and type 2 diabetes suggests
that new nutritional strategies are needed if the epidemic is to
be overcome. A promising nutritional approach suggested by this
thematic review is carbohydrate restriction. Recent studies show
that, under conditions of carbohydrate restriction, fuel sources shift
from glucose and fatty acids to fatty acids and ketones, and that ad
libitum–fed carbohydrate-restricted diets lead to appetite reduction, weight loss, and improvement in surrogate markers of cardiovascular disease. Am J Clin Nutr 2007;86:276–84.

Contact Diana Young, RD, LD/N, CDE for more information.

10 Medical Benefits of Weight Loss

noreply@blogger.com (Diana Young, RD, LD, CDE) — Fri, 17 Apr 2009 23:12:00 +0000

The medical benefits of a low-calorie diet include:

A reduction in blood pressure
A decrease in blood glucose levels
A decrease in total and LDL cholesterol levels
A reduction in triglyceride levels
An improvement in respiratory function and sleep apnea
A reduction or alleviation in pain associated with osteoarthritis, or inflammation of the joints
A reduction or alleviation of lower back pain
A decreased risk for gallbladder disease/gallstones
Increased mobility
The timid, introverted, and non-assertive individual gains greater self-esteem and self-worth as their external image improves. This also comes from their recognition of a goal achieved.