How much does obesity cost?

I’ve heard all the excuses.

“It’s too expensive to eat healthy”
“I can’t afford a gym membership
“I don’t have time”

I’ll shut down those arguments with a few facts that will blow your mind. More than 1/3 of our nation is considered obese. How much does obesity cost? Let’s take a look at the costs of a few obesity-related procedures. You tell me what’s more costly…

Total hip replacement
Average cost: $51,594
Range: ($38,612 – $86,716)

Total knee replacement
Average cost:  $46,679
Range: ($24,482 – $81,549)

Right Heart Catheterization
This is a procedure where a fine hollow tube (catheter) is inserted into an artery, usually through the groin area, passing it to the heart.

Average cost: $11,020
Range: ($10,024 – $12,296)

Left Heart Catheterization
Average cost: $11,384
Range: ($6,240 – $48,178)

I see so many patients in my hospital’s rehab unit who are overweight or obese. Their knees and hips cannot take the weight and they have to be replaced. The sad part is that unless they lose weight with their new knees or hips… it’s only a matter of time before the new become old and worn again. There are a few common factors I’ve identified when assessing these patients’ lifestyles:

Shake it like a salt shaker
The diet contains many foods that are high sodium and fat. Why? The majority of the food consumed is processed. Home cookin’ has lost its touch.

I (don’t) like to move it move it
Other than the walk from from the parking lot to the office, there’s not much exercise involved. Exercise helps to lower blood pressure & cholesterol and promotes bone strength from weight-bearing exercise. It makes sense why my patients don’t work out because it hurts their knees/hips to workout. It doesn’t make sense why we can’t prevent this from happening by getting our heart rate up even just a few days a week.

Zombie apocalypse
Habitual routines involve food. Some eat out of boredom. Some eat when the TV is on. Some eat while on the computer. Some didn’t realize they were eating while reading this article until I mentioned it ;)

Depending on the type of gym you want to join, it can be costly. However, there are endless options for exercise without a gym. I recently found an awesome free app called Nike Training Club and I’ve loved working out at home on days I don’t want to drive to the gym. Sure, it’s easier to swing by the drive through than slave in the kitchen, but there are many online resources that offer quick, easy, cheap, and healthy recipes. For every excuse you come up with, I will respond “If you fail to plan, you plan to fail.”

What is one practical step you can take to start planning ahead to make sure your health stays a high priority? It could be looking at your schedule a week ahead and writing in workout times. You make all of your doctors appointments and coffee dates with friends, why would miss a workout appointment? Maybe you could start by taking a half hour this Sunday to come up with meal ideas and a grocery list to avoid spontaneous visits to the drive through. Eating healthy doesn’t have to be expensive, but your health is something that’s highly worth investing. Now, would you like fries with that $50,000 hip?

What steps will you take to maintain or achieve good health?

Nike Training Club- get your app in shape!

I have a new favorite app- Nike Training Club. I still go to BodyPump and cycling at my gym, but the gym is a 12-minute drive away and I can’t always make the classes due to my inconsistent work schedule. This app surprised me with how much it made me sweat in 30 minutes using a few weights or just my body weight. I was very impressed with the set up of this app. Let me show you how it works:

I select “Get Workout” from the home screen
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I choose what type of workout I want

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I select an appropriate workout level
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I pick which workout I want to do
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I can see what moves I’ll be doing for the workout before I get started
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I start my workout
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Easy as that! If I don’t know how to do a certain move, I can click the “play” button on the picture and it shows a quick 5 second video of an athlete doing a demo of the move. The app keeps track of how long you’ve done each segment and even provides reminders to check in on your form. It also lets you know when you have 15 seconds or however many seconds you have left that way you don’t have to keep checking your phone.

I usually bring up my Spotify app and rock out to the “Club/House” radio station. The NTC app will quiet the music when it gives you any verbal prompts, so you don’t have to worry about accidentally doing three minutes of lunges instead of two because you missed your cue. Not that an extra minute of lunges would be a terrible thing to do :)

Do you use the Nike Training Club app? How’s your experience been?

High Protein Diet: Highs and Lows

As a Registered Dietitian (RD), I have to obtain 75 continuing education credits every 5 years in order to continue practicing as a RD. I recently took a short course on the benefits and risks of following a high protein diet to get a few credits. The information was interesting and I believe it would be beneficial for my readers to learn about this diet as well. Below is the premise of the course and I’ll share a few key points:

“High-protein diets such as the Zone, Atkins, and Sugar Busters have come and gone for decades, their popularity rising and falling like waves in the ocean. While high-protein diets do usually lead to weight loss, they may be unbalanced meal plans that sometimes restrict entire food groups and fail to meet humans’ essential needs for vitamins, minerals, and fiber. But that doesn’t have to be the case.”

A short-term study was published in 2011 in Nutrition Journal comparing women who were overweight or obese and followed a high-protein diet with those who followed a high-fiber, high-carbohydrate diet. Results showed that although both groups lost weight, the high-protein group lost more weight with greater fat loss and greater decreases in blood pressure.

This study and more like it have been pointing toward the scientific evidence that high protein diets may be a great tool to help fight the obesity epidemic hitting the US. According to my reading, “High protein diets may also be more likely to help keep the weight from coming back, improving weight maintenance, due to better compliance and increased satiety.”

Define High Protein
Dietary Reference Intakes (DRI) recommend a wide range of protein consumption from 10% to 35% based on total calories. Recommended Dietary Allowances (RDAs) are set at a minimum of 0.8 g/kg of body weight (about 0.4 g/lb) but the recommendation for high-protein diets is about 1.2 to 1.4 g/kg but less than 2 g/kg. This comes out to 25-30% of the calories from protein with the rest of the diet coming from carbs (40-45% of calories) and fat (no more than 30%).

Protein fills the tank better than carbs
Protein has an edge over carbs because protein promotes greater satiety than both carbs and fat. As a result, we feel fuller and more satisfied over a longer period of time.

Thermogenesis and muscle maintenance
There’s more to satiety with a high protein diet. Digesting protein has a higher rate of thermogenesis than fat or carbs. Thermogenesis is the amount of energy needed to digest, absorb, and metabolize nutrients. This means we burn more calories by digesting protein than we would digesting fat or carbs.

The biggest impact a high protein diet has on metabolism involves protein’s role in muscle building and maintenance. The test diet used in the studies performed for my reading involved a meal that included at least 30 grams of protein but no more than 50 grams of protein at a meal, especially breakfast. Americans don’t typically follow a diet like this because we skimp on protein at breakfast & lunch and then consume large amounts of protein at dinner. Americans average about 10 grams of protein at breakfast. Spacing out protein intake over the course of the day is important since positive protein balance only lasts for about 3-4 hours after consumption.

How do I increase my protein intake?
First off, it’s very important to assess how much protein you currently consume on average before you decide to eat a cow for breakfast in attempt to reach 30-50 grams at breakfast. A great tool to use in order to determine the breakdown of your calories is MyFitnessPal. This program can show you what percent of your calories you’re getting from protein, fat, and carbs. From this information you can gauge how to gradually increase your calories from protein to meet the 25-30% of calories range. The photo below is an example I found from a MyFitnessPal user. In this case, the amount of fat consumed in the diet would have to decrease to accommodate an increase in calories from protein. This could be changed by choosing lean protein sources low in fat or choosing less items that are high in carbs and fat like breakfast muffins, donuts, croissants, etc.
What food sources can I get protein from?
High-protein sources include chicken, turkey, pork (tenderloin…not your bacon & sausage), fish, meat, eggs, cheese, Greek yogurt, milk, beans, tofu, and other soy products. It’s important to be mindful of the protein choices you make since the sources listed above can be high in saturated fat depending on the type and/or amount you consume. Aim for lean sources and get a variety from the list above. Don’t forget it is possible to get protein from non-animal sources as well. If you choose prepared vegetarian items, be sure to monitor your sodium (salt) intake since some tend to run high.

Pair a high protein diet with exercise
If you’re aiming for weight loss, pairing a high protein diet with strength training allows your body to hold on to your muscle mass so that the weight loss comes from fat. Compare the muscle/fat loss ratio discussed in my reading:
“During starvation, we break down about 50% lean tissue and 50% fat. If you lose weight using a high-carbohydrate diet similar to the Food Guide Pyramid, you’ll be breaking down about 35% lean tissue and 65% fat. Now go on a high-protein diet, and our research shows lean tissue breakdown drops to 20%, while fat breakdown increases to 80%. Add exercise to the mix, and protein breakdown drops even lower—below 10%.”

Don’t leave out fruit & veggies!
Those who start a high protein diet without being properly informed tend to consume a lot of red meat and forget about the produce section. Choose healthy carbs and protein sources from whole grains, non-starchy vegetables (moderation with starchy veggies: peas, beans/legumes, corn, and potatoes), and fruit like berries.

Final thoughts
If you have trouble losing weight or failed to keep weight off, high-protein diets may be an great option for you to pursue. It’s very important to be mindful of fat intake and to consume whole grains, get five or more servings of fruits and vegetables each day, and drinking a variety of fluids since high-protein diets increase urinary output. This diet is not a one-size fits all and I highly recommend you see a Registered Dietitian to get a personalized plan that works best for your needs and to monitor your progress.

What are your thoughts on a high protein diet?

The author of the article I read for my continuing ed credit was written by Diane Welland, MS, RD, a dietitian, author, and freelance writer based in Springfield, Virginia, who is also an adjunct faculty member at Northern Virginia Community College. Her books include The Complete Idiot’s Guide to Eating Clean, The Complete Idiot’s Guide to Eating Local, and The Complete Idiot’s Guide to Belly Fat Weight Loss.

high protein photo source: www.lifecherry.com

Mashed Sweet Potatoes and Pears

Instead of having some sweet potatoes with your butter and sugar, these spuds get the spotlight in this recipe. Sweet potato casserole usually makes an appearance next to the turkey on Thanksgiving but it’s often a calorie-bomb hidden under a pile of marshmallows. My sister-in-law made this dish for Thanksgiving the first time I celebrated with Dave’s family. They were oh-so-good that I didn’t think it was possible for them to be healthy. I’m not sure where she even got the recipe from but I’ve made it a handful of times throughout the year. The secret to this dish is the natural sweetness from the pears and guess what else? The sweetness from the SWEET potatoes. It’s crazy talk, right?

Mashed Sweet Potatoes and Pears
(makes 8 servings)

5 lbs sweet potatoes
4 T. butter, room temperature
1 large can of pears (8 halves) (save 1/4 cup of juice)
1/4 cup brown sugar
1/2 tsp. cinnamon
1/4 tsp. nutmeg
1/2 cup chopped pecans

1. Preheat oven to 400. Pierce potatoes with a fork and place on a baking sheet. Bake till tender – about 1 hour.
2. While potatoes bake, puree pears and 1/4 cup of pear juice in a processor.
3. Remove potatoes from oven, peel, and place in electric mixer. Reduce oven to 350.
4. Add butter to potatoes and mash till smooth. Mix in pear puree, sugar, cinnamon, and nutmeg. Season with salt and pepper.
5. Spread mixture into a 13 x 9 x 2 in. glass baking dish (spray with non-stick first!)
6. Bake at 350, uncovered, until just heated through – about 20 minutes.
7. Sprinkle with chopped pecans.

What is your favorite dish to make for Thanksgiving dinner?

Photo source: Food Network

When calorie counting becomes an obsession

I recently got an iPhone 4s from my generous father and shared the useful apps I loaded. One of these apps was MyFitnessPal. I was so geeked that you could scan a barcode and get instant nutrition facts that I showed Dave more examples that he cared to see. As a dietitian I’ll be the first to admit that while I know what I should eat, that’s not always the case for me because 1. I am not perfect and 2. I have a major sweet tooth. Therefore, I wanted to log a few days to see what areas I could be working on since hey, I should be taking my own advice I provide clients on a daily basis, right?

Before MyFitnessPal there was Jess, Dietetic Student
An objective for one of my undergrad dietetic classes was to memorize the diabetic exchange list. This means that I learned how to calculate the calories, carbs, protein, and fat content based off of the serving size of just about any food. This is very useful now when I do a three-day calorie count to see if a patient is meeting their needs, but this memorization wasn’t initially beneficial to learn. Counting calories became second nature like reaching for milk to pour on your cereal is second nature. You don’t need to decide what to pour on your cereal; your hand just reaches for the milk (hopefully). I found myself adding up my total intake as I walked through the cafeteria line in the dorm and chose my lunch. I still ate what my body needed, I was just way more aware of the contents in every bite. If you read my post about body image, you know I was conscious of my lack of perfections. Comparing myself to an unrealistic standard was a little exhausting. Having a great community of women helped me address my new tendency to make food an idol and counting calories gradually lost its stronghold on me.

Enter marriage
Ever since I got married in 2010 it’s like a flip has been switched. Not that my insecurities completely vanished, but Dave continuously affirms my beauty; so much to the point where I forget about my insecurities because he never seems to notice them. My body does not look like any body you’ll see in a magazine but my body is Dave’s standard and frankly, he’s the only guy I want to want my body! Double win.

MyFitnessPal
Well I mentioned earlier about logging my intake for a few days… I logged 60 continuous days down to the bite. The funny thing is that I’ve weighed the same since high school, I enjoy eating healthy, and I enjoy working out a few days each week. Despite a wicked sweet tooth, my body has stuck around a weight that is healthy for me and anything less than this would likely be a weight I can’t maintain without making drastic changes. Logging my food intake on MyFitnessPal simply confirmed this because at the end of the day, I was eating the calories my body needs to maintain my weight. I didn’t need an app to tell me this but I did like the affirmation. Apparently I valued an app’s conditional approval of my body more than my husband’s unconditional approval of my body.

Parting ways
I would have continued to log my intake if I hadn’t asked a dear friend what apps she recently got for her new iPhone. MyFitnessPal was included in her list but then she explained that she deleted it because she saw it becoming an obsession. Humble me, I just smiled and responded “oh that’s good you realized that.” Talk about conviction! I knew my unnecessary calorie counting was definitely headed in that direction and I deleted the app after leaving her home. My phone even asked me if I was sure if I wanted to delete the app and lose my 60 days of data entered. Ugh. Yes, because that data does not define me and my body naturally knows what it needs.

No one person is the same
I think MyFitnessPal is a great app and I’ve heard multiple stories of how it’s helped friends and family lose weight and see eating trends that they need to work on. A friend of mine lost 20 pounds from logging his intake because it helped him realize that while he was eating 1,600 calories from meals, he was eating an additional 1,600 calories from snacking throughout the day. Making a few changes caused the weight to melt off and now he’s maintaining a healthy weight. For me, the app is not necessary because I got a degree in nutrition and basically have the app in my head. I did learn that I consume more sugar than I should and that I eat a bigger dinner than I need. I blame Dave for the big dinner because I feel that I should have seconds if he has seconds. Unfortunately I’m not 6’2” and almost 200 pounds so I have less body to maintain than he does. It’s a crazy concept, but when I eat nutrient dense food when I’m hungry and don’t eat when I’m not hungry, my body seems to get what it needs. I hope you won’t think less of me for sharing a period of weakness but instead you’ll be encouraged to listen to your body and learn to love it.

What are your thoughts on nutrition apps for phones?

Talk your way out of a fine

Have you ever been fined for something? Do you talk your way out of a fine? Aside from a few parking tickets on campus and a late fee for a library return, I haven’t had many fines. While this is a blessing, it may be the reason my first thought after getting a ticket isn’t to fight it. My husband and I missed our first rent payment EVER this month and didn’t even realize it until we got a repossession letter in the mail from our apartment complex saying we were 7 days past our rent due date and had a $50 late fee to pay in addition to our overdue rent. I was bummed that I totally forgot to pay it so I quickly wrote a check and ran it to the office before it closed at 5pm.

The next morning I told my co-worker about our fine and he responded “Why didn’t you fight it? If you’ve paid rent on time for the past year and a half; I’m sure they would have given you a pass on this one.” I never even THOUGHT to ask! Shortly after my coworker rocked me with this thought I remembered that I wrongfully got a parking ticket a few months ago for parking in a spot that was a visitor’s spot with no time limit after 6pm (I got there at 6pm). It was a $25 ticket but I just wrote a check and sent it in. The following week I arrive at my friend’s where I got the ticket and another friend who also got a ticket said they called the number and got the fine removed by simply stating that the sign only had a time limit until 6pm. To date since I’ve been living in the town I’m currently in…I’ve wasted $75.

Now that I’m aware of my tendency to roll over and take a punch, my fight response should be more in tune than my flight response next time I get a fine. Actually, I’m hoping I’ll just remember to do things on time and there won’t be a fine to fight, but now I know.

Have you fought to have a fine canceled? How far would you go to get rid of it?