If it’s one thing we as Americans are good at, it’s yo-yo dieting. Wouldn’t it be nice to lose it and keep it off? Last week we discussed how a high fiber diet can aid in weight reduction and weight maintenance. Afterall, its’ one thing to lose weight, but more meaningful in the long run to sustain the weight loss. A high fiber diet is not only beneficial to weight loss, it’s also helpful in prevention and treatment of diabetes.

While many plant-based foods are a source of carbohydrates, scientists have known they are often the ticket to diabetes prevention. This week on the blog we’ll explore how and why including more fiber in your diet reduces the chance for diabetes.

Which fiber prevents diabetes?

Diabetes is preventable. A recent study published in Clinical Nutrition looked at data from the PREDIMED study, research of over 3,000 subjects with elevated risk for heart disease, but without type 2 diabetes.  The study found that after 4 years, participants with the highest intake of legumes had a 35% reduction in risk for diabetes. The researchers compared types of legumes eaten and found that lentils in particular were linked with a 33% reduction in diabetes risk.  This was observed with just one serving of lentils per week versus less than ½ serving.  Chick pea consumption showed a smaller effect in lowering risk of diabetes, while other dried beans and peas showed no significant link. 1

In addition, results from large, prospective cohort studies show that very high consumption of insoluble cereal fibers (in most research studies, over 30 grams per day) or whole-grain products (in most studies, greater than 30 to 40 grams per day) high in cereal fibers may reduce insulin resistance and the risk of developing type 2 diabetes by up to 20–30%. 2

Carbohydrates and diabetes

Sadly, when individuals at risk for diabetes learn that their blood sugar is high, they start slashing all carbohydrates from their diets, including the nutritious ones. While it makes perfect sense to reduce intake of highly processed, high sugar foods and beverages (like cake, cookies, candy and sweetened drinks that raise blood sugar and lead to weight gain), don’t throw out the baby with the bath water.

High fiber carbohydrates such as shredded wheat, bran cereal, whole grain pasta, and brown rice can (and should) be included in your diet in moderation to provide adequate fiber as well as vitamins and minerals. As mentioned above, legumes such as lentils should also be embraced. The US Dietary Guidelines advise 25 to 30 grams of fiber for women and 38 to 40 grams of fiber for men daily. 3 Read below to achieve this goal.

Meal ideas

If you’re struggling to find ways to boost your fiber intake, try these:

  • Switch from instant oats to rolled oats. They cook up in 2 minutes in the microwave and can be seasoned with cinnamon, vanilla and ginger instead of brown sugar.
  • Snack on whole grain crackers and peanut butter or hummus and veggies.
  • Swap out white pasta or tortillas with whole wheat. You’ll pick up an extra 3 to 6 grams of fiber this way.
  • Try ancient grains like quinoa, farro and bulgur in grain bowls, salads or side dishes.
  • Enjoy lentils a few days per week beyond meatless Monday.

Lisa Andrews, MEd, RD, LD

References

  1. Nerea Becerra-Tomás, Andrés Díaz-López, Núria Rosique-Esteban, Emilio Ros, Pilar Buil-Cosiales, Dolores Corella, Ramon Estruch, Montserrat Fitó, Lluís Serra-Majem, Fernando Arós, Rosa Maria Lamuela-Raventós, Miquel Fiol, José Manuel Santos-Lozano, Javier Diez-Espino, Olga Portoles, Jordi Salas-SalvadóCorrespondence information about the author Jordi Salas-SalvadóEmail the author Jordi Salas-Salvadó. “Legume consumption is inversely associated with type 2 diabetes incidence in adults: a prospective assessment from the PREDIMED study”. Journal of Clinical Nutrition, 03.015
  2. Weickert MO, Pfeiffer AFH. Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes. J Nutr. 2018;148(1):7-12.
  3. https://www.dietaryguidelines.gov/
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F is for Fiber

With the popularity of fad diets low in carbohydrates, nutrition experts and health professionals are concerned with the F word. Not fat. FIBER.

When you drastically reduce a macronutrient from your diet (i.e. carbohydrate), which is a major source of dietary fiber, the consequences are not always pretty. A major study published in JAMA found that diets too high in carbohydrates (70% or more) or too low (below 40%), the risk for all-cause mortality went up. The researchers noted that the lowest mortality was seen with a carbohydrate intake of 50-55% of calories, which is similar to the US Dietary Guidelines. 1

Obviously, not all carbohydrates are created equal. Comparing apples to Skittles is not the same. Over the next few weeks, we’ll take a look at the WHY behind the advice to eat more fiber in your diet. With so many people trying to prevent (or fight) the COVID15, we’ll start with weight loss.

Fiber intake and weight loss:

The fiber found in plant-based foods has been found to have a big impact on weight loss. Results from the DPP (Diabetes Prevention Program), which looked at Metformin use, lifestyle intervention, and placebo found that subjects’ baseline weight was negatively associated with carbohydrate intake, specifically fiber. As weight loss aids in the prevention of diabetes, any dietary components found beneficial are encouraged. 2

A more recent study, appropriately dubbed “POUNDS” (Preventing Overweight Using Novel Dietary Strategies) evaluated calorie restriction and macronutrient composition in obese adults. In 345 subjects, those consuming a higher fiber diet experienced better weight loss in addition to adherence to the dietary prescription. Sustainability of diet modifications is key in long term weight loss success. 3

In a study of African American women, fiber consumption was negatively associated with BMI after an 18-month weight-loss intervention trial. Changes were seen at 6 months and even stronger associations seen at 18 months. 4

Where to get the most fiber:

Fiber content varies from plant to plant with different types of fiber coming from grains and vegetables versus beans, nuts, and/or fruit. Some of the highest-fiber grains include bulgur, farro, quinoa, and whole-wheat pasta, which are all part of the Mediterranean diet. Other high fiber foods include raspberries, pears, blueberries, and other fruit. We’ll discuss other fiber sources throughout this series.

Tips on calorie control when adding fiber

If you’re going to add more fiber to your diet to aid in weight loss, you’ll still need to control calories. A bowl of rolled oats is great, but if you’re adding butter and brown sugar, you might be negating the positive effects. Below are a few ideas to control calories.

  1. Try ginger, cinnamon, and vanilla in oats instead of butter and sugar.
  2. Season grains with dried herbs, vegetable or chicken broth, garlic, or onions over oil, butter, or cheese.
  3. Add more vegetables to the dish! These add color, flavor, texture, and more nutrition.
  4. Add beans to your salad- a half-cup serving boosts the fiber of your meal by 6 grams, which is nearly 25% of the Daily Value.

Lisa Andrews, MEd, RD, LD

References:

  1. Seidelmann SB, Claggett B, Cheng S, et al. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Health. 2018;3(9):e419-e428.
  2. Sylvetsky AC, Edelstein SL, Walford G, et al. A High-Carbohydrate, High-Fiber, Low-Fat Diet Results in Weight Loss among Adults at High Risk of Type 2 Diabetes. J Nutr. 2017;147(11):2060-2066.
  3. Miketinas DC, Bray GA, Beyl RA, Ryan DH, Sacks FM, Champagne CM. Fiber Intake Predicts Weight Loss and Dietary Adherence in Adults Consuming Calorie-Restricted Diets: The POUNDS Lost (Preventing Overweight Using Novel Dietary Strategies) Study. J Nutr. 2019;149(10):1742-1748.
  4. Buscemi J, Pugach O, Springfield S, et al. Associations between fiber intake and Body Mass Index (BMI) among African-American women participating in a randomized weight loss and maintenance trial. Eat Behav. 2018;29:48-53.

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We’ve been discussing the unwanted weight gain that many Americans have experienced since the start of the pandemic. Unless it’s dealt with, it may be similar to weight gained over the holiday season where it’s not lost year after year.

In addition to changes at the plate, it’s only natural to discuss exercise when it comes to fighting the COVID15.

Part of COVID weight gain is related to people being more sedentary as they work from home, visit friends and families through a screen, and binge on Netflix every night. Gyms being closed and fear of being in crowded parks may also keep people inside. But regular physical activity should carry on if possible.

Diet VS Exercise

Scientists have long known that regular physical activity is necessary for long-term weight loss success and may impact body composition more than a diet. When compared to a hypocaloric diet, a meta-analysis showed that exercise alone resulted in visceral adiposity loss while caloric restriction did not. Visceral adiposity is an important predictor of morbidity and mortality, so the less you have, the better. Even without weight loss, exercise reduces visceral adiposity by over 6%. Although calorie reduction may result in a larger weight loss, more body fat is lost with exercise, which is likely more significant. 1

If people say they don’t have time to exercise, consider this. A recent study comparing overweight and obese sedentary women assigned to either a long bout (50 minutes all at once) or short bouts (two, 25-minute bouts) of exercise, found that the group doing short bouts had more weight loss. No changes in lipid or carbohydrate metabolism were seen after 24 weeks. 2 Two 25-minute walking sessions could be a walk at your lunch hour and after dinner.

Exercise and mental health

In addition to improving your waistline, it’s well known that exercise is good for our mental health. A large cross sectional study published in Lancet Psychiatry analyzed adults over the age of 18 and their “mental health burden” with or without exercise. Those who exercised reported fewer days of poor mental health with largest associations seen with team sports, cycling, aerobic and gym activities. 3

If exercising inside or outside concerns you due to the pandemic, a recent study showed that increased physical activity provides a reset of physical and mental well-being. It aids in distracting people from worrying and negative thoughts related to the pandemic. Activities such as playing tennis, golf, cycling or hiking can be done at a physical distance. 4   Masks are advised inside or outside when people cannot be distanced.

Just do it.

If you’re not convinced that exercise can help during this pandemic, remember that it also boosts immunity. Cardiorespiratory activity such as walking, biking, hiking, rowing and running helps mobilize millions of lymphocytes to fight COVID. It may also reduce the severity of the disease in some people. If you’ve had COVID already, talk with your doctor about resuming exercise.

Here are some ways to get your move on:

  1. Put on your shoes and walk out your front door. Go around your block a few times or drive to a park and hit some trails. Don’t forget the benefits of vitamin D, which also reduce the risk of COVID.
  2. Dust off your bike. Take advantage of the cooler weather this fall and go for a spin. Bike shortages have been experienced but you may find a bike at a used sports shop or thrift store.
  3. Try pickle ball. This sport from the 60’s is tennis meets ping pong. Set on a smaller court, you and a friend can be physically distanced, but social.
  4. Use some free weights during your favorite show. While you’re killing time watching Netflix, get some weights out and do some curls.
  5. Download exercise videos on your phone or tablet. If you’re strapped for cash or can’t get to your gym, get your move on at home. Apps like Sworkit, Imuscle Home, 7-minute workout and more are FREE!

You’ve got nothing to lose. Or do you?

Lisa Andrews, MEd, RD, LD

References

  1. Verheggen RJ, Maessen MF, Green DJ, Hermus AR, Hopman MT, Thijssen DH. A systematic review and meta-analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue. Obes Rev. 2016;17(8):664-690.
  2. Madjd A, Taylor MA, Delavari A, Malekzadeh R, Macdonald IA, Farshchi HR. Effect of a Long Bout Versus Short Bouts of Walking on Weight Loss During a Weight-Loss Diet: A Randomized Trial. Obesity (Silver Spring). 2019;27(4):551-558.
  3. Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry. 2018;5(9):739-746.
  4. Dominski FH, Brandt R. Do the benefits of exercise in indoor and outdoor environments during the COVID-19 pandemic outweigh the risks of infection? [published online ahead of print, 2020 Jul 17] [published correction appears in Sport Sci Health. 2020 Aug 17;:1]. Sport Sci Health. 2020;1-6.  https://link.springer.com/article/10.1007%2Fs11332-020-00673-z

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We’ve been discussing how stress eating due to COVID19 (and the depressive effect it’s had on our lives), has impacted our waistlines. While comfort foods like chocolate and chips may seem tempting and harmless to indulge in at the moment, they may actually contribute to more stress, depression, and inflammation in your body.

It’s not all in your head

Did you know that 90% of the receptors for serotonin (the feel-good hormone) live in our guts? Diet, certain medications, and stress can impact the bacteria in our bowels both positively or negatively. For example, medications used for depression and anxiety known as selective serotonin reuptake inhibitors (SSRIs) often have gastrointestinal side effects like nausea or diarrhea. The biological dialogue between the brain and the gut through the vagus nerve may be the culprit. 1

Disease may occur when the balance of good and bad bacteria in our bowels is upset. Asthma, obesity, inflammatory bowel disease, diabetes, and mood disorders are a few examples. As much of our immunity is housed in the gut, the disruption of bacteria may lead to autoimmune disorders such as rheumatoid arthritis. 2 To keep the balance tipped in your favor, you have to be good to your gut!

Foods that hurt

It’s no surprise that the foods we know to raise our risks of diabetes, heart disease and obesity may also be linked to depression. A recent observational retrospective study using a diet history questionnaire found that depressed adults consumed more processed sugar, chocolate and sweets compared to those who did not report depression. 3 Did people eat more junk food because they’re depressed, or did the food increase their risk of depression? Individuals that did not report depression had higher intakes of whole grains, legumes, nuts, fruits and vegetables.

Additional studies have indicated that a traditional Western diet (high in fat, sodium and sugar) has been linked with depression in teens. Participants aged 14 to 17 were questioned about their food habits and depression. Individuals consuming a Western diet were more likely to be obese and suffer depression while those at normal weight consumed more nutritious foods including fruit, vegetables, fish and whole grains.

Feel good foods

As mentioned above, plant-based foods that are high in antioxidants are one of our body’s best defenses in improving our moods. These foods also provide fiber, which is fuel for balanced bowel bacteria. Below are some tips to get more “food in your food”:

  • Switch to whole grains- choose whole grain bread over white, brown rice over white and whole grain pasta over refined.
  • Choose cherries over chocolate. Got a sweet tooth? Go for seasonal fruit. With so much to choose from, there’s no excuse.
  • Add beans and legumes to your salads, soups and sides. They’re versatile and valuable!
  • Kick the can. Sugary soda isn’t doing anything for your body but causing weight gain and raising the risk for heart disease and diabetes. Thirsty? Sip on water.
  • Skip the fast food. Try simple recipes at home that include fish, lean meat, vegetables and fruit. Food doesn’t need to be fancy to be healthy.

Download handout

Lisa Andrews, MEd, RD, LD

References:

  1. Dash S, Clarke G, Berk M, Jacka FN. The gut microbiome and diet in psychiatry: focus on depression. Curr Opin Psychiatry. 2015;28(1):1-6.
  2. Philippou E, Nikiphorou E. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev. 2018;17(11):1074-1077.
  3. Grases, G., Colom, M.A., Sanchis, P. et al.Possible relation between consumption of different food groups and depression. BMC Psychol 7, 14 (2019).
  4. Wendy H.OddyabKarina L.AllencGeorgina S.A.TrappbdGina L.AmbrosinibdLucinda J.BlackbeRae-ChiHuangbPeterRzehakfKevin C.RunionsbFengPanaLawrence J.BeilingTrevor A.Morig. Dietary patterns, body mass index and inflammation: Pathways to depression and mental health problems in adolescents. Brain, Behavior, and Immunity Volume 69, March 2018, Pages 428-439
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Last week we discussed how this global pandemic has taken a toll on American’s waistlines. Roughly 60% of people surveyed on WebMD mentioned stress eating as a reason for weight gain.1 This is totally understandable. In addition to the fear of catching COVID19 or dealing with job loss or change, some people endure the added stress of having kids return to school, return remotely, OR having to find childcare for their children. Other families may be dealing with children going off to college, or taking care of, or not being able to visit their elderly parents. It’s enough to send anyone to the freezer for a pint of Ben and Jerry’s.

Why we overeat

Experts have a few theories on why people eat when they’re stressed. Anxiety and stress result in the release of a hormone called cortisol, which impacts appetite. High cortisol levels related to stress increase appetite and cravings for traditional comfort foods high in sugar and fat, which is why chips, baked goods, and ice cream may appear so tempting. Grehlin, a hormone which is produced in the stomach, is also impacted and can increase the urge to overeat.2

The other thing to consider is that eating gives us pleasure and may help us relax. Psychologists have linked anxiety and overeating for years. Since feeling tense, afraid, worried, and anxious are uncomfortable, eating is often used as a coping mechanism. Food may be used to reduce, numb, distract, soothe, avoid, or mask anxiety. 3

Stress-busting tips

While the stressors of the world will come and go, it’s our reactions to stress that makes us resilient. We all experience stress and anxiety differently, but a few coping mechanisms may help to reduce stress hormones that spur us to overeat.

  1. Get adequate sleep. We need regular sleep to calm our brains and restore our bodies. Adequate sleep (between 7 to 8 hours per night) regulates mood, improves concentration, and strengthens decision-making capability. It also keeps cortisol levels in check, which impact appetite.
  2. Recognize hunger. When the urge to eat hits because you’re upset or anxious, stop and ask yourself if you’re even hungry. If not, find something positive to do. Clean out a closet, call a friend, paint your nails. Get out of the kitchen. Eat when you're hungry, not under stress.
  3. Don’t forget to breathe. Taking time to stop and breathe may help quiet your mind during stressful times. Meditation allows your body and mind to take a break. It creates a space in your brain to recognize what’s essential and to quiet unnecessary noise. Studies show that meditation reduces stress by triggering your body’s relaxation response. 4

Next week we’ll look at how food impacts your mood!

Lisa Andrews, MEd, RD, LD

References:

  1. https://www.webmd.com/lung/news/20200518/webmd-poll-many-report-weight-gain-during-shutdown
  2. Mona Mohamed Ibrahim Abdalla. Ghrelin – Physiological Functions and Regulation Eur Endocrinol. 2015 Aug; 11(2): 90–95.
  3. Hayes, S.C., Wilson, K.G., Gifford, E.V., Follette, V.M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152-1168.
  4. Saeed SA, Cunningham K, Bloch RM. Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation. Am Fam Physician. 2019;99(10):620-627.

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Just when students are starting or returning to college, a time when many may pick up the infamous “freshman15”, people around the country are dealing with COVID15- those unwanted pounds that have crept on during the pandemic.

COVID19 provided the perfect recipe of risk factors for weight gain. The closure of fitness centers, employment uncertainty, lockdown, limited access to the grocery, an uptick in baking combined with the stress and anxiety of getting the virus, sent many people to their frig and pantry to stress eat. A hefty dose of insomnia at night and daytime boredom isn’t helping either.

According to a survey of Web MD readers, nearly 50% of women and 22% of men reported weight gain since the viral shutdown. Among U.S. readers who estimated their gain:

  • 15% said they gained 1-3 pounds.
  • 34% said they gained 4-6 pounds.
  • 26% said they gained 7-9 pounds.
  • 21% said they gained 10-20 pounds.
  • 4% said they gained 21 pounds or more.

A good majority (72%) of those surveyed identified lack of exercise as the cause of their weight gain, while nearly the same (70%) stated stress eating was the cause. Nearly 60% blamed both limited physical activity and stress eating as culprits, while over 20% cited increased alcohol intake as the etiology of their weight gain. 1 Clearly, those “quarantinis” aren’t helping anyone.

While a 15 lb. gain may not seem like much, it may easily raise blood pressure, blood sugar, and cholesterol levels in addition to the risk of cancer. It may also increase inflammation- making conditions like heart disease and arthritis worse. 2

Experts also note that overweight and obese individuals are at increased risk for complications of COVID19.  For individuals with chronic underlying conditions such as diabetes, hypertension and asthma, weight gain is an unwelcome risk factor. 3

The next few weeks we’ll be covering tips and tricks to battle the COVID15. Here’s a few ways to start:

  1. Keep a food diary. This will give you an idea of what, when and how much food you’re eating. If you bite it, write it.
  2. Track your weight. While noticing that your pants are getting tight is a good sign that you’re gaining weight, getting on a scale once a week may help prevent further gain.
  3. What’s your why? Jot down your reason for weight loss. Ideally- it’s something that will keep you motivated. Preventing diabetes, having more energy or fitting into your current wardrobe are examples.

 

Check back next week for more tips!

Lisa Andrews, MEd, RD, LD

References:

  1. https://www.webmd.com/lung/news/20200518/webmd-poll-many-report-weight-gain-during-shutdown
  2. Smith KB, Smith MS. Obesity Statistics. Prim Care. 2016;43(1):121-ix. doi:10.1016/j.pop.2015.10.001
  3. https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html
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