Sensible Eating

There are a lot of weight-loss diets available to the public these days. Some are desirable, in that special items everyone likes are available on that diet. WeightWatchers, for example, lets you choose what you want to eat. You can substitute one calorie for another so that you can mostly count calories but can eat more or less what you wish. If you eat a healthy diet with protein, some green foods, low glycemic carbs, and some good fats (not hydrogenated), you will do well. When you begin to steer away from this regimen, either on a temporary basis or as a permanent dietary approach, you don’t do well in terms of your long-term health and wellness. Compliance, or the ability to stick to a diet, is what makes it effective.

There are many things that distract us from being compliant to a good diet. “Bad” food choices are very convenient and easy to obtain almost anywhere (fast food restaurants) and are usually lacking some of the nutrients we need on a daily basis. While a meal including hamburger with French fries and ketchup is tasty, it is full of hydrogenated fat and high fructose corn syrup, and there are not a lot of nutrients in the bread and burger part. However, you do get protein, carbohydrates, and fat, just not the right quality of these foods.

Since compliance to a good diet is one of the most difficult things that we have to face in our daily eating habits, let’s look at some of the distractions. Foods which are “low fat” (not fattening?) may be full of sugar or other rapidly absorbing carbohydrates which affect your insulin level in a very negative way. Because low-fat foods are generally inexpensive, they don’t have much or any protein to help balance the insulin stimulus. We know that blood insulin levels, which are high, are made even worse with low-fat diets, and these stimulate the inflammatory hormones in your body, which are the basis of heart disease, cancer, stroke, etc. Other distractions in a day might include chocolate-covered snacks, food snacks with pretty packaging, and “specials” on the counter in front of you as you go by the register. Therefore, what you select to eat is part of your overall compliance to a good diet.

It’s also difficult in social situations to eat a strictly healthy diet because you will be offered larger portions than needed, and a variety of foods including desserts which you don’t want to refuse because it’s impolite or makes your host feel that you aren’t enjoying yourself. Going out to dinner at a restaurant can be a problem because a standard entrée is often too large to eat. However, when you’re paying for it, you don’t want to waste anything, and therefore you may eat more calories than you need. An alternative would be to choose a protein appetizer and a salad only or share your meal with your dining companion. If bread is offered on the table, don’t eat much and be sure to eat it with olive oil or butter because it delays the absorption time of the bread calories and keeps your insulin levels down. 

Another way to improve compliance is to realize that occasional failure in breaking your diet is something that you really can’t prevent yourself from doing, mainly because we are all human and subject to temptations. However, if you realize that you’re going to fail by eating dessert, pasta, or something else that is not healthy, you could plan ahead. For example, eat a donut once a week or eat a big meal with pasta and dessert on a weekend night. This gives you something to look forward to and may help you to keep to your diet for the rest of the week.

Another way you can improve on your compliance is to write down a week of ideal meals and snacks for you if you were doing your very best. When you make the list, which fits with your lifestyle and caloric needs, then add in a few indiscretions such as a chocolate chip cookie, a small bowl of ice cream, or something similar. It may be that you could simply look forward to Sunday brunch buffet and then plan “payback” for the rest of the week after that. Also, don’t forget to exercise off some of that excess caloric intake.

You can use “good” snacks to reduce your appetite also. In the evening when you get home, you can have a little block of cheese and some celery or a carrot along with your glass of wine, which will hold you until you eat later. This will not only reduce your appetite but also improve your digestion, since the wine stimulates gastric juices. At the end of your day, try writing down what you ate and figure out the number of calories you took in. You can do this online or through a small calorie counter book. Just get a rough idea and realize that most people eat between 1600 and 2200 calories a day, with the lower caloric figure obviously being better in terms of body weight and long-term health. We do know that caloric restriction with a good diet is the most effective approach to keeping your weight steady and living longer and healthier.

You should weigh yourself every morning without clothes and see exactly where you are, and then monitor your weight daily over time. Do this also when you are on vacation and are eating more snacks and other foods because you have more time to do this. Another good technique is to try fasting one day a week because it stimulates your own human growth hormone to reduce abdominal fat and builds confidence in your ability to go without food for a longer time. It gives you the opportunity to feel what hunger is like and see that it’s not so bad. If you don’t eat anything, you don’t get blood sugar variations, which will make you hungry. If you eat carbohydrates such as a donut for breakfast, you will be hungry again soon because of your insulin surge creating that hunger.

Compliance is one of the most difficult things to do. Remember that the first temptation of man in the Garden of Eden was food, and things haven’t changed very much since then. Also remember that your daily food choices and quantity determine what your health pattern will be like. If you can comply with what you set as your best diet, then you probably can stabilize your weight for the rest of your life. In women, the average weight gain is at least one-half pound a year beginning at menopause, and 70 percent of people in the U.S. are overweight. Plan what you will do, try to discipline yourself, and experience hunger occasionally. This will aid you in your compliance. 

Dr. Carraway is the director of the Plastic & Cosmetic Surgery Center of EVMS. Call 757-557-0300 for more information.

James H. Carraway, M.D.

Dr. James Carraway is a full-time academic and practicing clinical plastic surgeon.  He is Director of the Cosmetic & Plastic Surgery Center of EVMS, is board certified in surgery and plastic surgery, and is a fellow of the American College of Surgeons.  Dr. Carraway has been teaching and practicing for 30+ years and has been director and chairman of residency training programs and fellowship programs in plastic surgery.
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