Food, weight, and your take...and faux fried chicken

Most anyone who knows me or reading my blog knows by now that I am a HUGE supporter of the “Fit-Over-Fat” theory. And for those of you following the “Health At Every Size” (HAES) program are likely familiar with Linda Bacon, professor of nutrition at City College of San Francisco and author of “Health at Every Size: The Surprising Truth About Your Weight [1].”

Bottom line: some people are heavy and unhealthy, and plenty of thin people are unhealthy [1].

Health goes beyond weight status, far beyond. The National Health and Nutrition Examination Survey (NHANES), published in August of 2008, assessed the weight and metabolic health of 5,440 adults. While those in the “normal weight” group were the healthiest, metabolically speaking (76.5%), there were 51.3% and 31.7% metabolically healthy in the overweight and obese groups, respectively [1].

The researcher’s conclusion: Though fat people are more apt to be metabolically unhealthy, plenty of fat people are healthy, and plenty of normal weight people are unhealthy [1].

What to do?

Linda Bacon supports “intuitive eating” – a means of consuming food that is in tune with hunger signaling (i.e. eating when you’re hungry and quitting when you’re satisfied). Also recommended to all weight statuses is exercise [1]. Find something you enjoy…and do it. Regularly.

So, being fat is A-okay? No.

There are few individuals out there who can deem their diets flawless. Anyone and everyone should aim to incorporate healthy eating and lifestyle patterns to consume the right amount of the good and work to eliminate the bad. As a nation, we are so hyper-sensitive about weight status, clothing sizes, and weight loss…it’s nearly impossible to get excited about simply making a change because it’s the right move for your health and relationship with food and exercise. Maybe you’re like myself and just wish to escape from food from time-to-time to improve your “foodship” – your relationship with food.

While food, nutrition, and weight comprise my job each day, I would also consider food and nutrition a hobby. I guess you could say food is a HUUUUGE component of my life whether I’m shopping, preparing, eating, or thinking about food…everything seems to come back to food.

Individuals like my mother place little emphasis on food; my mother doesn’t think about food, “crave” food, over-indulge in food, or talk about food. It’s just not a focal point of her life, unlike mine. Which leads me to my next though -- those with little emphasis on food have not only good “foodship” but also healthier weight statuses. I think this also ties in to Linda Bacon’s “intuitive eating,” don’t you?

I’m sure others have heard the saying, “Eat to live, don’t live to eat.” I really feel like I don’t live this message often enough. As an RD, I feel over-consumed in food from all angles, and I can’t help but feel over-whelmed sometimes. And I can’t imagine others don’t feel the same – weight loss gimmicks smothered across magazines in the check-out lane, commercials and advertisements in all of our media, TV shows devoted to weight-loss…it’s every where. Every day. All day long.

So, question…do you feel there’s just TOO much exposure and emphasis surrounding weight-loss, dieting, food, etc.? Do you think your “foodship” could use a make-over?

Tonight, husband requested "fried chicken". The recipe is from The Biggest Loser and it is EXCELLENT! It makes a TON of chicken, but it reheats well in the oven for leftovers. I am using the extra 1% buttermilk to make super rich-tasting mashed potatoes - yummm! Comfort food in this house tonight! 

Biggest Loser "Fried Chicken"

2 pounds chicken tenders
1 quart 1% buttermilk
2 cups whole wheat breadcrumbs
1 cup cornstarch
2 teaspoons paprika
1 Tablespoon + 1 teaspoon organic seasoning Salt
1 tablespoon ground black pepper
Large pinch cayenne pepper
4 egg whites, beaten to very soft peaks
Pam cooking spray or olive oil 

Directions:

Soak chicken tenders in refrigerator, in buttermilk, for 6 hours or overnight. 

Drain and blot with paper towels to remove excess buttermilk. Meanwhile, preheat oven to 325 degrees Farenheit. Lay bread crumbs out on a baking sheet and bake until golden brown, stirring occasionally, about 40 minutes. Cool. 

Increase oven heat to 450 degrees Farenheit. Combine cornstarch, paprika, seasoning salt, black pepper, and cayenne in a large Pyrex dish - mix well. 

Dredge drained and blotted chicken tenders in seasoned starch. Next, coat dredged tenders thoroughly with beaten egg whites. Last, dip tenders in toasted panko to fully coat. Place chicken tenders on a foil-lined baking sheet, fitted with a baking rack. Lightly spray chicken on both sides with Pam and season lightly with salt, if desired. Bake for about 12 - 15 minutes or until outside is crispy and chicken is just cooked through and juicy. 

Yield: 8 Servings
Nutrient Analysis – per serving
Calories: 270, Fat calories: 40, Total Fat: 4g, Sat Fat: 1g, Chol: 65mg, Sodium: 210mg, Total Carb: 27g, Fiber: 2g, Sugars: 4g, Protein: 28g

....one problem. LOTS of dishes...

Yesterday's diabetic diet went like this...

Breakfast:

1/2 cup old-fashioned oats (2 carbs)

1 cup skim milk (1 carb)

1 tsp turbinado (1/2 carb)

1 tsp Splenda brown sugar (1/2 carb)

1/2 ounce pecans, chopped (0 carbs)

cappuccino with 2 Tbsp sugar-free International Delight (0 carbs)

     Total: 4 carbs

Snack:

pear (1 carb)

Lunch:

3 ounces deer meat (0 carbs)

wheat hamburger bun (2 carbs)

1 slice 2% Colby Jack (0 carbs)

1/2 large sweet potato (1 carb)

1/2 ear of corn (1 carb)

     Total: 4 carbs

Dinner:

2 small slices pizza (2 carbs)

1/2 lb mussels, steamed (0 carbs)

2 mini Twix (1 1/2 carbs)

     Total: 3 1/2 carbs

Snack:

1 small apple (1 carb)

2 wedges Laughing Cow Light (0 carbs)

     Total: 1 carb

[1]. Jameson, Marnell. Do Extra Pounds Always Equal Extra Risk? The Los Angeles Times. October 12, 2009.

Quit to get ahead?

With the endless cycles of yo-yo dieting among Americans seeking weight-loss, what gives? Celebrities such as Oprah have shelved the concept of "diet" and begun seeking something more important than weight loss: health.

An article entitled, "Tossing Out the Diet and Embracing the Fat" found in last week's New York Times discussed the current health trends regarding weight-loss and diets. With recent movements such as Health at Every Size (HAES) supported by Linda Bacon, the dieting empire is receiving hard looks.

Years ago when I worked for Weight Watchers for a brief two-year stint, I had members return three...four...five...maybe even ten times to "recommit". Several winners of the Biggest Loser, NBC's hit show, can't keep the weight off...even under the watchful, malicious eyes of all of America. What is it we can do to make habits habitual and ritual?

As I've said many times before, health and weight status are not synonymous. Steven Blair, professor of exercise science, epidemiology, and biostatistics at the University of South Carolina (who is also a "fat and fit" advocate) explains that by looking at someone's fitness, you can determine their risk of death. Further, Blair goes on to state, "obese individuals who are fit have a death rate one half that of normal-weight people who are not fit." Somewhat to the contrary, Walter Willett, the nutrition department chairmen at the Harvard School of Public Health, explains that virtually all overweight individuals would be better off at a lower weight [1].

So, the New York Times article poses a valid question: If yo-yo dieting often leads to weight gain, does quitting ever lead to weight loss? [1]

The new size-acceptance/fat-acceptance movement suggests living your life as though you've reached your goal weight and to act on ambitions postponed while trying to become thin [1]. Surely an interesting thought.

While every health professional preferences different approaches to health, I believe that tayloring approaches to produce behavior change based on the individual trumps any one approach. Hence, I will continue to educate myself on all theories and approaches in an effort to better reach all of my patients where they need to be met.

As for me, my current needs will be met with a refreshing glass of Chianti. It was a tough hockey game today! Cheers!

[1]. Katz, Mandy. Tossing Out the Diet and Embracing the Fat. The New York Times. July 15, 2009.

prioritizing problems

In health care, chronic diseases tend to travel in packs. Those with non-insulin dependent diabetes mellitus (commonly known as type 2 diabetes) are generally, without a doubt, overweight...if not obese. I could and would provide you with statistics, but it's pointless. Even in my infantile career...this fact is clear as day. So I'm talking with my co-worker today, discussing the role of each of our clinic's classes -- diabetes, lipids, prenatal, weight loss, DASH, etc. While we deal most with diabetes patients, overwhelmingly...patient's labs are not reflective of dietary and/or lifestyle modifications. Even with unlimited access to dietitians. Hmm.

Now, I'm not arguing the precedence of diabetes treatment, however, patient's just don't get it. Blindness, loss of limbs, and dialysis are just not realities to diabetic patients until it's too late. It's sad...and what's a dietitian to do? It is my job to prevent chronic disease complications and educate patients on prevention. Moving along. When I suggested an increase in the number of group weight loss classes, my co-worker disagreed. "Diabetes Self-Management must take priority ahead of weight loss." Hmm. Sure, I agree...but it's not working. I can ramble about carbohydrate counting and bedtime snacks day-in and day-out, but again...it's just not working. I propose weight loss classes but more specifically, lifestyle change classes. These people want to lose weight and may not have the support system or tools in which to get started. A mere 5% drop in body weight will help insulin resistance in our type 2 patients. Futher, patients view weight loss as 1) appealing, 2) comprehensible, and 3) tangible. One can see numbers on a scale drop and feel the self-satisfaction and pride in purchasing a smaller size pant. And while carb-counting may be intended to aid in weight-loss, health care providers typically get wrapped up in the "eat this, not that".

Granted, there are patients who strongly benefit from a good 90-minute crash course in carb-counting and diabetic meal planning, who walk out of my office feeling empowered, motivated, and prepared to fight the progression of their disease head-on. But sadly, those individuals are far and few between with the majority falling through the cracks.

The American Dietetic Association published a new research study looking at body size acceptance. The study was a 6-month randomized clinical trial with a 2-year follow-up period. The subjects were obese, Caucasian females aged 30 to 45 who were noted chronic dieters. A model used to address health at any size was used, versus a traditional weight-loss program. Variables such as satiety, hunger, and internal cues of hunger were addressed [1].

At the 2-year check-up, the health at every size approach produced long-term behavior change and improvement in all variable outcomes. The dieting group did not. Weight was maintained in the health at every size group while the dieting group had sustained weight loss for only a year before the weight was regained [1].

It is known that age, ethnicity, sex, and lifestyle make drawing absolute conclusions between health and weight nearly impossible, states Morgan Downey, policy director for the Stop Obesity Alliance [2]. While there is no denying obesity as a compounding factor of chronic disease, if American's could alter their thinking and "eat to live, not live to eat" (as my mother always says) and move more, one's weight would lose such emphasis in the health world.

As a dietitian, I obviously support the maintenance of a healthy weight. And if you're overweight/obese, you should lose weight...I should lose those fifteen dang pounds I harp about, darn it! However, dieting shows that sustained weight-loss is atypical. What can we do to permanently change our perception of how we eat and live in order to benefit our health? What I know is that I'm okay with my +15 so long as I live healthfully -- continue my healthy diet, continue my healthy lifestyle (drug-free, happy-go-lucky me), and regular moderate-to-vigorous activity. I am hitting the treadmill here at work today during my lunch hour. How 'bout that?

[1]. Bacon, L., Stern, J., Van Loan, M., and Keim, N. Size Acceptance and Intuitive Eating Improve Health for Obese, Chronic Dieters. American Dietetic Association. June 2005.

[2]. LaRue Huget, Jennifer. Eat, Drink and Be Healthy. The Washington Post. July 7, 2009.