Weight Loss: Ask A Personal Dietitian

Question:
I know that I’m supposed to be choosing low fat meats and cheeses but why can’t I have a steak once in awhile and just subtract the extra fat from my fat servings?

It’s fine to have a steak or some regular cheddar cheese, there is really no food that you have to avoid entirely, but the trick is to have these types of foods, which are high in saturated fat, only on an occasional basis instead of every day. As a general rule, to avoid a lot of saturated fat, I would not eat high fat red meats or regular cheeses more than one time a week, even less often if possible. The reason you shouldn’t just replace 4 ounces of lean meat and 2 servings of fat with 4 ounces of high fat steak or cheese is that it may be an even trade in terms of calories, but the fat in animal foods is much different than the fats I recommend in your plan. Animal fat is very high in saturated fat, which is extremely detrimental to your arteries, and therefore your heart health. Saturated fats include butter, bacon grease, the fat in meat, chicken skin, cream, and also includes tropical oils like coconut and palm oil. The fats recommended in your plan are mostly monounsaturated (Canola and olive oil) and polyunsaturated (other vegetable oils, soft margarines). The fat in high fat meats and cheeses are not exchangeable with the “good” fats because they don’t behave the same way in your body. So, enjoy a steak or some regular cheese once in awhile, but realize that it should be very occasional if you want good heart health!

Question:
I am going to have dinner with a friend, who is also overweight. She usually encourages me to have dessert, and I usually wind up eating more than I should when I am with her. Any suggestions?

Answer:

Eating is a very social event and it involves all kinds of emotions. Sharing a meal with a friend, going out on a date for dinner, or eating with family members are typical situations you have to address when you are trying to change your eating habits and food choices. You can still enjoy the company and good food with your friend, but you might try a new approach. Try taking the initiative by telling your friend ahead of time that you are trying to make some healthy changes in your diet and need her support. You might suggest a restaurant that you know has better choices and fewer temptations. If she still wants to share dessert or any extra food, tell her to feel free to make her own choices but that it doesn’t really fit into your goals at the time.
I think its important not to emphasize the idea of losing weight, but to focus on the fact that you are trying to improve your health, and don’t make a big deal about it. It’s also important to say such things with conviction, that you are sincere, to prevent further encouragement. You can’t force other people to join you in your efforts, and they can’t force you to eat something you don’t really want to. It always comes down to your own personal decision to eat or not to eat a food. It’s important that you practice these difficult situations because you can’t avoid social eating situations forever, and each time you get better control of your eating behaviors, you will feel more free to enjoy these times for what they are.

Can you recommend some good vitamins to take ?

Whenever you are following a diet to lose weight, you will be eating less food than you need to maintain your weight, which means you have a greater chance of not getting an adequate amount of vitamins, minerals and other nutrients. This is especially true for women, who are usually smaller to begin with, so when you go on a weight loss plan, you have reduce your calorie intake further to lose weight. The eating guidelines you get in your plan help you make the best possible choices within your calorie level. The best way to ensure an adequate intake of vitamins and minerals is to eat plenty of vegetables, and to vary your choices of vegetables and fruit. In fact, whenever possible, you should get most of your nutrient needs through foods, not pills.

However, as “insurance” I suggest a general vitamin and mineral supplement, one that contains at least 100% of the daily requirement for all of the vitamins and minerals, especially folic acid (a B vitamin and Vitamin C) which are often too low in a typical diet. This is a general recommendation for all people, but you may have an individual medical condition that may benefit or be harmed by supplementation, and you should discuss this with your personal physician, who knows your complete medical history. There is some controversy about taking extra iron: not everyone needs it and it could do some harm if you supplement. Talk to your doctor about this one. I don’t recommend iron supplementation unless there is a medical reason for it. Calcium is a mineral that is already usually too low in the diet of a typical women, so when you follow a weight loss plan, it’s a good idea to supplement with calcium. The recommended daily allowance is now 1200 mg/day for women. How much extra you take depends on your individual food choices, but taking an extra 800 mg/day would be a good start. Calcium citrate is a good form, as is calcium carbonate.

As for chromium picolate and other specific mineral, vitamin, or enzymes, there is a huge amount of misinformation and wild claims about specific supplements. A lot of this is unfounded, and some of these products are dangerous if you take too much of them. I am against taking any supplement that is not needed, and against taking large doses of even the supplements that are not considered harmful. Claims that chromium improves carbohydrate metabolism are not well founded, please discuss any supplementation with your doctor, as I do not know your individual need for specific supplements. What helps diabetes the most is achieving and maintaining a healthy body weight through proper diet and exercise, and taking appropriate medications for diabetes as needed.

Dear Mickie:

I agree with you - most weight reduction diets are too low in calories for someone who is physically active and need to lose a few pounds. In fact, many are too low in calories for most people, which leads to hunger and frustration. Since your diet is calculated based upon your individual calorie needs, you would get a diet plan that includes enough food to supply energy for your activities, then it would be adjusted downward for weight loss at a very moderate pace. This will allow you to cover your energy needs and lose weight without uncomfortable hunger and deprivation. In addition, if you find that you need an adjustment to your plan, we can do this at any time and no added cost.

This approach (moderate reduction in calories plus exercise) has been proven to be the most effective in preserving lean body mass and increasing the loss of fat tissue.

Carolyn Classick-Kohn, MS, RD

Dear Julie:

The first thing that must change is your attitude about diet and nutrition. Most of us are taught to think of diet as a short term project to get the weight off. When you go "on" a diet, it implies that there is an "off". Then, it's back to old eating habits and the weight returns. When your focus is on making some permanent, positive changes to your diet, it's an ongoing process towards a new way of thinking about food. Every time you eat, you are "starting" again. You have choices to make each and every time it's time to eat for the rest of your life - it's unavoidable and you're already doing it. The difference is your commitment to make the best eating decisions in the worst of conditions (office birthday parties, fast food lunches, etc.), and the knowledge of what are the best choices. Sometimes it's just eating a smaller amount of the "junk" food than you would otherwise have - that is a very good alternative to complete avoidance. A healthy eating style has balance - you can enjoy the occasional "junk" and fun foods, but they are simply put into proper prospective. A good sign is that you are planning to lose your 30 pounds within a reasonable time frame. It takes about two months to really make a behavior change that one might consider a new habit, and a reasonable, healthy rate of weight loss is no more than 1-2 pounds a week, on average.

Carolyn Classick-Kohn, MS, RD

Question:
“I spend a lot of time at the gym. I also run, bike, and hike a lot. My wish for help is to develop a very lean but muscular body. I find that the diet you gave me is too heavy on the carbs, especially the starchy kind, and that it isn’t providing me with the protein I need to keep muscle. (I am 45, muscle can slip away just like that). It is not just about pounds anymore, it is the entire package. Can you help?

Your concern about maintaining lean muscle is a very important point and it sounds like you are working as hard as you can to have a lean and muscular body. Whenever you are on a reduced calorie plan to lose weight, some of the weight you lose will be lean body tissue (which includes water ,muscle, and other tissues). The goal is to preserve as much lean tissue as possible and still lose body fat. This is best achieved by losing weight slowly, with a reasonable calorie level and adding exercise. Diets that cause the greatest loss of lean tissue are the starvation type - fasting or diets of 200 Calories or less. On those types of diets, about 68% of the weight lost is lean body mass. Next comes ketogenic (high fat, low carbohydrate) diets of 1000 Calories or less - 65% of the weight lost is lean tissue. The optimal diet plan to preserve lean tissue contains at least 1,000 Calories, contains mixed food (adequate protein, fat, and carbohydrate) and includes a plan for physical activity to build muscle. Even on plans such as these (your diet plan included), 21% of the weight lost will be lean body mass, and 79% will be fat. No diet or diet supplement can turn fat into muscle. Only exercise does that!

To answer your question about the amount of carbohydrate v.s., protein: an appropriate diet for weight loss should contain the same percentages of fat, carbohydrate, and protein as a healthy diet for maintaining weight, about 25-30% fat, 15-20% protein, and 50-60% carbohydrate. The Food and Nutrition Board (which determines daily requirements of nutrients for all people) has determined that the amount of protein needed to stay in protein balance (positive nitrogen balance) is about .8 gram per kilogram of body weight. For you, your protein needs would be 48 grams per day. On your current diet plan of 1200 Calories, your protein intake would be 60 grams, or about 20% of your calories as protein, so if you use those figures, you should have an adequate protein intake, even at an intake of 1200 Calories. Any additional protein above what is needed to maintain and build muscle would be unnecessary and would not by itself, build any additional muscle tissue. If you feel like you are losing more lean mass than you want, I suggest that you increase your calorie intake across the board: don’t just add protein, add 1 more serving of grains, 1 vegetable, and 1 oz of lean meat or 1 serving of dairy so you’ll be up to about 1400 Calories. You’ll have slower weight loss, but you’ll preserve more lean tissue. You are pretty close to the weight you want to be already, so it’s just a matter of fine tuning your diet, and you may even consider a weight maintenance plan rather then further weight loss at this point.

People in industrialized countries are used to eating more protein than they need, so it seems like a lower fat diet is too low in protein, but in fact, you’re just getting rid of the excess. In addition, when you choose low fat animal foods, each serving is higher in protein because the choices are lower in fat, so you’re getting more protein with each ounce!

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Answer:

Can you recommend some good vitamins to take ?

Ask your Personal Dietitian
Note: As a member you are guaranteed a quick response to all your questions.