Client Success Story: Vicki

Vicki before sideVicki Side After 11615
vickie before frontVicki After 11615

Vicki Before (in white) and After (in gray)

This is Vicki, one of the clients that I have been assisting for several months now.

She initially wrote to me, “I was always skinny as a child and young adult but since having two kids, I never lost that post-baby weight and feel like I have been expanding ever since. I have high cholesterol and blood pressure too. I am struggling with what healthy foods to eat and keep the right balance of nutrition for my family”.

We started with an initial fitness assessment. Her strength was minimal at first. She was only able to do one push up. I am happy to say she is capable now of performing 20.

Since she had never formally exercised so we began with a simple program to introduce her to weight training, cardiovascular exercise and stretching. We gradually increased the amount of exercise and the complexity of the exercises as she got stronger.

To address her weight loss goals and how to feed the whole family nutrition and delicious meals we began with assessing her diet with a food journal. Seeing what she was actually eating and her patterns allowed us to determine some changes to make. She began with adding more vegetables to meals and selecting healthy menus to try. She has now compiled a recipe book of all the recipes that she has tried and that she and her family like.

Her progress to date is 16 pounds lost, 12.75 total inches and 4.2% body fat. Most notable were the 4 inches lost around her waist and 2 and a half inches off her hips! And remember the increased number of push ups she did. That is an indication of muscle mass gain.

It will be interesting to see the results of her next doctor’s visit. I’m guessing that her blood pressure, cholesterol and blood glucose levels have improved as well.

Share Button

Assess Yourself for Optimal Health

Does your exercise program and diet contain the components for optimal health? Take this quiz then see the answers and explanations below to see how well you did.

If you don’t know some of the answers, your doctor or Maria can help you find out. Any positive progress on these proven measures will lead to better health outcomes. The payoff is that with even modest improvements in health, the benefit of a longer, healthier life free of disease is real.

For personal specific action steps to improve these measures contact Maria Faires, RD

Are you getting the recommended amount and type of exercise for optimal health benefits?

How many minutes of moderate or vigorous intensity aerobic exercise do you get per week?           _______

How many muscle-strengthening activities do you do that involve all major muscle groups?         _______

How many of these components of a healthy diet consistent with current American Heart Association guidelines do you have? For the most accurate results, log all food and beverage intake in an online food journal like My Fitness Pal and then answer the questions.

Do you eat 4.5 cups of fruits and vegetables daily? No Yes Don’t know
Do you eat at least two 3.5-ounce servings of fish per week? No Yes Don’t know
Do you eat at least three 1-ounce servings of fiber-rich whole grains daily? No Yes Don’t know
Do you eat less than 1,500 mg of sodium daily? No Yes Don’t know
Do you drink no more than 450 calories (36 oz) a week of sugar-sweetened   beverages? No Yes Don’t know
Do you eat at least 4 servings of nuts, legumes and seeds per week? No Yes Don’t know
Do you eat less than 7% of your total calorie intake from saturated fat? No Yes Don’t know
Do you eat no more than 2 servings of processed meats a week? No Yes Don’t know

Do you have ideal cardiovascular health?

The American Heart Association estimates that only 5% of Americans meet criteria for ideal cardiovascular health. Ideal cardiovascular health for adults is defined by the presence of these seven health measures. Take this quiz and see how many you have.

BMI <25 kg/m2 No Yes Don’t know
Never smoked or quit No Yes Don’t know
Physical activity for at least 150 minutes per week moderate or 75 minutes per week vigorous No Yes Don’t know
Total cholesterol <200 mg/dL or<170 children and adolescents No Yes Don’t know
Blood pressure <120/80 mm Hg; or 90th percentile for children and adolescents No Yes Don’t know
Fasting blood glucose <100 mg/dL. No Yes Don’t know
Healthy Diet score: Four to five of the key components of a healthy diet consistent with current American Heart Association guideline   recommendations above No Yes Don’t know

 

ANSWERS AND EXPLANATIONS

Q: How many minutes of moderate or vigorous intensity aerobic exercise do you get per week?

A: For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.

For additional and more extensive health benefits, adults should increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate intensity, or 150 minutes a week of vigorous intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity. Additional health benefits are gained by engaging in physical activity beyond this amount.

Moderate Intensity Exercise

A moderate level of activity noticeably increases your heart rate and breathing rate. You may sweat, but you are still able to carry on a conversation. You can talk, but you can’t sing.

Kinds of Moderate Intensity Exercise:

Ballroom and line dancing

Biking on level ground or with few hills

Canoeing

General gardening (raking, trimming shrubs)

Sports where you catch and throw (baseball, softball, volleyball)

Tennis (doubles)

Using hand cyclers—also called ergometers

Walking briskly — walking at more than 100 steps per minute on level terrain

Water aerobics

Easy jogging

Slow swimming

Vigorous Intensity Exercise

A vigorous level of activity noticeably increases your heart rate and breathing rate. You sweat. You can only say a few words without stopping to catch your breath.

Kinds of Vigorous Intensity Exercise:

Aerobic dance

Basketball

Fast dancing

Jumping rope

Martial arts (such as karate)

Race walking, jogging, or running

Riding a bike on hills or riding faster

Soccer

Swimming fast or swimming laps

Tennis (singles)

Biking faster than 10 miles per hour

Heavy gardening (digging, hoeing)

Hiking uphill

Sports with a lot of running (basketball, hockey, soccer)

Tennis (singles)

Q: How many muscle-strengthening activities do you do that involve all major muscle groups?

A: Adults should also do muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.

Q: How many cups of fruits and vegetables do you eat daily?

A: Most people should aim at least 4½ cups of vegetables and fruits a day. Sorry; potatoes don’t count. Eat for a variety of kinds and colors of produce, to give your body the mix of nutrients it needs. Best ones?  Dark leafy greens, tomatoes, and anything rich yellow, orange, or red color. Men should eat tomatoes at least once per week.

There are many health benefits from eating a diet rich in vegetables and fruits: Lower blood pressure; reduced risk of heart disease, stroke, and probably some cancers; lower risk of eye and digestive problems; and the fiber helps keep appetite in check.

Q: How many ounces of fish do you eat per week?

A: At least two 3.5 ounces servings a week. Fish is high in protein, vitamins, minerals, and some fish is rich in omega 3 fatty acids. Eating fish regularly lessens your chance of getting heart disease, and might help other medical conditions too. Fish that contain high levels of omega-3 fatty acids include mackerel, Atlantic salmon (canned salmon too), canned tuna, herrings and sardines.

Q: How many 1-ounce servings of fiber-rich whole grains do you eat daily?

A: Three for women and five for men1-ounce equivalent servings a day. Eating grains, especially whole grains, provides health benefits. People who eat whole grains as part of a healthy diet have a reduced risk of some chronic diseases. Grains provide many nutrients that are vital for the health and maintenance of our bodies.

Consuming foods rich in fiber, such as whole grains, as part of a healthy diet, reduces the risk of coronary heart disease, may reduce constipation. may help with weight management by providing a full feeling,  eating grains fortified with folate before and during pregnancy helps prevent neural tube defects during fetal development.

Q: Any idea of how many grams of sodium you eat daily?

A: Less than 1500 milligrams a day.  People consuming diets of 1,500 mg of sodium have blood pressure lowering benefits as well as other cardiovascular benefits.

Persistent high blood pressure can lead to serious problems such as:

  • Arteriosclerosis and atherosclerosis
  • Aneurysm
  • Coronary artery disease
  • Enlarged left heart
  • Heart failure
  • Transient ischemic attack (TIA)
  • Stroke
  • Dementia
  • Mild cognitive impairment
  • Kidney failure, Kidney scarring, Kidney artery aneurysm

Q: How many calories of sugar-sweetened beverages do you consume per week?

A: No more than 450 calories-worth a week. High consumption of beverages with added sugars has been associated with consumption of greater calories and weight gain. People tend not to compensate as well for calories consumed in liquid form when compared to calories consumed as solid foods. Because calories consumed as beverages may not be as satiating, we tend to over consume beverages.

Q: How many servings of nuts, legumes and seeds do you eat per week?

A: At least 4 servings a week. Meat and dairy are filled with saturated fats. Vegetarianism may not be right for everyone, but increasing non-animal based products in the diet does have its benefits. For those wanting to make a few healthy changes, legumes, nuts and seeds will be good choices in place of the meat and diary that is the usual source of most peoples’ protein.

Q: What percentage of your total calorie intake is from saturated fat?

A: Less than 7% of total calorie intake. Reducing saturated fat is the foundation of a heart healthy diet. A diet high in saturated fat is known to raise blood cholesterol and your risk of developing heart disease.

Animal foods are generally high in saturated fats.  Meat, milk, eggs, cheese, and butter. Plant foods are generally low in total fat, making them low in saturated fat. Some plant foods, like nuts, seeds, avocado and coconut, are higher in total fat. Although these plant foods have some saturated fat, they are higher in the healthier, unsaturated fat.

Diet Goal for Saturated Fat per Day

  • If you need 1,600 calories per day, that means 13 grams of saturated fat or less per day
  • If you need 2,000 calories per day, that means 15 grams of saturated fat or less per day
  • If you need 2,500 calories per day, that means 20 grams of saturated fat or less per day

Here is the saturated fat content of some common foods:

  • McDonald’s Quarter Pounder Hamburger –  14 grams
  • Cheese (such as cheddar or American), 1 ounce – 4-6 grams
  • Butter, 1 tablespoon – 7 grams
  • 1 large egg – 2 grams
  • Ribeye Steak, 6 oz – 4 grams
  • Coconut Milk, 1 tablespoon – 3 grams
  • Olive Oil, 1 tablespoon – 2 grams

Q: How many servings of processed meats do you eat a week?

A: No more than 2 servings a week. Eating processed red meat — such as hot dogs, bacon, sausage, and cold cuts — is linked to increased risks of heart disease, cancer and diabetes.

And processed meats contained, on average, about four times more sodium and 50% more nitrate preservatives than unprocessed meats.

 

Share Button

How to Evaluate the Data from your Online Food Journal

A study conducted by the Kaiser Permanente Center for Health Research  followed more than 2,000 dieters for six months and encouraged healthy eating and regular exercise. The results: they found that the single best indicator for dropping weight came down to keeping a food journal.

Two-thirds of all participants who adopted a low-fat diet rich in fruits and vegetables, and participated in regular exercise, dropped nine pounds or more. But those who kept a daily food diary lost 11 more pounds than those who didn’t.

In order to improve your habits and reach the weight you want, it’s important to take a good, hard look at your eating patterns.

Writing everything down will help you make smarter food choices and provides a more accurate picture of your daily caloric consumption. Researchers have found that Americans typically underestimate their food intake by about 25 percent while overestimating their daily physical activity levels.

You need to track exercise as well because exercise is as important to weight loss as a healthy diet. Research has shown that people who exercise most days of the week can reduce the risk of developing many chronic diseases, including obesity, heart disease, high blood pressure, stroke and some cancers.

How to evaluate the data to improve your diet

As I dietitian, when I am evaluating a client’s food journal, these are some of the factor’s I look at:

Calories. Did you have an intake at or below your goal?

Carbs. 50% of your calories should come from “healthy” carbs. Whole grain, fiber-containing, unprocessed.

Protein. 25% of your calories should come from lean protein.

Fat. 25% of your calories should come from “healthy” fats.

Was the fat contributed by healthy omega 3 fat found in soybean oil, canola oil, walnuts, flaxseed, fish: trout, herring, and salmon? Omega-3s boost heart health, help rheumatoid arthritis, depression, and reduce inflammation throughout the body.

Was the fat contributed by saturated fat found in high-fat cheeses, high-fat cuts of meat, whole-fat milk and cream, butter, cheese, ice cream, palm and coconut oils? Diets high in saturated fat have been linked to chronic disease, specifically, coronary heart disease.

Was the fat contributed by trans-fat from any product that contains partially hydrogenated oil, fried items, savory snacks (like microwave popcorn and chips), frozen pizzas, cake, cookies, pie, margarines and spreads, ready-to-use frosting, and coffee creamers?  

Cholesterol. 300 mg is the most you should have per day. Cholesterol is found in animal products: egg yolks, beef, poultry, lamb, pork, organ meats, fish and dairy products. Keep in mind that trans fat and saturated fat have a bigger effect on a person’s blood cholesterol than dietary cholesterol.

Sodium. 2400 mg or less is the goal.

Sugars. 40 grams or less. The American Heart Association recommends limiting added sugars to 100 and 150 calories daily for women and men. (12 ounces of regular soda supplies 35 grams; one teaspoon of table sugar contains 4 grams).

Fiber. Goal is 35 grams per day.

Did you get soluble fiber? Soluble fiber attracts water and form a gel, which slows down digestion. Soluble fiber delays the emptying of your stomach and makes you feel full, which helps control weight. Slower stomach emptying may also affect blood sugar levels and have a beneficial effect on insulin sensitivity, which may help control diabetes. Soluble fibers can also help lower LDL (“bad”) blood cholesterol by interfering with the absorption of dietary cholesterol.

Sources of soluble fiber: oatmeal, oat cereal, lentils, apples, oranges, pears, oat bran, strawberries, nuts, flaxseeds, beans, dried peas, chia, blueberries, psyllium, cucumbers, celery, cranberries, grapes, peaches, plums and prunes.

Did you get insoluble fibers are considered gut-healthy fiber because they have a laxative effect and add bulk to the diet, helping prevent constipation. These fibers pass through the gastrointestinal tract relatively intact, and speed up the passage of food and waste through your gut. Insoluble fibers are mainly found in whole grains and vegetables.

Sources of insoluble fiber: whole wheat, whole grains, wheat bran, corn bran, seeds, nuts, barley, couscous, brown rice, bulgur, zucchini, celery, broccoli, cabbage, onions, tomatoes, carrots, cucumbers, green beans, dark leafy vegetables, raisins, grapes, corn, fruit, and root vegetable skins.

Did you eat beans? 3-4 times per week use beans instead of meat, add them to salads, soups or use as a side dish.

Did you get at least 2 servings of dairy? Intake of dairy products is linked to improved bone health, reduced risk of osteoporosis, a reduced risk of cardiovascular disease and type 2 diabetes, and with lower blood pressure in adults. It also is a source of protein. For milk, 1 cup of fluid milk; For yogurt, 8 ounces; 2 cups of cottage cheese or half a cup of ricotta cheese; 2 ounces of processed cheese such as an American cheese slice, 1/3 cup of shredded cheese or 1 ½  ozs. of hard cheese such as cheddar, mozzarella, Swiss and Parmesan.

Was there a lot of “volume”? Choosing foods that are high in water and fiber and low in density allows dieters to enjoy larger, more satisfying portions, and to lose weight without feeling hungry. Fruits, vegetables, legumes, and cooked grains are examples of low-energy-density foods that give you plenty of water and fiber for very few calories.

Did you get 3 servings of whole grains? Do so and enjoy reduced risk of stroke, diabetes, heart disease, asthma, inflammatory disease, colorectal cancer, gum disease, better weight maintenance, and healthier blood pressure.

  RECOMMENDED MINIMUM
Women 19-50 years old 6 ounce equivalents 3 ounce equivalents
51+ years old 5 ounce equivalents 3 ounce equivalents
Men 19-30 years old 8 ounce equivalents 4 ounce equivalents
31-50 years old 7 ounce equivalents 3 ½ ounce equivalents
51+ years old 6 ounce equivalents 3 ounce equivalents

Did you eat at least 2 cups of vegetables?

Women 19-50 years old 2½ cups
51+ years old 2 cups
Men 19-50 years old 3 cups
51+ years old 2½ cups

Vegetable subgroup recommendations are given as amounts to eat WEEKLY. Over a week, try to consume the amounts listed from each subgroup as a way to reach your daily intake recommendation.

Dark green vegetables

Red and orange vegetables

Beans and peas

Starchy vegetables

Other vegetables

AMOUNT PER WEEK

Women 19–50 yrs 1½ cups 5½ cups 1½ cups 5 cups 4 cups
51+ yrs old 1½ cups 4 cups 1 cup 4 cups 3½ cups
Men 19–50 yrs 2 cups 6 cups 2 cups 6 cups 5 cups
51+ yrs 1½ cups 5½ cups 1½ cups 5 cups 4 cups

*Red or orange peppers, carrots, tomatoes, tomato paste and sauce, red potatoes, beets, radicchio, sweet potatoes, winter squash and pumpkin.

*Green: artichokes, arugula, asparagus, broccoflower, broccoli, broccoli rabe, Brussels sprouts, Chinese cabbage, endive, green cabbage, green peppers, leafy greens, leeks, lettuce, peas, snows peas, spinach, sugar snap peas, watercress.

Did you eat at least 1.5 cups fruit?

Women 19-30 years old 2 cups
31-51 years old 1 ½ cups
Men 19-51+ years old 2 cups

How many ounces of protein did you eat?

Women 19-30 years old 5 ½ ounce equivalents
31-51+ years old 5 ounce equivalents
Men 19-30 years old 6 ½ ounce equivalents
31-50 years old 6 ounce equivalents
51+ years old 5 ½ ounce equivalents

 

Share Button