Yes, Virginia: There Are 10 Ways to Have Holidays Without Weight Gain

So many people, clients, patients, co-workers over the years, have told me they’ve just given up trying to lose weight during the holidays – that food-festival parties, get-togethers, celebrations and general mayhem that spans the period between Thanksgiving and New Year’s Day.

What is about holidays that cause weight gain? If you know the contributing factors, you can make a plan. Here’s what you’re likely to deal with until New Years:

Workplace food court: The constant brigade of popcorn bins, chocolates, homemade cookies, cakes and sweets, all available all day long.

Drinking: We love eggnog, but it’s the most calorie-laden drink of any year – about 330 calories in a cup. Over-boozing has calories, too – and leads to mindless eating.

Stress-eating: time is short, obligations are long, stress triggers eating whatever is within arm’s reach!

More fooding, less moving: whenever you need a little more time to get things done, it’s easy to borrow from your workouts and walks. It’s also just when you need to burn some extra calories. Ow.

Happiness can be depressing! Everyone seems to be happy but you’re so-so. You’re not alone, either. It’s easy to think food is your BFF during the holidays, and it can be – if you choose the right friends.

Good News

You probably won’t gain much weight during the holidays! This review published last year found that average holiday weight gain in adults ranged from about 1-2 pounds in various studies, not the 5-7 pounds you may have heard about.
But what about you? If holiday weight gain has been YOUR typical, changing that is easier than you think. Take it on as a project and like every project, it needs a good plan. Plans may take some of the spontaneity out of eating, but you’re trading up – for peace of mind and body. That’s totally worth it.

Planning means that you start every day assessing the meals and eating occasions you’ll have and the foods you’re likely to encounter. What does the “no holiday weight gain” plan look like? Here are 10 strategies that put you on a path to enjoying holidays without weight gain:

1. Eat modestly, but don’t skip meals. You’ll just end up being hungry and over-scarfing.

2. Weave in some fiber: Aim for 3 pieces of fresh fruit daily. Aim for 2 cups of veggies, raw or cooked. Think you can’t?  You can – fill up one of those plastic take-out soup containers with cut veggies and it’s two cups right there.

3. Discriminate! Is it a regular store-bought something-or-other that’s loaded with empty calories or is it really tasty? Hold out for something really special. You’re worth it.

4. Never arrive hungry to a party:Eat some raw veggies or a piece of fruit before going to a party or social function. When the edge is off hunger, your focus is on social fun.

5. Go pro: Lean protein keeps you feeling satisfied, and helps prevent blood glucose levels from spiking then plummeting later. About 100-150 calories invested in options like turkey roll-ups, beef jerky, fat-free Greek yogurt, even a fat-free latte will pay off later.

6. Get functional: it’s a social function, so keep the priority on socializing rather than eating.

7. Be the last man (or woman) standing…in line: Always be among the last ones in line for the food. It’ll look a little less appetizing (probably a good thing) and there’s less time to have second portions.

8. Get out of Dodge: Lingering to the end encourages more nibbling.  Be social, sample what you want, then move along.

9. ONE – a singular sensation!  When you see something you want, have it. But one portion. One is the magic number, not a lonely number.  But read #10.

10. Get “hospital-sized”:  Not to eat, just to look at portion sizes. When you’re thinking of a high-calorie food, whether it’s mac and cheese or the Buche de Noel pictured at the top, it’s one “hospital-sized” portion. Keep it there and enjoy it. There will be another treat another day.

Why I Try To Be “Over 30” Every Day

Dee is an inspiration to me.  She has cerebral palsy and is confined to a motorized wheelchair. She has only minimal use of each hand, just enough to move her chair and use a phone if it’s placed into her hand. She’s not only cognitively intact, she’s pretty smart.

I’m lucky. I worked for 33 years with people with special needs, people like Dee.  It’s emotionally difficult work sometimes, but I always got more than I could ever give them. One powerful lesson they taught me was how lucky I was to be physically able-bodied.

She told me once she was fed up hearing what a nuisance people thought it was to take the stairs, walk the dog, or park farther away from your destination to get in a few extra steps. “They sit down all day long but they have a choice. I don’t. If I could walk I’d never want to sit down.”

When we think of chores, she thinks of abilities. Big wake-up call here.

Everyone Needs To Be Over 30

I speak not of years, but of minutes. Thirty minutes of physical activity for at least five days of the week is what’s recommended by the US Physical Activity Guidelines for Americans. How much do we get? The feds survey this info regularly and the latest data show 1 in 4 of us get NO leisure physical activity at all. None. That’s self-reported data, and it may be higher, as people do tend to enhance the amount of physical activity they do.

Flipping the Script on Activity

Many of us cringe when we’re told to be more active. So how about baby steps? How about focusing on being less INACTIVE?

If it’s too overwhelming to go to a gym (I speak not of “joining” because that doesn’t ensure “going”) or if you have little leisure time, then it makes sense to build some activity into your day, a little bit here and there, whenever you can.

Enter the “Exercise Snack”

A food snack is something less than a meal. An exercise snack is something less than a workout. It can take many forms and be done pretty much anywhere. It doesn’t have a minimum time, it just requires moving – anyway you can, and anywhere you can. You don’t need to develop a twitch, just think of doing what some of my physically disabled patients would LOVE to do:

Deliver it.  Why email a memo to someone close by, when you can walk down the hall to speak with them? Follow-up with a memo for the record.

Think glass,  not bottle.  Have one glass of water at a time, rather than brining a bottle to your desk. When you want more, you’ll get up and get it.

DIY: Make a photocopy yourself, get the staples from the supply closet, give the home floor an extra quick vacuuming. It’ll get done your way and it’s another exercise snack.

TV? A 30-minute sitcom only has about 22-23 minutes of actual programming. That’s about 7 minutes of time – in 2 or 3-minute intervals – for exercise snacking.  Get the playing cards, charge your phone, lay out your clothes for the next day, or even fold a few clothes.

Tidy up!  Not a deep clean, just clear the coffee table, run the dishwasher, or hang that coat that’s been there since you got home.

Remember, these are exercise snacks, not workouts, so you’re done after a couple of minutes, but do them several times a day and you’re on your way top getting that 30 minutes. Better still, you’re preventing your metabolism from slowing down. Remember – it’s not about being more active – just less INACTIVE.

It’s an easier goal to achieve and these exercise snacks might lead to bigger things, like “exer-meals”. And if you need motivation, remember: Dee would happily trade places with you.

As for motivation, check this video out of a 4-year-old girl with cerebral palsy, taking her first steps by herself.  You’ll cheer her on as loudly as I did.  Then get up off your chair or the sofa — just because you can!

Growing Up With Cacao Trees in the Backyard?

Maribel Lieberman did, so it’s no wonder she went on to found MarieBelle Chocolate and Cacao Market by MarieBelle in New York. We were both guests together on the show “Nutrition and Exercise” on Doctor Radio, (Channel 110 on SiriusXM), and she agreed to chat with me later to tell more of her story.

Born in Honduras, Maribel said “It was usual to have cacao trees in the backyard, so yes, I grew up with cacao trees.”. Those trees weren’t a direct line to chocolate making however. “My mother was a very passionate seamstress and my idea was to become a designer and continue with my mother’s tradition.” This led her to come to New York’s Parson’s School of Art and Design, intent on becoming a fashion designer.

“When I arrived in New York, I was absolutely in love with the city and its culture,” and finding herself mesmerized by all the different food cultures that have always been part of the city. “This is when I started experimenting cooking with unfamiliar ingredients,” and how she learned to combine them into unique flavors.  As her interests evolved from fashion into food, she bought lots of cookbooks, learning to be a chef.  Maribel eventually started a catering company, maintaining it for 5 years.

It’s during this period that she learned a lot about chocolate. “I experimented making truffles and really loved it,” but combining and fusing different flavors with chocolate is what fascinated her even more.

Bean-to-Bar with Women Farmers

The vast majority of the cacao Lieberman uses comes from Hondouras, “although sometimes from Nicaragua or El Salvador, also.” Most of her cacao beans are Trinitario variety — a hybrid of the more common Forastero and the uber-delicate Criollo beans.  She travels to Honduras several times a year. “I have a relationship with the growers, most of them are women farmers, I have about 60 women that I buy cacao from,” but from other farmers as well. “I work very closely with the Fundación Hondureña de Investigación Agrícola.  The non-profit FHIA provides her with a wealth of knowledge about cacao, and “they help me pick the best quality bean.”

Maribel’s shop offers about 50 different flavors of chocolates and truffles. Spices figure prominently in her ganache chocolates, with the cardamom flavor being one of her favorites.  For me, a couple of her ganache truffles and a cappuccino make an excellent  dessert.  Not high in calories either (given their size, figure about 70 calories per truffle), and just enough indulgence.  With the cap (I’ll take a decaf, thanks, and I know I’m in the minority here) supplying some protein and dairy nutrition, it’s one way to make dessert or an afternoon snack really work.

Sugar-free chocolate her way 

She also entered the sugar-free market, sweetening her 70% bar is only with organic whole milk powder. “I think it works well” and I agree. It has the creaminess of milk chocolate, but the intensity you’d expect from a 70% bar.  Added sugar? Zero.  Protein?  Yes — a little over 5 grams in a 40-gram portion (about 170 calories).  She’s currently developing one sweetened only with raspberries and blueberries.

Her ganache chocolates have unique airbrush designs on them. Some are her husband’s designs, other are the work of her in-house designer. All are whimsical and have their own explanations that come with the “paperwork” in each box sold.  She’s obviously figured out that people eat with their eyes, too.  Smart.

Does all the “business” of cacao make her less interested in eating it? Not a chance. “I eat cacao every day,” she said happily. “Sometimes when I travel and didn’t bring any with me, I end up buying it at the local store.”

Chocolate fans, I’d say she’s “one of us.”

BEST DIETS: THESE 2 TIED FOR GOLD

It’s January, and that means US News has issued its “Best Diets” rankings. Out of the 40 diets ranked, both the DASH diet and the Mediterranean Diet tied for first place – again.

Why? They have the most research behind them and they’re both great for your health. The DASH diet (Dietary Approaches to Stop Hypertension) was created to reduce high blood pressure and the Med diet is intended for heart health – two very common health conditions.

Both diets emphasize plenty of fruits and vegetables. The main difference is that DASH also emphasizes at least 2 to 3 servings of low-fat dairy foods daily. The Med diet is strong on heart-healthy fats like olive oil, nuts, and fish, like salmon, because of its high omega-3 fat content. The Med diet can be a bit low on calcium, due to the modest intake of dairy foods.

“Flexibility” Gets a Bronze!

The Flexitarian Diet approaches vegetarianism but not obsessively so. I like this approach. It takes the best from the vegetarian diets but the only thing it banishes is the absoluteness. You don’t have to choose a camp here. For many people, veg is fine – but not all the time. This diet , and so supports this thinking, and so do I. Plus, it’s actually very healthful.
What I love about the DASH, Mediterranean, and Flexitarian diets is that they’re basically eating styles. You can lose weight on them, but they can be a way of eating for the whole family, even the kids. This is ideal for families where one person is trying to lose weight, but doesn’t want to make, or eat, different food from the rest of the family. These diets are all about healthy (and tasty) eating. They also take no special work, don’t require exotic food, and have enough options for everyone.

>>>Cut-to-the-Chase Eating Style: A “MediterDASHean Diet”<<<
Here’s my short-order combo of the DASH and Med diets:
• All fruits and veggies – and 5 portions of them (at least!) daily.
• Low-fat dairy foods of the DASH diet Aim for 3 servings but at least 2 (that’s still an improvement for most).
• Extra-virgin olive oil, fatty fish, nuts, and sure, a glass of wine (if you drink).
Basically a Med diet with more low-fat dairy foods. More inclusive, flexible, less limiting – IOMO.
Up next: The Worst Diets (NOTE: this could get ugly)

JANUARY 1 IS FOR EVOLUTIONS, NOT RESOLUTIONS!

New Year’s resolutions are well-intended, but most resolutions fade away after a few weeks.

Every year, our number one resolution is always to lose weight, and it’s probably why gyms can offer such great deals in January, knowing that most people will never use the full membership.

Stop “resolving” and start “evolving”.

Resolution implies bold, massive change. Evolution is all about baby steps. What gives them impact is consistency. Be consistent with any effort and it doesn’t matter how fast or slow you go – you’ll get there. Indeed, “evolution” is more focused on the journey – a good thing – because that’s where we’ll spend most of our lifetime!

Many of our daily routines and poor habits didn’t just happen — they evolved gradually – through baby steps – to become part of our lifestyle. That’s what makes them hard to break.

Slow – but steady – wins every race. If our resolutions are too extreme, we don’t keep them. Then we feel like we failed, but the resolution failed us, because it was too giant a step when baby steps would have been better, and more productive. Bodies aren’t technology. Accept that our bodies, behaviors, and attitudes will change more slowly than our phones.

Ultimate Success Starts With Good Prep Work

A gradual build towards better eating styles, more satisfying life and happier habits starts with good prep work. Below are some little changes that appear at the outset to have nothing to do with weight or even eating habits, but they definitely impact the choices you make during the day.

Here’s a start:

Make only the changes you KNOW you can make.  Success is guaranteed if you break everything down into steps you are sure you can manage. Even small successes are so motivating and can happen often.
Get more sleep. Do you get up every morning wishing you had just 30 more minutes of sleep? Get it. Make a deal with yourself for just one night (baby steps!) to get to bed early, so you can get at least 7 hours of sleep. See how good you feel. Then do it again and again.
No screens for an hour before bedtime. This 2017 study suggests light exposure from various electronic devices – in the evening – “may have detrimental effects on human health and performance,” and was associated with greater sleepiness during the day. Go old-school and read a book before bed instead.
MOVE MORE. Even thin people need to be active, so everyone plays here, regardless of weight. Benefits: it’s a proven mood-lifter, and you often make better food choices when you’re active daily. Start walking even five or 10 minutes each day, or as often as possible.
Re-connect with non-food pleasures. Make this a priority. Food is such instant gratification that other pleasures get pushed to the side.  Let’s remind ourselves that pleasure isn’t always about food.  Some ideas to consider:

  • Take that class you’ve wanted – yes, even the tap-dance class, or the weaving one, or the ceramics lesson. (Notice how these are NOT screen-friendly?)
  • Join a film, book, or hobby club. You’ll be more accountable to the other members – and you’ll find they value your voice, a reward in itself.
  • Take a day-trip on a bus or train. You’ll be back at the end of the day tired but happy.
  • Do something touristy – even take a “tour”.

These are just suggestions, but think out of the box and go for your own.

Evolution happens over a year, not overnight. Commit to a new baby step every month. Next January 1, we’ll be twelve steps ahead of where we are now (and we’ll deserve that New Year’s toast!)

Eat Well During Holidays Without Crossing Over to the “Dark Side”

Healthy holiday eating and enjoyment are not mutually exclusive, IF you know the right tricks. Having a healthy eating style doesn’t have an “on-off” switch and. It’s not about choosing between living in a healthy food monastery, or crossing over to the dark side, where all enjoyment happens.

Being healthy is being on a food journey, not on a diet. On a journey, there’s room for everything.  Extreme, overly restrictive eating styles aren’t sustainable and most people wouldn’t want to sustain them either. I wouldn’t. But I think of holidays as just another opportunity to hone a better eating style. Keep in mind, my own eating style has evolved over the years. Give yourself permission to evolve a little, too.

Think about the reasons why our usual eating styles get “disrupted”:

• “…the kids were off from school this week”.
• “…it was the (fill in the holiday)”
• “…we had a party at the house this weekend.”
• “…we had family in from out of town.”
• “…we were doing a lot of socializing.”

Making holidays work FOR you, not AGAINST you

File all these reasons under “stuff happens” but they happen all year long, so make life’s little disruptions amount to nothing more than a minor nuisance. They may even open a new dimension to your eating style or give you different “routines” for each situation.

Here are some positive ways to help yourself during “disruptions”:

• MOVE MORE! Just make it a part of the fun. Activity is a total ace in the hole. The more you move, the more calories you burn, for sure, but the more fun you can have, too. Moving kicks in your brain’s “feel-good” chemicals called “endorphins” that lift your mood. Walk through decorated neighborhoods, go ice skating, and make sure you dance at all the holiday parties! Feel the fun, not the burn!
• Workday “me” time: take 30 minutes of your lunch hour and walk briskly. THEN have a modest lunch and you’ll deserve a little indulgence. Or bank it for tomorrow’s indulgence!
• Splurge on some delicious, healthful foods you like but usually deny yourself: smoked salmon and pre-seeded pomegranates, (where all the work is done for you) are two of my faves. Keep grapes and clementines on the counter for a tasty impulse-bite. Gift yourself the convenience of salad-in-a-bag to make sure you and your family have an easy way to get plenty of low-calorie, nutritious foods (throw in some of those pomegranate seeds!). It’s also an easy way to get kids started in the kitchen with simple prep. Try some high-end balsamic vinegar and you’ll need less oil.
• Expect the unexpected. If a disruption is likely to happen, keep the rest of your day’s eating smart. Leave 200 or so calories for something unexpected. That way it doesn’t set you back.

HOLIDAY WEIGHT GAIN? HERE’S HOW TO SKIP IT

Thanksgiving is over but we’re now in a full-on holiday food marathon. No one wants to diet or even hear about health until the first of the year. Food is everywhere. Even at work, people are deluged with treats “for the office”. Holiday parties abound, and all manner of family and social functions, each with their respective food character.

How much weight do people really gain during the holidays?
It was long thought that people gained about 5-7 pounds during the period from Thanksgiving through New Year’s Day. This, plus the obvious psychological milestone of January 1, probably triggered the massive focus on health and dieting at the first of EVERY year.

But a recent scientific review looked at studies that included adults, as well as children, and revealed that people tended to gain only about 2 pounds during the holidays. I know, you think that can’t possibly be true, and maybe it isn’t – for you. That’s the thing about these studies – they tend to put everyone into a big blender and get an average. This review did find however that overweight/obese people tended to gain more weight and normal-weight people. You’re not everybody, though. If YOU tend to struggle with your weight during the holidays, then maybe it’s time to do something different than in years past.

No holiday weight gain: It’s possible!

Maybe no weight loss, either, but that’s OK. Anything better than last year’s results entitles you to beat your chest with pride. How to get there? Think of this as just another “project”, and any successful project starts with a good plan and this one is no different. That said, it can be a fun plan that gives you a nice reward: waking up on New Year’s morning without the weight regrets of seasons past. If the holidays are traditionally a tough season for you, weight-wise, then victory is all about prevention.

Tips for strategic holiday eating:

Ask about the food and drinks that will be at social events. Plans work better without surprises.
Do a “buffet screening” and filter out one or two things you like the most. Keep the other choices good-for-you ones and eat those first, so you fill up on the low-calorie foods.
Keep it to one caloric drink only. Whether it’s an alcoholic drink or just a soda, minimize your liquid calories. Then, keep to water, seltzer, or diet soda (yes, they’re safe so calm down). Others may get smashed on booze, but you’ll wake up tomorrow feeling better and without the weight gain from the unneeded calories.
Never arrive to events hungry — it’s the ultimate trigger for overeating.
Get fussy about worksite food? If it’s some item you look for, plan for it. bring your lunch and make it a modest one, like Greek yogurt and some fruit or two hard-cooked eggs and some whole grain crackers and zero-calorie seltzer or iced tea. Keep the special food to a “hospital-sized” portion.
Move. More about this in my next post but get ahead of the game now. Do SOMETHING. Anything you do beats sitting still.

FINAL THOUGHT: Leave early. If the food is just too difficult to handle, it’s no party for you. Making a timely exit is a sing you’re in charge.  Pat yourself on the back!

FAMILY MEALS: ESSENTIAL TO FAMILY HEALTH

September is National Family Meals Month, and it couldn’t come at a more appropriate time than right now, when kids are back at school, yet for many families affected by weather, a family meal can be the most comforting thing ever.  For all families, re-committing to having family meals together is one of the most beneficial things parents can do for their kids and for family life.

The practice of having family meals isn’t dead, but there are signs it’s ailing.   Families still eat together, but according to a Harris poll cited in a 2015 study on family meals, only 3 in 10 families eat together every night.  There’s room for improvement here and there are many reasons to make the effort.

Family Meals: It’s About the ACT As Much As the Meal

A quick research rundown on benefits of frequent family meals:

  • Kids are 12% LESS likely to be overweight
  • Kids are 24% MORE likely to eat healthier foods (and 20% LESS likely to eat unhealthy foods!)
  • Kids are 35% LESS likely to have eating disorders (e.g. have a healthier RELATIONSHIP with food)
  • A separate study found that eating home-cooked meals most often (even if using some frozen or packaged convenience foods) resulted in eating about 130 FEWER calories for the day, compared to people who cook at home less often or not at all. Those families also ate less fat and sugar.

The benefits go beyond nutrition.  Better mental health, social skills and even higher grades In addition to the dietary benefits, research has shown advantages to eating meals together that go beyond nutrients and nutrition but that are every bit as important:

  • A 2015 study: Kids who grow up having regular family meals are more likely to have more desirable social behaviors (such as sharing, respect, fairness) as adults.
  • A 2014 study: have fewer signs of depression, less likely to abuse drugs, less likely to engage in delinquent acts.
  • Strong association between family meals and higher grades, higher self-esteem, less risky behavior.

So…What’s the Barrier to Family Meals?

Check the “Life Happens” folder.  There’s more demanded of everyone today.  Jobs aren’t 9 to 5 anymore.  Technology allows (and encourages) us to check work-related messages outside of typical workday hours.  Pile on the demands of the kids, their academic, extracurricular, and social schedules, plus the demands of just running a household, and family meal seems like an unnecessary expenditure of time.

It’s necessary. As often as you can have it and really make it a priority.   It sends important messages to your kids:

  • A little time spent together every day is important, and
  • You kids are worth my time every day.
  • I want to know what’s happening with you, and

Is there a downside to family meals?  Only if the family relationship isn’t strong.  It’s also another reason to establish the family table early on as a totally neutral zone for parents and kids alike.

How To Enjoy, Not Endure, Family Meals

  • No technology.   If kids – or patents can’t disconnect for the 20-30 minutes it takes for the family meal, then family meals aren’t the problem, family standards are, and it’s time for a reset.  They’ll miss a few texts and posts and they’ll learn the world still spins.
  • Switzerland. The family meal table is a fully demilitarized zone.  No fights, no bickering, no lectures.  Keep it positive.  If social skills need some work, this is the place.  Give some guidance, but always with encouragement, not judgement.  And ALWAYS give some positive feedback.  Kids (and adults) love to be told they’re doing a good job.
  • Table it. Research has associated eating together around the family table, not in front of the TV or in other rooms, with lower body mass index (BMI – a measure of weight-for-height) for kids AND parents. Keep them engaged until everyone is finished – that’s also associated with lower BMIs.
  • Everyone’s an owner. Parents are hungry for prep help! No matter the menu, give age-appropriate tasks for prep and clean-up.  Everyone gets dinner sooner and enjoys it more because they have a personal stake in its prep.  Big note: tell the kids you appreciate their help.  Positive feedback is the ultimate motivator.

Fave Family Meal Story

My friend, Marylou, told me about her former next-door neighbor, a widow with six kids and a huge house to care for.  Marylou visited one Saturday morning to find the widow with a huge pile of laundry to do, yet she was prepping to take all her kids on a picnic.  Marylou was aghast and said, What about all this laundry?!”  The woman said, “I know, but in ten years they won’t remember the laundry.  They’ll remember the picnic we had.”

I love that mom.  And thanks to my own mom, for making great family meals — including breakfasts!

ARE SMARTPHONES HELPING OR HURTING TEENS’ LIFESTYLES

A recent article in The Atlantic, written by Jean M. Twenge, a professor of psychology at San Diego State University, painted a bleak statistical picture of the “iPhone” generation – basically pre-teens and teens, as does her recent book on the subject.  Here’s a snapshot of what’s happening with kids today since the debut of the iPhone, much of which is drawn from data collected by Monitoring the Future:

  • Less going out without their parents.
  • Less likely to get at least 7 hours of sleep: By 2015, 41% of teens failed to get at least 7 hours of sleep nightly, up from 34% in 2007.
  • Nearly 1 in 4 teens admits to being online “almost constantly”.
  • More likely to feel lonely: In 2015 nearly 1 in 3 teens said they felt lonely, up from 1 in 5 in 2007.

Almost 9 in 10 teens have smartphones now, and they use them.  According to a study by the Pew research center, the typical teen in 2015 sent and received about 30 texts per day, versus none in 2007.  More than 7 in 10 teens use multiple social network platforms.

What’s the addiction to smartphones?

All humans learned to survive by monitoring any changes in their environment.  Social networks change every second of every day.  It’s easy to see how teens (and adults, let’s face it) can’t help feeling that they’re missing out if not constantly monitoring various social platforms.

Teens may be “super-connected” but are they “communicating”?  Their increasing feelings of loneliness suggest that they’re not.

Disturbing thought: kids can now be “socially” active without leaving their homes, without leaving their rooms, and even without leaving their beds.  Nothing physical required for this “social activity” except thumbs in motion. Even if they do physical activity in school, the more they’re using their smartphones, the more they’re essentially at bedrest.

What does this have to do with health?

A lot.  Staying at home more, going out less, feeling lonely, and getting less sleep, are all negative trends for developing teens. Add that to the lack of physical activity that’s enabled by this online, sedentary life, and it doesn’t bode well for their health.

According to the Centers for Disease Control, all kids ages 6-17 years should get at least 60 minutes of physical activity daily. Nationally, only 1 in 4 said they met this goal in 2015, according to CDC statistics.  Nearly 3 in 10 did as recently as 2011.  That also means 75% of teens are not active enough.

Former Surgeon General David Satcher, in his 2001 landmark “Call to Action to Prevent and Decrease Overweight And Obesity”, emphasized more physical activity, but also “fewer sedentary activities.”  That means an hour of exercise followed by 23 hours of laying around, doesn’t cut it.

Back to school is a perfect time to build a better routine, one that gives teens a lifestyle that’s not only healthier, but happier.  If feelings of loneliness are increasing, they often go hand-in-hand with low self-esteem, already too common in teens.  Behavior changes that help shift self-esteem positively deserve some attention.

Calories and Social Media Time: 2 Things to Spend Wisely

Here are three big triggers for mindless eating: feeling lonely, being tired, and staring at any screen.  If your teen thinks a smartphone is an umbilical cord to the world, cutting it off seems tyrannical and isn’t necessary.  Still, these tips can help them towards healthier behaviors, positive attitudes, and lead them to healthier eating:

  • Media diet: NEVER at the table and insist the meal last 30 minutes. Family dinners aren’t just about food, they’re about communicating and connecting.  If this requires some getting used to, it’s a red flag that it’s overdue.
  • Kitchen help. Assign them some part of the meal prep – it builds responsibility but it also keeps them off the smartphone a little longer.  If it’s preparing part of the meal, give them some freedom to make decisions about what vegetable to cook or what ingredients to include in the salad.
  • TELL THEM YOU APPRECIATE WHAT THEY DID and mean it. There’s never been a better motivator than that.
  • Keep ALL “screen time” to a max of 2 hours daily, but also support non-screen activities that interest them.
  • Shut down all media (and snacking) at least an hour before bedtime. Two hours is even better.

Silver lining: by 2015 teens were also far less likely to have a driver’s license and have sex than were teens in 2007 – but there have to be better ways to prevent driving accidents and teen sex than keeping them home, hypnotized by a screen!

Show Me LESS Money — I’ll Show You a Healthy Mediterranean Diet

A recently published study suggested there were “socioeconomic status (SES) inequities in the cardiovascular protection associated with the traditional Mediterranean Diet.”  Simply put, the Mediterranean diet reduced cardiovascular risk but only in higher socioeconomic groups.  The best benefits came among those who were well educated and had better incomes.  It also suggested that the better health outcome of this richer and more educated bunch happened because they were able to buy higher quality, healthier food.

This may make for great headlines: low-income, less educated people are victims of a cruel society that keeps them powerless and less healthy.  It also bugs me to no end.  I have spent most of my career working with primarily low- and moderate-income populations.  My patients read a headline that says only the wealthy and educated can benefit from a Mediterranean diet and conclude things are just stacked against them because they aren’t wealthy or upper-income people and may never be.

What’s in The Study but Not the Headlines:

Whenever I see conclusions like these I know it’s time to dig in a little deeper. There are other conclusions, perhaps more realistic ones, that could be drawn from this study, even if they wouldn’t grab headlines.

All studies have weakness and limitations.  Many never make it into the press releases and news articles, however, and that just adds to all the nutrition confusion out there.  This study’s authors acknowledged some of the study’s weaknesses, but there were others that weren’t considered.

  • The authors acknowledged the study’s somewhat short duration, only 4.3 years of follow-up. Fair enough — it is what it is.
  • They noted that dietary information was self-reported and taken only once and only at baseline. A lot can change over 4 years that could impact the value of the study’s findings and conclusions.
  • Average age of the subjects was mid-50’s.  There is no record of their dietary history up to this point.  It’s one of the problems with this type of research – current dietary pattern doesn’t indicate your lifetime dietary history, when many of your health risks were likely determined.
  • Differences in health outcomes were attributed to dietary disparities. That’s a leap.  The outcomes may have had more to do with health care disparities throughout the years prior to the study, rather than whether or not they ate a green vegetable the day before they were interviewed.
  • The study noted that higher SES groups “are more likely to get in line with dietary recommendations”. Very likely, but such groups may also be more likely to afford and seek medical attention, take prescribed medication, follow physician recommendations, and make other positive lifestyle modifications.  This is a huge piece of the puzzle.

Rich and Educated Didn’t Always Do the Smart Thing

Higher income participants actually ate a narrower variety of vegetables than the lower income group and practiced LESS healthful cooking methods for beef, such as grilling and frying.   Does that mean also that eating fewer types of vegetables and doing more frying and grilling of beef is “linked” to a better outcome?  Not likely, although, to be fair and balanced, that’s what the data show, and it’s just as statistically accurate to make such a statement from these data.  This is why describing a behavior as “linked” or “associated” to an outcome doesn’t always tell us much and should certainly never be considered equivalent to “cause-and-effect.”

Observational studies make it easy to cherry-pick what you want to conclude.  All they are really designed to do however, is generate a hypothesis, not a conclusion.

We should be empowering and motivating lower-income people, not treating them as victims.  I don’t have the luxury of telling my low-income patients sorry, but eating better and being healthier are a rich man’s game.  Hello?  They need and deserve help, motivation, and sound nutrition advice, not to hear their health is at risk because they didn’t go to college or make a lot of money.

A Healthy, Economical Mediterranean Diet

Your Mediterranean diet doesn’t have to be populated with lobster and shrimp and washed down with an expensive chardonnay.  For the rest of us, more reasonable options are the way to go, and they can be just as tasty and healthful.  After all, the original Mediterranean diet wasn’t about indulgence, it was about making the best from what was available.

Try these tips for eating a delicious Mediterranean diet.  They’re budget-friendly but they’re smart for any budget:

  • Canned salmon – a treasure. It’s my own go-to for omega-3 fats. Surprise: it’s almost always wild, but without the wild price of the fresh stuff. The edible bones are loaded with calcium and vitamin D, too.
  • Beans, any kind, canned, fresh, or dry: Hummus anyone? Canned kidney or garbanzo beans are great topped with some pasta sauce.
  • Eat in the “C-suite”. Super-nutritious affordable fave veggies: carrots, cabbage, collards, cauliflower, celery. All great choices any time of year.
  • Frozen: peas, green beans are awesome and just as nutritious as fresh, with no prep or waste.
  • Fruits: eat the best of each season. It’ll taste better and be more affordable.  Let it be your sweet treat instead of junk sweets.
  • Extra-virgin Olive oil: You only need a little.  Buy what you can afford and use it where you’ll really taste it — on salads, bread, even on hummus.
  • Dessert, anyone? Try Greek yogurt with fruit, nuts, and a teaspoon of honey. Great for protein when it’s a meatless meal, too.
  • Nuts in bags, not jars. You get more for the money. An ounce a day is enough for benefits.