Resolutions: Making a Plan

We have been very busy getting our new satellite office up and running in the last couple of weeks. If you have not seen it, the office is located at 307 Euless Westpark Way.

This time I’m going to talk about the next section in our healthy dietary change resolution for 2010. Once you make your resolution specific and achievable, make a plan. Again, make your plan specific. In our plan we have added our short-term goals. I tell my patients that this is what you will focus on. As I said in the previous blog, don’t focus on the end result. Keep your focus on what you are going to do today or this week.

MacArthur OB/GYNs’ Plan

  • Each person will weigh once a week
  • Each person will keep a weekly food diary
  • Each person will attend the diet and nutrition classes provided
  • Each person will begin to incorporate more activity (we will also walk as a group on nice weather days at lunch)

Our Short Term Goals include:

  • A 1-2 pound weekly weight loss
  • An improvement in dietary choices (one MA learned that the instant oatmeal has a lot of sugar in it and one MA learned that eating too much fruit can also prevent weight loss)
  • Some will learn how to read a package label and be able to incorporate that into daily food intake (a couple MA’s learned that the microwave meals they eat have too many carbohydrates in them)
  • Planning weekly menus

I am very proud of the accomplishments the staff has achieved so far. They are all making better choices. For instance, one day pizza and salad was brought in for lunch. Everyone ate only 1 to 2 strips of pizza instead of a plate full and filled up on the salad. I find the staff reading the package labels, looking at the carbohydrate count and the serving size. A couple of our more serious participants have joined a gym and are exercising.

Now that you and the staff are more aware of the amount of carbohydrates you consume, are making healthier carbohydrate choices and are keeping the serving size appropriate, let’s talk about that scary word…HUNGER.

Why do we get hungry?

  • We eat
  • Food digested turns to glucose
  • Sugar level in blood rises
  • Pancreas secretes insulin
  • Glucose and insulin enter cells
  • Glucose level in blood falls
  • Brain says its hungry
  • We eat again

Remember to drink plenty of water throughout the day. Many people mistake being hungry for being thirsty. Once you become thirsty you are already behind on your fluids.

This is probably the most asked question by the staff “Kim, I’m hungry. What can I eat?” The answer is “Whatever you want, as long as the portion is correct and you incorporate what you ate into your daily food intake”.

Snacking periodically throughout the day is important. It helps prevent you from overeating at your next meal and keeps your energy level up. Here I encourage both patients and staff to make healthy choices in your snacks. The snacks I take to work are very portable and easy to eat between seeing patients. Some of the things I like to take to work to snack on include:

  • Low-carb yogurt
  • Fruit and 6-7 2% cheese cubes or mozzarella cheese stick
  • Whole-wheat crackers and low-fat spreadable cheese
  • Beef jerky
  • Lunch meat and vegetables
  • Nuts
  • A dip to be enjoyed with vegetables or whole-wheat crackers
  • Salad
  • A couple of lettuce rolls (Roll a slice of turkey, bell peppers, onions, and stone ground mustard in your favorite lettuce leaf. Make it your own and change the type of meat and vegetables).

It takes about 20 minutes from the time food hits your stomach until your brain realizes there is actually food in your stomach. I am starving especially at the end of the day. I usually eat a snack before I leave the office. If I didn’t, I would easily be able to consume the entire contents of my pantry and/or refrigerator after I got home and then eat what I prepared for dinner. By the time I make my 30-45 minute trip home my snack has kept “Mr. Hungry” under control. I can then fix a healthy dinner, keep portions under control, and not consume the contents of my pantry and/or refrigerator before sitting down to eat my meal.

Here are a couple of dip recipes that you can make ahead of time, package in small containers, and easily take these to work.  This artichoke dip I brought to work with some whole-wheat crackers. The staff really loved it.

Warm Artichoke Dip

8 ounces reduced-fat cream cheese
½ cup mayonnaise
½ cup 1% milk
¼ cup grated Parmesan cheese
1 clove garlic, minced
1 tsp. hot pepper sauce
14 ounce can artichoke hearts, drained
1 tsp. lemon juice
Salt and pepper to taste
Non-stick cooking spray
Whole-grain crackers

Blend cream cheese, mayonnaise, milk, cheese, garlic, and hot pepper sauce in food processor until smooth. Add artichokes and pulse until well combined but still chunky. Transfer to a microwave-safe serving dish. Microwave on medium heat until heated through, turning once or twice, about 5 minutes. Stir in lemon juice and season to taste with salt and pepper. Serve with crackers.

Nutritional Information Per Serving:
Serving size: ¼ cup
Calories 140
Fat 11 grams
Saturated fat 3.5 grams
Protein 4 grams
Carbohydrates 5 grams

Source: The South Beach Diet Quick & Easy Cookbook by Arthur Agatston, MD

Modifications:

  • Use fat-free cream cheese
  • Use light mayonnaise
  • Use skim milk
  • I baked this in the oven at 350 for about 10-15 minutes until bubbly, stirred in the lemon juice, topped it with shredded Parmesan cheese, baked for another 5-10 minutes until cheese melted
  • I did not use the hot sauce or season with salt and pepper
  • Can also use fresh vegetables instead of crackers

Cucumber Rounds With Salmon Spread

6 ounces packaged or canned salmon in water
2 ounces low-fat cream cheese
½ tsp. lemon juice
Salt and pepper to taste, if desired
Fresh vegetables (cucumber, broccoli, cauliflower, bell peppers)

In bowl, mix the cream cheese, salmon, lemon juice, salt and pepper. Serves 2.

Nutritional Information Per Serving:
Calories 135
12 grams fat
4 grams unsaturated fat
4 grams carbohydrate
12 grams protein
1 gram fiber

Modifications:

  • Use fat-free cream cheese
  • Try lime juice

Source: www.southbeachdiet.com

MacArthur OB/GYN update:

Total weight loss for week for week: 17 pounds
Number of people who stayed the same: 2
Number of people who gained: 2
Number of people who did not weigh in: 7

Resolutions: To Achieve or Not to Achieve

This week’s tip for a successful resolution is:

Make your resolutions achievable

  • Losing 15 pounds in the next 3 weeks to fit into that bathing suit for your vacation to Mexico is not very realistic
  • however, losing 1-2 pounds per week for the next 3 months is.

Don’t bite off more than you can chew

  • When I go over diet and nutrition for the gestational diabetics, I tell them to first focus on eating the correct amount of carbohydrates at each meal and snack. We will then come back and fine tune the type of carbohydrate at later visits.
  • Don’t focus on the 100 pounds you would like to lose but a 5-10% weight loss. This means that if you weigh 200 pounds, then you only need to lose 15-20 pounds. Then lose another 5-10%.
  • Don’t try to lose 20 pounds in a month, prepare to run your marathon in 3 months and decide to train for a body building competition at the same time. Keep it simple and focus on one resolution at a time.

MacArthur OB/GYN’s Resolutions for 2010

Here are some of the ways the staff is keeping their resolutions achievable.

  • Of the MA’s that are losing weight, one has set a goal of 10 pounds in 3 months, the rest are competing with each other to see who can lose the most weight in 3 months
  • The MA’s that are eating more vegetables or keeping their carbohydrate servings appropriate are losing weight but much slower, about ½ to 1 pound per week
  • We learned today about complex carbohydrates changing our breads, pastas and rice to whole grain

Complex Carbohydrates

I mentioned previously simple carbohydrates. We are now going to start talking about complex carbohydrates or whole grain foods.

Complex carbohydrates:

  • Made up of longer chains of sugar molecules
  • Enter the blood stream at a steady rate giving you a consistent level of energy
  • Help prevent those highs and lows simple carbohydrates can give you
  • Contain fiber making you feel fuller longer
  • Fruits and vegetables are considered simple carbohydrates, but the fiber in them slows down their digestion

If you are between the ages of 19 and 50, you need 6 servings of complex carbohydrates per day. If you are over the age of 50 you only need 5 servings per day. One serving of a carbohydrate equals 15 grams or ½ cup cooked pasta or rice.

I know this sounds complicated but what I try to do is have one serving of carbohydrate for breakfast, 2 for lunch, and 2 for dinner. I save that last serving for the unknown because I never really know when I’m going to leave the office and what I have originally planned to eat changes. I can’t tell you how many times I’ve walked in the door at 7:00 pm and one of my kids invariably has a school project that is due the next day and they need a large Styrofoam ball. So instead of preparing the meal I had originally planned, I am now on my way to the nearest craft store.

I may also snack on something during the day that I was not really planning on. For instance, one of the doctors brought in some bagels and I really wanted one. So I enjoyed half a bagel with a little of the low fat cream cheese as a morning snack.

Breakfast

½ cup eggs
1 slice Whole-wheat bread

Snack

Cheese
5 crackers

Lunch

Chicken breast
Salad
½ cup potato

Snack

Yogurt

Dinner

Hamburger
Whole-wheat bun
Salad

So how do you know if what you are purchasing is a whole grain or a complex carbohydrate?

  • You must read the ingredient list on the package. Unfortunately, you cannot simply rely on what the
    package advertises. Just because the bread label reads “wheat” bread does not mean a whole grain was used or that it is 100% whole-grain.
  • Look for the nutrition list and look at the list of ingredients. What you don’t want to see is “enriched flour”.
    Enriched flour is white flour. In other words, during the
    processing they have removed the outer covering of the grain.
    That outer covering has the majority of the fiber and nutrition
    of that grain.
  • Look for key words such as whole wheat flour, multi-grain flour, stone ground

Grilled Chicken with Roasted Vegetables

(This is one of my favorite things to fix. Make this recipe your own by changing the chicken marinades and the vegetables you use).

1 package any grill marinade mix of chicken, pork chops, beef

Your choice of vegetables:

  • Eggplant
  • Zucchini
  • Yellow squash
  • Onions
  • Bell peppers
  • Mushrooms
  • Red potatoes
  • Asparagus

Your choice of herbs:

  • Fresh or dried basil
  • Fresh or dried oregano
  • Garlic

Balsamic vinegar
Salt and pepper to season

Prepare marinade per package instructions. Marinate your choice of meat for about 15 minutes. Meanwhile, cut vegetables in large chunks. Place in 13X9 oven-safe pan coated with non-stick cooking spray. Place vegetables in pan and add basil, oregano and/or garlic and season with salt and pepper if desired. Sprinkle with balsamic vinegar if desired. Roast vegetables until tender in oven at 400 degrees. Put chicken on grill and grill until juices run clear.

Serving Size ½ cup

Nutritional Information Per Serving of Vegetables:
Calories 170
Protein 5 grams
Carbohydrates 15 grams (without potatoes)
Carbohydrates 30 grams (with ½ cup potatoes)

Grilled Salmon with Rosemary

1 pound salmon fillet
2 whole lemons, sliced
Fresh rosemary sprigs, about 20
1 garlic clove, minced
1 tbsp. Dijon mustard
Nonstick cooking spray
Salt

Lay two pieces of foil on top of each other. Spray foil with non-stick cooking spray. Place lemon slices on foil. Top lemon with rosemary sprigs, reserving 2-3 sprigs. Strip rosemary stem of leaves and chop. In small bowl, mix the minced garlic, Dijon mustard and chopped rosemary. Spread on top of salmon. Place foil on grill and cook until salmon is opaque in center, about 20 minutes. Carefully remove foil and salmon wearing oven mitts. Cut salmon into 4 portions.

Nutritional Information Per Serving:
Calories 212
Saturated fat 2 grams
Total fat 12 grams
Carbohydrates 1 gram
Protein 23 grams

Serve with above roasted vegetables, salad and fresh fruit for dessert.

I am proud to announce that 2 more staff members have joined our group. Our weight loss for this week was 22 pounds!