Hit the Reset Button Part 1: Healthy Eating in 2019

Three PA Experts Suggest Ways to Tackle Post-Holiday Eating

January 7, 2019

By PAs Karli Burridge, Ellen Mandel, and Corri Wolf

PAs Burridge, Mandel, and Wolf

 

These three PAs have experience and expertise at counseling patients on healthy eating. So, what do they advise other busy PAs about hitting the reset button after the holidays? Read their suggestions here.

Part 2: The truth about added sugar, substitutes for high fat and high calorie foods, and how much water you should be drinking.
Part 3: What balanced eating looks like, how to fuel your body before a workout, and snack ideas.

What are your best tips for getting back on track after the holidays?
Corri – My first tip is to forgive and forget. Forgive yourself for getting off track and forget all the bad choices you made. My second tip is to set realistic goals. A realistic goal is one you can meet with sustainable changes that won’t make you feel miserable on a daily basis. My third tip is to plan ahead. Organize your week; recognize ahead of time that you have an event on a particular night, so you can compensate for any anticipated indulgences on other days.

Karli – The first step is going through your fridge and pantry and getting rid of the sugary and savory processed foods that may have made their way into your home over the holidays. Throw out those cookies, chips, and other unhealthy trigger foods. It’s hard for many of us to throw out “perfectly good food,” but remember, it’s better in the trash than in you or any of your loved ones. Stock up on a few healthy treats for when a craving hits, such as dark chocolate (at least 70 percent) or some nuts. One of my favorite tricks to get “off” sugar (yes, it really does act like a drug and will cause some mad cravings once you get started), is to make some high fat, whole food treats: Crush nuts, like almonds, macadamia, hazelnuts, pumpkin seeds, chia seeds, or whatever I have around. Add some no-sugar added coconut shavings, peanut butter or coconut cream, and 80 percent dark chocolate chopped into small pieces. Add a little chocolate protein powder for sweetness. Roll the mixture into small balls and put them in the fridge. Whenever my sweet tooth starts calling, I grab one of these healthy, whole food treats. Within a few days, my sugar cravings will be gone.

Ellen – The past is just that – done.  However, we need to learn from the past and reward our better eating choices and reflect on reasons why we may have derailed. So, out with the old and in with the new. Holiday stress brings many challenges and food may serve as a stress reducer. Think about why that happens, as holiday stress may be different, but daily stress does not evaporate when the family leaves. Simple ideas:  if possible, freeze favorite leftovers. Although it may be uncomfortable to throw out food, you may need to do so. Prevention is empowering too. When I entertain for larger groups, I keep a list of how much food is left over and apply these findings to the next year. At my big Hanukkah party every year I used to peel and fry way too many potato pancakes (latkes). Year after year, I reduced the number of leftovers to a manageable amount. I am also liberal with folks taking home leftovers and put containers out to encourage it. So, my refrigerator and my middle are less packed.

What are your thoughts about current trendy diets (Atkins, South Beach, Ketogenic, Paleo, Alkaline, Whole 30)?
Ellen – On this topic, I am boring. There is no magic bullet, and most trendy diets have some common denominators. They want you, the consumer, to:  a) see some magic in their formula; b) think you can follow it for the long haul; and c) underestimate the financial outlay of following their dietary approach.

Let’s face it — studies show that some diets may be better at early weight loss, but if you support the importance of weight loss maintenance, then many diets fall short. Pay attention, as proponents of trendy diets speak to rapidity and number of pounds lost in the first few weeks to months, and little about weight loss maintenance at one year. The Yo-Yo diet (and I don’t mean what the cellist eats), with its ups and downs, is a controversial subject with some studies showing limited risk increase in morbidity/mortality while others supporting significant risks. However, these studies are not addressing the psychological impact on the patient or the PA. For some individuals with obesity, weight loss with associated gain, again and again, carries immeasurable social stigma. Thus, avoiding weight gain may be more desirable.

So, the boring answer is that you can consider using one of the trendier diets for early, successful weight loss; however, the long nutrition game rests on portion control, variety, fruits, vegetables, whole grains, inclusion of non-meat meals and daily intentional activity (note I did not say exercise!).

Corri – I am not a big fan of any of the trendy diets. I think they may be able to jumpstart weight loss, but the majority are not sustainable long term and can be dangerous for people with chronic medical conditions. Trends are something that come and go, but developing a healthy lifestyle is a lifelong commitment and one that should be centered on variety and moderation without including lengthy lists of forbidden foods.

Karli – First, I would like to say that while some of these plans may be “trendy” right now, their concepts are certainly not new. People just like to put a label on “diets,” which then causes certain trends and hot topics. Instead of putting a label on these diets, and focusing on what makes one different from the other, I try to look at their similarities and focus on a nutrition plan that can work for someone as a lifestyle, not as a “diet,” which most people view as something temporary before they transition back to their “old way” of eating. So, what do most of these plans have in common? They focus on whole, minimally processed foods. Eat plenty of vegetables. Eat healthy fats like nuts, avocados, and olive oil. Get enough protein from whole sources like fish, poultry, meat, eggs, or plant sources like tofu, nuts, or beans. Find what works for you and make it a LIFESTYLE change. And another thing I would add: Don’t beat yourself up or give up on your healthy lifestyle if you deviate from your plan. Accept that no one eats perfectly 100 percent of the time, and all you can do is make the best choice you can make at the next opportunity and move on.

Which weight loss programs do you think are most effective?
Karli – I think evidence-based programs which use all four pillars of obesity treatment (nutrition, physical activity, behavior modification, and when appropriate, pharmacotherapy) are the most effective. Very low-calorie diets (VLCDs) have been shown to induce large amounts of weight loss but do require close medical monitoring by a provider who is trained in this. We also don’t want to overlook bariatric surgery, which is the most effective tool we have for those patients who have severe obesity and for whom other options have not been effective. However, VLCDs and bariatric surgery programs also need to include the other pillars of treatment as well in order to be effective long-term.

Ellen Weight Watchers has one of the longest track records of any weight loss program. It emphasizes real food, support, and record keeping, and stresses weight loss and then weight maintenance. I also strongly believe that weight loss success for an individual is tied to family eating. Unless living solo, meals and snacks are socially connected. Going it alone when cabinets and the fridge are loaded with tempting items is almost always doomed for failure. Splitting large restaurant portions makes a big difference in overall caloric intake and trains one to recognize the enormity of most dining-out portions. Empower yourself with positive nutrition-minded people, agree on nutrition house rules, and support each other. It’s the end game that matters most.

Corri – I am a strong supporter of Weight Watchers. It imparts a lifestyle that can be maintained and benefits the whole family. It teaches healthy eating, portion control, promotes cooking your own food, encourages exercise, has apps for the tech savvy, and no foods are forbidden. It is tried and true and has withstood the test of time.

Read More

Hit the Reset Button Part 2: The truth about added sugar, substitutes for high fat and high calorie foods, and how much water you should be drinking.
Hit the Reset Button Part 3: What balanced eating looks like, how to fuel your body before a workout, and snack ideas.

Additional Resources

Primary Care Obesity Management Certificate Program

Obesity Awareness Education Under Review

Two PAs Discuss Importance of Obesity Education to Patient Care

PAs in Obesity Medicine special interest group

Authors: Karlijn (Karli) Burridge [email protected], formerly with Baylor Scott & White Health Metabolic and Bariatric Surgery Center, Grapevine TX, recently moved to Chicago, IL, where she is looking for a new opportunity. Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE, is Clinical Professor, Pace University, Physician Assistant Studies-Lenox Hill Hospital – NYC, [email protected]. Corri Wolf, PA-C, MS, RD, is Associate Professor, Academic Coordinator & Assistant Chair, Department of PA Studies, New York Institute of Technology, [email protected].