Does your diet include variety, balance, and moderation

It’s been said that there are no bad foods, only bad diets. The idea is this: if we simply ate a wide range of foods – mostly healthy foods – and didn’t eat too much, we’d all be better off. But even though most people might understand the concept of a diet based on variety, balance and moderation, for many it’s still difficult to put into practice.

We crave variety. Humans evolved in surroundings overrun with a huge range of plant foods. And the drive to consume them was nature’s way to ensure that nutrient needs would be met. We carry this same urge with us today – which would still serve us well if we were merely selecting from a spread of edible plants. But we’re not. We’re faced with way too many food choices – not all of them good for us – and studies show that the more choices we have, the more we eat.

What does balance mean? Does it mean you can ‘balance’ a relatively unhealthy food with a healthy one? Do the nutritional positives of a grapefruit balance the negatives of a cream puff? This idea that ‘everything fits’ works out nicely if you plan a diet on paper. You could plan for a fast food burger and fries for lunch, and sandwich it between a really healthy breakfast and dinner. And, if you did the nutrient and calorie calculations for a day like that, it might not look too bad. With careful choices at breakfast and dinner, you could probably keep the days’ calories and fat under control, and even meet many of your nutrient requirements, too.

But who eats that way? I would bet that most people who opt for a fast food lunch are looking for something pretty similar for dinner. And, I wouldn’t expect that people who eat cottage cheese and fruit for breakfast are hitting the drive-through at lunchtime.

Moderation is usually taken to mean not overeating in general, but it especially applies to the ‘extras’, like fats, sweets and alcohol. Some people can moderate really well – they can keep a bag of cookies in the cupboard without losing control. But for others, the concept of eating a single cookie is completely foreign – and for them, learning to moderate intake may never happen. They may be better off to avoid temptation altogether, and never bring the cookies into the house in the first place.

So, are there bad foods, or just bad diets? I think we have both. I’ve got my own list of things I think are ‘unhealthy’, and it’s likely that you’ve got a list, too. Whether we choose to eat these foods, or how often, is a personal decision. But pile enough bad foods on your plate, and you’ve got a bad diet.

In the end, we should be striving to eat as healthy as we can. Variety should come, for the most part, from the huge range of healthy foods we have available. Balance should be less about countering the ‘bad’ with the ‘good’, and more about getting the right amounts of what your body needs – lean proteins, healthy fats, and ‘good’ carbohydrates like fruits, vegetables and whole grains – in order to meet your nutrient requirements.

This isn’t to say we can’t indulge from time to time, but the hardest part is moderation. It’s tough to take in only what you need when there’s temptation everywhere you turn.

How to gain five pounds during the holidays

Yes, you can pack on five pounds between now and January – and it’s easier than you might think. Most people only add a pound or two over the holidays, but when you look at what a few extra indulgences can cost you, the calories add up fast. To gain five pounds, you’ll need to take in an extra 17,500 calories or so between now and January Here’s how to get the job done.

First, turn the clock back a couple of weeks – to October 31. The average Halloween bucket holds about 250 pieces of candy at about 35 calories each. If you’re like most people, you bought too much – so you’ve been putting away a couple of pieces a day for the last two weeks. That’s given you a 1000 calorie head start.

Up next – Thanksgiving. We’re no longer content with just “Thanksgiving Dinner” – we’ve morphed the holiday into “Thanksgiving Day”, since we spend a good part of the day eating. Many people plan the main event early in the day – it makes it much easier to squeeze in a repeat performance later in the evening. Total calories for the day could easily top 5000 or more – conservatively, that’s about 2500 more than the average person needs.

Sometimes, your workplace can be your undoing during the holidays. Grateful customers and clients, or even coworkers, flood the office with cookies, candies and tins of caramel popcorn. Eat two handfuls of caramel popcorn three days a week for a month (2200 calories) and three pieces of chocolate candy a week for a month (1600), and you’re guaranteed to be a pound heavier by January.

You’re bound to have more goodies at home, too, when the gift baskets start to arrive. You could easily eat 10 mini muffins over the course of a few days (1000 calories), or make a few dives into the salami and cheese crackers (700 calories). Bake a couple of batches of holiday cookies or gingerbread and you’ll be in trouble, too. An extra 6 cookies (and a few samples of cookie dough) could set you back another 500 calories or so.

Now throw some cocktail parties into the mix. Hors d’oeuvres are little calorie bombs, averaging about 100 calories each, and some alcoholic drinks – like sweet martinis – can easily top 300 calories. Two parties = two thousand calories = two-thirds of a pound. Tack on what you’ll get from a couple of potato pancakes and some beef brisket at a Hanukkah party (1000 calories) and you’re almost another pound up.

It shouldn’t be hard to pick up the remaining 5000 calories or so, especially when you’re faced with foods like pecan pie (500 calories a slice), prime rib (800 calories for 8 ounces) and creamy artichoke dip (600 calories in a half cup) – or when Christmas brunch consists of a slice of quiche (500 calories) a giant cinnamon roll (500) and a cup of eggnog (400).

Last tip: be sure to couple all this eating with a bout of inactivity – if you give up your daily 45 minute walks (175 calories) for a month, you’ll be sure to seal the deal by New Year’s.

What to do with leftovers

You’ve heard it time and again. For many people – and I may be one of them – the best part of Thanksgiving is the leftovers. Don’t get me wrong – I love the holiday and all the preparations. But after a couple of days of gearing up, it seems like the meal goes by in a flash. So it’s nice to have a leisurely weekend to get creative with the leftovers.

While I don’t know exactly what’s in your ‘frig the day after the holiday, it’s safe to say that you’re likely to have turkey, some potatoes (white and or sweet), a bit of cranberry sauce, a little stuffing, a dab of gravy and probably a container of the ever-popular green bean casserole. Reheating is fine, but after a couple of meals, I’m usually looking for a change in taste.

Hands down, my favorite thing to make after the holiday is turkey soup. Once the turkey bones have been stripped of all their meat, I simmer them with onion, celery, carrots, salt and pepper for a few hours to produce a heavenly stock. From there, you can do a basic turkey noodle, or add your leftover mashed potatoes for a creamy soup base. A dab of leftover gravy will add a lot of flavor – but go easy, since it’s loaded with calories.

The turkey lends itself to a million uses, but if you have so much left over that you don’t think you’ll use it in a few days, shred it into meal-sized portions and freeze. It’s great to have it handy to add to dishes like soup, pasta or burritos. Here’s something you may not have thought of –turkey lettuce cups. Heat up some minced leftover turkey with some diced scallions and a little Chinese hoisin sauce, then spoon into iceberg lettuce leaves. It’s light and a refreshing change from the usual turkey sandwiches.

Cranberry sauce is amazing on top of plain yogurt or oatmeal, or spooned over mixed fresh fruit for a quick dessert. You can also blend it with nonfat cream cheese for a tasty spread for your whole grain toast. I also like to spike my cranberry sauce with some ginger, garlic and soy sauce and serve on grilled fish or tofu. It tastes like a really sophisticated barbecue sauce.

If your original sweet potato dish wasn’t too sweet, you can dice up the leftovers with the leftover turkey, then sauté with some onions and other veggies for a one-dish hash. Serve with a green salad and you’re all set. Sweet potatoes would also make the start of a pretty great curry with some leftover turkey added.

Stuffing and green bean casserole are some of the highest calorie leftovers, so you’ll want to use them sparingly, and stretch them out with some healthier ingredients. Add some canned tomatoes and chopped turkey to your leftover stuffing to make a filling for stuffed peppers. And that leftover green bean casserole? Try heating it up with some white wine or broth, then add some garlic and hot pepper flakes and toss with some whole grain pasta.

What do you spread on your bread

Let’s say you’ve gotten the whole grain message loud and clear.  You’ve combed the bread aisles or your local bakery – you’ve read your labels and you’ve found your healthy, 100% whole grain bread.  But wait… what’s going on those healthy breads? How you spread ‘em matters, too.

My husband’s grandfather could not make a sandwich – even a peanut butter sandwich – without first spreading both slices of bread with margarine.  Based on the dizzying array of products on the market, a lot of people must share his passion for oleo. You’ve got spreads, sticks and sprays, fat-free ones and ones that promise to ‘support healthy cholesterol’.  Calorie-wise, the full-fat margarines are pretty much identical to butter, although they do have less saturated fat.  Fat-free spreads are really low in calories – usually only about 5 per tablespoon compared to 80 or so for the regular stuff, but sometimes people use that as a reason to just slather on even more.  For some, the sprays work well to give a hint of flavor for only about 1 calorie per “spritz”.

Light versions of high-fat spreads like margarine can save you a lot of calories – and the same goes for light cream cheese and mayonnaise.  But consider this: if you habitually slather mayo on your sandwich, cream cheese on your bagel or margarine on your toast, you’ll use the high fat versions when you eat out, since the lower fat varieties usually aren’t available.  You might be wiser to try to break the spread habit altogether.

If you like your bread topped with something sweet – like  jams, jellies, preserves, fruit butters and honey – they’ll set you back about 45 calories a tablespoon.  And don’t be fooled into thinking that the “all fruit” jams count as a serving of fruit.  Jams that are made with “fruit and fruit ingredients” may list ‘fruit syrup’ (sugar), or ‘apple juice concentrate’ (sugar) as the first ingredient.  From a nutrition standpoint, regular and “all fruit” jams are pretty much the same.

If peanut butter is your thing, try some delicious almond or pistachio butter for a change.  Yes, nuts are heart-healthy, but peanuts aren’t nuts at all – they’re beans.  As such, they’re pretty good sources of protein.  But the fat in peanuts isn’t nearly as healthy as the fat in tree nuts like walnuts, almonds or pistachios – they’ve got half the saturated fat of regular peanut butter. If you can’t give up your peanut butter, stick with the natural style.  The oil floats because – unlike “regular” peanut butter – it hasn’t been turned into shortening.  Store it upside down in the frig to make it easier to use.

And let me just say that if you like those nutty-chocolatey spreads, I’d suggest you save those for very special occasions.  Yes, they taste like melted candy bars, but they’ve got more calories and saturated fat than even regular-style peanut butter.

Here’s something else to consider – if you think bread’s only function is to hold a spread or a topping, maybe you’re not eating the right bread. Delicious bread – fresh and fragrant, warm and yeasty – is so good on its own, it doesn’t really need any adornment.

Can your diet plans be too strict

Most of the time, I would never argue with someone who wanted to eat as well as possible.  After all, part of a dietitian’s job is to encourage people to eat healthy foods and to help them find ways to nudge their current eating habits in the right direction.   But sometimes I run across people who carry proper nutrition to the extreme; they have an unhealthy obsession with eating healthy food.

Perhaps you know people like this.  They pride themselves on their flawless eating habits, and look down upon others who don’t display a similar iron will.  They spend most of their time planning, preparing, and eating perfect meals.  Every food is chosen solely for its nutritional virtue.  And, to many who seek the perfect diet plan, the more virtuous the diet, the more honorable the person who eats it.

In a 1997 article in Yoga Journal, Colorado physician Steven Bratman suggested the term ‘orthorexia’ (‘orthos’ meaning ‘correct’ or ‘straight’) to describe people who have this unnatural focus on consuming a flawless diet.

I’ve met more than a handful of people who obsess over everything they eat.  Many keep records of everything they swallow, and most usually know what they are going to eat – sometimes days in advance.  They can provide lengthy discussions on the nutritional value of dishes they prepare at home, but ask them how the end result tastes, and you might be met with a blank stare.  Eating spontaneously and enjoying the pleasures of the palate often take a back seat.

Not surprisingly, when your diet standards are so high, it makes it really hard to eat at other people’s homes.  In restaurants, orthorexics will grill the wait staff about every detail – the source of the ingredients and the method of preparation of each and every dish – and yet still have trouble finding foods that suit their diets.  Not surprisingly, social isolation can be the end result.

Some psychologists think orthorexia may have an anxiety disorder at its root, while others think it may be more of an obsessive-compulsive disorder.  Still others say that if it’s simply a case of hyperfocus on something that’s healthy – like being a workaholic, or an obsessive exerciser.  Maybe there’s nothing wrong with that.

As originally defined by Bratman, orthorexia was meant to describe the ‘health food junkie’ and, specifically, those who are driven solely by the desire to eat healthy, not to eat less.  That’s an important distinction, because while it sounds like an eating disorder, orthorexia – at least in the spirit in which the term was originally coined –  isn’t considered one.  It’s only a problem if your diet plan is taken too far and leads to a significant weight loss in the process.

There are healthy eaters who haven’t become seriously underweight and who manage to find something to eat when they’re out with family and friends.  They’ve made their strict discipline work for them. For those who want to loosen up a bit, behavioral therapy can be helpful.  Learning to replace obsessive thoughts with healthier attitudes about food can help to put a little slack in the dietary reins.

Apple cider vinegar the diet fad that won’t die

Fads – whether they’re in food or fashion – usually have a very short life span.  But there’s one diet craze that just doesn’t seem to go away.  Apple cider vinegar has been touted as a weight loss remedy for as long as I can remember. 

When I was first studying nutrition in college (and this was 30 years ago), the use of weight loss vinegar was in full swing. I distinctly remember the rather twisted bit of logic that was offered up in vinegar’s defense – it was said that since vinegar and oil don’t really mix, that vinegar and body fat shouldn’t mix, either.  The leap from salad dressing to slimming was never explained, but millions were swept up by the virtues of apple cider vinegar, and – if Internet posts are to be believed – the apple cider vinegar fad still has millions of adherents today.

So I got to wondering about the longevity of the vinegar craze, since diet fads are, by definition, short-lived.  Why would the apple cider vinegar thing been so enduring, unless it might actually do something?

Imagine my surprise when I actually found a handful of scientific studies on the subject that have, in fact, shown that a dose of cider vinegar with a meal may actually help people to feel full.

In one Swedish study done five years ago, study subjects said that their food cravings were reduced for a few hours after they ate white bread with 1-2 tablespoons of vinegar – something plain bread failed to do.   But the study was small – just 12 people – and there wasn’t a ‘placebo’ group for comparison, meaning that no one ate bread with something that looked, smelled and tasted like vinegar – but wasn’t.

But in another small study published just this year, the study subjects ate their meals with a colored and highly sweetened vinegar brew that they were unable to distinguish from a placebo drink which was also tart, colored, very sweet – and vinegar-free.  When consumed with a meal, two teaspoons of apple cider vinegar – about the amount you’d get from a typical serving of salad with vinaigrette dressing – reduced the rise in blood sugar by about 20 percent when compared to the effects of the meal eaten with the look-alike drink.

It’s been speculated that apple cider vinegar either slows the rate at which the stomach empties after a meal, or interferes with the activity of digestive enzymes in the stomach – either of which could explain why meals would be more satisfying when vinegar is included.  And, slower digestion means slower absorption of carbohydrates, which would slow the rise in blood sugar after a carb-heavy meal – and support apple cider vinegar’s popular use as a home remedy for diabetes that goes back hundreds of years.

As intriguing as these studies are, they’re small and preliminary.  Keep in mind that there are many dietary players in the game of weight loss.  The health benefits of a good diet come from of the complex interplay between all of the nutrients it provides. Even if cider vinegar really does help to fill you up, it’s not nearly as nutritious or filling as the healthy salad greens and fresh vegetables you’re dousing with it.

Nitrates in fruits & veggies promote heart health

The story around diet and heart health has been around long enough that most people know the drill pretty well. Watch your weight, keep your total fats and saturated fats down, and don’t be too heavy-handed with the salt shaker. Add some soluble fiber from foods like oatmeal and some healthy fish oil into the mix, and you’ve got a pretty good dietary strategy.

All good advice, to be sure. After all, a high fat diet can put weight on you, saturated fats can elevate blood cholesterol levels, and excess salt can drive up blood pressure – all of which can increase your risk for heart disease. But there’s another piece to the heart health puzzle that’s getting more attention these days – a little molecule called nitric oxide.

Nitric oxide – produced in cells lining the surface of the blood vessels – is a gas that dilates arteries, which in turn aids blood flow and reduces blood pressure. It’s also a strong antioxidant, working to relieve oxidative stress in the body and reduce the threat of heart disease.

Our bodies produce nitric oxide from oxygen along with arginine, an amino acid found in abundance in protein-rich foods like nuts, beans and seafood. But there’s also another source – we can also manufacture nitric oxide from the nitrates in the foods that we eat.

When we consume nitrates in the diet, they’re absorbed in the small intestine and enter the bloodstream. About 25% of the nitrate is taken up by the salivary glands, where it’s concentrated in the saliva. Bacteria that naturally occur in the mouth then convert the nitrate to its chemical cousin, called nitrite, which is absorbed back into the system. From there, further chemical changes in blood and tissue leads to the production of nitric oxide.

You may only know nitrates and nitrites as an additive to cured meats like ham and bacon – they’re put there to primarily to preserve freshness, color and flavor. But before you start thinking that bacon is the new health food, keep in mind that it’s loaded with saturated fat and salt. And, very little of the nitrate we eat comes from cured meats.

It turns out that the majority of the nitrate we consume – between 70% and 85% – comes from vegetables and fruits, the richest sources being spinach, lettuce, celery, cauliflower, grapes, strawberries and root vegetables. Most of the rest of the nitrate we take in comes naturally in drinking water.

Fruits and vegetables have always been known as nutritional powerhouses – they’re loaded with antioxidants, fiber, vitamins and minerals, yet cost us little in terms of calories. They’re also loaded with vitamin C, which enhances the generation of nitric oxide from nitrite. But the fact that they’re also nitrate-rich just gives us yet another reason to eat them.

Food safety Old food & expiration dates

I have to admit that I’m a little bit overzealous when it comes to food safety, and I take the expiration dates stamped on food labels and packages pretty seriously. Sometimes too much so… If I have some raw chicken in my fridge that’s going to ‘expire’ the next day, I won’t eat it. I know it’s safe, but in my mind, that chicken is on its death bed and doesn’t belong in my stomach.

At the same time, I’ll keep mayonnaise in my fridge until it’s gone – and at the rate I use it, that could be past the expiration date – and I don’t give it a second thought. But if you fear old mayonnaise the way I fear expiring chicken, there’s no need – as long as mayo is properly refrigerated, it doesn’t really go bad (by that I mean, it won’t make you sick).

Confused? You’re not alone. Sorting out the dates on food labels isn’t easy. Some people ignore them altogether, others take them a little too seriously (like tossing out ‘expired’ bottled water).

You’ve probably noticed the “sell-by” dates on perishables, like meat, fish, poultry and milk. Once that date passes, stores are supposed to pull these items from their shelves, and most people assume that the food shouldn’t be eaten after that date, either. But that isn’t necessarily so.

Just because the sell-by date has passed on your carton of milk, it can easily stay sweet and tasty (and safe) for a week or so after that – provided it’s been properly stored in the refrigerator. Eggs can easily stay fresh and safe for 3-5 weeks after you buy them – which is likely to be long after the date stamp on the carton. Even ground beef, which is highly perishable, is safe to eat for a day or two after you buy it – even if the ‘sell by’ date has passed.

Then there’s the “use by”, “best by” and “best before” dates – which aren’t even expiration or safety dates at all. In fact, they’re not even required on the label. Manufacturers put them there to let you know that after that date, the quality of the food might decline. So you might see a change in texture or color, but the food is still perfectly safe to eat. Keep ketchup around long enough and it’ll turn brown – your burger won’t be as colorful, but it’s still perfectly safe to eat.

Mold is another story. If your bread is decorated with fuzzy green spots, or your lunch meat is coated with gray fur, it’s got to go. But if you find a little spot of mold on firm veggies like cabbage, peppers or carrots, or on hard cheese, you don’t need to throw it out. Just cut about an inch all around the moldy spot, and then it’s okay to eat the rest.

Clean up your diet  clear up your skin

So many changes take place as kids move from childhood to adolescence that it’s hard to keep up. For one thing, their diets – which you might have had a little more control over when they were young – now leave a little something to be desired. At the same time, pimples and breakouts start to literally rear their ugly heads. So it’s no wonder that the food-pimple connection seems to be a no-brainer.

Pimples and acne are largely due to hormonal changes, but that’s not to say that diet doesn’t play a role. The latest research tells us that there likely is a connection, but one that’s a bit more complicated than most people think.

Common wisdom has pointed the finger at greasy, fried foods – stuff that isn’t usually lacking in a typical teenager’s diet, like chocolate, pizza and French fries. But when it comes to connecting any of these individual foods to breakouts, studies have come up short.

The focus has shifted instead towards the overall quality of the diet – in particular, the relationship between skin eruptions and a diet heavy in refined carbs and sugars. And it looks like a diet that’s heavy in these ‘bad carbs’ – ‘white’ foods like white bread, pasta, potatoes, white rice and sweets – may be partly at fault.

When the diet is overloaded with refined carbs, it can lead to a condition of persistent, but mild, system-wide inflammation – a kind of slow simmering fire in the body that has been linked to all kinds of problems, including pimples and acne.

So it’s not simply the French fries that are the problem – it’s the fries coupled with the white bread burger bun and the sugary soda that lead to a heavy carb burden on the system.

Turning down the heat is pretty easy – it just requires a good nutritional offense. The focus should be on two things – healthier carbohydrates, and more anti-inflammatory omega-3 fats.

Clear out the refined ‘white’ carbs and sugars as much as possible. Occasional desserts are fine, but encourage your kids to cut down on sweets, especially sodas that dump tablespoons of sugar into the body in one gulp. Keep more of the ‘good’ carbs around – like fresh fruits and veggies, and whole grain bread, pasta, crackers and cereals instead of the usual white ones.

Kids can get their omega 3s from tuna – the one fish that many of them will actually eat.

Salt & your diet What’s your daily sodium intake

Salt & your diet What’s your daily sodium intake

We’re getting too much salt in the diet – largely from processed foods and restaurant items. There are several hidden sources of salt and health risks that can be associated with them.

Lately, we’ve been witnessing nutritional crackdowns on several fronts – the dangers of excess calories, fats, trans fats and sugars have all been recent targets. It seems, though, that salt (or, more technically, sodium chloride) is finally getting its turn in the spotlight.

Maybe it’s because we’re well aware of the risks of excess calories from fats and sweets by now – and we can easily witness the toll of excess calories in the form of an obesity epidemic. But the problems related to taking in too much sodium are not so ‘in your face’ – you generally don’t see or feel the effects unless you’re face-to-face with a blood pressure machine.

There’s no question that we love salt – and the craving is natural. Long before we had salt shakers, the pleasant flavor of sodium in plant foods may have been nature’s way to entice us to eat them – not just to get the sodium, but to ensure that we got plenty of other important minerals, like potassium, that naturally tag along.

The remarkable thing about salt – and probably the reason we crave it so – is that it does so much more than just make foods taste salty. Salt makes sweet foods taste sweeter (ever see anyone sprinkle salt on watermelon?), it decreases bitterness, it enhances aromas, and it even improves ‘mouthfeel’ – a term used to describe all the complex sensations we experience when we put food in our mouths.

We do need some sodium in the diet, but there’s a huge divide between how much we should be eating and what we’re actually consuming. The recommended daily sodium intake is about 2300 mg (and even less if you’re over 50). That’s a tall order when men are taking in, on average, more than 4000 mg of sodium a day – what you’d get from about 1 ½ teaspoons of salt – and women eat about 3000.

The problem is that sodium is so hard to avoid. There is so much salt in processed foods and restaurant fare that even if you never picked up a salt shaker, you’d probably be eating too much sodium. We get heaps of it from cheeses, lunch meats, condiments, snack foods and soups.

Restaurant items are a double threat – not only are the chefs heavy-handed with the salt shaker, but the portions tend to be huge, too. A rack of baby back ribs (not even counting the sides) from your local barbecue joint can pack nearly two day’s worth of sodium.

You can start by cutting out the obvious things – like salty snacks, canned soups, and heavily processed foods. Read labels at the store, and look for low sodium versions of packaged foods, like beans, tuna and vegetables. Preparing more foods from scratch can make a huge difference, too – not only can you control the salt, but you can make dishes taste even better by seasoning with strongly flavored spices, herbs, lemon, onion and garlic.


Don’t let family & friends ruin your healthy diet

A few months ago, I got a call from a long-time patient who hadn’t been in for a while. The last time I had seen her, she was doing so well with her diet and exercise program – she lost about 25 pounds with another 20 to go – that we agreed to loosen the reins between us a bit. So when she called, I expected her to give me the good news that she’d reached her goal. Instead, she asked if she could come back in to see me – and if she could bring her husband.

“You need to talk to him,” she said, “because lately, I feel like he’s sabotaging me. Every time I turn around, he’s bringing goodies into the house. Then last night he told me that he liked me better when I had more meat on my bones!”

No matter what dietary changes you’re trying to make – whether you’re looking to lose weight, lower your cholesterol or keep your blood sugar in check – you’re likely to run into a diet wrecker or two. Maybe your spouse cooks a high-calorie meal (“you’ve got to eat this, I made it just for you!”) or your co-workers entice you (“you’re doing so well, you can come have greasy fast food with us just this once”). Then there are the ones who hint that they liked the “old you” better, often because you are becoming less like them – and more like someone they could only hope to be.

There are all sorts of reasons why people interfere with our efforts at self-improvement. Sometimes the intentions are well-meaning – after all, what better way to show someone you care than to offer up their favorite food? But sometimes there’s a twinge of jealousy, too. While you’re getting fit and healthy, there are those around you who aren’t – and your success is making them look and feel more like failures. A man who sees his partner getting slimmer and stronger may worry that he’ll lose her. So – like my patients’ husband – he might do a subtle sabotage. He’ll tell her he misses eating ice cream together in front of the TV, or that he misses her curves.

I knew from my patient that her husband was carrying a little extra weight himself, so I had them come in for a visit – sort of “what’s good for the goose is good for the gander” approach. Sometimes this works, and sometimes it doesn’t. Bring two people into the same room to discuss a potential hot topic, and you’re never quite sure where it’s going to go. But when it goes well – which it does more often than not – both parties end up with a better understanding of what they should do, and why. It also gives them a chance to talk about the adjustments they each might need to make, and to commit to offering support, not sabotage. And usually, everybody wins. My patient and her husband started cooking together, and he started walking with her every night after dinner. Now she’s almost reached her goal, and he’s feeling great, too.

But it does take a lot of toughening up to deflect some of the sabotage. You can try the subtle approach – “yes, those pork rinds look delicious – maybe later”. When that doesn’t work, you just have to be more direct – “Mom, I love your fried chicken and I love you, but I’m trying to keep my cholesterol down”. Let your co-workers know that you’re the same person you always were, that you’d love to join them for happy hour – and that it would be really, really helpful if they could respect your efforts by not trying to tempt you with hot wings.


Adult picky eaters

Picky eaters can drive parents crazy – kids who demand the same foods day after day, or turn up their noses at foods they’ve never even tried.  But most grow out of it. Every once in a while, though, I’ll run across a grown adult who is as picky as a toddler.  Unlike the rest of us – who have a pretty short list of foods we’d rather not eat – these extremely picky adults have a very different short list, one made up of just a few foods they’re actually willing to eat.  While it’s tempting to just dismiss this – on the assumption that these folks are just choosing to be stubborn and rigid – research is suggesting that there may be other forces at work.

Typically, the food repertoire of very picky adults is so limited that it can actually interfere with their work or social life.  Their food tastes lean towards bland, salty, processed foods – French fries, grilled cheese and vanilla ice cream, for example – and little else.   Fruits, vegetables and spices are almost universally shunned, and their entire diet might be limited to only 10 or 20 foods.  Many say that the majority of foods they’re exposed to are simply disgusting – an unappetizing appearance, texture, color or odor are all grounds for rejection.  Understandably, many extremely fussy eaters try to avoid business functions and social occasions that involve food – which is pretty hard to do -so as to keep their condition under wraps.

I had a client like this not too long ago.  He was a successful investment banker, but business lunches were an absolute nightmare for him.  He wouldn’t touch fish, poultry, salads, soups, or vegetables – and subsisted primarily on bread, rice, well-cooked beef and the one fruit he could stomach – canned pineapple.

Researchers at the University of Pittsburgh and Duke University are trying to better understand this finicky eating, or what they are calling ‘selective eating disorder’.  They’ve set up the world’s first registry for picky eaters, the Food F.A.D. Study (Finicky Eating in Adults), in which participants are logging their eating habits and medical histories into an online questionnaire.  It’s hoped that the information gathered from the nearly 10,000 registrants to date will shed some light on an issue that, for now, remains pretty murky.

It’s not clear whether extreme food pickiness is psychological in nature, or physiological, or a combination of the two.  It’s possible that finicky eaters might perceive flavors, odors or textures differently, since so many are deemed inedible based on odor or texture alone.  In some cases, food allergies or swallowing problems seem to be at the root.  Or, extreme pickiness could be a form of food phobia.  Some persnickety eaters say that many foods simply don’t look like food to them – a plate of spaghetti may just as well be a plate of worms.

At this point, research has yet to account for the basis of extremely finicky eating.  And until it’s better understood, the best we can do is to try to help picky adults get over their extreme fear of new foods.  And it’s a slow, stepwise process.   I finally convinced my client to try a piece of fresh pineapple – which he did – but whether he’ll ever actually like it is yet to be seen.