Weight loss success: nutrient dense foods cut calories and control hunger

When it comes to maintaining or reducing body weight, the key to long term success is to choose foods with a low energy density. What is energy density in foods? The Center for Disease Control defines it as “the amount of energy or calories in a particular weight of food.” This is generally represented as the number of calories in a gram (kcal/g). This brings me to the law of thermodynamics, or energy balance equation, which I’ve discussed in a past post here.

Energy balance - Understanding this concept is important to successful weight loss, gain or maintenance.  So, here’s a brief review: if you consume more calories than you burn, you will gain weight. If you burn more calories than you consume, you will lose weight. However, a big caveat: while a calorie is a calorie, the nutrients you consume affects metabolic and hormonal secretions which may cause you to store fat instead of utilize the fat for energy, and vice versa. The types and varieties of food and beverages you ingest effect weight management, but more importantly, they are essential to your total wellness.

Understanding caloric need - Exercise is a variable that increases caloric expenditure and metabolism. In order to determine an estimation of the calories you need to consume to gain, maintain or lose weight, it's helpful to calculate your total daily energy expenditure (TDEE). You can use the calculator found here, which calculates basal metabolic rate (BMR) using the Mifflin-St Jeor equation, and then applies an activity multiplier. It's best to underestimate your acitivity level when using the calculator if you're looking to lose weight because this puts you on the conservative side of daily caloric needs. Then, if you want to calculate how many calories you should eat daily to achieve weight loss at a steady, healthy pace, you subtract 15-20% from your TDEE number. Conversely, if you're looking to gain weight, add 15-20% to the TDEE. It's not recommended that you subtract more than 25% from your TDEE calculation. You don’t want your calorie intake to drop to an unhealthy and unsustainable level.

The amount of calories you eat is important, but not the whole picture in a healthy diet. Good nutrition includes a balance in the macronutrients listed below and the way you accomplish this is in the way you combine the foods you eat in a meal. For example, rice and beans.  These two foods are considered a complete protein when eaten together. If you're a vegan. In general, try to get your total daily caloric intake from a variety of whole foods as follows: 

• Protein: 1 gram per pound of body weight
• Fat: .45 grams per pound of body weight
• Carbs: The remaining number of calories left will be filled with carbs

Nature counts the calories – Back to our discussion of low energy dense foods and how they help with weight loss.  It seems Mother Nature really does know best because “foods with a lower energy density actually provide fewer calories per gram than foods with a higher energy density (CDC).”  Also, low energy dense foods are typically more nutrient dense. Nutrient density is a measure of the nutrients provided per calorie of food, or the “ratio of the amount of a nutrient in foods to the energy provided by these same foods (Nestle).”

So, it’s a win/win situation when you choose low energy/high nutrient dense foods because not only do they contribute fewer calories to the energy balance equation, they also provide greater nutritional value per calorie, which is especially beneficial for our health. These foods are the best of both worlds so to speak. 

Let’s look at a simple example of a higher nutrient/lower energy density food and a lower nutrient/higher energy dense food containing the same amount of calories per serving:   

	Nutrient Dense	Energy Dense
171 calories/serving	2 wedges of watermelon (approximately 1/8 of a whole watermelon)	14 ounces of Dr. Pepper
Nutritional Facts per serving	Calories 171 Calories from Fat 7 Total Fat 0.743g Saturated Fat 0.371g Polyunsaturated Fat 0.371g Monounsaturated Fat 0.371g Cholesterol 0mg Sodium 7mg Potassium 636mg Carbohydrates 43.086g Dietary Fiber 2.229g Sugars 35.286g Protein 3.343g Vitamins & Minerals: Vitamin A 67% · Vitamin C 78% Calcium 4% · Iron 7%	Calories 175 Calories from Fat 0 Total Fat 0g Saturated Fat 0g Polyunsaturated Fat 0g Monounsaturated Fat 0g Cholesterol 0mg Sodium 70mg Potassium 0mg Carbohydrates 46.2g Dietary Fiber 0g Sugars 44.8g Protein 0g

Arguably, it might not seem equitable to compare a beverage with a food, but watermelon is 91% water by weight, so it's not too biased of a comparison. Remember, we are comparing identical calories per serving here. The numbers speak for themselves. If I’m trying to consume fewer calories in an effort to lose weight, watermelon is the better food choice by far. Where’s the Vitamin A and C in the soda? The numbers indicate a lot of sugar, no fiber or protein. The soda simply contains what are referred to as "empty calories" which provide energy, but no nutrition.  So after I drink my soda my body gets an injection of simple sugars and a blast of salt. Ironically, the salt can make me thirsty and this leads me to drink another soda later, but that's for another post!

On the other hand, the 2 wedges of watermelon provide 67% of the daily requirement of Vitamin A and 78% of Vitamin C.  That’s some good stuff! Plus, the 2.3 grams of fiber in the watermelon will help me feel fuller for a longer period of time than the soda, which has 0 grams of fiber. I might even feel full after eating 1 wedge of watermelon. Therefore, I can eat less of this food and decrease my calorie intake while keeping my hunger satisfied for longer than I could with a soft drink. This brings me to my next point, which can be pivotal to weight loss success.

Eat more to lose weight? – Really?! Usually losing weight is equated with starving oneself and eating minuscule portion sizes, right? However, foods with a low energy/high nutrient density typically contain fewer calories per serving than the same amount of a high energy/low nutrient density food and they provide more vitamins, minerals and also phytochemicals. You can read more about phytochemicals and their amazing health benefits here. 

Now, let’s look at another example comparing the nutritional information for servings of an nutrient dense food with a calorie dense food, but of differing calorie content:

	Nutrient Dense Food	Energy Dense Food
Food choice	Kale	French Fries
Calories per serving	1 cup chopped 33 calories	1 medium serving (117 g) 365 calories
Nutritional facts per serving	Total Fat 0.6 g    Saturated fat 0.1 g           Polyunsaturated fat .2 g               Monounsaturated fat 0 g              Cholesterol 0 mg              Sodium 25 mg    Potassium 329 mg            Total Carbohydrate 6 g   Protein 2.9 g Vitamin A 133% Vitamin C 134% Calcium 10%      Iron 5% Vitamin D 0%      Vitamin B-6 10% Vitamin B-12 0%               Magnesium 7%	Total Fat 17 g     Saturated fat 2.7 g           Polyunsaturated fat 6 g   Monounsaturated fat 7 g              Trans fat 0.1 g    Cholesterol 0 mg              Sodium 246 mg  Potassium 677 mg            Total Carbohydrate 48 g Dietary fiber 4.4 g            Sugar 0.4 g          Protein 4 g          Vitamin A 0% Vitamin C 9% Calcium 2%         Iron 5% Vitamin D 0%      Vitamin B-6 20% Vitamin B-12 0%               Magnesium 10%

Once again, the data doesn’t lie. As the above comparison shows, I would have to eat a whopping 11 cups of chopped kale to equal the amount of calories I would consume in a medium serving of fries! If I’m trying to lose weight, the good news is that I can eat more kale while consuming far fewer calories than I would if I were to eat the French fries. This means I will feel fuller for a longer period of time. I’m also fueling my body with less unhealthy fats and far more nutritional value. Like I said before, it’s a win/win.

Move over vegetarian, I'm a nutritarian -  So are you ready to transition to a nutritarian diet which is eating more low-energy/nutrient dense foods? If you said yes, congratulations! You're making a good choice for your health. Are you unsure how to decide which foods to choose? A good starting point to help you in your search to find the most nutrient dense foods is to check out the ANDI guide. ANDI stands for aggregate nutrient density index and was developed by Dr. Joel Furhman.

This is from Dr. Furhman's site: "Adequate consumption of micronutrients – vitamins, minerals, and many other phytochemicals – without overeating on calories, is the key to achieving excellent health. Micronutrients fuel proper functioning of the immune system and enable the detoxification and cellular repair mechanisms that protect us from chronic diseases. A nutritarian is someone whose food choices reflect a high ratio of micronutrients per calorie and a high level of micronutrient variety."

With this in mind, the ANDI guide categorizes whole foods and then scores them on a scale from 1 to 1000 based on an extensive range of micronutrients, including vitamins, minerals, phytochemicals and antioxidant capacities. In addition, Dr. Furhman's original ANDI guide has been updated to reflect a more accurate picture of each food's nutritional qualitywhich now considers certain beneficial phytochemicals, such as angiogenesis inhibitors (i.e. cancer prevention, read more here), organosulfides (found in onion, garlic and cruciferous veggies), isothiocyanates (organosulfur compounds found in cruciferous veggies and are among the most effective cancer-prevention agents known), and aromatase inhibitors (suppress the synthesis of estrogen and thought to aid in the prevention of breast cancer).

The ANDI guide can be a useful tool in your determining healthy food choices, but it isn't the holy grail. I like what Dr. Furham says and I believe his suggestion is the best advice when it comes to choosing foods.  He says: “…nutrient density scoring is not the only factor that determines health benefits… if we ate only foods with a high nutrient density score, our diets would be too low in fat. For that reason we have to pick some foods with lower nutrient density scores.” Also, he notes that if thin individuals or those who are very active ate only foods with the highest nutrient density, they would become so full from fiber that it's likely they would be unable to meet their caloric needs. Remember my kale example above? One can only eat so much fiber. Balance and variety are key to consuming the greatest number and variety of micronutrients.

You may already know that kale is a better food choice than French fries, so if you operate on the simple premise that your diet should emphasize fruits, vegetables, and whole grains and not prepackaged, processed or fast food, you probably don’t need the ANDI guide to tell you where to get the most nutritional bang for your buck. However, if you’re uncertain as to whether or not you’re making the best food choices for your health, the ANDI rankings are a good starting point. 

I really like Dr. Weil's anti-inflammatory "diet" approach and I have incorporated some of his wisdom into my lifestyle as well. I've blogged about the health benefits of reducing the risk for chronic inflammation in an earlier post. Look for more on that in a future post.  In the meantime, I'll leave you with this food for thought:

Sources:

• CDC Low energy dense foods and weight management - http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_energy_density.pdf
• Nutrient Density, Clemson Cooperative Extension - http://www.clemson.edu/extension/hgic/food/nutrition/nutrition/dietary_guide/hgic4062.html
• Food and Nutrition, Nutrient Density - http://www.nestle.com/asset-library/Documents/Library/Documents/Nutrition_Health_Wellness/Food-and-Nutrition-Issue09-Nutrient-Density-Jan2008.pdf
• Sports Science Exchange, Energy Balance and Weight Reduction - http://www.uni.edu/dolgener/UG_Sport_Nutrition/Articles/Energy_Balance.pdf
• Simple Science Fitness, Energy balance and law of thermodynamics -http://simplesciencefitness.com/ 
• Whole Foods Market uses ANDI guide - http://www.wholefoodsmarket.com/healthy-eating/andi-guide
• Nutrient Rich, ANDI Guide - http://www.nutrientrich.com/1/aggregate-nutrient-density-index-andi-score.html

Eating for healing:Where do I start?

Have you heard the expression change begins with the first step? Well, the last post (found here) discussed several strategies relating to eating for healing.  Did you feel empowered enough to try any of them? If you did, than congratulations! You just took the first step toward a lifestyle that promotes wellness.  On the other hand, if you read the post and said, "where do I begin," or, "I can't do this," please don't throw in the towel.  I'm sure you're not alone, because I felt overwhelmed, somewhat intimidated and a little frustrated when I first contemplated the eating for healing information I received. Respect yourself for where you are right now on your path to wellness. Obviously you're on the right road, or you wouldn't be reading this. So, let's get started.

Eating for healing - Let's get started

As I mentioned before, this lifestyle isn't just for people coping with illness. It's for everyone who wants to support their body as it attempts to deal with the daily assaults of living.  All that said, where does one begin? Well, I find it's easiest if I have a meal plan and a shopping list. Here are the main things I consider when planning my menu:

Roberta Larson Duyff "Complete Food and Nutrition Guide"

1. Get colorful - This is so important. There is no doubt that the phytonutrients, (organic chemical substances), found in plants are fundamental to the health of those that consume them (1). That's why it's imperative that we strive to eat a variety of fruits and veggies every day. By doing this you are providing your body with more of the vital phytonutrients it needs for healing.  According to Roberta Larson Duyff, American Dietetic Association, of the thousands of known phytonutrients, only a few hundred have been studied. It has been discovered that each fruit or vegetable has different amounts and types of phytonutrients. An orange, for example, has "more than 170 different phytonutrients" (1). Of the thousands of  known phytonutrients, "more than 2,000 are plant pigments"(1). It's now understood that the colors of the plants reveal a little about their health benefits. You may be familiar with the best known phytonutrients: carotenoids, flavonoids, and isoflavones. The table above outlines what they do and the foods that provide them. 
2. Choose functional foods - Researchers are also beginning to understand that phytonutrients work in concert with other nutrients and fiber in our diets, and as a result effect changes in our health (1). The foods that are capable of doing this are called functional foods because "they may provide a health benefit [or function] beyond basic nutrition" (2). The International Food Information Council Foundation has a useful listing of the top functional foods found here.
3. Buy or grow organic food -  Research shows that organic food contains "substantially higher levels of vitamins, minerals, and phytochemicals than non-organic food" (3). "For example, you would need to eat 4 conventionally grown carrots today to get the same amount of magnesium that you could get from one carrot in 1940" (3).  Organic foods are more nutritious. They also aren't exposed to conventional growing practices that utilize pesticides, herbicides, fungicides and fertilizers.  These chemicals contain heavy metals, like lead and mercury, which have been found in conventionally grown produce. Granted, buying organic can be slightly more expensive than commercially grown foods, but the benefits are definitely worth it. However, if budget prohibits, the Environmental Working Group has compiled a list of what they call the "Dirty Dozen." You can find a list of these foods here. The Dirty Dozen are the top 12 most pesticide contaminated fruits and vegetables in America. It seems prudent to focus on purchasing these as organic. 
4. Select whole foods - What's a whole food? These are foods that are "as close to their whole or natural state as possible" (3).  Examples of whole foods include fresh fruits and vegetables, nuts and seeds, whole grains and dried beans.  Whole foods are free of additives, preservatives, dyes, flavorings and are unprocessed. In addition, because they are in their 'whole' state, whole foods "retain all of the nutrients to properly digest and metabolize themselves" (3).  As a result, we have the potential to get more nutrients when we consume these foods.
5. Eat nutrient dense vs. energy dense foods - If you're eating whole foods, than this is really a moot point, because whole foods are typically nutrient dense foods. However, the point still bears repeating and I dedicated a prior post to this topic here. The bottom line is that eating nutrient dense foods like fruits, vegetables and whole grains aids in weight loss.  This is because energy dense foods like fast foods, cakes, and chips not only have less nutrients and fiber, they also typically have more calories. Obviously when it comes to weight loss, less calories is the goal.  Another down side of eating  foods categorized as being more energy dense is the greater fluctuations in insulin levels. If that's not enough, another negative of energy dense foods is that they also typically lack fiber.  Whole, nutrient dense foods containing fiber provide the added benefits of increasing satiation, as well as aiding with elimination.

What to eat? One week of eating for healing -

Sample Menu
Day 1

• Breakfast -
• hot buckwheat cereal made with homemade almond milk, ground flax, organic mashed apple, dried cranberries, walnuts, fish oil, turmeric and cinnamon; 
• matcha tea (Dr. Weil discusses the benefits of this tea on his website here).
• Lunch - 
• quinoa fiesta salad - made with chopped red, yellow and green peppers, black beans, jicama, grape tomatoes, spinach and cumin seed, with a lime cilantro dressing. I love the variety of colors in this salad and it is very satisfying. Don't let my pitiful food photography put you off. This tastes even better than it looks.
• fruit smoothie - frozen organic cherries, peaches, mixed berries, coconut water, 2 small spoonfuls of vanilla goat yogurt
• Dinner
• Grilled Seared Tuna Steak on a bed of red cabbage, chopped apple, celery, and green onion  with ginger sesame dressing

Day 2

• Breakfast
• Homemade granola (organic oats, pumpkin seeds, sunflower seeds, prunes, raisins, dried cherries and blueberries and nuts) in goat yogurt with diced pear, ground flax and fish oil.
• matcha tea
• Lunch
• leftover quinoa salad on bed of lettuce, sliced apple
• Dinner
• Spinach Frittata
• mixed green salad

Day 3

• Breakfast
• leftover spinach frittata
• matcha tea
• Lunch
• Asian sunshine salad - chopped green cabbage, tangelo, navel orange, mango, cashews, green onion, bok choy, chopped carrots, mixed micro greens and black rice with Asian ginger dressing
• fruit smoothie
• Dinner
• Quinoa polenta vegetable lasagna.  This is my husband's delicious and ever evolving dish. We use organic quinoa polenta found at our local grocery store, but he has made his own organic corn polenta from scratch.  The polenta is the base layer and then you put fresh basil, Mexican oregano, onion, garlic, sliced green or red peppers, heirloom tomatoes, spinach (from my friend's bountiful garden, thanks Ann), diced kalamata olives, and top it with a little goat mozzarella on top. This is a satisfying and tasty dish.
• micro greens salad

Day 4

• Breakfast
• Sweet potato hash with pastured eggs over easy
• fruit bowl
• Lunch
• leftover Asian salad
• piece of fruit
• Dinner
• Chicken soup
• homemade gluten free bread (the best recipe I've found so far for a tender white bread is from the back of Bob's Red Mill's Potato Starch bag, but you can view it here).  It's a bread machine recipe and it comes out consistently tasty.  I substitute powdered goat's milk and brown rice flour.

Day 5

• Breakfast
• Hot buckwheat cereal 
• matcha tea
• Lunch
• Quinoa polenta vegetable lasagna leftovers
• mixed greens salad
• fruit smoothie
• Dinner
• Soba noodle stir fry with shitake mushrooms, bean sprouts, green onions, carrots, celery, bok choy, peas and ginger in a tamari sauce topped with cashews
• dessert of fresh blueberries over coconut macaroons

Making the change
I hope this menu gives you a bit of an idea of how to begin eating for healing.  You can find more ideas, as well as recipes from the Whole Life Nutrition Kitchen site here. Side note: Because I receive food from my local food coop I have found that I make meals based on what is seasonally available.  This is a good rule of thumb. Foods that are grown locally will be fresher and are less taxing to the environment because they weren't shipped from distant places. Having said that, I confess to buying foods that aren't locally grown. 

Tips -

• Plan your menu and have a shopping list
• Make more food at one time- It might seem like a lot of cooking, but I usually make enough to get at least two meals out of what I've prepared and then eat those on days I'm pressed for time or don't feel like cooking
• If you make a pot of soup or a casserole, freeze some for later
• Snacking - I didn't list snacks in my menu suggestions because you may find that you don't want a snack every day.  The foods you're eating are more nutrient dense and satisfying.  However, if you do find yourself craving a snack, one of my favorite snacks is fruit, but when I want something crunchy I pop up some popcorn or I have an organic brown rice cake, spread with almond butter, topped with sliced dates, and sprinkled with coconut on top.  Yum. 

Final thoughts
Change can be challenging, especially if you're dealing with long standing habits. I encourage you to take things slowly. Begin by looking at your pantry.  Clean out what isn't healing. Try making one new dish a week. By the end of 7 weeks you'll have a bevy of eating for healing recipes and you'll have revamped your eating habits too. It's important to note that eating for healing will require an awareness on your part of not only the foods you find nourishing, but also those that make you feel healthier and more energized.  In this case your gut will literally tell you what it prefers. It's important to listen to your body.  Follow your intuition and begin with small changes. As I said in the last post, you really have nothing to lose, except for maybe a few unwanted pounds. Go ahead. Take that first step!


Sources
(1) Duyff Roberta, Complete Food and Nutrition Guide, American Dietetic Association, 2006
(2) International Food Information Council Foundation - Functional Foods PDF http://www.foodinsight.org/Content/6/FINAL-IFIC-Fndtn-Functional-Foods-Backgrounder-with-Tips-and-changes-03-11-09.pdf
(3) Segersten, A. Malterre, T., The Whole Life Nutrition Cookbook 2nd ed., Whole Life Press 2010

Eating for healing: the restorative power of food

It's been a year since a doctor gave me the life altering news that I had a disease. If, at this point you're thinking well I'm not sick, so this post doesn't pertain to me.  Please, consider reading on. Eating for healing isn't just for those dealing with illness. This lifestyle is for everyone who wants to support their body as it copes with disease, or attempts to deal with the daily assaults of living.  This may sound a bit dramatic, but our bodies really are in a state of constant warfare against environmental toxins, aging and disease. Doesn't it seem prudent to give the body a hand with some nutritional weaponry?

                                    Photo by Anna Pelzer on Unsplash

Eating for healing may not be a magic bullet, but research is showing that food and medicine are not distinctly separate domains (1).  This wisdom has been known by some cultures for centuries. In Western society, the trend away from botanical medicines began when two chemists took an herbal analgesic called salicylic acid and synthesized the synthetic drug Aspirin from it (2).  The pharmaceutical industry was born from this progress and has resulted in the ability to entirely or partly replicate many medicinal botanicals.

What are medicinal botanicals?
The University of Minnesota Life Science Foundation defines them as "plants (or substances that come from plants) that are used to treat or prevent disease" (3). To underscore the importance of botanicals in the treatment of disease,  the Biotechnology Center for Agriculture and Environment at Rutgers University states that "natural products continue to make the most dramatic impact in the area of cancer" (2).  This is because "a primary advantage of botanicals is their complex composition consisting of collections of related compounds having multiple activities that interact for a greater total activity" (2). In other words, synthetic compounds just aren't able to replicate what nature provides.


Plant foods as medicine
The European Botanical Forum has a compiled a very comprehensive and informative Compendium of Botanicals that have been reported to contain substances that may be of health concern when used in food or food supplements found here. Also of note, is their discussion of the role of plant food nutrients, as well as the plants' secondary metabolites and their effects on our health.  The following is a quote from their discussion of understanding the benefits to our health of botanicals:

"In seeking to achieve optimum nutrition, for many years attention has been focused on nutrients because their lack in the diet leads to deficiencies with characteristic clinical symptoms. However, the role of other food components in achieving optimal health is now better understood. Most of these food components are from plants which are rich in bioactive secondary metabolites. These are substances produced by the plant in adaptation to local environmental conditions, which, for example in the Mediterranean area, are often pro-oxidative. This requires an adaptive response from the botanical, producing protective bioactive compounds such as polyphenolic molecules. This is particularly relevant for human health because the intake of these plants results in the transfer of those protective compounds to the human organism."

Simply put, research is now beginning to understand that the interactions that occur between plants and their environment result in substances that can have a profound impact on the health of those of us who eat these plants. The researchers from Rutgers articulate this concept in another way:  "Plants must maintain and protect themselves through diverse arrays of complex natural products that they make from the inorganic components of air, soil and water because they lack the flight response. ...Plants can live hundreds of years without succumbing to diseases or predation.  It should come to no surprise that some of the compounds that have enabled plants to survive may also be used to maintain the health and well-being of humans" (2). Wow! This could give an additional meaning to Kermit the Frog's lament of "It's not that easy being green."

Seriously though, my purpose in sharing the above was to underscore the dire importance of including plant foods in your diet.  Having said that, eating for healing is not just about consuming a few more servings of fruits and vegetables a day, although this is definitely a good thing to do for your health. Let's take a closer look at a few of the nutritional strategies that were recommended to me. 


Options for nutritional paths to healing -
First, I'd like to share that when I began considering disease treatment plans, I sought the expertise of many qualified resources. What I'm sharing is the advice of these experts, and it has proven invaluable to me in determining the best course of action for me. Having a team of physicians that will consider and support your desire to choose the best treatment for you is priceless.  If you are dealing with an illness and struggling to navigate through the standard practice of care maze, I encourage you to pursue finding these experts.  They do exist!

My journey led me to an outstanding oncologist and functional medicine doctor who recommended the Comprehensive Elimination Diet, which is discussed in more detail here. In addition, this physician felt it was important to incorporate detoxification measures into my lifestyle (more about this in the post here). Another physician suggested I try the Anti-Inflammatory Diet.  Dr. Andrew Weil also has some excellent info on this program here. I have discovered that many components of these diet strategies overlap and compliment each other. Ultimately, what I found most productive for me was to pick certain components of these diets and combine them into an amalgamation that has become my lifestyle.

I'm ecstatic to say that the results speak for themselves. My annual follow up with the radiologist was so positive it prompted him to ask me about my treatment plan! I've also shared in previous posts that since my husband joined me on my eating for healing journey he has lost over 40 pounds, is healthier and feels better than he has in years. Clearly for us, making the decision to eat for healing has been positively life transforming! So, on to the bottom line. 

 
Key components of eating for healing
Here are the strategies that I feel are critical, along with their supporting elements. It's important to note that the components share many common elements. 

1. Eliminate or limit foods that can cause chronic inflammation
2. Aid the body in detoxification and support liver function
3. Increase foods that have healing properties
• Eat a colorful variety of plant foods - Serving recommendations can be found at the Centers for Disease Control (CDC) Fruits and Veggies Matter website here and you can also read more in my blog post about this found here and here.  
• When possible eat organic foods because pesticides and herbicides actually thwart the production of phenolics. As mentioned above, phenolics are chemicals that act as a plant's natural defense and they also happen to be good for our health. Read more here.
• Limit or avoid foods made with refined grains, like white bread and pasta and eat more whole grains. For now, I have made the choice to restrict wheat because I wanted to make more room in my diet for the nutritional benefits of other grains that I wasn't eating because of my love of wheat.  Ancient grains like farro, quinoa and amaranth, for example, are a few that I'm eating now. The important take away here, is that you want to avoid refined white flour and foods containing this flour because the refining removes much of the grains nutritional benefits, as well as negatively effecting insulin.  More about whole grains here and on insulin below.
• Avoid prepackaged, processed and refined foods. Always choose whole foods.
• Eat low glycemic index foods. This prevents a rapid rise in insulin which can contribute to infllammation in the body.  Check out this website for more info on the glycemic index (GI) of foods. A good rule of thumb: Foods with more fiber usually have a lower GI.
• Liberally use spices that have anti-inflammatory properties. Examples: ginger, turmeric and curry.
• I avoid dairy to reduce risk of inflammation, especially from non-organic sources (lactose intolerance runs in my family), but I do eat some organically produced goat dairy products. 
• Drink plenty of filtered water. 
• Get more Omega 3 in your diet. Western diets are much higher in Omega 6 fats. Research suggests that a 1:1 ratio of Omega 3 to Omega 6 is healthier (5).  Supplement with a quality fish oil and eat more food sources of Omega 3 fats. For example walnuts, ground flax seeds or flax seed oil. Read more about fats here and here.  
• Eliminate partially hydrogenated oils. Check food labels for trans fats and avoid fried foods.
• Reduce saturated fats by cutting back on red meat and full-fat dairy foods.

The University of Michigan's Healing Foods Pyramid is a great visual representation of many of the elements just discussed. You can view the full sized, printable version here.

University of Michigan's Healing Foods Pyramid

The journey back to health and a "new normal" has been a long, winding and rather bumpy road, but as it is with many of life's passages, it has led to greater wisdom and strength. It's important to stress that what I discerned to be the best course of treatment for me does not suggest it is the only path to take. My choice is not better or more correct than any other treatment options.  Only you, along with the assistance of your health care provider, can decide what is best for you. Healthy or otherwise, our bodies can always use the nutritional support that eating for healing provides.

The next post will outline a weekly menu with meal suggestions to get you started.  In the meantime, I encourage you to begin by implementing one of the dietary strategies mentioned above each week, or perhaps you're ready to dive right in and try the Elimination Diet, the Anti-Inflammatory Diet, or the Healing Foods Plan. Go for it! You have nothing to lose, except maybe a few unwanted pounds, and you might even find you have gained renewed health. 

Sources
(1) Pieroni, A., Price, L., Eating and Healing: Traditional Food as Medicine, Haworth Press, 2006.
(2) Barbara Schmidt, David M. Ribnicky, Alexander Poulev, Sithes Logendra, William T. Cefalu, Ilya Raskin, A natural history of botanical therapeutics. Science Direct. - http://mss3.libraries.rutgers.edu/dlr/TMP/rutgers-lib_24171-PDF-1.pdf 
(3) University of Minnesota Center of Spirituality and Healing - http://www.takingcharge.csh.umn.edu/explore-healing-practices/botanical-medicine-0
(4) European Botanical Forum - Benefits of Botanical Foods -http://www.botanicalforum.eu/uploads/Fact%20File%203.pdf 
(5) http://www.ncbi.nlm.nih.gov/pubmed/12442909
Wikipedia - secondary metabolites - http://en.wikipedia.org/wiki/Secondary_metabolite
Wikipedia - bioactive-  http://en.wikipedia.org/wiki/Bioactive
Wikipedia - polyphenol antioxidant - http://en.wikipedia.org/wiki/Polyphenol_antioxidant
Functional Medicine - http://www.functionalmedicine.org/content_management/files/ifm_Comp_Elim_Diet_091503.pdf
Dr. Weil - http://www.drweil.com/drw/u/PAG00361/anti-inflammatory-food-pyramid.html

Am I burning fat? Aerobic exercise & energy use

Now that we have a general understanding of the energy balance equation which was discussed in last week's post found here, let's focus on how this all relates to something commonly referred to as the fat burning zone. You may have seen this zone, along with the cardio zone, illustrated on the treadmills, elipticals or aerobic exercise heart rate charts at your fitness center or gym. These zones are based on aerobic training principles and in theory are true, but in application can be somewhat misleading.

Basic Principles of Fitness Training-

If one of your fitness goals is to lose weight, you might be thinking that the fat burning cardio workout listed on your treadmill is the way to go. However, before we look at the fat burning zone specifically, I want to highlight a few basic principles of fitness training first. In order to put together an effective exercise program we need to address:

1. Overload - Overload is the amount of stress or demand that we put on our body during exercise. In order to improve our level of fitness we need to challenge our bodies during our workouts by increasing our level of effort. The amount of overload effects the level of intensity of our workouts and this in turn influences the improvements in our fitness level. If we work out too easily we are likely to see little change in our fitness level, whereas too much overload can lead to injury or burn out.(3)
2. Progression - The human body has the amazing capacity to adapt to the demands of exercise by improving its functioning. Because of this ability it is essential to make changes to your workout after you notice that the current level you're working at is becoming too easy. This isn't always a simple assessment, nor is it something many people want to do.  We get comfortable with a routine, so it is easy to become complacent.  This is why many people plateau, or find themselves at a point where they see little to no change in their fitness level (3).

Now that we understand two core principles of fitness training, we need to know how to apply them. When putting together a workout we now know that we must consider the amount of overload needed to maintain or improve our particular level of fitness and for a specific fitness component.  In this post, for example, we're looking at improving our cardiovascular fitness level and body composition by doing aerobic exercise. In order to address the progressive overload principles we must consider 4 areas that are represented by the acronym FITT, which stands for:

• Frequency (how often we perform the activity)
• Intensity (how hard we are challenged by the activity)
• Type (mode of activity)
• Time (how long/duration of the activity) (4)

I prefer the acronym FITTER - which adds Enjoyment and Rest into consideration as well. Adherence to an activity is more likely if it is enjoyed. Arguably more important is the balance between exercise and rest. Too much of a good thing is possible with exercise.  Having said that, over training is something I rarely see.  In fact, the opposite is more often the case.

So, at this point you might be wondering what all this has to do with the fat burning zone. Well, what the fat burning zone is referring to is the level of intensity, along with the amount of time an aerobic activity is performed at, and the macronutrient (fats, carbs, proteins) energy sources used by the body to accomplish the task. By the way, if you're curious to know what exactly constitutes an aerobic workout you can read more here, and if you'd like to catch up on our discussion of energy sources from last week you can find that here.  Now, this bring us to the three energy systems utilized by the body during physical activity. 

Physical Activity and the Three Energy Systems-

As discussed last week, in order to function our bodies need energy in the form of food. We get this fuel from the carbs, fats and proteins found in what we eat and drink. However, the amounts of  these macronutrients the body uses for energy vary depending on the type of activity we're performing.

1. For immediate, explosive energy needs the body uses the immediate energy system. This system fuels activities that last for about 10 seconds or less.
2. For high intensity acitivities lasting for about 10 seconds to 2 minutes the body uses the nonoxidative (anaerobic) energy system. 
3. For any activities lasting longer than 2 minutes the oxidative (aerobic) energy system kicks in. (3)
   

It's important to note that the body typically uses all three energy systems when we exercise, or in activities of daily living (3).  "The intensity and duration of the activity determines which system predominates" (3). For example, if you're running late and walking quickly to catch the bus you're using the oxidative energy system. But if the bus pulls up and you need to sprint to catch it, the other systems become important because the oxidative energy system isn't able to supply energy fast enough to sustain this high-intensity effort.

Modified Borg Rate of Perceived Exertion Scale
Image from ACE

Fat Burning Zone and Exercise Intensity-

So, back to the fat burning zone... The wisdom behind this zone is that if you're exercising in a target heart rate range (read more about this here) of between 50-60% of your maximum heart rate (MHR) (4), or a level 3-4 on the on the modified Borg Rate of Perceived Exertion (RPE) Scale shown at left, (more about that here) you will be utilizing more of the oxidative system, which draws more energy from the body's fat stores.  While this is true, it's just part of the picture.

 Let's look at an example taken from research done at the University of Wisconsin at LaCrosse.  "A 160 pound male walks at a pace of 3.5 miles per hour. At this pace 40% of his energy is supplied from fat sources and 60% from carbohydrate sources.  On another day the same subject runs for 30 minutes at a pace of 6.5 miles per hour.  At this faster pace (higher intensity exercise), 25% of his energy is supplied from fat sources and 75% from carbohydrate sources" (7). Clearly, this would seem to validate the theory that lower intensity exercise utilizes a greater percentage of fat for energy.

However... Please hang in there for a little math, because this will distinctly illustrate the key point I'm attempting to make. "At the 3.5 miles per hour pace the subject burned a total of 240 calories during his 30 minute walk. He therefore burned 96 total fat calories (40% of 240 calories = 96 calories). At the 6.5 miles per hour pace, the same subject burned a total of 450 calories during his 30 minute run. Therefore, he burned 112 total fat calories (25% of 450 calories = 112 calories), which exceeds the number of fat calories burned during the lower intensity exercise session" (7). Not only did this study subject ultimately burn more fat calories, but he was able to burn more total calories overall working out at the higher intensity level for the same amount of time.

The bottom line-

Remember the energy balance equation? Calories in = calories out. When it comes to changes in body composition and weight loss, clearly higher intensity exercise is a better zone to shoot for because it burns more calories than the lower intensity so-called "fat burning zone". That being said, it is important to keep in mind your level of fitness. Obviously, if you're just beginning an exercise program you want to start at a lower intensity and build up gradually. This is where the progression and overload we talked about earlier comes into practice.  With all this talk about burning calories, let's not forget the impact that a healthy nutrition plan has on the "calories in" part of the energy balance equation. Armed with these fitness tools and knowledge, you're closer to achieving your weight loss goals and better health. 


Sources
(1) Whitney, E., Rolfes, S., Understanding Nutrition 11th ed., Thomson Wadsworth
(2) http://en.wikipedia.org/wiki/Metabolism
(3) Fahey, T., Insel, P., Roth, W., Fit & Well: Core Concepts in Physical Fitness and Wellness, 6th ed.
(4) IDEA Fit - http://www.ideafit.com/fitness-library/comparing-intensity-monitoring-methods-0
(5) American Council on Exercise (ACE) -http://www.acefitness.org/
(6) American Heart Association on body composition -http://www.americanheart.org/presenter.jhtml?identifier=4489
(7) Wescott, W.,  What is Fat Burning Zone?
(8) Hoeger, W. K., Hoeger, S. A., Lifetime Physical Fitness and Wellness: A Personalized Program 

Should I take vitamin and mineral supplements?

Health weight loss and balanced nutrition - 

Ideally, the calories a person consumes in a day would equal the calories they used for the day.  This calorie balance would help ensure that a person’s weight would remain in a balanced state.  Unfortunately, many of us struggle with using all the calories we get from our daily food consumption and as a result, we gain weight. One of the challenges in weight loss diet planning is reducing the daily caloric intake to a level below what is needed for daily energy requirements, and still consuming all the necessary nutrients needed for good health. If the nutrient amounts from foods in the weight loss diet fall short “subclinical deficiencies” (Whitney, Rolfes, 2008) in vitamins and minerals may result.  Subclinical deficiencies are those where the symptoms of a deficiency are not at a level that is as easily measured or observable by symptoms as are clinical deficiencies (Whitney, Rolfes, 2008). In either case, vitamin and/or mineral supplements may be appropriate and helpful.

Vitamins and minerals are vital - 

It is important to understand how vital vitamins and minerals are to our health. Vitamins are “organic, essential nutrients required in tiny amounts to perform specific functions that promote growth, reproduction, or the maintenance of health and life,” as defined by Whitney and Rolfes (2008). There are a total of 13 vitamins which are classified by whether they are either water soluble or fat soluble.  Regardless of how they are classified, they all play an essential role in our wellness.  To illustrate just how significant vitamins are one only has to look at the “nearly 1.5 million children worldwide” who are blind because of Vitamin A deficiency (University of California at Davis, 2006). We are fortunate because this type of deficiency on a scale like this is rarely seen in the United States.

Unlike vitamins, minerals are inorganic elements.  They are classified as major (greater than 5 grams) or trace, depending on the quantity of the mineral needed and present in the body (Whitney, Rolfes, 2008).  Minerals are just as vital to our health as vitamins.  This is demonstrated by the condition of osteoporosis, which is a result of a calcium deficiency. Clearly, a healthy diet consisting of a variety of nutrient rich foods that provide all the necessary vitamins and minerals is imperative to our health and wellness. 

Nutritional deficiencies - 

Unfortunately, in America and many first world nations, it is more common to see deficiencies of vitamins and minerals occurring not from a lack of food available to eat, but because the foods many Americans choose to consume do not contain essential nutrients.  Prepared, packaged, convenience and fast foods have replaced fresh foods that contain a variety of vitamins and minerals. Over consumption of these types of fast foods, along with a more sedentary lifestyle, has lead to a the calorie imbalance. Many of the calories found in packaged and fast foods can be described as empty, that is not very nutrient dense. Over time, this type of poor nutrition can lead to the subclinical deficiencies of nutrients, as well as obesity and other diseases. 

Most of us trying to lose weight will turn to a diet plan.  Unfortunately, this plan may come in the form of the latest and greatest fad diet being advertised. Who can resist the quick and absolute results that many of these diets claim? There are a multitude of diet books that contain unbalanced diet plans suggesting dieters eat only certain foods and completely limit or omit others.  When dieters base their weight loss plan on these types of diets they can become dangerously deficient in some of the necessary vitamins and minerals, as well as other nutrients that the body needs for optimum wellness. In addition, restrictive diets are often difficult or impossible to maintain as a long term, healthy lifestyle.  Doctors at the University of Southern California agree and experts at the Mayo Clinic also suggest that when it comes to weight loss or maintenance, “focus should be on developing eating habits you can follow for a lifetime.”

An essential key to success in avoiding vitamin and mineral deficiencies when dieting is to consult an expert.  A nutritionist or registered dietitian can plan a weight reduction diet that meets the recommended daily allowance or adequate intake levels of nutrient rich whole foods that will provide a dieter with those important vitamins and minerals needed for good health.  If a low calorie diet is found lacking in some of these nutrients, then the dietetics professional can also suggest which vitamin and/or mineral supplements are needed and at what amounts they should be taken. Getting a professional recommended dose of a particular supplement will help discourage the over consumption of supplements which can sometimes lead to toxic overdose. If consulting a nutritionist or registered dietitian isn't an option, you can also talk with your doctor, or there are plenty of other good sources of information available. Just make sure they are reputable.  Here are a few online references that may be helpful: http://ods.od.nih.gov/,  http://www.hc-sc.gc.ca/fn-an/nutrition/vitamin/index-eng.php, http://www.eatright.org/Public/content.aspx?id=5554, http://www.fda.gov/Food/DietarySupplements/default.htm, www.usp.org. The table below also outlines the dietary reference intakes (DRI's) and daily values (DV's) of nutrients. 

table from Jane Higdon PhD, Linus Pauling Institute

Benefits of whole foods -

The case for getting most of the nutrients we need from eating whole foods continues to get stronger. Experts now understand that the nutrients, vitamins and minerals contained in whole foods often work synergistically.  For example, foods containing Vitamin C also contain something called bioflavonoids. When we eat a food containing Vitamin C we are also eating the bioflavonoids which interact and cooperate with the Vitamin C. This effect found in nature is difficult to replicate with a supplement pill. As a result of our increased understanding of the interactions between the phytochemicals found in our plant foods, experts are suggesting that certain supplements be taken together. This example of synergy highlights why whole foods are preferred over supplements as the best source of vitamins, minerals and nutrients.  Research is continually illuminating the complex interaction of the phytochemicals found in plant foods and their benefits to us when we eat them.  

Yet another point in favor of getting our nutrients from a healthy diet rich in whole foods is the fact that it can be difficult for our bodies to absorb the vitamins and minerals in supplements.  Consider that some vitamins need to be taken with food, while others should be taken on an empty stomach.  There are also vitamins and minerals that should not be taken while eating certain foods or taking specific prescription medications because negative interactions can occur.

Last, but certainly not least, it is important to remember that vitamin and mineral supplements are an unregulated industry.  Supplement manufacturers are not required to prove the safety and effectiveness of what they are selling.  As consumers of these products it’s up to us to become informed and educated about supplements. Of course, there are reputable manufacturers, but buyer beware. The US Food and Drug Administration has a helpful resource to help consumers make informed decisions about supplements found here.

 The bottom line - “all the nutrients we need can come from food, so why not just eat food?” (Whitney, Rolfes, 2008) This isn't to say that supplements aren't without merit. This statement just underscores the importance of choosing healthy, whole foods to decrease the risk of health issues, like overweight/obesity along with nutrient deficiencies, that often result from poor nutrition.  By eating healthy foods that pack a big nutritional punch we can maintain or reduce our weight without the latest and greatest diet craze and expensive supplement pills or drinks.  Nutritional supplements are important, especially in cases where our diet doesn't provide all the vitamins and minerals we need for good health. However, it's important to remember that vitamin and mineral supplements aren't a replacement for eating nutrient rich, healthy foods. Their purpose is simply to supplement where our diet falls short.

We need to eat like our lives depend on it, 

because they do! 

Just a little food for thought.

Sources
D’Adamo, P. (2007). Eat right 4 your type. Retrieved November 15, 2007 from    http://www.dadamo.com/knowbase/newbie/1.htm
Whitney, E., Rolfes, S. (2008). Understanding nutrition. (11th ed.). California: Thomson Wadsworth.
University of California at Davis. (2006). Disease in third world countries: how biotechnology can help. Retrieved November 15, 2007 from  http://cosmos.ucdavis.edu/2006/cluster1_final_projects/IThvedtdisease_in_third_world_countries-4.ppt#256,1,Disease in Third World Countries
http://www.ajcn.org/cgi/content/full/78/3/517S?maxtosh%20ow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=apples&searchid=1%20&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIThttp://images.cnn.com/2010/HEALTH/expert.q.a/01/15/vitamins.absorption.jampolis/index.html
http://www.phytochemicals.info/
http://en.wikipedia.org/wiki/Flavonoid

Can you really eat more and lose weight?

The title of this post seems to suggest the impossible.  How can anyone eat more and lose weight?  Well, the reality is that it all depends on what we eat. As was discussed in the last post found here, if we choose to eat  less energy dense and more nutrient rich foods, than it is entirely feasible to lose weight and improve our health (CDC).  So, let's review step one and move on to the next steps, as well as go over a few helpful strategies for creating a diet that is low in energy density.

Step 1 - Make fruits and veggies the largest portion of your meals. 

This doesn't mean that paying attention to portion sizes is unnecessary. Portions still matter, however, because most fruits and vegetables are full of fiber and water, they generally provide more bulk.  As a result, we tend to feel fuller and less likely to overeat portions of these foods than we would if we were eating a different type of food.  For example, the American Institute for Cancer Research illustrates in the photo below the difference food choices can make when it comes to the amount of food served and calories.

Image from American Institute for Cancer Research

The Centers for Disease Control (CDC) has another way of illustrating the impact that making fruits and veggies a bigger portion of your meal can have on calories.

Fried Chicken Sandwich w/Tbsp. Mayo = 599 Calories

Grilled Chicken Salad with low fat dressing - 2 cups lettuce, 2 oz. grilled chicken breast, 2 tbsp. light
balsamic vinaigrette dressing
= 178 calories

Understanding Calories and Servings - 

At this point you may be wondering how many calories you need daily and how many servings of fruits and veggies you should be eating. Let's take a look at calorie needs first because, "knowing your body's daily calorie needs can be an important first step in adopting a realistic diet and physical activity plan that can help you attain and maintain a healthy weight" (Baylor College of Medicine). In other words, when we have an idea of how many calories we need, we can make more informed decisions about the foods we choose to eat. You can determine an estimate of your calorie needs by using this American Council on Exercise's calorie calculator found here.

Now let's take a look at how many servings of fruits and veggies are currently being recommended. There used to be a blanket recommendation that we all try to shoot for at least 5-7 servings a day. Now, according to the USDA, "the amount of fruits and vegetables you need to eat depends on your age, sex, and level of physical activity." You can find out your individual recommended total daily amounts for vegetables here and the daily amounts for fruits here. at the USDA's Choose My Plate site. Simply put, the current recommendation as of June, 2013, is to fill half of your plate with fruits and veggies.

The Chose My Plate site contains some really helpful information. By sharing all this I hope I haven't given you the wrong impression.  Adopting a low energy, high nutrient density style of eating isn't a burdensome chore of calorie counting and food weighing. Initially, there is a period of adjustment as well as a learning curve, but in no time at all healthier nutrition habits will be formed.

Step 2 - Supplement meals with starchy fruits, vegetables, whole grains, legumes (beans), lean meats, fish and low-fat dairy foods (unless you're looking to go vegan, or vegetarian obviously) to create a healthy balanced diet. 

For example, divide a dinner plate into 3 sections: the largest section would be the area containing vegetables, the remaining 2 sections of the plate could be supplemented with a whole grain and a lean meat. The Cleveland Clinic recommends the following:

• "Filling 1/2 of your plate with non-starchy vegetables like broccoli, carrots and green beans
• Filling 1/4 of your plate with protein foods (3-4 ounces of fish, poultry or lean meat)
• Filling 1/4 of your plate with starchy carbohydrate foods such as potatoes, bread, rice, pasta or starchy vegetables
• Adding a small piece of fruit or 8 ounces of skim or low-fat milk, which are additional carbohydrate choices
• Using 1-2 teaspoons of heart-healthy vegetable oil 

For breakfast, fill two quarters of the plate but not the other half. For lunch and dinner, fill the entire plate."

Image from Cleveland Clinic

Step 3 - Watch your fat intake-

Watch your fat intake, especially saturated fats, and avoid trans fats altogether. Keep in mind, when broken down in the body a gram of fat will provide about 9 kcalories of energy. Compare this with a gram of carbohydrate at 4 kcalories and a gram of protein which also yields 4 kcalories, and it becomes apparent why fatty foods are more energy dense. Also, the type of fat we eat is important. The current wisdom is that when it comes to fat, the unsaturated fats found in foods like olives and nuts are the way to go, but the CDC recommends we consume these occasionally and in small portions.  More information on this is available in the post on fats here and on the omega fats here. Bottom line - fat intake should not exceed 35% of calories and most fats should come from foods that contain unsaturated fat (CDC).

Step 4 - Rarely eat, or be especially careful about portion size of foods with little moisture.  

Remember that less energy dense foods typically contain more water. So foods that contain less water (like crackers, cookies and chips) provide a greater amount "of calories relative to their weight and can easily be over-consumed (CDC)."

A few practical strategies to reduce energy density -

• Reduce fat and/or add water. The CDC has another helpful illustration of this strategy. They replace a cream based soup which contains more fat, with a water and vegetable based broth soup. The result is a more nutrient rich, less energy dense meal. 

Cream-based soup
1 cup mushroom bisque
= 400 calories

Broth-based soup
1 cup minestrone
= 112 calories

• Add extra vegetables to dishes and use lower fat meats and cheeses, or simply substitute lower energy density foods for those that are more energy dense.  For example, instead of 1 cup of ice cream, have 1/2 cup of low-fat ice cream or sorbet, topped with 1/2 cup of fresh strawberries or blueberries (CDC).
• Watch your beverages. Liquid calories are sneaky and can add up. Just consider that a Starbucks grande iced caramel macchiato with 2% milk has 230 calories (Starbucks). 
• Drink water or try eating a low energy density appetizer at the start of a meal.  The CDC suggests a 100 kcal serving of a broth based soup or a green salad and recent studies have shown that drinking a glass or 2 of water before a meal helps also (National Library of Medicine).
• Preparation matters. The way foods are prepared is just as important as the foods we choose to eat. A potato that is baked rather than fried is a good example. Whenever possible fresh fruits, and vegetables are the way to go. Limit juices because these don't contain the fiber that can help with feeling full. Also, avoid fruit and vegetable dips that can add additional calories. Canned fruits without added sugar or corn syrup are ok. Canned vegetables without added salt, or frozen fruit and vegetables without added sauces are also good substitutes.   
• Tip the balance to veggies. Vegetables tend to be lower in calories than fruit so try to tip the balance between the two in favor of the veggies.

Step 5 - Watch out for empty calories-

Image from Livestrong

The USDA has a good explanation of empty calories on their site found here. Briefly, empty calories are usually found in foods that contain solid fats and added sugar. The ratio of nutrient dense/energy dense calories is heavy on the energy. In other words, these foods are usually higher in calories, but contain less nutrients in comparison to their caloric content.  For example, fried chicken - 3 medium fried chicken wings with skin and batter contain an estimated 478 calories of which an estimated 382 calories are empty! Compare this with a 3 oz. roasted chicken breast (skinless) that contains an estimated 138 calories ZERO of which are empty calories. The Choose My Plate site has a chart here that lists a variety of foods along with their empty calorie values. 

So, there you have it. Eating more and losing weight is possible, IF we follow the steps and strategies above.  Armed with knowledge of our calorie needs, the healthiest foods to choose for meals, and by incorporating physical activity into our health plan, we can be successful.  

Note: Anyone with a specific health condition should consult with a health care provider for a dietary plan that is right for them.

Sources
American Institute for Cancer Research - http://www.aicr.org/site/News2?page=NewsArticle&id=19233&news_iv_ctrl=2302
CDC -  http://www.cdc.gov/healthyweight/healthy_eating/energy_density.html
USDA MyPyramid -http://www.mypyramid.gov/mypyramid/index.aspx
University of South Florida Health and Diabetes Center - http://www.health.usf.edu/NR/rdonlyres/41BE75B0-87FD-4536-B563-2C98E1D11C22/0/idaho_plate_method.gif
Cleveland Clinic - http://my.clevelandclinic.org/disorders/diabetes_mellitus/hic_nutrition_basics_for_cchs_diabetes_guide.aspx
Starbucks nutrition data -http://www.starbucks.com/menu/drinks/espresso/iced-caramel-macchiato#size=155347&milk=63
National Library of Medicine - http://www.nlm.nih.gov/medlineplus/videos/news/drink_up_090310.html