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

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 

Health, weight and the energy/nutrient density of foods

Have you ever thought of food as medicine?  Well, if you have you're in esteemed company, because Hippocrates had the same thought when he said, "Let your food be your medicine and your medicine be your food." In our so-called modern age, how have we managed to stray so far from this ancient wisdom?  It's a well-established fact that what we eat impacts our health. Yet, for many of us who have access to an abundant variety of foods, often times what we select are foods like a fast food burger and soft drink, that have a higher energy density, but are more nutrient poor (USDA).

World Cancer Research Fund

When it comes to making decisions about what to eat, it's helpful to understand the energy and nutrient densities of foods. You're probably familiar with calories. A calorie is a unit of measuring energy. When referring to food the term kilocalorie is used. A kilocalorie (or kcal) "approximates the energy needed to increase the temperature of 1 kilogram of water by 1 °C" (Wikipedia).  This is important to understand because the nutrient and energy density of foods relates to calories. In general:

• Nutrient dense foods provide more nutrients with fewer calories per unit volume than other foods in the same food group (USDA). Another way to look at it is the ratio of nutrients to calories (energy) a food contains.  
• Energy dense foods  provide more energy with more calories for their volume than nutrient dense foods. At first impression, more energy dense foods may sound healthier, but typically the reverse is the case. Energy dense foods often contain "empty calories" that come from fat and refined sugars making them a less healthy choice (Clemson.edu). Foods that are lower in energy density provide fewer calories per gram than foods with a higher energy density (CDC). 

For example, foods such as candies, desserts and processed foods, are high in energy density and calories, but they are not very nutrient dense. Whereas, foods like fruits and vegetables contain fewer calories for their volume, so they are lower in energy density, but are higher in nutrient density. This is important to note, especially when it comes to weight loss, because for the same amount of calories a person can consume a larger portion of a lower energy dense food (like an apple) and feel fuller for longer than they would if they ate a higher energy dense food (like a doughnut) (CDC). Plus, they would be getting much greater nutritional value from the apple than the doughnut. It's a win/win situation.

When grocery shopping the nutrition label found on prepackaged foods can be helpful in determining its energy content per 100 grams. The World Cancer Research Fund has a useful food energy density calculator here, but as a general rule:

• high energy density (fast food, chips, cakes, cookies, butter and margarine) fall in the 225-275 kcal/100g range
• medium energy density (bread, lean meat, poultry, fish) fall in the 100-225 kcal/100g range
• low energy density foods (cooked grains like brown rice, whole meal pasta, beans and lentils) fall in the 60-150 kcal/100g range
• lower energy density foods (most fruits and vegetables) fall in the 10-100 kcal/100g range

How does the composition of food affect energy density? Three factors play an important role in the energy density of food:

• Water - Adds volume/weight to food, but not calories because water contains 0 kcal/gram. Fruits and vegetables contain a lot of water. For example, grapefruit "is about 90 percent water and has just 38 calories in a half-fruit serving. Carrots are about 88 percent water and have only 52 calories in 1 cup" (Mayo Clinic).
• Fiber - Adds volume and 1.5-2.5 kcal/gram to food, but fiber also increases the time it takes to digest foods and this contributes to our feeling fuller for a longer period of time after eating fiber rich foods.
• Fat - On the other side of the energy density spectrum is fat, which contains 9 kcal/gram.  Fat increases the energy (calorie) density of foods. For example, "one teaspoon of butter contains almost the same number of calories as 2 cups of raw broccoli." (CDC).

Keeping these factors in mind, it's not too difficult to spot a high energy density food.  They are usually high in sugar and fat, low in fiber and water and processed.

Weight loss/maintenance and energy density of foods - Research has shown that eating a diet that is "rich in low energy dense foods like fruits, vegetables, whole grains, lean meats and low fat dairy products helps people lower their caloric intake" (CDC).  However, even though calories consumed are usually lower with this type of eating, typically eating a diet that contains low energy foods doesn't mean skimping on nutrients. On the contrary, veggies and fruits are the superstars on our plates and will provide us with a good heaping of the required daily allowance of nutrients (CDC).

Not only can there be a weight loss/maintenance benefit from eating lower energy dense foods, but there is also strong evidence to suggest a reduction in the risk of certain cancers. In 2007, the UK's World Cancer Research Fund (WCRF) published findings from a panel of 21 of the world's top health experts who reviewed the current scientific research. After 6 years of work they produced the Expert Report. It is the most comprehensive statement "on the links between lifestyle and cancer risk. Because of the thoroughness of the Report and the expertise of the panel, people can be confident that it is the best advice on how to reduce cancer risk that is available anywhere in the world." (WCRF). Although it's been suggested for some time, the science is proving that taking steps toward improving nutrition, increasing physical activity and just generally making a healthy lifestyle a priority will actually help reduce risk for a recurrence of cancer, among other things.

In an effort to increase awareness of the health benefits of eating more fruits and vegetables, the CDC has designated September as National Fruits and Veggies More Matters Month. (Their site provides some useful information, along with a fruits and veggie consumption calculator.) So, it seems appropriate that step one of creating a diet that is low in energy density has to do with, you guessed it, fruits and veggies! 

First step to take to create a diet low in energy density:

Incorporate a larger portion of fruits and veggies into meals.  For many people, purchasing fruits and vegetables can be limited by their cost. The CDC has a helpful resource entitled 30 Ways in 30 Days to Stretch Your Fruits and Veggies Budget. You can find it here. Eating more fruits and veggies is the first step in reducing our diet's energy density because they contain more water and fiber and less fat than other foods.

However, not all fruits and veggies are created equal. The CDC suggests incorporating more cruciferous vegetables.  These include "broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale, kohlrabi, mustard, rutabaga, turnips, bok choy, and Chinese cabbage. Arugula, horse radish, radish, wasabi, and watercress are also cruciferous vegetables" (Linus Pauling Institute). Then rounding out meals "by adding starchy fruits and vegetables, legumes, lean meats and low-fat dairy food.  These foods are important for creating a healthy, balanced diet" (CDC).

The next post will discuss the other steps as well as a few helpful strategies that will aid in creating a diet that is low in energy density and high in nutrient density.  Even though the term "diet" is used, this way of eating is a lifestyle.  The TLC way to weight loss discusses in more detail here the importance of adopting healthy habits, rather than attempting various diets.  Also, dieting is usually associated with calorie counting and hunger.  This isn't the case with eating more low energy/high nutrient density foods. With all the mounting scientific evidence that underscores the importance of healthy nutrition, it seems more critical than ever to get back to thinking about our food as medicine.



Sources
National Institutes of Health
http://www.jacn.org/cgi/content/abstract/23/2/163http://www.ajcn.org/cgi/reprint/72/4/929.pdf
http://www.wcrf-uk.org/PDFs/EnergyDensity.pdf
http://medical-dictionary.thefreedictionary.com/caloric
http://www.mypyramid.gov/steps/nutrientdensefoods.html
http://www.clemson.edu/extension/hgic/food/nutrition/nutrition/dietary_guide/hgic4062.html
http://lpi.oregonstate.edu/infocenter/foods/cruciferous/