Weight loss in middle age (Part 2 of 2)

Weight loss in middle age (Part 2 of 2)

Part 1 of this blog focused on jump-starting a weight loss program and more general tips for losing weight in middle age. In Part 2, the focus of the tips is on eating and eating out.

Practice Volumetrics. Developed by Dr. Barbara Rolls (Ello-Martin et al., 2005), Volumetrics refers to a diet where there is an inverse relationship between the amount of a food you consume and its energy density. In other words, you should consume large amounts of foods that are not calorie dense (e.g. vegetables and fruits), moderate amounts of moderately caloric foods (e.g. whole grains), smaller amounts of calorie dense foods (e.g. cookies), and tiny amounts of very high calorie foods (e.g. candy). As you are not curbing the amount of food you eat, you should feel full and have fewer hunger-triggered binges. Volumetrics amounts to a lifestyle change that is highly sustainable. So, once you attain your weight loss goal, you should not revert to your former eating habits. Instead you should continue to practice Volumetrics throughout your entire life.  This will enable you to keep the weight off and not regain the pounds you worked so hard to shed. For maintenance, you can tweak the amounts of higher calorie food you consume, while weighing yourself often to make sure you stay within your target range.

All calories matter, even on vacation. Celebrations and vacations often involve eating (and even feasting). In the context of a weight loss program a few weeks of unconstrained eating can undo months of dieting. Although a choice to forego dieting during vacations and other holidays/celebrations may be understandable, binge-eating is not the only alternative. Instead, consider how you might enjoy delicious foods during these events without overdoing it. Be choosy when you order foods, and if you order that decadent desert, select something that you really love, and consider consuming a smaller quantity or sharing. Forego high calorie foods that you do not really love.

Severely curtail calories from beverages. Some research suggests that when the body takes in calories from liquids, the satiety mechanisms are different than consuming calories from solids (Shearrer et al., 2016). In other words, you will not feel as full if you drink your calories. Consequently, any weight loss effort should include severely curtailing liquid calories. Happily, several beverages are zero or low calorie including water, seltzer, diet sodas, coffee, tea, and ice tea.

Not everything at the salad bar is low calorie. As salad bars have become more lavish, dishes that are higher in calories are more common. Consequently, obtaining a meal from the salad bar does not mean that it is automatically low calorie. As you peruse the salad bar, note the calorie content of the offerings if they are posted, and as per Volumetrics principles, select larger quantities of the lower calorie options and small quantities of the higher calorie options. If calorie content is not posted, either look them up on line, or stick with larger quantities of greens, other vegetables, and/or fruits available by themselves (without oils, sauces, pasta, cheese, meats, etc).

Beware of buffets. Buffets are enticing as they offer many options. At the same time, the limitless nature of how food is presented can make overeating more likely (Casey et al., 2008; Levitsky et al., 2004) especially if the buffets are “all you can eat” for one price. Other factors that are associated with eating more include larger plate sizes and the presence of other diners. So, if you are eating at a buffet or an event with buffet-style dining, I would suggest first perusing the offerings and then deciding what you really want to eat. Based on the number of selections you want, practice Volumetrics (see above) taking very small portions of high calorie foods and large portions of lower calorie foods.

Mindfully eat sweets and other high calorie foods. Since the 1990s mindfulness meditation as a therapeutic practice has become more popular (Shonin et al., 2015). Mindfulness refers to being focused on present experience, usually incorporating elements of multiple sensations, especially hunger and satiety feelings. To mindfully eat, focus on taste and texture, in an environment free from other distractions (e.g. television; Mathieu, 2009).  By mindfully eating, you are eating more slowly and are also focusing on enjoying the food. This strategy works well for calorie-dense foods such as ice cream. Take smaller bites and swirl the food around your mouth so that your taste buds in different parts of your mouth are stimulating by flavors. If there are lumps of chocolate, try sucking the chocolate morsel rather than biting and swallowing, in order to maximize the flavor experience. By eating more slowly, you are also eating less. And, the increased focus on enjoyment can compensate for the fact that you are eating a smaller amount of a favorite food.

It’s OK to leave food on your plate. Many of us grew up with our parents (or other relatives) encouraging us to eat every morsel we were served. Hearing about the “clean plate club” or the starving children in other countries functioned as intended motivation for consuming the entire contents of our plates even if the portion sizes were excessive. Today, few of us are able to exactly estimate the amount of food we want to eat, so if we have been served (or have taken) too much we are being set up to overeat. In these instances, practice telling yourself that it’s all right to leave food uneaten, and is preferable to overeating.

One restaurant meal equals 2-4 meals. Research has shown that restaurant meal sizes have increased dramatically in past decades (Matthiessen et al., 2003). At the same time, people are eating out at restaurants more than they have in the past. Indeed, some of these meals contain an entire day’s allotment of calories. Even salads can be calorie packed if they have heavy dressing or other calorie dense foods (e.g. breaded chicken, cheese). To maintain weight and still eat out, try 1) sharing an entrée, 2) ordering half, lunch size or children’s portions, and/or 3) taking home at least half your meal. Many restaurants are now posting the calorie content of their meals, which can be an important guidepost for calorie conscious diners.

Beware the pre-meal freebies. Free food available at the table before your meal is served has become standard at some restaurants (e.g. chips and salsa at Mexican restaurants and bread at Italian restaurants).  Usually, people arrive at a restaurant hungry and having this food available (which is usually more calorie dense) can lead to unrestricted consumption. Your best plan of action is to ask your server to remove the bread or chips. However, if it must be on the table, and you have difficulty resisting, try the following: 1) if possible push it out of your reach, 2) forego the butter on the bread, 3) have a greater quantity of salsa (which is lower in calories) than chips, and 4) do not request additional portions.  Moreover, if you do plan to eat these freebies, you should reduce the amount of calories you intend to consume of your actual meal.

Portion size is important. A committed approach to weight loss involves both eating fewer calorie-dense foods and cutting their portion sizes. This may require a more active approach to eating where the portion size of everything you eat is scrutinized. Bagels, muffins, desserts all come in larger portions than they did previously (Young & Nestle, 2003). So, whereas 30 years ago, cutting the amount of “bagel” you consumed meant eating only half, as bagels have doubled in size, today to consume that same quantity, you would need to only consume a quarter! Moreover, regardless of where you are eating, take smaller portions to begin as this can help you to eat less. Studies have shown that the amount you initially have on your plate will affect how much you ultimately eat (Rolls et al., 2002). After you have consumed your initial portion, consider whether you want additional food before you take more.

Eat plants! Fruits, vegetables and plant-based proteins are less calorie dense than more carbohydrate-rich and fatty foods (Wheeler et al., 1996). Individuals consuming a vegan diet were found to consume on average 20% fewer calories than omnivores (Clarys et al., 2014). People placed on plant-based or vegan therapeutic diets tend to weigh less overall by 2.5kg on average (Huang et al., 2016). Furthermore, there are additional health benefits such as an improved lipid profile and reduced risk of other diseases such as Type 2 diabetes and coronary heart disease (Turner-McGrievey & Harris, 2014). There has been a proliferation of plant-based foods available in supermarkets, specialty stores, and at restaurants. Consequently, it has never been easier to shift to consuming more a more plant-based diet, which can enable you to reduce your overall calorie intake.

References

Casey, A.A., Elliott, M., Glanz, K., Haire-Joshu, D., Lovegreen, S.L., Saelens, B.E., Sallis, J.F. and Brownson, R.C. (2008). Impact of the Food Environment and Physical Activity Environment on Behaviors and Weight Status in Rural U.S. Communities, Preventive Medicine,  47, 600-604.

Clarys, P., Deliens, T., Huybrechts, I., Deriemaeker, P.,  Vanaelst, B., De Keyzer, W., Marcel Hebbelinck, M. & Mullie, P. (2014).  Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients, 6(3), 1318-1332. doi:10.3390/nu6031318.

Ello-Martin J.A., Ledikwe J.H., Rolls B.J. (2005). The influence of food portion size and energy density on energy intake: implications for weight management. Am J Clin Nutr., 82(1 Suppl), 236S-241S. doi: 10.1093/ajcn/82.1.236S.

Huang, R.Y., Huang, C.C., Hu, F.B., Chavarro, J.E. (2016). Vegetarian Diets and Weight Reduction: a Meta-Analysis of Randomized Controlled Trials. J Gen Intern Med., 31(1), 109-116. doi:10.1007/s11606-015-3390-7.

Levitsky, D.A., Halbmaier, C.A. and Mrdjenovic, G. (2004) The Freshman Weight Gain: A Model for the Study of the Epidemic of Obesity, International Journal of Obesity, 28, 1435 – 1442.

Shearrer, G. E., O’Reilly, G. A., Belcher, B. R., Daniels, M. J.4, Goran, M. I., Spruijt-Metz, D., Davis, J. N.  (2016). The impact of sugar sweetened beverage intake on hunger and satiety in minority adolescents. Appetite, 97, 43-48. doi: 10.1016/j.appet.2015.11.015.

Shonin, E., Van Gordon, W. &  Griffiths, M. D. (2015). Mindfulness in psychology–a breath of fresh air? The Psychologist 28(1), 28-31.  http://irep.ntu.ac.uk/id/eprint/25968/1/221445_2981.pdf

Turner-McGrievey, G. & Harris, M. (2014). Key elements of plant-based diets associated with reduced risk of metabolic syndrome, Current Diabetes Reports, 14, 524. https://link.springer.com/article/10.1007%2Fs11892-014-0524-y#citeas

Wheeler, M. L., Franz, M., Barrier, P., Holler, H. Cron-Miller, N. & Delahanty, L. (1996). Macronutrient and Energy Database for the 1995 Exchange Lists for Meal Planning: A Rationale for Clinical Practice Decisions. J Am Diet Assoc, 96, 1167–1171. https://doi.org/10.1016/S0002-8223(96)00299-4.

Young, L. R. & Nestle, M. (2003). Expanding portion sizes in the US marketplace: Implications for nutrition counseling.  J Am Diet Assoc, 103(2), 231-240. https://doi.org/10.1053/jada.2003.50027604.