It’s nearly March. Do you know where your New Year’s weight loss resolution is?
For many, the effervescence of New Year’s Eve has fizzled and the promise of a diet that will really stick and a weight loss plan that will make us svelte has been swallowed up by February’s doldrums.
By all appearances, Marin is one of the healthiest places around – with our endless walking trails and near-daily farmer’s markets. But they sell Krispy Kremes here too. We are not immune.
Thirty percent of Marin women and 58 percent of Marin men are overweight or obese, according to the Marin County Department of Health and Human Services. Thirty-four percent of Marin’s children ages 2-17 fall into this risk group. (More than half of the adults in California are overweight or obese, and more than two million are diabetic, according to a UCLA Center for Health Policy report.)
Why is dieting and healthy weight maintenance so difficult? What makes us fall off the wagon, and how do we climb back on and stay there? The answer, according to local experts, may be not to diet at all.
The Greek root of the word ‘diet,’ diaita means ‘to live ones life,’ says Sean Bourke, MD, Co-founder and CEO of the Jumpstart Medicine weight loss clinic. And living means enjoying a balanced life that includes the satisfaction of eating well.
“Dieting is a form of starvation and actually triggers overeating,” says San Rafael-based nutritionist Susannah Wallenstrom. And diets – whether the popular Atkins or South Beach versions or kooky trends like the Cabbage Soup diet or Baby Food diet, briefly popularized by Jennifer Aniston -- ultimately leave people feeling deprived. “Research shows that most diets fail, leaving people feeling like failures,” says Wallenstrom.
Eat to Live
Diet should be a lifestyle, which means that you transform your behavior and establish a way to live, says Bourke. “The only realistic way to do this is through a holistic approach.” While weight loss comes from diet, long-term maintenance comes from diet, exercise and behavior change, particularly the latter, according to Bourke, whose program promotes a range of healthy behaviors and daily living routines.
One of the first steps, says Wallenstrom, is to make gradual goals that you can live with. If you are trying to lose weight, a half pound to a pound a week is sustainable. She offers three jumping off points:
1. keep a food diary on paper, online or on your phone (she suggests an iPhone app called Lose It!).
2. make a plan and follow it.
3. keep active.
Twenty Minutes a Day
We have an increasingly sedentary, automated society, laments Bourke; yet weight maintenance requires daily physical activity. The key here is to find things that are easily incorporated, enjoyable and sustainable.
“We are so fortunate to live in a climate where we can enjoy the outdoors most days of the year,” says Wallenstrom. “There are endless opportunities to hike, bike, or do whatever activity makes you happy. The key to staying active is finding something you enjoy or you won’t do it.”
Ideally, include a 20-30 minutes of daily vigorous activity that breaks a sweat. This can include a gym workout, brisk hiking, running, dancing, or chasing your kids around the park. At work, use your lunch break to climb the office stairs or walk briskly around the block. Burke recommends a TRX suspension training program, “because it can go anywhere with you.” (Find more ways to healthfully move around Marin through Marin Trails, Safe Routes to School and the Marin County Nutrition Wellness Program.)
Shop the Farmers' Markets and the Periphery of the Grocery
Both Bourke and Wallenstrom advocate learning to navigate the grocery store and the near-daily farmers' markets we have here, as opposed to purchasing pre-packaged diet meals.
You can visit a farmers' market on most days of the week and shop for amazing seasonal fruits and vegetables, says Wallenstrom. “I know people get tired of hearing ‘eat more fruits and vegetables,’ but their high nutrient, high fiber, low calorie content is truly the best thing you can do for your health.” Make half your plate vegetables at lunch and dinner and enjoy at least 2-3 servings of fruit/day, she says, “and you are on your way. Take advantage of our locally grown produce. It doesn’t get much better than the Bay Area!”
For instant calorie control and appetite suppression, “shop the periphery of the grocery store,” says Bourke. “The center of the store is full of processed carbohydrates, and these make you want more.” He adds that he doesn’t think carbs are the devil. “There is an educational piece that has to happen before someone begins this process,” he says. “There are a lot of diets out there and a lot of misguided information.”
Bourke advocates that patients moderate carbohydrates, lower trans fat and saturated fat intake (but include good fats such as polyunsaturated and monounsaturated fat). And -- perhaps the holy grail of weight management -- practice portion control.
What the Twinkie Guy Can Teach Us
To drive home the premise that nothing matters more than portion control and pure calorie counting, Kansas State University nutrition professor Mark Haub devised a month-long diet of Twinkies, Doritos, sugary cereals and Oreos. He limited his consumption to under 1,800 calories a day (nearly half of what a man his size consumes in a day) and shed 27 pounds, lowered his bad cholesterol and even reduced his body fat content.
“The Twinkie guy’s project is totally absurd,” says Bourke. “But -- he may be factually correct.” While Bourke clearly does not advocate a junk food diet in any form, he appreciates Haub’s point: we eat too much.
Bourke suggests trying the CDC’s Portion Distortion quiz for a reality check. The messaging here is that if you have an extra 100 calories a day times 365 days a year, that’s 365,000 calories or 10 pounds a year. Five years later that’s 50 pounds.
“We have grown used to and expect more food on our plates, especially when we eat out,” says Wallenstrom. Most meals served in restaurants are enough to serve two or more people! Try splitting with a friend or taking half home.”
What to Do When You Slip
The average American quits a diet in two days, says Bourke. A big stumbling block is a ‘state of deprivation thinking’ that can doom weight control from the start. “You end up saying ‘I can’t live without [name the food] for the rest of my life!’ You set this thing up that is not about sustainability and enjoying food. And then you say ‘screw this!’”
A big challenge that will confront anyone trying to change behavior is the curve ball, says Bourke. A patient might be doing great, "then the husband or wife has an affair, someone loses a job, their teenager is stressing them out. They fall back to primordial, reactive emotional brain and immediately seek a place of comfort, which often comes in the form of food.”
In order to deal with life’s inevitable ups and downs, Wallenstrom advises that people eat regular meals and work to get in touch with hunger and fullness cues as a way to address emotional eating. “And give yourself non-food rewards when you achieve your goals.”
“Starbucks now has a 31 ounce, 230 calorie Trente-sized drink,” says Bourke with some dismay. “It’s so easy to become obese now – you have to make a conscious effort not to. We have to change our perception of what’s right. The Super Size people are not going to do that for you.”
Says Wallenstrom, “Think about it in terms of getting healthy instead of losing weight.”
Susannah Wallenstrom’s favorite healthy menus:
Café del Soul, Mill Valley
Sol Food, San Rafael
Café Gratitude, San Rafael
Insalata’s, San Anselmo
DreamFarm, San Anselmo
Marche aux Fleurs, Ross
Marin County Certified Farmer’s Markets