Want to double your weight loss results?

Researchers followed more than 2,000 dieters who were encouraged to record meals and snacks.  The single best predictor of whether a participant would drop weight was whether the person kept a food diary.  It trumped exercise habits, age and body mass index.  The number of pounds people lost was directly related to the number of days they wrote in their log.  Significantly, a trend was identified which showed that keeping a food diary can double a person’s weight loss.

6 Tips for Successfully Measuring and Tracking

Write as you go. Don’t wait until the end of the day to record what you ate and drank. Keep the tracker in your purse and make a habit of jotting notes right after you eat. If you wait until the end of the day, it is too easy to leave things out.

Focus on portion size. Practice at home with measuring cups, measuring spoons, and food scales. The measuring cups will help you learn what a one-cup portion looks like (it is a lot less than you think). Weigh and measure your food right after it has been cooked.

Be honest. Include every single bite, lick, and taste (anything larger than a crumb counts). And don’t forget to keep track of your sips. The rule is: You bite it – you write it.

Don’t skip your indulgent days. Keep records especially on days when you are tempted to overeat. What gets measured tends to get changed.

Cook at home, whenever possible. You will have more control over what you consume, and you know what that food contains, and how much of it you are eating. That makes for a more accurate food monitoring.

Use whatever tool or method that works for you. Greenlite Medicine provides you with a tracker that has been proved to be very useful to many of our clients. But there are other options: the PDA, a web-based food counter (such as the free USDA MyPyramidTracker.gov) or a tracking application on your Blackberry or iPhone. It doesn’t matter what method you use. What matters is that you use it.

So you think you are hitting a plateau or can’t lose the extra weight? Think again. According to scientific evidence, as well as the accumulated experience of Greenlite Medicine’s health educators, most people can lose weight if they have the right tools and support. Food tracking in conjunction with a weight management program is the ideal combination of tools and support.

“Tomorrow is often the busiest day of the year.” –Spanish Proverb. This is especially true if tomorrow is New Years Day. Once again, you have resolved to do whatever it takes to lose weight. In fact, this may not be the first time you’ve made this resolution. So how will this time be any different? This time, you are going to take the time to plan by following these powerful and effective goal-setting techniques.

Why set goals?:  The act of intentionally setting a goal begins the process of change. Goals give you organization and direction as well as providing a baseline for evaluating your efforts. Goals hold you accountable and help you keep your word to yourself. They also provide motivation and keep your attention focused on the desired outcome. There are four steps to successful goal setting:

Establish your goal: It’s time to get clear on your outcome; it must be something that you can realistically accomplish. How will you know when you’ve reached your goal? For example, “I want to lose weight” is a good goal, but “I want to lose 20 pounds or run 3 miles or reduce my body fat by 15%”, is much more specific and measurable. Next step is to write down your specific goal. The power behind writing down your goals is to give you a road map to follow and a great way to help engage your subconscious mind. Read it daily and keep it posted where you will see it several times a day. It will help to keep you motivated. Always state your goal as a positive outcome to reinforce your desired goal. For instance, “I will eat a healthy breakfast every day”, this statement is much more powerful than “I won’t forget to eat in the morning”. Lastly, set performance goals based on changing your daily habits and behaviors rather than goals based entirely on the outcome for example, eating dinner at the table instead of in front of the television as opposed to only focusing on what the scale says.

Identify the benefit:  Ask yourself “why” you want to change. How will your life be different or better once you have achieved your goal? What will your life be like if you don’t succeed or even try to make this change? What will your life be like if things stay the same or get worse? Identifying all of the reasons why you want to make a change is a great way to keep you going when times get tough.

Develop a plan: Turn your goal into specific behaviors. What specific actions will you take? How will you organize your time and prioritize your actions? What do you need that you don’t have? How will you be accountable for your actions? Get a support team! Why is accountability to someone other than yourself so important? By telling another person about your intentions, you are publicly stating your commitment to achieving your goal. You are taking responsibility for your success. If you know someone will be asking about your progress you are more likely to stay on target.

Evaluate and review your progress: What are your obstacles? Make a list of things that have been challenging and begin to create a strategy for managing these challenges in the future. If you are having trouble with an obstacle, then find out who and what your resources are and ask for help. Lastly, decide on little rewards to give yourself at regular intervals along the way for each of your successes.

If you are ready to change, using these goal-setting techniques can help you clearly identify the behaviors that will guarantee your success. Take the time to visualize how you want to feel at this same time next year. Practice changing the behaviors that are keeping you unhappy and unhealthy. Finally, be willing to make small adjustments along the way until you are living the life you truly deserve. As Mark Twain said, “Each one of us has the substance within to achieve whatever our goals and dreams define.”

One in three Americans could develop diabetes by 2050, unless a significant dent is made in the obesity epidemic, according to the latest Center of Disease Control and Prevention (CDC) projections.

We are often asked many questions about diabetes, such as “If diabetes runs in the family, will I develop diabetes, and is there anything I can do to prevent this?” If I have pre-diabetes, does this mean I am going to be diabetic?” “If I have diabetes, can I reverse my condition?” Can anything be done to change this outcome?

Let me share a story about two of our clients, which may provide insight to the questions, but first, let me share a few facts.

Overweight and obesity is one of the strongest risk factors for developing diabetes.  Almost 90 percent of people with Type 2 diabetes are overweight. If you have a Body Mass Index (BMI) of 30, the relative risk of developing diabetes is 10 times higher if you’re a man and 30 times higher if you’re a woman, when compared to having a normal BMI. 

During the 1990s, the number of Type 2 diabetes among American adults jumped by a third due to the growing prevalence of obesity and extra weight in the United States population.  Because obesity and diabetes often go hand in hand, a new term has been coined to describe America’s current healthcare crisis: “the diabesity epidemic.”

The good news is Type 2 diabetes is largely preventable.  Weight loss and increasing physical activity can make a big difference in terms of keeping or delaying people with pre-diabetes from getting Type 2 diabetes.

Studies, including the CDC’s Diabetes Prevention Program (DPP), have found that lifestyle changes can prevent or delay the development of diabetes by close to 60 percent when measured at four years.  The DPP program focuses on reducing body weight from five to seven percent  by emphasizing dietary changes and by gradually building up to 150 minutes of physical activity per week. The program also focuses on developing behavioral and coping strategies to help deal with issues that cause people to backslide.  (Sounds a little like what we do at Greenlite Medicine!) 

Managing your weight is the best thing you can do to prevent the development of diabetes.

Meet Greg Melton

Greg had been diagnosed with diabetes for 10 years, but one day, his doctor informed him that his diabetes pills were not enough to control his condition and that he was going to need insulin.  Fear struck home and Greg called Greenlite Medicine.  One hundred pounds lighter, Greg now has a fasting blood sugar of 90 with an HgA1C below five (normal range) off medication!  He feels wonderful and liberated.  He continues to come to the Greenlite Medicine Mountain View or San Jose clinics for his maintenance visits and is an inspiration to all of us aspiring for a healthy lifestyle.

When askied if Gred had anything to add, Greg stated, “I am very grateful to Greenlite Medicine for giving me a new start in life and a future of good health.”

Meet Peggy

Peggy just started her program this month with Greenlite Medicine.  She was taking three diabetes medications and was going to require insulin.  Her motivation for making a change came from watching her sister-in-law – who is also obese and suffers from diabetes – endure pain from the complications of poor wound healing related to diabetes after a recent surgery.  She did not want to have a similar situation happen to her.   To date, Peggy has lost about 10 pounds and is off one of her diabetes medications. She’s also reduced her other dose in half!  She reports feeling more energized and hopeful.

So, YES, managing your weight not only helps you prevent diabetes, it can also help improve your diabetes management, and possibly even reverse it!

By Allison Helms D.O. and Sooji Rugh, M.D.

What are Omega-3 Fatty Acids?
Omega-3 and omega-6 are types of essential fatty acids, which means our bodies cannot make them on our own and we have to obtain them from our diet. Both are types of polyunsaturated fatty acids (PUFA) that differ from each other in their chemical structure.

Where Omega-3 is Found in Our Diet
There are few sources of omega-3 fatty acids, mainly the fat of cold water fish such as salmon, sardines, herring, mackerel, black cod and bluefish. There are two critical omega-3 fatty acids (eicosapentaenoic acid, called EPA and docosahexaenoic or DHA) that the body needs. Vegetarian sources, such as walnuts and flaxseeds, contain a precursor omega-3 (alpha-linolenic acid called ALA) that the body must convert to EPA and DHA.

Omega-6 fatty acids are found in refined vegetable oils such as soy oil used in most snack foods, cookies, crackers and sweets, as well as in fast foods.

Why Western Diets Need Omega-3
Humans evolved on a diet with the ratio of omega-3 fatty acids and omega-6 fatty acids being 1/1, whereas today this ratio is 10/1 to 20-25/1 with excessive omega-6.  Western diets are deficient in omega-3 fatty acids and have excessive amounts of omega-6 fatty acids. The typical ratio seen in a western diet promotes the development of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases. Conversely, if there is an increase in omega-3, thus reducing the ratio of omega-6/omega-3, there is reduction and suppression seen in many chronic diseases.

For example, in the secondary prevention of cardiovascular disease, a ratio of 4/1 was associated with a 70% decrease in total mortality. A ratio of 2.5/1 reduced rectal cell growth in patients with colorectal cancer, whereas a ratio of 4/1 with the same amount of omega-3 PUFA had no effect. The lower omega-6/omega-3 ratio in women with breast cancer was associated with decreased risk. A ratio of 2-3/1 suppressed inflammation in patients with rheumatoid arthritis, and a ratio of 5/1 had a beneficial effect on patients with asthma, whereas a ratio of 10/1 had adverse consequences.

How Omega-3 Helps Weight Loss
In addition to the impact of omega-3 PUFA on cardiovascular mortality, EPA and DHA have been shown to impact obesity by improving insulin sensitivity,  reducing body fat and increasing satiety.  Omega-3 supplementation in animal studies has shown positive effects related to the prevention of obesity, as well as increasing and maintaining weight loss. Smaller human studies of shorter duration have also shown evidence that supplementation helps to reduce body fat formation during development, and to reduce fat cells once an individual is already obese.

How Much Omega-3?
The American Heart Association recommends consumption of 2 servings of oily fish per week (about 400-500mg EPA and DHA) for patients without cardiovascular disease. They recommend approximately 1 gram of EPA and DHA, ideally from oily fish (or supplementation after consult with your doctor), for those with diagnosed cardiovascular disease. For those with high triglycerides, 2-4 grams of EPA and DHA prescribed by a physician are recommended.

Most commercial fish oil capsules generally have 180 mg of EPA and 120 mg of DHA, therefore 3 capsules per day provides the recommended dosage of 0.9 grams per day. Another alternative would be to select pharmaceutical grade fish oil products which may provide more highly concentrated dosages of EPA and DHA.

Choosing Safe Omega-3s
Consumers of oily fish should be aware of the potential presence of heavy metals and fat-soluble pollutants like PCBs and dioxin which may accumulate up the food chain. Fish oil capsules may offer a safer alternative. There are companies, such as consumerlabs.com, an independent testing company, that have tested over 42 brands of fish oil supplements that have passed their criteria for safe levels of mercury and PCBs, with some also tested for dioxins.

For more information about omega-3 and how it can be incorporated into a healthy diet, speak with your Greenlite Medicine Physician or Health Educator.

Sources:
Biomed Pharmacother. 2002 Oct;56(8):365-79.
Exp Biol Med (Maywood). 2008 Jun;233(6):674-88. Epub 2008 Apr 11.
Curr Opin Clin Nutr Metab Care. 2009 Mar;12(2):138-46
Appetite. 2008 Nov;51(3):676-80. Epub 2008 Jun 14

If we want to change the shape and size of our bodies, the first battle is not the bulge, but the brain. The true challenge in adopting a new lifestyle is that we have to change our way of thinking about what we eat or don’t eat, our habits, and the entire weight loss process. Greenlite’s weight loss program is a lifestyle-oriented program, not just for losing, but for living.

The big picture view is that we’re exchanging a high carbohydrate life and/or a high fat life for one with satiating protein and fresh fruits and veggies. This balance of protein and produce along with reduction in calories is used to encourage the weight to drop away.

Included in that big picture view is exchanging a life of unawareness around the food we ingest to one of mindful awareness and attention to what we consume. Through the process of losing weight we begin to know how the food we choose fuels our body, how it makes us feel, and how is serves the larger picture of managing our day to day energy expenditures…and the even bigger picture of long-term health.

So, how does the brain play a role? It is vital in many ways, but let’s just start with an easy one: reframing our thoughts. One of the barriers to managing an ongoing weight loss program can be the way we “frame” the process. If we always think of the process as depriving ourselves, how will we feel about it? You guessed it, we’ll feel deprived.

One of the most scientifically proven psychological approaches to managing our thoughts (and thus the effect of our thoughts on our behavior) is called cognitive behavioral therapy (CBT). Reframing is a basic CBT technique you can use to become more aware of how your thoughts might be making your weight loss more challenging than it needs to be.

Don’t overthink this part, just begin to notice the “tapes” you play in your mind about different scenarios. Look for opportunities to change the thoughts that might be automatic.

For an easy starting point, begin to notice what you think about:

-Planning your meals and snacks

-The foods you eat

-The foods you try not to eat

-Your decision to find different ways to balance your intake

-Being on a restricted plan as part of the weight loss phase

Often, the keys to what we need to change in our brains will appear as the reoccuring themes in our “judgements”. This is the stuff that goes through your mind such as – I like, I don’t like, this is good, this is bad, I’m good, I’m bad, this is enough, or it’s not enough. Taking the time to get at those thoughts and then reframe them will be as vital as seeing the the number on the scale go down.

Additional pointers:

Do you think, “I have to restrict my intake because I can’t manage my weight healthfully?”  If so, try changing that thought to: “I have taken important steps to manage my weight with the support and direction I need—I am setting myself up to succeed.”

Do you think, “There is something wrong with me that I haven’t gotten this right to this point in my life?”  If so, try changing that thought to: “I am continually learning from my thoughts and actions; I am working on making positive changes toward health goals, including weight loss and overall health.”

Catching ourselves in the act of self-sabotage via destructive thinking and proactively making changes in those thought patterns is one of the fastest ways to realize our health and fitness goals.  Take it one day at a time and the brain can become your strongest ally in the weight loss process.  Just start by noticing your thoughts. Be mindful of assumptions and judgments and how they make you feel.  Good luck!

Written by Rochelle Adams, Greenlite Health Educator

Holly is our newest Health Educator at Greenlite Medicine. She is a certified personal trainer, Health and Weight Loss Coach and Nutritionist! With all of these certifications she is quickly becoming a favorite among our patients. Her wealth of experience makes her a natural fit for Greenlite.

When she isn’t working Holly can be found walking her dogs at the beach, working in her art studio, taking photos or going to hockey games. She is a big Sharks fan! She is a woman of many talents and also knows how to spin yarn and weave fabric.

She was drawn to Greenlite because she believes that accountability is the biggest key to success. She is passionate about talking with all of her patients to help them unlock, as she puts it, “the why”. Holly feels that when patients can talk openly with their educator they can unlock not only their inner motivation, but also the reasons for their bad habits which will then help patients learn how to correct them. Holly believes that this is what makes Greenlite a successful program. She looks forward to helping many more patients improve their health and happiness!

Our patients all know that we offer supplemental injections of the vitamins B6 and B12, but many probably don’t know exactly what these vitamins are used for. Below is a description of the vitamins and what benefits they can offer you. If you have any questions please be sure to ask us at your next visit!

B6 – (pyridoxine)  is a water soluble B vitamin involved in more bodily functions than almost any other nutrient. It affects both physical and emotional health, but cannot be stored by the body. It is excreted in the urine, and the recommended daily allowance in adults is 2 mg/day, and even more is required for pregnant and lactating women. In fact, the human body requires B6 for the proper function of more than 60 different enzymes.  A deficiency can be associated with over 100 different health conditions including heart disease, anemia, autism, asthma, carpal tunnel, diabetes, depression, epilepsy, immunity, kidney stones, morning sickness, osteoporosis, and PMS symptoms (especially food cravings, water retention, and hormonal imbalance).

Signs and symptoms of Vitamin B6 deficiency are characterized by depression, glucose intolerance, anemia, cracking of the lips/tongue, seborrhea (dandruff) and eczema, convulsions, and impaired nerve function, particularly brain function and the synthesis of our RNA and DNA. B6 is also crucial for the production of hydrochloric acid, which is essential for digesting food by breaking up fats and proteins. Hydrochloric acid also destroys ingested bacteria and other microorganisms. Adequate hydrochloric acid is necessary for proper absorption of protein, calcium, vitamin B12 and iron). B6 can also promote a better weight loss by its mildly stimulating effect on the thyroid.

B6 can be depleted by FD&C yellow#5, medications such as theophylline, dopamine, isoniazid, penicillamine, antidepressants, the diuretic hydralazine, and especially birth control pills or hormone replacement therapy. Other conditions that can increase the risk of B6 deficiency include alcoholism and high protein diets (considered 25-35% of daily calories, rather than 10-15%).

Some common food sources of B6 include chicken, eggs, meat, spinach, nuts and seeds, brussel sprouts and cauliflower.

Note: B6 is one of the few water soluble vitamins that may become toxic if consumed in extremely large dosages (over 1000 milligrams a day) for extended periods of time.

B12 – Cobalamin, another B vitamin, is a bright red crystalline compound because of its high content of cobalt.  It is the most chemically complex of all the vitamins, and due to the interestingly striking dark red color of its crystals, vitamin B12 has been called “nature’s most beautiful co-factor.” It is also considered special because even though it is water soluble, it can be stored in the liver for many years.

It works directly along with folic acid in many of the body’s processes particularly preventing anemia and regulating red blood cell and iron utilization.  It is also involved in the synthesis of DNA, and the insulation sheath (the myelin sheath) that surrounds nerve cells and speeds the conduction of the signals along the nerve. This vitamin is also required for proper digestion and absorption of the food we eat, as well as cellular longevity. It  prevents nerve damage, maintains fertility, and because of the protection of the myelin sheath, promotes normal growth and development of the nervous system. B12 is strongly linked with acetylcholine, a neurotransmitter which assists memory and learning, and B12 may also assist in enhancing sleep.

The recommended dietary allowance of B12 is 2.4mg per day in adults, and more is required in pregnant/lactating women.  Vitamin B12 is bound to protein when ingested, therefore hydrochloric acid and gastric protease in the stomach are required to release the free form.  The free form of B12 is found in fortified foods and supplements, but must combine with intrinsic factor (produced by cells in the stomach) before it is absorbed. B12 injections provide higher available serum concentrations, and have been found to improve energy, help the body’s ability to fight stress, protect immunity, improve peripheral neuropathy, and even support thyroid function to help regulate energy.

Studies have shown that older adults, vegetarians, those who have undergone gastric surgery, those with pernicious anemia (lacking sufficient intrinsic factor), and those with gastrointestinal disorders such as Celiac disease and Crohn’s disease are at greater risk for B12 deficiency. In addition, drug interactions that can lead to B12 deficiency include proton pump inhibitors (ie omeprazole), H2 blockers (ie ranitidine), chloramphenicol, and metformin. It is recommended that B12 levels be checked periodically if you are taking these types of medications, and this should be discussed with your doctor. In addition, some studies indicate that taking calcium supplementation improved B12 absorption while taking metformin.

Common food sources include: eggs, seafood, milk, low-fat cheese and meat. Fortified cereals and yeast products can also provide B12 sources for vegetarians.

Note: All vitamins work together like an orchestra so take your daily multi and calcium (women) too! They are just as important. 

Written by Greenlite Educator and Certified Nutritionist Elaine, and Greenlite staff physician Dr. Allison Helms.

Do you snore at night? Do you wake feeling like you need a nap already? Having trouble concentrating at work? If you answered “yes” to these questions, it is possible that you may have sleep apnea. Sleep apnea is defined as being central (caused by the central nervous system), obstructive (caused by collapse of the upper airway), or mixed (caused by a combination of both central and obstructive). As many as 12 million Americans are affected by sleep apnea, but many individuals do not get evaluated for treatment. This is due to many factors which include under-recognition of the disorder, as well as the assumption that sleep apnea is only found in obese middle aged men who snore. It is important to realize that up to 1 in 5 adults have mild sleep apnea, while 1 in 15 suffer from moderate to severe. Not only does untreated sleep apnea negatively effect job performance and increase car accidents, but it can lead to health problems such as heart disease, stroke, insulin resistance, weight gain, impotency, and headaches.

The most common form of sleep apnea is obstructive, and the most common symptom is daytime sleepiness. Questionnaires such as the Epworth Sleepiness Scale and the STOP BANG questionnaire (Snoring, Tired, Observed Apneas, High Blood Pressure, BMI >30 kg/m2, Age, Neck Circumference, male Gender) are highly sensitive for OSA, but the only way to confirm a diagnosis is with a sleep study, or polysomnography. This can be done through a home study or at a a sleep center, and can identify the most effective type of treatment for the individual. OSA is defined as greater than 5 events per hour with an effect on daytime function or symptoms. Risk factors include male gender, age over 40, obesity, a family history of sleep apnea, a recessed chin, a neck circumference of greater than 17 inches if you are a male and greater than 16 inches if you are a female, and tobacco or alcohol use. Important facts to consider are that the prevalence of OSA increases with age independent of weight, and that although weight loss helps the severity of the disorder, it may not completely resolve. There has also been more awareness of sleep apnea in recent years, but in the Wisconsin Sleep Cohort Study, it was estimated that as many as 93% of females and 82% of males with moderate to severe sleep apnea are undiagnosed. What is also alarming is that the risk of depression doubles in patients with mild OSA, and almost triples in patients with moderate or severe OSA.

In addition to cardiovascular risks caused by OSA, metabolic consequences occur that can be independent of weight. These consequences arise from poor quality of sleep, but also from increased sympathetic tone from frequent arousals. OSA increases both insulin and cortisol production, which leads to glucose intolerance and insulin resistance. The hormones leptin and ghrelin also become imbalanced, leading to down regulation of satiety and hunger, which in turn causes an imbalance of fat metabolism. Fat storage increases, while the utilization of it decreases, causing more weight gain and worsening OSA.

Sleep complaints can be very challenging for patients and their doctors, but if you suspect that you may have the symptoms of sleep apnea, it is extremely important to address it as soon as possible in order to prevent devastating consequences such as diabetes, heart disease, and stroke. Questionnaires and resources are available online to help as screening tools, and will aide in the discussion with your doctor. There are also various treatment options, depending on an individual’s exam, as well as degree of impairment.

Written Dr. Allison Helms

Summer is a wonderful time of active days and relaxing vacations.  There is so much to be said about the restorative power of a vacation (short or long!).  Getting away can make us grateful for what we have in our life, inspire us to make changes upon returning back home, and remind us of how wonderful it is to de-stress and enjoy family and friends.

All that said, it can be challenging to maintain efforts around planning meals and snacks when we are away from the home front. You have worked hard to stay healthy and lose weight, so consider the ways in which you can prevent yourself from slipping while you enjoy your vacation.

1) Keeping your goal top of mind: Before leaving, revisit your weight-loss goal and imagine yourself a week after your vacation. Are you feeling relaxed from your getaway, or stressed that you gained weight?  Place a small note with your goal weight on it in your wallet to remind you that you are moving in that direction.

2) Stay fit while you explore your vacation spot: From renting bikes and enjoying walking tours, to swimming and other adventures, there are lots of ways to burn calories and keep your energy up while enjoying vacation.

3) Plan ahead for snacks: Food that fits your dietary and weight loss plan may be hard to come by at times (like at the airport). Try to plan ahead and pack appropriate snacks and get plenty of water to have on hand (stay hydrated!).

4) Plan unique activity “rewards” instead of food rewards: Fun and unusual experiences will give you a dopamine lift that elevates our mood. Feeling good makes it so much easier to stick to your goals!

5) Do enjoy some treats, but keep it in check: Vacation is a huge reward in itself, but exotic flavors and old favorites (like a good ol’ trip to the ice cream parlor) are part of what makes life sweet. Share treats with your loved ones, but plan ahead to burn those calories so you can do so guilt free!

These are just a few of the ways you can plan ahead and stay active while enjoying vacation. When you get back, you’ll have lots of energy and you’ll be thankful you are marching toward your goal weight!

Written by Rochelle, Greenlite Educator