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The holiday season, spanning Halloween, Diwali, Thanksgiving, Christmas, and New Year, is a time of jubilation, happiness, and indulgence. However, it can be challenging to maintain your health goals amidst tempting treats and festive feasts. This handout provides tips to help you stay on track with your health goals during this joyful time
A concise guide on senior health and nutrition that I've crafted. This paper delves into the significance of nutrient-dense foods, highlighting their pivotal role in enhancing the well-being of our seniors. By adhering to the principles of the healthy eating plate, seniors can make straightforward yet powerful adjustments to their diet, resulting in substantial improvements in their health.
Want to lose weight but do not know where to start? Looking for something, which can give you long-term or sustainable weight loss results? Are you tired of fad diets, calorie counting, or staying unrealistically hungry? Then there is good news, you can lose weight while eating healthy, nutritious food and without staying hungry. A regular diet high in fiber-rich food is better for losing weight and keeping it off than complex diets or calorie counting. Not only it helps in losing weight, but it also makes you healthier, energetic and reduces the risk of several diseases such as diabetes, heart disease, cholesterol, etc.
Dietary fiber, also known as roughage or bulk, is present only in plant foods so there is no fiber in animal products such as milk, eggs, meat, poultry, and fish. Most of the fruits, vegetables, beans, and whole grains are rich in fiber, but it is mostly concentrated in the skin, seeds, and membranes. That means an apple with the skin has more fiber than a peeled one. Whole grains such as oats, brown rice, and wheat bran have more fiber than processed or refined food like white rice, white bread, pasta, etc.
Fiber is a type of carbohydrate found in most of our food. Our body uses (digests) carbohydrates and gives us sugar (calories), which, we use for doing various activities like walking sitting, cooking, etc., and excess of it, which we cannot use, is stored as fat. Though most carbohydrates are converted into sugar, fiber cannot convert into sugar. Instead, it passes through our intestine undigested without adding extra calories. However, it gives us several good vitamins, minerals that help our body to stay healthy. It helps in weight loss in various ways.
First, it takes longer to chew high fiber foods, so they give your brain time to receive the signal that you are full. It takes a lot longer time to eat a salad full of broccoli, carrots, and lettuce than to eat a doughnut.
Second, it increases the volume of the food without increasing calories; makes us feel full sooner for a longer period with less food intake.
Finally, yet importantly, fiber takes a long time to digest than refined carbohydrates. This is because refined carbs are high in sugar, which makes them easier for the body to digest. Fiber helps in regulating the body’s use of sugar and prevents blood sugar from rising, then falling, too quickly. Our body is triggered to eat or feel hungry when blood sugars begin to fall; Better control of blood sugar can keep hunger at bay and prevents overeating. For example, eating boiled corn as a snack instead of chips, or eating fruit instead of juice, will reduce calories and make you feel more satisfied with the food. It is unlikely that you munch on unhealthy snacks afterward. Therefore, fiber helps in weight loss by making you feel fuller for a long time with fewer calories.
Refined carbs like white flour, white rice, pasta, white bread, doughnuts, cakes, pastries, sweets, biscuits, candies, pie, etc., do not contain fiber and necessary nutrients required for good health. They often have high levels of added sugar, fat, or salt. Eating refined cereals cause a sharp rise in blood sugars that is not good for health and one of the main reason for weight gain. Even though they are tasty and are delightful to consume, they are low in nutrition.
An easy and effective way to reduce food intake without staying hungry to maintain or lose weight is to increase fiber in the diet. By simply shifting towards the plant, based foods and reducing processed food.
You can easily meet your daily requirement by including a 5-6 ounce of whole-grains (1-ounce =size of ½ baseball) per day and at least one serving in every meal. Include a 3-4 serving of colorful fruits and 3-4 serving of a variety of vegetables especially green leafy vegetables per day (one serving=size of a small fist) and by replacing red meat with beans or legumes twice or thrice in a week.
Normal weight people eat more fiber-rich food than overweight or obese do. Overweight or obese people generally eat larger portions from fat and a lesser portion from complex carbohydrates, especially dietary fiber. Currently, Americans eat only half of the recommended dose of fiber, so they are missing out on weight benefits and are also at risk of several diseases.
Fruits: especially those with edible skin, and seeds, for example, apple, berries, pomegranate. They also contain vitamin A, C, etc., good for the eyes and skin.
Whole grains. Include good quality, fibrous grains. They are a rich source of many nutrients; provide a feeling of fullness with fewer calories, and keep your digestive system work smoothly.
Vegetables: Eating leafy greens is a great way to increase the volume of your meals, without increasing the calories. They are loaded with many nutrients like potassium, iron, calcium, folate, etc., protect from heart disease, and reduces the risk of cancers, fight harmful radicals.
Beans and legumes: High in protein and fiber. Fill us full for a longer time and hence beneficial for weight loss.
Nuts & Seeds: Walnuts and almonds are a good source of fiber and healthy fat, the only handful of them are enough for good health. Rich in vitamin E, antioxidant(protect our cells from damage), helps in increasing memory.
It is best to get fiber from food rather than from supplements. Fiber supplements do not offer the same benefits that dietary fibers do. The synergy of all the nutrients in foods provides the best benefits. The supplement will not make up for the poor diet high in sugar and fat. However, supplements might help if getting enough fiber from the diet is difficult, especially in the case of constipation or health-related problems.
It is very easy to increase fiber in your diet, it is present in most of our food and does not require much preparation time, just a little bit of planning would help.
For breakfast, choose cereals that have whole grain as their first ingredient.
Include more oats, muesli, whole wheat bread, pasta, spaghetti, brown rice, etc.
Use wheat flour for baking and cooking. Add oatmeal to cookies, load homemade muffins with raisins, berries, or bananas.
Sprinkle flaxseeds, chia seeds over a salad, soup, breakfast cereals, and yogurt.
Add kidney beans, garbanzos, and peas, lentils into salads, soups, and casseroles.
Snack on raw vegetables and high-fiber fruits with skin such as apples, berries, pears, etc. instead of chips, crackers, or chocolate bars.
Eat whole fruit than fruit juice or canned fruit. Whole fruit contains more fiber.
If you are eating a very low-fiber diet then increase your fiber intake gradually rather than suddenly; too, much fiber too soon can cause a bloated feeling and increased gas. Water intake should increase to about eight glasses a day, to move fiber through the digestive system, and that helps against hunger too. Fluids can be in any form, such as beverages, soups, juices, and plain water. Water also contributes to feelings of fullness and controls thirst, which can often be confused with hunger. Without extra fluid, the extra fiber is likely to cause the problem of constipation.
Fiber is a good natural way of helping to reduce body weight. It does not metabolize fat quicker, but it will help by decreasing the intake of calories. A modest increase in intake of fruits, vegetables, beans, whole, and high fiber cereal would easily meet the requirement of fiber. Replacing most of the refined food with high fiber food would give an added advantage. That will not only make you feel good and energetic but prevent many health risks.
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We often get lost while looking at different varieties of oil at the grocery store and find it hard to choose the right kind of oil. Although everyone needs fat for the health, we want most of our fats to come from healthy sources. Good fat gives energy, required for healthy skin, and absorption of certain nutrients. But we need to be aware of the type of fat we are consuming as well as the amount we are consuming. Both, healthy and unhealthy fats, contains the same amount of calories and excess of them are harmful to health.
Some tips which can be helpful in making the smart choices while selecting oils/fats.There are three main kinds of fats in our diet:
They should come from plants and fish and should be liquid at room temperature like vegetable oils. Being a liquid, it can flow through arteries and veins easily, it will not stick in them and will not cause a heart disease. Good fats provide omega 3 fatty acids that body needs, also helps in lowering bad cholesterol LDL and hence reduces the risk of the heart diseases. Grate for the heart.
Examples of good fat/oil are:
Canola oil- American heart association recommends canola oil, they contain a second highest monounsaturated fatty acid (first is olive oil). They are economical has a mild flavor, high smoke point make it a good all-purpose oil for cooking, frying, baking etc.
Olive oil - Contains the most monounsaturated fatty acids (MUFA), a healthy fat of all and also contains omega-3. It is flavorful but expensive and used for cooking, dressing, and frying.
The terms virgin and extra virgin olive oil refer to the acid content of the oil, not its nutrient content.
Virgin olive oil: These are unrefined oil which means chemical or heat is not used to extract it from fruit which contributes to higher cost. Not common at grocery stores.
Extra-virgin olive oil: These are the highest-quality unrefined oil and is not treated with chemicals or altered by temperature. Food can be cooked with olive oil at low heat and is unsuitable for cooking as it has a lower smoke point than most of the oils, which means it burns at a lower temperature. It's best for dressing, dips, cold dishes.
Light olive oil: "Light" means the color and fragrance, not calories, fat content or flavor.These are refined oil that can be used for cooking, baking, sauteing, grilling and frying.
Pure olive oil: These are a lower-quality oil than extra-virgin or virgin olive oil, with a lighter color, more neutral flavor. This type of olive oil is an all-purpose cooking oil.
Peanut oil: They contains MUFA a healthy fat. Popular for frying as it gives a good flavor to fried food. It is slightly costly.
Refined safflower and sunflower: They contain high levels of PUFA fats and is a good all-purpose oil for cooking, frying, for salads etc.
Mustard oil: Mustard oil is not allowed to be imported or sold in the U.S. and Canada for use in cooking, due to its high erucic acid content. Erucic acid appears to have toxic effects on the heart at high enough doses.
Other good sources of invisible fat that are hidden within the food and most often we don’t consider them as fat are:
Fatty fish: Mackerel, salmon, trout, white fish, tuna, and herring. Rich source of omega -3 but sometimes contaminated with mercury so pregnant women and young children should be careful before consuming.
Avocados are the good source of heart-healthy omega-3.
Nuts especially almonds, walnuts, pistachio. Contains healthy Omega-3.
Seeds such as flax seeds, chia seeds not only contain good fat but also a fair source of fiber and antioxidants. Can make nutritious yogurt and smoothies
TIP: Include more omega-3 from natural sources. Supplements may not give the same health benefit.
They come from animal and are solid at room temperatures like butter or any kind of animal fat such as skin on a chicken etc. It’s a more solid fat and these are the one that can stick in the arteries or in the vein and its bad for the heart. Raise LDL or bad cholesterol and increases the risk of heart disease and stroke.
Most often saturated fat comes from animal sources which are also important sources of protein. Protein is important for energy, satiety building muscles, fighting infections. So, its very important to make smart choices to enjoy the benefit of protein while avoiding unhealthy fats. Saturated fats can be avoided or reduced by choosing lean cuts of meat or poultry, fish, non-meat options such as beans, legumes, millets, soya, seeds, and nuts etc.
Some examples are:
Animal fats- beef, pork, poultry with skin, bacon, organ meats like kidney, liver etc.
Spreads: Butter, lard, tallow, mayonnaise.
Whole milk & its products: cream, cheese
Palm oil: Due to a high level of saturated fat in it, is solid at room temperature. It is a cheap substitute for butter or trans fats where solid fat is desirable, such as the making of pastry dough and baked goods. Though palm oil is a better replacement for trans-fats but not a healthy replacement. Not a good substitute for trans fats for individuals with already-elevated LDL levels.
Coconut oil: It is highly saturated (82% saturated) and solid just slightly below room temp, it is used in confections. Excellent for frying as it is stable and has a long shelf life. It is inexpensive, and becomes rancid easily, similar to palm kernel. Due to its high levels of saturated fat World health organization, American heart association advice that coconut oil consumption should be limited or avoided
Ghee: It is also called as desi ghee, made from cows milk, common in Indian subcontinents. Ghee is a clarified butter composed almost entirely of fat, 62% of which consists of saturated fats. The nutrition facts label found on bottled cow's ghee produced in the United States indicates 8 mg of cholesterol per teaspoon.
These are the worst kind of fats where certain types of oils or fats are processed chemically that make them unhealthy. Trans-fat can be found under the food. Ex pie shells, baked good, shortening. Excessive intake of trans fatty acids are not healthful, but zero is also not realistic in today's world. Though there is no relationship between obesity and trans fats, there is a relationship to heart disease. Tran’s fats are not only responsible for raising the LDL, but also reducing good HDL cholesterol. It's a risk factor for heart disease and stroke. It’s important to look for these as they are shown to be detrimental to the heart.
Looking at the ingredient list of the packet is the only way to find out that it has trans fat. It would mention as hydrogenated or partially hydrogenated fat in the ingredient list. It’s also imp to know that even it says 0 grams of trans fat, on the nutrition facts, it’s important to look at ingredient list, because it could still be there just the serving size lacks trans-fat but if you eat more than the serving size say in a case of cupcake where one cupcake is the serving size but if you eat two, you may actually be consuming trans-fat. These are all gimmicks in the food industry, manufacturers take advantage of this as consumers find it hard to understand nutrition fact panel.
Examples are:
Baked goods-cookies, pastries, pies, crackers.
Snack food- Potato chips, microwave popcorn
Ready-to-use frostings, margarine, shortening,
Refrigerated dough products- biscuits, cinnamon rolls, and frozen pizza.
Fried foods- French fries, fried chicken, and doughnuts.
Vegetable shortening- Stick margarine, Coffee Creamer, Crisco etc.
Vanaspati ghee- It is a fully or partially hydrogenated vegetable cooking oil, often used as a cheaper substitute for ghee and butter. In India, vanaspati ghee is usually made from palm oil. It's very high in trans fat.
Trans fat can be found in many of the same foods as saturated fat.
F.D.A sets 2018 deadline to eliminate artery-clogging partially hydrogenated oils (PHOs), the primary dietary source of artificial trans fat in processed foods, must be removed from all food products in the United States.
Summary:
Unsaturated fats are the good fats and these are the fats to be used as the primary source of fat. It needs to be consumed in moderation as calories are same in all fats. Cook food more by grilling, roasting, sauteing, steaming, and less by deep frying. Choose lean cuts of meat, careful with baked goods and always read labels.
TIP: LDL and HDL types of cholesterol- LDL is bad cholesterol and HDL is good. HDLstarts with H which means Healthy, keep it high. LDL is bad, keep it Low
Alzheimer's disease (AD) is the most frequent cause of dementia characterized by progressive impairments of memory, language, reasoning, and other cognitive functions. Evidence suggests that omega-3 fatty acids and high fiber diet may act as a possible protective factor in AD. .
Studies have linked fewer years of formal education with increased risk of Alzheimer's. There is not a clear reason for this association but scientists believe more years of education help increase connections between neurons reduces risk for Alzheimer.
The brain-gut connection reflects the bidirectional, constant communication between the central nervous system (CNS) and the gastrointestinal tract . The inputs from the CNS can modify gut functions, while inputs from the gut to the CNS can modulate specific symptoms. Gut microbiota plays a crucial role in the structural integrity of the intestinal mucosa through the production of SCFAs. An altered microbiota may lead to a dysbiotic condition and increased intestinal permeability or leaky gut. Bacteria populating the microbiome have been shown to produce amyloids, LPSs, and other immunogenic compounds that might contribute to the regulation of signaling pathways implicated in neuroinflammation, brain Aβ deposition, and AD pathogenesis(Pistollato et al., 2016)
Stress, unbalanced diet, and drugs impact altering microbiota composition which contributes to dysbiosis to a subsequent increase in intestinal permeability, causing the leaky-gut syndrome.
The diet shapes the microbial community in the gut to a large extent so dietary strategies will be important in the prevention of Alzheimer’s. Omega-3 FAs supplementation increases SCFA production shifting gut microbiota balance towards a healthy status (eubiosis),Watson et al., 2018) and so does the high fiber diet (Pistollato et al., 2016).
Developed at Rush University Medical Center in Chicago, published in September 2015 in Alzheimer’s & Dementia. Suggest this diet can reduce the risk of developing Alzheimer's disease by up to 53 percent as well as slow cognitive decline and improve verbal memory. It combines many elements of two other popular nutrition plans which have been proven to benefit heart health: the Mediterranean diet and the DASH diet. MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. The MIND diet focuses on the intake of plant-based foods and limiting the intakeof animal products and foods high in saturated fat. It breaks its recommendations down into 10 "brain healthy food groups" a person should eat (green leafy veg, nuts, berries, beans, whole grains, poultry, fish, olive oil, wine) and five "unhealthy food groups" to avoid (butter, red meat, cheeses, sweets, fried or fast foods).
1) Anti-Inflammatory Properties: fenugreek seeds are recommended for lesions, healing rashes, and boils for their anti-inflammatory properties.
2) Lowers Cholesterol Levels: Fenugreek seeds aid in lowering LDL cholesterol within the blood and raises HDL within the body.
3) Helps Against Diabetes: Fenugreek happens to be one of the healthiest foods that a person can have if they have diabetes. It’s been found to reduce the blood glucose level within the body and raise the tolerance of glucose.
4) Helps With Digestion: Fenugreek helps to improve digestion. It releases mucilage, which creates a protective layer for the gut and bowels and lowers indigestion and gastric problems. Fenugreek has been helpful in constipation and it increases bowel movement.
5) Heartburn and Acid Reflux: It helps with soothing an inflamed gastrointestinal tract by being placed on the lining of the intestine and stomach. To utilize this as an effective treatment against heartburn, just scatter 1 teaspoon of fenugreek seeds on your food. Another alternative would be to consume them with water or juice and take one teaspoonful of seeds before eating.
6) Helps With Weight Loss: Fenugreek seeds soaked in water immediately can be consumed in the morning on an empty stomach to burn off extra fat within your body. Fenugreek seeds are full of fiber, which swells in the body and makes you feel less hungry. Overeating can be prevented by adopting this treatment in the morning and half an hour before dinner.
7) For Women: Fenugreek is proven to raise milk production in lactating women.
Prediabetes is a health condition where blood sugar is higher than usual but not high enough to be considered diabetes, and approximately 84 million US adults have pre-diabetes, which is 1 in 3 adults have pre-diabetes(CDC, 2019). People with prediabetes are at risk for T2DM, stroke, and heart disease. Many clinical trials proved that T2DM is preventable with a healthy lifestyle, a Diabetes prevention program is based on such study(“Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin,” 2002). It evaluated the impact of weight loss and physical activity on the development of type 2 diabetes among people with a high risk of type2 diabetes. The group assigned to weight loss by eating less fat, fewer calories, and exercising 150 minutes per week, reduce the risk of developing type 2diabetes by 58 percent in three years period compared to the placebo and medication group. The benefit continues even after the program is over. The program followed them after 15 years and the risk reduction through lifestyle intervention was 27% and with metformin was 18%(Diabetes Prevention Program Research Group, 2015). So it clearly shows the benefit of lifestyle change through losing weight and physical activity.
DPP program is a year-long program focused on long-term changes and lasting results, conducted by trained lifestyle coaches. The focus is on healthy eating habits, activity, peer support, accountability, the group dynamic of meeting in-person, and identifying and addressing barriers to healthy changes. The goal of the program is to lose 5 to 7 % of weight by eating healthier and being more physically active. The rationale behind this is that it will improve health and cut the risk of developing type 2 diabetes. The skills learned will help better manage weight and empower them to make a change in life.
Key principles of diet: Include foods that are low in calories, fat, and sugar, and high in vitamins, minerals, protein, fiber, and water. Include foods with less fat, trans fats, and saturated fat. Eating a smaller portion of foods high in calories, fat, and sugar that they are currently eating. Generally, eating 500 fewer calories/day to lose ½ kg/week but varies according to the individual’s weight loss goal. Drinking water instead of drinks with sugar such as soda, sports drinks, & fruit juice.
It is an MNT diet, based on Create Your Plate idea from the American Diabetes Association. According to this, filling half of the plate with non-starchy veggies, a quarter of the plate with grains and starchy foods, and another quarter of the plate with protein foods. Finally, a serving of fruit and non-fat or low-fat milk, low or no-calorie drinks are represented outside the plate. Choosing healthy fats like nuts, seeds and cooking with veg oils. The rationale of diet is that the higher consumption of carbohydrates specifically increasing the intake of dietary fiber, fruits, & vegetables and lower intake of fat particularly animal fat and added sugar when adjusted to changes to calorie intake promotes weight loss in individuals at high risk of developing type 2 diabetes(Sylvetsky et al., 2017).
Along with a healthy diet, it focuses on 150 minutes of activity each week that can help in burning more calories and in reaching weight loss goals. Diet and physical activity help prevent or delay type 2 diabetes by lowering blood sugar levels and other risk factors like lowering blood pressure, cholesterol, etc. Tracking progress such as weighing weight each week and tracking food and minutes of activity each day help in creating awareness about the lifestyle choices participants made and their impact on their weight.
Experience: My plate method is simple to use, versatile, helps in managing the portion size. It can be followed for the long term because it is not very restrictive or difficult to follow. Furthermore, many of the high-carbohydrate foods associated with this meal plan are very low in energy density, high in fiber which augments satiety and consistent with the concept of volumetrics for weight control. Though a diet is easy to follow, for me it was a real struggle because of the hectic schedule. I cannot seem to stick to a well-crafted meal plan. Initially, I did not like to track the food because of extra effort in planning, and entering data. However, it helped me to see that some of my nutrients need were not met especially iron. Writing a meal plan is easy compared to the following. I realize that even a well-crafted most thoughtful plan is useless if there is low motivation. Generally losing weight or treating chronic health conditions are good motivators. For clients, I would suggest understanding the reason why they want to pursue a particular diet, finding out what motivates them, and then working toward a goal. Even following a diet for a few days, I felt better, it positively impacts mood, energy, and stress levels. The day I made better choices I was more energetic and happy. This diet allows to choose from a variety of foods and can be created according to taste and lifestyle. It emphasizes veggies and fruits which are easy to get and carry, but sometimes it is hard to eat so many vegetables, and after a couple of days creates boredom. Because its emphasis is on non-starchy vegetables and less on animal protein, sometimes I find it challenging to meet iron needs. However, it was effortless to meet vitamin A, C, calcium, and potassium requirements. Surprisingly I have to look for sources for sodium as it was too low on sodium, the reason could be because I replaced processed food with fresh vegetables and fruits.
I would recommend clients to take small steps and being more aware of what they are currently eating and gradually replace unhealthy choices with healthy ones by including the foods they like and easily accessible to them and progressively incorporating them into the diet. Mindless eating is often the problem, the best way to counteract is to either log everything you eat or drink, in case time is constraint than recording those days you think you will eat more (like on weekends or randomly 2- 3 days in a week), could be an eye-opener. I would suggest that clients do menu planning and necessary preparation ahead of time, like cutting and chopping on weekends. Alternatively, buy a pre-cut salad package in bulk or can be creative with canned or frozen food. Having a menu planned for a week also helps in grocery shopping and eating out, so it is vital to put aside some time for menu planning, grocery list, and stocking pantry. This will also reduce anxiety related to meal preparation and impulse buying..
Bibliography :
CDC. (2019, February 1). Prediabetes – Your Chance to Prevent Type 2 Diabetes. Retrieved February 13, 2019, from http://bit.ly/2hMpYrt
Diabetes Prevention Program Research Group. (2015). Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet. Diabetes & Endocrinology, 3(11), 866–875. https://doi.org/10.1016/S2213-8587(15)00291-0
Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. (2002). The New England Journal of Medicine, 11.
Sylvetsky, A. C., Edelstein, S. L., Walford, G., Boyko, E. J., Horton, E. S., Ibebuogu, U. N., … Delahanty, L. M. (2017). A High-Carbohydrate, High-Fiber, Low-Fat Diet Results in Weight Loss among Adults at High Risk of Type 2 Diabetes. The Journal of Nutrition, 147(11), 2060–2066. https://doi.org/10.3945/jn.117.252395