Monthly Archives: December 2014

One Order of Fried Chicken: Hold the Calories

Right before Thanksgiving, the FDA announced its new regulation requiring restaurant chains as well as those selling ready-to-eat food; from convenience stores to even movie theaters, to post the caloric contents of the food they are selling. It was not the most fortuitous time to do so, considering that people consuming at least 3,000 calories during the kickoff the holidays feast would not be worried about eating a measly 1,000 calories from a bucket of movie theater popcorn.

The regulations will not go into effect for a year, however, and might be delayed by the protests of some in the food business concerned with the difficulty of providing accurate calorie contents. Pizza chains are concerned with posting the calorie contents of their almost infinite combinations of toppings, and supermarkets announced that they might have to decrease the number of ready-to-eat foods because of the difficulty in calculating the calories in many of their dishes. Moreover, who is overseeing the actual calorie count? Is there to be a calorie inspector counting black olive slices on a piece of pizza or the number of drops of olive oil sprinkled on the cheese? Will the supermarket hire a portion control guard to make sure that customers serve themselves a portion size corresponding to the posted calorie count? Are there officials who will keep track of the chocolate sprinkles on a doughnut or raisins in a raisin bagel? The possibilities of calorie error, yea even calorie fraud, seem endless.

And will any of this have an impact on food choice and ultimately weight?

Those already alert to the pound elevating capacity of innocent-looking foods like whole-fat yogurt with granola or a grilled chicken sandwich with pesto and avocado, will no doubt use the calorie information to prevent themselves from gaining weight and/or continuing to lose it. Others who have a vague idea of the calories in ordinary breakfast or lunch foods may experience something akin to sticker shock.

A chain sandwich shop located down the street has posted calorie contents for its sandwiches, soups, and salads for a few years. A friend told me that several times she walked into the restaurant very hungry but then walked out without buying anything because she couldn’t decide between what she wanted to eat, that is, a tuna wrap, and what she felt she should eat, a kale and egg white salad. The salad contained two hundred fewer calories than the tuna wrap, but she hated kale and wasn’t crazy about egg whites. But she could not bring herself to eat the tuna fish salad sandwich once she knew how many calories it provided. Some, already obsessed with calories and reducing their already skeletal frames to a smaller size, will undoubtedly find that calorie information confirms their worst fears: everything is fattening. Others who want to get the most food for their dollar, like people on a cruise or a teenage boy, might opt for calorie dense food. Why not eat 3,000 calories rather than 500 for the same $5.95 price?

Moreover, how does one reconcile the FDA’s belief that knowledge about calories will affect our eating when a major international weight-loss organization, Weight Watchers, has not used calorie counting for years in their diet program? In fact, how many weight reduction programs ask the dieter to count calories, rather than concentrate on portion size and number of servings of various food groups? How many of us even know how many calories we should be eating?

A construction worker, a corporate lawyer, a mom with two toddlers and an infant, a senior citizen who plays 18 holes of golf daily and foregoes the cart to walk, a tuba player, a taxi driver: what should their calorie quota be? Charts of calorie quotas for different age groups and size are available, but rarely do these charts factor in daily calorie output, i.e. construction worker versus taxi driver. When the food truck comes to a construction site, it is doubtful that the guys buying their meatball subs really care about calories. They have been working for hours, are hungry, and need energy to continue working for several more hours.

The FDA and other agencies concerned with our nation’s weight should put its efforts into informing the public about their personal calorie requirements and how this is influenced by their current height, weight, size and usual energy expenditure. Does the construction worker understand that come Sunday, when he may spend hours in a recliner watching football, he does not and should not be eating as much as during the work week? Does the corporate lawyer who works at her desk for 12 or 14 hours a day know that she can eat more calories on the weekend after several hours of cross-country skiing or a long bike ride? Should a woman in her late seventies, who has shrunk two inches, be eating the same number of calories as she did twenty years earlier? She is shorter because of compression of her spinal cord. Does this mean she should eat less?

On the other hand, and there is always another hand, calorie information is useful for dieters and non-dieters. When we buy something, we obviously know the price. Very few (is there anyone?) would buy something without knowing how much the item costs. Except for the multi-billionaires in the world, almost no one has unlimited financial resources. The same is true for calories. Unless one is training for an Ironman triathlon or has an overactive thyroid, who can eat an unlimited amount of calories? Labeling restaurant food with its calorie content allows us, if we wish, to avoid foods that use up too quickly our limited calorie allotment. If you know that a ladle of blue cheese salad dressing has 500 calories and a light oil and vinegar salad dressing only 100, that information would allow you to save calories and spend them on another food item. The calorie differences between a baked potato even with a pat of butter and a heaping plate of French fries, or between fried clams and baked lobster, gives you the knowledge to decide whether to ‘spend or save’ the calories.

The FDA is not your mother attempting to make your food choices for you. You make choices all your life based on whatever information you have. Calorie content of restaurant foods is helping you makes informed choices. It is up to all of us to use the information wisely.

Should Couch Potatoes Wear Fitness Bracelets?

Looking for a gift for a runner in our family, I wandered into our nearby sports store and stopped by a large display of devices and gadgets that monitor activity: sleep, calories, heart rate, and perhaps in the near future, how well your investments are doing from minute to minute. The price, as well as the tendency of the gift recipient to lose anything not fixed to her body (she is a young teenager), made me look for something else, but it got me wondering who would get the most use out of such gadgets? I have seen the rubberized bracelets on the wrists of people going into spin class or lifting weights, and the ever-increasing variety of devices suggests an ever-increasing market for self-health monitoring. But like the proverbial preaching to the choir, are these fitness devices attractive primarily to the already fit? Or are they like scales, to be avoided if you know you are sedentary and have gained weight?

The relevance of devices that measure activity to those who shun it was pointed out to me by my dog, an exercise avoidant dachshund, who tends to combat me for every inch he walks. Worried that his already slothful ways would increase as the temperature dropped, I considered buying a canine fitness device that, like a human fitness bracelet, would measure his daily mileage or centimeters walked. I reconsidered when I realized that his walking was my walking as he was always on a leash. The free app, MOVES, would tell me how many steps I was taking and although I am too mathematically impaired to see how that corresponded to four footed steps, at least I would get some idea of how weather was changing activity for both of us. Indeed, on some exceptionally frigid days, we both were quite sedentary (except that I could go to the gym).

Everyone knows that we as a nation are growing fatter, and lack of physical activity still remains one of the most prominent causes. But how much physical activity do we not do? How sedentary are we?

Patients who come to see me for weight-loss counseling usually claim to exercise a few hours each week and only a few would acknowledge how little they actually do. Those with gym memberships are vague about how many times they worked out and walkers are equally vague about the frequency of their perambulations. In fact, their vagueness is matched only by their inability to recall with any accuracy what they eat every day, especially at non-meal times. And once on a diet, promises to increase their physical activity are made but unlike Robert Frost’s poem, rarely kept.

Measuring physical activity, either with a free APP or purchased device, might be extremely useful in helping my patients reach their weight-loss goal. Calorie intake is only one part of the weight-loss process, and if physical activity monitoring showed very little activity, it would explain why the pounds were coming off so slowly.

Conversely, most people on diets, or just those seeking to become fit, would respond positively to even a slight increase in the number of steps taken and miles walked each day. The MOVES app tells you, as soon as you turn on your cell phone in the morning, how much walking you did the day before. And sometimes the results are surprising in a good way. You the walker might think you did relatively little walking the previous day, and find that all that going and coming from the basement to the attic, shopping at the mall for holiday gifts or, in my case, walking the dog, adds up to a respectable number. Suddenly it doesn’t seem so hard to move off the couch and get moving. And the congratulations, “Today is an all-time personal best for you” message appearing on the phone is a virtual pat on the back, and must have some positive impact on continuing to move.

The days that show little activity are just as important. Why was there so little walking? Was it because you had to sit in meetings, at your desk, or in a plane all day? Were you stuck doing errands and chauffeuring kids around? Was it simply too cold or too hot to walk outside? Were you getting or getting over a cold? Some situations that prevent you from walking may be resistant to change; you can’t alter the polar vortex or stop a trial so you can go for a walk. But if your app or monitoring gadget shows about the same amount of activity as if a 200 year-old tortoise wore it, then this is a warning of transformation back into a couch potato. Even something as simple as walking rather than sitting if you are talking on the phone, or getting up from your desk chair rather than rolling it over to the printer add steps to your day, and therefore caloric burned.

It is not easy to get thin and fit, especially as we recover from Thanksgiving and head into the pudgy season of Christmas. But these monitors may help support you, each step along the way.