Outrage Over the Tube Feeding Diet

Tube Feeding Diet

Searching for the perfect wedding dress can be stressful but in that one moment when all eyes are looking at you, the pressure  to  look beautiful and feel beautiful can escalate. Now more and more often, bride-to-be’s  are looking for quick and simple weight loss solutions. One diet that has recently grabed a lot of attention from the media is the Ketogenic Enteral Nutrition Diet—also known as the Feeding Tube Diet. Utilized by people who are looking for rapid weight loss, this procedure involves a constant flow of liquid nourishment that runs from the nose, through the esophagus and into the stomach. While people can lose a lot of weight in a short amount of time, there are many important factors to consider.

Misuse of Medicine: Tube Feeding is approved for gaining weight and providing nutrition. Tube Feeding is warranted in a state of malnutrition not to cause malnutrition One can still eat with NG tubes, so why not just eat less food? There are medical risks to tube feeding.

Eating Disorders: Tube feedings are used to in extreme cases to refeed people suffering from an eating disorder. Encouraging a tube feeding diet may trigger an eating disorder.

Temporary Weight Loss Extreme dieting is neither healthy nor permanent. Weight is quickly regained as fat after extreme diets.

Honeymoon Weight gain Brides are likely to puff up with swelling once they resume drinking fluids and eating on their honeymoon. At the end of a two week honeymoon, a woman is likely to have gained the weight back and not fit into the honeymoon clothes. What will happen then?

As a RD, CDE I am appalled by this diet and find it disturbing that women feel the need to go to such extremes for one day in their life. What are your thoughts? Would you do this?

The Non-Diet Approach

Q: What is the non-diet approach?

A: The non diet approach is a philosophy and lifestyle for feeding and eating based on making food choices using a hunger fullness scale rather than a restricted calorie and or portioned diet plan. It is appropriate for children and adults.  In theory, this is the way we eat as infants, using hunger and fullness when breast feeding or bottle-feeding.

 

Q: What is a hunger fullness scale?

A: This is a scale from zero to ten that helps someone rate their individual feelings according to the descriptions. Zero is starving, Five is neutral and ten is thanksgiving full. For instance, a number seven is equal to full. One would stop here when they have had enough food to keep them satiated for the next three to four hours.

 

Q: Are all people able to identify when they are hungry and or full? It seems that Americans have trouble stopping when full.

A: We are learning that some people may have hormone issues that prevent them from feeling full. But there are tools to help someone who is having difficulty identifying feeling full. I recommend the person stop before feeling stuffed and even before they think they are full. It is also helpful to get up half way through a meal and walk around. Checking in with belly fullness is easier when you get up from the table.

 

Q: Can people lose weight using the non-diet approach?

A: Yes, you can lose weight especially if you are a late night eater or someone who eats for emotional comfort. Many people change their relationship with food and feel freed from yo yo dieting.

 

Q: Are there any good resources to help them people learn more about this approach?

A: Two of my favorite authors are Geneen Roth and Ellyn Satter. My favorite book is titled Intuitive Eating By Evelyn Tribole and Elyse Resch. I am currently working on a book on how to raise your children using this philosophy. Listeners can become educated on my blogs www.eatingandlivingmoderaterly.com and momdishesitout.com

 

The Vogue Milk: Which milk is for you?

The Vogue Milk

Laura Cipullo, RD, CDE

Laura Cipullo Whole Nutrition Services, NYC

Almond, Cashew, Cow, Goat, Hemp, Oat, Rice…

Almond Milk

Gone are the days of whole, low fat, no fat milk. Now one can choose milk from other animals such as a goat or from other plants like hemp! Whether you have food allergies or practice a vegan lifestyle, milk options are as plentiful nowadays as fast-food. But which option is best suited for you? Moms, these milks are not equivalent to breast milk and or formula and should therefore never be substituted for a child less than one year old.

Milk’s Muscle: Most Important To Consider –  First and foremost consider the percent of calcium, Vit D, and Vit. B12; next consider how many grams of protein, calories, and for some people even the level of carbohydrate.

For Vegan or Even Vegetarian Diets: Almond, Cashew, Oat, Hemp or Rice – look for a milk high in calcium with at least 30-50% calcium. The milk should have B12 since B12 is otherwise deficient in a vegan diet.

For Food Allergies (spec. food allergies like dairy and soy): the right choice is rice milk but make sure it is enriched in calcium, and Vit D. Be sure to get protein through food, since rice milk is not a significant source of protein.

For Food Intolerances: If you have lactose intolerance you may want to try soy, oat or cashew milk. Goats’ milk does have lactose however each individual must experiment with each type of milk to see what is most easily digested.

For Diabetes: Consider unsweetened soy milk for only 4 grams of carb/serving (Silk Brand specifically).  Be wary of flavored milks and milks lower in protein (< 6-8 grams pro/serving).

For One Stop Shopping: Consider skim milk or 1% for great taste, a good source of  calcium, Vit. D and protein. It is equal to one carbohydrate exchange being that one serving of milk equals 12 grams of carbohydrate.

For Children ages 1-2: Whole milk is recommended between ages 1 and 2 unless a child has a food allergy or has been advised otherwise by their medical doctor.

Leaving Perfectionism Out of Your Diet

By Katherine Kaczor, Nutrition Assistant and Intern

We all want to eat right, but no one can (or should) have a perfect diet. This perfectionist mentality limits our enjoyment of food and ultimately out of life. Perfectionism does not belong at the table. Follow these tips to have a healthier relationship with food.

  1. Make foods morally neutral– Labeling foods “good” or “bad” gives them way more power than they deserve. Foods are meant to provide energy, nutrients, and enjoyment. Each food has its unique set of nutrients that can find its place in a healthy diet. Following a diet that restricts certain foods takes away from this enjoyment and can ultimately lead to feelings of deprivation and ultimately overindulgence.
  2. Live in the present– Don’t put your life on hold while you attempt to meet your dietary goals. Start living today! The positive experiences you go through will help motivate you to make healthier choices.
  3. Take a mindful approach- Take the time to truly savor your food. Experience all the flavors, textures, and aromas of the food. Listen to your body’s hunger signals and honor them. Try not to eat on the run or while distracted by television or reading material. This can inhibit your ability to enjoy the meal and reach a point of satiation and consequently, lead to over or under eating. Eating in a mindful manner will allow you to consume the appropriate number of calories and obtain the proper nutrients you need.
  4. Don’t listen to critics– These days it seems like everyone wants to be the food police. Do not allow people in your life or the promotion of fad diets steer you away from a wholesome lifestyle. Just because Dr. Oz or your mother-in-law scrutinizes you for eating a bagel, do not allow them to upset you or perpetuate you into restriction or overeating. Everyone has his or her own nutrition needs. Talk to your RD about your individualized needs and stand up for yourself when critics arise.
  5. Make SMART goals- Trying to change all of your eating and exercise habits at once is unrealistic and unsustainable. Accomplishing small goals over a period of time leads to greater success and helps ensure the changes become permanent. To make your goals smart, make sure they are specific, measurable, attainable, realistic, and provide a time frame for yourself.  An example of a SMART goal would be: I will eat 5 servings of fruits and vegetables daily for at least 4 days per week by the start of next month. Work with your RD to help find the SMARTest goals for you.

Happy Heart Month (and Day) Part 2

You need to love yourself, in order to take care of yourself. On this Valentine’s Day, learn to how to keep your heart healthy. Get you cholesterol and coconut questions answered!

By Laura Cipullo, RD, CDE

Laura Cipullo Whole Nutrition Services

www.MomDishesItOut.com

Q)   Does eating cholesterol really impact cholesterol level?

We have know for years that saturated fat is the true culprit to raising LDL production by our body. One should decrease their saturated fat intake to decrease their LDL (Low Density Lipoprotein- aka bad cholesterol). Many people have misunderstood this for years. The focus should not be on a cholesterol free product such as palm oil but rather a lower saturated fat and higher monounsaturated fat like almonds. Decreasing dietary cholesterol intake lowers your LDL about 3-5% where as decreasing your saturated fat intake decreases your LDL by 8-10% as reported by the National Cholesterol Education Program.

Q)   Will this depend on other nutrients that the food contains? If it’s not, what does impact cholesterol levels then?

Yes, levels of saturated fat, monounsaturated fats, polyunsaturated fats, exercise, stress and genetics all effect our cholesterol levels. A favorable fat profile of a food should look like this >Monounsaturated fats> Polyunsaturated Fats> Saturated Fats (need more research as to which saturated fats may be more beneficial).

 Q)   What about coconut oil and is it true it may help you to lose weight?  

The American Dietetic Association does not recommend consuming tropical oils such as Coconut oil. According to the Natural Medicines Database, ”there is insufficient evidence to rate the effectiveness of coconut oil for weight loss, hypercholesterolemia, diabetes, chronic fatigue, Crohn’s disease, irritable bowel syndrome and thyroid conditions.”

 Q)   From the types of saturated fats such as stearic acid, lauric acid, etc, are there any with health benefits?

Per the research I have found, there are not saturated fats with absolute health benefits. To be prudent, one should continue to limit their saturated fat intake at this time and replace them with unsaturated fats, fruits, vegetables and whole grains. For additional reference there is a chart that clearly identify the roles of saturated fat on medscape: Role of Different Dietary Saturated Fatty Acids for Cardiometabolic Risk, By David Iggman; Ulf Risérus Posted: 04/28/2011; Clin Lipidology. 2011;6(2):209-223. © 2011 Future Medicine Ltd.

 

 

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Happy Heart Health Month – Part One

OMGoodness there are so many mixed messages about heart health. Read on tho make sense of sugar and saturated fat as it pertains to our heart health. Lets prevent Cardiovascular Disease (aka CVD).

Q) There are experts who are now saying that the evidence between saturated fat and CVD may have been biased because research didn’t take into account the sugar content of the diet.  Is sugar the real culprit?

Added sugar is associated with increased TG levels and increased LDL cholesterol (hyperlipidemia being a risk factor for CVD). However, there is an inverse relationship with increased intake of healthier carbohydrates such as fruits, vegetables and whole grains, meaning the more you eat these foods, the less likely you are to increase your risk for CVD.  Saturated fat remains a part of the picture. Now the question is which type of SFA may be more closely associated with the increased cholesterol-raising effect of cardiovascular and metabolic risk factors. More research is needed to clarify. Most importantly focus on including fruits, veggies and whole grains and limit added sugars.

 

Q) What is the role of saturated fat in CVD risk?

Saturated fat is associated with CVD. Studies show an increase in total cholesterol and LDL cholesterol after eating a meal high in saturated fat. However, recent studies are examining the different roles of the specific types of saturated fats: Short chain, medium chain and long chain SFA.  This means continue to minimize your intake of saturated fat like the visual lard on a steak until more research is available. A simple guide: choose products with < 2 grams/ saturated fat per serving. Rather focus on including monounsaturated fats like olives and avocado. 

 

Q)  There are studies that show total blood cholesterol is not a reliable indicator of CVD. If it’s not, what are the indicators then?

Total Cholesterol is not a biomarker of CVD rather one’s ratio of Total Cholesterol to HDL ratio.  HDL also known as high density lipoprotein is the good cholesterol (h for helper) and LDL, low density lipoprotein (l for want less of) the bad cholesterol. The greater your HDL and the lower your LDL, the more favorable your cholesterol profile will be and the decreased chance of cardiovascular disease. Studies indicate a Low HDL, High LDL and High TG are associated with risk for CVD. You must ask the doctor for your cholesterol breakdown and the ratio with a goal < 5.  Always ask for a copy of your blood work.

 

Q)  If a higher sugar intake may be dangerous, why aren’t  triglycerides (blood levels) more important when assessing the risk of CVD, since this marker has a good correlation with simple carbohydrates intake?

TG’s are a good indicator of risk for CVD and it should be included in the lipid profile to assess for CVD risk. However, the ATP III report issued by the NIH, encourages using TG’s as a marker for other lipid and nonlipid risk factors that ultimately raise the risk for CVD. Ask Your medical doctor for your TG level and aim for < 150 mg/dl. 

 

Check back for Happy Heart Health Month Part 2 or like Laura Cipullo Whole Nutrition Services on Facebook to get weekly nutrition updates.

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Michelle Obama says Let's Move!

Laura’s Take on the Let’s Move! Campaign. Listen to Laura talk with Rita Cosby on wor710.com on 2/1/2012 or via podcast.

As a leader Michelle Obama is in a unique and powerful position to empower Americans to live healthier lives. She can influence food companies to provide less processed, higher quality foods to schools and to our supermarket shelves. She can raise the energy and spirit of health by advocating for health awareness and encouraging physical activity. Her celebrity status can help bring the USDA’s “MyPlate” to more families’ tables.  She can help spread the message to fill your plate with fruits, vegetables, whole grains and low fat dairy. Thankfully, Michelle Obama also stresses moderation and admits to eating her burgers and fries.

Let’s Move! is taking information that is already out there and bringing a greater awareness on how to access such health education. Many of the materials and guidelines are those developed by the USDA.

Michelle Obama has companies like Goya and California Fresh Work Funds trying to help initiative change.

Is this the right campaign?

At the end of the day, bringing awareness to health promotion and disease prevention needs to be the ultimate goal of someone like Michelle Obama. However, rather than fight obesity, the campaign may want to rephrase their negative spin and create a new positive tone to Let’s Move!

How about let’s move more, let’s move towards eating real wholesome foods and let’s move towards eating less processed food. Let’s move to building self esteem!!!

Can one person create change?

Yes, Jaime Oliver’s Food Revolution and The Biggest Loser are just two examples of how change happens. Even, the presidential chef is making change. In the Washington Post today, the presidential chef Cristeta Comerford reports losing 15 pounds and eating healthier with her own home garden. She was influenced by her boss, Michelle Obama!! That’s right, the White House has their own garden and serves seasonal garden veggies to their guests. Comerford now has her own garden too.

 

What can you do to make a difference? Can you change your language about health or perhaps just add a half cup of veggies to your dinner plate?

 

 

Are Super Foods So Super?

 

Are super foods so super?

By: Laura Cipullo, RD, CDE

www.eatingandlivingmoderately.com

Tropical berries such as gogi berries, acai berries, and more have been bombarding the food industry and the media. These products claim almost magical health benefits including a more youthful feeling, lowered cholesterol, and weight loss. But are these products really all their manufacturers claim?

For centuries, the Asian population has included Gogi Berries as part of their diets in hopes of longer lives and to reduce aliments. This is due in large part to their high antioxidant content. Antioxidants may slow the aging process by minimizing damage from free radicals that injure cells and damage. By doing so, antioxidants help reduce the risk of disease and possibly aging. A research article from The Journal of Alternative & Complementary Medicine, found that subjects who drank gogi juice daily for a 15 day period reported significantly higher energy levels, athletic performance, quality of sleep, ease of awakening, ability to focus on activities, mental acuity, calmness, and feelings of health, contentment, and happiness compared to the control group.

More popular than the gogi berry are the acai berries. These berries are also packed with antioxidants and are also good sources of fiber and monounsaturated fats (the good fats!). A pilot study published in a 2011 edition of The Nutrition Journal, found that in patients suffering for metabolic syndrome, supplementation of acai berry led to improved cholesterol as well as better fasting glucose and insulin levels. Other students have found that use of acai berries can reduce inflammation.

So, are you all set to run out and buy a bottle of juice or a box of supplements?

Not so fast.

While it is true that added these foods into your diet may have some health benefits, there is little research to indicate that these benefits are above and beyond those one would find from “non-exotic” products.

All berries are wonderful sources of antioxidants, fiber, and other nutrients. There is little evidence to show that gogi and other berries are better sources—only that they are significantly more expensive. There is no reason to spend $40 when you could simply add local blueberries or raspberries to your diet. Also, eating whole foods rather than swallowing supplements is the recommended way to get your macro and micronutrients.

So, these “super berries”  are just as super as your raspberries and blueberries. To have a lifestyle of health and longevity, fill your plate with fruits and vegetables daily. They don’t have to be from an exotic location, rather it is preferred if they were from your backyard or a local farm!!

 

 

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References:

http://www.ncbi.nlm.nih.gov/pubmed/18447631

http://www.liebertonline.com/doi/abs/10.1089/jmf.2010.0150

http://www.nutritionj.com/content/10/1/45

http://articles.cnn.com/2009-03-23/health/acai.berries.scam_1_advanced-wellness-research-acai-weight-loss-claims?_s=PM:HEALTH

 

The Hollywood Image

The Hollywood image that’s plastered everywhere—online, on TV, in magazines– is simply not realistic and can be harmful. Yet, it’s what some women and men strive for. They may see how skinny Demi Moore or LeAnn Rimes have gotten and think this is the ideal. I want to remind everyone that most people do not have such bodies naturally!  Most people do not have the time or money to focus on their bodies the way the Hollywood stars do. Most people can’t afford a full staff of a dietitian, a trainer, an esthetician, a chef, and a dermatologist…. Plus, celebrities are getting paid A LOT of money to look this way and if they don’t meet the criteria there is always editing and airbrushing to attain the super skinny, youthful look. To meet the Hollywood ideal, most men and women need to restrict their intake to a caloric level that is equivalent with that of an eating disorder. Most stars don’t acknowledge that they have an issue, although Victoria’s Secret model Adriana Lima openly admitted recently that she simply stopped eating solid food 12 whole days before the Angel runway show!

Remember, beauty is from the inside and shines when one is confident from their inner core. There is a great new web site promoting a new definition of beauty – check it out at www.BeautyRedefiend.net/.

 

Beauty Redefined Sticky-Notes

 

Is This Healthy?

How do you answer your child’s question “Is this healthy?” http://bit.ly/wRRBZe or read my answer at www.momdishesitout.com