An essential health resource for current and former smokers - An essential health resource for current and former smokers

Consuming too little salt: How recent research disputes current guidelines

Too little salt also isn't good

Many of the current health guidelines stress limiting the intake of salt (referred to as sodium on nutrition labels) as a means of reducing adverse health outcomes, particularly strokes and heart attacks. The current guidelines in the US recommend limiting salt intake to less than 2,300 mg of sodium a day and less than 1,500 mg in high-risk individuals.

However, recent research, including a large study published in the American Journal of Hypertension, disputes these findings.

The study authors looked at data from over two dozen studies investigating salt intake and mortality, especially from heart disease. Data included over 250,000 people, both healthy and with underlying diseases. What they found was that people who consumed the least amount of sodium (less than 2,645 mg daily) as well as the most (over 4,945 mg), had higher rates of mortality and cardiovascular disease by roughly 10-15%.

What does this mean for us? It so happens that for the most part, the saltiest foods are ones that are processed and unhealthy anyway. These include canned foods and soups, instant meals, chips, many breads, cured meats, etc. One way you can tell is by looking at the nutrition labels. Any food that has more than 150-200 mg of sodium per serving is on the high side (note that some canned soups can have up to 1,000mg!). By cutting down on processed foods, which are anyway unhealthy, you automatically reduce excess salt in your diet. After that, if you like to add a pinch of salt here and there, it’s unlikely to be a big deal.

The only caveat I have is for people with certain medical problems such as heart failure or kidney disease. They should follow the advice of their doctors and nutritionists.

- Tamir


How Can Smelling Fresh Fruit Help You Eat a Healthier Diet?

Fruit display

Sticking to a healthy diet can be difficult, so it’s good to have some aces up your sleeve.

Two new studies published in the journal Appetite show some neat little tricks you can use to help you choose healthy fare.

The first study split 115 people ages 18 to 50 into two groups. All test subjects were given some made-up purpose for being in the study. One group was told to wait in a room that was sprayed to smell like fresh fruit while the other group was told to wait in a similar room but without the fruity odor.

Afterwards, all participants were taken to another room and told to pick an appetizer, main course, and dessert from a set menu. Each course had a healthy choice and an unhealthy choice. The group that had waited in the room that smelled of fresh fruit were much more likely to choose the healthy dessert than the group from the unscented room (50% vs. 75%).

The second study looked at how food is presented. Diners at a restaurant on two different nights were offered an identical healthy meal; the only difference being how it was presented on the plate. More diners judged the meal as being tasty when the presentation was neat and appealing.

The take home message from both studies is that incorporating small changes/ideas can help you continue making healthy choices. It’s well-known that olfactory and visual stimuli affect what we eat and crave. Who hasn’t walked by a bakery, smelled the wonderful aromas, looked at the delicious baked goods in the display case, and not had a craving to run inside and buy something? By trying similar things with healthy foods (smell a fresh apple or orange before going out to eat, make your meals look vibrant and appetizing), you increase the odds of maintaining good eating habits.

- Tamir


8 kinds of “healthy” foods that are high in calories

There are few things more frustrating than going on a strict diet, trying your very best to lose weight or to improve your cholesterol or sugar levels, only to fail miserably – and all because of common misinformation. There are many foods out there that people think are healthy (or at least acceptable), but in reality are loaded with many calories, unhealthy fats, and sugar. Below, in no particular order, are 8 “healthy” foods that are high in calories.

1) Granola

High calorie granola

What can be healthier than rolled oats or puffed rice?

If you look at the nutritional labeling on most granola products, you’ll see that they’re high in calories, sugar, and fat. Often, the serving size will be quite small to deceive the consumer (make note of the serving size, figure out the actual portion size someone would typically eat, and add up the calories). Many brands also contain unhealthy high fructose corn syrup and cheap vegetable oils.

2) Sweetened yogurt

High calorie sweetened yogurt

Yogurt is usually thought of as healthy. Add the image of a fresh-looking strawberry or blueberry to the packaging, and what better food can you snack on?

Unfortunately, many fruit-flavored yogurts (or those with other flavors such as chocolate or vanilla) contain as much sugar as soda. A better choice would be plain yogurt with cut up pieces of fresh fruit.

3) Juice


I’ve had several patients, including people who are diabetic, tell me that they drink juice a lot, or that they substitute orange or apple juice for soda or iced tea. After all, juice can be “all-natural” with “no sugar added.”

Unfortunately, even 100% juice is jam-packed with sugar. Although there’s no sugar added to it, one cup of fruit juice contains the sugar content of a few pieces of fruit (which is often as much sugar as soda), without any of the fiber that the whole fruit has which helps slow down the absorption of the sugar. Stick to water or seltzer with a squeeze of lemon or lime for flavor.

4) Energy bars

Energy bar on a plate

Energy bars also give off the image of health; you picture some muscular athlete at the gym chomping on his power bar after bench pressing 500 pounds.

Energy bars may have their place with professional athletes who are training for hours every day. However, for the vast majority of people, one energy bar can contain more calories than what you just burned off at the gym.

5) Sports drinks

Sports drinks equal sugar for the most part

Another scam. They’re basically water, sugar, and a bit of salt for “electrolyte” replacement. Some will contain a few vitamins for “energy.” Again, these may have some merit if you’re running the New York City marathon; but for most of us, energy drinks basically equal sugar. Keeping a bottle of water, and eating a healthy snack after your workout will accomplish the same with fewer calories and more nutrients.

6) Healthy-sounding restaurant meals

Healthy-sounding restaurant meals

Every year, there are countless stories published online about healthy-sounding restaurant entrees such as salads that contain an enormous amount of calories. While it’s true that lettuce and other vegetables are quite low in calories, when you factor in the dressing, croutons, cheese, or any of the other high-cal toppings, some salads contain more calories than a large burger. The best thing to do is get dressing on the side and to stick to vegetables only.

7) Low fat foods

Low-fat foods

These include baked goods, prepackaged meals, ice cream/frozen yogurts, and other processed foods. Although they have less fat, they tend to contain more sugar. Furthermore, since fat provides some satiety, many people tend to overindulge out of hunger and/or the mistaken notion that something with less fat is the equivalent of celery or cucumbers in terms of its effect on the body.

8) Pasta

Pasta is calorically dense

In the age of low-carb diets, many people do avoid pasta when dieting. Pastas aren’t worse than any other grain-based product. The problem is that they’re extremely calorically dense. The serving size on most packages says ½ cup of uncooked pasta. Most of the time, people eating pasta consume much more than this amount. Factor in cheese, creamy sauces, or sugary tomato sauce, and you can easily pack away over 1,000 calories in a few minutes.

- Tamir

(Images link back to their sources.)


Hungry between meals? Snack on fruits and vegetables

When going on a diet, one of the hardest things to manage is hunger. Sure, it’s easy in theory to “cut back” on breakfast, lunch, and dinner, eating smaller portions. Forgo snacks, and voila, you’re well on our way to weight loss.

But as we all know, between our tiny meals, we feel hungry. Mmm – those donuts next to the coffee machine look good. That candy bar in the vending machine will hit the spot. And look at that, chips are only 75 cents!

Planning for when you’re hungry

If you don’t plan ahead, it’s very hard to stick to a healthy diet in the long run. One simple strategy is to simply incorporate more fruits and vegetables into your diet.

Snack on fruits and vegetables like these

To start off, include fruits or vegetables with all of your meals, and try to start off the meal with a fruit or vegetable. For example, start off breakfast with half a grapefruit. Start off lunch with a large vegetable salad. This will fill you up somewhat, leaving less room for unhealthier fare.

Throughout the rest of the day, every time you feel hungry, eat a fruit or a vegetable. Apples, pears, oranges, peaches, plums, apricots, berries, bananas, carrots, cucumbers, peppers, cherry tomatoes, and celery sticks are all examples of readily available snacks you can munch on instead of chips, cookies, and candy.

Furthermore, if you currently smoke and want to quit, you can try using fruits and vegetables as a smoking cessation aid. Every time you crave a cigarette, reach for a fruit or vegetable. Eat slowly, chewing your food at a relaxed pace, savoring the flavors. Hopefully, the symbolism inherent in consuming a healthy snack and the experience of it will cause you to second guess your desire for a cigarette while at the same time satisfying your oral fixation. Adopting healthy snacking habits may also help to mitigate the weight gain that often occurs when quitting smoking.

- Tamir

(Image links to source, shared under this license.)


Truth to the ‘apple a day’ adage

We all know the old adage, “An apple a day keeps the doctor away.”

An apple

There’s more truth to this than many realize. In an interesting study published in the British Medical Journal, researchers used a mathematical model to compare the reduction in cardiovascular disease (heart attacks, strokes, etc.) achieved by eating an apple a day to taking a “statin” cholesterol medicine in people over the age 50. They assumed a 70% compliance rate, and assumed that the caloric intake would remain the same in the apple group (presumably through the hypothetical person eating fewer calories from other food).

The results showed a similar reduction in cardiovascular risk between the 2 groups! Since statins can have side effects such as muscle aches, it seems that achieving the risk reduction through adding an apple to one’s diet makes more sense. (However, if you’re already on cholesterol medication or have other health problems such as diabetes or heart disease, then do NOT stop them on your own – there may be a good reason that you are on them.)

Small improvements can make a difference

The take home point is that in otherwise healthy people, a very small lifestyle change, eating one apple, makes as much of a difference in improving health as taking most potent blockbuster medications. This should be encouraging to those of you who find it hard to completely overhaul your unhealthy lifestyles. For example, if your current diet is fast food, donuts, and soda, if you smoke, if you don’t get much exercise, then you might be thinking, “What’s the point of making small improvements? I have so much to fix!” Instead, make small changes. Add some fresh fruits and vegetables. Cut out a serving of soda. Eat half a donut rather than 2. Add a 15 minute walk to your day. Reduce the number of cigarettes that you smoke.

After all, if eating one apple can improve a person’s health by a significant amount, then making several small changes, even if you don’t ultimately end up with a perfect lifestyle, seems well worth it.

- Tamir

(Image links back to source, and is shared under this license)


Portion control is essential for a healthy diet

In the world of fad diets and weight loss supplements, a common claim is “Eat as much as you want and still lose weight!” In some cases, people will lose weight. For example, if all I eat is cabbage or celery, then yes, I’ll lose weight. In other cases, this just isn’t true, and the duped consumer quickly finds out that the “amazing” weight loss supplement that they had shipped from abroad for the low price of $69.99 plus shipping and handling is a hoax.

But even when the claim is true, the problem is that once a person is sick of eating only celery or soup or whatever the fad of the day is, they revert to their old eating habits with the “eat as much as you want mindset” still very much in place – with disastrous consequences. I’ve seen many patients over the years who lost a lot of weight through extreme fad diets, only to regain it all, often with extra weight.

Portion control--not!

The few successful diets I’ve witnessed are ones that emphasize portion control. These include Weight Watchers and Overeaters Anonymous. Unfortunately, in the U.S., portion sizes have grown tremendously. Restaurants, aiming to please customers, offer gigantic sandwiches, mounds of fries, and sodas in cups large enough to fit most of your arm. Then there’s the ever present all-you-can-eat buffet. We don’t stand a chance if we don’t change our mindset.

Start by changing portion sizes

One of the most important things you can do when adopting a healthy diet is to work on limiting portion sizes. Even healthy foods will make you gain weight if eaten in large amounts. I would even go so far as to say that if you’re an impulsive eater, then before even changing the actual foods you eat, work on limiting the portion size. Have one donut for breakfast instead of two (or three). Have a small order of fries instead of supersizing. Take just one cookie from the cookie jar. Once you’re able to control how much you eat, it will be easier to start changing what you eat.

In addition, if you’re eating out of stress or depression, then seek treatment. Don’t drown your worries or sorrows in a pint of ice cream. If you eat out of boredom, then find a hobby to occupy your time with. Cut back on watching TV, an activity which is largely a waste of time and is associated with constant snacking.

Once you start successfully controlling portion sizes, you’ll find it easier to stick to a healthy diet in the long term. If you know you can control yourself when indulging in an occasional treat, you know you won’t have to give up junk food 100% – something that drives most of us to eventually drop a healthy diet. You know you’ll have more control over how much you eat.

Finally, self control may help you if you smoke, especially if you chain smoke. Of course it’s best to quit, but if that isn’t possible (or desirable) at the moment, then control the “portion” of cigarettes that you smoke daily. Instead of lighting the next cigarette with the previous one, limit yourself to a few “must have” cigarettes a day.

- Tamir

(Photo links to source, which is under this license)


The most idiotic fad diets

We live in a quick fix society where we demand quick results. Weight loss is one area that’s especially influenced by this mindset. Although it may have taken a person 30 years to become 50 pounds overweight, there’s somehow the expectation that 3 weeks of dieting and sweating at the gym should be enough to take off the extra weight.

Due to these naïve expectations, many overweight individuals fall prey to charlatans and quacks pushing all sorts of diets and weight loss supplements based on ridiculous claims (lose 20 pounds in the first week!). Although some fads are simply a waste of money, some are outright dangerous. To make things worse, sometimes these diets are plugged by celebrities that people look up to.

The British Dietetic Association recently completed its assessment of the worst celebrity diets. Some of the ones on the list aren’t so radical. However, some are so idiotic that it’s difficult to understand how a person with any common sense would even consider them. In addition, there are some recent headlines about an additional absurd “diet” known as the Cotton Ball Diet that I want to mention as well.

  1. The Breatharian Diet. Proponents of this diet, otherwise known as “starving to death,” claim that the body simply needs air and sunshine to survive. No food or water required. Nuff said.
  2. The Alcorexic Diet. Proponents of this diet recommend drastically cutting calories during the week, and then “banking” those calories for the weekend where they are used to binge drink. So I guess this diet can be referred to as an alcoholic starvation diet. Supposedly some models follow it.
  3. The Cotton Ball Diet. This disturbing diet is supposedly a fad among teenagers. Simply soak a few cotton balls in juice and swallow them to help you feel full. There are a few problems with this diet. First of all, all those cotton balls can become lodged in your intestines, causing an obstruction that requires emergency surgery. In addition, “cotton” balls are often made from artificial chemicals that were not meant to be ingested. Lastly, by filling up on cotton balls, you’ll end up becoming malnourished. This is even worse in teenagers as it can lead to stunted growth and brittle bones.

Of course all of these examples are more extreme than the fads we typically see. However, the mindset is always the same. “I quickly need to lose a lot of weight.” A healthier mindset is, “I’m currently overweight and lead an unhealthy life. Let me improve my diet and start exercising so that I can lead a long, high-quality life.” Obviously, we all have a degree of vanity, and looks are important. However, if your entire focus is quickly losing some weight for some upcoming event or vacation, then more often than not you will choose an extreme approach that isn’t sustainable and often not safe in the long run.

- Tamir


Do You Want to Make Thanksgiving a Day Off for Your Diet?

Tomorrow is Thanksgiving in the US. However, this blog post won’t be about lean turkey breast, steamed green beans, and a slice of melon for dessert.

Thanksgiving dinner 2010

Many of you are looking forward to a large turkey with stuffing, gravy, candied yam, pumpkin pie, cranberry sauce, mashed potatoes, rolls, cookies, etc. . . or are you? What if you’re on a diet? Shouldn’t you try to avoid any and all junk? I guess you’ll stick to a piece of turkey breast while the rest of the family enjoys every finger-licking last bite of Aunt May’s pumpkin pie.

Or maybe you should indulge tomorrow if you so choose. Try not to over do it, but without having any days off for your diet, by always being the odd person out, it becomes very hard to stick to any healthy diet in the long run. If the rest of your life is one long deprivation session without any hope for ever indulging a bit, then what’s the point? Yes, you may live a couple of extra months if you never touch a single sweet. However, I don’t know if it’s worth it for you.

On the other hand, if you are comfortable forgoing junk, then go for it! Continue doing what you’re doing. You don’t have to “cheat.” My point is that when planning for the long term, include some off days. Birthdays, anniversaries, and holidays are good examples. Just keep it stricter the rest of the time, throw in some regular exercise, and you should be able to stick to things long-term while enjoying life.

- Tamir

(Image links to source: princesspumpernickel on Flickr)


Pick the healthy food first

Thankfully, this country is blessed with an abundance of food. However, this doesn’t mean that everyone is eating healthy food in healthy quantities. There are unfortunately still people who are going hungry. And, in much greater numbers, there are people who eat too much food, especially too much junk food.

As a discussed in a recent blog post, behavioral factors often play a role in what we end up eating.

Food choices at a buffet

A recent fascinating study set up identical breakfast buffet tables in a room. On one table, fruit was the first item, followed by increasingly junkier foods (e.g. cinnamon buns, bacon). On the other table, the exact same food items were set up in the reverse order, with the unhealthiest dish first.

124 participants were randomly assigned to one of the two tables, but were not made aware of the purposeful nature of the food arrangement. They were told that they may go once to the table to get whatever food they want. This is what researchers found: 86% of people took fruit when it was offered first, versus only 55% when it was offered last. Furthermore, over 75% of the participants took the junkiest item on the table when it was offered first versus only 29% when it was offered last. At least 2/3 of the plate was filled up by the first three foods on the buffet table, regardless of whether or not it was the table with the healthier foods first or the junkier ones. Finally, people who loaded up on the junkier foods first were more likely to add other junkier foods to their plate, whereas those who took the fruit first were no more likely to pick one food over another.

What’s the take home message? If you’re at a buffet, a scenario which is quite common these days (think restaurants, business lunches, parties), especially in an “all you can eat” type situation, then load up on the healthy food first. Fill up on vegetables and fruit. Save a small portion for the junkier stuff.

- Tamir

(Image links to source: Wikimedia Commons.)


The connection between poor diet and depression

It’s well-known that an unhealthy diet high in processed food and junk food increases one’s chances of developing several different health problems, including heart disease, diabetes, and certain cancers. It seems that the same holds true for mental illness.

A recent article in Brain, Behavior, and Immunity followed over 43,000 women from the ages of 50 to 77 without any depression at baseline for 12 years. Compared to the women with the best diets, those with the worst diets (high in soda, cakes, cookies, fried foods, sugar, etc.) had an over 40% higher risk of becoming depressed.

The authors of the study suspect that the underlying cause is that poor diets increase inflammation in the body. Inflammation is known to lead to heart disease, cancer, and many other chronic diseases. In addition, it’s now known to increase one’s risk of depression as well. This additional evidence helps us dispel the erroneous notion that anxiety, depression, and other mental health conditions are “all in your head.” It seems that whatever isn’t good for the body (e.g. a poor diet, lack of exercise), also isn’t good for the mind (in fact, there’s a lot of evidence showing that regular exercise helps with symptoms of depression and anxiety).

The bottom line is that if you eat a poor diet, you aren’t only messing up your physical health; you’re hurting your mental health too.