I'm often inspired and amazed at the changes my clients make to improve the quality of their lives. Sometimes these changes are quite major, but most of the time they are small yet significant steps to better health.  So I thought it would be fun to anonymously spotlight my clients once a month.  I'll focus on actual behavior changes these people are incorporating into their daily routine.  And regardless of your stage in life and current habits, they just may inspire you to keep making healthy choices, one small step at a time.

We'll start with a client I'll call Lucy.  Lucy has battled emotional and binge eating for decades.  But it wasn't until a recent series of health crises that she realized that her food addiction had seriously implications for her health.  Years of overeating and an extremely sedentary lifestyle was taking a toll on her body.  While Lucy has made some significant changes over the past month, one of the most impressive is her commitment to daily physical exercise. Despite the extra 150 lbs she is carrying on her frame, she now gets out of her house and takes a walk every single day.

The benefits of daily physical exercise is astounding: it helps regulate sleep, improves mood, prevents the development of chronic disease and excessive weight gain, improves brain function, preserves body function, improves the ability to perform simple tasks of daily living, enhances metabolic function, and even reduces symptoms of chronic disease (i.e. helps regulate blood sugar control for people with diabetes).

So if you aren't all that active now, how can you follow Lucy's lead and start incorporating a little more movement today?

This is one of my favortie Fall recipes.  I love one pot meals and this one is a cinch.  The total prep time is probably an hour, but aside from chopping there is basically no work involved other than stirring.  If you don't have garam masala, I recommend you go pick some up at Whole Foods or your nearest ethnic food shop (i.e. Middle Eastern, Indian, Asian).  It is essential for creating tasty ethnic cuisine.  Enjoy!

Mixed Vegetable Masala
Serves 4, Vegan & Gluten-Free

1 1-inch piece of fresh ginger, sliced
2 cloves garlic, peeled (I use 3)
1 15-oz. can diced tomatoes (I use spicy or with jalapenos)
½ tsp. cayenne pepper
1 T canola or vegetable oil
1 medium onion, chopped (1 cup)
1 small yellow pepper, diced (1 cup)
2 medium boiling potatoes, peeled and cubed (1 cup)
2 medium carrots, sliced (1 cup)
1 ½ tsp. garam masala
½ tsp. chili powder
2 cups cauliflower florets (3/4 lb.)
½ cup light coconut milk

1. Pulse ginger and garlic in food processor until finely chopped. Add tomatoes with juice and cayenne pepper, and pulse until combined. Set aside.
2. Heat oil in saucepan over medium heat. Add onion and bell pepper, and sauté 10 minutes, or until softened. Stir in potatoes, carrots, garam masala, and chili powder. Cover, reduce heat to medium-low, and cook 10 minutes, stirring occasionally.
3. Add cauliflower, tomato mixture, and ½ cup water. Simmer 20 minutes. Remove from heat, and stir in coconut milk. Season with pepper.

Marci’s Note: I added golden raisins with the cauliflower florets and it was delicious!

I’m reading a book for my book club called “Mindless Eating” by Brian Wansink.  You’ve probably heard of it.  Professor Wansink has made his food lab at Cornell famous from such experiments including stale popcorn and endless soup bowls, to name a couple.

Essentially, he studies the subconscious cues which encourage all of us to overeat.  In his book he provides a multitude of suggestions to outsmart ourselves.  One of these suggestions I thought was particularly interesting.

Apparently, in the Japanese culture people eat until they are “no longer hungry.”  Yet we all know from experience that most Americans eat until they feel full, overfull, and often stuffed.  The concept of eating until “no longer hungry” has a phrase “hara hachi bu” which essentially means “eating until you are just 80% full.”

So as you dive into your next meal, pause half way through.  Can you envision your stomach and what 80% full might look like?  Take a step further.  Could you stop eating at 80%?  See if you can take this idea on as a challenge.  It’s not easy and it takes some practice.  But it feels pretty good to walk away from the table satisfied but not stuffed.

Professor David Nieman, Dr. PH. of Appalachian State University, conducted three trials with more than 150 females comparing sedentary individuals to participants who engaged in moderate exercise (i.e., a brisk walk for 45 minutes, five days per week). After three and a half months Nieman reported that, “the number of days of sickness in the walkers was just almost half of the [sedentary] control group. This is huge statistically. There’s no other supplement, no drug, that comes close to reducing the number of sickness days.”

Believe it or not, one of the things I'm most frequently asked about is my opinion on NBC's "The Biggest Loser" reality show.  And fans are getting geared up for the show's 8th season!  Simply put: The Biggest Loser is a TV show and TV shows are meant to entertain.  As a result, contestants are put through rigorous and unsustainable workout regimes and dietary restrictions.  So, the audience gets exactly what it's looking for, jaw dropping transformations that seem beyond human!

I actually had the opportunity to listen to the dietitian and medical physician who created the program for The Biggest Loser at a nutrition conference nearly two years ago.  They gave us all of the details for the contestants' diet and exercise regimen.  Yes, it certainly was jaw dropping.  I was so stunned to see so much exercise and so little food.  I was convinced, that this show was a recipe for disaster.

It's a pretty well known fact that restrictive eating and overexercising often lead to binge eating.  While all of these contestants would benefit from a healthier lifestyle, I just can't advocate such an extreme method.  While it may create the immediate desired result (weight loss) I have a hard time believing it can lead to the ultimate goal (permanent weight loss).  One of the reasons is that the show isn't getting to the root of the problem, but that must be dealt with in another blog post.

An excellent article by Time magazine summed up my feelings rather well.  While some people may find the show to be inspiring, the premise is so extreme, so unhealthy, and so unsustainable I cannot advocate it for anyone. 

Ryan Benson, the winner of the first season claims that after the show he gained back "32 pounds in 5 days simply by drinking water."  And another contestant, Kai Hibbard, consumed only sugar-free Jello and asparagus for several days along with jumping in and out of a sauna for six hours prior to the final weigh-in."  That folks, is what the producers don't tell you.  And that sounds like an eating disorder to me!

If you are interested, the Today show has a "Where Are They Now" slideshow.  It's a bit dated, but you'll notice the general trend- weight gain after the show.  And the sad thing, is that losing so much weight then gaining it back is extremely detrimental to a person's self-esteem and feelings of self-worth.

So, it's no surprise.  I am not among the millions of fans that support The Biggest Loser.  While making dramatic changes is pretty alluring, the consequences can be pretty damaging.  So rather than going round and round in circles (losing weight and gaining it back), why not slow down and find a healthy way of living that can last a lifetime?  Sounds like a boring TV show.  But hey who said the personal gratification of creating sustainable habits can't be every bit as rewarding?

As I munched on breakfast this morning, I thought to myself " I LOVE this cereal....I should blog about it!"  And then I thought, hey, I should blog about some of my favorite food products on a regular basis.  So, if things go as planned, you'll be getting a "product showcase" on the 10th of every month...if not more frequently.

First up, Barbara's Shredded Spoonfuls from Whole Foods (and other chains like Trader Joes).  A single box costs $4.99 (gosh, cereal is not cheap).  I topped mine with blueberries and it was delicious.  Why do I love the multigrain bites of shredded cereal?

1.) Great texture and mouthfeel
2.) First ingredient is "whole oat flour." A great source of fiber and whole grains which is great for digestion, gut health, and heart health.
3.) TASTE! It's a whole grain cereal that is very low in added sugar but doesn't taste like cardboard!  Most whole grain cereals are either hard and icky or contain loads of sugar to make up for the unpalatable taste.

So if you've been searching for a low sugar, high fiber whole grain cereal that actually tastes good, Barbara is your gal!  Plus, there is a whole line of products for people with special dietary needs (i.e. gluten free, dairy free, Kosher, vegan, etc).

If you try a box today, let me know what you think.  And if you think there is a product I oughta' try and recommend, please email me!

Many of you may know someone who has been diagnosed with Celiac Disease.  What was once considered an incredibly rare and often undiagnosed disease has gained more attention by clinicians, food manufacturers, and the media. 

The only treatment for celiac disease is to follow a gluten-free diet (harder than it sounds), so as a dietitian I've counseled clients with celiac disease.  Additionally, a close family member was recently diagnosed with the disease.  While I've never experiened what it's like to live with celiac disease, I do have a sense of how difficult it can be to follow a gluten-free diet.  Some of the frustrations include skipping out on foods you love (forever), finding gluten-free options while dining out, and the extra cost of buying special gluten-free products.

I recently came across a great article in the New York Times that addresses the last issue, the expense of eating gluten-free.  Here are the tips they offer:
1.) Avoid stocking up on special gluten-free products.  Try to base your diet on foods that are naturally gluten-free.
2.) Do your research.  It takes time and patience to find products that do not contain ingredients with gluten.
3.) Try making your own gluten-free products such as breads and cakes.
4.) Check out this great website: Gluten Free on a Shoestring
5.) Look for well-priced bulk items at chain stores.  Trader Joes carries a fantastic brown rice pasta and Wal-Mart stocks Alf's puffed brown rice cereal for $1/bag.
6.) Join a support group.  You'll get great cost-saving tips and vendors often come and provide samples.
7.) Itemize your tax return.  If your expenses exceed 7.5 percent of your adjusted gross income it qualifies as a write off.  "You can deduct the excess cost of a gluten-free product over a comparable gluten-containing product."
 8.) If you have a flexible spending account at work, ask your plan's adminstrator if you can use it to buy gluten-free products.

Also, be sure to check out Shelley Case's website and consider buying her book "Gluten-Free Diet: A Comprehensive Resource." She is an RD with Celiac Disease and her book is the Bible for Celiac Disease.  You can also sign-up for her free newsletter, check out her blog, and listen to her podcasts.  Because food and food products are always changing, it's essential to stay current.

Yesterday I got a phone call from my friend. She had just been to her doctor, who informed her that her serum Vitamin D levels were very low. Consequently, he prescribed a pretty serious supplementation regimen for her to follow for several weeks in order to raise her levels back to a normal range. Naturally, my friend (who is a pretty darn health conscious individual) was pretty alarmed. Not only was she concerned that what she believed to be a healthy diet was resulting in a pretty serious vitamin deficiency, but she learned that a chronic insufficiency of Vitamin D put her at risk for developing all kinds of problems in the future.

For the past year, Vitamin D has been the major topic of research and discussion in academic/research circles. Researchers are discovering that low serum levels of Vitamin D are associated with an increased risk for osteopenia, osteoporosis, high blood pressure, high blood sugar, asthma, and even a spectrum of mental health problems. Please note, these are ASSOCIATIONS, not known CAUSATIONS.

Additionally, reputable organizations (like theInstitute of Medicine) believe that the current DRI (Dietary Reference Intake) of 400 International Units seems to be way too low. Consequently, they are performing some pretty serious research and it looks like they will be making recommendations to significantly increase the DRI in the next year or so.

Interestingly enough, about an hour after I spoke to my friend, I received this article in my inbox. In short, Harvard recently issued a publication stating their rationale for recommending supplementation for Vitamin D. Typically, Harvard recommends obtaining vitamins and minerals from food, but Vitamin D seems to be an exception. The article states ' "Even a low-calorie diet can deliver all the vitamins and minerals you need, with one exception – vitamin D. So plan to take a vitamin D supplement.” ' It's actually a really great article and pretty short, so I recommend reading it.

Like Harvard, I typically recommend a well-balanced diet to get all of the nutrition you need. But Vitamin D is certainly one exception. I advocate for every adult to be taking a 1,000 IU supplement of Vitamin D3 every day. Both Vitamin D2 and D3 are sold over the counter. But research seems to indicate the D3 is more effective at raising serum Vitamin D levels and D2 is potentially toxic in supplement form.

One important thing to take note of is the fact that without adequate amounts of Vitamin D, our body is not able to use Calcium to effectively strengthen our bones. Sufficient Vitamin D is ESSENTIAL for bone health. So the next time you are in to see your doctor, ask him/her about testing for Vitamin D levels and pick up your Vitamin D3. It's one of the simplest things you can do for your health today.

Most of you have probably seen commercials for the over the counter weight loss pill Alli.  Currently, it's the only FDA approved non-prescription weight loss pill.  Back in 2007 the pill was approved and sales for the product sky rocketed...and I was skeptical.

According to the Alli website, the pill works by attaching to "some of the natural enzymes in the digestive system, preventing them from breaking down about a quarter of the fat you eat."  As a result, fewer calories from the fat in the food you eat are absorbed.  Additionally, eating a high fat meal results in some pretty unpleasant "treatment effects" so there is incentive to keeping your fat inake in check.

Since there is a history of ineffective and unsafe supplement options for treating overweight and obesity, I thought these pills were just to good to be true.  On August 24th, USA Today released an article entitled "FDA probes weight-loss pill alli over liver damage reports."  Needless to say, this is only an investigation and a direct relationship between the weight loss treatments and liver injury have not been established.  However, the FDA is reviewing additional details about the suspected cases of liver injury submitted by manufacturers.

If you have or are currently taking Alli, please talk to your Dr. if you experience symptoms of liver failure including fatigue, fever, nausea, and vomitting.

While many are hopeful that Alli is the magic cure, it seems we ought to remain a bit more skeptical.  Is 10 lbs really worth damage to your vital organs?  Of course not.