Fighting the Bulge

Admit it. When you see that your previously obese neighbor is now a size 8 you wonder: "How did she do it, what's her secret?" as though this woman may hold the answer to an American epidemic.

Fighting the bulge is a subject that almost every woman can relate to, whether it be struggling to lose weight, thinking about it, or being bothered by one's weight. So many of us have stopped looking after our health—between taking care of the kids, the husband, keeping up the household and, for many, juggling a job, our own health and fitness don't seem to make the top of our priority list.

There is no magic pill or miracle dietIn Jewish tradition there is a strong emphasis placed on taking care of one's health. There is a whole section in the Code of Jewish Law (Shulchan Aruch) which is dedicated to maintaining one's health. Many of these laws are based on principles of Maimonides.

In the second volume of his work Mishneh Torah (Hilchot Deot, 4:1) Maimonides states: "Since maintaining health and a sound body is among the ways of G‑d, for one cannot understand or have any knowledge of the Creator if he is ill, therefore, one must avoid that which harms the body and accustom oneself to that which is healthy and helps the body become stronger."

We all know that being obese is unhealthy, but even being slightly overweight increases one's risks of developing coronary heart disease, type 2 diabetes, hypertension, insulin resistance, and liver and gall bladder disease--to name only a few.

So how do you start losing weight? Unfortunately, there is no magical pill, miracle diet or fat-burning food. Ironically, most of us already know the answer: diet and exercise. If every woman who wants to lose weight has heard of this concept before, why are so many still struggling? The answer is: because it's not easy. Improving one's eating habits changes a million other things: the way you shop for food, the taste of food, the way you cook, your family's eating habits, the hours at which you eat and so on and so forth. As for exercise, well most of us feel great after a workout but hate every single minute of it. Besides, that too requires changing your schedule around.

As a dietitian, I always recommend people start their weight loss by first changing their eating habits. Trying to change your eating habits and starting to exercise at the same time can be overwhelming and often leads to failure. Many people feel that eating habits are much harder to change than introducing thirty minutes of physical activity into their schedule. In addition, exercise increases your appetite. If you are trying to eat less yet feel hungrier than usual because of your workout, it will be very hard to stick to your new eating habits.

So how do you start to change your eating habits? The two key words are quality and quantity.

Planning meals is essential to healthy eatingWhen you shop for food at the grocery store, stick to the periphery of the store--that's where all the fresh foods can be found: fresh fruits and vegetables, breads, meat, milk and dairy products. The first few aisles in the center of the grocery store will be healthier foods or staple foods such as dried beans, basic canned goods, oils, and flour. The rest of the aisles contain increasingly processed types of foods which you should stay away from: cookies, chips, candies, canned meals or instant meals.

Take ten minutes before the start of a new workweek to plan at least three to four of the meals that you will be having that week and make a grocery list accordingly. Planning meals is essential to healthy eating because we tend to resort to unhealthier options when we don't have the necessary ingredients for what we want to make on hand and everyone at home is hungry. Make sure your meals are healthy, and can be prepared in a reasonable amount of time. When you're in the grocery store, stick to your list—and never go shopping when you're hungry!

You should also keep your pantry well-stocked with essentials for out of the ordinary weeks, so that you and your family can still enjoy healthy meals at all times. Make sure to stock up on canned beans, whole grain pastas, canned tuna, and canned tomato sauce, and make sure to have some meat and frozen vegetables in your freezer. These will be your back-up plan—for when your car breaks down or something else throws off your schedule. For those kinds of nights, you can quickly make a stir-fry with the frozen vegetables and meat from your freezer, or make some whole grain pasta with canned tomato sauce.

On nights when you do cook, try to cook large batches of foods that will freeze well so that you can put away a meal for those "lazy" nights. Foods that freeze well include stews, soups, tomato sauces, raw turkey or chicken burgers (best if wrapped individually in parchment paper before freezing) and baked chicken.

Make sure your meals are both healthy and delicious so that you and your family can enjoy them and stick to your new eating habits. Add flavor to your meals with little calories by looking for low-fat marinades, different types of mustards, flavored vinegars (balsamic, rice vinegar, cider), roasted peppers, jarred olives and capers, chili sauce, low sodium soy sauce, marmalade, or teriyaki sauce.

Not all carbohydrates are equalBalanced and healthy meals should always include a source of protein, whole grains and vegetables. Good sources of protein include chicken, turkey, eggs, low fat cheese, fish or beef. When choosing your fish try a fatty one more often, as the fat in the fish is rich in omega-3 and is very important in maintaining a healthy heart and supporting the developing brain and eyes in children. Fatty fish include salmon, trout, tuna, sardines, mackerel and herring.

You should also include a source of whole grains such as barley, quinoa, kasha, whole grain pasta or brown rice. Carbohydrates have had a very bad reputation and many people often neglect including them in their meals, which is a big mistake. Not all carbohydrates are equal--the carbohydrates you find in sweetened and refined breakfast cereals will give you a sugar rush and not satisfy your hunger for very long. Unsweetened whole grain breakfast cereal, on the other hand, will provide you with many essential vitamins and minerals and satisfy your hunger, due to the higher fiber content, until lunchtime. When you buy pasta, cereals, crackers, or bread read the ingredient list and make sure the first ingredient is durum whole grain wheat flour or durum whole grain wheat semolina.

Finally, include a source of vegetables at every meal; the more colorful your assortment, the better. Colors in fruits and vegetables indicate nutritional value, including nutrients, phytochemicals and antioxidants (all things that are good for you).

Here are a few ideas of some quick, simple and healthy meals:

Place an individual piece of fish on a sheet of parchment paper, place your favorite veggies on top (strips of red peppers, mushrooms and red onions for example) and season it any way you like (olive oil, dill, salt and pepper). Wrap up the fish and veggies like a candy wrapper and wrap additionally with foil, then bake at 375°C for 20-25 minutes.

Make as many portions as you need, and as a side dish you can cook up some brown rice. Perhaps the best part about this recipe: there are no dishes!

Keep the meals simple For a dairy meal that children will love, combine cottage cheese, low-fat cheddar, eggs (preferably omega-3 enriched), thawed frozen broccoli or spinach, garlic, salt and pepper to make a delicious crust-less quiche. Bake at 375°C for approximately 40 minutes. Serve with a fresh salad and slices of whole-wheat baguette.

Another idea is to place pieces of chicken (leg, thighs, breast--which ever ones your family prefers), pour jarred salsa over the chicken, toss in some other veggies you may have on hand and bake at 375°C for about 45 minutes. Serve with quinoa or barley and a fresh salad.

The idea is to keep the meals simple in order to cut back on cooking time, and use healthy ingredients and cooking methods.

Once you have improved the quality of the foods you eat, portion control is crucial. I have often counseled patients who had almost flawless eating habits but still had a weight issue due to their portion sizes. So even if you're eating grilled fish and steamed vegetables, watch your portions. Limit your protein portions to approximately 3 ounces (cooked), whole grains to ½ -1 cup (brown rice, barley, kasha, quinoa) and approximatly 1 cup of colorful vegetables. Maimonides recommended eating until only three-quarters full.

Once you've embarked on the healthy path, you may encounter some unexpected bumps. What do you do if your best friend wants to celebrate her birthday at a Chinese restaurant where you know almost everything is fried? What do you do at a wedding? Everyone will encounter a sub-ideal situation at some point. The challenge is how to best deal with that situation. Will you say: "Well, I guess I have no choice but to order batter-covered-deep-fried pineapple chicken" or "If they serve six courses at the wedding I have to eat them, all otherwise it may be perceived as impolite?" You don't have to make excuses for eating healthy.

When eating out, stick to the main course only. Don't order an appetizer or dessert and definitely avoid whatever they serve on the table (bread, rolls…). Stick to foods that have the following description: baked, grilled or poached, and avoid those described as: fried, au gratin, escalloped, creamed, pan-fried or sautéed. Don't be shy to ask for modifications or substitutions, most restaurants will be happy to accommodate your needs. For example, you can ask for your fish to be baked instead of pan-fried or ask for more vegetables instead of a mountain of rice. And if you're going to a wedding or other festive event, don't go starving. Make sure you eat properly that day and also have a snack before leaving. This way you'll be less likely to give in to temptation. Most of the food served at the cocktail is not ideal, but you can look for the sushi or the salad station, avoiding anything in a creamy dressing. But save your appetite for the food served later in the hall, which is often adequate: the salad, the fish, and the chicken or beef. Just remember to have only a few bites of each, otherwise you'll be having four suppers that night. Moderation is key.

Start introducing some exercise once you feel your eating habits have improved and represent less of a challenge. Introduce exercise slowly, perhaps ten minutes of rapid walking per day for a week and increase by another ten minutes each week, until you reach a minimum of thirty minutes per day.

If you've gained a couple of pounds this Chanukah, know what you have to do. Start by improving your eating habits and then include some exercise daily. This doesn't mean you'll never have a latke again in your life. But when holidays and festivities do come around, you'll know how to eat in moderation. Next Chanukah, have just one sufganiya (doughnut) and don't make latkes your main course. Making a conscious effort to stay physically healthy is not optional, it's something we need to do to stay healthy and productive. After all, our body is a gift from our Creator, so how can we not treat it well?