North Atlanta Primary Care

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Healthy Weight Loss

Posted on March 01, 2013 by Alli Hemingway, MPH, PA-C

In an environment that promotes high calorie, nutrient-poor foods with a more sedentary lifestyle, too many people are regularly eating too many calories and the wrong kind of calories. This leads to the obesity epidemic and the subsequent health problems, such as heart disease, diabetes, high blood pressure, stroke and certain cancers. Many of my patients ask me for a weight loss pill to "quick start" a diet. The best way to lose weight quickly and healthfully is to choose the right things to eat in the proper portions. It's also important to choose smaller portions when eating at home and when eating out. In fact my husband and I always split a meal when we dine at restaurants. It's less expensive and we don't need all the calories!

Many Americans take in too many calories and eat too few vegetables, seafood, and low-fat milk and milk products. At the same time, most people eat too many simple carbohydrates, salt, added sugar, solid fats (major sources of saturated and trans fatty acids) and refined grains. Where to cut back? First and foremost, cut way back or eliminate simple carbohydrates. These include bread, rice, potatoes, pasta, carrots, corn and most fruits. These are primarily empty calories that will add inches to your waistline without providing good nutritional benefit. Even if you aren't overweight or obese, consuming too much sodium, solid fats, saturated and trans fatty acids, cholesterol, and added sugars increases your risk of heart disease and other health problems. A lower sodium level - 1,500 mg a day - is appropriate for people 51 years of age or older, and individuals of any age who are African-American or who have hypertension, diabetes or chronic kidney disease. Some proteins - namely, meat, poultry and eggs - contain solid fats. In contrast, the fats in seafood, nuts and seeds are healthier.

The guidelines recommend eating two 4-ounce servings (or one 8-ounce serving) a week of seafood. Choose a variety of proteins, including seafood, lean meat and poultry, eggs, beans, soy products, and nuts and seeds. Doing this will replace proteins that are higher in solid fats with those that are lower in solid fats and calories. The glycemic index, glycaemic index, or GI is a measure of the effects of carbohydrates on blood glucose levels. Carbohydrates that break down quickly during digestion, releasing glucose rapidly into the bloodstream, have a high GI; carbohydrates that break down more slowly, releasing glucose more gradually into the bloodstream, have a low GI.

A few basic guidelines to follow every day 1. Eat slowly, you'll feel full earlier and won't eat as much 2. Eliminate starches and sweets (I'll give specific examples later) 3. Have five small meals a day rather than 3 large ones - snack on nuts, hummus or string cheese between meals 4. Never drink regular soda or sweet tea - switch to unsweet tea, diet soda, flavored seltzer waters or plain water and use artificial sweeteners sparingly 5. Enjoy healthy fats like avocado and olive oil in moderation 6. Eat protein for breakfast every day. I like to have Egg Beaters and pre cooked turkey sausage at home, or go to Chick-Fil-A and order a breakfast burrito in a bowl. It has chopped sausage, scrambled eggs, and grilled onions and peppers. Perfectly low carb and full of protein for a good start to your day 7. Get some form of exercise at least 2-3 times weekly - even something as simple as walking a dog or taking the stairs at work rather than the elevator.

Foods to enjoy

Vegetables: Broccoli, green beans, cabbage, spinach (fresh or frozen), bell peppers, tomatoes, avocados, eggplant, artichokes, cucumbers, brussel sprouts, avocados, onions and cauliflower. Make ¾ of your plate these vegetables and you will remain full and satisfied longer.

Beans: Chick peas, lentils, cannellini, black beans, edamame, kidney beans

Fruits: Generally none, but if you have a craving for fruit you can have occasional grapefruit, cherries or a small apple. These are lower on the glycemic index than any of the melons or berries.

Nuts: Generally nuts like almonds, pecans, cashews, Brazil nuts and peanuts are a great substitute for simple carbohydrates. An ounce of nuts has about 150 calories and 5-6 grams of protein. Hummus with sliced cucumbers or cherry tomatoes is another good choice. Kroger has Carb Master yogurt with only 4 grams of carbohydrate. This is far superior to most yogurts which have 20-25 grams of carbohydrate each. Another great snack is dill pickles (great to cut sweet cravings) or the pickled cauliflower/peppers/carrots in a jar. Easy and delicious!

Meats: Lean cuts of beef, pork, chicken and also shellfish and fish. It's best to eat these meats grilled or baked.

Drinks: Black tea or coffee (or use sugar free creamers like Coffee Mate with the green label), unsweet tea (can sweeten with Splenda), diet sodas like Coke Zero, Diet Sprite or Fresca are fine for occasional use. As far as alcohol, avoid beer altogether and seriously limit wine. The way we pour it in our neighborhood it has about 15 grams of carbohydrate. Better choices would be tequila, scotch or vodka with carb free mixers. Alcohol has empty calories but at least it can be low carb if you choose to indulge.

Condiments: Mustard, horseradish, oil & vinegar, salsa and hot sauce are all carb free. Feel free to use them to add spice to your meals. I try to add jalapenos or hot sauce to most meals since it boosts the metabolic rate for a couple of hours after each meal.

Foods to avoid: For most rapid weight loss completely avoid all bread, rice, potatoes, pasta, orange vegetables, corn, sweets and fruit. Once you stop eating these types of simple carbohydrates you will lose cravings for them within about a week. It makes it easy to avoid them when you don't crave them. Many patients ask if they can have whole grain breads or pastas. My advice is to avoid them altogether so that you can get out of the habit of eating things that aren't very nutritious.

Easy substitutions when you eat out are hamburgers or chicken sandwiches without a bun (most restaurants will give you all the goodies on the inside on two pieces of lettuce), burritos without the tortilla (meat, lettuce and veggies in a bowl), an Unwich at Jimmy Johns (turkey or beef wrapped in big sheets of lettuce), Thai or Chinese food without rice, or split a large entrée salad with your spouse. Order cole slaw or a green salad instead of French fries.

This type of lifestyle is very easy once you get used to it. I have hundreds of patients who have lost weight eating this way. Once you get to your goal weight you can add in small amounts (1/3 cup or less) of brown rice or an occasional slice of whole grain bread. My own husband lost 35 lbs in three months a year ago and has kept it off because he hasn't started eating simple carbs again. A couple who are patients of mine have lost 60 and 65 pounds respectively and are delighted with their ongoing progress. One memorable woman lost 110 lbs and is hooked for life to this healthy way of eating!

For more information and recipes: http://www.southbeachdiet.com http://allrecipes.com/recipes/healthy-recipes/special-diets/low-carb-diet/

For a list of low glycemic index foods: http://www.health.harvard.edu/newsweek/Glycemic_index_and_glycemic_load_for_100_foods.htm http://www.southbeach-diet-plan.com/glycemicfoodchart.htm

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