Friday, January 4, 2013

Baby Step #1

What is the biggest waste of calories?


Anything in the liquid state.

Before you start defending natural fruit juice, milk, protein shakes, energy drinks, or alcohol, hear me out.

This blog is primarily focused on weight loss.  Not "healthy eating", not bariatric surgery, and certainly not telling people what they want to hear (I'm really bad at that in general!) And when it comes to losing weight, the first thing I tell all my patients (pre-op, post-op and no op) is to never let anything pass your lips that contains calories in a liquid form. 

Water is nice, if that's your thing.  It's not mine.  Diet Coke or any other diet soda works, as does Crystal Light or any artificially sweetened drink mix.  Iced tea or hot, sweetened with Splenda, Equal, Sweet n Low.  Black coffee with the same (no you may not have a mocha-latte-chino with whipped cream!)  Fruit 2 O, Vitamin Water Zero, Perrier or Peligrino.  You're getting the picture by now I think.  In reality, many of these do have a few calories per 8 oz serving, so I generally set the limit at 6 calories or less per serving.  If you've had bariatric surgery, you may want to avoid the bubbles as they can be quite painful.  Having said that, I know many post-op patients that indulge and either never have trouble, or have learned how to overcome their issues with carbonation.

Now, to address the haters among you who are decrying the absence of that wonderful substance, milk, from the above list.  Milk, to be blunt, stinks. Cows milk, just like human milk (which I guarantee, none of you are champing at the bit to drink) is meant to add weight to baby cows.  It was never designed to be consumed by weaned adult humans.  Not even by un-weaned child humans.  Name me one other animal on earth that routinely ingests milk after it is weaned from it's mother....nope, none.  Now name me one other animal on earth that drinks the lactation products of another species... right.

Milk is not naturally full of anything we need.  In fact, our milk is fortified with Vitamin D, Vitamin A (if it's fat free, since the Vitamin A leaves the milk with the fat) and often calcium and protein.  Of course, all this fortification is still not enough to provide us with the amounts we actually need.  This study in particular refuted the idea that drinking milk would protect us against bone loss: 

Most of us really should be on a multivitamin, Calcium and Vitamin D anyway.  So why waste the calories.

I prescribe protein shakes to my patients on a daily basis.  Used the right way, they have been a fantastic tool in the weight loss game and I couldn't do my job without them.  Their near-ubiquitous availability means many people are on the protein shake band wagon.  The problem occurs when overweight people start using them as a beverage.  I love protein, don't get me wrong.  I think it's the one thing we all need to make sure we're getting enough of daily.  But if you are overweight, you need to use the protein shake as a REPLACEMENT for something - not a supplement.  In other words, if you don't normally eat breakfast and decide to start doing protein shakes for breakfast, you have just added 200 calories to your day for no good reason.  Bad idea. If you normally eat a pack of Donut Gems for breakfast and decide to switch to protein shakes, you just saved yourself 200 calories and added about 9 grams of protein to your day.  Overall a win.  Of note, all protein shakes chosen should be at least 15 grams of protein, less than 200 calories and less than 10 grams of sugars per serving.

As for fruit juice - you might as well have a Coke.  Studies have repeatedly shown that there is a clear association between juice consumption and obesity among children.  There really is no benefit to drinking juice, besides that it tastes nice!  Even though there are some small amount of vitamins present in some (not all) natural fruit juices, it is still not enough to provide us with the amounts we actually need.  This abstract is from a very recent article confirming, once again, that fruit juices contribute to obesity:

Most of us really should be on a multivitamin, Calcium and Vitamin D anyway.  So why waste the calories.  (BTW, that repetition was not accidental.)

With regard to "sports" drinks, I am left scratching my head.  Maybe it's because our education system is so crappy when it comes to health related information.  Maybe it's because the language used in marketing is designed to confuse and obfuscate.  But when I see my morbidly obese patients or friends drinking energy drinks, I have to ask "Do you know what "energy" they are referring to?"  Energy, my friends, equals calories.  Why anyone who is trying to lose weight would intentionally down 20 ounces of "energy" is beyond me.  If the label said "Fat Rear", would you drink it?   Yes, you sweated when you walked to your far off parking spot at the mall.  OK, maybe you even spent an hour doing Zumba or riding bike.  But seriously, the only people who need an "energy drink" are underweight extreme athletes.  Ran a full marathon, go ahead, have one.  Ran a 5k?  Have a Diet Coke.

Now, to my saddest statement.  If you are truly serious about losing weight, you should not be drinking any booze.  I know, it stings, really I do.  But in addition to the empty calories (9 per gram, about the same as fat), it has other issues.  First, alcohol increases appetite. The last thing most of us need is an increased appetite, it's hard enough to behave with the one we started with.  Secondly, it decreases inhibition which also means in makes us much more likely to cheat or eat things we otherwise wouldn't.  Jenny Craig or Nutrisystem (I can't remember which) referred to this as the "tipsy taster".  If you need to take the edge off, you'd be better off with a massage, a Xanax or a joint (but only if you live in CO, and only if you can control yourself with the munchies.)  And seriously, if you find that you really can't stop drinking until you've reached your goal weight or are close to it, then you likely have some issues that need to be sorted out that are just as important as your weight, if not more so.

So Baby Step #1 is to eliminate all liquid calories from your life starting today.  Give it a whirl for at least a few weeks to decide whether it's a tolerable way of life for you.  Studies say that if you do something for 60 days straight, it becomes a habit.  And dropping a few hundred calories a day is probably a habit we could all use.

Coming Monday:  Weight loss mathematics! 

Have a great weekend!

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