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Johns Hopkins Health Alerts - Nutrition and Weight Control
- How To Maintain Your Weight Loss
Exercise is a valuable element of a weight loss program. Although exercise alone leads to only modest weight loss, and at a slower rate than calorie restriction, combining exercise with diet results in greater losses of body weight and fat than dieting alone. But what about your exercise program once you've achieved your weight goal? Johns Hopkins reviews that data to answer this important question.
Exercise is especially important for weight loss maintenance, which is harder to sustain than losing weight in the first place. And adding exercise to calorie restriction makes the dietary changes easier because they need not be as drastic. It is easy to see why this is so. To lose one pound per week requires a deficit of about 500 calories a day. By adding a half hour of moderate to vigorous exercise each day (enough to burn 250 calories), you can reduce the calorie restriction to a more manageable 250 calories daily.
But the good news is that high levels of exercise are not need to maintain weight loss – this according to a study published in the journal Obesity (Volume 15, page 1226). Exercising at a moderate intensity for an hour or more on most days of the week is generally recommended to maintain weight loss. However, a study from the University of Alabama at Birmingham suggests that a high level of physical activity isn't the only route to successful weight maintenance.Eighty-nine participants in the university's Eat Right weight-loss program were evaluated a year after they completed the program. Eighty percent of the participants had maintained their weight loss (regained less than 5% of their ending body weight). The researchers found that the maintainers consumed 384 fewer calories per day on average than the participants who regained their weight. They also tended to eat more low-energy density foods, such as low-calorie but filling fruits and vegetables, than the regainers.
However, no significant differences were noted in the amount of exercise engaged in by the maintainers vs. the regainers -- although there was a suggestion that subjects who exercised more regained less weight than those who exercised just a little or not at all.
The bottom line: While exercise is recommended to maintain a weight loss, you may be able to get away with more modest (and doable) amounts than typically advised if you eat a low-calorie diet.
- Small Changes Equal Big Impact on Your Cholesterol
Exercise and adopt a healthy diet. This age-old advice still holds true for those of us who need to improve our cholesterol profiles. In this Health Alert, Johns Hopkins nutritionists provide practical advice to help you achieve your cholesterol goals – even if you also take statin medication.
You hear it all the time: Watch your cholesterol. Elevated cholesterol levels, along with high blood pressure, smoking, and excess weight, increase your risk of coronary heart disease. But what exactly does watching your cholesterol entail?
It means lowering low-density lipoprotein (LDL) cholesterol, the type that narrows arteries, while striving to boost high-density lipoprotein (HDL) cholesterol ("good" cholesterol), which helps remove LDL cholesterol deposited in artery walls.
Total cholesterol levels should be less than 200 mg/dL, with LDL cholesterol as low as 70 mg/dL if you have coronary heart disease and as high as 160 mg/dL if you have no risk factors for coronary heart disease. Ideally, HDL cholesterol should be above 60 mg/dL or at least above 40 mg/dL in men and 50 mg/dL in women.
But to take the next step by making lifestyle changes to get your cholesterol levels in the right range, you need a game plan. That applies whether or not you've been prescribed a cholesterol-lowering medication.
Small Changes, Big Impact -- Try making gradual heart-healthy changes in your current diet. You're more likely to stick with your new eating plan if you start slowly:
- Add a vegetable serving to your lunch or dinner.
- Substitute a piece of fruit for cookies, cake, or ice cream as your dessert or snack.
- Drink low-fat or skim milk at lunch instead of soda.
- Cut back on meat portions by a half or a third at each meal. (Shoot to eat 3 oz, the size of a deck of cards.) Select only lean cuts; trim away fat; broil, roast, or boil (don't fry!); and remove skin from poultry.
- Eat one or two meatless meals a week.
- Choose whole-grain foods. (Look for the word "whole" instead of "unbleached" or "enriched" as part of the first ingredient listed in a product.)
In addition to dietary changes, experts recommend burning 1,500 calories a week with exercise to impact levels of cholesterol and especially triglycerides, which breaks down to about 20–30 minutes of daily moderate-intensity activity like walking, swimming, or cycling.
While lifestyle is important, oftentimes using a medication, like a statin, is the most effective way to reduce LDL cholesterol. Still, dietary changes can help ward off the need for drugs or help your medication work more effectively.
- Food Safety Advice
Johns Hopkins nutritionist Lora Brown Wilder explains how to keep bacteria from poultry or meat out of your kitchen.
Q. I recently heard that you should not wash poultry or meat before cooking it. Why is this?
A. It’s because: (a) cooking the meat or poultry thoroughly will kill any bacteria, and (b) rinsing meat and poultry can splash bacteria onto dishware, utensils, and other foods.
Always cook meats and poultry at recommended temperatures to kill bacteria and use a meat thermometer to ensure that the meat is cooked all the way through. The U.S. Department of Agriculture (USDA) recommends a safe internal cooking temperature of 160 degrees F for ground beef, pork, veal, and lamb, and 145 degrees F for steak and roasts. Chicken breasts and whole birds should be cooked to 165 degrees F.
Follow these other tips for safe meat and poultry preparation:
- Store raw meat, poultry, and seafood at the bottom of the refrigerator so their juices don’t drip onto other foods.
- Defrost and marinate meat, poultry, and seafood in the refrigerator -- never on the kitchen counter.
- Use different cutting boards and plates for raw meat, poultry, and seafood vs. produce, ready-to-eat, and cooked foods.
- Wash all utensils and cutting boards in hot, soapy water after you prepare each food item.
- Refrigerate leftovers promptly after eating.
- Wash your hands frequently before, during, and after cooking.
- Which is Healthier: Butter or Margarine?
In this "Ask the Doctor" column from the Hypertension and Stroke White Paper, a reader asks, "Which is healthier: butter or margarine?" The answer may surprise you.
A. Trans fat-free tub and liquid margarines are healthier choices than butter because they contain the least “bad” fats.
The trouble with butter is that it has both saturated fat (7 g per tbsp) and cholesterol (33 mg per tbsp), which can raise your total and LDL cholesterol levels and clog your arteries. Regular margarine isn’t necessarily better: The more solid a margarine is, the more trans fat it contains -- most stick margarines have a whopping 3 g of trans fat per tbsp (as well as 2 g of saturated fat per tbsp).
Since there is no established safe level of trans fat consumption, it’s best to eat as little as possible. Look for margarines that list liquid vegetable oil -- not partially hydrogenated vegetable oil -- as their first ingredient. Some have less than 0.5 g of trans fat per serving and are considered trans-fat free.
Just be sure to control your calories when using these products, since fats are the most caloric foods we eat: On a diet containing 2,000 calories a day, the Dietary Guidelines recommend no more than 6 tsp of oils and fats a day.
Finally, when cooking, use oils that are high in monounsaturated fat -- like olive or canola oil -- instead of butter or margarine. Monounsaturated fats are considered healthy when consumed in moderation because they reduce harmful LDL cholesterol levels and rai