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Entries in weight loss (6)


John Cisna and McDonald's Open Door Tour

Last week I wrote about Freshii, a healthy fast food chain. Now I get to talk about McD's, the fast food icon in an interesting position. Two weeks ago the emperor of fast food announced that it planned to close 900 of its restaurants worldwide after a $400 million loss in the first quarter this year. Increasing competition from new chain restaurants and a negative image of its "junk food" menu are likely contributors. With the rising costs of health insurance and out-of-pocket medical fees, consumers are proactively choosing prevention by eating better and losing weight. This has helped fuel the demand for fast food vegetarian and plant-based options while traditional fast food of hamburgers, French fries and soda loses ground.

Still I'll readily admit that I'm rooting for McDonald's. The golden arches are a familiar comforting sight whenever I'm on a road trip. I enjoy McD's low cost soft serve ice cream cones and oatmeal and allow my son a chicken nuggets/French fries meal a few times a month (and yes I do snitch a nugget and a few fries!). I hope they'll recognize the necessary trend of healthier fast food and continue to evolve their menu.

Fruit and Maple Oatmeal

I attended McDonald's Open Door Tour last weekend with other Boston-area bloggers to get a behind the scenes glimpse of their food production and hear an inspiring talk by John Cisna, the now famous Iowa science teacher who lost over 50 pounds eating only McDonald's meals for three months. This event clearly showed me that McDonald's radar is on, as they highlighted their fresh produce, fruit smoothies, oatmeal with fresh diced apples and dried fruit, and use of fresh whole eggs in their Egg McMuffins. The highlight of this event for me, as a dietitian who sees a majority of patients who eat out more than twice a week, was John Cisna's talk.

If you don't know his story, Cisna is a high school biology teacher who challenged his sophomores to design a scientific research study. With no ties to McDonald's at the time, they created the hypothesis, "Is it possible for a person to become better off by eating nothing but McDonald's for breakfast, lunch and dinner for 90 days?" His students set daily nutrition goals for calories and 14 other nutrients based on the Recommended Dietary Allowances and USDA Dietary Guidelines for Americans. They then researched the McDonald's menu, which discloses full nutrition information, to create a detailed menu for Cisna. This is a timely and relevant hypothesis, as McDonald's suffered a noxious blow with Morgan Spurlock's Super Size Me documentary in 2004. If you don't recall the queasy details, Spurlock ate only McDonald's for 30 days and not only gained 25 pounds but increased his cholesterol, developed a fatty liver, and suffered "mood swings." Despite the fact that Spurlock was eating about 5000 calories daily, double the amount the average overweight American eats, viewers walked away with greater distrust for corporate McDonald's and the "poison" it was serving.

Cisna didn't know what his students' experiment would reveal, but he followed their menu strictly. Sure he ate plenty of salads, oatmeal, grilled chicken wraps and Egg White Delights, but he also enjoyed cheeseburgers, French fries and sausage burritos. As long as the meals fit the nutrition guidelines, he was allowed to eat it. The calorie goal was 2000, though certain days he dipped to 1700. Though his sodium and sugar intake exceeded government recommendations on certain days, overall those intakes were significantly lower than in his previous diet. He exercised moderately, walking for 45 minutes 4-5 days a week. 

The results? ...and God bless him, I do have the exact results because he sent me the full Excel spreadsheet displaying all 90 days of each meal with 15 nutrients, his exercise routine, weight, body measurements, cholesterol and triglycerides. From 9-15-2013 to 12-15-2013:

  • Weight dropped from 280 to 243 (37 pounds)
  • Cholesterol dropped from 249 to 170
  • Triglycerides dropped from 156 to 80
  • Lost 4.5 inches from his chest, 6 inches from his stomach, and 4 inches from his hips

Cisna continued to lose weight after the experiment and by March 2014 he had lost a total of 60 pounds. The key factor is that he also kept it off. A self-proclaimed recovering foodaholic, he now believes that there is no such thing as bad food, and fast food is not the problem. Quantity is the problem. Though he still eats at McDonald's several times a week, he stresses that this was an experiment, not a "McDonald's diet," to show that choices matter. "It's ok to have a Big Mac some days but not all the time. If I eat a 700 calorie slice of cheesecake, I accomodate my meals the rest of the day to fit it in."

It's sound, real-world advice. When I counsel patients in the nutrition clinic, I heavily promote a plant-rich diet because I believe plant foods are healing for almost every chronic disease: obesity, cancer, diabetes, cardiovascular, gallbladder, kidney stones, etc. etc. etc.! Many patients are ready for that, but many others aren't. They rely on take-out and fast food. For these folks, I help create sample menus that include take-out food and gradually introduce more plant foods. We research online restaurant menus for nutrition information and make better choices, similar to what Cisna did. And they lose weight and improve their bloodwork, as Cisna did. I agree with Cisna that it's about choices. You don't have to be a vegetarian and a Whole Foods devotee to be healthier, despite what a growing number of whole foods believers preach. I'm actually seeing more patients in the clinic who are gaining unwanted pounds eating too many high calorie foods with a health halo.

I applaud Cisna for going against popular opinion and reminding us about the importance of choices and moderation. Check out Cisna's video 540 Meals for more details about his experiment:

Disclosure: I received compensation from McDonald's in exchange for writing this review. Although this is a sponsored post, all opinions are honest and my own.


Weight Loss Without a Gimmick?

Losing weight is no joke. Infomercials for new diet plans and exercise videos make it look so easy. Everyone gushes about how fast they shed the pounds. Reality shows that even 10 solid pounds is a mountain to conquer. Most people who are obese (body mass index greater than 30) who walk into my nutrition clinic say they want to lose 50 pounds if not more. Only a handful ever reach that number. Most lose somewhere between 10-20 pounds over one year. Keeping it off is another chapter, and I don't call it success unless the weight lost stays off. Those who have permanently lost a lot of weight never say it's easy. They realize it's a complete lifestyle change that targets your home and work environment, your ingrained eating habits, and your friends' and family's support (or lack of). If you can get that under control, you still have to deal with constant visual stimulation from media food porn, unexpected stressful events that may throw you off, and societal pressure to look a certain way or weigh an exact number on the scale.

April grew up overweight in an environment where exercise and fresh home cooked meals didn't exist

So if I meet someone who has lost and kept off a lot of weight, I'm seriously impressed. If they've lost the weight without pills or a silly diet that omits entire food groups, I'm floored. I met that person this year in Zumba class, April Lamrock. When I first saw her, my instant impression was a very pretty girl who looked strong and confident. I'd never guess that a year ago she had weighed more than 300 pounds. 

April grew up overweight, not physically active and not eating healthfully. Her parents never cooked meals at home and ordered take out or fast food. She became a picky eater.

When she reached her peak weight at 309 in January 2013, she joined the Tanger Be Well Center at Beth Israel Deaconess Medical Center. She attributes the staff leaders in the program in helping her to lose weight slowly but steadily in the next several months with a no-frills plan of exercising and eating a sensible diet. She was intimidated by the fitness aspect as she had never exercised before but they were encouraging and helped her ease into it. She started exercising three days a week with 20 minutes of cardio and 20 minutes of strength training. After a few months she had worked up to six days a week of 30 minutes each of cardio and strength training. April recalls what helped the most was when the staff would check in with her if she had skipped a day or two. She needed accountability.

Regarding eating, April says that she already knew what to do. But because she was a picky eater, certain foods like whole grains, fresh fruit and fish weren't an option. Chicken and broccoli became her staples. Her main challenge was and still is to expand the variety in her diet. 

Because of her discipline and determination with a consistent exercise regimen of one hour 5-6 days a week, cutting out fast food, and eating more lean protein and vegetables, she lost weight to 193 pounds by the end of November 2013.

April before and after, having lost 116 pounds in 11 months, without diet pills or a fad diet (wow!)

April admits that this year old habits have crept back, along with the weight. She has less drive. "Now that I've lost the weight and feel I can look good in clothes, there isn’t as much motivation to keep eating right. I have since gone to see a nutritionist and she gave me a few tips." She's considering joining a weight management support group and has resumed logging into MyFitnessPal, which helped before. "Hopefully having the cold hard facts right there will make me stop eating badly."

April working a pose; she had regained about 17 pounds here

Ready to shake it in Zumba















I only know April through Zumba class, so right now she only sees me as her Zumba instructor. But as a nutritionist I'm dying to tell her that healthy eating is not only chicken and broccoli and salads. I'd encourage her to try one new food a week, and I'd show her easy recipes that taste amazing. I'd tell her that negative reinforcement ("bad foods" mentality) rarely pushes people in the right direction for long, because they end up forever craving those forbidden foods. I've already told her that even though she's discouraged with her weight regain, even right now she has the curvy fit body that most Zumba instructors wish for and that she needs to let her body find its way, rather than beating it up to reach a personal low or meet a body mass index number. Weight loss without a gimmick or magic bullet can be a long tedious journey with highs and lows. But real permanent change takes time because it's not just about losing weight; it's about making peace with your body, learning to treat it with respect by responding to its physiological and emotional needs, and discovering who you are beyond your size whether you're a skinny minny or have 10 pounds to go. Easier said than done I know, so I'll just end with a favorite quote: 

Never give up, for that is just the place and time that the tide will turn  —Harriet Beecher Stowe


The I Diet: A Diet That Respects Your Instincts 

I don't often post about diet books. I guess it's because I find the tenets of effective weight loss to be pretty basic; my favorite quote is by longtime obesity researcher Dr. Jules Hirsch, "Eat as little as you can get away with, and try to exercise more." Of course that doesn't address the importance of eating a high quality nutrient-dense diet or the greater complexities of keeping weight off, but I believe it'll do for straightforward weight loss. Another reason may be that I view diet books as gimmicks even if they're perfectly nutritionally sound. They simply find a new angle or approach to view weight loss. That doesn't mean I don't recommend them to some people who may need yet another magic bullet or new hope to try again. One book I appreciate is The "I" Diet by Susan Roberts. It's not new; it debuted in 2008 and was revamped in 2010 in paperback. But during this time, it's garnered great reviews from reputable sources and from, most importantly, success story readers. Dr. Roberts is a professor of nutrition and psychology specializing in obesity research, and the director of the Energy Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, with almost 200 published research papers. I've heard both Dr. Roberts and Dr. Blumberg (from last week's post) speak from my grad school days at Tufts and I can vouch that they are the best of the best in their research fields. This L.A. Times review details some points of the book, and then check out my recent interview with Dr. Roberts as she explains the reasons why The "I" Diet (referred to as "iDiet" below) has been such a success.

Q: The big question is what makes your diet book different from endless other weight loss books that people have tried and given up on?

A: iDiet has a unique dietary profile and a different type of behavioral program that makes weight loss easier:

  • Most diets fixate on one specific dietary factor (e.g. high protein with the Atkins, or low glycemic index with The Zone) but the science shows that one single dietary focus doesn't work that well. iDiet is the only diet that packages together all the nutrition science into one diet. It effectively suppresses hunger and makes it more enjoyable (i.e., offering a greater range of good foods).
  • Our behavioral support program in the groups is unique. We actually don't focus directly on weight loss, but rather on scientifically changing food preferences with 'cognitive restructuring' exercises, and also we put a lot of effort into making it easy. The combination of these things allows our program members to say 'It doesn't feel like a diet.' That is why they're able to stick with it and enjoy it more.

Q:  What are the basic tenets of this diet?

A:  We recommend a moderately high protein, high fiber, mixed glycemic index and high volume diet. That sounds complicated and it is, which is why we have lots of menus, recipes and no-cook meals that people can get started with to learn what a good, satisfying (and tasty) meal looks like.

Q:  Can you briefly explain how the "I" or instincts are related to weight control?

A:  Our 'food instincts' are the basic aspects of our biology that drive eating. For example, when we are hungry we have to eat (hunger is one of our instincts). When food is present we eat it (instinct: availability). We need to eat things we know and love (instinct: familiarity) and we love high calorie foods. The last instinct is variety: when we have a varied diet we eat more unconsciously. iDiet recognizes these basic biological drivers of what our body and brain need; it works with these instincts and harnesses them to make weight loss easier. We put a lot of emphasis on not being hungry. That is a huge revelation to most dieters. They love feeling satisfied, which allows us to work more effectively on psychological challenges like stress eating that some of our dieters are prone to.

Q:  The book cover describes this as "A diet where the dieter never goes hungry or feels deprived." That sounds impossible for a weight-loss plan! You eat fewer calories, so you should feel hungry right?

A:  No, that is the perception but we have the science optimized and people really don't feel hungry. It isn't that hard when you know how!

Q:  Will I have to buy special foods or cook special meals, and can my whole family eat this diet (e.g., is it nutritionally complete for a child or teenager)?

A:  There are no special foods or meals in the sense of it being weird diet food. We have our own menus and recipes (because that is partly what makes the diet work better than other diets) but they are family friendly and many of our dieters say that their family likes the food more than other things they used to eat. We have pizza, chicken parmesan, and Chinese and Mexican recipes. Some members do a combination of iDiet meals (the Mexican Lettuce Wraps are really popular) and foods the kids want (e.g., chicken nuggets) and then they have their own iDiet food for that meal. Over time, they often find family members trying and loving their meals. We have many adult partners come to our annual parties and rave about the food and talk about their own weight loss while their partner was in the program!

Want to hear more from Dr. Susan Roberts in person? Check out a dinner and workshop being hosted by Healthy Habits Kitchen in Wellesley on Tuesday January 29 at 7:00 pm. The $29 fee includes the workshop, a delicious HHK dinner, and a copy of her book.