Monday, December 23, 2013

SMART Goal Setting Review

Tis the season for Setting Goals!

Do NOT sell yourself short! You can achieve what you set out to achieve, just be sure to create the right road map (i.e. behaviors to reach the goal).

Be sure to check out my YouTube channel coming in 2014!

www.dietitiandant.com -click on the Video tab.

Sincerely,

Dietitian Dan T

SMART GOAL SETTING

In the spirit of the Holidays, please enjoy my segment on how to set SMART goals.  Adopting this effective strategy should help to optimize your chances of successfully setting and reaching a goal rather than the business as usual New Year’s Resolutions, as you will see.  ENJOY!

Every New Years we do it...  Take a look at our lives and decided to change… something! January has the highest number of people starting lifestyle change plans, etc… However, it also has the highest percentage of these individuals who drop out, or quit!  Therefore, we examine how to set goals in a way that maximizes our chances of following through! 

SMART Acronym:
1)     Specific – Must answer the six “W” questions:
a.    Who – is involved?
b.    What – do I want to accomplish?
c.    Where – Identify a location.
d.    When – Establish a time frame.
e.    Which – Identify requirements and constraints.
f.    Why – Specific reasons, purpose or benefits of accomplishing the goal.
Example: SMART Goal regarding health = Do cardio training for 45 minutes 3 days / wk and resistance training for 45 minutes 3 days/wk at XYZ fitness club VS. Get in shape.

2)     Measurable – Concrete criteria for measuring progress towards the attainment of each goal you set & regularly scheduled progress checks.

3)     Attainable – You begin to figure out ways to achieve your goals.  Develop attitudes, abilities and the skills to reach them.  This “development” occurs only when you see goal achievement as possible for you.  Stair steps/Stage wise – over time what was once inconceivable to you becomes well within your achievement.

4)     Realistic – A goal must represent an objective toward which you are both WILLING and ABLE to work.  TEST of Realistic = DO you BELIEVE that the goal is attainable?

5)     Timely – A goal should be grounded with a time frame.  This increases your sense of urgency and can help you tap more of your resources to achieve the goal.

Other tips for Lifestyle Change Goals: 

A) Include adhering to your lifestyle habits as an outcome (i.e. I will consume 8 servings of fruits and vegetables per day; or 5 vegetables and 3 fruits per day; or I will do 3 cardio and 3 resistance training workouts this week (for 30 – 45 min each)).  This is critical, because change in measured parameters may take some time, but this way you know & are recognizing if you are on track behaviorally or not.
B) Research your desired outcomes and be sure to discuss them with a health professional who can help you set a realistic target and timeframe, as well as help you overcome obstacles and use effective, proven strategies.
C) Share your goals with peers who can support you and hold you accountable to your standards.
References:

1) Adapted from: Psycho-education.  2006.  Dr. I. Patelis-Siotis, McMaster University, Hamilton, Ontario.
2) Wikipedia entry on SMART/ER - http://en.wikipedia.org/wiki/SMART_criteria.

Friday, October 11, 2013

What is the Real Deal behind Preventing Cardiac Risk?


It's been quite a while since my last post.  I am neck deep in preparing for my PhD Comprehensive exam (early Dec 2013), working full time & caring for my almost 2 year old daughter as my wife and I have another child on the way (due Feb 2014).

I have to tell you honestly, that I am constantly disappointed by the current medical profession specifically when it comes to dealing with chronic diseases! As a registered dietitian I see it as my duty to constantly review the literature to see what new innovations might show promise. It's my responsibility to understand these novel studies so that when clients inevitably ask about them, I will be able to give them legit advice & not just tow some antiquated party line!

Okay, enough venting!  Let's dive into some of the newer evidence on Heart Disease Risk!


The Popular Dogma is Not Supported by Current Evidence

1)      Saturated Fat
a.       The current dogma is that eating too many saturated fats increases blood cholesterol, which in turn increases risk for heart disease.

b.      A few studies have shown that there increased levels of LDL increase risk for CHD.

c.       But, recent research concluded that there was in fact no association between dietary cholesterol and CHD.

d.      As of 1977 AMA/CMA recommended lowering fat intake to 30% or less in diet – result=significant change in diet composition - ­ Carb/­ PUFA (specifically vegetable oils – all ­ omega 6).

e.      If we oversimplify and just ask two basic questions, we start to see the challenges that have arisen: i) What about evolution? Did we evolve eating more carbs and seeds & nuts or animal & coconut fats? ii) What about inflammation? Which is more inflammatory in nature: SFA or omega 6 + refined carbs?

2)      Apo lipoprotein Changes
a.       This change in diet comp – resulted in changes to our circulating lipoproteins that actually increase our risk for CHD (specifically - ­ Triglycerides/ ¯ HDL particles).

b.      New technology explains why LDL amount is not as telling as once believed.  Particle size of   Think of cholesterol as the passengers in a car and the particle number is the number of cars on the road.  If there are more particles around then they are more likely to crash into the arterial linings and become trapped (atherosclerosis).  If LDL particles are smaller, there will be more of them present, when they are fluffy and big, and then there will be less of them.  Theoretically, the amount of LDL could be the same in both scenarios, but it’s the small, dense LDL particles (that are more abundant) that increase the risk for CHD.
LDL particle size is far more predictive of atherogenic risk.

3)      The Role of Carbohydrates in CHD
a.       Carbohydrates were pre-farming available in unrefined forms (vegetables & fruits) and only in the late summer and fall.  Today, we have year round access to the most highly refined carbohydrate sources we’ve ever seen.

b.      High carbohydrate intake shuts down fat burning & promotes fat storage.  This increased fat storage leads to an increased production of triglycerides.
c.       Hypertriglyceridemia is accentuated in people with abdominal obesity/insulin resistance.

d.      This insulin resistance occurs in the face of high carbohydrate diets & is now considered a protective measure by the liver to prevent substrate overload.

4)      The Role of Inflammation
a.       Athersclerosis does not occur in a vacuum (so to speak).  Inflammation and oxidation are required to promote infiltration of lipids within the arterial walls and the binding of minerals to them (plaque formation).

b.      High carbohydrate diets & especially refined carbohydrates are highly pro-inflammatory.

c.       Omega 6 fats are essential (small amounts) but in excess are highly pro-inflammatory.  They are highly available in Western diets (corn, soy & wheat oils) as well as most nuts & seeds.

d.      Recent studies have shown that low carbohydrate diets are effective at reducing cardiovascular risk factors.
Citations:
Djousse, L and Gaziano, JM, 2009.
German, JB and Dillard, CJ, 2004.
Agius, L, 2013.

Monday, August 19, 2013

Pratical Application - My Food Processing Spectrum

My research on choosing the best foods for best results for fat burning & best performance is based on a solid Paleo/Primal research foundation!  With respect to food processing, this translates to our bodies not having the ability to deal with many of the food processing techniques very well.  In some cases food processing increases availability of energy from foods but in many cases our bodies don't recognize the chemical compounds added to foods and often have effects on our bodies that are not good.  However, all of this can often be confusing for some people and put others off completely, therefore, I'm taking a crack at it from a different angle here.

Consider for a moment if everyone limited their exposure to processed foods.  I have discussed this in a previous blog post, which was more theoretical and less practical.  I've gotten a lot of questions about how to apply this and I've come up with my Food Processing Spectrum (below).  This provides a practical tool that people can use to guide them to create the least processed meal options available.

Think of food a spectrum of processing and choose the least processed foods that you can.  I'm not a raw food purist or anything, but be sure to eat more foods that are less processed over those that are more processed.  In fact, for 60 days just omit all foods from the processed side of the spectrum and see how that works for you.



You want to make sure that most of the foods you eat come for the least processed end of the spectrum.  Things that will "process foods" include:
a) Cooking: Bring foods to their safe (bacteria killing) temperatures, but try to avoid overcooking them.  Charring of meats (for example) leads to formation of heterocyclic amines (HCA) that have been shown to be highly carcinogenic compounds.
b) Pasteurization: This is essentially heating to very high temp. Most beverages that were once alive in North America (i.e. Dairy & Fruits beverages) are pasteurized to prevent bacterial growth.  This denatures enzymes that are normally present in the fresh foods. It is currently illegal to sell unpasteurized dairy products in North America.  Putting fruits & vegetables in a blender, however, creates a living smoothie with the entire enzyme profile intact. Canned foods (i.e. fruits and veg) are often pasteurized to prevent bacterial growth, but in doing so many of the plant-derived enzymatic benefits are lost.
c) Blending: Breaks up solids and even cells (depending on your blender).  It can liquefy many of the components and therefore creates a drinkable meal option.  Be VERY careful with smoothies as it's always better to eat your calories vs. drink them!  Depending on the composition of the smoothie, these can be very high in available carbohydrates and therefore cause huge spikes in insulin, therefore stopping fat burning & leading to fat storage!
d) Milling: This is pretty much exactly the same as Blending but with solids (i.e. all grains).  This is used to create flours and much of the original content is removed then added back. However, one of the biggest issues with this process is that it is all done by machine today and the particle size that results from machine milling is so fine that it can penetrate the gut wall and cause overt irritation or at least increase inflammatory response. There is also evidence that some of the naturally occurring irritants in grains (i.e. Lectins, etc...) that are not removed in usual production are causing increased inflammatory responses.  Either way, grains seem to be a bad choice!

d) Freezing: This process cools the food in order to significantly slow down the molecules and enzymes that lead to spoiling.  They are not stopped, but are severely slowed.  The major drawback with freezing some items (i.e. fruits) is that the fluid in the cells freezes and when they are thawed this intra-cellular liquid expands and bursts the plant tissues therefore making things mushy!  Freezing does NOT kill enzymes and is a great second choice to fresh for most people.
e) Chemical additives, preservatives & artificial ingredients: These are the most encountered and least recognized food processing techniques in existence today.  If you eat anything in a package at all, you are consuming these chemical ingredients.  Many are designed to extend shelf-life, decrease cost of production for the food company, and many also have the added benefit of stimulating appetite in consumers can lead to food addiction or over-consumption. Regardless, none of these ingredients are used with your health in mind.  Therefore, we NEED to avoid them as much as possible.
f) Fermentation: This technique is a more natural processing technique. It allows bacteria & enzymes that occur naturally in the foods to work to start breaking down the food into components (example is Eskimos that buried meat & consumed it fermented).  Obviously, this is not without some risk for foodborne illness, but when done properly it can be an awesome way to increase the nutritional value of many food items.

Obviously, there is a lot more to this story, but this seems like a good start.

Be sure to choose the least processed foods that you can on a regular basis.  Try this for 60 days and see how you look, feel & perform!