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Carrots and Sticks: Setting a Realistic Goal

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In his book Carrots and Sticks: Unlock the Power of Incentives to Get Things Done, Ian Ayres, a contracts professor at Yale Law School, writes about an interesting insight that he had regarding his own weight loss efforts. After numerous but only temporarily successful efforts, he finally had a realization. He knew, unfortunately, how to eat in a way that kept his weight around 210 or so (I can’t remember the exact number). He also knew how to eat in a way that brought his weight down to around 170 (or so), although he couldn’t sustain it for more than a few months. But he didn’t know how to eat for 190 pounds.

And so, he was doomed to see-saw back and forth until he finally figured that out. And it wasn’t until he learned this that he was finally able to sustain his new reduced weight. Although it wasn’t exactly the goal weight he had originally set, it was, on the other hand, permanent.

The research has shown, over and over, that most dieters are capable of sustaining a weight loss of no more than 10% over the course of a year. This is true across all kinds of programs, no matter how well known.

I believe that we will someday understand a biochemical basis for this. The question that I continue to ask myself is whether a person can spend sufficient time at their “compromise position” weight to establish it as a new baseline weight from which it might be possible to lose another 10% successfully and permanently.

Of course this approach requires a fair amount of patience and perseverance, both of which tend to be in short supply in people who want to lose weight. I still believe there is a neurochemical underpinning to this, which is why I counsel people not to focus on their weight.

Instead of weight, I focus on just two things. The first is to concentrate as much as possible on productive choices and not to sweat it if you’re successful only 50% or 75% or 90% of the time, let’s say. I’d rather have people identify the single least healthful activity in which they engage, and then work to decrease the number of ounces of soda or chips they eat on a daily, or weekly, basis. I encourage them to see where things stand in a few weeks or months. Their very best has got to be better than their current eating pattern, and it’s essential to remember that 100% is neither necessary nor practical.

Secondly, for people who like having something to measure, I recommend getting a tape measure instead of a scale. If you want to see how you’re progressing, check your waistline. To me that’s a much more valuable measurement. I really don’t care how much people weigh; I want to know how their pants fit.

As pants continue to fit better and better, weight begins to fall. When that happens I have seen the rest take care of itself. It may translate into “only” a 10% weight loss, but it will be real and permanent.

YOUR HEALTHY PLATE: Lemon Coconut Macaroons

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I don’t post too many desserts on the blog, not least because I’m always trying to think of strategies for decreasing, and not increasing, the amount of sugar in what we eat. But it’s a special occasion! And the almond flour and coconut have the benefit of decreasing the rate of absorption of the sugar in this recipe. But enough of that. I have always loved Passover. One of these days, after you make your own macaroons for the first time, you will NEVER — and I mean NEVER — again buy a can of those tasteless cardboard macaroons.

  • 3/4 cup almond flour
  • 1 1/2 cup dried, shredded unsweetened coconut
  • 1/4 cup plus 1-2 tablespoons honey
  • 1/4 cup coconut oil, gently melted
  • 35 drops organic, food-grade lemon essential oil
  • Pinch of sea salt

Line a baking sheet with parchment paper, and set oven to 200 F.

Combine almond flour, coconut, salt, honey, coconut oil, and lemon oil, and mix well. Form the macaroons by gently pressing the dough into a tablespoon, and then tapping the raw macaroon dough out of the upside-down spoon into your hand. Place each macaroon on the baking sheet.

Bake 45-50 min, and then allow to sit for 15-20 min. The outsides will be slightly dry and the insides will be soft and chewy. Makes about 18.

Thank you to www.mommypotamus.com for this recipe.

YOUR HEALTHY PLATE: Roasted Beet Salad with Arugula

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Arugula is quite possibly my favorite food.  For sure it’s my favorite green food.  I can’t get enough, and I can’t wait for it to start to grow in the garden.  Also, I love beets, so this salad was a natural for me. Nutrition-wise, this dish truly has everything. The dressing is absolutely scrumptious.  Here’s the recipe for you to think about tonight while it’s snowing outside (again) in Cleveland on the first day of spring.

  • 3 large beets
  • 1/4 cup balsamic vinegar
  • 1/2 cup water
  • 1/2 cup walnuts, divided
  • 1/4 cup raisins
  • 1 teaspoon Dijon mustard
  • 1 clove garlic
  • 1/4 teaspoon dried thyme
  • 1 cup cooked chickpeas
  • 1 /2 lb. arugula

Peel scrubbed beets, cut into 1-inch chunks, and roast at 400F in 1 t. olive oil for approx. 30 min.  You can do this the day before if you want.

Process the balsamic vinegar, water, 1/4 cup walnuts, raisins, mustard, garlic and thyme in a high-powered blender until smooth.

In a large bowl, combine roasted beets, chickpeas, arugula and about 3/4 cup of dressing, or more. Sprinkle with the remaining 1/4 cup walnuts.

The Best Vegetables in the World

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I’m planning a presentation on nutraceuticals and supplements in the coming weeks, so I’ve got vitamins on my mind. Also minerals (calcium, iron), phytonutrients (colorful pigments), and other kinds of products (kelp, cinnamon, omega-3 fatty acids). In gathering together the information on sources of various vitamins, I have been struck by how many of the vitamins list fruits and vegetables as a rich and important source, particularly green leafy vegetables.

 

I make a strong case for getting most of our vitamins in the food we eat, just so you know. But not everyone gets all they need from their food, and that goes double — at least — for people eating the standard American diet.

Vitamin A is found especially in orange foods like carrots, sweet potatoes, apricots, mangoes, and papayas, as well as in green, leafy vegetables. Whereas the type of Vitamin A in many supplements can be toxic, the Vitamin A in these orange fruits and vegetables will never be toxic. That’s because foods provide not pre-formed Vitamin A but, rather, beta-carotene, which is converted to Vitamin A by our livers only in amounts we need at that moment.

Why green, leafy vegetables? Because they, too, contain large amounts of the orange, beta-carotene pigments; they are simply hidden by the dark green pigments. In my college organic chemistry class, using a technique called chromatography, we reproduced our own version of a famous experiment in which we mashed up spinach with a mortar and pestle, and then extracted the various pigments. Yes, the orange pigment was in there; I saw it with my own eyes.


Folate (vitamin B9) is another one. Think of the word FOLiage to get a sense of the strength of the connection between green leaves and FOLate. 


Vitamin C, a vital substance for our skin, our gums, and all our connective tissues, is found in large amounts in green leafy vegetables and all the citrus fruits. Vitamin E protects the skin from ultraviolet rays and prevents cell damage from free radicals. Vitamin K makes a critical contribution to maintaining a healthy circulatory system, particularly blood coagulation. 


My colleague Dr. Caldwell Esselstyn includes in his presentation a long, impressive, and memorized(!) list of greens that includes spinach, kale, romaine lettuce, red- and green-leaf lettuce, mustard greens, collards, arugula (also called rocket), broccoli, turnip greens, cabbage, Bok choy, Swiss chard, chicory, dandelion greens, and more. I enjoy hearing him go through the list rapid-fire.

Take your pick. It’s like taking a vitamin, but way better.

YOUR HEALTHY PLATE: Roasted Onion Hummus

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I’m always looking for new and interesting ways to eat hummus, also known as garbanzo beans or chickpeas. Here’s a great onion version. Really good. You can serve it as an appetizer at a party in a big, scooped out, sweet Vidalia onion sitting in a bed of greens. You can try making Red Pepper Hummus, too. Same idea, just with red peppers. This is a wonderful version for people who are allergic to sesame seeds, which (as tahini, or sesame paste) are in virtually all the commercial brands.

 

1 large onion, sliced thickly

1/4 teaspoon olive oil

1/4 teaspoon salt

2 cups cooked chickpeas, rinsed and drained

1/2 cup sunflower seeds

4 tablespoons lemon juice

1 clove garlic

2 tablespoons olive oil

3 tablespoons parsley

2 tablespoons water

 

1. Mix onion slices into olive oil until well coated, sprinkle with salt. 

2. Grill 7-10 min; flip to other side for approx 5 min more, until onions begin to soften and caramelize.

3. Combine chickpeas, sunflower seeds, lemon juice, garlic, olive oil, parsley, salt, pepper, and 1 tbsp water in food processor or high-speed blender and puree until smooth. 

4. Add grilled onions and process again until smooth. Add a bit more water if necessary to get the right texture.

Happily adapted from Let Them Eat Vegan by Dreena Burton.

YOUR HEALTHY PLATE: Chicken in Mirepoix

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When my kids were little they went through a phase where they wouldn’t eat chicken with bones in it.  It used to drive me crazy, mostly because I thought (and still do) that skinless, boneless chicken tends toward the dry and tasteless side.  So I fooled around with a few ingredients and, over time, came up with this, which turned into one of my children’s favorite dinners.  I ended up making it many times while they were growing up.  It’s moist, flavorful, delicious, and anything but dry or tasteless.

To move things along, if you chop up the vegetables over the weekend and bag them in the refrigerator, or maybe buy them already chopped if you can find, it takes five minutes to throw together, and about half an hour to cook, which is just enough time to throw together a salad, sign a permission slip, review a couple of pages of arithmetic homework, and set the table.

If you’ve never visited “Your Health is on Your Plate” before, visit Lets Start at the Very Beginning to get a jumpstart protecting the health and well-being of the ones you love!! Then check out “A Milestone Celebration — Your Favorite Posts” and “The Most Popular Blog Posts of All” for more great ideas and recipes! Wondering why I capitalize the “f” in Food? See Food with a Capital F.


2 tablespoons olive oil

1 large onion, diced very small

3 celery stalks, rinsed, chopped finely

2 carrots, peeled, chopped finely

1 /2 teaspoon salt

1 /2 teaspoon pepper

3 cups chicken broth

6 skinless, boneless chicken breasts

Fry the onion, celery and carrots in olive oil in a large skillet over medium heat until the onions and celery are translucent and difficult to tell apart.  Lay the chicken pieces on top, sprinkle with salt and pepper, cover with chicken broth, and cover the skillet.  Bring to a boil, then turn down the heat to low.  

Allow to cook approximately 30 minutes, until chicken is well done, broth is partially evaporated, and the vegetables have formed a thick chunky mixture, the mirepoix (MI-reh-pwah). Remove the chicken breasts to a serving plate, and pour the mirepoix over the chicken breasts as a sauce.

Bon appétit!

Follow Dr Sukol’s posts on Twitter @RoxanneSukolMD and on Facebook at Roxanne Breines Sukol or Your Health is on Your Plate.

YOUR HEALTHY PLATE: My Green Smoothie

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Okay, here’s the deal.  I’ve been up and out of the house every day this week by 6:30, and I haven’t arrived home even once before 10 p.m.  But, lucky for me, the refrigerator has a few goodies, including almond milk, berries and spinach, and so here is what I’m going to make for breakfast tomorrow morning.  The freezer in my house usually has a few overripe bananas — that’s where I put them when they turn too dark to eat.  Remember to peel them before you freeze them; it makes it easier when you feel like a smoothie.


If you’ve never visited “Your Health is on Your Plate” before, visit Lets Start at the Very Beginning to get a jumpstart protecting the health and well-being of the ones you love!! Then check out “A Milestone Celebration — Your Favorite Posts” and “The Most Popular Blog Posts of All” for more great ideas and recipes! Wondering why I capitalize the “f” in Food? See Food with a Capital F.


2 cups almond milk (or make your own beforehand with 1 cup almonds in 3 cups water)

1 very ripe banana, preferably frozen

1 orange, peeled

1/2 cup blueberries, blackberries, or raspberries

6 strawberries

3 generous handfuls of baby spinach

2 cups ice 


Add the ingredients to your Vitamix or other high-speed blender in the order listed above.  Spin for 30 seconds or until well blended, and then drink up.  Can’t wait til morning!


Follow Dr Sukol’s posts on Twitter @RoxanneSukolMD and on Facebook at Roxanne Breines Sukol or Your Health is on Your Plate.


Food, Allergies & Eczema

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I ran into an old friend yesterday and enjoyed hearing stories about her two young children, Mallory and Mikey. Once upon a time, she babysat for my young children; now she has babies of her own. She talked about their struggles trying to get Mikey’s eczema under control. I thought it would make an interesting topic for a blog post, and she agreed.

If you’ve never visited “Your Health is on Your Plate” before, visit Lets Start at the Very Beginning to get a jumpstart protecting the health and well-being of the ones you love!! Then check out “A Milestone Celebration — Your Favorite Posts” and “The Most Popular Blog Posts of All” for more great ideas and recipes! Wondering why I capitalize the “f” in Food? See Food with a Capital F.

Eczema, in case you don’t know, means allergies in the skin. Medicine has different names for allergies, depending on where they pop up. Allergies in the lungs is asthma, in the sinuses is allergic rhinitis, in the eyes is allergic conjunctivitis, and so on. I, myself, have wondered whether anxiety isn’t a manifestation of allergies in the brain. What I know for sure is that if you have allergies in one place you’re a lot more likely to have them elsewhere.  And, conversely, the better controlled your allergies overall, the fewer allergy-related problems you’re likely to have anywhere.

Ordinarily, an allergy starts when the immune system mistakes a normally harmless substance for a foreign invader. The immune system produces antibodies to attack the invader. The body releases histamine, a protein that causes swelling, itching, irritation, and other common allergic symptoms. When the histamine is released in your skin, it gets itchy. When it’s released in your sinuses, they get drippy. This is why “antihistamines” are used to treat allergy symptoms.

In medical school we learn that eczema is “the itch that rashes.” I always found that kind of interesting. You would, of course, think that it’s the reverse. To me, this means that if you can figure out how to stop the itching you can probably make the eczema better.

Since eczema is likely to be allergy-mediated, my next goal is to identify its cause. What might it be? Well, the most common offenders are pets, mold, or food. Food is the reason for my interest here on the blog.

A doctor with specialty training in allergies and immunology can do tests to help identify the cause. That’s a good place to start. But testing is not always definitive, and so the doctor may recommend an “exclusion diet.” The idea behind an exclusion diet is, as it states, to exclude (to the best of one’s ability) one food category at a time from the diet for about three weeks. Following that, at the end of the three weeks some people may try to induce symptoms by eating a generous portion of the excluded food. Other people already know. Three weeks should hopefully be sufficient time to see improvement in one’s symptoms unless, that is, the allergy symptoms are being caused by more than one allergen. Keep in mind that there may be more than one cause.

The eight most common food allergens (proteins that cause allergies) are milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. These eight food categories account for approximately 90 percent of allergic reactions, so they are a great place to start. And, with luck, you’ll figure out what the problem is long before you reach the end of the list. 

When I was little almost no one at school suffered from food allergies. Now they are epidemic, some life-threatening. Immune-mediated diseases have been rising steadily, and no one has yet provided an adequate reason. Is it the glut of pro-inflammatory omega-6 fatty acids in most processed “foods”? Is it an additive, such as carrageenan, for example? Or maybe it’s the triclosan, aspartame, saccharin, sodium lauryl sulfate, or blue dye no. 2 in toothpaste? Is it our comparatively sterile environments, or maybe the high rates of cesarean section, that have significantly decreased our exposure to a wide variety of “healthy” microorganisms? Or is it all of these? I cannot say.

While my friend attempts to identify the allergen(s) bothering Mikey, I recommend that they apply baby oil gel to his skin immediately after his bath, before drying off. That should help to hydrate the skin better and decrease the irritation. But I’m going to put my money on a food allergy, especially after I learn that the eczema is especially bad around his mouth.

Follow Dr Sukol’s posts on Twitter @RoxanneSukolMD and on Facebook at Roxanne Breines Sukol or Your Health is on Your Plate.

YOUR HEALTHY PLATE: Beth’s Real Microwave Popcorn

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I was stunned to learn, the other night, that when my friend Beth wants popcorn she drops a couple of handfuls into a brown paper sandwich bag, adds about half a teaspoon of olive oil, and puts it into the microwave for a minute. Voila! Microwave popcorn! She is so smart.

No diacetyl, the fake butter flavoring that causes severe chronic lung disease. No trans fats, the fake fat that causes heart attacks and blockages. Just popcorn and olive oil.

If you’ve never visited “Your Health is on Your Plate” before, visit Lets Start at the Very Beginning to get a jumpstart protecting the health and well-being of the ones you love!! Then check out “A Milestone Celebration — Your Favorite Posts” and “The Most Popular Blog Posts of All” for more great ideas and recipes! Wondering why I capitalize the “f” in Food? See Food with a Capital F.


I tried it tonight and it came out just like you’d expect — popcorn! Don’t wait for the popping noises to begin to slow down; just take it out after a minute. On the down side, there will be some uncooked kernels at the bottom of the bag. But on the up side, there won’t be any burnt ones.
I shook some nutritional yeast on my popcorn, and watched a movie.

Follow Dr Sukol’s posts on Twitter @RoxanneSukolMD and on Facebook at Roxanne Breines Sukol or Your Health is on Your Plate.

YOUR HEALTHY PLATE: Stuffed Peppers (Vegan) and Split Pea Soup (Vegan)

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Take a moment and visualize what’s in your refrigerator.  If you’re like me, nobody had time to go grocery shopping this week, and the box of vegetables that arrived Monday is just about gone.  But it’s too late now.  It’s late Friday afternoon, and dinner should have been in the oven a few minutes ago.  There are a bunch of green peppers on the bottom shelf in the back.  And the counters have a few jars of grains, dried peas, beans, and even some raisins that I made by popping some tired-looking grapes into the dehydrator earlier in the week.  



If you’ve never visited “Your Health is on Your Plate” before, visit Lets Start at the Very Beginning to get a jumpstart protecting the health and well-being of the ones you love!! Then check out “A Milestone Celebration — Your Favorite Posts” and “The Most Popular Blog Posts of All” for more great ideas and recipes! Wondering why I capitalize the “f” in Food? See Food with a Capital F.




This raisin experiment, by the way, was quite successful; the raisins are sweet, chewy, and complex, with hints of tannic acid.  Some, the bigger ones, are even a bit juicy.  Yes, they are all different, and why shouldn’t they be?  That’s how grapes are in nature.  I never thought about that until this week.




Okay, back to dinner.  I pull out the green peppers and spin a knife around the tops to remove the cores.  Rinsed, they sit on the counter while I figure out how to proceed.  I turn to the jars and pull out red lentils and millet.  These will cook fast, I muse.




I dice two medium onions and fry them at the bottom of a saucepot with a teaspoon of olive oil for just a minute.  Then I pour in 2 cups of lentils, 3/4 cup millet, and 4 cups of water, and turn the heat to high.  Once the water boils I turn it to low, and the lentils and millet cook for 15 minutes until they have softened and turned the same yellow color.  Most, but not all, of the water has been absorbed.  I stir in a handful of the aforementioned raisins, plus 1/2 teaspoon turmeric, 1/2 teaspoon curry, and 1/2 teaspoon black pepper.  I spoon most of the mixture into the green peppers, now in a baking pan, and pour over them a jar of extra-chunky tomato sauce.  Covered with tin foil, they cook for 45 min at 350F. 




Now I turn to the other side of the kitchen, and I measure 2 1/3 cups of yellow split peas into the crockpot with 3 quarts of water, 5 carrots (peeled and sliced),1 medium potato (diced small), and 1 large onion (thinly sliced), plus 1 teaspoon salt, 1 1 /2 – 2 teaspoons black pepper, and 1 teaspoon sweet paprika.  Note: the potato is essential to the texture of the soup, so don’t skip it!  Without it the soup will turn out thin and watery.




The table is set, and we gather for dinner.  The green peppers are gorgeous when they exit the oven.  Served with pecan bread and leftover slices of turkey breast, roasted sweet potatoes, and Swiss chard, they are flavorful and filling.  When you eat like this you forget that it’s 24 degrees outside and it’s still February.




The crockpot cooks on low for eighteen hours.  Once everything is very soft, I push a potato masher into the soup a few times to thicken it and smooth the texture.  It comes out amazing — Chief Cook-and-bottle-washer eats two big bowls.




Finally, I just need to tell you that I put the remaining cup of cooked lentils and millet into the refrigerator, unsure what to do with them.  It turned out that, warmed and drizzled with maple syrup, they made a terrific breakfast.  I can’t wait to make that again!  Wanna see a photo of the green peppers?  Check out my facebook page.





Follow Dr Sukol’s posts on Twitter @RoxanneSukolMD and on Facebook at Roxanne Breines Sukol or Your Health is on Your Plate.