Imagine that you are looking at your dinner or lunch plate. You divide this plate into four equal sections.
One quarter of this plate should be filled with fruits.
The other 1/4 should be filled with vegetables.
The third quarter should consist of whole grains.
The last 25% should be made of lean proteins and some dairy. This should be the portion of different food groups you should eat at every meal.

This is pretty easy to remember. However, if you look at your plate and the portions don’t match the My Plate example, then you need to put a bit more thought into what you are eating in your daily meals.

One of the most important reasons why we gain weight is because we eat too much and because we eat the wrong kinds of foods. Sure, bad genes and a lower metabolic rate do contribute but not as much as the power of large portions of food when it comes to putting on the pounds.

Did you know that obesity did not become an epidemic until we started hearing terms like “supersize.” When this term was first introduced, it was the best thing that ever happened to us because we could pay a few more pennies and get another 50% more food. In order to accommodate this “supersized” food, our plate size had to increase to accommodate. After all, what would be the point of getting extra food if the plate wasn’t big enough to hold all that extra stuff?

If we look at the size of our dinner plate when our parents were growing up and the size of the plate now, there has been a dramatic increase in plate size.

Our food craze didn’t end there. When more food was put on these gigantic plates, we needed more liquid to wash it down. Thus, the size of our glasses and coffee mugs grew as well. The days of our mothers’ dainty little coffee cups hardly exist now. These pretty tea and coffee cups have become our “antiques.”

What has also happened to our diet is that we started adding things such as sugar, cream, flavored syrup, toppings such as rainbow colored sprinkles, nuts and the list goes on and on. We take a perfectly good plate of food or a cup of beverage and add another several hundred calories worth of stuff.

In addition, we usually complain when we don’t see heaping piles of food on our plates. We are impressed with gigantic slices of cheesecake. We are impressed with a whole pound or more of beef on our burgers. We aren’t satisfied until our plates are overflowing with food and our cups are literally filled to the top.

What is also adding calories to our muffin tops is the beverage we drink. If you drink more than one soda a day, you are ingesting more than 400 calories a day. Essentially, adding one can of soda to your diet a day increases your weight by 15 pounds a year. So, the next time you want to drink a can of soda, think about how hard you have to exercise to lose these 15 pounds. I don’t know about you, but I think I’ll give up my soda.

If you are one of those people who frequent Starbucks or your favorite neighborhood coffee shop and add a dollop of whip cream and/or a tablespoon of chocolate syrup, a glass of whole milk and heaping spoons of sugar to make your favorite coffee, just think about how many calories are in these giant cups of coffee. If you drink this coffee several times a day, just add up all the calories and see how much you are consuming.

Let’s put this in perspective with actual calorie counts. A cup of black coffee has 4 calories. The same cup of coffee with milk bumps the calorie count to 13. If you add cream, the calorie count increases by about 60-150 calories depending on the type of creamer you use.

When you add a splash of syrup or cream liqueurs, you bump another 80 calories or so. If you add a dollop of whip cream, there comes another 100-200 calories easy, depending on the portion. So, a little innocent looking cup of coffee now costs you another 300 calories easy. Multiply that by the number of times you drink this stuff and it is easy to see why we are gaining weight, just from your coffee!

Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

So, how did this buzz about alcohol and its health effects start? In August of 2003, researchers identified a compound called reservatrol in fruits and nuts, especially in red grapes, mulberries, raspberries and peanuts that can slow the aging process while increasing maximum lifespan.

This reservatrol is a natural antioxidant. It can activate enzymes that slow aging and extend the life of a cell. This can reduce the risk of age-related diseases such as certain cancers, atherosclerosis, heart disease and brain diseases such as Alzheimer’s disease.

So, if these anti-aging antioxidants are found in all of these fruits and nuts, why did red wine get all the hype? In the 1990s, a theory called the French paradox emerged. What is this French paradox? French people have lower rates of heart attacks despite their rich foods because they drink moderate amounts of red wine with their meals.
Thus, the bulk of research has been on grape flavonoids, an antioxidant, although the same flavonoids are found in black and green tea as well as dark chocolate. More than 300 studies cite plenty of antioxidants in red wine, grape juice, grape seed and grape skin extracts. Red wine is loaded with flavonoids.

These flavonoids may protect the heart by preventing blood clots, prevent cholesterol from damaging blood vessel walls, improve the blood vessels’ ability to expand and contract better. This pliability of arteries allows blood flow to be modulated and shunt more to places that need more blood. Heart attack happens when the heart doesn’t get enough blood flow. In addition, flavonoids stimulate the production of nitric oxide that can prevent atherosclerosis or hardening of the arteries.

Another antioxidant called reservatrol, found in grapes, raspberries and mulberries affect the age-regulated genes, allowing the cells to live longer and prevent age-related diseases such as certain forms of cancer, heart disease and Alzheimer’s disease. According to the American Heart Association, drinking one or two glasses of wine a day for men and one glass for women may lower the risk of heart disease.

Grape juice has similar antioxidants. A number of studies show that Concord grapes and grape juice have a higher concentration of antioxidants than ordinary table grapes. So, for those of us who don’t drink alcohol, drinking grape juice maybe as effective. Added benefit? You can’t get drunk on grape juice, although if you drink too much of this juice, you may gain weight. Anything in moderation is the rule.

Although it is tempting to ignore other fruits and nuts that contain these powerful antioxidants and just concentrate on red wine, remember that alcohol is not a drug. We don’t recommend drinking to improve your health. There are too many harmful effects of alcohol that can outweigh these potential benefits. Many of these same effects can be achieved by diet and exercise, although not as much fun.

Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

I’ll share with you one of the very interesting observations that I’ve made over the years dealing with obese patients. I was doing a procedure on a lady one morning. She started to tell me how difficult it was for her to plan her day around this surgery because she couldn’t eat after midnight the day before. So, she ate big meals all day long the day before so she wouldn’t be hungry. Even as she was getting ready for surgery the next morning, she was figuring out what she’d eat once she was out of her surgery.

It was astonishing to listen to her elaborate plans about eating. It was then that I realized that thin people think differently than heavier people. Most people would eat normal meals the day before and just stop eating after dinner. Sure, they’ll be a little hungry in the morning, but most people can deal with that. However, this obese patient of mine was obsessed with eating.

What is also astonishing was to hear how much she eats in a day. She told me that the day before her surgery, for breakfast she ate a stack of pancakes with bacon, potatoes and eggs. She drank a tall glass of milk to wash them all down.

On her way to work, she stopped at McDonalds’s and got an order of sausage and egg biscuit and hash browns to go and a supersized order of Coke. By the time she sat down at her desk at work, she was hungry again. She ate this order from McDonald’s before she started work.

For lunch, she ate a cheeseburger with fries. For dinner, she cooked a pork chop and accompanied that with mashed potatoes and some corn. She ate a piece of carrot cake for dinner. Since she was having surgery the next day, she added two scoops of ice cream to feel better.

This patient was about 5 foot 2 inches tall and weighed 350 pounds. This diet she ate, which according to her is her usual, was probably more than a professional athlete would normally eat in a day in terms of total calorie count.
So, this addiction to food is a huge underlying problem that leads to weight gain.

What is important to understand is that food allows us to live, but it is not natural to think about food all the time to a point where it becomes an addiction. Sure, we all like to eat. If we could eat all the time, we’d probably love that as long as we didn’t have to be concerned with out weight. So, this fine line between food addiction and loving food is truly a very thin line that is very easy to cross over. In fact, if we look hard enough, we have all crossed this line multiple times in our lives and will continue to do so. The difference between loving food and being addicted is that you know you have eaten too much but you still can’t stop thinking about food and can’t stop eating.

If you are obese and you must eat food all day long or at least think about eating all the time, you must seek help as you would seek help for any other type of addiction. When people get addicted to alcohol, smoking or drugs, there are rehabilitation programs for these people. The same must be available for people addicted to food because it is no different. The only problem is that we don’t usually see overeaters anonymous around the corner. We see plenty of AAA and drug rehab centers but not too many weight rehab facilities because we don’t consider this food addiction as a true illness. However, when this addiction causes morbid obesity that is threatening one’s life, then, it is an illness just like any drug addiction, maybe even more dangerous.

One of the reasons why we see relapses in people who undergo gastric bands and stapling procedures is that we don’t deal with the underlying addiction with food but we try to fix the physical mechanism. When we put a band around the stomach so a person can’t eat big quantities of food, it may restrict what that person can eat. However, over time, these people learn to gradually increase their food intake to stretch out the available portion of the stomach or eat multiple frequent meals to compensate. Thus, the surgery may have restricted what we can eat, but our mind still thinks we need to eat more so we find ways to cheat this mechanical barrier.

Therefore, these weight loss surgeries and weight loss pills and fad diets that promise quick weight reduction do not work unless we treat the psychiatric causes that live beneath the surface. Before we can begin to address the issue of decreasing our food intake, we must deal with our brain.

Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

Our Bodies Burn Calories In 3 Ways
1. Physical activity
2. Basal metabolic rate
3. Dietary-induced thermogenesis: this means that it takes energy to digest food.

It is true that some people have higher metabolic rate and burn more energy. However, studies show that these differences in metabolic rate are not a major contributing factor to obesity. The major factor contributing to obesity is increased food intake.

An interesting fact to note in terms of food digestion is that it takes very little energy to convert the fat we eat into adipose tissue (fat storage i.e. muffin tops and bulges). However, it takes 25% of the energy that we ingest in a form of carbohydrates to convert it to adipose tissue. What this means is that if you eat carbohydrates, your body has to burn ¼ of its energy to digest these foods. This also means that the net amount of calories you have when digestion is complete is only ¾ of its original calorie count.

However, if you eat fatty foods, you burn hardly any calories so almost 100% of the calories are still present for your body to deal with. This means that if you eat fatty foods compared to carbohydrates or proteins, you are adding another 25% more calories to your total caloric intake. End result? If you eat fat, you pretty much should expect all of it to go to build your muffin tops. Well, that should be a motivating factor for us to stay away from fatty foods! We can all do without this extra 25% of calories.

Mechanisms that help us control this balance between energy intake and energy expenditure is very complicated. Many pathways are involved to ensure that we have enough energy storage in the form of adipose tissue for a rainy day. Except, for most of us this rainy day doesn’t occur and food remains plentiful, so we keep eating.

Advances in transportation have led to more sedentary life so instead of walking to work or to school, we sit in our cars. So, we’ve decreased our energy expenditure but we keep eating.

What’s worse is that we eat the wrong kinds of foods. Instead of eating lean proteins and carbohydrates such as whole grains which actually burn energy to digest and tell our brains we should stop eating, we eat fat. Ingesting fat promotes fat storage and digesting fat doesn’t burn many calories. Plus, fat is not good at telling us that we are full. Therefore, we’ve already eaten too much fat by the time we feel full.

In conclusion, the regulation of body weight requires a very complicated system in our bodies that must balance how much we eat with how much energy we burn. The bottom line? If you eat more food than what you burn in a day for a long time, you will gain weight.

Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

Whil­e some people pr­ef­er to indu­lge in d­elicio­us, savory dishes, the­re­ are m­illi­ons more wh­o de­ri­ve f­ar more pl­ea­s­ure from l­earning how to pr­ep­are those perfect a­pp­etizers, d­esserts, a­nd m­ain courses, especially when meat is involved. With the inform­atio­n from the Chuck Wagon Rub that follows below, you can g­et a head start on your path to becoming the ne­xt best chef!

After all cooking is a­ll a­b­out education and practice. Take your time and put this simple to make rub together and you’ll have mastered one of the building blocks to beco­ming ­a better co­ok, no­w all you have to do i­s practi­ce, practic­e, practice! So­on you’ll be ma­ki­ng grea­t foo­d that you and your friends and family will lo­ve to­ ­e­at!

Makes 3 tablespoons, enough for 3 pounds of meat or poultry
Ingredients:
1 tablespoon black pepper
2 teaspoons sea salt
2 teaspoons chili powder
1 teaspoon brown sugar
1 teaspoon onion powder
1 teaspoon garlic powder
1 teaspoon dried parsley
1 teaspoon dried oregano

Directions:
Combine all ingredients and rub onto meat evenly. Chill for at least 1 hour.  

Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

And for something really special to trigger lots of salivating while your meal is being prepared, take a look at this easy to prepare Sage, Orange Marinade.

Makes about 1/3 cup, enough for ¾ pound of meat
Ingredients:
1 teaspoon finely shredded orange peel
1/3 cup orange juice
2 teaspoons extra-virgin olive oil
¾ teaspoon fresh rosemary or ¼ teaspoon dried rosemary
¾ teaspoon fresh sage or ¼ teaspoon dried
1 clove garlic, minced
¼ teaspoon salt
¼ teaspoon black pepper

Directions:
Combine all ingredients and pour over meat. Can be used for meat, poultry or fish. Marinate in the refrigerator at least 6 hours. Drain and discard when ready to cook.

Bon Appetite
Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

Dry Rubs For Meats­
As I mentioned in a previous recipe, marinate all meats before you start cooking them. This is on­e of the most overlo­oke­d wa­ys to ­improve yo­ur cook­ing and all it takes is to let your m­eat rest i­n m­ar­inad­e befor­e you­ co­o­k. Next you’ll want to generously cover it with a dry rub, and Cajun Spice Rub will provide results that will amaze you and your dinner guests.

Here are the steps for success:
Makes 3 tablespoons, enough for 2 pounds of meat or chicken
Ingredients:
2 tablespoons brown sugar
2 teaspoons paprika
1 teaspoon garlic powder
1 teaspoon onion powder
½ teaspoon ground allspice
¼ teaspoon cayenne pepper
¼ teaspoon black pepper

Directions:
Combine all ingredients. Rub onto meat and chill for at least 1 hour.

Wear your bib

Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

This recipe for Cilantro Pesto Marinade is simple to recreate and can help you add to your c­ooking skills & reputation for great meals:)

Makes 2/3 cup, enough for 1 ½ pounds of meat
Ingredients:
½ cup cilantro leaves, chopped
½ red onion, diced
1 teaspoon finely shredded lime peel
2 tablespoons lime juice
2 teaspoons Worcestershire sauce
¼ teaspoon ground cumin
¼ teaspoon dried oregano

Directions:
Combine all ingredients in a food processor. Pour over meat and marinate for at least 1 hour. Discard remaining marinade.

Enjoy
Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

The first step in any weight loss program is to take stock of where you are now. This means getting an assessment of your weight and what your weight goal should be. You can use BMI calculators, waist-circumference measurements…etc. To really know where you need to be in terms of your weight, talk to your doctor or a nutritionist to get some help.

It is also important for you to write down what you are eating. You’ll be surprised to find out the stuff you are eating without realizing what you are putting in your mouth. So, keep a food diary. Once you know what you are eating, then find ways to substitute the bad stuff with good foods. For example, if you predominantly eat white rice and white pasta, switch to brown rice and wholegrain pasta.

If you drink a lot of sugary sodas, switch to water or sparkling water. it is also important for you to remember that you can change everything over night. These eating habits have been developed over years and decades. Changing the way you eat is going to take a lot of commitment on your part and patience. Change one habit a day or in a week and take it slow. This ensures that your commitment will succeed. Radical changes too fast will not yield good results.

What diet book or plan is right for me? There is no perfect diet plan or diet book. If there was, we wouldn’t be talking about obesity epidemic. What is more important than picking one particular diet plan is to understand the basic principles on how your body regulates weight and what factors influence your weight. The way you eat, the way your body responds to your food intake and how that food intake becomes fat storage are very unique to each of us. What you can learn from these diet books (EMR included) is to learn these basic concepts and apply them to your own body.

Do I really need to exercise? The answer is no. If you restrict your calories, you will lose weight. However, exercise is an important component of weight loss because it helps you burn calories. This means that you can still eat without going hungry and by adding physical exercise, you can burn excess calories which will lead to weight loss. Without exercise you’ll have to cut back significantly on what you eat for weight loss to occur.

Also, if you just restrict caloric intake, your body will rebel and start lowering your metabolism because it thinks you are starving. It is a built in protective mechanism that ensures that we can live through starvation due to lack of food, even though the availability of food is really not at risk but your body doesn’t know any better. When your body goes into this energy conservation mode, you have to keep cutting back on your calories to lose weight. If you eat regularly but add exercise instead, your metabolism increases and you lose weight.

Exercise helps you build muscle which also contributes to increased metabolism and caloric expenditure. The bottom line is that without exercise, diet becomes extremely difficult because your body is working against you.

Jennie
Jennie Yoon Buchanan M.D.
Medical Director Women’s Imaging
Florida Hospital

How much exercise is enough? Ideally, 60-90 minutes a day to achieve weight loss. This sounds a lot, but “exercise” doesn’t necessarily mean that you have to go to a gym for this long. It means continuous movement throughout the day. If you find an activity you like and keep doing it, even if you have to break it up in 10-15minute intervals, the end result is the same: burn calories. A step counter is a great gadget to keep track of how many miles you are walking.

How many calories should I be eating?

To lose weight, 1200-1400 calories/day diet will work well. However, you can’t keep this up forever. So, the better plan is to eat a regular diet, around 1800 calories/day but incorporate rigorous exercise to burn the other 600 calories. The principle is simple: the more you exercise, the more you can eat. What you eat must be expended to maintain your weight. Excess calories left =fat.

What kind of foods are good for weight loss?

High fiber and low-fat diet works well. what’s also important is that you need to find foods that you can enjoy eating for the rest of your life. Weight management is a lifelong practice. You can’t lose a few pounds and go back to your old, bad habits. True weight loss and keeping that weight off forever takes permanent changes in your eating habits and lifestyle.

Should I take diet pills?

Some diet pills can help you get started. However, they are not magic bullets. Despite what the advertisement says, weight doesn’t just melt off of you because you are on these pills. You have to change the way you eat and exercise for these pills to work. But then, if you are going to do all the hard work by eating right and moving more, why do you need to spend all that money on these pills?

What is the most important meal of the day that I can’t skip?

that would be breakfast. As you learned in the EMR book, in the morning, your insulin level is high so even if you eat a big meal, your body is equipped to digest it and burn it. However, if you eat late at night, you should expect that most of that food will go to your muffin tops and other unwanted places because your body can’t digest it well. So, fill your tank in the morning and go light in the evening.