Ask the Expert

Posted here are archived questions from clients and Dr. Schulman’s answers:

Orange White Coat

Do men really gain “sympathy weight” when their wives get pregnant?

The answer to this question is unclear.  However, it is clear that men (on average) who become fathers, and live at home, experience a 2.6% increase in their body mass index or weight gain of 4.4 lbs at 6 feet tall.  Refer to: Northwestern University’s Feinberg School of Medicine study that was published in the American Journal of Men’s Health, 2015.

My friend is following a six meal a day diet plan and looks great.  Should I do this too?

In healthy adults, a regular meal and snack pattern is designed to give you the nutrients you need and to keep your metabolism working efficiently.  If your body “thinks” that it is not experiencing a famine, and that it is living in a period of abundance, it is more likely that you will be able to burn up the extra energy that you consumed.  Or, your body may be more efficient at tapping into your fat stores.  Researchers have shown that eating 4 to 5 meals or snacks per day is associated with reduced risk of being overweight. Consuming 3 or fewer and 6 or more meals per day may be related to increased risk of weight gain.  However, studies show that gender matters!  In men, higher eating frequency is associated with lower total daily energy intake (and body weight).  In women, the data is not conclusive.  In other words, your fit male friend who is consuming 6+ meals a day may end up losing weight.  On the other hand, if you are a female who is consuming 6+ meals a day, you may end up losing OR gaining weight.

Does timing of meals matter?

Some research shows that  eating more in the morning versus the evening is correlated with lower body weight and greater loss of weight.

What should my percent body fat be?

This refers to the amount of body fat rather than total weight.  I’ve found that percent body fat is a better indicator of nutritional health than overall weight.  Different experts have developed different standards for ideal body fat.  However, following is a reasonable guidepost in U.S. culture:

Women:  Essential fat = 8-12%, Athlete = 14-20%, Fitness/Health = 21-24%, Average = 25-31%, Obese = > 31%

Men:  Essential fat = 2-5%, Athlete = 6-13%, Fitness = 14-17%, Average = 18-24%, Obese = > 24%
How many carbs should a person consume a day?

Although there is an RDA (Recommended Dietary Allowance) for most nutrients, there is *no* set RDA for how much carbohydrate an individual should consume.  Still, many organizations suggest that about 45-65% of a 2000 calorie diet ought to come from carbohydrates. If an individual is aiming for weight loss or has a condition, such as diabetes, the amount of dietary carbohydrate may need to be adjusted by a “nutritionally literate” health care professional.

Why does your nutrition health matter?

Having good nutrition and health increases productivity, reduces health care costs, and, in general, it helps our economy to thrive.  However, it is important that we look beyond economic arguments for reasons why we should improve our nutritional health. Health is “…one of our most precious possessions and it is a prerequisite for human welfare and happiness” (Sigerist, 1996).  Life, liberty, and the pursuit of happiness can only be secured if individuals have access to good health; “Disease is a threat to life, holding man in bondage and obstructing him in the pursuit of happiness” (Sigerist, 1996).

Is nutrition counseling cost effective?

Yes!  According to the American Dietetic Association (2010) nutrition therapy provided by a qualified nutrition professional can:

(1) improve a client’s health and well being, and

(2) increase satisfaction levels through decreased hospitalizations and reduced prescription drug use.

Health economists may argue that preventing disease though health or nutrition education is not a noble effort but often a cost-effective one.  However, good nutritional health has the potential to improve quality of life, decrease human suffering, enhance individual responsibility, and preserve moral obligations to society. These are all social goods even if we can’t measure them with dollar bills.  “Ultimately, the economic argument has a fatal flaw. It fails to assert the moral primacy of health itself as a social good and the well-being of the members of the community as a legitimate concern of public policy” (Moreno & Bayer, 1985).

Should kids diet?

In most cases, the answer is “no”.  It is inappropriate for a child–who needs additional nutrients for growth and development–to “diet”.  Children can achieve an appropriate weight by eating a balanced diet and getting plenty of activity.  The USDA provides educational tools for children to learn about healthy eating. Refer to:  http://www.mypyramid.gov

The following are recommended:  (1) use appropriate portion sizes, (2) eat plenty of fresh fruits and vegetables, (3) reduce high fat foods (try using 1% milk), (4) avoid concentrated sweets like soda and candy, and (5) consume a balanced diet in general.  However, an increasing number of children are becoming overweight and obese.  In these cases, families are encouraged to work a registered dietitian to determine what meal plan is right for them.  A lower calorie meal plan or “diet” may be prescribed by the doctor and supervised by a registered dietitian.  In addition, it may be useful to work with an exercise coach and/or physical therapist.

What is the best way to eat healthy without going on a “diet”?

In a nutshell?  I’d say, “moderation and balance”.  People who are the most successful at maintaing a healthy weight tend to balance their energy intake (i.e., calories) with their activity level.  An easy way to do this is to focus on consuming vegetables, fruits, whole grains, fat-free or low-fat dairy products, seafood, lean meats and poultry, eggs, beans and peas, and nuts and seeds.  Eat until you have had enough and not until you are stuffed. This means following the right number of serving sizes for your age, sex, height and weight.  Also, it is vital that appropriate serving sizes are used.   Everything you need to know about the right amount of servings — and serving sizes — is available at www.mypyramid.gov. The USDA also suggests minimizing solid fats (or keep saturated fat intake close to 10% of total calories consumed), added sugars, refined grains, and high sodium processed foods.  However, there is no ideal diet for everyone.  Each person has a special set of life circumstances and genetics that call for an individualized diet.  It is best to work with a nutritionally literate health care professional to see what meal plan is best for you.

How much fruits and veggies should a person consume a day?

As a rule of thumb, you should fill half your plate with fruits and vegetables.  The amount of fruit and veggies you need depends on your age, gender, and level of physical activity.   (Individuals with special medical conditions will need different levels of or types of produce.)  If you want to determine the exact number of servings you need per day, refer to http://www.mypyramid.gov

How much exercise should a person get?

According to the American College of Sports Medicine, an individual should do moderate cardiovascular activity about 30 minute a day, five days a week.  This can be in the form of exercise classes, outdoor activities, etc.  For weight loss, I have found that closer to 60+ minutes per day of cardiovascular + strength training is needed.  For weight management, a mixture of high and low intensity exercise will promote weight stability for the long term.  All of my clients benefit from doing resistance training activities–for example, doing 10 different strength training activities with about 12 repetitions of each exercise.  Professional exercise and fitness coaching are available by request.

 

Comment (1)

  1. I.Deea

    I really like the way that you answer clients’ questions thoroughly and accurately.

    <3s, I.Deea

    Reply

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