We have all heard about the virtues of low fat, low carb, no trans fats, and low calorie diets in the news.  One item I see that is forgotten is the benefits of a high fiber diet.  Fiber is mainly found in plants and has multiple benefits for our health including:  better digestion with more regular bowel movements, reduces hemorrhoids, lowers bad cholesterol (LDL), lowers risk of certain types of colon cancer, makes us feel more full to avoid overindulging in “empty calorie” foods, reduces risk for heart disease, and lowers blood sugar.  In general, we should all aim for at least 25-35 grams of fiber each day.  As a guideline, a medium sized apple is about 2 grams of fiber.  Generally, any food where you feel like you have things stuck in your teeth after eating them is high in fiber (think celery with the “strings” or blackberries with “seeds”)

Here are some easy ways to get more fiber into your diet.

• Choose whole grains such as brown rice, whole wheat flour over non-whole versions (white rice, white flour)
• Eat fruits and vegetables at least 5 servings combined per day.  A serving is roughly the size of your hand.  This is a key component to the Mediterranean diet.  The fruits highest in fiber are berries and citrus fruits such as oranges. Make sure you eat them whole and not blended in juices.
• Add nuts and beans to your diet (both important components of the Mediterranean diet).  These foods are rich in fiber and protein.  Have a handful of walnuts or almonds in the afternoon to keep you from being too hungry in the afternoon.
• Add herbs to your food.  Whether dried or fresh, herbs such as basil, parsley, onions, etc. can add a significant amount of fiber to your meals while giving your food extra flavor.
• Add seeds to your food.  Adding just 1 tablespoon of chia or flax seeds to your yogurt can give you an additional 5 grams of fiber.
• Leave the skin on when you eat fruits.  Fruit peel is very high in fiber.  I would recommend that for fruits where you eat the skin, it is important that you buy the organic version since pesticides tend to be concentrated in the peel.
• Supplement with psyllium fiber.  My favorite brand is Konsyl.  This is a powder that you mix with water and provides all the benefits of fiber without excess calories.  It is all natural and gluten-free.

A story in the New York Times, titled “F.D.A. finishes food labels for how we eat now” describes how all food manufacturers will be required to put a new food information label on their products.  This new label highlights the calories in a larger bold font.  It also lists the number of servings per container more prominently at the top of the label.

I think these two changes are really going to help people make healthier food choices.  From my own experience, I find the current food labels quite misleading.  Just the other day, I looked a the label for an individually wrapped single cookie (about 3 inches in diameter) at a local coffee shop.  It said the servings per container was 4, and the calories per serving was 120.  Honestly, I can’t remember the last time I saw someone splitting a single cookie into fourths!  However, if you glanced quickly at the label, you would assume the whole cookie was 120 calories, rather than the actual 480 calories!  I have also seen food products labeling the serving size with amounts like “3 Oz.” which unless you’re a nutritionist may not be relevant to your concept of portion size.  Not coincidentally, these deceptive serving sizes usually appear on “unhealthy” foods as a way to make you think you are eating a low calorie item.

For the average person with a 2000 calorie per day budget, the goal is to keep snacks at below 150 calories per serving.  The snack should also have low amounts of saturated fat, cholesterol and no trans fat.  Reading food labels and comparing them when you go shopping is very important to maintaining good health.  I’m quite pleased at the efforts of the FDA to keep people informed about what is in their food.  I think for their next step, they should consider requiring nutrition labels to be placed on alcoholic beverages.  In my practice, I have seen several patients who eat relatively healthy but they pack on the weight due to the calories from ingested alcohol.  Beer is the classic example.  While some beers are below 100 calories, others can be as high as 350 calories (especially for the India Pale Ales, which are quite trendy right now).  To put that into perspective, a can of soda is about 140-160 calories.  While the beer does not taste sweet, it contains calories from the carbohydrate content and alcohol.  Imagine if you had 2 of these beers, that would be an additional 700 calories! With a 2000 calorie budget per day, that would be almost what you should get from a single meal!  Currently, there are few sites that have calories for alcohol and spirits.  I recommend Myfitnesspal.com as they have a very extensive list of foods and beverages where you can even find specific types.  For example, if you are looking for a certain brand of yogurt, it has the brand and even the specific flavor.  You can also track your calories with the App for your smartphone.

Recently, I’ve been on a quest for a high-protein snack for the afternoons that can stave off hunger until dinner time.  Ideally, it shouldn’t require refrigeration, should be easy to eat, and something that I can keep in my desk drawer.  I think I’ve found the perfect snack and much more in canned sardines!

Why am I so excited?  Sardines are a powerhouse when it comes to nutrition.  They are packed with Vitamin D, calcium (you eat the soft bones within the small fishes), and omega 3 fatty acids which can raise your HDL (“good”) cholesterol.  In addition, there are some canned varieties that use olive oil, which is chock full of good fats and will also increase your absorption of Vitamin D, since this is a fat soluble vitamin and must be taken with oil to be absorbed from your intestines.  Sardines can definitely fit in with the Mediterranean Diet as one of your 3 servings of fish per week.

Unlike many other fish, sardines are also very low in mercury.  They are not predatory fish and don’t live for a long time unlike high mercury containing fish such as tuna.  Yes, even canned tuna contains a significant amount of mercury.

How can you incorporate sardines in your diet?  First, I recommend finding a good quality brand.  Try multiple types, ideally packed in olive oil.  Some are less “fishy” than others.  Keep a supply of forks as you will need them to eat out of the can.  What’s great about most sardine cans is that you just pull the lid off and don’t need a can opener.  Lastly, most canned sardines are very inexpensive and easy to carry.  The most perfect snack, try them today!

We are currently having an epidemic of obesity.  We are more sedentary than ever and eating more than we should.  As a result, we are seeing a spike in obesity-related disease such as diabetes and high blood pressure.

On a recent trip to an antique store, I found this beautiful plate from the 1800’s (pictured below left).  At first I thought it was a salad plate which are generally smaller by today’s standards, but was told by the store owner that it was actually a dinner plate!  This got me thinking that our dinner plates have been getting gradually larger.  For comparison, you can see a modern dinner plate from my own cabinet (pictured on the right).  I decided to do a little experiment.  I put standard size portions of vegetables and meat (plastic models) on the antique plate.  I showed this to a group of people and asked whether they thought they would be full after eating that plate.  Most said it looked like a lot of food and yes they would be full.  Next, I put the same food items on the large white plate from my kitchen and slightly off center and asked them the same question.  Many said it looked like the food amount got smaller and that they would probably go for second or third helpings!  Our minds can easily be fooled by the empty space on large plates.

Look at your own dishes and think about eating on smaller plates.  Try eating your dinner on salad plates tonight.  If you go to a cocktail party, use smaller dessert plates rather than large dinner plates.  You may also want to purchase new dinner plates that have a decorative border which gives the appearance of a fuller plate.  You may find yourself losing weight!

UPDATE!!!  So, it’s over 2 months later since I started eating on the smaller sized plate at home every night.  Even if I ordered prepared food, I would place the food onto the plate and leave any excess in the container.  Believe it or not, I’ve lost 3 pounds so far!  This was even without the intention of losing weight or being conscious of the food contents.  I totally didn’t expect this weight loss and the only real variable I changed was the size of my plate. Try it yourself!  

Why is this recipe on a health website?  I mentioned in my blog about rewarding yourself that treats are an integral part of our culture.  I don’t intend this delicious recipe to be part of your daily diet, but it is a great idea for an office birthday party or a dessert around the holidays.  You can make this in less time than it takes to bake a batch of cookies, and it looks beautiful and fresh.

Fresh cut pineapple slices (triangles)

Strawberries sliced in half

Melon balls

Banana cut into 1/2 inch thick slices

Bamboo barbecue skewers

Hazelnut spread

Chocolate sauce (found in the ice cream topping section of your grocery store)

Caramel sauce

Put the hazelnut spread, chocolate sauce, and caramel into small bowls.  You can even heat them in the microwave for a quick 30 seconds to make them smoother for dipping.  Make skewers of the fruit and arrange them around the plate.  Be creative with different fruits in season like figs, mangoes, peaches, or kiwis.  You can also try variations on the dipping sauces, like adding raspberry jam to the chocolate sauce or having a small dish with sea salt on the side so that you can sprinkle some on top of the dipped fruit.  My favorite is caramel dipped apples with sea salt sprinkles.