In This Issue

• Fast-Food
• The Struggle To Stay Lean
• Slo-Mo Weight Training
• The Four Tastes
• Magnesium
• Exercise Corner - Squats
• Questions And Answers

For those visiting fast-food establishments at least three times a week, they consumed more calories and saturated fat than occasional patrons. And, surprise, surprise, those regular patrons (three times a week or more) were fatter than the not so regular customers.

And don't forget that regular restaurants are nearly as bad, if not worse, with their monster portions, fatty sauces, and . . . Eating out in general contributes mightily to the continual fattening of America.

The December 2001 issue of the Nutrition Action Health Letter contains an interesting article on eating out, and how you can do it without adding to the statistics that are all too familiar, and support the fattening of America; and some information you can use when eating out to help you stay lean (or if you aren't lean already, to help preserve your current state).

As you know the figures are pretty staggering, and they are only getting worse. Those who are overweight has skyrocketed from 45 to 56%, and obesity is even worse, it has increased from 12 to 20%, and these changes are just since 1991.

Were these trends to continue, we will face an enormous cost in terms of disease and health care, says Centers for Disease Control (CDC) director Jeffrey P. Koplan.

For example, diabetes rates have gone from 9,000,000 in 1991 to an estimated 15,000,000 today. The significance is that obesity raises the risk of getting diabetes (it is estimated that 15 million adults now have this disease) by tenfold in men and, startlingly, 20-fold in women. Unfortunately it isn't just adults that are getting fatter. So are children and adolescents - obesity among this population group has doubled in the last 20 years - too much junk food and not enough physical activity. Kelly Brownell, an obesity researcher at Yale University says the term adult-onset diabetes is falling into disuse because children (including teenagers) are now being diagnosed with the disease.

So, what is happening to make fatness a near epidemic? Activity levels are declining, but that's been true for most of the twentieth century and beyond as the work force has shifted from physical labor to much less physically intensive labor, such as office jobs. So why has the fat explosion occurred in the last 20 years or so? David Cutler, an economist at Harvard University, thinks it's partly the fact that more and cheaper food is being produced. U.S. families in 1950 spent 21% of their disposable income on food, but in 2000 it was 11%.

This extra food at a lower price isn't just to benefit mom when she buys groceries for family meals - now, mom often works outside the home, dad works, the kids get home late from school activities, so everyone charges off to a restaurant, where serving sizes and calories are proliferating wildly. [As an example, a couple of years ago I experienced the growing portion size phenomena. At a fairly ordinary restaurant (somewhere between McDonald's and Ché Louis or . . .), when it came time to order I chose a pasta dish. The waiter asked if I'd like "small" or "large." "What's the difference", says I? With a sly grin, he said "large" is obscenely large, and "small" is large. I opted for "small," which as it turned out could have adequately fed three hungry adults (or one teenager). I shudder to think what "large" looked like. And restaurants are about as common as gas stations were a few years ago.] Not only is food cheaper and served in large portions, but it is also ubiquitous. You can get a snack or a full meal almost anywhere. Go to a book store and get a drink and/or a snack, McDonald's supplies lunches at some schools, you can eat at gas stations, shopping malls, drug stores, department stores, and. . . And what about the nutritional quality? Junk food, by-and-large.

And we don't eat to survive anymore, it has become practically a social event - it is an emotionally charged event.

Okay, so food is abundantly available in the U.S., relatively cheap and convenient, has a positive emotional impact (it's very often a social activity). This all leads to a calorie explosion, and combined with lower activity leads to the fat explosion.

What can we do to fight back? There are of course people who have figured this out; after all, there are still some lean people around, and we can't blame it all on genetics. CDC epidemiologist Ali Mokdad says that prevention could be as simple as exercising, or just getting more active. At any rate, here are some strategies for fighting back:

1. Portion Control - Pay attention to this one. There is a tendency for us to eat more food if more is available. If you get a large serving, the tendency is to eat as much as is available. The bigger the portions, the more we tend to shovel in. I think it has to do with not wanting to waste food - you know, "starving children in . . ." To get around these huge portions, share with a friend, or take home a "doggie" bag.
2. Eat slow - People who wolf down their food tend to overeat - going well past the 'full' stage. Fast eating defeats the sensors that say "stop now, you're full." If you eat slow they can tell you to stop before it's too late. [According to Susan Roberts of the Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston, says it takes 30 minutes of eating before satiety hormones are activated to tell you you're "full."] It is pretty ridiculous to eat until you hurt.
3. Calorie-dense foods - The aforementioned Ms Roberts likes calorie-dense foods in one's diet because you don't have to eat much to feel full. But she doesn't mention any specific foods - does cheesecake qualify, it's about as calorie-dense as it gets. [I prefer slow eating of nutrient-dense foods, although calorie-dense foods sounds good depending on the nutritional quality.
4. Variety - The more variety in your diet, the more you eat. That sounds like what we don't want, but it can be used as a good strategy. Do the opposite: don't stock a large variety of foods. Take cookies, for example, if you have a half a dozen types, more will be eaten. So maybe just stock two or three varieties (or maybe one is even better). But of course a good variety of fruits, vegetables, and soups is acceptable - any low calorie-dense foods.
5. Liquid calories - They kind of sneak into your daily calorie count. They hardly get noticed, but unless you compensate by decreasing the calories you eat, the ones you drink can really add up. I'm talking particularly about fruit juices (or fruit drinks), soft drinks, or alcohol. Alcohol is the worst choice since it is calorie-dense (seven calories per gram - outdone only by fat at nine calories per gram) at the same time as being nutrient-poor. And in addition, it loosens your inhibitions so you may end up throwing away your resolve to eat and drink less.

   If you happen to be concerned about weight control, it would be best if you stick to water, seltzer, or other low-calorie beverages for accompanying your meals.

6. Exercise - This is no surprise, but exercise can both help you lose weight and keep it off. Significant weight loss typically requires two separate strategies: 1) exercise - aerobic exercise (and a little strength training helps), and 2) food/eating issues such as choosing low-fat, nutrient-dense foods along with portion control. And of course exercise doesn't necessarily mean you have to join a gym or participate in some kind of formal classes - just get moving.
7. Eating out - Restaurants typically design their menus so you get large portions of a variety of calorie-dense foods that are very palatable. These meals can really pack on the fat. And they usually have other unhealthful attributes such as plenty of saturated and trans fat, salt, and more. Below are a series of charts that can help you make more healthful choices at restaurants. Out of space considerations the charts are not reproduced in full, only enough is displayed to provide an idea about choices. If you want to see the charts in full, you'll have to dig up a copy of the newsletter mentioned at the beginning of this article.

Slo-Mo (aka SuperSlow) weight training has become somewhat fashionable in exercise facilities. The rationale seems to be that very slow movements eliminate momentum, thus making an exercise more effective. On closer examination, this may not be true. Momentum really comes from a source other than excessive speed: poor form (technique) during a lift.

Think about it! If you are doing a Military press could you push the weight up so fast that momentum would build up to the point where you could let go of the bar and it would continue on its upward path? I don't think so. Not unless you were using a relatively light weight. Or how about arm curls? If you've ever been in a facility with free weights (machine users are just as guilty of faulty technique) you will have seen a guy (its always a guy) begin a rep by leaning forward and "cocking" his elbows, then quickly hyperextending his back while flinging the bar up toward his chest. On the downward movement to the initial position, he will lean forward while essentially dropping the bar without resistance.

A lifter can eliminate/minimize momentum by using the Slo-Mo technique, if he/she is using a relatively light weight, but only proper form will correct it with maximal or near maximal loads.

In addition to the SuperSlow technique not having any intrinsic superiority over the same exercise done faster but with proper form, there are other possible risks associated with the technique:

• High blood pressure - it is well known that weight lifting momentarily elevates blood pressure (as high as 480/350). The SuperSlow technique can result in an elevated BP over a series of sets. For anyone with an already elevated risk for heart problems, this could be the straw that broke the camel's back.
• Tendon/ligament damage is a possibility from prolonged duration of loads.

You may know about the four tastes that have always been identified as the only tastes that us humans recognize, but there is another one: "unami." The fact that it is difficult to describe may be the reason it is unknown to most of us. The addition of MSG (monosodium glutimate) to foods produces this taste. Its addition to foods in Chinese restaurants is well-known; although it may be known more for its high salt content, even though it is actually added for taste enhancement.

The unami taste is caused by the amino acid glutamine (sometimes glutamate) when in its free state.

Many people are unable to detect this taste, even though it was first known in Japan nearly 100 years ago. It was finally recognized more broadly by scientists in the West once specific receptors that detect the taste were found.

Magnesium is an important nutrient that has taken a back seat to more well-known nutrients such as vitamin C or calcium, but it is important - involved in energy production, heat functioning, nerves and muscles, bone health, blood clotting, and more. For the heart, magnesium helps the heart muscle and nerves that control the heartbeat. It may help prevent arrhythmias, helps control blood pressure, and may help prevent angina by maintaining healthy blood vessels.

Population studies suggest that those with a diet rich in magnesium have a lower risk for heart disease and stoke.

Magnesium is crucial to insulin use and carbohydrate metabolism. As such, a magnesium-rich diet may help prevent diabetes.

In concert with calcium and vitamin D, magnesium is important to development and maintenance of strong bones and teeth.

Foods rich in magnesium include whole grains, beans, nuts and seeds, fish, leafy greens, and avocados.

For anyone not eating a balanced diet, a multi-vitamin/mineral supplement is a good choice.

Exercise Corner features squats in this issue. There are two basic styles relative to foot plant - narrow and wide.

The major muscles used for this exercise are the quadriceps group (four muscles on the front and sides of the thigh: the vastus lateralis, vastus intermedius, vastus medialis, and rectus femoris; the gluteus maximus (the muscles you sit on), and the hamstrings (back of the thigh: the semitendonosis, semi-membranosis, and biceps femoris). Additionally, the erector spinae muscles in the lower back are statically contracted to stabilize the spine. And, the wide stance puts a major emphasis on the thigh adductor muscles (inner thighs).

Execution of the narrow stance squat begins in a standing position with your feet at about shoulder width and with your toes pointed forward. Hold a barbell across your shoulders (upper trapezius muscles). You should grip the bar just outside of shoulder width - actually wherever is comfortable. And most recreational lifters would be wise to use a specially designed pad for shoulder comfort during this exercise. Now squat slowly - you should feel like you are sitting back into a chair until you reach a position where your thighs are approximately parallel to the floor. Some lifters will stop short of parallel (typically beginners, or those using too much weight), while others will go below parallel; but keep your knees from projecting beyond your toes, and keep eyes focused in front of you - you may look up by rotating your eyes, but don't bend your neck (that old keep-your-neck-in-line-with-your-spine thing). Also keep your heels on the floor. Some people elevate their heels (often on a weight plate), but that is not recommended. You shouldn't bend forward more than 45°, and raised heels encourage an exaggerated forward bend. Be sure to maintain the normal inward arch of your lower spine. Once you reach the bottom of your squat, quickly reverse direction to the original position.

Proper breathing during a squat involves a partial valsalva maneuver (holding your breath) - inhale and hold your breath before you lower yourself into a squat. Continue holding your breath to the bottom and into the reversal of direction, which is done quickly and forcefully. Start exhaling after passing the sticking point, and forcefully complete the exhalation as you reach the full standing position. On a very heavy lift, you may make small exhalations until complete exhalation at the top. The point of holding your breath is to maintain intra-abdominal pressure to allow you to complete the lift with your spine held in place.

I personally use a Smith rack for doing squats. It allows me to precisely maintain proper form. Free squats have the advantage of requiring some additional muscle activity to maintain balance and improve it, but they make poor form more common.

(Q) I've been trying to shop healthier for my family, but am having some difficulty with whole grains. As I look at the products on the shelves at the grocery store, I see: "Wheat Berry Bread," "Hearty Wheat Crackers," "Multi-Grain Cereal Bars," "Eggo Whole Wheat Crackers," "Hearty Wheat Crackers," "Stone Ground Wheat Crackers," "Raisin Bran," " Whole Grain Glazed Donuts," Nutri-Grain Twists," "12-Grain Muffin," "Multi-Grain Cereal bars," Nutri-Grain Twists," and on-and-on. Are these products as healthy as they sound?
A.M., Oswego, OR

(A) You can make better choices, although the manufacturers are trying their best to convince you otherwise. You have to read the nutrition labels (yes, it is tedious) to understand what you're buying. There are two keys to look for: 1) 100% whole grain, or 2) a whole grain should be number one on the Ingredients List.

If one of those two conditions is not met, I suggest you look for an alternative. Despite the fanciful, healthy-sounding names manufacturers use to try to induce you to buy their products, they may be a legal form of fraud.

(Q) When I browse book stores for books on nutrition, I am somewhat overwhelmed by the wide array of choices. Can you suggest some good ones?
B.R., Tulsa, OK

(A) Yes, here are several extracted from a list recommended in the Special Supplement to the July 2002 Tufts University Health & Nutrition Letter

1. The Long Life Cookbook: Delectable Recipes for Two, by Anne Casale. [Obviously not for large families.]
2. Eating Well When You Just Can't Eat the Way You Used To, by Jane Weston Wilson
3. The American Dietetic Association Complete Food and Nutrition Guide, by Roberta Larson Duyff. Get the third edition, coming out soon.
4. How to Cook Everything: Simple Recipes for Great Food, by Mark Bittman.
5. Thin for Life: 10 Keys to Success From People Who Have Lost Weight & Kept It Off, by Anne M. Fletcher.
6. Vegetarian Cooking for Everyone, by Deborah Madison.
7. Saved by Soup, by Judith Barrett.
8. Mediterranean Light, by Martha Rose Shulman.
9. On Food and Cooking: The Science and Lore of the Kitchen, by Harold McGee.