Sally Squires

• The Lean Plate Club archive • Recent stories by Sally Squires • Health Section: Nutrition • Health Section • Food Section • Talk: Health message boards • Live Online Transcripts • Subscribe to washingtonpost.com e-mail newsletters • mywashingtonpost .com -- customized news, traffic, weather and more

The Lean Plate Club
With Sally Squires
Washington Post Staff Writer
Tuesday, Dec. 18, 2001; 1 p.m. EST

Welcome to The Lean Plate Club, hosted by Washington Post health and nutrition writer Sally Squires. On Tuesdays at 1 p.m. ET, Sally leads a discussion for people who want to eat healthier, move around more and otherwise get better but not bigger. We're not about fad diets or crash weight-loss plans; we're about eating wisely and living healthy for the long haul.

We want to hear from you -- your tips, strategies, meal plans, successes, warnings, setbacks and more. Of course Sally will be happy to answer questions, and turn others over to the Club. None of this, of course, is a substitute for medical advice.

Health section editor Craig Stoltz will join Sally sometimes. Stoltz has none of Sally's impressive credentials but labors under a decade-long medical directive to control his weight and eat wisely, takes a statin to lower his blood cholesterol and keeps track of everything he eats on a Palm handheld computer, a fact most of his acquaintances no longer find interesting.

A transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Sally Squires: Welcome back to the Lean Plate Club. This is week five of the Holiday Challenge--the goal of maintaining weight this from Thanksgiving to New Year's. We continue to receive regular reports from folks who say they are holding the line on weight gain. A number even report that they've experienced a first for the holidays: trimming a few pounds. Look in today's Health section for tips to combat stress over-eating--something that plagues many people during this last, mad dash to the finish line for Christmas. I'll also try to address a few questions that have not been answered in previous weeks.

Here we go:

Santa Barbara, Calif.: I completed my 18-month odyssey of losing 80 pounds just over two years ago. I have managed to keep it off with just a couple of slips which I was able to catch and reverse. The Washington Post Health Section has been a wonderful online resource. My question is about the addictive nature of refined sugar particularly in combination with fat. I normally don't eat refined sugar choosing instead to enjoy the sweetness of fresh or dried fruit. However, if I have only a very small piece of pie or scone, I crave sweets for days, and the craving gradually goes away. Is this a physiological response? It feels pretty powerful and takes a lot of self discipline to control.

Sally Squires: First of all, congratulations. Eighty pounds! Awesome. You must feel like a completely different person. I imagine that you're also reaping the rewards of more energy from carrying around those 80 fewer pounds of weight. That's really quite an accomplishment.

You also raise an interesting question about food cravings, one that is keeping a number of scientists busy these days. There's no simple answer, but there are some tantalizing clues about mood and physiological functioning. Here's what some of the latest studies have found:

At the University of South Alabama researchers studied carb cravers versus protein cravers in a college-age population. Carb cravers reported feeling distressed prior to their cravings and satisfied, happy and relaxed after they indulged. Protein cravers, on the other hand, felt anxious or hungry prior to their cravings and happy, normal, bored and energetic after they indulged. Statistically, however, mood wasn't as strongly related to protein craving as it was to carb craving and the strongest links occurred among those who craved sweet, carbohydrate-rich foods.

At Western Psychiatric Institute and Clinic in Pittsburgh, psychologists Saul Shiffman, Rena Wing and CG Greeno compared obese women with and without a binge eating disorder. In the group who binged, they found that poor mood, low alertness, feelings of poor eating control and craving for sweets all preceded a bingeing episode. The surprise was that the obese women who didn't have a binge eating disorder still experienced a fair number of bingeing episodes. What predicted those indulgences? Feelings of poor eating control and craving for sweets.

Finally, a Welsh study looked at cravings for sweet rewards in both people and in rats and found that depressive mood increased chocolate cravings in both. Interestingly, however, there was also an interaction between the chocolate cravings and testing. It appears that chocolate may also increase the craving for sweet rewards.

Remember. These are studies, not the real world. But they are intriguing. And like I said, it's complicated...Anyone else had experiences out there on cravings that they'd like to share?

Friendly foods: Hello! Hope you can help out. I used to bring treats (mostly baked goods) to my wonderful elderly neighbors. However, it seems that the Mr.'s diabetes is advancing and the Mrs. has diverticulitus...any suggestions on what baked/cooked goods I could bring them? I'm stuck.

Sally Squires: You bet. There are a lot of choices. The Joslin Diabetes Center in Boston puts out a number of cookbooks that are really good. Start with these two:

The Joslin Diabetes Quick and Easy Cookbook : 200 Recipes for 1 to 4 People
by Frances Towner Giedt, Alan M. Jacobson (Foreword)


The Joslin Diabetes Gourmet Cookbook : Heart-Healthy, Everyday Recipes for Family and Friends
by Bonnie Sanders Polin, Frances Towner Giedt, Edward Horton (Foreword)


Hope that helps. Happy baking.

Arlington, Va.: Personally, I think being skinny is highly overrated, even from a health perspective as most of my colleagues, male and female, who weigh less than 100 pounds are some of the most ghastly people to look at. I mean, who wants to sleep with the cryptkeeper or Olive Oil? Bring on the cake and pie. I mean, it's like going to a seminar for people who need laser surgery and thinking even without glasses, these people are really ugly.

Sally Squires: Certainly, Arlington, too skinny is not good. But you just can't argue with the mounting scientific evidence that links being overweight and obese with health problems. Diabetes, heart disease, certain types of cancer, even asthma is being linked with overweight. So as Surgeon General David Satcher noted last week when he released the report on overweight and obesity this isn't a matter of appearance. It's a matter of health.

St. Petersburg, Fla.: Is there some new research indicating that taking Ibuprofen may slow down memory loss in older people?

Sally Squires: Scientists are looking at whole lot of things related to memory, including ibuprofen--which is one of a class of drugs known as nonsteriodal anti-inflammatory drugs. But there's no definitive evidence yet to say that it helps or hurts memory. Sorry.

Holiday Challenge: I've gone down a few pounds, then back up, but never over that magic line! I think just being aware of food, calories, and my weight has made it possible to maintain rather easily. The awareness at the back of my mind makes it easier to pass up those holiday cookies, or to just have one small cup of eggnog "to taste". The Washington Post should do this every year.

Sally Squires: Thanks! We've had a lot of good feedback about the effort. It seems to have struck a chord with regular readers and with some health professionals. A group of doctors and nurses faxed a letter to the Health section saying that they, too, had taken on the challenge. They purchased some equipment---resistance bands, hand weights and a jump rope--to do short workouts in the office of about 15 minutes daily. Their thinking was that if they were asking patients to maintain a healthy weight, why not participate too? The result, they report is that they've maintained weight, (some also lost a few pounds) and stress has been reduced as well as blood pressure.

Oxford, Md.: I lost 30 pounds about five years ago and I have been very successful in maintaining that loss. I think my biggest achievement toward that goal was to give up perfectionism. It freed me to make mistakes and know that it was OK and tomorrow would be a better day. Do you have any comment on that as a strategy? It worked for me. I hope it always does. It was my turnaround -- not for losing the weight -- but for keeping it off for five years.

Sally Squires: You discovered a wonderful secret. (And by the way, great job on losing those 30 pounds and maintaining the loss for five years! Do you know that you're probably eligible for the National Diet Weight Registry?)

It's looking at the big picture that seems to count for the long run. As psychologist James Prochaska notes in today's Health section, it's knowing how to prevent a lapse (in eating and exercise) from becoming a relapse. Sounds like that's what you've managed to do. It's also important to underscore that there's no one diet regimen for anyone despite what all the ads say. And what works for one person this year, might not work next year when their life circumstances change. The most important element to successful weight loss seems to be to navigate a reasonable course through all of life's ups and downs.

Washington, D.C.: Sally, are you doing the holiday challenge?

Sally Squires: You bet I am. And it just happens that I've had more travel during these past few weeks than probably the last year combined.

I've carted healthy food on board planes, taken my Digiwalker everywhere and done a few (sometimes not enough) exercise in my hotel rooms. I've also tried hard to keep healthy food in the house, readym and available for cooking. And I've sampled deep fried turkey, eaten at some great New Orleans restaurants and indulged in home-made English toffee. So far, I've maintained my weight.

Re: ibuprofen: just as a note -- don't take it on the assumption that it can't hurt you; it is highly allergenic to many people. I found this out the hard way (taking just one a day for an extended period of time to relieve aches and pains from exercising). TERRIBLE allergic symptoms, which I never connected to the ibuprofen until I took a long look -- the bottle one day.

Best way to improve your memory is to USE YOUR BRAIN! It'll fade without exercise, just like your muscles.

Sally Squires: NSAID's also should not be taken with alcohol. And you're right, doing new things is the best way to keep your brain cells plastic and alert.

Silver Spring, Md.: Various persons have asked about recipes for healthy food. The best resource I've found is the book, "Fat-Free and Flavorful" by the Washington, D.C. area's own Gabe and Diana Rich Mirkin. The recipes are low-fat and otherwise healthy, and they are also attractive, tasty, and also quick and easy. Family and friends who have used this book echo my praise. If someone doesn't do it by the time I retire, I would like to open a restaurant that served Gabe and Diana's recipes. It should be a five star for good health and good eating.

Sally Squires: I'll post this under the assumption that you're not either Gabe or Diana Mirkin. Haven't tried these recipes, but they sound good. What's really encouraging, however, is that there are range of wonderful cookbooks out there now. Since all of us don't have a lot of time to cook, most of the recpies take minutes of preparation. Someone also sent me Beter Homes and Gardens Three Stept to Weight Loss, which is based on a eating plan by Lawrence J. Cheskin, Director of Weight Management at Hopkins. It's got some great recipes too.

Other suggestions out there?

Chocoholic: Hi Sally!

I took your advice over Thanksgiving and made it my goal not to gain any weight. I think I stayed EXACTLY the same -- and it was a great and very feasible goal. Too often I tried to lose weight during the holidays and not only failed, but got frustrated.

I figure I'll concentrate on losing once I'm in a bathing suit. For now, I'm gonna stay the same.

Thanks for the (obvious but never occured to me) idea!

Sally Squires: Good for you! We keep hearing this from Lean Plate Clubbers. Kind of makes us wonder why we didn't think of it before. Other experiences out there to report?

Sally Squires: A few weeks back, someone asked about kilo joules versus calories. A kilo joule is simply another way of measuring energy and it's equal to 1,000 joules. A joule in turn is a meter-kilogram-second unit of work or energy.

USDA includes kilo joules as part of its on-line food list. (http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl) For example, one slice of oatmeal bread has 73 calories and 305 kilo joules. It takes about 39,000 kilo joules to lose a kilogram of weight (2.2 pounds.) That works out to roughly 17,727 kilo joules per pound--or approximately 3,500 calories.

Washington, D.C.: Can you get in shape doing yoga or is it more for stress relief?

Sally Squires: Absolutely you can get in shape doing yoga. There are a number of different types of yoga, including some that will really make you sweat. Plus, there's growing scientific evidence from Dean Ornish and others that yoga can be an important part of heart disease reversal. It's also great for flexibility. T'ai chi is another really good exercise.

Arlington, Va.: I gained over Thanksgiving, then I was sick with a terrible cold all last week and didn't eat much. Now my stomach seems to have gotten used to normal portions again -- as opposed to huge meals four times a day.

Sally Squires: Sorry to hear that you were sick, but sounds like it was a blessing in disguise. Remember, the goal of the holiday challenge is to maintain weight over the six weeks or so from Thanksgiving to New Year's. You may go up a pound or two. You may drop a pound or two. The goal is to avoid the weight gain--up to five pounds for those with a BMI of 30 or higher--that plagues most Americans.

Silver Spring, Md.: Two low calorie and enjoyable snacks in my food plan are baby spinach leaves and wheat berries. The baby spinach leaves come out of the store package (triple washed); the wheat berries are previously cooked in a quick and easy way as recommended by Gabe Mirkin: put the wheat berries in a thermos, then fill it with boiling water, cap and let sit over night. In the morning, drain off what little water hasn't been absorbed and refrigerate the berries (freeze those you won't eat within a couple of days).

Sally Squires: Sounds great, Silver Spring. I'm also a fan of soup and even broth (for a really cold wintry day, which we haven't seen much of this year.) Hot chocolate is another good snack. And if I want something savory, sometimes I mix olives with carrots and low-fat dip. It's nice and filling. Other suggestions out there?

Bethesda, Md.: Okay, I am sure there is no easy answer to this. I just cannot stop eating. I am not overweight or unhealthy. There is just so much yummy stuff out all over the place. What methods can I use to distract myself?

Sally Squires: This time of year is really tempting and you're absolutely right: every where you turn, there's food. (I can even buy chocolates when I go upstairs to retrieve office supplies.)

The experts say plan for the holidays. So don't deprive yourself completely. Just put yourself in control so that you're not mindlessly eating everything that crosses your path. In other words, think before you eat.

Budget a couple hundred calories for treats. Then eat three well balanced meals containing some protein, carbs and high fiber fruits and vegetables. Drink plenty of fluids. Think of other things for your mouth to do besides eating. In today's Health secion, one expert advises seeking oral gratification by talking to a friend rather than eating. Those are just a few of the strategies that you might try. And don't forget exercise. Can you talk a walk (away from the food) when you're tempted. Time can really be on your side for quelling your appetite.

Finally, ask yourself if you're really hungry when you're eating. Or are you just responding to the cue of the food (or to stress or a thousand other eating triggers?)

Good luck. Let us know how you do.

Alexandria, Va.: Have you heard that when you're under stress, you tend to accumulate weight in your midsection (as opposed to other places)? I think that has happened to me. I'm female, 42. Do you think if I reduce the stress, the weight will redistribute itself? I'm concerned because being "apple" shaped is linked to heart disease, correct?

Thank you.

Sally Squires: I have heard this theory, although I'm not convinced that all the scientific evidence supports it. Yes, an apple shape is more closely linked than a pear-shape to a risk of heart disease. But remember that there are many factors that play a role. Family history, degree of overweight, other measurements (including cholesterol, trigylcerides, etc.) Best advice: get on reasonable eating and exercise regimen. Exercise, in particular, is one of the very best ways to reduce stress. And don't forget to get enough sleep. That's also often overlooked and increasing evidence suggests that sleep deprivation takes a great health toll, including increasing appetite and even changing glucose tolerance test results.

Bethesda, Md.: How do you feel about the Slimfast ads that have been all over TV the past few weeks -- where folks claim (backed by photos) that they've lost upwards of 40-50 pounds on Slimfast and have never looked or felt better. I find it hard to believe that stuff works.

Sally Squires: Look. All these plans work to some degree to trim weight. Question is: how well do they work for the long run? Are they something that you can live with? You've got to find the healthy approach that works best for you. That's probably going to take trial and error. You may find that you're someone who does well drinking Slimfast for a meal. What you want to avoid is the diet mentality.

In other words: you want a healthy eating and exercise plan for life. Don't diet. Fnd a way to eat smart.

Falls Church, Va.:
Hey Sally!

Fellow LPC Challenger here, and doing pretty well! The weekends are always tough with all the parties, but I am keeping control of my portions and exercising daily! This-coming week will definitely be the hardest part of the Challenge, but I am thinking ahead. I will be heading out of town as of Friday, and know that my parent's home will be filled with junk food. So, I'm preparing to go out and buy myself lots of fruits and veggies to munch on instead. I know there will be a couple of little slip ups, but hopefully I can combat a major one!

Sally Squires: You've got the right approach, Falls Church. You recognize that you'll be in tempting situation, but you're already taking steps to counteract it. According to Jim Prochaska, best bet is to have three strategies ready for high-challenge situations. In other words: plan one might be to fill up on high fiber foods first at the party. Plan two: to limit alcohol to just the main course. Plan 3: to arrange ahead of time to buttonhole someone when you know you're feeling weak and are likely to binge. Some experts even say have a signal so that you and your buddy can move away from the table and focus on each other.

St. Petersburg, Fla..: What is the current thinking regarding the use of Accupuncture for pain control?

Sally Squires: There's some intriguing evidence for acupuncture, particularly for back problems. Be sure to check with your doctor first and get a referral to a facility that will take the proper precautions in sterilizing needles. Otherwise that could be a source of infection for everything from hepatitis C to HIV. And as with any health professional, it's good to find someone who does acupuncture often and well.

Washington, D.C.: Sally --
I want to make a tasty, yet healthy desert for my family's Christmas eve dinner. Any suggestions of websites that will provide good recipes?

Sally Squires: Hmm. I can probably give you more cookbooks than websites. But you could try:

http://www.cookinglight.com/
www.foodfit.com
www.foodnetwork.com also has recipes.

Don't forget to scan the women's magazines at the grocery checkout line. They're always updating recipes and often feature calories and fat grams. Weight Watchers magazine, Fit and Shape also include recipes. So does Men's Health.

Arlington, Va.: I've finally discovered my worst enemy in terms of losing weight -- setting goals. I would always say, okay I'll be at my goal weight in six months, and I'll have lost x pounds at three months. But I was setting myself up for failure, and so I always failed.

Now I've realized that I need to do my new routine for the rest of my life -- exercising every day that I can and being sensible about what I eat (without dieting). So now my only goal is to change and maintain my lifestyle.

And it's working. I had lost about 10 pounds in five weeks, and then got really sick. In the past, I would have been very upset that I had been knocked off track. But this time, I just decided that I needed to rest my body for the moment, and return to the gym once I've fully recovered. And yes, I've eaten too many Christmas cookies during this time, but I haven't yet put any of the weight back on yet.

Sally Squires: Great going Arlington. You raise an really important point: setting realistic goals. As you point out so well, the weight doesn't always come off the way you might expect. It's also important to remember that it takes most people months and years to accrue this unwanted weight. Figure that it's going to take months and maybe years to take it off. The point is to get on the road towards your goal, which you have done so well.

I'm also with you on exercise. This is not likely true of everybody, but if I don't exercise, I can feel the weight start to come on. And I agree with you that once you get in better shape, you can have a lapse in physical activity and it's not such a big deal--provided that you do get back to it within a reasonable time.

Fairfax, Va.: I'd like to let you know that I'm another one who hasn't gained. I'm doing great so far. I really like the idea, and it came at a perfect time for me -- I've been meaning to get started on losing a little weight, but I couldn't even think about doing it over the holidays. This way, I'll maintain until January and then get started on losing. Thanks!

Sally Squires: Great going, Fairfax. That's the hope that in January, everyone who participated will start the year with a fresh outlook--and without those unwanted pounds. At that point, they can choose to continue to maintain or choose to lose.

Washington, D.C.: Sally, I've heard/read that products that are calcium fortified (is that the correct term?) -- such as OJ with calcium -- isn't as healthy as getting your calcium right from the source, like a glass of milk, and that it's not always the same type or calcium we actually need. Is this true?

Sally Squires: There are slightly different absorption levels from different foods. And remember that there are different types of calcium too. Important thing is to get enough calcium each day, something that too few Americans do, especially kids. There's a big worry that we will be facing a major epidemic of osteoporosis. We think of it as a disease of the elderly, but the foundation is laid in youth. Bottom line: make sure you get enough calcium every day from a variety of sources. Yes, food is probably at the top of the list. But go for the fortified foods or supplements, if you're falling short.

Low-fat dip: Do you have a recipe you could share? Is it made with nonfat yogurt or sour cream? I like to try variations and would be interested in yours.

Sally Squires: I like to experiment with a lot of different stuff. So starting with a base of nonfat sour cream or yogurt I've added everything from hot chili paste to yes, onion soup.

Washington, D.C.: Hi Sally! I have a burning question about water. I KNOW that it is so important to drink water. I don't like to do it, but I try. In fact, I would almost rather run around feeling thirsty than drink something. So.. I do like seltzer water (carbonated, no sodium). Is this as good as "real" water? I've heard that drinking carbonated beverages, like soda, can contribute to osteoporosis, because something in there (aside from the caffeine) depletes calcium. What can you say about this? Does the same apply to seltzer water?

Last but not least, will you have a new change for us in the new year? How'bout the "One A Week" Challenge to promote gradual, healthy weight loss (one pound each week)...? Thanks!

Sally Squires: Seltzer is carbonated with CO2, which does not appear to deplete the bones of calcium. So go ahead and drink to your heart's desire.

Germantown, Md.: With regards to getting enough sleep: I'm a night person who can easily survive on 5 or 6 hours of sleep when it's from (for example) 4 am to 10 a.m. Getting up for work at 6 a.m. is another story, however. It seems that no matter how early I try to get to bed, I can't fall asleep until past midnight, so that I end up not getting enough sleep. I've even tried excercising in the afternoon, but even then I feel drowsy and tired in the morning. How can I change my habits so that I feel awake and refreshed in the morning?

Sally Squires: There are entire books on this, so I'll try to give you the short version. Some sleep experts recommend not exercising within about four hours of sleep (if you're having trouble getting to sleep.) Try soaking in a hot bath before bedtime. It will raise your core body temp and as the temp falls, it helps you fall into a deep sleep. Some experts have also told me that calcium supplements taken just before bedtime may have a drowsing effect, but that's not completely proven. Eliminate anything from your bedroom that might distract you from sleep and try to get to bed at about the same time every night.

That's just the tip of the iceberg. Hope it helps.

Sally Squires: Thanks everyone for participating. Because of the holiday, The Lean Plate Club will next appear on line on Thursday, Dec. 27 from 1 to 2 p.m. Good luck on this upcoming week. Happy--and Healthy--Holidays!

washingtonpost.com:

That wraps up today's show. Thanks to everyone who joined the discussion.

Stay tuned to Live Online:

Holiday Stress at 2 p.m. EST
Hollywood: Sharon Waxman at 2 p.m. EST
Live Online Special Coverage: America At War

Did you know that you can follow more than one Live Online discussion at the same time? Just open another browser window and toggle back and forth between discussions! And, if you miss one, catch up with the Live Online transcripts.

Keep up with the latest in news, sports, politics and entertainment with washingtonpost.com e-mail newsletters.

NEW! Personalize your Post with mywashingtonpost.com. Get customized news, traffic, weather and more.

   |      |