August 16, 2007

Speaking With...: Lisa Sasson

Lisa Sasson has been a clinical assistant professor at New York University’s Department of Nutrition, Food Studies, and Public Health for 15 years, and has almost twenty years’ experience counseling clients in New York City with their weight management goals.

She is also co-director of NYU's Food, Nutrition and Culture summer study abroad program in Florence, Italy. It's only appropriate, then, that one of her specialties is The Mediterranean Diet.

Her knowledge of nutrition and outspoken, affable personality led to appearances on Queer Eye for the Straight Guy and A& E as well as a one-on-one nutrition counseling session with supermodel Claudia Schiffer in 2004.

Ms. Sasson is currently Nickelodeon’s nutrition consultant and has been featured in The New York Times, Reader’s Digest, Self, Time, Fitness, and was Allure Magazine’s nutrition makeover coach in 2005 and 2006.

I sat down with Ms. Sasson and picked her brain regarding the latest fad diets. The result was a candid and insightful chat.

Small Bites: How have diet fads evolved over the past few decades?

Lisa Sasson: Nutrition reminds me of fashion. If you wait long enough, a certain diet will be in vogue again.

For instance, when you look back 25 years ago, you see low-carb, high protein diets like Atkins and Scarsdale being advocated. These exact same diets resurfaced in 2003.

Then, in the 90’s, diets were advocating counting grams of fat and eliminating it from your diet. In turn, people ate lots of carbs.

Well, carbs, like all nutrients, have calories. Fat-free does not mean calorie-free.

So, people ate lots of carbs and gained a lot of weight.

SB: What themes do the most recent diet books have in common?

LS: The glycemic index is back, and so is this idea of “good” versus “bad” carbs. Whole grains are also a focus of the newest diet books.

Luckily, fat is becoming a component of most weight loss diets. Instead of calling for its elimination, the current books suggest eating healthy fats like olive oil, salmon, avocados, and nuts, which is a good push.

SB: What’s your take on “good” versus “bad” carbs?

LS: The problem I have with it is that there is no good scientific research demonstrating the importance of the glycemic index and “good” or “bad” carbs. So many factors affect the glycemic index of a food as it is. For example, the glycemic index of a potato varies depending on what you ate before, what you are eating with it, and how you prepare it.

People take it out of context. A lot of these books focus on it because it’s a catch. It makes people think, “Oh! If I eat this I am going to lose weight.” It is a great way to draw someone into believing your book is special.

SB: Which would you say is the best of the current diets?

LS: Walter Willett’s book (Eat, Drink, and Weigh Less: A Flexible and Delicious Way to Shrink Your Waist Without Going Hungry) is one of the better ones.

I liked it because he has a realistic approach. I wish he wasn’t so fixated on whole grains and the glycemic index, but he allows other carbs that may not be whole grains or “good” in the glycemic index to be incorporated.

He also recommends healthy fats, and the meals featured in the book are simple to prepare.

I liked Bob Greene’s book (The Best Life Diet) in the sense that it is done in increments and he goes into the psychological implications behind weight management.

He also stresses the importance of exercise and being more physically active.

You can’t talk about weight loss and not mention being more physically active. Not necessarily lifting weights, but just moving more. That’s the key to a healthy lifestyle.

Exercising allows you to eat more, utilize glucose better, have more muscle mass and lose weight more quickly.

SB: Are there any new diet books you aren’t too fond of?

LS: Yes, The Sonoma Diet! The woman who wrote it, Connie Guttersen, is a registered dietitian. She should be ashamed! Do you know what her first “rule” is? “Throw out anything in your house that has white flour or sugar in it”!

I mean, she takes pride in the fact that her diet mimics the Mediterranean Diet and then has the audacity to say, “Never eat pasta.”

And then she has all these phases, or “waves”, as she refers to them. The first wave is VERY restricted. There is a whole list of foods you can’t have. You can only have certain veggies, certain nuts, and certain grains.

There are also all these recipes that are so complicated. I was leafing through it and thinking, “Is someone really going to get home after a busy day and make these dishes?”

The author also makes some outrageous statements. For example, she says you can’t eat fruit during phase one because of “the carbs”.

That’s ridiculous because fruits are chock full of nutrients and fiber. Besides, they are delicious and sweet. There is absolutely no reason why people should not be allowed to eat fruit.

Should you have limits? Of course. But to restrict a natural food makes no sense. I can’t accept that anything as natural as fruit should be eliminated from a diet.

For someone to say, “I can’t eat an apple, I’m on a diet,” is just laughable.

Oh, and throughout the whole diet you can only have Barilla Plus multigrain pasta, but not regular pasta. What bothers me is that Italians aren’t eating whole grain pasta.

What matters more is what they’re putting on their pasta.

SB: What do you mean?

LS: In Italy, pasta has very little sauce on it. It’s eaten with beans and lots of vegetables, and it’s usually a side dish, not a huge meal. It is not a huge portion.

SB: What would you say to someone who critiques nutritionists as being too objective when analyzing diets? It’s easy to look at the science, but what about the personal experience?

LS: Funny you should ask that. I was looking at all these diets and thought to myself, “What does it feel like to go on these diets?” I wanted to really experience it “from the other side”, so to speak, so I decided to go on South Beach for 2 weeks. I followed it very strictly.

The good thing was that while I was on it, I had very little freedom, so I was not tempted to just pick or snack mindlessly.

So, it was easy in the sense that there wasn’t much choice. I was so hungry that whatever I ate, I enjoyed.

The bad thing is that, while dieting, I continued living my normal life. It was very difficult to exercise during these two weeks. Yoga was particularly taxing.

I was so low on carbs that I was glycogen-deprived, and glycogen is the main source of fuel. I felt light-headed, had terrible headaches, and was very moody.

It was also hard for me to look forward to the social aspect of a meal. The joy and pleasure of food was taken out.

After five days I couldn’t look at another egg because every morning I had one for breakfast. I also found it frustrating that I couldn’t just have a glass of wine with dinner.

SB: So, psychologically, it was difficult.

LS: Yeah, and what I hate about all these diet books is that none acknowledge that losing weight is not always easy.

They talk about how delicious their recipes are and all the variety they offer and how you wake up and get to eat delicious things like ricotta cheese with Sweet and Low and Cocoa powder, which, ugh, I don’t know how anyone can find that tasty. It's disgusting.

And, again, none of these books mention fatigue or boredom. They dismiss it. All they talk about is how you’re going to lose all this weight in two weeks, and how you have so much choice, and how with each phase you can eat more. Please. I wanted to search the index for “headaches” and “moodiness” to make sure I wasn’t going crazy.

SB: What about food shopping?

LS: Oh, God! I would go to the supermarket and put all these artificial food products into my cart. I had diet gellatin, diet popsicles, diet ice cream, and all these products with fifty ingredients.

Diet Jello became my best friend because I would make 2 boxes a day and make it when I was hungry. I would eat eggs, diet Jello, sugar-free pops, sugar free this, sugar free that. Meanwhile, I’m thinking, “This is expensive and I can’t have fresh fruits in my cart!”

SB: What are some common pitfalls dieters make?

LS: Setting unrealistic expectations. Rather than think of this as a change of their lifestyle, people just think of it as “I need to lose 40 pounds by my birthday.”

Healthy eating goes hand in hand with living healthfully. So, apart from eating well, people should exercise and sleep enough. All these things affect your eating habits.

Don’t look at weight loss as “I need to eat more blueberries and less salmon” or some mathematical equation.

Also, learn to listen to your body. It lets you know when you are hungry, full, or satisfied. A lot of times people can’t differentiate between hunger and boredom. You shouldn’t feel stuffed after you eat.

Also, it’s a good idea to eat BEFORE you feel famished. This will reduce your chances of overeating or choosing unhealthy foods to immediately curb hunger.

SB: How should people who want to lose weight prepare themselves psychologically?

LS: First of all, have realistic expectations. Healthy weight loss is approximately 1 pound a week. So, for twenty pounds, you are looking at four to five months.

The key is to think of this as lifestyle changes. You want to lose this weight forever, not just so you can show off your body at the beach and then not worry about it because in the winter you hide under baggy sweaters and jackets.

When you lose weight quickly and go on these ridiculous restricted diets, you slowly start breaking the rules and then ease into your normal eating habits. So, what you need to change is your eating habits, and that’s going to take time.

When you make long term commitment, you will forever have a healthier relationship with food. Weight loss will not be at the forefront, it’s going to be changing the way you eat. Eating healthfully, physical activity.

It doesn’t – and shouldn’t -- mean you can’t have desserts two times a week or pepperoni pizza a few times a month. The idea is that these foods should play less of a role. Healthy eating is not about one meal or one food, it’s about dietary patterns.

People don’t succeed on overly restrictive diets because they focus on specific nutrients instead of changing their lifestyle. People get stuck on eating less of this, more of that, and it becomes difficult to sustain socially, culturally, physically, and emotionally.

SB: Say someone is reading this and wants to start losing weight today. What would you recommend as a good starting point?

LS: The first thing I tell my clients is to get rid of liquid calories. Liquids do not satiate the way food does, so it ultimately leaves room to consume more calories.

Also, these can easily be substituted with lower calorie healthy beverages. So I would begin by replacing sodas, juices, high fat milk, beer, alcoholic beverages, cocktails, and sugary iced teas with flavored sparkling water, diluted juices, unsweetened teas, and low or non-fat milk.

Then, each day try to do more physical movement than what you currently do. It can just be an extra ten minutes of walking every day. Then, two or three weeks later, add ten more minutes. Build it up slowly.

Don’t focus on how little you are doing. Whatever you do -- even if it’s a five minute jog -- is positive.

People just see the long-term goal and lose sight of the small steps in between. They say, “I can’t get to the gym tonight. I might as well eat a whole pizza.” Well, if you can’t go to the gym, walk for 10 or 15 minutes in your neighborhood.

Also, pay attention to what you feel when you eat. Before you put something in your mouth, ask yourself, “am I hungry? Or bored?” Rate your hunger. When you feel satisfied, try to stop.

Don’t buy things that make you feel vulnerable. If potato chips are irresistible, don’t have them in your house. If you have to buy them for other family members, put them somewhere out of your way so you have some time to think before reaching for them.

Focus on fresh fruits and vegetables. Don’t get hung up on this fruit, this vegetable. If you eat close to nature, if you are eating less processed food, you are already doing a really good job. Don’t think about eliminating plums and then eating watermelon only after the third week. Fruit is healthy!

SB: How can people spot a well-rounded “diet” book versus one that is unrealistic to follow?

LS: I don’t like books that tell you, “throw out everything that has white flour or sugar! Don’t eat these foods for six weeks!” It’s so ridiculous. Telling someone to ban 30 different foods does not mean they will stick to it or lose weight.

Also, these super strict rules are unnecessary. You don’t have to subsist on whole grain pasta or brown rice to lose weight. It’s OK to eat normal pasta as long as it is cooked healthily and you aren’t having three cups of it for dinner.

If you don’t like whole grain pasta, it’s OK. It’s not the magic weight loss solution. If you’re drowing your pasta in alfredo sauce, it doesn’t matter if it’s whole grain or not.

I like books that talk about making healthy changes rather than eliminate foods.

I like books that aren’t about just seeing the top of the mountain, but rather about the steps you need to take to get there. Looking at that tall mountain can seem overwhelming and defeating. People should be encouraged to concentrate on small, continuous steps. That’s a much healthier, more realistic approach.

I also think a good plan incorporates cultural sensitivity. Not everyone drinks milk, so to tell people to get calcium from dairy, that’s very shallow. Some cultures don’t drink milk and their calcium intake is just fine.

Thanks again to Lisa Sasson for a fun and thorough interview!

Over the next few weeks, Ms. Sasson will be analyzing some of today's hottest diets. Come back to find out which ones make the honor roll and which make the hall of shame.


Anonymous said...

Like a lot of dieticians, Ms. Sasson cannot phathom anything but what she was taught. She refuses to read any new research, but bases all her opinions on the science of years past. She then creates a fictionalized version of those diets (atkins, south beach) so she is doomed to fail.

Her actions speak louder than her words - for example, she says "I had diet gellatin, diet popsicles, diet ice cream." Does she normally eat ice cream, popsicles and gellatin all the time?

She talks of only eating eggs every morning. Did any of these diets require her to only eat eggs? She could have had some quickly grilled salmon and some miso soup? Or some lo-carb yogurt and pecans? There are thousands of other breakfast choices, yet she chose only plain eggs. Why?

She assumes that the first two weeks of these diets are exactly like the diet is supposed to be throughout the entire diet.h

This makes me very skeptical about her statements.

Anonymous said...

Really like this blog, and enjoyed this interview and the one with Marion Nestle. They seem to concur with the Michael Pollan principles: "Eat real food. Mostly plants. Stay away processed food" etc. Seems simple and obvious, but helpful to have it reiterated.

WifeMomChocoholic said...

I know this is an old post, but I tried the "Eat, Drink, and Weigh Less" diet and I was so ravenous I could have gnawed my arm off. I ended up bingeing on day 3.

I'm on day 5 of South Beach right now and have had no headaches, and have exercised normally every day. I've not been unusually hungry, which is a first on a diet for me! I wonder if she actually cooked some of the delicious recipes in the book? I haven't eaten a fake food yet.