September 30, 2008

Say What?: Japanese Dieters Go Bananas

And you thought the Master Cleanse diet was as ridiculous as it could get?

CBS-3 in Philadelphia is reporting that Japan's "morning banana diet" fad has led to shortages of the yellow-skinned tropical fruit.

What exactly does the morning banana diet entail, you ask?

Oh, just the usual nonsense.

Apparently, you can eat whatever you want --in unlimited quantities, no less -- for lunch and dinner (although dinner should preferably be no later than 6 p.m.) as long as you consume one raw, unfrozen banana for breakfast.

That's right, feel free to wolf down cheeseburgers, fries, and milkshakes -- the bananas will magically help you lose weight!

Two other rules -- you may only drink water and exercise is completely optional!

The diet's "official website," which credits a "white-collar worked named Hitoshi Watanabe" as creating the diet, provides some laughable theories as to why this weight-loss plan "works."

My favorites?

* "Bananas contain enzymes that assist in digestion, speeding it up and thus reducing the amount of time the intestines need to work to digest food, resulting in a metabolism more suited to losing weight. These enzymes only exist if the bananas are eaten in their raw state."

Oh, look, the digestive enzyme myth again!

Humans already have necessary digestive enzymes; we do not need any from our food supply.

Additionally, speeding up digestion sounds like a dieter's nightmare, as it would mean faster gastric emptying (and thus feeling hungry more quickly!)

* "Laying off the manditory[sic] exercise and allowing afternoon sweets reduces stress, which would otherwise lead to overeating."

There's a new one! So popping bonbons at four in the afternoon creates as many "feel good" endorphins as lifting some weights or jogging?

Who knew nutrition could be so comical?

In The News: California Counts Calories

Congratulations to California on being the first state to pass a calorie labeling law.

Unlike other cities and counties that have passed a similar bill, California is taking a two-step approach.

First, "beginning July 1, 2009, [restaurants] will be required to provide brochures containing nutritional information including number of calories and grams of saturated fat."

Calorie information on menu boards, meanwhile, must be implemented by January 1, 2011.

"The new law applies to restaurants with 20 or more locations in California, which includes more than 17,000 eateries."

Numbers Game: Answer

A 16 ounce can of energy drink SoBe Adrenaline Rush contains 16.5 teaspoons of added sugar -- all in the form of high fructose corn syrup.

Yikes!

By comparison, 16 ounces of Coca Cola offer 13.5 teaspoons of added sugar.

And since this energy drink -- like all others -- does not contain fat or protein, its entire caloric content (264 calories) is derived from high fructose corn syrup.

We're basically talking about soda infused with caffeine, amino acids, and vitamin B12.

I find that many people are unaware of the caloric punch these drinks can pack.

For example, I am often greeted with surprise when I tell someone that one SoBe Adrenaline Rush drink and two shots of hard liquor add up to 460 calories.

September 29, 2008

In The News: The Dark Side of Calorie Labeling?

How is this for an interesting spin on calorie labeling?

"After students and parents raised concerns about displayed calorie counts leading to or worsening eating disorders, Harvard University Dining Services removed the index cards detailing nutritional information from dining halls this year," CNN.com reports.

Interestingly, Harvard was going above and beyond, listing calorie, serving size, carbohydrate, and fat information for their dining hall menu options.

Although these values can still be found on the dining hall's website, they are no longer displayed at the actual eating establishment.

This decision makes absolutely no sense to me.

I simply do not see the effectiveness of removing a public health information service that has the potential to benefit a large percentage of the student body because it can be harmful to a smaller contingent of individuals (although eating disorder rates in college campuses are high, we are certainly talking about less than half of the total population.)

Besides, people living with eating disorders are usually hyper aware of caloric content out of their own valition.

If anything, they are more likely to seek out that information online than someone with a passing interest in maybe, perhaps, somehow wanting to manage their weight more efficiently.

Someone struggling with anorexia is already following an extremely regimented and restrictive diet.

It is highly probable that they walk into a dining hall with a pre-established harsh caloric limit on their mind (rather than finding out as they stand in line that, oh, the sandwich they were thinking of getting adds up to 900 calories.)

Although "Dining Services will continue to promote healthy eating among students through forums and information sessions," it is a shame that calorie displays will be eliminated.

If displaying actual numbers is out of the question, why not develop a color-coded range?

For instance, a yellow sticker next to an item signifies "0 - 200" calories, a blue one signifies "200 - 400," etc.

And if the administration is looking to convey an overall message of wellness rather than strict calorie counting, how about displaying health-promoting banners and signs throughout the dining hall (i.e.: "Whole wheat pasta is a great source of fiber," "Olive oil is high in heart-healthy monounsaturated fats," etc.)?

What is your opinion?

September 28, 2008

You Ask, I Answer: Hydrogenated/Interesterified Fats

Thanks for explaining all about trans fats.

I have a question, though.

I have recently seen hydrogenated oils on Crisco food labels (not "partially hydrogenated", but "hydrogenated".)


Are these also trans fats?


-- Patrick Altug
Boulder, CO


No, they are not.

Whereas the partial hydrogenation of a liquid oil transforms its chemical structure in such a way that yields a solid, yet pliable texture (i.e.: easy to spread on toast,) full hydrogenation results in a solid mass that you can't do much with.

So, in an attempt to remove trans fat from their formulations, many products will interesterify fats.

In this process, solid oils and liquid oils are combined in vats, hydrogenated, broken down to their most basic form (triglycerides) and later manipulated/reconstructed in order to to achieve a desired consistency.

Unfortunately, these fats come at a price.

Recent research studies in the United Kingdom and Malaysia have found that interesterified fats decrease HDL ("good" cholesterol), raise blood sugar, and, perhaps more worrying, suppress the secretion of insulin.

Why the worry?

Raising blood sugar while lowering levels of insulin (the hormone that moves glucose out of the bloodstream and into cells) is certainly a rather powerful risk factor for the development of Type 2 diabetes.

Although many people roll their eyes at this bit of news and often make statements like, "Are these dietitians EVER satisfied with anything? If it's not trans fats, it's something else," there is an important lesson in all of this -- stick with unadulterated fats!

Whether partially or fully hydrogenated, those fat molecules have been chemically altered.

A diet rich in minimally processed foods (whole grains, vegetables, fruits, lean protein, and heart-healthy fats) won't include either type of hydrogenated oils.

September 27, 2008

Crunch Away!

A few days ago, a friend was picking my brain for portable, nutritious, and tasty snack ideas.

He specifically mentioned that while he enjoys the taste of my standby bar recommendations (Lara, Clif Nectar, Gnu Flavor & Fiber, Pure), they are all missing "crunch" -- his favorite texture.

Crackers don't really do it, he explained, because he likes a tinge of sweetness to his snacks.

I suggested Kashi TLC (Tasty Little Crunchies) granola bars -- and was just told it's exactly the type of snack my friend was looking for!

One individually wrapped container offers two bars and provides:

180 calories
4 grams of fiber (3 of which are soluble)

8 grams (2 teaspoons) of added sugar
6 grams of protein

100% whole grains


I specifically point out the presence of soluble fiber as that is the type of fiber that has been linked with reductions in LDL ("bad") cholesterol.

You Ask, I Answer: Trans Fat Labeling/Margarines

I read somewhere that manufacturers can claim "no trans fat" only if there is absolutely [zero grams of] trans fat in the product. Is that true [or are there loopholes]?

Also, are there new means of hydrogenation that don't create trans fats?

[I ask because] some margarines claim [to have] no trans fats [and I don’t see how that can be].


-- Hemi W.

Via the blog


Since “no trans fat,” “trans fat free,” and “0 grams of trans fat per serving” all fall under the same loophole (watch the latest Small Bites YouTube video for more information,) you can’t always trust what a food product’s packaging says.

The best way to find out if a given food contains trans fats is to scan the ingredient list for “shortening” and/or any “partially hydrogenated” oils.

As far as new margarine products that truly ARE trans-fat free, they are made by a process known as fractionation, in which liquid oils are chilled until a solid part crystallizes and then filtrated for food processing purposes.

Although fractionation does not result in the formation of any trans fats, fractionated forms of oils have higher levels of saturated fat than their non-fractionated counterparts.

I know, I know -- it's always something, right?

The truth is, an additional gram of saturated fat in a serving of cookies is certainly the lesser evil to a gram of trans fat.

But here's the takeaway lesson. Processed foods – whether they contain trans fat or fractionated oils – are best consumed as outliers in (rather than central components of) our diets.

September 26, 2008

In The News: Raw Redux

Grrr. Here we go again.

So CNN.com is currently profiling 30-year-old Angela Stokes, who lost 160 pounds in 2 years as a result of going vegan and raw.

As Stokes explains it, "it's simple and natural, eating food straight from the earth. There's no rocket science, no mystery. Once you understand the simple principle that no other animal in the wild eats cooked or processed foods, that's it."

Although the article shares some of Stokes' tips -- she has authored books on raw dieting, despite limited nutrition knowledge -- for interested readers (such as going "at least 50% raw," a number that is thrown out there without explanation), there is absolutely no mention of possible concerns when adopting such a way of eating.

For example -- why doesn't the article mention that some nutrients in food are more available when cooked?

Or that the reason why animals in the wild don't eat cooked foods is because they simply don't know how to start a fire or turn an oven on?

After all, if I put some broiled salmon in a dish for my cat, you better believe he's chowing that down in seconds, licking his whiskers, and meowing for more.

It's also worth pointing out that there are several healthy, "straight from the earth" foods that need to be cooked in order to become edible (i.e.: oats)

I also find placing cooked and processed foods (for instance, a simple baked potato and a can of Pringles) in the same "unhealthy" category is ludicrous.

I enjoy vegan cuisine a lot, and have had some delicious dishes at raw restaurants, so this is far from a carnivore rant (I actually haven't eaten any meat other than seafood in 10 years).

However, going entirely vegan and raw overnight for the rest of your life is not something I would put my stamp of approval on, as it can be very easy to come up short with certain nutrients.

Like the majority of articles on weight loss, this one completely overlooks the elephant in the room -- calories!

It is not that going vegan and raw holds the magic key to weight loss. It's simply that raw, vegan diets are lower in calories than the diet Angela used to have ("eating junk food all time.")

She could have still shed the weight while including a cup of yogurt, roasted sweet potatoes, or a brown rice and seitan stir fry in her eating plan.

Numbers Game: Sugar Rush

A 16 ounce can of energy drink SoBe Adrenaline Rush contains ______ teaspoons of added sugar -- all in the form of high fructose corn syrup.

a) 16.5
b) 12

c) 14

d) 22.5


Leave your guess in the "comments" section and come back on Tuesday for the answer.

You Ask, I Answer: McDonald's

While I do not refute that McDonald's is not very appealing to me, do you think this article written by a "nutritional consult" has any value?

-- Kate Redfern
Alberta, Canada


The article Kate refers to is written by a "wellness educator" and nutrition consultant who argues that "[a] McDonald's [hamburger] fills an empty space in your belly. It does nothing to nourish the cell, it is not a nutritious food."

The author comes to this conclusion after pointing out that a hamburger she purchased at the Golden Arches 12 years ago and has since kept at her home has not decayed one bit and looks exactly like one someone ordered 5 minutes ago.

And the point of that would be...?

While that demonstrates that this hamburger contains plenty of preservatives, it does not negate its nutritional profile (which I will explain a few paragraphs later.)

One particularly confusing part of her argument is that "a [McDonald's] hamburger [in the United States] tastes exactly the same in China or some around the world place."

To that I say, "so what?"

After all, when you go to your favorite restaurant, you expect the dish you had 2 weeks ago to taste the exact same, don't you?

The fact that the taste is always identical does not mean said dish -- say, lentil soup -- is void of nutrition.

Standardized recipes and formulas are common practices in the restaurant business. They are there to ensure customer loyalty, not as some nutritional conspiracy.

While I do not disagree with the thought that McDonald's food is heavily processed, this notion that one of their hamburgers "does not nourish" is completely inaccurate (by the way, I'm still trying to figure out what the author means when she specifically mentions "cell nourishment.")

The plain and simple fact is that a McDonald's beef patty contains iron, protein, B vitamins, and a little vitamin A. The bun, meanwhile, offers iron, folate, niacin, thiamin, and riboflavin.

Is the hamburger high in sodium? Absolutely. Devoid of fiber? Yes -- but that's the case with ANY hamburger, not just a McDonald's one.

In short, these sorts of "articles" irritate me to no end because they aren't written within a framework of nutrition science (and by that I mean basic food composition; knowing what nutrients are in what foods.)

This is simply fear-mongering meant to titillate and shock, rather than educate.

Eating a McDonald's hamburger once a month, for example, will not kill anyone. The patty will not sit in your colon for 12 years. It will provide protein, iron, and B vitamins to your diet.

Would I recommend someone seek out food at McDonald's? No. But I am also not going to sit on some self-made ivory tower and condemn anyone who occasionally enjoys one of their plain hamburgers.

Besides, I have a hard time believing the hamburger shown at the link has been stored at room temperature for 12 years without a trace of mold -- not even on the bun!

As far as I'm concerned, it's the article at the link that's lacking substance.

September 25, 2008

Administrative Announcements: Internet Explorer Issues

Dear Readers,

It has come to my attention that if Small Bites is viewed with Internet Explorer, some posts do not show up!

In particular, posts published between September 21 and September 24 are MIA for Internet Explorer users.

You can always keep track of what has been published by scrolling down a little bit from the top of the page and viewing the blog archive on the right-hand margin.

Alternatively, I suggest using Mozilla Firefox as your web browser.

Numbers Game: Answer

According to a research article in the April 2006 issue of the New England Journal of Medicine conducted in part by the Harvard School of Public Health Department of Nutrition (lead author: D. Mozaffarian), "eliminating trans fats from the United States' food supply could prevent up to [20 percent] of heart attacks and related deaths."

As much as food companies love partially hydrogenated oils (trans fats) for the crispy textures and long shelf lives they offer, they are a nutritional enemy.

As evidenced by recipe modifications following trans fat bans in some parts of the country, it is perfectly possible to create a variety of snacks and baked goods that are trans-fat free (without altering flavor in the slightest).

However, thousands of products on United States supermarket shelves continue to list partially hydrogenated oils as an ingredient.

And if you're not living in a city or county that passed a trans fat ban for restaurants, you can bet you are getting a fair share of this man-made fat from French fries and baked goods.

Many European countries were able to completely remove partially hydrogenated oils from their food supply, so why not follow suit?

Buyer, Beware (And Be Smart)!

The latest video on the Small Bites YouTube channel discusses four popular deceptive advertising techniques relating to nutrition:

--> "A daily dose of antioxidants."
--> "Cholesterol-free"
--> "0 grams of trans fat per serving!"
--> "Made with fruit"

Once you're familiar with these tricks, you won't be a sucker at the supermarket!

video

September 24, 2008

You Ask, I Answer: Tea & Iron Absorption

The macrobiotic way of eating includes hojicha and kukicha (2 different kinds of teas) as a main beverage usually around meals, [so in light of your posting about tea affecting iron absorption,] is this a problem?

Are there studies as to which types of tea have high amounts of phytates or iron inhibitors?


-- "gd"

Via the blog

The issue of phytates and tannins in tea reducing iron absorption is only problematic for people with borderline iron consumption and/or whose only sources of iron are of the non-heme variety.

After all, it is only that kind of iron --found in plants, eggs, and dairy -- which tea binds (heme iron, found in meat, actually helps absorb non-heme iron.)

If the two teas you mention are recommended as accompaniments to meals, it will certainly cause a higher reduction of iron absorption than if they are consumed between meals.

I recommend playing it safe and separating "tea time" and "meal time" by at least 45 minutes.

I want to make it clear that total tea consumption does not affect non-heme iron absorption; it is the TIMING of the consumption that matters.

Remember, too, that vitamin C aids in the absorption of non-heme iron.

So, squeezing a wedge of lemon into tea, or including potent sources of vitamin C in our meal (i.e.: tomatoes, red bell peppers, kale, and broccoli, to name a few) can help counteract some of tea's iron-blocking properties.

Although all teas contain phytates and tannins and affect non-heme iron absorption, black tea contains the highest levels of these inhibitors, while herbal varieties contain lower amounts.

September 23, 2008

You Ask, I Answer: Low Blood Sugar (Hypoglycemia)

What happens when your blood sugar is usually low?

-- Anonymous

Via the blog


This is known as hypoglycemia, which many people with diabetes can experience if their blood glucose levels are not appropriately managed.

Whereas a fasting (remember, that's at least 8 hours of no food or drink, other than water) glucose of 125 mg/dL points to diabetes, anything below 50 mg/dL is a sign of hypoglycemia.

Symptoms can include dizziness, paleness of the skin, general confusion, and shakiness.

If the symptoms are detected early enough into a hypoglycemic episode, the situation can usually be remedied by consuming a predetermined amount of carbohydrate.

If, however, one of these episodes goes untreated, fainting will occur.

In this case, the only viable step is to inject glucagon (an enzyme that, like insulin, is also secreted by the pancreas but, unlike insulin, RAISES blood glucose levels.)

In The News: Do Soft Drink Bans At Schools Work?

Today's New York Times features a study published in the September issue of the Journal of the American Dietetic Association, which The Times briefly summarizes as demonstrating that "soft drink consumption of children at schools where it was sold and children at schools where it was not... did not [show] a big difference."

In fact, approximately "4 percent fewer children from the no-soda schools said they did not drink it."

So is this it? Has legislation to ban soft drinks from schools failed?

Not quite.

I find it odd that this study only focused on elementary school children.

After all, the "soda problem" mostly revolves around teenagers, many of whom get an average of 15 percent of their daily calories from soft drinks.

I think this same study conducted in middle and high schools would very likely show more positive numbers.

Forget sodas for a minute and just answer this.

Who is more likely to make a pit stop -- and have loose change to use -- at a hallway vending machine? A first grader walking back from art class with his teacher in single file or a 10th grader with two minutes to spare on his way to geometry class?

In The News: Just How Splendid Is Splenda?

Not very, according to some Duke University researchers who point the finger at the artificial sweetener, accusing it of "contribut[ing] to obesity, destroy[ing] “good” intestinal bacteria and prevent[ing] prescription drugs from being absorbed."

Interestingly, the study is financed by the Sugar Association.

Perhaps more ironically, the first two statements could also apply to sugar.

In fact, many foods and ingredients can feasibly be labeled as "obesity contributors" depending on consumed quantities.

Someone could very well point to olive oil as an "obesity contributor," which it can be if it is liberally poured over every meal you eat.

As you can see, such statements completely distract everybody from more relevant issues.

In the case of sugar and Splenda, these accusations are misleading.

After all, obesity rates were much lower 400 years ago (when sugar was consumed), and it's not as if a surge in obesity occurred when Splenda was unleashed to the public.

Here are my thoughts on the real issues at stake here:

1) Is Splenda safe?

A packet of Splenda in your morning coffee or enjoying a Splenda-sweetened beverage a few times a week with your lunch isn't a huge concern.

However, there are no long-term human studies -- Splenda is less than ten years old.

We truly do not know what, say, 40 or 50 years of consuming Splenda on a daily basis does to the human body. A little tidbit to keep in your back pocket...

2) Does Splenda contribute to obesity? What about sugar?

Well, sugar is the epitome of empty calories (you can down 500 calories of sugar water and not feel the least bit full.)

And, since most sugary treats are also high in fat and overall calories, I suppose there is a "two degrees of separation" concept going on here. However, sugar was consumed long before obesity rates skyrocketed, so branding it a culprit seems wrong to me.

As far as Splenda "contributing to obesity," I don't buy it.

What I will say is that it can certainly provide a false sense of security.

A slice of sugar-free cake (made with Splenda) is NOT calorie-free, although many people may inaccurately think so.

The fact remains that sweetener consumption in the United States has grown exponentially over the past 20 years.

Consequently, additional calories are being consumed from sucrose (table sugar) and high fructose corn syrup.

Sugar as a sole ingredient does not make anyone fat. Having endless grams (and calories) of sugar on cereals, cookies, frozen desserts, yogurts, and salad dressings, however, gets very problematic very quickly.

Artificial sweeteners, meanwhile, continue to become more available in a wide variety of calorie-free foods.

Completely absent from everyone's diet fifty years ago, they are a relatively new piece to the public health nutrition puzzle.

My suggestion? Scale back a little on both. You can't go wrong reducing your intake of empty calories and artificial chemicals.

September 22, 2008

Numbers Game: Shot Through The Heart, And You're To Blame... You Give Fat A Bad Name!

According to a research article in the April 2006 issue of the New England Journal of Medicine conducted in part by the Harvard School of Public Health Department of Nutrition (lead author: D. Mozaffarian), "eliminating trans fats from the United States' food supply could prevent up to [_______ percent] of heart attacks and related deaths."

a) 6
b) 20
c) 11
d) 33

Leave your guess in the "comments" section and come back on Thursday for the answer.

September 21, 2008

You Ask, I Answer: Frozen/Cooked Vegetables

If I microwave my vegetables instead of steaming/boiling them, will this prevent some of the vitamin loss (to water)?

Also, I know a lot of vitamins are heat-sensitive. To save time, I've started preparing a lot of foods beforehand, and then storing them in the refrigerator for a few days.


I'm wondering if, in doing so, I'm losing out on a lot of nutrients through heating, cooling, and reheating, as well as having them exposed to air (and, thus, oxidation) through my dicing/cutting.


Similarly, are frozen vegetables less nutritious than fresh ones?

-- Anonymous

Via the blog

Steaming and boiling provide very different nutritional profiles.

Since steaming does not place vegetables in direct contact with water, water-soluble nutrients (like vitamin C and the B vitamins) do not leech out.

Boil potatoes for 20 minutes, though, and you are kissing a lot of vitamin C goodbye (unless, of course, you end up using that water for soup, which not many people do.)

Microwaving is one great way to steam foods, but it ultimately comes down to how much water you are using.

Cooking broccoli in the microwave by dunking it in a big bowl of water is just as nutrient-leeching as boiling!

Although vegetables offer the most nutrition when they are cut and diced right before consumption (some nutrients are sensitive to air), keeping chopped pieces in an airtight container for a day or two in the refrigerator isn't anything worth worrying about (they key there being airtight.)

As far as frozen vegetables -- they can often be MORE nutritious than fresh vegetables.

The reason? They are, for the most part, flash frozen and packaged at their peak (when they contain the highest amount of nutrition), thereby retaining all these nutrients until you eat them at home.

Fresh vegetables -- particularly if they are not local -- can take a few days to be shipped long distances, and often sit for days at the supermarket, exposed to UV lights that can leach out certain light-sensitive nutrients (including B vitamins, vitamin C, as well as certain antioxidants).

As long as you are getting plain frozen vegetables (as opposed to the varieties that come drenched in sodium and saturated fat laden sauces), you are getting plenty of nutrition.

September 20, 2008

You Ask, I Answer: Blood Sugar Levels

One of my family members is a Registered Nurse.

She was over at the house today and took my blood sugar -- my number came out to 128.

Is this high?


-- Greg (last name withheld)
Los Angeles, CA


It depends.

Upon asking Greg for clarification, he mentioned that approximately half an hour prior to this "exam" he had eaten a Fruit Roll Up.

Bingo!

When determining blood sugar levels, it is important to make a distinction if this is a fasting or post-prandial ("after a meal") value.

If someone's fasting (for testing purposes, this is considered at least 8 hours of no food or drink other than water) blood glucose is 128, there is certainly cause for concern.

However, if that is the value 30 minutes after essentially eating pure sugar, it isn't worth worrying about.

If anything, the fact that your blood sugar was 128 so soon after eating that Fruit Roll Up is a good sign. If you had diabetes, that figure would probably be above 200!

For future reference:

Your fasting blood glucose should be lower than 100. Values between 100 and 125 tend to indicate "pre diabetes."

If your blood glucose is taken randomly, you are in good shape if you are below 140. Anything above 200 is problematic, and values between 140 and 200 in this case also point to "pre diabetes."

Since pre-diabetes poses negative health consequences to cardiac health -- and is clearly a precursor for Type 2 diabetes -- many doctors now start aggressively treating it.

September 19, 2008

You Ask, I Answer: Friend's Weight Loss

I have a question concerning my friend's health.

He is an obese 34 year-old man with a thyroid problem (which slows down his metabolism).

As far as I know, he eats very little throughout the day, and what he eats consists mainly of hamburgers, beef, pizza, etc. He does not -- and will not -- eat vegetables, and his taste for fruits is very limited.

He does not eat chicken or seafood either. He also skips breakfast every morning, and does not take vitamin supplements.


I'm really concerned about his healthy but can't seem to sway him to eat better.


What are the risks he's up against with his health if he continues to eat like this?

What kind of eating plan would you advise he go on?
Should he be eating more food in a day, but with fewer calories and in smaller quantities?

I feel like the food he is eating isn't getting properly broken down because of the lack of other foods in his diet. Is that true?


-- Kara (last name withheld)
St, Louis, MO


There are many things worth covering here, so let's take everything in order.

Your friend is certainly in a fragile situation.

The few statistics you provide (thyroid issues, obesity) as well as your observations of his eating habits (a diet lacking fruits, vegetables, and, I'm assuming, whole grains) paint quite a bleak picture.

I do find it interesting that you are curious to know what negative health effects this may have on him, because I have a feeling he is already experiencing some of them.

I am sure he feels short of breath when exerting the slightest bit of physical activity, experiences pain in his knees, and may even have sleep apnea (a potentially fatal condition in which people stop breathing for short periods of time in their sleep.)

The examples mentioned above give us a clue of what is happening to some of your friend's organs (i.e.: the heart may be working overtime, and joints can have too much pressure put on them.)

Although the human body is very resistant, years and decades of these conditions really run it ragged, and "system malfunctions" (or meltdowns) can begin to happen.

A heart that is put through the wringer every day for 10 or 15 years is not a healthy heart. Although your friend may be 34 years old chronologically, his organs very likely resemble that of an older person (depending on how long he has been obese.)

You mention not being able to sway him to eat better, and it appears you aren't too sure why.

I'd like you to go back and re-read the questions you sent me. Pay attention to the feelings they conjure up.

Perhaps you feel overwhelmed, not knowing where to start with your friend. Or hopeless that it will be hard to break this behavioral mold. You might even feel like whatever the "solution" is, it will be one that will take a lot of time, effort, and patience.

I ask you to think about this because the thoughts and feelings that come to your mind will very likely reflect what your friend is feeling about all of this.

A lot of tweaking needs to happen here -- eating more small frequent meals, consuming more fruits and vegetables, cutting back on calories, increasing physical activity... I could go on.

Believe it or not, though, that isn't really the issue right now.

Why? Because, most likely, your friend is already aware that some changes need to happen.

The issue here is what is keeping your friend repeating behavioral eating patterns that keep him at an unhealthy weight.

I am willing to bet that he either doesn't know where to start, or the entire concept of eating healthy and losing weight is so overwhelming that the mere thought of it makes him want to forget the whole thing.

It isn't uncommon to contemplate a "can of worms" scenario like this one and be at a complete loss as to which particular worm to untangle first.

All change, no matter how small, is difficult.

I can't provide an eating plan without knowing his medical history, food preferences, and bloodwork numbers, but here is what I suggest you do:

Once, and only once, sit down with your friend and thoroughly explain your concerns to him.

Let him know you are concerned about his weight from a health perspective, and ask him what his feelings and thoughts are on the matter.

Be mindful, though, to stay away from tips, suggestions, or recommendations about what he should or should not eat. The point of this conversation is not to tell him what saturated fat does to the body or which diet book he should read.

Simply recommend to him that, if his insurance covers it, he has the option of meeting with a Registered Dietitian, a trained professional who will work WITH him one-on-one to achieve whatever his goal may be.

Once this conversation is done, you have to make a promise to yourself to let the issue go.

That, my dear Kara, is really all you can do. Until your friend is ready to make a change, there is very little you can do.

Lastly, your question about whether the food he is eating is being broken down properly even though his diet isn't balanced? The answer is yes.

The human digestive system breaks down all foods, regardless of how healthy -- or unhealthy -- they are.

September 18, 2008

Numbers Game: Answer

Having a cup of tea with a meal decreases the body's absorption of non-heme iron (the only type of iron provided by plant-based foods, dairy products, and eggs) contained in that meal by roughly 60 percent.

Yikes!

This is particularly important for vegetarians as well as anyone diagnosed with anemia, as a meal moderately high in iron can lose quite a bit of that punch if you're accompanying it with tea (thanks to substances known as phytates).

If you're a tea lover, the safest bet is to drink it an hour before or after a vegetarian meal, so as to not inhibit absorption.

If you're interested in increasing non-heme iron absorption during a meal, be sure to include vitamin C (meat also aids in the absorption of non-heme iron, but this is a moot point for vegetarians and vegans.)

A cup of orange juice, for instance, increases absorption by approximately 80 percent!

Tea isn't the only inhibitor, by the way.

All foods containing phytates (mainly whole grains, coffee, and berries) decrease non-heme iron absorption rates.

September 17, 2008

Say What?: Hospital Food SOS

Some hospital food service decisions leave me absolutely perplexed.

Allow me to explain.

I side with the belief that with some cancer patients -- who can have a tremendously difficult time working up an appetite -- it is a good idea to liberalize their diet in order to include foods they love and, therefore, will WANT to eat.

One of the many goals is getting them off tube feedings and increase their caloric intake through solid food or beverages.

But I was rather horrified to see thick pre-packaged slices of Sara Lee pound cake on some patients' trays at one New York City hospital.

What on EARTH is a medical establishment doing serving up a product with trans fats to patients whose health has already taken a turn for the worse?

I would like to think that, of all places, a hospital would specifically seek out baked goods and treats free of partially hydrogenated oils.

I am not asking for cancer patients to be denied a treat. Far from it!

If a brownie offers as much as a single minute of pleasure in what is otherwise an unpleasant stay, they should certainly be provided with one.

But the notion of feeding sick patients foods with trans fats in them leaves me very, very confused. And, frankly, very upset.

Fiber! In Coffee?

A few months ago I told you about Starbucks' new "plus energy" shots, which enabled customers to infuse some B vitamins and other ingredients (including taurine and ginseng) into their beverages.

I'm assuming that has worked out well for the coffee chain, since they now offer a new "plus" option -- "plus protein."

Say those two words and your beverage will contain a few more grams of protein (4 for a tall, 5 for a grande, 6 for a venti) and one -- yes, one -- gram of fiber.

The coffee chain is pushing this as one of "three healthier ways to start your day."

It's worth pointing out that another involves a 420-calorie apple bran muffin and cup of espresso ("for a quick energy boost" -- yeah, a 420 calorie muffin will certainly provide that!)

Anyhow, this new booster is specifically advertised as containing"the added benefit of extra protein and fiber, to help fill you up and give you the energy you need to make the most of your day.

I simply don't get it.

For starters, protein is an over-consumed nutrient in most Western countries -- especially the United States.

The average adult in this country consumes, on average, 200 - 250 percent of their daily protein requirement.

Certainly not a danger, but also very far from the notion that we are all on the verge of protein malnutrition (you would think we were, based on how many products advertise their protein content with large fonts and exclamation marks.)

Additionally, the milk in these lattes already makes them a a very good source of protein.

A grande latte, for instance, provides 12 grams of protein -- roughly 15 - 20 percent of a day's worth for most adults.

An additional 5 grams of protein does not make it a "healthier" (or "unhealthier") drink, just a little bit higher in calories.

I'm also not a fan of that seemingly random measly gram of fiber. It's not really going to do much in the way of "filling you up."

Besides, there are plenty of foods offering a lot more fiber (and additional nutrition).

A medium apple contains 4.5 grams. A medium banana? Two and a half. A slice of whole wheat toast? 3 grams. A cup of oatmeal will add 4.5 grams to your day (most of that as soluble fiber, which is particularly helpful at providing a long-lasting feeling of fullness.)

If Starbucks is looking to lure more customers in, they should forget all this silly nutritional tinkering and simply lower their prices!

September 16, 2008

Starbucks' Little Secret

Did you know Starbucks menus are leaving out some vital information?

Although "tall" (12 ounces), "grande" (16 ounces) and "venti" (24 ounces for a cold beverage, 20 for a hot one) are the three sizes everyone is familiar with, there is a fourth one many people don't even know exist -- "short" (8 ounces)!

Funny, isn't it?

Whereas in many countries a standard coffee order comes in a very small cup containing just 2 or 3 ounces, here in the United States the smallest size is completely hidden from customers.

Don't be afraid to order a "short" beverage at Starbucks if it strikes your fancy -- I assure you every single barista knows what you're referring to.

However, two friends of mine have reported that two New York City branches had "run out" of 8 ounce cups (interesting, seeing as how most consumers don't even know there is such an option!)

The photo at right displays all four sizes. Quite the spectrum, wouldn't you say?

One great thing about smaller portions is that they present a manageable way to consume foods that can be problematic in large amounts.

A short latte with whole milk, for instance, contains 110 calories and 17% of the daily saturated fat limit.

Make it a Venti, and you're up to 290 calories and 45% of a day's worth of saturated fat!

September 15, 2008

Sensible Nonsense

The folks at Nabisco advertise some of their products under the "sensible snacking" monicker, meaning "they not only taste good, but you can feel good about eating them, too!"

One of these products is Ritz Toasted Snack Chips, which, Nabisco points out, "are not fried [and] have 40% less fat than potato chips."

Very well, but an ounce of these chips only offers 20 less calories than an ounce of potato chips -- and an additional 100 milligrams of sodium!

The main ingredients are white flour, sugar, and high fructose corn syrup.

The flavored varieties' ingredient lists, meanwhile, boast no less than 25 ingredients.

The dictionary defines "sensible" as "acting with or exhibiting good sense."

Perhaps Nabisco would be better off using another adjective? Like "run of the mill"?

Top 50 Online Fitness and Nutrition Calculators. And You Say...?

Thank you to reader Kelly Sonora for sending along this link to what College Training Schools Online considers the 50 best online fitness and nutrition calculators.

I haven't used too many of them, so I don't have much in terms of commentary.

Well, I do have one question. Why is Kentucky Fried Chicken's nutrition calculator singled out?

Most fast food chains offer nutrition information on their respective websites, and I don't see what makes KFC's particularly different.

Readers, I am interested in hearing your opinions.

Have any of these 50 worked for you?

Are there any you don't recommend?

Is your favorite not mentioned?

Speak out!

Not The Whole Truth

When it comes to determining whether a particular brand of sliced bread, crackers, or cereal is 100% whole grain or not, the popular recommendation is to look at the ingredient list.

If "whole wheat flour" appears as the first ingredient, the advice goes, you are dealing with a whole grain product.

Although this is both true and accurate (and I myself have given such a recommendation), food companies are starting to wise up.

They know consumers are seeking whole grain foods, but they want to continue using refined white flour.

Their solution? Confuse, confuse, and confuse some more!

There are now plenty of products on store shelves marketed as "whole wheat" that are not 100% whole grain, but rather a mix of whole wheat flour and white flour.

A look at the ingredient list reveals that while "whole wheat flour" is listed as the first ingredient, "unbleached enriched flour" (AKA white flour) is second or third.

A true whole grain product ONLY contains whole wheat (or any other grain) flour. Don't accept cheap knock-offs!

A quick way to spot the tricksters? Any product that states it is "made with whole grains" is usually a combination of refined and whole grain flours.

As you know, I am a big fan of the Whole Grains Council's stamp system.

This particular portion of their website
lists brands displaying their stamp (a "100%" stamp is a guarantee that you are getting a true-to-form whole grain food.)

Definitely worth bookmarking!

In The News: Boston Bans Trans Fats

Boston's trans fat ban officially began this past Saturday, affecting approximately 5,600 of the city's eating establishments.

Beantown joins New York City, Philadelphia, Tiburon (a small city in California), San Francisco, Maryland's Montgomery County and New York's Albany County in banning the artificial fat.

It's rather disconcerting that some people still don't understand the thought process behind this policy.

Well, here's a nice gem from the Boston Globe article:

"Studies estimate that having as few as 40 calories of trans fat a day can boost the risk of a heart attack by 23 percent."

FYI -- 40 calories of trans fat equal roughly 5.5 grams of the substance (a large order of Burger King fries offers 6 grams).

And here's a fun fact: Denmark was the first country to ban trans fats back in 2003.

So far, the only other nationwide ban happened in Switzerland.

September 14, 2008

Numbers Game: Consumption Vs. Absorption

Having a cup of tea with a meal decreases the body's absorption of non-heme iron (the only type of iron provided by plant-based foods, dairy products, and eggs) contained in that meal by roughly ___________ percent.

a) 25
b) 39
c) 47

d) 60

Leave your guess in the "comments" section and come back on Thursday for the answer.

On The Radio

This past Friday night, I was a guest on New York City-based personal trainer Jason Alexander's online radio show, All About Fitness.

Jason asked me a few general nutrition questions, and then it was on to listener phonecalls.

We discussed a plethora of topics, from fiber to protein to the Atkins Diet to fruit juice.

You can listen to -- and download -- the hour-long show by clicking here.

Enjoy!

For the record, I absolutely love doing radio and television (producers, take note!)

September 13, 2008

You Ask, I Answer: Chocolate Processed With Alkali

Sometimes I see "chocolate (processed with alkali)" as an ingredient on food labels.

What is that all about?


-- (Name Withheld)
Brooklyn, NY


Processing chocolate with alkali is known as the "Dutch method."

Take note, dear readers: any chocolate product labeled "Dutch chocolate" is not making reference to the cocoa beans' origin, but rather to this very processing technique!

The purpose of treating cocoa with an alkalizing agent? To remove its bitter taste and infuse it with a darker and more uniform color.

The trade-off?

Cocoa beans processed with alkali loses the flavonoids and antioxidants found in raw cocoa nibs or very dark chocolate (think 85% cocoa).

September 12, 2008

You Ask, I Answer: Vanilla Extract

I know you always tell us that "sugar is sugar" in terms of calories (whether it's brown, raw, or white.)

What about vanilla extract?

Does it have the same calories as sugar?


-- Linda Coyton
Hong Kong


Great question!

Vanilla extract doesn't quite fit into my "sugar is sugar" reference frame because unlike caloric sweeteners (i.e.: honey, table sugar, and agave nectar) it is not a pure carbohydrate.

The examples mentioned above all contain 4 grams of sugar per teaspoon.

A single gram of carbohydrate (remember, sugar is a carb) provides 4 calories.

Hence, a teaspoon of sugar contains 16 calories (4 grams at 4 calories per gram).

A teaspoon of vanilla extract, however, packs in approximately 13 calories.

The reason?

It contains 1 gram of sugar (4 calories) and 1.3 grams of alcohol (at 7 calories per gram, that's equal to 9.1 calories.)

A few companies offer alcohol-free vanilla extract, which provides 4 calories (1 gram of sugar and a few grams of water) per teaspoon.

Numbers Game: Answer

After controlling for confounding variables, the HDL (protective cholesterol) levels of women who smoke a pack of cigarettes a day are, on average, 17 percent lower than those of their non-smoking counterparts.

Source: The National Heart, Lung, and Blood Institute Family Heart

"Controlling for confounding variables" means that, in this study, cigarette smoking was isolated as a singular factor.

Although it is common knowledge that smoking contributes to atherosclerosis (hardening of the arteries), its HDL cholesterol-lowering properties are not as widely publicized.

The best news? As the Harvard Medical School so effectively summarizes it, "every 1% increase in HDL is associated with a 1%–3% reduction in heart attack risk."

September 11, 2008

In The News: Quick & Dangerous

Weight loss centers in Istanbul are coming under scrutiny after a 19-year-old patient in one of these establishments died after losing 33 pounds in six weeks.

"Turkish Dietetic Association Chairman Sacide Gümüşel stated that unqualified dietitians can easily find work in Turkey, which presents a serious public health threat."

This is precisely why looking for the right credentials is key when seeking professional help for health and/or weight management issues.

In the United States, the best thing you can look for is a Registered Dietitian credential (or, as I like to refer to it, the Real Deal credential.)

Of course your mileage may vary depending on which Registered Dietitian you work with (like in any other field, there are excellent RDs, average RDs, and not-so-great RDs), but you can count on them having a basic scientific understanding of nutrition that keeps your health in mind.

The article quotes the American Overseas Dietetic Association's Turkey representative who states that "numerous institutions in Turkey, from beauty salons to pharmacies, are able to write up a plan for weight loss [without consulting a dietitian]."

Anyone promising more than 8 pounds of weight loss in a 30 days or a "secret" weight-loss ingredient in pill or powder form should raise a "Caution!" sign in your mind.

Price Check

Recent newspaper articles have referred to Whole Foods beginning to earn a bit of a bad reputation as an elitist supermarket, thereby earning the monicker "Whole Paycheck."

Hogwash! I wholeheartedly challenge that simplistic label -- and I come prepared with proof.

Yesterday afternoon I stopped by a local (New York City) Whole Foods to purchase a few dinner ingredients.

Upon scanning my receipt, I was actually surprised at the good deals I got -- on items that weren't even on sale!

Let's start with a 16 oz (1 lb.) bag of Whole Foods' 365 brand whole wheat fusilli.

Name brands sell their 16 oz. boxes for anywhere from $2.49 to $3.99, even at conventional supermarkets.

This particular product? $1.49! Certainly one of the most affordable prices for whole wheat fusilli I have come across in MONTHS.

Lara bars, meanwhile, are a delicious staple of mine that can be rather costly if you buy them at the wrong store.

I have been charged as much as $2.49 for one of these bars in the past (upon learning of that price, my thoughts screamed out "Hell to the no!" and I promptly returned the bar to its display case) .

Whole Foods sells each one for $1.29.

That's actually forty cents cheaper than what Lara herself charges on her website (where a 16-bar box retails for $27.00, thereby making each bar worth $1.67)!

One of my other favorite snack bars is Gnu Food's Flavor & Fiber bars, which the manufacturer -- and most other stores -- sells for $1.99.

Well, today at Whole Foods I bought several 5-count at $6.99 per box.

Some simple division reveals that, thereby, each individual bar cost me $1.40.

I also bought fresh broccoli that was available for $1.99/pound.

Conventional supermarkets in New York City are selling that same amount of the flowery vegetable for $2.99.

If anything, my trip to Whole Foods proved to be a money saver.

Of course, there are some items at Whole Foods -- mainly cuts of meat -- that are certainly pricier than at other grocery stores, but this notion that they do not provide any affordable choices is ludicrous.

For more "nutriconomic" information, I highly recommend you take a look at this link, which shows how prices have changed for a variety of common foods -- and fuel! -- between July 2007 and July 2008 (NOTE: The left-hand column displays U.S. city averages, while the right-hand column particularly focuses on the Midwest region of the country.)

Some of the standouts:

White flour increased 54.1%
Long-grain white rice increased 45.3%
Eggs have shot up 33.9%
Sweet peppers rose 34.6%

If these increases don't make sense to you, scroll down to the very bottom and look at what has happened to fuel costs in the past 12 months.

September 10, 2008

In The News: Downsized Economy No Problem for Supersize Master

This article from Bloomberg.com states that "reported August sales [for McDonald's] rose more than some analysts estimated as consumers battered by higher gasoline and grocery bills bought $1 sodas in the U.S. and snack-sized chicken wraps in France."

The issue isn't so much that people are buying $1 sodas, but that it is the large sizes that are selling for the reduced cost of a single dollar.

A large Mickey D's cup offers 2 pints of soda, 21.5 teaspoons of sugar, and 310 calories (along with zero nutrition).

It's rather ironic that one of the main menu items driving up sales at McDonald's during an economic recession is one that offers no sustenance.

It's also very telling that the United States consumers opt for large sodas while French customers spend their money on snack-sized items.

Had McDonald's execs in the United States consulted me about menu changes during touch economic times, I would have suggested expanding the "dollar menu" by introducing smaller portions of more menu items.

Does advocating for smaller portions make me anti-American?

September 9, 2008

Say What?/Celebrity Diet Secrets: Teri Hatcher

One of the country's most famous desperate housewives recently shared some of the images and phrases on her "goal board" (described by Ms. Hatcher as "a collage of images of things you want to achieve in your life... all written, glued or drawn onto a big piece of paper.")

Among that inspirational collage? "Don't eat after 7 PM."

Uh oh, looks like the "calorie clock" myth is back!

Truth is, calories couldn't care less what time they are consumed.

A 600 calorie ice cream sundae will provide 600 calories whether it's gobbled down for breakfast or at 10 PM.

Let me just say that not eating after 7 PM will very likely result in some weight loss.

However, this is very simply due to a reduction in total daily caloric intake (rather than avoiding food after an arbitrary bewitching hour where calories are multiplied by twenty!)

I'm more disturbed by the notion that refusing food after 7 PM is someone's life goal.

I would have gone with "develop a healthy attitude towards food."

Represented by an illustration of someone happily savoring one (there's the key!) decadent dark chocolate truffle.

In The News: Genetics? Environment? Why Not A Little Bit Of Both?

Much like certain areas of sociology and psychology, the question of “nature versus nurture” permeates nutrition – or at least the consistently hot button issue of obesity.

A new study published in the Archives of Internal Medicine gives both factors the attention they equally deserve.

The end result?

“Vigorous physical activity can help even people genetically prone to obesity keep the weight off.”

A team of researchers led by Dr. Soren Snitker of the University of Maryland and Dr. Evadnie Rampersaud of the University of Miami “focused their study on a group of 704 Old Order Amish men and women in Lancaster County, Pennsylvania.”

Okay, not the largest sample size, but that doesn't mean we can't extract some juice -- and talking points.

As it turns out, participants who had the obesity (FTO) gene and engaged in the least amount of physical activity were, not surprisingly, "significantly more likely" to be overweight or obese.

However, those participants genetically predisposed to obesity but physically active were not heavier than participants without said predisposition partaking in similar amounts of physical activity.

It’s worth pointing out that the most physically active genetically predisposed group was burning an additional 900 calories than their satient counterparts.

That’s another point for the “calories count” camp!

By the way, the physical activity did not involve treadmills, Stairmasters, Swiss medicine balls, or pullup bars -- just old-fashioned chores (i.e.: gardening, farming, and even working the land with horses and plough!).

Do you think this study can be considered relevant for us non-Amish folks?

September 8, 2008

Numbers Game: Pack Attack

After controlling for confounding variables, the HDL (protective cholesterol) levels of women who smoke a pack of cigarettes a day are, on average, _________ lower than those of their non-smoking counterparts.

Source: The National Heart, Lung, and Blood Institute Family Heart Study

a) 25
b) 8

c) 17

d) 10


Leave your guess in the "comments" section and come back on Friday for the answer.

September 7, 2008

You Ask, I Answer: Oxalates

I know that spinach is not considered a good source of iron because it contains oxalates, which bind iron during digestion so your small intestine cannot absorb it.

I have heard, though, that cooking spinach will decrease the amount of oxalates.


Is this rumor true?


-- Christine (last name unknown)

Via the blog


The rumor is true, but irrelevant.

Yes, boiling reduces oxalate levels in food. However, this reduction is minimal, and it also leeches out vital water-soluble nutrients.

By the way, oxalates also bind the calcium in spinach, so if you're looking to get that mineral from a green vegetable, broccoli is a smarter bet.

September 6, 2008

You Ask, I Answer: Iodine

The only salt I have at home (and use for everything) is sea salt.

The packaging states that it is not a source of iodine.

Do I need to use regular table salt in order to get iodine in my diet?

How would I know if I had an iodine deficiency?

How much should I get each day?


-- Crystal Fales

Philadelphia, PA


Iodine has a very specific function in the body -- without it, our thyroid gland is unable to produce an important hormone called thyroxine.

Consequently, an iodine deficiency results in the enlargement of the thyroid gland (a condition known as goiter, pictured at left) as well as hypothyroidism (some of the main consequences of this include a slowed down metabolism and increased total blood cholesterol.)

Thyroxine is also crucial for brain growth and development in babies (both inside and outside the womb) and children.

Although table salt contains iodine (a direct result of fortification), so do many other foods.

Ironically, although iodine is not in sea salt, anything that lives in the sea (whether it's fish or plants) is a great source of the mineral.

Dairy and eggs are also fairly good sources of iodine, as a result of food processing techniques.

Vegetables are a little tricky because their iodine content varies on the amount of the mineral found in the specific soil in which they grow.

Adults should aim for approximately 150 micrograms a day. This figure is not too helpful, though, since most foods that contain iodine do not contain nutrition fact labels, and those that do do not list it.

A three-ounce serving of fish (the size of a human palm and as thick as the average adult's pinky finger) provides approximately 150 to 300 percent of a day's worth of iodine.

Vegans can sometimes be low in iodine (again, depending on the specific content of iodine in the vegetables they are eating,) so supplementation is always an option.

Be careful with over-supplementation, though. An excess of iodine results in hyperthyroidism, which can lead to insomnia, restlessness, and rapid heartbeat.

Lastly, allow me to point out that the sodium in processed foods is not fortified with iodine. So, a frozen meal containing sky-high levels of sodium provides absolutely no iodine.

September 5, 2008

You Ask, I Answer: Bulimia Nervosa

I'm not sure if you can answer this, but why is it that people who have anorexia [nervosa] are usually easier to spot than people who have bulimia [nervosa]?

-- Karen (last name withheld)

Orlando, FL


I think what you are referring to, Karen, are some of the physical symptoms of these two particular eating disorders.

Anorexia nervosa is accompanied by extreme -- and sometimes rapid -- weight loss.

In turn, faces can become gaunt, hair can start thinning, and clavicles and ribs can become more visible. To the naked eye, anorexia nervosa is certainly more visible.

One reason why people living with bulimia nervosa can live with it for so long without physical manifestations is because purging -- whether through self-induced vomiting or excessive consumption of laxatives -- does not eliminate all consumed calories.

The latest studies emerging from the University of Pittsburgh -- conducted in a laboratory setting, where researchers first calculated the amount of calories in patients' binges and then analyzed what was regurgitated for caloric values -- have determined that approximately half the calories in a binge are retained by the body.

Keeping in mind that some binges can consist of 3,000 to 5,000 calories in one sitting, it is very feasible that, even after purging, someone can provide their body with a day's worth -- or more -- of calories.

This is very much in contrast with an anorexia nervosa picture where caloric intake is often in the low three digits.