Lean Plate Club

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Sally Squires
Washington Post Health and Nutrition Writer
Tuesday, October 2, 2007; 1:00 PM

Confused about nutrition? Wondering how to fit in more physical activity? Welcome to the Lean Plate Club. Ask Sally Squires, nationally syndicated Lean Plate Club columnist for the Washington Post, about eating smart and moving more every Tuesday at 1 p.m. ET. Sally draws upon her master's degree in nutrition from Columbia University to preside over the lively Lean Plate Club web chat. Whether you're trying to reach a healthier weight or simply maintain it, you'll find plenty of tips and strategies.

Share your own food finds, creative workouts and secrets for healthy, great tasting meals. We'll cheer your successes and help with your setbacks. (None of this, of course, is a substitute for medical advice.) E-mail Sally, author of the newly published Secrets of the Lean Plate Club (St. Martin's Press) at leanplateclub@washpost.com.

Or just sign up for the free Lean Plate Club e-mail newsletter. The Lean Plate Club column appears Tuesdays in the Washington Post Health section and is nationally syndicated by the Washington Post Writers Group. Find other Lean Plate Club members at www.frappr.com/leanplateclub.

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Discussion Transcripts

A transcript follows.

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Sally Squires: Welcome to the Lean Plate Club! We've got a lot on the plate today, so let's get started and I'll do updates throughout the chat.

If you happen to live in the Tampa Bay area of Florida, I hope to meet you on Saturday, Oct. 27 at the St. Petersburg Times Festival of Books. Details are in today's LPC e-mail newsletter, which should be in your electronic in-boxes right now. In this week's edition, you'll also find lots more information and links to recipes for the DASH diet to help lower high blood pressure and for the Portfolio Eating Plan to help lower blood cholesterol levels.

Plus, for activity, there's a link to sites that will help you get fit for charity.

Now on to the chat!

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C Reactive Proteins: Why do doctors not want to test for CRP? Mine is high, and I was expecting it. None of my doctors have a treatment plan -- most ignore it.

Sally Squires: Here's a good example of how medical thinking evolves based on findings and not all the data is in yet, likely the reason that your doctors are being cautious. But in the meantime, physical activity is one of the things that can help lower C-reactive protein. And you'll find others in today's LPC column. So you can take some safe steps while medicine continues to sort all of this out.

Hope that helps. Thanks.

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Huntingdon Valley, Pa.: Comment: I NEVER buy pre-ground meat. At a supermarket I trust, I wait for chuck or round roast to go on sale. Then I ring the bell and ask the butcher to trim the fat and grind the meat. With all these recalls, I have more incentive than ever to do it.

Sally Squires: Good strategy, Huntington. (I just got off the phone interviewing a top official at the Department of Agriculture on food safety. Look for more info in an upcoming LPC column.)

But it's also important to use a meat thermometer to cook that ground beef to a safe 160 degrees. Here's why: you don't know what else was ground before your meat and what it might contain, although it's likely that a local grocery store grinds a lot less meat than a huge packing plant, so you're probably already ahead of the curve.

Thanks.

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Washington, D.C.: Favorite new find (no affiliation) -- Ziploc's Zip and Steam bags (Glad has a version, too). I made the potatoes and corn on the cob from the enclosed recipes and they were both delicious. I actually may eat vegetables a whole lot more (too bad most are going "out of season").

Sally Squires: Sounds like a great find. We'll try to post a link in a minute so that others can see what these look like too. And like you, I have not financial connection to the company either. Thanks for the tip.

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Los Angeles: About 4 months ago I stopped eating chicken, beef and pork. I have increased my intake of seafood, especially shrimp. A few friends have recently told me that I shouldn't eat so much shrimp because it can increase my cholesterol levels. Should I be concerned about this? My cholesterol levels are pretty low now.

Sally Squires: Shrimp and other shellfish do have some dietary cholesterol, but it's not a huge amount. And there are plenty of other good things in it, especially healthy omega-3 fatty acids. How much cholesterol does shrimp have? Three ounces contains about 166 milligrams or roughly half the amount found in an egg yolk. So enjoy. Thanks!

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C-reactive protein confusion: My c-reactive protein levels have measured from 3 to 10. Apparently, 1 is normal. My gynecologist can't explain it,and says it probably is due to being premenopausal. I've always had high cholesterol, both good and bad kinds, but until the CRP tests came back high, this was my only risk factor for heart disease. I really, really don't want to take statins for the rest of my life, and was excited to see in your column that diet may affect CRP levels. How worried should I be, and should I follow up with a cardiologist? I am in my mid-forties.

Sally Squires: C reactive protein can apparently rise with all kinds of inflammation. So everything from gum disease to obesity can help increase levels.

As for checking with a cardiologist: who prescribes your statins? That's who you could discuss your C-reactive protein levels with. And of course, in the meantime, you might take a look at both the DASH diet and the Portfolio Plan. Neither is extreme. Both have great tasting foods and both have been shown to have health benefits. So you can't do anything wrong by trying some of these approaches. See what they do to your C-reactive protein levels and blood cholesterol. And of course, the more physical activity the better.

I tried to remember that this morning while taking the dog for a constitutional. Hope you'll let us know how it goes. Thanks.

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Dallas: Sally,

My husband has diverticulitis and we have both read conflicting information about eating nuts and seeds. I think he is missing out nutritionally by not eating anything with nuts or seeds (including vegetables such as tomatoes). What is your take on adding nuts and seeds back to his diet?

Sally Squires: So sorry to hear that your husband has this problem. I know it can be quite painful, especially if one of these pockets gets inflamed. We'll post a link in a minute to the National Institute of Diabetes, Digestive Diseases and Kidney Diseases. They have a good fact sheet about the problem.

A high fiber diet is one of the treatments recommended. But I, too, have heard sufferers say that they've been warned about not getting nuts or seeds. Here's what the NIDDK site says about that:

"Avoidance of nuts, popcorn, and sunflower, pumpkin, caraway, and sesame seeds has been recommended by physicians out of fear that food particles could enter, block, or irritate the diverticula. However, no scientific data support this treatment measure. Eating a high-fiber diet is the only requirement highly emphasized across the literature and eliminating specific foods is not necessary. The seeds in tomatoes, zucchini, cucumbers, strawberries, and raspberries, as well as poppy seeds, are generally considered harmless. People differ in the amounts and types of foods they can eat. Decisions about diet should be made based on what works best for each person. Keeping a food diary may help identify individual items in one's diet."

Hope this helps. Thanks.

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washingtonpost.com: What I need to know about Diverticular Disease (nih.gov)

Sally Squires: As promised, here's one link. Another to come.

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Anonymous: I'm trying to help my 14-year-old daughter determine about how many calories she needs to lose weight at a responsible pace. Her physician says she has probably stopped growing but are there other considerations? Is she likely still to require more calories than an adult? She has about 30 pounds to lose. Thanks!

Sally Squires: At 14, she's probably close to her adult height, particularly if she is menstruating. So if she is having weight problems now, it's never too early to start to address them.

A good rule of thumb is to take her weight in pounds and multiple by 12 = calories that she likely needs to stay the same weight.

Subtract 250 calories from that. And then help her find ways to get 250 calories of activity every day. Together, these slight adjustments should help her lose about 1 pound per week -- a safe rate of weight loss.

Hope that helps. Hope you'll let us know how it goes. Thanks.

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Greek Yogurt: What kinds of dips can I make out of this? I thought it might make a good sub for sour cream in onion dip...

Sally Squires: It sure can. I love Greek yogurt, which seems richer because some of the water is drained. My favorite is Total by Fage. But Trader Joe's has a pretty good Greek style yogurt too, for a lot less money.

I've used this yogurt to put on top of berries, to make smoothies, for tandoori chicken, in cold soups -- the list goes on and on. Other suggestions out there? We'd love to hear about them.

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Overly Personal: Since this is anonymous, I can ask this question.

Ever since I had a baby two years ago, I get anal fissures off and on. Fiber certainly keeps everything happy. Are using Fibersure and Metamusil supplements okay, or can I get all my needed fiber from fruits and veggies? And which fruits and veggies are best?

Sally Squires: Anal fissures are not uncommon, particularly after childbirth. That's what those Sitz baths are designed to help relieve. Fiber definitely helps with anal fissures. You can get that fiber from those supplements or from eating plenty of high fiber fare, including fruit and vegetables and of course whole grains.

Berries are some of the highest fiber fruit. (And yes, frozen berries, which are cheaper, can be cost-conscious alternatives.) Beans are another fantastic fiber-filled food.

Hope that helps. And let me encourage anyone to ask personal questions, because this chat truly is anonymous. There's no way for me to know who asks what.

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Washington, D.C.: I've been eating more shrimp lately, too. Shrimp cocktail makes a really quick meal.

Just beware of the prepackaged cocktail sauces. I can't find one that doesn't have hydrogenated corn syrup as a main ingredient. I thought I'd make my own, but I the only jar of horseradish I could find contained hydrogenated corn syrup too! Don't most ketchup brands also contain corn syrup? What can I do to continue enjoying my shrimp cocktail?

Sally Squires: You might get some fresh lime and a little healthful margarine. Melt the margarine. Drip the lime on the shrimp and then dip it in the margarine. Voila! Yum.

You could also make your own cocktail sauce from ketchup and horseradish or Tabasco sauce. Other dips are great too including Tzatzki (please check my spelling!), hummus, even salsa.

Other suggestions out there?

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black magic peanut butter : I usually eat "natural" peanut butter (no hydrogenated oils, very few ingredients other than peanuts) which always has some oil on top and requires refrigeration. I recently purchased "Natural" Jiffy peanut butter which has no hydrogenated ingredients, yet doesn't require refrigeration, no oil on top, and it only has 2-3 ingredients. How is this possible?

Sally Squires: Interesting. I'm not sure, but after the chat I'll contact the company and see if I can learn more. Thanks.

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Indianapolis : Sally:

I know that CRP is a measure of inflammation in the body and elevated CRP implies higher risk of cardiovascular disease.

Since arthritis is an inflammatory disease, does the presence of arthritis also imply higher risk of cardiovascular disease?

Sally Squires: Not necessarily, but the current thinking seems to be that it's good to keep inflammation throughout the body to a minimum for optimum health, including avoidance or reduced risk of cardiovascular disease. Hope that helps. Thanks.

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Los Angeles: My stepfather, despite his healthy eating habits and daily gym workouts, was recently diagnosed with high cholesterol, which runs in his family. I always hear about how people can reduce cholesterol from food with plant sterols and stanols but what if your problem is genetic? Are there any natural (non-prescription) ways to fight genetic cholesterol?

Sally Squires: The Portfolio Plan, devised by David Jenkins and his colleagues at the University of Toronto, seems to help reduce blood cholesterol levels as much as some cholesterol lowering drugs (in some people.) So you might check the links in today's newsletter for the Portfolio Plan. We'll try to post some links in a minute. Thanks.

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Downtown DC: I feel like I've conquered fiber as best I can: the only pasta and bread I eat is whole wheat, even pancakes on Sunday are whole wheat. I think this has been easy because all these new bars and such make getting your fiber relatively convenient. What I'm missing in my diet are fruits and veggies; I know I'm just not getting enough. A banana with breakfast, some lettuce and tomato on my sandwich at lunch and a side of veggies at dinner I know isn't enough to make me healthy. It's much easier to keep granola bars at work than green beans. Any ideas? Oh, I also have braces, so some of the raw fruit needs to be minimized. Thanks!

Sally Squires: I had a lot of them, until you mentioned those braces, Downtown DC. That does make for an extra hurdle. But you could eat softer fruit, grapes, peaches, apricots, melons, etc. And salsa and hummus count as veggies. So does tomato, split pea and bean soup. So there are many hidden sources to help increase your intake.

And you probably know, but it's worth mentioning, that dried fruit is a great option EXCEPT for those with braces, since it tends to stick in them.

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washingtonpost.com: High Blood Cholesterol Prevention (cdc.gov)

Sally Squires: As promised, here's some information from the federal Centers for Disease Control and Prevention on blood cholesterol.

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washingtonpost.com: Portfolio Eating Plan

Sally Squires: Here's the link for the Portfolio Eating Plan.

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washingtonpost.com: Zip 'n Steam Microwave Steam Cooking Bags

Sally Squires: As promised, here's the link about the new Zip Lock bags recommended in this chat by a previous poster.

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Food Safety Question: I use frozen (non sweeteneed) fruit in everything from cereal in the morning to mixing it with yogurt at night. I microwave it to speed the defrosting down and someone told me I will lose nutrients and that microwaving the fruit was unsafe. Is this true?

Sally Squires: Fresh, frozen, canned and dried produce is nearly identical nutritionally. So if this strategy is working for you, keep it up.

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Northern Va: I could use some help to kick into action my desire to lose the weight I gained last year while I was pregnant. Unfortunately, I've never been successful at a food-based approach.

In the past I've gone to a medical clinic and done the "formula" (i.e. protein shakes) approach, then transitioned back to food. I would do that again, but I no longer live as close to D.C., and it is really expensive, which gets much harder to balance now that we're paying for daycare.

Any inspiration to get me onto 1,200 calories/day and exercising?

Sally Squires: Since the formula approach worked well for you, you might try making your own formula at home. You can do this by either carefully measuring out food (best done when you're NOT too hungry). Or you may want to have some frozen meals on hand. Kashi makes some great meals that are filled with fiber and are not highly processed. Other options include Healthy Choice, SmartOnes, Lean Cuisine.

You may also want to try one of the online electronic weight loss options. They range from Fitday, Spark People to Weight Watchers (which is a paid site.) But they could provide you with camaraderie and a place to help plan your meals, record your calories and your daily activity.

If 1,200 calories seems daunting right now, why not try 1,500 calories and slowly decrease your intake (or boost your activity)? The point is to make small changes that can over time add up to big rewards.

We're here to cheer you on. You might also want to scroll through our list of Successful Losers (at the LPC homepage) for inspiration. And the biggest inspiration of all is being around for that wonderful baby that you now have, isn't it?

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washingtonpost.com: Portfolio Diet: Tough to Stay Invested In (Post, March 21, 2006)

Sally Squires: As promised...

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London, U.K.: Hello from cold and rainy London! I'm a student studying here until January and as a result, have a limited budget. Food, like everything else, is expensive here so I'm mainly living off hummus, pita and carrots.

How unhealthy is this? (Is it fine to do just for a few months?) And do you have any advice to eat well/healthfully on a budget? Thank you!

Sally Squires: Hello from sunny DC. There's nothing wrong with what you're eating, except that it's not filled with variety. So if you could add some fruit or other veggies, it would be even more nutritious. Beans are quite cheap (and of course are already in that hummus.) Frozen fruit and vegetables and even fish, poultry or meat can be cheaper options too.

For more tips, you might check the Lean Plate Club homepage. Scroll to the bottom, where you will find a picture and feature on eating on a budget. It should translate somewhat to UK foods. Hope that helps.

Thanks!

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washingtonpost.com: Nutrition Fact Sheet: Dietary Fiber northwestern.edu

Sally Squires: Here's a fact sheet on viscous fiber.

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re:Portfolio Plan link: Just an FYI, that link is to a site sponsored by the Almond Makers. It doesn't mean the site isn't helpful (they should be playing up almonds if studies have shown the benefit) but all of their food examples have almonds. Take a look at the one day example food plan: you're literally eating almonds all day lol.

Sally Squires: Yes, I should have highlighted that more. The Almond Board participated in this effort. But there's no need to eat almonds. Any nuts will do. In fact, in a presentation today at the American Dietetic Association annual meeting, Penny Kris-Etherton from Penn State is slated to show a slide that demonstrates the benefits of multiple tree nuts. And almonds are good, but are not necessarily the very highest.

Thanks again for your posting.

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washingtonpost.com: Fitday

SparkPeople

Lean Plate Club

Sally Squires: As promised...

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Rockville, Md.: Re Food Safety question microwaving frozen fruit:

A friend of mine also said once that she doesn't use her microwave because it "kills" the nutrients in the food. Is there any basis to this claim?

Thanks!

Sally Squires: Ah, I feel a column coming on. No nutrients are not killed. Some are more heat stable than others, but cooking does not make a huge impact.

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Indianapolis - the portfolio plan: Sally:

My LDL cholesterol isn't bad, but my HDL is low. I like really the idea of curing these "diseases of choice" by making good dietary choices. So I took a look at the Portfolio Eating Plan. The first thing I noticed was lots of almonds. As I read further, I read about viscous fiber, soy protein, and plant sterols. The fiber part makes sense. I know about soluble and non-soluble fiber, but the term "viscous" fiber is new to me. What is it?

Back on the almonds, I eventually noticed that the Web site is "Brought to you by the Almond Board of California."

Alas, this leads me to be skeptical about the whole issue of almonds in the portfolio. This is my first exposure to the Portfolio and I haven't read all the material yet. Is there real science to back up the cholesterol reducing power of almonds?

Third question on this topic: I've been told that only 2 things affect HDL - genetics and exercise. At this point I can't do much about the genetics part, but I can and do and will continue to exercise. I have noticed that my HDL was higher when I was exercising more, so I'm working on getting back to those 4-5 mile walks (now that the weather is more conducive to long walks). The question here is whether this Portfolio Eating Plan is thought to offer any help toward increasing HDL?

Sally Squires: There is real science to back up the Portfolio Plan, which was created at the University of Toronto, with help from the Canadian government. And as you'll see from my previous posting, the Almond Board did have a hand in this Web site and did contribute to some of the research, but the findings have stood up. And you don't need to just eat almonds, despite what that site implies. Other nuts do fine too. But as in all food, nuts are high in calories, so moderation is key.

People who did best on the Portfolio Plan ate about 2 ounces of nuts daily. (And this can't be on top of all the other foods. Caloric balance to reach a healthy weight is also important to help control blood cholesterol.)

HDL levels are harder to modify than the unhealthier, low density lipoprotein (LDL)

High density lipoprotein -- HDL -- is the good kind of cholesterol. Exercise can help boost HDL levels, but it seems to take a lot of activity to do this.

Hope this all helps. E-mail me at leanplateclub@washpost.com if you or anyone else has other questions.

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San Francisco: Sally, regarding the reader comments on "The Biggest Loser," it's absolutely correct that men lose weight faster than women. A 44-year-old man, I dropped almost 30 pounds in six months this year, going from 171 to 141, and I'm convinced that would have been far more difficult had I been female. Male hormones will do that. Anyway, on another aspect of getting fit, I've come to realize that you need three things: time, discipline and effort. It's not a rule-of-three thing, where you get to choose any two (like "cheap," "fast" or "good" in a service industry) -- you really need all three, and understandably it's hard for most people to carve out enough space for it in their busy lives.

Sally Squires: Well said! Thanks much.

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Phoenix, Ariz.: I'm allergic to barley and almonds, but many of the DASH and other diets recommend multigrains (or barley specifically) and almonds as a good protein to cut hunger. So what should I be substituting for these two items? I already eat tons of whole wheat products, and peanuts for protein.

Sally Squires: Keep eating those peanuts and other whole grains are fine. Hope that helps. Also don't forget beans, a wonderful source of fiber, protein and complex carbohydrates that won't make your blood sugar spike the way other more processed sugars do. Thanks.

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Sally Squires: We're out of time, but thanks to all for a great chat. Winners today are Zip lock, Northern Va. (who's trying to lose post pregnancy weight), and Indianapolis and the first poster who asked about the Almond Board.

Please e-mail me your names, address to leanplateclub@washpost.com and please include winner in the subject line.

Until next week: eat smart and move more with the Lean Plate Club. And if you'd like to read this column in your local newspaper, please also e-mail me at the above address and include your name and name of your paper.

Thanks to all!

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Editor's Note: washingtonpost.com moderators retain editorial control over Discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions. washingtonpost.com is not responsible for any content posted by third parties.


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