Find the Hidden Calories

Who doesn't love fast food? And if you're like me, you got really excited about the new "healthy" menus at the big chains. Keep in mind, though, that these "healthy" foods can hide a lot of extra calories!

But don't worry — it's easy to tell the difference between the really good stuff and the health food impostors once you get the hang of it! Just use some common sense when ordering, and you'll be a fast-food pro in no time! Here are some tips to keep in mind:

• Ordering a salad? Skip or limit the dressing! It can add hundreds of unwanted calories. And those croutons? Toss them!
• Order chicken sandwiches without mayo or other fatty sauces.
• Keep an eye on portion sizes. In many cases, a small cheeseburger might have fewer calories than an entrée-sized salad with dressing! Likewise, a deli sandwich is only a good alternative to a burger if it's a sensible size. If it's not, consider splitting one with a friend, or take half home for later!
• Always go for grilled chicken rather than fried or breaded. That little detail can save you 100 calories.
• Avoid cheese on burritos, tacos, and baked potatoes.

The Weight-Depression Connection

Did you know that in any given year, around 18 million American adults deal with depression or a related condition? Depression is more than just persistent feelings of sadness or being "down in the dumps" — it's an illness that affects your body, your mood, and your thoughts. It's a leading cause of disability, and experts think that many people who experience depression do not receive a diagnosis or treatment. That's a shame, since treatment helps 80 percent of people recover from episodes of depression within a year.

While the connection is not yet understood, experts have noticed a link between obesity, lack of physical activity, and depression. The relationship between depression and weight gain can be likened to the chicken-and-egg scenario. Sometimes depression strikes first, leading to weight gain and an inability to muster the motivation needed to tackle the problem. Other times, excess weight gain leads to depression, which then makes tackling the weight gain even harder.

In any case, it's important to know that safe and effective treatments for depression, including cognitive behavioral therapy (either alone or in combination with prescription medications), are available. Medical studies have shown that regular exercise, along with other treatments, can also help to relieve the symptoms of depression.

Help is out there — but to get it, you must take the first step. In addition to eating well and getting regular exercise, talk with your doctor if you have concerns about your mood. If you have depression, facing it will only make all your life struggles — including the one with your weight — much easier to face. So don't delay.

Give (or Get) the Gift of Health

Now that you're making healthy living a part of your life, why not make it part of your gift giving — and getting — as well? If you're still looking for that perfect holiday gift, think about sharing your new lifestyle with others by giving presents that will encourage them to adopt the same kinds of healthy habits you've adopted. And if your friends or loved ones solicit ideas for holiday gifts for you, suggest items that will help you reach your goals. You'll have more incentive to keep up with the healthy changes you've been making — without the challenges presented by traditional offerings like chocolates, cakes, and other high-calorie foods.

During this gift-giving season, here are some health-inspired ideas to make it easier to eat well, exercise regularly (whether indoors or outdoors), or reduce stress. Consider these as presents:

• Exercise videos or equipment
• A meditation or self-awareness CD
• Workout clothing
• An assortment of herbal teas and a teapot
• Gift certificates for a spa treat such as a massage or pedicure
• Tickets to a concert or play
• A sports watch with a stopwatch
• A pedometer
• A colorful water bottle to take to workouts
• A yoga mat with a gift certificate to a yoga class
• A countertop grill or steamer
• A juicer
• A backpack or gym bag
• A basket of fresh fruit
• A portable music player
• A soothing tabletop fountain
• Aromatherapy bath products
• A cookbook featuring healthy fare
• An all-weather jacket
• Maps of hiking trails, or guidebooks to the outdoors
• Sunglasses
• A subscription to a fitness or health magazine

As you can see, there are many options for gifts that promote health and wellness. This list is just a beginning. This week, why not treat yourself or someone you love to one or more of these gifts — or put them on your own wish list?

Broiled Beef Slices With Bangkok Salad

A cup of Tom Kha Gai, a Thai coconut chicken soup, is over 200 calories. A portion of Pad Thai is over 400 calories. Treat yourself to a Thai iced coffee with that and you've added another 170 calories. So when I tell you that Thai food is delicious but deadly, you can see what I mean. Good news, though — I've come up with a Thai-inspired salad made with ingredients you'll be able to find in your supermarket, and it won't break the bank, calorie-wise. It's really filling and tasty!
Broiled Beef Slices With Bangkok Salad
Ingredients
12 ounces lean boneless beef top round steak, trimmed of all visible fat
1/2 tsp. crushed red-pepper flakes, divided
1/8 tsp. salt
3 tbsp. fresh lime juice
2 tablespoons fish sauce (sold in the international foods aisle)
2 tbsp. olive or canola oil
1 tbsp. sugar
1 garlic clove, crushed through a press
6 cups shredded red and green leaf lettuce, romaine, or mixed greens
1 cup sliced cucumber
1/2 cup thinly sliced sweet white onion
1/2 cup thinly sliced radishes
1/2 cup coarsely chopped cilantro
1/4 cup coarsely chopped fresh mint
Preparation
Preheat the broiler. Line a broiler pan with foil and coat the rack with cooking spray. Rub the steak on both sides with 1/4 tsp. pepper flakes and the salt.
Broil the steak 4 to 6 inches from the heat, turning once, for 12 to 15 minutes, depending on thickness, until a meat thermometer inserted in the center registers 145°F, for medium rare. Transfer to a plate.
In a large salad bowl, combine the lime juice, fish sauce, oil, sugar, garlic, and the remaining 1/4 teaspoon red-pepper flakes. Mix with a fork. Spoon one tablespoon of the dressing over the steak on the plate, and let the steak stand for 10 minutes.
Add the greens, cucumber, onion, radishes, cilantro, and mint to the remaining dressing and toss to mix well. Divide among individual plates.
Cut the steak into thin slices on an angle and arrange on top of the salads. Spoon the steak juices over the top.
Makes 4 servings
Per serving: 223 calories, 11 g carbohydrates, 22 g protein, 11 g total fat, 50 mg cholesterol, 3 g dietary fiber, 735 mg sodium

Coffee: Good or Bad?

To drink coffee or not to drink coffee: That is the question. Over the years, we've received many conflicting messages about this popular and addictive beverage. Concerns that it may lead to high blood pressure and heart disease once prompted some health-conscious folks to give it up, but a few recent studies have shown no link to heart disease in healthy people. In fact, some research indicates that coffee can actually decrease the risk of certain chronic diseases, including type 2 diabetes.

Although researchers are still learning about the effects of coffee on health, many experts agree that most people can safely enjoy it in moderation. However, you should keep in mind that only black coffee is calorie-free. The calories in cream, sugar, and coffee flavorings can add up fast — and be easily overlooked. Likewise, lattés and other espresso-based drinks can be surprisingly high in calories — up to 400 per drink! Stick to the old fashioned drip coffee, doctored with skim milk and artificial sweetener if you must add anything.

Keep in mind that coffee can have bothersome effects if you drink too much. If you have trouble sleeping, feel restless or irritable during the day, or have frequent headaches, nausea, diarrhea, or abnormal heart rhythms, it may be time to try cutting back on the joe. Try replacing some or all of the coffee you drink with decaffeinated options like decaf coffee and herbal teas. They provide the warmth and comfort of coffee without the adrenaline jolt.

With a healthy diet and regular physical activity, you might find yourself relying less on caffeine to help get you through the day and more on the natural, abundant energy that comes from living a healthy lifestyle.

Exercising When You're Away From Home

Are you traveling to visit family or friends this holiday season? Don't let being away from home become an excuse to take a vacation from fitness. While you may not be able to do the same routine you're used to doing at home, there are still plenty of options for staying active when you're on the road. Try the following strategies:

• Bring a pedometer and a pair of walking shoes with you. Aim for 10,000 steps a day. If you're sightseeing, this will probably be easy!
• Pack a resistance band. It will allow you to do strength training in your hotel room.
• Ask if the hotel you're staying in has a fitness center. Nowadays, many hotels do.
• Swim laps in the hotel pool.
• Bring along a fitness video, or ask if the hotel has any available to use.
• Take advantage of layovers and waits in airports by walking through the terminal.
• Plan activities during your trip to add movement to your day. If you're in a rural area, plan hikes or kayak trips; if you're in a city, take a bike tour or just wander and explore the local streets and shops.

If you're having trouble getting motivated to exercise on your trip, try thinking of it as an opportunity to break out of your usual routine. Think about how great you'll feel once your workout is done. Tell yourself you'll just start with five minutes of exercise and then see how you feel. Chances are, once you start moving, you won't want to stop!

Remember, there's always something you can do to stay active no matter where you are. With some creative planning, you can make sure travel doesn't get in the way of your fitness goals.

Is Tofu for You?

Tofu is a delicious, easy-to-prepare protein. It's a great way to add some variety to your meals, and it's so good for you! And tofu is only one of a range of soy-based foods out there to choose from. These foods tend to be low in calories and fat, and they're amazingly versatile! Here are some easy ways to incorporate soy foods into your day:

• Soy nuts: If you're new to soy and soy products, soy nuts are a great place to start! They're made from whole baked soybeans, and they make a healthful, crunchy snack. Take some along with you to work!
• Soy milk: This tasty beverage has cow's milk beat when it comes to being low in cholesterol, saturated fat, and calories. Cow's milk does contain more calcium, though, so why not keep some of both kinds in the fridge? That's the way to get all your nutrients! Soy milk comes in regular and light forms and even in flavors like vanilla and chocolate. Add some to your morning coffee instead of milk or half-and-half!
• Edamame: These green soybeans — sometimes eaten right out of the pod — are a delicious, amazingly healthy way to get your soy. You can find them in the fresh produce or freezer section of your grocery store, or order them at your favorite Japanese restaurant, seasoned with a dash of salt, as a scrumptious starter to your meal. They even make an incredible hummus!

Eating With Awareness

We all have them, those irresistible foods that we can't seem to eat enough of. If we're not paying attention as we eat them — perhaps because we're watching TV or doing work at our desks — we may look down to find we've eaten three helpings of lasagna or an entire bag of chips.

One way to prevent this kind of overeating is to practice eating with awareness, or "mindfully." When you eat mindfully, your aim is to focus solely on the here-and-now experience of eating — the sight, flavor, texture, and aroma of the food, plus the thoughts and feelings you have as you eat.

This week, use the following tips to help you practice mindful eating:

• Eat only when you are seated at your kitchen or dining room table. Don't eat while watching television, reading, standing by the sink, driving, lying or sitting in bed, or doing anything else that requires your attention.
• Keep the focus on the food rather than the conversation. Of course it's nice to chat with company while you eat, but don't get so wrapped up that you forget to notice and enjoy your food. Consider eating alone a few times until you get the hang of it. Then, add in conversation with others.
• Before you start eating, take a few deep breaths. As you eat, put your utensil down between bites. Take time to really savor each mouthful.
• Take a moment to assess your hunger. Are you a little hungry? Moderately hungry? Ravenously hungry?
• As you eat, pause to check in occasionally with your hunger. Aim to stop once you feel satisfied rather than eating until all the food is gone. Push your plate away, and give your body 15 to 20 minutes to register whether or not you are still hungry before you eat more.

Over time, learning to eat in the moment will help you break free from mindless eating and make your meals more enjoyable and satisfying.

Lighten Up Family Favorites

Remember Mom's rich brownies? Or Grandpa's five-alarm chili? They're in every family — sacred recipes that get passed down through the generations. The problem is that family favorites often aren't as healthy as they could be. But with a few alterations to the recipe and cooking methods, you can still enjoy the tastes you love while cutting out excess fat and calories. Try the following tips:

Spray, don't pour: Coat pans and baking dishes with cooking-spray butter, margarine, or oil.

Go nonstick: A nonstick pan can reduce the need for fat when you sauté.

Reach for broth: Sauté vegetables in low-sodium vegetable or chicken stock for great flavor minus the fat.

Strip the skin: Cut calories by always removing the skin from poultry and trimming visible fat off meat.

Soak up the flavor: Leaner cuts of meat can be less tender. Use a low-sodium marinade to add flavor and help tenderize.

Switch tactics: Bake, boil, or broil meats and other foods you'd normally fry.

Cut back: Cut the amount of cheese and other fatty ingredients in your favorite recipes by one half, or replace them with low-fat versions.

Get saucy: Try replacing some or all of the fat in baking recipes with applesauce.

Go veggie for a day: Replace meat in dishes with beans or meat substitutes like tofu or vegetarian crumbles.

Slow cook: Use a slow cooker to turn lean meats, vegetables, and beans into delicious soups, stews, and casseroles without adding fat.

Spice things up: Add flavor but not fat to foods with dried and fresh herbs and spices. From the sweet and citrusy flavors of basil and lemongrass to the distinctive flair of cilantro to the richness of curry, a world of flavor awaits your exploration.

Get to know yogurt: Replace the sour cream on your table with low-fat plain yogurt. It makes a great topping for baked potatoes.

And remember, no matter what you're cooking or baking at home, always keep portion control in mind when you sit down to eat it. Moderation is a key to success!

Yoga and You

The practice of yoga was developed in India roughly 5,000 years ago to encourage emotional, physical, and spiritual wellness. While it's an ancient art, the popularity of this form of exercise continues to this day. It's easy to see why — yoga not only improves balance, flexibility, and muscle strength, but it also can help to relieve stress.

Yoga is composed of a series of very specific movements, or poses, aimed at building strength and balance. Yoga moves can be done quickly, to build up heat in the body, or slowly and contemplatively to focus on flexibility. Meditation, breathing exercises, and chants may also be featured. There are many styles of yoga. Different styles emphasize different aspects of the practice, and some are more strenuous than others.

If you've never tried yoga, consider signing up for a class. You may want to start with hatha yoga, a style that tends to be slower paced and is good for beginners. Choose an introductory class where the instructor will teach you the poses involved and observe you to make sure you're doing them properly. After a few sessions with a good instructor, you can continue practicing yoga with a group, alone, or along with a yoga videotape.

You'll want to wear comfortable, breathable clothing that allows you to move easily. Yoga is done barefoot, so you don't have to worry about buying any special shoes. You'll need a mat that prevents you from slipping while you do poses, and these can be borrowed or rented at most studios or gyms that offer yoga. If you decide to continue practicing yoga, you may consider buying your own mat.

If you've never done yoga before, let the instructor know it's your first time. Remember, others in your class may have been doing yoga for years, so don't compare yourself to them. In time, you, too, will become comfortable with the poses, and you will begin to experience the benefits.

Stretch Safely!

You may have heard that it's good to stretch before and after your workouts, but do you know why it's so important? Stretching helps prime your muscles for action, keeping them supple and preventing injuries! However, it is possible to stretch yourself the wrong way, say the experts at Montana State University. To avoid this, they advise the following:

• Make sure you aren't stretching cold muscles. Get ready for the challenge with a gentle five-minute walk or jog, or even a warm bath.
• Think slow and smooth! Aim for what is called a static stretch. Reach until you feel tension but not pain, and hold that position for 20 seconds to one minute. Be sure to never bounce while stretching!
• Remember to breathe deeply and naturally throughout each move. Don't hold your breath! Ease into stretching, rather than trying to touch your nose to the floor the first time around. It will take time for your body to gain maximum flexibility — so don't rush it!

Eat Food That's Fast — But Not Fattening!

Can fast food be healthy? The big fast-food chains are trying to answer yes by introducing new menu items. Look for some of the following foods the next time you're visiting your favorite chain. Keep an eye on your portion sizes and ask about nutrition if you aren't sure what's best.

Try one of these smart choices when you need to eat on the go:

• Skinless grilled chicken sandwiches
• Whole-grain bread and buns
• Fresh fruit
• Breakfast sandwiches made with scrambled egg whites
• Yogurt-based snacks
• Low-fat ice cream
• Skim and low-fat milk
• Entrée-size salads (without dressing or croutons)
• Grilled chicken or steak wraps
• Deli-style sandwiches
• Baked potatoes (without toppings)
• Chili
• Tacos and burritos (without cheese or sour cream)

Metabolic Syndrome

In recent years, health experts have become increasingly interested in a collection of risk factors known as metabolic syndrome. They have found that people with metabolic syndrome are at an elevated risk for developing cholesterol deposits in the walls of the arteries (atherosclerosis), which causes most heart attacks and strokes. Metabolic syndrome also raises the risk of developing type 2 diabetes.

Because these illnesses are among the leading causes of death in the United States, preventing or treating the individual conditions that make up metabolic syndrome could save many lives. People may be diagnosed with metabolic syndrome if they have three or more of the following conditions:

• Increased abdominal fat: a waist circumference greater than 40 inches for men or 35 inches for women
• Elevated blood pressure on several measurements: 130 mm Hg or greater systolic (top number) or 85 mm Hg or greater diastolic (bottom number)
• Elevated level of triglycerides (blood fats): 150 mg/dl or higher after a 12-hour fast
• Low level of HDL (the "good") cholesterol: lower than 50 mg/dl for men or 45 mg/dl for women
• Elevated blood sugar levels: 110 mg/dl or greater after a 12-hour fast

While researchers are still investigating why these factors often occur together, they suspect a gradual resistance to insulin in the body may be to blame. Insulin is a hormone that helps the body's cells use the glucose supplied by food. If the body doesn't use insulin efficiently, cells can't take up as much glucose, so it accumulates in the blood. In response, the body makes more insulin, overloading the blood. As a result of the excess insulin, triglycerides and other fats build up in the blood, increasing the risk of abnormal cholesterol. At the same time, kidneys become strained by the additional load, leading to high blood pressure.

In some cases, the cause of insulin resistance may be genetic or environmental. But most of the time, overweight and inactivity seem to be the culprit. Metabolic syndrome occurs in only 5 percent of adults of normal weight but in 22 percent of those who are overweight and 60 percent of those who are obese. Lifestyle changes such as losing excess weight, exercising, and quitting smoking can help to prevent or treat metabolic syndrome. If you suspect you're at risk, ask your doctor to evaluate you for this serious condition.

Take Time for You!

It's easy to forget about taking care of our own needs. Prioritizing your own needs up there with everything you do for your family, friends, your job, and your other responsibilities is tough, especially if you have a family, but it's a must! You owe it to yourself to take a little personal time, even if it means shifting some duties and putting others second.

Start by talking to your family. Tell your spouse and/or children about your decision to make more time for yourself in order to meet your goals. If your children are older, perhaps they can take on a few more chores. Ask your spouse to lend a helping hand around the house or take over some of your other family responsibilities.

With their support, that "me" time will be more doable — and that renewed, refreshed feeling can be yours! As a bonus, you'll be more peaceful and energized, helping you tackle your family responsibilities with a fresh face forward. Everyone truly benefits! Get your family on board with your plan today!

Your Scale and You

Unlike other plans that recommend weighing in weekly or less often, we advise you to weigh yourself daily.

"Daily?" you ask. Yes! Studies show that people who weigh themselves daily are more successful at long-term weight loss than those who weigh themselves weekly. Experts speculate that frequent weigh-ins remind you of your goals and help keep you motivated. At the Duke Diet & Fitness Center (DFC), we feel that an essential part of this daily weighing strategy is tracking your weight on a graph. A graph helps you to see the big picture: Rather than focusing on one day's number, you're looking at trends over several days, weeks, or months. There's nothing more motivating than seeing that line move downward over time!

We also like graphs because they can help you to become accustomed to the fact that the number on the scale does fluctuate each day. The line won't always move downward, and that's okay. Weight normally varies from day to day, based on factors like how much water your body is retaining, among others. We find that seeing these normal fluctuations on a graph keeps our clients at the DFC from getting discouraged by them — they look past the little ups and downs and focus on the larger trends.

Another advantage to graphing with daily weigh-ins is that it helps you self-monitor more effectively. If you see your weight beginning to trend in the wrong direction, you can take steps to nip that trend in the bud.

Of course, weighing in daily isn't right for everyone. If you've ever had an eating disorder like anorexia or bulimia or if you find it extremely upsetting to get on the scale, you should talk to your doctor or mental health–care provider. Otherwise, give it a try and see how it works for you!

If daily weighing is a good strategy for you, we encourage you to keep it up — even after you meet your weight goals. Research has shown that people who've lost weight and continue to weigh themselves regularly afterward are better able to keep the weight off. So plan to make your friendship with your scale a lifelong one. Doing so will greatly increase your chances of both short-term and lifelong success.

Disease Prevention 101

You know the expression "An ounce of prevention is worth a pound of cure"? One of the very best — and easiest — ways you can prevent disease and ensure you stay healthy is through routine health screenings!

You may be thinking, But I'm healthy! Why should I get tested for diabetes, cervical cancer, or any of the other conditions my doctor wants to test for? The answer is that screening is meant for healthy people to determine if they're at risk before a condition develops or becomes more serious.

You won't get a diagnosis from screening; it will only tell you if you're at risk for having a condition or illness. Your health care provider may perform a diagnostic test as a result of your screening results — or he/she may simply recommend you come back after another year or two or some other period of time to be screened again. Your health care provider may also use your screening results to suggest lifestyle changes you should incorporate in order to reduce your risk, such as changing your diet, increasing your activity level, or quitting smoking.

Keep in mind that screening is not perfect. If a screening test shows that you are not at risk for a specific disease or condition, there is still a small chance that you may develop it. So if you are having symptoms that suggest a specific condition, be sure to tell your health care provider about them, even if the screening test told you that you were not at risk.

Screening is important at all ages — no one is too old or too young. Are you up-to-date on all of your tests and immunizations? Have you discussed your family history of specific conditions with your doctor? This month, make a commitment to yourself to finally take care of any outstanding doctor visits or tests. Not sure if you are up-to-date? Members can log in to check out the recommended screening tests for adult men and women.

Getting Over a Bump in the Road

Question:

I've blown it! I've been enjoying the results I've seen since I started your program months ago. But I got really busy in the past couple of weeks and stopped eating right and exercising. I've almost regained everything I lost, and now I just want to give up! What should I do?

Answer:

Okay, so you had a lapse. It happens. There's no time like the present to pick yourself back up! Start right this second. Don't dwell on your minor slip, but do learn from it. There's no doubt you'll get busy again, so prepare for such times! If you have to skip your spinning class, do some other activity to make up for it — say, walking to work. If you had a high-calorie lunch, have salad for dinner. Making these little substitutions will help keep you on track until you're able to return to your regular Fitness and Meal Plans! Don't give up!

Orange-Scented Cornmeal Cake With Fresh Berries

Extra-virgin olive oil — it's not just for salads anymore! Remarkably, EVOO is an important ingredient in this delicious dessert, but trust me, your cake will not smell like an Italian entree. The olive oil keeps things wonderfully moist. When you're ready to serve the cake, you top it with a luscious berry sauce and a sprinkling of fresh berries (though the frozen kind will do if berries are not in season). Never made a cake from scratch before? Try this one — you'll be amazed at how simple it is (and how lovely it will look on your table)!
Orange-Scented Cornmeal Cake With Fresh Berries
Ingredients
For the cake:
3/4 cup whole-grain pastry flour
1/4 cup cornmeal
1 teaspoon baking powder
1/4 teaspoon baking soda
1/4 teaspoon salt
1/3 cup + 1 tablespoon sugar, divided
3 tablespoons extra-virgin olive oil
1/2 cup plain fat-free yogurt
2 large eggs
1 tablespoon grated orange peel
2 tablespoons orange juice
1/4 teaspoon ground cinnamon
For the berry sauce:
1 cup blackberries
1 cup blueberries
1 cup raspberries
1 tablespoon sugar
1 tablespoon orange juice
Preparation
To make the cake: Preheat the oven to 350°F. Coat a 9-inch springform pan with cooking spray.
In a small bowl, combine the four, cornmeal, baking powder, baking soda and salt.
In a large bowl, combine 1/3 cup of sugar and the oil. Using an electric mixer on high speed, beat for 2 minutes. Add the yogurt, eggs, orange peel, and orange juice. Beat for 1 minute. Add the dry ingredients and beat until blended. Pour the batter into the prepared pan.
In a small bowl, combine the remaining 1 tablespoon sugar and the cinnamon. Sprinkle over the batter. Bake for 20 to 25 minutes, or until a wooden toothpick inserted in the center comes out clean. Transfer to a wire rack and let cool.
To make the berries: In a food processor or blender, puree 3/4 cup of the blackberries, the sugar, and the orange juice until smooth. Strain the puree through a sieve into a small bowl; discard the seeds. Cut the cake into wedges. Spoon the berry sauce over the wedges and sprinkle with the blueberries, raspberries, and remaining blackberries.
Note: When you use an electric mixer to beat citrus peel into a batter, a lot of the peel can cling to the beaters. Be sure to scrape any peel from the beaters back into the batter.
Makes 8 servings
Per serving: 189 calories, 30g carbohydrates, 4g protein, 7g total fat, 55mg cholesterol, 3g dietary fiber, 200mg sodium