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Dieting vs. Rethinking How You Eat

By Dr. Marisa Weiss on September 11th, 2013 Categories: Uncategorized

Managing my weight has been a lifelong struggle. Between the occasional summer bathing suit appearance and the upcoming stretch before the major holidays, there’s no break! What can I say? I have a real weakness for food and have to push myself to exercise. But my own diagnosis of breast cancer 3 years ago was a game-changer. Here it was, the biggest reason ever to get my act together. Time to stop the slip-ups and get a grip on my willpower to get to and stick to a healthy weight!

At first, the intense fear of breast cancer recurrence during and right after my diagnosis was enough to make me stay on task most of the time. But over the last year or so, it’s been harder. With age, my metabolism has slowed and the weight seems to creep on faster and stay around longer. Plus, tamoxifen makes me feel hungry unless I have something in my stomach. And I have one more excuse: Even though I try to limit my alcohol intake to keep my risk of recurrence as low as possible, it’s sometimes hard for me when I’m being social to limit myself to just one glass of wine or one beer, another source of extra calories. And then there are the not-so-healthy foods I’m more likely to eat along with and after wine.

Enough excuses! To control my urges, I try to stay focused on my main goal: to live a long and healthy life while looking good in my clothes. As much as I love summer, I can’t wait to get back into my solid black tights again.

Why is weight management so important?

When you’re trying to accomplish a difficult goal over time, you need to be convinced that the results are going to be worth the effort and sacrifice.

Here are some reasons why extra weight can be dangerous for your breast health:

  • Extra weight is linked to a higher risk of breast cancer diagnosis and recurrence. The extra fat cells can make a potent brew of extra hormones (such as estrogen and insulin growth factors) that can promote unhealthy breast cell growth.
  • Extra fat cells cause inflammation, which puts added stress on your immune system.
  • Many of the hormonally active chemical pollutants in our environment, including those in food, beverages, and personal care products, are stored in fat tissue.
  • While research consistently shows that drinking alcohol increases risk of breast cancer, some studies show that drinking alcohol is associated with an even greater risk of breast cancer in overweight women.

Also, extra weight puts you at increased risk for other major illnesses, including heart disease, stroke, diabetes, arthritis, pain syndromes, and depression.

So are you ready to shed the extra pounds? Let’s go!

Finding a diet that works

If you want to lose weight, you might be wondering which diet — if any — is best for you. There are LOTS to choose from, and many of them sound like they might work for me. I’m pretty suspicious about the baby food and cookie diets, but others sound more reasonable and medical researchers have tested some of them in clinical trials.

Here are the details on some of the more popular and well-tested diets:

  • Low-fat: For more than 50 years, most doctors have recommended a low-fat diet to lose weight and prevent disease, including heart disease, stroke, cancer, and diabetes. Low-fat diets are based on the belief that dietary fat is associated with body fat. A typical low-fat diet breaks up your daily food this way: 30% of total calories from fat (with 10% or less saturated), 15% from protein, and 55% from complex carbohydrates (found in vegetables and whole grains). Most low-fat diets also limit cholesterol to 300 mgs and salt to no more than one teaspoon per day (not just the salt you put on your food, but also the salt put in any prepared foods you eat). To lose weight eating this way, you have to eat fewer than your recommended daily maximum calories. For example, a dietician or nutritionist might suggest eating 2,000 calories per day on a low-fat diet instead of 2,500.The well-known DASH (Dietary Approaches to Stop Hypertension) diet says your total fat intake per day should be 27% of the calories you eat. The Therapeutic Lifestyle Changes (TLC) limits total fat to 22% of daily calories. The Ornish diet takes the low-fat approach even further. It limits fat intake to 10% of daily calories and encourages dieters to avoid all meat.
  • Mediterranean: The Mediterranean diet is what many people think of as a “healthy diet.” Like low-fat diets, it’s been found to reduce the risk for heart disease, stroke, cancer, and diabetes. The Mediterranean diet emphasizes eating vegetables, fruits, whole grains, nuts, fish, and oils such as olive and canola. It allows some red meat, poultry, and dairy. The diet isn’t low in fat or in carbohydrates, but it includes mainly unsaturated fats and complex carbohydrates, such as whole grains and beans. As with low-fat diets, to lose weight eating this way, you have to eat fewer calories than your recommended daily maximum.
  • Low-carbohydrate: These diets, including South Beach, Zone, SugarBusters, and Atkins, strictly limit the amount of carbohydrates you can eat while allowing lots of protein. In particular, dieters avoid sugar and refined carbohydrates, such as white bread and white rice. Instead you can eat high-protein, high-fat foods such as meat, eggs, and cheese. Some low-carb diets put no limit on overall calories. Some people think a low-carb diet works by changing the way the body breaks down food. Eating very few carbs lowers insulin levels, which causes the body to burn stored fat for energy. So even though these diets are often high in fat, people who eat this way usually lose as much weight and improve their overall health as people who eat low-fat diets – an outcome that challenges the common wisdom that dietary fat makes you fat.
  • Paleolithic: The Paleo diet is based on eating unprocessed foods that were likely found in the Paleolithic era, including all kinds of meat, fish, poultry, eggs, vegetables, fruits, seeds, and nuts. More modern foods that require more processing, including dairy, grains — especially grains that contain gluten — and beans, are considered off-limits. The diet also encourages people to avoid refined carbs, seed oils, hydrogenated fats, sugar, and any food that has more than three or four ingredients. People who eat this way usually don’t count calories to lose weight. Like low-carb diets, the Paleo diet may change the way the body breaks down food and cause it to burn stored fat for energy. Small studies on the Paleo diet have found that it can lead to weight loss and improve overall health, similar to the Mediterranean and low-carb diets.

To find a weight loss diet that works, researchers have focused on these four main diet types in recent years. They’ve come to some meaningful — if not magical — conclusions about weight loss:

  • If you’re trying to lose weight, any of these diet approaches can help. Research suggests that all of them are safe, at least in the short-term, and all of them can work, if followed carefully.
  • The mix of proteins, carbs, and fats really doesn’t matter when it comes to weight loss. Eating more fat may help you stick to a diet because it helps you feel full, but any diet that reduces your normal calorie intake works.
  • Still, there’s a growing debate about whether calories really matter. Some supporters of the low-carb and Paleo diets believe that dramatically reducing the amount of carbohydrates you eat changes the way your body breaks down food. This makes calorie counting unnecessary.
  • The key to losing weight and keeping it off is finding a diet you can live with. Just about any diet helps people lose weight at first, but the weight almost always comes back if you go back to your old eating habits. The ideal diet stops being a diet and becomes a way of life. So if you’re someone whose favorite food is pasta, the Paleo diet probably isn’t for you. If you love olive oil and avocados, the Mediterranean diet may be a better choice than the Ornish diet.
  • Having lots of support for any diet you undertake can help you stick with it. If you want to lose weight, don’t be shy about asking for help from your family and friends. Researchers have found that regular group meetings are as important to success as the type of diet you choose to follow.

Whatever diet you follow, be sure to get your calories from foods that meet your nutritional needs and support your overall health and well-being. Include enough high-quality sources of protein, plenty of complex carbohydrates, and some “good” fats. (The Breastcancer.org Nutrition pages have more information on nutrition and breast cancer risk.) Avoid any diet that extremely limits calories or tells you to eat just one food, such as cabbage soup, nutritional “shakes,” or cookies. These diets usually lack nutritional value.

You might find it easier to approach weight loss by rethinking how you eat, rather than by following a particular weight-loss diet. It’s what I’ve been trying to do. As I’ve talked about in the past, I’ve had to change my diet in order to reach a healthy weight and reduce my risk for all kinds of disease. It hasn’t been easy. I’ve made progress, though, by following a varied, well-balanced diet that focuses on nutrient-dense foods such as organic farm-fresh vegetables, hearty green salads, and wild-caught fish. After flirting with low-fat eating for many years, I’ve gotten comfortable snacking on nuts and eating a lot of fruit, big salads (dressing on the side), and roasted vegetables, plus all kinds of home-made soups and chili. (Vegetable lasagna with ribboned yellow squash instead of noodles and a small amount of parmesan cheese for flavor is my favorite.) I’ve experimented with different whole grains like quinoa, kamut, and farro. I’ve replaced cookies after dinner with fresh fruit or air-popped popcorn (and for a special treat, I toss the popcorn in plain melted dark chocolate — THE BEST).

Going to restaurants is still a major challenge for me because everything I want to order tends to be high in calories, plus I’m tempted by alcohol. So I work on portion control by ordering appetizers instead of entrees and asking for my food steamed, grilled, roasted, or broiled with dressing and sauces on the side. I try to eat a salad before I go out, to avoid over-ordering because I’m hungry. I also make my first drink a mocktail, not an alcoholic beverage. Finally, I follow a rule I learned from a friend: Enjoy only one of the following at a restaurant: bread, wine, or dessert.

Since nutrition and exercise go hand-in-hand for weight loss, I’m also working hard at exercising more. It really helps to find something you enjoy. For me it’s Zumba, but for you it might be classes with a personal trainer, morning jogs around the park, or speed walking with a friend. Whatever it is, just do it — there are lots of reasons to exercise beyond weight loss. Don’t ask yourself if you’re going to exercise, just go out the door and get to it.

Once in a while, I’m wooed by the promise of some new diet I hear about on a talk show or read about in a magazine. But I know — and you probably know by now, too — that what’s really important is eating well for the long run. Focus on eating good-for-you, wholesome foods. Avoid highly processed foods. Get creative with healthy ingredients in the kitchen. And, of course, limit that sweet tooth!

Dr. Marisa Weiss

Marisa Weiss, M.D. is the founder, president and guiding force behind Breastcancer.org, the world's most trafficked online resource for medically reviewed breast health and breast cancer information, reaching over 8 million visitors per year. A breast cancer oncologist with over twenty years of active practice in the Philadelphia region, Dr. Weiss is regarded as a visionary advocate for her innovative and steadfast approach to informing, empowering, and treating patients with breast cancer.

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