Online Health Chat with Anna Taylor, MS, RD, LD

November 11, 2014

Description

The holidays are around the corner, and along with the parties, traditions and time with family come decadent foods and ample opportunity for getting off track from your healthy lifestyle. It takes careful planning and determination to navigate the holidays healthfully.

A little extra planning can go a long way in maximizing enjoyment of the holiday season without all those extra pounds and without feeling like you’re missing out on the fun and traditions of the season.

Cleveland Clinic dietitian Anna Taylor will offer nutrition tips for surviving the holiday season without unwanted weight gain and will cover the following topics:

  • Strategies to use at holiday parties and traditional holiday feasts to avoid overeating
  • Easy cooking/baking substitutes that will help control calories and fat without sacrificing flavor
  • Smart snacking to keep hunger in check while cooking or shopping
  • Healthful holiday recipes
  • How to maintain an active lifestyle during the holiday season

About the Speaker

Anna Taylor, MS, RD, LD, is a registered dietitian at Cleveland Clinic. She has specialty interests in diabetes management, non-surgical weight loss, cholesterol reduction, oncology and wellness/prevention. She is also involved with nutrition education classes through the Cleveland Clinic Wellness Institute, as well as employee education and community outreach throughout the Cleveland area. Anna is a registered dietitian by the Commission on Dietetic Registration and a licensed dietitian by the Ohio Board of Dietetics. She has professional memberships in the Academy of Nutrition and Dietetics, Ohio Dietetic Association, Diabetes Care and Education Dietetic Practice Group and Oncology Nutrition Dietetic Practice Group.


Let’s Chat About Healthy Holiday Eating

Moderator: Welcome to our chat: Healthy Holiday Eating with Cleveland Clinic registered dietitian, Anna Taylor, MS, RD, LD. Anna, thank you for taking the time to be with us to share your expertise and answer our questions.


Recipe revisions

familia14: How can I make my family’s favorite traditional recipes healthier?

Anna_Taylor,_MS,_RD,_LD_: There are so many ways to makeover a recipe to improve its nutritional value. For example, try using plain, fat-free Greek yogurt or fat-free sour cream instead of regular sour cream, using skim milk instead of whole milk and using reduced sodium, fat-free broth/soup instead of regular broth/soup.

Here’s an example of how to make simple swaps with ingredients to improve the overall nutritional quality of a traditional holiday favorite without sacrificing taste. For green bean casserole, try using frozen or fresh green beans instead of canned green beans, and switch from regular cream of mushroom soup to reduced-sodium, fat-free cream of mushroom soup. This will greatly reduce sodium content. Mix the condensed soup with fat-free milk instead of whole milk to decrease fat intake. Add fresh mushrooms to increase vitamins and minerals. Instead of adding fried onions as a topping, try slivered almonds, which contain less saturated fat and more fiber and protein.

studebaker: Do you have any healthy holiday appetizer ideas?

Anna_Taylor,_MS,_RD,_LD_: A veggie plate with hummus, shrimp cocktail or fruit with Greek yogurt dip make delicious, easy and healthy holiday appetizers.

Lindy: What can I use as a replacement for light corn syrup in my holiday recipes? That is the same thing as high fructose corn syrup, right?

Anna_Taylor,_MS,_RD,_LD_: Corn syrup and high fructose corn syrup are actually two different things. High fructose corn syrup has a higher ratio of fructose vs glucose than other types of sugar. Research on high fructose corn syrup (HFCS) suggests a possible link between increased HFCS intake and increased risk for metabolic disorders (obesity, diabetes, etc.), but this research is not yet conclusive.Substitutions for light corn syrup depend mostly on what food is being made. Most replacements are just other sugar sources. For this reason, I would simply recommend careful portion control and moderation for recipes using this ingredient.

nyNJOHmi: My doctor says I should watch my sodium. Besides keeping the salt shaker off the table, what else do I need to do to limit my salt intake during the holidays?

Anna_Taylor,_MS,_RD,_LD_: Limit the processed foods! About 77 percent of the sodium in the typical American diet comes from processed, convenience and restaurant foods, not the salt shaker. For homemade holiday meals, avoid boxed mixes and canned foods. Strive to make as much from scratch as possible – stuffing, gravy, mashed potatoes, green bean casserole, etc. – and, of course, put that salt shaker away.


Social eating

Atlanta: If I save up my calories by skipping meals and snacks throughout the day, can I eat whatever I want at holiday parties to balance things out?

Anna_Taylor,_MS,_RD,_LD_: I don’t recommend skipping meals before holiday parties or meals. Under-eating in the hours leading up to a social eating event typically leads to overeating at that event – not to mention the discomfort and irritability skipping meals can bring. Instead, consider having small, sensible meals and snacks in the hours leading up to the event. Include a protein and fiber source regularly throughout the day to avoid losing your sense of control at holiday events.

livingwell: What are some tips for making better choices at all these holiday parties?

Anna_Taylor,_MS,_RD,_LD_: Bring a healthy dish to share, such as a fruit plate or a colorful salad. This will ensure there is at least one dish at the party you can use to fill up half of your plate. Chances are, the other party guests will be thankful to see some healthier options.

Prioritize. Scope out the table at the start of the meal and decide which dishes are your very favorites. For example, if you don’t think of bread as vital to your overall enjoyment of your holiday meal, then skip the roll and save at least 100 calories. Or, if the rolls are a must-have, then try leaving the crust to your slice of pie (or leave off the whipped cream) as an alternate way to save 100 calories. Little omissions like these can add up easily without feeling like you’re sacrificing anything at all.

Emphasize proper portion sizes. If you love mashed potatoes, stuffing and yams, don’t have full servings of all three. Instead, take just a few tablespoons of each. The calories saved will be significant, but you’ll still get to enjoy all the foods you’ve waited for all year. Other techniques to control portions are to use smaller plates and stick to only one plate of food.

Slow down and tune in. If you love pumpkin pie, serve yourself a modest portion, avoid distractions and enjoy every bite. So often, our excitement of the day keeps us from being able to fully appreciate the taste of an extravagant dish. By taking a moment and tuning in to the dish, you will not only enjoy the food more, but you will also feel more satisfied with a small portion.


Sweet treats

Worried: How can I stay away from the sweets? I love them! Making cookies does not help, but the holiday is a must for cookies. I have noticed that I make so much fudge sauce to give away that I no longer go berserk over it, but how can I stay away from the cookies?

Anna_Taylor,_MS,_RD,_LD_: I'm guessing you are not making all of these cookies just for yourself, in which case, it is all about planning. Once you make those holiday cookies, portion them into opaque containers, such as tins. Immediately designate where each tin is destined to go – family, friends, neighbors, work, specific holiday parties or events, and, finally, the ones that will stay in your own home. Clarifying the fate of every tin will make it easier to avoid uncontrolled snacking on those baked goods. Then, give them away as soon as you can!

As for the cookies destined to stay at your home for your own family, store them in the pantry or a cupboard, not out in the open on the kitchen counter. After all, out of sight, out of mind! If they are sitting out, you are more likely to snack on them at unplanned times. The concept of "moderation" is important here. Set yourself a limit for how many cookies you will be eating – such as one cookie per day – for a finite period of time.

Lastly, set yourself up for success. Eating at regular intervals throughout the day will help you keep your hunger and appetite at bay, which will make those cookies less tempting. You're right, we all have traditional recipes that are important to us during the holidays, but with a little planning, we can keep those traditions from getting us off track from an overall healthful lifestyle.

Heidi: Is it true that you can be addicted to sugar?

Anna_Taylor,_MS,_RD,_LD_: Sugar can have an addictive quality to it, absolutely. The main issue involves sugar's effect on blood glucose levels and the insulin response. Specifically, when people eat refined grains or sugary drinks, that food rapidly breaks down into sugar in the body and goes into the bloodstream, quickly elevating blood sugar. The insulin response then kicks in to help bring that blood sugar back down to normal levels. Unfortunately, this insulin response stimulates appetite, and guess what kind of food your body will be craving? That's right: sugar. In this way, sugar can be "addictive."

What’s the good news? All that is required to step away from "Sugar Addicts Anonymous" is to break that cycle. Specifically, start including protein and fiber at all meals, cut down on added sugars, avoid all sugary drinks and switch from refined grains to whole grains. In this way, you will slow down how quickly the foods you eat raise your blood sugar, leading to fewer sugar cravings.

All change takes time, but you should notice a big difference in cravings after just a few days or weeks. Remember, part of sugar cravings is simply having a habit of having something sweet at a certain time of the day. Making new patterns of eating will help break these habits until your sugar cravings become a distant memory.

nafky: How truly dangerous are artificial sweeteners?

Anna_Taylor,_MS,_RD,_LD_: Despite all the media hype, current research supports that sugar itself is more dangerous to humans than artificial sweeteners. At this time, we do not see any negative physical health effects of artificial sweeteners for humans, if consumed in moderation. The American Institute for Cancer Research has a top 10 list of recommendations to decrease risk of cancer. Avoiding sugary beverages is included on that list, while artificial sweeteners are not mentioned at all. In addition, sugar (regardless of its form – sugar, brown sugar, high fructose corn syrup, molasses, honey, etc.) is known to directly elevate blood sugar levels. For any person with diabetes, pre-diabetes or any type of insulin resistance, artificial sweeteners would be a better choice than regular sugar for this reason. Sugar also has calories while artificial sweeteners have negligible calories, meaning sugar intake can lead to weight gain while artificial sweeteners do not directly provide excess calories that can lead to weight gain. That being said, both sugar and artificial sweeteners are known to stimulate appetite. For this reason, I always recommend everyone try to limit their intake of sweetened foods/beverages overall, regardless of method of sweetening.

LucyintheSkies: What about using agave or honey as a substitute sweetener? Is it just as bad?

Anna_Taylor,_MS,_RD,_LD_: Agave nectar and honey both contain just as much sugar as regular sugar. It is true that agave nectar has a lower glycemic index than most other sugar sources, and that real honey contains some antioxidants; however, they still provide just as many calories and grams of sugar as regular sugar. For that reason, I still recommend avoiding overuse of any sugar source, including agave nectar or honey.


Food choices

mcpddisp09: Are there any foods I should stay away from completely or eat in moderation?

Anna_Taylor,_MS,_RD,_LD_: Sugary drinks really don't have much of a place in a healthy diet, especially things like soda, sweet tea or other sweetened beverages. I recommend avoiding these types of drinks as much as possible.

In terms of foods to eat in moderation, I recommend the concept of moderation for just about all foods. A healthy diet is one that is varied and contains all food groups – fruits, vegetables, grains (whole grains and starchy vegetables), low-fat dairy and lean sources of protein. Any foods with extensive, unpronounceable ingredient lists or lots of added sugars signify that the food is heavily processed, marking it as a food to avoid for the most part. These types of foods are only appropriate in small portions as occasional choices in an overall healthy diet. One way to consider this is the 90/10 rule: 90 percent of the diet should be built from minimally processed, nutritious foods. No more than 10 percent of the diet should include anything else.

avaR: I feel like the holidays are a non-stop rush for me – shopping, wrapping, cleaning, cooking and baking, and decorating. What are some examples of healthy snacks I can choose during the holiday season?

Anna_Taylor,_MS,_RD,_LD_: Focus on minimally processed, protein- and fiber-rich foods for snacks. Try nuts and dried fruit (no sugar added, of course), roasted garbanzo beans, string cheese and fruit, Greek yogurt with bran or whole-grain cereal, pumpkin seeds, cottage cheese and fruit, raw veggies with hummus, or apples with natural peanut butter to keep you fueled between meals.

studebaker: What holiday foods are better to binge on, and which ones should I try to avoid?

Anna_Taylor,_MS,_RD,_LD_: The concept of binging itself is not a pleasant one. It is the act of eating excessively and uncontrollably to the extent that the body experiences negative after-effects. Instead of losing all sense of moderation and control, consider using strategies to help manage portion sizes in a way that supports overall health. Focus on eating nutrient-dense foods – foods that contain lots of nutrients for very few calories, such as vegetables, fruits, beans/lentils, whole grains, lean protein and fat-free dairy – and limiting calorie-dense foods – foods that contain lots of calories but very few nutrients, such as candied yams, instant mashed potatoes with butter and gravy, macaroni and cheese, desserts and rolls made with refined grains.

holidayhappyfeet: How much does binging for the big meals actually hurt you? Any way I can get a free pass for these holiday meals?

Anna_Taylor,_MS,_RD,_LD_: Ignoring the effects of overeating doesn’t mean health consequences don’t occur. Even one day of overeating can lead to indigestion, acid reflux, mild weight gain, fluid retention, high blood sugars or other undesirable issues. Keeping your health in consideration, even on special events or holidays, is part of the requirements to enjoy the rewards of being a healthy person.

TipperTopper: What are the best options for holiday alcoholic drinks?

Anna_Taylor,_MS,_RD,_LD_: If you do choose to drink alcohol during the holidays, focus on sticking to proper portion size. A small glass of wine (5 oz.) can be a satisfying complement to a holiday meal without sacrificing excessive calories.

Alcohol is very calorie-dense: 1.5 oz. of 80-proof hard liquor such as rum or vodka contains nearly 100 calories. Similarly, only 5 oz. of wine has about 125 calories (and most wine glasses hold more than 5 oz.). Twelve ounces of beer have about 150 calories. A cocktail is even higher in calories due to the sugar content.

A festive holiday drink such as eggnog contains about 340 calories per cup because of the cream and sugar. When 1.5 oz. of rum is added, this drink contains a whopping 440 calories.

As you can see, it is easy to drink away hundreds of calories at holiday events without taking a single bite of food. Also, studies show that caloric beverages don’t tend to lead to satiety, meaning they don’t make people feel full or lead people to eat fewer calories from foods. In other words, drinks become empty calories – calories in addition to the foods being eaten. Try filling up with zero-calorie or low-calorie drinks, such as water, unsweetened tea and coffee. For a low-calorie spritzer, try mixing diet ginger ale with diet cranberry juice, and add some mint and fresh raspberries for garnish.


Weight control

DavisBaker: My wife is trying to lose weight. How can I support her during the holidays without feeling like I’m on a diet myself?

Anna_Taylor,_MS,_RD,_LD_: First of all, I’d like to commend you for being so supportive of her desire to improve her health. Here are some tips to help both of you enjoy the holidays:

Let her serve herself at parties, potlucks and dinners. Don’t bring her a drink without her asking for one, don’t offer to grab another slice of pie for her, and definitely don’t scoop her mashed potatoes for her. Although these may seem like harmless gestures, it will remove her control over her own portion sizes and dietary choices, and likely derail her best intentions.

Don’t bring extra holiday foods into your home. Your home should be a safe area for her with limited dietary temptations. Avoid bringing home leftovers from parties, buying holiday sweets or baked goods, or giving her boxed chocolate or other caloric foods as gifts.

Offer to be her exercise buddy. You mentioned you don’t want to feel like you’re on a diet, but everyone needs exercise, regardless of weight goals. Walking at the mall, going to the gym or even buying some new exercise equipment together (possible a holiday gift?) will show your support in a way unrelated to food.

Finally, show support through your words as well as your body language. Commend her for paying attention to her health during this time of year. If she shares any weight loss progress, celebrate with her in a non-food way (go to a play, watch a movie, buy her the scarf she has been eyeing). You don’t have to restrict your own calories to show her you support her efforts to improve her health.

holly: I seem to gain weight every year during the holidays, but I swear I keep my portions in check at holiday dinners. Why do I keep gaining weight?

Anna_Taylor,_MS,_RD,_LD_: There are many possible reasons for your weight gain. First of all, even if portions are small, having special holiday foods in the home over several days and weeks can definitely lead to excess calorie intake over time. Remember, it’s a holiday, not a holi-week or holi-month. Make sure to keep leftovers out of the home after special meals. Try sending things home with guests, or avoid taking leftovers home yourself if you are the guest. Be especially wary of sweets and baked goods. These pack a lot of calories into very small volumes. A few cookies can easily add up to hundreds of calories. Over time, those small portions can lead to a few pounds each year.

Also, many people find they are not quite as active during the winter months. If you are burning about 100 calories fewer each day, or eating 100 calories more each day, over one month, this will equal about 1 pound of weight gain. Try to stay active during the cold winter months. Find indoor exercises to do, join a gym or find a mall to walk in regularly. Aim for at least 150 to 250 minutes of exercise per week (or about 30 minutes five days per week) to support weight maintenance. Increased exercise intensity, duration or frequency will better support weight loss efforts.

Wilcox56: After gorging during a Thanksgiving feast, can I just exercise a lot the next day to work off the calories?

Anna_Taylor,_MS,_RD,_LD_: It’s true that exercise can help negate some of the unhealthful consequences of overeating, such as weight gain. However, a typical holiday meal with only one serving (no seconds) can have over 2,200 calories – and this is not including drinks, appetizers or desserts. It would take about four hours of non-stop walking (around 3 mph pace) to burn 2,200 calories. As you can see, this may not be a realistic plan to balance out over-eating during the holidays.

kernel: If I don't exceed my "weight maintenance" caloric intake for the day, can I eat anything I want during the holidays?

Anna_Taylor,_MS,_RD,_LD_: Indiscretion while making dietary choices can have far more health consequences than just weight gain, such as effects on cholesterol, blood sugars, blood pressure and digestion. These sorts of consequences can’t be directly “exercised away” in the same way that calorie intake can be balanced through physical activity (although it can help). For this reason, it’s important to remember that the nutritional quality of a meal goes beyond simply calorie-counting.


General information

thelma_louise: My husband always says that he needs a big breakfast on Thanksgiving morning to stretch out his stomach to make room for dinner. Isn't that a bunch of hogwash?

Anna_Taylor,_MS,_RD,_LD_: The human stomach is actually only the size of a human fist. For this reason, the stomach is meant to be able to stretch slightly to accommodate food intake. Following digestion, the stomach returns to its normal size. In other words, there is no reason to try to "stretch out" the stomach in the time leading up to a highly-anticipated meal. I would also recommend your husband consider reading the Q&A above regarding binging at holiday meals.


Closing

Moderator: That is all the time we have today for questions. Thank you everyone for participating today; and thank you, Anna, for your insightful answers to our questions about healthy holiday eating strategies.

Anna_Taylor,_MS,_RD,_LD_: I hope these nutrition tips help guide you in making healthy choices this holiday season. Although holiday foods are an enjoyable part of this time of year, remember to focus on what the holidays are really about – tradition, family, friends and celebrating the joy of the season with your loved ones. Happy holidays!


For Appointments

To make an appointment with Anna Taylor, RD, LD, or any of the other specialists in our Digestive Disease and Surgery Institute, Center for Human Nutrition at Cleveland Clinic, please call 216.444.3046 or toll-free at 800.223.2273, ext. 43046, or visit us online at www.clevelandclinic.org/nutrition.


For More Information

On Cleveland Clinic

Cleveland Clinic’s Digestive Disease and Surgery Institute (DDSI) offers patients the most advanced, safest and proven medical and surgical treatments primarily focused on disorders related to the gastrointestinal tract.

Part of the DDSI, the Center for Human Nutrition provides evaluation, education and treatment to people who have disease-related nutrition problems. Additionally, the Center is involved with a multitude of programs to promote health and wellness. Both of these efforts are driven by a dedicated team of registered dietitians, dietetic technicians, nurses, pharmacists, physicians and surgeons who work together to provide comprehensive support for patients with specialized nutrition needs.

The Digestive Disease and Surgery Institute has been ranked second in the nation by U.S. News & World Report’s Best Hospitals Survey since 2003 and first in Ohio since 1990.

Holiday Healthy Recipes

From Cleveland Clinic Digestive Health Team Dieticians:

Health Information
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