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A few small changes, and a big one, are keys to healthier living

April 23, 2006 12:50 am

TAHIRIH JORDAN wants to be healthier, for herself and her 10-year-old son. The 36-year-old is overweight and worries her son is destined for weight problems, too.

A Spotsylvania County day-care teacher, Jordan sent me her food diary in hopes of getting advice on how to plan and cook healthier plans.

"I have lost weight, but can't seem to lose the last 20 pounds," said Jordan, who teaches 3-year-olds.

Along with reviewing her food diary, I also interviewed Jordan to get a better sense of her lifestyle, food preferences and health concerns.

Jordan is 5-foot-4, weighs 202 pounds and is hoping to reach 150 to 160 pounds.

She reported eating five times daily and exercising for a half-hour to 45 minutes daily, both great habits for someone trying to lose weight.

But occasional binge eating lurks like a monster in the closet, sabotaging her efforts to take care of herself.

Jordan's days start early. Her first food diary entry was at 5 a.m., when she reported drinking a large cup of coffee with lots of sugar and milk.

She ate a decent breakfast that included fruit, and a relatively early lunch that included veggies but a bit too much turkey.

Home in the early afternoon, she ate a healthy snack. Dinner was heavy in meats and cheeses. To her credit, she drank lots of water throughout the day. (See her full journal on the back page.)

When I analyzed her diet, Jordan was getting enough of most nutrients and fiber. On that day, she consumed about 2,100 calories, which would be perfect for weight maintenance. It's a bit high for weight loss, though, at least for her age, height and activity level.

I would recommend 1,400 to 1,700 calories for Jordan to lose weight.

Also, Jordan is getting double the amount of artery-clogging saturated fat she needs, 46 grams rather than 23 or under. She's getting double the amount of fat in general, 120 grams, when her needs range from 47 to 82 grams.

And she consumed about 5,300 milligrams of sodium, much more than the 3,500-milligram limit for a person with normal blood pressure.

Finally, she's getting almost triple the amount of protein she needs, about 125 grams compared to the minimum of 45 grams.

Jordan, like so many others, could make a few simple changes to get her eating in line. First would be limiting meats to palm-sized portions, 3 to 4 ounces. This would cut her portion of lunchtime turkey in half. She could add some cooked veggies to get back to the same volume with fewer calories.

Trying fat-free gravy, made with flavorful low-sodium chicken broth simmered with a bit of cornstarch to thicken it, also would reduce calories and fat but preserve flavor.

To improve on the chili she ate at dinner, Jordan might switch to a savory vegetarian bean chili--or at least reduce the amount of ground beef dramatically.

Next, switching to lower-fat dairy products, like 1 percent milk for her coffee and low-fat cheddar and reduced-fat sour cream for the chili, also would help.

Jordan also could use a bit less cheese, about cup instead of cup. If she uses sharp low-fat cheddar, which has more flavor than mild cheddar, she may not even notice the difference.

These small changes would allow Jordan to continue eating familiar, comforting foods but reduce calories to 1,700 and keep a lid on saturated fat and sodium.

I'd also like to see Jordan take a calcium supplement to make sure she preserves strong bones while losing weight. She is pretty close to the recommendations and would need only about 250 milligrams of calcium, roughly the amount in a Rolaids tablet.

Jordan has many good habits already. She reports exercising for about 45 minutes daily, with an elliptical trainer, bike or treadmill.

She is highly motivated: "I will do whatever it takes," says Jordan. "I will spend as much time as I need to."

She says she's "very confident" in her ability to improve her health, especially because she's already made many changes.

Jordan and her son eat dinner together most nights, which sets a good example for her son.

I think Jordan's No. 1 problem is that she reports binge eating sometimes after work.

"I will eat until I am stuffed, and it doesn't matter what I am eating," she said. "I don't have to be hungry."

Most people with binge-eating disorder use food to soothe emotional distress, such as feelings of anxiety, depression, fear or inadequacy. They stuff down the difficult feelings with food.

I would recommend two things for this. First, that Jordan consider seeing a therapist or counselor who specializes in treating eating disorders. Therapy can help Jordan learn other techniques to deal with feelings. Working past her binge eating will set a good example for her son.

Regular visits with a dietitian who is familiar with binge eating problems also would be helpful.

Also, Jordan may try setting rules around eating to help prevent triggering a binge. It's often helpful to eat only at a table, with the TV off, using dishes, not eating out of packages. Jordan said she already came up with some of these ideas to teach her son good table manners.

Another thing that may be helpful is to try chromium picolinate supplements, about 400 milligrams daily. Not everyone responds to chromium. If Jordan didn't see any changes in her cravings to binge within a week, I'd recommend stopping the chromium supplements.

Omega-3 fats found in fish oil and ground flaxseed also can be helpful with eating disorders, so I'd recommend a supplement. But the chromium and omega-3s cannot replace therapy.

Jordan could consider a few other changes. She reported watching 35 to 40 hours of TV weekly. I recommend limiting TV and video games to two hours a day or 14 hours weekly, not just for her sake, but also for her son's.

Research shows that children who watch more than two hours of TV a day are heavier than their peers, probably because they watch TV instead of playing outside. They also see more commercials for junk food.

Jordan says her son sits inside with video games for long periods of time, and she is considering investing in a gadget to encourage him to move.

"I found a stationary bicycle that hooks to the remote control for the video game," she says. "You've got to pedal it to make the game work."

Jordan says she's not sure what to cook, how to cook, or how to plan meals. For her and others like her, I recommend the book "Meal Solutions for Busy People," by Shirley Chambers and Sharon Smalling.

The American Diabetes Association also has a great series of cookbooks, with mix-and-match menus, called "Month of Meals." Themes include "Meals in Minutes," "Soul Food" and "Vegetarian Pleasures."

Although Jordan doesn't have diabetes, the menus are healthy for everyone, and they are in the 1,500-calorie range, which would help her lose weight.

I wouldn't get hung up on counting calories, however. It sounds paradoxical, but for a person who has a tendency to binge-eat, counting calories can lead to feeling deprived, which can trigger the urge to binge.

For the long-term, I would recommend working with a dietitian using the nondiet approach, which emphasizes tuning in to the body's natural signals of hunger and fullness.

If Jordan is interested in cooking classes, many parks and recreation departments and community colleges offer them.

She also indicated she gets take-out meals or frozen meals several times a week. Again, a dietitian can give tips for reading labels and making healthy choices.

To summarize, I think the most important thing Jordan can do is consider counseling with both a therapist and a dietitian about her binge eating. I hope anyone in a similar situation would consider such counseling.

Bumping up her exercise to 45 to 60 minutes five days a week will help Jordan, too. And that advice can help anyone wanting to lose weight, or simply be fitter.

Other things to try that will be helpful on a smaller scale include limiting TV, eating less saturated fat and using menus to plan meals. For Jordan, and perhaps others in her situation, trying supplements of chromium, fish oil and calcium could help, as well.

For those interested in tracking their own eating patterns, check out mypyramidtracker.gov, a free Web site sponsored by the U.S. Department of Agriculture.

You plug in what you eat and what your physical activities are, and the site spits out an analyses of your consumption of calories, fats, carbs, protein, fiber, etc.

The Web site is not perfect. It does not, in my opinion, make enough adjustments in calorie recommendations for people who desire weight loss or gain, or who need special eating plans for medical issues. It also doesn't give you suggestions for how to tweak your eating patterns for the better.

For that, I recommend finding a registered dietitian. Try the American Dietetic Association's toll-free Consumer Nutrition Hot Line at 800/366-1655, or online at eatright.org.

JENNIFER MOTL, a registered dietitian, welcomes reader questions via her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.