Category Archives: Nutrition

10 Tips for Treating Yourself Without Overindulging

This is a guest blog by one of our amazing dietitians Narmin Virani.  Enjoy her “just in time” tips this week:

With the holiday season upon us, being around sweets and treats is inevitable.  Don’t let this stress you out though.  Anxiety and fear around food and eating only keep you from relaxing and eating mindfully.  And when you’re not eating mindfully, you don’t enjoy the food, and don’t feel satisfied, which ironically makes you want more.  Relax!!  And try these simple tips for indulging without over-indulging.  Oh, and don’t take my word!  Try out these tips curiously, as an experiment, rather than “dietitian’s orders”, and see for yourself if they work, to reduce cravings and increase satisfaction!


  • Treat yourself on an empty stomach. Intense hunger = eating fast and eating too much.  Save a treat for the end of a meal when you’re comfortably full
  • Skip meals or snacks. Skipped meal = low blood glucose levels.  Guess what our brain asks us to eat when our blood sugar level is low, to keep us from fainting….? Have a shake if not hungry or too busy.
  • Save your treats for the end of the day. Fatigue is a trigger for overeating, as the part of the brain responsible for impulse-control starts fading toward the end of the day, and the auto-pilot part of the brain takes over
  • Deprive yourself of your favorite treats for days or weeks. When does a food become a “trigger food” or cause you to eat too much? When you haven’t had it for days, and know you won’t be having it for days.
  • Categorize foods as “good foods” and “bad/forbidden foods”. When you define success as “not eating X/Y/Z food”, then eating even a little of these foods makes you feel like you failed, leading to an unhealthy relationship with that food.


  • Eat small, frequent meals, every 3-4 hours, and don’t eat in between. This keeps blood glucose levels from crashing, which reduces cravings.  Have a shake if not hungry, or out and about.
  • Include some protein at every meal and snack – this also prevents blood glucose levels from spiking and crashing, by slowing down the absorption of carbohydrates, which reduces cravings. Remember the 3 craving busters – protein, fiber, and small amounts of fat at every meal and snack.
  • Include treats on a regular basis. If you give yourself a small amount of your favorite treats on a regular basis, its easier to tell yourself when you’re craving a second helping, “I can have some tomorrow, and the day after.”
  • Include your favorite treats in small amounts on a regular basis, along with some protein to keep the carbohydrates from causing cravings later in the day. For example – a 100 calorie bag of chips or cookies or pre-portioned ice-cream sandwich or bread, along with a piece of cheese, or some yogurt, or ¼ cup nuts.  You can have this sort of “balanced snack” everyday if you wish, as part of your 5 small meals a day.
  • Eat slowly and mindfully when treating yourself, and generally. Engaging all 5 senses helps you maximize satisfaction from every single bite.  Try to avoid multitasking when eating.
  • Stay hydrated. Thirst can get mistaken for hunger or cravings.  Especially make sure you’ve had a glass of water before you treat yourself
  • Engage in activities that you enjoy on a regular basis: Sweets and treats give us a dopamine rush and hence feel rewarding, but so do hobbies, socializing, exercise that you enjoy, meditation, and making a difference to others. The more circulating dopamine you have in your system, the less pleasurable food will feel.
  • Know the calories in your favorite treats. That way you can indulge in just the right amount, as often as you want, without any guilt.  And when you eat mindfully, just a few bites might be enough.

-Narmin Virani, RD, LDN

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by | November 21, 2016 · 8:02 pm

“Carbs” Clarfied by our own Anna Polucha, RD

Confused about carbs?

Check out this video by our own Anna Polucha, RD on carbohydrates.

If you still have questions, submit it in the comments section.

Keep Moving, Be Well,



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by | April 21, 2016 · 6:18 pm

Boost Weight Loss Success

weightWhat does the number on the scale represent?

Everything that makes up body weight- fat, water, lean tissue(muscle) bone, etc.

Here is an important fact about weight loss (on the scale) to know.

About 30% of weight loss is muscle when a person does not do strength training!

So losing 100lbs on the scale could be the loss of 30 lbs of muscle!

The scale only shows that the goal weight was achieved, not what was lost.

Is this successful weight loss?
If the scale is your only goal then yes.
But your goal, I am guessing, goes beyond the scale.

Being able to do more. Being able to keep the weight of long term. Those are important goals I hear all the time.

The muscle loss means:

  • a lower metabolism
  • easier weight re-gain
  • lower strength
  • reduced balance
  • lower bone strength

It would be easy to attribute these changes to just getting older or genetics.  Reality is, when muscle is lost, the body changes. You could say it ages faster.

stMuscle loss is invisible, but not inevitable.

The good news is that the equipment the body needs to regain strength, metabolism bone and balance is still there. The muscle fibers are still there, they just need to be re-activated.

Cardio exercise such as walking, running, elliptical, swimming etc. do not re-activate the muscle fibers anywhere near as well as strength training.
Give yourself the best chance for success with weight loss with these three “not-so-time consuming” steps:

  1. Adopt a strength training routine with
    1. 2-3 non-consecutive days a week (ie: every other day)
    2. 1-3 sets of a group of exercises that challenges all the major muscle groups
    3. 8-12 repetitions to fatigue. The fatigue part is important. If you can do more than 15 repetitions it is time to up the weights.
  2. Time a snack with protein right before or right after your strength session. Studies show this will improve fat loss and muscle gain. The details of how much protein used in the studies are a bit complicated for this article. Generally adding 10-20 grams of protein beforemilk or after strength training seem to make the difference. One study found simple glass of milk was effective (8 grams of protein).
  3. Stick with strength training for life! Because we tend to lose muscle with aging, even after you reach your goal weight, strength training can insure your strength, metabolism, bone density and balance stay strong.

Keep in mind one set of strength training exercises to fatigue two days a week will do it – it is about quality not quantity. So if time is a barrier, a little investment in time can go a long way.

I cannot stress this enough.

These are three easy steps to boost your weight loss success in as little as one hour a week!

And please, please do not let the myth of muscle gain get in the way. It takes a lot of work to gain muscle that will show up on the scale. A lot of time that most of us do not have. With all that is working against muscle (weight loss, aging,  menopause, etc) too much muscle is not a worry for most of us. If you do feel you have too much muscle, cut back to the minimum level of 1-2 sets two days a week to fatigue. But don’t give up all together on this metabolism saving exercise.

If you are a Weight Center patient and are not following these three steps, email me for more information on how to get on a program.

Keep Moving, Be Well,


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.


by | November 12, 2015 · 6:42 pm

Mindful Eating Summit + Another reason to do strength training

Here is another great free online resource coming up.  The Mindful Eating Summit is a five-day, 20 speaker online event.  It looks like a great way to learn about how habits and emotions affect the way we eat and tools for eating healthy.

And here is a nice article about research on strength training and  brain health!  I have one caution – please do not do the exercise like they are showing in the picture – elbows above the shoulder increases the risk of shoulder injury. Only raise the elbows to just below shoulder height.  Otherwise enjoy the article.

Keep Moving, Be Well,


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.


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by | October 22, 2015 · 8:13 pm

New Series for Patients After Weight Loss Surgery

Please join us for our new series starting November 5th 2015:
“Fresh Meal Ideas To Help You Stay On Track”
• Food tasting sessions
• Quick, healthy recipes and snack ideas
• Smart shopping tips
• Tips for eating out
• Cooking demos
• Easy calorie-counting
• Healthy potlucks

*Reminder: this is for patients who have already had weight loss surgery.

1ST Thursday of every month, 4-5 pm
At the Lazare / Hiatt Auditorium (or other location on University Campus)
(Please call, or stop by the Weight Center to confirm: 774-443-3886)
• November 5 2015
• December 3 2015
• January 7 2016
• February 4 2016
• March 5 2016
• April 7 2016
• May 5 2016
• June 2 2016
• July 7 2016

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by | September 17, 2015 · 6:03 pm

Enjoying Exercise and Better Food Choices

enjoy exercie 2As a part two from last weeks blog about enjoying exercise, here is an article on research finding the enjoyment of exercise can lead to less emotional eating.

This is just one of many articles that highlight the great side effects of exercise.  Enjoying exercise creates a surge in ‘feel good’ brain chemicals.  These are many of the same brain chemicals that surge when we eat foods high in simple carbohydrates and fats. With a healthy dose of these chemicals helping us feel good after exercise, we are not as likely to search for comfort foods.

We can get so focused on the amount of calories we burn during a workout, forgetting the huge value of enjoyment for gaining this lasting effect.  Doing a high calorie burning workout that you don’t enjoy may not have as many benefits in the end for weight loss as doing a more enjoyable, yet lower calorie burning session.

The goal is to burn only as many calories as you can ENJOY burning!

As highlighted in the last blog, the reasons we don’t enjoy exercise are often created by a wide variety of challenges.   We might think these factors don’t matter, or that there is no good solution.  Since they keep us from enjoying exercise, this article reminds us that finding solutions and enjoy moving again is a key to success.

So, on this beautiful week of end of summer weather, choose an activity you enjoy or find a way to make what you can do more enjoyable.

It sounds like a win-win.  We get to enjoy some time moving AND enjoy feelinenjoy exerciseg good about our food choices too.

Keep Moving, Be Well,


These weekly emails are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

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by | September 17, 2015 · 5:28 pm

Nutrition for the Bariatric Athlete (Endurance Events)

Hello everyone! I’m Anna Polucha, a registered dietitian at the Weight Center. I’d like to thank Janet again for allowing me to guest post on her athletes 3blog.

Let me just say, it’s exciting to know that there are enough post-bariatric athletes out there that we have to write a blog post for you! I’m so happy to see this population of people embracing exercise and fitness.

There is not a lot of information out there for bariatric athletes, so I’m going to try to shed some light on that. First, a big disclaimer: if you are exercising at a low to moderate intensity for less than 1 hour, you probably don’t need extra nutrition/calories to support your exercise or recovery.  In fact, taking extra calories in this case may hinder your weight loss. My advice for those of you who fall into this category would be to structure your existing meals and snacks so that they support your workout.

For example, after surgery you should be eating about 6 times per day (3 meals, 3 snacks). If you work out at 5pm after work, make sure you save one of your snacks to have about an hour before you work out, then have dinner within the hour after you work out. You’re not taking in extra calories, but the timing of your snack and meal support optimal performance and recovery.

When you start an exercise regimen or increase the intensity of the one you are currently doing, you may experience an increase in hunger. For example, going from light walking 30 minutes per day to doing a 45-minute boot camp class 5 days per week would represent a big increase in exercise intensity. Adding an extra 100-200 calories to your day would help to curb hunger but would still allow for continued weight loss. Try adding the following 150 calorie recovery shake within 30 minutes of completing your workout:
1-2 Tablespoons protein powder
½ cup frozen fruit
1 cup skim milk
(Blend until smooth)

Please use the following guide to assess your calorie needs after weight loss surgery:

  • Man or Woman less than 1 year out from surgery needs 800-1000 calories per day
  • Inactive woman, more than 1 year out from surgery needs 1200-1300 calories per day
  • Active woman, more than 1 year out from surgery needs 1400-1600 calories per day
  • Inactive man, more than 1 year out from surgery needs 1400-1500 calories per day
  • Active man, more than 1 year out from surgery needs 1500-1700 calories per day

Endurance Athletes
As a note, many of the below nutrition requirements are based on an athlete’s weight. If you are overweight, considering using your ideal body weight (IBW) in place of your actual weight when doing the calculation. IBW for women is 100 + (5 x every inch over 5 feet). IBW weight for men is 106 + (6 x every inch over 5 feet). To get your weight in kilograms, divide pounds by 2.2.

For those who are training for long distance cardiovascular events, you have increased nutritional needs. You will need more calories and carbohydrates to support the large amount of energy you will be using during your training sessions and the event itself. For this reason, training for an endurance event should not be used as a way to lose weight. Completing long training sessions without enough calories or carbohydrates to fuel your body can lead to sub-optimal performance, burn out, or injury.

If you are still trying to reach your goal weight but would also like to train for a race, try a shorter distance race like a 5k or 10k. You can still fuel like an athlete, but you likely won’t need so many extra calories during the day to support your physical activity. An extra 100-200 calories per day would likely be enough to combat the increased hunger that will likely come from adding an exercise regimen to your lifestyle.
Calculating calorie needs for a post-bariatric patient is difficult and should be very individualized. For patients who have reached their goal weight, we generally recommend 1400-1600 per day for active women and 1500-1700 per day for active men. Your needs will go above and beyond this on days that you have longer training sessions.

It is recommended that endurance athletes eat 60% of their calories from carbohydrates. To calculate this, take your calorie intake for the day and multiply it by 0.6. Then divide that number by 4. That is the number of carbohydrate grams you need daily to support optimum performance. For a 1500 calorie per day diet, that number is 225 grams.

athletes 2The bariatric athlete may not be able to hit such a high number due to pouch space constraints or fear of dumping syndrome. In this case, try increasing your carbohydrate count slowly over time and use a number of high quality carbohydrate sources. Whole grains, fruits, vegetables and low fat dairy products are good choices. Be careful not to sacrifice your protein intake for carbohydrates.
Protein requirements for the endurance athlete are 1.2-1.4 grams per kilogram of body weight. For a 180 pound person, that is 98-115 grams of protein per day.

Keep in mind, most whole grains and vegetables have small amount of protein in them, so you can count the protein in those items towards your daily intake. A half cup portion of cooked steal cut oatmeal has 27 grams of carbohydrates and 5 grams of protein. Try mixing in half a scoop of protein powder or a few egg whites and you’ve got a perfect breakfast for the bariatric endurance athlete!

Before the Endurance Event

Before a long distance training session or event, the typical recommendation is for an athlete to take in 1-4 grams of carbohydrate per kilogram of body weight. For a 180 pound person, that is anywhere between 80 and 330 grams! Bariatric athletes may not be able to reach that number, so the goal would be to increase carbohydrate consumption before an event to a level at which you are comfortable and see performance improvement.

Carbohydrates before an event should be easily digestible. Bananas, figs and white breads are popular. Foods high in protein and fat are digested more slowly, and you may need to avoid them in the hour before the event. Liquid nutrition (sports drinks for example) may be preferred because they empty through the pouch quickly. Experiment with pre-race fueling during your training runs to see what works best for you.

During the Endurance Event

During long distance training or events, the athlete should take in 30-60 grams of carbohydrates every hour. The bariatric athlete will want to spread this out in smaller portions. Popular items for race fuel include carbohydrate gels and drinks. Gummy candies also work well for quick and easily digestible energy. Energy gels may have between 20 and 25 grams of carbohydrate per packet. Sports drinks have around 15 grams of carbohydrate per 8 ounces. Bariatric athletes may consider competing with hydration back packs, which would allow them to drink small amounts continuously while racing.
After the Endurance Event
Nutrition during recovery is vital for good performance. Aim to have 15 grams of carbohydrate (equivalent to about 1 slice of bread or 8 ounces of a sports drink) within 30 minutes of finishing. One to two hours after finishing, have a larger portion of carbohydrate rich food with some protein mixed in for muscle recovery. Good examples include a banana with peanut butter, a glass of milk or a turkey sandwich.
Special Considerations for the Bariatric Athlete

Taking in too many simple carbohydrates can cause dumping syndrome and will need to be avoided in those who have had gastric bypass surgery. There is some thought that glucose ingested while exercising is less like to lead to dumping syndrome, but this should be tested individually and carefully. Try taking a sport drink or sports gel during one of your training runs with facilities nearby. As a general rule, foods like bread and fruit do not cause dumping syndrome and could be used in place of sports drinks and gels.

Dehydration is common in bariatric patients and should be monitored closely while training. Getting a before and after workout weight is an excellent way to determine hydration status. If the post-workout weight is lower than the pre-workout weight, that indicates water lost through sweat and respiration. Make sure to replace those water losses during the event and shortly thereafter. Consider using a hydration back pack while running, cycling or hiking so that small, frequent sips can be taken during exercise.athletes 4

Bariatric patients are advised not to drink 30 minutes before and 30 minutes after meals, so as not to stretch the pouch. This may make taking in enough nutrition difficult. Try using liquid nutrition, like sports drinks, protein drinks or shakes if this is an issue for you. Liquid nutrition often counts as both fluid as well as calories (carbohydrate or protein). In fact, chocolate milk is often touted as the perfect recovery drink for endurance athletes!

Micronutrient Considerations
Training for long distance endurance events can change the athlete’s requirement for vitamins and minerals. This is especially important to note for bariatric athletes, who may have altered or limited absorption of some of these micronutrients. Below are some micronutrients worth considering.

Micronutrient Recommendations

  • Vitamins C, E, A:   Increased needs may be found in some endurance athletes. Taking a complete multivitamin should offset any possible deficiency.
  • Calcium, magnesium, potassium, sodium and chloride:  These electrolytes are often lost with excessive sweating, which is common in endurance training, especially in hot environments. Take a complete multivitamin with minerals. Rehydrate using an electrolyte rich sports drink (for example, Gatorade or Powerade).
  • Iron:  Runners may experience increased iron needs. Take a multivitamin with iron as well as the recommended iron supplement. Have your blood work done annually to ensure no iron deficiency has developed.

Check out this website  as an additional resource for recipes and advice specific for bariatric athletes.

Please post your comments on this topic…

Thank you!


by | June 11, 2015 · 8:06 pm