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DrRic Fit not Full (slide share edition)


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Lecture given by me and Dr Jason Gruss at the Elk Grove Library in May 2011

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DrRic Fit not Full (slide share edition)

  1. 1. Eat to be FIT,not FULL<br />Dr. Jason Gruss, M.D.<br />Dr. RicSaguil, M.D.<br />Spring 2011<br />We didn’t invent the practice of medicine….<br /> we’re just changing the way it’s provided.<br />
  2. 2. First Health Associates<br />2010 S. Arlington Heights Rd<br />LL Suites<br />Arlington Heights, IL<br />My Doctor:<br /><ul><li>Listens to my concerns
  3. 3. Cares what I have to say
  4. 4. Doesn’t Keep Me Waiting
  5. 5. Gives Me Options</li></ul>We didn’t invent the practice of medicine….<br /> we’re just changing the way it’s provided.<br />
  6. 6. The First Health Approach<br />We didn’t invent the practice of medicine….<br /> we’re just changing the way it’s provided.<br />
  7. 7. Your Community<br /> of Care<br />Ric Saguil, MD<br />Jason Gruss, MD<br />Tom Jordan, RD<br />Katrina Christie, LCPC<br />Jennifer Green, ND<br />Joe Musolino, DC<br />Amy Iaquinta, DC<br />Nick Nowicki, DC<br />Emery Paredes, PT<br />Courtney Day, EP<br />Yu Zhu, MD China<br />Mike Blumberg, LCPC<br />You<br />
  8. 8. Today’s Goals<br />Learn what hunger is<br />Discuss what ‘BEING FULL’ means<br />Explore what SATIETY is, and how that is DIFFERENT than ‘FULLNESS’<br />Learn how to be SATISFIED, without stretching your stomach and packing on Calories<br />
  9. 9. Before we begin . . .<br />Look around<br />The room<br />The village<br />The airport<br />The country<br />The world?<br />2/3 of the US is either Obese or overweight.<br />That number is GROWING!<br />Since 2006 Obesity is the #1 cause of preventable death <br />Ahead of cigarettes<br />
  10. 10. Obesity is a Disease<br />There is NO CURE<br />No pill / surgery / magic potion will take away obesity<br />There is SUCCESSFUL TREATMENT<br />The treatment is creating a healthy life, through whatever means YOU need<br />Everybody is different, not all the tips work for everybody<br />Take whatever tips work for YOU!<br />Ask for help if you need it<br />
  11. 11. What is Hunger?<br />Physiological Response (Survival mechanism)<br />Secondary Responses:<br />Psychological Response coping mechanism<br />It is easier to EAT than it is to admit you have a problem<br />Stress Response?<br />Ever eat when you are:<br />Bored? Procrastinating? Nervous?<br />
  12. 12. The Hormonal Tsunami<br />Break down of the physiologic response:<br />Stress Response- fight or flight<br />Hans Selye 1975<br />Relaxation Response- eat or reproduce<br />Herb Benson, MD 1975<br />
  13. 13. Epinephrine, adrenaline, cortisol increased in stressful, dangerous environment <br />Prolactin, oxytocin, NPY all increased in relaxed, protected environments.<br />Stress/Relaxation<br />=<br />Sympathetic/Parasympathetic<br />
  14. 14. Godzilla VS Ghandi<br />
  15. 15. Why can’t we just co-exist?<br />Athletes.<br />In a state of relaxation response but …<br />can turn on an abnormally high stress response<br />
  16. 16. Know Your Enemy Sun Tzu<br />To keep the herd alive;<br /> Starvation mode=Stress response<br /> Hunger will start the hormonal cascade<br />Hunger/Stress <br />
  17. 17. What Causes Hunger?<br />Low Blood Sugar<br />Erratic Blood Sugar<br />Binge eating<br />Fasting<br />Stress<br />Fatigue<br />Lack of sleep<br />Emotional/Physical<br />Binge Eating (Holiday Meals)<br />Junk Food Diet<br />Dehydration<br />Stress/Emotions<br />
  18. 18. What Causes Fullness?<br />Stomach Distension<br />FULLNESS can happen as fast as you can eat<br />
  19. 19. What Causes Satiety?<br />Smell/taste<br />Conscious eating<br />Environmental cues<br />Satiety cannot be rushed<br />The brain works slower<br />
  20. 20. Satiety Strategies<br />Avoid Distraction<br />Disrupts brain-to-stomach satiation signals<br />No eating at Car…. TV…. Reading….<br />Conscious eating<br />Goal: satisfaction not fullness<br />The brain is our most powerful tool,<br /> if we use it!<br />
  21. 21. Stress is a Distraction<br />Kathy<br />204#<br />Cholesterol: 245<br />Kathy<br />141# (in the 120s today)<br />Cholesterol:191<br />Weeks 1-4: 3 Pounds Lost (0.75# per week)<br />INTERVENTION: counseling to address stress<br />Weeks 5-28: 48 Pounds Lost (2# per week)<br />
  22. 22. Satiety Strategies<br />2) Pack in the Protein<br />Solid food <br />Soups ok, but not beverages<br />Stimulate CCK slow gastric emptying<br />FEEL full longer<br />Prevent Glucose Spikes<br />Prevents the body from going into STORAGE MODE<br />Prevent nutrient deficiencies (B1, B12, Fe…)<br />Your body will have cravings for what it’s missing, but your brain will just get the signal to EAT<br />Provides Amino Acids (building blocks)<br />‘Dieters’ lose fat AND muscle, eating more protein helps save the muscle and lose more FAT<br />
  23. 23. Satiety Strategies<br />3) Fill Up on Fiber<br />6g Soluble Fiber has the same satiating effect of 260 calories (ADA study 2009)<br />Refined Carbs=Satiety killers<br /> (insulin spike blood sugar crash  store the excess Cal as fat)<br />Whole Grain Carbs<br />‘100% whole grain’<br />25-35g Fiber Per day<br />Eat more often, avoid hunger by having 3 meals and 2 snacks a day<br />But avoid eating more than 600 Cal at any one sitting<br />Goal is 400 for a meal and 100-200 for a snack<br />
  24. 24. Protein and Fiber for Satiety <br />Bill<br />254#<br />Triglycerides: 338<br />Bill<br />189#<br />Triglycerides:68<br />Bill’s Meal PlanB: High FiberOatmeal<br />Sn: Cottage Cheese<br />L: TurkeySandwich + Carrot Sticks<br />Sn: 2 String Cheese<br />D: 4oz Protein, 1c Carb, 2-3c Veggies<br />
  25. 25. Satiety Strategies<br />Know What (and when) to Drink<br />Think of stomach like a balloon… full balloon=signals to stop<br />Liquid Calories = NO EFFECT on Satiation, they don’t spend enough time in the stomach to register a signal<br />Water Rich Foods (soup, salad, fruit, veg’s) = + Satiety<br />Drink water 30 min before meals, sip during<br />Avoid dehydration<br />
  26. 26. Satiety Strategies<br />5) Savor the Flavors<br />Chewing food increases “oro-sensory” factors<br />Smell / Taste are slower to process<br />(2009 Study) Chewing food for an additional 3 seconds reduced calorie intake<br />
  27. 27. Satiety Strategies<br />6) Downsize your Snacks<br />Small Frequent meals are good…. But 400 calories every 3 hours though<br />Goal of snack= 100-200 calories decreases binge eating or overconsumption at following meal<br />High Protein/Fiber options: beef jerkey, nuts, cottage cheese, Greek yogurt, fiber one bar, fruit<br />
  28. 28. Balancing Blood Sugars w/ Small Snacks<br />Pillars of Blood Sugar Management<br />Nutrition<br />Physical Activity<br />Weight Control<br />Stress Management<br />Medical Monitoring<br />Mary<br />292#<br />Fasting <br />Blood Sugar: 107<br />Mary<br />227#<br />Fasting <br />Blood Sugar:93<br />
  29. 29. The Glycemic Index Concept<br />David Jenkins initially studied effects of multiple small meals<br />vs 3 large meals (lower LDL and insulin levels)<br /> New England Journal of Medicine 1989<br />Further studies lead to classification system of foods….<br />
  30. 30. Absorption of the carbohydrate<br />
  31. 31. Spaghetti<br />White Bread<br />
  32. 32.
  33. 33. Food studies using the GI<br />When a proper breakfast is taken<br />“Second meal effect” with low glycemic index meals vs 81% more calories by end of day with high GI breakfast (just from hunting the remainder of the day)<br />The gut stress response is turned on:<br />Catecholamine, glucagon, cortisol, growth hormone hormone. <br />Blood sugar below baseline occurs <br /> “reactive hypoglycemia”<br /> Craving starts instinctively for starchy foods, feel ravenously hungry=<br /> out of control eating<br />
  34. 34. Other rating systems<br />Meijer = NuVal<br />Marianos = Nuval<br />Whole Foods Market = ANDI MANDI<br />Jewel Osco = Color Code/Index<br />Please see a profesional-<br />A Registered Dietician!!<br />
  35. 35. Satiety Strategies<br />Key Components:<br />Avoid Distractions<br />Pack in the Protein<br />Fill Up on Fiber<br />Know when (and what) to Eat<br />Savor the Flavors<br />Downsize your Snacks<br />Hara Hachi Bu (stop when 80% full)<br />
  36. 36. Bonus Round<br /> 1) Have food ready to eat:<br />Melon, Berries, Apples, Carrots, Cucumbers, Broccoli<br />Green Peppers, Tomatoes, Mushrooms<br />2)Double the veggies in any recipe<br />3) Egg white omelets + onion, tomato, green pepper<br />4) Add Flavor/Spice: herbs, pepper, cayenne, ginger<br />
  37. 37. Bonus Round 2<br />Hidden Gems:<br />Iced Tea (unsweetened)<br />Low Cal/No Cal Drinks<br />HEAT! Cayenne, Cumin, Chili powder, paprika<br />Flavor! Oregano, Dill, Lemon<br />Fresh Seafood<br />Vinegar: white, red, balsamic, cider<br />
  38. 38. Bonus Round 3<br />Plan ahead!<br />Do you go grocery shopping hungry?<br />Do you bring a list?<br />Use the same strategies with food:<br />Write down TOMORROW’S meals TONIGHT before bed<br />Meal or snack coming up soon? Drink a glass of water before getting the food ready<br />
  39. 39. The Satiety King<br />Paul<br />191#<br />“Eat until I’m stuffed” (FULLNESS)<br />Paul<br />173#<br />“Eat Until I’m Satisfied”<br />
  40. 40. What I’ve Learned<br />If controlling your weight was easy, everybody would be in great shape.<br />If I could have done this by myself, without help, I never would have gotten overweight in the first place.<br />
  41. 41. QUESTIONS?<br />RESOURCES<br /> Food Log:<br /> Weight Control:<br /> Medical:<br />