Healthy Food & Healthy Living by Dr. Ayala

Dr. Ayala's Baba Ganoush Video Recipe

This recipe is a Mediterranean favorite. Really easy. Keeps well refrigerated for 5 to 7 days. Let me know what you think of this visual recipe and enjoy!

Dr. Ayala

Fatter, in all the wrong places

The fact that the majority of Americans are overweight isn’t any news. But here’s a worrisome new finding: The extra padding we’ve added as a population has accumulated in the worst location for our health — our belly — and even people with normal weight seem to be getting wider waistlines.

A new study led by Helen Walls in the research journal Obesity looked at trends of both BMI and waist circumference, comparing the data of two US national surveys, one held in 1988-1994, and the other in 2005-2006. Overall, the study looked at the measurements of almost 20,000 nationally representative adults, and found that bellies expanded disproportionately during the decade and a half studied.

Short intro to BMI and waist circumference:

BMI (body mass index) is a screening measure for overweight, useful for studying populations, and calculated by dividing the weight in kilograms by the square of height in meters. It doesn’t differentiate between fat and muscle, but BMI correlates quite well with body fat in most people. A BMI of above 25 categorizes people as overweight, and above 30 as obese.

Waist circumference simply measures the waist at the top of the hip bone. A waist circumference of more than 40 inches for a man and more than 35 inches for a woman is considered as “increased risk” for chronic diseases affected by obesity (lower cut-off numbers are suggested for certain ethnic groups, such as Asians).

Here are the study’s main findings:

• Between 1988-1994 and 2005-2006 the mean BMI increased by 1.8 kg/m2 to 28.7 kg/m2 (BMIs above 25 kg/m2 are categorized as overweight)

• Between 1988-1994 and 2005-2006 the mean waist circumference increased by 4.7 cm or 1.9 inches

• During the decade and a half between studies waists widened over and above what would have been expected by BMI

• Waist circumference increased in all weight categories of people younger than 50 years: The waists of people with normal BMI’s went up too, and there were substantially more normal weight men and women with “increased risk” waist circumference in the later study.

• Waist circumference went up in all ethnicities, education levels, and for both men and women

BMI doesn't tell the whole story

The researchers warn that by using BMI as a single tool to monitor the population’s obesity we may be underestimating the risk burden of obesity related disease.

Indeed, several studies have shown that belly fat is much more risky than general obesity and that fat distribution patters do matter. Belly fat or “visceral fat” is the fat deposited between the abdominal organs, is especially active metabolically and plays a part in insulin resistance and diabetes, lipid abnormalities, hypertension and cardiovascular risk. Think of it as a big gland, secreting metabolically active signals.

And perhaps, fitting into your old tight jeans is a better measure of healthy weight than the number on the scale.

Why are bellies getting disproportionately bigger? Some ethnic groups — such as Asians, Indians and Hispanics — have a higher tendency to accumulate abdominal fat, but this study found the trend of widening waists held even after stratifying by ethnicity. Other factors suggested to affect belly fat buildup include lack of exercise, over-intake of sugars, sleep deprivation, aging, imbalanced hormones, being male, stress and certain drugs.

What’s clear is that we don’t get to choose where our fat is deposited. Unfortunately, no amount of sit-ups will make a fat belly go away (the overlying muscles will get stronger, but the fat inside won’t dissolve preferentially in the exercised areas).

So what to do about abdominal fat? Eating a healthy diet and adequate aerobic exercise can prevent the buildup of belly fat, and losing weight will shrivel it. The good news is that visceral fat is lost preferentially with even modest weight loss — belly fat is the first to go when you lose weight!

Dr. Ayala

Cooking makes the heart grow fonder

I started teaching my kids how to cook as soon as they showed the slightest interest. My first kitchen adventure with them involved making a good green salad, and included the basics of how to wash and dry lettuce, and the simple principles of mixing a good salad dressing. The second lesson’s product was a nice bowl of lightly salted edamame in their shell, which my kids still think of as “addictive food”.

I didn’t get into brownies and cupcakes until much later. I figured that creating a dish makes its creator treasure it, and why waste a lesson of love on brownies, which any kid’s bound to fancy anyway.

In his new book The Upside of Irrationality Dan Ariely, professor of behavioral economics, devotes a chapter to the well know phenomenon of falling in love with the things we make, and the irrational value we attribute to the objects we had a more intimate relationship with. Ariely titles the chapter “the IKEA effect”— the Swedish maker’s assemble-it-yourself shelf Ariely labored over for hours somehow has a special place in his heart, and Ariely investigates why it’s so.

Through a series of experiments, involving the creation of origami animals, Lego patterns, and real-life examples of successful and unsuccessful businesses, Ariely comes to several conclusions regarding the evident connection between labor and love:

• Putting effort to an object changes how we feel about it — we value the things we labor over

• The harder we work on something, the more we love it

• We’re so invested in the things we labored over, and value them so much, that we assume others share our (biased) overvaluation of our creation

• Although working hard on a task makes us love it more, not completing the task is a deal breaker. We have no attachment to tasks we failed at or failed to complete.

Interestingly, Ariely also shows that both people and animals would rather earn their keep and work for their food. Even mice seem not to value free meals, at least not on a regular basis.

Kids in the kitchen

The lessons above are valuable and applicable to many aspects of life: I think “the IKEA effect” chapter (the whole book in fact) is a good read for any employer or employee seekeng greater work productivity and satisfaction, and for any parent contemplating showing his kids photos to a stranger (no, he doesn’t think your kids are the cutest — he couldn’t care less).

But back to kids in the kitchen. Learning how to cook is a valuable life skill that will not only enable kids to eat healthier — no matter what you make at home it will usually be healthier than the bought version — but can also be a great tool in directing their preferences toward those foods you’d like them to eat more of, namely, fruits and veggies.

Ariely’s lesson also made me think of the importance of giving kids a task they can complete. I suppose that being responsible for just one small step in a complicated dish would result in much less creator’s pride than being able to claim the creation from start to finish as your work. So selecting recipes that are of just the right technical difficulty to be challenging, but not too hard for a kid to complete is the name of the game.

This week we made potato gnocchi from scratch. I wasn’t sure my kids would be able to create dumplings that hold up in the boiling water their first try — I had many less than stellar attempts at this dish before I sort of mastered it — but beginners luck, or maybe I can take some credit as the instructor, they made incredible light-as-a-cloud gnocchi.

Ariely wrote nothing about clean-up having anything to do with the creator’s adoration of his handwork. Wish he did — I tend to find myself all alone when clean-up comes, and honestly, I can’t tell my kids that clean-up will result in great satisfaction in the same way cooking and serving your creation does.

I’d love to hear about your adventures in the kitchen as a kid or with kids.

Dr. Ayala

posted as part of Food Renegate's Fight Back Fridays--go join the food fight!

Back to school with a healthy lunch

I'll be taking a few weeks off to spend time with my family and travel, and will write infrequently during August. Meantime, I'll be reposting some of the more popular posts I’ve written over the past years so that new readers have a chance to catch up.

I hope you all had a great summer, and a happy new school year to all!

As kids go back to school it’s a good time to take a good look at another aspect of their school days: What our kids eat at school, and which steps we can take to improve their nutrition, eating habits and food enjoyment this year.

Start with breakfast

It’s quite intuitive and common sense that children should eat breakfast before they leave home in the morning. Research has also shown that children who skip breakfast don't do as well in school as students who do, and tend to actually be heavier than breakfast eaters.

Yet many kids skip breakfast, and up to a third of teenagers skip breakfast regularly.

Whatever the kids eat at the breakfast table is better than no breakfast at all, but I’d recommend whole grain cereal, oatmeal or bread, a protein such as cheese, peanut butter or an egg, and fruit. Whole fruit, by the way, is much better than fruit juice.

I do not see pastries such as donuts and muffins as breakfast food. Those really sweet cereals that taste like a cookie fall into the same category. To me they're desserts, best eaten sparingly, infrequently, and on a full stomach.

What’s for lunch?

We’d like to believe that we can trust the schools to feed our kids’ bodies as well as their minds. Schools are in a unique position to help improve kids’ eating behaviors and prevent and reduce obesity.

Unfortunately, most school’s food environments are a far cry from what’s taught in nutrition classes. All to often cafeterias rely heavily on cheap processed food.

So take a good look at what’s offered at the cafeteria, and ask your kids what they actually pick from the offerings--if there is a salad bar, that doesn’t mean that the kids eat from it when the other option is French fries.

Also look at the competitive foods offered at schools. Those are the foods available for purchase, in a la carte lines, vending machines, school stores and school fund raisers, and consist mostly of beverages and snacks of poor nutritional quality—sugary drinks, chips, cookies and candy.

The only USDA regulations regarding the sale of competitive foods is that foods of minimal nutritional value shouldn’t be sold during meal times in areas of the school where USDA school meals are sold or eaten. However, those foods can be sold anywhere else on campus – including just outside the cafeteria – at any time. Foods of minimal nutritional value include chewing gum, lollipops, jelly beans and carbonated sodas.

On the other hand, chocolate bars and chips are not considered foods of minimal nutritional value and therefore can be sold right in the school cafeteria during meal times. Schools count on the revenues from these sales, and are reluctant to impose additional restrictions to their availability.

Yes, it’s hard to believe, but schools and the snack food industry share a common interest of peddling junk food to kids.

What’s a parent to do?

There are some schools that are great food environments, in which kids don’t only learn about nutrition, but also grow their own food, connect with local farmers, learn how to cook, and have delicious meals made from scratch freshly made in the school kitchen daily. I hope and believe the number of these schools is growing, but unfortunately, there are many schools that introduce kids to unhealthy eating habits and lots of junk food.

After assessing what’s offered in your kids’ school, if you don’t like what you see, voice your concern. Your opposition to the status quo can be a short letter or email to the school. Raise the topic when you meet fellow parents, or get more active and involved if you have the time and will.

But for immediate results you can decide to opt out. And the explanation you give your kids is as important as what they actually eat.

Packing your kids lunch on some or all school days gives them an idea of what you think lunch should be. Introduced right, it will be interpreted as some extra loving care and an opportunity for kids to have their own choices of good food, and not as a denial of treats.

There are vending machines in my kids’ middle school. I gave them some money on the day they visited the school for the first time, to “buy junk” – making sure they know that this will not happen often. As long as it’s framed in the right perspective, I think a little bit of junk will do no harm, and turning junk into forbidden fruit gives it too much importance and allure.

On the other hand, confusing these items with lunch, and eating them on a regular basis is why many people think that the school food environment contributes to the obesity epidemic.

Have some healthy food ready when they come home

My kids come home really hungry. Considering that there are many hours between lunch and the time kids arrive at home that’s not surprising. That’s why a small mid-afternoon or early evening meal makes sense.

Having a bowl of fruit or nuts out works well. In the past year I started serving yesterday’s leftovers as the afternoon small meal. It’s nice to sit together in the afternoon and talk about the day, and makes good use of the leftovers.

Regardless, the last thing you want is kids grazing on snacks the entire afternoon. Better sit them down for some real food and some conversation.

What’s your school’s food landscape like? What suggestions do you have for improving our kids eating habits?

Dr. Ayala