How Does Your Belly Measure Up?

Tape Measure

Use this to assess your risk for disease.

It seems that many Americans are in denial about their health. With two-thirds of our country classified as over-weight or obese and people looking to lay blame on everything or everyone but themselves, I find it alarming when people are surprised, no SHOCKED, when I tell them they are in the over-weight or obese.To classify people as over-weight or obese, we often measure their height and weight and plug it into an equation to find their Body Mass Index or BMI. It is a ratio of height to weight without taking into account gender or body fat percentage. Because of this, many health professionals look at risk factors for disease in other measures.

Measuring someone’s body fat percentage is the better way to assess their health status, but they are not always available in the privacy of your own home. For more on this, see more about measuring body composition/body fat in my earlier blog post “What Determines a Healthy Weight?”

Another way of measuring disease risk/health status is waist circumference. Gone is the measure of waist-to-hip ratio from the 90’s; measuring the waist circumference is the standard now.

Why measure waist circumference?

Excess abdominal/belly fat increases the risk of high blood pressure, type 2 diabetes, high cholesterol and triglycerides, and heart disease – all preventable diseases. When taking into account a BMI between 25 and 35 the waist circumference can help find the risk for these diseases. For example someone with a BMI of 29 but a waist circumference below the cutoff is at less risk than someone with a BMI of 27 and a waist circumference above the cutoff. Someone with a BMI over 35 will very likely be above the cutoff points for waist circumference.

How to measure waist circumference?

Get a tape measure and wrap it around your waist making sure it is parallel to the floor and that the tape measure is not twisted. Do not measure over your clothing, no matter how thin the material. The “right” place to measure is at the top of the hip bone known as the iliac crest. Some people have trouble finding this spot. If you can’t locate the top of your hip bone, then measure the waist at the smallest part making sure you are measuring the waist on not the hips. If there isn’t a smallest part of the waist, you can use the “landmark” of your belly button. You want to make sure the tape measure is on the same parallel to the floor all the way around the body/waist; not lower in the front and higher in the back. Also don’t hold your breath.

One of the biggest mistakes made when measuring waist circumference is measuring underneath the belly. For example, men with larger belly tend to measure where their waistband sits. This isn’t the right place. Men often disagree with my measurement results when I tell them they have a waist circumference of say 42”, when they wear size 36” pants. Not the same…

Now what does that number mean?  

What is the result – without pulling too tight on the tape measure? For women >35” (88 cm) and for men >40” (102 cm) is “at risk.” This measure it the same no matter how tall you are. If you are close to or right at these measures, you need to make sure you don’t gain more weight/fat. If you are at risk, you need to work on losing weight now to help you lose body fat.

It is not possible to cut body fat in one specific part of the body without surgical intervention. However, adding strength/resistance training, cardiovascular exercise, and right calories can help reduce overall body fat, and decreasing belly fat in the process.

After working on your eating and exercise habits measure again in six to eight weeks. Make sure you are heading in the right direction.


Coffee – Still Pretty Darn Healthy

coffee beans

Research continues to show coffee is more beneficial than harmful.

Nearly two years ago I wrote a post for National Coffee Day admitting that I have my family hooked on coffee and that our coffee maker would be the one appliance replaced within a day. I freely admit that one morning without it would throw me  into a tailspin – only because of habit and morning routine not addiction. Really…

I often say that coffee is my “drug of choice” – which is a joke, but not. I joke in the sense that I choose no other drugs except alcohol, but if given a choice, I would take caffeine over alcohol (though I hope I never have to). Caffeine is stimulant, and the most widely used drug in the world. It is legal for everyone in the world, though some religions frown at its use.

Today, the health benefits of coffee now far outweigh the risks associated with consumption.

Along with its apparent role in improving brain health and reducing risk of type 2 diabetes, coffee consumption is showing to help prevent certain types of cancer including basal cell carcinoma, the most common form of skin cancer, liver cancer, breast, colon, and rectal cancers.

Most of the benefits are with regular caffeinated coffee, though some studies have looked at decaf coffee. Most of the time, decaf does not have the same benefit as regular, but it appears neutral rather than harmful.

Additional research shows that it is still safe for pregnant women to consume coffee and that there is no risk for the child later in life, with the most recent research showing no link between mother’s coffee intake during pregnancy and behavior issues in her child later.

Again, it is preferable to consume your coffee with little or no added sweeteners and fat. While the benefit of the coffee is not diluted with these additions to the coffee, it does add calories. So, I always tell people to take this into account when putting it in the “big picture” for your day. I like my formerly calorie-free coffee with added sweetener and half and half, knowing that I am adding calories per cup.

Hot or iced, black or as a “mocha” – enjoy your coffee knowing that it is helping your overall health more than it is harming your health.

I love getting locally roasted coffee when possible (since there is only one state that can grow coffee, I can’t get locally grown right now…).

Check out these Albuquerque, New Mexico Roasters.

How do you like your coffee?


We all Scream!

A variety of ice cream

July 15 is National Ice Cream Day.

Sunday, July 15 is National Ice Cream Day (third Sunday in July). But does anyone need an excuse to eat ice cream?

Do you know why Baskin Robbins chose “31 flavors”? (Answer below.)

Who doesn’t like ice cream? With the seemingly endless varieties at the grocery store, the ice cream shops, the convenience store and the choice of “a la mode” with practically any dessert, there is something about ice cream that everyone can find a way to enjoy it.

Many people think of ice cream as a treat, something that they really enjoy, but feel they shouldn’t eat it. People often shy away from telling me that they eat ice cream thinking that I am going to tell them to stop…which I don’t. I say, enjoy it and don’t feel guilty. BUT yes, there is a catch: I don’t suggest that you enjoy a pint of ice cream every day. It is how much and how often you like to enjoy ice cream that is problematic or just fine.

A single serving of ice cream is one-half cup. Don’t laugh. That is four servings in one-pint of ice cream. Yes, that “small” container you eat from. Problem? The difference between the real serving and the full pint is around 700 calories for premium ice cream (230 calories in half cup vs. 920 calories in a pint) or 400 calories for other brands (130 calories in half cup vs. 520 calories in a pint).  Check out the Nutrition Facts label, the shop’s website or to find out how many calories in your favorites.

Ok, ok. I don’t mean to be a killjoy, but this is reality that people are often oblivious of. I love ice cream, especially making my own (last summer I had five flavors that I had made in my freezer). Because cold foods are usually less flavorful than warm-hot foods, ice cream needs a lot of fat and sugar to help it have flavor (and taste good). I acknowledge that many low-fat and/or low-sugar ice creams just don’t fill the need for some people. This is why I say have the REAL deal that you enjoy and satisfies you and not having a sub-par “ice cream” that you don’t really enjoy.

Some of my favorite ice cream recipes:

What is your favorite ice cream flavor, variety, or brand?

Answer to question: Baskin Robbins had 31 flavors so customers could enjoy a different flavor every day of the month.

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It is a Berry, Berry Nice Time of Year

Berries for Sale

July is Berry Month – go enjoy.

Many people love the summer season for many reasons – longer, warmer days, no school, vacations, cookouts and…summer fruit, including some of the best-loved fruit: berries, yummy berries. Loaded with vitamin C, potassium and fiber and not loaded with calories, strawberries, raspberries, blackberries, blueberries and cranberries are all part of this nutritious family of fruit. They are eaten fresh, frozen and sometimes dried – preferably without added sugar – and like so many fruits and other plant foods, they have many health benefits including disease prevention and anti-aging properties due to their many antioxidants and phytochemicals. Ranging from 25-50 calories per half cup serving, berries make a great snack or dessert by themselves or make a healthy ingredient to so many foods.

Strawberries: eight-medium strawberries are one serving and contain more vitamin C than an orange. While a botanist will tell us that strawberries are not true berries, we do think of them as berries and we are able to enjoy them year round.

Raspberries: are found as red, gold (looking like anemic red raspberries) and black. Most common to us as fresh are the red raspberries, though all of them are healthy in their own way. Raspberries contain twice the fiber of blueberries and strawberries and taste great warm right off the plant.

Blackberries: start red but turn “black” when they ripen. If you have ever enjoyed fresh blackberries you know that the full, shiny “fat” ones are just the only way to eat them since they have the best flavor.

Blueberries: aren’t really blue… Anyone who has eaten blueberries knows they have purple skin and green flesh. Touted as the fruit highest in antioxidants,  blueberries are often considered a superfood in the nutrition world. People enjoy blueberries fresh and in smoothies like other berries, but these are also very popular in baking (pancakes anyone?).

Cranberries: most people only think of cranberries during the winter holidays or when they are in the midst of a urinary tract infection (or when ordering a Cosmopolitan). Because the fruit is extremely tart most people prefer their cranberries with sweetener of some kind. This is why you often find cranberry juice cocktail and not pure cranberry juice and dried cranberries are also sweetened.

Don’t be shy about trying berries in new and different ways. While strawberry shortcake, blueberry muffins and smoothies are just fine and classic ways to enjoy berries, try new and different ways to use berries. Try this recipe from Eating Well: Filet Mignon with Blueberry Bourbon Sauce.

What is your favorite way to enjoy berries?

For more information and recipes check out:

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Holiday Dinner Guest and Diet Restrictions


Having guests? Have a plan for their dietary restrictions.

If you are hosting Thanksgiving this week, have you dared to ask your guests if they have any diet restrictions? A friend was telling me about her family gathering that included vegetarians, a family member with a wheat allergy, and another with a dairy allergy. Oh, and a couple of family members were diabetic.

What to do with so many dinner guests and their diet restrictions?

  1. Ask! When you invite people over, especially if they aren’t family, or are new family members, ask if they have diet restrictions that you should know about. Even with you usual family, double-check – you don’t want to forget that your niece has the nut allergy and cook the chestnuts in the stuffing inside the turkey. Then she may not eat the stuffing or the turkey due to cross-contamination.
  2. Bring a dish to share. Not sure how to make a gluten-free pie crust? When your guests say, “what can I bring?” invite your guest that is now eating gluten-free to his or her own pie, so they can have some dessert too and so everyone can see how tasty it is. And now, one less thing for you to worry about.
  3. Integrate the “special” food into the meal. Rather than making the mashed potatoes with milk, try it with olive oil (instead of butter) and soymilk (instead of milk or cream). This will fulfill the needs of both the vegetarian and the dairy allergy. And, don’t make two separate batches, just the one for everyone will do. We don’t need to make our guest feel like they have “special needs.”
  4. Include veggies! Whether someone needs low-fat, wheat-free, dairy-free, diabetic-friendly, or all of these, fresh or steamed seasoned veggies will fit the needs for everyone (green beans are always safe!) and it will help balance out the carbohydrates of the mashed potatoes, sweet potatoes, and stuffing.
  5. Offer alcohol and soda-alternatives! Stay in the Thanksgiving mood with cranberry juice, a squeeze of lime and seltzer and even the kids will think they are toasting with the adults. Also, plain water will do just fine too.

While we want to accommodate all of our guests, we don’t want them to feel left out either. Make everyone fit in as best as you can and try not to have the separate dishes for someone unless it is essential. Just keep in mind that some people do have very specific diet restrictions, and they aren’t all in their head (usually).

If you are hosting Thanksgiving this week – good luck to you. And enjoy the time you have with your friends and family however many you have coming over. And, please, leave the cleaning to someone else!

Do you hear what you want to hear?


Are you always being honest with yourself?

A friend told me the story of her mother’s recent visit to the doctor: In reviewing the result of the patient’s blood work, the patient’s blood sugar control was not a good as it should be (referring to the hemoglobin A1C results). The patient promised to be better and the doctor conceded to let her continue with her lifestyle changes and no medication as a result of this visit. The doctor’s instructions/orders: no desserts except for birthdays; the patient agreed. No problem, just birthdays.

What the doctor didn’t know: this patient has six children, all married, 17
grandchildren, many of whom are also married, and 23 great-grand children! With that much family, she averages a birthday a week, sometimes more. This doesn’t include the birthday’s she celebrates with her friends – she can’t leave out her friends. Giggling about this, she also said she could perhaps stand outside Wal-Mart and ask everyone when his or her birthday is, so when she had her dessert every day, she could say “This is for Tracy’s birthday, the woman I met at Wal-Mart.”And she honestly was not going against her doctor’s wishes.

Many of you have heard the story of my grandmother, of when diagnosed with lung cancer at the age of 79, asked her oncologist, at the same appointment he was giving her treatment options, if she needed to quit smoking. He told her, “I’d like you to.” (Personally, I think he was just stunned by the question.) She said, “He didn’t say ‘yes’.” She did quit a short time later but it was only because you can’t smoke in the ICU.

The point I am making here is for both the practitioners AND the patients/clients:

Practitioners: We must be literal with our patients. And, be careful with what you say, and how you say it. If we aren’t careful with what we say the patients, knowing full well what we mean, will take our words literally. We need to be specific. For example, don’t tell someone  they can have a hamburger “once in a while” or “on occasion.” Your “once in a while” or “on occasion” may mean one a month while their “once in a while” may mean every 48 hours.

Don’t speak in jargon. We must admit that we do speak in jargon, and may not realize it. Ask our patients and clients if they understand what we are saying.

Patients/clients: A lot of times our patients/clients know what their health professionals are telling them, but they choose to believe otherwise. If you truly don’t know what your practitioner is telling you, ASK. Do you really think that a hamburger every other day is fine? If you don’t know what your practitioner means by “once in a while” then ASK him or her. Really.

Also, when you don’t give your health care practitioner the truth, aren’t forthcoming, or have led yourself to believe something that isn’t entirely correct, you aren’t helping yourself. And we can’t help you be healthier. By this I mean don’t say, “I exercise all the time,” when you really mean, “I was an athlete in high school” or “I sit in a chair on the side-line of my kid’s soccer game and watch them exercise.” Driving you kids around to their activities makes you active but that isn’t exercise. (I am a parent, I know.)

Both sides need to get better with communicating, getting more clear with what they mean, and being more honest with themselves and their healthcare providers.

I Buy Hard-Boiled Eggs – Go Ahead and Judge Me

Hard-Boiled Eggs

Would you buy these to save time?

I work with a lot of people who want to eat healthier (I am a dietitian after all, so this does make sense). Some of the biggest challenges of the people I work with are that they are busy and feel that they don’t have time to eat healthy or prepare healthy foods. Who isn’t busy these days? A few people aren’t, but I suggest you don’t admit that to the rest of us.

So, when I am helping people who are trying to balance work, family, “me” time, fitness, other activities along with a healthy diet, I believe that is it sometimes okay to have short-cuts such as microwavable frozen brown rice or vegetables: a quick, easy, convenient way to get healthy food on the plate for the family.

So, earlier this summer on our weekly trip to Costco, a new item caught my attention this fir the bill for “quick and easy”: pre-packaged, peeled, hard-boiled eggs. Two–dozen for $3.99. I often mention to my clients that a hard-boiled egg can be part of breakfast out-the-door or a quick afternoon snack. I suggest boiling some on Sunday for the week.  It isn’t hard to do (with Albuquerque’s high altitude it does take some practice to get it right), but it does take time, and it is sometimes messy when it comes to peeling. Also, the kitchen and fridge stink a bit after the boil.

These hard-boiled eggs were also useful on a road-trip we took in mid-August (in rural New Mexico and Arizona) when we packed a cooler of snacks to include our water, fruit, string cheese and these eggs. We had our breakfast at the hotel, had our snacks through the day and our dinner out in the evening.

Now, I know that some people feel this is a ridiculous item – pre-cooked, pre-peeled, eggs? How hard is it to boil and peel an egg?! No one is saying it is hard. It isn’t. Anyone who can navigate the internet and read directions can find out how to make a hard-boiled egg. Members of my family would make a two or three at a time, several times a week. So, rather than boiling some eggs here and there during the week, we have chosen to use less energy, and spend less money and save time by purchasing this convenience item. To some people think it is silly, but for us it gives us more time to wash the fresh fruits and veggies that we also pack for lunch and snacks. Also, it can cut your deviled egg preparation time down dramatically!

The big question for these pre-packaged eggs: how do they taste? Answer: if you didn’t know, you couldn’t tell. The whites aren’t rubbery; the yolks don’t have a greenish-gray line (maybe that would be the giveaway). They tastes just like…eggs. There are real eggs, so they taste like real eggs. Go figure. And, no they are no more “slimy” than regular hard-boiled eggs, which are pretty slimy in my opinion. Try picking up a deviled egg from a plate some time.

When it comes to convenience foods, sometimes I take shortcuts.  As a rule, the shortcuts are “real” food and help me cut down on prep time: frozen vegetables, frozen brown rice (6 minutes vs. 55 minutes), a rotisserie chicken vs. my own roasted chicken (10 minutes vs. 90 minutes or more). But as a rule I don’t take shortcuts that will substitute a processed food. For example, I make my own peanut butter and jelly sandwiches  (not the un-crustables in the freezer aisle) and I make my own cookies, brownies and cakes from scratch (so no buying cookie dough or a cake or brownie mix).

November 2 is National Deviled Egg Day – try this yummy recipe from Cooking Light: Deviled Eggs with Smoked Salmon and Herbs, and with the pre-packaged, pre-cooked, pre-peeled eggs, you get to skip Step 1, and go directly to Step 2. Quick and easy.

Okay, now…judge away. What convenience foods to you use?