DIET II. SUBSTITUTING MEAL ITEMS

Now that we started practicing the first step in our healthier habits program with DIET I, let us talk about the issues we will face at short term.

SHORT TERM ISSUES:

VARIETY OF MEAL ITEMS:

   A. MILK. If you cannot tolerate milk, you can buy lactose-free milk, or take tablets of Lactase with your milk.

   B. CHICKEN. Some of my patients say, “I may grow feathers if I only eat chicken!” There are a lot of options for substitution. You can try 3 ounces of lean red meat, pork, fish, shrimp or scallops. Canned tuna and canned salmon, soy protein preparations are other options.  Of course, this is not the amount of this type of food we are used to; nevertheless, remember that we are trying to get into a new way of living that will make our body healthy. BEWARE OF VEGGIE BURGERS, AND OTHER GREASY VEGETARIAN PRODUCTS, we are trying to avoid UNNECESSARY CALORIES. Pork is a good source of protein when it is lean, the leanest part is the pork loin –try to avoid pork chops and other parts that have visible fat.

  C. BREAD.  Substitute a regular slice of bread for a medium size corn tortilla, or half a cup of steamed rice. Nowadays bread comes in so many different sizes that it can be confusing; just remember that we refer to the regular loaf of bread. Regarding tortillas, corn are the best because they do not have much fat. AVOID FLOUR TORTILLAS, THEY HAVE TOO MUCH FAT and they are a SOURCE OF UNNECESSARY CALORIES.

   D. FRUIT. Remember that the size we refer to is a size equivalent to a medium size banana, apple, peach,  or orange; half a cup of grapes, two small plums,  a two-inch slice of fruits like cantaloupe, honeydew; a one-inch slice of a watermelon, since it is a bigger fruit.

   E. VEGETABLES. We can add to our lunch or dinner the equivalent of a cup (eight ounces) of fresh lettuce, cucumber, plus a medium sized tomato, or two small Roma tomatoes. You can substitute this with a similar portion of fresh (or cooked) cabbage, cauliflower, broccoli, zucchini, or carrots. Avoid potatoes and yams, which, although fat free, will increase the amount of calories we want to ingest -SOURCE OF UNNECESSARY CALORIES. REMEMBER THAT WE ARE TRYING TO LEARN NOT TO EAT UNTIL WE FEEL FULL.

   F. ITEMS WE USE FOR FLAVOR. We can use with liberty items such as pepper, lemon, onions, celery, mint, basil, garlic, and other condiments. Salt can also be used but please use caution since it is linked with high blood pressure, worsening the fluid retention in heart, liver and other diseases..

   G. VITAMINS in FOOD INGESTED. Most vitamins we need are in the vegetables and fruits that are included in our meals. It is true that when we cook vegetables and other food products, they lose some vitamin content; however, they have plenty of vitamins and even overcooking them will not cause vitamin deficiency if we eat a balanced diet.

   H. BUYING FOODSTUFF WE WILL PREPARE AT HOME. It is a good idea to make a list of foods we will be preparing at home avoiding those which contain unnecessary calories, such as butter, margarine, cheese. Products like doughnuts, pastries, cakes should not be available because we are not that strong and we do not want to convert our home in a “slippery place”.

   I. EATING IN RESTAURANTS. At this early stage of our change program we try to avoid “slippery” places. The same way we tell alcoholics to avoid bars in the early stage of their recovery, we should avoid restaurants as much as possible until “our muscles of eating healthier” get stronger. We are too vulnerable right now and we need some practice before we risk our health at the moment. Remember what has happened in the past, many of us felt we could go to a restaurant and order the meal with the little heart besides it indicating its healthy nature, and only succumb to the smell of the fresh bread and butter the waiter brought to our table.   

   J. EATING WITH RELATIVES AND FRIENDS: For now let us postponed socializing over meals. Most times we end up eating too much of the food we are trying to avoid. We just need to be patient and wait a little until we get stronger. Our loves ones and our friends will understand –if they really respect our choices! However, remember that it is not their business to comply with our plan, it is our business to build healthy boundaries and the time is now!

VITAMIN CONSUMPTION:

   A. VITAMIN B 6, B 12, and FOLIC ACID. There is a study published in the February 2009 issue of the Archives of Internal Medicines that suggests that the use of folic acid, vitamin B 6 (pyridoxine) and B 12 may decrease the incidence of adult onset macular degeneration in postmenopausal women.

   B. VITAMIN D. Studies suggest that 600 IU of vitamin D may decrease osteoporosis in postmenopausal women.

   C. VITAMIN E. There are studies that have failed to show benefit of Vitamin E in heart disease.

   D. MULTIVITAMINS. Recent studies, including a large study in women by a reputable group of female scientists published in the Archives of Internal Medicine in February 2009 showed no benefit of use vitamins in decreasing heart disease and cancer.

We live in a world where vitamins are a big business. The baby boomers, who hold the money in United States are getting older and want to stay young and energetic, and it is not surprising that most of the vitamin supplements and other articles of dubious benefit are targeted to us (I am a baby boomer, too). I am not against people making a living selling whatever they wish to sell; however, as a medical doctor specialized in eating problems, nutrition and digestive problems I need to guide my patients to KEEP THINGS SIMPLE AND AVOID UNNECESSARY CHEMICALS.

   E. OTHER PRODUCTS. There is a multitude of so called “healthy” products,  i.e. yogurts to “keep us regular” or improve your immune systems. These products use the word “regular” in a very deceiving manner implying that they are good for constipation. Companies hire “respectable” movie stars like Jamie Lee Curtis advertising a yogurt that will keep you “regular”. Many of my constipated patients had been using the product saying very surprised “The yogurt never worked; but, it was Jamie Lee Curtis who said it!” Please remember that movie stars are actors, they are employed to repeat a set words for a certain amount of money, they are not medical doctors or scientists sharing their expertise, they are simply earning an income by doing what they do best, act in a world of “make believe”.

© Rafael E. Cuellar, MD, 2009