What’s up with this, guys?  Some experts believe that men are programmed to have that “devil may care” attitude. We see this in the animal kingdom: the male has to (literally) fight other males for the female’s attention. This guttural instinct has filtered down through the ages and is reflected within the modern man as bravado (picks fights in bars), risk-taking (drives aggressively), stubbornness (refuses to get a prostate exam), and even apathy (eats whatever he likes and doesn’t care how it affects his health).

So how to change this? Um, I’m sorry, you want to change a man? Silly rabbits. Unless you were born yesterday, everyone knows you can’t change a man.  But you CAN inform him, and let him make his own decisions. Men need to be TOLD what they need to do for their health, they generally won’t come up with a game plan on their own.  So to make things easy on everyone, I’ve come up with a list of “to dos” for the guys:

~Have your body mass index (BMI) calculated. If 25 or over, it’s time to cut back the calories, and ramp up the physical activity.

~Have your cholesterol checked annually starting at age 35. Younger than 35? Talk to  your doc about whether to have your cholesterol checked if you have diabetes, high blood pressure, if heart disease runs in your family, or you smoke.

~Have your blood pressure checked at least every 2 years.

~ Have a test for colorectal cancer starting at age 50. If you have a family history of  colorectal cancer, you may need to be screened earlier.

~ Have a test for diabetes if you have high blood pressure or high cholesterol.

~Your emotional health is as important as your physical health. If you have felt”down,” sad, or hopeless over the last 2 weeks, you may want to talk to your doctor about being screened for depression – no shame in this.

~ Talk to your MD to see whether you should be tested for sexually transmitted infections (including HIV).

Lastly: don’t smoke, drink alcohol only in moderation, exercise at least four times per week for 30 minutes or more, consume a healthy diet (lots of fruits, veggies, whole grains, low-fat dairy, lean meats-call me if you’ve got questions), and allow yourself some down-time from work and family obligations. Let’s hear it for the boys!

So regarding physical activity, what is specifically required to achieve a healthy weight? According to the latest Physical Activity Guidelines for Americans from the Center for Disease Control and Prevention (CDC), to maintain a healthy weight adults should aim for 150 minutes per week of moderate-intensity aerobic activity (eg. 30 minutes per day, 5 days per week), and incorporate muscle strengthening activities on two or more days a week that work all your major muscle groups. For additional health benefits, the CDC recommends upping the aerobic activity time to 300 minutes per week (eg. 60 minutes per day, 5 days per week). Walking fast, cycling, using cardiovascular equipment (like an elliptical or stair climber) all count as moderate-intensity aerobic activity. Lifting weights, working with resistance bands, yoga, or pilates all count as muscle-strengthening activities. A personal trainer can develop a program that fits your specific fitness needs and goals, as well as keep you motivated and on track.

Good nutrition is essential for improving one’s health, and goes hand in hand with regular exercise. With so much information (and mis-information) available regarding nutrition, it is easy to be confused about what to eat for optimal health. A diet rich in fruits, vegetables, whole grains, lean meats, and low-fat dairy can decrease the risk of many chronic diseases and assist with maintaining a healthy weight. Limiting your intake of sodium, increasing fiber, monitoring portions, and indulging in sweets and alcohol only on special occasions can also contribute to a sound diet. It is essential to know how many calories you need to maintain your current weight, and then from there you can determine how many you need to shave off daily to lose weight. A dietitian can help you by developing a nutrition plan that is effective and sustainable. Don’t succumb to weight-loss pills or fad-diets! These are temporary fixes that may be ineffective at best and harmful at worst.

1. Lunch tote. I encourage ALL of my clients to “brown bag” it. I like the Bento Boxes from www.laptoplunches.com. Zip in a cold gel pack to keep cold stuff cold and avoid foodborne illness.
2. Veggie Steamer. One of the best ways you can cook veggies and keep those wonderful nutrients intact.
3. Juicer. While we’re on appliances…juicing is a great way to get your nine servings of fruits and veggies daily (Note: a serving is a measly half-cup!). Just be sure the juicer juices the WHOLE fruit/veg –  you want enough power to pulverize the peel for all that fantastic fiber.  Splurge on a VitaMix, or save with a Nutri Bullet www.nutribullet.com.
4. Magazine Subscription. Women’s Health, Men’s Health, Shape, Self, Fitness, Cooking Light, Eating Well, the list goes on. For the hardcore nutrition junkie – Nutrition Action from the Center for Science in the Public Interest  www.cspinet.com.
5. Gym Membership. The ultimate get-fit gift. Many fitness facilities have great holiday specials going on right now. Stash the certificate in a shiny new gym bag to spark some serious motivation. I love the ones from www.athleta.com.
6. GPS training product. A.K.A. a Garmin watch (www.garmin.com). Great little gadget for the aspiring athlete (or inspired beginner). Help them navigate the night with a headlamp from LL Bean, essential for evening runs in the winter months www.llbean.com.
7. Cookbook. Ellie Krieger’s “Healthy Appetite” (my favorite and most famous RD!), The Complete Cooking Light Cookbook, American Dietetic Association’s Cooking Healthy Across America, or William Sonoma’s Salad of the Day www.williams-sonoma.com.
8. Wine and chocolate. It’s gotta be red and dark (70% or more cacao) respectively…in moderation of course! www.godiva.com.

Let’s tackle the bird. Roast the turkey on a rack so fat drips away from him. Use low-sodium broth or light whipped cream cheese to flavor mashed potatoes instead of half and half, butter and sour cream. Low-fat or even non-fat sour cream, cream cheese or yogurt can reduce the calories significantly in recipes that call for these dairy products. Instead of brown sugar, butter and marshmallows, sweeten sweet potatoes with orange juice. For baked goods, use applesauce, pureed white beans or canned pumpkin in place of oil or butter. Skip the fried onions on the green beans, and substitute a green salad for starchy corn.

Put out a platter of fresh fruit and crudite with low-fat yogurt dip and reduced-fat creamy dressing respectively for an appetizer to fill family up before the big meal.  During the meal, offer guests spray butter instead of tub or stick style to help control usage. Use smaller salad size plates for meals instead of dinner size to help reduce intake. Use a tablespoon instead of a large serving spoon when plating items . Remove the skin from the turkey before you eat, and for dessert, feast on some more of that fresh fruit with fat-free cool whip instead (don’t make me tell you how many calories are in pecan pie!).

Think your drink. Calories can add up fast so choose sugar-free or calorie-free beverages like water, unsweetened tea, Crystal Light, diet soda or flavored seltzer. Limit your libations such as wine, beer and liquor (after dinner drinks are a killer!). I have a rule – if I have wine, I skip dessert, and vice versa (helps me really reduce my calorie intake).

And it’s not Thanksgiving without a Turkey Trot. Look for fun runs/walks in your area to get a bit of exercise in before the festivities begin. Or take a walk around the neighborhood with the whole family, plan a hike in the park (we have great ones close by), or play flag football or soccer in the back yard.

If you blew it big time and ate till you burst your buttons, don’t sweat it – actually DO sweat it!  Get up the next day and get your butt to the gym. Do 15 minutes more of cardio than you usually do, drink plenty of water throughout the day, and eat lightly. Indulging in one large meal does not give you a free pass to pork-down for the rest of the weekend (or month for that matter). You’ve got four weeks till Christmas – monitor your munching so come January first, the scale won’t scare you.

1.Start by giving out a healthier Halloween treat. Some alternatives include: Cereal bars, snack packets of dried fruit, baked pretzels, nut and seeds, trail mix, animal crackers, 100 calorie packs of various products, single serve boxes of ready-to-eat cereal, mini boxes of raisins, fig cookies, individual juice drinks (100% juice), single-serve packets of low-fat microwave popcorn, sugar-free hot chocolate or apple cider packets. Or go the non-food route and distribute stickers, dollar-store toys, decorative pencils, erasers, bubbles, or glow sticks.

2. For a fun and healthy Halloween party idea, have kids make various creatures out of veggies, fresh and dried fruit, cheese and pretzel sticks. Provide low-fat dressing for dipping when done.

3. Another fun activity that doesn’t have to include sweets – pumpkin decorating! Let the kids’ imagination run wild (under supervision of course!). Have kids use paint, stickers, yarn and other craft materials for decoration (leave the carving to mom and dad!).

4. Get outside! The fall season is perfect for visiting an orchard or farm to get your whole family moving and out in the fresh air. Pick your own apples, search for the perfect pumpkin, and instead of the more sugary treats, take home some fresh apple cider to heat up with some cinnamon sticks for after dinner.

5. Instead of loading their lunches with candy, get a bit more creative and cut their sandwiches with a Halloween-themed cookie cutter for a spooky surprise.

6. Have a candid conversation with the kids about their candy. Tell them that while it’s okay to eat any food in moderation, candy is a treat generally reserved for special occasions, like Halloween. Review their loot after trick or treating, and discard anything that looks odd or is unwrapped. Ration out 2 small pieces at a time over the next few days. But after about a week it’s time to trash – or better yet – idea number 7!

7. Donate your candy to soldiers overseas! Soldiers use candy to coax local children in war-torn countries to disclose the locations of buried IEDs. To donate your family’s candy, visit www.opgratitude.com and send an email to opgrat@gmail.com. Check out this great video which describes the program: http://www.youtube.com/watch?v=WxIHgabfxKA&feature=channel_page.

You and the kids CAN have a healthy and fun Halloween. Moderation is key and focusing on other activities besides eating treats can make the holiday even extra special.  Happy Halloween everyone!

Pre-contemplation: You are not thinking about changing anything right now. Even though your MD may have referred you to a dietitian or suggested you join a gym, you have yet to make a move.

Contemplation: You are now thinking it’s time to make some changes, but have to weigh all the pros and cons. You say to yourself, “I know I should start eating breakfast, but I just don’t have the time.” The benefits of breakfast are compared with the investment of time.

Preparation: You have finally decided to change some aspect of your eating pattern or incorporate some regular physical activity into your week. You commit to small changes or baby steps. One or two practical goals should be set at this point.  For example, you start snacking on fruit or raw veggies instead of chips or cookies, and you go for a walk at lunchtime. Keeping a food journal or exercise log would be helpful in this stage. Plan ahead and have healthy snacks on hand or ask a co-worker to be your walking buddy.

Action: You have accomplished these small goals and now you are ready to kick it up a notch. Think about other changes you can make, but remember to keep your goals reasonable. Plan for possible issues that might get you off track. For example, soccer season is about to start for your son, so you make the following commitments: “I will plan to run around the soccer field while my son is at practice” and, “I will plan to pack some healthy snacks and take them on game days.”

Maintenance: You are eating better and exercising regularly. Your new behaviors have become a steady habit. The danger here is boredom with routine, a vacation or holiday that interrupts the routine, or some unforeseen personal challenge that shifts your focus for a time from the routine.  Know this: EVERYONE has setbacks or lapses in behavior. These should NEVER be considered a failure. Think of these episodes as learning experiences and move on. Seek help from a professional (a registered dietitian or a personal trainer) to guide you if you feel overwhelmed. Give yourself a break but DON’T GIVE UP!

It’s NEVER too late to change for the better, and any effort you make to improve your well-being will be worth it. Your health doesn’t just affect you, it affects your family, friends, even your community at large.  Find the courage within yourself to turn thoughts into action. Make a healthy change today!

Different therapies require different approaches. Often the patients I saw in the Radiation Oncology center had issues swallowing (particularly head and neck, as well as lung cancer patients) due to the size of a tumor or in preparation for the swelling that can occur from the radiation itself. These patients may require a feeding tube.  Many times these tubes are just a temporary means to administer the nutrition the individual needs during treatment but cannot get by normal eating.  A dietitian writes a script for the patient for a specific amount of mineral and vitamin-fortified formula that will meet their individual nutritional needs, taking into account total calories, protein, fats, carbs, fiber, and water, which their doctor will then approve. These patients are usually well enough to administer their own formula, which is easily “bloused” or injected into the tube via a large bore syringe.

For those patients not receiving their nutrition via tube-feeding, increased calories and protein is critical regardless of treatment type (chemotherapy or radiation). Individuals with cancer should take in about 30-35 calories per kilogram* of body weight, and 1.4-1.5 grams of protein per kilogram of body weight due to the increased stress the cancer and treatment can put on their systems.  Loss of lean body mass is of particular concern, so I encouraged my patients to increase their intake of high-protein foods, such as lean meat and dairy, whole soy foods, beans, certain grains such as quinoa, eggs and nuts. Supplement drinks such as Boost or Ensure can provide necessary nutrition when one has lost their appetite or solid foods make them nauseous. I also provided to my patients a variety of smoothie recipes they can make at home with protein powder, peanut butter, fruit, flax seed, even ice cream.

Fruits and vegetables are strongly encouraged for the antioxidant power and fiber they provide.  I stressed to my patients to wash fresh produce thoroughly since any bacterial or pesticide residue may compromise their weakened immune systems. Patients on “neutropenic” precautions are told to avoid all fresh produce as much as possible, or to at least consume cooked, canned or frozen items (including pasteurized juices) only during their course of treatment.  Individuals may want to purchase only certified organic items, taking care to wash these items thoroughly as well.

Supplements or any alternative treatments may be beneficial but a patient should always talk with their doctor or dietitian about any supplements/therapies they may be taking/receiving  concurrently with their conventional treatment, as they may be contraindicated. An example of this is mega-dosing of anti-oxidant vitamins like A, C or E, which may interfere with the chemotherapy agent, rendering it virtually ineffective.  Many times patients and their families are lured by the promises of unproven alternative therapies, which can be very costly and even potentially harmful to the individual, so caution and common-sense is advised.

*Find your weight in kilograms by dividing your weight in pounds by 2.2.

First things first: Why are you eating the bar?  As a meal replacement? Pre-workout fuel? Post-workout nosh? If using the bar as a meal replacement, look for at least 300-400 calories, with a generous mix of protein (20g or more), carbs (30-45g), and fats (under 10g saturated). Some examples of meal replacement bars would be the Myoplex Deluxe or the Met-RX Big 100. Don’t eat more than one of these bars a day though, because no bar can truly replace the nutrients we get from eating whole foods. I tell my clients to only consume these if they are in a pinch and there is not another healthy food option available (i.e. when traveling). In addition, if you are already taking vitamin or mineral supplements, eating a fortified meal replacement bar can give you over the recommended daily intake values for certain vitamins and minerals, which could be potentially harmful if consumed frequently (i.e. every day).

If you are looking for a good pre-workout bar, choose one with around 150-200 calories, moderate carbohydrates (about 15-30g) for sustained energy, but lower in fiber to decrease gastrointestinal distress, and moderate protein (5-10g). Bars with high amounts of refined sugars (sucrose, high fructose corn syrup) will give you a burst of energy, but if you’re working out for longer than a half-hour they may cause you to crash and burn mid-session. Bars with sugar alcohols (a.k.a. mannitol, sorbitol) are also known to wreak havoc on the gut, so taste-test one of these types of bars on a non-workout day to see how your tummy reacts. Pre-workout bars include the 3 Bar Tri Energy Bar, Pure bar, Kashi Go Lean bar, Raw Revolution, South Beach Cereal Bar, Luna Bar, half a Hammer Bar, or half a Clif Bar.

Good recovery bars will include moderate to high amounts of protein (10-20g) and moderate carbohydrates (15-30g), but should be under 250 calories (and higher amounts of fiber aren’t an issue now). You want to eat these types of bars within 15-30 minutes of your workout for maximum effect. It is recommended to eat a full meal (400-600 calories, depending on your daily needs) within two hours of your workout to continue the muscle-repairing benefit, so any bar more than 250 calories may interfere with weight loss or maintenance efforts. Some bars to choose would be The Simply Bar (which is also a good pre-workout snack), Luna Protein, Powerbar Recovery, Pure Protein, Detour low sugar, Hammer Recovery (half – or eat the whole as a meal replacement in a pinch since this bar comes in at 330 calories), and the Clif Bar Builder’s (although at 270 calories this bar is a little on the high side as well-I might eat half before my work out and half after).

Remember: some energy bars are made with trans-fats, and may contain as much sugar as a regular candy bar, so read labels carefully. All the companies whose bars I mentioned above have full nutritional information available on their websites, so check them out before you buy. Many offer sampler packs which can be helpful in determining taste, another important factor when deciding which bar to choose.

1. Blueberries – Packed full of anthocyanins and phenolics (powerful antioxidants), blueberries are also bursting with Vitamin C and fiber. Studies have shown they may actually slow the aging process. Throw half a cup in your oatmeal in the AM, and toss another half cup with a salad for lunch.
2. Broccoli – Packed full of vitamin C, fiber, and cancer-fighting carotenoids, it’s a diamond in the roughage. Aim for a cup a day – steamed, baked, mixed in salads, topped on homemade pizza, or dipped in low-fat ranch dressing.
3. Yogurt – Greek, plain, non-fat is best. Look for Oikos, Fage or Chobani brands in the 6-ounce serving size.
4. Fatty Fish – swimming in Omega-3s, which have been shown to reduce risk of heart disease and make us more insulin sensitive (good news for diabetics). Go fish at least twice per week with salmon, tuna or trout (bake, broil, poach or steam – NEVER fry!).
5. Leafy Greens – for about 50 calories, two cups per day give us a generous helping of vitamin C and K, folic acid, some calcium, magnesium and potassium, as well a ridiculous amount of vitamin A and lutein.
6. Tomatoes – Tasty sliced on a plate with some fresh basil in the summer, tomatoes are one of two veggies (carrots are the other) that get even more nutritious when you cook ‘em – so keep on eating way into winter. They contain lycopene, another powerful antioxidant shown to decrease risk of many cancers including lung, prostate, and stomach.
7. Quinoa – If you haven’t tried this wonderful whole grain, you need to – tonight. Quinoa has twice the amount of protein and almost 2g more fiber per cooked cup as brown rice.
8. Oats – Just ¾ cup a day may significantly reduce your cholesterol (when eaten regularly), and thus risk of heart disease. Steel cut is best, most instant packets useless (the less processed the better).
9. Beans – A vegan AND carnivore’s buddy, a cup of black beans contains 15g of protein as well as 15g of fiber (half your day’s worth). Serve with half a cup of quinoa and a cup of roasted veggies and you’ve got yourself a nearly perfect (meatless) meal.
10. Almonds –  Two tablespoons contain almost 4g of fiber, 75mg of calcium, just 1g of sugar, 9g of monounsaturated fat, and all for about 160 calories.