Category Archives: Ask The Doctor

Articles by Dr. Catherine Wilbert about health, nutrition and fitness.

A Not So Fat Tuesday

kingcakeQ: I really am committed to getting healthy this year, but before I even get a good start, here comes the temptation of Mardi Gras. How can I not blow it?

A: Uh oh… Just when you thought you were sticking to your resolution to be healthier, along comes Mardi Gras! How quickly visions of sugarplums get replaced with cravings for king cakes. Well here are a few strategies to keep you on course through the carnival season:

The party isn’t all day long.

Maybe it is, but more than likely not. And just because you will be attending a parade or party, doesn’t mean you’ll have to blow the entire day. Pace yourself at breakfast and through lunch with smaller, protein-based meals, reserving your fat and carb count for later at the event.

Eat before you go.

Eat a small, healthy, high protein meal before you head to the festivities. This will keep your blood sugar more stabilized, preventing you from being ravenous and less likely to over indulge.


Don’t quit the program just because it’s party time. Sticking with your exercise program will keep you feeling good about yourself, and you will be less inclined to go way overboard when choosing festive delicacies.

Dress to eat less.

Wear a tight-fitting outfit or a pair of jeans that you look great and feel good about yourself in, AND that won’t allow you to eat too much.

Make the calories count.

Scout out the spread and choose small, taste-size portions of interesting looking dishes you would like to try. Don’t waste calories on familiar foods to try. Don’t waste calories on familiar foods and remember portion control-little nibbles add up to large savings.

Drink, drink, drink Water.

Make sure to drink plenty of water before (and during) the party. This will not only help fill your belly, but hydrate you when you are drinking alcohol. And remember, alcohol is festive, but with little redeeming nutritional value – just lots of empty calories and often hidden fat and sugar.

Keep  it in perspective.

If you eat more than you had planned at a particular function, that doesn’t mean that you’ve blown it for the entire season, try to return to your normal healthy eating habits the next day. Your attitude about reaching your goal is just as important as the foods you choose.

‘Tis the Season of Temptation

Celebrate Without Gaining Weight

T’was the month before Christmas and the parties begin; can I eat, drink and be merry, and still remain thin?

When it comes to the Holiday season, party foods and alcohol are symbols of festivity. Holiday celebrations, with the traditional buffet-style parties and hearty servings of eggnog make it difficult for the average health-conscious individual, as the opportunity to eat and drink more than usual is available and enticing.
So how can you maintain good eating habits and still enjoy holiday parties and social gatherings? Here are a few strategies to assist you through this season of temptation.

The party isn’t all day long.

Maybe it is, but more than likely, it will be in the evening. And just because you will be attending a holiday event, doesn’t mean you have to blow the entire day. On the day of the party, pace yourself at breakfast and through lunch with smaller protein based meals, reserving your fat and carb count for later that evening where there will undoubtedly be lots of fats and carbs (and not much protein) to choose from.

Eat before you go.

Eat a small, healthy, high protein meal before you go to the party. This will prevent you from being ravenous when you finally get to the buffet table and you will be less likely to overindulge.


Don’t quit the program just because it’s party time. Sticking with your exercise program will keep you feeling good about taking care of yourself and you will be less inclined to go way overboard when choosing holiday delicacies.

Dress to eat less.

Wear the tight-fitting dress or pair of pants that you look great and feel good about yourself in, AND that doesn’t allow you to eat too much. It’s easier to discourage those visions of sugarplums dancing in your head when you can feel your pants getting tighter.

Make the calories count.

Scout out the spread and choose small, taste size portions of interesting looking dishes you would like to try. Don’t waste calories on familiar foods. Stay away from the cheeses and fattier foods and dips with heavier cream bases, and remember portion control – little nibbles add up to large servings. Vegetables and finger sandwiches filled with meats, like turkey, ham and roast beef make the best choices. Avoid the chicken, egg and tuna salad sandwiches, which are usually made with a lot of mayonnaise, high in fat and calories. Also, ditch the bread and just eat the meat. I’m sure Miss Manners wouldn’t be too appalled at you picking at your food in the name of health, and after all, they are called finger foods.

“Eat and get out!”

The slogan that made a popular restaurant in Chicago famous, is a good rule of thumb at parties. Once you have made your selections, take your plate and leave the table – in fact, leave the room. It’s easy to be tempted when the food is staring you in the face. Stay away from the table and keep busy so you won’t be tempted to eat.

Visit with friends rather than the food.

It seems like tradition to gather around the food table, concentrating on what to try next, rather than truly paying attention to the conversation at hand. Visit with friends, dance or mingle and focus on other things besides the tempting array of food. It’s good to enjoy food, but it’s even nicer to truly enjoy the company of friends and family you haven’t seen in a while.
Drink, drink, drink WATER.

Make sure to drink plenty of water before (and during) the party. This will not only help fill your belly, but hydrate you when you are drinking alcohol.

The burning question of alcohol.

Yes it’s festive, but with little redeeming nutritional value – just lots of empty calories and often hidden fat. An average eight-ounce glass of eggnog with alcohol contains about 490 calories, and more than 20 grams of fat. Daiquiris are loaded with sugar and after-dinner drinks like Irish crème and other cordials contain about 70-125 calories per ounce – which adds up rather quickly. Wines and clear liquors, such as vodka, make better choices. The darker alcohols like whiskey and rum contain more sugars, as do the cheaper, sweeter wines with the twist tops, rather than the corked type. Try using club soda or tonic to mix with your cocktail. Even wines can be diluted with club soda or sparkling water to make a wine spritzer for a refreshing low-calorie change.

Keep it in perspective.

Have a strategy before you leave for the party with a designated number of cocktails that you will drink and an allotted amount of food that you will consume. If you eat more than you had planned at a particular function, that doesn’t mean you’ve blown it for the entire holiday season, try to return to your normal healthy eating habits the next day. Your attitude about what you eat is just as important as the food itself.

Making the effort to watch your calorie intake is the perfect gift to yourself. . . no more need for those nasty New Year’s Resolutions!

When is enough, enough? When Looking Good becomes an Obsession

Too small, too big, too fat, too skinny – so what is just right?  Can we ever be truly satisfied with how we look?

Dissatisfaction with how we look is not unusual in this day and age. With advertising and media pushing appearance at us from all sides, it is quite normal for many of us to think we don’t quite fit the mold of perfection. Appearance can play a big part in life for most people, but never in history have we witnessed so many issues and potentially harmful trends arising out of striving for that perfect body.

It isn’t difficult to recognize that we live in a culture obsessed with “the perfect body.” In fact, this obsession is showing up at younger and younger ages:

  • 42% of 1st-3rd grade girls report wanting to be thinner.
  • In a recent study of 4th graders: almost half the girls “wished they were thinner.”
  • 81% of 10 year olds are afraid of being fat.
  • 8th and 9th grade girls have reported that the ideal female is 5 feet 7 inches tall, and weighs between 100 and 110 pounds. It is interesting to note that at this height and weight, most women would be considered clinically anorexic.
  • On any given day, approximately 25% of American men and 45% of American women are on a diet.
  • 40-60% of high school girls are dieting on any given day and over half of eighth grade girls report dieting during the past year.

The diet industry is a $40 billion dollar industry in the United States and growing every day. What is interesting is if diets worked so well, why would we need to keep throwing money away trying new ones? In fact, 95% of all dieters will regain their lost weight, and more, within 1-5 years. This is not a result of failed will power, but damaged metabolisms by trying to force their bodies to attain unrealisitc goals, and probably, unhealthy sizes.

Many people worry about their appearance, especially in their teens and twenties, when physical attractiveness, changing bodies, and social pressures come together to make appearance seem more important than ever. Who wouldn’t want perfectly clear lustrous skin, a beautiful head of richly colored hair, and the perfect physique? The answer for most people is sure, why not? But for some people, normal appearance concerns cross over into preoccupation or even obsession with their appearance. In more severe cases, these concerns seriously interfere with school work and relationships, and can cause significant distress. This relatively common but underrecognized disorder is known as body dysmorphic disorder, or BDD. Because BDD can cause so much suffering and disruption of normal functioning, it’s important to know about it. BDD, which usually begins during adolescence, can cause depression, social isolation, academic impairment, and, in more severe cases, unnecessary cosmetic surgery, psychiatric hospitalization, and even suicide attempts.

When we think of compulsive dieting, and what we might think of as a typical person with body dysmorphic disorder, anorexia and bulemia probably come to mind.  Never would we imagine that the bodybuilder or exercise fanatic, with “perfectly” toned and defined muscles would have an issue with body image.  Yet, for some bodybuilders, their body image is far from perfect. No matter how large they become, they may see themselves as small. What seems to others nothing more than exaggerated physical vanity may be a manifestation of distorted body image, or dysmorphia.  According to several ongoing studies of bodybuilders, it is speculated that as many as 10 percent of bodybuilders or as many as 500,000 to 1 million individuals may suffer from what is being termed muscle dysmorphia or “bigorexia”.

The physical risks of this type of BDD  or muscle dysmorphia are perhaps less life threatening than anorexia or bulemia, but are still quite serious as they are related primarily to substance abuse and secondarily to diet.  Muscle dysmorphia is a disorder defined mainly by obsessive thoughts about body size and shape, compulsive behavior regarding exercise and use of a variety of supplements and steroids in an attempt to bulk up and get lean. Anabolic steroids are the most commonly abused drug by those with the disorder and pose a host of physical and psychiatric risks. Chronic use may increase susceptibility to cardiovascular disease and other medical problems. Other drugs, including stimulants, pituitary, adrenal, and thyroid hormones, laxatives and diuretics may also be used and can pose dangers if used over an extended period of time.  Other health problems may also show up in the form of overtraining or continuing to exercise with injuries, often using analgesics to mask the pain.

Muscle dysmorphia may cause social problems, with going to the gym  as their exclusive social activity.  They may exercise to the exclusion of dating and sex, and may even alter their careers to spend more time at the gym.

For many people who have the disorder, they see their behavior as normal and are comfortable with their symptoms. Although it many seem that BDD and their variants are trivial illnesses, they’re not. People can have their lives totally consumed by this disorder which can cause substantial impairment in social and occupational functioning, as well as increased risk of death or suicide.

The criteria for muscle dysmorphia, as a recently identified variant of body dysmorphic disorder (BDD), are as follows.

  • The person has a preoccupation with the idea that his/her body is not sufficiently lean and muscular. Associated behaviors include hours of weight lifting and excessive attention to diet.
  • The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Individuals often forgo dating and recreational activities, or slack at work to maintain workout and diet schedules. They may also avoid situations where their body is exposed to others or exhibit great anxiety when they are in such situations. They may continue working out, adhering to a strict diet, or using performance-enhancing drugs even when suffering adverse physical and psychological side effects of their regimen.
  • The main focus of their preoccupation and behavior is on being too small or inadequately muscular, as distinguished from fear of fat or other aspects of appearance typical of other forms of BDD.

It is important to remember that BDD is not a rare disorder, only an underrecognized one. Diagnosing BDD can be challenging because sufferers often keep their symptoms secret due to embarrassment and shame. People with BDD often worry that other will consider their concerns superficial and vain, thereby making themselves feel worse for having the symptoms of this disorder. Others may see the BDD sufferer’s concerns as attention getting and will become irritated with them. In addition to being underdiagnosed, BDD can be misdiagnosed by professionals, partially because it is not yet widely recognized and also because BDD sufferers are often reluctant to discuss their symptoms. But BDD of any kind is nothing to be ashamed of and nothing to keep secret – it is a serious yet very treatable disorder.

It’s critical for people today to be educated, empowered, and inspired to create a change in the unattainable standard of beauty and the ideal body in our society. We must work to create a world where self-worth is based upon the qualities of one’s character, the strength of one’s convictions, the impact of a person’s accomplishments, and the power of one’s voice rather than by their weight on a scale or the size of their jeans.

Weighing the Myths of Women and Weight Training

If you have yet to learn the benefits of weight training, or are still debating whether or not to try it, this information is for you.

Tufts University conducted a study on the benefits of weight training which involved forty postmenopausal women. The control group – half of the volunteers – simply maintained their lifestyle for a year. The others lifted weights twice per week.

At the end of the year, the sedentary women’s bones and muscles had aged. They had lost bone density and strength. And they were even less active than before.

Contrary to that dismal scenario, the bodies of the women who lifted weights were fifteen to twenty years more youthful. They gained bone density and their strength level soared to levels typical of women in their late thirties or early forties. They traded fat for muscle, therefore, looked trimmer and dropped dress sizes.

The women who lifted weights actually got smaller, not larger, once again debunking the myth some women still believe about weight training making them bulky. These women gained nine percent muscle, and lost a corresponding amount of fat. Since muscle is denser than fat, they were smaller, leaner and more toned and no one complained about looking unfeminine.

Aside from the physical changes, the women who lifted weights felt happier, more energetic and had greater self-confidence. These women also became more active as they got stronger. They not only felt younger, they were leading younger lives. Physical changes caused emotional changes, which impacted their lives positively. They regained enjoyment of life they thought they had lost forever. All of that for two workouts per week!

Although research has shown that when women maintain a regular strength training program they will benefit from the long list of health advantages, many women are still held back by the many myths surrounding women and weight training.  It’s time to dispel those myths so women of all ages will begin participating in weight training and can start feeling the life long benefits that come with it.

Myth#1 – I should loose weight before I start weight training.

Fact – Why wait when weight training burns fat best. Weight training is the best way to loose weight because it permanently increases your metabolism. It is important to understand that dieting without exercise causes the body to lose muscle, which slows the metabolism. Only the combination of weight training and positive nutritional changes makes it possible to lose fat and keep it off.  As you add muscle, your resting metabolism increases, so you burn more calories all day long. For each pound of muscle you gain, you’ll burn 35 to 50 more calories daily. So, by gaining only three pounds of muscle, you’ll burn an average of 120 more calories per day, or approximately 3,600 more calories per month. That equates to a loss of 10 to 12 pounds in one year!

Myth #2 – Aerobic exercise is better than weight training to burn fat.

Fact – If you really want to lose fat – and keep it off — the best way to do it is with weight training. While it may feel like running on the treadmill for an hour (while you are dripping with sweat) is burning tons of calories, it’s only burning calories while you are exercising and for one to two hours after. Weight training is the most effective way to burn fat because the more muscle you gain, the more fat you burn all the time – 24 hours a day, 7 days a week.  With more muscle, you are not just burning fat one or two hours when you’re exercising, but every hour of every day, whether you’re exercising, eating, sleeping or sitting at your desk.

Myth #3 – If I weight train I will get bigger and I want to look smaller.

Fact –  Muscle actually takes up less space than fat, so ultimately, by weight training, you will be smaller, firmer and toner; and your clothes will fit better. What about weight? Yes, you may end up weighing the same or even more because muscle weighs more than fat, but remember the true test is how you look and feel – not what the numbers on the scale say.

Myth #4 – Weight training will make me bulky and masculine – I don’t want to loose my femininity.

Fact – No worries – weight training will not turn you into to an Arnold Schwarzenegger look-alike over night. Women don’t become overly muscular – it’s just not possible.
Women don’t naturally produce enough of the hormones it takes to grow massive muscle.
Weight training will, however, give you that toned look you’re striving for – you can’t burn fat off to see muscle tone that doesn’t exist. Crash diets that burn precious muscle tissue only leave you with a temporarily smaller version of your original fat self.  “Skinny fat” is still flabby, but muscle is sexy!  If you want curves and definition, and a tight toned body, weight training is the way to go.

Myth #5 – I’m too old to start weight training.

Fact – It’s NEVER to late to start weight training.  Studies have shown strength improvements and numerous other benefits from weight training are possible at any age, even in subjects well into their 70s and 80s.  In fact, a recent study, published in the
Journal of the American Medical Association, found that post-menopausal women can reduce their body fat, increase muscle mass, build up their bones, and improve their balance by lifting moderately heavy weights on a regular basis. Biologically, the women were about 20 years younger then they were at the start of the yearlong study.

Research has also found that weight training can increase spinal bone mineral density by as much as 13 percent in six months. So weight training is a powerful tool against osteoporosis.  The benefits of weight training are now indisputable, both to prevent the effects of aging in pre-menopausal women and reverse the effects of aging in post-menopausal women.

And if all that isn’t enough to convince you the weight training is the single most effective way to burn fat, increases metabolism, build strength and increase bone density, here are a few other benefits you may want to consider.

  1. You Will Reduce Your Risk of Diabetes. Adult-onset diabetes is a growing problem for women and men. Research indicates that weight training can increase glucose utilization in the body by 23 percent in four months.
  2. You Will Fight Heart Disease. Strength training will improve your cholesterol profile and blood pressure.  And the benefits only increase your regimen also includes cardiovascular exercise, flexibility training and a good nutrition and supplement program.
  3. You Will Be Able to Fight Back Pain and Arthritis. A recent 12-year study showed that strengthening the low-back muscles had an 80 percent success rate in eliminating or alleviating low-back pain. Other studies have indicated that weight training can ease arthritis pain and strengthen joints.
  4. You’ll Be a Stronger Woman Physically and Mentally. Studies have shown that moderate weight training increases a woman’s strength by 30 to 50 percent. Extra strength will make it easier to accomplish daily activities, such as lifting children or groceries. Most strength differences between men and women can be explained by differences in body size and fat mass. Pound for pound, women can develop their strength at the same rate as men.  In addition, a Harvard study found that 10 weeks of strength training reduced symptoms of clinical depression more successfully than traditional counseling did. Women who weight train commonly report feeling more confident and capable as a result of their program.

As you can see, the benefits of weight training far outweigh any myths that might be associated with it.  So hit the weights — and get ready to reap a host of health benefits that you probably never imagined possible with just one small lifestyle change.
See you at the gym!

The Case for Supplementation

“Do you believe in supplements?” It’s a question often asked as if taking vitamins were based on some kind of blind faith that they will actually provide some benefit or serve some useful purpose.  Thankfully supplementation, as a progressive and proactive approach to healthcare, is not based on blind faith, but on a growing body of science that is finally taking its place along side other health sciences.  What I do believe is that more and more people are increasingly interested in nutrition as a means of improving their lives and preventing illness.  They want to live longer, healthier lives, look better, feel better, handle stress better, have more energy, and minimize their risk of everything from the common cold to cancer.

As Americans seek to attain longer, healthier lives, and to reduce chronic disease, the evidence to encourage the use of supplements grows stronger. A recent study commissioned by the Council for Responsible Nutrition estimated that 8.7 billion dollars could be saved on four major diseases if Americans consumed optimum levels of the antioxidants vitamin C, vitamin E, and beta-carotene.  Diets optimal in these nutrients have been shown to reduce costs associated with breast, lung and stomach cancer, and dramatically reduce the incidence and severity of cataracts.   Additionally, the council evaluated ten years of the best scientific studies related to the benefits of vitamin and mineral supplements and concluded that the long term benefits could reduce neural tube birth defects by 70 percent, sick days could be reduced by 50 percent, and health-care costs by delaying cardiovascular disease, stroke and hip fracture could be reduced by a staggering $89 billion per year.

And while perhaps some of these benefits could be derived from diet, most individuals do not eat the five servings of fruit and vegetables as recommended by the National Cancer Institute.  In fact, it has been estimated that less than 10 percent of Americans actually consume two servings of fruit and three servings of vegetables per day and that over half eat no vegetables at all.  As for those of us who do practice better eating habits, and do include those daily five, we are still being left nutritionally void of many of the nutrients we believe we are consuming.

Food is not what it used to be.  Today our food is both less (nutritionally speaking) and more (chemically contaminated) than in the past.  On an average our food travels 1300 miles from farm to market shelf.  Nearly every state buys 90 percent of its food from out of the state.  Through irradiation, our food is bombarded with the equivalent of 233 billion chest x-rays to kill bacteria and extend shelf life.  Thirty percent of American dairy animals are fed genetically engineered bovine growth hormone.

Many modern agricultural practices adversely affect the quality of our food and its nutrient levels.  Many foods are grown using methods designed to increase quantity or to facilitate transportation and storage, and these methods often are detrimental to the nutritional value of the food. Modern farming methods also often degrade the quality of the soil in which our food is grown leaving it very low in minerals, and with added pesticides, herbicides, and other chemicals that are added during the growing process. High nitrogen fertilizers accelerate growth so fruits and vegetables are marketable size, long before they have had time to absorb minerals or synthesize nutrients.  Often foods are not allowed to develop to their full level of vitamins and minerals, which increases greatly during later stages of growth. Fruits and vegetables are often picked before they are ripe, or allowed to ripen during transit to the market, which greatly diminishes their vitamin or mineral content. Transportation and storage can also adversely affect nutrient content of fruits and vegetables as they can start to lose significant amounts of vitamins as soon as they are cut or harvested. Transit time alone can provide for produce that has been severely depleted of its nutrient content.  Produce can lose as much as 50 percent of its carotene (pro-vitamin A) and 60 percent of its vitamin C within as little as three days of being harvested.  Additionally, certain fruits and vegetables can lose significant amounts of vitamins when they are stored at cold temperatures or even at room temperatures.  Green vegetables lose all of their vitamin C after just a few days of being stored at room temperature.  Drying, as well as exposure to light and oxygen also diminishes nutrient content.  And while some may argue that many foods have been grown with the addition of certain nutrients, the nutrients optimum for plant growth are not necessarily optimum for our consumption.  Chemical fertilizers that facilitate plant growth do not replace the minerals necessary for human nutrition.  Even organic fruits and vegetables, while they are free of pesticides, are still harvested and transported using these same practices, unfortunately also rendering them nutritionally insufficient.  And unfortunately, produce is not the only food group fallen victim to modern processing and refining practices. Whole grains have suffered probably the greatest injustice inflicted by the food industry.  When wheat is processed in to white flour, up to 40 percent of the vitamin C, 65-85 percent of the various B Vitamins, 59 percent of the magnesium and 72 percent of the zinc are lost along with significant amounts of protein and fiber.  All in all more than 26 essential nutrients are removed.  Even our meat, fish and dairy products do not contain the nutrients we assume they do.

Supplements are a way for us to make up for nutrients lost in our food as a result of growing, shipping storing and processing practices.  Incorporating a good multivitamin into your daily routine is a good start to optimizing your nutrition plan and one of the simplest ways to begin a supplement program.  But even making good supplement choices can be difficult and often confusing.  The following are a few tips to help assure you get the most out of your choice.

  1. Always buy well-known, reputable brands – this is more easily assured when you buy from reputable nutrition stores with a knowledgeable staff, willing to assist you in making the best choice for you.
  2. Always choose food based, rather than chemical based vitamins.  Food based vitamins are more bioavailable, contain nutrients as they occur in food, and are not made from by- products of the petrochemical (or gasoline) refining process.
  3. Choose a vitamin that is taken in divided doses throughout the day rather than “one a day”.  While it may seem a little less convenient to take three pills as opposed to one, it is necessary to replace certain nutrients throughout the day.  Many vitamins are out of your system, or completely used up within hours of ingestion.  It doesn’t really make much sense to have antioxidant protection for the first three hours of your day, and not the next twenty-one.  Time released multivitamins also leave you lacking in nutrients, as vitamins and minerals are absorbed through different points in your digestive system, and often the timed release is “releasing” past its point of absorption.
  4. Avoid multivitamins that only offer 100% of the RDA. The recommended dietary allowances (RDAs) were established more than fifty years ago as the minimum amount of nutrients needed to prevent deficiency diseases in most healthy people.  These amounts do not take into account environmental changes and our constant bombardment with pollutants, or individual needs based on age, stress or dietary considerations.
    A good example of this would be with Vitamin C.  The daily intake of Vitamin C required to prevent Scurvy is between 30-50mg.  That is approximately the amount found in one orange, lime, or lemon.  Years ago, before much was known about the many other biochemical roles of Vitamin C, the RDA for ascorbic acid was set at 60mg, the minimal amount to prevent Scurvy. Despite recommendations by the Food & Nutrition Board of the National Academy of Sciences and the fact that over several decades many scientific studies have shown that optimum health requires many times more than 60mg of Vitamin C, the official RDA remains at 60mg.  Considering just one cigarette destroys approximately 500 mg. of Vitamin C (this includes second hand smoke), 60mg is well below the minimum necessary for those focusing on optimizing their health.

But remember, supplements are just that – supplements.  They should be taken in addition to, not in place of, an intelligent diet. Supplements will not make up for a diet high in refined carbohydrates and sugars and saturated fats, low in fiber, or a sedentary lifestyle.

As for the discouraging news about our produce, a visit to your local farmers’ market is well worth the trip.  This is one of the best ways to get vine ripened, fresh picked produce, that is more colorful, flavorful, and certainly more nutritious.