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The Seven Sins... of a Chinese Food Buffet?

>> Sunday, November 29, 2009

Okay. I'm not saying that the following are actually sins.

I'm also not suggesting that a buffet is a preferred venue for eating out, as it is very difficult to adhere to the principles of portion control in that setting. Nor am I recommending Chinese food as the fifth food group - most of the protein is swathed in a layer of fat, and Free Veg is a figment of another world far, far away....

However: A recent study by B Wansink and CR Payne, published in the journal Obesity, identified some important eating patterns amongst overweight people attending a Chinese food buffet. Here is a summary of their findings - and some suggestions for what can be done to improve upon these behaviors!

1. People with a higher BMI were more likely to choose a large plate than a small plate.

Studies have clearly demonstrated that the larger the plate provided, the greater the amount of food that is served up on that plate. This, in turn, results directly in a greater number of calories consumed, as compared to the same person eating from a smaller plate. Plate sizes have grown over the last few decades - in remarkable parallel to the growth of obesity.

This phenomenon stems from the simple fact that it is asthetically displeasing to have a half full plate! The solution is simple: be sure to use a smaller set of dishware. Also, make a conscious decision to choose a smaller plate whenever you are out and you have the option.

2. Thinner people browsed the buffet before loading up, whereas heavier people dished up before checking out what was available.

Taking an assessment of what is available before you make your food choices allows you to:

a. Budget your calories towards the food that you'd most like to eat (rather than choosing and eating something mediocre, and finding out after that that must-have favorite food is on the next buffet stand that you didn't make it to the first time around); and

b. Find the healthiest options on the buffet.

3. Heavier people sat facing the buffet head on; lighter people were more likely to sit in a spot without direct view of the food.

Out of sight, out of mind! Having food in your direct line of sight makes it hard to forget that there is unlimited food right at your fingertips. The truth of the matter is, that in our society, there is always unlimited food at our finger tips - the key is to do what you can to make it less accessible and less in the forefront of your mind.

It is okay to go to a buffet for the purpose of having a great selection from which to choose - but the usual principle of one serving only still applies. This is much easier to effect if you choose a seat that doesn't tempt with the view. The same is true for how you place food around the house - put a bowl of fruit on the kitchen counter, and put the cookies in the cupboard (far, far to the back....)!

4. Chopsticks were more often used by normal weight.

Now here is something that the Chinese food restaurant does right! Chopsticks are an excellent form of portion control, as you can generally take less food with sticks than you can pierce with a fork. It therefore takes a longer time to consume food with chopsticks - as such, by the time your satiety hormones kick in to tell you that you're full (about 15 mins into a meal), you have consumed less calories than if you had been eating with standard utensils.

If you are able to eat with chopsticks, it isn't a bad idea to use them routinely. And although many of us have not grown up using them, there is no time like the present to learn!

5. Thin people were more likely to place a napkin in their laps than heavier people.

This likely comes down to the amount of time that is spent preparing for and enjoying a meal, and to whether or not a person plans to stand up and head back to the buffet for seconds.

6. Thinner people chewed more times per mouthful.

Chewing more per mouthful enables us to take the time to enjoy the taste and sensation of food, thereby providing more satisfaction per mouthful and decreasing the number of mouthfuls needed to feel that a good meal has been consumed. In addition, slower eating results in less calories being consumed before those satiety hormones start to act (15 minutes).

7. Thinner people left more on their plate than heavier people.

Which is the chicken and which is the egg? It is possible that the thinner people left more food on their plate because their satiety signals are better able to tell them they are full? Or are they thinner because they make a conscious decision to stop eating sooner than the overweight person? Do overweight people have better ingrained manners to clean their plates? Is this a contributor to becoming overweight in the first place?

Though it represents a change in tradition, it needs to be okay not to finish what is on our plates. Instead of teaching our children to finish everything, the focus should be on teaching them to take smaller portions, to eat slowly and to enjoy their food. If sometimes our eyes are bigger than our stomachs, an unfinished plate sometimes just has to be.

Dr. Sue © 2009


Nouveau Quiche!

>> Sunday, November 22, 2009

Here is a fantastic recipe from the gurus of Crazy Plates! I know lots of people who are not quiche fans, so when I make this I tend not to say the 'q' word until after they've tasted it - and I always get a look of surprise! It is crustless, which cuts out lots of empty calories. This recipe is super tasty and packed with protein - trust me on this and give it a try!


  • 3 cups sliced mushrooms
  • 1 cup each diced onions and diced red bell pepper
  • 2 cloves garlic, minced
  • 1.5 cups egg whites
  • 3/4 c evaporated 2% milk
  • 1/4 c grated parmesan cheese
  • 1/2 tsp dry mustard powder
  • 1/4 tsp each salt and black pepper
  • 8 oz canned, fresh, or frozen lump crabmeat (drain well)
  • 3/4 c shredded, reduced fat sharp cheddar cheese (3 oz)
  • 1/4 c chopped green onions

1. Spray a large saucepan with non stick spray. Add mushrooms, onions, red pepper, and garlic. Cook and stir over medium heat until veggies are tender, about 6-7 mins. Remove from heat and let cool slightly.

2. In a large bowl, whisk together egg whites, milk, parmesan, mustard powder, salt, and pepper. Stir in crabmeat, mushroom mixture, cheddar cheese, and green onions. Pour into a 9 inch deep-dish quiche pan or pie plate that has been sprayed with non stick spray.

3. Bake quiche at 350 F for 40-45 mins, until firm to touch. Let stand 10 miuntes before slicing.

Makes 6 servings. Per serving:
  • 160 cal
  • 5g fat
  • 20.1g protein
  • 9.5g carbohydrate
  • 491 mg sodium
Dr. Sue © 2009


Who Said 'Never Trust a Skinny Chef'?

>> Monday, November 16, 2009

As much as everyone enjoys eating out, it can really be hazardous for someone trying to lose weight, as restaurant meals are a notorious source of hidden calories and huge portions. As such, research is being done to try to figure out how best to cut back on those calories, while preserving the experience and taste sensation of eating out.

Research presented by Dr. Barbara Rolls and colleagues at the recent Obesity Society meeting asked chefs how they thought the industry could best help out to shave calories in light of the obesity epidemic.

These chefs were more interested in creating new inventions for calorie-savvy customers, rather than changing their existing dishes: 67% thought that introducing a new reduced-calorie item would sell well, whereas only 44% felt reducing the calories in an existing item would be successful.

They were also divided on whether putting calorie information on the menu would hurt or help sales. Interestingly, a separate study from New York examined the effects of mandatory calorie labeling, which went into effect in fast food restaurants in their city in July 2008. It was found that although some people said they were purchasing fewer calories based on this information, there was actually no difference in the average number of calories people purchased before vs after the implementation.

In a previous survey study, chefs also admitted that they ladle up serving sizes that are two to four times the size of recommended servings!

Where does this leave us? Well, it is unlikely that restaurant food will ever be uniformly 'safe' to eat from a dieters' point of view, regardless of how many reduced calorie options show up at your favorite spot. The definition of 'reduced calorie' or 'reduced fat' remains somewhat nebulous, and remember that low fat dishes often replace the missing fat with sugar, which can bring the calorie count right back up to equal or exceed the high fat version! The best thing to do when eating out, is to bring the following principles with you:

  • Cut your portions in half. Ask your waiter to bring half your meal in a take away container before it even hits your plate.
  • Do look for options labelled as 'reduced calorie' or 'low fat' on the menu, as they are probably better options - but cut your portion in half as well. Ask your waitress what changes were made in the dish to make it healthier.
  • Opt for the dishes heavy in fresh greens, such as salads. Get your dressing on the side!
  • Give the menu back to the waiter as soon as you have ordered, to avoid the temptation to order dessert!
  • Choose restaurants that specialize in fresh food - this can be anything from sushi to Subway! It is harder to hide calories (eg cooking oils, sauces) in food that is fresh.

Gone are the days where we should say "Never trust a skinny chef!"


New weight loss drugs on the horizon!

>> Saturday, November 7, 2009

For people who have not had success with lifestyle interventions (diet & exercise) to lose weight, treatment with medication may be appropriate, to be used in conjunction with ongoing efforts to change from a lifestyle perspective. In addition to the two medications currently available (Sibutramine (Meridia) and Orlistat (Xenical)), there are at least three new medications that are in the final stages of research, and may become available soon:

Qnexa: This medication incorporates low doses of two previously approved prescription medications: the diet drug phentermine, and topiramate, which is used to treat epilepsy and chronic migraines. Phentermine reduces appetite, and is occassionally used alone to assist with weight loss in the short term (3 months). Topiramate increases the sense of fullness.

In two separate studies, the mean weight loss was 13.2% (30 pounds) and 14.7% (37 pounds) for patients who were treated with full-dose Qnexa for 56 weeks. When people who didn't complete the trials are included, the percentage of total weight lost drops to 10.4% to 11%.

Lorcaserin: It works by stimulating serotonin receptors in the brain, thereby decreasing appetite. Patients who stayed on lorcaserin combined with lifestyle changes for one year lost an average of 17 pounds. About two-thirds of lorcaserin patients lost at least 5% of their body weight; about a third of those who took the placebo and made lifestyle changes accomplished this. The most responsive 25% of patients lost an average of 35 pounds.

Contrave: This medication combines two drugs already on the market — bupropion, an antidepressant and smoking cessation medication (also known as Zyban or Wellbutrin SR), and naltrexone, currently used for alcohol and opioid addiction. It works to fight food cravings and improves the ability to control eating. The research shows patients lost about 6% to 9.3% of their starting weight in a year on the medication.

Medical therapy for weight loss can be considered for individuals who have a BMI of 30 or more, or a BMI of 27 or more with complications of obesity such as diabetes, sleep apnea, or high blood pressure. (You can calculate your BMI at using the 'BMI Calculator' in the right hand column!) Important considerations for drug treatment for obesity include:

  • Medications to treat obesity generally result in only a modest weight reduction. However, this weight reduction can be twice as much when combined with changes in lifestyle (healthier food choices, portion control, and exercise!).

  • Currently approved weight loss drugs have 2-4 years' of safety data. In other words, we do not know what the effects of taking such medications for 10 years might have, and therefore, they should not be used indefinitely. This has important implications, as studies consistently show that once a medication for obesity treatment is stopped, the vast majority gain the weight back.

  • All medications have risks and the potential for side effects, and these should be discussed thoroughly by your doctor if drug therapy is being considered. Drug treatment for obesity is available only by prescription from your physician, and should never be undertaken without medical (MD) supervision.
In my opinion, there is certainly a role for drug treatment of obesity, and it can be of great help to some people. The key to success is to view drug treatment as a kick start to weight loss, in combination with a permanent alteration of lifestyle habits, primarily geared towards reducing your caloric intake to 500 calories per day less than what you need. (You can calculate your daily caloric requirements at using the Basal Metabolic Rate (BMR) Calculator in the right hand column.)

Once 10-20 pounds are shed, and with an extra spring in your step, you can then ramp up the exercise (under the guidance of your physician) to increase your caloric expenditure. With these new diet and exercise changes solidly adopted into your life, the drug therapy can then be phased out. Obesity is a lifestyle problem for most people - and as such, the permanent solution lies in lifestyle too!

Dr. Sue © 2009



I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!

Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!

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