If you missed our live online chat with John Whyte, M.D., author of AARP New American Diet, read the transcript of the conversation.
Comment from Mimi: I am morbidly overweight, extremely tired all the time, no energy, depressed and the main caregiver for my grandmother. I need to lose weight and exercise but don't know where to start. Please help.
See also: Caregiving Resource Center
John Whyte: I often recommend to patients that they make changes in either food or exercise but not both at first. So let's start with food. Here are three changes you can make over a few days or a couple of weeks and you will see weight loss:
1. Limit beverages to only coffee and water. Water is naturally filling — it stretches your stomach, and that sends signals to your brain that you are full even though water has no calories. Water helps aid in the digestion process, which allows your body to absorb nutrients more effectively. And drinking water during a meal keeps your mouth busy, thereby taking you longer to eat.
2. Eliminate any food that is white unless it's low-fat dairy. I'm overgeneralizing a little, but by this I basically mean white bread, including pastries and cakes, as well as white rice. These are the processed grains that I want you to avoid. It's these processed foods that are one of the main causes of obesity and subsequent disease.
3. Eat breakfast every day. And this means a "real" breakfast — not a bagel and coffee.
I'm going to give you some specific breakfast recipes to make this easy but you should know that you might need to get up a few minutes earlier to prepare it and eat it. Believe me, it is worth it. Many people will say they are not hungry in the morning; I was like that for a long time. I barely ate anything and was always in a rush to get to the office. So I started with something small, like two pieces of whole wheat toast, and then over a few days built up to eating a variety of fruit, yogurt, fiber cereal and eggs. Now, I almost never leave home without taking some time to eat breakfast.
Eating a healthy, nutrient-dense breakfast is probably one of the best changes you can make to ensure success. And don't replace eating no breakfast with eating a breakfast of highly processed simple carbs — that's just one bad habit for another.
Comment from Debbie Aguer: Can I mix and match the daily meal plans or must I eat the three meals and snacks as they are put together?
John Whyte: Mix and match is definitely OK. The key is to eat three smaller meals a day and two snacks. As long as you eat healthy foods from the AARP New American Diet, it's OK to pick and choose your specific meals. Personally, there's three or four healthy foods I stick with for breakfast and lunch. So go ahead and mix and match. Just make sure they're healthy choices! I love oatmeal, so I'll eat that every day for about a month. Then I'll eat Greek yogurt with blueberries and walnuts every day for a week. For lunch, I might eat chicken breasts three days a week, and I go through periods of time when I eat tuna fish on rye bread. So again, find some foods you like from the meal plan, and go ahead and stick with them. We are all creatures of habit!
Comment from Rachel: Between work and caregiving, I'm constantly on the go, and taking time to make healthy meals goes to the bottom of the list. I find myself grabbing fast food on the way here or there. How can I make healthier choices at fast-food restaurants?
John Whyte: It's a common misconception that eating healthy takes a lot of time and work. The reality is that it takes more planning — you need to have the food around. For instance, fresh fruit is the original fast food. What's faster than eating a banana or an apple? And people often are fearful of cooking fish — but it actually only takes about 10 minutes — quicker than the round-trip to most fast-food restaurants. If you have to go to fast-food restaurants, please avoid anything fried; never say "supersize."
Comment from Nicole: I've been reading a lot about sugar recently ... how it's a toxin and should be a regulated substance. It's scary to think that we are putting something that's so bad for you in our bodies on a regular basis. Should we try to cut it out completely or what limits should we put on it?
John Whyte: It's hard to cut out sugar completely. Sugar can be a source of energy, and natural sugar — from fruit — is useful to our bodies. But I do recommend you limit sugar consumption. Definitely eliminate all the sugary beverages — soda, sweetened teas, specialty coffees — and check food labels. Fat-free foods are often loaded with sugar.
Comment from Diane: Is there any exercise I can do with my mom/dad that will also help me?
John Whyte: Walking is one of the best exercises we can do, and it's a great family exercise. The simple act of walking may also improve memory as we get older. It seems that people who walk more throughout life have greater brain volume than those who walk less. If you walk around seven miles a week, you are half as likely to develop problems with dementia than if you don't walk at all. There are approximately 2,000 steps in one mile. You can check how many steps you take by getting a pedometer — it counts the number of steps you take. If you average 2,000 steps a day, and 14,000 steps a week, I'll be happy!
Comment from Alison: Now that I'm in my 40s, my metabolism is really slowing down. I eat pretty healthy and exercise, but I'm still gaining weight. What can I do? Eat less and exercise more?
John Whyte: It's common to gain weight as we get older. Our basal metabolic rate — basically our internal furnace — slows down as we age. So we need to balance that slowing down of our basal metabolic rate. You can do that through either eating fewer calories or being more active. They're both important — but honestly, weight loss is probably 80 percent food, 20 percent exercise. So I recommend you focus first on eating healthier and fewer calories, and then tackle being more active.
Comment from Jake: What are the three to five best foods you can eat? What about the worst?
John Whyte: We all need to eat more fish — study after study has shown that those who eat fish three days a week have a lower incidence of heart disease and other medical conditions.
People often ask me if there's a magic pill for weight loss. Well, there is — you know what it's called? A blueberry! OK … it's not a magic pill but it is a superfood. It's packed with powerful antioxidants to keep the blood vessels in our heart and brain healthy. So start eating blueberries.
And you need to go nuts over nuts. Sometimes people are concerned about the number of calories in nuts — as long as you keep it to a handful, you'll do OK.
And of course, drink more water.
Your question is great because in order to lose weight and live longer, what we exclude is as important as what we include. So the worst foods are processed meats — the lunch meats — bologna, salami, hot dogs. Soda is your enemy. Anything with high fructose corn syrup should be avoided. If you're currently drinking soda, you need to stop. And all the highly processed foods should be eliminated — all the white breads. Bread is actually the number one source of sodium in our diet. Stop all the doughnuts, bagels and scones. (Scone is really just a fancy word for doughnut!)
Comment from Sarah: I've had cancer and am really focusing on my diet now. I've heard that a vegan diet is much healthier for you and could help prevent cancer and other diseases. What do you think?
John Whyte: The AARP New American Diet clearly demonstrates the healthy benefits of a modified Mediterranean diet. Fruits and vegetables are key, but so are fish and nuts. There's also data to support low-fat dairy. This is the diet where there is the most evidence that it helps to reduce the incidence of several different types of cancer.
Comment from Queen: I am on a fixed income and would like to eat healthy on a budget.
John Whyte: There's a belief that eating healthy is expensive. You can, however, still make healthy choices that are within your budget. For instance, tuna fish is quite inexpensive but very healthy. All-natural peanut butter is filled with healthy fats and is very affordable. Eggs are also reasonably priced — and eating eggs up to three times a week is still healthy. It might take a little more work and planning, but you definitely can eat healthy on a budget. And you'll likely avoid the diseases that often are costly later in life.
Comment from Lucy: I have gained 20 pounds since I started intense caregiving for my parents — I know it's partly the way I eat and don't exercise but I think it's also stress. What effect does stress have on my weight — in particular my belly fat?!
John Whyte: It's not surprising that the added stress caused weight gain. It is often related to the hormone cortisol. Cortisol is a hormone that usually can be very helpful. It provides glucose to the body for energy when there is a stressful situation that requires you to have more energy or to be more alert. However, chronic stress will cause cortisol levels to be high chronically, and this is not a good thing for your body. In this situation, the elevated cortisol levels cause high blood sugar, which will cause a series of other reactions that will cause you to store fat as well as hold on to it, making it very difficult to shed the pounds. That helps explain why stress can actually make you fat.
Comment from Margaret: I'm so tired from caregiving I never seem to have time or energy to go through all the steps of a healthy meal. What are some quick ways to eat well? Do you recommend making a Crock-Pot meal in the morning so it's ready for dinner?
John Whyte: The slow cooker can be a very effective way to eat healthy. The key to eating well quickly is to prepare. Make a grocery list on Saturday or Sunday morning and do all your shopping for the week. Too often, we eat unhealthy food because there's nothing healthy to eat. But if you stock your pantry, refrigerator and freezer with healthy options, you'll be able to eat well quickly.
Comment from Alvinia: I usually walk a lot. Recently I started having much pain in my hip joint and was diagnosed with arthritis in my hip. Any suggestions on what I can eat to help with arthritis pain?
John Whyte: I hope you are seeing an orthopedist or rheumatologist, since we do have effective therapies for arthritis. Swimming can be a great way to exercise when you have arthritis, since it puts less stress on the joint. Depending on where the pain is exactly, using a stationary bike or an elliptical machine might be OK. And don't forget about upper body exercises. A great exercise almost anyone can do is pushups. Start off doing 10 in the morning and 10 in the evening, and see if you can work up to 50 twice a day. That will get your heart pumping, as well as improve bone density.
Comment from Jim: I've heard so many things about different diets — Atkins, South Beach, etc. It's hard to know what you are and aren't supposed to eat. Can you clear up the confusion?
John Whyte: You need to find a diet for you to live on, rather than for you to go on. That's what the AARP New American Diet is about. Too many of us have this idea that we "just need to lose 10 pounds" before an upcoming wedding or child's graduation or the start of summer. We deny ourselves all sorts of food, and when we finally lose the weight, we celebrate it by eating gluttonously and resuming our bad habits. We "diet" for a few weeks or a few months to reach a short-term goal, rather than creating a new relationship with food that we can enjoy for life, without even having to think about it. You need a different and fresh perspective as well as a new attitude about food. You need to think about food — a diet — in a completely new way.
Comment from Lauren: How can I boost my energy through food? I take care of my mom in the evenings and go to work during the day. In the late afternoon, I start to feel really tired and just want to lie down and take a nap.
John Whyte: Feeling tired in late afternoon is classic presentation of too much sugar in the diet. I would work on reducing the amount of sugar you consume — especially from sugary beverages. I would focus on healthy snacking such as nuts and fresh fruit. I would eat small meals four or five times a day instead of three big meals. And we've learned recently that coffee has numerous health benefits. Keep it to less than three cups a day, and you'll get more energy and the health benefit.
Comment from Lulu: Should we be worried about mercury in our fish, and what about taking fish oil supplements instead?
John Whyte: Thanks for the follow-up question. Mercury can be a concern. But I would not stop eating fish completely, since the health benefits are enormous. I would check with the supermarket or fish store. Supplements are helpful — particularly if you don't like fish.
Comment from Shelley: Are there health benefits to juicing?
John Whyte: Juicing probably is not any healthier than eating whole fruits or vegetables. I'm a big supporter of whole foods, and fiber is lost during most juicing. Some people suggest that juicing is better for you than eating whole fruits and vegetables because your body can absorb the nutrients better through the juice — but there's not scientific data to support this. If you really don't like fruits and vegetables or aren't getting enough in your diet, then trying juicing could be worth it.
Comment from Philip: Is Splenda okay for teas?
John Whyte: I recommend to patients that they try to eliminate most artificial sweeteners. I think it's OK if you use one packet in tea once a day but I wouldn't consume more than that.
Comment from Brian: How can you beat the weight loss plateau? I do so well at first, but after a month, the weight does not come off. What do you suggest?
John Whyte: Our bodies conspire against us! They get used to the changes and stop us from losing weight. So there are going to be ups and downs. Remember, being healthy isn't a sprint — it's a marathon. So the key is you have to keep at it. And don't become discouraged.
Comment from Jennifer: I haven't read your book yet, so what's "new" about your diet?
John Whyte: It's new because it's based on the latest science that connects what we eat not only to weight loss but also living longer. Other diets are mainly concerned about weight loss, and don't have the level of scientific evidence that AARP New American Diet does.
AARP: You can find the book in the AARP Bookstore.
Thank you, Dr. Whyte, for all the great information here today. As a caregiver, I know I learned a lot! Have a caregiving question for one of our great caregiving experts like John Whyte? You can ask it here.