Eat More to Lose More: Healthy Snacks for Weight Loss

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the benefits of healthy snacking.

Don't overlook the benefits of snacking when trying to lose weight. Snacking helps you fuel up between meals and can prevent you from overeating and making unhealthy food choices. The healthiest snacks include a mix of complex carbohydrates and protein to keep you feeling full throughout the day.

In fact, many nutrition experts suggest shifting away from the traditional three-meals-a-day diet. Instead, they recommend eating small, nutritious meals every three hours or eating five to six times a day. Although it may seem counter-intuitive to weight loss, eating smaller, more frequent meals helps you maintain consistent blood sugar levels throughout the day, and prevents ravenous hunger that often leads to overeating and poor food choices.

If you are tired of your usual snacks or looking for healthier alternatives, here are a few ideas to liven up your healthy snack options:

• Celery sticks spread with one to two tablespoons of almond or peanut butter
• Fresh vegetables (i.e. carrot sticks, cherry tomatoes or fresh green beans) with two tablespoons of hummus
• One serving of whole grain crackers topped with one ounce of reduced-fat cheese and sliced green grapes
• One small apple, sliced with one tablespoon of peanut butter for dipping
• Half a cinnamon raisin, whole-grain English muffin topped with low-fat cottage cheese, no-calorie sweetener (i.e. Splenda^®, Truvia or Pure Via™) and cinnamon
• One serving Greek yogurt with fresh fruit
• One cup homemade vegetable soup
• One brown rice cake with pesto, canned salmon and diced tomatoes
• Three handfuls of air-popped popcorn seasoned with spray butter and herbs
• One brown rice cake topped with a sliced hard-boiled egg, light mayo and fresh herbs
  

- Cara Stewart, RD, LDN

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Greek Yogurt: Energizing, Healthy and It Tastes Good, Too!

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the health benefits of Greek yogurt.

Greek yogurt is all the rage lately – and for good reason. Although it has been a part of Mediterranean and Middle Eastern diets for centuries, Greek yogurt has only recently gained popularity in the U.S.

Strained of most of its whey content (the liquid portion of yogurt), Greek yogurt has a thicker and creamier texture than regular yogurt. It is also higher in protein, which is why Greek yogurt is a mainstay of many people’s diets before and after bariatric surgery. Ounce for ounce, it contains up to twice as much protein as regular yogurt.

As with any packaged food, it is important to read the food label. Beware of the fat and sugar content in some varieties. Full-fat versions can contain up to 20 grams of fat per serving while fruit-flavored versions may contain significant amounts of added sugar.

Stick to the nonfat, plain varieties with no added sugar. Non-added sugar listed on the label is from lactose, a natural milk sugar. Add fresh or frozen fruit or a no-calorie sweetener like Splenda^® to give Greek yogurt a healthy and flavorful boost without adding excess sugar or fat. Greek yogurt can also be a delicious ingredient in other recipes, including fruit smoothies.

See below for comparisons between regular and Greek yogurts.








- Cara Stewart, RD, LDN

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Get Moving! Tips for Exercising – Safely!

Sarah Krebs, DPT, and Pamela Welsh, PTA, members of the Penn Metabolic and Bariatric Surgery team, provide tips for starting an exercise program.

Are you interested in starting an exercise program? Congratulations! Making the decision to start exercising is half the battle. Avoiding injury and staying committed – that’s the other half.

Exercise is an important part of your weight-loss program. But before you jump right in, make sure to take the proper steps to ensure your safety and long-term exercise success. Taking precautions maximizes the efficacy of your workouts while helping you stay healthy and well, which means you can stay on track to your fitness goals.

Follow these tips to expedite your journey to tip-top shape:

1. Clear your workout with your doctor before starting resistive training.
2. Wear proper footwear (i.e. rubber sole sneakers).
3. Set realistic goals.
4. Start slowly.
5. Maintain proper form. Remember to seek quality, not quantity.
6. Warm up and cool down before and after every workout.
7. Stretch after every workout.
8. Focus on breathing techniques. Exhale on exertion and inhale on relaxation.
9. Monitor your heart rate and stay within target heart rate zone.

- Sarah Krebs, DPT, and Pamela Welsh, PTA

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Provençal Cooking Minus the Cost of Airfare: Eggplant, Zucchini and Tomato Tian

Dreaming of a summer getaway to the South of France? Fantasizing about leisurely dinners in the warm, Mediterranean air? Keep dreaming, but in the meantime, try this Provençal recipe for eggplant, zucchini and tomato tian. Tian [TYAHN ] is a French word used throughout Provençe that refers both to a shallow cooking vessel and the food that is cooked in it.

The recipe gives you a taste of delicious Provençal cooking while taking advantage of summer’s bounty of ripe, nutritious and colorful vegetables. An 11 x 7-inch glass or ceramic baking dish works well for this recipe.

Ingredients:

• 1 pound Japanese eggplant, cut diagonally into ¼-inch thick slices
• 1 pound zucchini, cut diagonally into ¼-inch thick slices
• Cooking spray
• 1 pound large beefsteak tomatoes, peeled, seeded and cut into ¼-inch thick slices
• 1 ½ tablespoons extra-virgin olive oil, divided
• ¼ teaspoon salt, divided
• ¼ teaspoon freshly ground black pepper, divided
• 4 ounces French bread baguette
• 1 cup (4 ounces) grated fresh parmigiano-reggiano cheese
• 2 tablespoons fresh flat-leaf parsley, chopped
• 2 teaspoons fresh oregano, chopped
• 1 ½ teaspoons fresh thyme, chopped
• 2 garlic cloves, minced
• ¼ cup fat-free, low-sodium chicken broth

Preparation:

1. Preheat oven to 375 degrees.
2. Arrange eggplant and zucchini in a single layer on a baking sheet coated with cooking spray. Lightly coat vegetables with cooking spray. Bake at 375° for 15 minutes. Arrange half of eggplant in a single layer in an 11 x 7-inch glass or ceramic baking dish coated with cooking spray. Top with half of zucchini and half of tomato. Drizzle 2 ¼ teaspoons olive oil evenly over vegetables. Sprinkle vegetables evenly with 1/8 teaspoon salt and 1/8 teaspoon black pepper.
3. Place bread in a food processor; process until coarse crumbs measure 2 cups. Add cheese and next 4 ingredients (through garlic) to processor; process until combined. Sprinkle 1 ½ cups breadcrumb mixture evenly over tomato. Repeat layers with remaining eggplant, zucchini, tomatoes, oil, salt, pepper and breadcrumb mixture. Pour broth over top. Bake at 375° for 1 hour or until vegetables are tender and topping is browned.
4. Bon appetit!
   

Nutritional Information:

• Amount per serving
• Calories: 191
• Fat: 8.1 g
• Saturated fat: 3 g
• Monounsaturated fat: 3.7 g
• Polyunsaturated fat: 1 g
• Protein: 10 g
• Carbohydrate: 22.3 g
• Fiber: 4 g
• Cholesterol: 12 mg
• Iron: 1.6 mg
• Sodium: 459 mg
• Calcium: 178 mg

This recipe makes 6 servings. Serving size is approximately 1 cup.

The recipe is courtesy of Joanne Weir, Cooking Light (June 2010).

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Check Your Heart Rate During Exercise: How to measure it and why it’s important

Sarah Krebs, DPT, and Pamela Welsh, PTA, members of the Penn Metabolic and Bariatric Surgery team, explain how to monitor and optimize your heart rate during exercise.

Exercise is an important part of your weight-loss program. It is important to measure your heart rate before starting an exercise program to assess your initial fitness level and to continue monitoring as you progress through the program.

There are three simple steps to monitor heart rate:

1. Find your pulse by placing your pointer and middle finger on your neck or wrist.
2. Gently press to feel your pulse.
3. Count the number of pulses that you feel in ten seconds and multiply that figure by six. This number tells you how many times your heart beats per minute.
   

When exercising, monitor your heart rate throughout the workout to ensure that it remains within your target heart rate zone. Health care professionals have determined that a healthy, safe and effective target heart rate zone during physical exertion is 45 to 85 percent of your heart rate maximum. The heart rate maximum is the fastest your heart can safely beat during exertion.

Follow these steps to calculate your target heart rate zone:

1. Determine your maximum heart rate by subtracting your age from 220. (Example: If you are 45 years old, your heart rate maximum is 220 minus 45, or 175 beats per minute.)
2. Multiply your heart rate maximum by 0.45 to determine the lower end of your target heart rate zone. (Example: 175 x 0.45 = 78.75 beats per minute)
3. Multiple your heart rate maximum by 0.85 to determine the higher end of your target heart rate zone. (Example: 175 x 0.85 = 148.75 beats per minute)
   

The range between the minimum and maximum constitutes your target heart rate zone. If you are beginning an exercise program, or just seeking light activity, aim for a heart rate on the lower end. If you are more physically fit or seeking strenuous activity, aim for the higher end.

Using the example above, the target heart rate zone for someone 45 years old is 78.75 to 148.75

Please talk to your health care team before beginning an exercise routine for help determining your target heart rate zone and designing an appropriate, effective and safe fitness program. It is often helpful to monitor your heart rate before and after everyday activities prior to meeting with your health care team to provide insight into your current fitness level. Keep in mind that as your fitness improves, your heart rate slows down as a result of your heart’s increased efficiency. Lowering your heart rate is an important step in the journey to better heart health.

- Sarah Krebs, DPT and Pamela Welsh, PTA

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Eat Healthy Without Sacrificing Taste: Creamy Pesto Chicken Kebabs

After weight-loss surgery, many people are on the lookout for recipes that are healthy, easy to make and don’t sacrifice taste. This tasty dinner recipe uses the vegetables you already have and chunks of protein-rich chicken to create a culinary delight. It is family friendly, nutritious and highly satisfying – and it only takes 20 minutes to prepare.

Ingredients:

• 2 teaspoons grated lemon rind
• 4 teaspoons fresh lemon juice, divided
• 2 teaspoons bottled minced garlic
• 2 teaspoons olive oil
• 1/2 teaspoon salt
• 1/4 teaspoon black pepper
• 8 (1 inch) pieces yellow bell pepper
• 8 cherry tomatoes
• 1 pound skinless, boneless chicken breast, cut into 1-inch pieces
• 1 small red onion, cut into 8 wedges
• Cooking spray
• 2 tablespoons plain low-fat yogurt
• 2 tablespoons reduced-fat sour cream
• 1 tablespoon commercial pesto

Directions:

1. Preheat broiler.
2. Combine rind, 1 tablespoon juice, garlic, oil, salt and pepper. Toss with bell pepper, tomatoes, chicken and onion. Thread vegetables and chicken onto 4 (12-inch) skewers (if using bamboo skewers, soak them in water before using). Place skewers on broiler pan coated with cooking spray. Broil skewers for 12 minutes or until chicken is done, turning occasionally.
3. Combine 1 teaspoon juice, yogurt, sour cream and pesto. Serve sauce with kebabs.
   

Nutrition information:
Amount per serving
Calories: 211
Fat: 7.3 g
Saturated fat: 2.1 g
Monounsaturated fat: 3 g
Polyunsaturated fat: 0.7 g
Protein: 27.9 g
Carbohydrate: 7 g
Fiber: 1.2 g
Cholesterol: 70 mg
Iron: 1.4 mg
Sodium: 441 mg
Calcium: 48 mg

The recipe makes 4 servings. Serving size is one kebab with one tablespoon of sauce.

The recipe is courtesy of Jackie Mills, Cooking Light (September 2010).

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How Big is One Serving? Use everyday objects as a guide

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides everyday objects as a guide for standard serving sizes of common food items.

Today, portion sizes are notoriously larger than ever before. With restaurants serving super-sized meals and food packages often containing more than one serving, it can be difficult to figure out how much you are eating. Uncertainty about portion size is particularly problematic when trying to lose or manage weight. For successful weight loss, it is essential to know and keep track of your food intake. Use these comparisons to everyday items as a guide to standard serving sizes of common foods.

• 3 oz. of meat = A deck of cards
• 3 oz. of fish = A checkbook
• 1 ½ oz. of cheese = 3 dice
• 2 tbsp. peanut butter = A ping pong ball
• 1 medium-sized fruit = A baseball
• 1 cup of cooked vegetables = A baseball
• 1 medium potato = A computer mouse
• 1 cup pasta = A baseball
• 1 bagel = A hockey puck
• ½ cup of ice cream = A light bulb
• 1 tbsp. butter or oil = A poker chip

- Cara Stewart, RD, LDN

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