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Healthy Eating during Ramadan

Sabrina Bitar, MS, clinical dietitian and center manager at Diet WatchersTM in Saudi Arabia, guest blogs about tips for maintaining a healthy diet during Ramadan.

Ramadan is the holiest month of the year for Muslims, but the restrictions on eating can be tricky for people who are trying to lose weight or maintain a healthy diet. With careful planning, thoughtful food choices and self-control, you can stay on track with your weight loss goals during the month of Ramadan.

During Ramadan, Muslims abstain from eating and drinking from dawn till dusk. Although the tradition goes against typical dietary recommendations for small, frequent healthy meals throughout the day, there are ways to sustain your healthy diet during Ramadan.

To maintain a healthy diet during the month of Ramadan, it is important to provide your body sufficient healthy nutrients during the non-fasting hours. That means having your first meal (Sahur) before the fast starts at dawn, an evening break-the-fast snack after dusk (Iftar) and dinner as the last meal of the day.

This guide can help you stay on track with your weight loss goals during Ramadan:

Pre-dawn Meal (Sahur):

The pre-dawn meal or Sahur is essential to jumpstarting your day, so make sure to eat a wholesome, balanced and moderate-sized meal.

A healthy morning meal gives you energy by the providing the nutrients you need to get through the fasting hours. It also reduces unpleasant signs of hunger throughout the rest of the day, including hunger pangs, headaches and sleepiness.

Stick to high-fiber foods and complex carbohydrates, such as grains. It takes longer to digest and absorb these foods, so they help you stay full throughout the day.

A healthy morning meal can include:
  • Whole wheat bread with cheese or labneh
  • High-fiber cereal with low-fat milk
  • Fresh or dried fruit, including bananas and dates
  • Unsalted nuts
Breaking the fast meal (Iftar):

Iftar presents the biggest obstacle to maintaining a healthy diet. The best way to approach breaking the fast is to treat Iftar as a light snack to hold you over until dinner instead of as a reward for fasting. That mindset can help you avoid indulging in the rich traditional desserts that are loaded with fat and sugar.

A healthy break-the-fast meal can include:
  • Three dates
  • Cup of water or low-calorie juice
  • Bowl of vegetable soup
Dates and water are traditional Iftar foods and they also have nutritional properties to replenish the body after a long fast. Dates help regulate blood sugar and provide a much needed boost of energy. If dates are not available, you can substitute them with any other fruit. Water rehydrates your body and helps reduce hunger.
 
Dinner:
During Ramadan, dinner is the best chance to get most of your important daily nutrients, so make sure to have a balanced meal that covers all of the major food groups. Plan to eat dinner after the evening prayer or Maghrib to allow sufficient time to digest your food from Iftar.

A healthy dinner can include:
  • Soup and salad
  • Grilled chicken, fish or lean meat
  • Grain such as brown rice, whole wheat bread or whole wheat pasta
  • Low-fat yogurt
  • Fruit – fruit is a much healthier substitute for the high-fat, syrup-sweetened treats that are common during Ramadan. You can also have fruit as a snack before bed.
Make sure to pace your consumption throughout dinner. It takes 20 minutes for the stomach to tell the brain that it is full, which means you have to allow adequate time for your stomach to send those signals. Try slowing down your eating by taking smaller bites, chewing well and savoring the taste of each bite to avoid overeating.

Most importantly, remember that resisting the temptation to overindulge not only helps achieve your weight loss goals, but also focuses attention on empathizing with the poor and needy, the centerpiece of Ramadan.

- Sabrina Bitar, MS
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Penn Weight-Loss Team Most Experienced In Philadelphia Region


When it comes to choosing a bariatric surgeon and program, experience counts. Research shows the more experience a surgeon has and the more procedures he or she performs, the better the outcomes. Penn surgeons in the Penn Metabolic and Bariatric Surgery Program perform more than 500 bariatric surgeries every year, making Penn the most experienced program in the greater Philadelphia region.

In this video, bariatric surgeon Alan Schuricht, MD, talks about the experience of the Penn Metabolic and Bariatric Surgery Team, and why when a patient loses weight, the whole office celebrates.








Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program. At this free session, you will learn more about weight loss surgery at Penn, and meet physicians and team members from the Penn Metabolic & Bariatric Surgery Program Register for this free event here.
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Why You Might Hire a Personal Trainer

You’ve seen the trainers on “The Biggest Loser” motivate contestants and maybe you’ve begun to think that a personal trainer might be the key to weight-loss success.

And, if you’ve just joined a gym, chances are you’ve been “pitched” to take advantage of personal training services.

A personal trainer is a certified professional who can help you define your weight-loss goals, design a program to meet those goals, and motivate you to work out during one-on-one sessions. While personal training is not for everyone, for those individuals who have never worked out or are not sure how they should work out, a few sessions with a professional might help pave the way to fitness success.

If you fit into one of these descriptions, you might want to consider hiring a personal trainer.

You Are New To Exercise

If you’ve never set foot in a gym, it can be overwhelming. There are free weights, weight machines, fitness classes and pieces of cardio equipment. All the “pros” can be intimidating and you probably don’t know where to start.

If you are an absolute beginner, a personal trainer is your ultimate gym buddy. A personal trainer helps you set goals and builds a routine for you, so you make the best use of your time in the gym. Also, he or she shows you the proper way to exercise, helps you with your form and shows you the best cardio machines to help you reach your weight-loss goals.

You may not need to meet with a personal trainer every week, but meeting with one a few times in the beginning, and then every few months to tweak your routine, can get you on the right path.

You Have an Injury or Health Condition

Just because you have a bad knee or an old shoulder injury that flares up on occasion doesn’t mean you shouldn’t – or can’t – exercise. A good personal trainer helps you identify your weaknesses and designs a program that strengthens your body without putting too much pressure or strain on any one area.

Your trainer also shows you how to safely exercise and look for signs of muscle overuse.

You Need Extra Motivation

Even a seasoned gym rat needs some extra motivation every now and then. Meeting with a personal trainer at a designated time each week can help you stick with a consistent exercise program. Certified personal trainers can provide structure and accountability, and help you develop a lifestyle that encourages health.

Remember, not all personal trainers are created equal. Ask if they are certified by the American Council of Exercise (ACE) or Aerobics and Fitness Association of America (AFAA) or other licensing organization. He or she should also be certified in CPR and have liability insurance.

Finally, find a trainer you like. This is a hired professional, and if it’s not working out with one, find someone else you can feel comfortable with.

Have you used a personal trainer at a gym? What was your experience?

Ready to commit to a healthier you? Register for a free informational session about weight-loss surgery at Penn. 
 
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Do You Zumba?


If you are tired of the same old exercise routine at the gym, chances are that your body is, too.

Any fitness professional or personal trainer will tell you that every few months it’s important to change up your routine. That’s because the more you exercise a certain muscle group or do the same type of exercise, the more efficient your body becomes at performing it. And the more efficient your body becomes, the less of a challenge that exercise is. Your body responds by outputting less energy, which means fewer calories are burned.

If it’s time to try something new, it seems like Zumba® is taking gyms and fitness centers across the nation by storm.

Zumba is a Latin-inspired fitness dance program created by dancer and choreographer Alberto "Beto" Perez. Zumba involves dance and aerobic elements, and gets the class moving with hip-hop, samba, salsa belly dance and mambo moves. Some instructors also incorporate light strength training into the class.

But don’t let all the fancy moves intimidate you. Perhaps the best thing about this class is that it keeps you moving and “on your toes” for the duration of the class. You’ll be paying so much attention to following the moves and having fun, you won’t even notice the time pass by.

Zumba classes are offered at many gyms and dance studios, but if you would prefer to exercise at home, there are Zumba DVDs and video games to get you moving in your living room.

Have you tried a Zumba class? What did you think? 

Ready to commit to a healthier you? Penn Medicine can help you lose weight. Learn how Penn Medicine can help you lose weight at a free information session. 
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Your Daily Dose: Vitamin B12 Supplements after Weight Loss Surgery

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the importance of the vitamin B12 supplements after weight loss surgery.

Vitamin B12 is the most common vitamin deficiency people experience after weight loss surgery. That is why it is important to supplement your diet with vitamin B12, especially after gastric bypass and sleeve gastrectomy.

Vitamin B12 is essential for proper nerve function, metabolism and red blood cell production. Deficiency can lead to B12 deficiency anemia, which causes fatigue, rapid heart rate, easy bruising and bleeding, stomach upset and diarrhea or constipation.

If the deficiency remains unaddressed, it can result in permanent nerve damage, including tingling or numbness in fingers and toes, difficulty walking, mood changes, memory loss and dementia.

Weight loss surgery reduces the acidity in the stomach, which makes absorption of vitamins and nutrients more difficult. That is why vitamin B12 deficiency is particularly common after surgery and supplementation is often required long after recovery.

Proper supplementation involves taking a daily form of vitamin B12 that dissolves under the tongue or getting a monthly injection, which is typically done by your primary care physician. 

To prevent vitamin B12 deficiency, follow the dietary recommendations for supplementation after weight loss surgery and get your blood work checked regularly by a primary care physician or bariatric care team.

If you experience the symptoms associated with B12 deficiency, please check with your health care team.

- Cara Stewart, RD, LDN
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Getting Enough Protein In Your Diet


Protein is an essential dietary nutrient. It builds tissue and regulates various bodily processes necessary for good health. After weight-loss surgery, all patients follow a liquid diet for two weeks. It is important to include adequate protein intake in the post-surgical diet to facilitate recovery. That is why patients are encouraged to find a preferred protein drink before surgery to ensure optimal nutrition and safe weight loss in the recovery stage.

You can find protein supplements at local supermarkets, pharmacies or specialty nutrition stores. There are a variety of choices and these tips can help you find your favorite, nutritious protein supplement:
  • Read the ingredients. Complete protein products containing whey, casein or soy provide more benefit than products that are mixed with less nutritious ingredients, such as collagen.
  • Determine if you prefer a powder or liquid protein supplement. There are pros and cons to each type of supplement. Powder products are mixed with eight ounces of water, low-fat milk or another low-calorie liquid to produce a beverage with the recommended concentration of protein. Liquid products come premixed and some have screw tops for easy storage after opening.
  • Sample a small quantity of the protein supplement. Purchase a single-serving to taste test before committing to a full container or case of the product.
  • Make sure the products are low in fat and sugar. The concentration of protein, fat and carbohydrates varies from product to product. It is important to select a product that is low in fat, calories and carbohydrates. Make sure the product contains 15 grams or less of sugar per serving. Keep in mind that a typical protein drink contains 150 to 200 calories per 8 ounce serving.
  • Check the expiration date. Like all food, protein drinks have a limited shelf life. Do not use products that have expired.
Please refer to the “Step-by-Step Diet Guidelines following Weight Loss Surgery” in your diet instruction booklet for a detailed list of recommended protein supplements.
- Karen Buzby, RD, LDN
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The Perfect Summer Meal: Arugula, Grape and Sunflower Seed Salad


A refreshing salad can be a perfect meal on hot summer day. To top it off, this recipe combines a variety of healthy ingredients, so the delicious salad also provides the important nutrients your body needs. 

With antioxidants from the grapes, healthy fats and vitamin E from the sunflower seeds and oil, folate and vitamin A from the arugula, it’s hard to beat the nutrition profile on this summer salad.

You can also try topping the salad with a protein like salmon or tuna to make a well-balanced dinner entree.

Nutritional Information:
Amount per serving 

  • Calories: 81 
  • Calories from fat: 34% 
  • Fat: 3.1 g 
  • Saturated fat: 0.3 g 
  • Monounsaturated fat: 0.5 g 
  • Polyunsaturated fat: 2 g 
  • Protein: 1.6 g 
  • Carbohydrate: 13.1 g 
  • Fiber: 1.2 g 
  • Cholesterol: 0.0 mg 
  • Iron: 0.7 mg 
  • Sodium: 124 mg 
  • Calcium: 47 mg 

Ingredients:

  • 3 tablespoons red wine vinegar 
  • 1 teaspoon honey 
  • 1 teaspoon maple syrup 
  • 1/2 teaspoon stone-ground mustard 
  • 2 teaspoons grapeseed or olive oil 
  • 7 cups loosely packed baby arugula 
  • 2 cups red grapes, halved 
  • 2 tablespoons toasted sunflower seed kernels 
  • 1 teaspoon chopped fresh thyme 
  • 1/4 teaspoon salt 
  • 1/4 teaspoon freshly ground black pepper 

Preparation:

  1. Combine vinegar, honey, syrup and mustard in a small bowl. Gradually add oil, stirring with a whisk.
  2. Combine arugula, grapes, seeds and thyme in a large bowl. Drizzle vinegar mixture over arugula; sprinkle with salt and pepper. Toss gently to coat.

The recipe is courtesy of Maureen Callahan, Cooking Light (May 2008). 
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