Take a lesson in healthy eating from your turkey this Thanksgiving.

My Health & Fitness column in the Aiken Standard this week is about Thanksgiving dinner. With all the talk about how to make it a “healthier” meal by replacing traditional dishes and modifying recipes, I think we may be missing an important lesson in healthy eating.


This is Thanksgiving week, and people throughout the country are planning a feast including traditional dishes and family favorites. Even though many of these are not the healthiest choices, they make an appearance on the dinner table each year. Combined with the common occurrence of over-indulging, Thanksgiving dinner can represent a day of poor nutrition choices.

In an effort to make Thanksgiving dinner healthier, recommendations for modifying or replacing traditional dishes are a common theme in magazines, on the morning TV shows, and on the web. While these suggestions are meant to be helpful, I’m not sure they actually serve to make a significant impact on health.

After all, Thanksgiving is one day, and if there was ever a day to give yourself license to indulge, this is it! Of course, trying new foods and cooking techniques is always good, but the impact of replacing the butter in your mashed potatoes with fat-free sour cream or taking the marshmallow topping off Granny’s famous sweet potato dish isn’t realistically going to make you any healthier in the long run.

The truth is that if you eat a healthy diet every day, or even most days, and you have an active lifestyle you can get away with a day—or weekend—of overeating. (Obviously, you should always follow dietary restrictions for any medical conditions you have.) The problem comes when Thanksgiving dinner is yet another unhealthy meal in addition to the others that week or month.

Some of these recommendations are worth trying, for sure. Making an alternative to a traditional dish can get your family to try new foods they might not otherwise consider. And cooking using different ingredients or techniques on Thanksgiving can give you ideas for other meals, too.

However, focusing on modifying your Thanksgiving dinner may distract you from appreciating the greatest potential health benefit of this meal. Given the current confusion about how much and what type of carbohydrates and fats we should eat, there is an increased push to get us to eat less processed food and more real food.

For many of us, Thanksgiving dinner is one of the only times we cook and eat real food. A real turkey, vegetables, and home-made dessert are a huge improvement over the processed foods most of us eat on a daily basis. While we eat turkey at other times, it is almost always in a processed form such as ground turkey or deli meat, which frequently includes other additives. Cooking and eating a whole turkey is, for most families, relatively rare. So is eating a meal that doesn’t come from a restaurant or is heated in a microwave.

Additionally, Thanksgiving dinner is shared simultaneously around a common table (and maybe a kids’ table, too). All too often, meals are consumed away from the family table, frequently at different times. The benefits of eating together as a family are well-known, and can impact nutrition, psychological well-being, and health in general. Maybe Thanksgiving dinner isn’t about the food as much as it is the company. Why not make this a habit at other meals?

This week, let’s all give thanks for family, friends, and a shared meal. Let’s also take a lesson from the day and try to prepare and eat more real food as a family. This may be the biggest benefit of Thanksgiving. That, and a second serving of pumpkin pie!

Your metabolism (and how to speed it up)

Many people are interested in speeding up their metabolism in an effort to lose weight. There are drugs, supplements, and even certain foods that are thought to increase metabolism. The effectiveness of many of these things is unproven and some may actually be dangerous. The goal of this article is to explain what the term “metabolism” really means and how it can be changed.

Metabolism refers all of your body’s processes that expend energy, or burn calories. Practically, this is how much carbohydrate, fat, and protein is burned throughout the day to provide energy for your cells. If you expend more energy than you consume in your diet, you will lose weight.

The amount of energy you expend in a day is composed of three main components: your resting metabolic rate (RMR), something called the thermic effect of food (TEF), and the energy you expend in activity.

Resting metabolic rate (RMR) is sometimes called the basal metabolic rate (BMR), but many people refer to it as their “metabolism.” No matter which name is used, it refers to the calories you burn at rest. It represents the energy needed to maintain your essential body functions: heart rate, breathing, body temperature, and normal cellular processes.

The RMR is important because it represents about 60–70% of the total calories a typical person burns in a typical day. Even though RMR is important, you shouldn’t worry about it too much.

First, it is difficult to change. RMR is based mostly on your lean body mass, so the only way to increase it is to gain muscle mass. While this is a good goal, it is challenging to do, especially while you trying to losing weight.

Second, although it does vary among people, it isn’t as different as people like to think. It is easy to think that someone who gains weight has a “slow metabolism” or that someone who is thin must have a “fast metabolism.” In reality, the RMR probably isn’t much different, certainly when you take lean body mass into account. The explanation for the differences in weight among people probably has more to do with what they eat and how active they are.

The thermic effect of food (TEF) represents the energy needed to digest, absorb, and store the nutrients you eat. It accounts for only about 10% of your total energy expenditure and it is practically impossible to change, so you can ignore it.

Activity is the most variable component of energy expenditure and the one you can most readily change. Obviously, it will vary based on how active you are, but for most people it accounts for 20–30% of total energy expenditure.

Activity includes both purposeful movement such as exercise and doing work or tasks that require you to move. Activity also includes non-exercise activity thermogenesis or NEAT, the calories you burn when you move around, but not in a purposeful way. Maintaining your posture when sitting or standing, fidgeting in your chair, or other light movements count as NEAT.

The surest way for you to increase your metabolism is to limit the time you spend sitting, be active as possible at all times, and dedicate time to exercise every day. Doing prolonged aerobic exercise such as walking, jogging, or exercise classes directly burns calories and including strength training will help increase your muscle mass, which can increase up your RMR.

The bottom line is that speeding up your metabolism requires you to move. So, get up off the couch and go for a walk!

Funny calorie math.

Have you ever heard that a few extra calories each day—an extra soda, for example—can add up to significant weight gain over time? Or that making small changes in what you eat, such as skipping dessert, can promote weight loss? If so, you are familiar with the concept of energy balance. And if you were ever surprised by those claims, you are familiar with what I call funny calorie math.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

Your body weight at any time is determined by the balance between the energy you take in and the energy you expend. The “energy in” part is simple, it’s the calories in the food you eat.

Your energy expenditure is determined by your basal metabolic rate (BMR), the calories burned keeping you warm and alive, as well as the energy you expend in activity. Of these, the BMR accounts for the majority of your energy expenditure, but you have the most control over your level of activity.

According to this energy balance model, eating or drinking an additional 250 calories per day would add up to about one pound of weight gain every two weeks and 26 pounds after one year (using the rough estimate that to gain a pound requires 3500 extra calories.

+250 calories/day  x  7 days/week  =  1750 calories/week  =  3500 calories/2 weeks

3500 calories/2 weeks  x  1 lb. weight gain/3500 calories  =  1 lb. weight gain every two weeks  =  26 lbs. weight gain per year!

Calculations like this are common, typically used to point out how fattening a particular food or beverage can be. But the same principle can be applied in reverse to determine weight loss.

Example: Eat (or drink) and extra 250 calories per day

250 calories/day  x  7 days/week  =  1750 calories/week  =  3500 calories/2 weeks

3500 calories/2 weeks  x  1 lb. weight loss/3500 calories  =  1 lb. weight loss every two weeks  =  26 lbs. weight loss per year!

The same formula predicts that cutting back by 250 calories per day should lead to losing 26 pounds in one year. This idea is the basis for suggesting that making small changes to your diet can lead to significant weight loss over time.

You can do the same thing with physical activity, too. Adding a 45-minute walk, which burns approximately 250 calories, each day should lead to the same 26 pounds of weight loss in a year.

Example: walk 2.5 miles in 45 minutes each day, using the rough estimate that you will burn 100 calories per mile.

2.5 miles/day  x  100 calories/mile  =  250 calories/day

250 calories/day  x  7 days/week  =  1750 calories/week  =  3500 calories/2 weeks

3500 calories/2 weeks  x  1 lb. weight loss/3500 calories  =  1 lb. weight loss every two weeks  =  26 lbs. weight loss per year!

The assumption, of course, is that you aren’t changing anything else as you eat 250 fewer calories or burn an additional 250 calories per day through exercise. It would be relatively easy to offset the energy expended though a walk by even a small change in what you eat. This is the biggest weakness of this energy balance model—in order for it to accurately predict weight loss or gain, nothing else can change.

Unfortunately, this isn’t the way it really works. Changes in body weight through eating or exercise also lead to changes in total energy expenditure. As you lose weight, the total calories you burn in a day drops, mostly due to a decrease in BMR, since it is based on your body weight. The result is that over time you don’t lose weight as quickly. The exact opposite occurs with weight gain, which causes BMR to go up, limiting weight gain.

This leads to a different outcome: the extra 250 calories per day is likely to lead to a weight gain of closer to 10 pounds (maybe less) due to your BMR increasing as you gain weight over the year. And the estimation of weight loss will be different, too, given that BMR will drop slightly over time.

This is one of many reasons why exercise is important for weight loss. You can offset the lower BMR that occurs as you lose weight by increasing energy expenditure through activity. Additionally, regular exercise can add to the weight you lose through a diet and help keep the weight off later.

Why turning off your phone is so hard, and what it means for losing weight

I had an interesting conversation with one of my students recently about making a behavior change. It brought up a good point. So good, I wrote about it in my Health & Fitness column in the Aiken Standard this week.


One of the courses I am teaching right now is Health & Behavior Change. In it we identify the major factors that contribute to chronic disease and discuss how to modify them to improve health. Throughout the course, the emphasis is on health behaviors and how to change them for the better.

For example, smoking is among the most difficult health-related behaviors to change. Obviously, there is the addictive nature of nicotine that makes smoking cessation challenging. Beyond the drug effect, smoking also has a behavioral component. This includes what a smoker does first thing in the morning, after a meal, or on a work break as well as the act of holding a cigarette in his or her hand. Add to that the social aspects of smoking, including the influence of friends and family members, and it is easy to understand why it is a difficult habit to break.

This same principle applies to other health behaviors, including eating and activity. Like smoking, what we eat and our activity level are complex behaviors that are difficult to change. Because of this, losing weight can be as difficult as quitting smoking for similar biological and behavioral reasons. We think of weight loss as being about a diet or exercise program, but it’s really about changing behaviors and habits.

his is a difficult concept to teach, so I have my students learn through experience. Since almost all of my students are non-smokers and most are active and at a healthy body weight, I have them complete a project in which they change some other behavior. They are responsible for identifying a behavior that has a negative effect on their life, coming up with a plan to change it, and embarking on a four-week behavior change experience.

One student wanted to change her social media habits. As a compulsive social media user, she spent more hours than she realized checking, posting, and commenting on Facebook, Twitter, and other sites. Her goal was to limit her social media time so that it didn’t interfere with classes or studying. One of the steps she took was to turn off the notifications that alerted her to new activity. This was helpful, but she still found the habit of checking her phone hard to break.

In a conversation, she noted that the one thing that would help more than anything else would be to switch her phone off during the day. This way she would have her phone if she needed it, but it wouldn’t be so easy, or tempting, to use it. Despite knowing the most effective strategy—the one thing—that would help her, she never did it.

I thought this was an excellent example of something that is common in making health behavior changes. In many cases, people probably know the one thing they need to do to be successful but for a host of reasons, they don’t do it. This may lead people to make other changes that aren’t nearly as helpful. While even the smallest behavior modifications can help, successfully losing weight or quitting smoking really does require making big changes.

This goes a long way in explaining why quitting smoking, losing weight, and changing eating and activity behaviors can be so difficult, even when people know what they need to do. There is no easy solution for this problem, but finding someone to hold you accountable for making the necessary changes and sticking to them is a good start.

Chill out! Why less stress is essential for good health.

Chronic stress can have serious emotional, psychological, and physiological effects that lead to or exacerbate many health problems. While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits. Regular exercise, including yoga, managing time better, and getting enough sleep, can help with minimizing your feelings of stress as well as the effects it has on your body.

The importance of stress management and getting enough sleep is the topic of my Health & Fitness column in the Aiken Standard this week.


Chronic stress can have serious emotional, psychological, and physiological effects that lead to or exacerbate many health problems. In fact, the negative health effects of chronic stress are similar to those of eating a poor diet or not getting enough physical activity. That said, managing stress, including getting enough sleep, is often overlooked as a key component of good health.

The word “stress” is typically used to indicate both the feeling of being “under a lot of stress” as well as the things that cause that feeling. The events and situations that cause stress are properly called stressors, which lead to a stress response that includes consequences we feel as well as physiological changes we may not notice.

The immediate effect of a stressor is called the “fight or flight” response since it prepares the body to deal with a dangerous situation. A classic example of this is a caveman who encounters a saber-tooth tiger, clearly a stress-inducing event.

The sympathetic nervous system is immediately activated, which raises heart rate and blood pressure to pump more blood to the muscles. Additionally, stored fat and carbohydrate fuels are broken down as fuel for the muscles. The adrenal glands release catecholamines (adrenaline) and cortisol (the stress hormone) to prolong and enhance this effect. This coordinated response makes sure the caveman’s body is ready for action. After the danger passes, everything returns to normal.

This physiological response is appropriate for major events like saber-tooth tiger encounters, but not for less perilous stressors like being stuck in traffic, pressure at work and home, or other personal and family issues. But the body responds with the same increase blood pressure and hormones to them all. Unlike a rare saber-tooth encounter, these stressors tend to occur on a daily basis, leading to continuous stress response.

The increase in hormones can lead to high blood pressure, obesity, type 2 diabetes, and other chronic diseases. This is partly due to elevated levels of cortisol, a hormone that plays a role in storing fat and increasing appetite. While elevated cortisol during exercise (including running away from a saber-tooth tiger) is normal, chronic overproduction can have negative effects.

While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits. To the extent that it is possible, avoiding stressful situations through better time management, setting realistic expectations for ourselves and with others, and learning to say “no” are common recommendations.

Learning how to deal with stressors to avoid the negative effects of stress is also important. Techniques that can be implemented in the heat of a stressful moment include taking a break from the situation, listening to calming music, and progressive relaxation. Even taking a deep breath can help.

Exercise has long been recognized as beneficial for reducing stress and the long-term effects of stress on your health. This includes doing something active during a stressful situation and exercising regularly to improve the way your body responds to stress. While all forms of exercise seem to work, much research and practice has focused on specific types of exercise including yoga and Tai Chi.

Other effective strategies traditionally include meditation and relaxation exercises. More and more research shows that getting enough sleep is also critical for reducing stress and the impact it has on your health. Eating a healthy diet can reduce the effects of stress as well.

The bottom line is that a healthy lifestyle includes stress management as well as a good diet and regular activity. Since all three are essential for good health, it would be wise to eat smart, move more, and chill out!

What parents and schools can do to make sure kids are ready to learn

Physical activity and good nutrition have long been recognized as essential for promoting good health in adults and children. More and more research suggests that these health behaviors can have beneficial effects beyond health, including how we perform both physically and mentally. The emphasis here is on children in school, but it applies to adults, too.

Unfortunately, taking time for activity and good nutrition is seen as a luxury or a distraction to learning in most schools. Far from being a distraction, physical activity and healthy eating are prerequisites for learning and academic achievement. In short, these often ignored factors can help make sure children are ready to learn.

Regular physical activity is essential for good health, growth, and physical development, including maintaining a healthy body weight. This last point is important given the epidemic of childhood obesity and related health problems, including “adult” diseases like high blood pressure and type 2 diabetes.

Current recommendations call for all children to get at least 60 minutes of activity per day. This can include activity at school from physical education classes, recess, other classroom activities as well as games, sports, and unstructured play. Unfortunately, most kids don’t get nearly enough activity at school and many aren’t active at home.

Physical activity is also important for academic performance. Research shows that children who participated in an activity program had better executive control, which includes resisting distractions and maintaining focus, improved memory, and doing better switching between tasks. This is particularly relevant for children with ADHD, but the effects can be seen in all kids. These positive changes can maximize class time and lead to improvements in academic achievement, especially math and reading test scores.

Similarly, good nutrition is also essential for health, growth, development, and academic achievement. Eating a good breakfast improves cognitive function, alertness, and academic performance in students of all ages. It should be no surprise, then, that skipping breakfast impairs cognitive function and academic achievement. This is one reason that many schools offer breakfast to start the day or include a healthy mid-morning snack.

The same is true for lunch, too. A good lunch can support learning in the afternoon and gives a chance to teach kids about good nutrition by providing healthy food that, unfortunately, many children may not get at home.

Schools have a unique opportunity to use physical activity and nutrition to promote health, support academic achievement, and teach healthy habits. Since formal nutrition education is missing from most curriculums and PE programs are being reduced or cut completely, schools must be creative to incorporate these essential subjects.

A way around this problem is to make sure children get a chance to move and play, ideally multiple times during the day. This is what recess is for. Teachers can also incorporate activity and nutrition education in the classroom and get away from the idea that kids must be sitting still to learn. As research shows, quite the opposite is true!

Schools are often hesitant to teach about nutrition and activity because it is thought of as a responsibility of parents, not schools. But most parents don’t teach these good habits at home, which affects what happens at school. Despite the obvious benefits, it will probably take years of effort to change this view.

In the meantime, parents can encourage their kids to be active and make smarter food choices at home so they are ready to learn in school.

What’s wrong with the way we eat, according to Jim Gaffigan.

I happened to catch a segment of the public radio show Here & Now yesterday afternoon. The guest was comedian Jim Gaffigan, who has a new book out, called Food: A Love Story. Food is a common topic in his comedy.

Anyway, in the discussion, he made a joke that I think perfectly describes what is wrong with the way we think about food. I’m paraphrasing a bit, but basically he says:

Artists have long painted bowls of fruit because no one will touch the fruit. There are no famous paintings of donuts because someone will eat them before the painting is complete.

That’s funny, at least partly because it is true. And that’s the problem.