The increased risk of developing significant co morbidities such as cardiovascular disease, type 2 diabetes, and sleep apnea can be avoided. In addition to coping with these medical conditions, children are often targets of social aggression, discrimination and bullying due to their obesity. 

How much self esteem do you want your child to have? How important is this to you? As a parent your home environment can be the environment to nurture self esteem. I once heard an interview and the woman related an incident in her own family. She said she realized whenever her children came into the room she did not have a smile on her face and she realized too late her children interpreted this as criticism. As parents we can structure home life to include eating meals together, possibly preparing them as a family. Creating discussion and sharing days events at the dinner table. I recommend shutting all outside media during mealtimes to create a safe environment for talking and sharing.

Parents are role models. What are your priorities? How important is it to be kind and generous? How often do you show your child how to be human? How vain are you? How honest? Education begins at home at an early age. Education is learned by example. Are you a smoker? The commercials on television are very graphic and are frightening to children if their parents are smokers. How is your weight? Do you eat healthy? Do you have medical conditions that can be improved with nutrition and activity? Children are not the decision makers of what foods are in the house. Too often I can relate poor parental health and lack of healthy available foods back to problems, my adolescent patients are facing.

Playgrounds are one of the earliest experiences for children. Encouraging physical activities that the entire family participates in is a wonderful means of helping your child to socialize and stay active. Is walking in your life? School teams are a built in way for your son and daughter to learn good sportsmanship, how to organize their time while being active.

Helping your child to be competent is another tool that will enable them to succeed in life. When you compliment your child, it increases their self esteem. When they are independent or create a picture or when they are polite acknowledging these positive behaviors emphasize that you are present and accept them. Chores are a wonderful way to instill competence. There are many charts that children can use to begin learning to organize their time. Small rewards are motivating. Children know their parents really “care” and “listen” so they carry themselves differently in school and activities outside of their homes. They are more inclined to try new activities without fear of failure. Isn’t that what we want for them?

Bullying has become out of control. This past week the news has reported a suicide of an adolescent precipitated by bullying. Obese children are targets. My immediate reaction is weren’t the parents aware? Why didn’t the child tell their parents? I see adolescents who have weight issues and I am the person to tell their parents their child I self conscious and is avoiding activities because they have been bullied.

I am writing this article to bring more attention to the problems and issues that obese children face. Please open up channels of communication with your children. Television and video games have their place but if those activities are using up all free time for communication or family activity time then as a parent you need to make changes.

My suggestions as a nutritionist are:

• One night every week a family member gets to prepare dinner. Healthy choices are the only qualification.
• Parents need to know what food and drinks your child is getting in school, at team practices, and in their friends homes.
• Investigate the food in your home. Is it providing vitamins and minerals without excessive saturated fats, sugar, sodium and chemicals?
• Set aside time once a week for a family physical activity. This can change with the seasons. For example walking during the fall, ice skating during the winter, swimming during the summer and bicycling during the spring.
• Set aside at least two meals per week with the entire family present. Everybody needs to participate in sharing their week. What was good and what wasn’t.

Our children are our future.

Please contact me @ info@berniceborow.com with any questions or comments about this article or share below.

Gout is a painful swelling of the joints, and a common form of arthritis. It is generally more common in men, and sometimes occurring in those with a genetic susceptibility. The feeling of thousands of needles that settle in the soft tissues around joints cause inflammation. Most severe pain usually occurs at night with the joints swelling, and skin warm, red, purplish and shiny. These crystals that feel like needles are uric acid combined with sodium. Uric acid, forms as a byproduct of the breakdown of protein digestion. When there is a high uric acid level there can be substantial pain, and swelling in the joints of the feet, ankles, knees, fingers, wrists and elbows.

Provided pantothenic acid is present, uric acid is converted into urea and ammonia, both of which are quickly excreted in the urine. If the body is deficient in pantothenic acid, uric acid is produced in excessive amounts and cannot be eliminated. The buildup is the cause of inflammation and pain.

Most cases of gout are controllable by keeping uric acid levels as low as possible. Low purine diets are the usual recommendation with a lot of fluids to prevent kidney stones. However, there is an anti-stress vitamin formula combined with dietary recommendations that has been effective.

I suggest getting a checkup including a test for metabolic syndrome, as well as checking vitamin levels. Metabolic syndrome is characterized by having at least three of the following symptoms: high blood pressure, high triglycerides, low HDL cholesterol, large waist circumference (greater than 35” for women and greater than 40” in men) or fasting blood sugar greater than 110 mg/dl.

My next recommendation is to examine your stress level. A symptom of any illness is the body’s reaction to stress. Adrenal hormones help the body to fight infections by setting up inflammation. The rest of the body is protected from the site containing bacteria and toxic substances. To obtain all nutrients that are necessary for production of adrenal hormones Is vital to dealing with stress. An inadequate diet alone can impose sufficient stress to cause gout. Emotional upsets can bring on attacks of gout. Suppressed anger is more prevalent in men than in women, thus. An assessment of stress and suppressed anger should also be addressed. This is more common in men and often afflicts the extremities more than other parts of the body.

I will address the stress vitamin therapy next. In addition to dietary recommendations combination of vitamins that need to be present in the body include vitamin B2, B5-pantothenic acid, and vitamin C. These vitamins being water soluble are excreted in the urine. These can be taken every three hour with low fat milk. Check vitamin E levels. Persons deficient in this vitamin may form excessive amounts of uric acid. This is a fat soluble vitamin, not excreted in the urine and can be toxic in overdose.

Avoid aspirin (salcylates) can raise uric acid.

Drink ½ your body weight in juices, milk and water daily. This encourages urination, excreting uric acid and preventing kidney stones.

Limit alcohol intake especially beer. Alcohol interferes with the body’s ability to clear uric acid, beer being the greatest offender as reported in a Harvard study 2004. Wine is the least offensive but I still recommend limiting consumption.

Two or three reduced fat dairy products including cheese and yogurt daily should be added to your diet.

Maintain a healthy weight. Extra body tissue means extra uric acid production.

I recommend a high intake of fruits, vegetables and juices, particularly orange juice to help keep the uric-acid crystals in solution so they can be excreted. Dietary recommendations include the avoidance of the following purine rich foods. Anchovies, herring, smoked meats, mackerel, scallops, caviar, sardines, sweetbreads, liver, kidney, red meat, poultry, wild game, lentils, dried beans, peas, asparagus, cauliflower, spinach and mushrooms.

Please contact me at info@berniceborow.com with any questions or comments about this article.

Recently I was in one of my favorite supermarkets. My favorite cereal was not to be found and I had to buy a substitute brand of cereal. I did look at the label briefly and thought it was okay.

Today I was going to have my usual breakfast parfait and I looked closely at the nutrition label and was really surprised. It made me realize that another important part of everyday nutrition can be mistaken.

I caught the misrepresentation because I know what to look for. I realized that there are probably so many innocent victims shopping and believing that what they are buying is accurately presented on the food label. This is why I am writing this article. If the public will start to acknowledge false labeling on food the companies will have to own up and stop misrepresenting their products.

The basic knowledge needed to assess a nutrition label starts with knowing that one gram of either carbohydrate or protein is equivalent to four calories. One gram of fat is equivalent to nine calories.

Without naming the culprit cereal I can tell you that there label reads ½ cup dry cereal has 50 calories.

Let’s compute this together:     Total fat: .5 gms (9/2=2.25 calories)

Total carbohydrate: 23 gms (23×4=92 calories)

Protein: 3 gms (3×4=12 calories)

So far the total calories are 106.25 calories. If that were not bad enough also listed at the bottom of the nutrient breakdown was to my horror: Other carbohydrate: 9 gms (9×4=36 calories). The total now for ½ cup of this cereal is 142.25 calories. That is almost three times the amount listed.

I decided to ask another respected nutrition professional and she told me that she had a similar instance with a different food product. I told her I was going to contact the company and her suggestion was to twitter them. I did a little research and found so many people on the internet with similar situations. I did tweet and I am hoping that enough people will read this article and my tweet and take some action.

I hope you will share your experiences with nutrition labels. The take home message is not to believe everything you read.

Working with a Registered Dietitian can be an effective plan to prevent these conditions from occurring. It is our job to create a strategy for overweight clients to lose 10% of their current weight in six months, while learning the basics of healthy diet, hydration, physical activity and stress management. This educational process can save time, money and possibly your life, while lowering your chances of developing these conditions that may lead to coronary heart disease.

One third of all Americans are classified as obese, and these statistics are growing. Starting with our children, there are predictions by 2015 approximately 23% of children 6 to 11 years of age will be obese. This statistic should be enough of a wake-up call. The diseased heart of an obese individual is enlarged because it is necessary to work so much harder to pump out the blood. In my experience, change starts at home with the entire family. Parents need to take control, plan menus and involve the family with cooking and shopping. What is more important than being a positive role model and teaching children how to take care of themselves? My patients are surprised when they realize that they are eating healthier, losing weight and saving time and money.

Our society has advanced in many areas bringing great improvements to our population. I cannot say, that about one industry, the food industry has improved. We are blessed with an abundance of food and, simply put, the emphasis is not “simple heart healthy nourishment” but overly fat, salt and sugar laden ”fake” products that are truly harmful. Recently, very famous chefs I admire have all started to redefine their recipes, reducing saturated fat, and sugar without sacrificing wonderful taste. It can be done!

Hypertension (high blood pressure) is a condition that when untreated can lead to congestive heart failure and kidney disease. According to the CDC, one out of every three adults in the United States has high blood pressure. Genetics play a part in this disease but making significant lifestyle changes has been shown to lower the risk. The DASH dietary plan (Dietary Approaches to Stop Hypertension), is an eating plan high in fruits, vegetables, and low-fat dairy foods which have been shown to reduce hypertension. Another important component of this plan are foods low in saturated fats. This diet emphasizes maintaining a healthy weight, utilizing healthy cooking methods (bake, broil, roast, steam, poach, boil, and sauté) to prepare menus high in fiber and low in saturated fat. Non animal foods such as nuts, legumes and beans in portion controlled servings are recommended. Other factors to examine are stress, and physical activity. Of course, tobacco should be eliminated, and alcohol intake needs to be controlled. The website www.nhlbi.nih.gov.com contains additional information.

More than 85% of diabetics are overweight. In 2010, 1.9 million people 20 years and older were newly diagnosed with diabetes, according to the National Diabetes Information Clearinghouse(NDIC). 80% of deaths in persons with diabetes are attributable to atherosclerosis (Pasternak et al., 1996), a hardening of the arteries caused by plaque buildup in the arteries. Again, as in the other conditions, caloric restriction to promote weight loss, better food choices and timing of meals and snacks are very important lessons for the diabetic. In my practice, I am seeing more children and adults with type II diabetes. Educating them and helping them to manage their lives and diets, has in many cases has allowed them to lower their blood glucose levels to normal ranges, which allows them to reduce or stop their medications.

In closing, I would like you to spend time examining your family history, your diet and lifestyle. If there are changes you need to make, no matter how difficult they might seem, professionals like me are ready willing and very able to help you achieve a better chance of avoiding these horrible diseases.

One of my jobs as a Registered Dietitian is creating winning strategies and a food game plan so my clients enjoy their social events while controlling their food and drink behaviors so they are also winners. Superbowl Sunday is one of the most watched sporting events in our country. My goal is for my clients to enjoy the social aspect and be proud of their win!

So let’s get started with my winning strategies:

1. You are invited to the event. Superbowl parties are social and traditionally filled with lots of food and drink choices. I suggest you start your plan two or three days in advance. Add some additional exercise time to your schedule. Banking calories can’t hurt.

2. Plan your menu for those two or three days of additional workouts by including frequent small fiber rich meals and drinking lots of water.

3. If you are the guest please call the hostess and volunteer to bring something. Find out if there are any food allergies to take into consideration. I recommend crowd pleasers like dinner salads that contain steak, or chicken or seafood. Chilies with protein packed beans, corn, lentils and low-fat cheeses also work well. The takeaway message here is that you are taking care of yourself and being a considerate guest.

4. If you are the hostess you would also need to consider any food allergies. Creating an appealing menu, that can be prepared in advance leaves you time to socialize and enjoy your guests. Second helpings in the fridge will give you insurance and free you to enjoy your own party.

5. Okay back to being the guest. Calculate the time you will be at the party. My most important successful strategy is to have a small meal one hour before you get to the party. Setting you up for success by not having an empty stomach.

6. Plan to nurse a glass of water for each alcoholic beverage. Wine, light beer, scotch, vodka, gin, tequila, sake, etc straight or mixed with diet tonic, club soda, lemon, or lime are best choices. Cocktails like daiquiris, pina coladas, and whiskey sours average between 250 -526 calories per 6.8 fl. Oz.

7. Take a visual survey of the displayed foods. Pretend to make a pyramid with raw veggies, salads, berries, olives, and nuts on the bottom. Generous portions of these finger foods are okay. Help yourself to the large dinner plates that are near the main courses and use the smaller appetizer plates for your next layer. As you add layers start decreasing the amounts to eat. Did you choose a hearty southwestern salad, loaded with mesquite chicken, and beans, or maybe turkey meatball chili? Soups, chilies, quartered wraps, and mini sandwiches would be your next addition. This plan will allow you to have finger foods to start and then something substantial to take away any hunger. After that it is easier to be picky and maybe pass or just taste the nachos, pizza or mac n’ cheese that might be offered.

8. Knowing you can always start again at the bottom of your pyramid will be helpful.

9. Finally there will be dessert. Having coffee or tea first can be helpful. You will have time to assess and plan your strategy. Again we return to surveying and creating a pyramid. Hopefully fruits, fresh and dried or fruit salad will be available and serve as your base. Individual cookies, pastries, chocolates, small portions of ice cream, or slivers of whatever delights you, would be your next layer. My clients have given me positive feedback that these strategies work.

Having a wonderful social evening and coming away with that empowering sense of control, while being satisfied is the best long term lifestyle strategy. Please feel free to contact me and let me know how this is working for you.

In my practice when counseling weight issues I always come back to treating the mental and emotional aspect of weight. This includes weight loss, weight gain, weight maintenance and eating disorders. There is a reflex from your brain to your hand to your mouth. 

The basics of balanced healthy nutrition are a science that can be taught. A Registered Dietitian has a four year Bachelor of Science degree, one year internship and then is qualified to sit for the national exam. The last step qualifies you to be state licensed to practice. For the lay person, knowing your own metabolism is the beginning. Next would be the ability to identify food groups and individual portions. There are other aspects as we go along but the very first issue is always “Who are you”? What have you tried before? How successful were you in achieving that goal? I can assume that you were unsuccessful in the long term and that is why you are reading this article. What do you want to do now? Are you ready to do the work required for long-term success? The answers to these questions are very telling.

In my experience once trust is established the next issue is learning who is sitting in front of me. Light bulbs usually go off because we all have messages that we send to ourselves. Many people are unaware until we start to examine thoughts and what we think of as habits. The subconscious is awesome. Memories come back and after true introspection a different conclusion usually occurs. There are many personas living in the subconscious. The outside environment where they must navigate determines which persona takes over.

Why do you think you might overeat? Is there awareness that you are really hungry and your body is looking for fuel or is a social situation where everyone is eating and food is abundant and available determining your hunger?

Were you told to finish every morsel of food on your plate when you were growing up?

Did you experience unpleasant situations in your childhood?

Are your parents healthy in their lifestyle? What diseases are in your family tree? Can you relate health issues and lifestyles to these disease states?

When you interact with strangers are you worrying about their assessment of you instead of conversing with someone new and learning if you have anything in common with them?

These are some common experiences that my patients have recognized and with my help have developed strategies to change the messages they used to receive that were triggers for among other things, binging, mindless eating, or emotional comfort. We either change the messages, or change the meaning of the messages and triggers into positive action thought processes.

It is a wonderful powerful transformation that has enabled many people overcome obesity or eating disorders.

This is a new year and the best advice I can give is taking care of this first. Learning to take care of you starts with this work. It is not easy and everyone has a different calendar of events to sort through. Once you have delved into your subconscious and understand what messages you were receiving and what triggers they arose, then you can be free to create a healthy plan to reach whatever goal you choose. The best news is this strategy and others are for the rest of your life and you can be a force within your own circle to help others.

Here you are at the counter with an array of vegetables, fruits, toppings, meats, chicken, eggs, bacon, olives and so many choices. The server listens to your instructions on what to put in that bowl. Therefore you need to take command of the situation; it is your choice. Keep in mind that their goal is to “stuff that salad bowl” so it will cost more money. This has been a major “aha” moment for many of my clients, and together we have devised a plan that puts them in the driver’s seat.

So first of all there is a choice of bowl sizes. Needless to say, the server is concerned with charging the most money. Your concern should be portion control. If you elect to fill the majority of the bowl with greens there will be much less room to add. Nowadays chopped salad is the newest trend. Please be aware that chopping the salad decreases the visual amount and therefore you would naturally add more salad fixings bringing the price up. That is “stuffing the bowl” the unhealthful way!

Instead after the greens, go for protein in a portion the size of your fist. All other vegetables should add fiber, color and of course crunch. Omit non vegetable items (croutons, crunchy noodles, bacon bits, etc) and anything marinated in oil, except sardines, tuna or anchovies. Ask for salad dressing in a separate container that you control. If soup is available that may be an option.

Keep in mind you can always have more if after eating and waiting 20 minutes you are still truly hungry.

Salad stations were not always around, they have replaced do- it -yourself salad bars in many neighborhoods, taking away your ability to create your own salad and monitor the portions. Many food items and large portion sizes are included. I have seen ravioli, lasagna, egg rolls, dim sum, spareribs, cocktail franks, meatballs, and white cheesy sauces. This is not in the best interest of the waistline, but in the interest of the business’ bottom line. Their added weight represents added revenue to the business. This added weight does not benefit you. On your next visit for lunch you can outsmart the salad server, save money and unnecessary calories.

It is challenging to be organized, on time, appropriately dressed and giving positive vibes to people you meet. The displayed foods are so abundant and inviting; how can we manage to enjoy these social events and come away in the same healthy body we work so hard to maintain? 

After so many failed attempts by my clients I have formulated a strategy to be successful during this time of the year. I am gratified to report that my strategy has worked for them.  They no longer fear these events but now enjoy the sense of empowerment they possess.

My best recommendation of course is to connect with me, Bernice Borow RD, CDN, Specialist in adult weight management, and together we will make a personalized plan that will get you through this holiday season with new contacts, increased business and still fitting in your clothes in January- or maybe even need a smaller size!

Let’s now focus on you at your event. One of the best decisions you can make is to assess what is being offered? Really take a good look and see what you can eat, what the portion size looks like and most important can you serve yourself? Walking the buffet is a great time killer and successful strategy; not only do you make the time to choose what you will eat you also give yourself an opportunity to talk without your hands full. I also suggest you check the time when you start eating.

Here are my tips:

• Start with having a mini meal 1-2 hours before the event. When you are not hungry you can be more objective and make smarter choices.
• Focus on small plates. You automatically will put less food on a small plate.
• Each small plate should have a protein and vegetable. Identifying the different food groups is a key strategy. Allow yourself twenty minutes before you take another plate.
• Exclude all food topped with cheese or sauce.
• Limit alcohol to wine or straight shots on the rocks or mixed with seltzer, lemon or lime.
• One glass of water for each drink is a must.
• Remember the reason you are attending is to mingle with people so eating and drinking are secondary.
• As for the dessert table, pick your favorite and enjoy the taste-the first taste is always the best!
• Keeping to healthy eating before and after events and continuing with the exercise plan that you have in place will help you balance the scale.

With the best of intentions, check out your wardrobe, focus on socializing and make eating and drinking “the least important part of the event”. I have heard from my clients that it gets so much easier with every event that you attend thanks to the planning and knowledge gained about how to overcome mindless eating.