Practical Tips for Healthy Eating Out

Eating out

Eating out doesn’t have to be avoided if you are losing weight or maintaining your weight losses.  Once you are at a restaurant consider these practical suggestions to support your healthy eating habits.

Eat before you go out

Eating before you go out assists in taking the edge off your hunger especially if you aren’t ordering immediately. This also helps with avoiding the nibbling that can often happen. Eating before you go out might be a piece of fruit, vegetables or a bowl of salad.

Request a glass of water upon being seated

Focus on sipping the water instead of nibbling on the bread or having a high-kilojoule cocktail.

Be the first person to order

Whether deciding on a main meal or dessert, ordering first will help you keep your resolve and stop order envy. If you know exactly what you want, skip looking at the menu.

Customise your meal

Be assertive. Don’t be afraid to order what you want, prepared the way you want. You are paying for the meal. Request that the chef reduce the oil in cooking your meal and ask for your vegetables with no butter or oil. Ask for cream, dressings or sauces to be omitted or at least put on the side. Beware not to use all the on the side dressing as this amount is often more than the amount normally placed on your meal.

Avoid fried foods

Avoid dishes that are fried, basted, scalloped, pan fried, sautéed, stewed or au gratin.

Foods to choose might say

Boiled, baked, braised, grilled, poached or roasted.

Cream!

Watch out for the “cream of…” dishes. Cream sauces, cheese sauces, gravies, hollandaise sauce should be avoided.

Quick Tip: Substitute the word ‘cream’ for ’fat’ eg: ‘Cream sauce’ becomes ‘Fat sauce’...Not so appealing is it!

Be better informed

Refer to your Fat and Calorie Counter book to find out the dietary information to assist in making healthier choices prior to eating out.  Knowing where you are eating out in advance assists with time for making healthier meal choices.

Breakfast foods

Avoid the traditional high fat breakfast items (eggs, bacon and sausages) and order fresh fruit, lean ham, hot cereals, low fat and natural yoghurts, bagels with jam or reduced fat cream cheese. If having eggs, try poached eggs and include vegetables such as spinach, mushrooms, tomato and asparagus.

When choosing steak

Choose lean steaks like fillet mignon, flank steak or sirloin and choose smaller cuts.

Lots of selection

Choose a restaurant that offers a varied menu with many alternatives rather than a limited menu.

A La Carte

Considering ordering ‘la carte’ to get the foods that you want.

Potatoes

Order a baked potato rather than chips.

Side orders

Refuse side orders such as chips if you don’t really want them. They are better not on the plate than having them there and saying you won't eat them.

Desserts

Avoid desserts, or if you are going to include a dessert, look for a fruit option. Try sharing your dessert with someone else.

Take some home

If the portion size is too big, request a take home container and put the extra in the container before you start eating. Some restaurants don’t allow the “doggy bag” – just check with them.

Eat slowly

Eat slowly to fully enjoy your meal and the atmosphere and that you didn’t have to prepare, cook or clean up the meal. Try eating half your main course and then taking a break. After the break, if you feel full take the other half home with you.

SLEEP More, WEIGH Less

Did you know that under-sleeping can lead to poor performance and impaired judgement and has also been linked to depression, obesity, diabetes and hypertension. A new study of 1,200 people showed that the average Australian adult gets less than seven hours sleep a night, below the seven to eight hours recommended by sleep experts.

A study by Columbia University, found people who slept four hours or less per night were 73% more likely to be overweight or obese. Also, people who habitually slept for five hours had 15% more ghrelin, a hormone which increases feelings of hunger, than those who slept for eight hours. Those who slept for less time were also found to have 15% less leptin, a hormone which suppresses appetite. "These differences are likely to increase appetite, and therefore contribute to obesity" Dr Taheri states. The subjects in the study also tended to eat more sweet and starchy foods when sleep was cut short.

While research continues, sleep still remains one of the body's most mysterious processes. We do know that sleep is absolutely necessary for survival and even occasional sleeping problems can make daily life feel more stressful or cause you to be less productive. Sleep loss also affects growth hormone secretion that is linked to obesity and impairs the body's ability to use insulin, which can lead to the onset of diabetes. It is paramount that we discover more about this activity where we spend a third of our lives - sleeping.

There are prescriptions and non-prescription drugs, herbs, remedies, technologies, etc that may help you get a good night's sleep. Some work for some and not for others.

Here are some tips you can try at home tonight. These tips are intended for the average adult, but not necessarily for children or persons experiencing medical problems:

• Imagining - Think of a hammock - you're up off the ground, wrapped in a cocoon of comfort, swaying gently in the open air. The sun is warm on your face and there's a cool breeze blowing you back and forth. This visualisation helps you "see" what the reward for sleeping will be, getting you more in the mood to sleep. Visualisation has proved helpful in developing the appropriate brain wave patterns for sleep.
• Magnesium - Has a calming effect on the nervous system. It is part of bones and cells, especially the smooth cells of arteries, and assists in the absorption of calcium and potassium. Over 300 enzymes in our body need magnesium to function properly. It is so important, that the brain stores a "safety supply" to have in the event of a drop in the magnesium reserves.
• Nutmeg - Grind fresh nutmeg and serve it with warm low fat milk and a touch of honey. Milk is naturally high in calcium and rich in tryptophan; together they can be a powerful tranquilizer (and very delicious).
• Hot foot baths - In the Eastern World, a hot foot bath is a traditional remedy; it draws blood from the brain to calm a racing mind. Try soaking your feet in a hot bath with a cupful of Epsom salts and a few drops of lavender essential oil, which will soothe you. Your feet absorb the magnesium from the Epsom salts and relax you further.
• Stomach rub - Soothes down the digestive system and helps bring about deeper relaxation. Lie on your back and place your hand on your belly button. Begin to make small circles in a clockwise direction as you gently glide your hand over your stomach. Let your circles gradually become bigger and bigger. When your circles reach the outside of your stomach, gradually reduce their size until you are back at your belly button again. Reverse the direction; repeat the whole series with your other hand and do this several times. Doing this with lavender oil can create an even more relaxing experience.
• Listening to an audio book - The brain works like a tape player - with one main auditory loop that processes words. If you fill that loop with an interesting book, there's no room for your own worrisome internal narrative. Especially helpful for those who have continuous thoughts running through their heads.
• Deep breathing - Take a deep breath in then slowly release out - focussing on your breathing causes your mind to get distracted from your worries and focussed on your breathing. Doing this for a few minutes can relax your mind and help you get a more peaceful sleep.
• Turn it off - Sleep experts suggest refraining from doing work, watching television, or being on the computer at least an hour before bed time. This allows your brain to start to 'wind down'.

Gangwisch. D, Malaspina. D, Boden-Albala. B, (2005) Inadequate Sleep as a Risk Factor for Obesity: Analyses of the NHANES I; COlumbia University, College of Physicians and Surgeons, New York, NY.

Taheri. S, Lin. L, Austin. D, Young. T, Mignot. E, (2004) Short Sleep Duration is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. PLos Med 1(3): e62. doi:10.1371/journal.pmed.0010062.

Major Fast Food Outlets Required to Disclose the Number of Calories in their Food by 2012.

Businesses with more than 200 outlets across Australia, or with 50 in Victoria, will have to display the amount of calories in their food under new Victorian State Government legislation by 2012.

As people order their Big Mac or bucket of crispy chicken, they will be able to see on the menu or on the display board how many kilojoules come with it. (Note: 1 calorie equals 4.2 kilojoules).

Victorian Premier John Brumby says his government is making it compulsory to display the details in a bid to cut down the rate of diabetes and obesity.

'The reason we are doing this is because we have a runaway epidemic in Victoria, right across Australia, particularly with diabetes,' Mr Brumby told reporters.

He said there are up to 270,000 Victorians with diabetes, with a further 20,000 becoming diabetic every year.

'This is a runaway train and we need to drag it back - the best way is by healthier eating and giving consumers information about their eating choices.' Mr Brumby said.

'Many people don't realise that if you eat a big hamburger, with a big coke and a big bag of chips that will be around half of your daily food intake.'

'Many people also don't realise the calories in a large Coke, almost 1,000kj or 20 teaspoonfuls of sugar.' Mr Brumby continued.

Health groups also support the move.

VicHealth Chief Executive Officer, Todd Harper said the plan was likely to be followed by other states.

'I have no doubt it will be popular initiative with consumers and hope that fast food outlets that fall under the threshold will voluntarily adopt it.' Mr Harper said.

'Until now, fast food companies have managed to keep kilojoule counters out of their displays but the time has come to put health first.'

Jane Martin, Senior Policy Adviser for the Obesity Policy Coalition, says clearer labelling on menus will help consumers 'sort the fat from fiction at a glance.'

'Many consumers would be surprised to find that some seemingly innocuous items such as frappes and smoothies contain one quarter of an adult's recommended daily energy intake,' Ms Martin said in a statement.

'To make matters worse many products with healthy sounding names are at the top of the worst offenders list.'

She says some of the highest kilojoule products have names such as Blueberry Blast, Garden Goodness and Green Tea Venti.

'While some of these products contain valuable nutrients, few people would realise that there's less than a 100 kilojoules difference between a Big Mac and the McDonald's Crispy Chicken Caesar Salad,' she said.

Story courtesy of Bigpond News.

Are You Getting Enough Sleep to Lose Weight?

In the last 40 years, the average duration of nightly sleep has decreased by 1-2 hours (1), a time during which the number of people classified as overweight or obese has doubled. It's been hypothesised that there is a correlation between these two trends: and it's not just because more waking hours means more time to eat.

Research has found that sleep deprived rats eat more than rats that are allowed normal amounts of sleep (2,3) . And several studies with human subjects show that people who sleep less are more likely to be overweight (4).

The cause is believed to be two hormones that regulate appetite and energy expenditure: Ghrelin and Leptin. The level of Leptin, a hormone that suppresses appetite, is decreased with sleep deprivation; and the level of Ghrelin, a hormone that stimulates appetite, is increased with sleep deprivation. So if you are trying to lose weight it's important that you are getting enough sleep.

How Much Sleep is Enough?

There's no perfect level of sleep for everyone, but the following table identifies the 'rule-of-thumb' amounts most experts have agreed:

Age / Sleep Needs Per Night (hours)
1-2 months: 10.5 - 18
3-11 months: 9-12 + 1-4 x 0.5 - 2 hour naps
1-3 years: 12-14
3-5 years: 11-13 hours
5-12 years: 10-11 hours
11-17 years: 8.5-9.25 hours
Adults: 7-9 hours
Older adults: 7-9 hours

To determine your own sleep needs, assess how you feel with different amounts of sleep.

How Can I Get More Sleep?

1. Make sleep a priority - don't make it the thing you do when everything else is done. If you have a daily planner; schedule sleep into it.
2. Drink a glass of milk before going to bed. Milk contains the amino acid Tryptophan, which may facilitate sleep.
3. Don't eat in the 2-3 hours before going to bed and aim to go to bed feeling content (i.e. neither full nor hungry). Going to bed hungry can affect your sleep as much as going to bed on a full stomach.
4. Exercise on a regular basis; avoiding the three hours before your bedtime. Some people exercise close to bedtime in the hope it will exhaust them; but this tactic can backfire as exercise stimulates the body by increasing your heart rate and metabolism.
5. Reduce your alcohol consumption. Although alcohol may help you fall asleep, it can disrupt your normal sleep pattern during the second half of the night and leave you feeling tired.
6. Avoid caffeinated drinks and foods after midday. This includes coffee, tea, cola and chocolate. If you are having trouble sleeping; try avoiding caffeine entirely and see if your sleep patterns improve.
7. Avoid smoking in the six hours before your bedtime (nicotine is a stimulant).
8. Avoid drinking too many fluids before bedtime to minimise night time urination.

References:

1. National Sleep Foundation, 2002, 'Sleep in America'
2. Danguir J and Nicolaidis S. 1979, 'Dependence of Sleep on Nutrients' Availability' Journal of Physiology and Behaviour vol. 22, pp. 735-740.
3. Everson CA, Bergmann BM, Rechtschaffen A. 1989, 'Sleep Deprivation in the Rat: III. Total Sleep Deprivation' Sleep vol. 12 pp. 13-21.
4. Hasler G, Buysse D, Klaghofer R, Gamma A, Ajdacic V, et al. 2004, 'The Association Between Short Sleep Duration and Obesity in Young Adults: A 13-year Prospective Study' Sleep vol.27 pp. 661-666.

Can You Lose Weight Without Exercise?

Wouldn't it be great if all you needed to do to lose weight was watch what you eat. No gyms, no perspiration or hard work... If you've heard people claim to have lost weight without exercise, you may be wondering if it's possible.

You Can't Maintain Weight Loss Without Exercise

Sure, you can shed kilos through calorie restriction alone, but the truth is that you can't maintain weight loss without exercise. Without exercise you will lose more water and muscle tissue than body fat. Losing muscle and water may look great on the scales, but it slows your metabolism and makes it easier for you to regain weight.

Exercise improves your body composition, meaning that you will have a larger proportion of metabolically active muscle tissue. And when your metabolic rate increases it's easier for you to lose weight and maintain your weight loss.

Additional Benefits of Exercise

Exercise is not just about weight loss. The health benefits of exercise include:

• Reduced levels of body fat, especially abdominal fat
• Increased metabolic rate
• Lower blood pressure
• Higher levels of HDL (good) cholesterol which protects your arteries
• Lower levels of LDL (bad) cholesterol which clogs your arteries
• Lower risk of developing diabetes
• Improved muscle strength
• Improved bone density, reducing the risk of osteoporosis
• Increased energy levels and improved fitness
• Sleep regulation
• Improved mood and fewer symptoms of depression.

How to Start an Exercise Program

Don't feel overwhelmed by the prospect of starting an exercise program: something is better than nothing. You don't need to start running marathons to lose weight: in fact a more moderate, comfortable exercise regime will be more manageable in the long term. Daily walking is a great habit, particularly with a friend to share the time. To burn fat, aim for a pace where you breathing rate is elevated but you can still talk.

For more tips on how to exercise for weight loss, see our articles on Exercise for Weight Loss and Maintenance and Finding Your Motivation to Exercise.

Outsmarting a Weight Plateau

You've been checking the scales each week and progress is steady, you'll achieve your weight loss goals in no time! But suddenly the scales refuse to budge... It doesn't make sense! You haven't changed your diet and you haven't skipped an exercise session...

It's disappointing, it's frustrating and it's called a weight plateau. But the good news is that you aren't the first to experience it, and that you can take steps to outsmart it:

Maintain your Metabolism

When you restrict your calorie intake it's almost inevitable that your metabolism will slow. Try incorporating more resistance training into your exercise program to maintain your metabolically active muscle tissue and eat small but regular meals.

Adjust Your Exercise Routine

As you become fitter your body becomes more efficient at performing a given exercise, i.e. you burn less energy. To burn more energy, try changing the type of activity that you do to challenge different (and less efficient) muscle groups. Try cycling, swimming, rowing, using a cross trainer or learning to use different equipment at the gym.

If you don't want to change your activity type, you will need to exercise at a slightly higher intensity. You can increase the speed or incline of your walks, the resistance on your exercise bike or your swimming speed in the pool. At this stage you may wish to consider purchasing a heart rate monitor to make sure that you are still exercising in your fat burning zone.

Reduce Your Stress and Anxiety Levels

Chronic stress means chronically elevated levels of a hormone called Cortisol in your body, which may predispose you to storing fat (1). If you are feeling stressed or anxious, investigate some stress management techniques.

Be Honest with Yourself

How long has it been since you weighed your meat portions or measured your cereal serves? Should you be counting that thick slice of raisin toast as one serve or two? These little things might not seem like much, but added together they determine if you gain weight or lose it.

Start weighing your food portions and recording your intake of food, including calories. Recording can be cumbersome, but it might just be enough to help you identify where the problem lies.

Are You Really at a Plateau?

Are your clothes feeling looser but the scales aren't moving (or even moving in the wrong direction)? It might be the case that your body composition is changing, i.e. you are gaining muscle tissue (which is heavier than fat). This is possible if you have changed your exercise regime to include more resistance training, or you have changed the type of exercise that you are doing. To find out if you have gained muscle, measure your waist and hip circumference instead of stepping onto your scales.

The benefits of exercise, stress reduction and healthy eating extend beyond losing weight - they bring out the best in your body. So focus on enjoying how you feel rather than focusing on the number on your scales. If you have lost weight you are probably feeling more healthy and energetic, and that's something to celebrate.

10 Tips for Weight Maintenance

If you've worked hard to achieve your weight loss goal, you'll want to enjoy your healthy weight for life. Here are our top ten tips for weight maintenance:

1. Monitor Your Weight

Check your weight each week (don't weigh yourself too often it's natural for your weight to fluctuate daily). Use your bathroom scales, or find a pair of pants that are comfortable at your goal weight and identify if they get significantly tighter or looser.

It's normal for your weight to fluctuate by 1-2 kilograms, but if you notice your weight increasing on two or more consecutive weeks try one (or a combination) of the following three actions:

1. Decrease your calorie intake
2. Increase the duration and / or frequency of your exercise sessions
3. Be honest with yourself: are there any areas of your lifestyle, behaviour or environment that have changed?

You should set an upper and a lower limit on your weight (a Dietitian can help you set appropriate limits). If you hit your upper or lower limit, seek professional help from a Dietitian or Doctor as soon as possible. And don't procrastinate for too long - it's much easier to reverse a 1-2kg weight gain than it is to reverse a 5-7kg weight gain!

2. Monitor Your Eating Patterns

Keep a food diary to ensure that you are eating the right amounts of food from each of the five food groups. It may sound tedious, but a food diary helps you to check that you are eating regularly. Try to maintain a consistent eating pattern, including weekends and holidays.

3. Exercise

To maintain your weight you need to exercise at a moderate intensity (a rate at which your heart rate is elevated but you can still carry out a conversation) for at least 250 minutes per week. Try walking for 30 minutes on five days of every week. For the fitter members of the audience, you can try vigorous cardiovascular exercise such as jogging for 20 minutes a day on three days of the week.

If you want to change the shape of your body or strengthen your muscles, try resistance training, or performing exercise against an opposing force such as water, free weights, weight machines, a theraband, a fit ball or even your own body weight. Resistance training increases the proportion of lean body tissue (muscle) in your body contributing to a higher metabolic rate, as well as improving your posture, flexibility and strength. If you are interested in starting a resistance training program, it's best to have a program designed by an Exercise Physiologist or a personal trainer.

4. Continue to Set Goals

The goal of weight loss is change, whereas the goal of weight maintenance is no change. It can be hard to maintain your resolve when you don't see results for the effort you are putting in. To account for this, try setting other life goals that are better enjoyed at a lower weight (e.g. joining a community walking group or travelling).

5. Reward Yourself

When you were losing weight you were probably enjoying the associated rewards: complements from friends, the excitement of fitting into smaller clothes and a dropping body weight. You'll have to devise a new set of rewards to keep you motivated during weight maintenance: treat yourself to a massage, buy a book or have a manicure of pedicure at the end of every month. You'll need to reward yourself for at least the first few years after weight loss.

6. Enlist Support

While you were losing weight it's likely that you received encouragement from family, friends and health professionals. Weight maintenance can be just as difficult as weight loss at times - and it can be a more isolated process. But it doesn't have to be that way. Tell the important people in your life that maintaining your healthy weight is important to you, and that you'd like their support and encouragement for the long term.

7. Stay Vigilant

It's easy to become complacent when you achieve your weight loss goal. People sometimes fall into the trap of thinking, "I can have an extra scoop of chocolate ice cream - I've lost a lot of weight and I'm feeling really good". Just because you've lost weight it doesn't mean that extra calories don't add up anymore!

It's important to treat yourself from time to time, but it's also important to recognise when extra treats are creeping into your diet too often. By keeping a food diary (or just listing your treats on a notepad) you can identify how frequently you are indulging. You should consume no more than 2-3 treats per week, and try to limit your treats to a 200 Calorie portion.

8. Be Organised

It's hard to manage your weight when the rest of your life is in chaos. Leave plenty of time to relax, sleep, shop for healthy foods, prepare healthy meals and exercise.

9. Maintain a Healthy Level of Self Esteem

Don't link how you feel about yourself to your weight. Be happy with you weight and proud of the weight loss that you have achieved.

10. Don't Use Food to Stabilise Your Moods

If you are feeling stressed or upset, find a non-food related way of calming yourself - go for a walk or call a friend.

Lastly, don't forget that weight maintenance can be just as challenging as weight loss (if not more so in the first two years). But it gets easier with time, and by following our advice you will be well on your way to success.

Menopause and Weight Loss

Many women associate menopause or the use of hormone replacement therapy with weight gain. But what are the facts? And what can you do about it?

In both women and men, there is an increase in Body Mass Index (BMI) with age, with the peak BMI occurring between 50 and 59 years of age (1). Many women claim that this weight gain is caused by menopause, however research doesn't support these claims. Women gain total body weight at a linear rate from age 35 - 65, a trend that is not related to loss of ovarian hormones or their subsequent replacement (2).

Menopause results in body composition changes that could indirectly lead to weight gain. During the menopausal years there is a shift in the distribution of fat from the traditional hourglass figure of the younger woman to a more central deposition in the abdomen.

These changes in fat distribution are independently associated with an increased risk of developing hypertension, abnormal lipid profiles, Type II Diabetes and cardiovascular disease (3). In addition to the change in the distribution of body fat, there is more body fat and less muscle mass. This may decrease resting metabolic rate, which in turn results in weight gain (4).

What's the best advice for women dealing with weight gain in their menopausal years?

Exercise. Try walking at a moderate intensity for at least 30 minutes a day (in 10 - 30 minute bouts) and partake in bi-weekly resistance training sessions. This prescription is supported by a study that demonstrated numerous health benefits for exercise in menopausal women, including loss of abdominal fat and overall body fat (5).

References:
1. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. 1994, 'Increasing prevalence of overweight among US adults, A National Health and Nutrition Examination Survey 1960-1991' Journal of the Americal Medical Association, 272:205-11
2. Davies KM, Heaney RP, Recker RR, Barger-Lux MJ and Lappe JM. 2001, 'Hormones, Weight Change and Menopause' International Journal of Obesity, 25:874-879
3. Sturdee D, MacLennan A. 2007, 'The weight problem', Climacteric, 10:2
4. Smith K. 2005, 'Exercise Can Help Control Body Changes During Menopause', Healthcare, Food and Nutrition, 22(10)10-11
5. Asikainen T, Kukkonen-Harjula K, Miilunpalo S. 2004, 'Exercise for Health for Early Postmenopausal Women', Sports Medicine, 34:753-778

Alcohol and Weight Loss

At the Wesley Weight Management Clinic we're often asked if drinking alcohol can hinder weight loss. Here's our answer:

To lose weight, you will probably need to moderate your alcohol consumption. We don't want to demonise alcohol (or any other food or drink) - we're strong believers in the saying "all things in moderation" and you still need to go out and enjoy yourself when you are losing weight. But it's important that you appreciate that drinking alcohol will hinder your weight loss efforts.

Alcohol is High in Calories

Alcohol contains 70 calories per serve. To put this into perspective, the following meals contain the same number of calories as three standard drinks:

- 100g lean pork/steak/chicken breast + 2 cups of salad
- 1 x 95g can tuna (98% fat free) + 4 Vita Wheat crackers
- 1 Weight Watchers Beef Burgundy frozen meal + 2 cups of vegetables

These meals provide important nutrients, vitamins and minerals, which can't be said for alcohol: alcohol calories are 'empty calories', or energy without any substantial vitamins or minerals. Additionally, alcohol may directly promote fat storage by slowing fat and carbohydrate digestion and increasing appetite (1).

If you were on a 1500 Calorie a day meal plan during weight loss and chose to consume 500 of these calories from alcohol (approximately 4 x 375mL cans of regular beer), you would need to provide all your essential nutrients from the remaining 1000 Calories. This may be difficult; and it's possible that nutritional deficiencies may occur over time.

And if you consumed 1500 Calories of food per day plus 500 Calories of alcohol per week (approximately 4 x 375mL cans of regular beer), you might gain 5kg of weight per year!

Can Alcohol be Beneficial to My Health?

The risks of consuming alcohol far outweigh any possible benefits. There are health benefits from drinking alcohol, but these can be obtained by drinking as little as half a standard drink per day (2).

How much Alcohol is Safe to Consume?

The Australian Alcohol Guidelines have recently been updated (3) and consist of four recommendations:

1. For healthy men and women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury (note that it is no longer considered safe for men to drink four standard drinks per day).
2. For healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion.
3. For children and young people under 18 years of age, not drinking alcohol is the safest option. 4. For women who are breastfeeding, pregnant or planning a pregnancy; not drinking is the safest option.

What is a Standard Drink?

See the image to the right. Note that there is no standard glass size used in Australia: you will often be served more than one standard drink.

How can I Reduce My Alcohol Intake?

Try the following practical tips for reducing your alcohol intake:

- Eat before you drink alcohol: food fills you up, slowing your drinking pace and possibly slowing your absorption of alcohol
- Drink water or a diet soft drink before drinking any alcohol and avoid salty foods while you are consuming alcohol
- Sip alcohol slowly and put your glass down between sips
- Intersperse your alcoholic drinks with non alcoholic drinks such as water or diet soft drinks
- Dilute wine with ice, water, juice or natural mineral water; dilute beer with diet lemonade or soda water and mix spirits with diet soft drinks or soda water
- Choose light beer over full strength
- Don't let other people 'top up' your glass: be more assertive and do not to let peer pressure make you drink more than you want to
- Avoid 'shouts' or get a glass of water when it's your turn to buy a round
- Volunteer to be the designated driver to avoid peer pressure to drink.

So go easy on the alcohol when you are trying to lose weight and you'll reap the rewards.

References:
1.National Health and Medical Research Council (2003), Dietary Guidelines for Australian Adults Commonwealth of Australia
2.Lewis S, Campbell S, Proudfoot E et al (2008) Alcohol as a Cause of Cancer, Cancer Institute NSW, Sydney
3.National Health and Medical Research Council (2009) 'Australian guidelines to reduce health risks from drinking alcohol' Commonwealth of Australia

Non-Hungry Eating: How to Take Control

If you eat when you aren't hungry you may be finding it difficult to lose weight. Here are some tips to help you fight the urge to eat when you aren't hungry, a habit which we call 'non-hungry eating':

What are Your Eating Cues?

When you understand why you eat when you aren't hungry you can take positive steps to prevent it from happening again. Do you eat when you are feeling down or lonely? When you are engaging in certain habits or activities? Because the weather is gloomy? Or simply because food is put in front of you?

Next time you catch yourself heading to the pantry when you aren't hungry, think about your motivations for wanting to eat. Then you can work toward re-gaining control of how you respond to your cues. Try removing the cue (e.g. take the packet of chips away from the TV room if you eat when you watch TV). Or you can actively respond to the cue in a different way (e.g. call a friend instead of heading to the kitchen when you are bored).

Don't be disheartened if you don't succeed in changing your habits straight away. Change is a process that takes time, dedication and the courage to persevere - even when you don't succeed.

Measure Your Hunger

Be aware of when you are engaging in hungry eating because hunger is an appropriate cue to eat. To ascertain your level of hunger, try using the following scale to rate your hunger before eating, then five minutes after you have started eating and then again when you have finished your meal:

Rating / Physical Sensation
1 Starvation, physical pain
2 Definite physical symptoms: headache, low energy, light headed feeling, empty stomach
3 Beginning of physical signs of hunger
4 Could eat if suggestion was made
5 Neutral
6 Satisfied
7 Feel food in stomach
8 Stomach protrudes, beginning of mood alteration
9 Bloated, definite mood alteration
10 Definitely full: physical pain and numbness

People who are successful at weight loss generally wait until they are at a rating of 2 or 3 before they eat, and then they only eat to a rating of 6.

Remember that you are in control of how you respond to your eating cues. And when you control how you respond to your eating cues, you can start to control your weight.

Reference: Kausman, R. 1998. If Not Dieting, Then What? Allen & Unwin

Find Your Motivation to Exercise: 10 Tips

Struggling to get out the door for your afternoon walk? Or finding that extra hour of sleep more appealing than hitting the pavement for your morning stroll?

Despite being well aware of the benefits of exercise - and knowing how great you will feel after exercising - you may find yourself struggling with motivation. Read on for some tips:

1. Adopt an Exercise Buddy

Exercise buddies keep you accountable - there's nothing like the commitment of knowing that someone is waiting for you. Walking groups or cycling bunch rides are a great way to meet people, and as your fitness improves, other people who have greater fitness will spur you on!

2. Walk to a Beat

Listening to music can motivate you during exercise, resulting in longer, more enjoyable sessions. If music isn't your thing, try listening to books on CD or podcasts.

3. Try Something New

Try cycling, aqua aerobics, water running, walking, swimming or even dancing. There is a form of exercise that you will love out there - you just may not have found it yet!

4. Just Do It

Sometimes overanalysing can be detrimental - you just need to get out there and exercise!

5. Enter Fun Runs and Walks

You don't have to be a serious runner or athlete to enter races, most have 'walker' divisions. Aim to do a fun run or walk to sustain interest and give yourself a goal to work towards.

6. Schedule It

Book an appointment with yourself and prioritise exercise just like you would any other appointment.

7. Exercise Early

If you want to get something done, do it before other tasks and responsibilities accumulate. If you exercise early you will benefit from an elevated metabolic rate for the remainder of the day, which means you are likely to burn more calories. If you can't fit exercise in early, try to do it before you get home. Once you get home, it can be difficult to go back outside!

8. Be Prepared

Keep a bag of exercise clothes at your work or in your car - you never know when you may be able to fit in an exercise session. If you are going to exercise in the morning, organise the gear you need the night before.

9. Keep Track

Keep an exercise diary, or use a heart rate monitor to measure your exercise intensity, duration and calories burned. When you meet your exercise goals, treat yourself to a non food-related reward. When you are pressed for time, a pedometer is a great way of measuring your incidental exercise.

10. Be Flexible

Don't worry too much about missed exercise days, but try to identify the barriers that prevent you from exercising and address them.

How Much Exercise Do I Need to Do to Lose Weight?

The amount of exercise you need to do depends on your weight loss goal. If your goal is:

1. Weight loss 150-250 minutes of moderate intensity* physical activity per week provides modest weight loss. People with a body mass index that classifies them as overweight or obese should aim for more than 250 minutes of exercise per week (e.g. 5 sessions of one hour per week) and perform resistance training to increase the amount of metabolically active muscle tissue in their bodies and reduce their health risks.

2. Weight maintenance More than 250 minutes per week of moderate intensity physical activity per week (e.g. 5 sessions of 50 minutes per week).

3. Preventing weight gain 150-250 minutes of moderate intensity physical activity per week (e.g. 5 sessions of 30 - 50 minutes per week).

*Moderate intensity physical activity is an increase in your breathing rate to a point where you are still able to talk comfortably but not sing. A more technical explanation is that it is exercising in a range of 65-75% of your maximum heart rate. Modes of exercise which are best suited to moderate intensity exercise are brisk walking, swimming, bike riding or cardio machines at the gym. Exercise should be continuous rather than in short bursts (these short bursts occur in sports such as tennis or touch football).

Remember that it's very difficult to lose weight through exercise alone. If you try to lose weight without reducing your calorie intake you'll need to exercise for at least 300 minutes a week! The best way to lose weight is to exercise AND consume fewer calories. Not only will you lose weight at a faster rate, but by engaging in regular aerobic exercise you'll keep the weight off for life.

Reference
Donnelly, J. et al., 2009, ' Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults', Medicine & Science in Sports & Exercise Vol. 41:459-471.

Healthy Eating on a Budget

You don't have to compromise your health to reduce your food bill. Here are some tips to help you buy low fat and nutritious food without paying top dollar:

Shop from a list Make a meal plan at the start of each week and decide what you need to purchase to make your meals. If you can be organised at the beginning of the week you won't need to shop at smaller, more expensive food stores. And if you have a weekly menu plan and ingredients to hand, you will be less likely to eat out at restaurants or buy take away foods on the way home from work.

Shop at fresh fruit and vegetable markets Fresh fruit and vegetables from specialty markets last longer (and taste better) than items purchased at large supermarket chains. Purchase fruit and vegetables that are in season (see the seasonal availability of fruits and vegetables).

Don't shop when you are hungry If you are hungry when you shop, you are more likely to buy items you don't 'need'.

Buy in bulk Buy non perishable items such as cereal and pasta in bulk at large supermarkets.

Shop online You'll be less likely to make impulse purchases if you shop online. And if you shop online from home you can check what is in your fridge and pantry to save doubling up! Woolworths and Coles have shops online.

Prepare meals yourself Buy fresh ingredients and prepare meals yourself rather than buying takeaway foods or pre-prepared items. By preparing your own food you can save calories - and dollars. Take a look at the following items that become more expensive as the amount of processing increases:

Potatoes (150g)
Potatoes 25c
Frozen chips 50c
150g potato crisps $2.99

Oats (40g)
Rolled oats 10c
Corn Flakes25c
Breakfast bar 95c

Chicken (100g)
Frozen whole chicken 35c
Raw whole chicken 50c
BBQ chicken 70c
Pre-made chicken kebabs $1.80

Apple (100g)
Apple 40c
Packet of sultanas 90c
Fruit bar $3.20

There are lots of online resources for quick and healthy recipes, including the National Heart Foundation Recipe Guide.

So it's no more expensive to eat healthy food - it just takes a bit of preparation and planning.

How to Increase Your Metabolic Rate

To increase your metabolic rate, or the rate at which your body burns energy, you need to exercise at a moderate intensity (a level where your breathing rate is elevated, but you can still carry out a conversation) for at least 250 minutes a week. You also need to eat small meals every three hours.

Metabolism Explained

Your metabolism is important in determining how much body fat you burn. Every person's metabolic rate is different, but in theory, raising your metabolic rate by 10% can decrease your body weight by up to 7.5 kilograms! Your metabolic rate comprises of three factors, two of which you have the power to change:

1. Resting metabolic rate the amount of energy expended when you are sleeping or sedentary (60 - 70% of the average person's daily energy use)
2. Physical activity (20 - 25% of the average person's daily energy use)
3. Thermogenesis an increase in your resting metabolic rate in response to stimuli such as food digestion (10% of the average person's daily energy use)

The two factors that you have the power to change are the physical activity (engage in regular exercise) and thermogenesis (eat every 2-3 hours).

Don't Slow Your Metabolism

One of the fastest ways to slow your metabolsim is to 'crash diet', or try fast diets and fasting. When you lose weight quickly, your body responds to perceived starvation by slowing your metabolic rate to conserve energy. Hence when you start eating normally again, your body stores fat because its metabolism has slowed!

Yo-yo dieting has a similar effect. The more weight you lose, regain and lose again; the more muscle tissue you will shed. Unlike fat, muscle tissue is metabolically active.

So by maintaining a healthy metabolism with exercise and regular eating, you'll enjoy a healthy metabolism - and a healthy weight.

Fast Weight Loss: Why it Doesn't Work

Fasting diets generate fast but false results. Here's why:

You lose fluid, not fat And any fluid lost will return as soon as the fast is completed, in other words you'll re-gain any weight that you lost.

Lowered metabolism During fasting your metabolism slows by up to 40% to prepare for starvation, so when you eat normally again your body burns fewer calories and you gain weight.

Hunger and lethargy Fasting leads to hunger and cravings - not what you need when you are trying to lose weight! And when you drastically cut your calorie intake you will feel weak, making it even more difficult to maintain your resolve to lose weight.

Yo yo dieting Fasting often leads to cycles of weight loss and weight gain called 'yo yo' dieting. 95% of people who go on fast weight loss diets regain any weight lost - plus more - within two years (1).

Abstinence leads to binging When your food intake is restricted you experience physical and emotional deprivation. This compels you to eat, which commonly leads to overeating or binging. As a result, you are likely to feel sensations of guilt and failure. This often becomes a cycle which is difficult to break and has devastating effects on your self esteem (1).

Nutritional deficiencies Prolonged fasting may lead to nutritional deficiencies. For example, if you don't consume enough calcium you may be at risk of osteoporosis, or if you don't consume enough fibre you may experience constipation.

Poor Health Fast weight loss is bad for your health because it:
- Increases your risk of medical complications such as gallstones, gout and constipation (2)
- Lowers your immunity
- Leaves you deficient in important vitamins and minerals.

Impracticalities Fast weight loss involves restricting food intake to the point where you are constantly hungry and lack the nutrients you need to maintain physical health and energy levels. This situation can't be sustained in the long term. Plus fasting makes it difficult to carry out normal social interactions - people who are dieting often avoid social situations and family mealtimes, leading to feelings of isolation and loneliness.

Some people claim that fasting can help rid your body of 'toxins' (i.e. the food you eat). 'Toxins' occur naturally in your body, and your body has fantastic systems to cleanse itself (your kidneys and liver).

Healthy Weight Loss

A sensible weight loss goal is 0.5 - 1kg per week, and the best way to achieve this is to make healthy changes to your eating and exercise habits. These changes should always be sustainable - that way you will lose weight and keep it off.

References:
1. Why Diets Don't Work, Eating Disorders Foundation of Victoria
2. Rapid Weight Loss Linked to Gallstones, Flinders Medical Centre

Meal Replacements: A Great Tool with the Right Advice

Meal replacements are designed to assist in controlling calorie intake, a critical plank for weight loss. But they can also be confusing, frustrating and disappointing and leave you back where you started.
That's because most meal replacements are sold without any advice, or any supervision from a health professional; as demonstrated by a recent CHOICE Magazine study. This lack of advice leaves you to work out your own treatment plan, adding to the increased chance of failure.

The Benefits of Using Meal Replacements

Used correctly, meal replacements can be a great short term weight loss tool. At the Wesley Weight Management Clinic we've found that meal replacements:

• Help you to become accustomed to eating smaller portion sizes
• Promote independence from food
• Narrow your food choices, allowing you to manage the amount and type of food you consume (people consume fewer calories when presented with a smaller selection of food)
• Increase your rate of weight loss
• Help you to feel satiated (not hungry) for longer
• Can provide all of the essential vitamins and minerals that your body needs if you choose a nutritionally balanced formulation (at the Wesley Weight Management Clinic we use Optifast 800)
• Help to regulate your blood sugar levels and maintain energy levels
• Help you form a habit of eating at regular intervals and focusing on one meal or snack at a time
• Require minimal preparation and fit easily into a busy schedule.

Get the Right Advice

If you want to use a meal replacement as a tool for weight loss, you should engage the assistance of a suitably qualified health professional such as a Dietitian or Doctor.

A health professional can help you work out an appropriate schedule of meal replacements, monitor your rate of weight loss and the nutritional quality of your diet, provide advice if you experience any side effects and help you transition back onto normal food when you reach your weight loss goal.

This advice is critical if you have Diabetes or Hypertension: meal replacements can change your symptoms or impact upon the effectiveness of your medication.

Life After Using a Meal Replacement

Meal replacements aren't a long term weight loss solution. When you reach your weight loss goal you need to transition back onto 'normal' food gradually. You also need to learn the skills you need to keep your weight off for life, including meal planning, healthy grocery shopping, meal portioning, exercise and low fat cooking.

For more information about the healthy use of meal replacements, talk to your Doctor or you can ask the health professionals at the Wesley Weight Management Clinic about our weight loss program.

Carbohydrate Blockers

Carbohydrate blockers cause unpleasant side effects and deny the body of important vitamins, minerals and dietary fibre. Here's why:

Side Effects
It is claimed that carbohydrate blockers permit carbohydrates to pass through the body undigested. The side effects of this process include gastrointestinal upset and excessive wind.

Poor Nutrition
Carbohydrate is the body's preferred fuel source: many carbohydrate-rich foods offer vitamins, minerals and dietary fibre. So when you block carbohydrates, you deny your body important nutrients.

Safety Issues
People with a medical condition should be wary of carbohydrate blockers: especially people with Diabetes.

Lack of Effectiveness
The manufacturers of carbohydrate blockers claim they can 'block' up to 1125 Calories per meal, helping people lose 5kgs in two months. These results are by no means remarkable. At the Wesley Weight Management Clinic our heaviest client group loses an average of 7.9kgs in one month, 15kgs in three months and 21kgs in six months.

So when it comes to healthy weight loss there's no quick and easy solution: you need to change your lifestyle by eating a healthy balanced diet and engaging in regular exercise.

Are Slimming Pills Safe?

Slimming pills will probably help you lose weight, but that weight loss comes at a price: your health.

Slimming pills don't contain the right balance of macronutrients (carbohydrate, fat and fibre) that your body needs for good health and proper function.

Plus by reducing the amount of fat in your diet, slimming pills risk your mental health. Your brain's cells need a type of fat called Omega 3 Polyunsaturated Fatty Acid (PUFA) to build their protective membranes. PUFAs are only found in a select group of foods including seafood, flax send, canola oil, soy bean oil and walnuts. A lack of PUFAs can disrupt your brain's cell membranes, a condition that has been related to clinical depression (1). In fact studies have found that it only takes one month for mood to deteriorate when the proportion of daily energy intake from dietary fat is reduced from 41% to 25% (2).

There's absolutely no need to risk your health to lose weight: weight loss should improve your health not harm it!

To lose weight the healthy way you need to eat a nutritious diet, with small meals and snacks every 2-3 hours, as well as engaging in regular exercise. To find out how you can integrate a healthy, balanced diet into your lifestyle see an Accredited Practicing Dietitian. If you are based in Queensland, you can see a Dietitian at the Wesley Weight Management Clinic.

References:
1. Lombard, C. 2000, 'What is the Role of Food in Preventing Depression and Improving Mood, Performance and Cognitive Function?' Medical Journal of Australia, 173:s104-105
2. Anita S. Wells, Nicholas W. Read, Jonathan D. E. Laugharne and N. S. Ahluwalia, 1998, 'Alterations in Mood After Changing to a low Fat Diet' British Journal of Nutrition, 79 , pp 23-30