March is National Nutrition Month®, a time to think about the food choices you make and commit to improving your eating habits. This year, the campaign's theme is, "Eat Right." Simple enough, right?

Here are the Key Messages:

Make Your Calories Count. Think nutrient-rich rather than “good” or “bad” foods. The majority of your food choices should be packed with vitamins, minerals, fiber and other nutrients – and lower in calories.  Making smart food choices can help you stay healthy, manage your weight and be physically active.

Focus on Variety. Eat a variety of foods from all the food groups to get the nutrients your body needs. Fruits and vegetables can be fresh, frozen or canned. Include more dark green vegetables such as leafy greens and broccoli and orange vegetables like carrots and sweet potatoes. Vary your protein choices with more fish, beans and peas. And, eat at least 3 ounces of whole grain cereals, breads, crackers, rice or pasta every day.

Know Your Fats. Look for foods low in saturated fats, trans fats and cholesterol to help reduce the risk of heart disease. Most of the fats you eat should be monounsaturated and polyunsaturated fats. Check the Nutrition Facts panel on food labels for total fat and saturated fat.

Physical Activity for Fitness and Health. Balancing physical activity and a healthful diet is your best recipe for managing weight and promoting overall health and fitness. Set a goal to be physically active at least 30 minutes every day. You can break up your physical activity into 10 minute sessions throughout the day. If you are currently inactive, start with a few minutes of activity such as walking. Then gradually increase the minutes as you become stronger.  

Which of these are you already doing? Which do you need to improve? Set a specific goal this month to change (for the better) at least one eating habit. Small, consistent changes lead to big results, so don't think you have to overhaul your entire eating plan to improve your health and achieve calorie balance.

Hey Americans, give yourself a big pat on the back.  Why?  Over 64% of adults were meeting the minimum level of aerobic physical activity in 2007.  That’s a 30% increase from 2005 when about 48% of men and women were getting the recommended amounts of physical activity.  Did Americans finally take the old Nike slogan to heart and, to paraphrase, “Just Did It?”

Not so fast.

What has accounted for this seemingly impressive gain in adults getting the recommended minimal amount of physical activity is simply a change in the way the government assessed physical activity.  In 2005, people were considered to be meeting the minimum public health requirement for physical activity if they were doing at least 30 minutes a day of moderate-intensity activity on 5 or more days a week, or at least 20 minutes a day of vigorous-intensity activity on 3 or more days a week, or both.

In the 2007 survey, adults were deemed “physically active” if they reported at least 150 minutes per week of moderate-intensity activity, or at least 75 minutes per week of vigorous-intensity activity, or a combination of  moderate-intensity and vigorous-intensity activity (multiplied by two) totaling at least 150 minutes per week.

So in the 2007 survey, simply taking away the requirement of a certain number of minutes on a certain number of days and allowing various combinations of moderate or vigorous or moderate AND vigorous activity to count boosted the proportion of physically active adults to an impressive 64%.

Which numbers should you believe?  It matters not.  The bottomline still remains that a large proportion of our adult population does not get adequate amounts of physical activity. 

Where do you fall in the active/not active spectrum??

Centers for Disease Control. Prevalence of self-reported physically active adults—United States, 2007.  Morbidity and Mortality Weekly.  2008;57:1297-1300

Centers for Disease Control. Prevalence of regular physical activity among adults—United States, 2001 and 2005.  Morbidity and Mortality Weekly.  MMWR. 2007;56:1209-1212

The debate about what type of diet is most effective for weight loss seems never ending. Yesterday you were told to eat low fat and today you're told to cut out the carbohydrates. A new study now says that while macronutrients (fat, carbohydrate, protein) are important to consider for overall health, it's calories that really count for weight loss.

Reported in The New England Journal of Medicine, researchers assigned 811 overweight/obese adults to one of four reduced-calorie diets:

• Low-fat, average protein (high carbohydrate) 
• Low-fat, high protein
• High-fat, average protein
• High-fat, high-protein (low carbohydrate)

Study subjects were asked to record their food intake in a dairy or online tool, do moderate-intensity physical activity for at least 90 minutes per week, and attend group and individual counseling sessions every (or every other) month.

Results showed:

• On average, participants lost 13 pounds at six months and maintained 9 pounds at two years
• The macronutrient composition (amounts of fat, protein, and carbohydrates) of the diet did not predict amount of weight lost
• Satiety, hunger, satisfaction with diet, and attendance at group sessions were similar for all diets
• All diets improved risk factors (triglycerides, LDL-cholesterol, blood pressure, HDL-cholesterol, and metabolic syndrome) for heart disease

What's great about these results is that they support the notions that 1) calorie intake is key (and that's what SU&E's all about!) and 2) people can choose whichever reduced-calorie eating plan they think they will be most likely to stick with. For people who do a lot of "mindless eating" of carbohydrates (e.g., eating chips while on the computer or watching TV), they may benefit from a higher fat and protein diet that isn't conducive to snacking. On the other hand, someone who eats out frequently may benefit from a low fat diet that encourages them to choose plain chicken and fish instead of fried or high fat meats.

This flexibility to choose an approach that fits into someone's lifestyle is key to long-term change and weight loss.

What are your thoughts? 

Sacks, F.M. (2009).Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. The New England Journal of Medicine. 360(9), 859-873.

“Phone a friend” is a way contestants on a popular game show recruit help on their quest for a million bucks.  If your goal is to lose weight, then phone a registered dietitian.  

A study published last month in the Annals of Internal Medicine compared different ways for supporting obese men and women in their efforts to lose weight while taking a weight loss medication called sibutramine, otherwise known as Meridia.  Patients were randomized to one of five groups:

1. Weekly face-to-face meetings with a RD for 3 months followed by bi-weekly face-to-face meetings with a RD (high frequency F2F)
2. Monthly face-to-face meetings with a RD for 6 months (low frequency F2F)
3. Weekly telephone calls with a RD for 3 months followed by bi-weekly telephone calls with a RD (high frequency phone)
4. Weekly email contacts with a RD for 3 months followed by bi-weekly email contacts with a RD (high frequency email)
5. No contact with a dietitian. (self-help)

All five groups received the same self-help weight loss manual and had access to the same weight loss web site.  And all were prescribed a moderate dose of Meridia.

At the end of the six month intervention, all the groups lost 5% or more of their baseline body weight, a clinically significant finding.  But the high frequency face-to-face and telephone groups lost significantly more weight (8.9% and 7.7% decline from baseline, respectively) than the other groups.  Thus, frequent contact was an important factor, something numerous other studies have shown. 

But this study suggests that meeting with a RD by phone or face-to-face may yield similar results.  The implication being that because phone contact with a RD can be more convenient and less costly than office visits, it may be a good alternative to face-to-face meetings.  Emailing instead of talking live may also be a good delivery option but more research is needed.

This is just one study and like many studies it had some flaws.  For one thing, there was not a group that did not take Meridia so it cannot be determined how much of the weight loss was due to simply to taking the medication.  Also, the patients were nearly all women so the it is not known if similar results would be found for men.

So the next time you want to lose some weight, call a RD instead of phoning a friend.  To find a Registered Dietitian in your area, go to www.eatright.org and click on “Find a nutrition professional” in the upper right corner of the web site.  

Digenio AG et al.  comparison of methods for delivering a lifestyle modification program for obese patients.  Annals of Internal Medicine.   2009;150:255-262.