Eating Healthy During the Holidays

It’s Holiday Time...Uh, oh.

The holiday season is rapidly approaching. We’re about to be bombarded by deliciously addictive sugary and starchy foods. Yum. This is the least wonderful time of the year from the perspective of an Obesity specialist. Unfortunately many of my patients arrive at the office several pounds heavier after New Year’s Day. “It was the holidays.” most people explain with an embarrassed shrug.

 Most adult Americans gain 1-2 pounds annually and the period between October 31 and January 1 is when two thirds of that happens.¹  Worse still, although most people do lose some weight in January as part of their New Year’s resolution, it is only a tiny fraction of what they gained during the holidays. Doesn’t sound so bad? Only 1 or 2 pounds. Right?? It is a big problem! This pattern typically repeats year after year resulting in the steadily climbing weight that most adults have come to expect as part of so called normal aging in America. In this manner, a person who was at a healthy weight when she was age 18 could be well overweight or obese by age 40. Take home point: Holiday weight mostly sticks...forever.

It’s tough to say no: Friends, family and neighbors, as well intentioned as they may be, can be your worst enemies when it comes to sticking to your healthy nutrition goals.  It all gets started with the candy onslaught that is Halloween, noshing on the candy that is supposed to be for trick-or-treaters or dipping in to the mountain that your kids collected. Then comes Thanksgiving with Grandma’s luscious, love-infused apple pie? Who could say no to Grandma?  Christmas: Your uncle’s homemade eggnog? Hanukkah: Bubbies beloved Latkes. Who can stop at just one? Take some home? Sure Bubbie. Your cousin’s world-famous candied yams that she made especially for you? Can’t say no to that.  And all those Christmas cookies that get left in break room and nobody sees you eat one, does it really count?  YES. Your fat cells don’t care.

Is it OK to surrender to unhealthy eating until January 2?  You can just go back to healthy eating in January, right? That’s how I used to think. I believed I could make up for weeks of splurging by “being good” again. I thought that overeating sweets and starches only affected my weight, and that as long as I got back on track after the holidays and lost the 10 or 15 pounds I’d gained, then no harm done.

But I’ve come to understand that this is not true.

The Price of Indulgence (or the Science of Splurging)

Eating too much sugar can permanently damage your metabolism. The more often you indulge, the more insulin-resistant you can become. You can’t get your carbohydrate tolerance back; once it’s gone, it’s gone. The more sweets you eat over the course of your lifetime, the more likely it is that you’ll gradually lose your ability to process even healthier whole food sources of carbohydrates, like fruits and vegetables. While some people are more susceptible to this process than others, we are all at risk.

More than 50% of Americans are already insulin-resistant, pre-diabetic, or diabetic. This means there’s more than a 50/50 chance that you, and most of the people you love, are in the same sugary boat. Your sugar threshold crossed. Insulin resistance is a huge risk factor for way more than just a bulging waist. It’s associated with diabetes, heart disease, cancer and dementia.

This is why it’s so important not to give in to seasonal temptations. Even if you don’t want or need to eat a low-carbohydrate diet, avoiding sugars and refined carbohydrates is the single most important thing any of us can do to preserve future health, regardless of how old we are, how much we weigh, how much we exercise, or whether or not we already have any medical problems. And while it’s true that you can halt or even reverse many carbohydrate-induced diseases such as obesity, type 2 diabetes, and cholesterol abnormalities by eating a low-carbohydrate diet, conditions like cancer or dementia are much tougher to reverse.

Practice Makes…Less Imperfect

I can’t promise you that I won’t succumb to temptation a few times this joyous season—we shall see! My goal will be to do my best, which is all any of us can do. It’s not about perfection, it’s about practicing making healthy choices as often as possible, and not judging yourself or anyone else about which sweet or savory treat may somehow find its way into one’s body. [Hey, how did that cookie get in there?]

Dieting During the Holidays

Here’s a suggestion: Decide on a strategy now, before the holidays hit. Make some rules and stick to them.  Sticking strictly with your normal healthy eating pattern is desirable but maybe you want a more flexible strategy.

1.  Agree to splurge only on dinner (and only dinner) on Thanksgiving and Christmas Day. Or only at the Hanukkah or New Year’s Eve party. Don’t say yes to every little treat that passes by every day of the holiday season. Keep your splurges contained.
2. Decide what a splurge is. Example: Avoid the starchy, sugary parts of a meal and save just one splurge for desert. You may want to set your heart on very specific indulgences that will really be worth it, as opposed to having a free-for-all. If you establish very clear goals you’re more likely to stick to them than if you try to wing it. Then, once you’ve decided on your goal, tell other people about it so they can support you. People will understand if you explain that how you are eating is to support your health goals.
3. Make your own foods that look like the bad stuff but are made with low carb alternative ingredients. There are loads of low-carb holiday recipes on the web. Example: https://www.dietdoctor.com/low-carb/recipes/happy-holidays Snacks, main courses, sides and even desserts can be made low-carb style. Your guests might be none-the-wiser.
4. Didn’t bring your own food? You can still usually can select some low sugar/starch options while passing over the bad stuff at most parties.
5. Avoid workplace junk. Go to work full. Eat eggs and cheese before going to work. That will keep hunger down which will make it possible to avoid dipping your hand into the giant box of chocolates somebody dropped off in the break room. Nuts are usually a good holiday snacking choice. Most are low in carbs. Keep your own supply of low starch snacks such as individually wrapped cheese sticks or almonds at the ready just in case.

Holiday Specific problem foods:

1. Halloween- Candy, Candy-apples, Chocolate. Just everything.
2. Thanksgiving-Stuffing, cranberry sauce, pumpkin pie and all other types of pies, pumpkin spice anything. (On the other hand-Turkey is A OKAY)
3. Christmas-cookies, candies, Coke (yes even if Santa is selling it) Candied yams and candied hams.
4. Hanukkah: Latkes, chocolate gelt.
5. Alcohol: 1 or 2 glasses of dry wine is fine. Small amounts of distilled spirits are also OK .However:  Beer is loaded with carbs and lots of mixers are sugary. Beware.

Eric J. Sodicoff, MD

Related articles:

 How to Celebrate without falling off the wagon

The skinny on Holiday Weight Gain

N Engl J Med. 2000 Mar 23;342(12):861-7.

PMA Medical Specialists Collaborates with Patients and Families to Enhance their Commitment to Primary Care

PFAC Council Members

PMA Medical Specialists launched a new initiative this summer as part of their CPC+ Partnership – Patient and Family Advisory Council (PFAC). PMA was selected early 2018 to participate in Comprehensive Primary Care Plus (CPC+). The PFAC, comprised of patients and family members of patients, in addition to PMA Physicians, Providers, and staff meet on a quarterly basis. Members of the council are encouraged to provide honest feedback and observations regarding the PMA Patient Experience and how to improve it. Discussions have included how to improve patient safety, appointment availability, patient portal usage, service excellence, communications, patient education and much more. 

 “The council is far more than a focus group; focus groups are ‘a once and done’ way of gathering data. Our PFAC is expected to evolve as we move forward and delve into additional topics,” said Timothy Rimmer, CEO of PMA Medical Specialists. “I’ve attended a few of the meetings and have found them very informative. We feel an open dialogue offers council members the opportunity to help us improve our patient-centered care model. Our pledge to patients and the communities we serve is to continually improve every patient encounter, every step of the way. Our mantra is Patients Matter Always.”

The foundation of the CPC+ partnership is to improve access to quality healthcare at lower costs. In addition to the PFAC, PMA has cultivated a topnotch Chronic Care Management Team for Medicare patients with multiple chronic conditions, who might benefit from a more “hands on” approach. The practice has also recently expanded their patient hours and now offer appointments on Saturdays from 8am until Noon at their Phoenixville MOB II location. PMA also reminds patients to “Call Us First.” This effort invites current patients to call PMA first for non-life-threatening emergencies.  Calls will be answered 24 hours a day, 7 days a week and a staff member will help the caller determine if an ER or Urgent Care visit is necessary.  In doing so, they hope to help patients avoid the higher medical expenses, longer wait times, and exposure to more serious illnesses that an ER visit can entail.

About PMA Medical Specialists

PMA Medical Specialists is a multi-specialty Physicians Network that understands the importance of providing patients with Continuous Coordinated Healthcare. We are committed to meeting the healthcare needs of our patients by offering a wide-range of medical specialties and patient services to help you stay healthy.

PMA Medical Specialists has office locations throughout Montgomery and Chester counties. Visit pmadoctor.com for a complete list of locations and specialties.

Hidden Sugars and the Impact on Your Health

Hi, I am Eric Sodicoff, M.D. Primary Care Internal Medicine doctor and Obesity Medicine Specialist at PMA Medical Specialists. I frequently query my patients about how much sugar they consume throughout the day. Happily, I have discovered many people are making some efforts to cut out sweets. But let’s back up a second and discuss why too much sugar is a problem. 

First, what is sugar anyway? 

Common table sugar, scientifically known as sucrose is a disaccharide. That means it is composed of two basic sugar units. In the case of sucrose, those are glucose and fructose. Blood sugar is only glucose; it’s what diabetics are checking when they prick their fingers. It isn’t very sweet. White rice for example is almost pure glucose, and most people don’t consider it sweet at all. Glucose circulates throughout the body 24/7. Cells throughout the body can use it as fuel. Red cells use it as their only source of energy and it powers most people’s brains most of the time. Glucose molecules get strung together and stored in the liver to be used between meals. The liver also can convert protein into glucose in a pinch.

Fructose, on the other hand, is the sweet stuff. It makes sugary soda, candy, cakes and ice cream so irresistible. Fructose comes from plants such as sugar cane, sugar beets, fruit, and since the 1970s, artificially and cheaply synthesized from corn. This is known as High-Fructose Corn Syrup. Fructose, either naturally sourced or synthetic, presents something of a challenge to our bodies. It must be converted to glucose in order to be used and there is only one location in the body that does that: the liver. The liver’s capacity to manage fructose can be overwhelmed by eating or drinking too much of it. When fructose is over consumed it becomes liver fat and then belly fat too. Fatty liver is presently an epidemic and is overtaking viral hepatitis and alcoholism as the main cause of liver failure. Fructose is very fattening.

How much sugar is too much? 

There are different answers. The American Heart Association sets the limit at 24 grams per day for women and 36 for men. The World Health organization say 50 grams. How much is that you might be asking? Just one serving of strawberry yogurt has 26 grams of sugar. Yup, just one so called healthy yogurt for breakfast is enough to break through a woman’s daily sugar budget. It’s not even considered a dessert!  Processed foods that aren’t even particularly sweet contain huge amounts of added sugars too. The processed food manufacturers have discovered people really, really love sugar and buy more when it is added to products. It pops up in unlikely places even foods that usually aren’t sweet at all.

-Check the labels and you’ll find it in jarred spaghetti sauce, whole wheat bread, ketchup and peanut butter.

- A breakfast bar made with "real fruit" and "whole grains" lists 15 grams
of sugar.

 - A single cup of bran cereal with raisins, in a box advertising "no high-fructose corn syrup," contains 20 grams of sugar per serving.

 - A cranberry/pomegranate juice product, also advertising "no high-fructose corn syrup" and "100% Vitamin C," contains 30 grams of added sugar per 8 oz. serving. Some of the sugar is naturally occurring, but some of it has been added.

 74% of all supermarket groceries have added sugar!  How does one avoid the epidemic of sugary foods? This is how I do it. Just eat real food. Avoid ultra-processed refined foods. They have long complicated ingredient lists that invariably contain something bad. There are at least 61 different synonyms that food manufacturers use that all mean sugar (see sugar names list below). As a general rule, avoid the center aisles of the supermarket.

Eat Real Foods

Choose real food that comes from a field, forest or sea. It doesn’t pass through a factory first. Real food is single ingredient. Real food doesn’t require reading an ingredient list because it’s whole and unprocessed. That being said, some fruit such as bananas and grapes do have high natural sugar content. If you are diabetic or are struggling with weight it is best to curb consumption of those as well. Above all else cut out all sugary drinks: Soda, all juice, sport drinks, sweetened teas and sweetened coffees. Many of my patients have made a big dent in their weight problems by only nixing sugary drinks.

61 Names for Sugar

●       Agave nectar--- Sorry Dr. Oz.

●       Barbados sugar

●       Barley malt

●       Barley malt syrup

●       Beet sugar

●       Brown sugar

●       Buttered syrup

●       Cane juice

●       Cane juice crystals

●       Cane sugar

●       Caramel

●       Carob syrup

●       Castor sugar

●       Coconut palm sugar

●       Coconut sugar

●       Confectioner's sugar

●       Corn sweetener

●       Corn syrup

●       Corn syrup solids

●       Date sugar

●       Dehydrated cane juice

●       Demerara sugar

●       Dextrin

●       Dextrose

●       Evaporated cane juice

●       Free-flowing brown sugars

●       Fructose

●       Fruit juice

●       Fruit juice concentrate

●       Glucose

●       Glucose solids

●       Golden sugar

●       Golden syrup

●       Grape sugar

●       HFCS (High-Fructose Corn Syrup)

●       Honey--Yup, honey is basically bee sugar, not better than any other type.

●       Icing sugar

●       Invert sugar

●       Malt syrup

●       Maltodextrin

●       Maltol

●       Maltose

●       Mannose

●       Maple syrup

●       Molasses

●       Muscovado

●       Palm sugar

●       Panocha

●       Powdered sugar

●       Raw sugar

●       Refiner's syrup

●       Rice syrup

●       Saccharose

●       Sorghum Syrup

●       Sucrose

●       Sugar (granulated)

●       Sweet Sorghum

●       Syrup

●       Treacle

●       Turbinado sugar

●       Yellow sugar

    Eric J. Sodicoff, MD

Source: http://sugarscience.ucsf.edu/

Further reading about sugar:

Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease

by Robert H. Lustig

Link: http://a.co/grXC1Ia

Fun documentary:

That Sugar Film

Amazon Video ~ Damon Gameau

Link: http://a.co/17SASzR

A Visit to the ER May NOT Be the Best Option

Chest pain, loss of consciousness, heat stroke, severe bleeding and other serious and life-threatening illnesses always need the fastest and most advanced medical care available.  Without question, that means immediate treatment in an Emergency Room or Urgent Care facility.  But, what about cuts, scrapes, minor bleeding, a fever, ear infection, vomiting or nosebleed?  When these and other    non-extreme emergencies happen, we suggest that you “Call Us First.”

Why Call Us First?

As one of the area’s most-respected primary and specialty physician groups, we offer a number of services to help patients get the care they need, without an unnecessary visit to the ER or Urgent Care.  In doing so, we hope to help patients avoid high ER visit cost, longer wait times, and exposure to more serious illnesses that an ER visit can entail.

The Call Us First effort invites current patients to Call Us First for non-life-threatening emergencies.  Calls will be answered 24 hours a day, 7 days a week and a staff member will help the caller determine if an ER or Urgent Care visit is necessary.  If not, we can schedule a same-day appointment at the nearest PMA office.  The Call Us First program is just one of the ways we fulfill our commitment to exceptional patient care.  To learn more about PMA Medical Specialists and the Call Us First program, visit pmadoctor.com.

Back to School and Sports Physicals Help to Keep our Children Healthy

Annual Physical Exams

Annual physical exams are vitally important for children of all ages, whether it's an annual back-to-school physical or sports exam. A lot can change in a child's health over the course of one year, and an annual physical exam allows a provider to monitor the health and development of your child. 

Annual physicals also ensure that your child is up-to-date with their vaccines which help to protect against various diseases. Completing the various recommended immunization series protects not only your child, but the community as well. 

Sports Physicals

Sports physicals help to prevent many injuries and identify current conditions that might make it unsafe to participate in the planned sports activity.  

Both back-to-school and sports physicals begin with reviewing the family’s health history, followed by the patient’s personal health and immunization history. 

What's included in a Physical?

The actual physical examination typically includes: 

• Examining the Ear, Nose and Throat
• Vision testing
• Height and Weight measurements
• Listening to heart and lungs
• Pulse and Blood Pressure checks
• Checking for abnormalities by examining parts of the body
• Observing range of motion, joint flexibility, spinal alignment and posture
• Testing motor skills, reflexes, coordination and strength
• Hernia check

Be sure to schedule an annual back-to-school physical or sports exam today, so that your child is ready when back-to-school rolls around!