Shape Up & Drop 10™
Step 2 — Drinking and Dieting, Do They Mix?
The daily habits of people have a great deal more to do with what makes them sick and when they die than all the influences of medicine. — L. Breslow, M.D.
Seven habits associated with health and longevity include: regular exercise, adequate sleep, a good breakfast, regular meals, weight control, abstinence from smoking and drugs, and moderate use of alcohol.
According to Breslow, men could add 11 years of life and women 7 years by following six of the seven habits.1
In this step we discuss all things liquid. We will explain, in detail, each of the following from a weight management standpoint:
- Why you should drink 8 glasses of water (containing ZERO calories) each day.
- Why you should limit or eliminate alcohol.
- Why you should limit or eliminate sugar-containing soft drinks or sodas.
- Why you should choose low fat or nonfat (skim) milk or milk based drinks.
- Why you should choose vegetable juices (tomato juice or V8, for example) or broth.
If you are in a rush and want to skip the details about what you can drink and why, the safest thing for you to drink is water. What we mean by "water" is plain water, mineral water, seltzer water, sparkling water or any other water you may have in your locality that contains ZERO calories. Be sure to check the label on any water you purchase because you may be surprised to discover sugar (sucrose or fructose or corn sweetener) or sodium or caffeine, or all three, in some of your favorite waters.
In Step 2, after a discussion of the importance of hydration, we will be telling you about the latest research on the dangers of "drinking" calories — that is drinking fluids that increase your calorie intake. At the end is an alphabetical summary to help you find the "bottom line" on alcohol, soda, diet drinks, coffee, tea, sports drinks, milk, cream, milk shakes, fruit juices, vegetable juices and water. We will be sharing some secrets with you about "Floo-ids" — that is fluids that are seen and handled by the body like "foods" and have satiating value that may help you reduce your food intake at a subsequent meal.
Before we begin...
We noted the February, 2003 issue of Consumer Reports has a nice article on canned soups, "Seven Soup Standouts" (see pages 29-32). In Step 1 we told you about the special value of soups — broth based soups that are not too rich — as a weight management tool. Keeping in mind that we want you to limit your soup selection to no more than 200 calories, check out that article if you want guidance on the taste and calorie content of a variety of soups that may be appealing to you. The article has a table of overall ratings that shows how much higher in fat and calories a creamy soup like New England Clam Chowder is when compared to a vegetable minestrone, for example. We found many soups that met our nutritional standards and we even found two brands of chowder that were ranked "good" that delivered only 155 calories and 6 grams of fat. Thank you Consumer Reports !
What You Need to Know About Hydration and Good Health
It is important to keep your body well hydrated. Under most circumstances, this can be accomplished by drinking 6 to 8 (8 ounce) glasses of water each day. Many people feel that there is something magical about drinking water — that it somehow promotes weight loss, flushes fat out of your body, or whatever. We have been unable to locate any scientific evidence to support this idea. What you need to know is that successful dieting is dehydrating, especially in the first few weeks. But whether you are dieting or not, you need to actively maintain good hydration by drinking the recommended amount of water each day. Running your body in a dehydrated state is like running your car engine without engine oil.
Drinking your way to weight gain
It is a big mistake to underestimate the danger to weight management of drinking sugared sodas, wine, beer, fruit juices, sugared teas and coffee drinks. The research suggests that, with very few exceptions, your body does not "see" the calories in the liquids you drink the same way that it "sees" the calories in the foods you eat. The calories you drink tend to be added ON TOP OF the calories you eat. They sort of "sneak" into your body without being registered. The result at the end of the day is a higher calorie consumption than you need, and those extra calories get stored as fat. In effect, liquid calories promote overeating. In the case of alcoholic drinks, the extra calories seem to accumulate in the abdominal area — leading to the classic "beer belly". So drinking your calories will definitely make weight management more difficult. That is why, in general, it is safest to stick to water.
PLEASE NOTE: We are not telling you to stop drinking milk. It is true that milk contains calories. But milk is a "floo-id" which means it is treated by your body like a food. It is both nutritious and satiating. You need three servings of milk or dairy products each day. We will discuss milk in detail below.
When you exercise, you lose water through perspiration as your body perspires to cool itself. So be sure to drink water before and after you exercise. If you are involved in an endurance event, you will need to drink water during the exercise event as well. The use of water combined with salt and sugar (such as Gatorade) is usually only necessary in endurance events. We have encountered athletes who have trouble drinking enough plain water to stay well hydrated. Since dehydration impairs performance, you should work with a qualified professional to work out the best solution for you.
When you exercise in high temperatures, your water losses will increase, so you will have to increase your intake of water to compensate. You may also have to increase your salt intake, although for most people, this is usually not necessary.
Many people believe in the "wisdom of the body" — that is the belief that your body "knows" what it needs and will seek to eat or drink what it needs. The science behind this belief is weak to nonexistent and when it comes to water — it seems the body gets less and less wise as it gets older. Thirst mechanisms grow increasingly unreliable as you age. So pay attention to your water intake and do not trust your thirst mechanism to keep you well hydrated. After age 40, dehydration often occurs well before thirst is felt. So don't wait until you are thirsty to have a drink of water.
Milk, Weight Management and Health
Milk is important because milk is a "floo-id" which means that it is treated like a food (rather than a fluid) when you drink it and it is satiating. For this reason, milk has a special role to play in your weight management efforts. Milk also promotes bone health and it is important for lowering blood pressure.
We live in a country where people do not drink enough milk. Yet, because of advances in medicine and pharmacology, we are living longer and longer. That is why more and more people above the age of 60 have poor bone health and nearly all women (and many men) have osteoporosis in their last decade of life. To make matters worse, when people diet, they tend to drink even less milk.
A large, very important study was published in the New England Journal of Medicine showing how important it is to consume 3 servings of milk and other dairy products each day in addition to a diet rich in grains, fruits and vegetables.2 Such a diet was successful in lowering blood pressure in both normal people and in people who are prone to high blood pressure (which is most of us as we grow older). This type of dairy-rich diet also lowers blood pressure in people taking medication for high blood pressure, a finding that took researchers by surprise.
If you believe you should not drink milk because of lactose intolerance, the science shows that you can safely and comfortably handle one serving of milk, provided that you consume it with a meal. If you eat three meals a day and include a serving of milk or dairy with each, you can get in your three servings of dairy in without difficulty. The other secret to handling dairy without discomfort is regular consumption. Your GI tract eventually adapts to any food — even beans — provided you consume it on a regular basis. The secret is to start out gradually with only one serving a day for a week or two. Then increase it to two servings a day for a week or two. Finally up it to three servings a day, and keep it at three a day on a consistent basis.
Milks that are lactose-reduced or lactose-free are now readily available3. We think these treated dairy products are another good solution for lactose intolerant people. If you still have questions about this issue, please email us.
Drop the Fat, Not the Dairy:
For weight management, the big issue is not to eliminate dairy, but to eliminate the fat in dairy — because fat is where the calories are. Cream is really over the top, even light cream is 29 calories per tablespoon. Here are the facts:
- Light cream is 464 calories per cup
- Medium cream is 592 calories per cup
- Heavy cream is a whopping 832 calories per cup (!)
Compared to those numbers, when you consider that skim milk is a mere 85 calories per cup, you realize how extravagant cream really is. Besides the calories, cream is loaded with saturated fat. All that fat is not good for your heart. Who needs cream in the 21st century when almost none of us are physically active on a regular basis? We say, skip it — unless it is a really special occasion, like a birthday or a holiday, in which case, even we may indulge a little.
Some people say they object to the color of their coffee when they use non-fat milk. Fat free half and half is now available and also ultra skim milk that has the creamy taste of higher fat milk, but zero fat! The color of your coffee will look more appetizing and the calorie (and saturated fat) savings over time will be huge.
If you decide you want to wean yourself from cream, start out by using whole milk instead of cream. After a few weeks of adjustment to whole milk, switch to 2% milk. After adjusting to that for a few weeks, switch to 1% milk and repeat the process until you can finally enjoy non-fat milk. (Note: "Non-fat", "fat free" and "skim" milk are all the same.)
Here is a little tip: If you want to fool yourself into enjoying non-fat milk in your coffee, buy yourself a milk frother. (We purchased our Bodum milk frother at Starbucks) Every morning we heat our non-fat milk in the microwave and then froth it up so that it looks and tastes just like a professional latte or cappucino. Try it! It works with soy milk too.
We will be watching for research that compares the satiating value of soy milk to regular milk. But at this point, we don't know if soy milk is a "floo-id" or not. For a variety of religious and ethical reasons, some people have replaced cow's milk with soy milk. We don't want to pry into your personal beliefs, but from a nutritional standpoint, the intakes of both calcium and riboflavin are determined by the amount of milk and other dairy foods consumed. Milk, cheese and yogurt also make a significant contribution to the intake of vitamins A, D, and B12. Nutritionally, plain soy milk does not contain a significant amount of calcium (see chart below based on data from the U.S. Department of Agriculture). That is why commercial soy milks that are commonly available in your supermarket are fortified with calcium. The calcium in milk is readily available (bioavailable) for use by your body and the calcium in soy milk in your supermarket may not have the same bioavailability. If you do choose to swap soy milk for cow's milk, take care to eat a diet that includes lots of dark leafy greens and other good sources of calcium as well as the other valuable nutrients found in milk.
We used the US Department of Agriculture's Nutrient Data Base (USDA NDB) to give the score on unfortified soy milk versus skim milk:
|Food||Calories||Calcium (mg)||USDA NDB#|
|Skim Milk||86 calories per cup||301||01085|
|Soy Milk (plain)||81 calories per cup||10||16120|
We use soy milk also, but the particular brand of soy milk available in our supermarket is significantly higher in calories than skim milk. So from a weight management standpoint, read the nutrition label to identify lower fat soy milk and be sure to make allowances for any added calories if you are swapping soy milk for skim milk.
Drinking and Driving is like Drinking and Dieting
Alcohol is metabolized by your body like fat and it contains almost as many calories as fat:
|Fat||9 Calories per gram|
|Alcohol||7 Calories per gram|
|Protein||4 Calories per gram|
|Carboydrate||4 Calories per gram|
From the standpoint of weight management, the thing to remember about alcohol is that your body doesn't really "see" alcohol calories. If you consume a cocktail or a glass of wine or a beer before eating dinner, you won't eat fewer calories at dinner to compensate. Research has shown that people consume just as many calories at dinner as they would on an evening without alcohol. The alcohol calories in your pre-dinner cocktail or glass of wine or beer get "added on" to your day's calories. There is no compensation — no reduction in food intake to balance the calories you drank before dinner. In short, alcohol promotes overeating.
In many people, alcohol promotes overeating by eroding your commitment to portion control and to more careful food choices. Alcohol has an effect on your brain that affects your reaction time, your depth perception and your judgment, which is why it is unsafe to drink and drive. It is also the reason why it is unsafe to drink and diet.
Having said that, we recognize that some people regard alcohol almost as a food. They see it as an essential part of a meal and they also point out that studies show beneficial health effects of alcohol. Alcohol lowers the risk of heart attacks, and so on. But the studies available at this time provide no good reason to start drinking if you currently abstain, and alcohol does promote overeating. Bottom line: if you feel that drinking alcohol is very important to your lifestyle, here is our guidance for you:
- If you must drink, the limit is one drink per day (for women); two drinks per day (for men).4
- Be guided by the table below for a reasonable portion size of "one drink" [Source: the US Department of Agriculture Nutrient Database (USDA NDB)]
- Drink alcohol only as part of a meal.
- Go for the lowest calorie drink possible (see table below).
|Alcoholic Beverage||Definition of "one drink"||Calories in "one drink"||Carbs Grams||USDA NDB#|
|Beer||12 fl. oz.||146||13||14003|
|Beer — "lite"||12 fl. oz.||99||5||14006|
|Wine — white||3.5 fl. oz.||70||0.8||14106|
|Wine — red||3.5 fl. oz.||74||1.7||14096|
|Pina Colada||4.5 fl. oz.||252||32||14017|
|Gin, Rum, Vodka or Whiskey (100 Proof)||1 jigger (1.5 fl. oz.)||124||0||14533|
|Whiskey Sour||2 fl. oz. mix + 1.5 fl. oz. whiskey||158||14||14029|
|Daiquiri||2 fl. oz.||117||4||14010|
Please note that most wine glasses these days hold A LOT more than 3.5 fluid ounces. It is not unusual for a glass of wine to hold twice that amount. Don't fool yourself... most glasses of wine count as two drinks.
Each of us is very different when it comes to alcohol. If you find that having one drink always leads to two or more, or it always leads to overeating, you may be a person who needs to give up drinking forever for the sake of weight management. Our job is to tell you the facts. You make the choices.
Do Sugary Sodas (Pop, Soft Drinks) Cause Obesity?
Depending on where you live, the names will vary from "soda" to "pop" to "soft drink". By whatever name, in the past three decades sugary soda has become a big component of the typical American diet and like alcohol, soda can undermine your efforts to manage your weight. We are not going to say much about soda that is flattering. Your body does not "see" the calories in soda and that means when you drink soda, you will eat just as much food as ever. There are no health claims that can be made for soda. Soda contains loads of calories and nothing else of nutritional value. Bottom line: soda contains "empty" calories that undermine weight management.5
Certain varieties of soda contain a great deal of caffeine — which is dehydrating — so check the nutrition label. Many parents believe that the sugar in soda is causing hyperactivity in their children. The research on hyperactivity does not support this belief, but if a child is drinking several cans of caffeinated soda each day, it may well be the caffeine that is the root of the problem. There are new sodas containing more and more caffeine that are being introduced on the market and these products are often targeted to children. This is not a good idea, especially considering the rising rates of obesity among children and teenagers.
If you can remember back that far, the standard size of a soda in the 1950's was 6.5 fluid ounces. Today the soda has gotten larger and larger, and it is not unusual for a soda to come in a 20 ounce or 32 ounce size, or even a 64 ounce size. Based on the growing number of studies we have seen on soda, food intake and obesity, our recommendation is to skip soda entirely. If you want to enjoy a soda as a thirst quencher after exercise or on a hot summer day, consider returning to the original portion size — drink only 6 ounces (half a can). It will cost you about 75 calories — which is equivalent to 5 teaspoons of sugar. Alternatively, drink diet soda instead of regular soda. So if you must drink soda, by all means switch to the diet versions that are artificially sweetened.
Summary (in Alphabetical Order):
Alcohol promotes overeating and should be limited carefully or eliminated entirely. See detailed discussion above.
If you are in the mood for a snack and you want to keep the calories low and the satisfaction high, try a cup of low fat broth. You recall that in Step 1 we talked about the special value of soup, cereal and other watery foods that make you feel full on fewer calories. The same thing is true of broth. The studies show that broth is a "floo-id" and is useful as a way to take the edge off your appetite and it makes you feel full.6 It may serve as a useful substitute for a drink before dinner because it may help you feel less hungry and eat less at dinner. Also see the discussion of milk above and vegetable juice below.
Without added sugar or cream, coffee contains no calories. But it does contain caffeine — even decaffeinated coffee is not entirely caffeine free. So make sure you drink a cup of water for each cup of coffee you drink.
Club soda contains no calories, but it does contain sodium (which is why club soda can taste a bit salty). If you like the fizz in club soda, try seltzer. It offers the fizz without the sodium.
Cream contains tons of calories and saturated fat (see above). On a regular basis, we recommend you skip it. We take our cream in the form of ice cream and only on special occasions (such as a birthday or a holiday).
If you must have soda, then diet soda is the right choice. Diet soda is a misnomer because it does not cause weight loss. But it does not promote overeating and you avoid all the calories from sugar. Remember to check the nutrition label to see if your favorite brand contains caffeine — which is dehydrating. If it does, then drink a cup of water for each cup of diet soda you drink.
Some flavored waters contain zero calories, but most of them do contain some sugar and calories. So you have to check the nutrition label. If you discover calories, you may want to switch to a brand offering the same flavor without the calories.
These drinks are just one more way to confuse consumers. Consumers think that fruit drinks offer something of nutritional value, when studying the nutrition label will tell you they don't offer much more than calories. Think of fruit drinks as you do soda (see above) and ask yourself if you wouldn't be better off without the calories.
Go back to Step 1 and refresh your memory about fruit. In general, we recommend eating a piece of fruit rather than drinking juice because it makes you feel more satisfied in addition to offering fiber and other valuable nutrients. The studies show us that the calories in fruit juice are not "seen" by the body so they do not contribute to a sense of fullness. If you choose fruit juice, make sure it is 100% juice from real fruit. A reasonable size for a serving of juice is 6 ounces. For kids, obesity is a growing problem. We think replacing fruit juice with real fruit is the right way to go. If your kids are thirsty, encourage them to drink water by not bringing home soda or fruit drinks, and limit juice to 6 ounces. Your actions speak to kids louder than words, so make sure you are choosing water yourself.
The bottled teas usually contain a great deal of sugar so read the nutrition label. There are a few iced teas on the market that contain very little or no sugar at all so keep looking. If you make your own, just remember that if you add two teaspoons of sugar to a glass of iced tea, that is 30 Calories. Ounce for ounce, home made iced tea is usually a lower calorie way to enjoy iced tea.
Same comments as for iced tea except that many people include milk or cream when they make iced coffee. We encourage avoiding cream and using milk (preferably skim milk) instead because of the lower saturated fat and calorie content. Limit sugar, if you use it at all, to no more than 2 teaspoons (30 calories).
Most commercial lemonade is quite high in calories because of all the sugar so you need to check the nutrition label. If you want to make your own using the juice of one lemon and 4 teaspoons of sugar (note that more sugar is used in lemonade than is used in iced tea because of the need to offset the tartness of the lemon). With 4 teaspoons of sugar, your lemonade is a 60 calorie drink. Compare that to most commercially available lemonade and you will see a big calorie savings with the homemade drink and a fresher, zingier taste.
Milk (milk shakes and other milk based drinks)
We discuss milk at length above. Milk is a "floo-id" because it is handled by your body more as a food than as a drink. This is probably because we evolved to consume milk as our only food during the first years of life. There are East African tribes that consume several quarts of milk each day as their major (and sometimes their only) food source. In fact, milk and milk based drinks are satiating. According to Dr. Barbara Rolls7, "They help people feel full and eat less at the next meal..." For good health, we encourage three servings of milk or dairy a day, but keep the fat as low as possible. If you choose milk shakes and other milk based drinks, check the nutrition label or make your own so you can control the calories and the fat.
A good choice if you want some fizz with your water. Check the label to make sure it contains zero calories. If you are controlling sodium, check the label for sodium content as well.
A good choice if you enjoy the fizz. Some seltzers contain flavors but still contain zero calories. So check the label to make sure.
Soda (Pop or Other Sugary Soft Drinks)
Should be eliminated or replaced by diet sodas. Sugary soft drinks are associated with obesity and have nothing to offer from a weight management standpoint.
An increasingly popular choice. In its unfortified form, it is not equivalent to milk and when flavored, it is sometimes higher in calories than skim milk. New products are appearing that are fortified with certain vitamins and minerals (like calcium) to achieve closer equivalency to milk. We don't yet know if soy milk is a "floo-id" or not. We will keep you posted.
Same as for seltzer. A good choice if you enjoy the fizz. Some sparkling waters contain flavors but still contain zero calories. So check the label to make sure.
A lot of money is spent on encouraging you to drink sports drinks. For the average American, this is unnecessary. But for the serious athlete, such drinks have a role. Consult a qualified professional if you are a serious athlete seeking guidance on sports drinks.
Tea (including Herbal Tea)
Plain tea contains no calories. The calories are in the sugar and milk you add. Most black tea and green tea does contain caffeine and many teas contain just as much caffeine as coffee. Caffeine-containing teas are dehydrating. Many herbal teas lack caffeine, but certain herbal teas contain other compounds that behave as a diuretic and are therefore dehydrating. In general, since it is hard to know what you are getting in the herbal teas, you should drink a cup of water for each cup of tea whether it is herbal or not.
Don't be fooled. Tonic water contains calories, so choose seltzer instead. If you don't mind the taste, choose a diet tonic water that uses a sugar replacer to eliminate the calories.
A big surprise in Step 2 is the value of vegetable juice as a "floo-id". Tomato juice, V8 and other vegetable juices deserve more research. The body sees vegetable juice as a food that is satiating. In studies conducted by Dr. Barbara Rolls at Penn State, it appeared that the calories in vegetable juice were "seen" by the body and reduced food intake at a subsequent meal.8 That does not mean we recommend drinking huge quantities of vegetable juice. But it does mean that vegetable juice is a good choice before dinner or for use as a snack.
Water with ZERO calories is the safest choice to make. Drink 6-8 glasses a day. If you are concerned about the water quality in your area, consider purchasing bottled waters. To save money, we use a filtered water system to filter our tap water. It is cheaper than buying bottled water even though we have to replace the filter once a month.
Drinking Tips for Dieters:
- Drink 8 glasses of water (with ZERO calories in it) each day because you need to stay hydrated.
- Limit or eliminate alcohol because it promotes overeating.
- Limit or eliminate sugar-containing soda for the same reason.
- Choose fat free or low fat milk or milk-based drinks because they are "floo-ids" — that means they are handled like foods by your body and they are satiating
- Choose vegetable juices (tomato juice or V8, for example) or broth for the same reason.
If you have one at home, take a good look at the standard 12 ounce can of soda. If you don't, then go to the supermarket to study a soda you often drink. Check the calories on the nutrition label. The typical soda is 150 calories in a 12 ounce can. There are 15 calories in a teaspoon of sugar. That means that a 12 ounce can of soda contains the equivalent of 10 teaspoons of sugar. Get out your measuring spoons. Carefully measure out 10 teaspoons of sugar into a bowl. Take a good look at the mound of sugar that you have measured out. If you have children, make sure they see how much sugar is in a 12 ounce can of soda. If you have a larger bottle or can of soda, figure out how many teaspoons of sugar are in it based on the rule that one teaspoon of sugar is 15 calories.
Check out the bottled teas, sodas, and fruit drinks. Note the serving size that is described on the nutrition label. How many calories are in one serving? Now check to see how many servings are in the bottle. Does the bottle contain more than one serving? Take a notebook with you to note the brands that are highest in calories based on the amount you are likely to drink. This is a great exercise for kids. They will learn that many bottled drinks contain far more than one serving and the bottle contains many more calories than they think. When they purchase a drink in a restaurant or a movie theater, they usually have no idea how many servings they are drinking at one time. Use this supermarket exercise to estimate how many calories are in the drinks in restaurants and movie theaters.
If you drink alcohol, take the glass you usually use to drink with and measure its volume using a household measuring cup. How does the volume of your glass compare to the definition of a "reasonable" serving size in the table above. Are you consuming more or less calories than is reasonable? If you are consuming more calories, ask yourself if you can afford the extra calories. Also ask yourself how alcohol may be undermining your weight management efforts in other ways. Write your answer down in a journal or other safe place so you can refer to it from time to time.
1Wildland Firefighter, Health and Safety Report, No. 1, Spring 2000, Missoula Technology and Development Center, page 9.
2Dietary Approaches to Stop Hypertension, or DASH, was published by Appel LJ et al. New England Journal of Medicine 1997; 336(16): 1117-1124.
3Milks that have been treated with lactase enzyme to be lactose-reduced or lactose-free are readily available and they are indeed useful to lactose intolerant people. The downside of using these products routinely is revealed when you are away from home, and can't find lactose-free milk in hotels or restaurants. If you choose regular milk instead, your GI tract may have difficulty handling the lactose if it has not been exposed to it in a while. At a coffee shop it is almost impossible to find lactose-free milk. At Starbucks, we have never been able to find it. If you request a soy latte or soy cappuccino at Starbucks, you will be given a coffee drink with vanilla soy milk that is higher in calories than plain soy milk. Tasty, but you have to watch the calories if a visit to Starbuck is part of your daily routine!
4The difference in this limit for men and women is based on body size, but it is important to note that men and women process alcohol differently and the same amount of alcohol will produce higher blood alcohol levels in women than in men.
5See page 94-95 in Volumetrics, by Barbara Rolls, PhD and R. A. Barnett published by Harper Collins, 2000, ISBN 0-06-019483-9 Dr. Rolls is a Professor at Penn State and a noted authority on weight management, food intake and satiety. This book is filled with valuable information on how to achieve fullness on fewer calories. A highly satisfying read !
7See Volumetrics, page 97.
8See Volumetrics, page 97.
9The big challenge for almost all people is to drink enough water... but you can go overboard. The condition known as "water intoxication" is extremely rare and we found only one case in which it was fatal [see Garigan and Ristedt in Military Medicine 1999; 164: 234-238. It has been estimated that it would require, among other things, chugging down 3 quarts of water at one time to cause water intoxication. But given some of the crazy things that happen on college campuses, we thought we should mention it.