The LILI Letter — February 2024

It is leap year this year, in case you haven’t noticed. It is a correction to our calendar based on the earth’s orbit around the sun, which is not exactly 365 days, but 365.24. To make up the difference, we add an extra day every four years. Course correction, problem solved. Life is like that, messy. We observe Valentine’s Day, Ground Hog Day, Ash Wednesday, Heart Month, Black History Month and Presidents Day this month. Whew. Wishing you a month filled with love and minimal course corrections!

In good health,

Jennifer James

Success story

Not a “Success Story” this month, but rather a wake-up call. How many of you have had one of these? The unplanned “ah-hah moment”? We all have, if we pay attention to our lives and the lessons they provide. My latest epiphany? I am so healthy and so rarely sick, that getting sick twice in January got my attention. I can hear all those who know me well say, “I told you so”. I have been told. The verdict?  I do too much. I have always been a high-energy person and pride myself on a clean house, balanced budget, healthy meals in the fridge, exercise regularly, and have it all together, until I don’t. I looked back over the last week, especially the weekend and Monday, and I gasped. There was NO downtime, anywhere. Work was non-stop that day, and so was my time spent away from work. Sheesh. No wonder my body called two time-outs.

My next question was, why do I behave this way? I am still pondering this. Part of it is being a dietitian and needing (in my mind) to be a good example. What would happen if I didn’t get everything checked off the “To Do” list? If I didn’t eat a few meals cooked from scratch or miss a workout? Uh, nothing.

My question to you is….what is going on in your life that is forcing you to step back? Without you wanting to step back? Your spouse asks for a divorce? You gain 10 pounds? You can’t get a loan because of your credit score? Better to humble ourselves, see how we contribute to our own messes, and go about cleaning up our act. In more sophisticated terms, it’s time for a paradigm shift. Not easy. But it beats the alternative of going on our not-so-merry and destructive ways. Please give it some thought. I will be for a while.

Have you tried……ricotta cheese?

The plateau

If you have done really well with weight loss, and then it plateaus, do not be surprised. I hear from people who have done well losing weight, then become supremely frustrated with their lack of progress. Even when people take weight loss medications, the body’s response will lesson and the weight stabilizes. We are in a tug-of-war with our biology. This is all very disheartening, but what can we do? On the flip side, losing weight indefinitely is not good for survival!

Realize this will happen, and try not to get too upset about it. Of course, we have to look at ourselves realistically…are we doing all we can? Or have we backslid a bit, such as eating more and/or exercising a little less? Are we sleeping less? Taking a new medication that promotes weight gain? There are a variety of reasons why this can happen, obviously.

If we truly have just hit a plateau, there are several things we can do. Up the activity. Go down a bit on the calories, but not too much. Understand the body has adapted to the changes presented to it, so we need to change things again.  If we can, give ourselves 12-14 hours without eating between dinner and breakfast the next day. Track every bite of food we eat. Get enough sleep, slow down and relax, be happy!

At some point our weight will plateau and not budge. If we want to lose more weight from vanity, maybe it’s time to let that go. If we have all our bases covered with a healthy diet, challenging exercise, good sleep and stress management, in addition to healthy blood pressure, blood sugar, etc., maybe that is all we can do. And be ok with it.

Many of us will not be able to weigh what we weighed in high school. But, if we are healthy, we look and feel good, and our weight has plateaued at a higher weight than we want, maybe that’s ok. Our body feels safer at this weight and is resisting going down further. We may still continue to lose, but slowly. I have patients who lose 5-10 pounds a year, and they keep at it.

Lastly, try not to get discouraged. The frustration, anxiety and anger that we may feel will not help matters. Reassure ourselves, extend some self-compassion and try not to take it all so personally.

I am a new convert to something I have known about for years, but didn’t pay much attention to it. I always noticed the people who participated in this activity were always so enamored with it. What am I talking about? Eating pickles? No. Pickleball. Good friends of mine introduced me and another mutual friend to it with an informal beginner lesson. I was hooked. To the point of wanting to buy a set that day. Then fall became winter and that was that.

I have now signed up for an indoor group lesson. What is so wonderful about this game? It is similar to tennis, but not as taxing. It is a mixture of ping pong, badminton and tennis. You engage your entire body while playing. It is very social. You normally play with 1-3 other people on a court that is half the length of a tennis court. It works on your eye-hand coordination. It gets your heart rate up, and is considered “moderate activity”, unless you are an intense player, which can burn up to 700 calories an hour for a 160-pound person. Best of all, it is FUN. It appeals to the Gen Z crowd as much as the Baby Boomers. It’s America’s fastest-growing sport.

You play with a paddle and a hollow, plastic ball that is hit over a net. It can be played outside on a court or on an indoor court. You can set up a court on a side street as long as you have a net and some chalk to mark the lines.

A study conducted in rural Utah with middle-aged folks who played pickleball as an exercise intervention found it to “1) elicit functional and cognitive-related improvements, 2) and motivate mid-life and older adults to adhere to exercise sufficiently long enough to benefit their health”. Less pain was noted among the participants. Most participants overwhelmingly wanted to continue playing after the study was over.

Finding an activity that gets us to move around, that we actually enjoy, is a big win. If you are looking for something new to stay active, consider this sport. You will not be disappointed.

Wray, P. et al. Pickleball for inactive mid-life and older adults in rural Utah: A feasibility study. Int. J. Environ. Res. Public Health. 2021, 18(16), 8374; https://doi.org/10.3390/ijerph18168374

Why Is Pickleball So Popular? - The New York Times (nytimes.com)

Processed food

Ponderings

I was waiting for tires to be installed at Costco the other evening. For the record, I am a big fan of Costco. I was waiting in the food court for a while, and noticed what people were eating. What struck me was how inexpensive the food was…$1.50 for a hotdog and a 20-ounce beverage, with free refills! A slice of pizza was $1.99, an entire pizza for $9.99. If you took your family shopping, how could you pass this up? You could feed the entire family for $10 after buying groceries. The kids stop whining and the dinner problem is solved, for that night. I noticed multiple young families there while I was waiting, eating their pepperoni pizza. The place was very busy. The employee at the tire counter was even telling me how yummy the new cookies were that he had tried.

The feelings it left me with were awe and despair. We are collectively waging a losing battle against the ultra-processed food titans. I feel like a soap box evangelist urging people to eat a whole foods diet, cook at home, eat more produce, and limit sodas and treats. Maybe all of the people there don’t normally eat a lot of processed food, and this was a treat for them. Or not.

Eating a healthy diet in our food culture can be a monumental task, especially when we have to swim against the current of all this inexpensive, tasty processed food. But it can be done. I do this, my coworkers do this, and many others eat a healthy diet. But we are in the minority, because it takes intention, know-how, time and energy. And it can cost more money upfront. The true cost of eating the S.A.D., (standard American diet), is reflected in our rates of obesity, with all the accompanying health issues.

I can’t force anyone to do anything, but I will leave you with this. The small choices we make over time will eventually shift our bodies towards health or illness. The occasional slice of pizza or ice cream will not hurt us. Granted, some genetically-based illnesses can’t be avoided, but for the most part, we have the choice to live a long and healthy life, or a shorter one with much suffering. Our call.

Ricotta cheese recipes

The full fat ricotta works best for desserts. The lower-fat version works well for savory fare.

• 32 oz. container ricotta cheese
• 1 egg
• 3 Tbsp. cocoa powder
• ¼ cup sugar
• ¼ tsp. almond extract
• ½ tsp. vanilla extract

Blend all ingredients in a food processor until very smooth. Pour into a 9x9-inch baking dish. Bake at 350 degrees for ~25 minutes. If you overcook it, it will revert to curdling. Let cool. Top with berries, sprinkles, cocoa powder, whatever you like. Be forewarned, this is very rich, a little goes a long way. It is similar to regular pudding, but with more substance to it.

1/9 of recipe ~ 185 calories, 8.5 gm protein, 117 mg sodium, 11 gm fat, 14 gm carbs

Ricotta Toast with Avocado

• 1 slice whole wheat or other bread
• ¼ cup low-fat/skim ricotta cheese
• 4 avocado slices
• 1 Tbsp. chopped walnuts

Toast the bread, smear with the ricotta cheese. Add avocado slices to cover the ricotta cheese, sprinkle with chopped walnuts.

Calories ~ 290, 12 gm of protein, 220 mg sodium, 17 gm of fat, 27 gm carbs

February support groups

Mondays, 2-3 pm

Free to LILI (and now BB) graduates

Heart Center Conference Room

“We accept the love

we think we deserve”.

— Stephen Chbosky, The Perks of Being a Wallflower