I met with a patient, Clare, this week to go through her food diary for the week just gone. When we last met she told me how she was struggling to reduce her weight after an initial good start some two months ago. She exercised at the gym three times a week, and her daily pedometer readings told us she was taking about 7000 steps each day. Her food diary was at first glance good. A healthy fibre rich cereal breakfast, a modest portion of a pasta dish or salad most lunchtimes, and an estimated 600 calorie evening meal, with added vegetables, most evenings. On the face of it she was doing everything she needed to do. But if she wasn’t losing weight there could only be one conclusion. Either she was eating too much, or exercising too little.
Exercise is key to any successful weight loss programme. For those who use a pedometer to measure every step, we know that 10,000 steps a day is ideal. Clare wasn’t quite achieving that, but she was supplementing it with three one hour sessions at the gym. So that box was ticked. Her diet appeared to be healthy, and calorie controlled, with just a few snacks between meals. And here was our problem. Clare has a desk job. She sits behind a reception desk greeting visitors and taking phone calls. By her own account, to stave off boredom, she snacks through the morning and afternoon. “But it’s ok”, she claimed, “it’s healthy snacking!” Sure enough, a little more questioning revealed that Clare was indeed healthy snacking, on at least 5 portions of fruit. Three in the morning and two in the afternoon. Now, doctors have been encouraging people to eat more fruit and veg for years. At least 5 portions a day. Packed full of nutrients, phytochemicals and fibre, fruit has to be good for you, right? And we all know they have “natural” sugars in them so that’s alright too, isn’t it?
The problem Clare has is that each piece of fruit, be it full of natural sugar or not, packs with it its own calories. Still far healthier and lower in calories than snacking on most other possible snacks, it still comes with a cost. For example, an apple has 50 calories, an orange 60 calories, a pear 90 calories, and a banana 95 calories. Even a small bunch of grapes brings with it around 60 calories. So over the day it’s easy to see how Clare could be adding in a “hidden” 250 calories a day. Over a week that soon adds up and might in part explain why she wasn’t doing so well. If she’s hungry of course, it’s better to snack on something. Going hungry doesn’t really help. But there might be ways in which she could reduce her mid-morning and mid-afternoon hunger pangs. I suggested she try and limit her between meals fruit intake to two snacks daily. Ways to conquer her waves of hunger might be to drink more water, start writing an email or letter, get up from her desk and take a walk, go and talk with a colleague rather than pick up the phone. In short using whatever technique she can to distract herself from feeling hungry. It usually works, and can help reduce those unaccounted for fruity moments.