By Dr. Ed Hendricks on December 20, 2009
History
Human Chorionic Gonadotropin (HCG) is a hormone normally secreted by the trophoblastic cells of the placenta during pregnancy. It was first described as a treatment for obesity in conjunction with a very low calorie diet by Dr. A. Simeons in 1954 [1]. The Simeons method consisted of a rigid diet of about 500 calories per day combined with 125 units of HCG injected six days per week for 8 weeks. For each of the two meals permitted daily, patients were instructed to select one item from each of four food groups, protein, vegetable, bread, and fruit. For protein servings patients were told to select from the following list: 3.5 ounces of meat, 3.75 ounces of fish, 4 ounces of Hoop cheese, or 6 egg whites. The latter two choices were to be selected occasionally [2]. The protein intake on the Simeons diet therefore ranged from about 45 to 50 grams per day. The Simeons method was very popular in the 1970s and advocates claimed that the method had numerous advantages including rapid weight loss with minimal hunger, no weakness, and dramatic loss of fat in the stomach, hips, thighs, and upper arms.
The method was wildly popular in the early 1970s; there were HCG weight loss clinics in every city in the U.S. After a series of clinical trials disputing the effectiveness of the Simeons method it fell from favor, but popular demand for HCG in the treatment of obesity has recently resurfaced in the United States. At the time the Simeons method was popular only HCG for injection was available. Sublingual HCG tablets were developed relatively recently. Perhaps this is one reason the method has resurfaced.
Discussion
Although there were a few early studies in agreement with Simeons recommendations [2-3], a number of subsequent studies produced evidence that the HCG in the Simeons method was ineffectual and that the weight loss was entirely due to the diet [4-7]. A meta-analysis review in 1995 of prior studies concluded that there is no scientific evidence that HCG is effective in the treatment of obesity [8]. The meta-analysis found insufficient evidence supporting the claims that HCG is effective in altering fat-distribution, hunger reduction or in inducing a feeling of well-being. The authors stated “…the use of HCG should be regarded as an inappropriate therapy for weight reduction…” In the authors’opinion, “Pharmacists and physicians should be alert on the use of HCG for Simeons therapy. The results of this meta-analysis supports a firm standpoint against this improper indication. Restraints on physicians practicing this therapy can be based on our findings.” PubMed and Google Scholar searches (on December 2, 2009) revealed no favorable reports on the Simeons method since the 1966 report by Lebon [3].
The diet employed in the Simeons method provides a daily protein intake below that recommended by the RDA for most patients. Although the caloric intake of the Simeons diet is similar to that of an early (prior to about 1985) VLCD, but the protein intake is much lower than that prescribed for VLCDs in current use. Indeed, in the last few years several well-known researchers have produced very convincing evidence that most adults benefit from protein intakes well above the minimum RDA and intakes more than double the minimum RDA improve weight loss during caloric restriction diets [9-10]. A further criticism of the Simeons diet is that the amounts of protein per serving recommended do not reach 30 grams, the threshold dose required for initiation of muscle protein synthesis [11-14]. In view of these recent advances in nutrition science, the Simeons diet is severely deficient in protein.
Recent studies indicate that HCG injections in men, especially men with testosterone deficiency, can produce a slight gain in muscle mass, thought to be due to rises in testosterone levels [15]. The doses in the latter study were 250 units twice weekly. However, no studies have been reported of muscle mass changes in patients before and after weight loss with the Simeons method. Therefore one cannot assume that weight loss with the Simeons method will result in a net gain in muscle mass. Rather, loss of muscle mass can be expected. There are no reports in the medical literature regarding the effectiveness of sublingual HCG.
Summary:
Numerous clinical trials have shown HCG to be ineffectual in producing weight loss. HCG injections can induce a slight increase in muscle mass in androgen-deficient males. The daily protein intake in the Simeons diet is set at about 40% of what we advise with our diets. The last favorable report of the Simeons method was in 1966, 43 years ago, at a time when scientific knowledge of protein requirements was rudimentary. All of the medical reports since 1966 reject both the use of HCG and the protein-deficient Simenons diet. Patients who are treated with the Simeons method lose weight because the diet is a protein-deficient starvation diet in which the patient loses muscle mass. Neither HCG infections nor sublingual HCG accelerates weight loss. The Simeons method is harmful since it promotes loss of muscle mass.
Recommendations:
References:
1. Simeons A. The action of chorionic gonadotropin in the obese. Lancet 1954; 2: 946-947.
2. Asher WL, Harper HW. Effect of human chorionic gonadotrophin on weight loss, hunger, and feeling of well-being. Am J Clin Nutr 1973; 26: 211-218.
3. Lebon P. Treatment of overweight patients with gonadotropin: follow-up study. J Am Geriat Soc 1966; 14: 116-125.
4. Greenway FL, Bray GA. Human chorionic gonadotropin (HCG) in the treatment of obesity: a critical assessment of the Simeons method. West J Med 1977; 127: 461-463. PMCID: 1237915.
5. Stein M, Julis R, Peck C, Hinshaw W, Sawicki J, Deller J, Jr. Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study. Am J Clin Nutr 1976; 29: 940-948.
6. Young RL, Fuchs RJ, Woltjen MJ. Chorionic Gonadotropin in Weight Control: A Double-Blind Crossover Study. JAMA 1976; 236: 2495-2497.
7. Bosch B, Venter I, Stewart RI, Bertram SR. Human chorionic gonadotrophin and weight loss. A double-blind, placebo-controlled trial. S Afr Med J 1990; 77: 185-189.
8. Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. British journal of clinical pharmacology 1995; 40: 237-243. PMCID: 1365103.
9. Layman D. Dietary guidelines should reflect new understandings about adult protein needs. Nutrition & metabolism 2009; 6: 12.
10. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. J Am Coll Nutr 2004; 23: 631S-636S.
11. Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care 2009; 12: 86-90.
12. Paddon-Jones D, Short KR, Campbell WW, Volpi E, Wolfe RR. Role of dietary protein in the sarcopenia of aging. Am J Clin Nutr 2008; 87: 1562S-1566.
13. Paddon-Jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-Plantenga M. Protein, weight management, and satiety. Am J Clin Nutr 2008; 87: 1558S-1561.
14. Symons TB, Sheffield-Moore M, Wolfe RR, Paddon-Jones D. A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J Am Diet Assoc 2009; 109: 1582-1586.
15. Liu PY, Wishart SM, Handelsman DJ. A Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Recombinant Human Chorionic Gonadotropin on Muscle Strength and Physical Function and Activity in Older Men with Partial Age-Related Androgen Deficiency. J Clin Endocrinol Metab 2002; 87: 3125-3135.
By Paula Hendricks - Nutritionist on December 4, 2009
PRODUCTS & SPECIALS
FROM THE DOCTOR You Want to Take my Blood Pressure Again?
Why so many? Beginning in November, the medical assistants have been taking 2-3 blood pressure readings per patient visit. Many of you are asking, “Why did we start doing this?” Well, there are several reasons. First, many patients are nervous when they first arrive at the office, and many have been rushing to make their appointment on time, or are anxious about their weigh-in. In these situations, the first blood pressure reading may be higher than normal. A second reading a few minutes later is often lower. Second, averaging two (or more) blood pressure readings is now the recommended standard of practice for measuring blood pressure in a physician’s office. Our own research has confirmed that a single blood pressure reading is sometimes inaccurate and misleading.
What do the blood pressure numbers mean and what should they be? The higher (systolic) number represents the pressure while the heart contracts to pump blood throughout the body. The lower number (diastolic) represents the pressure when the heart relaxes between beats. Review the chart below to determine your blood pressure category.
| BLOOD PRESSURE CATEGORY |
SYSTOLIC mmHg |
DIASTOLIC mmHg |
| Normal |
<120 |
<80 |
| Prehypertension |
120-139 |
80-89 |
| Hypertension, Stage 1 |
140-159 |
90-99 |
| Hypertension, Stage 2 |
≥160 |
≥100 |
Currently, the experts recommend lifestyle changes and/or weight loss as the only treatment for prehypertension. Patients with Stage 1 or Stage 2 hypertension are typically advised to make lifestyle changes, lose weight, and take anti-hypertensive medications. Untreated elevations in blood pressure are associated with higher mortality. It is now well-known that reducing blood pressure to normal levels extends life-span. This is the major reason a more accurate blood pressure measurement is important for your health.
What change should you expect with weight loss? If your blood pressure is above normal, you should begin to see a decrease in blood pressure with just a few pounds of weight loss. This is true even if you are already on medications to control hypertension. If your blood pressure is normal, less than 120/80 to begin with, you may see only a slight decrease in blood pressure. Of course if your blood pressure goes down with weight loss, it will go right back up if you regain the weight lost. An exercise program will also help to lower your blood pressure. Blood pressures for everyone tend to rise gradually as the years go by so if weight loss lowers your blood pressure, it may go back up with the passage of time even though you maintain your weight loss. If your blood pressure remains above normal, even with weight loss and exercise, we may recommend starting a blood pressure medication.
What about blood pressure medications? If you are on blood pressure medications, you may be able to reduce the dose or discontinue your medications entirely with weight loss. If you begin to experience lightheadedness or dizziness, it may mean your medication dosage should be adjusted. As with any medical concern, always discuss with your practitioner.
FROM THE NUTRITIONIST
By Paula Hendricks - Nutritionist on December 4, 2009
Appetizers for the Holidays – Skip the chips and dip, cookies, and other snacking pitfalls. Make it simple this year with great-tasting and beautiful presentations for your holiday appetizers that are both healthy and full of flavor. Your guests will love them andso will the host when you bring your beautiful dish to your next holiday event. Picturesof these recipes are available in the office.
| Caprese Salad – Such a simple, elegant appetizer! Slice tomatoes, the best tasting you can find in the winter, and cut again in half. In the deli section, buy either fresh cow or buffalo mozzarella. Rinse the cheese and slice into small bite-sized rounds. Layer an appetizer plate alternating with tomatoes and cheese. Cut some fresh basil into small strips and sprinkle over tomatoes. Drizzle some high quality olive oil over the dish, grind some fresh cracked pepper on top, and a sprinkle some kosher or sea salt to finish. | Cucumber Canapes – Top cucumbers with some fresh crabmeat (or imitation crab) that is tossed with a mixture of mayonnaise and Greek-style plain yogurt. Add some salt, pepper and fresh dill weed. Add a little mayonnaise-yogurt swirl to the finished product and sprinkle some capers around plate. Place crab atop fresh endive leaves instead of cucumbers for a different look and taste. Very light and refreshing appetizer. | ||
| Tomato Slices and Chopped Cheese – Slice firm tomatoes into thin rounds; half each round and place on a plate. Cut some hard gouda cheese into tiny bite-size pieces, or other firm cheese of your choice. In separate bowl, mix olive oil, lemon juice and some Italian herb seasoning. Drizzle over the tomato and cheese plate. Top with some fresh chives.
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Shrimp atop Endive – Another elegant presentation. Put bay shrimp in bowl and toss with olive oil, dill weed, minced garlic, lemon juice and a little Dijon mustard. Cut off the end of the endive and discard any brownish leaves. Arrange endive leaves on a platter and add about 1 tablespoon of the shrimp to each leaf. | ||
| Prosciutto and Melon Tasters – Slice honeydew or other melon into small bite-size slivers and put on a plate. Cut prosciutto into manageable bite-size pieces and layer on top of melon. Sprinkle with some fresh shredded parmesan. Delicious.
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Deli Plate – Buy a salami stick (look for a reduced-fat brand), peel off outer layer and cut into thin slices. Further cut the slices into little wedges and place the pieces on a plate. Top with fresh parmesan wedges and add some mini deli pickles to the presentation.
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Happy holidays and happy entertaining!
By Paula Hendricks - Nutritionist on December 3, 2009
Think 30!
Protein intake is your Key to effective weight loss. A daily optimum protein intake of at least 30 grams for breakfast, lunch and dinner allows you to maintain good health while you lose weight. In addition to helping with weight loss, protein helps build and repair body tissues including muscle, major organs and collagen, keeps hair, skin, bones and nails healthy, regulates body processes including digestion and metabolism, and forms hormones, enzymes, and immune system antibodies to help your body function properly. Need any more reasons to think 30?
Use the following list of approximate 30 gram protein choices to meet your Daily Target Protein Intake. Always follow the plan outlined specifically for you.
*Protein grams in food products vary. Always read the nutritional labels and weigh your servings to ensure you are getting the right amount. We recommend purchasing a food scale.
How does the Hendricks family prepare 30 Gram Protein Meals?
Here is a list of some of our weekly favorites:
* Shrimp Cocktail: Chop one celery stick into small bite-sized pieces. Place in small bowl and add 6 oz bay shrimp. Mix together. For the sauce, mix together 1 tsp. mayonnaise, 1 tsp. Greek-style yogurt, 1 tsp. horseradish, 2 T. salsa, and 1 T. low sugar ketchup, and a dash of garlic salt. Add sauce to shrimp and serve chilled. Looks elegant served on butter leaf lettuce cups.
* Vegetable Scramble: In mixing bowl, whip 2 whole eggs, one egg white, a dash of garlic salt and pepper. Add to the eggs 1/2 cup chopped vegetables (zucchini, red peppers, onion) and 1/6 of an avocado. In a non-stick pan over medium heat, melt a tiny bit of butter and pour the egg mixture in. Scramble until eggs are almost set. Add 2 ounces shredded reduced fat cheddar cheese; mix. Place on plate and top with 2 T. salsa if desired.
*Lemony Chicken Cesar Salad: For the marinade, mix the juice of 1/2 of a lemon, 1 T. olive oil, 1 minced garlic, and a dash of salt and pepper. Pour marinade over one 4.5 oz boneless skinless chicken breast and let sit for 10-15 minutes. Grill in a non-stick pan until cooked, about 4 minutes on each side. Cut chicken into strips and lay over a bed of Romaine lettuce. Drizzle 1-2 T. of creamy dressing (see Salad Dressing hand-out) and sprinkle salad with some freshly grated Parmesan cheese. Add a couple anchovies if you like.
* Filet Mignon over Greens: Sprinkle salt and pepper on one petite filet (4.5 ounces) and rub in a little olive oil. In a hot skillet, grill filet on one side for 2 minutes, flip and grill for 2 minutes, and repeat until meat is cooked to your liking. Saute 2 cups of raw spinach in 1 T. olive oil and seasoning of your choice. Place spinach on plate and top with the cooked filet. *
* Omelet with Canadian Bacon: In a mixing bowl, whip two whole eggs, one egg white, 2 ounces chopped Canadian bacon, salt and pepper. In a non-stick pan over medium heat, milt a tiny bit of butter and pour the egg mixture in pan. Cook until almost set. Add 1 ounce shredded reduced fat cheddar cheese. Fold egg in half to form an omelet. Slide omelet onto a plate.
* Tzatziki (Greek Yogurt and Cucumber): In a single serving bowl, put 1 1/3 cup Greek-style thick plain yogurt (ck label to ensure 30 grams). Add 1/2 cup finely chopped English cucumber, 1 small minced garlic clove, 1 tsp. fresh lemon juice, and salt. Mix. Drizzle 1 T. olive oil and sprinkle some dried mint leaves on top of yogurt.
* Deli Meat Roll-Ups: Take approximately 6 oz of your favorite lean deli meat (ck label to ensure 30 grams) and put on a plate. For the sauce, add 1 tsp. mayonnaise, 1 tsp. Greek-style plain yogurt, and 2 tsp. Dijon mustard together and mix together. Spread the sauce on each piece of deli meat and roll up. Add a little crunch and roll some chopped lettuce in each roll.
* Cheesy Lasagna: Mix together 1/2 cup low-fat cottage cheese, 1/2 cup low sugar marinara or spaghetti sauce, and 1/2 cup canned mushrooms (drained). Heat in microwave-safe bowl on medium for about 2 minutes. Add 1/2 cup shredded reduced fat hard cheese (Kraft brand). Mix and serve warm.
By Paula Hendricks - Nutritionist on November 5, 2009
PRODUCTS & SPECIALS
FROM THE DOCTOR
We’re pleased to report that Dr. Hendricks will soon be participating in a cutting edge clinical research project in partnership with staff at the Pennington Biomedical Research Center at Louisiana State University (LSU). The project will investigate circadian blood pressure rhythm (rhythmic biological cycles recurring at 24 hour intervals) in patients newly started on phentermine. Prior research has confirmed that blood pressure varies during the day and night with lowest pressures during early hours of sleep. Normally blood pressure increases in anticipation of arousal, then falls after awakening only to rise again at intervals during the day.
The LSU researchers have shown that some overweight individuals have abnormalities in this rhythm. We will be looking for evidence to support the hypotheses: circadian blood pressure rhythm abnormalities in overweight patients improve with weight loss.
In a prior, still ongoing study, we found no evidence that phentermine directly induces blood pressure changes and that blood pressure falls with weight loss. In the new study, we’ll also be looking for evidence to show that phentermine therapy doesn’t change an individual’s normal circadian blood pressure rhythm and that abnormal rhythms in obese patients improve when weight loss is enhanced with phentermine therapy.
Participating patients will wear an Ambulatory Blood Pressure Monitor which will record blood pressure every 30 minutes during the day and every hour during sleep for one week before starting their weight loss program, for one week early in the program after phentermine is started, and finally for one week after 12 weeks of weight loss. We anticipate a study report will eventually be published in a peer-reviewed medical journal.
This research is another in a series of investigations, dubbed by Dr. Hendricks as “The Phentermine Rehab Project,” intended to publish evidence of the safety of long-term therapy, and to refute long-standing phentermine safety concerns of the FDA and uninformed physicians, hopefully thereby countering governmental restrictions on the uses of weight loss medications.
According to Dr. Hendricks “Phentermine is the safest and most cost effective anti-obesity drug on the market today. It’s a shame its’ use has been marginalized because physicians fear governmental criticism and reprisals for prescribing it.”
FROM THE NUTRITIONIST
– Ingredients: one packet Tex Mex Chili Protein Packet, 10 protein grams of diced Canadian bacon, and 2 T. reduced fat shredded cheddar cheese. Instructions: follow Tex Mex packet directions. Add the bacon and cheese. Mix. Add some chopped fresh cilantro and a dollop of light sour cream.
- Ingredients: one packet Tex Mex Chili Protein Packet & ½ cup cottage cheese. Prepare Tex Mex Chili per directions on the box. Add cottage cheese. Mix and heat. Sprinkle with a little shredded cheese on top.
CALCIUM INTAKE AND BONE HEALTH: by Paula Hendricks, BS, Nutritionist-C
We have updated our calcium recommendations. Please review the following for the latest up-to-date information. I know, it’s a little technical – that is why the new recommendations are delineated first followed by a detailed explanation.
New Recommendations:
As we age, we all want to keep our bones strong, prevent osteoporosis, and reduce the risk of fractures. And if you want healthy bones, all you need is calcium, right? That is what most people believe but it’s not true – calcium supplements alone will help slow down or stop bone loss, which is great, but if your goal is to make them stronger and healthier by increasing bone mineral density, you need more than calcium alone. Eating as we recommend, doing weight bearing exercises, and supplementing with calcium, magnesium, and vitamin D all work synergistically to improve bone health.
Types of Calcium: Most calcium supplements are either calcium carbonate or calcium citrate. Since intestinal absorption of calcium carbonate is dependent on gastric acidity, we recommend taking calcium carbonate after a meal when gastric acidity is high. Calcium citrate isn’t as dependent on stomach acids for absorption and those patients taking medications to reduce acid in the stomach, such as Prilosec or Zantac, should consider taking a calcium citrate supplement. Post-gastric bypass patients should also take calcium citrate.
Calcium Intake: The Recommended Daily Allowance (RDA) for adults is 1000 mg, and after the age of 30 (the end of the bone-growth age), 1200 mg. daily. The maintenance diet we recommend can provide up to 300 mg of daily calcium, without any dairy products. Adding one ounce of low-fat hard cheese can provide 400 mg of calcium, and consuming a variety of protein supplement products sold in our office can add up to 600-800 mg daily.
By adding a 600 mg. calcium supplement in the evening, you should be close to the Recommended Daily Allowance of calcium for the day. If you have any bone health issues, consult with your physician for personal dosage levels appropriate for you.
Calculating Calcium Amounts in Food: To determine how much calcium you are consuming in various products, look for the percentage of calcium on the nutrition label. For calcium, the percentage is based on the recommended % Daily Value intake of 1000 mg. For example, the Cappuccino protein powder nutrition label states that the contents contain 10% of the % Daily Value of calcium, about 100 mg. One Vanilla Ready-To-Drink protein supplement contains 35% of your % Daily Value of calcium, about 350 mg. If you just consumed these two protein supplements every day, you would be adding approximately 450 mg. of calcium to your daily diet.
Vitamin D and Magnesium Intake: Calcium is more readily absorbed in the body if there is an adequate vitamin D blood level. Based on information from the Vitamin D Council, we now recommend that adults take 5,000 I.U. of vitamin D in addition to what is in your multivitamin and what is in your calcium. Children should be on 1,000 I.U. of vitamin D per 25 pounds body weight. These daily doses for adults will improve bone health and provide a multitude of other benefits. In addition to vitamin D, magnesium supplementation of 250 mg daily also aids in the absorption of calcium and incidentally, the combination of calcium and magnesium is a good evening tranquilizer. Who doesn’t need a good night’s rest?
By Paula Hendricks - Nutritionist on November 5, 2009
Chicken Fiesta Soup – Makes 4 Two-Cup Servings
Another Hendricks family favorite! We love the spicy flavor of this low carb hearty soup when the weather turns cool. If you have a large family or want left-overs, I recommend doubling the recipe. For those of you on the VLCD who are keeping your daily carbohydrate count at 20 grams, the carbohydrate count in this soup is approximately 15grams of net carbs per serving.
Ingredients for soup:
Optional toppings:
Instructions:
1. In small non-stick frying pan over medium heat, add 1 tablespoon olive oil; heat. Add the chili powder and mix with oil thoroughly. Continue mixing until chili turns dark, about 2 minutes. Mix in one more tablespoon of olive oil and add the diced onions. Cook for about 2 minutes. Add minced garlic and the tomato sauce. Stir and cook for another minute. Add the diced tomatoes and green chilies. Mix together and turn off heat.
2. In a large soup pot over medium heat, add the diced chicken, hominy and chicken broth. Transfer the tomato mixture into the soup pot and mix contents together.
3. Cook over medium heat for about 15-20 minutes. Add the cumin and oregano. Reduce heat and simmer for another 15-30 minutes. The longer you simmer the soup, the tastier it gets. Add another can of chicken broth, or some water, if you think the soup is too thick.
4. When ready to serve, ladle a serving into a soup bowl and add any of the optional toppings listed above.
Nutritional Value: Each two-cup serving, without toppings, contains approximately 325 calories, 35 grams of protein, 9 grams of fat and 15 grams of net carbohydrates.
By Paula Hendricks - Nutritionist on October 3, 2009
PRODUCTS & SPECIALS
FROM THE PRACTITIONER - Cheryl Mitchell, Physician Assistant-C, MPAS
As you progress with your weight loss program, sooner or later a question arises; “What should I do with my larger size clothes?” There is only one good answer – you must get rid of them. It doesn’t matter where they go, just as long as you can’t get them back. Give them to your favorite charity, a consignment store, or even consign them to the garbage can. It only matters that you can’t ever get them back to wear.
Why is this so important? It is really very simple. Human nature likes to put off dealing with problems. If you start to lose focus on your diet – and we all do at some point – and gain a little weight, it is very easy to put off refocusing as long as you can comfortably fit into some clothes. You tell yourself, “I’ll worry about it tomorrow.” Unfortunately, as long as your clothes aren’t ‘strangling’ you, tomorrow never comes.
There comes a point when you must do something. If you have a larger size in your closet, the easiest thing to do is to put on the larger size “just for today” and deal with the weight gain issue ‘tomorrow.’ As I said earlier, tomorrow never comes. But, if you have gotten rid of the larger clothes, then your choices are different. You can continue to ignore the weight gain by buying a larger size (ouch!) or you can refocus on your diet today. Tight clothes are a constant reminder to stay focused.
In the eight years I’ve been working with Dr. Hendricks, tight clothes is a primary reason why clients return after a ‘disease holiday.’ Those clients that get rid of the larger sizes generally come back with a much smaller weight gain than those who keep their larger clothes ‘just in case.’ Do you really want to give yourself permission to gain again?
FROM THE NUTRITIONIST – Paula Hendricks, BS, Nutritionist-C
By Paula Hendricks - Nutritionist on October 3, 2009
Grilled Flank Steak over Greens – Makes 4 Servings
This is a Hendricks family favorite! Dr. Hendricks has been grilling flank steak outdoors for over 30 years. It can be grilled indoors or outdoors but we like to grill outdoors, rain or shine. It is a nice, lean, and inexpensive cut of beef and the left over makes a great steak salad for lunch the next day. Enjoy on all Key Diets.
Ingredients:
Instructions:
Trim off any excess visible fat from steak and place steak in a large baking dish. Rub 3 minced garlic cloves into meat on both sides. Pour half the soy sauce on one side; flip steak over and pour remaining soy sauce on other side. Let steak marinade for about 10-15 minutes. Turn on the grill to preheat.
While the grill is heating, prepare the greens. If you are using fresh Swiss chard, cut the red stalk off the bottom and part way up the leaf as the stem can be a bit bitter. Chop into strips and rinse thoroughly; drain. Place in a heated wok style pan with about a tablespoon of olive oil at medium heat. Add a little salt and cover with a lid. With tongs, toss in pan every couple minutes until chard is cooked, about 5 minutes. Mix in one minced garlic clove. Turn heat off and let sit with the cover on while you grill the steak.
When grill is hot, throw the steak on. Cook on one side for one minute, flip and cook on other side for one minute. Flip again and cook for 4-5 minutes, and again for another 4-5 minutes. A 1-1/2 pound steak takes about 10-12 minutes to cook for a medium-rare center and about 12-14 minutes for a larger one. Cook longer if you like your meat well done.
Place the cooked steak on a slightly slanted cutting board next to the sink to let juices drain when cutting. Cut the entire steak across the short end (against the grain) into very thin strips, about 1/4 inch in thickness. The ends are always more cooked than in the center. When cutting, if the steak is not cooked to your liking, throw it back on the grill for a couple more minutes.
Divide the chard into four servings and place one serving of chard and a 4.5 ounce serving size (or more if needed) of steak on each dinner plate. A side salad of lettuce, cucumber, tomato and one serving of avocado makes this meal complete.
Nutritional Value: Each 4.5 ounce serving of meat contains approximately 30 grams of protein and the vegetable serving contains approximately 4 grams of net carbohydrates. Add the side salad and add 6 grams of carbohydrates and 5 grams of fat.
By Paula Hendricks - Nutritionist on October 3, 2009
Chided by your family doctor because you are losing weight on our program?
Every day, patients come into the office with a story about how their doctor, family member or friend ridiculed them on their weight loss efforts for various reasons. Is the doctor misinformed, family member worried about your health, or friend just behaving jealously? Below are three stories we commonly hear. You decide.
“The Dangerous Diet” You have started a weight loss and lifestyle change program which includes a combination of vitamins, minerals, protein supplements, and a prescription appetite suppressant. A few months later, you visit your primary care physician and on the annual medical sheet, you write down your new regime of daily supplements you are taking, including your appetite suppressant. In addition, you boldly note your 30+ pound weight loss, your now normal blood pressure readings, and your reduced LDL (bad) cholesterol levels and your increased HDL (good) cholesterol levels from the blood tests done with The Center for Weight Management. During your appointment, your doctor congratulates you on your weight loss and asks about the weight loss program. You proudly share your success with the doctor while he quietly sits and listens and reviews your lab results. After, he says, “Well, I am happy you have lost weight, and your lab results are good, and your diabetes and blood pressure are under control, but I am very concerned about the dangerous diet you are on. Just cutting back your calories as I have previously suggested would have probably produced the same results without putting yourself at risk, not to mention the expense. I recommend you stop.” Disappointed, confused, and scared, you leave the office, call The Center for Weight Management from your cell phone, and inform them that you will no longer be coming back because your doctor said the diet was dangerous to your health. Besides, you already lost over 30 pounds, and your health has improved… A few months later, you have regained your 30+ pound weight loss, are back on blood pressure and diabetic medication, and have made another appointment with The Center for Weight Management.
“Double Dipping” A call from your sister comes in that your mother had a stroke and was taken to a hospital by ambulance. Scared, you quickly get to the hospital and find your mom with various tubes and instruments surrounding her body. The doctor comes in, informs you your mother suffered a hemorrhagic stroke but is now stable and he is encouraged with her rapid improvement in spite of the severity of the stroke. A few days later, mom is transferred to a facility that will help her regain some of her neurological functions she lost and within a week or so, the doctor says she should be able to return back home. The doctor tells you that overall, she is remarkably and amazingly well for a woman her age. “She obviously has taken care of herself over the years and her health is excellent.” You tell him that she eats very well, watches her weight, takes supplements, and exercises often. During the hospital stay, your mom asks you to bring her the supplements she takes every day, her multi-vitamin, omega-3s, CLA, CoQ10, probiotics, etc. You bring them in and show the doctor her daily regime of supplements and ask for his approval for her to continue some of her supplements while in the hospital. He looks at the various bottles and says “She doesn’t need these things! A multi-vitamin is all anyone should take – everything else is just double dipping.” You are shocked! Didn’t the doctor just tell us that mom’s recovery is going so well because of the healthy lifestyle she leads? You give the news to mom and tell her that most doctors are not experts in nutrition and she can continue her regime when she goes home in a few days. But you wonder, is he right? Are we both wasting time and money taking supplements?
“Wrinkle Worry” You’ve decided to embark on a weight loss program because you don’t want to begin your next birthday overweight again and call The Center for Weight Management that your friend told you about. Three months later, you are doing great, losing weight, exercising and feeling wonderful. People are noticing. Your family is supportive and encouraging, your friends and co-workers are complementing you, and people are asking you about your program. You share. Some people think it sounds great and want to get started, too. Others are not so excited and tell you so. “Oh. I heard that losing weight through a medical program is bad for you – you will probably regain it once you stop.” “Aren’t you concerned about looking old?” “Now that you are older, isn’t it better to weigh more?” You ignore these comments and press on. Six months later and you are now 10 pounds away from your ideal body weight. You feel terrific, until an overweight friend you are having lunch with says to you, “I didn’t want to say anything, but…you are looking really old and your wrinkles are really showing. I think you’ve lost too much weight and you should stop that program you are on.” You are stunned! You look at her lunch of burger and fries, and down at your chicken salad, and then notice her face. She is the same age as you, looks older than you do, and is unhealthy and overweight. Nevertheless, you are hurt. You are getting older and wrinkles are inevitable but now you are looking in the mirror doubting yourself and your weight loss efforts. Is your friend right? Maybe you did look better when you were heavier and the wrinkles were not so noticeable. Maybe you are expecting too much. Maybe it is better if you are overweight as you age. Isn’t that better than looking old and wrinkled?
How many of you have encountered similar situations while you were trying to make positive changes in your life? You’d be amazed at how many stories we hear from patients who stopped the program because of negative comments, regained weight, came back and restarted with us. They restarted because they realized they did feel and look better before they stopped, and should not have listened to negative outside forces. They realized being overweight and unhealthy was not going to stop the age wrinkles from forming and in fact, many patients found that being overweight and unhealthy promoted premature aging, illness and disease – from personal experience. They realized being overweight certainly wouldn’t allow them to enjoy life as freely as when healthy and leaner, especially with hypertension or diabetes.
Remember the woman who listened to her doctor’s advice about stopping the dangerous diet? She regained her weight and went back on blood pressure and diabetic medications. Isn’t she living a dangerous lifestyle now?
And the story about the mother who had a stroke? She is fully recovered and living at home again, unassisted, and back to her normal routine. What if she didn’t take care of her body as well as she did all those years? She could very well be spending the rest of her days in an assisted living home. Or living with you.
And what about those wrinkles? Maybe your friend was jealous and unable to face her own weight loss demons. Wrinkles are inevitable – they are a fact of aging but being overweight and unhealthy shouldn’t be.
You chose to participate in our weight loss program, our medically sound, safe and supervised program for a good reason. You entrusted us…with your health, your goals, your life. Dr. Hendricks and the entire medical staff are dedicated to providing you with the highest quality medical care available today. It is their goal to help you succeed in living a long and healthy life as free as possible from disease and illness. And if you do get sick, chances are that being healthy and fit will minimize the illness and recovery will be speedy.
The diet we prescribe is rich with high quality protein and full of antioxidant rich foods to protect and promote strong muscles, bones, and a healthy immune system. We also recommend vitamins, minerals and other nutritional supplements to improve your chances at weight loss, reverse some of the damages being overweight may have caused to your body, and to promote long-term health. However, diet alone will not help you achieve optimum health and fitness. You also need to incorporate exercise into your daily regime – a goal to work towards. The younger you start, the better – this means your children should be eating, supplementing, and exercising, too.
Next time you hear negative comments about your weight loss efforts, discuss your concerns with us before you make a decision. We, the medical nutrition experts, are here to help you sort through the flood of misinformation you will receive, solicited or not, and provide sound medical advice that is right for you. In the meantime, congratulate yourself for the effort you are taking to make positive changes in your life. Take care of your body, and it will take care of you.
By Paula Hendricks - Nutritionist on September 10, 2009
PRODUCTS & SPECIALS
· For This Month Only! All Prepaid Office Visit Packages on Sale! Set a goal and keep on track this fall and take advantage of our prepaid office visit packages; 4, 12, or buddy visits. Whether you are a new, established or returning patient, you can purchase these already discounted packages and receive an additional 10% off. Decide, commit and succeed this fall and you will be better prepared for the holidays ahead. Call or stop by the office and get prices on the various packages. Don’t wait – this is only valid for the month of September. Tell a friend – what a savings for someone who wants to get started this month.
· Protein Special of the Month: Bulk Oatmeal and Hot Cocoa. Start the day right for you and your family – Bulk Oatmeal and Hot Cocoa tubs are on sale this month! While supplies last. Get kids off to a great start: mix one-two servings of Oatmeal protein with a half serving of regular whole oats; mix one-two servings of Hot Cocoa with ½ cut hot milk and ½ cup hot water. Each flavor has 15 grams of protein per serving. Special Price of $22 each. Regular price – $26.
· Supplement Special of the Month: – Multi-Vitamin/Mineral Total Formula 2 for Women and Total Formula 3 for Men #60. Boost your immune system and be ready to protect yourself from the upcoming flu season. The whole family should be taking a multi-vitamin, multi-mineral. Special Price $12.25 + tax. Regular price $14.50.
· Our 20th Anniversary Key Diet Book: Purchase our latest Key Diet Book today for yourself or for friends and family. The new version has up-to-date information on the best way to eat for long term health and wellness and new tips on exercise and motivation. $14.95 + tax.
FROM THE DOCTOR
After 20 years of practicing bariatric medicine, my clinical observation confirms that patients who set goals and keep regular appointments are more successful than those that don’t. Patients who commit, in spite of life’s obstacles, are more likely to keep regular appointments, follow their recommended diet and supplement regime, not skip breakfast, and maintain a regular exercise program.
Patients who skip appointments tend to get off track, or have a minor slip, and set themselves up for complete mental failure. I always tell my patients, “Don’t skip appointments just because you got off track. A minor slip is not failure. It is just one event. Move on and stay focused on your long-term goals.” Success with managing your weight requires both commitment and persistence. Sometimes other arenas of life loom so large that one is distracted, and the focus on weight disappears temporarily, and the weight goes up. This will happen to everyone from time to time. I do not think weight gain is failure.
Bottom line: Lose the perfectionist mentality. Weight management should not be set on an all or nothing, success or failure scale. When you lose sight of your goal temporarily, it just means you have to recommit. In fact, long-term success requires recommitment each and every day without fail.
My goal is to keep you active, fit and healthy for the long-term. Living a long, healthy life is also my personal goal and I have to work at it, too. Sometimes I get off track, have a minor slip, and have to recommit. I am not perfect, just like you, and need goals to keep me focused. I look forward to seeing you in the office soon to discuss your goals.
FROM THE NUTRITIONIST
· Recipe of the Month – Spinach Scramble. Growing up in the Bay Area, my family and I would frequent a restaurant called Original Joe’s. Whether it was for breakfast, lunch, or dinner, we often ordered one of our favorite dishes called “Joe’s Special,” which typically consisted of ground meat, spinach, onion and eggs. We hope you enjoy my version of the “Special.” Pick up a copy in the office today or go to website and download.
· Did You Know? – The Benefits of Probiotic Supplements and Probiotic Yogurt Intake. Read more about the benefits of probiotics – pick up the latest Fall Did You Know? hand-out in the office today or download it.
· Quick Meal Ideas – School is back in session, football season is here, and time is limited. Learn how to make some quick meals that will offer left-overs, or when the kids come home hungry from school, or for the gang watching football. Download the following recipes at our website under Blog:
- Taco Salad: make a double batch for dinner on Sunday and you have lunch or dinner for football Monday.
- Individual Pizzas: these are fun and easy to make. Let the kids create their own pizza.
- Deviled Eggs: these are a great breakfast, lunch or dinner snack.
For more quick meal ideas, look at our book of recipes while in the office.
Contact our non–surgical weight loss clinic, which serves Sacramento, Roseville, and surrounding areas, to schedule an appointment.
2310 Professional Dr., St. 200
Roseville, California 95661
Phone:916.773.1191
Fax: 916.773.0498
click for map & directions
2621 Capitol Ave.
Sacramento, California 95816
Phone: 916.551.1999
Fax: 916.551.1998
click for map & directions