THE NATION’S NEWSPAPER

Collegiate
Case
Study www.usatodaycollege.com

Author of ‘Mindless Eating’ wields a

new bully pulpit
By Nanci Hellmich
Foodology 101
Everyone — every single one of us — eats how much we eat largely because of
..................................................................................5
what is around us. We overeat not because of hunger but because of family and
friends, packages and plates, names and numbers, labels and lights, colors and
They aced Get Healthy 101
candles, shapes and smells, distractions and distances, cupboards and contain-
By Nanci Hellmich ers. We all think we are too smart to be tricked by packages, lighting or plates.
...............................................................................6-7 We might acknowledge that others could be tricked, but not us. That is what
makes mindless eating so dangerous. We are almost never aware when it is hap-
Which diet is best for you? pening to us. This topic, as illustrated in th book Mindless Eating, emphasizes
By Nanci Hellmich how small changes can make big differences in how much we weigh.
..............................................................................8-9

From South Beach with ‘Heart’

By Nanci Hellmich
..........................................................................10-11

Overweight teens bear extra burden

By Nanci Hellmich
..........................................................................12-13
Is your house making you fat?
By Mary Cadden
......................................................................................14

Critical inquiry
Discussion and future implications
................................................................................15-16
Case Study Expert:
Dr. Brian Wansink, Chief,
Center for Nutrition Policy and Promotion
By Katie King for USA TODAY
USA TODAY Snapshots® Life of fitness: Kemichelle Taylor, 33, of Mobile, Ala., has lost 227 pounds. She became a personal trainer in
December 2006. She is seen here working with client Robert Allen Tharpe Jr., 24, of Mobile on abdominal
Fad diets often fruitless
Results for those who followed a popular weight–loss crunches using a medicine ball.
program, such as Atkins, South Beach or The Zone, and

Dieters keep fat on the run

then stopped:

Returned to original weight 44 %

The secret is finding an activity they love

Kept Gained
weight more By Nanci Hellmich
off, than USA TODAY
with weight
ease lost
12% 27% If there's one lesson that successful dieters have learned, it's this: If you keep
Source: Impulse
Research for
America’s Milk
Kept all weight off,
with constant effort 17%
moving, your old fat can't catch up with you.
Processors

By Justin Dickerson and Robert W. Ahrens, USA TODAY

© Copyright 2007 USA TODAY, a division of Gannett Co., Inc. All rights reser ved.
AS SEEN IN USA TODAY’S LIFE SECTION, MAY 29, 2007
Kemichelle Taylor, 33, of Mobile, Ala.,
lifts weights and works out on an
elliptical trainer six days a week to
maintain her weight at 162 pounds,
down from 389. "I'm in the best shape of
my life," she says.
Kelly Rhoads, 48, of Bowie, Md., who
now weighs 160 but once hit almost 330
pounds, walks briskly with friends for an
hour several days a week. It's girlfriend
time, and walking is an activity "I can do
the rest of my life," she says.
Aidan Murphy, 41, of Annapolis, Md.,
bikes for nine or more hours every week
to try to keep his weight at 205 pounds,
down from 328. "I'm doing it because it
makes me feel better about myself," he
says.
Taylor, Rhoads and Murphy are among
the dozen weight-loss champions who
have been profiled during USA TODAY's
Weight-Loss Challenge this spring.
They and other participants lost weight
in a variety of ways, from following
eating plans of their own to joining
Weight Watchers. But one thing they all
have in common is that they are devoted
to exercise — and a lot of it.
Most allot chunks of time to endurance
activities such as walking, jogging and
biking, and they also strength-train.
Many worked out for an hour or more a
day to lose the weight and have
continued that pace to keep the pounds
off.
The bottom line: "You have to maintain
a high level of physical activity to keep
the weight off. It's a lot of hard work,"
says Suzanne Phelan, a researcher with
the National Weight Control Registry at
Brown University in Providence. "We see
this over and over again: If people's
exercise starts unraveling, they start
regaining weight."
Want proof?
Supporting evidence mounts:
Reprinted with permission. All rights reser ved.
o
Family phot
Attitude adjuster: Aidan Murphy, 41, of Annapolis, Md., bikes for nine or more hours every week to try to
keep his weight at 205 pounds, down from a high of 328. “I feel grumpy if I don’t exercise,” he says.
u Members of the weight-control
registry, about 5,000 people who lost an
average of 66 pounds and kept off at least
30 pounds for more than six years, walk
an average of an hour a day (11,000
steps) or burn the equivalent calories by
doing other activities such as cycling,
aerobics, strength training and running.
u A Brown University study of more
than 300 people who had shed at least
10% of their starting weight found that
those who were most likely to keep it off
did an hour of physical activity a day.
u Scientists at the University of
Pittsburgh discovered that overweight
people who lost and kept off 25 to 30
pounds walked briskly for 50 minutes to
an hour a day, five days a week.
If people adopt exercise early in their
weight-loss program and increase it
steadily, they eventually will be doing
enough to maintain the loss, says John
Jakicic, director of the Physical Activity
and Weight Management Research
Center at the University of Pittsburgh.
By Tim Dillon, USA TODAY
Plus, people who are physically active
during weight loss — compared with
those who diet only — will lose more fat
and retain more of their lean muscle,
says Russell Pate, professor of exercise
science at the University of South
Carolina.
Doing what you love
Experts have said for years that the
best exercise is one that you will actually
do. "The secret to the challenge of
participants' exercise success is that
they've found something they like," says
Edith Howard Hogan, a registered
dietitian in Washington, D.C., who helped
select the people featured in this year's
Weight-Loss Challenge. "They don't think
of it as a chore. It's a joy."
But it wasn't easy at first.
Kelly Rhoads says that when she first
started exercising, "I did it because I had
to." She weighed almost 330 pounds at
the time. "I had to start moving. The first
thing I did was walk around a city block
for 15 minutes. I got out of breath. My
hips hurt."
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AS SEEN IN USA TODAY’S LIFE SECTION, MAY 29, 2007
Family photo
Before: Kelly Rhoads, of Bowie, Md., once weighed
nearly 330 pounds.
Rhoads gradually started walking
faster and farther. Right now, a good hike
for her is about 4 miles and takes her
just about an hour, she says.
She walks briskly several days a week
and does strength-training and toning
exercises by following DVDs, in addition
to watching her food intake and getting
enough rest. She does all this to
maintain her 170-pound weight loss.
"Exercise is important, and I feel better
when I do it," she says.
Kemichelle Taylor says that early in her
weight loss she focused more on
strength training but quickly realized
she was gaining muscle mass and not
losing much weight. So she worked up
to doing about 30 to 40 minutes a day of
walking or biking and 20 minutes of
weight training. She also got serious
about improving her diet.
Over time, she increased her activity
level and now works out two hours or so
a day to maintain her weight at 162
pounds, 227 pounds lower than her
original weight.
Reprinted with permission. All rights reser ved.
After: Kelly Rhoads, right, walks with friend Marya Dennis. Rhoads, 48, calls her brisk walks “girlfriend
time,” and is down to 160 pounds. Rhoads also does strength training and toning exercises.
But what about people who say their
busy family and work lives force them to
choose between sleep and exercise?
Taylor says the exercise comes out of
her TV time. "I watch very little TV. This
is about getting off the sofa and making
sacrifices."
It's all a matter of scheduling, dietitian
Hogan says. People must schedule
exercise just as they do visits to the
doctor or their hairdresser. It's easy to
have your computer or BlackBerr y
remind you that it's time to get out and
get moving, she says.
People who have children can squeeze
in small amounts of exercise all day,
Hogan says. When your little one goes
down for a nap, jog up and down the
steps several times or walk around the
house wearing a pedometer. Do squats
when you're talking on the phone or
drying your hair.
'Energized by exercise'
When your child is at soccer practice,
By H. Darr Beiser, USA TODAY
walk up and down the field, she says.
"Remember you will be energized by
exercise."
Aidan Murphy says that when he
decided to lose weight, he also changed
his TV-watching experience. "Instead of
sitting on the sofa and watching TV, I
was on the treadmill watching T V. I
walked without fail, and I lost 40 pounds
the first year."
Now, he weight-trains regularly and
bikes 50 to 60 miles outside on both
weekend days, as well as inside on an
exercise bike several days a week. There
are times when he's so busy at work
that he can't do this much activity, but
the next week, he tries to get back on
track. It's important to prioritize, he
says.
"I always feel bad when I do not get to
ride my bike, because it means I am
putting everything before something for
me," Murphy says.
But, he says, if you don't exercise for a
day or two or even a week or more, that
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AS SEEN IN USA TODAY’S LIFE SECTION, MAY 29, 2007
"doesn't mean that everything you have
done goes away. Tomorrow is a new day,
so just get back to the plan."
He agrees that it's much easier to
commit to an activity you enjoy: "If you
feel it's a chore, it's impossible to do."
Two approaches to exercise
Endurance and strength training
contribute significantly to weight control
and overall good health, says Miriam
Nelson, an exercise scientist at Tufts
University in Boston and one of the
authors of Strong Women, Strong Hearts.
Studies show that regular endurance
exercise strengthens the heart and the
entire cardiovascular system so it works
more efficiently, which translates to
making it easier to do things such as
climbing steps or walking longer
distances. It also reduces the risk of many
diseases, including type 2 diabetes, heart
disease, cancer and osteoporosis, Nelson
says.
Reprinted with permission. All rights reser ved.
Cardiovascular exercise is "the real
sledgehammer" when it comes to
burning calories, she says. "If you go out
for a brisk walk for 30 to 45 minutes, you
are going to burn 150 to 200 calories
during that time."
Jakicic agrees. In one study, he found
that exercisers burned three times as
many calories in 30 minutes of walking
and biking as they did in the same
amount of time strength-training.
Both Nelson and Jakicic have done
research on the benefits of strength
training and are big supporters of this
type of exercise.
Strength training, which can be done
with free weights, machines or
functional exercises such as push-ups,
squats and lunges, helps preserve and
build muscle, and reduces the risk of
getting type 2 diabetes, heart disease,
osteoporosis, osteoarthritis and other
problems, Nelson says.
People lose about one-quarter of a
pound of muscle a year, starting in their
early 40s, she says. Much of that loss of
muscle can be avoided if they strength-
train two to three times a week for about
30 minutes.
Research suggests strength training
may increase resting metabolic rate, the
calories you burn while sitting still. One
study showed that people who strength-
trained vigorously for six months gained
about 3 pounds of muscle and burned
100 more calories a day. Each pound of
lean muscle burns an additional 30 or
more calories a day, the study concluded.
"Up until your 60s or 70s, you can hold
onto a heck of a lot of muscle with
strength training," Nelson says.
"Once you're 80 or 90, you are
probably going to lose some muscle, but
the resilience of the human body always
amazes me."
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AS SEEN IN USA TODAY’S LIFE SECTION, NOVEMBER 27, 2007

Author of 'Mindless Eating'

wields a new bully pulpit
By Nanci Hellmich
USA TODAY

Brian Wansink, one of the nation's top experts on eating

behaviors and the author of Mindless Eating: Why We Eat
More Than We Think, hopes that in his new federal job he can
take a stab at reversing the obesity epidemic.

Wansink, who last week was named executive director of

the U.S. Department of Agriculture's Center for Nutrition
Policy and Promotion, wants to encourage people to "bump
up their activity level." And he would like to work with
registered dietitians and schoolteachers to help them teach
others to use the government's nutrition tools, including the
Food Pyramid (www.mypyramid.gov).

He'll also be forming an advisory committee to create the

2010 Dietary Guidelines for Americans. These would be a
science-based update of the 2005 federal guidelines, which
are considered the gold standard of nutrition advice.
Wansink says it took about 30 years for obesity to get where
it is today, and "it's going to take some time to reverse it."
He is taking a leave of absence from his job as director of
Cornell University's Food and Brand Lab.
During the past 20 years, Wansink has conducted more than
200 studies of environmental factors that push Americans,
sometimes unconsciously, to overeat. He believes that people
are constantly "trapped" by their surroundings into consuming
100 to 200 calories more than they need or want.
He says Americans can trim a couple of hundred calories a
day and lose 10 to 20 pounds a year by doing things such as
avoiding open food dishes at the office, using smaller serving
By Eileen Blass, USA TODAY
Health’s a-popping: Behaviorist and author Brian Wansink is the new chief of
the federal Center for Nutrition Policy and Promotion.
bowls and spoons, and leaving serving dishes on the stove
instead of on the table.
His research includes the McSubway Project, a series of
studies that examine the habits of fast-food customers. Much of
the research compares foods at McDonald's and Subway, which
advertises that it has more healthful options.
Wansink found that there's a "health halo" around a lot of the
foods at restaurants such as Subway in which customers feel
virtuous about their choice of meals. So, his research shows,
they overeat in side dishes and grossly underestimate the
number of calories they consume.

For more educational resources,

Reprinted with visit http://education.usatoday.com
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AS SEEN IN USA TODAY’S LIFE SECTION, MAY 29, 2007
They aced Get Healthy 101
USA TODAY’s Nanci Hellmich profiles two college students who won big at losing
After a diagnosis
of obesity, former
'fat kid' gets
serious
Ben L aForest, 20, who
just finished his second
year at the University of
Buffalo, says he was always
the "fat kid" when he was
growing up. When he was
about 14, a doctor weighed
him and wrote on his chart
"an adolescent with
obesity."
LaForest was stunned. "I
couldn't believe he had
written that down about me,"
he says. So in the summer
between ninth and 10th
grades, he started exercising -
- rollerblading, running,
biking, weight lifting. He also
began eating high-fiber foods
and lean protein. "I saw
results and didn't look back."
His weight dropped from
260 pounds to 170 pounds in
three months. He maintains it
now at 180 pounds. He's 6-
foot-1.
LaForest and Katie Adler are
among the readers profiled in
the annual USA TODAY
Weight-Loss Challenge, which
ends today.
For more educational resources,
Reprinted with
USA TODAY
"One of my favorite tricks
was chewing sugar-free gum
and drinking water when I
was hungry," LaForest says. "It
helped me not think about
food, because I was
constantly chewing on
something."
He plays tennis for two
hours three times a week and
weight-trains for 30 minutes
three times a week. "I never
thought I could be as fit as I
am today. I thought I was
definitely always going to be
fat. And now I can't imagine
myself as being that big
again."
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permission. All rights reser ved.
Temptations of
college living are
no match for
determination
Katie Adler, 20, who just
completed her third year at
the University of Michigan,
says trying to shed weight
in college is as challenging
as making good grades.
Both take focus, planning
and commitment.
"You have to be
dedicated, because there
are so many temptations,
USA TODAY
with all the drinking and
late-night food," she says. "I returned to college in the fall.
was eating a lot of pizza and "The hardest thing in the
dorm food and not beginning was breaking the
exercising." candy addiction. My candy of
choice was Milky Ways. Every
Her weight ballooned to now and then I (still) have a
216 pounds. "Finally, I said, piece of candy. But I've really
'I'm tired of this. It's time to lost the taste for it."
do something'"
She limits her calories to
She changed her eating 1,500 to 1,800 a day, eating
habits with advice from a every three or four hours and
personal trainer, and she consuming lots of vegetables.
star ting making time to
exercise. She has dropped The payoff: "The weight loss
from 216 pounds in January has boosted my self-image
2006 to 156. and my self-confidence. I
didn't like who I was. I didn't
Adler star ted watching think I was pretty, but now I
what she eats last summer have more self-confidence."
and kept at it when she
7
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AS SEEN IN USA TODAY’S LIFE SECTION, MAY 29, 2007

Ben LaForest, 20 Katie Adler, 20

Hometown: Cohoes, N.Y. Hometown: Milford, Mich.

Occupation: Just finished sophomore Occupation: Just finished her third
year at the University of Buffalo. year at the University of Michigan,
Going to Cornell University next year majoring in chemical engineering
to major in food science.
Height: 5-10 Pounds
Height: 6-1 Pounds Weight in January 2006 216
Weight in August 2000 260 Current weight 156
BEFORE Current weight 180 BEFORE Loss 60
Loss 80

Goal: “I love my new healthy lifestyle and plan on becom-
ing a food scientist — making healthy, nutritious food for
everyone. Hopefully, I can work with the company that
makes Kashi bars.”
Insight for others: “Exercise as much as you can. When you
exercise, you want to eat better, and you feel better about
everything.”
Goal: “If I could tone up, that would be nice.”
Insight for others: “For college kids, it’s really hard. You
need to make a conscious effort and ask yourself: ‘Should I
really be eating this?’ You have to stick with it and do it for
yourself and not for anybody else.”
A sample day

A sample day 10 a.m.: Has a breakfast of Egg Beaters or oatmeal with

apple slices
10:30 a.m.: Eats one packet of instant oatmeal and a 1 p.m.: Snacks on a South Beach Diet bar and some kind of
banana fruit or vegetables, either an apple or green beans and
1 p.m.: Eats lunch of a turkey sandwich on whole-wheat cucumbers
bread, large salad (about two cups) with light dressing and 4 p.m.: Has a lunch of tuna or chicken with a little Miracle
an apple Whip,vegetables, salad and apple
1:30 p.m.: Weight-trains for 30 minutes, three times a week 8 p.m.: Has dinner
2 p.m.: Snacks on about 25 wholewheat pretzels with 10 p.m.: Goes to the gym
peanut butter and a low-fat yogurt 11 p.m.: Snacks on yogurt and an apple
2:30-4:30: Plays tennis for one to two hours, three times a
week What she eats Amount
5:30 p.m.: Eats dinner Lean Cuisine 1 entree
7:30 p.m.: Snacks on 100-calorie pack of popcorn Cooked vegetables 3 cups
with broccoli, carrots,
What he eats Amount cauliflower
Grilled chicken 6 ounces Salad with lettuce, 2 cups
Green beans 2 cups tomatoes, green
Brown rice 1 cup peppers, celery
Fruit 1 piece
Dieter’s routine Amount
Plays tennis One to two hours, three Dieter’s routine Amount
times a week Abdominal exercises 15 minutes, five times a week
Weight-trains 30 minutes, three times Runs 1 1/2 to 2 1/2 miles in 20
a week minutes,five times a week
Total weekly exercise 4 1/2 to 7 1/2 hours Total weekly exercise 3 hours

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AS SEEN IN USA TODAY’S LIFE SECTION ON JANUARY 3, 2007

Which diet is best for you?

One size does not fit all when it comes to diets, says Liz Vaccariello, editor in chief of
Prevention magazine. Research shows that to lose weight -- and keep it off -- you must
pick a plan that suits your personality, food preferences and schedule, she says. USA
TODAY's Nanci Hellmich asked Vaccariello and the editors of Prevention to pick their
favorite programs for different types of people:

For people who hate to cook
Jenny Craig
It satisfies most dieters' needs: pre-
packaged meals and snacks, tracking via
private weigh-ins, weekly consultations
(by phone or in person) and a website
for additional information and support.
Plus, it offers meal plans that you can get
delivered -- all you need is a microwave.
For people who like to cook
The South Beach Diet
By cardiologist Arthur Agatston
Never mind the fluffy name of the diet
book. This smart-carb, high-fiber plan is
an excellent way to reduce your intake
of highly processed carbs and increase
your awareness of super-healthy and
satisfying protein sources such as
seafood. The South Beach cookbooks
allow dieters the opportunity to flex
their culinar y muscles and enjoy
gourmet food, while still keeping
calories controlled. Last but not least,
because of its high-fiber requirements,
this diet is unlikely to leave you feeling
hungry.
For number crunchers
Weight Watchers
with less-than-perfect numbers, Weight Watchers teaches you
how to make it work within your allotted limit. It's this kind of
real-life dieting that makes the program one diet that's easy to
follow for the maintenance phase.
For people who love science
You: On a Diet: The Owner's Manual for Waist Management
By Michael F. Roizen and Mehmet C. Oz
This best seller explores the hows and
whys of weight loss in a friendly, easy-
to-understand way. Roizen and Oz
provide an in-depth analysis of how
your brain, stomach, hormones,
muscles, heart, genetics and stress
levels all interact biologically.
For fruit-and-vegetable lovers
Eat, Drink, and Be Healthy: The Harvard Medical School
Guide to Healthy Eating
By Walter C. Willett with Patrick J. Skerrett
Willett's insightful critique of the U.S. Department of
Agriculture's Food Guide Pyramid
reveals its limitations, and he constructs
an alternative. His ideas are nothing we
haven't read before: Eat more
vegetables and complex carbohydrates,
emphasize healthy fats, and enjoy small
amounts of a variety of foods. But his
matter-of-fact delivery and no-nonsense
tone earn this a place on Prevention's
reference shelf.

The Flex Plan points program

makes counting fun. We like that no
food is off-limits. If you choose a food

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AS SEEN IN USA TODAY’S LIFE SECTION ON JANUARY 3, 2007

For people who eat out a lot For people who want a gimmick that works

Dr. Shapiro's Picture Perfect Weight Slim-Fast

Loss: The Visual Program for Permanent
Weight Loss You know the deal: a shake for
By Howard M. Shapiro breakfast, shake for lunch, then a
sensible dinner. We'd love to say it's
If you have trouble telling right-size just a fad, but numerous published
from super-size when you're at a studies show why it works: It's a
restaurant, fast-food joint, coffeehouse simple, but effective, way to reduce
or even in your own kitchen, this book your calorie intake. It also has a
will set you straight. built-in maintenance plan. Pounds
creeping up? Shake 'em off.
For people who enjoy walking
For people who like the Web
The Step Diet
By James O. Hilland John C. Peters with Bonnie Jortberg WebMD Weight Loss Clinic

The co-founders of America on the This online program

Move offer a plan that's based on one of gives you an accurate
Prevention's favorite fitness routines: assessment of your
walking. It comes with a pedometer, in nutritional status, and
itself a $20 value, plus conversion charts the daily e-mail
and dozens of reduced-calorie recipes. reminder program
First, use the pedometer to gradually provides accountability.
increase the number of steps you take in But what we really like
an average day, then reduce your food about this program is that it helps you improve your diet by
intake by a quarter. Simple. making small changes rather than requiring you to overhaul
your entire refrigerator.

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AS SEEN IN USA TODAY’S LIFE SECTION ON JANUARY 3, 2007
From South Beach with ‘Heart’
In Agatston's new book, 'accidental diet doctor' keeps the beat going
By Nanci Hellmich
USA TODAY
One of the nation's top diet doctors has
trimmed many waistlines with his best-
selling The South Beach Diet. Now he's
going for the heart with a new book out
today.
Cardiologist Arthur Agatston, who calls
himself an "accidental diet doctor,"
originally created his eating plan to help
his patients lose weight, improve their
cholesterol and avoid diabetes and heart
disease. He says he never dreamed it
would take off as it did.
His 2003 book evolved into one of the
best-known diet programs. About 11
million copies are in print worldwide. It
recommends eliminating most
processed and fast foods and eating
plenty of fish, vegetables and fruit. It also
emphasizes whole grains and healthy
oils.
Now he wants to trade on that fame to
save hearts with his book, The South
Beach Heart Program (Rodale, $25.95).
In this book, he explains how the way
people live directly affects the heart and
all its machinery: the arteries, the blood
vessels, the hear t muscle itself. He
outlines the diagnostic tests for heart
disease and urges people to learn the
condition of their arteries and adopt
hear t-healthy living: eating better,
exercising regularly, stopping smoking
and reducing stress. The book offers a
crash course on his diet with a few daily
menus.
The Miami Beach doctor says he wants
to "speed up the cardiac prevention
revolution. One of the biggest secrets in
medicine today is that cardiologists and
internists who are practicing aggressive
Reprinted with permission. All rights reser ved.
Three key principles of 'The South Beach Diet'
1. Eat good fats. Choose good fats from olive oil, canola oil,
peanut oil, flaxseed oil, walnut oil, avocados, nuts and fish.
Omega-3 (fish oil) supplements also are fine.
2. Eat good carbs. Good carbs include high-fiber, nutrient-
dense fruits, vegetables, legumes and whole grains.
3. Eat lean protein. Eat eggs, low-fat dairy, nuts, seeds, legumes,
white-meat poultry, fish, shellfish and lean cuts of meat.
prevention are rarely seeing premature He says he treats mostly high-risk
heart attacks and strokes in people patients who have multiple risk factors,
under 70." but he rarely has to use invasive
procedures such as angioplasty or bypass
Early reactions from doctors and surgery. These procedures are done far
nutritionists who have read the book too often in the USA, he believes.
have been mostly positive, with some
reservations. If patients had a clearer picture of what
is going on in their arteries, they would
"We need to reawaken people. Heart be more motivated to clean up their
disease is a plane crash. We want to lives, he says.
prevent the crash and the near-misses as
well," says renowned New York heart Oz says more doctors are moving
surgeon Mehmet Oz, co-author of the toward prevention and agrees that
best-selling YOU: On a Diet: The Owner's knowledge may help inspire people to
Manual for Waist Management. change. As a surgeon who does many
bypass surgeries and heart transplants,
Keith Ayoob, a registered dietitian at when he opens his patients' chests, he
the Albert Einstein College of Medicine in sees all the "sludge" that's blocking their
New York, says Agatston's new book arteries. "This is not something they
"won't appeal to fad dieters who are were born with. It's actually something
worried about getting into a bikini, but it they did to themselves."
will appeal to aging boomers who have
realized they are not immortal." He's often disappointed that the
patient needed surgery. "It's like I'm
Cardiovascular disease is the No.1 killer bringing new pipes to your home when
in the USA, according to the American what I should have been doing is
Heart Association. About 865,000 new teaching you how to change the
and recurrent heart attacks strike each corrosive fluids that were rusting your
year, Agatston says. pipes."
He believes these grim statistics can be What's really going on inside
changed. He'd like to see more doctors
working as "healers" to stop hear t Agatston, an associate professor at the
disease before it goes too far, instead of University of Miami Miller School of
working as "plumbers" who go in after Medicine at Mount Sinai, says
the damage is done to make repairs with arteriosclerosis, or hardening of the
scalpels, balloons and stents. arteries, is caused by a combination of
genetics and environment. "Some people
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AS SEEN IN USA TODAY’S LIFE SECTION ON JANUARY 3, 2007
have fabulous genetics and can get away
with almost anything — smoking and
eating whatever they want," he says.
"Some people have horrible genetics and
can do everything right and live a perfect
life and still develop heart disease. But
most of the rest of us are somewhere in
between."
He writes that when he went to
medical school in the 1970s, he was
taught the "plumbing model" of heart
disease. Doctors believed heart attacks
resulted from a blockage of a major
coronary artery caused by a gradual
buildup of plaque. The idea was that as
the artery became more clogged with
plaque, it would narrow to the point at
which blood flow to the heart would be
cut off.
But this theory was wrong, he says.
The biggest reason for heart attacks are
what are called "vulnerable plaques."
These plaques are like little pimples, but
instead of being filled with pus, they are
filled with cholesterol, Agatston says.
When they pop, they cause tiny injuries
to the vessel wall. To heal the injury, a
blood clot forms.
If the blood clot is large enough, it will
block the artery and cut off part of the
heart's blood supply, he says. Blood-
starved heart tissue dies. This is a heart
attack.
The good news is that by improving
their diet, exercising and possibly taking
medications, most people can stop the
plaques from growing and bursting. "In a
sense, the plaques stabilize. They can
regress."
When it comes to improving the
condition of their arteries, most people
need to begin with their diets because
they "have horrible eating habits."
People are killing themselves with
high-fat burgers, sugary milkshakes and
trans-fat-laden fried foods, highly refined
foods with little nutritional value, he
writes in the book. "If we had
deliberately set out to design a diet to
make people fat, diabetic and candidates
Reprinted with permission. All rights reser ved.
for heart attack or stroke, we couldn't
have done a better job."
That can be changed, he says. Good
eating and exercise habits produce
weight loss, which improves
cardiovascular health. Every pound of fat
takes lots of tiny blood vessels to feed it,
he says. When a person loses weight,
there is less stress on the heart.
Plus, weight loss helps reduce waist
circumference, which is key. Having a lot
of belly fat increases the chance of type 2
diabetes and heart disease.
Agatston says that to improve heart
health, people should:
u Avoid trans fats, hydrogenated and
partially hydrogenated oils found in
some commercial baked goods and fast-
food fries.
u Increase the intake of fruits and
vegetables. Supplements won't give you
all the micronutrients that these foods
will.
u Increase their intake of omega-3
fatty oils by eating flaxseed oil or fatty
fish such as salmon or by taking
supplements.
Agatston's South Beach diet program is
divided into three phases. The first two-
week portion is the most rigorous and
eliminates such foods as fruits, carrots,
bread, cereal, potatoes and pasta.
Dawn Jackson Blatner, a registered
dietitian at Northwestern Memorial
Wellness Institute in Chicago, doesn't like
the first phase because, she says, "it
eliminates healthy foods."
Phase 2 is much better because it
"encourages people to eat a wide variety
of healthy foods, such as colorful fruits
and vegetables, fiber-rich whole grains
and heart-smart fats," she says.
Robert Eckel, former president of the
American Heart Association, says many
of the dietary principles outlined by
Agatston are consistent with those from
the AHA. "But we have no science that
the South Beach Diet is any better than
some other evidence-based diets for
weight control and prevention of heart
disease."
A battery of tests
Agatston says people would eat better
if they knew the condition of their
ar teries. He suggests a variety of
diagnostic tests, including blood tests for
cholesterol, triglycerides and other
factors.
For men over 40 and postmenopausal
women over 50 who have risk factors for
heart disease, he recommends having a
non-invasive heart scan, which indicates
the amount of plaque that's present in
the arteries. Some of his patients keep
pictures of their ar teries on the
refrigerator.
"Before they open the refrigerator, they
look at their arteries."
Eckel says Agatston does a good job
outlining the principles of heart disease
prevention and diagnosis, but he says
Agatston is overly "zealous" in his advice
for some tests, including heart scans.
The heart association calls the scan a
"potential useful tool" for people who are
at moderate risk but stops shor t of
recommending it. "The decision should
be made by the patient's physician,"
Eckel says.
Although Agatston is a passionate
believer in the power of diet and
exercise, some patients at high risk for
heart disease should be taking statins
and other drugs. "Millions of people who
should be taking cholesterol-lowering
drugs are not. That means that millions
of Americans have an unnecessarily high
risk of heart attacks, strokes or sudden
death.
"The medications we have today have
a fraction of the side effects that they
used to have. They are lifesaving."
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AS SEEN IN USA TODAY’S LIFE SECTION JANUARY 4, 2007

Overweight teens bear an extra burden

Kids who trimmed down share their trials and triumphs
By Nanci Hellmich AFTER
USA TODAY BEFORE

Registered dietitian Anne Fletcher has

heard the worst when it comes to the
emotional torture suffered by overweight
teens.

She has interviewed more than 100

teenagers who were able to lose weight,
and she recounts their stories of struggle,
pain and triumph in a new book. Among
them:

*One 13-year-old girl said kids chased

her around the playground yelling, "Run,
Fatso, run!" She came home cr ying
almost every day. She eventually lost 100
pounds.

*A high school boy said his baseball

coach taunted him, saying the teen hit
home runs because he "was so damn
slow" that he needed the extra time to
circle the bases.

Both guys and girls said being

overweight affected their body image,
self-esteem and ability to attract friends Family photos
and members of the opposite sex. "One Dramatic change: Wes Gilbert at age 18, above, after
of the things that hit me was the pain losing about 65 pounds, and at age 17.
most of these kids had suffered. This is
not a society that is kind to overweight decision to slim down and found a way to
Weight and Keep It Off -- and What They
people, particularly teenagers," says do it themselves. One girl said she
Wish Parents Knew (Houghton Mifflin,
Fletcher, who lives in southern changed her eating habits because she
$26). She wrote Thin for Life in 1994
Minnesota. realized feeling good about herself was
about adults who successfully lost
more important than eating an order of
weight.
On the other hand, they told her how supersize french fries.
weight loss changed their lives for the The teens lost weight in a variety of
better. She believes their stories will u Having parents who helped them
ways. Half received help from weight-loss
inspire others. out, not singled them out. They didn't
programs, health professionals or
like their parents' nagging but said it was
summer weight-loss camps. The other
"Success stories help other people helpful if they offered encouragement,
half slimmed down on their own, cutting
believe in themselves and their ability to bought the right types of food, served
calories, reducing por tions and
change," says Fletcher, who shares more healthful meals, paid for exercise
eliminating sugary drinks. The teens
insights from adolescents, their parents programs and joined them in losing
attribute their success to:
and nutrition professionals in Weight weight, Fletcher says.
Loss Confidential: How Teens Lose u Being ready to lose. They made the

For more information, log on to www.usatodaycollege.com Page 12

AS SEEN IN USA TODAY’S LIFE SECTION JANUARY 4, 2007
u Becoming more physically active.
This was their No. 1 strategy for losing
the weight and keeping it off, she says.
u Setting realistic goals. Many said
they are still heavier than they'd like but
realize that few can look like
supermodels.
Edith Howard Hogan, a registered
dietitian in Washington, D.C., says weight
loss is especially hard for teens because
"these are years of emotional turmoil."
They must select a program that's
nutritionally sound so they get enough
calcium for their bone health and enough
other nutrients for their general health,
she says.
Boston nutrition expert Elizabeth
Ward, who is the mother of three school-
age daughters, says teens may be
tempted to tr y to lose quickly by
following low-calorie diets or exercising
excessively, so it's impor tant their
families support a healthy approach.
"Showing concern without nagging is
one of the hardest challenges parents
face. A parent may be afraid that their
child will have the same weight
problems they did in their youth. But try
as they might, parents can't always
prevent a child from becoming
overweight," says Ward, author of The
Complete Idiot's Guide to Feeding Your
Baby and Toddler.
Fletcher says that if teens aren't ready
to lose, then parents must show them
unconditional love and be good role
models by eating healthfully and
exercising regularly.
Reprinted with permission. All rights reser ved.
Are you ready to take that step?
Here are some questions teens can ask themselves to see whether they are ready
to take steps to lost weight.
Very Sort of Not
Check the answer that applies to you:
very
How concerned am I about
my weight?
How much do I want to do something
about my weight right now?
How confident am I that I can do
something about my weight?
Do I think I can do something about
the things that are getting in my way?
How ready am I to change my
eating habits?
Is my family ready to support
me in my efforts?
Key: The more answers you choose that begin with "very," the more likely you are
ready to turn things around.
Source: Weight Loss Confidential
From personal experience, she knows "When Wes was heavy, he never acted
how hard this is to do. One of her two like his weight bothered him, in part
sons, Wes Gilbert, began struggling with because he had other things he was
extra pounds during sixth grade. confident about," Fletcher says. "But I
know he feels better about himself now."
Even though she is an expert in weight
control, Fletcher says nothing she said or
did seemed to stop him from gaining. He
eventually lost 65 pounds and has kept it
off.
Page 13
AS SEEN IN USA TODAY’S LIFE SECTION JANUARY 19, 2007

Is your house making you fat?

Decor does more than express our style — it can also expand our waistlines. USA TODAY's
Mary Cadden asks Brian Wansink, author of Mindless Eating: Why We Eat More Than We
Think, to identify the most common diet traps in our homes and design guru Christopher
Lowell how to steer clear of them with good design.
Dinnerware
Problem:
Over the
y e a r s ,
portions got
bigger in
restaurants
a n d
package d
food. As a
Maki plate/platter, $2.95- result, "our
$5.95 at CB2.com expectations
of what
constitutes a proper serving increased in
our homes," Wansink says. And so did
the size of our dishes -- from a standard
of 9 inches to 11 or even 12.
Solution: Focus on the tablescape. "Think
tapas — many courses, but much smaller
por tions," Lowell says. "Go with
individual ramekins, even sushi-style
plates, long and shallow," to shrink
portions.
Colors
Problem: Bright, stimulating colors such
as red or yellow can "increase the speed
at which you eat," Wansink says. And you
guessed it: "The faster you eat, the more
calories you ingest." On the flip side,
wood tones encourage us "to eat slower
but longer."
Solution: Stay away from colors found in
food — red, yellow gold, brown and
green, all of which are popular right now.
"They stimulate us in the wrong way,"
Lowell says. "Think in terms of a men's
haberdashery: taupe, a warm flannel
gray with white trim or a very pale blue.
Those are all very calming."
Electronics
Problem: "Anything that distracts us
from monitoring how much we're eating
is bad," Wansink says. The television is a
major culprit. "We mindlessly eat while
we mindlessly watch TV."
Living Marine Aquarium,Vol. 2, $14.95 at
Screendreamsdvd.com
Solution: If you feel the need to have
your plasma in plain view of your dining
area, trying turning the screen into an
aquarium. "It adds texture and mood to
the space, but it becomes background --
the architecture of the room vs.
entertainment that pulls you in," Lowell
says.
Lighting
Problem: "People tend to underestimate
the amount of food they eat in the dark,"
Wansink says. "Dimmed rooms set a
more relaxing tone" that prompts us to
eat longer.
Solution: If your dining-room chandelier
is on a dimmer, "add dark shades that are
metallic-lined," Lowell says. "This will
focus the light on the table and take the
focus off the rest of the room, making
you more aware of what you are eating."
Chandelier with base and shades in
opaque resin, $999 at Horchow.com
You can accomplish the same thing by
swapping incandescent bulbs for
halogens.
Sleep spaces
Problem: A good night's sleep matters.
"When we're tired, we
often overindulge in
carbohydrates," Wansink
says.
S o l u t i o n : Don't let
television intrude on your
sleep. "Create a sitting
area where the screen
isn't viewable from the
bed," Lowell says. "If you
don't have the space, you
can buy a great curio
cabinet or screen to
divide the room in half.
Keep activity separate
from sleep."
Shoji folding screen in black, cherry, natural or
white, $79-$149 on sale at JCPenney.com.

Reprinted with permission. All rights reser ved. Page 14

 1. USA TODAY articles referenced in this case study
CRITICAL INQUIRY
suggest exercising more and eating less. Which do you
think would be more effective for helping a person keep
from gaining weight? Which would be more effective in helping a person lose weight? Justify your rationale.

2. The book Mindless Eating (Bantam 2006) refers to small 100 calorie changes – small changes that help mindlessly
break bad eating habits. Based on the articles, what are three small changes you could suggest your roommate try out
to help him or her either lose a few extra pounds or maintain his ore her current weight?

3. There is frequent mention of the “Freshman 15” on college campuses. When you look at your friends who have gained
weight, what are the two top reasons you think they’ve put on the pounds? What simple suggestion could you give
them that could let them be themselves but not gain so much weight?

4. Busy, busy, busy. When you’re on the run from class to class, how could you possibly get more fruits and vegetables
into your diet? The more of these goodies you have the less you’ll naturally eat of the other foods that aren’t nearly as
good. What are two easy ways you can eat two more servings of these each day?

1. One of these articles uses an extreme Boot Camp

approach to dieting. What are two other options?
FUTURE IMPLICATIONS

2. When are some of the bad eating habits that you’ve seen other college students acquire? Think of a specific person
who adopted some of these habits. What are two specific suggestions you could give the individual? How could
you present your suggestions in a way that doesn’t make your friend defensive?

3. We could all enjoy the foods we like and still eat healthy. The problem is that we tend to overdo it. What keeps
people from eating reasonable amounts and instead leads them to overeat? What strategies could help people
learn to eat in moderation?

Additional Resources
v Wansink, Brian (2006), Mindless Eating – Why We Eat v "The Wizard of Why" by Robin Jenkins Mather The
More Than We Think, New York: Bantam-Dell. Chicago Tribune, 3-30-05, Section 7

v “Just put your mind to it" by Nanci Hellmich USA v “Seduced By Snacks? No, Not You" by Kim Severson
TODAY, 10-11-06, Life, 5D The New York Times, 10-11-06, D1.

For more information, log on to www.usatodaycollege.com Page 15

 Meet the Expert
Brian Wansink (Ph.D. Stanford
1990) is the author of the best-
selling book Mindless Eating:
Why We Eat More Than We Think
(Bantam 2006). He also holds the
John S. Dyson Endowed Chair in
the Applied Economics and
Management Department at
Cornell University, where he is
Director of the Cornell Food and
USA TODAY Brand Lab. Previously, he was a
Dr. Brian Wansink professor at Dartmouth College,
the Vrije Universiteit (The
Netherlands), the Wharton School at the University of
Pennsylvania, the University of Illinois at Urbana-
Champaign, INSEAD (France), and he was a visiting scien-
tist at the U.S. Army Research Labs in Natick, MA.
He is a Fulbright Senior Specialist in food marketing and
nutrition, and in addition to writing Mindless Eating, he is
For more information, log on to www.usatodaycollege.com
author of the books Marketing Nutrition, Asking Questions
and Consumer Panels. His award-winning academic
research on food has been published in the world’s top
marketing, medical and nutrition journals. It has been pre-
sented, translated, reported and featured in television doc-
umentaries on every continent but Antarctica.
The research findings of Wansink and his colleagues have
also contributed to the introduction of smaller “100 calo-
rie” packages (to prevent overeating), the use of taller
glasses in some bars (to prevent the overpouring of alco-
hol), and the use of elaborate names and mouth-watering
descriptions on some chain restaurant menus (to improve
enjoyment of food).
An Iowa native, he lives with his family in Ithaca, NY,
where he’s a mediocre saxophone player in a rock-and-roll
band and where he regularly enjoys both French food and
french fries.
Page 16