Cutting Calories And Dining Out
December 17, 2008
By
Dr. Brent Uyeno
Internal Medicine and Pediatrics
Interviewed by Melissa Moniz
Where did you receive your schooling and training?
I did my undergraduate, medical school and residency training all here in Hawaii.
How much of your practice is children and how much is adults?
Probably about 20-25 percent is infants, children and teenagers, and the rest are adults.
What are the most common questions you are asked by your patients?
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For children, I get a lot of questions from parents about diet and especially about how to get their children to eat fruits and vegetables.
For the adults, a lot of it is weight-related or questions related to their chronic illness like high blood pressure, high cholesterol and diabetes. I like to talk to them about their weight, diet and exercise. I’ve been struggling through it myself and have lost some weight. Hopefully it makes me more convincing when I talk to patients about diet and exercise.
Is there any clear-cut answer to trimming the obesity rates in children and adults, or does it really vary with each individual?
It varies on the individual and the family. A lot of it depends on how much the family is willing to prepare meals at home and how much they go out to eat. Parents also should start teaching children to eat healthy from a young age. It’s OK to go out to eat once in a while, because most restaurants offer healthy choices.
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How much are someone’s eating habits as an adult directly attributed to their eating habits as a child?
I think a lot of it has to do with our childhood. Growing up in Hawaii, as kids we’re eating plate lunches with a ton of starches and meats with little or no vegetables, then drinking a soda after that. I love my food, so I don’t like to tell patients they have to eliminate the food they like, but enjoy it less frequently and in moderate amounts.
Do you think some of the problem with adults is that the food pyramid taught in school has been found to be incorrect, which is why it has since been altered, resulting in much more balanced portions of starch, vegetables, fruits and proteins?
I think because of the increase of obesity and diabetes, that we are trying to get patients to cut down on their starches. I tell patients that I don’t like the really high protein diets because there should be a good balance. I also tell patients that with proteins it should be lean meats and fish.
Do you think portion sizes and what people think is a serving is a problem?
Yes, one of the things I tell my patients is that when McDonald’s first opened, a regular hamburger, small fries and a small drink were considered an adult meal. So for my patients who are trying to lose weight, I tell them that if they really get the craving for a hamburger or fries, to just get small sizes. For younger children, it should really be even less than that.
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Is it healthy for parents to put their children on diets if they are overweight or obese?
It depends on the age of the child and the weight of the child. If the child is not severely over-weight, I tell the parents to try not to let them gain weight, but to maintain a stable weight until they grow into it or at least slow down the weight gain. We try not to have the kids lose weight because they need some fats for hormones and development. But if they are severely obese, then we do talk about weight loss. I encourage slow, steady weight loss, which is healthier.
Is there still a rise in obesity or is it leveling off?
I think it’s still increasing. It’s been increasing for the past 10 years, according to the statistics, in both adults and children. I think a lot of it does have to do with the fast foods and the advertisements, but a lot of it also has to do with time limitations. It comes down to balancing time that parents spend preparing and cooking healthy meals as opposed to going out to eat. I tell parents that if they go out to eat, select healthy choices. The other thing about eating out is that it’s always hard to waste food. When you have small children, parents tend to eat their leftovers, and that can cause unnecessary weight gain.
For many adults, the holidays are a particularly hard time to watch what you’re eating. What are some tips to avoid overeating or indulging?
The general hints are balancing your meals and balancing your calories. My usual advice is still trying to maintain a healthy balance of fruits, vegetables, proteins and starches. If they are going to go out to eat a big dinner, then try to eat a lighter breakfast and a lighter lunch. If they are going to party with friends and family over the weekend, then to try to eat healthier, when they can, during the weekdays. It’s sort of a caloric trade-off.
Studies show that if you take your time eating, you tend to eat less. How many of us remember scarfing down a plate lunch in 10 minutes, then feeling that we ate way too much?
I also emphasize that they continue exercising. A lot of people give up their exercise during the holidays because they are busy. I try to compromise and tell my patients that even if they don’t lose weight during the holidays, they at least try not to gain weight.