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1. What are DIETDIRECTIVES portion sizes and quantities?

• 4 oz. protein main courses: meat, fish, poultry
• 6 oz. milk in cereal
• 6 oz. yogurt, cottage cheese, or ricotta
• 2 oz. cheese
• 2 eggs
• 1 ounce of nuts 9 10-15 depending on type of nuts)
• 1 & 1/2 cups of entree salad: spinach, chef, nicoise, cobb, greek
• 1 cup of salad as a side
• 2/3 cup prepared salad: egg, tuna, shrimp, crab, lobster, chicken, etc.
• 1/2 cup carbohydrate sides: rice, pasta, couscous
• 3/4 cup cereal
• 5 crackers
• 1 cup entree pasta
• 1/2 cup of sauce on entree pastas
• 1 slice of bread
• 2/3 cup vegetable sides
• 1 whole citrus fruit
• 1/2 non citrus fruit (except grapefruit).
• 1/2 cup sliced/diced fruit

2. What is the source of these portions?

The mainstay of American cooking for the past 40 years, Joy of Cooking and Fannie Farmer, published recipes that deliver these portions. Americans ate these only a few decades ago. They are still the standard in Europe where supersizing has not taken hold.

3. Why did portions grow? Several developments led to supersizing:

• Agricultural subsidies to farmers from the Nixon Administration.
• Agricultural overproduction, particularly CORN, led to the development of corn fructose, a sweetener which is now in most processed foods.
• The “good” food/”bad” food diet fads: eating unlimited quantities of the “good” food.
• The fitness industry told Americans that “fat” burning exercise would cancel out overeating.
• 75% of American families’ food budget is spent in restaurants, take-out, delis, fast food chains that supersize their “portions” so they can charge more or show value.
• WalMart sizing has accustomed people to thinking bigger about everything.

Today few people know the size of a portion. The TRILLION DOLLAR food industry wants us to eat more so they can sell more.

4. Why do portions vary?

First, the portions or quantities recommended are based on how the foods are similar in nutrient content. Because cheese contributes quality protein similar to meat it is in the protein category (4oz), but because cheese has a small amount of carbohydrate, unlike meat, we specify a smaller portion (2 oz.). Potatoes, while technically a vegetable, are similar in nutrient content to rice and noodles in their ability to influence blood sugar. So, they move from the vegetable to the carbohydrate category. The salad side (1 cup) is a function of how many bites it takes to eat it versus a side vegetable. So the second determinant of portion size is the number of bites.

5. How do we know a typical FARE (usually lunch or dinner) is  20-26 bites and a typical FIX (usually breakfast or an afternoon snack) is 12-16 bites?

We prepared the menus and counted the bites. While one person’s bite size may not be exactly the same as another person’s bite, the human mouth has a limited capacity. And, a limited quantity of food can be balanced on a regular fork or spoon. Thus bites don’t differ that much. The bite size we used for counting is NOT chipmunk size or a “doll” size, but in the middle of these two extremes.

6. Why is the Bite concept useful?

Counting bites gives flexibility to eat anywhere and estimate quantity. We have counted the bites in a portion of steak (4 oz.) and approximated it at 8-10 bites. Add in a 1/2 cup mashed potato (approx. 5 bites) and a cup of salad (approx. 5-7 bites) and you have a FARE of 18-22 bites. Bite counting is a training tool to reprogram your hand, mouth, brain and stomach to know and feel quantity. Soon you will master how to visually estimate correct portion sizes; it is then easy to compare our quantities to what is served in restaurants, delis, and dinner parties.

7.How did we figure calories?

Dietitians have access to computerized programs which give calorie counts for almost all foods and recipes. Calculating calories requires imputing a food and a portion size into a nutrient analysis program. How you may ask were foods such as meatloaf or pizza calculated? Nutrient analysis programs have recipes which a dietician can adjust. Even fast foods are analyzed. For scrambled eggs, the calculations are based on 2 eggs, 2 Tablespoons 1% milk and 1 Tablespoon butter. If your recipe uses half-n-half or non-fat milk the calories will increase or decrease. In all calculations, we have chosen the middle ground. Ground beef, for example is estimated at 10% fat, not 4% and not 20%. So when estimating calories, know that our counts are based on the middle range. Calories for solids (the ARE and the IX) were determined per item and totaled for the day. Fluid calories are additional and can range from 60-260. Garnishes are additional and range from an average of 15 calories for vegetables to an average of 90 calories for fats.

8. What was the DIETDIRECTIVES testing sequence?

1. Prepared the foods in the correct portion sizes.
2. Asked people to count how many bites they ate of these portions.
3. Calculated the caloric value using a nutrient analysis program of each food.
4. Orchestrated the daily menus to meet the 30-30-30 nutrient mix (with a 10% swing for flexibility). on the middle range. Calories for solids (the ARE and the IX) were determined per item and totaled for the day. Fluid calories are additional and can range from 60-260. Garnishes are additional and range from an average of 15 calories for vegetables to an average of 90 calories for fats.

9. How were the foods selected?

American preferences, availability, convenience and cost were primary considerations. Putting meals together involves contrasting taste, color, texture, eye appeal and shape. Selecting foods that are chewy makes eating less easier.

10. How does DIETDIRECTIVES reduce quantity dependency?

The program retrains by a combination of the correct quantities; the bites; the chews; the Fluids, and the parts (2 or 3 solids plus different liquids). Unlike most diets where the longer you stay on them the harder they become, this system gets easier as brain, hand, mouth and stomach are re-trained to understand that less is more.

11. Why can’t I drink unlimited quantities of water?

DIETDIRECTIVES discourages excess quantity and constant consumption of H2O. Yes, water is absorbed directly through the stomach lining, but only in small quantities. Excessive quantities of H20 (more than 10 oz.) are interpreted as quantity by the stomach and thus stimulates digestive action. Our program strives to give the stomach respites between digestive duties. Pay attention to your own thirst needs rather than trying to get 8 glasses a day. Our Menus specify many foods with a high moisture content such as fruits and vegetables.

12. Which Fluids are best?

Taste, availability, and digestive contribution were the selection factors. Fluids with an 8% carbohydrate concentration are more readily absorbed into the blood stream and so raise blood sugar faster which relieves hunger sooner. Fluids with an acid contribution help to lower the pH of the stomach and facilitate digestion of solids. Finally, flavored Fluids contribute to the overall eating pleasure. Water simply “rinses” the mouth and washes away flavor.

13. Why is FIX B fluid, nuts and citrus fruit?

Nuts are a terrific source of protein, healthy oils and other nutrients, especially Vitamin E. And, the good news is: almost 17%-18% of the calories from nuts are NOT absorbed. The American Heart Association says, “nuts may reduce the risk of heart disease.” The cardio-protection in nuts is attributed to the unsaturated fats, soluble fiber, arginine-rich protein and anti-oxidant properties of Vitamin E and selenium. We like nuts and fruit because they require chewing. While nuts contribute protein and fats, the citrus fruit provides carbohydrate in an acid base; thus FIX B is the perfect balance of protein and carbohydrate. The portability of this combo make FIX B an easy “snack.”

14. Don’t nuts have a high caloric content?

Since not all nuts are equal in caloric content, we recommend almonds, peanuts, pistachios and pine nuts during the weight loss phase.

15. Is Part 2 in a FARE always protein?

Some common American foods don’t fit our pattern of Part 2 protein. These are pizza, pasta, soup and entree salads (Chef, Spinach, Greek, etc.). These are the exceptions to the DIETDIRECTIVES Part 2 Rule of protein.

16. Why can’t I eat no-calorie or low-calorie foods between meals?

Eating between meals stimulates digestion and trains the stomach to expect food constantly. If the stomach is in constant digestion mode, hunger sensations are multiplied and intensified. The more frequently you eat the more you train the stomach that digestive activity is normal on a constant basis. There is no biological need to eat more than 4 times a day at 3-5 hour intervals.

17. Why eat no more than every 3-5 hours?

Spacing eating into 4 meals distributes nutrients throughout the day to meet energy needs appropriately and stop hunger pangs. Eating no more than 4 times in a day allows for digestive “recesses” between meals. When the body “learns” that regular fuel will be forthcoming, it does not have to “grab” the maximum calories ingested.

18. Why do I need to eat meals of either a FIX size (12-16 bites) or a FARE size (20-26 bites) if I reduce my total daily calories?

Constancy of meal size trains the stomach to be satisfied by a predictable quantity. Varying the size of the meal confuses the stomach and all its digestive enzymes. The body functions best with predictability and moderation.

19. What is the purpose of the breath mint?

It substitutes for dessert and signals the end of a meal, or no more eating and drinking until the next meal.

20. Do I have to garnish my food?

Garnishes enhance flavor, round out the nutrient mix, contribute to digestion, and give satisfaction. They add minimal calories while maximizing taste.

21. Can I substitute between days, such as FARE A Day 1 for FARE A Day 2?

The menus have been orchestrated for an optimal nutrient mix of one third each of protein, fats and carbohydrates, with a 10% swing for flexibility. Use the FIX and FARE Substitution to achieve balanced nutrition.

22. Besides giving my mouth a workout, why is CONSCIOUS chewing important for weight loss?

Chewing incorporates saliva into food and sends a chemical message to the brain to turn off hunger. Chewing reduces food particle size so that the stomach doesn’t have to overwork. Chewing eliminates digestive stress and stomach problems. Chewing prevents over-eating. Isn’t it easier to overeat pasta, rice and potatoes than apples, steak or broccoli? Chewing makes a little seem like a lot. And, chewing is necessary to release flavor. Attention to chewing allows you to “tune in” to flavor, texture, taste, and scent.

23. Why is a calorie- restricted diet a contributor to longevity?

We minimize wear and tear on our digestive organs by not over-working the digestive system. Excessive calories place a heightened demand on digestion and metabolism. Easing digestive duties by eating smaller quantities equates to a longer life.

24. What trends encourage overeating?

Food prices are so cheap that bigger portions are easy to afford. Food is sold everywhere while 4 decades ago accessibility was limited to restaurants and supermarkets. The combination of more opportunities to eat, more encouragement to eat (remember the food industry is counting on you) and more “nutritional” rationalizations led us to an obesity epidemic.

25. Why do people binge?

It could be the sight of a food, or the smell of a food, or the suggestion of a food or maybe not. Binge eating has certain repeatable characteristics:

1. The food is not nutritious.
2. The food is inexpensive.
3. The food is easy to chew, if chewing is needed at all.
4. The food is easily available (as in vending machines, gas stations, drug stores).
5. The food is usually sweet-tasting.
6. The food is considered a “bad” food.

That leaves out apples or Beluga caviar on toast points. The typical food binge is a box of doughnuts: no chewing, quickly consumed, cheap, available, definitely sweet and certainly not a “health” food. Donuts become irresistible if we forbid them. Allow a doughnut to be included infrequently in the diet and some of its attraction diminishes.

26. What is the Glycemic index?

The Glycemic index refers to the ability of a food or Fluid to raise the blood sugar. DIETDIRECTIVES recommends Fluids with 8% carbohydrate content. Regular sodas and some juices raise the Glycemic Index too quickly which stimulates insulin. This is not good. One of insulin’s jobs is to help convert excess sugars to stored body fat. Notice that the operative word here is “excess“. A moderate quantity of carbohydrate in the context of a meal will raise your blood sugar appropriately and shut down the hunger pangs.

27. Explain diet concepts that relate to weight loss.

• Set-Point Theory of Weight Plateauing: This states that you have an ideal size for your body. Perhaps this is size 14. When you battle your body to become a size 8, you will ultimately fail even if you are really “good”. This should not be an excuse, though; your body is not programmed to be an XXXL either.
• Lipolysis: Simply, fat breakdown. That’s what you want. That’s what happens when the body loses fat. It happens when the calories consumed are less than the body needs to function. It happens regardless of whether the calories come from protein, carbohydrates or fat.
• Ketosis: This is supposedly the magic state you must reach in order to lose body fat. WRONG. Ketosis is the second stage of lipolysis. You don’t have to reach it in order to lose body fat. The bad part about ketosis (the result of withholding carbohydrates) is nausea and bad breath and constipation. Ketosis does not have to occur for body fat to be broken down. It is an extreme state that can lead to kidney damage.
• High protein diets: While the scale may go down, it may not be fat loss. Much of the weight lost is due to loss of body water. Losing excess body fat is healthy; losing vital body water is dangerous.
• “Good Fats” & “Bad Fats”: We now delineate depending on how the fats affect the heart. Good ones such as polyunsaturated lower the risk of heart disease. Saturated fats clog the arteries and raise the risk. Triglycerides are fats that can increase your risk of heart attack. This fat is influenced by carbohydrates which causes it to increase. There are the “not so bad fats,” such as monounsaturated ones, which supposedly don’t have either effect.
• Cholesterol: You need it and you can eat it, but your body also makes it. Eating too many animal and dairy foods will increase cholesterol. Too much cholesterol in the blood causes clogged arteries which can lead to heart attack.
• Calorie Grab: The body gets very efficient at absorbing calories when there is erratic eating and varying quantities. The body wants a predictable and simplified routine. If the body learns that it will be fed another infusion of calories, it doesn’t grab all calories consumed in each meal.
• Food Manipulation: Focusing on calories or fat or carbohydrates by manipulating choices.

28. What are DIETDIRECTIVES goals?

• QUANTITY: How much you eat is specified by the portion sizes and/or the bites. If you overeat too much quantity at a meal you may reduce the next one by a few bites. What is more important is that you pay attention to quantity and how you feel if you overeat.
• CHEWING: This act helps you to focus and also taste the food. Insufficient chewing overworks your stomach.
• FLUIDS: Drink water between meals if you are thirsty. Diet sodas may have no calories, but they stimulate digestion.
• PREDICTABILITY: Eating 4 times a day and not eating and drinking in between. If you are used to nibbling low or no calorie foods and drinking fluids which stimulate digestion, this is the hardest part of the retraining. If you have days when you can’t limit yourself to 4 eating events then split a FIX and have 5 events. But don’t nibble.
• COMPOSITION: If you don’t have time or desire for the second or third Part, skip the carbohydrate, not the vegetable or the protein.

29. Why is DIETDIRECTIVES diagnostic about individual reasons for weight gain?

People are overweight because they eat super-sized portions, or nibble, or drink too much fluid, or too much alcohol, or they don’t eat every four hours and then they binge. These patterns cause pounds to accumulate because the body becomes inefficient. You may not know which pattern is yours until you experience DIETDIRECTIVES. Some DIETDIRECTIVES clients have discovered:

• Too much alcohol: Quantity and Constancy may not be a problem. You many find out that daily alcohol is the issue, not over-eating at a meal or nibbling continuously.
• Too much quantity: Tracking your bites for 3 days will tell you about quantity. Eating too much and too often may just be an unconscious habit which you can change. It may be the result of boredom or stress which may require help.
• Too little constancy: Skipping meals because you want to save calories or you are too busy can lead to a later binge. Carry a pre-measured FIX. Don’t go more than 5 hours without nourishment.
• Too many NO Chew Foods: You know these as “bad” foods, but if you think about doughnuts, ice cream, soda, and processed bite-sized “snack” foods, you will see that they are all easy to swallow.

30. What exercise is recommended?

Pilates, walking, swimming, dancing. Visit themethodpilates.com for information.

Click on an audio-track to listen.

1. Lunch: Lunch
2. Brunch: Brunch
3. Dinner: Dinner
4. Afternoon Snack (Fix): Afternoon Snack (Fix)
   

Some common questions about Fluids:

Why can’t I drink unlimited quantities of water?

DIETDIRECTIVES discourages excess quantity and constant consumption of water. Yes, water is absorbed directly through the stomach lining, but only in small quantities. Excessive quantities of water ( more than 10 oz. ) are interpreted as quantity by the stomach and thus stimulates digestive action. Excess fluid dilutes foods allowing the stomach to empty faster leaving you hungry sooner. Our program strives to give the stomach respites between digestive duties. Pay attention to your own thirst needs rather than trying to get 8 glasses a day. Our Menus specify many foods with a high moisture content such as fruits and vegetables.

How were Fluids selected?

Taste, availability, and digestive contribution were the selection factors. Fluids with an 8% carbohydrate concentration are more readily absorbed into the blood stream and so raise blood sugar faster. We do allow ZERO calorie beverages because habitual dieters can’t give these up so easily. These are diet sodas, and coffee and tea. Flavored Fluids contribute to the overall eating pleasure. Water simply “rinses” the mouth and washes away flavor.

FLUIDS : Drink water between meals if you are thirsty. Always sip. No gulping, guzzling or chugging, please!

A word about wine. Due to its health and gustatory benefits, a 6 oz. glass of wine is permitted 3 times per week during weight loss. post weight loss a glass of wine may be substituted by a three bite dessert once per day.

Turning Off Hunger

One of the keys to turning off hunger is to raise blood sugar. This can be accomplished by drinking a fluid that has the correct balance of fluid and carbohydrate. The balance of carbohydrate with fluid is readily absorbed and raises the blood sugar just enough to begin the process of sensing fullness.

DIETDIRECTIVES’ principles:

1. QUANTITY the digestive enzymes in the stomach work best on smaller quantities. When these enzymes are outnumbered, digestion is short-circuited which leads to weight gain.

2. CHEWING starts digestion. Overweight people don’t chew enough so they produce too little saliva. This means the stomach is forced to overwork. An overworked stomach stretches.
   

3. FLUIDS raise blood sugar quickly because they are absorbed first. Fluids and foods have to be compatible in order to shut down hunger.

4. PREDICTABILITY Erratic eating confuses the body and wrecks the metabolism, causing 95% of all calories to be absorbed. Each of us has an inherent ability to absorb fewer calories (only 75%).

5. COMPOSITION The digestive system is at its best if all food groups are consumed equally so that digestive enzymes process nutrients properly.

How big is your bite?

How big a bite you take or how much you fill your mouth can mean the difference in as much as 100 extra calories. Obviously, the bigger the bite the more calories are consumed. But bite size also affects your digestion. A smaller bite is more manageable in the mouth/easier to chew. In order to check in with how big your bite is, here’s a little exercise. Take a banana and a large carrot. Measure out a 4 inch piece of the banana and carrot. Now take your usual bite. Measure what is left over. If you have less than three inches left, your bite is too big. While a banana is soft and a carrot is hard, we vary the bite size only slightly by opening the mouth wider but in reality the bite size should in fact be no more than an inch or the size of a quarter. This allows the teeth to adequately chew and the taste buds to extract flavors.