A really bad diet can be made into a better one. And with so many possible changes that can make your diet healthier, results may come quickly.
“My diet is awful.” When my new patient “Dan” came to see me last week, these were the first words out of his mouth. After he told me what he usually eats every day, I had to agree that he had a bad diet (silently, of course). “I never eat at home,” he told me. “I stop by the coffee store in the morning for a cinnamon roll and a hot cocoa. Then I eat a heavy, meaty sandwich and fries most days for lunch. I pick up something for dinner, usually a burrito and chips, on my way home.” To top it off, he stays up until well past midnight, snacking on sweets. A competitive tennis player in college, he’s now 50 years old and barely moves at all (“I walk maybe once a week”). Is it any wonder he’s gained 40 pounds in the last 25 years? He wants to eat better, enjoy a healthy diet, “but I have such a bad diet, I just don’t know where to start.”
When your diet is truly terrible, making changes can seem overwhelming—even if you know what you should be doing. Maybe you figure you can’t teach an old dog new tricks. You’ve been eating this way for so long that you can’t imagine how you’d break out of your routine and start to eat a healthy diet. Maybe you just don’t want to have to think about what you’ll choose in restaurants, or how you’ll make sure to have healthier foods available at home or at work. But rather than seeing this as such a huge challenge, I tried to make Dan see this as an opportunity. If there is anything good to be said about his eating habits, it’s this: with so many potential changes he can make, he could see results relatively quickly.
With a patient like Dan, I have to take into account his lifestyle. While I’d love to see him preparing more foods at home, it’s probably not going to happen, at least not right away. He knows he’s eating too much fat and sugar, and not enough fruits and vegetables. So, my goal was to find some easy changes he could make, even with all the eating out that he’s doing. Here’s what we came up with.
Dan told me that he is always in a hurry to leave in the morning, so he doubted he would make anything at home before rushing out the door. His current breakfast offers up very little protein, and a lot of calories, so we talked about other options at the coffee store. He was willing to switch to a nonfat latte, which would provide some protein at a relatively low calorie cost. And he decided he’d try either a cup of oatmeal or an egg-white ‘wrap’ in place of the sweet roll. He also said he’d plan to pick up a fruit cup to eat at his desk when he got to work.
Dan knows his lunch choices are too heavy and fatty. And did I mention that he washes it all down with a quart of lemonade? Most of the restaurants he goes to at lunchtime have a large and varied menu. That’s a big plus for him, since he can switch to leaner meats for his sandwich and healthier side dishes like fruit or a side salad. He also said he’d be willing to try a main-dish salad—knowing that he should select one that’s heavy on vegetables and lean protein, and light on fatty ingredients like cheese, bacon and creamy dressing. And switching to water, he told me, was not going to be a problem—especially when I told him that that single change could lead to a weight loss of 5 pounds in a month.
Dan isn’t in the habit of snacking in the afternoon, but he should. He eats lunch most days at 11:30 and doesn’t get around to eating dinner until close to 8 PM. By the time he rolls up to his favorite Mexican restaurant, he’s starving. Especially with his lighter lunch, Dan agreed that he’d probably feel the need for a snack in the afternoon. And he understood that it offered an opportunity to work in some of the foods he’s not currently getting in his diet—fruits, vegetables, and dairy products. The easiest thing for him (something he was actually excited about trying) was to make a protein shake. His office has a small pantry, and he was sure he’d be able to keep it stocked so that he’d always have what he needed on hand for his shakes. As an alternative to the shake, he’s also going to try having a container of nonfat yogurt with a piece of fruit, or some baby carrots and a small scoop of hummus dip that he could pick up at the grocery store.
Although burritos were his “go-to” for dinner, Dan actually had several places that he went to most often, and many were large chain restaurants. Again, this can work in his favor. For one thing, the menus are large enough that he can select dishes that emphasize lean protein and vegetables. And, as with lunch, this is the time to work in as many vegetables as possible. Many large restaurant chains post their nutrition information online. I suggested that Dan take some time looking at the menus and calorie counts ahead of time, and then make a list of some healthier choices he could make at a cluster of restaurants.
Since Dan stays up so late, it’s not unreasonable that he might feel this need for ‘a little something’ during the evenings. But rather than rummaging in the pantry for pastries, he agreed that this would be a great time to sneak in an extra piece of fruit. He promised he’d stock up on the weekends so he’d always have fruit available.
One of the nice things that came out of my meeting with Dan was that he didn’t feel overwhelmed, because the changes we came up with work with his lifestyle rather than against it. But look at what we were able to accomplish:
Breakfast: Boosted protein, added a serving of fruit, and significantly decreased fat and sugar intake. Potential calorie savings: 400 or more.
Lunch: Significantly reduced fat and sugar, added 1-2 servings of vegetables. Potential calorie savings by switching to leaner proteins and ditching the lemonade: 800 or more.
Snack: Boosted protein, added a serving of nonfat dairy and a serving of fruit with the shake or yogurt snack. Boosted protein and added a vegetable serving with the hummus and veggie snack.
Dinner: Cut out a lot of fat and added 1-2 vegetable servings. Potential calorie savings: 400 or more.
Evening snack: Added another serving of fruit.
Bottom line: Dan cut out enough fat and sugar to save at least 1000 calories a day. And he’s added 2 fruit servings, 2-4 vegetable servings and a serving of nonfat dairy. He’s on his way to a healthy diet and feeling happier.
How have you managed to make your diet healthier without feeling deprived?