James O'Keefe, MD and
Joan O'Keefe, RD

by Joan O’Keefe, RD

The perfect diet – claims abound and you can travel from Sonoma to South Beach trying to stay slim for life, but what really works? Through the years, my clients have shed thousands of pounds without a single recipe, without a single calorie counted. My perfect recipe for breakfast, lunch, and dinner? Two colors and a protein. That’s it. It’s the perfect meal plan and here is all you need to know.

• Breakfast – Choose two colorful vegetables or fruits (ex an orange vegetable and a green, blueberries and strawberries, etc) and a lean protein source.
• Lunch – Choose two colorful vegetables or fruits and a lean protein source.
• Dinner – You got, it – Choose two colors from vegetables or fruits and a lean protein source.

The perfect diet really is this simple. This morning I had three egg whites scrambled (use a bit of PAM or other cooking spray on the pan) with broccoli and red bell pepper. For lunch, I’ll mix together spinach, chopped veggies like cauliflower and broccoli (I buy the big bag of pre-cut veggies at Costco), some leftover grilled chicken from last night’s dinner, and a splash of olive oil and vinegar. Just like breakfast and lunch, dinner takes very little time to prepare. See my recipe below for tonight’s dinner at the O’Keefe home.

Tilapia with Caper-Parsley Sauce (fresh or frozen tilapia both work well)

4 tilapia fillets
1 cup white wine
3 TBSP Benecol margarine
2 TBSP Capers
¼ cup Chopped Parsley

Season tilapia fillets with a small amount of salt and pepper. Cook in olive oil over medium-high heat until cooked through, 2-3 minutes per side.

Sauce: In a saucepan, boil 1 cup white wine until reduced by half 2-3 minutes. Whisk in Benecol, capers, and parsley. Spoon over cooked tilapia. Serve with your choice of two colorful vegetables!

Pac-Man, Antioxidants, and Inflammation
by Joan O’Keefe, RD

When I think antioxidants, I think video games. Specifically, Pac-Man. It sounds odd, I know, but keep reading and you’ll soon be thinking about Pac-Man every time you eat!

I love spring color! From artichokes to asparagus to spinach and strawberries, spring fruits and vegetables are all great tasting and super affordable right now. The key to any healthy lifestyle is plenty of fruits and veggies. They’re full of fiber, vitamins and minerals and low in calories. They’ll whittle your waistline, but they’re also FULL of antioxidants; and antioxidants fight inflammation.

Oxidation in your body is like rust on a car. Antioxidants are fabulous little compounds found in abundance in colorful fruits and veggies. Just like the name implies, they fight oxidation, or “rusting” inside your body. I like to think of the antioxidants in fruits and vegetables like little Pac-men that spend their days gobbling up the bad guys. In this case, the bad guys are all the nasty, disease-causing free radicals, or oxidizers, inside your body. Free radicals cause inflammation and inflammation causes disease. The more of these “Pac-men” you put in your body, the more power you have to fight inflammation.

by Joan O’Keefe, RD

After my daily strength training routine yesterday, I had some time to actually sit and think (for once). I came upon some new research about omega-3 and the prevention of muscle wasting. One study was done with cancer patients while on chemotherapy and another on preventing muscle wasting in the elderly. Granted, the participants were taking a lot of omega-3, two to four grams, and this is just two studies, but it really got me thinking and this concept is now on my radar screen. Muscle wasting is a huge component to aging and muscle maintenance is huge to aging gracefully.

I am naturally of a very fine build. Developing muscle is not easy for me, but I try my hardest every day because I know how important building and maintaining muscle is for my health (and, of course, my vanity)! I have a family history of osteoporosis. Building strong core muscles helps me lower my risk. Muscles are heavy and when they sit on your bones, they’re like constant weight lifting sessions for your bones- keeping bones fit and healthy.

Building muscle is also important to maintain metabolism. Lean muscle mass helps our engines burn as hot as they can, so we can burn calories all day. Core muscle, in particular, is important for balance – especially as we age. Strong core muscles will help you maintain your independence in old age by helping you stay strong and prevent falls, thereby staying independent.

I’m still waiting for more research, but I really do think there is something to this. We all lose muscle as we age and I’m fascinated by the possible connection to omega-3 intake. Did you know that it is only possible to build muscle without strength training into your 20s? Beyond that, we can build and maintain only with strength training and without it, we lose muscle. Look, the jury is still out on this one, but I’m keeping my eye on the research. For now, I’ll continue to work my tail off to build muscle and I’m boosting my daily DHA+EPA intake from 1,500mg to 2,000mg.

Alcohol and Cardiovascular Health
The Razor-Sharp, Double-Edged Sword
By James H. O’Keefe, M.D.

“It has long been recognized that the problems with alcohol relate not to the use of bad things, but to the abuse of a good thing.”
Abraham Lincoln

Alcohol is analogous to the proverbial double-edged sword; and no other health factor is capable of cutting so deeply in either direction depending upon how it is used. Science shows that light-to-moderate drinking done on a daily basis improves cardiovascular health and substantially reduces risk of death. On the other hand, excessive alcohol intake and/or “binge” drinking is toxic to the heart and overall health, and is the third leading cause of premature death among Americans.

Missouri’s own Harry Truman, one of the healthiest and longest-lived of the U.S. presidents, started off each day, before his morning walk, with his one daily drink—a shot of bourbon whiskey. Now, I am not suggesting that you start your day with an “eye opener,” but it is quite likely that his drinking pattern contributed to his exceptional vigor and longevity. The developing scientific consensus indicates that the specific alcoholic beverage you drink is less important than the quantity of alcohol and the pattern of intake. Having one drink daily (or up to two drinks daily for men) appears to be the ideal drinking pattern for improving cardiovascular health. Some studies suggest that wine, particularly red wine, might be the healthiest form of alcohol; but most studies show equal protection from any alcoholic beverage. It is the alcohol (ethanol) itself, rather than any other specific component of the wine, beer or spirits, that is the major factor in conferring health benefits. Alcohol reduces fats and sugar in the bloodstream and decreases inflammation, but only temporarily—for about 12 to 24 hours. This is probably why drinking a small amount five to seven days a week is more heart healthy than just occasional alcohol use. So alcohol intake, like exercise, is best done daily and in moderation. From a health standpoint, a drink immediately before or during your evening meal is ideal. However, avoid drinking within three or four hours before bedtime, because alcohol can disturb your deep, restorative sleep and/or worsen sleep apnea.

Doctors Know the Score

In the American Journal of Cardiology the Mid America Heart Institute published a study of 800 U.S. cardiovascular physicians that showed about three out of four drank alcohol regularly, with nearly half of those consuming one or two drinks a day; suggesting that American cardiologists personally recognize the potential health benefits of regular alcohol intake. However, nearly all studies evaluating the health effects of alcohol report a J-shaped curve, whereby light to moderate drinking confers health benefits, but increasingly heavy drinking results in progressive worsening of cardiovascular and overall health. A recent study of over one million people showed that one drink daily for women, or one or two drinks daily for men, was linked to an 18 percent lower death rate during follow up. In that same study, more than two drinks daily in women, or more than three drinks daily in men, increased risk of death in a dose-dependent fashion.

Reduce Your Risks for Other Diseases

Light to moderate drinking lowers risk of heart attack and cardiac death by approximately 30 to 35 percent, which for example, is about as much as we see with the powerful statin cholesterol drugs. A recent study showed that people who were already following all of the four major healthy lifestyle behaviors (not smoking, maintaining a healthy weight, exercising 30 minutes a day, and eating a healthy diet) still received the cardiac benefits of light to moderate drinking. Other studies show that consuming one or two drinks daily reduces the risk of stroke, congestive heart failure, high blood pressure, and even Alzheimer’s disease; but again, heavier alcohol intake progressively increases the risk for each of these problems.
A small to moderate dose of alcohol also reduces the risk of diabetes by about 30 percent. Evidence indicates that light to moderate drinking might even be good for weight control, especially for reducing belly fat. People who have one or two drinks a day seem to have less abdominal obesity than do non-drinkers, but those who consume more than two drinks a day have—you guessed it—a larger “beer-gut,” which expands in proportion to the amount of alcohol consumed.

Although Mark Twain once quipped, “Everything in moderation, including moderation,” in fact even occasional immoderate drinking is bad for your health. Regular drinking is a slippery slope that many individuals cannot safely navigate; and let’s be clear, getting drunk on Saturday night is not heart healthy. Binge drinking, defined as more than five drinks per drinking day, increases the risk of heart attack and other problems like motor vehicle accidents, stroke, dangerous heart rhythms, sudden death, suicide, cancer, liver disease, and death from all causes. Some studies suggest that alcohol abuse and binge drinking are on the rise, and alcohol abuse is currently the third largest preventable cause of death, killing more than 100,000 Americans each year.

Drink Responsibly

So, if you drink alcohol responsibly, you can take heart in the knowledge that it is good for your health. If you are considering taking up alcohol for its heart benefits, make sure you keep your intake to not more than one drink a day if you are a woman, and not more than two drinks a day if you are a man. Keep in mind that a drink is considered 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof spirits. If in the past you have had problems with abuse of alcohol or other substances, or if you smoke or have a history of depression, or have moral or religious objections to alcohol use, or have chronic health issues like liver disease that make alcohol use more dangerous, you should avoid alcohol use altogether. As always, it is a good idea to discuss issues or questions about alcohol with us when you come in for your visit.

We’ve posted this before, but it’s well worth a re-post. Journaling is one of the MOST important things you can do to maintain a healthy weight.

It’s amazing how many people say to me, “I’m doing everything right and just can’t figure out why I’m not losing weight.” Have YOU ever said these words? I’ve got one word for you: Honesty.

It’s not that people are lying or trying to cover-up their diet and exercise mistakes, it’s simply that they’re not aware of their dishonesty. The only way to be absolutely honest with yourself about what you’re truly doing for your health is to journal. A diet and exercise journal is a requirement of all of my clients. Journaling forces us to be honest with ourselves, especially when we’re trying to live healthier lifestyles. Studies show that those who journal lose more weight and keep it off better than those who do not. So, what are you waiting for?

A nutrition and exercise journal should be simple. Carry it with you everywhere and every time your fingers go to your lips with food, write it down. Journal everything you eat, drink, sip, or taste-test. Write down your physical activity and how much sleep you’re getting. Then when you say, “I just can’t figure out why I’m not losing weight,” we can go back, look and say, “Oh yeah, I see it now.”

Losing weight:
Diet has a lot to do with it. Make sure you’re getting plenty of color and protein in your diet. I recommend CardioWhey and CardioTea daily for all of my weight loss clients. Write down absolutely everything you take in. Record your physical activity. Do something every day. You will not reach your goal if you are not active every day. Even if it’s just 20 minutes going up and down the stairs in your house, make sure it’s something every day.

Sleep: Don’t underestimate the value of sleep. You need 7.5 hours every night. If you’re not sleeping enough, stress hormones will increase and so will your appetite. Record your sleep in your journal and you’ll be able to spot patterns.

The only way to know if you’re on track to reach your goal is to journal. When you don’t lose weight one week, we can say, “there’s the extra cookie and glass of wine, a missed workout, etc…” Journaling is the best way to stay honest with yourself.

Just another benefit of brightly colored berries. In the dead of winter, frozen berries are a great option. Pick up a big bag of frozen blueberries, frozen strawberries and mixed berries at your local Costco or Sam’s Club. Use in smoothies, oatmeal, mix with plain, nonfat yogurt and a dash of cinnamon or just thaw and enjoy!

What a tasty way to keep your blood pressure healthy!

Click the link below to view the full article:

I, Joan O’Keefe, hereby admit that I HATE to be cold. I am a California girl and I despise the cold. However, I’ll be the first to tell you that the weather is NO excuse for not exercising.

I’ve said it before – exercise is vital. You must do something every day. The benefits of exercise are only 25 hours long. Of course, exercise will help you lose weight, but the benefits of exercise are more than just the calories burned during your workout. Exercise makes you calmer, lowers stress hormones, it blows out the cobwebs, letting you think more clearly and making you a nicer person – Just ask my husband. There are times when he will get this look on his face and say as kindly as can be, “Joan, maybe you need to go exercise.” I am crabby, grumpy and generally unpleasant to be around if I haven’t exercised. He can tell if I need to lower my stress hormones!

Exercise also improves sleep and builds muscle. Building muscle is huge. If you are not exercising and using your muscles, you lose muscle and if you lose it, you’ll have to eat less because you’re not burning calories. Exercise increases your metabolism for the next 24 hours and you’ll burn more calories all day. Exercise + following the Forever Young Diet and Lifestyle + CardioTea (my personal secret weapon) + portion control all equal weight loss.

So, what’s a girl who hates the cold to do all winter long? Move the workout indoors. You always have a choice. Say you have four kids and you’re stuck indoors in an ice storm with no chance of making it to a gym. What do you do? Run your stairs! Do it for 30 minutes. I’m not talking taking laundry up a couple of times, I want you to put on your sneakers, start in the basement if you have one, and head to the top floor. Go downstairs and repeat – for 30 minutes straight. You’ll know you’ve done something after this.
I also suggest trying new classes. Winter is the perfect time for this. Many gyms run the best promotions of the year in January. Get in there and try a new class – you’re guaranteed to be with other beginners this time of year. Try yoga, pilates, even spinning. Just be sure to shake it up. Do something Tuesday/Thursday and something different the other days. Make it fun. Join an indoor pool. Let the kids play and then swim some laps yourself.

Now, if you don’t mind the cold, options abound for you. My husband, a North Dakota native, loves the cold. He finds early morning frigid temperatures exhilarating. So, if you’re like James and the cold doesn’t bother you, bundle up, get out there and skate, run or walk, or better yet, try interval training. Walk a block, run two, etc.

Please take my advice and don’t let old man winter keep you from exercising and being the best you can be!

We talk a lot about what to eat/what not to eat during the holidays. But what about drink options? Here are 6 healthy and festive options. Just remember, decaf after noon!

1. Chai Tea. An Indian spiced hot tea that is traditionally made with milk, chai also typically has a healthy dose of cinnamon. In recent years large coffeehouse chains have been offering their own versions of chai that are loaded with sugar, calories and fat. Try making your own healthy and delicious version by using a simple chai tea bag available at your local supermarket. It smells wonderful and tastes great, too. Try adding some skim milk or nonfat, plain soy milk.

2. Soy latte. Add plain, nonfat soymilk to black coffee (plain or decaf) for a very smooth, creamy feeling and delicious hot drink. This is my choice at my local coffee shop! Coffee is a terrific source of antioxidants and the nonfat soymilk makes this feel much more decadent than it is!

3. Red wine. A glass of red wine has potent antioxidant flavonoids and polyphenols that come from the purple grape pigments. The anti-aging compounds in red wine help reduce inflammation, and lower the levels of C-reactive protein (CRP)–a risk factor for heart attack. Keep in mind that although one or two 5 ounce glasses of wine can have health benefits, more than that can negate the effect.

4. White wine spritzer. White wine has polyphenols as well, although to a lesser degree. You can add tasty fresh fruit such as blueberries and strawberries to increase the antioxidant benefit. And if you want to try something different, add slices of kiwi, which also have organic compounds called phytonutrients that may help protect our DNA from oxygen related damage. Just one serving of kiwi contains more potassium than a banana, has the vitamin C of two oranges, and as much fiber as a bowl of bran!

5. Light beer. If you’re not a fan of wine, consider beer, especially pale ale. Some research finds that beer may provide high enough quantities of silicon to improve the formation of new bone growth, and to reduce osteoporosis. And as with other alcoholic beverages, beer provides the ethanol that studies suggest provide protective benefits against heart attack. Regular consumption raises protective HDL cholesterol, makes blood less likely to clot abnormally, and appears to even decrease the risk of developing diabetes. As always, beer is best taken in moderation, preferably no more than a single 12 ounce glass each evening.

6. Fruit sparkler. Keep it light and delicious with a holiday sparkler. Start with filtered carbonated water, and add 1 to 2 ounces of pomegranate juice. Then garnish with a slice of lime, and in keeping with the festive holiday spirit, fresh cranberries. According to a study reported in the National Academy of Sciences, pomegranate juice has a potent antioxidant effect, and may guard against atherosclerosis, or the hardening of the arteries, that can lead to heart attack and stroke. Pomegranate juice has been shown to promote the production of nitric oxide, thereby increasing blood flow, and reducing the effects of stress on our blood vessels.

Cheers!

1. Choose high-fiber, low glycemic index carbohydrates such as whole grains, legumes, vegetables and fruits.
2. Eat lean protein at all three meals.
3. Consume nuts on a daily basis, about one handful (with a closed fist). Eat with vegetables, berries or other fruits, or grains.
4. Eat as salad of leafy greens dressed with vinegar and virgin olive oil on a daily basis.
5. Avoid highly processed foods and drinks, especially those containing sugar, high-fructose corn syrup, white flour, or trans fats.
6. Keep serving sizes modest.
7. Avoid being overweight or obese; maintain a waist circumference less than one-half of height in inches.
8. Obtain 30 minutes or more of daily physical activity of at least moderate intensity.
9. Consider consuming one alcoholic drink before or with the evening meal (for those without a history of substance abuse).

Source: Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health by James H. O’Keefe, MD, Neil M. Gheewala, MS and Joan O. O’Keefe, RD. J Am Coll Cardiol, 2008; 51:249-255, doi:10.1016/j.jacc.2007.10.016

Those Halloween masks aren’t the only scary things on Halloween night. Watch out for these “frightening foods” as demonstrated in this WebMD slideshow. http://www.webmd.com/diet/slideshow-frighteningly-fattening-fall-foods?ecd=wnl_prg_101910