Ontrack with BARIX

JUNE 2011 on TRACK with BARIX Support to Keep You On Track With a Healthful Lifestyle

but change will happen slowly INCREASE your over time. Little can be done to alter the thermic effect of food. That leaves activity thermogenesis energy output as the component of energy output that we can fairly easily with NEAT manipulate. Exercise-related activity thermogenesis is an important aspect of the energy dependent upon age, weight, balance equation and a regular height, gender, body composition, exercise program is needed for diet and exercise, and can change most people to reach and maintain over time. For many people this is a healthy weight. Realistically, about 60% of daily caloric output. there is only so much time, energy and motivation one can devote to • The thermic effect of food an exercise program. Most of our (TEF) is the energy required to eight regulation is much time is spent working, taking care digest, absorb and metabolize more complex than the of our homes and families and food. This is about 10-15% of Wcalorie-in vs. calorie-out participating in leisure activities. daily caloric output. equation. There are a myriad of This then raises the question, factors that impact weight, and • Activity thermogenesis, you “Is there a way to move more once excess weight is gained it is guessed it, is the energy used during our daily activities to very difficult to reach and maintain for activity. It can be broken increase the non-exercise-related a healthy weight. Despite this, it down into two parts, exercise- activity thermogenesis (NEAT) and is still true that fat stores can only related and non-exercise-related enhance our energy output, and if increase when energy (calorie) thermogenesis (NEAT). Exercise- we can find ways to do this, will intake is greater than energy output, related thermogenesis is the it help us to reach and maintain and fat stores can only decrease energy used when engaged in a healthy weight?” Much of the when energy intake is less than aerobic dance, swimming, jogging, information we have about NEAT energy output. Obesity is the result bike riding and other forms of comes from Dr. James Levine of of a long-term energy imbalance of intentional exercise. NEAT is the the Mayo Clinic. months or years. The more we learn energy used in the activities of daily There are a host of factors that about the factors impacting weight, living; shopping, sitting, playing impact NEAT. Some are obvious, especially those that we can directly guitar, and walking throughout others not so much so. Let’s take control, the better we will be able to your workplace. NEAT can range a look at a handful of the factors. prevent and treat obesity. The focus from 15% of total daily caloric of this newsletter is on the energy expenditure in sedentary people • Occupation has a major role in output component of the energy to 50% or more in very active NEAT. Someone who engages equation of which there are three people. in manual labor for a living will parts: have much different NEAT than Energy output is a big part of the someone who has a desk job. • Basal metabolic rate (BMR) energy equation for weight loss and is the number of calories your maintenance. Take a look at the • Modern conveniences and body burns at rest to maintain three parts of energy output; the environments promote a normal body functions. BMR is basal metabolic rate can change, sedentary lifestyle. Examples of

this abound, from the motorized reason that it is so easy to regain Exercise is so much all walkway at the airport, the fast weight after having worked so hard food drive-through, elevators, about movement — getting to lose it. Scientists are not sure taxi cabs, suitcases with wheels, up from the television to run why this happens. and washing and jump and play. Sometimes • In the past, people have generally machines, been less active as they aged, to the more families are very sedentary, although this trend may be reversing recent online and they see it as too big of an with activity levels of seniors shopping. In increasing more than in young adults. addition, leisure obstacle ... but they don't Dr. Levine found that the average activities like have to go from sedentary to neighborhood person bu e people top 700 NEAT an hour-a-day workout. softball and calories on an average day). Obese dodgeball Tami Streich individuals move a lot less than games have normal-weight individuals, resulting largely been in less NEAT. If you set it up right, replaced by you may be able to burn up to 1,000 computer games, gaming systems, How Little Changes extra NEAT calories a day! Now that cell phones, and movies. Can Really Add Up! has got to have some implications for getting to and staying at a healthy Here are examples of how you can change your • Gender may play a role in NEAT weight. with boys generally being more daily routine to burn more calories: Simply put, to increase NEAT, active (higher NEAT) than girls, or Typical Day Calories burned the gender role of many women at the Office decrease sedentary time (sitting, who work outside the home and lying down) and increase standing also have the responsibility for the Park by building and and moving throughout the day. majority of the household work take elevator to your floor. 15 Some of these (higher NEAT). ideas you have Park 5 blocks from office heard before, • Education and income levels and take stairs to your floor. 80-120 but others may impact NEAT. Those with higher Make phone calls for an be new. education and income levels tend hour at desk. 15 to be more active than those with • Use a lower education levels. Take calls standing up and pedometer pacing. Put notepad on bookcase to track the • Weather and climate impact NEAT. or filing cabinet to take notes number of People tend to be less active when without bending down. 100-130 steps you take it is cold, cloudy, raining, snowy throughout Seated 45-minute lunch. 25 or otherwise unpleasant to be the day. This outdoors. NEAT can increase by Walk 30 minutes at lunch; will let you 50% when weather is conducive to sit and eat 15 minutes. 100-130 know how outdoor activities. Seated 1-hour meeting. 15 much you are moving throughout • Those with a higher body weight the day. An initial goal is to build will use more energy moving than 1-hour walking meeting. 150-200 to at least 10,000 steps a day, those with a lower body weight. Take elevator to ground floor. but some people will require up to • Those who have lost weight use Walk to car. Drive home. 15 15,000 steps a day to maintain a healthy weight. about 15% less energy during Take stairs out of the building, physical activity compared to walk back to car. 80-100 • Take the stairs when possible. Start those who have a stable weight. with one flight up or two flights This means that a 150# woman Typical day total: 85 down and build your strength and who just lost 30# will expend less Picking up the pace total 510-680 endurance. If you are going up energy walking the same distance several flights, walk one or two and than a 150# stable-weight Source: Adapted from Move a Little, Lose take the elevator the rest of the a Lot by James Levine and Selene Yeager woman. This may be part of the way.

• Walk or bike rather than drive when possible. This works great In the News for short errands when you live in Those 65 and older are not at greater risk for side a city or town. effects when undergoing weight loss surgery. • Walk while you talk with your More older people are undergoing bariatric co-workers. Rather than calling, surgery and the good news is that the research exchanging emails or chatting at confirms that surgery can be done safely. Seniors your workstation, walk down the may face an insurance challenge with Medicare to hallway or to the water cooler to have the procedure covered. See the full story: discuss your business. http://www.nlm.nih.gov/medlineplus/news/ fullstory_111854.html A man's health can be judged by which he takes two at a time — pills or stairs. The Treadmill Desk Joan Welsh f you like the idea of the treadmill desk, but don’t have $5,000 sitting around, • Walk at lunch. If you take your you can build your own. There are a lot lunch, rather than standing in the I of different versions of the treadmill desk cafeteria line, you may find that from the very simple to the quite elaborate. you have a few minutes to spare You may want to start with something for a 10 minute stroll. homemade and simple and then learn from • Put a treadmill or stepper in front the experience and upgrade if you find that of your TV and take a leisurely you like your new “mobile” office. Here are stroll as you watch your favorite some links to pictures and instructions to programs. get you started: • Add a • Build your own treadmill desk for workstation to $39.00 (http://www.treadmill-desk. your treadmill and com/2007/06/anders-burvall.html) walk at a leisurely • Build a detached desk (http://www.treadmill-desk.com/2007/06/ 1.1 mph rate. This step-2-building-your-desk-design-2.html) is a novel idea that would be • Dr. Levine talks about the treadmill desk (http://www.youtube.com/ sure to decrease watch?v=wiw-7-zY9iQ) sedentary time for many of us. Even • NY Times article (http://www.nytimes.com/2008/09/18/health/ if you are unable nutrition/18fitness.html) to do this at your • Walkstation (http://details-worktools.com/products/ place of work, you walkstation/?gclid=CIrgtMHU_qgCFcbc4AodKT1HUQ) could do it at home while you pay the bills, update your Facebook page, shop online, or even play computer games. Some Exercise is a journey, companies are embracing these new workstations—workers burn not a destination. 100 calories an hour, are more focused, and have more energy throughout the day. journey • Stand or walk in place while talking REQUEST on the phone. A FREE BROCHURE • Meet your buddies at the park for a for you or a friend. Call us at walk rather than going out to eat or 800-282-0066, or log on to talking on the phone. www.barixinfo.com

Asparagus Chipotle Citrus Featured Frittata Pork Tenderloin Product

2 teaspoons olive oil 2 pork tenderloins, about 1 pound each, ProFuse is now available 1 small onion, thinly sliced halved crosswise in 2 oz protein shots 1/2 teaspoon salt 1 cup orange juice for just $4.00 each or 1 pound asparagus, tough ends 6 tablespoons fresh lemon juice $42.00 for a case of 12 snapped off, spears cut diagonally 6 cloves garlic, smashed or the original 16 serving into 1-inch lengths 2 shallots, chopped 1 cup egg substitute, lightly beaten 2 dried chipotle chilies, crushed into container for $2.00. 1 cup shredded Swiss cheese small pieces with your hands Packed with essential Vitamins B12 1 tablespoon olive oil Heat olive oil into a 10-inch ovenproof and D3, ProFuse is a concentrated Kosher salt and freshly ground black high-dose protein shot broken down frying pan over medium high heat. pepper to be quickly absorbed into the body. Add onions and salt and cook, stirring 3/4 cup low sodium chicken broth occasionally, until onions are softened, 2 tablespoons chopped fresh cilantro With 10 times more protein, 2 times about 3 minutes. Add asparagus, more B12 and 1000 times more reduce heat to medium-low, and cook, Mix orange juice, lemon juice, garlic, Vitamin D3 than 5-hour energy covered, until the asparagus is barely shallots and chilies in a small bowl. Pour drinks, ProFuse is the ultimate tender, 6 to 8 minutes. Pour in egg over tenderloins and let sit for 20 minutes protein infusion. substitute and cook until almost set, at room temperature. Preheat oven to but still runny on top, about 2 minutes. 400 degrees. Following 8 years of development While cooking, pre-heat oven broiler. with Medical Nutrition, Dr. Schram Heat olive oil in a large, ovenproof skillet is happy to introduce ProFuse — a Sprinkle cheese over eggs and put in over medium-high heat. Remove the oven to broil until cheese is melted vitamin-infused liquid hydrolyzed tenderloins from the marinade, reserving and browned, about 3 to 4 minutes. the marinade. Wipe the tenderloins dry protein that tastes great. The Remove from oven with oven mitts with a paper towel and season with salt response from bariatric patients and slide frittata onto a serving plate. and pepper. Add to the skillet and cook, has been overwhelming. Every one- Cut into wedges. Makes four servings. turning as needed, for 4 to 5 minutes, ounce serving of ProFuse contains: NUTRITION INFORMATION until evenly browned. Transfer to the PER SERVING: 206 calories, 17 oven and roast for 12 to 15 minutes, until • 10 grams of protein: vital to energy grams protein, 12 grams fat, 5 grams they reach an internal temperature of 160 production, the regulation of carbohydrate, 304 mg sodium. degrees. Remove tenderloins from skillet metabolism and digestion and cover loosely with foil to keep warm. • 1000mcg of Vitamin B12: the Pour remaining marinade into skillet, add energy vitamin, essential for chicken broth. Bring to a boil over high supporting the body’s immune heat and cook for 8 to 10 minutes, until system reduced and thickened. Pour through a fine-mesh sieve into a bowl. • 1000IU of Vitamin D3: helps maintain strong bones, decreases Cut tenderloins across the grain into thin risk of cancers and infectious slices and arrange on a platter. Drizzle diseases sauce over top and sprinkle with cilantro. Serve. Makes 6 servings. • Only 48 calories, 2 carbs and fat free NUTRITION INFORMATION • Lactose and gluten free, a certified PER SERVING: 219 calories, 32 kosher product grams protein, 7 grams fat, 4 grams carbohydrate, 313 mg sodium. • Made in the USA

This month, you could earn a SPECIAL GIFT for your “It Worked For Me” tips or recipes! Just submit as many recipes and “It Worked For Me” tips as you like. The REWARD most original and creative will be awarded a special gift from our online store. Include your name and contact info with your entry—make sure your recipes follow YOURSELF Barix nutritional guidelines. Tips must be submitted by June 30, 2011. Please send comments, ideas, recipes and “It Worked For Me” tips to Deb Hart, RD, LD at [email protected].

©2011 Forest Health Services. All rights reserved. Unauthorized duplication or modification is prohibited. Page 5 SUBSCRIBE Protein Drinks to How do you find a protein drink that you look forward to each On Track With Barix day? For this and other valuable advice and feedback from other Barix SUGAR-FREE FINGER JELLO www.barixclinicsstore.com/ patients, visit forum.barixclinics.com. WITH FAGE YOGURT newsletter_sign_up.html A member posted this on the Barix 1 large box sugar-free jello forums and received the following 1 3/4 cup water feedback (edited): 4 Knox gelatin packets Posting: I absolutely hate protein 2-7 oz containers of Fage 0% RECONSTRUCTIVE drinks. I don’t know if it is the smell 1 protein bullet, flavor that or what but when I was on full liquids, complements the jello flavor it was all I could do to get those SURGERY down. And when I got on soft foods, Heat 1 cup of water to boiling. forget those shakes. But now I am not Meanwhile, put remaining 3/4 cup of cool water in a bowl and sprinkle the To receive a FREE RECON- getting enough protein in. Any ideas? Knox gelatin over top. When water STRUCTIVE SURGERY Response 1: Have you tried the comes to a boil, stir in jello until guide, call 800-282-0066 premixed ones like Slim Fast Low dissolved. Add jello mixture to the or send us an email at rc@ Carb or Atkins? I think they taste gelatin and stir until it is all dissolved, better than the powdered stuff and stir in the protein bullet, stir in the barixclinics.com with your name are thinner with no lumps. I still drink and contact information. Our Fage yogurt. Pour into a 9x13 pan. one a day to help get in the protein. Cover and refrigerate until set. Cut reconstructive surgery program Response 2: I couldn’t agree with into 24 pieces. Each piece has 25 is currently performed at our you more! About the only one I can calories and 4.5 grams of protein. centers in Michigan, Ohio, and stomach is the chocolate with peanut Response 5: I tried a couple protein Pennsylvania. Call us today for butter & milk. It makes a lot. I freeze powder shakes today with great more information! the other portion and pretend I’m success! The first one I had was a 6 eating ice cream...lol. oz container of Fage 0%, 1/2 cup skim Response 3: I was able to do milk, one scoop Nectar Caribbean the berry shot of fruit punch (New Cooler powder, 1/2 a banana and a Whey). I have to put that in a glass few ice cubes blended. I also tried SHARE YOUR with some light Hawaiian Punch. 1 scoop chocolate protein powder, 1/2 cup skim milk, 4 ice cubes, 1 Response 4: You do not need to Tbsp of peanut butter blended. It was SUCCESS use the protein powders to get your FABULOUS. Tell us about how your life has protein in, although it is hard in the changed as a result of your weight early without using them. Adding ice Response 6: I buy Premier Protein loss surgery. Your story may be in the blender helps immensely. The shakes from Costco! They are $24 for Any Whey protein powder that Barix 18 shakes (chocolate or vanilla) and printed in this publication or on one sells is virtually tasteless and pretty each shake has 30 g of protein. That’s of our websites and can serve as an much doesn’t change the consistency almost half my protein intake for the inspiration to others. of anything you put it in. day, and I just drink it on the way to work. Super easy and delicious! Submit your story online (http:// Here are two of my favorite Response 7: I wasn’t really into the www.barixclinicsstore.com/share_ protein-packed recipes: protein drinks until I found Syntrax’s your_story.html). PUMPKIN SHAKE Matrix Mint Cookie. Barix sells it. I love it! I use a half scoop of the We’d love to hear from you. ¼ cup pure pumpkin puree 3 Tbs Splenda granular powder, 1/2 cup milk and a few 1 heaping scoop vanilla protein frozen strawberries. It is delicious! powder I have also had it with a half banana ½ tsp pumpkin pie spice or cinnamon instead of the strawberries and that QUESTIONS ¼ cup Coffeemate Hazelnut Liquid is good too. ABOUT FINANCING Sugar Free Creamer Response 8: I’ll second the Syntrax’s 1 cup water Matrix Mint Cookie shake. That is my YOUR SURGERY? 6 ice cubes new favorite right now. I use one scoop in 12oz of skim milk to give Call a Barix Patient Combine all ingredients in blender— me 35g of protein. It tastes like you Service Representative pulse until smooth and frosty. Serve are eating melted mint chocolate chip at 800-282-0066 with dusting of cinnamon on top and cookie ice cream. Throw it in the a dollop of sugar-free Cool Whip. freezer for a bit and it’s even better! This has 28 grams of protein. It’s so good it shouldn’t be legal.