Month: October 2013

How bacteria with sweet tooth keeps us healthy

A new study is providing insights into the interaction between bacteria and mucus building mucins – proteins that have sugars associated with them – and how the specificity of these interactions affects health.

Dr Nathalie Juge and her team at the IFR have shown that the ability to use mucins in the human gut varies between different gut bacteria strains.

The IFR researchers looked at Ruminococcus gnavus. This is a common species of gut bacteria found in over 90 percent of people, including infants just a few days old. It has also been implicated in gut-related health conditions.

A number of studies have shown that patients suffering from Inflammatory Bowel Diseases have a disproportionate representation of R. gnavus.

This study looked at two different R. gnavus strains. Although both R. gnavus strains can use mucins, only one had the ability to survive when mucins were the sole source of food.

Comparing the genomes of the R. gnavus strains identified gene clusters used to breakdown mucins. Differences in these genes explain the different abilities of the strains to use mucins.

The mucin sugar structures change in different parts of the gut and over time, suggesting the strains may be adapted for different environments or to colonize us at different times.

A better understanding of which strains use mucins and exactly how they do this will give us new insights into what makes a healthy gut bacteria population, and how fluctuations from this might link to gut diseases like Crohn’s disease and ulcerative colitis.

The study has been published in the journal PLOS ONE

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Theatre could help autistic youth improve social deficits

A novel autism intervention program is using theatre to teach reciprocal communication skills to improve social deficits in adolescents with the disorder, a new study has revealed.

The newly released study assessed the effectiveness of a two-week theatre camp on children with autism spectrum disorder and found significant improvements were made in social perception, social cognition and home living skills by the end of the camp.

Called SENSE Theatre, the Social Emotional Neuroscience and Endocrinology (SENSE) program evaluates the social functioning of children with autism and related neuro developmental disorders.

Camp participants ages 8 to 17 years join with typically developing peers who are specially trained to serve as models for social interaction and communication, skills that are difficult for children with autism.

The camp uses techniques such as role-play and improvisation and culminates in public performances of a play.

Lead author Blythe Corbett, Ph.D., associate professor of Psychiatry and Vanderbilt Kennedy Center investigator, said that the findings show that treatment can be delivered in an unconventional setting, and children with autism can learn from unconventional ‘interventionists’ – their typically developing peer.

Corbett said that their findings show that the SENSE Theatre program contributes to improvement in core social deficits when engaging with peers both on and off the stage.

The study has been published in the journal Autism Research

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High altitude sickness: detected before physical symptoms

Researchers have found that hypoxia can be detected prior to the appearance of physical symptoms.

Jan Stepanek, M.D., the Aerospace Medicine Program Director and Co-Director of the Aerospace Medicine and Vestibular Research Laboratory, said that this study opens the door for objective assessments of hypoxia and additional safeguards for military and commercials pilots and others working in high altitudes.

Hypoxia is a lower than normal level of oxygen in your blood. To function properly, your body needs a certain level of oxygen circulating in the blood to cells and tissues.

When this level of oxygen falls below a certain amount, hypoxia can cause a variety of symptoms including shortness of breath, impaired speech, slowed reaction time and passing out.

The Mayo Clinic study team used the King-Devick neurocognitive performance test , commonly used to identify cognitive changes related to sports-related concussions, and to assess cognitive function under conditions of low oxygen-simulating altitude.

The King-Devick test assesses the time in viewing, identifying and reading aloud a series of numbers on three consecutive test cards. Based on test times of 25 participants, the study concluded that the King-Devick test is an effective tool to detect “impairment of cognitive performance at a presymptomatic stage of hypoxia.”

The findings have been published in journal Aviation, Space, and Environmental Medicine.

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First human trial of new bone-marrow transplant method

Doctors at London’s Great Ormond Street Hospital have carried out a pioneering bone-marrow transplant technique.

They say the method should help with donor shortages since it does not require a perfect cell match.

Mohammed Ahmed, who is nearly five years old, was among the first three children in the world to try out the new treatment.

He has severe combined immunodeficiency syndrome and had been waiting for a suitable donor for years.

Mohammed, who lives in Milton Keynes, was referred to Great Ormond Street Hospital when he was a year old.

We waited for a full match but it did not come. By the grace of God, we took the decision to have the treatment” Jamil Ahmed, Mohammed’s dad

His condition – a weak immune system – makes him more susceptible to infections than most, and a bone marrow transplant is the only known treatment.

While Mohammed was on the transplant waiting list, he became extremely sick with swine flu.

At that time, his doctors decided Mohammed’s only real hope was to have a mismatched bone-marrow transplant, with his father acting as the donor.

Mohammed’s dad, Jamil, agreed to give the experimental therapy a go.

Before giving his donation, Jamil was first vaccinated against swine flu so that his own bone-marrow cells would know how to fight the infection.

Mohammed’s doctors then modified these donated immune cells, called “T-cells”, in the lab to engineer a safety switch – a self-destruct message that could be activated if Mohammed’s body should start to reject them once transplanted.

Safety net

Rejection or graft-v-host disease is a serious complication of bone-marrow transplants, particularly where tissue matching between donor and recipient is not perfect, and is one of the most difficult challenges faced by patients and their doctors.

Mismatched transplants in children – where the donor is not a close match for the child – are usually depleted of T-cells to prevent graft-v-host disease, but this causes problems in terms of virus infections and leukaemia relapse.

The safety switch gets round this – plenty of T-cells to be transfused and later killed off if problems do arise.

Thankfully, the transplant carried out in 2011 was a success – Mohammed’s doctors did not need to use the safety switch.

Although Mohammed still has to take a number of medicines to ward off future infections, his immune system is now in better shape.

Jamil said: “We waited for a full match but it did not come. By the grace of God, we took the decision to have the treatment.

“Now he is all right. Sometimes we forget what he has been through. We are just so grateful.”

He said Mohammed would still need close monitoring and regular health checks over the coming years, but his outlook was good.

Dr Waseem Qasim, ‎consultant in paediatric immunology at Great Ormond Street Hospital and lead author for the study, said the new approach should hopefully mean children who received a mismatched transplant could enjoy the same chance of success as those given a fully matched transplant.

“We think Mohammed is cured of his disorder. He should be able to lead a fairly normal life now.”

A full report about Mohammed’s therapy and the research by Great Ormond Street Hospital, King’s College London and the Institute of Child Health has just been published in PLoS One journal.

There are currently about 1,600 people in the UK waiting for a bone-marrow transplant and 37,000 worldwide.

Just 30% of people will find a matching donor from within their families.

Donations involve collecting blood from a vein or aspirating bone marrow from the pelvis using a needle and syringe.

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Fat pledge ‘a drop in the ocean’

Someone eating a cheeseburger

A pledge by food manufacturers to cut saturated fat levels is “a drop in the ocean” in the fight against obesity, a top public health expert has said.

Morrisons, Subway and Nestle are among firms signed up to the voluntary “responsibility deal” between industry and government.

But Prof John Ashton, president of the Faculty of Public Health, said the approach “lacked credibility”.

The Department of Health (DoH) said it would “make a huge difference”.

It says the average man should eat no more than 30g of saturated fat a day, while the average woman should eat no more than 20g.

According to the British Dietetic Association, most people eat about 20% more than the recommended maximum levels – and a survey of 2,000 people for Sainsbury’s found 84% of those questioned did not know how much saturated fat was a healthy amount.

‘Healthy options’

The DoH said cutting the amount of saturated fat in people’s diets by 15% could prevent around 2,600 premature deaths every year from conditions such as heart disease and stroke.

Almost half of the food manufacturing and retail industry – based on market share – has signed up to this latest pledge to reduce the amount of saturated fat in products, the DoH said.

Measures planned by companies include Nestle altering the make-up of KitKat biscuits, Morrisons reformulating its range of spreads and Subway replacing biscuits and crisps in its Kids’ Pak with healthier options.

Other firms which are cutting saturated fat or have pledged to do so include Tesco, Sainsbury’s, Aldi and Mondelez International – which will alter products including its Oreo biscuits.

Prof Ashton said that, while it was “a good thing that some companies are making food that has less saturated fat than before”, the pledge did not go far enough.

Saturated fat

“They need to ensure that at the same time they lower the sugar and salt that they have used to make foods tastier as a result of lowering the fat content.”

He added: “This announcement is a drop in the ocean in comparison with the scale of the obesity crisis.

“We cannot rely on the voluntary approach of the responsibility deal to solve this problem.

“It now lacks credibility and can be seen as a feeble attempt by the industry to save face.”

Labour public health spokeswoman Luciana Berger said: “A few company names on a non-binding plan with no timescale stands little chance of delivering the fundamental change needed to improve our national diet.

“In the week that the chief medical officer warned of the long-term dangers of childhood obesity, we need to go much further.”

She said Labour had put forward “bold ideas to set legal limits on our food’s fat, sugar and salt content and achieve a cross-party ambition for a more physically-active nation”.

‘Huge progress’

Tam Fry of the National Obesity Forum, also called for regulation, adding: “The much-vaunted voluntary responsibility deal will never succeed until the government takes a grip and makes everybody sign up to it.”

The DoH said that “by reducing the amount of saturated fat in everyday foods, manufacturers and retailers are helping us lead healthier lives”.

“We have already made huge progress through the responsibility deal – there are reduced salt levels in many products, calories on high street menus and better information about alcohol units and drinking guidelines,” a spokesperson said.

“We know there is more to be done but today’s pledge will make a huge difference to our health.”

Prof Susan Jebb, chairwoman of the Responsibility Deal Food Network, said the manufacturers’ commitments to help reduce saturated fat were “an important step forward”.

The announcement of the pledge comes days after cardiologist Aseem Malhotra, a member of the Academy of Medical Royal Colleges’ obesity steering group, wrote in the British Medical Journal that the risk from saturated fat in non-processed food was “overstated and demonized”.

He said there was too much focus on the fat with other factors such as sugar often overlooked.

He told Radio 4’s Today on Saturday that “a sugary drinks tax, banning junk food advertising to children, ensuring compulsory nutritional standards in schools and hospitals… are things that are going to overcome the problems that we face”.

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Nestle to change Kit Kat recipe

KIT Kats are to undergo a recipe change in a bid to make the York-produced bars healthier.

Nestlé has announced that it is reformulating the Kit Kat following a three-year research program at its innovation centre in York.

The new recipe will see 0.4g of saturated fat cut from each two-fingered milk chocolate bar, the equivalent of 3,800 tones of saturated fat being removed from the nation’s diet.

The reduction has been made by changing the recipe of the wafer filling.

York’s Nestlé Confectionery factory in Haxby Road will manufacture the new bars, which will be on sale from early next year.

The move by Nestlé comes as the firm signs up to the Department of Health’s new Responsibility Deal Pledge on saturated fats.

Ciaran Sullivan, managing director of Nestlé Confectionery, said: “This is the next step on the journey where we are improving the nutritional profile of our products.

“Kit Kat is our biggest confectionery brand and therefore the obvious choice to identify a sat-fat reduction.

“Improving the nutritional profile of Kit Kat does not come at the expense of quality and taste and consumers will continue to enjoy the same Kit Kat as they have for over 75 years.”

Bosses say the new Kit Kats are the latest in an “ongoing commitment” to improve the nutritional composition of its confectionery portfolio. As a result of this all Nestlé confectionery chocolate biscuit bars are low in salt and meet the Responsibility Deal 2012 salt targets.

Nestlé has also reduced the portion size of many of its products such as Kit Kat, Aero, Yorkie, Lion Bar, and Rolo and is working to expand its range of 99-calorie biscuit bars, which last year included the addition of Blue Riband Caramel, Aero Biscuit Peppermint and Aero Biscuit Orange.

More than a billion Kit Kat bars are made in the York factory per year, with the site producing up to six million every day.

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FDA approves Abbott device for leaking heart valve

The U.S. Food and Drug Administration has approved Abbott Laboratories’ MitraClip medical device, used to stop heart valve leakage in patients deemed unable to endure valve repair through open heart surgery, the company said on Friday.

The MitraClip treats mitral regurgitation, a condition in which the mitral valve of the heart does not close properly, causing blood leakage that can lead to stroke, heart attack or even death.

It has estimated the disorder affects about one in 10 people aged 75 and older.

Those with the condition who are too frail for open heart surgery are typically treated with medicines and have high rates of heart failure and rehospitalizations.

“We think longer term in the U.S., (MitraClip) could be a $500 million product,” said RBC Capital Markets analyst Glenn Novarro. “This approval is sooner than we thought. It’s a pleasant surprise.”

Novarro said the timing of the FDA green light was excellent as it came just ahead of a major U.S. medical meeting for interventional cardiologists where Abbott will be able to showcase the device.

A panel of advisers to the FDA in March voted 5-3 to recommend approval of the implantable heart device. Some panel members questioned whether MitraClip would be effective.

The MitraClip was approved in Europe in 2008 under a system in which medical devices often reach the market several years ahead of the United States.

International sales are running at about $30 million a quarter, with sales growth at about 50 percent over 2012, Abbott said.

U.S. sales are likely to grow slowly at first as the company seeks reimbursement for the device, primarily from the Medicare healthcare program, and as more physicians are trained in its use. The MitraClip is implanted using a minimally invasive procedure in which it is threaded by catheter through a vein into place in the heart to stop the leak.

There are currently 50 centers in the United States that have experience with the device through clinical trials. That number is expected to double over the next year, John Capek, Abbott’s head of medical devices, said in an interview.

There are 20,000 to 30,000 patients in the United States who would likely qualify for MitraClip implantation, Capek said.

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HIV drugs may get new role in fighting cancer

A type of HIV medicine that stops the AIDS virus from entering immune system cells could in future be put to work against cancer in new combination therapies being developed by drug companies.

Interest in using so-called CCR5 inhibitors to fight tumors was fuelled last year when U.S. researchers, testing the drugs on mice, reported a marked reduction in aggressive breast cancer cells spreading to the animals’ lungs.

Researchers from the Thomas Jefferson University Kimmel Cancer Center described the results as “dramatic” after they were published in the Journal of Cancer Research.

Now industry analysts at Citi believe Merck & Co Inc is set to take things to the next stage by testing its CCR5 drug vicriviroc in cancer patients. The product was abandoned as a treatment for HIV in 2010 following an unsuccessful study.

Pfizer Inc and Bristol-Myers Squibb – which also have similar drugs in their portfolios – could follow suit, Citi said in a note on Friday.

Asked to comment on the suggestion that it would start testing vicriviroc in patients in 2014 as part of a combination therapy for cancer, a spokesman for Merck said: “We have not disclosed any such plans.”

Citi said it expected vicriviroc to re-enter clinical testing in combination with cancer immunotherapy as Merck explores its potential across multiple tumor types, including melanoma, colorectal, breast, prostate and liver cancer.

Immunotherapy, which harnesses the body’s immune system to fight cancer, is a hot new area for cancer research, with some experts predicting the approach will in future form the backbone of many cancer treatments.

However, drug combinations are expected to be critical to its success as oncologists will need to block cancer cells on several fronts at once.

One option is to combine two immunotherapies, while another approach, also being pursued by other companies like Roche Holding AG and AstraZeneca Plc, is to combine immunotherapy medicines with different drug types.

CCR5 inhibitors are one such option, given the encouraging signals from pre-clinical research. As these drugs have already been studied in HIV, their development could be relatively rapid.

Pfizer could also start clinical trials in cancer with its approved CCR5 drug Selzentry, which is currently marketed for HIV via the ViiV Healthcare alliance with GlaxoSmithKline Plc and Shionogi & Co Ltd.

Bristol, meanwhile, has a dual CCR2/5 inhibitor in mid-stage Phase II development, which is being tested for diabetes and kidney disease.

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7 Healthy Habits to Pass on to Your Kids

Turn everyday situations into opportunities to teach your children about healthy living

7 Healthy Habits to Pass on to Your Kids Intro

With 1 in 3 children and teens considered overweight or obese in the United States, it’s time to do something, and doctors agree that parents need to take the lead when it comes to educating children about staying healthy: Up to 90% of doctors agree that weight is the most important health topic for parents to discuss with their children, even more than safe sex, cigarette smoking, drug use, and alcohol consumption, according to the 2011 Raising Fit Kids survey by WebMD and Sanford Health. In addition to having an open dialogue, it’s important to lead by example. “Kids definitely take on the behaviors of their parents,” says Susan Bartell, PhD, a parenting and child psychologist in New York. To set your child on the right path, turn everyday activities like dinnertime, playtime, or grocery shopping into real-life lessons on health, nutrition, and fitness. Here’s how.

Leave Some Food on the Plate

In an attempt to make sure they don’t miss out on any nutrients, many parents ask kids to clean their plates, making them more likely to overeat later in life, says Sarah Krieger, RD, spokesperson for the American Dietetic Association and director of the Fit 4 All Kids program at All Children’s Hospital in St. Petersburg, FL. If your kids say they’re not hungry, wrap up their plates, says Krieger, but make them stay at the table until the rest of the family finishes (to avoid a situation in which they choose playtime over full tummy). And if they’re hungry later, warm up the plate of food instead of offering a snack.

Recognize the Difference between Hunger and Boredom

Even if you had to tape a stop sign on your fridge to get there, you learned to give yourself time to decide if you’re hungry or just need to pick up a hobby. Children shouldn’t have free access to the snack drawer, says Krieger, and should ask parents for permission to have a snack. “The first thing parents should offer is a piece of fruit and a reminder of the time for the next meal,” she says. If children are actually hungry, they’ll take the fruit. If they’re bored, they’ll wait until dinner.

 

Don’t Use Food as a Reward

Congratulating yourself with a sweet treat after a day of healthy eating is a little bit nuts. Rewards should help you work toward your goal—not against it, says Bronco. And making dessert—or anything edible—the pot of gold at the end of the eating rainbow could affect your child’s food preferences. One study published in the European Journal of Clinical Nutrition found that children who were rewarded with stickers for eating sweet red peppers consumed fewer pieces of the vegetable and had greater dislike for it than children who were told only that they could eat as much as they wanted. In other words, there’s a chance you could turn your child off broccoli if eating it puts him on the fast track to a brownie. If an after-dinner treat is standard in your household, downplay dessert by serving sweet, in-season fruit and small cookies only a few times a week, say Krieger.

Avoid Distracted Eating

Multitasking while you munch can lead to unwanted extra pounds. Distracted eaters—like those who surf the web or watch TV—have a hard time recalling what they eat, are less likely to feel satiated, and more likely to consume extra calories throughout the day, according to a study published in the American Journal of Clinical Nutrition. Good advice for adults and youngsters alike: Eat only when sitting at the table. No iPods, cell phones, or gaming systems allowed—just food and family. This helps encourage mindful eating, says Michael Bronco, a personal trainer and owner of Bronco’s Gym in Madison, NJ.

Stick to the List When You Go Grocery Shopping

Experts agree that shopping with a list helps you avoid fattening impulse buys and guarantees you have all the ingredients you need to make healthy meals. Get the kiddos involved in the grocery shopping by helping you compile the list, says Bronco. Make columns for proteins, fruits, vegetables, and whole grains, and ask your children to make recommendations for foods they’d like to eat that fit each category. It’s a great way to learn about the food groups and get familiar with the healthy options that fill them. It also doesn’t hurt that your kids get the sense that they “chose” the peas rather than feeling like victims of the vegetables on their plates.

Read Food Labels

Sneaky sugars and sodium can transform a seemingly harmless item into a diet disaster—that’s why reading nutrition labels is crucial to healthy grocery shopping. Turn a trip to the market into a nutritional scavenger hunt by asking reading-age children to find cereals with less than 8 g of sugar, canned soup with less than 300 mg of sodium, or a loaf of bread that clearly states it’s 100% whole grain. They’ll learn how to navigate a nutrition panel and be too busy to complain that the sleeve of cookies they wanted didn’t make it into the cart.

Find a Workout You Enjoy

Let’s face it, if you hate the gym you’re not going to go—and the same goes for your kids and soccer practice. “The adults who are most successful with their workouts found something they really love doing,” says Bronco. “It’s worth it to find an activity that your kid really loves, and if it becomes not so fun anymore, try something else. I think if you get too strict about sticking with one sport and it becomes a chore, you run the risk of turning your child off fitness completely.” When people are having fun, they stop worrying about how many calories they’re burning.

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Eat More Food, Lose More Fat

Some things are sadly predictable. Extra winter poundage, for instance. Or holiday binges. 3 o’clock slump which sags before you like a hammock every afternoon.

Here’s a happier prediction: Eat more often and you’ll avoid all of those problems. Spreading six smaller meals across your day operates on the simple principle of satisfaction. Frequent meals tame the slavering beast of hunger.

The secret? Each mini meal should blend protein and fiber-rich complex carbohydrates. “Protein and fiber give you that feeling of satiety and keep you from feeling hungry,” says Tara Geise, R.D., a nutritionist in private practice in Orlando and a spokeswoman for the American Dietetic Association (ADA).

Controlling hunger shrinks your gut. In a study published in the International Journal of Obesity, one group of overweight men was given five small meals, then was free to choose a sixth meal. A second group ate a single meal containing the same number of calories as the total of the other group’s first five meals, then later had a free-choice second meal. The six-meal men ate 27 percent less food at their last meal than the two-meal men did at their second.

Consistent eating will also keep your protein levels high, helping you build muscle. “Your body can metabolize only so much protein at one time,” says Katherine Tallmadge, R.D., author of Diet Simple. “Protein is metabolized better when it’s divided evenly.”

The challenge is keeping the mini meals mini. “It’s critical that at the end of the day, the calorie content of your mini meals does not exceed what you would eat in three larger meals,” says Jeannie Moloo, Ph.D., R.D., an ADA spokeswoman in Roseville, California. If you already know your calorie count, start eating.

With a suggested calorie count in hand, you can mix and match from the list of meals shown here. Yes, you can take two items from one meal list—if they’re small. Looking to lose? Choose lower-calorie options. Regular Joe? Be as flexible as you please. Building muscle? Double up on a couple of the items—have an extra slice of pizza or two containers of yogurt.

Breakfast: 6-8:30 a.m.

You’re sleepy, so we’ll keep it simple: Mix protein and quality carbs. “When protein is included in a meal, not only does it help prevent overeating at other times of day, but it also sustains energy levels and improves concentration,” says Bonnie Taub-Dix, M.A., R.D., C.D.N., an ADA spokeswoman.

This means choosing a milk-infused latte instead of plain coffee, or a slather of peanut butter along with the jelly on an English muffin. Do not leave home without breakfast—this is the foundation for the rest of your day.

1. 110 calories: Latte with reduced-fat milk
2. 140 calories: Skippy brand Squeeze Stick of peanut butter
3. 200 calories: 1 cup reduced-sodium cottage cheese with fresh peaches and cinnamon
4. 200 calories: 1 cup blackberries, blueberries, or strawberries with 6 ounces light yogurt and 1 tablespoon low-fat granola
5. 250 calories: Any-way-you-like-it egg on a whole-grain English muffin with melted cheese
6. 250 calories: Oatmeal made with milk instead of water; add brown sugar, walnuts, and/or any fresh or dried fruit
7. 260 calories: Cold whole-grain cereal, such as Kashi or raisin bran, with reduced-fat milk
8. 300 calories: Peanut butter and jelly on a whole-grain English muffin
9. 300 calories: Scrambled-egg burrito with turkey sausage and salsa
10. 300 calories: Two-egg omelet with spinach, mushrooms, and feta cheese
Morning Snack: 9:30-10:30 a.m.

Planning matters. If there’s nothing but junk in your workplace vending machines, buy the foods you need—string cheese, granola bars, trail mix, whatever—and keep a stash at your desk.

1. 80 calories: Stick of string cheese
2. 100 calories: Hard-boiled egg with a handful of grape tomatoes
3. 180 calories: Nature Valley granola bar
4. 250 calories: Ready-made reduced-fat smoothie, such as Stonyfield Farm
5. 250 calories: Clif bar
6. 275 calories: 2 or 3 small handfuls of trail mix
7. 290 calories: Kellogg’s Nutri-Grain bar with a handful of pistachios or almonds
8. 300 calories: Slice of whole-grain bread topped with peanut butter and banana
9. 300 calories: Small bagel with 2 slices of Muenster cheese, melted
10. 400 calories: Medium-size fruit muffin (best if made with whole-wheat flour)

Lunch: 12-1:30

Be careful here! If you’ve had only a latte, fruit, and some string cheese so far, go ahead and have a big lunch. But if you’ve already eaten 700 calories (an omelet and a muffin, say), keep lunch light. Whatever you do, eat slowly, no matter how un-American that seems. It’ll help you feel satisfied—and keep you that way.

1. 175 calories: Canned tuna with balsamic vinegar on whole-grain crackers or bread
2. 300 calories: 3 corn-tortilla flautas stuffed with refried beans and dipped in salsa
3. 350 calories: Half an avocado, sliced, or ½ cup prepared guacamole with tomato and onion in a whole-grain pita
4. 375 calories: Baked potato with chopped broccoli and a slice of American cheese, melted
5. 400 calories: Seafood salad in a whole-grain pita with diced tomato, cucumber, and onion
6. 400 calories: 3 or 4 slices of bacon, reduced-fat Cheddar cheese, thin apple slices, and peanut butter on toasted whole-grain bread
7. 400 calories: ½ cup hummus with roasted vegetables
8. 400 calories: Small ham-, turkey-, or roast-beef-and-Swiss wrap with vegetables and mustard, in a whole-wheat tortilla
9. 400 calories: Fresh mozzarella and tomato slices on a bed of greens, with balsamic vinaigrette and extra-virgin olive oil
10. 450 calories: Six pierogi with salsa or reduced-fat sour cream
Afternoon Snack: 2:30-3:30

Steer clear of the candy bowl on your P.A.’s desk. “You could eat four small chocolates for 100 calories,” says Geise, “or you could eat a cup of yogurt.” The chocolate gives you hardly any protein; the yogurt delivers 8 grams.

1. 160 calories: Reduced-fat Cheddar melted on apple halves
2. 175 calories: 5 Laughing Cow cheese wedges
3. 200 calories: ½ cup baba ghanoush (roasted-eggplant dip) with vegetables
4. 210 calories: Half a container of Cracker Jack
5. 250 calories: 1 cup reduced-fat yogurt
6. 250 calories: Small handful of chopped pecans over a cup of fruit salad
7. 260 calories: Apple, pear, or banana smeared with peanut butter
8. 300 calories: Cup of chickpeas with a dash of cumin and fresh mint
9. 340 calories: 2 ounces roasted nuts
10. 350 calories: 1 cup each fat-free milk and frozen yogurt blended with a spoonful of peanut butter
Dinner: 5:30-7:30 p.m.

Okay, this isn’t dinner as you used to know it. But don’t panic. At first, reining in meal sizes will seem strange. But portion control can make or break the plan. “This is crucial, whether you’re looking to control weight, manage blood sugar, or maintain energy levels,” says Tallmadge. And remember—you’ll be eating again in 2 hours.

1. 200 calories: 2 cups mixed vegetables (fresh or frozen) with ½ cup marinara sauce and some grated Parmesan cheese
2. 275 calories: 3 or 4 large handfuls of greens sautéed in olive oil with a handful of walnuts and ½ cup raisins
3. 300 calories: 6-piece sushi meal with a cup of miso soup
4. 325 calories: Buffalo burger topped with coleslaw, onion, and tomato
5. 350 calories: Quesadilla made with a small corn or whole-wheat tortilla, cheese, beans, shredded chicken or lean ground beef, onion, and jalapenos, and dipped in salsa
6. 400 calories: Slice of pizza topped with cheese and ground beef or ham
7. 400 calories: Turkey London broil cut into strips, sautéed with onion, red and orange bell pepper, and teriyaki sauce
8. 450 calories: Small plateful of nachos—baked tortilla chips, shredded reduced-fat cheese, refried beans, and salsa (plus some corn or black beans, if you want)
9. 500 calories: Lentil, minestrone, or tomato soup with a grilled-cheese sandwich on whole-grain bread
10. 550 calories: 1 cup pasta tossed with browned ground turkey breast, black olives, diced onion, a drizzle of olive oil, and 1 ½ tablespoons crumbled Gorgonzola cheese
Evening Snack: 8:30-10 p.m

Famished? Feeling as if this was the longest day of your life? Maybe your calorie count is too low. Adjust it by adding more sensible foods to your plan. Or try choosing higher-fiber foods; they’re digested slowly, so they’ll help you feel fuller longer.

1. 150 calories: 5 cups Jolly Time light microwave popcorn sprinkled with hot sauce and/or 1 tablespoon Romano cheese

2. 150 calories: 1 cup rice pudding

3. 150 calories: 6 or 7 strawberries dipped in yogurt and drizzled with chocolate sauce

4. 150 calories: 1 cup cocoa made with skim milk

5. 175 calories: Sliced sweet potato (with skin), tossed in olive oil and baked

6. 175 calories: 1 cup skim ricotta cheese sweetened with Splenda, vanilla flavoring, and a dash of nutmeg or cinnamon

7. 175 calories: Seltzer with 2 scoops frozen yogurt, a handful of berries, and a shot of flavoring syrup, such as strawberry or cherry

8. 200 calories: Root-beer float with 2 scoops frozen vanilla yogurt

9. 200 calories: 2 handfuls olives

10. 275 calories: 2-ounce Snickers bar

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