Fitness, Nutrition

Ask the Dietitian: What is Your Opinion of the Ketogenic Diet?

Full-fat everything you want — it sounds like a dream diet to lose weight on, right? The ketogenic diet, or keto diet for short, has risen to diet trendom. Health-wise, the ketogenic diet has also been shown to be beneficial for mental disorders, epilepsy, type 2 diabetes  and even weight loss. Even so, this diet is quite controversial.

Let’s explore this diet together, so you can make an informed decision for your personal health.

WHAT IS THE KETOGENIC DIET?

The ketogenic diet is a high-fat, low-carb and moderate protein diet. Despite recent popularity, the “classic” KD has been used for almost 100 years to treat children with epilepsy. It was later adapted into the well-known commercial weight-loss program, the Atkins diet. Different versions of this diet exist, but these two are among the most common:

  • Classic Ketogenic Diet: This diet uses a ratio of 3:1 or 4:1 for fat to nonfat (Think: protein and carbohydrates) in grams.
  • Modified Atkins Diet: This diet restricts carbohydrates to 20 grams of “net” carbs daily. “Net” carbs are defined as total carbohydrates minus dietary fiber.

Take a look at the chart below to see how the KD stacks up against what experts recommend; the difference is drastic. Keep in mind that the definition for a “classic” KD may be different than what people who practice a more mainstream ketogenic lifestyle for weight loss will consume. A modified version of the KD is more flexible on the number of carbs you can have in a day, so low-carb vegetables (think: broccoli, spinach, lettuce) won’t count against you. High-fat, keto-friendly foods include those higher in saturated fat (e.g., bacon, cheese, butter) and lower in saturated fat (e.g., olive oil, avocado, nuts and seeds).

*Note: A well-balanced diet rich in fruits, veggies, whole grains, lean protein and healthy fats will likely have a macronutrient (e.g. fat, protein, carbs) profile within the “acceptable macronutrient distribution range” (AMDR).

HOW DOES THE KETOGENIC DIET PROMOTE WEIGHT LOSS?

You may wonder how eating up to 90% of your calories from fat while turning a blind eye to calories can lead to weight loss. Nobody knows exactly but researchers have a few good guesses:

  • Fuel Switching. Eating a lot of fat and severely limiting carbs pushes you into “ketosis,” a state where mostly fat is burned instead of carbs. Even the brain, an organ that preferentially uses glucose (a sugar) for fuel must adapt to using fat in the form of ketones.
  • Appetite Control. Those on the KD claim it dampens their appetite. This is because ketones may play a role in signalling satiety within the brain.
  • Metabolically Expensive. Just because you transitioned into ketosis and can burn fat more efficiently doesn’t mean your body won’t need carbs at all. To keep blood sugar within a reasonable range, the liver converts protein into glucose through a process called “gluconeogenesis.” OK, biology lesson stops here. Just know that this process demands a lot of energy and burns an additional 400–600 calories daily.

The KD may be great for short- and medium-term weight loss, but there’s no clear outlook on what it will do to your health in the long run — and this puts many experts on edge.

WHY IS THE KETOGENIC DIET SO CONTROVERSIAL?

The US News expert reviews give the KD about 2 out of 5 stars. Right off the bat, here are two major reasons why this diet sank so low:

  1. It promotes foods high in fat, even saturated fat, which is bad for heart health. A diet that puts few limits on bacon, butter and full-fat cream automatically draws backlash.
  2. It can eliminate whole food groups if followed stringently. This includes high-carbohydrate vegetables, most fruits and whole grains. This could lead to nutrient deficiencies in the long run.

READ MORE > EVERYTHING YOU NEED TO KNOW ABOUT THE DASH DIET 


ARE THERE ANY BENEFITS?

Despite the controversy, let’s balance pros and cons. Yes, the KD is solid therapy for children with epilepsy, but they’re always under careful clinical supervision to correct for any micronutrient deficiencies. The KD is showing promise as therapy for Type 2 diabetes, cancer and neurological disorders such as Parkinson’s, Alzheimer’s, autism, etc. but the science isn’t yet well-established. The same applies for long-term weight loss.

THE VERDICT

Hopefully I’ve given you enough food for thought. In my opinion you should still try to lose weight first by following a well-balanced diet full of fruits, vegetables and whole grains. But, to be frank, I’m flexible on the ketogenic lifestyle, especially if you’re pursuing this diet with the help of a qualified health professional.

Clearly, the KD is restrictive and isn’t for everyone. Be realistic about whether this diet will align with the lifestyle you want. If you have a sweet tooth or love your fruits and veggies, you will likely struggle on keto. Those who are vegetarian or vegan will also find the KD challenging.

Finally, just because the diet is a poster child for all-you-can-eat bacon doesn’t mean you have to eat this way. There are healthy fats to choose including avocado, olive oil, walnuts and fatty fish.

by Trinh Le, MPH, RD

My humble opinion on the matter is that while Keto might be a great kick-starter for your weight loss goals, I don’t see this diet as sustainable (or healthy) for the long term. I firmly believe “balance is best,” and that includes real food from all the food groups in proper portions. You don’t need to restrict food groups or count calories when you follow my favorite resource for healthy eating – 90/10 Nutrition. Start with 90/10 first. You might find like me that you can “Eat like this forever!”

Fitness, Nutrition

How Can I Prevent Kidney Stones?

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I don’t know about you, but kidney stones sound absolutely awful. I hope I never get them. But entering “middle age” means my chances increase, which is why taking preventative measures now is important. Maybe following the advice of this article will help. Have you ever had kidney stones? Article copied in entirety from sources at bottom.

 

You may have heard the old line about kidney stones: These, too, shall pass. The better idea is to not get them at all. And that’s not as hard as it may seem.

With the right foods, plenty of water and proper medication, you can lower your chances of kidney stones. Maybe you’ll find they’ve passed right out of your life.

Who Is More Likely to Get Them?

“Kidney stones” is a one-size-fits-all term for what are actually different types of small, solid crystals. A number of things can cause them. Some are related to kidney infections. Others form because you have too much of certain minerals in your system.

Genes can play a role, too. Of the people who get kidney stones, 40% have a family history of them. Their bodies may create too much calcium or too little citrate (a chemical found in citrus fruits).

Other conditions that make kidney stones more likely include:

  • Obesity. When you’re overweight, you tend to get them more often.
  • Surgery. If you’ve had gastric bypass surgery or other intestinal surgery, your chance is higher.
  • Disease. One example is polycystic kidney disease, in which clusters of cysts grow in your kidneys.

Kidney stones are mostly associated with middle-age men, though they can affect people of any age or gender.

Things to Watch Out For

Even if you’re in good health, there may be other things going on that make the growth of kidney stones more likely.

One of the first things to look at is water. If you’re not drinking enough, you may not be making enough urine. That means they have more chance to form.

Other things to watch:

  • Colas. These beverages are high in phosphates, which may lead to kidney stones. (The sugar doesn’t help).
  • Oxalates. These are organic compounds found in a number of foods — including healthy plant-related ones such as spinach and sweet potatoes. However, oxalates also bind easily to certain minerals, including calcium. Calcium oxalate crystals are the leading source of kidney stone creation.
  • Salt and sodium. If you have a high-sodium diet, you’re more likely to have more calcium in your pee. Most people get their sodium through salt, so lots of salt means a greater chance for kidney stones. However, calcium intake itself is not a bad thing — just when it’s combined with high sodium. In fact, too little calcium in your diet may lead to kidney stones in certain people.
  • Too much animal protein. Too many steaks (and chicken, eggs, and seafood) can build up uric acid in your body. That’s another cause of kidney stones.
  • Previous cases of kidney stones. If you’ve had them once, you’re likely to get them again — unless you’re proactive.

Things You Can Do to Help Prevent Them

Being proactive means taking your medication, if you’ve been prescribed any, and taking charge of your diet. Other things you can do:

Drink plenty of water. Stay hydrated, especially when you exercise.

Check labels. Look at the packaging in the grocery store. Avoid or eat less of foods that have hidden things such as monosodium glutamate (MSG), sodium bicarbonate (baking soda), and sodium nitrate.

Cut back on certain foods. Usually you want to get more spinach and nuts in your diet, but your doctor may advise watching out for these or other foods if you have had a certain type of kidney stones. Here are some other foods rich in oxalate and phosphorus that you may be told to watch out for:

  • Cheese
  • Chocolate
  • Ice cream
  • Liver
  • Oat bran muffins
  • Oysters
  • Yogurt (Greek-style is OK)

Eat citrus fruits. Lemons and limes are high in citrate, which helps prevent kidney stones.

SOURCES:Harvard Health Publications: “5 Steps for Preventing Kidney Stones.”Mayo Clinic: “Diseases and Conditions: Kidney Stones,” “Polycystic kidney disease.”National Institute of Diabetes and Digestive and Kidney Diseases: “Diet for Kidney Stone Prevention.”University of Wisconsin School of Medicine and Public Health (uwhealth.org): “Urology: Genetic Heritability For Kidney Stones.”American Kidney Fund: “Who is at risk for kidney stones?”University of Utah Health Care: “Can Women Get Kidney Stones?”Harvard Medical School: “5 steps for preventing kidney stones”Children’s Hospital of Philadelphia: “Kidney Stones Are on the Rise Among Youth, Especially in Females and African-Americans.”National Kidney Foundation: “6 Easy Ways to Prevent Kidney Stones.”National Kidney Foundation: “Phosphorus and Your CKD Diet.”Clinical Journal of the American Society of Nephrology: “Soda and other beverages and the risk of kidney stones.”The Cleveland Clinic: “Kidney Stones: Oxalate-Controlled Diet.”Urology: “Can Sexual Intercourse Be an Alternative Therapy for Distal Ureteral Stones? A Prospective, Randomized, Controlled Study.”

Reviewed by Melinda Ratini, DO,MS on 12/9/2016

Fitness, Nutrition

Why Am I Not Losing Weight?

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Please enjoy this excellent article by Kara Wahlgren.

 

In theory, weight loss should be easy: Watch what you eat, work up a sweat, and reap the rewards.

But losing weight doesn’t always seem that simple. You can feel like you’re doing all the right things — and you might lose some weight at first, but then you might reach the dreaded weight-loss plateau.

I’m sure you’ve been there: You’ve followed your diet to a T, you’ve cut calories, you work out regularly, and you’re still not losing weight. When you’re putting in the work and still not dropping pounds, well, that’s mind-numbingly infuriating. Unfortunately, it’s not uncommon.

Don’t give up. Below you’ll find 10 reasons why the number on the scale might be stuck, as well as some suggestions on how to help you start losing weight again.

And, remember, it’s a journey. Even before you reach your goal weight by committing to a healthy lifestyle, you’ll start feeling stronger and learning to fuel your body with the right foods, and you might even find a workout you love!

10 Reasons You Might Be Struggling to Lose Weight

Losing weight takes work, but the rewards are worth it: a healthier heart, more energy, and checking yourself out in the mirror (and liking what you see), just to name a few.

1. You Have Unrealistic Weight-Loss Expectations

To be successful with losing weight, you have to have realistic and healthy expectations. And patience! You didn’t put on all the extra weight in a week or month, and you aren’t going to lose it all in a week or month either. And that’s OK.

Also, you might find that you are not actually losing weight but your body composition is changing, so the number on the scale might not be going down as fast as you like. Most scales don’t accurately reflect how much water you have in your system, how much body fat you’ve lost, or how much muscle you’ve gained. That’s why we encourage you to take “before” and “after” photos and to take your measurements.

When you lose body fat, you’ll be able to see it in how your clothes fit and in your pictures. Take a look at these “before” and “after” results to see what we mean!

“Often, I see clients get impatient and, if they don’t lose weight almost immediately, they change their regimens,” says Wesley Delbridge, R.D., a spokesperson for the Academy of Nutrition and Dietetics. “However, they may have been on the right path to begin with; they just needed to give it more time.”

2. You Don’t Eat Enough Food

Super low-calorie and elimination diets — like those that are probably clogging up your social media feed right now — ignore the fact that food is fuel. Calories, including often-maligned carbohydrates and fat, are required for you to live and breathe… let alone to lose weight in a healthy way.

“Because our body weight is regulated by multiple systems, starving ourselves activates the body’s protective mechanisms to defend our body’s weight,” says Ethan Lazarus, M.D., a board member of the Obesity Medicine Association.

“One of these mechanisms is dropping the metabolism as low as possible. In general, we recommend, unless under medical supervision, not keeping your calories below 1,200 calories per day.”

3. You’re Not Eating Carbohydrates (or Protein or Fat)

For a healthy diet — whether or not you’re trying to lose weight — the calories you eat should come from a combination of healthy carbohydrates, proteins, and fats, explains San Diego bariatric surgeon Julie Ellner, M.D.

Whole-food sources of unrefined carbs (ex. legumes, fruit, and raw veggies) are vital to keeping energy levels up so that you can crush your workouts. The fiber found in these carbohydrates (versus, say, a croissant), will help you stay full and help you be less likely to snack on something unhealthy.

In addition, when you eat too few carbs, your body doesn’t stock as much glycogen, the stored form of your body’s primary fuel source, glucose. And since each gram of glycogen is stored with three grams of water, the scale will reflect that reduction in water weight. But that’s all it is: water weight. So, while the lower number might be encouraging, it doesn’t reflect your progress toward your ultimate goal: fat loss.

In addition to losing primarily water weight, cutting back too far on carbs can leave you chronically low on energy, which can hamper your weight-loss efforts by keeping you more sedentary and lowering your workout performance.

You also need protein and fat. Both will help you feel full, but fat also helps regulate your hormones and protein is vital to building lean muscle mass, the primary determinant factor of your metabolic rate, Ellner says. The more muscle you have, the faster your metabolism will be.

4. You’re Not Working Out Hard Enough

When you go for a jog or long, slow bike ride, you burn calories, but your metabolism settles back to normal soon afterward. That’s one of the reasons high-intensity exercise like the kind of metabolic conditioning you’ll find in Beachbody programs such as CORE DE FORCE and 22-Minute Hard Corps is superior for weight loss. Not only do you burn more calories during every minute you work out, but your metabolism also remains elevated for days instead of hours.

5. You Only Do Cardio Workouts

When most people want to lose weight, the first thing they turn to is the treadmill, aka the “dreadmill.”

Hating your workout isn’t going to help you stick with a workout routine. And, you may find you have better luck losing weight if you take the emphasis off steady-state cardio and focus more on strength training.

According to one large-scale study from the Harvard School of Public Health, people who spent 20 minutes per day strength training gained less belly fat over the course of 12 years compared to those who logged the same number of minutes doing cardio.

“Even if following a healthy diet for weight loss with adequate protein, we don’t lose 100 percent fat,” says Lazarus. “We lose part body fat and part lean body weight (muscle), and losses in lean body weight can result in the metabolism slowing.”

“Strength training — whether it’s with weights, yoga, Pilates, or any other resistance-based workout — is important to preserve lean body weight and metabolism. Think about it: Weight training gives your body a bigger engine. That bigger engine burns more gas getting you around town,” Lazarus explains.

Cardio can certainly be a part of your weight-loss routine, but try to include weight-lifting sessions and bodyweight circuits into your routine several times per week.

6. You’re Trying to Change Your Whole Lifestyle At Once

Going on a diet sounds like it’s just one simple change. But, in reality, following a healthy diet and weight-loss plan may include shopping for new foods, learning new recipes, changing how you spend your time after work, potentially getting up earlier to work out, increasing your step count, fighting cravings for junk food , drinking more water, and so much more.

That’s a lot to take on at once and can leave you feeling overwhelmed.

That’s why a habit-based approach can help, especially for those who have a history of going on and off diets. A review from experts at the University College London’s Health Behaviour Research Centre shows that habit formation is vital to making sustainable, long-lasting changes.

Try focusing on changing one thing at a time, and practicing that change until it’s really cemented, and then work on adding in the next one. Some good examples of healthy changes:

  • Aim to eat vegetables in at least two meals each day

7. You Don’t Pay Attention to Your Body’s Cues

Trying to belong to the clean-plate club can hinder your weight-loss efforts because it ignores your body’s way of regulating food intake: namely, hunger and satiety.

“Paying attention to how each bite makes the body feel is critical to getting in touch with how much food we actually need, as well as what types of foods make us feel good and energized versus fatigued,” Ellner says.

She recommends eating when you are slightly hungry and to stop eating when you are slightly full. Although a 2014 Public Health Nutrition review suggests intuitive eating is a better tactic for weight maintenance versus weight loss, it has been shown to improve mental health and physical health factors other than body mass index.

If you find yourself gravitating to the kitchen or your desk’s snack drawer, ask yourself, “Am I really hungry?” Often we eat out of habit, boredom, and stress. (Or because we’ve confused hunger with thirst!)

As you eat, nixing distractions such as the TV, computer, and phone can really help you hone in and recognize when you’ve eaten just enough, Ellner says.

8. You Eat More Than You Think You Do

“When people track their food intake for the first time, they are usually shocked to see what they are really eating throughout the day,” says board-certified family and bariatric physician Spencer Nadolsky, D.O., a diplomat of the American Board of Obesity Medicine.

You don’t have to do it forever, but tracking every single thing you eat for as little as a week can help raise awareness of what you are eating and where you are getting excess calories or sugar, Nadolsky says.

Make sure to track everything — those little taste-test bites you take while cooking or handfuls of candy from your coworker’s desk add up.

Plus, if you add a “notes” column to your tracker or food journal, writing down how you felt prior to each meal can help you learn how your emotions, energy levels, and food schedule play into what you eat.

For instance, if you write: “I worked through lunch, and then my blood sugar completely crashed and I felt super shaky” after your “candy bar” entry, that gives you a lot more information as to what will help you avoid that daily 2 p.m. vending machine run, says Delbridge.

If you don’t have the time or headspace to count calories, you can also try the Beachbody Portion-Fix Eating Plan, which calculates your approximate total daily calorie needs and helps you stick to them with a color-coded portion-control container system. Simply eat the number of containers prescribed in your daily calorie range, and you don’t have to track or count calories.

Also, don’t try to accelerate your losses by slashing more calories than what’s recommended. If you don’t eat enough, your body will try to compensate for the excessive calorie deficit by slowing your metabolism. Your goal is to eat at just enough of a deficit to allow your body to burn through its fat stores.

9. You Don’t Get Enough Good Sleep

Just because you can “power through” on not much sleep, it doesn’t mean you can thrive that way — especially when it comes to weight loss.

“When we sleep, body fat makes two important hormones, leptin and adiponectin,” says Lazarus. “Leptin is our body’s best natural appetite-suppressing hormone, while adiponectin is helpful in making our body respond better to insulin.”

He explains, “After inadequate sleep, in addition to being tired, which we all know is every dieter’s worst enemy, we will be hungry and crave carbohydrates.”

In addition, one small study found that when dieters slept for only 5½ hours, they experienced 55% less weight loss and also saw their lean body mass decrease compared with those in the study who got 8½ hours of sleep.

The National Sleep Foundation recommends that adults ages 18 to 64 sleep 7 to 9 hours per night. If you consistently get less than that — and 35 percent of American adults don’t get this amount, according to the U.S. Centers for Disease Control and Prevention — it’s time to make sleep a priority.

Stop treating sleep as a negotiable or the first thing to go when things get busy. To set yourself up for success, plan your sleep (establish a regular sleep schedule), and then schedule everything else on your to-do list around it.

10. You Spend a Lot of Time Sitting or Inactive

Hitting your workouts is great, but for optimal results, you shouldn’t limit movement to your workouts, says Nadolsky, noting that it’s your total amount of daily activity that truly matters for weight loss.

Unfortunately, simply exercising for 30 or 60 minutes a day doesn’t move you out of the sedentary category, and research published in the International Journal of Behavioral Nutrition and Physical Activity shows that regular exercisers tend to spend just as much time sitting compared to those who skip their workouts.

Try integrating what Nadolsky calls “exercise snacks” throughout the day. Once per hour, get up and walk around your office, perform a single set of (bodyweight) squats, try deskercise,”or just enjoy a few standing stretches. Take a walking meeting, ditch the escalator for the stairs, or use a basket rather than a shopping cart when picking up a couple of things at the supermarket.

Fitness, Nutrition

Essential Guide to Healthy Eating

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Healthy eating does not have to be difficult or complicated. As an advocate for healthy living, understanding food and basic nutrients is important to me. I believe that to change your body (and physical health in general), you must start with your mind first, then your food, and THEN your exercise. You can’t outwork a bad diet, and you’ll never enjoy a lifestyle of healthy eating until your mindset is right about food.

Rather than re-creating the wheel, I’ve simply gathered some resources from the MyFitnessPal Blog that does a great job of simplifying the basics of healthy eating. I like these linked articles because they explain the importance of often persecuted food groups and defends my personal opinion that eating a balanced variety of foods is better than any restrictive “diet-of-the-month” that requires you to cut all carbs or fats. Take some time to read these links and educate yourself. Consider this your crash course in healthy eating.

Essential Guide to Macros

Essential Guide to Protein

Essential Guide to Fat

Essential Guide to Carbohydrates

Want more? Check out my video presentation of a Nutrition 101 course I taught for my employer.

Fitness, Nutrition

Tips for Healthy Grocery Shopping

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Want your family to eat healthier? It all starts with a healthy shopping list. If your cupboards and fridge contain mostly healthy foods, everyone in your family is likely to eat better. If the junk food is not in your house, you can’t eat it. Duh.

Surprisingly, healthier eating can lower your grocery bills, too. It’s true that ready-to-eat meals and packaged foods save time, but they can cost more and some have too much salt and fat. I was skeptical of this claim like you are, until I tried it myself. If you want real, sustainable change in your health, you’ve got to get the food part right. The good news is that it’s not that hard to do.

Follow these tips to get the most nutrition bang for your buck.

Stock Up With Staples

These pantry basics will give you the foundation you need for better family nutrition at home.

– Fresh, frozen, canned, or dried fruits and vegetables

  • Canned: Look for low-sodium vegetables and no-added-sugar fruits. We use a lot of canned green beans. Warmed up with whole wheat pasta and some lean meat for a super simple meal.IMG_0434
  • Frozen: Use what you need for a meal, then put the rest of the bag back in the freezer. We use a ton of frozen mixed veggies. I like to nuke the frozen veggies with raw broccoli. It steams the broccoli perfectly in 2 mins. Added to some pre-cooked chicken breast and whole wheat pasta or seasoned sweat potato chunks for a delicious healthy meal.
  • Dried: Check the label for and avoid added sugar, especially on fruits. I like raisins and dates. They are super sweet on their own to help satisfy my sweet tooth.

Whole grains, such as whole wheat bread, brown rice, and non-instant oatmeal

Steel-cut oatmeal costs just pennies per ounce and is a good source of fiber. I’ve cut a lot of bread out of my diet lately, but I still go for super cheap Quaker Old Fashioned Rolled Oats. No need to pay for the fancy stuff.

Beans, lentils, and peas

Packed with protein and other nutrients, they’re a great way to stretch your food dollar. Save! Use them in everything from soups to chili to burritos. Packaged dried beans cost less but take some planning to cook. Low-sodium canned beans are another option. Rinse canned beans to lower sodium even more.

Nuts like almonds, pecans, pistachios, and walnuts

Lean meats, poultry, fish, and eggs We eat lots of chicken breast, natural deli turkey, 93% lean ground turkey or beef, and eggs. Lots of eggs. So cheap and filling when mixed with veggies in a stir fry or omelette.

Low-fat or nonfat milk, yogurt, cheese, and other dairy products

Children under age 2 should have whole milk unless otherwise directed by your doctor. Yes, you can eat cheese. Real cheese though. Velveeta is not real cheese. Read the ingredients. We like Sargento Cheese. Yogurt and cottage cheese is tricky. Read the ingredients.

Buy Healthy Snacks

How to keep your kids from going overboard on chips, cookies, and other snacks? Make it easy to find the healthy stuff. We’ve learned that kids will adjust to the food you have. Don’t assume you must have junk food snacks for the kids because that’s all they will eat. You are in charge.

Keep these healthy options on the center shelf of the fridge: (this list is on our fridge)IMG_0616

  • cut-up fruit
  • baby carrots and low-fat ranch dip
  • string cheese
  • hard-boiled eggs
  • low-fat yogurt

And these on the counter:

  • dried fruit and nut mix
  • pretzels
  • whole-grain crackers and peanut butter

3 Surefire Healthy Grocery Shopping Rules

To keep your food choices on track with your family’s health goals, follow these three basic rules as you cruise the supermarket aisles.

Don’t shop hungry. Ever notice what winds up in your cart when you shop with hunger pangs? Eat a nutritious snack beforehand so the munchies don’t take control of your shopping.

Make a healthy shopping list. Even if you know what you need, a list saves time and prevents impulse buys. Organize your list into sections according to the store’s layout. Shop for the healthy items first, picking up the treats last. We use the Kroger ClickList to automate our shopping. When you shop from home via internet, you are far less likely to add items to your cart that aren’t on the list. Saves buckets of money!

Hug the walls — most of the time. Stay focused. Avoid parts of your grocery store with the unhealthy choices. The edges of the store (the perimeter) tend to have the healthiest choices. Detour down center aisles for beans, whole-grain pastas and cereals, and canned and frozen vegetables and fruit. Skip the aisles with chips and other temptations, or get only the items on your list. When you’re grocery shopping with kids, the temptations can be especially distracting.

Let us know your healthy grocery shopping tricks to save time, money, and sanity.

SOURCES: University Cooperative Extension Service, Iowa State University: “Convenience costs;” “Snacks for healthy kids;” “Stretch your protein dollar;” “10 tips for saving at the grocery store;” “Ways to save money in 2010;” and “What’s a good buy?”American Dietetic Association: “Raising healthy eaters from preschool to high school” and “Save time and money at the grocery store.”The University of Maine Cooperative Extension: “Winning ways to grocery shop with young children.”WebMD Health News: “Baby Milk Recommendations Changed.”