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From the Cardiologist's Wife: You Can Never Be Too Rich or Too Thin...or Can You?
Feb 15, 2012

With all the talk about the obesity epidemic and it’s related problems, another problem is often overlooked - being too thin. Unless we are looking at fashion models or talking about the Olsen twins, we envy those who can eat anything and seemingly gain nothing. But the truth is that there is a point at which you are too thin and just like being too fat, it has it’s own set of health issues.

People who are underweight are more likely to suffer from osteoporosis, have decreased immune systems, fertility problems and anemia. The elderly can also experience poor memory, decreased muscle strength and hypothermia. The causes of low weight vary from conditions such as bulimia and anorexia, food allergies, various illnesses, the extra conditioning and exercise athletes do, to normal growth in children. It is important to address the underlying cause to know what to do or whether to be concerned about someone who is underweight.

I’m not going to address eating disorders, food allergies or other illnesses as those subjects would require volumes. Rather I’d like to talk about healthy ways to gain weight for athletes or anyone whose BMI (body mass index) indicates they are underweight or on the borderline. A BMI for adults of less than 18.5 is considered underweight. If you’d like to calculate a BMI, there are plenty of good sources on the web.

If you need to gain weight, please don’t think that the solution is to visit McDonald’s more often or to eat a bag of Cheetos every day. Empty calories like those may pile on the fat but bring on other unwanted problems. We don’t want to trade nicknames from “Chicken legs” to “Michelin man”. Proper nutrition is the answer but you need to use foods with higher calories and protein at every meal.

For example, skip the bowl of cereal for breakfast and have a couple of scrambled eggs with a bit of cheese, whole wheat toast spread with peanut butter, milk, juice and some fruit. For lunch, add sliced avocados to your salad or sandwich, add extra meat or use pesto as a spread. Pile on the tomatoes, onions, lettuce or roasted red peppers. Eat Greek yogurt with some fruit and granola. Dinner should include more lean protein, maybe some pasta or other starch plus plenty of fruits and vegetables.

Snacks are important for someone who is underweight. Nuts, cheese, yogurt and smoothies are good choices. Make a smoothie with milk, a banana, peanut butter, protein powder plus Carnation Instant breakfast powder. Drinks like Ensure or Boost are good supplements for those who won’t take the time to make snacks. Be careful with protein or “power” bars. Some of these are just glorified candy and don’t have much nutrition.

It can be difficult to prepare food for someone who is underweight; I know, I have someone like that in my house. Feeding an athlete who is concerned about performance is a delicate balancing act. That person may not be able to eat more at first without feeling uncomfortably full so several small meals are better. Be supportive and sympathetic but make sure the person understands why they need to gain weight. If you suspect other health problems are the cause, consult a physician. A licensed nutritionist can also help with a diet plan.

Until next week,
Lisa

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