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Lecture 5 page 1 2 3 4 5 6 7 8

Practical Guidelines for
the Nutritional Treatment of Obesity

Susan Bowerman, M.S., R.D. and Pamela Saltsman, M.P.H., R.D.

Trigger Foods
Trigger foods are foods that have an unexpected amount of hidden fat or calories, and represent something you eat in a setting where hunger is not the prime motivation. In many cases, these are foods you eat unconsciously such as potato chips where "you canít eat just one". Obvious things like chips and chocolate are not listed, but see if these other snack foods and meal items sound familiar to you. A chart follows that shows the impact of changing your eating habits on your calorie intake:

Minimize the following especially if they are trigger foods for you:

  • Nuts, including peanuts, macadamia nuts, peanut butter and pistachios These are high in fat. It is true that they contain monounsaturated fatty acids in common with olive oil and avocados, but if we are going to cut fat calories, we have to cut the fat. It is true that if you keep total calories constant and substitute olive oil, nuts, or avocados for saturated fat from dairy and meat products your cholesterol levels will fall. So if your patient can burn off 140 calories per tablespoon of olive oil, go for it.
  • Salad dressings made with oil Advise a switch to wine vinegar, rice vinegar, or balsamic vinegar. Patients can also mix mustard and rice vinegar and make a dijon-like dressing. Some vinegars now have various spices mixed into them to enhance their flavor. I have even found a raspberry wine vinegar.
  • Mayonnaise, Margarine, Butter, Cheese and Cheese Pizza Did you know that Ultra Fat-Free Margarine is 100% fat? You see there are 5 calories per serving and 5 calories from fat. Last time I checked, 5 divided by 5 was 100%. The US Department of Agriculture says that if something has less than 0.5 gram of fat per serving (which is ca. 5 calories) it can be called fat-free. This is the only place in mathematics that you can round down from 0.5 to 0! Did you really think that there could be fat-free mayonnaise? In fact, the fat-free message encourages patients to eat more of this approved food. There are many women for whom cheese and cheese pizza are important trigger foods. The comments with regard to margarine all apply to cheese as well. It is not adding protein to a sandwich but rather taste and fat.
  • Red meat including veal, beef, pork, and lamb For most types of red meat, even when you cut away the visible fat there is fat between the muscle fibers. A 9 to 14 ounce piece of prime rib served in most steak houses and restaurants can be over 1200 calories and 50 grams of fat. These are all the calories and fat that an average five foot tall woman needs for the whole day and over half the calories needed by an average five foot ten inch tall man. If you have told patients to red meat for its iron content, advise them to get the iron in a multivitamin or iron supplement.
  • Fatty fish including salmon, trout, and catfish These are high fat farm-fed fish that sit around all day in fish ponds eating fishmeal. They donít swim a lot or catch other fish. They just sit around and get fat. If you can find ocean caught salmon, they are lower in fat. These are only available in some stores for part of the year. Most salmon you buy in stores is farm-fed.
  • Non-fat yogurt and ice cream Most women are looking to yogurt as a protein-rich food and a healthy snack. But frozen yogurt is high in sugar and low in protein The eating behavior associated with non-fat yogurt is exactly what you find with ice cream. It is a comfort food, a friend, and a relaxing habit. Substitute a meal replacement cooled in the freezer to a slush-like consistency and eaten with a spoon.
  • Cakes and Pastries Cakes have oil added to them to make them taste moist. A whole bran muffin can have lots of extra oil added. Croissants have 11 grams of fat each which amounts to 100 Calories of fat. A cinnamon roll can have up to 1000 Calories depending on how it is prepared.

Example 1: Nuts vs. Popcorn

Fat (gm)
1 cup of peanuts, dry roasted
70.5 gm
6 tablespoons of peanut butter
48 gm


3 cups of popped popcorn
0.5 gm

You save: 500 to 800 calories and 50 to 70 gm of fat


Example 2: Red Meat vs. Chicken Breast

Fat (gm)
9 oz lean sirloin steak
43 gm
9 oz lean pork chop
39 gm


3 oz chicken breast
4 gm

You save: 400 to 800 calories and 35 to 40 gm of fat


Example 3: Whole Milk vs. Skim(Non-Fat) Milk

Fat (gm)
8 oz whole milk
8 gm


8 oz skim (non-fat) milk
trace of fat

You save: 64 calories and 8 gm of fat per glass of milk


Example 4: Eliminating 2 ounces of Cheese from a sandwich

Fat (gm)
2 oz. American processed cheese
18 gm

You save: 212 calories and 18 gm of fat per sandwich made without cheese


Example 5: Having Wine or Beer instead of a Pina Colada

4.5 oz. pina colada mixed drink


12 oz. light beer
4 oz. light wine

You save: 250 to 300 calories each time you make this choice


Example 6: French Fries or Onion Rings vs. Steamed Vegetables

Fat (gm)
20 French fried potatoes
16 gm
7 frozen onion rings
19 gm


1/2 cup squash-zucchini, steamed
0.1 gm
1/2 cup broccoli, steamed
0.2 gm

You save: 260 to 300 calories and 16 to 19 gm of fat each time


Example 7: Ordering a 3 oz. grilled chicken breast
on top of a green salad with balsamic vinegar
vs. a big Chinese Chicken Salad at a restaurant.

Food Calories Fat (gm.)

Fat (gm)
Chinese Chicken Salad 1014 61 gm


Green Tossed Salad 210 4 gm

You save: 800 calories and 57 gm of fat each time you make this choice.

Altogether, the changes listed above saved up to 3300 Calories in all. This is about one pound of fat. Imagine how many calories you could save each day by making wise choices and educating your palate to avoid fats and sweets. As you read labels, play this game and you will see that you are saving up to a thousand Calories per day by simply making the right choices. These are really painless substitutions.

Stepwise: Gradual Change for Tough Trigger Foods
Here are some messages I use to soften the impact. "Make each one of these a goal to work towards. Itís a much different matter to drift away from these strict guidelines than to adopt guidelines that encourage margarine instead of butter. Look, at least you will always know when you are on or off the above diet without having to consult a dietitian and fill out a food record. You will get great results if you do this 80 or 90 percent of the time. You donít have to be a fanatic."

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Lecture 1
:Introduction to Nutrition in Western Civilization
Lecture 2:
Dietary Macronutrients, Body Fat, and Blood Lipids
Lecture 3:
Digestion and Absorption of Macronutrients
Lecture 4:
Basic Principles of Nutrient Metabolism
Lecture 5:
Lecture 6:
Fuel Utilization During Exercise
  Lecture 7:Biochemistry of Oxidant Stress in Health and Disease Antioxidants
Lecture 8:Nutrition for the 21st Century






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