00:00:00.000 --> 00:00:06.480
One of the most common things that I hear from patients trying to lose weight is I'm hungry all the time.
00:00:06.639 --> 00:00:08.240
And this actually makes sense.
00:00:08.400 --> 00:00:15.839
Many weight loss efforts focus on eating less, but very little attention gets paid to helping patients stay satisfied.
00:00:16.000 --> 00:00:21.839
So they spend their day fighting hunger, thinking about food, and wondering why their plan isn't working.
00:00:22.079 --> 00:00:24.640
Welcome back to the Exam Room Nutrition Podcast.
00:00:24.800 --> 00:00:26.480
I'm your host, Colleen Sloan.
00:00:26.640 --> 00:00:34.320
I'm a physician assistant and registered dietitian, and today we're kicking off a special four-part series called Avocados in Practice.
00:00:34.479 --> 00:00:44.399
Thank you to Avocados Loved One Today for sponsoring this series as we explore emerging nutrition research and practical nutrition strategies clinicians can use with patients.
00:00:44.719 --> 00:00:49.200
In today's episode, we're talking about satiety, satisfaction, and weight management.
00:00:49.439 --> 00:01:03.679
We'll discuss why satiety matters, whether foods higher in fat can fit into a weight management plan, and how to think about nutrient density and satisfaction when counseling patients, including some of our patients who are taking GLP1 medications.
00:01:03.920 --> 00:01:10.959
Joining me today is Patricia Bannon, registered dietitian, nationally recognized communicator, and healthy cooking expert.
00:01:11.120 --> 00:01:20.640
Patricia has shared evidence-based nutrition advice across major media outlets and is known for translating nutrition science into practical strategies people can use.
00:01:20.799 --> 00:01:22.959
Patricia, thank you so much for being here today.
00:01:23.200 --> 00:01:24.959
Hey, Colleen, it is so great to be here.
00:01:25.040 --> 00:01:26.159
I'm a fan of your podcast.
00:01:26.239 --> 00:01:27.439
So great to be on.
00:01:27.840 --> 00:01:28.640
Thank you so much.
00:01:28.799 --> 00:01:37.920
Yeah, so I'm sure you hear this from some of your patients, but one thing that we hear all the time is I'm trying to lose weight, but I am hungry all the time.
00:01:38.159 --> 00:01:45.680
So I'm curious, why do so many weight loss efforts leave people feeling deprived and thinking about food constantly?
00:01:46.000 --> 00:01:51.040
Yes, well, weight loss is hard enough, but when you're feeling hungry all the time, it is absolutely not sustainable.
00:01:51.200 --> 00:01:52.719
So there's several reasons for that.
00:01:52.959 --> 00:01:55.680
One can be that the calories were cut too aggressively.
00:01:55.920 --> 00:01:58.000
Another can be you just feel deprived, right?
00:01:58.079 --> 00:02:01.519
You've lost the enjoyment because you've cut out too many of your favorite foods.
00:02:01.680 --> 00:02:10.560
And then the third could be key nutrients are missing, those key nutrients that add satiety, the feeling of fullness, mainly protein, healthy fats, and fiber.
00:02:10.719 --> 00:02:18.960
And the interesting thing is we're finding people on GLP1s are one of the best things for them is their reduced food noise, right?
00:02:19.120 --> 00:02:23.680
That constant preoccupation with food and with feeling hungry.
00:02:23.840 --> 00:02:27.919
And they're often more in tune with those hunger and fullness cues.
00:02:28.080 --> 00:02:28.800
So that's great.
00:02:28.960 --> 00:02:35.199
But whether you have a patient on GLP1s or not, that meal composition still matters, right?
00:02:35.280 --> 00:02:37.120
The goal isn't just eat less.
00:02:37.360 --> 00:02:43.520
The goal is to find meals, balance meals that support fullness, nourishment, and enjoyment.
00:02:43.599 --> 00:02:52.000
And that's where avocados can really fit in nicely here with weight management because they provide a combination of fiber and healthy unsaturated fats.
00:02:52.080 --> 00:03:00.319
These are the two nutrients that can slow digestion and support longer-lasting fullness while providing those important nutrients.
00:03:00.479 --> 00:03:10.000
So one-third of a medium avocado has three grams of fiber, and also, you know, that creamy texture, it's gonna make those smaller meals more satisfying.
00:03:10.240 --> 00:03:16.080
The other thing you can do is often pair avocado with other foods that have fiber as well as protein.
00:03:16.240 --> 00:03:24.639
So, for example, it could be eggs and whole grain toast with avocado, it could be beans and vegetables and avocado to create more of a balanced filling meal.
00:03:24.879 --> 00:03:33.759
You know, talking about calories and weight management, there's like an interesting debate that goes on on social media, and that's whether calories matter or not.
00:03:33.919 --> 00:03:38.479
And so I would love to kind of pick your brain a little bit when we're communicating this with our patients.
00:03:38.719 --> 00:03:45.520
Should we be focusing on satiety and satisfaction or really just focusing on simply a calorie restriction?
00:03:45.680 --> 00:03:52.800
And then along those lines, are there certain foods that actually do help to support fullness if we are on that weight loss journey?
00:03:53.039 --> 00:03:54.080
Yeah, great question.
00:03:54.240 --> 00:03:58.800
So calories matter, but it's only a small part of the bigger picture.
00:03:58.960 --> 00:04:05.360
Satiety and satisfaction are essential in terms of sustainability and in terms of quality of life.
00:04:05.439 --> 00:04:08.800
And as we just talked about, so you're not feeling hungry all the time.
00:04:08.960 --> 00:04:19.759
So clinicians can encourage meals that combine protein, fiber, and healthy fats because these nutrients are going to promote satiety by slowing digestion and increasing appetite hormones.
00:04:19.839 --> 00:04:22.800
So signals that tell the body when we're full.
00:04:23.040 --> 00:04:29.439
So a study that's really interesting on avocados and satiety, this was supported by the Avocado Nutrition Center.
00:04:29.600 --> 00:04:37.600
It's a clinical trial of 31 adults with overweight or obesity and elevated fasting glucose and insulin.
00:04:37.759 --> 00:04:41.120
And they added half or a whole avocado to breakfast.
00:04:41.279 --> 00:04:51.360
And what they found was reduced hunger, enhanced meal satisfaction, and raised levels of PYY and naturally occurring GLP1.
00:04:51.600 --> 00:04:55.120
Those are two hormones that signal fullness to the brain.
00:04:55.360 --> 00:05:03.279
So this might be related to the combination of the fiber and the healthy fats that help slow digestion and support satiety.
00:05:03.519 --> 00:05:13.600
Of course, this can't be generalized through a larger population, but it's really adding to the evidence of avocados supporting weight management and in this case, satiety, that feeling of fullness.
00:05:13.839 --> 00:05:26.480
So something that comes up a lot when I talk about avocados with my patients who are trying to lose weight is they're worried because they've been traditionally told that avocados have too much fat, which means they have too many calories, right?
00:05:26.720 --> 00:05:31.920
And so they're kind of leery of eating avocados on a weight management program.
00:05:32.079 --> 00:05:34.800
So has that concern actually ever been studied?
00:05:35.040 --> 00:05:36.000
It has been studied.
00:05:36.079 --> 00:05:41.120
And one of my best friends who just went and she had high cholesterol levels and is trying to lose weight.
00:05:41.279 --> 00:05:42.959
We were talking about foods she could add.
00:05:43.040 --> 00:05:45.279
I mentioned avocados, and she's like, Yeah, but I'm gonna gain weight.
00:05:45.439 --> 00:05:50.800
And I was prepping for our episode, and I was like, oh, I have a study that addresses just that thing.
00:05:51.120 --> 00:05:53.839
So this is a study on avocados and weight loss.
00:05:53.920 --> 00:05:58.560
It's called HAT, which stands for the Habitual Diet and Avocado Trial.
00:05:58.720 --> 00:06:02.560
This is the most extensive clinical trial on avocados to date.
00:06:02.720 --> 00:06:07.680
It includes just over 1,000 adults with elevated waist circumference.
00:06:07.839 --> 00:06:13.600
And in the HAT study, they found that daily consumption of avocados did not add to weight gain.
00:06:13.759 --> 00:06:28.160
So participants in the study, they ate one avocado a day for six months, and they did not experience an increase in visceral fat or secondary measures of body weight compared to the control group, despite the extra calories.
00:06:28.240 --> 00:06:39.759
And I think that's where it really gets interesting because when you take a deeper look at the dietary data, you find that that avocado, which was a large avocado, added 281 calories.
00:06:40.000 --> 00:06:47.040
However, the participants' daily calorie intake was only 159 calories higher.
00:06:47.199 --> 00:06:55.360
So this shows that 43% of the avocados calories were offset by eating less elsewhere without them even thinking about it.
00:06:55.439 --> 00:06:58.000
And that's the part I love from a behavior change standpoint.
00:06:58.160 --> 00:07:02.480
And even though they were eating more calories, it didn't affect their overall weight.
00:07:02.639 --> 00:07:06.319
So the greater fullness or meal satisfaction may have played a role here.
00:07:06.480 --> 00:07:16.639
So I really think as clinicians, the conversation needs to shift from how many calories are in this food or meal to also asking what does this meal contribute, right?
00:07:16.879 --> 00:07:19.680
In terms of satisfaction and fullness.
00:07:19.839 --> 00:07:26.319
And that's where those avocados really provide the fiber, the healthy fats, and several other vitamins and minerals.
00:07:26.800 --> 00:07:36.560
Yeah, that's why that debate of like, do calories in, calories out really doesn't really matter on social media is tricky because nutrition is nuanced, right?
00:07:36.720 --> 00:07:39.360
And it doesn't, it doesn't paint that overall picture.
00:07:39.519 --> 00:07:43.680
We have to actually look at nutrient density and the quality of that food that we're discussing.
00:07:43.839 --> 00:07:47.360
So that brings me to my next point, and that's talking about protein.
00:07:47.600 --> 00:07:55.120
This macronutrient tends to dominate the conversation around weight loss, especially for patients who are on GLP1 medications.
00:07:55.600 --> 00:07:57.600
But we know protein is important.
00:07:57.759 --> 00:08:05.360
However, when patients are eating less overall, is there anything else we should be talking about in terms of overall diet quality?
00:08:05.680 --> 00:08:06.079
Yes.
00:08:06.240 --> 00:08:08.000
So protein, protein, protein.
00:08:08.079 --> 00:08:09.680
It's all the craze right now.
00:08:09.759 --> 00:08:10.639
And it is important.
00:08:10.720 --> 00:08:17.279
It's important for satiety, it's important for preserving lean mass, especially when patients are eating less and losing weight.
00:08:17.360 --> 00:08:19.759
Um, but it's only a small part of the picture, right?
00:08:19.920 --> 00:08:21.920
Yes, you just said, it's nuanced.
00:08:22.160 --> 00:08:28.240
And actually, most Americans are getting enough protein, especially during this protein craze, right?
00:08:28.560 --> 00:08:34.000
So the interesting thing is that 95% of Americans don't eat enough fiber.
00:08:34.159 --> 00:08:40.799
And most Americans eat too much saturated fat and not enough unsaturated fat, those healthy fats.
00:08:40.960 --> 00:08:53.039
So I think clinicians should consider these nutrients fiber and healthy fats when they're talking to their patients trying to lose weight, as well as other vitamins and minerals like potassium, vitamin D, and calcium.
00:08:53.279 --> 00:09:00.720
So one-third of a medium avocado provides three grams of fiber along with six grams of healthy unsaturated fat.
00:09:00.799 --> 00:09:04.799
And it's also adding that creamy texture, which again adds to that satisfaction.
00:09:05.039 --> 00:09:09.120
You know, my listeners are clinicians and you've sold us, you've told us the science.
00:09:09.360 --> 00:09:16.159
We all believe that, you know, avocados are really, really beneficial, but my listeners are educating real patients sitting in front of them.
00:09:16.240 --> 00:09:20.399
And so they need some practical advice and strategies that they can suggest to their patients.
00:09:20.480 --> 00:09:26.639
So I'm curious if you have any examples of some easy swaps or how they can suggest their patients use avocado.
00:09:26.879 --> 00:09:27.120
Yeah.
00:09:27.200 --> 00:09:29.360
So this is this is where it really matters, right?
00:09:29.519 --> 00:09:36.559
Like the science is important to tell us what we need to suggest, but how do we make it realistic for the patients that we're seeing?
00:09:36.639 --> 00:09:38.159
So, how do we get it on the plate?
00:09:38.240 --> 00:09:39.840
How do we get them to enjoy it?
00:09:40.080 --> 00:09:40.799
Swapping it.
00:09:40.960 --> 00:09:42.399
Swap is a great idea.
00:09:42.559 --> 00:09:47.519
You know, mashed avocado in sandwiches, dressings, dips, baked goods is great.
00:09:47.759 --> 00:09:51.840
I really think they're wonderful in baked goods because you can actually swap them one for one.
00:09:52.000 --> 00:09:57.360
So mashed avocado in place of the same amount of saturated fat in that baked goods.
00:09:57.440 --> 00:09:58.960
So, for example, in muffins.
00:09:59.039 --> 00:10:04.559
And because they're higher in water content, you're gonna get really moist baked goods, which is fantastic, right?
00:10:04.639 --> 00:10:05.360
That's what we want.
00:10:05.600 --> 00:10:06.480
You can also top it.
00:10:06.559 --> 00:10:11.039
You can top whole grain toast with an egg and avocado and blending it in.
00:10:11.200 --> 00:10:12.399
That works great too.
00:10:12.639 --> 00:10:16.879
Smoothies, uh, you can do it in maybe overnight oats and pairing it.
00:10:16.960 --> 00:10:24.480
Again, I mentioned this earlier, but pairing it with other fiber foods and protein foods for a more balanced meal that's gonna feel satisfying.
00:10:24.720 --> 00:10:25.519
That's really important.
00:10:25.679 --> 00:10:29.360
We can't just tell our patients you need to eat more fiber and unsaturated fats.
00:10:29.519 --> 00:10:35.279
Let's give them some really practical strategies and some suggestions that is realistic and doable into their daily life.
00:10:35.440 --> 00:10:36.960
So, Patricia, thank you so much.
00:10:37.120 --> 00:10:38.879
This has been such a helpful conversation.
00:10:39.039 --> 00:10:40.240
Thanks for joining me today.
00:10:40.320 --> 00:10:44.240
And thank you to Avocados Love One Today for sponsoring this series.
00:10:44.399 --> 00:10:48.080
I'll link the research and resources we talked about today in the show notes.
00:10:48.159 --> 00:10:58.320
And be sure to come back tomorrow when we're talking about what to eat when cholesterol is high and why what we add to the plate matters just as much as what we take away.
00:10:58.480 --> 00:10:59.440
We'll see you tomorrow.