Nutrition Scalesby David Mendosa Patient Advocate
All the real diet books say to start with a food diary. For the 85 percent of those of us with diabetes who are overweight or obese and are presumably trying to get down to something more healthy that sounds easy enough.
Let's see: The Chilean sea bass and Swiss chard that I had for dinner last night was just great. The fresh herbs and the chia seeds on the fish and sautÃ©ing the veggie in olive oil made all the difference.
That would be a diary entry all right. But it's not a food diary entry.
When we need to lose a serious amount of weight - or seriously get our blood glucose under control - we simply have to know exactly what we eat. And how much.
Only when we weight every bite of food that goes in our mouths can we know how many calories and grams of the macronutrients (carbohydrates, fat, and protein) that we consume. Only when we use a nutrition scale can we do that.
Sounds onerous? It was for me when all I had for weighing my food was a postage scale. But it isn't now with the latest scales that have huge food databases built in. This month I have been testing what I think are the two best models of these nutrition scales.
Both scales told me that last night's dinner added 430 calories to what I had eaten earlier in the day. Since I am trying to limit my both my calories and carbs, I was glad to see that the fish and the olive oil didn't add any carbs and the Swiss chard gave me fewer than 3 grams. I also calculated - and recorded in my food diary - the number of grams of fat and of protein that this delicious dinner gave me.
Yesterday's food diary showed that I ate a dozen different foods that gave me a total of 2,563 calories. Wow, that was more than I wanted, mostly because of the 445 calories in a handful (61 grams) of macadamia nuts. But I still lost a little weight, according to my bathroom scale this morning, probably because my net carbs (subtracting fiber from total carbs) came to just 26 grams.
During the past two weeks my nutrition scales and food diary tell me that I averaged 2,186 calories per day. That's a generous amount and normally I would have gained weight on that many calories. But I averaged only 40 grams of net carbs each day. As a result my weight is down to 166.6, which is 3.6 pounds less than what it was when I started my food diary just two weeks ago. My body mass index (BMI) is down to 21 based on my height of 6' 2.5".
Besides that, my weight loss had stalled for almost two months. Now I am close to my goal of 160 pounds, which will give me a BMI of 20.3.
At the time I didn't realize how important an email message that came into my in-box near the end of November would be for my final weight breakthrough. The message seemed at first to be just another of the hundreds of emails I get every day. But this one put me in control of my diet for the first time.
"I have practiced pharmacy for 30 years and have counseled many patients about diabetes and diet," the message from Bill Geronimo, president of HealthTools LLC in Mahwah, New Jersey, began. "This encouraged me to develop the EatSmart Nutrition Scale. This is a educational tool for individuals to learn about the nutrients in whole foods as they relate to portion size. It will calculate the calories and carbs in thousands of food that come with Nutrition Facts or 999 foods that do not come with nutrition facts when you buy them."
Bill has two excellent [demos] of his scale online and offered to send me an EatSmart Nutrition Scale for my evaluation. I jumped at the chance and have been using it ever since. I like it so much in fact that I bought one for my favorite Certified Diabetes Educator, who now also uses it regularly after giving away her old scale to a friend.
My first impression of the EatSmart scale was overwhelmingly positive. It's small, attractive, professionally presented, and easy to use. If I can't operate a new product without careful study of its owners manual, I often get frustrated. The EatSmart easily passed that initial test.
Then, I asked my favorite CDE what functions that she thinks a nutrition scale should have. The first thing she mentioned was that it if were battery operated, as the EatSmart is, it should use regular batteries, unlike the hard-to-find batteries her old scale uses. The EatSmart takes four AAA batteries.
She wanted a self-adjusting tare feature that lets you add or subtract food portions, and the EatSmart has it. It needs to be precise to one gram differences and handle large weights, useful when preparing foods that will be divided into multiple servings or which may have to include heavy plates that we can subtract out. In fact, the EatSmart is accurate to 1 gram and its capacity is 6.6 pounds or 3000 grams.
A nutrition scale needs easy conversion between ounces and grams. The EatSmart does that too.
It needs a removable top for easy cleaning. That's another feature of the EatSmart.
Finally, my favorite CDE said she would like the scale to automatically input to a nutrition program on her computer. But the EatSmart doesn't due that.
So I called John Walsh, the person who probably knows more about scales for people with diabetes than anyone else. John, who is a physician assistant and CDE, and his wife Ruth Roberts run the Diabetes Mall and have written several leading books about controlling diabetes. The Diabetes Mall probably offers more different nutrition scales than any other website.
None of the nutrition scales currently available provide automatic inputs to nutrition programs, John told me. "There would be a lot of effort involved, and very few people would use it."
John and Ruth don't sell the EatSmart scale. While I encouraged Bill and John to discuss this, the hang-up is that John and Ruth discount everything they offer, and Bill focuses on offering the EatSmart through professionals in diabetes centers, nutritionists offices, health clubs, and the practices of endocrinologist and cardiologists.
"These professionals all sell the scale for $75 retail," Bill told me."This is also the same price that we are charging on our Internet site plus shipping. These professionals are using it as part of their nutrition counseling and coaching programs. To sell at a discount, which John told me he would potentially do, would probably jeopardize those relationships."
Then, which of the scales that John and Ruth sell at the Diabetes Mall is most similar to the EatSmart? I had to ask John that question so I could make a proper comparison.
The closest thing to the EatSmart scale is the Salter 1400 Nutritional Gram Scale, John replied. Both the EatSmart and the Salter 1400 include a database of about 1,000 foods that you access using food codes in the booklets that come with the scales. The Salter 1400 retails for $89.99, and the Diabetes Mall [sells] it for $63.95 plus shipping.
The Salter 1450 Nutri-Weigh Dietary Scale is the top of Salter's line, John says. It lists for $149.99, but he [sells] it for $94. But its food codes are built in, and you search for the name of the food that you are eating alphabetically. It's too complicated for most folks, John concluded. I wanted one of these model of Salter scales so I could make a product comparison with the EatSmart. John didn't have a loaner for me, but suggested that I call Salter. I did, and the company immediately sent me a scale.
But not the Salter 1400. Liz Wentland in Salter marketing told me that they have discontinued that model. However, Ruth Roberts told me three days ago that the Diabetes Mall has ten of the 1400 scales left and continues to sell them.
Instead, Liz Wentland sent me a Salter 1450. I am still not sure whether I like the EatSmart or the Salter better.
Salter 1450 (l) and EatSmart
One difference is that the scales track somewhat different nutrients. Both of them track calories, carbohydrates, fiber, protein, total fat, saturated fat, total cholesterol, and sodium. The EatSmart also tracks potassium, magnesium, calcium, and Vitamin K. The Salter 1450 also tracks total sugars, net carbs, and the range of a food's glycemic index values.
The big difference between having one of these scales and having no nutrition scale is the ability to track what you eat. I enjoy the power over my diet that my new knowledge of what I eat gives me.
Tracking what I eat also reminds me of the Heisenberg uncertainty principle that you can't measure something without changing it. This basic principle of physics even applies to our diet.
You will probably find, as I have, that when you weigh and calculate the nutrients in everything you eat, you may just skip an extra snack, because you don't want to bother with the calculations. That is especially true for me with the tempting bits of different foods that our grocery stores seem to offer more and more. Since I don't know how many calories these free samples have, I skip them. And therefore eat less.