Jetting off to college brings excitement. New friendships and professional opportunities await.

But it also brings the obligation of taking care of your health without a parent’s watchful eye. Dorm buffets, sugary drinks and sleeping in all the time can lead to your clothes feeling tighter and your self-esteem feeling lower.

So what’s the scoop on the so-called freshman 15? How big of a problem is weight gain in college? How can you prevent it?

First things first: Rachel Bult, a supervisor dietitian at OSF HealthCare, says it’s more like three to 10 pounds weight gain in the first year on average, not 15. But the issue is still worth paying attention to.

“You add more calories than you intend to,” with food options in college, Bult says. “Also, stress and lack of sleep can cause increased cravings for sweets and comfort foods.”

Some tips to consider:

• Exercise portion control. Remember the saying “Are your eyes bigger than your stomach?”
   
• If you’re on a meal plan that means buffet meals every day, go to a healthier station first. Start with a salad and a vinaigrette dressing, Bult suggests. Non-starchy vegetables as your side can provide fiber. Protein like chicken, fish, beans, chickpeas and tofu will help keep you full.
   
• For exercise, find movement you enjoy. Don’t approach it as a chore. If you like pickleball, find a local league.
   
• Keep healthy snacks, not junk food, at arm’s reach.
  
  “When I was in college, I would have a protein smoothie in the morning to help fill me up,” Bult recalls. “But you could also keep fruit, string cheese, unsalted nuts or bell peppers with hummus. Just things that are healthier and quicker to grab and go.”
   
• Smartphone apps can be a short-term tool to get you on the right track, Bult says. Apps can track what you’re eating, your daily steps and more.
  
  “Those can help you understand the nutritional value of what you’re consuming,” Bult says.
   
• Talk to your primary care provider or a dietitian if you need guidance. Research what your local school, health system or social service groups offer.

Learn more

The OSF HealthCare website has healthy recipes.

Interview clips

Few beverages spark as much debate as diet soda. One week it’s linked to a new health concern, the next it’s defended as a helpful substitute for sugary drinks. So, what’s the truth?

Despite many studies and plenty of opinions, the answer isn’t as simple as yes or no. Health experts say for most people, an occasional diet soda isn’t going to hurt you – but it also shouldn’t be a substitute for healthier beverages like water.

One thing is certain: more research is needed, especially on diet soda's impact on dementia risk. A recent study published by the Journals of Alzheimer's Disease, shows an association. The results question a potential increased dementia risk associated with frequent consumption of diet soda.

Another recent unpublished study suggested a possible link between daily diet soda consumption and nonalcoholic fatty liver disease. However, experts warn that unpublished research isn’t conclusive and doesn’t prove that diet soda causes liver disease.

“I thought it was rather interesting, because when I did research on it, and looking into more medical articles and reliable sources, it actually found that it was inconclusive whether or not diet soda increased the risk,” says Erin Wojewodzki, APRN, a nurse practitioner with OSF HealthCare.

While research continues, most experts agree that moderate diet soda consumption is generally fine for healthy adults. The bigger issue is what else is happening in a person’s diet and lifestyle.

People may choose diet soda over regular soda to help manage blood sugar levels, lower the risk of tooth decay or manage weight. But diet soda typically lacks ingredients that your body needs. That’s when it’s time to turn to other options such as water, sparkling water, seltzer, skim milk, and unsweetened tea or coffee.

Wojewodzki says it’s important to meet her patients where they are when it comes to trying to reduce diet soda consumption. “We have to look at the patient as a whole,” she says. “If you're essentially healthy but you like to drink 10 diet cokes a day, let's work together.”

Wojewodzki adds recommendations can change depending on a person’s overall health. Someone dealing with obesity or Type 2 diabetes, for example, may require a different plan than someone who is not.

Nicole O’Neill is a dietitian with OSF HealthCare. Like Wojewodzki, she agrees with the adage ‘everything in moderation.’

“I personally like the idea of a diet soda for a good majority of my patient population,” she says. “So, if you can take a high-calorie regular soda and replace it with a non-calorie diet soda, it gives you a calorie deficit that leads to weight loss. One or two, I'm OK with that.”

There are other factors to think about, according to Wojewodzki. “Diet does play a big role,” she says. “Are we eating healthy? Are we eating out a lot? Are we eating fast food? Are we eating a lot of sugar, a lot of unhealthy food? We need to be taking care of our body and eating healthy and exercising as well.”

Unhealthy cravings

O’Neill concurs – people who drink diet sodas tend to crave other unhealthy treats at the same time.

“Most people want a diet soda with something like peanut M&Ms, pizza, a cheeseburger,” says O’Neill. “If you're drinking a diet soda and it's just a drink, it's not a big deal. But if every time you have a diet soda, you want a bag of chips, I would say we need to talk about alternatives.”

For people who are trying to cut back on their diet soda, O’Neill offers a few tips. Try substituting diet soda with sparkling water, flavored seltzer or unsweetened tea. Gradually reduce caffeine instead of going cold turkey. And determine what your triggers are – like certain times of the day that make you reach for a can of diet soda.

“We have to find alternatives, though, and it really is person specific,” says O’Neill. “If you hate water, we were going to try some water flavoring. If you hate water flavorings, because it's also got some artificial sweetener in it, maybe we talk about fruit infusions or herbs or something, just to give your water flavor.”

Zero sugar soda also contains no sugar or calories but is often formulated to taste more like the original sugary version. It may use a blend of sweeteners, such as aspartame, acesulfame potassium or sucralose, depending on the brand. Health experts don’t consider one category healthier than the other. The same advice applies to both.

Wojewodzki says there’s no magic drink for better health. Whether you drink diet soda occasionally or every day, the bigger picture is what’s important. Eat a balanced diet, stay active and make water your primary drink of choice.

Nicole O'Neill interview clips

Erin Wojewodzki interview clips

B-roll

Losing weight is hard. It can be a long process. But when you meet your weight loss goals, the feeling is euphoric. That is until you gain some or all of it back.

That’s where a concept called reverse dieting – a way to teach your metabolism by gradually adding calories back after a weight-loss journey – can help.

“Reverse dieting is used when you've been on an actual calorie-deficit diet for a while, and you're trying to get to middle ground, where you're no longer losing or gaining,” says Nicole O’Neill, a registered dietitian with OSF HealthCare. “It's a way to determine how many calories you need to maintain.”

The reverse dieting concept has been around for some time, but O’Neill says there was never a name for it. The premise is to add calories to your diet a little at a time after you’ve lost weight until you start to gain weight again.

“When you're trying to lose weight, there is a stop point you have with a goal weight in mind,” O’Neill explains. “So, if your goal weight is 150 and you've hit your 150, you don't want to go to 130. So, you have to adjust something to stop that weight loss and be where you want to be. And inevitably, it's adding a bit more calories. And that's all the reverse dieting is – adding a bit more calories.”

The way reverse dieting usually works is by adding back 50-100 calories each day. Often, you take the calorie load that you've been doing to lose weight and add 100 calories more. That doesn’t mean eating a cookie; experts suggest the added calories come from protein or your favorite fruit or vegetable.  

O’Neill suggests doing that for a week. Weigh yourself again and if your weight loss has stopped at that additional 100 calorie mark, that’s your end point. Some people might require up to an additional 500 calories to reach their stop point.

Reverse dieting is very individualized, and it takes time, cautions O’Neill. It also takes effort to track your numbers.

“I think it's a way to help you not have a regain,” O’Neill says. “We want to achieve a goal weight. We want to maintain the goal weight. The reverse diet thought process helps you do that.”

The biggest benefit is when you stop dieting, using a reverse diet to find your set point helps you maintain your weight instead of quickly regaining what you lost. O’Neill sees this often among her clients.

“They lose 60 pounds, they feel great, and then they're like, ‘Ha, we're done,’” she says. “Well, a year later, they've gained it back, because they returned to what they were doing before the diet. So, this is a way to incrementally increase, to get them to maintenance without that regain of weight.”

Reverse dieting is safe for anybody who's been on a calorie-deficit diet, according to O’Neill. For some, it might take one week to find that calorie amount. For others it could take a couple of months. Some people aren't going to be comfortable adding 100 calories to their daily intake. They'll start with only 50 calories, and so that elongates the amount of time that's necessary to get to their stop point.

O’Neill adds that what you eat on a reverse diet is a continuation of what you’ve been eating on your calorie-deficit diet.

“Say you typically were going to eat 1,500 calories to lose weight and now you want to do 1,600 calories,” she says. “You could add an extra hardboiled egg and an extra handful of carrots, and that's your 100 calories.”

The best place to start is by figuring out how many calories you are currently consuming. If you need help, working with a dietitian is a good first step.

For more information, visit the OSF HealthCare website.

Interview Clips 

If you’re thinking about using sugar substitutes to help with weight loss, think again. That’s the word from the World Health Organization (WHO).

According to new guidelines, replacing free sugars with non-sugar sweeteners (NNS) doesn’t help people control their weight long-term. The WHO first issued guidelines on sugar intake in 2015, recommending that adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake.

The latest review added that there might be "potential undesirable effects" from the long-term use of sugar substitutes such as an increased risk of type 2 diabetes and cardiovascular diseases. There were 283 studies included in the review.

Jason Crum, a dietitian with OSF HealthCare, agrees and adds there could be other potential risks.

“When you look at sugar substitutes, it's more why am I using the sugar substitutes? If I'm quickly replacing calories because I don't want calories from a can of Coca Cola or Pepsi, a sugar substitute would be something quicker to use,” he says. “However, most people are doing it for a long time, which is creating other problems.”

Those problems start with the gut. 

“We create dysbiosis – that altered gut bacteria,” Crum says. “They use the energy differently, and they make other products out of it, which we in turn absorb. And that messes with our receptors, our ability to understand what's going on in our gut. It triggers more cravings for those sugary foods anyway, it even helps us eat more, which can be an adverse thing for most people.”

Instead, experts say that other ways to reduce free sugars intake include consuming food with naturally occurring sugars, like fruit, or unsweetened food and beverages. Crum says it comes down to making a lifestyle change.

“For most of my clients we don’t want to expect weight loss by just simply avoiding the sugars and using sugar alcohols or sugar substitutes of a different type,” says Crum. “It's looking at why they are consuming the sugary form in the first place? They could have an imbalanced dietary intake, it could be eating foods at the wrong times, it could be emotionally eating. If you're going to have a sugar substitute, you're not quelling that emotional response anymore. So it makes those cravings worse later in the day, and you might end up eating more total calories then if you had something that had the sugar in it.”

Crum recommends people pay close attention to food labels when making decisions about sugar substitutes.

“What are the nutrition facts label telling me? Do I understand what a total carb is? Do I understand what the sugar is under there? Every four grams of added sugar is equivalent to one teaspoon, so if you have 12 grams of added sugar you have three teaspoons of sugar right there,” he says. “So, understanding that gives people an idea of where am I really at here.”

Crum says the bottom-line is don’t rely on sugar substitutes. If you do, you’ll end up craving more and eating more. Instead, evaluate why you’re selecting the foods you eat in the first place. It will make things easier in the long run rather than cutting out certain foods all at once. Going cold turkey, he adds, seldom works for most people.

Interview Clips