I was not surprised when my doctor told me I needed to take a calcium and vitamin D supplement after a recent bone density exam. Being at the age where bone density starts to diminish, and being a dietitian on top of it, I was fully aware that my intake of calcium was sub-optimal. But time flies by, doesn’t it? No matter how much I know about nutrition, somehow here I am. Although I do believe in good nutrition I have never been a fan of thinking about it too much (unusual maybe for someone in my field of work).
The reality is that dietitians and nutritionists are probably at a distinct disadvantage when it comes to “cognitive restraint”, or using your head to figure out what to eat instead of listening to your body. Our training can make it kind of difficult to “listen to your body” or “eat intuitively” which often translates into “eat whatever you want for heaven’s sake”. So, although I was well-aware of my dietary inadequacy, I admit to leaning more heavily into the “eat whatever you want for heaven’s sake” mentality…..which was not too good for my bones apparently.
When you hear the term “intuitive eating” it typically is in reference to dieting behavior and offered as an alternative to stop the insanity of dieting. Yes, billions of people diet to lose weight, and many yo-yo, gaining and losing the same weight year after year (which we know is not good for our health, yet it is hard to give up that hope that this time it will stick). Despite the statistics on the failure of diets, I don’t tell people what to do and will support those who wish to follow some type of guideline because for some people, re-learning how to eat can be very helpful, and yes, it can stick. But this is probably rare, and from what I have seen at least in my patients is when it “sticks”too much it is really disordered eating. When it “sticks” in a non-harmful way is when individuals truly change detrimental habits even when they no longer are following a specific “diet plan”. So, how can you prevent the negative consequences of “cognitive” eating yet also avoid the repercussions of interpreting “intuitive eating” as meaning “eat whatever you want”? The trick is learning how to do both: be “cognitive”, but also intuitive, gradually interweaving both into your eating style so that you can be both healthy and sane.
The first step is to try to determine if you are a “restrained eater”. Although “cognitive restraint” is often defined by the experts as “the intent to limit food intake to prevent weight gain or to promote weight loss” to keep it simple, I like to think of cognitive restraint as “using your head to figure out what to eat” despite the signals coming from your body. Sometimes people think too much about food even if it is not because of weight related issues. For example, it is lunch time and you brought a salad. You are absolutely famished, craving a burger but will not allow yourself to go to the cafeteria to get one. You read somewhere that red meat is bad for you so you are not going to eat it. Or, it is 9 pm at night, you are counting your calories and according to your records, you still have 200 calories left that you can eat. You are not hungry at all…..yet you go ahead and pop some popcorn because you like popcorn and you “can have it” since it is just the correct amount of calories. You don’t pay any attention to the fact that you are not hungry. Both situations are examples of “cognitive” restraint, using your head and ignoring your body. Both examples are contrary to “intuitive” eating.
For research, investigators use very specific tools to evaluate if someone is a restrained eater or not. Some of the common characteristics of restrained eaters include, but are not limited to:
- frequent dieting
- counting calories
- excessive fear of weight gain
- guilt after eating
- food avoidance
- labeling foods as “good” or “bad”
For our purposes, if you can relate to any of these statements, you may have some characteristics of restrained eating. For those of us who are dietitians or nutritionists, or even those of you who educate yourself about foods and nutrition, you can also fall into the trap of too much thinking about what you eat. I have seen extremes in thinking when it comes to nutrition, with fads coming and going as well as information that is not evidence-based. Some examples include avoiding gluten at all costs, not eating carbs,avoiding foods with added sugar, avoiding processed foods, etc. Some people need to be on special diets due to medical conditions or allergies, or even having a digestive intolerance to a food. Avoiding GMO’s or choosing to eat organic or fresh food is not what I am talking about. It is having an unreasonable fear of foods that on occasion have no affect on health whatsoever. Missing out on eating your grandmother’s famous sticky buns on a holiday because you have chosen to avoid gluten (without evidence of an allergy or medical condition) is restrained eating. Feeling guilty because you “don’t eat processed foods” yet gave in and bought some Girl Scout Cookies to support your niece (plus you LOVE Thin Mints) is also unrealistic. Refusing to eat a meal in a restaurant because you don’t know what they put in it (even if you don’t have food allergies) might be an issue. If what you allow and don’t allow yourself to eat tends to interfere with your social life, well, that may suggest a problem.
What about “Intuitive Eating”? The basic principles of intuitive eating can be found on the website Intuitive Eating. Basically, learning to be more intuitive with eating means getting re-connected with your natural body signals, rejecting the “diet mentality” and relearning how to trust your body’s natural wisdom. This sounds simple, but it is downright scary for many. “If I let myself eat what I want, I will gain 50 pounds! I will live on cookies and ice cream!” or so the thinking goes. To be honest, from what I have seen in former patients, the process of moving into a more intuitive eating style is different for every single person and depends on their unique eating/dieting history. I have seen people do exactly that: live on ice cream for a week. If you have lived for several decades denying yourself certain foods and suddenly the bars come down, it is almost instinctual to dive in! But a funny thing tends to happen. You honestly and truly DO get sick of ice cream. Suddenly, grilled chicken looks very appealing. The wisdom of your body really does win out in the end. But the path is not always simple or easy (which is why I always recommend anyone who has a history of dieting and is tired of it seek the help of a therapist and a dietitian, preferably both who have experience working with individuals with eating issues). Some people do fine on their own, after reading the book Intuitive Eating by
The question is, how do we be both “intuitive” and eat what we want while listening to our natural body signals (and trusting them) yet also be “cognitive” in a way that helps us make smart and healthy decisions about eating? I feel ignoring nutrition is a mistake. I like the term suggested with intuitive eating called “gentle nutrition”. The reality is, if we eat a variety of all of the food groups (meats or protein foods, fruits and veggies, grains or starches or other carbs, dairy and fat) we tend to crave less. Imbalances trigger cravings. Remember the chemical messengers our bodies have to tell our brains what we are missing? For example, serotonin levels drop in our brains when we don’t get enough carbs and trigger us to want sugar or sweets (survival!). Yes, our bodies are pretty darn smart that way. Eating well also makes us feel well. Learning what makes you feel your best (with foods that you actually really enjoy) is key. One example I often give is eating adequate protein to avoid that afternoon blood sugar crash. Without it, you will almost be guaranteed to run out of energy and be excessively hungry which is really irritating when you are at work and there is no fridge to run to. So planning to include your favorite yummy protein packed lunch is not what I call excessive “cognitive” restraint, but smart and enjoyable eating. Yes, you do have to think about it. But over time, you start to find your favorite, doable, somewhat healthy meals and snacks that taste good and make you feel good. You may make mistakes, you may change your mind (we all get burnt out on foods, even our favorites) and so you experiment with other meals and foods. The key is to keep learning through trial and error. You do have to educate yourself a bit about nutrition (the basics, not fads, even the My Plate government website is helpful for basic nutrition info if you can promise me you will ignore the weight loss focus of some of the links). Once you get a basic idea of how to balance meals to feel good and meet your basic needs, experimenting with cooking is also helpful. Last night I took my mom grocery shopping and made her favorite black bean and corn salad. She just loves it, and to watch her tasting it, you would have thought she was eating something amazing (to her it was, to me it is just bean salad, good, but not lobster salad which is much more amazing if you ask me). The point is, good food should be yummy, too.
For those of you interested in the reasons restrained eating often leads to increased hunger, you may enjoy the research article Cognitive Restraint and Appetite Regulating Hormones which describes a connection between ghrelin, the “hungry” messenger and dietary restraint. Despite the leaps and bounds we have made in understanding how what we eat affects our brain chemistry and appetite, there’s lots we still don’t know. All the more reason to work on a better connection to the natural wisdom of your body.
One more thing. Clearly, knowledge about nutrition does not translate into action. I was well aware that I probably was not getting enough calcium in my diet (the ice cream in my morning coffee, yogurt and grated cheese on everything was not enough). Don’t be like me and wait for something to happen. I did purchase that supplement. Now I need to remember to take it : O
One step at a time.