Should You Put Your Teenager on a Diet?

On February 14, 2016 By jodietitianIn Uncategorized2 Comments

I still remember that day I was sitting around a long conference table in the Endocrinology department at the children’s hospital where I was just hired to help develop a weight management program for teens and children. There were several nurses, a few endocrinologists, myself, another dietitian and my manager. They had decided the children would keep food logs as well as track their calories. I was so glad I was there to enlighten them about that! I explained that counting calories was a very bad idea as this would not only lead to more focus on food, they would likely gain weight, not lose, and even worse could develop an eating disorder. I explained that even the thousands of adults I had worked with over the past 2 decades were never successful with counting calories, and the only ones who were good at it had eating disorders. Phew, now we can move on (I thought).

No luck. They basically ignored all I said, and my manager was fuming. I was flabbergasted. So the other dietitian and I decided we would gather the research articles refuting this approach, and share it at the next meeting. We did just that but again, no luck. Although I was floored, I had faith they would learn their lesson when it all unfolded.

I was right. When it came time to teach the classes (parents would come as well as the child and siblings if they wanted), the first step was to share their notebooks. These were also brought to individual sessions with the nurses and dietitians. Lo and behold, almost none of the participants did it! Or if they did they were so obviously inaccurate, it was almost funny. Guess what? It took at least 2 years if my memory is correct but eventually they eliminated the calorie counting (Thank God!). The great news is they eventually hired a full time psychologist who had lots of experience with eating disorders and weight issues, and who went on to change the entire program to be more evidenced-based, and focus on health (and not dieting).

Anyway, I picked this topic to write about this week after getting my monthly newsletter from the weight management “practice group” I belong to in the Academy of Nutrition and Dietetics (AND). It included an article entitled “Alternatives to Calorie Counting: Consideration for Pediatric Weight Management”. The article mentioned the AND Position Paper’s recommendations that “treatment plans for managing pediatric overweight should emphasize multi-component, family based programs, which combine nutrition education, physical activity, and behavioral strategies….alternative approaches to calorie counting should be implemented for this population as a means of self-monitoring nutrition decisions”. The article summarized exactly what these “alternative approaches” were.

The author (Giselle Willeford, MS, RDN) does a great job of summarizing the research describing the detrimental affects of having kids or teens count calories (increased focus on food and eating, increased risk of eating disorders or further weight gain). Here is a brief summary of the “alternative to calorie counting” that were described:

Traffic Light Approach: this method (originally developed by Leonard H. Epstein) calls for dividing foods into 3 categories, Red, Yellow and Green. Green foods are things like vegetables and fruits that you can help yourself to (low calorie and low fat). Yellow foods are those foods that have more calories and that you need to be careful with portion sizes (chicken, rice, etc) but are still healthy. Red foods include sweets, fried foods etc. that you should try to limit and/or decrease in your diet. I am NOT A FAN of the “Stoplight Diet”. Although it sounds simple enough, I have seen first hand the damage it can do. I have had several very young children (age 8, 9) that took this diet to heart. They were those really “good” students who got all A’s and did not want to disappoint their teachers, so when they got the message that red foods should be decreased, they stopped eating them altogether. The patients I saw lost weight when they should have gained, stopped gaining in height, with great repercussions to their family relationships (“she won’t come out for pizza with us anymore”, or “he only will eat the “green” foods so we can’t go out to eat anymore, it is driving us crazy!” These children were on the verge of developing serious eating disorders and actually were at risk for stunting their growth if they kept it up. The good news if I have been successful with helping these kids because they just needed to hear another authority figure (“The Dietitian”) tell them all the reasons it was ok to drink milk and eat cheese and even pizza again. My recommendations: skip the traffic light approach. Traffic lights are for cars.
Plate Visuals: this is an easy tool to use for those who can’t read or write, so it makes sense to use it with children and teens. You might be familiar with the colorful diagram, and if not see the website: My Plate The visual shows half of the plate with “colors” and this means half your plate should be fruits and vegetables. A quarter of the plate is for “meats” or protein food and a quarter of the plate is for “grains”. The dairy is on the side and that is your serving of milk. There are some things I really like about “My Plate” for education. It is simple and the message is about adding in and not as much focused on taking away. I have used to demonstrate how much fruits and vegetables we need if we want to be healthy. The downside is that some kids, especially picky eating teenagers, really struggle with vegetables because they don’t like the texture or the taste, and so through most of their life refused them. Parents in turn, sometimes just stop making them with the unfortunate outcome being nobody in the family has been exposed over time to vegetables and so nobody eats them. When you show a teen that plate, they tend to feel bad, and like a failure because there is no way they are going to get to that amount of colors on their plate (unless you count brown or yellow, you know, french fries, macaroni and cheese, Doritos). I don’t like making teenagers or even adults feel guilty, so instead we work on increasing exposure and sometimes start with more fruits. Check out the website for more information.
Portion Sizes: this method uses your own hand to estimate portion sizes. So a “fist” might be a serving of rice. I am not especially irritated by this method, however what if you want 2 fists of rice? I guess the awareness that you are having 2 servings is ok, but then again, will it trigger guilt and overeating? This method traditionally has been used with diabetics, who really do need to follow a special diet with balanced amounts of carbohydrates, so for these folks, it could be very helpful.
Hunger and Satiety Cues: this of course, being the “non-diet” approach for kids and teens, is my favorite! It teaches strategies to help individuals pay attention to their body signals. For younger children, it is called the “Trust Model” promoted by Ellyn Satter (see Ellyn Satter Institute for specifics). This model describes the “Division of Responsibility” with a focus on the parent’s role of buying healthy foods, determining structured meal times, not catering to kids but allowing them to eat as much or as little as they want at a meal. This teaches children to trust their hunger and fullness mechanisms and promotes a healthier relationship with food and eating. With teens, it becomes tricky because sometimes, after over 10 years of being restricted by parents, an abnormal focus on food (such as sneaking food) has developed (survival!). It may require some counseling for some teens who have a significant “disconnect” between their hunger and fullness related to parental restriction. If your teenager sneaks food or binge eats, or restricts and alternates with binge eating, don’t ignore it. Get help by a therapist who specializes in eating issues.

So the answer is: NO do not ask your teenager to count calories. If they are using some app on their phone to track their food intake, pay attention. Instead, work together to find healthy recipes and meals, go grocery shopping to pick fruits and vegetables your children will eat, have taste tests with new ones. Shut off that TV during meals, sit at the table, don’t allow kids to nibble all day, and instead plan for snacks where kids sit down and enjoy it (not in their rooms, nibbling for hours in front of a computer…..who is going to want to try squash when dinner time rolls around?). Consult with a dietitian regarding strategies to make your environment healthier as well as ideas for healthy but yummy meals. But don’t focus on calories or dieting in your home. Instead, focus on EVERYONE being as healthy as they can be. Enjoy eating out, ordering pizza once in awhile, going out for an ice cream cone. Set an example by living the kind of life you want your child or teenager to live. Remember, kids do as you do, not what you say. If you count calories and diet, your teenager will too. If it hasn’t worked for you, it won’t work for them.

Then and Now: Is Technology Affecting Your Child’s Health?

On February 6, 2016 By jodietitianIn UncategorizedLeave a comment

Do you struggle with your child or teenager because they seem obsessed with a video game? Or maybe their cell phone seems to have become an extension of their body? Or, if your child has been identified by his pediatrician as “overweight”, have you gotten the spiel about limiting “screen time” to less than 2 hours a day? What is really going on here and does it really matter?

The purpose of this post is not only to share my experiences with families, but also share some of the research that gives us insight into this whole situation. We older folks like to reflect on “the way it was” back in the day. Although we tend to joke about it, “when I was your age….” the challenges parents face today truly are not funny. The direction we see kids going as far as health and lifestyle is scary.

First, let me get it over with. “When I was young”, make that the year 1974, when I was a senior in high school, this memory sticks with me: the typing teacher (yes, we had giant, heavy typewriters) called us into a room to show us the school’s first computer. It was the size of a refrigerator. It spit out cards with markings on them that meant nothing to me. He said “one day, you all will have one in your homes”. Not me! I thought. Who would want that giant thing in their house? Why would you need one? And here I now sit, nice and comfy on the couch, looking out over the newly fallen snow, with my convenient lap top resting on top of the cozy blanket on my lap, enabling me to write something that people as far away as Australia will (hopefully) read. My husband is in another room, on another computer checking all over the world for possible vacation destinations. My cell phone just beeped (got a message), but at least the television is off (OK, I admit, I am recording the sports station because I love all the pregame stories before the Super Bowl).

Here we go, you know this story, too: when I was young we had one TV in the living room with 3 channels. We walked 2 miles to and from school everyday. We had gym everyday. We walked to the park in the summer and stayed there all day in the pool (pond) or played baseball, hop scotch, hide and seek, rode our bikes, built forts in the woods. Our bedtime was our bedtime, and sometimes the sun was still out. If it snowed, nothing changed. We were still outside all day, building our snow forts and having snow ball fights. You get the picture. We loved it and we were happy. I imagine it was not easy for parents back then, having to be firm with us to get to bed, get us to the park for our swimming lessons before we were old enough to go ourselves. They had nothing to entertain or occupy us (except maybe coloring books and puzzles, or an Easy Bake Oven if you were lucky). Today, it is different.

Consider Tony (made up name) a teenager referred by his endocrinologist for nutrition counseling because of pre-diabetes and obesity. He came to the visit with his mother who was also large sized and had Type 2 diabetes. She was a single mom with mental health issues of her own. After talking to Tony for a very short time it was clear he was not motivated, and really was not worried about his health. For most of his life he has had a television in his bedroom as well as a computer and many video games. His favorite was the one that allows you to play with people all over the world (that was why, he said, he had to stay up until 4 am, because of the time zone differences, and that is when his “team” played). He went to his room the minute he got home after school and stayed there all night. Since his mom did not like cooking, they tended to order out a lot (pizza, Chinese) which Tony would eat in his room while doing his thing. He actually had a small fridge in his room to keep his soda cold, and that way, he did not have to walk down to the kitchen.

As I write Tony’s story, it occurs to me that his story is not unique in my world. Some of you may be thinking “that is horrible!” but the truth is, that story describes a typical teenager that I have seen over the years for the same issues. Yes, being a single parent, especially a parent with depression makes it even harder to make changes. But, this lifestyle is identical in many two-parent homes, with happy-go-lucky parents who are healthy and do not have mental health issues.

It seems to be our culture now that not only adults, but most children have a television in their bedrooms at a very young age (I have seen it even at the toddler age). I believe one of the reasons is that as a parent, it does make your life a bit easier when Johnny is occupied in his room with some movie or game so that you can get your laundry done! Also, peer pressure contributes to the scenario. I can count on one hand the number of parents I know who refused to get their child a cell phone (other than for emergencies, or when they are out so they can call home, which is different, and I don’t blame them!). It is hard to say no to a child who wants the latest video game (all his friends have it!) and it is nice I bet to have something to bribe your child with (if you do this, then I will get you that game!). Not to mention, these games and computers and phone plans are not cheap!

Besides the cost of technology, what are some of the other negative consequences? Here is what I have noticed:

Isolation (not much family time if your child is holed up in his room for hours). In one STUDY of over 5,000 children in 12 countries, that average time spend in sedentary behavior was 8.6 hours.
Poor sleep (many a teenager has admitted to me they turn their computers back on after parents have gone to bed. It is just too hard to resist). Poor sleep contributes to food cravings and abnormal weight gain.
Poor nutrition intake (kids are not snacking on carrots and hummus when they are playing video games, but tend to eat unhealthy foods that do not contribute to health and normal growth). See Study on food intake and physical activity
Lack of social skills (playing with imaginary people on an imaginary video game does not help kids learn how to talk to real live beings).
Addiction (some children are more prone to becoming addicted to video games, see One study on children and teens)
Dangerous situations (if a child has a computer and internet access in their bedrooms, and are logging on after parents go to bed, they are susceptible to trouble)
Physical inactivity (which leads to an unhealthy body, if we need an hour of fun physical activity daily, then spending over 8 hours a day in front of a screen does not leave much time left)

Even though it is clear to most of us that too much screen time is not healthy for our children and teens, what are you supposed to do if your child already has that TV in her bedroom, already has a cell phone they are attached to or already spends hours secluded in their bedrooms with their electronics and technology? Prevention, of course, is easier than a cure. A recent study on Parent’s Screen Viewing Time and children’s suggests that the apple does not fall too far from the tree, and that we need to direct our efforts for helping parent’s change their ways first. Here is my advice:

Take a look at your own habits as a parent. How much time do YOU spend watching TV or working on a computer? Are YOU addicted to any games yourself? Focus on changing your ways and your children will follow. Remember, kids do what you do, not what you tell them to do.
Start early. NEVER put a television or computer in a child’s room. Tell your child, the bedroom is for sleeping. Or maybe playing with friends or reading.
Challenge yourself: can you remove the TV from your own bedroom? That would free you up to join your children in doing something else…hhhhmmmm.
Remove cell phones and computers, tablets, etc. from a child’s room an hour before bed. If you let them keep it in their rooms, even if they “swear they won’t turn it on!” don’t believe them. Don’t expect a child or teenager to be able to control this. Most of them can’t (from what I have seen).
Get ready for some tantrums! If you have allowed your child or teen to be attached to the tablet or phone or TV, and now you suddenly try to change it overnight, there will be fireworks. You might want to start by having a discussion about making healthy changes, and gradually decreasing the time on devices. I have seen success with setting alarms and/or parental controls. I have also seen more success when parents join in and do something fun with their children (puzzles, cooking, hikes, games, etc) as a substitute. Most young kids really love doing fun things with you. Playing a game of checkers with my siblings was always a blast! I know, I know, how are you supposed to get anything done? That could be another post in itself: How to Live With A House That Is Not Perfectly Clean and Organized so That You Can Spend More Time With Your Children Because Before You Know It, They Will Be Gone
Consider transitioning to some active video games that you can do with your child. Kids just love watching mom or dad stumble over their feet with Dance Dance Revolution. It is a fun way to get to use technology yet get some good physical activity in at the same time. Start by moving your electronics to one common area like a family room or living room, that way everyone can participate. Also, it will be less likely your child will be spending excessive time on the device since it will be out in the open.
There are exceptions of course. Many children with special needs really can’t survive without a screen or tablet. They are used for motivation, communication or just to help a child focus. This is different, but you know your child best, so go with your instincts as a parent.

I am sure there are other important points, and good reasons to change this trend. Maybe it is because of the era I grew up that it strikes me as scary. It just bothers me when I enter an elevator in the hospital where I work, and even the young doctors can’t look up to say good morning because they are glued to their phones. It is not to address some emergency, it is clearly a discomfort with communicating in person. I don’t think it is good.

As for me, my screen time is up! It is almost noon here in New England, and I plan on breaking in those new snow shoes ; ) I hope you get out and enjoy the real world too.

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I’m Hungry…So My Body Must Be Broken

On February 1, 2016 By jodietitianIn UncategorizedLeave a comment

Great reminder of how important it is to trust your body…..and your hunger

Dare to Not Diet

Stomach_diagram_feedme It’s actually pretty simple.

“I’m so hungry…there must me something wrong with me.”

“I’m so hungry…it makes me want things I shouldn’t eat.”

“I’m so hungry…it’s really sabotaging my weight loss.”

I have heard all of these statements, and variations of them, A LOT. The only one I rarely hear among the general population these days is, “I’m so hungry…I really must eat now.”

We’ve attached an enormous amount of guilt to eating and worse yet, to hunger. We think our hunger is to be distrusted, that there is something wrong with our bodies when we experience hunger, and that we must do everything to thwart our hunger: ignore it, fill it with unsatisfying air food, quench it with copious amounts of water or coffee or tea or zero calorie soda (or worse yet an ungodly “master cleanse” concoction of water, maple syrup, lemon and cayenne pepper. Cocktail of champions.). We…

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How To Make Everyone Happy at Your Super Bowl Party (Vegans and Gluten Free Friends, Too!)

On January 30, 2016 By jodietitianIn UncategorizedLeave a comment

Have you ever struggled when you have to plan a party because you have guests coming who you know are on special diets? Or, perhaps like some of my friends and family, they can’t have gluten, or they don’t eat meat (vegetarian) or may be vegan (no animal products whatsoever). Now, maybe it is just my Italian heritage, but I always make sure I have food for everyone, gluten or no gluten. Although I may eat meat, and I am fortunate enough to have no digestive issues with gluten, I respect anyone’s decision to eat whatever way they want (for example, choosing to be vegan), and I definitely am going to support those who have medical issues with gluten, carbohydrates, or anything else. With the Super Bowl coming up next weekend, I thought it might be helpful to share some of my ideas for feeding everyone. And even if you don’t have any dietary restrictions, here are some of my favorite yummy, healthy and easy ideas for feeding a crowd.

For the Vegans (also gluten free):

Quinoi Bean Salad (can be used as a dip with corn chips (such as Tostito’s) or in a corn tortilla wrap (lightly fry the corn tortilla in a vegetable oil, drain on paper towel and fold in half to fill)

Make a cup of quinoi according to directions (more or less of it, depending on how much you like it). To this add a can of drained chick peas and black beans. I add a diced red onion, a few cloves of chopped garlic, diced grape tomatoes and sometimes diced kalamata olives, and diced avocado. Add salt, pepper, crushed red pepper to taste. Add some fresh chopped cilantro (I use about half a cup, or half a large bunch). You can squeeze a bit of lime or lemon juice on it (I don’t), or add some olive oil (I don’t). This can be made ahead of time, and again, used as a dip, a salad, on a wrap or gluten free corn tortilla.

For those who are vegetarian but do eat dairy, you can add some melted cheese to the tortilla, or add some feta to the cold salad.

Vegetarian Chili (can be used as a dip also, and you can modify for those who do eat dairy by leaving cheese on the side to add, be sure it is a gluten free brand such as Sargento). This is also known as “Puerto Rico Chili” because I made this while on vacation with a bunch of my friends and their spouses. We rented a beautiful home near the beach in Rincon, PR. That day I stayed at the house while they all went to the beach. It ended up down-pouring a torrential but brief rain, and I was happy to be there cooking!) Although they may have had more fun sitting at the Tiki bar watching the waves on one of the most beautiful beaches on earth…

Anyway, everyone adds their own twist to their chili, I never make one batch the same as another. But typically, I first saute a few cloves of garlic and an onion, also a diced stalk of celery, then add 2 large cans (28 oz) of diced tomatoes, about a cup of vegetable broth (I keep the cubes on hand). I then may add some red wine (maybe 4 oz) and simmer a few minutes. Add drained canned beans (kidney, black beans, cannellini beans and chick peas). I add a diced red and a green pepper. I may scrape some fresh corn from a cob or use a bit of frozen corn (optional). I also add some shredded carrots (half cup or so). For seasoning I add cumin (2-3 teaspoons), chili powder (~3 Tbsp), black pepper (1-2 teaspoons), salt (1-2 teaspoons), a dash crushed red pepper and sometimes hot sauce. This can simmer for hours on low while you make your other stuff, then can sit warmed in a crock pot for people to help themselves. Even meat eaters love it! Spread on tostitos for nachos, with cheese and guacamole on the side. Or use in wraps, add fresh greens, salsa, avocado, whatever you love.

Marion’s Baked Eggplant (can’t take credit for this one, it comes from my best friend Marion who is a wonderful cook and inspiration to her dietitian friend!)

Wash an eggplant and slice with skin on (thick slices, about 1/4 inch). Dip slices lightly in rice flour, then beaten egg (to make vegan just use water), and then gluten free bread crumbs (I get Italian seasoned). Bake on a dry cookie sheet at 400 degrees for ~15 minutes (a fork will go in easily, the outside is a bit crispy, inside mushy). Do not turn over. Remove from oven and layer with Victoria’s Marinara Sauce (delicious and gluten free). Once assembled, bake in the oven to heat up. We usually add shredded mozzarella for the vegetarians, but you can use a soy cheese for you vegan friends.

Roasted Red Pepper White Bean Dip

You can use 7 oz of roasted red peppers from a jar, but I rather roast them myself. Clean and slice in half about 3 red peppers, Oil a cookie sheet and roast peppers on high heat (400 degrees) until they are soft and browned (about 20 minutes, turn halfway). Cool. Blend in a food processor: the roasted peppers, 1/4 cup chopped fresh basil, 16 oz cannellini beans (drained), 1-3 cloves garlic, 1/2 teaspoon salt, 1/2 teaspoon pepper, 1 teaspoon of balsamic vinegar and at the end add 2 tablespoons olive oil. Blend until smooth. This also can be made ahead of time and kept for a few days. Serve with any gluten free chips.

For the Vegetarians

Chili Dip (also gluten free)

Use the vegetarian chili you made earlier, or purchase your favorite canned veggie chili. On the bottom of a flat casserole dish, spread a thin layer (1/3 inch) of cream cheese. Layer this with the vegetarian chili, top with a layer of shredded cheddar cheese and sliced jalapeno peppers (the kind you get in a can, drain first). Bake or microwave until cheese is melted. This is a great last minute appetizer, and I always have the ingredients on hand (frozen chili almost always there because I make so much there is enough to freeze). Serve with Tostitos.

Fish Tacos

I discovered a fish taco seasoning packet that I absolutely love, and these take no time to make. It is made by Ortega and is allergy free. All you do is mix it with water and marinate your fish (I like cod but you can use shrimp or any white fish) for just a few minutes (the directions are on the package). The fish cooks very quickly in a non-stick frying pan (about 3-4 minutes each side depending on the fish). We like to fry our corn tortillas quickly in vegetable oil then drain and fold in half. Add your fish, cheese,salsa, lettuce or coleslaw (see recipe below for yummy homemade coleslaw dressing!)

Coleslaw

I buy the package of already shredded stuff. You can just buy the bottled dressing but I found this great recipe scribbled on a piece of paper, probably from some old cookbook or on-line: Mix half a cup of mayonnaise, 2 Tbsp sugar, 1 Tbsp vinegar, 1/2 teaspoon pepper, 1/4 teaspoon salt, 1 and a half Tablespoons lemon juice. YUM.

Sweet Potato Black Bean Quesadillas

Peel cook and mash a few sweet potatoes, you will need 1.5 cups (add salt and pepper to taste). Set aside. In one tablespoon olive oil saute 2 minced cloves garlic and a diced onion till soft, add a 15 oz can of (drained) black beans, 1 teaspoon each cumin and dried oregano, and 1 tablespoon lime juice, heat through. You can use flour tortillas or corn if you want gluten free. Spread 1/4 of the sweet potato over tortilla, then spread 2 tablespoons shredded Monterrey Jack cheese, followed by a layer of fresh baby spinach leaves, then more cheese and top with another tortilla. Grill 4-5 minutes on each side until cheese melts. These can be made without the cheese to keep them vegan. They are delicious cut into quarters and served with salsa and guacamole.

Use your imagination and invent your own quesadilla! Saute some portabella mushrooms with red onion, layer with spinach and cheese, or for your meat eaters, add sliced chicken or cooked spicy chicken chorizo. The possibilities are endless.

Shrimp Cocktail: no recipe, but always a hit! You can buy the frozen already cooked and just defrost before the game. Serve with cocktail sauce. Always a good go-to fast healthy appetizer.

Salmon Sliders

Another fast and easy favorite of mine. I just saute salmon that I have seasoned with a sprinkle of Old Bay Seasoning (a stand by of mine for all fish). I use a little butter and cook in a frying pan until the fish flakes when you twist a fork in it (usually not more than 5 minutes each side depending on the thickness). I serve on small dinner size potato rolls with yet more coleslaw! But you can also serve with a thick slice of ripe tomato and lettuce, chips on the side, now it does not get better than that! Well, maybe add a glass of nice cold chardonnay.

For the Meat Eaters

Crock Pot Swedish Meatballs

My husbands favorite easy appetizer. To a crock pot add a bag of frozen meatballs (~2 lbs), the small Swedish ones, although I have used the Italian ones and it is still good. Add a 16 oz container of sour cream, a can of Cream of Mushroom Soup, a cup or 2 of sliced fresh mushrooms, and 3 good dashes Worcestershire sauce. Cook in the crock pot on low for several hours until the meatballs are cooked. My crock pot is old and it can take 6 hours. You don’t need to worry about overcooking if on low. Serve these with small snowflake rolls.

Quick Pesto Chicken Pizza

An easy favorite! Use already cooked chicken (buy a rotisserie chicken or one of the “quick” sliced cooked chicken packages). For the crust I use Boboli brand, then spread with Bertolli’s prepared pesto, add some diced or sliced cooked chicken, sprinkle with crumbled feta cheese, sliced kalamata olives, and then some shredded mozzarella. Bake according to directions on Boboli package, or just until chicken is heated and cheese melts. This is easy and delicious. Mix it up by adding some sun dried tomatoes or artichoke hearts.

Boneless Chicken Thigh Hot Wings

Brown about 4 boneless skinless chicken thighs in heated oil for 4 minutes on each side. Place in a baking dish and cover with sauce:

Combine 1/4 cup hot sauce, 3 tablespoons melted butter, 2 Tbsp. water, 1 Tbsp. white vinegar, 1/2 teaspoon black pepper.

Bake at 400 degrees for 25 minutes. You can double this recipe. These are healthier and tastier than the classic fried wings. I can’t take credit for this recipe, but I don’t remember where it came from…..I have it scribbled on a piece of torn paper, like many of my favorite recipes, always in a rush I suppose!

So there you have it, just a few of my favorite recipes which are bound to make everyone happy and most of which you can make the night before and just heat up. I always have the staples such as a platter of cheeses, olives, crackers and red grapes, good old potato chips and dip, and purchased hummus with pita chips if you don’t have time to make your own. I don’t enjoy making desserts (too much thinking, you have to measure, not fun to me!) but I personally may pick up something made at the store bakery just to keep it easy (something that does not require forks or plates, such as brownies or cookies). There is always fruit and ice cream for the gluten free folks. Oh, and I neglected to talk about drinks….no recipes from me (although we sometimes experiment with Sangria…wine looks so pretty with fruit floating in it…making it even MORE healthy!). Do remember, though, many people do not drink and so have those water bottles on hand along with other alcohol-free beverages.

Although I do love football, the most important message I wanted to share was this: enjoy the Super Bowl, enjoy the commercials and enjoy your Super Bowl food. But, always remember to consider your guests and their needs. Respect their personal choices, and definitely respect those who have medical or digestive issues. Nobody wishes that upon themselves, dietary restrictions are not fun, and repercussions of mistakes often painful. And some people, regardless of allergies, restrictions or whatever, just plain like to have healthy but yummy choices.

So who am I routing for? My son lives in Colorado so I may have to go with Denver….plus I love the thought of an older person going out in style…..

5 Mistakes Parents Make With Picky Eaters

On January 16, 2016January 17, 2016 By jodietitianIn Uncategorized2 Comments

eating-watermelon-1-1324695 I dislike beets. I have tried them 7 times. To me they taste like dirt. The 20 bite rule is hard for me when it comes to beets (I really want to give up). For those of you who aren’t familiar with the 20 bite rule, it just means you really don’t know if you like a food until you have tried it at least 20 times. It only took me about 5 times to know I actually did like sushi (not all of it, but the one I was persistent with trying, and even though it has fried tempura shrimp on top, it still counts as sushi). The point is that we all have foods that we don’t like, don’t want to try, or even make us go “eeeewww”.

When it comes to getting children to eat, most caring, wonderful parents that I have met tend to practice the same strategies with no success. I call them “old school” strategies because they are the same old things we have always done to try to get our kids to eat. Although I have shared a few posts on feeding kids and picky eating, I recently read an article in the Hartford Current(January 3, 2016) about Kids and food, and saying the right things. It brought up some great points and made me realize this stuff is worth repeating.

Parenting is not an easy thing, and we all look back with some regrets at the way we did things. But if you want to raise a child who grows up to be an adult with a healthy relationship to food, read these 5 common mistakes parents make, along with a better way.

Mistake #1. Making a child sit at the table until he finishes the peas (or meat, or green beans, or heaven forbid, the beets). If you have done this, you know what happens. Some kids will sit for hours and make a scene. Others will stuff the peas in, gag, and sometimes vomit or spit out the food. If you were forced to eat that one food you despise, what would be your reaction? I would be pissed! Is it no surprise that your child does not behave that well when forced into this situation? The down side of this is the table becomes a terrible place to be. It would not increase the likelihood of trying that food in the future and actually, due to the terrible experience, could turn off someone for good.

Instead, feeding therapists often use a “food scientist” approach to non-preferred foods. For example, the food will be on the table, or even a small amount may be on the child’s plate, but just for “exploration”. What color is it? purple. Is it hard or soft? a little soft. What does it smell like? dirt. Can you lick it? Yes, it is a little sweet, hhhhmmmm. No pressure. Just exposure in a fun, non-threatening way. and the good thing is the table is still a fun place to be.

Mistake#2: Making a child finish his plate. Or refusing seconds to a child. Imagine it is one of those days you ate a late lunch out with friends, and then came home and your husband decided to make an early dinner. You sit down to this beautiful dinner but you really are not that hungry. He piles your plate high with mashed potatoes and gravy, a large slab of turkey, stuffing and a big salad on the side. You tell him you just aren’t that hungry, however he says you have to finish the entire plate. Not a morsel can be left. How would you feel? Again, your body is giving you an appropriate message that you are not that hungry, yet your husband is telling you not to listen to your own natural body signals. You feel you have to force that food down, you feel stuffed and not good, and again, the table is not a fun place to be. The same holds true if the opposite occurs. Imagine you missed lunch and come home famished. The same lovely meal is waiting for you, however this time your husband says “that’s enough for you”. You wanted more potatoes but he won’t give them to you. You leave the table feeling hungry and still thinking about food (and when he goes to bed, because you are an adult, you probably would just go heat some up. But for a child, this triggers sneaking food, which then leads to feelings of shame, clearly not good for a kids self-esteem).

Instead, encourage a child to “listen to your tummy”. Start with smaller portions so you don’t end up throwing away food, then give more if a child finishes. Or simply save the leftover food for a snack for later. This prevents drama, and guess what…..makes the table a more fun place to be, along with teaching the importance of honoring your hunger and fullness. Kids usually have this internal mechanism that will keep them growing normally until we adults ruin it with forcing them to over or under eat.

Mistake #3: Allowing a child to graze or nibble all day long. When kids are picky and refuse meals, or don’t eat much at a meal, parents worry. They think their child is not getting enough nutrition and they really want them to grow. So, if the child asks for some crackers in between, mom is going to give them. Sometimes, a bowl of the snack is left on a coffee table so a toddler can go help herself. The end result is a child who is nibbling all day long on foods that don’t typically provide much nutrition, and then when dinner rolls around, the child has no appetite. Sometimes, the pressure starts, the scolding, the forcing, again, all leading to a negative experience. Imagine picking on food all day long. Are you really in the mood for a full meal when you can’t really tell if you are hungry or full?

Instead, parents should provide 6 opportunities to eat. Breakfast, a morning snack, lunch, an afternoon snack, dinner and one evening snack. If the child refuses lunch, then, without fanfare or pressure, the food is removed from the table (typical meal times are 20-30 minutes). If she comes around asking for food 30 minutes after lunch was offered, the answer needs to be NO. Water could be offered, but that is it. Yes, kids will cry, it is not fun, but they usually do much better at the next meal. Eventually kids get the message that they better eat at meal times or snack time because the kitchen is closed.

Mistake #4: Catering to a picky eater. Short order cooking. This is when you make that macaroni and cheese, or pick up those chicken nuggets because you know Johnny does not eat meatloaf. Or pasta. Or soup. Or fish. And on and on. And why would he? For his entire life he has gotten his nuggets. I have seen teenagers who are stuck on 3 foods because their parents catered to their picky eating. I sometimes joke that if I refused to eat unless it was lobster, I could probably get my husband to make me lobster every night ; ) People who care about us want us to be healthy, but catering to a child does not lead to healthy eating.

Instead, Ellyn Satter (see ellynsatterinstitute ) suggests offering a few “go to” foods that provide nutrition yet do not make you go out of your way. For example, most kids will eat your basic bread and butter, and will drink milk. If you are making meatloaf, potatoes and peas, don’t make a separate meal but have a basket of rolls or bread, a glass of milk and maybe some fruit. Let your child eat as much of these go to foods but do not give in and make that mac and cheese. Instead, have mac and cheese for a meal for everyone in the family once in awhile (we all like our favorite foods on the menu). If you do this along with the food scientist approach, it will be much more likely that your child will try something new. Again, this makes the dinner table a much more fun place to be.

Mistake #5: Forcing food, yelling, belittling, comparing or any other “not nice” behavior at the table. I have heard horror stories from parents about what they do to get their kids to eat. They literally have held down arms and stuck food in mouths (and you wonder why someone would hate sitting at the table?). Parents compare “your brother ate it, why can’t you?” They threaten “if you don’t eat, you won’t get dessert”. This of course could be it’s own mistake because holding back dessert to force a child to eat veggies just teaches them that something is wrong with veggies and sweets are the reward. This can stick with a person forever (when they grow up, have a job, and can afford to reward themselves whenever they want…..a big contributor to emotional eating).

Instead, set an example for your children regarding not only cooking and eating healthy food in a healthy manner (at the table, no TV, no electronics, etc) but also with using polite language. Don’t threaten. It is ok to remind children that it will be a few hours until snack time so be sure you had enough, listen to your tummy, etc. Involve children with menu planning, cooking, setting the table and clean up. Don’t use food for anything other than what it really is: something to enjoy and fuel us and keep us healthy so we can do fun things.

In the end, dinner times can create the most wonderful memories yet. Just keep it happy if you can. I miss those days with 3 kids chatting away around the table, then teenagers, and even the additional friends. It was a blast and even today, when I make certain foods, I think of them. Jen loved stuffed shrimp. Kara loved pesto pasta. Dan loved everything (beef stew for his friend Nick, banana pancakes for half the football team-rumor has it that I made the best of all the moms…just saying).

So start making precious memories of your own. The table is not the place for battles.

And I am going to keep trying beets. At least 13 more times.

New Dietary Guidelines 2015-2020 Released

On January 9, 2016January 9, 2016 By jodietitianIn UncategorizedLeave a comment

stock-illustration-65223149-top-view-of-empty-plate-with-spoon-and-knife The Eight Edition of the Dietary Guidelines was released this week, The Dietary Guidelines for Americans, 2015-2020. The guidelines refer to three different eating styles, Healthy U. S. Style, Mediterranean and Vegetarian. Please see the link below for all of the details. Please keep in mind the guidelines do refer to preventing “disease”, and they consider “obesity” to be a disease by definition. Those of us who believe in a Health at Every Size approach (HAES) understand that a Body Mass Index in the “obese” range does not mean a person is not healthy. It is all about lifestyle and healthy habits. So please look beyond the lingo and check it out if you want to know some of the details. I recommend using these only as a general guideline (it is good to know if you are not eating enough fruits, vegetables, calcium, etc.) but it would be nearly impossible to meet some of the unreasonable expectations for things such as sugar. I am a dietitian, trained in calculating needs regarding nutrition and I could not spend even one day on trying to calculate if what I ate exceeded the recommended 10 percent of calories from sugar. You do not have to do that to be healthy. Becoming aware of your eating patterns and how you feel (do you snack on sweets all day and crash every afternoon? Then adding in some healthy foods and protein of course will make you feel better!). You really don’t have to be so specific and add things up like that. Seek the help of a Registered Dietitian Find a Dietitian for even one visit if you really aren’t sure if you are getting what you need. Here is the link for the new Dietary Guidelines

The Academy of Nutrition and Dietetics (AND) New Position Paper on Interventions for the Treatment of Overweight and Obesity in Adults

On January 7, 2016 By jodietitianIn UncategorizedLeave a comment

scales-1536960 I like to share the most recent news regarding anything to do with weight loss or dieting. Every month I receive the Journal of the Academy of Nutrition and Dietetics (AND) which used to be the American Dietetic Association (ADA). It was hard for me to get used to the new name as I am an older dietitian and for a few decades it has been ADA to me. Anyway, the journal always comes because I pay my fees and it has lots of articles, mostly research (not always interesting to me, I have to admit). But I just love when they publish a new Position Paper because many dietitians have reviewed years of research (not the most fun thing to do) and then let us know how we should do our job. As a Registered Dietitian, I don’t have time to do that ( FYI a Registered Dietitian is an RD or RDN, Registered Dietitian Nutritionist, a newer designation I think recently added because people like the word “nutritionist” better than dietitian, and anyone, yes anyone, can call themselves a nutritionist, but only those of us who have gone through 4 years of college as well as a clinical training or internship and then passing a national exam can then call ourselves a “dietitian”). So when you are seeking advice about nutrition you really need to talk to an RD or RDN.

So I love Position Papers because it saves me all that reading of research which I do enjoy but takes time. Anyway, the new Position Paper on treating obesity that just came out was to update the last one of 2009. I wanted to share with you the important points just so that you know what the research says. For many of the questions there is not enough research to prove anything. So I am going to briefly summarize what I think you may want to know. I am a bit disappointed because the non-diet approach was not addressed. I also do not like that weight loss was the focus and we all know that an “obese” BMI (Body Mass Index) does not mean someone is unhealthy. This is where I think it gets hairy. There are so many other factors that are so much more important such as lifestyle, genetics, etc. that affect health. So I just hate that everyone thinks a certain BMI indicates a problem. What I have seen is that people tend to have a normal weight for them but sometimes their lifestyle and habits change, they may yo-yo diet, or become sedentary, have unhealthy lifestyles, gain weight above what their bodies really want to naturally be, and then yes, there may be health consequences. Dieting is not the answer but identifying those unhealthy lifestyle changes and working on those is the answer. Weight slowly will return to what is normal for them, and then health parameters typically return to normal too. For example, I have seen adults who maintained a certain weight for most of their lives, gone through some life change where they became more sedentary, gained weight, and had an increase in cholesterol level. When they added back their normal activities, eventually they would lose the small amount of unnatural weight gain and blood levels returned to normal.

Anyway, here is the take home messages I think people might want to know:

Reducing sugar sweetened beverages (SSB) does result in weight loss. I am all for decreasing soda in your diet because it really does not add anything. On occasion, fine. But as a daily thing (and I have had patients who get in the habit of drinking a liter a day) well, that is just a bad habit. Have a soda on occasion if you love it, but if it is a habit, it may be a good one to break.
Very Low Calorie Diets (VLCD) did not produce any better weight loss in the long term compared to the typical low calorie diet. I do not promote counting calories at all, or any restrictive diet. However, I know people do it and so I want to be sure you know that going below 1200-1600 calories is never a good idea.
It does not matter if you focus on fat or carbohydrates or anything else. “Macronutrients” are protein, carbohydrate and fat. Many diets focus on restricting “carbs”, or fat or focus on protein. None of these extreme diets work better than just focusing on being healthy. Yes, some of these diets may have some beneficial health benefits (the Mediterranean Diet was mentioned and that it may improve cardiovascular risk factors such as blood pressure, blood glucose and lipids) but that more research was needed.
Eating frequency and timing of eating: as it turns out, there just is not enough research to demonstrate that eating more frequently promotes weight loss. However, there is evidence that eating most of your calories earlier in the day improves weight loss outcomes. And although there is not enough research on breakfast consumption and weight, it does seem to be clear that if you want to be your most healthy weight then you need to eat more during the day. Think about it. I know I have seen many patients who try to restrict all day long and then only end up overeating at night. It makes sense. So eat a good breakfast, enjoy a great lunch, have a snack in the afternoon and then, when you are ready for dinner, you won’t be starving. The research proves this is the best way to have a healthy body.
Physical activity was another intervention mentioned, and a very important one. I loved that the paper stated that “physical activity interventions may assist in weight management via mechanisms that are not well understood”. In other words, it is not all about “burning calories” which is one of my pet peeves. I just hate when people are doing something really fun and then say something regarding the calories they are burning. Doing fun things like hiking or swimming or biking or just walking with a friend are so good for you in so may ways. I just want people to embrace the pure joy of moving and how good it feels. Yes, your body will get stronger and you will feel better with more moving in your life. And yes, you may like the way you look when your body gets stronger. But it is so much more than that. The Position Paper did mention some specifics. The recommendation was to encourage 150 to 420 minutes of physical activity a week (depending on intensity and medical contraindications). So that just means 30 minutes, 5 times a week (also mentioned was that 10 minute increments were acceptable), or if you are going for the upper limit, 420 minutes translates into an hour a day. That sounds like a lot to me and I am pretty antsy. My advice: start where you are. Do what makes you happy and feel good.
Reducing “sedentary behaviors” was addressed. This means decreasing things like “screen time” or TV, videos, computer, etc. It appears there is insufficient research to show if this is something we should focus on. From my experience, I like the general recommendations, especially for kids, to limit this to 2 hours a day. I think all of the great technology (which we all love) does make it easier to sit…and sit….and sit…So being aware of how much sitting you are doing is a smart thing. For instance, tonight is the first American Idol of the season. I am taping it. I could easily get addicted ( I love that show!) But I do not want to be tied to the TV and so by recording it I will be able to watch it while doing other things (like folding my laundry this weekend) and can fast forward through the commercials. Enjoy your screens but it is smart to be aware.
Computer based and e-health interventions: the use of the Smart phone was addressed, and the fact that there are many apps that can be helpful in eating healthy. Also, many dietitians are starting to do coaching over the phone or skype or facetime, etc because people really do want the one-on-one individual help but don’t have the time to travel to an appointment. It is the future of healthcare, and dietitians have joined in providing this service. Research is needed to see how effective e-health interventions will be.
It is important to use other interventions such as Cognitive Behavioral Therapy (CBT) as well as increasing mindfulness when it comes to promoting healthy eating. The paper addresses a variety of behavioral and psychological interventions that are helpful and makes it clear that merely prescribing a “diet” is not enough. We need to do more to help our patients.
Medications and Surgery: the paper does address some medications as well as bariatric surgery (gastric bypass, sleeve, gastric banding) and reviews some of the side effects of both. The point is made that dietitians need to work with a multidisciplinary team to support the patient. Medications and surgery are not for everyone. I have to admit to being very opinionated when it came to both of these interventions. I am not a fan. However, after working in this field for so many years, and especially learning more about individuals with metabolic and genetic disorders, I have changed my opinion. I believe everyone is different and we should never judge. I have learned that reputable bariatric programs promote healthy eating and lifestyles first. Surgery is not a magic answer and it is not an easy road. People have to make really hard lifestyle changes. They can’t have surgery if they don’t make the changes. It is not easy. Anyway, only your doctor knows if you are a candidate for any of these pretty drastic measures. I promote a healthy lifestyle to be the best you can be. But sometimes, people are successful with making changes and it is not enough and they still have health issues that can’t be resolved. Please don’t be judgmental of anyone with weight issues who are just doing the best they can.

The Position Paper also discusses policy level interventions as well as the scope of the dietitian and the importance of working with other professionals to support our patients (such as psychologists, physicians, therapists, school systems, etc.). The bottom line message to me was that we still have a lot to learn. Our health behaviors are very complex and depend on our environment, habits and psychological make up. Our bodies and lives are all different, and YOU are the expert on your own life. Being healthy and feeling your best are good goals to have, but there is no “one size fits all” when it comes to eating.

For more information, visit the Academy of Nutrition and Dietetics website at http://www.eatright.org

Blood Sugar and Willpower: Taking A New Look at New Year’s Resolutions

On January 1, 2016 By jodietitianIn Uncategorized3 Comments

First of all, I need to be honest, I don’t believe in New Year’s Resolutions (for myself anyway). But I know that a majority of people make them (over 75 percent of Americans) and most people, after a few months or so tend to give up (if you have ever belonged to a gym, you know what I am talking about). The resolutions some people choose are never that easy to keep. Since most of them focus on health issues or eating/weight loss and exercise behavior, I felt obligated to share my opinion (and experiences).

There are many reasons people are not successful with their resolutions, and there is disagreement as to what makes some people more successful. It has nothing to do with “willpower”, a word I don’t use because it insinuates some of us are “better” than others while others are “less than”. When it comes to behavior around eating, some individuals, due to their genetic make-up (the way they were born) get full fast, and consequently don’t tend to overeat (nothing to do with their character). Others just do not get that message to their brains (again, due to their genes, and not because they are weak or have no willpower) and so may need to eat more to feel satisfied. Other factors affect eating behavior of course, but that is one example of why willpower is not my favorite word. For more details, check a previous post for a review of Willpower

Anyway, while researching the topic of resolutions, I stumbled upon an article published in the Journal of Personality and Social Psychology (2007, Volume 92, No.2, 325-336), “Self-Control Relies on Glucose as Limited Energy Source: Willpower More Than A Metaphor”. The researchers investigated an important point that most people aren’t aware of: self-control processes act as if they depend on “some type of a limited energy resource”. The article reviewed previous research providing evidence that a single act of self-control (for instance, resisting dessert) uses up a limited energy source that makes it difficult to be successful at any other attempt at self-control.

The researchers hypothesized that glucose was the energy source that our brains have a limited supply of, and that the brain uses more energy (glucose, or blood sugar) with an act of self-control verses performing cognitive tasks. Participants in the research were college students, and nine different experiments were performed with different groups to test out various conditions (specifically, “the major goals of this investigation were (a) to establish that blood glucose levels are reduced from before to after performing an initial self-control task and (b) to show that low levels of glucose after a first self-control task predict behavioral deficits on a second self-control task”). In other words, when your are trying to resist something, you use up a lot of brain energy, and if you try a second time to resist something else, it gets harder and harder due to the fact that you have no energy left.

The experiments that were conducted challenged subjects in different ways. For instance, in just one part of the study subjects were asked to watch a video of a woman talking with words appearing under the video which the participants were supposed to use “self-control” and avoid reading. Challenges such as this were then followed by different challenges, with glucose levels monitored. In other parts of the study, glucose was provided in the form of a sweetened beverage (with a placebo of an artificially sweetened drink) to see if this had any affect.

Findings from this study supported the hypothesis that self-control depends on glucose. As reported in the article: “First, measurements of blood glucose showed significant drops following acts of self-control, primarily among participants who worked hardest. Second, low glucose after an initial self-control task (e.g., emotion regulation) was linked to poor self-control on a subsequent task. Third, experimental manipulations of glucose reduced or eliminated self-control decrements stemming from an initial self-control task”.

What does all this have to do with your New Year’s Resolution? The bottom line is that expecting yourself to have enough “willpower” or self-control to accomplish a bunch of resolutions is not only psychologically challenging, but probably physiologically impossible. The fact that it takes more energy (glucose) to use self-control means that you easily become depleted if you take on too much. And this is just one of the issues why making too many resolutions is not a good idea. Instead, if you insist on making a new year’s resolution,here is some simple advice. Some you may have heard before, but well worth repeating:

Don’t set yourself up for failure. Instead of biting off more than you can chew (“I am never eating junk food again!”) pick just one thing that has been gnawing at you. For example, do you always complain about lack of sleep? Or eating fast food because you don’t know how to cook? Or do you truly live off of fast food and have the indigestion to prove it? Instead of making an “all-or-nothing” decision which I can almost promise will set you up for failure (not good for either physical or psychological health), start small. Make it doable. Cooking a healthy meal even one night a week is a success that you will feel good about.
Keep it positive. Don’t use “negative” words. Instead of “I am NOT eating this or doing that, how about “I am going to……add a fruit to my lunch. Take a karate lesson. Walk to work. Taking away too much is not only negative, it tends to make you feel deprived and makes you want the forbidden whatever even more.
Don’t talk about it. Many people will disagree with me. Some people feel that if you tell everyone (or someone) that you have a goal that you are more likely to feel accountable. Really? It doesn’t sound right to me (and would not feel right to me anyway) to care about what anyone thinks of me or my health habits or lifestyle. I want to sleep better because it makes ME feel better. Plus, if you tell someone, or make a big deal about it, what if you don’t accomplish what you set out to do? Even the people you share with will feel uncomfortable. They likely don’t want you living up to their expectations either. Do what you want to do because you want to do it. On the other hand, there are some people who truly do love and need the support of others. This is different. If you are happy sharing, then do it. And if you need support, and have good friends or family who truly are supportive, go for it. Having healthy and supportive people around us can be inspiring.
No numbers. I just hate numbers when it comes to health. People get all wrapped up in numbers and I just don’t think that is healthy at all. It takes all the fun out of some really healthy things. Take physical activity for example. It can be really enjoyable to go for a walk, or a hike in the woods, or even to jog slowly around a track and daydream. When you have to count the laps, or measure the miles, or time your speed, yuck. It just is not fun.Yes, there are exceptions, those people who just love numbers. Some people thrive on competition and all of that. Those aren’t the people I am talking about. It is the people who start something but then stop because they can’t accomplish the number. Yes, a “smart goal” is specific, but that can mean making a goal of getting outside twice a week. It does not have to be something ridiculous. The same holds true with eating. It takes the joy out of meals and food, and disconnects you from what your body needs. The number on the scale is also pretty useless when it comes to health. I have known many individuals who have succeeded in bringing down blood pressure, glucose levels, and others who have taken up a sport and gotten fit, but then stopped just because the number on the scale stopped moving down. Why not skip the number goal and just focus on the health aspect?
Pretend it is not January 1st. Really. Yes, it is great to reflect on your life and health and want to make changes that move you in a better direction. But you can do that any time. June, September, your birthday. Actually, our lives change more than once a year in one way or another, and it is important to readjust sometimes. Getting into the habit of even just caring about your health is much more important than picking some unrealistic and extreme resolution on January 1.

So there you have it. No resolutions for me! As I get older, and my life (and body) change, my focus on figuring out how I can feel my best, be my healthiest (physically AND mentally) and live the longest fun life really doesn’t change. I hope you consider a focus on health too.

Here’s to a Happy Healthy New Year!!!!!!

Can YOU Make the Pledge? No Diet Talk for the Next 2 Weeks

On December 15, 2015December 16, 2015 By jodietitianIn body image, dieting, Uncategorized, weight2 Comments

The month of December is typically a time of joyful craziness. Young parents are scrambling to get everything on a child’s Christmas list, co-workers are organizing cookie swaps, friends are wanting to get together to make a holiday toast, toy drives and food drives are happening, the malls are insane, and on and on.

But something else is also occurring at this time of year. People are thinking about their “New Year’s Resolution”and at the top of the list is anything to do with losing weight and/or getting fit. Besides all the energy given to the fun stuff, some people are spending a lot of time thinking about and talking about how they want to change their bodies. Sometimes, the talk occurs because of a recent medical diagnosis, such as newly discovered diabetes or hypertension, or even elevated liver enzymes where it is important to make dietary changes. This is not what I am referring to. I am talking about those people who have spent much of their lives focusing on their weight and body size.

The things I hear come out of people’s mouths at social gatherings probably irritate me more than most (such as my husband) because of my work experience with individuals suffering from eating disorders, especially teenagers. Our culture’s focus on bodies has made it acceptable to promote disordered behavior around eating and exercise. Conversations abound regarding how to lose weight, diet products, and even how to supposedly mold specific body parts into your dream “whatever”. When young people hear adults (especially parents) discussing these things, it becomes clear that trying to achieve weight loss and a certain body size is a good life goal indeed. Is this really what we want our children to grow up with as an ideal that is important enough to take up all that time and energy? It makes me so uncomfortable when an adult is talking about their own body or dieting in front of young adults or children. I typically change the subject, or at lest try to. And it is not just children who are affected by this type of talk. Adults struggling with eating issues and weight are also affected in ways you may not be able to understand. One of the big struggles some of my patients experienced was having to convince themselves to stay on track with their recovery despite what felt like the entire world was doing around them. Why was it important for them to continue eating their meals and snacks when clearly it was alright for everyone else in their lives to restrict and diet? It would take a lot of work to help a patient get grounded again and fight the eating disorder voice that tortured them.

Besides focusing on their own dieting and weight goals, another topic of discussion is OTHER people’s bodies. My husband does not get it (he is an engineer and not at all familiar with a non-diet approach or the great divide in the professional world of weight management). Why would you not tell someone how great they look if you have not seen them in a long time and they lost a lot of weight? Won’t that make them feel good?

The problem is, you don’t know what they did to lose that weight. I have known countless patients who dread the holidays because of the focus on them and their bodies. Again, it gets confusing. For example, a young woman I worked with had finally been successful with gaining enough weight to stay out of an inpatient facility. She had stopped purging for several months but did not gain enough weight yet to restore herself back to her normal weight and was not menstruating. At her holiday family party, those who did not know what she had been through (and was continuing to work on) made the usual comments about how great she looked. Those who knew she had gained weight with much hard work complimented her on that too (also not good as this almost always makes someone who is recovering feel “fat”). Those who knew nothing of her ordeal told her she looked great with all that weight loss and “how did you do it?!”. Ugh. After the holidays and all of these conflicting messages, the work is never easy to get back on track.

With that said, you may know someone who you know for sure had been working hard to change habits and get healthy. Doing things like quitting smoking, taking up physical activity, eating more vegetables and learning how to cook healthier does result in weight loss for some. Instead of focusing too much on their bodies, giving praise or positive feedback for the healthy changes is different (“You must feel so good! You have so much more energy, that is great! Your blood sugar is back to normal, yay!)

So this is what I am asking you to do: Make a pledge.

Please pledge to try to recognize dieting and body talk.
Pledge to catch yourself doing it.
Pledge to stop doing it in front of children or young people.
Pledge to try to stop doing it constantly even with close friends.
Pledge to (try to) change the topic when others are doing it.
Pledge to avoid commenting on anyone’s body, especially someone you don’t know well because you will never know what they are going through and how it will affect them.

Thank you! Here’s to a wonderful holiday season and remembering what the season is about……

My Tips for Holiday Happiness

On December 8, 2015 By jodietitianIn Uncategorized1 Comment

I remember way back in the day when I was a child visiting my old Italian Grandmother at Christmas time. She had this tiny fake table top tree on a coffee table. Yes, it was lovely, but I thought to myself “how can anyone settle for such a small fake tree? I will never do that!”

But now I understand. I love traditions, but as time passes by, children grow up, time is short and priorities change, so do traditions. Sometimes these are hard to give up. The tradition when I was growing up was for my mom and her sister and two brothers and all of their kids to go to Great Grandma’s (small) home and have Christmas (25 people in addition to random great aunts and uncles and cousins who might stop in). There was always a gigantic fruit tray covered with dates and figs, nuts and chocolate along with all varieties of Italian food. We kids would be all over the place, climbing on couches and under tables, eating and laughing. As the years went on, Great Grandma passed away, and new traditions evolved.

After I had three children and a home of my own, I took it upon myself to have a gigantic family “Open House” the Saturday before Christmas. This way, my siblings (who also had children) and I could be home with our families Christmas Eve (easier for Santa Clause). Because most of us were struggling financially, we totally eliminated buying gifts for each other and instead, for this party, everyone bought a 10 dollar gift for their children, wrapped it and stuck it in a Santa Clause bag that was kept hidden. After much talking, eating and holiday music Santa would arrive with fanfare! He would be loud with his HO HO HO (since he was a professional who my aunt was able to get due to the fact she hired them for the malls…one year even I was almost fooled). Santa would take out the gifts one by one as each child would go and sit on his lap. We would gather around, the adults almost as excited as the kids. Since everyone brought a dish or dessert, and no one needed to bring gifts except for their own child, it was a simple yet wonderful night filled with all of the important things: family, fun and love. Since then, our children have all grown up . Many of them are in their 30’s with children of their own. Some have moved out of state and can’t afford to fly home every Christmas. Yes, times have changed. And so have the traditions.

I continued to have open houses however not everyone could attend. One year we decided to look for a retirement home in Naples, Florida (not that we are ready to retire, but prices were low at the time). We ended up purchasing a lovely condo with a “Lazy River”Pool that is fantastic. We are able to rent out the condo for all of the winter months, but for the last 3 years have gone down for 2 weeks over the holidays. At first it was hard because I felt guilty leaving the one daughter who still lived home in CT as well as missing seeing my parents and siblings who still get together at Christmas. Because I still had my “Open House” or at least a family holiday dinner the week before we left, I still had that feeling of connecting with family that I needed….just not on the exact day of Christmas.

Now, I count down the days to fly away! Last year two of our daughters were able to join us and that was wonderful. Thank goodness for Skype and Face-time because I was able to “see” my son in Colorado and my parents and family at home.

Even with all of the ways we have changed, and even simplified the holidays, this time of year can still be draining. Besides accepting that traditions are bound to change a bit, there are other things that interfere with enjoying this season that I think we all struggle with. These are my top issues and how I have learned to deal with them:

Making everyone happy. I remember when my daughter was about 7 years old and wanted this walking barking toy dog. They were all the rage….and no where to be found. My friend asked me if I wanted to drive to the next state because she found two there in some store. I declined. Where do you draw the line? If she does not get the walking barking fake dog, will it really ruin her Christmas? Instead, Santa left a note that he ran out but he would send some money to buy one if she still wanted one. A week went by, she got to see her friend’s walking barking fake dog…came home and said “I’m glad he ran out. I don’t want one”. What makes your family happy? YOUR happiness : )
Baking the traditional cookies for everyone so they will be happy. This may only be my issues (probably because making the same traditional cookies allows me to reconnect with my family, and all of those great memories). The fact is, I do not like baking. It has to be cold and dark, and maybe with a candle or two lit. Snowing is better, and conducive to baking enjoyment. It rarely snows when I have to bake. I need to send out my cookies to Colorado and Austin and South Carolina, so I need to get them done. I have learned to compromise. I no longer bake every single cookie. I no longer make 92 dozen. One small container per person will do. I need to fight my Italian instinct that more is better when it comes to giving people food. They truly don’t care. It is the thought that counts.
Getting gifts for important people in your life to show you care, when you don’t have extra money lying around. My close friends and I no longer exchange gifts. Instead, we go to Happy Hour. There are still people however that means something to you, maybe a special co-worker or even just the mail man, or your hair dresser. Yes, I may give a cash gift (especially if it is your hair dresser who you have known before your hair turned gray). Otherwise, I like to make what I call “White Chocolate Crunch”. This is a yummy mix that can be wrapped in those small cellophane holiday gift bags, tied with a ribbon, and good to go. A batch might make ten gifts. Here is the recipe that I found in a newspaper while waiting for my snow tires to be put on a few years ago: Melt 3 (12 oz) bags of white chocolate chips on low. Stir in 3 cups of cheerios, 3 cups of rice or corn chex, 3 cups of pretzel sticks (thin), 2 cups of raisins, 2 cups of peanuts, and a large bag of M and M’s. Mix well. You can add more or less of whatever you want. Spread on wax paper and cool completely. It is the best.
Parties. Happy Hours. Too many social events with people that you want to see but you don’t always have the energy for. Don’t get me wrong, I love parties and happy hours, talking and sipping wine and catching up. But not when I am exhausted. Unfortunately, I have had to decline a few happy hours, and had to leave one of my favorite annual holiday parties early because I am fighting a cold. It just is not worth it. So, my advice is, as usual “listen to your body”. Just say no. Your good friends and the people that matter will be just as happy getting together in January.
Taking care of your health (sleep, eating, fun moving, etc) when time is flying. Even though our schedule is busier, with more to do than usual, our bodies still need to be nourished with food, sleep and movement. Our diets don’t need to be perfect, we may not get our usual sleep, and our exercise/physical activity patterns may change for a month. It really does not matter much unless it is extreme. Are you missing meals or living off of cookies? are you drinking too much Wassail punch and not enough water? Are you staying up to the wee hours so all those packages can be wrapped perfectly? It is wise to look ahead at your week and weekends and be prepared. Plan to get to events early so you can leave on time and get to bed at a reasonable hour. Bring water or other non-alcoholic drinks to parties so you can stay in balance (or just know your limits). Don’t forget to buy your usual lunch food for work, food for dinner (even if you have to buy ready made food such as a rotisserie chicken) so that you don’t miss meals for the simple fact that you were so busy getting stuff done you forgot to buy food. Maybe you have too much to do and can’t get to your Zumba class, but you still deserve a break such as going for a leisurely walk on a weekend when you may have more time. On the other hand, if you have been shopping and cooking and cleaning all day, don’t try to get in visit to the gym just because you feel that you should. Listen to your body if it is exhausted. If is it not going to be rejuvenating, but will only serve to exhaust you more then skip it.
Christmas Cards. I know there is some kind of rule that you only need to send holiday cards out to people who send them to you. I love getting the cards from old friends and others, but I just honestly don’t love doing cards. I love making calendars though from the hundreds of funny pictures I collect throughout the year. So I may make a funny calendar for someone, or a funny card….or not. I used to feel like it was a job, an obligation, but not anymore. I don’t think people care. I know I don’t care if you send me a card. I just want everyone to have a happy and healthy holiday. But like I said, I may send a funny calendar, it just might not be on Christmas… So, that Funky Tree you see at the beginning of this post…..our new tradition started several years ago. Since we now go to Florida we can no longer have a real tree, so we purchased the funky tree which, you guessed it, stands on the table. Whenever we travel we keep our eyes open for the silliest funkiest ornament we can find (hippo on skies, Santa on a Hammock, etc). Each ornament carries a special memory….we love our little tree and everyone else has grown to love it too. So yes, traditions change, holidays are stressful, but, if you take the time to keep it simple, this time of year can be as special and meaningful as it was meant to be. Happy Holidays!
Santa Clause……