Giving Thanks For A Bumpy Road

On By jodietitianIn Uncategorized1 Comment

Image may contain: people standing, tree, plant, sky, outdoor and natureThere is a reason I don’t ski.  And it is not just because I am not a fan of heights, I hate speed and despise the cold. Why would I ever want to sit on some shaky lift that brings you way up high just so you could freeze your butt off while at the same time sliding out of control at an uncomfortable speed….with those things strapped to your feet? Well, when a ski trip is a Christmas gift from your boyfriend at the time, what choice do you have but go?

It was not pretty. What was supposed to be a wonderful weekend spent skiing with friends, then cooking a nice dinner in a beautiful chalet in the mountains of Vermont did not turn out exactly as planned. This girl decided to criss-cross her skis on the last run down the (baby) hill. Just to be clear, the baby hill at Mount Ascutney in Vermont is like a wall (if you ask me). Anyway, when I found myself face first in the snow, I felt a new joint in my shin, somewhere between my left knee and ankle. Yup, something broke. I didn’t move, and I didn’t look at it because I knew I would faint. I just stared up at the blue sky and waited……I could see my friends come toward me and tear off their equipment so they could help. Thankfully, they both were in medical school and knew what to do. Being as it was on the side of a mountain, in the middle of nowhere, there apparently were no ambulances or stretchers, so I was gently placed on a toboggan, slid down to the waiting station wagon that transported me to the hospital. Long story short, my left leg had 2 breaks (tibia ad fibula) and when I could not walk with the crutches, they realized my right ankle was broken also. So I arrived home with not one, but two casts, one on my entire left leg and the other a walking cast up to my knee.

It just so happened to be in the middle of my dietetic internship (at Vanderbilt Hospital in Nashville) and now I would have to stay home for a month. I was not happy. One minute I was enjoying a daily jog around the city of Nashville and bee-bopping around the hospital learning how to be a dietitian. I had just finished a dance-a-thon at the college. Now, I was flat on my back….for a month.

It was my younger brother David who said a few words that changed everything. Just as I was feeling like life was over, he said “just think….this is probably the only time in your life that you are legitimately going to get to sleeze!” hmm. I am not one to “sleeze”. I have lots of energy and feel lots of guilt when I don’t do what I think I am supposed to do. This was not easy, yet, I realized he was probably right. There was nothing I could do but wait. I might as well enjoy it.

So I started to watch all the dumb TV shows I never would have time for before. I read magazines and played board games and cards with whoever would sit long enough on the couch with me. The month flew by and before long, one cast was off and the other cut down to a walking cast, and I didn’t even need my crutches. Back to school, work, studying and moving again. The funny thing is, my brother was right. I learned so much from that time, a time that at first appeared to be a major bump in the road for me, one that made me afraid and want to give up. After that, I learned I actually could get through things. Little did I know at the young age of 22 how often I would need to remember this lesson over the next almost 40 years of my life.

Have you ever had a plan, or a dream that did not go as planned? Have you gotten rejected from what you thought was your dream job, or dumped by who you thought was the love of your life?  Did you ever have the rug pulled out from under you just when things were going along just perfectly? In the world of body image and dieting, have you worked hard dieting and exercising and lost all of the weight you wanted, but then gradually found yourself back where you started? Or, have you struggled with an eating disorder, worked hard at recovery, gotten to a better place, only to fall into ED’s clutches again?  With Thanksgiving around the corner, I have been reflecting about all of the things I am grateful for. Like everyone else I imagine, the simple things come to mind. Family, children, friends, shelter, electricity, food, flowers, music, a job, eyesight, hearing, taste, legs to walk, hands to cook and garden, a cozy bed to sleep in, peace in my home, love in my life. As I reflect on all of this obvious stuff, what I realize is that I would not be here if I had not had the bumps in the road. When I look back, all of the times I felt like crawling into a hole actually equipped me with strength. With every fall, I learned something about how to cope. Yes, it would be lovely if we could avoid every painful experience, or so it would seem. But I imagine life would be so much less rich, way too vanilla. How can you appreciate warmth if you have never been cold? How can you appreciate peace if you have not experienced friction? How can you treasure freedom if you have never been imprisoned (by something)? By that I don’t mean the steel bars of jail, but what may feel just as restraining and debilitating. Rules about how to behave, self-expectations about where we should be by now, self-imposed standards about pretty much everything. And I could go on and on about that one.

So with Thanksgiving and the holidays coming up, I think a lot about the people I have know throughout my life and how they are coping. I think about former patients and pray they get through all this, and even find themselves enjoying it all. I think about those who are dieting and have fallen (or feel like they have fallen) because they have taken a bite or a serving, or maybe succumbed to a binge because of all the triggers around this time of year. I can almost hear their self-talk and feel the weight of the guilt that descends like a ton of bricks, like a loud yelling voice, a voice that insults and berates….a judgmental voice.

It has dawned on me that when it comes to pretty much everything in life, we need to fall. But it is how we look at our falls that matters, not the fall itself. Even if it is not that we fell, but that something was thrown in front of us that caused us to stumble, it matters how we decide to look at it (yes, decide, because it is our choice). I understand that we are all different as far as how resilient we are. Some of us can just stand up after a fall, dust off our clothes, and move on. But others tend to get dragged down, and just can’t stop thinking about what they could have done, should have done, or even fall into the blaming of everything on their bad luck. Any way you look at it, these are what some consider to be the negative-ish people that always seem to complain about their circumstances. They may not be able to help it, it may just be their nature. But I like to think that if we become aware of what we are doing, and we don’t like it, at least we can decide to experiment with going in a different direction. Notice I said “experiment” and not just “decide to do it”. Maybe because I am not a fan of commitment when it comes to changing behavior. I think it is rarely that easy. I believe we do need to try different approaches to things, and that we don’t always know right away what may work for us. Part of the problem I see is that many people who want to change think there is only one way to do it, and that is just not true. There are a gazillion ways to change, and sometimes we need to try dozens of different things before we ease into what works for us. And therefore, that requires stumbling. And falling. But then you get up. And when you do, I hope you smile and say “that was interesting! well, that didn’t work! I wonder why…………..let me think about this”. Analyze it. What happened? What were the barriers? What are your triggers? How do you get rid of them? And then start experimenting….again.

Sometimes, though, the bumps in the road have nothing to do with us or our choices. Sometimes, really bad and sad things happen that we have no control of, and these sad things really affect us. Losing a loved one is the hardest thing (in my opinion). My mom has been struggling with the loss of my dad over a year ago. A friend of hers (who also lost her husband years ago) said to her “don’t let anyone tell you when you should be over it. It took me 7 years. It takes as long as it takes”. This one statement helped her so much. She let go of her own expectations and self-judgement as to why she was not in a better place. She now accepts where she is and does as much as she can to help herself. She is getting out, and hiking up mountains and getting lost in corn mazes (it was a first for both of us, we both get lost at the mall, a corn maze was not a good idea). She talks to strangers wherever we go. When she grocery shops (which is often…she is not good at keeping a list) she donates to the food banks when they are there. She bakes cookies for us and still cooks on Sunday. But, she no longer seems to be expecting herself to live up to some magical standard when it comes to getting over the loss of a man she spent decades with.

So with this holiday season, I wish everyone would be thankful for the bumps in their lives. I hope we all just accept wherever we are (it is probably where we are supposed to be, after all) because we may have more to learn. We DO have more to learn. We probably will ALWAYS have more to learn. I never want to be that person who knows everything (or who thinks they do). I am not a fan of those kind of people. I prefer the real ones.

I wish you a Happy Thanksgiving, and hope you find lots to give thanks for. Family, children, friends, shelter, electricity, food, flowers, music, a job, eyesight, hearing, taste, legs to walk, hands to cook and garden, a cozy bed to sleep in, peace in your home, love in your life.

The Gift of Good Enough

On By jodietitianIn Uncategorized9 Comments

When my son turned a year old, I made him a Choo Choo Train cake. It did not look like this. It kind of resembled a train “wreck” if you ask me. The frosting was kind of thick and it definitely did not have great wheels. I am not artistic but for some reason, since he was my first (and only) son, I thought he should have a train. When I look back, I realize no matter how bad I felt about the appearance of that very important cake, it was good enough. Now, he lives in a different time zone, and he has a birthday coming up, and I bet he would love to have me there making him a cake and would not care at all what it looked like. And neither would I.

Although this is a “nutrition blog” the idea of “good enough” is relevant. It doesn’t only apply to baking the perfect looking birthday cake for your child. It applies to all aspects of life, and especially to eating (and exercise). I have observed that many people tend to turn to food and eating to feel better about not being “good enough” in some aspect of their lives. I also have seen people avoid eating and starve themselves because they don’t feel “good enough”. Let’s face it, people, women especially, are super critical of their bodies. They are NEVER good enough. I don’t think it is always about comparing yourself to others, but often just being hypercritical of yourself. I have witnessed both women and men be critical of their bodies (but mostly women, probably because we women spend more time on things like appearance….unfortunately). Much of the time the discussions focus on weight loss but sometimes I notice we tend to over-scrutinize body parts. Butts too big or too flat, legs too flabby, arms too thin, chest too small or too big, hips too big or no hips at all. I am always fascinated when I get the chance to people watch on a beach. It is so glaringly obvious how different we all are when it comes to our bodies. Tall, short, muscular or not, round, straight, long legged, short legged, even kids and teens all differ. Dark, light, red headed, brown or black or white haired, curly, straight, bald. No two people look alike. And yet, we still scrutinize as if we can change things, and even worse, when we can’t we blame ourselves.

It is not only our bodies that we want to perfect, it is our eating. I absolutely love those nutrition-innocent adults I know who “just eat”. They don’t read labels, they don’t analyze every ingredient, and they definitely don’t jot it all down in their app. They may be healthy eaters or not-so-healthy eaters, but still, I just love them,probably because in my world it is refreshing to be around people who are not obsessed with it all. Yes, I do preach healthy eating and totally believe in the fact that you do feel better when you tend to eat a variety of healthy foods on a regular basis.But is it really necessary to find that one bar with less than 5 grams of sugar? What if it does have 10 grams but also has protein and fiber and tastes good? 5 extra grams of sugar translates into 20 calories. Do you really think that will matter? Yet, I have overheard people talking about things as minute as this, just to be a “perfect” eater. There are other things people monitor, and actually, some things definitely worth avoiding (such as trans fat). But when we take it to extremes, it just creates stress (not good for health).

Besides bodies, and eating, many people also have unrealistic expectations about exercise. I had a wonderful experience awhile ago with working with a young woman who was not feeling too energetic and thought maybe eating better would help. As it turned out, she was not sleeping well at all. She had recently moved and previously had been working out at the gym for 2 hours a day. Now, she just did not have the time so she stopped. She admitted to being an “all or nothing” kind of person, and said that if she could not do a full 2 hour workout, it wasn’t worth it. I shared with her some recent article I read stating that even 30 minutes of walking daily helped people sleep better. Anyway, I asked if she thought she might be able to incorporate something like that in her life to see if it helped, even though it was not her “perfect” workout. She agreed to try. Only a week later, she came in all energetic and happy. “This changed my life!” she said. Apparently, just adding in the walking helped her sleep which made her feel so much better. We also tweaked a few things in her diet (her snacks and lunch were lacking protein and so she was crashing pretty regularly). After adding in some protein sources and the walking (both doable) she felt much better. The best part of all in my mind was that she was able to do it despite her old “all or nothing” frame of mind. She was totally ready to change from that paralyzing way of life and embrace normalcy. It is not always that easy.

Anyway, I think we all can relate to being somewhat picky about certain things in our lives. We had fun at work the other day talking about all the things we had some OCD (obsessive compulsiveness) about. I just can’t leave dishes in the sink at night (it needs to be empty in the morning). I also can’t be late for anything. I used to have to stop on the treadmill when I was finished (say 3 miles, or 2 miles, but could never stop at 2.5). Now, I stop on some off number just on purpose (2.33 miles, or 2.71 or even 3.2). I do this just to challenge myself and stop being so silly. When I shared that with some co-workers they all cringed. It really bothered one person especially, and she said “Ugh! I could never do that!”

Has anyone every accused YOU of being a “perfectionist”? Can you relate to some of these scenarios? You might enjoy this article on perfectionism in Psychology Today

In the meantime, just for fun, why not challenge yourself? Don’t read that label. Don’t jot it down in that app. Skip the gym and go for a walk. Or stop on the treadmill (or bike or elliptical) on an off number. How does it feel?

And next time you are at the beach, or anywhere for that matter where you are people watching, embrace the beautiful diversity. And remember, “good enough” is a gift you can give yourself.

 

If Diets Don’t Work, What Does?

On By jodietitianIn Uncategorized2 Comments

The Ultimate Diet PlanI made the HAES Pledge. That means I consider myself a “health at ever size” dietitian, someone who refuses to focus on weight and body size, honors diversity and promotes a healthy, sane lifestyle that includes fun movement and intuitive eating. I would love to pretend that everyone cares about their health and not just their weight, however I know this is not true. It does not mean I will ever promote weight loss for the sake of weight loss alone, but I often feel uncomfortable when those around me are doing everything they can to lose weight. Although I know through my experience with patients as well as reading the research on weight loss (there’s lots there) that strict dieting is not the way to go in the long run, I am not one who discounts another’s feelings and goals. That just means that if you tell me you want to lose weight and you are starting a diet, I am not going to lecture you, or tell you to stop wasting your time and to focus on your health instead (and that you are beautiful no matter what your weight or body size). If you are a loving, kind, good, nice person, of course I feel you are perfect the way you are. But you may not feel that way (just because you don’t like your body since you have gained that weight). And although I wish I could make you see the light (that focusing on being healthy is the way to go), I know I can’t.

So although you won’t find me trying to convince people they should not feel the way they do, you won’t catch me advising people on how to lose weight. It goes against my principles. You WILL find me trying to educate dieters though, because I have seen it all, I have been affected by what I have seen and I will do whatever it takes to prevent the bad things that can happen from dieting.  And that is what this post is about. If you insist on dieting to lose weight then I want you to be safe, stay healthy and aware of what you are doing. I want you to avoid the typical traps that dieting often sets. I want you to recognize dieting for what it is: a temporary answer. But mostly, I want you to never give up trying to learn what the permanent answer is to your weight and body concerns. And that is different for everyone.

The fact is that some people gain weight and although they may not like it, it is completely natural and does not affect their health. There are others, however, who do gain weight resulting from some unhealthy lifestyle changes or other issues and the weight gain is not normal for them.  Even for these individuals, focusing on dieting and losing weight typically is not the answer. Actually, lots of people gain weight just as a result of their dieting. Either way, I like to believe there is a “normal, healthy weight range” that a BMI or weight chart can’t predict. It is the weight your body is happiest at, the weight you tend to fall at when you are living a relatively healthy lifestyle, sleeping well, enjoying regular enjoyable physical activity, eating regular meals, eating healthy foods as well as other foods when you want them (not starving, not binge eating, not feeling excessively full all the time, or walking around hungry half the time). My goal for you, and the true answer as to how to be the weight you are supposed to be is to do some reflecting and learning.  Here is my advice to keep you healthy, safe and alive and hopefully, in touch with reality when it comes to your weight and health.

  1. Find the REAL answer. What is the actual story about your weight? I find people fall into 2 categories: those who gain weight because they are supposed to and it is normal, and those who gain weight in a sneaky way because they have fallen into a lifestyle that is not supportive of their health or feeling good. An example of the first group is the high school/college athlete who used to run 70 miles a week in order to compete at a high level on the cross country team. After college, they get their dream job and now barely have time to exercise (or maybe they now take a walk every day, you know, normal life exercise) and gain several pounds over time. Their new weight settles in a stable range, yet they can’t fit into their old clothes. Not wanting to buy new clothes in a larger size, they start to diet. This has all kinds of negative repercussions (such as making them preoccupied with food, binge eating, etc). In this case, the weight gain is completely normal with no affect on health, and actually trying to lose weight is the last thing they should be doing as far as health OR weight is concerned. Even though they gained weight, they needed to. After all, running 70 miles a week is not the norm. Who wants to do that forever? Unless you are someone who truly loves running, well, that is different. I believe we all need to do what we love and if competing in road races, running long distance, biking 100 miles is something that makes you happy, then go knock yourself out. But if you are doing it only to prevent weight gain, hating every minute, well, that is no way to live.                                                                                      Or maybe you can’t relate to this at all, and when you look back and truly reflect on your life, you realize some things have changed. This is the second type of person who has gained weight over time.  I can share some stories I have heard from others. Maybe they started a new job after college and now that they are making money they start going out to eat more often. Dinner used to be whatever mom made, but now it is the favorite pizza joint (and they throw in a free 2 liter bottle of Coke, can’t beat that). Or maybe they got married and their entire lifestyle changed. Lots of baking for the new husband who loves his cookies, watching movies together with drinks and popcorn. He is a couch potato kind of guy, so you join him (you miss the gym, but this is fun, too). Over time, you notice your clothes getting tighter, you don’t sleep as well, you get a bit more indigestion than you used to. In this case, the weight gain resulted from some changes in lifestyle that were not conducive to health, and actually contributed to feeling less than great. Figuring out why your weight changed and if it is normal for you, or not, is important. Because then, it gives you a focus. A diet is not the answer. Getting back into your healthier habits is. And it has nothing to do with the weight, but everything to do with how you are living (and feeling).
  2. If you insist on dieting, be aware of the “all-or-nothing” trap. Just because you “fall off” your diet by eating a cookie you then go on to finish the box. If you were needing a cookie, it just means your diet plan likely does not provide enough of what the cookie has. Is your diet low fat, low carb? Then guess what? THAT is what you will crave! a cookie. Or chips, pizza, ice cream….carbs and fat. Who craves grilled fish when they are dieting? Instead, try to take it as a lesson. Learn to listen to these cravings and enjoy what you want in moderation. Instead of binge eating or saying “what the heck” (actually referred to as the “what the hell” effect) and eating everything in sight because “tomorrow you will be back on track”-meaning back on “the diet”, eating some of what you want actually makes the craving go away. You feel better. In fact, when you hopefully go off the dumb diet (sorry, I mean the diet) this will have taught you that you can enjoy both those foods defined as healthy as well as those other foods, and nothing bad will happen. You won’t gain weight. You will just be a normal eater.
  3. Don’t skip meals. You have heard this before. Just today I had a patient come back for a follow up visit. I saw her a week ago because she could not stop herself from excessive snacking at night. Come to find out, she had been skipping lunch and breakfast. By evening, she was out of control. She simply started eating a typical breakfast and lunch (plate of meat, potato, veggie, water, cookie) and then dinner, and lo and behold….no more excessive snacking. Plus, she said, she felt “so much better”. Yes, getting some nutrition during the day does have an impact on your energy level. If you find yourself dragging and exhausted by early afternoon, maybe you aren’t eating enough. And, skipping meals lowers your metabolism and encourages weight gain (but you knew that). Finally, skipping meals really does affect your brain and your thinking. For some, skipping meals a can trigger even more disordered eating. There is no way to know who is at risk, but I don’t want it to be you.
  4. Get enough sleep. You have heard me say it before, I believe in listening to your body and food cravings, but when you don’t get to bed before midnight, and don’t get enough sleep (7-9 hours for adults, it varies) your levels of ghrelin will be elevated and this messenger makes you excessively hungry, and also causes you to crave fat and sugar. It is really hard to eat healthy when this is going on. Not to mention all of the other benefits of a good night’s sleep (feeling better, having energy, fighting illness). Napping doesn’t count, and actually can make sleeping at night even more difficult. Yeah, don’t nap if you can help it..
  5. Stay hydrated. I worry about people who diet because they are at more risk of dehydration as well as hurting their kidneys. When you diet too strictly, you actually break down muscle,which is protein which has nitrogen that needs to be excreted through your kidneys. So water is essential so as not to damage your kidneys. Your pee should be light yellow and you should need to use the bathroom every 3 hours or so. The minimum for most adults is 8 cups of water a day, usually 9 or 10. If you feel dizzy sometimes, this can be a sign of dehydration. The other (less scary) issue with dehydration is that your metabolism will not be working at its best if you are dehydrated. Hopefully, that motivates you to drink that water!
  6. PLEASE don’t connect dieting with exercise. We all need to move, be active because moving in ways we really enjoy is so important to our health. We can prevent heart disease, keep our bones strong, help us sleep, improve our mood, make our muscles strong, help prevent us from falling (especially as we age) and all kinds of other good things, both mentally and physically. Often, when the diet ends, so does the exercise. This does not make sense! Although, if you have the mindset that exercise is only to help you lose weight, then I guess it does make sense. But, in the long run, the real answer? Keeping fun and consistent movement in your life has nothing to do with dieting and everything to do with your mission to have the healthiest body you can have. So when this diet ends, keep on moving.

The reality is that any single diet that tricks you somehow into taking in a lot less calories than you were eating is going to result in weight loss. The problem is that nobody can sustain any particular diet because it is too hard, too boring and just simply not a normal way to live. Instead, the answer is to reflect on the reality of your weight. Have you been at a stable weight and have a healthy lifestyle, but just want to be thinner? Then, I am guessing your body will fight you every inch of the way, and focusing on being as healthy as you can is the sane way to go. If, on the other hand, you have fallen into some really unhealthy habits, have given up some of your past healthier habits (that also made you happy and feel good), then figuring out how to move back into a more balanced lifestyle would be more helpful than another diet (which basically just puts off the inevitable). It is never about some magical number on the scale. There will never be one diet that works better than they all work. But it is about feeling good. There is just something about sleeping well, having energy, feeling good that really helps you feel better about the body you were born with.

In the meantime, if you are on a diet to lose weight, I hope you stay safe, listen to your body signals (they are smarter than we are!), maybe learn to cook some healthy meals while you are doing this, discover some new vegetables or fruits you like. But mostly, I hope you take the time to learn about YOU. When the diet ends, that is when your story really begins.

5 Tips to Deal With Food Anxiety: When You Can’t Make Up Your Mind About What to Eat

On By jodietitianIn Uncategorized2 Comments

buffetI am not a fan of buffets. I remember the very first time I went on a cruise, and hearing about the buffets and how wonderful they were. Not to me. Don’t get me wrong, the food looked amazing, but there were way too many choices: Asian food, Mexican, Italian, Thai, sushi bar, ice cream bar, salad bar, dessert bar, fruit bar and good old American burgers and fries. I would see something I thought looked yummy, but then walk a few feet and change my mind. I know the limits of my tummy capacity and there was no way I could try something of everything. So instead, we decided on the sit down dinner option (the only negative being you had to look presentable). Anyway, this option ended up being perfect. Each night we were presented with a limited (gourmet) menu with only a few choices for appetizer, salad, main course and dessert. This I could do. Not to mention, we were treated like royalty, and the food was spectacular. I loved it.

Cruises aside, I believe having anxiety about what to eat or even whether to eat is a common thing, especially among those who are trying to eat healthier, or trying to lose weight. Yesterday I did a workshop on a college campus (all women) and one of the questions was “How do we know what to eat? What do we go by? I have a friend who writes everything down, all this information about what she is eating (like grams of carbs, calories, fat), it seems so stressful, and I just don’t have time for that!”

Great question, I thought. But it is so hard to answer in this technological and perfect-body focused world we live in. Even websites and apps with good intentions, and that want to promote health (such as the Choose My Plate website) seem to be fat-phobic and hyper-focused on monitoring every morsel of food and calorie burned in exercise, all with the intent of assisting someone in attaining a lower weight. But with technology, and all of the new food products out there taking advantage of our phobias of sugar and carbs and fat, it really can get confusing. I hear people wondering out loud if their lunch is healthy, if they should eat this or that, complaining about eating something they consider “bad”, feelings of guilt about what they eat, or what they want to eat. When it comes to deciding what to eat for breakfast, or what to pack (or buy) for lunch, or what to cook for dinner, people struggle. And when a restaurant is involved, it can get very confusing.

Some people may not be able to relate to this stress at all. They eat whatever is there. They truly don’t care. God bless you! But please don’t get frustrated with your family members or friends who just can’t ignore the bombardment of nutrition information or body shaming that is out there. So, this post is for them. If you get really confused about what to eat, or if you feel bad about choices you sometimes make, here are some tips I hope make you feel better. After all, eating is only one small part of your very interesting life!

Tip #1: Food isn’t everything. Look at your “big picture”. When it comes to being healthy, things like stress at work, poor sleep, not exercising and not having good friends and/or family are truly more important. Food comes next. If you figure out how to make everything else good, usually eating healthy is much easier. So, answer these questions honestly: do you sleep well? are your relationships healthy and nurturing? do you love what you do? are you able to be active? If you don’t have these issues settled then it will be much harder to figure out how to manage to eat healthier too.

Tip#2: Do you eat your 3 meals a day? Breakfast, lunch and dinner are words that our modern lifestyle seems to forget. Back in the day, I remember looking forward to eating lunch. These days, lots of people feel guilty taking time out of their busy lives to enjoy a good lunch and instead get by with coffee, packages of crackers or fast snacks. They down giant coffees instead of breakfast and wonder whey they need to nibble all night. Making meal times a priority in your life is important. If you nurture your body by giving it enough energy in the form of a meal three times a day, you are more likely to feel good, have energy and make wiser choices when it comes to eating and your health.

Tip # 3: When it is time to decide what to eat, and you are confused, ask yourself: am I craving anything? If you are, well, there is your answer as far as what to eat. Remember, a craving is when you really want something that you did not see. It is different than a trigger food, which is a food you see and then think you want. You can get over a trigger food, because once you walk by it (or change the channel or walk away from the coffee break room where the donuts are) you will forget about that food. But, if you are truly craving a food, if it is on your mind all day (for example, I sometimes really really really want Buffalo Wild Wings boneless Thai wings and boneless Garlic Parmesan wings). I start thinking about them at work and have to order them so I can pick them up on the way home. This happens about 3 or 4 times a year. It doesn’t matter what I may have planned for dinner or what is simmering in the crock pot. I want wings. I believe in listening to that voice that tells you that you want something specific. You really can live without a salad every meal. If, on the other hand, you are not craving anything specific, then by all means, go home and have that yummy healthy whatever you are simmering in that crock pot. (Note: for those suffering from Binge Eating Disorder or other eating disorder, this advice may not apply and you should use the strategies that work for you).

Tip #4: If you are one of those people who are confused about your feelings of hunger (not really sure if you are hungry or not) then it can be difficult to know if you should eat or not. If you can relate to this, then you might want to do some reflecting at those moments when you are wanting to eat, or not sure if you should eat, or perplexed as to how much you should eat. First, ask yourself: when did I last eat? If it was an hour ago then you may not really be hungry. If it was over 4 hours ago then chances are, your are hungry and need to eat. But the other important question to ask is”what did I eat?” If you actually did eat only an hour ago but thought you could get by with just a yogurt for lunch, then you my friend are probably hungry. If, on the other hand, only an hour has gone by and you had a good meal with protein, fat, carbs and fiber (think nice sandwich with meat on a roll, lettuce and tomato, some pretzels and a yogurt) then you might not really be hungry and should try to figure out what you really DO need.

Tip#5: Nutrition Matters, but one meal does not make the man (or woman). In other words, yes, you need to learn about healthy eating, cooking, food preparation, and the basics about what someone your age needs to have energy and be healthy. You may not like milk so may need a calcium supplement. You may not eat meat so would need to find another source or protein and iron. Yes, there is a reason we nutritionists say you need to “eat a rainbow” every day (make half that plate colors!) But, your body does not really care that your day to day eating has to be perfect. All it cares about is that over time, you get what you need. Nothing bad will ever happen just because you did not drink milk or eat veggies and fruits for a day or 2. Trends over time are what matter.

So, if you don’t want to think too much about eating or nutrition, well, that might be a good thing. Instead, keep it easy. Just work on increasing the basics: more fruits and veggies, including protein foods with your meals so you don’t crash and drinking more water.

Extra Tip: If you ever find you stress out too much about what to eat you may want to seek out some support from a therapist who specializes in eating issues. Life is too short, and eating should be a joy, not add stress to your life. In fact, too much anxiety around eating may be a risk factor for disordered eating (see link below for a summary article on the relationship between anxiety and eating disorders). In the mean time, enjoy those buffets in moderation. Me, I will be at Buffalo Wild Wings.

Anxiety and Disordered Eating

 

Instilling Fear in Children to Prevent Obesity: Have We Gone Too Far?

On By jodietitianIn Uncategorized2 Comments

Little boy and soap bubblesDo you remember what you were doing when you were 4 years old? Hopefully, you weren’t getting terrified about becoming fat. I hope you were doing what I was doing, making an awesome worm castle out of mud. I loved when it rained and all the worms would come out, more soldiers for my mud castle.

These days, there are other things to think about apparently for our babies….preventing obesity.  We are so wrapped up in our fear of fatness that we are missing the big picture. I can’t share details however can tell you that I was horrified this week when I saw a patient for an eating disorder…..the child was 5. Last year, apparently, this child had seen a puppet show in NURSERY SCHOOL about nutrition and somehow got the message that if you ate the wrong food and got fat, you would die. So the child stopped eating. Granted, most kids might miss this subtle message, but I don’t care. This kid didn’t miss it, and acted on it and lost 10 pounds. The child was diagnosed with ARFID (avoidant/restrictive food intake disorder, a new diagnosis created to include disordered eating without the typical body image concerns). Maybe this kid would have developed an eating issue later in life, who knows, but all I know is that the attempt to prevent obesity with nutrition education of preschoolers is insane.

For those of you with children, I am pleading with you to believe me. I have been in this field for almost 40 years and I have spent the majority of my years working and learning from people with weight issues and eating disorders. I have spent the last decade working with obese kids as well as children with eating issues (such as ARFID) and their families. I am here to tell you that young children don’t need to know squat about nutrition. They also don’t need to think about their weight and should NEVER have access to a scale or worry about their weight. What they really need is role models that are healthy eaters, exposure to healthy foods, especially fruits and vegetables, and opportunities to move and be active and have fun. They also need all of the adults in their lives to accept and love them for exactly who they are, no matter what their body size or weight.

I have shared examples from my older patients I saw in the past. For example, the very intelligent nurse who was a yo-yo dieter, lost and gained the same 50 + pounds over the past 3 decades of her life. She lost her weight through restrictive dieting and she gained it back through binge eating. She finally came to the conclusion that she was binge eating to get back at her mother who restricted her food intake as a child. She became a closet eater because she could not let her mom catch her eating. Apparently, her mother was quite body-image conscious and my guess is she had an eating disorder of her own. Anyway, it was very difficult for this woman to allow herself to eat normally because the fear of fat was instilled in her by her mother. And even though she could cognitively figure it out she struggled with stopping her behavior…even after her mother passed away. Do I think fear of fat helped this woman in any imaginable way? No, it didn’t.

At the other end of the spectrum, we often see infants and children who struggle with weight gain and growth, or who are referred to as “failure to thrive”. We often recommend adding what we call “calorie boosters” to foods, such as melting extra butter into a food, adding in a teaspoon of oil, mixing is some heavy cream to milk, yogurt, etc. I can’t tell you how many times well-meaning parents have returned with their child who has failed to gain weight because of the parent’s fear of adding calorie boosters. Yes, it is great that parents are health-minded, cook healthy foods, etc, but when fat is avoided like the plague everyone suffers. Children need fat for proper brain growth. Saturated fat is a precursor to cholesterol which many important hormones are made of (yes, we need cholesterol!) And children need calories to grow (steamed veggies won’t do it).

Here’s another brain teaser: have you ever had a health issue, or known another adult who has had a health issue and needed to make a healthier choice, yet didn’t? Let me start with a very simple example, constipation. Have you ever experienced this very uncomfortable situation or known someone with chronic constipation that was caused simply by not drinking enough water and not eating enough fiber? “Eat more fruits and vegetables and drink 8 glasses of water a day” the doctor probably says. Do adults follow advice just because they know it is the healthy thing to do? It’s not that easy, is it? If most adults can’t do it then why on earth do we think educating preschoolers is going to teach them to make healthier choices?

If you want my opinion on the bottom line, here it is:

  1. What snack your child chooses at school, whether they decide to take the cookie at lunch or have the chips with their sandwich will have NO affect on their weight. The calories in one cookie, one bag of chips or a bowl of fruit salad are similar. Yes, the fruit has more nutrients, but hopefully, you are offering fruits and vegetables at home (right?). Having a cookie for dessert or a serving of chips with a sandwich is normal eating. I might predict that if you don’t allow children to eat normally, they may be destined to be that closet, sneak eater when they become an adult and nobody is there to restrict them anymore.
  2. Your 4 year old can’t drive. Therefore, it is you who is doing the grocery shopping (mom and/or dad). What you buy to have in your home matters more than if your child knows which snack is healthier. If you want your child to grow into the healthiest body he is supposed to then having access to healthy foods and a structured eating schedule (3 meals and 2-3 snacks) is what matters more.
  3. Don’t become obsessed with the fat on your child’s body. It just baffles me when a parent worries about a toddler’s “tummy”. Think about it for a minute. A 2 year old, a 4 year old, even an 8 or 10 year old is short. They have lots of time to get taller (hopefully). Do you really think when they are 3 feet tall they have the tummy they are going to have as an adult? Their little bodies are going to change so much as time passes,however much body fat they have today will be different tomorrow. But if you talk about it, point at it or worry about it you run the risk of affecting your child in a negative way (making them worry and stop eating, triggering food obsession and abnormal weight gain or just feeling scared (or sad) that you think something is wrong with them). Their natural little bellies should not be a topic of conversation. Ever.
  4. Your children probably won’t eat what you won’t eat. I have seen many picky eating adults who want their child to eat veggies even though they don’t. Probably not happening. Remember the Rule of Twenty: it takes 20 tries to really know if you like something. Model the behavior you want your child to do, so that means going through the process of taking that bite with a smile. Talking about how good veggies are for you won’t work (we adults know that, yet we don’t care…I still don’t cook beets).
  5. It is ok to talk in a fun way about foods being good for you, but you should not talk about getting fat. Talking about being fat, instilling fear of getting fat, making it seem shameful to have a fat body just contributes to the growing insanity and body shaming and discrimination that permeates our society today. I plead with you to avoid being a part of this problem by accepting your child’s body and your own body without judgement (at least don’t talk about your body insecurities in front of your child if you can help it). This does not mean ignoring health and fitness. It means focusing on health instead of body size and weight. You can tell kids that carrots have vitamin A and that helps you see, that whole grain cereal is good for your tummy and oranges have vitamin C and will help you fight colds. But don’t say “that will make you fat” because that is not true. No particular food makes anyone fat. Learning to eat ALL foods in a normal way (a few cookies, not the entire box) is really important and this may not happen if you villainize a particular food.
  6. Find out what your school does as far as nutrition education. Talk to the health teacher or whoever it is that is doing the teaching. Find out what their philosophy is then voice your concerns if you have any. We need to speak up to protect our children.

Don’t blame yourself if you have done the natural thing a good parent does at times. Sometimes, we do worry about our children and we also want to show the doctor that we care. Often that translates into a parent leaving the pediatrician’s office, having been told their child’s BMI is out of range and so the good parent does something. Unfortunately, what they do is focus on the child which does not work. Instead of ever mentioning weight to a child, we need to look at ourselves. I recommend the entire family focus on being healthier, not just the singled out kid. Everyone needs to get off those devices and get outside to play. We all need more fruits and vegetables. We all need to get enough sleep.

Another sad fact is that healthy food is expensive. One mom told me how much WIC gave her for fresh fruit (not much) and this made me wonder how on earth she was going to increase the fiber in this kids diet. I am addicted to grapes and a week ago noticed that my one bag of grapes actually cost almost 9 dollars. How do people do it? Maybe, instead of funding programs to teach 3 year olds how to pick a healthy snack we should figure out how to help poor families have access to more healthy foods. Maybe we should focus on educating parents on how to cook healthy on a budget.

I am thankful all I had to think about was mud castles when I was 4. I hope you keep your child’s life simple, too. And if you can prevent even just one child from developing an eating disorder, it is worth it.

 

Nutrition 101: Eat Like a Kid

On By jodietitianIn Uncategorized, weight2 Comments

Dunkin Donuts 0006

When I was a kid, I loved Sundays. My family would all go to church and after the mass my older sister and I would walk over to the rectory (where the priests lived) and go down to the basement to open the  money envelopes. It was a job we got paid for in donuts. Yup, after all the envelopes were open and counted, Father Flower (his real name) would come in with a box of donuts for all of us (maybe a half dozen of us trustworthy young Catholics). I loved donuts back then because we rarely got them. They were a treat. But it didn’t end there.

My dad would pick us up and him and I would go together to Valley Acres. This was a small local store that had the best cold cuts in town. We would wait in line and get our ham and salami and provolone. Next stop, Lin Lou’s bakery for the poppy seed hard rolls and Italian bread, the best. Finally, home for lunch. Mom would have the peppers all fried up by now. We would make the most delicious sandwiches on those fresh rolls with provolone and ham and salami  and fried peppers (nobody thought about cholesterol back then). After that, I would help my mom make the meatballs (it was Sunday after all, which was always pasta day, sauce, meatballs, sausage, eggplant if mom was feeling like it). I loved grating the Italian cheese and mixing up the meatballs for my mom. She would do the cooking and then we would all go playing outside while the sauce simmered all day. No electronics back then, and only 3 channels on the TV so not worth it, unless of course it was football season. Then I would be on the couch with my dad, glued to the Green Bay Packers, his team. Anyway, dinner would be all together at the kitchen table, a big bowl of meatballs and Italian sausage, pasta with sauce and freshly grated cheese, great Italian bread from Lin Lou’s bakery, green salad with tomatoes and cucumbers and lots of oregano and olive oil. Maybe dad would have a glass of cheap Italian red wine, and we would eat and enjoy every bite. Then we did our jobs, clearing the table, doing the dishes, putting them away. And that was it.

Today, many years later, I think about how eating was back then. Nobody really thought about it much that I can remember. When it came to eating as a kid, all I remember was that I loved the food my mom cooked. I loved the Italian traditions. And I loved those donuts. I sometimes roll my eyes when I listen to adults talk about food and diets and nutrition, and I often think “TOO MUCH THINKING!!!” Somehow, we survived, even without knowing much about nutrition. We just ate. And, mostly, we ate what we liked. What happened? Why don’t people do that anymore? How did it get to where we need to analyze every morsel we put in our mouths?

Yes, since then, we have learned a lot about how to eat to be healthy. We have learned about antioxidants and phytochemicals and fiber. Funny thing, the old advice of “eat your vegetables” pretty much covers all that. Back then, fast food establishments were far and few between. We had one McDonald’s in the state of Connecticut when I was in grade school and when we went once or twice a year, it was a treat. Those discs of a burger were very different than my dad’s burgers on the grill, but french fries were something new. Yes, we enjoyed our McDonald’s and it did no damage. But then again, we went so infrequently, and there were only normal sized burgers and fries and one size of shake. These days our food environment is much different. I think it messes with our natural ability to eat the right amount. I have worked with lots of families who don’t have much money, so going to buffets is a big treat. Back when I was in high school we had to drive to a different state to get to a buffet. It was a once a year thing all teenagers did when they got their license…I think the place was called Custy’s and it was in Rhode Island and the big draw was the seafood…lobster, shrimp and all the kinds of things you really could not afford on a regular basis. I never went but I was fascinated by the stories of how much people ate…how many lobsters, pounds of shrimp, etc. I didn’t really get it because I did not eat fish back then.

Looking back at our attitudes and behavior around food as kids or even teenagers is interesting when you compare it to how we think about food as adults. Somehow, along the line we lose something. We seem to lose (from my experiences anyway) simple appreciation for yummy food without judgment. As adults, we just can’t seem to help adding our adjectives to food. “This is bad but I am not eating carbs tomorrow”. When we go to a party or out to dinner, instead of looking at the menu for your favorite food, or to see what sounds the most yummy (like you did when you were little), most people are weighing the calories or healthiness or carbs or trying to figure out the points.  All of these cognitive methods to figure out what to eat weigh in to help you make the “right” or “healthy”decision about what to get. But, what most people are unaware of is that all this thinking interferes with your natural ability to choose food you like and enjoy.

Sometimes, of course, people who are on a “diet” or restricting to lose weight tend to behave somewhat differently. If they are being “bad” they tune out their body altogether, order too much food, overeat and feel very uncomfortable after because tomorrow, they will be “good” again. This is not what I am referring to as far as natural eating and choosing what you like. This is almost the opposite extreme, a type of “force-feeding” borne out of food insecurity, or the feeling that you may never get it again. That is what tends to happen with people who diet.

It is not easy for most people to accept the idea that you “can eat whatever you want to” and still be ok. You might be thinking “if I did that, I would gain 20 pounds!” The key word is “whatever”. The biggest mistake I have seen people make is giving power to food. Not any food, only certain foods. Somehow, a 200 calorie candy bar has more power than a 200 calorie spinach salad. People mistakenly believe that lone candy bar will “make you fat” because it falls into that “bad” category. The spinach salad with the high protein boiled eggs however, despite providing the same amount of energy (calories) is never the bad guy. Nope, most people would agree, hard boiled eggs and spinach will never make you fat.

What I have seen most people do who have moved away from eating foods they love is a tendency to walk around almost never being satisfied. As a result, they may tend to nibble and pick on more and more “good” or “healthy” food…..only to eventually consume more calories than they would had they satisfied their appetite (both physically and sensory satisfaction) by eating exactly what they really wanted. The key is they are less likely to overeat when they are satisfied. Remember, however, everyone is very different. I am referring to those who do not suffer from Binge Eating Disorder (BED) and those who have typical brains and appetites that may only be off a bit because of normal dieting. There are those whose brain chemistries will lead them to eat beyond a typical amount if they allow themselves certain kinds of foods (usually sugar and fat). Most people (I hope) who have such an eating issue usually work with specialists who help them cope with their issues. The typical dieter or even the typical “healthy” eater however, is who I am reaching out to.

The bottom line is that it is NOT the “whatever” that matters, but the “how much”. If you eat just one candy bar (or burger and fries, or whatever the case may be when it comes to “bad” food) it is no different to your body than eating an equivalent of “healthy” food that may not satisfy you. The secret is to listen to your fullness. For those of you who are disconnected from this feeling, it may take time, but don’t give up. Do some experimenting. I often use the example of a college girl I worked with years ago. She had been eating very little during the day, restricting herself to a plain salad for lunch, but then began nibbling on “healthy” snacks throughout the night. She would have several fat free granola bars, rice cakes, sugar free jello and apples and by the time she went to bed, she did not feel so great. She also was frustrated with having to be thinking about food and eating all night. When I asked her what she really wanted at lunch if she could eat whatever she wanted, she said “a cheeseburger”. So she took the risk and agreed that just once she would get a burger for lunch and see how she felt. I will never forget her expression (and happiness) she had at her next visit when she shared her experience with me. “I felt so satisfied! And the best part was that I was not thinking about food all day! I actually ended up having just one snack instead of a dozen and felt much better!” She had to take that risk and try it once. But it literally changed her life.

Does this mean you should throw nutrition caution to the wind? Not care about eating healthy ever again? Of course not! I believe in choosing healthy food, learning to cook healthy meals but educating yourself on how to make food yummy, too. However I also believe in living in reality. The fact is that you may really want the onion rings and not the side salad. And that’s ok. Plus, if you eat a few onion rings and feel satisfied I bet you are less likely to be seeking out food shortly after a restrictive meal.

So go ahead, take that step, even if it means just being honest with yourself (even if you can’t actually order that favorite food, at least you are considering it). Who knows, a fluffernutter may be in your near future yet.

PS A bit of advice: if you have been eating an extremely high fat diet such as visiting McDonald’s or other fast food joint on a daily basis, your body may actually be craving more fat than is typical. If you honestly don’t have a clue about nutrition, you may want to seek advice from a registered dietitian. Ask your doctor for a referral to a dietitian near you. Even one visit will give you direction.

 

 

 

 

Clothing Statements: What Message are YOU Sending?

On By jodietitianIn Uncategorized2 Comments

IMG_2649I love people-watching. The other night my husband and I went out for what was supposed to be a quick bite somewhere outside, but turned into a somewhat late night of watching the band that happened to be there………and dancing the night away. The outdoor venue we went to is a casual place that serves pretty good Italian food, pizza and bar food. We like it because it is not too expensive and has a nice big outdoor patio with umbrellas if you want shade. At the time we arrived it was pretty quiet. But as the band started setting up around 8 pm, people started trickling in. LOTS of people. We were planted in a good spot with a seat where we had a great view of everything. I had a fleeting thought that I should have worn something different had I known I was out for a night of dancing (especially because I was noticing that the newcomers were kind of dressed to the nines). I had thrown on a striped tee-shirt kind of dress I picked up at Marshall’s for about 12.99 which was super cool and comfortable, perfect for a muggy hot summer night. My shoes really didn’t match, as they were black Aerosole wedge sling-backs which feel like slippers. Anyway, I felt like I had my jammies on and I like that feeling. But somehow I initially felt a bit under-dressed as I saw (the women especially) strutting in with super high heels, low cut revealing slinky dresses, fancy short shorts and other glittery, attention-grabbing outfits. The men however did not seem to bother much as I can’t remember even one of their outfits grabbing my attention…..with the exception of one young man who had a really nice blazer and crisp shirt with nice slacks on and I wondered for a second if he might be a Trump…they always look nice like that. Or maybe he just came from work. He looked really hot (in a temperature sort of way) as it was about 90 degrees out, but anyway, he did stick out.

I ended up striking up a conversation with a very young woman who sat on a stool near us and seemed to be alone at first. She had a tatoo on her shoulder which appeared to be a poem or something, hard to read so of course I had to ask. She looked very different from most of the other young women there, as she was dressed in a hippie type fringed crop top with jeans, flip flops, straight black hair and looking kind of Moricia-ish (think Adam’s family). Anyway, she informed me that it was an excerpt from Jack Kerouac’s “On the Road”. Come to find out she was the lead singer’s girlfriend and she worked at a large law firm in Stamford. She was deceivingly intelligent (I admit to pre-judging her because of her appearance and her vapor pipe as probably a bit spacey. I was wrong). After a very cerebral discussion of politics and music, she left and I continued to look around and wonder what all the other stories were in this place. Clearly, you can’t judge a book by it’s cover but some people send out strong messages by the way they present themselves which makes it kind of hard to avoid making assumptions.

That night got me to thinking about how what we choose to wear sends out a message. Our outfits say something about us that we may not realize. I also wonder how many people torture themselves because of clothes. When I worked as a dietitian in a practice of therapists who specialized in treating eating disorders, we always got ready for the predictable surge in relapse of our patients right before prom season and before the start of summer. Starving and restricting to fit into a certain dress or dieting to get ready to display your half naked body on the beach was the norm for many of our patients. I am guessing the average person engages in similar body struggles and extremes of behavior but for those lucky ones, the urge passes and goes away and they are able to deal with the body God gave them. For others, just because of the clothing of the season, they are sent into yet another downward spiral that is never easy to bounce out of.

I have already written about the aging thing and women and our struggles with clothing, but the message we are sending because of what we wear is also interesting, no matter what our age. My point is not to change anyone, because if what you wear makes you happy, who cares about the message you send to those who might happen to be people-watching? The people who love you, your friends and family, those who really count know who you are. But what troubles me is when people (myself included) dress according to what they think is expected, and NOT according to who they are or what is comfortable to them. I am not referring to dress codes at work, such as at the school where I work. We are allowed to wear shorts in the summer, but they need to pass the “fingertip rule”. In other words, when your arms are by your side, your shorts should not be shorter than were your fingertips end. Apparently, we got some girls with really really short arms. And this, I don’t get really. Why does someone need to wear short shorts to work? My only guess is either they are single and want to attract attention from one of their co-workers (who are wonderful young men who work with special needs kids, so definitely lots of great catches in that school!). Or maybe, to give them the benefit of the doubt, they honestly don’t own any other shorts, and it truly has been hot this summer. But my guess is the former, or something else altogether.

Anyway, I am not referring to dress codes, but to the habit of people dressing in a certain way because they want to portray an image that really is not them. For example, that night we were out dancing there were several young women I noticed wearing revealing shirts and dresses but fidgeting to fix things. Pulling up the bust, yanking down the bottom of the skin tight dress to cover things, fixing straps, lots of work going on. Balancing the spiky heels walking across the brick patio was also fun to watch. I wondered why, what message they were trying to send. Maybe it is just a human thing, like the way birds and peacocks and other wildlife do things with their feathers and such to attract the opposite sex. But if this is the case, wouldn’t you want to attract someone who likes you when you are wearing what is truly you?

I am not innocent of wearing things that are definitely not me (and NOT wearing things that ARE me). I have a few pairs of tighter straight leg jeans that I wear when I go out and want to look like I am in style. I prefer my baggier loose jeans with the holes in them. I have a brown cowboy straw hat my husband bought for me at a fair the first year we dated, and I love it. But I never wear it in public places because I don’t want anyone looking at me thinking I am weird. I do wear in at the beach to cover my face from the sun when I am sitting on a blanket (but I am too embarrassed to walk around with it). It’s too bad because it is me.

I have also purchased flowing loose shirts that make me feel like I am back in the 70’s yet when I put them on and look in the mirror I look a little ridiculous. Those I wear anyway. I love the new styles of loose flowing shirts, even though I look lost in them, I wear those anyway too. And the ones with the cut-out shoulders. My older sister hates them, but to me they are genius. Hot flash heaven, air-conditioning.

Dress codes and human courting behavior aside, have you ever reflected on the reasons you wear what you wear? Do you find yourself feeling uncomfortable a lot of the time because you are dressing to impress others at the expense of being yourself? Do you torture your body with starvation or dieting just to wear a certain article of clothing? Do you feel happy and comfortable when you walk out of the door? My advice is to be yourself. Be comfortable, wear what makes YOU feel good.

And, a quote from Jack Kerouac:

“the only people for me are the mad ones, the ones who are mad to live, mad to talk, mad to be saved, desirous of everything at the same time, the ones who never yawn or say a commonplace thing, but burn, burn, burn like fabulous yellow roman candles exploding like spiders across the stars and in the middle you see the blue centerlight pop and everybody goes “Awww!”
― Jack Kerouac, On the Road

 

Body Size and Eating Habits: STOP Judging!Please?

On By jodietitianIn UncategorizedLeave a comment

little-girl-1430293I saw an article this week on Twitter that really disturbed me. It was about “thin privilege”, and it showed a post with two pictures that went viral….one of a thin young woman getting ready to eat a gigantic burger and fries, and the other of a young (larger size) young lady on the beach. The comments were offensive, I don’t even want to repeat it. The bottom line was that the thin woman was found appealing because she was eating but the larger woman was insulted. It made me think about my own experiences with patients who have spent half their precious lives dealing with these issues.  Feeling embarrassed for eating in front of people, wondering what others thought of them as they ate.

If you have never had any issues with weight then you may not relate, but for those of you who have dieted, or had issues with weight, well, you will get it. We like to pretend all are created equal, but it unfortunately just is not true. In the past year the racists seem to have crept out of the woodwork, and we all understand racism. I am hoping most of us know that the color of our skin or our country of origin does not predict who we are. Even I know (although I like to joke about it) that all Italian women do not love to cook and feed people…just the ones I grew up with. It’s a stereotype. Well, the same thing happens with people depending on their size. We make judgments (out of our ignorance, just as racism is out of ignorance). Most people do not have a clue about how our bodies work and the physiology around body size and weight. We make assumptions about people depending on how they look.

If someone is very large and big we assume they overeat or stuff themselves, they have no willpower. People wonder why they would do something like that, and put their health in jeopardy. How awful.

And then there is that skinny person. They must have willpower to be that thin. They care about their health, they must eat lots of vegetables for sure, and exercise. We really look up to these thin, strong willed healthy people. We wish we could be like them and do that too. Or, we make assumptions about them. They must have an eating disorder, why else would they be that thin? They should just eat a cheeseburger, for heaven’s sake.

Well, guess what. It is all a bunch of baloney. That skinny person you are assuming is healthy might just be living on Coke and chips. Their blood pressure might be horrifying, and maybe they have high cholesterol. They might smoke a pack a day and be out of luck if they need to catch a bus because they can’t run more than 2 feet. Or, maybe their entire life they have tried to gain weight, but they take after dad’s side of the family, all tall and thin and no matter what they eat, they can’t gain weight. They get called names all their lives, made fun of for being too skinny, as if there is anything they can do to change it. They hide under clothes, layers of them so hopefully nobody will notice their skinny arms.

And that obese young woman you have sneered at and wondered why she doesn’t take care of herself? Well, she may have the blood pressure of a teenager, and the flexibility of a yoga teacher. She may eat more veggies in a week than you eat in a lifetime. She may eat less fast food than you. And, I am guessing, she has more willpower in her left pinky than you have in your entire body. Because, if she has experienced what most larger people have, she has dieted in her life. She (or he) probably have given in to the pressure to change. Have you ever tried to follow a diet? If you haven’t because you have been BLESSED with the metabolism and brain chemistry and genetics to be thin then I promise you, just like any human being you would not be able to do it….as long as most larger people have done it. Yes, they diet and lose some weight but BECAUSE IT IS NOT THEIR FAULT their bodies and brains fight against this. For a good article explaining why diets don’t work and what happens to some people’s metabolism after dieting check out:

TIME Magazine article “The Weight Loss Trap”    

So, unfortunately, when weight is lost quickly and then regained often our metabolism lowers and makes it even harder. So that person who originally wanted to lose a bit of weight finds her or himself after the diet with more weight than they started with. What often happens is that person tries to diet again, and the cycle begins. And the judgment from others is even worse. This makes me sad because the weightism from others leads people to diet, regain weight and then some, and then they are subject to even more of it.

I know there are a lot of people who will continue to judge. My hope is to help people be more empathetic by understanding that we are all different. For example, our brains and digestive system are connected by a complex system of neurochemicals that act as messengers or hormones to tell us what and how much to eat. For example, there is a messenger referred to a PYY that tells your brain you are full. Some people release it very quickly and want to stop eating even before they even finished a meal. You know those people, the ones who leave a quarter of a sandwich or who can’t finish their fries (what??!) This has NOTHING to do with willpower, they were born this way. Then there are those with less effective PYY and their brains just don’t get the message. They aren’t full. You wonder, “wow, how did they finish that?” It is not gluttony my friends, it is probably their chemistry. They were born with it. So stop judging. How would you like to walk around feeling starving all the time? It can’t be fun in this world we live in. And sometimes, some people have amazing willpower and have succeeded in ignoring their chemistry and have lost weight but the message eventually wins, and they give in. Think of a time when you really really really had to pee. Like when you are on a road trip in the middle of nowhere. If someone said to you, “you need to have some willpower and wait until tomorrow!” how would you feel? Well, that physiological signal that is telling your brain that you need to urinate is just as strong as the one that tells someone they need to eat something. It is not about willpower. It is about physiology. So we need to stop blaming.

If, like me, you don’t know much about “Thin Privilege” check out this website which I stumbled upon and liked (it is a feminist website, so if you are not of like-mind you may not like it but I hope you are):Thin Privilege

And next time you find yourself wondering how someone could eat that, or why on earth they can’t finish their meal…..just stop and focus on yourself. Just as I hope you look beyond skin color or race or nationality or sexual preference or religion or any other meaningless definition of someone’s goodness, I hope you look beyond someone’s body size and definitely beyond what someone is eating. Thank you.

Women and Their Aging Bodies: Not That Fun, But Then again…

On By jodietitianIn Uncategorized1 Comment
Image may contain: 5 people, people smiling, people standing and people dancing
Mom and me dancing the night away at my nephew’s wedding

I did something really stupid about 2 years ago. Those of you over 50 but still stuck in your brain like you are still in your late 20’s will totally get it.  Well, I have never been athletic and have never liked team sports and definitely never participated in them. I hated that mile run in school because, well quite frankly, I could not run a mile when I was in high school. BUT, I could do a mean cartwheel. As a kid I would spend my time on the swing set and monkey bars, in my own little world. I admired my friend Terry who was an amazing gymnast (this was in grammar school) and she got me doing cartwheels, splits and hand stands. I would spend hours trying to perfect my back walkover, and eventually I could do it. I was so flexible, it was easy back then. In college I resorted to yoga since doing cartwheels around campus might be weird. I was good at it, able to touch my feet to my head, do handstands and back bends with ease. But as time went on, and I got older, I transitioned into biking and jogging and belly dancing classes with my friends. Well, it never occurred to me that I would lose my flexibility and strength. Until I decided to show off one day. I can’t remember who I was showing off for, maybe it was one of my 20 something year old kids but anyway, I went to do a cartwheel in the yard and it was not pretty. My arms gave way, I almost landed on my head were it not for my elbows hitting first. I was appalled, and frankly, kind of scared. What the heck??! Doing a cartwheel was nothing! and yet, there I was, almost with a cracked head.  I tried again, but very carefully, and determined, but yes, it was true. I can’t do it. And then, it dawned on me that something had happened. I might be thinking and feeling great, like I did way back then, but my body had changed. My arms could not hold me up. This was not good.

I went through a phase of trying to do something about it. I started practicing standing on my head…the easy way, you know, leaning against a wall. One problem….my neck hurt. Oh great, now even my neck is weak. Then I decided I was going to practice my back bends, and do a back bend by Christmas. This plan did not work (despite my husband promising to give me a monetary reward). I just was not motivated because doing a back bend did not benefit my life in any way. Yet, this lack of flexibility has bothered me so much that I made a plan to stretch over the winter. I am a firm believer in habits, and that you can create a healthy habit just as easily as you create a not so healthy habit. So every morning over the winter I incorporated toe touching and stretching exercises with my morning coffee and the news (which I watched anyways, so it was easy….10-20 minutes in front of the TV, not bad, kind of relaxing, 2 birds with one stone). It did work and by the end of the winter I was touching my toes with ease. Then came spring and flower season and those precious minutes in the morning had to be spent watering my garden and talking to the bunnies….so needless to say, my flexibility has lost its priority in my life.

Besides my inability to do a cartwheel or a handstand or a back bend…..there have been other changes I am not too fond of. I am guessing I am not alone. I am talking about eyesight. I have always been blessed with 20/20 vision and for that I am grateful. Yes, I went through the typical phase where you have to hold the menu 2 feet from your face to read it (I think this happens in your 40’s?) Anyway, I bought the cheap reader glasses and that solved the problem. But then I turned 50 and something else happened. Darkness. When it was dark, I could not see. So driving at night becomes an issue when you can’t see the exit until you are on top of it. Or read the signs. I finally had to admit, I needed an eye doctor to see what was going on. Long story short, I needed glasses. Expensive ones which I lost twice, so changed to disposable contacts because I lose things and that solved that problem (until I left them in overnight, because I forgot to take them out, loss of memory another issue but another topic). When you leave disposable contacts in overnight and try to get them out in the morning, you can cause a corneal abrasion which hurts and is not fun. But at least this sudden loss of night vision is treatable.

What isn’t treatable (unless you are a millionaire and kind of vain) is what happens to your skin. I can only speak for myself but it was kind of nice in just one way when I couldn’t see because when I looked in the mirror, I thought it was pretty cool that I wasn’t really getting many wrinkles. Wrong. When I got my contacts I was a bit flabbergasted. Not only could I see that my bathroom floor really DID get dirty (I always wondered how it stayed so clean…it was because I could not see the dirt)….anyway, I could now see my wrinkles. The only ones I really was not a fan of was the ones around my neck. I toyed with the idea of a bread clip in the back of my neck. It kind of works to pull everything back (but this technique is not comfortable, and I am all about comfort). Scarves work, but who wants to always where a scarf? If you hold your head high that helps. But it gets tiring. So making peace with these new neck wrinkles is the only answer.

Besides the neck, I have noticed my arms are starting to look like the principal from my elementary school. Mrs. Torrent was her name and she was terrifying. Back in my day, they were allowed to spank us if we misbehaved at school. Mrs. Torrent had a giant thick silver leather strap that she would whip the bad kids with. When she would point with her arm to walk a certain direction you shook in your shoes and went that way. Her arms shook too. She had these skinny arms with hanging skin that shook when she pointed in her dramatic scary way. And when I saw the picture of me dancing with my mom (above) all I thought was, dang, I am Mrs. Torrent.

Hair is another issue. I am not someone who has energy to put into hair. As a result, my head usually looks like a bit of a contrived mess. My issue is the skunk look. I am not ready to go gray. I am not sure why, maybe just that I don’t like the color gray. I do like white and if I was guaranteed that my hair would be the pure beautiful white that my grandmother had, or my mom now has (who says her hair was gray first, so maybe, just maybe if I am patient, there is hope). I love white. I am working on this shallow concern of mine. I just have not figured it out yet.

There are other issues that bother some other women I know who are getting older and not thrilled about the changes.  The tendency for the fat on our bodies to migrate to our tummies from our butts. Women for some reason (guessing culturally) have a big issue with belly fat. Yes, excessive belly fat is associated with some health issues, but if it is just natural aging belly fat, and your cholesterol and insulin and all your labs are normal then you have nothing to worry about. I absolutely love the new looser fashions and even the new bathing suit styles that are looser and more comfortable so that those of us who are no longer into wearing bikinis have really pretty things to wear. Although, I am all for anyone wearing anything they feel comfortable in. I totally loved the energy of the elderly women on the beach we visited on a cruise that stopped in Tortola and Virgin Gorda in the Caribbean. As I sat there on my towel feeling somewhat self-conscious in my two-piece, a women just strolled out of the water with NOTHING but a bathing suit bottom. Nobody blinked. She sat on her towel with her hubby and basked in the sun. I was jealous. I wish I had that confidence, but then again, we clearly grew up in different cultures that focused on different things. She was way older than me.

Despite all the things I am not thrilled with, there is much more that I am SO happy and grateful for. If you are, like me, noticing changes that might be throwing you a bit and making you think that you need to do something, take a moment to think of all the good things about getting older as a woman. To me, this is what I am grateful for:

  1. Knowing, through my years of experience, what is important. That someone’s energy and heart and soul is what matters, not the wrinkles on their neck or the gray roots coming in. The people I crave to be around have much more that straight brown hair or strong arms or a flat stomach. I need character and a loving and generous heart. Those who fight for a cause or care about the helpless, elderly, homeless, hungry and poor, those are the beautiful people.
  2. I am so grateful for health. Health is something worth working towards. Everyone is different so you need to do what works for you. To me, health does not really mean being able to do a cartwheel or a handstand, but it does mean being able to get up if I fall down, lifting a bag of topsoil, pushing my lawn mower, lifting my laundry basket up the stairs, and being able to bike along my favorite bike path for an hour or two. It means having the energy to make it up the multiple flights of stairs in a village in Cinque Terre Italy to be able to get to that restaurant on the top of that mountain to have a glass of red wine and watch the sun set. It means having the energy and stamina to hike down the Grand Canyon Angel Trail and make it to the bottom to camp at Phantom Ranch, and then hike back out (on my bucket list). Your idea of health may be different, but what you want for your life is what matters.
  3. The gift of time. As I get older, I am realizing that time, well, it is a slippin’ away. It feels more priceless now. So much so that I am getting a little bit better at saying no. I am guessing lots of women my age are feeling it too. We want to spend our time wisely, doing the things that mean the most to us. For me, that means being with family and friends, although my work time fills me up with more than most people have at work, and for that I am grateful. I also spend less time on having the perfectly clean house or the perfectly weeded garden. It is good enough. Good enough is now one of my favorite phrases (right along with “Here’s to….!”). Yes, time is more precious now.
  4. Comfort. Being comfortable is a priority for me now. For some reason, I can no longer stand tight clothing or belts. My shoes need to be Naturalizer or Aerosoles. I can’t wear anything itchy. I am guilty of wearing pajama bottoms underneath a long dress to work.  I have several blankets in my house for anyone who stays over to cuddle on a couch or wherever (the garden swing, fire pit, patio). I promote coziness.

I could go on and on, but my husband is waiting for me and our nightly “date on the couch” where we watch some silly show that we tape so that we get to eventually unwind at the end of the night. Yes, life is short, wrinkles and gray hair come but, in the end, if you have energy to dance the night away (like my 85 year old mom), then well, maybe getting older is not that bad. Although, if I am honest, I really do want to do a cartwheel again. And if I do get there, you will be the first to know it!!

 

 

 

 

 

 

 

 

With Age Comes Wisdom(But Not Always When it Comes to Eating)

On By jodietitianIn fullness, UncategorizedLeave a comment

Image may contain: 1 person, tree and outdoorI think of him as the “Bird Man”. I was only 18 years old and little did I know at the time it was probably because of him that I became a dietitian. I was a freshman at Clark University in Worcester, Massachusetts and he was the graduate student who taught my biology lab. I was a biology major because I just loved the subject and everything to do with how every living thing worked (except the paramecium or amoeba). I had no idea about what I “wanted to be” when I grew up. But I realized I never wanted to be the Bird Man. He studied birds and bird calls (apparently, his thesis was about this topic), and he had us listening to hours of bird tweets, marking down different marks according to how long or short the tweet was. This was not my idea of fun. Anyway, I had no idea at the time that I could have chosen any topic in the field to study, and maybe, it would have been more interesting. Instead, when I consulted with my adviser about changing majors, he asked what interested me. At the time, my best friend at school was a vegetarian, and the food she ate was very different from what I ate. I answered “vegetarianism”. “Well, you should be a dietitian” was his recommendations, and so I changed my focus and transferred to UConn where they had a nutrition program. If I mentioned this story before, I apologize. Age has taught me I am becoming my mother (pictured here, eating ice cream even though she is lactose intolerant).

Anyway, yogurt with sunflower seeds and honey no longer interests me, and if I am honest, I have no interest in vegetarianism either. That was short-lived, but I have no regrets because over the years, I have discovered what truly does fascinate me, and that is behavior. My passion is promoting health and happiness and peace, and being a dietitian , that means peace and happiness with food and eating. Food being such a basic part (and necessity) of life, you wouldn’t think it would be so hard, right? But for many, it is.

When I worked exclusively with patients with eating disorders, I grew to appreciate even more how hard it is for people to change. When I encountered older women or men (in their 40’s, 50’s and one woman I clearly remember in her 60’s), it struck me that age did not necessarily bring wisdom when it came to making healthier choices in life. It was way more complicated. Now, between working more with families who have children with eating issues and even with encounters with your average “dieter”, I am discovering there are many barriers to change and everyone is different.

These are some common scenarios I often see:

  • Your average middle aged person who has gained a few pounds and wants to lose it. They try a certain diet (be it paleo, juice cleanse, Weight Watchers, it really doesn’t matter), they lose weight, and as time passes they gain most of their weight back. But then, despite the fact that they regained the weight, they repeat the process.
  • The person with an eating disorder who is in denial, and despite family and friends expressing concern and worry, they refuse treatment.
  • The person with an eating disorder who does get treatment but still struggles (and often beats themselves up because they are still struggling).
  • The parent with a child who has health issues because of a poor diet yet can’t change their own eating habits.

With all of these situations (there are many more), one thing rings true among them all: despite a good reason to change and despite repeated experiences with failure, change does not happen. Why?

My thought (and experience) is that our expectations are not always realistic. No matter what the situation, we can’t change it overnight. Knowledge, and even age and experience does not translate into change. And guess what……that is ok. The problem is that most people trying to change have little tolerance for making mistakes or for failing. Instead of being accepting of themselves that it is perfectly normal to fail, the self-deprecating dialogue takes over. That leads to a very negative feeling that has the risk of overtaking everything. Feeling negative and berating oneself is not a good recipe for change.

Instead, can you entertain the thought of a different approach to eating? No matter where you are on the eating spectrum (it taken over your life because of an eating disorder, or are you just slightly concerned that what you eat may matter) YOU are the one in control of your thoughts. You may not feel in control of your eating, but there truly is hope.

My suggested steps to change? First, ask yourself these questions:

  1. Reflect. Take time to neutrally (non-judgmentally) think about where you have been when it comes to eating and dieting. Has your road been long, or are you just starting to think about what you are eating?
  2. What does your “self-talk” sound like? In other words, what are you saying to yourself that nobody else can hear? Are you being nice to yourself, treating yourself kindly as you would others, or are you being mean?
  3. How do you feel? Do you have energy galore, or is getting up and moving a battle? If you don’t have energy or you are dragging, do you know why? Have you addressed it with your doctor?
  4. Are there changes in the back of your mind that you really know you need to make for your health’s sake? More sleep, less wine, more exercise, quit smoking, more vegetables? Be honest and make a list. This does not have to do with weight. This has to do with health and feeling good and living longer (hopefully).

THEN, make an action plan:

  1. If your self-talk is negative, write down some “counter-statements”. These are positive things you could say to help put you in a better place. Instead of “I can’t believe I ate that (or did that, or whatever), try saying “nobody’s perfect! at least I am aware of what I am doing! I am working on it!”
  2. If you don’t feel good or have no energy CALL YOUR DOCTOR and get help figuring out why. I know many people who have thyroid conditions, especially later in life that after treatment changed their lives. Depression can also zap energy and will rarely get better without help.
  3. If you are trying to improve your lifestyle to be healthier, but struggling on your own, ask your doctor for a referral (you may need a therapist, physical therapist, sleep study or dietitian…check out Find An Expert to find a registered dietitian in your area.

Remember, any “mistake” you make is really a gift in disguise. It gives you insight into where your barriers and challenges are. You just need to take the time to reflect on what leads you down that path and be kind to yourself as you keep trying to find a better way. It may be that you need to seek help to get you to where you want to go, and remember, it will never be perfect. The path there is never smooth, but that’s ok. As long as you keep going. And learning. And accepting.

So what would I have been had it not been for the Bird Man? I have thought about this. I maybe would have been a Master Chef, or Master Gardener, or maybe a sommelier on a Caribbean Cruise Ship…..Maybe it’s not too late.