Nutrition 101: Eat Like a Kid

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.

 

 

 

 

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

IMG_3720The 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……

 

 

 

More Evidence: When it comes to diets, one size does not fit all

beach-1168473Have you ever heard of “glycemic index” (GI)? This is a way foods are categorized depending on the way they affect our blood sugar. Many people believe we should avoid foods that have a high glycemic index because those foods are supposedly likely to trigger a high insulin release which in turn will make us store fat. I am not a big fan of GI or looking at the gycemic index of foods because there is not enough evidence regarding how mixed meals affect us. For instance, if you eat pasta which has a high GI but have it with meatballs, what happens?

Well, a recent Research Study (check out the details) shows that people react differently to different glycemic loads. In other words, one person may be able to eat a certain food and not have any reaction regarding blood glucose whereas another may spike their blood sugar which eventually may lead to weight gain.  We all can’t have lab work to see how our bodies respond to one food or another, however we can accept that a diet may work for a friend, but now for you. Again, if you are grasping at whatever comes across your path as a possible quick fix to your concerns about your weight, remember, you are unique.

With the holidays looming ahead, and people starting to panic about food, eating and weight gain, and thinking about what diet they are going to take on come January 1, 2016, I am hoping you take a minute to get real. There is no perfect diet for you, or for anyone. There is no magical weight or body size that will make you happy.

Instead, what do you think about keeping it simple? What would happen if you decided you would instead focus on feeling good? What does that mean to you? Do you need to work on getting more sleep? Do you need to figure out a way to incorporate some fun physical activity into your life? AKA exercise…..don’t like that word because it insinuates something that is not fun. So you need to make it fun for YOU. Because moving makes you feel good.

What about eating? Eating is more complicated than you would think, and I can say that because I listen to what people eat pretty much every day. And I know how people struggle. Yes, you do need to think about it to a point. If you do not plan, you will not be healthy. Period. If you don’t buy healthy food, you will not eat healthy food. If you do not know how to cook, you will probably need to eat fast food or eat out often, and that will not only be unhealthy (after awhile) it will also make you broke.

So yes, it does take some time and planning to feel the best you can feel, but at least you do not have to waste your time and energy and money on just another diet plan that may not work for you anyway.

Instead, do the simple thing you did when you were 5. Eat when you are hungry. Stop when you are full. Whether it is a ham sandwich or a bowl of ice cream, remember when you just could not finish? or, remember when you needed more? That is intuitive eating, young children have it until adults step in to force them to finish, or restrict them because they did not finish, and then they learn to tune out the natural mechanisms that regulate us every day, every meal, if we would only listen. (Note: those with disordered eating may not be able to do this. If that is you, hopefully you are working with a therapist and dietitian so that you can eventually get reconnected to your natural body signals).

My old college roommate Marion and me at the annual Manchester Road Race in Manchester, CT

So during the next month, over the holidays, try to eat your favorite foods, but listen to your tummy like you did when you were 5. Feel good. Eat enough, but not too much so that you don’t feel good. It’s just food. Go do the fun stuff, like playing football out in the cold, or running a road race with your old college roommate,  because that is what you do on Thanksgiving. We all know people who can’t eat because of a medical condition, or who can’t play football or run a road race. So, if you can, it is the time to be thankful.  Happy Thanksgiving!

Regarding “Clean” Eating….

mopThis women’s face is how I feel several times per week. Have you fallen for the latest weight loss craze? This is driving me crazy!! It angers me when people are taken advantage of because they are desperate to lose weight. How do you define “clean eating”??? And why does it usually involve some type of juice that you need to purchase?? Anyway, try to find some good long term outcome studies on this diet approach, and please share them with me. I can’t find any. The bottom line is any trick to make you eat A LOT less will make the force of gravity on your body less over time (that means you will weigh less). It won’t last. Most of these diets have you do a juice fast or just fruits and vegetables or maybe a “clean” shake for a certain amount of time. You will lose weight as your body breaks down muscle (sorry but the Krebb Cycle prefers amino acids to keep producing it’s ATP’s for energy, not the fat you are hoping it would use). Not to mention the typical dehydration that occurs when your body is breaking down muscle from starvation (because when you break down muscle you need to get rid of the nitrogen through your kidneys, and your body knows to use water to dilute it otherwise your kidneys would be damaged…unfortunately, that happens to some people anyway). And if you are getting way too little calories, your body may be building up toxins in your blood called ketones….that isn’t too “clean” if you ask me.

Not to mention, don’t you have to eventually eat something? Then what? Have you learned anything about yourself? Have you identified some unhealthy habits you may have had and are you magically now able to change them? Probably not. If I could have a dollar for everyone I knew who lost weight on a plan like this, but then gained it back, I might have retired by now. This latest fad is nothing new, just like the low carbohydrate diets, the low fat diets, the high protein diets, and on and on, it just delays the inevitable work your really need to do.

I’m good with vegetables and fruits in your diet. But this is way too much thinking and that is something we know people can’t sustain over time. Why not simply work on adding in these healthy foods to your diet and continue working on listening to your hunger and fullness, recognizing when you are eating when you are not really hungry, taking time to move your body because it is fun and feels good and also contributes to your health? Stop all the “cognitive restraint” and focus on health. There  is no such thing as clean eating.

The Milkshake Study

milkshakes

About 40 years ago, a landmark study was conducted that launched the research investigating why diets fail. This important study is sometimes referred to as “The Milkshake Study” (Herman CP, Mack D. Restrained and unrestrained eating. Journal of Personality. 1975;43:647–660). In this experiment the researchers administered a “Restraint Scale” questionnaire to determine who the dieters were (restrainers) and who the normal eaters were. They then had subjects participate in what the subjects believed was an ice cream tasting where they were to rate the ice creams. They were given either one milkshake “pre-load”, two milkshakes pre-loads or no pre-load and then told to eat as much ice cream as they wanted or needed to rate them. What was expected was the more milkshakes a subject consumed before the tasting the less they would probably eat (because they were already full, right?). But that is not what happened!

Instead, the researchers found that those individuals who were highly restrained (dieters) actually ate MORE ice cream with the more milkshakes they had before they started tasting! They hypothesized that dieters who constantly restrain their intake tend to become “disinhibited” after they break their diet boundary (sometimes referred to as the “what the hell” effect). This study triggered many more years of research into “cognitive restraint” and its negative consequences (binge eating being one).

Unfortunately, most people are not aware of this vast body of research, and so the diet industry has been able to continue making its billions. The good news is that finally a “Non-Diet” approach to weight management has been researched and proven to be effective in promoting health. Keep posted for more information and resources to come!!!

Warm Weather Dieting Woes

 

IMG_4090Happy Spring!!

Have  you ever noticed how the start of warmer weather gets people focused on dieting? I have been biting my tongue at work these past few weeks as it seems so many people are talking about the crazy eating plans they are starting. The new buzz seems to be a one or two food diet that is supposed to magically “cleanse” your system in a few weeks (a “kick start” as some people refer to it). I usually keep my mouth shut unless someone notices the dietitian sitting at the computer and dares to ask “what do YOU think?”

I love it.

Today I got asked the question, and I gave my answer. The research has connected dieting (any kind of cognitive restraint where you tune out your body signals) with binge eating. And weight GAIN in the long run. Yes, any trick to make you eat a lot less will of course result in weight loss (that good old “kick start” that is supposed to motivate you). Unfortunately, that short term weight loss ends up frustrating people rather than motivating them. They of course can’t keep up that rate of weight loss (and if they did, the loss would be valuable muscle). They end up feeling bad and usually just go back to their old ways.

Instead, what I shared with my coworkers was that it is smarter to take a non-judgmental look at your lifestyle and eating habits. Do you often eat when not hungry just because food is there? Do you have the habit of watching too much TV or sitting in front of a screen for hours on end? Instead, work on listening to your body. If you are hungry for a snack, and you want a cookie, eat a cookie. It is the non-hunger eating that goes against your body’s needs. Sometimes it is our sedentary lifestyles that prevent us from feeling better about our bodies.

I’ve said it before, and I will say it again! Work on being healthier in every way and forget about dieting!!!! In the long run you just might end up being happier AND healthier.

Healthy or Thin?

IMG_2637My guess is these two words get different reactions from different people. It has been my experience over the years that in our culture we assume pretty much everyone wants to be “thin”. And most people equate being “healthy” with being “thin”. Most of us assume if we tell someone they look “healthy” it would be a compliment. Or, we assume telling someone they are lucky they are so “thin” is also a compliment.

What I have learned from my patients is for those with eating disorders, being told you are “healthy” is equivalent to being told you are “fat”. For some of the patients I work with who have trouble gaining weight, being told they are “too thin” is very hurtful, as their body image concerns are often interfering with their lives just as the person who is concerned about being “too fat”.

My goal is to help people see that a goal of “healthy” is the smartest goal. The first step for some is working on their “self-talk” around the word “healthy” and eventually accepting it has nothing to do with your size. For others whose goal is being “thin”, instead changing to a goal of being “healthy” because that may be a goal they can actually achieve (not to mention, a goal of being healthy is also mentally healthier!)

I will always remember a teenage patient of mine who had moved from Africa and had lost a few pounds (still a very normal and healthy weight). Dad brought her in because he was very concerned about this. When I asked about his concerns, he said “I want her to be fat. Doesn’t everybody want to be fat?” He was very serious but I couldn’t help but smile inside. I did have to explain to him that we can’t always control that but I wanted to be sure she was “healthy”. He never came back ; )