“Listening to Your Body”: not always easy

Christmas Cookies 2

In the midst of the holiday season the effort to “listen to your body” as far as eating is concerned is not an easy task for many. This article by a fellow dietitian (one of the most sane nutritionists I have ever encountered) is really insightful as far as feeling full and what it means. If you struggle with being in tune with your hunger, read on for some good advice: How Full Should I Be? by Glenys Oyston

 

Weight verses Health

scaleYesterday a co-worker told me about her husband who just found out he had high cholesterol as well as high blood pressure. She said he had gained about 20 pounds over the past 2 years and she wondered if that was the reason he was now having health issues. The stigma against body size verses health is one that can be very confusing. When we talk about a “health at every size” approach to weight, people often react and think we are crazy. Of course weight affects health, they say. To help clarify this confusion, I wanted to share this great post from Dare Not To Diet (dietitian GlenysO). As for my friend’s husband, he was told to start to exercise and to eat more fruits and vegetables. It sounded like his lifestyle was not too healthy, and the bottom line is even if his weight had not changed at all, he probably would have had his health issues due to the way he was living his life. If you are working toward being the healthiest you can be, but confused about the weight issue, be sure to check out this post! See link below:

What exactly does Health at Every Size® mean for my weight?

Source: Am I Healthy at Any Weight?

New Dietary Guidelines 2015-2020 Released

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

“Intuitive Eating” verses “Hedonic Hunger”: A Balancing Act

hungry man and burgerA few days ago I was walking out the door to go to work, and noticed the very last and very ripe banana in the fruit bowl that sits on the counter on the way out of the door in our kitchen. I like bananas, but really need to be in the mood for one. This is such a silly and repetitive dilemma I seem to encounter way too many times a month. Why do I buy so many bananas for just 2 people? I ask myself this every time I walk out the door and see those bananas going bad (yes, I can make banana bread, but I’m not a big fan of baking and without central air, it won’t be happening). Do I make myself take the banana just so that it won’t go bad, or do I follow my own advice and eat “intuitively” which means not forcing yourself to eat things you don’t really want (and also eating the things you really DO want!).

We all have to make decisions about what to eat every single day, and most of the patients I work with struggle with these decisions. They are torn by wanting to eat “healthy”, by having food “rules”, and by the “food police” in their brains screaming commands at every meal (“that’s bad! That has too much sugar! That has too many carbs!”). People who are dieting to lose weight especially have a hard time making food choices as well as tuning in to their hunger.

Then you have those of us who believe the repercussions of dieting and being too strict with eating usually backfire, trigger eating disorders, food obsession, or at the very least make life miserable (and boring). So we promote “intuitive eating” which means learning to “listen” to your hunger and fullness rather than relying totally on just your thinking (“cognitive” restraint). This approach to eating tends to promote feeling better both mentally and physically (related to no longer feeling starving, or not feeling overly stuffed).

Sounds simple, right? Well, as you probably know, it is not. Part of the reason is something called “hedonic hunger”.  Hedonic hunger is “the appetitive drive to eat to obtain pleasure in the absence of an energy deficit”. In a paper written by  Elizabeth Rose Didie in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Drexel University in June of 2003  an instrument called the “Power of Food Scale (PFS)” was introduced. According to the paper, “the 21-item Power of Food Scale (PFS) was developed to assess the psychological influence of the mere presence or availability of food” (a self-report measure of hedonic hunger). It is suggested that a “preexisting vulnerability toward over-responsiveness to food” may exist for some people. In other words, some people may be more responsive to a food plentiful environment which makes “intuitive eating” more difficult. Not every person is the same when it comes to hunger. (if you are interested in the original research article, read it here: Power of Food Scale The actual questionnaire is on page 110).

Since the PFS was validated more research has been done looking into hedonic hunger and binge eating. There’s a lot more to learn, however just knowing that you are not like everyone else may be helpful. Instead of beating yourself up because you were not able to resist something, instead start to pay attention to your behavior. Try to accept what you discover (“if I bake cookies, I can’t help eating most of the batch”) and don’t berate yourself (which is what most people do, leading to even more bad feelings). Instead, you may want to consider only baking when you need to and go out for a few cookies at the bakery instead when you really want a cookie. Work to create a less triggering environment if you are one of those people who is more susceptible to hedonic hunger. Don’t set yourself up!

In the meantime, we all should be eating foods we really enjoy. You still can work on making healthy foods yummy, planning your meals and planning to have the foods you enjoy on a regular basis. It is ok to “use your head” when it comes to creating a healthy eating environment. Learn to cook and experiment with different healthy foods so that you always have meals you enjoy, yet continue to take care of your health. Cater to food cravings in a smart way (remember, if you see a food and then want it, it is not a real food craving, and more of a “beckoning” environmental trigger). When you are really in the mood for something, go buy it! If you want ice cream, go out and get a cone. This is way different than having large containers of ice cream in your home when you know you have trouble stopping, and end up feeling bad about yourself.

Yes, hedonic hunger makes it hard to eat intuitively, but with a little self-acceptance and smart choices, you can have your cake and eat it too. So what did I do with that banana?

I froze it.

Dieting and Weight: A New Way to Think

healthy lifeI struggled with what to title this post even though I know exactly what I want to say. Sometimes I notice things or patterns or trends about people, eating, food, or whatever and say to myself “I need to write about that”. Especially when it is something I see over and over again. To me it may be glaringly obvious how ridiculous it is yet so many wise and wonderful people are still doing the same dumb things (I don’t mean to be insulting to anyone as they are not “dumb” at all, which is why it is so baffling they might make the same mistakes over and over, even after many years).

I am referring to dieting, specifically spending money to go on the same diet program they may have been “successful” on 2 years ago. Lately I have bumped into old friends or acquaintances who last time I saw them looked a whole lot different. It could go either way, either they may have gained a lot of weight or lost a lot of weight. Following the same “program”. Or not.

It seems they have so much faith in their diet program because after all, it did “work”. If only they could have stayed with it, had more willpower. So this next time should be the last. But it never is and the reason is because nothing has really changed except the number on the scale (down, then up). You have heard it before, from me and others, why dieting and focusing on your weight is not the answer to feeling good or being healthy…..you know that any new diet book hooks you in because it gives a false sense of hope.

Instead, my hope is you might be open to stopping for just a few minutes to reflect on this. Do you have a goal stuck in your brain that you absolutely will not give up until you reach a certain size or weight? Then I am asking you for just a few minutes to let go of that thought and think about all of the things you have done over the past months or years to change your body. If you have spent months or years working on this and are still in the same place, would you consider something different? You could go another few years repeating the cycle and many people do. And you should not be hard on yourself if you have, because that is the only way to learn (and learning what does not work is equally important as learning what does work). Just like with dating, you have to kiss a lot of frogs!

Anyway, my suggestion is putting on a “detective” hat instead. Instead of judging and commanding yourself, could you first of all try to stay neutral and nonjudgmental? What are some of the unhealthy habits you may have fallen into that you wish you could change? For instance, are you stopping for fast food on the way home from work on a daily basis? Do you plop on the couch the minute you get home? Do you notice you drink too much when you go out with certain friends or overeat when you have sweets in your house? How about considering some simple “health” goals and making a mental list of some of the healthy things you would like to incorporate in your life? Someone once told me, or maybe I read it somewhere, that you are either moving forward, backward, or staying still. It is ok to stay still sometimes. And we learn from going backwards too. But why not take some simple steps to “move forward” instead of starting that same old diet plan or program (or a new one) that will leave you in the same place a year from now? You may decide to pick just one day where you don’t stop for fast food and cook instead. You may just decide to collect some of those healthy recipes you actually did enjoy from that diet plan and cook dinner (even if you are not “on” the diet, if you found healthy meals you liked, that could be useful!). Or maybe you may decide to take just ten minutes after work to walk before you settled in to watch TV. Even just one day a week. It is all positive action and all with a good goal: to move into a healthier lifestyle. Yes, you can stop for fast food, overeat with your friends, drink too much sometimes, and decide to spend the entire day on the couch if that is what you need. It is finding the balance that leads to a healthy body and mind. In the end, you will probably find that a year from now, for once, you will be in a better place, both physically and mentally (and financially!).

So consider putting on that detective hat, think about YOUR unique lifestyle and habits, and YOU decide what you may want to start with to move FORWARD. One step at a time…..

Should You Have A “Cheat Day”?

donut vs apple and womanWhen I hear a person say “Saturday is my cheat day” I gotta be honest, it pushes my buttons. To most people it sounds like a harmless thing, but to me it is a red flag. An alarm goes off, triggering this irritating feeling throughout my body. I try not to react, it is a conscious decision on my part to ignore it if I am overhearing a conversation in the elevator of the hospital where I work part time, or somewhere else where there really is not time to get into it. Otherwise, such as a party or other informal gathering where women especially tend to chat about what they are doing to change their bodies…. I always take the opportunity to educate people about Health at Every Size, and how focusing on being healthy verses being thin is a much more sane goal. Then I may ask what they mean by”cheat day”. Inevitably, it means following some type of “healthy” eating plan or dieting throughout the week, then allowing themselves to overeat any of the foods  they have denied themselves during the week on Friday or Saturday, and often again on Sunday.

What bothers me about this approach to eating is that it ignores all of the principles of “mindful” eating, and about “listening to your body” . It gives food so much more power than it deserves. It makes me think of how back in the day (and actually still today unfortunately) food is used as a reward. For example, “if you finish your spinach, you can have the cookie”. What does that message send? It says “something is very wrong with spinach, and something is very special about cookies”. I wish food was never treated this way. If you are really honest with yourself, you have to admit, that sometimes fresh vegetables or a great salad or roasted garlic with asparagus is extremely yummy. And an Oreo cookie could never substitute for that taste. If however, one were to hold that Oreo up as a reward, then it might be different. Over time,we might become conditioned to look at that sweet in a different way, and want it even if we really didn’t want it! If we really were mindful and not conditioned to think some foods were good and some foods were bad (that we could only eat them on a “cheat” day) and REALLY listened to what our bodies wanted, then we would not even need a “cheat” day. We would eat in a mindful way, cooking meals that were healthy and that we enjoyed, because we want to feel good, have energy and live a long and healthy life. But that means enjoying the fun foods too, the ones that are important to us, in our culture, our family traditions or socially. Having a homemade blueberry muffin at Grandma’s house or sharing a favorite dessert when out with our old college roommate,or Grandma Harmon’s favorite cinnamon buns that you only get once in a blue moon. It may not be a Saturday or a “cheat” day, but it may be and should be just part of normal life. Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday….I hope everyday you listen to your hunger, and fullness, and enjoy healthy eating, have energy, and never miss an opportunity to enjoy a serving of a special food that you enjoy. Heck with “cheat” days. Enjoying life is living, not cheating.

Are You in Diet Jail?

Idiet jail first encountered the term “Diet Jail” in 1975. I was a biology major at Clark University in Worcester, Mass. I remember clearly working with the lab teacher who was doing his research on birds (he kind of looked like a cool woodpecker). He made me count bird chirps he had taped on a recorder. I decided I did not want to be a biology major because counting bird chirps was incredibly boring. So I met with my adviser who asked me what I was interested in. My best friend Joyce was a vegetarian and ate very interesting things such as yogurt with sunflower seeds and honey, and so I told him, I though vegetarianism was interesting. He told me I should be a dietitian. I did not know what that was, but anyway, I ended up transferring to the University of Connecticut to study nutrition. For my first nutrition class (Nutrition 101) I had to do a  report about fad diets and at the time there were many books out there on the market, including the Atkins Diet. But I found one called “The Psychologist’s Eat Anything Diet” by two psychologists, Dr. Pearson and his wife, also Dr. Pearson.  It changed my thinking in a way that lasted, well, forever. The authors were decades before their times in the strategies they were promoting, before we knew about mindful eating or how our bodies regulated themselves regarding calorie intake, fat, carbohydrate intake, etc. They described what they called “diet jail” where individuals who diet tend to “lock themselves up” in a jail where only the healthy foods exist. In other words, they tell themselves they are only going to eat healthy foods such as grilled chicken, vegetables, fruits, salad, etc until they lose the weight. So psychologically it is as if they “lock themselves up” in a world where only the healthy foods are available (or allowable). But outside the jail are all the other foods, the “bad” foods. The chips, cookies, ice cream, burgers, pizza, you get the picture. All the foods they have determined they are not allowed to eat (while they are on that diet). And so, most people can last a bit in Diet Jail. Yes, they get cravings, but they use their “willpower” and overcome them. Unfortunately, we now know our bodies send out very loud signals when we are not getting enough carbohydrate or fat (the foods that do not exist in Diet Jail!) and so eventually, our bodies drive our brains to give in. Add this physiological drive to an environmental trigger, such as walking into your friend’s home who just baked some homemade chocolate chip cookies, and things change. Your brain, which is triggered by the deficiency in your body, tells you to eat a cookie! It has just what you need, what you have been missing, that fat and carbohydrate! But you can’t have someone throw just one cookie into your jail cell, so you have to step out of the jail to get that one cookie…….the problem is, once you take that bite, your realize you are out there! Out of Diet Jail! And since you know you will go back in (you tell yourself that on Monday you will really start again!) you better eat while you are out here! So you decide to order pizza, and then have ice cream (a lot) because, heck, you are going to start again on Monday. Often a full blown binge results. Because you know this is just this one time. Soon you will be back on track. Back in Diet Jail. Until the next time.

As repetitive as this cycle is in so many people’s lives, they do not seem to stop. The next diet craze offers the next magic scheme. Weight is lost and then regained. Back then we did not know the physiological reasons people were driven to eat but now we do. We know if you restrict you will suffer from “disinhibition” or breaking out of Diet Jail.Often referred to as the “what the hell” effect. It is a very sad and draining cycle.

So why not take those bars down? Why not entertain the thought of changing what you have been doing that is not working? What if you were to start to believe that all foods are equal? No food is good, no food is bad, they all have a place in your life. Yes, we need certain nutrients to feel good, have energy, normal bowel movements, prevent disease, etc. So educate yourself (I will gladly help you!), experiment, enjoy your cultural traditions (yay. pasta fagioli!) but start paying attention to your body. Are you hungry? Are you full? Are you so confused that you might really want to get some help (such as from an eating disorder specialist?). Wherever you are, it is ok, just take some time to truly reflect on your patterns. My hope for you is to enjoy eating, be healthy, and take down those darn bars.

What is “HAES”?

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I have a few simple questions to ask before I explain what HAES is:

1. How many people have you known who have “gone on a diet” specifically to lose weight?

2. Have you ever known someone who has gone on a diet and who has lost weight and kept it off? I am not talking about the person who took up a sport or quit smoking and adopted a healthier life style. I am talking about someone who followed a specific “diet plan” such as a low carb diet or meal replacement diet or counting calories or points kind of diet.

3. Have scientists discovered the one diet that works to help people lose weight and keep it off? Of course we know researchers have been looking into this, since people have been struggling with trying to lose weight for a long time. The “obesity epidemic”is always in the news. So have they found the one diet that works?

Not sure of your answer for question #1, but for #2, I am guessing the answer is NO, and for question #3, I will tell you the answer is NO. What most of the public does not know (because who would be interested in the research over the years regarding dieting except someone like a dietitian?) is that many researchers have been looking into dieting behavior for decades. In fact, when I went back to graduate school and did my research on “cognitive restraint” back in the ’90’s, I was angry! I could not believe the world did not know that the “experts” already knew many of the reasons dieting did not work! But then I realized, it is about the diet industry combined with desperate people wanting to lose weight.

I was not the only one who was angry. There now exists a split among health professionals working with people with weight issues (actually, the split has been there for many years but only recently gaining attention). Thanks to the more recent research and new groundbreaking books (see below) by Dr. Linda Bacon, the “Health at Every Size” Movement  has now been brought into the public eye and the movement is gaining momentum.. Those of us who believe in promoting health instead of some perfect weight, are no longer alone. Yes, there are still doctors, nurses and dietitians who will put someone on a diet (boy could I tell you some horror stories). So it is important to ask any professional you are working with which side of the fence they are on. Are they familiar with the HAES Approach? If not, they may be a bit behind the times. Or, they may still be influenced by a society who values a certain physical appearance instead of health.

Here is an excerpt taken the HAES website at http://www.haescommunity.org/  :

“Health at Every Size” is based on the simple premise that the best way to improve health is to honor your body. It supports people in adopting health habits for the sake of health and well-being (rather than weight control). Health at Every Size encourages:

  • Accepting and respecting the natural diversity of body sizes and shapes.
  • Eating in a flexible manner that values pleasure and honors internal cues of hunger, satiety, and appetite.
  • Finding the joy in moving one’s body and becoming more physically vital.

  • and from Dr. Linda Bacon: “Health at Every Size is the new peace movement.”

    “Very simply, it acknowledges that good health can best be realized independent from considerations of size. It supports people of all sizes in addressing health directly by adopting healthy behaviors.”

    If you are tired of dieting and ready to focus on health instead of some magic number on the scale, check out  Health at Every Size: The Surprising Truth About Your Weight by Linda Bacon, PhD and her most recently released book, Body Respect (http://thebodypolitic.biz/bodyrespect/), co-authored with Lucy Aphramor

  • And be sure to check out the HAES website at http://www.haescommunity.org/