Tag: health

If Losing Weight is your New Year’s Resolution, Don’t Forget Your Secret Weapon: IA

On By jodietitianIn dieting, hunger, Uncategorized, weightLeave a comment

Everyone is born with it. Babies and children know exactly how to use it. But something changes over time, over months and years, as our vast and varied experiences with eating and food accumulate. It gets unknowingly numbed, sometimes obliterated, taken away inadvertently by others, then finally thrown away by our own means. Eventually, most of us forget it’s even there, let alone how to use it to our advantage.

I’m talking about IA. Interoceptive Awareness.

Think about almost any child you know. A 4 year old will get half way through a plate of spaghetti and suddenly stop. “I can’t eat anymore”, or “I’m full” the child will insist. The informed parent will be wise and listen. But the typical parent will often visually look at the amount of food the child ate and feels it is just too little, it can’t be enough. So instead of allowing the child to follow is natural body signals, they insist the plate be finished, or the child take “just one more bite”. And so it begins.

That 4 year old body knows just how much he needs to eat. But he will lose this natural ability if his parent keeps this up.

Well, it’s that time again….New Year’s resolution time. People pledging to lose weight is probably up there as one of the most common pledges. I am not here to promote losing weight as a good goal for everyone, but I do know that lots of people gain weight over the years because they have lost touch with their IA. That means the weight they gained is not normal for them, it was a gradual accident. So let’s talk about IA, what it is, how you lost it and how you can get it back.

Interoceptive Awareness in simple terms is the way your body communicates with your brain about what is going on which helps you understand and decide what your body needs. A simple example is being thirsty. We have all experienced that feeling. You are outside working in the heat, or walking on a hot day. Your mouth feels dry, you feel uncomfortable and somehow you know you need water. That is your body using IA to tell you to drink. It involves a complicated process with your mouth, brain, blood volume etc. integrating signals and monitoring your physiology to make sure you do the right thing to stay alive: drink more water.

The same type of process happens with food and eating. Back in the day when I first became a dietitian in the 70’s scientists really didn’t understand how we knew how much or what to eat. They knew it was complicated (certainly genetics were a factor, as well as culture and environment) but they were just scratching the surface of it all. Leptin was discovered which was a big breakthrough. This messenger was found to actually monitor our fat cells for changes then sending signals to the brain to eat more or less depending on how much fat was there. If you ate too much, leptin would send the signal to eat less. The discovery of leptin was just the start. For those of you who are interested in a more detailed explanation, check out this article:https://www.scientificamerican.com/article/decoding-your-hunger-during-the-holidays/

We now know there is a specific messenger for fat intake, and for carbohydrates (every wonder why you sometimes crave sweets? Chances are you didn’t have enough carbs at your last meal). Yes, your body wants (and needs) balance. Please note that some people have to be on special diets due to medical conditions. Ketogenic diets are sometimes used for patients with seizures. Paying attention to carbs is important for diabetics. There are definitely medical conditions and genetic abnormalities that contribute to an individual who is not able to follow natural body signals. Babies born with Prader Willi Syndrome fail to thrive at birth however then tend to overeat with no shut off later in life and may gain an unhealthy amount of weight if not monitored. These are the exceptions. For most of us, our body signals and IA work fine. We just don’t listen.

Besides having well-meaning parents interfere with our natural ability to listen to our hunger and fullness, when we consciously try to manipulate our eating, especially in extreme ways, over time we really can do damage. I have had many patients in the past say “I am always hungry” or “I am never hungry”. Often, they have slowed their digestive processes and their metabolisms down by skipping meals or restricting, and they lose that feeling of hunger. They have to follow meal plans to get their digestive system and metabolism working again. Even if you have not gone to this extreme, but instead have simply tried to diet by eating less, your mindset gets engrained in a way that gets stuck. Many people simply don’t trust their hunger because the diet mindset tends to be “all or nothing”. Either you are walking around hungry because you are dieting or you are overeating and feeling uncomfortable, throwing caution to the wind because you are off your diet. This on a diet/off a diet lifestyle certainly keeps you disconnected from your natural IA.

So is counting calories, measuring foods or cognitively restricting your food intake the answer? As I have said many times, people do have the goal of losing weight and often do lose weight dieting, however they usually gain it back because they have not even begun to try to work on getting in touch with what their body is telling them. How do you start? Where do you start? One meal at a time. One snack at a time. Here are some tips to get you started.

  1. Identify Habits: before you can get in tough with your body signals regarding hunger and fullness you have to work on eliminating the triggers that cause you to eat when you really are not hungry.
    • Do you eat while distracted, such as at the computer, in front of the TV or while talking on the phone?
    • Do you graze all day instead of actually sitting down to a meal?
    • Do you keep food in your car, at your desk, in your bedroom?
  2. Designate a place to eat without distraction both at home and at work.
    • To help tune in to your gut messages it is helpful to avoid distraction and pay attention to what you are eating
    • Sit in a chair at a table or counter. Do not stand and eat.
    • Turn off the TV, leave your phone somewhere else, don’t read. Just eat.
  3. Designate meal and snack times if possible.
    • Snacking all day instead of eating a real meal can confuse your body. If you are a snacker plan on a breakfast time, ONE morning snack, a lunch time, ONE afternoon snack, a dinner time and ONE night snack
    • If you are a meal skipper and tend to wait until dinner time and after to graze all night INSTEAD plan 3 meals a day and ONE pm snack. Plan a breakfast time, a lunch time and a dinner time. You may not feel hunger since you have been tuning out your signals for too long but they will come back over time. Start small.
    • Be flexible. Eating at the exact same time every day is not the goal. It is the pattern we want to change. Eating within an hour time frame (for example, breakfast between 7 and 8, or lunch between noon and 1 pm) is a good goal. If this is hard for you even within a 2 hour time frame is a start in the right direction.
  4. Take time to think about what you want to eat. Sometimes your IA will plant a specific food or foods in your brain and that often means your body needs something. If you have been dieting and have been feeling deprived this may be difficult, but don’t give up. Take the risk, even for one meal a day. Some people feel too guilty letting themselves eat something they consider unhealthy. The goal is not to turn you into a junk food eater. The reality is that once you are in tune with your body, you will realize that you actually rarely crave junk foods as often as you think you will. I recommend if nothing is calling to you strongly, if you really are not craving anything, then try to choose a healthy meal that you really enjoy. Please note that if you are suffering from disordered eating, or have been diagnosed with an eating disorder please consult with your therapist and dietitian before making any changes to your eating. If you feel overwhelmed just thinking about any of this, I suggest even one consultation/evaluation with and therapist who specializes in eating issues.
  5. Tune in to your hunger/fullness level. Consider keeping a diary with a record of hunger level before eating and fullness level after eating. A scale of 1-10 is often used with 1 being “starving” and 10 being “stuffed”. A “3” might indicate normal hunger whereas a 4 is just a little hungry and you could wait to eat. After eating, a “7” would be a comfortable normal fullness whereas an “8” would mean eating a bit too much, a 9 definitely getting to uncomfortable. Keeping this record often helps recognize patterns and makes it easier to not eat when not hungry, and to be sure to eat when you are. Remember, this is a very subjective tool and I have known many people who can’t relate to it at all so if this is you, no worries! Just take the time to think about it. Stop and think about how hungry you are before you start eating, and reflect on how full you are after you eat a meal. Eventually you will identify how disconnected, if at all you are to your IA, to your awareness of hunger and fullness. (Note: we are all different with respect to a messenger (PYY) that tells our brain we are full. For some people PYY works really quickly and after eating a certain amount the messenger tells their brain to stop eating. These are the people you may know who just naturally do not over eat. For most people it takes 20 minutes for this messenger to work. For others it is longer. These are the folks who can seem to eat a lot at times but then feel uncomfortable a half hour later, complaining that they ate too much. For this type of person it might be helpful to set a timer for 20 minutes and after a plate of food wait for the 20 minutes before taking seconds. Chances are the fullness will kick in by then and that feeling of being overstuffed can be avoided). Oh, we also know that regular physical activity may help you be more in tune with fullness AND hunger.
  6. Appreciate the complexity of appetite. It is not that simple. The complicated neurochemical picture is hard to comprehend. There is so much to know. Did you every hear about NPY, the messenger that tells you to eat and won’t go away unless you eat enough protein? That is why after what you think is a healthy lunch of salad and fruit leaves you wanting more. Have you heard of ghrelin? This messenger also stimulates appetite and is elevated if you don’t get enough sleep! That is why you can’t seem to satisfy your appetite on those days after a late night out. Can you imagine how hard it is for someone with undiagnosed sleep apnea to maintain their normal weight? If you don’t sleep well, talk to your doctor. Finally, our emotions and personal histories make things even more complicated. We now know that pathways overlap in our brain that regulate both food intake and emotions. So if you ever used food to soothe yourself expecting to be able to suddenly be able to “listen to your body” is not realistic. Again, if you believe you are an “emotional eater” it might be wise to seek help.
  7. Educate yourself. Intuitive Eating is no longer a new concept and Mindful Eating is something that many people are working on. It is a much better goal than “losing weight”. Moving toward feeling better, feeling and being healthier is a good thing. Check out the website for more info. https://www.intuitiveeating.org/

Happy New Year! Here’s to NOT trying to be perfect, but moving a little bit each day to a more aware, healthier and happier YOU!!!

Middle-Age Alert: The Time to Act is Now (5 Tips)

On By jodietitianIn UncategorizedLeave a comment

The other night a bunch of us retirees were joking about what exact “age” we now consider to be “old”. We all remember way back when we were approaching our 30th birthday and how we felt . Being 30 was “old” to someone in their 20’s. But then we turned 30 and realized nothing changed. Now, 40 is definitely young (we have kids in their 40’s for heaven’s sake), and 50 we can barely remember, so that is definitely not old either. Now, we look back and realize how fast time flies. We wish we only knew then what we know now. So that is why, after taking this break from writing, I felt motivated to write again. To share with you what you might want to know now rather than later when it could be too late.

Do you sometimes wish you could see into the future and know what you are going to be doing and how you are going to feel in 20 years? Will you be working in a job you love? Will you be energetic and healthy when you finally retire? Will you still have the friends you have now? Will you be happy in your relationships? Not everything is in your control. Unfortunately, tragic events change lives and disease is sometimes genetic and can’t be prevented. But as I progress in years (you know, get older) I can’t help but compare the quality of life in those that make certain choices verses those that make other choices. There are consequences to our behaviors. Over time, the detrimental (or beneficial) effects of our behaviors add up. In other words, what you are in the habit of doing TODAY has a HUGE impact on the life you will experience later. If you want to be sauntering up and down those cobblestone streets of Cinque Terre, doing that bike and barge river cruise in Amsterdam, or just enjoying a swim in the pool at a resort in Cancun, the time to start thinking about the future is now.

 Most of what I am going to mention is nothing new to you. What I am hoping is you might appreciate the experience and observations of someone who is living through it, witnessing the changes and experiences first hand through those around her and feeling it herself. If your partner or mom give their advice it sometimes makes us resentful. I hope this post makes you stop and think.

 Here is a list of what I have personally observed to have the greatest impact on your future enjoyment of life itself:

  1. Moving Too Little (or Too Much)

 One of the benefits of retiring to Florida is getting to know a bunch of snow-birders from around the country. I have been blown away by the very fit people over 70 down here. Every day I see both women and men, some over 80, riding their bikes to the pool for water aerobics at 9 am. I see them walking their little ankle biters (I mean poodles) around the almost 2 mile block early in the morning or after dinner every single day. The same group of elderly men and women are going at it with pickle ball 5 days a week. Pete, who is 80, arrives like clockwork at 4 pm at the pool to do his laps for almost and hour. These happy, healthy elderly people MOVE and as a result, their bodies keep working for them, enabling them to have fun.

 On the other hand, I have observed some other people who do not move so much. They struggle going up stairs, they can’t easily get into the car, their knees and hips and muscles hurt. Yes, it could be arthritis or osteoporosis or any other affliction that plagues us as we age. So that is why I also pay attention to younger folk, people my age or even younger, who don’t yet have those afflictions, yet suffer from the same poor quality of life. They get sore from simple repetitive activities. They lose their breath going from place to place. Their body hurts after a little exertion. They struggle getting up from the couch or a lower chair. They have to rest a lot because their muscles just are not used to moving. Their “habit” of avoiding movement at all costs regardless of reason(too much time on social media, watching TLC, working at home on the computer, etc) is starting to affect their quality of life. Even at the age of 40.

 And then, of course, there are those exercise addicts who pride themselves on going to the extremes their entire lives. I have known people who didn’t stop at a few rounds of golf and had to play all day, every day and now can’t play at all because of shoulder issues. There are those with tennis elbow because they overdid their sport. Stress fractures and hip issues seem to have afflicted some elderly runners I have known because they never took a day off. The list goes on and on. Too much of a good thing ends up being a bad thing sometimes when you get older.

 So which are you? Do you incorporate some kind of daily moving in your life? Unfortunately, lots of people only “exercise” when they are dieting because their end goal is losing weight. This is a HUGE mistake. Actually, if this is your goal, and you can project into the future, think about what kind of life you want to be able to enjoy when you are older. Walking for 30 minutes a day, even if you can’t do it all at once (such as 10 minutes, 3 times a day) could change your future life. Over time it adds up. The typical person I have seen over my many years in the field joins the gym and starts the diet on the same day. They are determined and diligent. But it turns out to be almost impossible to meet the (ridiculous) goal of going to the gym consistently at 5 am before work or 6 pm after work 5 days a week in addition to following that restrictive diet. It is pretty emotionally draining to think about eating all the time in addition to the grueling workout schedule. Most people give in. They break the diet because with all that physical activity your body requires (and will crave) more carbs….which of course are not on most diets. So once the need for carbs (ice cream, cookies, chips) is naturally satisfied the diet is broken and the gym days are over, for now. Until the cycle starts again.

Instead, just imagine that over the next 10 years your body managed to walk 3,000 miles! Do you think that body would be stronger, more fit and feel better, even without dieting? The reality is that body also would sleep better, be more in tune with how much it needed to eat, be less stressed and happier as well as be at a more natural weight. The point is, if we stop linking moving with losing weight and dieting and instead just focused on how to incorporate more movement, even just walking 2 hours a week our lives would be different when we are older. Much different.

Take my mom for example. She is 91 years old and is in constant motion, walking inside the house, counting her steps up to 100 if she can’t get outside. When other people her age nap on the couch all day, she is out having fun. Because she can. She is the best example of how moving every day, no matter what it is, will change your life. She also is pretty funny. She loves to say “that will be a dollar” every time she gives advice or says a prayer for you that gets answered. I should have added humor in my list of factors that make you healthy. Anyway, as far as physical activity, you don’t have to run a marathon. Just start moving.

2. Smoking Cigarettes

 Duh. Of course you know smoking is bad for your health (causing cancer, heart issues, etc). And yes, if I look around at people who are over 60 and smoke, it is true, they do appear older because of how smoking affects your skin and appearance over time, but the health repercussions are what is crippling, not wrinkles. With that said, I realize knowledge is NOT power when it comes to smoking. Smoking is an addiction to a substance as well as a deeply ingrained habit that is hard to change. I can speak to this issue because of personal experience, so I am going to share that in hopes it may shed some light. If even one person quits smoking from reading this, I will be thrilled.

 So when I smoked cigarettes it was in the 1970’s. I was a senior in high school. I vaguely remember that my Newports cost about 50 cents a pack. I went off to college and for some reason, I went from a half a pack a day to almost 2 packs! And then, I clearly remember the price jumping up to over 60 cents a pack. That was it. I couldn’t afford that! Also, I was moving in to an apartment with 3 women who did not smoke and I did not want to be the one stinking up the place.

 So here is the thing, the important take-home message: I MADE A DECISION. Yes, I had “tried” to quit smoking before, and if you have tried to quit, you may relate. Before, deep down I would be thinking, “how long will I last?” This was the first time my thinking was different. I DECIDED that I did not care what I had to go through, I was quitting. I also remember consciously adopting a brand new identity: Healthy Person. This was new (which is funny as I was a nutrition major at the time, but smoking was socially acceptable back then). I also (as a “healthy person”) started exercising for the first time in my life. I dragged myself to the pool in the field house at UConn several times a week at night to swim. I had ants in my pants and needed to do SOMETHING. I remember leaving the field house and walking to my car in the freezing cold and my hair would turn into icicles and clink. Then, in the spring I took up jogging. I was REAL SLOW, but I felt so empowered and very cool as a “healthy person” it didn’t matter that it took me 20 minutes to cover a mile. I loved it. I was hooked.

 That’s the good part. The bad part was the process. Several years after the fact I became a Registered Dietitian. I took a part time job at the local YMCA and was trained by the American Cancer Society to teach their “Fresh Start” classes on quitting smoking. I learned about the 3 parts of being addicted to nicotine and smoking. I reflected back on what I went through and it all made sense. The first part is the chemical addiction. Luckily, it only takes about 10 days to get the nicotine out of your system. The second part of the problem is the HABIT you have practiced over the years that has become deeply ingrained in your brain. This means that certain things become “triggers” to make you want to smoke. For me, I had a cigarette when I took a break from studying (and I studied a lot). I had one with my coffee in the morning and one with a beer on the weekends. I had one after eating and socially smoking was always involved. I smoked when I was stressed and I smoked while walking to class and after class. Like most smokers, having a cigarette was associated with all kinds of activities. That is why every time you do the activity (eat, drive, have a coffee or a drink, etc) you are going to want a cigarette UNTIL you KEEP PRACTICING a new behavior. For me, it was being very aware of simply sitting there…doing nothing. That was it. The hard new behavior was doing nothing. Funny thing is now I crave times like that, just sitting in quiet. The reality is for any bad habit the act of practicing doing something different over time actually changes the brain’s pathways so that eventually it becomes automatic. You don’t have to think about it or even try anymore. You just have to practice.

The third, and most difficult for me anyway, is the “emotional” aspect of the addiction. I did not understand what was going on at the time. I just found myself crying for no reason. I felt like someone died. After the fact I learned that I had made a friend of cigarettes. They were there for me every time I needed them. They connected the events of the day for me. They filled the space, a void. And when I DECIDED to let them go, well, the pain was real. It may sound weird to those of you who never smoked. But smokers will relate. It is painful to let it go, and that is because of the emotional addiction. It DID feel like someone died because something was gone. But just like with a bad break-up, you do get over it. And boy, life is SO much better, especially as you age. After I quit, when I walked to class, I could not believe how much energy I had! I could breathe! This is how I am supposed to feel, I remember thinking. Trust me, you don’t even realize how crappy you feel until you don’t feel crappy. It is life changing. I honestly, thank God, still feel that good. 45 years later (or more).

 Not to mention the money you save. Let’s just say if a pack of cigarettes is about 10 bucks, and you smoke a pack a day, that is over 3,000 dollars a year. If you quit now and retire in ten years, that’s 30,000 dollars for that new house down payment, or better yet, for that European River Cruise on your bucket list. Enough said about smoking. But please, think about it. I hope you make the decision, go through the pain and come out the other side. Check out The American Cancer Society website for help https://www.cancer.org/cancer/risk-prevention/tobacco/empowered-to-quit.html.

3. Ignoring Nutrition (or Obsessing about it)

 Unfortunately, most people I have known and met over the years think about eating and food with the very narrow view of how it affects their weight. They think “good” and “bad” when it comes to food. They often have dieted over the years, lost weight, gained it back and then stop paying attention at all. It is socially acceptable to diet and focus on eating only as it relates to helping you lose weight or not. That’s too bad because food and eating well can be such a wonderful and enjoyable part of life. It is sad that so many people are probably reading this and thinking “are you kidding me? I am tortured by thinking about food!” So, I am not going to pretend this is easy. It is not. What I am hoping to convince you to consider trying to change extremes of eating. The fact is that eating more fruits, vegetables and healthy fats as well as fiber have a huge influence on preventing disease in our future lives. Waiting until you have prediabetes or heart disease is not a great time to start thinking about what you are putting into your body.

 When it comes to healthy eating, there are a few different mindsets I have noticed. There are actually people who escaped the entire diet-obsessed weight-focused movement and do not have the diet mindset at all. They like to eat. They just honestly don’t think about it. Let’s say you fall into the “ignore nutrition” mindset. Maybe you don’t think about what you eat because you simply have no interest in food. You never enjoyed cooking, and having people over for a dinner party is more stressful than joyful. Planning meals for the week and packing a lunch to bring to work feels like so much work. So you tend to pick up a burger for lunch or just grab some chips, a soda and a candy bar to get through your day. Isn’t that why they invented Coca Cola? You feel ok, what is the big deal? It is also easy to buy some frozen meals or pizza or whatever. You grew up with canned green beans and corn. TV dinners were the norm as was hamburger helper. Twinkies and Bugles were a staple in your home (and they still are).We all did not grow up in families with adults who just loved to cook. Some of us just could not afford to eat differently anyway.

  OR maybe you DO have the diet mindset, and you don’t want to think about what you eat because you are not following a diet right now. You DID fall into the craze but right now, you are off the diet bandwagon. You know you will be going back on eventually, when you are motivated again to lose the weight. Maybe it’s Weight Watchers, or Noom, or counting carbs or calories or “clean eating” (hate that expression). It doesn’t matter, just that now you are ignoring it all. So why not just eat what is easy, convenient, tastes good, quick, and especially what you know you won’t be able to have when you start that diet?

On the other hand there are those of you who may be TOO focused on what you are eating (and it does not always necessarily mean you are concerned about your weight). You read every label looking for whatever it is you are afraid of (fat, carbs, additives, artificial ingredients, etc). You spend way too much time worrying about what you are eating. You used to enjoy food but now eating is work. You tend to eat the same thing everyday because over the years you have found the foods and meals that make you feel “safe”. From my experience these foods tend to be low fat and low sugar foods such as plain yogurt, vegetables, some fruits, lean chicken and cereals with absolutely no sugar (heaven forbid you buy the honey nut cheerios by mistake). Going out to eat or to a dinner party is never that fun because typically the foods offered are not on your safe list.

 The truth is there are many different types of “healthy” eaters too. If you buy and prepare healthy foods most of the time, but CAN enjoy, and actually look forward to going out to a favorite restaurant or to a friends for dinner, then no big deal. Maybe you even buy what I call “fun foods” like your favorite ice cream or chocolate to have in the house when you crave them. You never feel guilty after eating anything. You may read labels once in awhile to check for protein or sodium or a specific allergen you react to. Maybe heart disease runs in the family so you prefer to choose products with no trans fat and less saturated fat. Well, this type of eater is probably balanced, not stressed out over food, but simply trying to create a healthy food environment. This person actually truly enjoys their kale salads and Greek yogurt with chopped fruit. But they also like and enjoy a wide variety of foods. They have a healthy relationship with food and eating, and they likely never dieted.

Another type of “too healthy” eater typically feels guilty after eating. They may have a long history of dieting and weight fluctuations. They may be in and out of “diet jail”. They will not eat something if they don’t know what is in it. They count calories and will only eat small amounts, or they lose control and binge eat, alternating with dieting. If this sounds like you then getting an evaluation with an eating disorder specialist may the only way to know if you truly have a problem that needs to be addressed. You can ask your doctor for recommendations in your area and with your insurance. If you don’t get help now imagine still being trapped in this draining mindset 10 to 20 years from now. I know people who are. This is no way to live.

 So what is they best way to eat if you want to be enjoying life in your older years? I believe making the effort to eat healthier without excessive focus on being perfect sets the stage for both a healthier body in the future as well as lots of joy when it comes to food and eating . Learning about healthy cooking and eating actually DOES matter. I have seen people in their 50’s and 60’s experience all types of health issues simply because of poor eating habits. Type 2 diabetes, stroke, hypertension, heart disease, digestive issues, etc can often be prevented with just a little attention paid to healthier eating (without driving yourself crazy). Little changes add up if you start when you are younger. Simply focusing on adding in fruits and vegetables helps. Remember, all fruits and vegetables provide antioxidants. It is these wonderful substances that fight the bad things, that help prevent damage and disease. I know people in their 50’s who have had heart attacks and who have lived on “brown food” (burgers, fries and not much else) their entire lives. Could it have been prevented? It’s worth a try.

So where do you start? Maybe you could start buying apples and bring one to work. It is perfectly alright to make it easy. Add some frozen veggies to your freezer so you could just microwave a portion to have with your dinner, whatever that is (frozen broccoli has just as much vitamin A and fiber as fresh). Buy a bag of salad at the grocery store when they go on sale if making your own feels like way to much work. Maybe start experimenting with cooking on the weekends if you have more time then. The idea is to just start somewhere. Check out the website https://www.eatright.org/ and https://www.myplate.gov/ for more guidance on healthy eating and cooking.

 Remember, stressing about eating is not good either. The time to start working on your relationship with food and eating is now. Check out these websites https://thecenterformindfuleating.org/Principles-Mindful-Eating and https://www.intuitiveeating.org/10-principles-of-intuitive-eating/ for more guidance on mindful, non-diet eating.

4. Bad Sleeping Habits

  If you are going to bed with your phone or iPad or laptop, or binge watching your favorite TV show until the wee hours (after midnight) and you do this on a regular basis, it is going to be next to impossible to eat healthier or move more. We now know that lack of sleep actually has a profound affect on the foods we want to eat. Lack of sleep affects metabolic messengers that make us crave carbohydrates and fats so that our goals of choosing healthier foods are sabotaged. Have you ever noticed that you are craving junk foods or greasy fatty food after a horrible night sleep, or after late night partying? You just can’t ignore it. Your body won’t let you. The urge to eat junk food is as strong as the need to use the bathroom. It’s physiological. There’s no stopping it. So if you are motivated to eat healthier, please don’t blame yourself or feel bad if you struggle. If you aren’t sleeping well, that is most likely the culprit.

 The other huge factor in predicting a healthier life in the future, moving more, is also going to be next to impossible if you are tired. If you aren’t getting rested, if you wake up exhausted every day, even getting out of bed can be dreadfully difficult. Who could blame you if you don’t want to go for a walk and especially go to a gym? It’s even difficult to make the bed or do the dishes when you are consistently getting poor sleep, let alone go for a jog.

 I probably should have put sleep as number one, because without it nothing else healthy can happen. If this is you, I strongly recommend asking your doctor about a sleep study. Check out the website https://sleepeducation.org/sleep-disorders/. The sooner you find out what is going on and how to correct it the more active and enjoyable, healthy years you can add to your life! I know people personally who have said “I feel like a new person!” after getting their sleep issue corrected. Don’t wait! The time is now!

5. Avoiding the Doctor

 Prevention is so much easier than cure. If you knew you had a very tiny precancerous lesion on your body somewhere that, if removed, could save your life, what would you do? Remove it of course! But if you don’t know it is there, the outcome would be different. Yet, so many people just don’t take the time to do the important recommended “screenings” that could mean the difference between life or death. Everyone my age knows someone who passed away because they did not get diagnosed with a disease until it was too late. Don’t let that be you. Yes, it takes time and is not always fun but if you could see into the future, you would have wished you did it. I hope you get that mammogram you have been putting off, or that colonoscopy or skin check for that new mole you noticed. Do that stress test. Tell your doctor about that chest pain or shortness of breath or any other issue that is new and not going away. The earlier you address it the more likely you can prevent something horrible and the more likely you can look forward to enjoyable years ahead. 

There of course are more things that affect your future health. Hating your job, struggling with a relationship, going through stressful life events all affect health. It is well established that stress affects everything. If you wake up with dread everyday, don’t ignore it. Ask your doctor about affordable therapy. Taking that first step is sometimes all it takes to feel more positive about life. Making an appointment with a therapist is the first step towards your new, happier life.

 Don’t wait until you are 60. Don’t wait until you retire and you think you will have more time (you won’t). Do it now. Start today.

That will be a dollar.

 

Don’t Let Crappy Covid DeRail Your Move Toward Health

On By jodietitianIn Uncategorized2 Comments

healthy lifeI woke up at 4:37 am today. After tossing and turning most of the night, I could not figure out if it was anxiety over the fact that I have to have a tooth extracted today at 10 am….or if it is excitement that I am actually getting to go out and do something different.  I can’t believe those words are coming out of my mouth, someone who going to the dentist is right up there with getting a flat tire, or jury duty, or sliding off the road in a snow storm. I am afraid of those things and I dislike them immensely. But here I am, so excited about getting out that even getting a tooth pulled sounds good. What is this crazy quarantining doing to me? What is it doing to everyone?

I am sure you have noticed, as I have, how people around you are reacting. I have read some interesting and enlightening posts on social media expressing our struggles perfectly. Two of my favorites included one from someone I know and one from a stranger. The first one, from someone I know expressed the true struggle this has been for her. She expressed the dissonance lots of us are feeling: we want to do what is right and be safe, yet we so desperately want to get back to normal life. We are torn. We are scared, but we also can’t stand it anymore. The second post was long but worth the read. It was a great reminder that no, we are not in the same boat. We are in very very different boats fighting the same enemy. Some boats are pretty easy and fun. No small kids at home, sudden extra time to hang out at a beautiful home with plenty of funds for good food and Amazon purchases. Much different than the young single parent at home with two special needs children, living paycheck to paycheck (that they aren’t even getting right now) just to pay the rent, living in a busy city with no back yard and no transportation, no family support, no money for enough food or Amazon purchases. Yes, both posts were great reminders that we all have different circumstances, and we all are taking this differently (even differently day to day, or minute to minute). So, as I write this post, please keep in mind that I can only share my own personal trip on my own unique boat which is probably very different than yours.

However different our “boats” are, I am guessing you also may be noticing a few “themes” coming to light as to how some people are dealing with this. I have been paying attention to the comments of others when it comes to how this is affecting their daily habits, their thinking and ultimately, their health. So I have a few thoughts that might be worth sharing.  I have noticed lots and lots of joking around food, eating and drinking. Oh and also some funny ones about being stuck at home with a significant other who may be driving you crazy, but since I am no expert on relationships, I am not commenting on that one! However, when it comes to using food and eating, or drinking/addictions, that I do know more about. And I know not everyone is laughing.

There are lots of people who “use” food to feel better in a very “normal” way. “Emotional eating” can fall on a spectrum in a certain way. It really isn’t a big deal to treat yourself with chocolate because it makes you happy. Or, if you had a rough day and your partner wants to take you out for a drink and luxurious meal (again, this may be chicken wings for some of us, lobster and escargot for others). The point is, the food and the eating are part of the treatment for feeling better. Think homemade chicken soup when you are sick. Lots of us can relate to that. When I stayed home from school if I was ill back in the day, my mom would crank open a can of that good ole Campbell’s Chicken Noodle Soup, the kind with the big fat overcooked noodles and maybe three bites of chicken in every can. It didn’t matter, it made me feel better. Today, I make real chicken soup, because I know how to cook (not that mom didn’t but with four kids, Campbells came in handy). Anyway, it still works. Food makes us feel better sometimes. And that is ok. Comfort food, I love it.

Binge eating is not ok. By binge eating, I do not mean the kind of eating people are joking about right now. The jokes tend to be about being “good” all day, following a diet and then turning to cookies, chips, ice cream, pizza all night long. Some people think that is funny. To the “typical dieter” who may diet during the day and lose it at night, this may just be a pattern of eating they have gotten used to. Maybe it doesn’t bother them, maybe they do want to lose weight but they have fallen into this pattern and it hasn’t started to interfere with their life yet emotionally (getting depressed, poor self-esteem, etc). Yes, people think turning to food during a crises is funny. I don’t. Maybe because I know way too many people who actually do get affected in a very big way when they turn to food to feel better. I worry about those people now because this is one of those times where we all need some coping skills. If you have not worked on it in the past or gotten professional help to develop some healthy skills, using food in this way may occur and only add to the stress, not relieve it. That is the problem. When I read one of the posts that was supposed to be funny (and I am sure some people without any disordered eating DID think it was funny), well, it struck me that after all that eating in just a few hours, all you end up with is a tummy ache. The difference is one person can happily go to bed with that tummy ache while another is devastated.

I have noticed there arn’t any jokes about the opposite end of the spectrum: not eating as a means to cope. I don’t think people have concerns about people who diet or starve themselves.  Maybe because our (messed up) culture sees restricting food as a “virtue”. I am worried about the people I have known with eating disorders who are going through this. If you are a typical eater, when you feel hungry you don’t like the feeling so you eat lunch, feel better and move on. For others, not eating and feeling empty numbs them. It is a very dangerous way to deal with things, and it is much more complicated than I can even explain or even understand. But it is very important that we don’t ignore children, spouses, relatives or friends who are now suddenly losing weight, skipping meals or not eating. It is extremely important for those who have already been diagnosed with an eating disorder to pay attention and stay connected to support systems.

I have also noticed lots of joking about drinking. Again, some of these are funny to those of us who have some control over how much we drink. I totally relate to the use of wine to connect with people during this time over virtual happy hours and outdoor “social distancing” happy hours, etc. But I also know people who have worked so hard to figure out how to stop drinking because they needed to. This is not an easy time for them. Epecially since lots of the coping skills involve social support systems where people connect in person, whether it be a meeting or church or whatever. Now what? I am guessing we are all learning much more than we ever knew about social meeting apps, Zoom, Facetime, etc to enable us to keep these good things going. At least we all need to be aware of those around us, and try to be supportive as much as possible to enable loved ones to continue on their positive path.

Finally, I have noticed some funny comments about being lazy. Here again, we are all different. One person may be climbing the walls, cleaning every cabinet, rearranging every room, walking miles a day, biking, painting walls, cleaning garages, knitting sweaters, building lego towers, painting portraits, and on and on. Another person my not get out of their pajamas all day. They may walk from the coffee pot to the couch. They may be using this time to catch up on all of their Netflix series. And then go to bed to do it all over again the next day. And sometimes, we can alternate between these two. And I think that is ok.

I wish I had some brilliant advice to help everyone get through this when it comes to eating healthy, being active in a balanced way and coming out of this better than before. The only thing I can think of is to remind yourself that you have never gone through anything like this before, so therefore however you are dealing with it, whatever is getting you through is ok……as long as it is not seriously interfering with your mental or physical health. If you are someone who has had issues with depression, eating disorders, or addictions and you find yourself slipping or struggling to cope, don’t ignore it. Go back to your resources, your support system, your therapist or doctor or whoever it is that helped you before.

If, on the other hand, you are one of the lucky ones who’s boat is pretty simple, then use this time to learn about yourself. If you really don’t have any serious issues with eating or drinking or maintaining a healthy lifestyle, but find yourself ignoring what you are eating, getting out of your routine, drinking a bit more than feels good, then maybe it will be helpful to take back some control. This whole thing has taken a lot from us. It has robbed us of our freedom and fun, family and for some it has taken lives we loved. Now that we have been doing this awhile, maybe it is time to look back at what used to work for us. Did we eat three good meals a day before? Maybe instead of snacking out of stress it is time to do some meal planning to help feel more in control. Maybe you used to go to the gym at lunch time at work, or maybe after work, but you can’t do that right now. Instead, why not take that same time and go for a walk, or do some stretches or dance to some music to let out your energy? Was bedtime 10 pm before because you had to get up for work, and now it is 1 am? And you don’t feel so great the next day? Try getting back to your regular sleep schedule. Maybe controlling the things you actually can control will help.

Or maybe not.

If you just feel like taking this time to do whatever you want, and you are feeling just as happy and just as energetic and just as healthy, that’s ok too. The point is, whatever floats YOUR boat is what is best.

Oh, and wish me luck on my exciting adventure today! I hope you get to do something different today, too. Something more fun than going to the dentist.

 

 

 

Remembering a Day That Changed My Life

On By jodietitianIn Uncategorized1 Comment

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Your future is in your hands

It was a cold and drizzly fall day,the year was 1976. I had agreed to meet my friend Joe outside in the parking lot of the condominium where we lived off-campus at The University of Connecticut. At the very last minute, I found myself changing my mind. I did not want to do this. What if I couldn’t do this? I was feeling insecure and afraid, but yet, when I agree to something I hate backing down. My motto is “you never know until you try”. For instance, I tried golfing once, I tried to get on a horse, and I tried skiing. People seem to love these things, and I wanted to understand why. After getting kicked by the horse and breaking my leg in two places as well as my ankle on the bunny slope, well, I can say I tried. Golf didn’t work out either. It was kind of like baseball for me, I just could not hit the darn ball.

So there I stood in the drizzle, waiting in my new Nike sneakers and windbreaker. He finally shows up and starts talking, giving me such encouraging words, describing what we are going to do and how we are going to do it. Joe was a physical fitness major and he knew what he was talking about. I had recently quit smoking cigarettes, and I needed something else to help me deal with life in general. After chatting with him the days before, I agreed to give running a shot. He was here to help me, and to guide me on my very first “run”. He had mapped out our route, which simply was a half mile to the end of the street and back, totally an entire mile. He guided me through some simple stretches, and then we started. Can I do this?

I literally felt like a fish out of water. Just a few months ago, I could barely walk to class without running out of breath (and would light up a cigarette once I finally got to sit down and catch my breath). It had been awhile since I smoked, and I actually was feeling so much better (I did not realize how bad I felt until after the fact…..when I had much more energy and realized this is how I am supposed to feel! this is how people who don’t smoke feel very single day).  I also need to share that my roommate Marion at the time was my inspiration to even consider this. She was a runner, and loved it, and although I did not understand why, I wanted to be like her! So Joe and I started out on this country road, and I started to run as fast as I could (isn’t that what you are supposed to do?) but he stopped me. He showed me how to pace myself, and trust me, it was VERY SLOW! So slow, in fact, that it actually felt GOOD. I could breathe. My legs felt strong. I could do this.

We made it to the end of the country street and turned around. I will NEVER FORGET how I felt when we got close to the end of our “run” and I could see our condo complex. I am going to make it, I thought. We reached the parking lot and I felt something shift inside of me that changed me forever. I loved that feeling so much, that feeling of success and accomplishment, it changed my “definition” of who I was, and who I wanted to be. I think we all have our own self-dialogues going on in our heads, thoughts nobody else can see about ourselves that eventually create who we actually are. Sometimes the thoughts are self-deprecating. “You are so lazy! You can’t do that!”

Yes, I can. And I did.

After that, I looked at myself in a very different light. I loved the idea of feeling good, and being healthy and fit. THAT is who I wanted to be. NOT someone using cigarettes to deal with stress. But, I definitely needed something, and the reality is, when we give up a “habit” it is almost always necessary to substitute something else. In my case, it was running. It became my new “habit”. It stuck. For years. Over time, I increased my distance and my usual runs became 2 or 3 miles. I did not run fast, but I loved running longer. It gave me time to think and meditate, solve problems, plan and dream. As I got more fit, running was just as relaxing as sleeping. I started to do road races and loved the camaraderie of other friends who had discovered the same joy I had.

Over the years, my running habit has shifted along with my life. It is funny, but I think because I always ran after classes (4-5 pm), that is the time my body seemed to crave movement throughout my life. To this day, after work, I just can’t wait to move. My body just craves it. I went through phases of running longer distances, but now prefer walking and slow jogging. I can day dream on a track, on the side walk or even on a treadmill. It doesn’t matter to me, just let me move. It can be kayaking on a local reservoir or mowing the lawn. I just need to move. If you have ever taken a few minutes to watch young children outside, they usually can’t stop moving. I think it is innate in us to move our bodies in ways that are fun and enjoyable. When we put unrealistic goals and numbers and expectations on it all, well, to me the fun is gone. Maybe that is why people “hate exercise”?

The benefits to my life thanks to Marion and Joe are too many to count. Because of this life-changing experience, I can enjoy vacations as much now, at my (older) age as I did in my 20’s. I can hike up Red Rock in Sedona, or down the Grand Canyon. I can walk for miles up and down the cobblestone streets of Cinque Terre in Italy. I can walk almost the entire town of Venice, never tiring. I can enjoy all of the bike trails on Cape Cod, explore the cliffs of Gay Head, garden for hours, walk all over the lively North end of Boston and still dance the night away. Yes, that day changed my life.

Since that day, I also became passionate about promoting health. I felt it, the way this simple act changed my life and my identity, and I wanted everyone to feel it, too. With every patient I have ever worked with, this has been my goal. So many people focus on how they look, and not on how they feel. They focus on the number on the scale, they judge themselves for that, and the self-talk and dialogue in their minds do nothing to help them be who they are supposed to be. People “try” but unfortunately, not everyone has a “Marion” for inspiration, or a “Joe” in their lives who can guide them in such a gentle and self-loving way to be the best they can be. To just start. One foot in front of the other. One pedal around the block. Dancing to even one favorite song.

Unfortunately, not every has the physical ability to enjoy all kinds of fun movement. I know many with joint issues, back pain, muscle issues, and other ailments that will always impact them. I am so grateful to be blessed with a body free of pain, and know that many do suffer. If you can move without pain, you definitely are blessed.

As I was writing this blog, my husband walked in and asked me to read what I had written so far. So I did, but as I started to read the 4th paragraph (“We made it…..”) I could not continue. I got choked up. That is how powerful that experience was, that is how important to my life. It took me by surprise, how strongly I felt, but then again, life-changing shifts in self-identity can do that.

I hope you take a minute to stop and reflect on your own self-thoughts and the dialogue in your head. Do you have unrealistic expectations when it comes to “exercise”? Do you call yourself names? Use the “L” word? When it comes to moving, to be clear, I definitely do not think everyone should be running! I have absolutely no advice on what anyone should do as far as physical activity. YOU are the expert on that. YOU know what you love. Some people absolutely love competition, enjoy running fast, getting stronger and stronger, keeping track of times, and amounts of weights they can lift, how many reps they can do, etc. The bottom line is, they enjoy it. It makes them happy. If what you are doing is not enjoyable, or does not make you happy, that is a different story. I just hope you look at moving in a different light. If you look at it as a means to an end, it may be hard to enjoy. If you instead can find something that has the capacity to be one more thing to enjoy in your day, a fun way to move your body (think kids, think hula-hoop, think fun, think freedom), well, that may be something you keep in your life for as long as you live.

So, that is the story. A day that changed my life, who I am and is part of why I have a passion to help people be healthy. Not perfect. Just healthy. I don’t want to be the only one on the dance floor when I’m 80.

 

 

Weight verses Health

On By jodietitianIn UncategorizedLeave a comment

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?

Normal Eating, Dieting and Weight:Finding Your Way Through the Jungle

On By jodietitianIn UncategorizedLeave a comment

Finding peace with eating may take time, just like finding the perfect sea shell….but it is worth it

“Don’t listen to this Joanne” one of the teachers said as she walked into the office at work the other day. I knew immediately what the story was going to be. I knew it would be about food. I was right…..she proceeded to tell my co-worker about the peanut butter cheesecake she made for a baby shower. As well as she knows me, how could she still think of ME as the food police? But after I thought about it, I realized it is not about me, but about all of the cultural confusion about food and eating, and what normal is. Despite the increase in awareness that dieting does not work and intuitive eating is better, it is a mighty task to find a way to stand up to the utter illness in our society when it comes to food, bodies, weight and eating. This may sound extreme, but after you have been around for as long as I have I can say that (recently celebrating a BIG birthday to prove it…born in 1956, if you do the math, you will agree!).I have also spent years struggling to help those with eating disorders fight against the barrage of unhealthy messages coming at them from all directions each and every day.

Think about this scenario: Jessie is in her last year of college, but after losing too much weight and developing an eating disorder she has to take a leave of absence from school in order to get better. She attends a day program where she has group therapy, meals and snacks and also sees me for nutrition counseling. Jessie seems to get it that she needs to gain weight and eat more because she feels awful, is obsessed with food, is always hungry and now it has affected her life, having been forced to leave school. Although she is working through her issues, she is very confused about why she needs to gain all this weight back. Everyone she knows is dieting so why is it ok for them and not her? She lists some famous actresses along with their heights and weights (which are horrifying) and again wonders why it is ok for them? Plus, both her mother and her grandmother are on a low carb diet because they are trying to lose weight. On top of this, she watched Dr. Oz and learned some random things about certain foods and so now did not want to eat those anymore. Oh, and on the radio in the car the DJ was talking about some place that actually can sculpt your body to get ready for swim suit season….why can’t she do that?

How is this poor girl going to block all those unhealthy messages coming at her from all directions? There is such a thing as “normative discontent” which is just what it sounds like. It is pretty normal if you have something about your body that you just don’t love (great roots, for instance, curly hair, short legs, big ears, bulging tummy, you name it, we all have something probably). But we live with it, and don’t think about it that much and certainly don’t starve ourselves to change it. It seems to me we have become immune to what is happening in our world when it comes to food and eating and bodies, and slowly over the years it has become “normal” to talk about bodies, and avoid certain foods and exercise to lose weight (not for fun, not to feel good, but solely to change the body). It has become normal to praise people for body parts (either natural, genetic endowments-“she has such beautiful long legs”, or changes resulting from some drastic measure-“your legs look great since you’ve been going to the gym nine million hours a week”). It drives me nuts. Everywhere I go, every single day, it strikes me. In the car, on the radio, on TV, visiting friends or family, inevitable the talk turns to eating and weight and bodies and body parts.

So here I am, along with many other intuitive eating, “listen to your body”supporters, trying to help people live a life focused on what actually IS important, and it is very difficult. I feel like the odd man out most of the time. Even my own husband sometimes looks at me like I am a weirdo when I talk about this stuff. He does not understand why you would not want to compliment someone on achieving a weight loss. Unless you know a person well, it is dangerous to do this because we never know how the weight was lost, it could be through very unhealthy means and I for one do not want to compliment or reinforce anyone’s eating disorder. If, on the other hand, someone has done a lot of work to change an unhealthy lifestyle and now eating healthier and loving it (and maybe has lost weight) complimenting healthy changes feels ok to me. As a dietitian that is what I like to see if it is the goal of an individual to be healthier, and they are happy with what they are doing and it serves them well both physically and psychologically, that is different. But focusing on the body size alone is what most people tend to do, and that is the mistake.

As far as eating, I can totally understand why my mom calls me at least once a week to ask some pretty funny question about food. She watches Dr. Oz sometimes, and the news and so I often have to clarify. She also asks funny questions about what she cooked and if she can still eat it. “I made this beef stew on Sunday, is it still good? I hope so because I ate it!”Those questions I don’t mind : ) But sometimes she is triggered to start reading every label (lately, it is all about corn syrup…”that’s bad, right? But why? My gluten free crackers have it, does that mean they have gluten?”). Ugh.

And then there is the low carb craze that never seems to go away. You know what I mean, I bet if you go out on the street and ask every random stranger you meet if carbs are good or bad, you will see how we have been brain washed. Our culture just seems to love labeling foods. Is it good? Is it bad? I get that question all the time. “Joanne, kale is good, right? Potatoes are bad, right? White bread is bad, right? Is rye bread good? Are cheerios good? Are Froot Loops bad? It is 100% fruit juice, so that’s good, right? It is gluten free, so that is good right? ” You get the picture. No wonder we are all confused, the messages we get every single day are hard to ignore.

How do you see the forest through the trees? How do you know what to believe, and more importantly, what kind of relationship do you currently have with eating and food and your body, are you happy with it and content, or do you want to move in a different (and happier) direction? Then here is some advice:

  1. Remember, you are unique. Your eating style and lifestyle is a complicated matter that is unique to YOU. Your environment, habits and emotions all play a role. It may take time to unravel how each affects you. That is why one diet or another is not the answer. We are not all the same.
  2. Be kind to yourself as you go through your exploration of how you want to eat. You may feel that our culture judges you (trust me, every time I am spotted with a non-healthy food item in my hand, I get a comment, “your’re eating THAT! Aren’t you a dietitian???”). Remember, they are the crazy ones, not you!
  3. Be aware of the messages coming out of the mouths over everyone around you either on the radio, on TV, at work or even at home. Realize that you are being bombarded by messages you should question (and even stand up to if you have the inclination). On Facebook the other day someone shared how McDonald’s labeling of all of the calories was actually not helpful at all to those with eating issues, and many people agreed.
  4. Educate yourself about health and nutrition from reliable sources.I recommend even one consultation with a registered dietitian (preferably a Health at Every Size RD). There are some good websites such as Choose My Plate, but unfortunately, even reliable sources are slanted toward weight control, so be sure to put your own filter on it and ignore that focus. Stick with learning about what you need to have energy and feel good.
  5. One of my favorite definitions of “normal eating” is from Ellyn Satter. Check it out at What Is Normal Eating?  The important message is that it is not perfect : )
  6. If you are not able to get out of a rut of dieting and weight gain, or find yourself getting depressed about your body or weight or eating, get help. Ask your doctor about a referral to a therapist who specializes in eating issues. The sooner you get help, the better.

The bottom line is that eating and dealing with our bodies and weight can be a very complicated matter because of our cultural focus on dieting and weight and eating perfectly. Don’t accept everything you hear. Be aware of the amount of bombardment of these messages you get on a daily basis. In the end, you are the expert of your own life, and you get to decide how you want to live it.

As for that peanut butter cheesecake, I will share the recipe once I get it!!

Should You Care About Your BMI?

On By jodietitianIn UncategorizedLeave a comment

hips-don-t-lie-1324351Friday morning as I was having my coffee, doing my usual multi-tasking, kind of listening to the news from my bedroom, something I heard made me stop what I was doing and run to the TV. “Indiana Teen refuses to calculate BMI”. What? I am a huge anti-fan of BMI. I was dying to hear this story. In case you have not heard, this young eighth grade athlete has received national attention after her Facebook Post about refusing to calculate her BMI in a class at school. She had been shamed in the past when she was told she was “obese” according to her BMI. Although she says she knows she is a bigger girl, it never had bothered her before but after that incident she felt bad and so the next time, she refused. Instead she wrote an essay about why BMI should not be used to determine health, especially in a middle school where girls are already super body conscious and insecure. Check out just one article  Indiana Teen Refuses to Calculate BMI to read more. She went to her doctor who did a complete physical with labs and let her know she was fit and healthy. Her message is simple yet powerful: BMI has nothing to do with health.

An eighth grade kid understands perfectly, yet unfortunately, the medical community still does not get it. Besides falsely labeling larger sized people as unhealthy, people who are very ill but have a “healthy BMI” fall through the cracks. I have story after story of eating disorder patients I have worked with in the past who have been starving themselves, purging in all kinds of dangerous ways, yet when they go for their yearly check up, the doctor responds: “You look great! You lost weight!” Which leaves the poor patient who is suffering in a confused and sometimes angry state. Most of the time the health care provider never asks how the weight was lost. It seems assumptions are made that the weight loss was a result of some healthy eating and exercise, but in these situations it is not the case. As long as that number is where it should be, it seems it does not matter.

The reality is that having a healthy  body  is not a simple task. Eating a perfect diet or having the correct BMI does not result in a healthy body, and does not negate unhealthy behaviors such as smoking or starving yourself or being stressed out. Genetics play a gigantic role (we all joke about the old man who smokes a pack a day and drinks whiskey and lives to 100). How it is that we have come to rely on some number based on a calculation using height and weight to tell us anything about someone’s health is beyond me. I believe part of the reason could be because it saves time. It is so much quicker to get a height and weight measurement and calculate BMI than it is to ask someone about all of the details of their lifestyle. Most health care practitioners don’t have time for this. In the hospital where I worked as an outpatient dietitian, we moved into a “productivity” based practice, so instead of an hour with a new patient, I was now expected to assess and counsel a patient and family in 30 minutes. If they were 10 minutes late, I was in trouble. It was heartbreaking to me. How could I even start to help a family with so little time to even find out about who they were? I left that job because of it, but I imagine that office is not unlike many others. Time is money.

So, it you ask me, you definitely should NOT worry about your BMI. Instead, you should worry if your health care providers give you advice without ever asking you about your lifestyle. Oh boy, does it make my blood boil when I hear stories from both friends and patients alike about the assumptions made based on weight or body size. It is prejudice, plain and simple, and it is wrong.

Forget the numbers, and keep it simple. How do you feel? What things run in your family that you need to be aware of? Look at all aspects of your life, both physical and mental (which is why I left that job, the stress was affecting my health). What you eat does matter but just to a degree. For instance, if you don’t drink enough to stay hydrated, you just won’t feel good and it can hurt you, especially in hot weather. If you live on sweets, you will likely not feel good either. If you don’t consume any calcium your bones may eventually be at risk. If you don’t eat any fruits or veggies, you may experience constipation which is not fun. So yes, nutrition matters, over time. You can eat brown foods for a week with no repercussions. You can eat sugar every day and have no ill effects. It is all in the big picture, with all aspects of your life having an impact on your health. Food, sleep, stress, movement, fun, family, friends, all of it.

So when someone brings up your BMI, tell them you want to talk about your health, not some dumb number that is meaningless.

 

Forward, Backward or Standing Still: Where Do You Stand?

On By jodietitianIn UncategorizedLeave a comment

DSCN2664 The other day another co-worker emailed me a link to her new eating plan. She wanted my opinion. This is where it gets hard for me, because I just want to say “please don’t waste your time or money” but that is not what I said. As a dietitian who has researched dieting, and wrote my Master’s Thesis on restrained eating back in 1996 I clearly remember how blown away I was by the proof I found about the failure of dieting, feeling outraged that this never made headlines. Well, now, when people talk about dieting,  I keep my mouth shut……at first. I have learned that people will tune you out if you hit them all at once with the truth. I have learned that most dieters are very hopeful and truly think they can do it “this time”. Instead, I share my experience with my patients. So I may say “can I tell you what I have seen happen?” If they say “yes” that opens the door. I warn of “all-or-nothing” thinking, how going “on” something means you eventually will go “off”. And on and on and on.

What struck me the other day after chatting with this woman about her diet was a realization that when it comes to health, we are all either going backward, going forward, or staying still. This is not about losing weight (although that is the goal for so many people) but about your lifestyle in general, what is health-promoting about it or not health-promoting about it. Clearly, we all have things we do that we regret at times and swear to change. It could be trying to get to bed earlier (because you feel like crap the next day but can’t peel yourself away from CNN). Or maybe it is trying to drink less wine because although it is good for your health in moderation, you drink a bit more than one 5 oz glass, and you want to preserve your liver. Maybe heart disease runs in your family, or your blood pressure has creeped up over the years, and you really need to cut down on salt. You are getting to the age when being active is more important than ever, both for a healthy heart but also to preserve bone mass.

Anybody trying to change knows it is not an easy task. When someone goes on a diet to lose weight, and the diet seems to work at first, they feel as though they are moving toward their goal. But when the diet ends, most people slowly start gaining again. Frustration eventually sets in and the thinking goes like this “I can’t do this, it’s too hard”. When someone decides to start exercising, goes all out, gets shin splints, the thinking is the same: I can’t do this.  The person who is trying to stop drinking breaks down and has a drink. Again, “I can’t do this”. The person with an eating disorder and doing well with taking care of their bodies encounters a trigger, starts to restrict, or purges. The immediate feeling is the same. I can’t do this. It seems to me people tend to be harsh on themselves and feel that either they need to be doing it all, or not at all.

Instead, why not accept that sometimes we are moving forward, sometimes backwards, and sometimes just sitting still.

Ask yourself:

Are there certain unhealthy behaviors that you think about often, and have wanted to change? Instead of thinking “all or nothing” why not try to take a non-judgmental look at where you are? Here’s how:

  1. Try to identify the behavior first, and be sure it is something that really matters. Bounce it off of your partner, friends or even a health professional to see if you are being reasonable and are not distorted in your thinking. For instance, if you think snacking is unhealthy, maybe you need a reality check. Pretty much everyone I know who is a normal eater needs a boost in between meals. Are you hungry? If, on the other hand, you are munching out of boredom or because you have some excessive stress in your life and are doing some emotional eating (completely normal unless excessive and interfering with your life), well, if it is preventing you from dealing with the real issues then seeking help from a therapist would be wise. Taking a step to getting help is definitely “moving forward”.
  2. Think about the things you have done in the past to change the behavior. Where has it led you? If you are the person who got shin splints from overexercising and this turned you off for good, you could be simply “standing still”. It does not mean you are a failure or can’t do it. It just means overdoing it did not work. Could you think of some other fun things that won’t hurt you? I sometimes wonder why even going for a simple, short but enjoyable walk “does not count”. The idea is to move in a direction of health, not become a marathon runner. People who have a gentle approach to moving more tend to feel really good about even the small accomplishments and these small moves in the right direction really do add up to a healthier body and life. As for people who are bent on starting another diet, it often leads to binge eating. This is “going backwards” in that it typically makes people feel even worse about themselves than they did before starting the darn diet. Instead, just “staying still” and taking the time to reflect on the past diets you have tried and the affect they have had on you in the long run is a good thing.  People often tell me “it worked before”, and you know my answer to that one. Someone wrote (sorry can’t remember where I read it) that Weight Watchers was a successful business because it really does NOT work…..and so people have to keep coming back. Starting another diet is going backwards. Unless you are one of the few people who actually learns some positive things (such as great healthy recipes, getting in touch with hunger and fullness, etc.) and transitions well into normal eating, I just don’t ever recommend diets. The repercussions are almost always bad, it is truly risky business.
  3. Try to project and think about a year from today. If you truly have examined yourself and your past behaviors and where it has led you, could you just this once try thinking about simply “moving forward”? This means taking small but doable steps to accomplish your goal of being the healthiest you can be. Perhaps instead of starting a diet, you could make a positive change in your eating. For instance, if you waste money by buying lunch every day could you plan to bring your own next week? This means making a grocery list and planning your menu. If you can’t resist the peer pressure to go to happy hour every day after work, could you make a plan to start skipping a day? If you stay up too late and feel exhausted the next day (and this happens every day), could you start with just one day to get to bed early? Eventually you can add more early bedtime days as you get used to it. Feeling good the next morning will start to become the motivation for repeating the positive behavior. This is moving in the right direction. It is not about “all or nothing”. Eventually, you will find the right balance for you, where your body feels better yet you get to enjoy life, too.
  4. Don’t beat yourself up when you do indeed “go backwards”. Instead, these backwards steps are priceless teachers, and we need to be thankful for them. Can you instead ask “wow, I thought I had that habit licked! let me figure out why I did it”. When you find out your triggers, or barriers, you can come up with a better plan the next time. Nothing lost, and lots gained. Even from mistakes.

So for today, ask yourself if there is anything you have been thinking about regularly as far as health is concerned. Take the time to reflect on where you have been, where you are now and where you want to go. Remember, deciding to “stand still” is a much wiser decision, and better for your health than “going backwards”. Skip that crazy diet that promises fast weight loss. Stand still and reflect, then move forward. Every step counts.

 

My Tips for Holiday Happiness

On By jodietitianIn Uncategorized1 Comment

IMG_8074
New Tradition: The Funky Tree

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

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

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

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

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

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

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

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    Santa Clause……