New Study Links Positive Effects From Calorie Restriction: Why I Hate News Blurbs

On July 19, 2016 By jodietitianIn Uncategorized1 Comment

Green Bean I literally stopped in my tracks the other morning as I was walking out of the kitchen to go get dressed for work. The first thing I do when I get up in the morning (after pouring that critical first cup of coffee) is turn on the small television that is in our kitchen so that I can listen for the weather and traffic. Like most people, I have my routine that gets me out of the door on time. But that morning, the words I heard caught my ear and I had to listen. “New AMA Study shows calorie restriction has positive benefits!” Oh brother, here we go, giving people another reason to diet. I listened to the brief details (how much can you pack into a 2 minute blurb?) and learned that apparently decreasing your calorie intake by 25 percent can improve your mood, quality of life, sleep and sexual function. Really? I didn’t have time to check into it but knew I had to as I like to be prepared when someone asks me a question about things like this. Most people just automatically believe what they hear and that is what troubles me.

So I searched and found a summary of the study, see AMA Study To read the entire study you have to pay for the article unless you are a member of the American Medical Association (which I am not) so instead I just read the abstract. What I learned from working with many researchers in graduate school is that we need to consider many factors when it comes to study conclusions. We need to be critical. This is not easy, especially if the research is in an area where we are not experts. The field of nutrition and health is a complicated one because so many factors influence our health (and our weight). So I always look at a study and try to decide how much it means, if anything in the real world. I like to look at some of the obvious things, such as the number of subjects and the kind of people who were involved in the study as well as the length of the study. In this study, the 220 subjects were “nonobese” and “healthy”. The subjects were divided into 2 groups: “calorie restriction” (CR) or “ad libitum” (AL). The measures were taken over 2 years (initial, one year and 2 year) and the results are based on “self-report”, in other words, people answered questionnaires. We know there is always a degree of error in self-report measures as people often answer the way they think they are supposed to. We also can’t know all of the confounding factors, such as the other influences in peoples lives that might have had an effect (a new job, a new baby, getting married, etc.). There are so many factors that affect mood and energy level. To believe that simply decreasing calorie intake can have all these benefits is wishful thinking. Even if after many replicated studies (which is always needed to really show cause and effect) do you really think it would be easy to figure out how to decrease calories by 25 percent? That is a lot! How is nutritional status affected? What if someone decides to cut out milk to achieve this goal? What happens to their bone health over 10 years? Do you think you will be in a better mood if you have osteoporosis? When you can’t get up and walk without pain? Maybe I am being a bit sarcastic and extreme, but the point is, it is never ever that simple.

Unfortunately, the people who heard this news blurb and may react to it are probably the ones who are already dieting and restricting to lose weight. In particular, I worry about those with eating disorders who are looking for an excuse to restrict. Remember, there is always opposing research that shows the exact opposite. In this case, you probably don’t have to do a literature search to know (but there is plenty of evidence there) that starving yourself or excessive dieting is more likely to lead to depression, not being happy. It is more likely to decrease your quality of life, especially if dieting and weight obsession become your focus. People I have worked with who have struggled with eating disorders have often lost so much. Having to take time away from college, or your family to be admitted to the hospital due to dehydration or starving, not being able to participate in activities you always enjoyed just because you don’t eat enough, even not being able to drive (I have seen it). Losing friends because they just can’t be around you any longer and watch you do this to yourself. ….this is the reality of calorie restriction.

Instead, when you hear a news blurb that briefly shares a dramatic result such as this one, stop and think about how different we all are. Our lifestyles are unique, our dieting history and relationship to food is unique, and most importantly, our genetics are ours alone. Reign yourself in and refocus. What were your goals again? To feel good and be healthy and enjoy life to the fullest (I hope). What are YOUR obstacles and barriers? Are their habits you have that you know might be affecting your health? Stress from work (need a new job?) Stress in your relationship (need some couples therapy?) Smoke too much (need some help here?) Drink too much (do you need to get help, or work on your habits?) Too tired to be active (time to see the doctor for that physical you keep putting off?) Live on fast food (time to start learning how to cook?)

Achieving health and happiness is not always simple. And even when you do achieve it, trust me, a wrench will be thrown in from time to time, such is life (as my mom always would say).

Decreasing your calories by 25 percent?…..not this girl.

Carbs, Protein and Fat: How much?

On June 28, 2016 By jodietitianIn UncategorizedLeave a comment

buffet-variations-1321243 “What percentage of my diet should be carbs? What about fat? and how much protein do I need?” I get this question all the time and usually give the same answer: do you really want to think about that every day? The point is, even as a dietitian who is somewhat good in math I would never want to calculate these figures on a daily basis. Even using an app. But many people are confused about this, they hear things at the gym, their marathon running friends are carb loading, or maybe they saw a magazine headline at the grocery store check out. Not to mention goals of losing weight, which usually are part of the motivation to find the best combo of macronutrients that could be the magic answer.

As far as recommendations that would provide a “balanced” diet here is the general guide:

Carbs: 45-65% Fat: 20-35% Protein: 10-35%

Many are surprised that our diets should be at least half carbohydrates, with all the low carb diets out there, it may not make sense. Remember, everyone is different and it is important to consider your own health history, metabolism and body. There are some patients I have worked with who respond differently to carbohydrates (such as those with PCOS or polycystic ovarian syndrome) and balancing carbs with protein is important to prevent increases in insulin. And for the average person who wants to maintain a certain level of blood glucose, including protein in a meal definitely helps. It is more about balance and less about avoidance or restricting.

But what if you really did want to figure out what percentage of your diet is protein for example? I do know people who eat a lot of protein thinking it will help them build muscle (just yesterday at lunch a young twenty-something year old teacher had two bunless cheeseburgers on his plate….nothing else). You first would need to know the total amount of calories you ate in a day (nothing I would ever recommend doing, but just to demonstrate how ridiculous and irritating it would be), let’s use 2000 calories as an example.Then 10% of this would be 200 calories. That means 200 calories as a minimum should come from protein. Since protein has 4 calories per gram, that means 200 divided by 4 is 50. So the answer is 50 grams of protein is 10 percent of calories from protein in a 2000 calorie diet. An ounce of meat has 7 grams of protein, so 7 ounces of meat would just about meet the 50 grams. But protein also comes from other foods, even cereals and grains, dairy, beans, nuts and pasta have some protein. See why it would not be too fun to try to figure out? Even for one day, pretty irritating. So what should you do if you want to eat a healthy balanced diet?

I did do a brief review of the research regarding macronutrients and health as well as weight. To put it simply, I could not find any new breaking news regarding macronutrients and weight. Low glycemic index diets do not result in more weight loss as far as current research (that means low carb). The one macronutrient mentioned as affecting both health and weight was fiber. There were several studies that suggested a high fiber diet was beneficial for both health and weight. This means more fruits, veggies and whole grains. Now that is not exactly a newsflash, but does reinforce a “health” approach to eating verses a “weight loss” approach or trying to limit a certain food group. That is why the government came up with the simple “My Plate” illustrating half the plate as “colors”, or fruits and vegetables, a quarter of the plate whole grains and a quarter of the plate protein food, as well as dairy on the side. The message I like to send is variety, not restriction. I don’t think it is “dieting” to try to add more fruits and vegetables to your meals. If you throw strawberries in your salad or an apple in your lunch bag, it makes sense because you enjoy them. This kind of move toward healthier eating does not seem stressful to me. It does not take too much thinking (too much thinking about eating is not health promoting, and tends to add stress which is NOT good for health). If you don’t take the My Plate idea too far (you don’t have to have the perfect plate every meal), then it is a good general and simple guide.

If you are interested in more specifics regarding dietary recommendations, see Dietary Reference Intakes however please keep in mind we all have different needs, and not everyone eats or needs exactly the same amount of a nutrient. These are general recommendations.

The Academy of Nutrition and Dietetics also has a position paper (2002) on the topic called Total Diet Approach. Although it mentions the outdated Food Pyramid it also describes a way of eating where “all foods can fit” and again, stresses the importance of focusing on health without trying to be perfect. If you like a food, any food, you need to fit it in. It is the average intake of nutrients over an entire week for instance that matters. So even if you eat twinkies for all three meals one day, it does not matter….over time.

Bottom line: keep it simple. Learn from listening to your own body. Good old boring common sense…….

Eating “What You Want”: Easier Said Than Done

On May 22, 2016 By jodietitianIn UncategorizedLeave a comment

I was at a lovely outdoor graduation party yesterday and happened to walk in on a conversation that was going on between a sweet young man in his 20’s and my husband. “She’s a dietitian, you should ask her”. Apparently, this healthy-looking but thin young man was trying to gain weight. He had been a runner in high school, now worked out but not as much, sharing that when he was lifting he was able to put on some weight. I went into my spiel about “listening to your body”, explaining how our natural set-point makes it difficult to change (our genetics) and that even if he tried to eat more or add protein shakes (what he has tried in the past), it would be hard to maintain due to the fact that it requires way too much thinking and also, just as with dieting, your body tends to compensate and do what it needs to so you will go back to where you are supposed to be. “But what should he eat? He doesn’t know!” my husband says. I looked at this guy and he says “he’s right, I don’t really know”. Oy. How did eating become so complicated for even a twenty-something year old male? I kind of understand, it makes sense that women, especially older women who have spent a life time dieting and not being happy with their bodies continue to try one diet after another, end up on and off restricting and overeating, but this just felt odd to me. I just wanted to say “Just eat what you want!” It struck me at that moment that people who don’t know much about nutrition and really do care about their health (and body size, which always seems to be the motivating factor to look into nutrition) really don’t know where to begin.

I started to share a few websites I thought might be helpful about nutrition as far as basic facts (such as how much calcium an adult needs, protein needs, etc) and I tried to convince him to let his body determine how big it is going to be once he finds an eating pattern that he is happy with along with a healthy lifestyle (which he already pretty much had). But I left that conversation feeling as though I really didn’t help him much. I also got a bit of a reality check when my husband commented “people can’t eat what they want, they are not dietitians, they don’t know!”

If you can relate to any of this, I hope to give you another way to solve the puzzle of being healthy and at the same time, “eating what you want”. In another post, Humming and Beckoning Foods I mentioned a book I read decades ago called “The Psychologist’s Eat Anything Diet” which I now feel was way ahead of the game because the science behind what the authors were recommending was not yet discovered. We now know our brains are regulated tightly by many neurotransmitters, or messengers when it comes to eating. We now know the physiological reason why when people cut out carbs they may end up craving sweets (which often leads to binge eating them). Anyway, even though we know this, people continue to diet and restrict because they really want to lose weight.On top of this, if you are someone who wants to be healthy, eating “what you want” is a scary proposition because you may fear (as my husband thinks) you would live on corn dogs. And that would not be good.

The truth is, although it is not easy, you could do both (eat what you want and also be healthy). One exercise I remember from the book was taking the time to really think about what particular food you wanted. You were supposed to wait until a “meal time”, in other words, you were not supposed to mindlessly nibble all day, you needed to get to a point of physiological hunger (such as lunch time). This alone would be a very hard thing for many people to do, since random snacking is common. Mindless snacking without hunger is a behavior many of my past patients needed to work on since this was not conducive to the “intuitive” eating they wanted to learn. Mindless eating is disconnected eating. So this exercise forces you to be “mindful” in that you really have to check in to see if you are hungry. Then, when you get to the point of hunger, instead of automatically making what you think you should have, or eating food just because “it is there”, you are supposed to really think about what you want. Do you want something cold? Hot? Salty? Crunchy? Sweet? The healthiness of the food was not what you were supposed to think about. When you chose your foods (let’s pretend it is a tuna fish sandwich), then you are supposed to put it on a plate (or in a bowl?) , sit at a table without distractions (no TV, cell phones and tablets and all that weren’t invented yet, but none of that kind of stuff), and eat. Paying attention to the taste, texture and pleasure of the food you were eating was key. Funny how now we know that for our “fullness” messengers to get to our brain to tell us we had enough, we need to look at our food and pay attention. Mindful eating is how our bodies function best.

This type of exercise is not easy for those who have a “good food/bad food” mentality. It might be scary and uncomfortable for some people, especially those with eating disorders to do an exercise like this, and that is why therapists often supervise these kinds of experiences (and if you are interested in working on mindful eating, but have an eating disorder, you should ask your therapist about it). For chronic dieters, or those struggling with mindless eating, it might be helpful to think about really paying attention to how often you don’t let yourself “eat what you want” but never do enjoy what you eat.

So is it true that if you eat just what you want that you might want to eat corn dogs everyday? The tricky part is combining “eating what you want” or “intuitive eating” with healthy eating. Ask yourself: how often do you REALLY have a food craving? Is it every single meal or snack? Probably not. By food craving, I mean that urge for something that is not in your presence at the time (so not those donuts you saw when you walked into the break room, that is a “trigger” or “beckoning” food and not a true craving). The more imbalanced your diet, the more cravings you are likely to have. If your serotonin levels drop because you avoided carbs all day you might find yourself craving pasta every night. However, if you eat a variety, then you may have less cravings. This is where educating yourself about healthy but yummy cooking and nutrition come in. I believe that it is good to know about eating healthy, simple things like including more vegetables and fruits that you really enjoy because we know they promote health (different than forcing yourself to eat broccoli every night, instead discovering you love garlic roasted asparagus or kale salad with goat cheese-my new favorite, I am talking yummy). Learning that you need protein to keep your blood sugar stable, so you don’t get cranky by 2:30 pm in the afternoon is good to know. There are many resources out there on general nutrition (unfortunately, most of them are obsessed with obesity, weight loss, etc), so try to ignore that lingo and pick out what you need to know. My favorite book as far as learning about getting in touch with your hunger and what/how to eat is Intuitive Eating so check out the website for more great information to help you on the way to “eating what you want”….but being healthy, too.

Just to clarify, if have any predisposition to heart disease, or genetically inherited hypercholesterolemia or hypertension, or diabetes, or any other condition that requires a special diet, then you really do need to think about what you eat. We are all different and all unique in our health needs, as well as our eating style, cultural preferences, dieting history, emotional eating, disordered eating, or any other issue that may affect our health. But tuning into your body instead of ignoring it can only help.

And my body says go get another cup of coffee : )

No, it is not an easy task, but if you are not happy with your current eating style, why not try?

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

On April 30, 2016 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:

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.
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!
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.
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.
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 : )
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!!

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

On March 19, 2016 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:

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”.
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.
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.
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.

Should You Put Your Teenager on a Diet?

On February 14, 2016 By jodietitianIn Uncategorized2 Comments

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

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

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

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

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

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

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

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

On January 7, 2016 By jodietitianIn UncategorizedLeave a comment

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

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

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

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

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

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

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

On January 1, 2016 By jodietitianIn Uncategorized3 Comments

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

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

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

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

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

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

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

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

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

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

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

On November 25, 2015November 25, 2015 By jodietitianIn dieting, weight1 Comment

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

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

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

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

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

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

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

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

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

The Bite Diet: Fact or Fad?

On November 3, 2015 By jodietitianIn Uncategorized2 Comments

This morning while I was pouring my coffee and half-listening to the news like I always do in the morning before work, something caught my ear as I am guessing it did millions across the country. Breaking news about losing weight! You don’t need to count calories anymore! My first reaction was “Yay!” I have been accused of wearing those rose-colored glasses. I do tend to immediately look at the good in things, without thinking. And this was another one of those times when it was too good to be true.

Nobody was going to say that counting calories was useless (which is what I was hoping). They were just going to throw out another carrot, another false hope for people desperate to lose weight, another gimmick that is probably going to make people do silly things that have nothing to do with making them healthier.

In case you did not have the TV on this morning or were otherwise disconnected from the virtual world (maybe you were traveling in Italy?) then you may not have heard about the new study that made almost every morning show announce “you don’t have to count calories!” So what is the new discovery? Apparently, it is counting bites. Yes, there was a small pilot study conducted at Brigham Young University that had subjects count the number of bites they took per day for a week (to get a baseline), then decrease it by 20-30% over 4 weeks without changing anything else (no increased exercise, no counting calories, etc). Of the 61 participants, only 41 completed the study (was it too hard to count bites? just like it is too hard to count calories?). Of those completing the study, there was a 3.4 pound weight loss over the course of the study. The authors point out that after the first week, when a baseline number of daily bites was determined, subjects gained weight, but then lost weight over the next 2 weeks, and maintained their weight with no further loss over the final 2 weeks. They also point out the limitations of the study, for instance it was a small sample size which was not comparable to the general population. All subjects had at least some college education, were Caucasian with family incomes greater than $50,000 and were likely highly motivated to lose weight.

One point made by the authors of the study was that counting bites “does allow an individual to be conscious of their eating habits, which is an idea that somewhat resembles “mindful eating” diet theory”. They clearly state that future research is needed with a larger, randomly selected study sample, longer intervention period, a control group, and longer follow up. They also point out that quality and health of the diet of participants was not looked at and this is important.

Yes, the quality of someones diet is important, especially if we want to focus on health verses weight. We don’t need to be “perfect” eaters, but we should care about health if we want to feel good. It is an individual’s choice, but counting bites, just like counting calories has nothing to do with promoting health. And it clearly does not resemble mindful, or intuitive, normal eating which is more about being in tune with your hunger and fullness.

So, it is just my opinion, but I am not a big fan of counting anything when it comes to eating and health. Counting bites, like counting calories, would feel like way too much thinking if you ask me. I am not sure if it would help you to be more in tune with your hunger and fullness or not. If you gobble up food fast and get a stomach ache on a regular basis, then, yes, slowing down might help. But counting bites? It just seems like another gimmick (well, that is how the news station came across, probably just to get people like me to hang around and hear the breaking news!) I greatly respect the researchers who piloted the study as they are part of all of those who are working hard to try to help. All research that contributes to our knowledge helps. Just remember to read the details and know that you are unique. Your story and your life deserves to be treated that way. Keep taking care of yourself, your body, and your mind. And if you like the idea of counting bites, go right ahead. You know what is best for you (and I would love to hear about it!) In the meantime, check out the original article here: Bite Diet Study

I am kind of glad the news station was dramatic. I might not have heard about the study so soon otherwise. And with the time change, I still was not late for work : )

Joanne Arena MS, RD

Tag: weight loss