Saturday, September 22, 2012

Sugar, Fat, and Salt....addictive? How do we stop overeating?

I just finished reading David A. Kessler, MD's book The end of overeating. It was definitely an interesting read and I recommend it as some food for thought.

For about the first half of the book, Kessler talked a lot about the enticing nature of processed foods and restaurant meals due to their overuse of sugar, fat and salt. He discussed several research studies that really showed just how enticing those foods are. I want to be careful not to use the word "addictive" because there is quite a controversy on that topic. Many research studies conflict and I am not a believer that food is a addictive. I need to be convinced by a lot more research first! However, I do agree, and Kessler's presented research shows that there are certainly foods that are hard to stop eating.

I would like to take you back to Intuitive Eating for a minute. In that book, the authors discussed studies that showed a major decline in the satisfaction level of a food after eating only a small amount. Also, there was a lot writing in that book devoted to the message that making no food off limits results in less overeating. Perhaps the high sugar, fat, and salt foods do have a significant pull on one's tastebuds. Maybe if we do follow the advice in Intuitive Eating we might realize that the food really isn't as satisfying after the 10th or 15th bite.

Getting back to Kessler's book, the second half was mainly about overcoming the urge to overeat. The end result of Kessler's process was similar to the ideas of Intuitive Eating; however, the road to get there was quite different. Kessler stresses avoidance of all foods that might trigger you to overeat. My first thought was that deprivation leads to overeating. Kessler made a point to say that this is not "deprivation". Instead, it is just the conscious decision you make and say to yourself, "I just don't eat that food." I do believe there is more than one right way to do a lot of things, but in my experience, I don't see that working for many people. There will always be family events, holidays, birthdays, and other tempting occasions when everyone is eating something except for you. When you get to that occassion, will you be able to resist? What if you allowed yourself to have a small portion? Kessler believes that you will end up with another small portion, and another, and another, until you have had way too much. Yes, I agree with him if you are a person who is always depriving yourself. However, what if you have learned to eat intuitively and know that you can have chocolate chip cookies any time you want? When they show up at a family function, maybe just one would satisfy you. Learning to savor and really taste your food makes a big difference in how you eat as well. If you pop an entire cookie into your mouth while you're talking at the same time, how can you really taste and enjoy it?

Kessler also encourages the reader to avoid all situations that might derail you. In some cases, I completely agree. If you can't walk past a Starbucks every day without stopping in for a danish, then maybe you should find a different route. Those types of modifcations to your life seem reasonable. However, there will always be special events, dinners out with friends, etc that you shouldn't have to miss out on. Furthermore, you have to learn how to cope in these situations and still walk away feeling like you had a great time but didn't overindulge. You should not miss good times with friends and family because of food!

As I mentioned, the end result that Kessler is hoping to get you to is not making any foods off limits. He wants you to be able to eat mostly healthy foods, some "play foods" (term from Intuitive Eating), and just the right amount. In order to get to that point, he believes that you do have to go through this avoidance phase and "I don't eat that" phase in order to "detox" yourself, if you will.

The end of overeating. is certainly an interesting book with many great points; however, I would encourage you to try to become an intuitive eater. I would also love any feedback from people on what works for them; or from professionals who have tried either of these two techniques and what the long-term results are like. In my experience, eating intuitively is still the best way to go!

Sunday, September 9, 2012

Dietary Confusion

Meat will kill you, milk gives you cancer, all sugar is bad, bread is evil, fruit is nature's candy, carbohydrates make you obese, and any dietary fat will give you a heart attack. What do you get when you add all of these so-called truths together? You get a diet of exclusively non-starchy vegetables. I don't know about you, but that makes me feel hungry and frail just thinking about it.

Throughout my career I have encountered hundreds people who fully believe one of the dietary comments listed above. There are hundreds of books written by doctors (medical doctors and doctors of philosophy) who swear that you must cut one of these food categories out of your diet in order to save yourself from disease and obesity. Many times when I try to discuss one of these "dietary truths" with someone who is a firm believer in their respective "truth", I get the "You just don't know anything. ____ will kill you and you obviously just believe in all of that crazy stuff you learned in school" comment.

I find it humorous when I get a comment like that because they may be a person totally against all carbohydrates and they believe that eating plenty of meat will keep them healthy. Later in the day I might encounter someone else who is a firm believer in a fat-free diet and eats many fruits, vegetables, and whole grains; however, neglects heart-healthy fats in their diet. They may give me the same comment. So, you see, I am constantly encountering people who believe that my advise, which is based on scientific evidence, is wrong, yet everyone's "dietary truth" conflicts with each other.

All of that brings me back to the simple idea that I always try to convey to my patients and anyone who will listen. Eat a variety of fruits, vegetables, whole grains, and lean protein. Each food category offers its own unique set of health benefits. Eating too much of any one food category could cause its own unique problems and avoiding any particular food category could cause health problems. That advise, my friends, is rooted in decades of scientific evidence.

When you read or hear about the latest "sure thing" in nutrition, I beg you to remember these things:

1. Anyone can write an article or book. Check the credentials of the author. If the author has none, move on. Even if the article or book is written by a professional who is an expert on the subject matter, the unfortunate truth is that you still have to look at it with a critical eye. Books, magazines, newspapers, and web articles are not peer-reviewed like scientific journals. Therefore, you may be reading some ideas that really aren't proven facts; or the author may have manipulated research by only presenting the part of the story that supports their ideas.

2. Medical professionals who make nutrition recommendations under the USDA, American Heart Association, Academy of Nutrition and Dietetics, and other reputable organizations do so based on scientific evidence. I have noticed that there is a lack of trust in these organizations from a number of people. Please remember that the professionals who make up these organizations have studied this information for years. Not only can they look at research with a critical eye due to their background knowledge, but they are also better able to see the big picture of nutrition as it relates to health because they have been trained in this fashion.

3. Have you ever wondered why nutrition advise is constantly changing? Surprise! It really isn't changing very much at all! Fad diets change all the time. Writers who misrepresent facts give Americans the impression that recommendations are changing. If you look at recommendations that are released by reputable organizations, there is never much of any change going on. Sometimes the way the recommendations are reported to the public may change a little bit. Over time, research uncovers better ways to reach the public and so the way in which information is conveyed may change. Recommendations are also more specific than they used to be. This is partly because research has uncovered more details and party because we already knew it, but realized that we need to do a better job of teaching the public about nutritional details. For instance, it is very recent that public health officials started giving details about the need for eating different colored vegetables due to their variety of nutritional offerings.

3. Nothing is perfect about our food supply, but it is pretty darn good. Would it be best to eat all whole foods and nothing processed? Yes! However, keep things in perspective. Preservatives make our food supply safe and we are living longer lives due to technology that keeps harmful bacteria out of our food. I am not saying that you should live on a diet of Oreo cookies; however, I am saying that a bowl of Cheerios isn't going to hurt you.

Thanks for reading! Please post questions or comments if you have them!

Saturday, September 1, 2012

How to make "intuitive eating" work for your children

In my last post, I briefly discussed Intuitive Eating by Evelyn Tribole, M.S., R.D. and Elyse Resch, M.S., R.D., F.A.D.A, C.E.D.R.D. Many people may be wondering how that applies to children, especially as so many children battle obesity. Making the intuitive eating process work for children is covered in this well-written book; however, I also recommend Child of Mine: Feeding With Love and Good Sense by Ellyn Satter, MS, RD, CICSW, BCD. While there are many great guidelines in Intuitive Eating, Satter gives more specific information in her book on how to let children continue intuitive eating from birth or help them return to intuitive eating if they have strayed. Please see my previous post for more on Satter's book.

This topic of childhood nutrition is more important than ever as we continue to hear about the war on obesity. To incorporate intuitive eating, we as parents need to:

1. practice the division of responsibility as Satter discusses in her book.

2. stay neutral by not commenting on how much or little our children eat. Let your children trust their instincts. Also, avoid comments about calorie content and how healthy or unhealthy a food is.

3. set a healthy example. Try new foods, find plenty highly nutrient dense foods that you enjoy and eat them, and regularly be active with your children.

4. refrain from comments about a child's thinness or fatness. Focus on providing mainly foods that will help to nourish their bodies and allow some flexibility for "play foods". (The term "play food" is used in Intuitive Eating to describe what is often called "junk food".)

5. understand that children sometimes need to be exposed to foods up to 10-20 times before they will accept them. Provide the food and just relax. Children take the responsibility of exploring food and deciding when they are ready to try it. Don't give up on a particular food. Keep offering a variety of food and say nothing about it. Most likely, your child will eventually try it.

I want to leave you with one more suggestion. Refrain from telling your child that he/she must finish all of the ______ on his/her plate in order to get dessert. That well-known practice simply glorifies desserts by sending the message that it is a reward for eating that "yucky" dinner you served. I know that this is difficult for most parents as I struggled with it for a while also. It just seems so wrong to give a child ice cream when they only took one bite of their entree. Our parents told us we had to eat enough to get dessert and their parents told them the same thing. It is hard to break a habit that has been passed down over the generations. To avoid basing dessert on whether or not your child has eaten, you could choose a few days during the week when you will serve dessert. Serve dessert regardless of how your child ate. On the other days, your child will not receive dessert regardless of how he/she ate. I know this is a difficult change for parents to make, but it is a good one.