Category Archives: Nutrition Info

Why I am adopting a Health at Every Size® approach

After nearly five years, I have decided to leave my job in medical weight management to explore and practice a Health at Every Size® (HAES®) approach.

Here’s why:

Diets do more harm than good.  Research shows that dieting is more likely to lead to weight gain than weight loss.  A review of 31 weight loss studies found that dieting was ineffective at producing long term weight loss, and one-third to two-thirds of dieters gained more weight than they lost (Mann et al, 2007).  Calorie restriction leads to preoccupation with food, binge eating and weight obsession.

Weight loss programs contribute to weight stigma.  Weight loss programs perpetuate the idea that being “overweight” is a flaw or character defect. In reality, weight is determined by a complex interaction between genes, environment and social influences. Once a set-point weight range is established, the brain works hard to defend it.  Size diversity should be respected and embraced, just like other types of diversity.

Weight loss is not necessary for health improvement.  People who exercise regularly, eat a healthy diet, and practice other forms of self-care can improve their health, without losing weight (Matheson et al. 2012; Schaefer and Magnuson, 2014.)

What is HAES?

The Health at Every Size approach emphasizes:

  • Self-acceptance regardless of weight, size, or shape.
  • Physical activity for enjoyment and enhanced quality of life.
  • Normalized eating in response to physiologic hunger and fullness cues rather than external guidelines or rules.
  • An approach to healthy living that does not necessarily involve weight loss for overweight individuals.

My journey to embracing a HAES approach:

Reading Linda Bacon, PhD’s book, Health at Every Size, was the first step that led me to question the weight-centered approach.  But I still needed a few years to fully embrace the approach.  When I finally saw the harm that dieting was causing my clients, I knew it was time for a change.

Ultimately, Sandra Aamodt, PhD’s TED talk, Why Dieting Doesn’t Usually Work, was the catalyst behind my decision to embrace a HAES approach.  In this powerful video, Aamodt explains how the brain fights against lasting weight loss.  She recommends mindful eating as an alternative approach to health.

In April, I attended Ditchin’ the Diet: Non-Diet Approaches in Nutrition Education, a seminar hosted by dietitians and university professors Dawn Clifford, PhD, RD and Michelle Neyman Morris, PhD, RD, which furthered my commitment.  These amazing women are teaching HAES curriculum to students at California State University, Chico.  These HAES videos recorded by Clifford are available for anyone to watch.  I wish someone had taught me about the HAES approach when I was in school.

 Tools to support a HAES practice:

Intuitive Eating is a method that is very helpful in supporting a HAES practice of normalized eating. I read the book and completed the Intuitive Eating Pro Skills TeleSeminar series.

Michelle May, MD has also been an influential figure.  Reading her Eat What You Love, Love What You Eat books gave me new ideas and inspiration on how to teach mindful eating skills.

The book Wellness, Not Weight contains a wealth of information and is an amazing resource.  Each chapter is written by a different health expert and backed by dozens of research articles.

The National Association to Advance Fat Acceptance (NAAFA) has published Guidelines for Nutritionists and Dietitians to help us adopt a HAES practice.

I am excited and proud to be taking a stand for Health at Every Size.  If you have questions about HAES, please feel free to send me an email or post in the comments section.

Health At Every Size and HAES are registered trademarks of the Association for Size Diversity and Health and used with permission.

Eat Green for St. Patrick’s Day

greens

Instead of (or in addition to) wearing green and drinking green beer on St. Paddy’s Day, try something new– eating green!  Green vegetables and fruits are some of the most nutrient-rich foods on the planet.

I have recently started eating more greens, with the help of this tasty recipe.  A touch of maple syrup gives a sweetness that offsets the greens’ bitter flavor.

Sweet and Sour Braised Greens

Ingredients:

  • 1 bunch of greens (e.g. mustard, kale, collard, swiss chard, or beet greens)
  • 1 Tbsp olive oil
  • 2 Tbsp balsamic vinegar
  • 2 Tbsp maple syrup

Directions:

  1. Rinse the greens and tear or chop into pieces.
  2. In a large sauté pan, heat the olive oil over medium.  Add the greens and sauté for one minute.
  3. Add the balsamic vinegar and maple syrup.  Cook for 5 minutes or until the greens have wilted, stirring occasionally.

Want to learn more about the health benefits of greens?  My friend Jenny Westerkamp, RD coauthored a new book: Green Foods for Men.  Congratulations, Jenny!

Dangerous Diet Traps to Avoid

Mouse_TrapTrying to lose weight?  Avoid these 5 common dieting mistakes.

Diet Trap #1: “Saving” calories for a party or event

If you under-eat throughout the day to save calories for an event, you will likely arrive very hungry which can lead to overeating.

Instead: On the day of the party, eat balanced meals so you arrive only mildly hungry. At the event, mindfully enjoy a balanced meal. When you have reached comfortable satiety, move on to other activities.

Diet Trap #2: Exercising off extra calories

If you overeat at a meal, don’t try to burn off the calories with extra exercise. Excess physical activity can lead to overtraining injuries, and make exercise feel like a form of punishment.

Instead: If you overeat at a meal, don’t sweat it! Get back to your normal routine, and trust that your body will naturally compensate for the extra calories over the next few days. Exercise regularly for health and enjoyment—not for calorie burning. If overeating occurs frequently, try to find the root cause of the problem. Are you getting enough food/sleep/relaxation?

Diet Trap #3: Eating only fat-free food

Fat is an important nutrient for good health. Eating meals with some fat makes the meal more palatable and satisfying. Fat-free desserts and condiments still contain calories and are usually not any healthier than their full-fat counterparts.

Instead: Include some healthy fats, like nuts and oils, in your diet. Enjoy full-fat versions of your favorite foods, if they taste better to you. Slow down and savor these foods, and you may find that you are satisfied with smaller portions.

Diet Trap #4: Avoiding carbohydrates

Carbohydrates are the body and brain’s preferred form of energy. Eat too few carbohydrates, and your body will begin to break down muscle protein to covert it into carbohydrate.

Instead: Include adequate carbohydrates in your diet. Choose mostly nutritious foods containing carbohydrates, such as whole grains, vegetables and fruit. Some carbohydrates can come from “fun foods” like dessert and refined grains.

Diet Trap #5: Ignoring hunger

Hunger is your body’s request for fuel. Ignoring this signal will eventually backfire, and you will become ravenous.

Instead: Listen for your body’s hunger cues and honor them by eating a satisfying, balanced meal or snack.   This basic form of nourishment and self-care is more important than sticking to a prescribed calorie budget.

Intuitive Eating

Do you spend a lot of time and effort counting calories? Do you label food as being “good” or “bad?”  Is concern about your diet causing you more harm than good?  Consider ‘intuitive eating’ to develop a more peaceful relationship with food.

What is intuitive eating?

Intuitive eating is an approach to eating that relies on inner wisdom to guide food choices, rather than external cues (1).  The approach was developed by dietitians Evelyn Tribole and Elyse Resch in the 1990s.  Those who follow a practice of intuitive eating:

  • Eat when they feel hunger and stop eating when they feel full.
  • Make food choices based on both health and enjoyment.
  • Trust, respect and nourish their bodies.
  • Reject the “diet” mentality.

What are the advantages of eating intuitively?

Research indicates that intuitive eaters:

  • Are less likely to be overweight or underweight.
  • Are less likely to suffer from eating disorders.
  • Have better self-esteem.
  • Are happier overall.

One recent study compared a traditional weight loss program to an intuitive eating program (2).  People in the intuitive eating program improved their cholesterol levels, boosted their self-esteem and increased their body satisfaction.  Participants in the traditional weight loss program experienced no such benefits.

How do I start?

Try these tips to start eating intuitively.

  1. Stop the “diet” mentality.  Recognize that quick-fix diets usually fail. Resolve to making a lasting lifestyle change instead.
  2. Pay attention to your hunger and fullness signals.  Make a plan to eat when you are hungry, and stop when you feel comfortably full.  Jotting your feelings down in a journal or notebook might be helpful to you to understand what “hungry” and “full” feel like for you. Keep your energy levels up with regular healthy meals and small snacks.
  3. Stop labeling foods as ‘good’ or ‘bad.’  Labeling foods can make you feel guilty, and “restricted” foods often feel very tempting.   The truth is, any food in moderation can be part of a healthy eating plan.  Choose foods that honor both your health and taste preferences.  Take a sensible approach and choose a diet that contains a variety of different foods from all of the food groups.
  4. Enjoy eating.  It’s okay to relax and enjoy the experience of eating.  When you eat mindfully and savor every bite, you may find that you are satisfied with less.
  5. Learn to soothe yourself without food.  Anxiety, loneliness, boredom and anger are emotions we all experience.  For some, food may provide comfort in the short-term, but eating will never solve an underlying problem or worry.  Find ways to comfort, nurture, distract and resolve your issues without using food.
  6. Respect your body.  When you stop to think about it, you will see that the human body is amazing, and it’s the only one you will have for the rest of your life.   It’s important to understand that bodies naturally come in all shapes and sizes.  Instead of judging and criticizing, try truly caring for your body with respect. The results may surprise you.

Resources:

Book: Intuitive Eating, 3rd edition by Evelyn Tribole and Elyse Resch

Website: IntuitiveEating.com

References:

  1. Schaefer JT, Magnuson AB. A review of interventions that promote eating by internal cues. J Acad Nutr Diet. 2014 May;114(5):734-60.
  2. Bacon L, Stern JS, Van Loan MD, Keim NL. Size acceptance and intuitive eating improve health for obese, female chronic dieters. J Am Diet Assoc. 2005 Jun;105(6):929-36.

Your Child’s Weight: Helping Without Harming (Book Review)

childs-weightEvery parent and dietitian should read Ellyn Satter’s Your Child’s Weight: Helping Without Harming.  Ellyn Satter is a registered dietitian and family therapist, and is considered to be the leading expert on feeding and raising healthy kids.

In the book, Satter refutes the idea that parents must force their children to eat less and exercise more to lose weight.  In the long run, this technique backfires, as children become preoccupied with food and turned off to physical activity.  Rather, Ellyn coaches parents to feed well, parent well, and allow children to grow up to get the bodies that are right for them.

For a summary of the books main points, read on, or click here for a PDF summary from Satter herself.

Feed well.

Feeding embodies your entire relationship with your child.  Feeding your child is nurturing your child, and it should be about providing, not restricting.  Restricting hurts both emotionally and physically, and in the long run it will make your child fatter, not thinner.

To feed well, start by having regular family meals.  Family meals are more important than most people realize.  Not only do family meals teach kids how to eat well, they also provide kids with reliable social and emotional support.  Children who have regular family meals do better in school, have better mental health, and display better social skills.  Make family meals rewarding for everyone by following these tips:

  • Prepare and serve food that you enjoy.  It doesn’t all have to be healthy.  Find a balance.
  • Put 4-5 foods on the table and let everyone pick and choose what they want.
  • Teach and expect your children to behave nicely.
  • Understand enough about children’s normal eating behavior to feel successful with feeding.
  • Follow Ellyn Satter’s Division of Responsibility (below).

Follow Ellyn Satter’s Division of Responsibility.

Ellyn Satter’s Division of Responsibility states that:

  • Parents are responsible for the what, when and where of feeding.
  • Children are responsible for the how much and whether of eating.

In other words, if parents do a good job with feeding, they can relax and trust their child to do a good job with eating.

Parent’s feeding jobs:

  • Choose and prepare the food.
  • Provide regular meals and snacks.
  • Make eating times pleasant.
  • Show children what they have to learn about food and mealtime behavior.
  • Do not let children graze for food or beverages between meal and snack times.
  • Let children grow up to get the bodies that are right for them.

Children’s Eating Jobs:

  • Children will eat (although sometimes erratically, this is normal).
  • They will eat the amount they need.
  • They will eat an increasing variety of food.
  • They will grow predictabily.
  • They will learn to behave well at the table.
  • Gradually, during school age and teen years, your child will learn to manage the what, when and where of feeding for himself.  Slowly dole out responsibilities as they demonstrate responsibility to handle them.

Parent well: physical activity.

Ellyn Satter also promotes a division of responsibility with physical activity:

  • The parent is responsible for providing structure, safety and opportunities to move.
  • The child is responsible for deciding how much and whether to move.

In other words, if parents will provide fun and safe opportunities for physical activity, the child will take care of the rest.  Children are naturally inclined to move and find joy in active play.

Parents jobs:

  • Provide safe places for activity that the child enjoys.
  • Find fun and rewarding family activities.
  • Provide opportunities to experiment with group activities such as sports.
  • Set limits on TV but not on reading, writing, artwork or other sedentary activities.
  • Remove the TV and computer from the child’s bedroom.
  • Make children responsible for dealing with their own boredom.

Children’s jobs:

  • Children will be active.  Each child is more or less active depending on natural inclinations.
  • Each child is more or less skilled, graceful, energetic or aggressive, depending on natural inclinations.
  • Children’s physical capabilities will grow and develop.
  • Children will experiment with activities that are in concert with their growth and development.
  • Children with find activities that are right for them.

Know how to read your child’s growth chart.

Children grow predictably, usually along a similar path on a growth chart.  According to Satter, it doesn’t matter if the child is at the 5th percentile or the 95th percentile, as long as he/she is tracking along the growth chart.  There is only an issue if a child’s weight is accelerating or decelerating, and rapidly crossing growth chart lines.  (Slow and gradual change across the percentiles is typically normal.)

If a child’s weight is rapidly accelerating or decelerating, Ellyn asks, “What is undermining this child’s natural ability to grow in a way that is right for him/her?”

Usually, Ellyn finds that the cause is restrained feeding, poor feeding practices or stress.  Forcing food, restricting food, or allowing children to graze all day can all cause weight issues.  The solution?  Follow the division of responsibility, and the growth pattern will begin to track appropriately.

Allow children to grow up to get the bodies that are right for them.

Satter recommends that you let go of any agenda that you (or your child’s doctor) may have regarding your child’s size or shape.  Feed well, parent well and help your children to feel good about themselves at any size.

Questions?  Comments?  Let me know what you think.

How to Snack at the Office

Top-12-Best-Healthy-SnacksSnacking can help you stay energized and prevent overeating at your next meal.  But chips, candy and soda contain “empty calories,” meaning short-lasting energy and virtually no nutritional value.  Here are some healthy snack ideas to fuel your workday.

Fruits and vegetables: Hands down, the healthiest snack choice you can make is fresh fruits or vegetables. Try keeping a fruit bowl at your desk, or bringing fresh vegetable sticks to munch on.  If you are trying to lose weight, consider limiting snacks to only fresh fruits and vegetables to cut calories.

Dried fruit is less nutritious than fresh fruit, but a much healthier snack than candy.  The fiber in dried fruit helps to slow the absorption of sugar, making you less likely to have an energy spike and crash compared to eating candy.  Stay away from fruit juice, which has lots of sugar but no fiber.

Nuts: People often fear nuts because of their high calorie content, but a recent study published in the Obesity journal found that people who eat nuts at least two times per week were 31% less likely to gain weight than were participants who never or almost never ate nuts.  Grab a small handful of nuts for a mid-afternoon snack, or spread 2 Tablespoons of nut butter on apple slices or celery sticks.  Choose nuts or nut butters without added oil, sugar or salt.

Light microwave popcorn: Did you know that popcorn is considered a whole grain?  Whole grains are more nutritious than refined grains (such as white rice and white bread), because fewer nutrients are stripped away during manufacturing.   Three cups of light popcorn contain only 100 calories, making popcorn a light, yet voluminous snack.  Microwave popcorn packets fit conveniently into your desk drawer.  Just don’t overcook it in the microwave, unless you really want to tick off your coworkers!

A hard-boiled egg: Eggs have gotten a bad reputation in the past for their cholesterol content, but more recent research suggests that the amount of cholesterol consumed from food is not linked to heart disease.  Plus, eggs are an excellent source of important nutrients, including high-quality protein, selenium and choline.  Studies have found that people with a high choline intake have lower levels of inflammation.  This is a good thing, because chronic inflammation has been linked to a number of diseases, including heart disease, diabetes, and Alzheimer’s.

Most health groups in the US suggest that up to one egg yolk a day and unlimited egg whites will not increase the risk of heart disease, even for people who are watching their cholesterol.  Hard-boiled eggs and other protein-rich foods should not be kept at room temperature for longer than 2 hours.

Your food choices have a significant impact on your health and wellbeing.  The time spent preparing healthy snacks for work will pay off with improved energy and health.

This article was originally written for Comstock’s Magazine, the premier monthly business publication in California’s Capital Region.

Pick Holiday Food that Won’t Pack on the Pounds

ImageNavigating the food choices at holiday parties can be a challenge for nutrition-conscious people.  Here are a few general strategies and specific ideas to enjoy a healthy holiday.

Don’t arrive hungry.

Although it can be tempting to skimp on breakfast and lunch to “save up your calories” for a party, this strategy almost always backfires.  Eat balanced meals and avoid arriving hungry, or you risk overindulging in high-calorie party foods.

Fill half your plate with fruits and vegetables.

Fruits and vegetables are packed with nutrition, but low in calories.  When you fill up on fruits and vegetables, it’s easier to moderate the amount of higher-calorie foods you eat.  This is a good habit to adopt not only around the holidays, but year-round for good health.

Choose wisely.

Not all holiday foods are created equal.  Here are some common holiday foods and better choices to avoid packing on the pounds.

Drinks:

  • Instead of egg nog (350 calories), choose sugar-free hot chocolate (25 calories).  Packets of sugar-free or “diet” hot chocolate are available at most grocery stores.  Skip the whipped cream though, or you’ll add 150 calories.
  • Instead of mixed drinks (250+ calories), choose light beer, red wine or champagne (100 calories).  Keep in mind that alcohol lowers your inhibitions, making moderation at dinner more challenging.  After 0-2 alcoholic drinks, switch to calorie-free beverages.

Appetizers:

  • Instead of crab cakes (400 calories), choose shrimp cocktail (150 calories).  In general, appetizers that are fried soak up a lot of oil, and calories along with it.  Stick to appetizers that are steamed, baked, grilled or fresh.
  • Instead of chips and dip (290 calories), choose vegetables and hummus (75 calories).  Salsa is another excellent low-calorie dip choice.

Dinner:

  • Instead of prime rib (600 calories), choose grilled salmon, beef tenderloin, or roasted turkey breast without the skin (180 calories).  The proper serving size for meat is 4 oz, or about the size of the palm of your hand (fingers not included!)
  • Instead of traditionally prepared stuffing or mashed potatoes (300+ calories), find recipes with lighter versions online (150 calories).  Hidden ingredients like butter and turkey drippings add unnecessary calories.

Dessert:

  • Instead of pecan pie or cheesecake (600 calories), choose pumpkin pie and leave off the crust (150 calories).   Another good strategy is to share your favorite dessert with a friend.

The holidays are a time for celebration, so plan to enjoy small amounts of your favorite holiday foods.  Balance them out with a few of these healthful strategies, and you can relax and enjoy the holidays without worrying about packing on the pounds.

This article was originally written for Comstock’s Magazine, the premier monthly business publication in California’s Capital Region.