Nutrition and Skin Health: Can You Eat Your Way to Healthier Skin?

The effect of diet on human health has become a source of debate, and perhaps even an obsession in the US. Many beg to know “what foods or diet is best” … to improve overall health, prevent disease, achieve a certain aesthetic look, or optimize athletic performance? But, how does your diet affect the body’s largest organ – your skin?

Numerous factors affect skin health, including genetics, hormones, aging, stress, sleep, and exposure to alcohol, smoking or the sun. Some of these you cannot influence, however, what you eat (or don’t eat) may be one of the most important factors you can influence in modulating the health of your skin.

Most well-known is the impact of malnutrition and nutrient deficiencies on disorders of the skin. For example, malnutrition due to an eating disorder, such as anorexia nervosa, is often observed by significant changes to the skin, i.e. dry, red, itchy and/or inflamed skin, lanugo-like body hair, acne, petechiae (tiny purple, red, or brown spots on the skin), and in some cases, a yellowish discoloration of palms and soles of feet referred to as carotenoderma. It’s well documented that certain vitamin and mineral deficiencies, due to under-eating or malabsorption, are also associated with various dermatological changes, such as the clinical manifestation of pellagra with niacin deficiency, or hyperpigmentation of the skin due to vitamin B₁₂ deficiency.

A more frequent, and perhaps controversial, question is whether there is a relationship between diet and relatively common skin conditions, such as acne. The link between frequent dairy or milk consumption and acne is often referenced, but to date there is insufficient evidence with no high-quality randomized controlled studies to recommend milk restriction as a treatment for patients with acne (Burris, et al. 2013). The evidence seems to be more convincing for a possible connection between the quality and quantity of carbohydrate consumption and acne. Still, by today’s standards, nutritional studies that isolate a food-triggered influence on acne are reportedly costly and difficult to control, thus making it challenging to develop well-defined, evidence based nutritional recommendations (Fiedler et al, 2017). 

Best Foods for Healthy Skin

Foods rich in antioxidants. Antioxidants are chemicals found in foods that fight unstable molecules, called free radicals, that can cause damage to cells in the body. A diet rich in antioxidants is important for the whole body, but antioxidants have an important role in skin health by protecting cells against UV-induced damage which may prevent or reduce dry, wrinkled skin. Beta-carotene, lycopene and vitamins A, C and E are specific nutrients that have antioxidant properties, while vitamin C also helps to make a protein, called collagen that keeps skin strong.

Good food sources include: A variety of colorful fruits and vegetables are rich in antioxidants. Specific foods sources of beta-carotene and vitamin A include carrots, sweet potatoes, red and yellow bell peppers. Foods rich in vitamin C include bell peppers, oranges, strawberries, and tomatoes (also a good source of lycopene); and, foods providing vitamin E include avocados, nuts, seeds, and spinach.

Foods high in Omega-3 Fatty Acids. Omega-3’s provide important building blocks for each cell membrane in the body. Our body is not able to make these essential fatty acids, so they need to be supplied to the body from the foods we eat. Flexible, healthy cells rich in omega-3 fatty acids enable nutrients to move easily into, and waste easily out of cells while helping to reduce inflammation in the body, reducing redness, maintaining skin moisture, and may also help improve the clinical symptoms of psoriasis.

Good food sources include: Fatty fish, such as salmon, mackerel, tuna, herring and sardines; nuts and seeds, such as flaxseed, chia seeds and walnuts; and, plant oils, such as flaxseed oil, soybean oil and canola oil.

Fluids and Hydration. Staying well-hydrated by drinking plenty of unsweetened beverages throughout the day is good for the entire body. So, will excessive water intake have an even better effect on hydration and skin health? The “more is better” philosophy, as it relates to skin and hydration, was explored by Wolf, at al. who concluded that in otherwise healthy individuals, there doesn’t appear to be an improved benefit. However, as often recommended, further research is needed to provide definitive evidence (Wolf et al, 2010).  

Final Thoughts. Although nutrition may be one of the most important factors involved in promoting healthy skin, the link between diet and disease is not always as simple as a single food or nutrient triggering a particular sign that disease is present. For example, dietary restriction or the stress/anxiety induced by worrying that a certain food is “causing” a skin problem may actually be more problematic than any single food item. An individual’s overall dietary pattern (i.e. adequate calories with plenty of fruits and vegetables, whole grains, lean protein and healthy fats) together with lifestyle (i.e., regular physical activity, stress management, not smoking, quality sleep, and low alcohol consumption) take advantage of the additive and synergistic nature of these behaviors to promote healthy outcomes, including healthier skin.

Foods & beverages to prioritize in your meals and snacks:

Vegetables: broccoli, spinach, kale, peppers, zucchini, cauliflower, carrots, beets, etc.

Fruit: berries, grapefruit, oranges, apples, cherries, bananas, pears, grapes, peaches, etc.

Whole grains and starchy vegetables: Sweet potato, quinoa, butternut squash, brown rice, oats, buckwheat, etc.

Healthy fats: whole eggs, olive oil, avocados, nuts, seeds, nut butters, coconut oil, etc.

Plant-based dairy alternatives: cashew milk, almond milk, coconut milk, coconut yogurt, etc.

High-quality protein: salmon, tofu, chicken, turkey, eggs, shellfish, etc.

Legumes: chickpeas, black beans, lentils, kidney beans, etc.

Anti-inflammatory herbs and spices: turmeric, cinnamon, black pepper, parsley, garlic, ginger, cayenne, etc.

Unsweetened beverages: water, sparkling water, green tea, hibiscus tea, lemon water, etc.

Reasons This Dietitian Refuses to Cut Out Sugar

On the heels of the anti-carb movement is the notion that sugar is bad and to feel good, look good, lose weight, and be healthy, you just need to cut out sugar! Advocates of a sugar-free diet proclaim that people need to remove table sugar, sweeteners such as honey and maple syrup, condiments, dressing, refined flour, soft drinks, sweets, dairy products, and often fruits such as bananas and apples.

I don’t agree! Here’s some reasons why…

#1. I love food. All food.  And…”cutting out” a particular food “for the sake of health” would actually compromise health.

Health is more than just a physical state of being or defined by the mass of your body tissue. For any individual – especially a health provider – who believes otherwise, consider spending some time working with individuals struggling with all types of eating disorders. I have worked with plenty of people who have a healthy weight and BMI, and are far from “healthy” or able to enjoy life.

Mental and psychological well-being matters for overall health too and enjoying a variety of nutritious and enjoyable food supports this important aspect of health.

Yes, it’s true. Food is fuel and what we eat matters! As such, I’m a huge proponent of cooking at home (most of the time), and enjoying a variety of wholesome and nutrient-dense foods.

…But, there’s more to food and eating, such as food memories; heirloom recipes; favorite foods; celebrations; holidays; social events – many of which happen to include sugar. I prefer not to minimize the fact that there’s something special about food and how it brings us together. Whether it’s religious, ethnic, holiday or family traditions, food has a meaningful role.

Christmas hors d’oeuvres…my mom and daughter (making her famous fried pickles!)

For those who play the “I just enjoy these foods occasionally-card,” but you still believe the forbidden food is “bad”, or that your health will suffer because of eating these foods, that’s just a recipe for shame, guilt, stress, and anxiety. Research, Research, and more research demonstrate that people who worry about food are more likely to get caught in a cycle of restrict, eat, overeat, guilt, repent, and repeat; and, consequently gain more weight in the long run.

Most important is that some of my everyday “favorite foods,” that I’d rather not give up, contain natural or added sugar (yogurt, milk, fruit, bread, crackers), and happen to provide important nutrients (calcium, vitamin D, B vitamins, fiber, etc). Consumed in moderation, these foods make it easy to combine nutrition with convenience, affordability – and pleasure.

#2. I love to cook and bake – and sugar happens to be important ingredient for a quality food product.

One of my favorite recipes for Pecan Lassies…clearly it’s been used a bit!

I learned the hard way when fat was the “evil dietary villain”, that removing fat from cooking (i.e. replacing oil in muffins with applesauce; cream cheese in cheesecake with strained yogurt, or half-and-half with nonfat evaporated skim milk) resulted in poor food quality. At the time,  somehow I “believed” that the food was “good”. But, when I was really honest with myself, the truth was that the food and these cooking methods sucked!

The sugar-free diet explosion and food substitutions are no different. When boredom sets in after removing all the offending foods, efforts to replace sugar in recipes with Stevia or artificial sweeteners, sugar alcohols; or, the example of making a pancake with nothing more than an egg, some banana and a little cinnamon is, well, just history repeating itself.

Yes, sugar is valued (or demonized) for it’s sweet taste, but it also performs many other essential functions in cookies, cakes, and other baked goods. In addition to adding flavor, sugar affects the texture of food by creating tenderness and keeping baking goods soft and moist, while adding color and crunch in a recipe.

I’ve worked with folks who’ve tried to bake a so-called “healthy” dessert, i.e. leaving out sugar, and what resulted was a poor quality product that triggered a binge. No, this doesn’t happen to everyone, but the point is that when your experience with a particular food (taste, mouthfeel, aroma) is less than your expectations (or what your brain remembers), there can be an impulsion to keep eating hoping that eating more will provide the satisfaction you desired.

#3. I’ve been doing this “nutrition thing” for more than a couple decades and have helped many people over this time achieve their weight and health goals without needing to follow this particular “rule” and become worried or obsessed about sugar in food. I’m sensitive to the fact that we all have a unique relationship with food, so perhaps “cutting out sugar” seems like the right thing for some folks. It just seems a bit extreme and with a disrespect for the potential long term consequences of restricting or forbidding sugar – or any particular food.

I do not subscribe to the “eat like me, look like me” style of nutrition counseling, so I suppose my habits and relationship with food shouldn’t matter. Perhaps my clients, family, and myself are just “an anomaly.” I’ve actually heard that before. On the other hand, there’s a chance that all these folks, including myself, share many of the the same busy and stressful life and food challenges that everyone else does, and are evidence that it is possible to trust your body, trust your instincts with food, use non-food ways to manage stress and emotions and ultimately find balance with all foods so that you can enjoy pleasurable foods, and still “be healthy.”

#4. It’s called “Balance, Variety and Moderation.”
I know. Not a popular (nor sexy) headline. The idea that the sugar industry is out to kill us (per the reputable Dr. Oz) and headlines claiming that “Sugar is as addictive as cocaine and heroine” gets more views, followers and sells more.

For those readers who believe any of that, you may want to read “No, Sugar isn’t the new heroin” by Traci Mann, researcher from the University of Minnesota.

With respect and without judgement, the truth is that some people struggle with over-consumption – for many different reasons. Some unknowingly, while others recognize an intense and persistent draw to highly palatable foods for reward, comfort, etc. The reality is that some folks really do struggle with over-consuming sugar/food; alcohol (and I’m not referring to those with a known alcohol addiction); they may also overspend; over-commit; over-exercise – hopefully you get the idea.

In the case of over-eating – or when sugar feels like an “addiction,” making healthy and sustainable behavior change is possible. When a particular food (i.e. highly palatable foods such as sugar-laden goodies) take up residency as the go-to for nutrition, then we need to work on changing the “mental channel.”

This may mean “taking a break” from a trigger food or foods to create a safe and healthy eating environment that focuses on nutrient-dense foods. But, this is NOT
…a 10, 20, or 30- day detox.
…the idea that XYZ food (that contains sugar) is fatal and should be forbidden
…believing fear based messages about XYZ food.
…giving into the idea that “you are a flawed person” and someone else can “eat whatever they want.”

Finally…

#5. Plain and simple, it’s disordered eating to have forbidden foods.
Disordered eating has become normalized in our culture – but that doesn’t make it right or healthy. It is well established that restrictive eating, eliminating foods/food groups, and dieting is an environmental trigger for pathological eating problems and all types of eating disorders.

Not everyone has an eating disorder and eating disorders are a complex mental illness, but restriction and worrying about food is certainly an important risk factor that shouldn’t be disregarded or minimized when making or receiving nutrition recommendations.

The statistics speak for themselves. The National Eating Disorders Association (NEDA) reports that 35% of “normal dieters” progress to pathological dieting and that 20-25% of those individuals develop eating disorders. Furthermore, hospitalizations involving eating disorders have increased for all age groups, but hospitalizations for patients aged 45-65 have increased the most, by 88 percent, from 1999 to 2009.

When one considers the common emotional and behavioral symptoms of an eating disorder, it’s worth questioning the “normalization” of dieting or food restricting – “for the sake of health”.

Common Emotional and Behavioral Symptoms of an Eating Disorder:

– In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns
– Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting
– Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
– Appears uncomfortable eating around others
– Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
– Skipping meals or taking small portions of food at regular meals
– Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
– Withdrawal from usual friends and activities
– Frequent dieting
– Extreme concern with body size and shape
– Frequent checking in the mirror for perceived flaws in appearance
– Extreme mood swings

Source: National Eating Disorders Association

Finally, an individual’s relationship with food, eating and weight is a very personal and even intimate topic.

Nutrition is a science that interprets the interaction of nutrients in food in relation to growth, development, health and disease in an organism. But, overall health is more than just how nutrients function in our body.

Enjoying a variety of pleasurable foods and understanding how the “joy of eating” feeds our soul and makes life interesting, adventuresome and fun is something I would encourage anyone to not miss out on!

Healthy Eating – Interrupted

We talk a lot about “healthy eating patterns” in nutrition these days. In fact, the 2015 Dietary Guidelines for Americans emphasizes healthy dietary patterns for overall health and wellness, rather than getting overly focused on a single nutrient. The recommendations include the following:

A healthy eating pattern includes:

• A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
• Fruits, especially whole fruits
• Grains, at least half of which are whole grains
• Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
• A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products
• Oils

A healthy eating pattern limits:

• Saturated fats and trans fats, added sugars, and sodium

The Mediterranean diet is another example of a healthy eating pattern that is rich in fruits, vegetables, whole grains; a moderate consumption of reduced fat natural dairy products; and, emphasizes increased consumption of oily fish, legumes, nuts, seeds and extra virgin olive oil. fish, lowfat dairy and olive oil. Numerous studies have demonstrated a beneficial effect on overall wellness and a recent study showing that even a modified intervention proved to be helpful in managing depression.

I’m a strong proponent of these recommendations. I’ve lived out these recommendations and taught my family the importance of eating patterns that include these principles.

But then there are…

Interruptions. They seem to happen a lot, right?? We may even take them for granted as just a part of daily life – and we just keep moving along.

But then there are those interruptions in life – whether good or bad – that throw us for a loop. Those major life changes that might be anything from a marriage, a baby, college, a new job, or job loss, divorce, or an unexpected move. Those are the ones that seem to knock us off our feet – if even for a brief time.

We all endure these life changes and interruptions. Sometimes they feel tolerable while others are downright catastrophic and seemingly impossible to navigate. I think of myself as a rather resilient person, so when major life change(s) happen, I stop and notice! For me, I’ve noticed it’s a crazy a roller-coaster of emotions along with overwhelming chaos that disrupts my well-established “routine” (and I like routine!).

Recently, I recognized that one of the “side-effects” of a life interruption was a change in my eating. Yes! You read that correct, even a dietitian and nutrition nerd can seemingly get thrown off track with eating. I’m by far NOT a perfect eater, but I do practice what I teach and typically follow my good-ole “healthy dietary pattern.” But all that seemed to fall by the wayside when life through me a major curve ball.

I’ll save you the specifics about what happened to my eating, but let’s just say I wasn’t craving fruit and veggies – unless it was red wine or some fried pickles (pickles are actually considered a vegetable – LOL!). Also distressing for me were moments when my motivation to cook was dismal – while having no one to cook for – and a lack of appetite due to my constant state of stress I was experiencing.

Eating Interrupted! I stopped and noticed that not only was my life interrupted – but how do I navigate my interrupted eating pattern? Following are some of my tips – that got me through a tough time. I’m just hopeful that if you are going through something that is interrupting your “healthy eating pattern” these tips may help you too!

5 Tips for Navigating Life – and Eating – Interrupted

1. Stick to your food and eating schedule. Stress can really mess up your appetite! For some, it may trigger more hunger/appetite and for others it may completely shut down your hunger signal. Try to eat something at regular intervals throughout the day – and don’t overthink it or fall for the idea that your food needs to be “Instagram worthy!” For me, I had some “go-to” meals that I knew were nutritious and also “sounded good” so even if I didn’t feel hungry, I knew if I needed to slow down enough to eat something at my regular meal times. A few examples include: oatmeal with peanut butter and honey, a glass of milk and a banana; a simple egg and cheese sandwich with berries; or a frozen entree and some carrots/sugar snap peas with hummus. Easy snacks are string cheese, yogurt, cottage cheese, whole grain crackers, banana and berries (quick to wash and eat) – and also my favorite Ghirardelli dark chocolate with cinnamon tea is always a yummy treat.

2. Get to the grocery store or ask someone to do it for you. Simply put – if you want to eat good food, you need to keep good food in your house. For me, that meant I had to keep some of the snack-type foods (chips, cookies, and nuts) that I usually can eat in moderation out of the house for a time being. Why? Because those foods “sounded” a lot better than a meal, and I could easily rely on those foods – which is NOT helpful for managing stress.  I chose to keep foods around that I enjoy – but also would satisfy my physical hunger.

3. Cut yourself some slack with food, eating and exercise! I said this before, but I can’t say it enough – your food and meals do not have to be “Instagram worthy” and it won’t kill you to have a burger and fries or your favorite take-out meal. My desire to cook went out the window with the stress and workload of dealing with our life interruption. But, it comes back! Remember, this is just an event or season in life – it’s not a way of life.

4. Get some professional help for the stress.  If the emotional stress seems a bit over the top, try to meet with a therapist, psychologist, or counselor for talk therapy and some skills work to manage the stress. If possible, schedule a massage or some relaxing, personal time to re-group and manage the roller-coaster of emotions and physical stress on your body.

5. Be realistic with your goals with food, eating and weight. Dieting is never a good idea, but definitely not helpful during a major life change. Too often, restrictive diets and efforts at weight loss seem like a good idea as a way to “get control” when life feels out of control. Unfortunately, this is really a bad idea! Diets, restrictive eating, and intense exercise are just an added STRESS to the body. For me, I didn’t hesitate to take some time off from the gym and my workouts. I was already extremely active with the events we had going on and found my workouts made me more tired and fatigued – the exact opposite of what they were suppose to do. So, consider what’s most helpful for you. If your workout feels energizing and helpful for managing your stress and life change, then by all means, stick to your workout. But, if you can’t get in to the gym, or feel overwhelmed and fatigued, then give yourself permission to take a break!

Life Happens. But, it doesn’t need to be a life sentence for ill health. Be patient. Ask for help. And, your “normal” will return one day soon!

Feeling Uncertain about Your Nutrition Goals? Tips to Keep You on Track in 2017.

You’ve committed to health goals for the new year. Or perhaps you are just thinking about committing to some goals for the upcoming year?

Either way, whether you are hoping to lose weight, improve health, have more energy, feel better, run faster, optimize body composition, etc., the new year provides motivation that paves the way for new possibilities!

Then reality sets in: Now what? What’s your plan? How will you make these goals happen? What works? What doesn’t work? Perhaps you’ve tried before and weren’t successful. Or, the diet that you lost 30 pounds on before isn’t working now – and you feel uncertain about what is the “right” way to accomplish your health and wellness goals.

I get it! I truly understand your frustration. When a decision needs to be made; or, I’m investing in something with money or time, I want to know “What’s the RIGHT decision?”

One things for certain about uncertainty – it’s everywhere! And it seems to be increasingly more apparent in health and nutrition.

• What’s the best diet?
• What and how much should I eat to lose or gain weight?
• How do I fix my “broken” metabolism?
• How much exercise do I really need to do?
• Which exercise helps with metabolism: Cross Fit, yoga, spin class or kettle bells?
• What’s the best supplement? Do I need to take supplements?
• What foods decrease inflammation? Which foods increase inflammation?
• What do I need to eat to survive a 5K, 10K, marathon, or a triathlon?

These are the type of questions I hear from my clients, along with the confusing and misleading responses to these questions in the media. Some of these are easier to answer than others for a variety of reasons. But, we all want to know: what’s “right” for ME?

Uncertainty, according to Wikipedia, is a situation which involves imperfect and/or unknown information. We need to remember that nutrition is a science which means that the information and knowledge we have is incomplete and it is always changing. Believing that science is “for certain” can be misleading because the progress of science is based on a continuously changing picture of reality. Read More about The Science of Nutrition.

Another piece to this puzzle that makes it difficult to find a one-size-fits-all answer to the questions highlighted above is each individual is genetically and environmentally unique with their own personal and intimate relationship with food, eating and weight. I see this first hand with individuals trying to lose or gain weight. An individual struggling with Anorexia Nervosa struggles to gain weight eating over 3000 calories a day with no activity, while another individual can’t seem to lose weight eating 1200 calories and exercising 60 minutes every day. Clearly the “energy balance” equation we like to rely on seems a bit out of whack. We have many theories about why this happens (hyper-metabolism, metabolic adaptation, hormonal effects, etc), but we have yet to see one, perfect solution to either of these situations.

And to the uncertainty of the remaining questions:

What’s the best diet? Probably the one you can stick with.

How do I fix my “broken” metabolism? First off, let’s start with the fact that your metabolism isn’t really “broken”.

How much exercise do I really need to do? We need to move our bodies every day. What does “exercise” mean to YOU?

Which XYZ exercise is best for XYZ problem? What exercise do you enjoy doing?

What’s the best supplement and do I need to take supplements? It depends on what the deficiency is and whether you have a deficiency in the first place.

…and so on.

The point is this: We all “know” what we need to do, but struggle (for a whole bunch of different reasons) with doing it!

Following are a few tips or suggestions that may help you stay on track with any of your health and wellness goals in 2017:

Commit to Consistency. Whether it’s meal planning; cooking more; eating more fruit and vegetables; regular exercise; drinking less alcohol or soda; drinking more water, etc, you don’t need a nutrition expert or well-designed science experiment to tell you that these behaviors are important. But, just like eating one salad won’t help you lose weight, neither will enjoying an occasional burger and fries cause you to gain weight. It’s about what we do consistently over time that either helps or hurts.

So, what will help you maintain consistency? Do you need an accountability partner? Perhaps some education to challenge rules or beliefs about food and eating that are interfering with your success? Whatever it will take – I suggest you commit to a “365 day challenge.”

Pursue Progress not Perfection. Making behavior change that is sustainable takes time. If your plan to accomplish your goal to lose weight and get healthier in 2017 looks something like this:

• Eat less
• Exercise more
• Stop eating fast food
• Eat more fruits and vegetables
• Cook more at home (and you don’t know how to cook)
• Drink more water
• Eat more ________ and eat less ________
• Stop smoking
• Sleep more – and better

…which are all great goals – but how will you implement all of this, at one time, into your already crazy, busy, overworked, stressed-out lifestyle that created the unhealthy habits to begin with?

Remember “If you chase 2 rabbits, both will escape” ~ author unknown

Try to focus on one do-able behavior at a time. Perhaps you already exercise 3 to 4 days a week, but don’t take time to shop and cook meals at home. Instead of adding more exercise at this time, take that time to plan, shop and cook more fresh and wholesome meals at home. Sadly, I’ve seen individuals give up because they are only losing 1/2 to 1 pound a week when they are making these small, but important changes. When they revert back to a more restrictive (often unsustainable) plan that seems to deliver more, faster weight loss, a year later they’ve gained all the weight and more back – and haven’t accomplished any of their goals.

Focus on Non-Scale Victories. Many individuals unfortunately give up on their goals when results don’t match expectations. I’ve heard it over and over from folks who are going to the gym consistently; have cut out all kinds of “unhealthy” foods; are following through with their “clean” eating; but state that they don’t “look like they do all that.” Consequently, they feel frustrated and either invest in more supplements, a more restrictive diet, or give-in to urges that actually lead to other health problems – when the real problem likely has something to do with negative body image (a separate issue that needs attention, but no diet or supplement will fix that).

Make a list of health goals that have nothing to do with the scale or “what you look like.” Perhaps it’s feeling stronger (because you’ve taken up a weight lifting program), are saving money (from not eating out as much); have more energy (because you’re eating more fresh produce and exercising more); or enjoy cooking more at home (because they’ve learned to cook). These are all important victories that can’t be measured by any device.

The National Control Weight Registry (NWCR) is a research study that includes people who have lost at least 30 pounds and kept it off for at least one year. The NWCR reports that it is tracking over 10,000 people who have successfully lost and kept the weight off. How did they do it? Overall, they’ve modified their food intake in some way and increased their physical activity. The majority maintain their weight loss by consistently eat breakfast, watching less TV, and exercising about 1 hour every day. None of the research demonstrates that one particular diet or exercise program was superior – it was just the fact that the individuals made positive, healthy lifestyle changes they were able to stick with.

There is a great deal of uncertainty in the year ahead. But, one thing you can count on is 2017 is an opportunity for a new beginning! Remember to commit to consistency, pursue progress not perfection, and focus on your non-scale victories – and Let’s Do This!

 

Food Rules: What are the Costs?

Labeling food as good/bad or healthy/unhealthy is an example of a food rule. Food rules have seemingly become “normalized” in our culture as being helpful.  They are often suggested for dieters to use because they provide “limits” that often help the eater feel more in control.

Labeling Food:   Categorizing foods as unhealthy/healthy, bad/good, legal/illegal, fattening/nonfattening, safe/dangerous usually backfires.  The intent of labeling foods is to help people get control of their eating for the sake of losing weight, for example, and thus categorizing foods as either fattening or nonfattening provides a sense of control.  However, deprivation often increases desire.

Some possible benefits from food rules include:

• Focusing on the “rules” is a great distraction from focusing on more distressing issues
• Helps you feel safe or in control.
• Produces a “high” when you are successful at following the “rules” which in turn,  perpetuates the eating behaviors while feeling self-righteous or disapproving of your previous eating behaviors.

The downside is that these behaviors often promote rigidity and limits and individual’s choices with food, eating, health, exercise and weight. Simple, healthful guidelines become complex, demanding and powerful.

Another problem is that deprivation often increases desire. When the individual gives in to this desire and eats the “forbidden” food, feelings of guilt or shame are the result often leading to overeating or other compensatory behaviors, such as increased restriction or excessive exercise.

And the cycle continues… Eventually, a person begins to feel as if they cannot live without the strict rules and eating continues to become more rigid and disordered.

Therefore, following are some of the costs an individual suffers by relying on food rules:

• Food rules prevent the development of confidence in your own body, skills and judgment
• Rules exacerbate dieting behaviors and rigidity with food, exercise and weight
• Rules increase your sense of guilt if a rule is violated

Negative thoughts and perceptions about food, weight and eating patterns make it difficult to successfully change certain behaviors.  You may be overly critical of yourself, have a low self-esteem, or view foods as being either bad or good – which can all sabotage your efforts of achieving peace with food and your body.

Following are some examples of food rules: I can only eat one meal per day It’s not okay to eat after 7 pm Labeling foods as “Good” and “Bad” It’s never okay to eat between meals, i.e. snacks I can’t eat in restaurants because… No fried food I can’t eat red meat It’s not okay to feel full Never eat more than ______ calories If you eat a “bad” food, or break another rule, then …. I have to exercise at least 60 minutes every day, or …

Most would proclaim they want to stop this fight with food and their body, but having unconditional permission to eat feels very scary.  One of the most effective solutions for eating problems of all types is to begin to return all foods to a neutral status – to stop and give yourself permission to eat all foods, trusting you will find a healthy balance.

Legalizing food and eating requires action.  There are 3 things you will need to do:

1. Have a plan. Make a plan to bring forbidden foods into your home; (with support), you want to begin to expose yourself to foods you crave.

When you begin to expose yourself to foods you enjoy, it’s helpful to have a plan that includes: where to start, how to challenge negative thoughts, who can support you, etc.  Remember your goal is to stop the food fight and find a peaceful relationship with food and your body.  You cannot do that if you continue to evaluate food in terms of “good” vs “bad” or in terms of “fat” and “calories.”

2. Replenish supplies of favorite foods. When it feels safer, begin to have your favorite foods around, so you don’t feel deprived.

One suggestion is to make a list of food or foods you would like to reclaim.  Then, you may want to start with the least feared item on your list.  Then, I guide my clients through a “step-by-step” plan for experimenting with reclaiming this food. In this plan, we identify what are the irrational thoughts about the food, i.e. carbs will make me fat or sugar is toxic. Then, we identify what you will do to try the food. For example, if ice cream is forbidden and there’s a risk you will binge on a half gallon of ice cream if it is brought into the house, then plan to go out for a small dish of ice cream with a supportive friend. We discuss a plan for dealing with the irrational thoughts, i.e. education on how your body uses carbs for energy and finally evaluate how the plan went. Finally, we evaluate why your plan worked or didn’t work and what to do different next time.

3. Create a pleasant food atmosphere in your home.  This step is critical for setting you up for ongoing success.

Examples of changes you may need to make include: promising not to “yell” at yourself for eating foods you enjoy; eating slowly and mindfully at a table so you can truly savor your food; and/or use a realistic meal plan that helps you see the big picture of how these foods can fit while helping you achieve your goals with food, wellness and weight.  Journaling your food intake along with thoughts and feelings can be helpful at recognizing that you didn’t “blow it” when you enjoyed a small piece of dessert.

The point of all this is re-learning to trust yourself and your body with food and eating again. Food does not need to have all the power and deserves to be on the plate – not on a pedestal.

Which is Best for Weight Loss – Exercise or Nutrition?

We are bombarded by media messages that convince us the way to the “perfect” body is just a little more effort. Captions like “Remember the girl who gave up? No one else does either…”; or that Jillian Michaels has the formula to help you “lose up to 20 pounds in 20 days!” Perhaps you’ve seen the “It’s no longer about ‘skinny’ it’s about ‘healthy'” message tagged next to the half naked, ultra-thin model in the picture.

Sadly, I see way too many people give up on their best efforts at eating well and regular, enjoyable activity because they are disappointed in their results – whether they are not losing weight fast enough, they’re not “lean enough”, or they just don’t look like they should.

Let’s be honest. If your wellness goals are more about “skinny” vs “healthy”, you may either be disappointed (at the very least) or potentially trigger a cycle of disordered eating or worse, a pathological eating disorder. It’s disheartening to me when individuals become so overly focused with “how they look” that they miss out on the significant benefits of other “non-scale” victories, including improvements in energy and creativity, along with benefits related cognitive, heart, bone, and overall physical and psychological well-being.  Carmen Fiuza-Luces, et al. describes the tremendous drug-free, low cost benefits of exercise on preventing disease in their article, Exercise is the Real Polypill.

On the other hand, two studies provide examples of where more exercise isn’t necessarily better, especially related to weight loss.

A 2012 study by Rosenkilde, et al. in the American Journal of Physiology demonstrated similar amounts of fat loss in response to whether participants expended 300 kcal/day or 600 kcal/day. The high volume group ate more and were less active the rest of the day, while the moderate dose group ate the same and were energized to do more activity the rest of the day.

Another study, funded by the American Cancer Society, sought out to define how much exercise is necessary for postmenopausal women to lose body fat. Researchers recruited 400 inactive women who participated in either 300 minutes per week or 150 minutes of moderate to vigorous activity for one year. Participants were instructed to maintain their same caloric intake. Women ranged in age from 50 to 74 years old and lost an average of nearly 4 pounds (in the moderate volume group) to 5 1/2  pounds (in the high volume group). As hopeful as that may sound at first, this study is a great example of the disappointment many women may feel when they’ve exercised intensely for 300 minutes per week – only to lose five pounds in a year’s time. We don’t know much about their food intake. There’s a chance these postmenopausal women increased their intake in response to the additional activity.

So what is the “ideal” nutrition and exercise prescription for achieving your health goals? I’ve heard many times, it’s: “80% nutrition and 20% exercise”.  What do you think? Of course, we all have our own personal experiences that affect our response, but it’s likely that the proper amount of nutrition and exercise varies from person to person – what your health and wellness goals are; and, what your expectations are.

So, let’s take a look at some common goals or objectives people have.

The objective:  Weight loss

What’s best? Initially, nutrition makes the biggest impact on achieving your goal. Specifically, research indicates that individuals who need to lose weight and body fat are most successful by attempting to alter the energy balance equation by decreasing energy (food) intake. However, exercise is essential for keeping the weight off.  For this reason, an individual who is inactive when they begin a weight loss program needs to also include some form of activity. Starting off slowly enables them to work up to an intensity that will keep the weight off, prevent burnout and injury; and, help prevent muscle loss to keep their metabolism up.

The objective:  Prevent type 2 diabetes

What’s best?  Exercise can make the biggest impact in your defense against this disease.  Yes, diet is also important in prevention and managing diabetes, but active muscle tissue is like a “sponge” in being able to absorb sugar (glucose) from the blood stream using a mechanism totally separate from insulin.  When you are active, your cells also become more sensitive to insulin so it can work more efficiently.

The objective: Stabilize mood, relieve stress and boost energy

What’s best?  Exercise is the magic bullet!  The reason why is that exercise triggers the release of powerful brain chemicals, such as dopamine and norepinephrine, that are important in helping us feel good and have more energy. Exercise (any movement) can also lead to changes in the brain that help with resilience and managing stress. Nutrition is important in supplying the fuel needed to make these neurotransmitters, but just as you can improve your blood chemistry with a single meal, you can also boost energy, mental focus and mood with a single workout. As a result, exercise may be as effective as medication for treating depression in some people.

The objective:  Improve sports performance

What’s best?  Nutrition can have a significant impact for athletes who are looking to improve their performance and reduce injury rates.  However, it’s important to remember that the best athlete is well-trained, genetically gifted AND well-fueled. Fueling with the appropriate nutrients at the right time in their training regimen can make a big difference in helping an athlete achieve their goals with speed and performance; muscle growth and repair; and, recovery time.

The objective: Reduce risk of chronic disease, i.e. heart disease, cancer, osteoporosis, obesity

What’s best?  Both diet and exercise are important components of prevention and treatment strategies. Prevention of weight gain is critical because overweight and obesity are difficult to treat and are conditions that directly affect many other chronic diseases.  Additionally, diet (specifically the quality of food intake) and exercise also play non-weight-related roles in many chronic diseases.  For example, omega-3 fatty acids from fish are shown to have a direct affect on lowering your risk of heart disease. A diet that includes a high intake of plant-based foods along with consistent exercise remains the recommendation for decreasing your risk of cancer.

Clearly, your nutrition intake (quantity and quality) along with regular activity will have a significant impact on helping you achieve your health goals. The goal of a body builder is different than that of an endurance athlete, stressed out middle-aged man, or a woman trying to manage symptoms of menopause.  Diet plays a significant role in each of these examples, but hopefully you can see why it’s misleading to simplify movement and activity to “20%” of the equation.

5 Tips for Managing Emotional Eating

Emotional eating is when an emotion triggers a person to eat, instead of the physical symptom of hunger.

There are many misconceptions about emotional eating.  One of the biggest myths is that all emotional eating leads to overeating and weight gain.  In fact, it is natural to eat for emotional reasons and still maintain your weight.  For example, celebrations with family and friends often include special foods that we have an emotional relationship with.  Having birthday cake with friends, not because you are hungry, but because it feels good isn’t necessarily a prescription for overeating or weight gain.   In fact, a recent study investigated how an individual’s perceptions about eating a food, like chocolate cake, influenced their motivation to maintain a healthy eating plan.  Researchers discovered that those who felt “guilty” after eating a piece of cake were more likely to sabotage their weight loss efforts than those who associated the cake with “celebration.”

So then, what’s the problem with emotional eating?  Emotional eating is a problem when you abuse it.  When a person is out of touch with their feelings and eats to comfort themselves or stuff their feelings down, it can result in overeating.  When an individual engages in this behavior day after day, it is likely to result in weight gain.

Diets and forbidden foods often make the problem worse.  Dieters, or individuals with restricted eating patterns, are typically eating less than they need; less of the foods they enjoy; and, are chronically hungry.  When faced with stress or other emotions, the ability to maintain control of the restrained eating becomes intolerable for the individual who “gives in” and overeats.  In these situations, the individual eats quickly; is distracted; and, is disconnected from his or her internal cues.  Feeling guilty and remorseful, the dieter tries harder to restrict the eating and the cycle continues.

How to stop abusing emotional eating.

1. Identify your triggers.  Keep a mood food diary and track information about your meals and snacks (including unplanned eating), Write down what you are eating, when you are eating, where you are eating, whom you are eating with, and how you are feeling at the time.  Many of my clients strongly object to keeping a journal for various reasons.  Taking time with a nutritionist or other health professional to discuss strategies to overcome  those barriers may be key for you to take the first step in getting control of your emotional eating.
2. Don’t skip meals.  Feed yourself regularly while being mindful of balance, variety and moderation in your meal planning.
3. Eat whole foods.   Eating whole foods that you enjoy, on a regular basis, can help to balance out your mood and provide consistent energy during the day.
4. Develop alternative coping skills to manage your emotions. Take a moment to create a list of activities you can use when emotions run high.  Things like calling a friend, gardening, being outside, reading, and taking a bath are all examples.  Many activities result in the release of the chemicals in the brain that help us feel better.  I suggest that individuals have their list visible and easily available.  When you notice a trigger to use food for comfort, try one of the items from your list.  After 10 minutes, if the food is still beckoning you, try the 2^nd activity for 10 minutes, and so on.  Usually if you make it to the 3^rd activity, you will notice that the urge to eat is less.
5. Try Individual or group counseling. Talking about your triggers and getting support for planning healthy meals and snacks may be the key to making the behavior changes that are needed.

Battling Midlife Weight Gain: The “Perfect” Problem

“Life, Liberty and the Pursuit of Happiness” is an unalienable right we Americans have. For many women experiencing midlife weight gain, the pursuit of happiness seems to have been replaced by the “prison of perfection.”

I’m often asked by women who are experiencing symptoms of the menopause transition what’s the secret to the “battle of the bulge” – you know that increasing waistline that never used to be a problem? My answer is that the key to success is about making appropriate lifestyle changes that manage the effects of aging and declining hormones (keep reading to learn more about those). I know, I know! Not a very sexy answer, especially for the woman who is desperate and has already made significant attempts at “eating well” and “exercising regularly.”

The problem, I learn after more questions, is not just about what she needs to do to stay healthy through her midlife transition, but really this: “what’s the perfect diet to get thin/stay thin (you know like I was in my 20’s)… and remain ageless?” After all, we’ve been bombarded by messages from media, marketers and society that have seemingly convinced us that “healthy and happy” is found in perfection – the perfect body, job, husband, house, kids, food, skin…

Consider the fact that the number of cosmetic procedures using Botox (botulinum toxin which is a neurotoxic protein produced by the bacterium Clostridium botulinum) have increased a whopping 750% from 2000 to 2014, according to a report from the American Society of Plastic Surgeons. Somehow, cosmetic surgery and these types of procedures have become “normalized” for remaining ageless. We’ve become convinced that challenging the imperfection of aging is the key to happiness.

In fact, the battle with midlife weight gain may actually be a “perfect” problem, as well. The struggle many midlife women have over gaining a few pounds during the menopause transition can become quite intense; resulting in restrictive eating, diet cycling, disordered eating and excessive, compulsive exercise…if not a pathological eating disorder.

“The perfect problem,” according to Margo Maine, PhD, in her book Pursuing Perfection: Eating Disorders, Body Myths and Women at Midlife and Beyond, “promotes the myth that we can find life’s meaning and the answer to every challenge in the shape of our bodies.” Dr. Maine’s book eloquently points out that midlife women are not immune to the cultural pressure to attain a perfect body and may mistakenly underestimate the power of dabbling in pathological behaviors like these. She challenges the reader to many questions, but this one stood out to me:

“When was the last time we were part of an all-woman conversation where no one brought up weight, food, or personal appearance?”

Okay, time out. I’m a born and raised perfectionist, so I’m not here to throw any stones. In fact, my perfectionism has been a gift in many ways – pushing me to academic achievement, career success, and fiscal and financial stability. But, sadly it also got me into a lot of trouble (a prison as Dr. Maine refers to in her book), especially in my 20’s and 30’s as I sought out to have the perfect body, house…you know the list. I was desperate. Desperate to fit in at a time when I didn’t really know who I was. Without going into the gory details, the point is that no matter how hard I tried, it never felt “good enough”.  Someone else always had “it” better. Let’s just say my 30’s didn’t end well.

I’ve come a long way since those days (with a lot of hard work, therapy, faith, and good family and friends), thus the reason I am passionate about helping women of all ages feel confident and at peace with food, exercise and weight – no matter what their size. I want women to know it’s okay to age imperfectly! You are not your body. Wrinkles are normal. Skin will sag. Fat prefers to be stored in the belly after menopause… and, this: “There is no greater power in the world today than the zest of a postmenopausal woman.” ~ Margaret Mead.

So, do we just need to surrender to mediocrity?  Absolutely NOT!

Don’t get me wrong. I want to age as healthfully and gracefully as I can. I want to be strong, energetic and healthy enough to bike the country, travel the world, and chase grandchildren around. The difference is that the pursuit of health is different that the pursuit of perfection. Getting sucked into following the latest trends with food, exercise, skincare, surgery, etc. actually contributes to more stress and anxiety. There will always be something better. Something more “right” and the cycle just continues. Ultimately, none of these behaviors will help you achieve those important life-long goals.

So, the point is this: Do we need to give in to the multi-billion dollar diet, supplement and cosmetic industries – who are working hard to convince women we aren’t good enough the way we are, by the way – to be happy?

No, we don’t! But, what can we do?

Most people I know and work with want to feel in control. Life often feels out of control, so, it’s helpful to know what we CAN control and know it  will make a difference. Spoiler alert: The following list is not “sexy.” You’ve probably heard all this before. But, here’s the deal. These behaviors DO matter. When done consistently, you can be and feel strong, healthy, confident and energetic.

Stay active. Find things you enjoy doing and participate in those activities daily – hiking, gardening, biking, running, golfing, playing volleyball, and lifting something heavier than a soup can!

Cook at home. As we get older, have more money or even more time, eating out can become an all-too-frequent pastime. Change it up. Invite your friends over, explore new recipes, cook with new foods, or just learn to cook if you need to. We know that eating more nutrient dense (versus calorie dense foods) provides more vitamins, minerals, antioxidants, etc. and helps with weight management and overall health. Eating at home provides more control over what you are eating – saves money and can be a lot of fun too!

Eat more fruits and vegetables. I know this point may sound cliche, but the reality is that over 80% of Americans do NOT get the recommended five servings a day of fruits and vegetables, while 60 to 75% of Americans eat more than the recommended servings of grains and protein. So, it wouldn’t hurt to work on eating more of these wholesome nutrient dense foods which will naturally replace over-consumption of other foods. (What We Eat in America, NHANES 2007-2010.)

Eliminate restrictive eating and diet cycling. I can’t say enough about this. But whether intentional or unintentional, restrictive eating sends a powerful message to the body to become very efficient with metabolic processes; use less energy; and, store more fat to protect the body from a state of famine. Thus, although weight loss may happen initially, anything you can’t sustain will backfire with weight regain and likely even more weight stored as fat – in the abdomen! Thus the feeling midlife women have that “their old tricks don’t work anymore.”

Drink less alcohol. Any of the reported benefits associated with alcohol intake are based on drinking in moderation or less than one serving of wine or beer per day and less than three servings at a time. Research demonstrates that women who drink heavily are more prone to central obesity while increasing the risk of breast cancer and cardiovascular disease. Additionally, women at menopause are especially vulnerable to depression, and heavy drinking can just make that worse.

Get good quality sleep. This can be tough for midlife women experiencing shifting hormones that may interfere with sleep. Maintaining a regular bedtime routine and practicing good sleep hygiene (i.e. turn off electronics one hour before bed) may be helpful.

And, let us not forget:

• Don’t smoke – ever. Enough said.
• Brush and floss your teeth regularly.
• Wear sunscreen daily

There is a strong psychological association between taking important steps to take care of yourself and improving body image. For many women, just a week of eating well and regular exercise promotes positive thoughts about their body – even if they didn’t lose weight. There are many reasons for this, but the challenge is to remember that behavior change takes time. Getting support from friends or even a professional, such as a Licensed Psychologist or Registered Dietitian, may be critical to declaring your freedom.

You have a “right” to life, liberty and the pursuit of happiness. Don’t let the “prison of perfection” take that away!

Almond Milk: Health Food or Hype?

As a nutrition professional working with a diverse population of individuals – of various ages, different food preferences, individual struggles, and unique goals – I try to remain unbiased and open. But, I have to admit the almond milk craze confuses me. Allow me to explain. Typically the folks that are investing in this milk substitute are doing so because they have been convinced that it is “healthier.” They may not even be able to explain what that means for them, but they’ve bought into the idea, nonetheless. Some will explain they heard it is healthier because “it is a more wholesome food product” or because it is “less processed” or that it is “better tolerated”, “doesn’t cause inflammation”, “doesn’t contain hormones, antibiotics”, etc…(than cow’s milk or soy milk).

Well, I’m not going to dive into all the evidence-based reasons why those are not entirely true statements (perhaps for another blog). My point here is to encourage folks to ask questions, get curious, be a little more skeptical, and use some “common sense” instead of always relying on “google university” for information. Therefore, I’m offering some ideas on how my own curiosity about this popular food product helped me with my skepticism about whether almond milk is a health food or just hype.

Let’s get started. First off, I’m all about a diet that includes foods that are unprocessed, wholesome and as close to their natural state as possible! I love to cook from scratch and was brought up to enjoy fresh produce and great tasting food. More important, I agree that we are bombarded with a plethora of foods with ingredients and additives and we need to get back to eating more “real food”.

So, of course, I am interested in what like-minded (or so it seems) health and wellness professionals recommend. And, this almond milk recommendation comes up every time! This is interesting to me because even the least processed almond milk (“unsweetened”, “original”, “all natural”) I could find at the grocery store seems pretty processed to me and contains food additives, such as Gellan gum, natural flavors, salt, sunflower lecithin, etc. And…the very fact that the product has an expiration date 3 months passed the date of purchase suggests that this product may not be as wholesome as I’d prefer.

Well, because of my compassion for my clients who want natural, wholesome food products and don’t like, want to avoid, or can’t tolerate dairy, I thought I’d try making my own almond milk and see if that would be a decent recommendation.

I went out, bought my raw almonds and joyfully prepared my homemade almond milk…as directed in an article from the “healthy way of life company” ~ Life Experience Magazine (Lifetime Fitness). It’s fairly easy, not terribly time consuming and surprisingly produced a frothy, white-ish product that tasted somewhat similar to the store bought original and unsweetened almond milk.

Okay, so this is interesting. To produce about one-half quart almond milk (from 1 cup of almonds) – again according to the recipe from the source mentioned previously – cost me about $3.00 (1/2 of my $6.00 bag of almonds) and is supposedly shelf stable for 3 days in the refrigerator. For reference, the 1/2 gallon store bought almond milk was $3.50 – perhaps you can find it cheaper somewhere else, but that’s what I paid – and it is shelf stable until June 5 (again 3 months passed the date of purchase).

And, even more interesting, in the process of straining out the undesired pulp, you lose most of the nutrition and are left with basically almond-flavored water – thus only 30 kcals and 1 gram protein per 1 cup serving. So, okay. Perhaps a nice option for those who truly don’t want or can’t tolerate other, more nutritious milk products. But again, I’m confused by the momentum behind this being recommended and touted as a “health food.” To me, it seems hard to even consider it a food product. Maybe an ingredient for something. But, in terms of my overall daily nutrition needs, I’m really not convinced it’s contributing much, if anything at all to sustaining my health.

Again, I truly am not concerned whether someone wants or chooses to drink almond milk or any other nut milk – store bought or home-prepared. I respect everyone’s food preferences and the variety of reasons that contribute to those choices. But, what I get a little riled about is the “hype” and the misinformation that contributes to consumers being confused about food being “good” vs “bad” or “healthy” vs “unhealthy”.  Food is just food. There is not any one food item that will make or break your health status. On the other hand, eating too much or too little of anything, not moving your body, smoking, stress, not sleeping well, is another story.

So, my suggestion: be curious. Ask questions. Does this really make sense?

Remember, skepticism is a good thing. Denial, on the other hand, can be a problem. 

My conclusion: I’m personally sticking with my yummy and fresh cow’s milk. The rest of my family agreed (lucky for them, they all were subjected to a taste test). Even my cat agreed and wouldn’t touch the almond milk (before you get concerned: she seems to love and tolerate cow’s milk quite well). And, in case you’re interested, here’s the ingredients in cow’s milk (that expires within 2 weeks after purchase).  Cheers!

What Does it Mean to “Be Healthy”?

A good friend of mine invited me to contribute to a book she was writing, about what it takes to “Be the Exception.” It’s a wonderful project about steps to overcome hardship and live an exceptional life. She asked me to describe one of the steps, in my own words, about what it means to “be healthy.” It’s an interesting question. In fact, most of my clients will tell me exactly that: “I just want to be healthy.” To which I respond, “What does that mean? How will you know when you’re healthy?” Most reply that it means “to get in shape.” Others say that it is “to have more energy” or “to feel better.” It seems like a simple question, but what does it really mean to “be healthy”?

The above picture is the image that propelled me to think differently about what health means to me. I was at a turning point in my life after years of excessive, compulsive exercise, restrictive eating, and the never-ending battle to be “as healthy as I could be.” A painful divorce; sinking into a crippling depression; and, cycling into emotional, binge eating made me realize I had to figure out how I was going to be “healthy” for my two young children. My world had changed dramatically and no amount of exercise or eating well was going to change that.

The word “health” means different things to different people. In fact, it’s taken on new meaning to me over the years. I was brought up to value health, but most of what I understood about “being healthy” was related to physical health. And, most notably, if you weren’t thin, you weren’t healthy.

So, I pursued thinness. Right along with the rest of our culture, I pursued the belief that if you have the “right” body size and eat the “right” way, your problems will be solved and you will live happily and healthfully ever after.  And, being a perfectionist, I’m quite certain I did it the “right” way.  Unfortunately, there was no “happy and healthy” for me during this time. Now, there’s nothing wrong with trying to eat well and stay physically fit. However, when this is your number one priority in life, it turns out, it can become quite “unhealthy”!

Although I struggled with my distorted beliefs about health early on in life, I went on to pursue a master’s degree in nutrition science and completed the requirements to be a Registered Dietitian. I’m fascinated by science and really do love food and eating. So, in many ways, my education was an important part of correcting some of my misunderstanding about physical health.  With some practice, my personal relationship with food, eating, exercise and weight began to come into balance.

My quest for finding peace or a healthy relationship with food, eating and weight; however, has less to do with what I eat or how much I exercise, and everything to do with my mindset, priorities and learning to manage adversity. 

Over and over again, people try to quantify “health” by referencing weight, body fat percentage, BMI (body mass index), calories consumed, calories burned, how many steps you’ve taken, hormone levels, and on and on. Ugh! This is just madness! I know, I’ve tried it all.

Of course there is a correlation between many of these indices and one’s physical health, but it really doesn’t tell us anything about the person’s overall health – which includes how they manage stress; whether they have healthy, intimate relationships; if they smoke; do they get productive sleep; or what their overall emotional state is. Unfortunately, there is too much room for misinterpretation and judgement of a person’s true health with this preoccupation of numbers. The principles of Health at Every Size are a great example of expanding the definition of a person’s overall relationship with food, eating and weight.

Truly, the pain inflicted on people because of our culture’s obsession with weight bias and stigma (at every age these days) is far from healthy! 

So, if these numbers don’t give us the complete picture of health, what else matters? Well, what keeps a person functioning when stress, trauma and pain strikes, while another falls to pieces? Resilience. Physical health certainly plays a role in a person’s ability to be resilient, but there is much more to it. Plenty of research has demonstrated that nutrition and activity are important, but faith, sleep, positive relationships, and stress management are the difference makers for overcoming hardship and staying well.

A great example of this is illustrated in a landmark study, called The 90+ Study, of thousands of members of a retirement community in Southern California. This study is revealing factors that may contribute to living longer. It’s no surprise that researchers have found that smoking leads to shorter lifespans, while those who exercise live longer. Other findings have been unexpected — vitamins did not prolong life, but carrying some extra weight did.

My personal experience of overcoming divorce, loneliness, and stress along with my professional experience as a clinical dietitian working in mental health has clearly demonstrated to me that “being healthy” is more than a person’s body size.

My dear friend’s book, Be the Exception: Your 7 Steps to Transformation, dramatically illustrates this truth through her sensitive, kind and inspiring words.

And…most important my parents have demonstrated what optimal health is. At that dark, pivotal point in my life (over 15 years ago now), I saw my 60+ year old father pushing my kids up the hill in front of our home and realized, that’s what I want! I just want to be able to do that when I’m a grandparent.

Still today, my parents continue to role model a healthy lifestyle. They’re active, travel regularly, remodel and restore homes, climb houses (my dad pictured below oiling their weather vane), have healthy relationships, are devoted to their faith, eat intuitively and enjoy quality time with friends and family.

For me, I’ve learned to balance my time by living what I teach – eating intuitively and staying active. I don’t always do it perfect, correct and right, but my priorities of faith and family first, certainly keep me grounded.  My greatest joy is my kids and cooking, family meals and quality time with friends and family.

Pictured below is our family trip to Key West, Florida to celebrate my parent’s 55th wedding anniversary!  Life is tough – that’s for sure – but truly enjoying good food, eating and fun activity is just part of everyday life.