EnlightenU Nutrition Consulting, LLC

Enlightening You about Food and Nutrition


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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…

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#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.

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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.

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

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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. So bear with me as I share something that may sound a bit boastful, but really my intent is far from that. At 53 years of age, having raised and fed four active children, and with both parents thriving at 76 years of age – all healthy, energetic, productive…and a healthy weight – it’s just another reason it’s hard to agree with the black-and-white thinking that “cutting out sugar” is a good idea.

Perhaps my clients, family, and myself are just “an anomaly.” I’ve actually heard that from someone. 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 have been able to adopt a little moderate restraint, while still being able to enjoy pleasurable foods, and remain 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.

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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!


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3 Steps to Keep you Committed (and successful) with your Health Goals

New Year's ResolutionsResolutions seem synonymous with a new year and a new beginning with your health goals! Setting a resolution stirs up hope that this year really can be different! It feels mentally refreshing after a season of obstacles and disappointments.

But, how do we stay committed to our goals when 80% of new year’s resolutions fail and don’t see the daylight of February? 

A resolution or goal is often what you hope or wish for. A common example: “I’m going to lose 20 pounds by my spring break trip in March.” According to goal-setting criteria, this goal seems to meet the SMART criteria:
S – specific
M – measurable
A – achievable
R – realistic
T – timely
So….we are good to go – right?  

You could define a goal, “I’m going to make a million dollars by the end of 2018” but how will you make this happen, and is it realistic? 

The SMART criteria may be an important place to start and definitely better than “I’m going to lose weight.” However, how are you going to achieve your goal? Is it realistic? When it comes to weight loss, there are many reasons it may not be, including the misunderstood calorie equation that “eat less and exercise more = weight loss.” (This topic coming soon – so stay tuned!)  

So what else do you need to do to stay committed and successful with your resolutions this year? 

After carefully setting your new goal, consider the following 3 steps to help you stay committed and successful.

1. What is motivating you…and what will potentially get in the way of success?
We all want to be healthier, but why? Even the most tenacious individual will cave in to old behaviors or temptations if they’re trying to change for someone else – diet because your friend is; get thinner for a spouse or because society says so; exercise because you’re supposed to.

Question on a forkTo get motivated in a healthy way, it’s helpful to dig in and ask yourself a series of questions to understand what your true hopes, desires and intentions are.  These questions may seem challenging and time consuming at first, but allow yourself some space to reflect or even meditate about your thoughts.

What are your long term goal(s) for your relationship with food, exercise and overall health?

If you have listed more than one goal, pick the one that you would most like to tackle first.

List the three things in your life that are most important to you.

 

How would making this change improve your ability to nurture these three things?

Take either yesterday or today as an example.  How would your day have gone differently if you would have already made the change that you are currently contemplating?

What are you most afraid of as you embark on this new journey?

What could you do to prevent these fears from becoming a reality?

Which of these changes do you think you will find the easiest to achieve, and which will rank as the hardest?

List five ways that you could keep yourself motivated on especially hard days.

2. Start small. Define 2 to 4 specific behaviors you can change or do to help you achieve your goal. For example, if my well-defined “SMART” goal was to “increase revenue by 30% by the end of 2018”, I would need to change some behaviors or do some specific actions to make this happen. 

There are many ways to get started with your health goals. Making behavior change with food and eating to achieve your goals takes practice, patience…and time. But, as the saying goes, “If you change nothing, nothing will change”, so even the smallest change will move you toward your goal.

Simple examples of where you might start include the following:
• Increase my daily water intake
• Decrease my intake of “energy dense” fluids, i.e. soda, sweetened coffee beverages, energy drinks, alcoholic beverages
• Eat 3 meals daily
• Work with a dietitian to establish a meal plan to eat more balanced meals and snacks
• Reduce in-between meal snacks when I’m not hungry
• Increase awareness of pace when eating and eat more slowly
• Journal food intake and/or food and feelings or food and symptoms, i.e. low energy Etc…

If you tend to skip breakfast, skimp on lunch and overeat the rest of the day, then the behavior of “Eat 3 meals daily” might be most helpful. To follow-through on this specific behavior, a few steps to consider to ensure success include:
1. Review a list of nutrient dense foods and highlight or make a list of enjoyable foods or foods you can tolerate or will eat. (this is something I provide my clients)
2. Make a list of 2 breakfast ideas, 3 lunch ideas and 4 evening meals that you commonly eat or typically enjoy.
3. Use the meal ideas and/or eating plan (provided by a dietitian) to balance out each of these meals, i.e. if Spaghetti and meat balls is a family favorite; add a tossed salad or favorite vegetable and glass of milk or water.
4. Now do some meal planning for the week. Based on your schedule, when will each of these meals fit into your week?
5. After you’ve made a plan, assemble a grocery list by checking to see what you have on hand and what you need to get from the supermarket. Then, go shopping!
6. Work with a dietitian to learn what an appropriate portion or serving of each of these meals would be and begin to notice your hunger and fullness cues at each eating event. 

3. Get support. Who will you call for support when you are having a tough time sticking to your plan? Do you need any resources to make this time easier for you? 

Examples might include: a daily check-in’s and emotional support from provider, motivational book, gym membership or even something like vegetable steamer, electronic health monitor (FitBit, Jawbone, etc.).

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Finally, remember you can do this! If 20% of individuals who set goals and resolutions are successful, then you can too. The keys to success depend on your motivation to change; setting realistic and achievable steps/objectives that get you to your goal; and, getting support that makes sense for your lifestyle and goals. 

Whatever your goal or how you decide to begin, there are many resources and tools to support you and keep you on track as you work on your goals. Don’t forget, your dietitian is here to guide you in making decisions about what will work best for you and help you be successful, so don’t hesitate to reach out!

To success and wellness in 2018!
Val Schonberg
val@enlightenUnutrition.com
 

 

 

 


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

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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!

 


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Food Rules: What are the Costs?

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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.


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Which is Best for Weight Loss – Exercise or Nutrition?

if you work out you can look like thisWe 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.


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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…

Plastic surgery concept. Doctor hands in gloves touching woman face

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.

shutterstock_perfect body“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!

shutterstock_woman on bike

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!

shutterstock_woman preparing lunch

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.)

shutterstock_fruit and veggies

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!

shutterstock_life liberty and happiness


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“Evidence-Based” Diets: Sound Science or Practically Impractical

shutterstock_fasting dietTrue or False: Popular Diets (such as Paleo, Atkins/Low carb, and Intermittent Fasting) are all based on evidence-based research.

The answer is TRUE!  There really is some interesting research that demonstrates how each of these nutrition interventions can result in weight loss, fat loss and even improved health and cognitive functioning.

But, does that mean these diets should get a “seal of approval” as an appropriate intervention for weight loss or achieving optimal health?  Let’s chat about that…

Recently I watched a TED Talk by the Chief of the Laboratory of Neuroscience at the National Institute on Aging, Mark Mattson. He is also a professor of Neuroscience at The Johns Hopkins University and a leading researcher in understanding the mechanisms behind neurogenerative disorders, such as Parkinson’s and Alzheimer’s disease. Mark and his team from John Hopkins have published several papers that discuss how fasting twice a week could lower the risk of developing these types of neurogenerative diseases.

Pretty impressive, right? I mean that’s a big deal!

Then, there’s The Paleo diet, based on years of research conducted by Loren Cordain, PhD who bases his nutrition recommendations on the premise that there are some fundamental characteristics of our hunter-gatherer ancestors that will “optimize your health, minimize your risk of chronic disease and lose weight.”

I’ve also been learning more about the research behind Intermittent or Alternate Day Fasting (restricting intake to no more than 500 calories every other day) and the significant effect it can have on weight loss and other markers of health. Some of the most notable work on this approach has been done by research from the University of Illinois in Chicago.   And, of course documented in the popular book, The Every-Other-Day Diet: The Diet That Lets You Eat All You Want (Half the Time) and Keep the Weight Off.

What a great idea! Pretty much every individual I work with – midlife female, recreational or competitive athlete, professional dancer, or disordered eater – would like to optimize their health, lower their risk of chronic disease, most desire to lose weight, and would prefer the option of being able to “eat all you want” – even if it is only half the time.

And, of course, there’s all the latest research coming from the labs of Dr. Stephen Phinney, MD, PhD and Dr. Jeff Volek, PhD, RD about the “Art and Science of Low Carb Diets.”

Well, if you know me, you know that I LOVE science and am fascinated by research. I’m constantly digging into the latest literature in popular scientific journals or looking up supporting research on Pubmed about various topics in nutrition and beyond.

My question is always, “Why?”…Why do things work the way they do? Why are midlife women gaining weight when seemingly nothing else has changed? Why do some athletes perform better than others? Why doesn’t energy in = energy out for most of my clients?

Ultimately, I want to know: “What’s the best solution to the problem?” and “What will be the most effective nutrition intervention for my client?”  

So inherently research should be able to give us the answer – right?  Well, not entirely. Yes, we learn a lot from this research and the science can be extremely fascinating, but there are a number of problems with these diets that potentially cause more problems than what the dieter started with.

The use of evidence based medicine is important in any clinical practice – including nutrition. However, after working with 100’s of individuals who have gained and lost hundreds of pounds from these “evidence based” diets; who often know enough about nutrition to have a degree themselves; and who ultimately continue to struggle with food, eating and weight, I’ve learned that clinical judgement and practical application are critical to an appropriate and effective nutrition recommendation.

And, as obvious as that may seem, it’s very interesting how often folks (including well-meaning researchers and providers) get enthralled with the “science” and seem to miss asking an important question of “how will this recommendation work out in the long run for this individual?” and ultimately whether the application of this “science” is even practical.

Remember:  Clinical judgement is something you don’t learn in school, from an online course, or from reading Pubmed articles. It is something you learn in practice!

In fact, we are reminded in an editorial about Evidence Based Medicine: What it is and What it Isn’t, that “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”  In other words, it’s important that researchers and clinicians work together to develop realistic, practical and do-able approaches to health and well-being.

As an illustration of this point, let’s take a look at just 5 reasons why it might be “practically impractical” to use an intervention like Intermittent or Alternate Day Fasting.

Problem #1:  This is not normal eating. Rigid diets that rely on counting and restricting calories is just plain and simple disordered eating. At the very least, the majority of dieters will not be able to sustain this plan for the rest of their life (ultimately sustainability is important, right?). Many will likely suffer guilt and shame when they go over their 500-calorie limit; and consequently continue the cycle of dieting that, research has demonstrated, leads to even more weight gain, depression and a worsened health condition. There’s a lot more we could say about this point, but hopefully you get the gist.

Problem #2: How do you sustain your mental stamina, focus and not suffer from dizziness on a 500-calorie day?  The researchers state that your body “gets used to it” and you aren’t hungry on the fasting days. In a study published in the Journal of Nutrition looking at the  effect of alternate day fasting (ADF) on disordered eating behaviors, researchers noted that “Subjects undergoing ADF experienced mild gastrointestinal issues, occasional problems with staying asleep, and minor dizziness/weakness.” Bad breath seemed to be the most annoying symptom to which it was recommended for dieters to chew sugar-free gum in between meals. It’s also important to note that 20% of the study subjects dropped over the course of the 8-week study.

I just want to stop for a moment and remind the reader that tax payer dollars from the National Institute of Health are funding much of this research as an effort to “improve our health.”

Problem #3: How can an individual participate in stress-relieving, mood-stabilizing exercise on a regular basis, especially on a 500-calorie day? Researchers have a recommendation for that too. They suggest that the dieter get exercise or activity out of the way in the morning on the fasting days. What if you are an afternoon or evening exerciser – because of work, responsibilities, or that’s just what you prefer? Also, I’m a pretty active person who enjoys my exercise in the morning, but then I might also work in the yard for a few hours after lunch or I stay active running from appointment to appointment. It’s not an option for me to just “plop” for the rest of the day – nor do I want to or recommend as a solution!

Problem #4:  How does the dieter manage social events on the 500-calorie day? I’m guessing that if you tried to implement this plan consistently; at one time or another, you are going to have an event with food like a grad party, wedding, birthday party, work event, gala, etc on the calorie-restricted day. Are you just supposed to abstain from eating at these events? If the answer is yes, that’s unfortunate. And, if you decide to throw in an exception here or there, how’s that going to work in the long run? I know for most of my clients who are trying to make behavior change, not learning how to navigate these kind of events is many times the reason for sliding into old behaviors.

Problem #5: Eating doesn’t need to be this difficult. In a small, non-scientific survey I completed with a number of individuals of various ages, not one person thought they could (or would want to) implement this diet consistently. A common response was that it “sounded like a lot to think about” and they “weren’t sure they could keep the days that organized”.  I have plenty of clients who are just fine with the feeling of control they get from counting calories, but even these folks admit it’s distracting and a very compulsive and obsessive behavior, and frankly would rather not to have all those numbers in their head.

I’m completely aware that there is always the possibility that none of these scenarios would pose a “problem” for you. If that’s the case, and this sounds like a useful approach for managing food, eating and weight, then it may certainly be an option.

Ultimately, the decision about what nutrition intervention would be best for an individual hoping to lose weight, optimize their health and decrease their risk of chronic disease needs to be a collaborative effort between the health care provider and patient.

Being fascinated by science is a cool thing. And, providing sound, evidence-based nutrition recommendations is an important principle in any practice. But, science alone should NOT become a replacement for critical thinking and experienced clinical judgment about what is appropriate for each and every individual client or patient.