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    Archive for the ‘behavioral modification’ Category

    Guest Post: Give Your Goal Setting a Makeover by Asking the Right Questions!

    reduced author photoAs a coach, many folks come to me for support in reaching their goals.  Sometimes they are related to career. Other times, goals reference money, relationships, health and wellness, or are tied to multiple life spheres. I typically find that irrespective of the focus of the goal, goal setters usually come to me frustrated. What they have been doing hasn’t been working, and despite how important the goal is, they are ready to bang their heads against the proverbial wall.

    Continue Reading »


    Three Things You Can Do Today To Improve Your Dietary Habits

    to-do-list-croppedOverhauling dietary habits often takes years.  Although there are always exceptions to the rule, the journey from point A to point B requires time and gradual steps.

    Too often, I find that people talk about dietary habits as one big issue to unravel, as opposed to several interlaced factors that can be handled individually.

    I often employ the analogy of a tangled ball of yarn.  The only way to untangle it is to first loosen one thread, then another, and then another until the insurmountable knot disappears.

    If the concept of healthier eating appeals to you, but you have no idea where to start — or what to do — consider these three steps you can take today.

    • Cut down your sugar intake.  The average American adult consumes 22 teaspoons of sugar a day.  That’s approximately fourteen more teaspoons than what is recommended as a daily limit by the American Heart Association.  Start training your palate to get used to lower amounts of sugar by making small cutbacks today.  Usually add three packets of sugar to your morning coffee?  Try it with two.  Normally drink a 20-ounce bottle of soda with lunch?  Opt for a 12-ounce can.  Two weeks after implementing these changes, make a few more subtle cutbacks.
    • Set up a fruit bowl at home. One of the easiest ways to make sure you’re eating the recommended two servings of fruit every day is to have it readily available.  Sticking an apple in the back of your refrigerator’s fruit-and-vegetable drawer serves no purpose.  Place the fruit bowl in whichever room of the house you spend the most time in, and fill it with fruits you like.  If the only fruits you like are Granny Smith apples and grapes, so be it.
    • Stock up your desk drawers. Say farewell to the vending machine.  Next time you’re at the grocery store, stock up on healthful, work-friendly foods.  Some suggestions: nuts and seeds, 100% whole grain crackers, unsweetened dried fruit, 100-calorie bags of popcorn, and truly good-for-you bars like Lara, Clif Nectar, and Kashi Tasty Little Crunchies.

    Give yourself two to three weeks to get used to these changes, and then see how you can gradually build your way up to better health.


    You Ask, I Answer: Dealing With A Sweet Tooth

    NV977_Brownies_CookiesI have a HUGE sweet tooth.

    I tend to like things like brownies, cookies, candy, etc. I also like to bake a lot, which is a large part of the problem.

    It’s really hard for me to limit my intake of unhealthy sweet foods, though I would really like to make an effort to.

    Do you have any tips?

    — Christine Ho
    (Location Unknown)

    There are certainly a few different strategies you could employ.

    First off — keep your weaknesses in mind (we all have them, by the way!).

    By that I mean: if having baked goods at home makes it difficult for you to control your intake of sweets, don’t have them readily available.

    That is not to say you can not bake (especially since it’s an activity you enjoy).  However, you could always make a batch of cookies, keep two or three for you and then gift the rest to friends, family, neighbors, and/or co-workers.

    Another alternative?  Seek healthier recipes.

    No, that does not mean Splenda-spiked cookies or muffins with fat-free Frankenbutter.

    However, consider this simple and delectable chocolate truffle recipe that delivers a good amount of fiber, protein, and healthy fats.

    When you get a craving for unhealthy sweet foods, think about what the craving is really for.

    Is it for chocolate?  If so, instead of a highly caloric muffin or brownie, try an ounce of rich, dark chocolate (I love 85% cocoa chocolate bars because a small amount completely satisfies my sweet tooth!).

    Or, make a quick and healthy chocolate milk.  In a blender, combine your milk of choice (dairy, soy, hemp, almond, etc.) with a tablespoon of unsweetened cocoa powder, a pinch of salt, ice, and some vanilla extract.

    If it’s for peanut butter, make a smoothie with bananas and add a tablespoon of peanut butter.  Or, add sliced bananas to a peanut butter sandwich.

    Similarly, try incorporating some sweetness into healthier foods.  For example, add a tablespoon of chocolate chips to an all-nut trail mix, or ripe sliced pears to a salad.

    These kinds of dietary changes take some time, so approach it slowly and realistically.

    Most importantly, don’t ever completely deny yourself a food you like.  There are days when the only thing that will satisfy a craving for a decadent brownie is a decadent brownie.  That’s fine — simply be mindful of how much you eat and, above all, enjoy and savor it!


    Speaking With…: Brian Wansink

    This past Friday, Cornell University John Dyson Professor of Consumer Behavior and director of the Cornell Food and Brand Laboratory Dr. Brian Wansink stopped by New York University after being tapped as the second featured speaker of a new lecture series on nutrition and chronic disease.

    Taking off from his bestseller Mindless Eating, the talk was appropriately titled, “How To Turn Mindless Eating Into Healthy Eating.”

    With those prevously mentioned credentials, you might picture a stiff, “all business” type who solves complex equations in his head while half-listening to you.

    Dr. Wansink, however, is reminiscent of the cool high school math teacher who wanted you to learn — and have fun while doing so. His research explanations are peppered with personal anecdotes, comedy, and facial expressions that sometimes rival those of Jim Carrey.

    A few hours before his afternoon presentation, I sat down with Dr. Wansink for a one-on-one interview.

    If you are unfamiliar with Dr. Wansink’s work, please click here to familiarize yourself with his research before reading the interview.

    I get such a kick out of all your publicity shots for Mindless Eating [NOTE: see accompanying picture]. They’re great! Have they all been photographers’ ideas?

    Ha! Thanks. Yeah, I’ve had some really creative photographers who set up these elaborate shoots. Some of those popcorn shots literally took twelve hours, from setup to cleanup. There was a LOT of popcorn all over the floor at the end that had to be cleaned up (laughs).

    So, I recently read that all of this research started as a result of you wanting people in the United States to eat more vegetables.

    That’s right.

    How did you go from that to your current line of research?

    Yeah, before I started my dissertation [in the late 80s], I wanted to know: “why do you finish your vegetables sometimes and other times you leave them on your plate?”. “Why are you hungry for them one night and not the next?” That then evolved into the idea of environmental factors that affect our overall eating patterns. It’s a lot more complex than people think because so many of our eating behaviors are automatic. This is all about getting below that surface. One of my first research studies had to do with family serving behavior. We had people come in, eat, and then answer questions about what they ate.

    Then, we showed them video footage of their meal. It is amazing how many people flat out deny, or are not aware of, their eating behavior. You’ll say to someone, “you had three servings of peas.” They’ll tell you, “No, I only had one!” You feel like saying, “Well, unless you have an evil twin…”

    It’s not until you show them the videotape that they change their mind. I once had a woman cry when she saw herself eating on camera! My research considers three angles. Not only what people are eating and how much of it, but also with what frequency.

    How did all that research turn into Mindless Eating?

    In 2004, I was in France and thought to myself, “I’d like to write a book, but I don’t know if I want it to be academic or pop.”

    That year, Bonnie Liebman of the Center for Science in the Public Interest interviewed me for their Nutrition Action newsletter, and suddenly a lot of requests for book deal started coming in. Most of them were e-mails and, I don’t know, nothing really stood out. Then I got a letter — an actual letter! — from Bantam Dell Books. One of the things I liked about them is that, as they told me, they are in the business of creating “real books that people read.”

    Interesting you say that, because I think that’s definitely one of the factors behind the popularity of Mindless Eating. It is relatable for and interesting to the average consumer.

    So at this point, it’s been a few years since the book came out. I was wondering about recent developments. For example, have you conducted any research on the effects of calorie postings in fast food restaurants?

    Oh yeah, I was involved in a VERY well-done study with Carnegie Mellon in regards to calorie labeling. We looked at McDonald’s, Subway, and Starbucks in terms of what consumers were buying before and after calories went up. And, you know what? The results were indeterminate. They were all over the board. Some people consumed fewer calories, others didn’t. I would actually be suspicious of anyone who told you they have seen a dramatic effect as a result of calorie labeling.

    That strikes me as really odd. What are your theories regarding the results of that study?

    There’s a few things to consider. First of all, when it comes to weight loss, a lot of people think: Yeah, I wouldn’t mind losing ten pounds, but I don’t want to change a thing.” Then there’s reactance, which is a psychological term. It’s basically resistance. Reactance is at play when you’re in your car and the person behind you honks so you pull away more slowly than you would otherwise.

    (Laughs) Or when you know someone at a restaurant is waiting for your table, so you sit there and take a little longer.

    Yeah. So I think, in a way, some people are seeing these calories and thinking, “Oh yeah? Well, you’re not going to tell ME what to eat!” Something similar happened in a study I did with Cornell. So, Cornell has a huge dining hall that services about 1100 people at one time. I wanted to see what effect going tray-less would have. I thought it would have two positive effects — it would result in reduced waste and reduced calories.

    The idea being that people couldn’t pile everything on at once but instead had to get up from their table each time they wanted more food?

    Yeah, exactly. Well, the results came in, and that night there was roughly 30 percent MORE plate waste! I think it comes back to that idea of reactance, where people saw this and thought, “Fine, I won’t use a tray, but I’m not going to eat less.” “font-style:italic;”>But that’s not to say that I think calorie labeling isn’t useful. Let me tell you something. The other day I went to Sbarro and saw that the slice of pizza I wanted was 787 calories. Aaaaaaaah!! So I think these calorie postings are going to serve as incentives for these food companies to say, “Alright, wait a minute, I want to turn that 787 into 690.” I think it’s going to nudge companies to drop the numbers, and that’s what will, in turn, affect consumers.

    Speaking of consumers, you recently finished your one-year post with the United States Department of Agriculture’s Center for Nutrition Policy and Promotion working on the Dietary Gudelines. How did that go?

    Oh, it was great! I thought I was on a mission from God! My last day was January 20, when the new president took office. I was literally sending e-mails at 11:59 PM on January 19. I was still e-mailing at 12:05 AM on January 20, and I remember thinking “Wow, they didn’t shut off my inbox!” Then I got up to grab something to eat, and about ten minutes later I came back and I no longer had access.

    Any sneak peeks as to possible changes we may expect in the next round of Dietary Guidelines?

    I was involved with the selection of the 13 Dietary Guidelines committee members, and 11 of them have a behavioral focus. They operate where the rubber meets the road. That’s important, because they take pages upon pages of data and transform it into information for the masses that can be summarized in just a few sentences.

    So to wrap up, I’m interested in hearing about research you are in the process of conducting now.

    Oh yeah, sure. Well, we’re looking at what happens to people’s eating behaviors when they sit next to someone who has a much higher BMI than they do. We are also doing a study where we have someone wearing a fat suit and going through one side of a buffet very slowly, serving themselves a lot of food. Everyone on the other side of the salad bar takes a much lower amount of food compared to when that person is going through the salad bar without the fat suit on. It’s the whole concept of mimicking the attractive person. It’s terrible, because weight is the last acceptable prejudice in our society and it can really be crippling to a person’s self-esteem.

    Lately, the concept of “nature vs. nurture” has become central to the issue of childhood obesity. Do you have any thoughts on that from a behavioral standpoint?

    Well, we conducted a study with 4 year olds. We gave all the kids a questionnaire to take home. The point of the questionnaire was to determine to what extent parents forced their kids to eat everything that was on their plate. Of course, we disguised those questions among lots of filler like “what is your favorite TV show?”

    “What color are your curtains?”, etc.

    (Laughs) Exactly. So the parents, on a scale of one to nine, had to rate just how heavily they enforced “the clean plate club” at home. So, you know, nine was “my kids HAVE to finish everything on their plate or there is some kind of consequence” and one was “Ah, if they eat, they eat. If they don’t, they don’t.” We discovered that the children whose parents insisted they finish everything on their plate served themselves approximately 40 percent more cereal in our study.

    Wow! And based on what you talk about in Mindless Eating… the idea that, once food is in front of us, it is very easy to eat it all, that’s a significant finding.

    Yeah, the thinking is that children who are forced to clean their plate feel like the have no control when it comes to food, so they find ways to reassert their control and independence.

    Well, it looks like we’ve actually gone over time, but this has been fascinating. It’s been a pleasure speaking with you. Thank you!

    Oh, absolutely. Thank you and best of luck with everything.

    Many thanks to Dr. Wansink for his time!


    Takeaways from Brian Wansink

    I am in the process of transcribing the enthralling interview I conducted with Mindless Eating author Brian Wansink this past Friday morning.

    In the meantime, I want to share a little bit of what Dr. Wansink presented later in the afternoon when he addressed 150 New York University students and faculty members about details of his research.

    His talk, titled “How To Turn Mindless Eating Into Healthy Eating,” encouraged professionals in the nutrition field to shake up the traditional research model that commences in isolation in a laboratory and instead begin by thinking about human application first (rather than leaving it for last).

    It is precisely this alternative research model that led Dr. Wansink to become a pioneer in the science of consumer behavior as it relates to diet and nutrition.

    One of the most important phenomena he encountered during his research was the ripple effect one small change can have on individuals.

    In one recent study, Dr. Wansink and his team recruited individuals to take on one small nutrition-related change — such as eating on smaller plates or not eating in front of the television — for 90 days.

    While collecting data, Dr. Wansink observed that the vast majority of these people (roughly 70 percent) were losing weight in increasing amounts each month. Weight loss was not occurring at a steady rate, but actually doubling — and even quadrupling — in many instances.

    What was happening? Was the “small plate” group shrinking plate size even more? No — they simply began to implement more changes when they saw how painless their first behavioral modification was!

    A month into eating from smaller plates (and, therefore, almost mindlessly consuming less food), most of that cohort noticed the accompanying weight loss and thought, “Hey, this is painless! I’ll keep doing this AND cut down my soda consumption.”

    As a result, Dr. Wansink has seen many individuals lose up to thirty pounds in the course of one year without ever feeling like they had “started a diet” or “sacrificed everything.”

    Stop by tomorrow to read my full interview with Dr. Wansink!


    In The News: Holiday Eating

    Last Friday I was interviewed for this Reuters piece on holiday eating.

    I spoke with reporter Terri Coles about common traps people fall into during this high-caloric time where food is plentiful.

    We also spoke about helpful behavioral modification tips readers can implement to enjoy holiday meals without morning-after regret.



    You Ask, I Answer: Friend’s Weight Loss

    I have a question concerning my friend’s health.

    He is an obese 34 year-old man with a thyroid problem (which slows down his metabolism).

    As far as I know, he eats very little throughout the day, and what he eats consists mainly of hamburgers, beef, pizza, etc. He does not — and will not — eat vegetables, and his taste for fruits is very limited.

    He does not eat chicken or seafood either. He also skips breakfast every morning, and does not take vitamin supplements.

    I’m really concerned about his healthy but can’t seem to sway him to eat better.

    What are the risks he’s up against with his health if he continues to eat like this?

    What kind of eating plan would you advise he go on? Should he be eating more food in a day, but with fewer calories and in smaller quantities?

    I feel like the food he is eating isn’t getting properly broken down because of the lack of other foods in his diet. Is that true?

    — Kara (last name withheld)
    St, Louis, MO

    There are many things worth covering here, so let’s take everything in order.

    Your friend is certainly in a fragile situation.

    The few statistics you provide (thyroid issues, obesity) as well as your observations of his eating habits (a diet lacking fruits, vegetables, and, I’m assuming, whole grains) paint quite a bleak picture.

    I find it interesting that you are curious to know what negative health effects this may have on him, because I have a feeling he is already experiencing some of them.

    I am sure he feels short of breath when exerting the slightest bit of physical activity, experiences pain in his knees, and may even have sleep apnea (a potentially fatal condition in which people stop breathing for short periods of time in their sleep.)

    The examples mentioned above give us a clue of what is happening to some of your friend’s organs (i.e.: the heart may be working overtime, and joints can have too much pressure put on them.)

    Although the human body is very resistant, years and decades of these conditions really run it ragged, and “system malfunctions” (or meltdowns) can begin to happen.

    A heart that is put through the wringer every day for 10 or 15 years is not a healthy heart. Although your friend may be 34 years old chronologically, his organs very likely resemble that of an older person (depending on how long he has been obese.)

    You mention not being able to sway him to eat better, and it appears you aren’t too sure why.

    I’d like you to go back and re-read the questions you sent me. Pay attention to the feelings they conjure up.

    Perhaps you feel overwhelmed, not knowing where to start with your friend. Or hopeless that it will be hard to break this behavioral mold. You might even feel like whatever the “solution” is, it will be one that will take a lot of time, effort, and patience.

    I ask you to think about this because the thoughts and feelings that come to your mind will very likely reflect what your friend is feeling about all of this.

    A lot of tweaking needs to happen here — eating more small frequent meals, consuming more fruits and vegetables, cutting back on calories, increasing physical activity… I could go on.

    Believe it or not, though, that isn’t really the issue right now.

    Why? Because, most likely, your friend is already aware that some changes need to happen.

    The issue here is what is keeping your friend repeating behavioral eating patterns that keep him at an unhealthy weight.

    I am willing to bet that he either doesn’t know where to start, or the entire concept of eating healthy and losing weight is so overwhelming that the mere thought of it makes him want to forget the whole thing.

    It isn’t uncommon to contemplate a “can of worms” scenario like this one and be at a complete loss as to which particular worm to untangle first.

    All change, no matter how small, is difficult.

    I can’t provide an eating plan without knowing his medical history, food preferences, and bloodwork numbers, but here is what I suggest you do:

    Once, and only once, sit down with your friend and thoroughly explain your concerns to him.

    Let him know you are concerned about his weight from a health perspective, and ask him what his feelings and thoughts are on the matter.

    Be mindful, though, to stay away from tips, suggestions, or recommendations about what he should or should not eat. The point of this conversation is not to tell him what saturated fat does to the body or which diet book he should read.

    Simply recommend to him that, if his insurance covers it, he has the option of meeting with a Registered Dietitian, a trained professional who will work WITH him one-on-one to achieve whatever his goal may be.

    Once this conversation is done, you have to make a promise to yourself to let the issue go.

    That, my dear Kara, is really all you can do. Until your friend is ready to make a change, there is very little you can do.

    Lastly, your question about whether the food he is eating is being broken down properly even though his diet isn’t balanced? The answer is yes.

    The human digestive system breaks down all foods, regardless of how healthy — or unhealthy — they are.


    Survey Results: Hunger & Satiety

    The latest Small Bites survey dealt with the issues of physical vs. emotional hunger as well as recognizing satiety (a healthy feeling of fullness.)

    The results were pretty evenly spread out:

    Very well, always: 5%
    Very well, most of the time: 35%
    Somewhat well: 34%
    Not well at all: 24%

    I find this to usually be the most difficult hurdle for many people to jump over in their quest to achieve their healthy eating goals.

    After all, you can have the healthiest diet in the world (meaning, full of nutritious foods) but if your hunger and satiety recognition mechanisms are off, you can still end up overconsuming calories and gaining weight.

    These behaviors — and, in many cases, patterns — can be very frustrating to change largely because they stem from years of conditioning.

    I think a variety of factors can make it challenging for people to recognize their hunger level.

    For one, too many people assign themselves strict eating times.

    They may be hungry at 11 AM (say, two and a half hours after breakfast) but if they are meeting a friend for lunch at noon, they think, “Ah, might as well hold out. Don’t want to ruin my appetite!”

    WRONG! Part of being an active participant the hunger game is listening to your body’s cues.

    If your body is demanding a few nibbles at 11 AM, go ahead and provide them.

    This is not to say you now have a pass to eat two Entenmann’s donuts or half a stack of Pringles.

    However, if your next meal is in an hour, keep hunger at bay by snacking on an ounce of nuts (remember, an ounce is approximately 24 almonds – quite a bit!)

    Those 140 calories will keep you satisfied until lunch, making it easier to have one roll, rather than three, from the bread basket.

    What if the snack fills you up more than you think, and by the time you meet your friend you are only hungry enough for an appetizer? Then simply order an appetizer.

    Don’t order an entree just because your friend does and, well, you don’t want to “make her look bad” or “insult him.”

    Sharing lunch with a friend is about communication, catching up, and enjoying yourself. THAT should be your focus. Not second guessing yourself or putting your needs aside just to “look” good.

    The worst thing you can do is ignore your hunger. The trick is to feed your body foods that are filling and satisfying without breaking the caloric bank.

    A srerving of whole grain crackers, for instance, is a great way to give your body a little something in a 120 calorie package.

    Similarly, a piece of fruit or some baby carrots with hummus can help keep hunger at bay so you don’t have that insatiable need to devour something — ANYTHING! — on your way home from work later that afternoon.

    It is quite a simple formula. The more you ignore your hunger, the more likely you are to overeat and go past your satiety point.

    You can’t expect yourself to recognize a healthy feeling of fullness if you are absolutely starving!

    Another trap for many people? The idea that in certain locations — and situations — you must eat.

    Answer the following:

    How many of you eat a slice of cake at someone’s birthday party at your place of work simply because cake slices are being passed around, regardless of your hunger level?

    I know I have done it before. I distinctly remember a time when I had just finished a very filling lunch and stopped by a co-worker’s going away party.

    Whoever organized the food had gone all out. Cake, cookies, brownies, chips and salsa… it was all there.

    Sure enough, about five minutes after I arrived, the cake was cut, someone handed me a piece, and I dug right in.

    It was actually a little dry, and the frosting tasted like chemicals. After the third or fourth bite, I felt uncomfortably full — and dissatisfied!

    It suddenly hit me. I wasn’t having cake because I truly wanted some, or because I enjoyed the taste. I was having it because somewhere in my mind I thought I was “supposed” to.

    I still remember that event pretty vividly to this day because it truly gave me a different perspective on my relationship with food.

    Now, in social situations, I don’t think about what I “should” be doing or even what everyone else is doing. I simply ask myself: would I be eating RIGHT NOW if I wasn’t in this situation?

    Sometimes the answer is “yes,” but a lot of other times it’s “no.” And if someone asks why I’m not having a slice of cake or one of the catered sandwiches, I reply with the truth, “I’m not hungry right now, thank you.”

    And then there’s the movie theater. Sometimes I’ll snack on some whole wheat crackers and some trail mix (yes, I sneak food in — so sue me!). Other times, though, all I need is a beverage to quench my thirst.

    A few years ago, though, my mind always equated movie watching with popcorn, pretzels, malt balls, and soda.

    This is not to say you can’t enjoy some popcorn or share a chocolate bar with your movie companion next time you hit the multiplex, but the key is in doing that out of actual physical hunger, rather than some ingrained mandate that advertisers have lodged into our minds.

    These check-ins with yourself might initially seem odd and different. In a society so obsessed with consumption, we generally don’t hear the “Ask yourself — why am I craving this right now?” message.

    Once you develop it into a daily habit, though, you have quite a powerful tool in your hand.

    PS: I’ll discuss emotional eating in a future post (later this week.)


    In The News: Battling With Leptin

    The Wall Street Journal is reporting the findings of a recent Columbia University Medical Center brain scan study which found that “when humans (and rodents) lose 10% or more of their body weight, [a hormone known as] leptin falls rapidly and sets off a cascade of physiological changes that act to put weight back on. Skeletal muscles work more efficiently, thyroid and other hormones are reduced — all so the body burns 15% to 20% fewer calories, enough to put back 25 pounds or more a year.”

    This partially helps to explain why crash diets never work long-term. They are such a sudden shock to the body that our metabolism starts working against – rather than with – the weight loss.

    This also makes the case for long-term approaches to weight loss that implement behavior modification and a slow but steady overhaul of eating habits and dietary patterns.

    The important of physical activity is also front and center here, since all forms — and especially weight-bearing exercises — prevent basal metabolic rate from slowing down.

    As lead author Michael Rosenbaum states, “Anybody who has lost weight and kept it off will tell you that they have to keep battling. They have essentially reinvented themselves.”

    Thank you to Fred Tripp for forwarding me this article.


    Speaking With…: Milton Stokes

    Milton Stokes, MPH, RD, CDN is the owner of One Source Nutrition, offering a variety of private counseling and media consulting services.

    He is also an American Dietetic Association National Media Spokesperson who has been featured in a plethora of publications, including Self, Cooking Light, Men’s Health, Fitness, and the New York Daily News.

    I first met Mr. Stokes in January of 2007 when he served as an adjunct professor for New York University’s Department of Nutrition, Food Studies, and Public Health.

    He is an intelligent, sharp, and charismatic entrepreneur who is a wonderful asset to the field of nutrition and dietetics and communicates his nutrition knowledge in a most effective manner.

    On with the interview:

    What shifts, if any, have you noticed with your clients over the past decade? Is nutrition education really more widespread?

    Most people come to my office well-educated on nutrition and health.

    They develop admirable knowledge from websites, like anything associated with NIH.gov, and certain consumer publications, like Eating Well and Cooking Light. Clients know all about MyPyramid and reading food labels. So it’s not a knowledge gap.

    Instead, the problem is that gray area of disconnect, that missing spark to motivate clients to implement their knowledge.

    A lot of what we do in the practice is boost a client’s self-efficacy. We simply point out “You say you want to achieve health, but you continue with this behavior.”

    From there we proceed by encouraging them to start with a specific change today or this week. Showing clients we believe they can do it helps enhance their sense of self belief, which is what self efficacy is all about.

    What do you perceive as two of the most important behavioral modification changes people who are looking to lose weight can do?

    Step one is getting proof of what a client’s eating and drinking. Proof in the form of a simple food journal. It’s amazing what a difference seeing food consumption on paper really makes. Subtle, but significant, patterns start to emerge.

    Usually those patterns are enough to guide future work with the client. We work with eating disorders mostly, and as I said earlier, our patients are extremely educated in nutrition. But they do things, like sabotage themselves with unhealthy environments at home.

    Premium ice cream and other binge foods don’t crawl into the kitchen without help. With exercise, owning a treadmill is a good start, but you can’t use it as a wardrobe station in the basement. Take those clothes off of it–or whatever items reside there–and have it ready.

    This leads me to the next tip: plan. If you don’t plan to exercise, you probably won’t. Your sneakers and workout clothes won’t magically appear if you don’t take them out. Furthermore, take them with you in the morning. After work it’s a little easier to get to the gym when you don’t have to come home to change.

    Once home, it’s like pulling teeth to go back out. Home has dishes to be done, laundry to fold, mail to open, and so forth. Those are common distractions that become excuses. So I say bypass those and do the exercise first.

    Planning is applicable to food as well.

    Do most of your clients share a common obstacle/hurdle in reaching their health/nutrition/weight goals?

    We see mostly females in our practice. And the adult women tend to prioritize everything but their health.

    For one of many examples: They shop for food, they cook the food, and they clean up after it’s all over. I say, “Hold up, why can’t you farm out some of this work?” Give the list to your spouse; assign your 10-year-old the task of tearing lettuce for the salads and setting the table; each person clears his own dishes and loads the washer.

    That the woman has to do all this is really old fashioned. And it’s a common barrier to putting health first. If you aren’t healthy, how can you take care of your family?

    Finding ways to earn back 5 minutes here, 5 minutes there will add up. Soon you’re at 20 minutes, which is enough for a brisk walk and some alone time to clear your head.

    Are there two or three popular nutrition myths that most of your clients have interpreted as “truth”?

    Eating breakfast makes me gain weight.

    Stop eating after 6 pm or all the food turns to fat. But digested food isn’t like Cinderella’s carriage: at the stroke of midnight (or whatever time) it doesn’t turn into a pumpkin….or into fat.

    Holy grail of nutrition and feeding is some secret or mystical concoction. What’s the minute, teeny tiniest thing I’m missing to make me whole?

    Exogenous digestive enzymes….we would’ve died out ages ago.

    As a nutrition educator, are there certain inaccurate messages in the mainstream media regarding nutrition that especially frustrate you?

    In general, a lot of marketing jumps the gun on real benefits of specific nutrients or foods. This promotes adult food jags of sorts.

    One day dried plums or blueberries or tomatoes are the rage. The next, it’s some hideously bitter juice designed to extend life by 7 years.

    Then just a pill crammed with all the nutrition of 10 fruits and vegetables. There is no secret or miracle to losing weight or preventing disease. Eating real food does the trick–but that message isn’t sexy or provocative or profitable.

    Having said that, let me also pause to recognize the work of researchers.

    Nutrition is an evolving science, so what we know today may change tomorrow as research is completed. And that’s okay. There’s nothing wrong with continuing to pursue new findings.

    I do wonder, though, what would become of human health if we diverted some of those research dollars to subsidize fruits, vegetables and whole grains? We know that eating this way works. Do we need more research, or can we go ahead and pay farmers with research dollars to deliver their products to all neighborhoods?

    People could go to market several times a week, or whenever, and stock up. Farmers could be paid to go door-to-door. Consumers wouldn’t pay a thing.

    What particular direction would you like the nutrition field to embark in over the next 10 – 15 years?

    Stop putting everything under a therapeutic microscope.

    Stop hanging on the latest research finding that says a certain micronutrient might do this or might do that. Nobody eats solo nutritients. Clients tire themselves by getting carried away over headlines without understanding the full scope of the study.

    Studies isolate single nutrients without considering synergy or total nutrient packages in whole food. This relates to what we talked about earlier: the message to eat more fruits and vegetables isn’t glamorous or trendy.

    I am concerned with incessant food scares over pathogens and improper food handling.

    I’d like to see nutrition researchers partnering with sleep experts. Who isn’t sleep deprived? Without enough sleep we know it’s quite difficult to lose weight, and you’re more likely to reward yourself with high-carbohydrate foods as way to feel better.

    Vitamin D [is another subject that we need to look into further].

    I might get in trouble for this, but we may have missed out on the opportunity to consider low-carb diets. First of all, I believe no single diet fits every person. I also believe low-fat isn’t necessarily top dog.

    Researchers, like Jeff Volek, have shown low-carb diets promote fat loss, preserve lean muscle mass, and improve lipid profiles. Am I saying we all need to eat low-carb? No. But we could let the scientific process show us what low-carb eating can do.

    * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
    A huge thank you to Milton for participating in this interview.

    If you enjoyed this interview, be sure to visit his new blog for more information and tips.


    In The News: The McDonald’s "Diet"

    In case you haven’t heard, a Virginia man named Chris Coleson lost 70 pounds in 6 months eating nothing but McDonald’s.

    For whatever reason, several media outlets are having a field day with this one.

    I, personally, don’t see what’s so newsworthy here.

    Not only is this not new (a woman shed 37 pounds in 2005 by eating every single meal at the Golden Arches for 90 days), it’s also simply the result of very standard nutrition advice: eat less calories and you will lose weight.

    Works like a charm!

    In Mr. Coleson’s case, it is estimated that he reduced his daily intake from 3,000 – 3,500 calories to 1400.

    Yup, that’ll do it.

    The fact that he accomplished this by only eating two meals a day doesn’t sit well with me.

    Between lowering his calories so drastically and eating only twice a day, I suspect his metabolism may have been affected negatively.

    Remember, you could feasibly lose weight eating nothing but ice cream, Kit Kat bars, or French fries, as long as you lower your caloric intake to the required levels.

    The problem, of course, is that it doesn’t take that much ice cream (or that many French fries) to reach, say, 1500 calories.

    Additionally, an ice-cream-only diet would provide a good amount of certain nutrients (fat and calcium) and leave you entirely deficient of others (vitamin C, fiber, vitamin E, potassium, etc.)

    Choose wisely (vegetables, fruits, legumes, non/low-fat dairy, lean protein) and you can eat a larger quantity of food for that same amount of calories, all while meeting your nutrient needs.

    Mr. Coleson’s McDonald’s diet — which, fortunately, the fast food chain is not taking credit for — is low in fiber, high in sodium, and devoid of whole grains and legumes.

    Relying so heavily on one restaurant to lose weight is dangerous.

    What happens when Mr. Coleson goes over to someone else’s home for dinner, or has to cook for himself? If he hasn’t learned any new skills or concepts that will allow him to keep the weight off once he stops visiting Ronald the Clown’s house every day, he’ll be back to square one.

    I’m so f’ing tired of fad diets!


    Numbers Game: Answer

    In a 2006 study by Mindless Eating author Brian Wansink (of Cornell University’s Department of Applied Economics and Management), office workers ate an average of 7.7 Hershey’s kisses a day if they were in clear jars on their desks, and 3.1 a day if placed six feet away from their desks in opaque jars.

    That’s actually a 110 calorie difference!

    More importantly, though, this points to a key factor in human eating behavior — if something is within reach, we are very likely to eat it, even if from a physiological standpoint we are not hungry.

    This is partially why large portions of food at restaurants and movie theaters are such a problem — it is NOT easy to leave half our food on the table or tell ourselves to “stop” after finishing half of a medium-sized popcorn bucket.

    In Mindless Eating, Wansink recounts several experiments he and his team at Cornell University’s Department of Applied Economics and Management conducted in which caloric consumption increased simply when more food was available to participants.

    One famous study had a control group drinking soup from a regular bowl, and another group from a bowl that inconspicuously refilled itself in a continual fashion.

The results? Those drinking from the “bottomless” bowl not only downed 65 percent more calories than the control group, they also did not report feeling full for much longer than those who had a limited quantity of soup.

    In other words, they unknowingly consumed extra calories.

    Wansink also experimented with movie theater popcorn. Subjects who later remarked the popcorn tasted bad and stale still ate more if they were eating from larger containers. Oh, by the way, the popcorn tasted so bad because it was two weeks old!

    Weight management isn’t just about your mouth and stomach — make sure your eyes aren’t playing tricks on you!


    Numbers Game: Location, Location, Location

    In a 2006 study by Mindless Eating author Brian Wansink (of Cornell University’s Department of Applied Economics and Management), office workers ate an average of _____ Hershey’s kisses a day if they were in clear jars on their desks, and ______ a day if placed six feet away from their desks in opaque jars.

    a) 7.7, 3.1
    b) 5.5, 4.5
    c) 4.8, 1
    d) 6.2, 2

    Leave your guess in the “comments” section and come back on Tuesday for the answer!


    Celebrity Diet Secrets: Mariah Carey

    Us Weekly‘s feature on Mariah Carey’s “back to her teen body” diet left me thinking, “Forget copy editors. Magazines should really consider hiring nonsense editors.”

    As great as it is to have copy editors catch spelling, grammar, and syntax errors, someone needs to step in, look at nutrition-focused articles and say, “Are you KIDDING me?”

    Those are precisely the words I sighed when I read that Mariah’s diet (the one behind her “hotter-than-ever body”) “prohibits eating carbs and protein together.”

    Okay, first of all — Mariah is a megastar. Does she really need to pick up Suzanne Sommers’ weight-loss hand-me-downs to promote her new album?

    I was even more surprised to see a quote from Registered Dietitian — and New York University graduate — Keri Glassman apparently lending credibility to the silly idea of “food combining” by saying:

    “To digest [protein and carbohydrates] you need different enzymes. The theory is that if you eat them separately, you’ll break down more foods more effectively and increase weight loss.”

    It is my opinion — and sincere hope — that Glassman was merely asked what her thoughts about food combining diets were, and the magazine erroneously attributed her support to them.

    Anyway, it gets worse.

    We then get a sample of Mariah’s daily diet.

    First up — breakfast.

    On the menu? Plain yogurt, sliced fruit, and a banana.

    Is this a joke?

    Let’s go back a few lines and reread the following: “Carey’s diet prohibits eating carbs and protein together.”

    Yogurt contains protein AND carbohydrates. Hello???

    And this is no one-off typo.

    Her lunch also mixes protein (grilled chicken) with carbohydrates (zucchini, squash, and spinach). As it should!

    Food combining fanatics forget that the vast majority of foods are all a combination of fat, proteins, and carbohydrates.

    This is no secret — read any food label!

    You will see that pasta, milk, and bread contains carbs and protein.

    Chickpeas and kidney beans, meanwhile, contain fat, carbohydrates, and protein.

    The article finally — about fifteen paragraphs later — gets to Carey’s weight loss “secret”: cutting calories.

    Turns out she takes in approximately 1,000 – 1,200 calories a day and eats less of her greasy favorites like mac ‘n cheese and pizza.

    Oh, dear, how… how… common!

    I am increasingly becoming more irritated with the amount of deception and unnecessary complications surrounding weight loss and management in pop culture.

    I guess “cutting calories” isn’t A-list enough.

    Instead, people are bombarded with inane advice like count your carbs, don’t mix carbs with protein, get a coffee enema once a week, don’t eat after 6 p.m., sprout your chickpeas, eat only raw foods, eat nothing but red fruits on Mondays while standing on your head and wearing polka-dotted socks .

    Oh, please! Throw all that advice into the “macroneurotic” pile and start living life.

    I am not going to sit here and claim to know “a secret” to weight loss.

    I also refuse to start dictating obnoxiously high-maintenance rules you must follow to follow to achieve your weight and health goals.

    I believe a dietitian’s main responsibility is to help people develop strategies in order to make positive, feasible lifestyle changes. Nutrition is not — and should never become — a calculus 101 class with laws, rules, and inane theories.

    That said, I’m off to make dinner: Peanut-ginger tofu (protein!), sweet potatoes (carbs!), brown rice (more carbs!) and avocado (fat!)

    And I have the audacity to author a nutrition blog?


    Say What?: Lip Service

    I received a text message in all capitals (capped off with exclamation marks) from a friend this afternoon.

    It certainly had all the makings of an emergency. Maybe a celebrity sighting?


    I was instructed to Google “FUZE lip gloss”, a product she had just seen at Sephora, the fragrance and cosmetics powerhouse.

    Following her orders, I typed those three words into the search box and proceeded to roll my eyes so strongly I was afraid they would never stay still again.

    Let me give you some background first.

    As some of you may know, Coca Cola sells a low-calorie juice/tea beverage named Fuze (the target is adolescent females, hence the quirkly post-modern misspelling).

    The newest variety is Fuze Slenderize — a 10-calorie drink containing “slenderizing” vitamins and minerals available in six different flavors.

    All six flavors contain L-Carnitine and Super Citrimax, “metabolism boosters.”

    Citrimax is actually the extract of a South Asian fruit named Garcinia cambogia.

    The manufacturers of Citrimax claim their product “suppresses appetite and inhibits fat production.”

    There is mention of clinical trials proving this, but the only research I read found no difference between subjects taking Citrimax and a placebo.

    In any case, the people behind Fuze (Coca Cola!) now sell “slenderizing lip gloss.”

    Infused with the health, delicious fruit flavors and appetite curbing energy boosting ingredients found in FUZE Slenderize beverages. One delicious dab on the lips will give you a taste of what all the Hollywood starlets are losing it over! Always on the lips, never on the hips!” the press kit reads.

    What poor intern was given the painful task of writing THAT?

    The idea is that Citrimax is absorbed via your lips, thereby curbing your appetite. Well, hey, you can’t say the Fuze folks aren’t creative!

    Ironically, the lip gloss comes in fruity flavors like blueberry-raspberry and strawberry melon. Wouldn’t the taste of candy on someone’s lips make them start thinking of food and feel hungry?

    A much smarter — and efficient — strategy to help curb mindless snacking or eating out of boredom (rather than hunger) is to pop some gum in your mouth.

    It’s not about plant extracts, acai berry enzymes or “slenderizing” ingredients.

    Rather, the chewing action and strong minty/cinnamon/fruity taste in your mouth can help stop you from picking up that Snickers bar at the supermarket checkout counter that you only want because it’s six inches away from you.

    I was initially going to post this as a “Shame On You: Coca Cola,” but decided against it because the only people who should be ashamed are those who open their wallets for this product thinking it is a weight-loss aid.

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