Archive for the ‘Food’ Category

Beyond Broccoli’s Response to Article: “6 Things I Don’t Understand About the Fat Acceptance Movement”

December 29, 2014

This morning I read a blog post by Carolyn Hall entitled “6 Things I Don’t Understand About the Fat Acceptance Movement.” I realize that as with so many contentious current issues, people on all sides are so entrenched in their own views they struggle to step back and look at the whole picture. We all do this – we judge what we see and hear based upon our own life experiences. The bigger problem occurs when we are not open to changing our preconceived notions. As I tell my university students – if we want to be part of the solution to our current problems we must learn to communicate with people who don’t think like we do. This post is an attempt to do just that.

frozen creek

Though I felt frustrated reading this article I recognize Hall’s questions are shared by many who are unfamiliar with the nuances of the HAES (Health at Every Size) approach and provide an opportunity to respond with my take on these questions. I assume this author genuinely wants to hear a different view point and respond to her 6 points accordingly. Each response is based on my 14 years of work as a Registered Dietitian with a major focus on a non-diet approach to health, and a specialty working with problem eating all along the continuum, including eating disorders.

1. America is extremely accepting of fat.

Only someone who has not lived in America in a fat body could make this statement. To be clear, despite feeling fat most of my life starting in preadolescence, and going through periods of being 20-25 pounds or so above what is considered “healthy” for my height, my work with clients in larger bodies has shown me that I do not really know what it is like to be fat in our culture. I am haunted by their life stories however, and I can assure you this statement is not accurate.

I do agree with Hall that our culture accepts and even encourages many of the factors that contribute to unhealthy lifestyles, including excess weight and inadequate physical movement. As a whole (with some very vocal exceptions) we accept a food system that produces and promotes a plethora of unhealthy foods and makes them cheap, convenient, and accessible 24/7 for most of us. We accept that our “busy lives” don’t include time to prepare and eat health-promoting food at regular intervals and without distractions. We don’t encourage people to connect with their internal cues of hunger and fullness or with how their physical and mental health is linked to their eating habits. We accept a fear-based approach to education about virtually everything, including nutrition, and then blame people who don’t make sustainable changes based on fear (a topic for another post).

2. “Body positivity” should include health.

I cannot speak for every member of the Fat Acceptance or Health At Every Size Movements but I can tell you as a longtime advocate of a non-diet approach to health, and an eating disorder professional, my motivation to do this work is a focus on health. As with all social “movements” I suspect there are advocates with extreme and more rigid views than mine but having read many books by HAES proponents, any suggestion that health is not a key part of this movement is a misinterpretation.

The problem I see is that weight and health are so intertwined we overlook the fact that many lifestyle changes related to food, exercise, stress resilience, and more, can improve health with little or no change in body weight. Even if weight loss can increase health benefits, which is likely to be true in the extreme cases of morbid obesity the author refers to throughout her article, as long as positive lifestyle changes are tethered to weight loss, we encourage yo-yo dieting and unsustainable changes linked to metabolic mayhem that are not likely to yield long-term health benefits.

Body positivity does not mean you love being fat or want everyone to be fat. Accepting that you are a human being with worth that extends beyond your appearance is body positivity. In my experience working with people who struggle with food, weight and body image, the preoccupation with body weight, shape and size occurs in underweight, overweight and healthy weight individuals, male, female and transgendered. Shifting the focus toward what Connie Sobczak calls “intuitive living” in her excellent book Embody, is about self-care in every aspect of our lives. As long as we are only focused on a number on the scale we are not truly engaged in sustainable self-care.

3. “Health at every size” seems physically impossible.

Again, Hall is hung up here on the extremes – as many critics of the HAES approach are. As stated above, the main idea is that we need to shift the focus from weight to health, for everyone. Weight gain, or loss, may be part of the bigger health picture for people at the extremes of anorexia and morbid obesity. However, I see clients on a regular basis who are within a “healthy” weight range and routinely engage in unhealthy behaviors in an attempt to change (or maintain) the way they look.

I cannot count the number of times clients report compliments about how “good” they look or how much weight they’ve lost after days of erratic eating, purging, starving themselves, or exercising in dangerous ways. They not only hear this positive feedback from friends and co-workers but health professionals – doctors, personal trainers, and yes, sadly, nutritionists. All of us can be blind to the physical and emotional health consequences of a weight-focused vs. health-focused culture.

4. People are allowed to not be attracted to certain body types.

I have no issue with this statement. Attraction is thankfully diverse and individualized. My issue is that the fat shaming prevalent in our culture is an accepted form of discrimination and prejudice. Though I don’t believe we are anywhere near “post-racial” or beyond any other form of discrimination widely accepted earlier in my lifetime, I see examples on a regular basis of serious discrimination based on weight that is totally accepted in mainstream culture. Even people who still believe race, ethnic background, sex, gender, or religious preferences are undesirable, don’t express such views widely (except of course on the internet). Yet somehow there is a general acceptance of negative comments made about someone’s weight. As a society we allow fat to be a code word for lazy, stupid, weak, and other harmful judgments.

Promoting the idea that people come in different shapes and sizes does not mean we all suddenly have to be attracted to fat people. This is more of a social justice issue than a personal attraction or general health issue.

5. Food addiction is a real medical problem.

A complete response to this point is easily an entire blog post unto itself. In brief however, the concept of “food addiction” is controversial, particularly if we attempt to address this “diagnosis” as we do addictions to other substances. There are many issues that contribute to both what and how much we eat on a regular basis. While biochemistry and neuroscience can explain pieces of this complex puzzle, any attempt to reduce problem eating to “simple addiction” is not helpful.

Foods that are highly processed and bypass our internal cues of hunger and fullness are a problem. As stated previously these foods are cheap, convenient, and accessible. They are also heavily promoted using results from billions of dollars of food psychology research. I fully agree we need to address these issues.

To understand eating problems more completely however, we need to include the biochemical aspects of our response to food, along with our long-established neural pathways or habits, various influences in our food environments, and other aspects of human behavior. Evolutionary psychology can also help us better understand our currently maladaptive tendencies with the curiosity and compassion we need to make significant and sustainable changes to our behavior.

Like it or not, eating habits are complicated and reductionist “solutions” must be recognized as such. The HAES movement may not focus on all of the points I mention here but it does recognize the “answers” to the “obesity crisis” are not simple.

6. Childhood obesity is something we can’t be accepting of.

I could not agree more on this point. I know many health professionals who endorse non-diet and HAES approaches and none of them are “pro-obesity” of any sort, especially among children. Raising children to eat based on fear – don’t eat this or that because you will get sick, or worse, get fat, is not helpful. Continuing to advocate a weight-focused vs. overall health-focused paradigm will not help our children. They need to know that eating nutritious foods and moving their bodies daily is good for their brains, bodies, mood, energy levels, and overall health. But they also deserve to know that thin does not equal healthy; that as they transition from childhood to adolescence and then into adulthood, their bodies will grow and change, and these changes don’t mean they are unacceptable when they don’t fit narrowly defined ideals of beauty.

Our children need to know there is no “perfect body” or “perfect diet.” In fact it would be great if they abandoned the notion of perfection altogether. Striving to do the best they can is awesome. Chasing the illusion of perfection can be dangerous.

It is our responsibility as adults to provide an environment for our children that supports good health and a sense of well-being. In our current culture this is no easy feat. It is clear however, that what we have been doing for the past few decades is not working. Focusing on short-term fad diets, succumbing to the trappings of modern society that support unhealthy lifestyles and then blaming people who gain weight or don’t exercise enough, using fear-based tactics in an attempt to change people’s habits, are not helpful strategies to produce the changes we want to see.

I don’t like the phrase “fat acceptance.” I prefer “human acceptance” which gets more to the core of our various health problems linked to weight. In fact we know that the statistics related to weight and health also apply to socioeconomic status and health. This doesn’t mean we don’t pay attention to these relationships but hopefully it means we try harder to understand the complexity of the issues beyond what we see on the scale.

There is no single way out of the mess we are in related to poor health as a society. Blame, shame, fear, anger, and a lack of compassion for ourselves and others are not working to make us healthier physically or mentally. What I am drawn to in alternate paradigms such as Health at Every Size (HAES) is the refusal to reduce our current health problems to weight alone, nor to continue clinging to approaches that don’t work. It is time for a fresh perspective and frankly I don’t care what we call it as long as it takes us in a more positive direction.

Find Willpower in Self-Compassion and Calm

December 4, 2014

Have you ever tried to change a habit related to food or eating?

What I’m going to share with you today applies to any behavior chSwanange. I’m going to use a food example that most of us can relate to as eaters entering the holiday season.

Imagine this scenario:

You decide this year that you are going to take it easy on sweet treats throughout the holidays. Not only do you feel better on a daily basis when you keep sweets in balance, but this change is consistent with your long-term health goals.

You go to work and shortly after you arrive a co-worker walks in with a plate of home-baked cookies – your favorite kind. And there are a lot of them. You graciously accept a cookie then immediately start criticizing yourself for eating it. That voice inside starts in: “Not even an hour into the workday and you’ve eaten a cookie, so much for that healthy eating goal.”

Then you have a second cookie. The voice gets louder, and harsher. By the time lunch rolls around you’ve lost count of how many cookies you ate. You go out to lunch and order dessert after your cheeseburger and fries because at this point you have “blown” your healthful eating plan for the day.

You have just experienced a well-known behavioral psychology phenomenon called the “What-the-Hell Effect.” This cycle of indulgence-regret-greater indulgence was first described by psychology researchers Polivy and Herman.

Now I want you to think about what happens in these “What-the-Hell” situations for you. What are some of the things you tell yourself?

The most common response I hear from my clients is “I have no willpower.” They believe they “cave in” to temptation because somehow they just don’t have enough willpower or their love of food is so powerful they cannot resist that first cookie. They are convinced that first cookie paves the way to “What-the-Hell.”

The reality is that the initial decision to revert back to an old habit, to eat that first cookie, is NOT what leads to the What-the-Hell behavior. It is our feelings of guilt, shame, loss of control, or loss of hope that follow the first relapse that lead us to continue the path away from our longer-term goals.

According to Kelly McGonigal, a psychology researcher at Stanford who studies Willpower, to break this “What-the-Hell” cycle of indulgence-regret-greater indulgence we need self-forgiveness. We may think guilt motivates us to correct our mistakes but it’s just one more way that feeling bad leads us to give in.

Now here is where things get really interesting. There is another important factor in this scenario: your brain.

Some of you may be familiar with neurobiologist Dan Siegel’s “Hand Model of the Brain” (if not click here). The limbic area of the brain is where our “fight/flight” response starts when we are faced with a potential physical or emotional threat. Dr. Siegel calls this the “lower brain”.

The cortex, including the prefrontal cortex or the “upper brain,” covers the limbic area, and enables us to reason and to see the bigger picture –specifically our longer-term goals. Decisions from our lower brain are impulsive, short-sighted and reactive.

When we berate ourselves for eating the cookies, we engage the stress-response in our lower brain and set ourselves up to continue not acting in accordance with our longer-term goals. Blood actually diverts away from the cortex or upper brain.

When we beat ourselves up mentally, our brain works against us!

Study after study of adults shows that self-criticism is consistently associated with less motivation and worse self-control.

Self-compassion – being supportive and kind to yourself, especially in the face of stress and failure, is associated with more motivation and better self-control.

Psychologist Kristen Neff describes 3 core components of self-compassion:

  • Self- kindness (treat ourselves as we would a loved one who is struggling)
  • Recognize our shared humanity (we are all imperfect –connects us)
  • Mindfulness of our inner critic and our discomfort (to respond differently we first must be aware of what is happening)

Going back to our example of the cookie, what if your initial response is “wow, that cookie is delicious” and you eat it slowly, savoring the taste, appreciating that your co-worker made this cookie from scratch?

Afterwards when you are tempted to have another cookie (or 5), you take a few deep breaths instead. You gently remind yourself that enjoying a cookie here and there is consistent with your longer term health goals, but wolfing down 4 more cookies right now probably isn’t. You don’t beat yourself up for eating that first cookie. You are human and many humans like cookies!

When your inner critic kicks in and starts screaming: “You idiot! Why did you eat that cookie? What were you thinking?” you calmly respond, “I wanted the cookie and it was delicious.” End of story. If you stay calm, blood continues to flow to all parts of your brain and you are able to remember your longer-term goals.

This self-compassionate and calm response takes away the driver of the “What-the-Hell” (WTH) effect– if there is no guilt and self-criticism, then there is nothing to escape.

As we enter the holiday season filled with all kinds of ways to tempt us away from our health-promoting self-care habits, a time when we are prone to the “What-the-Hell” effect and to impulsive decisions made by our “lower brain” due to stress, let’s think about sharing some of the compassion we give freely to others, with ourselves as well.

In addition to the many holiday stresses, alcohol, sleep deprivation and distraction can also trigger our “lower brain” and cause us to abandon our longer-term goals. In these situations we need to be extra kind to ourselves. We also need a strategy to help calm our stress response and promote resilience.

One of the simplest stress relievers is to take 3 deep belly breaths. LET’S TRY THIS – 3 deep belly breaths, each followed by a long, slow exhale. ONE, TWO, THREE.

If you were stressed and your limbic brain was threatening to take charge, those 3 deep breaths just redirected the blood flow to your whole brain. Now your cortex has a chance to be part of your decision making.

This calmness in combination with self-kindness may be your most enjoyable holiday treats ever –ones you can look back on in January with a smile on your face!

Gratitude: Antidote to “Not Enough”

November 25, 2014

I didn’t get enough sleep

I don’t have enough money

I need to exercise more

There is never enough time to get everything done

I’m not ___________ (thin, fit, attractive, rich, strong, smart, etc.) enough

Does your day start or end with any of these thoughts? What about throughout your day? Is there enough? Do you do enough? Are you enough?

Regardless of the abundance that surrounds us we often perceive a “culture of scarcity” – a mindset that can lead us to focus on what we lack versus what we have. A couple of years ago I was introduced to the work of Brene Brown, a psychology researcher who studies shame and vulnerability. Through her work she observes ways this “culture of scarcity” plays out in our everyday lives. The observation that struck me most is that people who struggle with emotional eating or binge eating, sometimes use food in response to these feelings of “not enough.” Brene suggests one possible antidote to subconscious and conscious feelings of scarcity and inadequacy: a gratitude practice.

“Piglet noticed that even though he had a Very Small Heart, it could hold a rather large amount of Gratitude.” ― A.A. Milne, Winnie-the-Pooh

While it may be naïve to think a simple gratitude practice is the solution to behaviors as complex as binge eating, I am intrigued by the idea that focusing attention on what we have versus what we lack can help us feel more fulfilled in our everyday lives. Many clients struggling with emotional eating issues describe food as a way to “fill” some type of void that has nothing to do with biological hunger. Despite their “knowing” this is a reason they eat, they struggle to stop such behaviors. I often encourage clients to identify what is driving the eating because if it is not physical hunger then no amount of food will “fill” them. The idea behind this strategy is that whatever the real need is that drives this eating cannot be met if it goes unidentified. Unfortunately the process of unraveling underlying needs is not simple and takes time.

Is it possible that focusing more on what we are grateful for may help us feel more “full” in a positive way? Can we “fill up” on gratitude to replace mindless activities that don’t serve us well?

I decided to try a gratitude practice myself, just to see what would happen. Though I don’t currently struggle with eating issues, I definitely fall into that scarcity mindset with respect to time, money, and many other things I wish I had more of. When I learned about the scientific studiesGratitude jar related to gratitude I wondered if this practice could impact other behaviors that distract my daily life and keep me feeling “busy.”

Last fall shortly after my return to Jackson, I was sitting at my desk with Ginny curled up next to my chair. I glanced at my favorite wedding picture propped on my desk beyond my computer, and then out my front window toward Snow King Mountain bathed in afternoon sunlight. Overwhelmed with gratitude, I wanted to freeze that moment. I was home in Wyoming with Dave and Ginny, I re-launched my dream career at Beyond Broccoli, and I was surrounded by mountains, a community I care deeply about, and immediate access to so many of the things I love to do. I knew that at some point the proverbial “honeymoon phase” of this new chapter of my life would fade, so I decided to start a gratitude practice. My hope was that at some point when the mundane aspects of everyday life replaced my bursting enthusiasm for all-things-Jackson, I could retrieve a few of these strips of paper and remind myself of all the aspects of my daily life that provide richness beyond measure.

I already journal regularly so I chose to try a gratitude jar instead. I got a Mason jar from the kitchen and removed the steel lid. I cut a piece of paper into small strips and wrote a few of the things I was grateful for in that moment. I continued to do this daily for a while, savoring simple moments that made me feel joy and contentment. Dog walks and puppy kisses, random acts of kindness, playing in the snow, sunshine on cold winter days, feeling love and support. It didn’t take long to notice moments of gratitude everywhere I went. Now I don’t even have to read my little scraps of paper – I glance at the jar on my desk and am filled with gratitude.

I don’t know if this gratitude strategy can decrease general thoughts and feelings of scarcity for everyone. I do know this has been a powerful practice for me. I am more aware when I start down the scarcity mind set path and can stop myself or at least recognize what is happening. Though things are going pretty well right now, as with most years the past 12 months included moments of fear, pain, and discomfort, and there were losses. I can’t say I felt less of these uncomfortable emotions, but I do think I was a bit more resilient. The way I see it there is no downside to a gratitude practice and for me nurturing resilience following life’s inevitable hardships, is enough.

“To love someone fiercely, to believe in something with your whole heart, to celebrate a fleeting moment in time, to fully engage in a life that doesn’t come with guarantees – these are risks that involve vulnerability and often pain. But, I’m learning that recognizing and leaning into the discomfort of vulnerability teaches us how to live with joy, gratitude and grace.”
Brené Brown, The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are

Overweight and in Recovery from an Eating Disorder

November 17, 2014
Photo from a client in recovery

Photo from a client in recovery

Last week following a presentation about eating disorders to a group of mental health professionals a participant stood up and shared that a relative of hers had just returned from eating disorder treatment and was overweight. What should she (the relative in recovery) do?

Each time I hear this question my heart sinks. We live in a culture where the primary metric for health is weight. If someone does not meet clinical criteria for a “healthy” weight range she is encouraged by everyone around her, often including her health providers, to “diet.” It astounds me that even when a person has struggled with a full-blown eating disorder the focus remains on weight, and too often “dieting” is the recommendation. Keep in mind that a “diet” for someone with an eating disorder is like a drink for someone addicted to alcohol.

Responding to the question about what to do next is difficult for many reasons. First, I know nothing about this person’s eating disorder journey – how it began, the form it took, the treatment she received, current support, etc. What I do know is that no matter what her journey looks like, working with a combination of outpatient therapist and dietitian with training and experience in eating disorders is the ideal next step. I’d like to say this type of follow up care is essential based on the many stories I’ve heard from my eating disorder clients about working with professionals not experienced with eating disorders. Unfortunately the reality of living in areas where specialized services are not available makes this an ideal scenario rather than an essential one.

The long term nutrition goal is to create a positive relationship with food (body and emotions too but these are more in the psychotherapy realm). Here are my top 3 next steps for nutrition in eating disorder recovery after some type of residential or inpatient treatment:

  • Seek support related to a more intuitive and mindful approach to eating. There are several books and websites on these topics. For Intuitive Eating resources Evelyn Tribole’s website is great http://www.evelyntribole.com/resources/intuitive-eating-articles-studies-support-groups/10-principles-of-intuitive-eating and for Mindful Eating guidance Michelle May, MD has some really good resources http://amihungry.com/resources/about-the-mindful-eating-cycle/
  • Be aware of any type of food restriction – especially if your eating disorder includes binge eating. This is one of the most counter-intuitive aspects of eating disorder recovery for those who struggle with binge eating. This is also commonly ignored among dietitians and other health professionals not experienced in eating disorder treatment. The focus is too often on the binge rather than the food restriction that can begin a cycle of disordered eating. Skipping meals and snacks, avoiding certain foods or food groups, only allowing yourself to eat at certain times, or arbitrarily determining portions sizes rather than relying on your body to tell you what and how much you need, are all forms of food restriction that can be harmful in eating disorder recovery.
  • Watch for “always” and “never” thoughts and statements. These words are red flags for “black-and-white” “all-or-nothing” types of thinking that support disordered eating behaviors of all kinds. These words are rarely true when it comes to food and can help you identify struggles that lurk beneath the surface during your recovery journey.

There are many more issues to address in support of long-term, sustainable eating disorder recovery and a positive relationship with food. If you are overweight as you face the next stage of your recovery these steps can help you stay focused on health and well-being while you support your body’s return to a healthy weight range tailored to your individual needs.

“The Jungle Effect” as Antidote to Fad Diets

February 14, 2014

Many of you have heard me rant about various fad diets. I lament how easily these temporary promises of a better, thinner, healthier version of ourselves take hold in our often anxious and preoccupied minds. I know humans innately crave a mix of new experiences (and foods) as well as the comfort of familiar routines (and foods), so I get why at least some of these fads are appealing. We know at some level we will never look like the celebrity du jour touting this fad as the secret to her success. We understand that no matter how much we long for simple solutions to our problems, it is unlikely the complex layers of our issues will be unraveled simply and with minimal effort.

Yet we can’t help ourselves. The power of our imagination is so great that we enter each new fad wide-eyed with possibility. Maybe this time we will lose weight, gain health and self-confidence, and all of the problems we think are tied to our weight and appearance will magically melt away.

I am reminded of my favorite nickname of a hockey teammate in Seattle – “Dream Crusher.” Though I understand very well the myriad reasons all of us are attracted to different fads at some point or another (this extends beyond fad diets for those who think this post doesn’t apply to you), I am here to crush that dream. There are no quick fixes to solve complex problems related to weight and health.

Lucky for you I am not particularly comfortable with the moniker “Dream Crusher,” as appealing as it is for a defensive partner on the ice in the context of a hockey game. I prefer to inspire hope and to support the process of change that leads my clients toward their goals and whatever it takes for them to live in harmony with their values. So I have put together a class called “The Jungle Effect” to appeal to your sense of adventure while honoring your need for comfort and the familiar.

“The Jungle Effect” is a phrase coined by integrative physician Daphne Miller. Miller observed several patients who experienced health problems when they transitioned away from their traditional way of eating and adopted the ways of our modern, industrialized society. One client in particular spent time in a traditional community in the jungle as a child and when she returned to this place for an extended visit years later, many health issues she developed as an adult resolved.

Intrigued by this idea that returning to a simpler way of eating and living could reclaim health, Miller explores five areas in the world where populations still follow a mainly traditional way of life, including eating habits, and enjoy an unusually low incidence of various chronic diseases and conditions that plague much of the developed world.

There are many aspects of Miller’s approach that appeal to me. First, she uses stories of real people to introduce us to these exotic places and to give us ideas about how we can integrate traditional ways into our modern lives.

Next, there is a lot of nutrition myth-busting that occurs throughout the book, especially related to our annoying tendency to reduce nutrition to specific nutrients as a guide to a “healthy diet.” While she does introduce information about components in foods that have powerful health benefits like the omega-3 fats found in fish, she presents a broader picture of nutritional benefits. Popular ideas such as simply eating “too many carbs” is a general problem vanish as we learn that the people of Copper Canyon, Mexico eat a traditional diet that is composed of roughly 80% carbohydrates and enjoy one of the lowest rates of diabetes in the world.

Perhaps the best part of the book for me though, is that Miller provides a picture of each culture that extends beyond what they eat. There is no doubt the “what” is important, yet through Miller’s presentation of cultures as diverse as Crete and Iceland we are encouraged to look beyond what is eaten and contemplate how food is produced, prepared and shared, along with many other aspects of daily life in these communities that benefit their health.

“The Jungle Effect,” and more specifically the idea of pursuing more traditional ways of eating, is the closest thing I think we will find to a “simple solution.” By definition a culture that continues its way of life, including eating habits, over centuries is going to have a more simple approach than our post-industrial modern society.  The challenge then becomes reclaiming simplicity in a complex society, no small feat as many of you know.

Next week’s class through our local branch of Central Wyoming College is based on some of the important concepts from Miller’s book, complete with foods that represent these special places – Copper Canyon, Mexico, the islands of Crete and Okinawa, Cameroon, West Africa, and Iceland. We will explore some of the key concepts common to this diverse collection of cultures that contribute to good health and longevity.  Best of all, we will embrace the excitement that comes with trying something new while uncovering the comfortable, familiar aspects of this simple approach that require no special talents beyond our own inner wisdom.

What Do You Mean “It’s Not About the Food?”

January 29, 2014

Next week I begin a new series of Beyond Broccoli classes called Food & You: Exploring Beyond the “What.” I am excited about this unique option for nutrition education and support for the many people in our community who struggle with food, weight, and body image, using a behavioral nutrition approach that recognizes in many cases – “it’s not about the food.”

Not long after I started Beyond Broccoli back in 2001 I remember thinking that so much of my formal training and education in nutrition focused on what to eat (or not eat) for a variety of outcomes, and yet the most important work I did with individual clients came down to something we spent relatively little time studying: behavior change.

I remember learning about the “Stages of Change” model that describes the process most people go through to make changes. I was fascinated by this process, though I had no idea at the time this would be some of the most important information to my practice with individual clients. It didn’t take long for me to realize that struggles with food, weight and body image add layers of complexity to changing habits. If I want my clients to be successful in making sustainable changes, together we need to explore well beyond the “what” of their eating habits. So I have devoted much time and energy over the past dozen years to learning more about this whole process.

I suspect some find this idea of a nutritionist not focusing on the “what” confusing. Aren’t nutritionists supposed to be the experts on what to eat (or not eat)? Isn’t that why we consult with them?

As a Registered Dietitian it is important that I know about Medical Nutrition Therapy, or how nutrients can prevent or manage disease and illness. Here in Jackson it also helps me to know about sports nutrition to help my clients optimize food as fuel. Educating clients about the links between food and mood is important for both long-term health and how they feel on a daily basis, often a much more compelling reason to make changes. So yes, what we eat, and don’t eat, is definitely important and a major focus of my ongoing work (and continuing education requirements).

I am also passionate about the need for nutrition education to go beyond just spewing information. I enjoy helping clients acquire tools and build skills to actually apply this information in the context of their individual life situations – or more simply, the “how” related to eating habits.

However, I now know that actually making changes often goes way beyond needing to change, wanting to change, and knowing what to do. I can put together the best meal plan ever for someone, based on all the current research and my clinical experience, but if she isn’t engaged in the process of making the plan and it doesn’t fit into her lifestyle, isn’t compatible with her life goals and values, or doesn’t take into account where she is in the readiness for change process, this “ideal plan” is likely to fail. This leads me to the real crux of changing habits – the “why.”

As I see it, my area of expertise is food and nutrition while my clients and patients are the experts on themselves, even if they are not conscious of this fact. They know why they want to change, or think they want to change, and more importantly what they are willing to do. Sometimes it takes a bit of effort to uncover the layers of “why” and sometimes for clients who struggle with food, weight and body image (which is many of my clients) this process works better with the with additional guidance and support from a skilled therapist using a team approach.

This idea of enlisting additional support for the often challenging process of changing habits is why a group situation can be really helpful. The “Food & You” classes are a way to apply some of what I do with individual clients in a group setting. I offer nutrition education and support using this behavioral nutrition approach rather than dictating “eat this” or “don’t eat that.” Together we explore the myriad factors that influence what we eat, as well as how, when, where, and why. Each class includes a different relaxation or mindfulness technique to get things started, creative and interactive class activities to spur discussion, and a host of ideas, tools and a chance to practice building skills that can help participants move forward in their journey toward a better relationship with food.

I Resolve to Wait Until Spring for New Year’s Resolutions!

December 27, 2013

“We spend January 1st walking through our lives, room by room, drawing up a list of work to be done, cracks to be patched. Maybe this year, to balance the list, we ought to walk through the rooms of our lives… not looking for flaws, but for potential.”
–Ellen Goodman

A quick search on New Year’s Resolutions reveals roughly half of Americans bother to make them annually, some do it once in a while, and less than half of those resolutions are kept past the sixth month mark. Clearly even people who don’t make yearly resolutions at least think about them, and many write about them. So what is it that compels all the hoopla every year at this time?

Starting the New Year with some fresh habits that better support our life goals or our health is reasonable on the surface. But I suppose many years of living in places where January is cold, dark, snowy or wet, and not a time when I feel particularly bursting with excess energy has jaded my view of this practice. I also balk at the idea of forcing a change at this arbitrary point in the year, especially when the more natural time for making changes for me is springtime.

I think winter is a great time to contemplate change and perhaps to make sure I get back to any changes I made last year that may have reverted to old ways during the holidays amidst stress and all kinds of distractions. Habits I already worked to change but just weren’t quite my go-to during the busy holiday season are much easier to tackle in January than a completely new thing. For me, the long, dark evenings (and early mornings) are perfect for introspection and planning. As it turns out, planning is also pretty important for sustainable changes.

For me Spring is a natural season for changes, full of renewal and rebirth in the natural world, snow and ice melt here in the valley, buds appear on the trees, baby Bison wander the northern meadows. More hours of daylight and warmer temperatures lighten my mood and I feel more energized. By springtime I have also given thought to meaningful changes and perhaps even taken a few preliminary steps to get the ball rolling.

You may prefer summer or autumn to make changes – maybe you need lots of sunshine or impending winter to nudge you toward change. And sometimes we don’t get to choose when to change. A medical diagnosis or life event may motivate or necessitate change with no luxury of waiting until the time is just right.

As the New Year approaches if you do decide to make a change, here are some key basics to set yourself up for success – and to me that means a change that is sustainable.

  •  Understand your motivation to change. Is the change something you want to do or what someone else wants you to do (a spouse, doctor, friend, etc.). Are you clear about the benefits involved and will the change be a reward by itself? If not you may want to set up rewards along the path to change to keep you going.
  •  Consider all possible barriers to change. Know what you are up against then you can plan accordingly. We are all part of different groups – families, friends, co-workers, church, community, etc. and any changes in our everyday habits can be supported or sabotaged by those around us.
  •  Make a plan and be specific about how you will move forward. Vague statements like “eat more vegetables” are difficult to plan for, implement and measure – all ways we determine our success or failure. Planning will help you assess any skills, tools, knowledge, and support that will help you be successful.
  •  Seek or at least allow support from others for your change. The idea of being a solo badass is alluring to many of us. “Just Do It.” We subconsciously or outwardly buy into the myth that asking for any kind of help means we are weak. The reality is that we all need help sometimes and asking for it is hard. Really hard sometimes. People who care about you want to support you, so let them and increase the chance of successful change.

Beyond Broccoli Holiday Nutrition Tips:

December 10, 2013

Tired of the same old holiday nutrition tips that promote a focus on calories, fat grams, weight gain, and other negative consequences of dietary indiscretion, here are some ideas that fit more with the Beyond Broccoli nutrition philosophy and approach.

  1. Be kind to yourself. This does not replace the giving to others we emphasize during the holiday season – compassion for others is linked to self-compassion. You cannot give what you don’t have and you take the best care of what you love. You do the best you can and that is enough.
  2. Check in with why you are eating. The holiday season presents endless opportunities to graze mindlessly. Sometimes the simple question “what do I really need/want right now?” can stop or at least make you aware of eating for non-hunger reasons (emotions, environment, peer pressure).
  3. Eat slowly and intentionally. Identify pleasing flavors and textures in the food you eat and give your brain the 20 minutes it needs to identify fullness. It helps to eat sitting down with minimal distractions (not an easy task for many of us!).
  4. Notice how your body feels after you eat. This primitive instinct once let us know which foods (or amounts of food) caused digestive discomfort so we could avoid (or eat less of) the food the next time. Understanding which foods nourish our bodies best can empower us to make better choices.
  5. Eat regularly throughout the day. When we go too long without eating we set ourselves up to overeat. This is basic biology – part of our hard-wired survival instincts, now mismatched with our abundant food supply. If you are going to a holiday dinner or party in the evening you can make healthier food choices during the day, but skipping meals and arriving at your special occasion ravenous is not a good idea.
  6.  Stay hydrated. Our need for fluid increases with many environmental extremes including hot, cold, dry and high altitude. Many of us are conscious about drinking more water when it’s hot but forget we need more when it’s cold and/or dry too. Soups and hot tea are great ways to increase fluid on cold days.
  7. Strive to include joyful movement in your busy holiday schedule. Physical activity can take many forms – find ways to move that you enjoy and you are more likely to keep this as part of your holiday self-care regimen. Forcing yourself to squeeze in a gym session can create more stress than it relieves. Dance at holiday parties, acknowledge that holiday shopping and cleaning are opportunities to be active and “count” as physical activity.
  8. Savor food you perceive as special treats. Choose your special treat foods, knowing that in our modern world most foods are available any time of year so identify the truly special foods for you. Notice that when you give yourself permission to eat and savor these foods you may “need” less of them to feel satisfied.
  9. Shared meals provide benefits beyond physical nourishment. Food connects us as humans – we all must eat to live. There is research that supports many benefits of family meals. Taking time to share meals during the holiday season can help us feel grounded, connected to each other, and in charge of our lives vs. stressed out about how out-of-control this season can get.
  10. Remember to breathe. Deep breathing has many benefits, especially related to stress resilience. Stress is an inevitable part of life and our ability to work through stressful moments or events is important for many reasons, including the ability to not use food as an antidote. Just 3 deep “belly breaths” can change the blood flow in your brain from your “fight or flight” response to your more “rational” thinking.

Never Enough

December 6, 2013

Last week kicked off the holiday season with our celebration of Thanks. I love the simplicity of Thanksgiving – gather with family, friends, or neighbors to celebrate what we are grateful for and share good food. However, the irony of this day of thanks followed by the biggest shopping day on the American calendar is not lost on me, nor is the fact that we spend the rest of the holiday season focused on what we don’t have or what others don’t have (the latter to guide our giving). It seems that despite our gratitude for what we have, somehow there is never enough of something.

I am reminded of Brene Brown’s gem of a book The Gifts of Imperfection in which she writes about cultivating a gratitude practice to counter our feelings of scarcity. She points out ways that we buy into the myth of scarcity, often subconsciously. In our society, despite abundant resources relative to other parts of the world or other times in human history, many of us focus on the ways we don’t have enough, can’t get enough, or just are not enough.

We don’t get enough sleep, exercise, recognition for our hard work, or vegetables (couldn’t resist). We don’t have enough time, power, love, or money. We aren’t attractive, thin, fit, smart, or rich enough. These everyday thoughts and feelings of lacking something (or lots of things) keep us searching, both consciously and unconsciously to fill a void, real and imagined.

The reality is, many of these things may be true, at least on the surface. We may not have enough money to pay all of our bills on time or to buy the perfect gift for a loved one, and it’s no secret that lots of Americans are sleep-deprived. But the continued focus on what we lack in every aspect of our lives is not helpful, even if it is true.

Balancing thoughts of what we lack with thoughts of what we have, and more importantly what we are grateful for in ourselves and in others, may help us fill this void. No, positive thoughts don’t directly pay our bills and this isn’t some hippie notion like “love will conquer all” (though love is a great start). In fact ignoring discomfort leads to a host of issues beyond the scope of this blog post. But unless we take a closer look at what we actually have, it is difficult to accurately assess what we really need.

So how does all of this relate to nutrition? Well, it turns out that one of the ways many of us try to “fill” this inner void is by eating (or not eating – food restriction is another way to numb, distract or ignore emotional pain and discomfort).

Now Brene Brown and others who write about perceived scarcity and the benefits of cultivating a gratitude practice don’t frame this practice specifically as a way to address emotional eating (compulsive overeating, binge eating, or eating when feeling any number of emotions and not physically hungry). But I wonder what could happen if we try to focus daily on what we are grateful for, even in some small way. I understand the challenge of starting something new during the insanely busy holiday season but I don’t think this needs to be super time-consuming or complicated (see below for ideas).

I also realize this is an emotionally difficult time of year for many of us who have experienced losses. Though it has been nearly 20 years since my Dad died, his love of all things Christmas still makes me sad at random times throughout this season. It is clear to me though, focusing on the loss and sadness isn’t helpful anymore. However, focusing on how grateful I am for my memories of Dad, even if they make me feel sad, is intriguing to me. Will this somehow help mindless munching I do while not conscious that I am feel an emptiness? I don’t know but I think it’s worth a try.

It does occur to me however, that it may be better to not immediately try to counter feelings of sadness, emptiness, or other emotional discomfort with thoughts about gratitude since the idea is not to invalidate our feelings. I think it may be better to set aside a time to practice gratitude, and to allow thoughts of gratitude to naturally surface at other times but perhaps pay slightly more attention to these thoughts. Say them out loud or share them with someone close to you.

Perhaps if we all try to notice when we are falling into thoughts and feelings of scarcity, and acknowledge what we are grateful for more consistently and consciously, we may not feel a need to fill ourselves with food when what we need or want has nothing to do with food.

So let’s try an informal cultural experiment. If you struggle with any variety of emotional eating, try to somehow incorporate a gratitude practice for even a few minutes each day and see what happens. If you want to, you can come back to this post and let us know how the experiment went for you or you can email me privately (mary@beyondbroccoli.com).

Here are some ideas from people who practice gratitude:

  • Start a gratitude journal – each morning or evening write down at least one thing you are grateful for. Doesn’t need to be fancy, a small memo pad works just fine.
  • Create a gratitude jar in which you write thoughts related to gratitude that come up throughout your day on little pieces of paper and put the pieces of paper in the jar.
  • Begin shared meals with each person at the table sharing something they are grateful for.
  • Use prayer or meditation to reflect on what makes you feel gratitude.

Meanwhile, I am grateful for all of you who read my ramblings. I hope the holiday season is off to a good start for all of you and that you know – you are enough in all of the ways that matter.

Here is a lovely 6 minute video with a Gratitude theme by cinematographer Louie Schwartzberg http://www.youtube.com/watch?v=nj2ofrX7jAk

Eating Beyond “Superfoods”

November 22, 2013

“A fruit is a vegetable with looks and money. Plus, if you let fruit rot, it turns into wine, something Brussels sprouts never do.”     – P. J. O’Rourke

Recently as I perused the produce department of my local grocery store, a man asked me if I knew anything about juicing – he pointed to a bunch of fresh beets and chunk of fresh ginger root in his cart. He wondered if the bunch of fresh  greens in his hand from a bin marked simply “greens” was okay for juice, or if he should use kale. Just then a produce employee arrived on the scene and informed us the mystery greens were mustard greens. So I explained to the man that all of the dark leafy greens were very nutritious and the mustard greens have a spicier flavor so the choice of greens to juice is more a matter of taste preference. The produce employee interrupted us to encourage the man toward kale because – “it’s a Superfood.”

Irritated on several levels, (and I am not proud of my next move) I pulled the “I’m a dietitian” card with the hope the annoying employee would go away, which he kind of did. But now the man holding the greens perked up and asked if I knew another dietitian here in town, and when I replied that I did know her, the man beamed as he pointed to his cart and said “she’d be proud of me wouldn’t she?” I agreed, and wished him luck with his juicing adventure. As I walked away, he tucked a bunch of fresh kale next to the bundle of beets and headed toward the cash registers, not realizing mustard greens are also “Superfoods” they just don’t have a publicist yet.

Sigh. Mustard greens are cruciferous vegetables in the Brassicaceae family – along with kale, broccoli, cabbage, collard greens, brussel sprouts, Kholrabi (my husband calls this the “alien vegetable”), bok choy, and cauliflower.

This produce department incident is actually brimming with blog material but right now my focus is: “Superfoods.“ I know this isn’t a new concept. We live in a culture that LOVES superheroes, and celebrities, so it really isn’t a surprise we apply this concept to foods. In general there’s nothing wrong with encouraging people to expand their culinary horizons to include whichever food currently has the best PR campaign or celebrity endorsement. Generally these foods are rich in beneficial plant compounds or some mix of nutrients we don’t get enough of, but somehow I find this trendy obsession irritating. I googled “celebrity kale” and came up with an Us Weekly headline “Stars Who Love Kale” followed by a long list of articles, blogs and websites where apparently celebrities gush about this leafy Brassica. Sigh again.

I  guess I should start with the fact that I have nothing against kale. In fact, I really enjoy kale – starting several years ago when I was a work-share for a season at the Cosmic Apple Gardens, a local CSA over in Victor, Idaho. Prior to that summer, kale was simply a popular garnish used in many of the restaurants and banquets I’d worked in my former food and beverage career. (Current kale enthusiasts would cringe at the thought of the millions of pounds of this vegetable superhero tossed in the garbage of restaurant kitchens after serving its aesthetic purpose.)

I was also thrilled to discover this member of the cruciferous family, a group best known for cancer-fighting powers, grows beautifully in the harsh soil and abbreviated growing season here in northern Wyoming. Even I, brown thumb who generally does best with plants like cactus that thrive on neglect, can grow kale!

But here’s the thing, if we focus on a narrow array of “Superfoods,” we not only miss out on the variety of tastes and textures that make eating pleasurable, we burn out on whatever the latest thing is. I mean how many times a week can you eat kale before you are over it?

Not to mention that I can buy broccoli, cabbage and brussel sprouts for half the cost of a bunch of fresh kale (especially if I go organic).  And, better still, incorporating more variety allows me to make a delicious cabbage salad with toasted pumpkin seeds to go with Mexican main dishes, broccoli (or even more fun – broccoli rabe) with pasta, a mustard greens and goat cheese omelet, and by the time I get to the kale and white bean soup I’ve been in cruciferous heaven for days! Admittedly I stumble a bit with cauliflower and brussel sprouts – not my personal faves. Though I have found ways to make these two palatable, it takes a bit of extra effort (and a lot of garlic – or a grill) so I choose them less often.

I guess my point is – it is difficult to find a vegetable or fruit that isn’t a “Superfood.” Nutrition research shows again and again that eating more fruits and veggies of all kinds (non-starchy anyway) offers a whole host of benefits from lowering our risk of heart disease and many cancers, to helping us achieve and maintain a healthy weight. Just because Gweneth Paltrow and Jennifer Aniston aren’t raving about broccoli (and let’s not forget George Bush Sr.’s anti-broccoli tirade) doesn’t mean we need to forgo the (broccoli) trees for the (kale) leaves! And what if broccoli actually had a PR campaign? Check it out http://www.nytimes.com/2013/11/03/magazine/broccolis-extreme-makeover.html?ref=health&_r=2&


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