NU­TRI­TION FOR WOMEN

A com­plete nu­tri­tional guide for ladies of all ages

Health & Nutrition - - CONTENTS -

What if in­stead of re­stric­tive di­ets that la­bel some foods “good” and oth­ers “bad”, there was a fresh way to ad­dress eat­ing habits, your re­la­tion­ship with food and your own body shape. Strate­gies like “Mind­ful Eat­ing”, “In­tu­itive Eat­ing”, and the “Sati­ety In­dex” are de­signed for just this pur­pose – to help you fo­cus on the mo­ment, over­come crav­ings, choose foods that sat­isfy, and con­trol your weight to cre­ate a health­ier soul-sat­is­fy­ing re­la­tion­ship to food.

TUN­ING IN TO CLUES

If you ask peo­ple to mon­i­tor why they eat, their an­swers might sur­prise you. “They eat be­cause they’re stressed, bored, de­pressed, over­tired, lonely, or in a so­cial eat­ing sit­u­a­tion,” says Kathy Isoldi, MS, RD, CDE, co­or­di­na­tor of clin­i­cal ser­vices at the Weill Cor­nell Med­i­cal Cen­ter’s Com­pre­hen­sive weight Con­trol pro­gram. “Hunger is of­ten fur­ther down on the list.” En­ter “mind­ful” eat­ing which en­cour­ages peo­ple to rec­og­nize hunger, eat at­ten­tively with a sense of power and con­trol, and make healthy food and por­tion choices. It’s a nat­u­ral ex­ten­sion of the mind­ful­ness-based stress re­duc­tion pro­gramme pop­u­lar­ized by Jon Kabat-Zinn at the Uni­ver­sity of Mas­sachusetts Med­i­cal School two decades ago. “Mind­ful eat­ing teaches peo­ple to tune into their emo­tions and how it af­fects their eat­ing pat­terns,” ac­cord­ing to Isoldi. “At Cor­nell, we use this ap­proach to help pa­tients rec­og­nize and grade their hunger pangs, iden­tify the times dur­ing the day that they get hun­gry, and the is­sues in their lives that make them overeat.” Many peo­ple use eat­ing as a re­ward at the end of a long, stress­ful day, ir­re­gard­less of how hun­gry they may or may not feel, she ob­serves. “Part of our mission is to help pa­tients find an al­ter­na­tive to overeat­ing as a stress re­duc­tion tech­nique by cre­at­ing aware­ness in the mo­ment and learn­ing to di­vert overeat­ing ten­den­cies else­where.”

MIND­FUL EAT­ING

The first steps to more mind­ful eat­ing: Slow down and sit down. Deb­o­rah Kesten, MPH, au­thor of Feed­ing the Body, Nour­ish­ing the Soul: Essen­tials of Eat­ing for Phys­i­cal, Emo­tional, and Spir­i­tual Well-Be­ing ad­vo­cates putting spir­i­tu­al­ity back into eat­ing by bor­row­ing cul­tural tra­di­tions that help us slow down and fo­cus on the taste and smell of food. Many cul­tures have some kind of prayer or an­other rit­ual be­fore eat­ing that helps us to slow down and con­tem­plate the food be­fore us (for ex­am­ple, say­ing “grace”). In her book, Kesten sug­gests stop­ping for a few sec­onds be­fore eat­ing (whether it’s to take a deep breath and ap­pre­ci­ate the scent of the food, or to say a brief prayer) so that we slow down and ap­pre­ci­ate what we’re about to eat. There are also var­i­ous cul­tural tra­di­tions, such as the Ja­panese tea cer­e­mony, that fo­cus at­ten­tion on the rit­ual of eat­ing and the taste of food. It’s an­other way of slow­ing down. Sit­ting down for a meal helps to fo­cus your at­ten­tion on the meal; never eat stand­ing up. Fo­cus on sa­vor­ing each mo­ment of the meal, each mouth­ful of food. It takes around 20 min­utes for the brain to get the mes­sage that you’re full; rush­ing meals pro­motes overeat­ing. Cre­ate sooth­ing meal­time rit­u­als. Even if you’re dining alone, use china plates and your best flat­ware. Bring out the cloth nap­kins. Have flow­ers on the ta­ble. Light can­dles for the evening meal. Eat with your fam­ily or in­vite friends for a meal. Turn the tele­vi­sion off and don’t talk on the phone while you eat. En­joy con­ver­sa­tion. Not only will you feel more sat­is­fied by a meal, but you’re less likely to need antacids for dessert. Af­ter eat­ing, take some time to re­lax. Put on some mu­sic, or read a book, Kesten’s book sug­gests.

IN­TU­ITIVE EAT­ING

Many of us la­bel cer­tain foods “good” and “bad.” When you de­prive your­self of a cer­tain food, it can lead to binge­ing and sab­o­tage ef­forts at health­ful eat­ing. One way to quit judg­ing each fork­ful is to take an in­tu­itive ap­proach. “In­tu­itive eat­ing teaches a phi­los­o­phy of mak­ing peace with food pref­er­ences and choices, with the un­der­stand­ing that bal­ance and wis­dom re­gard­ing nu­tri­tion will emerge,” says El­yse Resch, co-au­thor of In­tu­itive Eat­ing: A Rev­o­lu­tion­ary Pro­gramme that Works. “Be­cause de­pri­va­tion feel­ings build when foods are re­stricted there’s of­ten a tran­si­tional pe­riod where peo­ple eat larger quan­ti­ties of foods that were once for­bid­den.

“Lift­ing the ‘ban’ on so­called ‘bad’ foods elim­i­nates as­so­ci­ated feel­ings of de­pri­va­tion and guilt. Over time, in­tu­itive eaters ta­per off from eat­ing ex­ces­sive amounts of th­ese items and be­come more able to en­joy them in quan­ti­ties good for main­tain­ing a nor­mal weight and healthy life­style.” Learn­ing to eat in tune with in­tu­itive hunger sig­nals will also help re-ad­just your set point so that you lose ex­cess

MIND­FUL EAT­ING De­ter­mine if you are eat­ing as a re­sult of phys­i­o­log­i­cal, so­cial, or emo­tional cues. Learn stress-re­duc­tion strate­gies to re­duce overeat­ing. Eat only when you are hun­gry and stop when full. Slow down around mealtimes to aid di­ges­tion. Fo­cus only on the meal; don’t mul­ti­task.

IN­TU­ITIVE EAT­ING Don’t at­tach moral judg­ments to foods – there are no “good” or “bad” foods. Al­low your body to sense what it needs to eat. Eat mainly when hun­gry and stop when sat­is­fied rather than full. Rate hunger on scale of 1-10. Don’t get down be­low a 3 in terms of hunger, and stop eat­ing when you’re at a 6 or 7. Main­tain nor­mal phys­i­cal ac­tiv­ity. Ac­cept your body. Ban­ish “di­ets.”

SATI­ETY IN­DEX Eat foods that help you feel sat­is­fied. Choose bulkier foods that con­tain more wa­ter and fewer calo­ries, such as fruits and veg­eta­bles.

weight, ac­cord­ing to Resch. “Each of us has a ge­net­i­cally determined set point weight which is main­tained through­out life by eat­ing in re­sponse to nor­mal hunger and full­ness sig­nals and by main­tain­ing nor­mal amounts of phys­i­cal ac­tiv­ity,” she says. “Un­for­tu­nately, many peo­ple be­come dis­tanced from this in­ner wis­dom due to di­et­ing and emo­tional fac­tors. They get into ‘pri­mal hunger,’ eat­ing be­fore hunger presents, and ig­nor­ing full­ness sig­nals so that they be­come over­weight.” If you’re not at your set point weight, you’ll slim down nat­u­rally by adopt­ing in­tu­itive eat­ing prin­ci­ples, ac­cord­ing to Resch.

THE “SATI­ETY IN­DEX”

The trick to con­trol­ling how much you eat is choos­ing foods that suc­cess­fully stave off hunger pangs so you don’t keep stuffing your­self. The “Sati­ety In­dex,” was cre­ated in 1995 by Aus­tralian re­searcher Su­sanna H. Holt, PhD, then at the depart­ment of bio­chem­istry at the Uni­ver­sity of Syd­ney. To see which foods gave a sat­is­fied feel­ing, she fed 240-calo­rie por­tions of 38 dif­fer­ent foods to stu­dent vol­un­teers, then rated their ap­petite lev­els over a two-hour pe­riod. White bread be­came the base­line mea­sure of 100. Foods that scored over 100. Foods that scored over 100 were more sa­ti­at­ing than bread; those rated lower than 100 were less sat­is­fy­ing. (See list, at right.) Foods high in fi­bre, pro­tein, and wa­ter sat­is­fied ap­petite longer be­cause they con­tain nu­tri­ents that are slowly ab­sorbed. A sim­i­lar ap­proach from Bar­bara J. Rolls, PhD, pro­fes­sor of nu­tri­tional sciences at the Penn­syl­va­nia State Uni­ver­sity, is called “Vol­u­met­rics.” Rolls ad­vo­cates eat­ing bulky, low calo­rie foods such as fresh fruits and veg­eta­bles (such as cel­ery, car­rots, broc­coli, let­tuce, melon, grapes, pears, and ap­ples), as well as low-fat and broth-based soups. Choos­ing foods that give you more bulk for your calo­ries in terms of por­tion size, such as pop­corn, keep

you from be­ing hun­gry longer so you don’t overeat.

THE NONDIET DIET

Mind­ful eat­ing and in­tu­itive eat­ing both stress learn­ing to iden­tify in­ter­nal cues for hunger, sat­is­fac­tion, and full­ness to avoid overeat­ing. That strat­egy ap­pears to have a pos­i­tive ef­fect on re­duc­ing key health risks like high choles­terol and blood pres­sure. Work­ing with a pro­gramme called “Health at Ev­ery Size,” nu­tri­tion­ists at the Uni­ver­sity of Cal­i­for­nia, Davis di­vided 78 women aged 30-45 in two groups. The di­et­ing group was put on a mod­er­ately re­stric­tive diet that trimmed calo­ries and fat. They were told to keep food di­aries, and mon­i­tor their weight. In­stead of be­ing re­stricted in their food choices, the nondi­et­ing group learned to tune into their in­ter­nal body cues to iden­tify true hunger, full­ness, and foodrelated feel­ings. The nondi­eters also par­tic­i­pated in sup­port groups to learn how to ac­cept their larger size. Blood pres­sure and choles­terol lev­els were mea­sured dur­ing the two-year study, along with phys­i­cal ac­tiv­ity, eat­ing be­hav­ior, and at­ti­tudes about their body and about eat­ing. Even though the nondi­eters didn’t lose weight, in many re­spects they were the big win­ners. Nine­tytwo per cent re­mained in the study pro­gramme, com­pared to just 58 per cent of the di­eters. By the study’s end, the nondi­eters had sig­nif­i­cantly de­creased their to­tal choles­terol, LDL (bad) choles­terol, sys­tolic blood pres­sure, prac­ti­cally quadru­pled mod­er­ate phys­i­cal ac­tiv­ity, and dramatically im­proved self­es­teem and de­pres­sion. Not so the di­eters. Their choles­terol and LDL were un­changed and they were un­able to sus­tain im­prove­ment in their blood pres­sure, phys­i­cal ac­tiv­ity, and de­pres­sion. BOT­TOM LINE: There was a sig­nif­i­cant im­prove­ment in the health of non-di­eters, even though they didn’t lose weight. Although the di­eters lost five per­cent of their orig­i­nal weight, two years later they had re­gained most of it. Di­et­ing didn’t make any­one health­ier; chang­ing eat­ing pat­terns to eat in re­sponse to in­ter­nal cues did.

WHAT THE EX­PERTS SAY

Louis J. Aronne, MD, clin­i­cal pro­fes­sor of medicine and direc­tor of the Com­pre­hen­sive Weight Con­trol Pro­gramme at Cor­nell Uni­ver­sity, and his col­league Kathy Isoldi be­lieve that each of th­ese ap­proaches con­tain ef­fec­tive tools that con­trib­ute to a life­long weight loss pro­gramme. Ap­proach­ing food mind­fully to learn whether you’re eat­ing in re­sponse to emo­tional or so­cial cues or be­cause you’re ac­tu­ally hun­gry is es­sen­tial to los­ing weight and keep­ing it off, says Dr. Aronne, In­tu­itive eat­ing brings a lot to the ta­ble by re­mov­ing the stigma at­tached to cer­tain foods like choco­late, candy, and “junk” food, thereby elim­i­nat­ing food-as­so­ci­ated feel­ings of de­pri­va­tion, guilt, and crav­ings. Se­lect­ing foods rated high on the Sati­ety In­dex will keep you feel­ing fuller longer, help­ing to con­trol the nib­ble fac­tor. Each is an in­ter­est­ing con­cept but none makes a whole plan. “We don’t agree that the body can sense its own nu­tri­tional needs as out­lined in In­tu­itive Eat­ing prin­ci­ples, but rather that ev­ery­one needs good nu­tri­tional guide­lines in or­der to choose a bal­ance of fruits, veg­eta­bles, whole grains, and lean cuts of meat,” says Isoldi. “What has to change is the myth that the only way to be beau­ti­ful is to be thin. Health at ev­ery size has shown us that you can be fit and healthy if you ex­er­cise, even if you are over­weight. And that’s where our fo­cus as a so­ci­ety should be: on good health for ev­ery size.”

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