Food Cop from an eating disorder perspective

I love this post by author and eating disorder activist, Laura Collins. Here is an excerpt:

"The grocery store is a guided map to "low" "no" "free" consumption that we then drive somewhere to "work" off in measured increments of self-loathing. We eat inside a moral sculpture in the shape of our bodies.

This is the hectoring unpleasantness we call healthy. This is the lifestyle we laud and the new Kool-Aid we give the kids. Do too much of it and you'll be the "Food Police" and do too little and you are part of the Childhood Obesity Crisis. The margin of normal? Vanishingly thin."

I like her passion and her observations. I also bemoan the fact that "normal" eating in our culture is completely abnormal. Having worked in a University Health Clinic, I saw a glimpse of the devastation that an eating disorder can bring on a patient and her/his family.

Thanks for your voice, Laura! Please check out her website FEAST for information for families and parents struggling with this illness.

mindful vs mindless eating

In the book, Mindless Eating, the author comes up with all kinds of ideas to help you lose weight: cut out the handfull of candy at the office, use smaller plates, use less cream in your coffee, switch to diet drinks... The thinking is, that by skipping the soda a day, or using one cream instead of two, you would save 100 calories a day and magically lose 10 pounds a year! This is just not how our bodies work. In fact, if they worked that way, I would have gained alot of weight these last few years.

You see, since having a child and having to learn to eat in a way that is mindful and trusting of my body, I have done lots of little things that in theory would add 100 calories a day. I now eat a small candy bar a few times a week with coffee (occasionally even two.) I eat tortilla chips with lunch a few times a week- full fat! Mostly I drink milk and water, but many weekday lunches, I enjoy mango smoothies or real soda, usually satisfied with a half a can or so. I have stopped eating fat-free yogurt (or fat-free anything for that matter.) I eat more eggs. And recently, I've been baking and eating lots of bread -fresh, crusty bread. Initially I would eat 2 or 3 pieces thinking , "This is so good, I probably shouldn't eat so much, but I'm trying to eat in a way that trusts my body, so I will eat what I have an appetite for." Versus be "good" and eat one piece, then craving and eating way more than I originally would if I just let myself eat enough in the first place! (An example of what I consider mindless eating.) I enjoyed my bread this way for a number of weeks. Nothing changed. My clothes fit the same, I otherwise ate the same way- satisfying meals and snacks. Soon thereafter my appetite for bread lessened. I could eat half a piece and still enjoy and savour it. My body figured it out.

What all the standard mindless eating thinking ignores is that it is more complicated than calories in/calories out. When we try to cognitively control what we eat- by points, plate size, strict portion control- we don't do a very good job at it.

You see, our bodies can compensate. Not maybe every day, but over days and weeks if we eat in a way that is truly tuned in to what our bodies need. Maybe I ate a candy bar's worth of calories less over the next few days? I have weighed within 15 pounds since I was 16. I stayed the same the summers I swam 2 hours a day, or the months when I did no exercise and ate Coke and Doritos at 2 in the morning during residency. (I probably also don't have a genetic predisposition to gain weight easily.)

How can we support eating well and trusting our bodies?

We need to give ourselves permission to eat what tastes good, and enough of it. We need to be disciplined enough to provide regular meals and snacks and to give some thought to nutrition when planning what to eat. We need to tune in to and enjoy food while we are eating it. There is room for the handful of candy at the office or the cream that makes your coffee heavenly. This can be harder for some than others. (See my website for information on the How to Eat series.)

How do we screw up eating well and our body's amazing self-regulation powers?

Diet, overexercise, deprivation, eating cognitively instead of intuitively. Losing weight or eating less calories than your body needs triggers a cascade of hormonal, neural and psychological factors that work really hard to get your body back to it's previous weight, often overshooting the mark and even resetting the weight your body will strive to maintain. Dieiting impairs your body's internal regulation system.

Practice mindful, not mindless eating.

Close your eyes, you might like it...

You'd think I was talking about broccoli, or some other challenging food, but I was talking to my 4 yo about a Snickers bar. Yes, I actually encouraged my kiddo to try a candy bar, and it was for breakfast... For those of you that I haven't totally freaked out, let me explain.

Recently I have been enjoying a fun-size Snickers with my afternoon coffee. I left one on the kitchen table and at breakfast M saw it and said with excietment, "Can I eat this for breakfast" Now usually I would say no and move on, but she's not had candy with breakfast except on one or two occasions and it wasn't one she usually asks for.

Me: "You can chose if you want it with breakfast or with dinner for dessert."

M:"I want it now. It doesn't have nuts in it, does it???" she whined with crinkled nose.

Me: "It does. Maybe if you close your eyes you might like it?"

Wait a minute, what was I doing? I remember my Dad saying that to me very sternly when I was little. "Close your eyes and eat it" if I complained that something looked gross. Was I pressuring?

These are the moments with feeding that I stop and check in with myself. (Something I ask parents to do when things aren't going well or they feel anger or frustration with a feeding situation.) What are my motives? What is my baggage around this issue? Am I pushing? Am I getting push-back? Are we emotionally in a good place? Are we getting upset or are things pretty pleasant and neutral still?

No. It didn't feel like pressure. I casually offered her the option of closing her eyes and mentioned that she might like it. She closed her eyes for the first bite and enjoyed the Snickers bar, somewhat surprised. She drank milk, had half a banana and a clementine and half a piece of buttered whole wheat bread with it. Not too shabby nutritionally, and it was a pleasant breakfast that felt special to her. Will I make a habit of it? No, but part of feeding is to be able to be flexible at times. If she had refused or not wanted to try it, I would have said, "Fine, you can have toast and fruit, and I could also make oatmeal."

Sometimes a gentle suggestion, given with the intention of honoring variety and being open to new tastes, versus pressure or trying to get your kid to eat something can help. When M doesn't want to try something, sometimes just saying, "OK, your napkin is right here in case you want to try it and spit it out." I then move on with my meal, usually eating the food that she refuses to try and most of the time in a minute or two she will be happily eating the offending food. See what works for you. Be careful not to push-you usually just get pushed right back.

Artisan Bread in Five Minutes...

I tried a bread machine for awhile and gave up. I love crusty loaves, but didn't love paying 3-5$ at the grocery store or bakery.

This seems to be one instance where the product lives up to the hype. It IS revolutionizing home baking– at least at our house. A neighbor gave me a business card of a local doc-turned bread cookbook author and I ordered a book. It's called Artisan Bread in Five Minutes a Day. I tried it and fell in love. (Picture is of European peasant loaf with rye and whole wheat flour.)

pluses: quick and easy

•M helps me measure and mix the ingredients (takes about 5 minutes)

•no kneading

•tastes awesome!

•relatively little investment for book and materials

•kid loves it

•home-made bread on a weeknight

negatives:

•the container takes up space in the fridge

•can't do a really high fiber or whole wheat content with this method

•did need an oven thermometer (our over in off by 60 degrees)

•bought a pizza stone

•now that it's colder, I am routinely letting the bread rise twice the recommended time (My FIL left a loaf out overnight and baked it and said it was delicious...)

If you like bread, the book, or a fresh loaf is a great idea for a Holiday gift. Yummy! (We've baked about 3 loaves a week for the last 2 months.) M likes it for breakfast. It's also an easy part oaf a snack. (I put butter on and wrap it up and bring some fruit and water and it's a good snack on the go.) I also recommend visiting their website and watching their video on the technique. It's really helpful.

Next post will be a musing on internal regulation and mindful eating. Long and short is when I first started baking the bread I ate lots of it and enjoyed it. Stay tuned.

Dr. Oz big fat questionable diagnosis

As I was wrapping 24 little advent gifts for our traditional German advent wall-hanging, I was forced to settle for Dr. Oz's medical show. (Again, why a cardiac surgeon is giving general medical advice is beyond me. See an old rant...) A gentleman stood up and asked if his hot flashes and night sweats were normal. With no further questioning, Dr. Oz basically told the man that he had a hormonal imbalance, akin to menopause and he could reduce his circulating estrogen by losing his belly fat. This gentleman was "average" to below average build, don't know if he was fit or had other health factors, but the first thing that jumped to my mind was not that he needed to lose a fairly insignificant amount of belly fat.

Since I've been learning about eating and wellness, I have become much more sensitive to instances of weight bias, which can manifest as a willingness to assign weight as the cause of a condition without any kind of indication it is a factor, and with potential danger in ignoring other possible factors– such as night sweats being a symptom of lymphoma and other serious illness.

Chances are he does not have lymphoma, but was any purpose served by blowing this off as an unlikely hormone imbalance? Will some guy at home who is a little heavy ignore night sweats now as simply another by-product of being big?

FYI, here is an excerpt of possible things that can cause night sweats...

Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy. (Am Fam Physician 2003;67:1019-24. Copyright© 2003 American Academy of Family Physicians.)

Just thought it was interesting. Another example of weight bias: a woman sprains her ankle, her BMI is 26 ("overweight" range.) Though she is an athlete with high muscle mass and her BMI is not indicative of any increased health risks, her physician says she probably sprained her ankle because she is "overweight." (Playing ultimate frisbee on wet grass had nothing to do with it...)

What are your thoughts and experiences?

India House buffet

I must again wax poetic about the benefits of a buffet when eating with children. (Read an old post for lots of restaurant ideas and tips for buffets with kids.)

No waiting for food (how many little toys can you cram into your purse or diaper bag to keep them happy for those interminable 20 minutes while you wait for your food– if you're lucky it's only 20 minutes.)

Variety

Tying new things without a big financial commitment, or too much waste

Not too pricey

We have long loved Indian food, and particularly the buffets. We found a new restaurant to us on Grand Ave in St. Paul. It's called India House and we enjoyed ourselves and the food.

Another bonus when eating with small kids is that they have booths. I am a huge fan. I have a kid who has shunned boosters since getting out of her high chair. She prefers to kneel (even though her feet fall asleep sometimes which is not fun...) and booths are a safe way to sit.

They have options for even the pickiest kids and adults. White rice, Nan bread, cucumbers with ranch, and our favorites are the chiken Tikka with a mild sauce, chick peas and Alu Gobi (curried cauliflower and potatoes.) There are spicy dishes too, but a nice variety.

First time there or eating Indian food? Get a few small plates of the dishes and bring them to the table so the kids can serve themselves family-style. Go in with a positive and curious attitude, don't force anyone to try something they don't want to and enjoy it! Even if they only smell, or lick something new, it's progress and you've had fun. Remember anyone can spit out a food they don't want to swallow, they just have to do it politely.

talking to kids about food

Here's a link to my article on talking to kids about food. Do you think we talk about food and nutrition entirely too much, or not enough? Are we as a culture sending the wrong messages? I think so, read it and tell me what you think!