Intuitive Eating

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Diet is the word “die” with a “t” on the end.

I’ve spoken highly of Jason Fitzgerald’s Strength Running podcast. I’ve been listening to past episodes and I just finished Episode 58: Superfoods, Veganism & Fasting: A Registered Dietitian’s Perspective. He interviews Heather Caplan, RD and she gave informative views on diets, veganism, meat, and fasting among other subjects. She also discussed her experience with the eating disorder known as orthorexia or the unhealthy preoccupation with eating healthy food.

I found Caplan’s discussion of dieting vs something called Intuitive Eating most interesting. Intuitive Eating isn’t a diet but rather a thought process and a way of relating to food in a healthy, non-restrictive way. Fitzgerald related diets and Intuitive Eating to a proverb you may have heard: “Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.”

Caplan suggested that dieting means giving control to someone or something else (the diet) whereas Intuitive Eating bestows agency on the individual. Intuitive Eating means respecting one’s own feelings around food like hunger, satiety, and enjoyment. Intuitive Eating gives permission and doesn’t restrict. To me, Intuitive Eating is a healthy way out of the self-loathing and negative relationship with food experienced by so many people. The 10 principles of Intuitive Eating are:

  1. Reject the diet mentality.
  2. Honor your hunger.
  3. Make peace with food.
  4. Challenge the food police.
  5. Respect your fullness.
  6. Discover the satisfaction factor.
  7. Honor your feelings without using food.
  8. Respect your body.
  9. Exercise – Feel the difference.
  10. Honor your health.

Listen to the full podcast for more information.

Motivation vs. Willpower

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I mentioned in the last post that I was reading and enjoying Matt Fitzgerald’s Diet Cults. Chapter five of his book contains some information that I found very thought provoking. This chapter discusses the process and details of those who’ve successfully maintained weight-loss. The National Weight Control Registry observed several key behaviors in those who lost weight and kept it off.

  • Weighing: If weight-loss is your goal then looking at a scale will tell you if it’s happening.
  • Monotonous eating: Eating very similar meals repeatedly makes it easy to track caloric intake. Further successful weight-losers to vary their eating less during the weekends and holidays. (“Monotonous” may imply boring. I don’t believe it has to be that way.)
  • Exercise: What we eat (and don’t eat) is absolutely vital for weight-loss. It seems that exercise is absolutely vital for maintaining weight-loss

(Interestingly, subjects do report eating healthier eating as part of the weight-loss process, no specific diet was identified as being best.)

More important than habits is the motivation that underlies these habits. Motivation is different from willpower.  Fitzgerald suggests that motivation activates will power, sort of like computer software (motivation) activates the hardware (willpower). He says that “evidence suggests that most people have all the willpower they need to lose weight and that what separates the successful losers from the failures is motivation.

The NWCR study found that 90% of members reported having failed in previous weight loss attempts. In other words, these people failed a lot. It seems the people who succeeded kept on trying due to motivation. This got me thinking about my own views on willpower vs. motivation.

It seems that we often talk about willpower as a negative thing. We criticize ourselves because we don’t have enough of it and we wind up eating a bunch of cake. Or else we see overweight people, drug addicts or smokers and we say they don’t have the willpower to lose weight or quit. The word willpower mostly seems to come up when there’s something negative drawing us towards it and we know we’ll succumb to this evil thing, and then we’ll hate ourselves afterward. The practice of willpower seems a cold, Spartan type of undertaking.

In contrast, something that motivates us is a positive thing that we want. It’s something that makes us look past the temptations, triggers and roadblocks to our success. We may not be perfect in our eating and exercise habits but the motivating factor makes us keep trying. I think in a lot of cases motivation actually makes us want to undertake the healthy behaviors that lead us to our goals. As noted in Diet Cults, it’s motivation that makes for successful willpower.

Not that everything about our motivation is positive. Fear may be a great motivator. For instance, a doctor says, “If you don’t lose weight you’ll have a heart attack in five years.” For a lot of people, that may be the type of revelation that motivates them to lose weight. A similar scenario may play out if we lose a loved one to a preventable illness like diabetes.

Maybe shame motivates us. I recall a client who stepped on a scale, saw the numbers and said, “That’s it!  I can’t do this anymore. I HAVE GOT TO LOSE WEIGHT.”  And he did.

Money is one of the best, most popular motivators out there. Look at participants on the Biggest Loser. They go through an especially ugly hell to win fame and fortune. (I’ve seen all of about 3 minutes of that show. It scared me.)

I was speaking to a very wise friend about all of this and he said that inherent in this motivation to change is a genuine belief that a change for the better is possible. Beyond the fear mentioned above, we must see and believe in a better life for ourselves. A living belief in a better future sustains motivation. Without this belief motivation withers and dies.

From what I know, motivation must come from within. I’m not sure how to impose motivation on someone. I think perhaps I can draw motivation out of a client by asking the right questions. This is a challenging prospect! This involves a developing a fairly intimate relationship with a client and asking some nuanced, sensitive questions. This has given me a lot to think about.

What motivates you in your fitness endeavors? Surely something must motivate you to wake up early or carve out time in your busy day to grunt, groan, sweat and lift heavy objects. Most of you aren’t pro athletes or models. So why do you do it? I’d like to know. What makes you keep on keeping on?

Must Read: Is Sugar Toxic?

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“High-fructose corn syrup, sugar — no difference.  The point is they’re each bad — equally bad, equally poisonous.” – Robert Lustig, MD, Professor of Clinical Pediatrics, UC San Francisco

The New York Times Magazine has a remarkably in-depth piece on sugar called Is Sugar Toxic? We get a lot of information on the sweet stuff from the history of sweeteners to the differences between sucrose and high-fructose corn syrup (There seem to be no differences.) to some of the unique physiological effects of sugar. Dr. Robert Lustig of the University of California San Francisco is a source for much of the information of the article.  He’s an endocrinologist who recently has focused on preventing obesity in children.  He contends that sugar calories are different from other sources of calories, and that sugar is genuinely poisonous to human beings.  (You can watch Lustig’s lecture,Sugar: the Bitter Truth on Youtube.)

Buyer beware...

Among the evils ascribed to sugar in the article: obesity, diabetes, metabolic syndrome, and atherosclerosis caused by elevated blood triglycerides (fat) which often results in heart disease. This idea that sugar causes blocked arteries is somewhat controversial and runs counter to several decades of “conventional wisdom.”  The article also suggest that in fact sugars may play a strong role in developing cancer. For years it’s been dietary fat that’s been the bad guy in the heart disease fight.  And to this point, the article does a good job of dissecting the various theories and evidence either in support of and/or against both sugar and fat as the edible evils in our lives.  I won’t go into all the fine details here but the discussion should remind us that one theory doesn’t necessarily cancel out another (Could be that both sugar AND dietary fat aren’t that great for us.), and that science is indeed a human endeavor which is subject to human emotion and judgment. The discussion on sugar and cancer is one that I’ve not heard before.  There is evidence to suggest that chronically elevated insulin plays a strong role here much as it does with diabetes.  Researcher Lewis Cantley, director of the Cancer Center at Beth Israel Deaconess Medical Center at Harvard Medical School, says:

“I have eliminated refined sugar from my diet and eat as little as I possibly can, because I believe ultimately it’s something I can do to decrease my risk of cancer.” Cantley put it this way: “Sugar scares me.”

That’s a strong statement by someone with what seems to be a thorough knowledge of his subject.  It certainly has me thinking about this stuff more than I have.  I love dessert and so does my wife.  We devote just one day a week to indulging in something genuinely tasty and fantastic.  I think that’s a fairly low level of consumption but now I wonder if sugar is like cocaine or meth.  Perhaps there is no such thing as a “moderate” amount of sugar. What is clear to me is that less is best.

Beating Obesity

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The latest edition of the Atlantic features an excellent article on our nation’s struggle with obesity.   Beating Obesity is written by Marc Ambinder and it’s a thoughtful, in-depth look at the political and social ramifications of this seemingly losing battle.  We learn about the major players including First Lady Michelle Obama, the food industry and the insurance companies.  (Ambinder himself struggled with obesity and eventually underwent bariatric surgery as a solution.)  Ambinder does a very good job in discussing the issues of individual responsibility and the environmental challenges we face such as food at every checkout line (not just at the grocery store), ever growing portion sizes, and junk food that is cheaper than fresh fruits and vegetables.

Most importantly he examines the moral and demographic issues of obesity.  He notes the following:

“Black children are more at peril of becoming obese than white children; black women are more than 50 percent more likely to be obese than white women. ‘At the current rate of increase,’ epidemiologists noted in a recent article in Obesity, ‘it will take less than 30 years for all black women to become overweight or obese.’ Obesity rates are above average among Mexican American boys, as they are among Hispanics generally. Obesity rates among young American Indians tend to be nearly twice the national average.

Please check out the article.  It’s an excellent piece.

NEAT and the Benefits of Hunger: Part II

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Previously we looked at the deliterious health effects of our seated, sedentary modern lifestyle; and we saw remarkable value of NEAT, or Non-Exercise Activity Thermogenesis.  Essentially, sitting a lot correlates to early death while moving around a lot makes you healthy–even if this movement isn’t what you might call “exercise.”

Part II of the discussion revolves around the article Movement comes with appetite, found on Science Daily.  We’re told of findings by a Swiss research team, whose study is found in the journal Nature.  (The full study can be accessed here for a fee.)  The science here is fairly complicated so I’m going to try and avoid the overly complex details.  Essentially, the star of the study is a molecule found in the liver and hypothalmus called Foxa2.  Foxa2 is found in humans and other animals.  Here we go with an attempt at explaining why Foxa2 is important.

Foxa2 found in the liver affects fat burning.  It’s also found in the hypothalmus which affects daily rhythm, sleep, intake of food and sexual behavior.  Researchers also observed that Foxa2 helps form two proteins (MCH and orexin) which trigger both the intake of food and spontaneous movement.  Foxa2 is blocked by insulin which is released when we eat.  In a fasted state–between meals for instance–insulin is absent and Foxa2 is active.  Thus animals tend to be more active while hungry.

If mammals are hungry, they are more alert and physically active. In short, they hunt and look for food. “If you watch a cat or a dog before feeding it, you can see this very clearly,” Markus Stoffel, a professor from the Institute of Molecular Systems Biology at ETH Zurich.

Researchers found a Foxa2 disorder in obese mice.  High levels of insulin blunted Foxa2 which in turn reduced production of the two proteins that triggered hunger and movement.  To prove this, the researchers bred mice with ultra-active Foxa2 production and the result were mice with high production of the two proteins.  These mice lost fatty tissue and formed larger muscles. Their sugar and fat metabolism increased considerably.

The practical suggestion from Stoffel is that we should be hungry sometimes.  “The body needs fasting periods to stay healthy.”  Hunger promotes movement and thus all the benefits we expect from an active lifestyle.  Both the study’s evidence and the suggestions from this researcher are contrary to much of the popular nutrition advice.

The suggestion that one should eat small frequent meals throughout the day (aka grazing) is standard advice found on almost any list (look here, here, here, here and here for starters) of healthy eating tips.  I’ve told clients this many times and I’ve followed this bit of common knowledge for years.  The reasoning behind the several-small-meals tactic is 1) eating throughout the day keeps the metabolism up, and 2) if we become too hungry then we tend to overeat at mealtime.  Is it possible we’ve been doing it wrong?  Could three meals a day in fact make us leaner and healthier?  I think the answer to that question is the same answer  to most questions: It depends.  I’ll discuss it more in Part III.