Showing posts with label Overeating. Show all posts
Showing posts with label Overeating. Show all posts

Friday, April 19, 2013

Mindless to Mindful Eating for Weight Loss

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The art of successful weight loss remains elusive for many. On one hand we learn that effective weight loss programs should shift their focus from outcome-based goals where we exhibit less control (e.g., losing 20 lbs. in 15 weeks) to more behavioral-based processes where we exercise more control (i.e., small strategies implemented daily). But we also learn that to better motivate by building importance and anticipation, we should de-emphasize daily caloric differences (e.g., 300 kcal deficit in 24 hours) in favor of speaking to a 31 pound weight difference in a year (i.e., 300 kcal x 365 days = 109,500 kcal or 31 lbs.). Although both effective, they might also be interpreted as somewhat contradictory strategies, so what do you do? In a practice where strategies generally target diet and activity, consider adding a new strategy that incorporates elements from both, yet also addresses the impact of environmental stimuli and how they influence eating behaviors. This strategy is slowly taking center stage as a key player in tackling the challenge of weight loss (1). Examine environmental cues and learn how to shift eating behaviors from mindless to mindful.
What we are discovering is many of us remain mindless, consciously unaware, over 100 – 300 calories of nibbles and bites throughout the day and only become mindful of what we actually eat when surpluses or deficits reach 500 – 1,000 calories (2). For example, if you overate today with an extra meal or 1,000 additional calories, you would probably think consciously about the consequences and quite consider compensatory actions or resolutions. However, the mindless 100 – 300 calories accumulated throughout the day (e.g., two small candies at a co-worker’s desk, a bite of your child’s ice-cream bar, etc.) generally fail to trigger conscious awareness. By the same token, many feel that they pay attention to everything they eat, but on average, we make more than 200 daily food decisions, although we believe we only make about 15 (3). The truth is that we often behave mindlessly around food and although some may discount 100 – 300 kcal daily, it can amount to a 10½ – 31 lbs. (4.8 – 14 Kg) weight gain in a year.
The focus therefore of this article is to examine various environmental cues that stimulate sub-conscious overeating and offer helpful mindful takeaways to consider sharing with your clients.
Portion Size
It is probably safe to assume we all agree portion sizes have increased steadily over the past 30 years for many reasons – technological improvements to economically mass produce food and consumer demands for more cost value. Yet, this slow and ever-expanding portion distortion, coupled with our ‘clean-plate’ mentality has spurred overeating. One interesting study examined different portion sizes with stale five-day old popcorn revealing that people consumed 53% more popcorn (173 kcal) when given larger containers (4), even with bad food.
As portion sizes expand, so do the tools used to eat (e.g., plates, glasses, etc.). Try reducing portion sizes by mini-sizing eating tools (e.g., use smaller plates or side-plates; use taller thin glasses, rather than shorter fatter glasses which can reduce over pouring up to 37%). Try capping portion reduction to 20% as this generally goes unnoticed. Portion size reductions reaching 30% or greater increases conscious awareness of the reduction inducing a sense of deprivation, and may trigger a psychological reactance effect (1). This is a phenomenon defining behavioral responses that occur when regulatory actions threaten or eliminate specific behavioral freedoms (5). In other words, when a person feels deprived of their choices or freedoms then undesirable behaviors become more appealing, motivating a person to recapture that threatened parameter.
Pace the Clock
After eating, the presence of food in the stomach and gastrointestinal (GI) track, and the entry of food into the blood trigger neural and hormonal responses that turn off our hunger sensation. Hormones such as leptin from the fat cells and cholecystokinin released from intestinal cells can suppress the urge to eat further. However, it is estimated that these responses may take up to 20 minutes after those first bites to take effect, which raises the question over how much calorie consuming damage one can do in 20 minutes. On average, fast food is consumed within 11 minutes, whereas food consumed in a moderately-priced restaurant takes 28 minutes (6). Implement a strategy to control your client’s eating pace by taking the time to stop, sit and eat, or to sit with the slowest eater in the group. Be mindful however of the dining ‘pacesetter’, the person who may unknowingly sets standards for how much food and how fast it will be consumed (7). If this person eats chips and salsa, he or she may influence others to mindlessly join in and eat comparable amounts. Identify the slowest eater and mindfully avoid the pacesetter.
In Sight Equals In Mind
The power of sight (what we see) can stimulate or suppress appetite, so be mindful of both. In a bottomless soup bowl study (automatically refilling bowl v. regular bowls) those eating from the bottomless bowl consumed more soup and 73% more calories (155 kcal v. 268 kcal) (8). Interestingly, the bottomless bowl group never made mention to feeling full and both groups, as expected, under-estimated total calories eaten.
On the other hand, we have also learned that sometimes what we see can raise our level of consciousness or awareness as to how much we are overeating. In a chicken wing study, when bones were left in plain sight for people to see how much they ate, they actually consumed 28% less food (9). Considering our stomach cannot count, and how we consciously or subconsciously are forgetful in tracking what we eat, we may need mindful reminders.
Interestingly, individuals who pre-plate their food (i.e., bring all they plan to eat to the table before eating) as opposed to making several trips to the buffet line will eat 14% less food (1). The takeaway message is that we need to be more vigilant about our ‘clean-plate’ mentality; sometimes visibly seeing what you plan to eat or have eaten may give reason to pause and be more mindful.
Out of Sight Equals Out of Mind
We appreciate a bargain and often buy in bulk because of its value. In industrialized nations (e.g., U.S.), this mentality is amplified by abundant wholesale stores and larger vehicles, whereas in nations where individuals walk to purchase groceries or drive smaller cars, buying in bulk is sometimes not an option. Generally, when buying in bulk, we tend to initially overeat from these larger containers, then grow tired of the food whereupon it becomes a castaway in the refrigerator, freezer or pantry (10). Researchers have also discovered that individuals consuming snacks from clear jars consumed 71% more food versus food concealed in opaque containers (11). Removing food visibility decreases temptations for mindless snacking (seeing, smelling or thinking). The takeaway message – if buying in bulk, immediately repackage larger containers into smaller, non-see through containers and store out of sight – this helps curb subconscious eating. Even a small strategy such as placing a lid on a container or covering it with foil can curb mindless munching.
Don’t Deprive Foods (Comfort Foods) – Control Them
Many food desires and cravings are trigged by thoughts, emotions or environmental stimuli. When we have such desires, comfort foods become a prime target to satisfy needs (1). People seek out comfort foods for many reasons, including rewards, celebrations, or feeling happy, bored, depressed or lonely. Although positive moods generally lead to healthier food choices in comparison to negative moods, we must help our clients consciously understand their triggers that spark specific food desires (12). Once mindfully aware of triggers, strategize distractions since these thoughts and emotions are generally short-lived. Aim to satisfy the thought or emotion while simultaneously reducing the likelihood of eating (e.g., calling a friend, expressing thoughts in a journal, playing with a pet or doing an activity). Keep things simple – the idea is to distract a short-lived desire, but also recognize that if the desire still persists after the distraction (i.e., a few minutes), allow the individual a small mindful indulgence to avoid any psychological reactance.
A trade-off is another effective strategy for controlling mindless eating. Give people autonomy (ability to choose) to choose their behavioral action, but use consequential persuaders (i.e., give client the power to choose from several options, while concurrently making them aware of the consequence of each choice). This again reduces chances of psychological reactance. For example, making them aware that a 100 kcal snack is equivalent to a 23-minute walk or standing for 52 minutes (13). Present these consequences and let them decide.
  • Women: 1 kcal = 20 steps walking (1-minute walking = 4.3 kcal).
  • Men: I kcal = 17 steps walking (1-minute walking = 5 kcal).
Control Choices
When more food choices and colors are presented, we typically imagine more enjoyment from the food. By comparison, when we have decreased food choices, we often experience a perception of less food enjoyment (1). Putting the same food into multiple bowls can also result in people perceiving more choices and eating more, by up to 18% (14). A challenge with food choices is that we don’t fully comprehend how much we should take or want, so we gauge our decisions by what we think is appropriate. When there is more food or when we perceive there is more food, we tend to think eating more is appropriate, a concept called sensory-specific satiety (1). In a study using M&Ms®, researchers compared 7 colors versus 10 colors, and while each color tastes the same, those given more color choices ate 43 more M&Ms® (99 v. 56 in total) (15). The takeaway message is that by controlling the number of food choices available, we may subconsciously develop a perception of less enjoyment from the food and may actually eat less.
De-convenience Convenient Foods – Create ‘pause points’
This approach is to make snacking a hassle and not a habit. This can be accomplished by making snacks less accessible and creating ‘pause points’ where one has a moment to consciously contemplate the consequences of snacking and possibly avoid mindless eating. In one study chocolates were placed on the corner of a desk, in a drawer, and then on a file cabinet six feet (1.85 m) away in random order (16). The results demonstrated that when chocolates were easily accessible (i.e., on the desk), an average of nine chocolates per day were eaten. By comparison, only six and four were eaten per day with chocolates in the drawer or on the filing cabinet, respectively.
Another classic and often-cited study looked at eating behaviors when conscious cues where utilized to help control eating. Participants were served tubes of regular Pringles® potato chips and allowed to eat as many as they wanted, but in some tubes red chips were placed at regular intervals (7th or 14th interval; 5th and 10th interval in follow-up study), a process called segmenting. Interestingly, in the tubes with no red chips, individuals ate significantly more chips whereas they ate less with the smallest red chip intervals (17). Individuals eating from the red chip tubes were also better at estimating how many chips they ate. Segmenting packages appears to effectively reduce food consumption by helping:
  • Call attention to and encourage better monitoring of eating
  • Controlling portion sizes
  • Breaking automated eating sequences by introducing a pause
The takeaway is to move snack foods outside of six feet where an individual has to physically move to access the food, giving time to structure an opportunity for a‘pause point’ where consequences can be contemplated (e.g., that 100 kcal snack will require 20 minutes of walking). Likewise, implementing strategies whereby eaters are given conscious ‘pause-points’ may also help curb mindless eating behaviors.
 Halo Effect
Healthy foods continue to garner more attention and popularity, but be cautious not to lose sight that healthy does not necessarily mean fewer calories. In a study comparing individuals who ate at McDonalds® versus Subway®, it was the people who ate at Subway that underestimated total calories consumed by a larger margin (34% underestimation v. 25% at McDonalds) (18). The notion of healthy may give eaters a false sense of confidence, believing that choices are healthier and leaner. The takeaway is to read the fine print – don’t be fooled by ‘healthy marketing’ where because food appears healthy, it must contain fewer calories.
Know your Dietary Danger Spots
Many of us are unaware of our dietary danger spots, those locations where we tend to exhibit poor dietary behaviors (choices, portion sizes, or rate of food consumption). Take time to become more aware of your client’s problematic eating environments as this is certainly an area where we can help them improve. Table 1 provides simple strategies to implement to take control of these danger zones.
 Table 1: Dietary Danger Zones
3-11-2013 9-46-34 AMExpectation Assimilation
Be aware of what is called an ‘Expectation Assimilation’ which refers to the expectations that the environment may have upon current and immediate eating behaviors (1). In a wine study using the same wine, but labeled either as a new wine from California (known for good wines) or from North Dakota (not known for good wine), participants were served the same food from the same servers, in the exact same environment, yet those drinking California wine consumed 11% more calories, dined for 10-minutes longer, and enjoyed their experience more, indicating that the food tasted better (19). The findings of this study appear to be one where our expectations of the eating experience may influence choices and quantities before we even eat. The takeaway is to explore environmental stimuli where clients find themselves overeating or choosing more calorically-dense foods.
In closing, whereas traditional weight loss models focus more exclusively upon the parameters of diet and activity, the goal of this article was to present another opportunity we can address when helping our clients target weight loss. Whether you’re a personal trainer or an NASM Weight Loss Specialist (WLS), it is important to simplify the process of behavioral change while motivating them with some of these simple ideas. Recognize that you should not implement multiple strategies concurrently, so create a to-do checklist, identify easiest strategies to implement first, challenge your clients to try them once, then build repeated behaviors as their self-efficacy and ability improve, then progress your program to target more problematic areas.

By Fabio Comana, MA, MS, NASM-CPT, CES, PES
NASM Director, Continuing Education

Monday, February 25, 2013

Push Back! Your go-to guide to not eating when you're not hungry


Push back � your go-to guide to not eating when you're not hungry | Herbalife | Discover Good NutritionEverywhere you go, it seems, there’s pressure to eat.  Here’s how to push back.


For most of us, the last thing we need is the pressure to eat more.  But it happens all the time.  A few years back, one of the fast food chains in the US began a push to add a whole extra meal to your day –  “the meal between dinner and breakfast”.  I do understand the desire for an occasional midnight snack – sometimes you eat dinner early, you stay up late and you get hungry. But once that midnight snack morphs into “the fourth meal”, it starts to sound more like an everyday need – which just makes it easier to justify why we cave into the pressure to eat it.
This pressure to eat faces us everywhere we go, and it seems as if we’ve come to expect it – and accept it, too. I’m no longer surprised when I see free donuts at the dry cleaners, or a plate of cookies at the bank.  When I go to a restaurant, I expect that the server will offer to “start me off” with some deep-fried something or other, or ask me if I’ve “saved room for dessert”.  You’ve probably experienced the occasional pressure to eat from friends, family or co-workers.  Even when you shop for groceries, there’s pressure to buy more (“buy two, get one free!”), which just means more food in the house – and increased pressure to eat it.
With this constant pressure to eat, it means that we have to spend a lot of time trying to stop ourselves from giving in.  And that isn’t easy to do, since it’s almost expected that we should be eating more, not less. (When was the last time a server in a restaurant tried to discourage you from ordering appetizers or dessert?)
But you can push back.  Here’s how.
Push back when there’s food where you least expect it.
Like the donuts at the dry cleaners or cookies at the bank, you can probably think of dozens of unlikely places where you’ve encountered food.  This situation is probably the easiest one to deal with, since you really weren’t expecting the food to be there in the first place.  Ask yourself:  “am I hungry?”,  “is this something I want?” and “would I walk across the street right now to get this?”  Pay attention to your answers, which are most likely some combination of “no”, “not really” and “probably not”.
Push back when you’re grocery shopping.
Grocery shopping is a minefield of temptations – there are literally thousands of items there to entice you.  This is why making a list – and doing your darnedest to stick to it – is so important, since it will curb your impulse buying.  When you’re faced with ‘value pricing’ – which encourages you to buy more than you need – consider how you’ll deal with the extra.  If it can be stored out of sight, or repackaged into smaller containers, that’s fine.  But if having more around means you’re likely to eat more, that’s a bargain you don’t need.
Push back when restaurants offer you more than you want.
Just like value pricing at the supermarket, restaurants like to offer you value, too.  Free bread or chips doesn’t cost them much, but the cost to you could be a few extra inches on your belly and hips. Instead of those “deep fried something or others” as a starter, just ask for some water with lemon to sip on while you look over the menu.  Turn down the offer of an extra ‘side’ for just pennies more – unless it’s an extra side of veggies.  And when the dessert menu comes around, don’t even open it.  If others at your table are indulging, have order some coffee or tea to sip on while they eat.
Push back when family, friends or coworkers put the pressure on.
You’d think it would be easy to be straightforward with the ones you know best, but eating with those you’re close to is often emotionally charged.  There’s the family member who prepared something nice and high calorie “just for you” – and, since you don’t want to offend them, you feel pressured to eat it.  If you just can’t bring yourself to say no, then ask for a small piece and take just a bite or two…because if you finish it, there’s a good chance you’ll be offered another helping, and you’ll just have to start the process all over again.  And when you’re out with friends or coworkers and you feel the pressure to have something “just this once” or because “everyone else is having some” keep this in mind – being sociable doesn’t require that you have a drink in one hand and an tempting morsel in the other.


Written by Susan Bowerman, MS, RD, CSSD