Anti-Obesity Campaign

https://www.youtube.com/watch?v=xUmp67YDlHY

The way the obesity epidemic is portrayed in this anti obesity campaign made me so upset and frustrated that I’d like to share this with all of you! The video focuses on food and reinforces the myth that obesity is caused by only one thing - eating too much. 

As we know obesity is a combination of genetic, environmental, psychological, social and many other factors that are yet to be determined. It is important the complexity is recognized so someone doesn’t make assumptions just based on eating behavior. This leads to weight bias, as shown in the video.

The parent shames on their child for hiding binge-eating foods in the video by yelling “you can’t do this!”. This is exactly what shouldn’t be done; yet this video is promoting these negative attitudes and behaviors. Children who are teased and victimized are vulnerable to depression; anxiety, low self-esteem and poor self-esteem, which can take a huge toll on emotional well being. This additional increase in vulnerability to unhealthy eating behaviors may reinforce additional weight gain.  

The video also skews the way the epidemic should be looked at and adds to the common myths. It reveals polarized  “black” or “white” thinking. After watching this a viewer might feel that if they made a feeding mistake with their child they are hopeless for life. It can also make viewers think some foods are “good” while others are “bad”.

The video definitely draws attention to the obesity issue but in order to have a positive effect on childhood obesity, there shouldn’t be shocking, stigmatizing and promotion of dissonant thinking. It is not constructive for weight loss and has exactly the opposite effect! This video is a prime example of what we need to change in society. We need positive attitudes, compassion, mindfulness, modeling and less shame!

Fad Diets in the News

If you are from Cleveland, OH or are a basketball fan, LeBron James return to the Cavs has been the talk of the town for months. If you are unaware, LeBron lost a significant amount of weight during his off season; about 67 pounds. This diet plan he followed was classified as the LeBron James Diet-- a new fad diet to add to the list! A quick breakdown of the diet: Allowed: lean proteins, fruits, vegetables, healthy fats/oils, Not Allowed: grains, refined sugars, alcohol, processed foods and dairy. It a nutshell, its very similar to the paleo/atkins diet.

I was approached by a local news station, WOIO, in Cleveland to help cover a story on the LeBron Diet. Two workers at the news station followed this diet to the best of their ability for one month. In total, they lost around twenty pounds. The role I had in the story was I walked around the grocery store with each participant discussing the diet as well as discussing the pros and cons of the diet. My main concern with helping was I did not want the news station to cut of major keys/important facts I mentioned. I also did not want to sound like I was promoting the diet. Here are a few quotes taken from the article that I was happy they included and did not distort my wording and opinions:

"Nutritionist Pelat admits this kind of diet will knock the pounds off quickly for most people. But, she is adamant about it not being the way to go for anything long term."

"She's concerned about a number of things, including eliminating certain food groups like dairy and grains. They provide nutrients we need like vitamins and even fiber."

"She also points out that going under 1200 calories a day, which could easily happen with this diet, is simply too restrictive and tough on your body. That's why she believes LeBron did the diet in his off-season when strength and energy weren't so crucial."

The news station did a great job at highlighting and stressing how I was not promoting the diet and included tips for following a well-balanced diet more so than following the LeBron (fad diet). I thought this situtaiton fit perfectly into our fad diet lesson. Below is the link to the news story and the article.
http://www.19actionnews.com/story/27406361/health-alert-the-lebron-diet-plan

Just another example of how cognitive distortion can happen-- if LeBron James follows this diet it must work! What they aren't telling you is he was under strict care of doctors and dietitians to monitor his food intake and to make sure he was getting all the right nutrients as well as had a personal chef to prepare his meals. Things most of us do not have and don't think about when beginning or trying fad diets.

How Our Environment Affects The Way We Eat

http://www.huffingtonpost.com/2014/09/17/slim-by-design-environment-mindless-eating_n_5737688.html?utm_hp_ref=healthy-living

As nutrition students and professionals in the field we realize there are many factors involved in a healthy lifestyle, and environment plays a huge role in that process.  The article published in the Huffington Post reinforces the significant role our environment plays on what and how much we eat on a daily basis.  Food psychologist and behavioral economist Brian Wansink, P.h.D. and director of The Food and Brand Lab at Cornell University, provides tips in improving food behaviors in various environments.

Interestingly enough, 80% of eating decisions are made within 5 miles of where a person lives.  The grocery store, kitchen, office/work place are the main places where we eat.  Wansink suggests chewing gum before doing grocery shopping to help with cravings and hunger for snack foods.  Also he suggests shopping for the healthiest foods first and eating a healthy snack before shopping can help with the temptation of convenience foods.

In the Kitchen Wansink recommends keeping a fruit bowl out on the counter instead of chips and cereal.  In one study chips and cereal on the counter space were associated with women weighing 21 more pounds than their neighbors.   At the workplace he suggests not eating at the desk because it is associated with eating unhealthy foods and/or later in the day.  When at a restaurant he suggests ordering the entree you want and allowing yourself to have 2 other items.  These items could be an appetizer, alcoholic beverage, or a dessert for example.  People that practice this rule tend to eat 21-23% fewer calories.  These are basic concepts that provide good reminders of everyday environmental triggers that can affect our eating patterns.  

~Amy  DerGurahian

Dietary Change is Easier Said Than Done! (Even when you’re a graduate nutrition student!)

A few weeks ago I gave students in my graduate weight management course an assignment.  They were asked to keep a three-day diet log (really just a decoy assignment) and then to analyze their daily food intake and identify a food that they habitually – or at least regularly – consumed.  Once these tasks were complete, I revealed the real assignment.  I asked them to completely eliminate the food they had identified for one week and to write about their experience. 

The intent of this assignment was allow them to “walk a mile” in the shoes of someone who is attempting to lose weight and being given advice or instruction (usually by well-intentioned nutrition professionals) on how to change their diet and which foods to eliminate.   While the reasons for these suggested changes are obvious to the professional with years of training, experience and insight, they may appear arbitrary – and even punitive – to the patient.    Likewise, dietary habits are just that, habits.  Habits are not easily changed and routines are not easily broken.  Dietary changes, even for a highly motivated individual, are extremely difficult and constantly thwarted by both psychological and physiological cues and sensations, not to mention environmental saboteurs (i.e., friends, family, food marketing and encounters with highly palatable foods).

Here are a few quotes from my students’ reflections:

“I chose to restrict chocolate since this is habitually consumed. Immediately after avoiding the chocolate I felt a sense of frustration and increased preoccupation. I continually thought about the chocolate and other similar (but allowable) items. I didn’t want to be thinking about food, I was trying to let it go. The more I tried to eliminate the thought the more my feelings of discomfort built up.”

“I chose to go without all cheese for a week for this project. At first it wasn’t difficult to think of food to eat without cheese but it became a real struggle upon eating out. Basically it seems that cheese comes on everything in restaurants, especially when you love cheese so much! When I ordered a tuna sandwich at my favorite café I couldn’t bring myself to order it without the pepper jack cheese, which was my first slip up. After I made that slip up, a couple days later I succumbed to cheese pressure from my roommate who would tell me to just eat it! Overall I probably made it a good four days without eating any cheese at all... the experiment was a bit of a fail.”

“…I thought if I am going to expect other people to be able to follow in my footsteps I need to prove that I am strong enough to do the impossible. It was so hard.  On day one my Dad brought home peanut M&Ms, my favorite binge candy which I had to beg him to hide from me.”

“It is easy to say “stop eating fast food” or “stop drinking soda”. But when you are so use to eating or drinking something, it is immensely hard to cut it out of your food. It also is not very sustainable. This is a good reminder that it is very difficult for lifestyle changes to be made.”

“Needless to say, trying not to eat pasta for a whole week was difficult, it was unpleasant, it was impossible. My experience abstaining from pasta can be summed up thusly: ate egg salad for three days, was still hungry, failed miserably. I can definitely see how an environment such as the cafeteria at work can undermine the efforts of anyone who is trying to lose weight, or even trying to eat healthier.”

“I hate to admit this but I found it difficult to complete this assignment. My chosen food to give up for the week was bread. On two days I forgot and was halfway through a sandwich before remembering. Although I don’t usually have toast in the morning, toast seemed to be what I wanted most.”

“It has been years since I’ve been on any type of diet or calorie restriction and I was very happy once the week was over and I could eat whatever I chose to. Although I’m careful with my eating, I never feel restricted and the thought of having to watch everything I eat, as someone on a diet would be doing, is an unpleasant idea.”

Admittedly, the requested changes for this assignment were arbitrary.  But it’s important to remember, that for the average person trying to lose weight, that’s exactly how most expert advice feels.   And while most credible professionals would never recommend total elimination of favorite foods, any dietary alteration is difficult and there are always forces opposing the change, whether they’re physiological or environmental. 

I think it’s interesting to note that even though the students were only asked to give up their favorite food for a week, and even though knew they were going to be held accountable, about half admitted “cheating”.  (And I suspect a few more just didn’t want to admit it!).   We would all do well to “walk a mile” in someone else’s shoes and appreciate the uphill battle fought daily by overweight and obese individuals attempting to make changes to improve their health. 

~Sonya Hauser 

Children in USA are eating fewer calories

I came across this article in NY times which mentions that the overall calorie consumption among children has declined in the past decade thus showing an improving trend in helping treat obesity. This decline was seen among children between the age of 2 to 11 and more among teenage girls.  This analysis was done from 1999 to 2010 and it showed  that the calorie reduction among boys was about 7 percent bringing their total intake to 2100 calories a day and among girls was 4 percent accounting to 1755 calories a day.  The main change was seen in increased amounts of calories from protein foods, reduced amounts of calories coming from carbohydrates whereas those from fats were fairly stable. One of the schools in north Philadelphia was incorporated salad as lunch which might have caused to the surprising drop in calories. This main drop in carbohydrates may have been related to decrease in consumption of sugars present in sugar sweetened beverages and cereal with added sugars. Yet it is unclear if there were other reasons behind the reduced carbohydrate intake.  

Another surprising research was that there was a decline in the consumption of calories coming from fast food among adults. It showed a drop of 1.5% of adult’s total daily intake in 2010 which were 11.3% when compared to the numbers in 2006 which was 12.8%. This decline was observed more 40-59 year old.

Though these numbers show some positive outlook, many more years of research is needed to make this a big change in the current obesity epidemic.

http://www.nytimes.com/2013/02/21/us/children-in-us-are-eating-fewer-calories-study-finds.html

US ranked 8th most obese nation

I came across this article that lists some of the countries with the highest rates of obesity. It was interesting to note that the United States is only the 8^th most obese nation in the world with an obesity rate of 31.8%. I think there has been some misconception that the US has the highest obesity rates in the world.  According to the updated Food Service Index, the most obese nation is Kuwait with an obesity rate of 42.8%. Other Middle Eastern countries including Saudi Arabia, Egypt, Jordan and UAE round up the top 5. The US is the most food secure nation where as the least food secure nations include Congo, Chad, Madagascar, Tanzania and Haiti. The FSI takes into account affordability, food availability, quality and safety and also adjusts for external factors when measuring global food security.

For more of the FSI findings check out the article at 

http://www.foodnavigator.com/Science-Nutrition/World-s-most-obese-nation-Kuwait-and-the-next-four-are-Middle-Eastern

Breakthrough in Diabetes Research

http://www.washingtonpost.com/news/speaking-of-science/wp/2014/10/10/scientists-create-breakthrough-recipe-to-grow-insulin-secreting-cells-by-the-billions/

Scientists have recently discovered how to create insulin-secreting cells from human stem cells. This would allow those with Type 1 Diabetes to be able to create insulin-secreting cells on their own, thus eliminating the need for insulin injections. The patients receiving the transplant of human cells are forced to take immunosuppressant drugs to prevent their bodies from destroying the foreign cells. This is the biggest risk to the patient, because their immune system will be compromised while taking the drugs which may allow for viruses and bacteria to possibly run rampant. As of now, the possibility of the transplant  is rare, with just 1,000 patients who have received it. The article states that the cells are incredibly difficult to obtain; the cells have been difficult to produce artificially and are difficult to retrieve from cadavers.

I feel that this is an issue that needs some publicity so that more progress can be made...Here lies, basically, a cure for those with Type 1 Diabetes, yet it is near impossible to receive a transplant. If this transplant were made readily available to the public, other healthcare costs/risks could greatly be reduced.

"The Impact of a Motivational Digital Video Disc on Parental Knowledge of Obesity-Related Disease in an Adolescent Clinic"

http://www.andjrnl.org/article/S2212-2672(14)00457-2/fulltext#sec1.1 

With the obesity epidemic booming, numerous studies are addressing this issue to help find the answer and how to increase weight loss. I found this research article very interesting because it is using a DVD to help educate and motivate clients to lose weight.

This was a randomized controlled design to compare impact of a 7- minute DVD plus standard care vs. just standard care on outcomes to overweight/obese adolescents. The standard care included assessments of height weight, an complete vital signs, nutrition/dietary intake, and psychosocial factors review. Also included verbal and written nutrition education to help to increase knowledge and plan weight loss schedule. The clinical trial was just 40 adolescents aged from 12 to 18 years old and their parents who were referred for weight management and attending a first appointment with a physician or nurse practitioner at the adolescent clinic. The DVD was developed using input of adolescents to motivate the youth to reach a healthy weight and to educate the families about obesity-related health risks.

The results showed that the DVD plus standard care was more effective then the standard care alone. Also the parents gained more knowledge on obesity-related diseases. Even though the results did show positive feedback the study also concluded that they would need to get a larger sample size and all ages to help determine if the DVD would be beneficial in a larger scale.

This study is just a start of using real life picture and technology to help weight management. This study also included the parents which is very important at this age since these adolescents still are living at home and parents are cooking for them. The person needs to be aware of the health risks but so do the parents. 

How Technology Can Aid in Weight Loss

In the world of advancing technology almost everyone has access to the internet. In some ways this is great, giving more knowledge to anyone looking. However, it also gives way for more confusion. Suddenly, a celebrity can be an expert on nutrition or a new diet plan can spread across the world, even when it is unrealistic or even worse unsafe for long term plan.

But with this access to technology, it can also provide tools for those who are looking for help. A phrase in the world of nutrition, especially among doctors and dietitians, is "the number one predictor of weight loss is keeping a food diary, the number one predictor of weight maintenance is exercise." This saying has been backed by multiple studies, and seems to be at least a good place for most people to start who are determined to lose or maintain their weight.

When I started my Bachelor's degree over 6 years ago, I had an assignment to keep a food diary. Back then, you had to drag around a piece of paper or spiral, write everything down by hand. Then you had to look at labels or look up in a book or online each specific food and write down all of the nutrients we were tracking. We only had to do it for 4 days, but I didn't ever want to do it again. I couldn't imagine someone having the stamina and determination to keep it up for a week, let alone months or years. Now there are apps such as MyFitness Pal. They have a large database of foods with their nutrition. You select how much you ate and it counts it toward your daily tally. Once you eat the food once, it is in your history and is even easier to find the next time. It makes it much easier to keep track of calories and goals for things such as calories and fat. It becomes a habit after a while, and before you know it, you've been tracking what you ate for over 3 months!

Then exercise. Some people are gym rats and will find time no matter what. But what about the people who are working 60 hour weeks or two or three jobs just trying to provide for their family? What about people who cannot afford to have a gym membership, and have no exercise to nice facilities? In multiple studies, it has been found that taking 10,000 steps a day is about equal to exercising moderately for 30 minutes. Some may ask how this works. But think about it. I'm 5'2",my brother is just under 6'. When I walk with him, I generally have to take 2-3 steps to match his one. 

The great thing about this knowledge is almost everyone can add walking to their day. They can take the stairs instead of the elevator. They can park in the back of the grocery store parking lot. They can walk around their building at lunch. Pedometers are widely available and can be anywhere from $5-$500, making it possible for any budget to get one. 

Continue to watch technology. There are daily new apps and gadgets that can help people learn to watch what they eat, be more active, and live a healthier life.

"How School Lunch Became the Latest Political Battleground"

http://www.nytimes.com/2014/10/12/magazine/how-school-lunch-became-the-latest-political-battleground.html

I wanted to share this article with you all about the all too familiar battle of childhood obesity. It was forwarded to me as a employee of the Stowe Food Service in Vermont, a place that doesn't have a high obesity rate. I work in an elementary school cooking these exact meals for about 150 students per day and want to express the difficulties, and benefits these rules have on us.

This article perfectly describes the battle in finding a common ground between feeding kids too much and not feeding them enough. While childhood obesity is a very serious issue it is also a problem to assume every student needs exactly the same diet nutrition wise. The main problem is that the Health, Hunger-Free Kids Act is grouping the nutrition requirements (and calorie restrictions) by grade which can leave one student feeling satisfied while another may still be hungry.

The main benefit I see, working in the elementary level, is teaching healthy eating habits at a young age that will hopefully stick with them throughout their lives. Introducing kids to new vegetables like spaghetti squash or roasted beets is not something that most of us had the opportunity of in elementary school.

There are definitely some kinks that need to be worked out but I definitely don't think that it needs to be considered the "latest political battleground." What needs to be kept in mind is providing school children healthy meals that will allow them to concentrate and remain healthy throughout life.