Dietary Delights

Having a "Hungry Day"?

Have you ever had one of those days where you feel like you could keep eating, and eating, and eating, and never get full?

I call these "hungry days" and they are far from unusual. In fact, they may be a sign of a well-functioning metabolism. Children naturally have "hungry days" when they consume everything on the table and then ask for a snack thirty minutes later. These are, of course, balanced by the days where a child doesn't feel like eating and barely takes a few bites. Athletes may experience "hungry days" on an almost constant basis, especially those involved in endurance events such as cross country running or swimming. Also, most women experience a slight increase in appetite for several days before their menses.

In all of the above examples, hunger is a natural result of the body's need for increased fuel. The best response in these cases is to honor the body and provide additional food. There are, of course, other causes for "hungry days" that may not reflect the body's need for increased calories. If you have been recently laid off or find yourself alone on a Friday night, emotions might be getting confused with hunger signals and lead you towards the fridge looking for a friend and confidant.

Interestingly, when emotional hunger speaks, it usually demands high-carbohydrate or high-fat foods (such as chips, cookies, or the stereotypical pint of Ben and Jerry's ice cream). Emotional hunger also tends to come on quickly, usually triggered by some environmental cue such as seeing Oreos in the cabinet. By contrast, physical hunger tends to build gradually and can be met by a variety of different foods (protein in particular helps to settle a physical hunger). When we meet a physical hunger, thoughts of food fade gradually throughout the meal and we are free to focus on other activities. However, when we eat for emotional reasons, feelings of guilt may escalate as we eat, possibly leading us to eat more because we "already blew it".

With attention and practice, we can learn to recognize where and how our bodies feel these different types of hunger. For example, my physical hunger feels like fogginess in my head and a slight rumble in my stomach (see below for my artistic rendition); whereas emotional hunger "hits" in the center of my head and my salivary glands start dripping. The next time you notice a sensation of hunger, check in with your body and see if you can describe exactly where and how you feel it. Try to notice subtle differences between different types and intensities of hunger. And if you feel creative, draw a picture of your hunger and send it to me at jvanarsdale@hmc.psu.edu!

 


Resolution Revolution

Blank resolutions list

Does anyone else groan at the idea of New Year's Resolutions? Or perhaps you have had your resolution set since August, but you have been waiting until the first of the year, because, let's face it, who would rather start tomorrow?

Setting and achieving goals can be an excellent way to build confidence, but New Year's Resolution goals that get pushed aside or forgotten often accomplish the opposite and make us feel like failures, reinforcing the idea that we cannot make progress towards health goals. Usually this happens because we set a goal that is too large, too ambitious, or too vague. Here are some examples of New Year's Resolutions that are unlikely to be achieved:

  • "This year I am going to get in shape!"
  • "This year I want to lose 40 lbs."
  • "Starting next month, I am going to exercise every single day!"

So how do we resolve to set better goals this year?

  1. Take small bites.

    First, let's start with a smaller time period. What about a January goal? If we are likely to drop the goal by February anyway, this strategy can change our perspective. Instead of "failing after only 3.5 weeks," we can succeed at pressing through to the end of the month and throw a personal party for our accomplishment. Then, if you feel so confident that you want to set another goal for February, go right ahead. Is a month too long? Try a week.

  2. Don't look at the mountain: Keep your eyes on the trail.

    Years ago, I went backpacking in the Appalachian Mountains. Early one morning, I looked up at the peak we were going to climb, and my feet started to hurt without even taking a step. It was SO HIGH! But then I looked at the path leading out of our camp and the next 100 yards looked do-able. I focused my attention on the steps directly ahead of me. By noon, I was looking down off the peak and thinking about how I had just climbed that distance.

    I've seen the same principle at work in my patients who want to lose a large amount of weight. The patients who focus only on the amount of weight to lose usually do not reach their goals. However, patients who focus on daily choices, such as whether their lunch contains fruit or when they can fit exercise into the day, are much more likely to see substantial weight loss.

  3. Start today.

    Today is better than tomorrow. If you can commit to starting within the next 48 hours, you are much more likely to follow through.

Do you have in mind a short-term goal that you can start on today? Are more than seventy percent confident that you can attain it? If so, then your next challenge is to tell a friend. Accountability will also improve your chances of success. If you are interested in professional accountability with a nutrition goal, your friendly neighborhood dietitians are just a phone call away (717-531-7260)!

 


Eating During the Holidays: Tips and Tricks

In her article, Holiday Eating Anxieties for Bariatric Patients (Hall 2006), Meloney Hall lists remarks that many of us have heard, especially during the holiday season. Some examples include:

  • "That's ALL you're going to have? I worked so hard on that dish."
  • "You better eat this now, because it won't be here for another year."
  • "It will hurt my feelings if you don't eat this."
  • "These are very special ingredients I ordered specifically for this dish."
  • "You can't be NOT HUNGRY! It's a Holiday!"
  • "Just ONE LITTLE BITE, PLEEEEEZEEEEZ!"
  • "Have more, there's plenty."
  • "Oh nonsense! You're allowed to eat a lot today!"
  • "You should have worn your FAT PANTS to gorge yourself like the rest of us."

Does the list bring to mind guilt trips you've received? Or are you reminded, like me, of well-intended nudges to eat that you have levied on others?

Hall, a bariatric patient herself, offers several suggestions on how to handle the stressful eating season. Below are her suggestions, with my adaptations.

  1. Prepare your mind for the event: Reflect on past holiday experiences. Have in mind what you will say and do when those around you encourage you to eat something you do not want or more than you want.
  2. Anticipate the food: Which holiday foods do you look forward to each year? Which ones do you eat, but could easily live without? Predetermine what you will and will not eat. Making a decision ahead of time will curb your gut-reaction to "cave in" to peer pressure.
  3. Take baby-bites of special foods: If you choose to take a bite of a traditional or decadent holiday food, go for a SMALL bite, preferably the size of your pinky fingernail. Savor the flavors and claim the truth that, "It doesn't get any better than the first bite."
  4. Vow to break free of the clean-plate club: In a social event where you don't want attention drawn to how little you are eating, take a small plate and help yourself to small portions of food. When you are finished, THROW the rest away. Starving children in foreign countries will not cry because you chose to care for your body and avoid excess. Your weight gain will not help them in the least. Another idea is to load most of your plate with low-calorie vegetables or fruit. This will give the appearance of a fuller plate without placing tempting foods directly in front of you.
  5. Eat healthy before you go and bring your own essentials: Never go to a holiday party hungry. NEVER! This is self-sabotage in the worst way! Take along your own treats and drinks that are bariatric-friendly. While they are eating pies and cakes, you can have the sugar-free fudgesicle or sugar-free pudding cups you brought along. If they are serving only sodas or alcohol, bring your own herbal teas or no-sugar-added hot chocolate packets. This alleviates guilt for you, for the host, and for other guests who may fear eating decadent foods in front of you.
  6. Talk more than you eat: The holidays should be about people, not food. Focus on the people; laugh with them, tell stories, listen to their tall tales, play games, etc. If you do these things, you will be amazed at how well the gathering will go for you, simply because you didn't focus on food.
  7. Change the food-subject: Others may want to cry with you if you keep telling them all the foods you're missing out on this year. Don't do that! Rather than mourn the loss of your favorite holiday treats, brag about the fact that you're feeling so much healthier.
  8. Wear a "knock-out" outfit: Wow them all this Holiday season by wearing a special outfit that you feel very proud to be seen in. Let people whisper to each other about how great you look rather than how little you are eating.
  9. Make your visit brief: If you are getting too much pressure from others, give yourself the option to leave early. Maybe you're tired, or the roads are getting bad, or you realized you forgot to do something. A "pre-planned" escape should be there for you if you need it.
Meloney Hall, "Holiday Eating Anxieties for Bariatric Patients", February 01, 2006)

Another key part of surviving the holidays is seeking support from others with similar goals and values. Make time to attend a support group meeting. It may give you the extra encouragement and connection you need to get through another week of temptations. Penn State Hershey Surgical Weight Loss's December support group is also a holiday party. (Thursday, December 19th at 6:00 p.m. Call 717-531-7260 to register.)

As always, don't allow family or friends to scare you with comments like "you are starving yourself" or "you will never survive on that much food." This is an area where your dietitian can offer a reality check for your individual body. I suggest the response of, "I appreciate your concerns. I will discuss them with my dietitian when I see her next."

Wishes for a joyous holiday season,
Jacklyn Van Arsdale, RD, LDN

 


How does a dietitian decide what to eat?

I can't speak for all dietitians, but I can explain the process in my own mind.

Patients in our pre-surgical program are introduced to the idea of an "exchange system", which is a way of "counting" different foods throughout the day. If you eat a certain number of each "exchange" during the day, they will add up to give you a certain amount of calories, protein, carbohydrates, fat, and calcium.

An "exchange system" means that foods are placed into categories along with similar foods - for example, fruit or dairy. A person following the exchange system can pick from any of the foods in the same category or substitute one item for another item within the same category (string cheese OR a cup of milk OR yogurt). The goal of an exchange system is to ensure that a person gets a good balance of nutrients at each meal and throughout the day. The most well-known exchange system is the American Diabetes Exchange Lists for Meal Planning. Although this system was designed to help diabetics manage their carbohydrate intake, it is a helpful tool that anyone can use. The benefit of an exchange system over simple calorie counting is that an exchange system gives additional guidance about what to eat for a healthy, well-balanced meal. You can find a good example of an Exchange List for Meal Planning here >>

My mind thinks in terms of exchanges throughout the day. For example, when I am considering what to have for dinner, I find myself asking, "How many servings of vegetables did I have today?" If my vegetable quota is low, I have a hefty portion with dinner or if I snacked on vegetables all day, then I will have fruit as a side instead.

I also plan meals based on the exchange system. When I am packing my lunch for work I think, "What will be my protein? My grain? My vegetable?" A variety of things can fit these categories. Today my lunch was celery (vegetable) with peanut butter (protein), a small chocolate chip muffin (grain), and chocolate milk (dairy). Now as I write this, I am hungry for a snack, and I'm thinking "hmm…I didn't have very much protein with lunch, so maybe I will have a cheese stick rolled up with turkey slices. I haven't had any fruit yet - how about an apple?" Often what has been lacking in my day is exactly what my stomach and my taste buds want.

I find it fascinating how the body starts craving foods according to the "pattern." If I missed out on a good source of protein at lunch, I know that I am going to be craving some protein for an afternoon snack. I also appreciate that no food is off-limits or "bad" with the exchange system. Do I want ice cream tonight? No problem, I'll consider it one dairy and two fats. I like my sweets, so I usually save my fats for ice cream or chocolate instead of "spending them" on higher-fat milk or butter on my veggies.

I know most people do not go throughout their day thinking about food according to the exchange system, perhaps it is one of my "quirks" as a dietitian, but may I suggest giving it a try when you are trying to figure out what to have for dinner tonight? Take a five-second inventory of what you've had so far in the day and use that as a template for what your body might like. If you've already had two desserts today, maybe your body would feel better if you wait until tomorrow for ice cream? I've found that suggesting to my stomach "you might like ice cream just as much, if not more, tomorrow" is very different from telling it "absolutely not, you've already eaten way too much today." Interestingly, my stomach responds well when I make "suggestions" rather than demands and give myself the option.

Need some help figuring out how many servings of each exchange to aim for? Check out https://www.supertracker.usda.gov/CreateProfile.aspx or make an appointment with your dietitian.

 


The October Vegetable Challenge Is On!

I recently gave a friendly challenge to a patient, and I think it is a good one for all of us to try!

For any of you who have had a conversation with me about not liking vegetables, you may remember me pulling out a giant list of vegetables and asking you to pick three that you were willing to try within the next two weeks. Most of us stick to the vegetables that our parents prepared for us when we were children, and regard others with suspicion. Like the children's' book, Green Eggs and Ham, how will we ever know if we like them if we have never tasted them?

One of my favorite "games" to play at farmer's markets is to pick a new fruit or vegetable that I've never tried before. Some of my favorite discoveries have been kale (makes a fantastic alternative to potato chips), brussel sprouts (despite a self-promise that I would never taste them, I ended up onstage at a cooking show and couldn't say no), and beets. I haven't played this game in a while, but it is time I start again, especially if I am going to push my patients to expand their own palates.

So, looking at my list of vegetables that are in season, I am going to try rutabagas this week. When I typed "rutabaga recipe" into my web browser, the first recipe that came up is for rutabaga oven fries with rosemary and olive oil. My mouth is watering already!

Here is the list of fruits and vegetables in season during the month of October. What are you willing to try in the next two weeks?

  • Apples
  • Beets
  • Blackberries
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Chicory
  • Cranberries
  • Dates
  • Figs
  • Grapes
  • Leeks
  • Lettuce
  • Okra
  • Oranges
  • Parsnips
  • Pears (late season)
  • Peppers
  • Pumpkins
  • Quince
  • Shallots
  • Star fruit
  • Sweet potatoes
  • Turnips
  • Watercress
  • Winter squash

Source for food list: What's In Season? - October Foods