It's Not What We Eat, It's the Way We Eat:
Common Sense Eating Habits Your Family Can Start Today

by Laura Aiken, Community Health Specialist, WakeMed Health & Hospitals
September 2008
Live Well, September Article 2

When you hear the phrases weight loss or weight management, does it immediately turn you off to the conversation? Have you lost count of the 'get-thin-quick' diets you or members of your family have tried with no long-term success? As our waistlines have expanded, so has the glut of information and products related to controlling our body weight. Unfortunately, the current deluge of books, magazine articles, Web content and infomercials seems to have had a counterproductive effect in that many now either ignore the topic altogether or approach it with a good measure of skepticism.

But what if you read a startling statement issued earlier this year by the Centers for Disease Control and Prevention (CDC) that estimated today's generation of children will have a shorter life span than their parents due to the obesity epidemic? In 1900 the average weight of a college-age male in the U.S. was 133 lbs. and the average woman was 122 lbs. But by 2000, men had beefed up to 166 lbs. and women to 144 lbs.

The bottom-line is that our culture of abundancy is killing us and setting up our children for a lifetime of health concerns. While there is no simpler or less direct way of stating the current situation, there are some simple ways families can begin addressing this TODAY. Forget the 30-day program promising fast results, the grapefruit-only diets and the protein-for-life plan. Take note of these tips compiled from years of experience by health professionals, and you will likely see a positive change in the health of yourself and your family.

Step 1: EAT!
"When our cars run out of gas, we go to the station and fill the tank," explains Diana Koenning, registered dietitian at WakeMed Health & Hospitals. "Yet, we seem to insist on pushing our bodies past empty. This is as much a part of the obesity epidemic as any other single factor." She points to a recent study profiled in Science Daily proving the rise in obesity rates is not only a matter of what we eat, but how often we eat. People who eat at irregular times run a greater risk of developing insulin resistance and what has been identified as metabolic syndrome. There were 4,000 participants in the Science Daily study, and those who said they rarely ate a regular breakfast, lunch and dinner had on average a larger waist size and more blood lipid disorders than participants who ate more regularly.

Koenning points to these key steps in "normalizing" your eating from the resource Binge No More: Your Guide to Overcoming Disordered Eating by Joyce D. Nash, Ph.D.:
• Allow no more than 4-5 hours between meals. "It's easy as a nutrition professional to tell patients to eat what is commonly described as 'regular meals,' but what does that really mean?" she explains. "I refer to it as 'well-spaced' meals where you initially focus on when you eat, not what you eat."
• Eat only planned snacks. Always keep a healthy snack in your purse or car to help you with this goal. A 200-calorie portion of trail mix or nuts is better than a trip to the drive-thru that could cost you twice as many fat-laden calories.
• After you are comfortable eating at pre-established times, begin to introduce healthier food choices.
• Avoid dieting that involves restricting eating or specific foods.

"It is important to think of this as eating more regular and consistent portion sizes," concludes Koenning. "When we undereat, especially in the early part of the day, it is only a matter of time before our hormones will trigger us to binge when food does become available."

Step 2: Once you normalize eating patterns, forget the scale in the bathroom for a while and get one for the kitchen counter.
Once you have started eating on a consistent schedule and have begun considering healthier food choices for those meal slots, the next credo should be portion control, portion control, portion control. If more focus was given to a food scale in the kitchen, the weight scale in the bathroom would not be such a foe for the large percentage of Americans who are battling weight issues. Once again this is important for future generations. Today's oversize restaurant meals are giving our children an unrealistic mental portrait of what is a healthy portion size.

"When I talk to people about the portions they are eating, I encourage them to think of it as sufficiency," explains Koenning. "We should not be eating to our hunger levels but to the levels of our metabolic rate. The food supply has become toxic with the double whammy of oversize portions and maximum calories."

The National Institutes of Health has teamed with the National Heart, Lung and Blood Institute to make an outstanding online resource and interactive quiz aimed to educate consumers on today's "Portion Distortion." For example, did you know that 20 years ago a standard cup of coffee was considered 8 oz. and had 45 calories. Today's standard cup at most coffee shops is 16 oz. with additional ingredients such as steamed whole milk and flavored syrups for a whopping total of 350 calories! The quiz also tells you how long you would have to perform moderate exercise to burn off those calories from the larger portion. (You would have to walk 1 hour and 20 minutes to burn off the additional calories in today's "standard" cup of coffee.) The quiz can be found by going to www.nih.gov and typing in "portion distortion" in the search menu, or link directly to http://hp2010.nhlbihin.net/portion/index.htm.

The site includes other interesting facts such as the difference between a portion and serving and gives ideas on how large recommended serving sizes really are.

Step 3: Reduce your plate real estate.
This is an extension of the ideas discussed in step two. If you do not have time to measure your portions on a food scale in the kitchen, dust off those salad plates and use them instead of dinner plates when eating meals at home. You can then use the dinner plates as serving platters. The reduced amount of plate real estate will help to control portion sizes.

Step 4: Do not drink calories.
When it comes to weight loss, most people focus on foods. Many people underestimate how many calories they are drinking. The CDC estimates that if you drink a medium café latte with whole milk for breakfast, add a 20 oz. bottle of nondiet cola to your lunch, have an afternoon snack with a can of sweetened lemon tea, and finish the day with a can of nondiet ginger ale at your dinner, you have added nearly 800 calories to your daily intake. So you don't really drink colas? If you drink a 20 oz. bottle of 100% orange juice, you add 280 calories to your meal. By switching to water, seltzer water, or unsweetened drinks, you can easily slash calories from your daily total and also decrease your sugar intake at the same time.
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Step 5: Beware of stealth torpedoes in a healthy eating routine.
Low fat, low calorie doesn't necessarily mean healthy. Granted grocery store chains have significantly increased their choices in the healthy products aisle, but many of those individual products have a whole day's serving of sodium added to make the food palatable. (2,300 milligrams is the recommended daily sodium allowance.) Also, if the list of ingredients includes sugar, corn syrup, high fructose corn syrup, dextrose or sucrose, chances are that the food is not as healthy as advertised. It is meant to satisfy the taste buds rather than the body. In short, it is always best to rely on fresh foods versus food products or processed foods.

Step 6: Take advantage of easy substitutions or subtle restrictions to dramatically reduce caloric intake.
One easy way to reduce caloric intake (and oftentimes reduce fat intake) is to make substitutions or minor eliminations in your portions. For example, an egg has approximately 70 calories while an egg white is 15 calories. Instead of having a three-egg omelet for breakfast, compromise with three egg whites mixed with one egg. Not only is it better calorie-wise, it will satisfy hunger cravings much better than two bagels.

If you desire a hamburger, get 97 percent lean meat and make the patty approximately three ounces, or the size of a deck of cards. Pizza? Eat whole wheat thin crust and top with high fiber vegetables and ground turkey. Really can't cut out bacon? Substitute ordinary bacon with Canadian bacon which has one-third less fat.

As far as diet restrictions are concerned, do it a tablespoon or slice at a time versus skipping entire meals. For example, eliminate cheese or mayonnaise when eating fast foods for instant caloric reduction. By skipping the mayonnaise from a McDonald's Premium Grilled Chicken sandwich, you eliminate over 100 calories. Web sites such as www.calorieking.com and www.dietfacts.com allow you to look up nutrition information for many different fast-food chains where you can customize a sample meal and add up the nutrition totals for different combinations. Don't stop there. Take what you learn and apply it to meals at home.

Step 7: Record it.
A recent study by the Kaiser Permanente Center for Health Research found that dieters who kept track of what they ate in a food journal lost twice as much weight compared to those who did not. The results of this study point to food diaries as an inexpensive and proven method for weight-loss. There are many, many online services where you can track what you eat and how many calories it will cost you. But, the best part of this step is that you don't have to have access to a computer to do it. Simply buy a spiral notebook, number two pencil (sans eraser!) and start recording. After one week, look back at your choices and see where easy changes could be made going forward. Once you get used to the journaling, you can graduate to the more sophisticated online tools if desired.

Conclusion
According to a recent Time Magazine article, we Americans come by our love of food honestly. The first settlers were so amazed at the plethora of food sources and the richness of the soil that our very first national holiday, Thanksgiving, celebrated the act of feasting. It's okay to love good food. Current health statistics from even our youngest age groups, though, are drowning out the ringing of the Liberty Bell with that of a blaring alarm warning us the time is now to shift our primary focus on good health.

Laura Aiken received her B.S. and M.A. from Appalachian State University. She earned an M.H.A. from Pfeiffer University. She has been employed with WakeMed Health & Hospitals for eight years in several areas including cardiac rehabilitation, weight loss for children and teens, and corporate and community wellness. Key accomplishments include the creation and implementation of an exercise program designed for overweight and special needs children and the startup of a community collaborative called Advocates for Health in Action whose mission is to make healthful eating and physical activity the way of life for Wake County citizens.

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