YMCA Weight Management and Healthy Eating

Claiming Your Independence

In my last commentary, I raised the issue that some people who “Live to Eat” may have more than just a taste for good food. I encouraged you to examine your relationship with food by asking yourself several questions. Can you enjoy a social event without eating? When something emotional, good or bad, happens to you, is your first thought to find something to eat? Is food always on your mind? Do you typically stop eating something only when it’s all gone? If the answers to any of these questions raise some concern, you may need to begin working on claiming your independence from food.

Food addiction is a fairly new concept for many scientist and clinicians. There is still some uncertainty if “addiction” is the best term to describe the phenomenon. Some debate if the phenomenon even exists. For our purposes, I’m going to suggest that anyone who attempts to restrain their eating and is unable to do so despite multiple attempts and knowing that excessive eating will lead to harmful consequences may have some form of food addiction. The idea is similar to that of drug addiction, but food addiction lacks the physical dependence that drugs produce. Whether or not you agree that addiction is the best term to use, the fact remains that an abnormal relationship with food leads to harmful consequences.

There are some basic strategies that may help you begin to redefine your relationship with food. One strategy that people often use is to restrict or avoid specific types of foods. The benefit is that avoidance keeps you under control and prevents you from fighting a battle of willpower. The downside is that you will be unlikely to avoid foods you like forever. I’m inclined to think of this as a basic initial step. Using avoidance can give you some time to learn more complex skills to handle different food situations. Another option is using a controlled allowance. Because restriction can often make a food item seem more desirable, allowing yourself to have a limited, well-contained portion on a regular basis can take away the allure of the food item over time. It is better to have one small piece of dark chocolate every day than to binge on a 1 pound bag of M & M’s at the end of the week. Getting in touch with your hunger and eating on cue is another strategy that can be helpful. I find that many people who are potential food addicts skip breakfast and ignore their hunger at many points throughout the day. However, when they do eat, it is usually to excess. You can retrain your body to sense hunger, and only eating when you are hungry reinforces the idea that food is primarily designed to provide fuel for your body.

Food addiction is very different than any other substance that one may potentially abuse. Tobacco, alcohol, or drugs can all be avoided. You have to eat in order to survive, so you must deal with food on a regular basis. This makes it the hardest substance to use responsibly when you have a potential problem. If you think you have a problem, seek help from your healthcare professional. Long term support is the best strategy you can use to help you make a lasting change.

Independence

We’ve all heard the saying “Eat to Live, Not Live to Eat.” However, most of us may suggest that it’s easier said than done. Food is everywhere, and even when it’s not directly in front of you, it’s not far away. The ready availability of very palatable food makes it easy to indulge whenever you feel the need to eat something. These days it almost takes more effort not to eat something than it does to eat something.

One of the biggest problems that arises from our ability to produce so much food is that food takes on many other roles in our lives…roles that were not necessarily intended for the purpose of food. By this I mean that food becomes an easy placeholder or substitute for something else we need. It becomes the friend that won’t criticize or the spouse that always understands. It becomes the comforter when things aren’t going well or the congratulator when something great has happened. Food is used not only to help us deal with emotions, it becomes the central attraction for many of the things that we do. A night out always includes a great meal; movies aren’t the same without the popcorn and candy; and what is a birthday without cake? Many of these roles for food are socially acceptable and often encouraged. However, for some of us, the extent of our relationship with food goes beyond what is healthy, and in many ways could be considered dependence.

But don’t you have to eat to live; of course you’re dependent on food. Actually, I’m talking about another type of dependence—the kind you might think of when you think about illegal drugs or alcohol dependence. Yes, food addiction is a real phenomenon, and it is claiming lives daily. In my opinion it is the most powerful type of addiction, and the fact that you must face food several times each day means that it can be the hardest to break. Food addiction can take many forms and doesn’t have to always be identified with the person that binges on sweets. Individuals who are food addicts are not always severely overweight or constantly eating. However, one consistent factor is that most have an unhealthy relationship with food, being dependent on food to provide something other than nutrition and energy.

Examining your relationship with food can be a difficult process. However, it is the first step to redefining your lifestyle. Here are some simple questions that may help you figure out where you are. Can you enjoy a social event without eating? When something emotional, good or bad, happens to you, is your first thought to find something to eat? Is food always on your mind? Do you typically stop eating something only when it’s all gone? Do you find yourself enjoying certain types of food only when you’re alone? Is your reason for eating more often due to hunger or something else (eg, time of day, boredom, meetings, etc)? If the answers to any of these questions raise some concern, you may need to begin working on claiming your independence from food. Next time, I’ll provide some basic solutions you can begin to use to help you with this process.

On Vacation

One of the things that most people don’t seem to understand about a healthy lifestyle is that it shouldn’t feel like work. It shouldn’t seem like a chore to get outside and take a walk or take the stairs instead of the elevator. It shouldn’t be a difficult task to include fruits and vegetables in your daily routine. Taking a 10 minute break to stretch your legs or exercise in the middle of a stressful and busy day shouldn’t be a dreaded assignment that feels awful.

When you approach a healthy lifestyle properly, it becomes second nature. As you realize the value provided by eating a diet that is ideal for you, obtaining regular physical activity, and incorporating stress relief into your daily routine, you begin to miss the benefits when you deviate from this pattern. Your body becomes accustomed to this pattern as well. You have regular bowel habits, feel more energetic, and avoid illness with much more regularity. The long-term consequences include prevention of things we can all do without, such as diabetes, heart disease, and cancer.

One way to assess where you are mentally in your approach to a healthy lifestyle is to consider your reaction to the idea of going on a vacation. Let’s say you get the opportunity to go on a cruise, where food is available in “all-you-can-eat” quantities around the clock. Do you immediately think, “That’s it. This diet is over!” Do you begin to fantasize about all of the things you are going to eat to make up for the things you’ve been missing? Or do you think about being able to really step up your exercise for the week because you will have more free time? I often find that people who approach a vacation with the idea that they are going to allow themselves to enjoy some treats in moderation, but otherwise stay focused on maintaining their healthy lifestyle, really understand the concept of a healthy lifestyle. A healthy lifestyle happens 24 hours a day, 7 days a week.

Vacation time can actually be a great opportunity to experiment with components of your program without the pressures of other responsibilities. Try taking a walk in the early morning to get the day off to a great start. See how you feel for the rest of the day and think about how that might transfer to your usual routine. Try some different foods for breakfast or experiment with some new fruit for dessert. Dust off an old hobby that gets you moving. All of these things can be an enjoyable part of a vacation and easily fit into your healthy lifestyle. If you can’t make the time to fit it in on vacation, when in the world do you think you will? So if you’re planning to take a vacation this summer, plan to bring home a few healthy habits instead of a few new pounds.

JOIN US IN TRUSSVILLE FOR OPEN HOUSE!

If you want to get more great information to include as a part of your wellness program, come to the EatRight “Meet and Greet” at the Trussville YMCA on May 22^nd from 4 to 7 pm.

All of the EatRight team will be there to answer any questions you may have about nutrition and your weight. Members of the YMCA staff and Healthy Connections (http://healthy-connections.com) will be present as well. Prizes, given away during the event, include free memberships to EatRight Lifestyle, free metabolic testing, discounts on the OPTIFAST program, autographed EatRight cookbooks, and a week of free meals from Healthy Connections.

Overweight and Sleepy

A good night’s rest could do you a world of good in more ways than you know. As we learn more about the factors that influence body weight, sleep is starting to emerge as a key factor. In several recent studies, scientists have discovered that people who sleep less have a tendency to weigh more. Over the last two decades, people have been sleeping less, with 30% of adult men and women between the ages of 30 and 64 sleeping less than 6 hours per night. This decline in sleep time coincides with the increase in body weight seen in the US. Currently over 30% of the population is considered to be obese. Are you sleeping less and fighting the battle at the scale?

The relationship between sleep and body weight is not entirely clear at this time. Sleep may affect body weight in several different ways. Some research suggests that important hormones that regulate appetite are associated with our sleep cycles. When we get adequate sleep, approximately 7-8 hours per night, these hormones appear to rise and fall in the normal manner. However, when sleep is less than 7 hours per night, the hormone levels are altered, leading to an increase in appetite. A chronic lack of sleep may also affect your overall energy levels, making you less likely to exercise. There is also a question of whether excessive sleepiness affects your metabolic rate. It is possible that over time, the body responds to the lack of sleep by decreasing your metabolic rate, making it easier for you to gain weight.

The relationship between body weight and sleep goes both ways as well. It is well established that being overweight increases your risk of sleep apnea. Sleep apnea is the cessation of breathing for periods of at least 10 seconds while sleeping. The type of sleep apnea typically associated with obesity is obstructive sleep apnea. In obstructive sleep apnea, the airway is completely blocked, preventing air from getting to the lungs. The blockage is usually a result of several factors, one of which includes an enlarged neck. If sleep apnea is not treated, it can lead to excessive sleepiness in the daytime (e.g., falling asleep at the traffic light) and chronic medical problems such as hypertension and heart disease.

So if you are not getting a good night’s sleep (think quantity AND quality), you can use many of the skills you are learning related to your diet and exercise program to get on the right track. Just as you should be eating at regular intervals, you need to have a regular bedtime and wake time. Eating at a regular interval happens best when you plan; the same is true for keeping a regular sleep schedule. Just like a food journal is a great way to self-monitor, a sleep journal can be helpful in determining what things affect your sleep schedule and the quality of your sleep. Lastly, prepare for sleep just as you might prepare for an exercise session. Develop a routine that puts you in the right frame of mind to get a good, restful sleep. To get more information on techniques to help you get to sleep, see the Sleep Foundation at http://www.sleepfoundation.org . Happy dreams!

All or Nothing....

Most of us believe that if you do something, you should give your full effort. No one embarks on a new project expecting not to complete it. This would be a self-fulfilling prophecy of defeat and less than satisfactory results. Giving your full effort is often required to see the ultimate success. Most of us apply this mentality to making a lifestyle change; however, we do not count on the duration of this effort (a lifetime!). This miscalculation can leave you disappointed and discouraged. This is especially true when progress toward our long term goal seems slow or stalled. I most often see this when people are trying to lose a large amount of weight or maintain their weight loss.

While the mindset of “going all out” may be useful when starting a new lifestyle change, it should not be your only mindset. When you hit a roadblock, challenge, or stall, the effort you put into your program does not seem to produce the same results. For example, when most people start out losing weight, they will generally lose more weight during the first part of their diet and exercise plan. Inevitably, this weight loss will slow down, and the true nature of this person’s intentions will be revealed. If they only have an all or nothing attitude, at the first sign of slowing results, they throw in the towel and say categorically “It’s not working, so why should I even try to do anything.” This thinking assumes that you were better off doing the things you were doing before—making poor choices, eating large portions, not exercising, less aware of what you were doing and living in poor health. The hard earned positive benefits that you achieved can be easily lost when the all or nothing attitude takes over.

To avoid the all or nothing attitude from taking over, I encourage people to do a few things. First, you must remember this is a process with the ultimate goal of being in better health. Process implies multiple steps that are continuous. Therefore, there is no “finish line.” When you reach your goal weight or your blood pressure decreases or your cholesterol improves, does the process stop then? Second, you have to know that a few days that don’t go as planned can be reversed. The beauty of making a lifestyle change is that you have the opportunity to undo a lot of accumulated damage. Just think, when you go out to walk those 3 miles, you are burning calories stored from years ago! Lastly, you need to value all of the progress you’ve made. If you’re long term goal is to lose 50 pounds, but you seem to be stuck after the first 25 pounds, it doesn’t make sense to throw in the towel because you didn’t reach 50 on the first try. Losing 25 pounds is better than gaining 5 pounds, and it certainly has significant benefits for your health. Value the 25 pounds, adjust your goals, and retool your plans to get going.  

Now That You Know - Jamy Ard

As we get older and wiser with each day's experience, we often look back on our days of youth and think how different life would be if we knew then what we know now. Perhaps you would have chosen a different job offer, or decided not to move to a certain area, or postponed that big purchase.  While these looks into our pasts seem like missed opportunities, it can also be a time to remind us that we are indeed smarter and wiser about a lot of things and as a result, our actions, behaviors and beliefes result in better consequences for our daily lives.

In an earlier post I encouraged you to learn something about yourself and your lifestyle habits.  You may have learned a few things about your food intake and physical activity (or lack thereof).  Hopefully by now, you've identified some areas of your lifestyle that are good habits and those that are not so good.....but knowing is only half of the battle.  If you had known 5 years ago that drinking or eating about 300 extra calories a week (contained in a 12 oz. Coke and a package of peanut butter crackers), would lead to an added 5 pounds a year or 25 pounds after 5 years, would you have done something differently?  If you had known 5 years ago that walking 30 minutes 4 times a week would prevent you from having diabetes now, would you have done something differently?  If you had known 5 years ago that eating 7 servings of fruit and vegetables daily would keep your blood pressure normal, would you have done something differently?

This is your opportunity to make the next 5 years different.  Now that you know something about yourself, you can take positive steps to achieve a different outcome.  It is important to realize that you MUST make CONSISTENT changes.  As Albert Einstein once said, "Insanity is doing the same thing over and over again and expecting different results." Begin to make the changes by setting short-term goals.  Short-term goals help you stay focused and provide you an incentive to stay on track.  An example of a good short-term goal is "For the next 2 weeks, I will walk in the mornings for 30 minutes on Wednesday, Friday and Saturday."  This is a good goal because it is SPECIFIC (all the details of what I will doa re included); and it is MEASURABLE (I will continue to self-monitor to record how many minutes I walk).  Write down your shot-term goal in your food and activity diary.

Now that you know, I expect you to do.

Take a Look in the Mirror - Jamy Ard

Health and wellness are important commodities for all of us.  If we don't have our health, it can be difficult to enjoy the blessings that life brings.  It is vital to realize that we have a lot of control over our own health, and many of our daily lifestyle choices directly affect our well being.  If you would like to improve your current state of health, no matter what medical problems you may have, over the next several months I will give you some key steps to take that can lead to a healthier you.

The first place to focus is on what you are doing now.  Becoming self-aware is the initial process that has to occur before any change in behavior can happen effectively.  Assess what you do on a daily basis and think critically about how that helps or hurts your efforts to become healthier.  The best way to increase your awarenes is to write down and record what you do.  A simple notebook will be sufficient; record everything you eat or drink for the next week.  Also record how much physical activity you get.  After one week, you may begin to recognize some patterns in your lifestyle.  Identify the good things that you do on a regular basis.  Make a commitment to continue doing those things (for example, taking a walk 3 times/week).  Identify 1 or 2 things that might improve.  One easy habit to start with is drinking sugar containing beverages, such as sodas, sweet tea, Kool Aid and fruit punches or juice.  These drinks contain a lot of calories and often provide very little else.  In other words, you can stop drinking them and do yourself some good!  If you drink these types of drinks on a regular basis, see if you can switch to diet versions or water.  If you usually drink 2-3 sodas a day, cutting those out of your diet will result in a decrease of more than 400 calories/day.  This could equal a weight loss of about 1 lb per week!

Once you start recording and become more self-aware, stay consistent with your recording.  It will be the key to your success.

Keep it simple - Jamy Ard

Developing a new healthy lifestyle does not have to be a complicated venture.  It generally does not require new, expensive equipment or multiple meneral and vitamin supplements.  Often, we make our lifestyle changes more complex than needed, making it difficult to maintain them for the long term.  Ultimately, any lifestyle change than can not be maintained forever is not really a lifestyle change.  In this instance, it becomes a temporary band-aid for the problem.

One reason I think people get into complicated routines is that they don't have all of the information necessary, or the information they have is bad.  There are lots of myths about what is helpful for maintaining good health, and many of the are quite popular.  This is especially true for people trying to lose weight.  Here are just a few you can avoid.

1. Eating late at night causes me to gain weight: This statement is false.  How late you eat your meals is not a factor in determining if you lose or gain weight.  You can eat your last meal at 10 p.m. and not gain a pound.  The key here is most people eat differently at night than they do during the day.  Most people eat desserts, heavy meals, and other high fat, high sugar snacks at night.  The types and quantities of food that we eat lead to weight gain.  Overeating can happen anytime; but it seems to occur more often at night, hence the myth that eating late at night cases me to gain weight.  If you struggle with overeating at night remove tempting foods from your home, put up leftover foods before you eat your meal, or take a late evening walk to help control your appetite.

2. I gain weight (or can't lose weight) because my metabolism is low: For 99.9% of people this is also a false statement.  Your metabolism, the amount of energy required to keep your body running, is determined by a number of factors.  These factors include how much muscle you have, your age, gender and current body weight.  Your level of physical activity and fitness are important as well.  Most people can lose weight if they choose the correct calorie level.  For women, 1200 calories a day, and for men, 1600 calories a day are good places to start.  Exercising on a regular basis also helps to boost your metabolism, burning more calories, even when you are resting.

3. To lose weight, all I need to do is exercise a little more: This tactic generally does not work because we often unconsciously eat more food, canceling out any calories we burned with exercise.  Exercising without cutting calories will not produce consistent weight loss.  The best way to get maximal results is to combine physical activity with a good meal plan that limits calories.  Exercise without cutting calories has bee shown to be helpful in preventing weight gain.  Typically to do this, you need to exercise at least 180 minutes a week.

Two parts of the equation...physical activity AND healthy eating.

Think globally – act locally.  It’s an often used axiom to describe the call for action in the face of overwhelming need.  On the global level our country is facing a dramatic lifestyle health crisis.

60 million adults – about 30 percent of the  U.S. adult population – and 9 million children are obese or overweight; 16 percent of our children have Type II diabetes.  According to the New England Journal of Medicine, the current generation of American children could be the first to lead shorter lives than their parents.

Nationally the YMCA has been identified as an organization uniquely positioned to help deal with this crisis.  Locally YMCAs are challenged to increase the awareness and availability of information and programs that can change this crisis of how we live.

To help address these needs the Birmingham YMCA has been working on partnerships with the weight management programs at UAB and Children's Hospital for several months.  The early fruits of this partnership are programs that add the YMCAs expertise in physical activity to these proven weight loss and weight management efforts.

This weblog will feature Jamy Ard, M.D., Assistant Professor Nutrition Sciences and Associate Scientist Clinical Nutrition Research Center.  Dr. Ard is one of the nation's leading young scientists in the areas behavioral therapies focused on cardiac risk reduciton.  He works closely with the Eat Right Program and the UAB center for Weight Management.

Guests authors may also include faculty from the Eat Right program and even participants who have seen the results of a healthy lifestyle of good nutrition and physical activity.