Self-Evaluation- Form Follows Function

In the first week of your program, I asked you to complete a basic but critical exercise as you begin to lose weight—self-monitoring. The primary purpose of self-monitoring is to provide an opportunity for you to examine your current behaviors, increasing your awareness of what you are doing currently in your daily lifestyle.

Now the second week of your program is about evaluating what you've recorded and making plans for how to move forward. In many instances when we ask people to journal their food intake the week prior to coming to the EatRight clinic at UAB, people will start to recognize patterns and areas for improvement in their typical intake. By the time our team of clinicians meet with them, they have diagnosed many of the problems that are making it difficult for them to manage their weight successfully.

What have you noticed about your week of journaling? Common patterns of eating that I see frequently include skipping breakfast, irregular spacing of meals, unplanned snacking, and grazing. Each pattern of eating has an underlying cause—I skipped breakfast because I stayed up eating "unmentionables" until midnight. So of course, I wasn't hungry at 7 am! Or I graze in the afternoons because I worked through lunch and didn't take the time to get a balanced meal.

I'm almost done with this post, and I still haven't said anything about WHAT you ate. And, I won't. This is all about understanding your structure of eating. In the design world, the phrase "Form follows function" describes a principle that the design of an object should be consistent with the intended purpose or use of the object. Your "FORM" of eating has a lot to do with the "FUNCTION" of your weight. You can't eat in a pattern designed to promote inconsistency and high calorie intake and expect to lose weight in the long-term. It just won't happen.

So for week 2, I want you to review your food journal from week 1 and identify any structural changes that you would like to make. Think about timing and spacing of meals and snacks (ideally every 3 hours); think about triggers that make you inconsistent; think about how the previous meal sets up the next meal. Figure out what you need to do to be consistent with your "FORM" of eating on a daily basis in the setting of your lifestyle. Continue journaling daily on your road to success.

A Case for Cooking

-Laura S. Burton, RD

As a dietitian, I have noticed that the number of people I see who cook regularly is dwindling rapidly. When individuals disclose how often they eat out, immediately a long list of excuses as to why cooking is not an option for them ensues. The top 5 reasons are as follows: 

1. “I can’t cook”
2. “I don’t have time to cook”
3. “I don’t know what to cook”
4. “Planning meals is overwhelming”
5. “It’s hard to plan healthy meals that will please everyone in my family”

I can relate!  Now although there are tips, shortcuts and resources that can make cooking much easier and more enjoyable (which I’ll share with you in a minute), I won’t argue that the drive-thru isn't still the easiest, quickest option. So what are the benefits of cooking and are they enough to get Americans back in the kitchen? Is cooking really worth it?

Cooking allows you to take control of what goes into your body. When we eat out, our health is at the mercy of food manufacturers, and all they’re concerned with is achieving maximum flavor and maximum shelf-life at minimum cost. Even grilled fish and chicken at restaurants can be loaded with sodium and smothered in high-fat sauces. We must start caring more about what goes into our food, especially when it comes to weight and disease management. Has your physician or dietitian recommended a reduced-sodium meal plan? With cooking, you can easily limit the amount of salt in your foods. Do you have trouble with high blood sugar? Cooking allows you to easily half the amount of rice or pasta in a casserole…and double the amount of vegetables! Heart disease or high cholesterol? You can still enjoy a burger when it’s made at home from extra lean ground turkey breast.  And the best part is that you can customize it based on your taste! Give it some Greek flair by mixing in breadcrumbs, red onions, reduced-fat feta cheese and dill. Be creative!

Set a good example for your family. The kitchen can be such a fun place to bond with your spouse or kids. Children who help their parents in the kitchen will not only develop cooking skills to carry into adulthood; they’ll learn about choosing healthy foods, learn to follow instructions, and realize that putting a little time and energy toward something often results in a great outcome. Cooking will likely foster a child's appreciation of teamwork, as well as give them a sense of ownership over the meal (which may make them more willing to eat it!)

It’s clear that cooking can be beneficial for a multitude of reasons.  But let me also suggest that cooking doesn’t have to be as daunting a task as we make it out to be. In fact, here are a few tips that might just change the way you think about cooking. 

1.  If you can read and follow directions, you can cook! Sure, cooking requires some basic knowledge of measuring, mixing, and heating techniques, but your faithful friends Google and SIRI are always there and willing to help. Simply type in those terms you don’t quite understand, or ask them how to “fold in the egg whites,” for example. Like any new practice, this may require a little extra time in the beginning, but you’ll find that once you understand the basics and get some practice under your belt, cooking will begin to come naturally for even the most anxious beginner chefs.

2. It may be worth it to spend a little extra money on shortcuts. If you’re low on time, purchase the pre-chopped onions rather than a whole onion (it’ll save you time and tears!). Or instead of buying the boxed rice that requires boiling, save time by purchasing the 90-second microwave brown rice in-a-bag.

3. Short on good, healthy recipes? Explore EatRight by UAB’s Nutrition Guidance System. With lots of healthy, easy, and kitchen-tested meals, our recipe collection won’t disappoint. In addition, the Nutrition Guidance System has teamed up with Piggly Wiggly to offer nutrition guidance as you shop! Watch a short promotional video here. Or sign up for one of EatRight by UAB's monthly cooking classes to learn new recipes as well as healthy cooking techniques.

What will you fix for dinner this week?

My $0.02- Leveling off of obesity in US

Last week there was a lot of news around the fact that obesity rates seem to be leveling off in the US (http://www.npr.org/templates/story/story.php?storyId=122536128). Generally speaking, this is good news. No one really knows why this is the case, especially since we continue to find creative ways to eat butter at every turn (Exhibit 1: see Paula Deen's Fried Butter Balls).

If you take your own weight as an analogy for what's happening to the country, we might be able to understand some of the dynamics at play here. If you're newly married or just got a nice job, you will likely have more access to food, eat out a bit more, and have less time to exercise like you did before you had a partner or were expected to show up somewhere on time. The adjustment to this new lifestyle can take some time. In the meanwhile, you put on a few pounds until your new level of activity balances with the new pattern of eating you've established. This might be where we are as a country. Our new lifestyles, filled with computer screens, mobile phones, 3D televisions, and food anytime and anywhere, have caused us to put on some weight while we're reaching that new balance. Perhaps, that leveling off time has occurred.

However, the natural course of weight gain suggests that we shouldn't become content. We know that kids who are overweight grow up with a higher chance of being overweight as adults. We also know that we continue to gain weight with age; this is already evident in the fact that median body mass index is shifting higher already. And, we know that the environment will continue to produce more devices that promote sitting and highly palatable foods.

Two things buried in this story that most concern me: a lot of the health consequences are yet to be realized and not everyone has leveled off at the same spot. The pending diabetes epidemic that is soon to follow because of obesity will blow the lid off of health care costs in this country, and unfortunately, a lot of that burden will be in low-income and/or minority communities where obesity rates are as high as 56%, nearly 20% higher than the general population.

We've still got work to do.

Self...Meet Self

Most of my patients have a pretty good idea of the issues that have contributed to their weight gain or inability to keep it off after losing it a few times over. One of the biggest reasons they often identify is themselves.

The first step I recommend that you take in your plan to get to a healthier weight is to learn more about yourself. Why is that you ask? Because despite all of the suggestions about genetic predisposition or the influence of the environment, we have to look at ourselves as the final decision maker in the choice between having seconds or putting the food away; between taking the walk (even when it's cold outside) or watching television and snacking. If you don't understand your own tendencies and inclinations, you won't be able to critically address the issues that plague you. For most of us, we are creatures of habit and respond to a stimulus in a fairly predictable way. That response may be programmed by years of conditioning (if I say "birthday" you think "cake") or naturally selected because it brings a survival advantage (the taste of sweetness signals us to eat more-- a useful trait when you're a caveman, not so much when you go to Krispy Kreme).

What does any of this have to do with your weight? Everything.

The key is to stop approaching your weight as simply a function of the number of calories you eat and how many minutes you can get in on the treadmill. You need to understand why you eat, when you eat, and how you  eat to be a healthier person. You need to understand if you move, when you have time to move, and how you move to be a healthier person. These issues represent your habits and tendencies that will either need to be overcome/modified or propel you on your way to a healthier lifestyle.

Week 1: Keep a journal for the next week, recording everything that goes in your mouth. Don't record calories (that's right, I said it)! However, do record the time you ate, what you were doing while you ate, where you ate, and your portions. Also make note of your mood and your mental and physical appetite [your mind is saying you could go for something to eat vs. your stomach is saying you need something to eat]. Think about your activity level as well. If you don't have a pedometer, now is the time to buy one.

This is your work for week one. As you jump in, we'll start to talk about some of the patterns that emerge and approaches to change your lifestyle.

Every Super Villain Has a Story

After having my name bantered about the blogosphere by several people, I figured it was time for me to take control of my story and tell my side of things.

You see, a couple of years ago I got labeled as the Evil Dr. Ard by a young man who shall remain nameless (to protect the identity of minors). However, his grandfather (Dean Harold Jones) is primarily responsible for initiating my turn to the "Dark Side." As I recall the story, he and his grandson were playing with action figures and Dean Jones, who had recently started the EatRight program at UAB, prompted him to come up with some nicknames for me. I'm sure his grandson said things like "Really Great Doctor" or "Super Man", but not being satisfied with those depictions of me, Dean Jones pushed for something a bit more sinister. Hence, you have the creation of the Evil Dr. Ard. (If you're interested in the whole story see Dean Jones is Losing It )

Well, being the popular guy that he is, Dean Jones got this nickname spreading around pretty fast. He told all the staff at EatRight and many of the other patients. He even paid Shonnie Wilson, one of our many outstanding OPTIFAST patients and author of another great blog- Diary of an Angry Fat Woman, to adopt the name. No matter how I try to shake the name, it seems to be sticking.

So, when you can't beat'em, you join'em. I'll be using my Evil Dr. Ard blog to share strategies to help you lose weight and keep it off. We work with individuals in the Birmingham, AL region on a daily basis in our award winning EatRight by UAB program, so I know that the fight to lose weight is a challenge. However, it's one that can be overcome with the right help. Our philosophy is that there is no magic bullet or one-size fits all approach. Everyone is different and may require some unique approaches based on those differences. We focus on the best medical evidence and technology to stay above the fray of fly-by-night weight loss plans that have no chance of working. What I plan to do with this blog is give you access to my expertise and opinion about how to tailor a plan for yourself.

The staff at EatRight will be assisting me with topics from time to time. We have a great team of professionally trained dietitians, exercise specialists, behaviorists, nurses, and physicians who provide a comprehensive perspective on what you need to build a successful weight loss plan. Please follow along and send your specific questions. I may be evil, but I'm always happy to help!