Dangerous vs. Postive Messaging for Girls & Women

This week has been Healthy Weight Week, and today is the 19th annual Women's Healthy Weight Day.  No, it's not a reminder to start that next diet!  It is designed to remind us to strive for a healthy weight for our specific bodies, and for the purpose of good health; NOT to endlessly long for an unrealistic body shape.  I get too many mothers, often with young girls, coming into my office wanting to lose that unrealistic 10-15 pounds - when their bodies are already in the healthy range already.  They eat healthy and exercise regularly, all labs are normal - yet they are plagued by wanting to be just a bit thinner.  What does that teach our girls?  I found this video last week on Dietitians-Online and thought it was perfect to run on women's healthy weight day today.



Shocking, right?!  My little Hannah loves all things girly, and it's fun to be that with her.  So, I don't think that we need to avoid all things feminine.  And we cannot shelter our children from all of the media expsoure that is found in magines at the grocery store line or television commercials or endless weight loss commercials.  However, we can limit the amount that they are exposed to, and we can balance any negative influences out with positive messaging.  It is so important that we work hard to build healthy self-esteems in our young girls.

In addition to the advertisements, children are influenced by:

• Having mothers concerned about their own weight
• Having mothers who are overly concerned about their daughters' weight and looks
• Natural weight gain and other body changes during puberty
• Peer pressure to look a certain way
• Struggles with self-esteem

Now the good news is that there are so many things that we can do to build a healthy self-esteem.  One big way is to have a healthy self-esteem as their mothers.  Let's start with ourselves!  Other ways we can off-set negative influences are:

• Make sure your child understands that weight gain is a normal part of development, especially during puberty.
• Avoid negative statements about food, weight, and body size and shape.
• Teach your children about a balanced approach to eating which excludes calling foods "good" or "bad" but instead seeing them more as "sometimes" and "always" foods.
• Allow your child to make decisions about food, while making sure that plenty of healthy and nutritious meals and snacks are available.
• Compliment your child on her or his efforts, talents, accomplishments, and personal values.
• Restrict television viewing, and watch television with your child and discuss the media images you see.
• Encourage your school to enact policies against size and sexual discrimination, harassment, teasing, and name-calling; support the elimination of public weigh-ins and fat measurements.
• Keep the communication lines with your child open.

For more information on healping to build self-esteems within yourself and your daughters, visit womenshealth.gov and girlshealth.gov.  Kudos to organizations such as Fed Up, Inc. for putting such powerful videos together (such as the one in this post) to get all of us to stop, think and act. 

Happy Women's Healthy Weight Day!

Calories Are a Good Thing!

My last post that encourages people to Get Off The 'Sick Cycle Diet Carousel' in 2012 has identified with a lot of people on Facebook and Twitter judging by the retweets and shares.  I wanted to dedicate some of the next handful of posts on expanding upon aspects of the diet carousel.

Let’s discuss the pink elephant in the room when it comes to weight control.  When was the last time that calories were discussed in a positive light?  Everywhere you look – you see articles written about how to minimize, decrease, eliminate and avoid extra calories.  We were saturated with it over the holidays.  I completely understand the general premise behind these suggestions.  Adults and children are more obese than ever due to calorie imbalance, so the logical recommendation is to find ways to decrease extra calories for weight management.  But what does the constant bombardment of painting a negative light on calories do for our society?  I will tell you what it does – it makes most people fearful of calories and too much fear has never helped anyone.  I see it every day in my private practice.  We need to put calories in perspective, and we need to see the potential of what we can do with quality calories.

Calories, or kilocalories in the biochemistry world, is a measure of energy needed to increase the temperature of one gram of water by one degree Celsius.  It is literally the way your body maintains energy to survive.  Without calories, our bodies would die.  It is an obvious statement, but it’s important to remember that calories are actually a good thing.  Too many calories taken into the body without sufficient calories expended will yield weight gain.  On the other hand, not enough calories taken in as compared to energy expended will yield weight loss.  In dietetics, I work with many children and adults that are not taken in enough calories – and their health is negatively impacted as well.  With children, inadequate calorie intake will stunt their growth so it is essential to get them back on track.

Now here is the fundamental problem that I have with many people these days.  Many health-minded adults have been groomed to be afraid of calories.  If you do not take in sufficient amount of calories, these things may occur:

·         Inability to build lean muscle, which is what drives the rate at which you burn calories

·         Lack of motivation to be very active

·         The body may not have enough energy to support basic functions such as fighting off illness or infection

·         Fatigue, irritability, insomnia that can confused for depression (seen frequently)

·         Inadequate intake of vitamins and minerals (resulting in other negative symptoms and issues)

For those of you that know me, you know I am a huge promoter of a very active lifestyle.  I encourage regular vigorous activities most days of the week, and believe in fighting to maintain muscle by breaking it down through strength training 3-5 days per week.  Muscle requires calories to build and/or maintain. It’s the wellness cycle that I discussed in my earlier post.

The next time you go to the grocery store, don’t just look at total calories of a food.  Look at the quality of those calories – i.e., how much nutrients your body will receive for the calories in that food.  A good example of this is comparing a piece of white bread with a piece of whole grain bread.  In general, whole grain bread will be higher in calories.  Why?  It is because there are many more wonderful nutrients in whole grain bread.  You literally have the whole grain.  White bread has been stripped from many of those nutrients and that removes calories.  There are many higher calorie foods that contribute excellent nutrients and health benefits including nuts, avocado, fatty fish and heart healthy oils like canola and olive oils.  Take in the quality calories and use those calories to lead an active lifestyle. 

If you need to figure out how many calories your body needs, go to the Daily Food Plans on the ChooseMyPlate.gov website.  Keep in mind that these are only general recommendations and that each person may differ slightly.  Your local Registered Dietitian can help you tailor a very specific number customized for you.  The key is to get the right amount throughout your active day and choosing quality calories specifice to your lifestyle.  Bottom line: do not fear calories, but instead balance them appropriately with an active, adventurous lifestyle.  We need to get this right in order to be on the right cycle of wellness.

Get Off the ‘Sick Cycle Diet Carousel’ in 2012

One of my favorite bands in the last 10 years is Lifehouse.  They are usually on my ipod on workout days, and their lyrics are always so true to life.  One of their all time best songs is Sick Cycle Carousel.   When you listen to the song, it really speaks to anyone because we all have those life struggles that don’t seem to go away no matter how hard we try. We keep going around and around doing the same thing hoping for a different result.



For us to be free of any issue in our lives, we must get off the carousel once and for all.  I have counseled hundreds of men, women and children (usually of those parents) on managing their weight.  More than ever, I am seeing people continuing on the same cycle that has left them unsuccessful over many years.  It is my job to have them consider another way so they can, not only be successful in the short term, but once and for all.  The cycle is usually something like this:

click to enlarge

Your approach may change slightly – switching from one fad diet to the next – but for the most part, it is the same.  I am here to tell you they do not work.  What I love about the new year is that it gives us each an opportunity to do things differently.  As mothers and fathers, we owe it to our children to get it right for ourselves so we can be better role models.  Jump off the sick cycle carousel and jump on the wellness cycle.  It looks more like this:

click to enlarge

Although this pictorial algorithm is simplified, each component is vital for success.  I spend a lot of my time encouraging my clients to eat enough calories at meals (especially breakfast) and snacks in order to get into the sweet spot of the wellness cycle.  When they do, weight drops, lean muscle increases and for the first time in many years, they feel great.  They are fit, and ready to tackle other challenges in their lives.

Some people come and go out of my office and choose not to get off the sick cycle dieting carousel.  After all, change is very scary.  Eat more calories?  Eat more times per day?  That goal of being thin no matter what will drive you to make wrong decisions.  The media does not help with this at all.  Everywhere you look, articles abound that promise the latest dieting secrets.  Be very careful.

So, it is up to you.  Which cycle do you choose for 2012?  As for me, I continue to choose the wellness cycle.  I have some agressive fitness goals for this year and it's the only way to get there.  If you want to choose wellness, consider contacting a Registered Dietitian near you that specializes in weight management that can lead you along your new path.  Many insurance companies are now covering the benefit.  Even if it's not covered, it will be money well spent.

Here's to a Happy & Healthy New Year!

Food Quantity: Portion Control or Intuition?

As I continue my years in the nutrition and wellness industry, I find that there is often a division between dietitians that subscribe to one or the other philosophy when it comes to food quantity: portion control or intuitive eating. I see blogs and articles heavily promoting one or the other. But I would argue that these two approaches are not mutually exclusive of each other. They are both important approaches that can be used together for optimizing health. I was recently interviewed by a company called Healthy Steps by Jokari – a company that sells practical kitchen tools, including very useful portion control gadgets. They asked me what portion control means to me. The interview is provided here, although the video interview did not allow for me to expand on these concepts. So let’s explore this discussion in a bit more depth as we look at portion control, intuitive eating and another important eating approach – meal frequency.

Portion Control: Portion control is a tool that is used to show standard and appropriate serving sizes of foods. Examples of portion control tools would be comparing a deck of cards to represent 3 ounces of meat, or a baseball to represent a serving of starch or starchy vegetable. Or, even the useful products that companies like Healthy Steps sell to consumers that help load your plate with standard portions.  Portion control tools are meant to be a guide to what the USDA decides is an appropriate portion for most Americans based on research. Again, it’s merely a guide. In fact, I wish we renamed this to a more friendly approach – portion guidance. The word “control” seems so militaristic in nature and that is what turns many intuitive eating promoters off to this helpful tool. This approach was never meant to be something that would relinquish our right to listening to our own bodily cues. Portion guidance systems also help us to make sure we are eating enough of a given food. We are encouraged to eat a certain amount of fruit and vegetable servings each day (go to http://www.mypyramid.gov/ to get your own custom plan by plugging in age, gender, weight, height and activity level) so we need to know how much a serving is.  Portion guidance seems to be especially helpful for my patients that were raised in the "clean plate club" and are now psychologically unable to end a meal until their plate is cleaned. They need to have a jumping off point to set up their plates, and then dial in the intuitive eating concepts. We use standardized portions when prescribing constant carbohydrate diets for diabetics in order to optimize blood sugars.  For instance, one portion of carbohydrate for diabetics is 15 grams, and they must know what those portions are in order to dose insulin and/or to stay within their carbohydrate prescription.  As you can see, portion guidance is a very useful tool in a variety of situations.

But before we talk about intuitive eating, let’s insert another eating approach here that sets us up well – meal frequency.

Meal Frequency: Americans are leading busier than ever lives and often times we go way too long to eat. Most of my weight management clients either skip meals or go way too long between meals. Many times this causes a person to not be satisfied by an appropriate meal portion. In fact, this can cause them to overeat in order to make up for the lost calories earlier in the day. My recommendation, consistent with current research, is to make sure you eat three solid meals and also include 1-2 in-between those meals in order to decrease your risk of (or treat) obesity. That way, you never come too hungry to a meal. Let’s be honest, it’s difficult to make optimal food choices when you’re starved. More than weight control, the correct meal frequency optimizes energy levels and  promotes both normal blood sugars and cholesterol levels. I do find that my patients get used to not eating breakfast and they ask me if they should eat even when they don’t feel like eating. This is the one meal of the day where I would say...yes. Your body needs to be re-trained to eat with regular frequency, and this will help start the progress.

And now we have intuitive eating.

Intuitive Eating: Meal frequency and portion guidance set-up allows us to practice intuitive eating. Intuitive eating is a nutrition philosophy or approach that encourages us to tune into our bodies more and eat for simply the feeling of hunger. Living in a world of multi-tasking, it can be difficult to do what seems like such an obvious thing. But we do. We eat because the clock tells us to do so (and we try to push our kids to do the same!), or because of stress, or boredom or a variety of emotional reasons. This approach is very important and something that all people should look at in their own lives. Many times people are not overweight because of food, but because of outside influences that drive us to eat in order to soothe our feelings or emotions. Obesity caused by emotional eating can dredge up fear around food because emotional eaters don’t feel in control in its presence. Intuitive eating concepts are important for the ex-clean plate clubber or the busy parent or the emotional eater. Let’s get back to the basics and eat for real physiological reasons. If you find that you are an emotional eater, consider getting support by a counselor or psychologist that specializes in this field.

When it comes to food quantity, all these 3 approaches - in my opinion – are great tools to be used together for optimal health. The right meal frequency combined with guidance using standard portions and then letting intuition do the rest. Combine that with food quality, and you are well on your way to living your best life!

Healthy Resolutions: A Healthy Parent = A Healthy Family

Well, it’s the end of the first month of the new year. Have you set any healthy resolutions?  Have you thought about how you plan to make 2011 healthy/healthier for your family?  What message does your personal lifestyle communicte to your children?  I think these are all questions we should contemplate for the sake of our family's future wellness.

I was contacted by Everyday Health to provide answers to very important questions regarding New Year’s Resolutions and wellness goals. As a big advocate for being a healthy role model for children, I felt it was important to answer these questions for all moms and dads trying to make 2011 the healthiest year yet. Many of these questions discuss weight loss and getting fit, however, they can be used for other nutrition and wellness goals as well.  So here we go!

Make 2011 your family's heathiest year yet!

1) We all make New Year's resolutions, and often these resolutions involve weight loss or fitness goals. But many of us quickly lose traction and don't achieve our goals. What are the psychological and emotional reasons behind these failures?

A person truly needs to be ready to make changes.  Any purposeful, positive change in life is rarely an easy thing, so you must be dedicate time and effort.  In those that come to see me for nutrition guidance, I usually can tell in the first session if they are truly ready to make the changes needed to achieve their goal.  Confidence and optimism at the start of any effort are both critical. Confidence certainly feeds into optimism and vice versa. Believe that you can achieve the goals that you set before you. Check your confidence level – and make sure you go into your resolutions with the right attitude. 

2) What is the biggest mistake people make when making a resolution?

They don’t get specific enough with that their resolution(s). They cannot just say, “I want to be healthier in 2011.” Well, what does that mean? And how do you plan to go about doing that? Goals need to be written down along with a game plan on how to get there and posted with a completion date. Lastly, choose an accountability partner that knows about the goals you have set and have them follow-up with you on your progress.

Are you setting yourself up for failure when you make a New Year's resolution to lose weight or get fit?

I don’t believe so. I believe every single day brings with it a new beginning – a renewed opportunity to head down the optimal path in any area of your life. Your past mistakes should be seen as learning curves, and not as a gauge to how you will do going forward. So, whether it's a new year, a new month or even a new day - they all bring with it a chance to start fresh.

3) How do you set reasonable, healthy expectations when you resolve to lose weight or shape up at this time of year or any other time of year?

One must resolve not to fall prey of fad diets or quick fixes. Many out there are desperate to get the result and this is the cause of that temptation. Instead, set very specific, realistic and measurable goals that include just a couple impactful nutrition goals and a couple exercise goals. Again, write them down and have someone else sign the document with you for accountability. Re-evaluate those goals and objectives every six weeks or so to work through any stumbling blocks or just to adjust goals to fit your progress. This helps to keep the challenge going as you get closer and closer to your goal.

4) What kind of support should you seek to help you achieve your goals?

I truly believe the guidance of a Registered Dietitian (RD) in the area of nutrition expertise is extremely helpful. RDs are nutrition scientists that practice evidence-based nutrition that are also equipped to assist in goal setting, accountability and practical tools that will help you get there. Dietitians that work specifically in weight management and wellness have experience working with many types of people and can tailor a plan that fits your specific needs. You can find an RD in your area by going to the American Dietetic Association website at http://www.eatright.org/.

5) What are three things you can do to improve your chances of success before you make a healthy lifestyle change?

1. Be motivated to live a healthy lifestyle for more than body weight only. In my experience in working with hundreds of weight loss clients, I find that most of those only motivated by weight loss or attaining a number on the scale are the least successful. But those wanting to have more energy, optimize their health, feel better – are the ones that do better. The cool thing is that the weight takes care of itself! I believe that this is true because the desperation leaves the scene and it allows a person to fully grasp healthy lifestyle concepts. Come to the realization that everything flows from a healthy body and you want to be healthy for more than a jean or dress size. Do you want to be a better parent? Do you want to climb the ladder in your profession? Do you want to positively influence others? It is all more achievable from a healthy and well body.

2. Clear the clutter out of your life. What are you involved in that is keeping you from living a healthy lifestyle? Many times we are involved in too many activities and they are not really nourishing to our lives. You may need to make a life goal list and then tailor all that you are involved in to that life goal list. Bow out of things that do not align to that list.

3. Know what a healthy lifestyle is and what it isn’t. Healthy lifestyles ebb and flow with the changes and adaptations of life. It should not be a militaristic approach that doesn’t allow for flexing. It is the simple changes made over time that have their biggest and long lasting impact.

6) Why is it so hard to keep the weight off after a diet, and what can you do to maintain weight loss?

Many people go on fad diets and they are very impractical – some 500 calories a day or less. Crash diets do nothing to train you for the real world. Again, seek the advice of a Registered Dietitian so they can put together a reasonable plan that will allow for a modest weight loss per week. Modest, but consistent weight loss preserves lean tissue – which is what drives the rate at which you burn calories. We lose lean tissue just by aging. We don’t need a fad diet’s help to do that for us!

But also, much research has shown that people that have previously been overweight need to be even more active to maintain a lower body weight as compared to others that have never been overweight. High levels of physical activity (one hour most days of the week) must be a regular part of a successful weight loser’s life. Other great things have been learned by the National Weight Control Registry out of Brown Medical School. Check it out!

7) Can you rearrange your life in any way to make it easier to avoid diet temptations?

If there is any food in your home or office that sends you into poor eating patterns then I would suggest keeping those foods away to avoid the trigger. Instead, enjoy them in moderation away from your everyday location. Also, your taste buds change as you start eating more nutrient-rich foods. After having lowered sugar and fat in your diet for a period of time, many people find when they go back to eating those foods they seem much richer and more sugary than before.

We also must dismiss all those reasons why a person may eat when not hungry. Be sure to address any emotional reasons why you might be turning to food when making changes to your lifestyle. If needed, seek the help from a counselor or psychologist and they can help you identify your deeper issues here.

8) What advice do you have for people who just don’t like to exercise or who avoid it for other reasons?

I say that a weak heart wants to stay weak. What I mean by that is that your heart is a muscle. When you are sedentary, the heart muscle gets easily fatigued. I don’t know about you, but it’s a scary concept to think about having a weak heart! It’s the organ that pumps blood to everything else. So I say, challenge yourself. Start off slow and observe the feelings after exercise. The body is made to move and must do so in order to be healthy. Don’t’ decide to work out or not to workout based on emotions. Do find something that interests you, but don’t decide to work out because you “don’t feel like it.” I absolutely love running, but there are still times that my mind tries to talk me out of it - and I teach this stuff! Set your exercise goals by detailing what days and times you plan to do them and follow through. I never regret going for a run. On the contrary - I say, “whew. I am so glad I did that!!”

9) When you’re making a resolution to improve your health, who should you recruit to be on your wellness team?

Annual medical checks by your physician are vital. In addition to being followed by a dietitian, encourage your loved ones to join you. Surround yourself with like-minded people and you will be more successful. As your lifestyle changes, you may surely find that the things you used to like to do will change as well. And that may involve a shift in the people you hang out with on a regular basis.

10) It’s easy to make excuses when you’re juggling work and family responsibilities. How can you make time for your resolutions in a hectic schedule?

Prioritize. If you truly feel something is important in your life, you will find the time. Bottom line: If you think you don’t have time for something, it’s truly not that important to you yet.  Ouch!  Yep, I said it.  It's just the truth.

If you have set any healthy New Year’s Resolutions, I would love to hear from you by commenting below. Or, if you have had past success by setting New Year’s Resolutions, let me know what component(s) of your plan helped to make you successful. Let’s all learn from each other!

Children, Follow My (Eating) Cues

Feeding behaviors are solidified early in life. In general, children are wonderful examples of listening to their hunger and satiety cues. Both of my children are great examples. My son is a really big eater in the morning and into lunch time and then has a tendency to pick the rest of the day. While other days, he eats very little. My daughter, on the other hand, eats a small amount at breakfast and then slowly picks up throughout the day.  Some days, she seems to eat the amount a grown woman would eat!  But I trust she is accurately listening to her own body as remains active and her weight is following a healthy growth curve. Unfortunately, many parents confuse children when they tell them to eat because it is meal time. Parents think, “Surely they should be hungry because they haven’t eaten in several hours.” And not only do some parents make children eat, some make them clean their plates. I recently wrote a letter to a well-known, elite school here in Dallas when one of my pediatric patient’s mother (who happens to be a physician) told me they still practice the clean plate club at their school. Really?! I thought everyone has figured out by now that this is not a good thing to do. The clean plate club trains the body “untrust” its physiological signals to eat or not to eat. This approach may have started back in the Depression when food was scarce, but I see many adult patients that are still trying to unlearn what they were taught by their parents. “Do not get up from this table until your plate is clean.” Or, “If you want that dessert, you better eat everything on that plate.” Dietitians cringe at the thought, although I truly believe parents are very well-intentioned. 

One of the best food behavior gifts we can give our children is the gift of trusting in their own hunger and fullness cues. I credit my own mother for allowing me and my siblings to make our own decisions to eat or not, and I firmly believe this has been one of the foundations to my healthy relationship with food. We ate as a family at the table without distractions (this is key), which helped us in listening to our individual cues. Because of mom, I can have my favorite food under my nose and if I am not hungry, I have no desire to eat it.

Hunger Scale by Paula Ryan, MS, of
Healthiest Regards Blog.
(Click to enlarge)

Paula Ryan, MS, author of the Healthiest Regards Blog, posted a great hunger and satiety scale that I wanted to share with Mommy Dietitian readers. It’s one of the best I have seen because it also lists the consequences of waiting too long eat, or not stopping when the body says it has had enough. If you find yourself eating in the absence of hunger or waiting way too long to eat, consider printing this scale off and going back to the basics. Many people eat for reasons other than hungers like when they are stressed, mad or sad. Deal with those issues directly instead of turning to food. It may be easier said than done for some, but this can be a start to a healthier YOU in 2011. And a healthier you means a healthier family because the children are watching – and doing what you do.

3 Keys to True Food Love

Have you ever thought of how the state of your body image impacts the relationship you have with food? It sounds obvious. But in my experience with hundreds of adult weight management clients, I certainly have seen the connection firsthand. I coach people on how to establish healthier food patterns and have observed that their own self-image seems to be a big determinant to their success.  If there are serious issues, of course I refer them out to a counselor that will assist with that compoenent. However, I was reminded of body image the other day in my own life, which was the catalyst of today’s blog post.  How, you ask?

Children can say the darndest of things! The other day, we were running around getting ready to head out to yet another 4th of July celebration when my 6 year-old daughter turned to me and grabbed my belly. She said, “Mommy, you look like you are going to have a baby.” Well, that certainly stopped me in my tracks. I thought to myself, “Did she really just say that to me? Yep, she did!” I would be lying if I said I was completely unaffected. But it’s a good thing that I have a health self-image. And it’s also a good thing that I have a great respect for food and how it nourishes my body. Otherwise, as I have seen so many times with others – the comment can cause a cascade of negative reactions. It would start with the allowance of that one comment to question my body satisfaction. This could then cause me to want to restrict food in order to achieve that body image that does not “look pregnant.” Do you see how this negative cycle can start so easily?

A positive body image not only helps
your relationship with food, but also
your children's.

This situation made me think of all the moms, women and even men out there that allow negative influences to impact their body images. I deal with so many adults in my private practice that are striving so hard to be that perfect body image that they imagine in their minds. This obsession most certainly impacts their relationship with food. You see, I am 5’5” and weight 118 pounds.  The only reason I share this information about myself is to prove a point - which is that even a normal body weight may not eliminate negative comments about your body.  It does not matter what your mind is telling you, there is no body weight that will allow you to achieve “body nirvana.” It starts with the inside and how you see your self-worth altogether. So, invest in your surroundings so they can promote a healthy body image regardless of body size. I came up with my top 3 things I tell my clients when discussing building a positive body image which in turn promotes a healthy relationship with food:

1. Rid Yourself of Negative Influences. No, that doesn’t mean disowning your children for saying negative things about your body! {giggle} It means avoiding magazines, television programs, friends, or places you go that might flood your mind with unrealistic body images or that might over promote aesthetic beauty. You may think that these are positive motivators, but they are not. As many people that I have seen in my practice, I have learned that these influences do not help you in keeping your overall health the highest priority in maintaining a healthy weight. It all becomes about the body weight and body image – and desperation becomes a sad part of this circus ride.

2. Consciously Surround Yourself with Positive Influences. Be around people that are positive and encouraging to you. Seek out reliable resources when it comes to food and nutrition so that you can truly see how food has so much more power than causing weight gain or loss. A local Registered Dietitian can help put you on a balanced plan that can be customized specifically for you. Dietetics school blew me away with the facts of food’s power in our lives. Food has the power to protect, prevent and in some cases, cure. Think of food in this way instead of only as a means of gaining or losing weight. And equally important, step back and realize the person you are regardless of what the scale says, and this will free you up to living a healthy lifestyle for the right motivations.

3. Be a part of something bigger than yourself. You can see the power of this perspective when becoming a parent. I was so much more self-absorbed when I was single. But now that I am a wife and mother, I make decisions not only for my own sake, but also those around me. If I don’t invest in a positive self-image that is grounded in more than aesthetics, it will certainly impact how I teach my children about food. Eating well and taking care of my body gives me the energy and good health I need in order to raise a family. Become part of a group, church or community that makes strives to make the world a better place for all. Being a part of something bigger than yourself really helps a person go deeper – deeper than surface motivations. For me, my faith in God is a huge part of why I do what I do - personally and professionally. It helps keep the focus off of me and instead on others.

You may be wondering what I said to my daughter after she made that comment. I calmly explained to her that it is not nice to say that to someone if they really are not pregnant. [I recalled a similar situation from back when she was 4 years old when she did the same thing to a morbidly obese friend at church. She asked her if she was pregnant. All of us in the group were extremely embarrassed, as you can imagine.] It is important that we have these teaching moments with our children without making it a huge deal. Fortunately, I was able to move on with my day pretty easily. I hope that if something like this happens to you that you can do the same. A positive body image frees oneself to truly appreciate food for what it truly offers.

For more information on how to achieve a positive body image, I recommend http://www.womenshealth.gov/bodyimage/. Consider reading the section on how the attitude of parents about appearance and diet affects their kids’ attitudes. They provide good tips on how to positively influence your child’s body image.

Ditching Dairy? CAUTION!!

Use caution when avoiding entire food groups,
including dairy.  You may be setting yourself up
for nutrition deficiencies that may manifest
in health problems.

I recently attended a Diary Forum in Alexandria, Virginia that was all about lactose intolerance. It amazed me to learn how many people avoid dairy products because they think they are lactose intolerant! Before ditching the dairy, consider my caution for you and/or your family as it can have major nutritional consequences.

When people think of milk and other dairy foods, they think of calcium. But the truth is that milk contains 9 essential nutrients that our bodies need in order to function normally. Of those nine essential nutrients, milk meets at least 20% of your daily value for not only calcium, but vitamin D, riboflavin and phosphorus. That is why the Dairy Guidelines of Americans strongly recommends three servings of low-fat dairy per day in order to meet your minimum nutrition needs. Did you know that dairy foods are most Americans primary food source of vitamin D? Much in thanks to the great work by Dr. Michael Holick, we have been learning more and more about the epidemic of vitamin D insufficiency and deficiency that is having serious health concerns.

The lack of nutrient information regarding dairy really hit home with me the other day. An amazing, well-respected doctor I work closely with in my practice shared with me that when a patient comes to him with lactose intolerance, he simply tells them to avoid milk and start a calcium supplement. I had to remind him that dairy not only provides so many more nutrients than just calcium as mentioned above, it also contains naturally occurring ACE inhibitors similar to the same components given in prescriptive form that help regulate blood pressure. That is why the government-backed blood pressure diet, called the DASH diet (Dietary Approaches to Stop Hypertension), encourages 3 servings of dairy because it has all 3 of the nutrients of the DASH diet that help regulate blood pressure – calcium, potassium and magnesium. Milk also contains melatonin that helps decrease stress and promotes sleep. (Ever drink a warm glass of milk before bedtime? There’s a reason behind that!) And as if that was not enough, over the last several years there has been a slew of research coming out on the impact of dairy foods in weight management.  Hmm...a link between a decrease in dairy foods and obesity?  Many say, yes.

Growing up, our favorite mealtime beverage was milk. I grew up in a combined family of 6 children (think Brady Bunch, and I was "Cindy" -- the youngest) and my mother reports that we went through 5-7 gallons of milk every week! I drank milk with every meal and so did all my siblings. But I remember very well that when I was around 17 or 18 years of age, milk and I started having problems. Within 2-3 hours of drinking milk, I would have bad stomach pain, bloating and eventually gas that was very characteristic of lactose intolerance. Oh, the shame as a teenage female! The very easy thing to do is just eliminate dairy to avoid the very embarrassing consequences. But as I fell in love with nutrition in the 90’s, I learned that this was a move was costing me dearly and as a result, negatively impacted my nutrition status.  Now, I am enjoying dairy again and that has helped me be a positive role model for my young children.  (Check out my son's Yogurt Emergency, which was a previous blog post.  I know many moms can relate!)

So, the question is for you – have you or a loved one ditched dairy for the same reason as I did as a teenager? If so:

1. Get Diagnosed. Don’t self-diagnose like I did because it could be something else other than lactose intolerance. All that rumbles in not lactose intolerance! A proper diagnosis is done via a hydrogen breath test and it is covered under most insurance plans. Keep in mind that lactose intolerance is very different than a milk allergy. Lactose intolerance involves the lack of an enzyme that helps digest the milk carbohydrate, lactose. Milk allergy or milk-protein intolerance, is mostly found in young children, and involves an immune reaction to the milk protein. If you or your child has milk allergy, it is highly recommended that you see a Registered Dietitian for nutrition guidance. In this case, complete elimination of dairy components is necessary due to possible dangerous allergic reactions. The good news is that most children outgrow milk allergy by the time they are 3 years of age. It is rare to that a person continues the allergy into adulthood. If they do, there are actually immunologists that can do milk challenges that will decrease or even eliminate the milk allergy altogether.

2. Work it in. Most people with lactose intolerance can tolerate small amounts of milk at a time and most can eat yogurt and cheese without the negative side effects. At your local grocery store, there are lactose-free milk products of varying brands – Lactaid®, Dairy Ease® and even store brands now. Lactaid® is even coming out with an organic version of lactose-free milk for those that prefer organic varieties. There are even over the counter oral lactase enzyme pills that a person can take that be taken prior to the ingestion of dairy. The National Dairy Council has a great educational resource to help you find ways to get dairy in even when you have lactose intolerance.

3. Seek a Registered Dietitian (RD). Anytime you are thinking of eliminating an entire food group, it is highly recommended that you meet with a Registered Dietitian (RD) in your area to develop a plan for you. You may not realize what key nutrients you are eliminating from your diet that may be compromising your health. As an RD myself, I am very sensitive to the food desires of my patients. If eliminating dairy or other foods are simply a personal preference, we will honor that and can ultimately work within your desires to put an alternate nutrition plan that will meet all your needs.

Get the facts when it comes to nutrition. Even if it's written, it doesn't always make it factual.  And we all come with our own nutrition biases, but ask questions about those biases that may have been handed down from generation to generation. Are they really true? As in lactose intolerance for instance, many African American families avoid milk altogether because they already assume it will be a problem. Lactose intolerance in African Americans is grossly overstated, and teaching your children to avoid dairy can have lasting consequences for yourself and for them. Proper diagnosis and learning ways to get dairy foods in can be the best move for you. What is your nutrition bias? Dairy or otherwise, ask the questions and get accurate answers. You owe it to yourself and you also owe it to your family.