200708Illige

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Published on February 14, 2008

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Practical Mindful Eating: Practical Mindful Eating Martha Illige, MD Rose Family Medicine 2007 Brian Wansink, PhD: Brian Wansink, PhD The best diet is the one you don’t know you’re on. Why do we overeat food that doesn’t even taste good? Mindful eating: Mindful eating Don’t mess with success Choose to eat…or not Have external markers Change setting Change plate/bowl/glass size Commit to three-content eating Known points: Known points No one believes it Experimental method Invisible cues: Invisible cues Can you be tricked? How many food decisions do you make each day? 15 47 200 Wansink & Payne “Daily Food Decisions and Estimation Biases” 2006 Psychological Reports Wansink & Sobel “Hidden Persuaders and 200 Daily Decisions” 2007 Environment and Behavior Signals and cues: Signals and cues Evidence-based behavior: Evidence-based behavior Research labs The U of Illinois Hospitality Management Porgram The US Army Natick Labs The Cornell Food and Brand Lab The Penn State Department of Nutritional Science References Deprivation : Deprivation Bodies and brains fight against deprivation “No one goes to bed skinny and wakes up fat” Most people gain or lose weight so slowly they can’t figure out how it happened Most people don’t remember changing their eating or exercise patterns Sherwood et al “Predictors of Weight Gain in the Pound of Prevention Study” International J Obesity April 2000 Margins : Margins Preventing weight gain in most people 100 calories/day 1 cola (140 cal)/day=14 pounds/year 1 donut (420 cal)/day=42 pounds/year 2,000 extra steps (1 mile)/day=10 pounds/year Hill and Peters “Environmental Contributions to the Obesity Epidemic” Science 1998 Hill et al “Obesity and the environment: Where do we go from here?” Science 2003 Okinawa and 20%: Okinawa and 20% Eating until you’re 80% full Hara hachi bu Dish out 20% less Eat food, not too much, mostly plants 20% more fruits and vegetables Mindfulness : Mindfulness “I’m not hungry but I’m going to eat this anyway” External constraints: External constraints Stomachs can’t count We don’t remember Benchmarks Daily weights Structured clothing Belt Tailored pants/skirts Comments/compliments from others Cheek hollows, muscle definition Stair climbing energy Volume (stomach POV): Volume (stomach POV) Volume trumps calories Clean plate/empty plate Speed Calorie underestimation Psychophysics 2 pounds-80 pounds 20 feet-200 feet As anything gets larger, we consistently underestimate worse and worse Rolls, The Volumetrics Eating Plan 2005 Strategy: Strategy See all you eat See it before Choose Preplate your choices See it during Keep bottles, cans, bones, crusts on the table Illusion: Illusion Which line is longer? Which dot is bigger? Strategy: Strategy Choose your table settings Observe variety Small boxes and packages Small plates and bowls Tall skinny glasses Leftovers signal: too much made AND eaten The See-Food Diet: The See-Food Diet Out of sight, out of mind In sight, in mind Make healthy food easier to see Make less healthy food harder to see The more hassle it is to eat, the less we eat Strategy : Strategy Make overeating a hassle Repackage from large size boxes Leave serving dishes on the sideboard or in the kitchen Put tempting foods in a high cupboard or low drawer Snack only at the table and on a plate Eat before you shop and shop on the perimeter of the store (fresh foods) Scripts: may be problems : Scripts: may be problems Get newspaper, pour cereal, eat until done reading Clean plate, keep eating until everyone’s done Get movie, popcorn, and soda (extra large!) Chat with dinner partners, take a roll, take another roll (what a funny story!): how many rolls was it now? Grab chocolates from bowl, grab chocolates from bowl, grab chocolates from bowl… Dining companions: Dining companions One – 35% more Three – 75% more >7 – 96% more Weight can be inherited Weight can also be contagious Strategy: Strategy Avoid dinner guests? Be mindful of the effects of companions Inanimate dining companions: Inanimate dining companions Habit Inattention Continued eating Atmosphere Stay longer – calm music and dim lights Eat faster – noisy and bright TV More TV – more weight Less TV – less weight Radio Reading Computers Driving Strategy: Strategy Move or remove bread basket or chip dish Plan to eat half the meal and take half home Be aware of lingering in pleasant environment and ordering more drinks and courses Share dessert: the best part is the first two bites Pick-Two rule: appetizer, drink, dessert – only two plus the main meal Research: Research What causes overeating? Food TV, newspapers, radio, computers Friends Weather Color Name Label “Expectation assimilation” “Confirmation bias” Culture and presentation: Culture and presentation China, paper plate, napkin? Chocolate cake, Black Forest Belgian Chocolate Cake? French How the French invented culture “We taste first with our eyes” Japanese Katachi no aji – “the shape of the taste” Strategy : Strategy We taste what we expect to taste Use positive descriptor words for your cooking Homemade Traditional recipe Special Fix the atmosphere Attend to the table setting, sound, and lights Comfort foods: Comfort foods Are comfort foods bad? What are they? Chips, ice cream, cookies, candy Pizza, noodles, soup, burgers, casseroles When do we eat them? Happy or sad mood? Gender differences Men: feel pampered, taken care of Women: hassle-free, effortless Hunger: Hunger Physical Gradual Below the neck (growling stomach) Hours after a meal Goes away when full Eating leads to satisfaction Emotional Sudden Above the neck (craving, taste) Unrelated to time Persists despite full feelings Eating leads to shame Primacy and recency: Primacy and recency Is the first food you taste great or bad? Is the last food you taste great or bad? Do you save the best for last? Do you eat the best one first? Is there/was there competition for food? You can mindfully override old learning and tendencies Strategy: Strategy Comfort foods are OK, whatever they are for you Don’t deprive yourself and do eat small amounts Recondition your responses – pair healthy food with positive events Celebrate with fruit and a little bit of ice cream Have one piece of great chocolate and a tall skinny glass of cold protein milk (skim!) Gatekeepers: Gatekeepers Who buys food? Who makes shopping lists? Who prepares meals? Local or distant? If you have no cookies in the cupboard, will you eat cookies? Strategy: right-type variety: Strategy: right-type variety Buy different foods Experiment with new recipes Try different ingredients (spices, vegetables) Take family to the grocery store and let them choose a healthy food to try Visit ethnic restaurants Smile when you eat! What is the right size?: What is the right size? Soda 4, 8, 12, 16, 20, 32, 64 ounces? Muffin Mini, cupcake size, giant Candies 1, 5, 27? Pizza Slice, wedge, pie? What we make it! Strategy: Strategy Bag snacks in a small baggie and put the rest away ‘Half-plate’ each meal or snack ½ vegetables and fruits ½ protein and starch Avoid creating food as punishment or reward Don’t have open-ended, un-ending, refillable servings of drink or food Politics and food cost How many calories can you buy with $5?: Politics and food cost How many calories can you buy with $5? Soda Chips Processed meat Cheese Water Carrots Whole grain bread Hummus Strategy : Strategy Beware the “health halo” Low-fat=OK to eat more Healthy=OK to load on the extras Think small Super-share, don’t super-size Food as mindful enjoyment, not temptation and regret Eat better consistently: small steps 100 calorie margin: 100 calorie margin Different margins for different folks Relevance is individual Motivation is unique Trade-offs and policies: Trade-offs and policies Food trade-offs I can eat X if I do Y: small concessions I am in charge of my food decisions and I choose to raise the price of overeating Food policies Eat food, not too much, mostly plants Serve myself 20% less Eat only at the table with tableware No second helpings of starches Only half-size desserts, if I choose a dessert Half-plate meals: half protein & starch, half fruit & vegetables Mindful eating: Mindful eating Make 100 calorie changes each day 100 calories less eaten 100 calories more expended Change small behaviors in meals, snacks, parties, restaurants, & while multi-tasking Use food trade-off and food policy choices Pick three easy, do-able, sustainable changes that don’t entail sacrifice Make a checklist and track yourself Timing and numbers: Timing and numbers Stick with three changes Three is manageable Small changes Break an old habit and replace it with a good one One month for sustainability Hold ourselves accountable Daily Use external cues and benchmarks well Checklist grid: Checklist grid Days across the top Three changes down the side 100-calorie changes each day 32 checks/month=about a pound 28 consistent checks=new habit Strategy : Strategy Rescript Distract before snacking, not during Eat only in the eating room Serve before starting – dish out onto a plate Don’t eat from the box or bag or serving bowl Rescripting: Rescripting Be the last person to start eating Pace to the slowest eater Leave some food on the plate as if you’re still eating Pre-regulate: decide how much to eat before the meal instead of during the meal External cues: External cues People – family and friends Packages and containers Names and numbers Labels Color, scent, shape Bibliography: Bibliography Wansink Mindless Eating 2006 Willcox et al The Okinawa Program 2001 Capaldi Why We Eat What We Eat 1996 Logue Psychology of Eating & Drinking 2005 Dweck Mindset 2007 Kingsolver et al Animal, Vegetable, Miracle 2006 Buford Heat 2006 www.platemethod.com Remember that things do change: Remember that things do change

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