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Dietetics Blog

Dietetics students have the chance to publish their blog posts on this site. From challenging the latest fad diets, to cool shadowing experiences, to engaging in thier community, you'll read posts from students who are broadening their writing and media skills using this platform.

HAES and IE: A Student Perspective

October 12, 2020

HAES and IE are two abbreviations that, before my senior year at UGA, I had heard in classes but did not fully understand. These two abbreviations have led me to read, research, and learn about an entire new set of ideas and teachings that I greatly relate to. Part of this is due to the opportunities afforded to me by professors who have allowed me to form my own thoughts through research, discussions, and deep thinking.

Health at Every Size and Intuitive Eating are methodologies that are rapidly gaining attention in the fields of foods and nutrition. Some people fall into a category where these approaches reign supreme for counseling and educating patients or clients. In contrast, others feel that more conventional and historical models have more success and validity. Still, some practitioners and individuals believe in a middle ground of this continuum, where both teachings and practices have a healthy place. Before determining what category you fall into, it is essential to understand what the ideals of each methodology are. 

 

So what is HAES?

HAES or more formally known as Health at Every Size, is a holistic approach to health, emphasizing that health is not the absence of disease but is individual to each person. HAES and its parent organization aim to end discrimination based on body weight and size.1 HAES is a voluntary program and each provider must choose for themselves if they wish to follow its teachings and practices. I believe it is important that Nutrition and Dietetics related fields continue to teach and promote HAES. It is crucial to provide students with all of the evidence and knowledge and allow these future practitioners to make their own informed decisions on ideas they choose implement into practice. This ideology is something I continue to research, learn, and develop opinions about every day.

 

Intuitive Eating

Along with HAES, intuitive eating is another practice that has emerged with more popularity in recent years. Intuitive eating is the ideology of weight-inclusive and evidence-based knowledge that uses human instinct, emotion, and thought to base eating. This teaching method focuses on the idea of self-care and using a person’s intuition and internal cues to choose what foods they want to eat and how much of that food to eat.2 Intuitive eating removes the idea of good foods and bad foods and emphasizes respecting and working for a happy and healthy body. IE, like HAES, focuses on health as not the absence of disease but a holistic view of your body. 

 

During the Spring of 2020, I was afforded the opportunity to read “Anti-Diet: Reclaim your Time, Money, Well-Being, and Happiness Through Intuitive Eating” by Christy Harrison. During my Medical Nutrition Therapy II class with Dr. Emma Laing, we read the book and wrote short responses on our emotions and thoughts based on individual chapters. Our reading was coupled with lessons in class about different dieting and weight-based techniques. Valuable lessons included methods of interpreting BMI and the pros and cons of bariatric surgery. This class allowed us to experience both ends of the anti-diet/diet continuum-learning the different practices, techniques, and ideas of both weight-inclusive medicine and weight-based medicine. This further sparked my interest and desire to educate myself in these two related ideologies. The lessons in the book, as well as other outside sources, led me to strongly support the principles of Health at Every Size and Intuitive Eating. While I feel that I am a strong proponent of Health and Every Size and Intuitive Eating, I feel as though I settle in the middle of the continuum regarding beliefs and practices. I want to encourage, educate, and support future clients and patients to follow these teachings while emphasizing there is a place reserved for those who wish to lose weight or worry about how their weight may be affecting their health or future. 

 

Links

  1. https://www.sizediversityandhealth.org/content.asp?id=76
  2. https://www.intuitiveeating.org/definition-of-intuitive-eating/


Protein shakes: Refueling your post-workout body

September 01, 2020

Muscle fatigue, soreness, and overall exhaustion are often experienced after exercise. What if there was a solution to combat these issues and allow your body to operate at its fullest following a workout? There is, it’s simple, and it’s right at your fingertips.

Protein shakes are a popular commodity in our society that values health and wellness. A combination of protein, carbohydrates, and vitamins, they live up to their hype. In order to get the best results, it is crucial to understand how the contents of protein shakes promote muscle recovery and why timing is a key factor.

What is glycogen?

Imagine muscles are a flashlight. A flashlight relies on batteries to function correctly, and it will continue to emit light as long as the battery has enough power. As the battery starts to die and the light begins to dim, the power source must be replaced in order to restore full function. Our muscles function similarly. They rely on glycogen as their primary source of power during exercise. Once these energy stores are depleted, muscles become fatigued. Refueling the body to promote glycogen repletion and protein synthesis is key to optimum muscle recovery.1

Carbohydrates and glycogen repletion

When glycogen stores are depleted, carbohydrates must be made available for the body to synthesize glycogen and restore muscles. Exercising results in an increased sensitivity to insulin, which allows for greater glucose uptake in muscles.1 This insulin sensitivity declines following a workout, so the timing of carbohydrate consumption is essential. Delaying carbohydrate intake has been shown to reduce muscle glycogen stores compared to immediate use.2 Further, waiting several hours after exercise to consume carbohydrates shows a 50% decrease in glycogen synthesis.1 It is recommended to refuel the body with carbohydrates within two hours of exercise for the best results.2

Protein and muscle recovery

Another contributing factor to muscle recovery is protein availability. Muscle fibers, or myofibrils, become damaged as muscles are worked. The splitting of myofibrils allows for muscle growth, but the body must have an adequate supply of protein for repair.3 Consuming protein after a workout increases muscle protein synthesis, allowing for this necessary tissue repair. Since exercise increases amino acid uptake, protein ingestion is most effective immediately following a workout. While protein plays a critical role in muscle repair, it also contributes to an increase in glycogen synthesis when ingested with carbohydrates. These two macromolecules together increase the rate of glycogen storage by about 38%.1 This evidence suggests that protein shakes containing both protein and carbohydrates are an effective way to refuel the body following a workout.

Supplying the body with essential nutrients to promote muscle recovery is paramount for improving body composition and maximizing workouts.4 Quicker repair of muscle tissues via protein supplementation can help reduce delayed onset soreness and prepare the body for the next workout.2 Like replacing a battery in a flashlight, carbohydrates in protein shakes promote glycogen synthesis that refuels muscles with the energy they need to perform.

When time is of the essence, protein shakes provide an efficient means of replenishing the body following exercise. They’re convenient, cost-effective, and they don’t have to be boring! The beauty of protein powder is that you can create a mixture that fits your taste. Blend it with water and crushed ice for a cold, refreshing smoothie, or add unsweetened coconut milk or oat milk for a satisfying thirst quencher. After your next workout, reach for a protein shake and feel confident knowing you’re recharging your body with the best fuel on the market!

References:

  1. Ivy JL. Regulation of muscle glycogen repletion, muscle protein synthesis and repair following exercise. J Sports Sci Med. 2004;3(3), 131-138. https://www.jssm.org/hf.php?id=jssm-03-131.xml#
  2. Ivy JL, Katz AL, Cutler CL, Sherman WM, Coyle EF. Muscle glycogen synthesis after exercise: effect of time of carbohydrate ingestion. J Appl Physiol. 1988 Apr 1;64(4), 1480-1485. doi: 10.1152/jappl.1988.64.4.1480
  3. Pearson AM. Muscle growth and exercise. Crit Rev Food Sci Nutr. 1990;29(3), 167-196. doi: 10.1080/10408399009527522
  4. Kerksick CM, Arent S, Schoenfeld BJ, et al. International society of sports nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2017 Aug 29;14(1). doi: 10.1186/s12970-017-0189-4

Links:

  1. https://www.jssm.org/hf.php?id=jssm-03-131.xml
  2. https://journals.physiology.org/doi/pdf/10.1152/jappl.1988.64.4.1480
  3. https://www.tandfonline.com/doi/abs/10.1080/10408399009527522
  4. https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0189-4


You are NOT what you eat: Exploring Intuitive Eating’s gentle nutrition principle

September 01, 2020

There is far more to health than what we weigh, yet we live in a society that ties the way we look, what we eat, and even what exercise challenges we do, to moral virtue. The popular phrase, “You are what you eat,” is often used to motivate people to healthfully fuel from the inside to produce a healthy appearance on the outside. This concept is not only short-sighted, but it can be potentially harmful. The insinuation with this phrase and others like it, is that you are not worthy if you do not eat a “clean” enough diet or fit a thin ideal standard of beauty. What if we all ate the same exact meals and snacks and exercised the same amount, would all of our bodies look the same? No, of course not.

Despite the personal responsibility that is often expected of people to be in charge of their body size, weight is actually not something many of us can control. Even if pursuing weight loss to improve health elicits long-term successes for some individuals, the truth is that many are unable to maintain this. In fact, repeated cycles of weight loss and regain, reduced self-esteem, disordered eating behaviors, and diagnosed eating disorders can also develop as a result of dieting, and people who fall into the pattern of weight cycling might end up gaining more weight than if they have never dieted at all. Feelings of inadequacy can perpetuate negative body image and the desire to diet restrictively or exercise punitively.

Dieting and exercising to the extreme and below basal energy needs, or even spending much of the day thinking about food, weight and body image, are never the answer to achieving optimal health. What if we took the focus off weight or outward appearance in determining a person’s health or moral virtue? What if we were able to eat when we were hungry and stop eating when we were full? One way to explore these concepts is through Intuitive Eating, which “cultivates a healthy relationship with food, mind, and body.” In this post, I list the 10 principles of Intuitive Eating with brief summaries adapted from the authors, Tribole and Resch (see the full list at this link), and I elaborate a bit on principle #10 – Honor your health with gentle nutrition.

  1. Reject the Diet Mentality

Throw out the diet books and magazine articles that offer you the false hope of losing weight quickly, easily, and permanently. Get angry at diet culture that promotes weight loss and the lies that have led you to feel as if you were a failure every time a new diet stopped working and you gained back all of the weight.

  1. Honor Your Hunger

Keep your body biologically fed with adequate energy and carbohydrates. Otherwise you can trigger a primal drive to overeat. Learning to honor this first biological signal sets the stage for rebuilding trust in yourself and in food.

  1. Make Peace with Food

Give yourself unconditional permission to eat. If you tell yourself that you can’t or shouldn’t have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, bingeing.

  1. Challenge the Food Police

Scream a loud no to thoughts in your head that declare you’re “good” for eating minimal calories or “bad” because you ate a piece of chocolate cake. The food police monitor the unreasonable rules that diet culture has created.          

  1. Discover the Satisfaction Factor

When you eat what you really want, in an environment that is inviting, the pleasure you derive will be a powerful force in helping you feel satisfied and content. By providing this experience for yourself, you will find that it takes just the right amount of food for you to decide you’ve had “enough.” 

  1. Feel Your Fullness

Listen for the body signals that tell you that you are no longer hungry. Observe the signs that show that you’re comfortably full. Pause in the middle of eating and ask yourself how the food tastes, and what your current hunger level is. 

  1. Cope with Your Emotions with Kindness

Anxiety, loneliness, boredom, and anger are emotions we all experience throughout life. Food won’t fix any of these feelings. It may comfort for the short term, distract from the pain, or even numb you. But you’ll ultimately have to deal with the source of the emotion.

  1. Respect Your Body

Just as a person with a shoe size of eight would not expect to realistically squeeze into a size six, it is equally futile (and uncomfortable) to have a similar expectation about body size. But mostly, respect your body so you can feel better about who you are. All bodies deserve dignity.

  1. Movement—Feel the Difference

Shift your focus to how it feels to move your body, rather than the calorie-burning effect of exercise. If you focus on how you feel from working out, such as energized, it can make the difference between rolling out of bed for a brisk morning walk or hitting the snooze alarm.

   10. Honor Your Health—Gentle Nutrition

Make food choices that honor your health and taste buds while making you feel good. Remember that you don’t have to eat perfectly to be healthy. You will not suddenly get a nutrient deficiency or become unhealthy, from one snack, one meal, or one day of eating.

The authors of Intuitive Eating have placed “honoring your health with gentle nutrition” as the 10th and final principle in their list – and they did this for good reason. It is essential to heal your relationship with food first before you’re ready to delve into making food choices that promote health according to national recommendations. Appreciating that the concept of “health” includes mental health as well as other aspects beyond simply body size, it makes sense that a positive relationship with food can have a positive impact on life.

While nutrition is of course an aspect that is important to health, food brings us together in ways that are also important to our wellbeing, such as connection, culture, satisfaction, and joy. Viewing food as a source of both pleasure and nourishment is a key part of the realization that health does not have to be so closely connected to what you eat. When you allow a wide variety of foods during meal times without strict rules attached, you have the chance to experience your own hunger and fullness cues.

Another aspect of eating intuitively involves paying attention to how a specific meal or snack impacts you physically, beyond satisfying your cravings. Taking note of how these foods or meals make you feel, in particular, if you feel nourished and comfortable after eating them, is a cornerstone of honoring your health with gentle nutrition. Though intuitive eating offers the enthralling notion that “no foods are off-limits” during meals and snacks, the process of discovering or re-discovering your natural hunger and fullness cues takes patience and time. As with any facet of nutrition, practicing gentle nutrition is not a one-size-fits-all approach, and its meaning may shift throughout various stages of your life. Tribole states in a blog post, that “Our bodies are dynamic and ever-changing: be patient & approach this practice with curiosity & compassion.”

If you think you might be ready to try intuitive eating and/or practice gentle nutrition, there are several paths to getting started. First, recognize that an overhaul in a lifetime of thoughts and behaviors surrounding dieting and body acceptance is not going to happen overnight. Preparing to practice gentle nutrition might also mean sitting with a bit of discomfort around your own fat phobic thoughts and rhetoric. For example, how likely are you to make a casual comment about someone’s weight loss, even if you phrase this as a compliment couched as a concern for health? Doing this might seem like the kind thing to do among friends or family members, but it actually perpetuates the idea that thinner bodies are more disciplined, healthier and more worthy of attention, and we know that this is untrue.

Reflecting on my own education and social interactions growing up, these pivotal times in my life were definitely steeped in diet culture. In my dietetics education, for instance, we were instructed to help people with obesity lose weight. I have since learned that this is not so simple nor is it a realistic or helpful health goal for many. Fat phobia and weight stigma can lead to stress, higher risks for chronic disease, and avoidance of healthcare. I often ask my students who are studying to become RDNs, PAs, and MDs, how useful they will feel as a practitioner if their patients avoid coming to their office because they fear being shamed due to their weight? For the many students who enter the field of nutrition to do their part in combating the obesity epidemic, just as I did, it’s a struggle for them to have a definitive answer to this question.

I am encouraged that the field is evolving to a place where weight-inclusive approaches to optimize health, including Intuitive Eating, are being explored. It is my hope that the message being taught to both students and the public shifts away from losing weight and toward developing eating and activity habits that are enjoyable and best support overall health for those who are able. In truth, I would like to see the phrase, “You are what you eat,” disappear. Embracing different body sizes and shapes and celebrating what they can do should be the priority, instead of judging them based on the societal virtue they don’t measure up to. Likewise, appreciating that anyone can choose to pursue health if they desire, regardless of the number on the scale or their body shape or size, would go a long way … as long as you consider their socioeconomic status, food insecurity, and any limitations to resources and activities.

What if you have a diagnosis of diabetes or IBS, as was mentioned in an earlier post – can Intuitive Eating still be applied to you? Eating intuitively in the context of these nutrition-related conditions is indeed possible, and might actually be preferable. My advice is to seek the guidance of a Certified Intuitive Eating RDN* and visit these posts regarding diabetes and IBS to learn more. Lastly, it’s important to eliminate any external messages that make you feel shame or guilt about how your body looks. Since unrealistic body ideals can exaggerate a negative body image, fill your newsfeed with body-positive images that encourage self-compassion and provide a space that is inclusive of the many ways we can approach health.

If you have read the 4th edition of Intuitive Eating, perused the website, and are still interested in learning more, I recommend checking out podcasts, books, blogs, and social media support groups created by RDNs and therapists, such as those listed below:

*If you would like to personally seek guidance from an RDN, suggested providers are listed on the Intuitive Eating website and also on Harrison’s website. If you are struggling with an eating disorder or are in the early stages of recovery, be sure to talk with your healthcare provider before embarking on Intuitive Eating. It’s possible that your hunger and fullness cues can be altered or absent.

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Emma Laing, PhD, RDN, LD is Clinical Associate Professor and Director of Dietetics at the University of Georgia. Her area of research encompasses imaging techniques for assessment of bone and body composition and employing dietary and physical activity interventions to reduce the risk of chronic disease, including osteoporosis. She is also interested in determining the efficacy of non-diet approaches to improve health and well-being. Her courses likewise challenge diet culture and incorporate the deleterious effects of weight stigma on health. https://www.fcs.uga.edu/people/bio/emma-laing

This post was originally published on In Defense of Processed Food (Link: https://processedfoodsite.com/2020/08/25/you-are-not-what-you-eat-exploring-intuitive-eatings-gentle-nutrition-principle-by-emma-liang/)


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