What's Wrong with Fat?

Photo Courtesy of Oxford University Press

I was fortunate enough today to attend a lecture with Abigail Saguy, PhD discussing her new book, "What's Wrong with Fat?"  It was a very interesting discussion and I'm excited to read the book to learn more about what she has to say about "fatness" and our society.

The major point of her discussion today was to help us question whether our society's emphasis on the "Obesity Epidemic" is really helping or are we stigmatizing those individuals who are overweight or obese.  By the way, Dr. Saguy used the word fat so I'll use that here instead of the former terms.

Her talk was very interesting and I'm not going list each point but the the highlight was learning about how we "frame" the obesity or fat issue has an effect on how we address it.  Most of my fellow employees in healthcare see fatness as a medical issue.  Something that can be cured or fixed with the right treatment.  Some of my fellow RDs see it as a public health issue where numbers are reaching epidemic proportions.  But lastly, there are some who would see fatness as a social justice issue, where fat is just a diversity issue and we must learn to accept people no matter what their size without bias or stereotypes.

She also discussed how no matter what perspective we use, there is research that would suggest that weight alone is not a good predictor of mortality.  One study she highlighted was Flegal KM, et al., 293[15]: 1861-7, 20 April 2005 in which the authors found this notion of an "obesity paradox" where people with BMIs between 26 and 29 (overweight) actually had a decreased risk of death compared to those in the normal weight category.

As we concluded she closed by questioning why our perception of fat changed over that last 100 years.  It used to be that being fat was a desirable trait but that is no longer the case.  But today, being fat is quite negative.  When you see someone who is fat, what do you think?  "They're lazy and weak. They're slobs and how could they do this to themselves?"  One interesting point that Dr. Saguy made was by explaining that a disproportionate number of minorities and lower income people are fat compared to other groups.  Fatness aside, these groups are also ones that are often discriminated against for other reasons so are we just adding another by making obesity such an issue?

As a dietitian, this topic is extremely important in the work that I do.  Many of my colleagues and other health-care providers will not agree with me, but I agree with Dr. Saguy and I feel that if we can take weight out of the equation we can focus on the behaviors that really matter.  Why should we force our clients to lose weight when 1) most will likely gain weight and 2) losing weight might not improve their health unless they change their behaviors?

As a individual, this topic hits home with me.  I am fat!  I have a belly but that does not limit me in my health.  I can run, I can play sports, I can bike and I am healthy.  I know that some of my clients and some of my fellow employees look at me and say to themselves, "Why is this guy teaching a class on losing weight! He should take some of his own advice."   Well to those folks I say this: my weight is just one part of me. From what I learned today and what I continue to learn, it does not mean I have five years less to live than you.

So what do you think, does Dr. Saguy make you change the way you think about how we frame the question of obesity/fatness?

CPK, Stop Marketing Soda to Kids

As a dietitian and a parent, I'm very sensitive to how foods are marketed to kids.  This week I took my daughter with me to meet some family friends for dinner at California Pizza Kitchen.  Of couse when we sat down, my kids got their own Kids Menu complete with pages to color, crosswords, and word searches.

I'm not going to go into their kids menu but let's just say it is pretty standard and could use some improvement but that's another post.

After my daughter was done coloring she wanted some help with the word search.  Since she's not even reading yet, I was doing most of the work and as I tried to help her find words, I noticed what one of the word search words was, "Pepsi!" See the picture below.

Well, needless to say I was a little upset about why on earth Pepsi would need to be included in the word search.  Maybe it's just what CPK thinks makes up a healthy kids meal.  Pizza, pasta, sundae, brownie and Pepsi.  Why that's just all the good stuff a growing body needs.  Sugar, fat and salt. Yum!

So I took to Twitter and posted the tweet below. 

Thanks @calpizzakitchen for marketing soda to my kids!"Pepsi" in the wordsearch on the kids menu? Really?! twitter.com/BVMRD/status/3…
— Aaron Flores, RD (@BVMRD) April 17, 2013

I didn't expect a response at all but the good news is that tonight, CPK sent me the following tweet:

@bvmrd @caseyhinds Thanks for voicing your concern. We're in the process of making new crossword puzzles & "Pepsi" has been removed. Thanks!
— CPK Restaurants (@calpizzakitchen) April 19, 2013

I'm always amazed by the power of social media.  I'm not naive enough to think that just because of my tweet that CPK is changing it's word search, but the point is, when you notice something that goes against what you believe in, make your voice heard.

How have you noticed junk foods marketed to kids?

Mission Accomplished!

Well, I can say that I am a marathoner!  I can't believe it but I completed my goal and finished the LA Marathon last month.

I've been waiting to write this post about my run because honestly, it has taken me a while to process what I've done.

Let's start with the basics.  My time was 6:32 minutes.  My goal was to be under 6 hours but that didn't happen.  I ended up waking the last 9 miles because I was feeling pretty nauseous.  Leave it to a dietitian to screw up race-day nutrition!  Regardless of my time, I never felt down, or upset or angry.  I finished and above all things, I kept moving forward. I even put a reminder on my hands to keep me focused on the goal, "Forward is a pace."

The day was filled with emotions.  I was scared and nervous as my wife drove me to the starting line. I could barely eat my pre-race meal because of my nerves.  When I got to the starting line I calmed down and I was so happy to have some friends from work there who I was going to run with.  My father also came to send me off as well.  We were supposed to run together but an injury during training sidelined him for the big day.

As the race started and I waited for my turn to cross the starting line, my first tears of the day began to form.  I was really going to do this.  With all the training and anticipation, I couldn't believe the moment was finally here and in that moment I realized why I was doing this.

Ready for the start.

I was challenging myself because even though I am a totally different person, there is still a part of me that thinks of myself the young man that weighed 300+ pounds that could not walk up a flight of stairs and who shied away from any exercise. That person does not exist anymore, but the memory of that former life is like I'm am still living it.  So crossing the start line I raised my hands up in joy because the courage was to start, and not in the finish.  I started this journey to prove to myself (again) that I am strong. That I am an athlete.  That I am a runner and that I can do anything I put my mind to.

Greeting my kids

During the race there were other moments of joy filled tears.  Tears came twice as I saw the video message that my wife and kids made as it played on the big screen at mile 8 and 21.  There were more tears as I met  my kids at mile 23.  It was a moment I will never forget and I honestly can't think which was more meaningful, the kiss and hugs I got from my kids or finally crossing the finish line. Of course there were even more tears as I finally crossed the finish line and was reunited with my wife!  What I didn't expect, though, were the tears that came in the days after as I began to reflect on what I had done.  Not one tear was from pain, sadness or anguish, but rather joy, pride and awe.

Hugging my wife at the finish line

I ran the marathon alone but I couldn't have done it without so much support from friends and family.  I have to, of course, thank my wife for being my biggest cheerleader and supporter.  Seeing my friends and family along the course was so great so thanks to everyone who came out to cheer me along.  Thanks also should be given to my father who helped me train.  Running with him early weekend mornings was an amazing experience!  I should also thank my un-official coach Juli for helping me plan training runs and listening to me while I worried about each new milestone.  And lastly, I have to thank my friend Dana who was my first running partner.  She was such a great help to me.  Every time I had a bad run or had any self-doubt, she helped me refocus and encouraged me to stay positive. The best thing she did was jumping in at mile 19 and walking the last part of that marathon with me.  Having her alongside me helped me move forward each step.  Thank you to you all!

Overall I have to say my marathon experience was nothing but positive.  Remember, up until just a couple of years ago, I've never been a runner.  So this milestone was huge for me.  If I can go from the couch to 26.2 miles in just a couple of years, so can you.  I'm already thinking of what my next race will be.  Maybe a half marathon, maybe a 10k or maybe another marathon.  Are you inspired by my story?  Want to join me?

I got my medal!

The mass of runners climbing Hill St.

All smiles at mile 24!

Dana greets me at mile 19

Ready for 26.2!?

My apologies for not updating this blog more frequently but life has been busy.

I've written about my fitness bucket list that I created to help motivate myself and others to be more active and so far its been working.  I am getting ready to cross the first thing off my list.  Watch out world, because I will be running the LA Marathon this Sunday, March 17th.

There are so many emotions as I get ready for this Sunday.  I'm excited because the long road of training is finally over.  I'm anxious about my performance.  I'm scared of not being able to finish.  I am proud of how far I have come to date.

My goal is to finish the marathon.  I won't lie, I wish I was faster but I'm not. I wish I could run without walk breaks but I can't.   I wish I could finish in under 5 hours but I won't.  But I have to keep telling myself that it is about progress not perfection.  Three years ago I would have never dreamed of doing a marathon and each long training run has been a new personal record for distance. I look forward to setting a new personal record this Sunday!

My running partner shared a great quote with me today that captures it all, "The miracle isn't that I finished. The miracle is that I had the courage to start." -John Bingham, spokesperson for the slow running movement.

What will you have the courage to start?

Happy Binge Eating Day

Binge (noun): a period of excessive indulgence in an activity, especially drinking alcohol or eating.

I am not really quite sure when Thanksgiving became more about the food than giving thanks but without a doubt in my mind, no other holiday is as focused on food as Thanksgiving.  Just tune into the Food Network or walk through the magazine aisle and see all the ads, programs and articles devoted to making a Thanksgiving feast. 

Talking to friends, clients and family I am struck by how many people really look forward to overeating.  It's almost like they embrace the fact that they can eat more than others.  They also say that without fail, they always feel like they ate too much.  They overeat and feel proud for doing it.  Because this is the one day of the year when you are allowed to sit down on the couch after the meal, unbuckle your belt, take a deep breath and sigh because you ate too much.

So I'm unofficially changing the name of Thanksgiving to Binge Eating Day.  Maybe if we acknowledge that this is really our behavior, we can take steps to change it.  

As I discussed holiday eating with my clients, one said something that really made sense.  They said, "My family and I really love Thanksgiving meals so what we do is we make turkey and stuffing a few times during the year.   That way get to enjoy that food more than once a year.  Then when Thanksgiving roles around, we don't go overboard because we know that we are going to have turkey again soon."  What a brilliant statement and a perfect example of Intuitive Eating.  They realized that they were so looking forward to turkey and stuffing that they would overeat because they thought they could have it only once year.  By having it more frequently, they didn't have to binge on Thanksgiving.  It's exactly what we all should be doing to help us make peace with food.  It is a foundation of Intuitive Eating

During this holiday, I hope that you can use some Intuitive Eating skills to try to prevent the yearly binge.  Maybe some of these tips might help you focus on your internal cues and be more mindful at this year's Thanksgiving.

1) Ask yourself how hungry you are before you start to eat.  Try rating your hunger on a 1-10 scale and check with yourself as you eat to see how it changes as you eat.
2) Avoid mindless snacking before the meal.  
3) Be concious of how alcohol can change your eating pattern.  Often times, people tend to eat more after having a couple of drinks so be aware how that might affect you.
4) Eat with gratitude.  Reflect on how the food you are eating got to your table.  Think about how long it took to cook the meal.  Think about the workers whose job it is to grow the food you are eating.
5) If you love it savor every bite!  Don't shovel it in your mouth but instead eat slowly and really experience each mouthful of food.

I hope you all have a great holiday and give thanks for all the positive things in your life.

I'm Not Playing the Box Top Game

Photo Courtesy of Simply Organized Blog

I'm sorry, I don't like Box Tops!  There, I said it and there's no going back now.

For those of you who might not have kids or who don't work in education, Box Tops are a program where you buy certain products which have the logo on the right, clip the top of the box, deliver them to your child's school and the school then receives money from the Box Top for Education organization.  From the Box Top for Education website, "Box Tops has helped America's schools earn over $475 million since 1996."  With school funding always an issue, especially here in California, it's great that there is a way for schools to have access to extra funds to provide quality education.

So if it's such a great way to help fund my local school, why should I hate Box Tops?  The answer is simple.  MOST (not all) of the products with the Box Tops logo are (how can I say this nicely) nutritionally challenged.

You can see the whole list of participating products here.  If you look at the list you quickly notice that there are some big name brands that participate.  Betty Crocker, Bisquick, Cheerios, Chex, Pillsbury, Kix, Fiber One and Yoplait to name just a few.  If you dig a little, you'll find that all of these products are owned by (drum roll please), General Mills. Interesting, right?  Can you guess which company started the Box Tops For Education program?  That's right: General Mills.  According to their site, Box Tops for Education was launched in 1996 in California on cereals like Cheerios, Total and Lucky Charms. 

What's wrong with General Mills being brilliantly smart by creating a program to boost sales and also help fund struggling schools?  Absolutely nothing except that their slogan which they proudly display is :

Photo Courtesy of Box Top for Education

How can you "nourish young lives" when the majority of the food you are feeding them is full of added sugars, artificial colorings and trans fat?  We hear a lot about how marketing to kids affects intake, but this program is genius because the schools do all the marketing to the kids and partents.  Kids come home excited to find Box Tops and compete to bring in the most in their class.  Parents feel good because they are helping their child's school and General Mills laughs all the way to the bank.  But General Mills simply can not "nourish young lives" when the food they are supplying is hindering our children.

There is some good news. 1) There are some healthier products that have Box Tops like Cascadian Farms cereals, Green Giant produce and frozen vegetables and Larabar Multipacks.  2) Box Tops are available for a variety of non-food items like Avery labels, Ziploc bags and Brita waterfilters.

Where does that leave me as a parent whose children are now Box Top crazy?  If it comes down to just money, I'll be happy to donate a few extra bucks to help fund my children's education.  Let's say hypothetically, my kids bring 10 box tops a week.  That's $0.10 per top for a total of $1.00.  If you subtract about 12 weeks for summer and vacations, that's about 40 weeks.  At $1.00 per week for 40 weeks is a grand total contribution of $40.  I can handle that!

As always I welcome your comments.

Let's Have a Healthy Halloween

Originally written for and posted on Grandparenting Plus Blog.  In the interest of full disclosure the authors of this blog are my mother and grandmother.   (Yeah they blog too...who doesn't these days?)

No other holiday tests our parenting skills more than the issue of how we handle candy on Halloween.  But as with many of our current holiday traditions, Halloween and candy haven't always been linked together like they are now.  Halloween was originally a Celtic harvest holiday and was brought to the United States with the 19th Century Irish immigrants.  As the holiday evolved, kids began to trick-or-treat and until the 1950's trick-or-treat'ers were more likely to get non-food related booty, like coins, pencils and other trinkets rather than candy.  It was not until candy manufacturers started to market candy as a way to boost revenues that sweets became synonymous with Halloween.   To illustrate just how much emphasis candy companies put on Halloween I took my 5 year old son along to check out two very different stores: Whole Foods Market and Rite-Aid Drug Store.  It's pretty shocking to see the stark difference between them.

The Halloween candy section at  Whole Foods in Tarzana, CA

The Halloween aisles at Rite-Aid in West Hills, CA

When we think of all the candy that kids might get for Halloween, the first thing we think about is all the sugar that our kids are going to eat.  Unfortunately, the sugar is the least of our worries.  Sadly, it's the artificial food colorings and trans-fat that is pervasive in many of these foods that we should be concerned with.  The Center for Science in the Public Interest (CSPI) published a great report on the risks of artificial colorings in 2010 called, "A Rainbow of Risks".  You should definitely read it and you might reconsider buying M&M's.

Despite all the horrible things in candy, for me as a parent and as a dietitian the biggest issue during Halloween is how I approach and handle my kids' candy intake.  If you follow my blog (www.BVMRD.com) you know that I believe in a non-diet approach to eating.  I am a believer in Intuitive Eating and I apply these principles to my clients and also to my family.  The other philosophy that fits nicely with Intuitive Eating are some of the theories on feeding children from Ellyn Satter.  When I decided to talk about eating and Halloween, Satter was the resource that I knew I had to include and thankfully she addressed the topic both in her book and in her website:

Halloween candy presents a learning opportunity. Work toward having your child be able to manage his own stash. For him to learn, you will have to keep your interference to a minimum. When he comes home from trick or treating, let him lay out his booty, gloat over it, sort it and eat as much of it as he wants. Let him do the same the next day. Then have him put it away and relegate it to meal- and snack-time: a couple of small pieces at meals for dessert and as much as he wants for snack time. (From EllynSatter.com The Sticky Topic of Halloween Candy, Family Meals Focus #30 on 10/22/08)  

I know you are reading this and saying, "Are you serious?", or maybe, "Oh hell no, I am not going to let my child dive head first into a full bucket of a candy."  But hear me (and Satter for that matter) out.  By allowing your child to have the freedom to learn to manage their own candy instead of you controlling it will allow him or her to develop a sense of trust around food.  If your child breaks this trust, you can take the candy away until they demonstrate that they can handle it.  The goal is to let your child build confidence and self-reliance around listening to their internal cues of hunger and fullness.  If this method still seems too extreme for you, try to modify it, but the key is for you not to interfere with what they choose or how much of it they eat.  The hope is that the relationship your child develops with food and sweets is based on their own internal cues and not on restriction.

One important thing to remember is that the best way we teach our children is though modeling our behaviors. If we call food "junk," "bad" or "garbage," our kids will pick up on that.  Conversely, if our children see us having a healthy relationship with candy, the chances are that they will develop the same attitude.  Be aware of how you handle candy because that will affect you child's behaviors.  These are just some of the concepts that are discussed at length in the new edition of Intuitive Eating in which the authors devote a whole chapter on raising Intuitive Eaters.  I highly recommend you read it.

Don't think of Halloween as a power struggle between you and your children.  If they are old enough explain to them what your plan is.  If they are too young to understand, try explaining your rules for Halloween so they know what to expect.

Halloween is just one day but feeding a child and raising an Intuitive Eater is the foundation for healthy eating for a lifetime. Here are some simple things you can do:

1) Don’t restrict dessert. Make it a part of regular meals and try serving it with all the other

things during dinner time.

2) Try to refer to food in non-judgmental terms. Take out the “good” vs. “bad” so that kids don’t

feel guilty for eating “junk.”  Try using terms like "play food" vs. "growing food."

3) Divide responsibility. It’s your job as a parent to provide balanced, nutritious meals with a

variety of play foods. It’s your child’s job to eat.

4) Don’t be a short-order cook.

5) Trust in your child’s innate abilities. Children know how much food they need so allow them the freedom to choose how much to eat. Overall, they will choose foods that help them grow and most of all they’ll develop a healthy relationship with food.

As always, I look forward to reading your comments.