Mindful Eating: Minding our hunger and fullness

We eat for a lot of reasons, and the most primal of them is hunger. Hunger is the physiological need to eat. When we're hungry, the question is "What is there to eat?"  Basically, almost anything looks good because when we're hungry we experience intense physiological responses, like a growling stomach, stomach pangs, or a headache, that motivate us to find food -- FAST if we're really hungry!  This is why we don't always make the best food decisions when we're ravenously hungry.

Based on my experience, I believe that people view hunger in several ways. Some consider it the enemy.  Others think of it as a nuisance. A few see it as their strongest ally in successful health management. I consider it a guide, and I'll explain how it can serve this purpose later. 

On one hand, some people fear hunger because they aren't sure how to handle it.  That is, they don't trust themselves to be able to handle it or to manage the thoughts and feelings experienced after so-called "handling it" (i.e., eating).  So, they might ignore the hunger hoping that it will go away and they will not have to deal with it.  Sometimes they try to fill up with diet soda or rice cakes. While there is an illusion that this fixes the problem, in reality it doesn't.  The body is exhibiting signs of hunger because it IS hungry!  It needs energy and nourishment from food, and trickery with non-caloric beverages and filler foods just won't cut it.  Our bodies are very intelligent, complex machines, and we must not underestimate them.

Additionally, some people view hunger as an inconvenience. It gets in the way of our being able to work or to get things done.  Some people tune out hunger for long enough that the hunger eventually subsides and the body's natural emergency response system that says, "Feed me. Feed me." becomes subdued.  At some point, this process is challenging for many to sustain as the body keeps score and a ferocious hunger often follows.

Finally, some people embrace hunger. It's seen as a badge of courage or medal of honor for a great accomplishment.  Some seem to believe that if you're on a diet and you're hungry, then you're succeeding. Others rally around them saying things like, "You can do it!"  "Great job!" "I wish I could do that!" However, research and experience tell me that hunger is not the best indicator of a successful weight management strategy.  In fact, an historical study conducted by Ancel Keys during World War II uncovered some of the negative effects of semi-starvation on 36 volunteers.  The results weren't pretty.  Subjects experienced fatigue, emotional disturbances, depression, apathy, preoccupation with food, and impairments in concentration, alertness, judgment, and comprehension.  Many people who've been on a restrictive diet can probably relate.

With all this talk about hunger, you might think I'm suggesting that we are a nation of starving people.  But something else is going on in our country:  67% of American adults, 18% of adolescents, 15% of children ages 6-11, and 11% of children ages 2-5 are overweight.  What gives? One thing I haven't mentioned yet is the ugly truth about hunger. That ugly truth is...if most of us eat when we're not hungry, we are overeating.  Given the stats above, notice that the older the population, the greater the proportion of overweight individuals. There are a multitude of possible explanations, but I will discuss one.  We've been trained to overeat.  Having spent enough time around children, I've seen how in tune they are with their natural hunger and satiety cues. On the other hand, many adults have been taught to override their sense of hunger or fullness.  Instead, they rely on family members, friends, diet books, or magazines to tell them when and how much to eat.  But honestly, who knows when and how much to eat better than you?  YOU are the owner's manual!

So, how do we mindfully manage our hunger and fullness?  The key is to check in with your body before and throughout the meal.  Here are some strategies to guide you.

• Listen for it.  In order to mind our hunger and fullness, we need to learn how to recognize each. Here are some of the typical signs of hunger: growling or rumbling stomach, mild stomach pangs, lightheadedness, fatigue, dizziness, nausea, headache, inability to concentrate, or crankiness.  Fullness can start with a comfortable feeling in the stomach, calmness, and increased energy levels. Extreme fullness can lead to the stomach  feeling stretched or uncomfortable, nausea, or sluggishness.
• Rate it.  Use a hunger and/or fullness scale. There are several different versions available, but they typically provide range of numbers by which you can assess your level of hunger or fullness (i.e., 0-10 with 0 being ravenously hungry and 10 being absolutely stuffed).  I personally like the ones discussed in the book Intuitive Eating: A Revolutionary Program That Works by Evelyn Tribole and Elyse Resch.
• Put down the fork.  Setting your utensil down between bites provides the perfect pause for reflection.  Consider two questions:  1) Is this food pleasing to me?  If it is, proceed.  If not, then you may choose to stop eating.  2) Am I still hungry? You may want to use the hunger/fullness scale to answer this question and determine your next step.
  
• Close your eyes. My mom once told me, "My eyes are bigger than my stomach."  Isn't this true sometimes?  Or maybe you've heard the joke, "I'm on the see food diet.  I see food and I eat it." (wink, wink)  Our sense of sight can definitely impact our eating as I've discussed before, so taking a visual break from our food can certainly enhance our mindfulness allowing us to make more informed decisions throughout the experience.  Again, ask yourself:  Is this food pleasing to me?  Am I still hungry?
• Hara hachi bu.  That is, eat until 80% full. This is one of many lifestyle practices that the Okinawans of Japan follow, and they have some of the longest averge lifespans on the planet.
  

Is it "bad" to eat beyond hunger? Not necessarily because sometimes eating for reasons other than hunger can bring pleasure. At the same time, the choice to eat regardless of hunger for most meals on most days could lead one to a place of displeasure and may contribute to ill health.  The good news is that it is our choice, and minding our hunger and fullness can guide us through such choices.  Making mindful choices may not be easy to start, but that's because many of us have been conditioned otherwise.  So, which of these strategies will you try this week?

Mindful Eating: How to get started

When some people hear mindful eating, they might cringe thinking, "Oh no, does this involve having to do a yoga pose or saying 'Ohmmmm' every time I eat?"  While it can, it doesn't have to!  As Jim Elliot said, "Wherever you are, be all there."  Notice the all..not kind of there, not sort of there, not halfway there.   "...be all there."  While there are no rules and regulations around it, the immediate goal is to create space between us and the noise so that we can enter the eating experience with a clear state of mind that allows us to be fully present in mind and body.  Listed below are several ways to bring you to the eating moment before you even start eating. While it's not a comprehensive, all-inclusive list, it's a start. In future posts, I will discuss ways to check in with your mind and body throughout a meal, too.

• Sit down.  Several years ago, I read a book entitled,  When You Eat at the Refrigerator, Pull Up a Chair: 50 Ways to Feel Thin, Gorgeous, and Happy.  The title and the story behind it provide an interesting idea. What would happen if we plopped ourselves down on a chair the next time we found ourselves face in the fridge or pantry looking for that...something?  I believe that act would bring greater awareness to the moment and give us just enough pause to reflect on our choices. So, if there is a time that you have a habit of not sitting down to eat for a meal or snack, give it a try.
• Silence!  Get rid of the noise. Turn off the t.v., iPod, or computer.  Stop working or reading the book.  Switch off all the chatter and regain focus over your meals.
• Location, location, location.  Designate a specific room or place where you plan to eat.  The dining room, kitchen table, or breakfast nook work great at home.  At work?  Leave your desk and head to the employee lounge or cafeteria.Do this, and you'll move yourself away from the noise.
  
• Bring curiosity to the table.  My two-year old loves to ask lots of questions about the food we eat before she digs in. Her inquisitiveness shows me that she's exploring her food, and I love that! We can learn from it!  Taking a curious perspective helps to direct our attention to the present moment.  Ask yourself questions that focus on what you're aware of or what you can experience with the food on this occasion:  Check in with your body.  Am I hungry?  How hungry am I?  Will this satisfy me right now?  Use your senses to explore the sight, smell, or feel of food. 
• Relax.  Just a few minutes of relaxation before a meal can create distance with all that mental clutter that we often bring to the table.  There are a variety of ways to do this.  Practice a few yoga poses (yep, I went there;)  In fact, some dietitians and therapists I know recommend this, especially for clients with eating disorders or gastrointestinal issues like IBS. Try prayer, thanksgiving, deep breathing exercises, or mental imagery to quiet the mind. My personal favorite is progressive relaxation.  I actually use this with my students prior to at least one exam.  Meditate. Rick Warren says that if you know how to worry, you know how to meditate. 

Are you ready to give mindful eating a shot?  Start with one mindful eating strategy before one meal or snack this week, and discover the moment!

Mindful Eating: The benefits

Over the last few days I've been sifting through old digital photos in an effort to properly organize and store them for safekeeping. As I browse through these photos, I am instantly brought back to those captured moments. I catch myself smiling, laughing, or even tearing up depending on the pic.  Sometimes the memories are so vivid that I can almost hear, taste,or even smell certain things. That is what I love about photography...capturing a moment in time...one that will never be again.

So, why am I talking about old photographs when this post is about mindful eating?  Well, I believe that mindful eating involves capturing a moment in a way similar to photography.  With mindful eating, we completely plug into the moment physically and mentally while leaving the judgments, criticisms, and worries behind, and we simply enjoy it for what it is...not what we think it could or should be.

In my last post, I presented four of my ideas of what mindful eating entails, and one of them was: "We direct our full attention to the immediate eating experience."  Many of us are so distracted by noise while we're eating.  Physical noise, such as the t.v., computer, or music, may be drowning out the experience.  Sometimes our mealtimes are inundated with psychological noise, such as "to-do lists", emotions, or an "inner critic" judging our eating. Regardless of the type of noise, if you are one whose meals are occupied by chatter, then you may not be getting the most out of your eating experiences.

And this brings me to how eating mindfully will benefit you, me, US!  Yes, food fulfills our basic physiological need for nourishment. You know, energy and vitamins and minerals, oh my! But I believe that food and eating serves a deeper purpose. Why else do so many foods look, smell, and taste so darn good?  Why do certain components of food trigger the release "feel good" chemicals in the body?  Why do {some} of us enjoy preparing it?  Why does it bring us together for so many celebrations? It's part of the fabric that supports our physiological, psychological, social, and cultural well-being.  Unfortunately, I don't think many of us think of eating in this way. Instead, some of us see it as the "enemy", a chore, too complex or confusing, something that must be done, or something that we dread or fear.

Mindful eating brings us to a more peaceful place with food. Wouldn't it be great if there were no difference between eating a piece of chocolate vs. eating an apple?  We aren't good if we eat the apple and bad if we eat the chocolate.  Mindful eating brings balance to our eating. It doesn't have to be the UFC (Ultimate Food Championship;) -- you know, US vs. FOOD.  On the contrary, mindful eating allows us the awareness to make thoughtful decisions about what or how much we're eating. No longer do we need to discontinue eating because the diet, calorie content, or something else told us to but rather we can stop because the experience is no longer pleasant.  Mindful eating allows us the pause needed to become more aware of hidden desires and cravings that we have for food, and in turn, this enlightenment may dissolve or help manage the cravings.  Above all, mindful eating helps us treat ourselves with more kindness!  We must eat to live, yes, but let's take it beyond that. Let's restore some of the pleasure that can be experienced through food and eating...without guilt, shame, judgment, or even indifference.

Stay tuned for my next post on getting started.

Mindful Eating: An Introduction

"Wherever you are, be all there." ~Jim Elliot~

Several years ago, two of my colleagues attended a conference on mindful eating.  Upon their return, they told me about an exercise they did while there.  They had to eat a raisin over the course of 7 minutes.  7 whole minutes!  During that time, they had to write down everything they noticed about the raisin...taste, texture, color, mouth feel, etc.  After doing this exercise, they revealed how eye-opening it was.  They both admitted that they'd never really noticed their food in this much detail.  I'm sure most of us don't.  Do we?  I was curious, so I tried this exercise at home.  I observed things about a raisin that I'd never recognized in the past.  It made the experience of eating the raisin more interesting and gratifying.  It may sound crazy, I know, but try it!

This exercise made me reflect on the variety of ways that many of us are out of touch with our eating experiences.  Although taste has been identified as the most influential determinant of our food choices, one survey suggests that fewer Americans report having as much pleasure associated with eating food.  Yes, pleasure goes beyond taste alone, but this surprises me given that about 2/3 of American adults are overweight or obese.  Sometimes we're just going through the motions because the clock says it's time to eat or because we're distracted by something else while we're eating whether it be the television or a thought. Occasionally, we let external factors influence our eating:  a diet, package or plate size, a friend, colleague, or parent.  More of us are distancing ourselves from the eating experience by relying on someone else to prepare our food for us.  In fact, the average American eats out for about 4 meals/week and spends 42% of the food budget on dining out.  That is up from about 3% in the early 1900's!  As a lover of cooking, I personally find that when I prepare my own food at home that I am more satisfied with the eating experience.  Some of us think of eating as a chore. Many of my clients and students skip meals or rush through a meal because they're "too busy" or "it's too much work".  These behaviors can definitely rob one of the satisfaction that can be gained through eating.

As a registered dietitian, one of my primary goals is to help people develop a more healthful and enjoyable relationship with food and eating.  So I'm going to spend the next few blog posts on the topic of mindful eating.  While a quick Google search will uncover many definitions for mindful eating, I will tell you what I think it involves.

• We direct our full attention to the immediate eating experience.  
• We connect our bodies and minds to facilitate more guided choices in eating.  
• We explore various aspects of food from production and preparation to flavor and aroma.  
• We savor the pleasure and nourishment eating offers without judgment.    

So, are you ready to take your eating experience to the next level?  If so, stay tuned as I delve into the topic mindful eating and discuss strategies that will enhance your eating experience!

Mindless Eating Pitfall #5: Distractions, Distractions

Mindless Eating Pitfall #5
Many of us manage very tight schedules at home, school, and work, and when the holidays roll around, we take our already jam-packed scheduled and times it by...oh, 100! And I think we're all guilty of this mindless eating pitfall...eating while distracted.  We're eating while driving, working, watching t.v., reading, watching a movie, cooking, cleaning up after dinner, playing video games, or watching a sporting event.  I know someone reading this right now is probably eating!  Distracted eating can be one of the most destructive types of mindless eating.  Why?  We have so many opportunities to do it, and what and how much we consume during these episodes can wreak havoc on our diet...and our waistlines.

There are three primary reasons distracted eating causes us to consume more food.  First of all, when our attention is diverted away from the act of eating, we are not as focused on how we feel as we're eating.  In these situations, it's very easy to override our natural satiety cues and become stuffed before we know it.  We also feel dissatisfied because we didn't really pay attention to what we ate, and therefore, we didn't get to enjoy it.  In some cases, we will eat things that don't even taste good.  A few years ago, Brian Wansink and his team gave movie attendees free medium or large-sized buckets of fresh or 14-day old stale popcorn.  Even those offered large buckets of stale popcorn ate 33.6% more than those given medium buckets of stale popcorn. Stale popcorn!  When we aren't focused on eating, we also might eat longer than we normally would.  If we're watching t.v., a movie, or a game, we might continue eating until the entertainment is over rather than when we feel physically satisfied.  Last but not least, it's a habit.  Is every person who eats popcorn at the movies actually hungry or have they simply developed a habit of eating popcorn at the movies?

These may seem like minor infractions, but even 100 additional calories per day from distracted eating can lead to a little over 10 pounds of weight gain in one year! On a more positive note, the simple nixing of that 100 calories of mindless eating can lead to 10 pounds of weight loss in one year.   

Strategies to Manage

• Detach.  Distract yourself with t.v., video games, the newspaper, etc. before getting something to eat. This way you're not eating when you start. Mindless eating averted.   
  
• Pre-portion your portion.  Serve yourself a smaller amount of food (minus refills) before engaging in another activity to reduce the impact of mindless eating.
• Location, location, location!  Only eat while seated in a certain room or place.  At home? Have a seat at a distraction-free dining table.  At work? Head to the employees' lounge or cafeteria to eat. 
  
• Switch it, change it, rearrange it.  Substitute a new habit for your old one (eating).  Instead of eating while watching television, do some...knitting?  Okay maybe not, but how about some stretching or crunches? Shake up your routine. Are you used to grabbing a coffee and muffin on the way to work in the morning? Take a new route to work. Before dishing yourself ice cream before your fave t.v. show comes on, munch on an apple or sip on a cup of hot tea instead? Consume food with your less dominant hand. When you do this, you actually need to focus more on what you're doing since you're not used to it, and you'll be able to monitor your intake better.

For more on mindless eating, check out, Mindless Eating: Why We Eat More Than We Think.

Mindless Eating Pitfall #4: Portion Distortion

My first job many years ago was at McDonald's where I worked for three (long) months during high school.  I happened to be there when super sizing was first introduced.  Yep, at one time I was personally responsible for asking people, "Would you like to super size that?".  At the time, I had no idea of the implications that super sizing would have in our country.  But I am not here to pick on McDonald's because expanding portions have hijacked our food supply in many other ways, too.  In fact, one study found that portion sizes for 181 commonly consumed food items ranging from beer and soda to steak, cookies, and muffins have ballooned significantly over the last 40 years.  Even "diet" foods, such as Weight Watchers and Lean Cuisine frozen entrees, have expanded in size.  An analysis comparing original and updated recipes from the popular cookbook, "The Joy of Cooking", found that newer recipes now yield larger portions.  It doesn't stop here. The sizes of standard dinner plates, bowls, and beverage and wine glasses have increased significantly, too. For example, the dinner plates I received as a wedding gift just a few years ago measure 11.5" in diameter.  A standard sized dinner plate used to be about 7-9" in diameter 40-50 years ago, so that means my plates are about 33% bigger!  This is where mindless eating comes into play.  Short-term studies show that when people are served food in increasing portions, in larger packages, or on more sizable dinnerware, they tend to eat more.  Researchers providing study participants with 6", 8", 10", or 12" deli sandwiches on different days found that the larger the sandwich, the more they consumed.

Why do we do this? Good question!  There are a few  possibilities.  One is that as we have been increasingly exposed to greater portion sizes, we have become accustomed to those sizes. We rely on those measures to determine how much we should eat rather than measuring and weighing for accuracy.  What seems extreme now has the tendency to become the new norm.  An example? Big Macs...remember when that was considered HUGE?  20 ounce bottles of soda? Once unthinkable, but now it's normal because many other larger sandwiches have been introduced. Thank you, Carl's Jr.  Another reason portion distortion could pose a problem is because we aren't very good at determining how many calories are in that portion, especially with larger portions.  Finally, we have the tendency to rely on perceptual cues to determine how much food to serve ourselves (size of plate, bowl, glass).  For example, serving smaller portions of food on a 12" plate may be perceived as an inadequate portion whereas if we serve the same portion of food on a 10" plate, we will believe the portion is more adequate.  It's an optical illusion.  The same goes for glasses. We have the tendency to pour more in a shorter, wider glass than a taller, skinnier one.  See examples here.

Strategies to Manage

• Downsize. Purchase smaller or single-serving packages of food.  Portion out larger packages of food into smaller ones (think snack baggies) or onto plates or bowls.
  
• Honey, I shrunk the plates!  Use smaller plates, bowls, utensils, and serving dishes.  By serving your food with smaller dinnerware, you're likely to eat less.  Check out The Small Plate Movement, a challenge to participants to use 10" plates for the largest meal of the day for at least one month.   
• Divvy it up.  Order two appetizers instead of one large entree. Consume half of your regular order and take the other home.  Share your dish with a mealtime companion.
  
• Load up.  If you do end up using larger plates, fill half of the plate with vegetables and/or fruit.  This way you'll satisfy yourself with a lot fewer calories and a lot more nutrition.
  
• Be an early bird. Prepare your plate in advance of the meal with smaller dinner portions. 
• Deep and High.  Replace shorter, wider glasses with taller, skinnier ones for caloric beverages like juice and alcohol.  

A Black Friday Healthy Holiday Gift Wish List

One of the most anticipated days of the year is embarking upon us...Black Friday!  I know that some people anxiously await this day. I'm not one of them.  In anticipation of this day, and of the shopping season ahead, I thought I'd post a blog with healthy holiday gift wish list ideas.  I like to get some fresh gift ideas just before the holidays, and I thought I'd share some of what I found here. These are a few of the items that I already have, have tried, or would like to have.  So in case you need some ideas for items that promote health for your holiday wish list or someone else's, these are a few of my favorite things...

Mindless Eating Pitfall #3: More is not necessarily merrier

Mindless Eating Pitfall #3 

• The more the merrier but maybe not when it comes to our food.  During the holidays, we spend a lot of time fraternizing with family, friends and colleagues...usually around food.  While the fellowship is great, the mealtime socialization can wreak havoc on our eating behaviors. When we eat with others, especially familiar people like family and friends, our dining experience can be more pleasurable and comfortable resulting in our spending more time eating. Also, what or how much they eat can influence what and how much we eat. This can work for us or against us depending on with whom we are dining.  Have you ever eaten around someone who made you think twice about what you eat?  A first date or a fit friend perhaps?  Maybe you're around what I call a "food pusher" or a "food caretaker", like a well-meaning mom or grandma?  Previous research suggests that as the number of mealtime companions we have increases so does the amount of food that we eat.  Meanwhile, another study found that when a group of people share a meal together, there tends to be less variance in the amount of food consumed compared to individuals eating alone. Heard of "groupthink"? Well, I'll call this "group eat", and if your comrades tend to eat more, then that could impact your eating as well.

Strategies to Manage

• Plan ahead.  Develop a game plan of what and how much you plan to eat in advance of the actual event. Making your food choices and committing to them before the meal rather than during the meal will reduce the influence that others may have on your consumption behaviors. If you know that Mom will want you to savor her special dishes, begin with small servings of her best dishes rather than big portions. Why?  People don't necessarily remember how much food we ate.  If you go back for more, she'll remember that, and you'll likely eat less.
  
• Be a leader. Serve yourself or order your meal first.  I know, rude, right?  At the same time, by taking the lead, you are less likely to be influenced by what or how much everyone else eats.  And you may actually have a positive impact on what those who dish or order after you consume. 
  
• Be a follower.  Take your eating cues from someone who appears to be consuming smaller amounts of food or who is eating at a more leisurely pace.
  
• Take a break...from the food. Arrive late and leave early and you'll be spending a lot less time around the food.  Offer to help put the food away after dinner. Help guests move to another room for socializing.  Take a walk together or do some exergaming after the meal to take the focus off the food.
• Do something different.  Most of the big holiday events we attend revolve around food, so it might be hard to avoid them. But what about those other get-togethers?  The shopping trip with the family? Gift exchange with the girls? Lunch with the colleagues?  Having a meal for all of these other outings can really add up.  Consider suggesting non-food-related activities, if possible. Meet up at non-meal times.  Go out for coffee instead of breakfast or lunch. 
  
• Focus on the family.  I've learned that love is spelled T-I-M-E not F-O-O-D.  The season presents many wonderful opportunities to celebrate and appreciate what matters most in life, and believe it or not, it's not about the food.  If you look back, what do you remember most about the holidays? Is it Auntie Esther's pumpkin pie? Mom's special stuffing?  That sweet gift you got from...who was it?  Or do you revel in the quality time that you spent with your family and friends above all -- playing games, sharing stories, reminiscing, connecting?

Mindless Eating Pitfall #2: The greater the variety, the greater the volume

Mindless Eating Pitfall #2

• The greater the variety, the greater the volume.  I've said it before, and I will say it again: the greater the variety of food that we are exposed to, the more we are likely to eat.  Participants in one study were offered sandwiches with either a single filling or a variety of four different fillings, and researchers found that when offered the sandwiches with more fillings, participants ate 14% (or ~282 kcals) more. Why does this occur? It's still unclear; however, something called sensory-specific satiety (SSS) has been suggested. Essentially, our taste buds don't get burned out as easily when we consume a wide range of flavors (i.e., salty, sweet, savory, etc.), and possibly even textures and colors, within a meal . We end up feeling less full after consuming a variety of foods and eat more as a result.  Just think about the variety of food that we're exposed to at meals and parties during the holidays.  The kickers are those {special} foods, like stuffing or pumpkin pie, that are specific to the holidays.  You know, the ones that we think we'll never get again...or at least not until next year this time, so we must indulge now.

Strategies to Manage

• Survey the scene.  Scan the food selection before serving yourself so that you can see what's available.  Keep the variety and your appetite at bay by zeroing in on 2-3 of your holiday favorites at any given time.  Yes, you may want to go back for seconds, but this strategy will give you just enough pause to think twice about it.
  
• Be wise, organize.  Even perceived variety can fire up our appetite, so shy away from offering more than one dish of the same food.  For example, serve the stuffing in one large bowl rather than two to three smaller ones.  Increased structure may also curb consumption, so position foods on the table in an orderly (think rows) rather than scattered pattern.
• Diversify with veggies and fruits. Let the variety factor work for you rather than against you.  Increase the variety of vegetables and fruits you eat by aiming for at least 5 cups a day.  You may want to read my previous blog post for more tips on this topic. 
  

Mindless Eating Pitfall #1: If it's there, you'll eat it!

Mindless Eating Pitfall #1:

• If it's there, you'll eat it.  And you know that during this time of year, the food will be there...and then some!  When foods are located in convenient locations, people tend to eat more.  Think about how easily accessible food can be during the holidays.  It's going to be at home, work, school, church, and our family's and friend's places.  Food will be everywhere.  In fact, some research suggests that the simple sight or smell of food can provoke our consumption of that food, whether an individual is actually hungry or not. One trial examined the affect of access on consumption by placing opaque or clear containers filled with 30 Hershey's kisses on office workers' desks or on a shelf 6 feet away from their desks.  Investigators found that the workers consumed a daily average of 3 kisses when placed in a clear bowls on their desk and an average of almost 8 kisses when placed in an opaque container 6 feet away from their desk, which equates to about 125 more calories at ~25 calories a pop.  I'm sure your mind could drum up at least one occasion in which you recall eating a food simply because it was there, right?

Strategies to Manage

• Out of sight, out of mind.  Keep tempting foods out of sight or in an inconvenient location (i.e., covered with a cloth or foil, top/back of the pantry, back of the fridge or freezer, in the trunk of the car).  I've even had clients who not only threw away such foods, but they also doused them in salt to drastically reduce the food's appeal. Better yet, consider not buying or making tempting foods. 
• Keep your distance.  One of my colleagues has a saying, "Stay away from the buffet!"  One study actually suggested that heavier restaurant patrons sit facing the buffet vs with their side or back to the buffet.  Leave serving bowls and platters off the dining table, and you might think twice about that second helping.   
• Occupy yourself.  When mingling at a party, carry something in each hand (i.e., a glass of water and napkin).  Without a free hand, you are less likely to mindlessly nibble.  Or hold something in your dominant hand. For example, if you're a righty, hold a drink in your right hand. This way you're less inclined to reach for something because it'll feel unnatural or uneasy to eat with your less dominant hand.  When cooking or baking, keeping your mouth busy with chewing gum or a hard candy.
  
• Fill 'er up.  Remember, if it's there, you'll eat it.  If you leave fresh vegetables and fruits on the kitchen counter, dining table, pre-prepped in the front of the fridge, or in other plain sight locations, you'll be more likely to eat them.  Aim for at least 5 cups of vegetables and fruits daily!
• Stay ahead of your hunger.  Saving up calories for the special event leads to an incredibly ferocious appetite, and this will not help you stay on track with your weight and health management goals.  Before heading off to an event, satisfy your hunger with a pre-event meal or snack.  Consider a source of fiber, a quality source of protein, and/or a quality source of carbohydrate.  Examples, you say?  Fresh vegetables or fruit alone or with low-fat cheese or nut butter, low-fat milk or string cheese, low-fat yogurt with fruit or whole grain cereal, whole grain pita bread with hummus.  Filling up on these options leaves a lot less room for other calorically dense, and sometimes less nutritious, holiday staples.
• Limit or avoid the alcohol.  Do I really need to explain it? I will add that it can also lead to lower blood sugar levels, which can stimulate hunger.
  

Mindless eating during the holidays

The tsunami of food is about to be upon us.  You know, that huge wave, after wave, after wave of food that occurs from Thanksgiving to New Year's. And while this time of year brings us memories and experiences of great joy, it also unleashes a great tsunami of work, and parties, and visitors, and to-do's, and stress!  With this onslaught of busyness, it is no surprise that American adults may gain about 1 pound during the period just before Thanksgiving through several weeks after New Year's (aka, the Super Bowl).  It doesn't sound too bad, but it is 1 pound that the average person also does not lose year after year.  And this is part of what I call the "weight creep". Weight creep is what happens when a person gains a small amount of weight over a long amount of time and then one day wonders, "How did this happen?"  While this isn't an ideal time to attempt weight loss, given the previously mentioned stats, it is an excellent time to practice maintaining our weight and managing our health.

During this time of year it's very easy to engage in a lot of mindless eating behaviors that undermine our goals to achieve and maintain optimal health and well-being.  Mindless eating occurs when we consume something without much thought, and this type of eating causes us to eat certain types or amounts of foods that we wouldn't normally consume had we paid closer attention.  Think about it. Have you ever eaten something and later thought, "Wow, I do not even remember eating that." or "How did I get so full?"  In order to stay ahead of the game, we need to see how mindless eating creates pitfalls for us. Remember that knowing doesn't equal doing, so we also need to develop defensive strategies to manage these pitfalls. Fear not, because the next series of posts will provide the playbook that you need for a more healthful, enjoyable, and nourishing holiday season ahead.

Chicken soup for the cold?

With the wave of sickness that's been hitting our little neck of the beach in Southern California, it's no surprise that many of us are sharing our personal cold remedies. In fact, just last week a friend whose entire family had been sick mentioned that she fed everyone lots of chicken soup.  Ah yes, chicken soup! Why hadn't I thought of that when my family was sick a few weeks ago?

Touted as "Jewish penicillin", a few investigators have found that chicken soup may have properties that make it beneficial in treating the common cold.  In one study conducted over 30 years ago, scientists found that the consumption of hot chicken soup briefly sped up the movement of mucus through the nasal passages.  Basically, it made for a temporarily runnier nose.  What this could mean for the cold sufferer is greater relief of nasal congestion and less exposure of the nasal passages to the cold virus (mostly rhinovirus, which binds and replicates inside the nose).  In another trial, investigators found that homemade chicken soup, as well as several commercial versions, suppressed the migration of neutrophils (white blood cells that move toward the site of viral infection and produce an inflammatory response that contributes to cold symptoms).  Essentially, chicken soup may act as a natural anti-inflammatory agent that lessens cold symptoms, such as phlegm production and coughing.  One major caveat of both studies is that they were conducted on healthy volunteers rather than people who were actually sick. So far, no studies appear to have evaluated the direct effect of chicken soup on infected individuals.

Though the evidence doesn't really cut it for Mama's favorite cold remedy, I say go for it as it's very unlikely to hurt and may actually make you feel much less miserable.  Not only could the hot chicken soup alleviate lung and nasal congestion, but it's also a great way to hydrate while sick, which is also important for helping to loosen up those secretions.  And there's just something to be said about having a comfort food like this when you're sick with the cold or flu.

Here's to some happy and healthful soup slurping!

Zinc up?

So, have you survived or have you succumbed to the awful cold season that is upon us?  I thought I'd follow-up my post on Vitamin C and the Common Cold with a post on another popular homeopathic cold remedy...zinc.  Because of its role in assisting with immune function, it is no surprise that quite a few studies have evaluated the effectiveness of zinc for the treatment of colds.  While its mechanism of action is still not clear, some investigators hypothesize that zinc plays a role in preventing the attachment and  reproduction of rhinovirus, the most common cause of all colds, inside of the nose and suppressing the inflammation that is responsible for many of the awful symptoms.

When it comes to zinc and the common cold, it appears that the jury is still out.  In a thorough review of research spanning 40 years that examined zinc as a cold remedy, investigators evaluated 14 of the highest quality studies conducted in this area.  Of those, half of the studies found no effect of zinc lozenges or nasal sprays on the common cold while the other half found zinc lozenges and nasal gels beneficial for reducing the duration and/or severity of cold symptoms.  Two other major review studies  also concluded that the evidence is inconsistent but that further research is warranted (1,2).

Of the studies that have detected potential benefits from zinc for treatment of the common cold, I found a few interesting and possibly helpful pieces of information.  Zinc lozenges in the form of zinc gluconate (aka, zinc gluconium) or zinc acetate taken every 2 hours while awake within 24 hours of the onset of symptoms (at the very first sign of the symptoms is best) may help reduce the duration of the cold symptoms by an average of about 3 days!  It also appears that low doses (<9 mg of elemental zinc) are not as beneficial as higher doses (~9-24 mg).  As for the nasal sprays and gels, I wouldn't suggest touching those with a ten foot pole for now as the U.S. Food and Drug Administration recently warned consumers to stop using such products due to numerous reports of anosmia (loss of sense of smell) that may be long-lasting or permanent! (Something I've been telling my students and clients for a long time!)  Be forewarned, too, that anyone using zinc supplements should not consume greater than 40 mg/day as there are some negative side effects associated with excessive zinc consumption, which include:  nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, headaches, copper deficiency resulting in anemia, elevated cholesterol, and interestingly enough...impaired immune function.  (Note that an individual could possibly experience some of these side effects given the typical dosages and treatment protocols of these types of supplements.)

If you're not so sure about taking the supplements and thinking, "Hey, maybe I can just boost my intake of zinc through food if I get a cold.", think again.  Increasing our intake of zinc through food at the onset of a cold will not have the same effect as that of the zinc lozenges given the proposed mechanism of action that I discussed before.  The rhinovirus is replicating in the nasal mucosa. Therefore, the zinc needs to be in close proximity to that area on a regular basis (every 2-3 hours) in order for it to possibly work, and food that's chewed and swallowed won't have the same effect.

So there you have it...the scoop on zinc-ing up when you come down with a cold, but you may still be asking yourself, "So, what should I do?"  We have to ask a few important questions.

1. Is this type of therapy more effective than mere suggestion or doing nothing?  Possibly.  
2. Is it as safe as doing nothing?  Maybe not.  
3. If there is a possibility of it being unsafe, does the potential for benefit exceed that of its potential harm?  Maybe not.    
4. WWMD? (or What Would Michelle Do -- lol)  Aw shoot, I admit it. I've taken zinc lozenges at the first hint of a cold.  Call me desperate!  In some cases, I believe it worked. In others, not so much. Maybe it's because I didn't follow the protocol 100%.  Or maybe it was good ol' placebo effect at it again. And maybe it just doesn't plain work!
   

Stay tuned for more along this same thread of some of the proposed cures for the common cold.

Some new tricks for your treats

Several years ago when I started my career as a dietitian, I decided to take a nutritional stand on Halloween by giving out non-traditional goodies.  Yes, you may officially slap me with a "Nutrition Geek" label.  As a newbie in the field, I possessed a great fervor for exposing my trick-or-treaters to nutritious alternatives in their goodie bag, and I figured they'd get their sugar fix from many other households. I started my Halloween goodie journey with boxed raisins. Don't ask me how they went over as I wasn't there when the kids sifted through their loot, but I wasn't too worried as my goal was to at least expose them to something they might not otherwise be exposed to.  (I will add that my child and many others I know DO like raisins for the record!)  Over the years, I've still maintained an enthusiasm about celebrating Halloween with the kiddos in different ways, so I thought I'd share some of my alternative treat options here in case you might want to experiment with this, too, if you haven't already.

• Non-food treats, like pencils, Play-doh, stickers, temporary tattoos, balls, spider rings, bubbles, crayons, etc.
  
• One study found that when given the choice between non-food treats, like Halloween-themed pencils, stickers, and toys and candy treats that children chose the non-food treats as often as they selected the candy treats.
• More nutritious goodies
• Small packages of dried fruit, fruit leathers, trail mix, whole grain pretzels or graham crackers, 100 calorie mini-bag popcorn, individual boxes of ready-to-eat whole grain cereal, whole grain granola or cereal bars
• Treats you (or your family) don't like
• This may help save you from temptation in the time leading up to Halloween and from the leftovers aftewards.  If you don't like it, there's less temptation to eat it.  For me, that includes anything with coconut in it -- Mounds, Almond Joy -- bleck!

Here's to a Happy and Healthful Halloween!

Dealing with the treat in the trick-or-treat

We're about to embark on one of the most beloved holidays for children -- Halloween.  I remember being excited about Halloween as a child. Maybe some of that had to do with the fact that it was also one of my dad's favorite holidays, too. As you reflect on your memories of this particular holiday, does any specific aspect of it come to mind?  Could you be thinking of the overflowing river of candy that is collected on this spooky night?  Many parents wonder how to handle all of that Halloween loot because it's full of sugar, sugar, and more sugar. Well, we can stir in the anxiety over the candy battle that could ensue or we can focus on the wonderful learning opportunity for our children.  So, how do we deal with the treats?

Relax!  When we consistently rely on the Division of Responsibility for feeding children, there's no need to worry that a little indulgence in the Halloween booty will cause a nutritional disaster.  If I've learned anything about feeding children, it's that extremes really wreak the most long-term havoc on a child's health and eating abilities. On one extreme, some parents establish total restriction of certain foods, nutrients, and amounts, and on the other, parents embrace a laissez faire attitude of "Oh eat what you want, when you want, and where you want."  Neither extreme will nurture a competent, well-nourished eater. Balance and moderation are two of the keys to a nutritious diet and to helping children foster a positive, enjoyable relationship with food.  While I genuinely admit that these dietary characteristics can be challenging to adopt at times, Halloween presents a perfect learning opportunity for your child.  It's okay to have some candy sometimes.

Decide on a few simple guidelines up front:  how much candy can your child have and when can he have it?  When your little one arrives home to admire the Halloween treats, help him divvy up the loot into stockpiles of "faves" and "not-so-faves".  You may just let him eat to his heart's content right away.  While that may sound startling, be reassured of this...children are very intuitive eaters.  They still get great pleasure out of eating certain foods and they know when they've had enough because they're very in tune with their natural hunger and satiety signals.  The Division of Responsibility gives us permission to let our children listen to their own internal cues to eating rather than relying on external cues (us).

Of the remaining treasures, one or two pieces can be eaten with meals and snacks. Allowing your child to satisfy his natural sweet tooth in this way provides an opportunity for your child to learn about balance and moderation -- two keys to his long-term nutritional health and well-being.  Your child will discover that he can delight in his candy and eat a well-balanced, nutritious meal.  Practicing these principles can be helpful in relieving some of the anxiety about those Halloween treats and will hopefully make the experience a happy and healthful one for everyone.

Is variety the spice of your diet?

It is said that "Variety is the spice of life!", but is variety the spice of your diet?   Did you know that when we're exposed to a greater variety of food, we tend to eat more?  Think about it.  Have you ever been to a buffet? A party where people brought special dishes from home?  A Thanksgiving dinner? Raise your hand if you've ever been in one of these situations and overate.  If you did not raise your hand, you are either a liar or have some superhuman ability to not get so tantalized by the numerous tasty-looking offerings.

Brian Wansink, author of Mindless Eating: Why We Eat More Than We Think, has conducted some interesting research regarding perceived variety and how it affects food consumption.  In one study, participants were given a bowl containing 300 M & M's.  However, one group received seven different colors of M & M's while the other received ten different colors.  You've had M & M's, right?  Even though some may disagree, they ALL taste the same regardless of their color. However, the people in the group given the bowl with ten different colors consumed 43% more M & M's than the other group (91 vs 64 M & M's). At 3.44 kcals per M & M, we're talking a 93 kcal difference here.  So, when it comes to some of the more energy dense foods, this whole variety thing could be a challenge.  Walk down any chip aisle or cookie aisle, and you might get an idea of where some of our problem with poor nutrition comes from in our country.  Geez, we have whole aisles in stores dedicated to chips, cookies, sodas, ice cream?!

Nonetheless, I tell my clients and students that variety can work against us but that it can also work for us.  Let's talk about how it can work for us!  I'm going to go out on a limb and conduct my own very informal mini-experiment here with you.  Look at the two following pictures of fruit bowls.

Option A

Option B

So, if given a choice, would you eat more often from Option A or Option B? I'm hoping you say B.  But if you selected A, might I suggest that you're a monkey or you have a banana fetish?  So, what's the point of having more variety in your diet? Well according to recent reports, only 33% of Americans consume 2+ servings of fruit per day and a mere 27% consume 3+ servings of vegetables a day, so we need as many strategies as possible to improve our intake of these two vital food groups.  Variety is one key to a more nutritious diet!  When we expose ourselves to more options -- colors, shapes, sizes, textures, aromas, tastes -- we might just eat more.  Eating a variety of foods adds a dimension of pleasure and interest in our eating, and I truly believe that we should enjoy eating...really!  Variety also helps increase the chance that we will consume adequate nutrients as well as non-nutrients, such as flavonoids.

So, here's the run down of  a few ways you might incorporate a greater variety of vegetables and fruits into your diet.

• Let your senses be your guide.  Look for new shapes (star fruit? lychee?), sizes (pommelo?), textures (cactus pads? kiwi?), aromas (durian?), and colors (tomatillos?). Note the photo heading this post...my inspiration.  This beautiful, succulent-looking, jewel-toned red pear caught my eye in the grocery store recently with its incessant calling, "Pick me! Pick me!".  I'm truly a sucker for something new, especially when it comes to my veggies and fruits. So, even if it's a different 'variety' within the same family of foods -- apples, pears, oranges, etc. --give something new-to-you a try.
• Savor your old favorites in a new way.  You already love 'em, but maybe you need to spice things up.  Vegetables in a smoothie?  Try Green Smoothies.  Like apples and pears? Bake them with spices  -- cinnamon and nutmeg work well.  Ever had a fruit soup?  Melons and berries and pears oh my!  Combine fruit with spice for some kick -- spicy melon salads add interest to the palate. Change the serving temp -- go for gazpacho.
  
• Enjoy seasonal eating.  When you eat seasonally, you get to appreciate fresh, ripe, and tasty food that has been harvested at its most natural time. Eating seasonally allows you to try out foods that you might not otherwise try.
  
• Visit your local farmer's market.  I absolutely love visiting the farmer's market as you can be introduced to a lot of great new-to-you produce, and you will often get to try before you buy.  Plus, it's also fun meeting the growers of my food:)  In California, you can search for certified farmer's markets here.
• Visit local ethnic markets in your area.  You will surprised at all of the new vegetables and fruits you'd never even heard of, seen, or imagined when you take an adventure into an ethnic market. 
• Join a CSA (Community Supported Agriculture).  Once you're a member, you receive a box of locally grown, seasonal produce every week.  While you typically know a little ahead of time what you can expect, it's often a wonderful surprise to see what arrives. It can definitely keep you on your toes in finding new ways to prepare the produce, especially if it's something you haven't really tried before.

Have a happy taste adventure!

Question: How do you incorporate variety into your vegetable and fruit options?

The 4-1-1 on Vitamin C and the Common Cold

It's definitely that time of year again...cold and flu season. It seems like people are succumbing to the seasonal plague left and right lately.  And maybe you, like many others, are ready to down some vitamin C to ward off that cold. Don't worry, I just went to Target the other day and their shelves are fully stocked with products, like Emergen-C, just for you.  But before you head on over to build up your own stash, let's take a look at the 4-1-1 on whether or not such products really work.

When researchers set out to see if our "cure" for the common cold really was a cure, their analysis of over 30 clinical trials conducted over a stretch of about 40 years uncovered some interesting results.  Overall, investigators found no significant effect of supplemental vitamin C on preventing the common cold for most healthy people.  I say most because the combined results of six studies detected a 50% reduction in risk of catching a cold for certain groups taking routine doses of 250-1000 mg/day of vitamin C  -- marathon runners, young skiers, and soldiers working in freezing temperatures to be exact. So, for the general population, loading up on vitamin C throughout the year or when cold season hits apparently doesn't really fend off those colds, but if you're exposed to extreme physical stress or cold temperatures, it might actually be helpful.

As far as vitamin C's use as a cold remedy goes, the evidence is mixed.  Thirty studies exhibited a slight reduction in the duration of colds for adults and children taking daily megadoses of vitamin C compared to those on placebo. What does this amount to?  If the average cold lasts about 7 days, this means that a routine vitamin C supplement may lessen the duration of a cold by 1/2 a day for adults and 1 day for children.  However, seven studies showed no difference between vitamin C megadoses and placebo for lessening the duration of a cold when supplementation started at the onset of symptoms.  In an analysis of 15 studies, regular megadoses or those taken after the onset of symptoms did not significantly affect the severity of cold symptoms.

One important note to make is that vitamin C is a water-soluble vitamin, which means that little of it is stored in the body.  A few studies suggest that the body's cells become saturated with daily doses of 200-400 mg and that digestive absorption decreases at doses >200 mg/day.  Given some of the hefty doses in available supplements, often around 1000-2000 mg, do you wonder what happens to the excess if our body cannot store it?  We eliminate it via the urine. And at intakes >2000 mg/d, one can potentially experience adverse effects, such as kidney stone formation, nausea, abdominal cramps, excessive gas, and diarrhea.

I know...you swear that you take (or have taken) vitamin C and it's truly helped prevent a cold, right?  Well, there may be good reason -- placebo effect.  In a surprising twist, investigators in one study found that individuals who took placebo but thought they were taking vitamin C recounted fewer colds than those who actually consumed vitamin C but believed they were receiving a placebo. 

So, where does this leave us -- the real, live persons surrounded by this onslaught of sneezes and sniffles?  If you don't mind sparing the expense and feel that saving yourself from 1/2 a day's worth of a cold (when you catch one) is worth it, then daily supplementation with up to 200 mg of vitamin C may be worthwhile to you. (The recommended intake is 75 mg/d for women, 90 mg/d for men, and an additional 35 mg/d for smokers.)  Will you be harmed by taking doses of up to 2000 mg/d? It's unlikely as the risk of potential adverse effects at that level is low.  However, one can easily obtain the recommended intake (and more) through food alone by aiming for at least 5 cups of vegetables and fruits daily.  Let's see how this is done.

• Breakfast: 1 large orange = 91 mg
• Snack:  2 kiwis = 128 mg
  
• Lunch:  1/2 c cherry tomatoes = 9.5 mg, 1 c romaine lettuce = 11 mg
  
• Snack:   1/2 c red bell pepper = 95 mg
• Dinner:  1 large baked sweet potato = 35 mg, 1/2 c broccoli = 40 mg
• Total =  409.5 mg of Vitamin C from the equivalent of 5 c of vegetables and fruits!

Stay tuned for future posts related to this timely topic.

Is gluten-free the new low-carb?

I've been seeing inklings of one of the latest diet crazes...gluten-free. Just a few months ago, Elizabeth Hasselbeck of The View published The G-Free Diet which is being presented as the next big thing in achieving optimal health and in treating conditions such as high cholesterol and ADD/ADHD. I'm sure the diet is catching on as I recently perused an online nutrition and health message board where I came across a poster who suggested gluten-free waffles as a "healthier" breakfast option. I cringed!  I really take issue with this new trend on several fronts.

First of all, it's a cRaZe -- aka, a fad, phase -- otherwise something that is going to come and go because it's really not what some people are making it out to be -- the panacea solution for achieving health. Ever hear the phrase, "If it sounds too good to be true..."? Yeah, that. There really are people who need to follow a gluten-free diet -- those with celiac disease or a sensitivity or allergy to gluten. However, going gluten-free before getting the proper diagnosis is ill-advised for a few reasons. In order to provide an accurate diagnosis for celiac disease, gluten actually needs to be present in the diet. If a person removes gluten from the diet, then the signs, symptoms and biological markers for the disease subside making confirmation difficult. To affirm a diagnosis of a gluten allergy or sensitivity, certain tests and special elimination diets or food challenges are recommended, and these tests can help determine the real culprit of someone's problems or rule certain things out with the guidance of a health professional.  And a formal diagnosis is important in order to ensure the appropriate steps are taken to manage the condition and prevent potential complications.  For celiac disease, the consequences are potentially serious including malnutrition, iron deficiency anemia and a slightly increased risk for intestinal and lymphatic cancer and osteoporosis. Also, an individual may run the risk of developing malnutrition by not incorporating appropriate gluten-free alternatives to ensure nutritional adequacy and from inadequate avoidance of gluten-containing foods and other products, such as medications, that contain hidden gluten.

Next, gluten-free does not equal healthy. Gluten-free products do not necessarily provide more vitamins, minerals, phytochemicals, fiber, healthful fats, etc. than their gluten-containing counterparts. Plus, gluten-free products can still incorporate plenty of added sugars, less healthful fats, sodium, and calories.  And don't even get me started on how I believe that one of the reasons the diet craze is taking off has something to do with the growth of this niche in the market and clever manufacturers/marketers adding fuel to the fire with more and more gluten-free offerings. Do we recall the low-carb thing?  It was EVERYWHERE, and what did it do for us? Hmmmm.... 

I've heard from some people who've gone gluten-free to manage autism, ADD/ADHD, and irritable bowel syndrome and others who are trying it out because they think it's more healthful. I've talked to people who claim that it's helped them feel better, and that may be true. At this point, there's not enough strong research-based evidence that suggests that a gluten-free diet does or does not help manage conditions such as these.  In some cases, the improvements may have a lot more to do with the shift in food intake from more processed foods to more minimally processed foods that happen to be naturally gluten-free (i.e., vegetables, fruits, nuts, beans, and lean proteins) than from the absence of gluten. I still believe it is important to receive a thorough medical assessment in order to assure that a proper diagnosis and treatment is obtained.  And I also think that professional guidance on meal planning is beneficial in order to ensure nutritional adequacy when eliminating gluten-containing foods from the diet. 

So, what's the bottom line? I'll go back to the beginning..."If it sounds too good to be true...".  While some individuals definitely benefit from following a gluten-free diet for medical reasons, most of us generally have no problem digesting, absorbing, and metabolizing gluten, and a gluten-free diet is not necessary nor is it more healthful. If someone hasn't been diagnosed with celiac disease or a gluten sensitivity or allergy and believes s/he may have a problem with gluten, then consultation with a physician(s) for the appropriate diagnostic tests is advised. When following a gluten-free diet, it's best to seek the help of a health professional, such as a registered dietitian, with experience in providing the appropriate nutrition education and developing individualized meal plans and strategies to ensure nutritional balance, adequacy, and safety when going gluten-free. For sound nutrition information on a gluten-free diet, you may want to check out Gluten-Free Diet: A Comprehensive Resource Guide by Shelly Case, a Registered Dietitian and expert in this area.  For recipes and cooking/baking tips, you may want to check out this blog at glutenfreegoddess.blogspot.com by Karina Allrich.


In good health...