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Nutrition

Behaviours and Stress Eating

Behaviours and Stress Eating

If we look at client lifestyles, which I consider to be a major component of weight management, we can identify behaviours that may help assist in advising clients on changes in their eating. Certain behaviours can be defined as eating disorders and others identified as maladaptive...

How Thin People Think

How Thin People Think

As part of the Precision Nutrition course there are some great book recommendations, my new favourite is The Beck Diet Solution (Beck, J) which basically looks at the inclusion of cognitive therapy techniques to help you learn to think differently enabling changes in eating behaviour...

Mindful or Mindless.... How much thought do you put into your Nutrition?

Mindful or Mindless.... How much thought do you put into your Nutrition?

I came across the concept of Mindful v. Mindless about three years ago. The concept was related to exercise. I'm afraid to admit a lot of the exercise I was prescribing at that time was verging towards mindless. In fact, even I was exercising like that to some extent. When I sat and thought about this, my mind turned to nutrition...

I Have Slipped Off My Path - How Do I Get Back On Board?

I Have Slipped Off My Path - How Do I Get Back On Board?

Ok, no names mentioned but here is a story of someone who found themselves slipping off the path. It happens to us all; something or a combination of things come along and before you know it you find yourself weighing more than you expected and maybe even heavier than you have ever been...

What Does The Indicator Light On My Dashboard Tell Me?

What Does The Indicator Light On My Dashboard Tell Me?

Indicator lights on the dashboard of your car telling you something is wrong are just annoying, right? But they are there for a reason (apart from squeezing money from you for some expensive service)! They blink away in front of you...

Liquid Calories Add Up Fast

Liquid Calories Add Up Fast

When people are filling in food journals I always remind them to add all liquids ....not just water but juices ( we recently discussed that  fruit juices could do without being in the fridge) , pop ( same as fruit juices) , alcohol, tea, coffee, yes calories are lurking every where especially fat and sugary ones...

Lean My Kitchen Up

Lean My Kitchen Up

If you buy it you will eat it. Eventually. If it's in your house you will eat it. Eventually. If it's in your desk draw you will eat it. Sooner or Later. If it's on your desk you will definitely eat it sooner. If some one gives you a food gift you will probably eat it. So if you can't resist temptation but can you minimize your intake of less than lean foods...

The Journey So Far 2013.. (Half way through the year already!)

The Journey So Far 2013.. (Half way through the year already!)

So how is it going? Yes it's almost half way through the year already! How is it going with your health and fitness goals? I thought I should review mine and do it publicly so to speak, kinda makes me more accountable. This is a summary of the year to date and the issues along the way.

How to Facilitate Change in Diet and Exercise Patterns

How to Facilitate Change in Diet and Exercise Patterns

For most people, modification rather than elimination is all that is needed when it comes to changing ones diet or physical activity levels. Unlike stopping smoking, for example, there is no "quit day" when it comes to behavioural change linked to exercise and nutrition. There may of course be targets...

Effective Habits of Lean Eaters

Effective Habits of Lean Eaters

I have been following the Precision Nutrition (PN) Lean Eating programme for sometime, recently this has proved more successful to me than before, in the last 5 months I have lost 7 lbs and maintained and dropped 3.5 % Body Fat, my hydration level has climbed 3 %, not bad but could do better...

Do I Live Each Day Close To My Values?

Do I Live Each Day Close To My Values?

After an amazing weekend at the Precision Nutrition (PN) course with like minded people from all across North America, I have many topics that I could  focus on. The weekend oooooozed information! I have pages of notes, tons of ideas and masses of perspectives that I am going to disseminate and write about.

Don't Eat Till You are Full : 80% is Full Enough

Don't Eat Till You are Full : 80% is Full Enough

Recently we were discussing the speed of eating and highlighting how few people take the time to eat slowly and find enjoyment in their nutrition...the premise was simple eating fast encourages over eating which in turn assists weight gain. This is a sort of part 3 to our 2 previous discussions related to this area...

Eat Slowly Lose Weight (Part 2)

Eat Slowly Lose Weight (Part 2)

"Fast Food", indeed lots out our nutritional intake has become "fast" , everything has to be eaten/ available/ done in the quickest possible time...we previously discussed that speed eating (maybe like speed dating?) is just not good for you on many levels. Most of our meals never reach twenty minutes...

My Journey ( so far) in 2013...

Its only late  April and I already feel that I have accomplished a lot and I am pleased about that... I am going to share with you some stuff that I am proud of... The Alcohol Factor

In previous blogs I mentioned that I abstain from alcohol from the 1st of Jan for as long as possible..I have done this without blemish for 30 years ( the longest was until the 27th April some 2 years ago) this year I hit Friday 22 March...its like the only New Years resolution that I have " started" i.e. I only have one habit to work on....It takes some resolve to achieve and one way of spurring me on is to tell my clients, this means that they check in on me and push me along. Anyway I don't really do it for direct health reasons but more I guess as a willpower test...if you knew how much I liked the occasional beer you would be proud. During this time my weight didn't change if you were wondering despite keeping up a pretty regular regime of spin biking and weights and a bit of running, more about the latter later.Just as an observation about 3 -4 hours exercise per week.

Running Factor

The running started mid to late February in preparation for a 10k in early May, its become a bit of an annual thing and as my body doesn't like to run that much I have to train early and smart. This year I decided to go out earlier despite the cold weather..and I found that I was comfortable running around 20 mins straight off and felt ok, usually the first run is a killer to my body but I seemed stronger from the off.I soon began to build up my times and within 6 weeks had hit 10 k, for a non runner this was a good feeling, maybe I even started to enjoy it but don't tell my clients as I like to have something to moan about from time to time..

Interestingly when the running started even though I felt my calorie consumption was increasing the weight started dropping off..in a month between 4 and 6 pounds stayed off after an xmas period weight gain. I also noticed how less stressed I became and little things stopped annoying me.

Trainer Gets a Trainer

Yes actually I went and got myself a trainer... Having been a trainer for around ten years this was a MASSIVE step for me...this was also around Xmas time. Why did I do this? This had been on my mind for a long time, as a trainer its easy to stop taking care of yourself as you spend so much time taking care of others...your days are often long and tiring... you can get fatigued quite quickly and it becomes easy tho skip workouts. There is always " tomorrow" , however as I am always telling my clients " tomorrow never comes the the fitness industry, so it was time to bite the bullet. It was becoming hard to stay true to my values and principals I also felt I needed a bit of " looking after"....someone to feedback to, someone to bounce ideas off of...someone indeed to monitor and put value on my achievements...The benefits it seemed spurred me on , someone else was worrying about my weight ( I am not heavy by the way just fancied losing a few pounds and set myself a target....and NO, I am not telling you, but so far so good)... I was actually being held accountable. Very strange and at times frustrating..however it... made me look at how I relate to clients a bit.. dare I say differently..

So we stuck to 2 x a week which was/ isn't always easy , but its been working. In one discussion we actually decided that the all round consistency was the key...if you wondering I got my first " goal" number and have managed to maintain that figure for over a month...it was also interesting, and maybe a bit personal.. discussing " my nutrition" with someone else. It appeared that my calorie balance dipped but not straight away.. in other words it took me a month of increased cardio to start seeing real change. In addition I started to see real strength gains in the gym.

Did a 10 k but not the planned one!!

So all good on the training, running fine with a few niggling issues ...and then I realized I might be away for the planned race date..(15th May) , I had made a promise to a client to run with them in this race...Dilema. The running was going fine and I had hit the distance twice already in training, so 3 weeks ahead of schedule we entered another 10k on exactly the same course...It was bloody freezing as we headed out yesterday morning. Normally I get nervous before something like this but not this time...the race went fine, a nice fast downhill course...and a strong finish, slightly slower than last year but with 3 weeks less running I was happy, and was within my predicted time! . Happy Days!!! The only soreness was light and in the thighs, I was however exhausted but proud.

SUMMARY

So far so good , 3 more weeks to the target race which is actually on the same course so thats going to be interesting ...we have stayed relatievly injury free, stayed within my weight boundaries..kept the cardio and resistance training going, only problem on the horizon is an upcoming vacation so we are going to have to plan to get round the issues that that presents.  Updates coming soon.

Eat slow, lose weight, it could be that simple..

Western society has become one of rush rush rush, busy is seen to be sort of status symbol. I hear it every day, "I am too busy to exercise", I once heard a fanatic quote surrounding this topic.In reply to " I am too busy"  a thought provoking reply was "tell me how you do too busy". Its a bit provocative but many people over busy their day and their lives , not only are they too busy to exercise but too busy to even look after themselves, too busy to even eat better, almost out of control.Food or nutrition is not a priority, in fact neither is looking after themselves. Even during the busy day everything is done at a rushed pace, driving is stressfully, the journey to work is fraught and stressful, breakfast is eaten a hurry ... its go.. go ...go... it ends up being a day of mindlessness from start to finish. Everyone needs 25 hours in a 24 hour day it seems.... we all know the end result .... stress, poor sleep, poor nutrition, increased good pressure, the negative list is endless, the positive list is less long. SLOW DOWN THE FOOD

It appears that this is the easiest way to lose some weight. Experiments have shown that eating quickly without putting the fork down can make a difference in a total amount of calories consumed by an amazing amount.Eating quickly showed a possibly 646 calories in 9 minutes but only 579 in 29 mins by eating slowly. A study showed that by not putting the fork down people could eat 67 calories more in 9 mins by eating fast than they could by eating slowly in 29! On top of that the fast eaters reported being hungrier after eating quickly even though they consumed more calories. A double whammy there. Where is rushing taking you?

The body breaks down enzymes slowly ...it takes over 20 minutes to get the brain to tell you that you are full...most meals are over in half that time. Its looking like a triple whammy! Our stomachs are full but we still keep eating ..if we slow down we only eat what we really need.We are treating our food disrespectfully, its all part of go go go... we eat in the car, we eat in front of the TV , we eat lunch of the phone,we eat standing up, it becomes stressful as we worry about our next task, our next job in our over stuffed day as we over stuff ourselves, and we don't really even know why we are doing this to ourselves.

I get up extra early for breakfast, I see it as essential, why would I rush the most important meal of the day...I like to be conscious of what my body is doing, its more enjoyable to taste what I am eating or drinking!!

Its simple when we eat fast we eat more than we need, its crap for our digestion, it increases weight gain, we feel over full...so chewers out there savour every morsel, slow down your day, make time for food, proper time, just slowing down your food is a great way to start to get healthier, start now, yes, tonight!

Everyone gets on of these along the way.. the PLATEAU !

There are many health and fitness magazines out there, they tend to be heavy on advice on " how to get a six pack" or how to get a " beach body in 14 days" or how " to look like Arnie " , I guess having this on the front page sells magazines , however, real nitty gritty stuff/ subjects    gets passed by. One subject that receives scant attention is one many if not all people on a change journey experience. Yup the dreaded plateau. CALORIE DEFECIT

To get weight loss you need to create a calorie deficit. Many times ( and I have said this about myself!!) clients will tell me they are doing everything thats being asked of them but are not or have stopped losing weight. This situation could be called weight stable or a eucaloric state where intake and expenditure are equal.There are 3 possibilities here.

1. They are consuming more than they think

2. They are exercising less than they think

3. A combination of 1 and 2.

INTAKE

If you are not keeping a journal or counting calories in some manner  then you may be totally unaware of where you are at in terms of calories per food or calories per portion.Raising awareness may be needed, clients may need to learn how to find out how to understand calorie content of foods, especially ones that they consume frequently. People can be shocked to find for example that a large latte has more fat and calories than a piece of deep fried chicken.Another big issue is the amount of calories that get forgotten about that are obtained via liquid intake.People often underestimate calories drunk...especially when it comes to alcohol, fruit juice, milk...some of these are hard for clients to remove. Journalling can also be improved to help identify eating patterns, making them more accurate can turn up many hidden calories and show where food is being consumed. ( e.g. restaurants where sometimes even " healthy " options have become calorie laden)

ENERGY OUTPUT

A plateau can occur in a number of ways. Most people when they start to loose weight enjoy some success especially if they have received both nutritional guidance and have started to follow a well designed individualized exercise programme, however, after changes occur some form of stalemate comes along . This can be very frustrating for the client " I have been working so hard"....this would be a time to change the programme around.As weight loss occurs then changes occur in the physiology of the individual, as this happens the energy cost per exercise goes down.This is for two reasons a) the person is lighter and they burn less with each activity and b) the metabolism slows due to a decrease in calorie intake...

As such the same programme that got the client to loose weight may not continue to help them on their journey. The physical changes that have taken place have altered the clients need  for energy intake or expenditure.

Often clients , product manufacturer`s , textbooks, websites, " experts" all over estimate the amount of calories used during exercise. People get very hung up on " what machine burns the most calories", well if you are just starting out it probably doesn't really matter.  If you  are only going to start off with 20 mins of cardio 10 extra calories isn't really a big deal.However seeing big numbers on the display of a machine can lead to a false position leading to actually increasing calorie intake in an over compensation .

PLATEAU THOUGHTS

As clients lose weight the amount of calories they need per se becomes reduced.This is because as there is less body  to actually burn calories.You could say that with every % point they decrease they will burn 1% less calories.In effect if the person wants to lose 10% of their weight they need to find a way of living on 10 % less calories.In "Best Weight" by Freedhoff and Sharma they ask how  to determine if a plateau has been reached. Two questions should be examined;

1. Can the client eat any fewer calories and still enjoy life?

2.Could the client exercise more and still enjoy life?

If the answer to either is " yes" then they have reached a plateau. If the answer is " no" and weight hasn't changed for 6 weeks then they have reached a floor where no further loss of weight is likely.

In summary plateau`s can be overcome , it can be a very frustrating time for both the client  and the professional alike..when this stage occurs its time to make changes..either to the volume of exercise or the nutritional part of the equation. The latter may be achieved by keeping a more accurate journal and an increased awareness of portions and calorific amounts of foods  and liquids consumed.

Client Objections : How to overcome them....

We have all been there...some one tells us we need to change something in our lives,but whats the common reaction...generally its some form of  resistance.Who likes change .... even people in desperate need begging for help offer resistance . There are always " objections " despite or regardless of the advice... " I can't do that X because of X , Y and Z" ( there are often multiple reasons boosting the credibility of the can't do reasons) Many of the objections are on paper illogical and are often a knee jerk reaction on just being asked to change or there are deeper anxieties over a bigger picture. So how do you manage these objections? How easy is it to change a mindset from one thats closed and negative to one thats open and positive to change.I find often clients are focused on what " they can't do" rather than what they can.... Once a client has made up their mind that their case is impossible the brian shuts down and accepts the failure. The solution may seem easy on the outside ( set a timer on your phone to buzz every hour to remind yourself to drink some water) but sometimes they can't see how to solve their own problem. Hence the coach may need to reframe the situation.

There are 3 compenents  to re framing. 1. Acknowledge the client concerns without being dismissive. To the client the concerns are real even if they might not seem so to the practioner. 2 Move away from negative obstacles towards what the client can do, build up the current good ! 3. Get client participation to solve perceived problems.

It may help to reframe objections by asking what sort of conditions would have to be in place to over come the obstacle that the client is presenting.Moving from acknowledging  of the situation but at the same time looking for solutions . A list of " what if " scenarios can help open up a clients mind to possibilities.If you start to think you can then maybe you can.

Having recognized responses to change objections can all so be helpful.Many of the objections have a common theme and are heard by a coach multiple times, you can re assure them that they are not alone in their quest  and can put the client at ease with a simple quick solution ...if some one has time issues its easy to work on providing solutions, if they have reluctance to give up a foodstuff ( and its funny how many people tell me " I am not giving up X before it has even come up in conversation) let them know that they don't have to and their actually not even being asked to.

Ref :Berardi / Adams " Essentials of Sport Nutrition"

Why I was resisting keeping a food journal and what I did?

Until recently I had not allowed myself the benefit of having a " trainer" . Obviously having been a trainer for ten years I have often asked , indeed even given out deluxe food journals for people to keep. From a casual observation it does appear the people who are more likely to fill in a journal are also more likely to get results! So when i told my trainer that I wanted to lose weight I was told to fill out a food journal, a not unreasonable request especially when the trainer knows I also ask the same of my clients. This would be easy I thought (I had never kept one previously despite once previously being asked, I wriggled out of it) , indeed I had wondered many times before  why people didn't, fill them despite the obvious benefits. The diary can show behavioural and organizational issues that a client may have, I sometimes ask people to add in emotional feelings associated with meals..." how does it feel when you eat that"? This can show patterns of non diet behaviours and highlight alternative choices that might be helpful in eliminating negative emotions or reducing calorie intake.

Making people log the times of the food can show for example how hunger has a role in disorganized eating.. we can see for example common patterns arising that contribute to poor eating patterns.

Most commonly ( and also from my observations) the following issues shown by the food journal that don't help " organized eating" :

Not eating within 30 mins of waking ( so many people resist this simple great start to a a good days nutrition)

Going longer than 3 hours between meals and snacks

The journal can also highlight simple issues ( too few calories per meal ), not including protein in all meals and snacks...

But like my clients I found myself resisting keeping a journal, was this going to be used to judge me, show that I could improve my own nutrition..was it going to take up too much of my time, so I had a decision to make. What to do?

However I considered the benefits..it was going to provide me with calorie level feedback ( after all slight weight loss was my goal)  and as such decision making, it would help me show patterns that may be compromising my efforts, ( I can track my hunger back to questions like " why did I get hungry"?) and it was going to help me create new habits ( it was even making me think..." if I eat this I have to write it down... do I want it that much?)

So I did it and guess what.... I kept it going, after all we are all creatures of habit, initially what was daunting became my new habit, in addition raising my level of food consciousness started to bring results, so far I am proud of my efforts, in future I will work on strategies to help my clients become more compliant in keeping their own journals.

I like the term " best weight"...

Recently I joined the Canadian Obesity Network, something that I stumbled on during my quest for more information on all subjects health related, they produce a neat little read entitled " Best Weight " ( Freedhoff and Sharma). I want to pick out some of the best bits that I think are helpful to those looking to loose weight...

I always like to see if my client has realistic expectations and a plan, more often that not I find that they don't have either. Further questioning may be needed to learn about motives and objectives.Aesthetic reasons can often be a prime motivator and these could be short term ( my daughter is getting married and i want to get into a specific suit) or long term goal like improve self esteem or finding a grew partner...However successful weight loss for aesthetic reasons may be harder to achieve than doing the same for health reasons. If weight loss is driven by self esteem or concerns over  body image then these issues need to be addressed first. To assist in that sometimes I refer clients out to a life coach...

If the goal is health related weight loss its nice to share with the clients what to expect, maybe increased energy or less knee pain....I try to define objective quality of life goals that can be obtained in a reasonable time..success should be measured by achievement of these goals rather than actual weight lost.Maybe we should take away that the goal of weight loss is not about numbers on a scale but to reduce health risks and improve quality of life. Even a 5 % weight loss can produce measurable medical results!

In goal terms its probably best that they are as least daunting and obtainable as possible...rapid weight loss cannot be sustained, it can be achieved short term , but has a negative affect on lean tissue in the body. Sustaining weight loss is more important than achieving massive numbers..its better to lose 50% less than too regain it all and sometimes more back...

This leads me to the concept of " best weight". I do like this concept, its refreshing and I am surprised that I have never come across it before. Its so simple.The book describes " best weight " as a non statistical goal that is easy to set. Clients can take their weight down to any weight they put their minds too, but to maintain that weight they need to enjoy the lifestyle that got them there.

The term " best weight" is the weight achieved whilst living the healthiest lifestyle that they can truly enjoy. They maintain that there is a point when you can no longer eat less or exercise more and still like their life. The weight achieved whilst still liking their life is the " best weight " achieved without further intervention...and that is the lowest weight currently possible.For sustained weight loss the client should consume the smallest number of calories that allows them to enjoy each day.With exercise clients should do as much as possible, but there is a maximum above which the person will not do, chances are they will come to hate exercise, then they quit.

Eating less and exercising more in a situation that the patient doesn't enjoy is the definition if a diet which is why 95% of them fail as the client returns back to previous lifestyle choices. A healthy lifestyle is the smallest number of calories and the greatest amount of exercise that a person can enjoy.

Ref: Best Weight . A practical Guide to obesity management ( Yoni Freedhoff and Ayra Sharma . ) Published by The Canadian Obesity Network

Compliance...why can't people just do it?

This is one of my favourite topics. I talk over the " compliance " issue more than any other subject and with a massive wide variety of people. For me its one of the hardest factors to "make sense" of, because really in black and white terms failure to do something that has been suggested to you as health beneficial is only going to cause your problems later down the line. Its sad in a way and frustrating for both client and trainer and I still have trouble understanding the root of this issue. I heard a recent story about a recovering heart attack patient who was not taking his prescribed medication because he didn't like pills,  compliance here was a potential  life and death issue  .I  guess people are so complex there is no one particular reason why this situation existed. Maybe he just didn't see the benefit, to most it appears black and white, take the pill, live, don't take the pill , potentially die.

However, there is growing consensus among researchers that the behavior of the health care provider has a significant influence on patient adherence. Specifically, the health care professional’s ability to communicate and explain information while expressing warmth and concern for the patient appears to be associated with increasing patient adherence. Which from a personal training perspective makes the job just that little bit harder. Some people just don't see the benefit of " extra " anything  or indeed " less " of something , getting them to even go to bed 30 mins earlier is like asking them to amputate an arm...we have become so stuck in out habits that all change however small is resisted. However small amounts of change can bring big returns.

 

WE TALK ABOUT IT A LOT

But on a more individual level I have clients that ask me for " 5 Minute " programmes of exercises they can do daily, how often do they follow through and do it, sadly almost never. I discuss these issues with a Lifestyle Coach and to sum up our joint  thoughts would translate to something like this..instead of me (trainer ) telling you WHAT to do, but that both the trainer and the client should work together to come up with a compliancey solution. Instead of being told what to do we need to find or create new thought patterns,or habits, in affect we have 2 people working on one problem, not one telling the other what to do !

We discuss sleep and mainly the lack  there of. I can find any client 100 articles promoting the benefits of sleep, I can send these articles to my clients..I can find no research ( haven't really looked ) promoting a lack of sleep and its benefits. However, people may still not see the value in sleep and you then may have to look for the reasons... " why" .. ." Why do you not value sleep"? Its the a matter of understanding the clients sleep beliefs and the disregard for it may come from elsewhere in that persons life and history.

It appears that what people value most they do most, when it becomes the most important thing to that person they may end up complying. From a  trainers standpoint we want everyone to comply with what we suggest and if that persons belief system is different to ours  then we have difficulty in understanding why people do what they do. Perhaps the best way forward is to simply say " what can I do today thats going to help me towards my goals?" Do something, small , simple and achievable...

One thought that goes through my head is we just don't love ourselves enough , then I found this quote which sums it all up

"You can search throughout the entire universe for someone who is more deserving of our love and affection than you are yourself, and that person is not to be found anywhere. You, yourself, as much as anybody in the entire universe, deserve your love and affection." – Buddha

SOME INFO FROM THE UK.

I found the following information on Wikipedia to give you some idea of the problem health care faces in the UK
  • up to 90% of diabetes patients do not take their medication well enough to benefit from that medication
  • 33-50% of some cancer patients take less of their anti-cancer medicine than required.
  • only 75% of coronary heart disease (CHD) patients take sufficient medicine for it to be effective.
  • Up to 75% of hypertensive patients do not adhere to their medicine.
  • 41-59% of mentally ill patients take their medication infrequently or not at all.
  • 33% of patients with schizophrenia don’t take their medicine at all, and 33% are poorly adherent.
  • Less than 27% depressed patients adhere to their medication

In the UK, the societal impact of such high levels of non-compliance is significant:

  • 110,000 people per year die prematurely from coronary heart disease that is largely preventable. Death rates are three times higher in manual workers than among managers.
  • If CHD patients adhered to their medication, each year 40,000 – 50,000 fewer people would have a stroke and 25,000 would not have a heart attack.
  • 25% of cancer patients have to cut back on food shopping to cover the extra costs of cancer.
  • 70% of patients with advanced cancer suffer with pain, very often in conjunction with other symptoms such as nausea, vomiting, loss of appetite, anxiety, depression, sleeplessness, and confusion, amongst other symptoms.
  • 1,400 people die from asthma attacks each year, 90% of which are avoidable

The most common causes for lack of adherence appear  to be aging, lack of education, lack of information about the benefits ( of taking the prescribed medicine) and on, I also read that between 20 and 30 % of prescriptions in the US go unfilled.