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Joyful, Competent Holiday Eating

The holiday season is a time when patients often expect to gain weight. I've even seen patients who plan for a 5- to 10-pound weight gain! Other patients try to lose weight during the holiday season, which is not an easy task. They often are unsuccessful.

In last December's column, titled "Holiday Eating Tips," I encouraged you to help patients who have progressed on a weight loss journey to continue this process through the holidays by incorporating careful monitoring of caloric intake and increased activity. Research shows that obese and overweight adults are likely to gain five times more weight over Thanksgiving than people of normal weight.1

How can we help our patients enjoy holiday eating without veering too far off track?

Feasible Strategies

A study published in 2011 found that a small group of mostly women who had already finished a 12-week weight loss program and were also enrolled in a 12-month weight loss program gained less weight than people not involved in any type of weight loss program.2 The study determined that holiday self-monitoring emphasizing reduced sedentary behaviors was necessary for continued weight loss, or at least maintenance of weight loss, over the holiday period.2

Encourage patients to make food joyful yet secondary to exercise over the holiday season. Recommend activities such as participating in holiday 5K runs. Visit http://www.active.com/ to find an event near you. Even if your patients walk instead of run, they will feel good for supporting local causes and will enjoy the social aspects of the event.

Competent Eating

Often we read discussions and suggestions about mindful eating. The term "competent eating" can be powerful for patients. Ellyn Satter, a registered dietitian and licensed social worker, has spent 30 years working with patients who have distorted eating attitudes and poor dieting practices. She suggests that "To be competent with eating, emphasize permission and discipline: the permission to choose enjoyable food and eat it in satisfying amounts, and the discipline to have regular and reliable meals and snacks and to pay attention while you eat."3

In a recent newsletter article titled "The Joy of Eating," she states that "You may worry that such permission will send your eating out of control. Not so. Being able to eat foods you like in satisfying amounts gives order and stability to eating. Foods that are no longer forbidden become ordinary foods that you can eat in ordinary ways."3

Strategies That Work

While it may seem tedious, tracking caloric intake can be a gift in disguise over the holiday season. Multiple smartphone and computer apps are available to allow us to assist in tracking calorie intake. Encourage patients to choose one of these apps and to use it on most days between now and mid-January. Most will later tell you how enlightening this activity has been to them.

That said, watch out for apps that suggest very low calorie counts per day. Some of the more valid online websites that also have apps for tracking intake include http://www.fitday.com/ , http://www.livestrong.com/ and http://www.sparkpeople.com/. A purchase of Weight Watchers online for the 3 months surrounding the holiday season can be a great fit. A lot of my patients end up tracking their intake up until dinner and then go into the last meal of the day knowing how many calories they can ingest, and where those calories should come from.

Another great place to find out how much to eat in a day is at http://www.choosemyplate.com/. Find the Daily Food Plan tool, enter client/patient data, and go to the PFD Meal Tracking Worksheet. This can be printed, and it can show portion sizes recommended from every food group but fat. The simple recording of food intake represents a low-resource intervention approach to curtailing holiday weight gain.1

Get Moving

Winter holiday weight increases often may be linked to a decline in physical activity levels. Help patients identify specific strategies that reduce sedentary behaviors. At the American College of Sports Medicine annual meeting held in Denver last spring, researchers reported that men who burned about 500 calories during 47 minutes of vigorous exercise continued to burn about 225 additional calories over the next 18.5 hours compared to a day in which they did not exercise.4

One of the best pieces of advice I have been able to impart to my patients, and one that I practice myself, is this: Make appointments with yourself to exercise. Spend 5 minutes on a Sunday night setting five appointments over a 7-day period for 5 hours of combined aerobic and anaerobic exercise. Knowing that life will take over and you'll only get to four of these appointments in a week, still schedule the five. You'll be amazed at how this can become habit.

Fad Diets in Your Stocking

If a patient absolutely needs to follow a "diet" over the holiday period, consider recommending one of the five diets ranked at the top of a 20-item list in a recent article published on WebMD. These rankings were made by a panel of 22 nutrition experts assembled by U.S. News & World Report: 1. Dash Diet, 2. TLC Diet, 3. Mediterranean Diet, 4. Mayo Clinic Diet and 5. Volumetrics Diet. Weight Watchers was ranked No. 6, and I highly recommend this plan's approach to weight loss and weight maintenance for just about any patient. All of these diets were ranked according to focus on nutrition and safety.5

Wishing you and yours joyful and competent eating strategies and at least one successful 5 K walk or run this holiday season!

Robyn Kievit is a family nurse practitioner, a registered dietitian and a certified specialist in sports dietetics. She operates a private nutrition practice in Boston and is on staff at Emerson College. E-mail your nutrition and weight loss questions to robyn@robynkievit.com or visit her website at www.robynkievit.com. On Facebook and Twitter, search for nutritionmentor.

References

1.      Hull HR, et al. The effect of the Thanksgiving holiday on weight gain. Nutrition Journal. 2006;5:1-6.

2.      Cornett R, et al. Daily self-monitoring during the winter holiday period: a feasible strategy for holiday weight maintenance. Scan's PULSE. 2011;30:1-6.

3.      Satter E. The joy of eating. Weight Management Matters. 2011;9:2.

4.      Knab A, et al. A 45-minute vigorous exercise bout increases metabolic rate for 19 hours. Med Sci Sports Exerc. 2011; epub ahead of print. http://www.ncbi.nlm.nih.gov/pubmed/21311363. Accessed Nov. 14, 2011.

5.      Doheny K. Best Diets? DASH, TLC, Mediterranean are tops, experts say. WebMD. http://www.webmd.com/diet/news/20111104/best-diets. Accessed Nov. 14, 2011.


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