Health

Understanding Emotional Eating

Have you ever come home after a stressful day and ended up eating a pint of Chunky Monkey?  Or maybe you’ve mindlessly eaten a bag of chips at your desk willing the workday to go by faster?  Both of these examples are types of emotional eating:  eating for reasons other than hunger.  While eating when you’re  hungry addresses a physical need (providing the body with food in order to function), emotional eating uses food to satisfy an emotional need.  Some common causes of emotional eating include stress, anger, boredom and loneliness.    Emotional eating can affect your diabetes management because often the foods eaten are high in sugar, fat and calories.  This can raise blood sugar and make it hard to lose weight.

So how can you tell if you’re eating because you’re hungry or because you’re stressed out?  Physical hunger comes on gradually and can be satisfied by any type of food. You stop feeling hunger when you have eaten enough to feel full.  Emotional “hunger” comes on very quickly and is focused on a strong craving for a particular food, taste or texture. Emotional eating is also often mindless and can lead to feelings of guilt afterward.

Now that we know the difference between physical and emotional hunger, here are some strategies to help manage emotional eating:

  • Know your triggers – If you know what it is that causes you to eat (e.g. boredom, stress), you can take action to prevent mindless munching before it begins. Use another activity to distract yourself from wanting to eat. Try going for a walk, talking to a friend or loved one, or listening to music.
  • Pause – Before reaching for the bag of chips, stop and think: am I hungry, or am I bored? Wait 10 minutes and see if you are still truly hungry.
  • Eat smaller portions –   If you wait 10 minutes and still can’t stop thinking about those chips, have a smaller, individual portion to keep you from overeating.
  • Practice mindful eating – Slow down and take the time to really enjoy the smell, tastes and textures of your favorite foods. Try not to multi task – make eating your only activity.
  • Seek help if you need it – Emotional eating can sometimes be a symptom of depression or anxiety.  If you feel this may be the case, talk to your healthcare provider, a diabetes educator or a mental health specialist.

Post content reviewed by Jen Searl, MLS, CHWC

Nutrition, Uncategorized

Serving Up Satiety

By Elizabeth Daly
Dietetic Intern

In today’s society, we are constantly tempted by food. Whether we are commuting to work, out with friends or watching TV at home, we are influenced by messages encouraging us to eat more. Living in an environment surrounded by food can make it challenging for people to make healthy choices, lose weight and manage their diabetes. There are many different weight-loss diets advertised in the media, but dieting often leaves us feeling hungry, deprived and ultimately defeated. How can we better control our intake without feeling the need to eat all the time?

Satiety is the feeling of fullness that comes after eating. If we feel satiated after a meal, we are less likely to snack between meals or eat large portions the next time we sit down to eat.  Learning how to feel more satiated after a meal may help us better control how much we eat, aid in weight loss and better control blood sugar levels.

Feeling satiated takes time, often up to 20 minutes after eating a meal. It is controlled by a number of factors that begin once we take our first bite of food. When we eat, our stomach expands, we begin absorbing and digesting nutrients and the brain receives signals that lead to feelings of being full.

Not all foods produce the same level of satiety. Here are a few tips to help you feel fit and full:

  1. Add lean protein to meals and snacks

Adding protein to meals or snacks helps keep you full for longer and control blood sugar levels. Meals that only contain simple carbohydrates are digested quickly, spike blood sugar, and make you feel hungry again soon after.

~Ex.  1 oz low fat cheese or ¼ cup hummus or 1-2 tablespoons peanut butter or 1 oz nuts

  1. Add fruit and vegetables to meals

Fruits and vegetables are high in fiber and water.  Both of these help you feel full. They are also good sources of important nutrients and contribute to overall good health.

~Ex. Add a side salad with meals, add berries to cereal or yogurt, add vegetables in soup

  1. Limit sugary beverages

Sweetened beverages are high in sugar and calories but low in nutrients. They do not cause your body to feel as full as solid foods do, and can lead to spikes in blood sugar and weight gain.

~Try swapping sugar sweetened beverages with water at meals to curb your hunger!

 Content reviewed by Melanie Pearsall, RD, CDE
Uncategorized

On Insulin and Weight Gain

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

Does my insulin make me look fat? The answer to this question is …it might. That would make it the wrong answer because none of us want to take a medication that may cause weight gain, especially as maintaining a healthy weight is such a crucial aspect of good diabetes management. The purpose of this post is to discuss how insulin works and how it may affect your weight. I hope after reading this you’ll have fewer reservations about using insulin if it becomes necessary.

Maintaining a healthy weight is so important for general health and is particularly important for people with chronic diseases such as high blood pressure, high cholesterol, heart disease, arthritis, and diabetes. A healthy diet and weight may mean fewer daily medications or a lower dose of medications you still require. Many medications have the potential for side effects; diabetes medications are no different. Weight gain IS a possible side effect of insulin, but it may also happen with oral medications.

Let’s talk about insulin as a first step. It is, simply put, a lifesaving medication. Insulin was discovered in 1921 at the University of Toronto and has been extensively studied and improved upon since. The job of insulin is to move the glucose from the food we eat into our cells so they’re able to stay healthy and work well. It then takes the remaining glucose from the bloodstream and stores it so it can be used for energy later. People with Type 1 Diabetes are totally dependent upon this medication for survival as their pancreas does not produce insulin. People with Type 2 Diabetes can manage their disease many different ways: diet, exercise, oral medications, and insulin. Diabetes is a progressive and chronic disease that as yet does not have a cure. That is why so many people with Type 2 Diabetes will require insulin as part of their management over time.

Two common symptoms of poorly controlled diabetes are significant weight loss and excessive urination. The weight loss happens because stored fat gets broken down to provide enough fuel for bodily functions (heart and lungs, for example) to operate and maintain life. You may start to notice the numbers on the scale decrease, regardless of what you eat or drink. This is because calories consumed aren’t being properly metabolized but rather directly excreted with urination.

The treatment for extreme hyperglycemia is insulin therapy. The insulin corrects the high blood sugar, correcting the excessive weight loss in the process. The insulin is helping the body work correctly; it’s not causing new weight but rather replacing what was lost when the body was in crisis. It’s a sign the body is healing and starting to work more normally again. This is a good thing, but it can also be frustrating for people who struggle with their weight regardless of their level of glucose control. If your weight is still creeping up after your blood sugar is better controlled, there are probably other reasons for this and further investigation is needed.

Frequent episodes of hypoglycemia (low blood sugars) can cause added weight. I’ve discussed hypoglycemia in more detail in the past, but I want to review a couple of points now. Under eating, over exercising, and both oral medicines and insulin are potential causes of this frightening and potentially life threatening condition. Proper treatment is key, but it’s common for people to over treat low blood sugars because they feel so poorly and think more is faster and better. This is not the case, and the extra calories may cause added weight over time.  The strategy I encourage my patients to use is trying things like glucose tablets and gels for treatment more often than juices or regular soda because they are pre-packaged for the correct carbohydrate (15grams). It can be hard to measure out 4 oz of juice or regular soda when you are feeling so poorly and anxious during an episode of low blood sugar. I also strongly encourage all of my patients to see our RD CDE on a regular basis to review meal plans and make any adjustments as needed to assist with better weight control. It is also important to be as active as possible as any type of movement will decrease insulin resistance and improve weight and blood sugar numbers.

Insulin initiation is a daunting prospect for some. Many of my patients, especially those who are really struggling with their weight, have told me the fear of gaining weight is why they refuse insulin. I hope that my explanation helps to minimize this fear. So, this brings us back to where we started. Does my insulin make me look fat? I prefer to answer this way: It makes your body healthy so you look marvelous!!!

Nutrition

Fiber

Fiber is a special type of carbohydrate the body can’t digest. The 2010 Dietary Guidelines for Americans recommends eating 25-35 grams of fiber a day, but most of us probably only get about half that amount. If it isn’t broken down for energy, why is there a concern about not getting enough? While it may not be used for fuel, fiber plays a role in helping other systems in the body run smoothly.

There are actually two kinds of fiber: soluble and insoluble. Soluble fiber has been shown to help lower cholesterol (especially the LDL or “bad” cholesterol). When mixed with water, it dissolves into a gel-like substance that binds bile acid and interferes with the absorption of dietary cholesterol.  Good sources of soluble fiber include beans, oats, and fruit such as apples. Insoluble fiber (which does not dissolve in water) helps with moving food through the digestive system and removing waste. Whole grains and vegetables are good sources of insoluble fiber.

In addition to supporting heart and digestive health, fiber can also aid in losing and/or maintaining a healthy weight. Most high-fiber foods are naturally low in calories, but more importantly fiber promotes satiety: that feeling of being “full” after eating. Increasing the amount of fiber in your meals can help you feel full faster and keep that full feeling longer. And, since fiber causes food to move through the stomach more slowly, it can help keep blood sugars steady after meals.

A Registered Dietitian can work with you to find ways to increase your fiber intake, but a good place to start is eating plenty of fruits and veggies, whole grains, and beans. Replacing refined and processed grains with whole grains, or eating a piece of fruit instead drinking fruit juice (unless treating a low) are other things to consider. One final note: it’s best to increase your fiber intake gradually and drink plenty of water. Each week, add 5 grams of fiber to your daily intake until your intake is between 25-35 grams per day. Too much too soon can cause uncomfortable gas and bloating.

(Post content reviewed by MGH Department of Nutrition)
Fitness

Exercise Excuses: Busted

Sign "To Gym". Photo Credit:  Christian Robertson Have you seen this commercial where a couple lists off the various reasons they couldn’t work out?  While some of the excuses are pretty funny (“Wednesdays are weird” is a favorite), they all emphasize one thing:  there is an almost limitless list of excuses for skipping out on regular exercise.  Here are some common excuses for not exercising – and ways to work around them.

I don’t have time:  We live in such a go-go-go society that sometimes knocking exercise off the To-Do list seems the only way to get everything done.  If that sounds familiar, maybe you need to rethink your approach.  In order to make regular exercise a part of your routine, you have to make it a priority.  Treat exercise like you would a meeting with your boss or a co-worker (think of it as a meeting with yourself).  If you still have a hard time carving out 30 minutes at a time to work out, try breaking it up into 10 minute segments throughout the day (this video from the Institute of Lifestyle Medicine is a great full-body workout you can do right at your desk).  If all else fails, multitask.  See if there are places you can fit in a little movement through your day, whether it’s walking around the office while on a conference call or doing some bodyweight exercises during commercial breaks at night watching TV.  Remember, a little bit of exercise is better than none at all.

Need to Care for Kids / Family:  Balancing work with the needs of kids and family is a major contributor to the lack of time mentioned above, so the same advice can apply here.  Another option is include your kids in your workout routine.  You’ll be setting a good example for the little ones, getting them on track to start healthy exercise habits of their own, and spending some quality time together as a family.

I don’t have access / like going to the gym:  Gyms and health clubs can be intimidating and aren’t a good fit for everyone.  The good news is you can still build a regular fitness routine without a gym membership.  Walking is one of the easiest ways to fit exercise into your day, and all you really need is a good pair of walking shoes.  There are a number of places to walk in Boston, and enough scenery to keep your walk interesting.  Weather causing you to move your workout indoors?  See if you can borrow a fitness DVD from your local library.  If you have Internet access, websites like sparkpeople.com have a selection of workout videos you can access any time – for free!

It’s boring!:  Okay, we’ll admit running on the treadmill, staring at the same wall day after day gets old.  If this is the reason you dread going to the gym, it might be time to try a new activity.  Adding variety to your workouts is not only good for your mind (by keeping boredom at bay) it’s good for your body too.  Changing up activities can prevent injury, and keeping your body guessing is one way to break through weight loss plateaus.  You could also try changing your scenery.  Going for a walk or bike ride outside gives you something new to look at (and you can easily add challenge by changing your route).  If all else fails, see if a friend can come with you.  Having someone to talk to while you work out can make the time fly by.

(Content reviewed by The Clubs at Charles River Park. Photo Credit: Christian Robertson)
Fitness, Guest Post

Overcoming Barriers to Fitness (Weight Management Part 3)

By Mike Bento, Personal Trainer
The Clubs at Charles River Park

Blue Dumbbells. Photo Credit: Christa Richert

I like to think of fitness as a risk management tool.  What you do today can have an impact on both your current state and on your future.  Developing a healthy lifestyle can help lower your blood pressure, reduces your risk of having a stroke, and can help protect against developing cardiovascular disease and certain cancers.  But there’s an emotional component to fitness as well. 

As your fitness level increases, daily activities become easier; you find you want to do more.  And more than that, you start to feel good.  Your mood improves, you have more energy (especially at the end of the day and the end of the week) and your sleep gets better.  All of these “extra” benefits are just as important as actually working out because they help you stay consistent.  Sticking with it is crucial—to really see results and get the full benefit of your routine you have to make exercise a habit.

But just as there are emotional factors that can help you build momentum, there are others that can be obstacles to beginning (or staying with) your fitness routine.  For some people, it’s fear of change.  If you’ve never really exercised before, starting a fitness program can mean moving outside your comfort zone.  Change can be difficult or even scary.  It doesn’t happen overnight; it takes time and reinforcement, but it does get easier as you go along and start seeing results.  Maybe it’s your clothes feeling a little looser, your waist getting a little smaller, or just someone commenting that you’ve lost weight.  Or maybe you notice your blood sugars are easier to control, or you’ve lowered your blood pressure.  And maybe it’s that you just feel better.  Any or all of these things can be the right motivation to keep doing what you’re doing.

At the end of the day, you are the only person who can do this for yourself.  It’s one thing in your life that you have complete control over.   And that can be very empowering.

Photo Credit: Christa Richert

Health, Nutrition

Weight Management (Part 1)

Debra Hollon, MS, RD, CDE, LDN
Senior Clinical NutritionistPear and tape measure. Photo credit: Asha ten Broeke

Now that we’re more that three months into the year, how are you doing with your New Year’s resolutions?  If you’re still sticking with it, good for you!  It takes a lot of commitment to keep up a major lifestyle change.  For many people, maintaining a healthy weight is a key part of their Diabetes management plan.  If you’re having a hard time reaching your weight loss goals, don’t give up.  You may just need to rethink your strategy.    

Weight loss is all about balancing calories—how many calories you consume vs. how many calories you burn.  One of your first steps is figuring out how many calories you need to consume a day in order to lose weight.  Your health care provider or a nutritionist can help you figure this out, but you can estimate your ideal calorie intake by multiplying your weight by 10 (again, this is only an estimate—you should still contact your health care provider for more tailored guidelines).  Your next step is paying attention to how many calories there are in the food you eat and watching your portion size.

I often suggest people think of their daily calorie intake as a budget.  You can “spend” those calories on whatever you like (ideally produce, whole grains and lean protein sources), but stop and think is it going to be worth it?  Keeping a food diary of everything you eat can be helpful for staying on top of your calorie intake.  Oftentimes people find they eat less simply by writing down what they ate every day.  Plus, it keeps you accountable.  There are a number of great programs out there now that can help you track your calories for free.  Lose It!, My Fitness Pal, and Fit Day are good choices. 

Remember, the scale is only one way to measure success at your weight loss efforts.  I once had someone suggest using the “pant-o-meter”, which is simply being aware of how well your clothes fit; as you lose weight, they’ll start to feel looser.  Other markers for success are better blood sugar control, lower blood pressure readings and lower cholesterol levels.  Next time, we’ll talk more about what makes up a healthy diet.  If you have any questions, leave us a comment below.

(Photo credit: Asha ten Broeke)