More Controversy!

Here's Blakes analysis of the LA Times article I put in my last post. How are we to know what to think?:


Hey Tess... here's one of the articles alluded to in the LA times column. It's pretty interesting to look. You're probably not interested in these details, though, and if not I'm sorry, but that's where the devil is. It shows how much each study has to be stared at to make sense, and how hard it can be to make sense of unrelated studies.

I guess if nothing else, as a friend, this shows you what a drag it is to be me.

Don't bother to read on if you don't want to see my analysis...

First, the study includes a total of 40 people. That is a very small number.

Second, it's important to segregate what they say about weight loss, fats circulating in the blood, and actual adipose tissue.

The weight before was about 210 pounds (plus/minus 20 pounds) for both grups. The high fat diet end weight was 190 (plus/minus 20 pounds) while the carb diet end weight was 195 (plus/minus 20 pounds). So, really, this study isn't making a claim about weight; the errors make the differences between and before/after indistinguishable. A better number to report would probably have been the % weight loss. This might wash out the big errors (comparing someone that was 170 with someone 210 won't reveal how each individual fared). Of course, this may have looked even worse than body mass.

The body fat was actually less in the high carb group.... 36.8% vs 38.2%... though the size of their error bars (8%) actually dwarfs any difference. The carb group had more non-fat body mass, which makes them slightly heavier overall.

Where they do see something striking is in concentrations of blood lipids. A decrease in triacylglycerols of 50% (as he said in the article). The carb group also saw a decrease of 20% (not mentioned in the article), which is also really striking. The error bars in both these numbers is 25%. Caloric reduction in general is a good thing for diabetes risk.

The other thing that's striking is the shift in the insulin response. This gets to that homeostasis thing I was mentioning before... the reduced carbohydrate load allows the body to shift to a lower insulin response: there's less sugar to import, so we require a smaller insulin response. On the other hand, the difference is response is really not too surprising: the body responds to the stimulus... less carbs, less insulin required to move fewer carbs into the cell. I bet if they looked after week1 of the study, they'd have seen the same thing.

To be fair, I think the metrics of diabetes risk is what they're emphasizing (circulating lipids). So, you can still be overweight (if I lose 20 pounds, I'll still be overweight), but reduce your risk for diabetes. Which is more important? I don't know. Being overweight but diabetes free is still probably linked to self-esteem and depression issues.

So, I guess the bottom line is that it's easy to confuse weight loss and health benefits. Also, such small studies are very hard to interpret because the errors are so large. However, it is nice to know that, even if you're too fat (at 210 myself, I can say that's too fat), you can still avoid risk for diabetes!

In the end, for me, the article is about how 210 pound people go on 2000 calorie diets for 12 weeks. I wish I could do that with a house full of pumpkin pies, candied yams, mashed potatoes, fudge and rolls.

Anyway, sorry! But thanks for posting the link, it was useful and fun for me!

bg

We Have a Controversy!

My friend Blake had the following to say about carbs and cholesterol. I'm hoping he'll read the Taubes book and help us all make sense of it!

"Hey Tess, this is obviously unsolicited, so sorry and feel free to ignore. I do teach metabolism, and have thought a bit about all this, not that I'm positioning myself as an Authority. But reading your post, well it made me think. What I will say overall is that its really hard for *anyone* to look at the nutritional science of the past 10, 20, 30 years and come up with definitive conclusions. I'm pretty suspicious of attempts to do so, though obviously an Answer is what everyone is after. Not that scientists are the only ones who can/should interpret the science, either...
Anyway, as to insulin:
Insulin's job is not to store fat. Its job is really to respond to sugar concentrations in the blood, and one of its principal duties is to induce import of glucose into the cell. When there's a dietary influx of carbohydrates (like the chocolate chip cookies I've been working through), that's a signal that the 'fuel level' is high, and it's time to store it away for future use. On the one hand, insulin induces storage of carbohydrates as glycogen (particularly in the liver). On the other hand, when glycogen levels are adequate, insulin stimulation leads to synthesis of lipids. This is the trouble! Excess carbohydrate is going to be stored as fat... the simplest-to-grasp reason is that, calorie-for-calorie, fat takes up less space... fat doesn't have to be bathed in water, like carbohydrate polymers such as glyogen do... for this and other reasons, fat is a better energy storage medium. Also, the liver has limited glycogen storage capacity, whereas we have lots of adipocytes for storing fat distributed all over the body. There are other effects of insulin on gene expression, etc... In the end, insulin is part of a 'homeostasis system' that works to keep energy levels constant. Incidentally, that tendency towards homeostasis makes it hard to lose the weight we've gained.
So insulin is good! Import of carbohydrates is good! Storage of glycogen and lipids is good! Loss of sensitivity to insulin (and the resulting health problems including perhaps obesity and CHD) is most likely the result of difficulties that arise from chronic overingestion of calories (of carbohydrates perhaps most specifically, but of food in general) and concomitant underconsumption (use of) those calories in exercise.
As for the Western diet, I just wanted to say that indigenous American and Asian diets are not lacking in carbohydrates: those non-western cultures gave us corn and rice, after all! Again, my impression is that it's this over/under problem that leads to issues of obesity, and thence to the other problems... As for the refined carbohydrate thing, I tend to think of it like I do the high-fructose corn syrup thing. Fructose is fructose - it all goes into the same energy production pathway - the problem is the amount of it we ingest. All plant fuel storage carbohydrates are made of glucose, and glucose is what insulin causes to be imported into the cell, whether the grain has had the bran removed or not. We just need to eat less of them to avoid storing them as fats.
I guess I just wanted point out that it's not carbohydrates per se that lead to insulin dysfunction, but overconsumption of these and other foods. Our lives depend on carbohydrates. Too, I think (having not read the book) that statement about 'everything we believe about a healthy diet is wrong' could be a bit hyperbolic. What's really problematic, I tend to think, is the search for a diet 'Answer' other than moderate eating and exercise (this, from a fat, lazy hedonist).
The books may have covered all this stuff, and I'm just being a didact (in fact, I know I'm a didact, so f@$& me!). I have enjoyed your blog... and the Taube book's in our library, so I'll check it out... I hope you don't mind my note, though, and I won't mind if you tell me to piss off! I totally respect your quest... my own quest focuses on finding time to do anything resembling exercise. Hopefully you take or leave my input without getting to irritated with me!"

Meanwhile, here's an article from the LA Times that summarizes what I've read better than I ever could:

http://www.latimes.com/health/la-he-carbs-20101220,0,5464425.story

My Primal Inspiration

Here's a link to my friend Holly's blog: http://www.underdogdesign.net/wordpress/2010/09/10/an-archaeologist-goes-primal/
Also see her next post: Primal in Paris.
She's been on the low carb primal path for awhile and has more to say than I do, plus she's a more sophisticated writer, so you might enjoy checking out her blog as well.
Cheers!

Carbs are Bad

If you have ever tried to lose weight by counting calories or simply by eating less and exercising more, or if you have ever tried to lower your cholesterol by lowering your fat intake, or even if you have just wondered how the food you eat affects your health, boy do I have a reading list for you. These books were so compelling that I had to sign back in to Skinnymamasdontdiet for yet another round.

First of all, "Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health" by Gary Taubes was recommended by my friend Holly. The back of the book claims, "In this groundbreaking book, award-winning science writer Gary Taubes shows us that almost everything we believe about the nature of a healthy diet is wrong." This is not an over-reaching statement. Taubes is not a doctor or a dietician: he's a science writer, and he explores the history of the politics of the science of nutrition with journalistic doggedness. He doesn't seem to set out with a particular hypothesis to prove or disprove. In fact, he says he never expected to find what he found. In that way, it reminds me a bit of "The Omnivore's Dilemma": just a thorough exploration of food without pushing a particular agenda. And this book IS thorough: a good 450 page tome, full of science and history. Sound like a page turner? I admit, it did occasionally get tedious, but generally I found it so compelling that I couldn't put it down.

Basically what he discovers is that the last century of science doesn't actually support what we've been taught about diet: that the way to lose weight is to cut calories and exercise more, that the way to cut cholesterol is to cut your fat intake. It's actually carbohydrates that do the damage. Usually when people go on low fat diets, they compensate by adding carbs, actually doing more harm than good. I can't explain the science very well, but basically, carbs initiate an insulin response, and lots of carbs lead to hyperinsulinemia which leads to metabolic disorder which leads to cardiac problems, diabetes, obesity and maybe even cancer and Alzheimers. The whole theory that fat raises cholesterol which in turn increases risk for cardiac disease is not backed up by good science. The science says carbs, not fat, contribute to heart disease.

What's even more fascinating than the science of nutrition is why and how it's been kept from the public. The history of the politics around all this is bizarre and revealing. And the mis-information is perpetuated by doctors, dietitians and the government. It's become conventional wisdom. It's everywhere.

When I went on the low carb diet in 2008 my doctor warned against it, sincerely worried it would create other health problems. When my cholesterol was inching up a couple years later (a year or so after I'd stopped eating low carb), she sent me to a nutrition class that instructed me to eat a low fat diet. I like my doctor, but her recommendations are not supported by the science. Our whole mentality about diet and health is based on ideas that are not supported by science. Science says bacon and eggs for breakfast is as healthy as you can get. That chili and cheese egg souffle that is all egg and cheese and sour cream is GOOD for you. That bran muffin: not so much. That Jamba Juice protein smoothie: not so much. Big fat steak and a glass of red wine: help yourself! Sounds crazy, huh?

I know you don't believe me. You have to read the book. There is no way you won't be convinced if you do.
Now that I am paying attention to this, it's turning up all over the place: carbs make you produce insulin. Insulin's job is to store fat. In short, grain is bad for you. Sad, isn't it? Have you heard all the studies of the indigenous cultures that had little or no incidence of obesity, cancer or diabetes or other "diseases of civilization" until a Western diet was introduced? Then it all went to hell. What exactly was introduced with that Western diet that compromised health so dramatically? Carbohydrates.

Taubes isn't the only one who has come to this conclusion. The next book I read was "Life Without Bread: How a Low-Carbohydrate Diet Can Save Your Life" by Christian B. Allan, PhD, and Wolfgang Lutz, MD. The back of this book says, "Based on more than forty years of clinical research conducted on over 10,000 patients, this illuminating book unravels the mysteries of nutrition and shows how a low-carbohydrate diet high in healthy fats can reverse--and possibly cure--diabetes, heart disease, gastrointestinal disorders, and obesity, as well as boost strength and endurance." This book covers basically the same information as Taubes' book in half the number of pages. I found it much more tedious to read, however, although that may have been because I had just finished reading 450 pages of basically the same information. Also, these guys did their own research and set out to convey the results, ultimately recommending a 72 carbohydrate a day diet, so their book doesn't have the open minded sense of exhaustive exploration that Taubes presents. Still, it's a much quicker read, so it might be a good choice if you just want to understand how all this works.

Finally, I have to tell you about The Primal Blueprint by Mark Sisson. Don't be put off by the obnoxious cover: Mark and his wife have a Malibu Barbie and Ken look to them that I found off-putting, so I had to throw the cover away and just read the plain, black hardback without it. Because of that, I can't quote the back cover of this one. Both of the first two books I described make reference to our evolutionary history, but Sisson bases his whole approach on it. They all agree that we evolved as hunters and gatherers and have not caught up with the agricultural revolution yet. Our bodies are still meant to eat nuts and berries and fatty meat, not grain and dairy. Sisson has developed a whole "primal" lifestyle to offer his genes the best possible shot at giving him a long and healthy life. It seems to be working well for him so far! This book is a quick and easy read, but serious and well researched. Sisson tries to be cute sometimes, tries to write like he's chatting with a friend. I found it a little annoying, a little gimmicky, but it keeps the book from being dry and tedious. What I like about this book is that he does create a whole primal lifestyle, not just a diet, and he does it in a fun and realistic way. He acknowledges that we have to live in the real world in the 21st century, that we aren't, in fact, still hunters and gatherers. So he adapts his primal ideals to the real world, and he has fun doing it. He makes you WANT to be primal because he makes it look so fun and easy.

He also addresses the issue of exercise, and does so in a refreshing way. He talks about the perils of "chronic cardio" and suggests our bodies are meant to do low level cardio with occasional sprints and heavy lifting. Personally, I have already felt liberated by this model. (Tina B, if you are reading, this is the book for you!)
If you want more information about The Primal Blueprint without reading the book, check out Mark Sisson's website: www.marksdailyapple.com. Also, if you want another take on the same idea, Loren Cordain wrote The Paleo Diet. I haven't read it, but my impression is he has a stricter approach, more restrictive, less fun; plus he says no dairy! That crosses a line.

I have to thank my friend Holly for setting me on this path, and since she's way ahead of me on the journey, I think I'll ask her if she has anything to share on the matter. In the meantime, I find myself in the same place I was exactly three years ago: about to embark on the mission of lowering my carbohydrates. This time, however, it's not a diet for a year to lose 25 lbs. It's a lifelong nutrition choice based on solid research with the goal of living the longest, healthiest life I can. One thing Judith Beck said that stuck with me was something to the effect of, don't start a diet you can't stay on for the rest of your life. I know if I say I can never have a plate of pasta--or even a SANDWICH for goodness' sake--for the rest of my life, this will never work. So it's not all-or-nothing. It's a day-to-day, meal-to-meal choice about life and health. It's kind of exciting! I'll let you know how it goes!

Signing Off

Well, my faithful readers, I believe this is my last post. I have said everything I set out to say, and more. This whole thing is definitely a process, and I still have a big stack of books on my bedside table to read about these and related issues. Perhaps I will have some post scripts in the future, but for all intents and purposes, the I am writing today just to wrap things up.

I have enjoyed the journey of exploring all of these issues and writing this blog so much. I feel like I have some momentum, so I am wondering what will be next for me. I have thought of turning this work into a small book, or a workshop. Either one will require a better name, so please let me know if you have any suggestions!

I hope you have found something in this blog useful or inspirational or educational, and I am also wondering what is next for you. I would love to hear from you about both of these questions: what is next for me, what is next for you?

Please let me know if you’ve tried anything I’ve suggested, what’s been helpful, what hasn’t. I’m very curious about what works for others. I know for myself, the basic goal setting is key, however tedious. I know I need to go back and re-read the beginnings of my blog and follow my own advice. When I am really setting and tracking small and reasonable goals is when I see the most change. Some of those changes are permanent; some need maintenance. Just thinking “I should exercise and eat mindfully”

is not enough for me!

I’d also love to hear any other feedback and if you have any opinion about whether I should try this material in a different venue, and if so, what kind? What would be the most useful for the most people, do you think? Or should I just stop now and cut my losses?

Like I said, I have enjoyed writing this so much. The fact that ANYBODY read my blog at all is just such a bonus! I am very grateful to all of you who have spent some time at www.skinnymamasdontdiet.blogspot.com. Thank you for your time and interest, and may you carry on with mindfulness and motivation!

The Political Approach to Weight Management

Well, I have actually said all I had set out to say. My goal was to review the “three-legged stool” of weight management that I learned in my aforementioned class: eating, exercising and self care. So there you go.

But wait! There’s more!

Somewhere along the line, during the months of writing this blog, I saw the movie “Food, Inc.” Now I thought I was a pretty savvy shopper, a pretty “green” consumer and a pretty knowledgeable voter. Well I have to say, this movie taught me a thing or two! I mean I knew the Food Industrial Complex was evil; I just didn’t know how evil...

If you have never seen “Food, Inc.,” run right out and rent it. I’d go so far as to say it changed my life. At the very least, it significantly changed the way I think about food--which is a pretty basic element of life. It will offer you all kinds of information about food that you will wish you didn’t know, and you will curse me, but you will eat with informed consent. You will make wiser food purchases. You will be healthier, and so will the Earth. This is important!

I can’t begin to cover all the information in this movie or any of the books I’ve read since (which I will mention later), so let me just implore you to educate yourself about the food industry and pay attention to what you’re eating and where it comes from. Every choice you make about what to eat makes a political statement. Food is big business. It’s not just about what you put in your mouth: it’s about where your money goes. It’s not just about your own health, but the health of animals, farmers, the planet.

I was surprised to realize what a large movement there is toward “slow food,” sustainable farming and ethical eating. Some of it gets complicated. The “organic” movement has been so successful that the food industry has started to take notice of this quickly growing market, hence the new organic sections at Wal-mart (I’ve never been in a Wal-Mart, so this is hearsay!). This is referred to as “industrial organic.” With organics becoming big business, think of all the acres of agricultural land that is not being treated with pesticides: hoo-ray! BUT, big business has, of course, undermined the whole original concept of organic farming. “Organic” no longer encompasses all it used to. Organic beef does not mean grass-fed beef. Organic pork does not mean humanely-raised pork. Organic vegetables do not mean sustainably grown vegetables. Organic just means without pesticides, and that’s a good thing, but such a small part of the picture.

If you want a very thorough, comprehensive and fascinating account of all of the issues, read “Omnivore’s Dilemma.” I am still plodding through it myself. It’s very detailed, but it’s also sort of the bible of sustainable food. It’s author, Michael Pollan, is oft-quoted in “Food, Inc.”--which is like the “Omnivore’s Dilemma”’s cliff notes--and will be oft-quoted by the end of this post.

I’m also working through the book “Animal, Vegetable, Miracle” by beloved author Barbara Kingsolver. If you’re not familiar with it, it’s an account of her family’s one-year commitment to eating locally and seasonally. They move to a farm and eat only what they and their neighbors produce themselves. I was having a hard time reading it straight through, so now I’m reading it month by month, as it was written. Like “Omnivore’s Dilemma,” it’s very detailed, very informative and very well-written. It inspired me to try to eat as seasonally and locally as possible, although I’m not about to move my family to a farm to do it. (My day job isn’t quite as flexible as hers is!)

We can hardly grow anything edible up here in these sandhills, but I have begun frequenting the plethora of local farmers’ markets much more regularly and checking produce to see where it was grown before I buy it. I also bought three inspiring seasonal cookbooks. I’d never given much thought to seasonality before since you can pretty much get any food any time of year--but how does that happen? The average meal in the US travelled 1500 miles to reach its eater’s plate. If it’s not in season locally, then it must have come from somewhere far away.

Eating seasonally and locally is a great way to reduce your carbon footprint and our dependence on oil. Next time you’re fretting over the oil spill, stop and think about how much petroleum it took to get your lunch to you. According to Pollan, “The food industry burns nearly a fifth of all the petroleum consumed in the US (about as much as automobiles do.) Today it takes between seven and ten calories of fossil fuel energy to deliver one calorie of food energy to an American plate.” He says only a fifth of the total energy used to feed us is consumed on the farm; the rest is spent processing the food and moving it around.

It’s not just transportation though. It’s processing and packaging, too. This is where the term “organic” lulls you into a false sense of security. Here’s one more Pollan quote to make you stop and think the next time you reach for that pre-washed package of lettuce and think you’re a “green” consumer because it’s organic: “A one-pound box of pre-washed lettuce contains 80 calories of food energy....growing chilling, washing, packaging and transporting that box of organic salad to a plate on the East Coast takes more tan 4600 calories of fossil fuel energy, or 57 calories of fossil fuel energy for every calorie of food. (These figures would be about 4 percent higher if the salad were grown conventionally.)”

Often it comes down to a choice between organic and local/seasonal. At first I was very stumped by this, but the more I read, the more I opt for local. Since organics have become big business, the regulations to be certified are more demanding, difficult and expensive--and in some cases absurd--prohibitive for many small, independent farmers. But small farms are more likely to grow food in the original spirit of the organic movement--humanely and sustainably.

Let me quote Pollan one last time to sum this up: “ It would...be a mistake to assume that the word “organic” on a label automatically signifies healthfulness, especially when that label appears on heavily processed and long-distance foods that have probably had much of their nutritional value, not to mention flavor, beaten out of them long before they arrive on our tables.”

The more I learned about this, the more inspired and discouraged I got at the same time. I felt both empowered and overwhelmed by all the information. The fact is, we are part of a society that processes, packages and transports its food, and it’s pretty hard to get away from that. It’s just like when you vote: it’s challenging to get enough information to feel confident that you really always know what you’re voting for. And it’s almost as difficult to always know where you’re food comes from and how it was made and what that means. Thankfully, more and more information is available to us, but unless you’re Barbara Kingsolver, you’re probably going to have to compromise a little!

One book that helped me simplify all these issues into some practical decision making at the grocery (natural food, of course!) store, was a straightforward little book called “Sustainable Food,” (which I happened to purchase at said natural food store). Another book which takes a simple and practical approach is Mark Bittman’s “Food Matters.”

I was drawn to “Food Matters” because I’ve been a fan of Mark Bittman’s cookbooks. Apparently at some point in his foodie career, he ran across a report that said global livestock production is responsible for about one-fifth of all greenhouse gases--more than transportation. This apparently got his attention, and he started looking into all these issues for himself, coming to this conclusion: “...a simple lifestyle choice could help you lose weight, reduce your risk of many long-term or chronic diseases, save you real money, AND help stop global warming...”

Bittman develops this whole “Food Matters” approach as an ethical, non-diet way to lose weight. He recommends we eat more plants and fewer animals and minimize highly processed foods as much as possible. It’s that simple. (By the way, his book is full of recipes and menu suggestions if you’re looking for that kind of practical guidance here.”)

So you see, here we have the political approach to weight management. You’d thought I’d gotten off track, hadn’t you? But no, I just shifted to my own three-legged stool approach to weight management: practical, spiritual and political. Now I have covered it all.

Respect Your Butt

I've always had a pretty flat butt, and at some point in my 43 years, it became flat and saggy. Last time I caught a glimpse of it I was dismayed to find it is now flat, saggy and lumpy. Horrors. It's hard to love an ass like that. (Of course, it's all relative. I've seen worse!) Every once in awhile you might spot a smooth, round, perky butt, but the truth is, most butts aren't all that pretty. And why should they be? Really, why do we expect our butts to be cute? They are for sitting and shitting! Nothing cute about that.

I don't want to get too carried away, but you get the point, don't you? A body's job is to carry it's person through life. Some bodies do better than others, but they all do the best they can. Think about the miraculous complexity of a functioning body. Think of all the things that have to work right for a body to thrive. And on top of all that, we expect it to look just so? My, we are a demanding bunch.

It seems like most of us are in a constant battle with our bodies. We are quite critical, judgmental and demanding. It is as if our bodies were somehow separate from us, and somehow deliberately behaving badly (by doing such deplorable things as becoming saggy and lumpy) just to thwart us.

I think if we can take a more forgiving and appreciative tone with our bodies, if we can show a little respect, it might become easier and more natural to eat well and exercise. Although I cannot fully accept my body the way it is (I do want it to change a little, but my expectations are very realistic--I'm not trying to make it into something it's not.), I can certainly appreciate it. I respect it. I am grateful to it for carrying me through every day of my life. And that makes me want to take care of it.

For some people, this is a no-brainer, but if you are someone who is at battle with your body, it might be very helpful for you to try to adopt an Attitude of Gratitude (as they teach in my daughter's martial arts class).

So the next time you glimpse your back end and immediately start thinking mean and ugly thoughts, stop and show a little respect. Imagine what it would be like to go through life without your butt. Say thank you to your butt for doing what it does best. Be grateful to your body and take care of it so it can continue carrying you through your life as long as possible.

On Being Zennier

One day I was driving down Highway 9 feeling exceeding frumpy. Not just frumpy, but also fat and fatigued. I worked myself up into a snit of dissatisfaction. I wanted to go buy new clothes, as if that would help. Then I stopped and noticed what I was doing, and told myself, in a slightly rude tone, "You should be Zennier!" As in, if only I could have a more Zen approach to life I would not be in this snit, if only, if only. I laughed at the irony of my silly internal dialog. I was approaching Zen Buddhism with the same whiny graspingness that I was approaching the desire to go shopping as an antidote for my unfortunate frumpiness.

I rolled my eyes at myself and moved on to something a little more productive. The being Zennier was not bad advice in and of itself. What would it mean to let go of desire--like the desire to be thinner and better dressed and more energetic--and simply accept each moment, accept my body (and my wardrobe)? Try to imagine fully accepting your body, just as it is. I felt very strongly that there was something to this, that this might indeed be the key I'd been looking for, that maybe accepting your body just as it is would unlock it's capacity to change into what you really wanted it to be. What? I might have been on to something, but I was clearly missing something.

Plus, wasn't fully accepting my body what got me into this in the first place? While I was pregnant with my daughter, I decided to do something I'd never done before: trust my body. Well, what my body told me to do during my pregnancy was eat, and, especially, to eat hot fudge sundaes. I gained 50 pounds and birthed a 10 1/2 pound baby. I continued to eat with great gusto, but breastfeeding my giant baby allowed me to lose all the weight I'd gained. It was a happy time. Then her new little teeth started to rot, and her dentist recommended I wean her. Although my body wanted desperately to keep nursing, my milk was turning her perfect little teeth to dust, so I did what I was told. Unfortunately, no one told me to stop eating for two.

As I continued to find great pleasure in eating, I simply accepted my body as it grew and grew. I thought of all my training in feminism and the impact of the media on our body images and expectations, our ideas of beauty, and I chose to be what I thought was a good feminist and a good Buddhist and just accepted my growing body for what it was.

Well, needless to say, that approach turned out to be a little misguided. There was nothing wrong with striving toward feminism and Buddhism, to be sure, but I must have been going about it all the wrong way, because I ended up too fat to be happy or healthy. I still can't quite work it all out in my head. There's something about this deep acceptance that still feels compelling and important, but if you accept your body as it is, how do you motivate yourself to set goals and make changes to help your body be happier and healthier? I'm really stuck on this, and I'm hoping someone out there is a better Buddhist than I am and can shed some light on this conundrum. (I'm not even a Buddhist, so that makes this whole circular argument even more off track!) In the meantime, I'm reading a book called "The Zen of Eating," so perhaps that will guide me. I'll let you know when I get it all figured out!

A Few More Things to Say About Relaxation

When I wrote my last post, I have to admit, I was not practicing what I preach in any way. I wrote it standing up in the kitchen cooking bacon (organic, of course) for my daughter. I apologize for not giving you my full attention. I hated re-reading the post and finding typos. But I have to take the opportunities to write when and where I find them.

In my distraction, I left out a few essential points.

Chronic stress is so harmful to our minds in bodies in so many ways, one of which is it causes us to retain weight, which makes it particularly relevant for our discussion here. Something as simple as taking deep breaths can have a huge benefit. In our class they told the story of a patient who came in with cardiac problems, and they showed us the EKG printouts from before and after the patient practiced two minutes of deep breathing. Before, the heart rate was dangerously high, and after, it was within normal limits. Such a simple intervention.

I also forgot to point out how relaxation techniques give us opportunities to BE IN OUR BODIES. Many of us live our lives feeling very disconnected from our bodies. We may judge, abuse and criticize our bodies, but rarely do we fully occupy them. When doing any kind of relaxation exercise, try to intentionally experience being in each part of your body. Start by just feeling your scalp. How is your scalp doing? What does it feel like? Give it your full attention. Then work your way down.

I tried this during my commute recently and found the process a little disappointing because so many parts of my body were uncomfortable on my long car ride. Hmm, here is my nose, it feels a little stuffy. Here is my jaw which is clenched. Here is my parched throat. This is not so fun. I was reminded of that scene at the end of Raiders of the Lost Ark when Karen Allen's character challenges Indy: "Damnit, Jones, where DOESN'T it hurt?!" I also thought of my mom who has so many physical problems that an exercise like this might seem like pure torture to her. But, as I worked my way down, I was pleased to discover that my elbows and knees were not uncomfortable in any way. They felt perfectly fine. As I spent some time with them, they started feeling zippy. They almost tingled with their happy absence of discomfort. That cheered me up.

So try being in each part of your body, but you don't have to stop there. Try breathing into a specific part of your body. Try imagining a warm light bathing each part of your body in relaxing, healing energy. Experiment a little.

If you need a little guidance with this kind of thing, check out www.kimeronhardin.com. (Sorry, I failed in my attempt to make this a link.) Click on "pain and stress issues" and take a look at his CD: Drifting Downstream.

Relaxation, Visualization, Meditation

Believe it or not, I've been reading a lot of neurobiology lately. According to Bruce Lipton in The Biology of Belief, most of how we respond to our environment is based on how our neural pathways were laid out when we were children. The only way around that is to be extremely mindful so we don't automatically resort to unconscious responses, or to work directly with the unconscious mind to make adjustments in those neural pathways.

I truly don't know how much we can consciously communicate with our unconscious minds, but I like to give it my best effort. I have developed this visualization practice that is based on guided imagery, self-hypnosis concepts, conscious dreaming, and--I hate to admit it--The Secret. It's actually been very fun experimenting with all this. It's no panacea, that's for sure, but it can't do any harm, and it makes you feel good.

There are a million ways to do this, and it's a very personal process, but I'll tell you about some of the highlights of what I like to do.

I always start out with the Conscious Dreaming Technique of focusing on the very center point of my psyche and then expanding that out into "my happy place." Don't laugh at the "happy place" concept: all the insight, wisdom, motivation and guidance you need is available to you here. It's really pretty handy. In conscious dreaming the idea is to picture your own mind as if it were a beautiful and peaceful place. It took my awhile to settle on an image for this place. First it was sort of an exotic jungle, but the big leaves and humidity felt oppressive. Then it was a riverside, but I noticed I was just standing there watching the river (my life!) go by. Finally I settled on a botanical garden! Perfect.

When I've been led through guided visualizations in the past and asked to imagine a beautiful and peaceful place, the images were always much different than when I was given the Conscious Dreaming instruction to imagine my own mind as a place. Either way, this place must be, above all, a safe haven. I imagine that the images I create here are planted like seeds in the garden to grow into the reality of my life.

Try to engage all of your senses when you're imagining this place, then imagine yourself in it, yourself relaxed and radiant, with all your needs met. This alone can be a very rejuvinating process.

Most guided visualizations don't jump right into it like that but take you first through a relaxation process. The relaxation techniques are helpful in and of themselves. Most of them focus on the breath, and taking a moment to focus on your breath can totally shift the way you feel. I am breathing in. I am breathing out. Taking deep breaths, belly breathing, yogic breathing--all kinds of breathing--can help you relax, but simply attending to your breath without trying to control it is my favorite approach. You might do progressive muscle relaxation or visualize a warm, relaxing energy moving through your body.

Self hypnosis techniques take it even further in an attempt to get into a trance-like state of consciousness. It involved images of moving downward, deeper into yourself, by walking slowly down a flight of stair or floating slowly down to earth on a feather in a breeze--you get the idea--to arrive at your very center.

There are so many directions you can go from here, depending on your goals, but focusing specifically on weight loss, you might imagine yourself looking and feeling the way you want to look and feel. What does it look like and feel like to have lost the weight you want to lose? Picture it as if it has already happened. You might get a little more specific and imagine your fat cells shrinking, your metabolism speeding up to burn more fat and provide you with more energy. You might picture those clothes you've grown out of fitting comfortably again. You might picture yourself exercising and enjoying it. See yourself stopping eating when your body has had enough, putting down the fork, pushing away your plate, and feeling completely satisfied. I often spend a moment focusing on a very specific goal, i.e. the "ideal" weight I am working toward, and how my mind, body and spirit are all working together toward that goal.

You can use this process to promote health, relaxation, general well being. You can use it as a spiritual practice. You can call in mentors or guides, you can receive gifts, you can connect with your chi energy, you can have a conversation with your body. The possibilities are endless. I alternate between focusing on health and fitness and focusing on other aspects of what I want in my life.

It's important to always communicate with your unconscious with direct, positive statements in the present tense. ("I stop eating when my body has had enough," rather than "Don't overeat!" or "I will learn to stop overeating.") And it is supposed to help to finish by suggesting to yourself how you will feel when you complete the visualization. ("This sense of fulfillment and tranquility will stay with me throughout the day.") Personally, I like to end with a moment of gratitude. (There's quite a bit of chatter lately about the many benefits of practicing gratitude.)

I have a set of CDs that I ordered from Sounds True called "The Self-Hypnosis Diet." If you want to pursue this kind of thing but have a hard time getting started, that is a great resource, although I found the guy (can't think of his name at the moment) a little annoying. And I know the neurobiology is a little tangential, but if you're interested, see www.brucelipton.com, or even better, check out Dan Siegel, neurobiology guru. (His approach is all about INTEGRATION.)

Bruce Lipton says our beliefs affect us on a biological--a cellular--level, so I like to believe that doing this visualization practice can affect my beliefs in very basic and positive ways, and thus directly affect my body. Hey, it's worth a shot.

And not only neurobiology but almost every approach to wellness I've run across is promoting mindful meditation practice. Jon Kabat-Zin, the Mindfulness King, recommends 45 minutes a day, but anecdotally, 10 minutes is enough to reap some benefits. People who do it swear by it. I don't have the knowledge/experience or the patience at the moment to go into it, and there are so many resources available that could do it better justice than I could, so I will not elaborate on the process here, but let me just speculate that there is no way in the world that mindful meditation would not significantly support every single aspect of weight management that we have discussed. Or, I should say, in a direct, present and positive statement, mindful meditation supports every aspect of weight management.

Self Care for Weight Management

Let's start with basic emotional self care. What does it mean? In class they provided a "Self-Care Inventory" which was adapted from "Take Time for Your Life: A Personal Coach's 7-step Program for Creating the Life You Want" by Cheryl Richardson. Although it will take a little more work than going through a check list, I think it might be more useful to come up with your own inventory. Think hard about what in your life makes you happy or fulfilled or at peace, gives you energy or satisfaction or pleasure. Make a list of everything you can think of. Now--and this might be easier--list what drains you. Which list is longer?

What would it take to maximize the parts of your life that fulfill you and minimize those that drain you? Are there things you want to be doing to fulfill yourself that you are not doing? And what is keeping you from doing them? Or is it that you are just doing TOO MUCH and need to be doing less, even if what you're doing is satisfying on some level?

I am debating how much to go into this. I think it is so personal that it would almost undercut the spirit of this exploration to offer specific suggestions or examples. Just take some time to focus on it and see what comes up for you. Aha! There is the problem, huh? "Just take some time..." Just take some time to be mindful while you eat, and just take some time to exercise, and NOW WHAT? "Just" take some time to ponder self care, which, we can only assume, should lead to taking just a little more time to provide said self care? Ay yi yi.

Well, there it is. Whether the things in your life that you identify as "nourishing" are weekend hikes, volunteering, candlelit baths, or whatever else, they all require a little TIME. And ultimately, I think that's what self-care is: taking TIME for yourself to do your heart's desire...or, to do nothing at all.

I know a lot of my followers are working moms, and we may be among the worst at taking time for ourselves. It is a constant challenge. But you know the rap about putting on your own oxygen mask first, right? If you do not take care of yourself, how can you possibly keep up with taking care of everyone and everything else?

This is where the little inventory exercise comes in. Are there small ways you could begin to shift the fulfilling/draining balance? Like everything else we've been talking about, start small. Start experimenting with saying no to requests of your time. Find some little thing that has been nagging at you and address it. Find even a five minute block of time each day where you do only exactly what you want to do.

If the way you take care of yourself is by eating when you're not hungry, you really must spend some time with this issue. If you incorporate some kind of spiritual practice or ritual or body work into your day on a regular basis, say no easily, tend to feel radiant most of the time, have plenty of energy, sleep well and feel deeply in touch with your "true self," feel free to move on.

Part III: Can Weight Management Be a Spiritual Quest?

I have really been stalling with this last (or second to last?) section because I just can't fully wrap my brain around it. It's a little more nebulous than the approaches to food and exercise. I guess you'd have to say it's a SPIRITUAL approach to weight management. The thing is, ultimately I'm afraid it will lead to having to LET GO of the whole concept of "managing" one's weight. I can't be sure until I write it, but I can't help thinking I'm in over my head with this one.

It all started with the class I took having a "three-legged stool" approach, the third leg being self care. (The first two, I hope you got, were intuitive eating and exercise.) They always said that self care was just as important as the other two legs of weight management, but when I started thinking about writing this, I realized they never really explained why.

First, they taught stress management tools: progressive muscle relaxation, visualization, deep breathing and meditation. A lot of people over-eat when they're stressed, so this makes sense. Then they focused on emotional self care, which included doing a self-care inventory to identify "what's fueling you" and "what's draining you" and then writing a self care list to remind us of specific ways to care for ourselves. A lot of people eat for emotional reasons, so caring for our emotions makes sense too.

I will elaborate on all this later, but I want to take the whole concept a little further first. I just found the one paragraph in the class workbook that offers their explanation for encouraging self care:

"When we listen to and treat ourselves with respect, compassion and gentleness, it helps us remain committed or get back on track with our nutrition, fitness and stress management behavior goals. Self-Care is a way of living that helps us maintain personal balance, replenish energy and motivation, and grow as a person. It is not selfish to practice regular self-care."

This is getting closer.

In my field (social work), there is a lot of talk about self-care. It's something we are meant to practice ourselves as well as teach our clients. I get sick of hearing about it. It's a great idea, but it's beginning to sound trite and contrived to me. For example, one of the suggestion in our work book is: mail yourself cards of encouragement and appreciation. Oh please! That one just makes me want to cuss.

But, I tell myself, take a step back. It's not just about treating yourself to a pedicure once a month. It's not just taking deep breaths to avoid eating a bag of fried pork rinds. (What ARE those, anyway?) It is a way of living with deep self respect. If we can, as they recommended, "listen to and treat ourselves with respect, compassion and gentleness," won't it just come naturally to eat healthy food, listen to our bodies, be physically active?

I guess where I'm struggling is that this self-care idea is presented as a means to an end, a TOOL to use to help you lose weight. Sure, it can be helpful that way, but can't it be so much bigger than that?

Instead of thinking of self care as the third leg of the stool, think about what it would mean to fully and deeply respect your body and appreciate the life it gives you. What would it be like to mindfully inhabit your body in each moment? Would that change your whole relationship to food? To exercise? To the whole idea of "weight management"?

Working with all of these ideas has really taken on a life of its own. While I still wish for a thinner, more fit body, I also feel like I've sort of stumbled on to something much more important. This has become, in a sense, something of a spiritual quest for me.

So, I will go back and talk about some more specific ideas regarding self care. (I keep changing my mind about whether or not to hyphenate that. Sorry for the inconsistency.) I also have a lot to say about visualization in particular. Then there is a little Zen Buddhism to address. And I have to write a little something which I will entitle: Respect Your Butt. I might throw in a little neurobiology. And of course, everything always comes back to mindfulness. (Have you noticed that?)

There is so much fun still in store, so stay tuned! Right now, however, I'm going to go on a little run with with the dog before it rains again.

Take care.

Ways to Motivate Yourself

I've found a few things that have significantly increased my motivation to exercise regularly which I would like to share with you.

1. Buy a pedometer. This was the first thing that got me to really pay attention to my daily activity level. I have to thank Kaiser for this one. They sponsored a "Walk Across Italy" race at work. Last year they walked across Cancun and I thought the whole thing was pretty silly, but for some reason, this year I got into it. I was even a team captain! In teams of six, we all tracked how many steps we walked each day for six weeks with the goal of all our steps adding up to some huge number of miles which is the distance from the north to the south of Italy. Or something like that. Anyway, being accountable to my team members motivated me a lot, and I really enjoyed tracking my daily steps. I continued doing it for months on my own after the race was over. It really makes you very conscious of the level of activity you have built into your regular routine and makes you look for simple ways to increase it. It's fun to see what your average daily steps are and then see if you can increase that average by 10% each week. Or something like that.

2. Set goals. People scoff at the goal setting routine I proposed earlier, but it really worked well for me. What's your long term goal for your regular activity level? What would be a small, simple goal that could be achieved in the next week? What could you do in the next 24 hours to increase your regular activity? If I had set a specific goal for the week I was much more likely to actually get up and do some sit-ups or take a quick walk after lunch. It changed the conversations I had with myself when I was lying in bed in the morning. You can get up and meet your goal, or you can lie in bed and fail to meet your goal. Hmm. It was a matter of pride. It was a way to make myself accountable to myself. There's something about that proverbial gold star on the chart that still holds power. Like the pedometer, it's really fun and easy! Using a pedometer is a really easy way to set and track goals, too.

3. Sign up for a race/Exercise with friends. A week from today, I'm running my first 10K--my first race ever, really, and a trail race to boot! If you'd told me a year ago I'd run a 10K this year (or write a blog about weight management), I'd've called you crazy, but here I go. Ten women signed up together and we're renting a house for the weekend. It's something I'm really looking forward to. Four of us have been meeting once a week to train. I can't believe how much farther I can run with friends than by myself! And running on a trail is much more fun than on a treadmill. I've never been so motivated to exercise regularly in my entire life. It's actually fun! Plus it's a great excuse to spend an hour with my friends each week, which is as good for my health as the running is! I look for opportunities to run during the week and I'm disappointed when I don't find them. I actually miss running if I go for more than a few days without it. Don't get me wrong, I'm a naturally sedate person, and the actual running still feels like torture, but now I want to do it anyway! Agreeing to run a 10K with friends has changed my life! (Incidentally, it is this to which I attribute most of the gains on my self-assessment.)

4. Toys make it fun. We got a Wii Fit Plus for Christmas, and it is so much fun! It's not all cardio-driven, but any of it is better than sitting on the couch and watching TV. It's fun for the whole family! I also splurged and spend an extra $30 on a Nike-ipod set-up when I bought new trail running shoes for the race. There's a sensor in the shoe and a gadget you plug into your ipod when you run that tracks your time and distance. I haven't tried this yet, but I guess you can upload it to nike.com and track your training and do all kinds of fun things with it. I usually steer clear of things like this, but both of these have helped motivate me to MOVE MORE.

Do the Math

Even though I just suggested you don't embrace the idea that you "should" exercise to lose weight, I think it's important to know how it works. This is basic information that may be common knowledge, but I had to look it up.

A pound = 3500 calories, so if, for example, you wanted to lose a pound in a week, you'd have to burn 3500 calories or reduce your intake by 3500 calories, or some combination of the two. That's 500 calories a day. That's about 5 miles (about one hour) of running. (Running burns about 100 calories in 10 minutes; biking 80, brisk walking 50, regular walking 30.) Most of us are not going to start running 5 miles every day, but that's okay, because a pound a week is too ambitious. Try this idea instead: if you add 2000 steps (about one mile) to your daily routine, you'll burn 100 extra calories a day which is over 35,000 calories in a year which adds up to ten pounds.

I've also heard that weight training, while not burning as many calories as cardio, increases your average daily metabolic rate. Muscles burn more calories than fat, three times more according to one source I found on line. I also found a source that denied the whole idea, so who knows, but I like the idea that as I'm turning fat into muscle, I'm speeding up my metabolism.

Move Your Body

When I finally got some decent medical insurance, I went in for a check-up to confirm that I was perfectly healthy. The only advice my doctor gave me was, "Exercise, exercise, exercise!" At the time I was in my 20's and living in the City. I'd just sold my car because the only time I ever drove it was to look for a new parking space on street cleaning day. I walked everywhere. Even at work we would walk to visit our clients. The first time I went out with Matt we saw a play South of Market and ended up walking all the way home to Noe Valley, half way across the city. I was single and plenty of time to go to the gym after work. Exercise was built in to my life. I didn't even have to try.

Things are a little different now. I drive an hour to work. I drive to my patients' homes. I go back to the office and sit in front of a computer. I drive an hour home. By the time I finish with dinner, dishes, helping Quentin with homework, etc., I'm beat. When am I supposed to exercise? Sound familiar? I hear so many people say, "I know I need to exercise, but I just can't find the time." I've said it myself a million times. It's not as easy as it used to be to incorporate into the old routine.

Even writing about exercise is hard to fit in! I wrote this whole entry and a couple more in my head about two weeks ago and am just now finding a chance to sit down at the computer. Now I can't remember what I wanted to say!

Well I think it's just a choice we have to make. I can't tell you how many mornings I lay in bed arguing with myself about whether or not to get up and exercise. What a waste of my mind-time! You just have to decide it's something that is important to you.

I think the idea that we "should" exercise to help us lose weight carries a lot of the same dynamics as going on a diet. I think it's much more effective to choose to be more active for the joy of moving your body and for mental and physical health. And it just has to be a priority, a given, like brushing your teeth. Instead of trying to figure out how to fit exercise into your busy schedule, figure out how to fit your busy schedule around your exercise. (I have to give Judith Beck credit for that one.) Is everything else that fills up your day really that essential? Is it as important as maintaining your mental and physical health?

My fried Laurie says, "anything is better than nothing." Start where you are. See if you can add just a little bit more movement to your days. If you're not getting any exercise at all, start by stretching for five minutes once a week: certainly you can find five minutes. And if you can find five minutes on one day, you can probably find five minutes twice a week. And so on. Find something fun to do--it doesn't have to be drudgery. Dance in the kitchen while you're cooking. Put on some rocking music while you're cleaning the house. And the old stand-bys: take the stairs and park farther away. The more you move, the better you'll feel. Really: it's true!

Transitioning

I don't know about you, but I went on a Christmas tear! I ate all the chocolate I could get my hands on, and I did some excessive after-Christmas-sale on-line shopping: general over-consuming. Thank goodness for the New Year to put an end to all this holiday mania! With resolutions in place, I was ready to jump right back in to my new, healthy, balanced relationship with food and put an end to the grasping chocolate addiction and overall wantingness.

Along with eating mindfully and intuitively, I had decided to stop eating sugar altogether and cut down on the carbs. Hmm, that sounds suspiciously like a dieter's mentality, doesn't it? Stopping the binge in favor or restrictive eating? Can you guess how well that worked for me?

That first day back to work there was the goodbye potluck for one of my all time favorite co-workers--a sad occasion, worthy of a good meal--to which someone brought the most amazing donuts I have ever seen in my life. Then there was not one but two big boxes of those fabulous little hazelnut chocolate balls wrapped in gold foil. It would be no problem if I could eat just one or even two or three, but no! I took it upon myself to work through those boxes as quickly as possible so that we could all be done with them and move on! I was shocked when someone pointed out that they actually have whole hazelnuts in the middle: I had never noticed! I don't like hazelnuts! Boy was I relieved when they were all gone.

It was not the start to the new year I had pictured for myself.

Now, as I'm reminding myself of all the things I have learned in the last year, I am calming down and relaxing into a more normal eating pattern, and I'm noticing that since I started working with all of these ideas four months ago, I do eat very differently. I couldn't eat as much as I did 6 months ago if I tried! I get full quickly and actually feel satisfied. I appreciate my food more, and, excepting the chocolate binge, I want less of it. This is no crash diet, that's for sure! It is testing my patience as a weight loss tactic. But it is so much more than that.

OK, it was time to retake that self assessment. Remember that? It was four months after I had taken it the first time when I started the weight management class. On a scale of 1-10, my satisfaction with all the areas it addressed had averaged a 5 back in September. Now it's a 7. Wow! I am 20% more satisfied with basic and important aspects of my life and my health than I was 4 months ago! That's a 5% a month increase--a pretty good return.

So, I had my Christmas tear, but overall, I am on a good path and want to continue in that direction. It is, overall, very satisfying.

As we transition into a new year, I am also going to transition the focus of this blog from eating to exercising--part 2 of 3. (Part 3 is about self care, stress management, spirituality, that kind of thing, but we'll get to that later.) I have much less to say about exercising than I have about eating because, well, it's just not as complicated, but it is just as important.

One last little aside I have to include about mindful eating before I move on, though: I told my 7 year old daughter about the mindful eating exercise I described in my last post, and she proceeded to show me how it's done. She spent the next FORTY-FIVE minutes eating three small squares of a chocolate bar. She's my hero!