Tag Archives: intuitive eating

The Privilege of Intuitive Eating

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While my time working in food service was mostly limited to academic teaching restaurants and hospital cafeterias, I learned that some businesses monitor the food that customers leave on their plates and interpret the observations as feedback for what the patrons thought of their orders. The less food remaining, the more the customers enjoyed it, is the general theory. This summer, I thought about that each afternoon as we opened our daughter’s backpack to see what portions of her snacks and lunches returned home from camp unconsumed.

We packed her an array of snack options each day without any expectation that she would eat them all, but we wanted her to have choices so she could select something that sounded good to her. Sure enough, each day she ate at least one of the snacks, but lunches were a different story. Providing multiple snack options was easy because they were all shelf-stable items that required no preparation; if she did not feel like eating a particular snack one day, it could stay in her bag until a different day when she did. However, the lunch options she said she wanted were perishable and took time to prepare, so sending her off to camp each day with multiple lunch choices was impractical. Thus, when a lunch returned largely uneaten, that got our attention because it meant she did not have much of a meal. 

If she just was not hungry at lunchtime, that would be fine, but our concern was the possibility that she was hungry but did not want the packed food. So we tried a bunch of lunch options, all of which she said she wanted, only to see them return home virtually or literally untouched. Eventually, I realized and accepted that she simply was not very hungry come lunchtime, and it became sort of humorous that she would request a specific lunch option only to not eat it.

As I chuckled at her uneaten food, I reminded myself of our luck and good fortune, and how being able to practice intuitive eating is a privilege. We did not mind if food came back uneaten and went down the garbage disposal, but what if that was the extent of the food that we could afford, and the choice was either to eat it or go hungry? Over the years, I have met people in our community who experience food insecurity, kids who either eat their free school-supplied breakfasts and lunches or have nothing all day, and families who accept what the food pantries have to offer or deal with barren kitchens.

Intuitive eating is embedded with privilege. Going through the matching process to choose one food over others requires having options available. Choosing when to eat necessitates having enough autonomy to be able to make such a decision. Ceasing to eat when comfortably full demands confidence that another opportunity to eat will arise again soon. Any of these privileges go out the window, and so does intuitive eating, at least to an extent.

However, subtle opportunities might still exist to utilize our intuition even in times when privilege is sparse. Buying dried legumes in bulk can be a thrifty way of obtaining protein, and with the prices of each bean being so similar to each other, we could choose the one that we most enjoy. A small array of cheap spices can impart somewhat different flavors on the same food for more variety in tastes. Free school meals include choices, such as chocolate or unflavored milk, and possibly different entree options. Foods that are shelf stable or at least function well as leftovers can be finished later, thus reducing the pressure to eat past the point of comfortable fullness.

The extent to which each of us practices intuitive eating is based at least in part on our circumstances. The laugh I got out of seeing our daughter’s uneaten lunches come home each day was a privileged reaction, and someone in different shoes might understandably have a very different reaction.

“Salad is a girl food”

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Needham elementary school lunches have changed quite a bit in the decades since I was a student at Broadmeadow. Each morning, our teacher would collect cash from the kids who wanted to buy that day’s lunch, stuff it in a metal Band-Aid container, and send the money down to the cafeteria so the workers knew how many meals to prepare for lunch. My favorite days were when they served pizza rectangles or tuna salad sandwiches, but others – such as American Chop Suey day – I was very happy to have brought lunch from home.

Now 40 years later, the cash and Band-Aid container are long gone, as basic meals are free, and my daughter has a four-digit code she enters into a computer to pay for any supplemental food she wishes to purchase. The other significant change is that instead of offering just one meal choice as they did when I was a kid, the cafeteria now provides an array of options. The main meal varies day to day and includes chicken in various forms, cheese nachos, pastas, hot dogs, hamburgers, “breakfast” foods such as assorted cereals, and different styles of pizza. Students who are not psyched about a given day’s main meal can choose from alternative options, including bagels, soft pretzels, and sunflower seed butter and jelly sandwiches.

Our daughter says that over the course of the year, she had each of the alternative options at least once, except for one: the chicken Caesar salad. When I asked her if any of her classmates routinely got the salad, she rattled off five or six names, all of whom are girls. According to her, rarely would any male students get the salad. 

With this information in mind, I thought about cultural norms and how children learn expected gender roles and behaviors at such an early age. Since our daughter was in kindergarten, we have had to counter messages she has picked up, like science, math, and sports are for boys, but not girls. Add “salad is a girl food” to the list.

Then I remembered a lesson that I learned at the very beginning of my nutrition career: cultural norms vary between settings. My first job as a dietitian was a research position that had me traveling the country gathering data regarding elementary school lunches and eating behaviors. On a typical day, I left my hotel room early in the morning in order to get to the school as soon as it opened so I could observe the cafeteria staff’s process for preparing the day’s food from the very beginning. My job involved taking a detailed look at the foods and their nutrient profiles, documenting the school’s food environment – including photographing the cafeterias and any nutrition-related signage that may have existed – and observing the children as they ate their meals. 

The variations between locations were striking. In one Chicago suburb, eating vegetables was considered “uncool.” Because students were more likely to use veggies as ammunition for food fights rather than for consumption, cafeteria supervisors intercepted the kids exiting the lunch line and removed the vegetables from their trays before they sat down. I remember looking into a trash can and seeing thousands of peas that were served but never had a chance to be eaten. In contrast, I visited a Tennessee hill town where the school was trying to figure out what to do about students trying to eat too many vegetables from the self-serve salad bar. I watched the cashiers ring up students with one hand and pick vegetables off the trays with their other hand in order to keep portion sizes in line with system guidelines.  

Given the contrasts, one could reasonably argue that cultural norms regarding what, when, and how much to eat are not inherent to age or gender, but are rather externally created and imparted upon our children. “Salad is a girl food” – or at least it is here in Needham, where very young girls have already picked up said message – but the situation could be different. What would school lunch selections look like if we taught our children to base their eating decisions upon internal cues rather than external expectations?

To food journal, or not to food journal?

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Back in 1993, I was a high school runner with a warped understanding of nutrition, so much so that my parents sent me to a dietitian, who had me keep a brief food journal as part of our work. After analyzing my journal, she told me that I was not consuming enough fat (Hey, it was the 1990s, and being afraid of dietary fat was the in thing to do.), and we brainstormed ways in which I could increase my intake.

More than 30 years later, food journals remain commonplace in dietetic counseling, and tracking apps like MyFitnessPal have popularized and normalized the act of documenting one’s eating even outside of working with a dietitian. But just because we can does not mean we should. As with anything, keeping a food journal can offer benefits, as it did for 16-year-old me, but plenty of potential cons exist, which is why the vast majority of my patients never keep a food journal as part of our work.

For those of you who are unfamiliar with what food journals are, they typically involve the user recording what, when, and how much they have eaten. When I do suggest that a patient keep a food journal, it is usually for one of four reasons, the first of which is reassurance. Sometimes a patient wants to make sure their intake of a particular nutrient or food group is appropriate, and having objective data to point to – as opposed to solely my subjective opinion – helps to relieve their anxiety while also serving as a double check for me. Along those same lines, I have found that when people eat intuitively, their macronutrient intakes almost always fall within their estimated need ranges without them even trying to make that happen, and analyzing their food journals is a way to confirm this.

Other times, I might suggest a food journal in order to prove a point. The science of nutrition moves steadily at a glacial pace while the pop culture of nutrition is labile. Just as my predecessors spent a great deal of time teaching people like teenage me that dietary fat need not be feared, I am sometimes in the position of reeducating patients about what their nutrition needs actually are versus what social influencers have made them believe that they need. Some patients take my word for it when I tell them they are getting way more protein than they need, but other people need to see their food journal analysis showing that their protein intake is equivalent to what we would give to a third-degree burn victim fighting for survival in order for them to understand that TikTok and its ilk are questionable sources of nutrition information.

If someone’s medical condition makes us particularly interested in their intake of a particular nutrient or nutrients, a food journal can help us to take a focused look at their consumption. For example, if bone health is an issue, a food journal can enable us to better understand their calcium and vitamin D intakes.

The fourth reason that I might recommend a food journal is simply to get our foot in the door to discuss a particular subject. People have different communication and learning styles, which is totally fine. Some patients like to converse, ask questions, and share their own thoughts, while others do better with a data-driven approach. For the latter folks, sitting down together and looking at their food journal yields a more fruitful conversation than if we were just looking at each other.

Despite their upsides, food journals have their drawbacks, which is why I only end up recommending their usage to a small subset of my patients. One of my main concerns is the tendency for people to use food journals as a tool to be hard on themselves. Sometimes people rationalize that if they have to record an eating behavior of which they are ashamed, they will be motivated to change. The expectation, in other words, is that keeping a food journal will provide accountability, but in reality, I cannot remember a single instance of such an approach bringing about long-term behavior change or an improved relationship with food. The risk is that food journaling exacerbates feelings of shame and damages a relationship with food that is already fraught.

My second concern is that keeping a food journal can be a step in the wrong direction for people who are trying to redevelop their intuitive eating skills, which involves making decisions about what, when, and how much to eat based on one’s internal cues. In contrast to intuitive eating, tracking apps, points systems, and lists of foods to eat or avoid are all external systems that distance people from their intuitive eating cues. While food journaling has the potential to help with intuitive eating, as previously discussed, I have seen many instances in which they are more of a hindrance. Although I always explain to people that the estimated needs that I calculate for their intakes of various nutrients truly are merely estimates based on algorithms that are the best we have yet are still highly flawed, sometimes people have difficulty internalizing such nuance, especially if they have a history of an eating disorder or disordered eating. Put more simply, they view these estimated needs not as ballpark guidelines, but rather as rules of what they “should” be doing, and becoming an intuitive eater while holding onto such a belief is an uphill battle.

Related to my previous concern, keeping a food journal opens the door to getting too caught up in objective data. Numbers are cool – I have a degree in mathematics from Tufts, and I spent my first three years out of college working as an operations research analyst for the federal government – but we can lean on them too much. SMART goals have their place, but the further I get in my career as a dietitian, the less I believe that they belong in nutrition counseling, where subjective data carries more importance. The more that a given patient seems to care about numbers, the more cautious I am about recommending a food journal due to the risk of exacerbating what is already an overemphasis on the objective.

Lastly, keeping a food journal is hard work! The best practice is to record the foods eaten in real time, as trying to remember what one ate in the past increases the likelihood of mistakes, which means that the individual has to be willing to write down or input into a device the details of their eating at the time of consumption, which takes time and has the potential to be socially awkward. Recording the necessary level of detail – including product brands, produce varieties, quantities, and details of each component of a meal or snack – is tedious. Because of everything that goes into keeping a food journal, the most that I ever ask anybody to record is three days of eating, and even in this instance, the third day’s journal is typically sparser and vaguer than the preceding two. Food journaling is an exhausting endeavor, and if someone is unable and/or unwilling to put in the effort to go about it properly, the data could end up being virtually useless, meaning all their time and effort is for nothing.

Earlier, I briefly defined a food journal as one’s recording of what, when, and how much they have eaten because that is what they usually include, but sometimes they take on different forms. For example, a food journal could omit quantity but prompt the user to record data such as their hunger level at the start of the feeding, their fullness level at its conclusion, the environment in which they ate, their mental and/or physical state, and any noteworthy thoughts or feelings that arose before, during, or after the eating experience. Utilizing this latter type of food journal can sometimes – but not always – be a way of taking advantage of the upsides of food journaling while mitigating their downsides.

Looking back, I am grateful that my own dietitian suggested a food journal all those years ago, as it was a useful exercise for me to go through at that moment in time. Food journals have their place, but like any tool, sometimes they are better left in the toolbox.

We are all going to die!

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One of my patients, who has been working hard to refine their intuitive eating skills, recently asked me to explain the concept of gentle nutrition in general terms. Although I already wrote a piece about this topic just last year, I want to revisit it because I realize in hindsight that I failed to adequately emphasize a basic truth that is of upmost importance to remember: We are all going to die!

Yes, yes, eye roll, we are already aware of our mortality, but thinking about our demise can be so unpleasant that it can be easy to put to the side and ignore. As scary and sad as it can be to think about, sometimes we need to remind ourselves that no matter how fast and how far we run, death will always chase us down. Always. Unless we get hit by that proverbial bus or suffer some sort of other physical trauma, a health condition of some form will do us in. That’s just how it is.

While death is a certainty, how exactly it will happen will remain a mystery until it actually unfolds. Some smokers never develop lung cancer while some non-smokers do. Predictions, like weather forecasts, are still just guesses. Sometimes the weatherman calls for a 5% chance of precipitation and we get a downpour.

Of course our overall dietary pattern has some influence, albeit limited influence, over our health, but the impact of any single eating occasion is likely negligible. Unless the food blocks or closes our airway or somehow inflicts catastrophic injury to our gastrointestinal system, tonight’s dinner is not going to kill us, nor will it save us from our ultimate fate. Given that an elementary eat-this-not-that approach fails to account for our nuanced reality, how, then, are we supposed to make decisions about what, when, and how much to eat? This is where intuitive eating and gentle nutrition can help.

My patient gave me an example of a situation they found themselves in, and we talked through how one might approach it using intuitive eating and gentle nutrition, but I am going to tweak the specifics a bit for the sake of their privacy. My patient is reassessing their intake of red meat after reading an article linking such meat with colon cancer, which runs in their family. Furthermore, their go-to order at the local pizzeria is a steak and cheese sub. Should they be reducing their intake of red meat and perhaps be ordering something else, they questioned, or would that be running counter to intuitive eating?

My response began by reminding them that having a steak and cheese tonight will not kill them, nor will opting for a salad save them. We talked about using matching questions to help guide their food choice. If the matching process squarely lands on the steak and cheese, then yes, of course, go ahead and order it. On the other hand, if the criteria they identify are broader, they anticipate that they could take or leave the steak and cheese and be equally happy, and since reducing their intake of red meat is a goal they are trying to achieve, then opting for a different menu item probably makes the most sense. In essence, gentle nutrition utilizes medical nutrition therapy as a tiebreaker of sorts, not a driving factor.

Furthermore, we talked about increasing their options by considering items on the pizzeria’s menu that perhaps they had overlooked. In other words, the choice need not be binary between a steak and cheese sub or a garden salad, but also include a pizza with chicken and broccoli, a Greek salad with shrimp, or any of the other menu items that omit red meat.

During the course of our conversation, my patient realized that sometimes they order the steak and cheese by default, not because they necessarily have a craving for it, and that sometimes it leaves them with a stomach ache. This information is important to consider too. Sometimes their desire for the steak and cheese is so strong that it will feel worth risking a stomach ache, but other times the craving will be low enough that it will be overshadowed by wanting to feel good the rest of the night. Even more importantly, realizing and acknowledging that they sometimes make their ordering choice on autopilot offers an opportunity to make more conscious decisions going forward.

Hopefully, this addendum to the piece I wrote last year helps to clarify the concept of gentle nutrition. Perhaps, as I continue to think of better ways of explaining, you will see me release a third installment at some point. That is, if I live long enough to write it, and if you are still around to read it.

“Food Noise”

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Over the past year or so, a concept has been popping up on my radar: “Food Noise.” It seems like with the growing popularity of the newish weight loss/diabetes medications Ozempic, Wegovy and Mounjaro, there has been more discourse around how these drugs are getting rid of the “food noise” in many people’s brains. Anecdotally, most individuals who take higher doses of these medications report feeling “less obsessed” about food. In fact, they almost stop thinking about food altogether. For many of these folks, this comes as a welcome change, as previously their brains felt like they were constantly perseverating on food and on what, when, or how much they should or should not be eating. People describe feeling relieved to no longer be overly focused on food and the “noise” that their brains create around it.

On the surface, I can completely understand how getting rid of the “food noise” can come as a relief for so many people. Constantly thinking about food uses a lot of mental energy and can be exhausting. To be freed from these thoughts can feel like one is breaking out of diet prison. But, as a dietitian who helps folks with intuitive eating, I also have some concerns around this concept. A number of my patients who are on these prescriptions report having no hunger cues whatsoever, that they have to remind themselves to eat, and when they do, they do only want to eat a little and get full quickly. While this might seem like a dieter’s dream, it is in exact opposition to what our bodies were built to do. We are born as intuitive eaters from the start; babies are quite adept at communicating when they need nourishment. It is normal for us to experience hunger multiple times per day, and, in response, to fuel ourselves as the need arises. Hunger is a basic biological function that is vitally important for survival. When hunger cues are removed, we are at risk for undernourishment and malnutrition.

One of the ways that these weight loss/diabetes medications works is by slowing down our digestive process so food lingers longer in the stomach. Unsurprisingly, when our digestive system slows down, we feel less hungry and feel hungry less often, which results in eating less. This process also helps our body to improve its ability to manage its blood glucose. While smaller/moderate doses of these drugs have been shown to be helpful for those with type 2 diabetes to manage their blood sugar, doctors are now prescribing them in much larger doses to “aid in weight loss.” The higher the dose, the more likely it is that one will experience gastrointestinal side effects such as nausea, vomiting, diarrhea, cramping, and bloating, which in turn leads to a decrease in appetite and ensuing weight loss.

Is this (or any kind of intentional weight loss) healthy? I would argue not in the slightest. These drugs are basically making it easier for folks to underfeed their bodies. It makes food restriction tolerable. It can seemingly get rid of the “food noise,” but at what cost? As we have learned over the years, intentional weight loss, especially when it is rapid, takes a huge toll on one’s health and almost inevitably results in weight regain. Weight cycling is a risk factor for many health conditions that the medical community blames on weight, such as cardiovascular disease and metabolic disorders. While we do have plenty of research on these medications and their efficacy in managing type 2 diabetes, the research on using these medications for weight loss is much sparser and of shorter duration. In a way, these weight loss medications feel like the weight loss medications of the past (e.g., Phen-Fen in the 1990s), promising to be the “miracle cure” for so many struggling with weight issues, only to be eventually pulled from the market due to the serious health risks they inevitably cause.

I would argue that for those who are able to eat intuitively – listening to their bodies’ hunger and fullness cues, responding accordingly, and rejecting the diet messages we get constantly in our weight-obsessed culture – “food noise” is not really a thing. Many folks feel like they are “food addicts.” While I certainly want to validate someone’s feelings, the research we have at this point does not confirm that this is a real, physiological issue, such as substance addiction. Much of the “food addiction” research that is out there currently does not account for the subjects’ previous or current dieting behavior which has had a considerable effect. Restriction, whether it is mental or physical, begets food preoccupation.

When someone learns to listen to their body’s cues and feed oneself in accordance with these cues, and when one gives oneself unconditional permission to eat, food preoccupation lessens greatly and, in some cases, disappears. We are supposed to feel hungry several times per day; this is our body’s way of telling us we need fuel throughout the day. Our bodies are constantly giving us cues and feedback, but we are taught that our hunger cues are “wrong” and are not to be trusted.

I will be curious to see how those who are taking these medications will fare in the future, specifically around “food noise.” Many studies have shown that most people are unable to tolerate these medications for more than a couple of years (despite the medical community and drug companies saying that these drugs need to be taken for the rest of one’s life). And for those who continue with these medications, we have yet to see the long-term health effects that they will cause. My hope is that more and more people will come to realize that we do not need to be at war with our bodies and that listening to our bodies’ wisdom is the best course of action.

The Lingering Effect of Scarcity

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Cleaning up the house earlier this week, I came upon a bottle of hand sanitizer that was functionally empty, as the remaining liquid was too shallow for the pump to reach. If I had found it in 2019 or earlier, I would have dumped out the little bit of sanitizer and recycled the bottle without even considering any other option. But that was before COVID-19, before cleaning products became precious commodities, before I went from store to store in search of them only to find empty shelves, before opportunists were reselling them online for ten times their sticker prices, and before a friendly pharmacy clerk discreetly slipped me a pocket-sized bottle of sanitizer as though she was passing off a top-secret document in a spy movie.

After all of that, even four years later, no way could I bring myself to waste any amount of hand sanitizer. And really, that comes as no surprise. Several decades after the Great Depression, my grandparents still could not bring themselves to leave any food uneaten, so much so that they once finished Chinese food leftovers despite knowing that my brother and I had found a boiled insect in the rice.

As I was doing my best to transfer the remaining hand sanitizer to another bottle without spilling a drop, I thought about patients of mine who are still working to recover from food scarcity that ended many years ago. Remember, food scarcity has several etiologies, including famine, financial hardship, political blockades, food deserts, and limitations imposed by oneself or by someone else. Intellectually, we know the difference between going hungry because flooding destroyed this year’s crop and putting a cap on our eating because we are on a diet, but on a biological level, all our bodies know is that they are not getting what they need. When the restriction ends, we are driven to get as much as we can of what we missed for fear that another period of restriction will come.

The solution is indefinite abundance. The more we surround ourselves with food, especially ones that were previously restricted, and the more we reaffirm that we are done with self-imposed limitations, the more the drive to overconsume decreases. (Side note: Overeating can have several different roots. Here, I am referring specifically to overconsumption that comes from restriction.) If someone finds that a specific food is particularly a trigger, the stocking technique might be helpful.

Certainly, the concept of abundance entails a great deal of privilege, such as access to foods, money to buy them, and places to store them. Some of the factors that influence access are beyond our control. To the extent that we are able to give ourselves consistent and ongoing access to a wide variety of foods and pledge that the days of restricting ourselves are over and never to return, we help to curb the frenzied drive for more and more.

And of course it takes time, maybe even a long time, to shake scarcity’s impact. Understandably, we want to reach a more peaceful relationship with food sooner rather than later, but there is no way to rush the process. We just have to be patient, ride the wave of everything that comes up along the way, and continually remind ourselves that we will always do our best to maintain our access to hand sanitizer – I mean food – going forward.

“Why can’t I eat dessert all the time?”

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In our quest to find entertaining and educational television shows for our kindergartner, I stumbled across an animated show on Netflix called “Ask the StoryBots.” In each episode, a child asks a question of the StoryBots, and they try to answer it by traveling to different locations and talking with different “experts” or individuals who might have answers. Most of these questions are about the world we live in, such as “why is the sky blue?” and “how do ears hear?” and they are answered in an accessible way. My daughter and I have found most of the episodes funny, entertaining, and interesting, as the show uses lots of humor and catchy songs to educate its audience. The StoryBots themselves are cute and silly and full of boundless curiosity. And the show also has guest appearances from a number of recognizable celebrities, including Snoop Dogg, Zoe Saldana, and Jason Sudeikis, among others.

When I came across the title for episode 2 in Season 2, I automatically cringed a little bit: “Why Can’t I Eat Dessert All the Time?” Teaching kids, especially little ones, about nutrition can be a tricky thing to do. I remember when our daughter came home from preschool one day and told us that her teacher made her eat lunch in a certain way (i.e., sandwich and veggies first and then dessert), I knew that we would have to step in and explain our food philosophy. The teacher was open to our request to let Lorelai eat her lunch in any order she would like, thankfully. But as the days and weeks went by, we started hearing Lorelai talk about “good/healthy foods” and “bad/unhealthy foods,” phrases we never use in our home, and I knew that it was going to be an uphill battle to maintain her intuitive relationship with food and her body.

Lorelai and I immediately skipped over episode 2 of Season 2 because I was afraid that it would be just another fearmongering treatise on why sugar is bad for us. Later on, I watched the episode by myself, and while I did not find it as harmful as it could have been, it definitely was not ideal.

The StoryBots field a question from a young girl named Lilyn who asks them why she cannot just eat dessert all of the time, as she does not like other food. The StoryBots are stumped and tell Lilyn that they will find the answer to this question and get back to her. The first stop for the StoryBots is at a bakery to ask the baker (played by Christina Applegate) why we can’t eat dessert all of the time. In an attempt to answer the question, the baker rolls out a chalkboard filled with formulaic equations and organic chemistry and begins a very lengthy (and swiftly spoken) explanation, using complicated terms that a child most certainly could not understand. She tells them that “an excess of monosaccharides can have an inherently negative effect on everything from our teeth to our metabolism.” She also explains that given the standardized 2,000-calorie diet, “the ratio of calories to nutrients found within your average sugary sweets deviates significantly from what has come to be widely accepted healthy percentages for what one’s caloric intake should be derived from.” Not surprisingly, the StoryBots are confused and at a loss for words.

Obviously, there is a lot that I don’t love about this explanation, but I especially disliked the part about the standardized 2,000-calorie diet. As we know, the 2,000-calorie standardized diet was created as part of the Nutritional Labeling and Education Act in 1990 as a way of simplifying the nutrition label to make it easier to calculate percentages of daily values. 2,000 calories was settled on after the USDA surveyed men and women and asked them how many calories they ate in a day via self-report. Women reported eating between 1,600-2,200 calories per day while men reported taking in between 2,000-3,000 calories/day. So, using these calorie ranges, researchers decided on 2,000 as it was a “nice round number” that would be easy to use for calculations. That being said, 2,000 calories is an arbitrary amount as we truly do not know how many calories one “should” be eating each day. Some folks need much more and others need much less, and the factors that determine this are largely genetic.

As the StoryBots stare at the baker with utter confusion, Jake the Supreme Cupcake (a cupcake that is a “bad boy”) tells them that they can, in fact, eat dessert all of the time and invites them to join him on a journey. The group ends up at Tummy University, where Jake brings the StoryBots to the Alpha Kobbler Pie fraternity. There the partiers (sweets including cake, Twinkies, and gummy bears) are having a sugar rave and initiating new frat pledges, one of which is a piece of broccoli named Brock. Jake explains that the parties at this fraternity are the best because they are “packed with sugar, which gives you short bursts of energy.” All of the attendees are basically bouncing off the walls and acting “crazy,” which they attribute to being “full of sugar.” Brock finds himself at a ritual initiation called “The Dunk,” where pledges are dunked into chocolate, and he decides to bow out.

At the same time, one of the StoryBots, Bing, gets swept up in the rave and is goaded into chugging a two-liter bottle of soda. Brock warns the StoryBots that drinking a two- liter bottle of soda is bad as “it’s almost 100 times the amount of sugar you find in a carrot!” Terrified, the StoryBots try to stop Bing from drinking the soda, but they arrive too late and find him chugging away. Of course, directly after this, Bing starts acting “crazy” like the others, sliding down the stairs on a sled, doing a cannonball into a glass of soda, etc. The StoryBots look on in horror and ask Brock what they can do. He tells them that they will just have to wait as “sugar gives you lots of energy, but you crash and burn pretty quickly.” Almost immediately, the partiers run out of energy, and all of them have sugar hangovers.

The StoryBots end up leaving with Brock as they do not feel that they got their question answered. Brock also wants to find his place at Tummy University. The group runs into the campus police, who are “healthy fats” including avocado and fish. The police chastise Bing for eating too much sugar and are surprised to see Brock coming out of the rave. The police recommend that Brock speak with Dean Banana who is known to say “every food can make the body a better place.” The police then go on to explain that they are healthy fats that are good for protecting the cells in the body. On the way to finding Dean Banana, the group comes across the “Protein Gym,” where a large sweaty T-Bone steak runs over to the group. He has an Austrian accent (reminiscent of Arnold Schwarzenegger) and tells them that protein is needed for building big muscles, and he challenges them to lift heavy weights. Brock does not feel that this is a good fit for him either.

Next the group comes upon a group of foods (including a bowl of pasta, a loaf of bread, and a potato) lined up at the starting line of a track, getting ready to run a race. Brock tries racing with the group who explain that they are “packed with the good carbohydrates,” which give the body sustainable energy, unlike simple sugar. Brock is unable to keep up with the runners and ends up collapsing at the track and then waking up in a hospital bed at the campus medical center. The doctors are fruits and vegetables and introduce themselves as “vitamins and minerals” that “prevent people from getting sick, make the cells in the body strong, and strengthen the immune system.” The doctors share that Brock’s vitamin and mineral levels are “off the charts,” as he has tons of folate, vitamin C, potassium, and calcium, and they tell him that he would be a great fit at the medical center. Dean Banana shows up and confirms that Brock has found his place among the nutrients. He explains that “while a little bit of sugar tastes good,” it’s protein, healthy fats, complex carbohydrates, and vitamins and minerals that “make people strong, smart, and healthy.” The StoryBots believe that they have finally found the answer to their question and are excited to share it with Lilyn.

Overall, the episode is not completely terrible. It is amusing and interesting and provides some solid nutrition education. What I take issue with though is how the simple carbohydrates are portrayed as “naughty crazy partiers,” while the other nutrients are shows as the “good” ones. Young children have very binary thinking, and setting up this “good food/bad food” dichotomy is not necessarily helpful. The message that children will hear from this is that “good foods” such as protein, healthy fats, complex carbohydrates, and vitamins and minerals are to be put up on a pedestal while simple sugars make you sick. This also gives simple sugars the allure of the forbidden food and can result in children over-valuing these foods rather than just having a neutral place in the diet. Kids are naturally born with the ability to be intuitive eaters, and the more that we intervene and try to push them in the direction of “healthy” foods, away from “bad” foods and scare them about the consequences of eating said “bad” foods, the more likely that they will lose their ability to eat intuitively.

Aside from very general nutrition education, namely telling kids that eating a wide variety of foods will help their bodies grow and feel good, I don’t think that getting into the nitty-gritty of how protein, fat, and carbohydrates function is particularly helpful. In our diet-obsessed culture that demonizes sugar and is responsible for the “childhood obesity epidemic,” these types of messages around nutrition do more harm than good. If you do end up watching this episode with your child, please be sure to explain that sugar is not the enemy and that there is more to food than just the nutrients they contain. Food is about connection, tradition, history and pleasure, not just nutritional content.

Working With a Running Coach: Why I Started, Why I Stopped

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In February 2019, I had one of the best racing performances of my life. My finishing time was just shy of the personal record that I set 12 years earlier, and had I better understood the course, I think I could have beaten it. Despite my age and three surgeries in the preceding five years, I was still running close to my best. Then, for reasons that I still cannot completely identify, my running ability abruptly fell off a cliff.

Sometimes I have dreams in which I struggle to run, like I am knee-deep in molasses, and this struggle became real in the summer of 2019. My legs were not tired, nor were they sore, but they just would not go. It was the oddest feeling, and the best way I can describe it is to compare it to having a limb that has fallen asleep: There is nothing structurally wrong with it, but it just does not work as it should. One morning, Joanne watched from the front door as I slowly jogged down to the end of the block, stopped, threw my hands up in exasperation and frustration, and walked back home.

From the summer of 2019 to early 2023, my running rebounded to a small extent. My endurance returned but my speed did not when I ran another marathon in 2022. In fact, my speed continued to worsen over those years at a pace that getting older alone does not explain. Each time I had an inexplicably slow run, each one seemingly slower than the preceding outing, my confusion and frustration grew and began to morph into disgust. In the midst of these runs, sometimes I thought about stopping – not just that day’s workout, but giving up running entirely.

After hearing of my frustration, a generous friend gifted me three months with a running coach who works remotely with distance runners all around the world. During our first conversation, the coach offered his opinion that I was running too fast during most of my training runs. Running slower in order to run faster sounded counterintuitive, but I was willing to try his approach for a few reasons. One, the training approach I had been taking clearly was no longer working for me. Two, he had helped numerous runners – including my friend – dramatically improve their running, which gave me hope that he could do the same with me. Three, in my line of work, I am used to offering suggestions that seem counterproductive at first glance, such as stocking, so I know to keep an open mind.

The coach used the workout pattern that I was already following as a starting point, but he made some significant changes. He added an additional day of running per week, increased my mileage, and significantly slowed my pace. Even during my interval workouts, he wanted me to refrain from running as hard as I could.

He gave me a training plan to follow, and while the specifics varied from week to week, the overall pattern was the same. Tuesdays were interval workouts at the track, Thursdays were recovery runs, and Saturdays were long and slow jogs. At first, the workout’s distances and paces were easy for me to achieve, which gave me confidence that I would be able to keep up with the coach’s training plan, and I felt optimistic.

Then problems arose. While I never got injured under the coach’s watch, I began getting sick more often than I ever had in adulthood. The frequent illnesses were more correlation than causation, as I suspect they were mostly due to exposure to the germs that our daughter brings home from kindergarten. However, I was pushing myself too hard. Sure, my speeds were slower than what I would have run on my own, but I also pushed myself to achieve the workout goals even when I was overtired or otherwise not feeling up to it because skipping or modifying a prescribed workout felt like failure. Instead of sleeping relatively late on Saturday mornings, I was waking up and starting my runs in the dark in order to fit in the mileage before beginning daddy duty. Between the decreased sleep and pushing myself too hard in my training, I was wearing myself out.

Still, I kept going, as I was clinging to the hope that following the coach’s training plan would make me a better runner, just like he had done for others. A few months into our training plan, coach began to prescribe faster workouts. After running so slowly for so long though, the goal paces felt lightning quick, and I failed to achieve them. At the beginning of our work, I routinely returned home from my training runs feeling optimistic, happy, and proud that I was able to achieve the goals that coach set out for me, but soon failure became the norm. Before leaving my house for a training run, I looked at the prescribed workout knowing I would need a miracle to achieve the day’s goals. Instead of feeling positive, I felt guilty and ashamed, and I wondered what was wrong with me.

Coach and I ended up working together for somewhere around six or seven months before I called it quits. He is a super nice guy, an elite runner himself, and he has vast coaching experience, loads of knowledge, and a long list of runners he had helped, but I seemed to be some sort of outlier in that my body was not responding positively to his training plan. We seemed to be bumping up against whatever mysterious factors had eroded my running abilities in the first place.

As you have read through my story, I wonder if you have picked up on the common themes between my work with the running coach and diet culture: turning to someone who “looks the part” for guidance, optimism based on testimonials that may or may not be indicative of typical results, reliance on external prescriptions rather than internal cues, and self-blame in the face of failure. Ultimately, realizing these commonalities is why I stopped.

Now I take a similar approach to running that diet survivors do to eating. My body’s internal cues are the primary factors in the decisions I make regarding when, how far, and how fast to run. Instead of focusing on my slow speed and feeling frustrated about it, I am working on accepting that all bodies change over time and the amount of control that I have over mine is limited. These days, I try to approach my running with a spirit of enjoyment and adventure, a fun and relaxing way to be outside, and feeling proud about covering ground on my own two feet – even if they do move much slower than they once did.

Prep

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At the beginning of this month, I had my very first preventive colonoscopy. For those of you in your mid-40s and over, you may know that the procedure is now being recommended at the age of 45 (previously it was age 50) to screen for colon cancer and other bowel issues. So when I turned 45 earlier this year, I booked my colonoscopy for this fall and thought it would be “no big deal.” But as the months went by and the procedure day drew nearer, I found myself getting more and more stressed about it.

I was not feeling anxious about the actual procedure itself because people I had spoken to who had had one told me that it is the easiest part. I was more distressed about the prep for the procedure. I knew that for several days prior, I would need to be on a “low residue” diet (basically low fiber), and then on the day before, I could only have clear liquids (but no red, purple, or blue).

I’ve been eating intuitively for over a decade and have not restricted or changed what I have eaten during that time other than while fasting for blood labs. Even though I knew the low residue diet was important for the procedure, it still filled me with dread, and honestly, I felt quite depressed. I found myself becoming preoccupied with what I “could” or “could not” eat. I obsessively looked at the lists of foods to avoid, and I felt such sadness. Despite the fact that now I was supposed to be eating foods lower in fiber (no seeds, nuts, beans, whole grains, or high fiber fruits and vegetables), it felt reminiscent of my dieting days.

Interestingly, I also found myself eating past the point of fullness more often during this time. It felt like I was having my “last supper” before the prep day, as I knew I would not have solid food for over 24 hours. Even though I rationally knew that food deprivation almost always leads to food preoccupation, I was still surprised at how difficult it felt.

The day of the “prep” was the worst day by far. I had stocked up on Jell-O, tea, apple juice, and vegetable broth, but it was (not surprisingly) completely unsatisfying. On the tip of a friend, I learned that I could also have gummy bears and Jolly Ranchers (just not the red, purple, or blue ones) as they liquify at body temperature, so I had some of those as well. Overall, I was a cranky, hangry person, and all I wanted to do was isolate.

By the time I started drinking the liquid laxative that early evening, I was pretty miserable. I will not go into the details of this part other than to say that I spent a lot of time in the bathroom that night and in the wee hours of the morning.

Luckily, I had booked the colonoscopy for first thing in the morning, which meant that I would be done with it all sooner. And, as advertised, the procedure itself was quick, easy, and painless (I was thankfully asleep for it all.) Of course, I was thrilled to hear that my colonoscopy results were excellent, with no areas of concern, and I will not need to get another one for 10 years.

Once I was able to eat normally again, I quickly noticed that my food preoccupation subsided, and I started feeling more relaxed around food. I was no longer a cranky, hangry mess and was able to eat in tune with my body’s cues.

I am very grateful that my procedure went well. And despite the discomfort, stress, and anxiety I felt during the days prior, I am glad that I had this experience. It reminded me that I never want to go through the restriction/food obsession cycle of dieting again. And it also reminded me that my body is amazing and always trying to protect me – that survival instinct is no joke! My advice to those of you who will be getting a colonoscopy? Take off the day before, make sure you have plenty of supplies at the ready, and remember that this too shall pass.

The End Is Near!

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Seven years ago, when I saw Chic in concert for the first time, Nile Rodgers used the interlude in one of their songs as an opportunity to tell the crowd about his recent cancer battle, which he ultimately won. The songwriter and producer explained that receiving the news inspired him to go on a music-making binge, as he figured he only had a short window of time left to express his art.

Earlier today, as I was driving home from the beach with our daughter, that memory crossed my mind. Since she will soon be restarting school, we have been trying to cram in as many daddy-daughter activities and outings – the Museum of Science, the Butterfly Place, farms, the zoo, fruit picking, restaurants, train rides, the aforementioned beach, etc. – as we can before the start of the school year interferes and forces these bonding experiences from frequent occasions to relative rarities. Before we have even left the parking lot of one activity, I am already thinking about the next one and all of the others that I hope to shove into our remaining time before it runs out. We have fun, but part of me is distracted, anxious, and sad as I think about the end.

Deadlines have their upsides because they can push us to accomplish tasks and achieve goals that might otherwise remain unfulfilled, but they bring with them stress and general feelings of unease that detract from the experience.

Life-threatening illnesses and the school calendar are examples of deadlines imposed upon us, realities that we just have to do our best to roll with, but sometimes we needlessly impose deadlines upon ourselves. A person who wants to get married by a certain age may settle because the timing is right even though the partner is wrong. Someone I know recently spent a hot summer evening in the emergency room with heat exhaustion and dehydration because they stubbornly kept hacking away at a tree they really wanted to cut down before dinnertime rather than conceding they should take an additional day to complete the project. When we were adolescents, a friend of mine wanted to bench press a particular weight before a school dance, and he ended up having to fight to free himself as the much-too-heavy bar laid across his chest.

Because this is a nutrition blog, I am of course thinking about the predicaments we can put ourselves and our relationships with food in due to self-imposed deadlines. An obvious example is the melancholy and frantic overconsumption that precedes a scheduled diet. Trying to lose weight before a wedding or another similar function is a common – yet problematic – behavior that is most likely to result in eventual weight gain and increased risk for developing a wide range of health woes. Someone I know severely dehydrated himself on his birthday and spent much of it at the gym because he had set a goal to be at a particular weight by his new age, and while he did survive and recover, he put himself in a dangerous situation for the sake of an arbitrary goal.

Imagine what these scenarios could look like instead without the needless deadlines. No diet on the horizon could mean more peaceful and intuitive eating without the threat of self-imposed food insecurity looming. Foregoing an attempt to lose weight before an event reduces the chances of harmful and discouraging weight cycling and creates space for the person to focus their time and attention on the big day itself and to go into it full of energy instead of depleted. Personally, I can think of more fun ways to spend a birthday than sweating out as much fluid as possible on an elliptical machine.

Time and opportunities are finite resources, and while we never know when they will run out, we can make life easier for ourselves by leaving self-imposed deadlines in the past.