Practical Mindful Eating

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Practical Mindful Eating

• Martha Illige, MD
• Rose Family Medicine
• 2007

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Brian Wansink, PhD

• The best diet is the one you dont know youre
  on.
• Why do we overeat food that doesnt even taste
  good?

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Mindful eating

• Dont mess with success
• Choose to eator not
• Have external markers
• Change setting
• Change plate/bowl/glass size
• Commit to three-content eating

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Known points

• No one believes it
• Experimental method

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Invisible cues

• Can you be tricked?
• How many food decisions do you make each day?
• 15
• 47
• 200
• Wansink Payne Daily Food Decisions and
  Estimation Biases 2006 Psychological Reports
• Wansink Sobel Hidden Persuaders and 200 Daily
  Decisions 2007 Environment and Behavior

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Signals and cues
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Evidence-based behavior

• Research labs
• The U of Illinois Hospitality Management Porgram
• The US Army Natick Labs
• The Cornell Food and Brand Lab
• The Penn State Department of Nutritional Science
• References

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Deprivation

• Bodies and brains fight against deprivation
• No one goes to bed skinny and wakes up fat
• Most people gain or lose weight so slowly they
  cant figure out how it happened
• Most people dont remember changing their eating
  or exercise patterns
• Sherwood et al Predictors of Weight Gain in the
  Pound of Prevention Study International J
  Obesity April 2000

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Margins

• Preventing weight gain in most people
• 100 calories/day
• 1 cola (140 cal)/day14 pounds/year
• 1 donut (420 cal)/day42 pounds/year
• 2,000 extra steps (1 mile)/day10 pounds/year
• Hill and Peters Environmental Contributions to
  the Obesity Epidemic Science 1998
• Hill et al Obesity and the environment Where do
  we go from here? Science 2003

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Okinawa and 20

• Eating until youre 80 full
• Hara hachi bu
• Dish out 20 less
• Eat food, not too much, mostly plants
• 20 more fruits and vegetables

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Mindfulness

• Im not hungry but Im going to eat this anyway

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External constraints

• Stomachs cant count
• We dont remember
• Benchmarks
• Daily weights
• Structured clothing
• Belt
• Tailored pants/skirts
• Comments/compliments from others
• Cheek hollows, muscle definition
• Stair climbing energy

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Volume (stomach POV)

• Volume trumps calories
• Clean plate/empty plate
• Speed
• Calorie underestimation
• Psychophysics
• 2 pounds-80 pounds
• 20 feet-200 feet
• As anything gets larger, we consistently
  underestimate worse and worse
• Rolls, The Volumetrics Eating Plan 2005

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Strategy

• See all you eat
• See it before
• Choose
• Preplate your choices
• See it during
• Keep bottles, cans, bones, crusts on the table

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Illusion

• Which line is longer?

• Which dot is bigger?

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Strategy

• Choose your table settings
• Observe variety
• Small boxes and packages
• Small plates and bowls
• Tall skinny glasses
• Leftovers signal too much made AND eaten

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The See-Food Diet

• Out of sight, out of mind
• In sight, in mind
• Make healthy food easier to see
• Make less healthy food harder to see
• The more hassle it is to eat, the less we eat

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Strategy

• Make overeating a hassle
• Repackage from large size boxes
• Leave serving dishes on the sideboard or in the
  kitchen
• Put tempting foods in a high cupboard or low
  drawer
• Snack only at the table and on a plate
• Eat before you shop and shop on the perimeter of
  the store (fresh foods)

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Scripts may be problems

• Get newspaper, pour cereal, eat until done
  reading
• Clean plate, keep eating until everyones done
• Get movie, popcorn, and soda (extra large!)
• Chat with dinner partners, take a roll, take
  another roll (what a funny story!) how many
  rolls was it now?
• Grab chocolates from bowl, grab chocolates from
  bowl, grab chocolates from bowl

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Dining companions

• One 35 more
• Three 75 more
• 7 96 more
• Weight can be inherited
• Weight can also be contagious

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Strategy

• Avoid dinner guests?
• Be mindful of the effects of companions

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Inanimate dining companions

• Habit
• Inattention
• Continued eating
• Atmosphere
• Stay longer calm music and dim lights
• Eat faster noisy and bright

• TV
• More TV more weight
• Less TV less weight
• Radio
• Reading
• Computers
• Driving

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Strategy

• Move or remove bread basket or chip dish
• Plan to eat half the meal and take half home
• Be aware of lingering in pleasant environment and
  ordering more drinks and courses
• Share dessert the best part is the first two
  bites
• Pick-Two rule appetizer, drink, dessert only
  two plus the main meal

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Research

• What causes overeating?
• Food
• TV, newspapers, radio, computers
• Friends
• Weather
• Color
• Name
• Label
• Expectation assimilation
• Confirmation bias

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Culture and presentation

• China, paper plate, napkin?
• Chocolate cake, Black Forest Belgian Chocolate
  Cake?
• French
• How the French invented culture
• We taste first with our eyes
• Japanese
• Katachi no aji the shape of the taste

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Strategy

• We taste what we expect to taste
• Use positive descriptor words for your cooking
• Homemade
• Traditional recipe
• Special
• Fix the atmosphere
• Attend to the table setting, sound, and lights

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Comfort foods

• Are comfort foods bad?
• What are they?
• Chips, ice cream, cookies, candy
• Pizza, noodles, soup, burgers, casseroles
• When do we eat them?
• Happy or sad mood?
• Gender differences
• Men feel pampered, taken care of
• Women hassle-free, effortless

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Hunger

• Physical
• Gradual
• Below the neck (growling stomach)
• Hours after a meal
• Goes away when full
• Eating leads to satisfaction

• Emotional
• Sudden
• Above the neck (craving, taste)
• Unrelated to time
• Persists despite full feelings
• Eating leads to shame

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Primacy and recency

• Is the first food you taste great or bad?
• Is the last food you taste great or bad?
• Do you save the best for last?
• Do you eat the best one first?
• Is there/was there competition for food?
• You can mindfully override old learning and
  tendencies

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Strategy

• Comfort foods are OK, whatever they are for you
• Dont deprive yourself and do eat small
  amounts
• Recondition your responses pair healthy food
  with positive events
• Celebrate with fruit and a little bit of ice
  cream
• Have one piece of great chocolate and a tall
  skinny glass of cold protein milk (skim!)

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Gatekeepers

• Who buys food?
• Who makes shopping lists?
• Who prepares meals?
• Local or distant?
• If you have no cookies in the cupboard, will you
  eat cookies?

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Strategy right-type variety

• Buy different foods
• Experiment with new recipes
• Try different ingredients (spices, vegetables)
• Take family to the grocery store and let them
  choose a healthy food to try
• Visit ethnic restaurants
• Smile when you eat!

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What is the right size?

• Soda
• 4, 8, 12, 16, 20, 32, 64 ounces?
• Muffin
• Mini, cupcake size, giant
• Candies
• 1, 5, 27?
• Pizza
• Slice, wedge, pie?
• What we make it!

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Strategy

• Bag snacks in a small baggie and put the rest
  away
• Half-plate each meal or snack
• ½ vegetables and fruits
• ½ protein and starch
• Avoid creating food as punishment or reward
• Dont have open-ended, un-ending, refillable
  servings of drink or food

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Politics and food cost How many calories can you
buy with 5?

• Soda
• Chips
• Processed meat
• Cheese

• Water
• Carrots
• Whole grain bread
• Hummus

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Strategy

• Beware the health halo
• Low-fatOK to eat more
• HealthyOK to load on the extras
• Think small
• Super-share, dont super-size
• Food as mindful enjoyment, not temptation and
  regret
• Eat better consistently small steps

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100 calorie margin

• Different margins for different folks
• Relevance is individual
• Motivation is unique

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Trade-offs and policies

• Food trade-offs
• I can eat X if I do Y small concessions
• I am in charge of my food decisions and I choose
  to raise the price of overeating
• Food policies
• Eat food, not too much, mostly plants
• Serve myself 20 less
• Eat only at the table with tableware
• No second helpings of starches
• Only half-size desserts, if I choose a dessert
• Half-plate meals half protein starch, half
  fruit vegetables

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Mindful eating

• Make 100 calorie changes each day
• 100 calories less eaten
• 100 calories more expended
• Change small behaviors in meals, snacks, parties,
  restaurants, while multi-tasking
• Use food trade-off and food policy choices
• Pick three easy, do-able, sustainable changes
  that dont entail sacrifice
• Make a checklist and track yourself

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Timing and numbers

• Stick with three changes
• Three is manageable
• Small changes
• Break an old habit and replace it with a good one
• One month for sustainability
• Hold ourselves accountable
• Daily
• Use external cues and benchmarks well

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Checklist grid

• Days across the top
• Three changes down the side
• 100-calorie changes each day
• 32 checks/monthabout a pound
• 28 consistent checksnew habit

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Strategy

• Rescript
• Distract before snacking, not during
• Eat only in the eating room
• Serve before starting dish out onto a plate
• Dont eat from the box or bag or serving bowl

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Rescripting

• Be the last person to start eating
• Pace to the slowest eater
• Leave some food on the plate as if youre still
  eating
• Pre-regulate decide how much to eat before the
  meal instead of during the meal

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External cues

• People family and friends
• Packages and containers
• Names and numbers
• Labels
• Color, scent, shape

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Bibliography

• Wansink Mindless Eating 2006
• Willcox et al The Okinawa Program 2001
• Capaldi Why We Eat What We Eat 1996
• Logue Psychology of Eating Drinking 2005
• Dweck Mindset 2007
• Kingsolver et al Animal, Vegetable, Miracle 2006
• Buford Heat 2006
• www.platemethod.com

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Remember that things do change