It’s been two months since my doctor asked me if I would like to meet with the in-house nutritionist. By the way, having an in-house nutritionist is absolutely brilliant. I’ve never known one to come into a general practice before! She is, however, only in the clinic twice a month…hence the loooooooooong wait time! Her name is Jennifer and she is fabulous.
I was with her for a whole hour. Her eyes lit up when I told her I was trying to eat slowly and only to 80% full. We talked about my tendency to comfort-binge eat (I just finished off a bag of Dare Fudge cookies last night as a matter of fact) and timing my meals. She also helped me come up with a few self-care activities to help with the whole “comfort” thing and lower my stress levels. We also came up with a few distraction activities to help me out when I want to eat all the things (but it isn’t time to eat quite yet.) And we talked about eating a before bed snack.
My first question to her was: “Should I eat breakfast even when I am not hungry?” And she said, “Yes!” In fact, it is the only time I should override my body’s hunger cues and eat within an hour of getting up. But, she recommended I eat my breakfast. Key word: Eat. I am to stop making my smoothies (or have them rarely) because, apparently, in rat studies, drinking your meal burns 30% fewer calories than chewing and swallowing the same meal. So, that makes me sad. (By the way, satiety has to do with how slowly I consume my shake….so as long as I drink my breakfast slowly, it will keep me just as satisfied as would eating the same meal in the same amount of time.)
Hunger and Meal Timing
I have trouble knowing whether I am hungry or not. For a while there, I ate only when I recognized my hunger cues. As I mentioned before, I was going without eating for many, many hours. But, that pattern of eating was not sustainable. 1) I never knew when I would be hungry which was hella inconvenient. 2) Sometimes, when I did eat, I would eat too quickly–and well over 80% full. The dietitian gave me a guideline: if I start thinking I may be hungry (which is usually me thinking about food, or, when I am home, heading for the kitchen) I can eat if it has been 4 to 6 hours since my last meal. If it hasn’t been at least four hours, I am to try one of these distraction techniques (she helped me come up with them):
- say the alphabet backwards
- do 5-10 minutes of housework
- do any of my self-care activities.
(I had a book out of the library which I want to take out again called 50 More Ways to Soothe Yourself Without Food, by Susan Albers. It’s full of these sorts of ideas.)
It is pretty safe to say that I am, by nature, high strung. When I was a kid, the other kids would tell me to “take a valium.” When we talked about my binge-comfort eating, Jennifer said the goal was not to clamp down on the behaviour–but to make it less likely to happen. The way to do that is to lower my overall level of stress–so that when things happened which caused even more stress, the tide wouldn’t rise quite as high as usual, and I wouldn’t go floating off head first straight into a family sized bag of potato chips. The path to less (overall) stress is indulging in relaxing activities I enjoy. We came up with:
- deep breathing
- 5-10 minutes of activity like dancing to music or walking outside
And then, Jennifer challenged me to do at least one of these every day. At least one, at least once a day.
She also made two further suggestions:
- Do not eat with distractions–in fact, she even encouraged me not to eat in the same spot where I use the computer (and do everything else.)
- Have a snack before bed.
As for the first, I think I’ll tackle it PN style and start with one meal (or snack) a day. And I’ll start in the smallest way possible–I’ll simply cover (or close) the computer to start. It will be just like the mindful meal challenge all over again–and that’s doable.
About the second–I don’t know. I guess I will have one if I’m hungry but not otherwise. It shocked me, actually. I’ve been reading so much about Intermittent Fasting for fighting Type II diabetes that the idea of introducing food to my system just before bed seems ludicrous.
She gave me an explanation involving my liver and glycogen (see the diagram above) and why fasting glucose numbers are higher in the morning than at any other time specifically because my liver is producing glycogen which circulates in my blood stream as glucose. Fundamentally, I didn’t understand this argument. Whether the glucose in my blood comes from eating food and digesting it–or from the glycogen in my liver–what does it matter? Insulin is still not doing its job–getting the glucose out of my bloodstream and into my cells. Anyway. It seems I have further research to do.
I am to meet with her again in six weeks–but of course, she’s fully booked. Still, I am thrilled to be able to consult with a nutritionist. I love having someone to discuss all of this stuff with. My daughter just shakes her head and says, “Mom, you’re such a geek.”