Tag Archive | Marc David

dear eaters

Recently, having taken the commuter bus to work, I walked past a low-income housing complex that is on the way to the Health Center from the bus stop. As I approached the complex, I saw two women standing on the sidewalk in front of the buildings. I would guess they were both in their sixties. One of them was blind and holding her white cane. The other stood very close to her, ready to guide her if necessary.

Bissau, Guinea-Bissau

I was quickly scurrying along, gauging my pace on my need to arrive at my office on time. As I only take the bus on occasion, I was aware that my mind was taking in very different impulses along this route than when I drive. As the two women came into view, I processed thoughts about the nature of their relationship, kindness, the burden of poverty coupled with blindness, and a reminder to myself to work on my gratitude list. Just as I was passing them, the blind woman said, “And I heard that sugar substitutes aren’t that good for you and that they make you crave more sugar.” The sighted woman replied, “Yes, I heard that too.” (Resources: Sweet Deception, Sweet Misery)

I often say that it does not take long in the course of my day for some nutrition-based message to filter into my consciousness. Yet, this was an unexpected source. By the time the women exchanged the two sentences my steps had already taken me just past them. For a split second, I thought to stop to engage them in a conversation, to inform them of my nutritional proficiency and expound on the topic of artificial sweeteners, affirming what they had heard. Instead, I felt my lips turn into a mild smile that was intended to be for them, but that neither would ever see.

I think I absorbed the experience as a quiet lesson that one never knows how or where new information flows. In this regard, it related to my own work of attempting to expand nutritional consciousness and yet not always knowing how or where my own or others’ efforts are reaching. I internally thanked the women and carried their story into my day–and referenced them as my teachers with some of my clients.

This story also has meaning for me as I come full cycle of having written this blog for two years–and as I contemplate beginning a third. Looking back, I see that I have written seventy-five posts on various nutrition-related issues. I see them as vignettes that describe the milieu that defines eating in this current and complicated time; the challenges that dictate and mutate our food culture and the experience of the real and humble people who eat in response and reaction to this environment. I hope others see them in this way too.

I often wonder if my stories have resonance and purpose and whether they are instructive. Or, if they need be. Many people out there are doing incredible work and informing in clear and beautiful ways on how to address and improve human nourishment. It is not infrequently that I have doubts about the service of my writings and if they justify the time they demand. Are my words flowing into any cracks and crevices that may be helping others that I may never know about? Or, as my wise friend Lisa Dungate, who writes Lion’s Whiskers suggests, if my writing serves to fulfill some need of personal expression, that is adequate as well. Sometimes I don’t know.

But here are a few things I do know:

Every day a small but real number of people from all over the globe are reading my blog. Thanks to the amazing stat collecting abilities of WordPress, I know that people from eighty-four countries have seen The Nutritionist’s Dilemma. Just yesterday I had readers from Poland, Bangladesh, India, Pakistan, and Saudi Arabia. People in Azerbaijan, Mauritius, Guinea-Bissau, Estonia, and Oman have crossed paths with my ideas as well.

My blog is listed in Healthy Living Blogs and I get some nice readers from that connection. This site offers a very vital community for people writing on many diverse topics devoted to health. I encourage anyone interested in writing and reading about these issues to visit and support the members of this site. I give thanks to Lindsey Janeiro and the staff at HLB for creating this exciting space and offering all the amazing opportunities that they do.

That my blog was also chosen by Marc David and the Institute for the Psychology of Eating as one of the Top 50 Emotional Eating Blogs of 2012. Check out #47. This was a big surprise and very exciting. It is particularly meaningful as Marc David’s work has been phenomenally inspirational to me on my own path. I have shared my feelings about the importance of Marc’s contributions in Three Good Mark(c)s.

And finally, that I have a circle of subscribers who do follow me and who offer words of kind support along with relevant insights of their own; as well as a few hundred clients a year who I am privileged to work with and who always inspire me with their courage and capacity for change.

So, though the anniversary date of my blog just happened to occur during one of the most intense of times–in the post-Superstorm Sandy and pre-election week; and, while my own dining room table was still littered with hurricane preparedness supplies and Halloween trappings; and my head swam with thoughts about health care reform and the millions affected by the storm for whom eating had suddenly taken on a new meaning regarding survival, I committed to continuing the blog that I had birthed into being one fall day, two years ago. For the occasion, I have dressed it up with a new decorative theme that I think is very nice and makes for a cleaner read. If you are a subscriber and usually receive my posts via email, do go to my home page to see its new threads. I hope you like it.

My commitment includes my decision to allow myself greater voice and visibility. In my tiny corner of the world, in the confined spaces of my offices, I bear witness to some big and powerful stories. If I can participate in the larger conversation and in turn can give expression to someone’s experience that may help others–then that can be a good thing. Who knows? Maybe a person standing on a sidewalk in Baku, Port Louis, Bissau, Tallinn or Muscan, or even in my own community will help carry the information or inspiration forward.

As always, comments, clicks on the like button, subscribing, sharing, stories, feedback, my plate haikus–and any suggestions for improving the quality, content or technological capacities of my work are greatly appreciated. No, let me amend that–deeply craved. Let me know you dropped by for a virtual cup of tea with me. Thanks.

In health, Elyn

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Julie’s My Plate

My Plate Haiku

Eat food

Mostly plants

Not too much.

by Michael (Pollan)

by the time i got back from woodstock

When last I left off in, By the Time I Got to Woodstock, I was chewing blissfully on arugula while practicing mindful eating in a cafe in Woodstock. Well, right after that little sweet outing, I began working with a new client who had recently had gastric bypass surgery–and so, since, the concept of mindful eating has taken on some new dimensions.

Holding someone’s hand as they enter into an entirely new relationship with food and eating relative to digestive restructuring is a fascinating and fragile task. Recognizing how many people are now undergoing these procedures, makes me realize this is a societal shift as profound as online dating. According to my quick search, more than 200,000 people in this country are undergoing some type of weight loss surgery in a year and the numbers are growing steadily.

My client had the Roux-en-Y procedure, which is currently the industry’s gold standard. It was one of the earliest procedures developed and ensures some of the best long-term success. It can now be done laparoscopically through small incisions in the abdomen thereby further decreasing complications and post-surgical discomfort. In the Roux-en-Y procedure, the stomach is stapled to create a smaller food pouch about the size of an egg and is then reattached to the small intestine further down, bypassing the upper portion. Most people who undergo the procedure lose pounds fast and furiously for the first few months and ultimately seem to shed about 65% of their excess weight–though this number can be higher as well. Additionally, serious medical conditions like diabetes, hypertension, sleep apnea and arthritis that plague this population significantly abate.

These surgeries and their aftermath, of course, entail some serious risk (including death) and have many profound physical, emotional and nutritional implications as well. However, highly remarkable are the changes in eating behaviors that these procedures both impose and demand. From the moment an individual awakens from the anesthetic stupor through the rest of their life, the relationship with food is forever changed. Some foods will be kissed a sad goodbye, while others will be reduced to tiny portions of their former selves. Sugary and fatty foods once-beloved will wreak severe and painful havoc on the altered innards; gas-forming foods will even more so make their presence known far and wide; proteins will demand front row seating at every meal and something as innocent as the skin on a tiny blueberry can pose a gigantic digestive problem. But, that is not all. Very big men and women will perforce be required to eat like little toddlers.

The refeeding path will wander from clear liquids to pureed foods and then to very carefully chosen solids. Liquids will be sipped slowly in frequent timed intervals throughout the day to prevent dehydration and they will not be taken at mealtimes. Bites will be teeny tiny, as teeny and tiny as a pencil eraser and sometimes tempted to the mouth on little baby utensils. Each mouthful will be so carefully chewed, quietly and consciously until fully emulsified. There is no room for feeding error as severe pain or vomiting easily can ensue. Portions per meal will be a mere quarter cup, then a half cup and eventually up to a one-cup maximum more or less for good. An ounce of food (or two tablespoons) will require about ten minutes to consume and a full one cup meal greater than an hour. Often fullness will set in before the meal is done.

I have turned to various readings lately to get a deeper appreciation of this extreme and tedious process from people who have experienced it– because it is difficult for me to fathom it on my own. I have taken to trying to eat one, just one, eraser sized bite per meal and to chew it consciously in some kind of solidarity with those who have chosen this path as a means to ameliorate years of physical and emotional pain. The decisions to undertake what these procedures required are not taken lightly.

Exploring this world more fully is challenging some of my own hesitancy regarding these procedures and I have been recalling my reactions to the bariatric conference I attended last fall and wrote about in How Can You Say No to a Brownie? Though there are at least two sides to every story, a recurring theme for many who have chosen weight loss surgery seems to be that despite all the attendant problems and adjustments–and there are many–eventually the new lifestyle is one that they become accustomed to and when the initial difficulties resolve–they feel so much better and have no regrets.

It is difficult but not impossible to imagine. But even in so considering the benefits, I have been struck by a certain irony. Is not the insistence or instruction of these procedures essentially mindful eating? Choosing food with care, approaching it respectfully, chewing it slowly, tasting it thoroughly and giving the body time to say enough and thank you–like I did with my meal in Woodstock? Interestingly, I just came upon an interesting clue regarding this.

Profound changes in body weight and metabolism resulting from RYGB cannot be explained by simple mechanical restriction or malabsorption. Changes in food intake after RYGB only partially account for the RYGB-induced weight loss, and there is no evidence of clinically significant malabsorption of calories contributing to weight loss. Thus, it appears RYGB affects weight loss by altering the physiology of weight regulation and eating behavior rather than by simple mechanical restriction or malabsorption.”*

Well, I am not positive, but I think that is what mindful eating does too. I don’t know what we will come to find when we look back at this period of extreme procedures for weight loss or review its long-term results. Surely, newer weight reduction methods will be developed that won’t be as invasive and extreme as those that are currently being employed. Hopefully, we will find a gentler solution, but, maybe we will come to realize that there has always been a simpler way.

What do you think?

For an enlightening understanding of the physiology of eating, check out Marc David’s book, The Slow Down Diet.

In health, Elyn

*Nicholas Stylopoulos, Nicholas, Hoppin, Alison G., Kaplan, Lee M (2009), “Roux-en-Y Gastric Bypass Enhances Energy Expenditure and Extends Lifespan in Diet-induced Obese Rats”, Obesity 17 10, 1839–1847. doi:10.1038/oby.2009.207

**It is actually amazing that I don’t write about Chico more. He really is the most remarkable cat as his large fan base can attest to. He does have some food and eating issues yet has actually lost weight through a diet, therapy and exercise program. He enjoys cantaloupe and cucumbers, takes walks with me and waits outside when I visit my neighborhood library. Here he is reading the Count of Monte Cristo upside down!

MyPlate Haiku

Food made joyfully

As a gift of time and self

Feeds body and soul.  Anne-Marie

attacking the causes of obesity, really?

I have been having what I suppose you could call a blog clog lately, or maybe a blogade. Lots of stuff and stories going around in the brain but they are experiencing a log jam while trying to get out in some type of orderly fashion.

Howard Johnson's Restaurant

Howard Johnson’s Restaurant

This seems to have started when Pete showed me a Jane Brody article from the New York Times a few weeks back called, “Attacking the Obesity Epidemic by First Figuring Out Its Cause”. I should probably just have considered it a moot subject and ignored it, but it wrapped its little serifs around me and wouldn’t let go. You mean we haven’t already figured this out? Apparently not. And, this is the missing piece that has still been feeding the epidemic so to speak?

According to Ms. Brody, an impressive team of experts spent the last two years investigating the big O and published their conclusions in a series of reports in The Lancet. I will assume that what she goes on to describe is a reflection of their findings and not a cover-up for some obscure but shocking discoveries that will remain hidden in a boring medical journal.

Apparently, the impressive experts determined that the demise of the following is responsible for the puddle of fat we now find ourselves in. From the 1940’s through the 1970’s more or less– the years that preceded the epidemic–we played, walked and biked more; watched less TV, ate meals prepared at home by moms who mainly did not work, ate out only for special events, downed mainly hot or cold cereal for breakfast, had fewer mass-produced convenience foods, and consumed fewer refined carbohydrates as well as fewer calories.

I will try to keep my cynicism to a minimum but remember I did warn you about this side of me in Diet for a Small Caterpillar. Maybe this is breaking news or perhaps fascinating ancient history to those born after those more svelte decades, but two years of research, really? Those impressive experts could have just come and asked me, or better yet could have paid me. I’d love to be a paid impressive expert. I was actually one of those referenced skinny, cereal eating, hop-scotching kids on a bike, who occasionally ate out at Howard Johnson’s with my family when my non-working mother was too tired to cook. Wait, how old are those exalted researchers, anyway?

With all due respect to Drs. Gortmaker and Swinburn, et al who were cited in the article– unless I am remiss for not reading the source material, this is superficial and obvious stuff. A lot has changed since that time and the changes have had many effects on the human experience besides causing obesity. I think it is myopic to put the attack and hence the shame and blame only on those walking around with the visible consequences of our societal shifts or imbalances. Many things have increased since the 1970s besides weight like divorce, cancer, childhood poverty, autism, learning disabilities, alcoholism, underage drinking, the perverse pursuit of thinness and high school dropout rates–and all carry a high cost as well–but these conditions are invisible in the rising tide of humanity. Still, even if we are to keep our attention just on the problem of obesity, one could identify other significant and more profound influences.

One of my impressive experts, Marc David, who I introduced previously in Three Good Mark(c)s, meaningfully and sensitively addresses this topic in his article, ‘A New Way to Lose Weight–Listen to It’. Moving beyond the easily observed poor food choices that plague us, he explores causes of the emotional hunger we face these days that propel people to overuse or abuse food. These are very important, and when personified, they are what present in my office every day–repressed feelings, unmet needs, self-doubt, chronic stress, disconnection from one’s body and loneliness.

These are associated as well with the larger cultural issues that he dares expose. These are not new, but the ramifications are coming to a head, perhaps similar to global warming. He speaks of a nation that has valued excess and overconsumption; a culture that values speed and ease; a world filled with fear, anxiety, and mistrust; and, a people separated from their spiritual source.

Though I don’t fit their demographic, I have come to enjoy reading the magazine, Outside. It is for those who live the active life–in a rather bold way–and is a tad less dry than The Lancet. In a recent issue, there was an article, Jamie Oliver Will Work 4 Food about renegade British chef, Jamie Oliver, who is sincerely trying to clean up our country’s food mess. I admire Oliver’s means and message. I share his penchant for crying. The author, Jeff Gordinier, describes the obstacles Oliver is facing here in America. He writes, “As one wag put it, Oliver “just doesn’t get the fact that excessive consumption is woven into our national DNA.” This concurs with some of what Marc David is saying.

If a lack of identifying causes is impeding solving the problem, then acknowledging our national and personal constitutional makeups is as important as looking at what we are eating for breakfast now, well, compared to in my day. Doing so would help to explain why we lay down reason in the feeding of ourselves and our children.

My own causative list would go even further. It implicates the usurping of the practice of medicine by the pharmaceutical industry, unethical corporate practices and the disempowerment of women in pregnancy and birth for starters. I’ll leave it there for now. As I’ve hopefully unclogged the blog, I will be able to pick up on those topics soon.

Stay posted. I promise that will be fun. And tell me what would be on your list.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

my plate

My Plate Haiku

Hunger tiptoes in

From bellies, hearts or minds

Feed me now she calls.

By, Eva

three good mark(c)s

Mark Bittman’s and my path have crossed at the library once again. In So, What’s the Dilemma?, I wrote about how the food writer, chef, and columnist threw his tome, “How to Cook Everything Vegetarian” in my way, blocking the entire 640-680 non-fiction aisle–just to get my attention. This time he was a little more subtle. He knew I needed something simpler for my new client, a 32-year-old guy who had been a vegetarian since his early teenage years, but despite his recent attainment of fatherhood was still eating like a teenager. His wife had called me frantically seeking help.

This time as I perused the library shelf looking for some inspiration, his similarly titled, How to Cook Everything: Vegetarian Cooking stuck out conspicuously from the other offerings. It was just what I was looking for. Weighing only about eight ounces with a mere 123 pages, I thought it would be the right serving size to present to the residual adolescent.

I was glad to see that Mark had my back. Not only did he help me with my client that day. His more recent work, Food Matters: A Guide to Conscious Eating (2008) and the follow-up companion piece, The Food Matters Cookbook: 500 Revolutionary Recipes for Better Living (2010) has helped to spread my message about personal health and the politics of food to a vast and appreciative audience. Through his books, NY Times column, and television appearances, he is raising awareness about global food issues while providing people with the ability to make a change–that tastes really good–right in their own kitchens. In his own words, he has committed himself for decades to “battling the ascendance of convenient processed food and a general decline in quality”  which has contributed to the big pickle we now find ourselves in.

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Mark Hyman and me 2019

While waiting to check out my books, I realized he is not the only Mark to have left his mark on me. The others are Dr. Mark Hyman and Marc David. I have not merely figuratively crossed paths with them. I have the pleasure of knowing them both.

I have literally sat in Mark Hyman’s bed–it was a long time ago. Back then, he was my college housemate and friend–a doe-eyed, gentle and sensitive spiritual seeker pursuing Asian Studies. Such interest and the influence of another housemate–a nutrition graduate student-led him to both medical school and the study of Chinese medicine. Today, he is one of the leading voices in the field of alternative medicine. Not only is he a deeply caring physician, but he is also a prolific writer and a leading proponent regarding the creation of a new health care paradigm.

Mark’s practice of medicine involves a whole systems approach described by a model called Functional Medicine, which includes nutrition and lifestyle support. Approaching health from this point of view and really understanding that food is medicine, changes the conversation I have with my clients every day. Presenting health care from this angle is challenging in the climate that defines our practice of medicine. We are programmed to be patients, essentially dependent on a pharmaceutical-based promise of healing. Though it is endemic on all levels, this thinking is especially entrenched in the low-income communities like the one where I serve, because options are not available and the stressors are exacerbated.

Every day I hear the pain and strain of being stuck in this prescribed role. People limp into my office with plastic bags filled with myriad medications. In spite of this, they still ache, they are often depressed, and they feel helpless and confused. But, I see the fire in their eyes and the longing in their souls as they suggest that they do not want to take an additional pill. Acknowledging that, I can remind them that they are capable of being an active participant in their own care and feeding. This is the consciousness shift that is happening through the work of people like Mark.

And then, there is Marc David,  a good friend of Mark Hyman. He is less well-known than the “k” Marks, but his message is phenomenally powerful and equally important. Marc is a nutritional psychologist, deeply learned in the areas of the physiology of eating, metabolism, and digestion. He is the founder of the Institute for the Psychology of Eating. His books, Nourishing Wisdom: A Mind-Body Approach to Nutrition and Well Being and The Slow Down Diet: Eating for Pleasure, Energy and Weight Loss are both revolutionary in their understanding of nutrition.

As most of the cultural chatter focuses on what we eat, Marc explores the more primal questions of who we are as eaters and why and how we eat. He writes that we can no longer separate the science of nutrition from the psychology of eating. I agree. His institute is training professionals to counsel from this perspective and his message is increasingly permeating the field. His ideas are very prescient and worthy to explore. He is a scientist, a Buddhist, a healer, and a wonderful writer–but as I once told him, I think he is mainly channeling his grandmother.

So, as I continue to walk among the eaters of the world, assisting where I can, I am glad to have these three good Mark (c) s beside me. These guys, along with some other wonderfully knowledgeable and visionary people are not only informing my work but are opening new doors to the understanding of human nourishment.

I’d be interested to know which piece of the nutritional puzzle you feel you most need to address, advance or heal your eating or health status. Is it informational, structural, shopping/cooking or emotional/behavioral support?

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

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Kripalu’s My Plate 

My Plate Haiku

Food made joyfully

As a gift of time and self

Feeds body and soul. by Anne Marie