Is washing dishes stopping you from preparing food?

     Many people are reluctant to cook or prepare food because of the dirty dishes that will result. Some people are very busy and don't have time for another task, and other people find that they continuously put off washing the dishes, and the dishes just pile up. Here are a few tips. 

• Use disposable cutlery and containers for packing your food for lunch or work
• prepare one-pot or one-pan meals to limit the amount of dishes you need to wash
• Cook in disposable pans and throw them away when you are done cooking
• Line washable pans with parchment paper to limit the mess and make washing them easier
• When you use pots or pans, immediately soak them in the sink to make cleaning them easier when you do get around to it
• fill a dish basin with soapy water and add your dirty dishes and silverware to it after eating so they can soak and make washing them easier

Tips for healthy eating with executive functioning challenges

• Have the same structure for dinner every week. For example, Sunday is pizza, Monday is chicken, Tuesday is fish, Wednesday is pasta, Thursday is ground beef, Friday is vegetarian, and Saturday is beef.
• Choose simple recipes. For example, chicken, beef, or fish topped with a store-bought seasoning mix or jarred marinade or  and baked. 
• Make partially prepared foods a part of your meal routine. For example, use frozen vegetables or instant/quick-cook grain mixes as sides. 
• Prepare breakfast the night before to be grabbed on your way out in the morning. For example, add the ingredients for overnight oats to a container or spoon yogurt or cottage cheese and fruit into a container. Put a spoon on top of the container in the fridge to have one less thing to remember in the morning. 
• You don't need to eat "breakfast foods" for breakfast or "dinner foods" for dinner. Do what works for you. For example, scrambled eggs and whole wheat toast can be dinner or leftover chicken and rice can be a filling breakfast. 

Executive function and nutrition

    Meal planning can be a challenge for people with executive function issues. Executive function is a set of mental skills that help us to plan, focus, remember, and organize. It involves the ability to control our thoughts and actions in order to achieve our goals. When we have difficulty with executive function, it can be hard to make decisions, stay focused, and follow through on tasks. This can make meal planning a daunting task.

Here are some tips for meal planning for people with executive function issues:

• Simplify your meals. The simpler your meals are, the easier they will be to plan and prepare. Choose recipes that have few ingredients and steps.
• Plan ahead. Try to plan your meals for the week in advance. This will help you to stay on track and avoid making last-minute decisions.
• Use a meal planner. There are many different meal planning tools available, both online and in print. A meal planner can help you to keep track of your recipes, ingredients, and grocery lists.
• Delegate tasks. If you have family members or friends who are willing to help, delegate some of the meal planning tasks to them. This could include grocery shopping, cooking, or cleaning up.
• Don't be afraid to ask for help. If you are struggling with meal planning, don't be afraid to ask for help from a friend, family member, or professional. There are many resources available to help you.

It is important to remember that everyone is different and what works for one person may not work for another. Experiment with different strategies and find what works best for you. With a little effort, you can meal plan successfully even if you have executive function issues.

What is the best food for weight loss?

     I often hear this question. I've been a dietitian for about 8 years, and I don't know the answer. End of post.

    Ok, I'll give you a bit more. There is no good answer to this question. In the research literature, there are many foods that are found to be associated with a lower body weight, but when we look studies that are trying to determine a cause and effect relationship, those foods are unclear or nonexistent. In short, there is no food that is known to cause weight loss, when all other factors are equal. 

    Honestly, the issue is really with what is behind the question, not the lack of answer. There are two problems. First, there is rarely a quick, simple, one factor answer any health concern. Second, this question insinuates that weight loss is the outcome to be looking for. Some more useful questions to ask are: 

• What types of foods will keep me feeling satiated while helping me maintain blood sugars in my goal range? 
• What types of foods can assist in improving my blood pressure? 
• How can I eat to lower my risk of heart problems?
• Are there any foods that can help prevent my kidney disease from getting worse?
• Why am I unsatisfied with how I look? What societal pressures cause me to be preoccupied with my weight?
• Given that there are factors that I can't change about myself, what can I do or focus on to feel good about myself? 
• Am I pushing off experiences until I reach a certain size? Can I pursue those experiences now?
• Do people around me make disparaging comments about my looks? Who of my friends are kind to me? Can I pursue those relationships more?

    Now, if after a thoughtful conversation with your healthcare provider, the two of you conclude that your weight is impacting your health, and you decide you would like to treat this medical concern, just know, that diet is not the only treatment of choice. Perhaps it is not even a treatment at all. 

Why does my weight fluctuate?

     Many of my patients are concerned and confused by day to day fluctuations in their weight. They wonder how they gained so much weight in one day. They wonder if their scale is broken. They wonder if this happens when they eat "badly." 

    Let's review some information. If you drink two cups of water, you will weight about one pound more. An average-sized meal weighs about one pound, so you will weight one pound more after the meal than you did before the meal. A bowel movement can weight one pound, so you will weight less after using the restroom. Many people lose one pound of sweat from a one hour run, so the pound of weight lost from that workout is from the sweat. In short, there are many normal bodily functions and activities that can account for day to day weight changes. 

    In general, daily weights can be exasperating for most people. Besides for some very specific medical reasons, it is not necessary for people to weight themselves daily. Many people would even benefit from rarely or never weighing themselves. Because our body uses many functions to maintain our health, our weight can shift from one day to the next. 

Triggers of binge eating

    Binge eating is a serious eating disorder characterized by episodes of eating large amounts of food in a short period of time, while feeling out of control and unable to stop. Binge eating can be triggered by a variety of factors, including:

• Emotional distress: Binge eating is often triggered by negative emotions, such as stress, anxiety, depression, or boredom.
• Dieting: Dieting can lead to binge eating in a number of ways. First, dieting can create feelings of deprivation and hunger, which can make it more likely to binge eat. Second, dieting can lead to feelings of shame and guilt, which can also trigger binge eating.
• Lack of self-esteem: People with low self-esteem may be more likely to binge eat as a way to cope with negative emotions.
• Body image issues: People with negative body image may be more likely to binge eat as a way to cope with these feelings.
• Genetics: There is some evidence that genetics may play a role in binge eating.

Disordered eating and guilt

    Guilt is a common emotion experienced by people with disordered eating. It can be triggered by a variety of factors, including eating foods that are considered "forbidden," overeating, or not eating enough. Guilt can lead to a number of negative consequences, including further disordered eating behaviors, low self-esteem, and depression. When people feel guilty about eating, they may try to restrict their food intake in an attempt to "make up" for what they've eaten. However, this often backfires, leading to binge eating. Additionally, people with eating disorders may avoid social situations where food is present, out of fear of eating too much or of being judged for their food choices. Guilt can also contribute to feelings of depression and anxiety, which can make it more difficult to cope with disordered eating.

Vacation nutrition

    Sometimes my patients raise concerns about their nutrition over a vacation or another time when they are off their typical schedule. My instinctual response is to assure them that vacation represents a small minority of their life, and to not give it too much importance. But that answer does not really address the core fear. The bigger worry behind this is the fear of loss of control. When you are on your routine, it is easier to stay in control. You can set up your life to make sure you always have the specific food you need when you need it. You can avoid every triggering situation. You can avoid people who might have "forbidden" foods or talk about disallowed topics. It seems that the real work is to be open to all possible circumstances and the real human likelihood of imperfection. 

I was bad yesterday and ate pizza

    The ideals behind this statement bothers me. "Bad" should be reserved for things that are morally wrong. Maybe for insulting a friend or stealing. Eating food doesn't meet that criteria. I understand why people say this and I want to unpack it. There is a perception that pizza is unhealthy. There is a perceived rule that one is supposed to eat healthy foods. There is a feeling of guilt for violating that rule. Then comes the conclusion that eating pizza equates with being bad. Now we need to acknowledge why people eat pizza. A few potential reasons are: hunger--a basic human drive that we all experience and act on every day, desire for pleasure--another normal human drive, and anxiety--who would not use a coping mechanism for anxiety if they can reduce their anxiety with it? Do any of these reasons to eat meat our definition of bad? 

Reasons my patients want to make healthy lifestyle changes

• so I can be around to play with my grandchildren
• to lower my risk of a heart attack
• to improve my blood sugar
• so I can have an easier time climbing up the stairs
• to have more energy
• to improve my mood
• to have less nausea
• to have less bloating
• so I don't eat until I am uncomfortably overfull
• to feel better
• so I can walk further without getting out of breath
• to improve my blood lipid levels
• to feel stronger
• to feel good
• so I can take care of myself
• because only I can do this for myself

I want to lose weight!

     "I want to lose weight!" This is the most common goal of people who I speak to for a nutrition consult. If there is one thing I have learned through my years of being a dietitian, it is that I can't guarantee weight loss. My patients can tell you better than I can tell you that weight loss is really hard to achieve and even harder to maintain. Generally, in the best case scenario, diet alone will lead to 5-10% weight loss, which is often not enough to meet the patient's goal. Fortunately, nutrition changes, even with no weight loss, can lead to real improvements in health and health risk reduction. 

Fear of deprivation

     One of concerns that my patients have is that once they change their eating habits, certain foods will become forbidden, and they will constantly feel deprived of these foods. This fear leads to the "last supper" phenomenon that precedes a diet. The thought is, "I will never be allowed to eat donuts again, so I better get them all in now before they become banned in my next diet." In reality, the idea of prohibited foods is a concept we create ourselves. The extension of that thought, that deprivation is inevitable, is also self-created. 

    I would like to point out the fallacies in both statements. First, we do not have to outlaw foods. I am not even talking about promoting the "everything in moderation" theory. I am simply talking about the black and white/all or nothing thinking that goes into banning foods. The "never again" mindset. Regarding the fear feeling deprived, there are a few other possibilities. Some of that fear stems from the fact we decide foods are forbidden. It is human nature to want what is not allowed. Easing up on the rules can help us avoid the feeling of deprivation. Additionally, there are other helpful and more accurate thoughts we can have. Perhaps a more accurate thought might be, "Let's see what happens if I have oatmeal for breakfast today instead of a donut. I don't need to make plans for the rest of my life right now. I am just deciding about right now" Or the thought could be, "I want to eat a donut when I can really enjoy it, like on a relaxed Sunday morning when I can sit down and savor the taste. Now I am rushing to work and will scarf it down and barely taste it." Or the thought can be, "I would like to sit down and enjoy a donut now. Not because I earned it or because I was good. But because right now I am choosing to eat and enjoy a donut." 

    Remember, knowing these ideas does not immediately translate into feeling and living these ideas. It takes a lot of effort, practice, and reminding ourselves of the perspective we prefer to have. Bumps in the road towards this are just moments to notice what happened. Each new moment is a new opportunity that does not have to depend on the past. 

Non-hunger reasons we eat

• tiredness
• boredom
• anxiety
• restlessness
• pleasure-seeking desires
• habit
• social setting that encourages eating
• location
• eating customs
• "last supper" mentality
• rebound from food restriction

    Which of these have you experienced recently? 

Hunger and Satiety: When to eat and when to wait

     Many of us have grown out of touch with knowing when to eat. Babies tend to be good at crying for milk when they are hungry and stopping to eat when they are satisfied. As we get older, other influences encourage us to eat. We are coaxed to finish our dinners, offered sweets as rewards, and we start using pleasurable foods to calm our nerves. It takes a lot of relearning to get back to that "baby" state of eating when hungry and stopping when full.

    One way to reteach ourselves this skill is with the use of a hunger and satiety scale. With this scale, we can rate our current state and have prespecified points that correspond to "time to eat" and "time to stop eating." We will use a 10 point scale. Let's put "starving" at 1 and "uncomfortably full" at 10. If you at a 1, you have waited too long and allowed yourself to be too hungry. If you are at a 10, you might have stomach discomfort or pressure in your abdomen from the quantity of food eaten. At the midpoint, near 5-6, is where you are neither hungry or full. You could eat without making yourself uncomfortable, and you could wait longer and not be too hungry. Around 3 on this scale is where you feel hungry and ready to eat, but not ravenously hungry. This is a good time to seek out something to eat and begin a meal. The meal can continue until you reach about an 8 on the scale. At this point you are comfortably full, but not overstuffed. Based on this scale, we want to remain in the range of 3-8. This prevents us from getting too hungry or uncomfortably overfull. 

    At first, knowing when to eat out of hunger and stop when full will be a conscious effort. It will take effort to remember to check in with your inner hunger and satiety cues. You might sometimes forget, and then later notice that you allowed yourself to get ravenously hungry or uncomfortably full. With practice, you will remember more frequently to notice your inner hunger and satiety signals to help you remain in the 3-8 range. And with even more practice, it will become second nature. 

How to improve your eating with mindfulness practices

• When you are deciding what to eat, take into account how you will feel after the meal—what you think will help you stay satiated, how much you need to eat to be satisfied but not overfull, and what will be comfortable in your stomach without GI discomfort.
• Sit down while you eat.
• Don’t multitask while you eat. Don’t watch TV or videos, don’t read.
• Focus your attention on the eating experience. Note the different sensations: the aroma, what the food looks like, the taste, the texture, the mouthfeel, the temperature.
• Consciously slow down your eating. Put your utensil down between bites. Allow yourself to taste every bite.
• Once you are finished your portion of food, give yourself 15 minutes to allow the satiety signals to get to your brain. Then you can make a decision if and what you should eat next.
• When you have an urge to eat, notice if it is driven by hunger, boredom, stress, loneliness, habit, socializing, or another cause.