The Google diet. No need to keep searching.

I've seen it first hand. And I'm certain that if you were to experience it first hand, that you'd be sold too. This is no testimonial for quick weight loss, nor for the latest cleanse. And I haven't lost my mind. And yes, I've already eaten my breakfast, and had my coffee--so my thinking is quite clear.

It's time to open our eyes to what Google already knows about being healthy and fit. And to apply those lesson plans to our schools--and to our selves. I'm talking about the Google diet: Google's approach to food and eating, to feeding it's many employees, that's super smart. It seems strikingly crafted, based on the research on keeping us healthy--and happy. I had no plans to blog on this, but after visiting a couple of Google offices I just had to share. Because we can all get some answers from Google.

So what's so impressive about the Google diet?

Snacking: from portions to placement

Google likes snacking. So yes, already I'm sold. There are snack stations at various sites throughout Google buildings, with several notable features: there are m & m's, and there are organic bars; there's dried fruit and fresh fruit (much of it local no doubt) and nuts and yogurts.  Take your pick. Yes, there are desirable snack options that encourage Googlers (employees) to snack. Because we all need to snack for energy, for clarity, for productivity. Or we get tired. And cranky. And impulsive when we finally get our hands on food. Or, we miss our opportunity to eat when hungry, and for some, interest in eating is lost.

There are very mini cups--the folded paper ones like what you get pills in at the hospital--and there are cereal size bowls, too. Need just a few peanut m & m's? Portion them into a mini cup and acknowledge you're eating them. And they'll look like much more, and appear more satisfying, than if served in a cereal bowl. (see Brian Wansink's work on this.) Googlers might even be encouraged to choose the more wholesome choices by placing them at eye level--just as supermarkets stock Fruit Loops at toddler height. 

And those snack areas? They are separate from work areas. We all need to have a time out for eating, separate from our other activities. And by keeping them separate, Googlers aren't prompted to eat them just because of the visual stimulus. Rather, they have to decide to go and get a snack because, I suspect, they're hungry. 

In contrast to Google,  our schools, specifically Middle and High schools, pretend that kids no longer need to eat between meals. They expect them to function well and not be irritable, in spite of drops in their blood sugar and falling energy levels. Yes, growing kids certainly need snacks between meals.

Yet teens are at the mercy of individual teachers to possibly break the rules to allow snacking in their classrooms; or, they must get permission when medically necessary to eat at the nurse's office. Sometimes kids need to sneak food in between classes--often the easiest option. Yup, nothing like encouraging our kids to start sneaking food.

Moderation

In schools, the curriculum speaks of good versus bad foods--although admittedly in slightly more opaque terms (see my last post). Fruits, vegetables and low fat foods--they're the good stuff, while fats and sugars--they're viewed as bad. It reminds me of the unsuccessful DARE drug education program taught in US schools, the program which had my middle schooler at the time appalled that I would dare to drink a glass of Cabernet with dinner. 

Not a Google dessert, but it could have been.

At Google it's about moderation. At the cafeteria, foods are labeled using the traffic signal approach: best choices get a green light, to be eaten freely; yellow, more caution with frequency and amounts, and red lights urge awareness that these shouldn't be eaten too often. (Think creamy clam chowder or fatty meat dishes.) But note that red light items are still served, and balance is the take home message. I can't say how effective the traffic light system actually is, but I surely like that they're not encouraging fat free or low calorie foods, nor displaying calorie counts in their cafeteria. Our schools, in contrast direct our kids to calorie count hoping that that awareness will solve the 'obesity epidemic'. 

I almost forgot to tell you about the desserts! They're served every day--but the portions seem rather reasonable. And they weren't placed at the start of the lunch line where diners are sure to grab it first thing--that's where the salad was displayed. Rather, it was somewhere in the center if I remember correctly--I had to search for it actually. And knowing there's no shortage of desserts being served each week surely must prevent Googlers from hoarding their desserts. No doubt they trust that it'll be there. And they can eat just as much as they need, because tomorrow will bring another dessert. (see Halloween post about this)

It's gotta taste good 

Ok. I realize that Google employs Michelin star chefs to prepare delicious food for their employees. But can't we even serve more desirable fruits and fruit salads in our schools? Can't we stir fry some tasty veggies to be more appealing for kids to want to eat? Can't we serve mini cookies with lunch--to teach balance and moderation? And can't we allow ourselves to eat foods we truly enjoy?

Support movement

Biking or walking to work? You get rewarded! Yup, in Google's case, financially. Bike to school and you might be sent home. Seriously. It happened to a patient of mine in MA. And you'd be lucky if there were a place to store your bike! In US schools, the move has been to reduce physical education. At Google it has been to add spin classes and yoga. Something needs to change in our communities to support more movement.

Consider these Google diet lessons

• We all need opportunities to snack, when we're hungry. 
• Be strategic in your placement of food in your environment--we don't need it shouting to us, but it needs to be available for when we want it.
• Food should taste good, and we all need permission to eat what we like--in portions appropriate for our individual need.
• Dessert are not just for birthdays and holidays.
• Incentives for movement encourage movement. 
• Foods aren't simplistically good and bad nor are we good nor bad for eating them.

Thanks for reading! Comments welcome!

The consequences of weight bias: beyond making you feel bad.

Debra came to me frustrated about her climbing weight, now about 20 pounds out of her normal range. This is nothing unusual for me—plenty of women and many men reach this point, desperate for answers and guidance to help them take charge of their weight. Others present for help managing symptoms or medical outcomes—like high blood pressure or cholesterol or GERD that have more to do with the quality of their diet than with their weight.

Debra was an active woman in her 50s, a non-emotional eater—yes, they do exist—who felt like she was doing most things right. She ate regular meals and snacks; she had to, as she started to feel really low energy, and fuzzy headed if she didn’t. And she’d start to get the sweats, too. She had a history of very high cholesterol, and a family history of Type 2 diabetes as well. And the weight she had previously maintained, her normal weight, was nothing crazy, nor did it require heroic measures to achieve it. Her goals were quite realistic.

After reviewing Debra’s intake and activity, I made modest recommendations to ensure she was doing whatever was reasonable in terms of change. Was she still getting the workout that she thought she was, or does she need to evaluate her intensity or duration? Perhaps with better conditioning she could prevent further weight gain. Was she inadvertently influenced by the halo effect—having more of those foods she believed to be healthy, such as lean protein sources or nuts—without an awareness of just how much was enough? (http://dropitandeat.blogspot.com/2011/05/halo-effect-your-thoughts-about-healthy.html) Fullness was challenging to observe, she had stated. Perhaps she needed to evaluate just how much she needed as opposed to portioning her food on autopilot, without much attention to her need http://dropitandeat.blogspot.com/2010/08/size-matters-but-not-how-you-think.html or http://dropitandeat.blogspot.com/2011/02/who-or-what-decides-how-much-you-eat.html While these recommendations were helpful—and prevented further weight gain—it was clear to me that another explanation was responsible. She had many markers for polycystic ovarian syndrome (PCOS) or hyperinsulinemia, a condition where high circulating levels of insulin result in symptoms of low blood sugar (including the sweats, fuzzy headedness, irritability and immediate need for food). (For more on hyperinsulinemia http://www.diabetes.co.uk/hyperinsulinemia.html)

At my suggestion, she went to see an endocrinologist—an MD appropriate for evaluating such conditions. From Debra’s report she shared her sense of despair about her climbing weight and belly fat, yet the doctor began to dismiss her, like all the overweight women who presented before her, with a simplistic, patronizing “Eat less and exercise more”. Yes, judgment was decreed without even listening to how high her activity already was and how appropriate her eating has consistently been. 

But once she added the comment about the symptoms between eating—those low blood sugar-type symptoms—he got it. He finally recognized that it was unfair to put the blame on her—to simply tell her she needs to exercise more or eat less because after all, weight management is about energy balance. He put her on metformin, which addresses the underlying issue—it’s an insulin sensitizer, so it helps prevent excess levels of circulating insulin.

The outcome? Most importantly, her symptoms stopped and she felt so much better. No more shakiness in between meals, and the sweats ceased, too. And, her weight dropped about 9 pounds over the past year, in contrast to the weight climb the preceding year that felt so out of her hands.

Weight bias in reverse

Another active woman—at a normal and stable weight, recently had a physical. She’s a 51 year old who enjoys food and eats a healthy diet. By healthy, I mean rich in healthy fats, whole grains, fruits and vegetables, with a reasonable intake of desserts and chocolate and wine. She’s not vegetarian—but her intake of meat is minimal—nor gluten free, nor dairy free, nor carb free. She’s a reliable reporter.  I know, because she is me! For the first time in her/my history, my cholesterol was high! The good cholesterol was high too—likely the result of my activity (I’d attribute it to genetics except neither parent had a high HDL)—but the bad, the LDL was out of any lab’s range of acceptable. Add that to my high blood pressure and that places me at further risk.

And what did my doctor do? Nothing. Other than telling me to continue to ‘watch my diet’ and maintain my activity (about which he knew little), that is. Yet the variables that I can control are already in order. My diet and exercise aren’t going to change for better so I don’t suspect there will be any astounding improvement. Most likely, my hormone status was likely the greatest factor increasing my levels—LDL can increase 15-25% with menopause! But heart disease risk similarly increases with postmenopausal elevations in cholesterol. 

Me (in Robin's hand-me-downs) and my slim father who had type 2 DM,
high blood pressure and high cholesterol.

In spite of my high cholesterol, my doctor didn’t suggest that I have it rechecked in 3 months or that I start a statin to lower the levels. He didn't explore my exercise frequency, intensity or duration. While the updated 2014 cardiac risk calculator concludes statins for cholesterol lowering aren't necessary for me, (and doesn't include weight in the assessment) he didn't plug the numbers into this risk analyzer (I did later though.) No, I did not look like a high cholesterol patient so my cardiac risk was minimized.

I share this for those of you still blaming yourself—for your health, and for your weight. That is not to say that there aren’t things you can do to take charge of your health. Physical activity in moderate levels can improve insulin sensitivity, lower cholesterol, improve blood sugar and assist in energy balance. Oh, and it certainly may help mood and sleep, too. And eating portions appropriate for your need can help everything from reflux to fatigue to your weight climbing out of your normal, healthy range. Eating more home prepped meals can give you more control of portions and meal content. Even for you non-cooks, there are plenty of easy-to-prepare, yummy dishes you can make, with practical strategies for pulling it all together. And avoiding long periods without food certainly will improve your energy level and your control of eating when you finally take the time to eat.

But if you’re already doing what’s in your hands to do, don’t let others burden you with blame. And start to advocate for the care you deserve.

When I see my new doctor, you can bet I’ll be discussing my labs and inquiring about any treatments that might lower my risk. Because truly, my high cholesterol is not my fault.

thanks for reading!

Want to know how much I ate today? The pros and cons of comparing your eating to others’

Today's breakfast-crepes with sauteed fruit,
melted chocolate drizzle and vanilla yogurt.

When I was little, I mean, when I was young, (I was never particularly little compared to my peers), I recall a recurrent argument with my mother. “She can have it/eat it/do it—so why can’t I?”, I’d beg to know, to which she’d respond something like “If she jumps off the Empire State building does that make it okay for you too?” (Yes, I’m from NY and that was the tallest building back then.) Her point, of course, was that what’s good for one isn’t necessarily good for another. And if you’re going to compare, be careful.

Which gets me to you and your need to compare yourself to others; and more specifically, to compare your eating and your weight.  So what do you think—helpful to compare or harmful? Is it okay sometimes, or must you be consistent and never compare? Does it matter if you’re under eating, or if you’re overweight or is it simply dangerous?

Does it really matter what I eat (or anyone else, for that matter)?

Well, yes. To be honest, that’s why I include all the so-called food porn on this blog—beautiful images of delectable foods—all of which I am personally eating. Perhaps it shouldn’t matter. I mean I can give you sensible guidance regardless of how I choose to eat. But knowing that someone else is eating cookies or including carbs, or adding fats—things you just might fear—and is perfectly fine, reassures us. Viewing a peer’s eating as they’re comfortably eating ice cream can help motivate. Yes, normal, healthy people can and do eat ice cream. Seeing this can help increase your flexibility around foods and food categories—and that surely can help you change your relationship with food.

Yet it’s rather unprofessional to suggest that because something is fine for me that it’s fine for you. When I make my recommendations, they are based on my clinical experience—my 28 years in the nutrition field—and my knowledge of nutritional science and the limited research we have to work with.  What’s fine for me, isn’t necessarily right for you; I might include lots of veggies daily, but for you that added volume might be a challenge, making it difficult to meet your calorie needs. I might make most snacks rather calorie rich—when I’m out cycling or hiking for many hours and I’d rather eat smaller portions at each snack for convenience—this may be unnecessary for you; I’m almost 5’8 and my weight is just fine where it is, but your needs may be different—based on your height, your bone structure, your muscle mass, perhaps from years as an athlete, and your needs to normalize your weight to support your health.

Be careful!

My lunch. Looks big, right? Two pitas 'cause they were those too-light-be-
adequate 80-calorie ones. Certainly larger appearing than my husband's!*

When comparing to others, you might think—“She’s only eating a salad, why is that not okay for me?” or “Why do I need to work out when none of my coworkers do?” You may look at a friend and wonder how they can eat whatever they like when you have to be more mindful, or else your weight climbs out of your healthy range with no effort. Patients get frustrated when they report that their coworkers eat fast food and “junk food” and their weight is just fine, whereas they have to work hard and watch everything they eat. But they aren’t with these coworkers 24/7. Who knows what happens the rest of the time. What you see is a small slice of time, which may or may not reflect how any individual really eats.

Maybe they eat lighter when others are around—but make up for it in private. Perhaps they eat more only when they’re out with friends like you, but restrict when they are alone. Essentially, you have no idea what really goes on when you’re not with them. Unless I asked (and unless he were honest), I’d have no idea that my husband eats the leftover baked goods from work functions when he gets hungry and hasn’t brought enough to eat from home. Or even if he has, yet they are sitting so attractively frosted and displayed in work common areas for all to grab.

What you observe others eat may not be in their best interest—nor in yours. They may be struggling, denying their hunger and feeling fatigue, and preoccupied with food all the time.

He looks sedentary, but you should've seen him run today!

Are you comparing yourself to others for the wrong reasons? Do you let your eating disorder do the comparing as in “She’s having the fries, but I’m going to just order the side salad” or “He’s ordering the large ice cream, so I’ll just get the kiddie sized one.” Not what I’d recommend!

But I’m different

Do you ever think “that’s fine for you, but my body’s different”? You’re not alone! Somehow you may struggle to believe that what’s true for everyone else—that they can eat a range of nutrients including fats and protein and carbohydrate and no foods need be absolutely forbidden—just doesn’t apply to you. In fact, this basic truth does apply! Take a look at this older post: http://dropitandeat.blogspot.com/2012/04/youre-not-so-special-rethinking-your.html

My FAVorite cupcake place--located in NYC.

There are dangers in comparing your eating with others, as one size does not fit all. Just like food labels should not dictate how much we should be consuming—they merely identify nutrition info—you need to learn just what will meet your body’s individual needs.

And just because they decide to put themselves at risk and jump from the Empire State building doesn’t mean it’s okay for you.


* And for the record, I had a Napoleon pastry late afternoon and take out Japanese for dinner--with some nice Chardonnay. And if you asked, I'd tell you there were a few other items, too.

Please share your thoughts and let me know you’re out there reading!

How yogurts and ‘milks’ mess with your head.

The big news in Olympic history before the games even started was the yogurt embargo. Yogurt, specifically US shipments of Chobani Greek (style) yogurt, was banned from Russia because of paperwork issues. If Americans were outraged about the politics of this ban on yogurt-eating liberty, fair enough. But trust me, the impact on athletes’ nutritional status and performance was non-existent. Did Gold miss medaling for figure skating due to it? Hardly. Did Ligety capture two golds in spite of his yogurt free diet? Absolutely.

Yogurt's impact on you.

Did you know? That individual yogurt you’ve been buying isn’t what you thought it was. Yes, you too have had limitations placed on your yogurt.  Same price, with even greater costs, as you’ll see, so keep reading.

I was rushing down the aisles of Stop and Shop last week, hitting the perimeter for the essentials. Produce, bread, eggs and yogurt, to name a few— were on the list. Not a regular ‘Stop and Shop shopper’, I was struck by the relatively low prices on the yogurt, the Greek yogurt, the Chobani Greek yogurt, specifically. So I grabbed some arms’ full and dropped them into my cart. But before moving on, I took a double take. The packaging was subtly different, though not strikingly so. Same shape, ever so slightly different label design. They were slightly cuter, even.

And then I realized. The container was once again downsized, this time from 6 ounces to 5.3. And the calories were similarly reduced. Yes, yogurt has slimmed down once again. The tag line should read “now with less calcium (only 15%!), fewer calories, and other nutrients you were expecting—all for the same price!”

What yogurts used to be.

When I was an elementary school kid, I remember buying individual containers of yogurt—Dannon at that time. They were 8 ounces, and they certainly weren’t lite—these were the olden days, where the only diet product with artificial sweeteners was an awful tasting cola called Tab. It’s possible they were low fat, but not fat free—that also didn’t exist back then, to my knowledge. And they were in the mid to upper 200 calorie range. At that time, it wasn’t odd to have a yogurt—along with a fruit or a muffin, let’s say, for a quick lunch or breakfast. And that might have been just fine.

That was then. But now?

While I hate to talk calories, I think it’s important here: prepackaged yogurts these days are the caloric equivalent of an 8 old glass of skim or low fat milk. That’s right. We're talking a standard paper cup size,  the equivalent of 2/3 of a 12 oz soda can portion. Would you expect a small glass of low fat milk, by itself, to be an adequate meal? How about for someone you really care about? Do you have a double standard here—okay for you, not for them? I consistently see patients consuming it with the expectation that it ought to be enough.

You and the Olympians.

The consequence on the yogurt-deprived American athletes may have been on their psyche—they may be accustomed to doing things the same way perceiving that if they change, they won’t get the same results. But truly, unless they are vegetarians dependent on the high protein content of Greek-style yogurts, protein malnutrition would not threaten a medal.

This one's 8 oz still!

But the impact of the manufactures’ sneakily shrinking serving size is much greater for you. You eat one and expect it to satisfy like it used to. Or if you, like me, grew up in the era of fuller fat yogurts, you may still be in the mode of considering a yogurt a meal or a significant part of one. No, we simply can’t rely on portion sizes to dictate our needs! (Read more on this topic: http://dropitandeat.blogspot.com/2010/08/size-matters-but-not-how-you-think.html and http://dropitandeat.blogspot.com/2014/01/role-modeling-with-lean-cuisine-diet.html)

Milking it

While we’re on the subject of dairy, let’s talk about milk, or rather, beverages mistakenly referred to as milk. Think rice, coconut, hemp, and almond beverages. Beverages, because referring to them as milk misleads us. There is nothing milk like about them, except, perhaps, the shade of grey/off white. Sure, they may be fortified with calcium or vitamin D (although not all are, in fact), but when you pour a glass of milk-beverage you expect that it’s going to satisfy like a glass of milk. Yet many of these beverages are little more than fortified water or fail to match milk nutritionally.

You’ve already heard my rant about almond beverage.

Some almond milks have as few as 30 calories--I'm not recommended these, and all have only about 1 gram of protein—that’s 7 grams less than a glass of cow’s milk. Soy milk is consistently better matched with cow’s milk for protein (usually at 6 or 7 grams) but may be much lower calorie as well. Coconut water is neither high in protein nor calcium or D, but at least they call if ‘water!’. Hemp milk (yes, really) comes in at 2-3 grams of protein and calorically is a match for 2% or whole milk. Rice milk also matches calorically, but has only 1 gram of protein.

Who cares?

Why address this topic? Because I want you to not be fooled into thinking that these yogurts and milk beverages are adequate. When you get hungry after a pseudo milk drink, I don’t want you to blame yourself. When you are feeling less than satisfied with what you thought was your usual yogurt, think again.

Maybe there's a reason you're scavenging for food!

Start looking around, because these aren’t the only items shrinking. Did you think you plowed through the whole 1/2 gallon of ice cream? Well for the record, most brands (at least here in the US) have shrunk, too. Breyer’s, one of my favorites, now has 6 not 8 cups per container. In fact, it has fewer calories per cup, too—but interestingly, they’ve not advertised that! They have substituted guar or tara gum as a filler, displacing some of the cream and whole milk.

I realize that we all don’t need more saturated fat from cream, and some might benefit from an adjustment in portions. But if you’re noticing you’re hungrier these days with your same products, take a second look. You just may not be getting what you thought. Maybe your body is just trying to tell you something. Perhaps it’s time to start trusting your signals—and taking a second look at the package sizes.

Have you had this experience? Wondering why you’ve been hungrier? Seen other products that have shrunk without telling us? Please share!

Thanks for reading and passing this on!