Monday, November 19, 2007
For anyone struggling with an eating disorder, you know it is a long and, oftentimes, discouraging process. You may wonder, at times or maybe even most of the time, if recovery is possible. It's easy to say, "Have hope." It's another thing to find hope.
To start the week off, I wanted to remember a few facts; not fleeting, feel-good, come-back-to earth illusions, but true, sink your soul into them, gather them up and find hope in them, cold hard facts. There is no denying that the statistics for recovery from an eating disorder are hopeful.
Here are just a few:
"76% of sample (anorexia nervosa) studied for 10-15 years after admission met criteria for full recovery." - Strober, Freeman, Morrell (1997)
"Treatment works. Of those followed 5-10 years, approximately half of sample had recovered and 25% had improved with some residual symptoms." -Garfinkel (1995)
Excerpt from “Overcoming Binge Eating” by Dr. Christopher G. Fairburn
“The cognitive behavioral approach to treating binge eating problems has been studied extensively over the last fifteen years. Major research projects conducted at Rutgers, Stanford, Minnesota, Vermont, Toronto, Edinburgh, Cambridge, and Oxford have produced remarkably consistent findings. Like antidepressant drugs, these studies have found that cognitive behavioral therapy has an immediate affect on the frequency of binge eating. Even more encouraging, though, is that the effect is not only greater in magnitude than with antidepressant drugs, but also longer lasting. For example, the most recent study from my group in Oxford obtained a 90% average reduction by the end of treatment that was maintained one and six years later” (the follow up periods in this particular study).
All of these studies involve components of a multidisciplinary approach including nutrition therapy, psychotherapy*, medical monitoring, and, in some cases, psychotrophic therapy. These methods of treatment are used conjointly, in both inpatient and outpatient settings, depending on the patient and where he or she is in the recovery process.
* Cognitive behavioral therapy, mentioned earlier, is only one form of psychotherapy. Some forms of psychotherapy may be more helpful than others depending on the patient. Nutriton therapists and psychotherapists work closely together when treating eating disorders. The following link may be helpful if you are looking to put together a knowledgeable treatment team.
Contributed by Monica Van Winkle, MS, RD
Tuesday, November 13, 2007
Thank you for your recent question about CrossFit, a popular workout program in elite fitness circles.
CrossFit workouts are incredibly demanding and, according to the CrossFit website, “tax the capacities of even the world’s best athletes.”
Momentum Nutrition and Fitness cannot endorse any particular fitness program without meeting you, but we can provide you with a few tips when choosing a program that meets your needs.
1. Are the personal trainers or coaches certified by reputable institutions?
Something to think about: To become a certified CrossFit “coach” the fee is more than 4 times the amount required by the ACSM and the NSCC, the gold standards in fitness training.
2. Does the program recommend supplements over food?
At Momentum Nutrition and Fitness we strongly believe people can get all the energy they need for daily living and even demanding workouts from food. For situations that may warrant a supplement, refer to the November 8 posting.
3. If the program offers nutritional guidance, is it being provided by a registered dietitian?
Something to think about: CrossFit endorses caloric restriction and the following caloric percentages from macronutrients:
30% calories from protein
30% calories from fat
40% calories from carbohydrates
Evidence based literature on sports nutrition tells us that athletes need at least 55-65% of their daily intake from carbohydrates (to prevent glycogen depletion which can jeopardize performance), 15-20% calories from protein, and 30% from fat. These percentages are similar for sedentary to mildly active people (with 55% intake from carbohydrates being sufficient to sustain daily activities).
Caloric restriction, especially in the setting of rigorous activity, can have several consequences. Here are a few:
-Muscle loss and fat conservation
-Altered immune function leading to increased sickness
-(In women) Irregular or absent menstrual cycle which can lead to bone loss and, sometimes, fractures
-Increased urges to binge eat
-Reduction in work output of heart
If you're interested in calculating how much energy you need from food, see yesterday's posting.
Thank you, again, for the great question!
Contributed by Monica Van Winkle, MS, RD
Monday, November 12, 2007
Saturday, November 10, 2007
Wait a minute. What’s that you say? All this hype about the obesity epidemic is really just that: hype. The epidemic that, according to some economists, threatens to topple America’s health care system within the next 50 years, is not really a problem?
According to Walt Willet, professor of epidemiology and nutrition at the Harvard School of Public Health, it’s a big problem. “It’s just ludicrous to say there is no increased risk of mortality from being overweight,” he told the Associated Press Wednesday, when asked about the study.
So why all of the confusion? Nutrition research, like all medical research, is not immune to human error or new discovery (which is, also, what makes it so exciting). The problem is that some people consider each new finding infallible, which sets them up for major disappointment. By the time they’ve purchased, prepared, and sat down to savor the latest food touted to prevent heart disease, they’ve just found out that it causes cancer.
What we need is more patience. Nutrition research is not a perfect science, but we do know this: the more studies that point to the same conclusion, the more likely that conclusion is true.
And we also know this:
Being overweight or obese does cause an increased risk for heart disease, diabetes, kidney disease and certain types of cancer. The body of evidence pointing to this is overwhelming and does not contradict itself.
What the papers don’t tell us about the recent JAMA article is that it examines the association between weight and mortality, not weight and quality of life. Losing a limb to diabetes or going to dialysis 3 days a week may not kill us, but it certainly decreases our quality of life. (There is, also, plenty of literature linking overweight to diabetes and kidney disease and, subsequently, to increased mortality; it is ludicrous to suggest otherwise). The other thing the media neglects to mention is that the study highlights how being overweight protects us against tuberculosis, emphysema, and pneumonia. I don’t know about you, but I’ve been hearing a lot more about heart attacks in 21st century America than I have been about tuberculosis. (And I can think of a much easier and cheaper way to ward off emphysema than becoming overweight).
So, can you still have that Starbucks almond-filled croissant and triple-grande Carmel Macchiato you’ve been avoiding?
Of course you can, but I would recommend you do so in moderation. (Half of the croissant and a single-tall Carmel Macchiato might also do the trick if you enjoy them mindfully and, on other days of the week, you might want to try something like a bowl of oatmeal with blueberries and almonds along with a cup of coffee. For more tips on the meaning of moderation and mindfulness as they relate to nutrition and some healthier breakfast ideas, go to http://www.momentum4health.com/).
And, remember, don’t forget to read critically.
Contributed by Monica Van Winkle, MS, RD
Thursday, November 8, 2007
Is all this really necessary? A multi-billion dollar industry. I often hear student-athletes complain of not having any money to buy food, but don't think for a minute about buying the latest supplement with promises of "more energy", "bigger muscles", and the latest "veins that pop out like garden hoses", ooh sexy.
Walking the aisles of your local supplement store is more confusing than navigating the corn maze at your local fair... even for nutrition experts such as Registered Dietitians Emily Edison and Monica Van Winkle from Momentum Nutrition.
So what is a person to do?
On a recent visit the following product surfaced (weird supplement of the week):
Argentinian Bull Testes- Specially formulated to "increase testosterone in the body." Does it work? Well...Testicles produce testosterone; they do not store it, so there won't be any more testosterone in that part of the bull than other parts. The jury is out on the effectiveness.
I don't know about you, but I have not seen a bull (Argentinian or not) whose testes I would want in my body.
Simply put, we believe that supplementation is only necessary when you are not able to get the nutrients you need from your food. This doesn't mean you can choose not to eat veggies and take a multi-instead. Remember vitamins and minerals need food and each other to be transported around and to function in the body.
Situations that might warrant a supplement:
Lactose Intolerance (calcium)
Strict Vegetarians (b12, iron, calcium?)
"Picky Eaters" (Multi Vitamin)
People who are on Low-Calorie Diets (multi)
Non-Meat Eaters (Iron)
Non-Fish Eaters (Omega 3 Fatty Acid Supplement)
Your mother was right...eat your veggies! (but you don't need to clean your plate)
Emily Edison, MS.RD.
Momentum Nutrition and Fitness