March 2014 Question #2
Both groups of participants consumed more water ad libitum
during the slow eating condition (i.e., 12oz vs. 9oz during the fast condition),
but the same total weight of food and water across both study days. Water adds
weight to the meal and lowers the energy density of the meal. Assuming that
most people consume an average of 8oz of beverage with their meals, how might
you counsel someone to make the most nutritionally out of their mealtime drink?
posted by Unknown @ 5:48 PM
28 comments
28 Comments:
I would suggest that they strive to slow down and enjoy everything they are consuming at meal time and really taste. I would probably say that water is one of the best meal time drinks because it does add weight and satiety but not energy.
One thought I had would be to encourage them to measure out a big glass of water before the meal, say 12-14 ounces, and make it a goal to have the water finished before the end of the meal. The water will help them to feel full at the table, and it might help them to consume fewer calories, while still feeling satisfied. I would explain to them that the goal is not to chug the water at the end of the meal, but to consume it before or throughout the meal. After a few meals, I would hope that they learn how to find the balance between the water and their food (not overloading on both), thus helping to lower the energy density of the meal.
I generally recommend that people limit their consumption of liquid calories, but not everyone likes to have only water with their meal. Some other beverages such as milk or juice may have nutritional value when consumed in reasonable quantities. If they want to consume beverages such as milk or juice, I would recommend also drinking water, which will help limit the calories from beverages.
I would first find out what they like to drink at their meals and then talk about the importance of drinking lower-calorie beverages. I would tell them that it is easy to drink a lot of calories without getting any real nutrition out of it (i.e. drinking soda or other sugary drinks vs. low-fat milk or water). I would then discuss their current beverage choices with them and help them come up with better alternatives that they would still find enjoyable.
Good Ideas, guys..I think something to add would be the always appropriate, moderation. As Jeanne mention, some people do enjoy beverages other than water with their meal. The question to ask is...Can this be a twice a week thing instead of an every meal thing.
I really like what Brady said about having the client measure out a large glass of water before the meal and make it a goal to pace themselves and to have the water finished by the end of the meal. That's a great way to increase water consumption with meals.
Like others have already said, different people like different beverages with their meals. Some of these choices are less than desirable than others (e.g. sodas, alcohol), but if a client really did insist on having their soda or alcohol with a meal (maybe the client really likes wine or something), I would advise having a serving of their favorite beverage with that meal as well as a moderate to large glass of water and to alternate sips of each. So have a drink of wine, then water and so on and so forth. I would also discuss that these types of beverages are known as "empty calories" because they are high in caloric content, but devoid of any real nutritional value. As Jessica said, moderation is the magic word. We must preach moderation, not elimination. And as always, water is always the best beverage choice...especially with meals.
As we all know, drinking before a meal leads you to being full quicker, so that would be one of my suggestions. Also, if someone dislikes eating fruits and/or vegetables, I would explain the concept of juicing to them that way they can still achieve their necessary vitamins and minerals. I would then point out that drinking fruit (or vegetable) juice doesn't have all the benefits as the actual fruit or vegetable like fiber so it should be consumed sparingly. Explaining the concept of liquid calories would be beneficial too.
I would suggest either a less calorically dense drink or a more nutrient dense drink during dinner. A glass of low-fat milk is a great example. Because it provides nutrients, it helps signal satiety cues more quickly than something like soda would. Some clients really like the fizzy kick of soda with their meals, so something like carbonated flavored water or juice might be a better option. The carbonation can also help with the feeling of fullness.
Brady brings up a good point about pre-measuring water before you start a meal. The people I know who drink water throughout the meal definitely eat less than others I know.
Great posts everyone! Moderation, caloric density, and volumetrics are all excellent topics to discuss when counseling someone on how their beverage choices impact mindful eating and their health.
I think that emphasizing how quickly calories add up with drinking sugary drinks and doesn’t really leave you feeling full quite like eating a meal does. Some people really enjoy drinking with their meals, so I would encourage drinking water, or another low calorie beverage if they really don’t like drinking water. I think Brady had a great idea to measure out a glass of water and have it a goal to finish the glass of water by the time the meal is over.
I think my suggestions would depend on the person's baseline nutrition. If the person was overweight/underweight, I would probably suggest a low calorie beverage with meals such as water or tea. For the person who is underweight, it is important that they get the most calories from food sources- so I wouldn't want them drinking all of their calories. For the person who is overweight, I wouldn't want them consuming additional calories from their beverages.
However, if the client is of normal weight, I would be okay with them consuming a nutrient dense beverage, like low-fat milk, with meals.
As many have said, I wouldn't recommend soda with meals because it adds calories without adding nutrition necessarily.
I like the suggestion of measuring out a certain amount of water for each meal and making sure to sip water throughout the meal until it's finished.
I would first try to suggest clients drink water at mealtime since water is tasteless and it wouldn’t interfere with the different flavors of the meal. Therefore, you can really focus on and enjoy the taste of the food. Water also fills you up so you are less likely to overeat. If clients don’t like plain water, I would suggest adding lemon or lime slices to the water or trying a carbonated water beverage. In order to help individuals understand that liquid calories add up quickly, I would create a handout that compares the nutritional information such as calories, sugar, and vitamin and mineral contents of an 8 oz serving of different beverages. I would compare soda, juice, alcohol, milk and water on this handout. This would illustrate how soda is simply empty calories and provides no nutrition. Then I would include juice, since many people don’t realize how high in calories and sugar some juices are. Alcohol would be included to show that it is very calorie-dense. I would include low-fat milk, which would provide protein and various vitamins and minerals. Water would also be included to show how it is low in calories. The client could use this handout when they are choosing which beverages they want to drink, and if they want to have soda, juice or alcohol, then hopefully they will have these in smaller amounts and choose water more frequently.
I really like Brady's idea of measuring out a large glass of water before the meal and finishing the water before the end of the meal. This will help people feel fuller and prevent overeating.
I have a hard time comprehending how people don't like the taste of water, but Caroline has a good suggestion about adding a simple lime or lemon wedge to spark it up a little bit. If someone absolutely has to have their caffeine for the day, I'd suggest that they finish most of their meal (especially the protein source) before drinking their Diet Coke so they won't become too full too quickly.
Assuming everyone drinks an 8oz beverage with their meals, I would discuss the different options for beverages. I would then assess whether their beverage of choice is calorically dense, and educate the patent on the issue of choosing sugary sweet beverages (added calories without adding feelings of fullness etc) and make suggestions based on their choices. Some patients may not be willing to change their beverage choices yet so starting to decrease the frequency of their choices is a good place to start. (Instead of soda at 3 meals, move down to one meal or choose a diet soda.) Some people are so used to having ultra-sweet beverages that their taste buds need to adjust. In this case, people who are willing to completely cut off sugary-sweet beverages may benefit from complete avoidance of these drinks. Most people find these drinks repulsive after a long time without them.
For some people, I agree that trying to drink more water at meals helps to increase feelings of fullness without adding calories. I also agree that adding lemon can make water more palatable for those who say they detest the flavor.
My counseling is really going to have to depend on client. If an overweight/obese client normally drinks a regular soda with their meals I would suggest switching to water or if they do not like water, drinking a diet soda. This will be very beneficially if they take full advantage of the unlimited refills at a restaurant. If the client is normal weight or underweight I would suggest choosing low fat milk or water. If they drink regular soda with meals often I would suggest limiting it to only 1 glass and than switching to water.
Drinking more water is a low-risk way to lose excess weight, especially if it takes the place of other liquid calories. Our body’s perform a number of processes while eating and digesting so it’s important to eat slowly and incorporate water into the meal. I would recommend water at meals because it is an excellent appetite suppressant that doesn't have any of the sugars or caffeine found in sodas. In addition, people often mistake thirst for hunger pains. If you feel hungry, make sure you've had enough to drink for the day.
I like the point that Caroline makes about water being tasteless and not changing the taste of the meal. Soda adds so many extra calories and should be considered the dessert if consumed with the meal.
Obviously, water would be the ideal choice for clients to consume during a meal, but this is not always a desirable choice for some individuals. I would make sure to inform my clients of the amount of calories in their favorite beverages and let them know that if they choose to consume them, they need to subtract these calories from the food that they are planning to consume. Moderation of these beverages is important, as others have stated, and should not be consumed at every meal. Hopefully, by seeing the calories that their favorite drinks contain, more clients would be motivated to swap them for water if it meant they could eat more food instead.
I think for clients who do not like the taste of water, forcing it on them may be a little hard to do. There are different ways to flavor water, which could appeal to some people. These include adding fruits or vegetables such as strawberries, mint, and cucumbers to water to add some nutrients, while flavoring the water. This may also be helpful to those who do not like eating fruits and vegetables because it can still infuse some nutritional benefits into the water. I would also suggest that even if they do choose to drink something besides water, to at least have a glass of water next to it and maybe taking sips from so that maybe less of their calories come from the liquid intake alone.
I like Brady's idea of pre-weighing and pacing water consumption throughout the meal. Hopefully, if they client does it enough, it will become second nature and be an added lifestyle benefit.
Anna J. said:
I agree with many of the comments that water is probably the ideal choice, fruit juice and milk in moderation provide nutrients, and low calorie flavored water or sparkling water can be option if someone is bored with plain water. Now there are also lots of “infusion water bottles” that you can add lemon, berries, cucumbers, or other ingredients to help add flavor to the plain water. Also a glass of hot tea can sometimes be a really nice way to end a meal and would still perhaps replace a dessert or a gnawing feeling that second servings are needed of the meal, decreasing the total energy intake.
Anna J said:
I like Caroline's idea to create an educational handout about the calorie content of different liquid products and to provide a comparison of nutritional value. That seems like it would provide a really good visual resource and additional information to motivate the client to make healthier choices.
I would suggest to the client to look at the ingredients list of the drink they would like to consume during the meal. If the label has any indication that sugar was added, I would suggest they choose another option. Sugary drinks are easy to consume very quickly, and can add a ton of calories. In my rotations I actually sat in on a counseling session for a client who had a lap-band procedure, but wasn't losing weight. It was discovered that the client drank a lot of sugary beverages. The liquid would go straight through the band, not providing the feeling of fullness, and still provide a lot of calories.
Caroline made a great point that water is tasteless, and will not interfere with the flavor of food. I think that is a great point to make to any client who is trying to be more mindful about eating. I also thought that use for straws can increase how fast a person drinks. If they are drinking a soda at restaurant, I would suggest they do not use a straw so the have to take smaller sips instead of large swigs through a straw.
I would recommend a low fat milk/dairy with each main meal and at least 8 oz of water on top of that. Drinking water with meals helps your belly fill up without adding extra calories and sugar that come from soda, juice, sports drinks, etc. Also encouraging clients to eat fruits/vegetables first and not fill up right away on a beverage and high fat/calorie items such as starchy foods (pasta/potatoes) and high fat foods. Also, encouraging more water throughout the day so when meal time comes around you don't feel completely empty and like you need to binge eat.
Many people don't enjoy water so suggesting adding a squeeze of washed lemon wedge or another low kcal/sugar free flavoring to make it more appealing to those "non-water lovers."
Jessica makes a great point of moderation which stems from Jeanne's point of people's preferences.
I would first determine what beverages the client typically consumes. If it was a weight loss client I would suggest plain water or water with fruit. If it was a normal individual wanting to eat better I would tell them to choose water or a low-fat milk for the extra calcium and protein. I would try to discourage them from choosing juice, soda, or sweet tea because they have a lot of unnecessary calories.
Sammy makes a good point about how quickly calories from sugary drinks add up.
I agree with Kaitlin that recommendations should be different for people who are underweight than for those who are overweight or normal weight. But if people are going to drink calories, it would be good if most of those calories came with other nutrients rather than added sugars.
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