Question 1
This study suggests that women may be lacking knowledge in healthful food habits. It was found that women who were trying to control their weights consumed energy dense foods just as frequency as those who were not attempting to control their weights. These results were consistent with a previous study that found those who are trying to lose or maintain weight had higher consumption of nuts and cheese than those who are not trying to control their weight. Do you believe we need to put more emphasis on food choices or portion sizes?
posted by Unknown @ 5:02 PM
13 comments
13 Comments:
When I read this study I didn’t find the results to be shocking. As the article emphasizes there is a need for education in the public and there is a handful of people who will believe any type of diet craze/fad diet they hear about.
I personally believe that it depends on who the client is. If there is a client that comes in who is eating healthy and is eating a balanced diet, but eats very large amounts, portion sizes will be a more appropriate focus. However, I do also believe there is a time to emphasis food choices. Every group in this article consumed high amounts of energy dense foods. For these women I would focus on food choices and encourage lower energy dense foods. Knowing that lower energy dense foods have more fiber and water it would be reasonable to assume that the women would get full faster thus, eating smaller portions. I think it is also important to focus on food choices to ensure that clients are receiving proper nutrition. Here in America we are surrounded by many food choices and it can be overwhelming. I think its important to have some type of knowledge on what foods we choose to put into our body and I have found from talking with friends and family that most people are very interested just have a lack of education.
I do not believe that food choices or portion sizes can be emphasized definitively. Each subject has a time and place to be emphasized. The approach to take really depends on the person and their particular dietary patterns and food struggles. Some people will have trouble choosing the right types of foods, while others may know what foods are good to eat but tend to eat them in the wrong portions. In terms of weight loss and consumption of energy dense foods, portion sizes and food choices are important to address. If a person attempting to lose weight is consuming one ounce of potato chips and one candy bar each day, the focus may be on substituting these foods for healthier choices. Portion sizes may not be the main focus here because these portions of “junk” food are appropriate portions according to package serving suggestions. Although, frequency of consumption of these items may need to be addressed. Further, in the cases of energy dense foods like cheese and nuts, portions may be a primary concern. Cheese and nuts are energy dense, but they are also nutrient rich foods that play a role in a healthy diet. It is easy to overeat cheese and nuts because the recommended portion sizes are small and the perception of them as “healthy” may encourage overconsumption.
I found the specific point about people trying to lose weight consuming higher amounts of cheese and nuts interesting. This is a topic that I have discussed at length with my mom—a middle aged woman trying to lose weight. She avoids most energy dense “junk” foods, but does tend to snack heavily on cheese and nuts daily. We have repeatedly discussed the nutrient benefits of these foods and the importance of moderation, since the fat and calories add up quickly. Overconsumption of healthy but energy dense foods can become a tripping point in weight loss because of the compilation of excessive calories form these types of foods.
While both are very important, from a psychological standpoint, I would want to focus on portion sizes. Even though nutrient dense food choices can set someone up for a healthy lifestyle, too much of anything is not always good(excessive calories). As mentioned, those trying to lose weight consumed the most nuts and cheese, which are high in different kinds of fat. I don’t think those choices are bad, but understanding moderation in those foods is key. With certain diets, foods are seen in a negative light or something that needs to be avoided at all costs. Teaching about portion control is key, and within that can focus on calories in/calories out and how portion sizes can control the amount of calories in. But now, it is hard to focus just on portion sizes because food choices is critical when looking at calories in/out based on how calorie dense certain foods are.
Moriah makes a good point that it all depends on who the client is. It is important to understand the client’s background and current habits, in order to deliver the education necessary for them to lose weight and succeed in weight loss/weight maintenance.
This was an interesting study since it found that neither decreasing meal/snack sizes nor decreasing fat/sugar foods were associated with weight change when controlled for age, BMI, race etc. These results seem to counter many of the recommendations (consume a healthy balanced diet) we provide to our weight loss clients. From the study’s conclusion, I feel that we should put more of an emphasis on food choices than portion sizes. Since both groups of women, those attempting to control their weight and those not, consumed high-energy-dense foods at the same rates, the effectiveness of weight loss/control would be increase with the elimination of these foods. For example, the elimination of one regular bottle of soda from the diet each day would reduce about 200 Calories from the diet. This reduction in calories should reduce the chance of weight gain and possibly result in weight loss. This elimination strategy would be far more effective than simply decreasing the portion of soda to a 12 oz can with 140 Calories (a reduction of only 60 Calories).
As Kirsten mentioned, it is difficult to separate food choices and portion sizes. It can depend on the person and situation and the focus will shift depending on each individual's struggles. As we all know, both are very important.
If I had to choose one, I would put more emphasis on potion sizes. As Nikki mentioned, it's possible to eat too much of anything and unknowingly make unhealthy choices such as eating too many nuts. The American culture is so fixated on size and value, especially when it comes to food, that consuming large portions is almost engrained in our way of life. I think most people have a general idea of what a healthy diet looks like, but more stubble with understanding a healthy quantity. If we could help people understand the balance of eating in moderation, I think they would benefit.
Of the two choices listed, priority should be placed on food choice over portion size. It is the common metaphor of bailing the sinking boat with a thimble or plugging the hole in the boat. Teaching a message of 'everything in proportion' may be pleasing to most of the public, but in truth many aspects of the modern convenience should be done away with from a health stand point. The instruction of positive food choices, plate building, and applying these concepts at home and in public are the necessary emphasis. I find the findings of the article plausible, though surprising in their degree of effect. Though I suspected the public with good intentions indulged in poor choices in common with the public without good intentions, I hadn't suspected it would be in equal ratios. The issue as a whole highlights the power of public advertising to enhance the perceived value and reward for consuming poor choice food items.
An additional point made by the article was the decreased weight gain associated with the implementation of a single nutrition/weight loss plan in comparison to multiple plans. This point is the most important from the article, in my view. There is a strong need to consolidate nutrition advice, eliminating conflicting recommendations. In a competition between food health and instant gratification, messages of health need to be as clear as our competitions, 'Pop, Fizz, Ahhh' advertisement slogans.
Nikki, I appreciate your points of managing calorie intake in all food choices. However, I hold that a need to introduce good food choices in any portion is forefront. The lack of public knowledge of what composes a healthy diet is so extreme as to cripple nutrition advice. We say add protein, they hear eat more hamburgers.
I do agree that emphasis should not only be placed on food choices, but portion sizes first and foremost. While choosing healthful foods is important, I believe the general population's definition of "healthy foods" is not consistent, nor accurate. Because I believe "choosing healthy foods" is opinion-based, I see the opportunity for portion sizing to be more effective in weight loss/management. When utilizing portion sizes with measuring cups and food scales, you leave opinions aside; thus, I believe one would see more success in weight management across a broad population.
I definitely think that we need to emphasize portion control as part of a healthy lifestyle as well as part of weight loss tactics. Food can gain a negative connotation of "good" vs. "bad," and I feel that this perpetuates the guilt and restrictive eating that can be associated with dieting--which results in "yo-yo" dieting and the increase in prevalence of binge eating noted in the study. Food quality and making healthier choices can result in a healthier weight, but intuitive eating allows individuals to eat without permission if the hunger cues are present. If we can teach people to build a healthy relationship with food by focusing on portion control in proportion to the individual energy needs of a client, it becomes apparent that they will be able to eat a higher volume of food if their meals contain fruits, veggies, whole grains, and lean protein (in contrast to energy dense fried foods, pastries, candy, fast food, etc.).
I agree with Justine that America puts a high value on getting the most "bang for your buck." Many individuals are consumed with the desire to get the most for their money, even if it means decreasing their own health. I think that Kandice also makes a great point in regards to making small, realistic changes in diet to improve overall health. By working to emphasize portion control and intuitive eating while making gradual changes to decrease empty calories in the diet, I feel that this would create an optimal balance for weight loss and weight maintenance.
I think there is a lot of truth behind Noel's reasoning for emphasizing portion sizes over food choices. What foods are considered "healthy" is subjective and varies significantly from person to person--even amongst nutrition professionals. Portions, especially when actually measured to with measuring devices or exact counts of foods, are objective. Teaching about portions as an objective way to manage dietary habits and impact weight loss does minimize the conflicting opinions of what is healthy.
Kirsten, I thought you brought up a great point about energy dense foods and recommended portion sizes in a healthy diet. Foods such as nuts and cheese are often apart of a healthy diet (i.e. Mediterranean diet) but the key to “healthy consumption” of energy dense foods is portion size. As you pointed out the recommended portion size of these foods is small, increasing the likelihood of overconsumption. This makes me wonder, should you recommend some clients to eliminate these energy dense foods from the diet help to increase weight loss? Then, once the client has a more complete understanding of nutrition, mindful eating, and a healthy diet, the energy dense foods can be reintroduced because the increase in client knowledge should limit the overconsumption of these foods.
I agree with Nikki, portion sizes is often the biggest challenge in maintaining ones weight; especially in today's era where we have distanced ourselves from standard portion sizes due to American culture. I believe maintaining correct portion sizes is the key success to weight maintenance; however, a person can psychologically tell themselves they will not feel satisfied or full from a smaller meal. When one is use to eating more, it is only natural to believe they will still be hungry-- This is where the intuitive eating method will be important.
Justine I agree with you that the American culture is fixated on size and value. I think what you said about teaching Americans to eat in moderation is very important. Not only in situations like this, but also because we as dietitians want others to enjoy their food and foods that are not necessarily "healthy for you" are still ok in moderation. Every time I tell someone I meet what I am going to school for they say "oh your going to tell people what they can't eat" and its not true. I think it is important to allow people to still enjoy the foods they eat and really focus on their portion sizes. I again just appreciated your comment and think you made an excellent point.
In my professional opinion, it’s difficult to prioritize these two components of healthy eating habits. When first counseling an individual, the dietitian should be able to gauge which area to touch on first. For instance, if a client states that they don’t like “diet foods” or that they are hesitant about trying new foods, the initial counseling session and client goals should be more geared to adjusting portion sizes. If the client states that they eat small portions of foods but that their diet quality is poor, counseling and goals should focus on making changes to their food choices.
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