Online Health Chat with Maxine Smith
March 19, 2014
March is National Nutrition Month and the theme is, “Enjoy the Taste of Eating Right”. Mindfulness is the practice of increasing awareness in the present moment—and is applicable to nutrition with favorable and rewarding results to your health! In today’s hectic, multitasking world, mindless eating has often become the norm and is related to eating more food with less satisfaction and increased weight. The impact of excess weight on overall health is undeniable, leading to heart disease, diabetes, and joint problems among other health problems.
- What is mindful eating?
- What are the benefits of mindful eating?
- How can one practice mindful eating?
- How can one eat a nutritious diet while practicing mindful eating?
The practice of mindful eating can help you gain more pleasure from eating smaller amounts, experience weight loss, and ultimately establish a peaceful relationship with food.
About the Speaker
Maxine Smith, RD, LLS is a registered clinical dietitian who works in the Department of Nutrition Therapy at Cleveland Clinic. Her specialty interests include disease prevention weight, lipid, and diabetes management, and disease prevention. She provides nutrition services to patients in Cleveland Clinic’s preventive medicine and outpatient nutrition areas. Ms. Smith earned her dietetics degree from the University of Akron, in Akron, and completed an internship at MetroHealth Medical Center, in Cleveland. She is a member of the American Dietetic Association and has received a certificate of training in adult weight management.
Let’s Chat About Mindful Eating: Freedom from Dieting
Moderator: Welcome to our Online Health Chat with Cleveland Clinic nutritionist Maxine Smith. We are thrilled to have you here to learn more about mindful eating.
Mindful Eating in Practice
treesap84: What exactly is mindful eating? Is it eating slower? I've never heard of the term before.
Maxine_Smith,_RD,_LD: Mindful eating can be described as paying attention to the "how" and "why" of eating vs. the "what" and "how much." To eat mindfully is to eat without distraction, paying attention to all of the sensory qualities of the food and how your body reacts to the food without judging yourself or the food.
mpierson: What exactly is mindful eating? What kind of foods do you eat?
Maxine_Smith,_RD,_LD: The freeing aspect of mindful eating is that there are no rules or "laws" about what foods to eat or not to eat. It entails self-exploration as to what your desires are at a particular time.
runner: I am not familiar with mindful eating. What is a good source(s) to read more about it?
Maxine_Smith,_RD,_LD: Some great websites are www.thecenterformindfuleating.org/, www.eatingmindfully.com, www.brighamandwomens.org, www.fammed.wisc.edu/integrative, and— a favorite—www.mindlesseating.org.
penminded: I have heard that mindful eating is a Buddhist practice and might conflict with my religious beliefs. Can you comment on this?
Maxine_Smith,_RD,_LD: Mindful eating is based on the Buddhist concept of mindfulness, which entails being completely aware of the moment at hand in a non-judgmental manner. Most mindful eating practices do not reflect any particular religious beliefs or practices.
Cheerzz: How do we get beyond the diet mentality and depriving ourselves of certain foods? And, once we do, how do we not overeat?
Maxine_Smith,_RD,_LD: It can be difficult as many of us have been "brainwashed" with the diet mentality. It takes practice, practice and more practice. A good place to start is when you sit down to eat, clear your head of placing any judgment on the "goodness" or "badness" of a particular food. Practice using a "mindful eating scale." Noting your degree of "fullness" is key to becoming more aware of your body's signals to stop eating.
Stevie: How long does it take to feel full after eating?
Maxine_Smith,_RD,_LD: It takes about 15 to 20 minutes to experience fullness after eating food for all of the satiety factors to affect the brain. The feeling of fullness will continue, however, with the time varying based on different factors.
BGrach911: What tools can people use to help them be more mindful of their eating?
Maxine_Smith,_RD,_LD: Again, use of a "mindful eating scale" is important. Part of mindful eating is taking smaller bites, so using a small fork or chopsticks may help. There are even forks that vibrate if you are using it too quickly. Small plates, bowls and cups can encourage mindful eating as well as putting on some soothing background music.
Lee: I just love to eat! It is really hard for me to stop eating even if I am full because my wife is a very good cook. What ideas can you share on this?
Maxine_Smith,_RD,_LD: The beauty of the practice of mindful eating is that you can actually enjoy foods to a greater degree while eating less. Also, we would not have the obesity epidemic if we all stopped eating when we were physiologically satiated. Eating tasty food affects the pleasure/reward center of our brain and may decrease stress. Consider non-food means of pleasure and stress reduction, which you can act upon after you stop eating. I had a patient that had a Jacuzzi put in his home. He found that he ate much less after that! You may also practice some truthful self-talk, and tell yourself that you will enjoy the leftovers more when you are truly stomach-hungry in the future.
LazyDaisy: I can tell when I am hungry, but it is difficult for me to tell when to stop eating. Do you have any suggestions?
Maxine_Smith,_RD,_LD: First of all you have to be eating slowly and mindfully to begin with. Pause between bites and ask yourself one or both of these questions: Do I need a couple of more bites to feel full? Could I exercise comfortably if I stop eating now without feeling sluggish or uncomfortable? These are signs that it is an appropriate time to stop eating. As you practice, you will become more familiar with the feeling and the cues.
tlcope: I tend to eat out of habit, i.e. at certain times of the day and/or when watching certain TV shows, etc. How can I begin to steer away from old habits?
Maxine_Smith,_RD,_LD: It sounds as though you have taken the first step in identifying the relationships between eating and other stimuli. Keeping a food journal noting the time of day, other stimuli (e.g., watching TV), your hunger level, the food you eat, and identifying patterns is the first step. Breaking those connections may be the next. Turn off the TV, change your routine at that particular time of the day, identify your feelings and find another non-food activity to meet that need.
Meal Planning and Scheduling
Overscheduled_Mom: I work full time, and manage a household of six. Four of my children are involved in middle school and high school sports and several extra-curricular activities. I am very vigilant that they are getting well-balanced meals. However, since I am busy taking them from place to place, I don’t take the time for myself. What would help me?
Maxine_Smith,_RD,_LD: It sounds as though you are very busy and care deeply for your family. Since you have healthy meals in place, it sounds as though you don’t have them available to you as you are not home. Would it be possible to take your portion of the meal and pack it to take on the road? (Perhaps you can delegate this to an older child.) Clarify your values, prioritize and seek out support from others where you can. Also, remind yourself of why you need to care for yourself. For one—you must take care of yourself, so that you can love to your children.
Carly: I know that I should eat more mindfully, but I just don’t have the time. Do you have any suggestions?
Maxine_Smith,_RD,_LD: We live in a face-paced world and, unfortunately, that often can conflict with eating mindfully. You may find that aiming to eat mindfully at one meal a day is realistic. Choose a time that you will have the fewest distractions and the most time. It could even be a snack time. It may also be helpful to consider how you can prioritize and increase your meal time. For example, can you go to bed a half hour earlier and wake up a half hour earlier to eat breakfast in a mindful manner?
Boredom and Emotional Eating
mlmorton22: I tend to be hungrier at night than during the day. I have always said it was boredom eating. Do you have any suggestions?
Maxine_Smith,_RD,_LD: "Boredom eating" is very common. Consider what you can do that brings you pleasure that is not related to food. Consider listing these on index cards and putting them in a jar. The next time you automatically want to eat of boredom, pick and a card and "just do it." Over time you may train your brain to consider other activities before eating.
Monalea: I am a type 1-2 diabetic. I am an emotional eater in response to stress, happy times, and when bored—so this is almost constantly. Food is my reward and for 40 years I have been hearing that I need to find other ways to reward myself. None of the possible rewards can come close to eating a favorite food. I even obsess about what I am going to eat for dinner, a snack, etc. What is one thing I can start with to eat mindfully?
Maxine_Smith,_RD,_LD: It sounds that you have forbidden foods. Possibly allowing yourself a small amount of your favorite foods will lessen the craving. Eating that food mindfully including keeping that food in your mouth for a long time has been shown to decrease the desire for more and desiring another serving of it afterwards.
AEISHAJ: How can I learn to eat a nutritious diet that has a lot of variety while practicing mindful eating?
Maxine_Smith,_RD,_LD: Do your research on what nutrients various foods have and how they can benefit your body. If you are convinced of the relationship and you care about yourself, these foods will become more appealing.
lenovo: I seem to over buy at the grocery store and then over pack my lunch with "healthy foods" because I'm afraid of being vulnerable to the "bad " foods, especially when I am stressed at work. What can I do to stop this safety net of food?
Maxine_Smith,_RD,_LD: Have a grocery list and include some of the foods that you have labeled as "bad." Pack a small amount of these in your lunch and take time to eat them mindfully and truly enjoy them. Research has shown that people over eat period when their reward and pleasure center in the brain is not satisfied as it could be with just a small amount of a typically labeled "forbidden" food like something sweet.
Diane: I have read that in mindful eating there are no good foods or bad foods. Won’t this lead to eating a bunch of junk?
Maxine_Smith,_RD,_LD: There are a couple of thoughts on this. First, when considering all foods equal and eliminating rules, one will not crave the “forbidden food” and then overeat it. Another is that when you are more accepting and loving to your body as it is, then you will desire to consume healthier foods. I feel it is important to not only pay attention to your body while eating, but consider how your body (and mind) feels after eating particular foods. Some, including myself, believe that you can also objectively assess the nutritional value of foods while not applying moral attributes (such as “good” or “bad”) to the food or to yourself when you eat a particular food. Another factor to consider is the satiety factor of foods. For example, if you eat a food that is higher in fat, and is therefore digested slowly, you will not feel “stomach hungry” for a longer time. You will then not eat as often if you are paying attention to hunger and satiety cues—which is an important part of mindful eating.
treesap84: What are some techniques you can use to disassociate "good" and "bad" labels for foods? It is so ingrained in me to watch what I eat and then feel guilty if I eat too many "bad" foods.
Maxine_Smith,_RD,_LD: When you are having those thoughts, acknowledge them and then consider putting them in an envelope or other receptacle to be carried away. You may write them down to help dismiss them and go back to them later and consider responses to counter the "good” vs. “bad" thoughts. It takes some trust in a new system of thought.
Ickis: Earlier you mentioned eating foods high in fat leaving you feeling full longer and needing to eat less often. What about those who advocate eating smaller portions more frequently throughout the day? My understanding is that this helps to maintain a higher level of metabolism. Is there any truth or value to this? I would think it would be possible to eat both mindfully yet more often in smaller bits and include healthy snacks like fresh fruit.
Maxine_Smith,_RD,_LD: Yes, health benefits have been identified in relation to eating more frequently and smaller amounts. The key is eating when you are truly physiologically hungry. You may find yourself eating smaller amounts and lower fat foods if you want to be hungry more often.
robtoby: I have been reading that sugar is the new “villain”, and can increase inflammation in the body. Do you have any recommended targeted daily goals for sugar intake for both men and women?
Maxine_Smith,_RD,_LD: In terms of mindful eating, sugar is not a "villain" as foods are not judged as good or bad. If one desires something sweet, one would consume it. Part of mindful eating, however, is honoring one's health. Part of this would be to research sugar and its processing. Note its effects on your body, how you feel when eating it and after consumption.
b98015: Even though I'm practicing “clean eating,” I always feel like I'm dieting and don't really enjoy my food. How can I make my meals feel less like dieting and more like just a way of life?
Maxine_Smith,_RD,_LD: It sounds as though you need to be convinced that your style of eating and food choices are truly honoring to your health and will provide you with a "gift" greater than any short-term disadvantage that the discomfort of change may bring. If you are not convinced of this with your research, consider what you feel you are missing and what you can have to make your choices more pleasurable. Consider what textures, smells, “mouth-feel”, tastes that you may be missing, and how you can meet that need.
Healthy Snacks and Timing
Onemoretime: How can I get over that mind vs. matter at snack time. I try so hard at work to have two to three “healthy snacks” at my desk during the day, but inevitably end up in my colleague’s candy bowl! Yet, I am still eating what I brought in.
Maxine_Smith,_RD,_LD: Remind yourself why you brought in your “healthy” snacks to begin with. Is it because you love and value your body and health. What are the benefits will you reap from providing your body with nutrient-rich food? Pausing and reflecting on this is crucial to changing your habits without feeling deprived.
EyesRCrossed: My dietitian told me to have a snack before I leave work, so that I am not ready to eat the cupboards when I get home. Even when I do though, my stomach starts growling when I am about five minutes from home. I have to grab food right away when I get home, so this is not helping. What should I do?
Maxine_Smith,_RD,_LD: You may have established a conditioned response if it has been your habit for some time to go home considerably hungry and then experience relief by eating uncontrollably. First, consider a snack that will be more slowly digested and will hold you over to dinner, such as a small apple and a small amount of nuts along with a glass of water. Then you may need to break the conditioned response, over time, by switching up your routine. It may be as simple as taking another route home to putting on your walking shoes before going in the house and walking around the block.
Intuitive Eating vs. Mindful Eating
temptest: What is the difference between mindful eating and intuitive eating?
Maxine_Smith,_RD,_LD: They are related terms. Intuitive eating was coined by two dietitians in the 1990s as a term identifying a broader philosophy of which mindful eating is a subset. Intuitive eating addresses such aspects as physical activity use of nutrition information and respecting your body.
Benefits of Mindful Eating
PONTUS: What are some of the benefits of practicing mindful eating?
Maxine_Smith,_RD,_LD: Some of the benefits of mindful eating (“ME”) that have been identified in the research include decreasing binge eating, weight loss, decreasing anxiety and depression, improved self-confidence, decrease in inflammation in the body, and decrease in prostate cancer recurrence. Some of these studies may have been small or short term and we would benefit from more research.
Sue: In what way do you think mindful eating is better than traditional dieting?
Maxine_Smith,_RD,_LD: Mindful eating is a positive experience and a loving approach towards one’s body that can have a sustaining effect on healthy eating behavior.
Mindful Eating and Medical Conditions
brmack: I had my thyroid irradiated in 2002 due to Grave's disease, and gained 60 pounds. Since then—despite that my levels are fine (if not overactive) —I cannot reduce the weight I gained during the process. Diets do not work because my natural metabolism doesn't exist anymore. Do you have any advice for me and for others suffering this dilemma?
Maxine_Smith,_RD,_LD: If—as you state, your levels are fine then practicing mindful eating may be a way to gradually lose weight. However, that cannot be the ultimate goal. The ultimate goal is to love and be loving to yourself and your body.
Mindful Eating and Weight Loss
mpierson: Should one think of mindful eating as a way to lose weight?
Maxine_Smith,_RD,_LD: High quality research has identified mixed results. Some studies have correlated mindful eating with weight loss, although weight maintenance is a stronger correlation.
Nutritional Guidelines for the Elderly
JonCas: What is a good resource for nutrition guidelines for those over 70 years old?
Maxine_Smith,_RD,_LD: The USDA Dietary Guidelines, which were revised in 2010, and the corresponding www.ChooseMyPlate.gov will identify specific nutritional needs for this population and provide helpful resources.
Mindful Eating for Children
BGrach911: I have a 14 month old baby. I don't want him to grow up with the same "food issues" that I have. How and when should we start implementing mindful eating with our kids?
Maxine_Smith,_RD,_LD: I am so happy that you are considering this as children model their parents’ behavior. You may start be doing something to "wind down" before coming to the table, such as cuddling and reading a short story, turning off all distractions, and creating a calm environment. Put smaller amounts of food on plates, and discuss briefly where the food came from, how it grows, how it got to the table, and then expressing gratitude. Model taking small bites, comment about flavors, textures, and aroma—and put down your fork between bites. He/she is watching everything you do and will catch on!
Addressing Mindful Eating to Others
Aleesha: I’ve recently started to adapt a mindful eating approach, but I’ve noticed that my friends and family have started to give me a hard time, saying “Oh, you’re eating so slow, we’re ready for dessert or to go.” How can I express my new approach without them thinking it’s some new diet?
Maxine_Smith,_RD,_LD: This is pretty common. Basically, all you can change is yourself and you are not obliged to tell them anything or convince them of anything. If they are unwilling to slow down or wait for you, be prepared to pack ask for a doggie bag. You may also request that half of your meal is served and the rest packaged up and brought out with the check, anticipating that you will not be eating a full portion. If they ask why you are eating differently, you may simply state that you are trying to appreciate your food more or that you are now eating “in sync “with your body’s needs. Anticipate some responses ahead of time. It may take some time to convince them that you are serious and they may test you. People are uncomfortable with change, but they will eventually adapt to the new you!
MaryJO: How do you handle the food pushers? My mother will not take no for an answer.
Maxine_Smith,_RD,_LD: The social, psychological and cultural implications of eating are tremendous! This is a common obstacle to eating mindfully. First of all, if you know that you are going to your mother’s to eat, plan your eating schedule so that you are hungry when she serves her meal. You can explain to her—ahead of time—why eating mindfully is important to you (and possibly her also—if you may be caring for her when she becomes older!). Reassure her that her food tastes wonderful and that you are enjoying it even more when you focus on every aspect of every small bite. For anything left over or courses not explored, you can kindly say that you are satisfied and that you would love to take a plate home to enjoy at a later time. Expect for a bit of resistance. As your mother sees that you are serious and you persist in your new eating behavior, she will become more accepting of it. You may assure her that you feel loved by her, as feeding you may be a primary way that she shows her love for you.
AEISHAJ: How can I practice mindful eating when dining out with friends?
Maxine_Smith,_RD,_LD: The best time to initially practice is alone. However, when you are ready to practice this with friends, depending on your relationship, you may choose to tell them your plan ahead of time. You may take a few deep breaths before starting your meal, have a moment of silence to reflect on the source and provision of your food, and put down your fork while talking. You may request a smaller portion or order a small dish, so that you will naturally eating slower.
Cheerzz: Eating and drinking is such a large part of our social activities. Isn't it difficult to be mindful in these situations?
Maxine_Smith,_RD,_LD: It can be difficult, particularly in the U.S. culture where we are trained to eat quickly and mindlessly most of our lives. It is counter-cultural and needs to be practiced.
Moderator: I'm sorry to say that our time with nutritionist Maxine Smith is now over. Thank you again, Maxine, for taking the time to answer questions today.
Maxine_Smith,_RD,_LD: Thank you for joining me today and for your thoughtful questions. I wish you all the best in your journey as you practice becoming more mindful eaters!
To make an appointment with Maxine Smith, RD, LD, or any of the other specialists in our Digestive Disease Institute, Department of Nutrition at Cleveland Clinic, please call 216.444.3046 or toll-free at 800.223.2273, ext. 43046, or visit us online at www.clevelandclinic.org/nutrition.
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