All kinds of behaviors can have an effect on your weight, and the solution to each is different.  

Maybe portion size is your biggest issue.  Maybe it’s hard to get moving, even though you know you need to get some exercise.  Maybe you have a sweet tooth that you can’t shake.  Maybe you’re completely stressed out, and you never get a decent night’s sleep.  Maybe you are a nighttime snacker.  Or maybe it’s some combination of these.

How do you know which of these applies to you?  Be honest with yourself.  Check the ingredient list of everything you eat, and keep a log for a week.  Can you actually say that there is very little sugar or virtually no corn syrup in your diet?  It may be hard to believe, but it’s in yogurt, breads, ice cream, salad dressings, sodas and sports drinks, muffins, non-dairy coffee whiteners, and even some kinds of dark chocolate.  If you’re doing a fairly good job avoiding it, then it’s not number one.  But maybe it’s number two.  I have no problem with a treat now and then, but I want to know when I choose it, and I don’t want to eat “hidden sugar.”  It spikes your insulin levels, packs on the fat, and makes you crave more.

American portions are out of control, and not just yours.  Bagels have tripled in size since the 1960s.  There’s always room for dessert.  You can get a bucket of soda for ten cents more, so why wouldn’t you?   Just super size me, you know?   But I don’t want people to feel hungry, or denied.  Eating well and being satisfied are synonymous.  Luckily, there are good solutions to hunger, and they are called fiber, fat, and protein.  Fruits and vegetables and beans are delicious and filling.  Fat is flavorful and satisfying.  Protein keeps you going.      

Exercising your right to free speech more than anything else?  Getting exercise can be difficult, but it’s not impossible.  First, remove as many obstacles as possible:  Sleep in your T shirt and shorts, and put the gym shoes by your bed so you have to step over them to get up.  Ride an exercise bike at home instead of having to drive to the gym.  Commit to meet a friend and walk together, so you don’t keep one another waiting.  Secondly, reward yourself, with a chart and gold stars if necessary, and then redeem those gold stars for something you’ve been dreaming about.  Think about what it will take to get you moving, and do whatever it takes.  Make it worth your while.  If your knees bother you, then take a Tylenol beforehand.  As I tell my patients, “I’ll pay any price to keep you mobile.”

On a scale of one (always relaxed and focused) to ten (frighteningly freaked out and finding it hard to think), how stressed out are you most of the time?  Know that a very important part of being healthy is relaxation, in both daytime and nighttime.  If you rate your stress level almost always as lower than four, keep up the good work, and continue to work on protecting your relaxation time.  If it’s higher than four, you may find that walking helps, or meditation, or yoga, or talking about it with friends.  If your stress level is higher than six, you may want to schedule an appointment to talk about it with your doctor.  Your doctor should be able to refer you to a professional with expertise in stress management.

If you’re having difficulty sleeping, learn about “sleep hygiene” and see if you are doing something that is actually making it worse.  Are you finding it hard to fall asleep because you can’t turn off your mind?  Do you wake up in the early morning hours and have difficulty returning to sleep?  Maybe you aren’t getting enough sleep, period.  Any of these can derail weight loss efforts.

Have you been eating a big bowl of cereal before you go to bed?  A peanut butter sandwich or a candy bar?  That’s a problem.  Start working on this issue by trying to eat a bigger breakfast and lunch, thereby getting in more calories earlier in the day.  You may still want a nighttime snack, but it can be a healthier one.  Eat berries, for example, which are sweet and satisfying, but low in practically everything else (except fiber).  

See how these apply to you, and start thinking about the one that resonates most with you.  One step at a time, one day at a time, one issue at a time.  I don’t believe in quick fixes.  I believe in slow, sustainable progress, so that someday you can say, “Wow, I really eat differently than I used to.”

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If you’ve never been on “Your Health is on Your Plate” before, and you’re not sure where to start, visit Lets Start at the Very Beginning to get a jumpstart on preventing diabetes and obesity in yourself and the ones you love!!

This weekend I was introduced to two great recipes, both of which owe their greatness to garlic.  The first is “pure de verduras,” or pureed vegetable soup.

My friend Stacy, who had the good fortune to live (almost 30 years ago) with a family in Spain for one year of high school, came home with enough recipes and inspiration to last a lifetime.  Yesterday she told me how her host mother would make pure de verduras with whatever vegetables were left at the end of the week and how, for this reason, it was never exactly the same twice.  Stacy sighed when she reminisced about the times that the recipe included red or golden beets.

Here’s what her host mother did:  She chopped up the combination of (washed, peeled) vegetables coarsely, and put them into a pan with a bit of hot olive oil.  After a few minutes of frying, she would add just enough water to barely reach the surface of the vegetables.  She covered the pan, and let the vegetables cook for maybe 10 minutes until they were just cooked through.  The cooking time differed depending on the types of vegetables.  Then she would put the contents of the pan into a blender and blend until the vegetables were pureed.

In the meantime, she would heat a bit more oil in the frying pan, and then add slices of fresh garlic.  These would cook for just a minute or so, so that they still retained their bite, but mellowed somewhat. To serve, she poured individual bowls and then spooned some garlic and oil onto the surface of each bowl of soup.  All these years later, memories of the taste of this simple dish brought such joy to my friend’s face.

Not two hours later, I was sitting in the kitchen of another friend’s home.  She brought out bowls of fresh vegetables, crackers, and a delicious red dip made of dried tomatoes.  This is great, I said, how do you make it?  Oh, it’s easy.  And she meant it.  

A couple of cups of dried tomatoes and 1 clove of garlic.  Put them into a food process or blender and pulse just a few times until it’s chunky.  Be careful though, she said.  If you turn on the machine and walk away, you’ll end up with tomato paste.   

I shared last week that cognitive dissonance is the uncomfortable feeling that comes from believing two conflicting ideas at the same time.  How does this apply to what we eat, and to its effect on our health, both as individuals and as a nation?

This week and next, I’m discussing the concept of “cognitive dissonance.”  Cognitive dissonance is the uncomfortable feeling that comes from believing two conflicting ideas at the same time.  Whenever a reasonable person engages in risky behavior, whether slight (a second slice of cake) or serious (texting while driving) he or she experiences some cognitive dissonance.  Humor is a common way to decrease the tension caused by cognitive dissonance, so beware if you find yourself chuckling when you tell your friends what you did last night.

What are other examples of cognitive dissonance?  Smoking is one.  Smokers reconcile their desire for a cigarette with their desire to live long, healthy lives. This conflict makes them feel uncomfortable.  The knowledge that “I am increasing my risk of lung cancer” does not support the belief that “I am a smart and reasonable person who makes good decisions.”  So how do smokers decrease their cognitive dissonance?  I have seen any number of strategies.

A smoker might rationalize that lung cancer, heart disease, and emphysema develop only in people who smoke more than they do.  They might trick themselves into believing that smoking actually protects them from illness.  Or they might decide, once and for all, to quit.  All these strategies reduce cognitive dissonance, but the last obviously works best.  

Aesop’s fable, The Fox and the Grapes, provides another example of cognitive dissonance.  A fox sees some delicious-looking grapes hanging high on a branch but cannot reach them.  The fox wants something that he cannot have, and he soon decides that the grapes are probably sour and not worth the effort.  In this way, he convinces himself that 1) there is something wrong with the grapes, and 2) there is something wrong with anyone else who might want them.  

Therapists sometimes use cognitive dissonance to help clients see how their own behaviors are causing them discomfort or harm.  It’s not always easy to see that on your own, but it’s often impossible to ignore once someone helps you see it for yourself.  When you understand your actual choices, it’s easier to make them in a way that supports your goals.  

Cognitive dissonance can cause a person to feel surprised, guilty, angry, or embarrassed. People experiencing this discomfort usually try to reduce it by changing their beliefs or adding new ones to reduce the conflict between the two conflicting ideas.  

Next week I will discuss how we have come to accept a large amount of cognitive dissonance in what we eat and how it makes us feel.  Americans live with so much food-related cognitive dissonance that it has become an invisible part of the background.  But that doesn’t mean it’s normal, or healthy.  Far from it.

Early this past week, a woman to whom I had just been introduced told me that she doesn’t do well with soy-based food.  It upsets her stomach, she said.  What kinds of items do you mean?, I asked.  Well, anything made of soy, she thought out loud, like soy chili, soy bacon, “texturized vegetable protein” made from soy, soy milk, and so on.  What about edamame?, I asked.  Or tofu?  Those are fine, she said.  I can eat those without any problem.  I don’t think you have a problem with soy, I replied.  I think you have a problem with food processing.  Processed soy.  It’s not the same as food.  

Michael Pollan says that it’s not food if your (or somebody’s) great-great-grandparents didn’t eat it.  So those processed soy products that are upsetting her stomach aren’t food.  

Think about the expression, “Trust your gut.”  If something seems not to agree with you, trust your gut, and don’t eat it.  Unless you want to feel sick.  End of story.  

On the home front, my parents came to visit this weekend, and they brought with them, from their NJ farm, half a dozen golden-laced Wyandotte chicks.  Those chicks are CUTE!  Right now they are cuddling up together for a little snooze.  We are looking forward to the increased egg production that these beautiful girls will help to provide.

Mom and I did some weeding in the garden today, and the big hens helped out by scratching around the weeds, scooping up bugs and worms, and just generally being good company.   Today is such a beautiful day.