by 

December 3, 2017

The primary intentions of this article are to provide a concise introduction to a relatively new approach to eating and to provide  practical strategies that can be used for getting lean. The strategies are easy to incorporate into everyday routines and do not require a lot of calculating or deep thinking.

Most people know the primary determinant of weight loss is calorie reduction.  That is, decreasing calories, consistently, below maintenance level. Apparently, just knowing the primary determinant driving weight loss is not enough. The difficult question to answer is – how to structure the environment, so weight loss becomes easier?.

The standard nutritional approach to eating focuses on calorie content, nutrient content of food and physiological response to eating.  The standard social / behavioral approach to eating focuses on eating behaviors, patterns of eating, learning and factors influencing consumption.  The nutritional approach doesn’t pay enough attention to eating behaviors, while the social / behavioral approach doesn’t pay enough attention to nutrition.  The standard models for studying nutrition and designing nutritional plans are missing something. They are missing a focus on the multiple factors that influence eating behavior.

Cognitive Behavioral Nutrition

(CBN) is the interface between nutritional science and social / behavioral science.  CBN is concerned with the development of comprehensive eating plans- nutritional aspects, learning mechanisms and the variety of factors driving food consumption.  In addition to standard nutrition recommendations, CBN provides strategies to improve eating behaviors, addresses the In-home food environment and suggests how the food environment can be structured to make it more conducive to nutritious eating.

Understanding why we eat what we eat can have a positive impact on controlling eating behavior.  Eating behavior is an important factor involved with bodyweight and health issues.  Excess weight is associated with increased mortality, morbidity, cardiovascular diseases, type 2 diabetes, hypertension, stroke, gallbladder diseases, osteoarthritis, sleep apnea, respiratory problems and some types of cancer.1,2  Calorie balance plays a key role in weight maintenance.  Weight loss can be expected with a persistent decrease in calorie consumption (eating less calories than maintenance).

Eating behavior is an element of culture, ideational values, social gatherings, pleasure systems, and identification and so on.  The importance of food and its relation to our everyday life cannot be overstated.

Food heuristics are mental shortcuts used in relation to food related issues.  Examples of food heuristics: low carb diets, low fat diets, traditional bodybuilder diets and volumetric eating. These examples often lead to calorie deficits without having to count calories.  To be clear, just because one doesn’t count calories doesn’t mean they aren’t important.  Not being conscious of caloric consumption is the norm.  Diets/ eating plans that result in weight loss are diets that create calorie deficits and those that result in weight gain are those involving calorie surplus.  A  small portion of  dieters maintain weight loss.  Providing information about the nutrient and calorie content of food may be helpful, but it may not be enough to ensure long-term weight loss or weight maintenance. Eating strategies are needed that do not require a lot of thinking.3 Humans are cognitive misers; they don’t like to think hard.

Factors influencing eating behavior

Some of the key factors influencing eating behavior: Food likes / dislikes, Expectations, Variety and Sensory specific satiety, Eating w/ others and Macronutrient content. A concise list of factors involved with eating behavior are mentioned here; a comprehensive overview is beyond the scope of this article.

The evidence concerning the impact of food likes on eating behavior is not completely in agreement, but the weight of evidence suggests that food likes play a major role in eating .4 Eating foods that are liked activate brain reward mechanisms, and this activation leads to a pleasurable experience.  Nutritious foods do not have to be bland. Adding some flavor will probably increase the likelihood that you achieve long-term eating success.  Eating with the objective to be lean can be enjoyable. Try different food combos and mixtures of spices and flavorings. You might be surprised at how many different flavor worlds you can create.

Different expectations (positive vs negative) about food may lead to differences in brain activity, leading to different outcomes (responses / reactions). In one study graduate students  attending a wine and cheese reception perceived the flavor of the wine and cheese as better when the wine was labeled California vs. North Dakota- even though the only difference in wine was label.3 Whether a food tastes good or not is largely dependent on expectation.

The larger the variety of food the more food consumed.  The premise that increasing the variety of food can increase consumption has been found in both genders and across a wide range of ages.3  In a recent study, it was found participants watching a humorous video ate more M&M’s from a bowl containing multiple colors than a bowl containing a single color (even though there is no difference in flavor).5  Sensory specific satiety is often implicated as one of the primary mechanisms underlying the variety effect.6  Sensory specific satiety refers to a decrease in pleasure with continuous consumption of the same food or flavor relative to an unconsumed food With continuous consumption of the same food we like it a little less with each bite.

People tend to eat a similar amount as the person(s) eating with them.  Research shows people eat more when they eat with more people.7  When eating with large groups there is a tendency to eat for longer durations and a tendency be less attentive to how much is being eaten.

Protein is generally found to be more satiating than fat or carbohydrate.  In one study researchers  investigated satiating hierarchy of fat, carbohydrate, protein and alcohol.8 They found that protein had a significant effect on short-term hunger with participants being less hungry after protein consumption. If a larger portion of the meal is made up of protein less food consumption may follow.

In- Home Food Environment

The In- Home Food Environment are areas of the home where you are generally exposed to food.  I designed an assessment tool (H-Assessment: Home Food Environment) that can be used in an effort to restructure the home food environment. With the appropriate structure nutritious foods become more tempting and non-nutritious foods less tempting. This type of environmental structure ensures that nutritious eating becomes automatic (little thinking needed). The assessment I use consists of 64 items.

Key points: H-Assessment: Home Food Environment

Modify different areas of the home where food consumption is likely

Make nutritious foods more tempting while making non-nutritious foods less tempting

Be attentive to what you are eating, minimize distracters

Strive to maximize number of checks on the list

A comprehensive approach to eating is essential in an effort to create long-term, successful eating plans.  Telling people what to eat, and educating them on the nutrient status of foods is important, but it is not enough.

Requirements of a Quality Diet

Many roads lead to the same place. There is no ultimate diet.  If you can’t stick to the diet, it won’t be successful. The psychological aspect of dieting is often overlooked, but is crucial in determining success. For many people, whether or not they stick to a diet is determined by psychological issues — support systems, coping with emotions, quality & frequency of counseling. Pick a diet that you can stick with. If you hate all of the foods included in the diet and you’re really dreading the diet—choose a different one. I will say it again- a quality diet doesn’t have to consist of only bland foods. There are plenty of spices and other low calorie, safe additives that can make your nutritious diet a tasty diet. If you don’t like anything you eat your diet is likely to fail. Of course, there are those that will eat anything (regardless of flavor or lack of flavor) to enhance performance or physique development. However, those people are the minority. Humans like food; eating can be pleasurable, and it should be, at least on occasion.

A quality diet takes the following into account:

Adequate calories. (This matters whether you’re consciously counting calories or not.) Calorie balance is the major determinant of weight loss)

Essential nutrients

Individual likes and dislikes

Metabolic abnormalities

Occasional breaks. (You don’t have to stick to the program 100 percent of the time to see the benefits)

Environmental factors (such as: Food likes / dislikes, Evaluative conditioning, Expectations, Variety and Sensory specific satiety, Eating w/ others, etc.)

Getting lean is a process; it is a matter of lifestyle. The following strategies are easy for anyone to use and decrease the difficulty often associated with good eating. Using these strategies will improve chances of sticking to a sound nutritional plan.

EZ Strategies

Don’t fall victim to Halo Effect! Recognize the nutritious foods have calories, and eating a nutritious entrée doesn’t mean you can over-indulge on the extras.  Low-fat or low-carb doesn’t necessarily imply low calorie, and it definitely doesn’t mean you can consume unlimited amounts.

Many eating plans fail because they are too strict, ask you to make too many changes and require severe deprivation.  These characteristics often contribute to failure; they may be tolerable for short-term, but probably not successful for the long- term.  Do not try to make too many changes early on, and do not ignore the importance of enjoyable food.

Do not leave tempting foods in plain view. Store them in less-convenient locations (in a basement or in a top cupboard). Foods in plain view are likely to be eaten, and it is unlikely that their consumption will be accurately monitored. Calories can add up fast, even when taking just a few bites here and there.

Do not leave serving bowls and platters on the dinner table. Easy access increases the likelihood of plate refills. If you have to leave the table to refill your plate you have to expend energy and you are more likely to accurately monitor what you are eating.

Decide how much to eat prior to the meal instead of during it. Once your pre-determined amount is eating put down the red flag. The red flag means “stop.” When you are done eating immediately move the tempting items away from you (plate, food remnants, food bags,etc…). Anything associated with the food might persuade further consumption.

Try to eat, only when sitting down, and do this at a distraction-free table. This behavior allows you to associate eating with sitting at the table and not so many other things (driving, watching TV, sitting at the computer desk, etc.). Eating at a distraction- free table allows better monitoring of food intake.

If you insist on eating a meal or snack while being distracted (such as eating while watching television or reading), pre-serve the portions and allow no “refills.”  It is hard to monitor food intake while having your mind elsewhere. We have a limited number of cognitive resources that can be used simultaneously. Trying to watch TV and trying to pay attention to how much you are eating, at the same time, results in a huge cognitive drain.

If you insist on eating more after you have finished your plate be sure to have some go to foods/ relief foods.  These foods should be high in water density and low in calories- mostly vegetables. You can flavor the vegetables; again, eating nutritious foods can be enjoyable. I suggest having go to foods/relief foods packaged and ready, always.

Place the nutritious, low calorie foods in the front of the refrigerator, and the less nutritious foods in the back of the refrigerator. This makes the nutritious foods more visible, easier to access and more likely to be eaten.

At buffets and receptions avoid having more than two different foods on the plate at the same time.  Variety generally increases food consumption.  And, the more different the sensory characteristics (taste, smell, texture, color, shape, temperature) of the food the more the food is eaten.  Less variety generally leads to less food consumption.

Repackage foods into smaller containers or packages to suggest optimal portions.  You will eat 20-30% more from larger packages.

Create positive expectations, for your family, regarding the food you are preparing.  Use words like “homemade” or “Cajun” when describing the food. This type of cognitive priming has been shown to enhance the liking of food (this persuades positive expectation).

Beware of leftovers.  The more containers you place the leftovers in the more you will probably eat when they are taken from refrigerator. This increase in eating is at least partly due to the variety effect. That is, the variety effect (tendency eat more with larger variety) may even extend to variety in the context of different containers.

References

  1. Must, A., Spadano, J., Coakley, EH., Field, AE, Colditz, G., & Dietz, WH. (1999). The disease burden associated with overweight and obesity. JAMA, 282, 1523-9.
  2. National Institutes of Health, National Heart, Lung and Blood Institute. (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in Adults. Obesity Review, 6(2), 51S-210S.
  3. Wansink, B. (2014). Slim By Design: Mindless Eating Solutions For Everyday Life. New York, NY: William Morrow.
  4. Beauchamp, G.K., & Mennella, J.A. (2009). Early Flavor Learning and Its Impact on Later Feeding Behavior. Journal of Pediatric Gastroenterology and Nutrition, 48, S25-S30.
  5. Hale, J., & Varakin, D. (2016). Awarence of the influence a Variety of Food has on Food Consumption. North American Journal of Psychology, 18(2), 203-210.
  6. Levitsky, D.A. (2005). The non-regulation of food intake in humans: hope for reversing the epidemic of obesity. Physiol Behav, 86(5), 623-32.
  7. Vartanian, L.R., Herman, C.P., & Wansink, B. (2008). Are we aware of the External Factors that inlfuence our food intake? Health Psychology, 27, 533-538.
  8. Poppitt, S.D., McCormack, D., & Buffenstein, R. (1998). Short-term effects of macronutrient preloads on appetite and energy intake in lean women. Physiology & Behavior, 64(3), 279-285.