National Eating Disorders Awareness Week

Hello all you lovely blog readers. You're looking extra lovely today, if I do say so myself. Seriously, go look at yourself in the mirror and see if I'm not right. 

I'm right, aren't I? Of course I am! 

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So this week's post isn't really about food, but it's an issue that's both highly important and very close to my heart. February 23 - March 1 is National Eating Disorders Awareness Week (it's technically an American thing, but that hardly matters).

So this post will be about various eating disorders, common myths, and information on how you can either help a loved one or get help yourself.

Before I begin here, I feel it is necessary to divulge a bit of personal information, which is kinda uncomfortable since I have no idea who will be reading this! Years ago, I struggled with an eating disorder and managed to beat it. The whole long, terrible, painful experience of illness, recovery, and rebuilding my life put me on the path I'm on now—studying nutrition with the hopes that someday I can help others in the way that I was helped.

Personally, if there was just one thing I wished people would understand about eating disorders, it would be this:

It's not about food. 

Truly. Not about food.
It's not even all about body image. It's also about coping, insecurity, control, loneliness, isolation, anxiety, perfectionism, identity, depression, past wounds and future fears. The idea that a mental disorder as complex as an eating disorder can be fixed simply by "eating properly" is as ridiculous as saying that depression can be fixed by "thinking positive".

There can be a lot of confusion surrounding the definition of eating disorders, but it's important to remember that symptoms manifest differently in unique individuals—there is no cookie cutter definition of an eating disorder. The American Psychological Association recognizes three main eating disorders, as well as a fourth "undefined" disorder:

1. Anorexia Nervosa

•  self-starvation induced by intense fear of weight gain and obsession with weight
•  individual engages in continual, compulsive behaviours to prevent weight gain, such as routinely exercising to the point of exhaustion or creating rituals around food and eating

2. Bulimia Nervosa

• eating a large amounts of food very quickly at one time, followed by compensatory behaviours such as vomiting, laxative abuse, and excessive exercise

3. Binge Eating Disorder

• frequent consumption of very large amounts of food, but without compensatory behaviours seen in Bulimia Nervosa

4. Eating Disorder not otherwise specified (EDNOS)

• often show a mix of symptoms of anorexia and bulimia, but don't necessarily fit into either category

That's a highly generalized summary, but it would take forever to go overly in depth. For more information, visit http://nedawareness.org/about-eating-disorders.

There are many misconceptions and confusions surrounding eating disorders. They've been glamorized, trivialized, ridiculed, and brushed off. What's more, having poor body image is considered "normal", as are dieting and negative body talk.

(On a sidenote, it is always an appropriate time to quote Mean Girls. The limit does not exist.)

So let's dive into what this "normal" looks like. The National Eating Disorders Association (NEDA) and the Canadian National Eating Disorder Information Centre (NEDIC) have compiled highly comprehensive statistics. Here are a few:

"81% of 10 year olds are afraid of being fat"
(Mellin et al., 1991)

"Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviours such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives" (Neumark-Sztainer, 2005)

"4% of boys in grades nine and ten reported anabolic steroid use in a 2002 study, showing that body preoccupation and attempts to alter one's body are issues affecting both men and women."
(Boyce, 2004)

"Anorexia Nervosa has the highest mortality rate of any psychiatric illness - it is estimated that 10% of individuals with Anorexia Nervosa will die within 10 years of the onset of the disorder."
(Sullivan, 2002)

As I talked about a few weeks ago, food and eating has somehow become extremely complicated. It can be hard to discern what is normal, and what isn't. Below is a definition for healthy eating used by an RD who works with eating disordered patients. As you read this, bear in mind that there is a different between disordered eating and having an eating disorder. Most people will likely exhibit some of these behaviours every now and again—this does not mean you have an eating disorder!  

With so many children, adolescents, and adults obsessing over weight, food, and body image to the point of debilitation and even death, we cannot afford to be silent about eating disorders anymore. So I'm going to take this opportunity to bust a couple ED myths.

Myth #1: You can tell just by looking at someone whether or not they have an eating disorder. 

Eating disorders are mental diseases. The toll they take on the physical body is devastating, but their effects on the brain can be unbearable. Someone may appear normal weight, overweight, obese, or even athletic but be silently facing thoughts of depression, inadequacy, hopelessness, fear, and anxiety.  

The media may cause us to think that in order to have an eating disorder, you have to be severely emaciated. Drastic starvation, even to the point of heart failure and death, does occur. But it's dangerous to brush off those who do not meet our expectations of what an eating disorder "should like look". This myth can discourage individuals from seeking help, for fear that they will not be taken seriously if they don't look like Jack Skellington. 

Myth #2: Eating disorders only affect teenage girls. 

Eating disorders primarily manifest in females aged 15-24, but it is estimated that 10% of individuals seeking professional help for eating disorders are male. It has also been noted in scientific literature that males are less likely to seek help for an eating disorder than women. So the actual percentage could be higher.

There are also studies emerging concerning the prevalence of eating disorders in older women. In one study of women aged 60-70, 4% of the study participants exhibited eating disordered symptoms (e.g. laxative abuse, bingeing). This is comparable to rates in women aged 15-24. 

Myth #3: Eating disorders only affect white, middle and upper class individuals. 

Eating disorders don't discriminate—they are prevalent amongst lower, middle, and upper socioeconomic classes. Additionally, rates of eating disorders are similar among African-Americans, Caucasians, Asians, and Hispanics. 

Myth #4: Eating disorders are caused by the portrayal of unrealistic bodies in media.

Research does show that increased exposure to fashion magazines, TV, and ads is directly related to increased levels of body preoccupation and dissatisfaction in young girls; however, if these images were the cause of eating disorders, everyone would have an eating disorder. 

While the media certainly perpetuates body dissatisfaction, most people do not develop full-blown eating disorders. Eating disorders are the result of a myriad of factors—personality, support system, coping mechanisms, genetic predisposition, and past experiences are only a few. 

Myth #5: Eating disorders are a choice. 

No one wakes up and thinks, "I'd really like to develop an eating disorder today". As mentioned before, eating disorders are often about control and perfectionism. What can begin as well-intentioned determination to get healthy and eat right can escalate into compulsive deprivation. Eating disorders can also be an outlet for gaining control over one's own life. 

Eating disorders are self-perpetuating cycles—they take hold and rip away one's control over their thoughts. It's a difficult thing to understand, which is partly why so many misconceptions exist. If you want to understand more, I suggest you read the stories of people who have experienced ED firsthand. 

For stories from eating disorder survivors: http://www.nationaleatingdisorders.org/stories-of-hope.

Now it's time for Emma's book recommendation! This is a thing I have just created, and I can tell you are very excited. 

The best book I have read on the topic of eating disorders is definitely "Unbearable Lightness" by Portia de Rossi. She describes so succinctly the silent pain of living with an eating disorder and the incredible struggle of recovery. Also, Portia is delightfully witty and a wonderful writer. 

For anyone wanting to better understand what goes on in the mind of someone suffering from an eating disorder, read this book! 

If you have any book recommendations for me, please leave me a comment! They don't necessarily need to be eating disorder related—I love books and am always looking for a reason to delay my chemistry homework. 

In conclusion, I would like to say (a) one BIG thank you for reading this very long post, and (b) if you are currently battling an eating disorder, or suspect you are at risk/have an eating disorder, PLEASE do not be afraid to seek help. There are so many resources to help you and people to love you. No one should have to deal with an eating disorder, especially on their own. 

For Information on Eating Disorders

National Eating Disorder Information Centre (Canada)

http://www.nedic.ca/

National Eating Disorders Association (USA)

http://nedawareness.org/

Medical Help in BC

Vancouver Coastal Health

https://www.vch.ca/your_health/health_topics/eating-disorders/eating_disorders

St. Paul's Hospital Eating Disorders Program

http://mh.providencehealthcare.org/programs/provincial-adult-tertiary-eating-disorders-program

Looking Glass Foundation for Eating Disorders

http://www.lookingglassbc.com/

Woodstone Residence Treatment Facility

http://www.woodstoneresidence.org/home/2

UBC AMS Counselling

http://students.ubc.ca/livewell/services/counselling-services

Medical Help in London, ON and surrounding area

Student Health Services (Western University)

http://www.health.uwo.ca/services/students/

Hope's Garden (London)

http://www.hopesgarden.org/

New Realities Eating Disorders Centre (Toronto & Thornhill)
http://www.newrealitiescan.com/

Sheena's Place (Toronto)
http://www.sheenasplace.org/

Citations:

American Psychological Association (2014). Eating Disorders. http://www.apa.org/topics/eating/.

NEDA (2014). Get the Facts. http://www.nationaleatingdisorders.org/get-facts-eating-disorders.

NEDIC (2014). Statistics. http://www.nedic.ca/know-facts/statistics.

NEDIC (2014). Research on Males and Eating Disorders. http://www.nedic.ca/know-facts/statistics.

Peat, C.M., Peryl, N.L., Muehlenkamp, J.J. (2008). Body Image and Eating Disorders in Older Adults: A Review. The Journal of General Psychology 135.4 (Oct 2008): 343-58. Accessed at: http://search.proquest.com.ezproxy.library.ubc.ca/docview/213637984/abstract?accountid=14656.

Sands, E. R., & Wardle, J. (2003). Internalization of ideal body shapes in 9-12-year-old girls. International Journal of Eating Disorders, 33(2), 193-204

Shepperd Pratt Health System (2014). Facts & Myths. http://eatingdisorder.org/eating-disorder-information/facts-and-myths/. 

University of Rochester Medical Center (2014). Myths about Eating Disorders. https://www.urmc.rochester.edu/childrens-hospital/adolescent/eating-disorders/myths.aspx

Water. It's Important.

This is an indisputable fact: water is important. Our bodies are made up mostly of water— about 60% to be exact! The amount of water that we need on a daily basis varies depending on the individual. It can change with your level of activity, your health and even with the climate you live in. A general rule of thumb is that males should consume approximately 3.0L, while females should get about 2.2L of water. This value includes water that you get from food as well as drinks.

Wondering how to tell if you are dehydrated? If you answer "yes" to any of the following, it's possible that you may want to grab a glass of water!

• Have a dry mouth/lips?
• Feeling dizzy? Lightheaded? Tired?
•  (a little personal now) Dark yellow, strong smelling urine?
• Feeling hungry? Sometimes our brains cannot distinguish between hunger and thirst!

Here are some tips to keep you hydrated and healthy!

Water is the best way to keep you hydrated, and the Canadian Food Guide recommends that you “satisfy your thirst with water” for good reason—it’s refreshing, calorie free and inexpensive! Here are some ways you can increase your intake of good ol’ plain water:

• Keep a water bottle with you, at your desk, in your backpack, in your purse etc. If it’s with you, staring you in the face, you are more likely to drink it
• Get a drinking cup or water bottle that you like. I have one that is really handy and fun—I always keep it at my desk!
• If you find you are still not drinking enough, make a goal for yourself and keep track of your fluid intake by filling up a container in the morning (like a larger bottle or even a Brita) and making sure you drink it by the end of the day

Don’t like the flavour of water?

• Add a slice of lemon, some cucumber or even some berries for a fresh, fruity flavour
• Add a flavour packet like Crystal Light Singles—I use these sometimes to change it up, my favourites are Acai White Peach Papaya and Tangerine Grapefruit. And yes, I know these have Splenda and/or Aspartame in them. These sugar substitutes are perfectly safe to use, and I will have a whole blog post in the near future about them!

And water is not the only thing that keeps you hydrated!

• The Canadian Food Guide recommends to drink 100% vegetable/fruit juices, but I think that making yourself a smoothie is a better option than juicing. Smoothies include all of the nutrients, such as fibre, which are lost when you remove the skin of the fruit or veggie. There are also many options for nutritious additives such as yogurt, milk and ground flaxseed. I think that a delicious smoothie recipe may be in order, just to make this blog complete!
• Drink skim, 1% or 2% milk, whether it is plain or chocolate
• Drink some tea or coffee. Now there is a lot of controversy surrounding caffeine intake, its diuretic effect and potential to dehydrate you. If you drink coffee or tea on a regular basis, these warm beverages actually count towards your fluid intake. If you are new to coffee or tea, it may take 3-4 days for your body to get used to the caffeine. During this time, I would recommend drinking a glass of water for every cup of caffeinated beverage that you consume.
• Have a piece of fruit, eat some veggies or even warm yourself up a bowl of soup on a cold winter day. There are many food items which provide your body with the hydration it needs.

Make sure you stay hydrated with some warm, minty tea (mmmm my favourite!) and stay tuned for Emma's post next week on National Eating Disorders Awareness Week! 

Sources:
Mayo Clinic (2011). Water: How much should you drink everyday?  http://www.mayoclinic.org/water/ART-20044256

Dietitians of Canada (2013). Guidelines for staying hydrated. http://www.dietitians.ca/Nutrition-Resources-A-Z/Factsheets/Miscellaneous/Why-is-water-so-important-for-my-body---Know-when-.aspx

Food: So Complicated?

You know what's confusing? Food. It shouldn't be, really. In a perfect world, eating would be simple and enjoyable. We wouldn't agonize over calories, diets, and toxins. We'd just eat.

Alas, this isn't our reality. It seems new nutrition trends pop up every day, most of which are endorsed by medical professionals, athletes, and celebrities. I'm a nutrition student, and yet I find it nearly impossible to distinguish fact from fallacy.

Food. Why do we have to go and make things so complicated?

With the uncountable number of diets trending right now, it'd take forever to dissect them all. But I'll touch on just two of today's particularly buzz-worthy trends: gluten-free and detox diets.

Gluten-free

Judging by the many, many conversations I've had with people on the topic of gluten, one thing seems certain: a heck of a lot of people have no idea what gluten actually is.

Riiiiight. 

Gluten is actually just a composite of two proteins found in the endosperm of wheat and other cereals. Celiac disease is an autoimmune disease in which individuals cannot digest gluten. 

Celiac disease is different from gluten intolerance or wheat allergy. People who are gluten intolerant show celiac-like symptoms after eating gluten, such as diarrhea and fatigue, but don't have the intestinal damage associated with true celiac disease. Wheat allergy, on the other hand, is a rare food allergy where people experience classic allergy symptoms (ie. rash, respiratory reactions). 

So there is definitely a good number of people out there who should steer clear of gluten for medical purposes. But what about people looking for weight loss? 

According to Dr. Alessio Fasano, the Director of the Center for Celiac Research in Boston, MA: 

"The major misconception, because it's called a diet, people believe that in going gluten free they will lose weight. And that's not necessarily the case, it depends how they implement the diet." 

Simply replacing your wheat breads and pastas with gluten free varieties will not trigger weight loss. 

In fact, many gluten-free products tend to be low in a wide range of important nutrients, such as B vitamins, calcium, iron, zinc, magnesium, and fiber.

Now, this isn't because gluten itself contains all these nutrients. Rather, gluten-free products are often made with highly refined, unenriched flour. Naturally gluten-free whole grains, such as quinoa, millet, and brown rice, are great sources of vitamins, minerals, and complex carbohydrates.

Regardless of whether you are gluten-free or not, complex carbohydrates are really important! Our brains need glucose for fuel. Need need need. Our brains are greedy little pigs when it comes to glucose. And this glucose is released more slowly from complex carbs (i.e whole grain breads, pastas, rice, oatmeal, quinoa, all that jazz) than from simple sugars.

Bottom line: despite its dazzling popularity on the red carpet, going gluten-free isn't necessarily the magic bullet you might be looking for in terms of health and weight loss. If you're feeling sluggish or heavier, have a look at your lifestyle. Are half your grains whole, or do you perhaps love your muffins and Timbits a little too much? Is your idea of physical activity watching the Olympics? The factors behind lethargy and weight gain are many - so give gluten a break.

But of course, if you are concerned, confused, or your body is doing weird things, go talk to a medical professional, such as a Registered Dietitian. 

(Click here for a really excellent review of the book "Wheat Belly"!) 

Detox 

The idea behind a detox diet is that toxins from food, chemicals, and our environments build up in our systems, thereby necessitating a "cleanse". 

Also, Beyonce dropped a whole lotta weight really fast on a detox diet, so it's gotta be good for something, right? 

While I acknowledge that Beyonce is basically a superhuman, I have to disagree with her on this one. The science just isn't there. 

"There is no scientific evidence to support the need for detoxification diets. Detox diets claim to "cleanse" your system of toxins, but your liver, kidneys, and intestines already do that for you."

- Dietitians of Canada

Detox diets usually involve a period of fasting followed by a really strict diet. I'm never one for strict, unsustainable diets simply because they are unrealistic and absolutely no fun. However, detox diets can actually be really harmful if carried on for too long, or if used frequently as a means of weight loss.

"Frequent fasting or fasting for more than a few days may cause unhealthy side effects such as headaches, dehydration, low blood pressure or an irregular heartbeat." 

- Dietitians of Canada

Fasting diets can screw with your fluid and electrolyte balance, leaving you super fatigued and unlikely to go out and get physically active. Extremely low calorie diets can also put the body into "starvation mode" - the metabolism slows right down and the body hangs on for dear life, and on to any shred of nutrition it can get its villi around. 

So by engaging in a "detox" diet, you actually could be inhibiting your body's natural mechanisms of maintaining healthy weight! 

Bottom line: If you're feeling bloated and groggy after a decadent Valentine's Day wine & dine, don't reach for the Master Cleanse. Rather than depriving your body of the vitamins and macronutrients it needs, try eating greener for a couple days. Increase your water intake and go for a walk, run, or bike ride.

And I guess if you live anywhere in Canada that isn't Vancouver, shovel some snow.

So that's my post for the week. Thanks for reading, and Happy Family Day/Valentines Day/Olympics/ Reading Week to you all.

Stay tuned for Alisha's post next week!

Sources:

Dietitians of Canada (2013). Myths. http://www.dietitians.ca/Your-Health/Nutrition-Month/Nutrition-Month-2014/Myths.aspx
Dr. Alessio Fasano (2013). What is Gluten? http://www.livescience.com/39726-what-is-gluten.html
Juliann Schaeffer (2008). Spring Cleansing: Assessing the Benefits and Risks of Detox Diets. http://www.todaysdietitian.com/newarchives/tdmay2008pg34.shtml
Nikki Talacek, Sarah Hanrahan, et al. (2010) Experts warn of the dangers of detox diets. http://www.sciencemediacentre.co.nz/2010/01/04/experts-warn-of-the-dangers-of-detox-diets/

How Can I Eat Healthier?

Hey everyone! Alisha here. Welcome to our blog and very first "informative" post! 

Whenever I mention that I am in school for nutrition, the first question people ask me is, “how can I eat healthier?” 

Although the amount and types of food needed for a healthy lifestyle is highly individual—it depends on many factors such as your activity level—I always respond with this helpful tip: follow Canada’s Food Guide (CFG). 

Although the CFG is a generalized guide, it is a great place to start if you cannot get a personalized nutrition plan from a Registered Dietitian.

Here is the link to Health Canada’s Website and the Food Guide:
http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php. 

You can download a PDF version or you can order a hardcopy that Health Canada will send to you, free of charge. This site is a great resource! I would really suggest that you tour this site, use it to its full potential!
I’ll introduce the CFG to you now though.

(I’ll be looking at this printable pdf version):
http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/food-guide-aliment/print_eatwell_bienmang-eng.pdf 

First things first. Based on your age and gender, determine your recommended number of food group servings. Keep in mind that this is a minimum number of servings, and it is important to listen to your body and hunger cues to maintain the proper energy levels for a healthy and active lifestyle. For example, I am a 26 year old female, therefore I should be consuming the following:

            ü  8-10 servings of Fruits and Vegetables

            ü  6-7 servings of Grain Products

            ü  2 servings of Milk and Alternatives

            ü  2 servings of Meat and Alternatives

Now you may be thinking to yourself, 8-10 servings of servings of fruits and vegetables?!? I don’t think I can do that, this healthy eating thing is a lost cause. Fear not my friend! The serving sizes are much smaller than most people think. For example, a serving of Fruits and Vegetables can be any of these:

             ü  ½ a mango
             ü  1 medium stalk of celery

             ü  1 medium apple or banana

             ü  1 cup of raw spinach or lettuce

             ü  ½ cup of peas, sweet potato, corn or bell peppers

Go get a set of measuring cups to help visualize what this amount will look like. Also, if you choose a piece of fruit or some veggies with each meal and snack, you will be well on your way to healthy eating!

And don't feel the need to cut back on fruits and vegetables if you find yourself consuming 11 or 12 servings. Fruits and vegetables are incredibly high in fibre, vitamins, minerals and antioxidants, so as long as the rest of your diet is healthy and adequate, eat up! However, I would never recommend fad diets involving nothing but grapefruit or spinach (stay tuned for Emma's upcoming post on fad diets!) 

The CFG includes some serving sizes for common food items, and you can find additional examples here:
http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/basics-base/serving-portion-eng.php.

Last but not least, the CFG includes some tips on healthy eating and physical activity! For example, it suggests that you eat one bright orange and one dark green fruit or vegetable daily, choose whole grain for at least half of your daily grain intake and satisfy your thirst with water. You don’t like drinking water? I’ll have some tips and tricks to keep yourself hydrated next time you hear from me!

Alisha