Transcription:
Setting Health Goals in the New Year

Melanie Cole (Host): Thanks for tuning in to Back to Health, the podcast that brings you up to the minute information on the latest trends and breakthroughs in health, wellness, and medical care. Listen here for the information and insights that will help you make the most informed and best healthcare choices for you. I'm Melanie Cole and we are discussing setting manageable weight goals and New Year's resolutions Joining me is Rachel Stahl. She's a Registered Dietician within the Division of Endocrinology at Weill Cornell Medicine. Rachel, it's a pleasure to have you with us. Always a great topic. So, we're going to talk about specifics, but I would like to just jump in when people ask you, knowing you're a dietician, what's your first piece of advice to get started on healthy eating habits, even a little bit before the holidays and create their plan of action. What do you tell them?

Rachel Stahl, MS, RD, CDN, CDCES (Guest): Great. Great first starter question here, Melanie, and thank you so much for having me. Big piece of advice I give to people is keep it simple. Everyone is ready to jump on board on these elaborate diets and meal plans and supplements, et cetera. And I encourage them take a step back, reflect on their current eating habits, because advice is so individualized. And I encourage them to think about, you know, what are they currently doing that they think might be inhibiting their, their weight loss or general health goals. And really starting from there is the first step.

Host: Certainly true. I mean, and, and definitely setting goals and really making up your mind is so key. Now, as people think about eating healthy, Rachel, is there a difference between healthy eating and eating to specifically lose weight?

Rachel: Yes, Melanie. And that's such an important piece that I would love to take the time to differentiate. When we think about eating to lose weight, right, it's very specific and it has a single overarching goal, right? Weight loss, very much more black and white, right. Eat this, or don't when it comes to weight loss. But eating healthy, you know, or general healthy eating is something that's more dynamic and much more mindfulness approach. It's less about this diet mindset more about a sustainable longterm strategy to support people towards healthy living. So, I think it's more inclusive and more real life.

Host: I think it is too. I completely agree with you now. We, we hear this SMART goals and as an exercise physiologist, I've been talking about these for years, but people don't really know what they are, and I think they apply so well to this conversation Rachel, as we're talking about weight loss and just healthy eating it doesn't have to be exercise for SMART goals. Right. It works for anything across the board. Tell us what those are.

Rachel: Yes, SMART goals are definitely a foundation of when I work with patients, right. We set goals that are SMART. And what it stands for is an acronym that is S for specific, M for measuring, A for attainable or achievable, R for relevant and T for time bound. So it's a, a framework that helps us to follow up on goals.

And I like your comment too. It's, you know, not only exercise, is not only nutrition. People use SMART goals in their personal and professional lives in all ways. And you know, why it's been evidence-based to be helpful is because it's specific to that person. I'm sure you can think of some goals you've had worked on with patients and your time, right around exercise?

Host: Oh, definitely I have, of course. And you want to, you know, like you say, you want to make them attainable and you wanna make them measurable, but you also want to make them realistic. And that's, I think where some people they say, okay, I'm going to do all of it at once and that's not always realistic is it?

Rachel: I know a perfect example, just the other week I had a patient, as you probably know, counting steps is very common as a goal, right? Everyone, Americans, you got to hit those 10,000 steps per day. And so I had a patient who's really, you know, we're talking about exercise, talking about setting goals and she loves that her smartphone has that step tracker built in. So she said, you know, she's currently doing around 2000 and she wants to hit 10 right away. I said, you know, let's look at these SMART goals, what would be a more achievable short-term goal? And, you know, for her, it was first 3000 and then the next week she worked it towards 4,000 and so on and so on. So I think, you know, setting those mini goals towards reaching something bigger is so important to help them achieve their goals.

Host: Well, it definitely is. So let's talk about motivation, once we get started and we're going to talk about labels and all this stuff, but motivation seems to be one of the biggest issues that I've ever run into in 30 years in the business is setbacks motivation. And we all fall off the food wagon, Rachel, we all, oh, God stick a spoon into the peanut butter, you know? So what do you tell people about that motivation and, and how we can stick to those goals that we're setting? And if we have a setback not to berate ourselves, women, especially right Rachel? We, we, we negative talk ourselves into oblivion and we tell ourselves things worse than anyone would ever actually say to us. What do we do about the motivation, the setbacks, the negative self-talk?

Rachel: Yeah, absolutely. So much of it is in our heads, right? There's such a mental piece towards trying to stay motivated and dealing with setbacks. So, I think we really need to take the approach holistically of having the courage or patience to be patient with the process, you know, change takes time. And also don't aim for perfection. You know, this is not a black or white kind of situation. We know that there might be days when they're just not feeling the energy to go to the gym and you know, or maybe their coworker brings in a dessert right, during the holidays. And they had sworn off dessert, but can't help themselves having a cake.

We need to remind ourselves is do that positive self-talk, thinking about being kind with yourself and there's definitely no benefit to beating yourself up. And also staying motivated is having accountability, you know, having people that can support you, friends or family that can help keep you motivated towards your goal or planning activities or meals that are healthy, that help you to stick to it.

We also know that making it fun is so important, right? Finding recipes that are different and new to try or different exercises. I'm sure as you can attest, I know myself as we're getting into these colder, colder weather, I can't run and bike like I normally would in, in the warmer weather. And it's honestly, it's frustrating for me.

I, I, you know, I like to exercise, so I've had to rethink, ideas to get creative with movement, whether it's online dance classes or kickboxing, something different to, to change it up. So that's definitely something I encourage. And for some people staying motivated, I find they find it helpful to write it down, sometimes writing down your goal and actually visually seeing it could really be helpful, placing it on your fridge or, you know, right next to your computer, a reminder of what your goal is and where you, where you want to be, can be really helpful.

Host: Ooh, those were all great pieces of advice. Listeners, you should be writing this down or you can always rewind the podcast and listen again. Now, one of the things you mentioned struck me, you said, get your support system. And I remember in Weight Watcher days and things like that. And my mother was in TOPS, that some people that you get involved can actually be more negative in that way. They'll say, should you be eating that? If they know you're diet, you know, or the saboteurs, we used to call them the saboteurs, right?

But then we may revert and stress eat. What do we do about those saboteurs and the stress eaters? Because we're all going, you know, now that COVID, we're maybe attending parties, maybe we're going back out a little bit now, what about those kinds of people and the stress?

Rachel: Yeah. Definitely. I think we, we want to make sure we're not just continuing to internalize it and, and getting ourselves upset about it. And that's where I think, you know, speaking to that loved one and voicing your concern with them. Being, you know, making sure that you set the boundaries of how they can be supportive and what comments or conversations they talk to you about that make you feel negative.

So I definitely think speaking and communicating is really important. And when we think about, you know, stress eating from, from that experience or just in general of life getting in our way, I feel like stress is prevalent in so many aspects. When we think about how it relates to our food intake, I really think again, that self-talk of, of pausing before you're reaching for those, that box of cookies or before you're reaching for an extra helping to say, you know, am I really, truly hungry. I think so many people are out of tune with their natural hunger and fullness signals, and that's something I really work to help my patients understand is, is this a emotional reason for eating or is it true hunger? And once you work to really differentiate those feelings, it can help you be a more mindful eater, which helps prevent those overeating and those stressful moments.

Host: Beautifully said and about setting boundaries with our supporters and also that stress eating and mindfulness. It's so important now. So, as think about those, those little bits, the things that we do to help our goals, whether it's portion control, reading labels, those kinds of things. And I remember back in the day when my mother was like president of TOPS, she said, you can either do a portion, you know, portion control, which is not always easy, or you can do large portions of non-damaging food, salads, and, you know, plain pastas. This was a while back, but the portion control was harder for some people who needed to see a lot of food on a plate. Tell us a little bit about some of those things, the label reading, the portion control. Are we still weighing our food? Tell us about that.

Rachel: Yeah. absolutely. You know, portion control is such a key aspect towards, you know, being able to achieve your health goals and, and, and weight loss. And one of the biggest foundations that I like to do, I'm a visual person. Something a lot of my patients are too. So it works well. Is thinking about your plate, right? Looking at your plate and looking at it in a visual way. And it's a concept known as the plate method and what it is, is thinking about dividing your plate into half of your plate, filling up with non starchy vegetables. So that could include the big salad, right? Lots of volume, but also could include roasted vegetables, steamed vegetables, as long as you're really try and make half of your plate vegetables.

And then the other quarter, when it comes to portion control is keeping the one portion of lean protein, like chicken or fish, tofu and the other quarter with a high fiber car or starch. So that includes whole grains, like quinoa or brown rice. You might've heard of all these now ancient grains on the market. Amaranth, millet, and so on. You know, these are high in fiber and you want to really include that to be a quarter of the plate. And so that really helps and is a balanced way of eating that still allows you, the portions of foods you enjoy, but in the right proportions. And then alongside that reading labels, right? When we think about food products, not fruits and vegetables, that don't have labels, but for everything else, reading labels is so important because that's what's going to tell you exactly what is in the food. Many patients I work with, they, you know, many people in general, you know, they read the front of the label, oh, it's high fiber.

It's no cholesterol, it's fat free. Right. It must be healthy, but we need to educate our patients to look at the back of the label. That's where the truth is. Right. These, you know, they want to trick us. We really have to play detective. And that's where, depending on the person's health goals, they may need to look at aspects such as calories or carbohydrates, added sugars and so on. So really becoming a label detective is definitely something that I teach my patients about.

Host: Wow. We are really giving such an informative podcast today. So what about things like eating fruits and vegetables? Not a lot of people want them, salads are a pain. Let's, let's face it. You know, I love to make them, but it does mean a lot of chopping and cutting and washing and all of those things are involved. So people tend not to pick some of these healthy foods. They don't even maybe know what to do with kale, or broccoli or Kohlrabi or something that they're not used to. How do we get some of those really, really healthy foods into our diet if we don't know what to do with them?

Rachel: Yeah, that's a great, great point. And certainly, you know, working with a registered dietician is a great way to make sure you have the support you need to help meet those specific general recommendations. But as I mentioned, right, half plate of vegetables for lunch and dinner but can also be sneaking in a way with snacks. So, one example I love to recommend is keeping raw vegetables handy and put putting them in Tupperware or Ziploc containers. If you're on the go, try to choose the vegetables, you don't have to pre-prepare like baby carrots, grape tomatoes, green beans. Those you just take out of the package and put them in something that you could bring with you.

And I love pairing it with like a pre-portioned hummus cup or guacamole cup for a really satisfying snack or as part of a meal. Another thing to do, you know, thinking about eating more fruits and veggies is having it available and visual, right? If, if sometimes if we don't see it in front of us, we forget it's there. So if you're, you know, fall time, right, a lots of apples and pears, keeping it on, in your kitchen, and those could be easy to grab and go on your way out the door. We're also thinking about smoothies. Those could be made ahead of time, when you do have that moment of time during the week, or a little bit of extra time, you can pre portion them into Mason jars and keep in your fridge you know, for the next day.

So that's another great way. I just was reading someone was using Popsicle molds, and actually making, putting smoothies in the Popsicle molds to then take with them on the go. So always learning something new. There's always gotta be a creative way. Yeah.

Host: Wow. That's a great, I'll have to tell my, my 19 year old and 21 year old about that. That's a really good idea. Now what about tech gadgets? Because you even mentioned counting steps before, and there's so many on the market. Are there any that you really like to recommend for helping keep control? There's label reading ones? There's ones that help us count our calories or keep track of what we've eaten. Do you like any?

Rachel: Yes for sure. I am a big fan of digital tools to help support different health goals. And you know, it really, again, depends on the person and depends on their goals. So, let's say if it's, if it's an exercise goal, having gadgets like Fitbit or an Apple watch, which could be tracking not only your steps and activity, but your heart rate, can be a nice added feature. Fitbit's I like, they send reminders. They like vibrate. You gotta move. You gotta move to encourage you to get that movement. I think of other gadgets or apps too, like I was just using Strava. I, I started getting into apps and now I could track my distance on my bike rides and it gives me encouragement.

People can comment. So, I always need to try it out myself before I recommend, you know, gadgets and stuff. I love trying them out. So, those can be great ways. And for nutrition, some apps people like, like, My Fitness Pal, if they are someone who likes to journal and keep count of, of the food that they're eating. And what's great about it, it takes the burden off the user. They could just actually scan the food item from their smartphone, so they don't have to go and enter, you know, and spell out and take the time of adding food. They can just scan it and it gets uploaded into their personal diary. And what's then fun for me is during our visits, I could actually see all that they've eaten, which really allows for a really fruitful discussion on their eating habits and how that's supporting or inhibiting their weight loss efforts or other health conditions. So yes, big fan of technology.

Host: We could talk for a very long time. Rachel, I only have a few more questions, but this is a big one because there's been some controversy. And I remember back in the day when my mother would say, write down your food and then read it to yourself in the mirror every night, because you are your own worst and best critic. Right. And she'd say that was harder than reading it to a room full of people in one of those meetings, if you could read it to yourself. But where do you stand on things like journaling and, and weighing yourself because some people say don't do it. And some people say, do weigh yourself on a regular basis so you can keep track.

Rachel: Yeah, those are great, great points. And again, it really depends on the person, you know, and that's where, you know, having an individualized appointment with, with me or another healthcare professional to really talk about that with the patient. So I don't blanket recommend patients to journal necessarily, and some have, you know, some, for some people it does create that negative feeling. And so I certainly don't want to promote that at all.

So we, there are other ways. The good thing is, is there are other tools and strategies to help patients reach their goals without food journaling. You know, on the other hand, I have patients that have found to be so incredibly helpful. So I am certainly supportive in that way.

As long as it does ultimately create a positive relationship about food. What I don't want is people to get so obsessed, right, with counting every single calorie. So, that is something for me that I personally feel we need to support them in a healthy way to do it. Some journaling now has expanded that they're not just listing the food and nutrients, but now it's just taking a picture of their food.

So it could be a little bit lighter, right? Less negative feelings if it's, you know, a picture and patients say that that they're like, I've become food. I become like a food journalist now, you know, excited to show me all their, all the pictures of their food. And then when it comes to the scale, again, personally, I don't recommend patients weighing themselves every day.

There's so many factors that can affect weight in any given day, you know, level of hydration, sodium, alcohol intake, for women, time on their menstrual cycle. And I don't want to, again, focus, being so obsessive about the weight, because there's so many other facets towards health, maybe it's how they fit in their clothes. Maybe it's their energy levels. Maybe now that they're eating healthier, they're sleeping better. So, I really like to take a multifaceted approach as opposed to just the scale.

Host: Wow. You are just a wealth of information Rachel and such a good educator, as well as we wrap up.

Rachel: Oh, thank you.

Host: It's the holiday time. Maybe we get to go to parties. Maybe we're eating out. Maybe we're throwing a little party for our friends and family. I would like your best advice for weight loss and healthy eating during the holidays and how we can get ourselves on track, stay on track, any little bits of advice you want to offer, now's the time.

Rachel: Okay. So I'll make it short and sweet here. When thinking about the holidays and I'm sure maybe people are having more get togethers certainly than they've had last year. You want to think about first off, being prepared and not going to these parties too famished, right, because that could often lead to people overeating. Right. They've been starving all day to save up for this big meal. But I would not recommend that. Have a normal well-balanced meals throughout the day. Maybe even having a small high protein snack right before you go, that way, you might be less tempted to indulge in some of the more heavy appetizers that might be coming your way. Also thinking about paying attention to beverages, right? Often people forget that holiday cocktails and mocktails and other alcoholic drinks can contain a lot of calories and a lot of added sugar. And oftentimes people might be more inclined to eat even more if they've, you know, drank a couple glasses, they kind of get that feeling.

So we want to make sure they, you know, sticking to drinking in moderation. And lastly, thinking about slowing down, you know, and really taste your food. Many people, at all times of the year, we're eating so fast. We have, we're, we're connected to technology, our phones. But now with the holidays, if you're eating with others, use this as an opportunity to pause and slow down, you know, savor that time with others and take those breaks between bites. Take a glass of water between bites. Just anything that you can to slow down, because it often takes, research says, 20 minutes from your stomach to signal to your brain that it's full. And Melanie, you've probably heard this yourself too, right? That you really need to give yourself that time to digest the meal, to help your body notice that it's actually hungry.

Host: Oh 100% and that's all such great advice. And Rachel, I can't thank you enough for joining us today and offering up those pieces of advice for women that we can all use and all hear. Thank you again for joining us. And Weill Cornell Medicine continues to see our patients in person, as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine.

Please download, subscribe, rate, and review Back to Health on Apple podcasts, Spotify and Google podcast. For more health tips, go to weillcornell.org and search podcasts and parents, please don't forget to check out our Kids Health Cast. I'm Melanie Cole.

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