Designing Individualized Food Plans

Ask The Expert: Tracy Stopler, MS, RD

2006: Volume 3, Number 1

 

Amy Blansit Broadbent

Editor, Medical Wellness Journal

 

Medical Wellness spoke recently with Tracy Stopler, MS, RD, President of Nutrition E.T.C.; Nutrition Director at Inform Fitness; adjunct professor at Adelphi University; Associate Editor of Total Nutrition, and co-writer of the up-and-coming book, The Right Weigh (Harper-Collins, 2007).

Medical Wellness: Ms. Stopler, you started your career in nutrition 20 years ago. What have been some of the notable changes you have seen?

Stopler: There have been so many changes through the years. Let me take you back, before our time. To 1916… The U.S. Department of Agriculture (USDA) published the very first government pamphlet on dietary guidelines, called "Food for Young Children." In 1917, the same agency published the first "Food Guide" which consisted of 5 food groups: "flesh, starches, fat, watery fruits/vegetables, and sweets."

In 1933 they expanded it to 12 food groups. The Recommended Daily Allowances (RDA) were established in 1941 by the Food and Nutrition Board (FNB) and the National Academy of Sciences (NAS). In 1946, the Food Guide was reduced to the "Basic 7.” In 1958, using the new RDAs as a guide, the Food for Fitness (Daily food guide) was published and the "Basic 4" food groups were born.

The 1st edition of the Dietary Goals for the U.S. was published in 1977 by the Senate Select Committee on Nutrition and Human Needs. This was the first government publication to discuss the importance of vitamin and mineral deficiencies and toxicities. By 1980, the government agencies as well as the American Medical Association (AMA) and the American Heart Association (AHA) started to develop their own publications similar to the original with Guidelines which recommended maintaining an "ideal weight", "eat more of" or "less of" some nutrient or food group.

As the years progressed so did the publications. In 1987 the National Cholesterol Education Program was started by the Department of Health and Human Services (DHHS) and the National Heart, Lung and Blood Institute (NHLBI).

The recommendations to reduce the risk of cancer were published in the National Cancer Institute (NCI) Dietary Rationale in 1988. The 3rd edition of the Dietary Guidelines was published in 1990. The 4th edition in 2001 became most responsible promoting maintaining a "desirable" weight and focusing on moderation, variety and balance of all foods, nutrients and alcohol.

From the Four Basic Food Groups, where fruits and vegetables were like brothers who shared a bunkbed in the same room, the fruits and vegetables were separated and called, The Five Food Groups. The new eating guide was published as the "Food Guide Pyramid" in 1992 by the USDA and Human Nutrition and Information Services.

The new "group" first moved into a pyramid (a plain but functional and educational residence), and then, in the Spring of 2005, contractors were hired to build steps along the outer perimeter of the pyramid to encourage everyone to exercise.

This new condominium was called “Mypyramid,” and focused on the individualization of both diet and exercise. Supporting the concept of the three key words, moderation, variety and balance, the newest pyramid promotes eating more from the six food groups (grain, vegetable, fruit, dairy, oil (fat) and protein) only if you've incorporated your exercise routine.

Functional? Only time will tell.

MW: Do you think that the food label is easy for the consumer to understand and apply to their everyday lives?

Stopler: Sometimes less is more! The Nutrition Education and Labeling Act that was passed in 1990 required mandatory nutrition labeling on all FDA-regulated foods.

The original "Nutrition Information" food label was straightforward but needed to be updated. The "Nutrition Facts" just underwent another makeover, incorporating the latest research, “trans fat.”

So, now, the label is a bit busier, and more confusing than ever, stating: the serving size, calories, total grams of fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrates (including dietary fibers and sugars), protein, and the percentages of vitamin A, vitamin C, calcium and iron. All the percentages of daily values are based on a 2000 calorie diet.

Now, with the sugar substitutes, the “net zero carbohydrates” and the “non-absorbable fibers,” the calories from proteins, carbohydrates and fats just don't add up anymore. It has become very confusing even to the nutrition “experts.”

MW: There have been many diets gain and lose popularity. How do you direct your clients struggling with “yo-yo dieting”?

Stopler: When my clients come to me and enthusiastically present the upside to the latest food fad or gadget that promises fast, painless weight loss, I take responsibility to educate them that where there is an upside there is usually a downside. Rational decisions can only be made when both the upside and the downside have been considered.

With regard to "yo-yo dieting" (repeated weight loss followed by repeated weight gain), the upside is that when the client is "on" track they are usually improving their body's physiology as well. For example, decreased body weight and body fat usually result in improved lipid profile, lowered blood pressure, and controlled blood sugar.

However, when a client is "off" track and "yo-yo" dieting results, research shows that the ego is not the only damage done. Brownell and his group (Lissner L et al: Variability of body weight and health outcomes in the Framingham population, N Engl J Med 324:1839-1844, 1991), conclude that regardless of starting weight, both men and women who experience this "weight cycling" have a higher overall death rate and as much as twice the chance of dying from heart disease.

I direct my clients by asking them three questions:

1) Is it safe?

2) Is it effective?

3) If you do not know the answers to the first two questions then, most importantly, do the risks outweigh the benefits?

Brownell's studies concluded that "the risks due to overweight may not outweigh the risks due to weight fluctuations." Relapses can be prevented by incorporating a realistic food plan that promotes gradual weight loss while opti­mizing nutritional status.

MW: Do you recommend any specific commercial diets? Are there any books or self-help guides you recommend?

Stopler: I do not feel that there is ONE diet, ONE BOOK, or ONE solution that needs to be addressed. There is only ONE person!

Each person needs to come to terms with themselves and the inner demons within themselves that cause them to be destructive to themselves and to their health. Any "diet" will work if the person follows it long enough, but the key is finding a lifestyle of eating that matches a lifestyle of living.

Every person needs to create their own individualized plan that allows them to eat more during those happy family reunions, and a plan that allows eating less on days that they are stressed out or just not in the mood. They may prefer a plan to allow for gourmet cooking because they find it educational, inspirational and just plain fun, and/or a plan that is compassionate to consuming a bowl of cereal or mac and cheese for dinner because time nor energy allow for more.

In our upcoming book, The Right Weigh (Adam Zickerman and Tracy Stopler with Porter Shimer, Harper Collins Publishing, 2007) the reader designs an individualized food plan based on personal preferences, genetics, and lifestyle. The writers make the reader accountable for monitoring his or her intake. It makes the reader responsible for searching out the solutions rather than the problems. It makes the reader empowered to think differently and therefore act differently.

The writers recommend that every person spend a day by themselves, eating what they prefer to eat, before they begin their "Diet By Design" journey. The reader will learn that he or she has ar­rived at the destination when he or she learns how to change irrational thoughts into more rational ones and feed his or her body with what it 'needs' AND the mind with what it "prefers".

MW: How does your book differ from other diet/nutrition guides?

Stopler: The Right Weigh is different because it gets right to the essence of what it will take to succeed at weight loss...authenticity! It forces the reader to answer the question "Why do you want to lose weight?"  and "Why now?"

Our book teaches the reader how to design their own nutrition and exercise program. You will not only learn the basic principles of nutrition and exercise, but you will be expected to apply these principles to your everyday life. You will learn (and apply) how to compromise (not sabotage) by choosing somewhere in between what you "prefer" to do verses what you "need" to do to reach your goals. It's the only book out there that educates you as a reader, but also motivates you as the writer.

This weight-loss plan lets YOU be the boss. It's a plan that will respect rather than try to change the patterns and pref­erences that have made you who you are. This plan will be yours and yours alone, custom-tailored -- by you -- to fit more comfortably than any diet has been able to fit before. And because it's yours, so, too, will be the success you enjoy, a success that will empower you as much as it will improve you, in appearance and performance, alike.