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.