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Prioritize Portion Size – Helping Clients Eat Intuitively

Prioritize Portion Size – Helping Clients Eat Intuitively
Our next #30in30 #nutritionmonth blog post is from Julie-Anne Seale, RD with the South East Toronto Family Health Team.  Thank you for submitting!
 
As you all know, March is Nutrition Month. This year’s theme is ‘Take a 100 Meal Journey. Make small changes, one meal at a time.’ Each week has its own mini theme, to help Canadians achieve healthier eating habits, one step at a time. I am very happy to see this year’s theme. There's a certain practicality to it; in order to make lifestyle changes that stick, little steps are often needed. Week three of Nutrition Month focuses on portion size. I am a HAES® dietitian, and counselling clients about portion size was a huge challenge to me when I adopted the HAES® principles in my practice. This blog will describe how educating clients on portion sizes can still work under the HAES® model.
 
HAES®
I just threw out an acronym that many of you might be unfamiliar with: HAES®. Well, HAES® stands for Health at Every Size1. It is a mindfulness-based, non-diet, weight neutral approach to fostering healthy lifestyles.  The HAES Principles can be found here.  
 
 What is Intuitive Eating
The concept of Intuitive Eating was developed by registered dietitians Evelyn Tribole and Elyse Resch2. Essentially, it's an approach that teaches people to listen and respond to their bodies to learn how to eat in the best way for them. For example, by tuning in to their internal cues for hunger and fullness (rather than relying on external cues) they will know when and how much to eat. It asks for body acceptance and to reject the diet mentality. It encourages people to learn how to distinguish eating for physical vs emotional reasons. There is also a focus on letting go of labeling foods as good and bad and making peace with food. Finally, exercise should be viewed as a means to feeling good and not as a way to lose weight. There are ten principles of Intuitive Eating and they can be found here. I wrote a blog about Intuitive Eating last September, and you can read it here.
 
I've heard many people use Intuitive Eating and Mindful Eating interchangeably, but they're not exactly the same thing. The best description I've heard of mindful eating was by Michelle May: eating with intention and attention (so it's part of intuitive eating, but intuitive eating is much more).
 
 How Can Information About Portion Sizes Help?
If Intuitive Eating involves listening to your body's cues to tell you how much to eat, informing clients about appropriate portion sizes seems, well, counterintuitive. And it certainly can be, if you end the discussion there. When I first learned about Intuitive Eating, my first instinct was to toss Canada’s Food Guide and talk about feelings instead. After all, Intuitive Eating is not about being prescriptive, and the last thing I wanted to do was continue telling people how much to eat. But the problem is, many people seem to be unaware of what a portion size actually is. So, I use portion sizes as a starting point. But I also discuss that the amount to eat (i.e. how many portions of each food to eat) varies from person to person and from day to day. This usually leads into a discussion around hunger and fullness and I provide them with a hunger-fullness scale instead of a list of the number of servings to have each day. I also spend time discussing balance (so the type of foods eaten).
 
Below is the handout for week 3 of Nutrition Month3. I am impressed that mindfulness seems to be an underlying theme on the handout. I have highlighted (in red) the points I will also be discussing when I use this with clients. Maybe I’ll even start using the handout before Nutrition Month...
  
References
1.         Retrieved from https://www.sizediversityandhealth.org/
2.         Tribole, E., and Resch, E. (2012.) Intuitive Eating. New York, NY: St Martin’s Press, 3rd Ed.
3.         Retrieved from http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Nutrition-Month/NM2016-Factsheets.aspx
 
Julie-Anne Seale has been a Registered Dietitian since 2001. She currently works at The South East Toronto Family Health Team as well as having a private practice, where she helps clients develop a healthy relationship with food. You can learn more about Julie on her site: www.sealenutrition.com.

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