- With Mayo Clinic nutritionists
Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
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Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
Katherine Zeratsky and Jennifer Nelson
Jennifer K. Nelson, M.S., R.D., L.D., C.N.S.D.
Jennifer Nelson is your link to a better diet. As specialty editor of the Food & Nutrition Center, she plays a vital role in bringing you healthy recipes and meal planning."Nutrition is one way people have direct control over the quality of their lives," she says. "I hope to translate the science of nutrition into ways that people can select and prepare great-tasting foods that help maintain health and treat disease."
A St. Paul, Minn., native, she is certified by the National Board of Nutrition Support Certification, has been with Mayo Clinic since 1978, and is director of clinical dietetics and an associate professor of nutrition at Mayo Clinic College of Medicine.
She leads clinical nutrition efforts for a staff of more than 50 clinical dietitians and nine dietetic technicians and oversees staffing, strategic and financial planning, and quality improvement. Nelson was co-editor of the James Beard Foundation Award-winning "The New Mayo Clinic Cookbook." She has been a contributing author to and reviewer of many Mayo Clinic books, including "Mayo Clinic Healthy Weight for EveryBody," "The Mayo Clinic Family Health Book" and "The Mayo Clinic/Williams Sonoma Cookbook." She contributes to the strategic direction of the Food & Nutrition Center, which includes creating recipes and menus, reviewing nutrition content of various articles, and answering nutrition questions posed to Ask a Specialist.
Katherine Zeratsky, R.D., L.D.
As a specialty editor for the Food & Nutrition Center, Katherine Zeratsky helps you sort through the facts and figures, the fads and the hype to learn more about nutrition and diet.A Marinette, Wis., native, she is certified in dietetics by the state of Minnesota and the American Dietetic Association. She has been with Mayo Clinic since 1999.
She is active in nutrition-related curriculum and course development in pediatrics at Mayo Clinic Rochester and nutrition education related to the physiology and recommended intakes for premature infants.
Other areas of interest include breast milk and formula safety, neonatal feeding, and nutrition for breast-feeding mothers.
She graduated from the University of Wisconsin-Madison, served a dietetic internship at the University of Iowa Hospitals and Clinics, and worked as a registered dietitian and health risk counselor at ThedaCare of Appleton, Wis., before joining the Mayo Clinic staff.
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Nutrition-wise blog
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Nov. 13, 2008
New help in the battle against obesity
By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
My colleague just returned from the annual American Dietetic Association's Food & Nutrition Conference & Expo. I'm excited by what she brought back — a new way for health care providers to approach obesity.
This method, developed by Robert Kushner, M.D., focuses on the critical skills that clinicians sorely need in order to empower individuals to make positive changes in eating, activity and lifestyle to successfully lose weight. First, some background.
Consider the challenges for you and for your health care team.
- For you: You have a serious problem such as your weight, obesity-related conditions such as high blood sugar, high cholesterol or high blood pressure, the expense of medications and probably your feelings of frustration at not being able to get a grip on this.
- Finances: A trip to the doctor is can be expensive and you already know that you need to eat less and exercise more. What more can your health care provider offer?
- For the provider: You have a busy practice that barely provides time to identify patients' problems — let alone begin to "treat" them. You really want to help, whether it's medication, surgery, or counseling on changing lifestyle. Even if you have the experience, do you have the time? If you have the time, how do you keep from giving everyone the same old message of eat less and exercise more?
A 2001 study in the "Annals of Internal Medicine" reported on patients' expectations of care from health care providers. The highest ranked expectation was "discuss my (the patient) own ideas about how to manage my condition."
So how can patients' expectations meet the health care providers' ability and desire to help in a meaningful way?
It begins with providers probing the patient for issues contributing to being overweight. We've heard that excess weight is due to many things. Beyond eating too much and exercising too little, we live with "globesity" issues such as not having the time, money, or skills to change our eating and physical activity. How many of us skip meals only to eat too much of the higher calorie stuff later in the day? Why? How do we change this? How many of us eat too few healthy foods and too much meat and high fat convenience products? Why? How do we change this?
From both the patient's and clinician's perspectives, it may seem like there are just too many issues to address in any sort of systematic way. However, the research presented at this year's conference has yielded some new ways to gather information from patients and how to use the patient's ideas about managing weight issues.
This approach focuses on groups of lifestyle patterns shown to contribute to excess weight and how to change them. They can be placed into 3 broad categories: eating, exercise and coping. Each of the patterns in each of the categories has strategies for addressing the problematic lifestyle pattern.
Over the next blog or two, I want to show you how this can work. It just might give you a way to identify what you want and how to best work with your health care provider in meeting your desires. Don't settle for the message of eat less, exercise more. Expect a frank dialogue about what you feel you can do, and what your provider can do to help you.
In order to begin, I need some information from you about the lifestyle patterns that you think contribute to unwanted weight. For simplicity, pick a category from below and one lifestyle pattern from it. Choose only 1 category and 1 lifestyle pattern that you think contribute the most to your weight. I'll then write about the most popular ones sent back.
| Category | Lifestyle Patterns |
|---|---|
| Eating | Skip meals Eat at night Snack a lot Eat big portions |
| Exercise | Couch potato Don't know how to start I'm all or nothing |
| Coping | Emotional eater Procrastinator Doubtful dieter |
Remember, choose 1 category and 1 lifestyle pattern that you think contribute the most to your weight and let me know why.
I'll look forward to talking with you more about this.
- Jennifer
79 comments posted
October 12, 2009 7:44 p.m.
I am an all or nothing exercise person.If I don't keep up with my plan I usually stop. I then get mad at my lack of follow through and polish it off with some ice cream or a couple of PB&J's before bed.
- Glenn
October 3, 2009 5:58 a.m.
Large portions. It's all I do. I'm never full and I'm always hungry. I can eat a large meal and I have no sense of being sated. Most of my overeating is done in the evening. Once I start eating it's hard to stop until I'm almost sick and even then I continue to eat. I did recently try Pristiq for depression and had a miracle of sorts during the first two weeks and ate like a "normal" person. Unfortunately, that wonderful side effect wore off. It was the first time in my life that I didn't have a huge appetite. I weigh about 260 and get very little exercise.
- janinpenna
August 15, 2009 9:11 a.m.
I am typically dealing with portion control and then if time allows, a couch potato. My days and evenings are filled with a very demanding job. By the way, I am great at playing mind games such as, I will exercise in the morning and head to bed. When morning comes, I will not exercise because maybe I didn't sleep well, or perhaps I slept so well that I would like to sleep a little more and not get up to exercise, and then I repeat. My age is in the early 50s and I have finished going through my menopause.
- mnhill
March 2, 2009 7:49 p.m.
I'M 59 AND STARTING THE MAYO DIET TODAY.I'M 6FT. AND WEIGH 260 LBS. I WANT TO LOOSE 40 LBS.. I'LL REPORT WEEKLY AND KEEP YOU POSTED . LF
- LARRY FLETCHER
January 28, 2009 10:07 a.m.
Just a comment on portion control: Why has it become popular to approximate portion size by parts of the body or decks of cards. A lg. mans palm is much bigger than a small woman's palm. I think dumbing down portion control is like saying we aren't smart enough to weigh or measure our portions.Once learned it's in your brain forever. What say you?
- Lou
December 3, 2008 10:28 p.m.
I am an emotional eater - can't carve time out for exercise because I'm dealing with a child who is a brain tumor survivor and her health and social issues are overwhelming to me as a single mom. I KNOW what I SHOULD be doing, but I procrastinate, put it off... one more night with dessert and I'll start tomorrow. But then tomorrow is a bad day so I'll start the next tomorrow... I even bought a treadmill... it disgusts me that there is dust on it. Bought and paid for, parked in front of the tv - but still i can't bring myself to use it. I have two pair of jeans and five hoodies that fit me - I know that I look great slender and 75 lbs lighter - getting started and changing habits it all just seems overwhelming. Damn - not I want a piece of cake... Looking forward to your next posts!
- Renee
November 26, 2008 2:05 p.m.
Hello every one - Just to let you know that I posted a new blog on Eating/Eat Big Portions on Nov 25. For those of you struggling with portion distortion - go to it for some suggestions. Don't settle for anyone telling you to simply "eat less/exercise more". There's more to it than just that. Next weeks blog is on Coping/Emotional Eater. It looks like quite a few of you struggle with this dynamic. Hey you "Couch Potatoes" - stay tuned. I haven't forgotten you! Watch for a blog on this topic during the week of December 8th.
- Jennifer Nelson - your blog host
November 25, 2008 2:07 p.m.
Couch potato. Not that I want to be - I used to be an athlete. Now 52, working full-time, single mom, coping with Lupus, kidney disease, and other auto-immune diseases. I'm exhausted, often in pain, and typically overwhelmed just trying to keep my head above water. The weight I carry is depressing and adding to my medical problems.
- ann
November 24, 2008 4:16 p.m.
Aside from the cravings for sugar and carbs I guess the Coping Category fits me. Also, I have no faith that I can ever lose the weight that I have been carrying for over 25 years.
- Diane Sclafani
November 23, 2008 2:03 p.m.
I could easily choose a couple. The primary one that stood out for me is emotional eating. I have struggled with anxiety and depression for years and find that my eating patterns are tied to my emotions and what's happening in my life. It's so hard to NOT eat the bad stuff when my head's telling me I have to have it. It's like a craving, but in overdrive.
- Vicki
November 21, 2008 7:30 p.m.
Our modern diets contribute to weight gain. I feel that artificial sweeteners are a big problem. They don't satisfy our body's cravings for sweet. I use Krisda stevia as a sweetener now and I have successfully lost weight. I would encourage everyone to try Krisda!
- Mark
November 21, 2008 12:51 p.m.
My main problem is I et in the evening after supper. I am hungry than I try not to but I just am hungry and an apple just doesn't cut it. So I eat an apple, then I am still hungry so I eat a peanut butter sandwich if fI have peanut butter in the house. Some times I don't buy that so I don't eat it. Then I will fry an egg. What do I do?
- Shirley Wallstrom
November 20, 2008 11:49 p.m.
Emotional eating has always been my problem from a very young age, as well as really loving good food. I've dieted and lost and dieted and lost and now I think I can't do it again. I'm over 60 years now and losing weight is very important to my health and longevity. But then I lose any will power and good sense that I have and just eat anything that is in the house.
- Anne
November 20, 2008 8:53 p.m.
I'm definitely a bad eater and don't like to cook. AND I'm a vegetarian.
- Sue
November 20, 2008 7:12 p.m.
Exercise is my category and I'm a total couch potato. With four kids and an endless amount of laundry and daily tasks, I never found time to exercise. Then my sister turned me on to these great slimming leggings through fitandsharp.com and I wear them comfortably under my clothes. The double knit fabric actually helps to tone me as I run through my busy day. I actually started to see a difference after only a month. Don't get me wrong, I try to watch what I eat but at the same time I really saw a change in the appearance of my skin and the shape of my legs when i used this product. I hope this helps.
- betty_penn
November 20, 2008 5:27 p.m.
Category - Exercise; Lifestyle - Couch potato! I have lost weight in the past and used to exercise when younger. As I got older I at least walked and took a yoga class. Now, however, the long work hours, limited home time etc., I just feel exhausted when I get home and want nothing more than to flop in a chair!
- Pam
November 20, 2008 4:36 p.m.
Eating is my catagory and I skip meals. If seems if I eat breakfast I am shakey within 2 hrs. However if I don't eat until mid morning I'm fine. I skip the evening meal and am so hungry later in the evening that I just grab anything quick that requires no preparation. My husband works afternoons and I just don't want to take time from whatever I'm doing to fix something for myself.
- Karen
November 20, 2008 12:21 p.m.
Coping- Emotional eater. Second would be having time in a busy family.
- Kate
November 20, 2008 9:43 a.m.
Jennifer, I am an all or nothing person, and right now my back pain (first degree degeneration of the lower spine) keeps me from going all in. When I walk enough to lose a pound a month, I gain it back as soon as I stop (walking required a heating pad to my back afterwards so I stopped for the summer). I may have rapid cycling bipolar disorder; I've been excluded from a study on depression because the screener thought so. I joined an exercise club but stopped going when my late life teens refused to go since they are not yet ready to stay alone at home. I may be a bit agoraphobic since I rarely leave the house alone (unless I have to) anyway. I gained over 40 pounds when I went through the change at 53 (in a brief span, though working harder and eating less than ever). I have since lost that job, I believe it was because as a woman warehouse manager (though having a plumber's license and a 4 yr. degree in health/rehabiliative services) I did not get any "helpers" and was expected to "do it all" which I COULD until I hurt my back which added to the degeneration and does not seem to be entirely healed.
- Debbie
November 20, 2008 12:54 a.m.
Coping - Emotional eater. When I am upset, all I want is something sweet and then something salty ... over and over!
- Carolyn
November 20, 2008 12:12 a.m.
Book : "Hungry planet" It will be a big help. Just see lots of photos in the book.
- Jin
November 19, 2008 9:27 p.m.
coping- emotional eater! binge on comfort foods when I am stressed which is often! Thanks, Robin
- Robin
November 19, 2008 4:46 p.m.
I'm really happy to see that I've struck a cord and that so many of you have responded. Just to let you know that I'm reviewing the responses and will be addressing strategies for controlling portion sizes next. Watch for the blog shortly - I think you'll find it helpful. Again, thank you for being so responsive!
- Jennifer Nelson - your blog host
November 19, 2008 3:43 p.m.
Eat at night.
- Lee
November 19, 2008 2:43 p.m.
TOPS Club, Inc. is the answer to many weight problems. This is a weightloss support group. It is non-profit and therefore not expensive. Check out a chapter in your area. Go to TOPS.org for more information.
- TXgrandma
79 comments posted