Tag Archives: portion control

Where Does Obesity Start?

I can’t believe that my perspective on obesity in America has shifted so dramatically in the last six or so months. I’ve been in the fitness industry for over a decade and have taken countless courses on metabolic diseases, health and wellness. I thought I knew most of what I needed to know…until I realized that I didn’t. One lesser-known fact that I recently learned has changed everything for me. I couldn’t believe it when I found out. It made my jaw hit the ground and simultaneously made me want to cry. This one simple statistic changes the ballgame for all of us. Big time.

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While conducting research for a manuscript I’ve been working on for the past year, I came across data about the prevalence of children who are overweight and obese in America. I was curious to read the stats but paused before getting to them. The age range taken into evaluation for childhood obesity is what struck me first. I always wrongly assumed that data on children who are overweight and/or obese referred to school-age children only. Kids get a little wiggle room to grow out of their baby fat, right? But no, the age range that the Centers for Disease Control and Prevention assesses starts at the tender age of TWO! I was floored. For me, this changes everything. Here’s why…

The fact that the age range evaluated for being overweight or obese is from 2-19 years old reflects the fact that obesity starts way before we are irresponsible teenagers guzzling down chips and soda or even school-age children being served controversial, less-nutritious lunches in elementary school cafeterias. Being overweight or obese literally starts when children are adored for having chubby cheeks and pudge. That got me thinking, how can you tell “healthy fat” tots from “unhealthy and overweight” ones? I dug a little deeper and found that the American Academy of Pediatrics (AAP) says that parents shouldn’t worry about the weight of children younger than 2-years old, citing that there is no current and relevant information supporting the notion that children who are heavy as babies are going to be overweight later in life. But just one second…

Today, 30% of American youth are overweight or obese (17% obese, according to National Health and Nutrition Examination Survey 2011-2014 data), with the prevalence of overweight 2 to 3-year olds being 40% higher than it was in 1994! What’s more is that overweight 2-year olds are apparently twice as likely to become obese as an adult. The older a child gets without outgrowing their extra layer of insulation, the greater the risk goes up. Obese 6-year olds have a 50% risk of obesity at 35 years old and obese 10-year olds have up to a 80% risk! Anyone starting to feel a little uncomfortable about these numbers yet? So, going back to the toddlers…how exactly does a 2-year old hit their second birthday and magically go from being considered healthy to overweight? That’s just not fair to the little ones! Obviously, there are things happening in the FIRST TWO YEARS OF LIFE that have the power to set us up as a society for a host of challenges in our childhood onwards into adulthood.

This brings me to my next question: What is happening in the first two years that sets a child up for certain “healthy” vs “unhealthy” habits that are perpetuated throughout their youth? Moreover, what can we do as ADULTS to prevent this? After all, the first two years of life have very little to do with what a child chooses for their nutrition and physical activity and a whole lot to do with what we offer them to eat and how we help them engage (or not) with the world around them. Our attitude towards wellness very directly impacts theirs.

These are my opinions as a health professional so take them for whatever they are worth to you. These are what I see as some of the potential root causes for their unhealthy habits and compromised gut health, and the implications for us as responsible adults.

 

3 Things that Impact Health in the First 2 Years of Life: 

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I. Breastfeeding vs. Formula

I’m a big proponent of breastfeeding but I understand that sometimes formula is medically indicated or otherwise chosen by moms who want or need it for convenience. I will spare you my opinions on women’s rights for maternity leave and the necessity to have both time and a place to pump at work, but certainly those factor into maternal nutrition decisions. I digress. When we compare breastmilk and formula side-by-side, we see a couple of differences in potential nutrition and how some babies are fed.

Breastmilk has been fine-tuned by evolution over the course of nearly 200,000 years and its complexities are only just beginning to be understood. Formula, on the other hand, was first developed on a grand scale in the early 1950s and was heavily marketed as an “ideal food” for babies. Yes, formula can adequately nourish babies. That has been proven, otherwise babies being fed formula would fail to gain weight and survive. But, the debate on whether or not it’s “ideal” is certainly a heated one, with proponents on both sides. Here is where I see formula falling short and having the *potential* to impact long-term health (albeit formula is a miracle for babies who have no other options – it was made to save lives – and is in no way, shape or form the only predictor of health outcomes):

Taste changes in milk

Just like unborn babies can taste their mother’s broccoli or potato chips via the amniotic fluid they swallow, nursing babies experience the diverse flavors of mom’s diet via changes in breastmilk flavor. There are breastfeeding advocates out there who would argue that this helps a baby embrace healthy foods later on during the introduction of solids (assuming mommy eats healthy in the first place, of course!).

Ability to digest

Just as there are experts who have brought light to the fact that one-a-day multivitamins are difficult for the body to digest, others have made us aware that formula is also difficult on a baby’s digestive system due to higher caesin content in the milk compared to breastmilk. Although parents get longer breaks between baby’s feedings while his tummy sorts everything out, this lends me to believe that a baby’s system is taxed by its food source and may not absorb all of it.  For this same reason, some formula manufacturers continue to attempt to make it with less curd to better simulate digestive processes aligned with breastmilk.

Antibodies and gut health 

Antibodies help build up our immune systems and healthy gut bacteria. Breastmilk is full of antibodies that respond and change daily to the specific needs of the baby. Baby gets sick with a cold and mama’s milk provides the medicine for healing. The healthier our gut microbiota, the healthier children (and adults) are in general. Studies are increasingly showing that gut health, inflammation and metabolic diseases (such as obesity) are scientifically linked. This means that protecting our children’s gut health needs to be a fundamental goal of any parent, and breastfeeding is just one way we can do that (and arguably the best way, for children under one-year old).

Bottle mentality

Bottle-fed babies are sometimes subject to parents and caregivers encouraging them to finish the entire portion of milk in the bottle. Babies have varying metabolisms and milk requirements so while it may be completely appropriate for one baby to guzzle down eight ounces of milk in one slug, this may be overfeeding another child. Milk requirements may also vary day by day. In this way, babies and children are not all that different from adults. We all have different needs and overeating can become a vicious and repetitive cycle thanks to our biological tendency to hoard fat when given the opportunity (I’m telling ya…our bodies still think we are getting chased down by bears). It’s important to practice baby-led bottle feeding.

What this means to us (the adults): If you are a mother or have friends, family or coworkers with a baby, try to be as supportive as possible of the breastfeeding relationship. Don’t give women snarky looks when they are nursing in public or a hard time if they are late to a meeting because they had to finish pumping. For women who choose formula out of necessity or desire, try to encourage them to follow baby’s lead and not push them to finish all of their bottles and food unless the pediatrician has medically advised it. Both breastfeeding and formula-feeding mothers can make enormous strides in their children’s long-term health with the introduction of solids and healthy foods…

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II. Introduction of Solids

The introduction of solids is an important time in a baby’s life. The new colors, textures and flavors are all fascinating to babies. While it’s obvious that overfeeding a baby solids can result in too much weight gain, there are some other things to consider that stack up and impact a little one’s health.

Sugary puree packets

Lots of puree packets look lovely – they are organic, produced by trusted brands and packed full of healthy ingredients. What’s not to love?! The challenge with lots of puree packets is that they are loaded with sugar. Baby is already getting about 17 grams of sugar from a cup of breastmilk and, at one-year old, 11 grams of sugar from a cup of cow’s milk. Clearly, sugar is a natural part of a baby’s diet, but as we know from the obesity epidemic taking flight in the 1990s when sugary sodas were having their heyday, too much of the stuff is definitely not good for our health or weight. Even veggie and fruit puree mixes have a ton of it – sometimes as much as 11-13 grams/packet! Even when you have good intentions for baby eating up all of those peas and spinach mixed in, that’s a ton of sugar! The best bet is to try to make your own baby food or choose lower-sugar, store-bought purees.

Veggie resistance

I will be the first to admit that getting a little one to fall in love with veggies is tricky business, but it’s 100% worth every effort, creative cooking method, and/or baby-friendly spices/seasonings you can muster up. Roughly 38% of American adolescents eat LESS than ONE serving of fruits or vegetables a day. Surely, we can ALL do better than that. We NEED to do better than that, starting right when solids are introduced and kids palates are impressionable. Start early and start healthy!

Time Constraints

Yes, it’s difficult to feed extra mouths, but it doesn’t have to be an elaborate, over-the-top ordeal that’s so stressful that we break down and nuke chicken nuggets every night. If we commit ourselves to eating healthy and slowly introducing our children to the same foods, we only have to prepare one meal; the family meal! I’m totally serious – my son eats everything we do and is just a year old. It’s not because he loves salmon, quinoa and veggies more than yogurt, cheese, bread and fruit, Trust me, he would eat all the aforementioned till the cow’s come home, if we let him. He accepts and enjoys healthy foods because we try to offer him the same nutritious foods that we eat (and when we eat them). It makes things far simpler on us and way healthier for him.

What this means to us (the meal providers): Whether or not we feel like we have loads of extra time on our hands to prepare homemade, healthy purees and meals, it’s really not a matter of choice. It’s a necessity for the health of the next generation. If we give up and let nine-month olds dictate an all fruit and bread diet then how are we going to hold our own when those children are five and we are telling them to eat their peas as they protest saying they don’t like the taste? It doesn’t have to be super scary to healthfully feed young children and there are a million blogs, pins on Pinterest and nutrition resources to help make it easy! Find some or personal message me and I will help you navigate it all!

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III. Modeling Good Eating

Kids are easily influenced by their surroundings. I’ve heard stories about people with babies who didn’t walk until 18 months when suddenly, on vacation with their older cousins, the child decides to morph into a walking toddler to chase after them. Our healthy choices (or lack thereof) are no different. Kids see their parents eating pizza while they have carrots and they are gonna want the pizza. Plain and simple. Who wouldn’t? Pizza is delicious and shaped like a triangle! Since when did an edible triangle not taste amazing? Watermelon, sandwiches, chips… How we influence the wellness of children is fundamental to solving childhood obesity and its propensity to carry through into adulthood.

Eat healthy foods (duh)

It’s as straightforward as that. Eat healthy foods, in front of a baby and young children, and they will be more apt to eat them too. Think of it as a chance for the whole family to get healthy.

Mindless Snacking

“Snacky” foods typically pack a lot of empty calories. In other words, lots of calories from carbs or sugars with very little return in the way of vitamins, minerals, fiber, healthy fats, etc. They can also cause children (and adults alike) to lose track of what “full” really feels like thanks to zoning out in front of a cartoon while eating fistful after fistful. Mindless snack habits set children (and adults) up for health problems because of the lack of nutrition and risk of overeating (which leaves less of an appetite for healthy meals).

Food as a tool

It’s definitely tempting to shove food in front of kids for any number of reasons, but when food is abused as a tool for getting children to behave better, we begin down a slippery slope that can tie unhealthy behaviors and expectations to treats. And we all know that if you give a kids an inch they take a….yup, mile after mile after mile. Or rather, cookie after ice cream after soda. 

What this means to us (the “models” for healthy eating): Modeling healthy eating takes commitment on a regular basis and also talking to kids about why you eat what you do. Even babies can sometimes be influenced to take bites of “yucky” foods when you show excitement and enthusiasm about them – or better yet, are eating the exact same thing in front of them. I understand that it’s unrealistic to expect people to eat healthy foods 24/7. I like to indulge a bit too. So, when you do go off the “healthy-food menu” simply make sure that you keep portions small for children (if you offer any at all) and discuss how certain foods are for unique occasions, and that if we ate them all the time, they would make us tired and give us stomach-aches. Your choice if and how you want to discuss the actual weight gain component. 

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There is a lot we can do as adults to impact the upcoming generations’ wellness and a lot starts with nutrition. It’s definitely worth noting that activity levels play a tremendous role in the childhood obesity epidemic too, even for babies. Take them out of their car seats and strollers, and let older children run around for fun – it’s the best exercise [playing] that there is! And if you’re feeling just a little bit daunted about setting a healthy example, focus hard on what it will take for YOU to be more healthy and the rest will gradually fall in place. It’s not fair to leave our children and children’s children in a place where they look down at the scale as adults and think “What the heck?! How did this happen? Where did I go wrong?” You will never regret setting a child up for good health because ultimately, it’s an integral part of what makes us happy as humans.

 

Yours in health and wellness,

Maggie

wellnesswinz-blue-sea

The Pros/Cons of Meal Prep

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If you’ve ever been on Pinterest then you know that it’s pretty much impossible not to have stumbled across people’s personal pins displaying a dozen or so lovely, similar meals packed away into individual Tupperware containers for the week. If you’re not into social media, then maybe you’ve heard of someone who does this; cooks all their week’s meals on Sunday afternoon or evening so they don’t have to worry about what to eat during the work week. Sounds ideal, easy and cost-effective – and it is! But there are some things to consider about planning your meals for the week, whether you’re portioning them out into grab-and-go containers or not.

I will start with the pros of meal planning and prep, and then I will get into some of the downsides. To end, I will offer a couple of simple suggestions to help you make informed choices about your food.

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PROS OF MEAL PLANNING

Weekend meal prep is a useful strategy for people wanting to lose weight via portion control and people who track their macronutrients (think bodybuilders trying to ensure maximal protein and minimal carbohydrate consumption). It also makes things easier for time-pressed working professionals and even busy parents!   

It’s Cost-Effective

Planning and cooking your meals for the whole week at once means you’re armed and ready with a set grocery list when you hit the store, allowing you more time to scrutinize prices while you shop. You’re also more likely to buy bulk or cheaper high-volume, low-cost items since you know that no ingredients will go to waste. More money left over to treat yourself!

 

Takes Away Last-Minute Planning

With a plan in place, you’re never going to be the person scrambling to find their way to the office vending machine at lunch time. You don’t settle for less than your well thought-out meals. No last-minute pizza or overpriced takeout for you!

 

Portion and Calorie Control

It goes without saying that you’re in charge of portions and calories when you put effort into measuring out food for each meal. Casseroles, soups and lasagnas might be tricky to figure out calories for, but you can at least put reasonably size portions into containers and not be tempted to overeat come lunch. Meals that are easier to calorie count (if that’s your thing) include salads, sandwiches and proteins with veggies, rice, quinoa, beans or fruit on the side.

 

Reduces Time in the Kitchen

Although you’re going to be clocking in some major hours in the kitchen one day of the week, you’re ultimately saving a lot of time – a bonus if you work late hours leading up to dinner or often have to take lunch at your desk.

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CONS OF MEAL PLANNING 

My mom’s opinion on Sunday meal planning: “Here I’ve worked hard all week and Sunday is finally my day of rest, and you’re telling me I’ve got to spend the whole time in the kitchen?!? Forget it!!!” If you share this sentiment, then maybe you’ll be happy to hear some of the drawbacks of meal planning. But, even if you don’t meal prep on the weekend, you still need a plan in place for healthy foods and cooking during the week.

 

Calories Don’t Change

Meal planning allows for calorie control, presumably a great thing for those of us looking to trim our waist lines. But wait…is eating the same number of calories every day a good thing? Not necessarily, according to science. “Calorie shifting” is an approach to eating that aims for a total caloric amount every week (aimed at weight loss or management, depending on one’s goals), but with varying calories consumed every day. This helps keep the metabolism “sharp” and from adapting to a set daily intake. The good news is that this approach allows you to consume more on days you need it! Our metabolisms are not static and our activity levels change day-to-day, so don’t be surprised, if you’re a meal planner, if some days the meals are too much or too little.

 

Potential Lack of Nutritional Variety

If your meal plan is a PB&J with an apple for every lunch and a chicken breast with broccoli for every dinner, you’re probably saving some money and controlling your calories, but you’re majorly missing the mark on nutritional variety. Where are the dark, leafy greens? What about some foods with heart-healthy omega fatty-acids (like salmon)? Variety in all food categories (veggies, fruits, proteins, grains, etc.) is going to be best for packing in the nutrients your body needs. One idea: Change up the protein and/or veggie with your dinner for half the week. Another: Trade your apple for an orange or mango. Better yet, try a healthier alternative to the PB&J like avocado toast or smoked salmon and capers on multigrain!

 

Susceptible to Stress or Overeating on “Off” Weeks

If you’re the type of person who flails and flounders without a set plan then you may be prone to overeating or stressing out when you don’t have time for meal planning. Ultimately, meal planning is a tool to help you with your work week, but thoughtful eating and confidence approaching on-the-fly food selections is a skill.

 

Boredom

Meal planning is generally not as suitable for those with adventurous and varied palates. If you cook a lot of one thing in bulk and plan to eat it day after day, you may quickly tire of the taste and opt for something else. This means you’ve wasted time, money and food! “There are starving children in Africa!” Eat your leftovers!

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IMPROVEMENTS FOR MEAL PREP & PLANNING

A happy medium can be found if you’re a meal planner. Here are a few ideas to help ensure you’re able to have the best of all words – cost-efficient foods, nutrient density, variety and appropriate quantity!

 

Back-up Plan

It’s important to have a back-up plan for weeks when meal prep just isn’t feasible. There will be times when you’re too tired to do it, when you haven’t hit the grocery store in time, when special events or travel conflict with cooking, etc. Here are a few back-up plans to consider:

  • Create a budget for a week of every month to buy meals from a healthy, affordable restaurant for lunch or dinner. For example, once a month you could plan to buy salads for lunch from your favorite local café.
  • When you miss your weekend meal-prep, plan another day and time early in the week to tackle your shopping and cooking.
  • Try your hand at cooking every other night of the week and make enough for leftovers at lunch the next day.

 

Stash Meals in Freezer

When you meal prep, try making several large-volume dishes at once. Use your slow cooker, oven and stove top to prepare three separate meals so that you can both use and store some of each meal for optimal present and future variety!

 

Supplement with Snacks

If you’re lacking variety in your planned meals, try supplementing them with nutritious snacks. Snacks are also a way to implement “calorie shifting” into your week (see “Calories Don’t Change” above). A few ideas you can easily prep: Kale chips, sliced fruit, carrots and humus, cottage cheese or greek yogurt and fruit, ¼ cup nuts, a healthy nut or protein bar, apple or banana and a TBS of nut butter.

 

Meal Plan for 1-2 Meals Only

One way you can ensure that you don’t get bored with your food is to meal plan and prep for just lunches or dinners. This will allow you to take the most time-pressed, stressful or expensive meal of the day and make it easier. By sticking to just one or two meals, you still have room in your daily diet for nutritional variety and flexibility.

 

Hope this is helpful info as you kick-off 2017! Cheers to health and happiness!

Yours in health and wellness,

Maggie

wellnesswinz blue sea

Skinny Girls Who Eat Junk

You’re not alone if you’ve ever wondered how other girls can get away with eating junk, while also retaining a slim waistline. I’ve had dozens of women complain to me that their friends can seemingly nosh on cheeseburgers and fries, down a pint of Ben & Jerry’s, or indulge in the bread basket on girls night out, without putting on a single pound. It’s time to solve the mystery! Here are a few ways that these girls-we-love-to-envy keep their weight in check.

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1) They are burning calories through activity 

I can easily recall my super skinny days, back in high school, when I could chow down nachos, eat two plates of pasta, and a big bowl of Breyer’s chocolate ice cream every night, but this was only thanks to playing sports all year round. I was exercising for several hours every single day, and I was still growing. Could I get away with this now? No. Can I still get away with indulging here and there? Yes, because I exercise and practice portion control when eating. Good news, you can too!

It’s the same, simple answer we keep returning to: Calories Consumed = Calories Burned, for weight control.

2) This may just be a snapshot of their diet, not the way that they routinely eat

As I mentioned above, no one…and I mean no one, can get away with eating junky foods 24/7 that are calorie laden and fattening. Over time, it results in weight gain. If your skinny friend isn’t gaining weight, then she must be exercising portion control at other, less social and less visible, times of the day. She may be vocal in social settings, saying how she loves eating chips or hot dogs all the time, but she’s probably just being theatrical, or perhaps she’s trying to justify her indulgence out loud. It’s probably not meant to shame you or make you question your own weight and eating habits. Laugh it off and stick to the choices you want to make for yourself. If we tell teens to avoid peer pressure about drugs and alcohol, then certainly we can exercise a little self-control about food in social settings, right?!

3) They don’t beat themselves up for eating what they want

I have coached lots of women to stop self-shaming when they eat foods they desire. It’s one of the most important things that I help with women with, and many of them tell me that being easier, not harder, on themselves has helped them manage their health for the first time in years. Ironically, emotional reactions to food, and feelings of shame, often lead to MORE eating, not less.

An article from MyFitnessPal’s Hello Healthy blog states that “we usually end up getting mad at ourselves for overeating. This sets us up for a vicious cycle of stuffing feelings with food (and thus not dealing with them), possible weight gain or excessive exercise and self-recrimination … until the cycle starts all over again. How frustrating!”

So, if you have a late-night of eating the whole bag of popcorn, when you intended to only scoop out two handfuls, move on from it. Tell yourself that tomorrow is a new day and that you have the power to make good choices each with each and every meal and snack.

But, maybe your friend isn’t getting away with as much as you think…

“Smoke and Mirrors”

Although some girls enjoy their greasy and sugary foods without immediate weight gain, there may still be health consequences to their actions. They may not be getting all the essential nutrients that their bodies need. For example, if “Kelly” tends to eat instant oatmeal and a banana in the morning, a turkey wrap and chips at lunch, and a small dish of pasta at night, she is probably not getting enough protein in her diet.

Although Kelly’s portions are modest, allowing her to remain slim, she may have brittle hair and nails because of the missing protein. This, combined with a lack of fruits and vegetables, may also cause Kelly to have skin problems (skin that lacks luster, breakouts, is aging quickly, etc.). Additionally, if she isn’t getting all of the essential vitamins and minerals that her body craves, then Kelly may not have good energy throughout the day.

In short, what’s happening on the outside of our bodies (i.e., how we look) is not always reflective of what’s happening on the inside…

So, is it okay to eat junk or is “clean eating” the best practice for weight control?

what to eat

It depends. It’s important to figure out what is going to work best for you. While clean eating, i.e., focusing on a natural diet full of fruits, veggies, and lean proteins, is definitely a step towards a healthy lifestyle, WebMD explains that certain diet protocols for clean eating, like The Eat-Clean Diet, are “so structured, restrictive, and unrealistic” that they “may be difficult to follow long term.”

WebMD further suggests that any diet plan that is based more on opinion, than on scientific evidence, must be taken with a grain of salt. Although people love to share their personal triumphs, we should all be wary of professionals who base their dietary recommendations solely on their own experiences. We’re all a little different physically and emotionally, and that changes how we eat and what we want to eat.

If you feel like you’re only eating healthy because you “should” be, then you’re in a deprivation mentality, missing out on the experience of pleasureful eating. When kept in check, pleasureful eating can be a part of a healthy eating plan.

Once you’ve recognized that there is not a “good” or “bad” food persay, you can start to break the chains of a dieting mentality. As I alluded to in my Detox Diets: Do They Work? post, “including foods considered unhealthful in a healthful eating plan can foster satisfaction to ensure a healthful eating pattern over the long haul.”

Here is one defintion of normal eating provided by Human Kinetics:

“…being able to eat when you are hungry and continue eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it – not just stop eating because you think you should. Normal eating is being able to use some moderate constraint in your food selection to get the right food, but not being so restrictive that you miss out on pleasureable foods. Normal eating is giving yourself permission to eat sometimes because you are happy, sad, or bored; or just because it feels good.”

Note: This is different from chronic emotional eating.

We’ll discuss that another day. 

This perspective implies that eating mostly nutrient dense foods will be helpful for your body, and that there is room to eat “forbidden foods” for pleasure here and there. An ice cream on a Friday night won’t spoil your waistline. Enjoying your favorite bubbly on a date night doesn’t mean you’ve ruined a healthful eating streak. If we stop fearing foods, we may just find that we don’t crave them as often, and we can start enjoying them in moderation alongside a balanced eating plan.

So, eat clean all the time if it works for you. If it doesn’t, don’t shame yourself. Just try to balance your intake of indulgent foods, and find ways to eat mindfully at every meal. The greens that once tasted bitter or repulsive can and will taste better once you take the time to think of ways to prep them to fit your palate. And, well…chocolate cake will always manage to taste amazing.

it's okay to indulge at times

 

Me + Lava Cake = Love

Yours in health and wellness,

Maggie

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References:

Hudnall, M., & Kratina, K. (2005, January 1). Disordered Eating in Active and Sedentary Individuals.

http://www.huffingtonpost.com/2014/07/17/bad-hair-nails-diet-foods_n_2964618.html

https://blog.myfitnesspal.com/how-to-break-free-of-emotional-overeating/?utm_source=mfp&utm_medium=email&utm_campaign=weekly20150330&mkt_tok=3RkMMJWWfF9wsRokuKvPZKXonjHpfsX66%2B0tUK6%2FlMI%2F0ER3fOvrPUfGjI4DTsVlI%2BSLDwEYGJlv6SgFSrTFMblm0LgLXhM%3D

http://www.webmd.com/diet/eat-clean-diet-review?page=3