Sugar gets a lot of good and bad attention in today’s society. It can be hard to tease through the opinions vs facts in social media, the fitness industry, and health care, or causes vs associations in research about sugar. So what is the truth? In this post I’ll break down what sugar really is, its functions in food, and why sugar is important to our health and wellbeing. You will get the truth on sugar.

What is sugar, really?

Sugar is a molecule made up of carbon, hydrogen, and oxygen. Sugar is another way to say simple carbohydrates: monosaccharides, meaning one sugar molecule, or disaccharides, meaning two sugar molecules, either the same or different strung together. Oligosaccharides, meaning more than two sugar molecules strung together, can also fit within the simple carbohydrates group. Below are some common simple carbohydrates found naturally and added to the foods we eat:

Monosaccharides
Glucose (like blood glucose or blood sugar)
Fructose
Galactose
Less common forms: Ribose, Xylose, and Arabinose
Disaccharides
Maltose (2 glucose molecules)
Lactose (milk sugar, glucose + galactose)
Sucrose (aka table sugar, fructose + glucose)

The monosaccharides explained

Glucose occurs as a monosaccharide in some foods: honey, sweet corn, grapes, and dried fruits like raisins, apricots, dates, and figs. It’s also added to food in processing, in the form of dextrose and corn syrup- extracted from corn or wheat: sauces, condiments, juices, breads or bakery items, and concentrates, to name a few.

Glucose is the human body’s preferred source of fuel. Whether we consume monosaccharides, disaccharides, or multiple saccharides strung together, glucose will be extracted for use, and other monosaccharides will be converted to glucose and/or glycogen in minimal steps. Unused glucose is stored as glycogen in the muscles and liver- approximately 400-500g in muscles and 100g in the liver. Once these store minimums are met the rest is stored as fat for long term use.

Our brain primarily runs on glucose. Approximately 20% of the glucose our body consumes and uses helps brain function. A diet low in carbohydrates could lead to symptoms associated with impaired brain functioning: poor concentration, impaired critical thinking and problem solving abilities, irritability, increased symptoms of anxiety and depression, mood swings and inflexibility, and more.

Fructose is the sweetest monosaccharide. It’s the main sugar found in fruits, and also occurs on its own in honey, syrups, sugar beets, sugar cane, and some vegetables. It can be produced from corn or broken sucrose bonds in food processing. Fructose and glucose are formed in a 50%:50% ratio to form the disaccharide sucrose, and is produced from sugar cane. High fructose corn syrup (HFCS) is also a ratio of fructose to glucose, just in different percentages such as 55%:45%, and produced from corn. Fructose is mainly metabolized in the liver to then be used for specific functions, such as converted to glucose.

Galactose is the third monosaccharide, primarily found naturally in dairy products, plus minimally in avocados, sugar beets, and some gums. Glucose and galactose are bonded by glycosidic bonds to make the milk sugar lactose. In our small intestines, lactose is broken down by the enzyme lactase, releasing the two monosaccharides. Galactose can be converted to glucose to form ATP for cellular energy. It also is part of various macromolecule structures in our body: glycoproteins and glycolipids.

The disaccharides explained

Sucrose is another word for table sugar, made up of glucose and fructose molecules in a 50%:50% ratio. It’s the sweetest tasting of the disaccharides. Sucrose is naturally found in sugar beets or sugar cane, foods we extra our table sugar from. This disaccharide also occurs naturally in fruits and vegetables. Sucrose is added to foods in the form of brown sugar, table sugar, granulated sugar, and syrups.

Lactose is the commonly known milk sugar as it’s found in mammals’ milk: goats, cows, and humans (yes, breast milk). It’s made up of the monosaccharides glucose and galactose. Lactose is found naturally but also added to foods such as sauces and meat products. Milk, yogurt, ice cream, and soft cheeses contain a higher concentration of lactose, compared to hard cheeses that have a lower concentration. This difference is due to the increased aging process of hard cheeses and greater extraction of the milk protein whey (composed of proteins, fats, and lactose).

Maltose is composed of two glucose molecules. This disaccharide is found naturally in barley and wheat, not typically in its raw form but formed during the malting (browning) process. Molasses is a concentrated maltose, a stand alone food item or added as an ingredient to energy/cereal bars, baked goods, breads, and cereals.

Functions of sugar in the foods we eat

Sugar has different functions when added to food: nutrients, sweetness, palatability and texture, and can improve shelf life. Added sugar (in terms of the monosaccharides and combined saccharides, zero calorie sweeteners are a whole other topic) meets all these functions. Naturally occurring sugar will give you whatever texture, flavor, and nutrients of the food it’s in.

Why our bodies need sugar

As mentioned above, glucose is the main source of fuel for our bodies. The body can convert protein and/or fat into glucose: proteins can break down to enter our body’s cells for energy conversion, or ketones, a fat molecule’s byproduct, can also be a usable form of fuel. However, glucose is the preferred source, the innate method to eventually form a usable cellular energy product. I’m going to explain why and how this is by making you think back to high school biology.

Remember a little thing called the Kreb cycle? Glucose is converted in a final step here to regulate various systems in our body. The human cells are permeable to glucose, and once in our cells it first breaks down into pyruvate, then 2 acetyl CoA molecules. Each acetyl CoA contributes to 1 round of the Krebs cycle. The most important product of this cycle is adenotriphosphate (ATP), a usable form of cellular energy. Without this energy source we would struggle to function as a whole.

Inadequate carbohydrate consumption could lead to obviously low cellular energy. On the surface it presents as some of the following:

head/brain region
impaired cognition
irritability
worsened anxiety, depression, or mood disorder behaviors
headaches
dizziness and/or lightheadedness
impaired vision
respiratory, circulatory
slowed heart rate
weakened heart muscle
poor blood circulation (leading to dizzy/lightheaded/faintness)
heart palpitations
muscles and bones
atrophy, weakness
brittle bones, like early onset osteoporosis
joint pain and muscle aches
easily fractured bones
fatigue
may impact your ability to perform a similar exercise routine or activities of daily living
metabolism and digestion
slowed metabolism- reversed with improved, adequate carbohydrate intake
nausea
constipation/diarrhea
the body starts breaking down ketones instead (fat’s byproduct)
less satisfied after eating (also complex carbs)
weight fluctuations (up or down)
…and more

Carbohydrates are a food group regularly demonized in mass media, and we are told to avoid it at all cost. As I’ve just explained in the above sections, sugar plays a key role in the food we eat AND is our bodies’ main source of fuel. Our body thrives on sugar. In later posts I will review the latest research on sugar and debunk common nutrition myths about this nutrient. If you want to learn more about the simple carbohydrates, such as their function and how much to regularly consume, start by reaching out to one of us dietitians to teach you the truth.

Resources:

https://nutritionj.biomedcentral.com/articles/10.1186/s12937-015-0114-0
https://www.self.com/story/how-different-are-naturally-occurring-sugars-really-from-added-ones
https://kaynutrition.com/simple-vs-complex-carbohydrates/#:~:text=Monosaccharides%20and%20disaccharides%20are%20considered,polysaccharides%20are%20considered%20complex%20carbohydrates
(https://doi.org/10.1111/1541-4337.12194 )
https://www.geeksforgeeks.org/galactose-formula/
https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/monosaccharide
https://www.sugarnutritionresource.org/the-basics/sources-and-types-of-carbohydrates-and-sugar
https://www.sugarnutritionresource.org/news-articles/what-is-sucrose
https://foodinsight.org/what-is-lactose/
https://draxe.com/nutrition/maltose/
https://www.sugarnutritionresource.org/the-basics/digestion-absorption-of-sugar
Clemens RA et al. Functionality of Sugars in Foods and Health. Comprehensive Reviews in Food Science and Food Safety 2016: Vol 15, 433-470 https://doi.org/10.1111/1541-4337.12194

Do you struggle with disordered eating habits? It’s important to know that your gut health could be impacted. Your gut is home to trillions of bacteria that play a crucial role in your overall health, including your mental health. Emerging research suggests that there may be a link between disordered eating and gut dysbiosis, or an imbalance of gut bacteria.

One study found that individuals with anorexia nervosa had lower levels of certain beneficial gut bacteria compared to healthy individuals (1). Another study found that individuals with bulimia nervosa had alterations in gut bacteria that were associated with increased inflammation and decreased levels of mood-regulating neurotransmitters (2). While more research is needed in this area, these findings suggest that disordered eating may disrupt the delicate balance of your gut microbiome, which can negatively impact your mental and physical health.

What you can do:

Improve your relationship with food
Consume a variety of foods
Pre/Probiotic Foods and/or Supplements

Reducing stress around food and improving one’s relationship with food can also have a positive impact on gut health. Chronic stress can lead to gut dysbiosis, inflammation, and a compromised gut barrier (3). Therefore, incorporating stress-reducing practices, such as mindfulness meditation or gentle exercise, can help support a healthy gut microbiome and potentially improve symptoms of disordered eating.

So, what can you do to support your gut health while working on your relationship with food? First, focus on consuming a varied and nutrient-dense diet that includes plenty of types of foods, such as fruits, vegetables, whole grains, rich protein sources, and healthy fats. Eating a diverse range of foods can help support a healthy gut microbiome by providing the bacteria with the necessary nutrients they need to thrive (4).

Additionally, incorporating probiotics and prebiotics into your diet may also be beneficial. Probiotics are live bacteria that can help support a healthy gut microbiome, while prebiotics are a type of dietary fiber that serve as food for the bacteria in your gut (5). Foods that are high in probiotics include yogurt, kefir, kimchi, and sauerkraut, while foods that are high in prebiotics include garlic, onions, leeks, asparagus, and bananas.

It’s important to note that if you’re struggling with disordered eating habits, seeking support from a healthcare professional is crucial. We can help you create a personalized plan to support your mental and physical health.

In conclusion, your gut health and your relationship with food are interconnected. By prioritizing a nutrient-dense diet, incorporating probiotics and prebiotics, and reducing stress around food, you can support a healthy gut microbiome and potentially improve your mental and physical health.

Sources for more information:

Kleiman SC, Watson HJ, Bulik-Sullivan EC, et al. The Intestinal Microbiota in Acute Anorexia Nervosa and During Renourishment: Relationship to Depression, Anxiety, and Eating Disorder Psychopathology. Psychosom Med. 2015;77(9):969-981. doi:10.1097/PSY.0000000000000211

Kleiman SC, Glenny EM, Bulik-Sullivan EC, et al. Daily changes in composition and diversity of the intestinal microbiota in patients with anorexia nervosa: A series of three cases. Eur Eat Disord Rev. 2017;25(5):423-427. doi:10.1002/erv.2526

Kelly JR, Kennedy PJ, Cryan JF, Dinan TG, Clarke G, Hyland NP. Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders. Frontiers in Cellular and Infection Microbiology. 2015;5:1. doi:10.3389/fcimb.2015.00055
Sonnenburg ED, Sonnenburg JL. Starving our Microbial Self: The Deleterious Consequences of a Diet Deficient in Microbiota-Accessible Carbohydrates. Cell Metab. 2014;20(5):779-786. doi:10.1016/j.cmet.2014.07.003

Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491-502. doi:10.1038/nrgastro.2017.75

Working towards becoming an intuitive eater requires flexibility and sometimes imperfect eating. Imperfect in the sense that each day can be different, each day does not have to be planned out perfectly, and your body will actually thank you. Flexibility meaning that food should be fun, exciting, and sometimes a little impulsive, while also still satisfying your nutritional needs. A gentle reminder: your body WILL NOT change or go into distress mode if you eat a whatever food: eating in between meals, taking a few bites to taste a food you prepared, or eating an unplanned food because it was offered at your work and it looked satisfying. Actually holding out and not honoring your cravings could possibly lead to overeating or binging. This could look like initially avoiding a whatever food, searching for something “healthier” to replace the food initially craved, maybe eating one or several items to replace that craved food yet still feeling unsatisfied, and eventually going to find that food that was avoided earlier on.

Can you still meal plan as an intuitive eater? ABSOLUTELY! Intuitive eating is a lifestyle that stresses body attunement and selfcare. So for example, understanding that your Monday will be filled with meetings and draining conversations that won’t allow you to step out and buy food or make lunch, and that you will need not just caffeine but actual energy-rich foods to get you through the day, is acting as an intuitive eater. Below are several tips to support you in practicing, or striving for, intuitive eating, and supporting you where you are at in your relationship with food.

1. KNOW YOUR SCHEDULE AND PRIORITIZE FOOD
For instance, take the above example. Planning for a busy Monday could involve making extra for dinner the night before to have for lunch the next two days, packing a variety of snacks to satisfy the sweet but also salty and savory needs, making a sandwich and one to two sides in the morning, or stopping at the nearest grocery store to find a ready-made sandwich or frozen entrée to nuke in the microwave at work. All of these are absolutely okay and can be filling enough to get you through the day, without losing concentration. If you find yourself hungry after a planned meal, having snacks available is another way to prioritize food. Keeping a planner or having access to your work calendar at home (without obsessing over it, but checking maybe one time on Sunday to help you prep and plan food for the next day) can help you in planning whether more snacks or a substantial meal and a couple of snacks would set you up for success best.

2. GROCERY SHOP WITH AN INTENTION
Grocery shopping is a key step in prioritizing food and planning ahead. Without shopping with intent and buying randomly (this can have its place 100%, just not when food is hard to plan in the moment during the week), meals may be overwhelming or harder to decide on.

Here are some tips to enhance your grocery shopping for prepping ahead:

• Shop with a list
• Try Instacart or another online shopping platform
• Use Pinterest, Tasty, or another food recipe app for inspiration
• Keep a journal of your favorite recipes to pull from
• Shop with a satisfied stomach
• Keep stock of your favorite staples
• Shop in bulk- this saves time and is more cost effective

3. IT’S OKAY TO PLAN SIMPLE
Your meal prepping and planning does not have to be glorious, like the social media influencers who make a following on what they eat in a day and create stacks of meal prep containers with similar ingredients they feel safe eating for the week. No… your meal prepping can be for one meal the next day or for a few days. It also should not be the same grain, protein, and fruit/vegetable repeatedly- variety is key for optimal nutrition plus feeling satisfied from food. You can use whatever containers available, or find ready-made meal ideas such as frozen entrees, a wrap, or leftovers from eating out the night before.

4. EAT THAT WHATEVER FOOD, WITHOUT BEHAVIORS
Don’t stress over wanting something outside of what you have planned. Also, there may be days where you’re hungrier than others, and what you packed for lunch will not fuel you until dinner. That’s okay, and there’s nothing wrong with you or your body just because you are feeling hungrier: our hunger/fullness cues ebb and flow. Giving yourself permission to eat something satisfying related to hunger, sight, or smell is supportive in improving your relationship with food. For example, if a coworker brings in brownies at lunch, and it’s your favorite dessert, add this to your lunch, or have it for a snack later. DO NOT compensate later by eating less, exercising more, or taking supplements to get rid of this extra food. Your body will know what to do with it. Plus, think of the types and amount of food you eat as an average, and that not one day will change your body-basically limit the all or nothing thinking. (On the flip side, it’s also okay to say no to food people offer you when you are full and working on honoring your internal cues.)

5. UNDERSTAND YOUR HUNGER CUES
Increasing your body awareness, body attunement will help you in planning ahead for the week and packing enough food/beverages to keep you satisfied. First, think about your specific hunger cues at each level, where 1 is famished, 5 is neutral but a snack could be satisfying, and 10 being very very full. Second, consider the type of day you’ll have ahead of you: your stress levels during a particular day (what adds to your stress?), activity levels before, during, and after work, the amount you will be on your feet, and how much of a break you’ll have between activities of daily living or work tasks. Your hunger cues are always going to be there, but hunger may be present earlier on with being more active or increased stress. On the opposite side of the spectrum, stress and emotions can sometimes decrease your appetite, but does not mean your body isn’t in need of food. Fourth, take the time to learn what food options are satisfying at each level of hunger/fullness. Lastly, avoid appetite suppressive behaviors to push off hunger and meet the task at hand vs satisfying your hunger. Drinking caffeine, chewing gum, chugging water or low calorie drinks, or sipping on carbonated beverages may give you a false sense of fullness, but is not what your body truly needs in that moment and will interfere with developing solid hunger/fullness cues.

6. TAKE TIME TO EAT
Start by limiting distractions while you eat, such as working while eating, video games, scrolling through social media, or work meetings. Light TV, conversation, or reading (a book, newspaper, or on your phone or Ipad) may be okay. Allot a minimum of 25-35 minutes for a meal (eating and socializing with colleagues, more if it requires prep time beyond just microwaving leftovers), and 10-20 minutes for a snack. Step away from your office space, current task at hand, and any stressful situation in general. I like to remind my clients that a work-life-food balance is necessary to not only develop a healthy relationship with food, but to keep work enjoyable as well. If you are having a hard time delegating time to food, block it off in your calendar or set alarms on your phone for meals. You deserve breaks and self care multiple times a day.

If you like the sound of becoming an intuitive eater and want more meal planning ideas, seek support from a registered dietitian at Enhance Nutrition. We love talking about food!…and want to support you in improving your relationship with food, no matter where that start line is.

By: Kaitlin Moses, RD, LDN

It’s National Eating Disorder Awareness Week – let’s talk about the warning signs of an eating disorder.

Eating disorders continue to be on the rise – knowing the warning signs can help you or your family member, friend or loved one, get support and get to feeling better around food.

Eating disorders start as disordered eating patterns and may include subtle changes in food preferences, eating behaviors and exercise – before becoming alarming symptoms.

6 Warning Signs of an Eating Disorder
Sudden desire to eat healthier and/or cutting out certain food groups like carbohydrates, dairy, meat or desserts. While changes in diet can be positive in many circumstances, drastic changes like cutting out whole food groups could indicate a stressful relationship with food.

Difficulty or avoiding eating in front of other people stems from worry or anxiety that others will judge what you’re eating or how much you eat. This can result in eating a large amount of foods when alone or only wanting to eat in private.

Developing rigid rules or rituals around eating may include eating foods in a certain order, not eating certain foods, using excessive condiments, cutting food into small pieces, pushing food around plate at meals – are used to mitigate the anxiety, guilt or shame felt around foods.

Ambiguous stomach problems mentioned often, especially as an excuse to avoid eating, may sound like “my stomach hurts” or “my stomach is upset” – may be a sign of disordered eating, especially if there is no well defined cause. Headaches, feeling dizzy, and constipation are common symptoms of malnutrition or not getting enough calories daily.

Talking about food as a reward for doing things or mentioning food needs to be burned off with exercise, may indicate a transactional relationship with food (calories in vs. calories out) or concern with how many calories are being eaten throughout the day.

Obsessive thoughts about food or body may sound like “how many calories is in this”, “if this has more than X calories I shouldn’t eat it”. It may look like engaging in diets, avoiding social outings that involve food, checking how body looks in mirror, wearing loose or baggy clothing majority of the time.
Eating disorder diagnoses increased 15% in 2020 among people under 30 compared to previous years

A recent study showed diagnosed eating disorders increased by 15% during the COVID-19 pandemic (2020) among people under 30, compared to years prior. The peak age of onset is 15-25 years old, but someone can develop an eating disorder at any age.

Eating disorders have the highest mortality rate of any mental illness. The sooner signs are noticed, and the sooner treatment starts, the less likely it is for severe complications to occur. While there are several formal diagnoses for eating disorders, you do not need an eating disorder diagnosis to seek support via therapy or nutrition counseling.

Types of Eating Disorders

• Anorexia nervosa (AN)
• Bulimia nervosa (BN)
• Binge eating disorder (BED)
• Other specified feeding or eating disorder (OSFED)
• Avoidant Restrictive Food Intake Disorder (ARFID)

If you have any questions or know someone who is struggling with their relationship with food, feel free to reach out to our team of dietitians for support.

Further resources:

• National Eating Disorder Association (NEDA)
• Carolina Resource Center for Eating Disorders (CRC for ED)
• Alliance for Eating Disorders
• ANAD

By: Sarah Stroup, MS, RD, LDN

As a dietitian I receive all sorts of first-impression comments when I share what I do. Most of the initial questions and comments come from the assumption that dietitians put clients on a diet, tell them to watch their weight, and they must eat a variety of fruits and vegetables while avoiding processed foods– end of story. Yet there is SO MUCH MORE to what a dietitian does and the advice we give. And believe it or not, we are humans too. We as dietitians, especially weight neutral, anti-diet focused, realize that all individuals are unique, and it’s important to create a safe space around discussing food and all that encompasses the topic. We are trained to provide evidenced-based nutrition advice through motivational interviewing and building rapport with clients, not insinuating a person is bad for how and what he or she eats.

WHY ALL DIETITIANS ARE NUTRITIONISTS, BUT NOT ALL NUTRITIONISTS ARE DIETITIANS

To further explain the role of a dietitian, I’d like to include a brief explanation on the training we receive and why we are qualified nutrition experts who work in various levels of care to treat chronic conditions through food and beverage changes. Dietitians are nutritionists, but not all nutritionists are dietitians. Dietitians are trained to provide specific health and wellness education regarding eating habits, exercise, and food-drug interaction; to develop individualized meal plans for their patients to help them better meet their nutritional needs; and can hold roles in the clinical, food service, research, or community setting. The credential for dietitians is RD or RDN, meaning registered dietitian or registered dietitian-nutritionist, and are interchangeable. This recognizes that the registered dietitian exam has been passed and all requirements have been met to be accredited nationally. Many dietitians will have the follow-up credential LD or LDN, for licensed dietitian or licensed dietitian-nutritionist, meaning the individual is licensed in a specific state(s) in which they practice– and this all depends on state protocols whether state licensure is necessary. Many dietitians hold an optional masters degree, not necessarily in nutrition, and will be required to achieve the RD/RDN credential starting in 2024. There are other credentials a dietitian can hold that highlight an individual’s expertise in the area of dietetics he or she has specialized in.

WHAT TO EXPECT WHEN WORKING WITH A DIETITIAN: CLINICAL DIETITIAN

Dietitians support many populations, varying in degree from one-on-one client coaching in the private practice setting to working with a group as part of a larger organization. Again, dietitians can provide nutrition education within four different roles. Here the focus will be on dietitians supporting clients in the clinical setting, such as when a patient/client is referred to a dietitian by another health care provider. Dietitians are trained to provide medical nutrition therapy (MNT) and incorporate nutrition goals and interventions for the following, but not limited to, conditions:

• Diabetes management, type 1 and type 2
• heart disease
• Hypertension (high blood pressure)
• bariatrics and weight management
• food intolerances, sensitivities, and allergies
• Nutritional deficiencies
• Irritable Bowel Syndrome (IBS)
• Irritable Bowel Disease (IBD)
• Crohn’s disease
• Ulcerative Colitis
• eating disorders and disordered eating

The first session typically will last 60-90 minutes for the dietitian to gain as much history as possible. Questions may be asked about food likes and dislikes, daily food/beverage intake, any allergies or food intolerances, or foods specifically avoided due to a concern of an intolerance; frequency of cooking vs ordering takeout, shopping experiences, financial stability to access an adequate amount (in variety and quantity) of food, current medications and dietary supplements, gastrointestinal health and symptoms, medical and mental health history, current and past anthropometrics, the individual’s short and long term goals in working with a dietitian, and more.

Follow up sessions with clinical dietitians in the outpatient setting are typically 30-60 minutes in length, weekly to start, and eventually transition to biweekly then monthly as a client’s nutrition goals and interventions are met. In the hospital setting and program levels in between, these sessions could be more than 1x per week and include nutrition educational groups, parenteral nutrition or enteral nutrition, treatment team meetings, etc. as part of the programming. Goals are meant to be timely, measurable, realistic, attainable, and specific to the client– also created by the client with help of the dietitian. Interventions could be assignments, designated ways to adjust one’s eating and lifestyle behaviors, using food logs to track success during the week or something to discuss in follow up sessions, etc. that support achieving set goals.

DEBUNKING MYTHS ABOUT WORKING WITH A DIETITIAN

A common misconception is that sessions with a dietitian will involve judgment, such as scolding someone for not eating the right way, or insinuating that he or she is eating too much and needs to cut back, or tell the individual that the foods he/she loves should be cut out immediately. Yet this is not how we as healthcare providers are trained to administer MNT. (If this has been a personal experience for you, I can only express my sympathy and hope you will give dietitians another chance.) We are trained to build rapport with our clients and provide recommendations to encourage health for the individual. We are trained that ALL macronutrients and micronutrients, each in varying amounts, help our bodies function– so clearly we have the skills to create specific food/beverage recommendations to incorporate unique client likes and dislikes. And we are trained to create meal plans for populations that may need to track or consume a specific nutrient sparingly, such as in Celiac’s disease or Diabetes care. As dietitians, we are passionate about what we do and want to help, are trained to listen, and try to create a safe space for discussing nutrition concerns.

In terms of the word “dietitian”, this does not mean that the ultimate goal will include “dieting” interventions. (Here I will use the word diet or dieting as a general explanation for restrictive eating habits focused on changing one’s body, weight, shape or size. The term diet could also stand for specific eating habits related to ethical, cultural, moral, religious, food allergy, or disease needs, not at all associated with wanting to lose weight.) Yes, in our culture this may many times be a long term or short term goal for a client, and the dietitian will create interventions in support of this goal. These are typically providers that advertise, among others, “weight loss” or “weight management”, “bariatrics”, or “obesity prevention” as their areas of expertise. However, not all dietitians practice with this intent. Another approach involves an anti-diet, Health at Every Size, weight-neutral focus. These dietitians see the harm that weight fluctuations and weight stigma inflicts, so support their clients in creating health-enhancing lifestyle changes through nutrition, body neutrality and body respect, and joyful movement.

MORE ABOUT: WHAT TO EXPECT IN WORKING WITH A ANTI-DIET DIETITIAN

We at Enhance Nutrition fully support that everyone is individualized, and that nutrition goals and interventions must be tailored to the person with this in mind. We are just one of many dietetics practices that make up this anti-diet registered dietitian community. Many of us in this community are intuitive eating counselors, trained to support our clients in working through its 10 principles and develop a healthy relationship with food and their bodies. Many of us have lived our own experiences with diet culture telling us we are not good enough unless we change the way we look or eat to fit specific societal standards, but came to realize its fallacy. Or we may have just stumbled upon this anti-diet community out of chance and found it life changing. The important point is that anti-diet dietitians are trained, plus some, to create a safe space to discuss food, body concerns, and joyful movement. Anti-diet dietitians will call out diet culture by, first, debunking the misconceptions that being in a larger body– falling within a higher BMI category– does not equal poor health, cause chronic diseases, or increase the risk of early mortality; second, help their clients make the connection that a person’s weight or shape does not define them, and someone is not good or bad based on what they eat; and third, make the connection that weight stigma in itself is oppressive, discriminatory, and leads to societal biases that can show up within healthcare, the workplace, or one’s home environment. In working with an anti-diet dietitian, a client can expect to learn and create changes in the following areas of their life:

• How to take control of their eating habits through eating enough– this includes enough in terms of both a variety and quantity of food.
• Gentle nutrition concepts and how to incorporate all the food groups in an enjoyable, life-enhancing balance.
• How to break free of the diet cycle and eliminate hyperfixation on how to eat, what to eat, how much to weigh vs spiraling through numerous pre-constructed, one-size-fits-all plans
  The importance of getting rid of number fixation: calorie counting, macronutrient tracking, frequent weighing.
• The biological, psychological, social, and emotional harms of dieting and the restrict-binge (undereating-overeating) cycle.
• How to enjoy food again in all food related situations.
• Why this approach applies to all populations: any size, any race, any gender, any disease state

NEXT STEPS: HOW TO FIND AN ANTI-DIET REGISTERED DIETITIAN

Intrigued? Start by searching for a provider that highlights anti-diet, weight neutral messages on their platforms. Ways to find an anti-diet dietitian through online searches: look for terms such as health at every size (or HAES-aligned), anti-diet, intuitive eating, and weight-neutral. On social media, anti-diet healthcare providers will sport hashtags such as #dietssuck, #HAES, #antidietdietitian, #disorderedeatingrecovery, #makingpeacewithfood and #allfoodsaregoodfoods. Red flag terminology that is not supportive of an anti-diet approach includes weight management, weight loss, or highlights of specific diets. Social media spaces and websites promising this will finally be a successful diet, the last approach necessary to loose the weight for good, are tempting, but like the diets before are not promoting a weight neutral, life enhancing approach. Also be skeptical if there is one or multiple of the red flag terms coinciding with making peace with food. It’s not possible to find food freedom and body neutrality while also inflicting more food rules and focusing on loosing weight— this keeps an individual further stuck in the restrict-binge, hyperfixation on food cycle.

Once an anti-diet dietitian sparks your interest, request an initial 5-15 minute consult call to assess if it will be a good fit for you and the provider as a team. It’s important to find a dietitian that will not only meet you where you are at in your relationship with food, but make sure to push them to be the best version of yourself. Most anti-diet outpatient dietitians will make room in their schedule for these inquiries, so just ask!

By: Kaitlin Moses, RD, LDN