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SCAN’S P U L S E Summer 2006

5. Fenton M. Engineering physical chips. Most chronic dieters have not Evelyn Tribole, MS, RD, has a nutri-
activity back into Americans’ lives. experienced food habituation. tion counseling practice in Irvine, Calif,
Progressive Planning. 2003;1-8. Instead, they live in the black-and- and is co-author of Intuitive Eating, 2nd
Available at www.plannersnetwork. white world of eating: good foods ed.
org/htm/pub/archives/fall03/fen- and bad foods, on a diet or off of a References
ton.htm. diet. 1. Ernst MM, Epstein LH. Habituation
6. Fenton M. Battling America’s epi- Paradoxically, knowing that you of responding for food in humans.
demic of physical inactivity: building can eat a particular food again when- Appetite. 2002;38:224-234.
more walkable, livable communities. ever you want makes it less compel- 2. Rozin P, Fischler C, Imada S, et al.
J Nutr Activ and Behav. 2005;37 (suppl ling to eat it now and eat it all. Con- Attitudes to food and the role of food
2). sequently, the thought to stop eating in life in the USA, Japan, Flemish
when full is no longer threatening. Belgium, and France: possible impli-
Intuitive Eating in the Treatment Eating no longer becomes the “last cations for the diet–health debate.
of Disordered Eating supper before the diet” or “eat it all Appetite. 1999;33:163-180.
by Evelyn Tribole, MS, RD while I can, no one is here.” It is no 3. Tribole E, Resch, E. Intuitive Eating,
longer threatening to be in touch with 2nd ed. St. Martin’s Press; 2003.
Intuitive Eating1 is a process-based the many body cues, whether they are
approach that ultimately teaches physical, hedonic, or emotional. Genes, Personality, and Eating
patients how to have a healthy rela- Challenging the “food police.” This Disorders
tionship with food, wherein patients calls for challenging the internal and by Ovidio Bermudez, MD, FAED
become the experts of their own bod- external rule-makers of so-called
ies. Patients learn how to trust their healthy eating on a cultural and fami- Eating-related pathology occurs across
ability to meet their needs, distin- ly level, and ultimately what this the lifespan. Eating disorders (EDs)
guish between physical and emotion- means for the patient. It involves the are complex illnesses that occur most-
al feelings, and develop body wis- use of cognitive behavior therapy, in ly in adolescence and early adulthood;
dom. On the surface this may sound which patients learn how to evaluate the etiopathogenesis of these illnesses
simplistic, but it is rather complex. their thoughts for distortions as they is not yet fully understood. All eating
For example, one of the basic cores relate to food and body. This means disorders share hereditary, familial,
of Intuitive Eating is the ability to challenging the status quo. temperamental, behavioral, psycho-
respond to body cues, ie “Eat when Fascinating research by Rozin et al logical, medical, and sociocultural
hungry and stop when full.” This sheds light on the significance of this characteristics, often viewed as predis-
may be easy for many people, but for issue.3 They found that Americans posing, precipitating, and perpetuat-
a patient with a history of chronic are “worry-warts” when it comes to ing factors. Dieting has been identi-
dieting or rigid “healthy” rules about food. Americans scored the highest fied as one of the major risk factors for
eating, it is very difficult to accom- among four countries on the level of the development of disordered eating,
plish because a number of issues need worrying about the fattening effects and obsessionality and impulsive cop-
to be worked on, some of which seem of food as opposed to savoring it; ing seem to facilitate the evolution of
counter-intuitive. Following are two they associated food the most with disordered eating into diagnosable
keys to working effectively with such health and the least with pleasure. eating disorders.
patients: Rozin and colleagues postulate that All eating disorders are character-
Unconditional permission to eat the stress-effect of worrying about ized by the presence of pathological
any food. How can this be healthy? food may be an important contributor behaviors and thinking in various
Patients struggle with this concept, to overall health. They suggest that combinations; these include restric-
because they worry that once they American worries and obsessions tion, binging, purging, fear of weight
start eating a forbidden food, they about healthful foods may be count- gain or fatness, and self-valuation that
won’t stop. Yet, it is the very process er-productive, producing substantial overemphasizes the individual’s per-
of eating that allows the patient to reduction in the quality of life. ception of their size or weight. There
experience food habituation. Studies The Intuitive Eating journey teach- is evidence supporting the dimension-
show that the more a person is es a patient that a healthy relationship al perspective of EDs. Full and partial
exposed to (and allowed to eat) a with food is just as important as the syndromes share sociocultural, famil-
food, the less desirable it becomes healthfulness of a food choice. ial, psychometric, behavioral, medical,
over time.2 This has been demonstrat- Intuitive Eating takes the morality and hereditary variables.
ed in studies involving many foods, and judgment out of eating, so Eating Disorder Not Otherwise
including pizza, chocolate, and potato patients also learn that their character Specified (ED NOS) share similar
and self-worth are not altered by their prognosis and morbidity to anorexia
■■■■■ choice of food, whether it’s a cheese- nervosa (AN) and bulimia nervosa
12 burger or salad for lunch. (BN) and should not be considered a
A Publication for Sports, Cardiovascular, and Wellness Nutritionists Summer 2006
® Vol. 25, No. 3

Results of the Detroit Faith-Based

Mini-Market Project
Results of the Detroit
Faith-Based Mini- by Quentin J. Moore, MPH and pating churches received information
Market Project 1 Brandess Wallace, MPH on health and wellness programs,
educational resources, other materi-
From the Editor 3 The Detroit Fruit and Vegetable Mini- als, and technical assistance. Staff pro-
Market Project was created as a col- vided support in troubleshooting as
Does Branched-Chain Amino laborative effort of faith partners who well as assisted in the coordination of
Acid Supplementation Offer were recruited to accomplish a shared health screenings and educational lec-
Ergogenic Benefits? 5 goal: to promote healthful eating and tures for the churches. The mini-
physical activity among African marts were targeted to low-income
CPE article—Diabetes: Americans in churches and faith- residents, offering them low-cost
Something to Stress About 8 based organizations as a means to fresh produce at accessible locations.
address the huge burden and dispari-
2006 SCAN Symposium ty of cardiovascular disease (CVD) Methods
Presentations 11 among blacks.1,2 The program’s goals The Detroit Fruit and Vegetable Mini-
and objectives, along with pilot data Market Project utilized quantitative
From the Chair 19 on its implementation, were previous- and qualitative methods. Quantitative
ly described in SCAN’s PULSE data were collected via a retrospective
2006 ADA Food & Nutrition (Winter 2006). Partnering with the pretest. This method of self-report
Conference & Expo (FNCE) 19 Michigan Department of Community evaluation offers a vehicle for docu-
Health, the Michigan Public Health menting behavioral change at an end-
Reviews 20 Institute (MPHI) obtained funding to point, with each respondent serving
conduct this special project to as his/her own control. The instru-
Sports Dietetics USA increase capacity and provide ments are relatively easy to develop,
Research Digest 21 resources for faith-based fruit and use, and analyze.5 Results are credible
vegetable mini-markets in 10 church- and are a proficient indication of pro-
SCAN Notables 23 es in Detroit and its surrounding gram impact when a traditional
areas. Faith-based wellness programs pre/post design cannot be utilized.5,6
2006-2007 Executive have previously been successful in However, retrospective pretests carry
Committee 24 empowering African-American some limitations. Validity can be com-
churches to promote fruit and veg- promised when self-reported data
Of Further Interest 27 etable consumption as a method to and recall are used. Insufficient recall
decrease the risks of CVD and hyper- and biased responses are possible
Upcoming Events 28 tension in the black population.3,4 problems with these types of evalua-
The 10 selected church sites were tive instruments.7
provided with training and materials The retrospective pretest used in
enabling them to conduct fruit and the mini-market project was revised
vegetable mini-markets. Throughout from a previous 5 A Day initiative
the 8-month project period, partici- survey targeting a low-income

Publication of Sports, Cardiovascular, and The viewpoints and statements herein do
Wellness Nutritionists, a dietetic practice not necessarily reflect policies and/or offi-
August 18-19, 2006
group of the American Dietetic cial positions of the AMERICAN DIETET-
“Nutrition & Exercise: An Intensive Association. ISSN: 1528-5707. IC ASSOCIATION. Opinions expressed are
Workshop,” Providence, RI. For info: those of the individuals authors.
Nancy Clark, www.sportsnutrition Editor-in-Chief Publication of an advertisement in SCAN’S Mark Kern, PhD, RD PULSE should not be construed as an
Exercise and Nutritional Sciences endorsement of the advertiser or the prod-
September 16-19, 2006 San Diego State University uct by the American Dietetic Association
5500 Campanile Dr. and/or Sports, Cardiovascular, and
ADA Food & Nutrition Conference & San Diego, CA 92182-7251 Wellness Nutritionists.
Expo (FNCE), Honolulu. SCAN ses- 619/594-1834 - w
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