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MINDFUL EATING, MINDFUL LIFELilian Cheung, D.Sc., R.D.

w,r\-)iObesity Trends+ Among U.S. AdultsBRFSS. 199O, 1999. 2OO9(.lMI >30, or .bout 3O lbs, overu6i9ht for 5'4" prson)^w ^w

f-!il"@.sn

Percentage ot Students Who Engaged in [DlsorderedEaling] Behaviors lo Lose Weight er to Keep tromGaining Weight During the 30 Days Betore the Survey

Took diet pills, Vomited or tookpowder, or laratNes'lquids'

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/ ro l, wwgl;{ldl

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,$':,\} . Literally:Experiencingthepresent moment with yourheart (mind) by bringing the'heart' into the 'now,. To be completely aware of allthat is within ourselves andaround us, from moment tomoment, without judgment orpreconceived notions

o John Kabat-Zinn (UMass): pioneeredsecular application of mindfulness forstress reduction in the 1980's

o Ellen Langer (Harvard): Simply payingattention to our everyday lives canmake us happier and healthier {1990)

1. Attention2. Awareness3. The present momenta. Non-judgmentals. Acceptance6. lnsight7. Self-regulation

Scientif ic measuret of miodf!lness: http://ww.mjndfulexperience.orB

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lncreased motivation for lifestylechanges (diet, physical activity, etc.)Social relationships, connectednessBeneficial biological changes(autonomic nervous system,neuroendocrine, immune)

Key: Orange tf: possible mechanism for healthyeiting behavior change

Adapted t.om

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@ Metabolic and lmmunologic Effects ofMeditation@ Novel lnteruentions to Reduce Stresslnduced Non-Homeostatic Eating@ A Randomized Controlled Trial of a NovelWeight Loss lnteruention for Obesity@ An lntegrative lnteruention for Binge Eatingin Adolescent Girls

1' ':-

Need to learn to STOPour mind and LOOKdeeply in the PRESENTmoment

Hanh & Cheung, Soyor: MindJul Eating, Mindful Life,Harperone,2010

@ FOOD NUTRIENTS: edible food and drinks@ SENSE lMPRESSlONS: what we see, hear, taste,smell, touch and think@ VOLITION: our inner motivations and deepestdesires@ CONSCIOUSNESS: imprint of all our experience andperceptions, including those of ancestors andsociety; both individual and collective

Hanh & Cheung, Sovo t: Mindful Edting, Mindt'ul Life,

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PROCESS OF TRANSFORMATION:MINDFULNESS ENERGY

5 SENSE CONSCTOUSNSS

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@ (ey concpt: energY balance@ For weight loss, calories matter-not specificamounts of fat, protein, or carbohydrate@ Stay away from "diet" mentality - emphasize health,taste, moderate PoTtions

Staying active is good for heart and weighto Head disease/chronic disease preveltion: 30 q '4,::mi./day,5daysaweeX ,.::i2.;..o Weitht control: t hr/day ,r?ib-*$,era,,NewrdeiMed.2@ Xmq'getar {fwtnerMed,r@ "-'- j_ -rrAcnvilycu'de'n.\rorA-er(!.s,2@8

-4*!.:Slt>,oos:,.

@ choose foods rich in unsaturated fatso Healthy plant oils, nuts, avocado, fattY fish

not mean I o Limit foods high in saturated fatO Butter, red meat@ Avoid foods that have

trens fat

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@ Nuts, seeds, beans, tofu@ To lower heart disease risk:o Eating more plant protein and plant oils, less

@ Fish and poultry are bestO Fish: heart healthy ome8a 3 fatso Poultry: skinisfine (healthyfat>unhealthyfat)@ Up to an egg a day is finefor healthy people

o Eat less ifyou havediabetes, heartdisease

O High in saturated fat@ Processed meat is high in sodium@ High intakes of red meat and processed meat )increased risk of

O Heart diseaseo Colon cancerO Diabeter

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@ High-sodium diets raise risk of high bloodpressure, heart disease, stroke

@ 75% of Americans' sodium intake comesfrom processed & prepared foods@ Make 1,500 mg your

dailysodium budget frt" 6- 'r'l':'lP:'e*$&,oM.2oro ,M t'{ **"IleNuri,r,o^soLrce,Rwwrh.nur'iliontoJ,(eo's .-..--:l:as -Tanins socce!, wnh cuilin' sar. .di&*.. #*1t,"**,)._NsPH rndTh. culi^rry lnnlur oIAnaric..2010

Men whose diets match the Pyramid:o 20yo .t risk of major chronic diseaseo 40% .1, risk of cardiovascular diseasewomen whose diets match the Pyramid:o 11. % .1, risk ofmajor chronic diseaseo 30% J risk of

cardiovascular disease

t al. AmJClin Nur.2m2

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I otwo roles of physical exercise andI activity:i o Br.n."lo.i",I] o Anchor of mindfulnessi oSimply walking mindfully can bring

us a feeling of stability, peace,I solidity and freedomHanh & CheunB, Soyo r: Mindlut toting, Mindlul Lle,HarDerone 701O

@ The breath is constant, convenientway to practice mindfulness@ Focus on breathing, and our breathand our mind become calm

@ Uniting mind and breathing makesus more in touch with ourselves

Breathing in, I know I am breathing inBreathing out, I know I am breathing out1n... Out...

Breathing in, I am aware of my frustration (orother negative emotion)Breathing out, I embrace my frustrationPracticing together

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@ Primary care physicians underwent 8week mindfulness training@ lncreased mindfulness and empathy,decreased burnout and

depersona lization@ Uncontrolled trial; randomized trials

neededKrasner et al, JAMA, 2009

@ Mindfulness can lower people's stress andhelp them change their behavior@ Mindful eating, moving, and breathing arepromising tools to help patients adopt andstick with healthy behaviors@ Mindfulness practice can help you improveyour clinical practice and maintain your ownwellbeing

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,.?r:.,|triia:,v%:a:,.\(.,f tri,7a:4;l+:p!lLi;::?y,ft rr,.::+.y.frgflThe past is already gone;The future is not yet here.We only have the present moment.lf we miss the present moment, we missour appointment with life.

Thich Nhot Hanh

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THE HEALTHY EATING PYRAMIDDepartment of Nutrition, Harvard School of Public Health

USE SPARINGLY:RED MEAI PROCESSED MEAT & BUTTERREFINED GRAINS:WHITE RICE, BREAD & PASTAPOTATOESSUGARY DRINKS & SWEETSSALT

ALCOHOL IN MODERATIONeveryone)

VITAMIN Dpeople)HEALTHY FATS/OILS:OLIVE, CANOLA, SOY CORN,SUNFLOWER, PEANUT& OTHER VEGETABLE OILS;TRANS-FREE MARGARINEWHOLE GRAINS:BROWN RICE,WHOLE WHEAT PASTA,OATS, ETC.

For more information about the Healthy Eating Pyramid:WWW.TH E N UTRITION SOU RCE . ORG

Eat, Drink, and Be Healthyby walter c. willett, M.D. and Patrick J. skerrett (2005)

Free Press/Simon & Schuster lnc.

copynght o 2008

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BibliographyAustin SB, Field AE, Wiecha J, Peterson KE, Gortmaker SL. The impact of a school-based obesityprevention trial on disordered weight-control behaviors in early adolescent girls. Arch PediotrAd o I e sc M e d. 2005; I59 :225-30.Austin SB, Kim J, Wiecha J, Troped PJ, Feldman HA, Peterson KE. School-based overweightpreventive intervention lowers incidence of disordered weight-control behaviors in earlyadolescent girls. Arch Pediotr Adolesc Med.2OO7; 161-:865-9.Gortmaker SL, Peterson K, Wiecha J, et al. Reducing obesity via a school-based interdisciplinaryintervention among youth: Planet Health. Arch Pediotr Adolesc Med.1-999; L53:409-18.Haines J, Neumark-Sztainer D. Prevention of obesity and eating disorders: a consideration ofshared risk factors . Health Educ Res.2006;2t:770-82.Hanh T, Cheung L. Savor - Mindful Eating, Mindful Life, HarperOne, 2OIO.Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxietyand depression: A meta-analytic review. J Consult Clin Psychol.2OL0;78:169-83.Kessler D. The End of Overeating, Rodale, 2009.Krasner MS, Epstein RM, Beckman H, et al. Association of an educational program in mindfulcommunication with burnout, empathy, and attitudes among primary care physicians. JAMA.2O09;302:1284-93.Ludwig DS, Kabat-Zinn J. Mindfulness in medicine. JAMA.2008; 300:1350-2.Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity.G a st roe n te ro I o gy. 2007 ; t32:2226-38.Wansink, B. Mindless Eoting, Bantam,2006.Wolever RQ, Best JL. Mindfulness-based approaches to eating disorders. ln: Clinical Handbookof M i ndfu I ness, Spring er, 2009: 259-87 .

WebsitesThe Nutrition Source, www.thenutritionsource.org Harvard School of Public Health's nutritionwebsiteThe Healthy Eating Pyramid http://www.hsph.harvard.edu/nutritionsource/files/Healthv-Eating-Pvramid-handout.pdfSavor the Book, www.savorthebook.com with downloadable mindful eating and mindful livingtoolsMindfulness Research Guide, www.mindfulexperience.org for scientific measures ofmindfulness and abstracts of mindfulness studies