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Family Meals Focus

The Ellyn Satter Institute Newsletter

Practicing nutritional judo

by Ellyn Satter, Registered Dietitian and Family Therapist

What most of us really want with eating is to eat enough of food we genuinely enjoy. Going with that energy, rather than fighting against it, makes us healthier. Research with the Satter Eating Competence Model indicates that this nutritional judo works. Eating competent (EC) people do better nutritionally and medically. They tend to have meals, eat a variety of food, not binge eat and have lower BMIs. They are more active, sleep better, and do a better job with parenting their children with food. 

Dietary Guidelines tells us to overcome our food longings

The Dietary Guidelines is up for revision, and we are invited to comment on the Scientific Report1 “foundation for developing national nutrition policy.” It appears to be headed in the same direction as many times before: eat this, don’t eat that, don’t eat so much. In the 400+ page report, “enjoy eating” doesn’t appear once. It is time for a change. Despite the fact that past Dietary Guidelines advice has been accompanied by dire health warnings for failure to comply, our average score for adherence is around 50%,2 which is in the fair to poor category. We just can’t do it. However, we have been brain-washed for decades by being told that we ought to do it. If you ask us what we want to achieve nutritionally, we are likely to say, “eat more fruits and vegetables . . . eat less fast food . . . eat less sweets.” But is that what we really want, or is that what we want to want—or what somebody else wants us to want?

 What we really want

In my clinical practice, starting almost 50 years ago, I discovered that deep in their heart of hearts (or in their taste buds and stomachs), what most people, me included, really want with eating is this: to eat enough of food we genuinely enjoy. So why not, I reasoned, practice nutritional judo? Why not go with the energy directed toward eating enough of food we find enjoyable rather than fighting against it? So my patients and I did just that, and it worked. People did better after I scrapped the rules and encouraged them to provide themselves with food they genuinely enjoyed. They had meals, ate a variety of food, and stopped restricting and then overeating. The Satter Eating Competence Model (ecSatter)3 and the Satter Eating Competence Inventory (ecSI)4 came out of that clinical judo work. Barbara Lohse’s webinar about the rapidly accumulating ecSatter research shows that, like my patients, people who are eating competent (EC)—those who respect their food wishes and regularly provide themselves with food they enjoy—do better nutritionally and medically. They tend to have meals, eat a variety of food, and not binge eat. They are more active, sleep better, and do a better job with parenting their children with food. The benefit extends to the next generation: Children of EC parents have decreased nutritional risk.

Trust your energy to learn and grow

Nutritional judo works because we are born with the energy to learn and grow. According to Abraham Maslow,5 growth occurs on its own, in its own time, in sequence. From the foundation through the apex on Maslow’s pyramid-shaped hierarchy of growth, those needs are: 

  1. Physiological needs: air, water, food, shelter, sleep, sex
  2. Safety, security, order
  3. Social affection: love, belonging
  4. Esteem, status; self-esteem and esteem by others
  5. Self-actualization: being all the individual can be. 

As we satisfy needs at each level, we address needs at the next level. Arranging food needs in a similar hierarchy, from the foundation through the apex, gives Satter’s Hierarchy of Food Needs.6

The energy to eat enough

Do you have enough to eat? If you are food insecure, on a weight-reduction diet, or on an airplane with no food stash, your major concern is getting something to eat. The hungrier you are, the more you go (or want to go) for high-calorie food—food that quickly fills you up.

  • Energy to get enough to eat defeats weight reduction dieting. It also defeats policy-driven expectations7 that the one in three low income people suffering from food insecurity in this country8 will prioritize spending on fruits, vegetables, skim milk, and other relatively low-calorie food.
  • Consider that women who grow up poor develop a prevailing fear of going hungry, panic when there isn’t enough food, and have a tendency to binge-eat when food again becomes available.9
  • Periodic disinhibition, which strongly correlates with obesity and less-healthful food choices,10 goes along with periodically not having enough to eat, whether it is caused by fluctuating money or willpower. In contrast, the EC, who eat consistently, have lower BMIs.4,11

If your income is low, you are wise to follow EC-consistent (but Dietary Guidelines inconsistent) strategies that ensure your getting enough to eat: choose whole milk, fry, use butter or margarine on vegetables and on the table, and buy fruit canned in heavy syrup. And do it with a glad heart, without shame or recrimination. Using fat and sugar to increase the calories in nutritious food doesn’t seem so bad when you consider what respectable, responsible, and hungry parents do to feed their families: They go hungry themselves, scrounge other people’s leftovers, remove spoiled sections, slime, mold, and insects from food, and cook meat found as road kill.12

The energy to eat “acceptable” food 

Do you have food you can stomach? Hand in hand with getting enough to eat is having access to food you consider “acceptable.” This is in large part experience-based. We learn from little on which foods are safe and desirable. My family never ate rice and considered a meal without potatoes as not being a meal at all. It may have been the opposite for you. People who scrounge for food discover what they can tolerate. One person finds using food stamps or going to food pantries acceptable, another doesn’t.

The energy to have reliable, ongoing access to food

Once today’s needs are satisfied, you can and will naturally begin to consider feeding yourself the next meal and the next day. You can and will do at least some cursory planning for subsequent meals, accumulate a food stash, and save up for food purchases. Having reliable access to enough acceptable food, not just today but also tomorrow and into the indefinite future, gives you food security. 

The energy to have good-tasting food

Having achieved food security, your appetite will become more prominent. Most people prioritize taste in food selection,13 but that is only when they know they will get enough to eat. When you are starving, almost anything tastes good and you settle for “acceptable.” Now that you aren’t starving any more, you get pickier. Honor your appetite. You are entitled. This too, will pass. 

The energy to seek novel food

After you have had plenty of time to eat as much as you want of food you enjoy, you will find yourself tiring of even your favorite foods. You will begin taking more interest in new foods or perhaps in familiar foods prepared in novel ways. You will begin to experiment. You will gradually increase the variety in your diet, which will improve its nutritional quality. Better nutrition is a nice side benefit, but don’t make it the primary benefit or you will revert to fighting against, rather than going with, your basic food-seeking energy. Once you have naturally grown to this level on the food hierarchy, you are in good shape nutritionally. Your energy to seek novel food will stay with you, unless you pervert it into a should rather than a want. You will learn and grow nutritionally throughout your life.

The energy to seek instrumental food

This is the level addressed in the item on ecSI 2.0, “I consider what is good for me when I eat.” When you have grown solidly through all of the other parts of the hierarchy, this is a both-and, not an either-or, consideration. You will eat food you enjoy and you can consider what is good for you. If you have been traumatized by trying to force yourself to eat by the rules, it will take a long time before you can comfortably consider what is good for you when you eat. This is not to say that you will do poorly nutritionally if you don’t get to this level. Having grown and developed to point of seeking novel food or, before that, seeking good tasting food, your nutritional status is likely to be just fine.

In skipping over all the other levels of the food hierarchy and concentrating on instrumental food, the Dietary Guidelines traumatizes us. It condemns our natural energy to eat enough of food we genuinely enjoy and sentences us to do the opposite.

 Trust yourself to learn and grow

Trust your process. Start at the bottom of the food hierarchy. Give yourself as much time as you need to grow through the levels. Feed yourself faithfully and give yourself permission to eat. 

  • Take good care of yourself with food. Consider the food that is readily available. Figure out practical and enjoyable ways of providing yourself with three meals a day, sit-down snacks if you need them.
  • Eat what you are eating now. Just have it at regular meal- and snack-times.
  • Trust yourself to learn and grow. You will move up on the hierarchy when you are ready. Don’t try to push yourself beyond what feels genuinely comfortable to you. You will slow your growth, not speed it up.

References

  1. USDA. Scientific Report of the 2015 Dietary Guidelines Advisory Committee. 2015; http://www.health.gov/dietaryguidelines/2015-scientific-report/.
  2. Guenther PM, Kirkpatrick SI, Reedy J, et al. The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr. 2014;144(3):399-407.
  3. Satter EM. Eating Competence: definition and evidence for the Satter Eating Competence Model. J Nutr Educ Behav. 2007;39:S142-S153.
  4. Lohse B, Satter E, Horacek T, Gebreselassie T, Oakland MJ. Measuring Eating Competence: psychometric properties and validity of the ecSatter Inventory. J Nutr Educ Behav. 2007;39 (suppl):S154-S166.
  5. Maslow A. A theory of human motivations. 1943.
  6. Satter EM. Hierarchy of food needs. J Nutr Educ Behav. 2007;39 (suppl):S187-188.
  7. USDA. Supplemental Nutrition Assistance Program Education Guidance. 2015; http://snap.nal.usda.gov/snap/Guidance/FinalFY2015SNAP-EdGuidance.pdf.
  8. Coleman-Jensen A, Gregory C, Singh A. Household food security in the United States in 2013. 2014; http://www.ers.usda.gov/media/1565415/err173.pdf.
  9. Olson CM, Bove CF, Miller EO. Growing up poor: long-term implications for eating patterns and body weight. Appetite. 2007;49(1):198-207.
  10. Bryant EJ, King NA, Blundell JE. Disinhibition: its effects on appetite and weight regulation. Obes Rev. 2008;9(5):409-419.
  11. Lohse B, Psota T, Estruch R, et al. Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile. J Nutr. 2010;140:1322-1327.
  12. Kempson KM, Palmer Keenan D, Sadani PS, Ridlen S, Scotto Rosato N. Food management practices used by people with limited resources to maintain food sufficiency as reported by nutrition educators. J Am Diet Assoc. 2002;102(12):1795-1799.
  13. Glanz K, Basil M, Maibach E, Goldberg J, Snyder D. Why Americans eat what they do: taste, nutrition, cost, convenience, and weight control concerns as influences on food consumption. J Am Diet Assoc. 1998;98:1118-1126.

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