- With Mayo Clinic nutritionists
Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
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Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
Katherine Zeratsky and Jennifer Nelson
Jennifer K. Nelson, M.S., R.D., L.D., C.N.S.D.
Jennifer Nelson is your link to a better diet. As specialty editor of the Food & Nutrition Center, she plays a vital role in bringing you healthy recipes and meal planning."Nutrition is one way people have direct control over the quality of their lives," she says. "I hope to translate the science of nutrition into ways that people can select and prepare great-tasting foods that help maintain health and treat disease."
A St. Paul, Minn., native, she is certified by the National Board of Nutrition Support Certification, has been with Mayo Clinic since 1978, and is director of clinical dietetics and an associate professor of nutrition at Mayo Clinic College of Medicine.
She leads clinical nutrition efforts for a staff of more than 50 clinical dietitians and nine dietetic technicians and oversees staffing, strategic and financial planning, and quality improvement. Nelson was co-editor of the James Beard Foundation Award-winning "The New Mayo Clinic Cookbook." She has been a contributing author to and reviewer of many Mayo Clinic books, including "Mayo Clinic Healthy Weight for EveryBody," "The Mayo Clinic Family Health Book" and "The Mayo Clinic/Williams Sonoma Cookbook." She contributes to the strategic direction of the Food & Nutrition Center, which includes creating recipes and menus, reviewing nutrition content of various articles, and answering nutrition questions posed to Ask a Specialist.
Katherine Zeratsky, R.D., L.D.
As a specialty editor for the Food & Nutrition Center, Katherine Zeratsky helps you sort through the facts and figures, the fads and the hype to learn more about nutrition and diet.A Marinette, Wis., native, she is certified in dietetics by the state of Minnesota and the American Dietetic Association. She has been with Mayo Clinic since 1999.
She is active in nutrition-related curriculum and course development in pediatrics at Mayo Clinic Rochester and nutrition education related to the physiology and recommended intakes for premature infants.
Other areas of interest include breast milk and formula safety, neonatal feeding, and nutrition for breast-feeding mothers.
She graduated from the University of Wisconsin-Madison, served a dietetic internship at the University of Iowa Hospitals and Clinics, and worked as a registered dietitian and health risk counselor at ThedaCare of Appleton, Wis., before joining the Mayo Clinic staff.
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Nutrition-wise blog
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Nov. 13, 2008
New help in the battle against obesity
By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
My colleague just returned from the annual American Dietetic Association's Food & Nutrition Conference & Expo. I'm excited by what she brought back — a new way for health care providers to approach obesity.
This method, developed by Robert Kushner, M.D., focuses on the critical skills that clinicians sorely need in order to empower individuals to make positive changes in eating, activity and lifestyle to successfully lose weight. First, some background.
Consider the challenges for you and for your health care team.
- For you: You have a serious problem such as your weight, obesity-related conditions such as high blood sugar, high cholesterol or high blood pressure, the expense of medications and probably your feelings of frustration at not being able to get a grip on this.
- Finances: A trip to the doctor is can be expensive and you already know that you need to eat less and exercise more. What more can your health care provider offer?
- For the provider: You have a busy practice that barely provides time to identify patients' problems — let alone begin to "treat" them. You really want to help, whether it's medication, surgery, or counseling on changing lifestyle. Even if you have the experience, do you have the time? If you have the time, how do you keep from giving everyone the same old message of eat less and exercise more?
A 2001 study in the "Annals of Internal Medicine" reported on patients' expectations of care from health care providers. The highest ranked expectation was "discuss my (the patient) own ideas about how to manage my condition."
So how can patients' expectations meet the health care providers' ability and desire to help in a meaningful way?
It begins with providers probing the patient for issues contributing to being overweight. We've heard that excess weight is due to many things. Beyond eating too much and exercising too little, we live with "globesity" issues such as not having the time, money, or skills to change our eating and physical activity. How many of us skip meals only to eat too much of the higher calorie stuff later in the day? Why? How do we change this? How many of us eat too few healthy foods and too much meat and high fat convenience products? Why? How do we change this?
From both the patient's and clinician's perspectives, it may seem like there are just too many issues to address in any sort of systematic way. However, the research presented at this year's conference has yielded some new ways to gather information from patients and how to use the patient's ideas about managing weight issues.
This approach focuses on groups of lifestyle patterns shown to contribute to excess weight and how to change them. They can be placed into 3 broad categories: eating, exercise and coping. Each of the patterns in each of the categories has strategies for addressing the problematic lifestyle pattern.
Over the next blog or two, I want to show you how this can work. It just might give you a way to identify what you want and how to best work with your health care provider in meeting your desires. Don't settle for the message of eat less, exercise more. Expect a frank dialogue about what you feel you can do, and what your provider can do to help you.
In order to begin, I need some information from you about the lifestyle patterns that you think contribute to unwanted weight. For simplicity, pick a category from below and one lifestyle pattern from it. Choose only 1 category and 1 lifestyle pattern that you think contribute the most to your weight. I'll then write about the most popular ones sent back.
| Category | Lifestyle Patterns |
|---|---|
| Eating | Skip meals Eat at night Snack a lot Eat big portions |
| Exercise | Couch potato Don't know how to start I'm all or nothing |
| Coping | Emotional eater Procrastinator Doubtful dieter |
Remember, choose 1 category and 1 lifestyle pattern that you think contribute the most to your weight and let me know why.
I'll look forward to talking with you more about this.
- Jennifer
79 comments posted
November 18, 2008 6:06 p.m.
Definitely coping-emotional eater. I'm sure we could all write books on nutrition and exercise, but "something" clicks in my head when I'm stressed and all the common sense goes out the window and the mindless eating begins. I exercise and do watch portion control, but coping with stressful situations, ahhhhhhh
- Eva
November 18, 2008 5:55 p.m.
My portions are too big. I don't seem to know when to stop. I'm a couch potato due to back knee and ankle problems. And I am a doubtful dieter. Tried a lot of them, couldn't make them work.
- Glo
November 18, 2008 5:19 p.m.
Eating - portions are too large.
- V
November 18, 2008 4:44 p.m.
I think my overweight issue is due to coping - emotional eater. I have learned how to excercise and eat right and go to the doctor on a regular basis but my hang ups are now when I am having a bad day or low day or happy day I want to comfort myself or celebrate. I am still learning not to eat for reason only eat when I am hungry. Eating is for fuel not comfort.
- Kim
November 18, 2008 4:38 p.m.
Exercise - couch potato due somewhat to laziness and partly due to an inability to walk very far due to knee and back problems.
- Audrey
November 18, 2008 4:30 p.m.
I love to cook, I love to eat "and" I love to entertain! I am always hungry. At one time I joined Weight Watchers and lost 60 lbs, but I gained all the weight back and don't wan't to pursue this route again because it is too expensive. Over the years I have tried and tried to go back on the meal plan by myself, but I always fail. I eat mostly healthy food, but too much of it. I must have some emotional reasons for all of my eating. Can a psycologist help?
- Ingrid
November 18, 2008 4:28 p.m.
I don't know how to convert recipes from the old style with sugar to another way of preparing the recipe with less sugar and some substitute.
- Mary
November 18, 2008 4:06 p.m.
Eating portions that are too large. I don't seem to get that signal that tells you you're full until I'm about stuffed. Then I suffer for it.
- Ann
November 18, 2008 4:02 p.m.
Eating - Eat at night My mother said that she was "always hungry". Once I hit menopause, I earned precisely what she meant. I am always hungry. Hunger awakens me at night. Usually, I can resist the urge to go to the kitchen when I awaken; but, it's the hours between dinner and bedtime when I seemingly must feed the maul. My weight has crept up 40 pounds in the 20 years since then. Feeding my skinny husband has never made it easy for me (how can I be so resentful that he can eat whatever/however much he wishes?!) I do feel that I need a support group; but, I'm unwilling to spend the time/carbon to get to one (15 miles one way).
- Louise
November 18, 2008 3:59 p.m.
i know i am a total food nut plus i love beer,,so all and all i am not likeing what is see in the mirro..but i am 70 years old and pretty much satisfied with my life,..wished they would come up with a pill where at 5 foot six inces i couls weigh 150 rather than 160 pounds
- a wolf
November 18, 2008 3:55 p.m.
I am an emotional eater. When I am upset, stressed or feeling blue is when I eat and eat and eat.
- Jan
November 18, 2008 3:50 p.m.
It is a difficutlt choice to make as I feel that I don't overeat, however I am full before I even start..no I don't snack. Therefore, I will go with exercising. I am not consistant enough.
- Cheryl B
November 18, 2008 3:43 p.m.
Eating - Snack a lot. If I am trying to work on a problem, I keep eating snacks. I am often not aware of how much I am eating. Keeping a food diary is not a task I want to do. When I try, I only put about down two meals and snacks, then I give up.
- Francie
November 18, 2008 3:37 p.m.
Exercise - couch potato. I have a demanding full-time job. By the time I get home I just want to plop on the couch. I love to walk but can't in the mornings and am so tired in the evenings. Occasionally I walk at lunch. Also, I live in a warm, humid climate and by the end of a walk (I don't like walking indoors) I'm all sweaty and have to shower and wash my hair. Guess I should just suck up and do it.
- Kathy
November 18, 2008 3:20 p.m.
My category is eating. I am a snacker and when meal time comes around, I usually am not hungry but feel I should east something healthier than my prior choices. I have been told I do not eat enough at times. I exercise at least two hours a day and that exercise rotates daily with cardio/ weights/ yoga.
- No name given
November 18, 2008 3:13 p.m.
Eating - too large portion
- Karen
November 18, 2008 3:10 p.m.
Exercise -- don't know how to start. I have arthritis in my spine, & both knees replaced. Insurance won't cover aqua therapy, typical physical therapy is painful & not aerobic enough to lose weight. Can't take pain meds at work. I eat healthy but can't lose enough to help alleviate the arthritis. Vicious circle.
- Sue G
November 18, 2008 2:59 p.m.
My catagory is exercise and my lifestyle is couch potato. I've lost 110 lbs over the last two years and know I can't lose any more without increasing my activity level. I've nothing but excuses for not walking everyday.
- Pat
November 18, 2008 2:54 p.m.
It's the evening eating. I'm tired by 8 but it's too early to go to bed and I'm way too tired to do much (especially in the winter)
- Chris
November 18, 2008 2:52 p.m.
Eating. I snack a lot. butter, margarine, toast, cookies, candy. I always think I still have time to diet and eat healthy. My diabetes neuropathy complications are getting more severe so it seems really dumb to keep eating!
- Carolann
November 18, 2008 2:36 p.m.
Eating is my category and lifestyle is portions. I have no will power. I know all the things I'm suppose to do and every morning I say today is the day and then about lunch time I go to heck.
- Samantha
November 18, 2008 2:12 p.m.
My downfall is eating, especially in the evening. I'm so good at breakfast and lunch. But, when I come home from work I eat large portions and all through the evening till bedtime.
- Janice
November 18, 2008 1:57 p.m.
I hate exercise -- so I do none. I do skip meals, probably because I feel guilty not doing exercises. I'm 74 and know better; right?
- Janet
November 18, 2008 1:43 p.m.
my category is eating and my lifestyle is all of these--skip meals, eat at night, eat large portions and snack a lot.
- Connie
November 18, 2008 1:39 p.m.
Im a skip meals...couch potato...procrastonater person...besides living on a very limited income and caring for a disabled spouse with Lou Gerigs disease...difficult to plan out meals..just do what is quick...HELP
- Rosalee
79 comments posted