Diabetes Self-Management Blog

When was the last time you really paid attention to what you were eating? Do you remember what you ate? How it tasted? How it smelled?

When I’m eating with other people, I can’t help but notice how people eat. I have a couple of friends who eat very quickly, almost as if someone is going to take their food away from them. I mentally scratch my head when they do this, as I believe there’s no way they’re really enjoying their food. Other people eat excruciatingly slow and I find myself wondering how they pace themselves to take a bite, put down the fork, chew their food slowly, and savor the flavor and texture.

Something else I’ve noticed: When I eat with my “fast eating” friends, I find myself eating quickly too. And then I realize, once I’m done, that my food is gone, I don’t really remember what I ate, and I’m uncomfortably full. Not the best way to enjoy food.

Mindful eating
The concept of “mindful eating” has recently taken center stage in the realm of diabetes management. You might wonder what this has to do with blood glucose control. As it turns out, perhaps a lot. Mindful eating (or eating mindfully) is a state of being aware of how nourishing food is, ranging from food preparation and the process of eating to acknowledging food preferences, recognizing hunger and satiety signals, and using your own judgment to make decisions about what and how much you’re eating.

It may sound very “new agey” but mindful eating practices have garnered more attention among behaviorists and dietitians as a way to help people manage certain health conditions and also learn that it’s OK to enjoy eating. It makes sense when it comes to diabetes. I read and hear a lot of comments from people with diabetes that imply that foods are “bad” because they’ll raise blood glucose, or that someone feels guilty because he ate dessert one night or they didn’t count carbs correctly.

Believe it or not, food is meant to be enjoyed. Food nourishes the body and the soul. Eating is a way of taking time to care for yourself and connecting with others (think of Thanksgiving or your annual Fourth of July picnic with family and friends). There’s nothing bad about these things.

Principles of mindful eating
If you’re interested in this concept, here’s an outline of the process of mindful eating. Michelle May, MD, runs mindful eating workshops and has published a book called Eat What You Love, Love What you Eat. What a concept! Getting into the groove of mindful eating involves asking yourself the following questions:

• Why do I eat? Focus on what prompts you to eat. Is it the clock? Are you bored, sad, or upset? Did you just watch an ad on television for a McDonald’s Big Mac?

• When do I want to eat? Your answer is related to the first question. Are you eating because you’re hungry or because the clock says it’s time? Are you eating because it’s a Saturday afternoon and you’re home alone with nothing else to do?

• What do I eat? Are your food choices based on location, convenience, money, taste, or comfort? Are you only eating protein and fat foods because you believe carb foods to be bad for you?

• How do I eat? Are you wolfing down your food? Are you hiding from others when you eat? Are you doing other things when you’re eating? Do you take time to taste your food?

• How much do I eat? Are you eating the entire bag of chips in one sitting? Do you take just one or two cookies from the package? Do you clean your plate? Is how much you eat in response to how much others are eating?

• Where does the energy go? How are you making use of the energy (calories) that you get from food? Do you take a nap after eating because you feel tired? Or do you get up and go for a walk or clean the house? What would you like to do with those calories? How would you like to spend your time?

Ask yourself these questions and answer them honestly. You don’t have to share your answers with anyone, unless you want to. There are no right or wrong answers and no one will judge you based on how you answer them. They’re intended to give you some insight into your food choices, food intake, and what prompts or triggers you to eat. Sometimes dietitians will ask people these very questions and then, depending on the answers, guide them to find solutions or better ways of eating.

Mindful eating and diabetes
I’ll bet a few of you are thinking that this “mindful eating” stuff is all well and good, but what about people with diabetes? How could this work? Surprisingly, quite well! A study was published in the November issue of the Journal of the Academy of Nutrition and Dietetics about this very topic.

The study compared two groups of people with Type 2 diabetes between the ages of 35 and 65 with a minimum body-mass index (BMI) of 27 and an A1C of at least 7%. One group followed a traditional diabetes self-management program with an emphasis on nutrition education. The other group was trained in mindful eating and meditation. Both groups attended weekly meetings and participated in physical activity.

The mindful eating group did not receive specific nutrition guidelines about what or how much to eat. Instead, they were instructed to tune into their level of hunger before they ate, make conscious choices about their food and how much they ate, and stop when they felt full. After six months, weight-loss and A1C improvements were similar for both groups. Both groups also lowered their calorie intake and chose lower-glycemic-index foods.

What’s the takeaway? It’s not that nutrition education isn’t important, because it is. But what may be missing is an awareness of food and eating, beyond counting carb grams or measuring out portions. Give it a try and see what happens!

If you’re interested in learning more, visit the Web sites www.diabetesandmindfuleating.com and www.tcme.org. You might also read the book Eat What you Love, Love What you Eat With Diabetes: A Mindful Eating Program for Thriving with Prediabetes or Diabetes, by Michelle May, MD.

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Comments
  1. Amy As a T1D for 56 years I have learned to enjoy what I wanted in a meal and also dealing with food allergies. But, always on a schedule!

    My questions is this: I am not sure this method of unscheduled meals would work for a T1D? I noticed that only T2D is mentioned in the Trials.

    Thanks

    Posted by joan |
  2. Hi joan,

    While I’m not aware of studies showing the benefits of mindful eating for Type 1 diabetes, I think that the “lessons learned” still apply. With Type 1 diabetes, you actually may have more flexibility as to when you eat if you take insulin before each of your meals and are on a long-acting basal insulin. You’re not locked into set meal times. Also, you can still use the questions that I mentioned in the posting to help you focus on when, why, what and how you’re eating. For example, you might discover that you’re eating more than you really need to because you eat in front of the television and aren’t really paying close attention to quantity. The beauty of mindful eating is that you can adapt it to meet your needs and learn more about yourself and your eating patterns. Give it a try and see what you discover!

    Posted by acampbell |
  3. As a T2, the only time not holding to eating schedules for me is if the liver is doing its fifo job properly without overloading the glucose.

    Being on insulin has provided far more flexibility in schedules and eating and dieting.

    The oral pills were downright pain in derrier.

    I find that having watched my body on cgms and watching the digestive glucose cycle that scheduled meals are most helpful running a type 2 diabetic body. The other riot is that digestive cycles really are two timings. 2 hours for the simple carbs and 5 to 6 on the proteins and complex carbs so that there are two glucose peaks out from gut/liver that nobody else seems to barely recognize.

    When the body runs on full auto - no sweat.
    Running a manual steam engine is a right pain and schedules help simplify that.

    Posted by jim snell |

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