Diet is an important component of any diabetes management plan. Consequently, people with diabetes often spend a lot of time learning about dietary recommendations and meal planning while also discovering how different foods affect their blood glucose levels throughout the day. However, in addition to adjusting what you eat to manage your diabetes, it might be equally helpful to change how you eat. Certain “mindless eating” habits, such as eating rapidly without really savoring the food, or eating while doing other activities, might influence not only what you eat, but also how much, most likely causing you to eat more than you wanted or intended.
“Mindful eating,” on the other hand, can help you gain control over what, how much, and even why you eat. Mindful eating might best be described as eating with attention and awareness, and it can be practiced anywhere and at any time. Paying attention will also increase your awareness of your current eating patterns and, in doing so, help you identify habits that you can change. Over time, even small changes in the way you prepare, serve, or consume your meals can lead to big improvements in blood glucose management and diabetes control.
Becoming aware of mindless eating
Everyone has moments of mindless eating. Some common examples include unintentionally munching through a whole bag of chips or popcorn while watching TV or automatically grabbing a handful of candy out of the dish at work each time you walk by, just because it is there. Mindless eating might also describe the habit of eating everything on your plate before you realize you have become uncomfortably full, or losing track of how many chicken wings you have eaten at the all-you-can-eat buffet.
Eating this way occasionally doesn’t usually cause health problems. However, doing so too often can lead to chronic overeating, weight gain, and poor blood glucose control. Fortunately, with a little awareness and a few changes in the way you serve and portion your meals and snacks, you can create new habits that can help you reach your weight and blood glucose management goals.
Brian Wansink, PhD, is an expert on the subject of mindless eating. As a professor of Marketing at Cornell University and director of the Cornell Food and Brand Lab, he has spent many years studying people as they eat in a variety of situations and environments. Wansink first wrote about his studies in his groundbreaking book, Mindless Eating, published in 2006, and, more recently in his new book, Slim by Design, released in September 2014. Mindless Eating raised awareness of how little things, such as the size of dinner plates or serving utensils, can have a big influence over what and how much a person eats.
Through many creative and sometimes humorous experiments, Wansink demonstrates how people almost always eat more when they are presented with large portions of food. For example, when people are served bowls of soup that never become empty (they are secretly gravity-fed through a tube from a large vat placed out of sight), they eat up to three times more soup than people with normal soup bowls but, curiously, do not report feeling any fuller.
A similar thing happens when individuals are presented with food on a 12-inch dinner plate rather than a 10-inch plate. Wansink estimates that most people eat at least 92% of the food on their plates, regardless of the size of the plate or their level of hunger before the meal. However, those with smaller plates and smaller portions tend to report feeling just as full and satisfied after a meal as those who eat larger portions.
Wansink concludes that most people judge their level of satisfaction after a meal by visually checking how much food is left on the plate, not by how full they feel. In other words, they decide when to stop eating with their eyes, not their stomachs.
Wansink also notes that people tend to eat more food when presented with a greater variety of flavors, textures, or even colors. Anyone who has eaten at a buffet is aware of this effect! People also tend to prepare and eat larger amounts of food when they buy food in big packages, like those sold in big-box discount stores. And they eat more of foods that are readily available and within easy reach. In other words, if you are hungry or just craving a snack, you are more likely to grab food that is ready to eat and visible, rather than something that takes time to dig out of a drawer and prepare.
Fortunately, in Mindless Eating, Wansink translates the important information he has gathered over the years into practical advice. He concludes that the secret to successful and permanent dietary changes lies in creating an environment that supports an easy transition to healthier, more mindful habits. For example, just using smaller plates and bowls at meals could reduce the amount of food you eat by 20% or more, which (depending on how much you have to lose) might help you drop as much as 20 pounds. According to Wansink, most people can reduce their usual portions by this much and feel as full and satisfied as they do when they eat more.
More of Dr. Wansink’s strategies for successful, mindful diet change are described in “Avoiding Mindless Eating.”
Simple steps to mindful eating
Donald Altman, MA, LPC, is a psychotherapist, author, and faculty member at Portland State University, in Portland, Oregon, who presents mindful eating workshops and retreats throughout the United States. During a workshop I attended, Altman would occasionally stop, survey the class, and ask, “Where are your thoughts right now?” In spite of being very interested in the presentation, some of us realized we were also occasionally busy with thoughts of planning dinner, planning a vacation, or remembering conversations with friends the night before. In spite of some mild embarrassment at being “caught” with our thoughts elsewhere, we began to appreciate these attention checks because they helped us understand how easily we can become distracted from what we are doing at any moment. In other words, we were not being mindful of the events happening in the room.
When you are being mindful, you are paying special attention to your experience as it occurs from moment to moment. To be mindful during a meal, for example, you might turn your attention first to what you see on your plate, then to any aromas you smell, and next to the movement of your hand in picking up a utensil and bringing a bite of food to your mouth. Alternatively, you might choose to focus completely on how the food tastes and perhaps on how the taste of the food changes as you chew and eventually swallow each bite. Eating in this fashion can seem a little awkward at first, especially if you are used to eating quickly or being distracted by other activities such as watching TV, driving, or reading. As Altman writes in his book, Art of the Inner Meal, “Familiar territory always feels comfortable until you find greater comfort elsewhere.” In other words, changing habits and learning any new skill can be challenging and usually requires practice and time, but is well worth the effort.
In his workshops, Altman shares a simple exercise called STOP, or The 4-Bite Method, to help foster mindful eating at meals. STOP helps you pay attention to just the first four bites of a meal and is described in “How to STOP.” Altman notes that you can certainly learn to be mindful during an entire meal, but paying attention to the first four bites is a good place to start.
Other simple strategies for fostering mindfulness at meals include eating only when you are sitting somewhere away from your computer or TV. Then, when you eat, just eat, and try not to be distracted by other activities. You might also try setting your fork or spoon down between bites, or eating with chopsticks. Any practice that slows your pace can shift your awareness from your thoughts to your meal. Taking three deep breaths before eating or taking a moment to consider your meal and all the people who contributed to growing, transporting, and preparing the food also helps focus your attention on what you are about to eat.
Mindful practices like these will shift your attention from your environment and your thoughts to the present moment and to the food you are about to eat. This, in turn, might make you more aware of how hungry you are and how much (or how little) food it will take to satisfy that hunger. Mindful eating can make you more aware of how food really tastes. When you pay attention to the taste of food, you might find that things you usually crave, such as salty, sweet, or high-fat foods, are less enjoyable than you previously thought. Alternatively, mindful eating might help you better appreciate food, as you place your full attention on the smell, texture, and taste of your meal. In fact, many people find that by really paying attention to taste, they can eat less and enjoy food more.
The story of a student enrolled in a recent diabetes self-management class illustrates this point. Liza (not her real name) could eat a pound of chocolate or more a day. After being diagnosed with diabetes, she wanted to change this habit but knew she couldn’t completely avoid eating chocolate. Liza realized that she ate chocolate for just about any reason: when she felt sad or glad, stressed or relaxed, while she was working or driving, or even in the middle of the night to help her sleep.
To change her chocolate-eating habit, Liza developed a few rules. First, she decided she would eat chocolate only when she could set aside time to just do that — eat chocolate. She would not allow herself to eat chocolate while she was doing any other task or activity. Second, when she was eating chocolate, she would pay attention to the smell, texture, and flavor of each bite. Eventually, Liza realized that the first few bites of chocolate were the most satisfying. They delivered the best flavor, aroma, and overall thrill. As she ate more chocolate, the satisfaction, taste, and aroma began to dwindle, and eating became a mindless activity as her pleasure lessened and her thoughts began to wander. She found that when her mind was fully focused on the experience of eating each piece of chocolate, she could eat less, but be more satisfied.
Liza was eventually able to satisfy her hunger for chocolate during the day with just a handful of her favorite candy. This story models both the simplicity and potentially life-changing effects of mindful eating practices.
Some people go beyond practicing mindfulness at meals and use regular meditation as a way to increase mindfulness and well-being throughout the day. Clinically, meditation has been shown to lower blood pressure and stress levels, lessen chronic pain, and even improve the health and well-being of people with diabetes. Recently, researchers in the Diabetes and Mindfulness (DiaMind) study demonstrated that an eight-week mindfulness-based, stress-reduction program (MBSR) significantly reduced symptoms of depression and levels of stress and anxiety while improving health-related quality of life for people with Type 1 or Type 2 diabetes. Participants in this study practiced meditation, yoga, and other mindfulness-building exercises daily. MBSR is clinically proven to help people cope and live well with chronic pain, illness, and stress and has been an integral part of the Stress Reduction Program at the University of Massachusetts Medical Center for almost 20 years. MSBR was developed by Jon Kabat-Zinn, PhD and is described in detail in his book, Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. (Bantam Books, 2013)
Other studies using MBSR have demonstrated the positive effects of mindfulness on hemoglobin A1C (HbA1C), a measure of blood glucose control. The people with Type 2 diabetes enrolled in the five-year Heidelberger Diabetes and Stress-Study followed the same MBSR program used in DiaMind. At the one-year follow-up, researchers found that although people practicing daily meditation experienced no significant drop in their HbA1C, level, those who were not practicing experienced an average increase in HA1C of almost 0.5%.
On the other hand, a small study published in 2007 in the journal Alternative Therapies in Health and Medicine did report a drop in HbA1C of almost 0.5% in those practicing MBSR. These people did not change their diets, level of physical activity, or medication regimen during the study, so the drops in HbA1C were attributed solely to their regular meditation practice. While the changes observed in HbA1C in these studies may sound small, even minor reductions in HbA1C can reduce the risk of diabetes complications.
Putting it into practice
Many people experience changes in their eating behaviors as a result of regular, daily meditation. However, simple mindful practices such as taking a few deep breaths before a meal, using the STOP method to pay attention to the first four bites, or making sure that when you eat, you just eat (and are not distracted by other activities) can also dramatically affect what and how much you consume. The more you practice mindfulness, the easier and more natural it becomes. But be aware that there will be times when this is more challenging than others. Donald Altman encourages people to practice mindfulness with a spirit of kindness and curiosity. He suggests, “Be easy, kind, and invite inner hospitality as you work with mindful eating…there’s no being ‘perfect’ with it.”