The Behavioral Path to MWL Success - September 2023 Group

[Mark Cooper]

Fantastic efforts! My congratulations and thanks to everyone participating; I'm finding the discussion really edifying and enjoyable.

Apropos of our various conversations related to how the broader communal environment can influence and disrupt our habits and behaviors in various ways, I came across this article about a nonprofit foundation attempting to reshape a community's "choice architecture" so that health-supporting options are more readily available and health-supporting behaviors are more attainable.

A leader in lifestyle medicine is at the forefront of an ambitious effort to make healthy choices the easy choices for families in eastern Pennsylvania’s Lehigh Valley.

Meagan Grega, MD, DipABLM, FACLM, co-founder and chief medical officer of the nonprofit Kellyn Foundation, spearheads a unique and collaborative healthy neighborhood immersion initiative to improve the short- and long-term health of the almost 700,000 people living in this one-time steel manufacturing hub north of Philadelphia.

The program utilizes schools and other community locations to pursue four areas of focus: access to healthy food, intensive lifestyle medicine interventions, school programming and teaching families to prepare delicious and healthy meals. Kellyn Foundation impacts more than 10,000 students in 36 elementary schools within nine school districts annually. Since 2016, it has operated the Eat Real Food Mobile Market, selling 136,000 pounds of nutrient-dense food during the past year in areas that lack access to healthy food options. The intensive lifestyle intervention program has documented success reducing HgbA1c levels of participants with prediabetes into the normal range over a three-month period.

This seems like the sort of expansive, comprehensive initiative that will be necessary for making a real difference in the lifestyle patterns of modern day citizens. People need to know WHAT to do and HOW to do it, and they need ready access to the necessary resources to make positive changes.

My family has been enjoying a new recipe lately, adapted from this recipe from Forks Over Knives. My own, MWL-adjusted version is below.

White Beans & Roasted Tomatoes

INGREDIENTS

3 cups of cannellini beans

1 large red onion, slivered

6 cloves garlic, slivered

1 or 2 tablespoons Italian seasoning

2 lbs. Campari tomatoes, quartered

1/4 cup low-sodium vegetable broth (I use homemade)

1/4 cup champagne vinegar or 2 tablespoons balsamic vinegar

INSTRUCTIONS

1. Preheat oven to 400F. Arrange beans in a ~1-inch-thick layer in a baking dish. Top with onion, garlic, and seasoning. Top with tomatoes. Drizzle with veggie broth and vinegar. Bake about 45 minutes, or until the tomatoes are very soft and start to brown.

2. Serve over whole grain pasta, brown rice, or other adherent starches, with an equal visual volume of non starchy vegetables. YUM!

Have an excellent week! Take care and be well!

[louie3084]

Hi Mark,

Wow where did time go! Sorry it got away from me and I would like to join in September. I did start to review the content in August but just didn't post.

If ok I will digest the content and join in the conversation again.

Thanks

[Mark Cooper]

Hi Mark,

Wow where did time go! Sorry it got away from me and I would like to join in September. I did start to review the content in August but just didn't post.

If ok I will digest the content and join in the conversation again.

Thanks

Great! That all sounds fine.

[BambiS]

9-15


1. Start each meal with a soup and/or salad and/or fruit.
Most days


2. Follow the 50/50 plate method for your meals, filling half your plate (by visual volume) with non-starchy vegetables and 50% (by visual volume) with minimally processed starches. Choose fruit for desert
Some days


3. Greatly reduce or eliminate added sugars and added salts. This includes gourmet sugars and salts, too. If either is troublesome for you, you can eliminate them.
Yes

4. Eliminate all animal foods (dairy, meat, eggs, fish, seafood).
Yes, not an issue here

5. Eliminate all higher fat plant foods (i.e., nuts, seeds, avocados, tofu, soy).
Yes

6. Eliminate any added oil.
Yes


7. Eliminate all higher calorie-dense foods including flour products (i.e., bread, bagels, muffins, crackers, dry cereals, cookies, cakes), puffed cereals, air-popped popcorn and dried fruit.yes

8. Don't drink your calories (especially from juices & sugar-sweetened beverages). Yes


9. Follow these principles, eating whenever you are hungry until you are comfortably full. Don't starve yourself and don't stuff yourself
Yes

10. Avoid being sedentary and aim for at least 30 minutes or more of moderate exercise daily (i.e., brisk walking).some days

Victories, comments, concerns, questions good week, nothing eventful.

It’s been a busy week with appointments. Nothing too exciting, eating was good. I got my steps in most days

[Rebecka22]

1.Start each meal with a soup and/or salad and/or fruit. YES
2. Follow the 50/50 plate method for your meals, filling half your plate (by visual volume) with non-starchy vegetables and 50% (by visual volume) with minimally processed starches. Choose fruit for dessert. YES
3. Greatly reduce or eliminate added sugars and added salts. This includes gourmet sugars and salts, too. If either is troublesome for you, you can eliminate them. YES
4. Eliminate all animal foods (dairy, meat, eggs, fish, seafood). YES
5. Eliminate all higher fat plant foods (i.e., nuts, seeds, avocados, tofu, soy). YES
6. Eliminate any added oil. YES
7. Eliminate all higher calorie-dense foods including flour products (i.e., bread, bagels, muffins, crackers, dry cereals, cookies, cakes), puffed cereals, air-popped popcorn and dried fruit. YES
8. Don't drink your calories (especially from juices & sugar-sweetened beverages). YES
9. Follow these principles, eating whenever you are hungry until you are comfortably full. Don't starve yourself and don't stuff yourself. YES
10. Avoid being sedentary and aim for at least 30 minutes or more of moderate exercise daily (i.e., brisk walking). YES

I made good choices this week even though it was a tiring week and I wanted to just eat out. While I know it’s possible to eat out and stay the course, it just feels like it takes so much more effort, so I generally just skip it and cook. We’re barely over we a week into school and one of my daughters has Covid, so I’m just trying to do everything I can to keep the rest of us healthy. I hope everyone has a great week.

[VegSeekingFit]

Hi Team Time & Adherence,

Hope everyone is doing awesome! Can’t believe September is half over already! The weather here abruptly went from 90’s to 70’s --- missing the 80’s --- maybe they are still to come! Beautiful weather though, so can’t complain --- windows are open and the birds are singing.

1 Start each meal with a soup and/or salad and/or fruit.
Mostly - about 2/3. I do have an opportunity here to increase the percentage of meals pre-loaded that I keep commenting on but haven’t executed. I will work on this.

2 Follow the 50/50 plate method for your meals, filling half your plate (by visual volume) with non-starchy vegetables and 50% (by visual volume) with minimally processed starches. Choose fruit for dessert.
Yes.

3 Greatly reduce or eliminate added sugars and added salts. This includes gourmet sugars and salts too. If either is troublesome for you, you can eliminate them.
Yes. Reduced, not eliminated.

4 Eliminate all animal foods (dairy, meat, eggs, fish, seafood).
Yes.

5 Eliminate all higher fat plant foods (i.e., nuts, seeds, avocados, tofu, soy).
Materially yes BUT had a “to go” oatmeal cup --- Bob’s Red Mill that has chia seeds and flax (and salt) in addition to oats. Would not do that often, but it worked in a pinch (and fits nicely in the cupholder in my car). I wish they had these cups without the seeds, but I can’t find anything like that. Greatly prefer my own oatmeal - just keeping a couple of cups in case of emergency (like in my work bag since I don’t have a desk anymore to store belongings).

6 Eliminate any added oil.
Yes.

7 Eliminate all higher calorie-dense foods including flour products (i.e., bread, bagels, muffins, crackers, dry cereals, cookies, cakes, puffed cereals, air-popped popcorn, and dried fruit).
Yes.

8 Don’t drink your calories especially from juices & sugar-sweetened beverages).
Yes.

9 Follow these principles, eating whenever you are hungry until you are comfortably full. Don't starve yourself and don't stuff yourself.
Yes. Did not stuff or starve.

10 Avoid being sedentary and aim for at least 30 minutes or more of moderate exercise daily (i.e., brisk walking).
Yes - 7 / 7. Love walking outside in the cooler weather. Also, I went to my work gym for the first time in 3.5 years (and then I went again)! Will keep doing this – was a wonderful and energizing break in the day. Started back up with park district “Pickle Spears” which is amazingly fun --- imagine playing to music – like Freebird! Starting up my fall league tonight with a new partner who is awesome. I have to say that #10 is part of my “why” --- I am so thankful to be back to being active and love doing so – the McD program and this checklist has given me back some lost self-esteem as throughout most of my life I was semi-athletic. So, just feeling wonderful about this.

Victories, comments, concerns, questions:
Mark – thanks for sharing that article last week. What a phenomenal example of a grassroots team supporting better health for the community! One thing I noticed in the link --- the pictures of the people who are driving this initiative--- they look so happy and healthy --- radiant! ❤️

Hope that everyone has a fabulous week!

Cheers,
Stephanie

[wildgoose]

Materially yes BUT had a “to go” oatmeal cup --- Bob’s Red Mill that has chia seeds and flax (and salt) in addition to oats. Would not do that often, but it worked in a pinch (and fits nicely in the cupholder in my car). I wish they had these cups without the seeds, but I can’t find anything like that. Greatly prefer my own oatmeal - just keeping a couple of cups in case of emergency (like in my work bag since I don’t have a desk anymore to store belongings).

Stephanie, it occurs to me that you can make your own oatmeal cups, with rolled oats or quick oats (not instant ) and whatever else you like. There are all kinds of "recipes" out there that you could use as a starting point. Find yourself a container with a lid that will fit in your car cupholder. The homemade cups should stay fresh for quite a while. At some point, if you don’t find yourself using the cup(s) you prepared, eat them for regular breakfast and make fresh ones for your "emergency stash."

My preference for "on the go" oats, as we've talked about before, is thermos oatmeal, but I know that requires more advance planning, which isn’t always possible.

Goose

[Gimmelean]

Post for week ending 9/15/13

Hello Everyone.

1) Start each meal with a soup and/or salad and/or fruit.
Yes.

2). Follow the 50/50 plate method for your meals.
Yes.

3) Greatly reduce or eliminate added sugars and added salts.  This includes gourmet sugars and salts too.  If either is troublesome for you, you can eliminate them.
Yes

4) Eliminate all animal foods (dairy, meat, eggs, fish,)
Yes

5) Eliminate all higher fat plant foods (i.e., nuts, seeds, avocados, tofu,soy).
Yes

6) Eliminate any added oil.
Yes

7) Eliminate all higher calorie-dense foods including flour products (i.e. bread, bagels, muffins, crackers, dry cereals, cookies, cakes), puffed cereals, air popped popcorn, and dried fruit.
Yes until I caved and had a bagel last night. I’ve learned that avoiding flour products of all kinds is key to my success and avoids triggering downhill spirals.



8 ) Don’t drink your calories (especially from juices & sugar-sweetened beverages). Yes.

9) Follow these principles, eating whenever you are hungry until you are comfortably full.   Don't starve yourself and don't stuff yourself.
Yes.

10) Avoid being sedentary and aim for at least 30 minutes or more of moderate exercise daily (i.e., brisk walking).
Yes

Victories,Comments,Concerns,Questions:
Thanks to suggestions here, I couldn’t wait for cold weather and made split pea soup, lentil brown rice soup and a batch of sweet potatoes. Everyone loved them and no leftovers!
Fuzzy squash and delicata are next on the list.
I cook my go to recipes the days I work from home and on the weekends so that we can simply reheat good food on busy work nights. I keep a big batch of washed raw vegetables that will last 4-5 days to grab and go and so that my family is eating like I do as much as possible. ( my intent!!)
I’m so looking forward to cooler fall weather.

See you next week!

[Starflower]

September 15th

Hi team!

1) Start each meal with a soup and/or salad and/or fruit. YES

2) Follow the 50/50 plate method for your meals, filling half your plate (by visual volume) with non-starchy vegetables and 50% (by visual volume) with minimally processed starches. Choose fruit for desert. YES

3) Greatly reduce or eliminate added sugars and added salts.  This includes gourmet sugars and salts too.  If either is troublesome for you, you can eliminate them. YES

4) Eliminate all animal foods (dairy, meat, eggs, fish, seafood). YES

5) Eliminate all higher fat plant foods (i.e., nuts, seeds, avocados, tofu, soy). NO - some avocado

6) Eliminate any added oil. NO - see #8

7) Eliminate all higher calorie-dense foods including flour products (i.e. bread, bagels, muffins, crackers, dry cereals, cookies, cakes), puffed cereals, air-popped popcorn and dried fruit. YES

8 ) Don’t drink your calories (especially from juices & sugar-sweetened beverages). NO - some vegan creamer in coffee

9) Follow these principles, eating whenever you are hungry until you are comfortably full. Don't starve yourself and don't stuff yourself. YES

10) Avoid being sedentary and aim for at least 30 minutes or more of moderate exercise daily (i.e., brisk walking). YES

Victories, comments, concerns, questions:

It was such a busy week I almost forgot to post! My triggers for poor choices definitely are fatigue and the need for quick decisions. I succeeded in having some compliant foods ready, but need to do more for the coming week. I sure could use a more supportive environment. The article Mark posted made me think about that, and what I can do to create one.

I plan to work on getting more sleep to prevent fatigue as much as possible. An ounce of prevention, right? Any SAD foods that trip me up are no longer in the house. I felt bad about that until I realized that they’re bad for my family, too. I’d rather not provide things that are bad for them.They can still get them elsewhere if they want. I found a local Asian market that has purple sweet potatoes and yams, red rice noodles and lots of wonderful new (to me) produce. Yum!

Mark, your recipe sounds delicious. As soon as I get a new oven we’re having that for dinner!

Wishing everyone a wonderful and successful week!

[Mark Cooper]

The window for reporting this week's behavioral results has officially closed.

My replies and the weekly summary will follow.

[Mark Cooper]

BambiS - Sounds like a good week! It feels nice when we are doing well in practicing our desired pattern of behavior even during a busy week, right? Keep at it!

Rebecka22 - Another 10/10 and an awesome effort this month, especially since the week felt tiring! I can definitely understand where you are coming from with finding adherent options for eating out feeling like it isn't worth the effort when compared to just cooking at home. Best wishes to your daughter for a smooth, easy, and swift recovery, and to all the rest of you for continued good health. Your efforts matter. Carry on!

VegSeekingFit - It certainly feels like September is zooming past me pretty rapidly, Stephanie! As usual your efforts seem well-considered and well directed. In wildgoose's response about oatmeal cups, she mentioned

Stephanie, it occurs to me that you can make your own oatmeal cups, with rolled oats or quick oats (not instant ) and whatever else you like. There are all kinds of "recipes" out there that you could use as a starting point. Find yourself a container with a lid that will fit in your car cupholder. The homemade cups should stay fresh for quite a while. At some point, if you don’t find yourself using the cup(s) you prepared, eat them for regular breakfast and make fresh ones for your "emergency stash."

That reminded me that Jeff mentioned this in his discussion of travel food:

7) Oatmeal

Place 1/4 to 1/2 cup oats (Rolled, or Quick) into a baggy. Add a TB or 2 of raisins and a tsp or 2 of cinnamon. Keep several with you. All you need is a some hot water and a cup.

Just omit the raisins and that should be fully adherent to the recommendations. I'm excited to hear you enjoyed your return to the gym; I haven't been back to mine since before the pandemic either, but maybe I'll give it a try soon. Your various "Pickle Adventures" always sound so fun; I could not be more in alignment with your about #10 being part of one's "why" - I definitely feel the exact same way, though I hadn't really considered it through that lens. Thanks for sharing! Those folks from the Kellyn Foundation did look really merry, didn't they? Have an outstanding week!

Gimmelean - Really fabulous work in the food prep department (as always)! Split pea soup sounds really appealing to me, and I ADORE delicata squash. I've been really enjoying all the seasonal produce from my local community supported farm share. Does anything stand out as precipitating that incident when you "caved"? The incidence of that single "exception," of course, is less important that maintaining your overall pattern of behavior in line with your goals, values, and what you've learned about supporting success. Learn what you can to apply in the future, and focus on what you know works to get back and stay on track. Cheers to your for building an environment that offers your family as many opportunities and as much help as possible in making their own behavioral choices ones that support good health!

Starflower - Glad you were able to post during such a busy week! The really great news about identifying fatigue and the need to make sudden, unanticipated decisions as particular challenges is that you've been able to start considering and devising potential solutions for those challenges. The more you can arrange your environment in support of the pattern of behavior you would like to attain and maintain, the easier you'll make things for yourself to succeed in that goal. The added benefit being, that same environment can support your loved one's in making healthy choices, too. Purple sweet potatoes - YUM-OH! If you try the out roasted tomato & white bean recipe, let me know how it works out. Onward!

[Mark Cooper]

Another great week filled with continuing progress! September is really rocking for our group!

In relation to discussions around the difficulties inherent in dining out, this article from Jeff's website seems quite relevant:

Many of you enjoy the pleasure of dining out in restaurants. Regardless of whether it is part of travel, business, or to just relax or socialize.... it's something many of you enjoy. You can eat out successfully, if you are aware of the problems and issues you face in a restaurant. One of the problems is that it is easy to overeat. A new study has found that eating out may encourage binge eating.

The study published in the Western Journal of Nursing Research was done on women which included both binge-eaters and dieters, found that both groups of women ate out frequently -- and downed between 200 and 300 extra calories a day in the process. One-third of their bingeing "episodes" over the two-week study occurred in a restaurant, according to findings. And, this was in spite of the fact, that these women ate only about 1/4 of their meals in fast-food places and usually skipped desserts, both of which are usually blamed for contributing to the obesity epidemic. Not only did they eat more calories, they also ate about 10 to 16 extra grams of fat, on the days when they dined out.

While binge-eating is often thought of as a solitary habit, the environment of a restaurant with all the food cues (aroma, sight, presentation, etc.) at restaurants can trigger a binge-eating episode. So, if you are eating out, order healthy, and be aware of the triggers that may cause you to overindulge.

In Health,
Jeff

SOURCE: Western Journal of Nursing Research, November 2006.

While I was checking out that above article, something else on Jeff's site caught my eye that you all may enjoy perusing: a scan of the first issue of his newsletter from August 1988! Enjoy!

Wishing you all an outstanding week to come! Take care & be well!

[Gimmelean]

The server on the site has been down and I’ve been unable to post until now. I continued to receive error code 503.

Post for week ending 9/22/23

Hello Everyone.

1) Start each meal with a soup and/or salad and/or fruit.
Yes. Not complicated to grab a piece of fresh fruit to take the edge off hunger.

2). Follow the 50/50 plate method for your meals.
Yes.

3) Greatly reduce or eliminate added sugars and added salts.  This includes gourmet sugars and salts too.  If either is troublesome for you, you can eliminate them.
Yes-

4) Eliminate all animal foods (dairy, meat, eggs, fish,)
Yes

5) Eliminate all higher fat plant foods (i.e., nuts, seeds, avocados, tofu,soy).
Yes

6) Eliminate any added oil.
Yes

7) Eliminate all higher calorie-dense foods including flour products (i.e. bread, bagels, muffins, crackers, dry cereals, cookies, cakes), puffed cereals, air popped popcorn, and dried fruit.
Yes

8 ) Don’t drink your calories (especially from juices & sugar-sweetened beverages). Yes.

9) Follow these principles, eating whenever you are hungry until you are comfortably full.   Don't starve yourself and don't stuff yourself.
Yes.

10) Avoid being sedentary and aim for at least 30 minutes or more of moderate exercise daily (i.e., brisk walking).
Yes -I pulled a hamstring and had to pull back on working out a bit to work through as it’s healing. Won’t stop though!

Victories,Comments,Concerns,Questions:
Mark, thank you for posting Jeff’s article from 1988. The more things change the more they stay the same! It looks like it was done on a typewriter. I remember the Fit for Life books and how I never thought I could eat that way. Just as I did the first time I looked at the MacDougall program. Back then I remember struggling with my weight and never having the confidence or assurance that I had a truly consistent, science-backed structure as I do now thanks to MWL.
When you asked what triggers my off track “events”
, I thought about it. I’m eating non-adherent foods always when I’m exhausted or stressed. I know that I’m making bad choices at times but still grappling with why I’m allowing the 2 yr old brat in my head to follow through on the decision to grab bread, chips, or candy. Make it a good week and see you next Saturday!

[Mark Cooper]

Hi, everyone! It seems that there was some sort of issue with the server for the discussion boards causing them to be down for much of the day (9/23), and they had to be restored from a backup. It appears that recent posts from this week were lost. My apologies for that, particularly to those who reported and had there posts lost in the restore. I know the posts I saw from BambiS, Rebecka22, & Starflower indicated a pretty great week, so well done!

Gimmelean - Awesome adherence and thanks for being so persistent in posting! It makes sense to me that times of exhaustion and major stress would be when one is most likely to falter. Would establishing a predetermined protocol for yourself that outlines what you'll do in those situations feel like a useful approach? Totally agree with you that the overall message related to this way of eating has been remarkably consistent through the years. I find that pretty comforting!

Again, apologies for the technical difficulties and best wishes to all. May your week be amazing! With any luck we will all be able to reconvene here again next Friday & Saturday.

Take care & be well.

[VegSeekingFit]

Hi MWL Peeps!

Sorry for the folks who lost their posts... I tried to post this AM and couldn't BUT was YAY able to save my post down --- so posting it anyway.

Hope that everyone has a great week!

Cheers,
Stephanie

-----------------------------------------------------------
  
Hi Team Time & Adherence,

Hope everyone had an awesome and successful week! Hard to believe that we are officially in fall! My neighbor put out all of his Halloween decorations last weekend --- including the ridiculously cute purple spider with a web. I feel like the Halloween grinch with nothing out (and not planning to decorate), but that’s ok!

1 Start each meal with a soup and/or salad and/or fruit.
More than last week’s 2/3, but less than 100%. I have bought various apples and pears to make this super easy to increase. They are delicious in the fall!

2 Follow the 50/50 plate method for your meals, filling half your plate (by visual volume) with non-starchy vegetables and 50% (by visual volume) with minimally processed starches. Choose fruit for dessert.
Yes. Mostly eating the same meals, but have started to add more starchy soup.

3 Greatly reduce or eliminate added sugars and added salts. This includes gourmet sugars and salts too. If either is troublesome for you, you can eliminate them.
Yes. Reduced, not eliminated.

4 Eliminate all animal foods (dairy, meat, eggs, fish, seafood).
Yes.

5 Eliminate all higher fat plant foods (i.e., nuts, seeds, avocados, tofu, soy).
Totally yes. Thanks again for the oats suggestions last week. I bought the quick oats and have used them once as a work breakfast when I went in early. There are coffee and hot water machines that this works perfectly with! I also bring an extra self-made cup in case I run out of food / get hungry during the day. I find it important to NOT be hungry at work (without compliant food handy) because this may be the environment that I spend the most time in on a regular basis that is full of Pleasure Trap foods. For instance, Wednesdays are popcorn days --- the whole campus smells of popcorn in the afternoon – everywhere you walk. Happily, my team’s in the office days no longer include that one!

6 Eliminate any added oil.
Yes.

7 Eliminate all higher calorie-dense foods including flour products (i.e., bread, bagels, muffins, crackers, dry cereals, cookies, cakes, puffed cereals, air-popped popcorn, and dried fruit).
Yes.

8 Don’t drink your calories especially from juices & sugar-sweetened beverages).
Yes.

9 Follow these principles, eating whenever you are hungry until you are comfortably full. Don't starve yourself and don't stuff yourself.
Yes. No starving and no stuffing.

10 Avoid being sedentary and aim for at least 30 minutes or more of moderate exercise daily (i.e., brisk walking).
Yes - 7 / 7. I have done better this year by transitioning to some gym usage in the darker and cooler weather which has been great for consistency in this space. I was able to go to my work gym before work and walk for an hour. I brought 2 containers of quick oats and a banana to eat afterwards. Also, have been back to my neighborhood gym a few times in the early morning. On warmer (and LIGHT in the early AM) days, I would always pick being outside vs. a gym, but I am getting used to being more flexible with the season so that I just do the exercise. I feel FANTASTIC when I start the day out with movement.

Victories, comments, concerns, questions:
Thanks, Mark for sharing great reading material from Jeff! Fascinating how we can use caution at restaurants and still overconsume calories. Loved also reading Jeff’s first newsletter. I was a student at UIUC the year prior – so connect with the locations, etc.

Hope that everyone has a wonderful week!

Cheers,
Stephanie