Jumat, 14 November 2014

BMI Measurement in Schools

BMI's in schools.  Huge issue.  Here are my thoughts.

I see both sides of the coin.  I have a unique stance due to my positions at one point in time being on both sides.

As a 22 year old dietetic intern at Vanderbilt, we have a very extensive final community nutrition project that needs to be executed before graduation.  My project was titled, "Address your Health. A Sample Systems Guide to Implementing Health Report Cards in your State."  Seriously, here is proof.




Back then, I was working in Tennessee, a state at the time that ranked 47th in childhood health.  I was in and out of the schools doing various nutrition presentations.  You can't help but physically see the obesity issue.  My project conclusion was a guide to help schools implement "Health Report Cards" that included height, weight, BMI, blood pressure, body fat percentage and waist circumference with suggestion of adding 24 hour diet recall.  It also included sending a letter out to parents in advance allowing them to opt their child out of the Address Your Health screening.  See below.



After I graduated from Vanderbilt, passed my RD Exam and jumped into the world of medical nutrition therapy, guess what my first job was?  Lead Registered Dietitian at a private intensive outpatient treatment center for eating disorders.  My world changed drastically and became a revolving door of anorexia, bulimia, binge eating and addiction.  Patients of all ages cried in my office every single day over how much they hated their bodies, how evil food was, and how they struggled to have a positive personal relationship with themselves.  My view of calories and numbers on a scale swung to the other extreme.  Maybe we should just get rid of all nutrition labels and all scales?

Currently, I treat various different people. I specialize in eating disorders but I also see kids, adults, issues of weight loss, chronic disease management, etc.  I have been in both camps and have felt both sides of the argument.  The bottom line is that health is a major problem with our youth.  The question is, what do we do about it, and who is primarily responsible to do something about it?

Here is my current stance.  It is the parent or guardian's responsibility to ensure that their children are as healthy as possible - in physical health and emotional health.  There are some great parents out there, there are some not-so-great parents out there.  There are also some great parents who struggle with certain aspects of life themselves; for example parents with their own eating issues.  The primary responsibility lies with the parents.

However, educators, administrators, health care providers, coaches and other adults also have a responsibility to demonstrate what a healthy life looks like.  I think it is absolutely ridiculous and hypocritical to be measuring children at school for health data and then offering soda and fried chicken nuggets to them for a meal at lunchtime.  French fries and ketchup are not vegetables.  Schools should be embarrassed if that is the case.  That sends a very confusing message to the child and the parents.

So here is my solution.  If you, your school, your district, your community, truly care and want to get involved in the youth health crisis on a personal or a school level, here is what you need to do.


  • As a school, send a letter to the parents.  State the the concern regarding the current youth health crisis and encourage them to visit their doctor or a dietitian to learn their child's trending height, weight, BMI as related to age, and waist circumference.  Let them know in the letter that your school nurse and school psychologist are available for any advice or questions.  And lastly, find a local registered dietitian nutritionist in your area and ask if they wouldn't mind being a resource for your students and parents.  And get the junk food out of your school, period.
  • As a school employee, lead by example.  Do not reward children in class with candy or any food.  Do not eat the unhealthy options in the lunch line.  Do not use the soda vending machines.  Let your students see you being healthy and making positive changes.
  • As a parent, lead by example.  Stock healthy foods at home.  Do not reward or punish with food.  Do not eat and drink junk food at home.  If you have your own issues with food, let your children see you work towards getting help and changing things for the better.  Do not talk about your body in a negative way.  Do not talk about their bodies in a negative way.  Be open to questions from your kids about anything.  
  • As a health care provider, ask the child what they eat in a typical day - yes, ask about nutrition always.  Monitor health data, but never react to it or comment about it in front of the child.  It is typically a comment from a health care provider, said hastily and without support, that will give children the idea that they are overweight, obese, unhealthy, or not good enough.  Please watch your words.


As a registered dietitian nutritionist I would be happy to talk about this topic anytime.  I'll even let you read my "Address Your Health" proposal from grad school.  I will connect you with a registered dietitian nutritionist in your area for a reference.  The road to cleaning up this mess is not easy, but we have to start by taking individual responsibility first, and then we can help others.  The old airplane oxygen mask rule right?


Selasa, 11 November 2014

5 Month Post Bikini Contest Check-In

It's been a little more than five months since I competed in my first NPC bikini competition and I wanted to share what life's been like since then and where I am now with my (lifelong) fitness journey.  I say lifelong journey because as long as I'm alive, I want to take care of myself and never take my health for granted.  With my Dad's illness, I've painfully watched his physical ability diminish to the point where he cannot walk, so I'm always mindful of how grateful I am to be able to move and exercise.  

the beginning

Almost one year ago, I had gotten out of shape and was ready for a big change.  I couldn't fit comfortably into my clothes, felt sluggish and missed feeling good about myself.  I started working out and eating better in February 2014 on my own, and began working with my trainer (3-4 days a week) at the end of March 2014.  We trained together for 15 weeks and I competed in the bikini contest on July 4, 2014.  I went from 112 pounds and 25% body fat (Feb 2014) to 100 pounds (July 2014).  We didn't test my contest body fat because I was supposed to go the BodPod for a very accurate reading, but the facility cancelled my appointment because they machine wasn't working.  My trainer guesstimated I competed at about 15% body fat.  


now

Immediately after the contest I stopped working with my trainer, mainly for financial reasons.  I figured I knew his workouts pretty well and could do them on my own at my gym.  I also started indulging in pint after pint of ice cream!  I did this for a long time (not sure how long exactly, but I probably ate 2 pints a week).  

And, sad to say, I did go to the gym some, but I could never bring myself to workout with the same intensity that I did when I had my trainer.  I didn't do a single burpee or jump squat.  At one point, I tried the group classes at my gym (which I loved and actually got a great workout), but I hurt my right shoulder in the kickboxing class and that sidelined me for over a month.  I didn't expect to stay at 100 pounds, but 105 is a comfortable weight for me at 5'1 and being petite.  

Below, the photo on the left is just after my contest and the photo on the right is me now.  It's not a terrible change, but I have gained just over 10 pounds and the pants are tight again.  I much prefer the leaner look on the left and want to get back to that.  

The pictures below are two weeks before my contest and currently.  

So, it's back to the gym and I have hired my trainer again!  We've been back at it for 3 weeks now and I feel so much better.  Our workouts are killer, but I LOVE how I feel for the rest of the day.  And, working out so hard is the only thing that helps regulate my sleep.  If left to my own devices, I'd probably be up till at least 1 am, but now, I'm heading to bed around 9:30 p.m.  and waking up at 6:15 a.m.  We workout from 8:30 - 9:15 or so and then I do 30 minutes of cardio 3 times a week.  I'm also doing 30 minutes of cardio on my own 1 or 2 more days.  This is pretty easy to accomplish because I can just go for a quick run in my neighborhood.  


meals 

I have learned there is no quick fix to getting in shape.  It's a matter of eating right, weightlifting, cardio and supplements.  Blood, sweat and tears and a lot of hard physical effort.  In the last five months, I got way off my previous meal plan and got into a bad habit of going way too long between meals.

I'm finding it actually comforting to be back on my meals because it's so no brainer and now I recall how my energy level stays constant throughout the day.  I eat about every 3-4 hours.  

Meal 1:  protein pancake
Meal 2:  fish, potatoes, veggies
Meal 3:  chicken salad or Tex Mex (meat, beans, rice) or omelet 
Meal 4:  chicken, potatoes, veggies
Meal 5: protein shake 




supplements 

Supplements played a big part in helping me build and repair muscle and have energy to get me through my intense workouts.  I've always taken a BCAA (Branched Chain Amino Acid) and supplemented with protein powder, but my trainer just recommended that I use a pre-workout supplement too.  I recently received some products from GNC PUREDGE to try and have been using them.  I read that the GNC PUREDGE line is whole-food based and has no GMO1-added ingredients, no wheat, yeast, fish or egg, no sugar alcohols, no artificial additives, colors or sweeteners, and no gluten-added ingredients. 



I started with their chocolate protein powder to make my shakes (the last meal of the day) which is so much easier to drink a tasty shake instead of another meal.  Since I don't like to drink a huge shake, I only use 6 oz of water + 2 ice cubes + 1 scoop of GNC PUREDGE protein powder.  One scoop of powder has 190 calories and 20 grams of protein.  They also offer vegan protein powder if you prefer.


The BCAAs are something I really rely on and don't miss a day of.  I'm using the GNC PUREDGE Complete Amino and put a scoop in my water bottle and drink it while I workout.  BCAAs protect, repair and fuel muscles.  


My trainer just recommended that I try a pre-workout supplement to help give me energy to get through my workouts.  I received the GNC PUREDGE Daily Energy Performance Energizer and will try it today and update this post with the results.  I want to make sure it doesn't make me jittery, but he said it shouldn't because it's formulated with green tea, black tea, guarantee and rhodiola.  

They have protein bars too that taste really good in chocolate, watermelon, banana nut bread and peanut butter cookie dough (my fave!).  I try to just eat these in a pinch and mostly eat the real food meals I explained above.  


I know most of us are just wanting to enjoy the holidays (and yes, the good good and drinks that go along with it!) and not focus on dieting or weight loss right now, but I didn't want to go into the new year with even more work to do, so I'm trying to get in control now.  Of course, I will indulge here and there, but spending the time, money, and energy with my trainer again, I know I won't go overboard.  We actually have a body-fat test this morning, which we will do every two weeks.  

It can be scary to post pics of yourself going from fit to not-as-fit, but I wanted to share honestly my story the good, the bad, the ugly, but most of all the truth.   If you have any questions, please let me know in the comments and I will answer them for you! 

I hope you have a wonderful, healthy and happy holiday!