mercredi 1 août 2007

Les études ne sont pas toutes débiles comme celle sur l'obésité contagieuse...

Counting calories isn’t the best way to lose weight, according to a new Brigham Young University study that suggests that an approach toward food called “intuitive eating” is better at producing lower cholesterol levels, body mass index scores and cardiovascular disease risk.

“The basic premise of intuitive eating is, rather than manipulate what we eat in terms of prescribed diets -- how many calories a food has, how many grams of fat, specific food combinations or anything like that -- we should take internal cues, try to recognize what our body wants and then regulate how much we eat based on hunger and satiety,” said lead researcher Steven Hawks, a BYU professor of health science, who adopted an intuitive eating lifestyle several years ago and lost 50 pounds as a result.

In a small-scale study to be published in the Nov. 18 issue of the “American Journal of Health Education,” Hawks and his team of researchers -- Hala Madanat, Jaylyn Hawks and Ashley Harris -- identified a handful of college students who are naturally intuitive eaters and compared them with other students who aren’t. Participants were then tested to determine how healthy they were.

As measured by the Intuitive Eating Scale, developed by Hawks and others to measure the degree to which a person is an intuitive eater, researchers found that intuitive eating was significantly correlated with lower body mass index, lower triglyceride levels, higher levels of high density lipoproteins and decreased risk of cardiovascular disease. Approximately one-third of the variance in body mass index was accounted for by intuitive eating scores, while 17 to 19 percent of the variance in blood lipid profiles and cardiovascular risk was accounted for by intuitive eating.

“The findings provide support for intuitive eating as a positive approach to healthy weight management,” said Hawks, who plans to do a large-scale study of intuitive eating across several cultures.

“In less developed countries in Asia, people are primarily intuitive eaters,” said Hawks. “They haven’t been conditioned to artificially structure their relationship with food like we have in the United States. They’ve been conditioned to believe that the purpose of food is to enjoy, to nurture. You eat when you’re hungry, you stop when you’re not hungry any more. They have a much healthier relationship with food, far fewer eating disorders, and interestingly, far less obesity.”

Hawks says that “normal” dieting in the United States doesn’t result in long-term weight loss and contributes to food anxiety and unhealthy eating practices, and can even lead to eating disorders.

“What makes intuitive eating different from a diet is that all diets work against human biology, whereas intuitive eating teaches people to work with their own biology, to work with their bodies, to understand their bodies,” said Hawks. “Rather than a prescriptive diet, it’s really about increasing awareness and understanding of your body. It’s a nurturing approach to nutrition, health and fitness as opposed to a regulated, coercive, restrictive approach. That’s why diets fail, and that’s why intuitive eating has a better chance of being successful in the long term.”

To be an intuitive eater, a person has to adopt two attitudes and two behaviors.

The first attitude is body acceptance.

“It’s an extremely difficult attitude adjustment for many people to make, but they have to come to a conscious decision that personal worth is not a function of body size,” said Hawks. “Rather than having an adversarial relationship with my body, where I have to control it, and force it to submit to my will so that I can make it thin, I’m going to value my body because it allows me to accomplish some higher good with my life.”

The second attitude, that dieting is harmful, is related to the first.

“Dieting does not lead to the results that people think it will lead to, and so I try to help people foster an anti-dieting attitude,” said Hawks. “You have to say to yourself, ‘I will not base my food intake on diet plans, food-based rules, good and bad foods, all of that kind of thing.’ For people who are deep into dietary restraint and dietary rules, again, that’s a very difficult attitude adjustment to make, to give up all those rules.”

Behaviorally, the next step is learning how to not eat for emotional, environmental or social reasons.

“Socially we eat all the time in our culture, we go out to eat ice cream if we break up with our boyfriend, we eat to celebrate, we eat when we’re lonely, we eat when we’re sad, we eat when we’re stressed out,” said Hawks. “Being able to recognize all the emotional, environmental and cultural relationships we have with food and finding better ways to manage our emotions is part of the process.”

The final step is learning how to interpret body signals, cravings and hunger, and responding in a healthy, positive, nurturing way.

Learning the body’s signals can be difficult at first, but Hawks suggests thinking about hunger and satiety on a 10-point scale, where “10” is eating until one is sick and “1” is starving. Intuitive eaters keep themselves at or around a “5.” If they feel they are getting hungry, they eat until they are back at a “5” or “6.” They stop eating when they are satisfied, even if that means leaving food on the plate.

One part of intuitive eating that may be counterintuitive to people conditioned to restrictive dieting is the concept that with intuitive eating there is a place for every food. In other words, there’s no food that’s ever taboo, there’s no food you can’t ever have.

“Part of adopting an anti-dieting attitude is the recognition that you have unconditional permission to eat any kind of food that you want,” said Hawks. “And that’s scary for people who say, ‘If I abandon my diet rules, then I’ll fill a pillowcase full of M&M’s, dive into it and never come up again. That’s what I crave, I know that’s what I crave, that’s all I will always crave.’ But that’s not the reality. The reality is that our bodies crave good nutrition.”

Dieting creates psychological and physiological urges to binge on taboo foods, and, although in the short term people may have binges when they first start eating intuitively, they eventually learn to trust themselves. One technique Hawks suggests is having an abundance of previously taboo foods on hand. Once the foods are no longer forbidden, a person quickly loses interest in them.

“If people are committed to recognizing what their bodies really want, the vast majority of people will say that they very quickly overcame cravings,” said Hawks, opening a drawer at his office desk filled with untouched junk food. “It certainly has worked for me.”

From Brigham Young University

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