How to guide patients to healthy eating habits

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The intersection of diet and health is undeniable, with nutrition playing a major role. However, doctors, constrained by limited time in consultations, often find it challenging to thoroughly address this crucial aspect of health with their patients. The problem is twofold. First, physicians don’t have enough time to discuss nutrition, diets, nutritional imbalances, food sources, food interactions and lifestyle choices. Second, it’s not a physician’s job to educate a patient about nutrition. However, there is an interwoven connection between a patient’s health and their diet. For these reasons I have created what I call the six simple rules, and I encourage everyone I have the privilege of speaking with to make them nonnegotiable in their life. My hope is that you will find them to be a great resource to share with all of your patients to encourage them to take back control and to get into their own bodies and off of Google.

It’s not that patients don’t know that kale is healthy, it’s that they can’t bring themselves to stop eating other foods with the kale or after they eat the kale. In my book, This Is What You’re Hungry For, I ask the reader why. Why lose weight? Why eat this or that? The truth is I believe what we are all hungry for is health, and peace around our health. One person might be told oat milk is terrible for you, and they are told by the person eating barbecue potato chips. There is so much confusion around nutrition. Only there isn’t, is there? It’s quite simple: Our bodies are amazing and self-regulating and self-healing if we align with their needs. This is where the six simple rules come in.

Kim Shapira, MS, RD

There is one more thing that needs to be addressed before the rules. White coat syndrome is very real. Many patients go to a doctor nervous, scared and emotionally triggered, and we see this by looking at their blood pressure. After a few minutes, some deep breaths and maybe even some gentle reassurances, they calm down. It’s after this we can have rational discussions about their health. But do they really know that their mind is still in the appointment? My guess is that their mind jumps ship when it gets scary. Our patients are out in the world, scared and nervous, and they rationalize bad ideas all day long. It’s very important to offer calming music. We know that high-vibration music is soothing to our nervous systems. We need to offer meditation practices and breathing techniques. We all know what stress does to our bodies; we all know what cortisol does. Health and well-being start with knowing where your patients’ minds are and accepting the moment they are in, even the uncomfortable ones. Then the transformation can begin.

One tool I like to offer my patients is to simply ask, “Where is my body?” Then to answer, “It’s right here.” Followed with, “Where is my mind?” Then to answer, “__________.” My hope is their mind is also right here. Sometimes they need to repeat it a few times, but what is amazing is that this tool can help them become mindful. Mindfulness is defined as knowing where your mind is without judgment and, back to the answer that my book asks for, being at peace in this moment. I often say no one wakes up in the morning and worries about the six toilets they will no doubt need on that day, because they simply trust they will find one when they need one. But our patients don’t trust there will be food when they need it, even though the average person will eat 21 meals a week – and not remember any of them.

Here are my six simple, nonnegotiable rules that will be game changers in your patients’ relationship with food, their health and the way you engage with them.

1. Eat when you are hungry. Start with half of your normal portion and wait 15 minutes to see whether you need more food.

Instead of talking about kale, talk about hunger. Talk about it like it’s a sensation that occurs in your stomach. It’s not scary or painful, and it is there to remind us to fuel up. We need to cut our portions in half, because who is making our portion – our moms, the chef, the person who created the food label? How much does a person need at this moment? Can it be different later or tomorrow? Yes. And we need to be OK with that and curious. Why wait 15 minutes? That’s how long it takes for the hormone leptin to tell our brains we are good for now. Let’s teach our patients how to be in touch with what their body needs, to honor this connection and to trust this connection. Not to mention this is fail-safe and will prevent overeating. The food isn’t going anywhere, and food is everywhere.

2. Eat what you love and make sure the food loves you back.

This is not permission to overeat; this is permission to understand what they love and how it is affecting their bodies. There is so much confusion around nutrition, and nobody is quite clear whether they should eat high protein or low carb. And many people are suffering from basic inflammation like diarrhea, headaches, constipation, heartburn and joint pain. Once a person sees that a food is not being tolerated, they are more likely to say “no, thank you,” and then the healing can begin. If we tell someone what they shouldn’t eat, they will want it more. So, let’s not. Let’s empower them to honor what their bodies need while encouraging what we know is smart. We know that a diet high in fruits and vegetables (patients can be in charge of which ones they love), fiber (25 grams for women and 30 to 35 grams for men), omega-3s and fermented food transforms a gut. Let them eat what they love, eating when they are hungry and starting with half.

3. Eat without distraction.

We eat for four reasons: emotions, cravings, because it is in front of us, and hunger. Mindful practices help with knowing the difference between being sad, thinking “food is a good idea,” and being hungry. Cravings are like a seduction because sugar is like a drug. I have found when people become more mindful, they see cravings are not hunger feelings and can normalize their diet patterns, such as having birthday cake on a birthday without being habitual and having it every day of the week.

4. Get 10,000 steps every day.

It’s simple: We need movement. The average American gets only 3,000 steps a day. Movement is medicine because it helps our circadian rhythms, improves our mood and digestion, and most importantly helps a patient stay the same weight. Weight maintained is the goal.

5. Drink eight cups of water every day.

It’s our natural resource to detox our body and our cells. Our kidneys need this resource to function well. And our bodies are so dependent on water that if we don’t drink enough, it wreaks havoc on our other organs. It’s a simple task: Drink more water.

6. Get seven hours of sleep.

I can go on and on about sleep hygiene. Have you seen the aisles and aisles of over-the-counter sleep aids? The average American gets six and a half hours of sleep a night. A lack of sleep increases inflammation, and the more inflammation we have, the lower the motivation we have in all things. Going to sleep tomorrow one hour later than tonight results in jet lag, and it takes up to three days to recover from that lost hour. Helping our patients sleep well and soundly, with the ability to fall asleep, stay asleep and wake up rested, needs to be a topic of conversation.

There you have it. A solution to a major problem and an easy entry-level conversation with six simple rules that your patients can follow to help them navigate their health. These rules will help everyone get and stay on a healthy journey without shame or persecution while positivity affects their life.

Kim Shapira, MS, RD, is a celebrity dietitian, nutritional therapist and author, with a bachelor of science in kinesiology from Tulane University and a master’s degree in human metabolism and clinical nutrition from Boston University. She has spent more than 25 years helping people lose weight and keep it off (with a giant emphasis on keeping it off) in her private Los Angeles practice, hospitals, sports clinics, addiction centers and universities. Her book, This Is What You’re Really Hungry For: Six Simple Rules to Transform Your Relationship with Food to Become Your Healthiest Self, is out now.