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5. Fenton M. Engineering physicalactivity back into Americans’ lives.Progressive Planning. 2003;1-8.Available at www.plannersnetwork.org/htm/pub/archives/fall03/fen-ton.htm.6. Fenton M. Battling America’s epi-demic of physical inactivity: buildingmore walkable, livable communities. J Nutr Activ and Behav. 2005;37 (suppl2).

Intuitive Eating in the Treatmentof Disordered Eating by Evelyn Tribole, MS, RD

Intuitive Eating1 is a process-basedapproach that ultimately teachespatients how to have a healthy rela-tionship with food, wherein patientsbecome the experts of their own bod-ies. Patients learn how to trust theirability to meet their needs, distin-guish between physical and emotion-al feelings, and develop body wis-dom. On the surface this may soundsimplistic, but it is rather complex.

For example, one of the basic coresof Intuitive Eating is the ability torespond to body cues, ie “Eat whenhungry and stop when full.” Thismay be easy for many people, but fora patient with a history of chronicdieting or rigid “healthy” rules abouteating, it is very difficult to accom-plish because a number of issues needto be worked on, some of which seemcounter-intuitive. Following are twokeys to working effectively with suchpatients:

Unconditional permission to eatany food. How can this be healthy?Patients struggle with this concept,because they worry that once theystart eating a forbidden food, theywon’t stop. Yet, it is the very processof eating that allows the patient toexperience food habituation. Studiesshow that the more a person isexposed to (and allowed to eat) afood, the less desirable it becomesover time.2 This has been demonstrat-ed in studies involving many foods,including pizza, chocolate, and potato

chips. Most chronic dieters have notexperienced food habituation.Instead, they live in the black-and-white world of eating: good foodsand bad foods, on a diet or off of adiet.

Paradoxically, knowing that youcan eat a particular food again when-ever you want makes it less compel-ling to eat it now and eat it all. Con-sequently, the thought to stop eatingwhen full is no longer threatening.Eating no longer becomes the “lastsupper before the diet” or “eat it allwhile I can, no one is here.” It is nolonger threatening to be in touch withthe many body cues, whether they arephysical, hedonic, or emotional.

Challenging the “food police.” Thiscalls for challenging the internal andexternal rule-makers of so-calledhealthy eating on a cultural and fami-ly level, and ultimately what thismeans for the patient. It involves theuse of cognitive behavior therapy, inwhich patients learn how to evaluatetheir thoughts for distortions as theyrelate to food and body. This meanschallenging the status quo.

Fascinating research by Rozin et alsheds light on the significance of thisissue.3 They found that Americansare “worry-warts” when it comes tofood. Americans scored the highestamong four countries on the level ofworrying about the fattening effectsof food as opposed to savoring it;they associated food the most withhealth and the least with pleasure.Rozin and colleagues postulate thatthe stress-effect of worrying aboutfood may be an important contributorto overall health. They suggest thatAmerican worries and obsessionsabout healthful foods may be count-er-productive, producing substantialreduction in the quality of life.

The Intuitive Eating journey teach-es a patient that a healthy relationshipwith food is just as important as thehealthfulness of a food choice.Intuitive Eating takes the moralityand judgment out of eating, sopatients also learn that their characterand self-worth are not altered by theirchoice of food, whether it’s a cheese-burger or salad for lunch.

Evelyn Tribole, MS, RD, has a nutri-tion counseling practice in Irvine, Calif,and is co-author of Intuitive Eating, 2nded.References1. Ernst MM, Epstein LH. Habituationof responding for food in humans.Appetite. 2002;38:224-234.2. Rozin P, Fischler C, Imada S, et al.Attitudes to food and the role of foodin life in the USA, Japan, FlemishBelgium, and France: possible impli-cations for the diet–health debate.Appetite. 1999;33:163-180.3. Tribole E, Resch, E. Intuitive Eating,2nd ed. St. Martin’s Press; 2003.

Genes, Personality, and EatingDisordersby Ovidio Bermudez, MD, FAED

Eating-related pathology occurs acrossthe lifespan. Eating disorders (EDs)are complex illnesses that occur most-ly in adolescence and early adulthood;the etiopathogenesis of these illnessesis not yet fully understood. All eatingdisorders share hereditary, familial,temperamental, behavioral, psycho-logical, medical, and socioculturalcharacteristics, often viewed as predis-posing, precipitating, and perpetuat-ing factors. Dieting has been identi-fied as one of the major risk factors forthe development of disordered eating,and obsessionality and impulsive cop-ing seem to facilitate the evolution ofdisordered eating into diagnosableeating disorders.

All eating disorders are character-ized by the presence of pathologicalbehaviors and thinking in variouscombinations; these include restric-tion, binging, purging, fear of weightgain or fatness, and self-valuation thatoveremphasizes the individual’s per-ception of their size or weight. Thereis evidence supporting the dimension-al perspective of EDs. Full and partialsyndromes share sociocultural, famil-ial, psychometric, behavioral, medical,and hereditary variables.

Eating Disorder Not OtherwiseSpecified (ED NOS) share similarprognosis and morbidity to anorexianervosa (AN) and bulimia nervosa(BN) and should not be considered a

SCAN’S

P U L S E

®

A Publication for Sports, Cardiovascular, and Wellness Nutritionists Summer 2006Vol. 25, No. 3

CONTENTS

Results of the Detroit Faith-Based Mini-Market Project 1

From the Editor 3

Does Branched-Chain Amino Acid Supplementation Offer Ergogenic Benefits? 5

CPE article—Diabetes: Something to Stress About 8

2006 SCAN Symposium Presentations 11

From the Chair 19

2006 ADA Food & Nutrition Conference & Expo (FNCE) 19

Reviews 20

Sports Dietetics USAResearch Digest 21

SCAN Notables 23

2006-2007 Executive Committee 24

Of Further Interest 27

Upcoming Events 28

Results of the Detroit Faith-BasedMini-Market Project by Quentin J. Moore, MPH and Brandess Wallace, MPH

The Detroit Fruit and Vegetable Mini-Market Project was created as a col-laborative effort of faith partners whowere recruited to accomplish a sharedgoal: to promote healthful eating andphysical activity among AfricanAmericans in churches and faith-based organizations as a means toaddress the huge burden and dispari-ty of cardiovascular disease (CVD)among blacks.1,2 The program’s goalsand objectives, along with pilot dataon its implementation, were previous-ly described in SCAN’s PULSE(Winter 2006). Partnering with theMichigan Department of CommunityHealth, the Michigan Public HealthInstitute (MPHI) obtained funding toconduct this special project toincrease capacity and provideresources for faith-based fruit andvegetable mini-markets in 10 church-es in Detroit and its surroundingareas. Faith-based wellness programshave previously been successful inempowering African-Americanchurches to promote fruit and veg-etable consumption as a method todecrease the risks of CVD and hyper-tension in the black population.3,4

The 10 selected church sites wereprovided with training and materialsenabling them to conduct fruit andvegetable mini-markets. Throughoutthe 8-month project period, partici-

pating churches received informationon health and wellness programs,educational resources, other materi-als, and technical assistance. Staff pro-vided support in troubleshooting aswell as assisted in the coordination ofhealth screenings and educational lec-tures for the churches. The mini-marts were targeted to low-incomeresidents, offering them low-costfresh produce at accessible locations.

Methods The Detroit Fruit and Vegetable Mini-Market Project utilized quantitativeand qualitative methods. Quantitativedata were collected via a retrospectivepretest. This method of self-reportevaluation offers a vehicle for docu-menting behavioral change at an end-point, with each respondent servingas his/her own control. The instru-ments are relatively easy to develop,use, and analyze.5 Results are credibleand are a proficient indication of pro-gram impact when a traditionalpre/post design cannot be utilized.5,6

However, retrospective pretests carrysome limitations. Validity can be com-promised when self-reported dataand recall are used. Insufficient recalland biased responses are possibleproblems with these types of evalua-tive instruments.7

The retrospective pretest used inthe mini-market project was revisedfrom a previous 5 A Day initiativesurvey targeting a low-income

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EVENTS

August 18-19, 2006“Nutrition & Exercise: An IntensiveWorkshop,” Providence, RI. For info:Nancy Clark, www.sportsnutritionworkshop.com

September 16-19, 2006ADA Food & Nutrition Conference &Expo (FNCE), Honolulu. SCAN ses-sion: “From the Training Table toCompetition: Fueling Athletes forSuccess.” For information:www.eatright.org/fnce

November 9-12, 2006Annual Renfrew Center FoundationConference, “Feminist Perspectivesand Beyond: Maximizing Change inthe Treatment of Eating Disorders,”Philadelphia. For information:www.renfrewcenter.com

April 12-15, 2007Join us for the 23rd Annual SCANSymposium in Austin, Tex. “SportsNutrition Training Camp” is thetheme. For information: SCAN Office,800/249-2875, www.scandpg.org

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Appropriate announcements are welcome.Deadline for Winter 2007 issue: Sept. 1.Deadline for Spring 2007 issue: March 1.

Manuscripts (original research, review arti-cles, etc.) will be considered for publica-tion. Guidelines for authors are available atwww.scandpg.org. Email manuscript to theEditor-in-Chief; allow up to 6 weeks for aresponse.

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SCAN’S PULSE

Publication of Sports, Cardiovascular, andWellness Nutritionists, a dietetic practicegroup of the American DieteticAssociation. ISSN: 1528-5707.

Editor-in-ChiefMark Kern, PhD, RDExercise and Nutritional SciencesSan Diego State University5500 Campanile Dr.San Diego, CA 92182-7251619/594-1834 - w619/594-6553 - faxkern@mail.sdsu.edu

Sports EditorsKathy Beals, PhD, RDNanna Meyer, PhD, RD

Cardiovascular EditorSatya Jonnalagadda, PhD, RD

Wellness EditorsKristine Kuhnert, RDChristina Verni, MA, RD

Disordered Eating EditorTracy Daly, MS, RD

Conference Highlights EditorNancy Clark, MS, RD

Reviews EditorNichole Dandrea, MS, RD

Sports Dietetics USA Research Digest EditorsNanna Meyer, PhD, RDJames Stevens, MS, RD

SCAN Notables EditorAmy Culp, RD

Managing EditorAnnette Lenzi Martin312/587-3781 312/587-3782 - faxalenzi@attglobal.net

To find contact information for an editor listed above, visit: www.scandpg.org

UPCOMING