Monday's With Maria

Monday's With Maria

What is Integrated Eating™? Part Two: Phase 1 Structured Eating
by Maria Sorbara Mora, MS, RD, CEDRD, PRYT, RYT

Read Part One Here

Integrated Eating™ has four developmental stages. The first stage is Structured Eating.

Structured Eating gives a form and organization to food and feeding. Structured mechanical eating is the first step in restoring hunger cues and requires the person to eat bite after bite in the absence of hunger cues until the meal is completed.  In this process an individual is given a structured or semi-structured meal plan that includes balanced meals and snacks. Restoration of appetite and normal eating begins mechanically and the stomach and brain begin to communicate again. It may take several weeks or months before appetite returns and begins to regulate itself. Without the practice of mechanical eating it is difficult to move toward regular balanced eating.

There are three basic components of structured eating: when to eat, what to eat and how much to eat.

When to Eat: As nutritionists we have come a long way from the idea of the “3 square meal” philosophy and have evolved to “3 meal plus snacks.” We have learned a lot about insulin levels from treating diabetics enough to understand that eating every 3-4 hours stabilizes your blood sugar and increases the chances of normalized eating. Eating within the first hour of waking is a very good rule of thumb to practice as it breaks the fast from sleeping and allows the body to move into more active and potential metabolism. It is well established that eating 3 moderate meals are essential to getting in our basic needs of macro and micro nutrients but balanced snacking is crucial to maintaining optimal energy and having steady hunger signals.

How many snacks you might be wondering? Our bodies need food every 3-4 hours so if you consider the average individual that wakes up at 7am and eats their breakfast at 7:30am then they should have a snack by 10:30am and lunch by 1:30pm another snack at 4:30pm and dinner at 7:30pm. This would be 3 meals/2 snacks per day. A third snack would be added in if this individual were up before 7am or sleeping way past 10:30pm. Now that you have your answer as to when to eat, let’s talk about what to eat.

What to Eat: Eating balanced meals and snacks allows for the continuation of creating structure in your eating. A balanced meal is one that includes each of the macronutrient components: complex carbohydrates, proteins, fats, and fruit/vegetables. A balanced snack contains a protein, fat and either a complex carbohydrate, or a fruit or a vegetable. You may be wondering why it is so important to eat balanced meals and snacks. To further the understanding of how important stable blood sugar is to normalized and healthy eating behaviors, when you eat is only part of the story. It is not only when you eat that will allow for stable blood sugar, but what your eating that contributes to full body balance.

Consider this: Let’s say you got up in the morning and decided to eat a bagel with butter. In this case, you’ve eaten within an hour of waking up but your meal was deficient in protein and a fruit so shortly after you finish your breakfast you’re hungry again. You decide on a salad with chicken but forget to add the complex carbohydrate. By snack time you’re craving those carbs but this time in the form of a giant chocolate chip cookie. By dinnertime you’re famished because you’ve not been able to adequately get all of your needs met and even though you choose a balanced meal, you’re too hungry and consume too much. This is a scenario that happens all too often. 

In a balanced structured eating plan, you wake up and eat peanut butter and an apple on 2 slices of toast. You’ve gotten all the macronutrients down and you feel full and satisfied and will not need to eat again for 3 or 4 hours. At lunchtime you decide on a tuna sandwich and bag of chips. The mix of protein, carbohydrates and fats keep you stable until late afternoon. At snack time you are ready to refuel and enjoy a yogurt with berries. By dinnertime you’re hungry and decide on a yummy balanced meal containing salmon, roasted potatoes and sautéed spinach. You eat an adequate amount because your blood sugar has been on track all day long.

Bottom line, when you eat and what you eat are very related, but having the right balance of foods in the correct amounts is essential to long-term success.

How Much to Eat: In this structured phase of Integrated Eating™ there is a method to how much one eats on a range…of course. Meals usually consist of 2-3 complex carbohydrate servings, 1-2 servings of protein, 2-4 fat servings and 1-2 servings of fruit/vegetables.

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Let’s consider what this means in actual food terms. A serving of Complex Carbohydrates equal 1 slice of bread, ½ cup of cooked grain or pasta, a small potato or half of a large potato or ¾ cup of cereal. We usually aim to consume 2-3 of these serving portions per meal.

Proteins vary because there are animal and non-animal proteins. A serving of animal protein (fish, poultry, beef, pork) is approximately 3 ounces, while beans and legumes are about ¾ cup. Eggs are protein so usually 1 large or 2 small eggs are one serving. Dairy is also considered a protein so 1 ounce of cheese is a serving, 1 cup of yogurt or milk and ½ cup cottage cheese.  We usually aim to consume 1-2 servings of protein per meal.

Fats occur in some proteins and some mixed carbohydrates but pure sources of fats include oil, butter, avocado, mayonnaise, and salad dressings. A serving is about 2 teaspoons of oil, 2 tablespoons of salad dressing, 1 tablespoon of mayonnaise, 1/8 of an avocado or 2 teaspoons of butter. In a moderate meal, we typically will consume 2-3 servings of a fat.

Fruits and vegetables are usually measured as one small piece of fresh fruit or 1 cup cut fruit or vegetable, ½ cup cooked or ¼ cup dried.

Based on these measurements, a balanced, well portioned breakfast meal would be include: 1.5 cups oatmeal, with ¼ cup of nuts and ¼ cup of raisins and 1 cup of milk. For lunch, a turkey and cheese sandwich with avocado, lettuce and tomato and a small bag of chips, for dinner, shrimp stirfry with 4 oz shrimp, 1.5 cups of rice and 1 cup cooked vegetables.

Snacks are similar but a bit different. For meals it’s important to have both complex carbs and fruits and vegetables but for snack you can choose which you want to use. For instance, for a balanced snack you can have a banana and 2 tablespoons of peanut butter or 2 rice cakes with 2 tablespoons of peanut butter. Snacks should include: 1 protein, 1-2 servings of fat, and either 1 fruit serving, 1 vegetable serving or 1 complex carb serving. 

This may seem complicated but the structured eating phase of Integrated Eating™ is so important because it lays down the foundation of when, what and how much to eat.  To recap:

1)    Eat within the first hour of waking.

2)    Eat every 3-4 hours.

3)    Eat approximately 3 meals and 2-3 snacks.

4)    Eat balanced, well-proportioned meals and snacks.

Consider these questions to assess your eating:

1)    What do you notice about the timing or schedule of how you eat? You may try to keep a food record for a day or two to observe your eating patterns.

2)    Are your meals and snacks balanced? If not, what do you notice is missing?

3)    Notice your meal/snack sizes. Are you eating proper portions of each component?