Is intuitive eating applicable when you have a chronic illness?

Nutritionist

Intuitive eating: is it applicable when you suffer from a chronic illness?

To begin with, we would like to clarify that this answer is for informational purposes and cannot replace the advice of a medical professional. If you have a chronic disease requiring dietary changes, we recommend that you consult a nutritionist, who can guide you.
Several chronic diseases, such as diabetes, fatty liver and high cholesterol, may require dietary changes. The traditional approach for many illnesses recommends losing weight and avoiding or restricting certain foods with little regard for food enjoyment and listening to bodily signals. This restriction can harm the relationship with food and lead some people to over-consume the foods whose quantity we are trying to adapt… A bit counterproductive, isn’t it?
Intuitive eating is an interesting alternative for people for whom the traditional approach is less suitable.

What is intuitive eating?

It is an approach that, in addition to taking into account the content of the plate, addresses the connection to the different bodily signals, such as hunger, satiation, cravings and pleasure while taking into account health. , emotions and the relationship with physical activity. It has these ten principles (1, 2):
  1. Reject the diet mentality
  2. Honor your hunger
  3. Making peace with food
  4. Stop classifying foods as good or bad
  5. Discover the pleasure of eating
  6. Feel your satiation
  7. Living your emotions with kindness
  8. Respect your body
  9. Move your body and see the benefits
  10. Honor your health
While the traditional approach primarily considers Principle 10, intuitive eating also encompasses the whole experience of eating and the relationship to eating. It is necessary to start by improving the latter (principles 1, 3, 4, 5 and 8) and to reconnect to its signals (principles 2, 6, 7 and 9) before being able to apply nutritional advice according to the state of health (principle 10). In short, the latter is an integral part of the approach, but not to the detriment of the other principles.

How intuitive eating can help

Intuitive eating has several mechanisms supporting health:

– Better connection to bodily signals: Hunger and fullness signals are one of the ways our body informs us about our real needs. Recognizing them well therefore makes it possible to globally adapt the quantities of food. Our body also sends us messages when a food is not well digested, such as when a lactose intolerant person consumes an excessive amount of a dairy product.
– Reduction of guilt and shame: Categorizing foods as “good” or “bad” can block listening to signals and lead to overeating. Feeling less guilt therefore also makes it possible to adapt the quantities of food in addition to improving the relationship with food. Reducing stress (including stress related to food) also contributes to health.
– Flexibility and freedom of choice: each person has the power to adapt nutritional advice to their daily life, which reduces pressure, guilt and stress and supports long-term health.
Let’s explore a more concrete example of intuitive eating in the context of a chronic disease, type 2 diabetes.
When someone has type 2 diabetes, the traditional approach would basically suggest that they control the sources of carbohydrates (sugars) in their diet, as they can influence their blood sugar levels (amount of sugar in the blood).
For its part, intuitive eating would suggest that it takes nutritional advice into consideration while making sure not to demonize the sources of carbohydrates in order to maintain a positive relationship with food. The person would learn to integrate the sources of carbohydrates according to nutritional advice and their blood sugar, but also to adapt their diet to their desires. She would trust her body to guide her through its various signals, such as hunger, satiation and even the physical impacts perceived during blood sugar imbalances (eg tremors). She will implement the changes that are realistic for her in a flexible way, which may be compatible with good long-term blood sugar management. On this subject, an observational study has also found an association between a more intuitive diet and better blood sugar control (3). It’s promising!
Finally, intuitive eating makes it possible to have a more global and flexible vision of food and health. For many, it is therefore more realistic to maintain over the long term and helps maintain a positive relationship with food.
References:
  1. Tribole E. & Resch E. 10 Principles of Intuitive Eating. Intuitive Eating. https://www.intuitiveeating.org 
  2. Tribole E. & Resch E. (2017). The Intuitive Eating Workbook: Ten Principles for Nourishing a Healthy Relationship with Food. New Harbinger Publications, Inc. 
  3. Soares FLP, Ramos MH, Gramelisch M, de Paula Pego Silva R, da Silva Batista J, Cattafesta M, Salaroli LB. Intuitive eating is associated with glycemic control in type 2 diabetes. Eat Weight Disorder. 2021 Mar;26(2):599-608. doi: 10.1007/s40519-020-00894-8. Epub 2020 Mar 30. PMID: 32232778. 
Maude Martinez, Nutritionist, Dt.P
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