Traffic Light Diet

Hi everyone, I wanted to begin by introducing myself. My name is Amanda Brown and I have completed my practicum experience through a research study on the Traffic Light Diet. It was through the UNC research department and was fully virtual. There were many reasons I was drawn to this experience. One being that from a very young age, I have always been interested in health, food, and body image. As a result, I hope to one day counsel patients on nutrition issues and healthy eating habits. This may mean helping individuals recover from eating disorders through weight gain, or helping individuals who are obese lose weight

To begin, I want to give a quick introduction on the Traffic Light Diet. The diet divides foods by the colors of  a traffic signal. Red foods are high calorie foods that should be eaten rarely or “stopped”. Some red food examples include desserts, cereals, granola bars, full fat cheeses, regular fat yogurts, coffee, energy drinks, and alcohol. The yellow foods are moderate calorie foods that can be eaten occasionally as they have some important nutrients, and the goal is to limit or “slow” the yellow food intake. Some yellow food and drink examples include diet sodas, bread, protein bars, pasta, white rice, low fat cheese, beef, eggs, lunch meat, and turkey bacon. And lastly, green foods are low-calorie foods that have important nutrients and can be eaten freely, and the goal is to “go” or increase green foods. Some green food examples include vegetables, fruits, chicken breast, egg whites, tofu, turkey, fish, and beans. The Traffic light diet has been used widely to encourage healthy eating habits among (Traffic Light Diet, 2012). The diet is full of nutrients like vitamins, fiber, and protein, and low in less healthy foods like added sugar and unhealthy fats (Traffic Light Diet, 2012). To be eligible for Julianne's study, participants need to be 18-35 years of age, have a body mass index (BMI) between 25 and 50 kg/m2, be english speaking and writing, and own a bathroom scale or are willing to purchase one. Participants in the study are provided with a daily dietary goal that is personalized to their weight. They are given access to the study website and are taught how to use it to stay on track with their diet. And lastly, they have weekly lessons that focus on different areas of diet or eating behavior.

Day to Day Basis

On a daily basis I track my food intake on the Traffic Light Log to make sure that it's running the way my supervisor wants it to and that there's no inconsistencies. I read articles to learn more about the importance of eating green foods instead of red foods, and how it can help with satiety and satisfaction. In addition, I have read through the consent forms, eligibility questionnaires, and dietary recalls. I have basically been experimenting with all the sources participants will be using once being admitted to the study. Since the research has been delayed, I won’t be able to recruit participants as I was expecting so I have mostly just been working behind the scenes. As a result, I really have only come into contact with my supervisor as well as another person who is interning with me.

Public Health Terms

Cultural Humility

Through my practicum experience I have learned about cultural humility, social ecological model, evidence- based public health, and public health ethics. To begin I want to start by explaining cultural humility. It gives us a greater understanding of cultures different from our own and helps us to recognize each person’s unique experience. Part of cultural humility is being able to self critique, reflect, recognize, and accept the biases and assumptions. As seen in the study, obese people are blamed for their weight, with the common perceptions that weight stigmitization is justifiable and may motivate individuals to adopt and practice healthier eating behaviors. Without even getting to know these people, obese people are placed into categories and harmful based stereotypes such as lazy, weak-willed, unsuccessful, unintelligent, lack self-discipline, have poor willpower, and are noncompliant with weight loss treatment. These stereotypes lead to stigma, prejudice, and discrimination in mutiple areas of life including the workplace, health care fascilities, educational instiutions, mass media, and close relationships. I've learned through my practicum experience that people need to accept these biases instead of blaming or categorizing obese people based on these stereotypes.

Social Ecological Model

This model explains the complex interplay between individuals and their affiliations to relationships, community, and societal factors. The intrapersonal or individual factors that could lead to obesity include body-weight genes, prenatal and early development, poor diets, and little physical activity. These are characteristics of the individual such as knowledge, attitudes, behavior, self-concept, and developmental history that contribute to obesity and desire to participate in the weight loss diet. 

Second, the microsystem refers to face-to-face influences in specific settings, such as interactions within one’s immediate family, informal social networks, or work groups. Social relationships provide emotional support, information, access to new social contacts and social roles, and aid in assisting in fulfilling obligations and responsibilities to lose weight. Support systems can either help or hinder weight loss goals.

The Mesosystem are institutional factors such as the surrounding environment that can contribute to the development of obesity. This could be a job that encourages more sedentary behavior such as a desk job or one that encourages fast food eating because lunch breaks are short. These organizations provide important economic and social resources as well as the opportunity to create healthier environments and healthier employees.

The Exosystem is the relationships among organizations, institutions, and informal networks within a defined region that is an important contributor to obesity. Once individuals are twenty six years old, they are required to move out of their parents health insurance which takes away access to obesity related services. These include obesity screening and counseling with no cost-sharing

Lastly, the macrosystem are cultural attitudes such as stigmas and negative beliefs. As mentioned before, stigma and discromination towards obese people are pervasive and pose numerous consequences for their psychological and physical health. This can have a detrimental affect on obese individuals and those looking to lose weight.

Evidence Based Public Health

Evidence-based public health is an integration of science-based interventions with the goal of improving population health. This includes certain interventions that target obese individuals that are backed up by scientific evidence. This research on the Traffic Light Diet is backed up by scientific evidence that green foods improve satiety and ultimately lead to weight loss. Adding fruits and vegetables to the diet while maintaining the fat content is associated with a decrease in spontaneous energy intake leading to weight loss.

Ethics

There are certain ethical standards that accompany all research studies. Research ethics are the moral principles that govern how researchers should carry out their work. Some of the ethics include following informed-consent rules, respecting confidentiality and privacy, and debriefing participants. Fidelity is central to the organization’s ethical standards. As stated in the article, fidelity involves loyalty, faithfulness, and honoring commitments. For participants in the study, they have to follow a diet plan in order to help them lose weight. It's up to the individual to stay on track with the diet. In addition, participants are randomly assigned to the control group and experimental group, and have to be okay with either group. Clients need to have faith that the diet plan they are assigned will lead to weight loss. In addition, researchers need to have trust that the participants will follow through and commit to the diet plan

Challenges

I felt nervous to begin this practicum because sometimes it can be hard for me to separate my goals around eating with others, especially when it comes to weight loss. In the past, I have struggled with my own eating issues and was afraid I was going to be triggered by weight loss. Another thing that was challenging for me was understanding how a diet can be maintained long term. My assumptions and stereotypes about diets are that they cannot be maintained long term. Since I dieted a lot when I was younger, it led to my elimination of entire food groups, which is restrictive, making it hard to sustain. My history with eating has led to my biases surrounding weight loss and diets, but I went into this practicum with an open mind and was able to learn how this specific diet has the potential to be maintained long term. I learned that interventions which advise an increase in fruit and vegetable consumption (i.e. green foods) along with a reduction in dietary fat (i.e. red foods) show that even when there is no emphasis on body weight, some people spontaneously lose weight and most maintain their weight loss. It is possible that by having few limitations on intakes of fruits and vegetables, it enhances satiety and may help people to avoid feelings of deprivation and hunger. Even in the challenging moments I was still able to persevere and learn about myself.

Another challenge was whenI felt stuck between acting as a participant and working towards the goals, while also keeping in check with what is best for me. There is part of my brain telling me to continue with my recovery and all the work I have made, but there is another part of me that is constantly hearing diet information during this practicum experience. Logically I know that diet culture has a way of making people feel bad for anything and everything we choose to eat and ultimately, it's how many eating disorders begin. I constantly had to remind myself that I do not need to lose weight but am just making sure the Traffic Light Log is running smoothly. 

Proud

Although it was hard for me at moments, I am proud to have been a part of this research because I was able to learn a lot about myself. I realized that I would love to go into the dietetics field and help people form healthier relationships with their body and eating habits. This may mean helping people who are struggling with eating disorders or their body image. Through this experience, I was able to rule out that helping people lose weight may not be the best career for me, but there are still a lot of people I can help as a dietitian to not only lose weight but eat healthier. I also hope that once I am fully recovered from my eating issues, I will be better at listening to my hunger and not comparing myself to others' eating behaviors, and so in the future, I may be able to help people lose weight. I will be better able to recognize that for some people, weight loss is necessary, while others weight gain is necessary. In a way, I want to create a goal for myself to help people form better relationships with their food and body. It will be interesting to see how far I have come in my recovery and will be a good check in point for me.  

Lessons Learned

Something I have learned through this process is that I don’t need to compare myself to others because I am not them. Instead, I need to accept myself for who I am, knowing that I have strengths and weaknesses. While weight loss may not be right for me, it may be the best for others, and I have to be open to that.

Goals

In regards to the academic knowledge goals, skill development goals, and personal development goals, I was able to accomplish them for the most part. One of my academic goals was that I wanted to learn more about the science behind how a diet plan can lead to weight loss goals. I learned how the body breaks down food and transforms it into fuel, and the different processes that come into play once we take a bit of food. I accomplished this by reading scientific articles each week to build my knowledge on the subject.

A skill development goal that I am still working on is improving my relationship surrounding food and not feeling guilty, anxious, or disappointed after eating. Throughout my practicum, I kept a journal with all the disordered thoughts that came into my mind so I could practice challenging the thoughts. In addition, logging the foods I eat on the Food Tracker helped me to hold myself accountable and feel less guilty about eating certain foods.

A personal development goal that I have accomplished is improving negative attitudes and perceptions around weight loss diets. I tried putting myself in particip[ants shoes to understand why weight loss may be helpful for them, but not for me. I also read more about the benefits of weight loss for overweight individuals in the assigned readings my supervisor sent to me.

The goals I made at the beginning of my practicum was a nice way to look back on my experience and check in with myself on how I did.