Author: Jamie Lopez, MS, RDN, CDN
Is it possible to still eat what you enjoy with a serious medical condition?
Mindful eating is a food philosophy that helps you become more aware of your eating behaviors. Rooted in the Buddhist practice of mindfulness, mindful eating teaches you how to cultivate self-awareness while eating and tune into your body’s cues of hunger and fullness to dictate what, when and how much you eat.
When practiced correctly, mindful eating can help you better engage with the eating experience – helping you better understand the relationship between food, mind, and body. Mindful eating can help you shed your negative thoughts and stigmas surrounding certain foods and learn to enjoy, not dread mealtime.
But is it truly possible to eat what you want, when you want, while also managing a serious medical condition?
The role of nutrition in treating chronic conditions
According to the CDC, chronic medical conditions are defined as “conditions that last 1 year or more and require ongoing medical attention.”  Chronic medical conditions such as heart disease, diabetes, and cancer are common causes of death and disability in the United States. Thanks to the advancement of modern medicine we now have medications and treatments that make certain chronic conditions manageable and maintain quality of life.
Nutrition plays a significant role in managing chronic medical conditions. The foods we eat on a daily basis contain nutrients that are necessary for proper body functioning. The primary nutrients that provide energy to the body, as known as macronutrients, include carbohydrates, fats, and protein. The body needs relatively large amounts of these nutrients daily. Carbohydrates are primarily used for energy production, promote proper digestion, and provide a variety of B vitamins that function as energy boosters. Fats provide protection to cell walls, produce hormones, maintain body temperature, and help absorb fat-soluble vitamins. Protein works alongside fat and carbohydrates to provide the body the building blocks it needs to function properly, such as building, repairing, and maintaining body tissues.
There are nearly 30 different kinds of micronutrients and each has a unique function ranging from regulating the immune system to antioxidant production that protects cells against oxidative damage. Vitamins and minerals are most commonly found in plant-based foods - like fruits and vegetables, which help reduce the risk of disease development.
Combining mindfulness with nutrition knowledge
Mindfulness helps people reflect on their direct experiences to assess how they feel and what they need. Many of our eating experiences are driven by unconscious thoughts that, for the average person, have been repeated for years and rarely questioned.
The practice of mindfulness can help individuals become aware of their behaviors and utilize this knowledge to make conscious food choices that align with their needs and values. For example, paying attention to our body sensations and cravings can help us determine what food sounds tasty when would be a good time to eat and how much of it to consume that feels good to the body.
The most common nutrition advice my clients hear from their doctors is to eliminate foods, often foods they love such as bread, pasta, and potatoes. While well-intended, this advice overlooks the complexities of our bodies and completely ignores personal food preferences. If health problems could be simply solved by eating one thing or restricting a certain nutrient, we wouldn’t need doctors and health screenings.
In my experience, this only feeds into the preconceived fears clients already have about certain foods.
In my 6 years as a Dietitian for God’s Love We Deliver, an NYC nutrition non-profit, I provided nutrition counseling to clients living with chronic medical conditions such as kidney failure, cancer, and HIV. Many of these clients had certain stigmas about foods and lists of foods they strictly avoided, either because they were told by a doctor to avoid them or they read online they were unhealthy to consume. It was my responsibility to educate them on the importance of balanced nutrition and try to rebuild some of these food trust issues they had with nutrients they swore off, often to their own self-detriment.
But just teaching people about nutrition science will rarely persuade people to change their eating behaviors. I’ve learned the hard way that what really motivates behavioral change is bringing awareness to the “why” behind what they eat. Most people don’t know where hunger comes from or how to identify its signals in the body. Practicing mindfulness can teach you how to combine your intuition with your external knowledge of nutrition so you can make conscious, informed food decisions.
What does the research say?
Jon Kabat-Zinn, Ph.D. who founded one of the most renowned mindfulness programs, researched how mindfulness can benefit patients with cardiovascular disease, cancer, chronic pain, and depression. His studies concluded that people who used mindfulness as part of their recovery regimen reported a decrease in stress levels and increased quality of life. 
More recent studies have also confirmed that mindfulness can improve health outcomes for people with diabetes. In a prospective controlled study published in the Journal of the Academy of Nutrition and Dietetics, researchers encouraged participants to combine their “inner wisdom” or mindful self-awareness around food with their “outer wisdom” or their outside knowledge about nutrition and diabetes.
During these sessions, one group practiced mindful eating and guided meditation to measure the effects it had on their blood pressure, stress levels, and other holistic health factors. The other participants in the control group received standard practice of intensive counseling on diabetes self-management, calorie counts, and exercise regimen. Both groups experienced improved glycemic control and there were no significant differences between the two groups health-wise, suggesting mindful eating techniques can complement or even provide a viable treatment option for people living with diabetes. 
How Can I Practice Mindfulness to Manage a Medical Condition?
Indeterminate of the severity, mindfulness can still be practiced while managing a chronic medical condition. Here are a few things you can do to incorporate mindfulness into your recovery process.
Learn About your Diagnosis
Practicing mindfulness towards your body means learning how you take care of it and paying attention to your body’s specific needs. Read books and publications written by medical professionals regarding your specific diagnosis. The more you understand how your body is currently functioning, the better you will be at making conscious food decisions that align with your needs.
Disassociate from Dieting
Diets and restrictive food rules lead to distorted thoughts about food and can exacerbate medical conditions. Diets have been shown to increase stress levels and cause weight cycling which has been linked to chronic inflammation. Pursuing weight loss dieting also increases the risk of muscle loss, food, and body obsession, disordered eating behaviors, or developing a diagnosable eating disorder. Strictly following external food rules disconnects you from your internal wisdom or mindful self-awareness.
Start observing your thoughts and behavior around food. Learn to identify early hunger cues and bring your attention to the food on your plate. Tap into your senses as you take each bite and notice fullness arises. It’s possible certain medications or medical conditions can make it difficult to tune into hunger and fullness. If that’s the case for you, practice scheduling meals every 3-4 hours.
Find your Balance
Regardless of your health status, consuming a balance of nutrients is still essential to maintaining proper body function. People with diabetes still need to eat carbohydrate foods, just as people living with heart disease still need to consume fat and salt in their diets. Managing your medical condition is learning how to balance these essential nutrients, rather than complete elimination. Those with diabetes can be mindful of their carb intake because they know their bodies digest sugar differently than those without diabetes. And people who have heart disease can be mindful of their salt intake because they know their body is more sensitive to salt than others.
Instead of focusing on what you can’t have, focus on how to incorporate more variety of foods onto your plate. Maintaining routine blood work as recommended by your doctor can help you ensure you’re balancing your food intake adequately. Working with a dietitian can also help empower you to make balanced meals a part of your daily life.
If you are a TCME member, you can access all these resources as part of your membership.
About the Author
Jamie Lopez is an NYC/NJ-based registered dietitian nutritionist and nutrition therapist passionate about food, science, and mental health. Jamie blends mindful eating with a non-diet, weight-inclusive approach into her virtual private practice. Her Mindful Meal Planning membership program offers one-on-on meal planning support and weekly mindful eating skill-building exercises for those healing their relationship with food and seeking personalized care to break out of the diet cycle. Jamie received her Master of Science degree in Nutrition and Food Studies at New York University. You can follow Jamie on Instagram - @jamielop_rd.
1. Centers for Disease Control and Prevention. (2021, April 28). About chronic diseases. Centers for Disease Control and Prevention. Retrieved January 17, 2022, from https://www.cdc.gov/chronicdisease/about/index.htm
2. Praissman S. Mindfulness-based stress reduction: a literature review and clinician’s guide. J Am Acad Nurse Pract. 2008;20(4):212-216.
3. Miller CK, Kristeller JL, Headings A, Nagaraja H, Miser WF. Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study. J Acad Nutr Diet. 2012;112(11):1835-1842.