One-Bite-at-a-Time Diet Makeovers

Jo Piazza is a party girl, and anyone who reads her New York Daily News gossip column knows it. In Full Disclosure, she dishes about the boldfaced names that make up Manhattan's nightlife, which means she has to go out—a lot, as in two to three evenings a week, working the red carpet circuit of movie premieres, TV show launches, and fashion galas. Dinner often comes in a wineglass with whatever finger foods float by.

Jo was the first subject in O's "mindful eating makeover" experiment. The idea: Take four women—a glamorous, out-on-the-town city girl  in her 20s; a new mother (once an adventurous cook, now an aficionado of cheese puffs and kiddie waffles) in her 30s; a 40-something fast food lover with a busy job at a brokerage house and a desire to lose weight; and an entrepreneur in her early 50s  whose diet is admirably healthy other than a penchant for snacking—and see if food behavior expert Brian Wansink, PhD, could gently get them to improve their eating habits.

Wansink is the John S. Dyson professor of marketing at Cornell University and author of Mindless Eating: Why We Eat More Than We Think. He is also a nontraditionalist when it comes to diet. Through ongoing research at his Food and Brand Lab, he's found that a number of surprising factors, having more to do with perception than taste, influence our decision to take a bite (or sip): Fancy wine labels, for instance, entice us to drink more, big plates make us eat more, and exotic descriptions on menus coax us to order dessert. Based on such information, Wansink has developed a series of simple tricks to help people change unhealthy eating patterns. The U.S. Department of Agriculture, impressed by his unique approach to food, appointed him executive director of its Center for Nutrition Policy and Promotion (CNPP). Now he's overseeing the 2010 Dietary Guidelines for Americans and new additions to MyPyramid, an interactive nutrition program. For our makeovers, O asked Wansink to share his insights into which cues might be prompting our subjects to eat poorly and to recommend the kinds of switches that could encourage behavioral shifts.

After agreeing to participate, each woman opened her door to the food makeover team—Wansink, Jackie Haven (a registered dietitian and director of nutrition marketing and communications at the CNPP), and me, a fly on the wall with a tape recorder. Wansink would start our visits by explaining, "There are five major diet danger zones: meal stuffing, snack grazing, party bingeing, restaurant indulging, and desk or dashboard dining." The subjects would nod in recognition. "Make three small changes in a problem area," he promised, "and you'll jump-start the rest of your life without even knowing it." All four of our volunteers were eager to try.

The night starts at 9 p.m. We stand on the red carpet at the trendy Bowery Hotel near Manhattan's East Village, where Bravo and the CW Network are hosting a party to showcase their new season's shows. Thin and deeply tan from a recent vacation, Jo is wearing a black satin miniskirt, a skintight blouse, and white patent leather heels. For the next hour and a half, she interviews a series of television actors outside the hotel. She has eaten nothing since 2 p.m., when she had a baked potato with cheese, sour cream, and bacon bits. Women are moving from foot to foot to relieve the tension on their heels.

When we finally get inside, every corner is filled with celebrities from popular shows including Gossip Girl and The Real Housewives of New York City. But there's hardly any food. A waiter offers us cucumber slices topped with a tab of Tuscan bean, a tiny mushroom cap, a kiss of goat cheese, and a chive or two, each less than the size of a thumbnail. Jo grabs an asparagus wrapped in prosciutto off another hors d'oeuvre tray. "I like it for the prosciutto," she says, reminding me that she hates vegetables. Over the next hour, she has two glasses of red wine, a couple of cigarettes, and two more appetizers. "What will I eat when I get home?" she wonders aloud. "Feta cheese? That's all I have in the fridge. You know, I often forget to eat."

Back at Jo's West Village apartment, Wansink and Haven open her refrigerator and find—Jo was right—a lone package of Feta, along with one Greek yogurt and a child-size serving of applesauce. Wansink snaps a picture on his iPhone. The kitchen is so bare it looks like the place is for rent. Jo admits she never eats at home, except for her daily breakfast of yogurt and honey. She also says she tends to order steak and skip the veggies when she goes out; she's a meat and cheese kind of gal, and she'll eat bread only if it's served with olive oil. (Wansink tells her that, although olive oil is healthy, people take in more calories from it than butter when it's on the table.) She adds that many days she'll go from 2 p.m. until 11 p.m. without a bite to eat; only then will she snag a few appetizers at an event or, if she's "really cranky," a slice of pizza for dinner on her way home. Jo is worried that her eating habits might have something to do with her energy level, which she admits is low for a 27-year-old.

Wansink's advice: Jo's irregular eating is the first thing Wansink addresses; she needs a steadier supply of healthy calories to keep up her stamina. And he wants those calories to be mostly from fresh produce. He encourages Jo to buy a tray of precut vegetables, suggesting the platters most supermarkets sell. "It can have dip or salsa in the middle. I know you love your sauces. Just pop open that container and eat some dip by using vegetables. Also stock your fridge with precut cheese cubes." Why does Wansink think Jo will change her anti-vegetable ways? Because his research found that people who store precut vegetables on the middle shelf of the refrigerator eat 230 percent more than those who leave the produce in the crisper. Similarly, he wants Jo to keep other nutritious snacks—mixed nuts, whole wheat crackers—visible, and eat a little something before going out. He also suggests repacking the vegetable platter and taking it to work. Finally, Wansink wants Jo to trick herself into reducing alcohol. "In my studies, we found that bartenders pour 28 percent less into tall, skinny glasses than short ones. And diners pour 14 percent less into white wine glasses than red wine glasses because they're taller, so they appear to contain more wine." Therefore, he advises Jo to "always choose the tallest, skinniest glass, and white, rather than red, wine."

Two weeks later: Jo reports she has found it easy to follow the glassware instructions when she could choose. "But the thing that worked best was buying a plate of cubed cheeses and vegetables and snacking on them when I come home to change clothes—or putting them in Tupperware and bringing them to work," she says. "Now I'm eating celery, carrots, cauliflower, and Jack cheese." Acknowledging that she feels better and more energetic during the day, she finds herself less likely to grab an unhealthy pick-me-up when the party ends.

Dinners chez Diana were once the kind of affairs that made other women nervous about extending reciprocal invitations. Although she's an attorney for the criminal tax division of the U.S. Justice Department, currently on maternity leave, her real passion has always been cooking. Hawaiian raw fish salad? Portuguese fish stew? Diana's friends all wondered how she did it. But she stopped playing chef two and a half years ago when she gave birth to her son, Ezra. And now there's Naomi, 3 months old. Although Diana looks fantastic, she's put on 10 pounds of postbaby weight.

"I'm home, so I'm eating," she explains to Wansink and Haven in the dining room of her Washington, D.C., home. "I sit on the couch half the day feeding Naomi, the hunger sets in, and the only things within reach are Ezra's Cheez-Its or popcorn." Ezra's dietary habits have sharply influenced Diana's. Because he's a "terrible eater," she is always trying to coax a little more food into him, serving larger portions than he'll finish. "He eats five out of six peanut butter crackers, and I'll eat the last. It's the same with chicken nuggets. And frozen waffles..." At the end of the day, she has dinner with her husband. And then afterward she consumes—by her estimate—an additional 1,000 calories. She shows us a "snack basket" full of cookies, chocolate-covered blueberries, biscotti. "As soon as Naomi starts to cry, I gather food to take to the couch—popcorn or chocolate or whatever I can grab," she says. "It's so rattling to hear her cry that I actually feed myself. It comforts me."

"Is it frustration?" Wansink asks. Diana nods. Boredom, too. Wansink wants to know about her protein intake at lunch and breakfast. Zilch. As for which foods she can't stop eating—no surprise: chocolate. 

Wansink's advice: Breastfeeding burns 300 to 500 calories a day, Haven reminds Diana, so she shouldn't diet right now. She needs the calories. Wansink agrees with Diana that, beyond the nursing, her constant hunger has to do with comfort and convenience. So his first recommendation is about the snack basket—not to dismantle it, which he thinks will lead to backsliding, but to swap its contents. In his lab, Wansink found that office workers who put a bowl of carrots on their desk ate 35 percent more per day than those who placed them 6 feet away. So, as with Jo, Wansink asks Diana to buy cut-up radishes, carrots, fruit, and cubed cheeses to fill the basket. The chocolate needs to go, he says: "Put it on a high shelf. As with carrots, 6 feet of distance cuts down chocolate consumption—by more than 50 percent." Wansink's research also found that when people stockpile a snack food, in the first week they consume it almost twice as fast as when they keep a smaller amount around. Next, he wants Diana to start incorporating protein—tuna, peanut butter, hummus, low-fat deli meat—into her breakfasts and lunches. ("Women are comforted by eating chocolate, ice cream, chips—but 15 minutes later, they feel guilty; they can get nearly the same comfort and feel less guilty if they eat a protein-based meal," he tells her, citing yet another of his studies.) Last, he suggests mint gum to help her stop picking off Ezra's plate. "It has a suppressing impact on smell-induced craving. We learned that from chefs who have problems snacking in the kitchen—they taste less if they chew gum while they work."

Two weeks later: The prepackaged mini-carrots in the snack basket seem to be working. "Partly it's about having something to munch on," Diana says. "The carrots are good for that because they take a long time to eat. I'm even buying cut-up apples." And the gum seems to be helping too. Protein is making its way into her lunch, although less so into her breakfast: "I'm a cereal person," she says. "But the other day at 4 p.m., instead of crackers, I made myself a scrambled egg." While Diana wants to lose the extra 10 pounds she's carrying, she knows she can't seriously diet until Naomi is weaned. "Most of all this has made me more aware," she says. "It was cathartic just talking. I realized, 'Wow, I'm eating a lot of chocolate!'"

After a healthy breakfast—Cheerios with 2 percent milk and a banana—Denise's eating habits go rapidly downhill. Vivacious and sunny, she bounces around her apartment as she details her food routine, telling the team that she knows she's overweight. Every day Denise drinks a gallon of Turkey Hill green tea. At 70 calories per serving, that's a lot of calories—1,120, to be precise. Like Jo, Denise doesn't cook. McDonald's, Subway, and Chinese takeout are regular stops on her way home from work at a Washington, D.C., brokerage firm where she works in customer relations, or from the Children's National Medical Center where she volunteers. "I adore Red Lobster. I get the Ultimate Feast, and everything is fried," she admits—the scallops, crab legs, lobster tail. "I have a baked potato with sour cream, butter, and chives. And I'll eat half a basket of biscuits. I also love Outback Steakhouse." Wansink asks if she likes their Bloomin' Onion—a massive fried onion cut like a flower—and Denise squeals, "That's my favorite appetizer!" He tells her it's 2,310 calories.

As the team anxiously starts to calculate Denise's caloric intake (oh, and about once a week she'll finish off an entire pint of Ben & Jerry's Chunky Monkey), she proudly brings out a box of frozen Eating Right Shrimp Linguine. Reading that it's 320 calories, Wansink perks up. Denise did lose 25 pounds on Weight Watchers last year, and half the time she heats up ultra-low-cal meals or a can of Progresso soup for dinner. Wansink asks about exercise. Fairly limited. Yet Denise is filled with positive energy. She has a great relationship with her sons, both in their 20s. She quit smoking almost a decade ago, and she's been clean and sober for 18 years.

Wansink's advice: He starts with the easiest fix: her Turkey Hill green tea. Assuring her that she shouldn't feel bad for being unaware of how much sugar she's been consuming, he says, "People almost always estimate 60 percent fewer calories than a drink actually has." He suggests she cut down to no more than two caloric bottled drinks per day—such as her green tea or a sports mix; better yet, switch to water. Recommendation number two is what he calls a "food trade-off." Rather than telling Denise "never" to eat pizza or an Outback Bloomin' Onion again—it's too discouraging and easy to fail—he suggests that she'll be more successful making bargains with herself. If she wants takeout, she walks home from work (Wansink and Haven give her a pedometer and encourage her to aim for 10,000 steps a day). At a restaurant, she can order her favorite entrée, but should skip the bread and appetizer and finish only half the dessert. "That means she has the power to eat what she really wants," Wansink explains. His third trick: Stash all snacks at the office in a colleague's desk. The 6 feet of separation that applied to Diana and her chocolate (remember, people ate 50 percent less) is true for Denise as well.

Two weeks later: Denise is a star pupil. She hasn't had a sip of her beloved green tea since we left the apartment; she's switched to water. The Eating Right dinners and Progresso soup have increased, and she never replaced the snacks at the office. She's also vowed to begin walking after work for 30 minutes a few times a week. "I am more conscious now," Denise says. "If there are three cupcakes, I will eat one instead of the whole pack, and I haven't deprived myself." Even her last trip to Red Lobster was modified. She still ordered the Ultimate Feast but skipped the artichoke dip appetizer and the basket of biscuits.

With stylish, short hair and intense green eyes, Marianne answers the door of her Washington, D.C., home wearing all black, looking like she's stepped out of the pages of a fashion magazine.

For the past five years, Marianne tells us, she has practiced the Sugar Busters! diet (no white food—sugar, flour, rice, potatoes). The only carbohydrates she eats are whole grain. Two mornings a week she wakes at 6:30, has a cup of coffee, then joins a neighbor for an hour-long brisk walk; two other mornings she works out with a trainer. She always has protein for breakfast (a poached egg or cheese on whole wheat toast)—and again with a salad for lunch. So far, so good. Then at 2, or 4, or 6—or all three—Marianne, who runs a successful business strategy firm called Larkspur Marketing from home, starts picking from a bowl of nuts or fruit, sometimes both. Shortly after 8, she and her husband, a radiologist, eat dinner together—usually salad, protein (fish, chicken, or a lean red meat), and sometimes brown rice. But afterward, "if we sit around the kitchen talking," she says, "we'll start eating other things. Even though it's all healthy, we don't have to eat after dinner. I used to be more disciplined about that."

Wansink asks Marianne what her life was like before she adopted her regimen. Marianne laughs. "I have two children. One is turning 20 and one is 25. When I was pregnant with the first, I worked at an office and ate steak and cheese sandwiches every day from a greasy grill downstairs." She exercised only sporadically until her husband began to prod her, pointing out that her bones would suffer if she didn't get active.

Wansink's advice: Despite Marianne's healthy-sounding diet, Wansink and Haven are concerned that she's not getting enough calcium. "Yogurt with muesli might curb cravings that lead you to nuts," he offers. "Even a latte instead of coffee—with fat-free milk—would be good." Ideally, she would add a cup of low-fat milk daily, but rather than buying it by the gallon, Wansink suggests the eight-ounce-carton size. "On average, a person eats or drinks 92 percent of what they serve themselves," he says, quoting another of his studies. "So if she opens that container to have a sip, she'll drink most of it by the end of the day."

Second, although nuts are good for her, Marianne is consuming too many of them. "They are one of the most energy-dense foods there is," says Wansink. "Before you know it, you've eaten hundreds of calories." He suggests that, rather than buying a big bag that she pours into a bowl, Marianne choose smaller packages, or make her own 100-calorie pouches. Based on his findings, Wansink predicts that she could reduce her nut habit by up to 27 percent. Another strategy is what he calls the pistachio principle. Given the same number of nuts (walnuts, peanuts, pistachios), people eat 45 percent less when they have to remove the shell. Wansink's final recommendation is to close the kitchen at night. Shut off the lights. Move to a different room to chat. "In our preliminary research, people who come home from work and walk through the kitchen claim to be bigger snackers than those who don't," he explains.

Two weeks later: The nuts are almost eliminated from Marianne's diet, and the kitchen is now off-limits at night; she hasn't done nearly as well with calcium. "I really wanted to reduce the nuts and stop eating after dinner. Increasing the calcium isn't something I've latched on to," she says, noting that her bone density tests are normal. Still, she has added more milk to her coffee and tried the yogurt with granola. "Maybe I will work my way up to the calcium," she says. "I know I feel better psychologically. And I feel better going to sleep without eating throughout the evening. This was a really good mind-set change."

Sarah Wildman lives in Washington, D.C., and writes for The New York Times and The Guardian, among other publications.