A healthy relationship with a Twinkie

As you know, I am providing a book report of this ground-breaking book Health at Every Size. because of it's radical suggestion that we can trust our own bodies to reach a natural weight set point and never ever diet again.  We can do this by 1. learning to feed physical hunger with nourishing food; 2. enjoying the food, 3. sensing when no longer hungry and 4. stop eating. 

In this edition of the book report, I venture into one of the more controversial aspects of her book...examining what we eat and why we are eating it.  According to the author, this is the crux of the matter; the food we commonly eat is simply not that nourishing. Hence the title of Chapter Four  "We're eternally hungry"

The first three chapters were meant to provide enough evidence from the vast number of studies on weight loss to convince you that perpetual dieting won't work and actually makes it more difficult to keep weight off for the long term. In addition, exercising without a long term change in eating habits won't lead to permanent weight loss either. So, the question is, "If we can't diet then what should we be eating?"  The author points out that the human body has evolved to thrive on a hunter-gatherer type of diet (greens, grains, fruit, nuts seeds and some meat). Hunter gatherers did not have high fructose corn syrup, stabilizers and emulsifiers that are common ingredients in processed food. In addition because the hunter/gatherers that gained weight and kept it on were rewarded by staying alive, while the ones who lost weight quickly died off, we are genetically presupposed to maintaining our weight around a well-regulated setpoint. In short, for longterm weight loss, WHAT you eat is more important than HOW MUCH you eat.

The problem with processed food is the mixed signals that it sends our bodies. In the hunter/gatherer diet, the food provided sufficient calories, nutrients and roughage (fiber) such that the body's weight control monitors located in the stomach, liver, pancreas and brain would turn off the appetite when sufficient levels were reached.  With a processed diet, the body will have sufficient (often an overabundance of)  calories but little nutrients and in some cases no roughage at all. So while some aspects of the weight control monitoring system say ENOUGH, others are saying MORE, MORE and we will eat more.

Chapter Four provides some history for the high-fat/high-sugar, overly processed and animal-product rich standard American diet but cautions the reader not to make broad generalizations like "all meat is bad" In fact she writes.
                 I'll say it now and I'll be saying it again: Please do not use this information to create or justify self-punishing rules for demonizing food or restricting your intake. if you find yourself  doing that, stop reading this chapter....


The chapter goes on to describe the health issues associated with high-glycemic foods and the benefits of fiber (an apple is better than apple juice). Also presents studies detailing the benefits of whole grains vs refined. (brown rice is better than white rice). There's a section on high fructose corn syrup (HFCS) that states just how much of this sweetener Americans consume (estimated ins 2001 to be 62.6 pounds per person per year). The issue with HFCS is that although we eat a lot of it, the body's weight control monitors don't register it as nutritious, so we get the calories but not the signals that we've had enough. This is a common problem with artificial sweeteners also. In fact, one study with rats showed that artificial sweeteners could also induce our brains to crave more sweets. 

The link between food and brain is also implicated in fat. In animal studies that included more repeated and frequent exposure to fatty food, brain mechanisms reconfigured to crave more fat.  The type of fat used in these type of studies is saturated fat (found in animal products) or transfats (found in processed foods) and not unsaturated fats which is found in plants.

The health benefits of a diet rich in plant foods is in the section called "Protein..and the Meat Controversy."   The author is not suggesting that we all become vegetarians. However, she is urging us to consider protein as an accompaniment rather than the main attraction on the plate. A plant rich diet reduces the risk of heart disease in addition to aiding in weight loss.While a little bit of meat protein will help you have the "full" feeling longer after eating.

In the final two segments, a theme begins to develop around how to create healthy eating and that is to PAY ATTENTION to what you put in your mouth. The segment about Drinks points out the strong correlation between soft-drink consumption and heavier weight. This is especially true with children and adolescents. The author suggests that we not only read labels to know how much HFCA or artificial sweeteners are contained in the beverage but that we also pay attention to how it makes us feel after we drink it: sluggish or energized; hungry or still thirsty.

The segment is followed by one on Processed and Fast Food, even though the entire chapter has really been about comparing the health and weight benefits of less processed food in the diet. That message is merely summed up in this segment where the author concludes that the type of food we eat has an effect on the weight monitoring signals between gut and brain. In essence, the food that we eat, sends us signals and communicates that we need to eat or that we need to stop eating.  However we need to first hear the signals before deciding on how to answer it.

The chapter concludes with a few exercises in which the reader can learn about their eating habits: "How Do your Eating Habits Drive Your Setpoint?" "Check Your Diet for Fiber;" "Fat Consumption" and "Eating Activity Habits."

Before ending, I'd like to return to the idea of PAYING ATTENTION to what we eat.  In Sacred and Fit, one goal is to not only pay attention to what we are eating but to also consider why we are eating it. In order to become a unrestrained eater (one who listens to her body's hunger signals) a person has to be paying attention and in order to pay attention the person can't be in an ever rushing, crazy frenzy. Even in this chapter, Dr. Bacon urges us to create a healthy relationship with food. and to do that we must rid ourselves of the idea that some food is good and some is bad. One has to admit that processed food tastes good. The goal is moderation. Dr. Bacon uses an example of a Twinkie..

  If you maintain a neutral attitude you can watch your response to (a) Twinkie. You can be more perceptive to its flavor, noticing whether it really tastes good to you or if it was just the idea that tasted good. Perhaps you learn that it doesn't satisfy your craving-that there was something else you really wanted that the Twinkie can't provide. Perhaps you become more sensitive to your taste buds toning down after the first few bites, making the next bite less pleasurable. Or perhaps you notice that half an hour after indulging in that Twinkie your energy crashes and you start craving sugar again. This information will ultimately affect your taste for Twinkies in the future. (So) is eating that Twnkie good or bad? It all depends on how frequently you eat it, how much you eat, what else you eat it with, whether you were attentive to it....By staying connected to your body,some foods may lose their appeal or you may no longer feel driven to over-indulge.

The simple answer to loosing weight-

Dear Friends,
 In the last  two blog entries, I wrote about chapters One and Two of the book Health at Every Size.  This book by Linda Bacon is affirming some of the Sacred and Fit principles- So, before going on let's review

From the book

#1 Self-loathing is counter productive. LOVE YOURSELF, no matter your size;
#2 Change your eating habits as part of a LIFE STYLE CHANGE instead of a temporary vacation from your regular eating. Remember, you will not keep weight off by being on a diet

 Additional lists from S&F

#3 SLOW DOWN enough to notice what you eat, where you eat, when you eat and how you feel while you are eating.
#4 Drink more WATER
#5 Find the fun in MOVING your body.

 The first two chapters were really focused on the science of weight loss; the biology behind yo-yo dieting and the role of the brain and hormones, like leptin in weight loss and gain.  We learned about set-points. We found out that there are restrained eaters who eat because of external cues instead of listening to their bodies natural hunger and satiety (not hungry) signals. We learned that dieting can turn off your normal hunger and satiety signals. We learned also that overweight people tend to be restrained eaters and that fighting your body with sheer will-power is a losing proposition.

In chapter three, Dr. Bacon provides even more information on  why losing weight by restricting calories is so difficult. She discusses other possible influences, such as stress, sleep and genetics. She even provides evidence that environmental toxins like pesticides can influence the delicate microbial balance in our digestive systems. Finally, she ends the chapter summarizing studies that have  measured the effectiveness of weight loss medicines and weight loss surgery. The bottom line, you will lose weight, but it comes at a cost to your health...and even then, you may gain the weight back.

One can conclude from all of this that weight loss is complicated and difficult. So what's the answer....According to this book, the answer is fairly simple. So let me fast forward.


Feed physical hunger with nourishing food, 

Enjoy the food immensely,  

Sense when you are no longer hungry and then 

Stop eating.
 
I know that this seems simple but just "feeling physical hunger" is a challenge if your set point has been thrown off. Don't worry. The body is adaptable. Set points can be re-set with nourishing food. But what exactly is "nourishing?" More about that in Chapter Four.

HAES Ch2 What prompts you to eat

In chapter two of the book Health at Every Size Linda Bacon takes on the topic of WHY we eat. Her conclusion- Most of us don't eat because we feel hungry. Instead, we eat because...

• it's TIME to eat; 
• there is still food on the plate and people in Africa are starving; 
• there is just a little left in the bowl and it shouldn't go to waste
•  something bad happened 
• something good happened
• feelings of sadness, guilt, boredom, frustration, loneliness or anger

On page 32, Dr. Bacon makes this radical statement:
As you read in the first chapter, denying your hunger doesn't lead to weight loss or better health. And eating when you're hungry won't make you fat. In fact, the opposite is true: eating when you're hungry helps maintain your setpoint and keep you at the weight that's right for you and denying your hunger leads to compensatory mechanisms that trigger fat storage and weight gain. (Emphasis mine)

I know that for many of us this is going to be hard to accept. I know that it was for me. Before I started Sacred and Fit, I did not regularly follow my own body signals to eat or stop eating. For the most part, I would follow my thinking. My MIND is what led my eating. For instance, sometimes, I would skip breakfast then conclude that meant I could eat a larger lunch and dinner. I would see a commercial or see someone eating something good then I would want it. I ate ice cream when I was upset. Chips when I was bored. Chocolate when I was upset, bored, sad or happy.  It wasn't until I became much more conscious of my thinking that I began to realize that I hardly ever let myself feel hunger.

On page 34 Dr Bacon continues:
If you don't trust and respond to hunger, after a while the self-regulatory setpoint mechanisms that controls your fat stores breaks down. You weaken your innate ability to hear you hunger and fullness signals. When this happens, you start to gain weight. No ideas you (or anyone else) may have about how to maintain a healthy and appropriate weight can be as effective as listening to your body. Losing weight is not about finding the perfect proportions of carbohydrates, protein and fat or tricking yourself into feeling satisfied. Rather, maintaining the right weight for you is about respecting your hunger and trusting your body to guide you in doing what's best. And that's hard  if you're regularly eating for reasons other than hunger....(Emphasis mine)

In the end of the chapter there is a test to determine if you eat because of messages that come from your body or if you eat primarily from messages that come from your mind's interpretations of external stimuli.  When eating is driven by external cues that your mind is interpreting as a signal to eat, the term used in the research field is "restrained eater."  Those who follow their internal signals are "unrestrained eaters."

The short survey is 27 items. A few examples are:

• Without really trying, I naturally select the right types and amounts of food to be healthy
• I generally count calories before deciding if something is OK to eat
• One of my main reasons for exercising is to manage my weight
• I seldom eat unless I notice that I am physically hungry
• I am hopeful that I will someday find a new diet that will actually work for me
• The health and strength of my body is more important than how much I weigh

It is important to determine if you are a restrained eater or an unrestrained eater.  Particularly because if you are a restrained eater then the attempts to control your food intake through willpower is an attempt to fight your own mind with your own mind. On one hand your mind is interpreting signals to eat from external sources, commercials, billboards, bad day. GO! On the other hand you are telling yourself that you shouldn't or that's fattening NO GO! So, while ignoring the body's internal signals the mind of a restrained eater is constantly battling...eat or don't eat; eat a little or eat a lot; eat this or eat that. In our society it is virtually impossible to ignore external cues to eat so the battle is easily lost. Restrained eaters will eventually overeat.

We are getting closer to Chapter 9 where Dr. Bacon explains how to become an unrestrained eater, how to move your body because you love to do it and what to eat in order to find your natural set point but before that, we are on to Chapter 3, what keeps a restrained eater restrained.

HAES- Chapter One- The biology of set points

In the last posting, I introduced Chapter One of the book "Health at Every Size" by Linda Bacon. In Chapter One we learn about homeostasis and natural set points, the biological basis behind why it is so hard to lose weight and keep it off.  Dr. Bacon ends that section of Chapter One by describing a 1995 study published in the prestigious New England Journal of Medicine. The study was called Changes in energy expenditure resulting from altered body weight and was authored by Rudolph Leibel, Michael Rosenbaum and Jules Hirsch.  After Googling this citation, I found the study and read it myself.

I copied the abstract and it is at the end of this blog.

What is so interesting about this article is that it is not a fluke? Actually, there have been hundreds, HUNDREDS of studies that conclude the same thing. The bottom line- Because our bodies resist starving, a diet of fewer calories than usual will trigger the body to lower the metabolism, so as not to wander too far away from the setpoint range.  During periods of overeating when more calories than usual are obtained, the body does the opposite, revs itself up in order to burn the extra calories, again in an attempt not to wander too far from the natural set point weight. This study points out another caveat..that for overweight people, the lowering and reving up of metabolism doesn't work the same way as it does in people who had never been overweight. For overweight people who eat fewer calories, the body works even harder to lower metabolic activity and retain weight.

Don't think that the brain is not affected by this lowering of metabolic activity. In fact, the master switch for set points is the hypothalamus, located deep in the brain. Brain and body are  linked by hundreds of chemical messengers: hormones, peptides and neurotransmitters that circulate in the blood stream. Chemicals that trigger a lowering of metabolism are not limited to the hypothalamus, they also can affect emotional and motivational centers in the brain. There are at least 40 identified chemical messengers that influence these interconnected physical, mental and emotional neural circuits involved in eating and satiety.

The chapter includes a a brief discussion on two of those chemicals, leptin and ghrelin. Leptin is a chemical that signals the brain to release other chemicals that turn down the appetite, speed up metabolism and increase the desire to move. In one early study, fat mice injected with leptin lost 30% of their body weight. In another study, mice with a genetic mutation resulting in no leptin production were fat even when they are caged with normal size mice.  Another chemical, ghrelin works to increase appetite and is influenced by leptin and other gut horomones that are activated by the type and volume of food that you eat. At the same time your brain and body are getting the message to "eat" or "don't eat", there is also a response to the myriad of chemical messages associated with your emotions and generated by your sleep/wake cycle. What's more, the amount of chemical messages and the receptors that exists on target organs throughout the body is influenced by genetics. According to the "thrifty gene" theory, the humans that eventually evolved from the hunter/gatherers were NOT the ones that were likely to be thin. The humans that could resist weight lost had evolutionary advantage and we, apparently, descended from them.

The chapter ends with a set of questions related to your natural set point for weight. Some of the items are:

• Do you have difficulty recognizing when you are hungry or when you have had enough?
• Do you routinely eat beyond a comfortable level of fullness and then feel lethargic, stuffed and uncomfortabe after meals.
• Do you go through periods where you eat out of control in anticipation of soon going on a diet?
• Do you eat as a coping mechanism?
• Questions are continued.....

The author concludes that if you answer YES to any of the items  then you are likely to be above your natural setpoint. She then explains that her book will help you get to the natural set point that is the weight that is healthiest for you.

...By the end of the book, you'll be answering "yes" to these questions:

• Do you eat naturally in response to signals of hunger, fullness and appetite withou fixating on your weight or food habits?
• Is eating effortless and enjoyable?

  Soon your body will be guiding you in making nutritious, pleasureable choices.  No more counting calories, totaling fat grams or weighing broiled skinless chicken breasts!  pg 99

 I know you want to hurry up and get to the "What do I do" part of the book. But that is in Chapter 9 and my next blog will be on Chapter 2 where Dr. Bacon identifies the two major reasons for set-point change: 1) Eating for reasons OTHER THAN sensing hunger and 2) Eating foods that make us full but DON'T really nourish the body.

Want to know more? Buy the book or Stay tuned......


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N Engl J Med. 1995 Mar 9;332(10):621-8.

Abstract

BACKGROUND:

No current treatment for obesity reliably sustains weight loss, perhaps because compensatory metabolic processes resist the maintenance of the altered body weight. We examined the effects of experimental perturbations of body weight on energy expenditure to determine whether they lead to metabolic changes and whether obese subjects and those who have never been obese respond similarly.

METHODS:

We repeatedly measured 24-hour total energy expenditure, resting and nonresting energy expenditure, and the thermic effect of feeding in 18 obese subjects and 23 subjects who had never been obese. The subjects were studied at their usual body weight and after losing 10 to 20 percent of their body weight by underfeeding or gaining 10 percent by overfeeding.

RESULTS:

Maintenance of a body weight at a level 10 percent or more below the initial weight was associated with a mean (+/- SD) reduction in total energy expenditure of 6 +/- 3 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P < 0.001) and 8 +/- 5 kcal per kilogram per day in the obese subjects (P < 0.001). Resting energy expenditure and nonresting energy expenditure each decreased 3 to 4 kcal per kilogram of fat-free mass per day in both groups of subjects. Maintenance of body weight at a level 10 percent above the usual weight was associated with an increase in total energy expenditure of 9 +/- 7 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P < 0.001) and 8 +/- 4 kcal per kilogram per day in the obese subjects (P < 0.001). The thermic effect of feeding and nonresting energy expenditure increased by approximately 1 to 2 and 8 to 9 kcal per kilogram of fat-free mass per day, respectively, after weight gain. These changes in energy expenditure were not related to the degree of adiposity or the sex of the subjects.

CONCLUSIONS:

Maintenance of a reduced or elevated body weight is associated with compensatory changes in energy expenditure, which oppose the maintenance of a body weight that is different from the usual weight. These compensatory changes may account for the poor long-term efficacy of treatments for obesity.

Know your Body/ Love your Self

As promised, I am beginning a series of blogs on the book "Health at Every Size" (HAES). The principles that are promoted in the book are consistent with the Sacred and Fit philosophy- EVERY LIFE IS SACRED, set apart, consecrated, put here on earth as part of a larger plan and grander purpose.  EVERY BODY IS A TEMPLE provided with all that is necessary to fulfill the grander purpose. 

Of course, there are people who  experience disabilities or  illnesses while on this earth They also have a purpose to fulfill.  But,  for those of us fortunate enough to have a healthy body I believe, that taking care of it is  an important part of the spiritual journey.

 HAES does not speak of  spiritual qualities, per se, but the principles behind the HAES movement require a level of spiritual maturity.  After all, Jesus' teachings culminate in the admonition to love God and He stresses that loving God includes loving others as we love ourselves. It's the "love ourself" part that often gets overlooked.

If HAES was part of a "Love Your Self" course, the first assignment would be to "Understand the Body That You Have Right Now." 

In Chapter One, we learn about the biology and neurobiology of weight. To sum it up- Our bodies, operate with biological systems that were inherited from early humans. In the hunter/gatherer environment, it was necessary to hold on to extra calories obtained during feast time since famine time was sure to follow. The brain and body systems responsible for feeding developed mechanisms that were designed around a functional set-point range. So, when there was a lack food for a long period, the body's metabolism would slow as to conserve every ounce of body fat for survival.   Motivation and behavior would also be affected.

Set points are part of a natural process called homeostasis and are not unique to weight. There is a range of ambient temperatures that are optimum for humans. When it is too cold we start to shiver so that our bodies can go back up to that range. When it is too hot we sweat. Blood pressure, blood glucose levels, insulin and a host of other hormones and biomarkers have set point ranges. We don't consciously control these functions. Our bodies and brains know what to do.

It is because of this regulatory metabolic set point that the body resists loosing weight and seeks to hold on to weight.  It is because of the brain's hormonal communication network, that we are largely unaware of all that our bodies do to try maintain our natural set point. Natural set points change as we grow older but our behaviors and food choices can overide or even alter the natural setpoint.

You can identify your natural setpoint:
- The weight you will maintain when you listen and respond to your body's signals of hunger and fullness and eat or stop eating accordingly.
-The weight you maintain when you don't fixate on your weight or food habits.

You can identify an altered setpoint
-The weight you keep returning to between diets.

Next time: There is more to weight than diet and exercise: The roll of hormones and genetics.