Blog

CBM Blog

Human Instincts – Possible Causes of Obesity and Other Problems

According to Deirdre Barrett, a clinical professor of psychology at Harvard Medical School, our primal urges have contributed to creating the obesity epidemic, social isolation, poor risk-assessment tendencies and sex addiction. She discusses the link between our impulses and how it relates to living in the modern world.

CANWEST NEWS SERVICE

APRIL 4, 2010 12:02 PM

The evolutionary impulses that allowed our ancestors to survive on the Savannah are sabotaging us in the modern world, finds groundbreaking new research.

According to Deirdre Barrett, a clinical professor of psychology at Harvard Medical School, our lingering primal urges have helped give rise to the obesity epidemic, social isolation, poor risk-assessment tendencies and sex addiction, among countless other things. All because our biology hasn’t caught up to the way we live.

“We still have Stone-Age brains inside contemporarily clothed bodies,” says Barrett, author of the new book Supernormal Stimuli. “So we can’t really trust our instincts; we need to trust our intellects.”

The problem, of course, is that most of us don’t. And according to Barrett’s studies, it’s because we’re governed by the same knee-jerk behaviour as so-called “dumb animals.”

Just as a songbird has been shown to prefer fake eggs over its own real ones, simply because the phonies offer an exaggerated version of reality — brighter colours, embellished markings, larger in size — so, too, are humans duped by their own instincts.

“When we see animals trying to mate with a little cardboard cylinder just because it has the right stripes on the side, it looks really silly to us,” says Barrett. “But magazine pornography isn’t any less unrealistic a depiction of a real woman.”

Because most big genetic changes take 10,000 years or more to pass, she says humans are still coded to respond to their environment in very primitive ways. Once-scarce fat, salt and sugar, for instance, is still pursued today, to the point of excess, despite the fact it’s become widely available.

“Our genes haven’t had time to stop craving those things and start craving green, leafy vegetables, which were around us all the time on the Savannah and didn’t need to be prioritized,” says Barrett.

Our social instincts are as easily fooled — and again, to our detriment — by TV’s exaggerated versions of things we naturally seek out.

“We have very attractive actors smiling at us, and laugh tracks playing, and funny quips coming faster than they ever could in real life,” says Barrett. “All the things that are meant to pull us into a social interaction but, in fact, are pulling us toward a television set.”

Even our ability to detect threats is affected, with Barrett noting people are likelier to gasp at a horror movie or picture of a giant gorilla than news of global warming, which wasn’t an obvious danger to our ancestors.

Because evolution won’t ever catch up to our changing times, she says the best we can do is to recognize what’s happening and try to behave logically.

“We have the tools to handle this, with our superior intellect and brain power,” says Barrett. “The problem is that we act reflexively most of the time.”

Fighting the ‘Fatso Gene’ by Exercising for an Hour a Day

It is not news that exercise and eating healthy can help to combat obesity. Additonally, according to lead author Jonatan Ruiz of the Karolinska Institute in Sweden, in a new European Study, one hour of moderate to vigorous exercise a day can help teenagers beat the effects of a common obesity related gene. The study appears in the April edition of Archives of Pediatrics and Adolescent Medicine. According to another study’s lead author, Evadnie Rampersaud of the University of Miami, and co-author, Dr. Alan Shuldiner of the University of Maryland, who studied Amish adults said the new findings are “very interesting” because they suggest one hour daily spent exercising can be enough for teenagers at risk. University of Miami researchers now are studying adults in an employee wellness program to see what it takes for them to overcome the fatso gene, Rampersaud said.

By CARLA K. JOHNSON
The Associated Press
Monday, April 5, 2010; 4:33 PM

CHICAGO — One hour of moderate to vigorous exercise a day can help teens beat the effects of a common obesity-related gene with the nickname “fatso,” according to a new European study.

The message for adolescents is to get moving, said lead author Jonatan Ruiz of the Karolinska Institute in Sweden.

“Be active in your way,” Ruiz said. “Activities such as playing sports are just fine and enough.”

The study, released Monday, appears in the April edition of Archives of Pediatrics and Adolescent Medicine.

The research supports U.S. guidelines that tell children and teenagers to get an hour or more of physical activity daily, most of it aerobic activity such as running, jumping rope, swimming, dancing and bicycling.

Scientists are finding evidence that both lifestyle and genes cause obesity and they’re just learning how much diet and exercise can offset the inherited risk.

One gene involved with obesity, the FTO gene, packs on the pounds when it shows up in a variant form. Adults who carry two copies of the gene variant – about 1 in 6 people – weigh on average 7 pounds more than people who don’t.

In the new study, 752 teenagers, who had their blood tested for the gene variant, wore monitoring devices for a week during waking hours to measure their physical activity.

Exercising an hour or more daily made a big difference for the teens who were genetically predisposed to obesity. Their waist measurements, body mass index scores and body fat were the same, on average, as the other teenagers with regular genes.

But the teens with the gene variant had more body fat, bigger waists and higher BMI if they got less than an hour of exercise daily. The results were similar for boys and girls.

The teens lived in Greece, Germany, Belgium, France, Hungary, Italy, Sweden, Austria and Spain. The study was funded by the Spanish and Swedish governments and the European Union.

The new study found that most of the teenagers had at least one copy of the variant gene. Only 37 percent had regular genes. The rest had either one of two copies of the pesky fatso gene.

An earlier study in Amish adults in Lancaster County, Pa., found they needed three to four hours of moderate activity daily to beat the gene. The adults in that study did things like brisk walking, housecleaning and gardening.

The teens in the new study may have exercised more vigorously than the Amish adults, Ruiz said. The new analysis was designed to see whether the current U.S. guidelines – which specify a moderate to vigorous level of exercise for an hour a day – made a difference for kids.

The lead author of the Amish study, Evadnie Rampersaud of the University of Miami, said the new findings are “very interesting” because they suggest one hour daily spent exercising can be enough for teenagers at risk.

University of Miami researchers now are studying adults in an employee wellness program to see what it takes for them to overcome the fatso gene, Rampersaud said.

“The message is clear: genes are not destiny,” said Dr. Alan Shuldiner of the University of Maryland, a co-author of the Amish study. “Those with obesity susceptibility genes should be especially motivated to engage in a physically active lifestyle.”

Obesity in Infants Can Be Diagnosed at 6 Months

Should we take this leap? Should we make this diagnosis? Well this is the same question people have been asking for quite some time about a relevant and concerning issue. Some groundbreaking new research indicates that obesity can be diagnosed earlier than we have ever imagined.  This study was published by researchers at the University of Texas Medical Branch at Galveston in Pediatrics.  Dr. David McCormick, UTMB clinical professor of pediatrics and senior author of the study, stated that clinicians have not really been focusing on obesity in infants and the longstanding effects of it. This finding brings attention to the possibility of preventing obesity via earlier identification of the problem.

ScienceDaily (Apr. 7, 2010) — Obesity can be detected in infants as young as 6 months, according to a new study by researchers at the University of Texas Medical Branch at Galveston.

By analyzing the electronic medical records of babies seen for routine “well-child” visits to the UTMB pediatric clinic, the investigators found that about 16 percent of 6-month-olds fit the study’s criterion for obesity — a weight-for-length ratio that put them in the top 5 percent of all babies in their age group. (Weight for length was used instead of the conventional body mass index because BMI is based on weight and height as measured while standing, which neither 6-month-olds nor 24-month-olds can do well enough to measure.) Further analysis of the records indicated that obese 2-year-olds were much more likely to have been obese at 6 months than 2-year-olds who were not obese.

The obese babies’ medical records rarely showed that clinicians had addressed the issue at either 6-month or 24-month visits, despite a well-established connection between obesity at a young age and obesity later in life, which is linked to such serious health problems as diabetes, heart disease and high blood pressure.

“Until very recently, pediatricians really haven’t been focusing on obesity in babies,” said Dr. David McCormick, UTMB clinical professor of pediatrics and senior author of the study, “Infant Obesity: Are We Ready to Make this Diagnosis?” which is now online in the Journal of Pediatrics. “We’re just getting a handle on it descriptively right now. What we’re hoping to do is alert our colleagues and our parents. If we address weight management through nutrition and exercise as early in life as possible, it’s going to work a lot better.”

According to McCormick, pediatricians confronting infant obesity can recommend a number of measures that other research has shown are linked to healthy weight, measures that should be particularly effective because babies’ mothers have much more control over their diets than mothers of older children do.

“Studies have shown that exclusive breastfeeding — breastfeeding alone, not breastfeeding combined with bottle-feeding — prevents obesity,” McCormick said. “Getting enough fiber — eating apples instead of drinking apple juice, for example — also helps keep babies on track to a healthy weight. By contrast, improper early introduction of cereal by adding it to an infant’s bottle promotes obesity.”

McCormick observed that maternal data collected in his group’s investigation matched well with other studies of children and adolescents that showed higher odds of obesity among boys and girls whose mothers were already obese before becoming pregnant or who gained an excessive amount of weight during pregnancy. Such results, he said, added even more urgency to the need to deal with childhood weight issues effectively and address what could be a multigenerational cycle of obesity.

“We need to do a lot better as clinicians and educators at getting our community educated and working through the entire age spectrum, because babies who are overweight are more likely to be overweight children and adolescents, and then later, when obese women are ready to have a family, their babies are more likely to become obese,” McCormick said. “We need to deal with this through all ages and through pregnancy, because if a woman is already overweight when she becomes pregnant, it’s extremely difficult for her to do anything about her weight at that point.”

Almost 33% of Children in the World are Couch Potatoes

Americans are NOT the only ones who are couch potatoes! According to a study, published in The Journal of Pediatrics, of over 70,000 teens in 34 nations. Regina Guthold of the World Health Organization in Geneva and her colleagues commented on the amount of exercise children are getting worldwide.

Mon, Mar 29 2010

NEW YORK (Reuters Life!) – American children aren’t the only couch potatoes with nearly one third of children globally spending three hours a day or more watching TV or on computers, according to study of over 70,000 teens in 34 nations.

From Argentina to Zambia, Regina Guthold of the World Health Organization in Geneva and her colleagues found most children aren’t getting enough exercise and it made no difference if they lived in a rich or a poor country.

“With regards to physical activity levels, we did not find much of a difference between poor and rich countries,” Guthold told Reuters Health. “Growing up in a poor country does not necessarily mean that kids get more physical activity.”

The study, published in The Journal of Pediatrics, looking at 72,845 schoolchildren aged 13 to 15 from North and South America, Asia, Europe, and the Middle East. The children were surveyed between 2003 and 2007.

The researchers defined adequate physical activity as at least an hour of exercise outside of gym class at least five days a week.

Children who spent three or more hours a day watching TV, playing computer games, or chatting with friends — aside from time in school or time spent doing homework — were classified as sedentary.

The researchers found only one quarter of the boys and 15 percent of the girls were getting enough exercise by these definitions.

A quarter of boys and nearly 30 percent of girls were sedentary and didn’t get enough exercise with girls less active than boys in every country aside from Zambia.

Uruguay had the highest percentage of active boys, at 42 percent, while Zambia had the lowest, at 8 percent.

Girls from India were the most active, with 37 percent meeting exercise recommendations, while girls from Egypt were the least active, with just 4 percent getting adequate exercise.

Children in Myanmar were the least sedentary, with 13 percent of boys and 8 percent of girls classified as sedentary. The most sedentary nations were St. Lucia and the Cayman Islands, with 58 percent of boys and 64 percent of girls spending at least three hours a day in sedentary activities.

While the study didn’t look at the reasons behind the lack of physical activity in various nations, Guthold speculated that urbanization could be a factor as well as access to cars and TVs.

She said schools can help children become more active by having physical education classes and educating students about the importance of exercise.

Adding lanes for bicycles, pedestrian crossings and other changes to promote walking and biking to and from school could help too, she added.

“Even with the limitations that questionnaire data (suffer) from, I guess it’s pretty safe to say that we have a huge problem with physical inactivity among schoolchildren around the globe and that we should take action,” said Guthold.

Workplace Turmoil Might Increase Obesity

Does workplace stress contribute to obesity? A recent study published in the Journal of Occupational and Environmental Medicine in January of 2010, investigated the correlation between chronic job stress, lack of physical activity and obesity. Lead author Diana Fernandez, M.D., M.P.H., Ph.D., an epidemiologist at the URMC Department of Community and Preventive Medicine, said her study is among many that associate high job pressure with cardiovascular disease, metabolic syndrome, depression, exhaustion, anxiety and weight gain. When the prevalence of overweight and obesity are combined, 68 percent of adults fit the category, according to a recent report in the Journal of the American Medical Association, which makes this issue particularly important as obesity is affecting many people.

ScienceDaily (Mar. 25, 2010) — A new study that provides a snapshot of a typical American workplace observed that chronic job stress and lack of physical activity are strongly associated with being overweight or obese.

Unexpectedly, researchers also found that a diet rich in fruits and vegetables did little to offset the effect of chronic job stress on weight gain among the employees, who were mostly sedentary. Instead, exercise seemed to be the key to managing stress and keeping a healthy weight.

University of Rochester Medical Center researchers conducted the study of 2,782 employees at a large manufacturing facility in upstate New York, but the results could be applicable to almost any job situation in which layoffs, or lack of control at work, is a major concern.

The Journal of Occupational and Environmental Medicine published the research in January 2010.

Lead author Diana Fernandez, M.D., M.P.H., Ph.D., an epidemiologist at the URMC Department of Community and Preventive Medicine, said her study is among many that associate high job pressure with cardiovascular disease, metabolic syndrome, depression, exhaustion, anxiety and weight gain. It’s time to improve corporate policies that better protect the health of workers, she said.

“In a poor economy, companies should take care of the people who survive layoffs and end up staying in stressful jobs,” Fernandez said. “It is important to focus on strengthening wellness programs to provide good nutrition, ways to deal with job demands, and more opportunities for physical activity that are built into the regular workday without penalty.”

Over and over, Fernandez’s team heard the same story from the upstate workers: After spending the day sitting in stressful meetings or at their computers, they looked forward to going home and “vegging out” in front of the TV. Anecdotally, researchers also discovered that when pink slips were circulating, the snacks highest in fats and calories would disappear quickest from the vending machines. Some workers said they did not take the time to eat well or exercise at lunch because they were fearful of repercussions from leaving their desks for too long.

Approximately 32 percent of adult men and 35 percent of adult women are obese in this country. When the prevalence of overweight and obesity are combined, 68 percent of adults fit the category (72 percent prevalence among men; 64 percent among women), according to a recent report in the Journal of the American Medical Association.

The upstate New York workplace mirrored the national statistics. Researchers collected baseline data from the nearly 2,800 employees, using body mass index (BMI) as the measurement for weight status. Overweight/obesity was defined as BMI greater than 24.9, and healthy/underweight was defined as less than 24.9.

They found that 72 to 75 percent of the employees were overweight or obese. Most of the study volunteers were middle-aged, white, married, highly educated (college degree or more), relatively well-paid (earning more than $60,000 a year), with an average of almost 22 years at the company.

Another important statistic: More than 65 percent of the employees said they watched two or more hours of television per day. Among those who reported watching two to three hours, 77 percent were more likely to be overweight or obese, and those who watched four or more hours of TV a day increased their odds of obesity by 150 percent, compared to people who watched less than two hours of daily TV.

“We are not sure why TV is so closely associated with being overweight in our sample group of people,” Fernandez said. “Other studies have shown that adults tend to eat more fatty foods while watching TV. But this requires more investigation.”

The study dates back to 2005, amid growing concern of an obesity epidemic, when Fernandez was awarded a $3 million grant from the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health, to investigate ways to influence people’s dietary and physical activity at work. The company that agreed to participate was involved in drastic restructuring and layoffs. In interviews the employees confided to researchers that they were “stress eating” and burned out from “doing the work of five people,” researchers reported.

Stressful working conditions are known to impact health behaviors directly and indirectly. Directly, stress can affect the neuroendocrine system, resulting in abdominal fat, for example, or it may cause a decrease in sex hormones, which often leads to weight gain. Indirectly stress is linked to the consumptions of too many fatty or sugary foods and inactivity.

The research team measured psychosocial work conditions through a detailed job questionnaire. Interventions were planned and employees who worked at intervention worksites participated in a comprehensive, two-year nutrition and exercise program. This included walking routes at work, portion control in food, and stress-reduction workshops. The data comparing control groups and the groups who took part in the nutrition and exercise program is still being analyzed, Fernandez said.

However, while analyzing baseline data investigators discovered that employees working in the most high-job-strain conditions had almost one BMI unit more of weight than people who worked in more passive areas. Researchers did not find that chronic stressors (general dissatisfaction at work) and acute stressors (being a layoff survivor, or having entire operations decommissioned) together had a larger effect on weight than when examined independently.

Diet was evaluated solely by the number of servings of fruits and vegetables a day, and probably had no influence on weight status because assessing diet in this way might not be a good measurement of quality or quantity, Fernandez said. A better way to look at diet quality might be through an evaluation of the whole diet.

In conclusion, the study suggests that workplace wellness programs should not only offer ideas on how to be healthy, but should examine the organizational structure and provide ways to minimize a stressful environment for everyone.

Attitude Toward Everyday Activity Important for Healthy Lifestyle

We all know that physical activity is important to good health and well-being. The U.S. Department of Health and Human Services’ recommends 150 minutes of aerobic activity throughout the week. David Conroy, associate professor of kinesiology and human development and family studies, along with Shawna Doerksen, assistant professor of recreation, park and tourism management, Amanda Hyde, graduate student in kinesiology, and Nuno Ribeiro, graduate in recreation, park and tourism management, studied 200 college students to determine the relationship between physical activity and level of unintentional activity. Their results were published in the April issue of Annals of Behavioral Medicine.

ScienceDaily (Apr. 3, 2010) — Unintentional physical activity may be influenced by non-conscious attitudes, noted David Conroy, associate professor of kinesiology and human development and family studies. The challenge of encouraging more activity can be met by understanding the motivation behind both deliberate exercise and inherent behaviors.

“If you aren’t in the habit of being physically active, you can run out of energy trying to force yourself to do it everyday,” said Conroy. “But if you can make physical activity habitual, being active becomes a lot easier.”

Efforts to increase physical activity are at the forefront of public health research because the benefits of a healthy lifestyle go far beyond physical and mental well-being. However, the majority of these efforts focus on explicit motivation — external factors that lead to a change in behavior. Explicit motivation can include following the U.S. Department of Health and Human Services’ recommendation for 150 minutes of aerobic activity throughout the week, or making plans with a friend to start a weight-loss program.

But explicit motivational processes are often unsuccessful in causing changes that people can easily maintain long-term.

Conroy, along with Shawna Doerksen, assistant professor of recreation, park and tourism management; Amanda Hyde, graduate student in kinesiology; and Nuno Ribeiro, graduate in recreation, park and tourism management, examined 200 college students for a connection between physical activity and level of unintentional activity.

“It wasn’t the overall level of activity we focused on, it was specifically the unintentional activity — those little things that you don’t even think about that help you burn those extra few calories,” said Conroy.

Their results, published in the April issue of Annals of Behavioral Medicine, show a positive correlation between individuals who have a positive attitude about physical activity and those who performed more unintentional physical activity, such as climbing stairs instead of waiting for the elevator, or walking further to the store because of parking in the first available spot rather than searching for a closer space.

The researchers measured the students’ unexpressed attitudes towards exercise with a common psychological test that uses words or pictures to trigger a person’s automatic response. The computer-based test requires categorization of a stimulus, in this case a type of physical activity, with words that are either “good” or “bad.” The faster a person associates a pairing as either good or bad, the more strongly they connect those two things in their memory.

Conroy and Doerksen also used questionnaires to determine the amount of physical activity the students predicted they would get during the week. The amount varied, depending on how active students were in their social group or the outcomes they expected from physical activity.

The researchers fit each student with a pedometer to calculate the total activity he or she experienced during one week. The amount of unintentional activity is estimated by adjusting total activity scores to account for people’s intentions to be active.

“We’re trying to follow this up now by looking at a broader range of populations,” said Conroy. There are major differences in what motivates young adults, mid-life adults or parents, and older adults who may have physical limitations, he noted.

The researchers are now exploring whether there are ways to promote or encourage physical activity without a person knowing it.

Coming to the Menu: Calorie Counts

Making better decisions about eating may increase because of the new health bill President Barack Obama signed into law recently. It requires that restaurant chains post calorie counts for all the food items they sell. “Dining out no longer has to be a nutritional guessing game,” said Margo G. Wootan, director of nutrition policy with the Center for Science in the Public Interest, a nonprofit health-advocacy group based in Washington. Will this change actually affect consumers’ choices of foods? Well, the hope is that it will. Cathy Nonas, director of physical activity and nutrition for the health department in New York City, a pioneer in adopting menu labeling and Ron Shaich, co-founder and chief executive of Panera Bread Co. , believe that this type of action against obesity that can make a difference. Researchers from Tufts University looked at the validity and truth behind the number of calories that restaurants were reporting. Deborah Dowdell, president of the New Jersey Restaurant Association is against this posting of nutritional information and believes there are better ways to reduce the obesity epidemic. On the other hand, others have embraced and welcomed the new information, such as Andy Hayler, a U.K.-based food critic who writes about restaurants world-wide.

By JEAN SPENCER and SHIRLEY S. WANG

Wall Street Journal

3/24/10

Chowing down on calorie-laden food at chain restaurants is going to become more of a guilt trip.

The health bill President Barack Obama signed into law Tuesday requires that restaurant chains post calorie counts for all the food items they sell. The law covers any chain with at least 20 outlets, amounting to more than 200,000 restaurants nationwide.

“Dining out no longer has to be a nutritional guessing game,” said Margo G. Wootan, director of nutrition policy with the Center for Science in the Public Interest, a nonprofit health-advocacy group based in Washington. “People could cut hundreds, thousands, of calories from their diet.”

Calorie counts must be listed on menus, menu boards, drive-through displays and vending machines under the law. Additional information—such as sodium levels, carbohydrates and saturated fats—must be available on request. Temporary specials and custom orders are exempted.

A growing number of state, county and local regulations already require similar disclosures, and those rules will be superceded by the federal law.

There has been debate about whether such menu labeling actually affects consumers’ behavior. Some recent studies have found that such labeling leads to healthier eating: The New York City health department examined the behavior of 12,000 customers of 13 chain restaurants in 275 locations in the city before and after menu labeling was implemented in the city in 2008.

Preliminary results show that one in six fast-food customers report using the calorie-count information. Consumers who said they used the information bought items with 106 fewer calories compared with those who didn’t see or use the information.

Separate studies have shown weak or inconsistent effects of menu labeling on consumer behavior, according to a 2008 review of the literature published in the International Journal of Behavioral Nutrition and Physical Activity.

“Calorie posting in and of itself is not going to change obesity per se, but it’s all of these kinds of layering opportunities that we’re doing for public health all across the country that are going to make the difference,” said Cathy Nonas, director of physical activity and nutrition for the health department in New York City, a pioneer in adopting menu labeling.

The National Center for Health Statistics reported in January that 34% of Americans age 20 and older were obese in 2007-08.

The restaurant industry is required to come up with a labeling proposal in one year, but the bill leaves it to Food and Drug Administration officials to determine specific regulations, including the printing fonts and their sizes to be used in calorie displays. Ms. Wootan said it could take three to four years before diners see the new information in restaurants.

One concern about the rules is accuracy. Researchers from Tufts University who looked into caloric disclosure from 29 quick-serve and sit-down restaurants found that restaurants under-reported calories by an average of 18%.

Some restaurant owners and groups have supported labeling regulations, in part because they don’t think such disclosures deter patrons from ordering what they want.

“This isn’t telling them what to eat or playing nutritional police—it’s about making nutritional information available,” said Ron Shaich, co-founder and chief executive of Panera Bread Co., said in an interview. The company said two weeks ago it would voluntarily add calorie information on menu boards at each of its 1,380 bakery-cafes nationwide by the end of 2010.

The National Restaurant Association said it supported the move to help health-conscious consumers track nutritional facts, and the law also solved the problem of restaurants having to deal with differing menu regulations around the country.

“This legislation will replace a growing patchwork of varying state and local regulations with one consistent national standard that helps consumers make choices that are best for themselves and their families,” the restaurant industry group said in a statement.

Darden Restaurants, which operates 1,800 Olive Garden, Red Lobster and Longhorn Steakhouse and other outlets, said the nationwide requirements will simplify its menu labeling. Only 130 of its restaurants currently are required to label menus, a spokesman said. Some fast food chains, including Burger King, also support the federal law.

But some restaurant owners aren’t so sanguine. Deborah Dowdell, president of the New Jersey Restaurant Association, which represents 23,000 food and beverage shops, said labeling increases menu costs for restaurants is inaccurate and doesn’t solve the nation’s obesity trend.

“If our goal is to curtail the trend of obesity, there are much more effective ways that can be implemented to accomplish that goal,” Ms. Dowdell said, suggesting exercise education as one example.

Some restaurant patrons welcomed the news.Andy Hayler, a U.K.-based food critic who writes about restaurants world-wide, said keeping track of calories was more difficult away from home. “It may not be obvious that something like blue cheese has twice as many calories as other cheeses,” said Mr. Hayler, who often eats out five times per week.

Dr. Kirschenbaum Argues Against the Food Addiction Hypothesis

Here is a commentary by yours truly, Dr. Kirschenbaum, discussing the food addiction hypothesis that so many people believe.


On a Potential Challenge to My Perspective about the Food Addiction Hypothesis (Food Addiction Causes Obesity and Prevents Weight Loss)

New findings from science can change what we do and how we think about the concept of food addiction.  After all, we changed our policy about self-weighing when the data came in that this practice seems quite helpful for LTWCs.  In my clinical work with obese people in the 1970s, I did not focus on a low fat or a very low fat diet.  Science taught me and most others in the 1990s, that this was the way to go.  Does this study with rats and cheesecake suggest considering an alternative way of thinking about obesity?  That’s a very reasonable question.

The results of this study seem to suggest that foods have drug-like properties.  Therefore, perhaps people can become addicted to certain foods just like people become addicted to drugs – and that addiction can cause obesity/prevent successful weight loss.  Many findings and factors argue against this hypothesis.  On the other hand, Dr. Phil, Dr. Oz and Dr. Oprah (oops…) believe in this notion whole heartedly.  It becomes difficult in this culture, especially when reading a study like this, to believe otherwise.  To see why this hypothesis does not work, I’ll describe more about the food addiction model, present an example of a true addiction in contrast (smoking), and argue, once again, in favor of the healthy obsession model (with the athletic metaphor prominently featured).

Food Addiction Model of Obesity

Science has proven repeatedly that under some conditions various foods have drug-like properties in animals.  Almost all of the studies on sugar and fat, like this one, seriously overdose animals and show some drug-like effects occasionally (including distraction, analgesic and even opiate-like effects).  Did you know that a high enough dose of carrots has a drug-like effect: death? Vitamin A toxicity can indeed kill you – as it killed dozens of people in Australia who went on a carrot-based diet. (Their skin even turned orange before they died.) High doses of sugar can reduce perception of pain in animals (e.g., tail pinching experiments with rats).  Have you ever met an obese person who seemed addicted to carrots?

The So-What Question.  What do these drug-like properties that occur in animals tell us about human obesity?  Not much.  Consider what happens to campers and students in our programs when they switch to a Wellspring Plan diet.  Has anyone seen symptoms of withdrawal (high fever, night sweats, hallucinations, reports of monstrously powerful cravings for cheesecake or doughnuts)?  Nope – not a bit.  Homesickness, yes, but withdrawal due to reduction in their “addiction to food?” Nope.  In fact, usually they start feeling better right away – more energetic and happier – and in some cases fewer GI symptoms, also right away.

What about tolerance?  Addictions, by definition, require withdrawal symptoms and tolerance.  Tolerance means that more of the substance is required to produce the same effect with continued use.  Addicts take higher and higher doses to produce the same effects over time: alcohol, heroine, cocaine, vicodin, etc.  The study described below seemed to show some type of dose related effect, but do obese people or those becoming obese show this?  If they did, then almost all obese people would be binge eaters.  They’d eat more and more of that cheesecake over time to feel OK, just like those crazed rats – totally preoccupied with their food.  So, do 95% of obese people binge eat or have a strong history of binge eating?  Nope.  80%? Nope.  50%? Nope.  About 10% of obese people binge eat consistently; a higher % of obese people who seek treatment binge eat – maybe 30% or so, but that’s about it.  So, what caused the obesity in the case of the 90% of obese people who do not binge eat?  Certainly not an addiction to cheesecake or any other type of food.

Smoking

Consider what we know about true addictions.  Smoking, for example, clearly comes closer to meeting the classic definition of an addiction.  Most smokers gradually increase the numbers of cigarettes per day (despite the inherent toxicity of smoking) until certain levels (e.g., at least a pack a day) are craved and smoked regularly.  Reduction of numbers of cigarettes per day or even time between cigarettes produces strong and immediate cravings – which have obvious biological bases.  When smokers switch to lower nicotine cigarettes, they smoke more of them and inhale more deeply; they regulate their nicotine levels that way.  Nicotine patches help smokers lower the number of cigarettes they require, although that will only happen if the smoker really makes a commitment to quit.  Studies in which smokers took pills that raised the acid level of their urine (Vitamin C or Acidulin), resulted in smokers increasing their smoking.  Acidic urine will result in excreting nicotine.  When nicotine gets excreted at a higher than usual level, we’d expect smokers to increase smoking to get that nicotine level back to what they’re addicted to consuming.  That’s exactly what happens.  Behavioral and environmental factors also influence smoking tremendously, but obviously this addiction has powerful and immediate physiological elements that affect it.

In what way does smoking resemble obesity?  Smoking involves one substance.  Obesity involves both eating (and eating thousands of different types of foods potentially) and activity levels + biological predispositions to gain weight + knowledge and skills to manage it.  People do not have biological predispositions to smoke (based on genetic studies).  Quitting smoking involves minimizing the physiological cravings and making changes in one’s environment (e.g., not hanging out with smokers) and learning alternative ways of doing things to avoid triggers, etc.  After many months of this, sometimes a year or more, smoking can become especially aversive to many smokers.  They find they can live full and happy lives without smoking and have relatively few cravings – sometimes absolutely no cravings, just revulsion, after years of abstinence.  Formerly obese people continue to eat food every single day.  Yet, thousands remain slim and do not become crazed or stay crazed.  They often feel much better as they modify their habits and attitudes and environments.

Healthy Obsession Model

Powerful biological forces combine with an obesogenic culture, lack of knowledge, and perhaps some personal tendencies to produce obesity.  Overcoming these consistently antagonistic forces, requires the development of an athlete’s mindset about goals, plans, focusing and commitment.  The athlete develops super-normal self-regulatory skills to overcome his/her body’s resistance to high levels of consistent performance.  The LTWC does the same thing.  They do not have to go cold turkey or wear patches to minimize consumption of doughnuts and cheesecake or cotton candy or white bread. They do not suffer withdrawal symptoms because they can no longer rely on food to make them feel good.  They use principles of science to minimize their appetites (very low fat diet; low calorie density diet, etc.) and to avoid metabolic reductions while maximize fat metabolism (i.e., by getting a good dose of activity every day).  They can still use food to make themselves feel good – just not the high fat kind and not without considering quantity altogether – at least most of the time.  They develop healthy obsessions via CBT (or in some other way) to help them stay focused consistently, manage themselves effectively, and stay committed when the inevitable lapses occur.

The food addiction model just does not work.  It does not explain what we know about the causes of obesity or the approach that seems best to lose weight and keep it off.

FATTY FOODS – ADDICTIVE???

(Health.com) — Scientists have finally confirmed what the rest of us have suspected for years: Bacon, cheesecake, and other delicious yet fattening foods may be addictive.

A new study in rats suggests that high-fat, high-calorie foods affect the brain in much the same way as cocaine and heroin. When rats consume these foods in great enough quantities, it leads to compulsive eating habits that resemble drug addiction, the study found.

Doing drugs such as cocaine and eating too much junk food both gradually overload the so-called pleasure centers in the brain, according to Paul J. Kenny, Ph.D., an associate professor of molecular therapeutics at the Scripps Research Institute, in Jupiter, Florida. Eventually the pleasure centers “crash,” and achieving the same pleasure–or even just feeling normal–requires increasing amounts of the drug or food, says Kenny, the lead author of the study.

“People know intuitively that there’s more to [overeating] than just willpower,” he says. “There’s a system in the brain that’s been turned on or over-activated, and that’s driving [overeating] at some subconscious level.”

In the study, published in the journal Nature Neuroscience, Kenny and his co-author studied three groups of lab rats for 40 days. One of the groups was fed regular rat food. A second was fed bacon, sausage, cheesecake, frosting, and other fattening, high-calorie foods–but only for one hour each day. The third group was allowed to pig out on the unhealthy foods for up to 23 hours a day.

Not surprisingly, the rats that gorged themselves on the human food quickly became obese. But their brains also changed. By monitoring implanted brain electrodes, the researchers found that the rats in the third group gradually developed a tolerance to the pleasure the food gave them and had to eat more to experience a high.

They began to eat compulsively, to the point where they continued to do so in the face of pain. When the researchers applied an electric shock to the rats’ feet in the presence of the food, the rats in the first two groups were frightened away from eating. But the obese rats were not. “Their attention was solely focused on consuming food,” says Kenny.

In previous studies, rats have exhibited similar brain changes when given unlimited access to cocaine or heroin. And rats have similarly ignored punishment to continue consuming cocaine, the researchers note.

The fact that junk food could provoke this response isn’t entirely surprising, says Dr.Gene-Jack Wang, M.D., the chair of the medical department at the U.S. Department of Energy’s Brookhaven National Laboratory, in Upton, New York.

“We make our food very similar to cocaine now,” he says.

Coca leaves have been used since ancient times, he points out, but people learned to purify or alter cocaine to deliver it more efficiently to their brains (by injecting or smoking it, for instance). This made the drug more addictive.

According to Wang, food has evolved in a similar way. “We purify our food,” he says. “Our ancestors ate whole grains, but we’re eating white bread. American Indians ate corn; we eat corn syrup.”

The ingredients in purified modern food cause people to “eat unconsciously and unnecessarily,” and will also prompt an animal to “eat like a drug abuser [uses drugs],” says Wang.

The neurotransmitter dopamine appears to be responsible for the behavior of the overeating rats, according to the study. Dopamine is involved in the brain’s pleasure (or reward) centers, and it also plays a role in reinforcing behavior. “It tells the brain something has happened and you should learn from what just happened,” says Kenny.

Overeating caused the levels of a certain dopamine receptor in the brains of the obese rats to drop, the study found. In humans, low levels of the same receptors have been associated with drug addiction and obesity, and may be genetic, Kenny says.

However, that doesn’t mean that everyone born with lower dopamine receptor levels is destined to become an addict or to overeat. As Wang points out, environmental factors, and not just genes, are involved in both behaviors.

Wang also cautions that applying the results of animal studies to humans can be tricky. For instance, he says, in studies of weight-loss drugs, rats have lost as much as 30 percent of their weight, but humans on the same drug have lost less than 5 percent of their weight. “You can’t mimic completely human behavior, but [animal studies] can give you a clue about what can happen in humans,” Wang says.

Although he acknowledges that his research may not directly translate to humans, Kenny says the findings shed light on the brain mechanisms that drive overeating and could even lead to new treatments for obesity.

“If we could develop therapeutics for drug addiction, those same drugs may be good for obesity as well,” he says.

Apples for Me, Potato Chips for You: Consumers Buy Healthier Foods for Themselves

After several studies on food choice, author Juliano Laran of the University of Miami explored to what extent consumers exerted self-control when they made choices for themselves. Laran argues that one of the reasons the population gets more and more obese is that a lot of the food we consume is chosen by other people. He explains that taking responsibility for their own choices instead of letting others choose could help consumers decrease obesity and lead healthier lives.

ScienceDaily (Mar. 23, 2010) — Feel like Mom is pushing dessert? According to a new study in the Journal of Consumer Research, consumers choose foods that are less healthy when they are purchasing for others.

In a series of studies on food choice, author Juliano Laran (University of Miami) discovered that consumers exert more self-control when they make choices for themselves.

In one study, participants were asked to make a sequence of four choices from 16 items that were healthy (items like raisins, celery sticks, and cheerios) or indulgent (items like chocolate bars, cookies, Doritos, ice cream, and doughnuts). Half of the participants were asked to choose four items for themselves, while the others were asked to choose four items for a friend.

“When making choices for themselves, participants chose a balance of healthy and indulgent food items,” Laran writes. “When making choices for others, however, participants chose mostly indulgent food items.”

The author conducted another study of real consumers exiting a supermarket, which confirmed the earlier results, and showed that consumers bought equally indulgent items when purchasing for their families, friends, or roommates. A final study showed that consumer choices became more balanced after they were made aware of a healthy goal when making choices for others.

The author suggests that education could help consumers make more balanced choices when they are shopping for others. He also suggests that this phenomenon may be affecting public health.

“One of the reasons the population gets more and more obese is that a lot of the food we consume is chosen by other people, like friends throwing a party or parents buying for their children,” Laran writes. “Taking responsibility for their own choices instead of letting others choose could help consumers fight against obesity and lead a healthier lifestyle.”

Does workplace stress contribute to obesity? A recent study published in the Journal of Occupational and Environmental Medicine in January of 2010, investigated the correlation between chronic job stress, lack of physical activity and obesity. Lead author Diana Fernandez, M.D., M.P.H., Ph.D., an epidemiologist at the URMC Department of Community and Preventive Medicine, said her study is among many that associate high job pressure with cardiovascular disease, metabolic syndrome, depression, exhaustion, anxiety and weight gain. When the prevalence of overweight and obesity are combined, 68 percent of adults fit the category, according to a recent report in the Journal of the American Medical Association, which makes this issue particularly important as obesity is affecting many people.

Intensive Treatment for Childhood Obesity?

What is the best method to treat childhood obesity? Useful information was published in Pediatrics by an influential advisory board panel- The U.S. Preventative Services Task Force suggests that children and adolescents should be screened for obesity and be sent to intensive behavioral treatment if they need to lose weight. This suggestion is especially important in developing treatment plans regarding how doctors treat obesity in youngsters. The Task Force chairman, Dr. Ned Calonge, asserted that identifying treatment strategies that might work is a significant part of the battle. Adequate funding would be necessary to implement these programs, Dr. Sandra Hassink, a member of the American Academy of Pediatrics’ board of directors, said in a Pediatrics editorial. Dr. Helen Binns, who runs a nutrition clinic at Chicago’s Children’s Memorial Hospital, says these treatment programs are rare because they are expensive. We provide this kind of treatment at the Center for Behavioral Medicine in Chicago – and families with PPO health insurance do not find it expensive at all.   Also, Wellspring provides a great version of this type of treatment across the nation – see www.wellspringweightloss.com. 

Treating obese kids can help them lose weight, but the U.S. Preventive Services Task Force also suggests a rigorous diet, activity and behavior counseling.

March 16, 2010

CHICAGO (AP) – An influential advisory panel says school-aged youngsters and teens should be screened for obesity and sent to intensive behavior treatment if they need to lose weight – a move that could transform how doctors deal with overweight children.
 Treating obese kids can help them lose weight, the panel of doctors said in issuing new guidelines. But that’s only if it involves rigorous diet, activity and behavior counseling.
 Just five years ago, the same panel – the U.S. Preventive Services Task Force – found few benefits from pediatric obesity programs. Since then, the task force said, studies have shown success. But that has only come with treatment that is costly, hard to find and hard to follow.

The good news is, “you don’t have to throw your arms up and say you can’t do anything,” said task force chairman Dr. Ned Calonge. “This is a recommendation that says there are things that work.”

Calonge said the panel recognizes that most pediatricians are not equipped to offer the necessary kind of treatment, and that it may be hard to find, or afford, places that do. The recommendations merely highlight scientific evidence showing what type of programs work – “not whether or not those services are currently available,” he said.

The new advice, published online in the journal Pediatrics, could serve as a template for creating obesity programs. It also might remove one important cost barrier: Calonge said insurers will no longer be able to argue that they won’t provide coverage because treatment programs don’t work.

Evidence the panel evaluated shows intensive treatment can help children lose several pounds – enough for obese kids to drop into the “overweight” category, making them less prone to diabetes and other health problems. The treatment requires appointments at least once or twice a week for six months or more.

The recommendations follow government reports last week that showed obesity rates in kids and adults have held steady for about five years. Almost one-third of kids are at least overweight; about 17 percent are obese.

The task force is the same group of government-appointed but independent experts whose new mammogram advice startled many women in November. That guidance – that most women don’t need routine mammograms until age 50 – is at odds with the American Cancer Society and several doctor groups.

In this case, the task force advice mirrors that of the American Academy of Pediatrics. Many pediatricians already measure their young patients’ height, weight and body mass index at yearly checkups.

Task force recommendations in 2005 said there wasn’t enough evidence to encourage routine obesity screening and treatment. The update is based on a review of 20 studies, most published since 2005, involving more than 1,000 children.

The review excluded studies on obesity surgery, which is only done in extreme cases.

The panel stopped short of recommending two diet drugs approved for use in older children, Xenical and Meridia, because of potential side effects including elevated heart rate, and no evidence that they result in lasting weight loss.

Calonge, chief medical officer for Colorado’s public health department, said evidence is lacking on effective treatment for very young children, so the recommendations apply to ages 6 to 18.

The most effective treatment often involves counseling parents along with kids, group therapy and other programs that some insurers won’t cover. But adequate reimbursement “would be critical” to implementing these programs, Dr. Sandra Hassink, a member of the American Academy of Pediatrics’ board of directors, said in a Pediatrics editorial.

Dr. Helen Binns, who runs a nutrition clinic at Chicago’s Children’s Memorial Hospital, says such programs are scarce partly because they’re so costly. Her own hospital – a large institution in one of Chicago’s wealthiest neighborhoods – doesn’t have one.

Many families with obese or overweight children can’t afford that type of treatment. And it’s not just cost. Many aren’t willing to make the necessary lifestyle changes, she said.

”It requires a big commitment factor on the part of the parent, because they need to want to change themselves, and change family behavior,” Binns said.