Pass the Chicken Fat! They Say it’s Good For You….

It turns out that eating butter, cream, egg yolks, fatty meats, and full fat cheese is no worse for our hearts than olive or canola oil, according to a recent study published by Dr. Rajiv Chowdhury and his colleagues in the Annals of Internal Medicine.  Maybe Paula Deen was right all along: We should be eating fried butter, cream, and cheese-laden casseroles, as well as egg yolk and whipped cream-stuffed desserts. This article appears to vindicate Ms. Deen because now (finally) we have scientific evidence that such foods will not immediately send us to the emergency room with chest pain.

As someone with a several generation-deep history of heart disease, I think I will pass on the lard, butter, and whipped cream, though. Even though the statistics of the study seem to show otherwise, I don’t want to be my own statistic in the cardiac intensive care unit.  But most people aware of the study are tossing their tofu and running, not walking, to eat marbled steaks and buttery croissants.  Indeed, one remarkable example of the current trend to embrace saturated fat comes from a recent issue of Bon Appetit magazine. A two-page spread prominently features an ingredient previously reviled for its artery-clogging (or so we thought) proclivity. The ingredient: chicken fat, or as it is known in certain circles, Schmaltz.

As someone whose grandmother taught her at an early age how to render chicken fat into a golden, chicken flavored spread for rye bread and potatoes, but who stopped eating it after a fair number of relatives died at an early age from heart attacks, I was astonished to see it making a comeback in, of all places, a magazine devoted to gourmet eating.

As a corollary to the safety of eating saturated fats, we are also told in this study that we must avoid starch since it, rather than lard and bacon, is contributing to heart disease, diabetes and other life shortening conditions. This poses a conundrum. Whereas it is possible to eat bacon with one’s fingers or along with eggs (a good source of saturated fat), how does one eat butter, or cream cheese, or whipped cream, or indeed, chicken fat, without something starchy or bready underneath? Dr. Atkins had many recipes that eliminated all starch but for many, no starch grew tiresome. How many butter-coated strips of bacon can you eat without feeling a wee bit nauseous? Whipped cream might taste good by itself, but it certainly tastes better when incorporated into a chocolate mousse.

Carbohydrate-free foods have been developed but rarely are they eaten more than once. Of course one could follow the suggestions of Bon Appetit and add duck or chicken fat, or failing that, more butter or lard to slow cooked vegetables.  It is curious however, that years ago, we were all told that the delicious but oh-so-unnutritious method of cooking greens for hours with salt pork should be stopped, immediately. We were all to steam our vegetables and not even allow a smidgen of butter to pass over them. But now? Pass the salt pork!

Sometimes it looks as we won’t live long enough to know what we really should be eating or not. Or if “they” are wrong, maybe we won’t live long at all. Moreover, what seems to be lost in the “I told you so,” or “How can they say that?” responses to every new conclusion about our diet and our health is that:

1. Unless we eat foods with the nutrients our bodies demand, we certainly are not going to be healthy as we should be;

2. Moderation in all food consumption has never been challenged; and

3. Excessive calorie intake, regardless of its source, it going to make us fat.

To be sure, collard greens cooked in salt pork, or turnips cooked in schmaltz for the better part of an hour, may taste better (to some) than the same vegetables prepared without gobs of saturated fat and cooked quickly.  But the nutrient poverty of such dishes after their vitamins have been cooked out of them should not be overlooked. Maybe they should be eaten with a vitamin pill chaser.

Eating moderate amounts of most foods (except those to which people are allergic) rarely causes any harm. But given the tendency of those in our country to do things in excess, how certain are we that giving a green light to eating butter and bacon will not result in the overconsumption of fatty foods? After all, none of the scientists in this study pointing out the non-relationship between saturated fat intake and heart disease has suggested making these foods staples in the diet.
What about calories? Will they go away just because no one is talking about them these days? What happened to the concept that if we eat more calories than our bodies need, the excess, regardless of where they came from, will end up in our fat cells? It is prudent to consider that all fat, whether it comes from olives or a chicken, contains 9 calories per gram. Protein and carbohydrate contain 4 calories per gram.  My grandmother expended more calories than I because she had no clothes dryer, no car, she lugged her groceries up many steps, chopped meat into hamburgers with a wooden bowl and chopping knife, rolled her dough for noodles with a heavy wooden rolling pin and beat rugs with a broom handle.  I beat the keys of a computer.

So let’s have a helping of common sense along with the pats of butter and dollops of whipped cream. It will go a longer way in keeping us healthy.

Are Baby Boomers Turning Into Dumplings?

“I just came back from my 45th college reunion,“ my neighbor told me, “and to my amazement, my Baby Boomer classmates have now turned into dumplings. They are overweight, walk slowly, don’t seem to have much muscle, and more than a few had difficulty negotiating the uneven brick walkways. What happened to them?!?”

We went on to reminisce about how Baby Boomers made health clubs, yoga, Pilates, kick boxing, high-protein diets, tofu, vitamin supplements, and yogurt part of American mainstream culture and thereby changed how the country ate, exercised, listened to music, and dressed.

“So how is it that they (our contemporaries) are now softer versions of Humpty Dumpty?“ she asked. Yesterday they were wearing long hair, fringes, and beads. Now they wear medical alert bracelets announcing that they have diabetes or pacemakers, and I read they have a higher prevalence of obesity than other generations.”

The Baby Boomer generation, which has been at the forefront of many changes in the lifestyle of our country, may now be leading the way into the unfortunate consequences of too much bad eating and too little time devoted to exercise. Are they giving up their emphasis on youth, as in the mantra of many decades ago of, “Don’t trust anyone over 30?” Are they whose early years were spent in marches and rallies now thinking walkers and canes? Are they capitulating to the inevitability of getting old? As someone I know who just turned 65 told me, “Finally I can eat what I want and not worry about how I look. Why should I care about being thin?”

The good news and the bad news is that given the increasing longevity of their generation, Baby Boomers ought to reconsider turning themselves into versions of their grandparents. It is premature for them to give up on exercise (presuming they had been doing it all along) and to be complacent about their bad food choices. Unless they run into bad medical luck, they may live to 100 and, as George Burns said when he reached that age, ”If I knew I was going to live so long, I would have taken better care of myself.”

In all fairness, changes in lifestyle that occur as the Baby Boomers retire, or at least work less, may make it harder to avoid gaining weight. Moving from a multistory house to a single-story dwelling, opting for the elevator instead of taking the stairs, doing fewer household and outdoor chores? This amounts to using up fewer calories in the course of the day. Dependence on a car may increase even above what it was during earlier years, if they are moving to communities without easy public transportation or access to nearby shopping areas. Social interactions revolve around dinners and often lunches as well; if one wants to see friends it is usually over a restaurant table rather than on a walk. A couple with whom we are going to a local museum insisted that we make reservations at the museum restaurant for lunch, even though the alleged purpose of the trip was to see the art.

Recreational sports such as skiing, tennis, and biking are often abandoned as coordination and balance deteriorate, thereby making a fear of broken bones seem too much of a risk. Health clubs are, in general, not particularly geared to those who are old enough to be parents of most of the members. Many classes are unsuitable for bodies that may have some orthopedic limitations, and standards by which to measure baseline stamina and muscle strength are rarely applicable to those over age 50.

Perhaps it is time for the Baby Boomers to lead the way into improving the lifestyle of those 60 and over. It is time for them to insist that restaurants serve portion sizes compatible to diners with a somewhat sedentary life rather than suitable for a construction worker. They should compel changes in menus so vegetables are included with a main course rather than being an item for which there is an extra charge. Might they able to compel food manufacturers to increase fiber content outside of a few breakfast cereals? No one expects bagels to be enriched with bran and chopped prunes, but the food wizards in the country could come up with more options than Bran flakes and Fiber One bars.

It seems that it is also time for this forward-looking generation to demand that health clubs start including classes with music that does not increase their already compromised hearing loss, and with movements which will not ultimately require knee replacements. They should consider turning, “Dine and Discuss” book clubs into walking discussion groups, or put pressure on golf courses to allow players to walk the course rather than ride in a cart. And why not ask towns to make indoor pools for water aerobics as common as wading pools for toddlers?

Baby Boomers must stop accepting their potential status as dumplings and do what they are best at: seizing hold of their life and making changes that will benefit their health and that of the generations to follow.

Depression After Gastric Bypass Surgery

For those whose weight has climbed steadily after years of failing on traditional diets, gastric surgery to reduce the size of the stomach seems almost inevitable. If the stomach pouch is made so small that it holds about the same amount of food that would feed a gnat, weight loss is inevitable. So little food can be eaten at a time that patients are told not to drink water at mealtime because doing so leaves no room for food. Pounds seem to melt off, leaving the post-operative patients optimistic about improved health, energy, and a lifestyle no longer limited by excessive weight.

But for some, as the pounds disappear, the problems begin. Nutritional deficiencies due to changes in absorption of food into the body are well characterized but handled by monitoring of food intake and vitamin-mineral supplements. Eating too much causes severe nausea and pain, another unpleasant but avoidable side effect if the temptation to take one too many bites is overcome.

However, some problems don’t disappear as quickly as the weight, and for some, may persist for years. Anxiety, depression and insomnia may be so severe and resistant to medication that some patients consider having the operation reversed. Anxiety about the operation is understandable. Who among us awaiting any operation has not awakened at 3AM with a pounding heart and in a cold sweat thinking about the procedure about to be done? And anxiety after the stomach reduction is also understandable. There is no rehearsal time to prepare for an entirely new way of eating and a newly emerging body. Clinical depression and insomnia are not so easily explained.

One could surmise that depression might follow the realization that certain foods are never again going to be eaten. Presumably waking up after surgery and knowing you would never eat chocolate again might put you into a permanent funk. But the depressions reported both in the scientific literature, and in the hundreds of personal anecdotes on gastric surgery blog sites, suggests otherwise. Some have associated depression with the very low-calorie diet followed for several months following the surgery. Studies carried out during and post-World War II on volunteers given a semi-starvation diet similar to those in prisoner of war camps showed significant depression that disappeared when the subjects were given enough food. For some, however, a clinical depression lasts well beyond the first months of very restricted feeding and is resistant toantidepressant therapy.

Could the cause be the lack of a specific nutrient in the diet, i.e. carbohydrates? The absence of carbohydrate in the diet invariably alters serotonin levels and that neurotransmitter activity. It is the insulin release after carbohydrates are eaten that indirectly allows more serotonin in thebrain to be made. Insulin changes the levels of amino acids in the blood and this enables one amino acid, tryptophan, to enter the brain. Serotonin is made from tryptophan, and thus is dependent on its brain availability.

Dietary regimens before and after bariatric surgery often create the perfect storm for serotonin depletion. High-protein/very low-carbohydrate diets are imposed on pre-surgical patients so they will lose some weight before surgery. Post-operatively, patients eat only protein and supplements to prevent muscle, vitamin and mineral loss. Even though tryptophan is one of the amino acids making up protein, studies done over several decades at MIT showed that when protein is eaten, little or no tryptophan enters the brain.

Low and/or inactive serotonin is associated with depressed mood and anxious mood, anger, irritability and fatigue. Women normally have less serotonin in their brains and are more likely to be depressed than men. Might their depression after bariatric surgery be related to their serotonin depleting diet?

How to increase serotonin production during the protein feeding phase is a difficult problem. The stomach is so small, there is not room for both carbohydrate and protein and the latter must be eaten. Would giving tryptophan as a supplement help? Should studies be done to see if increasing the synthesis of serotonin prevents or decreases depression?

Insomnia is also an unexpected side effect of the surgery. Other than patient reports, not much is known about the cause or how to handle it. “I was awake until 2AM, fell asleep, and then woke up at 4 AM. The only way I can sleep is by taking prescription sleep medication,” is not an uncommon description of persistent wakefulness of many post-surgical patients. According to some of their reports, the insomnia lasts for months and even years. Some people reported taking melatonin but in such large doses (the correct dose is 0.3 mg) that it shut off their body’s own production of this hormone and stopped working. Others would attempt to limit the use of prescription drugs for fear of addiction, but eventually give in after several sleepless nights.

Would eating more carbohydrates help? Might more serotonin help calm and soothe the mind so it stops racing around like a gerbil on a running wheel and allow sleep to come?

No one disputes the life-saving consequence of bariatric surgery as it removes or decreases the many health problems of excessive weight. But unless depressed, insomniac individuals find some way to feel and sleep better, they are a risk for regaining weight and losing their health. Call it an unexpected blindside of a surgery meant to make life easier to begin with.

A New Diet Each Day May Make The Pounds Go Away

There is something enticing and optimistic about a brand new diet. Like buying a cream to eliminate wrinkles or a set of language tapes to finally learn French, we hope that this time THIS diet will work. This new diet will detoxify the liver, decrease the acidity of our stomach, remove those inflammation-causing glutens from our blood stream, burn the fat, increase muscle mass, and eradicate any desire we have for food… permanently. Just the past month, magazines and newspapers have touted the advantages of a 10-day detox diet, an alkaline diet (no foods can be eaten that lower the pH in the stomach) and the life-affirming effects of avoiding any food that is white (cottage cheese, chicken, and yogurt excepted).

Novel ways of eating in the interests of losing weight have been put forth for decades. Liquid diets have come and gone and will come again. Eating certain foods on specific days (does anyone remember the Beverly Hills diet?), fasting, the Atkins fat and protein regimen, diets based on blood type, personality, and presumably on whether one uses a Mac or PC, keep popping up in both respectable and sketchy magazines. Indeed, I am seriously contemplating inventing the Patriotic Diet in time for the 4th of July. This novel diet insists that the dieter eat only red, white, or blue foods on specific days of the week during July. In addition to honoring our flag, the diet could promote weight loss or at least make the dieter dislike red, white and blue foods based upon an aversion through restriction model.

My diet is not real, but alas others with little more great authority and scientific basis are. They are marketed so the dieter believes that they will really work. And for a while, they do.

They work because they are examples of the effect of a placebo on changing behavior. A placebo is defined as an inert, inactive substance or intervention or device without any function. For decades clinicians have found that placebo treatments, e.g., the sugar pill or colored water or sham acupuncture needle, really do work to reduce pain, depression, and a large variety of other ills that seem impervious to medical treatment. [1] The explanation is that if one believes something is going to work, in many cases, it does. So if a new diet comes along that claims to detoxify my intestinal tract, rejuvenate my liver and make me energetic and happy, I may reap these benefits because I truly expect that these things will happen.

Another reason is a logistical one. Diet plans that target certain foods for consumption or avoidance must by necessity eliminate large numbers of foods that are fattening. Do away with bread, and presto! One therefore also eliminates butter, cream cheese, peanut butter, mayonnaise, cheese spread, and Nutella. Tell people that dairy products will do dreadful things to their gut and they right away stop eating not only fat-free yogurt and skim milk, but ice cream as well. Having a newly-discovered gluten sensitivity used to be a reliable way of losing weight because so few foods could be eaten. Now, alas, so many manufacturers are making gluten-free foods which resemble the old foods we used to eat problem-free, that it is hard to eliminate much from our diet.

Alas, there is no placebo for smaller portions, lower-calorie foods, substitution of vegetables and fruits for chips and cookies, and none for exercise. New diets become old very quickly as the weight returns and the diet plan is shoved under a stack of others that are no longer interesting.

The weight-loss plans that work are boring, predictable, slow acting, and do not make for interesting conversation. Very few people who exercise consistently rarely consider their workouts sufficiently unique to chat about them with others. (Golfers are an exception.) Who wants to know how many minutes your neighbor spent on an exercycle or doing a yoga pose? People who always eat salads, fish, low-fat dairy and steamed rice rarely mention these foods as the newest diet fad in the tabloids. Who wants to know how many servings of vegetables you ate this week or cups of cottage cheese you managed to swallow? Alas, a boring, slow weight loss, sensible diet will not make celebrity headlines or you, the follower, the center of attention at a party.

A new diet-a-day will not make the weight go away. What will make it go away is finding and following an eating and exercise plan that works for you, day after day, year after year. Eventually having a fit, thinner, healthy body will no longer be a novelty. It will simply be a way of life.



If Kids Played More, Would They Be Less Fat?

As someone who was called “butterball” by my second-grade classmates, I was aware of the social stigma of being one of the fattest (my mother preferred chubby) in my class. Fortunately, the pounds came off a few years after the braces and, unlike current predictions of how fat kids become fat adults, I managed to go through my adult life at a normal weight. The good and the bad news is that today, being chubby, a.k.a. fat, would no longer make me an outlier on the playground but one of the gang.

National concern is growing over the rapidly increasing number of obese in our youth population and interventions have begun, such as changing the menus of school lunches and contents of school vending machines. Unfortunately, these nutritional improvements do not extend to fast-food chains or convenience stores, so kids who have the money and mobility can buy the fattening meals, snacks, or drinks they no longer can get in school. Indeed, I’ve seen a convenience store near the subway stop for an urban high school doing a brisk business in Doritos and Cokes, the preferred breakf

Excessive calorie intake seems to be the most obvious reason behind the weight gain of the young population. I certainly can point to an endless stream of homemade sour cream coffee cakes, blueberry pies, and peanut butter cookies as the reason I waddled around when I was 7. But a steady decline in physical activity over the past couple of decades may also be a potent reason for the increase in weight we are now seeing among school children. Walking to school, running around the playground during recess, riding a bike, jumping rope, skating, sledding, and kicking or hitting a ball in your friend’s backyard may be as old-fashioned as a black-and-white movie. Where did we lose our sense of play in the great outdoors?

Today’s kids are more likely to let their thumbs run around a touch screen. Kids are bused or driven to school and are either so laden with homework, afterschool activities or jobs, that playtime seems as quaint as a landline. Even something as commonplace as after-school team sports like Little League or its newer alternative, soccer, is losing members. A recent Wall Street Journal article reported an across the board decrease in participation of team sports such as football, soccer, basketball, and baseball, and the decline was seen among both elementary school and older students.1 The reasons for this shift were not known and may be related more to the inability of schools to pay for the support staff for such activities and /or parents to spend the time and money on equipment, uniforms, and getting the kids to practice. But the effect is a drop in physical activity that is not compensated for with kids running around the neighborhood.

No one wants to go back to a time when children were sent out to work at age 8 or 9 and were thin because they spent hours at hard labor and never were fed enough. Indeed, one of the historical errors of the very popular TV show Downton Abbey is the robust health of the young servants who seem to live in the kitchen. Young girls who went into service at 13 or 14 worked 16-18 hours days doing what we would consider today to be hard manual labor and were underfed and undernourished.

When are we going to take seriously the effects of very limited opportunities for daily physical activity on the health and longevity of our young population? If, as now seems to be the case, obesity in childhood predisposes an individual to obesity throughout adulthood, can we continue to ignore the problem? Making time for daily physical activity is an obvious solution, but one whose implementation seems dubious. Where and when are kids going to be able to really exercise? Where is the child who goes to school in the inner city going to be able to play ball or where, in the sidewalk-less, heavily trafficked, no shoulder roads, can a suburban child ride a bike? Kids have to leave school when the buses come; they can’t hang around and play in the schoolyard. And the necessity to fill every hour of the school day with teaching leaves little time for leisurely recesses.

And yet, what will have the most lasting effect on our kids? Remembering the periodic table or the capitals of all of our states, or being of a healthy weight and good nutritional status? This is not to suggest that kids stop going to school so they can play soccer or go sledding. But we can’t wring our hands over the overweight status of our children and moan over the implication for their future health but then provide them with no financial support or time to keep them physically active.




Stand Up straight: It’s Good for Your Health

“Sometimes I slouch so much after a day of staring at my computer screen, my chin nearly reaches the dining room table.” A friend who had been a physical therapist in her early career was berating herself for her inattention to good posture. The rest of us sitting around a restaurant table automatically straightened up. Another chimed in with, “I take all these classes that work on my core, which makes me think I am an apple, but once the class is over, I go back to walking like a banana.” Her fruit analogies left us a bit puzzled, but we got the idea. Somewhere in those decades between learning to walk and needing a walker, we had lost that wonderful erect posture of a child and slowly took on the slouch of the no-longer-young.

“Why doesn’t anyone talk about posture?” wondered another. After a few minutes giggling over our memories of the posture pictures that were taken of freshman in some women’s colleges (and were eagerly sought after by neighboring men’s colleges), we wondered whether posture was still emphasized among the young and not so young. When was the last time any of us had read an article emphasizing the need to stand up straight, to adjust the laptop computer so it did not require sinking the neck practically into the belly button to be seen, and walking without the head down as if counting the cracks in the sidewalk? Indeed, the current trend to wearing shoes whose heels resembles stilts (perhaps a trend finally slowing down) rarely even discusses the possibility of breaking one’s neck while negotiating slippery steps or brick sidewalks, let alone standing up straight.

But posture is critically important and not just to make us look taller without wearing 5-inch heels. Good posture can reduce uneven pressure on a knee, hip or back and thus is protective against injuries and pain. Even a small misalignment of the spine can cause nagging back pain, as I learned when I had to wear an orthopedic boot while recovering for a torn Achilles tendon. If I did not compensate for the slight difference in elevation between the foot wearing the boot and the other, my back ached miserably after only a few minutes. Inattention to how we are standing, sitting, walking or bending may cause chronic pain. Who needs that?

There are so many upsides to good posture. Better balance is one consequence of better posture; but does anyone pay attention to this basic aspect of movement unless one is learning to skate, paddle board or ride a bike? Balance is something we take for granted until we no longer can rely on it as happens with, for example, a mild case of vertigo or an icy sidewalk. As we age, we may gradually find balance unreliable while walking on an uneven sidewalk or maneuvering around a small space. All children can walk or even run on narrow elevated curbs. How many grandparents can run after them without falling off?

Not sure how good your balance is? Try standing on one bare foot, with your eyes closed. It is hard to do it for a minute or longer without needing to put your foot on the ground. Indeed, having done this in health clubs, I find it somewhat embarrassing to stand on one foot, with my eyes closed, hoping I won’t hit my head on a nearby machine.

But despite the ubiquity of balance impairment, improving balance, like its first cousin, posture, is pretty much ignored as a fitness goal. To be sure, some yoga positions work on balance and the large rubber balls bouncing around health clubs and half sphere rubber “balance boards” promote better balance while exercising specific muscle groups. However, machines designed specifically to improve balance are by and large non-existent. I suspect that a reason for lack of attention given to posture and balance is that they seem so old-fashioned, hardly cutting edge, exciting workout concepts. Visions of one’s great grandmother walking around with a book on her head come to mind when talking about posture, and lack of balance seems to be something physical therapists work on with movement-limited clients. Presumably people who walk tight- ropes or surf megawaves don’t need too much help in improving their balance, and models with stellar posture would not be strutting down runways during Fashion Week if they shuffled like a bear. But if women’s magazines and upscale health clubs emphasized these two aspects of movement for the rest of us, we would all benefit.

Good posture and balance also have health significance far beyond looking taller without heels or being able to look like a tree in yoga class. These two traits are critically important in preventing falls, one of the major causes of death among the older population. As such, it is important to improve both before they are needed.

Strengthening core muscles, aka your abdominals, and the other muscles that allow you to carry out the movements of ordinary life, have an immediate impact on balance and posture. Ballerinas, gymnasts and tightrope walkers stand and walk straight; their muscular strength won’t allow them to do otherwise. For the rest of us, who do not spend our days in pointe shoes, classes like Pilates and yoga are effective ways to improve our posture and balance-related muscles. Simple exercises to strengthen the thigh muscles can markedly improve difficulty in getting up from a chair without losing balance or keeping a stumble from turning into a fall. The laptop computer slouch can be reversed with back, neck and arm exercises in a yoga class or gently using weights or machines in a health club. The Internet has some clever animated programs on improving balance but it is advisable to read through them beforehand, as some exercises require you to close your eyes. Do something simple, like asking people with whom you work or live, to remind you to stand up straighter or to notice whether your laptop is positioned so you won’ t have to bend your neck to see the screen. Go walking with friends and check out each other’s posture. A reminder to stop stooping while you are moving is much more effective than thinking about it while sitting in a chair.

It may take several months for your balance and posture to improve but they will. And when it happens, be prepared for someone to ask, “Were you a dancer when you were young?”

Our Natural Love for Sugar: Should We Be Doing Anything About It?

Too much sugar is bad for us. The evidence for its association with cardiovascular disease, diabetes and cavities is compelling and should certainly make one hesitate before buying that box of Valentine candy for someone special. But just as the science section of any major newspaper reports the dire consequences of consuming too much of the sugary substance, the Dining/Food section of same newspaper tells us that ultra-expensive, cutting-edge restaurants are promoting dessert-tasting menus.  It is no longer necessary to eat a main course before getting to dessert. Instead, you can go immediately, if you wish, to that luscious chocolate confection. Indeed, allowing people to indulge their sweet tooth makes one wonder what would happen to the menus for traditional meals such as Thanksgiving dinner if the same tactic were tried. Imagine being able to skip the Brussels sprouts, mashed turnips, and dry turkey and fill up instead on pecan, pumpkin, and apple pie?

The drive to eat sweet-tasting foods is with us from birth. Breast milk tastes sweet, probably because of the lactose in the milk. Taste tests carried out with very young babies decades ago showed that they prefer a drop of sweet water to that of salty, bitter and sour. We are not surprised at these results. After all, most of us would, as adults, pucker up our mouth after tasting intensely bitter, sour, or salty flavored water. But as with most natural behaviors, the attraction to sweet rather than the other tastes is protective and indeed life saving. Sweet foods are not poisonous. When our ancestors wandered around the forest looking for something to eat, they quickly learned to choose sweet-tasting foods and avoid those with a bitter or sour taste if they wanted to live another day. Foods with an excessive sodium content are also unhealthy because of their effect on blood pressure.

Before there was sugar, there was honey. The story of Samson  (aka Samson and Delilah) describes how he found a honeycomb in the carcass of a lion. Scooping out the honey, he ate it as he walked home and offered the rest to his parents. But honey was a prized sweet long before Samson. A 12,000 year-old cave painting in Spain depicts a woman collecting honey, and   sugar cane was known to the peoples of Indonesia, China and India more than 8000 years ago. Alexander the Great brought sugar cane to Greece from India around 800 BC, and the Arabs brought sugar to the western area of the Mediterranean. Sicily and southern Spain grew sugar cane and the city state of Venice refined and then exported it. Indeed, sugar was such a desirable and expensive commodity that it was referred to as white gold and was accumulated rather than consumed as a form of equity.

Eventually the cost of sugar decreased, especially when a second source, the sugar beet, was discovered after Napoleon blocked sea trade routes and prevented raw cane sugar from being imported by ship. And when sugar was scarce or too expensive, people found sweet substitutes like maple syrup and honey, fruit such as berries, guava, dates, figs, raisins and even sweet potatoes.

Deprivation of sugar does not lessen its appeal. Rationing of sugar in Great Britain lasted well beyond the end of World War II, but years of going without resulted in what seemed to be an almost excessive consumption when it was finally available. This seems also to be the effect of diets that are stringent in their elimination of sugar. Many years ago, when I was volunteering in a medical clinic promoting a high–protein, carbohydrate-free diet, I heard a woman patient tell another in the waiting room that she was counting the days until the end of the diet so she could eat a hot fudge sundae.  Indeed, bingeing on sugary foods was so commonplace, along with massive weight gain after the diet regimen ended, that eventually the program was abandoned.

So how are we to reconcile the medical consequences of excessive sugar intake with our innate desire to consume sweet foods? The answer may be in the approach taken by the restaurants that now offer dessert as a main course. The diners are not given 50-ounce jugs of sugary Slushees to sip on as they munch on sugar-infused green marshmallow Peeps topped with maple syrup. Rather, they are served miniscule portions of crafted desserts that have an intensely satisfying taste.  Several courses of bite-size confections may be offered and the diners eat them slowly and with great pleasure.  The amount of sugar consumed is small while the enjoyment is immense.

Preaching about the evils of sugar in the hopes that people will reject forever the consumption of this nutrient will, I fear, have the same success as Prohibition.  But I pose that just as people are urged to sip rather than gulp their alcoholic beverages, to drink moderately, and not drink alone, so too, eating sugary foods should be done slowly, if possible, with others, and consumed in small quantities.  Europeans understand the delights of combining delectable pastries and good conversation. Coffee shops are often filled with people in the afternoon drinking tea or coffee, nibbling on mouth-watering pastries and, of course, talking.  The patrons are, by and large, thin, or at any rate, thinner than we Americans, and show no hesitation at ordering squares of thick chocolate cake or large pieces of apple cake (a Dutch specialty).  There is no shame in eating a delicious sugary food anymore than there would be going to a wine bar and enjoying an excellent wine.

As an innate desire for sweet seems to be part of our biological makeup, we should accept it rather than try to preach against it or legislate it into extinction. However, we should change our eating habits so that eating something sweet is a treat to be anticipated and enjoyed rather than gulped and gobbled.  There is no reason we can’t have our cake and eat it too as long as we don’t make cake and other sugar-laden foods one of our four food groups.

Forget the Nutritional Fire & Brimstone (On Special Occasions now that the Game is Decided)

Is it ironic or perverse that just as January (aka, National Diet month) ends, the country is plunged into its first annual national binge day? Sure, there is much more hype about the multi-course Thanksgiving dinner, with its festive and traditional foods, but that dinner at least has a vegetable or two on the table. And although the meal may last an hour or two, the eating does not occupy the better part of a day. Not so with The Game. If one reads about the venue, it seems as if there is more information about what to eat in New Jersey on the days preceding (cheese and onion covered sausage rolls seems to be a winner), than the actual game itself.

Theoretically, the point of game day is to watch the game. Theoretically, it should be possible to do this without constantly eating and drinking. Theoretically, the game should be so compelling that no refreshments should be necessary, except perhaps a few pretzels and some ice water.

The reality is somewhat different. Someone figured out that Americans consume about 30 million pounds of food and over 50 million cases of beer on game day. Chips are the favored snack food. We eat on that day about 11.2 million pounds of potato chips. It is a wonder that anyone can hear the game over the sounds of crunching and the popping of beer can lids!

But why not enjoy all aspects of this day, including the frivolous eating? Despite the constant preaching about the evils of eating foods that really taste good and satisfy some deep hidden craving, I suspect that people will ignore the sermons and eat what they want.

It is unlikely that too many people will be crunching only celery sticks. Potato chips will probably not be replaced by kale chips across the living rooms of America. Advertisers at half time are not going to lecture us about the sins of eating gluten, sugar and salt and then wax on about the joy of eating blocks of tempeh. It is possible that some game watchers will be sipping their colon-cleanse diet drink of lemon juice and pepper? Cleanse diets, I suspect, are suspended and a clean colon will have to wait until the next day. And if a poll were taken to see how many game watchers are into serious discussions about the effect of their snacks on insulin resistance, as opposed to the skill of a particular player, few would be found in the former category.

Perhaps this multitasking day: eating and watching television, or eating and watching the game from the stands, maybe it’s good for us. Maybe it halts, at least for a day, the almost constant barrage of nutritional fire and brimstone. We can stop paying attention, at least for a few hours, to the television gurus and authors who are claiming that every ill we experience or will be forecasted for our personal futures is caused by what we are putting in our mouths. Maybe we can relax about what we are eating for a few hours and not contemplate how many days will have to be spent on the treadmill to compensate for all those Buffalo wings.

To be sure, many of us do not eat nutritionally adequate or sensible diets on most days, not just Super Bowl game day. Munchies, pizza and beer may represent a typical diet for a few, with the consequent weight gain and its medical side effects, i.e. high blood pressure and high cholesterol. Eating a Super Bowl diet all year could have a disastrous effect on whether one will be around the following year to watch the game again.

But Super Bowl game food may push the pendulum of hysterical, “You will die an early death if you eat that!” back to a more common-sense approach to our food intake. It is not really necessary to punish ourselves by completely eliminating the consumption of foods that we love in order to live a healthy long life. Can’t we return to a moderate, sensible approach to changing our diet from an approach that condemns without mercy many ingredients in our food that makes food enjoyable, festive and special? Can we not “cut back” rather than “cut out” foods we are told are poisoning our bodies, such as sugar? (Curiously the sugar police never mention cutting out alcohol completely. I wonder why?)

Let food be part of a pleasurable, albeit possible stressful, game-watching experience. Is game food good for us? Probably not. Will it shorten our life span, cause memory loss, mental illness, sexual impotence and all sorts of other dire problems that we are told could befall us if eat a cheese-drenched sausage roll once a year? Unlikely.

No one knows who is going to win The Game. And eating some wings, pizza or dips will not affect the outcome. But it may make watching the game more fun, regardless of who wins.

Why Cranky People Crave Sugar

In all the almost hysterical hype about sugar, which can paint this food with the same toxic attributes as arsenic or even nicotine, one fact is never mentioned. This sugar craving by emotionally miserable individuals may be a symptom of something awry with their serotonin levels.

Some who crave sugary foods are women who suffer from premenstrual syndrome. These women suffer from monthly menstrual cycle mood changes that would take them out of a competition for Miss Congeniality. Although these symptoms, thankfully, rarely last longer than two weeks each month and usually only two or three days, women feel transformed into a female Godzilla. Anger, muddle headedness, anxiety, depression, fatigue, mood swings, and irritability are some of the more common symptoms that women often feel helpless to do anything about.

Similar symptoms and sugar cravings are also common among people going through alcohol withdrawal. The symptoms usually appear within a day or two after alcohol intake ceases and may last for weeks. Anxiety, depression, not thinking clearly, fatigue, irritability and mood swings are characteristic feelings among those who have gone from excessive alcohol intake to none.

A change in season is sufficient to cause excessive moodiness, exhaustion, irritability, depression and anger. People who live where the sun rises late and sets too early for much of the late fall, winter, and early spring feel these moods descend on them like ice coating a car windshield, and may be unable to rid themselves of these miserable feelings until mid or late spring. These symptoms are not a reaction to depressing weather reports. They have been identified as a particular type of depression called Seasonal Affective Disorder and are tightly associated with cravings for sweet foods.

Why are PMS, alcohol withdrawal, and Seasonal Affective Disorder associated with an intense craving for sugar? These are three entirely different types of emotional misery and yet the woman with PMS would, “…kill for chocolate,” the recovering alcoholic could, in the words of a blogger on an alcohol withdrawal web site, “…eat a bucket of sugar,” share cravings for sweet carbohydrate. They also share this craving with a diagnostic feature of seasonal depression. Are these people sugar addicts? Has sugar caused their symptoms? Has it rotted their brains so they are left with all these dreadful emotions? If so, then why don’t women crave sugar when they don’t have PMS, as in the early stage of their menstrual cycle?

Why do recovering alcoholics eventually lose their overwhelming craving for sweets? Why is it that the person with Seasonal Affective Disorder rarely eats sweets during the spring and summer when the depression is gone, and replaced by the feeling of well-being? Indeed, if, as the sugar police suggest, sugar leads to addictive behavior, worse even than cocaine addiction, eating sugar should cause a permanent longing and craving for this dreadful nutrient. Why aren’t these people permanently addicted with brains shredded from their sugar consumption?

Certainly among the categories of intense sugar cravers described above, this does not happen.

The craving for sugar, like craving water, is simply a signal that something is missing in the body. When we are thirsty, we do not think we are having withdrawal symptoms from water. We know that thirst is a signal that the body needs water. No one is addicted to water even though severe withdrawal symptoms, including, ultimately death, can occur when denied.

Sugar is not water. No one is going to die from its absence. But the moods associated with a craving for sugar can be pretty dismal. This is because the sugar cravings associated with the crankiness of PMS, alcohol withdrawal and Seasonal Affective Disorder signals low serotonin activity. We know, but know not why, monthly hormonal changes affect serotonin. We know, but not how, the absence of light in the winter affects serotonin. And we know, but do not completely understand that low serotonin activity is common among many excessive drinkers.

Animal and research studies conducted over the past 30 years or so have shown that consuming any carbohydrate (except fructose) increases serotonin levels, and subsequently can improve moods. As sugar is digested faster than, say, rice or buckwheat groats, the longing for it among the emotionally distressed may be based on an unconscious desire to consume something that will work fast to make the eater feel better. When one is very thirsty, one gulps water. In a sense, eating something sugary is like gulping water. It takes away the bad feelings faster than chewing on a hard piece of whole grain bread.

Is it necessary to eat sugary foods to feel better? NO. As soon as any non-fructose (fruit won’t get the job done) carbohydrate is digested, serotonin will soon thereafter be made and moods will get better. And indeed, going through PMS each month, enduring weeks of alcohol withdrawal, or months of Seasonal Affective Disorder by munching on rich chocolate may increase weight as well as improve mood. Oatmeal, plain Cheerios, or a couple of graham crackers will do just as well.

But one should heed the dual symptom of crankiness and sugar craving. It is just your body’s signal to increase serotonin, and thus go from feeling miserable to mellow.

Global Fattening

We seem to be taking up more space on earth. This is not just because our numbers are increasing but because our girth is as well. A report of global weight gain and diminishing food resources by Sharada Keats and Steve Wiggins (Future Diets: reveals that, “the percentage of adults who are overweight or obese grew from 23 percent in 1980 to 34 percent in 2008.” One in three adults — 1.46 billion worldwide — is now obese or overweight. And this number may be considerably higher in developed countries.

The consequences range far beyond airplane seats being too small or clothing manufacturers investing in developing new lines of outsized clothing. As we have been told for decades, rising weight means a rising incidence of health problems related to excess pounds. The list is familiar: diabetes, stroke, heart disease, orthopedic problems, and perhaps some cancers.

Changes in diet is the most obvious culprit. According to the report, when people are sufficiently solvent to be able to switch from their inexpensive starch-based dietary staples to more costly foods, they do not replace their daily staple of bread, rice or maize with more fruits and vegetables. Rather (and our country is an example of this), they eat more oil, sugar and high-fat animal products and larger portions. Moreover, the extra calories are not spent on as much physical activity as previously, since their better economic status allows them to travel via motorbike, bus, or car, rather than by bicycle or foot.

Like global warming, global fattening seems difficult or even impossible to halt or reverse. Decades of January diets, public exhortations to exercise, mandatory labeling of packaged foods and calorie contents of restaurant items and even the banning of trans fat has had little visible effect. We are told to eat more fruits and vegetables, low or fat-free dairy products, and more fiber. We are directed to pay attention to portion sizes, to stop drinking sugary beverages, to eat apples in place of daily cupcakes, and broiled fish instead of fried clams, and to watch our alcohol intake. But do we? Perhaps we do, at least until the end of the New Year’s diet.

There are two problems: How are people going to be convinced to eat better nutritionally, and how are they going to be convinced to eat less? The article pointed out the “wimpy” (my word) responses of public officials and institutions to this problem. No one, except perhaps the past mayor of New York City, wants to impose taxes on junk foods or restrict how much of a bad food an individual is allowed to eat. Admittedly, there are some positive changes. School lunch menus have improved, and many vending machines that used to dispense chips and soda are either banned, or their contents replaced with yogurt and fruit.

Supermarkets sell ready-to-eat fruits and vegetables, so the sloppy task of peeling, slicing and dicing should no longer keep anyone from eating these important foods. Organic food sections have enlarged, and the dairy product cases are filled with so many containers of Greek yogurt, you feel as if you have learned Greek by the time you make your selection. Many items, from ready-to-roast marinated fresh salmon to freshly cooked turkey breast, make preparing healthful meals fast and relatively inexpensive.

But supermarkets also devote yards of aisle space to the chip family of snacks, as well as cookies, and food bars with the same calories and ingredients of a candy bar. No market, including those promoting organic foods, puts up a sign in front of the high-calorie food aisles warning about the temptations lining the shelves, or detours people back to the produce aisle.

Restaurants also contribute to the ease with which we can eat too much, and without nutritional soundness. Putting the nutritional wasteland of fast-food chains aside, how many restaurants promote, or even offer fruits and vegetables, without charging extra? High-fiber foods are rarely offered unless the restaurant is vegetarian, or defines itself as a place where healthy foods are served. And, of course, portion sizes only get smaller when the prices get higher.

So how do we convince people to reconsider eating a 2-pound steak, or a bucket of fried chicken, or polishing off a six-pack of beer along with chips and dip? Certainly not through government intervention. We are not about to install surveillance cameras over the heads of people ordering double cheeseburgers or buying a 64-ounce bag of Doritos. So far no EIS (Eating Investigative Units) has been established to monitor the overeating crimes of its citizens. And, as the authors point out, “Many people see food choices as a matter of personal freedom.” They are not likely to accept the same sort of restrictions on eating as we as a country have accepted for smoking. No one is going to make a co-worker stand outside to eat his cupcake.

Complicating solutions to the growing obesity situation even more is the kaleidoscope of opinions as to what constitutes the right diet for weight loss, good health and longevity. For example, the Internet is replete with warnings to avoid eating white carbohydrates such as potatoes and rice. These foods are considered serious threats to weight and health in general, not withstanding the fact that cultures such as the Irish ate almost solely potatoes for decades, and that rice was and remains a dietary staple in vast areas of the world. We have been told for decades to take mega amounts of supplements to avoid a variety of health woes. Now it seems most of them are useless. For everyone who says that a certain food is good, someone else contends that food will poison the body.

Whose information can we really trust? The answer may be the decidedly boring one of moderation. Eating moderate amounts of a variety of high-fiber carbohydrates, fruits, vegetables, lean protein and dairy products is not the kind of advice that makes for best-selling diet books, but doing so will sustain good health and a sensible weight.

But how can people be motivated to do something about their weight? When one in three individuals in your family, workplace, and neighborhood is either overweight or obese, does the individual even see this as a problem? Think of how we are now accustomed to seeing men with shaved heads. This is a look that, in the past, represented the unfortunate consequence of chemotherapy, or the results of a stressful situation that caused total hair loss. Now it is simply a fashion statement. If most people we see are not thin, we accept this as normal. Why worry about our weight and the possible health issues that may be developing because of it when everyone around us are also the same size or larger?

The answer may be in the strength and creativity of advertising. Motivating consumers to take on new behaviors such as buying gigantic TV screens, new cars, or the latest generation of cell phones is what effective marketing is all about. Stopping global fattening may depend on the talent of these professionals to convince us that we need to change our behavior in ways that make it seem that it was our idea all along.