Monthly Archives: September 2014

Why Most of Cannot Become, Nor Maintain, Thin

A few days ago, my husband and I were walking back from the farmer’s market lugging plastic bags full of corn and tomatoes. It was hot, dinner was still a few hours away, and we had all those ears of corn to shuck. Then I saw her. She was thin, almost wiry, carrying her own bags of farmer produce but one hand held a large soft serve chocolate ice-cream cone that she must have bought from the ice-cream truck parked near the food stalls. My mouth watering and stomach grumbling, I watched her take a large bite of the ice cream and smile. I would have smiled also had I just taken a bite. But then what she did astonished me. She walked over to a nearby trashcan and, with a napkin, dislodged most of the remaining ice cream into the can so that only a tiny bit remained barely visible above the rim of the cone. “Did you see that?” I asked my husband. “She threw away most of the ice cream!”

“No wonder she is thin,” he replied. “I couldn’t have done that. “ “Me neither,” I said, thinking that as hot and hungry as I was, the ice cream would have been inhaled by the time I walked home.

Indeed, how many of us practice what weight-loss professionals are forever suggesting: eat only half of what is served to you in a restaurant. If you want a fattening treat, take a few bites and throw the rest away. Don’t allow a micro drop of fat or sugar or salt to cross your lips even by accident. Never, ever, eat anything dipped in batter and fried. If you are at birthday party, eat a rice cake (bring it with you) rather than birthday cake. Don’t skip meals. Make sure breakfast consists of more than a cup of coffee and piece of toast. Don’t eat after 9PM. Avoid drinking more than one glass of wine and don’t do that too often. If you want to snack, eat fruit, fat-free yogurt or oven-roasted kale. Oh, and exercise as much as possible.

Many people are able to summon the compulsive discipline, and motivated aspects of themselves when they are determined to lose weight. “Set a goal and stick to it!” people are always advising the obese. Then you WILL lose weight. To be sure, we can do this whether it is going on a five-day cleanse, eating nothing but grapefruit and broiled salmon for a month, or living on a 500-calorie beverage that contains all the nutrients we need to stay alive until we lose 75 pounds. Years ago Oprah Winfrey did this and lost an enormous amount of weight, appearing on one of her shows dragging, in a wagon, bags full of the same amount of fat she had lost.

But then the diet is over. And as the professionals tell us, we now must practice discipline and rigor to KEEP OFF the weight. And sometimes, some people actually do. I have a friend who lost more than 70 pounds before she got married many years ago and has never deviated more than 2 or 3 pounds from her goal weight. If she finds herself weighing more than that, she races to her nearest Weight Watcher meeting. A life member, she goes back on a diet and loses those two or three pounds before they turn into 10 or 15. The woman who dumped most of her ice cream into the trash can may be another example of someone who took to heart the advice of eating a tiny amount of a treat and disposing of the rest. But as a neighbor who is always going on and off diets told me, “Who can live like that?”

Maybe we were not intended to live like that. Is it not unrealistic to expect that we humans should eat like machines, consuming the precise number of calories in relation to the precise amount of calories we use up? After all, we are not fitted out with a car-like fuel gauge, with the need for fuel, i.e. calories computed before and after we eat.

Obviously eating too many calories, meal after meal, day after day, will rather quickly elevate our weight to unhealthy levels with all the attendant health risks associated with obesity. But on the other hand, once we attain the weight we want, we should be able to feast occasionally on entire ice-cream cones, or a plate of fried clams during a once-in-the-summer trip to a clam shack, or a Sunday morning chocolate croissant from a French bakery. The key word is occasionally.

Exercise, the other factor keeping us at the weight we want to be should be a regular part of our daily activities. But this doesn’t mean going to the gym every day or walking around the block ten times or doing 200 push ups daily. It means being cognizant of how and when our bodies are moving so that we do not mimic a 200-year-old tortoise in the amount of energy we expend in physical activity. However, having an occasional lazy day is something that ought to be built into the post-diet exercise regimen as well. Once your body is accustomed to regular physical activity, it will want to get moving again after an afternoon lying in the sun watching dandelions turn to fluff or catching up with all your recorded television shows over a weekend.

Even our pre-civilization ancestors rested after chasing a wooly mammoth for three days and feasting on it until nothing was left but the wool. So if you find yourself hot and hungry on a sunny late summer afternoon, and a soft serve ice-cream cone crosses your path, indulge yourself. Just don’t do it too often.

Why Didn’t Subjects Stay on the Low Carb Diet?

The recent widely publicized study by Tian Hu and colleagues at Tulane University School of Public Health put a small number of subjects on a supposed low carb or low fat diet for a year and monitored cardiovascular health and weight loss. To the delight of carbohydrate bashers, subjects on the low carb diet lost 8 pounds more (over 12 months) and improved levels of their good cholesterol and triglycerides.  So the conclusion is that Dr Atkins diet is really better: fats are good and carbs are bad.

If one believes headlines, that is truly the case.

But…..look at what was not hyped by the media:

This ground breaking study had 148 subjects at the start, but by the end of the study 20% of the subjects in both groups dropped out.  If this study were testing blood pressure medication or the best way to treat poison ivy, results with the tiny number of subjects would have been considered interesting, not ground breaking.

More to the point: by the end of the year, many of the low carb subjects did not follow the strict low carb regimen.  Contrary to the study imposed limits of 40 grams of carbohydrate each day (slightly less than the carbohydrate in two servings of oatmeal), they increased, if you can call more than tripling a mere increase, their intake to 130 grams a day. Interestingly, the high carbohydrate group was allowed only 200 grams of carbohydrate a day, hardly a gigantic amount of starchy grains, legumes, beans, and rice.

A disturbing feature of the study purporting to be a definitive answer as to how to lose weight is that sedentary subjects were told NOT to exercise. That’s right. Just stay on your couch.

But this was probably a good idea since those not allowed to eat carbohydrates, wouldn’t have had the fuel, i.e. carbohydrate for their muscles.

And no one is talking about the lack of fiber in the low carbohydrate diet this research study espoused. Not even a serving of Fiber One cereal was allowed.

The next time such a study is done, call it by its correct name: low fat versus high fat. And make sure the subjects stick to the protocol.

But the good news is that when the baked potato is served, a pat of butter or sourcream might actually prolong your life, or at least be good for your good cholesterol.

Finally: An Explanation of Night Eating?

Even though many of us wake up in the middle of the night thirsty and/or needing a bathroom, few of us decide to stay awake to eat another dinner. To be sure, we may munch on a graham cracker, nibble on some leftover pie, or drink a glass of milk with some cookies. But with the exception of a category of people called night eaters, we rarely are hungry enough to eat a full meal, even though it has been hours since we last ate. The almost physical inability to put much food in our stomachs is evident with the lackluster appetite we may approach breakfast served on a transatlantic flight at two or three in the morning. We are awake, more or less, but our stomachs are not. Conversely, some of us can tell time by the mid-day and early evening rumbles in our stomach signaling, “Time to eat!” Why are we hungry for lunch or dinner five or fewer hours since the previous meal, and yet not hungry in the middle of the night, eight or nine hours after we had dinner? By the time we leave infancy, most of us are unlikely to wake up for a 2 A.M. feeding.

A hormone, secreted by the stomach, but acting on the brain, may be the answer. Ghrelin (rhythms with Mary Ellen) seems to initiate eating at certain times over a 24 hour cycle, but not at other times. Although it seems as if we eat by the clock as in, “It is noon so I must be hungry,” this is apparently not the case (At least not in a research situation). About seven years ago, in a study published in the American Journal of Physiology by D.E. Cummings and colleagues, ghrelin levels were measured in volunteers whenever they started eating a meal. The researchers found that when the volunteers were most hungry, right before they started a meal, their ghrelin levels were high. After eating, ghrelin levels in the blood decreased and, as time passed, slowly began to rise again. Five or six hours after the previous meal, hunger and ghrelin levels again were high, and the subjects started on their next meal.

So why are we all not in the kitchen at 1 or 2 A.M. looking for something to eat, 6 or 7 hours after dinner? Most of us are asleep and if awakened would probably turn down a sandwich or some scrambled eggs. We are not hungry. The reason? According to research reported in the European Journal of Endocrinology by Natalucci, et al, the level of the hunger hormone is lowest between midnight and 7 A.M.

But some people do wake up every night hungry enough to eat more than a few crackers and drink some milk. These so-called night eaters may actually consume as many calories as the rest of us eat at dinnertime. They are not eating in order to fall back asleep but because they are hungry. It is unclear if they wake up because they are hungry or notice how hungry they are when they wake up for other reasons such as noise or a need to go to the bathroom. Hungry they are, however, and apparently because night eaters have an abnormally high level of ghrelin in the blood between midnight and morning. It is as if this hormone is out of sync with the other hormones, primarily melatonin, that should be keeping them asleep, not microwaving pizza or defrosting a steak in the middle of the night.

No one quite knows what to do about the high levels of the hunger hormone in the wee hours of the morning. Researchers acknowledge that the rise of gherlin is delayed, so that instead of increasing late in the afternoon/early in the evening, when we normally would be eating our evening meal, it seems to peak five or six hours later. One thought is to expose night eaters to early morning light therapy similar to the light boxes used by people with SAD (Seasonal Affective Disorder). According to a paper by Goel N. Stunkard and others in the Journal of Biological Rhythms, night eaters who have been exposed to early morning light respond by eating at normal meal times and will decrease their nightly food consumption. Maybe the light changes the rhythm of ghrelin release so that it approximates the normal sleep/wake cycle. Or perhaps waking people up early to sit in front of a light box gets them to eat breakfast early in the morning (although it is hard to believe they will be hungry) and this sets up a normal ghrelin prior to lunch and then dinner time.

Or perhaps the answer is to move to Spain where everyone seems to eat supper after the late show.