2012-05-18T05:14:26Z Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Copyright 2012, Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD SPHPBLOG
Interestingly, gluttony during biblical and post biblical times was not condemned as a major cause of obesity. Acquinas stated that the glutton does not intent to harm his body but seeks food because of the pleasure he receives in eating. If injury results to his body, (think obesity) it is accidental. There were no stores selling triple X size robes at the time to remind the glutton of the impact his and/or her excessive intake.

It's now the resulting disease from gluttony that concerns us. The Government statistics on the prevalence of obesity in 2010 reports that over 30% of adults are obese and 17% of children between 2 and 19 are obese. The health risks associated with obesity, as well as the increased health costs are well known.

But is this epidemic of weight gain caused by people who like being gluttons?
Yes and No. I propose that there are two kinds of gluttons: intentional and involuntary.

Intentional gluttons delight in eating whatever they like, in as large an amount as they can. I saw a woman a few nights ago in a restaurant served what looked like a 20 ounce steak with a gigantic baked potato. To my amazement, after filling the potato with 4 or 5 pats of butter, she ate everything on her plate. It is hard to believe that it took that much food to take away her hunger. Intentional gluttons rejoice in ‘all you can eat’ eating venues like cruises or Sunday brunch buffets, because such situations give legitimacy to their food intake. Foods are savored for their taste and little attention may be paid to the weight gain potential of eating large amounts of eggs, butter, cream and bacon.

Involuntary gluttons may also overeat or eat inappropriate foods but they seek food not for the sensory pleasure it gives them but because of eating such foods improves their mood and controls their appetite.
Let me describe some types of involuntary gluttons.

The most common gluttons are those (you and I may be among them) who feel a need to snack in the late afternoon or a few hours after dinner. The need to eat is not driven by hunger, but a nagging feeling of wanting something on which to munch. Usually this feeling is associated with restlessness, impatience, distractibility and fatigue. The foods sought are sweet or starchy- crunchy snacks.

Winter darkness also produces involuntary gluttony during for the months with minimal light. Lack of light causes a depression called ‘winter blues’ or Seasonal Affective Disorder. People eat large amounts of food intake, especially carbohydrates, and this overeating may persist for months.
Premenstrual women are involuntary gluttons, usually for chocolate. They may eat carbohydrates excessively during the last few days of their menstrual cycle, and like people with Seasonal Affective Disorder, feel depressed, angry, irritable, and exhausted.

Others are involuntary gluttons because they can’t stop eating when a sufficient amount of food has been consumed. Psychotropic drugs such as antidepressants and mood stabilizers prevent people from feeling full or satisfied after eating. People on such drugs may eat two meals, one after the other, or snack constantly.

Why are carbohydrates the preferred food sought by these involuntary gluttons? When we studied them, we found that they eat carbohydrate because they have learned, perhaps unconsciously, that after carbs are consumed, they experience an improvement in mood, increased satiety, or both.
These improvements in mood and satiety are associated with the increase in serotonin synthesis that follows carbohydrate intake. When any carbohydrate, except fruit, is eaten, an insulin mediated change in the profile of amino acids in the blood occurs, and the uptake into the brain of the amino acid tryptophan increases. Tryptophan is the precursor of serotonin, and its availability drives the synthesis of this neurotransmitter.

Behavioral testing of afternoon carbohydrate snackers, women with PMS and people with winter depression showed a consistent pattern: better mood, increased focus, calmness and greater energy. Indeed the most significant changes were among women with PMS who found that even a small amount of carbohydrate took the edge off of their premenstrual symptoms.

A weight loss program based on the consumption of a small carbohydrate snack ( 20-30 g with less than 5 g each of protein and fat) two or three times a day was effective in increasing satiety among people on medications whose side-effect caused overeating.

One reason that these populations of involuntary gluttons tend to gain weight is that they often eat more than is needed to bring about serotonin synthesis. Only 30grams or so of a fat free or very low fat carbohydrate must be eaten. This is about the carbohydrate content in a cup of plain cheerios. People also may consume the carbohydrate with protein (milk with the cheerios), or following a protein containing meal (eating desert after an entrée of chicken or fish. But bear in mind that when carbohydrate is eaten along with protein, or immediately following protein intake, no serotonin is made.

Involuntary gluttons also make the mistake of choosing carbohydrates for their sensual rather than neurochemical effects, eating doughnuts rather than dry toast, or French fries rather than steamed rice. The fat in these carbohydrate foods not only slows digestion and thus serotonin synthesis, it also may contribute to weight gain.

But if the right kind and amount of carbohydrates are eaten, then everyone, glutton or non-glutton alike, do not have to worry about the sin of overindulgence. Indeed, they will instead fulfill the biblical injunction from the book of Deuteronomy: eat and you shall be satisfied.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120504-085918 2012-05-04T00:00:00Z 2012-05-04T00:00:00Z
White fat is the repository of our excess calories and it is used to provide energy when too few calories are coming into the body (for instance when dieting or starving) or during prolonged periods of exercise.

Brown fat (that color because it contains a cellular component, mitochondria, that gives it its brownish hue) is the furnace of the body. These mitochondria generate heat and use up calories to keep our bodies warm in cold environments. Adults have very little brown fat. What they do have is located in the upper back, in the hollow between the collarbone and shoulder and along the spine. Newborns have much more, about 5 percent of their total body mass. Newborns are susceptible to the cold and cannot shiver to generate heat. The brown fat prevents them from suffering from hypothermia.

Even the small amount of brown fat we have as adults uses up or “burns” calories when the body is exposed to cold. In a study in the Journal of Clinical Investigation by endocrinologist Dr. Andre Carpentier, men were kept in a cold environment so they were chilled but not shivering. The heat-burning brown fat increased their metabolic rate by 80 percent and even though they were just sitting in an under-heated room, they expended or used up 250 calories in three hours. The relationship between cold exposure and burning fat for heat suggests the less-than-enticing possibility of losing weight by spending each day sitting on an ice floe in a T-shirt and shorts.

However, other recent studies have shown that one does not have to go to the Antarctic to increase brown fat and become thin. The solution may be as close as the nearby health club. Scientists are excited about discovering a hormone called irisin that is secreted by muscle cells after exercise and turns white fat cells (the kind we want to get rid of) into cells that act like brown fat cells. Dr. Pontus Bostrom and colleagues, who discovered the white to brown fat cell conversion, reported in the journal Nature that these new fat cells are not identical in color to the brown cells we have from birth. He named them brite, or brown-in-white, cells. (Presumably the color beige did not occur to him.) They act like brown cells by increasing heat, burning calories and decreasing elevated glucose levels.

Although most of the research has been carried out in mice, some studies on humans found a significant increase in this hormone, as well as metabolic rate in humans after 10 weeks of regular exercise. It has also been suggested that the increased metabolic rate seen for a couple of hours following completion of exercise may be due to the continuing fat burning by these newly-formed brite cells.

Studies using mice suggest that increasing the level of irisin may reverse obesity and its related problems, such as diabetes. Obese mice did not have to go on a treadmill to increase their irisin levels. They were genetically manipulated into producing a high level of this hormone, and the result was every dieter’s dream. The mice increased their energy production, thus using up calories and losing weight while improving glucose tolerance.

Might irisin be the magic weight-loss pill everyone has been waiting for? Would taking it in pill form eliminate the need to exercise to lose weight and decrease elevated glucose levels? An editorial in the April 19th New England Journal of Medicine suggests that irisin would be beneficial for those who are unable to exercise because of severe muscle or skeletal disability or cardiovascular conditions. For example, people with spinal injuries or congestive heart failure who cannot exercise would experience the benefits of this hormone.

It doesn’t take much imagination to envision how most people would respond if such a pill were available. Gyms would lose their members who work out primarily to lose weight (why bother if one can take a pill?) People obsessed with the need for quick weight-loss might exercise and take irisin in pill form to increase its benefits.

What would we lose, beside weight, if we replaced working out with a pill? How about:

Muscle mass. Might we all have big heads and shrunken bodies?

Cognitive improvement. Exercise benefits our ability to think and remember. Would we forget where we left the irisin pill?

Recreational sport. Will golf courses and tennis courts be turned into vegetable gardens and sheep pastures?

Escape from unrelenting obligations. What excuse would we have to turn off our computers, smart phones and iPads and thus the stress of constant bombardment of work and family obligations? A pill will give us no excuse to hide from this stress.

Social interactions. What will happen to conversation if people can’t talk about their running time or how cute the new spin class instructor is?

So as someone said, “Be careful what you wish for.” At this point, what we all should be wishing for is more time to exercise.]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120502-071400 2012-05-02T00:00:00Z 2012-05-02T00:00:00Z
"Don't you have to be at least l00 pounds overweight before you can have bariatric surgery?" I asked.

Apparently not. She described a suddenly popular new surgical technique that shrinks the stomach by folding the stomach lining and stitching it in place. Patients who want to lose as little as 25 pounds are going through the procedure because although it requires general anesthetic, there is no cutting of skin or muscle. As some of us gagged, our friend told us that the procedure called POSE, or Primary Obesity Surgery Endoluminal, uses an endoscopy tube that passes through the mouth and esophagus to reach the stomach and then makes tummy tucks.

POSE is so new that it has not gone through rigorous clinical testing to see whether it is more successful than other surgical techniques in producing permanent weight loss; nor has it received FDA approval. Nevertheless, people who want to be thin are using this procedure to get rid of weight that does not respond (so they say) to conventional diets and exercise. Our friend said that she had considered liposuction to get rid of some of the fat she could not seem to diet of,f but the stomach-shrinking technique seemed a better option. "This way I will never be able to eat very much, so losing weight and keeping it off will be easy."

Is POSE the so-called magical weight loss option every overweight person has been seeking? Is its relatively quick and non-surgical procedure the answer to a permanent way of keeping off weight? It is much too early to tell. Other surgical procedures to reduce the amount of food that can be swallowed and contained in the stomach have been effective in producing massive amounts of weight loss in the first year or so after the procedure. Yet long-term outcomes are inconsistent. Patients have found that if they consume high-calorie liquids food like melted ice cream, or gradually introduce large amounts of food into their stomachs, they can enlarge its size. Eventually, they are able to eat enough to regain the weight lost during the first year after the operation.

The question I would have liked to ask my friend who is considering the POSE procedure was this: Why couldn't she lose 20 or 25 pounds the conventional way? I didn't, of course. There are some things one cannot discuss, even with close friends. But I think I know the answer. She, like so many others, is consistently inconsistent in her weight-loss efforts. Weeks of a stringent diet and exercise will be followed by an equally long periods of paying little attention to calories and avoiding the gym. Not surprisingly, at the end of every diet year, her weight has not changed by more than a few pounds. She did lose some weight for her daughter's wedding, but put it on a year or so later when her mother was diagnosed with Alzheimer's disease and her father had a stroke. Like it is for so many of us, food became her source of comfort.

She claimed that diets simply never worked well enough to get her to lose 25 pounds. But we all know that under the right circumstances, we all can lose weight. I am sure that if she were shipwrecked and forced to live on raw fish and coconuts, she would be a size 0. She had been on diet programs so many times, she could recite the list of foods that should be eaten every day and could demonstrate how to use the exercise equipment at the gym. But time and again, she abandoned these positive habits, ate whatever she wanted and never went to the gym. How can an operation on her stomach have any effect on making her choose healthy foods and engage in regular physical activity?

What was also worrisome was that she automatically turns to food when she is stressed, eating large amounts of carbohydrates, like potato chips and cookies, that are packed with fat. Will the surgical procedure stop her emotional eating? Can any surgical procedure to reduce stomach size accomplish this?

Our brains are behind our overeating when winter darkness makes us depressed, when PMS causes major mood swings, when we are exhausted from too much work or too little sleep, or stressed to our limits because of financial, family, or health problems. How can a smaller stomach make these stresses less painful and upsetting?

We have learned, perhaps unconsciously, that when our brains respond to our consumption of carbohydrate by making new serotonin, the edge is taken off the stress. We are able to cope and become calmer, more focused and able to handle or endure whatever has upset us. The amount of fat-free or low-fat carbohydrate that has to be eaten to increase serotonin contributes less than 200 calories to our daily food intake. Moreover, the increase in serotonin also has the added benefit of making us feel less hungry.

Bariatric surgery may be lifesaving for people whose weights are propelling them into life- threatening medical disorders. But bariatric surgery, whether a stomach bypass operation or sewing together bits of a stomach lining, is not sufficient to prevent emotional overeating or the failure to accept a permanent commitment to health eating and exercise.

The only solution -- and there is nothing magical about it -- is to understand how to use serotonin to stop emotional overeating and to employ self-discipline for healthy eating and exercise as a program for life.

]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120421-091248 2012-04-21T00:00:00Z 2012-04-21T00:00:00Z
However, our current focus on the impact of food on our physical and mental health did not occur overnight. We did not wake up one morning, throw out the cold cuts and start eating soy products. It took decades to recognize that we should use canola oil rather than solid white shortening and eat more fish and less red meat. Our healthier food habits developed very slowly, and many of us are still struggling to make them a habit.

The story is entirely different for dieters. When they go on a diet, they are asked to make radical and instantaneous changes in their food choices. They are told to stop preparing meals with butter, cheese, cream, bacon and eggs and start using low-calorie ingredients instead. Familiar, comforting foods like macaroni and cheese and meat loaf must be abandoned, and steamed spinach with poached salmon eaten instead.

Most important, instead of making these changes over years, the dieter must make these modifications in a New York minute. The diet plan is presented, the guidelines reviewed, and diet foods put in the refrigerator. Fattening foods are thrown out and the diet begins.

For dieters, making these changes is like moving to “Thin Country,” where everything is new and disorienting. This place, with its restrictions, forbidden foods, portion control, demands to exercise, and insistence on making food choices based on nutrient and caloric content, rather than taste alone, feels strange and uncomfortable. Anyone who has traveled to a place where the language and customs are hard to decipher is familiar with the bewilderment and even helplessness that comes from not knowing how to communicate. The dieter staring at a bunch of kale in the supermarket or trying to figure out what to order at a restaurant where every item is coated with batter and fried may feel the same confusion and helplessness.

Keeping the weight off after the diet is over is even harder. It is the difference between staying in a strange country with the knowledge that you will go back home in a few weeks and emigrating to a new land. Losing weight is like being a tourist with an extended visa. Keeping it off means applying for citizenship.

Obesity experts have failed to recognize that the dieter who has reached the end of his diet and taken up residence in “thin country” needs as much support to survive as any new immigrant. If the dieter is to keep his weight off permanently, then he needs help in dealing with the issues that caused the weight to be gained, strategies for resisting the temptation to go back to his old ways of eating, aid in making him feel comfortable in his newly thin body, and ways of dealing with those around him who don’t believe he will succeed in staying slim.

Compare the absence of group support for successful dieters to the presence of support for people who stopped drinking. Recovering alcoholics can find meetings everywhere, every day, to help them maintain sobriety. Where are the comparable support groups for the formerly fat who are now thin? Except for some weight-maintenance programs that deal mainly with modifying food intake to keep weight stable, there really are no groups to help the dieter who has reached his goal adjust to a life of being permanently thin.

For example, many newly thin people feel that they are being treated differently than when they were obese and don’t know how to deal with this. I have had weight-loss clients who complained that they were always the same inside so why were they being treated better now that they are thin? Why were they now getting attention from the other gender when they were ignored while fat? The newly thin need to form new friendships with people who speak the language of healthy eating, rather than returning to old friends who speak the language of overeating and poor food choices. That decision, and the action that it requires, only adds to the difficulty of maintaining new lifestyle choices.

Many of us who are now thin after years of being obese should reach out to those who have just crossed the border into this country. Like any new immigrant, they need our help and support to stay on the road to better health and long term happiness. Isn’t that what all newcomers seek, after all?
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120414-073028 2012-04-14T00:00:00Z 2012-04-14T00:00:00Z
Not so with diets. Sure, one can choose among different weight-loss options such as packaged portion-controlled meals, low-calorie liquid diets, calorie counting, point counting, reducing stomach size through surgical techniques or following a celebrity-generated fad. But once the dieter is enrolled in a program, little attention is given to how he or she may differ in metabolic, psychological or hormonal characteristics from the other dieters.

Some diet programs with gender-specific plans don't take into account that some women may be as large as men and vice versa. For example, should a 5'6" man whose starting weight is 190 pounds be given more calories to eat than a 5'11" woman whose starting weight may be 250 pounds just because he is following the men's diet and she, the women's? Should someone who is used to consuming 4,000 plus calories a day be started on the same diet as someone who eats 2,500 calories a day? Predictably the former is going to be really hungry for the first week or two and perhaps leave the diet because of that. Recent surgical interventions take into consideration the individual physical differences of the patient, but how much attention is given to the differences in their psychological profiles and reasons for gaining so much weight? A patient, morbidly obese because of years working as a chef, and a patient with the same excess weight who gained it because of childhood sexual abuse may have totally different long-term outcomes from the surgery.

A friend who is on Weight Watchers was staying with us recently and expressed her frustration with the program because it is simply not set up to deal with individualized diet counseling.

"The program is wonderful for people who have been eating unhealthily and really didn't know that a bacon double cheeseburger with fries has more calories than a grilled turkey sandwich on whole wheat bread. They not only lose weight; they learn to improve their food choices. But I know all this. My problem is that when I have to go to court [she is a litigator] I eat my way through hours of preparation. And of course I pay no attention to the diet. I want someone to tell me how to lose weight when I am stressed -- and I am always stressed."

It is time for personalized weight-loss therapy? There is no (at least to my knowledge) facility that does in-depth analysis of a dieter's life style, emotional health, susceptibility to hormonal and seasonal changes in eating, exercise commitment and previous diet history. So the dieter or potential dieter has to figure out whether a diet fits their life profile and/or push for more personal intervention if a diet is not working.

A home hospice worker and I talked on the phone for an hour so we could figure out how she could eat most of her meals in the car, as she spent sometimes up to 10 hours driving from home to home. And more importantly, we talked about what she should eat to take away her own emotional pain after a day of helping the families of someone on hospice care. A neighbor who lost the first 100 of the 200 pounds he has to lose after lap band surgery sat in my living room and confessed that he was gaining rather than losing weight. "I am lonely," he said. "I eat all evening. I am careful not to put too much food in my stomach at once but I can consume several hundred calories after supper." He thought if the band was made tighter, reducing even more the size of his stomach, that his problem would go away. But I pointed out to him that what he really needed was therapeutic support so he could turn away from eating to solve his loneliness.

Personalized weight-loss programs must become part of our efforts to decrease the national rise in obesity. It will initially be more expensive than simply recommending a program without determining if it offers the best support for the personal needs of the dieter. But, like identifying specific types of cancer cells before settling on a chemotherapeutic protocol, it may have a better long-term outcome.

One thing is certain: Failure to reach a weight-loss goal and/or to maintain the loss does not mean the dieter can never lose weight. Like finding the perfect pair of jeans, it is simply of matter of seeing what fits best. ]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120324-125634 2012-03-24T00:00:00Z 2012-03-24T00:00:00Z
“Are they feeling better because the days are getting longer?” I asked.

“No, they are still depressed or anxious or both...But their antidepressants made them fat, and they’d rather be sad than gain weight.“

Her remarks came to mind yesterday when I received two separate emails from women whose dress sizes increased from the single to double digit range because of their medications. In all fairness, both were taking not only antidepressants but also a type of drug called mood stabilizers, which may cause a weight gain of 75 or more pounds.

Drug side effects are a risk with any pharmacological agent, even the over the counter drugs come with a list of possible problems. Certainly weight gain does not seem like a serious side effect if compared to those associated with chemotherapeutic agents, for example. After all, no one has debilitating nausea from an antidepressant.

But we should not trivialize the impact of weight gain associated with drugs used for mood disorders. Imagine that you are slim, never had to diet, always had energy, and looked good in clothes. Three months after starting on a mood stabilizer or antidepressant, none of your clothes fit, the scale goes up every time you step on it, your friends and relatives are commenting on your round face and chubby limbs, and your formerly energetic body feels like a sack of potatoes because of the excess weight you are dragging around…Yet you can’t stop yourself from eating. Diets don’t work because even though your stomach is full, there is something compelling you to continue eating.

The pills that are taking away your depression are causing you to despair every time you look in the mirror. So, like the friends of my lunch companion, you look at your pills and say to yourself “Do I want to have a good mood or a good figure?”

Why do these drugs cause weight gain? There is still no sure answer, though this side effect has been known for several decades. What is also known is that the excess food intake does not occur because patients are genuinely hungry. Rather, people on these drugs describe themselves as never feeling full no matter how much food is in their stomachs. They often will eat a sizable meal and one or two hours later think that they haven’t eaten at all. The feeling of contentedness and satisfaction that comes when the brain and the stomach agree that enough food has been consumed is simply not there.
Will power doesn’t seem to work; after all these drugs have powerful effects on the brain that may overwhelm one’s determination not to give in to the incessant cravings. What does seem to work, however, is engaging the brain’s own satiety center to fight the effects of the drugs.

Serotonin, the brain neurotransmitter involved in regulating mood, is a central player in control of appetite. It stops voracious eating by increasing satiety or the feeling that enough food has been consumed. (The feeling of being satisfied with food is similar to feeling satisfied when enough water has been drunk to dispel thirst. When you are sated you don’t want to put anymore food in your mouth.) Although antidepressants increase the potency of serotonin’s effect on mood, these drugs do not increase serotonin’s regulation of appetite, and some may even block this function.

While running a weight management center at a Harvard University hospital, we discovered a natural, non-drug method of halting the medication-induced need to eat. We found that certain nutrients increase serotonin synthesis (or manufacture), and when more serotonin is made, it seems to act as an appetite suppressant. Carbohydrates, with the exception of fruit, are the nutrient that increases serotonin synthesis. Carbs do this indirectly by allowing tryptophan, the amino acid out of which serotonin is made, to enter the brain. Protein foods prevent this process from occurring, so when protein is eaten alone or added to a meal containing carbohydrate, no serotonin is made.
Our weight loss clients consumed a carbohydrate snack an hour before lunch and again between 3 and 5 pm. Supper contained mainly starchy carbohydrates such as pasta, vegetables and fruit. The increased synthesis of serotonin from the snacks and dinner stopped the medication-induced cravings and left the dieters sated and content.

As we mentioned in the book we wrote describing our diet plan, (The Serotonin Power Diet, weight was lost even though the dieters were still on their medication.

Whether or not someone stays on medications for anxiety and depression should be decided by the therapist and patient, not by the numbers on the scale. Fortunately, by making simple carbohydrate-based changes in your food choice, it is possible to be in a good mood and have a good weight.

]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120317-102205 2012-03-17T00:00:00Z 2012-03-17T00:00:00Z
"My dog never comes when I call him," the owner of a rather pudgy lab said. "He pretends to be asleep or deaf. But as soon as I open the refrigerator or pantry door, there he is, standing there waiting for a handout." Her remarks were echoed by several of us. One woman who seemed to have lost weight ever since she got her puppy chimed in.

"Herman [her dog] looks so reproachful if I put something in my mouth without giving him a treat that I have stopped snacking. He makes me feel guilty at chomping on cookies or spooning ice cream into my mouth without stopping to give him a doggy biscuit. So my many evening trips into the kitchen have stopped. I think both of us have lost a little weight as a result. "

It is true, of course, that many of us do not like to be seen when we are eating foods that we know we should be avoiding. One of life's more embarrassing moments is when someone walks into the kitchen as you gobble up the last of the pie or spoon ice cream right out of the container. You thought you were so quiet and then your spouse, your kids or your dog is right there, looking at you.

I doubt if there will be a new category of service dog trained to appear and bark when it's owner, the dieter, is sneaking a snack. But would surveillance, by dog, human or a video camera, like the kind that catch you if you run a red light, inhibit the covert eater from plunging into a box of cookies or bag of chips? The so-called closet eater doesn't want to announce his snack intake to anyone and usually waits to eat until everyone is either asleep or out of the house. If the opportunity to eat is thwarted by the presence of someone else, the would-be snacker may put off eating entirely, or at least until the next day.

One of the dog owners mentioned that it was a relative, not a dog, who made her stop nibbling every evening. She lived alone and was in the habit of sitting in her kitchen, paying bills, watching television and eating. When a cousin, a law student, had to live with her for several months after there was fire in his apartment building, she lost five pounds. "He comes home late and goes into the kitchen to eat the dinner I leave for him. I don't want him to see me snacking and watching TV, so I watch my programs upstairs. He has saved me from eating hundreds of calories because I don't eat anywhere but in the kitchen."

There are devices that record what you are eating and instantly convert the food into calories so once the item is entered into the program, the dieter knows exactly how much caloric damage that jelly doughnut or slice of pizza caused. But I doubt if such devices can really modify snacking behavior when it occurs in a habitual and mindless fashion. Would my dog park acquaintance who nibbled every evening in her kitchen have stopped to record every quarter cup of potato chips on such a device? Would someone, quietly opening the refrigerator to eat a slice of cake, take the time to calculate its size before gulping it down, and then enter the amount into a recording device? No. If you know that you shouldn't be eating the frosting off of the chocolate cake on the counter, then why would you record doing so?

On the other hand, if we saw ourselves eating mindlessly would we stop? I suspect we would, based on my non-scientific dog park discussion. Everyone agreed that the silent witness to their attempt to nibble did inhibit them by making them confront their snacking patterns. "I never realized how many times I walk into the kitchen when I am editing my manuscripts." She is an author who went on to say, "until I noticed my dog appearing there as well. Poor dog, he never got to nap because he was constantly getting up from his bed to follow me. "

Clients who come to me for weight-loss consultation rarely reveal their actual pre-diet food intake. When I first started out, I used to ask them if they snacked but quickly learned to ask instead what they snacked on and when to obtain a somewhat better picture of their food habits. Even so, I knew, and so did they, that the answers were vague and inaccurate because who pays attention when nibbling is going on?

Tracking eating would be such an asset when a diet begins to fail. The common response of a dieter at this time is that, "The diet is not working anymore." This is like saying that the antibiotic is not working anymore when a patient stops taking it too soon. It would be so useful for the dieter to notice lapses in eating like drinking too much wine, ignoring portion sizes or extra fat ingredients creeping into a dish and uncontrolled snacking. Lapses always occur, and one of the missions of a weight-loss consultant is to identify weak points and work out strategies to prevent them in the future. But these lapses have to be recognized, and right now there is no easy and acceptable way of doing so.

So back to our dogs. What if we outfitted them with tiny video cameras attached to their dog tags? Or they could be trained as watch dogs, barking when the dieter deviated from the food plan? I fear, however, that not all dogs would be equal to the task. Mine wouldn't bark, instead he would appear to be saying, "As long as you are up, get me something, too."

]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120310-074348 2012-03-10T00:00:00Z 2012-03-10T00:00:00Z
The nutrient intake of the solitary eater does not bear scrutiny. It would make a dietician's mother weep. I found that one of my greatest challenges in weight-loss counseling was motivating the solitary eater to spend time buying and preparing the foods on the diet. Invariably, I would be asked which microwavable meals could fit into the diet plan, because the dieter could not be bothered even with the simplest of meal preparation. Suggestions such as buying bagged vegetables that were already cleaned, pre-cooked chickens or sliced roast beef were viewed as just too much trouble. It was easier to order take-out or microwave something inside a cardboard box.

I used to fret over how to convince my clients that they would save calories and money if they could extract a few hours each week to go the market and then spend 10 to 15 minutes to prepare a meal. But then I realized that the problem wasn't merely lack of time, the tedium of food shopping or cooking. The real problem was that, whether it came from a box or was delivered by a butler, it would be eaten alone.

"Why bother cooking for one? I won't enjoy eating it alone," was the mantra I heard over and over again.

Eating is a social activity. It always has been, mainly because in the early ancient days finding food, whether by hunting or harvesting, was a communal activity, as was its preparation. Few people lived alone (I don't think there were caves for singles in those days) or ate alone. There are those who claim they set the table, light candles, use cloth napkins and nice china when they eat dinner, but I have never met anyone who does this. Most of my friends who eat alone frequently, or on the occasion when the other members of their house are away, manage to consume their dinner standing over the sink or stove or sitting in front of their computer, TV or even on their bed. If they do sit down at a dinner table, they tend not to linger once the meal is over. The niceties of a set table, candles and good china are saved for those times the meal is being shared with others.

A reluctance to cook and instead rely on take-out or cereal and milk has nutritional limitations. Few take-out menus that I have seen meet government standards for foods containing whole grain and nutrient-rich vegetables and fruits. And even seemingly healthy take-out foods like those offered by supermarkets such as Whole Foods may contain large amounts of fat. Oil is quietly added to cooked foods such as chicken, vegetables, potatoes and rice to keep them moist.

Ironically, it has never been easier to buy semi-or entirely-prepared foods and, with only minutes of effort, transform them into a nutritious meal. Supermarkets are full of food items that require only heating to make a main course, vegetables, a starch and dessert. The entire process will take less than 10 minutes, but since many solitary people still won't do it, other solutions are needed.

What about this?

Make lunch, not dinner, the major meal of the day. Sharing a meal at lunch is easy... Co-workers, friends, other at-home moms or workers can usually share 30 minutes time for mutual munching of a lunchtime meal. Restaurants offer complete meals, the price is considerably less than at dinner, and the service is designed to be quick. You may hate eating grilled chicken, stir-fry vegetables and rice alone at night, but eating the same meal in a lunchroom with your colleagues or while sitting on a park bench with a friend on a warm day will add the taste of companionship to the meal.

There is another good reason for making lunch your main meal. In my experience, lone eaters rarely make themselves breakfast, or if they do, it is often limited to a hot beverage and toast or cereal and milk. Hunger may arrive around lunchtime due to the sparse morning meal. A well-balanced lunch may provide the first substantial nourishment of the day. (It may be the only meal to provide a variety of nutrients if dinner, like breakfast, is limited to cereal and milk.)

So what do you do at dinnertime if you have eaten your main meal at lunch? Eat a dinner that feels all right being eaten alone, which could mean:

A bowl of vegetable soup, a roll and fresh fruit
Scrambled eggs with melted cheese and an English muffin, sliced tomatoes and red pepper
Oatmeal with chopped apples, apricots, raisins and handful of walnuts (All the fruit comes sliced and chopped in the supermarket.)
Pineapple cottage cheese layered with fresh strawberries and a banana topped with handful of granola
English muffin and jelly
Toaster waffles used as base of open sandwich. Top with sliced turkey or roast beef (from deli), red pepper slices and red onion. Add mustard and pickles as desired

All of these menu items can be eaten standing up, while walking around, at your desk, doing laundry, watching TV or reading. If you want to add candles, wine, a real plate and napkins, please do so. Bon appétit!]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120309-102903 2012-03-09T00:00:00Z 2012-03-09T00:00:00Z
A Weight Watcher dieter is told to plan his/her daily food intake based on a point system. Foods are given specific number of points, and it is up to the dieters to choose among the selections so they do not exceed that number. For the most part, the more calorically dense the foods, the more points assigned to them. Some foods, however, regardless of their caloric value, have more points than others. These tend to be snack foods and to some extent, carbohydrates in general. The higher points of these foods supposedly encourage the dieter to eat lean protein and other foods that have fewer points rather than squandering two or three out of the daily allotment of 26 points on a snack. As a friend who is a Weight Watcher told me, "You learn quickly not to eat a food with too many points because it is like overspending your pay check. You may not have enough food to eat for the rest of the day."

The absence of points for fruits and vegetables was adopted as a means of shifting the dieter's food choices to some of these vitamin-rich foods, relatively low calorie foods. However there are some puzzling aspects to removing points from fruits when some of these foods have the same number of calories as foods with points. For example: Both a large banana and one serving of oatmeal have approximately the same calories. Yet according to the Weight Watchers plan, banana consumption is unlimited, whereas two or three servings of oatmeal will use up the limited number of points. The newspaper article quoted officials at Weight Watchers as being unconcerned that dieters might not lose weight if they indulge themselves in eating as much fruit as they want since most of fruit consumed will be low enough in calories to have little impact on total daily intake. But is this really true? Weight loss occurs only when calories consumed are less than calories needed, regardless of whether the calories are coming from pork rinds or watermelon rinds.

Although a conscientious dieter will be as restrained in eating fruit as cheese cubes, some dieters may find themselves reverting back to the mindless nibbling that brought them to a weight loss program in the first place. My weight loss clients often told me that they had no idea how much fruit they would consume each day, especially during the summer when the variety was vast. Two or three peaches, a cup of watermelon and handfuls of blueberries or grapes would not even be on their food intake radar because, as I was often told, "Fruit is good for you, so I never counted calories or even counted how many pieces of fruit I ate. When I felt like putting something in my mouth, I would reach for a plum (or strawberries or tangerine or apricot)."

What is even more troubling is that some dieters may resort to eating excessive amounts of fruit because they are attempting to satisfy their cravings for something sweet. In the New York Times article, Elizabeth Josefsberg, a New York area Weight Watchers meeting leader, disputes this notion. "When you finish a banana, you don't say, 'Gosh, I want another banana,'" she is quoted as saying. Ms. Josefsberg is only partially right. No one wants another banana. They really want a cookie. However, they may eat the second or third banana or the fifth peach because the cookie costs them too many points and the fruit doesn't cost them any.

Some people, dieters and non-dieters alike, experience a brain-influenced craving for something sweet or starchy, usually in the late afternoon but sometimes in the mid-evening. The need to eat carbohydrate is felt as, "... a jaw-aching need to munch on a carb snack," according to one of our early volunteers in a study carried out about 20 years ago. Our research at the MIT clinical research center uncovered the reason people we termed, "carbohydrate cravers," need to snack. Extensive studies revealed that the craving is linked to a decrease in the activity of the brain chemical, serotonin. This alteration in serotonin activity was associated with feelings of restlessness, distractibility, anger, fatigue and irritability. Our volunteers told us that they tend to feel this way every afternoon or mid-evening; they claimed that following a carbohydrate snack, their mood improved, and they become more focused and energetic.

Were they eating carbohydrates as a way of making themselves feel better? That turned out to be the case. Serotonin is made and its activity increased when an amino acid, tryptophan enters the brain. Tryptophan enters the brain after insulin is secreted, and insulin is secreted after carbohydrates are eaten. We believe that the urge to snack on carbohydrates in the late afternoon or evening comes from the need of our brains to increase serotonin synthesis.

Unhappily for the fruit consuming dieter, the sugar in fruit, fructose, is the one carbohydrate that does not promote serotonin synthesis. In other words, no matter how much fruit is eaten, the serotonin-generated cravings will remain.

As we describe in our Serotonin Power Diet book, relatively small amounts of carbohydrate are needed to start the process of increasing serotonin synthesis. The consumption of about 120-130 calories of a fat-free or very low-fat carbohydrate snack such as shredded wheat squares, rice crackers, jelly beans or breadsticks, is sufficient. Snacks that contain more than 1-3 grams of protein prevent tryptophan from entering the brain, so the carbohydrate snack works best to increase serotonin if eaten a few hours after protein has been consumed.

Serotonin may be a dieter's best friend, as not only does this neurotransmitter improve mood, it also increases satiety, i.e. the sense that enough food has been eaten. Eating a serotonin-producing snack an hour or so before a meal increases pre-meal fullness so that a small portion controlled meal does not leave the dieter yearning for more to eat. The snack may not be point-free according to the Weight Watchers plan, but it will free the dieter from his or her cravings.]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry120308-090644 2012-03-08T00:00:00Z 2012-03-08T00:00:00Z
But desk-jockeys, too, can use diet and nutrition to increase their energy, focus and mental agility. And that means there are three opportunities a day to be your best self at the office.

Dr. Judith Wurtman, a nutrition expert who wrote the book “Managing Your Mind and Mood Through Food” and a regular Huffington Post blogger, has made a career of telling people how to eat to their best advantage. Luckily, her advice falls well within the realm of “normal” daily diets – and the offerings of most office cafeterias. Even luckier still, she has good news for the java junkies among us.

“There are two components of food that have a proven effect on mental performance: protein, and caffeine,” says Wurtman. “For any situation where you need mental alertness – say you’re a lawyer arguing a case, or a negotiator sitting down with opposing parties to find a solution – you need protein,” she says. As for the java jolt, “of all foods, caffeine has been shown to be the most potent stimulant of mental acuity, alertness, and reaction time for problem solving.”

In other words, people who are used to starting their day with a strong cup of joe should keep at it. And drinkers of caffeinated cola or tea, which has a substance similar to caffeine, can relax in the knowledge that their stimulant of choice is delivering the goods, as well.

So, let’s say that, like an athlete, you’re watching your diet. You’re eating proteins at breakfast and lunch, and carbs at night. You’re drinking water all day long (and no alcohol at lunchtime), and you’re avoiding fat-laden snacks. You’re good to go, right? Focus, energy, and attention, here we come?

Almost. There is one more factor we need to keep in mind, and it’s the most important of all, Wurtman says. In fact, it could mean the difference between winning the race, and not crossing the finish line at all.

Get your shuteye

“A lack of sleep has an incredibly powerful effect of decreasing cognitive ability,” Wurtman says. “You can’t eat your way out of it.”

Seven hours of sleep at night is considered a miniumum, and sleep is especially important for the modern global executive, who may be on-the-job nearly round the clock, working in many time zones at once.

“You wouldn’t want an airline pilot to fly you if hadn’t had sufficient sleep, would you,” Wurtman asks. “Well I wouldn’t someone in that condition to pilot my financial situation either.”
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