http://www.serotoninpowerdiet.com/blog/index.php Copyright 2010, Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD en-US SPHPBLOG 0.4.8 http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100720-122026 If you are 65 or older, expect to be called elderly. This term is used in statements of national health policy and, unfortunately, conjures up a picture of a frail individual, walking very slowly or with the aid of a walker, and needing help getting into a car or over a doorsill. There are obviously people in the 7th decade of life and beyond who fit this description. But many in the “elderly” age category make the term seem ridiculous. I became aware of this after visiting a gym in Lenox, MA this summer.
Lenox is the summer hub for musical and other cultural activities and draws visitors from nearby New England states and New York. Many retirees spend long weekends or even a month or two in the area, and the people on the streets or walking the grounds of Tanglewood where the Boston Symphony performs might justify the term elderly. They walk slowly, some with canes, and do not seem particularly fit. But the gym we visited on a Sunday morning made me realize that there are many who would be dismayed at being classified as “elderly.”
Looking around as I paused between some arm exercises, I noticed with surprise that the majority of the people exercising were in their sixties or older. There were similar numbers of men and women and all were exercising quite intensely And, unlike my gym at home where at least half the members have a trainer next to them, urging them to work out even harder, here everyone was exercising alone. They were working out quite hard. A woman on a mat—she looked as if she was close to 80—was doing so many abdominal crunches that my own stomach hurt just watching her. A man who must have been at least 75 was lifting at least twice his weight over his head and a woman on a machine I wanted to use next was grimacing with exertion as she exercised her back muscles. After she was finished, we began to chat and I learned that she was 72. She had the body of an athletic 55 year-old. The same age groups occupied the various aerobic workout machines and their sweat and facial contortions indicated some serious calorie burning.
Later that day, I met some acquaintances who were staying in Lenox for a long weekend. Two of them were comparing their long, hot, hilly runs earlier that day and talking about what routes they would take the next day. One was 78 and the other, 69.
All these people meet the age-based definition of elderly but they hardly fit the stereotype of an old person. The 72 year-old woman with whom I chatted told me that after retiring from an extremely busy career as therapist, she now is a full -time artist with a gallery show coming up in the fall. Being physically fit is only one component of her vigorous and stimulating life.
These exercising elderly are, unfortunately, an exception. National statistics on the lifestyle of people 65 and older indicate that considerably less than 50% of people in this age category exercise routinely and very few do anything as vigorous as what I saw in the gym. Their sedentary lifestyle did not typically start when they received their first Social Security check but rather decades earlier. The majority tends to avoid physical activity rather than seeking it out even though the benefits on health, weight, mental alertness and even memory have been recited over and over. Many people use their age as an excuse for not starting or maintaining any exercise routine. Several years ago a new client in our weight-loss clinic announced that we should not expect her to join our exercise program because she was too old. She had just turned 40.
Telling people how important exercise is and then giving them a long list of benefits doesn’t seem to work. People who exercise routinely will quote its virtues but usually the only ones who listen are those who are also engaged in regular physical activity. We asked people at our weight-loss center if they would bother exercising if it had no impact on their weight and the answer was an almost universal NO.
So maybe the argument that will work is “exercise will let you lie about your age” because you will definitely look younger than those your age who are sedentary. You will stand straighter, the flab on your arms will be exchanged for muscle, your walking pace will increase, you will climb stairs easily, have no problem carrying heavy packages, and will easily give up your seat on the subway to someone at least 15 years younger than you. And you will be like my friend who ran several blocks to catch a bus. When she climbed aboard and showed her senior bus pass to the driver she was told to pay full fare. He told her, “Anyone who runs like you isn’t a senior citizen.”

]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100720-122026 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Tue, 20 Jul 2010 19:20:26 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100720-112446
Farmers markets are one of the joys of the summer. For those of us who typically buy our produce from supermarkets, and are happy if the vegetables and fruits did not have to travel more than several thousand miles to the display bins, being able to buy locally grown fruits and vegetables is a special treat. Pulling together tasty low-calorie carbohydrate main or side dishes, with only a few items from the farmers market, is easy and doesn’t require spending time in a hot kitchen.
Newly picked corn is already appearing in the markets and as we go into August more will be available. Because the carbohydrate in corn kernels turns from sweet to starchy as the corn ages, we tend to think of this yellow vegetable as densely starchy, particularly as cornstarch, corn meal and grits. Young corn is just the opposite. It needs only a few minutes of cooking and doesn’t require butter or salt for flavoring. It has a delicate sweet taste and the kernels are juicy, not dry. A dinner of cold soup, salad and new corn is a perfect way to dine on a hot evening. If lack of teeth, braces or dental floss requirements make eating directly off of the cob impossible, remove the kernels with a sharp knife before serving.
Peas still in the pod always jar me into remembering that they do not grow in frozen bags on the vine. And like corn, before eating, they have to be removed from their container or pod. Peas are another starchy vegetable that, when old, lose their sweetness. But fresh off the vine, they taste sweet with a flavor not found in the frozen or canned versions. Shelling them is fun and a task enjoyed by young children. They require only brief steaming or simmering or, if added raw to hot rice or pasta, no additional cooking. They also taste good as a snack, sprinkled with a little salt after a brief steaming.
Tiny potatoes called fingerlings are now available and along with red-skinned potatoes and Yukon Gold, become the basis for a variety of potato salads. These salads are not the typical mayonnaise-drenched potato salads with bits of green pickle. Instead they use mustard, lemon juice, small amounts of olive oil and fresh herbs as seasoning. By adding various vegetables from the farmers’ market such as new onions, halved cherry tomatoes, diced zucchini or yellow squash, fresh corn kernels, new peas, and diced new carrots, the salad is not only colorful but packed with vitamins and fiber from all these vegetables. Make sure the potatoes are not overcooked; otherwise they will turn mushy. Test them for doneness with the tip of a paring knife. Remove them from the heat just before they are done, as they will continue cooking for a few minutes until they are cooled. The trick to enhance the flavor is something that I learned from Julia Child’s Mastering the Art of French Cooking: Pour the dressing over them while they are still warm. Julia Child’s recipe calls for homemade beef or chicken stock and white wine but a contemporary version made from apple cider vinegar, olive oil, Dijon mustard and chopped fresh basil leaves works just as well. (Don’t use balsamic vinegar. Doing so will make the potatoes look like beets.)
Because crusty fresh bread makes any carbohydrate craver happy, buy some from the local bakery stand at the farmer’s market. If you are lucky enough to shop where locally made goat cheese is also for sale, purchase some to eat along with the bread or add it to a salad. Because the cheese has such a robust taste, a small amount will satisfy you.
Don’t overlook the local fruit for sale either. Even though the carbohydrate in fruit does not make the comfort brain chemical, serotonin, the blueberries, raspberries, and blackberries that are being picked now make even the hottest days of summer endurable.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100720-112446 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Tue, 20 Jul 2010 18:24:46 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100712-121347 When people start a new sport, say skiing, running or tennis, they start slowly. A bunny slope for the new skier, jogging for the runner and a tennis partner who expertly hits all the balls into the racket of a brand new tennis player are all appropriate for beginners.
The new dieter should also be allowed to start slowly but this is rarely the case. The early days of many diet plans are designed to get the weight off as quickly as possible and this means that the dieter must learn and immediately obey every rule set out by the diet program. This is expected despite the fact that many plans are extremely complicated and designed to take over the life of the dieter. The novice may have to learn how to weigh and measure everything that she eats, figure out the difference in points between orange and grapefruit juice, record every morsel that crosses her lips, and eat all the food on plans offering prepared meals and snacks (no substitutes allowed).
For the novice dieters, indeed for many dieters, all this is very hard to do. Unless the dieter is living in a residential weight-loss center where all this is done for her, she has to figure out how to shop and prepare the foods on the plan, learn how to measure an ounce of dry spaghetti (without spilling the pasta on the floor) and eyeball a banana and tell whether it is small or medium. Her taste buds must adapt themselves to salad dressings consisting of lemon juice or vinegar and skinless chicken breasts seasoned only with mustard. Social interactions that restrict food choices pose additional problems, as the new dieter struggles to balance the demands of the diet with the demands of a relative to eat. The admonition to keep a food record represents an additional burden, as the dieter must remember at l1 PM whether she ate six or was it seven grapes as a snack at 4 PM. And because the dieter has a life, one that probably includes family and work responsibilities, she also has to worry about what to eat at work and what to feed the family and herself at dinner.
These challenges may be simply too much. It is as if a person who can barely jog down the block and back again is told to run a marathon or someone who just learned how to tread water is expected to swim the English Channel. In order for a dieter to reach a successful completion, she has to be allowed to feel her way into the diet gradually, retreat from it if it seems too overwhelming and then start again. It’s like the way most of us who spend summers in New England enter the frigid ocean water. Few plunge in and if they do, may feel frozen in place. The rest of us go in gradually until our bodies feel accustomed to the temperature and then happily paddle around until we start turning blue.
The following guidelines are designed to help you, the new or returning dieter, start a diet successfully so that it will end successfully.
1. Begin when you have the appropriate equipment and food and not before. (You aren’t allowed to bowl until you put on the right shoes or go on the ice without ice skates.) Equip your kitchen with measuring cups and spoons, a couple of sharp knives and a cutting board, a carrot peeler (good for potatoes also) and some sturdy cookware. If you are over a certain age, make sure you have your reading glasses with you to check food labels when you go food shopping. Buy foods that will make up the staples of your diet and in a form you are willing to eat. Hate milk? Eat cottage cheese. Don’t like cooking vegetables just for yourself? Buy packaged salad mixes and peeled, sliced, bagged vegetables. Cooked lean roast beef, chicken and turkey are available at the deli counter, if you don’t want to convert a raw chicken breast into something edible.
2. Get rid of the tempting, fattening foods in your house, your car, your desk at work and your bag or briefcase. You can’t be expected to resist popping an old Halloween candy into your mouth if it falls out of your linen closet or finishing off a quart of ice cream stuck behind a bag of frozen Brussels sprouts.
3. Plan menus that are convenient and comfortable for you. This is like planning a running route as a beginning runner. You would not start out jogging up a hill if making it to the end of your driveway was about all you could do without need oxygen. The same is true about what you eat. No time for breakfast? Don’t plan on making egg-white omelets. Eat cereal and milk, toast with a low-calorie spreadable cheese, or a bowl of oatmeal with a dollop of yogurt. Are you in the car from 4 to 6 PM taking your kids to their activities? Make suppers for all of you that can be assembled in minutes. Note: Invest in a rice cooker. They keep rice fresh and warm for hours and it is lovely to come home to the scent of jasmine or basmati rice. Add roast chicken bought from the supermarket and bagged salad and cut up veggies from the produce section. Your dinner for everyone will be ready before your kids have washed their hands.
4. Anticipate problems before they occur. Business meals, travel, social obligations and vacations may conflict with the diet program’s menus and often the timing of meals. If you realize before you start the diet that there will be times when you will not be able to follow it, then you will avoid feeling guilty and angry with yourself.
5. Expect mistakes. Remember starting at the bottom of the learning curve means that you can only get better at what you are doing. Anyone who wants to get better at a sport or playing an instrument or writing a book has to practice. So if you make a mistake following the diet, you are in a club with an infinite number of members.
6. Allow yourself a time-out if following the diet becomes difficult, frustrating or overwhelming. When you feel your motivation slowing down and excuses replacing adherence to the diet, stop. Beginning runners are told to run for 2-3 minutes and then walk until their breathing slows down, usually about a minute. The pause gives them the strength and stamina to start up again. Do the same with the diet. Be mindful of what you are eating during the diet pause so you don’t risk gaining weight but do relax your strict adherence to the diet plan. Take time-outs as often as necessary during the early days of the diet. Eventually, just as the new runner can drop the run-walk-run pattern and just run, you will be able to drop your diet pauses and just diet. The diet will feel easy and comfortable all the way to your goal.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100712-121347 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Mon, 12 Jul 2010 19:13:47 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100628-180134 In the old days, maybe five years ago, dieters were warned against combining eating with other activities such as reading, watching television, looking at the computer, studying or taking care of desk work. Now talking or texting on the cell phone and perhaps playing with the iPad (if one is lucky enough to have one) can be added to the list of things forbidden while eating is in progress. I wondered how many people know or even care about these so-called dieting rules. During this season of sidewalk dining, it is easy to stare at what people are doing during a meal or snack as often their tables are practically in the path of passing walkers. A quick survey during a warm, sunny lunchtime interval indicated that few eaters had heard about not multitasking while eating. A good number were tapping away at a computer keyboard with one hand and holding up a sandwich so it would not drip with the other. Many were on their phones, biting into and chewing sandwiches while they chatted. Several others had stopped eating for a few minutes to do some texting and those not engaged with their electronic companions were reading newspapers or books. A few were talking intently but I saw no adult concentrating only on eating one bite after another without any other on-going activity. The only individual doing this was a toddler intent on bringing one Cheerio at a time into his mouth without dropping it on his chin.
According to experts on how to control overeating, multitasking while eating is a prescription for eating too much. Presumably if you do not pay full attention to every bite that goes into your mouth, you will eat more than you intended or eat foods that are incompatible with your diet or attempts to keep your weight stable. For example, you order a sandwich and fries or potato chips surround it. You look at the plate, decide that you can’t possibly eat the fries or chips, push them aside and start on the sandwich. But your phone rings, your computer signals a new e-mail, your dining companion starts to tell you a fascinating story or you become engrossed in a book. Your hand reaches out to the fries or chips and, without realizing it, you end up eating all of them. When your hand encounters emptiness, you stop, horrified at what you have consumed. “See, “ your inner conscience chides you, “you should have been paying attention. Now look at how many calories you just ate.”
But is this true? Would we eat less if we paid attention only to our eating and nothing else? If you are eating alone and the only thing that keeps you company at a meal is your napkin and maybe a dog waiting for a handout, would you eat less than if you were watching television or texting a friend? I suspect the answer is no. I doubt that someone who sits and has nothing to do but count the number of chews it takes before a carrot slice can be swallowed will end up eating less than someone engrossed in a good book. Indeed, the individual doing nothing but eating might decide that he or she has the right to eat something enjoyable and presumably fattening to compensate for the boredom of having nothing else to do.
However, just to be sure that multitasking while eating does not lead to the consumption of too many calories, follow the simple guidelines below.
Eating alone at home? Serve yourself everything you plan on eating and eat somewhere other than in the kitchen. Do not go back and take more food just so you can keep on watching television, talk on the phone or read. As long as the portion you served yourself represents everything that you should be eating and drinking for that meal, it doesn’t really matter whether you pay attention to every morsel you put into your mouth.
Eating alone in a restaurant? Be mindful of what you order and remove temptations before they arrive on your plate by alerting your server to substitutions. If chips do come with the sandwich ask if you can have a salad instead and if necessary pay extra. (It is cheaper than going to a Weight Watchers meeting.) Make sure the salad dressing is not dumped on your salad and don’t mindlessly dump it on yourself. If something arrives that you would like to eat but should not, such as fries, ask that they to be taken back or if dining outside, feed them to the squirrels. Here’s a minor but important point: Don’t read and soak bread in the saucer of olive oil. Each dunk is probably about 14 grams of fat and almost 200 calories.
Eating at work? Here it is important to stop working even for five or ten minutes so you can do something relaxing while eating. Don’t answer the phone, tap away at your computer or feel you have to answer the e-mails on your Blackberry. Take out your book or newspaper or find a colleague and relax while you are eating. But also be careful about what you eat. If the local greasy spoons offer only highly caloric foods, it won’t matter how mindful you are of what you are eating. You will still eat too many calories. Bring your lunch or find a local restaurant with more nutritious food.
Finally, the best way to multitask while eating is to share your meal with someone you want to be with. People rarely overeat under such circumstances. Novels are filed with narratives of shared meals and rarely, if ever, do these episodes lead to one of the parties worrying about eating too much.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100628-180134 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Tue, 29 Jun 2010 01:01:34 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100622-144513
Several weeks ago, we were planning a retirement party at work. The employee had taken upon herself the task of planning parties for others throughout the years, and we all felt she was owed an elaborate send-off. But the plans were dropped after we learned that she was currently a volunteer in a six-month long nutrition research study. All food and drink during the study had to be consumed at the research center, and she was not allowed to consume anything else.
What was the point of having a party if the guest of honor couldn’t eat or drink? She insisted that it didn’t bother her to see others enjoying the food and beverages but somehow it didn’t seem right. Could one have a social gathering without serving something to drink and nibble on? This was the question left by our decision to cancel our plans and now, weeks later, no one has come up with a satisfactory answer.
“Come over for drinks.” “Let’s meet for coffee.” “So you want to have lunch?” “Are you free for dinner?” “Refreshments will be served.”
These, and countless other food and drink-based invitations, reinforce the idea that when people get together to socialize or even have a meeting, food and drinks should be available. And even if no announcement about eating and drinking is made ahead of time, it is a rare meeting, talk, workshop, or reunion that does not have a table somewhere on which snacks and drinks are displayed.
The association between being with other people and eating and drinking must have its roots in our earliest history as social beings. Food had to be shared, especially when its source may have been a long and dangerous hunt. And presumably (my information comes mainly from dioramas in the Museum of Natural History in New York) people gathered together to eat after a successful hunt or later on, a harvest. But in these instances, the food came first and people assembled to eat it. Now, in contrast, even if our primary reason for getting together is to socialize, exchange information, support each other or conduct business, we assume that eating and drinking will accompany the business at hand.
Dieters find this particularly trying, especially as many of the foods available at business meetings, conferences and family celebrations are too caloric to fit into a diet and too tempting not to be eaten. Many dieters have complained to me about the difficulty they have sticking to their program when they are confronted with pizza, chips, cookies and regular soda at a business lunch or workshop .
Is it possible to get together without eating or drinking? Could we have had a celebration of the employee’s years with our group without food and beverages? No, we couldn’t do so in a conventional setting. It is hard to imagine a group of people standing around chatting with the guest of honor with nothing but napkins on the table. But there are situations in which people do assemble without reflexively looking to see what is being served. They include:
1) Airplanes trips. Carriers will continue to serve drinks but, as everyone knows, unless you bring your own food, or spend an outrageous amount of money for a cookie, you are going to sit through a several hour trip not eating. Interestingly, on trains almost everyone gets something to eat from the café car.
2) Religious services, especially weddings and funerals (although the lack of food in the house of worship is made up for afterwards)
3) Sports. Other than drinking water or a sports drink, most people participate together in many sports without eating. (This does not apply to people in the stands.) I noticed that hikers and long-distance bikers will eat to keep the body going and not as a form of social activity.
4) Spontaneous social interactions. Bumping into a friend on the sidewalk, supermarket or hardware store may lead to conversations lasting several minutes without either party feeling the need to eat or drink while talking.
5) Museums, concerts, ballet, theater. Although many cultural institutions provide places to drink and snack prior to or after an event, many people manage to walk through an exhibit with friends, or sit through a long opera with family members, without eating or drinking. (This is not true for movies.)
6) Watching the fireworks on the 4th of July. Although much eating and drinking occurs before and often after the event, people are too busy saying ooh and ahh to eat or drink. The same goes for really good parades or air shows.
7) Playing cards. A friend who takes her bridge and her bridge partner very seriously told me that while they might nibble before the game begins, it is considered bad form to eat while playing a hand.
8) Seriously interesting conversations. Although I have no proof, I suspect that if two friends get together for an exchange of what is known as gossip, they don’t care if there is food or not.
9) Amusement park rides. One rarely sees couples eating or drinking while being tossed around in something that looks as if it is about to crash.
10) At your own wedding! Everyone else may be eating and drinking but the honored couple are unlikely to forgo their first dance in order to eat the appetizer.
We still haven’t figured out how to socialize at work without food or drink but our guest of honor benefited. We used money that would have gone for the party and bought a going-away gift instead.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100622-144513 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Tue, 22 Jun 2010 21:45:13 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100616-131111 For thousands of years our bodies have relied on the sun to change certain compounds in our skin into vitamin D. Even though this is the natural way of acquiring this essential vitamin, it is not always the most reliable. Even if you don’t live in a part of the world where it is dark six months of the year, difficult weather conditions may make sun exposure uncomfortable or impossible. Moreover, few of us have jobs that allow daily sun exposure; presumably lifeguards get enough of this vitamin during the summer but those jobs are fairly rare and seem to be limited to people who not only can swim well but sport excellent hair and great bodies.
Additionally, our national concern with skin cancer and, for some of us, the wrinkling and aging of skin, have made us into sunblock and sunscreen users. Even at low strengths, these substances can block the skin synthesis of vitamin D.
Yet this vitamin is absolutely essential for bone growth and maintaining bone integrity. Much ongoing research is being done to characterize its role in the heart disease, diabetes, hypertension and even mood disorders.
People most at risk for not getting enough sun and vitamin D are infants, young children and the elderly. The rapidly growing child needs vitamin D for bone growth and the frail indoor- living older individual needs vitamin D to prevent bone loss. Rickets, a disease caused by lack of vitamin D that used to be common in children, led to bone deformities and short stature. Fish oils and oily fishes such as mackerel are good sources of vitamin D; a prevailing memory of my pediatrician’s office was the odor of cod liver oil, which was considered a reliable source of this vitamin. Fortunately, vitamin pills have removed the struggles of mothers in getting their kids to swallow the foul-smelling liquid. Unfortunately, not all kids get this vitamin in pill form because it is assumed, erroneously, that fortified foods like cereal and milk will provide the vitamin D not being made by the sun. But the vitamin D content of food is too low to do this unless large quantities are consumed.
Elderly individuals have a different problem. They may not be using sunscreen to prevent wrinkles; presumably when one reaches the late eighties or nineties, worry about wrinkle development in latter life is no longer an issue. But they are rarely outside and when they are, they sit in the shade or are covered up. I volunteer as a visitor at a Miami old age home. My offers to take the women I visit outside, in their wheelchairs, is always rejected as being too much of a bother. So despite the prevalence of sunny days, these women never are exposed to the sun and never benefit from its effects on vitamin D manufacture. They don’t take vitamin pills either, even though they are available, because as one woman told me, “ I take enough pills everyday. Why add one more?”
But one does not have to be very young or very old to be at risk for vitamin D deficiency. According to government standards, the vitamin D requirement raises from a daily requirement of 200 I.U (international units) before the age of 50 to 400 I.U for the second half of life. These figures are now considered too low and recent conferences on vitamin D have markedly increased the requirements, especially from middle age on, to 1000 I.U. or more. Physicians can order blood tests to determine the levels of active vitamin D and make recommendations based on what you personally need.
Vitamin D deficiency has been suggested as one factor in depression, although the research findings are controversial and it may take several more years of research to know whether the vitamin will help depression. It is unclear which comes first: vitamin D deficiency or the lifestyle of someone getting depressed who stops taking vitamins and doesn’t go outside. But unless physicians, or the family members of someone who is depressed, are aware that an individual may be vitamin D deficient, it may be weeks or months before supplements are taken.
Many people hate taking pills, even vitamins. An alternative is cod liver oil. But one taste should drive even the most determined pill avoider back to that bottle of vitamin D tablets. Think of it as sunshine in a bottle (without causing wrinkles).



]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100616-131111 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Wed, 16 Jun 2010 20:11:11 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100601-184359 A new weight-loss client of mine (let’s call her Susan) was explaining why she had gained almost 80 pounds over the past l8 months. The death of a parent had led to chronic problems with her siblings over the disposition of the mother’s home and possessions. As she explained to me, she felt angry much of the time and found that eating helped soothe this uncomfortable emotion. The foods she selected were very high in fat: fried chicken, French fries, bagels heaped with cream cheese, salads heavy with mayonnaise, baked potatoes with gobs of butter. “When I realized that I was going to lose my fight with my siblings, I just couldn’t bear thinking about it. Eating lots of fat made me tired enough so I could retreat to my bed and go to sleep. It was a way of escaping from a really bad situation.”
It is difficult to find studies that affirm Susan’s experience but anecdotal evidence is robust. Large quantities of fatty foods produce a lethargy and fatigue that some have described as “being drunk on food” or being in an “emotional coma.” One consequence of feeling this way is that the eater feels incapable of dealing with the problems caused by the stressful situation. In some cases, where there really is no way of making things better, the escape offered by the fatty foods is quite compelling.
Carbohydrate consumption produces a different sort of emotional effect. Many research studies have shown that because the brain chemical serotonin is increased after carbohydrates are eaten, a general improvement in mood results. Anger, anxiety, irritability, confusion and fatigue decrease and energy, vigor, and hopefulness increase. The stressed individual who eats carbohydrate is less likely to try to escape her problems and more likely to try to cope with them.
In my experience with weight-loss clients, many switch from the fatty foods to carbohydrates when they realize that they are going to have to deal with the problems presented by the stressful situation. Many years ago, I had a client whose husband had a terminal illness and was given a very short time to live. She told me that she deliberately ate large quantities of fat in order to knock herself out after visits to the hospital. She came to see me several weeks after her husband died because, as she told me, “I have to make all sorts of decisions now and I can’t think clearly when I eat so much fat. What can I eat that will keep me calm but not interfere with my thinking?” She responded to eating therapeutic amounts of carbohydrate, especially in the afternoon and evening when her loneliness and grief threaten to overwhelm her.
The problem with using fatty foods as a way of avoiding difficult problems is that, like going on an alcoholic binge, the relief is short lived and has side effects. The health consequences from a diet of fried everything may last much longer than the problems caused by the stressful situation. (Susan still has not solved her conflicts with her siblings and now is dealing with the need to lose those 80 pounds.) Carbohydrates are not only healthier; they do not leave the eater with potential medical problems and, if chosen wisely, supply a variety of vitamins, minerals and fiber to the diet. But they do not act as an edible anesthetic. The stressed eater is still aware of the problems that triggered the eating.
Perhaps the answer to what should be eaten when stress arrives is this: Eat carbohydrates (but not fruit as it does not lead to serotonin production) and seek emotional support from your family, friends or health care providers. Stress is hard to bear alone but the solution is not to curl up with a bag of potato chips for company. Recognize your need for emotional help if you see yourself turning to fats as a way of turning off your stress. There is sure to be someone who can offer more comfort and help than a candy bar does.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100601-184359 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Wed, 02 Jun 2010 01:43:59 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100531-060320
“Next to Normal” is a Broadway musical dealing with the common, but rarely sung about, problems of mental illness and the impact this has on the family. Despite its theme, the musical is often very funny while being uncannily accurate in depicting the symptoms of bipolar disorder and how current therapies affect the patient. In one very long musical sequence, the patient, the mother of the family, is put on a variety of medications to stabilize her out-of-control mania. In scene after scene she comes back to tell her psychopharmacologist about the side effects of the various medications he is trying and their lack of efficacy. To my amazement, she sings that one medication took away her appetite and then made her gain 10 pounds. “ Did you hear that?” I whispered to my husband as people around us laughed. “They sing about weight gain from anti-depressants on stage but psychiatrists still won’t talk about it.”
As we left the theater, I felt hopeful that this hidden cause of obesity might finally become mainstream. If it could make its way into the lyrics of a popular play, then maybe weight gain due to antidepressants and drugs used for bipolar disorder might be recognized as contributing to the epidemic of obesity In fact, the only part of the song that did was not entirely accurate was the weight gain of l0 pounds. Of course, this was supposedly after only a few weeks of treatment. Many drugs, especially those used for bipolar disorder, can produce weight gains upwards of 70 pounds over six months or so.
One of the saddest aspects of medication-induced weight gain is that people who experience it were often a normal size before drug use and without any history of eating problems or obesity. In our weight-loss center at a Harvard University hospital, we saw many clients who not only had been thin but also had led physically active lives. They would tell us that they did not recognize their own bodies after several months on their medication. Not only were they unable to control their eating, they no longer could exercise as their extreme weight gain left them fatigued and often with back or leg pain. Their family and friends did not understand what was happening and these formerly thin people were subjected to unkind and sometimes abusive statements about their new size. A few became recluses because they could not bear people looking at them. One of our clients, in high school at the time, refused to go to school because of the way she looked. Her mother had to home-school her.
And yet, as we point out in our book, The Serotonin Power Diet, this does not have to occur. The side effect of chronic hunger produced by the medications can be aborted by getting the brain to make more serotonin. No one is sure how the weight-gaining medications affect food intake but serotonin’s role in turning off hunger has been known for at least 35 years. It would be ideal if a drug existed that turned serotonin into an appetite terminator but there isn’t any. The only safe and effective way to get serotonin to function more potently as an appetite suppressant is to make the brain manufacture more of this chemical. This is easy to do and it is too bad the Broadway show didn’t mention it. Serotonin is made when non-fruit, starchy or sweet carbohydrates are eaten. As long as the food is eaten without protein and with very little fat, serotonin is made within 20 minutes or so. And as soon as it is made, it acts to shut off further eating.
Clients in our hospital weight-loss center and our private practice were given a diet we have reproduced in our book. They were told to consume a carbohydrate drunk, which we had developed for the clinic. It allowed the brain to make serotonin very quickly. They were also allowed to substitute a carbohydrate food for the beverage, if they wished.
Weight loss was immediate and easy because the additional amount of serotonin seemed to diminish or remove entirely the need to eat all the time. Some of the clients had to stay on the weight-loss plan for many weeks because they had gained so much w eight from their medication. They all told us they wished their psychopharmacologist had told them about our diet when they first started gaining weight and not after their weight gain became a major side effect.
But who knows? Now that weight gain from antidepressants and mood stabilizers is put to music, maybe some songwriter will tell the audience about eating carbohydrates to lose weight.

]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100531-060320 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Mon, 31 May 2010 13:03:20 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100522-053726 Television advertisements for highly caloric, yummy-looking foods have been around for so long that some of us avert our eyes when they appear so we won’t immediately give into the temptation to obtain the food. Otherwise, we would be phoning the local pizza place or raiding the freezer every time the commercials came on the screen.
Over the past several months I noticed something about the commercial breaks that may drive all of us to the kitchen to find something to eat even if the advertised product is not food. The time dedicated to showing commercials between segments of a network television show seem to be getting longer and longer. I noticed this when, during the commercials. I tried to take care of those last-minute household chores of the evening. To my astonishment, it was possible to get the coffee maker ready for morning breakfast on one break, brush my teeth for the allotted time on another and, if my dog was fast enough, take him out for a last minute “pee” break. But then once these tasks were completed, I was faced with the problem of what to do during the subsequent two or three minutes of advertisements. Going to the kitchen to find something to eat was always a possibility as was spending the time deciding whether I wanted to eat or not.
Eating to use up time is a chronic problem that many of us face. regardless of whether we are on a diet or simply trying to maintain our weight. When faced with large amounts of uncommitted time, such as on a rainy Sunday afternoon or during the evenings, it is too easy to spend the time walking back and forth from the kitchen. Often the best way to prevent this is to get out of the house or become so involved in an activity that the desire to snack is forgotten. In fact, diets will succeed only if the dieter can figure out how to spend the time he or she used to be spend eating doing something else.
It is easier to identify activities that use up several hours than it is to find something to do for three-minute intervals every ten minutes of a television show. Few people are going to run to the piano to practice a scale or put a few strokes of oil on a canvas during the commercials.
So I thought I would come up with a list of activities that can be done during the advertising interval and are far away from the kitchen.
1. Look up definitions of words whose meaning is a mystery to you. If you don’t have a dictionary, Google them.
2. Write a thank-you note or sign and address birthday, anniversary or other celebratory cards.
3. Check your appointment schedule for the next day. This is particularly important for people such as myself who write down meeting and other appointment dates but fail to open the calendar where they are written.
4. Scan the weather report in the newspaper so you can find somewhere in the world with worse weather than tomorrow’s forecast for where you live.
5. Check to see if your pet’s water bowl is filled.
6. Get down on the floor and do a minute’s worth of push-ups or abdominal crunches.
7. Stand on one foot during the commercial. With practice you might be able to do it for the full length of the advertising. This is a great way to improve your balance.
8. Go through the container where you keep your earrings and line up them up. Think about what to do about those missing a partner.
9. Fold clothes (this always has to be done).
10. Write down what you remember eating during the day and check to see if you consumed any vegetables, fruits or dairy. If not, program your cell phone or computer to remind you to do so tomorrow. This may take two commercial breaks to accomplish.
11. Empty your wastebaskets or yell at your kids to do it if it is their chore.
12. If you plan to travel to a foreign country, repeat an essential phrase in that country’s language like “where is the toilet?”
13. Check the thermostat and argue with your partner/spouse over the setting. This may take longer than the commercial break.
14. Floss your teeth, again. It’s impossible to do this enough.
15. Brush your cat or dog. Do not do this if animal is on bed unless you want fur on your pillow.
16. Watch the advertisements. Sometimes they are funny.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100522-053726 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Sat, 22 May 2010 12:37:26 GMT http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100520-104958 Television advertisements for highly caloric, yummy-looking foods have been around for so long that some of us avert our eyes when they appear so we won’t immediately give into the temptation to obtain the food. Otherwise, we would be phoning the local pizza place or raiding the freezer every time the commercials came on the screen.
Over the past several months I noticed something about the commercial breaks that may drive all of us to the kitchen to find something to eat even if the advertised product is not food. The time dedicated to showing commercials between segments of a network television show seem to be getting longer and longer. I noticed this when, during the commercials. I tried to take care of those last-minute household chores of the evening. To my astonishment, it was possible to get the coffee maker ready for morning breakfast on one break, brush my teeth for the allotted time on another and, if my dog was fast enough, take him out for a last minute “pee” break. But then once these tasks were completed, I was faced with the problem of what to do during the subsequent two or three minutes of advertisements. Going to the kitchen to find something to eat was always a possibility as was spending the time deciding whether I wanted to eat or not.
Eating to use up time is a chronic problem that many of us face. regardless of whether we are on a diet or simply trying to maintain our weight. When faced with large amounts of uncommitted time, such as on a rainy Sunday afternoon or during the evenings, it is too easy to spend the time walking back and forth from the kitchen. Often the best way to prevent this is to get out of the house or become so involved in an activity that the desire to snack is forgotten. In fact, diets will succeed only if the dieter can figure out how to spend the time he or she used to be spend eating doing something else.
It is easier to identify activities that use up several hours than it is to find something to do for three-minute intervals every ten minutes of a television show. Few people are going to run to the piano to practice a scale or put a few strokes of oil on a canvas during the commercials.
So I thought I would come up with a list of activities that can be done during the advertising interval and are far away from the kitchen.
1. Look up definitions of words whose meaning is a mystery to you. If you don’t have a dictionary, Google them.
2. Write a thank-you note or sign and address birthday, anniversary or other celebratory cards.
3. Check your appointment schedule for the next day. This is particularly important for people such as myself who write down meeting and other appointment dates but fail to open the calendar where they are written.
4. Scan the weather report in the newspaper so you can find somewhere in the world with worse weather than tomorrow’s forecast for where you live.
5. Check to see if your pet’s water bowl is filled.
6. Get down on the floor and do a minute’s worth of push-ups or abdominal crunches.
7. Stand on one foot during the commercial. With practice you might be able to do it for the full length of the advertising. This is a great way to improve your balance.
8. Go through the container where you keep your earrings and line up them up. Think about what to do about those missing a partner.
9. Fold clothes (this always has to be done).
10. Write down what you remember eating during the day and check to see if you consumed any vegetables, fruits or dairy. If not, program your cell phone or computer to remind you to do so tomorrow. This may take two commercial breaks to accomplish.
11. Empty your wastebaskets or yell at your kids to do it if it is their chore.
12. If you plan to travel to a foreign country, repeat an essential phrase in that country’s language like “where is the toilet?”
13. Check the thermostat and argue with your partner/spouse over the setting. This may take longer than the commercial break.
14. Floss your teeth, again. It’s impossible to do this enough.
15. Brush your cat or dog. Do not do this if animal is on bed unless you want fur on your pillow.
16. Watch the advertisements. Sometimes they are funny.
]]> http://www.serotoninpowerdiet.com/blog/index.php?entry=entry100520-104958 Judith J. Wurtman, PhD and Nina Frusztajer Marquis, MD Thu, 20 May 2010 17:49:58 GMT