Wednesday, July 13, 2011

Simple Food: Thoughts on Practicality

Some people have reacted negatively to the idea of a reduced-reward diet because it strikes them as difficult or unsustainable.  In this post, I'll discuss my thoughts on the practicality and sustainability of this way of eating.  I've also thrown in a few philosophical points about reward and the modern world.
 

The idea that excessive food reward/palatability contributes to fat gain, besides being well supported by scientific evidence, is also very intuitive.  It's not the kind of idea that will draw strange looks from the person sitting next to you on the bus.  If you take a careful look at the diets of healthy non-industrial cultures, even if some contain highly flavored items, they are almost invariably centered around one or a few simple staple foods such as taro, sweet potatoes, hand-pounded rice, milk, meat or nuts.  These typically make up the majority of the meal, are usually eaten plain, and are sometimes accompanied by smaller amounts of other more exciting foods.  Wealthy individuals throughout history that had access to expertly prepared rewarding/palatable food were much more likely to be obese.  No one, until recently, had access to commercially processed foods that were professionally designed and industrially created to maximize flavor consistency and reward value. 

We live in a society where most of the food is at a level of reward/palatability that our species has never encountered before.  We're surrounded by it, and everywhere we turn, someone is jockeying for our attention, trying to get us to purchase their food.  We're used to it-- and for the most part, we like it.  This professionally engineered food drives our behavior in a way that is only loosely under our conscious control, with a small percentage of the population succumbing to frank addiction.  So I can understand why some people are resistant to change.

However, losing fat and getting healthy will require some effort.  What I've offered is a plan that puts the effort in food selection, rather than fighting the urge to eat more calories, which is typically a losing battle anyway.  It also does not restrict micronutrients, macronutrients or any other health-giving element of the diet.  If you think you will be able to find a way to lose fat and remain in long-term health while eating mostly commercially processed food (including restaurant food), you are fooling yourself.  Processed food is the main problem, and if there is a solution, it is to avoid it.  If you aren't willing or able to eat mostly home cooked food made from basic ingredients, as every healthy culture does, you will have to accept a higher likelihood of fat gain and disease.  That is the cold, hard truth.

Cultures around the world have thrived, and continue to thrive, on very plain food.  Our grandparents ate simpler food than us when they were our age, and the food that their grandparents ate was even simpler.  There is nothing physically or psychologically necessary about the type of food that most people in affluent nations eat today.  Level 1 of my plan should not be difficult, and if it is, it should serve as evidence of an unhealthy relationship with food.  Levels 2 and 3 are at least as easy as most diet plans out there.  And they are much easier and less restrictive than a number of popular diets (e.g., Ornish).  The higher levels (4-5) require more effort and are for people who don't respond adequately to the lower levels.  Each person is different and can pick the level that is appropriate for his/her own body, lifestyle and preferred weight.

The Basic Nature of the Problem

I believe that we live in a culture of overstimulation.  The nature of commercial competition means that only the most stimulating products survive. These far exceed what many of us are equipped to handle constructively.  Video games are a good example.  Many people, particularly boys and young men, have a destructive relationship with video games.  Have you seen the news report about the Korean man who died after playing video games for 50 hours straight in an internet cafe (1)?  Television is another example.  The average American watches roughly four hours of television a day.  I'm sorry, but that is just sick.  Although I recognize that it has some positive aspects, TV has replaced a lot of constructive activities in our lives because it is rewarding enough to compel us to stay glued to it.  I stopped watching TV nine years ago, and I can't express how liberated I feel.  I never liked watching TV very much, yet I had trouble tearing myself away.  When someone asks me how I have the time to do a postdoc and write this blog, I say "I don't watch TV".

Food works the same way.  We are overstimulated by commercial food, and it drives us to obesity and ill health.  There are certainly other factors involved, but that is a central one, and it has the broadest explanatory power of any diet-obesity hypothesis I've encountered. 

Reducing Exposure

The most effective way to prevent yourself from succumbing to high-reward stimuli is to avoid them.  Cues such as smells, sights and even sounds that are associated with certain foods can trigger a level of desire that exceeds willpower.  That's why restaurants pipe smells onto the sidewalk, it's why food manufacturers have ads, and it's why they design packaging very deliberately.  These cues slowly, slowly lose their power over time if you avoid the foods that are associated with them. 

The best way to avoid succumbing to junk food is to steer clear of it.  Don't keep it in your house if you can avoid it.  Only keep foods in your house that you are comfortable eating.  Another tool is to make rules for yourself.  If you say "I'm not going to eat any food at the party tonight", you don't have to wrestle with yourself once you get there, weighing the pros and cons of having "just one" chocolate chip cookie.  You have a rule and you just stick to it.  Simple yet effective.  I first encountered that idea in Dr. David Kessler's book "The End of Overeating"-- it comes straight from the drug cessation playbook.

Resetting Reward Sensitivity

I believe that highly stimulating food is desensitizing, just as drugs of abuse are desensitizing.  People who eat sweet food regularly find it less sweet than people who rarely eat sweet food.  Ask just about any immigrant to the US what they think about how American food is sweetened.  A similar process occurs with salt, and probably many other flavors.

I believe that we can reset our reward sensitivity to some extent simply by avoiding excessively rewarding food, and become satisfied by simple food again.  Simple food becomes more satisfying over time.  I've found that to be true, but it seems to require several weeks. 

Some people are highly susceptible to rewarding things, and rely heavily on excessively rewarding food to feel good. These people often have an "addictive personality", which is very common and nothing to be ashamed of.  However, it does make life more difficult in the modern environment.  These are the people who tend to pick up a new addiction every time they get rid of one-- trading an addiction to cigarettes for food, gambling for alcohol, etc.  For these people, it may help to deliberately introduce a constructive rewarding activity such as exercise at the same time as the diet change. 

I think meditation is potentially a powerful tool for resetting reward sensitivity.  Mindfulness meditation is the ultimate low-reward activity, as you are basically staring at a wall for a while and seeing what happens.  It re-trains your mind to notice and be more satisfied by ordinary stimuli.  Perhaps you'll notice yourself breathing, or notice a dog barking outside, whereas before, those stimuli were not sufficiently salient to capture your attention.  After multi-day meditation retreats, I'm always amazed at how intense it feels to eat food.  Even simple food is a sensory explosion and extremely satisfying. 

That is also a key difference between meditation and psychedelic drugs.  Psychedelic drug intoxication is a high-reward state, whereas meditation is generally a low-reward state.  Drugs can cause a feeling of oneness that is similar to what a person can experience while meditating, but they lack the ability to increase reward sensitivity and restore a constructive relationship with everyday life.  Zen Buddhism emphasizes coming to terms with the ordinary nature of life with phrases such as "just this", "ordinary mind" and "everyday mind".  Seeking enlightenment or any new fancy relationship with the world is seen as delusion, which admittedly is a bit paradoxical.  But it becomes less paradoxical with practice.

I see meditation as a powerful antidote to the challenging psychological environment in which most of us live.  I think that relates at least in part to its ability to increase reward sensitivity, increase perceptiveness, and decrease stress.  If a person is concerned that they will not be able to feel satisfied without modern high-reward foods, I suggest meditation as an adjunct practice to eating simple food.  It should become easier over time as your tastes adjust.  I posted a meditation primer here.

137 comments:

Ed said...

Its interesting, when an activity becomes a social norm, it's tough to opt out. My friends at work play video games, watch hours of tv, and eat out frequently. They are all falling into ill-health, but they seem happy and enjoy each others company. Sometimes I wonder if the lonely-er path is worth it.

Thomas said...

Interesting comment, Ed. I think a key to all of this is finding similar others. Being alone too often is definitely not paleo.

taw said...

I'd still like something even vaguely approaching controlled trial of this idea. There've been so many "obvious" solutions to obesity and so far none have really worked, so burden of proof is on your side.

I'm not arguing that it will have no benefit whatsoever, I just expect most of the benefit coming from restricting industrially processed food (with its added refined oils, trans fats, added sugar etc.) while keeping it as tasty as you'd like with spices, salt, variety and whatnot.

Alternatively try eating nauseatingly bland diet of liquid Crisco and sugared water, and see how it goes. Its reward value should be extremely low, and I'm fairly sure you'll get fat fast anyway.

David L said...

Stephan,

On an earlier post, you repeatedly referred to "not treating meat harshly," or something to that effect. I did not understand the point you were trying to make.

I broil most of my meat or fish, which could in somebody's mind be considered harsh treatment. However, given that the protein is only exposed to 8 minutes of heat and is tender inside, I do not consider it harsh treatment.

What about barbecue? Forgetting the issue of barbecue sauces, the cooking process is very long (harsh?), but the result is slowly cooked, soft meat.

I understand you are against (deep fat) frying, but I am not quite sure what else you are implying with your position on the treatment of meats.

Thanks again for your thoughtful relies to my comments.

Esby said...

Wondering if you have any ideas about why I am not losing weight?
I have been on a very rigid elimination diet for 6 weeks: no dairy, no gluten, no sugar, no caffeine, no alcohol, no beef, no pork, no eggs.
I basically eat veg. other than corn, some fruit, herbal tea, tinned and wild fish, occasional bison and lamb and poultry. rice and rice cakes and rice crackers, hummus. I often juice the veg. as I cant seem to eat as much as I think I need to. also take supplements.
have not lost one pound in 6 weeks. Most people I know drop weight immediately when just quitting carbs.
Weight loss is not my primary goal, and I do feel my health is much improved, but why am I not losing weight?? I dont exercise much as I have a neurological auto-immune disease that makes it almost impossible to move much. I am also post-menopausal.
any ideas?
thanks.

Agatha said...

I've never had my weight fluctuate much, even when I ate a lot of unhealthy food in the past, when I was vegetarian with a high-carb diet and now with a low-carb diet rich in meat. I've largely removed a number of unhealthy ingredients from my diet such as seed oils, sugar and wheat. Why exactly should I reduce reward levels by cutting out spices and herbs? My body shows no sign of excess consumption of or under-consumption of any nutrients. Or is your low-reward diet advice really only relevant for those susceptible to obesity?

Kat Eden said...

I think you hit the nail on the head with this one: "Some people are highly susceptible to rewarding things, and rely heavily on excessively rewarding food to feel good" - to that I would add rewarding food to manage stress.

I know this is going to be a little sexist (against my own sex!) but so many women (including myself on and off) manage stress by resorting to favourite 'naughty' or comfort foods.

Personally I find it effective to not have those options on or off the table 90% of the time, but to allow for 1-2 scheduled and pre-planned treat meals per week, in which anything goes but only until 'your butt leaves the chair'.

I'd be curious to know what you think of this approach?

bentleyj74 said...

@ Stephan

I think lowering the stimulation boom is a great idea and I think most people will agree with the principles but will struggle with the "minutes".

If we are looking for purposeful and meditative rather than depressed and isolated then I think more direction may be necessary than just dietary changes.

Harry said...

Hi Stephan,

Thank you...nice summary on the practical aspects of your findings.

I note that you mention David Kessler's book...just wondering, when did you read it and what are your thoughts on his findings relative to yours?

Cheers
Harry

Aravind said...

Stephan,

This post really struck a chord with me. At some point, civilized man decided that we "live to eat" rather than "eat to live". When I engage people in discussion about the effects of gluten, for example, they don't give a rip about the biochemistry..."you are telling to not eat bread, are you insane? I can't live without bread!!!". We have become a society of addicts.

Apart from the physiological basis of Food Reward, from the beginning of this series and given my Eastern philosophical bias, I was viewing this more from a spiritual point of view than anything else. EAT TO LIVE. This post seems to close the loop for me.

Thanks and see you at AHS!

Warm Regards,
Aravind

Jim said...

I wrote a nutrition software program 15 years ago and came to my conclusions about human nutrition by moving nutrients up and down and seeing how I respond. Stephan, I have come to exactly the same conclusions as you from this perspective. In addition, I think turning off the TV (permanently!) and spending some of the resulting free time in mindfulness meditation is essential. Yes, it retunes our sensitivities, but it also makes it clear exactly how we feel and how we think, and if we then relate how we feel and think to our food choices and our nutritional requirements, we can make real progress. There are social costs to these activities, but I think it more virtuous to focus on how much we can potentially offer society rather than how much we receive from society.

kulimai said...

"Even simple food is a sensory explosion and extremely satisfying."

Exactly. This is what I was trying to say in connection with an earlier post of yours where I suggested distinguishing palatability (orofacial expression, until we know more, if you want to measure it in rats)and reward (eating more of the stuff, or probably even better defined, I think, wanting to eat more calories) more carefully.


I still think following through this distinction consistently might clear up much of the confusion also evidenced in many of the comments you get. You seem to continue to be ambivalent about this, using reward and palatability interchangeably most of the time. (It's easy for me perhaps to feel certain about the distinction, I stopped eating refined sugar and industrial food generally in the seventies and although life has often made me forget these principles, somehow I always returned to them. I can now rarely enjoy the excessive sweetness of 90% chocolate for example and have to stick to 100% or the beans.)

We probably agree more than terminology suggests. For example in my earlier comment I was talking about 'habituation' whereas you say 'resetting sensitivites'. No wonder I think your work is very important and worthwhile.

Anonymous said...

Esby,

if you're not losing any weight it's because you're consuming too many calories.
What Stephan is talking about is simply a way of spontaneously reducing calories, but if that isn't working for you you'll need to find another way. Or simply do what I do, which is to count calories and reduce them slightly below my BMR. That allows me to eat whatever I want.

Vladimir Heiskanen (Valtsu) said...

Here are some interesting anecdotes of people who have quited watching adult videos (some say they are extreme superstimuli):

http://yourbrainonporn.com/what-benefits-do-people-see-as-they-reboot

Some examples:

"If you can manage at least 3 weeks, you'll see how powerful all of this is. The clarity and lack of depression for me was extremely noticeable and you will likely feel like a different person..."

"Regarding abstaining and music: My hands are able to move more freely, they're less tense and shaky when I play guitar. I can improvise a lot better with certain scales and what not. Also creativity flows out of me when I'm drawing or playing guitar..."

"I was just talking with a friend. He wasn’t a porn addict, but he looked at porn. He didn’t need to abstain from orgasm for a period, but he did just as an experiment. It was interesting to hear his experience from a non-porn addict perspective. He simply said that he felt super focused and felt more like the person he wanted to be. He works in a stressful, fast-paced job that requires leadership and creative skills. He mentioned that he now feels like he is able to do his job effectively and thrive in the environment. He loves self-help and go-getter stuff, so he was thrilled to have been introduced to this. He mentioned that since his experiment, he doesn’t masturbate anymore just because he is bored—because he knows the consequences now."

IMO that's very interesting.

There's also the Benefits pdf file for more anecdotes.

Chris said...

This has been a great series Stephan. Thanks

Evgeny said...

Esby,

rice crackers aside (sounds like highly processed food to me), why do you feel the need to juice the vegetables? It sounds as if you're not hungry, but you still consume some extra calories in liquid form. You're not losing weight, why are you worried that you do not eat enough?

Stipetic said...
This comment has been removed by the author.
kulimai said...

It occurs to me that real espresso geeks not only wouldn't dream of putting cinnamon, milk or whatever in their drink, but wouldn't even mix the beans and tend to drink SO (single origin). In fact wine, chocolate, you name it, when people focus on a given food-group they invariably make a point of generally not mixing the stuff. So real gourmets (in the sense of "persons with refined or discriminating taste") who care about what they eat generally, ...

So AFAICS, Stephan's proposal is not just to follow a high palatability apprach, but in fact a generalized gourmet diet.

If it is indeed the cultural-industrial-behaviorist environment with its superstimuli that prevents us from distinguishing enjoying and wanting (more), from unequivocally recognizing that high reward is typically low palatability and conversely

then

Perhaps we can think of the eastern advice of slow meditative/focused eating, as being helpful in part because this makes it easier to distinguish reward and palatability and to concentrate on the latter.

This is relevant in that I think Stephan's detailed steps are only a generally applicable strategy, the details of which may not work for many people as indicated by various comments. However that does not question the bigger general proposal of reducing reward value by whatever diet tweaks that means for a given person at a given time. That may reduce palatability temporarily, sometimes radically, but in many, perhaps most cases that might be the road to re-establishing real palatability/food enjoyment eventually.

Stipetic said...
This comment has been removed by the author.
kulimai said...

Also notice that the term "reward" has the misleading connotation that you get something good. But you might repeat something not only because it was good and you want more, but also becuse it was teasing and bad/unsatifying and you hope to correct the experience by repeating, --only to continue teasing yourself recursively again and again (cf. Freud's concept of repetion compulsion for example)

David Moss said...

Sorry to be picky, but while 'food reward' is very intuitive in one form- i.e. absolutely every-one thinks the main problem is 'tasty food makes people want to eat more [too much] of it [that is, greedy]'- if you tell any-one 'that's right, high reward food makes your body want to get fatter [raises your bodyfat setpoint]' they will look at you funny.

More constructively, on all your points about resetting reward levels through meditation, I'm surprised fasting still hasn't gotten an explicit mention. Certainly has that very effect on me. Fasting would seem to be the ideal 'low reward diet.'

Kindke said...

There is a common denominator amongst obese and obese-prone people and that it that they do not find carbohydrate foods satiating.

Some studies to back this up

http://www.ncbi.nlm.nih.gov/pubmed/21219950
http://www.ncbi.nlm.nih.gov/pubmed/21255472
http://www.ncbi.nlm.nih.gov/pubmed/20399242
http://www.ncbi.nlm.nih.gov/pubmed/19820013

Those of you who believe in the Food Reward hypothesis may find that Artificial Sweetness study of particular interest.

I dont personally because the only thing which determines how good food tastes is how hungry I feel. As I start to become satiated, everything becomes tasteless.

Philippa von Ziegenweidt said...

Esby:

You appear to be consuming very little fat and your protein intake is limited too. Is there a reason you're not eating any eggs?

On the other hand, consuming all those fruits and veggies may be adding up to more carbohydrates than you realize. Especially when you juice them, they can add up quickly.

I suspect this is the reason your weight hasn't changed.

Melchior Meijer said...

Stephan, just curious, how is your stance on wheat right now? I smell a tendency among intelligent health bloggers (not you!) to abandon or even ridicule the paleo principle as a useful tool to identify possibly inappropriate foods for humans (wink to CarbSane). I remember you are very familiar with this paper by Lindeberg et al:

"A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3009971/?tool=pubmed

How do you explain the observed difference in satiety? A relative blandness of the paleo diet compared to the Mediterranean diet (the Mediterranenian diet thus being more rewarding)? Or the exclusion of gluten and WGA (which probably mess with leptin signalling)? Or both?

Monica said...

"I just expect most of the benefit coming from restricting industrially processed food (with its added refined oils, trans fats, added sugar etc.) while keeping it as tasty as you'd like with spices, salt, variety and whatnot."

I'd expect that too and I believed it for years, but for some of us this doesn't work. I'd lost weight initially with this approach (whole foods low carb "paleo"), but the pounds slowly crept back. There are plenty of other anecdotes online of people eating paleo and not losing, or even gaining. Don't get me wrong: it resulted in a lot of health benefits: just not weight loss. I've been eating mostly at home (and low or at least moderate carb paleo) for 3 years because we live 40 minutes from town or a grocery store, so I could never blame my problems on processed food.

I went to level four (primarily no added salt, spices or fat to my food) several weeks ago. Before that I was doing Seth Roberts' protocol for a couple of weeks. I've spontaneously reduced calories by about another 400 calories per day (down to 1200-1300), and I've lost around 7 lbs. in a month using these two strategies: Roberts' first, and Stephan's second. I don't enjoy gulping olive oil, so I'm sticking with this. Time will tell exactly what worked, but I'm pretty excited because I haven't been down to this weight in over a year.

Most people don't seem to need to go to this level, but some of us do need extra steps. I suspect that most people who need to get those last "20 lbs" off need to reduce the palatability of their diet rather than obsessing about going "zero carb" or lowfat -- though that strategy will work for some people.

My personal experience is consistent with how hard it was for my mother to lose weight when she was alive. She always maintained her weight at around 20-30 lbs. heavier than her ideal weight. She would never go over this amount, but she couldn't lose. She also did a low carb diet, lost about the same amount of weight that I did (15 lbs) and eventually regained it all. My suspicion is that in some of us, the body sees low carb as being low reward at first, but then as more and more added fats and salt triggers us to eat more, that becomes rewarding and the pounds come back on.

The amount of fruit I'm eating is totally anathema to low carbers and most paleo advocated (around 3 cups per day). Yet I'm losing weight. And if I replaced that with starch I suspect I'd probably lose faster.

Peggy Holloway said...

Esby:
You may be extremely insulin-resistant, so that the rice and fruit (and some of the vegetables, if they are starchy or higher in sugar such as tomatoes) are preventing weight loss.
Go extremely low-carb and be sure you are getting plenty of fat. You may need to eat more meat and other high-fat foods. Aim to become ketogenic, which means you are burning your body fat. That may require you to keep your total carbs at 20 to 25 grams a day.

gunther gatherer said...

"My suspicion is that in some of us, the body sees low carb as being low reward at first, but then as more and more added fats and salt triggers us to eat more, that becomes rewarding and the pounds come back on."

I totally agree with this. A lot of people are compensating with added fat, salt and protein when they go low carb. Some end up overcompensating and gaining weight. These paleo cookbooks and recipes designed to make a family "lifestyle" out of all of this aren't helping either.

Tasty food is one of many addictions of neolithic life, so just like any addict, we can expect people to react to the idea of a bland food diet with denial, excuses and rationalizations.

Khwarezmian said...

Hi Stephan, I have two questions tangentially related to this post.

1. Do you consider baking (not roasting) to be a harsh method of treating tubers? I know that it involves very high heat, but I was under the impression that most of the actual cooking is accomplished through steaming of the moisture inside.

2. Do you think removing added fats, i.e. butter with potatoes, or added flavorings, i.e. herbs and spices, is more effective in crafting a low reward diet?

As an aside, and maybe you are already working on it, I think a great topic for your next series would be the effect of cooking temperature on health. You've alluded to it a few times, and it would be great to get a full presentation of your ideas.

Monica said...

gunther -- I agree. What complicates this is that some of us need lower caloric intake to begin with. I weigh 158 right now and even when eating with added fats I usually wasn't going over 1800 to 2000 calories a day. I wasn't really gaining, but I wasn't losing, either.

Anyone can rationalize really tasty food when they say, "Oh but I'm only eating X number of calories per day!" Well, some of us don't require that many calories.

Anand Srivastava said...

You have given me the perfect reason for joining a meditation group. I will do that. Before this logic I didn't understand what is so great about doing it in this way.

Robert said...

A lot of good points in this post, Stephan. This is why I'll keep coming back to WHS.

Scott W said...

Just want you to know that this series have been life-altering for me. Your analysis, along with several of the thoughtful comments, have allowed me to identify destructive reward relationships with food and other stimuli in my life. I'm already seeing changes for the better. Thanks.

You've made it too unrewarding to follow other, less well-reasoned nutrition blogs...and so I've also gained some time from giving up those.

Scott W

dg said...

A little bit of discipline will help all this. Don't know how some have it and others don't, genetic? I play one video game only. It is very constructive, that's it. I don't kill, maim, etc. any one. just a thought. Any comments on discipline or something akin to it, if you don't like that word

John said...

Stephan:

I'm also curious about whether altering meal frequency could fit into your recommendations. I know you've said that fasting seems to lower the setpoint; and it seems like one logical antidote to the problem of excessive palatability/abundance, if coupled with some of your other recommendations. I know you say not to snack, but I assumed this recommendation had more to do with the reward value of the crap people tend to snack on than altering meal frequency.

Elizabeth Walling said...

After reading a couple of your original posts on food reward, I got Kessler's book and have been reading (and re-reading) it for the last several weeks. I admit, this idea strikes an uncomfortable but much needed chord with me. We really do live in a world of hyper-palatability (and not just with food), and it's extremely hard to break the cycle and develop new habits (or should I say reintroduce the habits of old).

I think this is especially true for the younger generation who has most likely been exposed to more intense stimuli, and much earlier in life than previous generations. It makes for some deeply ingrained habits to break.

Monica said...

Someone asked about meat cooking earlier in this thread. As an attempt to follow steps 3, 4 of Stephan's plan, over the past few weeks I've been cooking meat and fish gently in a pan with water: no added salt, spices or fats. It makes a big difference in the flavor. Much less palatable and as such I often have a difficult time finishing what is on my plate, particularly with lower fat items like wild salmon. Steak cooked this way seems pretty gross (right now, at least). Searing alone would add a lot of palatability, even sans salt and spices.

Ross said...

"I believe that we live in a culture of overstimulation."

I believe we live in a culture that lacks self control. You choose to not watch TV. You choose to eat the right foods. I don't want my wife to 'dress down' and stop trying to stimulate me. No, I want to be stimulated thank you very much. I want great tasting food. I like a well prepared holiday meal at grandmas house. BUT, I also need to work on self control. And that is where meditation, faith, yoga, running .... all comes into play.

This advice was written almost 3000 years ago.

Proverbs 25:27-28
The Message (MSG)

27 It's not smart to stuff yourself with sweets,
nor is glory piled on glory good for you.

28 A person without self-control
is like a house with its doors and windows knocked out.

Keep up the thought provoking blogs. Love it.

Beth@WeightMaven said...

I don't have time right now to dig back through all of the presentations at the Obesity and Food Addiction Summit (very much worth viewing!), but two presenters made similar points re obesity and food addiction in animal studies. What they found was that they found a connection between binge eating/overeating high reward foods AFTER a period of deprivation.

Not sure how it fits into Stephan's overall theory, but it's an interesting nugget: perhaps people who restrict their food (i.e., diet) are more prone to food reward issues than those who don't?

Beth@WeightMaven said...

Oops, just enough time for one more comment before job beckons. I second Stephan's endorsement of meditation (timely link from yesterday's HuffPo: Why Meditation And Orgasm Feel The Same To The Brain ).

Also, if monkey mind seriously derails your efforts to meditate, you may want to try what I call "assisted meditation" (or meditation with training wheels).

Two devices that I've tried that I like are the HeartMath emWave system and RESPeRATE. Neither are meditation trainers, but they do allow you to sit quietly and provide feedback to keep you going.

I've not yet graduated to a meditation retreat, but I can now sit quietly for 20 minutes. And (nod to Chris Masterjohn's related post), find I can actually be in the car without the radio on ;).

lightcan said...

Please excuse me for a silly question.
When you say eat the fat separately, do you mean have some butter on its own or have some meat, have some potatoes and have some butter? I don't know when I should have the fat.
Thanks.

Susan said...

It strikes me that it is not just processed food at the grocery store that creates a problem, nor is it simply restaurant food. I live in a neighborhood that has several ethnic restaurants. If I were to buy tacos at a chain taco joint, they would be very different from the tacos I get at a local taqueria. At the restaurants most Americans can afford, everything is burried under layers of processed cheese and sauce. Every meal includes desert. Pizza is cheap and filling. It is this style of eating that has become "palatable" to many of us, and is therefore rewarding.
Higher up the income ladder, folks seek out the "best" wine, sausage, oil, salt, and so on and so on. "Best" has become normative, everyday fare. That is crazy. Cake should be a birthday treat, or special gathering treat, not the last item on a weekly grocery list.
But we are surrounded by food, of every price point, and inundated with magazines and tv shows preaching, get the best, cook the best, etc. On one show, Man -v- Food we are offered the amazing spectecle of watching a man become obese on national television.
It seems to me that "reward" and "palatablity" are socially derived, and therefore hard to get away from but therefore, not aplicable in other societies. Obesity is not a moral problem it is a social and (yes, Martha) a political problem. My tax dollars shore up "cheap corn", whether I want them to or not.
It is also true that bodies react to the social norms differently. I have friends who are rail thin and yet eat what I now consider garbage. But those of us who have bodies which react poorly, i.e. tend to or become obese, have an additional personal problem which necessitates retraining our bodies. You cannot do that by eating smaller pieces of cake, or going without cake for a few months to see what will happen.
I have been eating paleo (an absurd term) for many months, and have lost a lot of weight. I am leaner and much, much healthier. I will take a lot of convincing that cooking method is anywhere near as important as what it is you are cooking and how much of it you eat.
In that regard, these posts have been extremely helpful, and I thank you for them. I backed off salt and cut way down on cooking oil (olive and coconut) and notice that I am satisfied much sooner and my weight loss has excellerated again. Your highlighting "food reward" and starch caused me to experiment with my meals again.
The only nit I have to pick is that I consider my meals to be very palitable and nicely rewarding. I have simply retrained myself to derive more flavor with light or no salt and fat. Since spices and herbs were not my trigger, I never felt the need to cut them out. Only minds crave, mouths and stomachs do not.
Also, I am totally having a piece of cake on my birthday and a root beer float at our summer social!

Margaretrc said...

If tasty, delicious food is at the root of the problem, how do you explain the relative lack of obesity in countries like France (rich, delicious food!) and Thailand where the traditional food is far from bland? I think we need an explanation for our (and the modern western world's) problems that doesn't have so many exceptions to the rule. Just as the "French Paradox" and others like it disprove the Lipid Hypothesis that saturated fat and cholesterol in our diet cause heart disease, "Paradoxes" of food traditions where the reward factor is great and yet the people are not by and large obese call the Food Reward Hypothesis into question, as far as I'm concerned.

Laura said...

I find the simple food approach to be very easy. Although I have only lost 9 lbs in 3 months, I have not been hungry and have found my attention and focus improved. I do not meditate, but I knit (which I personally prefer, but to each his own).
Thanks to Kindke for the references.

mem said...

@Stephan: I don't have time to post my thought right now, but have been thinking ALOT about all of this, as well as my personal journey with a very large weight loss, whihc I've kept off just under 9 years now.

What I'll say for now, untill I have some time to write is:

mem said...

Oops! The last word in my post did not show. It was: CLAPS!

Paleo Phil said...

Stephan said...
''Only keep foods in your house that you are comfortable eating. Another tool is to make rules for yourself. If you say "I'm not going to eat any food at the party tonight", you don't have to wrestle with yourself once you get there, weighing the pros and cons of having "just one" chocolate chip cookie.''

Yes, I have found this to be a key factor. Don't bring your problem foods into your home and try to avoid restaurants that serve them (of if you get invited to one, fill up before you go) so you won't be tempted to eat the problem foods.

If you live with people that eat bad stuff, segregate out your foods from theirs, such as in a separate fridge and pantry, so you won't have to look at their foods often.

I have also found that the people who say "But I can't live without ____" tend to fail. They are essentially surrendering.

ItsTheWooo said...

Esby -
Post menopausal women are a special group, as their estrogen deficiency conspires to cause weight gain. The female body evolved a complex feedback between estrogen levels, leptin, and body fat, and this evolved to protect her during starvation by turning off fertility.

A drop in body fat drops leptin and estrogen, which causes amenorrhea and signals fat gain with changes in metabolism and appetite. A drop in estrogen does the same, which triggers a gain in body fat until estrogen levels are restored. Menopause is a profound drop of estrogen.


In a pre-menopausal female this works fine and she avoids obesity (because her ovaries make a lot of estroge assuming she is not starving or underweight or congenital leptin deficient or premature ovarian failure etc) but in a post menopausal female, body fat gain is impossible to avoid as this is the only way for her to reach a "critical estrogen" level enough to terminate the weight gain. Her ovaries cannot work to terminate the cycle of fattening and "starvation mode".

This is well demonstrated in ovarectomized rats who become extremely obese; all symptoms are reverse with an estrogen replacement. This terminates the starvation adaptation.

A post menopausal female can lose weight one of two ways. First is to get on HRT and take low dose estrogen (avoid progesterone in high doses as this antagonizes estrogen and causes weight gain - contrary to idiots on the web, progesterone CAUSES metabolic syndrome and fat gain).

The second is to take a dopaminergic medication like bromocriptine, which has been demonstrate dto reverse menopausal weight gain without any change in diet at all. Most estrogen deficiency weight gain is mediated by leptin insensitivity in the brain (estrogen makes leptin receptors work), which again the leptin-estrogen-body fat feedback works quite well in a premenopausal woman because it is designed to turn on or turn off fertility depending on nutrient status...but it does not work in a post menopausal female and she can not avoid gaining body fat because this is the only way she can terminate estrogen deficiency (and resulting central leptin / dopamine deficiency).

Bromocriptine is a dopamine agonist, which helps terminate starvation adaptation by circumventing the leptin mediated component of dopaminergic signaling. Leptin causes starvation adaptation largely be shutting down dopamine - if you take bromocriptine you will lose weight even if your leptin signaling is FUBARed.

SO, a post-menopausal female can take either estrogen or dopamine agonists and circumvent the problem, restoring integrity to the system and effortlessly drop weight.


However, attempting to lose weight while being "ovarectomized" with no way to generate estrogen sufficiently is a losing battle and you will find you have to essentially starve yourself and severely underconsume nutrients in order to be low weight.

Anonymous said...

woo if you wanna read lyles book i have it, let me know on thats druge

to bethweights comment about deprivation being followed by binge/overeating... in my experience around the ED blogsphere and meetings/units recovery etc...MANY MANY MANY like 80+% of anorexics post recovery go on to become binge eaters who lack all control around hyperpalitable food, actually hyperpalitable ANYTHING. this is mostly the reason i try and advocate a real food recovery as the level of self hatred coupled with the feeling of losing control in the opposite direction is the worst feeling in the world.

seems sticking to just real food, lots of it...forces you to learn your hunger cues, what real hunger vs satisfaction is etc.

i for one dont eat a bland steamed food diet but if i ever did need to lose weight i definitely would

got to thinking, if your cutting fats how are you getting your butytric acid??? i rely on butter and really believe in the gut connection to the brain, and thus to obesity. also, it seems tim ferris may have been onto something with his book after all.

he advocates a plain, boring beans/meat/eggs slow carb week followed by an hyperpalitable day where butter & cheese are fair game(possibly regulating/enhances the gut for another week of boring digestion....hmmm

ItsTheWooo said...

Stephan -
Don't you think it's likely that meditation, if / when it helps weight, is effective not because of "reward" but because of how powerfully meditation reduces the stress response in the body? Cortisol excess is well known to lead to weight gain and diabetes. It's likely that one facet of obesity is an abnormally stimulated cortisol response due to abnormal modern lifestyles with sleep deprivation and never ending work related stresses.In a natural environment stress was episodic - predation, hunting. Only in modern western society do people sit at a desk for 8 hrs on high alert with no completion of the stress, only to go home, fret some more until sleep (far too little might I add, which worsens the stress as sleep deprivation also ramps up cortisol)


Over the years I have become very aware that anything which increases my stress response is something that is going to lead to blood sugar and weight decompensation. Whenever I am able to relax and calm myself, my glucose stability, carb tolerance, and weight is better.



You make a compelling argument here but all of this just does not at all jive with my obesity. At all.

I just ate a toasted piece of diet bread, thick, with sweet kerrygold, and full fat bree, and garlic. Do I feel more compelled to eat now? Not at all, in fact I feel very sharp minded, satisfied and happy. My skin feels nice as kerrygold tends to make it. I am very alert and energetic.

On the other hand, if I ate a soggy frozen diet pizza loaded with carbs and not much fat, and far less appetizing, I would feel lethargic, depressive, my head would be buzzing from glucose, I would feel like crap.
In an hour and a half, I would be ravenous and shaky.



Hey, maybe I am a freak. Maybe most fat people are eating because of food addiction. But not me, at all. For me it's pretty clearly, obviously, and 100% a metabolic problem handling glucose and insulin. I just find it hard to believe my obesity is all that much different than other people.

ItsTheWooo said...

@ed

As someone who has eaten a "weird" diet for vital health reasons for many years, the loneliness is difficult only initially. After awhile you get used to eating differently, and you learn how to handle any situation.

If I were hanging out with "friends" playing video games watching TV I would get a large chef salad with meat and cheese and full fat dressing, I would get buffalo wings with blue cheese dip. I would eat just a few chips, and focus more on the dip. If there was pizza I would eat only the cheese and a very small amount of the bread.


If you find your diet is so restrictive that there is NOTHING you can eat unless you painstakingly prepare before hand, odds are better than not that diet is irrational and not something which can be followed long term.

But yea, early on before you are steady and sure about what you can or can't eat in a given situation it is hard.

After doing this for 8 yrs, it's not.

ItsTheWooo said...

@agatha - if you are an obesity resistant person, what would make you think that you need to concern yourself with treatments for obesity?

I don't have parkinsons disease either, therefore I don't take sinemet 25/100, and I am not up to date on the cutting edge research of parkinsons disease.

However, as someone with reactive hypo, hyperinsulinemic tendency, PCOS, atypical depression (which I relate to my metabolic issues) and morbid obesity, all of which is now controlled, I am very interested in any research pertaining to what may cause this and any intervention which helps it.

Thank heavens I am or else I would be a total wreck.

I've learned about:
-Low carbing (controlled about 75% of the problem)

-Inositol (HUGE help for depression and also metabolism - and evidence suggests PCOS is a specific glucose metabolism disorder resulting from a genetic weak ability to make enough inositol to cover a high glucose diet).

-Chromium (very helpful as well)

-Flax/omega 3s (pretty much moped up the residual depression, and when I skip my flax for a day or two I start decompensating with obsessive behavior/thoughts, nervous tension, and a mild dysthmia very quickly)

-Bright light therapy (very, very helpful for both my depression as well as my reproductive disorder, seems to augment catecholamine levels allowing ovulation to occur - before using bright light therapy, even while on leptin, I still had ovulatory irregularities. Bright light therapy gave me monthly regular cycles. It also completely eliminated a very significant seasonal depression.)

-Tyrosine, DL-phenylalanine (both seem to help status post leptin wtihdrawal, by preventing low dopamine/NE, although while on leptin it didn't help).

- Acetyl-l-carnitine (this amazing supplement allows me to eat many more calories without glucose metabolism decompensation. I can eat pretty much "as much as I want' and gain far less fat with NO major signs of hyperinsulinemia such as acanthosis of the skin. I do get reactive hypo still but I can NOT become "hyperinsulinemic" the way I was while morbidly obese, with dark skin patches and all)

-Magnesium (taking magnesium supplements, which I discoverd purely by accident, instantly boosts my mood significantly and improves my glucose stability). I had alwasy wondered why I felt so awesome if I ate nuts or drank magnesium laced water. I felt good in a very specific way that high fat food in general or regular water could not give me.

After taking magnesium supplements I have since learned that magnesium, in my body, is very very important to supplement and instantly improves my mood and glucose problems.

-St johns wort and 5-htp have also helped my mood.



I do all of these things and if I did not I would be a TOTAL HUGE WRECK.

The first time I quit leptin, when I was doing none of these things, I gained weight RAPIDLY , entered a depression, had major signs of hyperinsulinemia as when I was obese (acanthosis around skin cracks), etc.

This time I quit leptin again and I am having absolutely none of these problems and I owe it all to taking this bevy of mood / dopamine-augmenting, glucose metabolism correcting factors.

I gained trivial amounts of body fat and seem to be leveling off now... I am still extremely thin and people still tell me I am "too thin", etc.

Laura said...

Re: simple foods. While still tasty, there is a HUGE difference between sweet corn plain and sweet corn with butter and salt. I stumbled on this blog when trying to reduce salt intake due to increased blood pressure. Simply eating to reduce salt intake caused me to adopt many, if not most of Stephan's recommendations (most processed/industrial food is very high in salt). I thought it was coincidental that I started to lose weight. Maybe not.

schmoopee said...

Esby,
Rice cakes have a very high glycemic index/load...higher than Wonder Bread, corn and ice cream and rice cakes don't have much nutrient density. http://www.health.harvard.edu/newsweek/Glycemic_index_and_glycemic_load_for_100_foods.htm

Juice is higher glycemic also (even green). Plus you're getting more calories from it because if you just ate the whole veg you'd eat less and have more of a sense of fullnes from the fiber.

I've lost 100+lbs cutting out all starch, including beans and starchy veg, I'm 46 and leptin resistant (of course!). I had no intention of being low carb, it was just the only thing that worked.

Stephan,
Thank you for championing meditation. Aside from changing my diet to clean simple home-cooked foods, meditation has made a huge impact on my life. Also trashed my tv, limit internet use, and have been on a "news fast" for 6 months or more.

I agree we are way too overstimulated :)

Michael Byrnes said...

Hi Stephan,

Given what you mentioned in your last post regarding sensing of caloiries by the small intestine and food reward, what is your take on diet soda?

Soda (with caloric or non-caloric swe eteners) seems to be very "high reward"... but if raising the setpoint requires sensation of calories by the small intestine, then diet soda in isolation should not be able to affect it. On the other hand, diet soda with a meal may be expected to increase the reward value of the meal and thus raise the set point. Or is this a case where once the flavor-calories relationship is established, it doesn't have to happen every time, so diet sodas would raise the set point?

I think we can all agree that diet sodas have no place in anyone's "healthy" diet, but I am curious as to whether they can influence weight gain despite their lack of calories.

CarbSane said...

@Malpaz & antispirit: As regards butyric acid/butyrate, I wrote this on my blog about butter v. resistant starch about dietary sources.

I think comparing these two sources of butyrate also deserves some scrutiny. Butyrate is a small water soluble compound. Delivered orally in butter, one wonders how much actually reaches the colon (large intestine) vs. the butyrate generated by bacterial fermentation of fibers "on location". Think what you will of the pharmaceutical industry, you can learn a lot from delivery methods employed. Indeed sodium butyrate is used in the treatment of Crohn's disease, and supplements are coated to ensure release in the ileo-caecal region and colon. This would lead me to believe that the majority of butyrate in butter is absorbed well before it gets to the end of the small intestine and large intestine in the fully developed digestive system. May well be why it's found only in the infant food of mammals that have yet to establish bacterial populations in their guts. It seems to me that soluble fibers are a much better source of butyrate than butter. We get more from high fiber sources, delivered directly at the point of use/need with fewer calories and a larger bulk of food. I would suggest inulin is a better source of butyrate than resistant starch simply because foods high in inulin tend to not be overly high in digestible starch.

If one is trying to feed their gut bacteria or increase butyrate delivery to gut cells, fibers like resistant starch are probably a better source. If someone doesn't want all the non-resistant starch carbs, you can buy RS, and if you can't incorporate it into a smoothie or something it might be worth making your own capsules. I'm not aware that it is available in that form.

Jim Whitman said...

The leading line of the article may be a hangup for some people but it is certainly not my issue with the reward theory. As Stephen writes, “some people have reacted negatively to the idea of a reduced-reward diet because it strikes them as difficult or unsustainable.” There is nothing complicated for me in the application or sustainability of what was outlined as the low reward diet. In fact, after losing 60 lbs between 4 and 2 years ago and then stalling for the last two years about 10-20 lbs higher than what I should be (I’m 175 at 5’7”) while on the same, if not more “extreme” diet, I have long settled into what is considered a very bland and monotonous diet which does not include any processed foods and is about 95% the same each and every day. I eat so far away from the (current) conventional way of eating that I am -- ostracized is too strong of a word – “playfully” scrutinized by coworkers and family for being so dull and boring (with regard to food choice). I get called things like “rabbit” for the amount of greens I stack up the same way every single day in the office, but I digress… My main discomfort with the theory is something else entirely.

To me, the argument that we eat more and get obese because food is rewarding is like saying that we go to the bathroom because it feels better once we are relieved. The statement is almost a tautology. Of course food is rewarding and we wouldn’t be here if there weren’t a mechanism in us that seeked food. So the fact that food is rewarding isn’t the issue it’s just the hyper palatability or overstimulation issue we have to work around? I tried my best to pay attention carefully during the series so far and think there is a lot of truth in the words that are written on food reward, it’s just that for me, after having unknowingly settled between level 4 and sometimes into level 5 for the last couple years just to maintain my somewhat overweight fat mass, I’m left with the understanding that my system must be completely out of whack with regards to reward seeking behavior for this to be a dominant factor at least for me. (Although I don’t seem to have other addictive behaviors.) Which is entirely possible but doesn’t tell me what to do if this is the case. i.e. wouldn’t we want to fix the reward pathways somehow and if so how is that accomplished?

And so it seems to me that beyond the obvious food choice changes that can be made to lower what foods we speculate are highly rewarding, the idea of “what to do” is vague. Contrast this with the notion that has been repeated here that sounds as if the food manufacturers have without a doubt found multiple successful formulas that create a long lasting, potent and “addictive” quality to their products. Were they privy to some early reward research that we didn’t know about? Or did they more likely just make stuff that tastes good? And despite our efforts to do the opposite we don’t entirely solve the problem.

One of the things you hear a lot of people say when they reduce sugar from their diet is that other foods begin to taste sweeter. Or you hear the high protein paleo folks bragging about how good their food is and that they get to eat steak, eggs, butter and bacon. So is reward not relative? Will we not simply find foods that are less rewarding on an absolute scale far more rewarding when we eliminate the high absolute reward foods from our diet? If so, then how to maintain any benefits from a low reward diet scheme long term? Will we not just increase our “reward sensitivity” if we have less of it coming directly through the diet?

Maybe I jump on level 5 for awhile and see what happens. Practicality is not the problem. Makes shopping so much easier and I really don’t get that hungry or feel drawn to food. Efficacy is what I am after.

Steve said...

I can personally attest that when you are eating foods for your blood type you are avoiding such stimulation overload. It works quiet well as your body goes from extremes to a calm and centered feeling of well being from within..

www.stevebeisheim.com

gibby1979 said...

When you talk about rewarding foods are we thinking only in their nutritional sense.
How do you feel things like mouth feel play into the effect on fat set point?

TCO348 said...

If you think you will be able to find a way to lose fat and remain in long-term health while eating mostly commercially processed food (including restaurant food), you are fooling yourself. Processed food is the main problem, and if there is a solution, it is to avoid it. If you aren't willing or able to eat mostly home cooked food made from basic ingredients, as every healthy culture does, you will have to accept a higher likelihood of fat gain and disease. That is the cold, hard truth.

Thank you, thank you, thank you! People are just so reluctant to accept this. It needs to be said bluntly. It really is a sacrifice. When I go to a restaurant and think about odering something healthy, like a salad with grilled chicken and a viniagrette, instead of something delicious like a bacon cheeseburger, my heart just sinks. It's a definite loss from the pleasure I was anticipating. But its the only way! Or don't eat out - I don't feel that way when I cook up something simple at home. But again I'm just glad Stephan said it so bluntly because it needed to be said bluntly.

TCO348 said...

Television is another example. The average American watches roughly four hours of television a day. I'm sorry, but that is just sick. Although I recognize that it has some positive aspects, TV has replaced a lot of constructive activities in our lives because it is rewarding enough to compel us to stay glued to it. I stopped watching TV nine years ago, and I can't express how liberated I feel. I never liked watching TV very much, yet I had trouble tearing myself away. When someone asks me how I have the time to do a postdoc and write this blog, I say "I don't watch TV".

Another great point. I've tried several times to quit or cut down on tv and I've had little success. When I think about it I get the same sinking feeling of loss as when I think about eating ok food instead of delicious food at a good restaurant. Maybe I'll try again but I'm a big sports fan so it will be difficult.

James Kimbell said...

Say I eat 2000 mg of salt a day, and I decide to cut that to 1000 mg. At first I feel worse, then I get used to the new intake. But I can't claim to compare my new baseline level of salt-related reward to my old one - I can't quantify the difference (can I?), I can't just remember (unless the difference is huge.) Is my new reward for salt (or tv, or porn, or whatever) any better, or do I return to a general baseline at any reasonable intake, or are the benefits solely related to other health effects and not the reward itself?

Jim said...

James Kimbell, if you can't tell the difference after trying it a couple of times, then sodium is not a problem. Although a null result, the positive aspect is that this means you can look at other aspects of your diet and forget about sodium.

ItsTheWooo said...

@Melchior

@Melchior

First lets define "paleolithic diet" and "mediterranean diet" because as far as I see these are nonsense words. The only thing that matters is what they were actually eating. I can eat playdoh and say it's paleo, or I could call it part of the goo diet, all that matters is what I'm actually eating.


This is the so called "paleo diet"
"lean meat, fish, fruit, vegetables, root vegetables, eggs, and nuts"


This is the so called "med diet"
"whole grains, low-fat dairy products, vegetables, fruit, fish, and oils and margarines "


Right away it is beyond obvious paleo people were eating way less carbs. They eat no grains and root veg are relatively low in carb compared to pasta and such junk.


Reading the full text, my suspicions are confirmed. "Paleo" diets are very low in carb compared to med diets.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3009971/table/T2/

Paleo diet = 129 grams of carb with 22 grams ffiber (net carb just a hair over 100 - this a low carb diet if I saw one).

Med diet = 211 carbs with 27 grams fiber. Not nearly as low in carb.


Why did paleo dieters eat less? They eat way less carbs and so they are not as hungry.

ItsTheWooo said...

@kindke

Yes, obese people do not process carbohydrate normally. Many studies suggest metabolism atypicalities, e.g. suppressed uncoupling protein after a high carb meal found in obese teenagers, and effect obliterated on a low carb high fat diet... or the finding that GLP-1 release is attenuated in response to carbohydrate injestion in obese people, but the obese person makes normal GLP-1 in response to an oral fat load.

I suspect all of these findings are downstream effects of hyperinsulinemia/glucose oxidation disorders which then lead to obesity.


Now that I am on a low carb diet, this is exactly what I find - when I am not hungry, food loses all taste. I also get nauseated.

This was impossible to occur on a high carb diet/while growing obese, or when my metabolism is prone to fattening (e.g. during luteal phase of menstrual cycle I can often become insatiable and lose the ability to feel nauseated/never find food tasteless due to high progesterone).



The poster who said that this hypothesis is tautological is correct. Why do some people NEVER feel full? Why are some people ALWAYS down to eat?
All normal people find their favorite food disgusting after eating 3 or 4 thousand calories. Why does this fail to occur in some people? Why did that happen to me when I was a 19 year old with morbid obesity?


It's insulin, usually mediated by glucose intolerance in the context of a high carb diet. Chronic elevated insulin orients metabolism to grow body fat, which keeps appetite chronically elevated as an adaptation. It's really no different than having a GH secreting tumor. If you have such a tumor, your appetite never stops because the chronic and abnormal elevation of GH leads to tissue growth, which leads to hunger. Insulin does the same thing, specifically to body fat, and so your appetite remains high to fuel the growing body fat. Plus hypoglycemic / drop in FFA from insulin surges also play a role in it.



I find I can eat absolutely ANYTHING and stay thin... as long as my carbohydrates don't go too high. I can eat sweets and junk food, even real sugar and carbs... but I have to keep my over all carb intake low.

ItsTheWooo said...

@monica

I think metabolism is very different when we are talking about true obesity (e.g. me gaining 160 pounds before I was an adult), vs "vanity weight" (e.g. being 20 or 30 pounds over some ideal weight).

I think people who are just 20 or 30 pounds over their socially ideal weight may or may not have a glucose metabolism disorder, they may or may not have hypersinulinemia... but EVERYONE who is severely overweight has a clear cut metabolic disorder.

This is a big problem I see everyone make when we discuss obesity. People conflate "vanity pounds" with "severe, disease type obesity". There is no comparison. Something is very wrong with my body to have allowed this to happen before I was even an adult. I can NOT eat carbohydrate food in quantity and feel normal or be thin, particularly without loading up on various glucose tolerance augmenting supplements (inositol chromium acetyl l carnitine omega 3s all of these have allowed me to tolerate many more carbs but I still need to eat low carb).


There is no way I could just eat a bland diet, without watching carbs, and expect to stay thin.

Today I ate:
2 ounces salted roasted nuts,
Half an atkins bar
creamy coffee with lots of splenda,
1 REAL brownie and a quarter cup cool whip with foam cake,
peas and carrots and meat loaf,
egg salad with mayo
a can of processed soup (low carb),
2 pcs of sugar free chocolate.

My diet is full of highly rewarding and processed food.
I am extremely full.

I am only extremely full because my over all carb intake is low. I estimate I did not eat more than 80 carbs. I feel warm and satisfied.



If I ate 2 ounces of wheat thins (instead of nuts), if I ate half a high grain granola health bar, if I ate a lattee with real sugar and low fat milk, if I ate pasta with peas and carrots, if I ate a syrupy fruit salad, if I ate peanut brittle instead of sugar free chocolate...

... if I did these things, I would PROBABLY be ravenously hungry right now and shaking from sugar drops. Just saying.


The "processed" content would be the same. The "reward" content would be the same. The only difference would be carb, fat, and protein levels.


I tend to think nearly all severely obese people have a glucose disorder and need - require - a low carbohydrate intake to equal a normal person metabolically.

ItsTheWooo said...

@gunther

I for one am really thankful for good low carb recipes. It allows me to eat yummy food without being shaky and feeling like a depressive fog later.

I EXPECT hypoglycemia when I eat a lot of carbs. I Anticipate it and am rarely wrong.

If I go out to a restaurant and eat carby appetizers and such things, particularly if my calories are high (as they almost always are at restaurants), then I know as soon as I stop eating about 1.5 hrs later I'm going to be shaking and feel nervous from my adrenals freaking out due to insulin mediated glucose drop. Even if I just ate a 2000 calorie pig out, I will still be hungry from this insulin surge.

However, now I know the proper way to handle that is to eat a very small snack which has just a few carbs in it and a small bit of fat/protein. My sugar won't drop again if I eat a low calorie, low carb snack. When I was an obese teenager I didn't know any of that I would just eat a big bowl of cereal and it would happen over and over and over again until I was 300 pounds.



The hunger won't totally go away, however.

That doesn't happen until the overnight fast and my body can "see" all the food I just ate and my leptin levels.

After an overnight fast, THEN I feel really full and my appetite drops. Why? My insulin levels come down, but my glycogen is replenished and my fat cells were stimulated to take up fatty acids and so my leptin is now higher.


But it should be noted in the acute post feeding phase I will maintain a high appetite and it will not go away until I fast a few hrs



Insulin dynamics explain 100% of my appetite and weight gain history. Now that I know how to control them, I know how to stay 115 pounds.

As long as I am eating (carbs), I will be hungry. Even if I eat 5000 calories I will still be hungry. I will only stop being hungry when I stop eating which drops my insulin a lot.

kulimai said...

one reason it's difficult to understand this theory is the inborn horror at losing palatability we all have perhaps because that must be unconsiously equivalent to losing food and famine. the second is the inability of our civilization to distinguish enjoyment with satisfaction --cf.palatability--from wanting (more):cf reward.

Put the two together.

@itsthewoo see above re: Jim Whitman's point about tautology

that is your diet seems to me low reward (for you) but high palatability, --exactly what Stephan suggests though perhaps not in the exactly right wording.
His general strategies for reducing reward won't of course work for everyone/many, but I think they are excellent starting points for many/most.

ItsTheWooo said...

@margaretrc

Good point.


Also, we seem to be confusing seperate phenomena.

THere is a big difference from eating a lower reward diet for years, vs suddenly altering your diet to be far less appetiing

I suspect that the latter will lead to a very, very temporary reduction of food intake.

The former will not.

If you are used to eating x amount of salt and then abruptly cut it out, your food will taste bland and gross and you won't want ot eat it. Especially if you are a chubby person with high leptin who is capable of easily losing weight, you will suddenly find yourself effortlessly losing weight.


However your taste receptors will ADAPT to this, your salt taste will adapt, and soon even nearly saltless food will taste adequately salty and you will find it pleasurable to eat.


Do you really think HG people found their diets to be bland and disgusting?

Or is it more likely that their brains are adapted to a simple diet and so they find those simple foods as rewarding as a typical obese american finds highly sweet highly salty food.


Short term appetite vs long term body weight are different. Can't stress this enough.

mem said...

@ It's the Woo2:

It really isn't ok to trivialize other people's weight issues by referring to 20 or 30 pounds as being about "vanity."

IMO, what I have often seen, is people NOT taking a 20 or 30lb overweight issue seriously enough, and over the years, just adding more and more on.

Whatever the sitution is for any individual who is overweight ANY amount, is NOT trivial.

And anyone who has lost a very large amount of weight knows that it is that last 20-30 which is by far the greatest struggle.

kulimai said...

"
Do you really think HG people found their diets to be bland and disgusting?

Or is it more likely that their brains are adapted to a simple diet and so they find those simple foods as rewarding as a typical obese american finds highly sweet highly salty food."

Very strong point in my view. Why don't HGs change their diet without outside influence, to one with higher reward if that is what people generally desire? With the terminology everyone uses here how can we answer?

I'd say because their diet is highly palatable for them, more so than one with higher reward.

Giving up superhigh reward food is a painful process if palatability and reward have become identified. But when they are separated then maintaining a high palatability low reward diet involves no hardship at all. Stephan's important point is that by reducing reward you can again reach this state. Whether it is true for everyone who is able to reduce oversize reward (clearly not all) would be an emprical question.

Melchior Meijer said...

Itsthewoo wrote:

"Why did paleo dieters eat less? They eat way less carbs and so they are not as hungry."

That’s a bold claim. You can’t tell from this experiment. The same scientists have published a well documented suspiscion that gluten/WGA disrupt leptin signalling. It’s plausible that it wasn’t the lower amount of carbs, but the absence of cereals that caused them to eat less.

Thanks for defining the 'paleo diet'. 'Paleo' is nothing more than a framework and a hypothesis generator. I considered that a given.

luckybastard said...

paleo, as dr harris lays it out in paleo 2.0, for many of us has evolved from the "lean meats, fruits, vegetables" cordain approach to removing the toxic offenders(gluten, industrial seed oils, and excess fructose) from the diet instead of assigning a macronutrient ratio. having said that, in most cases a paleo diet will indeed be lower carb than a typical american diet being that if you take out the foods that contain the toxic offenders(sounds like a comic book supervillain collective) it's pretty hard to hit the levels of carbohydrate that the people who indulge in those products, which would be the vast majority. so low carb in this case would be relative.

personally, i started out low carb paleo and transitioned over to moderate carb paleo once i wasn't obese anymore. the whole food carbs don't make me hungry anymore. for instance, after my brutal squat session yesterday, on the way home i stopped and picked up 3 large sweet peaches and ate them all before i got to my front door. when i got in the house, i fried 3/4lb ground beef and fried 3 med russet potatos and a half of a large sweet potato in coconut oil spiced with all types of spicy goodness. when i was done, i relaxed a bit and did my normal evening chores without the wanting to rush my kitchen and eat everything in sight or make a late night run to the store to pick up a gallon of haagen daaz.i do these heavy carb days 2-3 days a week and they don't cause me have insatiable cravings. on the other days, i don't go as hard on the carbs, i maybe stay around 100g with copious amounts of fruits and nonstarchy vegs. my weight has stayed stable while doing this.

i guess this is where i agree with the previous poster about separating reward from palatabilty. this blog has been instrumental in pointing out the main toxic offenders and i believe most people will do well just cutting these out and letting their metabolic pathways reset themselves- and i include most of the genetically metabolically challenged such as myself, save for those with genetic leptin deficiency, prader willi or the like. i think people who lose weight by calorie restriction or generic low-carb who still complain of hunger should really consider removing all processed foods, industrial seed oils, gluten, and added sugar to their diets and see if that doesn't clear up. i have a feeling that is the reason many people who've lost a lot of weight yet still feel at the mercy of their cravings- i was one of those people when i did atkins the first time- is because they may be hitting some of the pathways that lead to insulin resistance and other precursors to obesity but they're still not fully addressing the root source of the problem.

Mirrorball said...

Here is a new study about food reward:

Relation of addiction genes to hypothalamic gene changes subserving genesis and gratification of a classic instinct, sodium appetite
http://www.pnas.org/content/early/2011/07/06/1109199108

Salt is powerful.

Janelle said...

What is the balance between food not being satisfying there for wanting more. And food being uninteresting, therefore you aren't rewarded and don't want more.

Can food be unrewarding and satisfying?

For example, I crave chocolate occasionally. I don't have chocolate, I feel restless, I pick at food, try several different things, but don't feel satiation even though I eat more than normal. Next time I crave chocolate I have a small amount and immediately satisfied and do not over eat.

Janelle said...

Also why is everyone obessesed about losing weight? You can be healthy at almost every weight. Losing weight for purely athsethic purposes isn't a quest for health. It buys into the shallow "looks based" hollywood artificial adgenda. Just look at older/non-hollywood movies and you see people much closer to who they really are. different sizes, facial blemishes, odd teeth. Back then story lines and acting were important. Not shiny skinny people.

Ideal weight is a generic formula which doesn't take anybodys individuality it to it. If you have gotten rid of the toxic food in you diet, how can you help but feel healthy? Health is NOT a number on the scales and never has been. Weight isn't the problem, disgusting processed food is.

Monica said...

My macronutrient breakdown for the past week is around 1/3 calories from carbohydrate, 1/3 from fat, 1/3 from protein. That seems to be where I naturally fall when I don't obsess about macronutrient ratios. I'm eating quantities of fruit that most low carbers would consider heretical. About 3 cups a day.

If you can call the above a low carb diet, you can also call it a low fat or a low protein diet and the term low carb then becomes meaningless.

Of course very obese people have different problems than those who are simply overweight. But that's part of the point of this series of posts: that one dietary strategy isn't going to work for everyone, and some people will need to take extra measures to lose weight. Yes, low carb seems to work for very overweight people. The problem is that it (and low fat, paleo, and every other diet out there) has been pushed as the holy grail for every type of overweight problem.

Now, just to keep things light, anyone remember that Bud Light Real Men of Genius commercial?

http://www.liveleak.com/view?i=113_1202548061

luckybastard said...

@janelle

i topped out at ~350, janelle. you think i was healthy at that weight? health and fitness aren't synonymous but they overlap in many places and not being able to achieve some basic physiological functions because of that is not healthy at all. besides that, excess adiposity in the amount that it takes to get obese is indicative of some major mechanisms in disarray under the hood. right now i'm 225@16% bf. that feels good for me but my body still slowly drops weight without effort because i addressed those under the hood issues and now it's returning to where it was meant to be. my hobby is helping obese people. many of them come to me because of aesthetics; i help them because i know what the current and future implications of carrying that around can mean. i'm all for lifting the stigma of being overweight and obese in this society but let's please separate that from what it means from a health perspective.

bentleyj74 said...

@Janelle

36-24-36 is the old school hollywood ideal and is not an obese measurement by any means. It was also pronouncedly curvier than the average Josephine at the time.

Show me an obese woman with a 24 inch waist and I'll show you a near mythical outlier.

Monica said...

"36-24-36 is the old school hollywood ideal and is not an obese measurement by any means."

No kidding. Sizes of clothing have also inflated. It's been said that Marilyn Monroe was a size 12. Seriously? I'm a size 10, but I'm no Marilyn Monroe. What's not commonly acknowledged, but is a hard fact, is that a size 12 now was a size 8 of even a 6 then. Anyone dealing in vintage clothing knows this as they have to relabel their goods as "xtra small" "small" etc. lest the sizes mislead people.

Certainly most people in Hollywood are still thin, but that's hardly representative of the weight of your average American. Take a look at old vintage photos from any town in the US and you will see a big difference in peoples' weight, unless it's just old grandmothers who have spent their entire lives in the kitchen.

Movies are instructive but in my opinion not because the actors were bigger. If anything, I think they were thinner. It's interesting how much food has changed in just the past 40-50 years. There is a scene in one of the Columbo episodes where they show a big lineup of food and the plates of two people as they talk: it's filled with eggs, meat, and veggies and hardly any of the pasta salads and other junk routinely seen today at potlucks and buffets.

My favorite is a classic scene in "To Catch a Thief" where Grace Kelly pulls out a chicken leg from the picnic basket. Very different chicken compared to what we are eating today, that's for darn sure.

Kindke said...

@Mirrorball

What this study shows is that, "Salt is powerful" if your

- Sodium deficient
- stressed
- pregnant
- less than 10 minutes has elapsed since you started drinking salt enriched solution in a sodium deficient state.

In the cases above, dopamine receptors in the hypothalamas are upregulated (aswell as a bunch of other stuff) highlighting that your brain is in effect tricking you into thinking that salt tastes REALLY good, presumably so that you deliberately increase your intake of salt to correct the sodium deficieny.

When the researches blocked the dopamine receptors with drugs, salt didnt taste fantastically good anymore, despite still being sodium deficient.

This resulted in the mice drinking sodium enriched water less quickly and drinking less total volume of said water when compared to sodium deficient mice that didnt have thier dopamine receptors blocked.

The researchers are speculating that known addictive drugs like cocaine are forcefully turning on this deceptively rewarding pathway and that is one of the reasons said drugs are addictive.

What was unexpected for the researchers however was that there seems to be an apparent disconnection between brain derived gratification and physiological gratification.

That is, the brain turned off sodium appetite before "significant absorption from salt in the gut".

This study shows that the Food Reward Hypothesis logic ( atleast as I understand it ) may actually be backwards.

we do not consume food because it is tasty

but rather

food is tasty because we want to consume it.

montmorency said...

@Janelle,

No, losing weight is not everything, and health is the main thing.


But they are not exactly unconnected.

For example, like another poster, I am "only" about 20 lbs over an acceptable (not an ideal) weight for my height (specifically the weight that would bring me down to BMI=25, i.e. the high end of "normal").

But I clearly have excess visceral fat, not a goood thing for a man to have, and which would raise the eyebrows of a medical practitioner. It also suggests that the metabolic imbalances that caused me to be even more overweight at one time, have not been totally reversed by the significant changes I made to my diet (low-carbing, then very low carbing, based on "real foods", no artificial or processed anything).

I know that I've made health gains in terms of e.g. lipids, feeling good, lack of hunger, etc, but I still have some way to go, maybe a long way to go. I get the impression there are quite a lot like me out there.

Brandon Berg said...

Furthermore, the esthetic aspect of fat loss really is important. There's nothing "artificial" about wanting other people to find us attractive, or preferring to associate with people whom we find attractive. These are natural desires, and every bit as valid as the desire for good health.

ItsTheWooo said...

@mem

I'm not trying to trivialize people's weight issues. That was not my point.

My point is that people like me are not like people who gain 30 pounds and stop, so we should not extrapolate effective interventions for slight weight gain to morbid obesity. There is something extremely wrong with my biology to allow that to happen to me, and it's not because I am a food addict. I only eat when hungry, and carbs make me hungry 24/7 as well as causing numerous other health problems.


Very, very few people are capable of gaining 160 pounds of body fat - even if they TRIED, their body would not allow it.

This is a real disease and it's not the same as gaining 10 or 15 pounds. Unfortunately, laypeople and even obesity researches conflate minor weight problems (and effective interventions) with severe obesity. "well if cutting fat helps your average slightly large person, then maybe the morbidly obese should try a low fat diet too". Um no, most times morbid obese people are glucose intolerant and metabolize fat far more normally. People who are like a few pounds overweight don't have these same innate endocrine problems.



Regarding your idea that people who don't handle the first 20 or 30 pounds risk becoming 200 pounds overweight - sorry, that's not true. Obesity is a real disease and very few people are vulnerable to morbid obesity. Many of us are vulnerable to minor weight gain, few of us are capable of being 300 pounds of body fat. It's like saying people who get down sometimes if their environment is boring, are at risk for psychotic depression. Nope, very few people will ever have psychotic depression and it really has no pathophysiological relationship to the normal blahs that we all get when our environment is dull.

ItsTheWooo said...

@Kulimai -

I notice we have separated "paltability" from "reward".

If these are not the same, what then is reward?

Does it become the pink elephant on my shoulder that no one can see but I promise it's there?

Is it god, which no one can prove, or see, but you better listen to me and my religious views or else you're going to hell?

Is that like "reward" in regard to food and weight gain? If a food causes weight gain, must be high reward! When asked for proof, one merely points to the weight gain. Circular logic, faith.

I always assumed "reward" was the same as "palatability". If it is not, we need some kind of PROOF for this "reward" thing, otherwise I"m just going to default to good old hyperinsulinemia - the real cause of body fat accrual.



Palatability is something that can be measured. Fried corn chips with corn oil sprinkled with MSG are very palatable, therefore very rewarding, therefore people prefer to eat this vs carrots (which are not fried, do not contain MSG, and contain no oil).
You can give people little scales where they measure their hunger and their desire for various foods, and this is a concrete analysis of palatability.

If palatability is NOT reward, then reward must be defined by something measurable. Otherwise it becomes faith.

ItsTheWooo said...

I would note that people have very poor insight why they do what they do.

I would also note that appetite and hunger is extremely complex. there are numerous cues which prompt, or inhibit feeding, not just one. We merely call this combined constellation of neuroendocrine factors "appetite" or "anorexia".

Having experienced hyperinsulinemia and morbid obesity, having experienced being underweight and leptin deficient, having experienced being thin while leptin adequate... you learn a LOT about the various feelings of "hunger".


People generally have extremely poor insight the kind of hunger they feel, why the feel it, or why they are eating. Many fat people think they are eating for no reason, but they only think this because the only perspective they know is that of an obese hyperinsulinemic person, trapped in a body which is growing fatter. There are many different kinds of hunger and I assure you that hyperinsulinemic (fat gain) hunger feels remarkably different from leptin deficient (fat atrophy) hunger. Very, very different. I blogged about this before, pity I deleted the post, but it was one of the earliest observations I made while first experimenting with leptin.



Hyperinsulinemic hunger is less about guttural physical need for caloric energy, and it is more a drive to eat. You are more selective in what you do or do not eat. Hyperinsulinemic hunger is defined primarily by a lack of satiety... that means to say, there is never really a point where your body is like "okay, I've had enough". Even if you eat a thanksgiving feast, an hour or two later you want more. There is never a point at which you lose interest in food. There is never a point where you become nauseated or energetic. Your body feels like a one way shunt for food , and your appetite remains high because of that. If you find yourself without food for a day, you find your appetite is paradoxically diminished and you stop wanting to eat.


Hypoleptinemic (starvation) hunger is radically different. This is more of a guttural need for calories. The "start" and "stop" of your appetite work relatively normally... meaning to say, if you pig out on a thanksgiving feast, you will feel REALLY full, you can get nauseated, and you won't want anymore... at least, temporarily. Like a day , the chronic starvaiton hunger will get better (due to the elevation in leptin). Hypoleptinemic hunger involves a total lack of food selectivity - all food is awesome, even ketchup on lettuce. You prefer protein and fat over carbs because your body craves nutrition.


What makes hyperinsulinemic hunger very different from hypoleptinemic hunger is this: Calories make hyperinsulinemic hunger worse. Calories make hypoleptinemic hunger better. The more you eat, the better your hypoleptinemia gets and the less hungry you are.
On the other hand, while in hyperinsulinemia, the more you eat, the more you WANT to eat, and the only cure is to not eat anything (or alternatively, go on a very low carb diet with high fat).


So when fat people say stuff like "I don't like little debbie cakes but keep eating them - must be the reward factor"... I know that state very well, and I also know the real reason is insulin propelling the obese person to gain body fat, shunting glucose and fat into stores abnormally. If you reduce your insulin level (e.g. eating cupcakes which have no starch or sugar ) then you find this stops.


Calling irrational hunger "reward" is circular logic; unless this reward thing is something that can be measured (the way insulin response to food can be measured, or the way palatability can be measured) I have to assume that it is a nonsense word which explains nothing, kinda like saying "flowers exist because of god".

ItsTheWooo said...

Also, having experienced hyperinsulinemic (obese) hunger vs leptin deficient (starvation) hunger is why I so profoundly reject the leptin resistant hypothesis of obesity.

There is no similarity to the sort of hunger in leptin deficiency as found in obesity, I know as I lived both. They feel very different. Leptin deficient humans eat very differently from obese ones and phenotypically are also much different.

Obese people, for example, usually are quite selective in what they will or won't eat - they are often more selective than thin people, and VERY much more selective than starving (leptin deficient) people. I often hear fat people brag they won't eat this or that as if it is proof they shouldn't be fat. Ironically, they do not realize this is a hallmark of obesity and hyperinsulinemia, and is precisely WHY they are fat. Being highly selective or "picky" in what you eat suggests that certain appetite hormones are being suppressed by insulin and hyperleptinemia, and it is a sign of fatness.

The lower your leptin binding in your brain, the less and less picky you are. Soggy lettuce on old bread? YUMMO.


This has been demonstrated in leptin studies, and I myself participated in a MRI scan of my brain pre and post leptin. People without leptin have brains which are ON FIRE whenever food is around, any kind of food, no matter how blah. As leptin is replaced via subcutaneous injection, the MRI becomes normal - the brain only lights up when food is yummy and the person perceives it as pleasurable to eat.



Obese people are driven to eat not because they don't have leptin in their brains, but they are driven to eat because their fat tissue does not add and subtract nutrients normally. It's really that simple. Think about it: if you have endocrine stimulation to your fat tissue which says "add fat in, but don't let fat get out very well" what do you suspect will happen to your body fat? How do you anticipate drive to eat via hypothalamus might change?

ItsTheWooo said...

@Melchior -

Perhaps it is a bold claim... but as soon as you wrote the statement "why do paleo dieters eat less than med dieter" immediately I guessed that the paleos were eating very few carbs. Reading the full text validated my hunch, "paleos" are definitely low carbers by defintiion, barely clearing 100 carbs per day. Lower food intake is expected from lower insulin levels, especially if the group is selected for pathologies of insulin metabolism (heart disease patients often have underlying metabolic disorders/diabetes).


The study would better be described that "diet with lots of starch is not as satiating as lower carb diet". Paleo and med are meaningless labels, all that matters is what you are eating. In this case, a so called "med" means pasta and grain, and a so called "paleo" means meat and nuts and a few root veg. Low vs moderate carb, basically.

If the "paleos" were eating honey roasted peanuts and carrots sprinkled with splenda and other not so paleo things I am certain their calorie intake would not change that much. It's not the "paleo", it's the lack of the carbs.


Similarly if the med dieters replaced their pasta with spaghetti squash, you would find their appetites dropped similarly.

ItsTheWooo said...

@luckybastard -

It's tough to say that 'paleo" is the reason you can tolerate more carbs. Weight loss seems to help glucose sensitivity in general.

Also, if you are more physically active now (i.e. consciously taking up an exercise hobby) you will find you can eat more carbohydrates before signs of hyperinsulinemia set in.


Speaking personally I work as a registered nurse. I am in a supervisor position at my facility (low physical activity) but I also work the floor (high physical activity). On the days I supervise, it takes few carbs before I start falling asleep and feeling that "want to keep eating, never full" high insulin thing.

On the days I work the floor, the activity keeps my insulin lower. This results in me being less hungry IN GENERAL (better release of fatty acids), plus when I do eat I can eat more carbs before getting hit in the head with apathy, fog, depression, ringing in ears and other high insulin / high glucose signs.


Most people enjoy lounging about , watching TV, etc. I am always trying to move after a big meal because I hate that feeling of being plowed over with glucose and insulin... and then I know an hour or two later it's either hypoglycemia and/OR a chronic insatiable appetite for more food (lack of satiety)


Exericse is very effective at reducing insulin levels because it helps glucose uptake w/o the insulin stimulus.


Most floor nurses hate working the floor and wish they could sit at a desk. I personally wish I could work the floor and stay active and awake and not be as easily vulnerable to being tranquilized by food (they made me supervisor because I am one of the few with brainz who did not refuse).


In fact, I specifically elected to be a RN because I anticipated it is a great job which will keep me on my feet moving around - and I feel best when doing that. I dread sitting at a desk, I associate that with messing up my metabolism and feeling fatigued, depressed, and always hungry. And indeed on supervising days I am often lethargic and hungry and a bit down in mood.

Ironic that my efforts to avoid desk work were fruitless as they still wound up sticking me behind a desk anyway. NOOOO.

kulimai said...

Hi, it's thewoo2


"I notice we have separated "paltability" from "reward".
If these are not the same, what then is reward?"

I defined both and also stated how they could be measured in earlier comments.

"Does it become the pink elephant on my shoulder that no one can see but I promise it's there?

Is it god, which no one can prove, or see, but you better listen to me and my religious views or else you're going to hell?"

Colorful. But you seem to be sharper in general than to think that everyone else is stupid.

"Is that like "reward" in regard to food and weight gain? If a food causes weight gain, must be high reward! When asked for proof, one merely points to the weight gain. Circular logic, faith."

I never said or implied anything like this. (Neither did Stephan afaics)

"I always assumed "reward" was the same as "palatability". If it is not, we need some kind of PROOF for this "reward" thing, otherwise I"m just going to default to good old hyperinsulinemia - the real cause of body fat accrual."

You want 'proof' for a definition? Surely not. You must mean you want evidence for Stephan's theory. But he has given various arguments. So really you can only mean you don't believe those are correct.Fine. But not very interesting or convincing by itself.

"Palatability is something that can be measured. Fried corn chips with corn oil sprinkled with MSG are very palatable, therefore very rewarding, therefore people prefer to eat this vs carrots (which are not fried, do not contain MSG, and contain no oil)."

No. (a)That is not how I understand palatability, but you are free of course to understand it this way. As I noted earlier, citing a chips maker, chips are purposely engineered to be high reward low palatability food. It's precisely their overall low palatability profile (strong but very brief, quickly fading) that contributes strongly to making them high reward. (b) But in any case your preference generalization miserably fails. It's totally false for me for example. (Not everyone is an addict --and, this is important, no moral judgement implied in the term.)

"You can give people little scales where they measure their hunger and their desire for various foods, and this is a concrete analysis of palatability."

"reward" for me. For addicts (whatever made them to be addicts, a multifactorial question and most, --but NOT all-- people in our civilization are food addicts) there may be no discernible difference between this concept and palatability: enjoyment/hedonistic value/rat orofacial expression/ x,y,z cellular pathway activation

"If palatability is NOT reward, then reward must be defined by something measurable. Otherwise it becomes faith."

Reward AND palatability need to be defined. Agreed. Exactly my point from the start. And I made an attempt to do it. But you have not given any arguments against my proposal that I could address.

Melchior Meijer said...

Hi Itsthewoo,

Thanks for your response. I think I did not express myself clearly. My suspicion is that gluten and WGA all by themselves disrupt appetite and energy homeostasis, at least in some people. I agree that excluding 'neolithic agents of disease' (let's call them grains, legumes, excess n-6 and excess fructose for the sake of the discussion) generally leads to a decreased carb intake. But as Lucky Bastard reports, some people notice 'normalized' appetite on a relatively high carb diet sans grains etc. It's not worth much, but after years of 'high tuber paleo', I experience the almost forgotten 'jitter hunger' when I eat some bread for the sake of being social.

How do you explain the absence of diabetes, CHD, cancer, etc in populations who eat a high carb diet without grains, sugar, plant oils?

ItsTheWooo said...

palatability as defined by freedicitonary.com:

pal•at•a•ble (p l -t -b l)
adj.
1. Acceptable to the taste; sufficiently agreeable in flavor to be eaten.
2. Acceptable or agreeable to the mind or sensibilities: a palatable solution to the problem.


It seems that chips are precisely a very palatable food. They taste very good. They have fabulous mouth feel. Perfect crunch. Bright colors which trick you into thinking they are nutritious. Nice mouth feel, texture, flavor. MSG. What's not to love? If chips were as low carb as nuts I would eat the crap out of chips every day, the way I do my roasted salted mixed nuts. LURVE CHIPS I DO but my body doesn't.


It also seems, then, that "REWARD" must be the result of eating palatable food. If your food is tasteless and therefore not palatable, you will therefore not experience any reward for eating it. If your food is low in fat, no flavor, nothing at all that can stimulate your taste, your brain will not perceive palatability and no reward result will occur. How can your brain find a tasteless, unpalatable food item to be rewarding? It can't.

Palatability is the cause of the reward effect.
I'm not getting this "low palatability, high reward" thing. It does not seem possible at all. It seems as if reward is intimately linked, if not the direct RESULT of palatability, which is why stephan's advice is to eat gruel and more gruel and never flavor anything and not even combine macronutrients etc.

If you disagree please explain your definition of palatability and how it is possible for there to be a low palatability high reward food item. Chips, as I said, do not qualify, as every conventional definition of palatability suggests chips are hyperpalatable for anyone who enjoys salty fatty crunchy food.

ItsTheWooo said...

@Melchior

It is a nice hypothesis that gluten/WGA are the problem, and I WISH IT WERE TRUE (I love rice!!) but again, I have never ever ever observed any problem with my appetite for eating wheat products. Maybe some people but I suspect this really isn't the issue for most people.

I think the beat - up -the-bad-guy bandwagon to attack wheat and wheat gluten comes from a few issues:

1) People DO NOT want to accept a total carb reduction is the most effective intervention for obesity and diabetes; they would rather fight tooth and nail to justify carb consumption.


2) People on low carb diets find they lose weight and have better blood sugar control if they eat less calories; many flavorful low carb foods are made with WGA; therefore they conclude wheat itself causes problems.

3) Food fads leading to everyone diagnosing themselves with celiacs disease. That was all the rage like 2 or 3 years ago or so.


4) People who eliminate wheat from their diet find they start losing weight. However, what they don't realize is that by eliminating wheat they are dropping their carbs alot and thats why they lose weight. They are less hungry. They are eating more nutritious foods like meat and vegetables.
Is it the WGA, or is it that they stopped eating a box of triscuits and calling it a well balanced meal?



Regarding luckybastard's observation that he can eat fruit after a strenuous work out and losing a bunch of weight... that's expected. Yes, I can eat a lot of fruit too if I run around like CRAYZAY on the floor as a RN at work.

If I try that while sitting on my ass as a supervisor, then I get to fall asleep at my desk, chronic unsatisfiable appetite and hypoglycemia and all sorts of issues. Today I ate a ton of calories precisely because one, high progesterone (fatfatfat) and two, sitting on my butt while eating cupcakes. Fog, hunger. I actually ate so much sugar I LOST MY APPETITE (highly stimulating food like sugar actually suppresses appetite for me... at least until my insulin comes soaring to send my blood nutrients crashing). I almost miss hypothalamic amenorrhea because progesterone makes me this sedated hibernating bear that just wants to eat everything in sight, and this was true even while on leptin. Progesterone is awesome at making you a fatty. But I digress.



I explain the lack of diabetes and CHD and cancer in those populations by concluding that metabolic disorders are highly multifactoral and those populations were not and are not exposed to the causative factors. Carbs do not cause the problem - they merely set it off, sort of how throwing a match on a pile of oily rags is the magic ingredient that allows a tremendous fire to start.

kulimai said...

"please explain your definition of palatability and how it is possible for there to be a low palatability high reward food item"

I have, several times. Never mind.

Incidentally I noted that most people in our civilization being food addicts, there will be no immediately experientally discernible difference for them between the two concepts. I think for many this will also mean that for emotional/cognitive/whatever reasons the distinction will also remain cognitively impenetrable.

Kindke said...

The salt study that Mirrorball linked ( thanks btw Mirrorball excellent find ) definitely suggests that palatability and reward pretty much the same thing.

In the study, the control mice found salt to be hyperpalatable, but that was only because the brain had already preemptively prepared a highly rewarding brain biochemistry setup for it.

The brain had already decided that salt was going to be very tasty long before the mouse actually did taste any salt.

Perhaps it would be a bold move to extrapolate this finding to other things like our high palatability for sugar, flavours ,spices, etc but well, there you have it.

kulimai said...

Hi Kindke

I agree it's a likely assumption that mice find salt palatable. But high reward? Reward (in my book) is about eating x making you want to eat more x or making you want to eat more calories. I'm not sure how this study is relevant.


"In the study, the control mice found salt to be hyperpalatable, but that was only because the brain had already preemptively prepared a highly rewarding brain biochemistry setup for it."

rewarding biochemistry setup? but we are talking about consumption of a given food being rewarding or palatable. Salt by itself may be palatable but not high reward in the above sense *when eaten in isolation*. In combination with calories, that is another matter.

luckybastard said...

@melchior @woo

let me get a little more specific about my workout. until last week, i was working out once, maybe twice a week for 30 minutes. my workout consisted of lifting heavy weight- deadlift,squat, weighted pullups, weighted dips- no cardio EVER. i spend no more than an hour in the gym a week(last week was a rare exception where i spent ninety minutes). the reason i went to the gym 3 times last week was because i hadn't been in few weeks and didn't want to lose any strength. funny thing is, eating the way i described earlier, even with no working out for that 3-4 weeks i still dropped a couple of pounds- pounds i wasn't trying to lose. my dirty little secret is that i actually lift heavy to keep weight on because i like the size that i'm at. whereas i used to feel as if i was battling my body to keep weight off, i now nearly feel the opposite because my body dictates via my activity how much i should eat. now when i overeat, my body will not feel hungry for a long time- whether i eat potatoes/rice or fat/meat.

i've read about the problems with gluten- i think robb wolf has a pretty good summary of those here http://robbwolf.com/2011/01/12/hey-robb-this-person-said-gluten-free-diets-are-bogus/. i think gluten's only one part of the equation(excess fructose and industrial seed oils) but i don't think it can be underestimated. my personal experience with gluten is that i've never shown any signs that i was gluten intolerant celiac but once i took it out of my diet, along with the other offenders my lifelong metabolic syndrome cleared up nicely. i've only tried to add gluten back in on a couple occasions early on but my body would have none of it. besides the gastointestinal pain, that hunger you speak so eloquently about returns with a vengeance. i NEVER have that happen with rice or potatoes or fruit. NEVER. i was low carb for years but when i took gluten(and i think that even small amounts are potentially harmful and have a snowball effect)and the other offenders out, it did wonders for my metabolism and let me now enjoy copious amounts of starch carbs and fruits with no worries about weight gain- something i've never been able to do.

one more point. my activity level in the gym is actually about 1/2 to 1/3 of what it was when i weighed ~300lbs.

Kindke said...

Kulimai,

"Reward (in my book) is about eating x making you want to eat more x"

That sounds like addiction. Are Reward and addiction synonymous then?

I dont know how to explain it other than just saying the taste *IS* the reward.

Doesnt it *feel* rewarding to you when you eat say a bagel with nutella?

The moment that stuff hits your tongue and you taste it, do you not feel a surge of pleasure?

The only other thing that is rewarding about food that is not linked to taste is the feeling of satiation ( or rather, the deletion of hunger ) that occurs in the stomach after you swallow the food.

Melchior Meijer said...

Itsthewoo, it’s none of my business, but considering your metabolic problem, why on earth do you eat cupcakes, splenda and such poor shit? Have you ever tried to eat only real foods? I don’t want to patronize you at all, but if you always have been including the crap you describe here and there, you haven’t given your system a fair chance to normalize. If you have tried ‘paleo’ a la Sarah Fragosso or Paul Jaminet and haven’t seen results, then I take this back immediately, but if you haven’t, I must take your skepticism regarding ‘paleo’ with a grain of salt.

The evidence that wheat has adverse effects also on non celiacs is mounting. It might not be rock solid, but the preliminary research findings are too compelling to pooh pooh grain leavers as faddish idiots.

Diabetes, CHD and cancer are multifactorial, you say. I agree. They become endemic as soon as populations introduce wheat, sugar and vegetable oils. Like the ancient Egyptians did. Association is not causation, but it gives us a hint we should not ignore.

Melchior Meijer said...

Hi Lucky Bastard,

Thanks for sharing. Same experience here, except that I never have been overweight and always haven been very active (addicted athlete, a little more cautious since reading Harris et al). Never had the slightest hint of gluten intolerance, but just about everything has improved without grass seeds. I don’t care if my improved performance and wellbeing is due to one big placebo effect.

Monica said...

I'll second the effect of wheat on non-celiacs. I noticed a huge difference when I cut out wheat. I thought it was just carbohydrate reduction. As I gradually added carbohydrate from fruit and tubers back in, I was surprised to find that these didn't really affect me mentally in any way. Even if I eat gluten free bread, it doesn't really affect me. But if I eat regular bread, especially on an empty stomach, watch out. Those types of mood problems simply don't happen when I eat a plain potato.

I felt fine on low carb, but it is more limiting when you restrict yourself to whole foods. And I wasn't losing weight. Carbohydrate alone does seem to affect some people, but that wasn't the case for me and I would wager that most people who are moderately overweight are still insulin sensitive. An insulin sensitive person can still eat quite a few carbs without them turning to fat. And this may also result in less cortisol production in some people.

Carbohydrate intake simply cannot universally explain weight loss. If it's all about carbohydrate, I should have weighed less 6 months ago when I was restricting my eating to 8 hours a day, when carbs were under 30 grams a day, and I was sustaining that almost every day for months on end, compared to now. Carbs 200 grams yesterday (50% of yesterday's calories), and I lost 0.2 lbs overnight, continuing the downward trend I have seen for over a month now.

I find it very interesting that carb counting does seem to work for many people, and that is consistent with Taubes' hypothesis. But there's a lot of non-Taubesian obesity out there. A little tongue in cheek here, but there is simply no way I am going back to my nearly three year experiment of counting carbs every day and hoping they add up to the magic number: 0.

Kindke said...

The salt study may also be a good explanation for the phenomenon of "Acquired taste"

The brain may interpret repeated exposure to a certain food and taste as a signal that other foods are scarce and in short supply. In order to increase your survivability, your brain needs to make sure you consume enough of this food to meet nutritional requirements.

How can your brain encourage you to eat more of this food? Simple, do as in the salt study, upregulate reward pathways in the hypothalamus to increase the palatability of said food.

Just a thought..... :)

Melchior Meijer said...

Non Taubesian Obesity (NTO). Thanks Monica ;-)! Priceless term. To add another personal personal experience, if I eat bread or porridge, I will bonk or get that ‘bonky’ feeling in the swimming pool. If I eat other starches (or nothing), I won’t.

David Moss said...

Interested to hear David Kresser say here at 51:20 (chapter 20: How to eat in moderation) that "It's very important that we emphasise this: eating has to be pleasurable, it has to be rewarding" and "if anything you need to focus on foods you like MORE than the fat, sugar and salt."

How does this compare to Stephanesque reward reduction?

http://fora.tv/2009/05/08/The_End_of_Overeating_Dr_David_A_Kessler#fullprogram

kulimai said...

@Kindke
look, this is what Stephan wrote a few posts earlier:

"Rewarding food is not the same thing as food that tastes good, although they often occur together.

Food reward is the process by which eating specific foods reinforces behaviors that favor the acquisition and consumption of the food in question."

So I am just taking a point he made and emphasizing it because I think, perhaps more than he does(?), that various aspects of the problem can only be understood with the distinction between reward and palatability or taste-enjoyment clearly in mind.


You say reward sounds like addiction and ask if they are synonymous. Well certainly, a high reward feeding event is one with low satisfaction. And indeed on the Stephan-type definition if a food is consistently high reward for someone then we can say that the person is addicted to it. However I have suggested a slight modification of the definition of reward that may be useful for the problems we are addressing: rewarding food is food that makes you want to eat more calories (not necessarily more of that food, though there will probably be a tendency)


"I dont know how to explain it other than just saying the taste *IS* the reward."

You are saying that you don't understand/accept Stephan's distinction, --as I said I think most people out there won't and not because it is conceptually difficult.

Doesnt it *feel* rewarding to you when you eat say a bagel with nutella?

You are asking the wrong person. I don't like the bagel and positively dislike the nutella. You are presumably using "rewarding" in the sense of 'enjoyable' here. If I liked it but eating it was satisfying in the sense that it did not make me hungry for more food/nutella I would not call it high reward in the sense defined.

"The moment that stuff hits your tongue and you taste it, do you not feel a surge of pleasure?"

No, but if I did, I'd call that palatability.

"The only other thing that is rewarding about food that is not linked to taste is the feeling of satiation ( or rather, the deletion of hunger ) that occurs in the stomach after you swallow the food."

You are again using rewarding in this paragraph not in the somewhat more precise senses defined above, but vagely, in the sense of pleasurable. high reward correlates with low satisfaction and not with high satisfaction. If you are satisfied you tend to stop eating. That means the food was low reward, it did not make you eat more.

kulimai said...

Hi David

"Interested to hear David Kresser say here at 51:20 (chapter 20: How to eat in moderation) that "It's very important that we emphasise this: eating has to be pleasurable, it has to be rewarding" ...How does this compare to Stephanesque reward reduction?"

It must be obvious what I think. Kresser is using "rewarding" in the general sense of 'pleasurable' like Kindke above, as your quote actually makes very clear. That is not how Stephan understands the term and correspond instead to palatability/taste/hedonistic value. It is crucial to keep the distinction in mind, IMO.

Jin said...

Since this series started here at WHS, I've been trying to pay attention to which foods in my diet trigger that feeling of wanting more and MORE instead of satiety.

It's probably obvious to most: tortilla chips, any baked goods or sweets including dark chocolate, nut butter, trail mixes, heavy whipping cream in coffee...

I've been GF for several years, so that helps. I've also employed the tactic of keeping things out of the house, and taking most meals at home.

Again, obvious, but I enjoy eggs and potatoes for breakfast, but I'm NOT going to get up and help myself to another 2 eggs and helping of potatoes. I'm satisfied with that meal and it does not induce cravings.

But, make a batch of GF muffins? I'm barely finished with one and my brain has the idea of reaching for another one.

Same with alcohol. Instant craving for more.

Thanks Stephan, for posting this series!

Kindke said...

"I dont know how to explain it other than just saying the taste *IS* the reward."

That is not completely right and I want to correct myself. The reward is the feeling of pleasure and euphoria experienced in the brain and also on the tongue.

Taste is obviously merely the detection of nutrients on the tongue.

What I meant was taste initiates the reward.

David Moss said...

Hi Kulimai,

Thanks for responding. It seems to me that Stephan's proposals to reduce reward aim implicitly at reducing pleasure. Whatever the relation between the two conceptually, in his mind, in the absence of an obvious objective measure for reward, Stephan seems to be suggesting reducing palatibility in generaL:

"Eat only single ingredients with no flavorings added. No spices, herbs... added sweeteners... etc. If you eat a potato, eat it plain. If you eat a piece of chicken, eat it plain. It can be in the same meal as other foods, but don't mix anything together. If you would like to keep salt in your diet, dissolve it in water and drink it separately."

That seems to go beyond what I took from Kresser's proposal which is to eat pleasurable low reward or at least pleasurable low fat/sugar/salt or (what seems to be the crux for him) pleasurable low calorie food. Perhaps Stephan would note that food can be low reward, simple but still pleasurable, but there still seems to be a tension between the strategy of making food as bland as possible and (what one might think is the way to go after hearing Kresser) which is to find a palatable low fat/sugar/salt/calorie food. Still, Stephan has read Kresser iirc, and I haven't, so will be interesting to see...

ItsTheWooo said...

36 - 24 -36 must be extremely tiny, unless she is 5'2 or 5'3 or something.

I am 5'5 and my waist was 24 inches and my hips were 35 inches, last time I measured. I have since gained like 3-5 pounds so this may have changed (when you're thin, even a pound is obvious and changes how your clothes fit).

People say I looked extremely thin like a "runway model" with those measurements. No one would every call me curvy but they say I have a nice figure.

I suspect that in old school hollywood, the actresses were lying about their measurements. Imagine it now. "Miss Marilyn has a perfect hour glass figure - 36 24 36" ...meanwhile in reality she's more like 34 26 37.
36 24 36 just SOUNDS perfect. It sounds so perfect it's almost a slogan, catch phrase, something made up for marketing.

I don't think it was ever real.

Like I said, with a 24 inch waist and 35 inch hips I could barely find clothes to fit me and my arms are very slim sharp and bony (not soft like old hollywood actresses) and people compare my figure to a runway model.

But again, perhaps holywood actresses are 5'1 or something in which case 36-24-36 would be relatively soft and curvy, not thin and model-like.

ItsTheWooo said...

@luckybastard

Out of curiosity, were you restricting calories before when you were just purely low carbing?

Also, were you doing extreme low carb for extended periods of time? Note that at 100 carbs a day, you are still low carb... the fact you don't seem to consider this low carb suggests that you may have been eating very few carbohydrates before.

Yes it is true that very low carb is more fatiguing than moderate low carb, but sometimes it is more effective for weight loss (sometimes it's not, everyone is different).


If the types of food we eat (rather than major macronutrients and micronutrients ) primarily affect appetite and fat storage, I don't see how it is possible that I could take leptin and be "cured" of my post weight loss hunger and fatigue. If anything, while on leptin I started eating far WORSE in terms of junk food and wheat and things that are supposed to be "bad", but my energy and weight only improved.

It seems at least in my experience the primary issue is low leptin after weight loss and there isn't much I can do about that other than eat a lot and start gaining weight (which I have been doing, since getting off leptin 2 months ago).

ItsTheWooo said...

@luckybastard (pt 2)


The way you feel now is pretty much the way I felt while on leptin, super duper easy to maintain, tons of energy, anything I eat just turns into energy, etc.

I feel that way OFF of leptin as well, however, it's not nearly as easy or effortless.

If I pig out on junk food (like I did yesterday), after I fast (to reduce insulin) then I find I feel very much the way I felt while on leptin - energy, low appetite, good mood, moving around dancing etc. Presumably over eating junk food spikes insulin which spikes leptin and I can then benefit from the leptin after I go back to low carb and reduce my insulin.



I've found I have made TREMENDOUS improvements in my carb tolerance and weight gain resistance, simply by supplementing flax oil and DHA/EPA, acetyl l carnitine, and inositol and chromium. In the past there is no WAY I could eat the way I am now eating, without far worse consequences.

The first time I quit leptin it was like a disaster train wreck bomb exploding. I had lots of signs of hyperinsulinemia and I was gaining fat really rapidly and my hypoglycemia was far worse.

This time, I gained fat but it isn't rapid and I have no skin fold darkening (acanthosis nigricans - a clear sign of hyperinsulinemia). THe first time I quit leptin, I developed a dark line around my abdomen and other skin folds which suggest just how severe my insulin levels must have been. This time, I barely am experiencing hypoglycemia even though my calories and carbs are significantly higher (I often clear 2000 calories a day and my carbs are often 100 or so... in the past this would have been DISASTER).

It's also true the first time I quit leptin it was november, and this time I quit in may... seasons powefully affect my metabolism and my exaltation is july, my nadir is january and this correlates with peak temps/light.

Perhaps in the winter I will find myself hit with a metabolic bomb, but I doubt it. I now use a bright light box which has really really really helped my depression as well as my metabolism; I no longer "succumb" to the fall and winter the way I used to, in terms of mood and weight gain.


Maybe you are right and some obese people are wheat gluten sensitive, but I am not. I definitely observe hypoglycemia and crashes from fruit and potatoes assuming my total carbs are too high (and I attempt to do high activity after eating... the activity needs to be BEFORE eating, after eating it just triggers a worse hypo).

I feel no need to remove wheat from my diet because I have never observed a correlation between hunger and wheat. If I eat a piece of pepridge farm carb controlled bread, loaded with kerrygold and natural PB, I feel AWESOME with energy (assuming my over all carb intake is not high).


The fact I simply can not correlate wheat with my chronic hyperinsulinemic hunger leads me to believe that it is not a factor for me. Lots of potatoes and lots of fruit has spiked me very nicely and made me dazed, depressive, foggy, fatigued, and endlessly insatiably hungry. ON the other hand, high fiber very low carb bread with tons of butter has had me rocket fuel energy feeling fabulous and losing weight.

ItsTheWooo said...

@MELCHIOR
Oh sir that's a complex question to answer.

First regarding yesterday, that was an anomaly and I very rarely eat that much junk. There are a few reasons why I did. First, progesterone (it's much more difficult to eat "good' this time hormonally speaking). Second, I am still learning my dietary limits. I just quit leptin 2 months ago, and while on leptin, I could eat pretty much anything and not get fat.
Now when I try to eat the way I used to eat I find that yes, it makes me EXTREMELY tired from high insulin and I get ravenous from that same high insulin. It's sort of how in college you may have went to a party and had a drink only to find you are already drunk and then you've drank too much. YOu need to learn your limits. I need to relearn my limits and yesterday it was definitely past. I was a walking fog and hungry and that lasted until just a few hrs ago (Now I am rocking a nice energy high, presumably post leptin spike, post insulin decrease. I feel very leptinized right now in the sense that I am very warm and not hungry and energetic. Weeee).


Also let me say I do not consider splenda "poor shit". I consider it manna from heaven that allows me to eat sugar without eating sugar. It is of no consequence or problem for me. This irrational polarizing of food as "good" or "bad" based on some arbitrary emotional "feeling" is one of the reasons it is so hard to follow a glucose balancing diet. People try and eat nothing but boring crap like eggs and meat and scorn splenda, and then they wonder why they are constantly pigging out on junk food. Duh, you are making your diet a punishment (note, this is why I don't like this "low reward diet" idea... it's almost BEGGING people to give up on trying to lose weight and to gorge on shitty fattening carb food).

If I get myself a nice 32 ounce iced coffee, half cup filled with delicious small ice cubes, half cup filled with fresh brewed coffee, pour in rich light cream, and add in about 1/2 a cup sweetness of a splenda packet.... all that happens is I FEEL FABULOUSLY GOOD the way cream and coffee tends to make me feel. I have tonnns of energy and my appetite is low, presuming I don't f*ck it up in other ways (e.g. eating too many junk food things with carbs).

When I lost the majority of my weight I was on a very spartan ketogenic, DEEP ketogenic diet. IT contained mayo, eggs, butter, meat, few greens. I was hemorrhaging body fat and it worked like a dream. I was SO PISSED OFF at 20 years old when I found out I never had to have been fat, all I had to do was eat fat and not eat carbs. I was beyond PEE OHed. It felt as if you had learned to accept the death of a family member by natural cause, but then suddenly you learned your family member didn't have to die, rather he was MURDERED. That level of anger and betrayal (of the medical establishment/society) and sadness all over again. I remember quite arrogantly waddling into the family room still morbidly obese and announcing I am going to be thin, because I cured my obesity. On like, the first week of the diet, I knew I would be thin. THey all laughed at me. WHOS LAUGHING NOW har har har I'm the thinnest one in the family. But anyway, I digress.

So yes I have done the "only basic ingredients" thing, and I have done the "lets use splenda and not be a technology phobe" thing, and the latter option is infinitely better. I feel less hungry and better whenmy diet tastes good. I don't want to eat crap food when my diet tastes good.


Right now I am just trying to maintain my weight more or less, I am not trying to lose. If I ate this way while fat I am certain I would not lose any weight , but maintenance is a bit different.

ItsTheWooo said...

@monica

I am not trying to say everyone needs to eat low carb, anymore than I am arguign that all people need to take haldol and thorazine simply because of an observation that schizophrenia is calmed by it. I would not want "normal" people with relatively "normal" metabolisms to go around eating eggs and bacon and limiting fine foods like potatoes and fruit for no good reason.

But as you point out, moderate weight problems are not the same as extreme ones. I am an extreme polar end of metabolism and endocrine system, as is someone like luckybastard. We tend to require to eat diets which are abnormally low in carbohydrate. At 5'5 and 115ish pounds, 100 carbs per day is plenty, 80 is better, 60 is better still.
If I tried to eat 200 carbs per day, I ASSURE YOU my calorie intake would not be 1600 it would be more like 2600 and climbing. There would be no humanly possible way for me to eat 1600 calories while also eating 200 carbs. I can imagine it now, as I have felt for years and years. The fog, the depression, the apathy, difficulty moving, and a chronic insatiable appetite for food. Never is there a point hwer eyou get energetic, or nauseated. Just more and more hunger, more and more fat gain, as your insulin levels remain elevated and food has a one way shunt into your adipose due to that.

The fact you can easily eat 200 carbs and keep your cals at 1600 suggests you are not glucose intolerant and you are not prone to being hyperinsulinemic, and therefore, your mild weight problem is different from my early onset morbid obesity.

Also, when you say you felt "fine" on low carb, I can tell you first hand that there is NO comparison to the horrible shit way you feel while on carbs vs the clear, energetic, "normal" way you feel on a lower carb high fat diet. I am almost afraid of a "normal" diet because I loathe that tethered down, fatigued, dead, apathetic feeling. I love energy and mental energy and clarity. I don't miss severe depression either.

In summary: not everyone needs to limit carbs... but I would guess that 95% of the time if you have a someome who is 300 pounds, with acanthosis nigricans, with reactive hypoglycemia, (if female) with PCOS, all clear cut disorders of hyperinsulinemia, you should probably place that person on a high fat low carb diet and see if these symptoms remit. They probably will.

kulimai said...

David,

the Kessler video you linked is very relevant. But as I said neither he nor Stephan uses the word 'reward' consistently, making their theories more impenetrable than they need need to be. (And they will be fairly impenetrable to most food addicts/people in our civilization anyway because they don't experience the relevant distinctions any more)

So there is reward, call it g-reward or reward-1 in the sense of gratification, like in "we eat because of the expected reward"

And there is reward-2 or r-reward in the sense of reinforcement of behavior as Stephan and Kessler both define it (but then they seem to forget their definitions more often then not and use reward in the sense nearer to g-reward/gratification)

Palatability and satisfaction are g-rewards. But satisfying food for example is not r-rewarding, you don't eat more when you are satisfied. etc.

I think you can't begin to sensibly discuss this topic in any depth without being mindful of such distinctions.

I think many apparent differences (not all) between Stephan's and Kessler's approach are artefacts of these conceptual unclarities.

For addicts reducing r-reward will inevitably reduce g-reward and palatability at least temporarily. That's the cold turkey part that Stephan appears to focus on. For non addicts and healed addicts a diet that is highly palatable (g-rewarding) but not r-rewarding is both feasible and desirable, --see your earlier quote from Kessler.

luckybastard said...

@woo

i was not restricting calories when low carbing initially. like you, i thought i'd found the end all be all of correcting my weight problem the first time i went low carb because initially, i didn't feel hungry on it. however, my body found a way "around" the inherent calorie restriction- especially with all the low carb processed food and technically low carb food being cooked in oils that leave the body in inflammation.

i did at times do vlc. i am aware that in except on those 2-3 days a week where i hit 200-300carbs a day, that my 100g a day is low carb RELATIVE to someone eating a diet in which they are still eating bread and processed food with wheat, added fructose and high omega 6 oils. the thing is, on those days, 100g is all i want. i don't desire anymore than that because my body doesn't seem to want it- it goes back to feeling like for the first time in my life my brain is actually in tune with my energy balance and when i'm actually satiated.

It's funny that you mention fasting and leptin sensitivity. many days(i'd say anywhere to 70-80% of the time) i eat inside of an 8 hour window where my first meal is at 11 or 12 and my last meal is 7-8. i got this from martin berkhan over at leangains.com. my body feels better on this regimen and i'm not sure all the benefits it has but there seems to be many including allowing my body to gauge when i am really hungry and i suspect it keeps leptin sensitivity high. also, most weeks i do a long fast one day of 20+ hours because it also seems to have a good effect and it seems alot of research is coming out to support my feelings on fasting.

also the high carb days following short intense weight training also seems to be good for insulin and leptin sensitivity. i've gone off of both of both before but my body always seem to come back to them as the natural way i should be eating. i feel horrible if i consciously overeat, eat mindlessly or eat things that i feel aren't fit for consumption. i don't like that feeling so i rarely do any of those things. i used to think i wanted to eat like my skinny friends and never gain weight(btw, most of those skinny friends are bigger than me now. biochem catches us all eventually)but now i see that all i ever really wanted- and seem to have achieved- is to not feel like i'm constantly battling my body's propensity for adiposity.

JBG said...

Woo, someone has to say it-- You need to cut back...WAY back...on your participation here. Numerous extended responses to many people would be appropriate on your own blog, but not here.

This does NOT mean you should leave in a huff. It does mean you should consciously cut back substantially on the length and number of your posts.

One man's opinion.

JBG said...

It’s been known for a long time that if young children are presented with a sufficiently broad buffet of healthy foods, they will reliably make balanced, healthy choices. “Primitive” people in their original contexts do the same. Many modern Americans do not.

My guess (not original with me) is that there is more than one route to overweight, but one that should not be overlooked is simple craving by the body for a sufficiency of the 40-some nutrients that humans require for life and health.

In an environment where so many culturally-accepted foods are so sparse in nutrients, it is easy to imagine the body continuing to give hunger signals even when calorie intake is already excessive.

This would explain why a relatively small quantity of some particular food might be quite satisfying, while larger quantities of others would not.

As a number of people have observed, it is strange and confusing terminology to call unsatisfying foods “rewarding”, but a food that provides a tiny, little bit of some nutrient for which the body feels an acute need, would be “rewarding” in the sense that word has been used here precisely because it is *not* satisfying.

No doubt some foods for some people have a quasi-addictive quality, and that is one way that eating some of a food could lead directly to eating more of it. But another possible way is that the body says, “Ah, that Food X I just ate has a tad of Nutrient Y. More!” If Food X had lots of Nutrient Y, then a modest portion would have been enough.

Take into account that there are in fact 40+ nutrients the body needs, and it is easy to see how people eating SAD would be constantly unsatisfied and constantly eating too much as a consequence.

PMC said...

Very good post you have on food reward and obesity.

Unfortunately, I didn't pay much attention to this in the past, as I thought it was a minor issue. I have to admit I was flat wrong!

TCO348 said...

The theory is not totally worked out. That's fine. I think there are some things that can be said about the theory. Food that tastes too good is rewarding even when only very slightly hungry. More plain food is only rewarding when the level of hunger is greater. When extremely tasty food is available many people will eat beyond their caloric needs but they won't do this when only relatively plain food is available. The exact mechanism doesn't need to be worked out to know that palatability is playing a big role in people being overweight.

I'm not convinced that overeating is an attempt to meet micronutrient intake levels. Its true that processed food is deficient in micronutrients. However people who switch to higher quality food don't usually lose very much weight if the high quality food is just as delicious as the lower quality food that it replaced. I think they lose some weight but not very much. Another thing is that I don't think that anyone is suggesting that to lose weight you must eat only food that gives you no pleasure at all. I think the idea is that the less pleasure you are deriving from food the more sensitive you will become to it and so will be satisfied with less food that is less rich, sweet and salty and you will have fewer and less intense cravings for extremely palatable food. Less palatable food will start to taste pretty good.

I don't think that there is any distinction to be made between palatability and reward. The reason that food tastes good is that it stimulates one's reward centers. That stimulation of the reward centers is also what reinforces the behavior. They are the same. As for food whose taste fades quickly in the mouth that is just a food that has an immediate intense reward but the reward fades very quickly. Wanting the reward to continue the person will quickly eat another and another to keep the reward going. I don't see how this means that reward and palatability are different things.

On the supposed french paradox, Kessler (End Of Overeating) thought that the fact that the french don't eat between meals mitigated the high palatability of their diet. I think that their diet and the previously mentioned Thai diet are not as hyperpalatable as our junk food diet. I think that alot of people are reluctant to admit even to themselves that fast food and packaged snack food and candy really are extremely tasty (very highly palatable). You aren't going to impress anyone with your distinguished palate by telling them that Doritos or Yodels or McGriddles taste just about as good to you as anything else in the world but for most people its true. I think that's where the confusion comes in. Our junk food is not sophisticated but it is damn tasty. I just don't think its true that the french are stimulating their reward centers with their food as intensely as americans are stimulating their rewards centers with fast food and snack food. I don't think there is any paradox at all, only the misconception that their food is as rewarding to them than ours is to us.

Anonymous said...

Stephan, about super-stimuli, so you think video games are harmful? What about other potentially addictive-like activities like intense music, movie-series watching, certain fiction reading (harry potter) or role-playing (dungeons and dragons) or other kinds of games? I've seen people spend hour after hour in such activities, often at the expense of other more productive, healthful things (like sports, studying, etc.), and react with severe anger or distress when such activities are denied, just as may happen with tv and video games. Are they super stimuli? Personally, I can't avoid feeling somewhat sad, and confused, since, besides the fact that I think video-games can be art, I have a strong emotional connections to many I played in my youth (just as one can have one with a movie or book), and is one of the things I love to do the most... And yes, it often takes quite a bit of my time.

Yaffi Lvova, RDN said...

"I believe that we live in a culture of overstimulation."
I have been saying this for a while. We have gone from simple black and white TV to many movies available in 3-D. I believe that the stimuli provided (in this type of entertainment) is inversely related to creativity in children, and hence in the adults they become. Addiction to sugar and salt have been proven, along with the subsequent dulling of tastebuds associated with the flavors. This is particularly a problem with diabetics who use sugar substitutes with a much higher sweet frequency than real sugar- it leads to more sweet cravings.
Thanks for the blog.

Mirrorball said...

This new article seems extremely relevant:

Long-term habituation to food in obese and nonobese women
http://www.ajcn.org/content/early/2011/05/18/ajcn.110.009035

It has been summarised here:
http://www.sciencedaily.com/releases/2011/07/110719114340.htm

Rap said...

Just to add a historical note to this discussion, the following descriptions of Socrates' approach to food might be of interest here. Socrates was an advocate of eating plain food, and also of eating only when hungry. (I believe most of these quotes are from Diogenes Laertius’ “Lives of Eminent Philosophers”.)

>>He used to say that he most enjoyed the food which was least in need of condiment, and drink which made him feel the least hankering for some other drink ...
>>He took only so much food as he could eat with a keen relish; and, to this end, he came to his meals so disposed that the appetite for his meat was the sauce to it. Every kind of drink was agreeable to him, because he never drank unless he was thirsty. If he ever complied with an invitation to go to a feast, he very easily guarded, what is extremely difficult to most men, against loading his stomach to excess. Those who were unable to do so, he advised to be cautious of eating when they were not hungry, and of drinking when they were not thirsty; for he
said that those were the things that disordered the stomach, the head, and the mind
>> . . . with endurance of toil for thy character; never art thou weary whether standing or walking, never numb with cold, never hungry for breakfast; from wine and from gross feeding and all other frivolities thou dost turn away.(from Aristophanes, The Clouds). [Does the "never hungry for breakfast" mean that Socrates tended to skip breakfast?]
>> [And as for Socrates’ state of health as a result of all this] He was so orderly in his way of life that on several occasions when pestilence broke out in Athens he was the only man who escaped infection.

Thus, from the sounds of it, Socrates greatly enjoyed even bland foods simply because he was always hungry when he ate them - which I think anyone who has been truly hungry can readily understand. But what are the implications for food reward theory if plain food for Socrates was as highly palatable at the time that he ate it as donuts are for a modern day junk-food junkie?
A
lso, I came across some old behavioral research which showed that rats that are given Food A when slightly hungry and Food B when extremely hungry will choose Food B if later given a choice between the two. This means that the hedonic value of food can readily shift over time as a function of experience. Again, what are the implications for food reward theory?

I suppose on the one hand, this suggests that perhaps a bland diet won't be so boring after all if what it does is lead you to eat only when hungry. (This was my experience with intermittent fasting; food became so much more enjoyable when I did eat that it helped motivate me to persist with IF, though I made no effort to restrict myself to bland foods.) But this then makes me wonder if the critical factor is not the taste of the food, but rather that bland tasting food increases the extent to which someone is likely to experience hunger before eating? Has this been properly controlled for in these food reward studies?

Finally, as someone else commented, no one ever hears that eating bland tasting foods is good for you (I suppose Socrates recommended it but then again he recommended plain living in general), but one often hears that eating only when hungry is good for you. And grhelin (which stimulates hunger) seem to have all kinds of important metabolic and neurological effects. It is easy to see how grhelin levels and fluctuations could have a significant impact on something like one’s set point, but it’s more difficult to see how eating food which is spicy versus bland could have an impact.

Stephan Guyenet said...

Hi Rap,

Great quotes!

I think people do adjust to simple food and come to find it more enjoyable over time. And yes, hunger does make food more rewarding.

However, I don't agree with the idea I've seen several times now that enjoying highly palatable food is the same as enjoying simple food once you're used to it. For one, I'm not sure you will ever enjoy a plain potato to the same degree as a plate full of chocolate truffles, no matter how used to it you are. But I think you can learn to be satisfied by the simple food, which is not quite the same thing.

But even if it's not a complete adaptation, there does seem to be some degree of adaptation that happens in reward sensitivity when food reward is changed for a long period of time. This adaptation obviously has a neurological mechanism in the brain. For example, dopamine D2 receptors in the dorsal striatum are downregulated during chronic exposure to highly palatable food in rats, perhaps as a reaction to increased dopamine release.

The point is that the state of being adapted to high-reward food is not exactly equivalent to the non-adapted state. The difference between the two states is probably what drives the changes in body fat homeostasis, and D2 receptors may play a part in that.

misty mclarry said...

I think self-discipline will really offer a big help to combat obesity. if people, especially those who have a higher risk for obesity, will be more cautious on their calories intake then such condition can be prevented

gunther gatherer said...

The Socrates stories are really interesting. I heard he lived to 91, which must have been extremely rare for the times he lived in.

I don't consider this a coincidence. His prescriptions for health were as useful thousands of years ago as they are today.

Laura said...

@mirrorball:
the sites you posted don't seem to work - but I found the article here: http://www.ncbi.nlm.nih.gov/pubmed/21593492

garymar said...

Socrates was probably about 70 when he was executed/committed suicide.

Stargazey said...

My own experience with carbohydrate intake (of any kind) parallels that of ItsTheWooo2. However, a while ago I did a blogpost on the effect of insulin sensitivity on the effectiveness of low-carb versus low-fat weight loss programs. It appears that for those who are insulin-sensitive, a low-fat/low-calorie diet works best for weight loss. For those who are insulin-resistant, the low-carb approach seems to work better. We may be discussing personal experiences that differ because some of us are insulin-responsive and some of us are insulin-resistant.

Here is a link to my blog on the topic. (I recognize that this constitutes self-promotion, so please ignore it if it offends you. Thanks.)

Rap said...

Hi Stephan,
Yes, I have to admit, it is hard to imagine enjoying a potato as much as a chocolate truffle. Then again, the best meal I ever had was a dish that I usually found quite tasteless (almost bitter) but which I was given after several hours of exremely heavy labour. Holy smokes, what an appetite I had and it completely changed my perception of that dish.

Here's another example of an eat-only-when-hungry individual who greatly enjoyed plain food as a result. This is Luigi Cornaro who, in the 1400s, became famous for having recovered his health through temperate eating and ended up living almost to 100.(http://alternativehealthcommunity.com/blog/luigi-cornaro-art-of-living-long/). He had quite a restrictive diet, though; essentially an early version of CR. But it does suggest that bland food and eating-only-when-hungry often go hand-in-hand.

>>O truly happy life, which, over and above all these favors conferred on me, hast so improved and perfected my body, that now I have a better relish for plain bread, than formerly I had for the most exquisite dainties!

In fact I find such sweetness in it, because of the good appetite I always have, that I should be afraid of sinning against temperance, were I not convinced of the absolute necessity for it, and knowing that pure bread is, above all things, man’s best food, and while he leads a sober life, he may be sure of never wanting that natural sauce, —a good appetite—and moreover, I find that, whereas I used to eat twice a day, now that I am much older, it is better for me to eat four times, and still to lessen the quantity as the years increase.

Harry said...

Here's a point I think may be being missed:

Forgive a philosopher his pedantry, but...

If hyper-palatable (high reward) foods are the problem, it does not follow that 'low' palatability foods (low reward) foods are the solution. To think so is to confuse 'negation' with 'opposition'.

In other words, the negation of hyper-palatable is 'not hyper-palatable'. On the other hand, 'low' palatable foods (i.e. bland foods) are not the negation of hyper-palatable foods: they are the OPPOSITE of hyper-palatable foods.

Now, it is a logical error to posit that one must 'oppose' the cause of a pathology, when merely negating it would be ample redress (imagine someone suggesting that the solution to over-exercise was to take paralysing drugs so as to preclude any and all bodily movement).

Now, this is not to say that low palatability foods may not work better at promoting weight control than merely 'not hyper-palatable' foods. But, this hypothesis needs to be tested. It does not follow naturally from the mere discovery that hyper-palatable foods are the problem.

It may, for instance, turn out to be the case that, once you've reduced the palatability of hyper-palatable foods below a certain threshold, further reductions have no impact.

Food for thought.

kulimai said...

Rap,

Thanks for these great quotes and references. I think we are on the same wavelength. In my view you are absolutely right to emphasize the relevance of fasting/hunger.

Of course Stephan is correct when he, effectively, says that not being addicted once you are used to it is still not the same state and experience as being addicted.

However his repeated lukewarm agreement that "people do adjust to simple food and come to find it more enjoyable over time. And yes, hunger does make food more rewarding" suggests to me that he is not personally very familiar with the experiences you describe. That you can get extreme high g-reward / palatability with low r-reward "bland" eating. Whether we take this state of hightened sensitivity to be 'normal' is another issue of course but not a very well defined one.

Anna said...

This guy did a monotonous diet with "fasting" and lost over 130 pounds:

http://youtu.be/7bYs57HsH80

He doesn't recommend anyone do the exact copy of what he did, fwiw.

Stargazey said...

Thanks for your logical point, Harry. Reducing the palatability of hyper-palatable foods seems a more reasonable solution than going to a completely bland diet. Now that you bring it up, that hypothesis deserves to be tested.

Em said...

Very interesting read. The only thing I disagreed with - and found rather presumptuous and not fact-based - was what you said about asking immigrants about how American food is sweetened.

Although it's quite "trendy" to complain about American food, and for foreignors to act like there's a huge surprising difference, I travel a lot and have been to most of the origin countries of US immigrants. The US is actually the only country I've been to where sugar-free options are ubiquitous. In Europe, the Middle East, Westernized Africa and places like Thailand, Korea, or China (the more Westernized Asia), I get weird looks for asking for my coffee, milk tea, or other beverages unsweetened. A lot of restaurants don't even have that option, as things come premixed! In China, it was impossible to find unsweetened bottled tea, except for one Japanese brand some stores carry. And in Korea there were Dunkin Donuts everywhere, with painfully sweet premade coffee. (My Korean friends tell me the standard big city breakfast is pastries at places like that)

Furthermore, in many many many 3rd world countries, sugar is added to nearly every broth or sauce to make things more palatable (such as Thai curry or practically any Japanese recipe involving soy sauce bases). Portion sizes are also large, with the exception of parts of Europe and Japan.

I think too much sugar is a world-wide thing, not 'American.' I think it's the fault of most people just not having had the opportunity to travel around that these cliches of American food's difference with the rest of the world persist.

Brian said...

Anyone (including Stephan):

Do you have any experience with sous-vide cooking, and would you recommend it as a way to cook meat for this diet?

tighe said...

Hi Stephan,

I'm interested to know your opinion on the role of natural spices and herbs in food reward. I know some research has shown significant health benefits from certain spices and my personal expereience is that eating highly spiced food, particularly when there's significant heat, results in saiety after a smaller amount of food.