Gastric Band Service

Net Carbs - Slowly Driving me Insane

If I hear one more person say, "I need to give up carbs," I think I'll scream.

Please, people, hear me now: Give up junk! Not carbs. Whole food carbs are good food, necessary food. Carbohydrate is a primary fuel source, along with proteins and fats. You need a balance, not to give up carbs or even severely restrict them. Just choose quality carbs.

The low carb food products are also a pet peeve. How is it helpful to provide tons of "low carb" cookies, cakes, pies, breads, cereals? It's may be helpful to Atkins Corp's bottom line but not your bottom. Those products are not a whole lot different than the original except they're expensive so don't bother. If you want a piece of bread, eat quality whole grain bread. Skip the Barbie loaves.

Choose good carbs - whole fruits and vegetables, whole grain breads (100 percent whole grain, not just labelled whole grain), beans, brown rice (yes, rice), potatoes (?). Food that grows in the ground and on the trees - not grains that have been pulverized to a fine powder with all the bran removed (white flour), with a few vitamins added back for good measure then passed off as food.

If you are convinced you need more protein and less carbs, that is fine, but choose good carbs and avoid the heavily processed foods and you'll be ahead of the game. Go through your cupboards today and see how many boxes you have of foods that started out wholesome but are now ... dead. Check your grocery receipts next time you shop and see how many whole foods you eat compared to how many processed? Your grocery costs will drop substantially when you eat more produce, less boxed, pre-made foods.

How to Calculate Net Carbs: This question is asked because people want to be able to eat bread again, so they see a label that says "2 Net Carbs!" and they notice it is bread, but they think, "Hah, the label says it's only 2 Net Carbs, so that must mean it's okay," and they go ahead and eat twice as many slices, because, it's not very many carbs, after all. Guess what? They could do the same calculation on the regular bread and come up with the same result! You don't need the special "low carb" version, they are just labelled that way. It's junk science - a new name for a bogus way of counting your nutrients. Stop driving yourself crazy with counting every little nutrient - just make better choices.

Today's Advice: Eat Fruit & Vegetables for Snacks

Choose fresh fruit over juice, and real juice over soda pop. Avoid artificial sweeteners - eat a piece of fruit if you want a sweet.

Drink more water. Wean yourself off sugary drinks. Even artificially sweetened drinks still cause you to crave sweets - get off them. If you drink four diet drinks a day, switch to three and one tall glass of water. Add a squeeze of lime if you absolutely must have flavor, but remember, if you lived in the forest, with no stores nearby, and you had a fresh stream of clear running water, it would be enormously pleasurable to take a nice, cold drink from that stream. We are meant to have pure water, and fresh food - let's get back to basics.

Appetite, Hunger and Weight

To be able to control your food intake and maintain a healthy weight, you need to understand why you feel the need to eat.

Appetite & Food Intake

Experts believe that basically, three factors regulate food intake including:

• The hunger center located in the hypothalamus section of the brain.
• The appetite, located in the brain stem.
• The satiety center, which is neurologically connected to the hunger center and the appetite.

Appetite Factors

Experts believe that appetite is influenced by the brain stem, which is independent of the hypothalamus. The hunger center stimulates an individual to eat while the satiety center extinguishes the need for food. The appetite also stimulates a person to eat. Appetite is often referred to in the same sense as hunger. It includes and is influenced by time of day, smell, and sight of food.

Appetite is Learned

However, appetite relates to the desire for specific types of food and eating experiences, instead of food in general. Appetite helps select the quality and balance of food as learned by an individual in his or her environment.

Appetite and Hunger Center

The hunger center is responsible for the long term, metabolic, regulation of food intake over weeks and months. The hunger center maintains normal quantities of nutrient stores and controls physiological hunger. The hunger center is influenced by the following factors:

• When glucose concentration in the blood is lowered, hunger develops which increases feeding activity until the glucose concentration stimulates the satiety center to eliminate the hunger.
• When amino acids concentration in the blood decreases, hunger increases, although this effect is not as powerful as the need for glucose.
• When the quantity of fatty molecules in the body increases, physiological hunger decreases.
• When exposed to cold weather there is a tendency to eat more as cold temperature interaction in the hypothalamus increases the metabolic rate and provides fat for insulation to correct for the cold state.

Hunger vs. Appetite

• Hunger is a craving for food associated with a number of objective sensations including hunger pains or a tightness or "gnawing" feeling in the stomach, general tenseness, and restlessness.
• Appetite, in contrast to hunger, is the short-term, environmental regulation of feeding from hour to hour over the course of a day. The appetite is concerned with the immediate effects of eating factors including salivating, tasting, chewing, swallowing, and the condition of the stomach and intestines.

Appetite & Eating Control - Upper Gastrointestinal Tract Nerves

When you overeat and overstretch the abdominal cavity, nerves in the upper gastrointestinal tract signal to stop eating. This is particularly important in bringing a halt to a heavy meal and explains why drinking water before a meal or why having soup with a meal can reduce total calories consumed. When these "eating factors" controlled in the brain stem have been satisfied, the hunger center in the hypothalamus becomes temporarily inhibited.

Since complete inhibition of the hypothalamus does not occur until both hunger and appetite are satisfied, you may desire food soon after you have eaten if appetite has been satisfied but not hunger. This also explains why people eat when they do not have hunger.

Use Appetite to Control Hunger for Healthy Weight

The fundamental principle underlying adequate eating is to use your appetite to control your hunger. If you wait to eat until you are physiologically hungry, you may eat four or five times the amount you need to fill the nutritional stores. Many people skip meals and then "pig out." It is relatively easy to fight off your appetite but nearly impossible to fight off your hunger. To prevent this situation from occurring, eat nutrient balanced meals every day, avoid allowing yourself to become physiologically hungry by using your appetite to control your hunger.

Hunger, Appetite & Satiety

Satiety, the opposite of hunger and appetite, indicates a feeling of fulfillment in the quest for food. Satiety occurs when your nutritional storage deposits, such as the adipose or fat tissue, and glycogen stores are filled. The appetite is satisfied when a person's learned nutritional needs are satisfied.

Balance Hunger, Appetite & Satiety

• It is important to eat efficiently, balancing hunger and appetite with satiety. Eating nutrient-balanced meals to avoid hunger, and at the same time to fulfill your appetite with positive eating associations are the objectives of an adequate diet. You can learn to use your appetite to control your hunger.
• If you eat foods with sufficient nutrients to prevent hunger, satisfy appetite, and balance energy, you can avoid the major nutrition-related disorders. The objective is to learn to eat nutritionally balanced meals which will avoid the onset of physiological hunger.
• Eating within your caloric range is the first important principle related to adequate nutrition. If you do not eat within your caloric range, it will be very difficult or impossible to balance your nutrients.

Source: © Dine Systems 2003 (website: www.dinesystems.com)

Obesity Report in Primary Care Research Project

Dr Foster Introduction

In March 2003, the report of the WHO/FAO joint expert consultation into diet, nutrition and prevention of chronic diseases (WHO technical report series no. 916) highlighted the threat that obesity now poses to world health. The report found that obesity had reached epidemic proportions globally, with more than 1 billion adults overweight at least 300 million of them clinically obese and concluded that obesity was a major contributor to the global burden of chronic disease and disability.

It blamed increased consumption of energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity. The result is obesity rates that have risen three-fold or more since 1980 in many parts of the world including the United Kingdom. The latest figures available for England show that obesity is a growing problem the prevalence of obesity has increased steadily during the last 50 years and trebled since the 1980's. The prevalence of serious obesity increases with age. In 16-24 year olds the prevalence is around 5% in men and 10% in women. By age 55-64 years the prevalence is over 23% in men and 29% in women; a three to four fold increase (Health Survey for England, DoH 1998).

Being obese or overweight means a higher risk of suffering a range of serious chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer. Analyses carried out for World Health Report 2002 found that approximately 58% of diabetes and 21% of ischaemic heart disease and 8-42% of certain cancers globally were attributable to a BMI above 21 kg/m.

The report found evidence that obesity accounts for 2-6% of total health care costs in several developed countries but suggested the true costs were much greater as not all obesity-related conditions were included in the calculations. The report stated that obesity should be considered a disease in its own right as well as a risk factor for other chronic diseases. The report recommended certain responses:

• Creating supportive population-based environments through public policies that promote the availability and accessibility of a variety of low-fat, high-fibre foods, and that provide opportunities for physical activity.
• Promoting healthy behaviours to encourage, motivate and enable individuals to lose weight by:
  • eating more fruit and vegetables, as well as nuts and whole grains
  • engaging in daily moderate physical activity for at least 30 minutes
  • cutting the amount of fatty, sugary foods in the diet
  • moving from saturated animal-based fats to unsaturated vegetable-oil based fats.
• Mounting a clinical response to the existing burden of obesity and associated conditions through clinical programmes and staff training to ensure effective support for those affected to lose weight or avoid further weight gain.

This report aims to establish the degree to which these responses are currently being put into practice across the UK by the organisations with primary responsibility for management of obesity.

The key conclusions of the report are:

• Policy around obesity is focused primarily on obesity as a risk factor for other chronic diseases rather than an illness in its own right.
• Recent efforts to promote health behaviours and accessibility to healthier foods have been widely adopted by primary care organisations. Recent central government policy initiatives such as the '5 a day' campaign in England, 'Eating for Health' in Scotland and the 'encouragement of exercise' on prescription schemes have ensured that such initiatives are now almost universal.
• In terms of clinical response, there is more consistency around second line treatments (drugs and surgery) than around first line treatments. Perhaps this is because public debate and the intervention of the National Institute for Clinical Excellence in England has focused on the cost effectiveness of second line treatments rather than primary treatments.
• There is significant variation between areas in the UK in terms of primary clinical response to obesity. This applies both to the services available, the communication of these services to the public and the way in which these services are organised and the people who have primary responsibility for delivering them.
• There is scope to improve information for the public about schemes to tackle obesity. Almost on in ten areas said they did not provide any form of written information about such services.

Source: Dr Foster Health Guide 2003

Studies employ trickery to find why the U.S. is so fat

Chicago Tribune, Jan 2 2004

On a brisk fall morning, professor Brian Wansink welcomed four graduate students to his lab for what they thought was a taste test of tomato soup. Unbeknown to the students, two of the four soup bowls were rigged to remain full, fed by hidden tubes. Twenty minutes later, the two students were surprised to learn their bowls had supply holes in the bottom and that they had eaten a third more than their colleagues.

That test is one of the experiments the University of Illinois' Wansink has conducted to figure out why people often eat more than they should, a concern when the medical community, the food industry and the government are under pressure to figure out why so many Americans are overweight and what can be done about it.

Wansink is among researchers nationwide who are studying how external factors from packaging to advertising to dining companions influence eating behavior. Experiments show that people do not necessarily stop eating when their stomachs tell them to and in some cases offer lessons that could help to curb the obesity epidemic in America.

"People believe they're pretty good at calibrating what they eat," said Wansink, 43, who studies the psychology of food. "I don't think they are. I think they rely on benchmarks, essentially the fill level of the bowl. There tends to be this visual cue that you're full."

During two years of Wansink's soup experiment, students with bottomless bowls tended to eat 40 percent more than test subjects with regular bowls. "I wasn't aware of it," said Nina Huesgen, one of the students with a trick bowl. "That's why I feel so filled up, I guess." Jason Stokes, who was similarly duped, said, "I did notice that my bowl level wasn't going down very much, but I thought that was because I wasn't eating very much."

The soup test is one of the methods Wansink has used to show that people often struggle to control their eating. People will shovel in a bucket of popcorn even if it's stale, and they'll gobble one candy after another if the treats are within arm's reach, Wansink has found.

Portions getting bigger

The research by Wansink, a professor of marketing, nutritional science and agricultural economics, is particularly relevant because recent studies have shown that portions in restaurants and in homes have increased in the last few decades, most notably in "super-size" fries and soft drinks offered by fast-food restaurants.

Some nutritionists say the increase in portion size has fueled the obesity epidemic, but Barbara Rolls, a professor of nutritional sciences at Penn State University, said it is difficult to prove that the increase in portion size causes obesity. The focus on where and how people eat needs to continue, said Rolls, who has conducted research similar to Wansink's. "I think it needs to be easier for people to eat healthier," she said. "It's too easy for us to eat huge portions of high-calorie food. ... They are cheap. They are everywhere."

In Rolls' research, she offered men and women different sizes of submarine sandwiches over four days. When served a 12-inch sandwich as compared with a 6-inch sandwich, men ate 56 percent more than the men given a 6-inch sandwich while women served the longer sandwiches ate 31 percent more than their counterparts who received the shorter sandwiches.

Wansink said he believes portion size is a factor that contributes to obesity, along with such features of modern life as elevators and computer games that discourage exercise. "In the obesity war, portion size is the first casualty," said Wansink. "It's easy to point at, and we don't have to take responsibility because we can blame the restaurant or the packaged food manufacturer."

The chips are down

As for ways the food industry could help, Wansink conducted an experiment that people who have stuffed themselves on potato chips might appreciate. He offered three different groups Lay's Stax potato chips, a product that boasts "The crispy crunch will keep you coming back for more."

The first group received regular chips; the second got chips in which every seventh chip was red, and the third were served chips in which every 14th chip was red. Without being told the reason for the red chips, participants nonetheless used them as a guidepost for how much to eat, Wansink said. The participants who ate the least had the potato chips in which every seventh chip was red, followed by the group in which every 14th chip was red.

"With chips, we kind of eat until we feel sated," he said. "But what happens if in a very in-your-face kind of way at the seventh chip there's a divider and you say, `Hey, how many have I eaten?' All of the sudden, it's an abrupt way to monitor how much you ate."

Wansink's research has produced some common-sense tips for weight- conscious consumers. Office secretaries ate 25 percent more candy when it was on top of their desk rather than in a desk drawer. People who drank out of short, fat glasses consumed considerably more than those who used tall, skinny glasses, even though the glasses held the same amount. "The tendency we have is to focus on heights instead of widths," Wansink wrote in a report on the study.

His analysis of comfort foods, meanwhile, found that women felt better about themselves after they ate snack food such as brownies or cookies, while men were soothed by hardier fare such as pizza or steak. The women surveyed preferred snack foods because they didn't require uch work, whereas they associated meals with cooking and cleaning up, Wansink said. The men surveyed favored meals because they conjured up the image of someone preparing the food for them, he said. Wansink also found that both men and women feel better after eating small amounts of comfort food.

A nibble can do the job

"You don't have to eat the whole pizza," he said. "People get psychological comfort by eating small amounts of these comfort foods." But as Wansink has seen again and again, many consumers cannot stop with small amounts, a problem he attributes in part to the time-honored exhortation to eat until your plate is clean. People who are given larger portions eat more even if the food tastes bad, he said.

In one of Wansink's more revealing experiments, he offered free popcorn to moviegoers at a $1 movie theater outside Philadelphia. The movie "Stargate" was showing, and Wansink told the moviegoers the free popcorn was part of a celebration of the theater's anniversary. Half the audience was given fresh popcorn, either in small containers or in jumbo buckets; half received 14-day-old popcorn in small and jumbo containers.

"We had them write down what they thought about the popcorn, and 82 percent of the people who were given the old popcorn said it was terrible," Wansink said. Nonetheless, the moviegoers with the jumbo buckets of stale popcorn ate 33 percent more popcorn than those with the smaller container.

"One guy drank almost a quart [of soup]," Painter recalled. " I said,`What were you doing?' And he said, `I was trying to reach the bottom of the bowl."