Timi Gustafson, R.D.
Helping people to live healthy and fulfilling lives.
That high sugar consumption contributes to weight gain has widely become accepted as a fact, but the possibility that eating the sweet stuff could make us actually sick is another matter. Questions about potentially devastating health effects of sugar are the subject of a recent article by Gary Taubes in The New York Times Magazine (4/17/2011).
While Taube’s investigation stops short of passing final judgment, he does in fact make a persuasive argument that sugar may be a dangerous toxin or poison on par with tobacco and alcohol – “something that’s killing us.”
The latter are not Taube’s words but those of Robert Lustig, a specialist on pediatric hormone disorders and a renowned expert in childhood obesity at the School of Medicine of the University of California in San Francisco. Lustig has long been convinced that sugar is not only bad for our health because it offers too many empty calories without much nutritional value. “It’s not about the calories,” he insists. “It’s a poison.”
By sugar, he does not single out the white granulated variety that you pour in your tea or coffee or on top of your breakfast cereal, which is known as sucrose. He also (and especially) includes high-fructose corn syrup (HFCS), which is almost omnipresent in processed foods and soda drinks. In fact, over the last 30 years, HFCS has become the sweetener of choice for manufacturers of processed foods and sodas, primarily because it’s cheaper than refined sugar. Only now the tide seems to be turning back in favor of old-fashioned sugar, as HFCS is becoming increasingly unpopular with health-conscious consumers.
Lustig agrees with the assessment of the majority of nutrition experts that the high sugar content in the typical American diet plays a major role in the current obesity- and diabetes epidemic, but he goes much further than many of his colleagues. He believes that sugar is also a likely dietary cause of several other chronic ailments and diseases of Western lifestyles – like heart disease, hypertension and some types of cancer. Consequently, he demands that sugar should be classified as a toxic substance.
From the start, Taubes does not hide his belief that the professor has a point: “ Lustig, who has genuine expertise, has accumulated and synthesized a mass of evidence… compelling enough to convict sugar,” he writes.
Lustig’s general (some say “loose”) use of the term “sugar” has made him vulnerable to his critics. By “sugar,” he says, he means both sucrose (e.g. beet- and cane sugar) as well as HFCS. Sucrose consists of carbohydrate glucose and carbohydrate fructose as a 50-50 mixture. By contrast, HFCS contains 55 percent fructose and 45 percent glucose. Since fructose tastes much sweeter than glucose, the desired sweetening effect is higher in HFCS than in refined sugar. Still, both forms of sugar end up as a glucose-fructose combination in our bodies, or as Taubes puts it: “The question, then, isn’t whether high-fructose corn syrup is worse than sugar; it’s what do they do to us.”
That is also Lustig’s argument. It’s not about what kind of sugar we should use and what kind we should avoid. It’s not even about the empty calories many of our food products are overloaded with. Rather, it is about the “unique characteristics” of sugar and the ways our bodies metabolize the fructose in it “that may make it singularly harmful, at least if consumed in sufficient quantities.”
And this is where Lustig makes his case most compelling: The fructose component of both sugar and HFCS is primarily metabolized by the liver, while glucose is metabolized by every cell in the body. The more fructose you consume, the harder the liver has to work. And if you take high amounts of fructose in liquid form, e.g. through sodas and fruit juices, the liver will have to struggle even more to handle the onslaught. Eventually, the poor organ won’t be able to keep up metabolizing and will eventually convert much of the fructose to fat. This also can induce a condition known as insulin resistance, which is well known as a causal factor of type 2 diabetes.
A growing number of physicians and medical authorities now agree that high sugar consumption is harmful in a number of ways. For instance, “metabolic syndrome,” which includes significant risk factors for heart disease and diabetes, is dramatically on the rise. The Centers for Disease Control and Prevention (CDC) estimates that currently 75 million Americans suffer from metabolic syndrome.
Insulin resistance and metabolic syndrome in connection with high fructose intake have been studied in clinical laboratories for some time. When test animals are given lots of sugar, their livers eventually turn “fatty.” As one scientist involved in such studies put it: “If you want to cause insulin resistance in laboratory rats, feeding them diets that are mostly fructose is an easy way to do it.”
Chronically elevated insulin often leads to unhealthy increases in cholesterol as well. Higher triglyceride levels can lower HDL (“good”) cholesterol, further worsening insulin resistance and also the risk of heart disease.
Taubes waits almost until the end of his article to make his own, perhaps most devastating argument against sugar. “What are the chances,” he asks, “that sugar is actually worse than Lustig says it is?”
One of the diseases that routinely coincide with obesity, diabetes and metabolic syndrome is – cancer. The World Health Organization (WHO) through its International Agency for Research on Cancer concluded after a large population study in 2004 that there are clearly identifiable connections between these various diseases. “You are more likely to get cancer if you are obese or diabetic than if you’re not, and you are more likely to get cancer if you have metabolic syndrome than if you don’t.”
Does this mean that a large percentage of cancers may be caused by our dietary and lifestyle choices? The World Cancer Research Fund and the American Institute for Cancer Research seem to back up such thinking. But how so?
Taubes cites clinical research that has connected insulin resistance to the growth of tumors. “Some cancers develop mutations that serve the purpose of increasing the influence of insulin on the cell; others take advantage of the elevated insulin levels that are common to metabolic syndrome, obesity and type 2 diabetes. Some do both.” Researchers believe that many precancerous cells would not mutate into malignant ones “if they weren’t being driven by insulin to take up more and more blood sugar and metabolize it.”
In other words, while we still may not know enough about the dietary causes of cancers, there are strong indications that insulin resistance caused by high sugar intake plays a role in the formation of at least some types of cancer – and that should be enough to set off the alarm bells.
Taubes himself is reluctant to do just that, and so the article ends not with a call to arms but rather with a shrug. “Officially,” he writes, “I’m not supposed to worry because the evidence isn’t conclusive, but I do.” – Me too…
To read the article, “Is Sugar Toxic?” by Gary Taubes, go to www.nytimes.com
Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com
For the longest time, Amy’s mother didn’t think there was anything wrong with her daughter needing to go to the bathroom every time right after meals. Her youngest had trouble with a “nervous stomach,” as she called it, for as long as she could remember. Eventually, though, she became concerned with her child’s weight. At the age of 11, Amy was five feet tall but weighed less than 60 pounds.
“All the popular kids in her class are super thin,” she told me when we first met for a consultation at my practice. “It’s the look they see and adore on TV and the Internet.”
Dieting for looks is not unusual among young girls. The message that “you can’t be too thin” is conveyed to all of us by the media. But because children are far more impressionable than adults, they tend to take these beliefs much more to heart and act accordingly. Peer pressure, the desire to live up to certain fashion standards as well as body changes during the early stages of puberty are all well-known factors that can contribute to the development of eating disorders at a young age.
Of course, weight-consciousness does not automatically result in eating disorders. The issue of dieting during childhood has only come to the forefront with the ever-growing childhood obesity epidemic. Still, clinical studies have found that children who diet for weight loss are much more likely to develop dysfunctional eating habits later in life.
What are eating disorders?
Eating disorders are foremost psychological disturbances. People who suffer from eating disorders have a dysfunctional relationship to food. Fear of becoming overweight – and therefore unattractive – is only one of many possible causes, although a common one. This state of mind is clinically called “anorexia nervosa” (AN), which is derived from the Greek words an, meaning “without,” and orexis, meaning appetite. Taken literally, however, the term is somewhat misleading. Anorexics don’t starve themselves because of lack of appetite. Rather, they are afraid of what eating even small amounts of food can do to their body image. Especially girls and young women who work (or aspire to work) as photo models in the fashion industry or have athletic ambitions are at risk of developing anorexia.
Another frequently occurring form of eating disorder is called “bulimia nervosa” (BN), which can include regular bouts of overeating or binge eating followed by self-induced vomiting or use of laxative to prevent weight gain. Like anorexics, bulimics are deeply concerned about their body image, but because their eating patterns are inconsistent, they resort to extreme measures to undo the perceived damage.
On the other end of the spectrum, there is a behavior called “binge eating disorder” (BED), which results in compulsive overeating without subsequent countermeasures to avoid weight gain. Those suffering from BED are likely to face weight problems eventually.
All eating disorders carry great health risks, especially when they start early in life. Potentially serious harm is not only caused to the physical- but also the mental health and well-being of those who engage in this kind of dysfunctional behavior.
How does one recognize and treat eating disorders?
Regrettably, eating disorders among children are not yet sufficiently understood both by science and the public. Parents are often not equipped to deal appropriately with the phenomenon. Sometimes, it can be hard to even recognize the symptoms of unhealthy behavior when kids go through different phases of growing up.
But if there are any indications that something is amiss, parents should look for a number of potential warning signs, such as rapid changes in eating patterns, self-imposed dieting, skipping meals or refusing to eat in the presence of other family members. Parents who find their kids taking diet pills or laxatives on their own and without supervision should definitely be alarmed. Other possible indicators are changes in physical appearance, like swelling of the cheeks or jaw or stained teeth and bad breath from self-induced vomiting.
When parents become aware of this kind of behavior, they must take action at once and get professional help for their kids if necessary. Effective treatment of eating disorders may require consultations with several health care specialists besides your family doctor, possibly a pediatrician, psychiatrist and nutrition therapist.
Parents may have to participate in the therapeutic process as well. Eating disorders do normally not develop in a vacuum. Older siblings, friends, classmates, even the parents themselves can contribute to a child’s disturbed relationship to food.
There are a number of proactive measures concerned parents can take. For starters, it is important to maintain a healthy “food culture” at home. Children should learn from early on to appreciate the value of good nutrition. Food-oriented family activities, like grocery shopping and farmers market visits, growing a vegetable garden or preparing meals together can help promote healthy eating habits. Food should never be used as means of reward or punishment.
It is up to the adults to be good role models. That includes open discussions about issues of physical beauty and self-esteem. If parents deal with negative body images themselves and convey these by, let’s say, obsessive dieting or fitness training, they are likely to pass their sentiments on to their kids as well. As it is often the case, leading by good example may be the best approach to get everybody back on track.
If you enjoyed this article, you may also be interested in reading “Exercise at a Young Age Has Many Benefits Besides Physical Fitness” and “Helping Your Child With Weight Problems.”
Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com
People who are prone to overeating may not be able to control themselves, not because they lack sufficient willpower, but because they are addicted to food, not unlike addicts who depend on alcohol or drugs. A study conducted at Yale University and recently published in the Archives of General Psychiatry concludes that “people who report symptoms of addictive-like eating behavior appear to show the same pattern of brain activity as we would see in other addictions.”
This study, which was headed by Ashley N. Gerhardt, a doctoral student in clinical psychology, is the first to investigate eating disorders by comparing eating habits to specific brain activities. Based on their findings, Gerhardt and her research team argue that addiction is at least in part responsible for the widespread development of obesity in this country and around the world.
Altogether 39 women in their early to mid twenties were involved in the study. Their body shapes ranged from slim to obese. All participants were asked to complete an initial questionnaire to evaluate their eating behaviors. Less than half scored high in terms of food addiction. Then a MRI test was applied to measure certain neurological responses that took place when the women were given, let’s say, a tasty chocolate milk shake. Not surprisingly, the MRI data showed significant changes in brain activity for almost all participants. The results were more or less the same when only a photographic image of a milkshake was shown. What was not known until now, however, was that those who identified themselves in the questionnaire as highly addicted to food also showed the highest levels of activity in the parts of the brain that are responsible for control of behavior – or lack thereof. In fact, the pattern turned out to be strikingly similar to that of alcohol- or drug addicts.
The researchers have been careful not to suggest that there are direct connections between food addiction and obesity. In fact, the study emphasizes that no specific links were found between food addiction and body mass index (BMI) because some women who were not overweight still displayed addictive behavior toward food.
What is food addiction?
It is a simple fact that, in some ways, we are all addicted to food. Eating is essential to our survival. Our bodies are in a constant stage of starvation alert. That’s part of our nature and for good reasons. In the days of our hunting and gathering forbearers, food was often hard to come by. Life was a constant struggle against famine. For most of our existence as humans, we had to anticipate shortages and do everything possible to prevent them from happening.
This is also the experience of addicts. People who are dependent on alcohol, nicotine or drugs are typically obsessed with securing their supplies. The thought of running out of resources can be quite anxiety-producing. More to the point, it is the fear of being unable to cope with stress, boredom, loneliness and other forms of suffering without the relief and comfort these substances can provide. It is not any different with food addiction.
There are other similarities between food- and drug addiction as well. Research has shown that both sugar and fat – two of the most common contributors to weight gain – can have an “opiating” effect on the body. Clinical lab tests with rats have suggested that sugary, fatty and highly caloric foods can affect the brain in much the same ways as cocaine and heroine does. Rats that were given excessive amounts of sweets and junk food eventually developed compulsive eating habits that resembled the symptoms of drug addiction. Even when electric shocks were applied to drive them away from their food supply, they continued eating despite of the pain that was inflicted on them. In studies on rats addicted to cocaine, the animals also ignored punishment in order to keep using.
Is there effective treatment for food addiction?
If food addiction turns out to be a disorder on par with alcohol- and drug abuse, it will have a number of significant implications for the ways we have traditionally been treating eating disorders. A number of experts have long advocated that the obesity epidemic should be confronted like other addiction problems. This means that dieting and surgery alone won’t be as effective as we have believed in the past. If food addiction is based on both physiological and psychological components, they must all be addressed together.
The most important question, of course, is why people develop addictive behaviors in connection with food in the first place. People who struggle with addictions know that their actions will eventually do them great harm, but they still continue, unable to stop the self-destructive cycle.
A comprehensive treatment plan for food addicts would have to follow similar procedures as other addiction recovery programs, such as creating awareness and acceptance of the addiction as a serious problem, identifying the trigger sources for addictive behavior, ongoing professional counseling and guidance toward behavior modification, establishing and maintaining a functioning emergency support system and so forth.
Food addiction is undoubtedly a serious issue and, unfortunately, not yet fully understood by both science and the public. The study at Yale University will hopefully encourage more researchers to pursue the subject further. Patients suffering from eating disorders should also discuss their treatment options with their health care professionals, including therapists specializing in addictive behavior.
If you enjoyed this article, you may also be interested in reading “Intuitive Versus Conscious Eating.”
Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com
It is getting harder to put food on the table, not only for low-income households but for middle-class families as well. Prices have soared lately not just at high-end grocery stores, like Whole Foods or QFC, but also at large chains known for their price competitiveness, like Safeway, Sam’s Club and Costco. And nearly all food products are affected by the dramatic price hikes.
Since the year 2000, the last time we saw relatively low food prices, the cost of wheat has more than tripled. Corn is now twice as expensive. The price of rice has increased by more than double just in the last three years. And for dairy products, meat, poultry and edible oils you have to pay significantly more than only a year ago.
A “perfect storm” scenario
According to the Consumer Price Index (CPI), these trends are expected to continue for the foreseeable future. A number of key factors behind the price increases have been identified. All taken together, they potentially form a “perfect storm” that could seriously impact people’s ability to afford quality food for quite some time.
For example, corn prices have risen due to use for ethanol as an alternative to fossil fuel. Higher revenues from corn have caused farmers to move away from wheat and soybeans, thereby reducing supplies and increasing prices for those crops.
Especially price increases for corn can have a wide ripple effect because corn goes into many processed foods and is also an important component of farm animal feed, which in turn drives up the costs of beef, pork and poultry.
Global stocks of agricultural commodities in general are depleted because of crop failures, droughts and flooding in many parts of the world where major producers are located, most notably in Eastern Europe, Russia, the Ukraine and Australia.
Higher demands for better quality foods in China and India with their mega-sized populations are putting more pressure on global food markets. The weak dollar enables many more countries around the world to import agricultural goods from the U.S., driving up costs here at home.
Ever-rising energy costs affect all industries and agriculture is no exception. Record crude oil prices force growers to spend more on fertilizers, harvesting and transportation. At the production-, wholesale- and retail levels, expenses for processing, warehousing, packaging and distribution all go up and get passed on to consumers in form of higher prices.
The healthiest foods are the most expensive
Don’t blame your local farmers (especially the small farm operators), since they don’t get rich because of higher food prices at the grocery store. On average, about 20 cents on the dollar for all foods are the farm share. It’s much less for highly processed foods where the end products bear little resemblance to the original commodities. For instance, an 18 oz. box of breakfast cereal contains less than 5 cents worth of corn (most expenditures come from processing, packaging, advertising and distribution). That is why price fluctuations in the commodity markets can be more easily absorbed by manufacturers. By contrast, price increases for less processed items, like milk, eggs, fruits or vegetables, impact consumers much faster. Diminished or failed crops can lead to dramatic price changes over night.
If consumers respond by cutting back on fresh foods, growers can find themselves quickly in a tight spot: They either have to keep selling low (often at significant losses) despite of higher demands or risk sitting on highly perishable goods they can’t get rid of because people can’t afford them. The same is true for grocery stores. Fresh foods have a much shorter shelf life than processed items. Everything that can’t be moved before it’s spoiled must still be paid for – ultimately by consumers in form of markups.
Eating healthy without breaking the bank
Still, that is of little comfort for the rest of us who want to eat healthy – and that means including plenty of fresh produce in our diet – but have to stay within a reasonable budget. Unfortunately, the saying, “you must be wealthy to be healthy,” rings more true than ever. While there is not much we can do as individuals about changing supplies and demands on the global stage, there are a number of smart steps we can take to stretch our dollars and cents a little further. Here are a few ideas you can implement right away:
• Cut back on expenses for fresh foods by taking advantage of sales. Fresh produce is highly perishable. Whenever supermarkets are overstocked on certain items, they must lower their inventory fast by reducing prices. Unfortunately, following sales events can be a bit time consuming, but if you stop by your grocery store two or three times a week, you should be able to benefit from some of the better offers.
• Plan ahead. Try to use your more expensive items in several meals. For example, many vegetables make perfect ingredients for soups, stews, pasta sauces and rice dishes. They also go as accompaniment with any meat-, poultry- and fish dinner. So, before you shop, make a detailed meal plan for the entire week and lay out different combinations that allow you to incorporate your purchases in the most efficient ways.
• Eat out less often. Home cooking is still less expensive than eating out. Restaurants are not immune to rising food prices and they will pass their costs on to you. If restaurant portion sizes are too large for you, take half of your order home and make it another meal the next day.
• Stock up on basics. Buy staple foods, like rice, beans, pasta and other less perishable items. These are also the ones you can get in bulk and for less.
• Grow your own vegetable garden. Many vegetables, fruits and herbs can be grown at home, if you have a yard. To start your own herb garden, you need nothing more than a few pots or crates on your patio or balcony.
• Eat less junk food and snacks. You may think that fast food is cheap. But considering the small nutritional benefits you get, it is really not. Chocolate bars, candy or a bag of popcorn may sound like simple treats, but they cost money too. Even a cup of coffee or caffe latte every morning can cut a hole in your budget, even if you don’t notice it right away. It all adds up. It can be helpful at some point to calculate how much money you actually spend on snack food and other discretionary treats throughout the day. You may be surprised.
• Bring lunch to work. Eating out with colleagues and friends may be fun, but you still can get together in a nearby park and have a picnic of sorts. Making your own lunch at home instead of getting a bite to eat at a restaurant or deli is probably not only healthier, the difference in cost can also be significant.
• Use coupons and membership cards. Many supermarket chains offer discounts through membership- or club cards. Others send you coupons in the mail or make them available on certain sites on the Internet. Choose items with the steepest discounts first. However, don’t buy things you don’t really want or need, only because they are on sale.
• Buy what’s locally grown and in season. The further food products have to be transported, the more expensive they are likely to be. By buying locally grown foods, you not only get fresher groceries, you also support your community’s economy. For this reason (and many others), you should visit farmers markets near you whenever possible.
Higher prices force a lot of people who are on a limited budget to cut back on their food consumption. The temptation is to buy cheaper foods of lower nutritional value. Unfortunately, this is bound to have negative health effects in the long run.
There are no easy answers, however, when it comes to nutrition, quality trumps quantity every time. A smaller wholesome meal will give you more energy and leave you more satisfied than a large portion of empty calories. Think of it as an investment in your good health, which is all the more important when times are tough.
If you enjoyed this article, you may also be interested in reading “In Hard Times, Good Nutrition and Physical Fitness Are Often Among the First Casualties” and “Staying Healthy in Tough Economic Times.”
Since the Food and Drug Administration (F.D.A.) has lowered the minimum weight requirements for gastric Lap-Band surgery, which made many more millions of Americans eligible for the procedure, a whole new industry of weight loss device makers has emerged, trying to cash in on this vastly expanding market (no pun intended).
Until now, people who wanted to have weight loss surgery (and qualified for it) had basically two choices: Gastric bypass, by which the size of the stomach is surgically reduced and parts of the small intestine are bypassed, or gastric banding, which applies an inflatable ring around the stomach to restrict food intake. Both procedures require invasive surgery, which carries a number of risks, including infections from incisions. And there is also the cost factor. Surgery involving general anesthesia is expensive, and insurance companies who cover gastric surgery are extremely interested in lowering these costs.
So, now there is a great rush to find surgery-free alternatives. A number of new techniques have already been developed and are being tested. For example, there is the so-called “sleeve gastrectomy” (still requiring invasive surgery), which narrows the stomach by stapling and permanently reducing it in size. Different variations of sleeve gastrectomy are still being tried out, such as gastric imbrication or plication, which does not cut off any parts of the stomach but simply folds it, like pleating.
The hope is that surgery can eventually become altogether obsolete in the fight against obesity. And there are already many innovative minds hard at work to achieve this. One company tried to develop a procedure that uses a stomach-stapler that can be inserted through the mouth, making incisions unnecessary. Another came up with a pill to be taken before each meal, which then swells up in the stomach and fills it to the point where there is less room left for actual food. There is also a “pacemaker” that sends jolts of electricity to the stomach wall with the intended effect of triggering fullness signals. Artificial stomach and intestine linings could some day prevent food absorption (it’s being worked on).
The idea of inserting devices in the stomach to reduce volume is not all that new. Balloons that can be swallowed and then inflated in the stomach have been around for a while. But they seem to lose their effectiveness over time and don’t always function as intended. The manufacturers of gastric banding are also trying to refine their line of products. One device that is currently being tested would allow “banding” from within the stomach, making it possible to insert the device through the mouth without the need for surgery.
Perhaps, one should marvel at the innovative ingenuity that goes into all of this, but I cannot help but feeling uncomfortable over the thought that all this effort seems to be necessary, simply to keep people from overeating and becoming obese. Cutting stomach sizes in half, inflating balloons and other items to take away room for food, tricking organs into false signals, and so forth. What has ever happened to self-restraint? Can we no longer count on a minimum of willpower to stop stuffing ourselves when we are clearly eating more than our bodies can handle?
All these clever devices will not change a dysfunctional relationship to food. These are band aids, not solutions. Having a plastic band around the stomach does nothing for the improvement of someone’s eating habits. It’s like mopping up the floor without turning off the faucet when your house is getting flooded. We would be better off by going to the roots of our flawed lifestyle choices instead of only treating the symptoms.
But, of course, the odds are that this will not happen any time soon. Weight loss technology is already big business and carries the promise of a financial blockbuster. Also, health insurance companies are much more inclined to pay for clearly defined procedures, such as surgery, rather than for open-ended, hard to measure approaches, like supervised dieting, exercise and counseling.
So, most likely we will be seeing more technology and less appeal to positive lifestyle changes in the fight against obesity, which is a shame.
Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, available in bookstores, at http://timigustafson.com and at Amazon.com. You can also follow Timi on Twitter at http://twitter.com/TimiGustafsonRD
Women who can’t lose weight quickly enough can add yet another tool to the ever-growing arsenal of fad diets. Here’s one that uses a pregnancy hormone, called “hCG,” which is administered through injections with the help of a syringe.
HCG, which is derived from the urine of pregnant women, tricks the body into a hormonal state that simulates actual pregnancy. The purpose of this is to increase fat burn, as it occurs naturally during pregnancy when the expecting mother passes calories on to the fetus.
The concept is by no means new. As far back as in the 1950s, a doctor in Rome, Italy, reported to have treated more than 500 patients with the hCG hormone. Others followed suit. A major study, which was conducted in 1995 by a Dutch team of researchers and published in The British Journal of Clinical Pharmacology, was inconclusive. So far, there is still no definite consensus among the experts over the effectiveness of hCG as a weight loss drug.
What is commonly acknowledged, however, is that the hormonal manipulation by itself does not cause weight loss. In fact, the daily injections only work in combination with a near-starvation 500 calorie a day diet. The truly amazing part of the diet is not the actual weight loss but that the women who undergo the regimen typically don’t feel anywhere near as hungry or tired as they should.
And there seem to be even more advantages. Being able to reduce one’s calorie intake to such low levels does not only result in fast weight loss but also helps to eliminate old and often persistent fat stores, like around the belly, hips and thighs – something a lot of women find very desirable.
The Food and Drug Administration (F.D.A.) has recently issued warnings about using hCG for the purpose of weight loss, especially the varieties sold on the Internet from obscure sources. But the injectable form that can only be obtained by prescription for infertility treatment is F.D.A. approved and this loophole is obviously being widely exploited.
The treatment is not cheap. According to The New York Times (3/8/2011), doctors charge well over $1000 for an initial set up of an hCG program, which includes a physical exam, injection training and a month’s supply of hormones and syringes.
The potential health risks are not all clear at this point. Some experts have raised concerns over cardiovascular health effects. The nutritional impact of a 500 calorie diet is obviously worrisome as well. This diet basically takes its cues from anorexia.
Especially in times of intentional weight loss due to dieting, it is absolutely critical that the body receives enough essential nutrients to make up for the loss of food intake. With a diet that provides only a third to a quarter of a normal daily calorie supply, healthy eating habits can be hard to maintain.
I strongly agree with critics like Brittany Glassett, RD, who wrote in her article “The HCG Diet, Worst I’ve Ever Seen”:
“This is a semi-starvation diet and doesn’t provide adequate calories to support normal brain functions or muscle stores of glucose. Such calorie restrictions can trigger the body to significantly slow the metabolism in an effort to conserve calories to survive. The body will very quickly begin breaking down muscle as a source of energy. Semi-starvation also affects hormones and electrolytes in the body, […] which can have serious side effects, including heart arrhythmias and sudden death.”
It is obvious that people, especially women, will continue to look for quick weight loss solutions. Many traditional approaches to dieting seem no longer to work, at least not fast enough. The rapidly increasing demand for weight loss surgery speaks for itself. Still, I cannot think of a situation where manipulating hormones for the single purpose of speedy weight reduction would be justified. Those who seek hormonal treatments need to be aware that they are running the risk of interfering with multiple important body functions. As long as there are more traditional options to induce weight loss, they should be given preference.
You’ve probably heard this story before: A business man vacations on the tropical island of _______ (fill in the destination of your dreams). After enjoying the amenities of the luxurious resort he stays at for a few days, he ventures off to explore other parts of the island. There he comes across a small fishing village that looks most idyllic but is very poor. He encounters one of the locals, a young man reclining comfortably in his hammock with seemingly nothing to do. They strike up a conversation and eventually the business man asks: “Why don’t you get a job or start a business of your own? You could make so much money in a place like this. You’re practically sitting on a goldmine and you’re doing nothing about it.” The young man replies: “What would you do in my position?” “I would make a ton of money from all the tourists that are coming here. I would work my butt off to make it a success.” “And then, what would you do after that?” the young man prods. “Well, I would retire and move to an island like this one and enjoy myself for the rest of my life.” “There you go,” says the young man, “I’m just a bit ahead of you.”
The morale of this little anecdote is obvious: We all wonder from time to time what would make us really happy? As reported in the New York Times (3/6/2011), a Gallup poll was conducted for over three years to determine what it takes in America to be truly happy. A thousand randomly selected participants were asked every day about their sense of satisfaction, their physical health, their stress levels and other factors that contributed to their overall sense to wellness. The researchers then developed what they called a “Well-being Index,” which is basically a composite of elements they deemed relevant for what should count as general happiness.
As it turns out – if you believe in the accuracy of the survey – men are on average happier than women, older people happier than younger ones, Hispanics happier than Caucasians. The overall happiest people were Hispanic women between the age of 18 to 29 who were in stable domestic partnerships. The least happy folks were Hispanic females between 45 and 64 who were separated or divorced.
The survey also looked at geographic differences. To no one’s surprise, Hawaii took the cake – hands down. If you are lucky enough to live in a warm climate all year around and are surrounded by stunning scenic beauty, you have a real chance to feel good about your life. I’m sure that most of us could have guessed that without a scientific survey.
The importance of scenery becomes even more compelling when you look at the runner-ups: Wyoming, North Dakota, Alaska, Colorado. The northern parts of the country seem to have something to offer that the South clearly lacks.
What I like about the survey is that it includes a vast diversity of criteria. Physical health, job satisfaction and financial well-being are obvious issues, but no less important are emotional health and being part of a safe and supportive community. Access to health care also ranks high. That is why Vermont received good grades for health-conscious lifestyle. States with the most pressing fiscal problems also seem to have the most worried population – another no-brainer.
The levels of happiness and education seem to go hand in hand as well. Folks who are better educated may not only find it easier to gain or maintain employment and financial security, they also tend to be more creative and skillful in applying their talents and interests.
I have always been a great believer in the importance of happiness for good health. Perhaps, “happiness” is not the right word because it gets easily confused with emotional exuberance. “Contentment” may be a better choice. Being content is not so much a momentary emotion than a consistent state of mind. We may feel happy because of an upcoming event, like getting married or going on a dream vacation. We may call ourselves happy based on certain possessions, like a house or a new car. Contentment, on the other hand, does not depend on any particularities. It is part of our entire being, almost regardless of the circumstances we find ourselves in at any given time.
When clients seek my counsel to improve their health and well-being, they usually have one or two issues they want to address, such as losing weight or getting their high blood pressure under control. When I ask them about their lives beyond their eating habits or their exercise regimen, they react surprised. What does their social life or their professional situation have to do with their physical demise? Why would I want to know whether they feel sufficiently emotionally or intellectually stimulated?
Eventually, however, they recognize that there are many factors to be considered for the healing process to take place. Yes, there is a hierarchy of needs, which must be addressed in due order. But there are important needs to be fulfilled in every part of life and they don’t exist independently and in isolation from one other. People don’t only fall sick from exposure to bacteria and viruses or detrimental lifestyle choices, but also from stress, loneliness, boredom, anxiety and loss. When the mind suffers, the body responds and visa versa.
Unfortunately, we cannot all move to Hawaii or any other exotic islands and live there happily ever after. And, of course, that is not really the point. What matters is that we strive for balance as best we can and nurture every aspect of our lives with equal care. Think of a mobile by Alexander Calder: Everything flows beautifully when all elements balance each other. That’s basically all there is to it.
The facts are clear and simple. According to a study recently published in “Health Beat,” the newsletter of the Harvard Medical School (3/1/2011), five lifestyle habits are considered responsible for heart disease and many other widespread illnesses that plague us today. They are smoking, lack of sufficient physical activity, weight problems, poor eating habits and excessive alcohol consumption.
Alone or together, the study says, these lifestyle choices set the stage for artery-damaging atherosclerosis. They also adversely affect blood pressure, cholesterol- and blood sugar levels. Known long-term results are heart attack, stroke and artery disease. Beyond the cardiovascular system, lifestyle-related damages are caused to the kidneys, bone structure and other organs, including the brain
The survey concludes that turning most or all of these habits around can decrease the likelihood of suffering a heart attack – which is the number one cause of death in the United States – by up to 83%.
As a strategy for health-promoting lifestyle changes, the researchers recommend to quit smoking, exercise regularly, maintain a healthy weight range, eat a highly nutritious diet and reduce alcohol consumption to moderate levels.
None of this can be considered “news,” of course. If you ever had any interest in adopting a healthier lifestyle, you already know that you shouldn’t smoke, drink too much, eat junk food and sit on your butt all day. So why keep talking about the same old stuff over and over again?
The answer is that we seem to keep fighting a losing battle, despite of the fact that we have all the information needed to dig ourselves out of our public health crisis. Obesity rates are still growing unabatedly. Two thirds of all Americans are overweight. Catastrophic weight problems affect one third of today’s children. How can this be when we know exactly what it would take to change all that?
I watch with great interest the popular TV show, “The Biggest Loser,” on NBC. Although, I don’t like the idea of turning people’s health problems into a spectacle, I can see some value in witnessing the enormous struggle that comes with obesity on many levels. Listening to the highly personal stories of the candidates, how they kept getting heavier and heavier despite of their best efforts to regain some measure of control over their lives, is heartbreaking. But what I keep hearing from all participants of the show is this: “I did not know how to stop gaining weight because I did not have the knowledge or the tools to make the necessary changes.” So much for people knowing best what’s good for them.
It is unrealistic to expect consumers to make better choices by themselves without providing them with the necessary information they must have to know the difference. For example, when New York City required fast food outlets and coffee shops to post calorie counts of their products, critics of the measure were quick to spread the message that it would have no significant impact on the behavior of customers. But, as it turns out, it did make a difference – not right away, but over time. Researchers found that average purchases at fast food places showed a 6 percent reduction in calories, almost 15 calories per item, within a year after the requirements were enacted. At coffee shops, like Starbucks, calorie cut-backs were as high as 26 percent. These numbers may not be all that dramatic, but they show that giving fact-based information to consumers does matter. Or, as one of the participants in “The Biggest Loser” show said: “I changed my life by making decisions based on knowledge.”
Unfortunately, this is not the way it works in the real world. As consumers, we are not informed but rather seduced into making choices that are not really our own. Advertising is not about education but selling, we all know that. It is hard to almost impossible to escape the constant manipulation and take more control over even the smallest decisions we make every day. As one of my clients who used her three-weeks vacation to lose weight at an exotic spa resort said to me: “When I go home, I will be back in an environment where healthy lifestyle habits are neither plausible nor possible.” A sad but by no means unique scenario.
As a health counselor, I naturally believe in the power of positive lifestyle changes. But I’m also keenly aware of the very real limitations that are imposed on us by life’s circumstances. We can’t hope to live on an isolated island forever, whether it is a TV set or a luxurious health spa. All we can do is navigate our way around the very real obstacles life keeps throwing at us and take on our challenges one by one. There are no easy ways or shortcuts.
In the end, we may have to be content with a few small achievements at a time and keep trying for more, hoping it will eventually add up to something bigger. In the meantime, even the tiniest victories deserve to be treasured.
I was full of sympathy and quite touched when I heard one of the candidates of “The Biggest Loser” say: “What is life-changing? It is not some special event but a thousand little things in life that we all take for granted until we no longer have them.” And then he drove off in his convertible sports car, the one he couldn’t fit in for many years. He looked really, really happy.
If you enjoyed this article, you may also be interested in reading “The New Government Guidelines for Healthy Nutrition” and “Upbringing, Education and Health.”
The Consumer Price Index (CPI) for all foods is projected to increase this year by 2 to 3 percent. If that doesn’t sound particularly alarming to you, consider this: While the average costs for processed foods continue to remain relatively stable, fresh food items, like meat, dairy products, eggs, vegetables and fruits are all much more expensive now than they were a year ago.
Beef prices increased over 6 percent last year. Pork is up by 11 percent. The costs for dairy products are almost 4 percent higher. Milk is over 5 percent more expensive. Prices for cheese are up by over 4 percent on average. Eggs cost over six percent more. Butter prices are nearly 22 percent above last year’s. Potatoes cost 7.4 percent more. And prices for fresh fruits increased by almost 4 percent on average.
These are just a few examples and the statistics vary considerably between government- and media reports trying to keep up with highly fluctuant markets. But the trend is clear: Food prices are steadily increasing and there are no signs for this to change in the foreseeable future. The Bureau for Labor Statistics has calculated that costs for food will continue to rise faster than overall inflation.
The reasons for this price spike are multiple. For example, more farmland is being used to grow crops for biofuels, like ethanol, which is made from corn. Over six percent of the world’s grain supply is now being diverted to fuel production and the numbers will only go up as the price of oil continues to climb.
Another factor is the greater demand for food worldwide. As the world population grows and developing nations become increasingly wealthier, there is globally more demand for quality food. Especially meat products are being consumed in much greater quantities than they were ten years ago. To satisfy those emerging markets, more livestock is being raised and additional grain is used for feed.
Commodity speculation, which bets on the direction of prices for rice, corn, soybeans and wheat, also drives prices up and contributes to the global food price inflation. Throw in the fact that important food producers, like Russia and Australia, have recently been impacted by severe droughts and flooding, which destroyed large parts of their crops, and you have a perfect storm.
Food price inflation has not yet reached acute crisis levels in the United States. Other countries around the world are much more threatened than we are at this point. But the growing demand, combined with limited supplies and market speculation will eventually have a significant impact on our shores as well.
These alarming developments cannot be easily reversed. Unlike the housing market, the accelerating food prices are not a bubble waiting to burst. According to the United Nations Food and Agriculture Organization, the costs for world food supplies have reached this year the highest level since records were taken in 1990 and there are no indications that this trend will change any time soon.
Consumers trying to make ends meet, of course, don’t have any means to respond. While it is possible to postpone or forgo expenditures for luxury items or cut back on gasoline costs by driving less, it is much harder to stretch one’s food budget. Yes, there are ways to save money for groceries, but buying food items of lesser quality has direct negative consequences for people’s nutritional health.
At a time when so many families struggle to keep their heads above water, it is especially worrisome to think that healthy nutrition is becoming less and less affordable. Our best efforts to turn our national health crisis due to obesity and malnutrition around will fail if fresh and wholesome foods become luxury goods that are out of reach for an ever-growing part of the population. In fact, a serious food crisis would quickly accelerate our existing public health crisis as well. Both concerns are closely connected and need to be addressed as one.
On an individual level, we all must re-learn to treat food as the precious commodity that it is. Many of us are willing to spend more of their income on gas for their cars than on good nutrition for their bodies. Buying and eating healthy food is an investment in our health and well-being that can save and protect us from diseases and provide us with energy and strength. Therefore, the quality of our food should have the highest priority among all other purchases.
Buying your fresh food supplies at a farmers’ market near you is a first step in the right direction. There you can get the best quality for your money, reduce transportation costs and you support the local economy as well.
I have written about the importance of public policy changes many times in the past and those who read my blog know where I stand on these issues. I am a strong advocate for tax incentives and government subsidies for organic and sustainable farming, especially for small family-owned farms that serve their local communities. I also like to see many more fresh food outlets in the so-called “food deserts,” that persist in our inner cities and low-income neighborhoods, so people don’t have to travel for miles to find a decent supermarket or have to make do with junk food from convenient stores and fast food joints. As I said, this is a fast developing crisis, and it is not only about money but also about our ability to maintain our health and well-being.
If you enjoyed this article, you may also be interested in reading “In Hard Times, Good Nutrition and Physical Fitness Are Often Among the First Casualties.”
The Dietary Guidelines of the U.S. government list sugar and artificial sweeteners among foods and food components we are urged to reduce in our diets. While natural sugar sources, like fruits (fructose) and milk (lactose), are recommended for their nutritional benefits, the so-called “added sugars” are not.
Sugars are added during processing to foods and beverages to sweeten flavors and add texture, body and browning capacity. Sugars are also used for preservation purposes.
Adding sugar to processed foods increases their calorie content without providing any significant nutrients, which is the reason why they’re called “empty calories.” In fact, added sugars contribute an average of 16 percent of total calories to the typical American diet.
Added sugars include high fructose corn syrup (HFCS), white (refined) sugar, brown sugar, corn syrup, pancake syrup, fructose sweeteners, liquid fructose, honey, molasses, anhydrous dextrose and crystal dextrose. (Source: Dietary Guidelines for Americans, 2010)
The most common sources of added sugars are sodas (36%), grain-based desserts (cookies, etc.) (13%), fruit drinks (10%) and dairy-based desserts (ice cream, etc.) (6%), followed by candy (6%).
While the government recommends to limit or reduce the consumption of the most notorious sugar sources, it gives only vague advice on how to actually accomplish this, like replacing sweetened foods and beverages with non-sweetened ones and the likes. The American Heart Association is a bit more specific with its recommendation that women should limit their daily intake of sugar to 100 calories, or approximately six teaspoons, while men should stay under 150 calories, or nine teaspoons per day.
As with other commonly used nutrients in processed foods, like sodium or fat, it is hard for consumers to cut back on sugar intake because they simply don’t know which foods contain higher or lower amounts of sugar. For instance, certain breads can have as much sugar as some sweet-tasting cookies. Frozen dinners and pizzas that don’t taste sweet at all can in fact be filled with sugar. The same goes for many condiments, soups and sauces. Sodas and candy may be well-known culprits, but cereals, energy bars and flavored yogurts are all considered as healthy by most people. While they do have some nutritional value, their high sugar content may offset the benefits.
Eating foods with high amounts of sugar can contribute to weight problems, high blood pressure, heart disease, high triglycerides and inflammation. The best defense against excessive sugar consumption is a diet dominated by fresh, unprocessed foods, like fruits and vegetables. Soups made from scratch with fresh ingredients are also recommended. Whole-grain breads are preferable to refined grain products for several reasons, including reduced sugar content.
It is also helpful to use condiments like ketchup, barbecue sauces, salad dressings and other flavor-enhancers as sparingly as possible.
Some artificial sweeteners have been suspected of containing carcinogenic agents, meaning that consuming them in large amounts could increase the risk of cancer. Most experts agree that more studies are needed to establish a direct link. The National Cancer Institute affirms that no clear evidence of a correlation between artificial sweeteners and cancer in humans has been found. Yet, some manufacturers of sweeteners containing saccharin have issued warnings about possible carcinogens in their products in the past. (These warnings were repealed in the year 2000.)
One particular sweetener has recently come under attack again, though. High fructose corn syrup (HFCS) has had a bad rap for some time, but now it is being singled out by some as a significant factor in the growing obesity epidemic. The finger-pointing has motivated the Corn Refiners Association trade group to seek the Food and Drug Administration’s permission to rename HFCS as “corn sugar,” in order to “remove the stigma from the product.”
If you enjoyed this article, you may also be interested in reading ”Cutting Back on Sodium -Easier Said Than Done.”