We all know our country is in for a gross trip over the next four years, but this new CNN study about the presidents diet just makes us a little more alarmed about the future American people. Americans are already obese and unhealthy, and professionals are worried Trumps eating habits will make the situation even worse. I mean, no one expected Trump to be convincing kids to snack on baby carrots, but apparently the presidents gross eating habits actually have a huge effect on the country.
In a recent article, Suzy Evans, a historian and literary agent, spoke to CNN about how the eating habits of American presidents have historically mirrored the diets of Americans. “,” Evans said. “.”
So lets talk about what were in for, considering president-elect Donald Trump eats a diet consisting of Kentucky Fried Chicken, McDonalds, and tacos. Were not saying those dont sound like good choices at 3am on a Saturday night when youre too blacked out to make a conscious decision, but um, maybe not the most responsible choice when youre sitting down for lunch in the oval office. Lets just hope kids remember Michelle Obamas campaigns to like, eat vegetables and jump rope.
Now, it seems that a fast food connoisseur will enter the White House.
“The Obamas are very calorie-conscious and health-conscious, which is a reflection of the first lady. Her vegetable garden is a serious thing, something permanent for White House residents to come,” Seale said, “In Mrs. Obama’s parting, her garden has been endowed handsomely by the Burpee seed company.”
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Now, with the Trump administration, Bentley said, we might see a different model of eating that might be something of a “throwback to the post-World War II era of being enamored with the qualities of fast food.”
“You could argue that Trump’s food aesthetic is similar to this earlier post-World War II era, where the dominant values for food were sameness, predictability and quantity over quality,” she said.
If you’re struggling to lose a serious amount of weight, imagine you had a weight loss option that helped more than diet and exercise, but wasn’t as invasive as gastric surgery. Enter the Obalon balloon system, a new treatment that involves swallowing balloon-filled capsules to curb overeating. According to new research, it helped obese people shed almost double the weight compared to people who made diet and lifestyle changes alone.
The FDA-approved system (slated to hit the market in January) consists of three tiny capsules, each containing an inflatable balloon attached to a catheter. People swallow each of the capsules, three weeks apart, and X-rays are taken to ensure they are in the right spot.
Gas is then pumped through the catheter, filling the balloon up. The catheter is removed, and the patient goes home with a small balloon (or balloons) in his or her stomach. The balloons stay there for six monthsfilling up the stomach, so people feel full and dont eat as much. After that, they are removed via minimally-invasive endoscopic surgery.
In the most recent study, presented last week at an annual conference of obesity experts, researchers gave 387 obese volunteers the balloon treatment or sugar-filled capsules, which were complete with catheters and designed to look like the real thing. A registered dietitian met with volunteers every three weeks, helping them to make healthy lifestyle changes.
After six months, those who got the real Obalon treatment had lost 6.81 percent of their total body weight (about 25 percent of their excess body weight, or the amount theyd have to lose to have a BMI in the normal range), while those in the placebo group had lost only 3.59 percent. So, for example, for people who weighed 200 pounds and needed to lose 50, those in the Obalon treatment group would have lost 13.6 pounds compared with 7.2 pounds in the control group.
At this point, the placebo group was dismissed from the study and the Obalon group had their balloons removed. They continued to keep the weight off, though: Six months later, 89.5 percent of the average total weight lost during the treatment period was maintained.
The balloon treatment helped them eat less, but they were also learning to make healthier choices through the support provided with the program, says study author Aurora Pryor, MD, director of the Bariatric and Metabolic Weight Loss Center at Stony Brook University in New York. And they were able to maintain those healthier choices even after the balloons were removed.
Real-world Obalon patients (as opposed to those in the study) will also be expected to meet with a dietitian regularly as part of the program, Dr. Pryor told Health. She stresses that the balloons are meant to work in conjunction with healthy eating and regular exercise, not as an alternative.
Thats part of why the study was so successful, she says. I think having the balloons added in a staged fashion helped the patients get more used to a diet and exercise program over the course of a few months.
The combination of lifestyle modification and balloon therapy does provide a new and low-risk option for patients struggling with obesity, says Dr. Pryor.
Specifically, she says, people who choose not to have weight-loss surgery (such as a gastric bypass)or who dont weigh quite enough to be a candidatemay opt for this less invasive option. Obalon is approved for people with a BMI of 30 to 40, while weight-loss surgery is usually recommended for people with a BMIs of 40 and up, or 35 and up with weight-related health problems. A person who was 5′ 6″ would need to weigh 186 to 248 pounds to have a BMI of 30 to 40.
In the study, 90.8 percent of patients experienced abdominal cramping and nausea, but almost all of them rated the side effects as mild to moderate. A few patients said that after the third balloon was inserted that they could feel it; that it made them feel pregnant, says Dr. Pryor. But most of them couldnt tell they were there, and they actually wanted to keep them in longer than six months.
One serious eventa bleeding gastric ulcerdid occur in one patient taking high-dose NSAID medication after knee surgery. NSAIDs are a known cause of gastric bleeding.
Raul J. Rosenthal, MD, president and chairman of the American Society for Metabolic and Bariatric Surgery, said that this type of balloon treatment may help fill the large gap between lifestyle strategies and medical therapies like invasive surgery.
There is no magic pill for obesity, but this swallowable balloon and other intragastric balloons may offer new hope to people who otherwise would not seek treatment or not have as good a result with diet and exercise alone, said Dr. Rosenthal in a press release.
Another swallowable balloon, called Elipse, is also in clinical trials for weight loss, but has not yet been approved by the FDA. There are two balloon devices currently on the marketReShape and Orberabut both require an endoscopy for insertion as well as removal.
You can easily have a balloon put in and go to work the same day with Obalon, which you wouldnt be able to do with the other two, says Dr. Pryor.
The study was funded by Obalons parent company, Obalon Therapeutics, Inc. Dr. Pryor says the device will not likely be covered by insurance at first, and figures were not available for estimated cost to patients.
Studies show that people with BMIs higher than 30 have a 50 to 100 percent greater risk of premature death compared to their healthy-weight peers. And losing just 5 to 10 percent of total body weightthrough diet, exericse, or medical procedureshas been found to significantly improve health.
(CNN)Women older than 50 who eat high-protein diets could have a greater risk of heart failure, especially if a lot of their protein comes from meat, according to a new study presented at the annual scientific conference of the American Heart Association.
Researchers found that postmenopausal women who follow a high-protein diet had a significantly higher rate of heart failure than those who ate less protein daily or ate more vegetable protein.
This could be attributed to the molecular mechanisms of animal protein, Barbour said, explaining that animal proteins can turn to toxic molecules, which can in turn affect the function of the heart’s left ventricle and lead to heart failure. They can also increase the body mass index, a known risk factor for heart failure.
“Our study should be interpreted with caution,” warned Barbour. “It appears that a high-protein diet may increase the risk of heart failure among postmenopausal women; however, more research will be needed.”
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Dr. Mingyang Song, a researcher at Massachusetts General Hospital and the Harvard T.H. Chan School of Public Health, described the findings as interesting. Song was the lead author of research published this year that found replacing animal protein with plant protein in a person’s diet was associated with a decreased risk of death. He was not involved in the new research.
“People who eat high vegetable proteins may also have a healthier lifestyle,” Song said. This may imply that other factors are responsible for lowering the risk of heart failure for that group, he added.
“I think it’ll be good to replicate the results in other studies,” he said, suggesting that a more controlled group with a more controlled food intake could be required for that purpose.
1. Protein helps keep your blood sugar stable. When you eat carbohydrate-containing foods, your body breaks them down into simple sugar (glucose) and sends it into your bloodstream. Your pancreas, an organ located behind your stomach, produces the hormone insulin, whose job it is to usher blood sugar into your cells for energy.
Foods that break down quickly into simple sugars cause a rapid rise in your blood sugar, followed by an equally rapid fall. When blood sugar drops, low blood sugar triggers hunger and dampens your energy level and, often, your mood. This series of events can lead to cravings for sugar and carbohydrates, because sugary foods raise your blood sugar more quickly than other foods. You may have experienced this after eating a high-sugar or high-carb breakfast — a donut, pastry, or bagel with orange juice, for example. Your energy peaked initially due to the large rush of sugar you dumped into your system, but then it dropped just as rapidly, leaving you feeling hungry, low, and craving more sweets.
Our goal in all phases of the Doctor On Demand Diet is to keep blood sugar relatively stable, because that helps you control hunger and cravings. One of the best ways to do this is to include protein in your meals and snacks.
2. Protein helps control hunger and cravings. Calorie for calorie, protein is more filling than carbohydrates or fat. Research has shown — and I’ve seen it among my patients as well — that on a higher-protein diet, people eat less and feel fuller than when they eat a high-carb diet. This effect may be especially significant with a higher-protein breakfast.
3. Protein helps you lose the right kind of weight. Your goal is to lose fat rather than lean muscle. Various studies have shown that diets higher in protein can help you maintain muscle mass and lose more fat (especially belly fat). This is good for your metabolism, because muscle burns more calories than fat. Having less belly fat also improves your health because excess bely fat is associated with several chronic diseases.
I don’t advise you to go overboard on protein, or to think that eating protein means helping yourself to large portions of fatty meats, unlimited amounts of nuts, or large portions of full-fat dairy foods. But because protein helps control hunger and keep blood sugar stable throughout the day, it can help you stick to your healthy eating plan and feel good along the way. That’s why I recommend eating some form of protein with every meal and most of your snacks.
Modified excerpt from The Doctor On Demand Diet: Your Prescription For Lasting Weight Loss by Melina Jampolis, MD (Ghost Mountain Books). Ghost Mountain Books, Inc., along with Doctor on Demand, is owned, in part, by Dr. Phillip C. McGraw and Jay McGraw.
Join Doctor On Demand and Dr. Jampolis for a Twitter Q&A Thursday, 11/12, from 11am-noon PST. Submit your questions using #AskDrMelina.
But a recent study from Australia’s Queensland University of Technology revealed a major downside to solo life: People who live alone tend to have worse diets compared to those who share a space.
The research, published in the journal Nutrition Reviews, analyzed 41 previous studies to uncover the link between living alone and food and nutrient intake. Those who live alone are more likely to have a lower diversity of food and nutrients and eat fewer fruits and vegetables, which are packed with vitamins, minerals, fiber and antioxidants that can help protect against certain diseases.
Some of the reasons solo-dwellers were found to be worse off included poor cooking skills, no partner to help with grocery shopping, the high cost of food for one, and a lack of motivation to cook. Solo men were more likely to have an unhealthy diet than women.
“Our results found that people who live alone have a lower diversity of food intake and a lower consumption of some core food groups like fruits and vegetables and fish,” said Katherine Hanna, one of the study’s authors and a lecturer at the university. “The research suggests living alone may represent a barrier to healthy eating that is related to the cultural and social roles of food and cooking.”
Hanna and her colleagues found that people who lived alone not only often lacked the motivation to cook, but they didn’t enjoy eating or cooking alone, and were more likely to prepare simple or ready-made meals lacking important nutrients. At times, it seems, it can be helpful to have a nagging caring partner around.
“The absence of support or encouragement to comply with healthy eating guidelines and difficulty in managing portion control were also factors influencing diet,” Hanna said.
Money also played a role in the diets of single-person households: Healthy foods like fish and fresh fruits and vegetables require more trips to the grocery store and a speedier rate of consumption (if you don’t eat it, it’ll spoil).
Have you ever followed your doctors weight loss nutrition plan to a T, only to stubbornly remain at the exact same weight — or worse, gain weight?
Theres a reason for that, according to an ambitious research project by scientists in Israel. Researchers Eran Elinav and Eran Segal of the Weizmann Institute of Science have just published the results of a large, comprehensive study in the journal Cell that found people can metabolize the exact same foods in very different ways.
What this means is that a healthy diet for one person may not be healthy for another person. Yet doctors all over the world tend to prescribe the same kinds of foods to people struggling with weight or health issues. Rather than recommend a cookie-cutter solution to weight problems, the researchers say, doctors could be more effective by recommending a personalized nutrition plan to a patient, based on the way that patient metabolizes certain foods.
“After seeing this data, I think about the possibility that maybe we’re really conceptually wrong in our thinking about the obesity and diabetes epidemic, Segal said in a statement. “The intuition of people is that we know how to treat these conditions, and it’s just that people are not listening and are eating out of control — but maybe people are actually compliant but in many cases we were giving them wrong advice.”
Some fellow doctors, however, are a bit more skeptical about the pair’s conclusions.
To measure how food was digested, Elinav and Segal recruited 800 people and studied them intently over the course of one week. Participants were asked to log every bite, sip, exercise session, bowel movement and sleep session on a phone app. Their blood sugar levels were measured every five minutes by a device attached to their bodies, and they turned in stool samples for gut bacteria analysis. They also gave blood samples and ate a few of the same exact meals for breakfast, so that the scientists could gauge all of the different effects the same food would have on different people.
Using all that data, Elinav and Segal mapped out which foods affected participants blood sugar the most. They used blood sugar as a health risk indicator because the higher blood sugar spikes and the longer it stays elevated, the more likely a person is to develop Type 2 diabetes, obesity and other facets of metabolic syndrome like high blood pressure, fatty liver disease and cardiovascular disease.
What they found was that the participants all responded very differently to foods, even after meals in which participants were eating the same exact provided foods. In the video above, the researchers explain that sushi actually caused one mans blood sugar to spike higher than ice cream did. For another participant who had struggled to lose weight on different diets all her life, the researchers found that eating a seemingly healthy food — tomatoes — spiked her blood sugar.
“Examples are numerous — some participants (in fact most participants) feature a lower glycemic response to bread with butter as compared to bread, despite its higher caloric content, Elinav told The Huffington Post. “Some individuals glucose levels spike to fresh fruit while not spiking on [a] moderate amount of alcohol (a glass of beer); in some individuals pizza produces a large spike, in others it did not.”
The researchers then selected 26 of the participants to see if they could provide personalized nutrition recommendations would bring down the subjects’ blood sugar levels. And indeed, Elinav and Segal were able to lower blood sugar levels after recommending meals made of foods they knew wouldnt spike individual participants blood sugar.
Interestingly, these dietary changes also resulted in a change in gut bacteria in the participants. That may be important because gut bacteria — the billions of microorganisms living in our body — help us by breaking down our food for us in our stomachs and intestines. Past studies have suggested that while weve all got unique communities of bacteria living inside us, depending on our environments and what we inherit, some kinds of bacteria are more helpful than others when it comes to blood sugar, obesity and diabetes. And we can perhaps influence which gut bacteria live in our intestines by eating certain kinds of foods.
Segal and Elinavs research was funded by general academic grants and they received no commercial funding. But the pair said theyve already licensed their research methods to an outside company to continue building on their findings. They want to develop a service that creates personalized nutrition plans for people with pre-diabetes, diabetes, obesity and other health complications that are linked to nutrition.
For example, because they were able to test their methods on each other, Segal and Elinav have made some personal changes to their own diets now that they know what foods spiked their blood sugar levels. Elinav found that for him, it was best to reduce both bread and beef, while beer seemed to have no effect on his blood sugar. Segal, on the other hand, has to avoid sushi and bread. Happily, he has found desserts that he can eat without guilt.
“I also found out that dark chocolate and ice cream do very little to my sugar levels, and I now eat these on a regular basis, said Segal. Lucky guy.
Unfortunately, until the service launches, Segal and Elinav dont have much advice to give those who want to customize their diet now, except to confirm that there really is no one size fits all diet that would work well for everyone.
Is it a breakthrough?
Dr. James DiNicolantonio, a cardiovascular research scientist at Saint Lukes Mid America Heart Institute and associate editor of BMJs Open Heart journal, was not involved in the study and is skeptical of Segal and Elinavs results. He says theres little practical takeaway for patients or health care providers, and questioned their decision to measure blood sugar levels after a meal, as measuring insulin levels after a meal is a more established way of determining whether people are developing insulin resistance that can lead to type 2 diabetes.
Segal and Elinav agree with DiNicolantonio that insulin level measurements would have been helpful, too, but pointed out that only blood sugar levels can be continually measured the way they wanted for the research. They recorded over 2,000 blood sugar levels per participant with the attached device, while pricking a person for a drop of blood 2,000 times to get insulin levels would have been impossible — or at least highly unpleasant, especially while the participants were sleeping.
Dr. Suneil Koliwad, an assistant professor at the University of California, San Francisco Diabetes Center and the Gerold Grodsky Chair in diabetes research, also had concerns about Segal and Elinavs findings. He was wary of the studys reliance on self-reported diet, a method of data collection that’s notoriously inaccurate, especially with people who are obese or have diabetes. He also pointed out a lack of research about what a blood sugar spike may actually mean if, say, it was truly triggered by a healthy food such as a tomato.
But despite the fact Koliwad thought it was premature to be developing a consumer product based on this study, he was much more optimistic about its potential to spur future research that could one day lead to reliable consumer products and services that create personalized health plans in general.
Potentially market ready tools that can be a great service to people who want to prevent obesity, diabetes and cancer, are on the horizon, and its going to be studies just like the one youre asking me about that will lead us to that point, Koliwad told HuffPost. And thats not too far off — Im talking years, not decades, and thats very heartening to all of us who work in the field of metabolism.”
For decades it has been labelled public enemy number one and a “low-fat” food label is used to convince us that what we’re buying is healthy.
The problem is low-fat can mean vegetables or just clever marketing for “we took out all the fat and then pumped it full of sugar”.
So there I was having a moment in the supermarket – a tub of low-fat yoghurt in one hand and a full-fat one in other – pondering which was actually better for me.
If I had a third hand, it would have been scratching my head. And I’m not alone.
“When there’s a huge wall of yoghurt, even I find it paralysing,” said Susan Jebb, a nutrition professor at the University of Oxford.
When you take the fat out of products, particularly dry ones like cake or biscuits, then something has to replace it.
“It tends to be sugar – the calories in digestives and low-fat digestives are almost the same,” Prof Jebb continued.
“Lots of yoghurts are rammed with sugar, that is the thing that annoys me about yoghurt.”
There is a simple answer with yoghurt – a few brands are both low in fat and sugar, although I need to chuck in a bit of fruit to make it palatable.
But what about the case that we should be eating more fat?
Some have argued that the message about cutting all fats when discussing bad saturated fats from processed foods was oversimplified.
While others have made the case that favouring carbohydrates in our diet – particularly refined carbs like white bread and pasta, is playing havoc with our hormones to increase the risk of type 2 diabetes and making us pile on the pounds.
We do all need fat in our diet – it contains essential fatty acids and is important for absorbing fat-soluble vitamins such as A, D and E.
The question has always been: “How much fat should we eat?” And the mantra has been low-fat, high-carb.
The World Health Organization advises that between 30% and 35% of our calories should come from fat arguing there is “no probable or convincing evidence” that the total amount of fat in our diet is altering the risk of cancer or cardiovascular disease.
So when it comes to the total amount of fat (and there is a separate argument when we come to consider different types of fat) it’s really a question of how it affects our waistlines.
And fat is certainly calorific.
A gram of fat is worth around nine calories – twice the amount as carbohydrate or protein at four calories per gram.
Too much fat, like too much of anything, will make you put on weight and it is incredibly easy to overeat calorie dense foods.
So it appears to be an easy target for people trying to lose weight.
“There is very good evidence that if you cut down on total fat it causes a small reduction in weight, but it’s not big,” said Dr Lee Hooper from the University of East Anglia in the UK.
But those eating relatively more fat actually lost marginally more weight.
Dr Deirdre Tobias, who led that study, told me: “If you’re trying to reduce your calories and you take out the fat then you get a lot of bang for your buck, but that strategy clearly doesn’t play out.
“Fat has been villainised because there’s a mentality that ‘fat makes you fat’. I think our evidence pretty much puts a nail in that coffin.”
She is not saying that carbs are the villain instead, but that the best diet is the one you can actually stick to – some people would find it pretty easy to give up on white bread and pasta while others would find it impossible.
But she did warn that focusing on simply avoiding fat risked missing out on known beneficial foods – such as nuts, oily fish and olive oil – or convincing yourself that a low-fat muffin is healthy.
When refined carbs are digested they rapidly lead to a spike in blood sugar levels and in turn of the hormone insulin. People with type 2 have difficulty controlling their blood sugar levels so preventing the spike could help in theory.
Although studies show the advantage of cutting carbs was not sustained in the long-term.
In the UK the total amount of fat being eaten is broadly in line with recommendations, but with slightly more saturated fat than advised.
Dr Hooper concluded: “I would be saying we don’t need to be cutting down on fat, but we do need to think of the type of fat.”
That’s an issue we’ll consider on Wednesday when we ask: “Is butter back?”
But clearly there is never going to be health advice to just pour cream down our throats and polish off all the pies and biscuits we can.
Even drowning a salad in olive oil could lead to weight gain.
Going overboard on fat, just as having too much sugar or refined carbohydrate, is a bad thing. Sugar is just stealing the headlines at the moment.
“The reality is that nutrition comes and goes in waves, we’ve had a fat wave and we’re for sure in a sugar frenzy,” says Prof Jebb.
She says she worries “enormously” when people reduce all the nation’s health problems to being “all about fat or all about sugar”.
The long read: Our relationship with food has become disordered and obsessive. As the new year brings diet madness, it neednt be such a struggle to learn good eating habits
So many of our anxieties around diet take the form of a search for the perfect food, the one that will cure all our ills. Eat this! Dont eat that! We obsess about the properties of various ingredients: the protein, the omega oils, the vitamins. But nutrients only count when a person picks up food and eats it. How we eat how we approach food is what really matters. If we are going to change our diets, we first have to relearn the art of eating, which is a question of psychology as much as nutrition. We have to find a way to want to eat whats good for us.
Our tastes follow us around like a comforting shadow. They seem to tell us who we are. Maybe this is why we act as if our core attitudes to eating are set in stone. We make frequent attempts more or less half-hearted to change what we eat, but almost no effort to change how we feel about food: how well we deal with hunger, how strongly attached we are to sugar, our emotions on being served a small portion. We try to eat more vegetables, but we do not try to make ourselves enjoy vegetables more, maybe because theres a near-universal conviction that it is not possible to learn new tastes and shed old ones. Yet nothing could be further from the truth.
All the foods that you regularly eat are ones that you learned to eat. Everyone starts life drinking milk. After that, its all up for grabs. From our first year of life, human tastes are astonishingly diverse. But we havent paid anything like enough attention to another consequence of being omnivores, which is that eating is not something we are born instinctively knowing how to do. It is something we learn. A parent feeding a baby is training them how food should taste. At the most basic level, we have to learn what is food and what is poison. We have to learn how to satisfy our hunger and also when to stop eating. Out of all the choices available to us as omnivores, we have to figure out which foods are likable, which are lovable and which are disgusting. From these preferences, we create our own pattern of eating, as distinctive as a signature.
In todays food culture, many people seem to have acquired uncannily homogenous tastes. In 2010, two consumer scientists argued that the taste preferences of childhood provided a new way of thinking about the causes of obesity. They noted a self-perpetuating cycle: food companies push foods high in sugar, fat and salt, which means that children learn to like them, and so the companies invent ever more of these foods that contribute to unhealthy eating habits. The main influence on a childs palate may no longer be a parent but a series of food manufacturers whose products despite their illusion of infinite choice deliver a monotonous flavour hit, quite unlike the more varied flavours of traditional cuisine. The danger of growing up surrounded by endless sweet and salty industrial concoctions is not that we are innately incapable of resisting them but that the more frequently we eat them, especially in childhood, the more they train us to expect all food to taste this way.
Once you recognise the simple fact that food preferences are learned, many of the ways we approach eating start to look a little weird. To take a small example, consider the parents who go to great lengths to hide vegetables in childrens meals. Is broccoli really so terrible that it must be concealed from innocent minds? Whole cookbooks have been devoted to this arcane pursuit. It starts with the notion that children have an innate resistance to vegetables, and will only swallow them unawares, blitzed into pasta sauce or baked into sweet treats; they could never learn to love courgette for its own sake. We think we are being clever when we smuggle some beetroot into a cake. Ha! Tricked you into eating root vegetables! But since the child is not conscious that they are consuming beetroot, the main upshot is to entrench their liking for cake. A far cleverer thing would be to help children learn to become adults who choose vegetables consciously, of their own accord.
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By failing to see that eating habits are learned, we misunderstand the nature of our current diet predicament. As we are often reminded, eating has taken a dramatic collective wrong turn in recent decades. Around two-thirds of the population in rich countries are either overweight or obese; and the rest of the world is fast catching up. The moral usually drawn from these statistics is that we are powerless to resist the sugary, salty, fatty foods that the food industry promotes. But theres something else going on here, which usually gets missed. Not everyone is equally susceptible to the dysfunction of our food supply. Some people manage to eat sugary, salty, fatty foods in modest quantities, and then stop. Its in all our interests to find out how they have done it.
Many campaigners would say cooking is the answer. If only children could be taught how to cook and plant vegetable gardens, they would automatically become healthier. It sounds convincing: school gardens are a lovely thing. But by themselves, they are not enough to make a child relate to food in healthy ways. Our difficulty is not just that we havent learned to cook and grow food, however important that is: its that we havent learned to eat in ways that support health and happiness. Traditional cuisines across the world were founded on a strong sense of balance, with norms about which foods go together, and how much one should eat at different times of day. Much cooking now, however, is nothing like this. In my experience as a food journalist, chefs and food writers tend to be prone to compulsive eating and other disordered food obsessions. For cooking to become the solution to our diet crisis, we first have to learn how to adjust our responses to food. Cooking skills are no guarantee of health if your inclinations are for twice-fried chicken, Neapolitan rum babas and French aligot: potatoes mashed with a tonne of cheese.
Like children, most of us eat what we like and we only like what we know. Never before have whole populations learned (or mislearned) to eat in societies where calorie-dense food was so abundant. Nor is overeating the only problem that plagues modern affluent civilisations. Statistics suggest that around 0.3% of young women are anorexic and another 1% are bulimic, with rising numbers of men joining them. What statistics are not particularly effective at telling us is how many others whether overweight or underweight are in a perpetual state of anxiety about what they consume, living in fear of carbs or fat grams and unable to derive straightforward enjoyment from meals. A 2003 study of 2,200 American college students suggested that weight concern is very common: 43% of its sample group were worried about their weight most of the time (across both sexes) and 29% of the women described themselves as obsessively preoccupied with weight.
The question of how we learn to eat both individually andcollectively is the key to how food, for so many people, has gone so badly wrong. The greatest public health problem of modern times is how to persuade people to make better food choices. But we have been looking for answers in the wrong places.
David L Katz of the Yale-Griffin Prevention Research Center is a rare voice of sanity in the clamorous world of nutrition. He disputes the commonly held view that the reason we dont eat better is because there is so much confusion over what the best diet really is. The medical evidence suggests that it doesnt matter whether we reach this point via a low-fat route or a low-carb one (or vegan or paleo or just good old-fashioned home cooking). Our problem, notes Katz, is not want of knowledge about the basic care and feeding of Homo Sapiens. Our problem is a stunning and tragically costly cultural reluctance to swallow it.
Take vegetables. The advice to eat more vegetables for health could hardly have been clearer. We have been given the message many times, in many forms. Many people, however, have absorbed the lesson from childhood that vegetables and pleasure and more generally, healthy food and pleasure can never go together. Consumer scientists have found that when a new product is described as healthy, it is far less likely to be a success than if it is described as new.
When it comes to our dining habits, there is a giant mismatch between thought and deed; between knowledge and behaviour. Eat food. Not too much. Mostly plants, says the influential food writer Michael Pollan. A wise and simple mantra, much repeated; yet for many it seems anything but simple to follow in daily life. A tone of judgmental impatience often creeps into discussions of obesity, from some of those lucky ones who have never struggled to change their eating, along with the quip that all that needs to be done to fix the situation is to eat less and move more. The implication is that those who do not eat less and move more are somehow lacking in moral fibre or brains. However, the way we eat is not a question of worthiness but of routine and preference, built over a lifespan. As the philosopher Caspar Hare has said: It is not so easy to acquire or drop preferences, at will.
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Once we accept that eating is a learned behaviour, we see that the challenge is not to grasp information but to learn new habits. Governments keep trying to fix the obesity crisis with well-intentioned recommendations. But advice alone never taught a child to eat better (I strongly advise you to finish that cabbage and follow it with a glass of milk!), so its strange that we think it will work on adults. The way you teach a child to eat well is through example, enthusiasm and patient exposure to good food. And when that fails, you lie. In Hungary, children are taught to enjoy eating carrots by being told that they bestow the ability to whistle. The point is that before you can become a carrot eater, the carrots have to be desirable.
Many of the joys and pitfalls of childrens eating are still there for adults. As grown-ups, we may still reward ourselves with treats, just as our parents did, and continue to clean our plates, though they are no longer there to watch us. We still avoid what disgusts us, though we probably know better than to throw it under the table when no one is looking.
There is a common assumption shared, curiously enough, by those who are struggling to eat healthily and many of the nutritionists who are trying to get them to eat better that we are doomed by our biology to be hooked on junk food. The usual story goes something like this: our brains evolved over thousands of years to seek out sweetness, because in the wild we would have needed a way to distinguish wholesome sweet fruits from bad bitter toxins. In todays world, where sugary food is abundant, or so the thinking goes, our biology makes us powerless to turn down these irresistible foods. Nutritionists use the word palatable to describe foods high in sugar, salt and fat, as if it were impossible to prefer a platter of crunchy greens dressed with tahini sauce to a family-sized bar of chocolate. Yet around a third of the population manages to navigate the modern food world just fine and select a balanced diet for themselves from whats available.
There are those who can eat an ice-cream cone on a hot day without needing to punish themselves for being naughty; who automatically refuse a sandwich because it isnt lunchtime yet; who usually eat when they are hungry and stop when they are full; who feel that an evening meal without vegetables isnt really a meal. These individuals have learned the eating skills that can protect them in this environment of plenty.
Viewed through the lens of behavioural psychology, eating is a classic form of learned behaviour. There is a stimulus an apple tart, lets say, glazed with apricot jam. And there is a response your appetite for it. Finally, there is reinforcement the sensory pleasure and feeling of fullness that eating the tart gives you. This reinforcement encourages you to seek out more apple tarts whenever you have the chance and depending on just how great you feel after eating them to choose them over other foods in the future. In lab conditions, rats can be trained to prefer a less sweet diet over a sweeter one when it is packed with more energy and therefore leaves them more satisfied: this is called post-ingestive conditioning.
We know that a lot of this food-seeking learning is driven by dopamine, a neurotransmitter connected with motivation. This is a hormone that is stimulated in the brain when your body does something rewarding, such as eating, kissing or sipping brandy. Dopamine is one of the chemical signals that passes information between neurons to tell your brain that you are having fun. Dopamine release is one of the mechanisms that stamps in our flavour preferences and turns them into habits.
In our lives, the stimulus-response behaviour around food is as infinitely complex as the social world in which we learn to eat. It has been calculated that by the time we reach our 18th birthday, we will have had 33,000 learning experiences with food (based on five meals or snacks a day). Human behaviour is not just a clear-cut matter of cue and consequence, because human beings are not passive objects, but deeply social beings. We do not just learn from the foods we put in our own mouths, but from what we see others eat, whether in our own families, at school or on TV.
As children watch and learn, they pick up many things about food besides how it will taste. A rodent can press a lever to get a sweet reward, but it takes an animal as strange and twisted as a human being to inject such emotions as guilt and shame into the business of eating. Before we take our first bite of a certain food, we may have rehearsed eating it in our minds many times. Our cues about when to eat and what to eat and how much to eat extend beyond such drives as hunger and hormones into the territory of ritual (eggs for breakfast), culture (pies at a football match) and religion (turkey at Christmas, lamb at Eid).
Our modern food environment is fraught with contradictions. The burden of religious guilt that has been progressively lifted from our private lives has become ever more intense in the realm of eating. Like hypocritical temperance preachers, we demonise many of the things we consume most avidly, leaving us at odds with our own appetites. Numerous foods that were once reserved for celebrations from meat to sweets have become everyday commodities, meaning not only that we overconsume them but that they have lost much of their former sense of festive joy. The idea that you dont eat between meals now seems as outdated as thinking you must wear a hat when you step out of the house.
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In many ways, children are powerless at the table. They cannot control what is put in front of them, where they sit, or whether they are spoken to kindly or harshly as they eat. Their one great power is the ability to reject or accept. One of the biggest things many children learn at that table is that their choice to eat or not eat unleashes deep emotions in the grownups close to them. They find that they can please their parents or drive them to rage, just by refusing dessert. (And then the adults complain that they are difficult at mealtimes.)
After a certain point in our lives, we discover the glorious liberation of being able to choose whatever we want to eat budget permitting. But our tastes and our food choices are still formed by those early childhood experiences. Rather alarmingly, it seems that our food habits when we were two whether we played with our food, how picky we were, the amount of fruit we ate are a pretty accurate gauge of how we will eat when we are 20.
The acquisition of eating habits is a far more mysterious skill than other things we learn in childhood, such as tying our shoelaces, counting or riding a bike. We learn how to eat largely without noticing that this is what we are doing. Equally, we dont always notice when we have learned ways of eating that are dysfunctional, because they become such a familiar part of ourselves. Having particular tastes is one of the ways that we signal to other people that we are unusual and special. We become known as the person in the family who adores munching on bitter lemon rind or the one who eats apples right down to the pips.
You might say that food dislikes do not matter much: each to their own. I wont give you a hard time for hating the fuzzy skin of peaches if you will excuse my squeamishness about the gooey whites of soft-boiled eggs. The danger is when you grow up disliking entire food groups, leaving you unable to get the nutrition you need from your diet. Doctors working at the front line of child obesity say it has become common in the past couple of decades for many toddlers to eat no fruit and vegetables at all. This is one of the reasons constipation is now such a huge though little mentioned problem in western countries, giving rise to 2.5m doctor visits a year in the US.
Some hold the view that it doesnt really matter if children have unhealthy tastes, because once they grow up they will effortlessly acquire a penchant for salad, along with a deeper voice and mature political opinions. Sometimes it does work out this way. In the 1970s it was a common rite of passage to reject the conventional bland watery foods of a 1950s childhood and embrace mung beans and spice. Many tastes for green tea, say, or vodka are acquired, if at all, in adulthood. When we learn to love these bitter substances, we undergo what psychologists call a hedonic shift from pain to pleasure. You may overcome your childish revulsion at the bitterness of espresso when you discover the wonderful after-effects, how it wakes up your whole body and infuses you with a desire for work. The great question is what it takes for us to undergo a similar hedonic shift to enjoying a moderate diet of healthy food. The process will be different for each of us, because all of us have learned our own particular way of eating, but wherever you start, the first step to eating better is to recognise that our tastes and habits are not fixed but changeable.
Poverty makes eating a healthy diet harder in numerous ways. Its not just because it is far more expensive, gram for gram, to buy fresh vegetables than it is to buy heavily processed carbohydrates. Maybe you live in a food desert where nutritious ingredients are hard to come by; or in housing without an adequate kitchen. Growing up poor can engender a lifetime of unhealthy food habits, even if your income later rises. When the flavour of white bread and processed meat are linked in your memory with the warmth and authority of a parent and the camaraderie of siblings, it can feel like a betrayal to stop eating them.
Yet its striking that some children from low-income households eat much better than others, and sometimes better than children from more affluent families. The problems with how we eat now cut across boundaries of class and income. It is feasible to create decent, wholesome meals bean goulash, spaghetti puttanesca on a shoestring budget. Equally, one can have the funds to buy chanterelle mushrooms and turbot but no inclination to do so. According to feeding therapists with whom I have spoken, there are successful businesspeople who will literally pass out from hunger at their desks rather than allow an unfamiliar meal to pass their lips when their preferred junk food is not available. Assuming that you are not living in a state of famine, the greatest determinant of how well you eat is the way you have learned to behave around food.
This behaviour is often immensely complex. In 1998 the social psychologist Roy Baumeister did a famous experiment. Baumeister, who is known for his work on self-defeating behaviours, found that the struggle of will required when a group of people were asked to eat virtuous foods such as radishes instead of the foods that they really wanted, such as chocolate and cookies, led to diminishing returns. They were so depleted by the effort of the task that when faced with another difficult task solving a tricky puzzle they would give up more quickly. The emotional effort of not eating the cookies had a psychic cost.
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Changing food habits is one of the hardest things anyone can do, because the impulses governing our preferences are often hidden, even from ourselves. And yet adjusting what you eat is entirely possible. We do it all the time. Were this not the case, the food companies who launch new products each year would be wasting their money. After the fall of the Berlin Wall, housewives from East and West Germany tried each others food products for the first time in decades. It didnt take long for those from the east to realise that they preferred western yoghurt to their own. Equally, those from the west discovered aliking for the honey and vanilla wafer biscuits of the east.
Even though most of us have tastes acquired very young, we can still change. EP Kster, a behavioural psychologist who has spent decades studying why we make the food choices we do, says that food habits can almost exclusively be changed by relearning through experience. That is, if we want to relearn how to eat, we need to become like children again. Bad food habits can only change by making healthy food something that is pleasure-giving. If we experience healthy food as a coercion as something requiring willpower it can never taste delicious.
Its seldom easy to change habits, particularly those so bound up with memories of family and childhood, but, whatever our age, it looks as if eating well is a surprisingly teachable skill. This is not to say that everyone should end up with the same tastes. But there are certain broad aspects of eating that can be learned and then tailored to your own specific passions and needs. There are three big things we would all benefit from learning to do: to follow structured mealtimes; to respond to our own internal cues for hunger and fullness, rather than relying on external cues such as portion size; and to make ourselves open to trying a variety of foods. All these three can be taught to children, which suggests that adults could learn them too.
For our diets to change, as well as educating ourselves about nutrition and yes, teaching ourselves to cook we need to relearn the food experiences that first shaped us. The change doesnt happen through rational argument. It is a form of reconditioning, meal by meal. You get to the point where not eating when you are not hungry most of the time is so instinctive and habitual it would feel odd to behave differently. Governments could do a great deal more to help us modify our eating habits. In place of all that advice, they could reshape the food environment in ways that would help us to learn better habits of our own accord. A few decades from now, the current laissez-faire attitudes to sugar now present in 80% of supermarket foods may seem as reckless and strange as permitting cars without seatbelts or smoking on aeroplanes. Given that our food choices are strongly determined by whats readily available, regulating the sale of unhealthy food would automatically make many people eat differently. Banishing fast-food outlets from hospitals and the streets surrounding schools would be a start. One study shows that you can reduce chocolate consumption almost to zero in a student cafeteria by requiring people to line up for it separately from their main course.
But at an individual level, we wont achieve much by waiting for a world where chocolate is scarce. Having a healthy relationship with food can act like a lifejacket, protecting you from the worst excesses of the obesogenic world we now inhabit. You see the greasy burger and you no longer think it has much to say to you. This is not about being thin. Its about reaching a state where food is something that nourishes and makes us happy rather than sickening or tormenting us. Its about feeding ourselves as a good parent would: with love, with variety, but also with limits. Changing the way you eat is far from simple, but nor, crucially, is it impossible. After all, as omnivores, we were not born knowing what to eat. We all had to learn it, every one of us, as children sitting expectantly, waiting to be fed.
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But getting the best evidence in nutrition is always a bit of nightmare.
Some studies rely on food questionnaires asking people what they ate in the past year and then seeing what happened decades later. Now I can’t tell you what I had for dinner three weeks ago and diets also change with time.
And it’s ever so slightly unethical to lock people up and experiment with their diets for decades to see if they have a heart attack. So the evidence ends up being a patchwork quilt of studies that gives an overall impression that saturated fat is bad.
Public Health England, which advises people to cut down on saturated fat, says one of the key pieces of science on which they base their recommendations on is a review of 15 clinical trials which changed more than 59,000 people’s diets for at least two years.
However, even this starts to show why there can be confusion about saturated fat.
It showed no impact on deaths from heart disease or any other cause of dying.
And the analysis concludes that if you cut saturated fat out of your diet and replace it with carbohydrates or protein then it makes no difference to your risk of a heart attack.
Carbs, and especially the refined ones in white bread rather than the complex ones in vegetables or wholegrains, are as bad for you as the saturated fat we’ve been warned off for years.
It is only when saturated fats are replaced like-for-like by polyunsaturated fats that you see a significant reduction in heart attacks.
Dr Lee Hooper, who led the study at the University of East Anglia, said: “What we’ve realised in the last few years is that saturated fat isn’t quite as much a villain as we thought.”
Types of fat
Saturated fat – Found in meats including processed foods such as burgers and sausages as well as butter, dairy and coconut oil
Monounsaturated fat – Found in avocados, olive oil, and many types of nut.
Polyunsaturated fat – Found in oily fish, vegetable oils and seeds.
Trans fat – Found in biscuits, cakes and margarines
I put it to Public Health England’s chief nutritionist, Dr Alison Tedstone, that just telling people to cut saturated fat was too simplistic.
She was adamant that saturated fat is a bad thing in our diets but “it’s a fair point that sometimes the fat message gets oversimplified”.
Dr Tedstone continued: “The data over the years has flip-flopped slightly as new studies have emerged and that’s because you’re looking at subtle things on whether it should be monos or polys or wholegrain carbohydrate.
“I agree it’s inappropriate to give the population messages to increase your carbohydrate intake without thinking about what that carbohydrate intake is.”
The advice from both Drs Tedstone and Hooper is to cook in sunflower oil instead of butter and have a low-fat spread.
But some have argued that even this is wrong and that butter and other foods rich in saturated fat belong in a healthy diet.