Exploring the sense and nonsense of food and health

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The Facts about Diabetes

We may be approaching one of  the greatest healthcare crises ever. The numbers keep rising and no one really seems  to earnestly do much about it. That is where the Diabetes Prevention programs may offer some help in the future. Prevention always is the best medical advice but it’s difficult to find help due to a lack of interest or funding.  In my opinion, many cases of diabetes type 2 can be prevented if enough attention is paid to understanding the dietary and exercise aspects of the disease. Studies of previous prevention programs have shown to make a difference. One particular study compared lifestyle  modifications with the anti-diabetes drug, metformin and found that the lifestyle modifications were just as effective as taking the drug.





You can find the complete study HERE.

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The Diary of a Dieter

How does the Human Body Regulate Food intake and Body Weight?

Body weight remains fairly constant for long periods of time. To regulate weight and fatness at a constant level, the body must be able to respond both to changes in food intake over the short term and to changes in the amount of stored body fat that occur in the long term. We have hunger and satiety signals that act over the short-term time frame (meal to meal) whereas signals from the fat tissue trigger the brain to adjust both food intake and energy expenditure for long term regulation. Sounds simple, right? That’s what some weight loss plans keep telling us (especially if we are following their claims).  Here is partly the reason why it is NOT easy.

For example, there are two major hormones that participate in this process. The first one is called ghrelin which is a hormone produced by the stomach that stimulates food intake (often called the “hunger hormone”).

The second one is called leptin which is a hormone produced by fat cells that signals information about the amount of body fat.  I will spare the details, but it is important to keep in mind that weight regulation is determined by the body in conjunction with the brain and is It is actually not simple but very complex. And keeping the lost weight off is a special challenge that requires a great deal of mindfulness and vigilance. The body tends to not want us to starve for obvious reasons.

The following article presents us with a realistic experience that many people are forced to take on when they finally address their repeated weight gains and suggests ways that must be followed to make this time a success (for health, not vanity).  There is a lot of wisdom in her article.  In my opinion, she finally gets it. I wish her success!

Hope she doesn’t mind if I borrow her viewpoint for a while.  To find more about her, click on the author, Cheney Meaghan below for a link to her work. (S. Feltner, PhD at Food, Facts, and Fads).

It’s Time To Diet Again, Dangit

For health, not hopes of hotness.

Cheney Meaghan

Jul 19, 2018 · 3 min read

I’ve lost count of how many times in my life I’ve been on a diet, and now it’s time to do it again.

I hate dieting.

Dieting consumes my entire life.

To track what I eat, to count calories, to more thoughtful food shopping, to prepping food, meal planning, tracking weight — all of it — I hate it.

But today I went to the doctor because I have been having more knee pain than usual and my right foot has been swelling every day for a week, and even before lab work returns, the news is not good.

I’ve gained thirty pounds in the last six months, my blood pressure is a steady 140/100ish (I’ve been checking it at home for two weeks), the doctor is worried that the swelling is due to hypertension, she’s testing me for diabetes, and she’s sure that the crunching and squishing and pain I am feeling in my right knee is bone on bone arthritis.

Basically, I’m turning into my mother, and quickly falling apart as I spread across the couch one pound at a time.

I guess this time, the dieting really matters.

All the extra weight isn’t good for my knee, and, well, all the extra weight just isn’t good, period.

But did I mention I hate dieting?

When you weigh as much as I do (over 250 pounds now, and holy s… I can’t believe I just admitted that on the internet) losing weight isn’t just a small shift in eating healthier and getting more exercise.

It means scrutinizing every morsel you put into your mouth and weighing (ha!) in your mind whether that bite is worth it compared to all the other bites left you have that day.

It means weighing and measuring your food to make sure you stay under your calorie goal, it means fewer meals out with friends, it means less ice cream.

I hate dieting.

But, like, I’m kind of dying.

My doctor looks like she weighs around the same amount as I do and joked with me during the appointment about how hard it is to get healthy.

When she mentioned that I should give up coffee with cream and sugar, which happens to be one of my only remaining addictions, I wanted to cry, but she said it was her favorite thing in the world and the thing she had the hardest time giving up, too.

It’s hard, I know it’s hard, I have a hard time doing it myself, obviously, she told me as we laughed and groaned over the benefits of dieting to prevent diabetes and the pain of cutting back on sugary treats.

She also shook her head and talked about how crazy it is that America is such a fat country in general. She said it was because we’d become such a busy society focused on getting stuff done, we’ve stopped focusing on taking the time to rest, eat healthy, and do good things for our bodies and lives like so many Europeans do.

It’s harder in America to be healthy than it is in a lot of other places in the world, and “they say” that over half of Americans are overweight now, and yet I can’t take any comfort in being on the side of the majority here.

Now I wait for results to see how things are — my thyroid, my sugar levels, my cholesterol and all that fun stuff — oh, and my creaky, decrepit knee.

Meanwhile, I’ll be updating my new weight and goals on the MyFitnessPal app and start logging everything I put into my body — my own personal science experiment as I try to shrink and not disappear.



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Obesity on the Rise – Some Solutions?

The Obesity/Diabesity Pandemic

Obesity is a major risk factor for the development of  type 2 diabetes mellitus, so much so that the epidemic is often called diabesity. It has been described as one of the most important crises that has invaded our public health system.

Global Statistics,  Source: Lancet

  • Since 1980, the number of adults with diabetes worldwide has quadrupled from 108 million to 422 million in 2014.
  • Diabetes is fast becoming a major problem in low and middle-income countries.
  • From 1980 to 2014, the prevalence of diabetes more than doubles for men in India and China.
  • Half of adults worldwide with diabetes in 2014 lived in five countries: China, India, USA, Brazil and Indonesia.

So what are some solutions?  

The standard American diet is in much need of an overhaul and our national food systems need to change if we wish to reverse or at least slow down this trend. Many say that it would take the same determination as the campaigns to change behaviors that were utilized during the campaigns against smoking. .

Prevention awareness should be first on the front lines of treating the people with prediabetes that can often be reversible using lifestyle modifications. There are already some prevention models in the community; however, these should be expanded so that they become more easily accessible to more people. The Diabetes Prevention Program (DPP) uses intensive behavioral therapy to help people lose a little bit of weight (typically 5-10%). When this program is followed, the number of people progressing to have diabetes comes down by more than half. In people over 60, the reduction was 70%.

Nutrition education should be incorporated into the school system in the early years to help young children understand the importance of knowing where our food comes from and why nutritious foods are the best choice. They can be taught about balanced eating, calories, reading labels and grocery shopping. Nutrition education can also be offered at the middle and high schools levels by returning to a revamped and modernized home economics course in the curriculum. 

A lingering problem has existed for many primary care physicians for many years in that they say they were never adequately prepared in nutrition principles in medical schools. In a survey of family physicians (2009), two thirds said that dealing with extremely obese patients is “frustrating “and one-half said treatments are often ineffective. This is reflected by a lack off obesity training.

Shockingly, another survey in 2010 of 140 doctors revealed that nearly one-third were not even familiar with the American Diabetes Association (ADA) prediabetes guidelines. Only 6 percent were able to identify all 11 risk factors and on average, the doctors could only identify just eight of the warning signs. Only 17 percent knew the correct laboratory values for blood glucose and only 11 percent said they would refer a patient to a behavioral weight loss program..

There should be an increased access to professional treatments. Medical professionals not trained in obesity management should refer their patients to outside providers such as dietitians, exercise trainers, behavior therapists, psychologists, or a new concept of health coaches. These providers should be trained, certified, and credentialed to protect the public from unscrupulous treatments and to provide quality care. Reimbursement of qualified health professionals needs to be enhanced to keep. Otherwise patient volume high and they lessen out-of-pocket expenses.

We have become a nation of non-cooks and prefer to have our meals prepared by someone else. Encourage home cooking and home kit meals to help to counter using fast foods and packaged highly processed meals loaded with calories, fat, sugar and salt.

Educate the public on food labeling including ingredient lists. Beware of food companies that promote products with a “health halo” meaning exaggerated claims are made that appear to make unhealthy foods seem healthy because of an added nutrient or ingredient. Corporations also mislead consumers with their labeling so they include four different types of sugar to keep sugar from being listed as the first ingredient. This is misleading to the consumer when attempting to make wise food choices.

Stop corporate-government partnerships and diminish lobbying.
The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is funded by myriad food companies such as Coca-Cola, PepsiCo and Kellogg’s. The dairy industry has a long history of influencing the food pyramid and Dietary Guidelines. A good example is the placing of a glass of milk on the MyPlate Logo.

Another health organization guilty of taking in millions from food companies is the American Heart Association. They offer a “Heart – Check logo for a price: $5, 490 to $7,500 that is renewable for another fee annually. The product has to be low in fat, saturated fat and cholesterol to gain this “honor.” However, some products such as Boar’s Head processed meats have the logo and still may still contain high levels of sodium. If the AHA were sincere in their efforts to help consumers choose healthier foods to rein in obesity/diabetes, they would realize that research has shown that a 1.8 oz. daily serving of processed meat raised the risk of diabetes by 19 percent and heart disease by 42 percent. Most current dietary recommendations emphasize a reduction in processed meats (my emphasis).

There is bad news on rising obesity rates – read about them HERE.

It will take a concerted effort from government, politics, industry, communities, and consumers and the perpetrators of our obesigenic culture to begin to change this trend.



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A Good Look at Global Childhood Obesity

A succinct look at how the global pandemic of obesity and diabetes has led us to the unbelievable statistics comparing 40 years ago versus 2016.

The numbers speak for themselves: In 1975 we had 11 million obese children globally; now it is 124 million. Amazing! And we continue to blame the victims and ignore the real issues behind the crises: a food industry more interested in increasing consumption of their products and reaping the profits than contributing to the health of the consumers. There is also an obesity industry that has evolved and relies on pushing Americans toward surgeries, crash and fad diets and potentially harmful diet drugs. We need to really begin to understand the complexities of dieting, weight loss, and the conflicts we face in our current food environment.

For a summary, click HERE.

For more on the dilemma, CLICK HERE.

There are three excellent books I have read that clearly describe the facts.

Salt, Sugar Fat: How the Food Giants Hooked Us, Micheal Moss, 2014.

Fat Politics: The Real Story Behind America’s Obesity Epidemic, J. Eric Oliver

Rethinking Thin: The New Science of Weight Loss and the Myths and Realities of Dieting, Gina Kolata, 2007.

Sally J. Feltner, MS, PhD


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Our National Eating Disorder: Facing the Facts

Preventing obesity in childhood and adults is the primary goal. Many adults gain weight at a slow pace as they age (about a pound a year); however, others gain a substantial amount in a shorter period of time primarily between the ages of 25 and 34 years. Perhaps we are taking the wrong approach in helping people restrict that “natural” weight gain by using very restrictive fad diets (less calories) that often fail to result in maintaining weight after weight loss.

Since our food environment does not seem to change, more emphasis on mindful eating should be taught early in life by paying more attention to the “I’m hungry” and “I’m full” signals of our bodies.  Because appetite is triggered by external cues such as the sight and smell of food, it is usually appetite, and not hunger that makes us stop for ice cream or chocolate chip cookies while at the mall.

Getting eight hours of sleep at night may also be somewhat effective. Lack of sleep is linked to obesity, new evidence shows. Inadequate sleep impacts secretion of the signal hormones ghrelin, which increases appetite, and leptin, which indicates when the body is satiated. This can lead to increased food intake without the compensating energy expenditure. Paying attention to the kinds and amounts of food we consume can also help.  Studies have also indicated that eating fast may lead to eating more. It takes about 15 minutes for your brain to decode that your stomach is full.


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Why We Get Fat?


The influence of obesity on health is the most important aspect of the condition even though a lot of people consider appearance to be  the most important. What ever the reason, it’s useful to know that our health should be the biggest concern.

Health problems associated with obesity makes up a very large list:

Type 2 diabetes, chronic inflammation, hypertension, stroke, elevated cholesterol, certain cancers, heart disease, gallbladder disease, fatty liver disease, discrimination, depression, skin disorders, sleep disorders, shortened life expectancy.

The increased risk of disease appears to be primarily due to a higher prevalence of metabolic abnormalities in many obese people. About 70% of obese people have two or more metabolic disorders such as:

  • Hypertension
  • Elevated triglycerides, glucose, and/or insulin
  • Low HDL-cholesterol (the “good cholesterol”)
  • high C-reactive protein (a marker of inflammation)

Weight loss of 10-15% of initial body weight, paired with exercise improves physical fitness level, reduces metabolic abnormalities and the risk of disease.


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Binge Eating?

Binge-eating disorder is probably the most prevalent eating disorder that affects about 3.3% of women and 2.0% of men. It is estimated that 10 to 15% of people enrolled in commercial weight loss programs suffer from this disorder.  I would suppose that  there are many others that have never been diagnosed or are not even aware that they may suffer from this insidious condition or occasionally fall victim to its effects on weight. The condition may result in a lifetime of weight gain leading to obesity. There is an established diagnostic account of the binge-eating disorder based on the following criteria:

  • Binge eating episodes are associated with three or more of the following:
  • Eating until feeling uncomfortably full.
  • Eating large amounts of food when not physically hungry.
  • Eating more rapidly than normal.
  • Eating alone due to embarrassment of how much you are eating.
  • Feeling disgusted, depressed, or guilty after overeating.
  • The behaviors occur, on average, at least two days a week for six months.

Smolin and Grosvenor, Nutrition: Science and Applications, Third Edition.

The treatment focuses on the underlying psychological issues. Persons with this disorder will often be asked to record their food intake and note feelings and circumstances that prompt this behavior. The treatment can also include individual or group therapy and provide nutrition counseling on mindful eating. This approach can include paying attention to hunger and satiety cues, and slowing down the pace of eating to identify the triggers to this eating behavior. Sometimes it’s as simple as realizing that very restrictive eating and hunger is a contributor.

Judith E. Brown, Nutrition Now, 7th Edition


The article is a first-hand account of a dieter and her journey with an eating disorder as well as the complexities associated with weight control.

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The Spread of Global Obesity

There is so much speculation about the causes of obesity?  The following article makes it pretty simple. Consider affordability, convenience, palatability and prosperity. It all adds up to increased consumption of fast foods and/or processed foods.


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The Best Way to Lose Weight (and keep it off)


So much has been said about weight loss, but finally the following article brings us some realities about maintaining those lost pounds we worked so hard to lose.

Extreme, restrictive, fad-type diets  just don’t work for most people in the long-term. However, some restriction of refined carbs or highly processed food and snacks can be effective.

It makes no sense to lose weight by deprivation and then to gain most of it back after a few months.

Will power is an old term that should no longer be associated with weight loss. Being vigilant is the new “will power.”  Being aware of what and when you eat can make a difference – e.g. keeping a food journal and a prudent use of the scale are simple things you can practice. For example, weigh yourself once a week, if the number goes up, cut down your calories. One way is to be aware of your snacking habits and choose nutrient dense snacks, such as cut-up veggies. Most snack foods are designed by the food industry to lead to the “eating right out of the bag” habit. Read serving sizes on the label – carbohydrate grams can add up very quickly.

Be aware of weight cycling. Drastic reductions of food intake can lead to rapid weight loss but also cause a drop in the basal metabolic rate (BMR) which may result in increased food cravings and weight gain. This makes it difficult to maintain the weight loss and contribute to weight cycling that decreases the likelihood that future attempts at weight loss will be successful.

An example of a successful weight control program is one that offered monthly lifestyle coaching sessions with goal setting, behavior change strategy development, and follow-up sessions to evaluate and fine-tune personal approaches. They should be individually tailored with sustainable lifestyle changes.