Food Reward Friday

This week's lucky "winner"... fried Coke!

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Atherosclerosis in Ancient Mummies Revisited

Many of you are already aware of the recent study that examined atherosclerosis in 137 ancient mummies from four different cultures (1).  Investigators used computed tomography (CT; a form of X-ray) to examine artery calcification in mummies from ancient Egypt, Peru, Puebloans, and arctic Unangan hunter-gatherers.  Artery calcification is the accumulation of calcium in the vessel wall, and it is a marker of severe atherosclerosis.  Where there is calcification, the artery wall is thickened and extensively damaged.  Not surprisingly, this is a risk factor for heart attack.  Pockets of calcification are typical as people age.

I'm not going to re-hash the paper in detail because that has been done elsewhere.  However, I do want to make a few key points about the study and its interpretation.  First, all groups had atherosclerosis to a similar degree, and it increased with advancing age.  This suggests that atherosclerosis may be part of the human condition, and not a modern disease.  Although it's interesting to have this confirmed in ancient mummies, we already knew this from cardiac autopsy data in a variety of non-industrial cultures (2, 3, 4, 5).

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Food Reward Friday

This week's lucky "winner"... Yoplait Go-Gurt!

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Does the Mediterranean Diet Reduce Cardiovascular Risk?

By now, most of you have probably heard about the recent study on the "Mediterranean diet" (1), a diet that was designed by diet-heart researchers and is based loosely on the traditional diet of Crete and certain other Mediterranean regions.  The popular press has been enthusiastically reporting this trial as long-awaited proof that the Mediterranean diet reduces the risk of cardiovascular events-- by a full 30 percent over a 4.8-year period.  I wish I could share their enthusiasm for the study.

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Your Brain on Potato Chips

Or, more accurately, a rat's brain on potato chips.  Last week, PLoS One published a very interesting paper by Dr. Tobias Hoch and colleagues on what happens in a rat's brain when it is exposed to a highly palatable/rewarding food (1).  Rats, like humans, overconsume highly palatable foods even when they're sated on less palatable foods (2), and feeding rats a variety of palatable human junk foods is one of the most effective ways to fatten them (3).  Since the brain directs all behaviors, food consumption is an expression of brain activity patterns.  So what is the brain activity pattern that leads to the overconsumption of a highly palatable and rewarding food?

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Christie Removes Another Republican Excuse for Passing on the Medicaid Expansion

The New Jersey Governor became the eighth Republican to take the Medicaid expansion deal.

What I found notable is that he essentially mimicked Florida Republican Governor Rick Scott in reserving the right to back out in future years if the feds don't keep their funding promises. While the feds are paying 100% of the cost of expansion in the first three years, that support ultimately drops to 90%

Salt Sugar Fat

I'd just like to put in a quick word for a book that will be released tomorrow, titled Salt Sugar Fat: How the Food Giants Hooked Us, by Pulitzer prize-winning author Michael Moss.  This is along the same lines as Dr. David Kessler's book The End of Overeating, which explains how the food industry uses food reward, palatability, and food cues to maximize sales-- and as an unintended side effect, maximize our waistlines.   Judging by Moss's recent article in New York Times Magazine, which I highly recommend reading, the book will be excellent.  I've pre-ordered it.

C. Everett Koop, MD

Anyone who has ever read this blog and noticed its upper right hand corner has known that Dr. Koop and I were friends––for more than 20 years.

One of my more amazing experiences with Dr. Koop centers on a walk we took from the White House to my office up Connecticut Avenue. In the length of about a mile, I don't know how many people stopped him and thanked him for his service. Just regular

Food Reward Friday

This week, Food Reward Friday is going to be a little bit different.  I've received a few e-mails from people who would like to see me write about some of the less obvious examples of food reward-- foods that are less extreme, but much more common, and that nevertheless promote overeating.  Let's face it, even though they're funny and they (sometimes) illustrate the principle, most people reading this blog don't eat banana splits very often, much less pizzas made out of hot dogs.

So this week's "winner" is something many of you have in your houses right now, and which was also the subject of an interesting recent study... potato chips!

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Florida's Republican Governor Scott Does a Deal With Sebelius on Medicaid

A million Floridians will now be eligible for Medicaid––the Obama administration is happy about that.

Republican Rick Scott gets to do it his way––in an almost entirely private market.

This from today's Tampa Bay Times:

His [Scott's] endorsement of the expansion came hours after the federal government
agreed to grant Florida a conditional waiver to privatize Medicaid
statewide for the

Cosmetic Surgery Loans Open Up The Opportunity to Rediscover Yourself

Each one of us wants to look "best". Different people use different techniques to look good; the most popular among them is cosmetic surgery. Cosmetic surgery can do tremendous change to one's personality. But, the huge cost involved in undertaking a cosmetic surgery must be stopping you from the change you have been long waiting for? Don't wait any longer; rediscover yourself with a cosmetic surgery loan. It's in the very nature of human beings to keep on demanding more and more. Everyone is running in the race to look better than other. Looking more beautiful has always provoked both men and women. In the past, the word beauty was confined only to woman. But with the changing time man too have got conscious about their looks. They too want to look good and possess a perfect body. Cosmetic surgery can be a perfect solution for enhancing one's physical appearance. Cosmetic surgery is often known as plastic surgery. Undertaking even a small cosmetic surgery involves good sum of money. It is not in the reach of common man and the worst part is that cosmetic surgery expenses are not even covered under health insurance scheme. Only rich people used to get it done. But, with the passage of time and introduction of cosmetic surgery loan has flourished an opportunity for the working class and income earners to get the funds to finance the expenses involved in getting a cosmetic surgery done. Treatments covered under cosmetic surgery are liposuction, hair transplant skin resurfacing, forehead lift, abdominoplasty, breast augmentation, scar revision and many more. With a cosmetic surgery loan, you can finance cosmetic surgery ranging from £1000 to £25,000 to meet the expenses involved in the cosmetic surgery. Usually the loan is granted for a period of 24 to 60 months depending on the purpose for which you are taking the loan. Before you apply for the loan find out how much cost is involved in the cosmetic surgery you want to get done. A prior research will help you meet all the expenses with ease. Cost involved in getting a minor surgery is not much and can be easily met by unsecured cosmetic surgery loan. Tenants as well as homeowners can apply for an unsecured loan. A secured cosmetic surgery loan is ideal if you plan to undergo a major cosmetic surgery. To avail a secured loan you need to put your property as collateral against the loan. Homeowners by putting their home as security can grab good sum of money to finance the expenses of cosmetic surgery. The entry of online lenders in the finance market has overshadowed all the shortcomings that existed when only traditional lenders were there. Now, you can apply for a cosmetic surgery loan online and that too from your office or home. You just need to have a computer with Internet connection and a few clicks on the loan provider's websites and you are not too far away from getting the surgery done for yourself. You just need to fill up the online application form that will hardly take few minutes out of your busy schedule. Make sure to collect as many loan quotes as you can which will help you find the loan deal, most of the lenders offer them free or for some nominal charges. Once you collect all the quotes compare them on the basis of loan term, repayment options and choose the one that suits your pocket to the best. Increasing consciousness among man and woman regarding their looks has added to the popularity of cosmetic surgery loan. Now, with a cosmetic surgery done you too can look the way you dream. With a cosmetic surgery loan, change the way you look at life and the way people look at you.

Body Fatness and Cardiovascular Risk Factors

I recently revisited a really cool paper published in the Lancet in 2009 on body fatness, biomarkers, health, and mortality (1). It's a meta-analysis that compiled body mass index (BMI) data from nearly 900,000 individual people, and related it to circulating lipids and various health outcomes.  This is one of the most authoritative papers on the subject.

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By Refusing to Implement the Medicaid Expansion Republican Governors May Be Making the Republican Block Grant Proposals Impractical

Paul Ryan's Medicaid block grant proposals have always made sense to me. Give the states their Medicaid allotment and real flexibility over how they spend what will inevitably be less federal money.

But as I have thought about the impact of implementing the Medicaid expansion under the Affordable Care Act ("Obamacare"), Medicaid block granting is looking more and more problematic.
Under the new

Food Reward Friday

This week's "winner"... the Banana Split!

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Food Reward Friday

This week's lucky "winner"... an unnamed hot dog-laden Pizza Hut monstrosity with tempura shrimp and mayonnaise!

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Why Do We Eat? A Neurobiological Perspective. Part VIII

In the (probably) last post of this series, I'll take the pieces that I've gradually outlined in previous posts, and put them together into a big-picture, common-sense framework for thinking about human eating behavior, and why we eat more today than ever before.

Why is Eating Behavior Regulated?

Let's start at the most fundamental level.  To be competitive in a natural environment, organisms must find rational ways of interacting with their surroundings to promote survival and reproduction.  One of the most important elements of survival is the acquisition of energy and chemical building blocks, either by photosynthesis, or (in the case of animals) eating other organisms.  This imperative drove the evolution of rational food seeking behaviors long before the emergence of humans, mammals, reptiles, amphibians, fish, worms, and even eukaryotes (organisms with nuclei).

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Why Do We Eat? A Neurobiological Perspective. Part VII

Welcome back to the series, after a bit of a hiatus!  In previous posts, we covered the fact that humans eat because we're motivated to eat, and many things can motivate us to eat.  These include factors related to energy need (homeostatic factors), such as hunger, and factors that have little to do with energy need or hunger (non-homeostatic factors).  These many factors are all processed in specialized brain 'modules' that ultimately converge on a central action selection system (part of the reward system); this is the part of you that decides whether or not to initiate eating behaviors.

This will be somewhat of a catch-all post in which I discuss cognitive, emotional, and habit influences on food intake.  Since these factors are not my specialty, I'll keep it brief, but I don't mean to suggest they aren't important.

Food 'Cost'

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Why Do We Eat? A Neurobiological Perspective. Part VI

In previous posts in this series, I explained that the brain (primarily the mesolimbic system) integrates various factors to decide whether or not to drive food seeking and consumption behaviors.  These include homeostatic factors such as hunger, and non-homeostatic factors such as palatability and the social environment.

In this post, I'll examine the reward system more closely.  This is the system that governs the motivation for food, and behavioral reinforcement (a form of learning).  It does this by receiving information from other parts of the brain that it uses to determine if it's appropriate to drive (motivate) food seeking behavior.  I covered its role in motivation in the first post of the series, so in this post I'll address reinforcement.

Behavioral Reinforcement

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Why Do We Eat? A Neurobiological Perspective. Part V

In previous posts, I explained that food intake is determined by a variety of factors that are detected by the brain, and integrated by circuits in the mesolimbic system to determine the overall motivation to eat.  These factors include 'homeostatic factors' that reflect a true energy need by the body, and 'non-homeostatic factors' that are independent of the body's energy needs (e.g. palatability, habit, and the social environment).

In this post, we'll explore the hedonic system, which governs pleasure.  This includes the pleasure associated with food, called palatability.  The palatability of food is one of the factors that determines food intake.

The Hedonic System

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Why Do We Eat? A Neurobiological Perspective. Part IV

In this post, I'll follow up on the last post with a discussion two more important factors that can affect energy homeostasis and therefore our food intake and propensity to gain fat: age and menopause.

Age

Although it often isn't the case in non-industrial cultures, in affluent nations most people gain fat with age.  This fat gain continues until old age, when many people once again lose fat.  This is probably related to a number of factors, three of which I'll discuss.  The first is that we tend to become less physically active with age.  The second, related factor is that we lose lean mass with age, and so energy expenditure declines.

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Why Do We Eat? A Neurobiological Perspective. Part III

In the first post, I explained that all voluntary actions are driven by a central action selection system in the mesolimbic area (the reward system).  This is the part of you that makes the decision to act, or not to act.  This system determines your overall motivation to obtain food, based on a variety of internal and external factors, for example hunger, the effort required to obtain food, and the sensory qualities of food/drink.  These factors are recognized and processed by a number of specialized 'modules' in the brain, and forwarded to the reward system where the decision to eat, or not to eat, is made.  Researchers divide food intake into two categories: 1) eating from a true energy need by the body (homeostatic eating), e.g. hunger, and 2) eating for other reasons (non-homeostatic eating), e.g. eating for social reasons or because the food tastes really good.

In the second post of the series, we explored how the brain regulates food intake on a meal-to meal basis based on feedback from the digestive system, and how food properties can influence this process.  The integrated gut-brain system that accomplishes this can be called the satiety system.

In this post, we'll explore the energy homeostasis system, which regulates energy balance (energy in vs. energy out) and body fatness on a long term basis.

The Energy Homeostasis System

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Why Do We Eat? A Neurobiological Perspective. Part II

In the last post, I explained that eating behavior is determined by a variety of factors, including hunger and a number of others that I'll gradually explore as we make our way through the series.  These factors are recognized by specialized brain 'modules' and forwarded to a central action selection system in the mesolimbic area (the reward system), which determines if they are collectively sufficient cause for action.  If so, they're forwarded to brain systems that directly drive the physical movements involved in seeking and consuming food (motor systems).

The term 'homeostasis' is important in biology.  Homeostasis is a process that attempts to keep a particular factor within a certain stable range.  The thermostat in your house is an example of a homeostatic system.  It reacts to upward or downward changes in a manner that keeps temperature in a comfortable range.  The human body also contains a thermostat that keeps internal temperature close to 98.6 F.  Many things are homeostatically regulated by the body, and one of them is energy status (how much energy the body has available for use).  Homeostasis of large-scale processes in the body is typically regulated by the brain.

We can divide the factors that determine feeding behavior into two categories, homeostatic and non-homeostatic.  Homeostatic eating is when food intake is driven by a true energy need, as perceived by the brain.  For the most part, this is eating in response to hunger.  Non-homeostatic eating is when food intake is driven by factors other than energy need, such as palatability, habitual meal time, and food cues (e.g. you just walked by a vending machine full of Flamin' Hot Cheetos).

We can divide energy homeostasis into two sub-categories: 1) the system that regulates short-term, meal-to-meal calorie intake, and 2) the system that regulates fat mass, the long-term energy reserve of the human body.  In this post, I'll give an overview of the process that regulates energy homeostasis on a short-term, meal-to-meal basis.

The Satiety System (Short-Term Energy Homeostasis)


The stomach of an adult human has a capacity of 2-4 liters.  In practice, people rarely eat that volume of food.  In fact, most of us feel completely stuffed long before we've reached full stomach capacity.  Why?

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Why Do We Eat? A Neurobiological Perspective. Part I

As with all voluntary movements, eating food is an expression of activity in the brain.  The brain integrates various inputs from around the body, and outside the body, and decides whether or not to execute the goal-directed behaviors of food seeking and consumption.  Research has uncovered a lot about how this process works, and in this series I'll give a simplified overview of what scientists have learned about how, and why, the brain decides to eat.

The Gatekeeper of Voluntary Behaviors

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Comment Policy

Over the last year, I've noticed that the quality of the comments section here has deteriorated significantly, with a high proportion of poorly grounded and/or disrespectful comments, typically from anonymous or semi-anonymous people.  This is the nature of the Internet I suppose-- comments sections are rowdy places.  But ultimately I do have control over this, and I intend to exert it to maintain a higher level of information quality and decorum in my corner of the Internet.

For the foreseeable future, I'll be moderating comments.  Here are my criteria for deciding whether or not a comment will be published:

1. Value.  Comments should be well thought out, and points supported by research or at least solid logic.  Personal anecdotes are welcome as long as they aren't over-interpreted.  Thoughtful questions are also welcome, although I can't guarantee I'll answer them.  As always, anyone is free to disagree with me in a constructive manner, or simply offer a word of support.  
2. Respect.  Comments should be respectful to me and other commenters, and composed in a concise manner.  It isn't difficult to disagree in a respectful way.
3. On topic.  Comments should be at least somewhat relevant to the subject of the post.
4. Full name.  Attaching your full name to a comment means taking responsibility for what you write.  I'll continue to publish anonymous comments if they add value, but I'll be more likely to publish if you include your full name in your screen name, your profile, or at the bottom of your comment.
5. No ads.  I will not publish links to commercial sites that do not add value to the discussion, nor will I publish any other link I find objectionable.

Because I'll be moderating, I've decided to remove the captcha word authentication, which many people found difficult to use.  We'll see how that goes.  Since I have a lot on my plate, and Whole Health Source is a one-man show, I may not always moderate comments in a timely manner.  I apologize in advance for the inconvenience.  

Announcing the Ideal Weight Program

I often receive requests from people asking for my overall perspective on fat loss and health.  I share my opinions here, but they're scattered throughout hundreds of posts, there's a lot I haven't had a chance to write about, and I rarely give practical recommendations.  However, I knew I'd eventually put everything together into a cohesive fat loss program-- it was only a matter of finding the right opportunity.

That opportunity presented itself in 2011 when I met Dan Pardi, a researcher whose work focuses on sleep and food intake, and the CEO of a company called Dan's Plan.  I was immediately impressed by Dan because he stood out as someone with a high level of expertise in sleep and physical activity, as well as someone who has successfully lost a substantial amount of fat and kept it off for several years.

Dan and his team had developed a set of unique and engaging tools for tracking weight, sleep, and physical activity to help people maintain daily mindfulness over the simple fundamentals of health.  These tools are 100 percent free and incredibly easy to use, particularly if you sync them with an electronic scale and step counter.  When synced with these devices, the Dan's Plan website automatically uploads and displays your weight, sleep, and physical activity score, as well as integrating them all into a single user-friendly Health Zone Score that lets you know your overall performance at a glance.  Even if you have no interest in fat loss, I highly recommend using the free tracking tools on the Dan's Plan site-- I do.

In early 2012, Dan approached me about creating a fat loss program for Dan's Plan that incorporates their unique tracking tools.  This struck me as an excellent opportunity to create a diet and lifestyle program that combines sound science with exciting new technology.  Dan and I both brought science to the table, and Dan also brought the perspective gained from working with others to help them lose fat, as well as his own successful fat loss experience.  Dan and I have been working hard on this project, and we're finally ready to launch.

I'm happy to announce the Ideal Weight Program, an effective new system for fat loss and maintenance.

What is the Ideal Weight Program?

The Ideal Weight Program is a unique system for fat loss and maintenance that draws from the latest science on diet, physical activity, sleep, and behavior modification, and pairs it with engaging tools that help you define your goals and meet them.  It keeps you consistently focused on the everyday factors that really matter for fat loss, and gives you the skills you need to make sustainable diet and lifestyle changes.  Based on your own goals and priorities, you can choose one of two diet strategies for the initial fat loss phase:

• The Fat Loss and Sustainable Health (FLASH) diet, an intensive high-protein diet for rapid fat loss.
• The Simple Food Diet, a more flexible diet based on whole, natural foods specifically selected for fat loss.  One important goal of this diet is to teach healthy cooking skills, using recipes and tips provided.

These diets are designed to naturally promote a lower calorie intake and fat loss, without requiring calorie counting.  The Ideal Weight Program also includes important physical activity and sleep components, and explains why these are so critical for fat loss and health.  Dan and I discussed some of the principles underlying the Ideal Weight Program on Chris Kresser's podcast recently.

Here's what you get when you sign up:

• Detailed documents that walk you through the program
• Weight, sleep, and physical activity tracking tools tailored for fat loss
• Simple recipes and cooking tips that work with almost anything in your fridge
• Videos that explain the key concepts behind fat loss and maintenance
• An e-book explaining the scientific rationale behind the program

Signing up for the Ideal Weight Program gives you lifetime access to everything.  We've discounted the initial price, because we want to hear your feedback so that we can continue to improve the program over time.  If you follow the link below, first you'll be prompted to sign up for a basic Dan's Plan account, and once you have your account set up, you'll be able to purchase the Ideal Weight Program:

Ideal Weight Program



Financial disclosure: I will receive a portion of the revenue from the sale of the Ideal Weight Program.  I do not receive revenue from the sale of other products associated with Dan's Plan or the Ideal Weight Program (such as the Fitbit, cooking tools, and other programs).

Food Reward Friday

This week's "winner"... the KFC Double Down sandwich!

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Comment Published in Nature

I recently read an opinion piece by Gary Taubes in the scientific journal Nature, titled "Treat Obesity as Physiology, not Physics", in which he promoted NuSI and repeated the statement that obesity research is a "house of cards" because it focuses on calories in/out, at the expense of studying the "hormonal regulatory disorders" underlying obesity (1).  I wrote a letter to the editor in response to Taubes's commentary, which has been published in Nature (2).

I'm used to seeing these kinds of claims in the popular press at this point, but to see it published in a scientific journal is galling (even if it's in the opinion section).  This is the equivalent of a person who has never held an ax telling a group of lumberjacks they need to focus on cutting trees.  It's part of a disturbing trend of popular writers in the low-carb and Paleo world attacking researchers, and even entire fields of research, they have little understanding of.  Of course this only applies to a minority of the community, but this argumentation style smells of desperation and reflects poorly on the community as a whole.

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Dogs Eating Carbs

Five years ago, I had an interesting conversation with a veterinarian friend about dog food.  We were talking about diabetes in one of the dogs she was treating, and I remarked "that's what happens when you feed a carnivore carbohydrate".  She gave me a funny look.  At the time, I was seeing the world through the low-carb lens, and I remember thinking how bizarre it was that she didn't yield to my impeccable logic.  As they say, live and learn.

The journal Nature published a fascinating paper on the evolution of the domestic dog today (1).  Researchers compared the genome of wolves and domestic dogs to see what genetic changes accompanied domestication.

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Food Reward Friday

This week's "winner"... the Garbage Plate!!

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One Fiscal Cliff Down and Three To Go––But No Real Solution On the Horizon

Last week's deal to avert the "fiscal cliff" settled very little.

For those in the health care market, I will suggest the big takeaway is that we should expect very little will be settled in the coming months and we will continue to face a great deal of uncertainty for years to come.
Without an agreement to alter the course we are on, it is estimated that we will add more than $10 trillion to

Appearance on "Ask the Low-Carb Experts" Podcast Postponed

I was scheduled to appear on Jimmy Moore's show "Ask the Low-Carb Experts" this Thursday.  I don't consider myself a low-carb expert, but I do have expertise in obesity and metabolism, and Jimmy had invited me to discuss these topics on his show.

Due to a confluence of events, I've decided that this is not the best time to do the show.  I want to be clear that I don't intend this as a rebuke of Jimmy Moore or his show-- most of my reasons for postponing have nothing to do with Jimmy.  Thanks for your understanding.

Overfeeding and Elevated Insulin

It's commonly accepted in the obesity research community that fat gain causes insulin resistance and an increase in circulating insulin, and that this is a major reason why obese people usually have insulin resistance and high circulating insulin. Part of the rationale is that substantial fat loss by almost any means improves insulin sensitivity and causes circulating insulin to decline, and substantial fat gain from deliberate overfeeding causes insulin sensitivity to decline and circulating insulin to increase.  I recently cited three references to support this contention on another blog, and was challenged, so I decided to revisit these references to make sure I had understood them correctly (1, 2, 3).  Since I took the time to do this, I figured I may as well write it up for my readers, since these studies are quite informative.

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Food Reward Friday

This week's "winner"... the Heart Attack Grill's Quadruple Bypass Burger!

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Extreme Flu Activity in the US

A friend of mine came down with a nasty flu recently.  I checked Google Flu Trends, and found that flu activity is currently at "intense" levels throughout the US.  This is the highest flu activity Google Flu Trends has recorded in the last six years (image from Google Flu Trends 1/3/12).

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