Your Brain on Potato Chips

Wednesday, February 27, 2013
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

Monday, February 25, 2013
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

Friday, February 22, 2013
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

Thursday, February 21, 2013
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

Tuesday, February 19, 2013
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

Sunday, February 17, 2013
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

Friday, February 15, 2013
This week's "winner"... the Banana Split!

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Food Reward Friday

Friday, February 8, 2013
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

Tuesday, February 5, 2013
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

Monday, February 4, 2013
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

Sunday, February 3, 2013
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

Saturday, February 2, 2013
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

Friday, February 1, 2013
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.


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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