Hunger Signals Are Linked to Brown Fat

“Is it hot in here?”

That would be me asking, the day after I overate. I could literally feel the extra calories leaving my body as heat. My brown fat must be up to snuff, probably because I exercise and I don’t “weight cycle” (loose weight and regain.)

Brown fat (also called BAT, brown or beige adipose tissue) is a new critical determinant of energy expenditure. BAT seems to be an endocrine organ that influences metabolism. Aaron Cypess, M.D., a metabolic researcher from the Joslin Diabetes Center, explains that 54% of the variation in metabolic rate correlates with an individual’s activated brown fat. Wow! Maybe it’s time to retire the Harris–Benedict Equation and other formulas that predict basal metabolic rate.*

Last week, I wrote an article about new brown fat research for DietsInReview.com. In my opinion, the research links a healthy supply of brown fat to “intuitive eating” – in mice.
See my article, and the TIME magazine report, that got me thinking.

Your thoughts: Do you love brown fat as much as I do?

* Basal Metabolic Rate:  The rate at which energy is used by an organism at complete rest, measured in humans by the heat given off per unit time. It is expressed as the calories released per square meter of body surface per hour. 

What Ever Happened to Gluttony?

When I was a full time nutrition counselor, I remember a day when I saw two women who each gave me pause to consider. With both, the conversation was about when to stop eating after the start of a meal. The first woman, an English war bride, shared her granny’s advice: “Always leave room for one pancake.” (What? Wow! Brill…) The second woman, from Lebanon, said the Qur’an advises: “Eat with one third of your stomach and drink with one third and leave one third of your stomach to breathe so that you may think.” On a Hunger-Fullness level scale of 1 (empty) to 10 (stuffed), they were saying to stop eating at around 7.5 or 75 percent full.

Eat and Drink but Not to Excess

The Qur’an recommendations got me to thinking about religious rules pertaining to overeating. Not that I am promoting any one religion because I’m the “spiritual but not religious” type. Nor am I condemning those who binge-eat emotionally. God knows, they suffer. Rather, I don’t know why we’ve forgotten the long traditions warning us not to over eat. (7-Eleven Double Gulp at 50 ounces, I’m talking to you.) Let’s consider these words of admonition against gluttony:

  • “And do not get drunk with wine, for that is debauchery, but be filled with the Spirit….” (Ephesians 5:18)
  • “And put a knife to your throat if you are given to appetite.” (Ephesians 5:18)
  • “Have the wisdom to show restraint.” (Proverbs 23:1-4)
  • “Eat and drink, but avoid excess…”  (Taha: 81)
  • Do not overeat, over drink or over indulge in sex. (Rules of Hinduism)

Your thoughts: There must be more. Share your religious truths about overeating.

How I Use Calories on the Menu

Yesterday, at a rest stop in New Jersey, standing in the combined line for Cinnabon, Popeyes and others, waiting to pay for the blueberry-granola-and (un)real yogurt that I always get, I spied a “MiniBon” roll and mentioned that, calorie-wise, it was better than the classic. (The Cinnabon Classic has 880 calories, while the Minibon has 350 calories per roll.)  My daughter and the woman standing ahead of me, both in their 20s and of slim/normal weight, admitted they had no idea of the number of calories they need. Neither one seemed the worse for the lack of information, but I gave them a tiny lesson on calories (and told them never to “diet.”)

Later that night, I read this on the Intuitive Eaters Professionals Group on Linked-In:
“The other day I went to a restaurant for lunch with friends and was surprised to see calorie counts next to each menu item. My friends, both fairly health conscious “normal” eaters, didn’t seem to mind, but did remark on the counts. I was bothered because I found that the counts drew me away from eating intuitively and back to my days, half a lifetime ago, of dieting. I had to force myself not to look at them and then was okay. My question is: Are menu item calorie counts helpful or not? Might they be useful for different populations, i.e., okay for “normal” eaters who want to eat more nutritiously but not so much for anyone who leans toward dis-regulated eating?”

Calories on the Menu

Expect to see calories on the menu in restaurants with 20 or more outlets as part of the Affordable Care Act upheld by the Supreme Court last week. Restaurants and movie theaters must post calorie information on menus, menu boards, and drive through displays, and provide written information about total fat, saturated fat, cholesterol, sodium, carbohydrates, sugars, dietary fiber, and protein upon request.

For people like my daughter and the woman in line, the information will be meaningless, but for others, it may be extremely informative or downright disconcerting. As a longtime registered dietitian, intuitive eating practitioner, and former dieter over thirty years ago, I think a “calorie information free menu” should be available to anyone upon request, no questions asked. (Heaven forbid the Affordable Care Act returns to the Supreme Court for alleged “actual harm” coming from calories on the menu!) Anyway, I live in New York City where calories have been on the menu since 2008. Real-world studies show that, as a public health intervention, it has only a modest reduction or no effect in the calories purchased by customers. In time, the issue could be a moot point.

For what it’s worth, this is what I told my daughter and the woman in line about how I approach calories on the menu:

  • Women need about 2,000 calories a day and men need around 2,400.*
  • When the calorie count is high – say greater than 20% of the daily total or 400 calories – look askance
  • Decide if the extra calories are from too much wholesome food or from “empty calories” full of added sugar and/or animal fats but with negligible nutrients.
  • For wholesome food, I split the serving with my companion or carry away half, and for empty calories, I decide if I love it enough and have to have it right then. (Luckily, I’m not impulsive.) If yes, then I have it; if no, then I skip it. But if I were to feel guilty or otherwise, awful, I’d ask why and think of it as a growth opportunity.

Righteous indignation seems to fuels me. You can’t get me to eat most of the crap sold in American chain restaurants. I don’t value filling my body with junkie food. I am attracted to fresh food well prepared, mostly by me. Usually, I’m sated at don’t care about dessert. If I really want dessert, then I eat it only a little at the meal.

Your thoughts: What do you think about calories on the menu?

*To find your calorie requirements, use this chart from the government or use a calculator fromany one of the online diet websites.

Are You An Intuitive Eater? Take the Test

I am finishing up my presentation for the Women’s Health and Fitness Expo on Saturday in Kingston, NY. Lucky me! I get to go to Rhinebeck, a place where fairies flower-bounce in the glade. (Ahem, back to work.) I’ll be speaking on behalf of Diets In Review, discussing intuitive eating, the only weight loss method that makes any sense to me. I’ll be using a scale (questions – not a device for measuring weight) to portray the mindset of an intuitive eater vs. a traditional dieter. Take a look and see.

This Intuitive Eating Scale has pretty good questions, but it is by no means the only test in town. I’m not even using it correctly, insofar as it is meant to be a Likert-type scale (rate your answers from strongly disagree to strongly agree), not a True or False test. But, the way I see it, all incorrect answers call for some soul-searching. Like many research tools, this scale has been validated for Caucasian, middle-class, healthy, normal weight college students. Still, the level of agreement is highest for non-dieters (individuals at peace with food).

Take the Test
The correct answer is always “yes” except when (R) is present, when the correct answer is “no.”

  1. Without really trying, I naturally select the right types and amounts of food to be healthy.
  2. I generally count calories before deciding if something is OK to eat. (R)
  3. One of my main reasons for exercising is to manage my weight. (R)
  4. I seldom eat unless I notice that I am physically hungry.
  5. I am hopeful that I will someday find a new diet that will actually work for me. (R)
  6. The health and strength of my body is more important to me than how much I weigh.
  7. I often turn to food when I feel sad, anxious, lonely, or stressed out. (R)
  8. There are certain foods that I really like, but I try to avoid them so that I won’t gain weight. (R)
  9. I am often frustrated with my body size and wish that I could control it better. (R)
  10. I consciously try to eat whatever kind of food I think will satisfy my hunger the best.
  11. I am afraid to be around some foods because I don’t want to be tempted to indulge myself. (R)
  12. I am happy with my body even if it isn’t very good looking.
  13. I normally eat slowly and pay attention to how physically satisfying my food is.
  14. I am often either on a diet or seriously considering going on a diet. (R)
  15. I usually feel like a failure when I eat more than I should. (R)
  16. After eating, I often realize that I am fuller than I would like to be. (R)
  17. I often feel physically weak and hungry because I am dieting to control my weight. (R)
  18. I often put off buying clothes, participating in fun activities, or going on vacations (hoping I can get thinner first). (R)
  19. When I feel especially good or happy, I like to celebrate by eating. (R)
  20. I often find myself looking for something to eat or making plans to eat—even when I am not really hungry. (R)
  21. I feel pressure from those around me to control my weight or watch what I eat. (R)
  22. I worry more about how fattening a food might be, rather than how nutritious it might be. (R)
  23. It’s hard to resist eating something good if it is around me, even if I’m not very hungry. (R)
  24. On social occasions, I feel pressure to eat the way those around me are eating—even if I am not hungry. (R)
  25. I honestly don’t care how much I weigh, as long as I’m physically fit, healthy, and can do the things I want.
  26. I feel safest if I have a diet plan, or diet menu, to guide my eating. (R)
  27. I mostly exercise because of how good it makes me feel physically.

Your thoughts: How did you do? What do you think of the questions?

My Intuitive Eating “Aha” Moment

On LinkedIn, I am a member of the Intuitive Eating Professionals Group, where Evelyn Tribole, MS, RD, group founder, asks us to “share something…that is not included in your profile, perhaps an “aha” moment in your career.”  I am inspired to share my “aha” moment after attending the BEDA (Binge Eating Disorder Association) national conference on Saturday, where I learned that, treatment-wise, not much has changed over the years.

In 1985, I worked in a large gastroenterology practice affiliated with a teaching hospital. I saw lots of eating disordered patients because one of the docs did medical evaluations of patients with bulimia and AN. At the same time, another gastroenterologist performed a procedure with a device called the Garren-Edwards Gastric Bubble. A deflated ‘bubble’ made of stretchable plastic (like a pool toy) was placed by endoscopy in the stomach of a severely overweight patient.  With the pull of a cannula, the bubble was inflated and left in place to fill the stomach while the patient followed a low-calorie diet. That’s where I came in. The bubble was developed by a team at Johns Hopkins. It was all above the board. The hospital asked us to do the procedure, but we stopped after a patient got a small bowel obstruction from the bubble. Those were interesting days. My patients’ eating patterns were all over the map.

But my “aha’ moment came by way of a patient referred by an internist for a simple weight loss diet.  She was a favorite patient, a young woman of my age, overweight but far from obese, with my mother’s maiden name. We were doing the balanced, flexible diet thing with a focus on behaviors when one day, she looked at me and said, “Mary, you don’t understand. I peek behind the curtain, and when my husband drives away, I make a batch of scalloped potatoes, and I eat the whole thing.” Aha! I thought, “they didn’t teach us this in school.” And then I thought, “this is really real.”

I was lucky because psychologists who specialized in EDs would stop into  the office. They turned me on to Susie Orbach, Fat Is a Feminist Issue (1978); Geneen Roth, Feeding the Hungry Heart (1982) and Breaking Free from Compulsive Eating (1986) and, of course, Hilde Bruch. Evelyn’s book, Intuitive Eating (1995), wasn’t published yet and there was no Gurze catalogue. But, I read and read and saw lots of patients, and attended Geneen’s workshops,  consulted with therapists, and taught others how to do it. And now it’s wonderful to see so many dietitians espouse the non-diet approach. But, after all those years, the pills, shakes, meals, stomach stapling (but not swallowing pool toys) are all still here.

Your thoughts: Why don’t more people give up dieting and follow a non-diet approach?

A Reading List for Yo-Yo Dieters and Emotional Eaters

I am happy to report that my online nutrition counseling practice is taking off. And the best part is that I get to work with my favorite patients/clients/customers: yo-yo dieters and emotional eaters. They are the folks that don’t feel good about their weight and the way they eat. A history of traditional diets knocked them off their natural course and, for many, childhood trauma had a role. Their weights cycle up and down because, unfortunately, diets make you fat. My job is to help them get off the wobbly track and back into the groove. It doesn’t matter if they have a medical condition; everyone has a personal best. When they stop dieting and their weight no longer cycles, better health always returns.

My Favorite “How To” Books for Intuitive Eating

Evelyn Tribole and Elyse Resch, two registered dietitians, wrote the 1995 classic, Intuitive Eating, that gave a useful name to the “non-diet” approach. The approach uses physical and emotional feelings (and knowledge) to guide intake and rebuild pleasure in eating. The mindset can be learned, especially with the help of a skillful teacher, and so to understand the ins-and-outs of intuitive eating, I always ask my yo-yo dieters to read at least one of these excellent books:

When I asked the LinkedIn Group of Intuitive Eating Professionals to recommend their favorite books, they also suggested books that address self-acceptance, self-care and spirituality, essential issues of breaking free. Here are some of the books for emotional eaters that they recommend:

Your thoughts: Which books help you to a healthy life and eat with joy?