Sunday, August 25, 2019

Retrospective #190: “Can (sic) I ask you a personal question?”

I walked up to the bar at the jazz club to get a refill, and a woman in her 40s, sitting at a nearby table with her mother and her mothers friend, struck up a conversation with me. I engaged the brazen (lonely?) hussy, gave her my “business” card (“The Nutrition Debate”) and began immediately to proselytize about Very Low Carb eating. She indulged me, with indifference bordering on insouciance, and then said, “Can I ask you a personal question?”
Two thoughts crossed my mind: How much had she had to drink? And why am I feeling on the defensive? Anyway, I said “sure.” It could be interesting, and, as my readers know, I do not guard my health and medical privacy. I am thrilled to share the news about how changes in what I eat over the last 17 years have transformed my health.
I wont repeat all the statistics here. For new readers, though, I have been a Type 2 for 33 years, and 17 years ago I weighed 375 pounds. After changing what I ate from the Standard American Diet (“balanced” and very high in carbs), I lost 170 pounds, my blood glucose went from “uncontrolled” on 3 oral meds to “well-controlled” (“non-diabetic”) on a minimum dose of Metformin. My cholesterol also improved very dramatically, my blood pressure improved (on fewer meds) and my inflammation marker also dramatically improved. So, I said, “Ask away!”
To my surprise, she asked, “How can you drink on your diet?” Relieved, I went into a boring explanation of how many carbs are in 2 glasses of wine (my “limit”), how much ethyl alcohol, etc. It must have sounded like a rationalization, but she was satisfied. Short answer: I am not an ascetic; I am a hedonist. I do not eat (or drink) to survive; I eat and drink for pleasure. Bottom line: I had better like what I eat (and drink) or 1) I wouldn’t like doing it and 2) I wouldn’t be able to do it indefinitely as a “lifestyle change,” which is needed if I am to succeed long term.
This is not just about my former glutenous and bibulous lifestyle. It’s true I had to change what I ate to save my health. But I am not an ascetic, so I had to find an “alternate” lifestyle with equal or greater gustatory rewards. Eating is not a volitional thing. This is about a driving force that controls the urge to “consume food just for pleasure” and not just to “maintain energy homeostasis.” This is called “hedonistic hunger.” Im not making this up.
I had just read an article in the Journal of Clinical Endocrinal Metabolism titled, “Hedonic eating is associated with increased peripheral levels of ghrelin and the endocannabinoid 2-arachidonoyl-glycerol in healthy humans: a pilot study.” The story line: the hunger hormone (ghrelin) and opioid receptors in the brain regulate eating behavior based on palatability. Its not will power, folks. So, the “trick” to sidestep cravings is to transition from a high-carb dietary, engineered by processed food manufacturers for maximum palatability, to an equally hedonistic lifestyle based on energy homeostasis. Eat for pleasure, but just enough to be healthy. The key is to avoid feeling hungry.
Cravings, as we know them, are signals from the stomach (ghrelin) and the brain (hypothalamus) telling us to eat. The signals are, frankly, sometimes almost impossible to resist. Our response: to eat low energy density foods (carbohydrates) with high palatability. But, if you eat a breakfast that enables you to go all day long without feeling hungry, because your blood glucose has been stable all day long, you will not have hunger cravings.
The body will regulate energy homeostasis using different mechanisms. You body is “happy” to burn body fat for energy if you dont eat carbs. It is designed to work that way. We didnt evolve eating “three squares” a day. We ate “catch as catch can” and sometimes went days working off stored energy from a previous feast. It’s natural.
This PubMed Abstract concludes: “The present preliminary findings suggest that when motivation to eat is generated by the availability of highly palatable food and not by food deprivation, a peripheral activation of two endogenous rewarding chemical signals is observed. Future research should confirm and extend our results to better understand the phenomenon of hedonic eating, which influences food intake and, ultimately, body mass.”
I always ate for pleasure, but I was hooked on carbs. I craved carbs; now, I still eat for pleasure, but I am not craven. I eat foods that satiate (fat and protein), and so I am not hungry between meals. In fact, I often skip lunch. 

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