Dieting ain’t no picnic…or is it?

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“You can live to be a hundred if you give up all the things that make you want to live to be a hundred.”

– Woody Allen

Perhaps one of the first lessons we learned in life is that everything we enjoy is bad for us. In a juvenile utopia, an ice cream breakfast would be considered the most important meal of the day. As we mature, we begin to make peace with denying ourselves what we want for what we ought to do. We begin to make more healthful choices of our own volition as we age. It’s called being responsible right?

But why do we sacrifice instant gratification for some uncertain promise of more birthdays? Aside from the grander goal of self-improvement, there is another drive that is at work in our daily decisions.

Weather we realize it or not, we don’t really make healthy decisions out of fear of an early demise. A successful “dieter” acquires information over time from the subjective experience of their food and activity choices. Consciously or not, they begin to sense the subtle improvements on how they feel as they make more healthful decisions in their daily life.

We’d like to think we are self-disciplined enough to proactively delay gratification simply because we know it’s what we should do to live a long time. We pride ourselves for our triumphant displays of will-power and self-discipline. Deep down in our hearts, however, we know that tomorrow is not promised to us. Try as we may, we can not let go of the fact that we don’t know if we will meet our maker because of our sweet tooth or because of a drunk driver. When presented with each individual culinary tempation, each possibility seems just as likely.  And so we enter this internal struggle between what we want to do and what we ought to do…..

…and it’s no picnic.

PIC/NIC and the ABC’s of behavior modification

The business world has utilized a theory of behavior modification simply referred to as A-B-C. The letters stand for antecedents, behaviors and consequences. Simply put, it’s a theory that explains motive for behavior in the context of not only the observable action (behavior) but also the circumstances before and after the action. With the additional identification of these antecedents and consequences, the behavior modifier can categorize any given system of A-B-C’s for the purpose of predicting adoption of behavior.

A simple example is that if the antecedent is the offer of a raise for improvement of sales (more sales is the desired behavior) than the subject is to expect a positive (P), immediate (I) and certain (C) consequence. Such a situation (PIC) has a high likelihood for an increase in behavior. Change that positive (P) to a negative incentive, or punishment (N) and you have a NIC situation. An observable reduction in behavior can be expected under NIC circumstances.

Health choices are rarely either PIC or NIC because the consequences, positive or negative, of eating right, exercising and staying away from toxins, are rarely immediate. What’s worse is the consequences of making healthy decisions are not only mostly in the future but they are relatively uncertain in nature. If you are a lifelong smoker, it’s not exactly guaranteed that cutting back or going cold turkey will buy you x amount more years of life. The same is true with each menu selection when you are out to eat with friends. Each individual decision to pass on dessert and spend a few extra dollars on organic carries with it very little certainty that it will be of very much consequence, one way or another. This is why we are able to rationalize every one of our dietary indiscretions away with the infamous words, “everything in moderation”. But what would happen if the ill effects of unhealthy decisions were much more immediate and certain?

Image: Alli

Long before we were graced with horror stories of stained sofas and clothing, I fantasized about a candy bar that would taste great but immediately induce a stomach ache. Aside from some masochists out in the market, this would allow consumers to condition themselves to pass on that 2pm trip to the vending machine for a sweet and salty snack. The message we would learn is that the acute pain experienced immediately after consumption is proportional to the low-level, chronic pain and stress we inflict on ourselves by eating junk food.

What?..pain from eating junk food?…chronic stress?…

Yes, you heard me. Junk food causes acute injury to your body. It is just on such a subtle level that it goes unnoticed. This injury occours as inflammation in the blood vessels (amongst other places in the body). Dr. Dwight Lundell paints a rather vivid picture of this process:

Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. you kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.

read more about this from Dr. Lundell here.

Senseless eating

I remember a patient story from one of my professors of Ayurveda. He was describing to us, the importance of being present and conscious of our food when we eat. He described the typical middle-aged, overstressed American male who came to him for help. He had nothing clinically wrong with him and was given a clean bill of health by his primary car doctor. He just wasn’t feeling 100%. Dr. Suhas conducted a normal intake interview and realized the man would need help in many areas of his life. The one assignment he gave to the man was to stop his lunchtime ritual of eating in his car. The man routinely ate lunch on the go. Needless to say, he ate fast food almost daily. He rejected Dr. Suhas’ first recommendation to eat a home cooked meal for lunch because he couldn’t imagine life without a cheeseburger. Dr. Suhas retreated and simply advised that he eat his cheeseburger in a quite place with few distractions.

The man did so and returned to Dr. Suhas to report that he was astonished to discover that he didn’t really like the taste of cheeseburgers. Consciously eating, chewing and truly tasting the cheeseburgers brought the man to find that he actually wasn’t too crazy about cheeseburgers. He had also been sensitized to the way the food made him feel afterwards. Having cleared his mind from other distractions, he allowed himself to feel the negative, immediate and certain consequences of his dietary decisions.

I recently became even more convinced that consciously consuming good food can overpower our attraction to junk food once we are sensitized to how it makes us feel. My daughter is the most picky eater (I’m sure she isn’t that much different from most 9-year-old girls). She recently came to me with a request after a particularly hectic week. My wife and I didn’t make it to the market that week so it was dinner in a bag for a few days straight. My daughter asked, “can we have real dinner tonight? I don’t feel sick but I’m just not feeling right.” I couldn’t have been more proud and ashamed simultaneously. I was elated that my little girl knew her body well enough to listen to its cries for real nutrition but I was upset that we had allowed distraction to keep us from putting real sustenance on the table during that week. Now that we know she’ll let us know when she is nutritionally deficient, we don’t fuss so much over the nightly struggle with her to finish her vegetables.

The same sensitization to the NIC consequences is possible in the positive direction (PIC). Once we limit our distractions and pay attention to what we eat and how it makes us feel, we disprove Woody Allen’s assertion that the things that are good for us are also not enjoyable. Good food makes us feel good. I’m not talking about all the rice cakes and soy milk the industry tries to tell is health food.  I’m talking about real food. Food like your great-grandparents used to eat. There was no such thing as “diet food” 50 years ago; there was just food.

Diets do not have to be agony. Once we stop listening to what others tell us is healthy and start listening to our genes and our bodies, we can find our optimal diet while not sacrificing gustatory delight. The key is to resensitize ourselves to be able to hear our “body language”. That very subtle feedback we get when we make good decisions and consequently feel great can be leveraged as a powerful motivator for future behaviors. This is at the heart of wellness. The state of wellness is not simply absence of disease. It is thriving at your full potential and harvesting all the fruits of your labor.

Caloric Bargaining

Caloric Bargaining

Caloric bargaining

These stairs in Norway attempt to make the point that if you take the stairs, you may enjoy the extra calories in regular Coke. Seems counter productive for Coke to remind us that one is bad for us and the other is supposedly better (Movers don’t do “diet” drinks either). The beauty for Coke is that rather than reminding us that we shouldn’t be drinking sugar sweetened beverages, they show us that we deserve the reward for completing our activities of daily life. It’s bad enough when we binge after a workout because, “we deserve it” but now we’re giving ourselves “calorie credits” for taking the stairs.

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The Great Ca Calorie Count 2011

A menu at a McDonald’s drive-through window in New York, calorie counts included.

Ed Ou/Associated Press

It has been in effect for almost half a year and many Californians still don’t know what to make of the calorie labeling law.  It seems that more people were up in arms when municipal officials in New York City and San Francisco passed more surgical laws aimed at sugar sweetened beverages and kids meals respectively.  There was a lot of debate going around about personal liberties and other TEA Party ideals, and all that was at stake was the prospect of switching to diet soda and swapping apple sticks for your french fries.

It seems this grand-scale food labeling law was passed and implemented with nothing more than a collective, “hummmmm” as we let these ubiquitous nutritional qualifiers rain all over our lunch-time parades.  I find myself balking at the 4-digit figures on the rare occasions the forces of nature drive me to such an establishment.

Lawmakers and Public Health officials hope that they can lead us to make better choices about our food through, quite literally, “in-your-face” caloric content labeling.  I hope they can, however, even before the latest behavioral studies started trickling in, I had my doubts about the success of this tactic.  Ok, I can’t lead you to believe my doubts were purely intuition and professional prowess.  The sad fact is that New York City has already had a similar law in effect for nearly two years.  So why would CA attempt to pass it across the State after sad reviews from New York City?  Four silly little words that has the power to concentrate more hubris then you’ll find in a back alley pissing contest behind some Texas roadhouse:

More Research is necessary…

Gee, wouldn’t it have been nice to do the research, then pass the laws?  I can tell you right now that even after we spend millions of tax dollars on self-evident research, I will still not incorporate this public calorie count tactic in to the Movement for Wellness.  Food is a very personal thing and needs to be addressed in a highly specific manner.  I applaud those government officials responsible for this law for being progressively minded in that they are looking for ways to improve our overall health using the means available to them.  My regret is that this broad-brush health promotion directs the conversation to a place where we find ourselves stumbling over decisions that in the (rear) end, are of little consequence.

Knowledge ≠ Behavior

I can remember in school, just as we were awakening from the overly romanticized dream of getting an education and being promised the world at our fingertips, our professors would periodically try to pump us up with a little study-related pep-talk.  Being an Exercise Science major, I often heard such studies cited that correlated level of education with longevity and quality of life.  I remember thinking, “If knowledge equates to better health, why are we not doing a better job at spreading the word as a society?”.

The truth is that leading a person to approach their everyday health decisions armed only with a slew of numerical goals and limits reduces the human being to a Newtonian closed-system machine subject only to the ancient physics of yesteryear.  Our relationship with food is one of both emotion, quantum mechanics and finally caloric consumption.

Few scientists have explained this truth better than Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology.  In his very long and comprehensive lecture titled Sugar: The Bitter Truth, he explains how we obsess over our intake and expenditure of energy when it comes to our diets.  As a specialist of the hormones, Dr. Lustig asserts that when it comes to our food having an impact on our body shape, it’s not the amount of calories that we should worry about; however we should worry about how our body responds on a hormonal level to the type of food we ingest.  The new fixation on calories takes us even further than we already are from the true focus according to so many ant-obesity researchers such as Dr. Lustig.

New loop-holes

It goes without saying that with new legislation comes new possibility to cheat the system.  When the public is lulled in to a false sense of security and they abdicate all of their food consumer responsibility to the suits in the FDA, USDA, NHS, et al., it creates open season on the public for the wiley marketing teams and media manipulators in the food industry.  This has been at work for quite a long time.  How else did we get to a point where we down Anti-oxidant soda, and stuff ourselves with sugary “low-fat” treats in the name of making healthier choices.

Childs Play

Keep in mind that adults are not the only ones exposed to these new social eating norms.  Children learn what is valued in their society by their keen sense of observation.  As they see adults torture themselves over indulging in a calorie-dense meal, they’ll learn to largely base their food choices on caloric values.  Children should be taught to maintain their innate sense of intuitive eating.  Sure we need to limit their affinity to the sugary and salty but they certainly do not need to inherit our obsession with calorie content over quality of food and eating that truly matter; food, farm and family.

Jamie Oliver is on the right track when he partnered up with a Los Angeles fast food restaurant in his latest season of Jamie Oliver’s Food Revolution.  One of the first questions he asks the owner of the restaurant is, “do you know where your food comes from?”.  It’s sad to hear that the well-meaning guy only stumbles as a response and mentions a guy…in a warehouse…downtown somewhere.  These are the questions we should demand get answered by those who feed us; not the caloric value rather the integrity of the product itself.  Get back to basics and as my good friend Sean Croxton of Underground Wellness says, JERF!…….Just Eat Real Food!