Mary-Jo Murphy, MS, RN, CDE, certified diabetes educator
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You Go To My Head

3/28/2012

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YOU GO TO MY HEAD

The research of Randy J. Sheely, PhD, the recipient of the Outstanding Scientific
Achievement Award at the 2009 American Diabetes Association meeting, tells us that our excess weight goes to our heads. Fat cells talk to our brains.

Humans have evolved to grow and protect those fat cells, but we used to have an on and off switch when it came to appetite. For millions of years we homo sapiens ate when we were hungry, and when we sensed we were full, we stopped. Of course, some of us ate too much or too little now and then, but mostly our brains got the signal from our hypothalamus to regulate our appetite and therefore our food intake. Recently scientists discovered that the hormone leptin was in charge of this function.

So, you're thinking, why can't I just make myself a big pot of Leptin Soup and be done with it?

Well, let's go back 150,000 years to a time when food could be scarce; when a caveperson with tendency to hold onto weight was at an advantage. Appetite was a driving force. Mornings would find hungry, hairy guys gathering around the fire pit. After a strong cup of boiled roots, our ancestors would head off to pursue the kill.

While they were gone, the cavewomen would gather fruits, grubs and berries. As they'd sort the day's harvest, they'd chat about potential mates. The first to be eliminated from the dating pool were any skinny, picky eaters.

If the hunters didn't become prey, the setting sun would find them silhouetted against the orange sky. The tribe would look with ravenous anticipation, as the tired guys would drag in, often empty handed. Root and berry gruel again!

Imagine after nuts and grubs for weeks maybe months on end, a mastodon finally found its way onto the campfire. This was not a one-bite-at-a-time event. Everyone gorged themselves. They were expected to. They sang, danced and flirted; maybe for the next few days, until slight twinges of hunger reminded them it was time to be off pursuing another major meal.

Fast forward to 2012, where a fast-food restaurant sits on every corner; hundreds of kinds of chips tempt us at the convenience store. A root or berry can't compete. And
here we are, the product of natural selection, still programmed to be famine-resistant.

Can we resist? Is this desire for more of a good thing all in our heads? Dr. Sheely tells us, yes. The changes in our diets in recent decades have reprogrammed millions of years of evolutionary advantage.

We feel like we're starving, he explains it's because the high fat foods we often prefer interfere with the signals to our brains. When we've finished the equivalent of a wooly mammoth meal, we still pursue the next delicacy with craving, longing and yearning, as if the survival of our species depended on it. He says this response is not part of our evolutionary direction. Our brain function has actually been altered by what we eat.

Former FDA commissioner David Kessler, takes it a step further and says we are the targets of a food industry campaign. The hunter, the consumer, has become the prey.

In his book, The End of Overeating, he contends that foods containing fat, sugar and salt stimulate the brain to release dopamine, which for humans feels like pleasure. How
about chocolate covered bacon? I saw it at the Ventura County Fair. Yum!

He tells us we feel emotional relief when we eat foods rich in these three. And we create pathways in our brain that make us want more. At the mere thought, we're making a plan. Deprivation only intensifies the desire for the hunt.

Kessler also says that 15% of the caveman's descendants are immune to this planned conditioning by the food industry. He proposes more research to find out why some are so blessed.

Researchers are already trying to find out why some people, even though they have high levels of leptin, are resistant to the effects of their body's beneficial hormone. Heredity
verses environment? Or a little bit of both?

I once heard a story about a woman who was trying desperately to lose weight. At the same restaurant where she would sometimes eat, was another woman. While one
would order salads the other always indulged in a hamburger, fries and a shake. She was annoyingly skinny, clearly a mutation of the evolutionary process.

One day the weight-conscious woman confronted the gorger, "I'm starving myself trying to lose weight. Every time I see you in here, you're eating like this! How do you stay so slim?"

"Well," she dipped her fry in ketchup, "I only do this once a week. It's my reward for eating healthfully the other six days."

An evolutionary idea?


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Hindsight, Foresight and Insight

3/16/2012

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Heredity and environment influence health. The first is our inheritance, the second our investment. Luck also plays a part.


Recently while having my teeth cleaned, the hygienist delivered this line, “Let me guess; you don’t floss very often.”

I indicate that I have something to say. She retrieves her fingers. (Lucky for her) I peer into her friendly eyes, thinking of how much I invest in this project of trying to keep ahead of my receding gums.

“If I miss one day all year, that’s unusual.” I take a deep breath to calm myself. “And I have my teeth cleaned every four months,” I continue. “This gum disease is hereditary,” I say with emphasis as I close my eyes, lie back and open my mouth, willing myself to be more pleasant.

I should be, because the truth is I have that same urge to make observations and assumptions and the same compulsion to offer anxiety-provoking advice.

After the polishing phase, she encourages me to continue my “good habits,” but warns that my gums aren’t likely to last through old age without some surgery.

I thank her, and on the way out make an appointment for early summer. Driving home I feel discouraged. I am doing all the right things and still my heredity has dealt my poor gums a deathblow.

As we gallantly try to keep one step ahead of our genetics, ours health care providers may offer advice we find less than inspiring.

I get it, and I’m afraid my very competent hygienist does too. Some of our health problems are a combination of bad genes and bad luck. But not all of them. Our job is to sort out the difference and push in a positive direction.

We may be carrying around Grandma’s pancreas, Grandpa’s blood vessels, Dad’s weak lungs, Mom’s waistline and Aunt Lizzie’s gums.When it comes to health we should consider our heredity. But if you are a little short for your weight, you might also consider your environment, in other words the things over which you do have control.

We all have heard accounts of someone who was overweight and lived a long life; someone who smoked daily and lived to be 100; someone who drank excessively, never wore a seatbelt, ate burgers, never wore sunscreen, never flossed and had a long, healthy and toothful life.

Even though they gambled and beat the odds, I think my hygienist and I would agree that these people shouldn’t be role models.

Last year, while waiting for Crazy Heart to start, I sat in the darkened theater and watched Kirsti Allie promote her new show. First she gained 75 pounds, then lost it, then gained the 75, plus a few more.

Mark Twain said, “Losing weight is easy. I’ve done it hundreds of times.” Dr. Walter M. Bortz II, MD in his piece in Diabetes Wellness News, February 2010, reminds us that Jared Foyle, the “Subway Boy,” publicly lost 145 pounds on his sandwich diet. He continues his campaign to eradicate childhood obesity, but he too has relapsed. In a past issue of Endocrine Today, Dr. George Bakris, observes that, “all long term studies demonstrate that weight loss can be maintained for six to nine months, but after one year there is regression to the mean.”

What he’s trying to tell us is that when our weight yo-yos, our bodies get programmed to go back to some midpoint between our high and our low. Our set point creeps up, whether we are Oprah or Kirsti. Weight gain after the original loss is not surprising. Nor is nicotine relapse, even if you are the president.

People who succeed at any goal go slowly. They understand that maintenance after the initial push for change is the most important part of the process. They embrace the concept of progress not perfection.

When the movie finally came on, there on screen was Jeff Bridges, playing a BMI challenged, chain-smoking, hard-drinking country singer, a guy whose environment has gotten the best of him.

After an auto accident, (in which he wasn’t wearing a seatbelt) his doctor has a 20 second, change-or-die, heart-to-heart talk with Bridge’s character, Bad. Within 60 seconds, Bad, is back to his old ways. No surprise to me or likely to my hygienist.

I love stories of redemption! I won’t ruin the movie for you, except to say that Bad has an epiphany.

During this month of the wearin’ of the green, when we wish for a pot of gold at the end of every rainbow, I wish for epiphanies, and offer you sentiments that came my way during a trip to Ireland a few years ago.

May you have the hindsight to know where you’ve been, the foresight to know where you’re going and the insight to know when you’ve gone too far.

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