Tuesday, June 28, 2011

Food Reward: a Dominant Factor in Obesity, Part VII

Now that I've explained the importance of food reward to obesity, and you're tired of reading about it, it's time to share my ideas on how to prevent and perhaps reverse fat gain.  First, I want to point out that although food reward is important, it's not the only factor.  Heritable factors (genetics and epigenetics), developmental factors (uterine environment, childhood diet), lifestyle factors (exercise, sleep, stress) and dietary factors besides reward also play a role.  That's why I called this series "a dominant factor in obesity", rather than "the dominant factor in obesity".


Nevertheless, the more I read, the more I'm convinced that excessive food reward and/or palatability is the elephant in the room when it comes to obesity and metabolic dysfunction.  We live our lives surrounded by foods that are professionally crafted to satisfy our basest gustatory desires-- to drive us to eat more, against the wisdom that our bodies have accumulated over millions of years.  They do this by exploiting the hard-wired preferences that guided us toward healthy food in the natural environment.  

Obesity is not always going to be 100 percent reversible.  I know no one wants to hear that, but I'm not in the business of selling snake oil.  Some people can reverse it completely; others won't lose any fat at all; the majority can probably lose a substantial amount of fat but not all of it.  Highly controlled diet studies in rodents show that obesity due to eating highly rewarding/palatable refined food is mostly reversible when they are placed back on low-palatability whole food, but they don't usually lose all of the excess fat, and the longer they've been obese, the less fat they lose (1, 2, 3).  The capacity for the fat mass "setpoint" to re-establish at a lower level may diminish over time, varies between individuals, and probably also depends on other factors that no one currently understands.  I think it's important to be kind to yourself, and not set unreasonable expectations.

I can't guarantee that what I'll present here will help everyone, but it is unlikely to do harm.  As always, these are simply ideas for you to consider.  You are fully responsible for your own implementation of them, and your own outcomes. 

Recommendations

I've organized this weight loss strategy into five different "levels" based on the desired outcome.  Some people may want to use this strategy in a preventive manner, or to address metabolic disorders other than overweight that are related to excess energy intake (insulin resistance, fatty liver, etc.), in which case they would probably want to stick to levels 1-3.  Levels 4 and 5 are primarily for people who are not losing weight at the lower levels, and would like to further reduce food reward and the body fat setpoint.

The goal is to adopt a diet that allows fat mass to return to a healthy level, while eating nutritious food to fullness.  You may initially feel deprived, but you should become more satisfied by simple food over time.

Level 1

The low-hanging fruit:
  1. Avoid the highest reward foods: candy, sweetened chocolate, ice cream, cake, cookies, other sweet baked goods, fast food, pizza, and other foods that you know are particularly problematic for you.  Don't put yourself in a position to be tempted by these if you can avoid it.
  2. Minimize liquid calories, particularly sweetened beverages, beer and sweet cocktails.  Modest quantities of milk, wine, and unsweetened spirits are fine.
  3. Don't snack.  In France and many other countries with strong food traditions, snacks are for children.  Adults eat at mealtime, in a deliberate manner.
Level 2

In addition to everything in level 1:
  1. Avoid industrially processed food in general, particularly packaged food with many ingredients.  Minimize restaurant food.  Cook your own food from single ingredients to the extent that you're able.
  2. Avoid adding sweeteners to food and drinks-- including artificial sweeteners.  The sweet flavor itself is a reward factor.
  3. Avoid seed oils (corn, soybean, sunflower and safflower in particular).
  4. Include a regular source of omega-3 in your diet.  This can come from some mixture of wild-caught fish, flax seed/oil, pastured meat/dairy/eggs and green vegetables.
Level 3

In addition to everything in levels 1 and 2:
  1. Reduce the overall energy density of your food (calories per volume) while keeping it nutritious, but don't go overboard.  This can be accomplished by adding extra vegetables to the meal, and using potatoes and sweet potatoes as the main source of starch (rather than bread, pasta, rice, etc.).  Microwaving is a fast and effective way to cook potatoes and sweet potatoes for those who are short on time.
  2. Focus on minimally processed foods.
  3. Don't add fat to your food.  That doesn't mean don't eat fat, it just means keep it separate from your cooking.  If you want to eat butter, eat it separately rather than mixing it in with your dish.
Level 4

This level is about simplicity.  Here, we are approximating the reward value of certain non-industrial diets.  In addition to everything in levels 1-3:
  1. Eat only single ingredients with no flavorings added.  No spices, herbs, salt, added sweeteners, added fats, etc.  If you eat a potato, eat it plain.  If you eat a piece of chicken, eat it plain.  It can be in the same meal as other foods, but don't mix anything together.  If you would like to keep salt in your diet, dissolve it in water and drink it separately.
  2. Cook foods gently.  Minimize grilling, sauteing, broiling, frying, and particularly deep frying. Add a bit of water to the pan, rather than oil, when cooking meat or vegetables, and cook gently with the lid on.
  3. Minimize all liquid calories.
  4. Only eat foods that taste good when you're hungry; avoid foods that you'd be inclined to snack on even when not hungry.  A lot of foods move from the latter category to the former when they're completely unseasoned.
  5. Some people will benefit from avoiding wheat.  Your mileage may vary on this.
Level 5

This level reduces variety, which is another reward factor (4).  This is something that you attempt at your own risk, as there may be downsides to eating the same foods every day.  I think the risk is small if you choose your three foods carefully.  I wouldn't recommend doing this indefinitely, but rather as a short-term strategy to lose fat, followed by a more relaxed maintenance phase.
  1. Pick three foods, and eat nothing else.  Try to pick foods that will provide a relatively balanced diet.  A starch, a meat and a green vegetable is one possibility.  For example: potatoes, broccoli and beef.  Again, cook everything gently and add no seasonings to your food whatsoever, including salt.
Macronutrients

Some people have lost fat simply by avoiding carbohydrate or fat.  I've heard people say that a low-carbohydrate diet in particular curbs their cravings and allow them to have a healthy relationship with food again (although others have developed strong cravings on low-carbohydrate diets).  I believe this is partially driven by the fact that carbohydrate and fat are major reward factors.

I believe that all things being equal, it's best not to restrict any macronutrient to an extreme degree (there may be some exceptions, such as diabetes).  That being said, as carbohydrate and fat are major reward factors, they are additional tools in the toolbox that you can use to further reduce reward if you choose.  

Don't be a Drill Sergeant

Ultimately, for any diet to work, it needs to be sustainable.  It's probably a good idea to allow yourself a meal or two a week that you really enjoy.  Just don't indulge in the worst offenders-- foods that will stay on your mind, and reinforce your cravings for days or weeks.  You know what your own trigger foods are.  Don't even put yourself in the vicinity of those foods if you can avoid it.  If your diet is balanced and nutritious, your cravings should subside over time, and you will become more satisfied by simple food.

An Alternative Strategy

In his book The Shangri-La Diet, psychology researcher Dr. Seth Roberts outlines a simple strategy that he claims can lower the body fat setpoint without significantly altering the diet.  The technique involves taking flavorless calorie-containing foods between meals, which lowers overall energy intake by suppressing appetite (according to him, by lowering the setpoint).  I'm not going to steal his thunder, so you can read his book, or visit his website or forum if you want more information about how to implement it.

I tried Dr. Roberts' strategy for a week out of curiosity, and it did suppress my appetite somewhat.  According to the theory, the more excess fat mass you begin with, the more your appetite should be suppressed.  I didn't have much fat to lose, but I noticed a modest effect on my appetite nevertheless.  I have a few reservations about the technique.  I don't know much about its long-term effectiveness or safety, and neither does Dr. Roberts, according to our communications.  It doesn't strike me as having the potential to be very dangerous, but as our ancestors didn't sip refined olive oil between meals, the precautionary principle applies.  Still, it's an interesting technique that I'll be keeping my eye on in the upcoming years.

93 comments:

Thomas said...

Brilliant post. Thanks Steven. In getting rid of my own cravings, I used virtually the exact strategy you outline, and it worked.

Nico said...

Thanks, as always, for the outstanding work, Stephan.

I have to say I'm a little skeptical about the benefit of not using any flavorings- many cultures do use lots of spices without having much obesity, no?

Also, I remember reading a post on Seth Robert's blog about a person who lost weight by never eating the same meal twice. Perhaps familiarity is also a factor in food reward? In my personal experience, overweight people tend to have certain foods/drinks that they consume everyday.

I suspect that, for most people, sticking to whole foods, and eliminating white flour and vegetable oils will do the trick. I have yet to meet an overweight person who strictly follows such a diet.

David Moss said...

I'm surprised you call it the "elephant in the room." Whenever you pick up any mainstream medical commentary on obesity, the first thing blamed for the obesity crisis is the 'toxic' environment of having highly palatable foods in abundance.

gunther gatherer said...

Hi Stephen. Your point at Level 5 is the take-home for me. When examining all the paleo diets, it's interesting to note that most books and theories stress their variety and diversity. The picture always painted (and the one promoted around Duh Innernets) is that we should be eating a wide variety of natural foods all the time, every day, every meal, to get maximum amounts of vitamins, minerals and yadda yadda.

But on closer examination, it seems having variety and novelty 24/7 are actually products of neolithic life more than the paleo one. An HG with no fridge and only one cooking method never had all these options for taste and flavor at the same meal, whether the foods were natural, "paleo" or whatever.

Variety and diversity defintely exist for a hunter gatherer, but over a calendar year, with several months of eating ONE seasonal subsistence food, cooked a very simple way the same way EVERY time, then moving to the next one when it becomes available.

I think this is an essential point largely ignored by those wishing to lose weight on an ancestral diet. The elephant in the room for paleophiles, which gurus such as Eaton and Cordain and other diet book writers are trying desperately not to face up to, is that food was boring in the paleolithic.

taw said...

So, how would you design a trial testing your ideas against other diets? To be honest I don't have high hopes here.

Megan said...

Stephan, thanks again for an intriguing series of articles, and like others I've been looking forward to this post.

It was going so well ... until I reached Level 3 #3!! How does anyone eat potatoes and vegetables without fat or a little salt?? Perhaps my reaction is one reason for my weight problems!

Layer 4 #1 looks rather difficult for anyone who cooks for, or eats with, other people. The average family is rather resistant to dietary changes, particularly when they are slim and healthy. Nevertheless, I'm going to try to work out some way to incorporate the ideas where I can.

Regarding the Shangri-La diet, I've seen it suggested by several people that coconut oil might be a good substitute for the olive oil, and as I find them equally unpalatable, perhaps I'll try that as well.

Gazelle said...

@Megan, one of Seth Roberts's recommendations is to use a swimmer's nose clip when taking the oil to remove all flavor association. I did this with coconut oil, and noticed a significant appetite suppressant effect after a few days. Sadly it only lasted about a week.

SamAbroad said...

Hi Stephan,

Thanks for this series, I was initially skeptical of the theory, but I've found it to be a rather parsimonious explanation for a lot of diet studies that I previously didn't understand the results of.

Regarding the steps, I think all well and good, but it still doesn't address the issue of how to stick to a blander diet. It's the same issue with low fat and low carb. They work, but people go back to the super palatable food like the drug-addicts they are.

I've tried implementing a few of these strategies since you mentioned them in the podcast with Chris Kresser. I normally eat really flavourful food and lose weight quite easily with very moderate carb restriction (120g a day), but after 3 days of the bland approach (not restricting anything but eating plain simple food), I was overcome by unusually strong cravings and fell face first into a large mcdonalds meal! My body missed the dopamine.

I think you're right on with the cause, but not with the long term solution. I mentioned the approach to a few people and their initial reaction was: I'd rather be fat. I think 'eat bland' is going to be a harder sell than cut carbs or fat to be honest.

Jack Bennett said...

I respect the idea of the Levels. It makes sense to work in stages to do the easiest / "lowest hanging fruit" first,then working upward to the more challenging stages.

j said...

Great post doctor.

Quick question:

is there a commercially available flavorless food supplement? i recall your citation of studies done using this type of supplement some time ago.

for those of us who eat 2 large meals a day it would seem that substituting 1 meal with a nutritionally complete but largely flavorless supplement might go far in reducing overall caloric intake and food cravings?

luckybastard said...

Stephan, I like the plan and to most generic paleos it seems spot on for the most part. I have 3 main concerns though. 1) Is there an actual mechanism we can point to that says that eating fat separately from the other macronutrients is more helpful in controlling obesity? 2) why take the herbs and spices out of a meal and 3)is the blandness and monotony really necessary?
I ask this because if as i've read here and in other places, our satiety meters(hypothalamus interection, leptin signalling,etc) being wrecked is the main cause of obesity in the vast majority of people. That being what it is, if the the likely culprits of that inflammation- elevated fructose levels and industrial seed oils- are eliminated from the diet and enough time is given for a recorrection, shouldn't that be enough to get the ball rolling?

trix said...

I don't have a weight problem myself, but I think that herbs and spices add more than just flavor to foods. They may provide added minerals, medicinal, or other nutrients. (for example: the purported health benefits of Turmeric)

I can't see how eating less palatable or bland meals will be sustainable over the long haul and most people will feel deprived and punished and eventually fall off the wagon. They may lose some of the joie de vivre. But maybe with a meal or two a week being less restrictive as you suggest may work.

You are mainly addressing people who have damaged metabolisms and are overweight. There are people who can eat whatever they want and not gain weight; sugary sweet foods, white flour, pasta, well seasoned and all and not gain weight...(other health concerns not withstanding). But...there used to be more of us like that than there are now. I am still interested in understanding why.

Carl M. said...

Level 6: don't cook anything but meat. Everything else raw, and unmixed. No spices. No salads. Eat what currently tastes good by itself until it doesn't. 30 pounds gone in a month or two.

Cooking, even simple traditional cooking, messes with our instincts.

BTW, the sense of taste (and other senses) crank up hugely on such a diet. On the down side, the spectrum of edible foods available at the grocery stores is too small to maintain enough body weight on this diet. The body likes to rotate its raw foods, its nutrient balance and plant toxins.

kulimai said...

"Only eat foods that taste good when you're hungry"
Isn't another "only" missing here ("...only when...")?

I've been doing this up to level 4 with fairly minimal variations (spices allowed, IF instead of no snacking, also for some periods added fats were allowed, for some they were not) for at least 5 years now.
(Not for weight loss: my BMI was always low, --between 18 and 20 since I started this). I can testify that I never enjoyed food more than during these five years. So AFAICT palatability is a highly misleading misnomer in the context of Stephen's excellent ideas.

I never theorized about what I was doing, beyond this being (among other things) about reestablishing normal taste sensitivity and food reactions. As I noted in an earlier comment, given the pervasiveness of habituation I simply don't see at all how the notion of palatability can be defined in a sense that is useful here. In any case after practicing essentially this for years and years, no term could seem more counterintuitive to describe the diet than "low food reward". (I can imagine stage 5 being "low reward" since stage 5 might scare the mind-body that it won't get its nutrients and it might then protest by signalling lack of satisfaction.)

bentleyj74 said...

Dittoing SamAbroad...could you explain how/if this would be as or more successful than other methods which also seek to diminish food reward?

I think I'm a little confused re chicken/egg dopamine. Is the overconsumption driving the lack of receptivity? If so then what is driving the overconsumption? What is going to resolve the dopamine inadequacy?

I played lab rat for a few weeks eating as you outlined in your interview with CK and it did indeed reduce my calorie intake dramatically. By half at least, maybe more. As I mentioned previously I grew up eating in a relatively similar fashion so it didn't seem bland or painful but it also didn't cause any weight loss [I am not obese but I do gain and lose weight with pregnancy. My usual nonpregnant weight is around 110-115].

So that's a bit of a concern. I expected to either lose weight or become ravenously hungry and got neither. The cause of my low cal intake was not satiation per say but GI discomfort. The foods I was eating were not terribly energy dense especially with much diminished additional fats and probably much increased indigestible matter [I did eat potatos and sweet potatos and beans without any butter or seasoning].

Looking at these theories you outline and observing in an admittedly amatuer fashion it does seem to me that short of inpatient treatment or "lost in a jungle" scenarios having a person attempt to resist the impulse to seek food reward at the local McD's [which is probably in walking distance] by serving a plain potato or steamed broccoli is an excercise in "white knuckle it for 3 days then binge" futility.

That being the case if I wanted or needed to lose considerable weight and knew food reward was going to be a problem I'd probably opt for the solution that would most closely mimic my food reward.

I'm suprised to arrive at a different conclusion than expected especially given my discomfort with the nutritional disadvantage I perceive [perhaps ignorantly?] low carb to impose.

There it is though. After reading and experimenting with what you suggest I arrive at a different conclusion than you do perhaps because I am not stuck in the academics of it all but rather the pragmatic requirements of running a household without a perpetual state of coup d'etat from dissatisfied villagers.

The low carb failures I have witnessed usually failed due to continued "binge" behaviors with some cognitive dissonance or even outright denial that binge behaviors of any sort are problematic. I see people looking for a magic bullet that will allow consequence free binging.

"If I don't eat carbohydrate I can dissolve a half cup of butter into a single serving of green beans and not gain weight!"


The successes seem to take advantage of the rewarding nature of the food for compliance and consistency combined with the appetite suppressing nature of the ketogenic state. This seems an efficient approach to my solution/results oriented brain which would allow people to be pleased with their meals while still restricting total food reward.

Is there a reason you would prefer low stimulation to low carbohydrate?

Do you have concerns about low carbohydrate that would cause you to specifically advise against it?

Reid said...

Stephan -

What are your thoughts on the type of oil one should use if attempting the Shangri La techniques? In the book they suggest extra light olive oil, walnut oil, canola oil, etc.

Extra light olive oil is highly refined and I won't even consider canola oil to be a healthy alternative.

Coconut oil would seem to be the best option to me.

Taylor said...

Nico - according to Seth's theory no food, no matter how rich or tasty will raise your setpoint until your brain learns that it is calorie dense. Once it makes the association and you eat it again then your setpoint will rise. That is Seth's theory. So yes according to Seth's theory familarity is not just a factor it is essential to increasing the appetite.

David - people talk around it all the time and focus on toxicity, macro ratios, micronutrient content and all manner of other minutiae without even mentioning palatability. Especially in non-mainstream circles. Calling it an elephant in the room is right on in my opinion.

Gunther - good points but who is Stephen?

taw - I think a trial where people eat bland food but have no restrictions on when and how much would yield spectacular results. But we'll have to waint and see until one is done. Similar trials have all been a success including the funny machine with the tube.

SamAbroad - Sticking to a blander diet sucks - tasty food is great - that's the reason where in this mess to begin with. But the real key is for everyone to acknowledge that the palatability and easy availability of the food really is the crux of the weight problem in the western world today. Until that is widely accepted people will be distracted by all manner of red herring theories and won't focus their energy on ways to diminish the temptation of hyper-palatable foods. Its like somehow its not politically correct to say that the food is too difficult to resist when its always right in front of us so lets do things to make it easier for people to resist. I guess it goes against our capatalist foundations to suggest that we'd be better off if it were made more difficult to buy food in some situations.

trix - isn't it a perfectly good explanation for why there used to be more people who could eat whatever they wanted and not gain weight that there is just so much more hyper-palatable food at arm's length than there ever was before? There is more every year - heck even every month. I think that explains it perfectly well. Yes a person will feel deprived forgoing their favorite junk foods to eat less palatable healthier foods but then a drug addict feels deprived when kicking his drug habit. It really is no different. Yes this will be hard to do but its doable. Its not an argument against Stephan's theory that it will be difficult. That just means it will be difficult not that its wrong. If you are waiting for a theory that suggests that it will be easy well there have been plenty and all of them have failed.

Taylor said...

I should add 1 more point. Yes you feel deprived not being able to eat what you really like best but at least you don't have to go hungry on this plan. You eat to fullness according to hunger. You just don't get to eat the tastiest foods.

bentleyj74 said...

Are people with disordered eating eating to hunger? Are we accepting the premise that binge eaters are eating because they are physiologically hungry?

DogwoodTree05 said...

You lost me at level 4, #1. Adding spices helps me eat and enjoy nutritious non-starch vegetables like kale, broccoli, cabbage, and lettuce. There is no way I would eat these bitter vegetables plain, so does that mean I would eat fewer calories overall? No, it means I would substitute with something more naturally flavorful and probably caloric. The Japanese and Koreans have the lowest obesity rates in the OECD at 3%. They flavor their dishes with a short list of additives: ginger, garlic, sesame seeds and oil, soybean sauce and paste, and hot peppers. Too much food austerity may lead to feelings of deprivation, which in turn lead to cheating and bingeing.

madmax said...

I guess it goes against our capatalist foundations to suggest that we'd be better off if it were made more difficult to buy food in some situations.

Oh. So more government coercion is needed to solve the obesity problem? That's the ticket. Maybe we should create a Paleo-police-state. Who needs all that freedom anyway?

Lovely. (sarcasm)

Stephan Guyenet said...

Hi Nico,

You have to keep in mind the total reward value of the diet. In India for example, where they eat a lot of spices, the traditional diet was mostly plain rice, or wheat chappatis, and was low to extremely low in fat. Plus, the average person was not going to make a complicated spiced dish for every meal. Now that the diet is more affluent, less repetitive and macronutrients are more balanced, they have a big overweight problem in cities. Accompanied by a huge CHD and diabetes epidemic.

Hi David,

I see your point. "Elephant in the room" implies that no one can see it, which is not the case here. But I do think it's the elephant in the room for certain diet circles, like low-fat and low-carb.

Hi Gunther,

Agreed.

Hi Taw,

If I could design a trial, It would be like this: two randomized groups. Each fed the exact same foods. One group is fed normal meals cooked in the normal way, the other is fed the ingredients separately. Spices, herbs and salt would be taken in pill form rather than added to food. Fats used for cooking would be given separately in the low-reward group.

Hi Megan,

You can tailor the ideas to your own situation, but I don't think it's that hard to implement them if you're the chef.

Hi SamAbroad,

Yes, the implementation is not necessarily going to be easy, but it should become much easier over time. You went from low-carb to a macro-unrestricted bland diet, which is a major shift. Perhaps you'd have better luck if you did it gradually. It takes a couple of weeks for the body to adjust and become more satisfied by simple food. Check out my interview with Chris Voigt the "potato guy" for evidence of this.

I'm going to think about ways to ease the transition and make compliance less challenging, but there's no getting around the fact that it will require some willpower, at least initially.

Taylor said...

I'm not in favor of government coercion. Didn't say so either.

Greg said...

Adding fat to meat seams very traditional. Steffanson wrote how the Inuit dipped their lean into fat, although I haven't seen the issues discussed in other sources.

Mirrorball said...

I also don't see why we shouldn't add a little fat to non-starchy vegetables. They are basically no-reward, no-calorie foods and adding a bit of fat just makes them pleasant enough to be enjoyed as a side dish. Without this small incentive people might start skipping vegetables altogether and lose their many nutritional benefits.

DogwoodTree05 said...

Taylor wrote: "I guess it goes against our capatalist foundations to suggest that we'd be better off if it were made more difficult to buy food in some situations. "

Obesity is concentrated among the lowest socioeconomic groups, who buy much of their food with SNAP, the food stamp program, and WIC and whose children are likely to eat waffles and sausage biscuits for breakfast as part of the free and reduced school lunch program. We don't need to "make" it more difficult to buy food. Rather, we need wean people off government subsidies. My working poor parents fed us six children from their own earnings and our backyard garden. Dinner was typically a slab of cheap, fatty meat like a pork chop, boiled potatoes, and a dollop of canned vegetables, cheap, not particularly flavorful but adequately nutritious. My eldest brother was a little chubby while the rest of us were lean.

Might-o'chondri-AL said...
This comment has been removed by the author.
Stephan Guyenet said...

Hi J,

The diet used in the machine feeding study is called "Nutrament" and it is still commercially available. The problem is that it's now flavored. There appear to be other similar products that are not flavored.

Hi luckybastard,

In response to 1 and 2, yes I think both will reduce the reward value of the diet. As for 3, it depends on how you define "necessary". It just depends on what your goals are. If you have a hard time losing weight and your goal is to lose a lot of fat, it might be necessary. If you're healthy with no weight problems, it probably isn't.

Hi Trix,

You said "There are people who can eat whatever they want and not gain weight; sugary sweet foods, white flour, pasta, well seasoned and all and not gain weight...(other health concerns not withstanding). But...there used to be more of us like that than there are now. I am still interested in understanding why."

The American diet has changed dramatically just in the last 40 years, shifting from a pattern of simple home-cooked food to processed commercial high-reward foods. People are not eating the same things as always yet gaining more weight; their diets have changed substantially in parallel with the weight gains. That may be hard to see because the change has been so gradual, but I have some graphs I'll post at some point that illustrate the changes numerically.

I think some people will feel deprived at first, but they will adjust. That's what happened with me. I missed ice cream and cookies for a while, but I don't anymore. Even though I still enjoy the flavor of them, those foods could disappear forever and it would be no skin off my back. What I enjoy now is simple, real foods. People have thrived on that for tens of thousands of years.

Hi Kulimai,

Thanks for the comment. It squares with my own experience, that simple food becomes satisfying over time.

Hi bentyleyj74,

It should be more effective because it directly targets the problem, rather than targeting it indirectly based on ad hoc justifications. My recommendations allow you to select the appropriate level of reward for your situation, which is not as true of LF or LC diets. Where do you go when you've cut out all the fat but you're still overweight?

You said "I think I'm a little confused re chicken/egg dopamine. Is the overconsumption driving the lack of receptivity? If so then what is driving the overconsumption? What is going to resolve the dopamine inadequacy?"

The problem is exposure to excessively rewarding/palatable foods. These reset the body fat setpoint at a higher level. I suspect that dopamine is involved, and perhaps a loss of sensitivity to it in the hypothalamus. But the mechanism is not totally clear at this point. It could involve opioid signaling as well.

I think it's preferable to ease into low-reward eating gradually rather than doing it cold turkey. If your calorie intake really was reduced by 50% eating this way, I guarantee that you would lose fat if you stuck with it (although you are clearly not overweight judging by your weight). However, the fact that you experienced GI discomfort is troubling. Perhaps easing into it gradually would be more effective, and/or refining your food selection.

My concerns about low-carb come primarily from the precautionary principle. It's likely that very few peoples' ancestors ate high-fat low-carb diets at any time in the last several hundred thousand years. The long-term safety of LC has not been established. Still, I recognize that it has helped a lot of people and can improve health under certain circumstances, so I'm not totally against it. Just a little bit suspicious.

themondays said...

This may be old news to everyone, but if you haven't seen them, there are three amazing documentaries that will allow you to observe many of the ideas that Stephan mentioned in action. They are called "Living with the Kombai Tribe" (2008, West Papua), "Living with the Mek" (2008, West Papua), and "Mark and Ollie: Living with the Machigenga" (2009, Peruvian Amazon). Mark and Ollie are westerners, and while I do not condone the fact that they did this, they went to live with these tribes for months on end. My fear is that they exposed these vulnerable peoples to disease. During certain episodes, some tribal members get sick, and I can't help but wonder if Mark and Ollie aren't unwittingly the source of these illnesses. That said, the documentaries clearly illustrate what life without a supermarket is like. Lack of food availability, bland food, repetitive food, starch as an important reliable food, and foods eaten individually and without seasonings or flavorings are all things that you will witness. Of course, for these tribes, these food ways are not a matter of choice. It is interesting that the path to better health in our society may involve artificially imposing these restraints upon ourselves.

These dvds are all available from Netflix, and each one is comprised of several episodes. Be prepared for tribal nudity, butchering of animals, intertribal murder, use of hallucinogens, and things of that nature. Enjoy!

Thanks for taking the time to share all of your research and ideas, Stephan!

Kym

Stephan Guyenet said...

Hi Reid,

I seem to recall that Seth did a poll to see which oils were the most acceptable/effective. I think a lot of people didn't do well with coconut oil.

Hi bentleyj74,

Binge eaters are not eating from physiological hunger, they are eating from food addiction. But binge eating is not the same as gaining body fat. Body fat depends on where the setpoint is, and the overall balance between calories in/out. You can gain fat by overeating beyond what you would normally consume, but it isn't easy. Fighting homeostasis in either direction takes discipline.

Stephan Guyenet said...

Hi themondays,

Cool, I should check those out.

Travis Culp said...

I think pointing out that there are are non-obese cultures eating a palatable traditional diet is missing the point. These recommendations are for undoing the effects of a lifetime of hyperpalatable food. In order to do that, you're going to have to go in the other direction for a while, and once you've acclimated to it, you can increase palatability to traditional levels.

New York said...

I lost around 18 lbs on lowcarb (Protein power) and briefly attempted Shangri-la to get rid of the 5-10 that I still want to lose.

Consuming the flavorless calories did seem to suppress my appetite. It also seemed to make food less appealing - except for real junk food, which now seemed more appealing than ever.

bee said...

the raw milk diet seems to be successful in getting people to lose weight and fat. it seems to gel with what stephan is talking about - a lack of variety, blandness, etc.

my own experience seems to gel with his observations too. i am from india where we eat everything heavily flavoured and spiced. i've transitioned to a very bland form of eating, with no grains and not too much variety.

things that i would have found absolutely unpalatable even two years ago - a plain avocado, for instance - appeal to me now. earlier, it had to be spiced or in the form of guacamole. now, i like a plain avocado.

guess what, this bland way of eating has made me lose a lot of visceral fat. i use to monitor my diet very closely and struggle to get to 18% body fat. for the past year, on a bland grain-free diet, i'm at around 17% without even trying.

Taylor said...

I'm not in favor of govt intervention to force a healthy way of eating. I want to be perfectly clear about that. The comment from the earlier post is just because I have a sense that the food industry will stand in the way of any attempts (by anyone) to reduce the consumption of high value-added packaged or processed foods. Anyway that's not my focus. Most of all I just think it would go a long way to resolving the obesity epidemic if it became generally accepted common knowledge that the regular, daily, consumption of delicious, hyper-palatable foods that stimulate our reward centers through multiple pathways at once, is the primary cause of obesity. There are so many competing theories attracting people's attention that this one is somewhat like the elephant in the room. No one likes this theory because it means you can't have those delicious foods and still be thin (for those of us with weight problems). I think people are eager for other theories because this one does imply a degree of deprivation (only temporary it is hoped). Again I don't advocate govt intervention of any kind to solve this. I think the 1st step is for it to somehow become common knowledge that too much food that tastes too good is the main cause of overweight. And that this is not just common sense but is supported by a good deal of quality research.

My own experience on the deprivation thing is consistent with the others mentioned here in that it dissipates. I've tried to eat salads for lunch at work. The first time I had to overcome a strong urge just to make myself order a salad (with chicken) for lunch. For dressing just oil and vinegar which is bland compared to my usual dressings. The second day was tough also. By the third it wasn't so bad. By the fourth I actually enjoyed it. The problem is that I'll always find myself in a situation that sets me back on hyper-palatable food and the cycle starts over from there. But the deprivation diminishes if you stick with it and it happens surprisingly quickly.

bentleyj74 said...

Re high fat low carb...

I see a lot of high fat low carbers [who are failing to lose or even maintain weight] doing what can only be described as super douching with fats. Veggies drowned in butter and heavy cream. Added fats to already fatty meats.

I am also very skeptical that this is either a natural way of eating or optimal for most people.

Is this food reward seeking/addiction in play or misunderstanding? What I'm seeing described in the actual literature looks very different than what I see people espousing.

The same could probably be true of low fat dieters who exchange broccoli [what the lit suggests] for no fat cookies and calls it legit 'cause it's all about that fat content.

Teddy said...

For me - Level 0: Avoiding super-stimulating behavior in all other life endeavors.

I notice that the idea of blandness not only applies to diet but all other life endeavors. Anxiety and stress reducing behaviors and mental strategies by far work the best at controlling my cravings for food.

These include deep breathing relaxation techniques, progressive muscle relaxation, meditation, positive reinforcing coping statements, assertiveness with others and many others (all of these from the anxiety and phobia workbook).

In particular, avoiding blogs and message boards about food seems to have been my best strategy. It appears that much of the paleo/primal people have orthorexic tendencies and concentrating on food past a certain degree is exactly what sabatoges potential success.

Megan said...

What exactly is meant by eating ingredients separately, or keeping fat and protein separate?

Are we talking about eating them in the same meal, one after the other, or treating each as a separate course, with long pauses between each, and spreading the meal over a much longer period?

Also, how do you keep fat and protein separate when you eat a naturally-fatty meat such as pork belly or lamb?

engineering-health.org said...

Great article! I love how the series progressed from a hypothesis, to supporting evidence, and then practical advice.

However, I don't totally agree with the advice to eat starches plain (without fat) for obese people, since a large portion of obese people have poor glucose control.

Myself, as a borderline type II diabetic, if I eat a plain white potato I will see 2h blood glucose levels of over 180mg/dL! The same potato with 3 TBSP butter and a salmon fillet I will never see levels above 110mg/dL.

I suspect the same is true for most obese people- eating sufficient fat along with starch will make the difference between virtually zero blood sugar spike, and dangerous levels that can eventually cause long term damage.

About a year ago I lost 50lbs on a low carb paleo diet, and have not gained any back after adding potatoes or other root starches with butter to nearly every dinner. Paleo + potatoes with butter does not seem to raise my already healthy bodyfat setpoint.

Morris said...

Stephan
Thanks for an interesting post. You wrote “The long-term safety of LC has not been established. Still, I recognize that it has helped a lot of people and can improve health under certain circumstances, so I'm not totally against it. Just a little bit suspicious”.
What would you consider long term? Half life of cell replacement of longer lived cells, say 1-2 years? Longer? I ask because my experience after one year on the LC diet is completely opposite to your hypothesis. I eat flavourful food and do not experience cravings for snacks and have lost a small amount of fat . Before LC I was certifiably “not sick” and lean but had to take care to balance intake calories with expenditures. Now I feel better, am much more tolerant of energy intake swings without gaining fat and some aging biomarkers have definitely improved, although the improvement came early and have stabilized. I did not eat junk food and for the most part did not find it tasty. Curiously, certain food now cause an adverse reaction which previously was absent. My experience leads me to suspect that population study findings while statistically useful may be swamped by individual variations.

Morris said...

Stephan
Thanks for an interesting post. You wrote “The long-term safety of LC has not been established. Still, I recognize that it has helped a lot of people and can improve health under certain circumstances, so I'm not totally against it. Just a little bit suspicious”.
What would you consider long term? Half life of cell replacement of longer lived cells, say 1-2 years? Longer? I ask because my experience after one year on the LC diet is completely opposite to your hypothesis. I eat flavourful food and do not experience cravings for snacks and have lost a small amount of fat . Before LC I was certifiably “not sick” and lean but had to take care to balance intake calories with expenditures. Now I feel better, am much more tolerant of energy intake swings without gaining fat and some aging biomarkers have definitely improved, although the improvement came early and have stabilized. I did not eat junk food and for the most part did not find it tasty. Curiously, certain food now cause an adverse reaction which previously was absent. My experience leads me to suspect that population study findings while statistically useful may be swamped by individual variations.

bopes said...

I think I handicapped myself by reading this post about bland food while eating a huge plate of roasted potatoes, peppers, onions, and chorizo; liberally seasoned with pimenton, cumin, salt , pepper ; and topped off with a side of leftover london broil.

Good lord, talk about food reward!

Might-o'chondri-AL said...
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Alan said...

>>> My fear is that they exposed these vulnerable peoples to disease. During certain episodes, some tribal members get sick, and I can't help but wonder if Mark and Ollie aren't unwittingly the source of these illnesses


Those tribal folk are not a different species than you and me. There is no human right to never get exposed to change.

Ann Anagnost said...

"cook food gently" but "microwave your potatoes"????

Beth@WeightMaven said...

Two things. One, I suspect food needn't be bland ... it just can't be palatable (or hyper-palatable) *and* provide a big reward (e.g., provide high calories or other brain "rewards" like opiate receptor pings). Everyone's different, but I've found that a little bit of fat and a lot of spices (thank you Penzeys!) don't translate to appetite problems for me, even with carbs, and probably provide a benefit in terms of nutrients and vitamin absorption.

Two, I think it is very unlikely that a change in diet alone will be sufficient to really tackle obesity (especially persistent obesity) -- for one, there's likely been other downstream damage that will need to be addressed.

I think Chris Kresser's 9 Steps to Perfect Health are a good complement to Stephan's recommendations (especially the steps re exercise and managing stress).

Andrew Wallace said...

I definitely wouldn't consider Korean and Japanese food bland, bland it's interesting that the main source of calories - rice - is something that even now is almost always eaten plain and totally unseasoned. Eating fried rice or even just putting other foods on top of rice was traditionally more of a special treat. On the other hand, the side-dishes (mainly low-calorie vegetables) by contrast are usually very flavourful - often quite heavily seasoned and/or pickled. Meat and seafood is usually quite lightly-seasoned with only salt or soy. I wonder if this could be a good strategy if you wanted to include a little more flavour in your diet ie. Eating your main source of calories bland and saving the seasonings for the low-calorie foods like vegetables?

themondays said...

Alan,

Thanks for sharing your thoughts about my post. Your comment made me pause and reflect. Good food for thought. I'm still wrestling with it.

While my feelings about the creation of the series are conflicted, they are apparently not conflicted enough to keep me from suggesting that everyone who is interested should watch it.

Malibu said...

hmm...I posted a similar comment on Health Correlator yesterday but here's my opinion...

I hated flavored food growing up. If food was 'mixed' together I would not touch it. This drove my parents wild. I wouldn't eat spaghetti because the sauce went on the noodles. I would eat the noodles and sauce separate only because they made me, but not together. Salads, obviously I hateeeeed. I wouldn't put anything on a baked potato and despised gravy on mashed potatoes. rice, plain. I think if I wouldn't suffer deficiency I could live off rice cakes. Eggs, plain preferably soft boiled. Hated fried chicken but LOVED the plain chicken livers from them- still do. Even mixed vegetables I hated I would separate them then pick at them. Something as ‘normal’ as a sandwich I didn’t like because putting mayo(which I hated) together with a slice of bologna was gross to me. I would have bologna on a plate lol.

Then, I remember this all changing as I approached high school. My mom started buying diet soda. I started drinking diet soda- I really think this changed everything. I started developing tooth problems, needed a root canal. Started enjoying ‘other foods’ and mixed foods. Had a car and access to fast food, which we didn’t get growing up. I fell in love with chicken fingers dipped in honey mustard. I discovered oatmeal crème pies, sugary ketchup for seasoned French fries. And I lost interest in the food I originally enjoyed. In college then I discovered beer  I put on a lot of weight in one semester, prolly like a record weight gain in a semesters time period. Then I went on a low carb diet, lost weight, OCDed and developed anorexia nervosa(which I think ticked a switch with malnutrition and changed something in my brain). Lived off plain food. Canned tuna, rice cakes, carrots. Then eventually plain lettuce and plain low calorie wraps. I think one of the hardest aspects of recovery for me, which I never put two and two together before you started this series, is food always having to be eaten together, mixed together, and all kinds of sh*t added to it.

I still LOVE PLAIN food. I love a sweet potato but hate it with butter. I adore a Hawaiian sweet potatoes but hate it anyway but plain. I love broccoli but I like it plain and steamed. I actually like plain chicken, it doesn’t need anything. Avocados, a new found taste as I never ate them until recently, I like but they’re overwhelming if I eat a lot of them. Nuts, I hate salted. Actually liking and enjoying plain food is pretty socially frowned upon. My mom, being a Cajun creole Louisianan cannot stand it. I tell her I have no problem eating any real food, really, there is no disorder attached to any one food- I JUST WANT IT PLAIN. So she tries to make meat/veggie skewers but then marinates them I sh*t, so no, I hate food like that. Plain, yes. Same with potatoes I get hounded for not buttering them, but I DON’T like them that way. I have no problem with the steak beside it fat and all I just don’t want it on my potato.

But, I am not OCD about it and am working on it, as I have attended a load of crawfish boils this summer(seasoning.msg overload) and pretended to enjoy the food.

Somehow, I think we might all be born to desire food as it comes but how many babies ever have the chance. They go from bottle feeding to cereal… way long comment, apologies but I can relate to the food as it comes thing.

Michal said...

When it comes to natural spices you use meat their function is often antibacterial and antifungal. Other spices are even anti-cancer (eg. turmeric). Spices put on carb-based foods can be anti-diabetic (eg. cinammon).

So by giving up on natural spices you are giving up their pro-health function. This may not be a good tradeoff.

Stephan Guyenet said...

Hi Michal,

I agree that herbs/spices can have positive health impacts. However, the most antidiabetic thing is to be lean and in energy balance. That is a more important factor than the protective effect of polyphenols.

Still, it would be ideal to have both. One way to get around that is to drink herbal teas between meals.

pablo DLS said...

bland food ? i rather die. but wait this is not all BS. i do eat the same basic food every single say. it works. BUT my food is highly Palatable and nutritious: first the sweet stuff > chocolate. lots of milk, ( half with cocoa) Then the real food: yolks, meat, butter, lots of spices and cheese-s- i do this one huge meal a day in the morning, and that's it. im lean, muscular and never ever get hungry.

Jenna said...

http://www.youtube.com/watch?v=ovin6fe4mvo

ItsTheWooo2 said...

Yesterday I ate 1300 calories, consisting mostly of peanuts sprinkled with MSG and pork rinds which were heavily salted. Seasoning galore.

I felt calm and peaceful. I woke up the next morning with that placid, mellow vibe. I had no appetite at all, I was not hungry, and was easily using body fat for energy.

What was the difference between yesterday and the day before?

Yesterday I ate 30 carbs, only 70 grams of protein, did a lot of activity, and so I was clearly in ketosis.

Today I ate a lot more protein (100 grams) and more carbs (35). I am still less hungry than I was a few days ago, but I am distinctly hungrier than yesterday. I also do not have that mellow/placid vibe I had yesterday while in ketosis.



If I were to start eating a cup of unflavored rice right now, I would be ravenous in short order.


People can lose weight on a wide variety of diets .... but I firmly believe that the only diet which has a chance of being permanent long term is a high fat, low carb, moderate protein diet. This is the only diet which can truly correct the underlying defect causing obesity - too much insulin, to little fat leaving fat cells.

It won't work for all types of obesity.
It won't work for all people.

But for many obese people this is the only one which works.

I think part of the reason so few obese people succeed is:
1) the social complications involved in doing this diet (people are always sabotaging you and they don't understand it's not as simple as choosing to "be good" after "just one cookie" - that cookie has screwed your endocrine system for at least a few hrs if not a few days)

2) a lack of firm understanding of why it is important to eat this way (cheating is easy if you don't get why it is important to eat the foods you eat and not eat the foods you don't eat)

3) Accidentally screwing your diet up without realizing it.
For example, a mistake many low carbers make is they think protein is "free food". The reality is protein is broken down into glucose and raises insulin just like bread. If you have a problem with excessive hunger, or a problem getting into ketosis, and you are SURE Your carbs are controlled, the problem is probably too much protein.

I'm very guilty of this. Protein does my appetite just like carbs but I consistently over eat it because I've been brainwashed by low carb diet "gurus" that it is okay to do so. No, it is not okay to eat a lot of protein. You will end up eating too many calories precisely because of the fact protein raises your insulin and glucose input, suppressing fat burning and body fat loss.
I might as well eat fruit and get the benefits of minerals and hydration and less stress hormone increase and more efficient glycogen replenishment, and the dopamine/opiate boost of real sugars (which then helps metabolism and appetite). Protein in excess just makes you frigging HUNGRY without any of those benefits.

ItsTheWooo2 said...

See, while on leptin, I can eat pretty much anything and stay thin. While on leptin my metabolism works way more normally. Leptin prevents your liver from making excessive glucose. When you are leptin deficient, as I am now, protein is very bad and must be reduced.

Leptin also normalizes energy use so that my cells oxidize glucose better. This allows me to tolerate a lot more carbs.


While off leptin, in a state of chronic leptin insufficiency due to massive weight loss, the only way I can maintain my weight is if I am actively or borderline ketogenic a lot of the time.

Unfortunately, this will probably trigger hypothalamic amenorrhea sooner or later (probably sooner). At my weight, eating in a highly fat oxidizing diet will only worsen leptin insufficiency and hasten infertility and subsequent estrogen deficiency. I can't seem to avoid infertility while also being thin. I don't make enough basal leptin for normal endocrine function. The leptin stimulated from diet is insufficient while also maintaining weight (my diet does not stimulate insulin - my diet burns fat).

But that's something most obese people won't need to worry about for a long time if ever; most obese people still need to worry about actually LOSING their excess fat.

Any dietary prescription given to obese people which IGNORES the insulin link is doomed to fail... it may work, but not without hunger, white knuckle battling your insulin low and calorie restriction to extreme levels.

Dr. Curmudgeon Gee said...

methink "bland" food taste is a misnomer.
how about "subtle" or plain?

(with the exception of unseasoned leafy green vegetables; they're suitably bland all right!)

regards

tayyab said...

very nice information.. i like this.

Might-o'chondri-AL said...
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bentleyj74 said...

@Stephan,

Curious ... your take on common binge foods being quite bland [plain white rice, pasta, unadorned bread].

Do these fall into the "A dominant factor not the dominant factor" category?"

gunther gatherer said...

Hi Stephan, I'm kinda curious about what Bentley says too.

Do you think grains in general, even when plain and bland, have their own separate potential to cause hyperphagia regardless of their reward?

I'm sure this is the case with wheat and other gluten-containing cereals, but what about white rice, quinoa, amaranth, oats and other quasi-ancestral diet items that taste pretty boring without butter, salt, sugar or other flavorings on them? I notice oats is a favorite of body builders too, maybe since their really hard to overeat when plain.

Are there any "natural" foods to stay away from entirely, whether bland or not, in your opinion?

montediaz said...

Level 5. Amen.

Have you studied anopsology? Basically in this style of "instinctive eating" you consume single, unprocessed, (raw if possible) palatable foods until you notice a change in palatability. At the point you sense the change you stop eating the food and move on to another palatable food.

It is argued that this is the bodies natural feedback loop that keeps us from over-consuming any one food. It's also argued that any processing (cooking, seasoning, freezing) of a food overrides our ability to sense when we've had enough. The argument goes we've evolved for millions of years with foods in their natural state and the body doesn't fully understand how to deal with a complex casserole as much as it does a tomato.

Examples given are usually: If you're craving a banana, the first one is delicious, the second one less so, the third much less, and the fourth would be quite grueling to eat. This effect does *not* coincide with fullness.

Your eating ideas detailed in this post and your Food Reward series overall very closely mirrors, in my opinion, Guy-Claude Burger's Anopsology which coincidentally, or not, it was popularized in France in the 70s. :p

I suggest all interested get the excellent book on the subject, Instinctive Nutrition by Severen L. Schaeffer. Find it used on Amazon.

montediaz said...

@Nutrament

That is an extremely unimpressive product. There are much better commercially available choices.

I would go with a combo of Vega and my own custom protein powder consisting of:

60% Beef Protein Isolate
20% Whole Egg Powder
20% Complete Dairy Concentrate (80/20 Casein, Whey).

Trueprotein is a good site to use for ordering custom, made-to-order protein mixes. This custom protein mix along with Vega would be gluten free, soy free, low fat, low cal, unrewarding, high in omega 3, antioxidants, and leave no deficiencies in any vit/min/EFA negating the need for any additional supplements. It wouldn't be that expensive either.

Beth@WeightMaven said...

Re insulin, I've long thought that there was more to the story of obesity than the Taubesian view of insulin promoting fat storage. I mostly thought this involved what Stephan's talking about wrt food reward/brain chemistry.

But recently I've come across links to other ways that high insulin can create problems. One, high insulin levels may be involved in converting dietary LA to something that pings the endocannabinoid system (just like THC in pot does). Think that could mess with appetite? I do!

Also, just watched this presentation yesterday on cravings & stress which talked about the role high insulin & cortisol play on cravings (which was a mini "a ha" on why meditation helps with weight loss).

My fasting insulin in March was 12 (down from 25 in Oct 09) after 6 months of mostly low-to-moderate carb paleo. I added Body By Science shortly after the March test given the exercise/insulin sensitivity link. Was just retested and will learn the results next week.

Veiled Glory said...

Here is one example of a lower-processed, mostly vegetarian "plan", based on repetition:

http://www.10in10diet.com/

One could easily substitute in more omnivorous choices for the peanut butter sandwiches, for example, and have a solid basis for a Level 2-3 plan.

http://www.10in10diet.com/weight-loss.php

Morris said...

Hi Stephan
My questions seems to have been lost in the shuffle. You said “The long-term safety of LC has not been established. Still, I recognize that it has helped a lot of people and can improve health under certain circumstances, so I'm not totally against it. Just a little bit suspicious”.
My qustion is: what is long term for an individual? Thanks

Jenna said...

'Relation Between Obesity and Blunted Striatal Response to Food Is Moderated by TaqIA A1 Allele'

Here is the abstract of the study:

The dorsal striatum plays a role in consummatory food reward, and striatal dopamine receptors are reduced in obese individuals, relative to lean individuals, which suggests that the striatum and dopaminergic signaling in the striatum may contribute to the development of obesity. Thus, we tested whether striatal activation in response to food intake is related to current and future increases in body mass and whether these relations are moderated by the presence of the A1 allele of the TaqIA restriction fragment length polymorphism, which is associated with dopamine D2 receptor (DRD2) gene binding in the striatum and compromised striatal dopamine signaling. Cross-sectional and prospective data from two functional magnetic resonance imaging studies support these hypotheses, which implies that individuals may overeat to compensate for a hypofunctioning dorsal striatum, particularly those with genetic polymorphisms thought to attenuate dopamine signaling in this region.

http://www.sciencemag.org/content/322/5900/449.short

The direction of causality???????

Jenna said...
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Jenna said...
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Jenna said...
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graciel said...

Stephan, I think you really nailed it with this series of posts. What you are describing, seems to me, is the ultimate paleo diet. Plain jane food, not much variety (although it would change seasonally), not mixed with much of anything else. Early man probably would have considered food as an animal does: Just something you need. These days all food seems to be a treat or a reward or to be looked forward to (I feel like throwing something at my TV any time that damned PopTarts commercial comes on lately). View it as fuel and remove the "yummy" and we'll all be better off.

Really nice post, thanks.

Taylor said...

Malibu - fascinating comment. I have a friend at work who doesn't put ketchup on burgers. I can't understand it, ketchup just makes burgers so delicious. Hmmmmm..... burgers with ketchup.... But I digress. He's very lean - probably 10% body fat or so and he doesn't diet.

Stephan Guyenet said...

Hi bentleyj74,

I'm no expert on binge eating, but my impression is that the most common binge foods are high reward. Things like ice cream, cake, pizza, etc. But I'm willing to be enlightened if anyone has evidence to the contrary.

Hi Gunther,

I don't think grains in general have any special ability to trigger reward. Take for example the many lean cultures in Asia and Africa that traditionally ate mostly grains (rice, millet, sorghum, teff, etc). Wheat may have the ability to disproportionately trigger reward, but that's just speculation. It may be more about the fact that so many high-reward items are based on wheat-- cookies, cake, pastries, etc. I'd be willing to bet that even plain bread is higher in reward value than plain rice, due to the texture.

Hi montediaz,

Thanks for the information.

Hi Beth,

Yes, endocannabinoids are important in weight regulation and reward signaling. It is possible that they could be modified by the n-6:3 ratio. That has been shown in animals, but as far as I know it has only been shown under extreme dietary conditions.

Hi Morris,

The longer, the better. There have been dietary studies on LC diets that have lasted a max of ~3 years I believe. Over that time period, they appeared relatively safe to me, at least based on what was reported in trials. But disorders like CHD take decades to develop. I'd like to see a study on long-term low carbers who have been doing it for 20+ years.

Taylor said...

If you've ever tried to eat gluten-free you've realized that gluten makes a big contribution to the palatability of a lot of foods, especially bread. Gluten-free baked goods and tortillas just don't taste good. They can have all the fat, salt and sugar of the regular version but they still won't satisfy. The elasticiity of baked goods comes directly from the gluten. That's probably why wheat products tend to be high-reward foods. That's my guess. I don't know about the opioid stuff, that may be a big part of it but the gluten definitely makes them taste better.

Tracy said...

Re: grains and reward.

Before I knew I was celiac, I was vegetarian and ate a ton of grains. (One of my fave foods was plain french bread). I started getting intense cravings all the time, mainly for starchy (as oppose to sweet) foods - potato chips, bread, pasta. I remember after one really intense craving suddenly 'coming to' in my kitchen, with a mouth FULL of plain, whole wheat crackers.

Once I cut all gluten out of my diet... cravings GONE. Literally, they just went away completely with no effort on my part.

I have noticed 'food reward' happening in my own life, so I do think there's something to this... for example, one diet soda, and I want more and more. A really tasty starch, I'll want more (don't find the same happens with a really tasty protein). But in my case, at least, gluten grains (and the way they affected my brain and gut) seemed to have been the major culprit.

Monica said...

Great post, Stephan. I have struggled with my weight most of my life. In high school and college I went through the cycle of gaining and losing roughly 40 lbs., twice.

Since beginning grad school, about 30 of those lbs have been creeping up on me at a rate of about 3 lbs. per year. Sadly, I eat mostly paleo because I feel better eating that way, not because it makes me thin. I have been eating this way for at least three years, during which time I've had a net weight loss of perhaps 3 lbs. Frankly, I have found many of the success stories of paleo trumpeted on various websites to be depressing, because I can't figure out why it's not working for me. But I know I'm not alone, because more and more anecdotes like this are popping up on paleo websites. There seem to be a significant number of people who are not VERY obese that aren't really helped by paleo eating (in terms of their weight).

Over the past month, I've been experimenting with Roberts' protocol and have found that it does decrease my appetite somewhat. I'm tracking the weight loss in Excel. Not much yet -- a few lbs. However, I'm going to augment or replace that with the bland food protocol you've outline here. I already do some level of both 3 and 4 but am now going to implement all of them. I'm not ready for step 5 yet!

Commenter above: "I think this is an essential point largely ignored by those wishing to lose weight on an ancestral diet. The elephant in the room for paleophiles, which gurus such as Eaton and Cordain and other diet book writers are trying desperately not to face up to, is that food was boring in the paleolithic."

I completely agree. Most paleo advocates tend to be foodies. Now there is a huge focus on making every paleo meal novel and exciting. Unfortunately, I think there is too much of an obsession in the low carb/paleo communities with assuring others that food can still taste good without refined sugars, grains, and seed oils. "See, look how much steak and bacon I'm eating!" I retort inside my head, "Great, but perhaps that's why some people like me are not losing weight on paleo and have even gained..." :) Frankly, I can't believe something so obvious hasn't occurred to me before. If food tastes really good, you'll eat more than you otherwise would. Yes, because for me to eat a lot of food, it has to taste good and I spend quite a bit of energy making good tasting meals. I don't snack outside of meals, but when I find myself eating at meals, I definitely keep eating past the point of fullness at times merely because it tastes good.

Just FYI, your long term weight loss post comparing the efficacy of low fat vs. low carb diet really resonated with me as well. Over three years, I have done quite bit of experimentation and found that the level of carbohydrate in my diet has zilch to do with my weight. I can cut it to under 30 grams for weeks without a change, increase that dramatically to eating 50% calories as carbohydrate with maybe a fluctuation of a couple of pounds (glycogen). I don't count macronutrients anymore to reach targets. I find that I generally fall at around 30/30/30, or slightly less protein than that.

Grammaticus.Sum said...

When attempting level 5, are dairy foods prohibited? I've read about them being chemically addictive, and they are certainly extremely palatable on their own. Do you think L5 would be less effective if one of the foods were, say, plain full fat yogurt?

Grammaticus.Sum said...
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Monica said...

Hey Grammaticus. I don't know what Stephan will have to say about that, but I can tell you that dairy is a huge trigger food for me. When I start, I can't stop. 6 oz. of cheddar cheese in one sitting? A huge bowl of cottage cheese of full fat yogurt? A 16 oz. glass of full fat Jersey milk? Right over here! Right. Over. Here.

It wasn't always that way. I've been bingeing on dairy most of my life, yes, but it was lowfat or nonfat. (I am not against fat. However, it naturally contains more calories.) So right after my lowfat days when I lost my preconceptions about full fat dairy, I was quite satisfied to eat two big tablespoon fulls of full fat greek yogurt and that was satisfying enough for me for practically a whole breakfast. But the same amount became less and less satisfying as time went on. Until a year later I was eating whole bowls of Greek yogurt, drinking 1/3 c. heavy cream daily in coffee, etc. As someone said above.... superdouching with fats. Of course, you can get the idea this is good for you if you spend too much time listening to WAPF. :)

If dairy is a trigger food for you, I would cut it out entirely if you are trying to lose weight. I learned a lot when I eliminated dairy cold turkey. The extreme constipation I had most of my life, which I had no clue wasn't a completely normal phenomenon, totally disappeared. It definitely causes me to overeat.... but that's just me. I can't say that I've lost any weight cutting out dairy, but I certainly feel a whole lot better.

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Saponaria said...

I did something very similar to this for about a year and it worked incredibly well with weight loss till I got pregnant. While pregnant I was not losing weight but I still had no food cravings. It did not matter what other people ate I really had no cravings for it. It was a wonderful place to be and I have not been able to get back there. But I've found this series inspiring and want to try it. What I did was basically a bland Rosedale Diet. I cut out dairy for a while and that's when it worked the best for me and the weight was falling off. I ate my fill of bland vegetables and meat and that was it. I didn't eat any of my treats of low carb chocolate and coffee with cream and stevia I'm addicted too. I gave them up and nothing I ate was anything that stirred up those cravings for food. It wasn't a miserable place to be because I did not find my food bad. I just ate to satisfaction and that was it. None of that insatiable craving for something sweet and then something salty. It just was. And I was much happier with my diet that way. But it took a lot of self control to eliminate all that I really liked and wanted to eat. :/

Ned said...

As far as boiling rather than grilling meat, is that to reduce the flavor reward? Or are you more concerned with consuming too many glycation end-products?

John said...

Stephan:

Do you think meal frequency is a component in the overall food reward of a diet? One of your previous posts suggested that occasional fasting seems to lower the setpoint. If the signalling of overabundance is the real problem here, as you and Chris M. seem to suggest, wouldn't fasting now and then be a pretty unambiguous way to communicate to your metabolic systems that energy isn't so abundant after all?

Eric W said...

Stephen,
I've been alternating between low-carb and low-glycemic diets since January. The results have been good so far: I've lost over 50lbs, and am within about 10-20lbs of my ideal weight. As seems to be the case for most people I was having trouble with that last bit of unwanted adipose tissue. In fact, I'd been stuck at a plateau for over two months despite following a CKD very closely. I therefore took some of the advice from this article and made some very simple changes to my current low-carb diet. Basically, I reduced the cooking time for vegetables, which I eat a lot of, and greatly reduced added salt and saltly seasonings for everything I cook. That's it, and I've begun losing weight again-about 3lbs a week so far.(Even after I managed to eat an entire pizza on my cheat day). And I've not reduced fat intake at all. In fact, I've had bacon for breakfast three times this week, and I like to cook greens in the leftover drippings. Based on this experience, I'm somewhat doubtful that dietary fat by itself plays a big role in fat gain. It really seems like it has to be combined with salt, starch or sugar to cause problems. Steak, avocados, pork ribs, nuts, seem to have a low reward without salt and marinades and such. Animal fat, especially, is not very appetizing without seasoning, which explains why people not on diets still leave the fat on the plate after eating steak. Fats by themselves also cause a lasting feeling of satiety. At any rate, I thought you'd like to hear that your advice seems to work.

Adam Washington said...

Stephan,
I believe your views have evolved somewhat over the years (not that that's necessarily a bad thing); back in 2008 you seemed more favorable than now toward a low-carb diet. Do you agree? If so, why have you changed your mind?

Toivo Ellakvere said...

"No spices, herbs"

is this your personal preference or do you have some evidence behind it ???

Sanjeev said...

"No spices, herbs"
I second the request for clarification here.

Some spices surely are rewarding, like cinnamon and maybe some hot peppers, but most would seem to me to be innocuous.

Dr. Roberts has been recommending "crazy spicing" for some time - eating substantially differently flavoured food will block the establishment of the flavour to the calories

My guess is that you emphasize the reward circuits and Dr. Roberts emphasizes the learning / habituation pathways.

Steve Parker, M.D. said...

I have a theory about the Shangri-La Diet...

I’m not sure if it's a hoax or not. It’s possible it's a social psychology experiment. Maybe Dr. Roberts had a bet with someone that anyone can write a popular diet book if they just use the formula. You can find the formula at www.sethroberts.net under Reviews and Media ("How to write a diet book...").

I suspect it’s a hoax but, then again, Dr. Roberts may himself be a true believer. What’s the evidence for hoaxiness? The subtitle was my first clue: The No Hunger Eat Anything Weight-Loss Plan. Legitimate, scrupulous doctors would be embarrassed to use that phrase. The second clue is that Dr. Roberts seems to be a former contributor to Spy magazine. This is precisely the sort of hoax the editors of Spy would concoct. The third clue is that he uses just enough quasi-legitimate scientific theory and jargon to rope in many readers.

A 2007 article in the Journal of Molecular Medicine exposes a genetic variation that seems to prevent high fat consumption from contributing to overweight. The gene variant may be found in 10-15% of the U.S. population. Consumption of monounsaturated fats, as in olive and canola oil, almost seems to protect against overweight in people who carry this genetic variation. I’m talking about single nucleotide polymorphisms of the apolipoprotein A5 gene, specifically, -1131T>C. But you knew that, right? Nutritional genomics may eventually allow us to customize our food intake to work best with our personal genetic make-up.

A number of people, including Dr. Roberts, swear by the Shangri-La Diet. It works for them. I don’t think most of them are lying. Maybe they are in the subset of the population with the appropriate genetic variant.

It would be easy to design and execute an experiment on 100 subjects to test the efficacy of the Shangri-La Diet. Until that’s done - and it probably never will be - you could inexpensively try the Shangri-La experiment of one on yourself. From what I’ve read, you’ll know within the first week if you achieve the natural appetite suppression that substitutes for the willpower and discipline required by effective diets.

If it is a hoax, I complement Dr. Roberts on his ingenuity. His book was a bestseller in 2006. For those he may have duped, it didn’t cost them much and probably caused no harm.

-Steve

Sanjeev said...

> If it is a hoax, I complement

First time I ever heard of Dr. Roberts was a CBC news piece on the Shanghri La Diet and this was my first reaction.

I came around enough to read further IIRC about a year after that, when a blog discussed some of the studies Dr. R cited.

Swinesoul said...

This concept seems really plausible. My mother as a child in the Carribean ate lots of tubers without measuring and was very lean. Ive been following Jaminet's PHD. I feel great on it. But this says u shouldnt combine starch with fat, something we do regularly. So can I eat some protein glazed with fat in a plate before having a separate plate of starch n veggies?

Anonymous said...

This is not all that difficult to do. Bodybuilders do it all the time. The same few foods over and over. You need to tell yourself food is for fuel. You'd be surprised at the wonderful flavor a potato has without salt, butter, etc. You must train yourself to eat this way but if you're successful, the taste experience is incredible. After a while, it will become tasty, which may not be such a good thing for lowering set point.

dguttgrl79 said...

What the heck is wrong with enjoying food? one of the most interesting things in life is the flavors of each culture and the way each culture uses spices (or not). This makes me sad. I get the point of it, but why? After you do this you appreciate food again even more? Well interesting information I suppose. To each their own.

Anonymous said...

The title of this article just says it all, imo. I believe it's not only responsible for obesity but for food addiction, as well, which is not necessarily the same. I don't like comparing myself to other cultures, though. That seems to be a big favorite for folks. My European heritage is certainly not the same as other cultures, who are more than likely a completely different race. It's like comparing myself to the rats/mice that studies use and thinking I will have the same results. Maybe yes, maybe no. It's just a tool. I bought the Shangri-La book. Yuk. Way too extreme for me. I don't think extremes work too well. I appreciate your writing about this topic and giving us some great ideas. Something to think about.

Anonymous said...

I agree with the Anon that said bodybuilders do it all the time. The successful ones with the most size and great definition have this down. They are indeed, lucky dudes. It takes vision and perseverance to do what they do. They just eat and go. Don't even think about it. And you don't need variety and tons of different kinds of foods to get all the nutrients, etc. Healthy, whole food. The same ones seasonally over and over is the best way for your body to take in nutrients.