Why We Eat (Too Much)
Page 36
UTP-1 76
Qatar 44
radiation exposure 49
raw foods 118–19, 120–21
relaxation response 72, 73, 74
renin 10
replicant chains 112, 113
reproductive fitness hypothesis 47
resting metabolic rate see basal metabolic rate (BMR)
rice 130–31, 212, 219, 222
egg-fried 251
glycaemic load 269, 290
and vitamin B1 165–6
Rimonobant 188n
Rockefeller University Hospital, New York 17
safflower 172, 181
sarcolipin 76–7
sarcopenia 267
satiety 25, 26, 29, 80, 89
and fat 210, 211
hormones 80–81, 83–4, 89, 100, 103, 104, 105, 210 see also leptin
as the off-switch 83–4
saturated fats 133, 150–51, 160, 172–3, 176, 179, 250–51n
cholesterol in 141, 148 see also cholesterol
demonization of 171, 211, 277, 278
and ‘diet–heart’ hypothesis 141–50, 160, 171, 181, 277–81, 282–3
and the French Paradox 211–12
replaced with omega-6 fats/vegetable oils 150–51, 160–63, 172–3, 179–82, 183, 194, 208
Saudi Arabia 44
scurvy 168–70
seasonal foods 213
seed oils 181, 194
seeds 123, 127, 130, 156, 222, 258
and advent of agricultural age 127–8
cereal see cereal grains
dried 261
sesame oil 180, 289
Seven Years War 168–9
sex hormones 175, 225–6
shortenings 173, 199
slave trade 48–9, 131
sleep 238–9, 252–4
deprivation 253
hormone see melatonin
preparing for 253–4
and weight set-point theory 254
sleeve gastrectomy xi, 25, 104–5, 105
SlimFast 219
Slimming World 19, 106, 219
Slovakia, processed food 229
smoking
and heart disease 146, 149, 149
and sugar consumption 141
snacking/snacks 100, 193, 202–4, 209, 219, 249, 250, 278
and omega-6 258, 260, 261
sugary snacks 203, 217, 249, 267
soap, hydrogenated vegetable oil 153–4
South Beach diet 106
soybean oil 151, 179, 180, 194, 289
spices 250
starvation
Minnesota Starvation Experiment 21–2, 24, 141
in the womb, and obesity in offspring 51–3, 55, 56, 57
see also famine
statins 150, 282, 283
Stein, John 189
stress 155, 237
of city life 265
hormone see cortisol
metabolic stress and the ANS 70–71, 73
and mindfulness 241–2
reducing family/work stress 239
student stress and weight gain 224
sugar 130–32, 135, 137–9, 157, 160–61, 252
addiction 134–5, 203–4, 232, 240–41
and alcohol 204 see also alcohol
beet 133, 139
blood see blood sugar
cane 130–31, 139
Caribbean 131–2, 133
consumption rises 138–9, 139, 174, 208
cravings 73, 130, 201, 208, 240
glut 131–2
glycaemic index see glycaemic index (GI)
glycaemic load 290
and hyper-insulinaemic clamp 196–7
loaf 132n
and McGovern Report 148, 202
and obesity 140, 193
in processed foods 99–100, 135–6, 150, 154, 160
research into effects on health 140–41, 147
roller coaster 201–4, 202, 208
and slave trade 131
and smoking 141
stored in muscles and liver 199
sugary snacks 203, 217, 249, 267
taken with insulin 196–7
and tooth rot 132
trade 49, 131–2, 138–9
and vegetarian/vegan diets 222
suicide 188n, 189
sunflower oil 172, 180, 288
sunflower seeds 258, 261
sweet potato 36, 118, 123, 124, 157, 268, 269, 286
sympathetic nervous system (SNS) 71–2, 77, 264
and over-eating 73–4
Takaki, Kanehiro 167
taste buds 129
taste types 130
television viewing 252
testosterone 175, 225–6
thermogenesis 70, 74–7, 78, 267
thiamine deficiency 163–8
thirst 10–11, 20
hormone 10
thrifty gene hypothesis 47–9
TNF-alpha 95, 96–7, 186, 199
and insulin 98–9, 99, 199
tofu 261
trans-fats 153, 154, 182, 209, 281
triglycerides 200
tubers 36, 118, 123, 124, 126, 127, 156, 156, 157, 212
tyrosine kinase 98n
United Arab Emirates (UAE) 44, 50, 54–5, 206, 229
United Kingdom, processed food 229
United States of America
and African slave trade 48–9
consumption of added fats/oils 152, 173, 174, 175
daily calorie consumption by average American 174
Department of Agriculture 173
dietary guidelines, McGovern see McGovern Report and US dietary guidelines
link between obesity and intake of vegetable oils in 190
linoleic acid levels in citizens’ body fat 181
obesity rates 44, 48, 172
processed food 229
weight gain in people migrating to 48–9, 229
university, student stress when starting 224
University College London Hospital (UCLH) ix, x
urine 10–11, 20
UTP-1 76
vegan diets 222
vegetable oils 32, 151–4, 152, 157, 160–61, 172–5, 179–82, 180, 194, 202, 208, 237, 258, 259–60, 278
and cholesterol 152, 153, 172
frying/cooking avoidance with 151–3, 222, 259, 261, 263
glycaemic load 288
hydrogenation 152–3, 182
and insulin 199
and obesity rates in USA 190
and omega-6 179–80, 180, 181, 182, 183, 194
shelf life 182, 194, 258, 261
and trans-fats 153, 182, 281
vegetables 118, 123, 126, 127, 132, 212, 250, 256, 262, 263
glycaemic load 269, 286–7
scurvy and the lack of fresh 168–70
vegetarian diets 222
Venus of Willendorf 159
Vermont State Prison over-eating experiment 16–17
Victorian diet 132–3
Virchow, Rudolf 145–6
vitamin B1 deficiency 163–8
vitamin C deficiency 168–70
Wardle, Jane 42
water intake 10–12, 20
Watson, James 53
weight-cycling dieting 65–7, 67
weight gain
and calorie consumption 12–15, 13, 14, 17
of cattle 32–6, 60–61
and insulin therapy 197–8
and leptin resistance 92–101, 99, 186, 198, 223, 227–8
and life events 223–30
and marriage 224–6
and migration 48–9, 228–30
and negative feedback see negative feedback in weight regulation
and night work 226–7, 252–3
and subconscious power of the brain 27–8, 29, 77
in Vermont State Prison over-eating experiment 16–17
weight loss
and appetite following bariatric surgery 79
through bariatric surgery see bariatric surgery
biggest losers in the lab 64
/>
and calorie restriction 19–23, 23
and dieting ix–x, xii, xiii, 19–20, 29, 61–7, 86, 214–17
difficulties in sustaining x, 19–30, 64–7
and DNP 75–6
and energy balance see energy balance
through exercise 217–18
and infertility 94
and leptin 85–6, 86
with lifestyle changes 217–19, 218
through lowering set-point 28–30, 102–3, 217–19, 218, 231–2 see also weight set-point-based programme for losing weight
and malabsorptive procedures 103, 104 see also gastric bypass
and metabolism/BMR 28–30, 29, 64–5, 65
and microbiome 230–31
and Minnesota Starvation Experiment 21–2, 24
and negative feedback see negative feedback in weight regulation
programme using set-point theory see weight set-point-based programme for losing weight
realistic expectations for 236–7, 276
shows on TV 63–4, 65
surgery see bariatric surgery
and vegan diets 222
and vegetarian diets 222
weight set-point resetting necessary for sustaining 28–30, 102–3
weight regulation
and calories see calories
of cattle 31–6, 60–61
through dieting see dieting
and insulin 197–8, 209
leptin as master regulator see leptin
losing weight see weight loss; weight set-point-based programme for losing weight
and metabolic adaptation 18–19, 22–3, 23, 26–30, 29, 69–70, 77, 203, 248, 273
and Minnesota Starvation Experiment 21–2, 24
and negative feedback see negative feedback in weight regulation
and subconscious power of the brain 27–8, 29, 64–5, 66, 77, 107, 217 see also weight set-point theory
and weight set-point see weight set-point theory
weight set-point-based programme for losing weight 235–71
first step: eat more 249–52
second step: get more sleep 252–4
third step: prime your cells 255–63
fourth step: tone your muscles 263–7
fifth step: reduce your insulin 267–71
and breakfast ingredients 250–51
and cooking 237–8
enjoying the programme 240
and evening meal ingredients 252
and home environment 237–9, 253–4
and lunch ingredients 251
mental preparation 240–47 see also mindfulness
preparing to reset weight set-point 235–47
realistic expectations 236–7, 276
reducing family/work stress 239
throwing out foods to be avoided 249–50
understanding weight set-point 237
weight set-point theory 28–30, 29, 170–71
and alcohol 204–8
and bariatric surgery 102–4, 237
food quality, environment and 32–3, 34–42, 43–4, 47, 61, 193–4, 199
and the French Paradox 211–12
and genetics 33–4, 35, 43–4, 47, 61
and insulin 173, 187, 197–8, 199, 201, 203–4, 209, 222, 230, 240, 249, 256, 265
and leptin 85–6, 86, 89, 203, 227–8, 230, 253
and life events 223–30
losing weight through lowering set-point 28–30, 102–3, 217–19, 218, 231–2 see also weight set-point-based programme for losing weight
and marriage 224–6
and the metabolism 28–30, 29, 64–5, 66–7, 77–8, 171
and migration 228–30
moving of set-point 30, 33, 35, 66, 67, 68, 96, 103, 104, 106, 107, 170, 171, 187, 189, 191, 192, 193–4, 195, 197–8, 199, 203–4, 207, 208, 215, 217–18, 218, 221, 222, 223–30, 231–2 see also weight set-point-based programme for losing weight
and negative feedback 28–9, 29, 64–5, 66–7, 77, 85–6, 86, 89
and night work 226–7, 252–3
and omega fatty-acid ratio in Western diet 182–3, 187, 189–91, 195, 199, 203–4, 229–30, 258–9
preparing to reset set-point 235–47
resetting set-point as necessity for sustaining weight loss 28–30, 102–3
return to set-point 29, 29, 64–5, 77, 85, 86, 86, 89, 104, 215, 216
and sleep 254
and weight loss through lifestyle changes 217–19, 218
and young people leaving home/starting university 224
Western-type foods see processed/Western-type foods
wheat 100, 128, 130–31, 134–5, 157, 173–4, 180, 208, 212, 222, 250, 252, 278
addiction 135, 232
Wheeler, P.: ‘The Expensive Tissue Hypothesis’ (with L. C. Aiello) 115–16
Williams, Mark 242
Wonderwerk cave, South Africa 118
yo-yo dieting 65–7, 67, 107
yogurt 250, 251, 269, 288
Yudkin, John 140–41, 147, 148
THIS IS JUST THE BEGINNING
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PENGUIN BOOKS
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Penguin Books is part of the Penguin Random House group of companies whose addresses can be found at global.penguinrandomhouse.com.
First published 2020
Copyright © Dr Andrew Jenkinson, 2020
The moral right of the author has been asserted
Jacket photograph © Shutterstock
This book is based on my own experience as a consultant surgeon with a special interest in advanced laparoscopic, or keyhole, surgery. In order to protect the privacy and confidence of patients, I have, of course, not used any real names and I have changed all physical descriptions and other features to ensure that no one is identifiable. I have, in some cases, also changed genders and racial origins. This is because this is not a book about the individuals I have described, but about what we can learn from them.
ISBN: 978-0-241-40054-8
This ebook is copyright material and must not be copied, reproduced, transferred, distributed, leased, licensed or publicly performed or used in any way except as specifically permitted in writing by the publishers, as allowed under the terms and conditions under which it was purchased or as strictly permitted by applicable copyright law. Any unauthorized distribution or use of this text may be a direct infringement of the author’s and publisher’s rights and those responsible may be liable in law accordingly.
ONE: Metabology for Beginners
1 In critically ill patients, the minimal urine output should be 30ml per hour to prevent kidney failure and to ensure survival. This equates to 700ml per day. We also lose water through our breath (400ml), through sweating (400ml) and in faeces (100ml), but this is offset by the amount of water we generate through our own metabolism (400ml) and the water contained within the food we eat (500ml).
2 Calories taken in from the food supply, when adjusted for food wastage, are the most accurate method of determining a population’s calorie consumption. Several studies have used self-reporting of food intake to estimate consumption. This was recently confirmed by the UK’s Office for National Statistics to be up to 70 per cent inaccurate.
3 In chapter 12 of this book, we will look at the most common diets, how they work, and why they fail.
TWO: The Sacred Cow
1 Anyone who has travelled to India will have noticed that cows are allowed
to roam the streets and roads freely. Early Hindu Vedic texts encouraged the peaceful coexistence of cows and man. Cows are venerated for their peaceful temperament and maternal qualities such as milk-giving – a very important food source for the population. Not only is their milk used, but the ghee (the clarified butter from the milk) is used for cooking and burned during blessings. Everything that the cow produces is seen as useful (its dung is used as fuel to burn in the winter or as fertilizer in the summer), and it is not unusual to find people in rural areas drinking and bathing in cow’s urine (a useful source of sterile fluid).
2 By industrialized foods I mean food that has been processed by food companies. The processing involves the removal of a lot of the goodness from the foods, to make them suitable for transport and storage, as well as to make them palatable, so that people buy them (in preference to fresh food) and the food company makes money. This type of food is what we mean by ‘Western’-type foods.
3 It is estimated that, between the sixteenth and nineteenth centuries, approximately 2 million enslaved Africans died during the passage. Another 4 million died in Africa, after capture but before embarkation, on enforced marches and in detention camps. Only 10.5 million survived the passage.
THREE: Dieting and the Biggest Losers
1 In this chapter, when I use the word ‘metabolism’, I am referring to the ‘basal metabolic rate’, i.e. the amount of energy used in a day before any type of physical activity is added – the amount of energy you would use if you stayed in bed all day (usually 70 per cent of total energy output).
2 They were 500kcal less than pre-diet levels after adjustment for weight loss.
3 BMR (basal metabolic rate): women: BMR = 655 + (4.35 × weight in pounds) + (4.7 × height in inches) – (4.7 × age in years); men: BMR = 66 + (6.23 × weight in pounds) + (12.7 × height in inches) – (6.8 × age in years).
4 In this chapter I use the word ‘muscles’ to describe our ‘skeletal muscles’, i.e. those muscles that are attached to our skeleton and that we consciously use to move ourselves around.
FIVE: The Glutton
1 Insulin is a hormone released by the pancreas when we eat any food containing glucose (e.g. sugar, bread, pasta). Its job is to transport the glucose from the blood into the cells themselves so that they can use it for energy.
2 Inflammation is essential for our health – it fights infection and repairs cells. Signals from damaged cells and from foreign invaders into our bodies stimulate our inflammatory response.