Fall is here and with it comes numerous holidays (Rosh Hashanah/Yom Kippur for us Jews, Thanksgiving, etc), football games and celebrations (Oktoberfest, renaissance festivals, etc). Fall is then followed by winter which brings eggnog, potato latkes and LOTS of parties. Needless to say, the opportunities to overeat run rampant. Unless you are seriously committed to eating well (as some of you are), you will likely overindulge.
But all is not lost! I just read a blurb of an article written by Dr. Weil on a study who found another biochemical reason for why we overeat. Basically, in this study from Yale and the Univ of Southern California, study participants had their blood sugars medically lowered by IV medication (yes, we can do that) and then underwent functional MRIs (fMRI) of their brains while being shown pictures of foods. Specific sites in the brain known for encouraging eating, called the insula and striatum, lit up on fMRI and ignited a desire to eat. Another area of the brain, the prefrontal cortex, which is known for its inhibitory functions on desires and cravings, appeared to lose its ability to stop these impulses while blood sugars were low. Fascinating!!
What's even more, this action played out time and again with subjects of normal weight who's blood sugars were dropped. Interestingly, this action occurred at all times in obese subjects, regardless of their blood sugar levels. In other words, the brains of the obese subjects sabotaged their bodies! This is an extremely important finding as it shows that people with food impulse problems cannot, single-handedly, just quit eating. It doesn't work as the cravings take on a life of their own.
But how, then, does one go about undoing the sabotage? For one, by keeping only fresh fruits, veggies and a handful of nuts at home (or the office) handy, one can avoid caving in to their more calorie-laden cravings. Secondly, mind-body therapies, such as hypnotherapy or Mindfulness-Based Eating (an accredited mind-body program) can help deflect these cravings by bolstering the prefrontal cortex's ability to inhibit the impulses. They teach you to think about and savor every morsel of food you place in your mouth. Slowing down to savor each morsel CAN AND WILL change your life! These therapies are widely available throughout the U.S. and in most developed nations. Be sure to check out the following website on mindful eating and try to locate a practitioner near you - http://www.tcme.org/mindfulness_practices.htm. Or call me and I can help you locate one or recommend some relevant resources.
I hope this helps those of you who, like me, have intense food cravings understand what's going on in your brain/bodies. The more enlightened we are about these processes, the more easily we are able to change them.
Happy holidays to those celebrating and thanks to Dr. Weil for the write-up of this article. It was featured in the Sept. 19th edition of Journal of Clinical Investigation.
Have a fantastically mindful weekend,
If you're like most Westerners (which, I assume you are since you are reading my blog), you likely haven't thought too much about your death. In fact, if you're like most Americans, you probably have never seen someone die nor do you likely have the most pleasant feelings regarding the death and dying process. In fact, you probably want to avoid death at all costs and are pretty much willing to do anything to do so. Right?
The feelings of avoiding death (ie, survival) is biologically engrained in all of us. It is normal to want to live. It is normal to want to fight to live. But, it is my opinion that in Western society, we may be taking the avoidance of death and aging a bit too far. Annually, Westerners spend billions of dollars on beauty and lifestyle products to make us look feel and healthier. But are we really any healthier than those of other societies with much less? Yes, we have increased the average life expectancy (now in the late 70s, early 80s for women I believe), but how's our quality of life? Westerners are definitely living longer, but as a result, we suffer from more and more chronic diseases (diabetes, heart disease, dementia, cancer, etc) which debilitate us more and more (examples - diabetics may lose limbs or go blind; cancer survivors are almost always left with long-term side effects of their treatments, whatever they may be), causing us to be less and less happy and on more and more medication (ie, anti-depressants). Many elderly, frail patients end up in nursing homes without family or friends around. Is this really what early 20th century docs and public health officials had in mind? Is replacing a heart valve with one from a pig or made from metal really the way to go when an already fragile person does not have more than 3-5 years of life left? What are the risks of the surgery? What will the person's life be like after surgery? Will they be able to walk, talk, dress themselves, enjoy the company of friends and family? These are the unknowns of medicine and I definitely don't have any concrete answers as much of them are based on the individual and what they value in life. If a 45 year old man is diagnosed with a moderately curable cancer (G-d forbid) and seeks treatment in order to save his life, so be it. This is MUCH different than a 78 year old frail woman needing heart or abdominal surgery. These issues are very complicated, sending some in to a tivvy (myself included).
The reason I bring this up is not so much to discuss the ethics of medical treatment. It's more to discuss the ethics of non-treatment and to convince some of you that palliative care (ie, hospice care) is a humane and practical form of medical care that is not embraced as often as it should be. I attended a very interesting conference at the hospital today on the conflicts health care practitioners face when caring for the dying (I won't go in to details about the actual conference as I swore to keep it inside the room (HIPPA)). To start, I want you to keep in mind that nurses, doctors and other healthcare practitioners experience just as many conflicting emotions about their patients' deaths (and lives) as the patient and their families. We are, after all, human. And no amount of training can take that away.
Anyways, the conference discussion brought up some very salient points about our current mentality on death and dying. One of the main points was that there is a disconnect between the services provided by palliative care teams and what the public perceives these services to be. To be "on palliative care", you a) must meet specific criteria (ie, have a terminal illness or condition for which your life expectancy is predicted to be up to 6 months) and b) can still receive antibiotics, fluids, wound care, nutrition, etc, etc. You are not left to wither away and die alone.
In fact, a study from last year's New England Journal of Medicine found that early palliative care team involvement enabled patients with newly diagnosed metastatic non-small cell lung cancer to live 3 months LONGER than those on chemotherapy without palliation. These patients, like their control group counterparts, received chemotherapy as well as "comfort care" from nurses specially trained to take care of their day-to-day needs - pain, nausea, malnutrition. Not only did the patients in the palliative care group live longer, but they also reported significantly higher scores on questionnaires focused on their quality of life (defined as physical, functional, emotional, and social well-being) and mood (anxiety and depressive symptoms)! Although the study was not perfect (they hardly ever are), I find it to be quite refreshing as well as confirming of what I already know - palliation is not a bad thing. However, until we as a society can come to grips with our fear of death and dying, I believe it will be a far too often underutilized modality.
Something to think about and discuss with your families and health care practitioners. I'd love to hear your feedback.
Have a great rest of the week!
Reference source: Temel JS, et al. Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer. N Engl J Med 2010; 363:733-742.
Wow, I just read an interesting research article in my email box accusing high-speed cartoons, in this case, SpongeBob SquarePants, of decreasing the attention span and cognition (speed of processing of information) of children.
The scientists involved in the study measured the accuracy of kids' responses to questions measuring their attention and cognition after 9 minutes of watching a fast-paced cartoon (SpongeBob, whose screen changes every 5 seconds) or after 9 minutes of drawing. They concluded that the kids' responses varied between the 2 groups (were what we call 'statistically significant') with the former group showing giving fewer correct responses than the latter.
This significant result actually does not surprise me as actively stimulating the brain by drawing would, to me, logically, recruit more brain cells to work to imagine the drawing and use motor and hand-eye coordination skills to create it. TV, while it does stimulate the auditory and visual parts of the brain, does not recruit the same degree of neurons (brain cells) and therefore would not significantly improve a child's cognition or attention. In addition, the fast-paced changing of scenes in any fast-paced TV show decreases attention span and cognition in general. I learned while taking my medical school entarnce exams (MCAT) as we were all instructed to watch a movie and NOT TV the night before our exams. We were also instructed to listen to classical music on the day of the exam during breaks...who knows if any of it made any difference in my scores, but I made it through medical school following this advice. ??
Anyways, enough about me...back to SpongeBob! The study does have some major flaws (as do ALL studies!). For one, the number of children studied was small (only 60 children participated). Secondly, the statistics were analyzed "post-hoc", meaning ran a second analysis of the data with some presumed changes and not the originally planned data. This is considered a major flaw. Thirdly, the children were investigated after only 9 minutes of watching cartoons or drawing. This obviously doesn't represent their true TV wwatching habits as most children watch a LOT more TV (and cartoons) than that. And, they may end up drawing afterwards. Therefore, the confounders are varied.
Despite all of these flaws, I find this research to present a valid argument. Fast-paced TV likely does less for the neural circuits in our head and too too much TV is bad for EVERYONE'S health! That being said, if I were SpongeBob, I would definitely have my lawyers pursue a lawsuit for slander!
Have a great day and stay safe,
Source reference: Lillard AS, Peterson J. "The immediate impact of different types of television on young children's executive function" Pediatrics 2011; DOI: 10.1542/peds.2010-1919.
Still not convinced that your health and climate change are connected? Don't believe that preserving rain forests impacts your health and the future of man-kind? Then check out this article from Environmental Health Perspectives, a peer-reviewed journal published by the National Institute of Environmental Health Sciences, on the connection between climate change and the spread of infectious disease. It's sure to explain a few connections and the concern that public health workers have for our future.
Enjoy and have a GREAT and SAFE Labor Day weekend!
Dr. Maltz earned a Medical Degree and Master in Public Health from the University of Texas Medical Branch (UTMB) in Galveston, TX. She completed a combined Internal and Preventive Medicine Residency at UTMB in June, 2011. She then completed a 2-year Integrative Medicine Fellowship at Stamford Hospital in Stamford, CT, during which she simultaneously underwent an intensive 1000-hour curriculum created by The University of Arizona Integrative Medicine Program founded by Dr. Andrew Weil.