A Litmus Test for Elected Officials

by Brian Klepper and David C. KibbeSix months ago, who could have imagined that a large percentage of rank-and-file Americans would support the Occupy Wall Street (OWS) against special interests’ rigging of the American dream? So why not go to the next step? Why not pointedly ask political candidates, “Will you take money from lobbyists?” and “If elected, what will you do to stop special interest

Paul Ryan and Ron Wyden Blow the Medicare Reform Debate Wide Open!

House Budget Chair Paul Ryan (R-WI) and Senator Ron Wyden (D-OR) have embraced a Medicare reform plan that in concept borrows heavily from one championed by former New Mexico Senator Pete Domenici and former Clinton budget chief Alice Rivlin.Specifically, Wyden and Ryan are proposing to alter the earlier Ryan Medicare plan by:Continuing to offer the traditional Medicare plan—Ryan would have

A Sign of the Times

Every now and then, I venture out to go shopping at mainstream chain clothing stores.  Although I find it onerous, there are certain things I can't get at thrift stores.  For example, I can never find nice jeans.

The last time I set foot in these stores was about two years ago.  It was tough to find pants my size at that time-- many stores simply didn't sell pants with a 30 inch waist.  This year, it was even harder, since some of the stores that formerly carried 30W pants no longer did.  I managed to find my usual 30W 30L size in two stores, but I had a bizarre experience in both cases.   I put them on, and they were falling off my waist.  Since my waist size hasn't changed in two years, and my old 30W 30L pants of the same brand still fit the same as they did when I bought them two years ago, I have to conclude that both stores have changed their definition of "30 inches".  My new size is 28W 30L, which is tough to find these days.
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60 Minutes Report on the Flavorist Industry

A reader sent me a link to a recent CBS documentary titled "Tweaking Tastes and Creating Cravings", reported by Morley Safer.

Safer describes the "flavorist" industry, entirely dedicated to crafting irresistible odors for the purpose of selling processed and restaurant food.  They focused on the company Givaudin.  Dr. David Kessler, author of The End of Overeating, makes an appearance near the end.

Here are a few notable quotes:

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New Review Papers on Food Reward

As research on the role of reward/palatability in obesity continues to accelerate, interesting new papers are appearing weekly.  Here is a roundup of review papers I've encountered in the last three months.  These range from somewhat technical to very technical, but I think they should be mostly accessible to people with a background in the biological sciences. 

Food and Drug Reward: Overlapping Circuits in Human Obesity and Addiction
Written by Dr. Nora D. Volkow and colleagues.  This paper describes the similarities between the mechanisms of obesity and addiction, with a focus on human brain imaging studies.  Most researchers don't think obesity is an addiction per se, but the mechanisms (e.g., brain areas important for reward) do seem to overlap considerably.  This paper is well composed and got a lot of media attention.  Dr. Volkow is the director of the National Institute on Drug Abuse, a branch of the National Institutes of Health.  The NIH is the main source of biomedical research funding in the US, and also conducts its own research.

Here's a quote from the paper:

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Another Simple Food Weight Loss Experience

Whole Health Source reader Sarah Pugh recently went on a six-week simple food (low reward) diet to test its effectiveness as a weight loss strategy, and she was kind enough to describe her experience for me, and provide a link to her blog where she discussed it in more detail (1). 

Consistent with the scientific literature and a number of previous reader anecdotes (2), Sarah experienced a reduction in appetite on the simple food diet, losing 15 pounds in 6 weeks without hunger.  In contrast to her prior experiences with typical calorie restriction, her energy level and mood remained high over this period.  Here's a quote from her blog:

Well, it looks like the theory that in the absence of nice palatable food, the body will turn quite readily to fat stores and start munching them up, is holding up. At the moment, the majority of the energy I use is coming from my insides, and my body is using it without such quibbles as the increased hunger, low energy, crappy thermo-regulation or bitchiness normally associated with severe calorie restriction.

I can't promise that everyone will experience results like this, but this is basically what the food reward hypothesis suggests should be possible, and it seems to work this way for many people.  That's one of the reasons why this idea interests me so much.

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A Brief Response to Taubes's Food Reward Critique, and a Little Something Extra

It appears Gary Taubes has completed his series critiquing the food reward hypothesis of obesity (1).  I have to hand it to him, it takes some cojones to critique an entire field of research, particularly when you have no scientific background in it.

The food reward hypothesis of obesity states that the reward and palatability value of food influence body fatness, and excess reward/palatability can promote body fat accumulation.  If we want to test the hypothesis, the most direct way is to find experiments in which 1) the nutritional qualities of the experimental diet groups are kept the same or at least very similar, 2) some aspect of diet reward/palatability differs, and 3) changes in body fat/weight are measured (for example, 2, 3, 4, 5, 6, 7, 8, 9).  In these experiments the hypothesis has both arms and one leg tied behind its back, because the most potent reward factors (energy density, sugar, fat) have nutritional value and therefore experiments that modify these cannot be tightly controlled for nutritional differences.  Yet even with this severe disadvantage, the hypothesis is consistently supported by the scientific evidence.  Taubes repeatedly stated in his series that controlled studies like these have not been conducted, apparently basing this belief on a 22-year-old review paper by Dr. Israel Ramirez and colleagues that does not contain the word 'reward' (10). 

Another way to test the hypothesis is to see if people with higher food reward sensitivity (due to genetics or other factors) tend to gain more fat over time (for example, 11, 12, 13, 14, 15, 16).  In addition, studies that have examined the effect of palatability/reward on food intake in a controlled manner are relevant (17, 18, 19, 20, 21, 22), as are studies that have identified some of the mechanisms by which these effects occur (reviewed in 23).  Even if not all of the studies are perfect, at some point, one has to acknowledge that there are a lot of mutually buttressing lines of evidence here.  It is notable that virtually none of these studies appeared in Taubes's posts, and he appeared largely unaware of them. 
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The Super Committee Failure—What’s Next?

The stock market today was shocked, simply shocked, that the Super Committee didn’t come up with a debt deal.I don’t know why. Republicans can’t vote for more taxes unless they're willing to get “primaried” from the right and risk losing their seat. Ditto for Democrats who would face the same punishment from their base if they voted to change the sacred defined benefit entitlements without at

Two Recent Papers by Matt Metzgar

This is just a quick post to highlight two recent papers by the economist and fellow health writer Matt Metzgar.

The first paper is titled "The Feasibility of a Paleolithic Diet for Low-income Consumers", and is co-authored by Dr. Todd C. Rideout, Maelan Fontes-Villalba, and Dr. Remko S. Kuipers (1).  They found that a Paleolithic-type diet that meets all micronutrient requirements except calcium (which probably has an unnecessarily high RDA) costs slightly more money than a non-Paleolithic diet that fulfills the same requirements, but both are possible on a tight budget. 

The second paper is titled "Externalities From Grain Consumption: a Survey", with Matt Metzgar as the sole author (2).  He reviews certain positive and negative externalities due to the effects of grain consumption on health.  The take-home message is that refined grains are unhealthy and therefore costly to society, whole grains are better, but grains in general have certain healthcare-related economic costs that are difficult to deny, such as celiac disease.

There are a lot of ideas floating around on the blogosphere, some good and others questionable.  Composing a manuscript and submitting it to a reputable scientific journal is a good way to demonstrate that your idea holds water, and it's also a good way to communicate it to the scientific community.  The peer review process isn't perfect but it does encourage scientific rigor.  I think Metzgar is a good example of someone who has successfully put his ideas through this process.  Pedro Bastos, who also spoke at the Ancestral Health Symposium, is another example (3).

Does High Circulating Insulin Drive Body Fat Accumulation? Answers from Genetically Modified Mice

The house mouse Mus musculus is an incredible research tool in the biomedical sciences, due to its ease of care and its ability to be genetically manipulated.  Although mice aren't humans, they resemble us closely in many ways, including how insulin signaling works.  Genetic manipulation of mice allows researchers to identify biological mechanisms and cause-effect relationships in a very precise manner.  One way of doing this is to create "knockout" mice that lack a specific gene, in an attempt to determine that gene's importance in a particular process.  Another way is to create transgenic mice that express a gene of interest, often modified in some way.  A third method is to use an extraordinary (but now common) tool called "Cre-lox" recombination (1), which allows us to delete or add a single gene in a specific tissue or cell type. 

Studying the relationship between obesity and insulin resistance is challenging, because the two typically travel together, confounding efforts to determine which is the cause and which is the effect of the other (or neither).  Some have proposed the hypothesis that high levels of circulating insulin promote body fat accumulation*.  To truly address this question, we need to consider targeted experiments that increase circulating insulin over long periods of time without altering a number of other factors throughout the body.  This is where mice come in.  Scientists are able to perform precise genetic interventions in mice that increase circulating insulin over a long period of time.  These mice should gain fat mass if the hypothesis is correct. 

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The Brain Controls Insulin Action

Insulin regulates blood glucose primarily by two mechanisms:

1. Suppressing glucose production by the liver
2. Enhancing glucose uptake by other tissues, particularly muscle and liver

Since the cells contained in liver, muscle and other tissues respond directly to insulin stimulation, most people don't think about the role of the brain in this process.  An interesting paper just published in Diabetes reminds us of the central role of the brain in glucose metabolism as well as body fat regulation (1).  Investigators showed that by inhibiting insulin signaling in the brains of mice, they could diminish insulin's ability to suppress liver glucose production by 20%, and its ability to promote glucose uptake by muscle tissue by 59%.  In other words, the majority of insulin's ability to cause muscle to take up glucose is mediated by its effect on the brain. 

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Romney Jumps on the Waiver Bandwagon--And Creates Even More Uncertainty Over the New Health Care Law

Republican presidential frontrunner Mitt Romney has pledged to end “Obamacare.” Upon taking office, he would immediately begin the process by granting the states waivers from having to implement it:“I’ll grant a waiver on Day One to get repeal started. On Day One, granting a waiver for all 50 states doesn’t stop it in its tracks entirely. That’s why I also say we have to repeal Obamacare, and I

Harvard Food Law Society "Forum on Food Policy" TEDx Conference

Last Friday, it was my pleasure to attended and present at the Harvard Food Law Society's TEDx conference, Forum on Food Policy.  I had never been to Cambridge or Boston before, and I was struck by how European they feel compared to Seattle.  The conference was a great success, thanks to the dedicated efforts of the Food Law Society's presidents Nate Rosenberg, Krista DeBoer, and many other volunteers. 

Dr. Robert Lustig gave a keynote address on Thursday evening, which I unfortunately wasn't able to attend due to my flight schedule.  From what I heard, he focused on practical solutions for reducing national sugar consumption, such as instituting a sugar tax.  Dr. Lustig was a major presence at the conference, and perhaps partially due to his efforts, sugar was a central focus throughout the day.  Nearly everyone agrees that added sug`r is harmful to the nation's health at current intakes, so the question kept coming up "how long is it going to take us to do something about it?"  As Dr. David Ludwig said, "...the obesity epidemic can be viewed as a disease of technology with a simple, but politically difficult solution".

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Losing Fat With Simple Food-- Two Reader Anecdotes

Each week, I'm receiving more e-mails and comments from people who are successfully losing fat by eating simple (low reward) food, similar to what I described here.  In some cases, people are breaking through fat loss plateaus that they had reached on conventional low-carbohydrate, low-fat or paleo diets.  This concept can be applied to any type of diet, and I believe it is an important characteristic of ancestral food patterns.

At the Ancestral Health Symposium, I met two Whole Health Source readers, Aravind Balasubramanian and Kamal Patel, who were interested in trying a simple diet to lose fat and improve their health.  In addition, they wanted to break free of certain other high-reward activities in their lives that they felt were not constructive.  They recently embarked on an 8-week low-reward diet and lifestyle to test the effectiveness of the concepts.  Both of them had previously achieved a stable (in Aravind's case, reduced) weight on a paleo-ish diet prior to this experiment, but they still carried more fat than they wanted to.  They offered to write about their experience for WHS, and I thought other readers might find it informative.  Their story is below, followed by a few of my comments.

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The Case for the Food Reward Hypothesis of Obesity, Part II

In this post, I'll explore whether or not the scientific evidence is consistent with the predictions of the food reward hypothesis, as outlined in the last post.

Before diving in, I'd like to address the critique that the food reward concept is a tautology or relies on circular reasoning (or is not testable/falsifiable).  This critique has no logical basis.  The reward and palatability value of a food is not defined by its effect on energy intake or body fatness.  In the research setting, food reward is measured by the ability of food or food-related stimuli to reinforce or motivate behavior (e.g., 1).  In humans, palatability is measured by having a person taste a food and rate its pleasantness in a standardized, quantifiable manner, or sometimes by looking at brain activity by fMRI or related techniques (2).  In rodents, it is measured by observing stereotyped facial responses to palatable and unpalatable foods, which are similar to those seen in human infants.  It is not a tautology or circular reasoning to say that the reinforcing value or pleasantness of food influences food intake and body fatness. These are quantifiable concepts and as I will explain, their relationship with food intake and body fatness can be, and already has been, tested in a controlled manner. 

1.   Increasing the reward/palatability value of the diet should cause fat gain in animals and humans

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The Case for the Food Reward Hypothesis of Obesity, Part I

Introduction

When you want to investigate something using the scientific method, first you create a model that you hope describes a natural phenomenon-- this is called a hypothesis.  Then you go about testing that model against reality, under controlled conditions, to see if it has any predictive power.  There is rarely a single experiment, or single study, that can demonstrate that a hypothesis is correct.  Most important hypotheses require many mutually buttressing lines of evidence from multiple research groups before they're widely accepted.  Although it's not necessary, understanding the mechanism by which an effect occurs, and having that mechanism be consistent with the hypothesis, adds substantially to the case.

With that in mind, this post will go into greater detail on the evidence supporting food reward and palatability as major factors in the regulation of food intake and body fatness.  There is a large amount of supportive evidence at this point, which is rapidly expanding due to the efforts of many brilliant researchers, however for the sake of clarity and brevity, so far I've only given a "tip of the iceberg" view of it.  But there are two types of people who want more detail: (1) the skeptics, and (2) scientifically inclined people who want mechanism.  This post is for them.  It will get technical at times, as there is no other way to convey the material effectively.

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The Ryan Health Care Proposals—Not Your Congressman’s Health Plan

Update: The New Wyden-Ryan Plan - Paul Ryan and Ron Wyden Blow the Medicare Reform Debate Wide Open! In a speech at the Hoover Institution today, Representative Paul Ryan (R-WI) argued again that his proposal to reform Medicare, and now his tax credit proposal for replacing the Democratic health care law for those under-age 65, would guarantee to citizens “options like the ones members of

The Health Leadership Council Medicare Proposal: Too Much Responsibility on Beneficiaries and Not Enough on Providers

The Health Leadership Council (HLC), a coalition of CEOs from many of the leading health care companies, has created a list of Medicare reform recommendations for the Super Committee tasked with finding at least $1.2 trillion in budget savings.As we begin the national debate over what to do about Medicare's unsustainable costs, I will suggest that the HLC proposal gives us one, of what will have

Humans on a Cafeteria Diet

In the 1970s, as the modern obesity epidemic was just getting started, investigators were searching for new animal models of diet-induced obesity.  They tried all sorts of things, from sugar to various types of fats, but none of them caused obesity as rapidly and reproducibly as desired*.  1976, Anthony Sclafani tried something new, and disarmingly simple, which he called the "supermarket diet": he gave his rats access to a variety of palatable human foods, in addition to standard rodent chow.  They immediately ignored the chow, instead gorging on the palatable food and rapidly becoming obese (1).  Later renamed the "cafeteria diet", it remains the most rapid and effective way of producing dietary obesity and metabolic syndrome in rodents using solid food (2).

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Primal Docs

Chris Armstrong, creator of the website Celiac Handbook, has designed a new non-commercial website called Primal Docs to help people connect with ancestral health-oriented physicians.  It's currently fairly small, but as more physicians join, it will become more useful.  If you are a patient looking for such a physician in your area, or an ancestral health-oriented physician looking for more exposure, it's worth having a look at his site:

Primal Docs

Update 9/22: apparently there is already another website that serves a similar purpose and has many more physicians enrolled: Paleo Physicians Network.

The Debt Super Committee—Will We Get a Deal?

It’s back to work in Washington, DC and all the attention is now on the Super Committee and their goal of cutting spending by at least $1.2 trillion over ten years.If the committee fails to come up with a plan that passes the Congress, there would be $1.2 trillion in automatic cuts. The health care special interests have reason to hope they will fail—the fallback cuts would only impact Medicare

Fat Tissue Insulin Sensitivity and Obesity

In this post, I'll discuss a few more facts pertaining to the idea that elevated insulin promotes the accumulation of fat mass.  

Insulin Action on Fat Cells Over the Course of Fat Gain

The idea that insulin acts on fat cells to promote obesity requires that insulin suppress fat release in people with more fat (or people who are gaining fat) to a greater extent than in lean people.  As I have written before, this is not the case, and in fact the reverse is true.  The fat tissue of obese people fails to normally suppress fatty acid release in response to an increase in insulin caused by a meal or an insulin injection, indicating that insulin's ability to suppress fat release is impaired in obesity (1, 2, 3).  The reason for that is simple: the fat tissue of obese people is insulin resistant.

There has been some question around the blogosphere about when insulin resistance in fat tissue occurs.  Is it only observed in obese people, or does it occur to a lesser extent in people who carry less excess fat mass and are perhaps on a trajectory of fat gain?  To answer this question, let's turn the clocks back to 1968, a year before Neil Armstrong first set foot on the moon. 

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Hyperinsulinemia: Cause or Effect of Obesity?

Is Elevated Insulin the Cause or Effect of Obesity?

The carbohydrate hypothesis, in its most popular current incarnation, states that elevated insulin acts on fat cells to cause fat storage, leading to obesity.  This is due to its ability to increase the activity of lipoprotein lipase and decrease the activity of hormone-sensitive lipase, thus creating a net flux of fat into fat cells.  I'm still not sure why this would be the case, considering that fat tissue becomes more insulin resistant as body fat accumulates, therefore insulin action on it is not necessarily increased.  Total fat release from fat tissue increases with total fat mass (1), demonstrating that insulin is not able to do its job of suppressing fat release as effectively in people who carry excess fat.  But let's put that problem aside for the moment and keep trucking.

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Catered Paleo Dinner with Yours Truly

Gil Butler, organizer of the Western Washington Paleo Enthusiasts group, has organized a catered "paleo" dinner on Sunday, October 9th.  He will be screening the first episode of "Primal Chef", Featuring Robb Wolf and others.  He invited me to give a short (20 minute) presentation, which I accepted.  There are still roughly 30 spots remaining [update 9/21-- the event is full].

The event will be in the Ballard neighborhood of Seattle and the price is $15.76 per person.  I will not be paid for this talk, it's just an opportunity to share ideas and meet people. 

Click here to register.

Book Review: The End of Overeating

The End of Overeating was written based on the personal journey of Dr. David A. Kessler (MD) to understand the obesity epidemic, and treat his own obesity in the process.  Kessler was the FDA commissioner under presidents George HW Bush and Bill Clinton.  He is known for his efforts to regulate cigarettes, and his involvement in modernizing Nutrition Facts labels on packaged food.  He was also the dean of Yale medical school for six years-- a very accomplished person. 

Kessler's book focuses on 1) the ability of food with a high palatability/reward value to cause overeating and obesity, 2) the systematic efforts of the food industry to maximize food palatability/reward to increase sales in a competitive market, and 3) what to do about it.  He has not only done a lot of reading on the subject, but has also participated directly in food reward research himself, so he has real credibility.  The End of Overeating is not the usual diet book baloney. 
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A Roadmap to Obesity

In this post, I'll explain my current understanding of the factors that promote obesity in humans.  

Heritability

To a large degree, obesity is a heritable condition.  Various studies indicate that roughly two-thirds of the differences in body fatness between individuals is explained by heredity*, although estimates vary greatly (1).  However, we also know that obesity is not genetically determined, because in the US, the obesity rate has more than doubled in the last 30 years, consistent with what has happened to many other cultures (2).  How do we reconcile these two facts?  By understanding that genetic variability determines the degree of susceptibility to obesity-promoting factors.  In other words, in a natural environment with a natural diet, nearly everyone would be relatively lean, but when obesity-promoting factors are introduced, genetic makeup determines how resistant each person will be to fat gain.  As with the diseases of civilization, obesity is caused by a mismatch between our genetic heritage and our current environment.  This idea received experimental support from an interesting recent study (3).

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Seed Oils and Body Fatness-- A Problematic Revisit

Anthony Colpo recently posted a discussion of one of my older posts on seed oils and body fat gain (1), which reminded me that I need to revisit the idea.  As my knowledge of obesity and metabolism has expanded, I feel the evidence behind the hypothesis that seed oils (corn, soybean, etc.) promote obesity due to their linoleic acid (omega-6 fat) content has largely collapsed.

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Food Palatability and Body Fatness: Clues from Alliesthesia

Part I: Is there a Ponderostat?

Some of the most important experiments for understanding the role of food palatability/reward in body fatness were performed by Dr. Michel Cabanac and collaborators in the 1970s (hat tip to Dr. Seth Roberts for the references).  In my recent food reward series (1), I referenced but did not discuss Dr. Cabanac's work because I felt it would have taken too long to describe.  However, I included two of his studies in my Ancestral Health Symposium talk, and I think they're worth discussing in more detail here.

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I Got Boinged, and Other News

The reaction to my post "The Carbohydrate Hypothesis of Obesity: a Critical Examination" has been overwhelmingly positive, particularly among the scientists I've heard from. 

On Saturday, the inimitable maker and writer Mark Frauenfelder posted a link to my post on the variety blog BoingBoing.  BoingBoing has been on my sidebar for three years, and it's the place I go when I need a break.  It's a fun assortment of science, news, technology and entertainment.  BoingBoing was originally a zine started by Frauenfelder and his wife in 1988, and it has been on the web since 1995.  Today, it has multiple contributing authors and it draws several hundred thousand hits per day.  I'm thrilled that Frauenfelder posted my article there.  Apparently he likes my blog.  Thanks!

I added a new section (IIB) to my original post.  It discusses what human genetics can teach us about the mechanisms of common obesity.  It is consistent with the rest of the evidence suggesting that body fatness is primarily regulated by the brain, not by fat tissue, and that leptin signaling plays a dominant role in this process. 

The Carbohydrate Hypothesis of Obesity: a Critical Examination

Introduction

I'd like to begin by emphasizing that carbohydrate restriction has helped many people lose body fat and improve their metabolic health.  Although it doesn't work for everyone, there is no doubt that carbohydrate restriction causes fat loss in many, perhaps even most obese people.  For a subset of people, the results can be very impressive.  I consider that to be a fact at this point, but that's not what I'll be discussing here. 

What I want to discuss is a hypothesis.  It's the idea, championed by Gary Taubes, that carbohydrate (particularly refined carbohydrate) causes obesity by elevating insulin, thereby causing increased fat storage in fat cells.  To demonstrate that I'm representing this hypothesis accurately, here is a quote from his book Good Calories, Bad Calories:

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Ancestral Health Symposium

Last weekend I attended the Ancestral Health Symposium at the University of California, Los Angeles, organized by Aaron Blaisdell, Brent Pottenger and Seth Roberts with help from many others.  It was a really great experience and I'm grateful to have been invited.  I was finally able to meet many of the people who I respect and admire, but knew only through the internet.  I'm not going to make a list because it would be too long, but if you take a look at the symposium schedule, I think you'll understand where I'm coming from.  I was also able to connect with a number of Whole Health Source readers, which was great.  I recognized some of them from the comments section.  Now I know it wasn't just my mom with 57 Google accounts.

The symposium was the first of its kind, and represented many facets of the ancestral health community, including "Paleolithic" diet and exercise patterns, low-carbohydrate diets, Weston Price-style diets, traditional health-nutrition researchers as well as other camps.  For the most part they coexisted peacefully and perhaps even learned a thing or two from one another. 

I was very impressed by the appearance of the attendees.  Young men and women were fit with glowing skin, and older attendees were energetic and aging gracefully.  It would be hard to come up with a better advertisement for ancestrally-oriented diets and lifestyles.  I saw a lot of people taking the stairs rather than the elevator.  I like to say I'll take the elevator/escalator when I'm dead.  I think integrating exercise into everyday life is healthy and efficient.  Escalators and elevators of course make sense for people with physical disabilities or heavy suitcases.

The first talk was by Dr. Boyd Eaton, considered by many to be the grandfather of the paleolithic diet concept.  I was very impressed by his composure, humility and compassionate attitude.  Half his talk was dedicated to environmental and social problems.  Dr. Staffan Lindeberg gave a talk titled "Food and Western Disease", which covered his paleolithic diet clinical trials as well as other evidence supporting ancestral diets.  I like Dr. Lindeberg's humble and skeptical style of reasoning.  I had the great pleasure of having dinner with Dr. Lindeberg and his wife, Dr. Eaton, Pedro Bastos, Dr. Lynda Frassetto, Dr. Guy-Andre Pelouze and his son Alexandre.  Pedro gave a very nice talk on the complexities of traditional and modern dairy.  The following night, I was able to connect with other writers I enjoy, including Chris Masterjohn, Melissa McEwen, John Durant, and Denise Minger. 

Dr. Pelouze is a french cardiovascular surgeon who strongly supports the food reward/palatability concept of obesity.  We had a conversation the evening before the conference, during which he basically made the same points I was going to make in my talk.  He is particularly familiar with the research of Dr. Michel Cabanac, who is central to the food reward idea.  He eats an interesting diet: mostly raw, omnivorous, and extremely simple.  If I understood correctly, he mostly eats raw meat, fish, fruit and vegetables with little or no preparation.  He sometimes cooks food if he wants to, but most of it is raw.  He believes simple, raw food allows the body's satiety systems to work more effectively.  He has been eating this way for more than twenty years, and his son was raised this way and is now about my age (if I recall correctly, Alexandre has a masters and is studying for an MD, and ultimately wants to become an MD/PhD).  Both of them look very good, are full of energy and have a remarkably positive mental state.  Alexandre told me that he never felt deprived growing up around other children who ate pastries, candy et cetera.  They woke up early and ran six miles before the conference began at 8 am. 

I gave my talk on Friday.  Giving a talk is not like writing a blog post-- it has to be much more cohesive and visually compelling.  I put a lot of work into it and it went really well.  Besides the heat I got from from Gary Taubes in the question and answer session, the response was very positive.  The talk, including the questions, will be freely available on the internet soon, as well as other talks from the symposium.  Some of it will be familiar to people who have read my body fat setpoint and food reward series, but it's a concise summary of the ideas and parts of it are new, so it will definitely be worthwhile to watch it.  

We have entered a new era of media communication.  Every time someone sneezed, it was live tweeted.  There are some good aspects to it-- it democratizes information by making it more accessible.  On the other hand, it's sometimes low quality information that contains inaccurate accounts and quotes that are subsequently recirculated. 

It was a great conference and I hope it was the first of many.

Rethinking the Value of Medical Services

by Brian Klepper and David KibbeOne of American politics’ most disingenuous conceits is that health care must cost what we currently pay. Another is that the only way to make it cost less is to deny care. It has been in industry executives’ financial interests to perpetuate these myths, but most will acknowledge privately that the way we value and pay for medical services is a deep root of

The Debt Deal: There Will Be Blood on the Floor on November 23rd

The debt deal is finally done. But it really isn’t an agreement on what cuts will be made, just the process that will be used to make them.The real work is left to the Congressional appropriators for the first $917 billion and for a super-committee of Congress for the second $1.2 trillion to $1.5 trillion in ten-year cuts.That second tranche is where health care will make its contribution. The

Let Them Eat Meat: An Interview by an Ex-Vegan

INTRODUCTION
Rhys Southan's interview of me on his ex-vegan blog, Let Them Eat Meat, went up this morning. According to Rhys:

If anyone could convince me that I’m wrong about veganism, it’s Adam... [T]he interview is worth reading if you’re curious to see the strongest formulation of vegan beliefs that I’ve seen.

Please check out the interview if you haven't read my posts this summer. (Below I've included some not previously posted excerpts from the interview and several links to challenging articles written by Rhys).

Questions in the interview include:

1. What do you believe is wrong with the standard consumer veganism that the most mainstream advocates promote?
2. How would you describe the form of veganism that you advocate?
3. Most vegan solutions for ending the exploitation and killing of animals (animal liberation) seem to require a human/animal separatism. How would your idea of veganism avoid that?
4. Why do you refer to animals that aren’t humans as “animal others”?
5. Is veganism a moral obligation?
6. Do you think veganism, particularly your take on veganism, fits into Nietzsche’s idea of slave morality?
7. When you first emailed me, you mentioned an interest in Ernest Becker’s Denial of Death, which is a book that was influential on my thinking after I quit veganism... However, you believe Becker’s arguments could work for veganism. How so?
8. Veganism is an attempt to not cause death — is this not also a denial of death?
9. Vegans admit that veganism is imperfect, and that we can’t really follow the ethics to where they want to take us — being truly anti-speciesist and not causing animal death and suffering. What is the point of having an ethics that we can’t actually follow?
10. Why should I accept your vision and make the one life I have to live worse in order to say that I am against speciesism?
11. Why should people become vegan despite the ineffectiveness of becoming vegan on an individual level?

Most of my answers are abridged versions of pieces I've previously posted in June and July:
I. A Critique of Consumption-Centered Veganism
II. Socially-Centered Veganism vs. Consumption-Centered Veganism
III. Veganism Without Vegetarianism: On Guilt, Disability, and Ex-Vegans
IV. Veganism as Social Somatic Response-Ability
V. The Animal Therefore I am Not: Eating Animals and Terror Management Theory (forthcoming)

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Dietary Guidelines for Americans, My Way

I just saw this on BoingBoing.  Simple but true. 

This image was created by Adam Fields. 

The people who design government dietary guidelines are gagged by the fact that politics and business are so tightly intertwined in this country.  Their advice will never directly target the primary source of obesity and metabolic dysfunction-- industrially processed food-- because that would hurt corporate profits in one of the country's biggest economic sectors.  You can only squeeze so much profit out of a carrot, so food engineers design "value-added" ultrapalatable/rewarding foods with a larger profit margin.

We don't even have the political will to regulate food advertisements directed at defenseless children, which are systematically training them from an early age to prefer foods that are fattening and unhealthy.  This is supposedly out of a "free market" spirit, but that justification is hollow because processed food manufacturers benefit from tax loopholes and major government subsidies, including programs supporting grain production and the employment of disadvantaged citizens (see Fast Food Nation).

We Are Reaping What We Have Sown—The Debt Standoff

On this blog a month ago, I said the politicians were starting to scare me with the apparent eagerness of some to actually take the government to default to make a political point.For weeks we have heard political leaders on both sides tell us there would be no default.But the two sides have so backed themselves into opposite corners that they have left no opportunity to meet in the middle.

Interview on Super Human Radio

Today, I did an audio interview with Carl Lanore of Super Human Radio.  Carl seems like a sharp guy who focuses on physical fitness, nutrition, health and aging.  We talked mostly about food reward and body fatness-- I think it went well.  Carl went from obese to fit, and his fat loss experience lines up well with the food reward concept.  As he was losing fat rapidly, he told friends that he had "divorced from flavor", eating plain chicken, sweet potatoes and oatmeal, yet he grew to enjoy simple food over time.

The interview is here.  It also includes an interview of Dr. Matthew Andry about Dr. Loren Cordain's position on dairy; my interview starts at about 57 minutes.  Just to warn you, the website and podcast are both full of ads.

Weight Gain and Weight Loss in a Traditional African Society

The Massas is an ethnic group in Northern Cameroon that subsists mostly on plain sorghum loaves and porridge, along with a small amount of milk, fish and vegetables (1, 2).  They have a peculiar tradition called Guru Walla that is only undertaken by men (2, 1):
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Simple Food: Thoughts on Practicality

Some people have reacted negatively to the idea of a reduced-reward diet because it strikes them as difficult or unsustainable.  In this post, I'll discuss my thoughts on the practicality and sustainability of this way of eating.  I've also thrown in a few philosophical points about reward and the modern world.
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How Does Gastric Bypass Surgery Cause Fat Loss?

Gastric bypass surgery is an operation that causes food to bypass part of the digestive tract.  In the most common surgery, Roux-en-Y bypass, stomach size is reduced and a portion of the upper small intestine is bypassed.  This means that food skips most of the stomach and the duodenum (upper small intestine), passing from the tiny stomach directly into the jejunum (a lower part of the upper small intestine)*.  It looks something like this:
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The Awful Dichotomy Between Health Care Politics and Policy

Amy Goldstein has an important article in today’s Washington Post detailing the place Don Berwick, the Medicare and Medicaid administrator, finds himself in.It is all but certain he will have to leave his post at year’s end, when his recess appointment expires, because the Senate will not confirm him for a lack of Republican support.Berwick is one of the most respected health care experts in the

Liposuction and Fat Regain

If body fat really is actively regulated by the body, rather than just being a passive result of voluntary food intake and exercise behaviors, then liposuction shouldn't be very effebtive at reducing total fat mass in the long run.  People should return to their body fat "setpoint" rather than remaining at a lower fat mass. 

Teri L. Hernandez and colleagues recently performed the first ever randomized liposuction study to answer this question (1).  Participants were randomly selected to either receive liposuction, or not.  They were all instructed not to make any lifestyle changes for the duration of the study, and body fatness was measured at 6 weeks, 6 months and one year by DXA. 

At 6 weeks, the liposuction group was significantly leaner than the control group.  At 6 months, the difference between the two groups had decreased.  At one year, it had decreased further and the difference between the groups was no longer statistically significant.  Furthermore, the liposuction group regained fat disproportionately in the abdominal area (belly), which is more dangerous than where it was before. The investigators stated:

We conclude that [body fat] is not only restored to baseline levels in nonobese women after small-volume liposuction, but is redistributed abdominally.

This is consistent with animal studies showing that when you surgically remove fat, total fat mass "catches up" to animals that had no fat removed (2).  Fat mass is too important to be left up to chance.  That's why the body regulates it, and that's why any satisfying resolution of obesity must address that regulatory mechanism.

Veganism as Social Somatic Response-Ability

Igualdad Animal Demonstration in Spain (www.igualdadanimal.org)

No one can deny the suffering, fear or panic, the terror or fright that humans witness in certain animals... the response to the question "can they suffer?" leaves no doubt… War is waged over the matter of pity... To think the war we find ourselves waging is not only a duty, a responsibility, an obligation, it is also a necessity... I say "to think" this war, because I believe it concerns what we call "thinking." --Jacques Derrida (1997, 2002)


The Ethics of Veganism: an Open Wound called Compassion
When I advocate veganism, I’m advocating it as recognition of a phenomenon, not as a prescription of a principle. That is, veganism is a recognition of the human condition of finitude, fallibility, and meagerness in a universe shared by other finite, fallible, and meager beings. As I wrote before, veganism as a social existence with animal others is not a foreign attitude. Rather, it is a mode we are “thrown into” when we become subjected to our own curiosity and compassion for other mortal creatures. Recognizing veganism as such holds us responsible to animal others’ interests, and holds us accountable for closing off this mode for relating to animal others as “killable” instruments for some so-called higher-value (i.e. profits, “life,” “humanity”). Thus, veganism as a social attitude motivates and is facilitated by vegetarian consumption. Veganism-vegetarianism are the means and the end of a non-exclusive social responsibility.

Veganism is therefore not the application of a principle of obligation, but the phenomenon of obligation from being addressed by the animal other to respond in return as a social being. I’m not saying that a pig or salmon speak to us or voice themselves as a human might, but that we experience the phenomenon of being addressed, being called to ourselves as social and ethical beings, by recognizing the others’ different perspective, interests, and shared vulnerability. This phenomenon is with us from infancy. Just watch the expression of wonder watching the expressions of other species. It’s similar to their gaze into the face of a human. Children are not born distinguishing the moral considerability between humans and many other animals. Just recently, psychologists Patricia Hermann and others found that anthropocentirsm is a perspective acquired around the age of five, not something innate.

The veganism I advocate fits well with Ralph Acampora articulation of ethics as a phenomenon of the body’s existence as an ecologically and socially interrelational being in contrast to popular thought that ethics is the product of transcendental principles of pure reason or codes intersubjectively consented to. Reason may be valuable in that it exposes latent prejudices and inconsistencies in how one treats others, but only by presupposing our existence as social, caring, vulnerable, and potentially violent bodies. From an ethical paradigm of the interrelational lived body, the “burden of proof” is not placed upon veganism as an extension of ethics, but rather the “ethical isolationism or contraction” of a an ethics based upon self-interest.

For example, reflect upon the times when reason has been used not as a preventative measure against violence and prejudice, but as an instrument against our sociality with and care for others (e.g. “just war,” “ethnic cleansing,” “honor killings,” vivisection etc). It is through manufacturing a code and imposing it upon the world that we can justify acting violently toward others because of the class we place them into. Arguments for fending off veganism and vegetarianism are usually no more than an elaborate game of logic to preserve one’s power and privilege over others by making violence reasonable. They defy our underlying capacity to recognize others as social beings.


Humanism's Double Standard: The Unreasonableness of Consistency
Veganism is the immanent, not the abstract, relationship we have to animal others as social beings. Although my description of veganism is abstract in form, in practice, the reasons we assign to violence are the abstractions. Animal others are exploited under the justification that they belong to a separate race we’ve created and called “animals,” and they are institutionally exploited for the good of something we call “civilization” and the “economy” for something called “capital.”

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Food Reward: a Dominant Factor in Obesity, Part VIII

Further reading

I didn't come up with the idea that excessive food reward increases calorie intake and can lead to obesity, far from it.  The idea has been floating around the scientific literature for decades.  In 1976, after conducting an interesting diet study in humans, Dr. Michel Cabanac stated that the "palatability of the diet influences the set point of the ponderostat [system that regulates body fatness]" (1).  

Currently there is a growing consensus that food reward/palatability is a major contributor to obesity. This is reflected by the proliferation of review articles appearing in high-profile journals.  For the scientists in the audience who want more detail than I provide on my blog, here are some of the reviews I've read and enjoyed.  These were written by some of the leading scientists in the study of food reward and hedonics:

Palatability of food and the ponderostat.  Michel Cabanac, 1989.
Food reward, hyperphagia and obesity.  Hans-Rudolf Berthoud et al., 2011.
Reward mechanisms in obesity: new insights and future directions.  Paul J. Kenny, 2011.
Relation of obesity to consummatory and anticipatory food reward.  Eric Stice, 2009.
Hedonic and incentive signals for body weight control.  Emil Egecioglu et al., 2011.
Homeostatic and hedonic signals interact in the control of food intake.  Michael Lutter and Eric J. Nestler, 2009.
Opioids as agents of reward-related feeding: a consideration of the evidence.  Allen S. Levine and Charles J. Billington, 2004.
Central opioids and consumption of sweet tastants: when reward outweighs homeostasis.  Pawel K. Olszewski and Allen S. Levine, 2007.
Oral and postoral determinants of food reward.  Anthony Sclafani, 2004.
Reduced dopaminergic tone in hypothalamic neural circuits: expression of a "thrifty" genotype underlying the metabolic syndrome?  Hanno Pijl, 2003.

If you can read all these papers and still not believe in the food reward hypothesis... you deserve some kind of award.

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".
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The Debt Ceiling Debate—Some of These People Are Nuts

I don’t know about you but the politicians are starting to scare me with their inability to make progress in the federal debt limit discussions. Worse, is the apparent eagerness of some to actually take the government to default to make a political point.I know a lot of conservatives say missing the August 2 deadline isn’t a big deal but I think it is.The 2011 deficit is projected to be $1.6

Drug Cessation and Weight Gain

Commenter "mem", who has been practicing healthcare for 30+ years, made an interesting remark that I think is relevant to this discussion:

Recovering substance dependent people often put on lots of weight and it is not uncommon for them to become obese or morbidly obese.

This relates to the question that commenter "Gunther Gatherer" and I have been pondering in the comments: can stimulating reward pathways through non-food stimuli influence body fatness?  

It's clear that smoking cigarettes, taking cocaine and certain other pleasure drugs suppress appetite and can prevent weight gain.  These drugs all activate dopamine-dependent reward centers, which is why they're addictive.  Cocaine in particular directly inhibits dopamine clearance from the synapse (neuron-neuron junction), increasing its availability for signaling.
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Food Reward: a Dominant Factor in Obesity, Part VI

Reward Centers can Modify the Body Fat Setpoint

Dopamine is a neurotransmitter (chemical that signals between neurons) that is a central mediator of reward and motivation in the brain.  It has been known for decades that dopamine injections into the brain suppress food intake, and that this is due primarily to its action in the hypothalamus, which is the main region that regulates body fatness (1).  Dopamine-producing neurons from reward centers contact neurons in the hypothalamus that regulate body fatness (2).  I recently came across a paper by a researcher named Dr. Hanno Pijl, from Leiden University in the Netherlands (3).  The paper is a nice overview of the evidence linking dopamine signaling with body fatness via its effects on the hypothalamus, and I recommend it to any scientists out there who want to read more about the concept.
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Veganism without Vegetarianism: On Guilt, Disability, and Ex-Vegans

THE QUESTION
While attending the Thinking About Animals conference in the spring 2011, I stumbled upon an odd and heretical questions: Could someone practice veganism without being vegetarian?”

The question is intended to be provocative in order to challenge vegans’ complicity or even dogmatic adherence to a particular understanding of veganism. That veganism is becoming mainstream through its assimilation into the capitalist economy as a lifestyle choice or a fashionable diet le`ves a stale taste in my mouth. Veganism should be revolutionary, not marketable. This question also enabled me to experiment with creating a more productive tension between veganism and vegetarianism.*

So could someone practice veganism without being vegetarian? My answer is

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Socially-centered Veganism vs Consumption-centered Veganism

Owen (right) & Mzee (left) @ Haller Park (Malindi, Kenya)

The most fundamental difference between the veganism I advocate and that advocated by others is focus. Veganism as a purely vegetarian lifestyle typically focuses on consumption practices associated with the individual, abstention, and identity; however, I’m interested in veganism as a social practice, a mode of being with others, that is relational, affirmative, and transformative.

I understand veganism as a social modality, an affiliation and solidarity with others beyond (species) boundaries, in which animal others are regarded as someones, not somethings. The origin, the means, and the end of veganism are being in “conversations” with others. Veganism, in other words, is fundamentally an affirmation of and care for the “voices” of animal others through “listening” (i.e. receptive curiosity and regard). Since careful listening takes place between particular responsive beings, not abstract or inanimate ones, killing animals irreversibly terminates conversations, silencing animal others. Exploiting animals may not terminate conversations absolutely, but enables and is enabled by an emotional “deafness” to their resistance whenever it becomes inconvenient to using them. Like a good conversation, a vegan social modality is incompatible with asserting oneself onto and over others. If their singularity and agency are to be recognized, affirmed, and cared for in conversation, we must act least violently toward them. By baring us to the responsibility of our care for animal others, veganism is the practice of intersectional and interspecies participatory justice, not personal purity (i.e. cruelty-free, body-as-a-temple), moral pragmatism (i.e. “the best choice for our health, the environment, and animals”), or political protest (i.e. economic boycott).

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Inconvenient Facts for Both Republicans and Democrats—Neither Side’s Health Care Proposals Are Supported By Past Performance

I call your attention to Ezra Klein’s column in the Washington Post this morning.In it he cites data that has been out there for a long time but Ezra puts some perspective on it that never occurred to me before.Examining the Kaiser Family Foundation brief, “Health Care Spending in the United States and Selected OECD Countries” he points out, “Our government spends more [as a percentage of GDP] on

A Critique of Consumption-Centered Veganism

INTRODUCTION: The mainstream discourse and practice of veganism as an individual’s (abstention from) the consumption of animal products, I believe, is problematic in three interrelated ways: practically as an economic boycott, socially as a privileged consumerism, and philosophically as an equivocation with a vegetarian lifestyle. I propose a new understanding of veganism as a social modality with and in regard to animal others which can be distinguished from and exist independently of vegetarian consumption. However, this distinction does not so much as invalidate vegetarian consumption so much as place it in a dialectic relationship with veganism, in which it can be regarded as a valuable means, but not an end.


PRACTICALLY, positioning veganism as an economic boycott is a very limited tactic given the prevalence of global capitalism. Mainstream veganism only addresses the content (i.e. animal products) and not the form/structure (i.e. capitalism) of the global market that facilitates the exploitation of animals as commodities and obstructs people from transforming society. This is evident in several ways.

First, many mainstream vegans tend to regard the very culprits of animal exploitation as the remedy. Veganism is now sold to people in the form of products (sometimes explicitly labeled “vegan”) by the very corporations (i.e. Kraft, Dean, Con-Agra, Burger King, etc.) that exist and profit off the exploitation of animals. While the availability and convenience of these products is celebrated as “victories,” their support only sediments the control these corporations have over the market and government. These agri-businesses that own, produce, and distribute most of our food supply have tremendous political power winning government subsidies and combating policy changes that would abolish animal exploitation practices..

Second, even if consumer vegans extend their boycott from the individual product consumed to the company who profits from it, without also challenging the present political-economic order of capitalism in which the interests of corporations persistently trump the interests of the general public, vegans remain complicit in the system that entitles businesses to exploit animal others (and human others as well). Besides, it’s not as if animal agribusiness is an isolated phenomenon; it is sustained by what Barbara Noske calls “the animal industrial complex”—an amalgamation of feed and chemical companies, the pharmaceutical industry, representatives and officers in government, public research and educational institutions etc. that are all mutually dependent upon one another through capital. Animal agribusiness will not be overthrown until these regimes and what gives them power are transformed. Even if consumer vegans were able to make significant dents in the national market, all this will be reversed by the rise of the affluent animal-eating class in the developing world to whom animals raised nationally will be exported, or—in “a race to the bottom”— to where the industry will be exported—displacing farmers and wildlife and externalizing production costs upon their communities.

Third, veganism as an economic boycott does not even universally enable people to practice veganism. Since wholesome food is regarded as a commodity rather than a socio-political right, large populations of disadvantaged people have little to no financial and/or market access to vegetarian food and goods, and thus are severely disadvantaged from living a secure vegan life. Food will continue to be grown for profits before people’s needs and preferences so long as food remains a commodity. A vegan world will not be brought about by the asocial, amoral market but by people in what Vandana Shiva calls “food democracy”—when food production and access is determined by people, not the imperialism of the market. In sum, mainstream vegan discourse and activism's focus on economic boycott is problematic primarily because, not because it is ineffective, but because it is insufficient. Without challenging the political, economic, and social structure of society, veganism as a movement will make little progress reducing and abolishing animal exploitation.

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Food Reward: a Dominant Factor in Obesity, Part V

Non-industrial diets from a food reward perspective

In 21st century affluent nations, we have unprecedented control over what food crosses our lips.  We can buy nearly any fruit or vegetable in any season, and a massive processed food industry has sprung up to satisfy (or manufacture) our every craving.  Most people can afford exotic spices and herbs from around the world-- consider that only a hundred years ago, black pepper was a luxury item.  But our degree of control goes even deeper: over the last century, kitchen technology such as electric/gas stoves, refrigerators, microwaves and a variety of other now-indispensable devices have changed the way we prepare food at home (Megan J. Elias.  Food in the United States, 1890-1945). 

To help calibrate our thinking about the role of food reward (and food palatability) in human evolutionary history, I offer a few brief descriptions of contemporary hunter-gatherer and non-industrial agriculturalist diets.  What did they eat, and how did they prepare it? 
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Food Reward: a Dominant Factor in Obesity, Part IV

What is Food Reward?

After reading comments on my recent posts, I realized I need to do a better job of defining the term "food reward".  I'm going to take a moment to do that here.  Reward is a psychology term with a specific definition: "a process that reinforces behavior" (1).  Rewarding food is not the same thing as food that tastes good, although they often occur together. 

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Earth to Republicans: You Are In Big Political Trouble Over the Ryan Medicare Plan

Update: The Wyden-Ryan Medicare Plan - Paul Ryan and Ron Wyden Blow the Medicare Reform Debate Wide Open! It should now be clear to Republicans they are in trouble over the Ryan Medicare plan.Yesterday, they lost a seat in a solid Republican New York House district. Their candidate had benefited from lots of money and House leadership attention. The big issue was the Ryan Medicare plan.All month,

Healthy Skeptic Podcast

Chris Kresser has just posted our recent interview/discussion on his blog The Healthy Skeptic.  You can listen to it on Chris's blog here.  The discussion mostly centered around body fat and food reward.  I also answered a few reader questions.  Here are some highlights:

• How does the food reward system work? Why did it evolve?
• Why do certain flavors we don’t initially like become appealing over time?
• How does industrially processed food affect the food reward system?
• What’s the most effective diet used to make rats obese in a research setting? What does this tell us about human diet and weight regulation?
• Do we know why highly rewarding food increases the set point in some people but not in others?
• How does the food reward theory explain the effectiveness of popular fat loss diets?
• Does the food reward theory tell us anything about why traditional cultures are generally lean?
• What does cooking temperature have to do with health?
• Reader question: How does one lose fat?
• Reader question: What do I (Stephan) eat?
• Reader question: Why do many people gain fat with age, especially postmenopausal women?

The podcast is a sneak preview of some of the things I'll be discussing in the near future.  Enjoy!

Fast Food, Weight Gain and Insulin Resistance

CarbSane just posted an interesting new study that fits in nicely with what we're discussing here.  It's part of the US Coronary Artery Risk Development in Young Adults (CARDIA) study, which is a long-term observational study that is publishing many interesting findings.  The new study is titled "Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis" (1).  The results speak for themselves, loud and clear (I've edited some numbers out of the quote for clarity):
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Food Reward: a Dominant Factor in Obesity, Part III

Low-Fat Diets

In 2000, the International Journal of Obesity published a nice review article of low-fat diet trials.  It included data from 16 controlled trials lasting from 2-12 months and enrolling 1,910 participants (1).  What sets this review apart is it only covered studies that did not include instructions to restrict calorie intake (ad libitum diets).  On average, low-fat dieters reduced their fat intake from 37.7 to 27.5 percent of calories.  Here's what they found:
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Clarifications About Carbohydrate and Insulin

My statements about carbohydrate and insulin in the previous post seem to have kicked up some dust!  Some people are even suggesting I've gone low-fat!  I'm going to take this opportunity to be more specific about my positions.

I do not think that post-meal insulin spikes contribute to obesity, and they may even oppose it. Elevated fasting insulin is a separate issue-- that's a marker of insulin resistance.  It's important not to confuse the two.  Does insulin resistance contribute to obesity?  I don't know, but it's hypothetically possible since insulin acts like leptin's kid brother in some ways.  As far as I can tell, starch per se and post-meal insulin spikes do not lead to insulin resistance.
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Healthy Skeptic Podcast and Reader Questions

Chris Kresser, Danny Roddy and I just finished recording the podcast that will be released on May 24th.  It went really well, and we think you'll find it informative and maybe even practical!

Unfortunately, we only got around to answering three of the questions I had selected:

1. How does one lose fat?
2. What do I (Stephan) eat?
3. Why do many people gain fat with age, especially postmenopausal women?

I feel guilty about that, so I'm going to answer three more right now.

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The Lightweight Romney Health Plan

Mitt Romney has outlined his new health plan. He outlined five key steps in an op-ed in USAToday. Here is a summary:Step 1: Give states the responsibility, flexibility and resources to care for citizens who are poor, uninsured or chronically ill.who are poor, uninsured or chronically ill.Step 2: Reform the tax code to promote the individual ownership of health insurance.Step 3: Focus federal

Administrative Note

My blog is being mercilessly ripped off by cheesy feed aggregators that are using my material for commercial gain, often without attribution.  I was able to ignore them when there were only one or two, and when they appeared far down the list on Google searches.  But at this point, there are 20+ rip-off sites that ride my coattails under questionable circumstances, and are getting decent Google rankings, so I've had enough.  I'm changing my feed settings so that I only partially syndicate my posts, and I'm adding a short plagiarism warning to each post.

What that means is that if you're using an RSS reader, you'll have to click through to my blog to read my material in full.  I apologize for the inconvenience, but I don't see any other solution.

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Neither the Republicans Nor the Democrats Want to Face the Provider Cost Problem But Both Want to Dump the Problem on the Consumer

A key piece of Paul Ryan’s deficit reduction plan is to change Medicare as we know it. It appears his bold Medicare premium support proposal is failing to gain traction--it is dead as part of any deficit reduction deal this year. Worse, his Medicare proposal looks to be giving Democrats lots of political ammunition for the 2012 elections.What lies at the heart of Ryan’s Medicare difficulties is

Ask Me a Question

On May 13th, I'll be recording a podcast with Chris Kresser of The Healthy Skeptic. Chris interviewed me about a year ago, and I thought it went well. Chris is a good host and asks interesting questions.

This time around, we're going to do things a bit differently. I'll start with a little overview of my current thoughts on obesity, then we'll answer reader questions. The show is going to be mostly about obesity and related matters, but I may answer a couple of questions that aren't related to obesity if they're especially interesting. There are two ways to leave questions: either in the comments section of this post, or the comments section of Chris's post. The show will air on May 24th.
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There Aren't Enough Rich People To Pay For Medicare And Medicaid!

I hear more and more of my progressive friends arguing, in the context of deficit reduction, that we should be raising taxes before getting aggressive about reducing the cost of Medicare and Medicaid -- as well as Social Security.To a point, I agree.This country is in such a hole that it is senseless to deny that at least some new taxes will be needed to pay for all of the nation's bailouts and

The Budget Fight: It Will Be A Long Hot Summer, and Fall, and Winter…

The good news is that Democrats and Republicans are finally seriously engaged over the country’s fiscal crisis.And, each side is presenting a starkly different course for the voters to choose from.When it comes to the health care entitlements, Republicans want to cut the health care entitlement benefits and therefore ease the pressure on federal spending.Obama wants to largely leave the programs

What It Will Take to Bring America’s Health Care Costs Under Control––We Have to Change the Game

Last week, I posted that I was disappointed in Paul Ryan’s health care budget proposal because it lacked cost containment ideas other than the usual conservative reliance upon the market and defined contribution health care.In my last post, Why ACOs Won’t Work, I argued that the latest health care silver bullet solution, Accountable Care Organizations (ACOs), are just a tool in a big tool box of

Why ACOs Won’t Work

First, I think Accountable Care Organizations (ACOs) are a great idea. Just like I thought HMOs were a good idea in 1988 and I thought IPAs were a good idea in 1994.The whole notion of making providers accountable for balancing cost, medical necessity, appropriateness of care, and quality just has to be the answer.But here’s the problem with ACOs: They are a tool in a big tool box of care and

The “Path to Prosperity”—Where’s the Health Care Cost Containment?

Paul Ryan’s overview of his proposed 2012 Budget Resolution contains an honest and compelling description of America’s debt and deficit spending dilemma.Every American should read it.As I read through his discussion of the huge hole we’re in and the imperative to fix it, he had me thinking that we finally have a politician willing and ready to deal with the problem. But when I got to the end of

Favorite Human-Animal Relation Quotes

Designed by Christie Nicole and Adam Weitzenfeld

Thought I'd share some quotes I've encountered  researching Human-Animal relations, ethics, and subjectivity as I pull together a post on the moral psychology of animal encounters. Enjoy!

Stories with animals are older than history and better than philosophy.
--Paul Sheppard

The more I spoke about animals, the less possible it became to speak to them.
--David Abram

Man becomes aware of himself returning the [animal’s] look… [Today] animals are always the observed. The fact that they can observe us has lost all significance... The more we know, the further away we are.
--John Berger

The most matter of fact person could not help thinking of the hogs they were so innocent they came so very trustingly and they were so very human in their protests and so perfectly within their rights... It was like some crime committed in a dungeon all unseen and buried out of sight and of memory... Relentless remorseless it was all his protests... his screams were nothing it it did its cruel will with him as if his wishes feelings had simply no existence at all it cut his and watched him gasp out his life

He had stood and watched the hog-killing, and thought how cruel and savage it was, and come away congratulating himself that he was not a hog; now his new acquaintance showed him that a hog was just what he had been--one of the packer's hogs!...What they wanted from a hog was all the profits that could be got out of him; and that's what they wanted form the working man... What the hogs thought of it, and what he suffered, was not considered; and no more was it with the working man... That was true everywhere under capitalism.
--Upton Sinclair

How many of my ancestors
Were treated like today’s farm animals?
How many of us look the other way?
When I hear of calves
Being taken from their mothers
To be sold as veal
I can hear the wailing voices of mothers
Crying for their babies
As the slave master takes them away
The mother cow breastfeeds the human race
My ancestors breastfed the white race
So when I looked into those stunned eyes today,
No one could have said to me,
‘What’s the big deal?’ ‘ It’s only an animal.’
I could have remembered a time
When someone might have said the same thing about me
--Mary Spears

The possibility of the pogrom is decided in the moment when the gaze of a fatally-wounded animal falls on a human being. The defiance with which he repels this gaze—‘after all, it’s only an animal’—reappears irresistibly in cruelties done to human beings, the perpetrators having again and again to reassure themselves that it is ‘only an animal,’ because they could never fully believe this even of animals
--Theodore Adorno

Men do all they can in order to dissimulate this cruelty or to hide it from themselves, in order to organize on a global scale the forgetting or misunderstanding of this violence that some would compare to the worst cases of genocide (there are also animal genocides)… conditions that previous generations would have judged monstrous, outside of every supposed norm of a life proper to animals that are thus exterminated by means of their continued existence or even their overpopulation.

No one can deny the suffering, fear or panic, the terror or fright that humans witness in certain animals… the response to the question "can they suffer?" leaves no doubt… War is waged over the matter of pity… To think the war we find ourselves waging is not only a duty, a responsibility, an obligation, it is also a necessity … I say "to think" this war, because I believe it concerns what we call "thinking."
--Jacques Derrida

There were seventy of us in a forestry commando unit for Jewish prisoners of War in Nazi Germany… halfway through our long captivity, for a few short weeks before the sentinels chased him away, a wandering dog entered our lives... we called him Bobby, an exotic name, as one does with a cherished dog. He would appear at morning assembly and was waiting for us as we returned, jumping up and down and barking in delight. For him, there was no doubt that we were men... This dog was the last Kantian in Nazi Germany, without the brain needed to universalize maxims and drives
--Emmanuel Levinas

However, even vegetarianism in your hands, would make a capital article... its connection with modern socialism, atheism, nihilism, anarchy and other political creeds... Brussels sprouts seem to make people bloodthirsty, and those who live on lentils and artichokes are always calling for the gore of the aristocracy and for the severed heads of kings... in the political sphere a diet of green beans seems dangerous.
--Oscar Wilde

So How Are Democrats and Republicans Different?

Just how is the way Wisconsin Republicans have handled the political confrontation over worker rights different than the way Washington, DC Democrats handled last year's health care vote?With apologies in advance to Ezra for taking some liberties with his column yesterday evening in the Washington Post:What happened in Wisconsin [Washington DC] tonight [last March]By Ezra Klein [Bob Laszewski]

Fixing America's Health Care Reimbursement System

This post is authored by Brian Klepper and first appeared at Kaiser Health News:A tempest is brewing in physician circles over how doctors are paid. But calming it will require more than just the action of physicians. It will demand the attention and influence of businesses and patient advocates who, outside the health industrial complex, bear the brunt of the nation's skyrocketing health care

The Republicans Had Better Get Organized on Health Care

If the past week is any indication, the Republicans will have real trouble come 2012 trying to convince voters they have a plan to fix the American health care system.Last weekend, President Obama endorsed the Wyden-Brown bill that would give the states the opportunity, in 2014, to take their share of the almost $1 trillion the new health law collects and use it to craft an alternative health

Defined Contribution Health Care—The Conservatives' Silver Bullet

Conservatives are in a full court press these days telling us the answer to America’s out-of-control health care costs—and our fiscal crisis—is to move Medicare, Medicaid, and the tax code subsidy for private insurance to a defined contribution system.Instead of the federal government defining a benefit and then shouldering the cost of whatever that promise leads to (today’s defined benefit plan)

Will the Congress Change the Health Care Law During the Next Two Years?

No. But I expect the Patient Protection and Affordability Act to be “relitigated” in 2013, to one degree or another.I recently posted on the controversy over the individual mandate. I suggested a number of alternatives to the mandate—including my own ideas.I was asked if I really thought the Congress would change the individual mandate in the short term.As I have posted before, it will be the

Alternatives to the Individual Mandate—Some Are A Lot Better Than Others

With Constitutional challenges to the individual mandate now threatening the very life of the new health care law, Republicans aren’t the only ones that would like to see it jettisoned and replaced with something better.And it isn’t just the Constitutional challenges that are prompting a second look. The mandate doesn't work politically and it doesn't maintain the integrity of the market because

Things Are About to Get Ugly—-Republicans Plan to Defund the Health Bill Next Week

Word is that House Republicans will attach an amendment to the latest federal spending bill that will cut-off funding for the health care bill.The last Congress never finalized a budget for the current fiscal year—the feds have been operating under a series of continuing resolutions. The most recent one will expire on March 4th. If another resolution is not agreed to, much of the government has

Has the Florida Judge Stopped the New Health Care Law in Its Tracks?

Reading page 75 of today's Florida opinion it sounds like that is his intent:(5) InjunctionThe last issue to be resolved is the plaintiffs’ request for injunctive relief enjoining implementation of the Act, which can be disposed of very quickly.Injunctive relief is an “extraordinary” [Weinberger v. Romero-Barcelo, 456U.S. 305, 312, 102 S. Ct. 1798, 72 L. Ed. 2d 91 (1982)], and “drastic” remedy [

Now We Have Real Uncertaintly--The Entire Health Law Ruled Unconstitutional!

We all knew the question of the constitutionality over the new health care law was going to be taken up by the Supreme Court.We knew that because the law inexplicably lacked a severability clause a judge could throw the whole thing out if the individual mandate were to be found unconstitutional and critical to the legislation.And, we expected this Florida judge would likely rule against the law

It Will Be Democratic Senators Leading The Charge To Fix Or Improve The New Health Law

I wrote this Kaiser Op-Ed before today's federal court ruling, that held the entire health care law unconstitutional because of the individual mandate. Now that two federal judges have held the individual mandate unconstitutional, this one overturning the entire law because of it, I have to wonder just how long the Democrats are going to wait before they try to amend the Affordability Act in

Brian Klepper and David Kibbe have a notable column at Kaiser Health News arguing that the American Medical Association's Relative Value Scale Update Committee (RUC) is specialist dominated and steers health care resources away from primary care:Not surprisingly, the Committee’s payment recommendations have consistently favored specialists at the expense of primary care physicians. More

The House Health Care Repeal Vote, the National Debt, and the Imperative for Democrats and Republicans to Compromise

This week's House health care repeal vote is little more than a political stunt--everyone knows the effort will die in the Senate.But, when the day is done the only way for the Republicans to do anything with the new health law will be to work out a compromise—repeal before the 2012 elections is impossible and it isn’t very likely after the 2012 elections. Even if the Republicans sweep the

Decolonization and Animal Liberation: Love, Violence, Becoming-Other-Wise

Beehive Design Collective. "FTAA." Source: www.beehivecollective.org

Introduction
Some cyber-friends have been pestering me to put up another blog post since I haven't posted anything in three months--well, maybe that's an exaggeration but i really wanted to use the word pestering--, so  I'm posting two abstracts I recently submitted to the Thinking About Animals conference at Brock University (St. Catharines, ON, Canada) going on between March 1 and April 1, 2011. This will be the 10th Critical Animal Studies conference, and Brock is perhaps one of the most deserving universities since its establishment of a critical animal studies minor and an official vegan policy in the Sociology department.

On that note, I encourage you to check out the Critical Animal Studies resource page I created over winter break!!!

The first paper, on Frantz Fanon's The Wretched of the Earth, is a paper I wrote for Existentialism in the Fall. I went through some angst writing it, but came out overall satisfied with the paper. If any of you are interested in reading it, I'll send you a copy in exchange for some good feedback. The second paper ought to be more familiar to avid readers of this blog. It's basically a summation of what I have written on the understanding of veganism over the last two years or more.

1.
Decolonization and Animal Liberation:
Violence and Becoming-Animal in Frantz Fanon’s The Wretched of the Earth
In 1961, the Algerian psychoanalysist, Frantz Fanon, published, Les Damnés de la Terre, a book specifically about the revolutionary movement in French Algeria, but a guide to decolonization in general. In The Wretched of the Earth, Fanon gives a phenomenological account of the Algerian independence movement, from its inception in local, spontaneous violent uprisings, to a national political movement, to the development of a national culture and new humanism. For Fanon and his friend Sartre, violence is a necessity for the colonized to become fully human and political subjects. Similarly, the development of a national culture is necessary development for not only the liberation of Algeria, but for the future of humanity.

While Fanon’s primary goals are the achievement of national consciousness and a new humanism, a subversive reading of this text foregrounds “the animal” that beseeches his description of decolonization. Fanon’s characterization of the relationship between decolonization and animals is complex: on the one hand, animal being is to be transcended, if not negated through self-assertion and violence, yet the animal virtues of spontaneity, ferocity, and pack-forming are crucial for the overthrow of the colonizers. If humans’ metaphoric relationship to “animality” and animal others materialize in their relationship with one another, as is argued, then decolonization will not be achieved so long as a hierarchical and exclusionary identity politics exists between human and animal others (as is inferred by Fanon and Sartre’s subject-centered humanist discourse). It is argued that the anarchistic process of “becoming-animal” described by Gilles Deleuze and Félix Guatarri is a more transformative and promising alternative to humanism for not only human liberation, but also the liberation from humanist violence against “animality” and animal others.

2.
Deconstructing Veganism:
Love, Listening, Conversations, and Companionships Beyond Boundaries
For over a decade, Gary Francione (1996, 2008) has been championed for his bold challenge to the efficacy of “new welfarism” and the sufficiency of lacto-ovo-vegetarian advocacy in the contemporary “animal rights” movements. Yet relatively few animal abolitionists have ever challenged the sufficiency and status quo of veganism. In a time when neoliberalism has come into a greater appropriation of veganism (Hammer 2008), real animals have become absent from the discourse of many animal and vegan advocacy campaigns (Adams 2006), and to be a vegan is more about one’s way of life (i.e. the subculture one belongs to) than one’s actual relationship to animals, a more radical critique of not only vegetarianism but veganism too is needed.

While many celebrate the mainstreaming of veganism, I would like to caution self-identified vegans and animal activists from accepting the present understanding of vegan as an identity of (abstention from) consumption. The present understanding of veganism as a) an identity b) defined negatively as an abstention from c) consumption has lead to a certain modality of political and private life which has been legitimately accused of self-righteousness, identity politics, militancy, colonialism, and privileged consumerism. In light of this, we are called to a radical rethinking of veganism not as a noun (“ vegan”) to be identified with, purchased, consumed, and completed, but as a modality and relationship with others that is never yet complete.

Veganism is something to be understood affirmatively, as an affirmation of our own feelings and the voices of others. Those who have come into veganism as a liberation project must adamantly recall that they did not do so because of convenience, out of tradition, or merely out of pleasure, but because they are in search of affirming love. This love must never be forgotten as their point of departure and arrival. The ends of veganism are in the means of not forgetting, disavowing others. It is through disavowal that people commit the most violence by ignoring their own and others’ sentiments; they wage war on themselves and others for foreclosing ends, ideals, and identities, rather than waging conversation. The end of veganism is thus not to become a vegan, but to become other-wise in conversations and companionships beyond boundaries and “language.”

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