Hunger and appetite -- the lost relationship

     "Eat your vegetables." "Clean up your plate." "Don't you know that there are starving children in XXX and YYY who would love to have that food?" It may not be quite as true for children in the United States as it was 50 years ago, but I suspect many of the same statements are heard around the table. Of course, the last question of food distribution is more of a political issue than an economic or nutritional one.

     On the positive side, I was not allowed to become a "picky" eater. If it was cold, I ate it. If it was spoiled, I ate it. If it was burned, I ate it. If I hated it, I ate it. (If I loved it, I ate it but might, or might not, have more.) I remember one time when I refused to eat something and I was required to stay at the dinner table until I cleaned my plate. As I recall, that was at about 4 in the morning. I possibly could have (and maybe not) "toughed it out" and "succeeded" in not eating it but I reached the point of realizing that I might win that battle but I would lose the ongoing struggle.

     On the negative side, there was no control over portion size or what I ate. In fact, on those rare occasions when we ate out, I was not only expected to clean my plate but my mother seemed to feel that I was there as a garbage collector to clean her plate as well ("the growing boy needs his food and we are not going to waste any"). Any relationship between hunger and eating was burned out of me.

     As a result, it is probably not a surprise that I had problems controlling my weight. My older brother was "blessed" with a more active metabolism and didn't gain weight until after his metabolism changed when he was about 30. He stayed skinny. I did not. It wasn't until I was away from home and had direct control over my eating that I succeeded (with the help of a swim class and a mile of swimming per day) in getting my weight under control.

     That success did not carry over to the basics of appetite and portion control. I still had no correlation between how much my body needed and how much I ate. So, over the years, I regained the weight. During this same period (from the 1960s on), portion sizes at restaurants started on their continual gradient  (see my "Supersizing" blog about the economics behind that trend) -- and "fast foods" became more of a daily reliance than an occasional treat.

     The relationship between need and consumption is still not encouraged by the economic system of the U.S. Consumption is increased by various methods: commercials and general media as well as additives within the food. Addition of sugar adds to the calories, reduces the nutritional balance, and takes advantage of the "swallow reflex" to cause the body to want to eat beyond any (now ignored) response of fullness. Extra salt and/or MSG is added to enhance the other flavors to make it more appetizing without the need for careful preparation or more expensive ingredients.

     It is possible to escape the cycle of eating without need (in the areas of the world where food is not in shortage) but it is "swimming up stream". First thing to do is to set portion control. I now have the mantra of "to waste or to waist" -- meaning that I may waste extra food but it is not going to add to the inches around my waist. It is still difficult for me to actually throw food away so leftovers come back to the house (adding to landfill contents and, often, still being thrown away when there is no opportunity to actually need it for a meal). And people in the U.S. (not such a problem elsewhere) expect larger portions for the prices that are paid.

     After portion control (which can be done by mathematics rather than recovering one's ability to feel full) comes a deliberate reduction (or attempted elimination) of refined sugar and carbohydrates in the diet as well as the artificial sweeteners and substitutes which are, most likely, no better for your body (and possibly a lot worse). Not eating out gives much more control but processed foods are more accessible and more economic than home-prepared foods. I can buy grated cheese for less than I can buy block cheese and grate it myself (economics of scale, packaging, and distribution). In other words, a significant change in lifestyle as well as ignoring the economic, commercial, and media pressure to do otherwise is needed. Very difficult.

     Another item which can help is to take time with meals -- both in preparation and in consumption. My wife talks about the 10 minutes that we get to spend with our sons at the dinner table before they head back off. In many countries, and societies, that is a half-hour or more. The average amount of work hours in the United States is so high that various other non-work activities are cut down. And one of the dominant areas of reduction is in meal time.

     I am still fighting (at almost 60) to regain a relationship between need and consumption -- hunger and satiation. I make some progress but it is not easy -- society has evolved to make it undesirable for it to be easy. When you reach for the next bite of food, start asking yourself (this will slow down your eating also) whether you really want it. You may be surprised at the answer.

What's in a name: sugar and marketing

   When it comes down to looking at the way that words are used in marketing, the use of sugar is a prime candidate as an example. Have you heard of these terms? Unsweetened, no sugar added, sugar-free, naturally sweetened all seem to suggest a healthy drink or food but you had best examine the ingredient list carefully. What do these terms (and others) really mean? This is a situation where sometimes the literal meaning is usually the one that is "true" but most of us hear what we think it implies rather than what the word says.
   Let's start with the word unsweetened. It is not used consistently even in the market. Sometimes it is used to mean "without sweetness" -- such as unsweetened tea or coffee. However, it is also used for situations where added ingredients include sugar but no separate refined sugar or sweetener is added. For example, tea with cream is a sweetened drink because cream includes various sugars (primarily lactose). Unsweetened cereal means no refined sugar was added to the mix but almost all grains include sugars (maltose, fructose, and sucrose).
   I used to buy a slice of "no sugar added" apple pie at a local restaurant. I love to cook and bake (it's really an at-home chemical laboratory) and know that it is possible to make an apple pie without any added sugar (one does have to do something to "draw out" the moisture from the apples, however, or it will be quite dry) because the apples have enough sugar within. But, it turns out that, at this restaurant, they actually make use of Splenda (sucralose-based) which is an "artificial sugar substitute". So, their definition of "no sugar added" really means "no caloric natural sweeteners added". I guess that it doesn't have the same ring to it -- but it is a lot more direct.
  "Sugar free" is one of my least favorite marketing phrases. Unlike "unsweetened" which, at least sometimes, means no sweeteners are added -- it almost always means artificially sweetened. I guess that "chemically sweetened" doesn't have the same marketing pizazz as "sugar free". I keep hunting for a real sugar-free drink but water seems to be the only one that can be really trusted.
   Finally, there is the term "naturally sweetened". Generally, this does have a meaning -- no refined sugars are added and no artificial sweeteners are included. This does not often mean without considerable sweetness as it usually means that extracted fruit juices are used in combination with the "primary" flavors. For solid foods, it means the same but the added sweetness comes from the other ingredients (like the tea with cream) in the mix.
   So, how do we determine what is actually in the drink or food. Like most foods, one has to learn to read the labels (in countries where nutritional labels are required). First, read the list of ingredients. Ingredients that end with "alose" (NOT "ose" which is at the end of most natural sugars) or "itol" are likely to be artificial sweeteners. Natural sugars end with "ose" or are described with everyday words (sugar (sucrose), corn syrup (maple syrup is the only other included syrup of which I am aware is used). Check the order and frequency. The highest percentage come first but if the list includes sugar AND corn syrup AND fructose then the total might very well be first or second highest amount -- another marketing trick to shift the order of ingredients and help you to think it has less sugar.
   After checking the list of ingredients, one has to look at the nutritional label. In the "carbohydrates" section, it will be broken down into dietary fiber and sugar. The sugar should correspond to the natural sugars in the ingredient list. When you add up the amount of sugar and dietary fiber, it will usually be less than the total amount of carbohydrates. The difference between these two amounts indicates the amount of more "complex" carbohydrates.
   Carbohydrates are a classification of food elements that combine carbon and Hydrogen-Oxygen (think "hydration" -- or water added -- although hydrates are not quite the same as adding water). As from the previous blog on sugars, dietary carbohydrates can also be grouped into saccharides. The simple monosaccharides and bisaccharides are given the name of "sugar" while the polysaccharides are sometimes called "starches". Starches require the body to break them down into simpler molecules before using (as sugars). At any rate, the difference between the total of sugars and dietary fiber and total carbohydrates indicates the amount of "starch". As you can read from my earlier blogs on nutrition, the healthiness of starch depends on the mixture -- the ratio of dietary fiber versus sugar and simple starches should be kept high.
  So, let the "buyer beware" -- the names used (and with many other aspects of life) have multiple meanings and uses. Marketing terms are used to make the consumer interested in the product -- not to inform. I really will talk about differences between "natural" and "artificial" sweeteners in my next blog but I thought that the use of marketing terms and sugar was important to understand first.
  

How Sweet it Is; sugars and the body

    Our bodies, when we pay attention to them, include a group of tastes. These are usually referred to as sweet, sour, bitter, salty, and umami. They work by the chemicals activating  specific sets of nerves on the tongue. Bitter tastes are associated with poisons and sweet with high-energy foods. It is rare, in nature, for one taste to dominate and this causes a huge set of possibilities. Also, the "flavor" of foods is how the brain interprets the taste, smell, and texture of the food in combination.
    Since sweet tastes are an indication of higher-energy (calorie) foods, our bodies tend to favor sweet foods. Sweet tastes also activate a swallowing reflex within the mouth. (If a person is dehydrated but has trouble swallowing, try adding a single teaspoon of sugar to a glass of water.)
    In the past, a "taste" for sugar has not been a problem as, within most of history, getting enough food has been a much greater problem than eating too much. With modern food processing, concentrated sweetness is a cheap method of making food more appealing and, thus, has become a problem for many people.
    Natural sugars are a group of carbohydrates called saccharides. These may be monosaccharides which include glucose (a "blood sugar"), fructose (a "fruit sugar"),  and galactose. Disaccharides include sucrose ("table sugar"), maltose ("grain sugar"), and lactose (a "dairy sugar"). I put these common referents in quotes because, although associated with these types of foods, the sugars are not exclusively in these foods. Other substances can also activate the sweet sensors of the tongue. These include a group of chemicals called glycosides, some proteins and amino acids, and even some inorganic compounds.
    All fruits and vegetables include sugar as it is a by-product of the process of photosynthesis (conversion of water and minerals into food using solar energy). Some vegetation is considered a primary sugar source because the concentration of sugar is sufficient to warrant extraction and can be used directly as a sweetening agent for foods during cooking. Three of these are sugarcane, sugar beets, and Stevia leaves (which includes a glycoside rather than a saccharide)
    Historically, natural sugars have been used as sweeteners -- adding to food to make them more enjoyable to eat. It is possible, by the process of extraction, to increase the percentage of sugar by eliminating the fiber (pulp) and leaving a solution of sugar and water (still including other water soluble vitamins and mineral compounds). A final method of concentration reduces, or eliminates, the amount of water and non-sweet compounds until only relatively "pure" sugar remains.
    From the body's point of view, the unprocessed sugars are what the body was designed to appreciate. Eating an orange, combined with the pulp, is healthy (in moderation). Orange juice,with the pulp extracted, is much less healthy -- and a tablespoon of sucrose is the least healthy. Our bodies were not designed to deal with "pure", refined, sugars and making use of such within a diet can cause various problems, including an overwhelming of the pancreas causing diabetes.
    In order to combat problems associated with natural sugars -- including high calorie intake and tooth decay (the sticky sugar can remain on the teeth as food for bacteria) -- humans have created "sugar substitutes". Many of these substitutes activate the sweet sensors on the tongue to a higher degree than natural sugars. This means that a much smaller amount may be used for equivalent sweetness (increasing profits and decreasing any caloric intake that may still exist).
   This sounds like a win-win for producers of food as well as consumers but, as we will cover in the next blog, fooling "mother nature" can cause the body to react in ways that are not easily foretold.