Health News

1. Be aware of the physiological causes of hunger and cravings. This may reduce guilt in clients and increase motivation to combat difficult periods.

2. Tease out factors enhancing appetite such as social custom, food availability and restrained eating, and encourage an awareness of these for modifying eating behaviour.

3. Encourage slow eating to give the body a chance to recognise that feeding is taking place.

4. Graze rather than gorge so as not to risk periods of intense hunger. Snacking every 3-4 hours (using low-fat, sweet foods such as fruit) can promote satiety and reduce possible dietary compensation that may occur at a 5-6 hour time period.

5. Differentiate between biological and emotional hunger and rate levels of hunger to reduce unnecessary over-eating.

6. Wait 15 minutes before eating to see if a craving is physiological or emotional.

7. Reduce availability of high-fat foods. Sensory properties may influence susceptible individuals.

8. Choose high SI foods where possible to maximise satiety, e.g. All Bran, porridge, untoasted muesli, pasta, fruits, beans, lentils, spaghetti and potatoes.

9. Where possible, include high-fibre foods at each meal to help maximize satiety throughout the day.

10. if alcohol is consumed, there should be an awareness of the possible increase in food consumption due to reduced inhibition and possible higher intake of fatty foods .

11. The use of artificial sweeteners or fat substitutes may provide benefits to some individuals but requires individual monitoring.

12. Be aware of the nutritional limitations on fat loss and advise clients to avoid food restriction beyond their individual threshold of hunger.

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Like the TCAs, antidepressants of the MAOI class raise the levels of crucial neurotransmitters, but they do so in a different way, by inhibiting the action of an enzyme called monoamine oxidase. This enzyme breaks down certain compounds in the blood. By keeping monoamine oxidase from doing its job, the drug allows higher levels of certain neurotransmitters to circulate.

Studies show that two MAOIs, phenelzine and isocarboxazid, effectively reduce or eliminate bingeing. The dosages are the same as those used in treating depression. Drugs of this class pose a somewhat greater risk of side effects, such as lower blood pressure, agitation, or sleep disturbances, than do the TCAs.

There’s another problem with MAOIs. Because they interfere with enzyme action, they affect the body’s ability to break down an amino acid called tyramine. Too much tyramine floating around in the bloodstream can cause problems related to high blood pressure, such as excruciating headaches, internal bleeding and even death.

Certain foods contain high amounts of tyramine. The list includes cheeses, wines, beers, pickled herring, liver, yeast extract (including brewer’s yeast), salami, pepperoni, bologna, yogurt, and fava beans. A patient should only take an MAOI if she understands the risk involved and agrees not to eat any foods containing tyramine.

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Everyone in Regina Owens’s life understands that nothing interferes with her workouts. After all, it was this kind of passion and devotion that enabled her to lose 65 pounds and reduce her dress size from a 22 to a 10.

Each day, Regina rises at 4:30 A.M. for a 5-mile walk. In the evening, after work, she packs herself and her kids in the car and drives 30 miles to a gym. While she lifts weights for an hour, her kids do their homework.

“Yes, I’m obsessive. But at least the whole exercise thing is a healthy obsession for me. That hasn’t always been so,” says Regina, a 46-year-old housing director from Eustis, Florida.

Indeed, before Regina latched on to exercise, she was eating too much and abusing sleeping pills—her ways of coping with the emotional strain of a difficult marriage. Turning her life around required that she pursue health as obsessively as she once had those destructive behaviors. “I needed to do something positive, and I needed to do it wholeheartedly,” she says.

She began by taking long walks around a lake near her home. During those walks, she thought about her problems and her desire to change. Within a few months, she was averaging between 8 and 10 miles a day. She began eating better, too, by reducing her fat intake, restricting sweets, and learning to control her compulsive snacking. She took up weightlifting and studied to become a certified trainer, which she now does as a sideline.

“To succeed, I knew I had to go at it full force,” she says. “Later, my motivation came from seeing my body go through this incredible transformation. I got leaner and fitter.

“Once that started happening, my workouts became something I needed to do,” she says. “Now, if I don’t get my workout in, I don’t feel like my day is complete.”

WINNING ACTION

Work with your personality, not against it. Concentrate on turning negative obsessions and behaviors into healthy passions and choices. Be obsessive, but in a positive way, if that suits your personality. If you’re more laid-back, focus on making small changes. Find the style that works for you.

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If you eat the kinds and quantities of foods outlined in my modified food guide pyramid, including the Chitosan, of course, you’ll probably be able to stay within the Fat Blocker guidelines for protein, carbohydrate, and certainly for fat. That leaves just two other things to watch out for: cholesterol and sodium.

Everybody knows that high blood cholesterol is a risk factor for heart disease. Cholesterol is a major component of plaque, a substance that contains fat and accumulates on the walls of

arteries, clogging these vessels the way hair clogs up bathroom pipes. And remember when you pull the fat out of plaque, the body can do a better job of dilating the blood vessels.

About 75 percent of our blood cholesterol is manufactured by the liver, with the other 25 percent coming from the foods we eat. The major dietary cause of high blood cholesterol is saturated fat. If you’re following the Fat Blocker Eating Program, you’re eating only reasonable amounts of lean meats, poultry, and fish, and many of your dairy products are low or nonfat. More important, you are also blocking a large percentage of your saturated fat with Chitosan. As a result, saturated fat intake shouldn’t be a problem for you. But for some people, blood

cholesterol increases when
they eat cholesterol-containing foods, even ones that contain

relatively little saturated fat. Among the biggest offenders are egg yolks, organ meats (liver, kidney, heart, brains, sweetbreads), and certain shellfish (shrimp and oysters).

One egg contains as much cholesterol (300 mg.) as you actually need in a day. So try to limit yourself to no more than one egg per day, and no more than three eggs per week. This can be difficult since this includes eggs in baked goods or other foods. However, if you exceed your limit, don’t worry too much. Now that you’re on a Chitosan diet, at least you know that you’re not building more cholesterol from absorbing excess saturated fat.

Also, it’s useful to take some other precautions against taking in excess cholesterol. For example, I eat only the whites of the eggs to ensure that I consume no cholesterol. I love a simple omelet made with egg whites, vegetables, and spices. It tastes excellent and requires virtually no fat to cook, thus letting me save Chitosan for other things that do require fat. Also, when I eat a high-cholesterol meal, I try to make the rest of the meals that day vegetarian. Even if you don’t quite succeed in this, the attempt is worth the effort. For remember, you are not expecting to instantly achieve the ideal diet, only one that is a step closer to the ideal than you were yesterday!

High-sodium diets can contribute to another heart disease risk factor—hypertension, better known as high blood pressure. Called the silent killer because it produces no symptoms in the early stages, high blood pressure can exert enough pressure on your arteries to cause tiny cracks to appear in their walls. Clots and plaque can form in the cracks, and before you know it, you’ve got the makings of a heart attack or stroke. Sodium in excessive quantity can cause blood pressure to rise in certain sensitive individuals, eventually leading to heart enlargement and congestive heart failure. We doctors have many medicines to lower blood pressure, but they all have side effects. Perhaps the best medicine is to avoid the problem altogether by reducing your salt intake. As I described earlier, if you do this very gradually, it is not hard to do.

Some diets recommend lowering your salt level by going cold turkey and just throwing your salt shaker away so you won’t be tempted to add salt to your food at the table. If that works for you, great. But if it doesn’t, the slow-and-easy method described earlier works, too. And it’s in line with my thinking about Chitosan. It’s better to go real slow and easy, making tiny changes regularly and helping yourself along with Chitosan, than it is to take huge steps only, inevitably, to stumble and fall.

Whether you use the gradual or the cold turkey approach to cutting down on salt, sooner or later you will want to keep the salt you use in cooking to a minimum. Put in half the amount the recipe calls for, or even less. Stay away from salty foods such as smoked, pickled, or cured foods, canned soups, frozen dinners, salad dressings, catsup, baked goods, crackers, chips, or salted popcorn. Eat fresh vegetables and fruits, not canned. After a while, you’ll find that your old favorites suddenly taste much too salty. And you’ll discover the more delicate, true tastes of food.

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Often called the silent killer because it provokes no discernable symptoms in the early stages, elevated blood pressure can be a killer. Some 60 million Americans suffer from this disease, which is more likely to strike if you are obese or eat a diet high in saturated fat and low in fiber.

We know that populations consuming large amounts of fiber do not suffer from the age-related rise in blood pressure seen among those eating low-fiber, high-fat diets. We also know that adding fiber to the diet lowers elevated blood pressure—it can even lower it in those with normal pressure readings.²⁴

The British Medical Journal²⁵ reported on a study looking at the relationship between fiber and blood pressure. Ninety-four people ranging in age from 18-60 were grouped according to their fiber intake. Those who consumed high-fiber diets had lower blood pressure than those who did not. To test the immediate effect of fiber on blood pressure, 11 of those who normally ate a high-fiber diet decreased their fiber intake. Four months later, their blood pressures had increased. Meanwhile, 31 people who normally consumed low amounts of fiber began eating more fiber. Four months later, their blood pressure levels had dropped.

Claire, a 48-year-old, 200-pound nurse whom I’ve known for many years, recently showed me her computerized “diet database.”

“Look at this, Dr. Fox,” she said proudly, pointing to the computer screen. “Here’s a list of the diets I’ve been on, arranged alphabetically.” It looked like there were 30 or 40 diets on the screen, from Atkins down to Zone.

New words and numbers appeared on the screen moments after she tapped a few keys on the keyboard. “Now they’re arranged by pounds lost. See?” She pointed to the first item on the list.

“I lost 50 pounds on liquid protein, that’s the most, then 42 pounds when my jaw was wired and 28 pounds on this fruit only diet. And look at this.”

The display changed as she tapped a few more keys. “Now I’ve got them listed by amounts of weight regained after going off the diet. And the list in this column shows the side effects of each diet.” She sat back in her chair, smiling proudly. “This is the most complete record of dieting ever compiled. By name, by dates that I was on the diet, by pounds lost, pounds gained, side effects, and cost; I’ve got it all.” Her smile faded as she continued. “Unfortunately, I’ve also still got all the fat I started with.” Claire is not alone. One out of every three American adults is obese¹ and millions more are carrying around too much fat and becoming obese. Despite the fitness craze that arose in the 1970s and still continues, America is not a slim and healthy nation. But we certainly want to be (and quickly), so we turn to fad diets.

In the early years of my practice of internal medicine and cardiology, I put many people on weight-loss diets in an attempt to improve their health. But things did not go nearly as well as I had hoped. In fact, I once joked to a colleague, “I think I’m running a weight gain practice.” Many of my patients were actually getting heavier on the unimpressive diets we doctors used to recommend back in the 1950s and 1960s.

In the 40 years I’ve practiced medicine, I’ve seen every kind of diet you can imagine: water diets, grapefruit diets, the Drinking Man’s Diet, the Stillman and Atkins diets, pineapple diets, starvation diets, no-carbohydrate diets, starch-blocking diets, diets with pills, diets without pills, “scientific” diets, “common sense” diets, army diets, air force diets, American diets, foreign diets, liquid diets, and liquid protein diets. I learned about these diets from my colleagues, from the medical literature, from my patients, from my secretary, from my wife, even from Reader’s Digest and The Ladies’ Home Journal.

My patients have always asked me which diet was the best, which one they should be on. I knew you could lose a lot of
weight quickly on almost any of the diets, but I always hesitated to recommend one. Once I was approached by a manufacturer of the supplement used in the

Starch-Blocker Diet, who asked me to say something positive about the pill. As I spoke with the manufacturer, I realized that he didn’t know how much trouble this starch-blocking supplement could create as it blocked the ability of the pancreas to make an enzyme called amylase. Sure enough, many people who went on this diet suffered from nausea, vomiting, and other problems. The moral of the story is you must learn everything you can about a diet or supplement before you take it, and avoid it if the answers are not positive.

The problem with most all the fad diets is they are ill conceived, ineffective in the long run, and often dangerous. The originators and purveyors of these diets do
not understand (or have chosen to ignore) the underlying meaning and rationale of diets. Most of us think of a diet as a quick way to lose weight. We see it as a temporary device, a way to control ourselves or juggle food around. And once we’ve lost the desired amount of weight, we quickly and happily discard it.

The word “diet” comes from the Greek word “diaita,” which means a mode of life or a regimen. A diet, then, is not a temporary aid to be dropped and forgotten when the weight-loss goal is met. Instead, it is a lifelong plan, a blueprint for your life and health.

You can lose weight (at least temporarily) on just about any diet. But before you do, ask yourself 2 very important questions: How are you losing the weight? And how will the process affect your health?

There are three ways to lose weight: 1) By getting rid of water in your tissues; 2) By forcing your body to consume lean body tissue such as the heart, lungs, kidneys, or muscles; or 3) By burning fatty tissue.

Losing water weight, as you do with the high-protein diets and diuretics, is absolutely worthless because you will quickly replace the lost water and find yourself right back where you started. Losing and regaining water is not only a big waste of time and money, but it can also cause you to lose vital minerals, which can prompt serious medical problems.

Cutting into your lean body tissue is also a dangerous, possibly deadly, approach. Vital organs can become undermined, leading to organ damage and even organ failure. The only safe, sound, and permanent weight-loss method is burning off excess fat. Doing so takes time and patience, but fad diet promoters would rather promise quick and easy weight loss. Unfortunately, their promises are usually just hot air. Numerous studies have shown that 95 percent of those who lose 30 to 40 pounds or more on fad diets will gain it all back (often with interest) within 1 year. And 99 percent will have gained back all the lost weight within 3 years.

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Chitosan is a fiber, similar in many respects to the cellulose in foods. But the human body cannot digest Chitosan, so it passes harmlessly through the body. Since the Chitosan is not assimilated by the body, it obviously adds absolutely no calories to the diet.

In the stomach Chitosan turns into a gelatin-like substance that grabs on and holds tightly to saturated fat. Stuck in this Chitosan gel by the electrostatic “cling” between its positive charge and the fat’s negative charge—very much in the way lint sticks to wool-the fat cannot be absorbed. Instead, it is carried through the upper and lower intestines and right out of the body. It is as if, suddenly, the fat became as nondigestible as Olestra (the new nonabsorbable fat, which recently became available for use in
some snack foods). Fat attached to Chitosan has as much impact on the body as fat left on the dining room table!

Early impressive evidence that this phenomenon really works came from a series of animal experiments. At least 18 such studies have been conducted at research centers in various

countries. The first major study² was conducted by J. L. Nauss, J. L. Thompson, and J. Nagyvary of Texas A&M University in 1983. In a carefully controlled project, these three scientists proved that for each gram of Chitosan a group of rats ingested, they excreted 4-5 more grams of fat than the control group.

Heart disease, hypertension, osteoarthritis, back pain, difficulty breathing, and we’ve only begun to discuss the ill effects of excess fat. For example, did you know that skin disorders are more common in the obese? One reason is that sweating increases due to the extra insulation that fatty tissue provides. (This sweating can be especially heavy after eating.) Sweat can get trapped in the thick skin folds and become a medium for pathogenic bacteria, leading to skin infections. Skin maceration, pain, and discomfort can also occur as the obese person’s arms and legs rub against the flanks and thighs when walking. Swelling of the feet, ankles, and lower legs, which is common in the obese, can lead to the breakdown of skin and further pain.

Obesity is also a major cause of diabetes mellitus Type II, which we used to call adult-onset diabetes. This devastating disease can lead to blindness, strokes, heart attacks, gangrene, kidney failure, and infections. Yet often it can be eliminated simply by losing the extra pounds.

So there is no doubt about it—obesity is a dangerous condition. In fact, it is a risk factor for 4 of the 7 leading causes of death in the United States. But before delving further into the hazards of excess body fat, let’s define a few important terms.

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