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Thursday, February 7, 2013

Just Eat a Healthy Diet - Part 1

I have heard doctors say this to patients, "Just eat a healthy diet and you should be fine."  Other times, i have heard - "You just need to make healthier choices."  At the time, I thought this was a stupid thing to say to someone for several reasons.  First of all, there is much disagreement on what constitutes a healthy diet.  Next, the chances are that the patient has no idea what this means or often the case, thinks they are eating a pretty health diet, when in reality it is often quite poor.  And lastly, making dietary changes is notoriously difficult.

Let's look at that last issue first.  People often start out with the best of intentions to try to eat "healthier."  Usually this comes around New Years as a resolution or sometimes after a health scare.  And yet despite, starting strong, we often fall back into the same rut that we were in before.  I believe that there are a few reasons for this:
  1. Food triggers dopamine pathways in the brain.  Dopamine is the a neurotransmitter in the brain that is associated with pleasurable feelings.  Cocaine and many other drugs will boost dopamine.  Food will also boost dopamine.  The three largest boosts of dopamine come from sugar, fat, and salt.  If you think about your food cravings, they usually contain some combination of 2 or 3 of these.  In a sense we are addicted to our foods and especially those rich foods that give us comfort.  Making changes in our diet to healthier choices will often lead to mood shifts and generally just not feeling good.  This could be compared to an addict going through withdrawal.
  2. Food has a social value as well as just nutritional value.  Almost any family or friend gathering involves sharing a meal together.  Many of our best memories are associated with eating with others. When we start to make changes, we often feel like we are being sabotaged by our family, friends, BBQs, potlucks, holidays, business meetings, etc.
  3. Food has complex reward vs punishment motivations.  Think back to as a kid - if you were good you would get ice cream or pizza party, but if you were bad you would go to bed without dessert.  This sets up a scenario when many of us feel like we are depriving ourselves without proper pleasure foods or we do little food rewards throughout the day.
  4. Marketing.  The first thing you notice when you are on a diet is all the food advertisements around.  TV commercials with melting cheese oozing, billboards with hamburgers, magazines with some yummy treat.  The goal of advertisement is to make you feel like your life is lacking without something and that your life will be better with their product.  Advertisers are quite skilled at getting you to want their product.
  5. Food processing industry tricks.  The food industry has a financial motivation in getting you hooked on their product.  The reason for certain ingredients like increased sugars (often hidden under multiple names - like dextrose, galactose, invert sugar, etc), MSG (again often hidden under names like autolyzed yeast, or hydrolyzed protein), salt, caffeine, and artificial sweeteners is to make us more addicted to a food and want to buy and eat more and more of it.
  6. Habits. Often we have come to associate certain foods with certain activities.  Whether it is chips and dip while watching a game or a cookie or baked good with your cup of coffee.  Breaking these habits can be difficult.
  7. Government subsidies.  I have heard that 80% of government food subsidies go to corn and soy in this country.  Much of this is used to make junk foods using high fructose corn syrup and cheap soybean or corn oil.  Much of this also goes for animal feed to keep the price of dairy and meat down.  It does not make sense that it should be cheaper to buy processed junk food rather than real food.  In most parts of the country, you can buy a hamburger or hot dog for less than the price of a piece of fruit or a salad.  Dollar and value menus at fast food restaurants reflect government subsidies - if meat, cheese, and bread were at their true market value, you could not find a hamburger for a dollar.
  8.  Many people, especially in inner-city urban environments, do not have access to fresh real foods - fruits, vegetables, whole grains.  Often people are forced to buy from the stores in their area which have mostly processed (boxed, canned, or pre-packaged) foods with less nutritional value than real foods
So telling someone to just eat a healthy diet, or just make healthier choices is not a great piece of advice.  As you can see, we have many things setting us up for failure.  As we continue this series, we will look at ways to improve our choices and make the type of changes that are lasting and hopefully life-long.

Check back for future discussions about what we can do to overcome the cards that are stacked against us.

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