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• Your life and health are your own responsibility.
• Your decisions to act (or not act) based on information or advice anyone provides you—including me—are your own responsibility.

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Better Health: It’s Less Complicated Than You Think

As gnolls.org has become more and more widely read, I am receiving more and more questions from my readers in comments, on the forums, and over email—and a significant number of them boil down to “I have [a list of problems], what should I eat?”

First, let me be absolutely clear: I am not complaining! I work very hard every week to write articles that are not only worth your time—they’re worth forwarding to others using the social media buttons at the end. I’m glad you’re here.

However, I need to correct a common misconception. And though this article is mostly addressed to those new to paleo or the paleo-curious, it’s worth all of our time to briefly remind ourselves of a basic truth.

Getting Lost On The Path To Better Health

Most of modern medicine treats physical and mental dysfunctions as medication deficiencies.

  • Acid reflux? You’ve got a proton pump inhibitor deficiency.
  • Can’t sleep? A classic sign of Ambien deficiency.
  • Insulin-resistant? Your metformin intake is inadequate.
  • Depressed? Clearly your blood levels of Prozac are too low.
  • High blood pressure? That’s textbook—you’re Toprol-deficient.
  • Obese? Well…actually, we haven’t found a medication that doesn’t make you crap your pants. Maybe you should do some jumping jacks or something.

Even “alternative medicine” takes this approach, telling us we’re deficient in everything from crushed crab shells to olive leaf extract.

Lots o' Vitamins

According to the labels, every one of these bottles is absolutely necessary for our good health. It's best not to ask how Paleolithic humans survived without them.

Of course this is baloney, designed to sell us pills. But this pervasive approach has a more subtle destructive effect on our thinking: it lulls us into applying the same fallacious analysis to our dietary needs. Whatever’s wrong with us, there must be an individual dietary prescription to fix it. Some magical balance of protein to fat to carbs, some obscure rainforest fruit rich in antiphytocatopolyresistophenolins, a nut butter that won’t make us fat…

Yes, we all want to believe that we’re all beautiful and unique snowflakes, that each of us deserves a personalized fitness plan, our very own roadmap to better health. Even the paleo community falls victim to the weak version of this fallacy, which is throwing up our hands and saying “Since we don’t understand everything, hey, whatever works for you.”

Consequently, it is important to remember the following:

Afflictions that redefine “healthy eating” are extremely rare.

Acid reflux? Eat like a predator.
Can’t sleep? Eat like a predator.
Insulin-resistant? Eat like a predator.
Depressed? Eat like a predator.
High blood pressure? Eat like a predator.
Obese? Eat like a predator.
And so on.

Unless you have one of a few rare and specific conditions like phenylketonuria (for which you were either tested at birth or died of the complications) or seizures (for which ketogenic diets are often appropriate), it’s highly unlikely that eating a functional paleo diet will cause anything to get worse—and it’s highly likely that you will enjoy improved health, relief of some or all symptoms, improved body composition, and higher energy levels after the period of adjustment required by any major dietary change.

At this point it is important to note the disclaimer I’ve had on the left sidebar for some time:

• Your life and health are your own responsibility.
• Your decisions to act (or not act) based on information or advice anyone provides you—including me—are your own responsibility.

Furthermore, if you ask me “What should I do about my GERD/insulin resistance/recurring rashes/IBS/40 remaining pounds of fat”, the first thing I’m going to ask you is “How many of the steps from Eat Like A Predator have you taken?” If you’re still eating gluten grains, cooking with seed oils, consuming packaged foods (especially those labeled “heart-healthy” or “low-carb”), or drinking soda, my first advice will be “Then stop that.”

Occasional cheating is a different matter…I don’t want to encourage orthorexia by blaming everything on half a brownie you had three weeks ago. But you need to be honest about whether you’re really just cheating, or whether you haven’t fully committed to change.

Conclusion: Better Health Is Less Complicated Than You Think

It’s very profitable to make better health seem like a complex undertaking. If we view “health” as an individual prescription difficult to follow, nearly impossible to maintain, and only dispensed by authority figures, we’ll become dependent on the continual assistance of others—and their pills—and we’ll be forever running in circles chasing the next diabetes drug or magical rainforest antioxidant extract.

Don’t believe the hype. Our ancestors survived, thrived, and multiplied for millions of years, using only their wits and sharp rocks. Humans are not born with medication deficiencies—nor are we metabolically dependent on chemicals extracted at great cost from plants that only fruit or flower seasonally in one small region we didn’t even inhabit until perhaps 11,000 years ago.

No, eating like a predator will not fix every problem. (For instance, infections require antibiotics, antifungals, or anthelmintics…and if your beta cells are gone, you need exogenous insulin.) Neither will it fix your problems overnight: damage done over decades won’t heal fully in days, and some damage may be permanent. But as Dr. Doug McGuff once said about medical testing:

“If the number is bad, eat healthy.
If the number is good, eat healthy.”

You may well be a beautiful and unique snowflake—but you’re a human animal, just like everyone else, and your path to health begins just like everyone else’s.

Live in freedom, live in beauty.

JS


Postscript: Your questions are welcome! There is much to discuss, and plenty of room for optimization once you’re following the basic plan.

What Was Your Wakeup Call? And A Review Of Jeff O’Connell’s “Sugar Nation”

“Why Are We Hungry?” will return next week.

Note that if you’re new to my ongoing blockbuster series “Why Are We Hungry?”, it’s best to start at Part I. Otherwise, if you haven’t already, you should read the latest installment, "When Satiation Fails"—because like the previous article "When Satiety Fails", it both presents important information and ties together a lot of issues that are currently vexing the community. And we’re not done yet!

Finally, I note with pleasure that several readers and regular commenters are already starting to pull together the Big Picture on their own. This is great! If I’ve explained the science correctly, the consequences and conclusions should follow logically and be non-controversial.

Ever since I was little, my mother used an analogy that, for me, is still the mental equivalent of worn-out disc brakes squealing in metal-to-metal contact—or the incessant, high-pitched, yelping bark of an obsessively manicured lapdog suffocating in a cloud of its owner’s perfume.

She called it the “pain thermometer”, and it goes something like this:

It doesn’t matter how much you don’t like something or how much it hurts. Until your pain thermometer reaches the top, you won’t do anything about it.

Typing that still makes me wince, so I’ll say it my way:

We don’t get what we want: we get what we are just barely willing to tolerate.

This is a powerful concept, and it explains so much about the world and our lives. We want honest politicians, but we’re willing to tolerate corrupt, venal liars. We want privacy, but we’re willing to tolerate a surveillance state. And we want to be healthy and fit, but we’re willing to tolerate being sick, obese, and diabetic.

Stated more explicitly, it doesn’t matter how crummy your life is or how much pain you’re in—unless you get so fed up that you finally do something about it.

“Network” was released in 1976—35 years ago—and that speech could have been made yesterday. Think about that for a minute.

Unfortunately, yelling out your window won’t solve anything, which is where Howard Beale’s ideas ran out. But until you’ve decided that you’re no longer willing to tolerate your situation, nothing will change. The change is up to you.

How Did We Get Here?

Based on the paleo eaters I’ve talked to, including the authors of more than one well-known paleo diet book, very few of us came to the concept of ancestral health from a position of strength. Most of us tried a paleo diet because of medical problems that the medical establishment was (and is) remarkably powerless to treat, or because the side effects of the medications were just as bad as the disease. GERD, IBS, arthritis, innumerable autoimmune syndromes, poor sleep and digestion, or just long-term malaise…and, of course, anywhere from 15 to 200 extra pounds of fat and its associated metabolic syndromes that both “heart-healthy whole grains” and “eat less, move more” were powerless to shed.

In other words, we had to become so broken that we were no longer willing to tolerate being broken.

This leads naturally into my review of “Sugar Nation”.

Congratulations, You’re Prediabetic: Jeff O’Connell’s Wakeup Call

Synopsis: Jeff O’Connell, despite being tall, slim, and apparently in decent physical shape (he’s been the editor of everything from Muscle & Fitness to Men’s Health to Bodybuilding.com), finds out that he’s not just stressed out from work: he’s inherited his father’s Type II diabetes. He doesn’t want to end up like his father, dying bedridden with amputations and on dialysis, and the advice he was given upon diagnosis seems remarkably inadequate:

    Dr. H, having told me that I was prediabetic, mumbled something about switching from white rice to brown. He also instructed me to come back in six months for another round of blood work. Wow, that’s it? I thought. I didn’t know much about disease, but managing it seemed like it should require more than tweaking my order at the local Chinese restaurant.

    What I didn’t receive, and what most patients don’t receive, is any advice that would address, let alone fix, the problem…”

Currently $14.36 at Amazon.com (price may change)


The rest of “Sugar Nation” recounts Jeff’s effort to understand what Type II diabetes is, and what he can do about it—with an additional twist that I’ll leave readers to discover. Though Jeff’s prescription will be shocking to anyone in the mainstream, its two pillars shouldn’t be a great surprise to most of my readers, or anyone in the paleosphere: T2D is a defect of glucose metabolism, it is treatable by diet and exercise, and you should therefore 1) stop eating so much friggin’ glucose, i.e. eat a low-carb diet, and 2) perform short, intense, glycogen-depleting exercise to help restore your insulin sensitivity.

Furthermore, he repeatedly hammers home that the progression from insulin resistance to T2D to numbness, dialysis, amputations, and blindness is a direct consequence of diabetes “treatment” that advises patients who cannot properly metabolize carbohydrates to eat lots of carbohydrates—and, with them, an ever-expanding pharmacopoiea of drugs that fail to mitigate their poisonous effects.

Where I find the book to be most interesting, and most valuable, is in two areas: the history of diabetes treatment (as with obesity, past treatment programs were often more effective) and the demographics of its relentless spread, and in the dysfunctionality and outright corruption of the medical industry. He lays bare the deep, incestuous financial relationships between the American Diabetic Association and the pharmaceutical and medical equipment manufacturers who profit so handsomely from diabetics—as well as the profoundly malicious cluelessness of the mainstream medical community, including the NIH and AAFP:

    During a 2007 interview with the American Association of Family Physicians’ then-president James King, M.D., a family physician in Selmer, Tennessee, I asked him how to eat properly as a prediabetic so that I could inform others in the pages of Men’s Health.
    “I tell diabetic patients to consume more carbohydrates—mainly from fruits and vegetables, not from simple sugars and starches—while decreasing the amount of meat and fat in their diet,” he said.

    I e-mailed the lead author, Philip E. Cryer, M.D., professor of endocrinology and metabolism at Washington University School of Medicine … “A glucose-tolerance test is never indicated in the evaluation of a patient for hypoglycemia,” he wrote back.

    “I’m sorry, but that item’s not recommended for your diet,” said the pleasant woman on the other end of the line. I had told the doctors that I was prediabetic. I was impressed that this information had been conveyed to the cafeteria.
    But I was also confused. “What, the peaches?” I asked.
    “No, the sausage.”

O’Connell is an experienced writer and journalist, and it shows: he exposes the rampant corruption and cluelessness in a remarkably neutral tone, without coming across as either paranoid or a crusader.

His understanding of the science is reasonably sound, too: he understands the role of glycogen depletion and how it improves metabolic flexibility, and even touches on the known issue of mitochondrial dysfunction in the obese. My only quibble is a whiff of saturated fat phobia here and there—but on the whole he does a solid job of understanding and communicating that low-carb necessarily means high-fat as well as high-protein, and that this is not a problem. And despite the title “Sugar Nation”, he is clear on the fact that “heart-healthy whole grains” are just as carb-heavy—and, therefore, unhealthy—as refined grains and refined sugars. However, I wish Jeff had summarized his hard-won knowledge at some point in the book: a short chapter, or even just a bullet list of “Here’s how I manage my Type II diabetes”, would have been welcome.

In conclusion, “Sugar Nation” is a hard-hitting exposé that reads more like a biography. While its basic prescription won’t be news to you, my readers, it’s a shocking accounting of the cluelessness and corruption of the mainstream medical establishment, and the extent of the suffering its terrible advice causes. It’s also a solid source of information for people in your life who can’t swallow “paleo” or “primal” but are still in danger of ruining their health. And it’s full of scary facts and trenchant observations, so I’ll close with one:

…The standard recommendation of consuming 50 percent of your calories from carbohydrates translates to 250 to 300 grams’ worth a day. Split over three squares a day…means consuming more than a glucose tolerance test’s worth of carbs at each meal. “We use glucose tolerance as a metabolic stress test and yet prescribe a diet that produces that at every meal,” says Raab. “It highlights just how ridiculous this advice is.”

Wrapping It Up: What Was Your Wakeup Call?

“Sugar Nation” is Jeff O’Connell’s story.
What was YOUR wakeup call?
What finally made you say “I’ve got to do something about this” and motivated you to start eating like a predator?
Leave a comment, even if it’s just a link to the bio on your own blog…it’s always fascinating to hear others’ stories.

Live in freedom, live in beauty.

JS


Are you new to gnolls.org? Welcome! There’s a lot of good information here for you to read and discover: the index is a great place to start. My FAQ should answer many of your questions, and I do my best to respond to comments on my articles and questions in the forums.

When Satiation Fails: Calorie Density, Oral Processing Time, and Rice Cakes vs. Prime Rib (Why Are We Hungry? Part V)

Caution: contains SCIENCE!

(Part V of a series. Go back to Part I, Part II, Part III, or Part IV—or skip to Part VI.)

In previous installments, we’ve established the following:

  • Hunger is not a singular motivation: it is the interaction of several different clinically measurable, provably distinct mental and physical processes.
  • In a properly functioning human animal, likes and wants coincide; satiation is an accurate predictor of satiety; and the combination of hunger signals (likes and wants) and satisfaction signals (satiation and satiety) results in energy and nutrient balance at a healthy weight and body composition.
  • Restrained eating requires the exercise of willpower to override likes, wants, and the lack of satiation or satiety; the exercise of willpower uses energy and causes stress; and stress makes you eat more. Therefore, a successful diet must minimize the role of willpower.
  • A lack of satiety will leave us hungry no matter what else we do to compensate. We fail to achieve satiety by not ingesting (or not absorbing) the energy and/or nutrients our body requires, and by an inability to retrieve the energy and/or nutrients our bodies have stored due to mitochondrial dysfunction.

Satiation vs. Satiety, Satiated vs. Sated: Understanding The Differences

In common use, “satiation” and “satiety” are basically synonyms. Even the scientific literature does not always maintain or respect the difference, so it’s important to understand and distinguish exactly what’s being discussed.

Satiety is your body’s response to the availability of nutrients from food that you’ve already digested and processed. (We discussed satiety at length in Part IV.)

Satiation is your immediate reaction to the ingestion of food—the drive that causes you to stop eating. It is your body’s attempt to estimate future satiety via sensory input: smell, taste, texture, and stomach distention.

I’ve quoted this passage before, but I’ll quote it again, because it’s important:

Nutrition Bulletin Volume 34, Issue 2, pages 126–173, June 2009
Satiation, satiety and their effects on eating behaviour
B. Benelam

Signals about the ingestion of energy feed into specific areas of the brain that are involved in the regulation of energy intake, in response to the sensory and cognitive perceptions of the food or drink consumed, and distension of the stomach. These signals are integrated by the brain, and satiation is stimulated.

When nutrients reach the intestine and are absorbed, a number of hormonal signals that are again integrated in the brain to induce satiety are released.

It’s difficult to draw a sharp line between satiation and satiety: some foods digest very quickly, and their nutrients are available quickly enough for satiety to affect the satiation response. (Example: simple sugars and carbohydrates, whey protein isolate.) And there is strong support for the idea that taking longer to eat results in lower food intake, probably because the satiety response begins to come into play.

Satiation Is Relative To Satiety

Since satiation is an attempt to predict (via sensory input) future satiety (i.e. nutrient absorption), it should be obvious that our current state of satiety affects what foods we find satiating—or not satiating. Here’s an interesting example of this effect:

J. Nutr. January 1, 1998 vol. 128 no. 1 61-67
Prior Day’s Intake Has Macronutrient-Specific Delayed Negative Feedback Effects on the Spontaneous Food Intake of Free-Living Humans
John M. de Castro

Food energy intake during a day was found to only mildly affect intake on the subsequent day (mean r = −0.07, P < 0.001), but was more strongly negatively related to intake occurring on the second (mean r = −0.18, P < 0.001) and third day (mean r = −0.10, P < 0.001) afterward.

Each macronutrient was shown to have a maximal negative relationship with subsequent intake of that same macronutrient, with 2-d lag mean autocorrelations equal to −0.11, P < 0.001 for carbohydrate, equal to −0.18, P < 0.001 for fat, and equal to −0.13, P < 0.001 for protein. These effects on daily intake were found to result from separate negative feedback effects on meal size and frequency.

Stated plainly: not only does eating more food cause you to eat less food 2-3 days afterward—eating more protein, fat, or carbohydrate causes you to eat less of the same 2-3 days afterward. Here are the graphs:

The effect is not large, but it is consistent and significant.

And though deCastro didn’t graph meal size and frequency, they were also compensated for with a 2-3 day time lag.

There are some studies that claim to show macronutrient compensation doesn’t exist—but they examine only the next meal eaten on the same day, or perhaps the morning after.

This is only one example of satiety affecting satiation, but I think it proves the point: satiation is relative to your current state of satiety. (For another real-world example of the effects of previous meals on satiety, see the study referenced in my classic article How “Heart-Healthy Whole Grains” Make Us Fat.)

We’re all familiar with the manifestations of this effect. For instance, after two weeks of living primarily on bento boxes and bowls of ramen while in Japan, my friend and I found ourselves absolutely craving red meat—and we proceeded to draw a crowd of spectators at an all-you-can-eat yakiniku restaurant, by eating more than any of them had probably seen consumed at once by anyone but a sumo wrestler.

Yakiniku = grill your own meat, at your own table. Basically Korean BBQ without the kimchi.


How Satiation Fails: Bypassing Sensory Input

Since satiation is dependent on sensory input, it seems logical that we can break satiation by bypassing or attenuating the sensory experience of eating.

This is, in fact, the case.

It has been known for a long time that the obese eat more quickly than the non-obese:

Int J Obes. 1977;1(1):89-101.
Eating in public places: a review of reports of the direct observation of eating behavior.
Stunkard A, Kaplan D.

…Two measures showed promise in discriminating obese from non-obese persons. The first was food choice: obese persons chose more food than non-obese persons (and men chose more than women and tall persons more than short ones). The second measure was rate of eating: obese persons consumed more food per minute than non-obese persons.

Further reading: Psychosom Med Vol. 42, No. 6
Eating Style of Obese and Nonobese Males
Kaplan D

And under controlled conditions, people eat more when they are allowed to eat quickly than when their eating rate is restricted:

Am J Clin Nutr August 2009 vol. 90 no. 2 269-275
Effect of bite size and oral processing time of a semisolid food on satiation
Nicolien Zijlstra, René de Wijk, Monica Mars, Annette Stafleu, and Cees de Graaf

Results: Subjects consumed significantly more when bite sizes were large than when they were small (bite size effect: P < 0.0001) and when OPT [oral processing time] was 3 s rather than 9 s (OPT effect: P = 0.008). Under small bite size conditions, mean (±SD) ad libitum intakes were 382 ± 197 g (3-s OPT) and 313 ± 170 g (9-s OPT). Under large bite size conditions, ad libitum intakes were much higher: 476 ± 176 g (3-s OPT) and 432 ± 163 g (9-s OPT). Intakes during the free bite size conditions were 462 ± 211 g (free OPT), 455 ± 197 g (3-s OPT), and 443 ± 202 g (9-s OPT). Conclusion: This study shows that greater oral sensory exposure to a product, by eating with small bite sizes rather than with large bite sizes and increasing OPT, significantly decreases food intake.

Many food choices can increase our rate of eating. We can eat liquid foods more quickly than solid foods, soft foods more quickly than hard foods, tender foods more quickly than tough foods.

For instance, “meal replacement shakes”, being liquid, don’t produce the same satiation response as eating real food:

Journal of Comparative and Physiological Psychology Volume 68, Issue 3, July 1969, Pages 327-333 doi:10.1037/h0027518
Preloading and the regulation of food intake in man
Barbara C. Walikea, Henry A. Jordan and Eliot Stellar

“17 human Ss [Ss = subjects] ate 20-min meals of Metrecal through a straw connected to a hidden reservoir. Oral preloads of Metrecal were administered before the meals, and these varied 20-120% of the amount of the base-line meal intake and were given 1-120 min. before the meal. Test-meal intake was depressed as a function of the size of the preload; however, the Ss did not take the preload fully into account and they overate.

Note: Metrecal started the 1960s craze for meal replacement shakes. Its ingredients: “A mix of skim-milk powder, soybean flour, corn oil, minerals and vitamins.” (More information here.) It is also claimed that Metrecal tasted absolutely terrible—though since it hasn’t been produced since the 1970s, there’s no way to know for sure.

And people eat more yogurt when they can suck it through a straw than when they have to use a spoon:

Am J Clin Nutr April 2010 vol. 91 no. 4 841-847
Intake during repeated exposure to low- and high-energy-dense yogurts by different means of consumption
Pleunie S Hogenkamp, Monica Mars, Annette Stafleu, and Cees de Graaf

Results: Intakes (P = 0.01) and eating rates (P = 0.01) were highest in the liquid/straw group. Average intakes over 10 exposures were 575 ± 260 g for liquid/straw, 475 ± 192 g for liquid/spoon, and 470 ± 223 g for semisolid/spoon; average eating rates were 132 ± 83 g/min for liquid/straw, 106 ± 53 g/min for liquid/spoon, and 105 ± 88 g/min for semisolid/spoon.

Conclusions: We observed no energy intake compensation after repeated exposure to yogurt products. Differences in ad libitum yogurt intake could be explained by eating rate, which was affected by the different means of consumption.

From this, we can see that it’s easy to bypass our satiation response by eating highly processed foods. Processing (and cooking) basically pre-digests food for us, which increases both the speed at which we can eat it and the speed at which we can absorb it.

Even the toughest, stringiest cut of modern beef is from an animal that has never had to run from predators…and it’s been ‘aged’ for at least two weeks, which is to say that it’s been left to slowly rot in its own digestive enzymes in order to make it softer and more tender.

Thought experiment: consider the rate at which you could hack meat and fat off of a fresh bison carcass using sharp rocks, and the rate at which you could chew and swallow that raw meat—versus the speed at which you can gobble down medium-rare hamburger or prime rib.

Finally, I’ll note that an increasing cultural tendency to “eat on the run” increases our rate of food ingestion. Gobbling down food in a hurry because we need to get back to work, or pick up the kids, or get our shopping done, seems likely to cause us to eat more regardless of what we’re eating—and taking the time to savor our food and enjoy the process of eating is likely to cause us to eat less, again independently of what we’re eating.

Not an environment that encourages savoring food.

It's called 'fast food' for excellent reasons.



It is also most likely the case that eating while distracted—watching TV, working, driving—attenuates the sensory experience of eating, and thereby the satiation response. (Hat tip to alert commenter JKC.) There is much more to investigate here.

Stomach Distention: Necessary But Not Sufficient

Finally we turn to stomach distention: the sensation of being “full”.

I’ve saved the best part for last…so keep reading!

A lot of noise has been made about how “energy density” is the key to dieting—usually by low-fat apostles who never fail to recite the fact that protein and carbohydrate have roughly four calories per gram, whereas fat has about nine. The same theory lies behind the Volumetrics Diet, which pushes high-bulk, low-fat foods as the key to weight loss—and it drives our medical establishment to perform tens of thousands of lap-band surgeries and gastric bypasses every year.

Unfortunately, feeling “full” is not the entire story, as we can demonstrate by one simple fact: if it were, all anyone would need to lose weight is a giant jar of sugar-free Metamucil. Now that we’ve solved the obesity problem, we can all go home, right?

Well, no. As I explained back in Part II, you can fake satiation, but you can’t fake satiety. Eating extremely energy-dense foods can indeed cause us to overeat…but if we’re not getting the energy and nutrients we need, consuming more water and eating more indigestible fiber does not magically make us feel satiated or sated.

In support of this, note the long-term results from stomach stapling (VBG, or “vertical banded gastroplasty”) and lap-band surgery:

J Gastrointest Surg. 2000 Nov-Dec;4(6):598-605.
Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity.
Balsiger BM, Poggio JL, Mai J, Kelly KA, Sarr MG.

“Weight (mean +/- standard error of the mean) preoperatively was 138 +/- 3 kg and decreased to 108 +/- 2 kg 10 or more years postoperatively. Body mass index decreased from 49 +/-1 to 39 +/- 1. Only 14 (20%) of 70 patients lost and maintained the loss of at least half of their excess body weight with the VBG anatomy. Vomiting one or more times per week continues to occur in 21% and heartburn in 16%.

Note that the long-term results of lap-band surgery (“gastric banding”) are very similar: “no significant difference in weight loss was registered between the 2 study groups” (Miller et.al.)

While the average patient maintained a 30 kg weight loss, this didn’t get them even halfway to normal weight: only one in five patients managed to maintain this milestone.

Energy Density: It’s Not The Fat, It’s The Water

Clearly low energy density isn’t a panacea—but it does make some difference to satiation. Let’s take a look at the data!

Besides protein, fat, and carbohydrate, foods typically contain “fiber” (indigestible carbohydrate) and water. While the anti-meat, anti-fat brigade concentrates on 9 vs. 4 calories per gram, we need to take into account the fact that meat is comprised primarily of water.

I’ll handicap the comparison by choosing an extra-fatty USDA Prime grade of prime rib, which contains 367 calories per 100 grams, or about 3.7 calories per gram. (Link.)

In contrast, rice cakes contain 392 calories per 100 grams, or almost 4 calories per gram. (Link.) That’s right: rice cakes are a denser source of calories than prime rib!

That’s because rice cakes, like all shelf-stable foods, have most of the water removed in order to preserve them and retard bacterial growth. As a rule, anything you’ll find in a box on the shelf will be dehydrated—and, in consequence, extremely calorie-dense.

Dehydration and Preservation

We’re all familiar with the phenomenon of stored food getting wet and rotting, or going moldy. Since life requires water, one of the best ways to keep food from spoiling is to remove all the water, and seal it to stop water from getting in—thus preventing bacteria from growing on or in it.

For instance, pemmican is just meat with all the water removed: the fat is separated from the meat and boiled to remove the water, while the meat is air or oven-dried and ground into bits.

Here are some “calories per 100 grams” readings for common “healthy” packaged foods—

—all of which are more calorically dense than prime rib!

In contrast, here are some statistics for whole paleo foods commonly derided as “rich”, “heavy”, and “fattening”:

Furthermore, as long as we’re talking about water, we must take into account the water we consume along with the food we eat. Some studies claim that oatmeal is the most satiating food in the world—but if you don’t allow people to drink, a food made with mostly water will be more ‘filling’ than a drier food, even if the real-world result would be equal bulk due to the drier food making you more thirsty.

A Speculative Hypothesis About Water Intake

Since we require water in order to process salt, it might very well be that a low-salt diet causes decreased water consumption and a parallel decrease in satiation during real-world meal consumption. A similar situation might also occur with bland vs. spicy food: increased water intake with spicy food might result in greater satiation.

If anyone knows any research that addresses this issue, please let me know. Most studies don’t allow or record ad lib water consumption, and therefore aren’t much help.

(It is also the case that it takes more time to chew and eat a less calorically dense food than a more calorically dense food…so density most likely affects eating rate as well as gastric distention. And how much do you have to chew a steak, versus breakfast cereal?)

Finally, we address the standard bulking agent: “fiber”. Most of the controlled studies on fiber address the “heart-healthy” claims and focus on blood lipoprotein levels, but this review conveniently summarizes the available literature relating to weight loss:

Gastroenterology. 2010 January; 138(1): 65–72.e1-2.
Dietary Fiber Supplements: Effects in Obesity and Metabolic Syndrome and Relationship to Gastrointestinal Functions
Athanasios Papathanasopoulos, M.D. and Michael Camilleri, M.D.

Recent meta-analyses of randomized controlled studies (RCTs) suggest only minor effects on weight loss for commonly used DF supplements.

Conveniently, Table 3 lists the studies and their findings—and a quick reading shows that the studies whose only intervention was additional fiber resulted in zero or insignificant weight loss, whereas the studies that resulted in significant weight loss were compound interventions of which fiber was only one small component.

Conclusion: How We Break Satiation

  • Since satiation is an estimate of future satiety based on sensory input, much of satiation is driven by our body’s nutritional needs, and the factors that affect satiety will also affect satiation.
  • Therefore, we can fail to achieve satiation by eating nutritionally incomplete foods, with no protein (or incomplete protein) and few nutrients.
  • Since satiation is dependent on sensory input, we can fool satiation by decreasing sensory exposure to our food—or otherwise attenuating the sensory experience of eating.
  • We can do this by eating quickly, which we usually accomplish by eating food in liquid or other highly processed (and, therefore, pre-digested) forms. It is also likely that caloric density enables quicker eating to some degree.
  • Cultural factors may also play a role in satiation. A culture that treats eating as an inconvenient obstacle to accomplishment, rather than an experience to be savored, seems likely to decrease our sensory exposure to food by eating quickly (“on the run”) or while distracted, thereby reducing satiation and encouraging overconsumption.
  • Decreased caloric density also increases satiation, to a degree—but it is primarily driven by water content, not by calories per gram of macronutrient. Packaged foods are typically far more calorie-dense than whole, fresh foods due to dehydration.
  • Dietary fiber may increase satiation—but since it has no significant effect on long-term weight loss, it clearly has no effect on satiety.

Continue to Part VI: Hedonic Impact (“Liking”), Incentive Salience (“Wanting”), and “Food Reward”: Why Are We Hungry? Part VI

Live in freedom, live in beauty.

JS


(Part V of a series. Go back to Part I, Part II, Part III, or Part IV.)

Did you find this article surprising or illuminating? Yes, you did, because you didn’t know that prime rib is less calorically dense than rice cakes.

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