Snapshot of the brain

Technology. Isn’t it amazing? Well, actually – it’s only as amazing as the person using it. And for someone like me – who may be an early adopter of such things, but can’t read instructions or follow intuitive prompts – that limits the capability of the machinery. However, we all have the equipment that is the most sophisticated piece of machinery there is. Ourselves. The human body – how amazing is it? This is not a post that is an ode to our awesomeness in general (and, let’s face it – you are awesome) – it’s more a miniscule look at the requirements of our brain to maintain the level of amazing our body needs at the any one time in order to operate effectively. (Of course, the ability of the brain to do this varies on a day to day level…as anyone who has misplaced something, misspoke, or misstepped can attest – i.e. everyone).

That takes quite a bit of energy and it’s no wonder then, that humans have evolved to have an extraordinarily large brain in relation to the body – the adult brain takes approximately 20% of resting energy expenditure (or basal metabolic rate), and around 10% of total energy expenditure. Not bad for an organ that only accounts for 2% of overall body mass. An infant requires even more, with 50-70% of their BMR being used to support their brain function, and up to 9 years of age, their brain requires around 50% more energy than that of an adult brain. Blame the increased number and activity of synapses (the bridge between neurons in the brain, delivering messages) in their grey matter. Makes sense given the developmental phases that occur during childhood. Back to the size of our brain, though – this sets us apart from other mammals. As children, our body is actually really slow to develop compared to other infant mammals – it can take up to 15 years for human offspring (love that term? Me too lol) to reach puberty, something that is achieved in mere months in other mammals. The high energy requirements of our brains play some part in that. When measured against our predicted brain mass  we (humans) punch above our weight. The encephalisation quotient (actual versus predicted brain mass) is off the chart at 6.5 – compare that to a cat (around 1). Hmm. Enough said. No wonder there are those amongst us who boast that we are the most intelligent species. I’ll leave that up for you to decide.

Given the myriad of functions required by the brain to maintain our most superior standing in the Animal Kingdom (that always makes me think of Rudyard Kipling), fuelling the brain is essential. The brain can effectively run off three different fuel systems. Predominantly – and in most people today – glucose is the preferred fuel source, and can use up to 120g of glucose a day. As you know, this will come from dietary carbohydrate (CHO). However, in times of CHO restriction/depletion – we can provide glucose from stored CHO (glycogen), our protein stores (gluconeogenesis – breakdown of protein), and from glycerol (the CHO backbone of triacylglycerol – a fatty acid). In fact, our evolutionary response to CHO restricted environment is to shut down the delivery system of CHO to other areas in the body and deliver it to the brain (i.e. insulin resistance). This isn’t to say that the brain can’t run on other fuel sources – indeed, if that were the case then we probably wouldn’t have survived the last gazillion years (or insert actual years here) if that was the case. The body is smarter than that – in fact the only part of our body whereby glucose is essential is the red blood cells. However, if you have a diet that is predominantly made up of carbohydrate – and therefore glucose is the preferred fuel source – the likelihood of glucose depletion and a subsequent energy crash, lack of concentration and overall brain fog is far greater.

The next main fuel source is from fat – ketone bodies derived either through the diet or through the breakdown of fatty acids in the body. This only really occurs in times of CHO restriction/depletion – this happened at a much more frequent rate throughout evolutionary times when food was scarce, which clearly isn’t the case in today’s modern world. An individual is able to tap into ketone bodies for the brain if they’ve gone through an extended period of carbohydrate restriction and a higher fat diet. The brain can then begin to utilise fat as a fuel source. Those who follow a ketogenic diet (whereby fat makes up 80% of overall caloric intake, with adequate protein and minimal (~5-10% calories) carbohydrate can shift the fuel preference from glucose to ketones. Lastly, the brain can also use lactate as a fuel source, and this is called upon during times of intense exercise when glucose is depleted – see this post by James Murphy for a detailed look on the use of lactate for the brain.

So the calorie requirements of the brain can be easily met in today’s environment of an abundance of food – however the metabolic consequence of the different fuel sources available can wreak havoc on the brain’s ability to function – both in the short and the long term. As I’ve often discussed – the metabolic breakdown of carbohydrate into glucose to use as a fuel is damaging – and the brain isn’t spared from this. An excessive amount of glucose in the brain can have a neurotoxic effect – increasing the oxidative stress, inflammation, and causing damage at the cellular level. There is robust evidence clearly showing the link between a high sugar diet and cognitive decline in adults, and cognitive impairment in both adults and children. More important than ‘where did I put my keys?’, it is also associated with serious neurological disorders such as dementia and Alzheimer’s, and stroke and epilepsy. Ketone bodies, on the other hand, are a clean burning fuel – causes less oxidative stress, less inflammation and better neuronal recovery can take place in an environment where ketones are used to fuel the brain. Indeed a ketogenic diet is used as a therapeutic tool for people with epilepsy, Alzheimer’s and to slow the growth of brain tumours.

Does that mean that you need to go on a ketogenic style diet to help protect the brain from oxidative stress caused by glucose metabolism? No. Certainly a reduction in glucose load by reducing overall carbohydrate (i.e. processed, refined foods) is the starting point. However, like all metabolic processes in the body, it takes more than just calories to enable the brain to function optimally – and I’ll talk more about that next week. Until then, look after the most sophisticated piece of equipment you have. And keep being awesome.

Cancer: you suck. (A random collection of thoughts based on recent events).

Cancer. The scariest thing about it to me is just how random it seems to be. Yes, there is definitely a genetic component – for some types of cancers more than others – but equally sometimes it just hits. Out of all of my family, we would likely all agree that I’m the one that has lived as close to the ‘healthy’ lifestyle out of everyone. There was once a time where five of the seven of us smoked. Dad and I excluded (I took it up when I was 11y old, then had to quit a week later as Kylie Wirepa, the friend that had also decided to start smoking with me, said she had a heart murmur. Thank god!) While my family have begun to be more interested in their diet over the last 10 years or so (for various health/weight reasons) and intermittently jump on the exercise bandwagon, consistently only Dad and I would be the ones that – all things equal – would be the least likely to be diagnosed. All things being equal. But that’s not how it works. A close friend of mine has just found out that her sister has aggressive breast cancer that has spread to her lymph nodes. She described her as the ‘healthiest’ out of all of them* – the ‘alternative’ soy-drinking, non-smoking, moderate drinking, exercising sister when compared to the rest of her family.

Cancer is the uncontrolled growth of abnormal cells in the body. Instead of growing old, dying, and being replaced by new cells, cancer cells are cells that become damaged replicate, and then the mutation is replicated yet the cell doesn’t die – they continue to accumulate and form a tumour. When we studied the pathophysiology of disease in nutrition I remember Murray Skeaff teaching us that those predisposed to cancer can stay cancer free their entire life – there can be a long a latent period, if you like. However if they are exposed to risk factors, then this can start the process of cancer developing. Lifestyle can play a large part in determining risk of developing chronic conditions, as you know. Looking at the epidemiological evidence, a high intake of fruit and vegetables, maintaining a healthy weight, regularly exercising, a low alcohol intake, oral contraceptive pill use and hormone replacement therapy are all linked to an individual’s risk of breast cancer. This doesn’t determine cause and effect, but gives an idea of the types of lifestyle factors associated with the risk of developing it.

We discussed the fact that her sister avoided dairy and drank soy milk in the interests of health. Interestingly, there is a lot of controversy around the consumption of soy and breast cancer risk. Soy and soy products contain isoflavones a particular class of phytoestrogen that interacts with endogenous estrogen signaling pathways. Isoflavones can either block our endogenous oestrogen from being taken up in the body, or can increase the oestrogen receptor activity. This impacts our risk as increased exposure to oestrogen can drive hormone-related cancer. Asian populations have long consumed soy in its unprocessed or fermented form, in foods such as tofu or tempeh, whereas Westerners more commonly eat it either as dietary supplement or as a source of an industrial seed oil and protein substitutes. Nowadays, proteins or oil of soy origin also appear in numerous food products – such as infant soy-based formula, bakery items, (biscuits, doughnuts and cakes), fast foods (hamburgers, chicken nuggets, takeaway hot chips and pizza dough), cereal bars, protein bars and salad dressings. However the isoflavone content of these processed foods is far less than the traditional Asian diet – the typical Western diet consuming less than 1g/day, compared to intakes of up to 30g/day in Korea or Japan.

For women who are of Asian ethnicity, who have consumed whole soy products (such as soy beans) and fermented soy products (Natto and tempeh two such examples) their entire lives, in small doses, have a reduced risk of developing risk cancer. The relationship with European women is not the same. It is thought the processed nature of soy products, that they aren’t in their whole form, and they are consumed in the context of the Westernised lifestyle, changes the relationship. Indeed Asian migrant women have a higher risk of developing breast cancer when moving from Asia to the US. Women in Asian eat less processed food and have less of a caloric dietary load overall – these two factors undoubtedly contribute. Statisticians can adjust away a lot of factors to find significant relationships within epidemiological evidence – but many argue that, in real life, you can’t account for the differences in lifestyles that contribute to higher or lower risk regardless of the p value.

As we sat around on Friday night it’s fair to say that the rest of us were reeling a bit from the news too. Obviously it’s not the first time any of us have had someone close to them be diagnosed with cancer, but its sobering that, where once it seemed to affect those in the older age group more than anyone else, increasing numbers of younger, fitter, healthier people are being diagnosed with cancer – of all types. Yes, mortality rates are decreasing – increased awareness, earlier diagnosis and better treatment will all contribute to this. But more and more people are living with chronic illness and reduced quality of life – affecting them and those around them. Anyway, in my normal Women’s Weekly approach to this blog, this isn’t to educate you on the metabolic pathways and how these interact with diet and lifestyle to impact on your risk of cancer. Indeed I didn’t even mention sugar – I could write a book on that (likely don’t need to, I’m sure it’s been written). It’s more a reflection based on recent events. That’s fairly obvious actually, if you just look at the title of this. I couldn’t put a title on this that gave you an idea of the content – this is just a collection of thoughts based on recent events.  One thing that my friend did say was that her sister is someone who tends to stress more than most people. This has a massive bearing on our overall health and wellbeing and may, down the line, be found to be THE most important contributor to ill health. Diet, lifestyle, physical activity and sleep patterns all contribute to this. As we start to reflect more on how we live our lives and the concessions we make to keep up with what modern life demands of us, I think more people may look to take a step back and try to do things differently.

 

*– though she is no slouch when it comes to the health front, especially over the last couple of years as she’s switched from a higher sugar diet that included processed food to a paleo-approach to diet.

The bigger picture…

You’ll be familiar with the term ‘you can’t see the wood for the trees?’ When someone is so fixed on their point of view that they fail to take a step back and see that, actually, they are missing the bigger picture. I notice this when chatting diet with a friendly acquaintance who is staunchly vegetarian. Not infrequently, she argues that paleo is a fad and that the healthiest diet to eat is vegetarian. It strikes a nerve with me on three levels* – one; the notion that eating with ancestral principles as a guideline could be considered a fad; two: that I, as a health professional, would willingly promote a fad diet that is detrimental to health; and three: that there is a massive leap between a vegetarian diet and the paleo approach in the first instance. Either she was getting her information from an unreliable source (probable) or she fails to see that, stepping out of the vegetarian bubble, the similarities between vegetarian and paleo are greater than their respective differences.

The same can also be said for the Grant versus the rest of NZ academics nutrition debate (lol). While publicly Grant might be known as the guy that eats sausages or scoffs down pats of butter (though hopefully most of New Zealand has moved on from that), ultimately the main crux of his argument is to eat real food. For some, also, this entails lowering their carbohydrate content (regardless of source) to improve their health. Funny – when you see it written down like that, it’s hardly inflammatory and I would be surprised if anyone who knows anything about health would argue with it. However, when asked to respond to questions about our comments regarding the most recent dietary guidelines draft, the overall ‘real food’ message seemed not to be considered. The guidelines went through a consultation process whereby limited stakeholders were able to feedback on them. Grant managed to gate crash that party and AUT was put on the list of stakeholders. We (with George Henderson and Cliff Harvey, aka Nutrition Extraordinaires) spent a considerable amount of time responding to the guidelines which were, in essence, no different from those that were already in existence. I did wonder how much money had been spent on the draft guidelines which seemed to be word-smithing their predecessors. Whether they take on board our feedback (which can be found here) remains to be seen, however when you read over the response I’m sure you’ll agree that there is nothing in there that a health professional or member of the public interested in eating well could argue with.

Interestingly, the feedback WE received asked us to defend our position on saturated fat. This may not be surprising, but certainly it is another example of not seeing the wood for the trees. Saturated fat isn’t a ‘food’, yet these are food guidelines. Food sources of saturated fat bring with them many beneficial constituents that are important for brain, gut and overall health. Dairy is a great example of this, and is the richest dietary source of saturated fat. We dutifully put forth information as they asked (MOH Sat Fat response 30 5 141) and hopefully this will be considered along with our other, real food guidelines. Personally I think it would be more flummoxing if they ignore it completely, rather than consider what we have to say. It’s about health, after all. I don’t believe that anyone sitting around the table truly could look at our proposed guidelines versus the ones that were asked to be consulted on, and say that ours would promote harm. I truly don’t. However, I think the thing that will stop them from taking on board our suggestions will be the translation of these to the public health message. That’s the key. How do we then take real food guidelines and start promoting them at a population level in a way that people understand? And I’m not saying people are idiots- most people are not; it’s the translation of messages that is the complex issue. If you tell people they can eat fat, then for some that equates to a Carl’s Jnr burger big size combo – because we ALL know that’s a high fat food, right? Seldom is the processed carbohydrate or the refined oils nature of that particular food item highlighted as the main problem.

I know I’ve banged on about this before, but it’s worth repeating, and considering it in context with overall lifestyle, as it’s not just about food. Ancestral principles of diet doesn’t eat the same foods as our ancestors. Much like our lifestyle. We can’t live the way our ancestors did millions of years ago, and most sensible people wouldn’t want to – yet there are guiding principles which most of us could consider as part of our overall health and wellbeing. Yet many people aren’t familiar with what this means. If this is you, then I’d recommend checking out the up and coming Ancestral Health Society of New Zealand symposium taking place on Sunday 29 June in Christchurch at Rydges, Latimer Square.

Aptly entitled ‘Ancient Genes versus a Modern World’, I’m lucky enough to be part of the line-up of health professionals from varying backgrounds giving their professional and personal perspectives on how modern life affects health. Despite our different backgrounds, we all share an underlying belief that – in terms of health anyway – there are things that we could be doing differently.

Speakers and Topics

“Are Health Professionals Too Focused on Health?”
Brad Norris, Director, Synergy Health. Christchurch

“Food for Thought: Nutrition and Brain Health”
Dr Mikki Williden, PhD.  Senior Lecturer and Researcher, AUT. Auckland

“Ancestral Health in General Practice: Art, Science or Quackery?”
Dr Pam Olver and Dr Greg Brown, General Practitioners. Wellington

“The Ancestral Woman in a Modern World: Strong, Sexy and Fertile.”
Kate Callaghan, Nutritionist. Wanaka

“I See Weak People: The Under-Appreciated Role of Muscle in Health and Disease”
Jamie Scott, Health Researcher, Synergy Health. Christchurch

“Sunlight: Friend or Foe? Skin Cancer Controversies”
Dr Anastasia Boulais, Medical Practitioner. Christchurch

“Stress in the Modern World”
Aaron Callaghan, Peak Performance Coach. Wanaka

“Urban Design and Health: The Spaces in Between”
James Murphy, Nutritionist, Synergy Health. Christchurch

“Ancestral Principles in Managing Autoimmune Disease”
Julianne Taylor, Nutritionist. Auckland

EXPERT PANEL: Anti-Fragile in Christchurch: Individual Health Strategies in a Changing City

Go here for more information and to register. If you think it’s time we started thinking differently about the way we eat, move, think and live – then make this your first port of call.

*four, actually – as there is SO much research showing the nutrient quality of a paleo-approach to diet

The power of consistency (…keep being awesome)

The best piece of advice I received when I was completing my doctorate was from friend and colleague Erica. Like many people, I was working full time and studying at the same time. While allowances within my job were made for me to carry out the research, there were times when the demands of the teaching superseded any ideas of blocking out time for the PhD. Erica advised me to spend an hour each day working on my it, non-negotiatable. Obviously there were days and weeks that would be devoted to focus solely on the thesis, but even on the days where I couldn’t imagine there would be time to complete anything useful, I spent an hour on it. Though I am a person who works much better to a (looming) deadline, following that piece of advice was the best thing I could have done. On the days that I thought I was just opening up my computer, flicking through some statistical analysis information and perhaps running two or three statistical tests, I took comfort in the fact that spending the hour in that time meant it was one less hour I had to spend at the end of the road. However short or unproductive it could have felt, it was more productive that not doing it. This consistent practice got me to the end of the PhD journey in relatively one piece.

The power of consistency. Winter is a good time to reflect on the ability of this to keep you on track with your health-related goals. Remember how awesome you were? Getting outdoors for a run, making salad as a staple for dinner, and incorporating seasonal summer fruit into your diet becomes second nature when the weather is warm. Come June and the start of winter, it is this time of year where the snooze button on the alarm is utilised more, the running shoes are left in the cupboard and the gym carpark starts to thin out. Motivation tends to diminish along with the sunlight hours and even the most dedicated among us start to waver in the face of the cooler temperatures and shorter days. The number of missed training sessions can start to accumulate without realising it and suddenly, instead of hitting the gym 5 days a week, the number of sessions barely add up to 5 in a fortnight. More often than not, when exercise goes out the window, our motivation to eat well also tends to slide. Again – part of this is habit. When we are in the routine of going for a run or swim, we tend to also have to be a bit more organised around our meals. Yes, exercising does make us busier but, equally, when in a routine, it’s often easier to have a set plan in place when it comes to deciding what to eat. Many people get home from work, pack their bag for the next day (if training away from home) and then prepare breakfast and lunch. It’s routine. If the gym falls by the wayside, then there is no need to pack a bag, therefore things tend to get more relaxed around organising meals. In addition, our priorities around food tend to change. If you’re an athlete and are training for an event, the focus is on fuelling properly for the training sessions. In the off-season, there is less perceived need to be concerned about diet, and poorer choices around food tend to creep in, particularly if diet has only really been used as a tool in training and not in ‘life’.

If your mood, sleep, health and overall well being weren’t affected by these blips in training and eating habits, then it wouldn’t matter. You’d make it through winter and dust off the running shoes to go for a jog come September, no worse off than you were in May. However more often than not these are what are affected the most. Perhaps (like me) you notice a slight shift in the aforementioned due to winter anyway (heard of Seasonal Affective Disorder?) This is only exacerbated when the very habits that help support emotional and physical well being fall by the wayside. In addition, often in this instance people start to fall further down the rabbit-hole rather than lift themselves out of it – a cycle of events perpetuated because we feel bad. We can turn to food in an effort to feel better, knowing full well that it will only make us feel worse.

So let’s not even go there. Let’s stop this cascade of events from ever eventuating. Even if you’ve been hitting snooze on your alarm clock or have grabbed a dirty muffin from the café near your work a few more times than usual over the last couple of weeks, all is not lost. At all. You are still awesome. Here are my top tips to pick yourself up, dust yourself off and charge into the cooler months knowing you’ve got it covered.

  1. Re-evaluate your goals around healthy living – this will help you reprioritise where necessary. Setting short goals (month by month) makes them far more salient. Even day by day goals (exercise, prepare lunch, feel awesome) can help refocus when you find yourself going astray.
  2. Stop hitting snooze. Well that’s a no brainer, isn’t it? Getting out for your morning training session isn’t going to kill you. Put the alarm clock at the other end of the room so you have no choice but to get up to switch it off.
  3. No-one regretted a session they ever completed, but plenty of people regret the one they missed. Of course, if you do miss one – don’t dwell on it. Make sure you don’t do the same the next day. If you’re someone who usually gets up and goes in the morning but would rather not go out in the dark, perhaps shift the time that you exercise to lunchtime. Or, if you have the flexibility in your job, go to work earlier to clear emails (and miss the traffic), then go out when it’s beginning to get light. You can do a lot in ¾ of an hour and would be back at your desk ready to go by 8.30am. There are options. Use them.
  4. Look at your exercise routine. If you’re in the habit of getting up and going for an hour run every single day, then perhaps it’s time to rejig that so you start doing training to mix it up and keep it fresh. Shorter, sharper sessions not only take up less time, they are far more effective for cardiovascular and muscular health, but also can provide a big boost of endorphins in far less time. Too many people I talk to think that if they don’t have an hour to train, then it’s just not worth it. The smarter people I know spend 25 minutes and are those that are physically in the best shape. Yes, this isn’t going to suit you if you are training for a marathon – those long runs have to happen. But not every day and in fact, you’d probably benefit more from the aforementioned sessions.
  5. Get to bed earlier. It’s too easy to feel warm and cosy rugged up by the fire or on the couch, and how often is the TV left on later than necessary because we feel too comfortable to move and get to bed. If this is you, make a deal with yourself to use the time between the last couple of ad breaks in the programme you DO want to watch to organise yourself. Brush your teeth, sort your work gear, and clear the dishwasher – whatever. Do what you need to do so once the show is over you are done.
  6. On #5: set an alarm. We set one for the morning – so why not set one at night. It takes discipline to go to bed at a reasonable hour, and an alarm will signify that it’s time to turn in for the evening.
  7. People always equate ‘comfort’ foods as being stodgy puddings, potatoes and chocolate. Sure they might make you feel awesome when you (over)eat them at the time, but there’s seldom anything awesome about how you feel the next morning. Stay consistent in your healthy eating habits by keeping them fresh. Investigate new winter dishes that will provide the same level of comfort and warmth in winter but without the associated carb-coma that inevitably follows. Soups, slow cooker meals, cauliflower-based dishes (aka the AMAZINGLY versatile vegetable), butternut, swede or pumpkin based dishes can all take the place of stodgier items that can weigh you down at dinner time. I’ve plenty of ideas in the recipe section or (more up to date) my facebook page.
  8. Keep eating salad but make it a winter one. Who said salad always had to be lettuce, cucumber, tomato and a $4.99 avocado, thanks very much. Mix it up with a different one every week (coleslaw, roast vegetable, silver beet as a base), throw some seeds, a different home-made dressing etc.
  9. Investigate taking a vitamin D supplement. We need vitamin D to synthesis hormones in the body responsible for thyroid and overall energy (among other things). Many people in New Zealand are vitamin D deficient as the sun doesn’t hit the earth in the right position to deliver the UVA rays we need to synthesis it. Doctors often find it unnecessary to test for vitamin D levels (expensive compared to other tests) so if you’re someone who wants it checked, then ask them for it. They may well suggest just taking a vit D3 supplement.
  10. Have you heard of the 100 Happy Days project? Or of a gratitude journal? What about the 30 days of dancing challenge? These are just some of the wellbeing projects you can put some energy into which, when you carry them out, will make you feel better. I’ve completed the 100 Happy Days challenge, posting a photo every day of something (anything!) that made me feel happy that day. Most of the time, it was relatively easy. But some days it wasn’t and I really struggled (I’m a largely positive person too!) However I liked the focus on being happy – so much so that now I’m on a 100 foam roller day challenge (strange, no-one has joined me…) and the 30 dancing days challenge. These require no additional explanation – the name says it all. If you start any of these (or your own challenge) now, winter will fly by.
  11. Get out into the sunlight during the day. Nothing is as refreshing as time outside where you can get rejuvenated by the elements, be it rain, wind or sun.
  12. Hug someone. There’s nothing nicer.

Note: these aren’t all food and exercise related – in fact, if we support our emotional well being, it can drive the maintenance of physical health behaviours. And vice versa. The key is to do them today. Then wash, rinse and repeat tomorrow. And the next day. Consistency is arguably the key to good health, as long as those habits serve the purpose. Keep on being awesome.

 

Pre-eating? On that…

Pipped at the post. I was all set to pontificate (and had written ~ 600 pearls of wisdom about) why people eat when they aren’t hungry. Then I notice the email notification for Sarah Wilson’s blog, and I click on it to reveal…. Pre-eating. Great minds…

There are many other reasons though for people to eat when they’re not hungry, but pre-eating –eating in anticipation of being hungry, or – in the case of the athlete – eating in anticipation of needing fuel for a workout – is a biggie for some people. Just a few days ago in the clinic an athlete told me their afternoon snack wasn’t because they were hungry, it was in case they ran out of fuel for their workout in the afternoon. I asked  what the worst thing that could happen was. Of course the automatic reply was that they couldn’t finish the workout. I then asked if they’d ever tried it to see if that was indeed the case. They hadn’t.

So many people pre-eat for because they fear being hungry. I get this a LOT. When I recommend that someone forgo the snacks during the day, sometimes it really is  fear in their eyes when they ask me ‘what if I get hungry?’ What if? While hunger has been the cause of death for millions of people worldwide, it hasn’t actually killed anyone I’ve ever sat down with. Or anyone they’ve ever sat down with. But the idea of being hungry can create this ingrained panic in some people that, if they don’t eat – even if they’re not particularly hungry – they will not be able to resist temptation that comes their way in the form of the jar of lollies on their colleague’s desk, or the biscuit tin in the staffroom. As Sarah pointed out, a lot of people are uncomfortable with the sensation of being hungry –and don’t trust themselves to hold back once they do get to eat.

The other obvious reasons people eat are out of boredom, habit, guilt, stress or because it’s scheduled. All of these deserve a blog post in themselves. A lovely friend I studied with was the classic scheduled eater. I remember quite clearly being in our office, both of us working away on our theses (this was before the internet was anything more than email and I was one of the first people I knew to have a cellphone; there was no Twitter or Facebook to distract us. Thus, I do believe we were in fact working). She started being a bit random in what she was saying (which wasn’t unusual, she was the most intelligent girl I knew, yet could be quite fluffy too…) however when I asked her about it she declared she could barely focus on the screen in front of her because her blood sugar levels had plummeted and she needed to eat. I suggested that we go for lunch, but she was adamant she couldn’t eat until 1pm, yet it had barely turned 12pm. This self-imposed scheduling of meals is not about the fear of being hungry, but more about exerting a level of control. For some, these food rules that govern our intake is a comfortable place to reside in, and if you have the willpower to adhere to them, then that’s the internal battle won.

Another example I came across where the wheels fall of was in the comments section at the bottom of Sarah’s blog: Kat has commented that she delays her breakfast until 8.30 (for as long as possible) yet this leads her to snack constantly throughout the morning. Again, this conscious (or otherwise) rule to not eat until later – trying to delay food intake and (in essence) reduce food intake has  unintended consequences. I see this a bit in my clinic also – people are scared that if they begin to eat earlier in the day, then the overall volume of food will increase because they will be hungrier earlier. Of course, right? Increased food, increased weight. Not necessarily. And, in this case, I believe the opposite is true. The reasons I thought Kat wasn’t able to regulate her appetite was that she either isn’t eating enough at breakfast (which is possible, as she mentions her weight has stalled and she’s not able to shift weight) or she’s not eating enough protein and/or fat to help stabilise both her stress hormones and her blood sugar to enable her to coast through the morning snack free. Those two food-related reasons could lead to higher than normal stress hormones as she isn’t responding to her body’s hunger cues. The body will store more fat in this environment, making it difficult to shift weight. The stress hormones will also cause the liver to dump additional glucose in the bloodstream which leads to fluctuations in energy and mood and (at worst) the dreaded ‘hangry’. Of course, if Kat is constantly grazing, she might never feel that way and could be overeating to compensate for the changing energy levels.

If Kat ate breakfast earlier, and ate MORE for breakfast, I believe she will feel far better. In addition, if this did lead to an increased food intake, the body’s stress hormones will be far more stable, and the way the body responds to calories is largely dependent on the environment within the body. The increased stress response created by delaying the meal could mean that Kat is far more likely to store those calories for later use. By tuning into her hunger signals and regulating her stress response, Kat might find that she is able to eat more food (and thus, more dietary energy) and burn it more effectively.

I actually think that whether Kat is eating too much (or too little) is almost a moot point. If Kat is hungry, she should eat. If she isn’t hungry, then she should wait to eat. As Kat was reading Sarah’s blog, then at least we know she is eating the right type of food to help maximise her nutrient intake and thus her health goals. When she told me what she was eating (quinoa porridge with chia seeds and almond milk), I suggested she go ½ and ½ with almond milk and coconut milk – and (obviously) eat when she was hungry. That’s what I love about open forums. It’s a great place to offer unsolicited advice. 😉

What, why, how, when and where we eat garners so much attention and so many emotions. Sarah’s blog was really just to highlight a fraction of the discussion (as this is), to get people thinking about why they eat and whether or not they needed to snack. It didn’t say to NEVER snack, it was about tuning into your hunger cues and recognising when you are hungry. For a lot of my clients, it’s a habit rather than a physiological drive. That’s why for many people I discourage snacking. However it’s really individual and there is no one size fits all approach. Do you snack? Do you need it? Do you even know? Try going without a snack at a time you would normally eat. What’s the worse that could happen? You get hungry. Well it’s unlikely to kill you.