Published On:Wednesday, February 10, 2010

AS CHRISSY LOVE said recently on the ZNS call-in show Immediate Response, "Chile I been on more diet than Oprah."

Her point was that diets don't work -- at least not in the long-term. As we all know, it's hard to stick to any diet, and sooner or later we give up and rejoin the world of uncontrolled eating, usually gaining back the few pounds we lost plus a little more.

Most of us simply shrug our shoulders and move on. But a groundbreaking new book by the former head of the US Food and Drug Administration reveals that food is now a top public health issue, and he tries to explain how we can scientifically address our compulsive urge to overeat.

The unfortunate fact is, says Dr David Kessler in The End of Overeating, that we have all become addicts -- hooked by overstimulated brain chemicals on huge portions of food layered and loaded with sugar, fat and salt, which offers little or no nutritional value.

Kessler, a Harvard-educated paediatrician, argues that until we fundamentally alter our eating behaviour, we will continue to waste money on ineffective weight-loss schemes while running the risk of all those deadly medical conditions that are caused by obesity -- including diabetes, heart disease, stroke, liver disease, arthritis and some cancers.

Naturally, his book focuses on Americans and the American food industry in particular. But Bahamians are in the same overloaded boat, as Health Minister Dr Hubert Minnis has frequently pointed out. And since most of our prepared foods and chain restaurants are American, Kessler's facts about overeating are just as applicable here.

Kessler is perhaps best known for his efforts to investigate and regulate the tobacco industry, and his accusation that cigarette makers intentionally manipulated nicotine content to make their products more addictive. His new book compares the food industry to big tobacco, and shows how our responses to food need to change.

"The attitudes that created the social acceptability of smoking shifted, and many of us began to see smoking as deviant, even repulsive behaviour. A consensus emerged that the cigarette, and the industry that manufactured it, was abhorrent. We moved from glorification to demonisation."

So we need to change our thinking about big food in the same way. As Kessler says, "Its ubiquitous presence, large portion sizes, incessant marketing, and the cultural assumption that its acceptable to eat anywhere at any time (are you listening civil servants?) puts us at risk...And people need to hear repeatedly, from many sources, that selling, serving, and eating food layered and loaded with sugar, fat and salt has negative, unhealthy consequences."

The book begins with the observation that for thousands of years human body weight stayed remarkably stable, so that people who were overweight stood apart from the general population. A perfect biological system seemed to be at work, until something happened in the 1980s.

When researchers surveyed government health and nutrition data collected from 1988 to 1991 it became apparent that fully one-third of the entire American adult population was overweight -- an abrupt increase. The landmark study showing that the rate of obesity in America had exploded was published in the July 1994 issue of the Journal of the American Medical Association.

Kessler's book is the result of the years of thinking and study he went through to try to make sense of those results. As he points out, food had become more readily available in the 1970s and 80s, along with larger portion sizes, more chain restaurants, more neighbourhood food outlets, and a culture that promoted more out-of-home eating. But there had to be something more driving us to overeat.

His conclusion -- in a nutshell - is that sugar, fat and salt cause us to eat more sugar fat and salt. It's all about "palatability", a term scientists use to refer to food that has the capacity to stimulate the appetite and drive us to eat more. "It's the stimulation, rather than general hunger," he says, "that makes us put food into our mouths long after our caloric needs are satisfied."

Decades of research into human taste, food preferences and dietary choices, have confirmed that what stimulates us most is a combination of sugar and fat. Mix the same amount of sugar into low fat and high fat products and people always choose the higher-fat mixtures -- something that restaurants like the Cheesecake Factory were quick to figure out.

Kessler cites one experiment with two strains of rats. One was bred to overfeed when a high-calorie diet was available, producing an obesity-prone rat. The other strain did not ordinarily overfeed -- an obesity-resistant rat.

After a period of eating extra calories, the obesity-resistant group cut back their food intake much faster. But when both groups were offered highly palatable foods rich in sugar and fat, all the animals ate without restraint.

Another experiment let one group of animals eat freely while restricting the diet of another group.

Both groups then headed towards a chocolate-flavoured cereal high in sugar and fat at almost the same speed. The absence of hunger made no difference to the appeal of the reward.

But it is Kessler's insights into the food industry that are the most interesting part of the book. He reports inside information from a variety of food consultants who confirmed that the industry creates dishes specifically to hit the three points of the compass -- sugar, fat and salt.

"Chicken tenders," he writes, "are so loaded with batter and fat that my source jokes that they're a UFO -- an unidentified fried object. Salt and sugar are loaded into the fat. The White Chocolate Mocha Frappuccino served at Starbucks is coffee diluted with a mix of sugar, fat and salt. Blooming Onions -- the trademark Outback Steakhouse dish -- provide plenty of surface area to absorb fat. Fried in batter and topped with sauce their flavour comes from salt on sugar on fat."

Eating high-sugar, high-fat foods produces opioids in our brains that help calm us down and make us feel better -- at least in the short term. That's why infants cry less when given sugar water and animals feel less pain when administered opioid-like drugs. "Eating highly palatable food activates the opioid circuits...The more rewarding the food, the greater the attention we direct toward it and the more vigorously we pursue it."

In addition to that, the conditions under which we encounter foods switch on powerful brain chemicals that compel us to eat. We learn to want a food or some other substance we once liked. Putting all this together gives the following picture, he says: "A cue triggers a dopamine-fueled urge...dopamine leads us to food...eating food leads to opioid release...and the production of both dopamine and opioids stimulates further eating...The more rewarding the food, the stronger the learning experience that creates the automatic behaviour."

And the goal of food design is to make products as rewarding as possible. For example, Kessler describes the boneless chicken wings at Chili's Restaurant. The meat is injected with a solution of water, soy protein, salt and sodium phosphate. At the manufacturing plant the chicken is battered, breaded, and pre-dusted to create a salty coating that becomes crispy when fried in fat at the restaurant.

The coating is some 40 per cent fat and represents up to half of the volume of nuggets that end up on your plate. Added to this is a sweet and salty sauce and a mayonnaise-based dressing -- it's hyper-palatable food that requires little chewing and goes down easily. The fact is that chemical-based processing has created a sort of adult baby food.

According to US government figures we are eating more of everything these days. Per capita consumption of fats and oils jumped 63 per cent over the past 30-odd years. Use of sugars and sweeteners was up 19 per cent. We ate 43 per cent more grain and 7 per cent more meat, eggs, and nuts over the same period. We are also eating 24 per cent more vegetables -- but most of those are deep-fried potatoes, otherwise known as french fries.

Then there are the portion sizes. Food designers say that if you make plates bigger and fill them more, everyone makes more money.

Supersize options and all-you-can-eat specials give consumer access to a bottomless well of food for a fractional increase in cost. It's cheap and its always available.

"Based on these findings," Kessler says, "an argument can be made that conditioned overeating is a syndrome, or a condition characterised by a cluster of symptoms...These patterns almost certainly contribute significantly to the exploding obesity epidemic...A conducive environment is necessary to trigger hypereating. That's exactly what we have today."

The bad news is that there's no quick fix -- it's simply impossible to avoid the temptation of highly palatable foods all the time in today's world. The good news is that we can begin to train ourselves to alter the reactions that are generated by stimulation.

And awareness of the problem is the first step along this road, Kessler says.

"Once I thought a big plate of food was what I wanted and needed to feel better. Now I see that plate for what it is -- layers of fat on sugar on fat that will never provide lasting satisfaction and only keep me coming back for more. I have changed the reward value of the stimulus."

Over to you Chrissy.

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