Monday, April 13, 2015

Eating Disorders. What are they? What is the treatment? What about food? By Pat Pappal

We need nourishment to maintain our bodily functions, to grow and survive.
We eat out of necessity and for enjoyment. Social occasions, holidays, special events
focus on food. What happens when eating becomes disordered and are eating disorders 
really just about the food?

This post will focus on the 3 most common forms of eating disorders, the first being Anorexia
Nervosa. Those afflicted with Anorexia Nervosa have an intense fear of weight gain and often have a false perception of their size, body shape and weight. People will often resort to extreme
measures to control their weight, including food restriction, excessive exercise,and the misuse of diet aids and laxatives.

According to The National Institute of Mental Health (NIMH):, medical complications of AN may include:
Thinning of bones such as osteopenia and osteoporosis
Brittle hair and nails
Severe constipation
Low blood pressure
Heart damage
Drop in internal temperature, cold intolerance 
Extreme fatigue
Cessation of menstrual cycle

Bulimia Nervosa, people may eat an large quantity of food then vomit ( purge ) the food afterwards. There is usually a feeling of disgust after this act. The use of laxatives and diuretics 
may also be involved. This cycle may happen several times a day and is often done in secret. 
People with BN may be of normal weight but may still have intense concerns about gaining weight.

Symptoms associated with BN according to The NIMH include:
Chronic sore throat
Swollen salivary glands in the neck
Decaying teeth and worn tooth enamel
Gastric Reflux
Changes in electrolyte balance particularly potassium, sodium and calcium which can affect the regularity of the heart

Binge Eating Disorder consists of an individual eating more food in a 2 hour period of time than what would be considered usual. This occurs once a week for at least 3 months. As in BN, there is usually a feeling of disgust and a loss of control. People who binge may do so due to stress, anxiety or loneliness.

Prolonged Binge Eating may lead to:
Obesity and resulting complications of such as joint pain, immobility, sleep apnea
Type 2 Diabetes
Cardiovascular disease
Emotional distress, unhappiness with ones appearance, social isolation

In many cases there may be determining factors of who develops an eating disorder. As noted by The American Psychological Association,, specific psychological factors and personality traits such as perfectionism may predispose a person towards an eating disorder. Situations experienced in life may also predispose a person towards an eating disorder. 
And in many cases there is no known cause.

There are many avenues of treatment for eating disorders, a multidisciplinary approach is beneficial between primary care providers, specialists in the field of eating disorders,obesity specialists,dietitians, psychologists, and licensed mental health providers.
It’s very important to seek treatment early. As noted by The American Psychological Association,, the longer abnormal eating patterns continue, the harder they are to treat and become more implanted in a persons life. Outpatient, inpatient, partial programs may be ongoing for years before recovery is attained. As noted by the Academy of Eating Disorders, Anorexia Nervosa has a mortality rate of 6 to 12 times higher in women comparable to the general population. Early intervention and recognition is key and essential.

Eating Disorders are not just about food. They are a complex medical and psychological condition that is medically treatable. Food may be used to feel in control of other symptoms as noted by

While nutritional stability is a goal of those treated eating disorders, the recognition that people do not choose to eat in a disordered manner is essential. The treatment of eating disorders is not just about food but achieving a healthy relationship in the social aspect of eating and the recognition that recovery is possible.

The National institute of Mental Health; Eating Disorders: More Than Food. Retrieved April 1, 2015, from 

American Psychological Association; Eating Disorders. Retrieved April1, 2015, from

Academy of Eating Disorders ( 2012) Eating Disorders; Critical Points for Early Recognition and Medical Risk Management in the Care of Individuals with Eating Disorders

Women’; Body Image About Eating Disorders. Retrieved April 1, 2015.

Wednesday, April 1, 2015

Saturated Fat: Do you want a BUTTER brain, or a BETTER brain?

To sat fat, or not to sat fat - that has been a recent question.  Perhaps we should rephrase the question:  do you want a BUTTER brain, or a BETTER brain?

I have been frustrated and concerned that recently some fad diet writers have been pushing (and selling) the idea that saturated fat is some kind of a health food, or health miracle.  Saturated fat is the fat found in butter, full-fat cheese, fatty red meat, fried food.  I suppose some people will say anything in order to sell a book or product (and yes I'm looking at you, Nina Teicholz, and you, the guy who has been telling people to put butter in their coffee!)   We've long known that excess saturated fat raises inflammation in the body, worsens insulin resistance (a precursor to diabetes), and can even create inflammation in the brain which can interfere with 'fullness signals' - AND raise bad cholesterol levels, to boot.  Now new research shows that excess saturated fat is associated with a higher risk of Alzheimer's disease - AND we can lower our risk of Alzheimer's by adopting a diet LOW in butter, beef, fried food, and sugary-fatty desserts, and  HIGHER in healthy foods such as leafy greens, berries, some beans, nuts, fish, olive oil, poultry, whole grains, and even a little red wine!  (That sounds pretty good to me!)   The research was published online on March 19, in the journal Alzheimer's & Dementia:  The Journal of the Alzheimer's Association.

The healthy diet is called the MIND diet, and is a blend of the Mediterranean diet and the DASH diet.   Here is an excellent article on the new research:  How much of a difference did the diet make?  Those who adhered rigorously to the diet lowered their risk of Alzheimer's by as much as 53% - and good news for those of us who are less than perfect - those who adhered 'moderately well' still lowered their risk of Alzheimer's by 35%.   Pretty impressive.

Exactly what is in this super-healthy MIND diet?   Daily salads with abundant leafy greens, moderate amounts of nuts almost every day, olive oil as the primary fat source, berries at least twice a week, beans and whole grains daily, fish at least once a week, poultry at least twice a week, and a little red wine (I suspect you could substitute grapes or raisins).  What is NOT in this diet?  You guessed it - the healthy eaters severely cut back on butter (less than 1 tbs per day), beef, full fat cheese, fried and fast food, and pastries/sweets.

Put these on your shopping list:

Brain-healthy foods:
  • Green leafy vegetables
  • Other vegetables
  • Nuts
  • Berries
  • Beans
  • Whole grains
  • Fish
  • Poultry
  • Olive oil
  • Wine 
Keep these off the shopping list:
The five unhealthy groups are:  

  • Red meats
  • Butter and stick margarine
  • Cheese
  • Pastries and sweets
  • Fried or fast food"
 Read more here:

And if that's not enough to convince you, check out more research on saturated fat:
PLoS One. 2014; 9(12): e115642.

Published online 2014 Dec 26. doi:  10.1371/journal.pone.0115642

"Overnutrition-induced metabolic dysfunction is a severe health concern in both industrialized and developing countries. Sustained exposure to excess dietary fatty acids (FA) causes lipid accumulation in non-adipose tissues with limited storage capacity. This lipotoxicity causes cellular stresses and inflammation that lead to cell damage [1], and in peripheral tissues contributes to insulin resistance and metabolic syndrome [2], [3]. The hypothalamus is similarly vulnerable to lipotoxicity. The hypothalamus senses availability of nutrients, including fat, to control food intake and regulate energy balance [4], [5]. However, elevated saturated FA is sufficient to induce lipotoxic stress in the hypothalamus and attenuate responses to insulin and leptin negative feedback, con
tributing to dietary-induced obesity (DIO) and attendant metabolic dysfunction [6][8]."

"An acute increase in plasma fatty acids by lipid infusion causes insulin resistance in animals (43) as well as in healthy and diabetic humans (4447), potentially by altering insulin signaling downstream of PI3K (2843). Recently, we extended these findings to include fatty acid inhibition of insulin signaling in hypothalamic circuits that control energy homeostasis (10)….Many recent reports have linked insulin resistance with other disorders of the CNS, including Alzheimer disease and mild cognitive impairment …"

Or you can forget science, and listen to gobbledegook spouted by someone trying to make a buck - or a million - off us:

Pass me the olive oil.  I'll take a pass on the disgusting butter coffee.