Does a high-fat meal reduce appetite? Professor Blundell and his colleagues at Leeds university have studied the effects of dietary fat on feeding patterns in humans. They have shown that the most important determinant of the amount of energy consumed in a meal was the macronutrient content of the meal and not the prior level of hunger. For comparison, subjects were required to eat a high-fat dinner one day and then a high-carbohydrate dinner on another day. Surprisingly, the high-energy, high-fat meal did not suppress eating later in the day, nor did it have a significant effect on energy consumed the following day when compared to the lower energy high-carbohydrate meal.

This means that periodic exposure to high-fat meals will lead to over-consumption of energy which is never compensated for later. Fat can also leave a type of ‘fat hangover’ which causes a person to feel full or bloated, but still with an appetite to eat more. It is useful to learn to recognise this ‘hangover’ and to realise that it can be avoided (by reducing the fat content of meals). In a practical sense, it is always easy to slip some more fatty food (e.g. Chocolate dessert) in at the end of a meal, but this is much less likely to happen with carbohydrate.

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Remember, anorexics often don’t think they are sick. Instead, their illness is their identity. Thinness makes them special. They are thus poorly motivated to accept treatment. Patients often agree to gain weight just so they can get out of the hospital. Once out, they may starve themselves all over again.

Also, although thinness makes them proud, many anorexics feel that at their core they are rotten, unlovable people. Therapy might mean exposing the horrible “truth” of their rottenness to an unsympathetic stranger. Given this fear, who wouldn’t resist treatment?

Bulimics are often more receptive. As Lisa’s story indicates, a bulimic’s loss of control often impels her to seek help. Many welcome the chance to learn how to restore control over themselves and their eating.

Resistance springs not just from poor mental attitudes but from the physical consequences of the disorder as well. In anorexia, for example, the starvation itself may cause disturbed thinking. And some bulimics are so uncomfortable with any amount of food in their stomachs that even a small meal triggers the urge to vomit. Therapy that requires her to eat can cause physical as well as emotional discomfort. It takes time to get used to eating correctly again.

You need to work through the problem of resistance with your daughter. You both need a lot of support to reduce your fears- fears that are very real for both of you.

*52/35/5*

Kathleen, her husband, Tom, and their son, T. J., journey to Florida twice a year to spend time at their second home in Sarasota. In the past, Kathleen barely moved on the 9/i-hour flight from Germany to Florida, and she consumed anything that the airline attendants offered her, because there was nothing else to do.

To make matters worse, Kathleen’s activity level didn’t improve much when she touched down. “I didn’t do any formal exercise in Germany, but I was up and down the four floors of my house dozens of times a day, and I always biked to the food shops,” she says. “In Florida, I sat in a ranch house and drove everywhere.”

Kathleen suspects that all the inactivity pushed her weight upward. “Of course, when I was back home in Germany, all that high- fat German food didn’t help much—nor did the German beer,” she says. By January 1998, she reached her top weight of 184 pounds. “I had kind of been accepting my weight gain, but what that scale said was really a shock,” Kathleen recalls.

Trying to slim down in a country that’s known for its sausages and potatoes was, to say the least, a challenge. But Kathleen worked on reducing her fat intake and eating more whole grains, fruits, and vegetables. For exercise, she joined a fitness club where one of the personal trainers on staff customized a workout regimen for her that included toning and cardiovascular routines. She also attended aerobics classes. By the time she arrived in the United States that summer, she was down 22 pounds.

She didn’t want to lose ground by being idle in Sarasota. “Instead of sitting around all day, my husband and I walked every morning for an hour, then used free weights and did situps for another half-hour,” she says. “The activity curbed my desire to eat.”

On the flight back to Germany, instead of just sitting, Kathleen got up and exercised six times. She went into the galley and did deep knee bends and ran in place. She also walked laps around the big 747. She repeated the routine about every hour. “I didn’t gain a pound that trip,” she says. “And what a great way to beat the boredom!”

Now 40 pounds lighter, Kathleen takes her walking shorts with her wherever she goes, even if it’s a weekend trip to London to visit relatives. And she always stands up and moves around the plane. It not only prevents boredom and improves her circulation, it stops her from eating.

WINNING ACTION

Traveling? Take your workout with you. I’ve learned that exercise doesn’t have to take a vacation. Pack a pair of comfortable walking shoes and take a brisk walk every day. I’ve found that going for an early-morning walk in a new city is the best way to really get to know it and feel like you’re actually there, even if you’re on a business trip. On long flights, walk around the plane cabin and stretch.

*106\89\8*

When designing your eating program, think about how the ancient Egyptians designed the pyramid. The bulk of the pyramid’s bricks were laid at the bottom, with each subsequent layer having fewer and fewer bricks. The same should be true of your eating plan: Most of your food should come from whole-grain breads, cereals, and pastas, which are the rock-solid basis of a good nutritional program. To this, add lesser amounts (but still plenty) of vegetables and fruits. Working your way up the pyramid, add still smaller amounts of nonfat dairy products and

protein foods like meat, fish, poultry, peas, beans, and lentils. Finally, top it off with minimal amounts of fats, oils, and sweets (if desired). Obviously, in practice, this pyramid would often become inverted because we like fats and sweets so much. But you can generally keep to the pattern you seek by the ingestion of Chitosan, shrinking the bulge at the top of the pyramid that would otherwise occur.

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Anorexia—Anorexics impose on themselves a severe, unhealthy restriction of eating; are consumed with thoughts of food; impose and adhere to rigorous exercise regimens; don’t believe they are thin even though they may have lost more than one-fifth of their body weight; seek to control their emotions through self-starvation.

Bulimia—The bulimic eats voraciously (binges) then purges (vomits, starves, or takes laxatives, and/or engages in extreme amounts of exercise) as a means of weight control; has an insatiable desire to eat and finally gives in to it, allowing the appetite unrestrained expression. Then, fear of weight gain causes the victim to purge. This binging-and-purging cycle can occupy most of the victim’s time, occurring as many as 10-20 times a day.

Oral Expulsion Syndrome—Victims of this syndrome chew food but spit it out rather than swallow it. Some may spend hours chewing in secret, and can develop intense anxiety about swallowing. They may become seriously malnourished, isolated, and fearful.

*59\29\2*

There are many tests in a standard blood panel, but two of the most important as far as heart health are concerned are the levels of LDL cholesterol and triglycerides, or blood fats. Elevated levels of LDL cholesterol and triglycerides have both been strongly linked to an increased risk of heart disease. Our livers continuously try to eliminate excess LDL from our bodies by dumping it into our intestines. However, often our livers are not fully successful at eliminating LDL. At other times, a portion of the LDL is reabsorbed through our intestines because we have insufficient fiber to carry it away. Thus, excess LDL, and its concomitants, atherosclerosis and heart disease, are problems faced by millions of people as they age.

To combat excess LDL, doctors prescribe cholestyramine, Mevacor, Zocar or various similar medications. These classes of drugs are effective in reducing LDL, but can cause significant damage to the body. People who take these drugs must be carefully monitored by their physicians.

To a large extent, Chitosan solves the problem of excess LDL because it acts in two ways. First, as stated, it bonds with the fat, thus blocking it from even being absorbed by the body before reaching the liver. At the same time, it acts as a regular dietary fiber and helps carry out any fat that was dumped by the liver into the intestines, avoiding reabsorption. Remarkably, researchers have found in studies comparing Chitosan to cholestyramine that Chitosan is as effective in lowering LDL but, of course, have no known side effects.

The net result of all this is that Chitosan can help reduce the risk of heart disease by lowering the bad cholesterol in our bloodstreams. This was evident as early as 1991, when Norwegian researchers noted that taking Chitosan led to a significant reduction in cholesterol and blood fats.⁸ The study put Chitosan’s cholesterol-lowering prowess to the test in 8 healthy men ranging in age from 20 to 23 who were given

♦ Biscuits (without Chitosan) for the first 6 days of the study,

♦ 3 grams of Chitosan baked into biscuits, every day for the next 7 days,

♦ 6 grams of Chitosan, via similar biscuits, every day for the ensuing 7 days,

♦ Biscuits without Chitosan for the last 7 days of the study

*42\29\2*

1. The incidence of cancer of the colon and rectum was low

in Japan.

2. The traditional Japanese diet is low in fat (only about 10 percent of its calories come

from fat).

3. The children of Japanese who immigrated to this country adopted our high-fat

American diet.

1. They also suffered from a tremendous increase in the incidence of colon and rectum
   

cancer.

You can see the evolution of disease risk by tracing its rise as people move and change diets. For example, Japanese women living in Japan have one-fifth the incidence of breast cancer that American women do. When Japanese women move to the United States their incidence of breast cancer remains low. But it begins to rise for their daughters, who often adopt a mixed traditional Japanese-modern American diet. The incidence of the disease rises even more for their granddaughters, who are often completely Americanized and eating our unhealthful fare
with gusto.

Similar studies have been performed on other populations. The results are the same: When you move to this country and adopt our high-fat diet, you also tend to adopt our diseases. As an internist and cardiologist with over 40 years of experience, I have had the opportunity to treat a great number of immigrant families from Japan, China, Mexico, and other countries. I noticed that the elderly immigrants who continued to eat their traditional, low-fat diet were often much healthier than their native-born children and grandchildren, who relished the standard high-fat diet we eat in this country.

I remember one patient, a pleasant Japanese-American man. By age 48 he had had three heart attacks and was unable to work. His brother had died of a heart attack at age 45, and a sister had had a serious heart attack when she was 50. But the problem was not genetic. There was no history of heart disease in their family and their parents, both in their late 70s, were in excellent health. The difference between the parents and their children and grandchildren was mostly in their respective diets. The elderly parents continued to eat the traditional low-fat, high-complex carbohydrate Japanese diet. The children and grandchildren were living off—and dying

from—the fat of the land.

The damage done by the standard fat-laden American diet can be horrifying. Forty to 50 percent of its calories come from fats. When you consume that much fat, large amounts of bile acids are secreted into your intestines to help emulsify, or break down, the fat particles. These bile acids and their breakdown products are excellent activators. The more fat you eat, the more activators you release into your system.

As both a cancer initiator and activator, fat is one of the reasons why we who live in the United States and other affluent nations suffer from the cancers of affluence. These are cancer of the breast, ovaries, and uterus in women; cancer of the pancreas and prostate in men; and cancer of the colon and rectum in both sexes. The National Cancer Institute believes that approximately 60 percent of cancer deaths in women and some 40 percent of cancer deaths in men can be attributed directly or indirectly to the standard, high-fat American diet.

*24\29\2*

Another theory proposes that certain hormones are responsible for telling the brain when you’ve had enough to eat. The interaction of food and the stomach prompts the release of a hormone or group of hormones that travel to the brain and turn off the appetite. A gastrointestinal hormone called CCK (cholecystokinin) may be one of these “I’m full” hormones. Indeed, animals injected with CCK stop eating.