Food Preferences

Most people have strong food preferences which are almost entirely learned. The book First Bite by Bee Wilson offers an excellent review of the study of eating habits and food preferences. Wilson references hundreds of experiments and studies of eating. Her observations and conclusions should be very helpful for those trying to eat a healthier diet or lose weight.

The French designed Sapere Project introduces children to a variety of unfamiliar foods. Pre-school children are divided into small groups and given a variety of foods which they are encouraged to handle, taste and discuss. Each food is offered several times over a period of a few months. Parents report that children request and eat a much wider variety of foods at home; their palates expand without coercion. Finnish educators modified this technique to emphasize fruits and vegetables, using it in a large number of kindergartens countrywide. Several years later control groups of children were compared to those who had been exposed to the Sapere technique. The Sapere group had much less overweight and obese children. This technique has been tried in teenagers and residents of retirement homes with similar results, but changes are greater when it is applied to children up to six years old. All groups on whom this has been used enjoyed the process and the results.

In parts of the world where spicy foods are common and preferred, children usually start to try these foods around age five and they don't like them. Since the older people eat and enjoy the spicy foods children keep trying them and eventually prefer them. Everyone who eliminates all added salt for a month comes to prefer less salt on food. Avoiding all sweets for two weeks allows less craving for them. These sorts of trial periods allow children and adults to come to prefer something besides the high sugar, fat and salt of the standard American diet which is captured so well in fast and prepared foods. "Eating is a skill that each of us learns, and we retain the capacity for learning it, no matter how old we are."

Happy childhood memories of unhealthy foods like candy bars, ice cream and extra rich holiday meals are strongly imprinted. We eat these foods to regain that time and place with terrible results for our waistline and health.

Wilson also examines other approaches to health through better eating habits. She concludes that exercise is healthy but not a major source of weight loss unless done to potentially dangerous extremes. Taking small tastes of healthy foods over and over often allows an expansion of good dietary options. Smaller plates and wineglasses cut down on consumption. Soup before or during the meal has the same effect mainly because it's hard to eat soup quickly and slower eating by any technique cuts calorie consumption. Foods grown and/or prepared yourself are more enjoyed and appreciated.

            Understanding Diabetes

Most diabetics don't understand their disease. This is usually because their physicians don't understand diabetes either.

Unfortunately it is not uncommon for diabetics whose blood sugar has been controlled by diet and/or oral drugs to have their blood sugar skyrocket because the pancreas no longer produces enough insulin. This overworked organ has failed and effectively their type 2 diabetes has become type 1 diabetes. Insulin is now necessary to maintain normal blood sugar levels. A tragedy often ensues. The patient assumes that an unhealthy diet is now okay since they can just take more insulin to control blood sugar levels. This is the basic misunderstanding of diabetes.

A good analogy for diabetes is a brush fire.  Brush fires are usually easily handled unless they start in California during the dry season. Diabetics are like dry season California. They have the underlying conditions to allow massive damage mainly because of vascular disease which is always present in diabetics. Macro-vascular disease leads to heart attacks, heart failure, strokes, limb infections and amputations. Microvascular disease leads to dementia, blindness, kidney failure, neuropathy. Diabetics on insulin have hugely increased rates of all these conditions.

The only way to avoid the progression of this vascular disease is through diet. Blood sugar control with insulin helps; it postpones the dreadful vascular complications for a while. But only diet prevents them. A good diet is like a long, drenching rainfall for California fires; it is the only way to prevent and treat diabetic complications. As prior blogs have explained, this means little or no animal products including dairy, vegetable oils, refined sugars and refined grains, salt. Good diet also requires plenty of vegetables, fruits, legumes, nuts, seeds, herbs and spices to provide nutrients necessary for health of blood vessels and all organ systems.

                     Eating Awareness Training

The first book I recall reading about diet is Eating Awareness Training written in 1985 by Molly Groger. It's subtitle is "The Natural Way to Permanent Weight Loss." Groger observed that her friends of optimal weight took food in more deliberately and often left food on their plates rather than finishing portions. She changed to this eating style, lost weight, and maintained good body weight with this approach. Her technique was to pay attention to the eating process, chew food thoroughly, and not eat while watching TV or reading. When she realized she was full she stopped eating.

Mindfulness techniques adapted from Buddhist meditation practices have been applied to eating, effectively the same approach Groger advocated.

German researchers recently designed an experiment in which obese people had their mouths wired so that they could not eat quickly or put a large amount in their mouths. There were no restrictions on types of food or quantity. All subjects lost significant weight, often in the hundreds of pounds, and many maintained much of the weight loss after the mouth wiring was removed. They had learned to eat more deliberately and consume less food.

My observations of overweight people support this approach. Many eat large quantities quickly and robotically not allowing time to recognize satiety (or often even enjoy their meal.) For those trying to lose weight this is a logical, painless way to cut back on calories without formal dieting.

                                      XULA

Xavier University of Louisiana is a small(2300 undergrads), traditionally black school in New Orleans started in 1925 by Katharine Drexel. Drexel, now honored as a saint by the Catholic church, was a Philadelphia heiress who became a nun and devoted her life and fortune to helping native and black Americans. 

We discovered Xavier through an article in the New York Times which described it as the school that had sent the most African Americans to medical school. Since then I've seen several other college evaluations rating Xavier as exceptional value for education received (tuition is $23,000 a year, less than half of most private schools.) Xavier is 70% African American students and over 70% women. Most students receive full or partial scholarships. A quarter of the students are pre-med and 90+% of those completing the pre-med program are admitted to medical school. Rochester University Medical School has a strong affiliation with 2-6 students a year offered early acceptance, summer school in Rochester and scholarships. A recent affiliation with UCSD sends Xavier students to San Diego to work in the biology department. Alumni are strong contributors, recognizing the valuable education they have received.

We decided to support Xavier because of the urgent need for black physicians. African American communities are poorly served medically and rates of chronic diseases are very high. Urban African Americans have four times the rate of severe kidney disease; twice the diabetes; an 80% greater risk of fatal stroke; and much more cancer. (Fuhrman, Fast Food Genocide, Harper One, 2017.) The major cause of this chronic disease is diet; fast and processed foods filled with sugar, fat, salt and chemicals are the dietary staples of this population.

Deb and I visited Xavier last week where I made a presentation on diet and nutrition to a group of public health and pre-med students. Students, faculty and staff are remarkable, many dedicated, intelligent, hard working people. The campus is filled with small study spaces each with a schedule of tutorial times from early morning until late in the evening. Faculty and upperclassmen help students as needed in every class. Xavier has fostered a strong spirit of cooperation rather than competition among the students. This is an institution where learning is taken seriously; even the dormitories are quiet to allow studying.

                           KAMPO MEDICINE 

Kampo medicine is the Japanese version of Chinese medicine imported to Japan in the 7th century. Medicinal plants and herbs, including mushrooms, have been used to create several hundred standardized formulations approved and paid for by the Japanese national health care system. Manufacturing and purity are monitored as carefully as for standard drugs. Most Japanese and 86% of Japanese physicians use Kampo drugs as part of their practice. In the United States these drugs are  used mainly by alternative medicine practitioners, but there are research projects in the United States (and Japan) assessing the value of different drugs. Palliation of cancer treatment side effects is a popular subject of research with promising results for diarrhea, constipation, nausea and other common drug side effects.

We visited a Kampo medicine store in Kyoto. As with most Japanese stores it was pristine and beautifully designed: a pleasure to make you very comfortable while buying expensive items. We spent almost an hour with one of the clerks, a well spoken, intelligent young woman who had a college degree in an unrelated field that she did not enjoy. But she loved this work. The Kampo drug company that owned the store trained her for several months about the different products which she understood and explained well. Most of her customers come to her because they are unsatisfied with their medical care. She tells them that lifestyle will determine their health; a diet of mainly or exclusively whole plant foods is critical together with exercise and some form of meditation. Her business of selling Kampo drugs is the secondary treatment. She's making some money for her store but providing wonderful medical advice. Wish we could replace some of our pharmacies with this business!

The formulations themselves are logical since we know that most herbs and mushrooms are very nutritious with a wide variety of vitamins, minerals and micronutrients. Recent NutritionFacts videos (link on right side of this page) have analyzed the powerful effects of amla (Indian gooseberry) which has been a mainstay of Ayurvedic medicine for millennia.

                                    JAPAN

Deb and I recently spent 18 days in Japan, visiting different parts of the country. Japan has the greatest longevity of any large country, five years more than the United States. The well accepted reason for this longevity is diet; processed foods and animal products are eaten much less than rice, vegetables and soy products like tofu. The mortality, heart disease and cancer rates of Japanese people who have westernized their diets in Japan, the USA or Europe are similar to those of European heritage who eat standard western diets. Stroke due to high blood pressure is common because of the high salt content of many popular dishes.

The Japanese spend 26% of their income on food compared to 6% in the United States. Cities and towns are filled with specialty shops and restaurants for different foods; some sell only tofu products, others a specific noodle. When we watched the local people eating they usually chose meals including few animal products with fish popular. Shops had a beautiful choice of seasonal produce with many items we had not seen before. The mushroom varieties were particularly interesting and tasty with some popular ones very expensive, more than meat or fish. Unesco has named Japanese cuisine a world cultural heritage, important to be preserved for future generations.

As we traveled through the countryside we were amazed at the number of homes which had well tended vegetable gardens on their small lots. The cities had fast food options but much fewer than in the states. Smaller towns had none; people there eat at home consuming their own produce, other local garden products and lots of rice. Several people we talked to prefer brown rice, but all we ever saw was white, several times bragged about as "new," from the harvest in the last few months. Although white rice has few nutrients it seems to allow a healthy diet when a variety of fruits and vegetables are plentiful with little meat, dairy and moderate fish. City dwellers typically work long hours, have small apartments and eat many meals out, usually choosing a noodle house (ramen (thin, wheat), udon (thick, wheat), soba (buckwheat) or sushi. Noodle dishes usually have a meat broth, but the bulk of calories are from the noodles with the meat (or fish) as flavoring. Most are also filled with a variety of mushrooms and vegetables. Delicious vegan options were offered in every noodle house we tried.

                             Blue Zones

In 2004 Dan Buettner wrote a NATIONAL GEOGRAPHIC cover story about the "Secrets of Long Life" which led to that issue becoming one of their top selling of all time. In 2008 Buettner expanded this theme in a best selling book The Blue Zones which examined lifestyles in four areas of the world (parts of Sardinia, Okinawa, Costa Rica and California) with populations who had many long lived people and high average life expectancy. In each area scholars had confirmed the accuracy of age records and looked at possible factors for the longevity which was not genetic since genetically similar groups of people in other areas did not have such long lives.

Buettner identified commonalities in all these areas:

     A whole food plant based diet which included little dairy, meat or seafood

     An active lifestyle with daily physical activity

     Strong family and community support 

     Minimizining stress

     Having a life purpose and spirituality

Buettner was so impressed with what he discovered writing the article and book that he organized The Blue Zones Project, an attempt to create areas of healthiness and longevity. Individuals, community leaders, churches, businesses, schools, restaurants and grocery stores are recruited to improve the lifestyle of all in the community. Nine areas in the United States with millions of people now participate including Fort Worth, Texas; Southwest Florida; and Hawaii. Areas with the longest history in the program are seeing success in weight loss and other health markers as well as student attendance and academics.

Man is a social animal who responds to family, friends and community. Enlisting community support to improve lifestyle and thereby health, quality of life and longevity is an exciting goal which Buettner and his colleagues seem to accomplishing.