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Control of Eating
It Is estimated that globally 4.7 million people die prematurely as a result of obesity related problems.
A simple measure of obesity is BMI (Body mass index). Which is a measure of weight in relation to height. This has been used as a general indicator of weight-related health risks. However BMI measures can overestimate the number of overweight individuals. For example, muscle mass can increase bodyweight, resulting in athletes or individuals with a high muscle mass percentage being deemed overweight, even if they have a low or healthy level of body fat.
Similarly comparisons between groups can also be misleading. Muscle and bone density tends to decline as we get older. This means that an older individual may have a higher percentage of body fat than a younger person while having the same BMI. Also women tend to have a higher body fat percentage than men for a given BMI.
Given the above qualifications it can be a useful measure when looking at trends globally and between countries. As a general rule it is noticeable that the more affluent countries tend to be the more obese. However within countries there has been a stark change over the years, with poorer households disproportionately having a greater incidence of obesity.
A simpler way of measuring obesity is by using the Waist-to-hip ratio. Dividing the measure of the waist by that of the hips will give an indication of the amount of excess fat within the abdomen.
For men a healthy ration would be considered as 0.9 or less, and in women 0.85 or less.
Physiological control of eating
Physiologically the body responds to a meal in a fairly predictable manner. As carbohydrates are broken down, there is a rise in glucose levels within the blood and Insulin is secreted as a result.
Following the ingestion of a meal the levels of Cholecystokinin CKK rises. CKK is a hormone which is secreted by cells in the duodenum and which stimulates the release of bile into the intestine and enzymes by the pancreas, which continue the process of digesting the meal. CKK delays gastric emptying, that is, partially digested food within the stomach. This plays a role in the sense of satiety, that is of being full. It has been found that Insulin potentates the role of CKK. The role of Insulin is less effective when a high fat diet is consumed.
Glucagon also produces the effect of satiety, along with Calcitonin which regulates Calcium levels in the body. Glucagon is released by the pancreas when the levels of glucose are low, and it stimulates the liver to break down glycogen. The body’s response during exercise is to break down glycogen to support the greater energy requirements of the body, but it does not stimulate hunger.
Somatostatin, found in the digestive tract, inhibits the secretion of both insulin and glucagon, in conjunction with inhibiting the release of growth hormone and thyroid stimulating hormone, resulting in suppressing hunger.
When glucose levels drop along with insulin levels, Neuropeptide gamma is activated which stimulates hunger. It has also been observed that low Serotonin levels have also been associated with carbohydrate cravings.
Body fat (adipose tissue), is now considered an active endocrine organ, responsible for the synthesis and secretion of several hormones. One particular hormone that has been studied is Leptin. When secreted from adipose tissue it inhibits the feeding behaviour of rodents. Curiously obese individuals tend to have more Leptin in their bloodstream than their leaner counterparts. This has led to the idea of Leptin sensitivity. That is, it is no longer effective.
Research is still ongoing as regards the various systems involved in regulating feeding and the balancing of energy requirements. However it appears that the body is more sensitive to the energy needs of the body as regards to feeding, rather than having a tight control over when to stop.
It is also noticeable that we often misinterpret the sensation of dehydration as a sign of hunger, which again seems to indicate that the body is more sensitive towards increasing food intake rather than suppressing.
It would seem that being more mindful regarding food consumed in relation to the body’s needs would help a great deal in controlling food intake.
Generally, particularly when food is plentiful, other factors will also stimulate the desire to eat. We do not just eat to satisfy hunger but are stimulated by the sight and smell of food, and of its pleasurable aspects. We are more drawn to foods which are sweeter and have a higher fat content, with very little fibre or water, foods of higher density (greater in sugar and fats) but lower in nutritional value. Another factor that stimulates overeating is variety. We tend to eat more when there is a greater variety of sensations within the meal.
For many, food choices are also based on cost and/or convenience. Cheaper convenience foods tend to be higher in sugar and fat. This may be the major contributing factor as to why we now see differences in obesity levels between lower and higher economic groups.
How to Decrease Adipose Tissue
Obesity is associated with insulin resistance. Resulting in the cells of the body not being able to take up glucose. This excess glucose then remains in the blood. There is also an increased level of fatty acids as Insulin inhibits lipolysis (fat breakdown). This state leads towards a greater degree of inflammation within the body. It is important for maintaining overall health to decrease the excess fat stored around the abdomen.
- Decrease energy intake, while increase energy output through exercise.
- Eat low glycemic load (GL) carbohydrates, particularly before 3 pm to minimise fat storage potential.
- Breakfast is vital and should include protein and low GL carbohydrates. Protein increases satiety more than carbohydrates. It more strongly increases CCK, helps increase muscle mass, and strongly influences thermogenesis.
- Include protein with every meal/snack.
- Chew food well, while also turning off all stimulators while eating. Be mindful as one eats.
- Enjoy the ritual of food versus food to survive.
- It may be helpful to keep a food diary, as it can help to identify patterns in overeating, for example how one feels after a particular meal. It may also indicate times of day when fatigue sets in, or when what is eaten out of habit rather than need.
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