TrueNorthHEALTH

Important new information that will help you understand the roadblocks to health and develop a plan for optimal health and happiness!

If you are not already on it, we would like to introduce you to an exciting new diet program called "Fat for Life"!  Would you like to eat whatever you want whenever you want it? Would you like your exercise program to be as easy as pressing the remote control button on your channel-changer? The Fat for Life program allows you to do whatever comes easiest for you. No thought or effort is required! Millions of Americans swear by the Fat for Life program, and now you can too! In fact, it was recently announced that for the first time in history the majority of adults in the United States are obese. This just shows how quickly the Fat for Life program is catching on. "But, aren't there risks associated with being fat?" you ask. Well, while it is true that at least 75-80% of all deaths in the United States are attributable to unhealthful diet and lifestyle choices, government officials, doctors, and even health associations often insist that the standard American diet is "healthy"! So, think positive! You may be among the lucky one-in-five Americans who won't suffer unnecessary illness and premature death. And besides, what is so bad about cancer, heart disease, strokes, diabetes, arthritis, and osteoporosis? Isn't that why you have health insurance?

Admittedly, not everyone is comfortable being fat and sick. But that is no reason to forsake the Fat for Life program. If you don't like carrying the extra weight, you can get your doctor to give you appetite-suppressing drugs, or to staple your stomach.

"But, you ask," doesn’t research indicate that it may be more likely that my doctor can cure cancer than cure obesity?" Well, ask yourself this question: Why do you have to be so negative? Just think positive thoughts. Everything is exactly the way it is supposed to be. Go with the flow.

Diet no laughing matter

By now, you can tell that we have been writing tongue-in-cheek. But doesn't what we have written sound all too familiar? Most people, even most physicians, are really in the dark when it comes to diet and nutrition. Fortunately, there is an easy-to-understand approach to weight loss, and it doesn't involve any pills, powders, potions, or other gimmicks. It does involve learning how to eat and to exercise in ways that are consistent with our natural history. That means eating a diet consisting of whole natural foods. It also means engaging in frequent, moderate exercise.

Does our program work? At the TrueNorth Health Center, we have helped many people lose unneeded and unwanted fat, and keep it off, by following a few sensible guidelines. But before we describe our approach, let's look at why conventional diets don't work. One reason that diets don't work is that they contain foods that were never present in the natural environment! As a result, these foods - such as bread, cheese, crackers, "low-fat" chocolate shakes, margarine, and "light" beer - have the ability to fool the brain's natural appetite mechanisms.  When this happens, people tend to over-consume, and that over-consumption is stored as fat. It is just about as simple as that.

Fooling our nature

Our brains are built to sense the caloric value of foods we eat. When we've eaten enough, our hunger drive is designed to shut down naturally. Notice that you have never "accidentally" eaten 50 apples. Your body "keeps count" and shuts your hunger down at the appropriate time. The brain mechanism that organizes this feat is called the satiety mechanism. It was built into our psychology over countless generations, as part of our natural biological heritage. All creatures need to know both when they are "hungry" and when they are "full," so that they can live most effectively.

The satiety mechanism appears to depend upon two types of receptors in our mouths and stomachs. These are stretch receptors, which give our brain information about how "stretched out" our stomach is, and nutrient receptors, which tell us the caloric density of the food we have eaten. Notice that if you eat four pounds of raw salad, you may feel "full" in terms of being "stretched out," but the nutrient receptors in your stomach also will be saying, "Hey, that was 'OK,' but it wasn't nearly enough! Get me some calories, or I'm going to continue to complain!" You might feel "stretched out" but still hungry. To be satiated, or hunger-satisfied, we have to have our stomach both stretched out and filled with some "real" calories. In the environment of our ancestors, the foods had moderate caloric density; that is, those foods both stretched the stomach and also caused significant nutrient signaling to the brain. People couldn't easily overeat on foods of moderate density because the stretching of their stomachs would hurt. Our ancestors ate everything they could, until they felt full, and then stopped eating! They never worried about overeating and getting fat (which might have been dangerous in a natural setting). They didn't need to be concerned about this because on a natural diet, people rarely get fat.

Processed foods

Modern, processed foods tend to be more calorically dense than natural foods. They can fool our satiety mechanism! When people eat substantial quantities of processed foods, it is quite natural for them to overeat, because the stretch receptors in their stomachs are not getting much chance to signal "enough" - until too much has been eaten.

Let's look at the caloric density of some popular foods. Raw vegetables, such as salads, contain about 100 calories per pound. Cooked vegetables, such as carrots, contain about 200 calories per pound. Fresh fruits contain about 300 calories per pound, and starchy vegetables and grains contain about 500 calories per pound. (See chart on p.12.) But breads, pizza, ice cream, and other processed products are usually between 1000 and 1500 calories per pound!

Easy to overeat

A pound of bread, for example, has about 1200 calories! Because of processing, bread is a more concentrated product than grains or starchy vegetables. Therefore, when eating bread, there will be less stretch receptor activity in the stomach signaling for satiety than when eating grains, given the same caloric intake! Some examples might make this easier to understand. Which is easier to eat: a pint of ice cream, or five pounds of cooked carrots? Which is more likely to make you feel full: a pound of pizza, or eight pounds of cooked broccoli? Four ounces of chocolate, or three large baked potatoes? You can see that overeating is easy to do if concentrated, processed foods are prominent in the diet. Meats are also very concentrated - one of the few naturally concentrated sources of calories. Meat consumption was probably relatively unusual in the natural environment, and it packed a big punch at about 1200 calories per pound.

In today's world, the Fat for Life crowd is eating a diet that predominately consists of processed foods and meat, fish, fowl, eggs, and dairy products. This guarantees that the caloric density of the average American's diet is much, much greater than their appetite machinery is built to handle! Any creature given a diet that is more concentrated than is appropriate for its design will tend to overeat - and get fat. Birds eating processed foods, for example, may fatten to the point that they can no longer fly. Given this perspective, it is hardly a surprise that over 50% of U.S. adults are obese; and another significant percentage are well above their optimum weight.

Remarkable new approach to weight loss

A key strategy in any successful weight loss program is to treat your body in the way it was meant to be utilized. A top priority of this strategy is to eat a diet consisting of whole natural foods - fresh fruits and vegetables, and the variable addition of whole grains, raw nuts and seeds, and legumes. In addition to the many other health benefits, this dietary strategy will provide sufficient stretch receptor activity, resulting in satiety. With this dietary strategy, significant overeating is much less likely to occur. At the Center, for lunch and dinner, we recommend that meals be eaten in a particular order. First, eat a large, raw vegetable salad. Steamed vegetables should be eaten next.

Finally, eat starchy vegetables and whole grains. There is a reason for this recommendation. We have observed that once a person gets a taste of higher-calorie foods (such as cooked grains), lower-calorie foods (such as raw salad) are suddenly less appealing. This can result in less salad and vegetable consumption, which, in turn, can cause an overall increase of the meal's caloric density. By starting with the least caloric foods - when we are the most hungry - more low-density food is consumed. This results in more stretching of the stomach, which helps us to feel full and thus less likely to overeat.

Using this strategy, there is little need to be concerned about portion size. There is truly no need to "go hungry." By consuming the majority of calories from moderately concentrated, unprocessed, whole, natural foods, most of the "fat battle" is easily won. Combined with a moderate exercise program, this strategy really works - just as nature intended. We have found that our overweight patients tend to lose about two pounds per week using this strategy. Most medical researchers would consider our patients' successes to be "miraculous." We don't, but we are very pleased to see our patients consistently rewarded for following this "uncommon sense" approach to weight loss.

We should add a few comments about exercise because some people place so much emphasis on it. We have seen people who exercise almost constantly, but still fail to lose weight. Exercise is a useful and important adjunct to healthful living and to weight control, but exercise alone is not enough. We recommend that our patients engage in moderate exercise 4-5 times per week. Actually, we think it is a good idea to exercise moderately almost every day, if you have the time. By "moderate" exercise, we mean an activity that causes you to have to work at it a bit. If you are an Olympic marathoner, it might mean a five-mile run. For most of our overweight patients, however, it probably means a brisk 20-30 minute walk. If our program seems "too good to be true," we're not surprised. While our diet and exercise strategies are very simple and easy to understand, they are sometimes difficult to implement.

Many factors can get in the way, but the most potent obstacle that you face in conquering the Fat for Life challenge is your built-in "energy conservation programming. "Programmed for convenience foods, all animals, including humans, have energy conservation programming built into their nervous systems. The nature of this programming differs from species to species, but it is always there, nonetheless. Migratory birds, for example, will fly in a characteristic "V" pattern, so that they can use each other's bodies to break the wind - and save calories.  Many fish swim in schools, saving calories riding in each other's wake. And predators, all over the world, are found to pick on the "weak," so that they get the greatest number of calories for the least amount of effort expended.

Humans, too, have this type of programming as part of human nature. We are programmed to want to get as many calories as we can, with the least possible effort! This is great programming for humans living in an environment of scarcity, which is where almost all humans lived until just the last few decades. Now, however, most of us in the modern Western world are no longer living in an environment of scarcity. But our natural programming is still with us - encouraging us to eat as much as we can with as little effort as possible! Is it any wonder that obesity is an epidemic within industrialized societies?  Your "natural" tendencies may be to eat the most concentrated foods available - and to exercise as little as possible. But you needn't be a slave to these tendencies. People are often able to over-ride them with some moderate effort. You can "use your head" to think ahead when it comes to your health and fitness. Plan ahead to have plenty of whole natural foods available at all times so that it is convenient, and schedule time to engage in regular, moderate exercise. No need for miracles you do not need a "miracle" to have a healthy, trim body. But you need to understand and respect how you were naturally designed to live.

You were designed to consume a diet of whole natural foods - and engage in moderate, regular exercise. Your energy conservation programming may make it seem "unnatural" to live this way, but that is only because of the modern environment. Progress has made unhealthful living all too easy. You do not need to follow the herd, which is headed toward fatness and failure. By implementing these simple strategies, you can join the fortunate few who are fit - not fat - for life.     

Important strategies for dealing with modern problems that can trick our natural psychology!

Our moods and emotions are signals to tell us about how our lives are going. When things are going well, we tend to feel good. When something goes poorly, our moods or emotions tend to shift towards an unpleasant internal state. In this way, moods and emotions act as feedback systems to help us act in productive ways—to keep going in the same direction if things are going well, and to change direction if things are going poorly.

When much in our lives is going poorly, it is not uncommon to experience depression. Depression acts as a signal, and as a motivating force, to help us look carefully at what is not going well, and to consider alternative courses of action. In order to deal with depression most effectively, it can be useful to understand how we sometimes come to be depressed, and what actions we can take to restore better mood functioning.

Feelings and feedback

Moods and emotions—our psychological feelings—are feedback systems that can indicate the effectiveness of our actions. They work in a similar fashion to physical pains and pleasures. If we sprain an ankle, for example, we feel physical pain because our behavioral error has resulted in physical damage—and has potentially compromised our survival. The pain of walking on the injured ankle helps discourage us from doing anything that could cause further injury, and thus aids the healing process.

On the more pleasant side, we often feel physical pleasure when we eat calorie-rich foods when we are hungry, or while we stand in front of a warm fire when we are chilled. These and other physical pain/pleasure mechanisms assist us in our survival by encouraging some behaviors, while discouraging others.

Our psychological feelings include moods and emotions. These two experiences have subtle, but important, differences. Moods are the gentle, long-term states that can last for hours at a time. We can say, often with accuracy, that we were "in a good mood all morning" or even "all day long." In such instances, our internal states are quite positive, though with fluctuations, possibly throughout the whole day.

Emotions, on the other hand, are very intense experiences, usually lasting only a few minutes. Emotions, like moods, are signals of a positive or negative relationship between person and environment, but they reflect the person’s perception of something as immediately important. We cannot be intensively emotional for very long, because our neurochemical machinery cannot sustain intense emotional reactions for hours on end, as is possible with mood states. Like an "emergency" signal—for good or for bad—emotions tend to be intense and short-lived. When a football team wins a big game, for example, the players and fans may celebrate intensively for several minutes, but then the celebration tends to run out of steam. The cheering quiets, and the stadium empties. A good mood may come after the celebration, and linger for hours or even days, but the intense positive emotions following victory quickly will fade.

It has long been recognized that physical pains and pleasures are fairly reliable guides with respect to physical dangers (injury and illness) and positive survival values (food, water, and appropriate temperature). Less recognition has been given to the connection between our psychological feelings—our moods and emotions—and their utility at signaling dangers and positive survival values.

Important signals

Throughout much of history, moods and emotions often have been considered independent of reason—of being unpredictable and sometimes nonsensical. Psychologists now understand that this is not the case. Just as physical pains and pleasures are important signals, so, too, are moods and emotions. For example, we may feel anxiety when we are not certain that we can perform a given task.

Anxiety is generally a useful guide—signaling us that our proposed endeavor may require our very best effort to succeed, and, in fact, may require talent beyond our current abilities. Anxiety signals us to consider carefully whether the action is a worthwhile risk. It is unusual to feel anxiety over "nothing." While people sometimes experience anxiety attacks "out of the blue," this is not the most common pattern.

The survival value of anxiety is obvious—if you are contemplating a trek across dangerous terrain, you had better be anxious. You had better consider carefully whether this is an intelligent undertaking. And if it is, your anxiety will help to facilitate careful planning, checking and rechecking of supplies, the rehearsing of potentially needed skills, worrying about things that could go wrong, and so forth.

Depression

In this short article, it is not possible to address psychological functioning per se (that would require an entire book). So let’s focus on one particularly problematic experience—that of depressed moods. The approach I take begins with recognizing that depressed moods may best be thought of as "psychological pain"—and be taken seriously as signals that some life issues may be out of balance.

A sensible approach to pain is to attempt to identify the cause of the pain, remove it if possible, and try to create the conditions most likely to lead to recovery. For example, if a person has pain from a sprained ankle, the prescription of painkillers should not be the first option considered.

While in some circumstances painkillers might be useful, their use carries substantial risks. When pain is masked by painkillers, damaging behavior is more likely to continue. Similarly, while medications for depressed moods may be useful and sometimes necessary, they should not be considered ideal treatment, and they are not risk-free.

Many medical professionals consider depression to be a "disease"—an aberration of normal neurochemical functioning that is best treated with powerful antidepressant drugs. The success of these drugs is sometimes remarkable, and it would be both foolish and irresponsible for a mental health professional to ignore their utility. However, the view that depression is always—or even often—simply a function of aberrant brain chemistry is probably incorrect. In my opinion, aberrant brain chemistry should not be considered the "first hypothesis" by mental health professionals, or by their patients.

Instead, depression should be first considered as a signal—a symptom that a person’s life is out of balance and may need examination, reorganization, and personal growth. Very often, there are legitimate reasons for a person being depressed, and those reasons cannot and should not be ignored or hidden behind the power of antidepressant drugs.

Many mental health professionals disagree with this view. Their argument goes something like this: "It doesn’t matter what causes depression—what matters is that it is unpleasant. Therefore, it doesn’t matter how we get rid of it—what counts is that if we can get rid of it, we should get rid of it!"

They also often downplay the "side effects" (the unwanted effects) of medications (antidepressant drugs). Their argument might continue as, "The pain and suffering of a depressed person is awful, and if there is a quick, effective, and low-risk method for eliminating the suffering, that should be the treatment of choice."

Pills not always best
   
While there is understandable logic in the above view, recent scientific evidence gives us reason to dampen the enthusiasm regarding the use of antidepressant drugs. In addition to the substantial issue of potentially dangerous side effects, there is the issue of long-term effectiveness. When the long-term effects of antidepressant medications are compared with cognitive-behavioral therapy—a treatment style that attempts to address underlying psychological issues—the medications perform relatively poorly.

Both antidepressant medications and cognitive-behavior psychotherapy for depression work effectively in 60-70% of cases, within a few weeks. Medications tend to work a bit more quickly. But after the discontinuation of their medication, about 50% of patients can be expected to relapse into a depressive episode within the following year. This is in stark contrast to patients who receive cognitive-behavior psychotherapy, with periodic maintenance therapy, for depression. Their risk of relapse is perhaps 10-15%.

This remarkable distinction in relapse rates suggests the possibility that patients who receive effective psychotherapy may be getting "to the root" of the causes of their depression, putting them in more control of their psychological lives. The suggestion is that cognitive-behavior therapy results in the self-examination, reorganization, and personal growth needed to meet challenges that previously were overwhelming.

Dealing with depression

Many people experience periods of time during which they have recurrent depressed moods. When depressed moods begin to dominate a person’s day-to-day life for several consecutive weeks or longer, professional assistance may be indicated. Persistent depression can be a sign that 1) the person needs assistance in developing more effective happiness strategies, or 2) a serious biochemical disturbance exists that may benefit from antidepressant medication. It is a myth that mental health professionals can easily tell the difference between these two alternatives. Future research efforts may help us learn to better clarify what the most appropriate treatment alternative should be for a given patient.
    Mental health professionals, such as psychiatrists and psychologists, often have very different views about the most appropriate initial intervention strategy for a given situation. My own bias is to focus on the possibility that persistent depressed moods are at least partly, if not largely, due to the person needing assistance in developing more effective happiness strategies. If these strategies appear to be ineffective, medical management may then be indicated.

Good basic strategies

Many people have found the following three mood-supporting strategies to be helpful. They are not complicated and require no professional assistance.

1. Make a list of pleasant activities and then schedule them into your calendar. Too often, we get caught in the routine of familiar patterns and habits that do not challenge or motivate us. Our negative moods may be a signal that our actions are not being sufficiently directed towards activities that we most value.

2. Take on new challenges that lead to personal growth. Sometimes depression comes about because we are stymied in personal growth. Taking on new challenges can rekindle the excitement of youth—when everything was new, much was exciting, and things were often worth doing to the best of our abilities.

Take steps to eliminate your unhealthful lifestyle habits. Unhealthful lifestyle habits sometimes can contribute to depression. If you are having recurrent depressed moods, one place to start taking control is by addressing the following three basic issues—eating properly, exercising regularly, and getting enough sleep. In some cases, therapeutic fasting may help, since a properly conducted fast provides the opportunity for a period of profound physiological and psychological rest.

When you need help

There are times when these basic strategies are not enough. Sometimes our depressed moods may be signaling the need to examine major life issues carefully, make difficult choices, and find creative ways to expand our self-confidence. Sometimes such processes are done better with the assistance of a skilled professional. The psychotherapy medium that I recommend (and practice) is called cognitive-behavior therapy (or sometimes just "cognitive therapy"). This style of therapy is recommended because it represents the best-researched, most apparently effective style of psychotherapy currently available. While other styles may have merit, none at present can claim the solid foundation of scientifically-demonstrated success of this approach. This is the approach we use at the TrueNorth Health Center.

Clearly, there are times when antidepressant medications are indicated, and the assistance of a psychiatrist can be important (psychiatrists are medical doctors who work with mind-altering medications). I don’t want to give the impression that such interventions should be viewed only as a "last resort." Rather, I am uncomfortable with the view that medications should be "first resort," which too often is the case. If depression persists in the face of cognitive and behavioral therapeutic strategies, it can be comforting to know that medications exist that may make a difference.

Reasons for good cheer

There are many reasons why we no longer need to feel overwhelmed or intimidated by a period of depressed moods. Earlier this century, a depressed patient seen by a Freudian analyst was thought to be, in effect, psychologically healthy! Freud considered misery to be reflective of rationality—that life was inherently miserable and that only those who were somewhat oblivious to the facts of their lives could be reasonably happy. Little wonder that treatment approaches of those times were notoriously unsuccessful!

Today, we no longer view depression as a sign of psychological health or clarity of insight. Depression is perhaps best viewed as a symptom—a signal that there are life challenges that may need to be examined and addressed. Sometimes our thinking can be so unclear as to require the services of a skilled professional—and the results are often very positive. There are excellent books that can help people treat themselves, such as Feeling Good: The New Mood Theory, by the cognitive therapist/psychiatrist Dr. David Burns. And should medical intervention be indicated, we now have access to antidepressant medications that are safer and more effective than ever before.

Depressed moods are no fun. And if they persist, your life can sink into a depressive episode that can last for months, and sometimes longer. The good news is that depressive processes are understood better than ever. If you cannot solve it yourself, get help! Take action. This is one problem that you can definitely learn to live without.