Barriers to Healthy Eating

Transcription

“Obesity has been described as a mismatch between human physiology and the
environment in which we live.”1
Food Availability
Taste and Price
There were up to 530 more calories
available for each Canadian to consume in
2002 than there were in 1985.2 This increase
in available calories is directly correlated with
the rising obesity rate, making increased
energy intake the most likely reason that
people have gained weight.2
Taste is the most important factor influencing
food choice, followed by food cost.3-10
Studies show that price modifications are
more effective than educational health
messages to motivate people to purchase
healthier foods.7,11
Is “pizza cheaper than salad”12 in your workplace?
Project Health – Rethinking Healthy Eating: Examining the Evidence
37
How the Environment Impacts Individual Choice
Portion Sizes
Portion size appears to be a major factor for
how much food people consume; as the
amount of food served suggests that it is an
appropriate amount to eat.10,12-15 In fact, the
‘French paradox’ appears to be nothing
more than smaller portion sizes.16
Meals eaten away from home typically
encourage people to eat too many calories
because of high calorie density and large
portion sizes.4,7,17-20 One study showed that
when eating out, people purchased meals
that contained an average of 827 calories
per meal.17
In addition, on days that people eat fast
food, they consume about 205 more calories
than they do on days they do not eat fast
food.21
People often underestimate the calories in
food, especially for unhealthy items.21 In one
study, participants underestimated the
caloric content of meals by more than 600
calories.22
Trends in larger portion sizes make it difficult
for individuals to resist eating foods that are
high in calories, fat, sugar and salt especially
when not at home.
Over the past few decades the largest increases in portion sizes have occurred in fast
foods such as hamburgers (18% larger), cheeseburgers (24% larger), french fries (57%
larger), and sweetened beverages (62% larger).23
38
Educating people about the effects of portion
size seems to have little to no effect on their
food consumption.24 In an experiment, a
group of university graduate students were
educated on the effects of portion sizes on
food consumption. Six weeks later these
students were invited to a party where they
knew they would be part of a study. The
students were divided into two groups, with
each group receiving different sized bowls.
The students were allowed to consume as
many snacks as they wanted. The group
with the larger bowls served themselves
55% more food compared to the group with
smaller bowls. When the students were
informed of this effect, the typical response
was “maybe that happens to other people,
but not to me”.25
Food For Thought: PORTION SIZE
People who are served larger portion sizes consume more food but do not report
greater feelings of fullness. This is true even when it involves food that tastes bad. In
one study, people were given stale 14-day old popcorn in boxes twice the normal size.
Even though they complained about the taste, the participants who were given the
larger boxes of stale popcorn ate 34% more popcorn than participants given stale
popcorn in normal sized boxes.13
The bottom line: Larger portion sizes cause people to eat more
39
Television, Media and Advertising
The nutrient content of the majority of
advertised foods goes against nutrition
education and guidelines and may
encourage the development of chronic
disease.26 The pattern of nutrition imbalance
found in advertised food mimics the pattern
of imbalance in the common North American
diet, leading researchers to believe that
television commercials have a direct impact
on what consumers eat. Approximately 85%
of foods advertised in Canada are for foods
designated as “Foods to Limit” by Canada’s
Food Guide.27
Among children, there is an association
between watching commercial television and
obesity. However, when children watched
other forms of media that did not contain
food commercials, there was no association
with obesity. These results suggest that it is
the commercials themselves that stimulate
unhealthy food consumption and weight
gain.28
Social modelling theory predicts that we will
mimic the behaviours of other people. This
effect was shown when people watched soft
drinks commercials and then subsequently
drank more pop.29 Similar effects have also
been shown after people are shown fast
food commercials.30
Advertised foods do not have to be present
in order to have an effect. Adults shown food
commercials ate more food overall even
though the food they ate was not presented
in any advertisements they watched.31
Women who habitually diet and monitor their
weight and men in general may be
especially prone to increased eating when
exposed to advertising food cues.31 Food
commercials may act as a stimulus that can
trigger a desire to eat, even when the viewer
is not hungry.31
Other forms of advertising such as brand
logos may also act as food cues, which can
also subsequently affect food consumption
patterns.31
40
Convenience
“Effort is not required to continue eating when food is present; effort is required to
refrain from eating when food is present.”12
Many studies have examined the
relationship between the food environment
and weight. A high ratio of fast food
restaurants and convenience stores in a
neighbourhood is associated with increased
weight.32-35
The availability of poor nutritional choices
has a profound impact on what people eat.36
For example, many stores sell unhealthy
‘snack’ foods placed near the cash register.36
The mere presence of convenient ready-toeat foods increases the likelihood that
people will consume them, leading to higher
overall energy intakes.36
Therefore, the impact of vending machines,
food in common areas and foods placed at
influential locations such as near cash
registers in cafeteria lines should be
carefully considered.
Food For Thought: THE LAW OF LEAST EFFORT
In one study, secretaries who had chocolates placed on their desk ate twice as many as
secretaries that had chocolates placed only six feet away.37
The bottom line: As effort goes up, food consumption goes down.
41
Time Pressures
Forty-one per cent of Canadians say that
their life is so hectic that they find it hard to
include healthier foods in their diets.38 The
feeling that there is not enough time in the
day to do everything has been implicated in
the decline of family meals and the
increased consumption of convenience and
fast foods.39,40 When asked, people admitted
making ‘quick’ foods because they did not
have the time or energy to cook, despite
knowing that it was not ‘good’ for them.39
Common barriers to making family meals
include: being a single parent, working an
inflexible job, and working a schedule that
interferes with family time such as evening
and night shifts.39
People are more likely to cook meals at
home if they have cooking skills and flexible
or reduced work schedules (i.e., they can be
home in the afternoon).39,40
42
Point-of-Purchase Nutrition Information
Most individuals underestimate the calorie
content of food. Providing nutrition labels
gives consumers an opportunity to improve
nutritional intakes.3,17,41-43
However, nutrition information has to be
readily available at the point-of-purchase, as
only 0.1% of people look for nutrition
information before making their purchase.
Websites, pamphlets, and tray liners are not
an effective format to promote behaviour
change.20
In order to prevent indulgence at a later point
in the day, it is also important that nutrition
information be provided along with an
average estimate of how many calories
people need for the day.44,45 For example,
“this menu item has 500 calories; the
average person needs 2000 calories a day.”
Consumers welcome information in the form
of nutrition labels and logos.46 However,
providing nutrition information is not always
an effective way to improve dietary
intakes.4,14,47-49
Most Canadians report being interested in
nutrition, however, 61% think that there are
so many different things to consider when
buying foods, (e.g., fat, trans fat, sugar,
calories, fibre, locally produced, organic,
etc.), that it is impossible for an ordinary
person to figure out what to eat.38
Consumers report that nutrition logos
assigned to products that meet specific
nutrition criteria influence their food
choices.50 However, studies on this type of
labelling fail to show substantial positive
effects on actual food choice when logos are
placed on healthier food items.51
To complicate matters, nutrition labels are
not always accurate. One study analyzed
foods in a lab found that the calorie content
of packaged food was an average of 18%
higher than what was stated on the label.52
Therefore, providing nutrition information is
probably not effective as a stand-alone
intervention but may be useful as part of a
comprehensive strategy.14
Is it Healthy?
It is difficult for the average person to tell if a food item is healthy.
For example, one very healthy sounding Raisin Bran Muffin has:53
360 calories (almost 20% of average daily needs)
10 grams of fat (15% of average daily needs)
790 mg sodium (over 50% of daily recommendation)
6 grams of fibre (considered a very high source of fibre)
37 grams of sugar (100% of daily recommendation)54
43
Stress
A stressful work environment where workers
experience high demand, low job control,
and low social support can negatively
influence eating behaviours, and often leads
to skipping meals, eating at workstations,
extra snacking, and a preference for calorie
dense foods.12,55,56 In this type of work
environment, health problems are more
likely to occur.12,57,58
Increasing BMI has been associated with
work related psychological factors such as
fatigue, tension, anxiety, and depression.58-60
It is likely that some workers use food as a
way to cope with job strain, which
contributes to the development of
obesity.58,61,62
“It’s like a quick pat on the
shoulder or something like that.
You’ve kept up with your day;
you’ve done a great job, here have
a cookie”.12
- Manufacturing Worker
44
Social Norms and Cues
Eating food with other people can create a
sense of belonging, and social norms can
dictate individual behaviours.22,63 Therefore,
individual employee behaviour can be
influenced by the health-related norms and
values of other co-workers.57,66
Having other people present while eating
can influence both the amount and types of
food people eat. Eating with others,
especially familiar people, can extend eating
occasions and suppress self-monitoring.15
Individuals use social cues to decide what to
eat and how much to eat without attracting
negative judgment from others.19,64 It has
been shown that individuals will eat more
when eating companions eat more and vice
versa.65 This effect can be profound, with
one researcher finding that meal size almost
doubled when subjects ate with seven or
more people.15
Work related activities that revolve around
eating and drinking can promote excess
caloric intake. Such activities include
workplace celebrations, fundraisers, social
events, and entertaining clients.34
Food For Thought: SOCIAL INFLUENCE
In one study, two different bowls of crackers were provided to participants. Subjects
unknowingly copied another person’s behaviour by eating whichever type of cracker
the other person ate.13
The bottom line: Eating behaviours are unknowingly influenced by others.
45
Holidays
“Corporate break rooms need
not become repositories for
unused Halloween candy and
holiday leftovers.” 66
The increased stress, caloric intake and
lower physical activity levels that occur
during the holiday season significantly
contribute to the weight status of
employees.68
Most people gain between 0.62 to 0.70 kg
(1.4 to 1.5 pounds) per year.69,70 Half of this
weight is gained between the Thanksgiving
and Christmas holidays and is not lost in the
summer months as commonly believed.68,71
The holidays are a time when cultural and
social influences combine to create high risk
environments conducive to weight gain.68
Factors such as eating with others, longer
meal times, easy access to food, and large
portion sizes increase overall calorie
intake.68 In addition, holiday celebrations are
likely to include alcoholic beverages, which
contribute a significant amount of calories.
The cumulative effects of holiday weight gain
are likely to contribute to an increase in body
weight.70,71 Overweight and obese people
seem to be especially prone to holiday
weight gain.68,71
46
Implications for Workplaces
Many of the environmental factors that
influence food choice are outside the control
of individual employees. This highlights the
necessity for creating a supportive healthy
eating environment in the workplace. There
are many strategies and policies that
workplaces can implement to help improve
employee’s eating habits.
Refer to the section ‘Part III - Making the
Shift: Comprehensive Strategies to Promote
Healthy Eating’ for strategies to improve the
food environment in your workplace. This
resource is available for download at:
http://www.projecthealth.ca under ‘Project
Health Resources’.
47
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49
Common Psychological Biases That Influence
Health Behaviours
The human mind is extremely complex and influences food choices without
conscious awareness. These psychological biases can prevent people from making
consistent healthy food choices.
Cognitive Bias
A cognitive bias occurs when the brain
allows judgments and decisions to be made
based on personal experience, likes, dislikes
and cultural experiences without supporting
evidence. Several cognitive biases exist that
apply to how people think about health.
Optimistic Bias
From a nutrition perspective, optimistic bias
causes people to underestimate the
consequences of their food intakes. People
usually rate their nutrition-related risk to be
lower compared to others.1,2 As a result of
this bias, people accept the messages in
health promotion campaigns but believe
them to be more applicable to others than to
themselves.
Because of this bias, people do not realize
that their diet requires improvement. As a
result, they fail to take action.
Tailored feedback from health professionals
seems to be the most appropriate method to
address this bias. However, research shows
that some people receiving negative tailored
feedback are even less likely than others to
take action on a health issue.2
Optimistic bias was evident in the report:
Recommendations of the Sodium Working
Group.
“Public opinion research has shown
that Canadians are aware of sodium
as a health issue, but perceive it as
everybody else’s problem. Very few
understand what a healthy amount
of sodium is, and most continue to
have high dietary intakes.” 3
50
Status Quo Bias
“When in doubt, do nothing!”
People seem to prefer having things stay the
same.4
Part of the status quo bias is a tendency to
feel worse about poor outcomes of changes
they made compared to poor outcomes that
resulted from not making a change.5
Brand loyalty is an example of status quo
bias. Once people are relatively happy with a
product, they will not seek out alternatives,
even if superior products become available.4
The status quo bias might help to explain
why it is so hard to make changes as an
individual. It also might help to explain why
people tend to resist imposed changes.
Restraint Bias
“I’ll buy this bag of cookies and
just have one…”
There is a tendency to overestimate one’s
ability to resist impulsive behaviours, which
causes people to expose themselves to
temptation.6
The assumption that individuals “should be
able to” control themselves could explain
acceptance of food temptations in the
workplace environment. Unfortunately,
people are tempted and eventually succumb
to behaviours that result in poor health
outcomes. A common example is bringing in
high-calorie “treats” to share with for coworkers, ultimately contributing to weight
gain.
51
Hyperbolic Discounting
“The time to begin most
things is ten years ago."
~Mignon McLaughlin
People seem to be aware of the risks related
to eating unhealthy foods but seem to
“forget” about long-term health goals when
they make food decisions.7
Hyperbolic discounting is the preference for
immediate payoffs compared to future gains.
For example, eating a tasty brownie now
verses enjoying good health in the future.
This bias is also evident in the form of other
human traits such as procrastination,
overspending and failure to save for
retirement.8
Third Person Bias
“…that might fool someone
else, but it won’t fool me…”
The third person bias is the tendency to
believe that others are more influenced by
media messages than oneself.9
However, simply seeing a logo or watching a
food commercial might create a desire to
eat!10
The billions of dollars that are spent
advertising food products should suggest
that they are an effective way to increase
sales. Especially since the pattern of
nutritional imbalance found in the common
American diet mimics the pattern of
imbalance in advertised foods.11
‘Sin taxes’ such as those placed on tobacco
or alcohol products have been used in the
past to decrease this bias, as there is an
immediate negative consequence to making
an unhealthy decision.7
52
The “Halo” Effect
“These chips have no trans fat,
so I can eat as many as I want…”
How a particular food is marketed can
influence whether or not one chooses to
eat it and how much of it is consumed. A
halo effect occurs when one judges a
food be ‘healthy’ because one
component of it is perceived as healthy.
People tend to underestimate the caloric
content of foods served at restaurants
that market themselves as ‘healthy’. As a
result, they often order higher calorie
side dishes, which contributes to higher
overall caloric intakes.12
Similarly, when snack foods are
marketed as ‘healthy’ many people
assume that these foods either taste bad
or can be consumed in limitless
amounts.13-15
Just mentioning certain ingredients or
attributes can create positive or negative
biases about the perceived taste of food.
In one study, the mere mention of soy
made people evaluate a product as
“grainy” and “tasteless” compared to
those who tasted the same product with
no mention of soy. Suggesting that the
product contained soy made people
believe that they tasted it, even though
the product did not contain any soy.13
Food product names also have a huge
effect on whether people choose to eat
them. Descriptive names tend to
increase taste ratings and overall sales.
They also make people think that they
contain more calories and are more
satisfying than menu items with plain
names.12 For example, “Traditional
Cajun Red Beans with Rice” verses “Red
Beans with Rice”. 13
The psychological factors that influence food
related behaviours occur outside the
conscious awareness of individuals.
Educating people about these psychological
influences does little to change the individual
perception of health and lifestyle behaviours,
as people continue to believe that the
messages are more applicable to others
than themselves.
It is important for health promoters to be
aware of these psychological influences and
accept them as part of the human condition,
rather than having an expectation that
people ‘should’ behave differently.
The most important strategy to counter these
psychological biases is to ensure that the
workplace food environment is structured in
such a way that healthy eating is ‘just
another part’ of the average workday. For
strategies to implement supportive healthy
eating environments in workplaces, please
to the section ‘Part III - Making the Shift:
Comprehensive Strategies to Promote
Healthy Eating’. This resource is available
for download at: http://www.projecthealth.ca
under ‘Project Health Resources’.
53
Psychological Bias References
1. Shepherd R, Shepherd R. Resistance to changes in diet.
Proc Nutr Soc. 2002;61:267-272.
2. Raats MM, Sparks P. Unrealistic optimism about dietrelated risks: Implications for interventions. Proc Nutr Soc.
1995;54:737-745.
3. Sodium Working Group. Sodium reduction strategy for
Canada, recommendations of the Sodium Working Group.
2010.
4. Samuelson W, Zeckhauser R. Status quo bias in decision
making. Journal of Risk and Uncertainty. 1988;1:7-59.
5. Fleming SM, Thomas CL, Dolan RJ. Overcoming status
quo bias in the human brain. Proc Natl Acad Sci U S A.
2010;107:6005-6009.
6. Nordgren LF, van Harreveld F, van der Pligt J. The
restraint bias: How the illusion of self-restraint promotes
impulsive behavior. Psychol Sci. 2009;20:1523-1528.
7. Scharff RL. Obesity and hyperbolic discounting:
Evidence and implications. J Consum Policy. 2009;32:321.
8. Angeletos G, Laibson D, Repetto A, Tobacman J,
Weinberg S. The hyperbolic consumption model:
Calibration, simulation, and empirical evaluation. Journal
of Economic Perspectives. 2001;15:47-68.
9. Sun Y, Pan Z, Shen L. Understanding the third-person
perception: Evidence from a meta-analysis. Journal of
Communication.;58:280-300.
10. Harris JL, Bargh JA, Brownell KD. Priming effects of
television food advertising on eating behavior. Health
Psychol. 2009;28:404-413.
11. Mink M, Evans A, Moore CG, Calderon KS, Deger S.
Nutritional imbalance endorsed by televised food
advertisements. J Am Diet Assoc. 2010;110:904-910.
12. Chandon P, Wansink B. The biasing health halos of
fast-food restaurant health claims: Lower calorie estimates
and higher side-dish consumption intentions. Journal of
13. Wansink B, van Ittersum K, Painter JE. How
descriptive food names bias sensory perceptions in
restaurants. Food Quality and Preference. 2005;16:393400.
14. Wansink B, Huckabee M. De-marketing obesity.
California Management Review. 2005;47:1-13.
15. Howlett E, Burton AS, Bates K, Huggins K. Coming to
a restaurant near you? Potential customer responses to
nutrition information disclosure on menus. Journal of
54
Physiological Barriers to Healthy Eating
Will Power, Self-Control, and
Personal Responsibility
Self-control is required help people follow a
healthy diet. But what is will power?
The Self-Control Theory
Researchers have been investigating the
ability of subjects to exert self-control under
different conditions. There are a wide variety
of behaviours that are expected of
employees during any given workday that
require the use of self-control (e.g., paying
attention during meetings).3 What is
interesting is that self-control seems to have
a limited energy source.3
How Will Power Works
Researchers believe that will power is
controlled by the brain. Even though the
brain only makes up 2% of body mass, it
uses 20% of the body’s energy.3 Each time
participants in studies engage in an effort of
self-control, there is a small but measurable
drop in blood glucose.4,5 It appears that
exerting self-control causes the brain to use
up just enough blood glucose to make it
difficult to complete a secondary act of selfcontrol. 3
1. Employees will likely perform better
when they are well nourished (i.e.,
skipping meals will lead to a drop in
blood glucose that impair one’s ability to
concentrate).
2. Tempting employees with unhealthy
foods when self-control is at its lowest
(e.g., right before lunch), or when they
are trying to concentrate (e.g., during a
meeting) makes it very difficult for them
to consistently eat a healthy diet.6
The self control theory may also help to
explain some other food related
phenomenon such as the “What the Hell”,7,8
and “Token Salad” effects9 as well as other
justification type behaviours described on
the following page.10
Food for Thought: SELF-CONTROL INFLUENCES HEALTH BEHAVIOURS
Even if employees resist temptation initially, research shows that individuals who are
trying to maintain a healthy diet usually have a breakdown in self-control later in the
day.3,4 One study even showed that smokers were more likely to smoke after being
required to resist eating cookies.11
The bottom line: Unhealthy food temptations may impact other health behaviours as
well.11
55
“What The Hell?”7,8
“I’ve already blown my diet; I
might as well keep going”
The “What The Hell” effect is a reaction that
dieters have, often causing them to abandon
their diets especially in situations where
dieters have less control over food choices
or feel deprived. Once dieters give in and
break their diet, they feel that the day is lost.
This results in giving into further temptation
and eating more of whatever food is
available.7,8
The Token Salad
“I’ll have the burger and fries”
The majority of consumers are health
conscious, however, the food industry
reports that consumers say they want more
salads offered, but when they are added to
the menu, salad sales do not increase.9,13 In
fact, when healthy items are added to the
menu, some food providers notice an
increase in the sale of the least healthy
menu items.9,13
The self-control theory may explain why
people seek out nutrition education, request
healthy eating programs, demand healthy
foods on menus and then fail to actually
make healthy ‘choices’. The very thing that
people need to exercise self-control when
faced with eating decisions is depleted when
they are hungry (i.e., blood glucose), causing
them to make more indulgent ‘choices’ when
they are available.
Justification
“It was a tough day at the office,
we should go out tonight…”
People working towards a goal that requires
high-personal effort, (e.g., completing a
major presentation at work) feel that they
can indulge after meeting that goal.9,10,12
Food For Thought: INDULGENT DISTRACTIONS
A group of participants had to resist eating a plate of cookies while completing a
challenging mental task. They gave up after only 8 minutes. The group that was
allowed to eat the cookies lasted 19 minutes, while another group that did not have any
food provided to them lasted 21 minutes.6
The bottom line: The availability of tempting foods when employees are trying to work
can be mentally distracting and counterproductive.3,13,14
56
Physiological Barriers References
1. Krebs-Smith SM, Reedy J, Bosire C. Healthfulness of
the U.S. food supply: Little improvement despite decades
of dietary guidance. Am J Prev Med. 2010;38:472-477.
8. Polivy J, Herman CP, Deo R. Getting a bigger slice of
the pie. Effects on eating and emotion in restrained and
unrestrained eaters. Appetite. 2010;55:426-430.
2. Hill JO. Can a small-changes approach help address the
obesity epidemic? A report of the Joint Task Force of the
American Society for Nutrition Institute of Food
Technologists, and International Food Information Council.
Am J Clin Nutr. 2009;89:477-484.
9. Wilcox K, Vallen B, Block L, Fitzsimons GJ. Vicarious
goal fulfillment: When the mere presence of a healthy
option leads to an ironically indulgent decision. Journal of
3. Gailliot MT, Baumeister RF. The physiology of
willpower: Linking blood glucose to self-control. Pers Soc
Psychol Rev. 2007;11:303-327.
4. Gailliot MT, Baumeister RF, DeWall CN, et al. Selfcontrol relies on glucose as a limited energy source:
Willpower is more than a metaphor. J Pers Soc Psychol.
2007;92:325-336.
5. Miller HC, Pattison KF, DeWall CN, Rayburn-Reeves R,
Zentall TR. Self-control without a "self"?: Common selfcontrol processes in humans and dogs. Psychol Sci.
2010;21:534-538.
6. Cohen D, Farley TA. Eating as an automatic behavior.
Prev Chronic Dis. 2008;5:A23.
7. Canadian Obesity Network. False hopes and
overwhelming urges. Conduit. 2009;Winter.
10. Sela A, Berger J, Liu W. Variety, vice, and virtue: How
assortment size influences option choice. Journal of
11. Shmueli D, Prochaska JJ. Resisting tempting foods and
smoking behavior: Implications from a self-control theory
perspective. Health Psychol. 2009;28:300-306.
12. Chandon P, Wansink B. The biasing health halos of
fast-food restaurant health claims: Lower calorie estimates
and higher side-dish consumption intentions. Journal of
13. Keohane J. Fat profits: On the services of fast food
chains. Portfolio.com. 2008 Accessed 3/10/2009.
14. Muraven M, Baumeister RF. Self-regulation and
depletion of limited resources: Does self-control resemble a
muscle? Psychol Bull. 2000;126:247-259.
57
Is Eating an Addiction?
“A loss of control over food intake” fits the
description of classic substance abuse
disorders.1 As with drug abuse, people
continue to ‘use’ despite knowing about the
negative effects on their bodies, feeling the
negative physical consequences of use,
(e.g., pain or chronic disease), and
experiencing feelings of isolation due to the
stigma of being overweight or obese.1
Obesity and Addiction
Just as poppies and coca beans are
relatively harmless in their natural form, once
components are extracted, refined and
concentrated, they become potent drugs
such as cocaine and opium. Sugars and fats
are also found in nature in small
concentrations and like drugs, are not
addictive, until processed.1
“I just need something sweet.”
The involvement of the dopamine reward
system may explain the desire to eat
something (e.g., dessert), even when no
longer hungry (e.g., after a big meal).
The addictive process is likely a key reason
that the majority of individuals have not been
able to control their intake of refined grains,
fats, and sugars. However, unlike other
addictive substances, foods containing
refined grains, fat and sugar are heavily
advertised, inexpensive and difficult to avoid.
Researchers have found that eating refined
grains (i.e., white flour), sugars, and fats
commonly found in processed food,
stimulate the dopamine system in the brain
similar to the reward pathway for drugs of
abuse.1-5
Obese individuals have fewer dopamine
receptors than lean people, (comparable for
drug users compared to non-users).6 Eating
foods that contain refined grains, fats and
sugars causes the loss of dopamine
receptors.7 The result of having fewer
dopamine receptors is that more substance
(i.e., food) is required to feel satisfied.2 This
promotes overeating and a preference for
processed, high-fat, high-sugar foods, which
increases the risk of developing obesity.
58
Eating is an Addiction References
1. Ifland JR, Preuss HG, Marcus MT, et al. Refined food
addiction: A classic substance use disorder. Med
Hypotheses. 2009;72:518-526.
2. Mahapatra A. Overeating, obesity and dopamine
receptors. ACS Chemical Neuroscience. 2010;1:396-397.
3. Lutter M, Nestler EJ. Homeostatic and hedonic signals
interact in the regulation of food intake. J Nutr.
2009;139:629-632.
4. Avena NM, Rada P, Hoebel BG. Sugar and fat bingeing
have notable differences in addictive-like behavior. J Nutr.
2009;139:623-628.
5. Zheng H, Lenard NR, Shin AC, Berthoud HR. Appetite
control and energy balance regulation in the modern world:
Reward-driven brain overrides repletion signals. Int J Obes
(Lond). 2009;33 Suppl 2:S8-13.
6. Volkow ND, Wise RA. How can drug addiction help us
understand obesity? Nat Neurosci. 2005;8:555-560.
7. Stice E, Yokum S, Blum K, Bohon C. Weight gain is
associated with reduced striatal response to palatable food.
J Neurosci. 2010;30:13105-13109.
59

Barriers to Healthy Eating

Transcription

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