Also Known as Skipping or Skimping Meals

I am convinced that eating patterns of food-restriction, followed by re-bound, are a weight-control deal-breaker for all or very nearly all people who have an ongoing or significant issue with excess body fat (we keepers).

I think that this is very under-acknowledged.  A quiet quicksand pervasive in our culture.

In fact, I think that restrict/re-bound eating patterns have been one of the biggest contributors to today’s obesity crisis.  I think this contributes in a very major way to weight gain over time and also strongly sabotages success in achieving weight loss and in weight maintenance.

I suspect that the uncontrolled-for effect of within-day or within-week cycles of restrict/rebound has contaminated a great deal of the obesity reasearch when free-living people have been studied.

I think that the official endorsement and professional recommendation of Hunger-Inducing-Therapy (calorie-restricted dieting) has contributed to the very wide-spread presence of such eating patterns in our society. Also, that this is behind the fact that such eating habits are commonly regarded as fairly benign and have now been the habits of so many people over such a long time that they are now commonly seen even as being perfectly healthy.

Our great-grandmothers would have ‘had none of it’ if their sons or daughters had tried to pull such stunts at the breakfast table.

Some Clarification:

By restrict/re-bound eating patterns, I include patterns that occur within a day, within a number of days (often week-days versus week-ends) and over a cycle of some weeks or months.

Typically, a within-day cycle would start with skipping or skimping or substantially delaying breakfast and/or lunch.  Following this, the re-bound would start in mid or late-afternoon or in the evening.  At either or both of these times there is a strong hunger that develops, with recognizable characteristics.  The person will generally have a strong urge for food that is calorie dense and that will, at least in part, hit the blood stream quickly.  When food is consumed, satiety seems to be dampened or delayed in response.

Under normal appetite conditions (not set-up by prior restriction) one can ‘eye-ball’ in advance fairly well what amount of food to choose as a serving size for a meal or snack that will satisfy.  Once most of this serving size is consumed, if the person stopped to think about it they would realize that they are somewhat less hungry.  By the end of eating it, or certainly within 20 minutes or so later, they will find that they are substantially less hungry.  Even if they still want a bit more, they will feel less hungry than initially  – that is, they will feel an effect on their hunger/satiety from what they have eaten.  If they then eat more, they will feel progressively less hungry in response.

With re-bound eating, when that serving they have judged for themselves has been eaten, often the person can feel just as hungry as before they ate.  It’s like they haven’t eaten at all.  If fact, they might feel even hungrier.  Several servings may be eaten without feeling much less hungry.  It’s like the signalling systems that register food intake have been almost completely shut off. (that’s hint, see below)

This easily results in a net food intake over the day of more calories than the person needs, promoting weight gain. (Unless the lucky person has been blessed with fortunate metabolism that gifts them with a degree of relative resiliency against weight gain.)

When they get up the next morning, they remember they have eaten more than they intended and are determined to make up for it.  And what better way to do that and to really get started on some weight loss than to skip breakfast!

The within-week pattern is similar, except the restriction (often with calorie-output-oriented exercise) is on week-days and the re-bound is on the week-end.

Often a lot of coffee is involved, or taking advantage of stress and the morning adrenalin rush as appetite suppressant.

People can be fiercely convinced that this pattern is not only not contributing to their difficulty loosing weight – they can be convinced that it is good for them.  They can get really mad if you try to suggest that they test out that idea by even a couple of weeks of trying a different eating pattern just to see if it works better for them.

Doctors who have focused a lot of their practices on weight control know this.  Within medical circles, as a group people who have persistent difficulties controlling their weight are famous for their tendency to skip/skimp/delay breakfast and lunch.  Doctors and nutritionist get very frustrated with it, although not all would agree with me that it is such a serious or deal-breaker issue. Nutritionists have campaigned against skipping breakfast for decades.

This sounds a lot like binge eating disorder.  And it is a lot like binge eating disorder, but they are not identical.  Still, this could be an eating pattern that would promote the development of binge eating disorder in someone who was susceptible.  Also, such an eating pattern would make it much harder for a person to control their disorder.

This also sounds a lot like what people describe as their experiences with food addiction.  Same as above – it is not identical with food addiction, but it might be a factor promoting the development of food addiction in a susceptible person.  Food addiction and disordered eating pattern acting together would certainly be a difficult situation for any person to be in. (But what a feeling of relief and accomplishment for them when they break free!)

Does the liver give morning food aversion?  When the liver is ‘sick’, often the very first symptom is a lack of appetite or food aversion.  Taken a little farther, this becomes nausea.  This is just speculation, but I wonder if the aversion to eating breakfast that some people report when they are into this eating pattern might reflect strain on the liver.  Perhaps there is some alcohol involved, perhaps there is too much fructose over a short period of time, perhaps there is fatty liver, perhaps stress combined with the large food load causes a flood of inflammatory molecules from the gut over-night – such as from too many food molecules spilling through a leaky gut.

“I’ve always eaten this way and wasn’t over-weight always!”  You were younger, or perhaps you were not as stressed or you have since developed some insulin resistance, or you now have poor sleep or you now have pain or now have fatty liver or you now have some food addiction mixed in, or?  A simple test trial of changing the eating pattern for a few weeks will show how important the eating pattern is or isn’t.

What about the bottomless hunger?  I think it is a parasympathetic re-bound that disables the normal signals that register food intake.  The person has been running on adrenalin and cortisol all day, maybe with some coffee, rushing, anxiety, anger, frustration, conflict and exercise along the way.  At some point in the later day, often when mentally one is now ‘off-the-hook’ (e.g. they have arrived home) the parasympathetic nervous system (which is responsible for tissue repair and maintenance) just says “enough of that, matey, I’m flipping a switch and you are now going to sit on a sofa, eyes glazed, brain like a zombie, feeding your face”.

The sympathetic system and the parasympathetic system together make up the autonomic nervous system, which runs un-noticed in the background, running all the automatic functions of the body – everything that you don’t have to think about to make it happen – such as your digestion and your heart beat.  The sympathetic and parasympathetic counter-balance each other to manage your body functions in response to all the needs, situations and challenges of your life.

When you have a sudden surge in the sympathetic system, we all are familiar with what that is called – the ‘fight-or-flight’ response.  For example, think how you would feel if you had just had a minor fender-bender (with no-one hurt).  Your heart might be racing, your breath quicker and shallower, your palms sweaty, perhaps your hands shaking, likely with an anxious or jittery feeling.  The response runs with a mind of its own, you would have to be extremely skilled to be able to over-ride these physical effects by, say, willing your palms to not be sweaty.

If your parasympathetic system, on the other hand, has a sudden surge of activity, what do we call that?  We ignore the parasympathetic system so much that it almost seems like a non-sensical question.  If you asked a hundred friends, no-one would have an answer for that.  In western society, we do love the sympathetic system.  I think one ways that such a surge of parasympathetic activity could be felt is as the master of the re-bound phase of the restrict/re-bound eating cycle..

The way I see it, this is a tissue repair and body maintenance response.  The normal systems that your body uses to sense what you have eaten I think are switched off.  The relentless stress throughout the day is perceived  as a mini crisis and full control is now handed over to the parasympathetic system, now The Boss. The re-bounding parasympathetic system wants simply “lots” of food so you can re-build tissue torn down during the sustained fight-or-flight metabolism you indulged in all day.  The piper is to be paid, but the calibration of the re-payment is wonky.  You don’t stand a chance.

Intermittent Fasting  –  Added Oct 23/12 – I wrote what follows in response to a question (on another post) about intermittent fasting and regarding intermittent fasting producing ketosis.

As always and with everything about health, it all depends on who you are and your present circumstances.
 Inermittent fasting would produce some amount of ketosis as in “ketones measurable in the blood” – which is not what we mean by the term keto-adaptation (when your body has become adapted to burning fats and ketones as the major fuel supply).  I do think that there is probably something important about intermittent day-by-day periods of ketone production – such as not eating in the later evening/overnight and prolonged periods of activity from time to time. I haven’t seen this being discussed, but I speculate that it likely isn’t a good thing that in our modern society people may go years or even decades and virtually never have a time when they go into ketosis (and thus “wake up” the ketogenic machinery and ketone transportation and burning infrastructure).  Given how different people are, including the existence of those mysterious people called “slim” despite our modern ways, perhaps for some people this maintenance of more metabolic flexibility may be all the metabolic “tune-up” they need to have a reasonable time controlling their weight.
 In the context of ketogenic diets (here, as always, I use the term “diet” for its meaning of “pattern of food intake”), intermittent fasting will deepen ketosis – at least briefly (although there may be considerable cycling of ketone levels depending on the meals consumed). I suspect that this is part of what is going on regarding Jimmy Moore’s quite high ketone levels. However, there can be too much of a good thing and too rapid a transition to a good thing.  We need to pay more attention to learning from the experiences of the keto kids and adults in the epilepsy community – where they have learned to treat ketone levels with great respect and have been forced to learn a certain caution and wariness about rapid increases in ketone levels and individual tolerances of different ketone levels. (Book review coming soon of “Dietary Treatment of Epilepsy: Practical Implementation of Ketogenic Therapy”.)
 Intentional intermittent fasting can be done 3 ways (1) deliberately not eating for a period of time, despite hunger, (2) truly spontaneous lack of food intake and (3) deliberately not eating for a period of time and telling yourself that you are not hungry. Note that “intentional” means not counting when due to such things as drugs or illness – such as cocaine or flu. Situation “1″, if practiced routinely, is a version of the ever popular “hunger therapy” that disguises itself in countless ways. Some hunger in the 30 – 60 minutes (or so, not to be taken literally as a specific number) before meals is fine and likely healthy (if it doesn’t make your over-all eating goals more tenuous due to emergence of cravings or unplanned eating). Sometimes some hunger is difficult to avoid for a brief period of time while making certain transitions in your eating pattern or lifestyle – meaning occasionally, not as an intentional recurrent pattern. (I use “difficult to avoid” rather than “desirable”.) All versions of hunger therapy carry risk of setting off disordered patterns of eating – although it must be acknowledged that some people have done well over time with calorie restriction and value that choice.
 How different is the new darling “intermittent fasting” from the old nemesis “breakfast skipping” that has been infamous as the bane of weight control.  It always comes down to “how is that working for you”, which sounds fine, but often it can be surprisingly difficult to know the true answer to that. Depending on how young and how healthy and how much other stress and genetics and past stress exposure (including programming in utero and in infancy) and on and on, a person might do well (or appear to do well) with this over even quite a period of time.  There isn’t any kind of testing that can tell you how much stress you are putting on your body and your body control systems with this.  If over-done, it can sneak up behind you and bite. Your appetite control system is designed to put a stop to this and doesn’t mind some excessiveness in the rebound. Many an over-weight body has been built by the systematic application of breakfast skimping/skipping.  Caffeine and stress both count as “stimulants” that fool people into thinking they aren’t hungry.  I think hunger therapy, in all its versions, runs a close second behind high carbs as a major causative factor in the development of the obesity “epidemic”.
What about truly spontaneous periods of not eating for, say 12 – 24 hours? Ketosis does have some appetite suppressing effects and some people may be having a fair amount of ketones if they are generally low carb, or a very high level of ketones is they are generally keto-adapted.  Some might also be using stimulants such as coffee or high intensity exercise to suppress appetite.  We will have to see over time how people do with this. The body might not send “rebound, please” signals if the flow of fat from fat stores is ample and metabolised well.  Trouble is, the fat may not readily come out of the fat stores in all people all the time – or at least not at the high rate required with fasting. When eating to appetite, you will intuitively respond to this by eating, thus preventing over-stressing your body, raiding your muscles for energy, developing cravings or having your metabolism slow. Besides that, some people may not feel well at the suddenly higher level of ketosis.
 Finally, I think that calorie restriction is so insidiously woven into our thinking and our culture that it can be at play even when a person isn’t aware of it.  For example, one manifestation of this is people telling you that what you’re feeling “can’t be hunger” – because it doesn’t match with their idea of when you should be hungry.  Most of this re-labelling of various hunger sensations (not all) is still hunger therapy, under another guise.  When people say they are fasting and not hungry – I’m sure some people really aren’t, but I also have my concerns that some may not mean the same thing when they say this.  For anyone who has struggled with weight over time, it could be difficult not to hear at least some small inner whisper of “you did good” when some form of calorie restriction is done.
 You might be aware of this already, but Stefani at Paleo for Women is quite interested in this topic.
Time will bring more insight and knowledge on these topics.  Hope this has been of some help.  Dr Dea

Added Oct 31/12 – Dr. Vera Tarman has a good post about the pattern of restricting food in the day and saving eating for the evening. LINK

14 thoughts on “Restrict/Rebound

  1. What about people who simply are never hungry in the morning? My father and I both prefer to skip breakfast or just have a small bowl of plain yogurt, while my mother and sister are both breakfast eaters. We also have a divide in my family between the pairs, my father and I are naturally fairly slender (but we can fatten with excess sugar), and my sister and mom have massive problems with weight even after carb restriction.

    My father and I both tend to graze and eat a fair amount at night, but I’m grown and live away from home now, so I don’t know if he does as much as I do. My weight is a bit higher than I’d like, but it’s well within the healthy range.

    Sorry for being long-winded, I’m mostly curious if I should be trying to eat breakfast even if I’m not hungry for health reasons?

    • Hi, Thanks for your comment.
      Step one: the “How is that working for you” test.
      Step two: the “Was making that change worthwhile” test.
      Since everything needs to be individualized and then also adjusted with changeing needs over time, the crux question always comes down to the classic “How is that working for you?” The trouble is, none of us are nearly as good as we think we are in figuring out the answers to that question.
      The very short answer – try it, try it, and you’ll see (quote: Green Eggs and Ham). An informed test trial would be the way to find out – all else is theory.
      In terms of weight control, your family is a perfect example of the fact that some people are more resistant/resilient in their susceptibility to gaining weight. This resiliency will always have it’s limits. When enough barbarians gang up at the gate, or your resiliency is weakened, some extra pounds will start to pack on.
      Youth is probably the biggest resiliency factor of them all. Sometimes I have had to tell someone that, unfortunately, the diagnosis is simply that they aren’t 25 anymore. Various lifestyle habits that a person might have may seem to be tolerated fine when they are younger and yet start to backfire when they get a bit older. Another major resiliency factor is stress. Stress can creep up on you and then, one day you look back and notice you have been exposed to a lot more chronic stress than you realized. Have a thought also about how much good quality sleep you are getting. Have you been as physically active? If not, your muscles may not be quite as sensitive to insulin as they used to be.
      You see it all adds up. I couldn’t list all the things to think about that may, for you personally, be factors that might contribute to shifting a few pounds on or off. But the more extra burdens you are putting on your body’s coping capacity, (and we all do) the more you might want to look to find the ones that you can eliminate. The question then is – is skipping breakfast for you now, in the net total situation of your life, helpful, neutral or a burden of your health?
      I would think mostly of two indicators to look at for this. One – is it impacting your stress for the day? Two – since it can impact your weight control, is there any reason to consider that your appetite/satiety systems may not be working their proper magic for you lately?
      In terms of the stress impact, you would want to consider how your energy is over the day. Any impact from chronically skipping breakfast would most likely show up in the afternoon (no matter if you have a good lunch) or in the early evening. Also consider any other signs of stress such as anxiety, tension, irritability, etc.
      In terms of whether you should have a think about your appetite/satiety control systems, that would take a consideration of your body weight and also your body composition. It is much, much, much better to make small adjustments early to head off small body composition problems than to wait until you are officially overweight. If you are still within the normal weight range, the two thngs for you to think about are – is your weight trending up in a way you can’t seem to get a grip on and/or – are you putting on weight inside your abdomen (tummy weight). There isn’t an easy way to test this directly (think DEXA or MRI scan), so we have ways of getting an approximate idea. Since these methods are indirect assessments, it is best not to rely on only one method.
      The British just published a guideline suggesting that you consider your height, then think about the number that is half your height, then measure your waist. The distance around your waist should be less than half your height. For example, if a person is, say, 5 feet 8 inches tall, this is 68 inches, so that person’s waist is best kept below 34 inches.
      You could also consider how big your waist is compared to your hips. For a woman, the hips should be bigger than the waist. In fact, a woman’s waist is best kept at no more than 80% as much as her hips. This is called a waist/hip ratio of 0.80. If a person’s hips (measured at the point where the measurement is the biggest) is, say 36 inches, then 80% of 36 is (on your calculator 36 times 0.8) is 28.8 inches. Measuring the waist accurately can be a bit tricky for people who have gained weight, but not so much if you are slim. In the mirror see your navel. Feel your sides at about the level of your navel (just above where you would “put your hands on your hips”) for the top of the crest above your hip bone. Take your measurement around the waist just above the top of the bone on eatiher side. There is a good short video of this on the Heart and Stroke Foundation website (link below).
      As you can see also on that site, there are cut-off guidelines for the waist measurement itself, which varies for different ethnic groups. For example, for caucasian (white) women the waist measurement is best kept below 35 inches (88 cm) and for Asian women it is best kept below 32 inches (80 cm).
      You don’t have to be obese or even be officially overweight to start having the type of metabolic damage that we have been tending to blame on obesity itself. It turns out that having fat inside the tummy (even fairly small amounts of it) is the real culprit.
      That all is a very long-winded way of arriving at the topic – does it seem to you, from all this, that your stress or your appettite/satiety systems aren’t doing so well?
      If so, you might want to consider a test trial, for a few weeks, of the age-old sage advice to eat your breakfast. You might need to ease into it a bit. Prepare something appealing and sit down to it. If, with the food in front of you, you really do feel put off by the idea of eating any of it, then I would tend to wonder about (1) your level of chronic stress and/or sleep deprivation, (2) how much you are eating in the later evenings or (3) how much you are tricking your appetite control with caffeine. Breakfast means a meal, not a snack, and includes protein.
      The whole point of medicine is to support and protect over time the most well-being with the greatest personal freedom for each person. Consider a test trial – your experience will tell you whether you find it worthwhile or not to continue.

  2. Pingback: long-ish reply to question about breakfast | it's the satiety

  3. I take it you are not in favor of intermittent fasting. You have lots of company in that regard. In her low-carb cruise presentation earlier this month, Jackie Eberstein insisted that for low-carb success, you should NEVER, EVER skip a meal (yes, it was even capitalized like that on the Powerpoint slide). When I asked about fasting on last year’s cruise, *every* MD on the panel insisted that fasting was a really bad idea.

    I disagree.

    Intermittent partial fasting has worked extremely well for me, at least so far. Except for the week of the low-carb cruise (during which I did a different N=1 experiment, in lieu of skipping any meals), I have been doing a partial fast every other day for the last few months. Not only did it break a multi-year “stall”, I feel better, and I have not experienced much hunger. One of the nice things about a ketogenic diet is that missing a meal (or even 3 or 4 in a row) is not a Big Deal for me.

    • Hi, Howard and thanks for the comment. I expect this page to draw the most heat. (That’s only because I haven’t posted yet about sleep and regularity of daily meals and sleep times, which will really draw fire.) Everything always varies with the individual. Still, many a man before you has tried this only to have it sneak up on them later and bite them on the tusch. Your appetite/satiety control system is ancient, is interwoven into every aspect of your functioning and is multiply redundant in all its functioning. You sure you want to provoke a fight?

      • Provoke a fight? I assume you are talking about a fight with my appetite/satiety control system. I won that fight in 1999, when I cut the grain and sugar out of my diet. Prior to that time (on a horribly unhealthy *cough* Ornish-style *cough* low-fat diet), I was Hungry. All. The. Damned. Time. Hunger is very much like the proverbial Chinese water drip torture. You can ignore it for a while, but it never lets up, and eventually, you cave.

        As I mentioned, missing a meal or two is no longer a Big Deal for me. I’m simply not hungry most of the time. There is substantial evidence to suggest that humans evolved (and thrived) in an environment where the norm was four or five meals a week, with large seasonal variation, if you want to get into the “ancient” part. I didn’t get to attend the Ancestral Health Symposium, but I have friends who did, and I have had some lively and interesting discussions with them about it (I managed to record a podcast with a couple of them, which I plan to publish sometime this coming week, although we did not specifically talk about the AHS in that interview). I hope that I will be able to attend AHS in the near future.

        If PIF should ever become intolerable for any reason, I will simply do something else (I’ve mentioned before that I’m really not fond of being hungry). So far, it has not only been tolerate, but enjoyable, on balance. Initially, I had some issues with it, but I managed to track down and eliminate the real problem before it got intolerable. Anybody who has trouble with a partial fast for one day is probably eating wheat, sugar, or some similar toxin.

        I don’t know if I have yet covered any topics on my own blog that would interest you enough to comment on, but you are certainly welcome to come visit — and comment. I also have another blog on which I permit guest authors, on which I would welcome your input. It’s not a particularly high-quality blog, but it gets tons of traffic, and it could get you some exposure. If you are interested, let me know. You have my email address.

      • Hi Howard, thanks for dropping back. About your comments, I refer to the usual calorie-restricted dieting as “Hunger Therapy”. I’m not just concerned that Hunger Therapy is commonly ineffective, miserable and some people can then feel trapped, depressed or incapable. I am also worried that chronically putting up with hunger can (maybe, some people are proposing this), in a slow and subtle way, wreak havoc with the appetite/satiety system long term and that this may only show in a delayed fashion. The trouble is, this safety question has never been seriously explored.
        Thus I am not comfortable with intake restriction, other than temporarily (e.g. a few days or week or so) if one is instituting a major shift (such as going low-carb or stopping night eating, for example) while one’s body adjusts. By which I mean continuing intake restriction in the face of hunger or in the face of evidence of appetite/satiety disruption, such as a driven, excess appetite in the afternoon or evening.
        As I have written in various places in my blog, the over-riding preface for anything is that in health and medicine everything must be considered variable according to the individual and, even for the individual, varying over time. Therefore we are completely on the same page. If you look at my previous reply to the question posted about breakfast, my position is that the key question is “How is that working for?”. The trouble is that in answering that question the parameters one should consider are not always known (at all), are not always known by the person and are not always evident just by self observation. For example, diabetics would not need glucose monitors if they could answer for themselves “how is that working for you?”. People who were about to have a stroke could go to the hospital the day before even though they had not had any symptoms and felt right as rain.
        I’m very interested in your experience with this. We sure are in need of more options for people who do not reach their healthiest weight target with what we know so far. If we knew everything we need to know, I wouldn’t have to spend so much time trying to provide useful content on this blog. Over time and by putting together many people’s experiences, we should be able to develop insights into who does well over time with intermittent fasting and who are the people for whom it blows up.
        I’ll drop by your site and have a read.
        Thanks again for such an interesting discussion.

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  5. Hi. Love the post. Restrict-rebound (is this what all MDs call it?) is in my opinion the primary, or perhaps at least most insidious, driver of dysregulated hunger. Sometimes this happens on accident–as with people who are dieting–and sometimes it happens on purpose, with IF. Not everyone on IF experiences this, but many I think, do. and I agree with you Dr Roberts, that many people experience great benefits at the start, but the system becomes dysregulated over time. I won’t say “always” of course not, but I will say “in a large number of the practitioners I know.” Which is to say– most of them are women. A la my rage about recommending fasting, particularly for women. “It feels great now!” they’d say after a few weeks. But, first: why? Are you hyper alert? That’s probably then because your body is exercising an evolved response to starvation, exciting your hippocampus and HPA axis in order to keep you awake and foraging for food. For other reasons? Yes, there are many. In any case. I think fasting can do wonders for some people, as their own testimonies point to–but I also think that is both limited by case and by time.

    BY TIME. I can’t stress that enough. It takes time, but the longer and longer a person restricts (again, particularly women against men, and particularly normal weight women against overweight women) the worse and worse dysregulation can get.

    Leading to circadian rhythm problems, about which I have also been thinking and composing for a long time.

    All that being said, I have a couple of questions.

    When you talk about tissue damage, which tissues are you talking about? Is the tissue damage directly related to the hormonal dysregulation, in your opinion? And how does that hormonal cascade work, if you have a general framework? Does it go Sympathetic arousal > appetite hormone suppression > parasympathetic activity > flood of appetite stimulating hormones > adrenal response > sympathetic arousal…. or something like that? I’m fascinated by the role that adrenal hormones and sympathetic arousal has on food and appetite. I think it’s a crucial key that so many of us are missing in the appetite and weight loss worlds.

    • I had to make up a term to use (Restrict/Rebound). That’s the problem in a nut-shell. Insidious, slow quiet bomb going off in our society and it is not being recognised for what it is. Yes, you will often see heart-felt comments on the importance of eating breakfast, yes over-eating in the later day is known to be wide-spread, yes night-eating syndrome is recognised as being a growing concern, but the true nature and scope of the problem is not quite grasped. And I think it can’t be addressed without seeing the link to the “officially” sanctioned advice to endure chronic hunger as part of calorie-restricted dieting, with its implication that enduring sustained hunger is harmless (not even researched, let alone proven) and “good” behaviour.
      People can’t tell how they are doing over time with any restrictive eating pattern because there is a general lack of awareness of how to interpret the language of the body in this regard. Everyone knows what an “adrenalin rush” is, but who even has heard of the para-sympathetic system? (Actually, that name is part of the problem right there.) We don’t have any term at all for when the para-sympathetic system decides the time has come for its turn.
      The biology? The damage I refer to is simply the fact that a high adrenalin/sympathetic state is “catabolic”, which means molecules and tissue are being broken down. The “louder” the signal, the less finesse in the response. A strong sympathetic surge (like to keep your blood sugar up when you are going for hours after getting up in the morning without eating, while dashing off to work, traffic, stressful job, etc.) is not a finely-calibrated state. The para-sympathetic counter-balance to this is very under-studied. Why conduct basic science when there are patent-oriented things to pursue? The biggest problem is that we still do not have very good markers/tools to use in research (or the clinical office) to study these topics. I have tried to find research reports related to the concepts I have of the “loud” para-sympathetic surge over-riding the appetite/satiety signalling system. I have not had success in this, but I may not be using the right search terms or have found the right researchers to track. Certainly we accept that a sympathetic surge over-rides the usual appetite/satiety signals the opposite way – if you are running for your life you aren’t thinking how you’d like to have a snack right then.
      Circadian rhythym problems? I have said before that I think that will be the most difficult hill to take. You can find people galore all over the web talking with interest and enthusiasm about the myriad changes they have made to the foods they eat, how they prepare food, where they buy food, recipes, meal patterns, on and on and on. How many of those people take seriously the issue of getting their computer turned off and getting to bed??? The emotion and sense of personal threat about sleep/circadian issues is even worse than that relating to food, excercise or even (drum roll, dare I say it) breakfast.

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