Healthy Food & Healthy Living by Dr. Ayala

The healing power of gratitude

Practicing gratitude is one of the keys to a positive outlook on life. Positivity may come naturally to some people, or during certain periods of your life, but for the rest it requires practice, habit building, strengthening it like a muscle – because our mind naturally gravitates towards worry and the detection of danger and misfortune. A positive attitude doesn’t sugar coat or deny the many challenges around us – it just reminds us that there’s also so much that’s going well and that there's plenty that's good in our lives.

There’s a large body of evidence showing that positivity enhances mental and physical well being. Thankfulness predicts lower rates of depression, better emotional states, and healthier relationships. 

A review in the Journal of Positive Psychology focuses on interventional studies rather than observational ones – a better way to test the effectiveness of a treatment modality. These studies test gratitude practice in a test group, and compare the outcomes with a control group that did not use a gratitude intervention. Interventions included gratitude journaling (writing regularly about what you’re grateful for), writing a gratitude letter (devised by Martin Seligman – the father of Positive Psychology – constitutes writing and delivering a letter of gratitude to someone previously not properly thanked) and the Three Good Things exercise, in which you writing down three good things that happened within a stated time period.

The review includes 25 experimental articles that tested gratitude interventions and psychological wellbeing symptoms, such as depression, anxiety, stress, negative emotions and aggression and finds some evidence that gratitude may contribute to improvement in psychological well being.

There were 32 interventional studies centered on emotional wellbeing: happiness, life satisfaction, quality of life, flourishing, etc. and the vast majority of studies show that gratitude practices increased emotional wellbeing.

Regarding social wellbeing, consisting of social skills, contacts and relationships, and purposeful employment, the review includes 19 experimental studies: Practicing gratitude helps maintain healthy relationships and the formation of new ones.

The mind and the body are one and the same, so mental wellbeing likely affects many aspects of what we call physical health. There are, however, only a few studies focused on gratitude and physical health, but there’s some indication that gratitude lessens stress, lessens self reported symptoms, may lower blood pressure, cholesterol and inflammatory markers, and improves sleep. 

Gratitude – for the small things in life

Paying attention to the smaller things to be grateful for is central to the practice of gratitude. The bigger gifts of life are eminent and require less practice. It’s the small stuff though, that lightens your heart repeatedly once you notice it.

Food is a useful, yet fraught, way to recognize our good fortune. Many of us are troubled by food, and have an ongoing stressful fight with it, labeling some of it, or some of its macro nutrients as bad and even evil. But food should really be our constant reminder of how lucky we are for the bounties of nature, for the nourishment that comes from the sun and the earth and from the labor of all who participate in the vast network that makes our every coffee cup, slice of bread, and every morsel of food.

As is nature. There’s a sunrise and a sunset every day for you to admire, a flower, a bird, a colorful leaf, and an old tall tree. Gratitude to nature not only improves wellbeing, it may also help us to better protect our environment.

Wishing you a happy Thanksgiving holiday, and grateful for your readership.

Dr. Ayala

What happens when you overeat?

Whether it's stress, boredom, the proximity of the fridge, ready-for-Zoom loose clothes, food shortages, or comfort seeking, the coronavirus crisis got many of us worried about overeating. In a WebMD poll half of the women reported pandemic weight gain.

Maintaining body weight is tough in the best of circumstances. People usually slowly gain weight over time, over many many years. Our situation nowadays is quite unique though, as so many of us are undergoing a dramatic change – that’s why it’s been dubbed the quarantine 15, akin to the shift in weight students are rumored to undergo when they first move to college.

When life’s disrupted eating patterns change.

The Freshman 15 might be a bit of an exaggeration. But are we experiencing a worldwide experiment in caloric overload? And if so, are we indeed going to see a jump in overweight and obesity? Or is our body’s tendency for keeping weight around its setpoint going to kick in and somehow make the extra energy, or the overeating itself, sort itself out?

The science of overeating

The biology of human overfeeding has been studied since the early 20th century. A recent article in Obesity Reviews looks at 70 years of research and more than 300 scientific papers on the subject.

The first few studies, which took place before 1950, studied just one volunteer – the researcher himself – and reported less weight gain than expected, suggesting the body “wastes” some of the extra energy away.

Later studies gathered sophistication and volunteer numbers, some were short term, lasting just a few days, some lasting as long as 6 months, and they utilize many overfeeding regimens. 

Analyzing this data holds both reassurance and warnings.

Outcomes vary

There’s a wide variability between people’s response to overfeeding. Focusing on studies in which people were overfed an overall extra 50,000 kcal, people gained from 7 to 17 pounds, and the difference between people equally overfed was as much as threefold. There’s clearly a genetic component, twin studies show. Age, gender and ethnicity seem to matter, and some of the most important predictors are baseline fat-free mass and fitness – muscular, fit people gained less weight. People with a family history of diabetes and insulin resistance are at higher risk of weight gain when they overeat.

Do we waste energy when overfed?

Overall, although the excess amount of calories correlates with weight gain across 19 studies relevant to this issue, people gain less weight than expected. The old rule of thumb is that every extra or deficient 3500 calories result in one pound of weight gained or lost, but in overfeeding studies only 60 percent of calories translate into accumulated fat, and weight gain isn’t linear, it slows over time.

Some of this extra energy may be wasted through a rise in resting energy expenditure – overfeeding can increase metabolic rate. Studies also show that during overfeeding the energy cost of physical activities, such as walking, climbing stairs etc. goes up. Some animals, such as rodents, dissipate extra energy as heat when they’re overfed, but we humans usually don’t have the talent to activate brown fat in this way. 

Does the kind of food you overeat matter? 

This relates to a longtime debate in nutrition: Is a calorie just a calorie, or does the source and quality of the food affect weight outcomes? While it’s clear that certain foods lend themselves to overeating – an open pack of Oreos can quickly disappear, yet an equal calorie huge bowl of broccoli rarely does – experiments in which overeating is imposed show that what you eat affects fat storage location.

Overfeeding on a low protein diet increases the percentage of energy stored as fat. Fat type also makes a difference: Adding more saturated fat as opposed to polyunsaturated fats leads to increased fat accumulation in the abdomen and in the liver.

Several studies compared overfeeding high carb and high fat diets. Blood insulin, fatty acids and other markers changed according to the diets, weight gain, however, was similar. An interesting study compared overfeeding with candy to overfeeding with peanuts for two weeks. Equal amounts of consumed calories led to almost 2 pounds of weight gain, and an increase in waist circumference when eating candy, and just about half a pound in the peanut group.

But overall, the authors conclude that the overfeeding diet type plays a big role in fat distribution but not a significant one in the amount of fat stored. Fat distribution is pretty important though.

What happens when overfeeding ends? 

When participants completed overfeeding studies, they lost the gained weight rapidly within a few weeks or months, even if they weren’t trying to. Just returning to the pre-overfeeding diet, without caloric restriction, led to recovering the pre-overfeeding weight status.

This has been documented in many studies.

With this, too, there was wide interpersonal variability.

Stay calm and nourished

These stressful times call for kindness to yourself, so if you feel like you’ve strayed a bit try not to worry, but rather, correct course when you’re able. 

Research shows again and again that it’s the long term habits that matter, and just like short periods of overindulgence during the holidays don’t matter so much, baking your way through Covid-19 doesn’t mean you’re on a slippery slope towards unbridled weight gain.

This large-scale review offers a bit of reassurance: Overfeeding affects people less than they fear, and bouncing back from it may require less effort than anticipated.

When life’s disrupted eating patterns do indeed change, that's why this is also an opportunity to change them for the better.

Dr. Ayala

This Thanksgiving count your blessings, but what about your calorie count?

Excessive gratitude has no known side effects, but Thanksgiving overeating is a concern that’s on many people’s mind.

In much the same way that a rotation of foods and nutrients are demonized and blamed, (fats, carbs, gluten, eggs, dairy – the villain changes the theme remains the same) Thanksgiving, holidays and celebrations are seen as weight gain disasters.

But just likes gluten can’t be blamed for all that ails us, one or two indulgent meals can’t change your fate or weight by much.

That’s not to say that the heavy feeling – and regret – people have post Thanksgiving isn’t real, and that it isn’t time to approach the overflowing holiday plate a little different.

Holiday weight gain, myth or fact?

Thanksgiving marks the beginning of a 6-week festive season, in which office parties, food gifts and cookie displays at the office are interspersed between holiday meals. While one meal can only add so much, 6 weeks can open the floodgates.

A review in the journal Obesity, looked at six studies in adults, demonstrating significant weight gain over the holidays in five of them. In one of the studies following 195 people over 6 weeks, from late November to mid-January, the participants gained an average of 0.8 pounds – which they kept on one year later. Weight gain was even greater in the other four studies and ranged from 1.2 to 2 pounds!

The review examined another six studies of people trying to lose weight, and those fared no better: they gained on average 0.6 to 2 pounds. So even when the intent is to lose weight, even when people are watching their weight, the holiday season stands in their way.

Binges and steady indulgences

It’s interesting to compare holiday weight-gain studies findings to those of studies of overfeeding. In an overfeeding experiment participants were fed 1000 excess calories a day for three weeks. Not surprisingly, the participants gained more than 4.5 pounds. But they lost this excess weight within 6 weeks after the overfeeding experiment ended. Another overfeeding experiment, which lasted 100 days, resulted in greater weight gain – 18 pounds – and although much of the weight was lost when the experiment ended, the participants remained about 3 pounds over their starting point, and continued to gain weight over the years.

Another recent study, had volunteers add 1000 extra calories derived from high-calorie snacks such as chocolate, potato chips and meal replacement drinks to their regular regimen.

Five days of overfeeding had little effect on body weight and body fat, but 28 days changed body mass and fat mass: after 28 days participants gained on average 3.5 pounds of weight, of them, almost 3 pounds of fat. There were also metabolic consequences: Post-meal blood glucose levels spiked when participants overfed for 28 days and insulin levels spiked as well. These changes in insulin production and insulin clearance suggest of the emergence of insulin resistance – the body loosing its sensitivity to insulin.

These studies, each of them small, suggest that at least in healthy, young people, short-term overeating is buffered; the body regulates and shifts the excess energy so that glucose and insulin, and even weight are quite stable.

On the other hand, oversupply that lingers can take its toll and may have metabolic and long lasting consequences.

Clearly, the more you repeat a damaging behavior the more of the exposure you accumulate, but beyond that, when you repeat a behavior it becomes a habit; habits stick and are hard to break.

Do you really enjoy being stuffed?

Many people comment on how stuffed they feel after the Thanksgiving meal.

Being stuffed is not a holiday core requirement.

There’s no reason to fill your plate with the most caloric-dense of the dishes offered – if you fill half the plate with the veggies you’ll lighten your load. If you watch what you drink you can shave off hundreds of excessive empty calories – sugar and alcohol in drinks add up and go unnoticed.

There’s no reason to eat until you can’t eat another bite.

But if you enjoy the occasional binge just relax about it. Overindulgence happens. That absolutely doesn’t mean you might as well just give up. One meal or one day don’t matter, you can surely get back to your healthy routine.

Make the most of the holiday. Count your blessing, not your calories.

Happy Thanksgiving,

Dr. Ayala

The healing power of gratitude

The Thanksgiving holiday celebrates giving thanks – for national events in the distant past and in our own personal here and now.

We’ve been urged to say, “thank you” by our parents, teachers and spiritual leaders. Scientists back this advice with mounting evidence. Thanks, apparently aren’t just pleasant for the receiver of appreciation; a state of gratitude improves our own health in clear and measurable ways.

Thankfulness and happiness

Gratitude, the state of thankful appreciation, is strongly associated with greater happiness. Some go as far as defining happiness as a state of gratitude. Finding what we should be grateful for, counting our blessings, leads to a sense of well being, and positive emotions shoot up.

In a study by Robert Emmons and Michael McCullough in which participants listed either points of gratitude, or, alternatively, their daily hassles, the gratitude group experienced greater happiness and well-being.

In a famous experiment led by Martin Seligman – the father of Positive Psychology –participants were asked to deliver a letter of gratitude to someone in their lives whom they haven’t properly thanked before. The positive effects from that one act alone lasted a full month!

Expressing gratitude also boosts your romantic life, keeps a marriage strong, and helps you make new friends – all these promote joy.

Thankfulness and physical health

Grateful people complain of fewer ailments and feel better, but is there proof that gratitude can actually improve one’s health?

A recent study of 186 men and women with heart failure showed that the patients with greater gratitude had less systemic inflammation.

In another randomized study the same authors demonstrated that the patients assigned to gratitude journaling – daily entries of 2-3 things they’re grateful for – had reduced inflammation markers.

Practicing gratitude: a few tips

1. Write a journal/note: Writing beats just thinking thankful thoughts. Having to write forces you to organize and formalize those thoughts.

2. If you’re already on social media Instagram/Tweet/FB your gratitude: Your thankfulness might become contagious. I follow several Gratitude Projects that are truly inspiring, and remind me to not take anything for granted. My dear friend Sheri opens my eyes to the marvel of hearing a beautiful song on the radio and having air conditioning on a scorching hot day. (If you’re not on social media, you might be promoting your wellbeing by continuing to stay away from this distraction.) 

3. At the table: Despite its proven benefits, noticing our blessings isn’t easy. Loss and bad luck are much more obvious. 

Food can be a good cue to remind us to appreciate what we have and to give some thought to the wonder of what made our meal possible. 

Plant foods – vegetables, fruits, grains, legumes, spices, herbs – depend on the accumulated knowledge and cultivation of humankind over millennia, the graces of the sun, the presence of rain, dew and irrigation, the pollination favors lent by insects, the manpower of those who sowed, weeded picked and delivered, and skip forward many many steps, to the cook who crafted and combined it all together into what’s on your plate right now. As to animal source foods: animals practically gave their lives for it. 

Food’s so plentiful for most of us, we forget how rare our state of abundance really is, and how much of nature’s bliss, people’s labor, luck, talent, experience, sweat and love went into making it.

Food, especially healthy food, could be your constant – several times a day – reminder to be grateful, this holiday, and every single day, for the nourishing gifts we receive.

Thanks are good to give, and good to receive. I hope you experience both in plenty this holiday and in the coming year.

Happy Thanksgiving,

Dr. Ayala