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Diet Myths

 Your stomach is the place where you store your belly fat.

 Diets are mostly about calorie control.

 Your brain is the only part of your body that reacts emotionally to food.

We all know about the daily skirmishes that play out in the battle against obesity. You versus the ranch dressing, you versus the dessert tray, and in the title fight, your butt versus your college jeans. But it would be a mistake to think that every weight-loss war happens at the table or in the privacy of your own closet. In fact, millions of little firefights break out inside your gut every time you eat or drink—and these are the most influential battles in your personal crusade against excess weight. Deep inside your éclair-encrusted gut, you have cells and chemicals that react and respond to food in two ways: as an ally or as an enemy.

As we move along in our digestive journey to the second half of our digestive system, we’ll explore these battles and how they influence your waistline. Here, your body doesn’t just form allies or fight enemies according to how many calories a particular food has, or how greasy it is, or whether its mascot is a red-haired clown. When interrogating nutrients as they pass through your digestive system, your body classifies them by what kind of inflammatory effect they have; the enemies contribute to inflammation, and the allies quiet it.

We’re not just talking about the inflammation that happens when your belly balloons to the size of a convention center, or the inflammation that happens to your joints if you have arthritis. We’re talking about the chemical reaction of inflammation that happens within your bloodstream and is an underlying cause of weight gain. This process is like the rusting of our bodies. Just like metal rusts when exposed to oxygen, inflammation is caused when oxygen free radicals (no political affiliation) attack innocent bystanders in our bodies.

Inflammation happens on many different levels and through several different mechanisms, many of them having to do with food. Not only can you get inflammation through allergies to food, but you can also get inflammation in the rest of your body—through the way your liver responds to saturated and trans fats, and through the way your body and belly fat respond to such toxins as cigarettes and stress. In turn, these inflammatory responses can cause things like hypertension, high cholesterol, and insulin resistance—and those inflammatory responses influence the total-body mother of all inflammation in your arteries, which leads to heart disease. (We’ll discuss these at length in the next chapter.)

How Tolerant Are You?

With more than 100 million neurons in your intestines, gastrointestinal (GI) pain is immediate, but the level of GI discomfort you feel depends on your genetics; specifically on your tolerance of or allergies to certain foods and your genetic disposition for feeling the effects of those GI land mines. While there are certainly pharmaceutical solutions for dealing with the digestive explosions, there are also foods that produce an anti-inflammatory effect and can come in and put out the fire (see YOU Tips). During these inflammatory firefights, your intestines are contracting too much, or are being dilated-a painful process that works through the vagus nerve. Too much stimulation or distension of the bowel is what causes the pain. Some of us are less sensitive to those internal motions, so we may not always be getting the clue from our gut. These are some of the more common GI firestorms involving food intolerance:

 Enzyme deficiencies: When your intestines lack enzymes to metabolize specific foods like milk or grains or beans, the food remains undigested, so you start feeding your intestines’ ravenous bacteria. The result: lots of intestinal dilation and more gas than a Hummer fuel tank. The most common of these is lactose intolerance (the lack of GI agreement with dairy products), and a close second is an allergy to the protein gluten from wheat (and rye and barley; nutritional good guys). As an example, when you lack the enzyme lactase, the sugar lactose in the milk reaching your intestine is not metabolized, so it’s presented to your intestinal bacteria, which metabolize the lactose in your intestines, producing a lot of gas.

 General GI disorders: Problems like irritable bowel syndrome, which causes gut-related symptoms like diarrhea and abdominal pain, are caused by sensitive nerves and result in inflammation in the intestinal walls. For example, we usually all pass the same amount of gas a day (about fourteen times, or 1 liter total), but some of us sense discomfort from that gas more than others do.

 Psychological responses: Food aversions can develop if, say, a person had a bad vomit-inducing shrimp dinner one night. The response would be to associate the shrimp dinner with the painful aftereffects and avoid it.

Of course, there are a number of extreme-end GI problems like infections, parasites (worms are the world’s most successful weight-loss technique-but we don’t recommend the Fear Factor diet), and violent and even lethal allergic reactions to food. The point is that we all may have degrees of intolerance in ways we may not even recognize. And we need to start listening to what our small intestine is trying to tell us about what we eat. Once you recognize that the general sense of “feeling off” can be caused by the foods you eat you can identify—and work to eliminate, reduce, or substitute-the substance that makes your gut twist like an animal balloon.

FACTOID

For those of you who’ve stayed up wondering, here’s the reason why your gas may smell and other people’s gas may not: Think of your body as a refrigerator. If you let food sit in there, it’s going to smell after a while. In your body, sulfur-rich foods like eggs, meat, beer, beans, and cauliflower are decomposed by bacteria to release hydrogen sulfide-a smell strong enough to flatten a bear. Avoiding these foods is the ideal solution, but when stinky gas persists, the best solutions are leafy green vegetables and probiotics (specifically lactobacilli GG or Bifidus Regularis), which work like baking soda in your fridge to reduce odor. Beano can sometimes work with beans, but soaking the beans ahead of time is useful as well.

Here, we’ll look at how inflammation happens at the gut level, and then, in the next chapter, how that can lead to inflammation at the total-body level.

Inflamed Gut: The Intestinal Firefights

At the intestinal level, foods can cause inflammation of your intestinal wall through such things as allergies, bacteria, or other toxins. When food incites inflammatory responses in your gut, it’s as if a grenade has been launched throughout your digestive system (see Figure 4.1 on page 81). Then in response to this already damaging grenade, your body tosses more grenades to create an apocalyptic digestive War of the Worlds. The effect is that the more inflammation we have in our intestines, the more toxins can enter our bloodstream.

During this firefight along the digestive border, your body perceives a foreign intruder and assigns its special forces—mast cells and macrophages—to eliminate the culprit. These are the cells that start an immune-response process throughout your body by ingesting foreign elements and alerting the rest of your body’s protecting cells that intruders have entered the area. Foods that don’t agree with your body’s sensibilities are seen as foreign invaders, so the macrophages attack these foods and tell everyone that this war is going on. This causes your whole body to start firing away at these foods and at innocent bystanders—and thus causes inflammation in your bloodstream. In that way, eating unhealthy food is really like having a chronic infection that triggers an immune response, which then causes inflammation.

One of your body’s goals is to get glucose into your brain cells—to feed those brain cells so that they can function. But inflammation in your body prevents sugar from getting to those cells, so you end up wanting more glucose and eating more sugary foods, which then increase inflammation and starts the whole cycle again.

FACTOID

Probiotics like lactobacillus GG or Bifidus Regularis repopulate your small intestine’s bacteria with healthful bacteria, especially after a course of antibiotics. The good bacteria calm down the dangerous ones-meaning that they can help you have less GI irritation, less gas, and less risk of an inflammatory uncivil war breaking out.

While we should be concerned about decreasing our body fat, we should also concentrate on decreasing our body’s inflammatory response so we become more efficient in managing potential complications of our waist size. There’s some genetic component to inflammation (some us have more than others, and smokers tend to have higher levels of inflammation than nonsmokers). Most important, the process of gaining weight is often a process of inflammation. YOU-reka! When you decrease your body’s inflammatory response, you will decrease your weight and waist as well.

The more inflammation you have, the less efficiently you use your food calories, and the worse you feel. The worse you feel, the more bad foods you eat to try to make yourself feel better. The more bad food you eat, the less well you can respond to the normal stresses of life, and the more inflammation you experience. And the more inflammation you have, the higher your risk of developing:

 diabetes

 high blood pressure

 bad cholesterol numbers

 and all of the other conditions that contribute to your increase in size and your decrease in health

Plain and simple: Inflammation ages your body by making your arteries less elastic and by increasing atherosclerosis (the rusting of blood vessels). Inflammation also makes it more likely that your DNA will be damaged, and a cell will become cancerous. And it increases your risk of infections. If the inflammatory mediators are fighting in the arteries, they can’t be defending elsewhere, and this situation increases the risk that your body will turn on itself, causing an autoimmune disease in which you attack your own tissues (for example, some forms of rheumatoid arthritis and thyroid disease).

FACTOID

We have two main sources that power nature’s rear-propulsion system. Gas comes from the air we swallow (20 percent) and the digestion of foods by bacteria in our intestines (80 percent). These bacteria love digesting sugars, fiber, or milk (if you’re lactose-deficient). The result is lots of gas made up of carbon dioxide, nitrogen, and methane (which—duck!—is flammable). You can reduce swallowing air by avoiding cigarettes, gum, and carbonated beverages, or by eating and drinking more slowly.

Inflammation stresses your body

Inflammation fattens your body.

Obesity isn’t just a disease of doughnuts and baked ziti. Obesity is a disease of inflammation. As we travel through the rest of our digestive journey, well be stopping at three digestive landmarks to see how foods influence inflammation and how inflammation influences fat:

Your Major Interstate of Food: Your Small Intestine. This approximately twenty-foot-long organ (it’s about three times your height) serves as your second brain, deciding which foods agree with your body and which foods cause your body to rebel like sixth graders with a substitute teacher.

Your Parking Lot of Fat: Your Omentum. The omentum, which is located next to your stomach, serves as your primary storage facility of fat, where you park some or (in really bad cases) all the excess foods you eat. Ideally, the garage is empty. But as we gain weight, some of our bellies are housing four stories of Winnebago-worthy fat. Most important, the omentum serves as our body’s ultimate stress gauge: YOU-reka! As we’ll explain in a moment, bigger bellies indicate higher levels of inadequately managed chronic stress—which causes chronic levels of inflammation.

Abdominal Pain Is a Pain in the Neck

Your abdominal discomfort may be caused not by what’s happening inside your belly but by what’s happening outside. According to one researcher, there’s such a thing as Tight Pants Syndrome, which is abdominal pain lasting two to three hours after a meal. Its cause? Yup: pants that are too tight. (The researcher says there’s as much as a three-inch difference between waist size and waistband.) Funny, but the same thing happens with men and shirt size. Two-thirds of men purchase shirts with a neck size that’s too small, so they get headaches, changes in vision, and even changes in blood flow to and from the brain.

Your Post Office Processing Facility: Your Liver. Your liver is the second-heaviest organ in your body (the largest, your skin, is actually twice as heavy) and is your body’s metabolic machine. Your liver works a lot like an urban postal center, taking in all the incoming mail (in terms of nutrients and toxins), sorting it, detoxifying it, and then shipping it off to different destinations for your body to use as energy.

While the three organs all play different roles, the upshot of their relationship is this: The small intestine initially processes your food, and your omentum helps store it. Inflammation occurs in your small intestine and omentum, but the big battle happens in your liver, where the mother of all inflammatory responses takes place. That’s the one that makes you store fat—and experience the unhealthy effects of it.

FACTOID

Fat is like an organ, but the omentum is the supercharged version. Omentum fat has more blood supply than any other kind of fat and is quickest to mobilize itself to feed the liver.

Yes, we know that in-your-gut physiology isn’t always pretty, but we want you to keep in mind our main gut goal: By understanding how food travels through this leg of your digestive system, you’ll be able to identify the foods that will help you reduce harmful and weight-related inflammation. When you do that, you’ll have signed a digestive peace treaty that can end the war on your waist.

FACTOID

About 10 percent of Americans have fatty livers that are overwhelmed with fat sent from the intestines and omentum for processing. Fatty livers can lead to fibrosis-reduced liver function, and even the serious liver disease cirrhosis over time, although for most folks, you just end up looking like foie gras on the insides.

Gathering Intelligence

They say that a woman thinks with her heart, and a man thinks with his personal periscope, but when it comes to sheer anatomy, the organ closest to your brain isn’t the one that flutters over a midnight serenade or the one that tingles over a lingerie catalog. It’s the one that coils through your gut like a sleeping python.

From a purely physiological standpoint, your small intestine functions as your second brain. It contains more neurons than any organ but your brain (and as many as your spinal cord), and the physical structure of the small bowel most resembles that of the brain. In addition, after your brain, your small intestine experiences the greatest range of emotions—in this case, your feelings manifest themselves in the form of gastrointestinal distress. In your brain, you react to actions: You feel love when your spouse holds your hand, mad when he forgets an anniversary, humiliated when he takes off his shirt at the Bears game and thumps his densely forested chest for a shot at being on SportsCenter. Your small intestine does the same thing. It reacts to foods that enter its pathway, depending on their anti- or proinflammatory effect. Your foods dictate whether your small intestine feels mild annoyance (a little bloating), anger (gas), stubbornness (constipation), or all-out temper tantrums (a thar-she-blows case of diarrhea).

Of course, you’re the one who decides what foods you’ll eat, but your small intestine works like an undercover agent—gathering information about all the nutrients and toxins that enter your body.

Your small intestine feels. Your intestine thinks. And your intestine performs a critical job during digestion: It helps guide you in all of the decisions you make about eating, because it tells you which foods agree with your body and which ones don’t. How does it do that? Through the absorption of those foods. Your small intestine has an absorptive surface area that’s 1,000 times larger than its start-to-end length because of all of the accordion-like nooks, crannies, and folds within it. Those spaces are where your body actually absorbs nutrients. So your intestinal absorption area isn’t just 20 feet long; it’s the equivalent of 20,000 feet long. No wonder you absorb so much of what you eat. When you have inflammation in the wall of your small intestine (through a food allergy or intolerance), it dramatically cuts down on that absorptive surface area—from about 2 million square centimeters to 2,000 square centimeters—because of swelling and poisoning of the functional surface cells. And if the intestine can’t absorb nutrients, you experience an upset stomach and diarrhea.

Why Some People Stall

We’d like to think that our bodies work like cars-press the accelerator to go faster, tap the brakes to slow down. But our body’s metabolic switches don’t quite work that way: We may not gain or lose weight at the rate in which we expect to. When we have inflammation, our bodies are less efficient meaning that we burn more calories-as a way to protect you, even as you gain weight. As we lose weight and decrease inflammation, our bodies go back to being efficient, and we may not burn calories at the proportional rate in which we gained them. So when we eat the right foods and more efficiently metabolize them, weight also may stall temporarily-meaning you still may be heavy, but might not have as many health risks associated with the weight.

While we’re all familiar with those overt, emergency intestinal crises, our intestinal emotions also influence us in ways we don’t normally associate with food. The reason we may feel groggy or have less energy than a drained nine-volt could be because our intestines are trying to tell us we’re choosing the wrong foods. If you pulled out the small intestines of your entire family and laid them on the back deck to compare them (latex gloves, please), you’d see that they all look alike; they’re the classic, wormy tubes that wind throughout your gut. In terms of basic physiology, we all have the same intestines, just as we all have the same basic brain structure. But just as all of our brains don’t function the same way even though we have the same parts, our intestines don’t function the same way either. YOU-reka! Our intestines are as different as our smiles, as our laughs, as our political views, as our fetishes. A particular food can make one person feel energized and make another person feel as lethargic as a rag doll.

FACTOID

You may hear that celebrities get colonics because they seem like some sort of miracle weight-loss cure. Here’s how they work: You get a tube pushed up into your lower intestines (via your back end). You’re infused with a solution, and you roll around to wash out your colon, then the fluid gets sucked out (you’re given coffee, to help you go to the bathroom quickly). The purpose is to cleanse out the toxins and “reboot” your intestines. You’ll produce a lot of waste after a colonic, but the main waste here is of money. Your colon only absorbs water, so there’s no weight-loss benefit from colonics. In fact, you can get the same colon-cleansing and toxin-eliminating effect with a twenty-four-hour fast.

Anatomically, your intestinal wall is Clint Eastwood tough. With more than a trillion bacteria living in your intestines at any given time (most of them helpful, but at least 500 species of which are potentially lethal), your body protects itself with a fortified infrastructure to keep the bacteria out of your bloodstream. But your body—though it relies on that Fort Knox-like wall—has to have a way to give clearance to authorized visitors. That is, it needs to allow nutrients to get through the wall to your bloodstream so you can use food as energy to keep your organs functioning, to go to work, to pry the kid’s fingers from the panicked frog’s leg. (One of the ways this penetration system works is through bile, which tricks the wall’s security so fats can get through to the bloodstream.) This selection of what stays in your intestines and what can cross the line is one of the least understood anatomical processes, but it’s part of the inflammatory battle that plays out daily in your body. When your intestinal wall is inflamed, some unauthorized visitors get in.

Figure 4.1 Internal Conflict Food and toxins continually line the frontier of our intestines. Good foods slip through to provide us nutrition, but combatants stimulate an aggressive response from local immune cells. The resulting inflammation causes swelling, gas, and belly cramps.

FACTOID

While hundreds of herbs and supplements have been purported to help you lose weight, many of them have not been studied well enough to support those claims and are not regulated by the FDA. Safety can be an issue-as was the case with ephedra, which helped people lose weight through adrenalinelike action but put them at risk of heart attacks. Here are some common herbal remedies and why they may not be all they’re supposed to be, which is why you shouldn’t put your weight-loss faith in any of them:

 Calcium: It’s been touted as an ingredient that speeds weight loss. Studies have shown that those with low calcium are more likely to gain weight and be overweight. But the people who lost weight with increased calcium were also on short-term, calorie-restricted diets, so the weight loss was more predictable than an Oscar winner’s speech.

 Bitter orange: It’s been shown to decrease weight but has the same side effects as ephedra, such as increasing heart rate and blood pressure.

 Chitosan: It’s extracted from the shells of shellfish, and the theory is that it works a little like some weight-loss drugs, by blocking fat absorption in your body. But studies show that chitosan doesn’t lead to weight loss.

Essentially, alien bacteria are living in your intestines, trying to get into your bloodstream to multiply (which is their goal) and cause havoc, but they’re being fought at the intestinal wall by those who guard it. (Your gastrointestinal tract, but especially your intestines, is one of three places where your body interacts with the external world; your skin and lungs being the other two.) In your small intestine, your mast cells and macrophages, which are part of your immune system, serve as the bowel brigade, fighting alien invaders.

When foods enter the small intestine and are transported across the intestinal wall, they’re met by this bowel brigade border patrol, which screens the nutrients. The bowel brigade lets the food through because it has an authorized ID card—it’s food, and your body wants it. But if it’s the wrong kind of food, or if it’s got some toxins with it, your bowel brigade responds by calling in more mast cells and setting off time-released bombs throughout your intestines. This is where the inflammation firefight starts. The result? Pain, gas, nausea, or general GI discomfort.

Milking It

If you suffer from a milk allergy, it can make your gut feel like a washing machine in the rinse cycle. Here are some ways you can help manage it:

 Milk’s one of the easiest ingredients to substitute in baking and cooking by using an equal amount of either water, fruit juice, or soy or rice milk.

 Watch out for hidden sources of dairy. For example, some brands of canned tuna fish and other nondairy products contain casein, a milk protein. The U.S. Food and Drug Administration (FDA) is currently working on requiring products to eliminate the term nondairy if they contain milk derivatives.

 In restaurants, tell your server about your allergy. Many restaurants put butter (which comes from milk) on steaks and other food after they’ve been grilled or prepared to add extra flavor, but you can’t see it after it melts.

 Some ingredients seem to contain milk products or derivatives but actually don’t. These are safe to eat if you have a lactose allergy: cocoa butter, cream of tartar, and calcium lactate.

By the way, there’s a higher ethnic predominance of lactose intolerance in those of non-European origin. It’s just another example of how genes-not willpower-help dictate what you can and cannot eat.

Why is this crucial? Not just because of the initial inflammatory reactions, but for the role it plays in your eating emotions (your small bowel is your second brain, and 95 percent of your body’s serotonin, which is a feel-good hormone, is in your gut). How you feel influences how you eat, and how you eat influences how you feel. When you eat food that makes you feel bad, you self-medicate with food that may make you feel good in the short term but will actually contribute to both inflammation and weight gain. Ultimately, when you’re caught in a cycle of feeling bad and eating worse, you’ll create a chemical stress response in your body—one that’s handled by your parking lot of fat.

FACTOID

About 2.5 percent of us suffer from milk allergies, making it the most prevalent of food allergies. While allergies to dairy products are generally outgrown, peanut allergies are not (and they’re the most potentially lethal). By the way, it seems like allergies are more prevalent the earlier in life we’re exposed to the foods.

Figure 4.2 Belly Up Not all fat is skin-deep. Deep down under your muscles, the omentum drapes off the stomach like stockings on a hanger. As we store fat the omentum wraps around to give us the dreaded beer belly.

FACTOID

Most of our body parts are adaptable enough to use multiple energy sources to survive. Only two organs need sugar directly: the brain and the testes. Evolutionary hints often come in these forms of clues.

The Storage of Stress in Your Belly

The best way to tell how stressed you are: Take a look how much belly fat you have. The larger your waist, the higher your stress.

Along the intestinal freeway, the parking garage for fat that is your omentum looks like a stocking draped over a hanger (the stomach is the hanger), but changes depending on how many calories you’re storing (see Figure 4.2). In a person with little omentum fat, your stomach looks as if it has nylons hanging off it—thin, permeable, with some webbing. But in a person with a lot of omentum fat, the hanger looks as if snow pants are hanging on it—the fat globules are so fat that there’s no netting or webbing whatsoever. (While cells can convert to fat in the liver, getting fatter is more a case of your existing cells growing. When you add body fat, you don’t get more fat cells, just more fat in each cell.)