A study on the effectiveness of an ADHD drug on Binge Eating Disorder was published in the journal JAMA Psychiatry. Doctor Freedhoff explains the significance on his blog, Weighty Matters, in the post from January 15:

Yesterday a study was published in JAMA Psychiatry. In it researchers looks at the impact of 14 weeks of 3 different doses of lisdexamfetamine (Vyvance) on binge eating disorder and weight in 260 patients via a randomized, double-blind, parallel-group, forced dose titration, placebo-controlled trial. Eligibility for the study included meeting the DSM-IV criteria for binge eating disorder, having a BMI between 25 and 45, and being between the ages of 18 and 55. There were a boatload of exclusion criteria with perhaps the most important being having any other eating or psychiatric disorder, having had a history of substance abuse, or having been recently treated with a psychostimulant, or having had a recent psychological or weight management treatment history.

The study's primary endpoint was the number of self-scored binge eating days, and among the secondary endpoints was weight.

The results were striking, especially in those taking the highest dose who nearly stopped binging.

Weight loss was also not insignificant, again, especially with the higher dose, with those folks losing an average of nearly 10lbs over the 11 weeks (versus an average loss of 1/5th of a pound for those taking a placebo).

Unfortunately there were also side effects with dramatically more people in the highest dosing arm reporting dry mouth, and insomnia. All told 5% of the highest dosing arm dropped out due to adverse effects.

While far from conclusive, this study is promising. Binge eating disorder is a tremendously difficult condition to endure. Psychologically it can be devastating due to overwhelming feelings of guilt which in turn can lead to decreased self-esteem and decreased perceived self-efficacy. Right now treatment for binge eating disorder involves cognitive behavioural therapy, and indeed, there's fair success, but were there a safe medication that could be used as an adjunct to counselling, speaking personally, I'd be thrilled.

There's still lots of work to be done to prove long term efficacy, safety, and tolerability. Fingers crossed.


What I find the most heartening about the study is the fact that it was even done. So much money is invested in magic weight loss pills, where the focus is on how to burn fat or alter the body ... especially without having to change eating or exercise habits. Whether Vyvance is as effective as it appears to be, based on a preliminary and relatively small study, I like that they're (a) looking for drugs which help to alter behaviour, and (b) that B.E.D. is being taken more and more seriously as a legitmate psychological condition.

It's a small ray of hope, but it's still a ray.

Baloney is putting it mildly. BMI is a load of bull. And the misuse of the Body Mass Index as a measurement tool muddies the waters when we talk about obesity, and contributes to systemic fat shaming.

BMI = weight(kg)/height(m)2

Now, I'm not mathy. Numbers are not my strong suit. But even I can see that it's a relatively arbitrary formula that does not take into account all the variables which measure health. BMI doesn’t differentiate between muscle and fat, it just takes your weight and height into account. It doesn't measure your overall body fat. Leaving aside the "muscle weighs more than fat" argument, which is mainly applicable for elite athletes, more than the general population, the formula is especially flawed because it doesn't take into account where the fat is stored. And that does make a difference. Belly fat and visceral fat is far worse for your health than the blubber on your butt or under your arms. It's the waist that matters - it's what I mean when I refer to "my gut." So, even if BMI did accurately measure body fat (and it doesn't: it only measures body weight), it still wouldn't tell us accurately how healthy a population or an individual is.

So, why use it? BMI was never really meant to measure an individual’s weight or health, or to put individuals into categories. It was developed over 200 years ago, and was meant to be used as a tool to measure the overall "health" (or average weight) of a population. "The BMI was introduced in the early 19th century by a Belgian named Lambert Adolphe Jacques Quetelet. He was a mathematician, not a physician. He produced the formula to give a quick and easy way to measure the degree of obesity of the general population to assist the government in allocating resources." We do need ways to track populations and general trends, so that health care decisions and policies can be made, and using BMI in that way makes some sense ... IF you understand what is being measured. When we use BMI, we learn obesity rates. What worries me is how much obesity is being correlated to health. There are a lot of assumptions that go with the term "obesity." A better measure of a population's health would be body fat percentages, but BMI only measures overall weight.

Where it becomes really problematic is when statistics show sharp increases in obesity, and words like "epidemic" and "crisis" start getting thrown around. It's how we've arrived at a point of declaring war on obesity, how fat shaming children has become acceptable, and how screening programs in schools and workplaces seem like a good idea to administrators. What is discussed far less is that BMI category cut-offs got lowered over 10 years ago, so people woke up one day without changing one bit, only to all of a sudden be labelled overweight or obese when the day before they had been normal. This also partly accounts for the sudden increase in “overweight” people, leading to all the hysteria about the Obesity Epidemic (like fatness is somehow contagious). While lifestyles are changing and are more sedentary, when stats are used to back up the “Obesity Crisis” it’s usually traceable back to when they changed the category numbers, making it look like there was a huge spike in fatness.

What's needed is better science, and clarity in statistical analysis. How obese the population is doesn't really tell us how healthy it is, yet decisions are made based on our collective fatness. If the stats helped hospitals to purchase more beds and equipment that fit the morbidly obese, or if the stats helped city planners to include more bike lanes and sidewalks and to limit the number of fast food restaurants in areas around schools, or if the stats supported insurance companies to cover claims which currently are paid out-of-pocket, then I wouldn't be as outraged by the continuous mis-use of the BMI. That's not the case. Instead, the stats are used for headlines to hype up a crisis of epidemic proportions, which people are expected to address on an individual level. Therein lies the blame and shame.

On that individual level, don't worry about your BMI. Worry about your HEALTH. If your doctor or fitness professional uses the BMI and nothing else to determine your weight category, call them out on it. There are far better ways to determine whether you need to lose weight, and how much. Or whether it's affecting your health. "A more reliable, but still relatively simple, assessment of fatness would rely on a skin-fold score based on measurements taken with a caliper at several areas (in men, the thigh, midchest and abdomen, and in women, the thigh, triceps and area above the hip bone) that reflects the amount of fat under the skin. Or, since abdominal fat is more hazardous, simply take a tape measure around the widest part of the abdomen and another at the hips and calculate the waist-to-hip ratio. For men it should be no higher than 0.90, and for women no higher than 0.83." In addition to your waist circumference and body fat percentage, any medical professional should be assessing blood pressure, blood glucose levels, cholesterol, and heart rates.

We simply can't leave our health to an outdated, ineffective formula.

Because, as I keep trying to remind myself, you can't tell how healthy someone is or isn't just by the size of their body.

More arguments about BMI and why it's not as clear-cut as we are led to believe:

• Obesity rates: is the BMI a good measurement? (CBC News)
• Nevermind your BMI: to measure your health, it's all about the waist (The Globe and Mail)
• Weight Index doesn't tell the whole truth (The New  York Times)
• Top 10 Reasons why the BMI is bogus (NPR)
• The Duh Truck rides again (Shapely Prose / Kate Harding)
• Yes, Virginia, the BMI is BS (Dances with Fat / Ragen Chastain)
• Don't expect government to win the war on obesity (The Globe and Mail)

When Facebook puts a "Gut" related news item in my direct path, it begs to be shared. How much gutsier can you get than the G.I. tract? I've heard about "gut flora" but it's one of those things that you can't see, that you don't necessarily feel until it's out of whack, and that is harder to manage because it's not at all sexy. But it's important. So check the full article out: The Case for Good Gut Health by Jaime Martinez

Here are some highlights from the article:

The primary focus of every nutrition plan should be the health of the gastrointestinal (GI) tract. It doesn’t matter if you’re sedentary, an athlete, overweight, or lean. The gut is key to your optimal health.

The GI tract is an impressive and intricate organ. About 30 feet long and comprised of trillions of cells, the GI tract provides a secondary line of defense (after the skin) against toxins, and is the primary line of defense for anything harmful we ingest.

70-90 percent of our immune system is found in the gut.  Of the trillions of cells in it, 100 trillion are bacterial cells, and these cells have a profound effect on our health.

The collective group of both good and bad bacteria in the gut is called the gut flora. Gut flora help maintain the integrity of the lining of the GI tract three ways:

• First, they convert unabsorbed dietary sugars into short-chain fatty acids, which are a major source of energy for epithelial cells.
• Second, they adhere to the mucosa, forming a protective layer and blocking harmful bacteria.
• And third, they secrete immunoglobulin A (IgA or sIgA), which is an antibody that plays a critical role in immunity and helps prevent infection.

The gut flora can also assist in preventing allergies by balancing the histamine response and down-regulating inflammation.

Sugar, additives and preservatives, pesticides, herbicides, hormones, and antibiotics all have an impact on the balance of good and bad bacteria. Non-dietary influences include prescription and over-the-counter medications,
such as NSAIDS, stress (physical, psychological, or physiological), radiation, immune deficiencies, and aging.

As harmful bacteria levels rise, the intestines become more permeable, making them less likely to keep harmful pollutants out and to aid in the absorption of nutrients. Bacteria, toxins, and undigested proteins and fats can leak into the bloodstream and trigger an autoimmune reaction, which increases the levels of histamine, cortisol, and cytokines.  This situation is often referred to as “leaky gut syndrome.”

When the health of the gut continues to decline, food sensitivities and autoimmune disorders can develop.

Our digestive health and function largely determines our ability to maintain optimal health, fitness, and performance.

The folks at Precision Nutrition have done it again: taken a complex topic and explained it thoroughly both in an article and in a handy infographic.

The full article can be found at http://www.precisionnutrition.com/workout-nutrition-explained. As always, I favour those who offer balanced and sensible advice, and the PN staff deliver. Not only do they break it down by body type ('cuz we're not all exactly alike, after all), there is also an acknowledgement in the article that for many people there is no need for the complex and confusing detail behind nutrient timing. First, figure out your specific goals, and THEN work your nutrition around it.

I trust science. I do not always trust how science is interpreted. It's the reason there is so much confusion and misinformation about health, fitness, and - especially - weight loss.

So, when anyone tackles the pursuit of truth in a balanced, researched, unbiased and amusing way, I pay attention. Especially when they are also amazing people in real life. I got to catch up with Mitch and Greg at camp this past weekend, the duo behind ASAP Science. What can I say? They're smart, and I trust their mad research skillz. They're not bad with a white board and dry-erase markers, either.

I've included some of their videos on this blog already, like the one about sleep. And when I try to get science-y myself, to figure out or explain things like Ghrelin and Stress, I think about how they might pare it down to the simplest explanation and infuse it with humour. Because, let's face it, to tackle topics like morning wood, why babies are so cute, or whether silent farts are worse takes a sense of creative whimsy.

But the ones I'm most interested in are related to health and fitness. There are plenty. The effects of water. Sleep. Stress. Stretching. Their series of videos made for CBC during the winter Olympics are all about sports, competition, and athletes. Totally fitness-related!

Whether you're ready to unleash your inner science geek, want to waste time on YouTube but are sick of videos about cats, or just want to understand answers to burning questions about daily life, Greg and Mitch have done a great job of making science entertaining and accessible. Check out all the cool videos they've made on the ASAP Science channel.

I'll admit it: I am the queen of "15 more minutes." As it turns out, that could be hurting me more than helping, when it comes to my sleep patterns. The amount of sleep that you get is important. It's a fine balance between not enough and too much. So you would think that if you wake up tired, and hit the snooze button, you'd be doing yourself a favour. You'd be wrong.

The National Sleep Foundation defines sleep inertia as "the feeling of grogginess and disorientation that can come from awakening from a deep sleep." It slows down your decision-making abilities, impairs your memory and hurts your general performance once you do get out of bed. The impact can be felt throughout the entire day. You throw off your whole circadian rhythm when you interrupt your sleep cycle, because you re-set it and start over when you hit snooze or when you re-set your alarm. Do this enough times on a regular basis, and you're not just making yourself dumber through the day, you are putting yourself into sleep debt. Chronic sleep deprivation. And THAT correlates to a higher body mass index (ie: makes ya fatter).

When I'm in a consistent routine of waking up early, it's the easiest to just get out of bed. Even when I'm still sleepy and groggy. Last summer, when most of my workouts or classes were in the mornings (early, early mornings), I got myself into the best routine I've had for years. Wake up, hop out of bed, never look back.

Lately, I've reverted to more after-work classes at the gym, leaving my early mornings open. While I've tried to maintain the habit of getting up at the same time, what I inevitably end up doing is re-setting the alarm. Negotiating with myself. The list of things I was going to do in the morning? Meh. Can wait. Always seems less pressing in the wee hours than it did the night before. And so I go back to sleep. Again and again.

The problem with this method is that it interrupts the regular sleep cycle. The boys at ASAP Science explain it well in this video. (And, shout-out here to former camp staff Greg Brown, who is the illustrator of these videos. While I'm terribly proud of him for the success of ASAP, I can't help but picture the young camper I watched grow up, when I see these. Thank goodness he grew into one smart dude. You can trust the science.)

I don't use the snooze button - I don't trust it. Instead, I actually re-set the alarm for another time. Sometimes it's 15 minutes. Sometimes longer. I totally do the backwards math of "if I have to be at work at this time, I have to leave the house at that time, so I have to shower before this time..." And no matter what I decide the night before, especially when I'm feeling all responsible and like "of course I'll have the energy to get up and put in a full day's work before I leave the house" I really never do.

At some point I should just acknowledge that I'm probably going to go back to sleep, and set my alarm accordingly, so that I am waking up at the time that I intend to get up.

Starting this week, four of five weekdays will be early-ish workout mornings. It's only Tuesday evenings that are the consistent class time at the gym. Which is why, this morning, I set the alarm for 5:45 am ... and then again for 6:15 am ... and then again for 6:50 am ... and finally got out of bed and got going well after 7:15. Best intentions, and all. Didn't help having the rain pounding the window, and without a pressing reason to get out of bed, it was pretty hard not to re-set the alarm. Next week? I'll just be more realistic and set the alarm for a decent time, allowing for a sleep-in, without interrupting my sleep cycle over and over and over.

People often ask me questions about nutrition and exercise, which makes me laugh a little, because I’m no expert. I read a lot, but I am stumbling through this as much as anyone else. I mean, I can tell you what I've chosen to do, and why, but what's right for me will not be right for someone else because we are all so different. And, let's face it, I might not even be doing what's right for me. It is an evolving process to figure it out. For example, this question was submitted to the blog:

Have you researched the highly advertised appetite suppressant PGX? It sounds safe... But would it really be that much more effective than a couple glasses of water and an apple? Also do you use whey powder in smoothies? What are the best plant-based protein sources?

I’m going to give you the most librarian answer there is: QUESTION EVERYTHING, and do your research.

While I can't necessarily provide answers to direct questions (again: not an expert, just opinionated or well-read in some areas), I *can* provide guidelines on how to research and decide for yourself!

When it comes to anything related to “diets” – whether it’s a new study, a pill or supplement, or a fad diet itself, I trust no one. I research the hell out of it before deciding to try something. First, I try to find out “is this potentially harmful? What are the negative side effects or consequences?” If I don’t find any, then I’ll ask: “does it work?”

More often than not, if it’s not actually harmful, it’s not effective.

So, let me break it down. When you hear about the latest and greatest, these are the questions you should ask yourself:

• Who stands to profit from this? And am I seeing an advertisement or press release carefully disguised as a blog post, article, or testimonial? There’s nothing wrong with someone making a profit, but you’d better question their motives if it’s all about the bottom line. Is a celebrity schilling it? Because chances are, if it needs an endorsement, it probably can’t stand on its own feet. Frankly, my rule of thumb is that if Dr. Oz is promoting it, it’s crap. That’s perhaps not fair, but he will lend his name to anything. And his image gets used without permission on more items than you’d think.
• Were studies done? Who did them? Because not all scientific studies are conducted without bias. Again, the main question is who funded the study? How connected are they to the company producing the final product? Next question to research is whether it’s a peer reviewed study, and whether there are several studies that independently reach the same conclusions.
• When considering the results of the studies, think about how long they followed the participants, and how long the results were maintained. If it’s only been 6 months to a year, that’s not really long in people terms. I want to know if a pill that makes you lose weight also helps you to keep it off 5 years later, not just 5 months later. Also, were the participants mice? Because you wouldn't believe the number of conclusions reached about weight loss that are based on mice. It's a start, as far as research goes, but the results don't always translate directly to humans! I want to know about the studies with, y'know, real people in them.
  
• What are the ingredients? Many times, when you look at what is actually IN a pill capsule, you realize that you could make your own variation much more cheaply, and what you’re buying is packaging. A good example is how many products use caffeine as the magic ingredient, because it either speeds up the efficacy of the other drug it’s interacting with (like acetaminophen), or it’s what makes you jumpy and feel like something is working (in pre-workout concoctions). If caffeine’s the thing that is raising your metabolism, you might as well drink coffee, take a much cheaper caffeine pill on its own, or at least be aware of it, because if you don’t realize it, then you might just be raising your blood pressure needlessly. Or dangerously.
• Is it sustainable? How often do you take it, and for how long? What happens when you stop taking it? This is true for supplements and diets alike. Once you start, what happens if you stop? Is it something that you can maintain, in the case of a diet, for the rest of your life? (Think about shakes, meal replacements, or even severely restrictive diets: can you realistically keep to that regimen forever?)
• Can you get the same thing from a natural source? Like, raspberry ketones are a big thing these days. So is green tea, and acai berries. All of them can be purchased as pill formats, because the active ingredient for weight loss has been broken down and isolated. Wouldn’t it be better to just eat the acai berries, or to eat raspberries, or to drink green tea? Look into what the studies actually found, because sometimes the amount you'd have to ingest in its natural format (like with green tea) is so high that it would be nearly impossible to drink that much. On the other hand, with many foods the chemical compound that is the active weight-loss ingredient works best when it's part of a whole, or when combined with other elements, and it loses its magic when it's isolated into a powder. Acai berries are being promoted as a superfood for their antioxidants but blueberries are just as effective (and way more readily available, and tastier). Understand what, exactly, the studies found and what amounts are effective, and in what format, to save yourself money at the pharmacy.
  
• What’s your source? Is it credible? If you’re using Google, understand that advertising often looks the same as legitimate links. And companies pay for Google rankings. Search engines are not benign. Also, a lot of ads look like news articles. Read the testimonials carefully. You’ll notice that a LOT of them are exactly the same, even though they're promoting different superfoods, diets, or supplements. It’s ad copy. That’s how you know you’re essentially reading a press release and not a unique article, let alone a study. But you only realize this once you've read enough of them for it to sound familiar.
  

You have to do your research, and that takes time and a critical eye. Question absolutely everything.

A big problem today is oversimplification. Information gets dumbed-down to sound bites and headlines. People don't want to read a lot of text. Even a news report that is unbiased may be honing in on one aspect of a finding, or they may blow the results of a study out of proportion, which is how we get wild claims and superfoods and diet fads. Everything is over-hyped, from the weather to the obesity crisis and all the possible solutions to it. As consumers, we have to sift through the information to separate the grain from the chaff, and only select the healthy and digestible parts. It is overwhelming.

So, where do you start?

First, find a few credible sources. Having “Doctor” next to a name doesn’t mean everything, but that PhD does make someone more reliable if they are actively researching or working within an academic institution. I follow Dr. Yoni Freedhoff’s blog, Weighty Matters, because he questions policy related to obesity. Dr. Arya Sharma is an often-quoted expert whose balanced and cautious approach is based on a reasonable and realistic understanding of the science behind obesity. Both are Canadian, which can make a difference when it comes to policy or regulation. Dr. John Berardi of Precision Nutrition is also Canadian, and a trusted source for nutritional information. Not every popular or well-known name is bogus, but I trust the celebrity doctors and nutritionists and trainers - the "personalities" - far less than the people who spend their time in a lab or working with patients on a regular basis.

Start by searching for criticisms and reviews. If you just Google the diet, or the pill, or the food, you’ll have to wade through all the ads, the testimonials, the rah-rah-this-is-the-best-thing-ever kinds of results. Those sites PAY to be at the top of a Google search. So, search smart: include the word “review” or “criticism” or “negative results” in your search. All it takes for me is to find two sources explaining why something is bogus for me to believe it. Don’t fall for the positive hype! Your mantra should be "if it sounds too good to be true, it probably is."

How many sources can you find to back up the claim? This can be tricky, because a lot of news outlets pick up a story in the rush to be the first with breaking news, and so mis-information gets repeated until we believe it. Having said that, I still look to find three or more sources that seem to independently find and say the same thing, about a diet’s results, or a food’s properties, or a supplement’s efficacy. And I look to see if they are all quoting from the same original source (regurgitating the same interview or article in different packaging).

When researching online, what kind of website are you on?  The dot-coms are usually commercial and selling something. If it’s a dot-gov, then it’s put out by a governmental agency. One would hope that it makes it more credible, though that’s not always the case. These days, anyone can create a website or blog ("hi!") and say whatever they want to say. Whose site is it? Is it someone who makes their living in the fitness industry? What is their role and reputation? Is there transparency? I would find someone who wants to share information freely to be a better source than someone who requires you to purchase a subscription or service in order to access their latest and greatest secret, but if they are a professional (trainer, body builder, chef) and staking their reputation on the information they put out, it’s probably more accurate than a news magazine.

And, please, for the love of all that is accurate and factual, get yourself to a library! Don't rely solely on the Internet. While there is equally bad information in books, newspapers, and magazines, these are sources which have usually had to go through some kind of editing process. A little bit of fact-checking, so the information was somewhat accurate at the time of publication. (Always a good idea to check the publication date, because medical and nutritional information can get old and outdated FAST; go with fairly recent dates). You don't even have to go in to the library to research. Most libraries will have databases you can access with a valid library card. And a database is sort of like the Internet (it's online and you search it), except that what you're searching is a collection of magazines, articles, and encyclopedias. You know the source, you get more journals (peer reviewed! academically sound! well-edited!), and you can narrow your search to get better results.

There is so much information out there, and it's overwhelming to wade through it all. I find it overwhelming to process the accurate information, and figure out what to do with it, let alone have to take into account the myths, misinformation, and outright lies.

I may not be able to answer all the questions that come my way, or give concrete advice about what you should do. But I can always help to find a resource that will.

Made it through March Break, one of the busiest and most stressful weeks of the year if you work in the Children's Dept. of a public library. I did not make it through chocolate-free. Or icing-free. Or beer-free. Or, well, you get the idea. March Break is also the reason for the less-than-personal, non-original-content posts from the past few days.

And March Break is the catalyst for this post about stress. Well, stress and belly fat. The two seem to have a messy, tangled-up, co-dependent relationship.

This could get a little bit science-y, and I am emphatically NOT a science-y kind of person. Which is why I have had to do a lot of reading and research to boil it down. But here's what I know:

• You can't control where your body stores fat (that's genetics; you can only control gaining and losing overall percentages of body fat). Sadly, you also can't spot reduce or target where you burn your fat from.
• I have a lot of belly fat; my gut is where my body stores and clings for dear life to it. Hence the name of the blog. It's all about my Gut. I have a vested interest in trying to figure out how to get rid of belly fat, or at least how to avoid gaining more of it.
• Abdominal fat is just about the worst kind of fat. Fat in other places may be unsightly, but it's not always harmful. The spare tire? Packs serious health impacts. Deadly ones. Subcutaneous fat is the muffin top, the fat just under the skin that you can grab on to around your mid-section. Even worse is visceral fat, the kind that you can't see, but which fills the spaces in and around your vital organs. "Visceral fat has been linked to metabolic disturbances and increased risk for cardiovascular disease and type 2 diabetes. In women, it is also associated with  breast cancer and the need for gallbladder surgery." (1)
• There are two Hunger Hormones: Ghrelin and Leptin. Ghrelin increases the appetite, and Leptin decreases the appetite. It would follow that if you are trying to lose weight, you don't want to produce too much Ghrelin. You want that hormonal bad-boy kept under control.
• When you are under stress, the adrenal glands secrete the hormone Cortisol. It increases blood sugar levels. And Ghrelin levels are elevated by chronic stress.

So ... what I'm piecing together is that stress and abdominal fat are highly correlated. Nuts. So much for a simple solution.

I can't see the word "ghrelin" without thinking "gremlin." And, you know, those Ghrelin Gremlins are nasty. They increase your hunger. They decrease your willpower. They grow the more you feed them, especially if it's a high fat diet. Given the negative effects of eating too late at night, the "don't feed them after midnight" Spielberg rule is applicable.

Stupid, insidious Ghrelin Gremlins.

But, it's not all their fault. The Cortisol hormone, we'll call him Captain 'cause the other hormones pretty much follow his direction, is what tells the Ghrelin Gremlins to release in the first place.

And Captain Cortisol responds to stress. Constant stress, too many stressors, and it becomes a chronic problem. The body never relaxes. The Captain never retires or takes a vacation. So the metabolism slows down, and you are always in an unnatural fight, flight, or defeated state. Those high levels of cortisol don't just release the Ghrelin Gremlins that tell your body you're hungry. Oh, no. Those Gremlins crave sugar, fat, and salt. In fact, a diet high in protein and good carbs will help to decrease ghrelin levels (as will sleep, and relaxation). That is part of the reason that it's harder to maintain willpower in times of stress, because it's not just psychological. The cravings can be a biological response, too. More ghrelin and you're not just hungry, you're hungry for the unhealthiest stuff available. Double whammy.

Huh. Well, maybe we should go to the source, then, and eliminate stress altogether? Not so fast. There is good stress, too, which we need in order to not be completely boring. It's that competitve drive. It's what makes you do a good job. It is what makes you passionnate about something you are interested in. The flip side to caring can be negative stress. I care about what people think, about how well I do my job, about how others are feeling, and that worry and anxiety goes hand in hand with caring. I don't know how to turn off caring about some things and not others. That kind of stress is hard to eliminate, even if I am not in crisis mode with something tangible to point to as the cause, as the stresssor.  You know the kind of things I mean: injury, car accident, family crisis, getting fired, a breakup. Or the things which may not be acknowledged as a crisis by the outside world, but feel rather large to us: overdue bills, getting stuck in traffic and missing a meeting, job interviews, that sort of thing. Everything feels ... important. Rushed. Hurried. We live in a world of chronic stress, but it's not just the mental or emotional. Anything, ANYTHING that puts demands on the body causes stress (2). Like, oh, intensive exercise. And an extremely low caloric diet.

You heard that right. Dieting is a source of chronic stress. So is exercise. The top two methods of dealing with and reducing stress are also stressors. Ugh. No wonder we're caught up in a cycle that is tough to break out of. I should note here that it's intensive exercise, or over-training that is more likely the stress culprit; good exercise will release endorphins, which make you feel good. And it's dieting, in the restrictive, low-calorie sense of the word which is harmful, not changing your diet permanently. It can be hard to see the difference, especially if emotions are involved. If you feel deprived, you're creating stress for yourself, even if your body is getting good nutrition. What did I tell ya? Complicated and tangled.

Aside from changing diet and getting smart about exercise, finding a balance in both and ensuring adequate rest and sleep, there are things that I do to try and reduce my body's cortisol-releasing response to stress. I take fish oil (Omega 3 only) daily to help with inflammation. I take a Vitamin B complex, since the B's are the ones which are associated with cortisol (and which are often packaged and marketed as stress reducers. Save yourself some money, just buy a regular B-complex vitamin, because if you look closely at the ingredients in a lot of the "for stress" concoctions, that's basically what's in it). Laughing and crying are both stress releasers, and I do an awful lot of laughing. Crying, not nearly enough. I hate crying in front of people, but sometimes when I need an emotional release I'll pop in the part of a movie that I know will get me to heart-stabby levels of weepy.

Other things I know I should do, or do more of, include getting adequate sleep. More yoga with meditation. Journalling (the private kind, to vent and release and work out problems, not the blog-to-the-world kind of writing). Turn off devices and disconnect for at least 30 minutes a day (and story time programs don't count); phone, computer, TV - should be off. I need more nature on a daily basis. It really needs to be a multi-pronged approach to coping with stress, kicking Captain Cortisol to the curb, and get those Ghrelin Gremlins under control.

After all, I want to have a tight ass, not be a tight-ass.