Everyone's Health

Your mouth commits the gateway crime of your century, the rest of you is the partner in this crime

With summer in full swing and clothing at a yearly minimum, concern about weight is naturally at a maximum. You may wonder why we just keep becoming fatter despite all the diets millions of Americans have latched onto in recent decades.

Don't any of them work? And, if not, why not? Hasn't all the research into the causes and treatment of weight problems yielded clues to help most people achieve and maintain normal body weight?

Americans now spend more than $46 billion a year on weight-reduction programs, an amount that has grown more than a thousand fold in the last three decades: money literally thrown away. To be sure, genetics plays an important role in the weight problems of some people – perhaps 10 percent of those who are seriously overweight.

But genes do not account for the doubling and tripling of obesity rates among both adults and children since the '70s. For this, there is only one possible explanation: the environment in which our genes are forced to act – the foods people eat, how they eat them and how they expend the energy their bodies do not need.

For most Americans, bigger is better – bigger cars, bigger houses, bigger portions. About 30 years ago, the restaurant industry tried to introduce Americans to a French dining style called cuisine minceur: small, elegant portions served on large, usually white plates (but priced as if the plates were heaped with food).

It was doomed from the get-go. Americans want more for their money, and more is what they got – portions big enough to feed a horse.

An average serving of pasta is now 480 percent greater than the one-cup recommended serving size, Lisa Young and Marion Nestle, nutritionists at New York University, reported in 2002 in The American Journal of Public Health. Some cookies, they found, are 700 percent larger.

Drinks are in 24-ounce sizes or larger, often with free refills. And most people eat and drink what they pay for.

Only the most expensive restaurants emphasize quality over quantity, serving reasonable portions that satisfy a normal appetite and do not leave diners feeling stuffed.

A single serving of various products can supply vastly different numbers of calories. Thus, a cup of low-fat yogurt with fruit and sugar can have 240 calories, whereas a cup of artificially sweetened nonfat yogurt has 100.

Half a cup of Java Chip ice cream from Starbucks has 250 calories, but the same serving of Edy's (Dreyer's) Espresso Chip has 150. Frozen yogurt may sound less fattening than ice cream, until you read the label – 200 calories in a half-cup of Haagen-Dazs frozen yogurt.

Dr. Barbara J. Rolls and colleagues at Pennsylvania State University have recently shown that portion size acts independently with another characteristic of meals – energy density – in satisfying hunger and reducing the number of calories ingested.

What is likely to be more satisfying, a quarter-cup of raisins or two cups of grapes? Both supply about the same number of calories. How many calories are packed into a given amount of food can make a big difference in how many extra calories people consume.

The more energy-dense a food is – that is, the more calories per ounce or gram – the more calories people tend to consume.

In previous studies, Rolls found that, all other factors being equal, people eat about the same weight of food each day.

If those foods are in the moderate range of energy density (like meat, cheese, pizza and french fries) or at the high end of energy density (like crackers, nuts and cookies), people consume more calories than they do if their meals contain lots of low-energy-density foods (like soup, green salad, non-starchy vegetables and fruit).

The main ingredient that influences energy density is water. The more water in a food, the fewer calories per ounce it is likely to contain. But drinking water with meals does not have the same effect as eating a food naturally high in water like broccoli or watermelon, Rolls said.

A second important factor in satisfying appetite is fiber, which is found in whole-grain breads and cereals, brown rice and other whole grains, beans and other legumes, fruits and vegetables. Fiber adds non-caloric bulk to foods. It is filling, it holds water, and it slows the absorption of food, so people are more likely to feel satisfied.

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