Carbohydrates and insulin

For several million years, humans existed on a diet of animals and vegetation. It was only with the advent of agriculture a mere 10,000 years ago — a fraction of a second in evolutionary time — that humans began ingesting large amounts of sugar and starch in the form of grains (and potatoes) into their diets. Indeed, 99.99% of our genes were formed before the advent of agriculture; in biological terms, our bodies are still those of hunter-gatherers.

While the human shift to agriculture produced indisputable gains for man — modern civilization is based on this epoch — societies where the transition from a primarily meat/vegetation diet to one high in cereals show a reduced lifespan and stature, increases in infant mortality and infectious disease, and higher nutritional deficiencies.

Contemporary humans have not suddenly evolved mechanisms to incorporate the high carbohydrates from starch- and sugar-rich foods into their diet. In short, we are consuming far too much bread, cereal, pasta, corn (a grain, not a vegetable), rice, potatoes and Little Debbie snack cakes, with very grave consequences to our health. Making matters worse, most of these carbohydrates we consume come in the form of processed food.

That 65% of Americans are overweight, and 27% clinically obese, in a nation addicted to sesame seed buns for that hamburger, with a side of French fries and a Coke, is no coincidence. It is not the fat in the foods we eat but, far more, the excess carbohydrates from our starch- and sugar-loaded diet that is making people fat and unhealthy, and leading to epidemic levels of a host of diseases such as diabetes.

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If you are experiencing any of the following symptoms, chances are very good that the excess carbohydrates in your body are, in part or whole, to blame:

Excess weight
Fatigue and frequent sleepiness
Brain fogginess
Low blood sugar
High blood pressure
High triglycerides

We all need a certain amount of carbohydrates, of course, but, through our addiction to grains, potatoes, sweets and other starchy and sugary foods, we are consuming far too many. The body’s storage capacity for carbohydrates is quite limited, though, so here’s what happens to all the excess: they are converted, via insulin, into fat and stored in the adipose, or fatty, tissue.

Any meal or snack high in carbohydrates generates a rapid rise in blood glucose. To adjust for this rise, the pancreas secretes the hormone insulin into the bloodstream, which lowers the glucose. Insulin is, though, essentially a storage hormone, evolved over those millions of years of humans prior to the agricultural age, to store the excess calories from carbohydrates in the form of fat in case of famine.

Insulin, stimulated by the excess carbohydrates in our overabundant consumption of grains, starches and sweets, is responsible for all those bulging stomachs and fat rolls in thighs and chins.

Even worse, high insulin levels suppress two other important hormones — glucagons and growth hormones — that are responsible for burning fat and sugar and promoting muscle development, respectively. So insulin from excess carbohydrates promotes fat, and then wards off the body’s ability to lose that fat.

Excess weight and obesity lead to heart disease and a wide variety of other diseases. But the ill effect of grains and sugars does not end there. They suppress the immune system, contributing to allergies, and they are responsible for a host of digestive disorders. They contribute to depression, and their excess consumption is, in fact, associated with many of the chronic diseases in our nation, such as cancer and diabetes.

I encourage you to delve into this subject in greater detail by clicking on the links below, or by using our powerful search tool above.

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The bottom line is this: Americans need to reduce their intake of grains, including corn-based foods, and all sweets and potatoes, dramatically.

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Chew your Food

Chew On This!
Diet Education, Eating Behavior
Most researchers say that it takes about 20 minutes for our brains to realize that we are full. In accordance with this, most people who are trying to change their eating behavior are given advice to do the following – Put your utensils down in between bites, chew your food X amount of times, wait X seconds after you have swallowed to take the next bite, drink water in between each bite, stop half way through your meal and wait 10 minutes. These and other strategies like them are designed to increase the time it takes you to eat your food. The hypothesis is that taking more time will get you towards the “20 minutes mark” that it takes for your brain to register what you have eaten.

For many people such strategies can be quite helpful. They ensure that you are more mindful when you eat and that you pay attention to the signals of your body. One of the most common is – “Chew your food X number of times”. This is a good little habit to get yourself into, not so much because it will take you longer to eat your food, but because it will ensure that you eat foods that actually require chewing. Let me explain…

Food manufacturers know that the quicker that you eat, the more you eat. The more food that you eat, the more you buy, so getting you to eat quickly is of high priority for food designers. This means that they produce foods that are specifically designed to break down immediately in your mouth.  Less chewing time means quicker consumption. Quicker consumption means more food consumed. You get the picture.

They do this in a variety of ways from putting water into chicken which makes it softer and easier to chew, to adding fat, simply to make the food break down easier in your mouth, and even injecting marinade into meat so the connective tissue is destroyed making it almost “pre-chewed”.

As you can imagine, processed foods also contain additives and chemicals that reduce the effort it takes to break them down and swallow. This means that you are often taking the next bite even before you have swallowed the first. So not only are the highly processed foods more calorie dense, but you are also eating more of them because they are designed to be eaten very fast. In most situations your brain will not register the fact that you have just eaten 1,000 calories in 5 minutes, so you continue to eat.

The most important point here is that when you are choosing foods to eat, make sure that you choose foods that you actually have to chew. Foods that don’t require chewing are designed that way, and almost guarantee that you will eat more. Foods that require chewing are usually healthier options and you will eat less because it takes you a little longer to consume them.

In the past we needed to chew a food around 25 times before we could swallow it. Now it may take you 2 or 3 quick munches for the food to be headed into your stomach. Stick to foods that you need to chew and you will magically see yourself eating a lot less.

All this chewing also gives you a fantastic side effect.  Chewing enhances flavor! It’s called savoring your food.  When the food stays in our mouth longer our sense of smell really has a chance to kick in and provide an extra flavor boost.  We all are aware of this on some level – every kid knows if they don’t like the taste of something they should try and AVOID chewing and gulp the food as quickly as possible.

So slow down, chew and savor your food.  Eat mindfully.  Think about choosing foods that are less commercially processed and require a little more effort to chew.  Your stomach will be able communicate fullness appropriately and at the same time your taste buds can be really satisfied.

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Bottomless Soup Bowl

After discussing the effects of volume and duration (the “space-time continuum” as applied to dieting), Wansink describes what is probably his most (in)famous experiment, the Bottomless Soup Bowl.
The Bottomless Soup Bowl experiment took place in the Spice Box, the experimental restaurant dining room sponsored by the Department of Food Science and Human Nutrition at the University of Illinois at Urbana-Champaign. Wansink and his fellow researchers arranged four 18-oz soup bowls around a table. Two of the bowls were connected to food-grade tubing, which was connected in turn to six-quart vats of Campbell’s Tomato Soup. The vats were kept out of sight, and the height was adjusted so that the level of soup in the bowls was at the same height as the liquid in the vats. As the diners ate their soup, the trick bowls refilled, but not to the top. Rather, the level dropped, providing some indication that progress had been made. As Wansink tells it, there were a few kinks to be worked out, and not just in the tubing:
Of the 62 people who showed up for lunch, only two discovered what was occurring. One bent down to retrieve a dropped napkin, and quickly pointed out the Borg-like tubing under the table to the rest of his lunch companions. The second person had a much more dramatic experience. Forgetting for a moment that he was not at a medieval banquet, this man picked up the bowl to drink out of it as if he were channeling one of his Viking ancestors. It made a loud gurgle and the tomato soup-filled tube slithered up through the table like a coral snake. This made the woman next to him shriek, and the man across from him tipped over his chair in his haste to escape. These two people and their companions were dropped from the study. None of the other 54 suspected a thing.
To me, there is an interesting lesson to be drawn from the Bottomless Soup Bowl. As you know if you’ve been reading my earlier WHEE diaries, Dr. David Kessler argued in his book The End of Overeating that the American food industry is making processed food irresistible through the addition of sugar, fat, and salt. What the Bottomless Soup Bowl shows is that sugar and fat (at least) aren’t necessary to keep us eating more and more. In fact, the diners with the trick bowls at the Spice Box ate more than 50% more soup on average. Wansink says that some ate more than a quart of soup! That’s three times what the diners with the normal bowls ate.
For Wansink, the most important lesson is that we aren’t good at estimating the number of calories in our food. The “normal” diners underestimated their calories by about 20 percent – they thought they’d eaten around 123 calories, but had actually consumed over 150. The other diners thought they’d eaten 127 calories,  but they’d actually consumed 268 calories on average – their estimates were off by over 100 percent. Yet most of the bottomless bowl diners reported feeling no more full than did the others.
Wansink then refers to other studies to show that the 20% underestimate is not just an artifact of his experiment. In fact, the 20% is a typical underestimate – for normal-weight people, that is. Overweight and obese people underestimate their calorie by 30, 40, or even 50%. But these studies are not common knowledge:
Scientists, physicians, and counselors have often blamed overweight people for trying to fool others (or themselves) about how much they’re eating. Some dieticians, physicians, and family members tell them flat out that they’re “lying” or “in denial.” Hurtful accusations like these only make diet counseling effective at scaring off overweight people, rather than changing them.
Why are overweight people more inaccurate in their estimates? Wansink suggests that in fact, everyone is less accurate at estimating calories as meals get larger. In fact, says Wansink:
It seems that when estimating almost anything–such as weight, height, brightness, loudness, sweetness, and so on–we consistently underestimate things as they get larger…That Popsicle-stick skinny person eating a 2,000-calorie Thanksgiving dinner will underestimate how much he’s eaten by just as much as the heavy person eating a 2,000-calorie pizza dinner. The trouble is that the heavy person tends to eat a whole lot more large meals.
Reengineering Strategy #2: 
See All You Eat 
As I noted in my previous diary, Wansink closes each chapter with a healthy eating strategy related to the lessons of the chapter. This chapter’s strategy is a two-part strategy:
“See it before you eat it” 
Rather than eating from a Bottomless Bowl of tomato soup – or worse yet, a Bottomless Bowl of ice cream or candy – preplate your food. Decide how much you’re going to eat, take it out of the larger container, and put it in a smaller container before you eat it. Make it easy to see the level going down, like the subjects in the Spice Box who had the normal bowls, rather than the Bottomless Bowls.
“See it while you eat it” 
Or rather, keep the empties visible while you’re deciding whether to have more. If you’re eating chicken wings, keep the bones on your plate while you decide whether to have seconds. The same applies to beverages, says Wansink. If you’re serving wine at your dinner party,
…keep the empty wine bottles on the table and pour refills into fresh glasses, without clearing the others. This should help stretch your supply of North Dakota wine.

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Mirror Neurons And Eating Behavior

Below are some great articles about eating and mirror neurons that are easy to read and understand
Mirror Neurons And Eating Behavior

Another reason that we eat more with people that are overweight is because of something called “Mirror Neurons”.
Click on the link below for the waitress study, or go to the next slide for more information on mirror neurons.
Might an overweight waitress make you eat more? How the body type of others is sufficient to alter our food consumption

How Your Friends Can Make You Overeat

– Sabatouers and mirror neurons.

Check this out :

Why Looking at Overweight People Makes Us Want to Eat More, Not Less

Mirror neurons work automatically and unconsciously so if you would like to keep your healthy weight then you must learn to work with them. You see, mirror neurons can be your best friend or your worst enemy. In our brains they reproduce the activities that we are observing. So if you see somebody eating a chocolate brownie “chocolate brownie eating” parts of your brain get activated and so increases your desire to eat one. Even just looking at photos can activate these areas of our brains and motivate us to eat. The more our mirror neurons are exposed to eating, the more powerful the brain activation and the more intense the craving.

As you watch your friends eating the chocolate brownie your mirror neurons are telling your brain what’s going on, but your pleasure centers are shut happy because they are not getting any stimulation. This amps up your cravings even more, because now your brian begins to ANTICIPATE what eating the brownie would be like. You start to think how delicious it would taste. You think how the texture would feel in your mouth and how you would feel if you just took a bite. This is all the workings of your brain, as it goes through your past experiences of eating foods similar to the chocolate brownie.

You are doing well if you have still managed to hold out, but next comes the biggest craving. The greatest brain activation is achieved when anticipation is paired with a degree of uncertainty. So you have your limbic system telling you how delicious it will be, your mirror neurons are activating the movement patterns that are associated with eating the chocolate brownie, and your pre-frontal cortex is saying “No please, I have to stick to my diet!”. Under these conditions of “it might happen, it might not happen”, humans are extremely motivated to seek pleasure because we get an intense reward when it does occur. This is what you constantly face when you see people eating foods that you desire but cannot have. It’s not long before the intense cravings finally overpower your willpower and you give in to temptation.

The food industry knows about mirror neurons all too well. That’s why they place their food everywhere for you to see. They know that the more you are exposed to their advertisements the more you are likely to consume what they are selling. They are also extremely cunning in how they present their product. Have you ever noticed that food manufactures sell their products by having people consume them while having fun and being really happy. Its because these manufactures know that when you watch this the areas of your brain related to happiness and fun and pleasure get associated with their food or drink. Check it out the next time you watch an advertisement. Oh and isn’t it weird that the actors are almost always really good looking and in great shape? Its almost like consuming their product can help you with that too…..


In this study, researchers give a study participant some cookies to eat and then placed a plant/pacesetter beside them to share the cookies. The pacesetter is instructed to eat a certain number of cookies. This could be 6, 3, or just 1 cookie.
The results of this little experiment is always the same. Whatever the pacesetter ends up eating, the unsuspecting snacker ends up eating also. If the pacesetter eats 1, the snacker eats 1. If the pacesetter eats 6, the snacker eats 5 or 6.
As humans, we tend to eat the same as those that we eat with. This is because eating is a social, emotional, and intellectual activity, not just a necessity for our physical survival.

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How Food Cues Makes Us Eat More

Food and behavior researcher Brian Wansink conducted a study where he brought a group of people into a movie theater and separated them into two groups. The first group got a medium size bucket of popcorn, the second group recieved an extra large bucket of popcorn.
The catch was that the popcorn wasn’t fresh. In fact it was purposely stale. It was popped five days earlier and stored in sterile conditions until it was stale enough to squeak until it was eaten. However the study subjects had no idea, they were just happy to be watching a free movie with free popcorn.
After the movie, Wansink tallied how much popcorn was eaten. Amazingly, there were only 2 people who did not eat the popcorn out of the entire group! But that’s not all, the big-bucket group ate on average 173 more calories than the medium bucket group. Bear in mind that the only difference was the size of the popcorn bucket. This was 53% more! Give them a lot and they eat a lot, and this was 5 day old stale popcorn!
Why did almost everybody eat the popcorn? Because they were distracted by the movie, because everybody else was eating it, and because eating popcorn at a movie is the socially accepted thing to do. The environment trumped their taste buds as it almost always does.
Make junk foods and the foods you tend to overeat “inconvenient.” Put the ice cream in the garage or basement freezer and the cookies and chips in bins in the back of the pantry. Put the foods you want to eat (cut up fruit, yogurt, and veggies) out or in the front. Stack the deck in your favor with what you keep in your office drawer or at the front of your refrigerator because when you are hungry and out of time – the most convenient is likely to be the choice.

Beyond convenience, studies show that visible foods trigger eating in a way that is difficult to resist. One study found that secretaries reached into a clear candy bowl 71% more times than a white colored one. Visibility makes us “too mindful” of food. Neurochemically, the anticipation of food trips secretions that add to our craving and our overeating.
Unless you want to battle or overeat all day – don’t leave food, soda or items you really don’t want to eat- out. Don’t expect children to resist overeating snacks that are always visible.
Use visibility as a deterrent. Given that one of  Wansink’s studies showed that leaving the chicken bones from eating wings out on the table made people eat less, don’t get a clean plate – leave visible evidence of what you have already eaten in front of you.
Visual Cues as Guides
Historically many people will tell you that from an early age they were trained to use the plate as their norm for consumption (“the Clean Plate club”), rather than their bodily sense of fullness. Most can’t shake it.
In one of his most noted studies, “Bottomless Bowls,” Brian Wansink demonstrates how people’s use of visual cues makes them unable to correctly detect how much they are eating. In two groups, one eating out of normal soup bowls and one eating out of soup bowls rigged up from the bottom to keep refilling, those with the re-filling bowls not only did not recognize their bowls were refilling – they reported eating a similar amount as those in the normal soup bowl group. They had actually consumed 73% more soup.
If you are stuck with the clean plate club – use a smaller plate and a smaller glass and that will be a safer guide. In this culture of super-size and “Big Gulp” it is easy to lose perspective as well as your body’s sense of overload. Fill all the food you plan to eat on one plate- let be your portion. If, as they suggest at a buffet, you keep taking a new plate( resist this) – there is no telling how much you will eat.
Mindless Eating
Anything that takes our focus off the food makes us more likely to overeat. People eat more in front of TV, while reading, sitting at their desks, and snacking in the movies because they are eating in a mindless way.
If eating while viewing is a treasured activity – plan for it. Plan what you will eat and dish out the portion. Remember- people with big ice cream bowls dished out 31% more ice cream!
Social Influence
Research has found that smoking, deciding to get the flu shot, and taking vitamins are all socially contagious behaviors. But our friends have even more influence on how much we eat and drink. They affect our consumption norms and expectations.
Professors Fowler and Christakis found that having a friend who is gaining weight makes you 57% more likely to do so yourself. They consider that consciously or unconsciously, people use what others are eating as a gage for themselves- be it the oversized fries or the chocolate dessert.
Rather than getting mindlessly swept into overeating – plan what you will order before you meet your friend or go out with your partner.
Order extra water or a non-alcoholic beverage you like so that you can continue to drink while your companion continues to eat.
Divide and conquer- if your partner or friends are game, plan on dividing everything – you get to taste without overeating.

When you consider how easy it is to overeat without realizing what you are doing, slowing down or stopping can begin to feel overwhelming.
Consider experimenting with taking back control.
Try one of these simple strategies. In the long run in many ways: “Less can be more.”


Sweets in the workplace are just part of the problem. Your workplace could be  a minefield of temptations, so you need to have a good offensive strategy – and that means keeping foods out of sight (and mind), and making sure you have healthy alternatives available.  I had one patient who put a mini-refrigerator in her office to stash her lunch and healthy snacks – so she could avoid the lunch room altogether.
Vending machines have a way of calling out to you – especially around 3 or 4 PM when you’re hitting an afternoon slump.  So again, make that food harder to get.  Maybe you don’t keep cash with you at work, or maybe you find another route to the restroom that doesn’t take you past the vending machine.  Better yet, bring healthy snacks to work with you – some fresh fruit, a handful of nuts, some low fat cheese and whole grain crackers, or a carton of yogurt.
Here’s something else that helps.  Next time you’re faced with food that you know you shouldn’t have – and probably don’t even really want – ask yourself this:  “if this (doughnut, cold pizza, stale popcorn) weren’t here, would I go out of my way to get it”?

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Why Are Some Foods So Delicious?

For some people food is just fuel, for most of us it is more, sometimes a lot more. Throughout most of our history our primary drive has been to seek out and acquire food. We have a built in mechanism to sustain this drive – our reward system. Whenever we eat food and sometimes when we just think about it, chemicals in our brain stimulate certain brain ares that give us a sensation of pleasure.

Certain foods are more rewarding than others. Scientists call this quality “palatability”. When we say that a food is palatable, oftentimes we are referring to its taste. Here though, palatability refers to a food’s ability to stimulate our appetite and prompt us to eat more. Palatability of course involves taste, but it primarily involves our motivation to pursue certain foods. It’s the reason that when it comes to certain foods, we just can’t stop eating.

What makes a food palatable? A food’s palatability is largely dependent on the food’s ability to engage all of your senses. This experience is called your perception and is a subjective experience for all of us. It explains why you may like certain foods but your friend may not. We all have different perceptions on how something tastes, smells, looks or feels which in turn creates an experience that is unique to you. Food that stimulates all of senses has the potential to create intense memories. This was the basis for one of the most famous books of all time, Swann’s Way, usually called “A Remembrance of Things Past” by Marcel Proust.

When we describe food, people usually talk about taste. When it tastes really good we say it is “delicious”. But when we eat, taste is only one of the senses that use. We also describe the SMOOTH, CREAMY pleasure of our favorite chocolate cake, the RICH AROMA of our favorite coffee, or the CRISPY texture of our favorite fried shrimp. Any food writer knows the importance of highlighting these characteristics to make the food seem more desirable and appetizing.

The food industry knows exactly how to create this experience for you, and they do everything in their power to provide a bite that will MELT in your mouth. Here is a short description of an entree that I picked up at a restaurant recently:

“Juicy fire–grilled chicken breast drizzled with our Jack Daniel’s® glaze and some crispy Cajun–spiced fried shrimp with dipping sauce. Our creamy mashed potatoes and veggies seal the satisfaction. “

Now you may not be hungry, but just reading that will definitely tickle your taste buds. Just the words on the page will create a picture in your mind of what this dish would look, taste, smell and feel like in your mouth. All of this is packaged together to create a perception of the experience we would have if we could eat this meal right now. This perception sends massive anticipatory reactions to the pleasure centers of your brain and you say “ That SOUNDS scrumptious, I think I’ll have that!”

It is this anticipation of stimulation which motivates you to eat long after your physical drives for food have been satisfied. It is why you can’t stop thinking about desert even though you have just started to eat your main course, because you know how delicious desert will be. Humans like to be entertained and have pleasure. The way food is presented to us in today’s society, entertainment and pleasure can easily be satisfied by simply going to your local restaurant.

So the next time you call something “creamy and moist”, realize that you are probably not eating to satisfy your physical hunger, but instead to delight your senses.

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Grazing/Snacking myths

Until recent human history, eating food in-between meals was not even heard of. The behavior was not even considered. It was foreign and it was common knowledge that everybody got their daily intake of food eating meals. That was it.

There were a few exceptions to this norm. Babies and toddlers needed to eat more frequently than adults, simply because their stomachs are too small to hold any excess calories. This is still true today. Babies and toddlers eat small frequent meals because that is how their bodies are designed to eat.

The second exception was active teenagers. Such people were often involved in heavy manual labor, and possibly athletics. With a growing body and such high expenditure of calories, it made sense that this group would also require some supplemental food throughout the day, if only to keep up with their tremendous workload. Today, teenage athletes still may require some snacks throughout the day, but since most teenagers are far more sedentary then ever before, the normal mealtime is more than sufficient.

Outside of these examples, there is very little evidence to suggest that snacking is a good behavior for any individual, especially adults. Adults have more than enough capacity to eat a meal that will sustain them until their next meal. Adults can also have the self-discipline to wait until their next meal, and in doing so to be a role-model for others.

The correct answer is that eating all the time helps you accumulate and store body fat.
Many people, including some “experts” believe that it is important to eat all the time, or to “graze”, for the following reasons:

#1 – Grazing will help you maintain a steady blood sugar level

The idea here is that we all need a constant and steady supply of sugar from food to ensure that we maintain adequate blood sugar levels. This is partially true. Yes our blood sugar needs to remain within a certain range, but no, we are not supposed to do that by grazing on food! We all have plenty of sugar in our livers and in our fat cells. Once the sugar in the liver is depleted, then our bodies move to using our fat. This is how our body maintains an adequate blood sugar level. If we graze we never allow our bodies to use those fat reserves and therefore that fat will stay exactly where it is no matter what you do.

#2 – Grazing will help you keep hunger at bay

The idea here is that eating on a constant basis will keep you from becoming hungry. There are a few problems with this. The first is that the old primitive part of your brain wants you to eat at all time. If it thinks that you will always eat when you are hungry then it will always make you hungry, even if you have plenty of energy and nutrients in your system. Secondly, by never allowing yourself to become a little hungry you forget what that sensation is. You become unaware of what hunger really feels like and you train yourself to avoid it at all costs by constantly grazing.

#3 – Grazing maintains your energy levels

Again the idea here is that by grazing you will somehow be giving your body a constant supply of energy. This misconception is derived from the notion that as soon as you eat food, it is converted into energy immediately and therefore can be used immediately. What actually happens is that when food enters the stomach, our body needs to break it down and decide what it is going to do with it. Some food will be used, some will be stored, and what is not needed will be eliminated. However, when you graze the food that you eat will almost always be stored.

The reason is that grazing promotes a constant release of insulin which is the storage hormone. When insulin is present it hoards all of the energy that is derived from the food and sticks it into your fat cells. It doesn’t matter if your cells are screaming for some energy, when insulin is present it will store everything if it can. So you could end up in a situation where you have very low levels of cell energy because all of the food that you are eating is going straight into your fat cells! This is what the behavior of grazing can do for you, and this is the most potent recipe for fat accumulation.
If you want to learn more about hunger click here…

Cultures that snack more have higher rates of obesity
In America, 26% of total calories are consumed as snacks outside of meals. That’s twice as high as the rate of calories consumed as snacks in 1976. The obesity rate is now over 31%.
In France, 10% of total calories are presently consumed as snacks and the obesity rate is correspondingly lower at 12%.
In China, 3% of total calories are presently consumed as snacks and the obesity rate is only 5%.
Many stdies correltate rise in obesity with snacking
Click here on blog post of that study

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