I’m going to toss off a question about the paradoxical nature of low-carb diets. Here is the set up. Most people reading this post will have – at some point, at least – enjoyed the benefits of a low-carb diet. They will have had more energy, slept better, rid themselves of heartburn and GERD, stabilized blood sugar, reduced blood pressure, normalized lipids and lost weight. Many will have been able to rid themselves of one or even a handful of drugs. All will have felt much, much better than before starting the diet. And, if most are like me, will marvel on what a wonderfully filling and satisfying diet it is and will tell them selves that the low-carb diet is really the only diet worth following.
Okay, that’s the set up. Here is the question:
Why are low-carb diets so difficult to stick to for so many who have had the above experience?
When I am in full low-carb mode, genesis-ing that neo glucose like crazy, I feel like a million bucks. I’m not hungry, I don’t really obsess on food, and I have energy out the yang. So, why would I ever go off the diet? I can assure you that I do. And sometimes I go off in a bad way for longer than I should. I pick up a few pounds, finally get a grip on myself and plunge back into low-carbery. When I’m back sailing along, I wonder why I ever went off in the first place. So, why did I do it? Why do we all do it?
Here is what Don DeLillo writes in White Noise that is apropos to our question:
Who knows what I want to do? Who knows what anyone wants to do? How can you be sure about something like that? Isn’t it all a question of brain chemistry, signals going back and forth, electrical energy in the cortex? How do you know whether something is really what you want to do or just some kind of nerve impulse in the brain? Some minor little activity takes place somewhere in this unimportant place on one of the brain hemispheres and suddenly I want to go to Montana or I don’t want to go to Montana.
The above quote leads off Jonah Lehrer’s new book How We Decide, which I’ve started, but haven’t finished. I got the book because of an article of Lehrer’s I read in the Dallas paper when I was there a couple of weeks ago. So far, the book has met and exceeded all my expectations. And tomorrow night, I’m going to meet the author, so I’d like to get most of the book finished by then.
The article in the Dallas paper got me thinking about diets, low-carb diets in particular. And about how much easier it would be for all of us if a lot of things changed. Before I go into detail, read this excerpt from the article:
A recent experiment…sheds light on what happens inside the brain when people make shopping decisions. While economists have long assumed that consumers are rational agents and purchase goods based on calculations of utility, that assumption turns out to be false. In reality, every shopping decision is an emotional tug-of-war, as the pleasure of getting something new competes with the pain of spending money.
The experiment went like this: A few dozen lucky undergraduates were given a generous amount of cash and offered the chance to buy dozens of different objects, from a digital voice recorder to gourmet chocolates to the latest Harry Potter book. While the students were making their shopping decisions, the scientists were imaging the activity inside their head with a powerful brain scanner.
They discovered that when subjects were first exposed to the item, a part of the brain called the nucleus accumbens (NAcc) was turned on. The NAcc is a crucial part of our dopamine reward pathway – it’s typically associated with things like sex, drugs and rock ‘n’ roll – and the intensity of its activation was a reflection of desire for the item. If the person already owned the complete Harry Potter collection, then the NAcc didn’t get too excited about the prospect of buying another copy. However, if he’d been craving a George Foreman grill, then the NAcc flooded the brain with dopamine whenever that item appeared.
But then came the price tag. When the subjects were exposed to the cost of the product, the insula was activated. The insula is associated with aversive feelings, and is triggered by things like nicotine withdrawal and pictures of people in pain. In general, we try to avoid anything that makes our insula excited. Apparently, this includes spending money.
By measuring the relative amount of activity in each brain region, the scientists could accurately predict the subjects’ shopping decisions. They knew which products people would buy before the people themselves did. If the insula’s negativity exceeded the positive feelings generated by the NAcc, then the subject almost always chose not to buy the item. However, if the NAcc was more active than the insula, the object proved irresistible. The sting of giving up cash couldn’t compete with the thrill of getting a George Foreman grill.
So far, nothing much new other than putting names to the parts of the brain – NAcc and insula – that constantly debate with one another over what we’re going to buy or do. We think we make decisions rationally, but we really don’t. We make them because our brain chemicals tell us what to do. As I mentioned in a previous post, we can control this to a little better extent than Mr. Lehrer indicates that we can.
But this constant debate goes on in our brains, with our spendthrift hedonistic NAcc wanting to buy, buy, buy while our tightfisted, frugal, money-hoarding insula trying to hold the line. That this debate occurs is not lost on retailers. They want to do whatever they can to encourage the NAcc and discourage the insula.
…retail stores already manipulate this cortical setup. Just look at the interior of a Costco. It’s no accident that the most covetous items are put in the most prominent places. A row of high-definition televisions surrounds the entrance. The fancy jewelry, Rolex watches and other luxury items are conspicuously placed along the corridors with the heaviest foot traffic. And then there are the free samples of food, liberally distributed throughout the store.
The goal of these discount warehouses is to constantly prime the pleasure centers of the brain, to keep us lusting after things we don’t need. Even though we probably won’t buy the Rolex, just looking at the fancy watch makes us more likely to buy something else, since the coveted item activates the NAcc.
But it’s not enough to just excite our reward centers: Retailers must also inhibit the insula. This brain area is responsible for making sure we don’t spend excessively, and when it’s repeatedly assured by retail stores that low prices are “guaranteed,” it stops worrying so much about the price tag. In fact, researchers have found that even when a store puts a promotional sticker next to the price tag – something like “Bargain Buy!” or “Hot Deal!” – but doesn’t actually reduce the price, sales of the item will still dramatically increase.
These retail tactics lull our brain into buying more things, since the insula is pacified. (Paying with a credit card seems to have a similar effect. Because the actual payment is postponed until the end of the month, the insula doesn’t fully process the pain of spending money. Of course, this leads, over time, to rampant credit card debt.)
This inner-brain debate we all have going on and the retailers response to it is a kind of model of what happens to us when we’re cruising along on our low-carb diets. Before we get into the specifics however, let’s look at how this model works with another form of pleasurable and addictive behavior.
Smoking involves these same parts of the brain, the NAcc and the insula. Back in the 1930s, 40s and 50s a whole lot of people smoked. In fact, it was all the rage. As my mother never tires of telling me whenever I point out the negative health consequences of her own past smoking, back then you were regarded as an outcast if you didn’t smoke. Although people may have wondered deep in their heart of hearts if it were really a good thing, their NAccs got plenty of encouragement everywhere. All the movies made during the time were filled with actors smoking, characters on television series smoked (Mary Tyler Moore and Dick Van Dyke, for instance), talk-show hosts smoked (Johnny Carson always had a cigarette going), cigarette ads were everywhere. And if you thought that maybe tobacco might not be good for you, there were even ads showing doctors who smoked and who recommended smoking. Even cartoon characters smoked. People smoked on planes, in restaurants, at work, at meetings – everywhere. You couldn’t get away from it. It was the norm. Your NAcc got a boost everywhere you looked and your insula was inhibited.
Compare then with now. In most places you can’t smoke in restaurants, in California you can’t even smoke in bars, you can’t smoke in planes, you can’t smoke much of anywhere. You don’t see a lot in movies, and when people do smoke, it really stands out, and looks pretty revolting. If you do try to smoke publicly, you will be glowered at by someone. You are bombarded with ads showing the negative effects of smoking. Whenever you hear someone died of lung cancer, you always ask if he/she was a smoker. And if so, you may have less sympathy. Whereas in the 30s, 40s and 50s the entire system was set up to encourage and enable smokers, it is the opposite now. As a consequence, way, way fewer people smoke. Why? Because even though the NAcc might still want to smoke, the insula has so much encouragement from the world around, that it easily overcomes whatever desire the NAcc might have.
The insula can be pretty strong, too. Alcoholism is a severe type of addiction and dependency, but can be held at bay by Alcoholics Anonymous. How? By attending meetings and getting the insula all fired up to cease and desist when alcohol is around. I have a friend who is an addictive personality type and who is a bad alcoholic with a bad, bad history of alcoholic self destruction. He’s been sober now for over ten years, but right before attending ANY event where alcohol will be available (including dinner at our house), he finds an AA meeting to get his insula topped off.
When we think about low-carb dieting in these terms, it is clear that we low-carbers are operating in a high-carb world. We are the low-carb equivalent of the non-smoker in the 1950s. We are considered unusual.
Everywhere we look we are bombarded with carbohydrate temptations. No place is safe. Just like the cigarette ads that were ubiquitous in days gone by, so now are the carbohydrate ads. You can’t pick up a magazine, turn on the TV or even look in a newspaper without your eye falling on an advertisement for carbohydrates. Nutritionists recommend them; dietitians recommend them; doctors recommend them; even the government recommends them.
If you tell three people you’re on a low-carb diet, I can almost guarantee that at least one of them will tell you that you are going to croak your kidneys or dissolve your bones. Probably another is going to tell you that although you may lose some weight, you will do so at the risk of clogging your arteries. Your insula is gathering info. Everything you hear like this beats down your insula just a little more, making it more prone to look the other way when your NAcc wants to take control.
Looking at this situation, it’s remarkable that anyone is able to stay on a low-carb diet for any length of time at all. In the ongoing debate in our heads between the NAcc and the insula, the insula doesn’t stand a chance. Society is aligned today to prod the NAcc with carbs just like it did with cigarettes a couple of generations ago, even though it was/is disastrous for health. And as it was then, society today is aligned to discourage the insula. Just like the retailers with merchandising, societal forces are pimping our NAccs and distracting our insulas.
When you’re doing well on the low-carb diet, your NAcc is happy, and if you hang in there and keep immersing yourself in low-carb info (this blog, other low-carb blogs, low-carb forums, low-carb books, etc.), your insula stays happy. But let yourself get away from this insular world, and what happens?
You go out for a nice dinner and hear comes the bread basket, often filled with warm, aromatic bread. All your dinner companions are scarfing it down. Hey, what’s a little piece of bread going to do to you, for God’s sake? (If you happen to find yourself in the unfortunate position of having not had a booming weight-loss week, you’re really in trouble.) Then the dessert tray comes after dinner, and if you’ve had a little bit to drink, you may be a goner. Alcohol is the gateway drug for carbs – as a general rule, the more you drink, the more carbs you eat. Hey, you only live once. Go for it. You head home after consuming about three day’s worth of carbohydrates. You resolve to do better the next day, but you’ve derailed the smooth running of all the metabolic processes that your low-carb diet had set in motion, and the next day it will be a little harder to get back on track.
Your NAcc has been beguiled by the carbs while your insula has been overcome (overtly) by your dinner companions and (covertly) by the high-carb society in which we all live, where you’ll hear things such as: Hey, it’s okay. Everyone knows that carbs are good for you. We’re supposed to consume at least 150 g per day for good health. I saw a doctor on Oprah who said we don’t get ENOUGH carbs.
And you wonder why it’s tough to stay on a low-carb diet? And you wonder why you have cravings? It’s pretty obvious when you think about it in these terms.
What can we do? Aside from the Glasser techniques that I wrote about before that serve mainly to get us away from the temptation, the best thing to do is pump up our own insulas. Just like my friend who goes to AA before any exposure to alcohol to get his inhibitory insula ready to dominate his NAcc, you’ve got to prep yourself. Go through all the reasons you’re on a low-carb diet. Think about how good you’re feeling. Think about all the good things you have going with your low-carb diet. Get yourself psyched up just as if your were going out to play in the Super Bowl. It sounds corny, but that’s what AA does, and it’s very effective. I call this getting into diet mode or putting on your diet face. We’ve all got to do this until the world changes.
Think how nice it will be when the world comes to its senses about diet and realizes the superiority of the low-carb diet for health and weight. We will be bombarded with ads for different cuts of meat. Instead of the smell of fresh baked bread in stores, we’ll get the aroma of sizzling bacon. We’ll be presented with dozens of options for foods prepared with coconut oil and butter. We will look at an overweight person eating a big carb meal with the same disgust we now feel toward someone who is coughing his/her lungs out while smoking. At restaurants we will have to ask for starch, and it may cost extra. Dessert trays will be filled with different varieties of berries and other low-carb fruits. If there is a tart or something similar, we’ll be assured that it comes with a crushed-almond crust and no added sugar. Should such a world ever exist, our NAccs will constantly be stimulated with the foods that are actually good for us and that are, unlike carbohydrates, satiating, and our insulas won’t really have to be inhibited, so we will be in constant NAcc drive to eat properly. Won’t it be grand?
When that time comes (and it probably will – who would have thought in the 40s that a time would come when no one smoked), I’ll pity the poor folks trying to sell low-fat diet books.