The first idea that fibre could protect against certain diseases appeared in I960, when researchers observed that the degenerative illnesses common in affluent societies were rare in rural Africa where diets were high in unrefined plant foods. Subsequent studies confirmed the health properties of fibre and it is now considered to have a role in protection against chronic diseases such as cardiovascular disease, colorectal cancer, and the management of constipation and diabetes. The specific benefits depend on the type of fibre. Foods high in insoluble fibre reduce transit time (i.e. shorten the time for food to pass through the GIT), soften stools by holding water and increase stool volume. In contrast, foods high in soluble fibre have little effect on bowel transit but appear to slow the rate of carbohydrate absorption due to their gel-forming ability. This helps to reduce rapid fluctuations in blood glucose and insulin among people with diabetes.

The combination of the effects of different fibres (including resistant starch), the SCFAs produced and a diet low in fat are all thought to protect health, so it has been difficult to credit any one factor. Nutritionists therefore recommend a diet low in fat with a variety of foods containing all types of starch and fibre.

A low intake of carbohydrate in any form appears to be linked to obesity on a population level because, by default, it is a high-fat diet. The claim that carbohydrates, whether as sugars or starches, are fattening’ is a myth. However, it is prudent for some individuals who are obese and who consume large quantities of sugars, to moderate their intake as a second level of priority after decreasing fat.

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As we have seen, the incidence of depression in relatives of eating-disordered people is higher than the rate found in the general population. Researchers have long been intrigued by this apparent connection between eating disorders and affective disorders (mood disorders, such as depression and mania). Is it possible that both types of illnesses arise from a common source?

We don’t yet have all the evidence we need to answer this question with confidence. However, there is no doubt that disruption along certain neurochemical pathways can lead to disturbed moods of varying severity.

Consider, for example, some of the fairly common syndromes in which feelings of depression play a part. The first, and most widely known, is PMS-the premenstrual syndrome. Symptoms of PMS include sudden mood swings, irritability, anxiety, feelings of hopelessness, difficulty concentrating, sleep disturbance, food cravings, and physical problems such as headaches or joint pain.

Another illness that has received considerable publicity in recent years is SAD, or seasonal affective disorder. With the onset of winter and its shorter days, people with SAD begin to feel depressed, hopeless, and lethargic. The illness is particularly troubling because during the summer these same people are lively, outgoing, and energetic. The contrast can be confusing, not just to the patient, but to family, friends, and co-workers as well.

Less familiar is the syndrome known as CCO, or carbohydrate-craving obesity. The name is self-explanatory: Patients with this condition overeat carbohydrates to the point of severe, health-threatening obesity. A variant of this illness is a form of bulimia in which patients, usually mildly obese women, engage in severe bingeing, often involving carbohydrate-laden foods, but with little or no vomiting.

These conditions share certain symptoms, including depression, lethargy, difficulty concentrating, and periodic bouts of overeating leading to weight gain. People with these disorders seem specifically to prefer carbohydrates above all other foods. One of my patients, who as it turned out had SAD, described herself as a “bread and pasta fiend” in the winter, while in the summer she ate more protein.

Bouts of depression in SAD, as its name suggests, appear in a cycle determined by the changing seasons. PMS strikes regularly every month (though it is worse for some people during the winter months). CCO, however, seems to trigger abnormal eating virtually every day, most often in the late afternoon or early evening. It’s this regular rhythm-seasonal, monthly, daily-that caught the attention of investigators concerned with the ways our bodies change over the course of time.

We now know that many of our bodily functions operate on what is known as a circadian cycle. Circadian means “about a day.” The word refers to the fact that many natural functions- sleep, hunger, sexual arousal-are not discrete events but rhythmical processes that continue over a period of approximately twenty-four hours, with peaks and valleys that occur at different times. As a rule, these processes are regulated by the hypothalamus.

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Now age 45, John still finds joy in the great outdoors. It not only relaxes him but it also helped him lose 30 pounds.

John, who ran his own farm for more than 20 years before becoming a student at the University of Maine, had a weight problem | for most of his life. He ate too much of the wrong kinds of foods, and despite his active lifestyle, it showed.

“My family always kept a lot of sweets around the house,” he says. “And I had a special fondness for french fries and Coke. I drank Coke all the time.”

Every now and then, John would diet and lose some weight, only to regain it. By age 40, he reached 220 pounds. “I realized that slimming down wouldn’t get any easier as I got older,” he says. “And I knew that I’d be a lot healthier without the extra pounds. So I made up my mind to get rid of them for good.”

John paid more attention to his food intake, eliminating fried foods, desserts, and high-calorie snacks. He kept an eye on his portion sizes, too. For exercise, he began doing situps, working up to 100, five times per week. But what really made a difference, he says, were his nightly nature walks.

Every evening after dinner, John, sometimes accompanied by his wife, would step out his backdoor and head for the old logging roads that cut through his 270-acre farm. He’d wander the roads for an hour, sometimes two, observing nature in all her glory. He’d spy bears and their cubs; coyotes; moose; and deer. “Even when I walked alone, it was never lonely,” he says. “I might see muskrats or beavers or trout in my stream. But I knew I’d almost always see something.”

John so enjoyed his nature walks that he never really thought of them as exercise. Yet in combination with his improved eating habits and his sit up regimen, they got him down to a healthy 190 pounds in about 6 months. He’s been holding steady since 1996.

“If I wasn’t active, I’d gain weight quickly,” John says. “But the exercise that I do is a pleasure. I’m always glad to get outdoors. It’s where I feel best. It’s the place where I most love to be.”

WINNING ACTION

Pursue your exercise through your passion. One of the best ways to stick with your exercise routine is to find an activity that you look forward to. If the traditional choices such as running, biking, and swimming don’t interest you, ask yourself what does. Bird watching? People watching? Karate Swing dancing? Anything that gets you moving can help you slim down and shape up.

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