We explored the comprehension of the informed consent in 77 cancer patients previously enrolled in randomised phase II or phase III clinical trials, between March and July 2011, at the San Raffaele Scientific Institute in Milano. We asked participants to complete an ad hoc questionnaire and analysed their answers. Sixty-two per cent of the patients understood the purpose and nature of the trial they were participating in; 44% understood the study procedures and 40% correctly listed at least one of the (...) major risks or complications related to their participation in the trial. We identified three factors associated with comprehension of the informed consent: age, education and type of tumour/investigator team. We suggest several possible improvements of how to obtain informed consent that will increase patient awareness, as well as the validity and effectiveness of the clinical trials. (shrink)

The effects of calorie restriction have now been studied in two non‐human primates, the macaque Macaca mulatta and the mouse lemur Microcebus murinus. The study on lemurs and one of the two studies on macaques have reported a lifespan increase. In this review, I argue that these results are better explained by a lifespan decrease in the control group because of a bad diet and/or overfeeding, rather than by a real lifespan increase in calorie‐restricted animals. If these results can be (...) readily translated to humans, it would mean that no beneficial effect of calorie restriction on lifespan can be expected in normal‐weight or lean people, but that overweight and/or obese people could benefit to some extent from a decrease in excessive food intake. (shrink)

Calorie labeling on menus is one of the more recent public health responses to calls for increased access to nutrition information. The goal is to encourage consumers to make more healthy food choices. In this commentary on ‘Equity in Public Health Ethics: The Case of Menu Labelling Policy at the Local Level’, I focus first on research supporting health equity-directed goals for menu labeling policies; then I turn to the issue of challenges and opportunities for menu labeling as a part (...) of local food policy and food activism. I argue that, while there is some evidence that changes in menu labeling may help to promote health equity, other moves are needed at all levels of political organization. In particular, effecting shifts in attitudes and consumption will require changing our relationships with the food sources in our neighborhoods, and changing those food sources themselves. Leveraging our knowledge of behavioral economics and social marketing, using social networks and developing programs to transform eating patterns; all of these require participation and coordination among many stakeholders. Menu labeling is one tool, but many others are needed to effect change in communities. (shrink)

More and more packaged products in China have been labeled as low-calorie products since the official implementation of nutrition claims in 2007. But little was known about the impact of such claims on the Chinese consumption of low-calorie food on the background of increasing rates of obesity among the Chinese population. This study sought to fill the gap by applying a consumer behavior model to a nationally representative online survey by means of structural equation modeling. The findings revealed that nutrition (...) claims significantly affect the consumption of low-calorie products. Specifically, marketing stimulus on low-calorie products first affected consumer psychology, then consumer decision-making, and finally consumer responses. Despite the significant role of consumer psychology and decision-making in consumption, consumers were susceptible to the influence of targeted marketing strategies for foods with a low-calorie claim. It is recommended that appropriate use of low-calorie nutrition claims by manufacturers and choices of low-calorie food by consumers according to their own needs should be encouraged. (shrink)

Calorie restriction results in an increased lifespan and reduced fecundity of rodents. In a natural environment the availability of food will vary greatly. It is suggested that Darwinian fitness will be increased if animals cease breeding during periods of food deprivation and invest saved resources in maintenance of the adult body, or soma. This would increase the probability of producing viable offspring during an extended lifespan. The diversion of limited energy resources from breeding to maintenance of the soma is seen (...) as an evolutionary adaptation, fully compatible with the ‘disposable soma’ theory of the evolution of ageing. (shrink)

Pictures of sides of beef, hanging from overhead rails in refrigerated warehouses and meat-processing plants, often leave a feeling of unease. These pictures provoke the notion that human beings have no right to inflict suffering and death on other sentient beings for the sole purpose of providing food. However, the ethical analysis conducted in this study shows that meat production, if animal welfare and deaths per calorie created are considered, is less of a pressing problem compared to the production of (...) milk. While meat can be provided with minimal suffering to animals, the consumption of milk is always associated with considerable suffering during the dairy cow’s life-span and the lives of their offspring. Moreover, more bovine deaths per unit of calorific value created are associated with milk production compared to meat production. The vegan movement, which is currently growing, wishes to minimise farm animal suffering as much as possible. However, if a vegan diet is not possible, consumers should make an informed decision about the products they consume. Replacement of the calories obtained from meat with those from milk and dairy products is not rational if animal welfare is considered. (shrink)

BackgroundMany discretionary foods contribute both to individual health risks and to global issues, in particular through high carbon footprints and water scarcity. Snacking is influenced by the presence of snacking cues such as food availability, observing others eating, and negative affect. However, less is known about the mechanisms underlying the effects of negative affect. This study examines whether the individual odds of consuming high-calorie snacks as a consequence to being exposed to known snacking cues were moderated by experiencing higher or (...) lower total negative affect per day or higher or lower negative affect variability per day.MethodsSecondary analysis of an ecological momentary assessment study of 60 participants over 14 days with food logs and randomly timed assessments of known snacking cues. High total daily negative affect levels and negative affect variability were examined as moderators to predict high-calorie snacking in three-level hierarchical random effects logistic regressions.ResultsConsistent with previous studies, the odds of snacking increased when food was available, when others were eating, and when participants experienced more negative affect. Associations for food availability and others eating were significantly moderated by negative affect variability such that associations between cues and high-calorie snacking were weaker on days with higher negative affect variability, but not negative affect levels.ConclusionThe relationship between cues to high-calorie snacking and snacking behavior varies with variability in negative affect, suggesting a complex relationship between affect and high-calorie snacking. Clearer conceptualizations on the relation between affect and eating are needed. (shrink)

This article works in a recursive manner by using the tools of a food regime approach to reinterpret the nutrition transition that has been underway internationally for 100 years, and then describing the contributions of nutrition science to the 1st and 2nd Food Regimes and the passages between Food Regimes. The resulting history—from the ‘imperial calorie’ through the ‘protective’ vitamin to the ‘empty calorie’—illuminates a neglected dimension to food regime theorising: the role of socio-technical systems in shaping a set of (...) value relations that are central to class relations. Contestation over one such system, nutritionalisation, currently involves an ungovernable array of actors. In describing the protagonists to the system of nutritionalisation, a classic confrontation emerges between technical and lifeworld rationality. Representing the former approach are actor networks responsible for the ‘trade-in-health’ sector which produces foods and nutritional values aimed at both over-nourished and under-nourished populations. Clinging to a lifeworld rationality are ‘culture eaters’ worldwide, for whom nutrition value relations are secondary to communal and ecological relations. This dynamic appears within wealthier Asian states which are emerging as central to the trade-in-nutritional health sector while acting to protect their own customary dietary practices. (shrink)

This study reports an ecologic analysis of the relationship between mean birth weight (MBW) and nutritional, medical and social variables, using 1982 data for 47 prefectures in Japan.

Is shadowboxing an effective form of functional exercise? What physiological and morphological changes result from an exercise program based exclusively on shadowboxing for 3 weeks? To date, no empirical research has focused specifically on addressing these questions. Since mixed martial arts (MMA) is the fastest growing sport in the world, and since boxing and kickboxing fitness classes are among the most popular in gyms and fitness clubs worldwide, the lack of research on shadowboxing and martial arts-based fitness programs in the (...) extant literature is a shortcoming that the present article aims to address. This case study involved a previously sedentary individual engaging in an exercise program based exclusively on shadowboxing for 3 weeks. Body composition and heart rate data were collected before, throughout, and upon completion of the 3-week exercise program to determine the effectiveness of shadowboxing for functional fitness purposes. An original shadowboxing program prepared by an Everlast Master Instructor and NASM Certified Personal Trainer (NASM-CPT) and Performance Enhancement Specialist (NASM-PES) was used for this 3-week period. The original shadowboxing program with goals, techniques, and combinations to work on throughout the 3-week program is included in this article. This case study demonstrates that a 3-week exercise program based exclusively on shadowboxing can increase aerobic capacity, muscle mass, bone mass, basal metabolic rate, and daily calorie intake, and decrease resting heart rate, fat mass, body fat percentage, and visceral fat rating in a previously sedentary individual. The results of this research demonstrate that shadowboxing can be a safe and effective form of exercise leading to morphological and physiological improvements including fat loss and increased aerobic capacity. The results of this research also demonstrate that the Tanita BC-1500 is a reliable tool for individuals to evaluate their own fitness progress over time. (shrink)

_Not exercising as much as you should? Counting your calories in your sleep? Feeling ashamed for not being happier? You may be a victim of the wellness syndrome._ In this ground-breaking new book, Carl Cederström and André Spicer argue that the ever-present pressure to maximize our wellness has started to work against us, making us feel worse and provoking us to withdraw into ourselves. The Wellness Syndrome follows health freaks who go to extremes to find the perfect diet, corporate athletes (...) who start the day with a dance party, and the self-trackers who monitor everything, including their own toilet habits. This is a world where feeling good has become indistinguishable from being good. Visions of social change have been reduced to dreams of individual transformation, political debate has been replaced by insipid moralising, and scientific evidence has been traded for new-age delusions. A lively and humorous diagnosis of the cult of wellness, this book is an indispensable guide for everyone suspicious of our relentless quest to be happier and healthier. (shrink)

In his contribution, ‘Represent me: please! Towards an ethics of digital twins in medicine’1, Braun shows that there is a fundamental ambivalence inherent in digital twins: they can either open up new freedoms for the simulated persons, or, conversely, endanger and restrict their freedom. To prevent digital twins from restricting people’s freedom, Braun suggests a strong focus on control. Braun’s focus on control is insufficient, I will argue, because his idea of control works only retroactively: it can only react to (...) restrictions of freedom that have already occurred, but it cannot prevent them, nor can it restore any lost freedom. Control is therefore insufficient to defend people’s freedom. To prove my claim, I will first use an everyday example to illustrate the fundamental ambivalence inherent in digital twins. Second, I will show that digital twins endanger people’s freedom in a hermeneutic way. Finally, I will demonstrate why controllability cannot prevent this hermeneutic endangerment. I understand digital twins, like Braun, as simulation of a person, as their dynamic and precise effigy. Simulated twins use machine-learning and artificial intelligence capabilities to make predictive analyses about the simulated person and the future development of her health. Imagine: You are eating dinner. Meanwhile, your partner lectures you about the calorie density and nutrient composition of your food, warns you that your portion size exceeds your daily calorie requirement by x calories. It calculates how your dinner will negatively impact your body mass index and physical fitness, and predicts what the consequences will be for your overall health. Based on these data and predictions, it creates an individualised diet plan for you—and at the same time shows you by how much you could improve your vital values by sticking to that plan. This example helps to illustrate the fundamental …. (shrink)

It is often believed that attentional bias for food is a stable trait of certain groups, like restrained eaters. However, empirical evidence from this domain is inconsistent. High-calorie foods are double-faceted, as they are both a source of reward and of weight/health concern. Their meaning might depend on the food-related context, which in turn could affect AB for food. This study primed 85 females with hedonic, healthy, and neutral contexts successively and examined whether food-related context affected AB for food and (...) if effects were moderated by dietary restraint. Both the mean tendencies of AB for food and variability of AB for food were assessed in a food dot-probe task with a recording of both reaction times and eye movements. Contrary to our hypotheses, AB for food was not significantly affected by either context or the interaction between context and dietary restraint. Instead, liking of the presented food stimuli was related to longer initial fixations and longer dwell time on the food stimuli. In addition, in line with prior research, body mass index was correlated with variability of AB for food instead of mean AB for food. In conclusion, this study did not find any support that AB for food is dependent on food-related context, but interestingly, reaction time-based variability of AB for food seems to relate to BMI, and eye movement-based mean AB seems to relate to appetitive motivation. (shrink)

One of the strongest objections to the development and use of substantially life-extending interventions is that they would exacerbate existing unjust disparities of healthy lifespans between rich and poor members of society. In both popular opinion and ethical theory, this consequence is sometimes thought to justify a ban on life-prolonging technologies. However, the practical and ethical drawbacks of banning receive little attention, and the viability of alternative policies is seldom considered. Moreover, where ethicists do propose alternatives, there is scant effort (...) to consider their merits in light of developing world priorities. In response to these shortcomings, I distinguish four policy options and, on the basis of a plausible intuition about fairness, evaluate their implications for a fair distribution of healthy lifespans. I claim that even in developing nations it would be fairest to favor policies that promote equal access to at least one promising category of substantially life-extending intervention: calorie restriction mimetics. (shrink)

The Italian government recently criticized the UK’s “traffic light” food labelling system for unfairly discriminating against some traditional Italian foods such as mozzarella, Parma ham, and Parmesan cheese . This type of labelling highlights the percentages of fat, saturated fat, salt, sugar, and calories of each food and classifies them by using red, amber, and green colors depending on the level of each nutrient. While it is true that some Italian foods do contain a high level of fat or salt (...) , the Italian government pointed out that traffic light labelling sometimes privileges certain processed foods or fizzy drinks with artificial sweeteners over .. (shrink)

This article works in a recursive manner by using the tools of a food regime approach to reinterpret the nutrition transition that has been underway internationally for 100 years, and then describing the contributions of nutrition science to the 1st and 2nd Food Regimes and the passages between Food Regimes. The resulting history—from the ‘imperial calorie’ through the ‘protective’ vitamin to the ‘empty calorie’—illuminates a neglected dimension to food regime theorising: the role of socio-technical systems in shaping a set of (...) value relations that are central to class relations. Contestation over one such system, nutritionalisation, currently involves an ungovernable array of actors. In describing the protagonists to the system of nutritionalisation, a classic confrontation emerges between technical and lifeworld rationality. Representing the former approach are actor networks responsible for the ‘trade-in-health’ sector which produces foods and nutritional values aimed at both over-nourished and under-nourished populations. Clinging to a lifeworld rationality are ‘culture eaters’ worldwide, for whom nutrition value relations are secondary to communal and ecological relations. This dynamic appears within wealthier Asian states which are emerging as central to the trade-in-nutritional health sector while acting to protect their own customary dietary practices. (shrink)

As consumer lifestyles have changed over recent decades, people have increasingly turned to meals prepared away from home. A major consequence of this shift in eating patterns has been a concomitant rise in obesity rates worldwide. Research has consistently documented that consumers tend to make less healthy choices when purchasing prepared meals away from home. In part, this can be attributed to inadequate information at the time of purchase; both nutrition experts and lay consumers tend, for example, to underestimate calories (...) in food purchased away from home and thus portion sizes tend to be larger. Thus, by requiring restaurants and other purveyors of prepared foods to provide the calorie content and other nutrition information at the point of purchase, consumers should be able to make more informed decisions and public health should be improved. The often maligned Affordable Care Act (i.e., “Obamacare”) addressed this issue in a mandate calling for compulsory nutrition labeling of prepared foods at the point of sale. In response to this effort, conservatives in Congress introduced the “Common Sense Nutrition Disclosure Act” (CSNDA) which, if enacted, would have effectively eviscerated the menu labeling provisions mandated by the Affordable Care Act. The stated rationale behind this legislation: to protect small business and prevent job loss resulting from overly‐burdensome federal regulations. This article provides a historical look at the evolution of federally mandated menu labeling in the United States with particular emphasis on opposition to its passage. The position is taken such that this legislation is beneficial, warranted, and long overdue, and its opposition, as reflected in the CSNDA, points to the need for new metrics when evaluating public policy. (shrink)

Little is known about how to generate plausible new scientific ideas. So it is noteworthy that 12 years of self-experimentation led to the discovery of several surprising cause-effect relationships and suggested a new theory of weight control, an unusually high rate of new ideas. The cause-effect relationships were: (1) Seeing faces in the morning on television decreased mood in the evening (>10 hrs later) and improved mood the next day (>24 hrs later), yet had no detectable effect before that (0–10 (...) hrs later). The effect was strongest if the faces were life-sized and at a conversational distance. Travel across time zones reduced the effect for a few weeks. (2) Standing 8 hours per day reduced early awakening and made sleep more restorative, even though more standing was associated with less sleep. (3) Morning light (1 hr/day) reduced early awakening and made sleep more restorative. (4) Breakfast increased early awakening. (5) Standing and morning light together eliminated colds (upper respiratory tract infections) for more than 5 years. (6) Drinking lots of water, eating low-glycemic-index foods, and eating sushi each caused a modest weight loss. (7) Drinking unflavored fructose water caused a large weight loss that has lasted more than 1 year. While losing weight, hunger was much less than usual. Unflavored sucrose water had a similar effect. The new theory of weight control, which helped discover this effect, assumes that flavors associated with calories raise the body-fat set point: The stronger the association, the greater the increase. Between meals the set point declines. Self-experimentation lasting months or years seems to be a good way to generate plausible new ideas. Key Words: breakfast; circadian; colds; depression; discovery; fructose; innovation; insomnia; light; obesity; sitting; standing; sugar. (shrink)

It is estimated that over 800 million people are hungry each day and two billion are suffering from the consequences of vitamin and mineral deficiencies. While a paradigm shift towards a multi-dimensional and multi-sectoral approach to food and nutrition insecurity is emerging, technical approaches largely prevail to tackle the causes of hunger and malnutrition. Founded in original in-depth field research among smallholder farmers in southwest Kenya, we argue that incorporating cultural or social dimensions in this technical debate is imperative and (...) that by systematically overlooking these dimensions, food insecurity cannot be accurately captured nor properly addressed. Based on a sub-location in rural southwest Kenya where the food plate is rapidly narrowing towards a high-calorie low nutrient diet and where over 80 % of households experience food shortages at least once a year, conclusions suggest that preferences, the local function of food, and the practices that emerge therefrom can affect the regularity of meals and their composition. The findings allow us to complement emerging research and program development with a more comprehensive and locally adapted approach to tackle food and nutrition insecurity. (shrink)

Public policies to reduce the extent of obesity in the United States have generated considerable public controversy. The paper examines the implications of proposed policies for the principles of justice and autonomy and key assumptions underlying the major contending positions with respect to the relative weight that should be assigned to them in balancing their respective claims. The analysis traces the crux of the debate regarding the ethical warrant for policies to restrict access to calorie-dense foodstuffs to two key issues: (...) the appeal to different and conflicting theories of justice, and the conflation of autonomy with negative liberty in public debates. After clarifying the ethically relevant characteristics of autonomy that merit defense, the paper concludes with a description of how the capabilities approach to justice may offer a more coherent ethical framework for developing and evaluating policies to address the current obesity epidemic. (shrink)

In the case discussion, ‘Equity in Public Health Ethics: The Case of Menu Labelling Policy at the Local Level’ , Mah and Timming state that menu labelling would ‘place requirements for information disclosure on private sector food businesses, which, as a policy instrument, is arguably less intrusive than related activities such as requiring changes to the food content’. In this commentary on Mah and Timming’s case study, I focus on discussing how menu-labelling policy permits governments to avoid addressing the heart (...) of the problem, which is high-calorie, high-sodium restaurant food. Menu labelling policy does not address food content in a way that is meaningful for change, instead relying on individuals to change their behaviour given new information. Besides having questionable efficacy, this raises concerns about moralizing food choices. (shrink)

This paper uses distinctions between differing senses of “private,” “public” and “political” in the United States to argue for the value of framing food issues as a collective problem that calls for broadscale demands for justice. We argue that food choices do not simply belong to the realm of private preferences and market transactions. Rather, they are a set of decisions that have systemic causes and public consequences. They are shaped and constrained by public policies that underwrite the transportation of (...) food over long distances as well as particular crops and foodstuffs, and by the vendors and advertisers who try to convince us to eat more of the foods they produce. Because the consequences of eating an abundance of empty calories are not easily remedied at the personal level, citizens need to demand public, systemic solutions, including better food information, youth food education, and a healthier food supply. (shrink)

Pain is most often an unpleasant experience that alerts us to actual or possible tissue damage. However, insisting that pain is always bad news may hinder understanding of pain’s many facets. Despite its unpleasantness – or perhaps because of it – pain is known to enhance the perceived value of certain activities, such as punishment or endurance sports. Here, we review evidence for a series of mechanisms involved in putative benefits of pain. A byproduct of pain’s attention-grabbing quality can be (...) enhanced perception of concurrent pleasurable stimuli. This is thought to explain why pain may augment the pleasure of spicy foods. By providing an aversive contrast, pain can also improve the experience of events that follow pain’s offset and lead to pleasant relief. Other potential benefits of pain derive from its ability to inhibit other unpleasant experiences and to elicit empathy and social support. The experience of pain can benefit our defence systems, since pain can enhance motivation to accumulate resources such as social support and calorie-rich foods. It can also reduce the guilt we feel after self-indulgence or moral transgressions. In sum, we highlight a series of potentially positive effects linked to pain. This framework can aid the understanding of why people sometimes seek out, enjoy, and gain rewards from pain as well as pleasure. (shrink)

Obesity is widely recognized as a preventable cause of death and disease. Reducing obesity among adults and children has become a national health goal in the United States. As one approach to the obesity epidemic, public health practitioners and others have asserted the need to provide consumers with information about the foods they eat. Some state and local governments across the United States have introduced menu labeling bills and regulations that require restaurants to post information, such as calorie content, for (...) foods offered on their menus or menu boards. A major dilemma is whether state and local menu labeling laws are preempted by the federal Nutrition Labeling and Education Act . While few courts have addressed this issue, ongoing litigation in New York City provides an early glimpse of judicial interpretation in this area. This article explores these preemption issues, arguing that appropriately written and implemented menu labeling laws should not be preempted by the NLEA. We offer guidance for states and localities that wish to develop and implement menu labeling laws. (shrink)

In 1936, the journalist Hannah Lees published “Two Million Tightrope Walkers,” drawing attention to the significant number of people in the United States estimated to have diabetes. Focusing on how people with diabetes should live, she emphasized the importance of recording the exact values of everything they ate and avoiding all “riotous living” lest they be unable to keep careful measurements of calories, insulin, and sleep. Employing two meanings of measured – as counted and as moderate – Lees was doing (...) more than communicating how someone might control their disease; she was also calling for a “controlled and self-reliant citizenry.” Indeed, Lees insisted that diabetics who followed a regime of measurement “make a good deal better citizens than the average.” Drawing on the writings of Lees and other social commentators, I explore the link between biometrics, citizenship, and diabetes in the United States in the interwar years. In particular, I look at how this disease came to symbolize both the regimes of discipline thought to be necessary in a society moving to consumption as its economic motor, and the fears of what could happen if consumption ran amok. Biometrics, I argue, offered clinicians and patients a potent tool for measuring deviance and, potentially, for restoring a person to the “norm.”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female student population is (...) involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female student population is (...) involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

Widespread obesity poses a serious challenge to health outcomes in the developed world and is a growing problem in the developing world. There has been a raft of proposals to combat the challenge of obesity, including restrictions on the nature of food advertising, the content of prepared meals, and the size of sodas; taxes on saturated fat and on calories; and mandated “healthy-options” on restaurant menus. Many of these interventions seem to have a greater impact on rates of obesity than (...) does simply providing information about health risks and healthier lifestyles. The more interventionist policy options have, however, been implemented only slowly, in large part because of criticisms that they are unjustified infringements on the liberty of consumers. Food industry groups, free-market think tanks, and the popular press regard measures that incentivize or penalize particular food and lifestyle choices as unjustifiable state regulation of purely self-regarding behavior. To counteract the liberty-oriented position, those who favor a more interventionist role for the state have recently argued for labeling obesity as a public health emergency. By labeling obesity as a public health emergency, policy-makers could override concerns about individual liberty in order to pursue more interventionist policies designed to guide consumer choices toward healthier lifestyles. In this paper, we argue that, contrary to initial appearances, obesity possesses some of the morally relevant features of public health emergencies, though we do not argue that it actually constitutes one. (shrink)

The nutrition transition—a process of dietary change that describes the shift to calorie-dense, higher fat and protein diets from cereal based ones—is happening in India. This paper argues that relatively little is known about the nature of nutrition transition in India. This is a result of both a lack of adequate and timely data and a consequence of national and state-level statistics, which render an incomplete and potentially misleading picture of how these processes are unfolding in local contexts. This may (...) be especially true in India where very little ethnographic research has documented the dual edges of nutrition transitions. Analyzing data collected from the Kumaon Hills, Uttarakhand in 2013, this paper suggests the ways in which aspects of the nutrition transition have developed unevenly over space and time. In particular, while new types of calorie dense foods have infiltrated these rural, remote areas, the process has been uneven and fraught with contestation due to preexisting social practices. More troubling is the evidence that though incomes are rising, the predicted increases in high value, protein rich foods may actually be declining. This paper concludes by arguing that the widely influential nutrition transition literature needs look to ethnographic and in-depth qualitative methods to form better policies relevant to the contingencies of dietary and epidemiological change. (shrink)

Chalmers introduced the hard problem of consciousness as a profound gap between experience and physical concepts. Philosophical theories were based on different interpretations concerning the qualia/concept gap, such as interactive dualism (Descartes), as well as mono aspect or dual aspect monism. From a bio-psychological perspective, the gap can be explained by the different activity of two mental functions realizing a mental representation of extra-mental reality. The function of elementary sensation requires active sense organs, which create an uninterrupted physical chain from (...) extra-mental reality to the brain and reflect the present. The function of categorizing reflection no longer needs sense organs, so that the physical chain to extra-mental reality is interrupted and now reflects the past. Whereas elementary sensation is an open system, categorizing reflection remains a closed system, separated from extra-mental reality. This creates the potentiality/reality gap, since prediction from the closed to the open system remains always uncertain. Elementary sensation is associated to specific qualia for each sense organ. Chalmers also attributed qualia to thoughts, with more neutral thought qualia. Thus at the qualia level, there is also an important gap, but now between specific sense qualia and neutral thought qualia. Since all physical concepts are simultaneously linked to neutral thought qualia, the hard problem might be explained by a qualia/qualia gap instead of a qualia/concept gap. The mental function of categorizing reflection induces the change from sense qualia to thought qualia by a categorization process. The specific sense qualia mosaic of an apple is reduced to physical concepts with neutral qualia by progressive categorization first to fruit, then to food, to chemicals and finally to calories. This might explain the gap felt in the hard problem, since specific sense qualia are completely different from neutral thought qualia, so that the hard problem could already be encountered at the qualia level. Since the gap of the hard problem is due to the interaction of different mental functions, it is compatible with a philosophical monism. (shrink)

The belief that obese people ought to lose weight and keep it off is widespread, and has a profound negative impact on the lives of the obese. I argue in this paper that most obese people have no such obligation, even if obesity is bad, and caused by calorie input exceeding output. Obese people do not have an obligation to achieve long-term weight loss if this is impossible for them, is worse than the alternative, or requires such an enormous effort (...) in relation to what stands to be gained that this option is supererogatory rather than obligatory. It is highly plausible that most obese people fall into one of these three groups. Politicians may still have obligations to fight obesity, but they ought to do so through progressive politics rather than blaming and shaming. (shrink)

New York City has extensive public health regulations. Some regulations aim to reduce smoking, and they include high cigarette taxes and bans on smoking in public places such as bars, restaurants, public beaches, and public parks. Other regulations aim to combat obesity. They include regulations requiring display of calorie information on some restaurant menus and the elimination of transfats in much public cooking. One important issue is whether New York City officials -- including both public health officials and other city (...) officials -- have adequately explained the justification to the public. Explanation has practical importance; the public might not back controversial and restrictive regulations unless offered a good rationale. But explanation is also an official duty, since public officials should make their reasoning transparent to their constituents. This article argues that New York City has not adequately communicated the rationales for its regulations to the public. It then offers several suggestions for improving public communication. After laying out those suggestions, this article points out that even if communication were improved, New York City’s regulations would still raise difficult philosophical issues. Those issues are briefly discussed in the final sections. NOTE: this is a reprint of a conference presentation. (shrink)

In adopting a deontological lens to assess message ethicality, this study identifies and explicates the ethical dimensions of fast food advertising through five principles of the TARES framework of persuasion ethics. In moral weight, fast food—with its high calories and low nutritional value—is negatively prejudiced. A deontological-ethical perspective, by focusing on the quality of the advertising message, shifts the focus from the product to a more measured deliberation about the moral responsibility of fast food advertisers to reposition them as moral (...) agents who are accountable for their messages. A content analysis of 380 television and print ads for fast food in Singapore shows that few ads met the TARES's expectations. Ads targeting children and teenagers are associated with lower message ethicality than ads targeting adults and the general audience, lending empirical support to the literature critical of fast food advertising's insidious approach of targeting the young. (shrink)

An empirically based view of size and distance perceptual content and phenomenology is introduced, in which perceivers measure worldly size and distance against their bodies. Central principles of the formal, representational theory of the measurement of extensive magnitudes are then applied in framing the account in a precise way. The question of whether spatial-perceptual experience is “unit-free” is clarified. The framework is used to assess Dennis Proffitt's proposal that spatial setting is perceived in various “units,” “scales,” or “rulers”, some of (...) them non-spatial—distance in terms of calories burned to traverse and the like. The debate between Proffitt and Firestone about the commensurability of differing measurement scales held by Proffitt to be relied on by perceivers is then clarified and resolved. Finally, the measurement theory framed account of size and distance perception is used to illuminate Gibson’s famous but elusive contrasts between “geometrical optics” and “ecological optics” and between the “physical world” and the “animal environment”. (shrink)

If physicians and health practitioners could do one thing to markedly improve the health of their patients, what could that be? Counsel them to reduce or stop drinking sugar-sweetened beverages.The science is clear: sodas, juice drinks, iced teas, and vitamin, sports, and energy drinks provide the largest source of empty or non-nutritional calories in the American diet and accounted for an astonishing 46% of all added sugars consumed in 2010. Sodas top the list of all sugar-sweetened beverages consumed, with the (...) soda industry producing nearly one 12-ounce serving per person per day in 2011.While it's true that sugar consumption has decreased in recent years... (shrink)

Knowledge about eating habits is relevant for understanding the relations between diet, obesity and development of Chronic Non-Communicable Diseases. The storage of calories as body fat, mainly in the visceral subcutaneous adipose tissue, as consequence of hypercaloric diet poor in nutrients, is responsible for increasing sublinic inflammation and overloading the immune system. Diet plays an important role in reducing inflammation. In time of infectious pandemia, of the new corona virus (COVID-19), the food quality and nutritional status of Brazilians may interfere (...) in fighting this infection. Based on the literature, this article aims to discuss the Brazilians eating habbits and nutritional status. The data shows that Brazilian are gainning weight and tend to a diet poor in nutrient intake. Consequently this scenario favors the subclinical inflammation and the weakness of the immune response. We suggest that Brazilian Health Authorities pay attention to this issue. (shrink)

Urbanization affects concurrent human-animal interactions as a result of altered resource availability and land use pattern, which leads to considerable ecological consequences. While some animals have lost their habitat due to urban encroachment, few of them managed to survive within the urban ecosystem by altering their natural behavioral patterns. The feeding repertoire of folivorous colobines, such as gray langur, largely consists of plant parts. However, these free-ranging langurs tend to be attuned to the processed high-calorie food sources to attain maximum (...) benefits within the concrete jungle having insignificant greenery. Therefore, besides understanding their population dynamics, the effective management of these urbanized, free-ranging, non-human primate populations also depends on their altered feeding habits. Here, we have used a field-based experimental setup that allows gray langurs to choose between processed and unprocessed food options, being independent of any inter-specific conflicts over resources due to food scarcity. The multinomial logit model reveals the choice-based decision-making of these free-ranging gray langurs in an urban settlement of West Bengal, India, where they have not only learned to recognize the human-provisioned processed food items as an alternative food source but also shown a keen interest in it. However, such a mismatch between the generalized feeding behavior of folivorous colobines and their specialized gut physiology reminds us of Liem's paradox and demands considerable scientific attention. While urbanization imposes tremendous survival challenges to these animals, it also opens up for various alternative options for surviving in close proximity to humans which is reflected in this study, and could guide us for the establishment of a sustainable urban ecosystem in the future. (shrink)

The model organism Saccharomyces cerevisiae is providing new insights into the molecular and cellular changes that are related to aging. The yeast protein Sir2p (Silent Information Regulator 2) is a histone deacetylase involved in transcriptional silencing and the control of genomic stability. Recent results have led to the identification of Sir2p as a crucial determinant of yeast life span. Dosage, intracellular localization, and activity of Sir2p all have important effects on yeast longevity. For instance, calorie restriction apparently increases yeast life (...) span by increasing Sir2p activity. Since Sir2p‐related proteins have been identified in many prokaryotic and eukaryotic organisms, the fundamental principles derived from the studies in yeast may prove valuable in directing our future research toward an understanding of the mechanisms of aging in higher eukaryotes. BioEssays 23:327–332, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

The understanding of food cue associated neural activations that predict future weight variability may guide the design of effective prevention programs and treatments for overeating and obesity. The current study investigated the association between brain response to different food odors with varied energy density and individual changes of body mass index (BMI) over two years. Twenty-five participants received high-fat (chocolate and peanut), low-fat (bread and peach) food odors and a nonfood odor (rose) while the brain activation was measured using functional (...) magnetic resonance imaging (fMRI). BMIs were calculated with participant’s self-reported body weight and height collected at the time of fMRI scan and again at two years later. Regression analyses revealed significant negative correlations between BMI increase over 2 years and brain activation of the bilateral precuneus and the right posterior cingulate cortex in response to high-fat versus low-fat food odors. In addition, brain activation of the right supplementary motor area in response to food vs non-food odor was negatively correlated to subsequent BMI increase over 2 years. Taken together, the current findings suggest that individual differences in neural responsivity to (high calorie) food odors in brain regions of the default mode and motor control network serve as a neural marker for future BMI change. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:My Story:Evolving ObesitiesAnonymous OneI am a 66–year–old Caucasian woman. I have always had, either in perception or fact, a “weight problem.” In my childhood and early teens when my weight was within the normal range, I felt fat and was always trying to lose weight. After gaining weight in college, I had a weight problem in body as well as mind. Weight concerns have consumed much of my energy (...) over the years. I have spent most of my life evolving toward a healthy way to manage my weight.Act 1: Obesity as MetaphorI can’t remember ever not feeling fat. Growing up I felt humiliated and shamed by my body, even though I was not overweight, just bigger than my peers, with a pear shape and heavy legs, thighs, and ankles. In high school my BMI, although not used at the time as a measuring tool, was 22.8. Yet despite these facts, I was made to feel fat.In my family being overweight was tantamount to sin. My father and sister were tall and skinny; my mother was petite and shapely. I took after another genetic code—the dumpy ones with knocked knees—the grotesque branch of the family tree. Hand–me–downs from my sister were supposed to fit me, but we were too different, and the difference was not celebrated.Other things were at play, a perfect storm of conditions that contributed to my feelings of worthlessness. I really shouldn’t have been born. The earth should have opened up and swallowed me. Of course I was not conscious of reasons for these feelings at the time. That awareness came later. But these feelings of loss, grief, terror, and terrible wrongness were the context of my struggles over the years.I developed a pattern of binge eating, which satisfied two contradictory impulses: my need to nurture myself combined with my desire to punish myself. The intensity of a binge–eating episode was also an avenue for rage. I was young so the extra calories didn’t result in weight gain, but the behavior had begun to take root.Stepping on the scale was like the final judgment. The scale did not measure weight; it measured value. I would see the number, as would the person weighing me, and my failure, as a person, would be evident. My secret shame would become public. I would be declared guilty for the worthless grub that was me.Nothing else mattered: that I was an A student; that I was kind and compassionate; that I had friends. These facts had no bearing. All that counted was the number on the scale. That number sent a shudder of condemnation down to my very soul. That number threatened to hurl me into a bottomless abyss from which I could not escape.I avoided being weighed. I was a very obedient youth, with an exaggerated respect for authority drilled into me by my father. The one time I ever cut class was in high school. I skipped health class where I had heard we would be weighed.The situations when I could not avoid being weighed confirmed my worst fears. Before one gym class we were publicly weighed in [End Page 96] assembly–line fashion. As I stepped off the scale my gym teacher yelled out “Diet” for all to hear. Doctors who knew nothing about me, to whom I had been sent for various required physicals, told me to lose weight.In the mysterious and internally logical way that the mind works, my weight became a metaphor for all that was reprehensible in me. With no comprehension of why I was so unhappy, it was easy for me to fixate on my weight. It was too horrible to contemplate that I was the problem. The problem with me was my size, my body.As I look back now, I am angry that because of its shape, this perfectly wonderful body was judged as wrong, and that there was no compassionate voice loud enough to contradict this message. But at the time I felt no anger. To feel anger over being made to feel bad requires self–respect... (shrink)