If eating and living healthier is one of your goals this new year, then consider a Mediterranean diet and eating more like the Italians. Basically, at the top of the Mediterranean food pyramid are grains, fresh fruits and vegetables, olive oil, cheeses, yogurt, nuts, and legumes, all of which are consumed on a daily basis.
The Mediterranean eating style significantly reduces the risk of further heart disease in individuals who had already had a heart attack.
The traditional diet among some Mediterranean countries includes fruits, vegetables, pasta and rice.
The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking. You can successfully incorporate the Mediterranean diet into your life by being an informed consumer and a smart shopper. Choose plenty of fresh fruits and vegetables, limit intake of red meat, eat fish — not fried or laden with butter or heavy sauces — at least once a week, don’t be afraid of healthy fats such as olive oil, nuts and canola oil (but use these in moderation because of their high calorie content), and reduce or eliminate saturated fat and trans fats (also known as hydrogenated or partially hydrogenated oils) from your diet. If it’s OK with your doctor, go ahead and have a glass of red wine at dinner with your pasta or fish.
It is not surprising to learn that people following the Mediterranean diet have a lower incidence of heart disease and cancer. Once you experience the delicious and healthy choices the Mediterranean diet has to offer, it just might become your favorite diet or way of eating.
You may have had success losing weight on a low calorie, low carb, low glycemic or low fat diet. All of these diets have some merit and are more or less effective for different individuals. If you are interested in the scientific basis for the Deconditioning Diet, continue reading from this point. The Deconditioning Diet retrains how your brain and physiology respond to food and food cues, in order to reduce or eliminate the intense cravings that would otherwise undermine any diet. If the blood sugars dip quickly, and if glucagon, the stress hormones and ATL lipase are sluggish in responding to release stored energy, the brain perceives hunger. Eventually, within hours, insulin levels will come back down, and the release factors (glucagon and the stress hormones) will rise, allowing ready access to stored sugar and fat. Like Pavlov’s dogs, we have become conditioned to a whole host of cues in our environment. However, even among these advocates, insulin reduction is not fully appreciated as the basis for hunger signals and cravings. Some of you may also be concerned that fasting will lead to eating disorders such as anorexia or bulimia.
Having adopted this plan, it is amazing how, if done gradually, one can go for 24 hours at a time without eating. Appetite control through carbohydrate moderation or intermittent fasting doesn’t necessarily mean under-eating.
But the Deconditioning Diet goes beyond macronutrients and micronutrients altogether, by changing the way your body responds to food, eliminating craving and freeing you from the need to eat frequently.
A Mediterranean diet has many significant health benefits, while not skimping on taste or making you feel like you are depriving yourself. Remarkably, this benefit was not related to any significant difference in cholesterol levels — rather other components of the diet seem to work in concert to protect the body. For example, residents of Greece eat very little red meat and average nine servings a day of antioxidant-rich fruits and vegetables. The focus of the diet isn’t to limit total fat consumption, but to make wise choices about the types of fat you eat. Here are some specific steps you can take: -Eat natural peanut butter, rather than the kind with hydrogenated fat added.
If you’ve lost weight on a restrictive diet, the cravings are still there in latent form, and they can be extremely difficult to resist when activated.
The purpose of the Deconditioning Diet is not to lose weight directly but rather to permanently change how you respond to food.
I personally believe that the low carbohydrate and insulin reducing diets are the most effective, based on the science so-well summarized by Taubes, Eades and others (See Diet Links in panel at right).  However even these insulin lowering diets don’t necessarily alter your underlying appetite or your food preferences! If blood sugar temporarily goes up after a meal, the pancreas secretes the storage hormone insulin, which enters the bloodstream and acts to shunt the excess glucose into glycogen and adipose stores. The most common cause of a dip in blood sugar is an increase in the storage hormone — insulin, without a concurrent replenishment of blood sugar or fats.
If the insulin secretion is modest, blood sugar will dip only slightly, and will readily be restored. The rate at which insulin rises is controlled by the rate at which the energy macronutrients (carbohydrates, proteins and fats) in the meal break down. Many people may be surprised to realize that one of the most significant factors influencing insulin secretion is psychology–the aroma, sight, flavor and even thought of food! Teff’s paper describes in some detail the nerve pathways that connect flavor and aroma to insulin secretion by way of the brain.
It is likely that this site in the brain can be conditioned to respond to or ignore other environmental cues, such as appearance, texture and even apparently arbitrary conditioned stimuli like the flashing lights and musical tones used in Pavlov’s experiments. Pavlov’s dogs naturally responded to the sight and smell of food (so-called unconditioned stimuli) but became conditioned to respond to perceptual cues that were not inherently or initially associated with food (conditioned stimuli).
A sudden rise in insulin level immediately causes hunger, so to control appetite we must keep insulin at a low and steady level. Insulin increases prior to and during eating, as a response to unconditioned and conditioned food cues such as taste, odor, texture, appearance and peripheral environmental stimuli. Pre-prandial insulin secretion can be deconditioned from existing food cues or conditioned to new cues. Insulin control: A sudden rise in insulin level immediately causes hunger, so to control appetite we must keep insulin at a low and steady level. And while overall reduction in insulin levels is stressed, what is usually overlooked is the role that immediate, short-term fluctuations in insulin play in the psychology of appetite. Insulin response to food cues: Insulin increases prior to and during eating, as a response to unconditioned and conditioned food cues such as taste, odor, texture, appearance and peripheral environmental stimuli.
I’m not going to review the details here, since there is so much information on this available elsewhere. Contrary to much of the advice you’ll hear, you should eat only at defined mealtimes and no more than three times a day.
If you must snack, make sure the snacks are mostly fat, and have no more than 10 grams carbs or 5 grams protein. Play detective and start writing down your craving episodes to figure out what your cues are. Read over your craving log to note the specific food cues, including time of day, that triggered your cravings. Keep your eating confined to defined meal times, if you can manage to, and never eat immediately after doing food cue exposure session. Don’t move to Phase 3 until you are having some success with suppressing cravings in Phase 2.
The literature is fairly clear here, that these conditions are caused by specific psychiatric or metabolic disorders. I hope you will be as successful as I have been in suppressing your appetite, eliminating cravings, and losing weight. Mediterranean people consume red meat less often on a monthly basis, and red wine about 1-2 glasses per day. The Mediterranean diet is similar to the American Heart Association’s Step I diet, but it contains less cholesterol and has more fats that contain the beneficial linolenic acid (a type of omega-3 fatty acid).
Nuts are high in fat — up to 80 percent of their calories — but tree nuts, including walnuts, pecans, almonds and hazel nuts, are low in saturated fat. Red wine has an aspirin-like effect, reducing the blood’s ability to clot, and also contains antioxidants. It is simply a healthy eating pattern – a pattern close to the dietary guidelines recommended by the American Heart Association. But in many cases a restrictive diet is not enough and you find yourself regaining the weight. Instead, it gauges the level of available calories in the bloodstream, specifically the level of sugars, fatty acids, and ketones in the blood. If a person keeps eating, more insulin is secreted (along with other regulatory hormones such as leptin). The brain detects and integrates the overall amount and rate of change in level of available metabolic fuels–glucose, fats, amino acids and ketones. Primarily this means simple glucose and starches (which themselves readily break down into glucose). Even though protein is less insulinogenic than carbohydrate and is partially offset by glucagon, you can still get a large insulin rise if you eat enough protein. Their extra body fat (especially abdominal fat) leads to health problems like cardiovascular disease, diabetes, circulatory problems and inflammatory conditions.
This brain center then integrates these responses automatically and passes the integrated signal on to the vagus nerve.

These conditioned stimuli included bells, flashing lights, and even specific musical passages. Some of these cues have an especially strong and direct effect – odors and flavors in particular. The importance of insulin control is well known for its importance in weight loss, and forms the basis of low carbohydrate diets. The stimulus-response relationship between food cues and insulin secretion is much less recognized, and mentioned barely if at all by the advocates of diet and exercise. Dramatic changes can be made in how we respond to food, but it is best to do this slowly, in small steps.
Basically, just avoid or minimize consumption of foods and drinks with sugars and starches.
Make a list of two or three activities you like to do that do NOT involve eating or being near food, that you can do immediately after your your cue exposure session, and that you can sustain for at least 15 minutes. Always insert at least 30 minutes (or a 15 minute counter-conditioning session) between the cue exposure and the meal. By eating less frequently and less reactively, you will avoid the short term insulin spikes that create cravings in the first place.
If you’re looking for a heart-healthy eating plan, the Mediterranean diet might be right for you.
Grains in the Mediterranean region typically contain very few unhealthy trans fats, and bread is an important part of the diet there. The Mediterranean diet typically includes some red wine, but this should be consumed only in moderation. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter. This diet is high in the good fats (monounsaturated and polyunsaturated fats) as present in fish, olive oil and nuts; and low in saturated fats and trans fats. Clearly, most of us have enough fat on our bodies to skip the next meal, or for that matter, many meals. Some researchers believe that the rate of change in glucose and fat concentrations may be more important than their absolute values in how the brain calculates hunger. And unless you are pre-adapted to quickly up-regulate expression of the release factors, which take some time for the body to produce, the response may be sluggish and weak. But insulin will also respond to protein, although at a lower level than carbohydrates, although the insulin will be partially offset in effect by secretion of glucagon, which responds specifically to amino acids in the bloodstream. Whether or not carbohydrate is present in the meal, the elevated insulin will tend to prevent glucose from coming out of storage, and fat burning will likewise be suppressed. But once you understand the insulin mechanism, it becomes clear that a small amount of food can cause a quick spike in insulin and a dip in blood sugar in the short term, thereby increasing the appetite.
They also exhibit higher baseline insulin levels, and the insulin levels typically respond to meals with a larger rise and slower return to baseline. This goes back to Pavlov’s physiological psychology of digestion, discussed in detail on the Psychology page of this site. These receptors activate neural fibers into the brain center for taste, specifically the nucleus of the tractus solitarus.
The dogs could learn to salivate and become hungry at specific times of day or after fixed intervals. If you think that food odors are naturally appetizing, ask yourself: Why do we respond to food odors differently than other evocative and pleasant odors – flowers and plants, soil, sea, even pleasant or sensual human scents? Many advocates of these diets, including the Atkins, Zone, and Protein Power diets, as well as various Paleo diets recognize the role that a generally low insulin level plays in weight loss and health. If you have been on a low carb diet, a high fiber diet, or a very low calorie or intermittent fasting diet, you can skip this phase. The best plans are Atkins, Protein Power, Paleo or any plan in which carbohydrates are limited to no more than 100 grams per day. You need to plan for this and always have available high caloric, non-insulinogenic snacks. Nevertheless, to be very clear, I do not recommend intermittent or extended fasting for anyone with a metabolic or hormonal disorder such as diabetes or hypoglycemia, or for anyone who has or suspects that they have an eating disorder. The Deconditioning Diet is not a path to eating disorders, because it is based on the principle of positive reinforcement, not aversive conditioning. The Mediterranean diet incorporates the basics of healthy eating, plus a splash of flavorful olive oil and perhaps a glass of good red wine, among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea. Fish — another source of omega-3 fatty acids — is eaten on a regular basis in the Mediterranean diet. Nuts are high in calories, so they should not be eaten in large amounts — generally no more than a handful a day.
This means no more than one 5-ounce glass of wine daily for women (or men over age 65), and no more than two 5-ounce glasses of wine daily for men under age 65. It provides excellent source of fiber and antioxidants through encouragement of eating lots of plant-based foods. Often these cravings result in loss of self-control and you give in to the temptation to eat, undermining the diet. Many of these diets do work in the short term, by reducing net calories (Weight Watchers), reduced caloric density (low fat or high fiber diets), reducing insulin and suppressing appetite (Protein Power, Atkins and other low carb diets, Mediterranean diets, Paleo diets), or using flavor control to induce satiety (Shangri-La Diet, Flavor Point Diet and Sensa tastants).
A relatively constant level of blood sugars and free fatty acids (FFAs) or ketones in the blood ensures that the cells throughout the body are getting the food they need.
If their levels are raised, and insulin is present, lipoprotein lipase works to release these lipids from circulating triglycerides and lipoproteins in the bloodstream, and transport them to be stored in adipose tissue. Levels of insulin, leptin and other hormones also modulate the receptors in the brain and other tissues that determine availability. In sedentary or obese individuals, it make take some adaptation to up-regulate the necessary enzymes and hormones for this so exercise can induce hunger or light-headedness if sufficient glucose or fatty acids are not at hand. In the extreme case, if blood sugar continues to drop, the hypoglycemia could put you into shock or even a coma, similar to what diabetics experience when they misjudge the dose of insulin they are injecting and it overshoots.
If you were to wait an hour after a small appetizer, you might lose some of that hunger, but not all.
Pavlov identified enzymes such as amylase among the digestive fluids that he isolated from salivating dogs, but he did not at the time realize that insulin and other hormones (including the hunger signaling hormone ghrelin) were part of those secretions.
Other protocols, including low glycemic diets, overall calorie restriction, intermittent fasting, and exercise have also been studied and advocated as methods of lowering insulin as a means of weight loss and improved health. But as soon as flavor cues are reintroduced in combination with each other or with added insulinogenic calories, the appetite suppression effect goes away.
In all the above diets, the stimulus-response relationship between food cues and appetite are taken as a given.
You could skip ahead to the final phase if you want fast results and are highly motivated, but I think the chance of success is best if you follow the recommended order.
You can be a bit looser than that if you want, and go as high as 200 grams of carbs per day. You can choose your mealtimes and you can eat as much as you like at each meal, but try to keep the actual eating at meals to less than 45 minutes. It is important that these snacks have no or little glucose or starch, and even protein should be minimized. There are good many websites on intermittent fasting and different schools of thought regarding the ideal length and frequency of the fast — which can range from 12 hours every day, to 24 hours once or twice a week.
Most healthy diets include fruits and vegetables, fish and whole grains, and limit unhealthy fats. Throughout the Mediterranean region, bread is eaten without butter or margarines, which contain saturated fat or trans fats.
Studies have shown that omega-3 fatty acids lower triglycerides and may provide an anti-inflammatory effect helping to stabilize the blood vessel lining. Any more than this increases the risk of health problems, including increased risk of certain types of cancer. Many Mediterranean cultures adopt a laid-back attitude toward life, which decreases daily stress. His synthesis of this research lends overwhelming support to the hypothesis that hunger and satiety are governed at a fundamental level by how hormones regulate the availability of metabolic fuels like fat and glucose in the bloodstream.
The appetizer effect is especially pronounced when the appetizer has carbohydrates. Rodin et al. This comes about because their more abundant body fat becomes insulin resistant, requiring more insulin to do the same job of storing sugar.
The secretion of insulin prior to eating can lead to a rapid drop in blood sugar and fatty acids, with a corresponding an increase in appetite. The tractus solitarus then relays a signal to the vagus nerve, a major nerve in the parasympathetic nervous system, which in turn branches extensively into the primary digestive organs: the stomach, intestines, pancreas and liver. It is not surprising that dogs could be deconditioned from responded to buzzers and lights, but what is most surprising is that they could learn to no longer salivate when presented with food. Could we be conditioned to salivate and secrete insulin in response to the smell of a rose if we always sniffed a rose before gulping down a sweet drink? In these flavor control diets, you have not unlearned any flavor cues, you just avoid their effect by sidestepping them based on food choices.

Appetite is suppressed by avoiding or limiting cues like flavor, but not altering or extinguishing them.
But if you have a strong appetite all day long, snack throughout the day, and cannot miss a meal without going bonkers, then I recommend you start here with Phase 1. Note the time and date, the nature of the craving (general hunger or for a specific food, and what may have set off the craving. The more active the better –watching TV or reading a book may not get your mind off food.
Whether or not you are having the actual craving, go to the refrigerator or do whatever you would normally do in that situation. To keep the cravings in check, I recommend saturating your sense of smell by alternating between smelling the trigger foods and other fragrant food smells that don’t give you cravings.
That’s because pre-prandial insulin secretion is brief, and ends within about 15 minutes. It may be a hours later, or days later…even weeks after you thought you had dampened the craving. It has been adequately debunked by a number of studies of fasting. Not only does reducing your caloric intake not cause your metabolism to slow down, it also does not result in a loss of your hard-earned muscle. You’ll still have a healthy appetite and eating food will be just as pleasurable as before, but not compulsive. While these fundamental parts of a healthy diet remain tried and true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease.
The Mediterranean diet discourages saturated fats and hydrogenated oils (trans-fatty acids), both of which contribute to heart disease.
If you are unable to limit your alcohol intake to the amounts defined above, you have a personal or family history of alcohol abuse, or you have liver disease, refrain from drinking wine or any other alcohol. By using deconditioning techniques to silence your cravings, you will gain the freedom to lose as much weight as you want and to eat or not eat at will. A recent world record for fasting was set by Agasi Vartanyan, a Russian man who lost 60 pounds during a 58-day fast, drinking only water. Nor will it be elevated by non-caloric components of the diet, such as fiber, minerals or water.
In some ways, insulin resistance is an adaptive response — if you are getting more fuel than you need, try to slow down the rate of storage by making the price of admission to the store room higher. So the flavor control diets are not Pavlovian diets, because they don’t change conditioning. The goal of this phase is to reduce your basal insulin and normalize your blood sugar stability as much as possible and as soon as possible. It may be that the food cues are slightly different and the craving arises in slightly different context.
There is one imperative rule that goes along with this statement: you have to be involved in some sort of resistance exercise, such as lifting weights. By eating at pre-scheduled times, you will be in control of your appetite, rather than your appetite being in control of you. Seafood plays a very important part in the diet, and portion sizes of meat in particular, as you can see above are often smaller. What you need an effective approach to long term weight management that is psychologically sustainable. We are capable of tapping into our glycogen and fat stores for energy for several days, without losing significant muscle mass. A more complete picture would include the other hormones and enzymes involved in transport of sugars and lipids. However, if these bloodstream calories cannot readily come from storage, they must come from food, and fast.
Unfortunately, if eating continues and blood sugar levels rise beyond what the body can tolerate, the sugar must go somewhere. This is curious, because the research cited by Roberts and Hirsch actually support Pavlov’s early findings that food cues can be conditioned or deconditioned. Once you have that in hand, give up snacking within two hours before lunch and dinner, but allow snacking otherwise. The idea here is that multiple fragrances will fully saturate your sense of smell and dampen the craving response. The goal here is not to lose weight (although you will) or to do a spiritual penance of some sort. While long term caloric restriction on its own can cause you to lose muscle mass (such is the case with hospital patients who are on a low calorie diet and confined to bed rest), the combination of caloric restriction with resistance exercises has been proven to be very effective at preserving your muscle mass.
Many people find they feel wonderful on their fasting days–clear headed, full of energy, focused. By alternating between eating and fasting, you will have adapted your body to be able to readily switch between storage mode and fat burning mode. In other work, she also found that the obese secrete far higher levels of insulin in response to the smell or sight of food than do lean individuals. So the pancreas responds by putting out even higher levels of insulin–paying the higher price of admission.
Anything more than 200 grams per day could spike your insulin levels, make weight loss harder, and maintain your ravenous appetite.
Allowing long breaks without food between meals (and especially at night) is absolutely critical to establishing a low basal insulin level.
Research published by the American College of Nutrition showed that men and women undertaking a 12 week long, very low calorie diet consisting of only 800 calories and only 80 grams of protein per day, were able to maintain their muscle mass as long as they were exercising with weights three times per week.
I and many others even find that exercising and intense workouts on fasting days bring great results. Further, by eating less and less urgently, your levels of glucagon, the hormone involved in gluconeogenesis and lipolysis, will increase, and stored glycogen and fats will be more easily broken down to raise blood sugars and fatty acids, increasing your sense of satiety throughout the day.
Without training, you will only be able to get so far before you exceed your capacity, and it would be futile to push yourself beyond your limits. If this goes on too long, the pancreas can burn out, unable to keep up with demand, and the result is full blown diabetes. By contrast, post-prandial insulin secretion does not start until 15 minutes after eating, and peaks at about 30-45 min. And that fact that food preferences and their intensity are not inborn, but can change significantly across cultures or within the life of a single individual. Inhale the food fragrance in 5 to 10 deep breaths, enjoying the pleasure of each inhalation. Treat each craving as an opportunity to demonstrate your extinction and counter-conditioning techniques.
Additional supporting information can be found on the excellent sites on intermittent fasting and exercise at Log My Loss, Fitness Blackbook, Leangains, and Eat-Stop-Eat.
In lean individuals pre-prandial insulin secretion may represent only about 3% of post-prandial insulin release. For now the key question is why most people can’t even skip one meal or snack without irresistible cravings and loss of control over their eating behavior. But it has been noted that in obese humans and rats, pre-prandial insulin is significantly higher. While it may avoid insulin spikes on the high end from large meals, it never allows your insulin levels to hit bottom. One great way do to cue exposure is when you are accompanying others to eat (when you don’t) or preparing a meal for others.
This is a completely healthy phenomenon, not to be confused with the dangerous ketoacidosis and blood acifidication that diabetics get from insufficient insulin.
By contrast, lean individuals have a much lower basal insulin level, and a more muted response to eating meals. If you have cravings, wait until 15-30 minutes after they subside to a low rumble before eating. During ketosis, you will find your blood sugar is typically very even and you have bountiful energy while you are living off your own fat! If you away from home, walk though a market, bakery, or coffee shop with aromas that you like, foods with a prominent signal like doughnuts, cinnamon buns, coffee or cocoa. You can have calorie free beverages (coffee, tea, or herb tea) between meals with no added sugar, but you can drink as much water as you would like.
Remember cue is the full context, including the room and walking into the room at that time of day.
Don’t be afraid of exposing yourself to the food and experiencing cravings, look forward to it!.

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