Love Your Guts!

Intestino

The health of your intestines effects, not only how you digest and absorb foods and nutrients, but also contributes to the health of your body and how your brain functions.

We still do not fully understand all the different links between our gut and the rest of our body, but we have enough research that links our gut health to the health of our body and risk for diseases.

Our goal should be to reduce inflammation and increase good bacteria in the large intestine.

How do you do this?  There are multiple factors that contribute to gut health.

  1. Stress.  Some individuals have intestines that are more sensitive to stress than others.  I am one of those individuals.  The combination of certain foods and a stressful situation can result in irritable bowels.  Why does this happen?  Stress slows down the digestion of food and as a result may cause abdominal pain and discomfort.    Practicing stress management, taking time for you (doing non-food related activities) and using different types of psychotherapy such as Cognitive Behavioral Therapy, Relaxation Therapy, or Hypnosis can all be beneficial.
  2. Be physical active!  Activity is important and helpful for the movement of the intestines.  The key is to be active regularly and throughout the day.  If you have a sedentary job, try to stand every 20-30 minutes and move around.  Optimally, walk around for 2-5 minutes.  It is better to move and be active throughout the day than to have a 30 minute workout in the morning and then sitting all day long.  Walking is one of the simplest and easiest forms of exercise as it can be done any time and does not require any special equipment except a good pair of shoes.IMG_2936
  3. Eat Fiber!  It is reported that Americans consume less than half of the recommended amount of fiber per day.  Fiber is found in all our plant foods including vegetables, fruits, beans, lentils, nuts, legumes, and whole grains*.*(check with your doctor before eliminating wheat/barley/rye as often it is not an issue with gluten but may be FODMAPS or other factors; some people may be gluten sensitive/gluten intolerant – but these do not cause damage to the intestines. Individuals with celiac disease must eliminate gluten completely – the body cannot handle it and as a result the body attacks the small intestine wall and destroys the villi which how nutrients are absorbed.)* Research on non-gluten diets for weight loss in those who do not need to eliminate gluten has been shown to not be effective.
  4. Eat whole foods.  Make the majority of your diet whole foods, foods that have little to no processing.   Limit and reduce packaged/processed foods and drinks. Prepare foods at home vs. eating out.mix of foods
  5. Include Resistant Starch in your diet.  If you are eating a variety of whole foods, than you are likely already getting resistant starch in your diet.  Resistant starch is found in grains, seeds, legumes, cashews, raw oats, green (unripe) bananas, raw potato starch, cooked & cooled (retrogradation) potatoes, pastas and rice.   Resistant starches are not digested in the small intestine, passing into the large intestine similar to soluble fermentable fibers. It feeds the good bacteria which then produces short chain fatty acids, specifically butyrate which fuels the cells that line the large intestine to maintain a strong intestine wall.
  6. Probiotics and Prebiotics.  -Probiotics are good bacteria in foods or added to foods (yogurts, kefir, milk, cheeses).  They work to inhibit the growth of bad bacteria, antigens, toxins and carcinogens.-Prebiotics are non-digestible foods that promote the growth of good bacteria in the large intestine found naturally in raw garlic, raw leeks, raw dandelion greens, raw onions, cooked onions, raw asparagus, raw wheat bran, baked wheat flour, raw banana.

Foods to limit and avoid

The following are foods that are known to destroy good gut bacteria and increase bad gut bacteria.  A greater prevalence of bad bacteria has been linked to a number of diseases (heart disease, diabetes, obesity, etc).

  1. Non-nutritive sweeteners (NNS).  Limited research (mostly done on saccharin), but so far it does not look good. Research shows that it alters the gut bacteria in just 5-7 days. They have observed that gut bacteria is negatively different in those individuals who consume NNS.
  2. Added sugars.  Foods with added sugars, sweetened beverages, (including any NNS beverages), processed packaged foods.
  3. Fried Foods
  4. Long term antibiotic use – destroys the good bacteria – which can lead to weight gain as a result of higher rates of digestion.

To improve the health of your intestines, use a combination of all six factors discussed above.

We have been fermenting our own kefir.  It requires daily processing, but can be done very quickly.

IMG_9805
Kefir fermenting

One of our favorite ways to use the kefir is to make overnight oats.  I use Coach’s Oats, fresh strawberries and kefir.  To me the strawberries are the perfect fruit to help mask the tartness of the kefir.

IMG_9804
Preparing overnight kefir oats with Coach’s Oats, Strawberries and kefir

Our kids love to have kefir in smoothies.  You can put anything you want in the smoothie.  Our favorite combinations have been banana berries or tropical using mangos, banana and pineapple.  Throw in some ice and it makes a nice frothy, thick smoothie!

 

 

References and Resources

  1. Academy of Nutrition and Dietetics (AND) outright.org
  2. https://ed.ted.com/lessons/how-the-food-you-eat-affects-your-gut-shilpa-ravella
  3. http://fodmapfriendly.com/what-are-fodmaps
  4. http://www.eatright.org/resource/food/vitamins-and-supplements/nutrient-rich-foods/prebiotics-and-probiotics-the-dynamic-duo
  5. https://www.bbcgoodfood.com/howto/guide/health-benefits-kefir
  6. http://www.health.harvard.edu/newsletter_article/stress-and-the-sensitive-gut

Making the Holidays Healthier

The Holidays can be a challenging time to maintain health.  There are   many parties and lots of food choices, especially treats and higher calorie options. Here are some ideas for how you can navigate through the holidays by making some healthier choices and still enjoy some of the treats.
Collab_SweetsWinter_part5 (4)

Make treats a little healthier: We enjoying making treats, however, we look for ways to improve the nutrition quality of those treats. For example, many cookie recipes call for more sugar than needed, so simply reducing the sugar can be beneficial (we prefer to reduce the sugar versus using a sugar substitute). Instead of white flour – try using whole grain flour, ground oats or a combination of whole grain and white flour. In brownies or any chocolate recipe – we always use whole grain or multi-grain flours as you don’t notice the difference due to the rich flavor of the cocoa or dark chocolate. But this whole grain substitution can also work in regular cookies.  I have adapted a s’more cookie recipe by using ground grapenuts and multi-grain flour vs. the ground graham crackers and white flour the original recipe calls for and no one notices the difference.

bowl of veggiesBring healthy treats: Skip the cookies and sugar sweetened treats and bring vegetable and/or fruit trays or salads to your holiday parties and then fill your plate with the fruit and vegetables and you are less likely to reach for the cookies, cakes and sweetened treats.

Eat a healthy balanced meal first:  If you know you are going to an event that is not likely to have many healthy choices, eat a nice balanced meal before hand so you are less likely to eat at the event.  If you know you would like to enjoy some of the treats at the event, eat something nutrient dense but low calorie before going to the event so you are satisfied. For example a spinach salad (or any dark greens) with a mix of vegetables, maybe some fruit and then some type of fat/protein (olive oil, some cheese, nuts, egg or pieces of meat like chicken or salmon).

Prioritize:  Multiple events and added stresses may cause you to adjust your typical workout schedule.  Be sure to evaluate your time and schedule and ensure you are still getting in your regular workouts, even if it means shortening your workouts.  By staying consistent with your exercise, you will be less likely to be tempted by all those holiday treats.

Moderation:  If there is that special cookie, treat or bread that your co-worker, neighbor or family member makes that you look forward to all year, then plan in that treat.  A couple of treats over the holidays will not result in any major change or set back in your pathway to health.  In fact, studies show that individuals who do plan in treats in moderation have greater health and satisfaction.

Enjoy the holidays in moderation so you stay on your path of good health.  That way when January 1 rolls around, you can continue to focus on your progress forward versus how to make up for your choices over the holidays.

Kristine

Great article with additional strategies from ACE: How to throw a Fit and Healthy Holiday Party

 

 

Does when you eat matter?

Does your body care when you eat your meals throughoutClock the day?  Yes, there is research showing that the timing of our meals throughout the day does appear to influence weight management.  We highlighted in a post last week that the type of foods you eat matters more than the calories.  We have also talked about the importance of breakfast and how important it is to have both a good protein food source as well as good high fiber food sources (such as eggs with oatmeal and raspberries).

Now consider when you eat throughout the day.  This is always an interesting topic in my Nutrition class, as many college students explain that they skip breakfast because they don’t have “time” to eat usually because they wake up right before they need to be out the door.

What effect does skipping breakfast have on you?  Can’t you just adjust your meals to eating late breakfast, lunch and dinner to compensate for waking up late?  You can, and many do (or they just skip a meal altogether).  But then how does that affect your choices throughout the day and how does it affect your body?  A few research studies 2 years ago specifically looked at the effect of pushing meals back and eating them later than typical.  One study evaluated two different groups.  Those who ate their lunch at a regular time versus those who ate their lunch “late”.  Interestingly, total calories, dietary composition, estimated amount of energy they expended in a day, appetite hormones and sleep duration were all similar between groups.  However, those in the group that ate lunch late (after 3PM) lost less weight and experienced a slower weight loss over the 20 week study period.  Additional research is planned to evaluate these factors.

A second study that came out the same year, evaluated the impact of the size of the meal throughout the day.  In this study, individuals were again divided into 2 groups.  One group consumed a large breakfast, medium lunch and small dinner (they evaluated based on calorie content).  The second group had the reverse meal schedule starting with a small breakfast and ending with a large dinner (this is typically what we see in the American diet – little to no calories for breakfast, an average lunch and then a large caloric dinner).  The results are pretty surprising.  The group that started the day with a large breakfast (~700 calories) lost an average of 17.8 lbs (3 inch waist circumference decrease).  While the group that consumed the large dinner (~700 calories) had less than half the success with an average of 7.3 lb lost (1.4 inches from waist).  This was evaluated over a 12 week period.

What about the diets that state it is better for your metabolism to eat small frequent meals throughout the day versus 3 big meals?  This to has been researched and the latest research has shown that individuals who eat small frequent meals throughout the day are not satisfied and end up eating more calories throughout they day versus those who consume 3 regular meals with perhaps a snack or two.  Physiologically, meals should be timed about every 3-4 hours throughout the day.  What I find most people struggle with is they eat lunch around noon and then dinner around 5-7 PM.  The problem here is going going 5-7 hours without food.  Then, when they finally eat, they usually do not make the best food choices and/or eat more than they intend.  This would be a good reason to include a healthy snack mid afternoon (~3 PM) to help curb hunger until dinner time.  A snack should really be a small meal, a combination of a healthy source of carbohydrate, protein and fat (nuts and fruit, veggies with savory yogurt dip, cheese or peanut butter and an apple, etc).

In summary, Eat Breakfast!!  Go to bed a little earlier, prepare your breakfast/or parts of your breakfast the night before to help reduce prep time and make Breakfast a priority.  All meals should be a good balance of healthy carb, protein and fat food choices, but the best breakfast is one that includes protein and fiber (cereal and milk just doesn’t cut it).  For example, a multi-grain toast with peanut butter and banana with a glass of milk is quick and easy to prepare.  Be consistent with your meals throughout the day.  Be sure to eat every 3-4 hours with the greatest amount of calories consumed at breakfast and gradually decreasing over the course of the day.

Kristine Clark

Wellness Associates

Sources:

1. Garaulet MGómez-Abellán PAlburquerque-Béjar JJLee YCOrdovás JMScheer FA. Timing of food intake predicts weight loss effectiveness. Int J Obes (Lond). 2013 Apr;37(4):604-11. doi: 10.1038/ijo.2012.229. Epub 2013 Jan 29. http://www.ncbi.nlm.nih.gov/pubmed/23357955

2. New Study Highlights Weight Loss Benefits of Proper Meal Timing. http://www.acefitness.org/prosourcearticle/3460/new-study-highlights-weight-loss-benefits-of/

3. Night Snacking Woes: Is Food timing Key to Weight Loss?  http://www.foodnavigator-usa.com/Manufacturers/Night-snacking-woes-Is-food-timing-is-key-to-weight-loss

4. Cameron JDCyr MJDoucet E. Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet. Br J Nutr. 2010 Apr;103(8):1098-101. doi: 10.1017/S0007114509992984. Epub 2009 Nov 30. http://www.ncbi.nlm.nih.gov/pubmed/19943985

5. Ohkawara KCornier MAKohrt WMMelanson EL.Effects of increased meal frequency on fat oxidation and perceived hunger. Obesity (Silver Spring). 2013 Feb;21(2):336-43. doi: 10.1002/oby.20032. http://www.ncbi.nlm.nih.gov/pubmed/23404961

Don’t count calories, eat food that counts!

UnknownMost all diets are based on reducing calories.  Some diets require a certain calorie level.  Restriction, usually in calories as well as foods enjoyed by the individual, may result in some weight lost, but the ability to sustain the diet is not feasible.  A cycle of yo-yo-dieting begins in the search to find a “diet” that will provide the weight loss and “body” individuals are seeking.  There are two problems here.  First, focusing on weight loss or the “perfect body” is outcome based.  When outcome is the focus, how one gets there usually is not, resulting in unhealthy, sometimes dangerous methods.  For most, outcome focused “dieting” is not sustainable or an enjoyable process and leads to regaining pounds, plus some, when the individual reverts back to regular habits.  Second, greatly reducing your caloric intake is problematic for a number of reasons.  If calories are too low, you will not be able to consume adequate amounts of necessary nutrients.  In addition, not only do most diets require a reduction in calories, but usually encourage the elimination of one or more whole food groups.  Eliminating whole food groups means eliminating necessary and important nutrients (vitamins, minerals, fiber, phytochemicals, antioxidants, etc).

Well known metabolic researcher, David C. Nieman, has found the resting metabolic rate (RMR) on average for females is ~1200-1400 calories/day and ~1500-1800 calories/day for males.  What does this mean?  This is the amount of calories required by your body just to sustain the functions of your body while at rest.  This does not include any daily activity or physical exercise.  Therefore, it is no surprise that individuals find it challenging to try to “diet” on 1500 calories or less a day.  At this level, you may not even be providing your body with the minimum amount of calories it needs.

What if you did not have to reduce your calories at all, but simply change the type of foods you were eating to experience some weight loss (an greatly improve your health)?  While we have known for a long time how important it is to provide our bodymix of foods with nutrient dense whole foods, new research out this week examines other countries diets’ compared to the American diet and shows quantitatively what could happen if just the makeup of an individual’s diet was changed without reducing calories.  For example, they found that if you simply changed your diet to a mediterranean diet with no change in typical caloric intake, your BMI (body mass index – a simple ratio of your weight over your height) would be reduced by about 2.5 points.  If you adjusted your diet composition to mirror that country as well as followed the average amount of calories that country consumes, you would experience a greater reduction (up to 3 point reduction in BMI based on a Japanese diet).

How is it possible that you could reduce your weight just by changing the foods you eat without reducing calories?  Not all calories are created equal.  Our bodies prefer whole, unprocessed foods which provide a variety of naturally occurring nutrients.  Most other countries rely on and consume a higher amount of plant-based whole foods.  While the American diet is composed of highly processed and refined foods.  The most recent report shows the top 5 sources of calories for adults are: grain-based desserts (cookies, cakes, pies, donuts, sweet rolls, etc), yeast breads, chicken/chicken dishes, sodas/energy drinks/sports drinks, alcoholic beverages).  It has also been reported that eating in restaurants contributes on average about 20% of overall calories.  bowl of veggies

Are you ready to make a change?  Evaluate what you have in your fridge and cupboards.  Make a plan for how you can eliminate those highly processed, empty calorie foods and begin replacing them with less processed, whole food options.

This new research supports the approach of Wellness Associates of focusing on the composition of the diet, rather than calories.  if you want to tweak your diet or begin to use more whole foods give us a call and let us guide your journey toward a more healthful diet.

Kristine Clark

Wellness Associates

References:
1. The Cost Savings of Changes to Healthier Diets in the U.S. http://ageconsearch.umn.edu//handle/205608

2. How Americans can lose a lot of weight without giving up a single calorie.
http://www.washingtonpost.com/news/to-your-health/wp/2015/07/27/how-americans-can-lose-a-lot-of-weight-without-giving-up-a-single-calorie/

3. Disturbing chart shows the 25 foods that make up most of the calories Americans eat. http://www.businessinsider.com/foods-that-make-up-most-of-the-calories-american-consume-2015-2

4. Your Metabolism: Facts and Fables. http://ncrc.appstate.edu/sites/ncrc.appstate.edu/files/Nieman-Your%20Metabolism-NCRC.pdf

5. Eat More, Weight Less. http://www.cdc.gov/healthyweight/healthy_eating/energy_density.html

Can certain words have an impact on how you feel about food?

How we think about our food impacts our food choices and how we eat.

11 Sep 2007, Garnerville, New York, USA --- Assortment of High Fiber Foods --- Image by © Envision/Corbis

In the article, Five words you should stop using when you talk about food, the author highlights the reasons to eliminate the words detox, cleanse, skinny, never and perfect from our vocabulary when talking about food.  A few other words we hear frequently that could be added to the elimination list include “clean” and “cheat”.
Clean in itself is not a negative word, but the way it is used in association with food creates an opposition in our minds, implying that some foods are “dirty.” Initially, trying to eat more “clean” may be a very positive step for some individuals, as usually processed foods are eliminated first.  For some individuals, this view of food can lead to extreme thinking resulting in the elimination of what is consider healthy and nutritious foods. Over time, they justify why a food is no longer “clean” or “pure” (some refer to this extreme way of eating as orthorexia) and eliminate even more foods from their diet until they only consider a handful of foods acceptable to consume.

greens
“Cheat” on the other hand, is a negative word and implies we are doing something wrong or something we should not. Many individuals will eat “clean” all week and then allow a “cheat” day where they can eat those foods they do not consider “clean” or they view it as a free day to eat whatever they want that day. This mindset contributes to unhealthy eating behaviors. On “cheat” day many individuals tend to over-consume or over-indulge in what is considered the not-so-healthy food choices.  This approach is similar to restrictive dieting, where individuals eliminate foods they enjoy because it is not “allowed” on their diet.  The funny thing about restricting foods from our diet, is it creates a desire to want it more.  As a result, when individuals get to the point where they just can’t deny their favorite food/treat any longer, they typically over-consume that food.  This can lead to a cycle of negative feelings, such as shame, failure, and unhappiness followed by compensating with additional unhealthy behaviors including more over-eating (some would call this emotional eating) and/or trying to compensate by exercising.  mix of foods

How can you have a positive relationship with food?  The first step is to eliminate negative words you associate with foods. Second, focus on consuming a balance of different foods which include, vegetables, lean meats/proteins, fruits, whole grains, healthy fats and low fat dairy.  Each food group provides the body with important nutrients the body requires.  If you eliminate a whole food group – you will likely be eliminating important and required nutrients your body needs.  Third, it is okay to have treats or the not-so-healthy foods on occasion.  We like the 90/10 guideline which means try to make 90% of what you eat each day as nutritious as you can allowing yourself 10% of what you eat to be from not-so-nutritious foods.  When you plan in the treats and less nutritious foods, then there is no association of guilt or shame from consuming them.

The research supports this idea of eating healthy the majority of the time and planning in small treats in moderation.  Why does this work?  If you plan in your treats (dining out on occasion, going to a party, etc) then you eliminate the negative feelings that come when you eat something that you have decided is restricted from your diet.  Eliminate the restrictions and focus on a balance of whole foods with your favorite treats in moderation and you will find yourself happier and more satisfied with eating.

If you are struggling or have a negative relationship with food, let us help you think of food in a positive way in order to develop a positive relationship with eating.

Kristine Clark

Wellness Associates

Supporting article written by some professional colleagues: “Why Treats should be Part of any Healthy Diet”

Iron or Spinach?

Do you worry about getting enough iron, omega-3’s, calcium, or other specific nutrient?

Or is your focus on getting enough vegetables, fruits, lean proteins, whole grains and low fat dairy options?

Not surprisingly, the media, advertising and research results have influenced us to have greater concern and focus on a single nutrient versus the whole food that contains that nutrient.  Is there a problem with focusing on the nutrient (or being nutrient-centric) vs. focusing on whole foods (or being whole food-centric)?  Based on new research, yes, it appears this is a concern.

A study published just this month evaluated the perceptions of over one-hundred adults.  Each group received a description of a man and his behaviors and were asked to rate his risk for disease.  The descriptions were exactly the same except for the description of the diet.  One group received a description that listed the type of nutrients consumed, while the other group received a list of the foods consumed.  The information was equivalent. The way the information was presented was the only difference for the nutrients amounts matched up with the foods where those nutrients found.  However, the interesting part is those who had the nutrient list for their diet, ranked the person as having a lower disease risk.  And those who received a corresponding list of whole foods containing the same nutrients, ranked the man with a higher risk for disease.

So what does this mean?  As a society, we seem to think that isolated nutrient focus is more important than focusing on whole food consumption.  The reality is that there is a greater health benefit and absorption rate by consuming our nutrients in whole foods (with a few exceptions).  For example, if you consume raspberries (vs. taking a vitamin C supplement) you will not only be getting vitamin C, but fiber (raspberries are an excellent source of fiber per serving! ), potassium, and some calcium, iron, B-6 and magnesium to name a few.  We still do not fully understand all nutrient interactions, but we do know that consuming whole foods usually results in better absorption rate for the body as well as utilization within the body.  These interactions within the body are important for reducing risk for disease.

food

From a safety standpoint, there has been no evidence of dangerous levels of nutrients within the body when people are obtaining their nutrients from whole foods.  However, when supplements are involved toxic levels may build up in the body and result in negative health issues.  For example, we have seen negative health consequences linked to supplementation of Vitamin E, beta carotene and calcium.  This is why it is important to speak with your physician and/or registered dietitian regarding whether a supplement of any kind is warranted, necessary or appropriate for you.

For more individualized feedback and help, please contact Kristine Clark Wellness Associates.

Resources:

JP Schuldt, AR Pearson. Nutrient-centrism and perceived risk of chronic disease. J Health Psychol June 2015 vol. 20 no. 6 899-906. 

Woodside JV1, McCall DMcGartland CYoung ISMicronutrients: dietary intake v. supplement use. Proc Nutr Soc. 2005 Nov;64(4):543-53.

The Weight Management Puzzle

Do you struggle with maintaining your weight or losing weight?

Do you feel like you are eating well, but not seeing any results?

Does it seem that you are eating well and exercising but still feeling frustration from a lack of visible results?

Some of the issue could be in what, when and how much you are eating.  Though important, Diet and Exercise are only two pieces of the puzzle.  Keep in mind that some of your weight puzzle is influenced by genetics and other biological factors outside your control. This is one reason comparing our weight or appearance to others is not very helpful. Most of weight management is a balance between several behaviors beyond just diet and exercise.  The most commonly overlooked pieces of the puzzle are sleep and stress. (Watch for our next Blog post on stress).

Screen Shot 2015-06-02 at 4.42.26 PMHow does sleep affect weight management?  Getting too little sleep (less than 6 hours) and getting too much sleep (9 hours or more) disrupts the hormones that help to regulate hunger and fullness and how our brain responds to different stimuli.  For example, individuals who slept half their usual time (~4 hours instead of 8) just one night, were drawn to more fattening, unhealthy type foods and the front part of the brain that governs decision-making was found to be relatively inactive which led them to eat more unhealthy foods.  It is also found that individuals who get too little sleep, have a tendency to eat a small breakfast and increase calorie intake after dinner.  Getting less sleep results in greater fatigue during the day.  This fatigue may influence individuals to be less active and more sedentary.

What effect does stress have on the body?  If you have been up late at night, perhaps you have seen one of many infomercials highlighting the effects of increased cortisol due to stress which increases abdominal fat.   This part of their commercial is true.  However, the key to reducing that abdominal fat is to reduce the negative effects of stress and learning healthy ways to manage your stress.  Stress can result in a build up of anxiety.  Anxiety and stress can lead some individuals to turn to food as unhealthy methods of “coping”or “comfort” rather than seeking appropriate methods of working through the stressors.  When food is used as a coping method, often it is consumed mindlessly, meaning the food is consumed because it is there, but you are not enjoying the process of eating or really tasting the food in front of you.

Sometimes it is hard to figure out how all the pieces of the weight management puzzle work best for you.  Just like putting a real puzzle together, you may be able to easily fit some pieces together, but others are just so challenging to figure out.  A good start is recognizing that the corners of the puzzle must include not only a balance in nutrition and exercise, but proper sleep and stress management as well.  The remaining inside pieces of the puzzle are then made up of the various healthy behaviors that can help you be successful managing each of the main components.  This is where we can help you.  Wellness Associates can help you identify the behaviors and barriers that are effecting your progress.  We can help you develop the skills and determine the tools that will best help you be successful in your progress.

Kristine Clark

Wellness Assoicates

http://www.WAcounseling.com

References:

St-Onge, M.-P., Wolfe, S., Sy, M., Shechter, A., & Hirsch, J. (2014). Sleep restriction increases the neuronal response to unhealthy food in normal-weight individuals. International Journal of Obesity (2005)38(3), 411–416. doi:10.1038/ijo.2013.114.

Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring). 2008; 16:643-53.

Chaput JP, Despres JP, Bouchard C, Tremblay A. The association between sleep duration and weight gain in adults: a 6-year prospective study from the Quebec Family Study. Sleep. 2008; 31:517-23.

Roberts, C. J., Campbell, I. C. and Troop, N. (2014), Increases in Weight during Chronic Stress are Partially Associated with a Switch in Food Choice towards Increased Carbohydrate and Saturated Fat Intake. Eur. Eat. Disorders Rev., 22: 77–82. doi: 10.1002/erv.2264.