How Tasty Foods Change The Brain
Former FDA Commissioner Dr. David Kessler discusses how milkshakes, buffalo wings and other sugary, fatty and salty foods train the brain to overeat. Gail Vance Civille, president of food consulting firm Sensory Spectrum, talks about the most alluring flavors and textures.
IRA FLATOW, host:
You're listening to SCIENCE FRIDAY from NPR News. I'm Ira Flatow. We're going to be talking now about health and nutrition and food.
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Mr. BERT LAHR (Actor): Lay's Potato Chips. Bet you can't eat just one.
Unidentified Announcer: Nobody can do that. A potato you can slice this thin makes a chip so light, so crisp, you can eat a million of them, but nobody can eat just one.
FLATOW: Remember that old slogan, the Lay's Potato Chip commercial, Bert Lahr there, bet you, you just can't eat one, just one. I don't know if I've eaten a million of them in one sitting, but why is it so hard to win that bet to eat just one?
My next guest has written a book on the topic. It's called "The End of Overeating: Taking Control of the Insatiable American Appetite." But if you could then condense those 320 pages down to three words, they would probably be sugar, fat and salt. In combination, these three ingredients have a powerful hold over us and not just because the food tastes good but because they taste good, and they make us feel good. And at least for a little while, that is, before we start getting a stomach ache.
Eat and feel good enough times, and pretty soon, your brain pushes you to seek out that food more and more, and you keep eating that food if it's out there in front of you. You create a cycle of craving. It gets stronger every time you pop open a bag of chips or you sip that milkshake.
So what's going on inside your brain, inside there to make you do that, and is there a way to just eat one chip? Joining me now to talk about that and some of the science on craving is Dr. David Kessler, professor of pediatrics, epidemiology and biostatistics at the University of California San Francisco. He served as commissioner of the Food and Drug Administration from 1990 to 1997. He joins us from KQED in San Francisco. Welcome to SCIENCE FRIDAY.
Dr. DAVID KESSLER (Professor of Pediatrics, Epidemiology and Biostatistics, University of California San Francisco; Former Commissioner of the Food and Drug Administration): Thank you for having me.
FLATOW: Did you start thinking about this while you were still at the FDA?
Dr. KESSLER: No, I didn't. We worked on the food label when I was at FDA. You know that little box, the nutrition facts, you know, when you pick up that food, and you look and it says it has 100 percent of your daily fat and you put it back, and that was our fault when we did that in the 1990s.
But no, this started about seven years ago, and it started with a question when I was sitting - I was at Yale with a group of medical students in residence, and we asked the question, if you want to live longer, just your previous guest, your previous topic - if you want to stay alive, what are the things you can do? What are the things we know work and know work in human?
We know that three-quarters of us are going to die from cardiovascular disease, cancer or stroke, and what are the things that work? And I noted as we were pulling the evidence, the literature on prevention, of what works, the librarian who was helping me lost 30 pounds just because so much of what contributes to morbidity and mortality is related to excess weight. But then I started thinking about why is it so hard? I mean, if it were just a question of diet and exercise…
Dr. KESSLER: …we'd all be doing it. And why is it so hard? And that was - one night, I'm watching Oprah. There's a woman on the show, well-educated, you know, spoken very well, and she said, and I just remember listening. She said, I eat when my husband leaves for work in the morning. I eat before he comes home at night. I eat when I'm happy. I eat when I'm sad. I eat when I'm hungry. I eat when I'm not hungry. And then she said: I don't like myself.
And I was listening and trying to listen, and listen as a physician, as a clinician. What was going on with this woman? Why was she doing what she didn't want to be doing? Now, I can relate. I have suits in every size, and it was that journey, trying to understand the science. What was I hearing? What was it about this woman and her behavior that led her to do what she didn't want to be doing?
FLATOW: Is sounds like, you know, as they say, you weren't eating - and she said I wasn't even hungry when I ate, but I was eating to satisfy some craving or some habit that I had, and…
Dr. KESSLER: When we use the word craving, you know, what do we mean? Why does that chocolate-chip cookie in front of me have such power over me? Is it that chocolate-chip cookie, or is it something how my brain encodes that chocolate-chip cookie? And how many people - out there, you know, can relate, have, you know, the same kind of experience as, you know, as that woman? And that was one of the questions.
So there were three characteristics. Let me give you three characteristics. Some people, when I raise these, have no idea what I'm talking about. One, a hard time resisting your favorite foods, a loss of control in the face of highly palatable foods. Two, a lack of feeling full, a hard time stopping. Three, a preoccupation with thinking about foods. You're thinking about foods in between meals or even when you're eating, you're thinking about what you're going to eat next. Those three characteristics - loss of control, lack of satiation, a preoccupation with foods - we call that conditioned hyper-eating.
You know, those are the elements of a conditioned and driven behavior. It's not a disease, but what we found, you know, with my colleagues here at UCSF, we found that 50 percent of obese individuals, 30 percent of overweight individuals, 20 percent of healthy-weight individuals report very high on those three characteristics. That may not sound like a lot, but if you extrapolate, and there's risks of extrapolation, that's some 70-million people. And there's many of us who have some of those characteristics.
You know, there's a small percentage of the population, and to me they're the most interesting. We don't know how many, but I would guess about 15 percent, for whom food is not a very salient stimuli. For them, if you ask them privately, they say, you know, I'd just as well take a pill rather than eat. They're the ones I want to study.
FLATOW: Yeah, I knew someone who says I don't like desserts. I can sit here and watch you all eat desserts, and I haven't got the slightest desire to eat any of this stuff.
Dr. KESSLER: But if you take the rest of us, if you take those who have this - score high on these three characteristics, this loss of control, lack of satiation, a preoccupation with thinking about foods, and you study their neural imaging, and we did it in two phases. My colleague, Dana Small at Yale, one of the great neuro-imagers, what we did is we took people who have this conditioned hyper-eating, and we studied them in two phases. First was just without the food itself, just the anticipation of food.
I mean, the power of food comes from its anticipation, and what we saw is in those individuals, just the smell of food had greater activation of their neural circuitry. And when they ate the food, the activation continued and stayed activated until all the food was gone. So we now have a neural correlate, a biological basis for why it's so hard for millions of Americans to resist food. It's not a matter of willpower.
FLATOW: But did they learn that? Was that conditioned like a rat running a maze, or was that something hard-wired from their birth or a combination of those two?
Dr. KESSLER: You know, that's a great question, and I wish I knew the answer exactly. I think there are components of both. There's no question in my mind that it involves the learning, motivational, memory and habit circuits of the brain.
Is there a genetic basis? I don't think it's a genetic basis for food. I gave my colleague, Neil Risch, you know, a professor of human genetics and one of the great human geneticists, all the data. And I said, you know, what's the hereditability of this kind of behavior? And the data is somewhat mixed. What there may be - you know, I go into restaurants now and I watch people, and you know, you watch a couple. One of them is reaching over to eat the fries of the other person, and that person just eats three-quarters of their sandwich. What is that behavior?
My sense is, and we don't have a very good word for it, it's almost an impulsiveness. Some people are more extroverted. The approach stimuli more willingly. Others are more avoidant. Now is that learned, or is that genetic? Well, it's certainly conditioned.
FLATOW: Well, that's what I'm asking. Is it conditioned, you know?
Dr. KESSLER: Well, there's no question it's conditioned, but it's important to understand it's not only conditioned, and this is key, Ira, it's conditioned and driven behavior. Understand the cycle. Based on past learning, past memory, you get cued. It could be the sight, the smell, the location, the time of day. You get cued. Your brain gets activated. There's arousal. Your attention gets focused.
You consumed. You have this moment of pleasure. It occupies working memory. You get cued again, you do it again, and every time you do it, you strengthen that neural circuitry. And if you try to stop that behavior once your brain is activated, you understand how hard it is.
It's not just learned behavior. It's not just conditioned behavior, it's driven behavior. The implications not only for us as individuals, when we come to understand that we're conditioning and motivating, it's conditioned and driven behavior not only of us but of us and our children for a lifetime, and we're laying down those neural circuits. That has major implications, certainly major implications from a policy standpoint.
FLATOW: But if I were to take away the word food, and you describe all those conditioned behavior elements to me, I would say that sounds like an addiction. I'm addicted to the food. I can't stop myself. I get - I see it, I have to have it. I drive by - and you talk about the In-N-Out Burger place in California that you have trouble driving by. That, to me, sounds like an addiction, that you've created neuropathways in the brain of an addictive sort. Would I be wrong in assuming that?
Dr. KESSLER: No, I don't think you're wrong. Understand the basis of that: We are all wired to focus on the most salient stimuli in our environment. For some of us, it could be alcohol, it could be illegal drugs, it could be gambling, it could sex, it could tobacco. For many of us, the most - one of the most salient stimuli in our environment is food. And what's the core components? How do you make food even more salient? Fat and sugar, fat and salt - fat, sugar and salt.
I thought I was eating for nutrition for nourishment. I - in writing this book, in researching "The End of Overeating," I learned that those things don't satisfy me. They stimulate me, and stimulate me to come back for more and more.
FLATOW: Mm-hmm. It sounds very much in the same kind of a pew as a Michael Pollan, to say these - very much the same kinds of things. It's junk food.
Dr. KESSLER: I think Michael - well, it's not just the fast food restaurants…
Dr. KESSLER: …right? I mean, it's - you go to, you know, Main Street America and you pick, you know, pick an appetizer in any of the, you know, modern American restaurants. And I would go pick buffalo wings.
FLATOW: Buffalo wings.
Dr. KESSLER: What are they? All right, you take the fatty part of the chicken. They usually fry it in the manufacturing plant first, that adds 30, 40 percent increase fat. You fry them again in the restaurant. That red sauce - what is it? Fat and sugar. That creamy white sauce on the side? Fat, sugar and salt. What are we eating? Fat on fat on fat on sugar on fat, sugar and salt.
FLATOW: Can't look at a - I can't look at a buffalo wing again the same way.
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FLATOW: But you know what happens. And I hear you want this. But, you know, I've noticed this myself because I like, you know, wings. But there's a time where I've overeaten and then the other side hits me. The stomach ache, the feeling of bloating, the sense that - why did I do that? Why did I inflict that on my body?
And if I can focus on that a little bit more the next time I see that buffalo wing, I'm able to say, don't eat it a little easier. If I can - let that negative thought creep in where the positive says eat me, then I've won the battle a little bit more. Can we do that? Can we train ourselves to do that a little better?
Dr. KESSLER: You just use the word training. Once that neural circuitry is laid down, that old learning is there, that old neural circuitry. How do you change that behavior?
First, let's disagree that diets are not going to work. I mean, sure, they'll work in the short-term. You can, you know, deprive yourself for 30 days, 60 days, 90 days. But if you go back after you finish dieting and you've not laid down new learning, new neural circuitry, change your relationship with food, and you go back into your environment and you can continue to get bombarded with food cues, what do you think is going to happen?
Dr. KESSLER: Of course, you're going…
Dr. KESSLER: …to gain the weight back.
In the end, what do we have to do? We have to cool down the stimulus. And if you look at those buffalo wings and say, that's my friend. I want that. There's nothing I can do to get between you and that bucket of buffalo wings.
In some ways, when you have a reinforcing stimulus - understand how this works.
FLATOW: Hang on, let me - you're going to make a point. I have to interrupt. I have a station break. Let me remind everybody that this is SCIENCE FRIDAY from NPR News. Talking with Dr. David Kessler, author of "The End of Overeating: Taking Control of the Insatiable American Appetite." And we're focusing in on a good example of the buffalo wing. Go ahead. Finish up that thought.
Dr. KESSLER: Just the comparison.
Dr. KESSLER: Because it's not any one ingredient. I mean, take nicotine, for example, right? Nicotine's a moderately reinforcing chemical. But for people who smoke, take the nicotine, you add the smoke, you add the throat scratch, you add the crinkling of the cellophane pack, you add the color of the pack, you add the emotional gloss of advertising - that image, you know, 30, 40 years ago that it was sexy, it was cool, a bit of cowboy. What did we end up with? A significantly addictive product.
I give you a package of sugar and I say, go have a good time. You're going to say, what are you talking about? Add to that sugar, fat, add texture, add temperature, add color, add the emotional gloss of advertising - put it on every corner, say you can have it 24/7. It's socially acceptable to eat and we can make it into entertainment. And what do we end up with? One of the great public health crises of our time. And why is it so hard to stop?
When you're looking at a reinforcing stimuli, if you look at it and say, that's my friend. That's going to make me feel better. You know, I know I don't want to gain weight, right?
Dr. KESSLER: I know I don't want to be obese. But that - those plate of fries really look good. I mean…
FLATOW: There's got to be brain chemistry going on in there, too, that's been laid down and tells you that that's hard for you to overcome. It's not just the vision of this, right?
Dr. KESSLER: Based on that past memory, past…
Dr. KESSLER: …learning, right? You get stimulated, you get cued, that anticipation of the food. I'm walking down Powell Street and I start thinking about chocolate covered pretzels. Why? Because I had been in a store, you know, six months earlier on that street and I ate those chocolate covered pretzels. I had forgotten entirely by it. It was such effective learners.
Dr. KESSLER: Right? So my brain gets activated. I get aroused. My attention gets focused. I have this moment of, you know, the pleasure that when I'm eating, it fills my working memory, it occupies my thoughts. I'm not thinking about anything else, so I'm fully - almost, you know, what do we want to call it, distracted. I mean, I'm in, you know, sort of a mini trance while I'm eating. Next item I get cued, I'm going to do it again, and I just stay in the cycle. And the more - when you want to stop, right, once your brain is activated - you know that inner dialogue…
Dr. KESSLER: …boy, that looks good. No, I shouldn't have that.
Dr. KESSLER: Maybe just a little. Now, that only increases the reward value of the food. That's the stuff of obsessions. That's the stuff of cravings. So, in some ways, the more you want it, the harder it is to stop.
Dr. KESSLER: You know, not wanting to be obese, not wanting to be fat but wanting the food is no solution. In some ways, Michael Pollan is very right. We have to start with changing our relationship with the food.
Tobacco, how did we - what was its success over the last, you know, three, four decades? Product is the same. It wasn't until two weeks ago when President Obama signed, you know, the historic piece of legislation. It wasn't legislation. It wasn't regulation. We changed how we view the product.
FLATOW: All right. We'll talk about changing how we view food with Dr. David Kessler, author of "The End of Overeating: Taking Control of the Insatiable American Appetite." Stay with us. We'll talk about how they design food to make it addictive like that. We'll be right back after this break.
I'm Ira Flatow. This is SCIENCE FRIDAY from NPR News.
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FLATOW: You're listening to SCIENCE FRIDAY. I'm Ira Flatow.
We're talking this hour about overeating and what drives you to keep reaching for that chip after chip after chip or that extra buffalo wing even if you don't want it.
My guest is Dr. David Kessler, author of "The End of Overeating: Taking Control of the Insatiable American Appetite." He served as FDA commissioner. He's now professor at UC San Francisco.
I'd like to bring on another guest now. She spent most of her life studying the characteristics that make us crave the food we love to eat, things like texture and crunch, sweet and salty, flavor hits, chewiness, tooth stick - you've heard of that one? - melt-in-your-mouthiness. I'm guessing here that that last one isn't the industry term for it but something like it, maybe she can help us out.
Let me introduce her now. Gail Civille - Gail Vance Civille is the president of Sensory Spectrum in New Providence, New Jersey. She joins us by phone. Welcome to SCIENCE FRIDAY, Ms. Civille.
Ms. GAIL VANCE CIVILLE (President, Sensory Spectrum): Thank you very much.
FLATOW: Hi. The - did the - for people who make the process, would they know all about what you crave and how to make it work for you?
Ms. CIVILLE: Yes. Actually, a lot of the food companies are very tuned in to what consumers want and can, in fact, dial in the characteristics of their products that consumers want or crave. And so, they are constantly doing research to learn about their consumers depending on the age or the…
Ms. CIVILLE: …demographics of the consumers, but they want to get to those consumers and learn about what they want.
FLATOW: What are you thinking about - as someone who's in the industry, when you put something in your mouth to eat it, what's going on in your head?
Ms. CIVILLE: Actually, I'm closer to one of David's pet peeves, which are those people who don't understand this whole thing about loss of control. I mean, I have my moments, but by and large, I'm usually taking a product in my mouth and actually thinking about, what are the sensory properties, what is the smell, what's the taste, what are the aromatics, what are the textural characteristics.
And so, my recommendation to people who want to lose weight is to - if you stop thinking about the pleasure you're getting and start thinking about what are some of the characteristics that are in the product, half of them you won't even eat because they're not very good-tasting.
FLATOW: Is that right? So that's some behavior modification, you might try.
Ms. CIVILLE: My belief is if you think about it hard and long about what are you actually perceiving, you'll be less inclined to just go with the joy ride of the kick of the food and actually start thinking about what it is.
Half of the things that are out there are out of date or not very tasty. And if you're just doing it for the fat, salt and sugar kick, which is absolutely what a lot of people are doing, I think if you pay attention to what you're actually tasting and perceiving, you might actually eat less.
FLATOW: Mm-hmm. One of the helpful things that has been suggested over the years is that if you take smaller bites and just chew it a lot more, because a lot of the stuff we're getting these days are all these liquids. You just gulp it down. We're not chewing anymore, are we?
Ms. CIVILLE: Well, and that's another big factor that I happen to point out to David is that in the many years that I have been in the food business, we used to have foods that we chewed for 15 times and 20 times and 30 times before we swallowed.
And now there's rarely a food out there, outside of a sweet chewy candy, that you have to chew more than 12 times and it's gone, and therefore you're in for the next hit, you know, to get more pleasure. And we used to have foods that, in fact, took more work. And I'm wondering what it's even doing to your dental health.
FLATOW: Hmm. Yeah. In your book you talk about a real design success for the food industry, and one of those would be the Snickers candy bar. Why is that such a great success as a designer food?
Ms. CIVILLE: Well, you know, and I - the Snickers bar is a very old product, and I'm wondering if they actually designed it or hit upon it. But the interesting thing about the Snickers bar is that it has the chocolate, it has peanuts, it has caramel and nougat. You put it in your mouth and all those things work together so that the pieces of peanuts, which can be very annoying - if you think about trail mix and such, sometimes you can all those particles stuck in your mouth. And in fact, what happens with the Snickers bar is the particles of the peanuts break up and are carried away into the melting and dissolving caramel and nougat. And then you have all the lubricity from the chocolate as well.
And so, everything in your mouth comes together and disappears at the same time. And it's really well-designed, as opposed to some of its competitors, where you have particles of peanut or you have no peanut and you have just caramel stuck on your teeth.
FLATOW: I'm thinking of an Oh Henry, which has got a lot of the same ingredients.
Ms. CIVILLE: Mm-hmm.
FLATOW: …but it doesn't have that sort of same mouth feel or cleanup.
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Ms. CIVILLE: Yeah. The unity.
FLATOW: The unity.
Ms. CIVILLE: Yeah, the whole unity piece.
FLATOW: We - you know, we've had old - I remember when whole foods started coming out you had whole wheat, you had bran, things like that. They weren't very popular. What did we do to make, you know, to make them more palatable?
Ms. CIVILLE: Yeah. It's interesting. I think, unfortunately, too many products that have whole grain have added too much sugar and too much fat in order to make Americans find them more palatable. But I do think that with whole wheat, if you toast it, if you have the grain and you toasted it and don't have so much of the bran flavor and the raw grain flavor, it actually is much tastier and actually tastes like roasted nuts.
FLATOW: David Kessler, who is to blame for all of these kinds of foods? Are we, because we'll consume them or are we being bombarded with so - with the advertising and - gee, I just can't help myself, you know, because I'm seeing this stuff being thrown at me all the time, like we used to be with cigarettes.
Dr. KESSLER: I'm sitting in Los Angeles in Santa Monica in one of Wolfgang Puck's restaurants. And he walked by and I introduced myself. And the appetizer was clearly enough for two, three people. And I asked him, how did we end up like this? And he said something - he knew exactly that it was sugar, fat and salt that stimulate people for coming back for more and more. But he said something that's still sticks in my mind. He said: We did this together.
Once we understand that our behavior is becoming conditioned and driven and we're laying down this neural circuitry and we're laying down this neural circuitry for a lifetime, the business plans of the modern American food company has been to take fat, sugar and salt, put it on every corner, make it available 24/7, make it accessible all the time - gas stations, in your cars -make it socially acceptable to eat, to make it into entertainment.
Once we understand that we're conditioning and driving the behavior and laying down the neural circuitry of our children - does the food industry have to change? Absolutely. Is there a greater role for government disclosure, for education? Absolutely. But in the end, just because my brain is being hijacked doesn't mean that I shouldn't take steps to protect myself.
But up until now, we've not explained to people why it's so hard. We've made it into something that it was a question of willpower. You were lazy. You didn't have self-discipline. We didn't tell people that their brains were constantly being bombarded. When they walk down the street, their activation - the cues are constantly bombarding their brains. But we have to give them the tools. So, in the end, the answer to your question…
Dr. KESSLER: …there's the food industry. There's a role for government. But we have to take steps ourselves, to protect ourselves to fight back.
FLATOW: Gail, would you agree?
Ms. CIVILLE: Yes. Absolutely. This is a collusion among every - you know, the consumers are telling the food companies what they want and the food companies are giving them what they want, and then they want more of it. And so, in fact, I'm totally in agreement with David that this has to be like it was with cigarettes, that we have to educate people so that they understand what the cues are so they can avoid the cues, or they can be aware of those cues and at least I say, well, here it comes.
I think David has a part in the book where he says, you know, the chocolate chip cookies were in the room, the hotel room, and he took them and he threw into trash because he knew he couldn't eat just one - to go back to the original opening remarks. I think we need to figure out how each individual is going to know what's going on and respond to what's going on, and the individual has to take responsibility. The food companies have to take responsibility. And the government will probably have to do some heavy duty lifting with labeling to make sure that people can be aware of what they're eating.
FLATOW: Mm-hmm. 1-800-989-8255. Greg(ph) in Ann Arbor, welcome to SCIENCE FRIDAY.
GREG (Caller): Hey, Ira.
FLATOW: Hi, there.
FLATOW: Go ahead.
GREG: Yeah. Well, it's really a losing battle. Being a chef for many years, you fine tune your menu to what people were buying and went further and further in that direction. And really, it has been an escalation of, you know, everybody in the food industry battling competitively to put out that flavor that will bring the public back in. And I can't see the public winning on this one at all.
FLATOW: Did you try to make more healthier foods when you were a chef?
GREG: Well, personally, I'm a triathlete. And yeah, I went in the direction of healthy food. And I actually - well, I was dismissed from my job from taking the restaurant too far in that direction because that's what wasn't driving sales.
FLATOW: Aha. And so, as you say, it's a losing battle as far as this is concerned.
GREG: Oh, definitely. Definitely. The first companies that will start to put out non-salty, nonfat and everything else on top of their foods will be the first ones to go out of business.
FLATOW: There you have it. Thanks for that insight, Greg.
GREG: Hey, you're welcome.
FLATOW: Do you agree, David?
Dr. KESSLER: No I don't.
FLATOW: How do we fight back? No?
Dr. KESSLER: We have to change how we look at food. How do - you know, we talked a little about tobacco earlier. How you perceive these things, what do you want - I mean, we used to look at tobacco as something that was cool, that was sexy, that was something that was going to make you feel better. Now, we look at it, we change how - as a country, we view this stimulus. We look at it as a deadly, disgusting, addictive product.
Tobacco was easy because we can live without tobacco. Food is much harder. But I will tell you, I mean, increasingly - and I think we're going to see this -people are looking at food, the highly processed food, the food that's just layered and loaded with fat, sugar and salt, you even look at it and you say, where is the real food.
I think, increasingly, we're going to see over the next decade or two, people saying, I want to be nourished. I want to feel good. I don't want to just be stimulated. I just don't want to eat food that's going to stimulate me to come back for more and more because there's never any satisfaction with fat and sugar, fat and salt, fat, sugar and salt. Once you're in this cycle…
Dr. KESSLER: …and you get to - your brain gets activated, you get aroused, you have that moment of satisfaction…
Dr. KESSLER: …but then you do it again, you're constantly chasing. Is that what I want? Is that for my satisfaction? We're going to have to change our relationship with food and the movement toward real food, and also the big portions. I think that's where we're going to have to start.
If you look at that huge plate of fries and say that's my friend, you're going to finish that. I now look at huge plates, huge portions and I say, I don't want that. That's not going to make feel good.
FLATOW: Mm-hmm. Talking with David Kessler, author of "The End of Overeating: Taking Control of the Insatiable American Appetite," and Gail Vance Civille on SCIENCE FRIDAY from NPR News. I'm Ira Flatow.
Gail, what happens in other countries? Don't they overeat like this? Don't they have the same kind of cravings?
Ms. CIVILLE: Actually, I was just thinking as David was talking about the portion size. One of the things that - and your other caller - one of things that pleases me is to see restaurants that offer small portions. And that's what happens in other countries as well.
No one expects that you're going to have to have three - a ginormous appetizer, a huge main course and then a dessert. They're perfectly happy if you have, you know, two small portions and finish. And some restaurants are encouraging that kind of behavior and not looking down on you if you order that way.
And I think, like David says, we have to learn, we have to teach people. And I think that's one place to start, is to encourage restaurants that offer smaller portions. And certainly if you go travel in Europe and you travel in Japan - I mean, Japan's well noted for the fact that you can have a five-course meal before you ever get to dessert. But each portion is small. And so, in the end you have a little - you have all these seven diverse little tastes. But they're just tastes and you're not overindulging on any one thing, which I also think is part of the problem. I think it's this overindulgence of the fat, sugar, salt delivery, such as the fries, instead of having diversity in your menu.
FLATOW: So if you can start with one thing - and let's try to keep it simple. I only have about a minute left. And you want to start to eat better and not -and get rid of the fats, the sugars and the salts, if you could just hold off on the fries, begin slowly, that would be a good first step, David, and then move on to other things.
Dr. KESSLER: Eating in a planned way - the other thing, if you look at the French, they would never eat between meals. They won't walk down the street eating. They won't eat in their car. What did we do in this country? We took down all the barriers. We took fat, sugar and salt, put it on every corner, and we're eating it all the time.
Eating in a planned, structured way, not chaotically, is a good step. But in the end, you've got to change how you view the food. If you view it as your friend, you're going to eat it all.
FLATOW: If you view it as an emotional support rather than nutrition, you're going to eat it all.
Dr. KESSLER: If you think it's going to make you feel better, you're going to eat it. You have to change what you want. Diets are not going to work.
FLATOW: Do you agree, Gail?
Ms. CIVILLE: Yeah. I absolutely agree. And I think people should start with the whole recommendation of more vegetables and more fruits - and I don't mean French fries. If you eat - you know, back to Pollan, if you eat fruits and vegetables and you eat them in reasonable amounts, it's a good way to start, you know, to start losing weight because they're filling, they're satisfying and they're not going to give you the fat, sugar, salt hit over and over again.
FLATOW: And don't bring the stuff into the house.
Ms. CIVILLE: Oh, absolutely.
FLATOW: Right? Because it's sitting there, waiting for you to eat it. It's yelling out at you.
Ms. CIVILLE: Calling to you from the pantry.
FLATOW: Mm-hmm. So if you don't…
Dr. KESSLER: Activating your brain.
Ms. CIVILLE: Absolutely.
FLATOW: And your brain remembers and it forgets the bad side effects. That's such an overpowering strong force that it's - I want to thank both of you for taking time to be with us, and hoping you have a healthy weekend. Thank you.
Ms. CIVILLE: Thank you.
FLATOW: Thank you.
Ms. CIVILLE: Thank you very much.
Dr. KESSLER: Thank you.
FLATOW: You're welcome. Dr. David Kessler, author of "The End of Overeating: Taking Control of the Insatiable American Appetite," a great read, I highly recommend it. And Gail Vance Civille, president of Sensory Spectrum in New Providence, New Jersey. Transcript provided by NPR, Copyright NPR.