I've always been a crossword person, even if I couldn't finish the Sunday (or even the Friday) one in the New York Times. Since I got teased as a fifth grader for using big
words in the schoolyard, language has always been the most inviting area of the
playground, the place to develop mental strength and agility. Numbers were my nemesis. Growing up in the days long before
calculators, I learned to be arithmetically reliable the hard way. I still use my fingers, refer to deeply
memorized multiplication tables, and add columns two or three times (in
How peculiar, then, that I have become addicted to the
KenKen puzzles along with my morning coffee.
It happened a while back – couldn't say exactly when – and I found
myself trying to figure out what was expected of me in the easy version, just four
squares across. Cute! Not too hard.
Very satisfying when after a few obvious clues were solved, the answers
tumbled into place. I began working on
the daily six-square puzzle and could successfully complete Monday through
Wednesday after a few weeks of practice.
Then I moved up to the big league, seven-squares on Sunday.
My style, as with the crossword, is to work in pen,
lightly filling in the possibilities until they are certain. In those tiny, unforgiving squares, it is
sometimes necessary to use white out – or even to copy the whole grid on lined
paper after a really a messy start. How
embarrassing. Let’s not even discuss the
nearly pathological compulsion that has driven me to work a Sunday KenKen
puzzle until the Magazine Section appears on the stoop with next Saturday’s
paper. But it calms me, settles my mind, and kind of clears the decks for other issues and problems I need to sort
What profound life change has made me a numbers person
after all? I ponder this while figuring
out in which square the last “5” can reside, or what combinations can be
eliminated to fill in the third row down. What am
I doing? Testing a double “3” and a
“7” to make “63X” resolves the connecting horizontal and vertical, and I experience
a pleasurable tingle in the brain.
My neural fibers crave this activity. I need this exercise – now. I don’t need to be told that “Mental Stimulation
Staves Off Dementia,” although I’m pleased as punch they’re doing studies to
confirm what my mind and body are already whispering in my ear. All I have to do is listen. I’m sure that’s always
the best place to start.
I’m thrilled to see the hypothalamus back in the
news. I've been intrigued for years with
this pea-sized area deep in the brain that plays such an important role in our
relationship to food. Indeed, the title
of a New York Times article that appeared on Sunday (April 28, 2013), “The
Brain: Our Food Traffic Controller,”
echoed a title from the same paper I quoted in the late 1960s: “Obesity is Traced to Signal Failure”
(January 23, 1968). Back then, long
before the days of imaging, it was found that the hypothalamus provided
“internal eating cues” to tell us when to eat and when to stop. The mechanism might get out of whack and “set
so high that normal amounts of food no longer satisfy.” The old source proposed a complimentary
theory that, without appropriate signals from within, people might become
overly dependent on “external eating cues” instead. To me, that meant diets, paying too much
attention to other people’s idea of what we ought to eat. And, I’m still convinced the stubborn,
long-term and constantly escalating problem of overeating owes a great deal to
An approachable synonym for the hypothalamus was coined
in those days: “appestat.” I pictured a switch on the wall to regulate
heat in the winter and thought the workings of the human brain had to be more
elegant than that. The term is defined
now as: “the neural center in the brain
that regulates appetite and is thought to be in the hypothalamus.” My italics
emphasize the difficulty in pinning down exactly what goes on in there when we
eat. And that’s what Kathleen A. Page
and Robert S. Sherwin, authors of this Sunday’s piece, are working on.
Page and Sherwin call the hypothalamus a “primitive brain
region” that evolved to support survival in a time when food was scarce and
obtaining it was a lot more labor-intensive than a trip to either McDonald’s or
Whole Foods. As scientists and
endocrinologists, they have been focusing on observable responses in the human
brain to glucose and to fructose. For
example, they find that glucose – an energy source vital to brain activity –
while calorically equal to fructose (no commercial pun intended), does not
taste as sweet as its relative, and yet is associated with greater feelings of
fullness and satisfaction. Fructose, on
the other hand, gets screened out somehow by the liver; not much of it reaches
the brain, so the “appetite and reward areas remain active.” Thus, the notion that sugar is sugar may be
nutritionally accurate, but neurologically, it may be worth another look.
I find this stuff fascinating. New technology allows even the layperson an
appreciation of the elegance and complexity we all know is there. According to Page and Sherwin, the hypothalamus
constantly monitors blood glucose, hormones, and various contributors to
metabolism that are intricately involved in energy maintenance, appetite and
satisfaction. The “integrated circuit”
they outline includes “brain areas that control taste, reward, memory, emotion
and higher-level decision making.” They question how this wealth of new
information can be used to help combat the epidemic of obesity, but seem in no
rush to judgment. The work is just
Dr. Norman Jolliffe at Columbia University’s School of
Public Health wrote a piece available on the web entitled “How to Reset Your
‘Appestat’ and Reduce Hunger.” I cheer the following quote from his first
paragraph: “Infants do not have the natural ability to overeat. Overeating is a
learned behavior that needs to be unlearned to reduce hunger.” Wow! I couldn't have said it better, and I’m so glad he did.
Then, he loses me – fast.
“Eat less food more often to reduce hunger;” “Choose lean proteins and healthy fats to
keep your appetite at bay;” “Skip simple carbohydrates that cause sharp drops
in blood glucose and cravings for more;” “Exercise often, but not for weight
loss;” and “Skip the scale.” There is
not a single suggestion here without merit – even though 7 meals a day
absolutely does not work for me, and I personally find the Atkins diet
onerous. What I do object to – have
always objected to – is the list of guidelines that are nothing but “external
cues” as far as I can see. Jolliffe
makes an exquisite case for each item on his programme. Clearly, it works for him. But, how can one re-activate one’s own
primal, evolutionarily-tested internal cues while following someone
else’s? Sorry to criticize, but I think
that’s the wrong way to go.
It’s not going to be so quick and easy to glean solutions
to overeating from what we have begun to learn about the brain, I think Page
and Sherwin would agree. One statement in particular suggests to me an area in
which more study would be useful. They
write: “When food is restricted, the
hypothalamus sends signals that increase your desire to ingest high calorie
foods.” Wow! I knew that.
My body knows that. I couldn't have said it better, and I’m so glad they did.
So, how about doing a bunch of studies that follow brain
activity under dietary restriction? Does
restriction trigger deprivation signals all by itself, without regard to what
is forbidden? Let’s see what the brain does in the context of diet regimens of various
kinds. Let’s take a closer look at the
mechanisms of desire. In those gorgeous scanned images of indigo, gold and
magenta, could we observe the mechanism in the brain that makes going off a
diet a sure thing?
I want to know what happens in the hypothalamus when one
is made to feel chronically guilty or afraid about food choice. How do we store in our memory and constantly
reinforce the admonition that foods are fattening, unhealthful, or bad? For example, would the phrase “Sugar is
indeed toxic” trigger a stronger or weaker signal in my brain to eat more or
less of it? I only quote Mark Bittman
here because he’s one food writer whose opinions I truly value. Conversely, does a sense of
self-righteousness about healthful choices affect satisfaction levels in a
positive or perhaps in a negative way?
Do these effects last? How are
satisfaction levels affected by limited or unlimited choice? Could we study how hypothalamic activity is
conditioned, as well as the reversal of it?
Could we examine conflict of interest arising between “internal” and
I don’t think we’ll ever free up the channels to our
“Food Traffic Controller” until we answer some questions like these. They may not be tops on the agenda for
endocrinologists, but they are certainly relevant to the issue of obesity, to
health and to pleasure in eating – which is of course the object of the
In addition to her success in the classroom, esteemed
Plaza College English Professor Lynn McCann recently celebrated another major
accomplishment: a published book!
Professor McCann recently spoke with Seasons about
revisiting a book she first wrote in 1966, and the steps she took to publish
the book once more … on her own!
Question: When did you first start writing The
McCann: In 1966. We actually did have
electricity back then, but my typewriter was a manual, and it didn’t even have
Question: What drew you to this particular
McCann: I never dreamed I’d write about
dieting. A good friend who had watched me overcome an eating problem by
increasing awareness instead of cutting calories suggested that I write about
the experience. “I can’t do that!” I said. “Sure you can!”
She said, and kept encouraging me. I finally gave it a try, and it took about
two years to write. It was a learning process.
Question: What response did your book receive
when it first came out?
McCann: I appeared on a radio talk show and a
TV program to promote the book in the U.S. I also went to London to
promote the book on TV there. It was exciting. But, I think the
book was a little ahead of its time, and I was disappointed when sales didn’t
go through the roof. After a while, I began to get letters from people
all over the country, and from Canada, saying that The Anti-Diet had
really helped them a lot.
Question: How many years passed between its
initial publication and your decision to revisit it?
McCann: It came out in the U.S. in 1971 and
in England in 1972. After many years, I noticed that some of the Anti-Diet ideas
had gone mainstream (“conscious eating,” “mindful eating”). Even Weight
Watchers was talking more about the importance of awareness and
satisfaction. When I started teaching at Plaza College five years ago, I
was already working on the revision.
I go to the gym in kind of a rush because my husband and
I have a dinner invitation up in Westchester tonight. We want to miss the
Friday traffic, and I still have to find a little gift for our hostess.
I hop on my favorite bike, punch in the resistance setting and plug in my
earphones. The little TV screen in front of me is tuned to The Talk. One
channel up there’s a sloppy soap opera. Soccer dominates the next – and so on.
I put the machine on pause and go over to the desk where the media controls
are. I've never seen the guy on duty before. Not a day over 25 with bright eyes
and dark curly hair. He’s very cute and fit.
“Could you get CNN on there, please?” I point to the rank
of TVs over the machines.
“Whaddaya want that for?” I’m surprised when he
challenges me with a flirtatious smile.
“Well, it’s not a great station, I’ll grant you, but it
sure beats a studio full of shrieking women.”
Who is this cheeky upstart? Just put on the damn
news, I mutter to myself as I climb back up on the bike and start
A few minutes later, I still can’t get CNN. I
glance back at the desk. The young man is sitting there slurping a
smoothie through a straw. I catch his eye and shrug reproachfully, like
the school teacher I am. He puts the energy drink down and strolls over
to my bike, comes around to the side.
“It’s not on?”
He leans in toward the screen. His well-defined
bicep is brushing my arm. How peculiar.
I scroll to the channel where CNN is supposed to be.
“Looks like ABC to me.”
To create a more comfortable distance, I sit back on my
seat, but he closes it up. What’s going on here? I sense
pheromones, and I’m old enough to be his great grandmother!
“Thought I had it right,” he’s checking very carefully
indeed. “Sorry, I’m new here. Guess I don’t know how to do that. ”
Now, I have a choice. The kid is obviously trying
to be friendly and nice. I should probably drop my schoolmarm attitude
and be nice back. I pull out the earplugs and drape the cord around my
“I thought so. Congratulations! Are you a
He really lights up at this. Besides athletes, he
tells me he works with pregnant women and new moms, business executives and
housewives. His pitch is infused with the unmistakable promise that working
with him would bring, at least, a blush to my cheeks. I know I’m getting
the prospective customer treatment but I still feel like he might just climb on
the bike with me.
So, I do my best to steer the conversation safely around
to the topic of my book. It’s part of my campaign for everyone on staff
at my gym to know about The Anti-Diet and recommend it to the
membership. This seems like as good an opportunity as any. Maybe I can get the guy
to go to my website and “like” me on Facebook.
“It’s all about awareness,” I say, “and it’s the same, I
believe, with food and with exercise,” I’m pedaling hard now. “Somewhere,
somehow, we all know what we really need if we can just get in touch with
it. And that’s the best place to start.”
“Definitely!” My new friend has a dazzling
smile. “So, when did you publish this?”
“First time, in 1971, and the revision came out this
He looks at me oddly.
Now, I’m impressed. I feared I
would scare him half to death by coming clean. But he steps back,
appraises me with a professional eye, then re-establishes the cozy distance
he’s maintained from the start.
“You really don’t look it. You’re in great shape.”
“And your face – you just can’t be that . . .”
“Old. I’m afraid so.”
He grins a little sheepishly but holds his ground.
“I would have . . . come on to you.”
I speed up a little on the bike – only three minutes left
on the clock – and smile gratefully.
This really makes my day. I must be doing something right.
On January 7th, in one
of those moments that can alter the life of a 76-year-old, I fell on my way to
a faculty meeting at school before start of the new term. Rested and relaxed after the holidays,
enjoying a sunny day and a quick commute, I missed the last step going down the
stairs from the train. As I crumpled to
the landing, my right knee bent under my full weight much more tightly than it
should and my nose pressed to meet it. Surrender
was the only option. “Give,” I pleaded through tan corduroy stretching over the
joint, and I heard a tiny pop near the surface of it. Not good.
My entire focus zoned into that knee, into the hip I found myself sitting
on, into my lower back and the hand I’d used to break the fall. But before I could assess the damage, a man was
hoisting me by the armpit. “Wait!” I put him off, then stood cautiously and assured
him I could manage.
And manage I did, hobbled
the two blocks to school and propped my leg on a chair during the round table
discussion. I hardly heard a word that was spoken for the “chatter” that was
going on in every cell of my body. I
think that’s part of what shock is, an overload of the information system and
the exhaustion that comes from trying to sort it all out. I found an ice pack in the teachers’ fridge
to apply during an hour or so of training for the new campus website. I was busy the whole time replaying and
analyzing the fall in my mind, in slo-mo, like a sports mishap on TV. There had been no impact and no torque or
twist to the joint; it was just the deepest plié I’d done in 30 years. There was practically no swelling and no
discoloration. Pain came only when I
mid-afternoon, I was a wreck. Standing
completely still, it felt like I had no knee to hold me up, nothing at all. When I walked, commanding my leg to stiffen
like a splint, it really hurt. My
husband came to get me, brought a cane, and got me home where I spent the
evening Resting, Icing, Compressing and Elevating. I lay there imagining my supportive
colleagues wheeling me from class to class in a chair, or on a gurney. (A certain sense of drama is a useful quality
in a teacher.) Surgery for a torn
ligament, even a knee replacement did not seem out of the realm of possibility.
But I slept okay that
first night without Ibuprofen. The next
morning, I was surprised there was still only minor swelling and no general
discomfort, but the joint still felt like a bowl of Jell-O. Cut to the diagnosis which I hastened to get from
an X-ray within 48 hours: a stable,
hairline fracture of the patella that would likely heal completely on its own within
4 to 6 weeks – unless I did something really stupid.
At the time of this
writing, about half way through the miraculous healing process of which all our
bodies are fully capable, I am teaching, walking normally indoors and out,
taking stairs slowly, and pondering the odds – my odds – according to recent
statistics selected from a government website:
·One out of three adults
age 65 and older falls each year.
·Among older adults
(those 65 or older), falls are the leading cause of injury death.
·Rates of fall-related
fractures among older women are more than twice those for men.
·People age 75 and older
who fall are four to five times more likely than those age 65 to 74 to be
admitted to a long-term care facility for a year or longer.
Not me! That’s not the life change I’m looking for,
I’m back at the gym
today for a gentle spin on the stationary bike and some easy stretching. I welcome the gift of acupuncture sessions
from a friend even though I’m needle-phobic.
And I will listen, listen, listen to every single little signal my body
sends to tell me what it wants and needs, where it does and does not want to
go. And therein lies the secret of my
knee healing like a youngster’s.
A long history of dance
training prepared me well for this. I
learned the truth of “use it or lose it” before it became a cliché and I honor
the need faithfully. I do 3 or maybe 4
twenty-minute sets on a bike at the gym each week, and with very low
resistance. I do other lower body work
to keep the leg muscles tuned, but I hardly break a sweat. If I skip my workout (for reasons of illness
or a holiday) I start to “lose it” in about two weeks, meaning that I feel
unbalanced, less energetic, prone to kinks in my neck and fatigue in my back from
sitting. Digestion is affected, too.
But I am astonished by
how little “using it” is necessary to maintain ownership of my body. It seems I have completely underestimated the
edge my modest, regular attendance to exercise has given me. Along with the ever so slightly broken bone,
an MRI revealed that my right knee has developed considerable arthritis.
“How can that be?” I
exclaimed defensively to the PA on the phone.
“It’s completely asymptomatic. I
haven’t had a moment’s trouble with that knee until I fell.”
She had no good answer,
and I really want to know why the “arth” part of my condition shows in an MRI
while the “itis” part is non-existent. I
wonder if the “arth” part of arthritis, a thickening of the bone, just comes
with age. Maybe avoiding the painful,
inflammatory part is more of a choice many of us already make and many more of
us could make, without drugs. It’s
abundantly logical that keeping the sinew strong will undercut the pull of
gravity and reduce abrasion of bone on bone.
To make a stronger case for the long term benefits of “using it,” why
aren’t there studies of the incidence of asymptomatic arthritis and the
lifestyle choices of older people who have this but function perfectly well and
do get up from the occasional embarrassing spill?
I think young people,
middle-aged people, and older people are put off by unrealistic images and
daunting regimens from doing the simple, little things that make a
difference.My acupuncturer (as I have
dubbed her) makes a house call, slips in a needle and agrees:
“There’s got to be some
ground between ‘couch potato’ and ‘six packs galore’.”
I’m not watching her,
and I welcome the distraction, because I really don’t like the idea of
needles. I ’m showing up for this because
even with all I know about the body I live in, there are many wondrous and
mysterious things to learn. A wake-up
call, like the fall I took, is a chance to open up new possibilities.
On the table, a towel
over my eyes, I report an extraordinary sensation, a slight fluttering of the
diaphragm. I associate this with a
reaction I sometimes have listening to certain singers, or a live chorus. I feel tremendous energy, but it is diffuse,
directed to no purpose. I am very
relaxed. It seems as if every cell in me
is communicating with every other. The
next day, my knee feels much stronger and I succeed at three movements I have
not attempted since the injury. What‘s the connection? I do not know. I don’t have to.
I just have to pay
attention. I only need to trust the
subtle cues that tell me it’s okay to rise up on my tiptoes again, that the
twinge I feel in my knee as I carry the groceries home is a necessary stretch
and not a harbinger of more trouble. I
must heed the larger message that – having survived a potential calamity rather
well – every moment of the day from now on is going to feel a little more like