Filling Up

Recent Titles in
The Psychology of Everyday Life

Working Out: The Psychology of Sport and Exercise

Justine J. Reel

Chilling Out: The Psychology of Relaxation

Christine L. B. Selby

Hooking Up: The Psychology of Sex and Dating

Katherine M. Helm
 FILLING UP

The Psychology of Eating

Justine J. Reel

The Psychology of Everyday Life

Copyright © 2017 by ABC-CLIO, LLC
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, except for the inclusion of brief quotations in a
review, without prior permission in writing from the publisher.
Library of Congress Cataloging-in-Publication Data
Names: Reel, Justine J.
Title: Filling up : the psychology of eating / Justine J. Reel.
Description: Santa Barbara, California : Greenwood, an imprint of ABC-CLIO, LLC,
[2017] | Series: The psychology of everyday life | Includes bibliographical
references and index.
Identifiers: LCCN 2016024339 (print) | LCCN 2016039805 (ebook) | ISBN
9781440840890 (hardcopy : alk. paper) | ISBN 9781440840906 (ebook)
Subjects: LCSH: Eating disorders—Psychological aspects. | Eating disorders—Social
aspects.
Classification: LCC RC552.E18 R433 2017 (print) | LCC RC552.E18 (ebook)
| DDC 616.85/26—dc23
LC record available at https://lccn.loc.gov/2016024339

ISBN: 978–1–4408–4089–0
EISBN: 978–1–4408–4090–6
21 20 19 18 17 1 2 3 4 5
This book is also available as an eBook.
Greenwood
An Imprint of ABC-CLIO, LLC
ABC-CLIO, LLC
130 Cremona Drive, P.O. Box 1911
Santa Barbara, California 93116-1911
www.abc-clio.com
This book is printed on acid-free paper
Manufactured in the United States of America
This book is dedicated to my loving husband for his unconditional
support over all these years. His passion for food coupled with his cook-
ing talents has given me the opportunity to practice the act of mindful
and intuitive eating. You had me at “chicken parmigiana”!
 Contents

Series Foreword ix
Preface xiii
Acknowledgments xv

Part I: Eating in Everyday Life 1

1 What: The Many Forms of Eating 3
2 Why: The Importance of Eating in Our Lives 29
3 How: The Positive and Negative Effects of Eating 51
4 Who: Psychologists’ Theories about Eating 89
5 When: Eating throughout the Life Cycle 113
6 Where: Eating around the World 135

Part II: Scenarios 159

Part III: Controversies and Debates 171

viii Contents

Directory of Resources 195

Glossary 199
About the Author and Contributors 205
Index 209
 Series Foreword

Psychology is the science of behavior; it is the field that examines how and
why people do, feel, and think the things that they do. However, in a very
real way, everyone is a psychologist. Each of us observes and tries to under-
stand the thoughts, feelings, and behaviors of people we are around, as well
as trying to understand ourselves. Have you ever thought, “I wonder why
she did that?” Or perhaps, “Why did I do that; it makes no sense.” If you
have, then you are asking psychological questions. Most people enjoy being
“students of human behavior” and observing and thinking about people,
human nature, and all of the variants of the human condition. The differ-
ence between “most people” and psychologists is that the psychologist has
spent many years in school studying and learning about people.
In addition to studying and doing research, psychologists also work
directly with people in many settings. For example, clinical and counseling
psychologists work with people who are dealing with psychological disor-
ders or are having problems in their lives that require professional assis-
tance, but there are many other branches of psychology as well. Sport
psychologists work with athletes and teams to improve performance and
team functioning. Industrial/organizational psychologists help workers,
managers, and organizations function more effectively and efficiently.
Military psychologists deal with military personnel and organizations.
Forensic psychologists work with police and other law enforcement organ-
izations to help solve crimes and assist law enforcement personnel. In
x Series Foreword

addition to all of the things that psychologists know about people, for any
person, understanding psychology can help take advantage of what psy-
chologists have learned to help all people live better and healthier lives
and to deal more effectively with others.
The Psychology of Everyday Life is a series of books that will address many
different and important psychological issues and areas, the goal being to
provide information and examples of how psychology touches all of our
lives on a daily basis. The series will also show ways in which psychological
knowledge can help us. These books will address psychological concerns
with the most up-to-date and relevant knowledge from the field of psy-
chology. Information from the laboratories, classrooms, clinics, hospitals,
and other settings will be brought together to help make sense out of some
important and often complex ideas. However, these books will be directed
toward readers who are not psychologists, but are interested in learning
more about the field and what it has to offer. Thus, the language is not
technical but is common language addressing “regular” people. There will
be times when professional and technical language may be used, but only
if thoroughly explained and related to the issues being discussed.
This series of books will focus on specific facets of our daily lives and
show how psychology can help us understand and deal with these issues.
A wide range of topics will be covered, from eating to exercising to
relaxing to interpersonal conflict. Each book will consist of three distinct
parts. Part I will answer the “who/what/where/when/why/how” questions
related to the topic. These chapters will examine everything from how
the subject manifests in our day-to-day lives and how it impacts our
psychological well-being to differences across the life span and cultures to
what famous psychologists have to say on the subject.
Part II in each book will focus on “real-life” examples and will address
many of the issues that were introduced in each book in Part I, but will
do so with examples and explanations that will make the issues even
clearer. It is one thing to have knowledge, but it is an entirely different
thing to be able to apply and use that knowledge, and this is what will be
covered by the scenarios and interpretative analyses in Part II. When peo-
ple read Part II they will begin to see many of the ways in which our daily
lives are touched by psychology, and the many ways that psychology can
be used to support and help people.
Part III in each book will address the controversial issues related to the
book’s subject. Like any academic and professional discipline, psychology
has many areas where there are spirited disagreements among academics,
practitioners, and researchers about important issues in the field. It will
be very instructive for people to understand these issues and to see the
Series Foreword xi

careful and systematic ways that scholars think about and conceptualize
various topics, and to see how they debate, discuss, and resolve some of
their differences of opinion. For non-psychologists, these controversial
issues and how they are addressed will lead to a greater understanding of
psychological matters, but also a better grasp of how scientists and profes-
sionals deal with differences and controversies and how these disagree-
ments are addressed.
Psychology is a broad and diverse field with many different approaches,
theories, methods, and ideas, and to capture this field in its breadth and
depth would be impossible in a single book. This series of books, however,
will serve as an introductory journey through psychology as it relates to the
daily lives of ordinary people. I have been teaching, studying, and practic-
ing psychology for many decades and I can hardly wait to read each of the
books in this very exciting series, and I welcome readers to take this
journey with me.

Rudy Nydegger, PhD, ABPP

 Preface

Eating is an integral part of everyday life for people from around the world.
Eating is much more complex than merely consuming food to keep the
body running. In fact, eating involves the mind, body, and, many people
would argue, the soul. To that end, eating behavior has very significant
psychological implications. Psychologists argue that food fuels the body
as well as the brain. Not receiving enough food or the right types of food
can impact one’s body physically as well as one’s psyche. Eating is a social
event in many cases and reflects relationships, family traditions, and cul-
tural trends in society.
A current popular trend in the United States, for example, is to elevate
chefs such as Bobby Flay, Giada De Laurentiis, and Gordon Ramsay to
celebrity status. These chefs have become household names, with their
own television shows, restaurants, and cookbooks. A current trend toward
gourmet food, including extravagant sit-down restaurants with seven-
course dinners, a large farm-to-table movement, and farmers’ markets with
local food, represents a shift toward eating as an “experience” or an event
rather than a basic need for some of the world’s population.
The first chapter of this book will deal with the many ways people
engage in eating and how food has special meaning in our American cul-
ture and everyday life. The history of fast-food restaurants, food trucks,
and types of food will be discussed to show the evolution of our eating pat-
terns throughout the ages. We will dissect the ways that food is important
xiv Preface

in meeting our biological, psychological, and social needs in Chapter 2.

Chapter 3 will cover the positive and negative factors associated with eat-
ing. Although there are many positive aspects of eating, issues such as food
insecurity concerns, eating disorders, genetically modified foods, and pesti-
cides will be addressed in this chapter.
In Chapter 4, theories around food and eating will be identified to pro-
vide explanations behind why human beings eat the way we do.
Interestingly, eating patterns and food choices may evolve across the life
span. Considering eating behaviors of children will be important to under-
stand how we begin to define our overall relationship with food and set the
foundation for our eating patterns. For example, how is food viewed within
different families? Is the daughter rewarded with ice cream when she gets
good grades? Are certain foods labeled “good” and “bad” or are some foods
off limits entirely? Vegetarianism will be covered in this chapter, with a
focus on disordered eating problems among adolescents that can continue
throughout one’s life. Chapter 5 will illuminate how various eating habits
and taste preferences will change during pregnancy, menopause, and the
aging process. Chapter 6 in the first part of the book will cover eating pat-
terns across the world.
Part II of the book will include scenarios that demonstrate real-life sit-
uations surrounding food and eating. The third part of the book will high-
light several areas of debate surrounding our food culture in the United
States. The first set of debate essays will focus on the merits and drawbacks
of the Paleo Diet. Secondly, there will be a debate about whether sugar
addiction is a myth or a plausible condition supported by science.
The third debate will examine whether the “Freshman 15” is factually based
or if gaining 15 pounds in one’s first year of college is a myth. This book
uncovers why people eat what they eat and how food provides for biological,
psychological, and social needs of human beings across the globe.
 Acknowledgments

Thank you to my family, friends, and husband who have been my writing
cheerleaders throughout the years. I appreciate you encouraging me to read
books of all kinds and fostering creativity from a young age. I would like to
extend a special acknowledgment to Maxine Taylor, who has served as my
developmental editor for three books with two more book projects in the
pipeline. Your feedback is direct, responsive, motivating, coherent, and
makes the work stronger. I also would like to recognize the persistence,
enthusiasm, and commitment of the UNCW faculty writing circle mem-
bers. Working alongside you in coffee shops throughout Wilmington for
regular and “pop-up” sessions inspired me to stay on task and timeline.
 Part I

Eating in Everyday Life

 1

What: The Many Forms of Eating

In this first chapter we identify the styles and historical trends of food.
The cultural underpinnings and origins of various customs and family tra-
ditions surrounding food and eating that occur around the United States
are also described. This chapter illuminates the many settings of food,
including eating for convenience and more elaborate meals at home.
An overview is provided of the evolution of the current trends toward
gourmet food trucks. This chapter allows readers to increase awareness
about the food and eating choices made on a daily basis. It is important
to reflect upon the meaning of food and eating in one’s life to fully under-
stand the role of food in our society.
As the title of this chapter indicates, there are many forms of eating.
There are eating rituals that you, your friends, and your family may already
be doing that may involve a celebration of special occasions. There are
also specific nutritional recommendations given to us by professionals
related to what we should eat and how to get the best benefits from the
foods we consume. Let’s start by looking at some of the popular styles of
eating that people enjoy in the United States.

THE MANY WAYS WE EAT

In a fast-paced society, human beings have many choices when it comes to
food. There are countless ways that we eat and involve food in our every-
day lives. For the most part, we operate on automatic pilot when it comes
4 Filling Up

to eating. We have breakfast when we wake up, eat lunch when there is a
break in the school or workday, and eat dinner before going to bed. Eating
has become a largely unconscious activity. However, if we consider the
many forms of eating, we begin to understand the diversity of food choices,
eating patterns, and experiences around the basic need to eat. We also
realize that there are many types of foods around the globe and styles of
eating that range from a formal sit-down meal to selecting fast food from
an international chain restaurant. Additionally, we begin to learn that
our food selection does not happen in a vacuum. We are influenced by
many factors, including accessibility to certain kinds of foods and season-
ings as well as the type of exposure we received to a wide range of foods
when we were children. Our family may have special foods for holidays
or foods that represent our ethnic heritage. Religious beliefs also serve to
drive the types of food we consume as well as periods of time when we
abstain from certain types of food or engage in fasting behavior. As you
read this book, you may begin to notice some of your own patterns around
food and eating. You might realize that you gravitate toward certain types
of food and find that you are hungry at specific times of the day.

Eating While Driving, Watching Television,

and Working
Today, we find that Americans tend to eat food “on the run.” There is a
clear preference for convenience when considering the daily eating habits
of people in the United States. In fact, at least one in four people were
found to consume fast food on a daily basis. Moreover, 10 percent of dis-
posable income is spent on fast food annually by Americans. Packaged
foods were more popular than fresh sources of food—Americans ate
30 percent more of the packaged variety. Eating on the go has taken on a
whole new meaning to include eating in one’s car. Unlike our American
counterparts in the 1950s who enjoyed a burger delivered by a carhop as
it was fashionable to sit in a car, many Americans are scarfing down a
meal in solitude while driving to their next destination. It has been
estimated that 20 percent of American meals are consumed in the car.
Unfortunately, this choice to multitask by eating while driving contributes
to 80 percent of car accidents. Furthermore, consuming food or drink tends
to represent mindless eating with no consideration for hunger, fullness, or
the nutritional content of foods. A mindless type of eating also is likely to
occur when people eat while watching television. Studies have shown that
watching television during a snack or meal results in being distracted from
biological cues, leading to increased food consumption. A similar trend of
What: The Many Forms of Eating 5

distraction and eating has been demonstrated with people who eat at their
desks or while surfing the Internet. Interestingly, only one out of five
Americans actually leaves their place of employment to consume lunch.
The majority of American workers eat at their desks. One study found that
65 percent of Americans eat at their desks or neglect to take a lunch break.
For executives surveyed, 40 percent report taking their lunch to work, 20 per-
cent had lunch at a sit-down restaurant, and 17 percent consumed fast food.
These findings demonstrate a shift from longer lunches out to eating on the
go. Unfortunately, mindless eating and these aforementioned examples
(e.g., eating in the car) of multitasking while eating contribute to an
increased risk for weight gain associated with overweight and obesity.
The history of food and eating throughout the centuries is rich and
diverse. By understanding the social trends related to accessibility of food
sources as well as changes to food storage and production, we can better
understand how eating patterns have evolved to the present day.
Furthermore, by understanding the origins of some customs, like serving
cake at birthdays and weddings, we can have greater appreciation of these
rituals we often take for granted. Although we have special traditions
related to life milestones like getting married, we also engage in eating
practices on a daily basis. Therefore, it is important to discuss the many
forms of eating for everyday living.

Eating for Everyday Living

Eating takes on different meanings for families around the globe. Given
that food and water represent basic needs, all living beings must engage
in some type of eating behaviors. Daily eating may involve certain types
of food rituals or typical habits, or may include foods that are eaten on a
regular basis. Additionally, eating patterns may vary depending on a
person’s geographic location, cultural group membership, or ability to buy
or access specific food sources, to name just a few factors. Furthermore,
the introduction of “dieting,” in which a person deliberately restricts cer-
tain types of food or limits food intake, can further complicate the decision
of what humans eat. If historical factors of food storage, preservation, and
technological advances in food production are considered, we realize that
what we eat is more complicated than meeting our basic biological needs
as human beings.
Generally, infants are believed to have an innate need to nourish them-
selves. Although decision making in infancy may be less focused on taste,
as we grow older we develop distinct likes and dislikes around food. In fact,
we begin to develop various food identities that may be based on foods we
6 Filling Up

exclude from our diets or on our ethnic heritage. Our family has a strong
influence on our exposure to foods during our childhood and adolescence.
Given that adults in a household are generally the main source of purchas-
ing and preparing foods, the tendency for adults to be adventurous around
foods or conversely to be resistant to trying different types of food has an
effect on their children’s willingness to try new foods. For example, if cow’s
tongue, escargot, and turtle soup are served on a regular basis at home, it is
expected that children will not be surprised to see them on the menu as an
adult. Likewise, children exposed to a variety of more “exotic” foods may
be open to trying different types of dishes. Of course, what is considered
exotic or unusual varies from one culture to the next and over time.

Diverse Styles of Eating

When we think about eating as an everyday event, we realize that food
consumption happens around the clock. Eating must be squeezed into a
busy workday or school day. Because it is such an integral part of the
day for most living beings, there needs to be an abundance of food
sources. In our fast-paced society, it is not uncommon to hear Americans
say they “eat on the run,” which can mean having lunch at a desk or con-
suming a sandwich in the car. It has become popular in the modern day to
purchase food at drive-through restaurants rather than taking the time to
sit down for a proper meal. Another fast option for obtaining food is a con-
venience store, which offers a variety of prepackaged meal and snack
options. In 2015, Taco Bell rolled out a delivery service in a few cities to
meet a growing demand for food delivery. Starbucks trialed a similar pro-
gram in New York City. Even drive-through restaurants have become
inconvenient for busy Americans who do not want to leave their desks
for a meal.
Interestingly, food has not always been fast or convenient. There has
not always been a Starbucks on every corner of city streets or the golden
arches visible from exit ramps along interstate highways across the country.
In the beginning of North American food culture, it was necessary for peo-
ple to obtain food sources by hunting, gathering, or fishing, and then cook
and preserve foods at home. In the modern day, cooking at home repre-
sents just one of the many diverse ways we enjoy a meal. The way that
we eat at home has looked different over the centuries to the present
day. Although early colonists needed to rely on creative food storage solu-
tions prior to refrigeration, in the 1970s the popularity of the “TV dinner”
grew, with furniture (TV trays) created to move families from the dining
room to the living room.
What: The Many Forms of Eating 7

Eating at home today can mean many things, including bringing home
“take-out” food from a restaurant or fixing and preparing an elaborate
meal. It could include a neighborhood block party, potluck at work, or a
dinner party for our close friends. The focus on families sitting down for
dinner has been valued as important but in practice today has become rel-
atively rare. On average, families rarely have their evening meal together,
with fathers missing dinner the most frequently. In reality, 10 percent of
families never share a meal together. An exception to this inability to
coordinate family dinners is reflected in holiday meals. In this case,
88 percent of families eat together for Christmas and 79 percent have
birthday dinners with one another. In addition to our styles of eating hav-
ing changed, our tastes and food preferences have evolved over time and
have found their way into our homes.

EVOLUTION OF FOOD TRENDS IN AMERICA

Early colonists in America had limited access to fruits and vegetables
depending on soil conditions and climate, which meant a pretty simple
diet for everyday living. Foods were stored in different ways from our
modern electric refrigerator. Beans were salted, pickled, and dried
whereas beverages were stored in cellars or the coolest part of the house.
Meats, like bacon and corned beef, were either salted or canned. Milk
was typically converted to cheese and coated with wax for protection.
Cold storage was important for storing root vegetables in the cold sea-
sons. Typically, a middle-class family breakfast would consist of just bread
and milk. The heaviest meal of the day, lunch (which was often referred
to as dinner by the early settlers), was consumed in early afternoon and
might include an elaborate offering of pudding, bread, meat, roots,
pickles, vinegar, salt, and cheese. “Supper” resembled bedtime snacks
rather than a full meal, given that it was served later at night. Supper
might be leftovers, bread, or roasted potatoes without butter. Egg dishes
were considered delicacies for the Southern plantation lifestyle for lunch
(i.e., dinner) or supper.
Food preparation in the colonial era used a home brick oven to bake
cakes and breads. Interestingly, lobster was considered “poor man’s food”
(i.e., a food accessible to all people regardless of wealth) in the 1600s, as
it was unfamiliar yet widely available to English colonists. The Native
Americans influenced the diets of settlers by the cultivation of wild mush-
rooms, nuts, and berries, which prevented English colonists from starving
after their arrival to America. Colonists quickly embraced pumpkin, which
resembled the familiar squash, and accepted corn as part of their diet out of
8 Filling Up

necessity. Wheat did not thrive as a crop until the eighteenth century and
remained expensive until the 1830s.

Geographical Food Differences in America

Colonial food varied greatly by the region of the United States, including
the Northeast, the South, the Plains, the Southwest, and the Northwest.
Although the early diet in the Northeast was based on Native American
recipes, foods like clam chowder, codfish balls, corn pudding, and pumpkin
pie were also popular, along with maple syrup as a flavoring. Southern
foods consisted of oysters and shrimp from the ocean as well as game ani-
mals. Colonists also included hominy and grits in their diets under the in-
fluence of the Native Americans. The Plains region was highly focused on
hunting for meat, with bison plentiful for making stews. The meat would
also be dried to be kept as jerky for several years. By contrast, the
Southwest had some of the oldest Native American settlers, who had an
almost entirely vegetarian diet. They consumed staples of different colors
of corn as well as beans and pumpkin seeds in their diets. Finally, the
Native Alaskan diet was associated with salmon and ocean mammals such
as seal and otter. The availability of fish meant farming skills were not
required.
Initially, Americans were fairly resistant to adopting other cultural foods
into their diet and the British influence stayed strong. This British influ-
ence was evident in the largely carnivore diet and large consumption of
pork prior to 1860. In fact, it was suggested that the United States might
be the “Republic of Porkdom.” In the 1800s, beef, lamb, and chicken were
also eaten in large quantities. Puddings and pies made from meat were
popular, but vegetables and fruits were extremely limited, with potatoes
and cabbage the primary exceptions. Apples were the most common fruit
in the United States. The popularity of apples was likely linked to the
belief that this fruit possessed health-promoting properties such as reduc-
ing constipation and preventing illness. Specifically, the old adage of “an
apple a day keeps the doctor away” was alive and well in 1880s America.
Generally, foods were notably heavy and spices were used sparingly, except
in the preparation of some desserts. Although the influence of Great
Britain on the American diet was undeniable given the emphasis on meat
and potatoes, there was one major distinction. The American diet was
marked by large quantities of food and apparent gluttony. It is suggested
that Americans ate double the beef of their British counterparts. Prior
to the emergence of restaurant “all you can eat” buffets, American hotels
in the 1840s and 1850s offered an “American plan” that included meals
What: The Many Forms of Eating 9

(i.e., board). The food was literally served on a board that would groan,
and “board” often meant a hearty breakfast for early travelers in the
United States. Generally, the abundance of food associated with
American meals was viewed with disgust and as wasteful by foreigners.

Influence of French Cuisine on Food in America

North American tastes in food became more refined with the infusion of
French cuisine during the 1880s, in what some historians have referred
to as the “age of elegance.” French chefs were hired by hotels to satisfy
the desires of wealthy patrons who valued fancy meals of abundance.
Paradoxically, this time of extravagance occurred during a time of food
scarcity for many Americans. A decadent affair in 1880 was characterized
by many courses of food and an overabundance of leftovers, which were
purportedly sold to the poor.
Bodies during this time were rotund and celebrated a hearty appetite.
The tradition of a sizable and heavy breakfast continued in the United
States during this time period, albeit with an attempt to strike a more
elegant tone. The desire to sleep later and have a full breakfast later in
the morning led to the creation of our modern-day “brunch,” which began
around 1884. It was popular during this time for upper-class Americans to
entertain guests in their home with incredibly excessive amounts of food
and typically eight courses. Foods were served on platters, and the concept
of “conspicuous consumption” was operating in full force.
The presence of servants largely shaped the type of ingredients used and
the varieties of foods served at home. Even middle-class homes in the
1880s opted to have at least one servant, but food in these homes was typ-
ically limited to roasts, potatoes, and thick gravies rather than the sophis-
ticated French cuisines found in upper-class households. Another
important contributing factor to this cuisine shift in America was related
to technological advances in cooking preparation. For example, home
kitchens were able to replace brick ovens with iron stoves and ovens.
Middle-class families attempted to elevate their social status by hosting
extravagant dinner parties in the 1880s, serving foods like the finer cuts
of beef and seafood to guests. Cookbooks and cooking classes surged in
popularity during this time to help advance the cooking skills of middle-
class homemakers. Interestingly, cooking classes were extended to
working-class children in the 1890s in an attempt to train future servants,
which led to the emergence of high school home economics classes in the
early 1900s. An illustration of the abundance associated with this time is
offered by Maria Parloa from the Boston Cooking School who provided
10 Filling Up

instructions for a 12-course meal that was informed by the influences of

New England in her 1896 cookbook.

Simplification of the American Diet

At the turn of the twentieth century, Americans were receiving a contrary
message from the elaborate and extravagant food trend of the 1880s.
Instead, nutritionists were urging Americans to simplify meals and exam-
ine the dietary content of their food choices. There was a movement to
reduce the number of house servants, and the ingredient list dropped expo-
nentially for recipes, as meals returned “back to the basics.” Accessibility to
the car and other forms of transportation as well as the emergence of res-
taurants helped propel eating out to a popularity that has been sustained
in our busy lives today. Throughout the early twentieth century, however,
Americans continued to consume fairly simple meals at home, prepared by
women of the home, or servants for upper-class families. The type and
quantity of food was dependent on availability as well as an ability to pre-
serve food from spoiling. Generally, tastes were fairly plain with a heavy
emphasis on meat and potatoes. The use of spices was minimal except by
certain ethnic groups.
The Great Depression and resulting food scarcity contributed to a con-
tinued focus on simplicity and away from the French cuisine from the late
nineteenth century. Instead, the focus for many families across the United
States was to obtain food that was relatively affordable and widely acces-
sible. This paved the way for the emergence of casual restaurants and even-
tually fast-food chains. In the Great Depression, dishes like meatloaf
allowed families to stretch their pantry by adding bread or cereal grains
to meat so the food budget went further. Ironically, junk foods flourished
in the 1930s, with food items like Twinkies, Girl Scout cookies, and Ritz
Crackers peaking in popularity. The original introduction of junk foods
to the American diet was the 1893 World’s Fair. This eclectic event
exposed people in the United States to a variety of sweet and unhealthy
foods. Junk foods continued to be a mainstay in the American diet into
the 1940s and beyond with the production of chocolate bars like Mars
and Junior Mints for soldiers overseas during World War II. Cheetos were
invented toward the end of the decade, introducing our country to artifi-
cially flavored cheese snacks. Roast beef sandwiches and soups were fre-
quently prepared for lunches at home or packed for work.
The snack food culture emerged in the early 1900s and ventured into
the fast-food sphere as the country headed into the 1950s. During the
1950s and 1960s, a variety of new snack foods, such as Cheez Whiz,
What: The Many Forms of Eating 11

Doritos, and celery Jell-O, became available. The 1970s brought the coun-
try Eggo waffles and instant ramen noodles, demonstrating a preference for
convenience even within the home setting. Paradoxically, there was an
underlying dieting culture that briefly emerged in the 1920s and took hold
more strongly in the early 1970s.

The Dieting Culture: Thinning Down throughout the Ages

It may be difficult to believe that dieting dates back to the 1800s. Lord
Byron is rumored to have promoted a vinegar-and-water diet that entailed
consuming an apple cider vinegar and water mixture. For the most part
during this era, the ideal female body was slightly overweight and voluptu-
ous, which demonstrated wealth and a good bill of health. However, in the
1920s there was a growing obsession with the thin bodies of short-haired
flapper girls who were devoid of any curves. This shift to a thinner body
ideal carried over to some women’s restriction of certain foods or their
overall food consumption. Physical activity and sports participation for
girls and women increased during this time as well. Further, the Lucky
Strike cigarette brand created an advertising campaign emphasizing the
appetite-suppressing features of nicotine in the interest of refusing desserts.
Being thin was seen as elegant, sophisticated, and glamorous. The 1930s
marked the popularity of the so-called Grapefruit Diet, which was also
called the “Hollywood Diet.” This restrictive meal plan promoted the
inclusion of grapefruit at every meal to reduce caloric consumption. A sim-
ilar approach to dieting was used by the Cabbage Soup Diet that emerged
in the 1950s. The body ideal in the 1950s was not as restrictive as the ear-
lier flapper girl physique or today’s supermodels, as women like Marilyn
Monroe grew in popularity. Monroe was rumored to wear a size 14 and
was pictured as curvy and healthy. The focus on one’s body and food con-
sumption was still present, as the dieting craze never fully died.
Interestingly, Weight Watchers was founded in 1963 by a homemaker
named Jean Nidetch in her own personal efforts to suppress a self-
proclaimed addiction to cookies.
This dieting trend was reenergized in the 1970s with the glorification of
thin bodies like Twiggy, who represented a whole different type of beauty
ideal than the physique of curvaceous Marilyn Monroe. Twiggy, a British
teenage model, became famous for her extremely thin build without femi-
nine features and represented what was referred to as the “swinging sixties”
in London. American society began to believe that one can never be too
rich or too thin. In fact, a new kind of food was created to capture this diet-
ing segment of the population. One example of a diet food was Slim Fast,
12 Filling Up

which was invented in 1977. This type of healthy shake was promoted as a
successful weight control method and marketed as a meal replacement.
Lean Cuisine meals were created in 1981 to replace the heavier and more
calorically dense Stouffer’s frozen meals. Lean Cuisine frozen dinners
were a powerful signal of a new culture consumed with weight, and they
represented a wave of foods lower in calories and other nutrients (e.g.,
fat, carbohydrates) that would follow in the years to come. Lean Cuisine
meals surged in popularity during the 1980s and 1990s and continue to
be available in the frozen food section of grocery stores across America.
In 1984, Americans spent 20 percent of the $290 billion food industry
just on diet or “light” food (i.e., reduced or no fat) expenditures alone.
These diet alternatives were the latest trends to restrict foods or certain
kinds of foods considered to be “unhealthy” at a given time. For example,
labeling on foods provided information about low-calorie options.
Today’s Kraft snack packs of Oreos, crackers, and other snacks tout being
under 100 calories per serving. Other foods are labeled “gluten free” or
“sugar free” to attract consumers who are weight-conscious or follow spe-
cial diets. Models like Kate Moss, who famously appeared in Calvin
Klein Obsession ads with an appearance of starvation, have reinforced
the trend toward ultrathin appearance ideals. A variety of diets have
emerged throughout the past several decades, including the low-
carbohydrate trend associated with the Atkins Diet and South Beach
Diet as well as the more recent Paleo Diet, which will be debated in
Part III of this book.
Despite the diet craze that popped up in the 1920s and 1970s, there
was a parallel movement of cheap and fast food. Given that Americans
did not want to take time to prepare and wait for food, it is unsurprising
that fast-food restaurant chains were born and thrive today.

Moving to “Fast” Food in America

The fast-food movement began in the 1950s, and exploded in the present
day to become a hundreds of billions of dollars industry worldwide. Some
examples of current fast-food restaurants are McDonald’s, Burger King,
Wendy’s, Taco Bell, Pizza Hut, and Bojangles. It is estimated that, on aver-
age, at least one in four individuals in the United States frequents a fast-
food restaurant on a given day. Fast food is part of everyday life for human
beings around the globe. Fast-food restaurants have appeared in strip malls,
as stand-alone businesses on highway exits, and in suburbia. Food courts,
which contain a variety of fast-food outlets in a central location, have pep-
pered casinos, student unions on college campuses, and shopping malls
What: The Many Forms of Eating 13

throughout the United States. Having these familiar chain fast-food res-
taurants in the 50 states and around the world allows for consistent expec-
tations related to food choices on the menu and how the food will taste.
The confidence that one can order the same type of quarter pounder with
cheese and that it will taste similar in cities thousands of miles away offers
comfort to people who prefer to avoid unknown or exotic foods.
Interestingly, these multibillion-dollar, nationwide fast-food chains typi-
cally started as a single “mom-and-pop style” food stand with no intention
of going global. The history of fast food is fascinating, and many of the
early attempts at “fast” restaurants have survived over time to remain in
business today.

The History of Fast Food

Although the hamburger and French fries represented American icons in
the 1950s, the evolution of a reliance on cars happened a decade earlier.
Southern California was the birthplace for the nation’s car culture, inspir-
ing the world’s first “motel” (a marriage of “motor” and “hotel”) as well as
the first-ever bank with a drive-up window. Food stands began offering
curb services to customers in cars. Jesse G. Kirby founded one of the early
drive-in restaurant chains, called “Pig Stand,” in Texas. This chain was
expanded to Los Angeles, California, where the mild weather afforded an
opportunity to serve customers year-round, unlike other states that offered
food stands on a seasonal basis.
The early food stands of the 1940s were often rounded in shape and
appearance as well as easily noticeable to drivers on the road, who were
going at increasingly faster speeds. The building structures usually had
pylons, towers, and neon signs advertising their location. These early
drive-in restaurants used various gimmicks to attract customers, including
the bright signage and the costumes of the waitresses. The waitresses,
called “carhops,” worked by carrying trays of food to wait on customers
who sat in their cars. These early carhops tended to be attractive female
servers who wore flashy costumes to dress up as majorettes or cowgirls.
The earnings for these early waitresses were entirely dependent on cus-
tomer tips, rather than an hourly wage. Therefore, customer service was
top-notch and waitresses were friendly. The drive-in restaurants tended
to have longer hours than their counterparts (i.e., sit-down restaurants)
and were especially popular with a younger crowd.
When we consider food options in the 1940s, it is important to note the
presence of hot dog stands in cities such as Los Angeles. Carl Karcher,
believed to be a fast-food pioneer, had four hot dog stands in operation
14 Filling Up

by 1944. Karcher opened the Drive-In Barbeque restaurant in January of

1945 in a lot across from the Heinz farm. This fast-food restaurant special-
ized in hamburgers with a “special sauce” using carhops to deliver food to
paying customers. Demand grew noticeably larger and thrived after
World War II, when local industries, such as airplane factories, steel
mills, and military bases, were added to the existing film and oil businesses.
However, Karcher was aware of competition from a restaurant 60 miles
away that also sold hamburgers. It was rumored that people were lining
up for quality hamburgers that were priced at 15 cents compared to the
35 cents Karcher was charging. After learning about this inexpensive
self-service competitor (McDonald’s), Karcher opened the first Carl’s Jr.
restaurant in 1956 using the same format.
The men behind the concept of moving away from a drive-in to a self-
service restaurant format in the industry were Richard and Maurice
McDonald. These brothers moved to Southern California in the 1930s
in search of jobs in the film industry. After buying a movie theater in
Glendale, California, which was not successful, they opened a drive-in res-
taurant in 1937. This drive-in restaurant, located in Pasadena, served
mainly hot dogs and had several carhops; however, the brothers’ frus-
tration grew due to the high turnover of short-order cooks and carhops,
who were in high demand. The McDonalds also disliked the fact that
teenage customers would regularly steal silverware, glassware, and dishes
from the restaurant. Interestingly, the brothers closed their restaurant in
1948 after firing their carhops. They reopened their San Bernardino res-
taurant several months later after installing large grills designed to increase
speed and volume of food production. The brothers simplified the menu to
include only hamburgers and cheeseburgers, so forks and spoons were no
longer required. Furthermore, they replaced all permanent serving items
with disposable ones like paper bags and plates. In order to increase the
speed of filling orders, the McDonald brothers created a production line
for hamburger preparation. One worker grilled the burgers and another
one dressed and filled them with the same condiments—ketchup, mustard,
onions, and two pickles. This Speedee Service System eliminated the need
to hire skilled short-order cooks and kept costs low.
In fact, this system of food production revolutionized the restaurant
industry. The brothers eliminated carhops and referred to their restaurant
as “self-service,” which was initially confusing for customers. Customers
at that time were displeased that they had to wait in lines for their food
rather than being served in their cars; however, the low prices won out,
and customers were ultimately willing to adapt to the new format.
Another important marketing strategy employed by the McDonald
What: The Many Forms of Eating 15

brothers was to ensure brand recognition from the road. They created an
architectural design of two arches on the roof that when lit by neon
resembled the letter “M” from a distance. The McDonald’s restaurant
paved the way for accessibility to working-class families, as families of all
means were able to afford restaurant food for the first time. Entrepreneurs
of the food industry observed the innovative model created by the
McDonald brothers and found the low start-up costs to be appealing.
For example, Keith Cramer, who owned a drive-in restaurant in
Daytona, traveled to California to see the McDonald’s operation in action.
Cramer and his brother-in-law, Matthew Burns, opened the first Insta-
Burger King in 1953 to emulate this self-service model in the southern
state of Florida.
Another early example of convenience food in the 1940s is illustrated
by what has become an iconic doughnut shop. William Rosenberg, who
drove an ice cream truck, opened the first Dunkin’ Donuts in Boston in
1948. Around the same time as Dunkin’ Donuts, Glen Bell envisioned a
fast-food restaurant format in which individuals could walk up and be
served at a window. This idea paved the way for his hamburger stand
called “Bell’s Burgers” that he started in California after selling his sister’s
refrigerator. In the 1950s, the burger revolution had spawned numerous
competitors in the fast-food burger space. Therefore, the McDonald’s
model of assembly-line food production inspired Bell to create what would
eventually become a fast-food Mexican chain called Taco Bell. He knew
the importance of providing food that was easier to consume than the hard
and crunchy taco shells from traditional Mexican cuisine. Glen modified
the new taco to include a variety of ingredients that would satisfy an
American palate, and the taco began to outsell the burgers at his food
stand. Glen opened the Taco Tia restaurant in 1954 to provide a food
stand that served Mexican food exclusively. The restaurant’s instant suc-
cess led to the opening of El Taco and eventually a restaurant called
Taco Bell. His first Taco Bell location was opened in Downey,
California, in 1962. The exterior appearance of Taco Bell restaurants was
intended to represent a California mission, with the adobe-like exterior
walls and a bell in front. Today this early food stand is a highly successful
multibillion-dollar franchise that can be found around the world.
Another fast-food restaurant entrepreneur was Dave Thomas. Thomas
eventually opened the Wendy’s Old Fashioned Hamburgers restaurant in
Columbus, Ohio. Dave, who was born in Atlantic City, New Jersey, had
worked at Walgreen’s as a soda jerk (i.e., preparing carbonated beverages
at the early soda fountains in pharmacies across the country) and at the
Hobby House Restaurant in Fort Wayne, Indiana. After owning several
16 Filling Up

Kentucky Fried Chicken restaurants, he opened his first restaurant in

1969. Wendy’s Old Fashioned Hamburgers was named after Thomas’s
daughter Melinda “Wendy” Thomas. This fast-food restaurant distin-
guished itself from the other restaurants in the industry by advertising
made-to-order burgers using fresh meat. This chain established a reputa-
tion for selling high-quality foods at an affordable price after a couple of
decades of fast and cheap fast-food restaurants had effectively cornered
the market. Although Wendy’s struggled to compete in the 1980s, at
present it is the third-largest burger fast-food chain in the world.
As fast-food restaurants popped up around the country, Harland
Sanders was serving home-cooked food in a gas station in Corbin,
Kentucky. He shared the “secret recipe” for his delicious fried chicken with
restaurant owners, leading to the opening of the first Kentucky Fried
Chicken restaurant in 1952. To promote the new restaurant, which was
located just outside Salt Lake City, Utah, Sanders dressed up in a white
suit with a black string tie. Interestingly, Kentucky Fried Chicken was
the largest restaurant chain in the 1960s.
A slightly different type of restaurant serving “fast” food was Waffle
House. Brisk service was delivered by friendly waitresses who treated cus-
tomers like family. The first Waffle House was opened in Avondale
Estates, Georgia, in 1955 by Joe Rogers and Tom Forkner. This restaurant
in an Atlanta suburb quickly earned a reputation for its friendly service
and soon expanded to the rest of Georgia and states across the Southeast.
The yellow signs were recognizable from streets and interstate highways.
What was unique about a Waffle House was that the restaurant was open
24 hours a day, 365 days a year, carving a niche in the industry of provid-
ing “fast” food in a slightly different way than other fast-food chains.
Realistically, not all restaurant chains expanded in the same way as
Kentucky Fried Chicken, McDonald’s, and other leading brands did
between 1960 and 1973. Other restaurant chains were less successful and
closed their doors quickly. Still others tried innovative technologies like
remote controls for ordering, which effectively made the use of carhops
from the 1940s and 1950s obsolete. More recent fast-food restaurant
chains have opened their doors and rapidly worked to increase the number
of franchises throughout the country. Subway was a sandwich shop that
was opened in 1965 by Frederick DeLuca. This Connecticut-based busi-
ness is second only to McDonald’s in the number of franchises in opera-
tion. Although the franchise business for fast-food restaurant chains has
become an increasingly lucrative business, other eating establishments
should be described that fit into our everyday living and have historical
What: The Many Forms of Eating 17

significance. One trend of eating relates to increasing not only access to

restaurant food for everyday Americans of working-class families but also
to upping the quantity of food available at these dining establishments.
This category of “fast food” relates to other types of restaurant models,
including pizza delivery and buffets.

Pizza Delivery in America

Around the same time fast-food chains were hitting their stride, Thomas
Monaghan, who owned a pizzeria, bought a business with his brother that
was eventually named Domino’s. Domino’s Pizza is currently the second-
largest pizza franchise and was founded in 1960. The original business
started when Tom and James Monaghan bought DomiNick’s, which was
a tiny pizza store in Ypsilanti, Michigan. They used a Volkswagen Beetle
to make pizza deliveries to customers in 1961, which some historians have
credited as being the first to deliver pizzas. This traditional delivery-based
“door-to-door” service has been popular with customers worldwide,
who no longer needed a car to partake in a restaurant-prepared meal.
The emphasis on fast delivery was upheld by their policy starting in 1973
that pizzas would be delivered within 30 minutes of placing the order or
customers would receive their pizzas for free.
Having food delivered to one’s home, school, place of employment, or
dorm room has revolutionized access to food. Pizza parties have been popu-
lar in the United States, with pizza becoming another icon of everyday
American living. Although burgers and hot dogs represent the fare served
at earlier food stands, the Italian influence on pizza remained. Ordering
pizzas in today’s world can now occur online or via a mobile application
and may involve using GPS tracking technology to monitor one’s delivery
status. Over time, various pizza franchises and small mom-and-pop pizza
shops have experimented with ways to keep the pizzas fresh, hot, and
mess-free. The pizza box got its start in Naples, Italy, in the 1800s, when
bakers used metal containers to hold pizzas. Pizza take-out restaurants put
pizzas on round cardboard covered with a paper bag starting in the 1940s.
Interestingly, Domino’s is credited with having designed the popular flat,
square pizza box in the 1960s during its early days as a company. Pizza shop
owners had to worry about how to keep the pizzas hot during transporta-
tion to customers. Hot bags or thermal bags made of nylon or vinyl typi-
cally have contained heating elements that retain heat. For customers
willing to “eat in” for part of their experience, buffets offered an alternative
to both fast-food restaurants and pizza delivery options.
18 Filling Up

The History of Buffets as a Self-Service Style of Eating

The popularity of lavish buffets is evidenced by the numerous casino res-
taurants that advertise “all you can eat” on the Las Vegas strip. Buffets
are also frequently used for private functions to serve a variety of taste pref-
erences and to avoid exact headcounts. Buffets allow for large groups of peo-
ple to be served efficiently with fewer staff required due to the self-service
model. Theme buffets may feature certain cuisines such as seafood, Asian,
or Italian. Moreover, buffets may provide breakfast, lunch, or dinner. The
concept of being able to eat as much as you want at a particular sitting con-
tributes to an American consumer’s psyche of getting one’s money’s worth.
Unfortunately, the idea of eating as much as possible or at least having infin-
ite amounts of food available can lead to gluttony and overeating. The price
of buffets ranges from $10 or less to well over $50 per person, depending on
the type of restaurant and meal. A recent study found that the more people
paid for a buffet, the more food they tended to consume. Clearly, buffets do
not encourage a philosophy of eating in moderation.
Breakfast buffets may consist of extravagant omelet stations and extras
in addition to a line with self-served dishes like eggs, bacon, and potatoes.
Lunch buffets may include a variety of sandwiches and salads along with
some dessert options. Dinner buffets tend to be more extravagant, offering
more choices of meat and entrée options. The concept of the buffet table
originates from the Swedish smorgasbord. The “buffet” actually represents
a piece of furniture and relates to people serving themselves. Although
the buffet table was around in the sixteenth century, its popularity
increased in the eighteenth century in Europe. Consumption and wealth
were more subtle during this time period. The original smorgasbord
involved a pre-dinner drink in separate rooms for men and women, with
dinner to follow. The smorgasbord buffet continued to thrive in the nine-
teenth century with the railroad expansion; however, it is believed that
the smorgasbord buffet was introduced to the United States in the 1930s
by the Swedes in New York. The smorgasbord buffet was featured at the
1939 New York World’s Fair in order to show off a variety of Swedish
foods. The significance of the buffet is tied to the cultural shift toward
accepting and celebrating conspicuous consumption. In other words, it
became trendy to display huge amounts of food and have unlimited access
to a variety of food and drink as a sign of wealth.
This buffet style of serving food can be found in school and dormitory
cafeterias as well as restaurants. This format can also be found in military
institutions and prisons. This “all you can eat” style of buffet was intro-
duced in 1956 by Las Vegas businessman, Herbert McDonald, as the
What: The Many Forms of Eating 19

epitome of luxury and included ice sculptures, meat-carving stations, and

expensive seafood options. Less extravagant buffets followed in the late
1950s, 1960s, and 1970s. The modern Sizzler chain, which was originally
named Del’s Sizzler Family Steak House, was opened in 1958 in Culver
City, California, by Del and Helen Johnson. The original restaurant was
intended to be a step up from the fast-food restaurants at the time. In the
1970s and 1980s, steak was emphasized on the menu, with a salad bar
option that offered an “all you can eat” format. This format expanded to
certain nights and specials to evolve into the modern “all you can eat” for-
mat. Popular buffets in the United States that currently offer an “all you
can eat” access include, but are not limited to, Chuck-A-Rama, Sizzler,
Ponderosa Steak House, Golden Corral, and Sweet Tomatoes.
Given the excitement around self-service buffets that offer an endless
array of quantities and types of food, it is not surprising that yet another
avenue of food production continues to be popular in our country and
around the world. Food trucks, which line the streets in many major cities,
originated in the 1950s.

The History of Food Trucks

An alternative to traditional restaurants, a food truck is a vehicle that
allows for the cooking, preparation, and selling of food. The food truck
market in the United States has increased 80 percent since 2009 and is a
nearly billion-dollar industry. Today the average cost of a food truck ranges
from $75,000 to $85,000, compared to over $250,000 for a brick-and-
mortar restaurant. It is estimated that $290,556 of revenue is generated
annually per truck. Food trucks have become very popular in hip cities like
Portland, Seattle, and San Francisco, which have large populations of
younger adults and are associated with the current cultural trend of “pop-
up restaurants.” Although we may view the arrival of food trucks as a
recent phenomenon, it is important to realize that a variation of these
vehicles has existed for over a hundred years. The original food trucks
offered limited fare, usually ice cream treats. These ice cream trucks, which
sold prepackaged ice cream sandwiches and Creamsicles, were the first
food-related businesses on wheels that provided children with excitement
on a summer day. We can still hear the music from one of these trucks as
they cruise through the neighborhood streets in search of young customers.
It can be argued that the origin of food trucks comes from the original
Texas chuck wagon. Specifically, a chuck wagon was used to transport food
and cooking supplies across the United States in the 1800s. This wagon
20 Filling Up

served as a mobile kitchen for early settlers and workers who traveled long
distances before the advent of the automobile. Charlie Goodnight, who
was a Texas rancher, was credited with introducing the concept of chuck
wagons in 1866 to feed cattlemen. Following the Civil War, the market for
beef expanded in Texas, which meant that feeding cowboys and cattlemen
was of enormous concern. The durable wagon was equipped with a “chuck
box” that had drawers and a flat cooking surface. Firewood was carried along
with cooking supplies to prepare meals. Generally, food was pretty basic and
included fare such as salted meats, beans, coffee, cornmeal, and sourdough
biscuits. No fruits or vegetables were available on the chuck wagon.
Interestingly, an early version of the modern food truck of today was
created in 1872 by Walter Scott. He used a covered wagon to transport
pies, sandwiches, and coffee to sell to journalists and workers of the press
in Providence, Rhode Island. This invention led to lunch wagons by the
1880s that included refrigerators, cooking stoves, and sinks. Mobile can-
teens represent another predecessor to our modern-day food trucks.
These were created in the late 1950s to serve food to military members
and tended to operate on U.S. army bases. Importantly, a related food dis-
tribution method was represented by New York City street vendors who
began selling food from push carts as early as 1691.
Another example of early food trucks were referred to as “roach
coaches” in the 1960s. These mobile food trucks provided service to
construction workers across the United States during their workday.
These vehicles provided access to food sources in areas where restaurants
were scarce. Immigrants from Mexico brought the taco truck culture, and
some of these original “roach coaches” evolved into modern gourmet food
trucks. The Great Recession, which officially lasted from December 2007
to June 2009 following an economic downturn in the United States, gave
a dramatic boost to the modern food truck business. These trucks provided
the opportunity for unemployed chefs to own a business with minimal
start-up costs. The demand for inexpensive dining options also increased
as consumers had less disposable income to spend at fancy restaurants.
The modern gourmet food trucks arrived around 2007 and grew 8.4 percent
to 2012. Typically, these trucks had a particular theme or niche represent-
ing a certain ethnic food or a small menu. The current food truck market is
a multibillion-dollar industry and offers the gamut in types of food from
lobster rolls to Korean BBQ. The food truck owners have relied on nontra-
ditional marketing strategies to promote their locations, such as the use of
Twitter and Facebook social media sites. Although they got their start
in large cities like Portland where trucks line the streets with more perma-
nence, similar vehicles are found in many smaller towns and beach
What: The Many Forms of Eating 21

communities. In some locations, it is possible to reserve a food truck that

specializes in waffles or cupcakes for a special event. The use of food trucks
at special occasions like birthday parties and weddings has changed the
food landscape. However, some traditions for our special occasions tend
to linger that are associated with particular food items or family traditions
that are passed down from one generation to the next.

THE MEANING OF FOOD FOR

SPECIAL OCCASIONS
Although this chapter has discussed the meaning of food in everyday
living, it is also worth considering the role of eating for holidays and other
special life events. Holidays such as Thanksgiving, Christmas, and Easter
feature certain traditions regarding food and using meals to honor one’s
ethnic heritage or religion. For example, the Thanksgiving feast we eat to-
day resembles the original feast consumed in Plymouth Colony in
December 1621. The autumn harvest meal consisted of wild turkeys and
pumpkin pies that were enjoyed by members of the Wampanoag tribe.
Thanksgiving was celebrated annually in the United States and President
Abraham Lincoln declared it an official holiday in 1863. The Fourth of
July is another patriotic holiday that is celebrated in the United States.
Common foods for this summertime holiday include American favorites
like burgers and hot dogs on the grill as well as our celebrated apple pie.
Celebrating milestones in one’s life may also involve using food to sym-
bolically represent the day. Some events, like retirement parties or class
reunions, may be diverse with regard to the amount and types of food
offered. However, there are some common elements including food that
is served on special occasions. For example, serving cake is symbolic when
celebrating different occasions and holidays. Specifically, cake has been
used to celebrate getting married, birthdays, and the regional celebration
of Mardi Gras. It is important to understand the history of the special occa-
sion cakes that we tend to take for granted today at events like weddings.

History and Social Meaning of the Wedding Cake

The use of cakes at wedding celebrations dates to the Roman era.
In ancient Roman wedding ceremonies, a sweet cake made of wheat or
barley was broken over the bride’s head. This gesture symbolized good for-
tune for the newly married couple. The couple then ate several crumbs of
the cake together. Wedding guests would then gather the remaining
crumbs to bring good luck to the couple at the wedding banquet. At the
22 Filling Up

conclusion of the ceremony with the wedding cake, guests would receive
handfuls of “confetto”— assorted nuts, almonds laced with honey, and
dried fruits. This sweet treat was consumed and thrown at the newly mar-
ried couples. Eventually, the nut and fruit mixture was replaced with fresh
or dried flowers, rice, or bird seed as done today. Interestingly, early Roman
traditions around weddings and foods were adopted by Great Britain
following the Roman invasion.

History and Social Meaning of the Birthday Cake

Today we take it for granted there will be some type of cake when we go to
a birthday party. The flavor of cake—vanilla, chocolate, or strawberry—
typically reflects the preferences of the birthday boy or girl rather than a
rigid tradition. In some cases a birthday cake may be shaped into a favorite
superheroine, Disney character, or a flower and decorated with candies,
sprinkles, or coconut. It is also trendy to have cupcakes in unique flavors
such as caramel apple, maple bacon, and chocolate peanut butter cup
present at a birthday to replace a traditional round or rectangular cake.
Candles representing the number of years of age are strategically placed
on the cake of choice to allow for the tradition of blowing out the candles
and making a birthday wish. While today’s ritual of blowing out the can-
dles on a cake is associated with one’s birthday wish coming true if all can-
dles are extinguished, birthday candles originally represented birthday
wishes up to God. In ancient times people prayed over the flames of an
open fire rather than individual candles. Smoke associated with blowing
out the fire was believed to carry birthday wishes up to the gods.
The origins of the birthday cake custom are a controversial point of dis-
cussion. Although some historians argue the custom began in ancient
Greece, an opposing belief is that birthday cakes originated in Germany
during the Middle Ages. Greeks were believed to bake honey cakes or bread
to represent the birthday cake. They celebrated three different types of birth-
days—those of family and friends, cities and temples, and imperial family
members or past and present emperors. The 50th year was symbolized by a
honey cake consisting of wheat flour, grated cheese, honey, and olive oil.
By contrast, birthday cakes were believed to originate in Germany during
the Middle Ages. Birthday cakes were actually sweetened bread dough
molded into the shape of baby Jesus to celebrate his birthday, representing
the religious overtones of the holiday. This custom reemerged in Germany
to celebrate birthdays for young children. In England, early birthday cakes
were baked with symbolic objects inside the batter including coins and thim-
bles. The superstition followed that a person finding the coin was expected to
What: The Many Forms of Eating 23

receive riches whereas the unlucky person finding the thimble would never
marry. The tradition of hiding special objects inside of cakes mirrors the tradi-
tion of the popular “king cake” in New Orleans, during Carnival.

History and Social Meaning of the King Cake

Interestingly, the name “king cake” has roots in the Bible, as it was coined
after the three kings. Historically, the original king cakes were dry French
bread dough covered with sugar and with a bean inside, per custom in the
Roman Empire. A person who was served the piece of cake with the hidden
bean was honored as the “king of the feast.” Fast-forward several hundred
years and king cakes are sweet and sugary dough laced with cinnamon and
topped with icing and sprinkles in an array of purple, green, and yellow.
The colors of the sugar crystals for the king cake have roots in Christianity.
Symbolically, purple represents justice, gold signifies power, and green is syn-
onymous with faith. Furthermore, purple, gold, and green serve to honor the
three kings who traveled to see baby Jesus on the 12th day of Christmas.
Since 1870, king cake makers have replaced the bean with a porcelain
figure. The modern-day king cakes hide in the cake batter a plastic doll-
like baby figure that represents baby Jesus. The trinket symbolizes wealth
and luck for the person who finds the baby in his or her piece of king cake.
The person who locates the baby is also ordained the “king” or “queen” of
the evening; however, the person is also obligated to buy the next year’s
king cake or, in some cases, throw the Mardi Gras party.
The king cake is served around the word as a popular food choice during
the Christmas season. For example, Belgium, France, Switzerland, and
Spain, to name a few countries, closely observe the custom of the king
cake. In U.S. towns with French origins, such as New Orleans, Saint
Louis, and Galveston, the king cake follows Mardi Gras traditions and is
present throughout the Carnival season, which runs from Epiphany Eve
(January 6) to Fat Tuesday. Cakes and lengthy, drawn-out meals like a
Thanksgiving feast may happen only during the holidays for some families;
however, another trend should be discussed that represents a change in the
American diet. Specifically, that coffee and other beverages have come to
be defined as meals in their own right.

OTHER FOOD PHENOMENA

The Meaning of the Liquid Diet

Although emphasis is usually placed on outlets that specialize in food ser-
vice such as fast-food chains, sit-down restaurants, and food trucks, some
24 Filling Up

businesses focus on helping customers obtain nutrients in liquid form.

The meaning of food beverages such as carbonated beverages, smoothies,
and specialty coffees over generations cannot be ignored when considering
the food industry. The truth is, consumer dollars have shown the high
value placed on a morning java or afternoon “pick-me-up” that equates
to a multibillion-dollar industry for the United States.

The Starbucks Phenomenon

It is hard to go to a busy city without seeing a Starbucks on a street corner.
Although fast-food chains and convenience stores have served as places
for people to go and receive a fast and casual cup of coffee for most of the
twentieth century in the United States, coffeehouses have a rich history.
The first documented “coffeehouse,” named Kiva Han, was located in
Istanbul, Turkey, and dates to 1475. Coffee was significant in Turkish cul-
ture and was served strong and black. Our common habit of adding cream
or sugar to coffee did not begin until 1529, when the first coffeehouse
appeared in Europe. Franz Kolschitzky, who opened a coffeehouse in
Vienna, developed a method for filtering coffee and taking the edge off
by adding milk and sugar. The drink was well received by the coffeehouse’s
patrons and soon spread to other parts of Europe. The first coffeehouse
opened in Great Britain in 1652. In Great Britain coffeehouses were
referred to as “penny universities” to represent the price for coffee and
the clientele, who tended to be upper-class businessmen who would go to
socialize. Italy, France, and Germany opened coffeehouses in 1654, 1672,
and 1673, respectively.
Coffee was part of America’s early history, as it was brought from
England by the colonists. The original coffeehouse in the United States
was the Tontine Coffee House in New York City, which opened in 1792
to serve the businesses on the New York Stock Exchange. Regular coffee
was served until 1946, when espresso was invented. In Italy, the Gaggia
coffee bar was the first to use espresso machines to offer espresso as well
as regular coffee. This invention marks the beginning of our modern cof-
feehouses that have become a permanent fixture in American society.
The first Starbucks store opened in Seattle in 1971. This initial store
sold coffee beans and coffee-making equipment rather than mocha drinks
and lattes. Ten years later Starbucks began to sell drinks when Howard
Schultz was hired as the director of retail operations. Schultz was inspired
by his trips to Milan, Italy, where he frequented espresso bars. Starbucks
did not expand to the rest of the United States until the 1990s.
Currently, the Starbucks chain has more than 21,500 stores in 64
What: The Many Forms of Eating 25

countries and territories around the world. Coffeehouses like Starbucks

indeed represent a way of eating, as customers go to enjoy coffee drinks
and food (the modern establishments offer bakery items, a variety of
snacks, and sandwiches). The coffeehouse experience has revolutionized
the “eating out” business as working lunches are replaced with coffee meet-
ings. Coffeehouses offer the flexibility to meet or be social at any time of
the day regardless of a requisite mealtime. Finally, coffeehouses represent
culture, an opportunity for people watching, and a lack of time limitation
placed on the visit that diners experience with other restaurants. Some
customers prefer the “fast-food” model for coffeehouses, as Starbucks intro-
duced the drive-through window in 1994. Moreover, restaurant brands
like Starbucks demonstrate the ability to adapt to changing economies
and customer tastes. Starbucks products are found in many outlets, as they
are stocked by grocery stores and convenience stores alike. Starbucks and
other coffee outlets can be found on college campuses, airports, shopping
malls, hotels, and public libraries, which demonstrates the prominence
the coffeehouse culture has in the United States.

CONCLUSION
Eating as “experience” is firmly entrenched in American culture. As part of
everyday living, we enjoy many styles of eating that include eating and
preparing foods at home as well as eating out. The introduction of faster
and more convenient options for food has changed the accessibility to food
for people from different social classes. Fast-food chain restaurants, which
took the country by storm in the 1950s, represent a rich history and food
revolution. Beyond everyday living, special occasions hold unique mean-
ings for food served and family traditions around holiday meals. In many
cases, food provides symbolic meaning to a particular event or life mile-
stone. In the next chapter, we discuss the important role food plays in pro-
viding for our biological, psychological, and social needs.

BIBLIOGRAPHY
Branca, Patricia. “Reviewed Work: Food and Drink in History by Robert
Forster and Orest Ranum.” Journal of Social History 14, no. 2 (1980):
315–16.
“Food Truck History: From Roach Coach to Gourmet Eatery on Wheels.”
Cloudfront.net. Accessed June 26, 2015. https://d3jc3ahdjad7x7.cloud
front.net/bRGo3eJcBSmUj0s8dmi1hgxmWdTPgExuSDnEliH3VM3
WCSEv.pdf.
26 Filling Up

Grier, Sonya, and Brennan Davis. “Are All Proximity Effects Created
Equal? Fast Food Near Schools and Body Weight among Diverse
Adolescents.” Journal of Public Policy & Marketing 32, no. 1 (2013):
116–28. doi: 10.1509/jppm.11.158.
Heald, Felix P. “Fast Food and Snack Food: Beneficial or Deleterious.”
Journal of Adolescent Health 13 (1992): 380–83. doi: 10.1016/1054
-139X(92)90033-8.
“History of Wendy’s: How It All Began.” Fast Food Menu Prices. Last
modified August 12, 2013. http://www.fastfoodmenuprices.com/
history-of-wendys-how-it-all-began/.
Hull, Holly R., Duncan Radley, Mary K. Dinger, and David A. Fields.
“The Effect of the Thanksgiving Holiday on Weight Gain.” Nutrition
Journal 5, no. 29 (2006). doi: 10.1186/1475-2891-5-29.
Khare, R. S. “Fast Food/Slow Food: The Cultural Economy of the Global
Food System.” American Anthropologist 110, no. 1 (2008): 153. doi:
10.1111/j.1548-1433.2008.00018_81.x.
Levenstein, Harvey A. Revolution at the Table: The Transformation of the
American Diet. New York: Oxford University, 1988.
Locher, Jamie, and Owen Moritz. “Eating while Driving Causes 80% of All
Car Accidents, Study Shows.” New York Daily News, July 19, 2009.
http://www.nydailynews.com/new-york/eating-driving-80-car-accidents
-study-shows-article-1.427796.
London, Bianca. “Families Only Manage to Sit Down Together for Dinner
Twice a Week—With 10% Never Eating Together.” Daily Mail.com.
Last modified November 19, 2012. http://www.dailymail.co.uk/femail/
article-2235161/Families-manage-sit-dinner-twice-week–10-NEVER
-eating-together.html.
Madhadi, Aamer. “Taco Bell Begins Testing Delivery in 200 Stores.” USA
Today, July 8, 2015. http://www.usatoday.com/story/money/2015/07/08/
taco-bell-to-test-delivery-california-texas/29832469/.
Marshall, Colin. “The First Starbucks Coffee Shop, Seattle—A History of
Cities in 50 Buildings, Day 36.” The Guardian, May 14, 2015. http://
www.theguardian.com/cities/2015/may/14/the-first-starbucks-coffee
-shop-seattle-a-history-of-cities-in-50-buildings-day-36.
McCarthy, Nicola. “A Lean Holiday Season.” Nature Reviews 7 (2007).
doi: 10.1038/nrc2286.
Muhammed, Larry. “More Workers Work through Lunch or Eat at Their
Desks.” USA Today, April 13, 2013. http://usatoday30.usatoday.com/
money/workplace/story/2012-04-15/lunch-at-work/54167808/1.
What: The Many Forms of Eating 27

Oelbaum, Jed. “All-You-Can-Eat Buffets: The Scourge of Modern

Behavioral Economics.” Good, December 17, 2014. http://magazine
.good.is/articles/economists-vs-buffets.
Procida, Mary A. “No Longer Half-Baked: Food Studies and Women’s
History.” Journal of Women’s History 16, no. 3 (2004): 197–205. doi:
10.1353/jowh.2004.0070.
Reel, Justine J., ed. Eating Disorders: An Encyclopedia of Causes, Treatment,
and Prevention. Santa Barbara, CA: Greenwood, 2013.
Salmon, Catherine, Charles Crawford, Laura Dane, and Oonagh
Zuberbier. “Ancestral Mechanisms in Modern Environments, Impact
of Competition and Stressors on Body Image and Dieting Behavior.”
Human Nature 19 (2008): 103–17. doi: 10.1007/s12110-008-9030-8.
Satran, Joe. “The Forgotten History of the World’s First Taco Bell, and
Today’s Attempt to Save It.” Huffington Post. Last modified March 11,
2015. http://www.huffingtonpost.com/2015/03/09/first-taco-bell_n
_6818968.html.
Scholosser, Eric. Fast Food Nation: The Dark Side of the All-American Meal.
Boston: Houghton Mifflin, 2001.
Sered, Susan S. “Food and Holiness: Cooking as a Sacred Act among
Middle-Eastern Jewish Women.” Anthropological Quarterly 61, no. 3
(1988): 129–39.
Thomson, Di, and Anne-Marie Hassenkamp. “The Social Meaning and
Function of Food Rituals in Healthcare Practice: An Ethnography.”
Human Relations 61, no. 12 (2008): 1775–802. doi: 10.1177/00187267
08098085.
Trubek, Amy B. “Food and Love: A Cultural History of East and West.”
American Anthropologist 102, no. 4 (2000): 943–44. doi: 10.1525/aa
.2000.102.4.943.
Veri, Maria J., and Rita Liberti. “Tailgate Warriors: Exploring
Constructions of Masculinity, Food, and Football.” Journal of Sport and
Social Issues 37, no. 3 (2013): 227–44. doi: 10.1177/01937235124
72897.
Wrzesniewski, Amy, Paul Rozin, and Gwen Bennett. “Working, Playing,
and Eating: Making the Most of Most Moments.” In Flourishing:
Positive Psychology and the Life Well-Lived, edited by Corey L. M. Keyes
and Jonathan Haidt, 185–204. Washington, DC: American
Psychological Association, 2003. doi: 10.1037/10594-008.
 2

Why: The Importance

of Eating in Our Lives

Food and eating play an important role in our everyday lives.

Acknowledged as a basic need for human and animal survival, food is
essential for all of life on earth to exist. This chapter will show the ways
that food and eating satisfy a broad array of biological needs in animal spe-
cies and humans alike. The importance of consuming nutrients in the form
of food to fuel the body’s diverse systems will be discussed. In addition, the
negative health consequences related to having too little or too much food
over time will be identified.
In addition to being vital for our body’s functioning from a biological
standpoint, food also meets our psychological needs in a variety of ways.
Our sense of self and identity is tied to the types of food we eat and the
way we prepare our meals. Furthermore, food gives meaning to our inter-
personal relationships and is associated with both positive and negative
emotions. Our relationship with food can underscore the potential conflict
between the dichotomy of experiencing pleasure and guilt as well as the
denial of food versus the overindulgence in treats. In fact, some people
are emotional eaters and have a tendency to overeat when they are experi-
encing certain types of emotions or psychological triggers. Indeed, eating
certain foods in response to emotions like joy, frustration, and sadness
has been well documented. It is important to examine whether the exis-
tence of food cravings and addiction to sugar have any scientific merit.
30 Filling Up

One’s relationship with food may be strongly driven by both biological and
psychological needs; however, the social meaning of food reflects interac-
tions with other people and cultural norms.
Related to our social needs as human beings, the importance of food
and eating in providing meaning, companionship, and belonging cannot
be ignored. Food plays important roles across diverse cultures around the
world. The consistent need to eat meals throughout the day offers a stage
for social interaction to occur in everyday life, whether in the office break
room, student cafeteria, or local coffee shop. The meaning of food is reflected
in various religious beliefs and holidays. In fact, fasting or the absence of food
is frequently seen as a way to devoutly observe one’s religious beliefs. Family
traditions and customs often revolve around the preparation of certain types
of food and special meals. One’s ethnic culture may play a role in influencing
food preferences as well as which types of foods are served together. Heritage
may also determine what foods are appropriate at a certain time of the day.
Social trends may incorporate specific styles of dining, types of food, or ways
food has social meaning at a particular point in time. Moreover, food can
serve as a metaphor for what is happening in the larger society related to food
access and attitudes about what types of food (and nutritional diets) are desir-
able. We will begin this chapter by describing the way that food fills a variety
of biological needs for human beings.

FOOD AND EATING: A BIOLOGICAL NEED

At the most basic level, all living beings require water and nutrients to sur-
vive. Searching for food is a central activity for animals in the wild, which
can be highly dependent on the surrounding environment. In fact, the acts
of finding and consuming food dominate the major portion of many ani-
mals’ day. Knowing about the food selection for individual animals can
provide information about their overall biology and behavior. For exam-
ple, what an animal eats reflects its capabilities related to cognitive and
motor skills as well as the sophistication of its digestive systems. Some ani-
mals, such as anteaters, pandas, and koalas, ingest a limited diet that con-
sists of only a few select foods. Having a narrow diet has been associated
with being tuned in to detecting one’s food source. These animals are
usually less developed in other areas. By contrast, other animals, such as
monkeys, which consume a combination diet that is more varied, tend to
have broader skills and more well-developed cognition or intelligence.
These “generalist” animals often face the challenge of locating foods that
provide the balance of life-sustaining nutritional sources while avoiding
foods like poisonous berries that can be potentially toxic. Interestingly,
Why: The Importance of Eating in Our Lives 31

there is ample evidence that people possess a natural preference for sweet
substances or sugars. This preference extends to newborn infants, which
suggests a biological explanation rather than a psychological or social
one. Moreover, there is some preliminary evidence of innate preferences
for both salt and fatty textures, although these tendencies have not been
proven in newborns. These innate preferences demonstrate a biological
explanation for adult preferences for sweet, salty, and fatty foods. By con-
trast, it has been shown that an innate aversion to bitter substances is often
tied to toxins. This dichotomy of eating represents the positive and nega-
tive sides related to the foods consumed by both animals and human
beings. The familiar adage “You are what you eat” can be applied to both
the biology and psychology of humans’ eating patterns.

How Humans Differ from Animals When

It Comes to Food
Human beings require energy, water, and nutrients to survive and thrive.
Food is a fundamental need for human beings in the same way that cloth-
ing and shelter are required for everyday existence. This overall need to
nourish the body drives the tendency to eat and drink frequently through-
out the day in a particular pattern that is sometimes referred to as “meals.”
Unlike other animals, humans have not adapted to eat food sources that
have low caloric value to sustain the bodily systems and maintain survival.
Can you imagine if the server at your favorite restaurant asked you what
type of leaves you would like to order? In contrast to animals, humans tend
to eat more calorically dense foods at certain points of the day. Although
some humans prefer a form of grazing behavior that consists of continuous
snacking throughout the day, the majority of humans prepare and con-
sume food in the form of clustered segments referred to as meals.
Humans are different from other animal species in a variety of ways.
Eating more calorically dense meals as opposed to, for instance, leaves is
one way that has already been mentioned. Humans also represent an
advance in the development of an efficient and reliable food source
through the creation of sustainable agriculture. Farming provides rich food
sources in the form of vegetables (plants) and meats (animals) that were
not available prior to the evolution of humans. In today’s society, humans
tend to spend the most time during their waking hours in activities related
to work and food. This large amount of time devoted to food-related activ-
ities is prevalent in multiple countries, including the United States, Peru,
and France. In other countries, such as China and India, food activities
like preparation and consumption occupied the greatest number of hours
32 Filling Up

in the day. Another way that humans are different from other animals is in
the adaptation of bringing food to their mouth rather than bringing their
mouth to the food. Unlike almost all other animals, which move their
mouth to consume their food source, humans have developed “table man-
ners” and may use implements such as forks, knives, and spoons to carry
the food to their mouths. Food has much more social meaning than merely
being a source of nutrition for humans.
Eating behavior may differ across individuals or cultural groups, but gen-
erally a certain energy requirement or amount of calories is desired to sup-
port bodily systems and daily functions. When these energy needs are out
of balance and caloric intake does not meet nutrient requirements, weight
loss can occur or, at the extreme, starvation can be the ultimate result.
Anorexia nervosa is a condition that is classified as a mental disorder and
has frequently been referred to as “self-starvation syndrome.” Individuals
with anorexia nervosa are underweight and restrict their dietary intake in
a way that nutrient demands are no longer met, which negatively affects
a variety of bodily of systems. Unfortunately, this lack of nourishment
can lead to a number of health consequences, such as low blood pressure,
amenorrhea (i.e., the absence of a female’s menstrual cycle), decreased
bone health and increased risk for osteoporosis, and electrolyte imbalan-
ces. Disturbances to the reproductive cycle and infertility can result from
anorexia nervosa. Finding the right level of food consumption is critical
to meet bodily functioning needs; however, eating an excessive amount
of food can also be problematic for one’s health.

Excessive Food Intake and the Relationship to Obesity

Consuming an excess of calories throughout the day over an extended
period of time can lead to weight gain and increased risk for overweight
and obesity. If an individual becomes overweight or obese as a result of
the weight gain, he or she will also face increased risk for certain cancers,
cardiovascular disease, hypertension, joint trauma, back pain, and diabe-
tes. There has been some evidence that obese individuals may experience
a lower life expectancy and that there is an association between obesity
and mortality (death). Although physical problems can be extensive,
obesity can have a negative impact on a person’s mental health as well.
For example, researchers have suggested that there is a relationship
between obesity and a higher rate of depression. Other psychological con-
cerns associated with obesity include higher anxiety, negative body image,
and poor self-esteem. Being overweight in a thin-obsessed society can
mean experiencing stigma regarding one’s size. Overweight and obese
Why: The Importance of Eating in Our Lives 33

individuals report incidences of weight-related teasing and bullying by sib-

lings, parents, and extended family members. Moreover, overweight and
obese children and adolescents may face bullying in the school environ-
ment from their peers. Eating behaviors have been found to be strongly
tied to stress and emotions, which feeds this vicious cycle. Given that
obesity reflects both physical and psychological consequences, it is impor-
tant to understand the many ways that food is essential to serving psycho-
logical needs for human beings.

FOOD AND EATING: A PSYCHOLOGICAL NEED

Food has special meaning when it comes to the psychological makeup of
an individual. Although there are a variety of ways that eating is related
to psychological needs, one of the most prominent is the ability to create
a meaningful identity of an individual within a particular culture or
broader society. This statement of self is communicated in various ways
including the expression of internal needs, wants, and a sense of self.
For example, food choices can serve as a means of self-expression that can
reflect individual values, purpose, and relationships. The identity of a person
can extend to embracing a particular food movement or way of eating that
impacts everyday living. Some of the various identities related to food and
lifestyle that will be discussed here include the gluten-free movement, veg-
etarianism, and the Paleo Diet. Of course there are many ways that people
eat that are tied to a personal meaning or psychological identity.

The Meaning of Food for Identity

Food is served at almost all social functions, and it is common for hosts to
ask whether the attendees have any food allergies or food preferences, includ-
ing dislikes. Although many guests may hesitate to say anything in an
attempt to be polite, food allergies can be a real issue for sufferers. The exis-
tence of dangerous allergies to nuts has prompted the requirement for food
labeling. Labels indicate whether the product contains nuts or was created
in an environment that has nuts or nut dust in it. Although peanuts are regu-
larly offered as an option on airline flights, if a passenger has a severe allergy
to peanut exposure, none of the passengers will be offered them.
Likewise, experiencing digestive discomfort associated with certain
types of food has led to the decision to adopt a particular diet, for example,
the recently popularized gluten-free movement. Individuals who had pre-
viously struggled with digesting certain types of food can now be tested
to determine whether they have intolerance to gluten products including
34 Filling Up

wheat, rye, and barley. Interestingly, the awareness of gluten intolerance

has led to the adoption of a mainstream gluten-free movement within soci-
ety. Entire businesses like bakeries and restaurants offer gluten-free baked
goods, and foods are labeled as gluten-free in the same way that some
had previously received an “organic” or “low-fat” tag. It is evident that
many individuals have determined that eating a gluten-free diet is a
healthy way to eat even for people who are not intolerant to gluten prod-
ucts. This trend underscores the fact that people’s identity is tied into the
type of food consumed as part of their regular diet. Indeed, a whole cat-
egory of eating around a gluten-free lifestyle now exists. Although there
are individuals who consume gluten-free products for medical reasons,
others state a preference for gluten-free eating as a healthy lifestyle.
A movement that emerged decades before the gluten-free trend was
vegetarianism. Vegetarianism, the avoidance of meat and other animal
products, varies greatly depending on the type of vegetarian diet selected.
Reasons for choosing a vegetarian lifestyle may also run the gamut from
looking for a healthy lifestyle to ethical reasons or religious beliefs related
to animal sacrifice. The decision to become vegetarian is often deeply per-
sonal. Individuals may range from identifying as vegetarian and still eating
chicken, fish, eggs, and cheese to choosing a vegan lifestyle. Individuals
who identify as vegan do not include any meat or animal products (e.g.,
cheese, eggs, milk) in their diet and must supplement protein and nutrients
from other sources. This entails finding the proper food combinations that
work for one’s vegan diet as well as the few restaurants that offer truly vegan
food options. Vegan individuals often consciously avoid products beyond
food sources that have come from animals, such as silk, leather, and wool.
The decision to become vegan or vegetarian is highly based on being socially
conscientious. In fact, some vegetarians and vegans, like actress Alicia
Silverstone, advocate for others to adopt a vegetarian lifestyle.
As stated previously, there are types of vegetarianism that involve incor-
porating some dairy products while avoiding meats. For example, lacto vege-
tarians eat dairy products like cheese, milk, and yogurt, but avoid any meat
(red meat, fish, or fowl) or eggs. Ovo vegetarians will consume eggs.
The most common type of vegetarian is lacto-ovo vegetarian, which entails
including dairy and egg products in one’s diet while avoiding meat of any
kind. So-called semi-vegetarians are pollotarians who eat poultry or fowl
while avoiding red meat and seafood. Pescatarians consume only fish and sea-
food products while avoiding red meat, poultry, and fowl. Although vegetar-
ian and even vegan lifestyles are increasingly more popular, these diets go
counter to the “all-American” diet of burgers and hot dogs observed through-
out the country at many public events and social gatherings.
Why: The Importance of Eating in Our Lives 35

The Meaning of Food for Relationships

The psychological context around food and eating goes well beyond the
types of food selected by an individual. In fact, food carries social meaning
relative to gender, sexuality, and cultural values. An individual’s belief
about gender roles can influence how she or he interacts with various food
environments. For example, a woman who embodies traditional values of
what being “male” and “female” implies within the context of a relation-
ship may choose to adopt a strong domestic presence by engaging in the
preparation of food. For instance, the 1950s societal image was often that
of an attractive woman in the role of domestic homemaker wearing an
apron and standing in the kitchen behind the stove. In the present day,
many cooking shows feature amateur chefs of both genders and various
ethnic backgrounds.
Another interesting factor to consider is the way food has been tradi-
tionally used to express emotions such as love or caring. The tradition of
cooking for one’s loved ones or bringing food to a new neighbor both
express a sense of compassion through food. A date night may consist of
a partner preparing a special meal. Grilling outdoors may be a way to host
friends to create the opportunity to have social interaction or build mean-
ingful relationships. Moreover, it is common for people in the United
States who experience a loss to be brought a variety of dishes by their
friends, families, and neighbors. The casserole is a popular dish for gather-
ings after a funeral. An example of a well-known comfort food is “funeral
potatoes,” which consists of potatoes, cheese, onions, and cream sauce.
This dish will be discussed in more detail in the Food and Eating:
A Social Need section later in this chapter.

Food and Sexuality

At the most fundamental level, food fulfills a basic need for all living
beings, but it has been associated with sexuality in a variety of ways, rang-
ing from advertising spots to romanticizing an event or special occasion.
Specifically, some foods, such as oysters, have been directly related to sex-
ual desires and thereby labeled an aphrodisiac. Food has been used as the
backdrop for a romantic encounter such as a “candlelight dinner.”
Certain foods are used in romantic gestures, including but not limited to
chocolate-covered strawberries, bubbly champagne, and ice cream.
Finally, blatant sexuality can be found in some fast-food commercials.
The use of media in displaying sexuality and food can be found in commer-
cials for Carl’s Jr. restaurants, which feature supermodels indulging in a
36 Filling Up

juicy burger at a car wash or other unlikely setting. Finally, descriptors of

sexuality are often related to food, such as the use of the terms “beefy” or
“meat market.” Given the meaning of food in society, eating reflects strong
statements about sex and emphasizes the individual as a sexual being.

The Role of Food in One’s Psyche: Eating versus Denial

Food represents a variety of emotions and the conflict between opposing
forces. For example, the tension around allowing oneself to eat on the one
hand and denying oneself on the other have been evident throughout his-
tory. Especially for women, there has been a tendency to deny one’s personal
needs for the sake of preparing food and feeding one’s family. Although this
principle of denial is complex, it has been argued that women may put others’
needs before their own in times of scarcity. Furthermore, this denial principle
continues to linger in times of prosperity or privilege because women have
been discouraged from participating in the excessive consumption of foods.
Specifically, eating in excess has been associated with lack of attractiveness
and in the present day is associated with a fear of fatness. Although eating
clearly can be a source of enjoyment, many women are faced with a conflict
between choosing to indulge themselves in the pleasure of food and choosing
to deny themselves that pleasure. This denial of food and the link to dietary
restraints of certain foods or the size of a meal have been correlated with
psychological disorders such as anorexia nervosa.
Similar to the paradox of eating and denial is the conflict between pleas-
ure and guilt. Although certain foods, such as chocolate cake or pie, are seen
as divine and luxurious—a real treat—they are also viewed as “guilty pleas-
ures.” In other words, foods are perceived to hold power over humans rather
than the other way around. Certain foods may be referred to as evil or viewed
as “forbidden fruits.” This feeling around foods can be related to emotions of
guilt or perceived lack of control over one’s eating. Being able to successfully
deprive oneself of certain food-related temptations in that vein is associated
with having a strong sense of self-control, whereas giving in to tasty foods is
seen as a sign of weakness. The emphasis placed on psychological emotions
and eating shows the importance we place on food in our society.
Therefore it is important for us to distinguish between biologically driven eat-
ing patterns and the phenomenon of emotional eating.

Emotional Eating
Eating behaviors can be highly psychological in nature. We think of
infants and animals as consuming food when they experience biological
hunger; however, adolescents and adults may be more likely to develop
Why: The Importance of Eating in Our Lives 37

eating patterns that are triggered by certain emotions. For example, some
people identify themselves as stress eaters—when they experience feel-
ings of tension or being overwhelmed, they reach for their food of choice.
Other individuals report that they eat when they are angry or frustrated.
Still others may soothe feelings of sadness, guilt, or disappointment with
food. Interestingly, even feelings of elation may be celebrated by consum-
ing certain types of food. Emotional eating has typically been defined as
eating when a person experiences feelings that are separate from biologi-
cal cues of hunger and fullness. An individual may select certain types of
food such as ice cream, potato chips, or chocolate candy bars when eating
for emotional reasons. The act of eating is intended to serve as a coping
strategy or a way to soothe oneself. Unfortunately, the emotionally
driven consumption of food, which is often highly caloric and fattening,
may lead to eventual feelings of guilt and disgust over the amount of food
that has been consumed. Therefore, instead of having the intended effect
of calming one’s strong emotions, the result is feeling even less satisfied
than before the emotional eating took place. When individuals eat emo-
tionally rather than listening to biological cues of hunger and fullness to
determine starting and stopping points for food consumption, they begin
to lose the ability to distinguish between biology and psychology over
time. Emotional eating is thought to be related to the concepts of food
cravings and food addiction that are popularly described in books and
the media.

Food Cravings and Food Addiction

You may hear your friend tell you, “I have to eat chocolate right now or I’ll
go crazy,” to express a raging urge for a specific type of food in the moment.
Food cravings can range in intensity, but they reflect an intense desire for a
particular food item. Incidentally, the most popular craving in the United
States is chocolate, but salty foods are also frequently reported as cravings.
The ability of a person to access the object being craved is the strongest
predictor of whether the food is actually consumed. To this end, human
beings will go to great lengths to satisfy their craving, including driving
to specific restaurants that carry the particular food item or making a spe-
cial trip to the grocery store. Researchers found that cravings tended to
increase for individuals who followed a rigid diet or were restricting their
intake of food amounts or types. Therefore there has been strong support
for increasing the variety of foods in one’s diet to ward off potential crav-
ings. Furthermore, cravings were found to be inversely correlated with
age; as individuals got older, they were less likely to have intense food
38 Filling Up

cravings. Cravings are typically independent of any physiological need and

are considered to be psychological in nature.
The psychological “craving” of food has been popularly labeled “food
addiction” to underscore the sense of being drawn to a particular food
and feeling out of control about one’s eating patterns. In fact, this overeat-
ing or emotional binge behavior often results in feelings of shame and
secrecy. Individuals who struggle with emotional eating report experienc-
ing a binge in private or going to fast-food restaurants to get the object of
their craving or “fix.” This emotional eating has also been associated with
yo-yo dieting and body weight fluctuations. Because the body does not
have a chance to stabilize caloric consumption, binge episodes tend to
involve high energy intake without the necessary energy expenditure to
keep weight steady. Therefore weight gain or fluctuations in weight are
commonly associated with emotional hunger and so-called addictions to
food. Yo-yo dieting, which involves periods of liberal eating alternated
with highly restrictive eating periods, may be predictive of this psychologi-
cal hunger and inability to rely on physical cues for hunger.

Characteristics of Psychological versus Physical Hunger

The following are common characteristics of emotional hunger compared
to physical or biological hunger:

1. The first feature of emotional hunger relates to the tendency for one’s
appetite or feelings of hunger to appear suddenly rather than a gradual
building over time as is found with a more physical type of hunger. In
other words, hunger tends to skyrocket immediately with the introduc-
tion of a particular emotion, feeling, or psychological trigger. By con-
trast, physical hunger is experienced throughout the day in between
meals and is accompanied by body signals such as growling.
2. Psychological hunger is characterized by a clear preference for a par-
ticular food or foods, whereas biological hunger tends to be more gen-
eralized. Although individuals will express certain food preferences
whether they are experiencing emotional or physical hunger, there
is a tendency to be flexible if someone is physically hungry, whereas
emotional hunger is often associated with specific foods that tend to
be trigger foods. Common types of foods reported by emotional eaters
are pizza, pasta, and foods that are fast to obtain and can be consumed
easily and quickly.
3. Emotional eating is often referred to as an “above the neck” way of
eating, which means that one’s mind is driving particular cravings
Why: The Importance of Eating in Our Lives 39

or food desires. By contrast, physical hunger is largely driven by bio-

logical needs related to hunger and having an empty tank. Physical
hunger is located in the stomach region and is often accompanied
by gnawing, emptiness, pain, or rumbling.
4. Given that emotional eating is tied to psychological triggers and
emotions, there tends to be an urgency or feeling a need to eat
“right now,” whereas physical hunger may be delayed and more
patient.
5. Emotional hunger is linked to a specific event or triggering situation
associated with a feeling or emotion, for example, consuming food
or experiencing craving after an interpersonal conflict. For
instance, Trina, a college student, has a fight with her roommate
about borrowing clothes, which leads to an increase in appetite
and a specific desire for Ben and Jerry’s Chunky Monkey ice cream.
Physical hunger arises out of a biological need to fuel the tank.
There may be physical symptoms associated with not eating when
one is physically hungry, such as feelings of lightheadedness or hav-
ing stomach pains.
6. Emotional eating is often characterized by mindless eating, which
means that the person is not paying attention to the food’s texture,
taste, or other characteristics. This lack of mindfulness around eating
can lead to overeating because biological cues are not attended to for
adequate information about physical hunger. Emotional eaters are
surprised when they find themselves at the end of an empty bag of
chips or ice cream gallon container. By contrast, physical hunger
involves making deliberate choices about when to eat and how
much. How much food is consumed is driven by feelings while eating
and by listening to bodily cues related to feelings of fullness. This
attention to how the body is feeling before, during, and after eating
is referred to as mindful eating.
7. Unlike the person who uses biological cues to determine fullness
and stop eating, the emotional eater does not stop when full.
Psychological hunger involves emotions and overeating is common.
Overeating is rare with physical hunger, which is intended to nourish
the body and fulfill the nutrient demands of the body systems.
8. Unfortunately, emotional eaters experience tremendous guilt due
to the tendency to overeat. Although a psychological trigger
caused the overeating to occur in the first place, the act of eating
to satisfy the craving has the opposite effect. Rather than soothing
their intense emotions, emotional eaters are often left with feel-
ings of intense shame. Individuals who engage in eating to meet
40 Filling Up

their biological needs feel no emotional relationship with food. In

other words, food does not have power over them. These individ-
uals view food as the necessary fuel to feed the functions of the
body.

Mindful versus Mindless Eating

In today’s society, it is common to multitask or engage in many activities
at the same time. Eating has become part of our busy life routine. We
may look over at the car next to us while driving and see the driver con-
suming a sandwich while at the wheel. We might watch television while
we are eating dinner. We might have lunch at the computer while we
continue to work on assignments for the day. Engaging in multiple
activities while eating sets us up for a “mindless” way of eating.
Specifically, mindless eating refers to being absentminded about what
food is being consumed. Mindless eating involves not really noticing
the taste and texture of the food. Because of this detachment around
eating, there is a tendency to experience decreased enjoyment around
the meal. Likewise, mindless eaters do not attend to biological cues
around hunger and may experience a higher tendency to overeat. This
overeating has been predictive of risk for developing overweight and
obesity.
Educational programs that focus on obesity prevention and healthy
eating teach participants to adopt a more mindful way of eating.
Mindful eating involves focusing on the food itself and slowing down
while eating. In order to eat mindfully, all distractions must be removed,
including television, computers, and other devices. Mindful eating
incorporates the senses of sight and smell to fully enjoy the meal. Have
you ever heard of a wine tasting, where wines are admired for look,
smell, and taste? Imagine tasting a food item in the same way. Can you
take a piece of fruit or chocolate and do a mindful eating experiment?
Notice the texture and amount of shine on your food item as well as
the color of the object. Sniff the fruit or chocolate and put words to
what you smell. Finally, take a small bite and be sure to let the food roll
around your mouth. Notice each taste sensation as you chew the piece of
fruit or chocolate. Can you imagine if we ate each meal like this? This
mindful eating would definitely slow us down. Mindful eating has been
associated with maintaining more stable body weight and listening to
physical cues of hunger and fullness, whereas mindless eating can lead
to overeating.
Why: The Importance of Eating in Our Lives 41

Intuitive Eating
A separate but related concept to mindful eating is called intuitive
eating. Intuitive eating is an approach to eating that focuses on moving
individuals away from having a highly emotionally charged relationship
with food. The intuitive eating approach attempts to help an individual
normalize his or her relationship with food in the present and avoid adopt-
ing the dieting mentality. Intuitive eaters are encouraged instead to trust
their bodies to provide hunger and fullness cues. Individuals are therefore
led through a series of stages to change their relationship with food that
involves listening to their bodies for biological cues of hunger within a par-
ticular range for when to eat. In return, the approach suggests that truly
intuitive eaters will discover that their weight naturally stabilizes, and in
some cases emotional eaters will find that they actually lose weight once
they stop engaging in dieting behaviors.
The intuitive eating approach is characterized by being in touch with
how the body responds to certain foods and includes several key compo-
nents. First, individuals who are intuitive eaters give themselves uncondi-
tional permission to eat when they experience hunger rather than making
judgments or denying the types of food desired. This approach allows an
individual to remove the power of food. Furthermore, intuitive eating
determines that there are no “good” or “bad” foods. Second, intuitive eat-
ers will eat food only to satiate physical hunger rather than to soothe par-
ticularly intense emotions. Intuitive eating also involves relying on
physical hunger cues to drive when and how much food to consume in a
given moment. Although the concept has been somewhat controversial
given that foods are no longer labeled as acceptable and unacceptable,
intuitive eating has yielded several health benefits. Specifically, it has been
positively correlated with healthy coping, improved self-esteem, increased
optimism, and increased life satisfaction for college women.
One of the most promising aspects of intuitive eating has been the
reduced preoccupation with food as a psychological need. Instead, hunger
is driven by the body’s needs and is monitored to raise awareness about
cues for hunger. For intuitive eaters, fullness, like hunger, is determined
by biological cues and is measured by using the self-administered fullness
discovery scale to rate one’s fullness. Learning to have a positive psycho-
logical relationship with food and moving away from emotional eating is
important. However, it is critical to acknowledge the social influences on
food that set the stage for our eating habits throughout our life as well as
the social needs that food and eating fulfill for human beings.
42 Filling Up

FOOD AND EATING: A SOCIAL NEED

Social Influences on Eating

Food plays a strong role in everyday living as well as special events that
involve social gatherings for family and friends. In reality, food is central
in gatherings of social beings (e.g., meeting for coffee) and has been used as
an incentive to get people to attend an event. For example, college students
may be incentivized to show up at a presentation or activity with the promise
of a pizza party. Birthday parties feature some type of cake as part of the cel-
ebration. For holidays such as Thanksgiving, Christmas, and Easter, the meal
is central in the celebration of the occasion and to commemorate the tradi-
tion. Depending on one’s ethnic heritage, different types of foods may be
served for special occasions, for holidays, and in daily living.
Cuisine refers to the type of food or eating patterns that characterize a
particular ethnic culture. The type of cuisine varies depending on country
of origin and a range of factors including religious beliefs and cultural rules.
Generally, cuisines reflect a particular taste palate determined by the key
ingredients used to flavor food. For example, Indian culture employs differ-
ent types of curry to season food including lamb, chicken, and rice. New
Mexico is known for their famous green and red chiles, which originated
from 1888 farming practices associated with New Mexico State
University in Las Cruces. These different chile peppers (e.g., Hatch chiles)
are used in a variety of southwestern dishes as a sauce or served in whole
form.
Cultural rules that vary by ethnic group may determine what types of
food are consumed on a daily basis as well as the kinds of food that are
avoided always or at certain times of the year (e.g., to observe certain reli-
gious holidays). There may be differences in the types of food that are con-
sumed at various points of the day and in the size of each meal. Moreover,
certain food rules may apply to what combinations of foods are allowable
and deemed to be socially acceptable for a particular group. For example,
“bulletproof coffee” is a recent trend and involves blending organic (i.e.,
grass-fed), unsalted butter into one’s black coffee. This unusual coffee fad
has been associated with relatively unsubstantiated claims that health ben-
efits such as improved cognitive functioning, lowered cholesterol, and
energy boost can be realized from the ingestion of healthy fat in this liquid
breakfast. With bulletproof coffee being the exception for a small slice of
the population, coffee is typically served with cream and/or sugar in most
cultures. The strength of the coffee served may vary from culture to cul-
ture, with European cultures offering small cups of espresso-style coffee.
Why: The Importance of Eating in Our Lives 43

Ethnic Differences in Food Preferences

Not all cultures are alike when it comes to food. Cultural rules may apply
about what foods should be served together (coffee and cream as mentioned
above or rice and beans). As mentioned previously, the time of the day that
certain foods are served will also vary from culture to culture. Although it is
common for Americans to eat cereal and milk for breakfast, in Japan it is more
typical to consume some combination of fish and rice, and in Bermuda it is
customary to have a combination of boiled potatoes, fish, and vegetables.
Many of these food choice variances may reflect traditional values or reli-
gious beliefs of an ethnic group. Accessibility to certain types of food has a
large influence over which ingredients are used by a particular ethnic group.
In several cases, there is an observed social adaptation based on the sensitiv-
ity of digestive systems among specific cultural groups. For example, the low
levels of lactase in some ethnic groups lead to a higher prevalence of lactose
intolerance. And adults from some ethnic groups (e.g., those from Africa or
Asia) may experience stomach sickness when they consume milk or dairy
products, which has led many cultures to develop adaptive eating in which
they replace milk products in their cooking and menu items.
Availability of food sources is another important factor in determining
cuisines among ethnic groups. The use of certain ingredients is directly
related to having consistent access to these food sources at a relatively
low cost. In addition to differences across countries, there are clear geo-
graphical differences that vary from state to state across the United
States. For example, fresh fish and shrimp can be a regular part of the diet
of a family who lives on the coast of North or South Carolina, whereas
those who live in a landlocked state may not have access to those local,
fresh sources of seafood. Likewise, certain crops and produce will flourish
in specific climates with varying growing seasons. The extended growing
season in California is reflected by the presence of year-round farmers’ mar-
kets that provide access to locally grown fruits and vegetables. Even sea-
sonings such as herbs, like sage, basil, and cilantro, are influenced by the
ability to grow consistently within the local climate. Differences in rural
and urban lifestyles abound, including the ability to have one’s own garden
or access to certain types of foods.

The Influence of Religion and Cultural Attitudes

on Food Choices
The meaning of food has been largely impacted by a person’s or group’s
religious beliefs, heritage, and cultural attitudes across the decades. For
44 Filling Up

example, certain foods have been considered sacred or symbolic of particu-

lar religious practices. Foods served at holidays or for special occasions may
be influenced by one’s identified religious affiliation. Some foods have
been routinely used in conjunction with various religious ceremonies, rit-
uals, or practices. Moreover, eating and the practice of fasting have held
special meaning for certain religious groups.
Food choices for particular cultures can be affected by religious beliefs,
for example, the Hindu belief that the cow is a sacred animal. Not only
do Indians who practice Hinduism avoid eating beef in any form and
believe that cows should not be killed, they also consider the consumption
of beef to be revolting. As evidence of their strong religious beliefs, many
Hindus choose to adopt vegetarian diets.
The ritual of fasting occurs in both Christian and Jewish religions. One
example of a food-related practice is Lent, which is observed by many
Christian denominations, such as Methodists, Lutherans, and Roman
Catholics. Lent lasts approximately six weeks, from Ash Wednesday to
Easter Sunday, and involves either fasting or giving up a special item
(e.g., one’s favorite food). This tradition started as a way of showing one’s
devotion to God. Among Middle Eastern Jewish women, it is common to
see their holiness communicated via food preparation and other domestic
work. Food has become a strong symbol for sharing religious beliefs and
customs in families across religions.
The designation by an ethnic group or in a particular region of certain
foods as taboo or disgusting can change over time, and the foods may be
culturally acceptable in another region or by another group. The consump-
tion of animals that are considered pets in one region of the world, such as
dogs in the United States, would be unacceptable in most Western soci-
eties. Yet dogs are considered an acceptable food source in certain other
cultures. Meanwhile, eating insects such as caterpillars, locusts, and cock-
roaches is common in African and Asian cultures, whereas Western soci-
eties would serve these sources of high protein only on a dare in a reality
television show like Survivor.
An example of a food associated with a particular group is “funeral pota-
toes,” which have also been called “Mormon funeral potatoes.” This tradi-
tional casserole is served at social functions for the church as well as at
family dinners. The original dish was frequently served as a side dish at
gatherings after funerals. It is particularly popular in the Intermountain
West region of the United States, where there is a large population of
members of the Church of the Latter-Day Saints, also known as the
Mormon faith.
Why: The Importance of Eating in Our Lives 45

The Importance of Food in Everyday Social Interactions

The way that food is used to show human compassion and love was men-
tioned earlier in this chapter. Food is truly a vehicle for bringing family
members, friends, and strangers together in a variety of contexts. If we
remember our earliest memories around food, we may recall having dinner
at our neighbor’s home. Was there a cookout and sharing of burgers or hot
dogs on a grill? Did your neighbor’s mother bake cookies? Were you told to
finish your dinner of meat and vegetables before you were allowed to
indulge in dessert?

The Meaning of Food in Schools

Food has meaning in a variety of settings, from home to school to work to
eating establishments. Most elementary schools provide some type of food
in the form of breakfast and lunch to their students. Some students bring
their own lunch to school, but many purchase their meals at a cafeteria
housed within the campus. Eating food at the school cafeteria brings social
meaning around “Who will I sit with for lunch?” and “Will I sit alone for
lunch?” Although the lunchroom scenario and potential anxiety has been
featured in many television shows and movies, having lunch at school
environment allows for friendships to form beyond the academic setting.
Meals can be symbolic of friendship, as friends might trade items from
lunches brought from home that match with food preferences.
The ability to bring certain food items for lunch or to purchase meals at
the cafeteria represents the level of access and privilege that the children
at school have. For example, vouchers for school meals are provided for
students whose families are determined to be of low socioeconomic status
(i.e., not having the means to pay for the school lunch due to meeting
poverty-level requirements) under the National School Lunch Program.
This federally assisted meal program was organized in 1946 to provide free
and reduced-cost lunches to children during the school day. Specifically,
children from families with lower income levels are eligible for free or dis-
counted meals at school. The government’s recognition that access to food
is a basic need reflects the importance society places on eating, given that
more than 224 billion lunches have been provided to children in need
since the National School Lunch Act created the school lunch program.
Another way students can obtain food during the day beyond tradi-
tional cafeteria settings is through vending machines or stands that offer
snacks at certain times of the day. Unsurprisingly, vending machines and
46 Filling Up

snack shops in schools have been the subject of much controversy given
the increased access to unhealthy food options such as candy bars, soda
cans, and potato chips. School lunches have been the focus of recent
obesity prevention initiatives aimed at improving access to healthy and
nutritious foods for children.
To this end, a special emphasis has been placed on increasing the avail-
ability of fresh fruits and vegetables at school cafeterias and decreasing the
amount of processed and fried foods in order to combat the obesity epi-
demic in the United States. Moving away from tater tots and corn dogs
and toward whole fruit and vegetables seems to be a move in the right
direction for health. Some high schools do not host an on-campus caf-
eteria due to space or resource limitations. In these cases, students may
have the choice to bring their lunch or go off-campus for a meal. Given
the time constraints associated with traveling to food establishments, this
often means going to a fast-food restaurant or convenience store to pur-
chase lunch. Finally, there is a decidedly social element related to going
to lunch with one’s peer group. Although food is a normal part of everyday
life, whether we go to school or work, food takes on a whole new meaning
for special occasions.

The Importance of Food for Celebrating

Customs and Special Occasions
Food has important meaning for all of us and often conjures memories of
special events in our lives or of family traditions. For example, your family
may have enjoyed preparing and eating certain types of food on Christmas
or Easter. For the celebration of each new birthday, you may have received
a cake decorated candles, the number of which represent each year of
your life.
A well-documented tradition that has been observed around the globe
is the wedding cake. In Britain, the presence of cake at wedding events
was associated with a specific ceremony around cutting the cake. Today’s
ceremony involves a bride and groom who cut the cake and enjoy the first
piece together. Much merriment exists around the newly married couple
feeding each other. In some cases, the groom offers the dainty bride a small
bite, whereas at more raucous affairs the groom may smear the frosting over
the bride’s face in a form of jest. These customs are rooted in the belief of
ancient Romans that sharing the cake crumbs at a wedding brings good
luck to a newly married couple. Similarly, the ritual of blowing out birth-
day candles is embedded in important history and customs related to
beliefs about praying to the gods. Wishes are made over an open flame,
Why: The Importance of Eating in Our Lives 47

with smoke expected to carry the wishes to the gods. Today’s birthday
tradition has shifted to the sectarian belief that the birthday boy’s or girl’s
wish will come true if all the candles are successfully blown out in one try.
Some food-related customs provide meaning to communities and bring
people together. For example, the king cake had tremendous social signifi-
cance to residents of New Orleans following Hurricane Katrina in the
Mardi Gras season of 2006. During that Mardi Gras season, popularity of
the king cake surged as thousands of orders were made to support victims
of Hurricane Katrina, and people in New Orleans gathered together
around king cakes in a show of solidarity. Another example of the social
relevance of the king cake relates to the New Orleans Pelicans, who have
incorporated the tradition of the king cake baby into their NBA team by
having the King Cake Baby as their second mascot during games around
Mardi Gras. Food has special meaning for us during holidays and special
events as well as in everyday living and social interaction.

CONCLUSION
The meaning of food in a variety of contexts has been discussed in this
chapter, with a special focus on the importance of food to meet biological,
psychological, and social needs of human beings around the globe. Clearly,
there is a biological need for all living beings related to food consumption
and adaptive eating behaviors. Food fuels the physiological systems of the
body and is needed for survival. However, there are psychological factors
related to eating as well that incorporate emotions and feelings around
food.
Food reflects how we see ourselves and those around us but also conjures
intense feelings. The role that emotions play in the types of food we eat
and in driving food cravings has been a popular topic in the field of psychol-
ogy. The phenomenon of food addiction has been intensely debated and will
be covered in Part III. The role of relationships and sexuality has exemplified
the deep meaning that our society attaches to food. Furthermore, our sense of
self and our identity formation are reflected in the food we eat, expressed by
the old adage “We are what we eat.” The social implications of food are in-
triguing and reflect various cultural norms around the world. Traditions and
customs are reflected in the foods we eat and the types of foods we choose
to avoid both in daily living and for special occasions. Ethnicity and religion
may influence our eating patterns and beliefs around food. We place great sig-
nificance on food in a variety of social settings including schools, work, and
romantic environments. Food trends reflect a microcosm of what is happen-
ing at a current time in society.
48 Filling Up

BIBLIOGRAPHY
Avalos, Laura C., and Tracy L. Tylka. “Exploring a Model of Intuitive
Eating with College Women.” Journal of Counseling Psychology 53,
no. 4 (2006): 486–97. doi: 10.10137/0022-0167.53.4.486.
Balantekin, Katherine N., and James N. Roemmich. “Children’s Coping
after Psychological Stress. Choices among Food, Physical Activity,
and Television.” Appetite 59 (2012): 298–304. doi: 10.1016/j.appet
.2012.05.016.
Brownell, Kelly D., and Mark S. Gold. Food and Addiction: A Comprehensive
Handbook. New York: Oxford University Press, 2012.
Buscemi, Joanna, James G. Murphy, Kristoffer S. Berlin, and Hollie A.
Raynor. “A Behavioral Economic Analysis of Changes in Food-Related
and Food-Free Reinforcement during Weight Loss Treatment.” Journal of
Consulting and Clinical Psychology 82, no. 4 (2014): 659–69. doi:
10.1037/a0036376.
Collins, Rebecca, and Lorenzo D. Stafford. “Feeling Happy and Thinking
about Food. Counteractive Effects of Mood and Memory on Food
Consumption.” Appetite 84 (2015): 107–12. doi: 10.1016/j.appet.2014
.09.021.
Corsica, Joyce, Megan M. Hood, Shawn Katterman, Brighid Kleinman,
and Iulia Ivan. “Development of a Novel Mindfulness and Cognitive
Behavioral Intervention for Stress-Eating: A Comparative Pilot
Study.” Eating Behaviors 15 (2014): 694–99. doi: 10.1016/j.eatbeh
.2014.08.002.
Edwards, John S. A., Heather J. Hartwell, and Lorraine Brown. “The
Relationship between Emotions, Food Consumption and Meal
Acceptability when Eating Out of the Home.” Food Quality and
Preference 30 (2013): 22–32. doi: 10.1016/j.foodqual.2013.04.004.
Evers, Catharine, F. M. Stok, and Denise T. D. de Ridder. “Feeding Your
Feelings: Emotion Regulation Strategies and Emotional Eating.”
Personality and Social Psychology Bulletin 36, no. 6 (2010): 792–804.
doi: 10.1177/0146167210371383.
Fleig, Lena, Rudolf Kerschreiter, Ralf Schwarzer, Sarah Pomp, and Sonia
Lippke. “ ‘Sticking to a Healthy Diet Is Easier for Me When I Exercise
Regularly’: Cognitive Transfer between Physical Exercise and Healthy
Nutrition.” Psychology and Health 29, no. 12 (2013): 1361–72. doi:
10.1080/08870446.2014.930146.
Haedt-Matt, Alissa A., Pamela K. Keel, Sarah E. Racine, S. A. Burt, Jean
Y. Hu, Steven Boker, Michael Neale, and Kelly L. Klump. “Do
Emotional Eating Urges Regulate Affect? Concurrent and Prospective
Why: The Importance of Eating in Our Lives 49

Associations and Implications for Risk Models of Binge Eating.”

International Journal of Eating Disorders 47, no. 8 (2014): 874–77. doi:
10.1002/eat.22247.
Iannotti, Ronald J., and Jing Wang. “Patterns of Physical Activity,
Sedentary Behavior, and Diet in U.S. Adolescents.” Journal of
Adolescent Health 53 (2013): 280–86. doi: 10.1016/j.jadohealth
.2013.03.007.
Kang, Silvia S., Patricio R. Jeraldo, Aishe Kurti, Margret E. B. Miller,
Marc D. Cook, Keith Whitlock, Nigel Goldenfeld, Jeffrey A. Woods,
Bryan A. White, Nicholas Chia, and John D. Fryer. “Diet and Exercise
Orthogonally Alter the Gut Microbiome and Reveal Independent
Associations with Anxiety and Cognition.” Molecular Neurodegeneration
9, no. 36 (2014): 1–12. doi: 10.1186/1750-1326-9-36.
Manjrekar, Eishita, Michelle Schoenleber, and Wenting Mu. “Shame
Aversion and Maladaptive Eating-Related Attitudes and Behaviors.”
Eating Behaviors 14 (2013): 456–59. doi: 10.1016/j.eatbeh.2013.08.012.
Morin, Pascale, Karine Demers, Sylvian Turcotte, and Lyne Mongeau.
“Association between Perceived Self-Efficacy Related to Meal
Management and Food Coping Strategies among Working Parents with
Preschool Children.” Appetite 65 (2013): 43–50. doi: 10.1016/j.appet
.2013.01.012.
National School Lunch Program (NSLP). USDA.gov. Last modified
March 16, 2015. http://www.fns.usda.gov/nslp/national-school-lunch
-program-nslp.
Neumark-Sztainer, Dianne, Peter J. Hannan, Mary Story, Jillian Croll,
and Cheryl Perry. “Family Meal Patterns: Associations with
Sociodemographic Characteristics and Improved Dietary Intake among
Adolescents.” Journal of the American Dietetic Association 103, no. 3
(2008): 317–22. doi: 10.1053/jada.2003.50048.
Neumark-Sztainer, Dianne, Melanie Wall, Jayne A. Fulkerson, and Nicole
Larson. “Changes in the Frequency of Family Meals from 1999 to 2010
in the Homes of Adolescents: Trends by Sociodemographic
Characteristics.” Journal of Adolescent Health 52 (2013): 201–6. doi:
10.1016/j.jadohealth.2012.06.004.
Rozin, Paul. “Food and Eating.” In Handbook of Cultural Psychology, edited
by Shiobu Kitayama and Dov Cohen, 391–416. New York: Guilford
Press, 2007.
Somov, Pavel G. Eating the Moment: 141 Mindful Practices to Overcome
Overeating One Meal at a Time. Oakland, CA: New Harbinger
Publications, 2008.
50 Filling Up

Spanos, Samantha, Lenny R. Vartanian, C. Peter Herman, and Janet

Polivy. “Failure to Report Social Influences on Food Intake: Lack of
Awareness or Motivated Denial?” Health Psychology 33, no. 12 (2014):
1487–94. doi: 10.1037/hea0000008.
Sprake, Eleanor F., Jean M. Russell, and Margo E. Barker. “Food Choice
and Nutrient Intake amongst Homeless People.” Journal of Human
Nutrition and Dietetics 27, no. 3. (2014): 242–50. doi: 10.1111/
jhn.12130.
Stewart, Charles T. New Ideas about Eating Disorders: Human Emotions and
the Hunger Drive. New York: Routledge, 2012.
Tribole, Evelyn, and Elyse Resch. Intuitive Eating: A Revolutionary Program
That Works. New York: St. Martin’s Press, 2003.
Ty, Melissa, and Andrew J. P. Francis. “Insecure Attachment and
Disordered Eating in Women: The Mediating Processes of Social
Comparison and Emotional Dysregulation.” Eating Disorders 21
(2013): 154–74. doi: 10.1080/10640266.2013.761089.
Utter, Jennifer, Simon Denny, Elizabeth Robinson, Theresa Fleming,
Shanthi Ameratunga, and Sue Grant. “Family Meals and the Well-
Being of Adolescents.” Journal of Pediatrics and Child Health 49 (2013):
906–11. doi:10.1111/jpc.12428.
Woodruff, Sarah J., and Ashley R. Kirby. “The Associations among Family
Meal Frequency, Food Preparation Frequency, Self-Efficacy for
Cooking, and Food Preparation Techniques in Children and
Adolescents.” Journal of Nutrition Education and Behavior 45, no. 4
(2013): 296–303. doi: 10.1016/j.jneb.2012.11.006.
 3

How: The Positive and

Negative Effects of Eating

Eating is a popular pastime in North America and around the world.

Although food can be beneficial for individuals, families, and society,
there are also some negative and unhealthy aspects of the food industry
and our relationship with eating. On the positive side, hobbies such as
cooking, entertaining, and consuming delicious meals convey a unique
social meaning and provide a leisure activity that revolves around the
preparation and enjoyment of food. Additionally, eating has been a way
of life that brings families and friends together over a meal. Food fulfills a
basic human need by fueling the body to survive and thrive. The bodily
systems require food to keep running and performing at an optimal level.
For athletes, who perform at an elite level, eating the right foods can make
the difference between winning and losing an event.
Food can also foster meaningful interpersonal relationships and a sense
of belongingness for human beings. Eating represents a culinary adventure
with a nod to certain social movements, fad diets, or trends. Moreover, at
the individual level, food is intricately tied to a myriad of human emotions
that can epitomize both positive and negative aspects of eating. At the cul-
tural level, food also serves as a way of celebrating one’s unique cultural
identity and can reflect customs as well as the maintenance and celebra-
tion of important traditions and holidays.
52 Filling Up

Despite the popularity of food trends and traditions, the topic of eating
can be surprisingly controversial. Food access is not equal across all groups
and socioeconomic levels. Some individuals lack a regular and consistent
diet and face challenges related to consuming the recommended amounts
of fruits and vegetables. This lack of access may lead certain segments of
our population to resort to fast-food outlets and other convenient, readily
available food sources (e.g., corner stores and vending machines) as the
primary way to satisfy their daily food intake. Eating diets rich in fat, salt,
and sugar has been linked to increased risk for obesity, diabetes, and a vari-
ety of chronic diseases.
Another negative aspect of eating, food poisoning, has been responsible
for severe illness and even death. Outbreaks of E. coli and other pathogens
in restaurants and grocery stores have contributed to anxiety about the
safety of the foods we eat and have destroyed the reputation of eating
establishments. Further, these outbreaks have been devastating for the
financial health of companies due to the resulting loss of product and clo-
sures of stores and restaurants. An equally alarming aspect of eating
revolves around circumstances in which food products are not “as adver-
tised.” Fraudulent products, like extra virgin olive oil tainted with less
expensive oils, are sold on the market for a large profit.
Another dangerous aspect of our food supply involves the addition of
chemicals that have been linked to cancer risk. Specifically, food can con-
tain chemicals, artificial ingredients, genetic modifications, and other
unwanted additives in order to boost flavor, extend shelf-life, or reduce
the cost of production. Furthermore, some individuals may feel obsessed
about eating healthy foods to an extreme degree. That is, food can be asso-
ciated with negative feelings similar to addiction that resemble compulsion
and guilt. Overeating and binge eating have been tied to gaining weight
and increased risk for weight cycling, overweight, and obesity. Therefore
it is important to explain how food can serve as both a positive and nega-
tive force at an individual level, at a family unit or cultural group level, and
in the larger society.

POSITIVE ASPECTS OF EATING

Food as Fuel for the Body

Food provides the necessary nutrients to help our bodies grow, thrive, and
perform at an optimal level. For the average human being, daily food con-
sumption supports the functioning of our organs and bodily systems. Not
all foods are created equal, and what has been considered “healthy eating”
How: The Positive and Negative Effects of Eating 53

has shifted over the decades. In contrast to our typical American breakfast
of eggs, bacon, and toast, in 1824 the recommended diet was a plain bis-
cuit along with mutton chops (i.e., a cut of meat from a sheep) or broiled
beef steaks minus the fat. The beverage of choice at the morning meal
was typically a half-pint bottle of ale. Alternatively, strong tea or coffee
was served with breakfast. Weak coffee was considered to be unhealthy
during this time period. Dinner was similar fare to the breakfast meal, with
a preference for meat and bread over fresh fruits and vegetables.
The U.S. Department of Agriculture (USDA), which provides recom-
mendations for a healthy diet, previously indicated that Americans
should follow an approach to daily nutrition based on the “food pyra-
mid.” The pyramid provided symbolic representation for amounts of food
groups, with the base representing the largest quantity (grains and carbo-
hydrates), moving up to the point of the pyramid representing foods that
should be eaten less frequently (e.g., sugars and fats) because they were
considered less healthy for the American diet. The USDA has recently
shifted away from the food pyramid and at the time of this publication
recommends using a “plate approach” to depict the prescribed amounts
for each food group in one’s diet. Specifically, this food plate represents
a healthy quantity and variety of fruits and vegetables along with a gen-
erous portion of carbohydrates such as breads, potatoes, cereals, and
other grains, particularly those high in fiber. Meat, fats, sugar, and dairy
are part of a healthy diet in smaller quantities. That is, for a healthy diet,
Americans are encouraged to consume at least five servings of fruits and
vegetables daily. Lower-fat versions of meat and dairy products should
be selected, such as fish and skim milk. Fattening foods like candy, soft
drinks, ice cream, and potato chips are acceptable only in small amounts
and infrequently.
Eating the proper diet has been associated with increased energy.
Human beings commonly experience a dip in energy during the afternoon
hours between the meals of lunch and dinner. Furthermore, a sugar “crash”
can occur when certain foods (e.g., those high in sugar content) are con-
sumed. A short-lived boost or perceived energy jolt is followed by a quick
decline in one’s energy. In sum, energy is stored by the organism to acti-
vate bodily functions. Once the energy has been depleted, bodily systems
will operate below capacity and eventually energy starvation will occur.
Therefore food is vital to providing the body with an adequate source of
energy for all physiological needs to go about daily living. Additional
energy input needs (and resulting expenditures) may be required for vigo-
rous activities such as intense exercise and sport involvement. Sport nutri-
tion is a popular area of focus that highlights the necessity of consuming
54 Filling Up

enough and the right kinds of food to support the body’s performance
demands.

Sport Nutrition to Enhance Performance

Athletes and coaches of competitive sports have recognized the impor-
tance of food as fuel for achieving optimal performance. Therefore athletes
often report that they follow a different diet while they are in season for
their sport compared to when they are not playing their sport.
Competitive athletic teams may enlist the expertise of a dietitian to deter-
mine meal plans that will maximize quality of food content while striving
for or maintaining the desired body weight for one’s sport. In one study,
elite figure skaters reported that they tried to avoid potato chips and ice
cream even though they liked the taste because they knew these foods rep-
resented “empty calories.” Given that figure skating is a sport that is highly
dependent on aesthetics and the appearance of the athletes, food intake—
that is, the amount and type of calories consumed—is highly monitored.
Athletes across sports recognize the need to eat healthily to perform at
the top level.
Athletic teams employ dietitians, and college campuses often hire a
nutritionist as part of the sport support staff. Teams may receive nutrition
education in a group format with general information about the types
and amounts of food to consume, or individual athletes may work with a
sport nutritionist to devise a specially tailored plan for their specific needs.
Dietary requirements may vary depending on the sport and other factors.
In addition to particular energy (caloric) needs, certain sports may pro-
mote weight loss (wrestling) or gain (football). Athletes may become
motivated to examine their nutritional intake in the effort to change their
weight.
One example of athletes who pay special attention to caloric consump-
tion is distance runners. Individuals participating in marathons as elite
competitors or amateurs must consume an appropriate balance of calories,
electrolytes, and hydration during a 26-mile race. One common strategy is
to use energy drinks that are specifically designed to provide the right bal-
ance of electrolytes to athletes along with a caloric boost. Another popular
way to ingest the necessary fuel is to take advantage of products like GU
Energy Gel packs and chewable gummies that advertisers claim have the
ability to deliver the necessary carbohydrate blend to the athlete’s system
instantaneously. These types of products are well suited for athletes, as
they are lightweight, easy to consume, and often provide intense amounts
of energy. However, some athletes may experience adverse effects from
How: The Positive and Negative Effects of Eating 55

these products such as nausea or diarrhea. Generally, food provides energy

that athletes and exercisers need to train and compete at optimal levels.
The importance of individualizing the sport nutrition plan to athletes
based on the demands of their particular sport, their own tolerance for par-
ticular products, and their taste preferences cannot be stressed enough.
Sport nutritionists will usually advise athletes to practice their meal plan
in advance of the actual event to avoid any unnecessary discomfort.
Food also plays a role in game-day rituals for certain athletes. Some ath-
letes have strong convictions about specific foods they should eat or avoid
consuming prior to competition. The practice of “carb-loading” was popu-
larized in the early 1990s prior to endurance competitions like triathlons.
Pasta parties continue to be commonplace for triathlon and marathon
events for precompetition camaraderie. Football teams have been known
to consume awful-tasting liquids such as pickle juice. Interestingly, this
superstitious ritual has some scientific grounding, as pickle juice purport-
edly reduces muscle cramps, helps with regulating the body’s temperature,
eases sunburn, and enhances performance.

Food as a Protective Factor against Chronic Diseases

Following the USDA guidelines for a healthy diet can help prevent
diseases associated with environmental factors such as physical activity,
nutritional habits, and stress levels. One such diet, the Mediterranean
Diet, has been linked to protective factors against diseases, given the high
life expectancies associated with populations that use in these patterns of
eating. The Mediterranean Diet refers to a way of eating that has been
followed in Crete and the majority of Greece and Southern Italy since
the early 1960s. It typically involves consuming generous amounts of plant
foods such as vegetables, breads, beans, nuts, and seeds, with fruit serving
as the traditional dessert. Olive oil represents the primary source of
fat and has long been considered a “healthy fat” by scientists. The Medi-
terranean Diet is characterized by low amounts of dairy products, fish,
eggs, and red meat. By examining longitudinal data (i.e., collecting infor-
mation over multiple years to understand patterns across time), it was
determined that these groups had significantly lower prevalence rates of
chronic diseases. Specifically, eating a balanced and healthy diet like the
Mediterranean Diet has been found to prevent certain diseases and health
conditions such as coronary heart disease, stroke, cancers (e.g., esophageal,
stomach, large intestine, breast), and diabetes. Interestingly, in Medi-
terranean populations these health factors were actualized despite a clear
gap in access to medical services available locally.
56 Filling Up

Generally, making small changes in one’s diet can result in dramatic

changes to one’s disease risk profile. For example, reducing one’s salt and
cholesterol intake has been directly linked to lowering one’s blood pres-
sure, thereby reducing risk for hypertension. It is noteworthy that starting
and maintaining a healthy diet has been shown to actually reverse the
development of certain illnesses. In other words, the management of dis-
eases (and treatment) has been tied to eating a healthy diet.
Interestingly, fad diets have often been linked to a perceived health
benefit of a trendy power food. The Atkins Diet was promoted as a way
to lose weight and fight heart disease. The food industry caught on to the
popularity of this meal plan and created prepackaged items that were
endorsed by a particular diet (e.g., the South Beach Diet). For example,
foods rich in antioxidants such as berries have been promoted to help
boost immune systems. Eating like a caveman was on trend with styles of
eating such as the Paleo Diet. This meal plan, designed around eating
natural foods—meats, berries, nuts, and the like—gained popularity in
2013. Its popularity led to the first caveman restaurant, called Pure
Tastes, opening in the Notting Hill district of London. The merits and
drawbacks of following a Paleo Diet are debated in Part III of this book.
Recently, some news stories have touted the positive health benefits of
drinking up to five cups of coffee per day. Coffee is believed to be associ-
ated with longer life spans, prevention of type 2 diabetes, protecting
against liver disease and cancer, lowering the risk of developing
Parkinson’s disease later in life, and reducing risk of heart failure. This pre-
ferred morning beverage has also been linked to higher athletic perfor-
mance in some scientific studies, although the amount is higher than the
typical human would ingest, and more research is needed to confirm these
benefits.

“Comfort Food” as a Mood Enhancer

Some dietitians argue that human beings should strive for eating habits
that are driven by their internal, physiological cues of hunger and fullness;
however, there is an undeniable connection between food and positive
mood associations. Specifically, the existence of “comfort foods” is present
in almost every culture around the world. The common experience may
involve feeling soothed and relaxed by consuming certain foods.
Typically, human beings will intricately link the concept of eating for
comfort with food cravings. Cravings for foods high in sugar or sodium
content, such as potato chips, candy bars, ice cream, and cookies, are fre-
quently identified. These foods are easy to eat, full of taste, do not require
How: The Positive and Negative Effects of Eating 57

extensive preparation, and are reported to bring immediate sources of

gratification and pleasure.
Although the sense of satisfaction is highly temporal in nature and may
be followed by intense negative emotions including guilt, the initial
response is often a positive boost in mood. In fact, some studies have dem-
onstrated a short-term reduction in stress and depression associated with
the ingestion of comfort foods. Psychologists and biologists have attempted
to understand and explain the nature of food cravings, but the field
remains highly controversial. For example, for certain foods serotonin is
believed to play a role in sending a signal to the brain, which in turn is
received as an antidepressant. This positive signal then results in an
elevation in mood as a result of the comfort food properties. This mood-
elevating effect is most common in foods rich in carbohydrates. Some indi-
viduals actually report being “carbohydrate cravers” due to an intense urge
to modulate emotions using certain foods high in carbohydrates.
Given that this behavior is especially apparent when the “carbohydrate
cravers” experience a dip in mood, the tendency to use foods to induce
positive emotions has been considered a form of self-medication.
Individuals report snacking on foods when they are stressed, which is
referred to as “stress eating.” Most food consumption associated with stress-
ful emotions is in the form of snacks rather than meals and resembles com-
fort foods rich in salt, sugar, and fat. Most dietitians agree that treats can be
enjoyed in moderation as long as they are consumed on an occasional basis
rather than in excess. Overeating comfort foods tends to negate positive
feelings associated with these individualized food cravings.

Food as a Fashion Statement

Just as certain clothing accessories like leg warmers, headbands, and lace
gloves have made it to center stage over the decades, foods can take on a
life of their own. The popularity of certain groups of foods and specific
types of food over time has waxed and waned throughout the centuries.
Foods, like jewelry, hats, or purses, can come into favor and develop a
cult-like following. Those attractive culinary delights make their way into
the trendy restaurants and eventually into homes for entertaining pur-
poses. When particular foods become the “it” items in consumable prod-
ucts, their popularity impacts a wide variety of businesses from grocery
stores to restaurants. Depending on the food item, an entire business may
be created around selling the trend in the proper packaging.
A recent example of a fashionable food in the United States is the cup-
cake industry. Although cupcakes, which have been around since the
58 Filling Up

1700s as a miniature version of the cake or muffin, were sometimes used as

an alternative to a larger cake, cupcakes have taken on a life of their own.
Gourmet cupcakes, in a new palate of unique flavors such as maple bacon,
red velvet, and cappuccino, have popped up in shops and restaurants
across the country. Popular television shows such as Sex in the City are
credited with bringing attention to these individual cakes decorated to
be fit for a princess. It is estimated that more than 500 cupcake shops have
opened around the United States since the turn of the twenty-first century,
and some cupcake owners sell their gourmet desserts online or from a food
truck. The popularity of these baked goods is underscored by a television
show that was dedicated to making the perfect cupcake. Cupcake Wars first
aired on the Food Network in 2009 with a $10,000 prize awarded for the
best cupcake. Although the final episode aired on December 28, 2013,
cupcakes continue to represent a popular and trendy way to celebrate
special occasions and to indulge in a gorgeous and delectable dessert.
A close relative of the gourmet cupcake is the doughnut, another trendy
baked good. Doughnuts have been popular in the United States since the
1930s with the World’s Fair of 1934 and smaller businesses like Krispy
Kreme Doughnuts popping up in southern towns. Notably, the doughnut
business started in 1937 when two brothers in Winston-Salem, North
Carolina, sold the doughy sensations out of their Pontiac. Fast-forward to
present day and not only does Krispy Kreme continue to thrive, but com-
petitors such as Dunkin’ Donuts and other local doughnut companies have
sprung up. The gourmet doughnut was popularized by an eccentric dough-
nut store in Portland, Oregon. Voodoo Doughnut, which started as a
hangout that locals would frequent for a late-night sugar kick, has served
up an unusual array of doughnuts since 2002. The popular shop, which
has a cult-like following and attracts tourists from around the world,
includes a picturesque catalogue of each of their colorful doughnut
choices, like little baked cakes topped with cereals like Cap’n Crunch
and Froot Loops. Their brand has spread to a variety of beverages served
in an iconic pink bottle. Similar types of gourmet doughnut shops have
popped up in places like Carolina Beach, North Carolina (e.g., Wake N
Bake Donuts).
If gourmet cupcakes and doughnuts are not fashionable enough, a fun
spin-off has been the combination or hybrid version of traditional desserts.
The “cronut,” which rose in popularity during 2013, is a cross between a
doughnut and croissant. In 2014, more variations to desserts were intro-
duced, including the “duffin” (a doughnut and muffin), “scruffin” (a scone
and muffin), and “cragel” (half of a bagel combined with half of a crois-
sant). Finally, the newest combination dessert, “townies”—a hybrid of a
How: The Positive and Negative Effects of Eating 59

tart and brownie—entered our food repertoire. No matter what the dessert
du jour becomes in the future, it is easy to argue that an enjoyable aspect of
eating is riding the food trends throughout the decades.

Food as Green: Eating for the Environment

and the Economy
Food represents more than our daily caloric intake. Over history, the way
we eat reflects how we think about social issues and various causes.
For example, vegetarians and vegans make a conscious decision not to
eat some or all animal products. The farm-to-table philosophy representing
the locavore movement provides the perfect backdrop for the promotion
of locally producing and delivering the freshest food from the region to
diners’ plates. The slow-food movement also provides an alternative to fast
food while at the same time trying to preserve small businesses and make
socially responsible and healthy food choices.
In the early twenty-first century, restaurants began popping up with a
cause beyond serving tasty food. In Berkeley, California, the restaurant
Chez Panisse, which has been around since 1971, is credited with being a
trendsetter for what has been referred to as “California cuisine” or “farm-
to-table” dining. Restauranteurs such as Alice Waters of Chez Panisse tried
to serve only foods grown locally and organically by farmers in the imme-
diate region. These dining establishments have promoted the farm-to-
table concept (also known as “farm-to-fork”) by indicating the number of
miles that the original source of the product (e.g., cheese, milk, meat) trav-
eled to the restaurant. Advocating for a farm-to-table style of eating is typ-
ically synonymous with producing ingredients in local areas using
sustainable farming practices resulting in fresh, organic, and high-quality
meals.
It can be argued that the farm-to-table movement is beneficial to both
individuals and their communities. First, by using locally grown produce,
individuals are able to take advantage of seasonal ingredients to prepare
healthy dishes as part of their overall meal plan. Going out to eat at a
farm-to-table restaurant to support local farmers feels like “the right thing
to do” and represents a socially responsible decision.
This locavore movement also supports local businesses and small farm-
ers who otherwise would not thrive. In fact, some small farms are estimated
to hit sales that range from $10,000 to more than $1 million per year.
Local farmers’ markets provide visibility to a variety of local farmers and
artisans as well as the opportunity for consumers to sample products.
In many cities, farmers’ markets represent a “place to go” and enjoy the
60 Filling Up

freshest foods while supporting the farmers. A relatively lesser known ben-
efit has been the economic impact of these county farmers’ markets. For
example, King County in Washington State reported that farmers’ markets
grossed $30 million annually, not including revenue generated from park-
ing costs. It is evident that a certain number of Americans value locally
sourced foods, feel that these foods taste better, and are willing to pay more
for them.
Employment opportunities exist for these companies, and they tend to
create customer loyalty. Enjoying dinner at a farm-to-table establishment
has great appeal to tourists visiting a new city. For example, the
Brasserie, located in downtown George Town on the Grand Cayman, is
extremely popular with both tourists and locals alike. For a country that
is known to import all goods and products, this restaurant distinguishes
itself from the competition by making the decision to help the environ-
ment. The owner happily provides tours of the raised beds growing fresh
herbs and vegetables found in the dishes. Composting is a regular part of
the restaurant’s activities for processing scraps, and chickens provide
fresh eggs.
The history of the international slow-food movement (i.e., moving
away from fast and processed foods toward farm-to-table options that sup-
port local businesses) began in 1986 with Carol Petrini of Italy. This activ-
ist sought to build a global coalition to support a shift away from the highly
processed food trend (e.g., McDonald’s) that was popularized throughout
the 1960s, 1970s, and 1980s. Given that overly processed foods were
reported to contribute to various health problems including cancers, advo-
cates of this movement recognized the need to produce and deliver fresh,
healthy, and non-genetically modified food sources. As a result, trends
related to the slow-food philosophy have sprouted, including food
cooperative stores in many cities, community-supported agriculture, com-
munity gardens, slow-food movement organizations, and dining clubs for
“foodies” that support locally sourced ingredients.

Foods as a Culinary Adventure

A “foodie” culture has emerged recently that places a new level of impor-
tance on eating as an experience rather than just consuming food for nec-
essary nutrients and sustenance. The term was formalized in the early
1980s to label individuals who have discriminating tastes and seriously
enjoy different foods. The concept of “foodie” was intended to distinguish
from “glutton,” which was considered a negative way of referencing
someone who eats anything without consideration for taste and quality.
How: The Positive and Negative Effects of Eating 61

The term was further popularized by the original publication of The

Official Foodie Handbook in 1984. Although this book might be considered
outdated today, it helped to cultivate a category of people interested in the
pursuit of food-related interests who self-identified as foodies. Importantly,
a foodie participates in eating as a pleasurable hobby to be enjoyed in a
variety of forums. Various interests may include but not be limited to sam-
pling new foods and wines, visiting wineries or cheese factories, attending
cooking classes, buying the latest cookbooks, and reviewing up-and-
coming restaurants they frequent.
Foodies are probably at least partially responsible for the increasing pop-
ularity of ever-changing menus based on seasonal ingredients. Multiple-
course (three-course, five-course, seven-course) meals are provided on a
regular basis by some of the more upscale restaurants attempting to provide
an extended dining experience. Given the relatively recent advent of the
foodie, it is tempting to assign gourmet tastes to our contemporary history.
However, it should be noted that there is evidence that the European in-
fluence on American meals was demonstrated at hotels and restaurants
around the United States in the late 1800s.
Specifically, the presence of French chefs in the United States is
believed to have begun in New Orleans during the early 1800s. This early
infusion of elegance into meal preparation led to the subsequent hiring of
French chefs by finer hotels in New York. Interestingly, menus for pri-
marily upper-class patrons in the mid-1850s included up to 50 choices to
provide diners with a wide variety of options. In fact, the New York City
Brevoort House purportedly offered 145 menu options for dinner in
November of 1967. Food was described in rich detail on these menus to
entice diners, who tended to pick at their food, resulting in many leftovers.
This period of time was unapologetic about excess and was dubbed a
period of “conspicuous consumption.” In fact, the norm for entertaining
was to serve eight courses to the guests. The New York Cooking School
instructor Juliet Corson published a cookbook in 1877 promoting recipes
for sophisticated French cuisine, which represented the gourmet interests
of the upper class in the United States. Cooking classes and fancy,
French-inspired meals began to reach middle-class kitchens in the 1880s
as housewives yearned to learn techniques to produce these meals that
would emulate those being served by “upper-crust families” of the day.
Entertainment was clearly on a grand scale, and class differences were evi-
dent in the way the food was served, with an entire team of servants bring-
ing the food out for upper-class families.
Viewing food as an adventure has allowed for the opening of specialized
kitchen stores such as Williams-Sonoma and Sur La Table that cater to the
62 Filling Up

gourmet interests of this group. For example, Williams-Sonoma originally

opened in 1956, but it experienced massive growth and popularity in the
1980s and 1990s as a number of new stores opened in the United States.
Having this group of people with a special interest in food also has led to
the popularity of food-related and cooking shows such as Top Chef,
Kitchen Nightmares, and Master Chef. Individuals who enjoy food as a
hobby may actively research restaurants when they travel by searching on-
line reviews from websites such as TripAdvisor and yelp.com. They may
participate by reviewing restaurants with the critique of a professional food
critic. They may also read food blogs or even write food blogs to document
their own culinary adventures.
In summary, food has taken a central role in the lives of individuals,
families, and society. Eating is a vehicle for bringing individuals together
as well as a hobby built around tasting, cooking, and discussing food.
The importance of food to optimize the functioning of our various bodily
systems as well as the ability of food to support athletic performance at
high levels should be emphasized. Eating a healthy diet can help individ-
uals reduce the likelihood of developing certain health conditions like car-
diovascular disease and cancers. Finally, food serves as a microcosm of
larger societal trends by giving us a glimpse into the lives of people around
the globe at a particular point in time. To this end, food has been fashion-
able over the past century, but different types of food and meals have been
in vogue depending on the decade. Despite all of the positive attributes of
eating, there are some unfortunate challenges associated with the food sup-
ply. These negative aspects of eating will be discussed in the next section
of the book.

NEGATIVE ASPECTS OF EATING

When Food Makes You Sick: Food-Borne Pathogens

A dangerous aspect of food relates to the presence of contaminants in food
that can cause illnesses. More than one in six Americans is affected by
ingesting contaminated foods and beverages. There are more than 250
kinds of bacteria, viruses, parasites, molds, and algae that can negatively
affect the food supply for humans. These microbes can be found in farm
animals as well as in the soil, air, and water. Some of the common patho-
gens include Escherichia coli (E. coli), listeria, norovirus, salmonella, and
bovine spongiform encephalopathy (BSE). These contaminants may occur
simultaneously, as evidenced by what happened in 2015 to the popular
Chipotle Mexican Grill restaurant chain when they received negative
How: The Positive and Negative Effects of Eating 63

publicity around the outbreaks of the food-borne pathogens E. coli, salmo-

nella, and norovirus in many of their restaurants across the country. These
food-borne pathogens can cause people to experience uncomfortable gas-
trointestinal symptoms, neurological problems, and even fatality.
Additionally, the need to test food safety creates large costs for companies
hoping to prevent these outbreaks. When an outbreak occurs, a restaurant
or grocery store suffers a negative economic impact due to the harm caused
to the business’s reputation.

E. coli
The well-known food contaminant E. coli has been blamed for sickening
customers of many restaurants over the past century. For example, in
1982 this bacterium was associated with an outbreak involving under-
cooked hamburgers sold at McDonald’s restaurants in Oregon and
Michigan. It also infected 732 diners who ate undercooked beef patties
in hamburgers at 73 Jack in the Box restaurants in California, Idaho,
Washington, and Nevada in 1993. The Jack in the Box E. coli outbreak
is probably the most well-known food poisoning incident to date, and it
affected many children under 10 years old. Unfortunately, 178 children
and adults suffered kidney and brain damage, and 4 children died as a
result of the Jack in the Box outbreak, which changed food safety proce-
dures for meat. Specifically, E. coli strains that grow in cattle intestines
have been banned in meats.
Most recently, E. coli affected customers at Chipotle in at least nine states,
leading to the closure of more than 43 stores in the Northwest region of the
United States. Having these types of outbreaks has a significant negative
impact on the reputation and economy of food-related companies.
Chipotle shares slipped immediately following news of the E. coli outbreak,
and the necessary closures led to slowdowns in their sales growth. Similarly,
Jack in the Box experienced negative publicity and plunging sales of 30 to
35 percent following the media coverage of the E. coli outbreak a couple of
decades ago. Unfortunately, it is often difficult to determine the source of
the contamination, and poisoning cases may occur before the contaminated
meat is removed. Closures (temporary or permanent) are often result for res-
taurants, and items believed to be at risk are removed from grocery shelves.

Salmonella
The food-borne pathogen salmonella is the second most common, with an
estimated 1.4 million cases of salmonella each year in the United States.
Of those, the vast majority (95%) are associated with tainted food.
64 Filling Up

Eating salmonella-contaminated food can cause a myriad of acute symp-

toms such as fever, stomach cramps, bloody diarrhea and mucous, and
extreme nausea, and children are generally most vulnerable. A salmonella
infection can be fatal, and for survivors, recovery is slow and can take
many months. In severe cases, individuals may continue to struggle with
ongoing health problems including joint pain and chronic arthritis.
Salmonella poisoning has been linked to food-handling procedures,
especially when employees do not wash their hands with soap. Meats such
as beef, poultry, and eggs are most commonly infected with salmonella;
however, vegetables and other foods may also be tainted, which cannot
be detected by appearance or smell.
The Chipotle Mexican Grill restaurants—which had already suffered a
blow to their reputation of serving the freshest and best-quality ingredients
with the E. coli outbreak—were also blamed for salmonella poisoning of
customers who frequented their Minnesota-based chains. This contami-
nant was linked to tomatoes from another state. In this salmonella out-
break, 64 people fell ill—9 seriously enough to be hospitalized, 1 of
whom continues to suffer from severe gastrointestinal symptoms. Not only
do these outbreaks tarnish a restaurant’s reputation, but there are also sig-
nificant financial impacts, and in this case Chipotle is facing multiple law-
suits associated with food-poisoning cases.

Norovirus
The largest number of illnesses, hospitalizations, and deaths is caused by
norovirus pathogens. Specifically, norovirus outbreaks are responsible for
19 to 21 million acute cases of gastrointestinal distress, nearly 2 million
outpatient visits, more than 400,000 emergency visits, and 570 to 800
deaths annually. The populations most susceptible to norovirus-
associated deaths are young children and older adults. This food-borne
pathogen is most commonly found in leafy greens like lettuce, fresh fruits,
and shellfish (e.g., oysters). When food is served in raw form or is handled
after the cooking process, there is risk for contamination. In another strike
against the formerly popular Chipotle restaurant chain, norovirus was
responsible for sickening more than 140 Boston-based customers in
December 2015. This outbreak is believed to have stemmed from a sick
employee who worked his shift and proceeded to pass the virus to custom-
ers. A lawsuit has been filed against the chain in relation to this norovirus
outbreak, underscoring the huge negative economic impact as well as deep
health-related concerns tied to food-borne pathogens.
How: The Positive and Negative Effects of Eating 65

Norovirus outbreaks are often synonymous with settings that involve

food preparation. When infected employees touch food that is ready to
eat with their bare hands, the virus is passed to patrons in banquet halls,
restaurants, and family diners. Recently, much attention has been paid to
the outbreaks of norovirus on cruise ships. The majority (90%) of food-
borne pathogen outbreaks on cruise ships that result in gastrointestinal dis-
tress (e.g., diarrhea) are caused by norovirus. The tight living quarters and
shared dining experience of cruise ship passengers contribute to increased
susceptibility to norovirus. Because norovirus can be carried on board in
contaminated water or food, can be present on shared surfaces throughout
the ship, and tends to be resistant to commonly used disinfectants, cruise
ships are notorious for norovirus outbreaks. Other settings that are vulner-
able to norovirus outbreaks include day cares, schools, prisons, and military
camps. For example, the U.S. Marines suffered from acute gastroenteritis
due to a norovirus outbreak during Operation Iraqi Freedom.

Listeria
Another bacteria that causes food poisoning is listeria. Listeria is typically
found in water and soil used by animals such as cattle and poultry; how-
ever, it can also be present in raw milk or persist in food-processing plants.
Unlike common household germs, listeria can thrive in cold temperatures
found in refrigerators and freezers. Foods that commonly serve as sources of
listeria contamination are deli meats, hot dogs, raw milk and dairy prod-
ucts, smoked seafood, raw sprouts, and meat spreads (e.g., pâtés).
Therefore it is necessary to kill the bacteria through the cooking process
and pasteurization.
Listeria can cause symptoms such as fever, chills, headache, vomiting,
weakness, diarrhea, confusion, and stiff neck. The populations most vul-
nerable to being infected by the listeria bacteria are pregnant women,
older adults, individuals with weakened immune systems, organ transplant
patients, and people with autoimmune diseases, alcoholism, or diabetes.
Healthy individuals are much less likely to be sickened by the listeria bac-
teria, but listeria can be deadly for unborn babies and newborns. In fact,
listeria has been associated with infamous outbreaks in the United States
that were extremely deadly.
The most well-known listeria outbreak took place in 2011 and was
linked to tainted cantaloupes. This contaminated food led to 33 deaths
as well as 142 hospitalizations and 146 people getting sick. Given that this
was the first listeria outbreak associated with melon, the strain was difficult
66 Filling Up

to detect and spread quickly. Other examples of listeria outbreaks have

been traced to Camembert cheese (British Columbia, Canada) and ricotta
cheese (Forever Cheese based in the state of New York). Forever Cheese
determined that the contaminated cheese had led to more than 15 listeria
cases and several deaths in 2012. In 2015, the popular Blue Bell brand
products were tainted with listeria in an outbreak that spanned four states
(Arizona, Oklahoma, Texas, and Kansas). The Kansas cases resulted in
three deaths and the recall of products including ice cream, frozen yogurt,
and other frozen treats.

BSE
Another pathogen associated with the foods we eat, BSE, also known as
“mad cow disease,” is a brain disease that afflicts cattle that can be passed
to humans consuming contaminated beef, resulting in illness and even
death. Cases have occurred around the world, including the death of sev-
eral hundred residents of the United Kingdom. These cases have triggered
an understandable fear around eating meat products, especially when cases
are reported. The Centers for Disease Control and Prevention estimates
the prevalence of BSE to be higher in Canada than the United States.
Specifically, a projection of 3.0 to 8.0 cases per million was observed in
Canadian cattle versus 0.167 case per million in American cattle.
In summary, food-borne pathogens such as E. coli, listeria, norovirus, and
BSE represent the darker side of our food supply. Food safety issues around
using the right feed for animals such as cattle and poultry as well as monitor-
ing soil and water are critical. Food processing and preparation can have an
influence on whether foods become contaminated. Health education mea-
sures such as exercising appropriate hygiene behaviors (e.g., washing hands
with soap) should be employed and enforced. Unfortunately, consumers
have relatively little control over outbreaks, which can result in negative
health implications, sickness, and even death. Vulnerable populations such
as infants, young children, and older adults may be especially at risk for infec-
tion. For small and large businesses, serving contaminated food linked to an
outbreak can be detrimental for brand-related reputation. The economic
impact is staggering, related to disruptions in sales growth, drop in shares,
and legal costs associated with lawsuits tied to outbreaks.

When Food Exposes Us to Chemicals

That May Increase Disease Risk
It is difficult to escape the harm of chemicals in food, including pesticides
used to prevent insect infestations on plants, antibiotics and other drugs
How: The Positive and Negative Effects of Eating 67

used in animal products, and mercury found in seafood. Artificial flavors

that contain chemicals may also be added to foods. Chemicals are widely
used in the production and preparation of different types of food in order
to protect crops, increase the food supply, and keep the food supply safe.
Why then is there a concern about chemicals in food given that they are
so widely used? The simple answer is that exposure to chemicals in food
sources has been linked to certain types of cancer and disease risk among
humans.

Pesticides
Pesticides are widely used by farmers to increase the amount of usable food
collected at harvesttime. Once pesticides are applied, there will be some
remaining pesticide residue that is then evaluated by the U.S.
Environmental Protection Agency for legal limits. Specifically, there has
been ongoing concern that the use of pesticides, which are widely applied
to fruit, vegetable, and grain crops to protect them from insects, fungi, and
various other pests (e.g., mice and deer), can be hazardous to our health.
Pesticide residues that are beyond the legal limit or pesticide tolerance,
and often are found in fruits, vegetables, and animal feed, can result in
the ingestion of these chemicals, leading to health problems. Even small
amounts of pesticides and other chemicals may negatively impact fetal
development and healthy childhood development. Usually, once food is
displayed on grocery shelves, there is the expectation that pesticide
residues are below the limits set by the Environmental Protection Agency.
One solution has been to buy organic versions of fruits and vegetables
that are not grown with pesticides that contain chemicals. These organic
products are typically much more expensive and need to undergo a strict cer-
tification process that many farmers cannot afford. The Environmental
Working Group has urged parents to invest in organic versions of the items
that make it to the “Dirty Dozen” list, which contains the fruits and vegeta-
bles most likely to be contaminated: apples, strawberries, grapes, celery,
peaches, spinach, sweet bell peppers, nectarines, cucumbers, cherry tomatoes,
snap peas, and potatoes. These foods when evaluated were found to have the
highest level of pesticides, even after being washed and peeled prior to test-
ing. Additionally, food items such as hot peppers and blueberries have been
added to the food watch list due to heavy use of insecticides and possibly high
levels of toxicity.
Despite the increased popularity of organic foods in the United States,
the topic of pesticides and food safety has been controversial. Some
researchers claim that pesticides actually improve food safety. In fact, the
68 Filling Up

National Pesticide Information Center touts the benefits of pesticides as an

increased quality of food supply and extended shelf-life of certain food
items. Agencies such as the USDA have claimed that food in the United
States does not face any safety risks related to pesticide residue content
based on numerous testing cycles. However, society has embraced a trend
toward organic produce, and some groups of people, such as parents, often
are not willing to take the risk.

Antibiotics and Hormones

Hormones have been popularly used within the meat and dairy industries.
The most commonly used hormones have been estrogen and testosterone.
Specifically, farmers use hormones to inject livestock with a substance that
will help them gain weight, thereby producing more usable meat and
increasing profit. In the 1950s, most beef cattle were injected with a con-
troversial estrogen-based compound called diethylstilbestrol, which was
found to contribute to increased risk of vaginal cancer and thus was
removed from agricultural practices. Estrogen has also been linked to
higher risk for breast cancer, which has led consumers to question its use
in cattle.
Another hormone, recombinant bovine growth hormone, has been
used to generate increased milk production in dairy cows; however, its
safety is unknown, given that there may be interactive effects with other
chemicals ingested as well as with chemicals already in the body. Some
studies have demonstrated increased cancer risk from hormones found in
milk products, but the results have been largely mixed. Further, the contri-
bution of eating meat that contains hormones has not been decisively
linked to early puberty, even though the relationship has been suspected
by scientists and food advocates. Clearly, the long-term effects of hor-
mones in food are unknown and further research is needed. Given the
level of concern, some countries are regulating the introduction of hor-
mones into beef. Specifically, Australia, Canada, Japan, New Zealand,
and the European Union have banned recombinant bovine growth hor-
mone, and the European Union has gone a step further and restricted the
use of all hormones in cattle.
The use of antibiotics in meat is also a point of focus for consumers.
Generally, farmers and ranchers give antibiotics to cattle with the inten-
tion of boosting their weight gain instead of an attempt to improve the
animals’ health status. In other words, rather than using antibiotics as
medicine, these substances are used as “weight gainers,” like we might find
in an athlete’s diet. Unfortunately, the presence of antibiotics in our foods
How: The Positive and Negative Effects of Eating 69

can contribute to health issues for human beings. The use of antibiotics in
beef directly affects the increase in antibiotic-resistant bacteria. This has
been associated with salmonella poisoning and intestinal illnesses in cer-
tain studies. Whether it is hormones in milk or antibiotics in meat, there
is concern over their presence in the production of food. As awareness
increases about ingredients found in food as well as where food is sourced,
consumers are advocating for foods without these added ingredients.

Seafood Toxicity
Although seafood is a popular delicacy in the United States and around
the world, seafood poisoning can result from the ingestion of certain types
of seafood. The prevalence of illnesses resulting from seafood ingestion is
thought to be increasing as a product of more travel throughout the world
and expanded trade of seafood within the food industry. Specifically,
seafood-borne illnesses are thought to result from the consumption of food
that is harvested from the sea and can range from mild to very severe.
For example, shellfish poisoning can occur as a direct impact from food
sources ingested by the shellfish, which are then transferred to human
beings when they consume their meal. Most commonly, shellfish poison-
ing has been associated with oysters, scallops, mussels, and clams.
The types of shellfish poisoning are classified as amnestic, diarrheal,
neurotoxic, and paralytic, based on the symptoms that occur. The amnes-
tic and paralytic types of shellfish poisoning are considered the most severe
as they have been fatal in a few individuals. Amnestic shellfish poisoning
often results in symptoms such as permanent short-term memory loss, brain
damage, and death, whereas paralytic poisoning can cause the loss of co-
ordination, defects in speech patterns, vomiting, and death. Diarrheal
and neurotoxic types of shellfish pathogens are not usually fatal; however,
they result in adverse symptoms such as diarrhea, vomiting, and nausea for
diarrheal and vomiting, nausea, and slurred speech for the neurotoxic
shellfish poison.
Mercury exposure is widely discussed relative to toxicity from fish.
Certain fish and shellfish have been identified as containing high levels
of mercury, which may be highly toxic to humans regardless of whether
they are caught in local waterways or ordered from a restaurant menu.
Examples of seafood sources highest in mercury that should be avoided
by women who are pregnant or planning to become pregnant include king
mackerel, shark, swordfish, ahi tuna, orange roughy, and marlin. Health
risks associated with mercury poisoning include damage to the heart,
lungs, brain, and kidneys as well as disturbances in immune system
70 Filling Up

functioning. Mercury exposure can also be harmful to fetuses or young

children by disrupting the development of the central nervous system
and thought-processing capabilities. Mercury poisoning can result in symp-
toms including muscle weakness, speech impairment, poor coordination,
decreased peripheral vision, and strange sensations of feeling “pins and
needles.”
Although the long-term effects are largely unknown, disease risk has
been associated with exposure to certain chemicals found in food.
Pesticides and insecticides used to preserve the longevity of crops can
result in negative health consequences for fetal and childhood develop-
ment. Likewise, the use of hormones and antibiotics to stimulate weight
gain of beef and dairy cattle can expose humans to increased likelihood
of developing certain cancers. Finally, sources of food such as fish and
shellfish containing mercury can be detrimental to health if they are con-
sumed in levels deemed toxic.

When Food Is Fraudulent: Olive Oils and Agromafia

Italy is synonymous with fancy olive oil, fine wine, and special cheeses.
Can you imagine how you would feel if you learned that something you
ate was not consistent with the packaging? How can a consumer be certain
that the extra virgin olive oil is really first press? Extra virgin olive oil is
typically priced more than 35 percent higher than other types of oils and
is highly sought after, creating a demand similar to that for illicit drugs.
A recently discovered crime referred to as “agromafia” is to blame for
tainted products and the corruption of the business of exporting foods into
the United States. Specifically, agromafia refers to the system of producing
and selling fake versions of a particular product such as highly expensive
extra virgin olive oil to unknowing consumers in order to make a huge
profit. The presence of organized crime and corruption has been suspected
in every aspect of agriculture, from production to selling products in the
grocery stores.
Instead of selling extra virgin olive oil in its pure form, other seed oils
like sunflower oil are added in order to use less of the precious olive oil.
The resulting tainted product is especially concerning for individuals
who have certain seed oil allergies and believe they are getting the pure
substance. A report released in 2015 suggested that more than 350,000
farmers and producers in Italy are likely involved in this form of food fraud.
Although olive oil seems to be central to the agromafia phenomenon,
other products such as cheese, pasta, and hams have also been found to
How: The Positive and Negative Effects of Eating 71

be fraudulent. Italian olive oil companies are under investigation with sus-
picion that more than half of products brought to the United States con-
tain lesser oils and have been tainted. One alarming report on CBS
indicated that as many as 80 percent of olive oils brought to the United
States that are labeled extra virgin may be tainted.

When Eating Healthy Becomes an Obsession:

Orthorexia Nervosa
Unfortunately, in the attempt to adopt a healthy diet, food obsession has
resulted in some individuals becoming overly restrictive in their food
choices. The term orthorexia nervosa was coined in 1996 by a medical
doctor named Steven Bratman and refers to a condition in which indi-
viduals develop an unhealthy or dysfunctional mind-set around food
that translates into a rigid fixation on the quality and purity of food.
This obsession with “eating right” tends to take on an almost righteous
tone, as these people feel superior to others who are not following a strict
eating pattern. Orthorexia nervosa is not an official eating disorder; how-
ever, the condition is considered by psychologists to be an unhealthy eat-
ing pattern.
Individuals with orthorexia nervosa suffer from intense anxiety around
meals, and self-esteem becomes deeply entrenched in the types and
amounts of food they are consuming. Further, like other eating disorders,
orthorexia nervosa may negatively affect social relationships, work perfor-
mance. When calories are restricted and food choices become too narrow,
individuals with orthorexia nervosa may experience negative health
consequences.

When Food Is No Longer Healthy: The Battle

against Obesity and Diabetes
Although eating a healthy diet can contribute to protective factors around
disease, eating too much food or the wrong kinds of food is also associated
with overweight and obesity. Approximately two-thirds of the adult popu-
lation is estimated to have a body mass index (BMI) that qualifies them as
overweight (BMI score from 25 to 29.9) or obese (BMI score higher than
30). Specifically, one-third of these adults is obese and approximately
1 in 20 adults is morbidly obese. Overweight and obesity among children
and adolescents occur in one-third of youth aged 6 to 19 years of age.
Approximately 20 percent of youth meet the criteria for being obese.
72 Filling Up

Obesity is directly linked to eating and physical activity behaviors across

the life span.
Negative health outcomes such as increased risk for diabetes and other
chronic diseases such as cardiovascular disease and cancers have been asso-
ciated with poor dietary intake and negative food environments. Although
there are many contributing factors, including genetic and sociocultural
concerns, improving access to nutritious foods is an important step to pre-
vent obesity. Unfortunately, many stereotypes exist around body size and
weight that undermine helping individuals win this battle. For example,
being larger in size or heavier on the scale has been associated with labels
such as “lazy,” “sluggish,” and “unmotivated” with no recognition for
genetic factors that contribute to overweight and obesity. Causes of obesity
are multifaceted and complex. Both genetic and societal factors contribute
to the development of overweight and obesity among youth and adults.
The access to fresh fruits and vegetables also needs to be explored fur-
ther, as individuals living in certain geographical areas may lack conven-
ient ways to obtain healthy foods. Food deserts have been traditionally
defined as census tracts where at least 20 percent of the residents are in
poverty and have low access to grocery stores or supermarkets (i.e., at least
1 mile away in urban areas or 10 miles in rural areas) that would poten-
tially supply healthful food choices. The “food desert” metaphor has been
used to characterize geographic areas associated with low socioeconomic
status and inadequate access to healthy food choices that tend to have
high poverty rates. While the food desert metaphor is particularly appro-
priate for rural areas that are literally missing access to fresh fruits and veg-
etables, urban areas have unique problems. These areas, which have more
recently been referred to as “food swamps” to show a distinction from rural-
area food deserts, boast a high availability of energy-dense food options
from fast-food establishments and corner stores that increase risk for
obesity. Unfortunately, issues around food security and access to healthy
food options have existed over the history of our food supply.

When Access to Food Is Uncertain:

Poverty and Insecurity Issues
Throughout history, the availability of food has represented various
dichotomies including shortage versus abundance, fasting versus feasting
(overeating), and poverty versus wealth. Food shortages tend to occur
due to factors such as the climate, soil conditions, water availability for
crops, as well as structural conditions such as one’s socioeconomic status.
For example, for someone living in poverty, a lack of access to food may
How: The Positive and Negative Effects of Eating 73

result in involuntary fasting. By contrast, a wealthy individual who faces

an abundant food supply may choose to voluntarily engage in fasting for
religious or other reasons (e.g., watching one’s figure, dieting).
This food security (or insecurity) is represented by cycles of either
experiencing either a food shortage or having plenty of food. These periods
of shortage and overabundance cycles waxed and waned throughout the
centuries, representing food supply and cultural trends. For example, from
1400 to 1800 there were hunger crises and mass poverty throughout
Europe. Historians have focused on food trends throughout the centuries
related to the diet of individuals from different social classes from the very
rich to the extremely poor. While the wealthy were known to try to
impress others by serving abundant amounts of lavish foods, individuals
in low-socioeconomic-status groups tended to eat narrow diets consisting
of just a few foods. Moreover, for individuals experiencing poverty, there
was a lack of access to consistent and predictable food sources. This trend
has persisted and is evident in present-day class differences in society.
The societal problem of poverty and starvation led to the emergence of
food assistance programs in the nineteenth century. Many cities operate
soup kitchens to serve hot meals to populations who are facing food secu-
rity issues. Food banks collect donations of foods such as canned items to
distribute to people in need.

Food Stamps
The sometimes controversial food stamp program was initiated to provide
government assistance to individuals below the poverty line (low and no
income) in order to support the purchase of grocery items. The first food
stamps were issued in the 1960s to buy foodstuffs for the household; however,
the idea was conceived much earlier by the U.S. Secretary of Agriculture in
1939. This early program involved giving out physical stamps that were
either orange or blue. Orange stamps were provided to purchase any type of
food, whereas blue stamps were used to buy selected types of food approved
by the government as being surplus items. This early program ended in
1943 and was not revived until 1961. The Food Stamp Act of 1964, signed
by President Johnson, formalized the food stamp program of government as-
sistance with a $75 million investment to benefit some 350,000 individuals
and to improve nutrition among low-income households. The program has
been revised throughout the decades and now uses a debit card system called
“electronic benefit transfer” rather than actual stamps. The next section will
focus on the way that flavoring foods with artificial and so-called natural
flavors can also be harmful to one’s health.
74 Filling Up

When Food Is a Science Project: “Natural Flavors,”

Artificial Flavors, and Chemicals in Foods
The importance of taste has been attributed to an onslaught or a plethora
of food design practices that involve flavoring foods using both “natural”
and artificial ingredients. Many of the popular American snack foods and
meals contain both “natural flavors” and “artificial flavors” to give proc-
essed foods their taste. The flavor industry has been around since the
middle of the nineteenth century and recognized the importance of taste
and smell early in its evolution. To support the development of additives
for food, companies relied on the expertise of perfume companies in
France, England, and the Netherlands to produce flavor compounds.
Interestingly, for both natural and artificial flavors, man-made additives
are used to enhance frozen foods, fast foods, and other processed items.
Soft drinks and Kool-Aid represent well-known products that use additives
to enhance both taste and appearance (e.g., color). How else would that
grape Kool-Aid get the deep violet color? Artificial flavors hit their stride
in the 1960s, with popularity rising for items such as Pop-Tarts, Tang
(a type of orange-colored drink made from powder), and Filet-O-Fish
sandwiches, but consumers have since rallied for so-called natural flavors,
falsely believing that they are somehow healthier. In reality, these types
of flavors are similar and can contain the same chemicals. Natural flavors,
in fact, are not necessarily more pure or healthy than artificial ones; they
are just made differently.
Many of the flavors used by the food industry represent secret formulas
and read like a scientific code rather than an edible ingredient on a dietary
label. Unfortunately, the Food and Drug Administration has not required
flavor companies to reveal their list of ingredients as long as they are “gen-
erally regarded as safe.” The American flavor industry purportedly has
annual earnings of more than $1.4 billion and represents a stronghold in
processed foods. Nearly 10,000 brand-new types of processed foods are
introduced to consumers each year, and almost all include the addition
of flavoring. “Flavorists” represent an elite group of a few scientists who
create the ingredients for flavors found in food products in the United
States. These scientists understand that consumers have specific food-
related cravings that usually involve sweet or salty tastes. Further, texture
and smell of foods are important for a particular food’s desirability.
Therefore foods are engineered to have the perfect composition of tastes
with the right texture and aroma. Take the example of a popular straw-
berry milkshake served at a local fast-food restaurant. Are real strawberries
are being used to create that dreamy dairy sensation? More likely the
How: The Positive and Negative Effects of Eating 75

strawberry milkshake uses an artificial strawberry flavor to mimic the

food taste of a strawberry. This typical artificial flavor would contain a
long list of more than 40 ingredients including but not limited to the
following chemicals: amyl butyrate, amyl acetate, amyl valerate, anethol,
anisyl formate, benzyl acetate, butyric acid, dipropyl ketone, and
4-methylacetophenone.

Genetically Modified Foods

There is debate over whether genetically modified foods are harmful or
helpful. Genetically modified organisms (GMOs) are defined as crop
plants that have been engineered or created using molecular biology tech-
niques and have been modified in a laboratory in some way. Modification
techniques may be used in the lab setting for a variety of reasons, such as
increasing resistance to insect pests, weed-killer, and disease. GMOs may
also be advantageous for improving a plant’s tolerance to droughts or cold
weather. Finally, modifications can allow for the enhancement of a food’s
nutritional content so that nutritional deficiencies (e.g., vitamins and
minerals) can be addressed. This “genetic engineering” of plants allows
for the desired traits to be actualized in plants in a short period of time with
incredibly accuracy. By contrast, conventional methods of breeding to
achieve desired traits can be a time-intensive process that is not very exact.
Genetically modified crops are becoming more pervasive in the United
States and abroad. Soybean and corn are the crops most widely genetically
modified to combat herbicide and insect threats to the plants. Around the
world, genetically modified crops have increased 25-fold. However, public
outcry has been adamantly opposed to the production and expansion of
GMOs. Groups such as religious organizations, professional associations,
and environmental activists have argued against the use of GMOs in our
food supply. There are several criticisms of genetically modified foods,
and they revolve around the following categories: health risks to humans,
economic issues, and hazards to the environment.
Although research continues to progress with respect to the effects of
consuming genetically modified food, the long-term implications for
health are not conclusive. Some initial animal studies have found that
genes introduced into food could be toxic. For example, identified conse-
quences from GMOs have included but are not limited to precancerous
cell growth in the intestine region, inflammation of the kidney, stunted
growth, higher blood sugar, impaired immune systems, and mortality.
In fact, activists argue that genetically modified foods may lead to
76 Filling Up

increased risk for cancers and other disorders in humans. Another negative
effect on health relates to the potential of a gene modification creating an
unexpected allergic reaction similar to a food allergy.
A second concern with regard to genetically modified foods is the
impact on traditional farmers and the agriculture business. The process of
genetically modifying plants is complicated by the introduction of patents
used to protect the technology of companies working in the genetic engi-
neering space. Unfortunately, patent enforcement could become a costly
venture. Another challenge relative to genetically modified foods is the
role of government and regulation of the industry. Health testing will
become mandatory in certain countries and will create a strain on the
existing infrastructure. Foods will require certain labeling, which may
impact consumer preference for non-genetically modified foods over
GMOs.

When Food Becomes a Guilt Trip: The Dieting Mentality

Although diets are popular in the United States and around the world, it is
necessary to recognize the psychological connection to dieting behavior
that can lead to negative consequences. For example, when people experi-
ence guilt around eating certain types or amounts of food, a dysfunctional
psyche can develop that results in a constant state of dieting (restricting
calories or eating only specific foods). The dieting mentality is pervasive
and can become ingrained from a young age. Chronic dieting has been
called “yo-yo dieting” to reflect the inconsistent pattern of cycling between
overeating and undereating. The unfortunate outcome of this cycling
behavior is that weight fluctuates rapidly and many individuals may expe-
rience weight gain over the long term. Some individuals have reported
that preventing weight gain becomes a more intense struggle after engag-
ing in a string of diets.
The dieting mentality is intended to promote discipline around food
choices. Diets may involve eliminating certain foods, decreasing overall
intake, or following a prescribed food plan such as the Paleo Diet. While
enthusiasm for losing weight is high in the beginning, motivation and
interest may begin to wane as foods become mundane. Another problem
with diets is related to intense hunger cues that undermine a person’s abil-
ity to stick to the plan. Finally, temptations to consume foods outside of
the diet rise. Mentally, the person on a diet might begin to obsess about
the foods he or she is trying to avoid. This combination of stressors can
contribute to a “slip”—eating just a little of the forbidden food—or to a
“slide”—eating too much food and engaging in a full binge.
How: The Positive and Negative Effects of Eating 77

This inconsistency in how food is consumed can impact biological

cues of hunger and fullness. A person on a diet may no longer feel full
after eating a meal and instead feel hungry all the time. Another negative
consequence of yo-yo dieting is that metabolism is adversely affected by
the inconsistent calorie intake when someone binges one day and
severely restricts food the next. It is also important to note that “diets”
are typically considered short-term changes to food intake rather than
lifestyle shifts. By nature, these short-lived restrictions will not have a
positive impact on health. Furthermore, being in a chronic state of diet-
ing consumes a lot of time and energy and is expensive. Certain diets
require the purchase of specific (and costly) meals. A further concern is
that some diets do not meet minimum recommended levels of caloric
intake and food groups (such as fruits, vegetables, and grains). Engaging
in eating patterns that do not meet the nutritional guidelines set by the
USDA may be detrimental to health, as certain vitamins and nutrients
are missing from one’s diet.
Philosophically, when a society is in a constant state of dieting, a men-
tality of dissatisfaction with self and one’s body is reinforced. The dieting
industry benefits from having individuals wanting to lose weight and striv-
ing for a better body. Unfortunately, the dieting mentality contributes to
negative emotions such as self-doubt, reduced self-esteem, and the devel-
opment of depression and anxiety. Rather than promoting a series of inef-
fective diets, a more positive approach to eating would be to focus on
making a change in lifestyle.

CONCLUSION
This chapter covered both the good and bad aspects of food. Eating goes
far beyond providing for basic needs related to survival. The meaningful
nature of food has been captured in this chapter to illustrate how eating
can be associated with one’s personal identity, relationships with others,
and health status, and with societal trends. However, some negative
aspects associated with eating were also illuminated in this chapter to dem-
onstrate some of the persistent and newer challenges associated with food
production, supply, and distribution.

BIBLIOGRAPHY
Adachi-Mejia, A. M., M. R. Longacre, M. Skatrud-Mickelson, Z. Li, L. A.
Purvis, L. J. Titus, M. L. Beach, and M. A. Dalton. “Variation in Access
to Sugar-Sweetened Beverages in Vending Machines across Rural,
78 Filling Up

Town and Urban High Schools.” Public Health 127 (2013): 485–91.
Accessed December 3, 2015. doi: 10.1016/j.puhe.2013.01.024.
Aggarwal, Dipesh, Latha Sabikhi, and M. H. Sathish Kumar. “Formulation
of Reduced-Calorie Biscuits Using Artificial Sweeteners and Fat
Replaced with Dairy-Multigrain Approach.” NFS Journal 2 (2016):
1–7. Accessed January 21, 2016. doi: 10.1016/j.nfs.2015.10.001.
Aktar, Wasim. “Organic Food and Pesticides: Myth and Reality.” Journal
of Information, Intelligence, and Knowledge 6, no. 3 (2014): 273–94.
Accessed January 25, 2016. https://www.novapublishers.com/catalog/
product_info.php?products_id=50683.
Andersen, G. Douglas. “Non-Mercury Toxins in Seafood.” Dynamic
Chiropractic 25, no. 18 (2007): 14. Accessed December 7, 2015. http://
www.dynamicchiropractic.com/mpacms/dc/article.php?id=52305.
Auvolat, Anais, and Nathalie G. Besse. “The Challenge of Enumerating
Listeria Monocytogenes in Food.” Food Microbiology 53 (2016):
135–49. Accessed December 3, 2015. doi: 10.1016/j.fm.2015.09.003.
Bajpai, Vivek K., Kwang-Hyun Baek, and Sun Chul Kang. “Control of
Salmonella in Foods by Using Essential Oils: A Review.” Food
Research International 45 (2012): 722–34. Accessed December 3, 2015.
doi: 10.1016/j.foodres.2011.04.052.
Barlow, Susan M. “Risk Assessment of Foods and Chemicals in Foods.”
Encyclopedia of Food and Health (2016): 653–58. Accessed January 21,
2016. doi: 10.1016/B978-0-12-384947-2.00597-3.
Batz, Michael B. “The Foods Most Often Associated with Major
Foodborne Pathogens.” In Foodborne Infections and Intoxications, edited
by J. Glenn Morris Jr. and Morris Potter, 19–35. San Diego, CA:
Academic Press, 2013.
Bearth, Angela, Marie-Eve Cousin, and Michael Siegrist. “The
Consumer’s Perception of Artificial Food Additives: Influences on
Acceptance, Risk and Benefit Perceptions.” Food Quality and
Perception 38 (2014): 14–23. Accessed January 21, 2016. doi: 10.1016/
j.foodqual.2014.05.008.
Bernini, Valentina, Elena Dalzini, Camilla Lazzi, Benedetta Bottari,
Monica Gatti, and Erasmo Neviani. “Cutting Procedures Might Be
Responsible for Listeria Monocytogenes Contamination of Foods: The
Case of Gorgonzola Cheese.” Food Control 61 (2016): 54–61.
Accessed December 3, 2015. doi: 10.1016/j.foodcont.2015.09.021.
Blanco, Juan, Fabiola Arévalo, Jorge Correa, M. Corina Porro, Ana G.
Cabado, Juan M. Vietes, and Angeles Moroño. “Effect of the
Industrial Canning on the Toxicity of Mussels Contaminated with
How: The Positive and Negative Effects of Eating 79

Diarrhetic Shellfish Poisoning (DSP) Toxins.” Toxicon 112 (2016):

1–7. Accessed January 27, 2016. doi: 10.1016/j.toxicon.2016.01.061.
Botana, Luis M., Amparo Alfonso, Ana Botana, Mercedes R. Vieytes,
Carmen Vale, Natalia Vilariño, and Carmen Louzao. “Functional
Assays for Marine Toxins as an Alternative, High-Throughput-
Screening Solution to Animal Tests.” Trends in Analytical Chemistry
28, no. 5 (2009): 603–11. Accessed January 27, 2016. doi: 10.1016/
j.trac.2009.02.014.
Brisbois, Benjamin. “Bananas, Pesticides, and Health in Southwestern
Ecuador: A Scalar Narrative Approach to Targeting Public Health
and Responses.” Social Science & Medicine 150 (2016): 184–91.
Accessed January 20, 2016. doi: 10.1016/j.socscimed.2015.12.026.
Brody, Jane E. “Chemicals in Food? A Panel of Experts Finds Little
Danger.” New York Times. Last modified February 16, 1996. http://
www.nytimes.com/1996/02/16/us/chemicals-in-food-a-panel-of-experts
-finds-little-danger.html?pagewanted=all.
Burke, Mary V., and Dana M. Small. “Physiological Mechanisms by
Which Non-Nutritive Sweeteners May Impact Body Weight and
Metabolism.” Physiology and Behavior 152 (2015): 381–88. Accessed
January 21, 2016. doi: 10.1016/j.physbeh.2015.05.036.
Caloni, Francesca, Cristina Cortinovis, Marina Rivolta, and Franca
Davanzo. “Suspected Poisoning of Domestic Animals by Pesticides.”
Science of the Total Environment 539 (2016): 331–36. Accessed
January 20, 2016. doi: 10.1016/j.scitotenv.2015.09.005.
Campàs, Mònica, Beatriz Prieto-Simón, and Jean-Louis Marty. “Biosensors
to Detect Marine Toxins: Assessing Seafood Safety.” Talanta 72 (2007):
884–95. Accessed January 27, 2016. doi: 10.1016/j.talanta.2006.12.036.
Caruso, Michelle L., Elizabeth G. Klein, and Gail Kaye. “Campus-Based
Snack Food Vending Consumption.” Journal of Nutrition Education and
Behavior 46, no. 5 (2014): 401–5. Accessed December 3, 2015. doi:
10.1016/j.jneb.2014.02.014.
Chegini, Soheil, and Dean D. Metcalfe. “Contemporary Issues in Food
Allergy: Seafood Toxin-Induced Disease in the Differential Diagnosis
of Allergic Reactions.” Allergy and Asthma Proceedings 26 (2005):
183–90. Accessed January 21, 2016. http://www.ingentaconnect.com/
content/ocean/aap/2005/00000026/00000003/art00004.
Clark, R. F., S. R. Williams, S. P. Nardt, and A. S. Manoguerra. “A
Review of Selected Seafood Toxins.” Undersea and Hyperbaric
Medicine 26, no. 3 (1999): 175–84. Accessed January 21, 2016. http://
archive.rubicon-foundation.org/xmlui/handle/123456789/2314.
80 Filling Up

Costa, Anna I. G., Maria E. L. R. Queiroz, Antônio A. Neves, Flaviane A.

de Sousa, and Laércio Zambolim. “Determination of Pesticides in
Lettuce Using Solid-Liquid Extraction with Low Temperature
Partitioning.” Food Chemistry 181 (2015): 64–71. Accessed
January 20, 2016. doi: 10.1016/j.foodchem.2015.02.070.
De Steur, Hans, Dieter Blancquaert, Simon Strobbe, Shuyi Feng, Jeroen
Buysse, Christophe Stove, Willy Lambert, Dominique Van Der
Straeten, and Xavier Gellynck. “Consumer Acceptance and
Willingness-to-Pay for Genetically Modified Food with Enhanced
Vitamin Levels.” In Genetically Modified Organisms in Food, edited by
R. R. Watson and V. R. Preedy, 195–206. San Diego, CA: Academic
Press, 2015. doi: 10.1016/B978-0-12-802259-7.00018-X.
Dickson-Spillmann, Maria, Michael Siegrist, and Carmen Keller.
“Attitudes toward Chemicals Are Associated with Preference for
Natural Food.” Food Quality and Preference 22 (2011): 149–56.
Accessed January 20, 2016. doi: 10.1016/j.foodqual.2010.09.001.
Dorne, J. L. C. M., and J. Fink-Gremmels. “Human and Animal Health
Risk Assessments of Chemicals in the Food Chain: Comparative
Aspects and Future Perspectives.” Toxicology and Applied Pharmacology
270 (2013): 187–95. Accessed January 20, 2016. doi: 10.1016/j.taap
.2012.03.013.
Eagle, Ken. “ADHD Impacted by Sulfotransferase (SULT1A) Inhibition
from Artificial Food Colors and Plant-Based Foods.” Physiology &
Behavior 135 (2014): 174–79. Accessed January 21, 2016. doi: 10.1016/
j.physbeh.2014.06.005.
Ekmay, R. D., S. Papineni, and R. A. Herman. “Nutritional Assessment of
Genetically Modified Crops Using Animal Models.” In Genetically
Modified Organisms in Food, edited by R. R. Watson and V. R. Preedy,
39–50. San Diego, CA: Academic Press, 2015. doi: 10.1016/B978-0
-12-802259-7.00005-1.
Etheridge, Stacey M. “Paralytic Shellfish Poisoning: Seafood Safety and
Human Health Perspectives.” Toxicon 56 (2010): 108–22. Accessed
January 21, 2016. doi: 10.1016/j.toxicon.2009.12.013.
Fox, Edward M., Patrick G. Wall, and Sëamus Fanning. “Control of
Listeria Species of Food Safety at a Poultry Food Production Facility.”
Food Microbiology 51 (2015): 81–86. Accessed December 3, 2015. doi:
10.1016/j.fm.2015.05.002.
French, Simone A., Mary Story, Jayne A. Fulkerson, and Anne Faricy
Gerlach. “Food Environment in Secondary Schools: Á La Carte,
Vending Machines, and Food Policies and Practices.” American Journal
How: The Positive and Negative Effects of Eating 81

of Public Health 93, no. 7 (2003): 1161–67. Accessed December 3, 2015.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447927/.
Gao, F., and X. Lu. “Detection of Pesticides in Food by Enzymatic
Biosensors.” In Improving and Tailoring Enzymes for Food Quality and
Functionality, edited by Rickey Yada, 147–60. Cambridge: Woodhead,
2015. doi:10.1016/B978-1-78242-285-3.00007-7.
Gavoronskaia, Galina, and Bjørn Hvinden. “Consumers with Allergic
Reaction to Food: Perception of and Response to Food Risk in
General and Genetically Modified Food in Particular.” Science,
Technology, & Human Values 31, no. 6 (2006): 702–30. Accessed
January 22, 2016. doi: 10.1177/0162243906291867.
Gil-Campos, M., M. A. San José González, and J. J. D. Martin. “Use of
Sugars and Sweeteners in Children’s Diets.” Anales de Pediatría 83,
no. 5 (2015): 353.e1–353.e7. Accessed January 21, 2016. doi: 10.1016/
j.anpedi.2015.02.013.
Gómez-Pérez, María L., Roberto Romero-González, José L. M. Vidal, and
Antonia G. Frenich. “Identification of Transformation Products of
Pesticides and Veterinary Drugs in Food Related Matrices: Use of
Retrospective Analysis.” Journal of Chromatography A 1389 (2015):
133–38. Accessed January 20, 2016. doi: 10.1016/j.chroma.2015.02.052.
Goodman, Richard E., Susan L. Hefle, Steve L. Taylor, and Ronald van
Ree. “Assessing Genetically Modified Crops to Minimize the Risk of
Increased Food Allergy: A Review.” International Archive of Allergy and
Immunology 137 (2005): 153–66. Accessed January 22, 2016. doi:
10.1159/000086314.
Gruère, Guillaume P., Colin A. Carter, and Y. Hossein Farzin. “Explaining
International Differences in Genetically Modified Food Labeling
Policies.” Review of International Economics 17, no. 3 (2009): 393–408.
Accessed January 22, 2016. doi: 10.1111/j.1467-9396.2008.00788.x.
Han-Markey, T. L., L. Wang, S. Schlotterbeck, E. A. Jackson, R. Gurm,
A. Leidal, and K. Eagle. “A Public School District’s Vending Machine
Policy and Changes over a 4-Year Period: Implementation of a
National Wellness Policy.” Public Health 126 (2012): 335–37.
Accessed December 3, 2015. doi: 10.1016/j.puhe.2012.01.007.
Hendel-Paterson, Maia, Simone A. French, and Mary Story. “Parental
Attitudes towards Soft Drink Vending Machines in High Schools.”
Journal of the American Dietetic Association 104 (2004): 1597–1600.
Accessed December 3, 2015. doi: 10.1016/j.jada.2004.07.2013.
Hennekinne, Jacques-Antoine, Sabine Herbin, Olivier Firmesse, and
Frédéric Auvray. “European Food Poisoning Outbreaks Involving
82 Filling Up

Meat and Meat-Based Products.” Procedia Food Science 5 (2015): 93–96.

Accessed December 3, 2015. doi:10.1016/j.profoo.2015.09.024.
Hill, Sarah E., Marjorie L. Prokosch, Amanda Morin, and Christopher
Rodeheffer. “The Effect of Non-Caloric Sweeteners on Cognition,
Choice, and Post-Consumption Satisfaction.” Appetite 83 (2014):
82–88. Accessed January 21, 2016. doi: 10.1016/j.appet.2014.08.003.
Ibelings, Bas W., and Ingrid Chorus. “Accumulation of Cyanobacterial
Toxins in Freshwater ‘Seafood’ and Its Consequences for Public
Health: A Review.” Environmental Pollution 150 (2007): 177–92.
Accessed December 7, 2015. doi: 10.1016/j.envpol.2007.04.012.
Jalonick, Mary Clare. “Food Companies Push Voluntary GMO Labels to
Head Off State Efforts.” Huffington Post. Last modified February 6,
2014. http://www.huffingtonpost.com/2014/02/06/voluntary-gmo
-labels_n_4739949.html.
James, K. J., B. Carey, J. O’Halloran, F. N. A. M. van Pelt, and Z.
Skrabakova. “Shellfish Toxicity: Human Health Implications of
Marine Algal Toxins.” Epidemiological Infections 138 (2010): 927–40.
Accessed January 21, 2016. doi: 10.1017/S0950268810000853.
Jefferson, Valeria. “The Ethical Dilemma of Genetically Modified Food.”
Journal of Environmental Health 69, no. 1 (2006): 33–34. Accessed
February 25, 2016. http://science.jburroughs.org/mbahe/BioEthics/
Handouts/GMFoodReadings.pdf.
Jensen, Bodil H., Annette Petersen, Elsa Nielsen, Tue Christensen, Mette
E. Poulsen, and Jens H. Andersen. “Cumulative Dietary Exposure of the
Population of Denmark to Pesticides.” Food and Chemical Toxicology 83
(2015): 300–307. Accessed January 20, 2016. doi: 10.1016/j.fct
.2015.07.002.
König, J. “Food Colour Additives of Synthetic Origin.” In Colour Additives
of Foods and Beverages, edited by M. Scotter, 35–60. Cambridge:
Woodhead, 2015. doi: 10.1016/B978-1-78242-011-8.00002-7.
Kubik, Martha Y., Melanie Wall, Lijuan Shen, Marilyn S. Nanney, Toben
F. Nelson, Melissa N. Laska, and Mary Story. “State but Not Nutrition
Policies Are Associated with Less Junk Food in Vending Machines in
School Stores in U.S. Public Schools.” Journal of the American Dietetic
Association 110 (2010): 1043–48. Accessed December 3, 2015. doi:
10.1016/j.jada.2010.04.008.
Kumari, Anuradha, Sonika Choudhary, Sumit Arora, and Vivek Sharma.
“Stability of Aspartame and Neotame in Pasteurized and In-Bottle
Sterilized Flavoured Milk.” Food Chemistry 196 (2016): 533–38.
Accessed January 21, 2016. doi: 10.1016/j.foodchem.2015.09.082.
How: The Positive and Negative Effects of Eating 83

Lang, John T. “Elements of Public Trust in the American Food System:

Experts, Organizations and Genetically Modified Food.” Food Policy 41
(2013): 145–54. Accessed January 22, 2016. doi: 10.1016/j.foodpol
.2013.05.008.
Leitch, K. A., S. E. Duncan, S. O’Keefe, R. Rudd, and D. L. Gallagher.
“Characterizing Consumer Emotional Response to Sweeteners Using
an Emotional Terminology Questionnaire and Facial Expression
Analysis.” Food Research International 76 (2015): 283–92. Accessed
January 21, 2016. doi: 10.1016/j.foodres.2015.04.039.
Lewis, Richard J., and Mark Poli. “Toxins in Seafood.” Toxicon 56 (2010):
107. Accessed December 7, 2015. doi: 10.1016/j.toxicon.2010.05.002.
Lin, Chih-Hui, and Tzu-Ming Pan. “Perspectives on Genetically Modified
Crops and Food Detection.” Journal of Food and Drug Analysis 24 (2016):
1–8. Accessed January 22, 2016. doi: 10.1016/j.jfda.2015.06.011.
Macilwain, Colin. “US Food-Safety Body Hears Protests over Genetically
Modified Food.” Nature 402, no. 6762 (1999): 571. Accessed
February 25, 2016. doi: 10.1038/45049.
Marinovich, Marina, Corrado L. Galli, Cristina Bosetti, Silvano Gallus,
and Carlo La Vecchia. “Aspartame, Low-Calorie Sweeteners and
Disease: Regulatory Safety and Epidemiological Issues.” Food and
Chemical Toxicology 60 (2013): 109–15. Accessed January 21, 2016.
doi: 10.1016/j.fct.2013.07.040.
Masone, Diego, and Céline Chanforan. “Study on the Interaction of
Artificial and Natural Food Colorants with Human Serum Albumin:
A Computational Point of View.” Computational Biology and Chemistry
56 (2015): 152–58. Accessed January 21, 2016. doi: 10.1016/
j.compbiolchem.2015.04.006.
Miles, Susan, Øydis Ueland, and Lynn J. Frewer. “Public Attitudes towards
Genetically-Modified Food.” British Food Journal 107, no. 4/5 (2005):
246–62. Accessed January 22, 2016. doi: 10.1108/0007070051
0589521.
Morasso, Gabriella, Claudia Bolognesi, Elena Duglio, and Marco Musso.
“Pesticides as Food Contaminants: A Pilot Project for Correct Public
Information.” Trends in Food Science & Technology 11 (2001): 379–82.
Accessed January 25, 2016. doi: 10.1016/S0924-2244(00)00071-6.
Mulvenna, Vanora, Katie Dale, Brian Priestly, Utz Mueller, Andrew
Humpage, Glen Shaw, Graeme Allinson, and Ian Falconer. “Health
Risk Assessment for Cyanobacterial Toxins in Seafood.” International
Journal of Environmental Research and Public Health 9 (2012): 807–20.
Accessed January 21, 2016. doi: 10.3390/ijerph9030807.
84 Filling Up

Neltner, Thomas G., Heather M. Alger, Jack E. Leonard, and Maricel V.

Maffini. “Data Gaps in Toxicity Testing of Chemicals Allowed in
Food in the United States.” Reproductive Toxicology 42 (2013): 85–94.
Accessed January 20, 2016. doi: 10.1016/j.reprotox.2013.07.023.
Newsome, R., N. Tran, G. M. Paoli, L. A. Jaykus, B. Tompkin, M.
Miliotis, T. Ruthman, E. Hartnett, F. F. Busta, B. Petersen, F. Shank,
J. McEntire, J. Hotchkiss, M. Wagner, and D. W. Schaffner.
“Development of a Risk-Ranking Framework to Evaluate Potential
High-Threat Microorganisms, Toxins, and Chemicals in Food.”
Journal of Food Science 74, no. 2 (2009): 39–45. Accessed January 20,
2016. doi: 10.1111/j.1750-3841.2008.01042.x.
Nodousani, Omid, Jayme Sintay, and Carol Stewart. “Genetically
Engineered Food and Genetically Modified Organisms.” CF 13, no. 1
(2015): 136–41. Accessed February 25, 2016. http://search.proquest
.com/openview/d745c60745a25a551ac6874b73b055db/1.pdf ?pq
-origsite=gscholar.
O’Hara, Jeffrey K., and Lindsey Haynes-Maslow. “Examining the
Association between School Vending Machines and Children’s Body
Mass Index by Socioeconomic Status.” Journal of Nutrition Education
and Behavior 47 (2015): 526–31. Accessed December 3, 2015. doi:
10.1016/j.jneb.2015.08.001.
Oliveira, M., M. Abadias, P. Colás-Medà, J. Usall, and I. Viñas.
“Biopreservative Methods to Control the Growth of Foodborne
Pathogens on Fresh-Cut Lettuce.” International Journal of Food
Microbiology 214 (2015): 4–11. Accessed December 3, 2015. doi:
10.1016/j.ijfoodmicro.2015.07.015.
Osborn, Alan. “EU Food Legislation Review: Management Briefing:
REACH – the Registration, Evaluation and Authorisation of
Chemicals.” Just-Food (2006): 12–13. Accessed January 20, 2016.
http://www.just-food.com/management-briefing/eu-food-legislation
-review_id110328.aspx.
Pandey, Renu, Meenakshi Dwivedi, Shishir K. Gupta, and Daman Saluja.
“Genetically Modified Food Animals: An Overview.” In Genetically
Modified Organisms in Food, edited by R. R. Watson and V. R. Preedy,
19–26. San Diego, CA: Academic Press, 2015. doi: 10.1016/B978-0
-12-802259-7.00003-8.
Park, Sohyun, William M. Sappenfield, Youjie Huang, Bettylou Sherry,
and Diana M. Bensyl. “The Impact of the Availability of School
Vending Machines on Eating Behavior during Lunch: The Youth
Physical Activity and Nutrition Survey.” Journal of the American
How: The Positive and Negative Effects of Eating 85

Dietetic Association 110 (2010): 1532–36. Accessed December 3, 2015.

doi: 10.1016/j.jada.2010.07.003.
Pepino, M. Yanina. “Metabolic Effects of Non-Nutritive Sweeteners.”
Physiology & Behavior 152 (2015): 450–55. Accessed January 21, 2016.
doi: 10.1016/j.physbeh.2015.06.024.
Petrun, Elizabeth L., Anthony Flood, Timothy L. Sellnow, Marianna S.
Edge, and Katie Burns. “Shaping Health Perceptions: Communicating
Effectively about Chemicals in Food.” Food Protection Trends 35, no. 1
(2015): 24–35. Accessed February 25, 2016. http://www.foodprotection
.org/files/food-protection-trends/JAN-FEB-15-petrun.pdf.
Prati, Gabriele, Luca Pietrantoni, and Bruna Zani. “The Prediction of
Infection to Consume Genetically Modified Food: Test of an
Integrated Psychosocial Model.” Food Quality and Preference 25
(2012): 163–70. Accessed January 22, 2016. doi: 10.1016/j.foodqual.
2012.02.011.
Preece, E. P., Barry C. Moore, and F. Joan Hardy. “Transfer of Microcystin
from Freshwater Lakes to Puget Sound, WA and Accumulation in
Marine Mussels (Mytilus trossulus).” Ecotoxicology and Environmental
Safety 122 (2015): 98–105. Accessed January 27, 2016. doi: 10.1016/
j.ecoenv.2015.07.013.
Qaim, Matin, and Shahzad Kouser. “Genetically Modified Crops and Food
Security.” PLoS ONE 8, no. 6 (2013): e64879. Accessed January 22,
2016. doi: 10.1371/journal.pone.0064879.
Renwick, G., S. M. Barlow, I. Hertz-Picciotto, A. R. Boobis, E. Dybing, L.
Edler, G. Eisenbrand, J. B. Greig, J. Kleiner, J. Lambe, D. J. G.
Müller, M. R. Smith, A. Tritscher, S. Tuijtelaars, P. A. van den
Brandt, R. Walker, and R. Kroes. “Risk Characterisation of
Chemicals in Food and Diet.” Food and Chemical Toxicology 41
(2003): 1211–71. Accessed January 20, 2016. doi: 10.1016/S0278
-6915(03)00064-4.
Rovner, Alisha J., Tonja R. Nansel, Jing Wang, and Ronald J.
Iannotti. “Food Sold in School Vending Machines Is Associated with
Overall Student Dietary Intake.” Journal of Adolescent Health 48
(2011): 13–19. Accessed December 3, 2015. doi: 10.1016/j.jadohealth
.2010.08.021.
Shim, Soon-Mi, Sun Hee Seo, Youngja Lee, Gui-Im Moon, Min-Shik Kim,
and Ju-Hee Park. “Consumers’ Knowledge and Safety Perceptions of Food
Additives: Evaluation on the Effectiveness of Transmitting Information
on Preservatives.” Food Control 22 (2011): 1054–60. Accessed
January 21, 2016. doi: 10.1016/j.foodcont.2011.01.001.
86 Filling Up

Sobel, Jeremy, and John Painter. “Illnesses Caused by Marine Toxins.”

Clinical Infectious Diseases 41 (2005): 1290–96. Accessed January 21,
2016. doi: 10.1086/496926.
Solymosi, K., N. Latruffe, A. Morant-Manceau, and B. Schoefs. “Food
Colour Additives of Natural Origin.” In Colour Additives for Foods and
Beverages, edited by M. Scotter, 35–60. Cambridge: Woodhead. doi:
10.1016/B978-1-78242-011-8.00001-5.
Sörqvist, Patrik, John E. Marsh, Mattias Holmgren, Rebecca Hulme,
Andreas Haga, and Paul B. Seager. “Effects of Labeling a Product Eco-
Friendly and Genetically Modified: A Cross-Cultural Comparison for
Estimates of Taste, Willingness to Pay and Health Consequences.”
Food Quality and Preference 50 (2016): 65–70. Accessed January 22,
2016. doi: 10.1016/j.foodqual.2016.01.007.
Souza Tette, Patrícia A., Letícia R. Guidi, Maria B. de Abreu Glória, and
Christian Fernandes. “Pesticides in Honey: A Review on
Chromatographic Analytical Methods.” Talanta 149 (2016): 124–41.
Accessed January 20, 2016. doi: 10.1016/j.talanta.2015.11.045.
Stephan, Roger, Denise Althaus, Sabine Kiefer, Angelika Lehner,
Christoph Hatz, Claudia Schmutz, Marianne Jost, Nadine Gerber,
Andreas-Baumgartner, Herbert Hächler, Mirjam Mäusezahl-Feuz.
“Foodborne Transmission of Listeria Monocytogenes via Ready-to-Eat
Salad: A Nationwide Outbreak in Switzerland 2013–2014.” Food
Control 57 (2015): 14–17. Accessed December 3, 2015. doi: 10.1016/
j.foodcont.2015.03.034.
Swithers, Susan E. “Artificial Sweeteners Are Not the Answer to
Childhood Obesity.” Appetite 93 (2015): 85–90. Accessed January 21,
2016. doi: 10.1016/j.appet.2015.03.027.
Townsend, Ellen, and Scott Campbell. “Psychological Determinants of
Willingness to Taste and Purchase Genetically Modified Food.” Risk
Analysis 24, no. 5 (2004): 1385–93. Accessed January 22, 2016. doi:
10.1111/j.0272-4332.2004.00533.x.
Vandermeersch, Griet, Helena M. Lourenço, Diana Alvarez-Muñoz, Sara
Cunha, Jorge Diogène, German Cano-Sancho, Jens J. Sloth, Christiaan
Kwadijk, Damia Barcelo, Wim Allegaert, Karen Bakaert, José O.
Fernandes, Antonio Marques, and Johan Robbens. “Environmental
Contaminants of Emerging Concern in Seafood—European Database on
Contaminant Levels.” Environmental Research 143 (2015): 29–45.
Accessed December 7, 2015. doi: 10.1016/j.envres.2015.06.011.
Van der Schaft, P. “Approaches to Production of Natural Flavors.”
In Flavour Development, Analysis and Perception for Food and Beverages,
edited by J. K. Parker, Stephen Elmore, and Lisa Methven, 235–48.
How: The Positive and Negative Effects of Eating 87

Cambridge: Woodhead, 2014. doi: 10.1016/B978-1-78242-103-0

.00011-4.
Vidacek, Sanja, and Tibor Janci. “Safety of Fish Products.” In Regulating
Safety of Traditional and Ethnic Foods, edited by V. Prakash, Olga
Martin-Belluso, Larry Keener, Siân B. Astley, Susanne Braun, Helena
McMahon, and Huub Lelieveld, 79–98. San Diego, CA: Academic
Press, 2016. doi: 10.1016/B978-0-12-800605-4.00005-0.
Wills, Wendy J., Angela Meah, Angela M. Dickinson, and Frances Short.
“ ‘I Don’t Think I Ever Had Food Poisoning.’ A Practice-Based
Approach to Understanding Foodborne Disease That Originates in
the Home.” Appetite 85 (2015): 118–25. Accessed December 3, 2015.
doi: 10.1016/j.appet.2014.11.022.
Wohlers, Anton E. “Labeling of Genetically Modified Food in the United
States.” In Genetically Modified Organisms in Food, edited by R. R.
Watson and V. R. Preedy, 433–41. San Diego, CA: Academic Press,
2015. doi: 10.1016/B978-0-12-802259-7.00038-5.
Wright, Jeffrey L. C. “Dealing with Seafood Toxins: Present Approaches
and Future Options.” Food Research International 28, no. 4 (1995):
347–58. Accessed December 7, 2015. doi: 10.1016/0963-9969(95)
00001-3.
Wu, Lijie, Mingzhu Hu, Zhanchao Li, Ying Song, Cui Yu, Hanqi Zhang,
Aimin Yu, Qiang Ma, and Ziming Wang. “Dynamic Microwave-
Assisted Extraction Combined with Continuous-Flow Microextraction
for Determination of Pesticides in Vegetables.” Food Chemistry 192
(2016): 596–602. Accessed January 20, 2016. doi: 10.1016/j.food
chem.2015.07.055.
Yu, Rui, Qiang Liu, Jingshuang Liu, Qicun Wang, and Yang Wang.
“Concentrations of Organophosphorus Pesticides in Fresh Vegetables
and Related Human Health Risk Assessment in Changchun,
Northeast China.” Food Control 60 (2016): 353–60. Accessed
January 20, 2016. doi: 10.1016/j.foodcont.2015.08.013.
 4

Who: Psychologists’ Theories

about Eating

There are numerous explanations for why human beings eat the way they
do. Food preferences are thought to be driven by innate tendencies as well
as experiences people have growing up. This chapter will focus on a variety
of conceptual models used to characterize eating patterns. Further, the the-
ories related to the development of obesity will be identified to provide
deeper understanding about overeating among human beings.

DEVELOPMENTAL MODELS OF FOOD CHOICE

Developmental models around food choice focus on the process of learn-
ing and the way that eventual food preferences evolve among human
beings. Specifically, the models address the importance of exposure to
foods, social learning, and associative learning, arguing that rather than
having innate food preferences, our experiences with food are the driving
force. How we feel after eating a food—nauseous or full—can contribute
to a negative association with a particular food. The taste, smell, appear-
ance, and texture of the food can also play a role in creating a particular
preference. Although this effect of learning food preferences has been
studied extensively with animals, there is some evidence to support food
preference shifts in humans and the necessity for humans to be exposed
to a variety of food sources.
90 Filling Up

Although the significant health benefits of consuming a well-balanced

diet that consists of diverse food sources have been well documented,
human beings tend to be averse to trying new kinds of food. This resistance
to venturing into new territory for food is called “neophobia” and stems
from early childhood. Neophobia is defined as the fear and avoidance asso-
ciated with trying novel food items and has also been referred to as the
“omnivore’s paradox.” This condition is more prevalent in boys and men
than girls and women. Furthermore, neophobia has a tendency to run in
families. Though developmental theories suggest that neophobia has been
shown to decrease with age, the condition is more apparent in toddlers and
preschool children than in infants, who are just beginning to adjust to
solid foods. The ability of children and adults to shift food preferences
has been thought to be linked to repeated exposure to certain foods.

The Exposure Hypothesis

The mere-exposure effect, which was identified in 1968 by Robert Zajonc,
refers to a passive type of learning related to food choice. Nonhuman ani-
mals realize that eating certain types of food (e.g., poisonous berries) will
lead to negative outcomes. Feeling sick in response to having the toxic
food reinforces a fear associated with that food source and potentially with
trying other novel foods. However, having a positive experience with a
particular food (i.e., not becoming sick or uncomfortable) can reinforce
the viability of this food as a sustainable part of one’s diet. This mere-
exposure effect carries over to human beings of all ages and can start from
a young age.
Overcoming this fear of trying new foods can occur when children are
encouraged to try different types of food. Specifically, one study found that
two-year-old children who were given new foods over a six-week period
showed noticeable shifts in food preferences after being exposed to the
novel food at least 8 to 10 times. A separate study with children two to
six years of age found that repeated daily exposure to a disliked vegetable
over a 14-day period resulted in increased favorability ratings of that food
compared with groups who had not received the exposure condition.
These research studies show how increasing exposure can greatly shift food
preferences and intake among human beings. An interesting explanation
for the relationship between exposure and food preferences relates to a
“learned safety” view. This perspective indicates that the fact that eating
new foods has not resulted in any negative consequences links to an
increased willingness to try novel foods and expand food preferences.
Although studies have shown that visual exposure (i.e., looking at a new
Who: Psychologists’ Theories about Eating 91

food) was not enough to move the needle for broadening food preferences,
tasting new foods and being told that foods taste good seemed to influence
people’s attitudes around food.

Social Learning Theory

The social learning theory, which has also been called observational learn-
ing, is characterized by the tendency of children to observe others to learn
certain types of behaviors. For eating, this observation can occur with
parents and friends acting as role models. The media can also play a role
in displaying certain types of eating behaviors. It has been argued that for
omnivores from rats to human beings, food preferences are mainly driven
by experience rather than innate likes and dislikes of particular food items.
In looking at the influence of their peers on children’s food preferences,
one study examined children who observed various role models. These role
models consisted of other children, an adult stranger, and a superhero.
The children in the study observed these role models making food selec-
tions that differed from the children’s eating patterns. Although the adult
stranger had no impact on children’s food choices, the children’s food pref-
erences changed in response to the modeling of a friend, older child, or
superhero. This trend to shift food preferences was replicated in another
study, which involved having a role model consuming less-preferred vege-
tables (e.g., peas rather than carrots). At the end of the four consecutive
days of modeling, children reported a change in their preference for the
vegetables included in the study. Importantly, this food preference shift
was sustained at follow-up, which underscores the significance of having
healthy-food role models who are viewed as salient by children. The pres-
ence of other children carried over to several other studies involving food
choice. Another child being present was found to influence when and
what children consumed. For example, one study found that children
who sat next to overweight peers consumed more than when sitting next
to a child who was not overweight. Moreover, children ate more cookies
when sitting next to a sister or brother than when sitting next to an unfa-
miliar peer, suggesting that the relationship to the model is an important
driver for food preference shifts. Finally, a powerful finding was that chil-
dren were more likely to eat new foods like fruits and vegetables when see-
ing others eat foods of the same color in front of them or in a video.
Parents are critical role models in the development of food preferences
for children. Not only are parents responsible for providing access to a
variety of foods (and thereby exposure to novel foods), but also what they
eat influences the behaviors of their children. It was noteworthy that one
92 Filling Up

study found that adolescents were more likely to choose to have breakfast
if their parents were breakfast eaters. Similar patterns have been revealed
for dieting and food restriction behaviors. That is, if parents view foods
as scary or “bad,” kids are more likely to resist trying those foods or novel
food choices. Similarly, a study with 197 families determined that the
mother’s level of dieting, food restraint, and perception of risk that her
daughter would be overweight were the strongest predictors of prepubes-
cent daughters’ eating behavior. The important message here seems to be
that not only does what a parent talks about related to food choices and
health matter, but so does the actual action around a parent’s own food
choices.
Given the salient role that modeling can play in affecting children’s eat-
ing habits, the media can also serve as a powerful influence. Unfortunately,
the majority of commercials feature processed foods that have high sodium
or sugar content rather than whole fruits and vegetables. To support this
contention, it was found recently that food advertisements aimed at chil-
dren under five years old were twice as likely to contain unhealthy food
products. Interestingly, the media attention geared toward a particular
diet can have a large impact on sales in grocery stores. For example, if a
high-fiber diet such as the F-Plan Diet in 1982 is promoted, there is an
expected increase in the purchase of high-fiber types of whole wheat
bread, bran cereals, and whole wheat pasta. Likewise, if the gluten-free
movement is celebrated on television, products branded as gluten-free
may become increasingly more popular with consumers. The recent
trend toward the Paleo Diet (i.e., a diet that our ancestors would eat—
seeds, nuts, fruits, vegetables, and meat) could have a reverse effect by
decreasing sales of processed foods and breads in favor of “whole foods.”
Interestingly, media can also play a role in spreading fear around eating
certain types of food. Food-borne illnesses such as salmonella are
reported on, and in 1988 egg sales fell by 50 percent in response to
the news about infected eggs. News reports regarding risky beef in the
United Kingdom during the early 1990s were thought to contribute to a
20 percent drop in beef sales.
Media influenced children’s tendency to eat certain foods in larger
quantities. One study found that children who were exposed to commer-
cials featuring food were more likely to eat more snack foods than when
they were shown nonfood commercials. The “modeling” provided by sour-
ces like the media cannot be denied. Coupled with role models consisting
of peers and family members, it can be argued that eating behaviors and
food preferences are shaped by observational learning. A third explanation
for a developmental basis of food choice is related to associative learning.
Who: Psychologists’ Theories about Eating 93

Associative Learning
A third theory within the developmental models of food choice is associa-
tive learning. Associative learning refers to the development of a particular
response to food based on a variety of factors that may positively or nega-
tively reinforce the consumption of that food item. These reinforcing fac-
tors may be related to an emotional expression of a liked or disliked food,
using access to food as a reward, parental control or restriction of certain
kinds of food, and inducing physiological responses to a given food.
One study explored the link between food choice and adult attention
related to children’s food preferences. To this end, children were provided
with food in one of two conditions. They were either shown positive adult
attention or faced with a neutral environment (i.e., neither positive nor
negative attention) as a result of a particular food choice. Receiving posi-
tive adult attention was connected to developing a more favorable
response to a particular food and increasing preference for that food.
A separate study examined whether showing faces of people related to dif-
ferent foods—liked or disliked food items—had an effect on food prefer-
ences. If the picture featured a person emoting pleasure when eating a
disliked food, one’s food preference was shown to increase. However, the
desire to eat the liked food was not impacted by the emotional expression
pictured in the study. If the disliked food was associated with a face show-
ing disgust, the desire for the disliked food decreased.
An interesting intervention was used to reward healthy choices of fruits
and vegetables during a school lunch program. Specifically, tokens were
provided for consuming fruits and vegetables. The tokens, which could
be traded in for a prize, resulted in an increased preference for healthy food
options within two weeks of the program’s initiation. Unfortunately, the
positive effect was not sustained as levels returned to baseline. This sug-
gests that providing a reward for certain food choices may result in a
short-term behavior change; however, once the reward is removed, the
behavior change may not continue.
In addition to rewarding children who make healthy choices with posi-
tive attention or non-food tokens, it has been relatively common for
parents to offer food as the reward for eating well. For example, we may
recall a time when we heard our parents say, “You can eat dessert once
you have finished your vegetables.” This strategy for increasing fruit and
vegetable intake among children has been shown to directly influence
beliefs about the object of the food reward. The dessert becomes more val-
ued and seen as positive, whereas the vegetable or healthy food is per-
ceived in increasingly more negative light. In other words, offering a
94 Filling Up

“reward food” in exchange for eating an “access food” may backfire, as the
access food (e.g., vegetables) is seen as even more negative.
A related but separate issue involves the control of parents over food
choice and the eating behavior of children. Instead of offering desserts as
a reward for eating healthily, some parents may actually restrict desserts
altogether. This restriction of forbidden foods may be well intentioned
but has been found to make the restricted foods become more valued and
preferred. One study found that when certain foods were eliminated from
a child’s diet, they became more desirable once they were made available
again. Children would more often choose the restricted food, especially
when the parent was not present. Although there is some controversy over
whether parental control of food choice helps or hinders healthy eating
behaviors, it seemed that parents could most positively influence diet by
the amount of food on a child’s plate rather than limiting certain foods.

Flavor-Flavor Associative Learning

Associations with food tend to relate to both flavor preferences surround-
ing the specific tastes of food as well as the nutrient content. Flavor-
flavor associative learning takes into account that human beings have an
innate food preference for sweet and salty items from an early age.
Likewise, human beings tend to dislike foods that have a bitter or sour
taste, as they have been associated with toxins. Therefore the theory
behind flavor-flavor associative learning is that pairing unpopular foods with
favorable tastes such as sweet or salty flavors can be used as a strategy to
encourage eating disliked foods. For example, some people report that black
coffee without anything added tastes bitter, but once sugar and cream are
added, the beverage usually becomes more satisfying. A similar pairing would
involve adding cheese or butter to vegetables like broccoli or cauliflower.
Although this pairing of a liked food with a disliked food has been found to
be fairly effective in increasing food preferences, there are some cases in
which flavor-flavor associative learning can cause conditioned aversions.
The pairing has the potential to work in the reverse so that an individual
develops a dislike for the originally preferred food item (e.g., cheese).
Generally, this result has been unlikely to happen because the food prefer-
ence for sweet or salty tended to override a dislike for a particular food.

Flavor-Nutrient Associative Learning

Flavor-nutrient associative learning, described as using a flavor with a
required substance such as calories, minerals, or vitamins, can lead to
Who: Psychologists’ Theories about Eating 95

increased food preferences. Interestingly, flavors that were paired with

higher calories were found to be preferred over flavors paired with fewer
calories. Flavor-nutrient associative learning was effective even in the
absence of continued reinforcement and could be sustained over time.
Some individuals have considered this approach to be synonymous with
the “medicine effect”—that is, feeling good as a result of consuming the
needed nutrients in one’s diet. These results have been consistently dem-
onstrated in rats and human beings alike. In one study using humans, pud-
ding that was high in calories was preferable to the low-fat version, even
when they were identical in appearance, taste, and smell. Flavor-nutrient
associative learning offers an interesting perspective on the link between
flavor and nutrients; however, it is also important to consider how the con-
sequences of consuming a particular food can play into one’s belief or food
preferences.
The biological explanation for early food preferences of both animals
and humans relates to survival. The necessity of eating foods that are safe
to eat and avoiding toxins was the primary driver behind consistent sour-
ces of dietary intake. Furthermore, the perceived consequences of eating
a particular food can influence one’s decision to try a food as well as the
development of positive or negative perceptions about a given food.
To this end, studies have monitored how physiological responses to eating
certain foods can impact the potential for food aversions. For example,
experiencing gastrointestinal distress related to having consumed a par-
ticular food such as seafood or sour milk can trigger a future negative
response. Similarly, feeling overfull can also be equated with negative per-
ceptions about a particular food as being too heavy or calorically dense.
These findings have been identified in studies that found infants adjusted
their consumption of milk to fit the caloric density of the product.
The impact of physiological factors on food intake will be covered in more
detail later in this chapter in the Physiological Theories section.

Limitations of the Developmental Models for Food Choice

Although there has been much scientific and practical evidence to support
a developmental model for studying food choice, there are some potential
drawbacks to using this approach. First, the studies used to test the effects
of reinforcing factors on eating behavior have primarily taken place in
the lab setting. Therefore it is difficult to understand fully how humans
react in a less controlled environment. A second criticism of the develop-
mental approach to food choice involves the tenets of food as a reward and
food as pleasant or disagreeable. The broader meaning of food can include
96 Filling Up

more than the parental relationship or a simplistic reward system. In fact, it

is necessary to consider the implications of food related to factors like
socioeconomic status, religion, power, and culture, which are not taken
into account in the developmental perspective. Likewise, the social mean-
ing associated with body size is not considered in this model. Nor are
attractiveness, control, and success factored in when considering a devel-
opmental approach to eating behaviors. Finally, although this approach
does allow for the role of cognitions or thoughts surrounding foods, these
are not described in an explicit fashion. Therefore it is important to con-
sider the cognitive models of food choice.

COGNITIVE MODELS OF FOOD CHOICE

A cognitive approach to understanding food preferences tends to focus on
cognitions or thoughts around food that predict or explain eating behav-
ior. Specifically, these models have been used to describe the way a per-
son’s attitudes or beliefs about his or her ability to personally manage
health outcomes can impact choices about food selection and behaviors.
Several models have focused on cognitive approaches to demonstrating
this relationship between health attitudes and corresponding dietary
behaviors, including the well-known health belief model, the protection
motivation theory, the theory of reasoned action, the theory of planned
behavior, and the transtheoretical model. These theoretical frameworks
are commonly referred to as behavior change theories because they are tar-
geted toward promoting positive health behaviors (e.g., physical activity)
or extinguishing undesirable behaviors (e.g., smoking).

Health Belief Model

The health belief model was developed in the 1950s and is popularly used
to explain health behaviors. This theory argues that people tend to behave
in response to what they perceive as consequences for their actions.
For example, people will assess the risk for disease and severity of the dis-
ease (e.g., fatality) associated with a negative health behavior such as
smoking and will act accordingly. There are three important tenets of this
theory to explain health-related behaviors. First, there must be adequate
motivation or health concern to ensure that health issues apply and should
be addressed. Second, there needs to be a belief that one will face a per-
ceived threat if negative behaviors are continued or if action is not taken.
Finally, a person must believe there is an actual benefit to acting on par-
ticular health recommendations. If the health belief model is applied to
Who: Psychologists’ Theories about Eating 97

food choice, there are several conditions that must be considered. An

individual must believe that eating healthily is a need that is personally
relevant. For example, it is possible that he or she may have a genetic pre-
disposition to developing diabetes or heart disease, which supports the idea
that he or she is susceptible for disease risk. If he or she perceives diabetes
or heart disease to be serious, there is higher likelihood of acting on this
health concern. Finally, there must be a perceived benefit or benefits to
changing one’s eating behavior to prevent chronic disease conditions such
as diabetes and heart disease.

Protection Motivation Theory (PMT)

The protection motivation theory (PMT) was devised to understand the
effects that scare tactics may have on influencing health-related attitudes
and associated behaviors. This theory has been extended since its original
development in the 1970s to serve as a broader framework for understand-
ing the use of persuasion to elicit certain elements of behavior change.
The PMT also incorporated the principles of rewards and self-efficacy for
explaining health behaviors. There is a similar focus on weighing the costs
and benefits of taking a particular action for one’s health. However, the
PMT also focuses on external sources of health-related information such
as verbal persuasion (communicated messages) and observational learning.
The role of one’s personality is taken into account when considering
behavioral responses to persuasion-based communication. One considers
the threat of a particular behavior (eating unhealthy food or overeating)
and assesses both the derived pleasure from the negative behavior as well
as the perceived severity of a potential threat. Meanwhile, an individual
considers the helpfulness of health-enhancing behaviors to include beliefs
that positive behavior will address perceived threat and self-efficacy that
one can complete health-enhancing behavior. For example, I might iden-
tify eating more fruits and vegetables to be my health-enhancing behavior
to address a perceived health threat such as obesity or diabetes. According
to this theory, I will review whether the consumption of fruits and vegeta-
bles will indeed reduce my risk of developing diabetes or becoming over-
weight or obese. I will also assess whether I feel I am capable of
increasing my fruit and vegetable intake. The PMT has argued that behav-
ior change is most likely to occur when the risk of health problems is
severe and likely. Importantly, an individual needs to believe in the
health-enhancing behavior’s ability to prevent the health risk as well
as his or her ability to engage in the health-enhancing behavior in a
successful way.
98 Filling Up

Theory of Reasoned Action

The theory of reasoned action was developed in the late 1960s to explain
all behaviors that are selected voluntarily, including health-related deci-
sions. This theory attempted to dissect the differences in attitude, belief,
intention, and behavior as a way of understanding a person’s tendency to
act. Behavior was thought to be based on a person’s attitudes about the
behavior along with subjective norms related to the behavior. Attitudes
toward a particular behavior matter—having a positive attitude toward
eating healthy as a way to control weight and ward off diseases will trans-
late into increased likelihood of adopting that behavior. If a person
believes that eating behavior is not tied to weight, that person will be
unlikely to watch the types of foods he or she consumes. Therefore the
belief associated with the effectiveness of engaging in a particular behavior
to promote one’s health—positive or negative—is intricately linked to
actual action or intention to engage.
“Subjective norm” refers to receiving a degree of social pressure from
others to engage in a behavior. For example, depending on one’s peer
group, a person may face intense pressure to smoke cigarettes. By contrast,
a person may be ostracized by a different group for engaging in the same
behavior, based on the norm of the group. This social pressure can come
from a variety of sources including family members, friends, work col-
leagues, teachers, doctors, and other role models. A work environment
may foster a climate that supports making healthy lunch selections or, con-
versely, may disregard nutrition as an important part of an employee’s day.

Theory of Planned Behavior

When examining actions that are voluntary, the theory of reasoned action
is strongly supported. However, this theory is inadequate for explaining
intended behaviors that are not executed despite the presence of positive
attitudes and congruent subjective norms. One example is if an individual
believes that it is important to get plenty of fruits and vegetables each day
to prevent diseases but does not actually consume more healthy foods.
The theory of planned behavior extends the theory of reasoned action by
including another construct, the influence of intention as it relates to per-
ceived behavioral control. Specifically, perceived behavioral control,
which is similar to the concept of self-efficacy, is a person’s perceived abil-
ity to adopt a particular behavior or behaviors. Therefore the theory of
planned behavior predicts behavior will be more likely to occur if there
are positive attitudes toward the behavior, subjective norms congruent
Who: Psychologists’ Theories about Eating 99

with the behavior, and a level of perceived control that the behavior can
be performed. This theory is important because it considers the role of
motivation and one’s actual behavioral control. An individual’s belief that
they have control over their ability to engage in a particular behavior has a
strong impact on behavior change.

Transtheoretical Model
Another popular approach for understanding behavior change related to
health behaviors is the transtheoretical model, which has also been
referred to as stages of change, as a framework developed to understand
how individuals begin to move toward positive health behaviors.
The original model was developed to address the stages individuals move
through when quitting smoking including—precontemplation, contem-
plation, preparation, action, maintenance, and termination.
The precontemplation stage of the model recognizes that most indi-
viduals may face a time when they have no intention of changing their
behaviors. In fact, they are not even thinking about changing the behav-
ior (e.g., starting to exercise or eat more vegetables). During this stage,
people are unlikely to feel motivated to engage in educational programs
or interventions that involve action steps. The contemplation stage is
when people begin to think about behavior change and intend to change
within six months. Although no action is happening, people in contem-
plation may be reading about the problem or thinking about the positive
and negative aspects of creating change. The preparation stage refers to a
time when people begin to take steps closer to action. For example, peo-
ple in preparation may read a self-help book about the benefits of a
healthy diet in fighting diabetes or they may visit a website that offers a
nutrition tracker. Preparation may also involve meeting with a nutrition
counselor to discuss the benefits of a behavior change. In the action
stage, people begin to make real changes to their behavior. They may
be cooking with vegetables, for example, or bringing carrot sticks to work
for lunch. Finally, the maintenance stage involves maintaining healthy
behaviors for at least six months and building confidence that this
change is part of a permanent lifestyle. The last stage, termination, was
originally included to reflect that someone had reached a stage where
he or she had zero temptation to return to his or her “old ways” or
undesired behaviors of smoking (or drinking). When health behaviors
like engaging in physical activity and eating fruits and vegetables are
the focus, the termination stage does not apply.
100 Filling Up

Limitations of Cognitive Models of Food Choice

Although cognitive models of food choice offer the opportunity to investi-
gate the relationship between thoughts and beliefs about health and
particular foods and corresponding dietary behaviors, these models
have come under fire for being overly simplistic to explain food choice.
Their approach has tended to look at variables focused on the individual
and does not allow for variations across individuals. Some scientists have
argued that a more comprehensive model is needed to explain food prefer-
ences among children. Several specific limitations have been identified
with using cognitive models.
The majority of studies employing cognitive models have used quantita-
tive methods. This means that structured questionnaires were used to
guide the identification of specific cognitions. Therefore individual partic-
ipants were unable to offer information about their cognitions in an open-
ended fashion. This methodology raises concerns that certain beliefs about
food intake could have been missed by the researcher. Social cognitive
models do not take into account the role of emotion in determining
behavior and use only rational thought as a predictor. The complexity of
personal meaning related to body size and food within the context of
greater society are not explained or included in these models. For the most
part, the role of other human beings within the social setting is discounted
in cognitive models of food choice. Finally, and perhaps most important,
the role of attitudes toward foods does not fully predict resulting behaviors
as unexplained food choice decisions tend to extend beyond rational
thought and beliefs.

PSYCHOPHYSIOLOGICAL MODELS
OF FOOD CHOICE
Another theoretical perspective related to eating behavior focuses on the
concepts of hunger and fullness (satiety). Hunger has traditionally been
defined as feeling motivated to eat following a period in which one has
neglected to eat. There is a conscious desire to eat and there is the pres-
ence of physiological responses in the body signaling that it is time to
eat. By contrast, the feeling of satiety is associated with the desire to stop
eating as a result of being full. There is a conscious understanding that
enough food has been consumed to reach satisfaction and a person is moti-
vated to stop eating. This theory recognizes that these feelings of hunger
and satiety are the result of interacting factors including a person’s cogni-
tions, behavior, and physiology. This model also considers factors such as
Who: Psychologists’ Theories about Eating 101

drugs that address neurochemicals that impact hunger and cues of fullness.
Psychophysiological models do not discount the complex relationship
between emotions and eating behaviors and therefore study stress-related
eating.
Metabolic models of eating behaviors have emphasized the biological
perspectives in which homeostatis and negative feedback are involved.
Homeostatis is defined as the regulation of eating within certain limits,
usually around our experience of hunger. When we feel hungry, we eat.
Likewise, it has been found that human beings tend to have a body weight
set point that is acceptable within a particular range for that individual.
This school of thought argues that the body has a sense of hunger that
triggers our desire to eat to a certain point.
Brain researchers have also recognized the role of the hypothalamus in
producing cues around eating. Although early studies argued that the
hypothalamus was central to food intake, researchers have recognized a
role for numerous other brain regions. In fact, the psychophysiological
approach to understanding food choice illustrates the influence of several
major neurotransmitters on eating behavior. Some neurotransmitters work
to increase food intake, whereas other neurotransmitters have the opposite
effect. Specifically, norepinephrine, neuropeptide Y, and galanin all
represent neurotransmitters that increase appetite and result in a desire
for food intake. While galanin tends to trigger a preference for fats, both
norepinephrine and neuropeptide Y cause a preference for carbohydrate
intake. Conversely, several neurotransmitters have been found to reduce
appetite, including cholecystokinin, bombesin, corticotropin-releasing
hormone, and serotonin.
The chemical properties of food are also an important influence on food
preference. Further, food has a particular appearance in its color, size of
morsel, and the way it is displayed—all of which will impact food choice.
The role of olfactory senses cannot be ignored in food choice, as the smell
of food can influence both its selection and taste. Moreover, the preference
for sweet or salty tastes has led to certain foods being selected and others,
perhaps more bitter-tasting options, being avoided.
As mentioned, certain substances may also influence food choice and
affect cues of hunger and fullness. For example, nicotine has been associ-
ated with decreased food intake and weight loss. This finding has led to
smoking being used as a dysfunctional and dangerous weight loss strategy.
Conversely, marijuana has been found to increase feelings of hunger and
has translated to higher food intake among users. It is unclear as to the role
alcohol plays on hunger cues and food intake. Although some studies have
noticed that alcohol can stimulate hunger, others have found that hunger
102 Filling Up

cues were actually suppressed among participants. Some researchers have

argued that alcohol consumption leads to inhibition, which leads to
decreased attention to hunger cues and increased risk for food binges.
Because there are a diverse range of drugs (both prescribed and illicit) that
result in contradictory effects on hunger, fullness, and food intake, it is
important to underscore that natural systems will be altered with the intro-
duction of outside substances.

Do Coffee and Chocolate Have an Effect on Mood?

Just as we consider the role that drugs may play on our hunger and fullness,
it is important to consider the influence that particular chemicals/drugs
may have on our emotions. In the cognitive models of food choice, the
relationship between certain thoughts and the tendency to eat was
explored; however, the psychophysiological approach considers the rela-
tionship from a different angle. That is, it is critical to consider the effect
that certain foods like chocolate or caffeine may have on one’s mood or
emotions. You’ve probably heard someone say, “I need caffeine,” or a slight
variation of that, “I need chocolate.” Is there a chemical basis for these
statements?
Caffeine has been the subject of much controversy around whether it
has a positive or negative health benefit for human beings. In fact, caffeine
is found in highest content in coffee (60 milligrams per cup) and to a lesser
extent in soft drinks like Coca Cola (34 milligrams per 12-ounce drink)
and in tea (40 milligrams per cup). Early studies were particularly contro-
versial, with findings in both positive and negative directions associated
with caffeine intake. Interestingly, more recent studies have resulted in a
much rosier picture for caffeine. Caffeine has been found to improve mood
while increasing vigor and alertness. Also positive has been the finding
that caffeine tends to reduce depression and anxiety. It is also believed that
caffeine can help enhance athletic performances related to improved reac-
tion times and increased vigilance. Given these positive findings, it is
unsurprising that Americans and Europeans consume so much caffeine.
Chocolate conjures feelings of romance, calmness, and harmony.
Not only has chocolate been the object of media displays and advertise-
ments, entire businesses have been created around this one food item.
Chocolate shops and chocolate makers embody the true demand for these
tasty morsels, and the term “chocoholic” was coined to denote the addic-
tive properties of the mouth-watering substance. One study found that
individuals who self-identified as chocoholics were likely to eat around
12 chocolate bars weekly and to experience chocolate cravings at least
Who: Psychologists’ Theories about Eating 103

six times per week. When exposed to chocolate cues, these individuals
demonstrated increased arousal, enhanced feelings of craving, and
depressed mood. A separate study found that the consumption of
chocolate was linked to feelings of guilt. However, many studies around
chocolate have had conflicting results. It is unclear whether chocolate has a
direct link to depression, as many studies found no effect at all. There is anec-
dotal evidence that eating can be triggered by certain emotions and that
certain types of food are more likely to be the object of such cravings.

The Relationship between Stress and Eating

Although parallels have been made between emotional eating, food crav-
ings, and stress-related eating, the link between stress and eating is com-
plex. There has been some research that suggests that stress triggers a
decrease in food intake for both animals and human subjects.
Conversely, some studies have yielded the opposite effect, with both ani-
mals and humans tending to snack more under a stressful condition.
Further, an explanation that eating provides a coping response to difficult
situations has been advanced.
A study with college students found 73 percent of students increasing
their snacking behavior while decreasing their consumption at meals.
High work stress was correlated with increased consumption of fats,
calories, and sugar. Additionally, stress eating was associated with a greater
tendency to have a binge eating episode due to the mindless nature of the
eating experience. Mindless eating—consuming food while being dis-
tracted by other activities such as television or driving a car—places an
individual at risk for overeating due to neglecting biological cues of satiety
even when they were present.
The term “stress eating paradox” captures the individual differences in
response to stress. For some individuals, food intake goes down. For others,
the response to stress is to eat more fatty types of food. This response lends
itself to increased risk for becoming overweight or obese, which has been
associated with numerous chronic diseases and health consequences.
A physiological explanation has been offered to explain the stress and eat-
ing relationship. That is, stress-induced arousal when measured by blood
pressure and heart rate was found to be related to increased food intake.

Limitations of the Psychophysiological Model of Food Choice

This model is important as biological explanations are considered for
understanding hunger and satiety. Likewise, the role of learning, cogni-
tions, and emotion (i.e., stress-related eating behavior) on eating behavior
104 Filling Up

is acknowledged within the psychophysiological model. However, much of

the research supporting this model has occurred in lab settings with ani-
mals rather than human beings in more naturalistic environments.
Therefore the generalizability to real-life situations and human beings is
limited and remains uncertain. Although brain activity may influence eat-
ing patterns, it is also critical to recognize the influence of social factors on
food choice. This model does not identify social learning and social mean-
ing within the causal pathway for eating behavior. Further, the psycho-
physiological model possibly oversimplifies the link between hunger and
fullness with biological cues without consideration for social motivators
related to food choice given the social influences on eating behavior.
Finally, it is important to consider that the assumption that a human being
will eat when experiencing hunger and stop eating when experiencing full-
ness is not always upheld—for example, an individual who is initiating
dietary restraint (i.e., denying oneself food despite feeling hungry) or
who lacks control over food decisions. Additionally, other factors such as
accessibility to food and food likes and dislikes may play a role in determin-
ing eating behavior beyond the presence or absence of biological cues.

THEORIES OF DIETING
In a culture that demonstrates clear value for appearance with powerful
media images displaying what is believed to be beautiful, there is a strong
focus on body weight. Naturally, changing one’s eating habits in attempts
to alter one’s body size, shape, or weight is the outgrowth of a society
obsessed with attractive bodies. Dieting has been directly linked to feelings
of body dissatisfaction. Theories related to dieting that will be discussed in
this section include the restraint theory for dieting, the boundary model of
overeating, and the escape theory.

Restraint Theory for Dieting

Body dissatisfaction is the strongest predictor of developing disordered eat-
ing behaviors. Dieting refers to behavior designed to restrain eating in
order to restrict one’s food consumption to certain foods or to limit one’s
overall food intake. Dieters are more likely to be girls or women than boys
or men, and the majority of the female population has gone on a diet at
some point in her life. In fact, one study showed that 87 percent of female
participants had dieted at one time or another, with some participants ini-
tiating dieting behavior as young as nine years old. The restraint theory of
dieting was developed in the late 1970s in an attempt to explain the
Who: Psychologists’ Theories about Eating 105

relationship between dieting and body weight. Initially, this theory was
used to predict food intake rather than body weight.
The terms “restrained eating” and “dieting” have been used interchange-
ably to refer to a restriction of overall intake or certain types of food. For stud-
ies using restraint theory as the framework, findings have been mixed about
eating patterns of restrained eaters versus eaters who do not restrain their
intake. Although some studies determined that restrained eaters ate less than
nonrestrained eaters, other studies found there was no difference between the
two groups. Interestingly, restrained eating, which was designed to limit food
intake, often led to episodes of overeating or binge eating. This tendency was
explained by feelings of poorer mood, and notably the restrained eaters were
found to consume larger amounts of fat. Several explanations have been
offered to explain this tendency of restrained eaters to engage in overeating,
such as the causal analysis of overeating, the boundary model of overeating,
and escape theory.
The causal analysis of overeating argues that binge episodes and dieting
behavior are connected—that restrained eating causes overeating behav-
iors. Interestingly, the effort to prevent oneself from eating leads to an
increased likelihood of eating too much. In a controlled study, participants
who were on a diet consumed more food than the other groups.

Boundary Model of Overeating

Another explanation for the relationship between dieting and overeating
was proposed in 1984 called the boundary model of overeating. This model
asserts that a “dietary boundary” exists to determine control for eating types
or amounts of food among restrained eaters. The dieter will remained moti-
vated as long as he or she remains inside the diet boundary; however, once
the line has been crossed, all bets are off. The resulting behavior is the ten-
dency to consume more food until they feel full rather than relying on the
diet boundary anymore. Unfortunately, this leads to overeating behavior for
the restrained eater.
This boundary model offers a dual pathway for the regulation of food
intake—either the diet boundary or the satiety boundary. Researchers have
examined the differences in eating behavior between binge eaters, dieters,
individuals with anorexia nervosa (an eating disorder that involves severe
restriction of food), and so-called normal eaters. Interestingly, the binge eat-
ers were found to use the satiety boundary most often but were unable to dis-
tinguish when they were full, leading them to overeat. Meanwhile, the
anorexic individual tends to deny hunger cues and ignore satiety cues, eating
based on only thoughts and emotions rather than biology.
106 Filling Up

Escape Theory
Another explanation advanced to understand overeating behavior is escape
theory. Escape theory has been used to study both dieting behavior as well as
binge eating episodes typically found in eating disorders like bulimia nervosa
and binge eating disorder. This theory focuses on the role of self-awareness
and self-criticism with regard to eating behavior. Researchers discovered that
overeaters displayed low self-esteem, poorer mood, and demanding ideals or
standards for themselves. Overeating was associated with negative criticism
and depressed mood. An escape from having a high level of self-awareness
to low self-awareness tended to result in decreased inhibitions, making an
individual more vulnerable to overeating behavior.
Overeating has also been viewed as a type of relapse similar to an alco-
holic or smoker. The binge episode is equated with a “slip-up,” leading to
feelings of guilt and decreased self-esteem. Further, this perception of over-
eating as a relapse may trigger a full-blown pattern of overeating, as behav-
ior is seen as black or white (i.e., “all or nothing”).

Limitations of Restraint Theory

Restraint theory links dieting behavior with overeating to show how food
choice can be highly influenced by one’s tendency to restrict the types or
amount of food consumed. The theory applies to individuals who have
bulimia nervosa or binge eating disorder as well as to dieters; however,
the restricting behavior of individuals who are diagnosed with anorexia
nervosa is not well explained. Further, the behavior of vegetarians and
other groups who successfully limit the intake of certain kinds of food
(e.g., meat) is not understood. For example, how do vegetarians manage
to never consume meat if, as restraint theory suggests, they will be more
vulnerable to eating that very food if they restrain eating? Finally, this
theory does not account for the successful dieters who actually restrain eat-
ing, lose weight, and maintain their weight loss. In sum, the restraint
theory is not sophisticated enough to deal with the complexities of eating
behavior, dieting, and overeating. The next section will discuss theories
around the causes of obesity.

THEORIES FOR THE CAUSES OF OBESITY

It is no secret that society is always searching for the magic bullet to lose
weight and fight obesity. Although there are many theories to explain
the multifaceted contributing factors for obesity, the explanation has been
argued from physiological, psychological, and social perspectives.
Who: Psychologists’ Theories about Eating 107

Physiological Theories
An individual’s biology can play an important factor in the development
of appetite and predisposition to becoming overweight or obese.
Specifically, physiological theories include considering one’s genetics,
metabolism level, number of fat cells, the regulation of appetite, and an
evolutionary approach to understanding obesity.
Genetics helps determine not only your hair and eye color but also your
height and weight. The probability that a parent who is obese will have an
obese child has been calculated at 40 percent, whereas two parents who are
obese yield an 80 percent chance. Conversely, the chance of thin parents
having overweight children is only 7 percent. To understand this genetic
connection, twin studies were conducted to examine the influence of envi-
ronment on obesity. In these studies, researchers found that genetic factors
were the strongest contributor to becoming overweight or obese and
trumped environmental factors. Likewise, studies with adopted children
found a similar pattern, with genetics playing a strong role for inheriting
obesity.
Another physiological explanation for obesity is that having a lower
resting metabolic rate (which is genetic) can result in burning fewer
calories at rest, thereby contributing to obesity. This finding was supported
by a study with Pima Indians, who have a high tendency to be obese
(80–85% of the population). People who gained weight tended to have
the lowest metabolism at the beginning of the study. Unfortunately, this
“low metabolism” theory has yielded mixed findings and much contradic-
tory evidence. For example, overweight or obese individuals use more
calories for the same movement as someone who is not obese. Therefore
this theory of obesity is no longer well recognized in scientific circles.
A separate genetic explanation for obesity involves the number of fat
cells. Individuals who are obese tend to have many more fat cells (up to
100 to 125 billion) compared to individuals of an average weight (25 to
35 billion). It is now recognized that people can continue to create new
fat cells as needed (there is no predetermined number at birth) and that
fat cell count is not entirely genetic. The regulation of appetite has also been
considered as a potential reason for obesity. Genes such as leptin support
appetite regulation, which is responsible for recognizing bodily cues of feeling
full. For overweight individuals, there may be a tendency to overlook (or
ignore) these cues due to a leptin deficiency or leptin resistance. Another
explanation for obesity relates to the role of neurotransmitters. It is possible
that people may overeat if they have too few neurotransmitters that relate
to feelings of satiety and too many that promote appetite and food intake.
108 Filling Up

Interestingly, an evolutionary model of obesity has been proposed that

helps us understand how humans have evolved over time to become more
vulnerable to obesity. The development of overweight and obesity may
have been a coping response to survival with a lack of available and con-
sistent food sources. Logically, storing fat in a society wherein food was
in short supply would be a wise adaptation rather than a negative health
habit. Some researchers have dubbed this perspective the “thrifty gene
hypothesis” to explain obesity from the basis of being successful at conserv-
ing energy. Is it possible that humans today represent those who were self-
selected from our heavier ancestors that were the most likely to survive?

Limitations of Physiological Theories

Certainly, there is plenty of evidence to support the contribution of genes
to the development of obesity. The specific link remains unclear, as many
theories have emerged about the potential causes (poor metabolism, high
number of fat cells, leptin resistance) of obesity. Further, it is difficult to
isolate the effects of different genes. These theories require additional
research and need to consider the role of the environment in promoting
behaviors that will lead to development of overweight and obesity.

Behavioral Theories of Obesity

Understanding environmental factors that contribute to obesity is vital in
shaping the whole picture. Behavioral theories consider specific behaviors
such as physical activity and nutritional patterns that contribute to one’s
body weight, size, and shape. Physical activity plays an important role in
the energy expenditure part of the caloric equation. Considering the level
of activity one receives on a daily basis can be significant in balancing one’s
food intake. Most important, the level of inactivity or sedentary behavior
has been found to significantly predict the development of overweight and
obesity. Therefore occupations that are primarily sedentary (desk jobs) tend
to carry more risk for obesity than more active occupations. Children and
adults face additional risk by adding screen time from computers, games,
and smartphones. In fact, television watching was associated with an increase
in obesity due to a reduction in energy needs. Moreover, obese girls were
found to be more inactive (77% of the time), whereas girls of a normal
weight were inactive 56 percent of the time. Using stairs rather than the
elevator was found to combat obesity in another study. Finally, physical
activity can be beneficial in reducing food cravings; specifically, walking
was linked to a decrease in chocolate cravings.
Who: Psychologists’ Theories about Eating 109

Eating behavior is also important to consider when understanding obesity.

Obese individuals tended to grow up in families where foods were forbidden.
There has been evidence that obese people were more likely to respond to
external cues (sight or smell of food) for eating rather than internal, biologi-
cal cues (hunger and fullness). Researchers also discovered that obese indi-
viduals were more likely to engage in emotional eating than individuals of
a normal weight. The results have been inconclusive regarding the amount
of food consumed by obese versus normal-weight people. Study findings have
been mixed and suggest that genetics may account for the difference.

Limitations of Behavioral Theories

It has been difficult to generate consistent findings relative to testing
behavioral theories of obesity. Measuring behavior often requires the use
of self-report data. People may have a tendency to paint themselves in a
positive light. That is, participants may tend to overreport positive health
behaviors (consumption of fruits and vegetables, physical activity) while
underreporting negative health behaviors (consumption of fatty foods,
binge episodes, screen time), supporting a social desirability bias.

CONCLUSION
Understanding eating behaviors is complex and requires the consideration
of a multitude of factors including biological, psychological, and social.
Developmental models of food choice are informed by perspectives that
exposure to certain types of food during childhood is paramount and that
behaviors will be influenced by role models. The role of thoughts and emo-
tions related to eating must be considered in cognitive models. Theories
about dieting help us understand the way that restrained eating can
actually lead to the undesired behavior of overeating. Likewise, theories
of obesity have ranged from physiological explanations that take genetic
factors into account to behavioral explanations that identify physical
activity and eating behavior when predicting one’s tendency to become
overweight. In sum, the likely conclusion is that food choice is character-
ized by a developmental process, influenced by genes and the environ-
ment, and disrupted by thoughts and emotions.

BIBLIOGRAPHY
Allison, Kelly C., Scott G. Engel, Ross D. Crosby, Martina de Zwaan, John
O’Reardon, Stephen A. Wonderlich, James E. Mitchell, Delia Smith
110 Filling Up

West, Thomas A. Wadden, and Albert J. Stunkard. “Evaluation of

Diagnostic Criteria for Night Eating Syndrome Using Intern Response
Theory Analysis.” Eating Behaviors 9 (2008): 398–407. doi:10.1016/
j.eatbeh.2008.04.004.
Augustus-Horvath, Casey L., and Tracy L. Tylka. “A Test and Extension
of Objectification Theory as It Predicts Disordered Eating: Does
Women’s Age Matter?” Journal of Counseling Psychology 56, no. 2
(2009): 253–65. doi: 10.1037/a0014637.
Avalos, Laura C., and Tracy L. Tylka. “Exploring a Model of Intuitive
Eating with College Women.” Journal of Counseling Psychology 53,
no. 4 (2006): 486–97. doi:10.1037/0022-0167.53.4.486.
Berge, Jerica M., Katie Loth, Carrie Hanson, Jillian Croll-Lampert, and
Dianne Neumark-Sztainer. “Family Life Cycle Transitions and the
Onset of Eating Disorders: A Retrospective Grounded Theory
Approach.” Journal of Clinical Nursing 21, nos. 9–10 (2012): 1355–63.
doi: 10.1111/j.1365-2702.2011.03762.x.
Capaldi, Elizabeth D. “Conditioned Food Preferences.” In Why We Eat
What We Eat, edited by Elizabeth D. Capaldi, 53–80. Washington,
DC: American Psychological Association, 1996.
de Sampaio, Fernanda Tapajóz P., Sebastian Soneira, Alfredo Aulicino,
Graciela Martese, Monica Iturry, and Ricardo Francisco Allegri.
“Theory of Mind and Central Coherence in Eating Disorders:
Two Sides of the Same Coin?” Psychiatry Research 210, no. 3 (2013):
1116–22. doi: 10.1016/j.psychres.2013.08.051.
de Sampaio, Fernanda Tapajóz P., Sebastian Soneira, Alfredo Aulicino,
and Ricardo Francisco Allegri. “Theory of Mind in Eating Disorders
and Their Relationship to Clinical Profile.” European Eating Disorders
Review 21, no. 6 (2013): 479–87. doi: 10.1002/erv.2247.
Grave, Riccardo D. Multistep Cognitive Behavioral Therapy for Eating
Disorders: Theory, Practice, and Clinical Cases. Lanham, MD: Jason
Aronson, 2013.
Louis, Winnifred R., Marc K.-H. Chan, and Seth Greenbaum. “Stress and
the Theory of Planned Behavior: Understanding Healthy and
Unhealthy Eating Intentions.” Journal of Applied Social Psychology 39,
no. 2 (2009): 472–93. doi: 10.1111/j.1559-1816.2008.00447.x.
McKenzie, James F., Brad L. Neiger, and Rosemary Thackeray. “Theories
and Models Commonly Used for Health Promotion.” In Planning,
Implementing, and Evaluating Health Promotion Programs: A Primer,
162–204. Boston: Pearson, 2013.
Who: Psychologists’ Theories about Eating 111

Ogden, Jane. “An Integrated Model of Diet.” In The Psychology of Eating:

From Healthy to Disordered Behavior, 2nd ed., 276–87. Malden, MA:
Wiley-Blackwell, 2010.
Piquero, Nicole Leeper, Kristan Fox, Alex R. Piquero, George Capowich,
and Paul Mazerolle. “Gender, General Strain Theory, Negative
Emotions, and Disordered Eating.” Journal of Youth and Adolescence 39,
no. 4. (2010): 380–92. doi: 10.1007/s10964-009-9466-0.
Rowland, Neil, and Emily Crews Splane. Psychology of Eating. Boston:
Pearson, 2014.
Rozin, Paul. “Food and Eating.” In Handbook of Cultural Psychology, edited
by Shiobu Kitayama and Dov Cohen, 391–416. New York: Guilford
Press, 2007.
Tiggemeann, Marika. “Objectification Theory: Of Relevance for Eating
Disorder Researchers and Clinicians?” Clinical Psychologist 17, no. 2
(2013): 35–45. doi:10.1111/cp.12010.
Williamson, Donald A., Marney A. White, Emily Yorke-Crowe, and
Tiffany M. Stewart. “Cognitive-Behavioral Theories of Eating
Disorders.” Behavior Modification 28, no. 6 (2004): 711–38. doi:
10.1177/0145445503259853.
 5

When: Eating throughout

the Life Cycle

Eating patterns change throughout the life span, from birth to the time we
grow older. This chapter highlights relevant nutritional concerns specific
to each milestone and stage in the life cycle. The topic of obtaining proper
nutrition during pregnancy or prenatal nutrition is covered, along with
eating issues that arise related to pediatric populations and adolescents.
Once teenagers leave home and grow into adulthood, a new set of chal-
lenges may emerge related to eating the right types and amounts of food.
Finally, as people age, they may find that their taste preferences and
hunger levels shift.

EATING DURING PREGNANCY AND

PRENATAL NUTRITION
During pregnancy, the dietary habits of a mother are paramount for
the healthy development of the growing fetus. The nutritional health
of a mother has been directly correlated to the child’s later health.
Interestingly, the connection between maternal health and the child has
been evident since biblical times, as the Bible made clear that expecting
mothers should avoid alcohol consumption (such as wine) and make
healthy food choices.
114 Filling Up

Poor nutrition has been linked to a variety of consequences, including but

not limited to miscarriage, developmental disabilities, and other mental
health concerns in the unborn child, and death of the infant or mother.
Further, it is the strongest predictor of low birth weight (i.e., body weight
under 5.5 pounds), with 75 percent of low-body-weight cases attributed to
inadequate nutrition during pregnancy. Women of low socioeconomic status,
who may face a lack of access to consistent nutritious food sources and quality
health care, are considered at risk for having poor maternal nutrition and
babies with low birth weight, which has accounted for two-thirds of all post-
neonatal deaths. This link between birth rate and maternal nutrition is sig-
nificant, as children who do survive to school age have less-developed
language and social skills, increased behavioral and attention problems, lower
IQ, and lower academic achievement and cognitive ability. The problems
continue into adulthood, as low fetal and infant growth rates have been cor-
related with increased likelihood to develop cardiovascular disease, diabetes,
or high blood pressure or to experience premature death.

Key Nutrients and Super Foods during Pregnancy

Women who are pregnant need to maintain a balanced diet that takes into
account a higher need for certain nutrients than nonpregnant women.
Supplementing one’s balanced diet with folic acid and vitamin D is recom-
mended to ensure positive pregnancy outcomes. Folate can also be
increased by eating foods like peas, beans, oranges, green leafy vegetables
such as spinach and potatoes. Pregnant women and women who are
breastfeeding can increase vitamin D by taking a dietary supplement.
Iron, omega-3 fatty acids, and calcium also represent key nutrients for
women to monitor during pregnancy. In general, the need to supplement
iron will be individualized and highly dependent on a woman’s iron status
prior to pregnancy. Iron-rich foods can be used to supplement diet, such as
red meat (e.g., lamb, beef, and pork), fish, beans, breakfast cereals that are
fortified with iron, dried fruit, and green vegetables. Omega-3 fats can be
consumed in the form of oily fish or supplements. Calcium generally does
not need to be supplemented; however, adequate intake can be ensured
if pregnant women consume foods like milk, cheese, yogurt, and tofu on
a daily basis.

Foods to Avoid or Limit during Pregnancy

While certain nutrients should be boosted or supplemented, other foods or
drinks should be discouraged when considering the diet of pregnant
When: Eating throughout the Life Cycle 115

women, including certain types of fish, liver, alcohol, and caffeine. Liver
and liver products (pâté) should be avoided due to high levels of retinol.
Although oily fish, which represents a rich source of omega-3 fats, can be a
healthy part of a balanced diet, it should be limited to two servings per week
due to other contents that may be damaging to the fetus. Tuna should be lim-
ited as well as swordfish, marlin, and shark due to high mercury levels in the
fish. Sushi and raw shellfish such as shrimp, cockles, and mussels should be
eaten with caution, as they may present a food safety risk.
As indicated above, alcohol has been discouraged during pregnancy for
centuries. Scientific evidence is clear that there is a link between alcohol
consumption during any stage of pregnancy and a variety of risks for the
fetus, including increased likelihood of a miscarriage. Specifically, alcohol
in the mother’s bloodstream actually crosses the placenta into the fetus’s
bloodstream. A potential consequence of drinking during pregnancy is
having an increased risk for fetal alcohol syndrome, which features a small
head and congenital abnormalities. Alcohol consumption also undermines
the utilization and absorption of folate, which is strongly encouraged
during pregnancy. Generally, it is not advisable to drink at all during preg-
nancy; however, small amounts of alcohol (i.e., no more than once or
twice per week) have not been shown to be harmful.
Caffeine consumption can also be detrimental during pregnancy.
Specifically, caffeine intake has been associated with low birth weight of
the child or increased risk for miscarriage. It is important to consider that
caffeine can be found in a variety of foods and beverages including espresso
(140 milligrams for a shot), tea (75 milligrams), brewed or instant coffee
(100 milligrams), soft drinks (40 milligrams), energy drinks (80 milli-
grams), and chocolate bars (25–50 milligrams), as well as in certain types
of cold and flu medications. It is recommended that caffeine consumption
be limited to no more than 200 milligrams daily during pregnancy.

Food Cravings during Pregnancy

It is not uncommon for a woman to experience changes related to appetite
and taste of certain foods during pregnancy. Food cravings usually re-
present a normal response to hormonal changes or physiological changes
in the body. For example, a woman may suddenly desire a food she previ-
ously did not like before becoming pregnant. This is not a cause for con-
cern as long as she maintains a healthy balanced diet throughout
pregnancy and does not consume anything on the list of foods to be
avoided. A rare condition called pica refers to a craving for nonfood items,
such as coal, chalk, and soap.
116 Filling Up

INFANT NUTRITION
Nutritional demands during infancy can be satisfied by breastfeeding.
An alternative to breastfeeding, infant formula, can provide the necessary
nutrition for a baby from birth to six months. Vitamin D supplementation
may be required beginning at one month for babies whose mothers did not
supplement with vitamin D during pregnancy. Exclusive breastfeeding or
feeding pumped breast milk as a choice has been associated with providing
complete nutritional requirements for the baby prior to the introduction of
solid foods as well as protection against a variety of illnesses.
Nutritional needs for a mother who is breastfeeding include ensuring
adequate amounts of vitamin D, calcium, and vitamin B12 (especially for
vegan mothers). Strict dieting should be avoided during breastfeeding,
In addition, breastfeeding mothers should limit oily fish, alcohol, and
caffeine consumption to avoid disruptions for their infant.
Weaning refers to the transition in an infant’s nutritional intake to slowly
introduce solid foods to accompany the milk feeding (breastfeeding or for-
mula). The purpose of weaning is to increase caloric intake for infants six
months or older and to expose infants to a variety of new tastes and textures
of foods. It is ideal that throughout the weaning period for breast milk or for-
mula to serve as the primary source of nutrition. Solid foods in stage 1 of
weaning may include a smooth puree or well-mashed food as well as any vari-
ety of commercially available baby foods. Initially, it is suggested that soft and
mushy versions of the following be introduced to the infant: vegetables,
fruits, chick peas, plain yogurt, and well-cooked meat or eggs.
During the period of six to nine months (weaning stage 2), once an
infant has transitioned to solid foods, new textures can be slowly intro-
duced. For example, foods can have a thicker mash with soft lumps.
Limited finger foods may be offered to infants. Infants also begin learning
how to sip liquids like water from a cup.
The third stage of weaning involves nutritional exposure during 9 to
12 months of infancy. At this time, infants should be offered diverse types
of foods representing a variety of food groups and tastes. Salt and sugar
should be limited but should reflect a balanced family meal that includes
grains, fruits, vegetables, and meat. Food during this phase can incorporate
chopped or minced textures. Family meals should model a balanced diet
that is not based on convenience foods. In summary, infant nutrition
should be deliberate and intentional. Breastfeeding is considered the gold
standard, and solid foods should be avoided in the first six months.
By exposing infants to a variety of tastes, textures, and food groups from
a young age, they are more likely to develop a balanced and healthy diet.
When: Eating throughout the Life Cycle 117

NUTRITIONAL CONCERNS FOR CHILDREN

AND ADOLESCENTS
Children and adolescents have specific nutritional needs. Once weaning is
over, parents of preschool children are advised to provide healthy snacks
and meals for toddlers. Nutritional recommendations for primary-school-
age children and adolescents will differ. Education and prevention around
certain conditions such as obesity, diabetes, and eating disorders will also
be explored in this section.

Preschool Children
Children between the ages of one and four years old benefit from being
offered nutritious family meals that serve as an extension of the third
stage of weaning during infancy, although younger toddlers may require
assistance cutting up food into smaller portions. Toddlers also require
more calories for their body weight (70 kilocalories for every kilogram
of body weight) than adults (35 kilocalories for every kilogram they
weigh) to support their growth and development. Ideally, their snacks
and meals are packed with nutrient-rich food choices. One challenge
related to getting enough food is that toddlers’ stomachs are small and
they will feel overstuffed quickly. Generally, toddlers are (and should
be) physically active, which should be accounted for relative to nutri-
tional intake.
It is recommended that preschool children receive foods that represent
all of the food groups and a balanced diet. Bread, rice, pasta, and potatoes
provide much-needed energy for these toddlers, but too much fiber should
be avoided. Fruits and vegetables may be less popular with this age group;
however, it is important to continue offering them at every meal. Parents
can encourage these power foods by adding them to popular foods like
pizza and macaroni and cheese or by blending them into a smoothie.
Milk, cheese, and yogurt needs decrease to merely three servings of dairy
per day. Toddlers may be picky about meats and certain textures. In gen-
eral, fish should be limited to two servings per week for girls and four serv-
ings per week for boys. It is not recommended that children under five
years of age be served swordfish, marlin, or shark due to the high mercury
content of these types of fish. Foods and beverages that are packed with
fat and sugar should be limited, and it is important for these popular treats
to not replace more nutritious dietary choices. Providing a sweet and nutri-
tious pudding might be a way to satisfy a toddler’s sweet tooth while still
meeting dietary requirements and avoiding tooth decay.
118 Filling Up

Soft drinks may lead to tooth decay and should be discouraged.

Beverages like water and milk should be consumed instead of sugary ones.
Fruit juices have high sugar and should be diluted and limited to mealtimes
to reduce the risk of tooth decay. Beverages like coffee and tea are not
encouraged for young children due to caffeine and tannin content.
To avoid food poisoning, all foods should be thoroughly cooked for chil-
dren under five years of age.

Primary-School-Age Children
From the age of five years old, children are highly influenced by their envi-
ronment. Eating behaviors of children tend to reflect the actions of others
around them rather than their own biological cues of hunger. Parents are
key role models and offer social cues to children, who watch carefully
about how to respond. Further, parental behavior around what foods are
provided and when they are consumed is the primary driver behind their
children’s eating patterns. Generally, children will choose sweet and salty
foods over more nutritious ones, and healthy choices like fruits and vegeta-
bles will need to be accessible and encouraged.
Around the age of seven years old, the influence of peers becomes more
important. The energy intake needs of children will vary depending on
their size, gender, and level of physical activity. Certainly, being under-
weight is cause for concern, as is dieting behavior. Children at a young
age can demonstrate body dissatisfaction and may restrict their food intake
in order to control their weight. This focus on body weight was often
found to be related to parental attitudes and comments around their
bodies, weight, and food.
Just as for preschool children, efforts should be made to decrease sugar
consumption in order to prevent tooth decay. Unfortunately, school
lunches are often determined to be loaded with sugar, fats, and calories.
Some popular school items are pizza, burgers, corn dogs, tater tots, cakes,
buns, and doughnuts. Packed lunches can also contain poor nutritional
content. Research has indicated that packed lunches often lack any fruit
while containing foods dense in salt and sugar like cracker packs, cookies,
and chocolate bars. These lunches can set children and adolescents up for
higher risk of developing obesity and diabetes.

Adolescents
The period of adolescence represents the transition from childhood to
adulthood. The body and mind experience a number of changes.
Physical development occurs, including puberty, and may involve growth
When: Eating throughout the Life Cycle 119

spurts as well as increased fat tissue and breast development for girls.
Adolescents also experience emotional changes and may begin to question
their parents. While children’s eating patterns tend to mimic those of their
parents and peers, adolescents may adopt perspectives that are different
from the rest of their family. For example, they may opt for independence
and prepare their own meals. Another common trend is for adolescents to
choose a vegetarian or vegan lifestyle that is devoid of meats or animal
products. They may claim that their new dietary choices are based on eth-
ical decisions related to treatment of animals or more tied to a decision to
be more healthful.
Food choices of adolescents are highly influenced by their peer group
and convenience. They may have school lunches or go off-campus for
lunch. Fast-food restaurants and convenience stores may supply junk food
as a substitute for their regular meals. They will also be influenced by their
peers’ tastes, preferences, and the brands of foods they prefer. Many adoles-
cents will take strong stands about where the food comes from and adopt
certain ideologies about food (e.g., the decision not to eat meat).
Adolescents will also demonstrate a stronger preoccupation with their
bodies and weight control. Likewise, patterns of emotional eating (i.e., eat-
ing to cope with strong emotions) may be present rather than eating mind-
fully or when one is hungry. Snacking or grazing behavior is also common
among this age group. Unfortunately, the majority of these snacks are usu-
ally represented by calorically dense sugary foods with low or no nutri-
tional value. Therefore adolescents may find themselves at increased risk
for becoming overweight or obese.

Obesity and Diabetes

Dietary factors are considered a primary contributing factor for developing
overweight, obesity, and other health-related concerns like diabetes.
Although physical activity serves as a protective factor against obesity
and plays an important role in affecting the youth’s ability to expend
calories consumed, the focus of this chapter will be on nutritional habits.
Some hot topics such as meal patterns, sugar-filled beverages, consumption
of fast food, and portion sizes will be covered. Children and adolescents
may face a number of challenges that can put them at increased risk for
becoming overweight or obese. There is strong evidence that an overall
lack of knowledge has resulted in excessive caloric intake and teaching
kids to reward themselves with particular food choices.
Specifically, a lack of nutrition education has shown that parents may
begin feeding children “junk foods” from a young age because kids show
120 Filling Up

a strong preference for them. The approach of “eat your vegetables so you
can have dessert” seems like the optimal solution for the problem of get-
ting children to eat foods they would rather avoid. Unfortunately, this
early socialization of labeling foods as “good” and “bad” may backfire.
Children may develop a bias against healthier foods and may assign posi-
tion associations to sugary foods like cookies and brownies that are used
as rewards. When food is used as a reward or punishment, children learn
to attach emotions to eating rather than consuming food for strictly bio-
logical reasons (e.g., “I am hungry, so I’ll eat this apple.”). This condi-
tioned emotional eating sets up the child or adolescent to reach for
comfort foods or treats when coping with intense feelings, as in the follow-
ing scenario: “I feel sad. I was picked on today by the other kids. I’m going
to help myself feel better by eating these salty chips. I like chips, so I can
experience that small pleasure.”
This learned response for coping with strong emotions does not stop
and can be carried into adulthood. Being an emotional eater can result
in overeating, undereating, and mindless eating (i.e., not paying attention
while one is consuming food). Food also can be used as a reward for a job
well done or to celebrate an event. In our culture, we learn from a young
age that birthday parties will almost always include a cake of some kind
and some food for the guests. We honor religious holidays like Christmas
and Easter with treats (often candy) in a stocking or basket. Still other hol-
idays are completely centered around the collection of sweet items.
Halloween, for example, involves having children go door-to-door to
obtain a variety of candy confections from strangers.
Childhood obesity has been linked with several dietary factors: beverage
consumption, meal patterns and frequency, television viewing, fast-food
consumption, and portion sizes. Sugar-sweetened beverages like soft drinks
have increased in popularity and consumption for children and adoles-
cents since the 1980s. In fact, 21 percent of an American’s total caloric
intake comes from beverages. A 12-ounce can of Pepsi has 150 calories,
but fruit juices, sweetened coffee, and energy drinks can also be calorie cul-
prits. These sugary beverages are associated with excessive dietary intake
for the day unless physical activity levels are increased to accommodate
for the calorie load. The consumption of these beverages has been shown
to predict overweight and obesity among children and adolescents. It has
also been found that children drink more soft drinks as they get older.
Nutrition experts agree that youth should learn early to replace calorically
dense beverages with water to promote hydration and health.
Another factor that contributes to weight gain is skipping breakfast.
The number of children and adolescents who eat a regular breakfast has
When: Eating throughout the Life Cycle 121

dramatically declined since the 1970s (as their soft drink consumption has
risen). It is estimated that 10 to 13 percent of children and adolescents do
not have breakfast. By contrast, snacking between meals has increased
among children and teenagers. Unfortunately, snacks represented a signifi-
cant caloric load on young people’s dietary intake. This increase was
attributed to the preference for snacks that were “empty calories” or those
foods that tended to be high in sugar, salt, and fat. Ideally, these snacks
would be replaced with healthy choices such as fruits and vegetables to
prevent childhood obesity.
Sedentary activities such as television watching, working on the com-
puter, and playing computer games can also increase risk for overweight
and obesity among children and adolescents. This “screen time” has been
associated not only with physical inactivity but also with increased snack-
ing behavior. Specifically, studies demonstrate that children who were
watching television ingested more calories than children who had the tele-
vision turned off. The explanation for this difference was the level of
attention to bodily cues of hunger and fullness. The television (or another
device like one’s smartphone) creates a distraction that inhibits one’s
degree of mindfulness around eating. Easily consumed foods like potato
chips tend to be preferred for snacking, resulting in excessive caloric
intake. An additional challenge related to television is that so many com-
mercials feature sugary and unhealthy treats and fast-food establishments.
The popularity of fast-food restaurants has exponentially increased,
with a noticeable impact on U.S. children and adolescents. With the
home environment shifting since the 1970s wherein one parent tended
to stay home to one where both parents are working, youth are often in a
position to fend for their own meals. Foods consumed at home are often
quickly prepared, and fast food is a common solution for dinner. It is esti-
mated that 30 percent of youth aged 4 to 19 years of age consume fast food
on a daily basis. Unfortunately, fast-food restaurants serve calorically dense
foods, large portion sizes, and large amounts of sodium, sugar, and fat.
Further, these foods do not meet the fruit, vegetable, and fiber intake rec-
ommended by the USDA for healthy nutrition.
In addition to increased fast-food consumption since the 1970s,
American portion sizes have expanded in all settings. This “Costco” men-
tality of ‘the larger the better’ can be observed in grocery stores, food ware-
houses, restaurants, and even the preparation of meals at home. There is a
direct correlation between these larger portion sizes and higher caloric
intake. Moreover, overeating can lead to a tendency for children and ado-
lescents to disregard feelings of fullness. When lack of attention is paid to
biological cues of fullness (and hunger), overweight and obesity may occur;
122 Filling Up

therefore it is critical to educate youth and their families about appropriate

portion sizes.

Eating Disorders
During adolescence, the focus on one’s body, shape, weight, and size is
intensified. Body dissatisfaction, which is the strongest predictor of eating
disorders, is pervasive among both male and female adolescents. Further,
eating disorders have been shown to be the outgrowth of dieting behavior.
Therefore a teenager who innocently begins to restrict food intake to lose
five pounds may begin to experience an obsession around continued
weight loss and additional attempts to control eating.
There are several types of eating disorders that fall along a spectrum of
disordered eating behaviors. The most recognizable eating disorder, ano-
rexia nervosa, involves the severe restriction of food associated with nega-
tive body image. This restriction is accompanied by sharp and rapid weight
loss at an unhealthy level for one’s height and may be associated with the
loss of a menstrual cycle for girls.
Another eating disorder, bulimia nervosa, is characterized by periods of
binge eating or eating too much, followed by the use of a purging method
to eliminate the food. Examples of compensatory behavior used to purge
include vomiting, the abuse of laxatives, diuretics, enemas, and excessive
exercise. This binge-purge cycle is weekly and occurs over the period of
several months. Bulimia nervosa also features body dissatisfaction and hav-
ing an intense focus on one’s body shape and size.
Binge eating disorder involves overeating that occurs within a short
period of time. Binge episodes are associated with feeling out of control
and are followed by intense guilt. Individuals with binge eating disorder
do not use a compensatory method to purge food. All of these eating disor-
ders are problematic and can lead to negative health consequences.
Moreover, eating disorders can start at a young age (even in childhood)
and may persist into adulthood if left untreated. Despite the common mis-
conception that people can “grow out” of eating disorders, research has
found that individuals will likely continue to struggle without appropriate
intervention.

NUTRITIONAL CONCERNS IN ADULTHOOD

As adolescents transition into adulthood, numerous factors impact their
eating patterns. For example, habits around eating such as a tendency
toward mindless or distracted eating (e.g., eating in the car or in front
When: Eating throughout the Life Cycle 123

of the television) have been well established. Emotional eating to soothe

intense feelings may dictate the type of foods consumed as well as
increase the likelihood that a person may ignore his or her physiological
cues of hunger and fullness. One’s environment, whether a college dorm
or a family home setting, will influence the availability of certain types of
foods, accessibility to healthy food choices (like grocery stores), and a
culture of healthy or unhealthy nutritional patterns. It is important to
note that certain milestones are especially ripe for discussion around
nutritional requirements. The need for special attention to maternal
nutrition during pregnancy was described in an earlier section. In the
following section, the nutritional needs and challenges of college stu-
dents, menopause, and older adults will be covered as critical times in
adulthood.

College Nutrition and the “Freshman 15”

The period of time, often dubbed “coming of age,” when an adolescent
moves into adulthood represents a monumental transition in nutritional
health. Although not all individuals will pursue a college experience, this
point in the life cycle is popularly captured in movies and television shows.
Further, research studies have examined the opportunities and challenges
faced when a person leaves the “nest.” In fact, the term “Freshman 15”
has been coined to represent an expectation that weight gain will occur
in the first year of college.
Although the actual numbers are up for debate (as highlighted in Part
III of this book), college students face some real barriers to healthy eating.
Specifically, the college dorm setting is not conducive to healthy, balanced
meals. A student may have a microwave, hot plate, or the ability to order
late-night pizza delivery. The meal plans at universities are now widely var-
ied and may include healthy options or be dominated by less-than-healthy
offerings. Most universities have moved toward bringing fast-food outlets
such as Pizza Hut, Subway, and Chick-fil-A onto campus.
Dining halls may provide the largest variety of options and represent the
most reliable source of fruits and vegetables, but college students experi-
ence a newfound independence to eat the way they want. Whether the
college student lives on campus, in an apartment, or at home, he or she
will be stressed with class, work, and social life responsibilities that may
negatively impact the opportunity to follow a balanced nutrition plan.
Unfortunately, as college students graduate and enter their working career,
they will experience a similar challenge of long workdays and a limited
ability to eat substantive and nutrient-dense meals.
124 Filling Up

Menopause
A midlife milestone, menopause, is part of the reproductive life cycle for a
woman. The beginning of the life cycle (i.e., premenopause phase) hap-
pens at the time of puberty, usually around age 12 or 13 for girls.
Menstruation, which is commonly referred to as a female’s period, occurs
in cycles of 28 days. The next phase, perimenopause, represents a meno-
pausal transition between puberty and menopause and is often character-
ized by intense hormonal changes. Menopause is defined as the point of a
female’s last period; however, she will technically not experience meno-
pause until a year following her last menstrual cycle. Finally, postmeno-
pause represents the span of time following menopause.
A number of physical changes occur during menopause, including hor-
monal changes, increased fat tissue, changes in menstrual bleeding pat-
terns, and hot flashes. A hot flash refers to an intense feeling of increased
temperature and heat in the body that may result in perspiration and red
blotchy skin. Hot flashes can also be associated with “night sweats,” which
occur during a woman’s sleep. Hot flashes can occur from perimenopause
to postmenopause. More evidence is needed, but anecdotal reports suggest
that certain foods (spicy or hot foods) and alcohol may trigger hot flashes.
Generally, the recommended nutritional guidelines for women in meno-
pause follow those for middle-aged and older women.

Older Adults
The American College of Sports Medicine recommends that as people age
they adopt a healthy lifestyle around their daily dietary habits. For aging,
taking a moderate and balanced approach to exercise and nutrition is
advised rather than focusing on “good” and “bad” foods. Some of the
advice for nutrition in aging is familiar. Adults are encouraged to eat a
breakfast daily that may include fruits, low-fat milk, yogurt, and/or a
bran-type or fortified cereal to supplement fiber and vitamins. Older adults
are encouraged to obtain sufficient protein in their diet through items like
skinless chicken and other lean meats. Consuming plenty of water is
important, and older adults should be encouraged to substitute beverages
like coffee, tea, soft drinks, and alcohol with water.
Older adults should be particularly cognizant of obtaining adequate fiber
intake in their diet. Fiber can be consumed in the form of a supplement
(e.g., Benefiber) found on drugstore shelves, whole-grain cereals, raw veg-
etables and fruits with skin, and dry beans. In general, although the con-
cept of dieting or avoiding “bad” foods does not apply, it is important as
When: Eating throughout the Life Cycle 125

in any other life stage to limit sugars and highly processed foods. Sweets can
be eaten as a “treat” but should be minimized. It is also important for adults
to recognize that as their physical activity increases, their caloric needs will
also rise. Therefore daily exercise allows for 100 to 400 calories more in an
adult’s diet and should represent the inclusion of healthy food choices.
Women will need to pay close attention to calcium and vitamin D lev-
els as they age. Their need for calcium will increase to 1,500 milligrams
daily once they are over the age of 50. To avoid health problems the rec-
ommended vitamin D levels increase with age as well; however, care
should be taken to not ingest too much vitamin D.

CONCLUSION
This chapter has highlighted the nutritional concerns throughout the life
cycle. Each phase—from prenatal nutrition to older adults—has been
covered, with attention to special milestones. Although each stage of life
may differ in nutritional requirements, generally a balanced diet that
emphasizes fruits and vegetables is encouraged to promote one’s level of
optimal health.

BIBLIOGRAPHY
Anderson, Drew A., Angela M. Simmons, Matthew P. Martens, Amanda
G. Ferrier, and Melissa J. Sheehy. “The Relationship between
Disordered Eating Behavior and Drinking Motives in College-Age
Women.” Eating Behaviors 7, no. 4 (2006): 419–22. Accessed
March 1, 2016. doi: 10.1016/j.eatbeh.2005.12.001.
Bailly, Nathalie, Isabelle Maître, and Virginie Van Wymelbeke.
“Relationships between Nutritional Status, Depression and Pleasure of
Eating in Aging Men and Women.” Archives of Gerontology and
Geriatrics 61, no. 3 (2015): 330–36. Accessed March 1, 2016. doi:
10.1016/j.archger.2015.08.020.
Beck, David, Regina Casper, and Arnold Andersen. “Truly Late Onset of
Eating Disorders: A Study of 11 Cases Averaging 60 Years of Age at
Presentation.” International Journal of Eating Disorders 20, no. 4 (1996):
389–95. Accessed March 1, 2016. doi: 10.1002/(SICI)1098-108X
(199612)20:4<389::AID-EAT6>3.0.CO;2-J.
Bennett, Jessica, Geoffrey Greene, and Donna Schwartz-Barcott.
“Perceptions of Emotional Eating Behavior. A Qualitative Study of
College Students.” Appetite 60, no. 1 (2013): 187–92. Accessed
March 1, 2016. doi: /10.1016/j.appet.2012.09.023.
126 Filling Up

Braet, Caroline, Barbara Soetens, Ellen Moens, Saskia Mels, Lien

Goossens, and Leen Van Vlierberghe. “Are Two Informants Better than
One? Parent-Child Agreement on the Eating Styles of Children Who
Are Overweight.” European Eating Disorders Review 15, no. 6 (2007):
410–17. Accessed March 2, 2016. doi: 10.1002/erv.798.
Brandsma, Lynn. “Eating Disorders across the Life Span.” Journal of
Women & Aging 19, nos. 1–2 (2007): 155–72. Accessed March 2,
2016. doi: 10.1300/J074v19n01_10.
Branen, Laurel, and Janice Fletcher. “Comparison of College Students’
Current Eating Habits and Recollections of their Childhood Food
Practices.” Journal of Nutrition Education and Behavior 31, no. 6 (1999):
304–10. Accessed March 2, 2016. doi: 10.1016/S0022-3182(99)
70483-8.
Bravo, Irene Maria, and Melissa Noya. “Culture in Prenatal Development:
Parental Attitudes, Availability of Care, Expectations, Values, and
Nutrition.” Child Youth Care Forum 43, no. 4 (2014): 521–38.
Accessed March 2, 2016. doi: 10.1007/s10566-014-9251-4.
Carolan-Olah, Mary, Maria Duarte-Gardea, and Julia Lechug. “A Critical
Review: Early Life Nutrition and Prenatal Programming for Adult
Disease.” Journal of Clinical Nursing 24, nos. 23–24 (2015): 3716–29.
Accessed March 2, 2016. doi: 10.1111/jocn.12951.
Clark, Phillip G., Bryan J. Blissmer, Geoffrey W. Greene, Faith D. Lees,
Deborah A. Riebe, and Karen E. Stamm. “Maintaining Exercise and
Healthful Eating in Older Adults: The SENIOR Project II: Study
Design and Methodology.” Contemporary Clinical Trials 32, no. 1
(2011): 129–39. Accessed March 2, 2016. doi: 10.1016/j.cct.2010
.10.002.
Daniels, Stephen R. “The Consequences of Childhood Overweight and
Obesity.” The Future of Children 16, no. 1 (2006): 47–67. Accessed
March 2, 2016. doi: 10.1353/foc.2006.0004.
De Castro, John M., and Sandor J. Goldstein. “Eating Attitudes and
Behaviors of Pre- and Postpubertal Females: Clues to the Etiology of
Eating Disorders.” Physiology & Behavior 58, no. 1 (1995): 15–23.
Accessed March 2, 2016. doi: 10.1016/0031-9384(95)00027-G.
Domoff, Sarah E., Alison L. Miller, Niko Kaciroti, and Julie C. Lumeng.
“Validation of the Children’s Eating Behaviour Questionnaire in a
Low-Income Preschool-Aged Sample in the United States.” Appetite
95 (2015): 415–20. Accessed March 2, 2016. doi: 10.1016/j.appet
.2015.08.002.
Dovey, Terence M., Paul A. Staples, E. Leigh Gibson, and Jason C. G.
Halford. “Food Neophobia and ‘Picky/Fussy’ Eating in Children:
When: Eating throughout the Life Cycle 127

A Review.” Appetite 50 (2008): 181–93. Accessed March 2, 2016. doi:

10.1016/j.appet.2007.09.009.
Edahiro, Ayako, Hirohiko Hirano, Ritsuko Yamada, Yumi Chiba, Yutaka
Watanabe, Morio Tonogi, and Gen-yuki Yamane. “Factors Affecting
Independence in Eating among Elderly with Alzheimer’s Disease.”
Geriatrics & Gerontology International 12, no. 3 (2012): 481–90.
Accessed March 2, 2016. doi: 10.1111/j.1447-0594.2011.00799.x.
Erinosho, Temitope O., Derek P. Hales, Christina P. McWilliams, Josie
Emunah, and Dianne S. Ward. “Nutrition Policies at Child-Care
Centers and Impacts on Role Modeling of Healthy Eating Behaviors
of Caregivers.” Journal of the Academy of Nutrition and Dietetics 112,
no. 1 (2012): 119–24. Accessed March 2, 2016. doi: 10.1016/j.jada
.2011.08.048.
Fisher, Jennifer O., and Tanja V. E. Kral. “Super-Size Me: Portion Size
Effects on Young Children’s Eating.” Physiology & Behavior 94, no. 1
(2008): 39–47. Accessed March 2, 2016. doi: 10.1016/j.physbeh
.2007.11.015.
Fox, Edward A. “Purdue Ingestive Behavior Research Center Symposium
2007: Influences on Eating and Body Weight over the Lifespan—
Childhood and Adolescence.” Physiology & Behavior 94, no. 1 (2008):
1–7. Accessed March 2, 2016. doi: 10.1016/j.physbeh.2007.11.013.
Franko, Debra L., Douglas Thompson, Robert Bauserman, Sandra G.
Affenito, and Ruth H. Striegel-Moore. “What’s Love Got to Do with
It? Family Cohesion and Health Eating Behaviors in Adolescent
Girls.” International Journal of Eating Disorders 41, no. 4 (2008):
360–67. Accessed March 2, 2016. doi: 10.1002/eat.20517.
Fulkerson, Jayne A., Nicole Larson, Melissa Horning, and Dianne
Neumark-Sztainer. “A Review of Associations between Family or
Shared Meal Frequency and Dietary Weight Status Outcomes across
the Lifespan.” Journal of Nutrition Education and Behavior 46, no. 1
(2014): 2–19. Accessed March 2, 2016. doi: 10.1016/j.jneb.2013
.07.012.
Galloway, Amy T., Claire V. Farrow, and Denise M. Martz. “Retrospective
Reports of Child Feeding Practices, Current Eating Behaviors, and BMI
in College Students.” Obesity 18, no. 7 (2010): 1330–35. Accessed
March 2, 2016. doi: 10.1038/oby.2009.393.
Gregory, Jane E., Susan J. Paxton, and Anna M. Brozovic. “Maternal
Feeding Practices, Child Eating Behaviour and Body Mass Index in
Preschool-Aged Children: A Prospective Analysis.” International
Journal of Behavioral Nutrition and Physical Activity 7 (2010): 1–10.
Accessed March 2, 2016. doi: 10.1186/1479-5868-7-55.
128 Filling Up

Hale, Matthew W., Sarah J. Spencer, Bruno Conti, Christine L. Jasoni,

Stephen Kent, Morgan E. Radler, Theresa M. Reyes, and Luba
Sominsky. “Diet, Behavior, and Immunity across the Lifespan.”
Neuroscience and Biobehavioral Reviews 58 (2015): 46–62. Accessed
March 2, 2016. doi: 10.1016/j.neubiorev.2014.12.009.
Hebl, Michelle R., Enrica N. Ruggs, Sarah L. Singletary, and Daniel J.
Beal. “Perceptions of Obesity across the Lifespan.”Obesity Journal 16,
no. 2 (2008): S46–52. Accessed March 2, 2016. doi: 10.1038/
oby.2008.458.
Heron, Kristin E., Stacey B. Scott, Martin J. Sliwinski, and Joshua M.
Smyth. “Eating Behaviors and Negative Affect in College Women’s
Everyday Lives.” International Journal of Eating Disorders 47, no. 8
(2014): 853–59. Accessed March 2, 2016. doi: 10.1002/eat.22292.
Hou, Fangli, Shaojun Xu, Yuqiu Zhao, Qingyun Lu, Shichen Zhang, Ping
Zu, Ying Sun, Puyu Su, and Fangbiao Tao. “Effects of Emotional
Symptoms and Life Stress on Eating Behaviors among Adolescents.”
Appetite 68 (2013): 63–68. Accessed March 2, 2016. doi:10.1016/
j.appet.2013.04.010.
Jenkins, Paul E., Renee R. Hoste, Angela C. Doyle, Kamryn Eddy, Ross D.
Crosby, Laura Hill, Pauline Powers, James E. Mitchell, and Daniel Le
Grange. “Health-Related Quality of Life among Adolescents with
Eating Disorders.” Journal of Psychosomatic Research 76, no. 1 (2014):
1–5. Accessed March 2, 2016. doi: 10.1016/j.jpsychores.2013.11.006.
Johannsen, Darcy L., Neil M. Johannsen, and Bonny L. Specker.
“Influences of Parents’ Eating Behaviors and Child Feeding Practices
on Children’s Weight Status.” Obesity 14, no. 3 (2006): 431–39.
Accessed March 2, 2016. doi: 10.1038/oby.2006.57
Kant, Ashima K., and Barry I. Graubard. “40-Year Trends in Meal and
Snack Eating Behaviors in American Adults.” Journal of the Academy
of Nutrition and Dietetics 115, no. 1 (2015): 50–63. Accessed March 2,
2016. doi: 10.1016/j.jand.2014.06.354.
Le Grange, Daniel, Meredith O’Connor, Elizabeth K. Hughes, Jacqui
Macdonald, Keriann Little, and Craig A. Olsson. “Developmental
Antecedents of Abnormal Eating Attitudes and Behaviors in
Adolescence.” International Journal of Eating Disorders 47, no. 7 (2014):
813–24. Accessed March 2, 2016. doi: 10.1002/eat.22331.
Lioret, Sandrine, Mathilde Touvier, Lionel Lafay, Jean-Luc Volatier, and
Bernard Maire. “Are Eating Occasions and Their Energy Content
Related to Child Overweight and Socioeconomic Status?” Obesity 16,
no. 11 (2008): 2518–23. Accessed March 2, 2016. doi: 10.1038/
oby.2008.404.
When: Eating throughout the Life Cycle 129

Lovell, Jennifer L. “How Parents Process Child Health and Nutri-

tion Information: A Grounded Theory Model.” Appetite 97, no. 1
(2016): 138–45. Accessed March 2, 2016. doi: 10.1016/j.appet
.2015.11.024.
Mangweth-Matzek, Barbara, Claudia I. Rupp, Armand Hausmann, Karin
Assmayr, Edith Mariacher, Georg Kemmler, Alexandra B. Whitworth,
and Wilfred Biebl. “Never Too Old for Eating Disorders or Body
Dissatisfaction: A Community Study of Elderly Women.” International
Journal of Eating Disorders 39, no. 7 (2006): 583–86. Accessed
March 2, 2016. doi: 10.1002/eat.20327.
Mata, Jutta, Ronald Frank, and Ralph Hertwig. “Higher Body Mass Index,
Less Exercise, but Healthier Eating in Married Adults: Nine
Representative Surveys across Europe.” Social Science and Medicine 138
(2015): 119–27. Accessed March 2, 2016. doi: 10.1016/j.socscimed.
2015.06.001.
McBride, Brent A., and Dipti A. Dev. “Preventing Childhood Obesity:
Strategies to Help Preschoolers Develop Healthy Eating Habits.”
Young Children: Journal of the National Association for the Education of
Young Children 69, no. 5 (2014): 36–42. Accessed March 2, 2016.
http://digitalcommons.unl.edu/famconfacpub/112/.
McCabe, Marita P., and Lina A Ricciardelli. “Body Image Dissatisfaction
among Males across the Lifespan: A Review of Past Literature.”
Journal of Psychosomatic Research 56, no. 6 (2004): 675–85. Accessed
March 2, 2016. doi: 10.1016/S0022-3999(03)00129-6.
McClain, Arianna D., Mary Ann Pentz, Selena T. Nguyen-Rodriguez,
Hee-Sung Shin, Nathanial R. Riggs, and Donna Spruijt-Metz.
“Measuring the Meanings of Eating in Minority Youth.” Eating
Behaviors 12, no. 4 (2011): 277–83. Accessed March 2, 2016. doi:
10.1016/j.eatbeh.2011.07.010.
Meena, Taruna, and Nandini Rekhade. “Impact of Nutrition Education
on Eating Habits of Both Parents and Children While Treating
Childhood Obesity.” International Journal of Food, Nutrition, and
Dietetics 1, no. 3 (2013): 87–91. Accessed March 2, 2016. http://search
.proquest.com/openview/d2eedd2c7cb1ae6b9124dfe93ef814d5/1.pdf ?
pq-origsite=gscholar&cbl=2031936.
Migraine, Audrey, Sophie Nicklaus, Patricia Parnet, Christine Lange,
Sandrine Monnery-Patris, Clotilde Des Robert, Dominique Darmaun,
Cyril Flamant, Valerie Amarger, and Jean-Christophe Rozé. “Effect of
Preterm Birth and Birth Weight on Eating Behavior at 2 y of Age.”
American Journal of Clinical Nutrition 97 (2013): 1270–77. Accessed
March 2, 2016. doi: 10.3945/ajcn.112.051151.
130 Filling Up

Moller, Lisanne M., Marieke L. A. de Hoog, Manon van Eijsden, Reinoud

J. B. J. Gemke, and Tanja G. M. Vrijkotte. “Infant Nutrition in
Relation to Eating Behaviour and Fruit and Vegetable Intake at Age 5
Years.” British Journal of Nutrition 109, no. 3 (2013): 564–71. Accessed
March 2, 2016. doi: 10.1017/S0007114512001237.
Moschonis, George, Alexandra Georgiou, Katerina Sarapi, and Yannis
Manios. “Association of Distorted Eating Behaviors with
Cardiometabolic Risk Indices in Preadolescents: The Healthy Growth
Study.” Appetite 91 (2015): 35–40. Accessed March 2, 2016. doi:
10.1016/j.appet.2015.03.023.
Nevin-Folino, Nancy, Beth N. Ogata, Pamela J. Charney, Katrina Holt,
Holly L. Brewer, Mary K. Sharrett, and Liesje N. Carney. “Academy
of Nutrition and Dietetics: Revised 2015 Standards of Practice and
Standards of Professional Performance for Registered Dietitian
Nutritionists (Competent, Proficient and Expert) in Pediatric
Nutrition.” Journal of the Academy of Nutrition and Dietetics 115, no. 3
(2015): 451–60. doi: 10.1016/j.jand.2014.12.005.
O’Dea, Jennifer A., and Suzanne Abraham. “Onset of Disordered Eating
Attitudes and Behaviors in Early Adolescence: Interplay of Pubertal
Status, Gender, Weight, and Age.” Adolescence 34, no. 136 (1999):
671–79. Accessed March 2, 2016. http://www.worldcat.org/title/onset
-of-disordered-eating-attitudes-and-behaviors-in-early-adolescence
-interplay-of-pubertal-status-gender-weight-and-age/oclc/117940337
&referer=brief_results.
O’Neal, Catherine W., Kandauda Wickrama, Penny A. Ralston, Jasminka
Z. Ilich, Cynthia M. Harris, Catherine Coccia, Iris Young-Clark, and
Jennifer Lemacks. “Eating Behaviors of Older African Americans: An
Application of the Theory of Planned Behavior.” The Gerontologist 54,
no. 2 (2012): 211–20. Accessed March 2, 2016. doi: 10.1093/geront/
gns155.
Orrell-Valente, Joan K., Laura G. Hill, Whitney A. Brechwald, Kenneth
A. Dodge, Gregory S. Pettit, and John E. Bates. “ ‘Just Three More
Bites’: An Observational Analysis of Parents’ Socialization of
Children’s Eating at Mealtime.” Appetite 48, no. 1 (2007): 37–45.
Accessed March 2, 2016. doi: 10.1016/j.appet.2006.06.006.
Paquet, Catherine, Danielle St. Arnaud-McKenzie, Zhenfeng Ma, Marie-
Jeanne Kergoat, Guylaine Ferland, and Laurette Dubé. “More Than
Just Not Being Alone: The Number, Nature, and Complementarity of
Meal-Time Social Interactions Influence Food Intake in Hospitalized
Elderly Patients.” The Gerontologist 48, no. 5 (2008): 603–11.
Accessed March 2, 2016. doi: 10.1093/geront/48.5.603.
When: Eating throughout the Life Cycle 131

Payette, Hélène, and Bryna Shatenstein. “Determinants of Healthy Eating

in Community-dwelling Elderly People.” Canadian Journal of Public
Health 96 (2005): S27–31. Accessed March 2, 2016. http://journal
.cpha.ca/index.php/cjph/article/viewFile/1502/1691.
Podfigurna-Stopa, Agnieszka, Adam Cyzyk, Krzysztof Katulski, Roman
Smolarczyk, Monika Grymowicz, Marzena Maciejewska-Jeske, and
Blazej Meczekalski. “Eating Disorders in Older Women.” Maturitas 82,
no. 2 (2015): 146–52. Accessed March 2, 2016. doi: 10.1016/j
.maturitas.2015.06.036.
Procter, Sandra B., and Christina G. Campbell. “Position of the Academy
of Nutrition and Dietetics: Nutrition and Lifestyle for a Healthy
Pregnancy Outcome.” Journal of the Academy of Nutrition and Dietetics
114, no. 7 (2014): 1099–1103. doi: 10.1016/j.jand.2014.05.005.
Quick, Virginia, Suzanne Shoff, Barbara Lohse, Adrienne White, Tanya
Horacek, and Geoffrey Greene. “Relationships of Eating Competence,
Sleep Behaviors and Quality, and Overweight Status among College
Students.” Eating Behaviors 19 (2015): 15–19. Accessed March 2,
2016. doi: 10.1016/j.eatbeh.2015.06.012.
Reas, Deborah L., and Kristin Stedal. “Eating Disorders in Men Aged
Midlife and Beyond.” Maturitas 81, no. 2 (2015): 248–55. Accessed
March 2, 2016. doi: 10.1016/j.maturitas.2015.03.004.
Rø, Øyvind, Deborah L. Reas, and Jan Rosenvinge. “The Impact of Age
and BMI on Eating Disorder Examination Questionnaire (EDE-Q)
Scores in a Community Sample.” Eating Behaviors 13, no. 2 (2012):
158–61. Accessed March 2, 2016. doi: 10.1016/j.eatbeh.2011.12.001.
Rockenfeller, Patrick, and Frank Madeo. “Ageing and Eating.” Biochimica
et Biophysica Acta 1803, no. 4 (2010): 499–506. Accessed March 2,
2016. doi: 10.1016/j.bbamcr.2010.01.001.
Runfola, Cristin D., Ann Von Holle, Sara E. Trace, Kimberly A.
Brownley, Sara M. Hofmeier, Danielle A. Gagne, and Cynthia M.
Bulik. “Body Dissatisfaction in Women across the Lifespan: Results of
the UNC-SELF and Gender and Body Image (GABI) Studies.”
European Eating Disorders Review 21, no. 1 (2013): 52–59. Accessed
March 2, 2016. doi: 10.1002/erv.2201.
Serdar, Kasey L., Suzanne E. Mazzeo, Karen S. Mitchell, Steven H. Aggen,
Kenneth S. Kendler, and Cynthia M. Bulik. “Correlates of Weight
Instability across the Lifespan in a Population-based Sample.”
International Journal of Eating Disorders 44, no. 6 (2011): 506–14.
Accessed March 2, 2016. doi: 10.1002/eat.20845.
Shahar, Danit R., Richard Schultz, Avner Shahar, and Rena R. Wing.
“The Effect of Widowhood on Weight Change, Dietary Intake, and
132 Filling Up

Eating Behavior in the Elderly Population.” Journal of Aging and Health

13, no. 2 (2001): 186–99. Accessed March 2, 2016. doi: 10.1177/
089826430101300202.
Shomaker, Lauren B., and Wyndol Furman. “Interpersonal Influences on
Late Adolescent Girls’ and Boys’ Disordered Eating.”Eating Behaviors
10, no. 2 (2009): 97–106. Accessed March 2, 2016. doi: 10.1016/
j.eatbeh.2009.02.003.
Slane, Jennifer D., Kelly L. Klump, Matthew McGue, and William G.
Iacono. “Developmental Trajectories of Disordered Eating from Early
Adolescence to Young Adulthood: A Longitudinal Study.”
International Journal of Eating Disorders 47, no. 7 (2014): 793–801.
Accessed March 2, 2016. doi: 10.1002/eat.22329.
Slevec, Julie H., and Marike Tiggemann. “Predictors of Body
Dissatisfaction and Disordered Eating in Middle-aged Women.”
Clinical Psychology Review 31, no. 4 (2011): 515–24. Accessed
March 2, 2016. doi: 10.1016/j.cpr.2010.12.002.
Sohail, Rida, and Amina Muazzam. “Correlates of Disordered
Eating Behavior among Pregnant Women.” Pakistan Journal of
Psychological Research 27, no. 2 (2012): 153–72. Accessed March 2,
2016. http://www.pjprnip.edu.pk/pjpr/index.php/pjpr/article/viewFile/
192/163.
Spurrell, Emily B., Denise E. Wilfley, Marian B. Tanofsky, and Kelly D.
Brownell. “Age of Onset for Binge Eating: Are There Different
Pathways to Binge Eating?” International Journal of Eating Disorders 21,
no. 1 (1997): 55–65. Accessed March 2, 2016. doi: 10.1002/(SICI)
1098-108X(199701)21.
Steinberg, Emily, Marian Tanofsky-Kraff, Marc L. Cohen, Jane Elberg,
Renee J. Freedman, Mariama Semega-Janneh, Susan Z. Yanovski, and
Jack A. Yanovski. “Comparison of the Child and Parent Forms of the
Questionnaire on Eating and Weight Patterns in the Assessment of
Children’s Eating-Disordered Behaviors.” International Journal of Eating
Disorders 36, no. 2 (2004): 183–94. Accessed March 2, 2016. doi:
10.1002/eat.20022.
Steinhausen, Hans-Christoph, Silvia Gavez, and Christina W. Metzke.
“Psychosocial Correlates, Outcome, and Stability of Abnormal
Adolescent Eating Behavior in Community Samples of Young
People.” International Journal of Eating Disorders 37, no. 2 (2005):
119–26. Accessed March 2, 2016. doi: 10.1002/eat.20077.
Stevenson, Clifford, Glenda Doherty, Julie Barnett, Orla T. Muldoon, and
Karen Trew. “Adolescents’ Views of Food and Eating: Identifying
Barriers to Healthy Eating.” Journal of Adolescence 30, no. 3 (2007):
When: Eating throughout the Life Cycle 133

417–34. Accessed March 2, 2016. doi: 10.1016/j.adolescence.2006

.04.005.
Story, Mary, Dianne Neumark-Sztainer, and Simone French. “Individual
and Environmental Influences on Adolescent Eating Behaviors.”
Supplemental to the Journal of the American Dietetic Association 102,
no. 3 (2002): S40–51. Accessed March 2, 2016. doi: 10.1016/S0002
-8223(02)90421-9.
Svensson, Viktoria, Linda Lundborg, Yingting Cao, Paulina Nowicka,
Claude Marcus, and Tanja Sobko. “Obesity Related Eating Behavior
Patterns in Swedish Preschool Children and Association with Age,
Gender, Relative Weight and Parental Weight—Factorial Validation
of the Children’s Eating Behaviour Questionnaire.” International
Journal of Behavioral Nutrition and Physical Activity 8, no. 134 (2011):
1–11. Accessed March 2, 2016. doi: 10.1186/1479-5868-8-134.
Tavolacci, Marie P., Sébastien Grigioni, Laure Richard, Gilles Meyrignac,
Pierre Déchelotte, and Joël Ladner. “Eating Disorders and Associated
Health Risks among University Students.” Journal of Nutrition
Education and Behavior 47, no. 5 (2015): 412–20. Accessed March 2,
2016. doi: 10.1016/j.jneb.2015.06.009.
Taylor, Frances. “Eating Disorders Are Not Just a Problem for the Young.”
Working with Older People 12, no. 3 (2008): 31–33. Accessed March 2,
2016. doi: 10.1108/13663666200800049.
Wilksch, Simon M. “Where Did Universal Eating Disorder Prevention
Go?” Eating Disorders 22, no. 2 (2014): 184–92. Accessed March 2,
2016. doi: 10.1080/10640266.2013.864889.
Wood-Bradley, Ryan James, Sarah Louise Henry, Amanda Vrselja,
Victoria Newman, and James Andrew Armitage. “Maternal Dietary
Intake during Pregnancy Has Longstanding Consequences for the
Health of Her Offspring.” Canadian Journal of Physiology and
Pharmacology 91, no. 6 (2013): 412–20. Accessed March 2, 2016. doi:
10.1139/cjpp-2012-0352.
Xie, Yiqiong, Aubrey Spriggs Madkour, and Emily Wheeler Harville.
“Preconception Nutrition, Physical Activity, and Birth Outcomes in
Adolescent Girls.” Journal of Pediatric and Adolescent Gynecology 28,
no. 6 (2015): 471–76. Accessed March 2, 2016. doi: 10.1016/j.jpag
.2015.01.004.
Zauche, Lauren Head, Talyor A. Thul, Ashley E. Darcy Mahoney, and
Jennifer L. Stapel-Wax. “Influence of Language Nutrition on
Children’s Language and Cognitive Development: An Integrated
Review.” Early Childhood Research Quarterly 36 (2016): 318–33.
Accessed March 2, 2016. doi: 10.1016/j.ecresq.2016.01.015.
134 Filling Up

Zerwas, Stephanie, Ann Von Holle, Hunna Watson, Nisha Gottfredson,

and Cynthia M. Bulik. “Childhood Anxiety Trajectories and
Adolescent Disordered Eating: Findings from the NICHD Study of
Early Child Care and Youth Development.” International Journal of
Eating Disorders 47, no. 7 (2014): 784–92. Accessed March 2, 2016.
doi: 10.1002/eat.22318.
 6

Where: Eating around the World

All people, regardless of where they live, must eat to sustain life. Diverse
eating patterns around the world reflect a variety of influences. The impor-
tance of family socialization and passing down certain foods and recipes
from generation to generation is paramount. Likewise, one’s cultural con-
text sets the stage for the value and availability of specific types of foods
and the use of ingredients like spices and flavoring. Finally, there are vast
differences in the amount of food consumed and types of food that are con-
sidered to be delicacies among people around the globe. Although over-
consumption occurs among many people in so-called affluent countries,
large numbers of individuals still struggle to meet their daily nutritional
needs for sustaining life. It is also noteworthy that as the food industry
becomes increasingly globalized, Western foods can reach many countries.
What follows in this chapter is an overview of eating patterns found
around the globe. Some of the unique foods that originated in a particular
region are highlighted, although the list of dishes does not capture every
dish you can expect to find throughout the diverse world regions.
This chapter will be organized by geographical regions to include Asia,
the Middle East, Europe, North America, Central America and the
Caribbean, South America, Australia and Oceania, and Africa. Each sec-
tion will conclude by covering the trend of fast-food globalization that
has strongly influenced the availability of certain foods in each region.
The effects of globalization will be examined with an eye to how individ-
uals are able to access new foods. Further, the impact of this trend that
136 Filling Up

has the potential to make eating behaviors more homogenous over time
will be discussed.

AFRICA
When considering the many cuisines of Africa, the word that comes to
mind is diverse. Foods have largely been influenced by migrants who
brought novel ingredients to the continent in the late 1800s. For example,
in North Africa spices such as nutmeg, ginger, cloves, and cinnamon have
a prominent position in seasoning foods as a result of Arab influence on
cuisine. Olive oil is also commonly used in cooking in North Africa.
In studying other regions of Africa, we can see that cattle are considered
to be a status symbol. Within the southern region, there continues to be
a reliance on vegetables, grains, and beans and corn (or ground maize) to
be used as a base ingredient for preparing meals. People in West Africa
tend to favor heavy starches in their diet. Hot spices and peppers are
widely used in this region to provide flavor to popular dishes such as rice
or stew. Finally, the Central African region continues to embrace tradi-
tional African foods. Plantains and starches are widely popular and usually
accompanied by stews.
In general, foods in Africa tend to be starch based and include different
types of vegetables, roasted fish, and meat. Many items are eaten, such as
the varied fruits, vegetables, and nuts can be grown throughout the year,
and are organic. Generally, African foods have been considered healthy
and rich in fiber as long as the portions are reasonable. Unlike other cul-
tures that may favor one meal over another, African meals are prepared
for morning, midday, and evening. Let us consider what types of food
may make up each meal.

Breakfast
The early morning meal of breakfast is highly regarded in Africa.
Breakfast, particularly in farming communities, is necessary to provide
fuel for the workday. The actual breakfast foods can range from light to
a more substantial fare. Some examples of types of foods consumed at this
meal include but are not limited to beans, fried plantain (similar to a
banana), fresh fish, rice, African stew, boiled yam, fish soup, and boiled
sweet potatoes. There is also a dish called “ogi” or “akamu,” which refers
to a type of bean cake and is popular in eastern, western, and southern
Nigeria.
Where: Eating around the World 137

Lunch
The midday meal in Africa typically occurs between the hours of noon and
4 p.m. Lunch represents the largest meal throughout the day and often
consists of key staples, which may vary depending on the part of Africa.
Common food items at the lunch meal are rice, millet, yams, plantains,
potatoes, and beans. These ingredients are often served in a texture similar
to mashed potatoes or are boiled to serve with a variety of stews or soups.
Lunch is accompanied by dessert in Africa. Dessert, which may consist of
fresh fruit or yogurt made from goat milk, is also healthy. Another popular
dessert, “zobo,” is a traditional Nigerian drink also known as the hibiscus
drink. The nutritious drink is made from dry petals of the hibiscus plant,
ginger, fruit such as pineapple, and honey or some other sweetener.
This herbal drink is thought to promote health and fight diseases.

Dinner
The evening meal or supper is typically served between 5 and 10 p.m.
Dinner typically consists of some combination of food items and can resem-
ble other meals in the day. Common food combinations include rice and
fried plantain, rice and roasted chicken, and sweet potatoes and greens.

Special Dishes
When traveling to Africa, there are some favorite dishes that visitors
should take the time to experience. First, a local favorite, barbecued meat
and maize porridge, represents a combination of starch and protein com-
monly found in the native diet. “Shisa nyama” means “burn the meat”
and also refers to the practice of restaurants providing a choice of meats
from the butcher shop next door. Once the meat is selected by the cus-
tomer, it is cooked over hot wood fires.
Another popular dish in South Africa is called “bunny chow.”
This unique dish refers to a loaf of bread that is halved and hollowed out
to provide an edible serving bowl in which to serve hot curry. This street
food favorite is offered in meat and vegetable varieties and has been a
crowd-pleaser since the nineteenth century. A popular food in Kenya
called “irio” is both a staple of the Kenyan diet as well as considered a com-
fort food. This beloved dish consists of mashed potatoes, beans, corn,
onion, and peas served alongside spicy roasted meat. The popularity of this
dish has been associated with Kenya’s well-known tradition of long-
distance running.
138 Filling Up

Fast Food
Fast-food restaurants have arrived in Africa. KFC was the first of the fast-
food chains from the United States to spring up. Hundreds of its stores
now operate throughout South Africa, but one can also find Burger King
and Domino’s Pizza. The price of food at fast-food outlets tends to be
higher than in the United States, which puts it out of reach for people
living under the poverty line.

ASIA
Food in Asia is extremely diverse and includes many types of regional cui-
sines that have gained immense popularity around the world. The focus for
this section will primarily be Eastern Asian regions, as Middle Eastern cui-
sine is covered in a later section. The list of countries covered and food
highlights is by no means exhaustive or fully representative of the extraor-
dinary selections of food cultures and dishes that exist in this culinary-
focused region. Some of the ingredients common to Asian kitchens
and restaurants are ginger, soy, sesame, and garlic, to name just a few.
Rice and noodles are staples used in many Asian dishes, although the type
of rice used may differ by countries in the region.
In Japan, for example, rice is typically prepared in a rice cooker in order
to achieve a sticky texture that is ideal for creating a variety of dishes, such as
fried rice. However, in Japan and Korea, short-grained rice is typically pre-
ferred rather than the long-grained version used in China. Pickled vegetables
such as pickled cabbage (referred to as “Tsukemono” in Japan) are commonly
used in dishes and served with rice. Fish, the fresher the better, is celebrated
throughout the region. Beef, duck, and pork are incorporated into a variety of
Asian dishes such as soups, curries, noodles, stir fries, and dumplings.
“Chinatowns” and other Asian communities throughout the United
States in large cities such as San Francisco have exposed visitors to native
foods for these countries. It is important not to generalize or make assump-
tions about diet across Asia, as the types of foods vary greatly. However,
certain commonalities do exist, including the use of rice and noodles as a
staple and the tendency toward smaller portions with continuous meals
throughout the day. In this section, a few dishes and traditions are high-
lighted that are usually associated with specific regions across Asia.

Dim Sum
Although Chinese food is incredibly popular in the United States, it is
natural to wonder whether traditional Chinese fare is prepared the same
Where: Eating around the World 139

way as in American-based restaurants. Chinese cuisine varies by region,

with taste palates ranging from light and sweet to hot and spicy. Maybe
you have tried a few of these traditional Chinese dishes or participated in
a dim sum. Dim sum represents a meal similar to a brunch that begins in
the morning and traditionally is served until mid-afternoon. Dim sum
includes a variety of small dishes such as steamed buns and dumplings
brought to the dining table and usually placed on a lazy Susan-style serving
tray in the middle of the table to be shared family-style. An unusual offer-
ing provided at a traditional dim sum is chicken feet, which are sometimes
referred to as “Phoenix Claws.” This meal item is eaten by sucking the
bones dry, but most Americans find the skin and cartilage associated with
the dish to be off-putting.

Peking Duck
A widely popular Chinese dish, Peking duck, originates from Beijing and
has been served since the imperial era. The dish is served for special occa-
sions and usually consists of the dark meat with crispy skin being wrapped
in crepe-style pancakes and drizzled with a hoisin sauce. Hoisin sauce, a
dark-colored sauce with a sweet yet salty taste, is used for a variety of
southern Chinese dishes like meat and stir fries. Unlike American dishes
where skin is often removed from meats, skin is intentionally left on the
slices of duck and is the “star” of the dish.

Jellyfish
Edible jellyfish is consumed in many Asian countries including Japan,
China, Thailand, Singapore, and Korea. Although jellyfish does not make
a regular appearance on restaurant menus throughout the United States, it
is considered a delicacy in Asia. Usually it is dried, dehydrated, and may be
pickled. The tentacles are removed in the preparation process before
serving. Dishes containing it may include a variety of salads, noodles, or,
strangely, ice cream. Not considered to have much flavor but described as
chewy, edible jellyfish is mainly added to provide texture to dishes.

Basashi
Something that would be considered offensive to many Americans,
basashi, or raw horse meat, is considered a delicacy in Japan. The meat is
served at a cold temperature, being nearly frozen in the middle, and is
often dipped in soy sauce or garlic. Horse meat is not only consumed in
Asian countries, but also has historical roots as a food source in Europe.
140 Filling Up

Although the ethics of using this meat have been questioned around the
globe, there have been many scandals involving the use of horse meat by
restaurants. As a delicacy, horse meat continues to be consumed in quan-
tities estimated at close to 5 million horses per year. Basashi is typically
served in slices and ranges by quality of cut that can get quite expensive
(i.e., up to $30 per plate for five to seven slices).

Sushi
As previously mentioned, fish of all kinds is a focus of many dishes in
Japan, the fresher the better, as the highest per capita consumption of sea-
food goes to this country. Sushi of all varieties is created through the use of
culinary knife skills and the freshest ingredients available to roll up in
toasted nori seaweed. Sashimi sushi refers to high-quality and fresh pieces
of raw fish such as tuna. By contrast, sushi rolls consist of sticky rice, sea-
weed, and fresh fish and are usually considered a side dish in Japan.

Wagyu
Another Japanese delicacy that has spread around the globe is wagyu.
This beef is considered healthier than others due to higher levels of
omega-3 and omega-6 fatty acids thought to reduce heart disease.
The taste is described as smooth like butter and extraordinarily tender.

Tofu
An alternative to meat, tofu is popularly used in cooking a variety of
dishes. This ingredient provides vegetarians access to popular Asian dishes
as a meat substitute or a way of adding texture to a vegetable or noodle
dish. The popularity of tofu has spread throughout the world and it can
be purchased in grocery stores and restaurants in the United States.

Tea
The popularity of hot tea is undeniable across this region. Tea is associated
with a variety of remedies, from boosting the immune system to providing
relaxation effects. Further, socializing over this warm beverage is synony-
mous with meeting for coffee in Sweden. Whether one frequents a tea-
house to enjoy a cup of steaming beverage and conversation with friends,
or drinks green tea associated with specific health-related benefits, tea
can be found in every restaurant and household. Tea ceremonies, which
vary depending on where you are, can be formal affairs lasting several
Where: Eating around the World 141

hours. For example, in Japan the tea ceremony, which is referred to as the
“Way of Tea,” is influenced by Zen Buddhism. Tea is served in fine pottery
or porcelain, with a focus on qualities of harmony and respect. The warm
beverage is typically accompanied by a light meal.

Fast Food
The types of American fast-food chains you can expect to find in the
United States are scattered throughout Asia. However, the local traditions
and cultures influence some of the menu additions. In McDonald’s in
Seoul, South Korea, you may find on the menu a burger loaded up with
bulgogi, which is Korean grilled beef. Likewise, the American chain
Baskin Robbins scoops up kiwi sorbet in its outlets in Japan.

AUSTRALIA AND OCEANIA

The region of Australia and Oceania comprises 15 countries and largely
occupies water rather than land. The largest country in this region is
Australia, which has a rich history of blending European and bush
Aboriginal cultures. New Zealand and smaller countries including Fiji,
East Timor, Kiribati, the Marshall Islands, Nauru, Palau, Papua New
Guinea, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu, and the
Federated States of Micronesia comprise this region. The dinner meal
tends to be considered the most important meal of the day.
If you take a trip to Australia or New Zealand, you will likely recognize
the strong British influence on cuisine as well as a focus on locally grown
and produced food. You can still expect to find favorite dishes to include
roast lamb, oysters, and fish and chips on a journey to this region. In the
twenty-first century, an eclectic variety of ethnic cuisines is available as a
result of an influx of immigrants from many parts of the world. This has
allowed natives and tourists alike to enjoy Chinese, Mediterranean,
Indian, Vietnamese, Middle Eastern, and African cuisines. The early influ-
ences of the Aboriginal and Maori people contributed to a strong focus on
meat, such as the unique dish of kangaroo that can still be found in this
region.

Kangaroo
Before the emergence of fast food, family life in the bush meant slaugh-
tering sheep and catching porcupine for dinner. The earliest influence
on the food culture in Australia can be attributed to the Aboriginal
142 Filling Up

people, who were skilled at trapping kangaroo and other game such as
duck, quail, and pigeons. Catching fish and having a consistent source
of water was vital to survival. The unique dish of native kangaroo per-
haps seems strange to you, but this dish was preferable to other sources
of meat in the early 1800s. Kangaroo, which is said to taste like North
American deer and is typically served medium to medium rare, was origi-
nally prepared by steaming the meat before adding an array of onion,
milk, salt, and pepper. Then, the dish was flavored with bacon or salt
pork and a dollop of ketchup. Kangaroo meat is much less popular today
than in colonial times; however, some experts consider this type of meat
to be more sustainable than beef given that kangaroos are considered
pests to farmlands Down Under. The export business of kangaroo meat
amounts to $17 million, which is undeniably smaller than the $6 billion
beef industry. In fact, kangaroo meat can be found in several niche mar-
kets such as New York City, San Francisco, Lima, Peru, and the United
Kingdom.

Desserts
Pumpkins are also quite popular and have served many purposes in cook-
ing. They were versatile, used in soups, desserts, pancakes, and scones.
Dishes with pumpkin continue to thrive in this region, as evidenced by
present-day pumpkin festivals and the iconic pumpkin scone. Desserts, in
general, are popular in this region, and a unique dish made in both
Australia and New Zealand is called the “pavlova.” Australians lay claim
to the invention of this dessert, which is a type of cake named after a
Russian ballet dancer, Anna Pavlova. The dish took the name as a way
to capture the light texture of the cake that resembles a meringue.
In preparation of the dish, corn flour and vinegar are beat into egg whites
before being topped with fruit such as peaches, kiwi, or passionfruit and
cream. This sweet dish regularly appears on Christmas menus in New
Zealand households.
Another popular favorite of the sweet variety in New Zealand is the
indigenous chocolate fish, that is, a marshmallow that is shaped like a fish
and covered in chocolate. A variation, the pineapple lump, is another
treat for the person with a sweet tooth. This square candy consisting of
pineapple covered in chocolate has been available for sale since 1935.
Finally, the “jaffa” is another New Zealand favorite. This orange-flavored
hard candy contains a chocolate center. These candies are celebrated
annually at the Cadbury Chocolate Carnival in New Zealand.
Where: Eating around the World 143

Barbecues
The barbecue has been a popular way to socialize over food since the 1920s
in this region. The original barbecue was called a “chop picnic” and
referred to an outdoor party at which an animal was roasted. These barbe-
cues continued to take place throughout the twentieth century and even-
tually in the 1950s became a permanent fixture in both public parks and
Australian homes. The modern expression “to throw a shrimp on the bar-
bie” represents a continuation of the barbecue’s popularity as part of the
culture of this region, as well as the more recent addition of shrimp
skewers. Present-day barbecues are common in the summer as a way to
bring people together to socialize. Guests are often invited to bring a side
dish or salad consistent with a “pot luck-style party” while the host pre-
pares the meat. The traditional Maori gatherings in New Zealand featured
a “hangi” or pit in which to cook meat, fish, and vegetables. This tradi-
tional cooking method involves digging a hole in the ground, lining the
pit with stones that are then heated by a large fire, placing baskets or tins
of food on top of the red-hot stones, then covering everything, first with
vegetation and then finally with earth, leaving it to cook for several hours.

Fast Food
The earliest “fast” food in this region could be found on the streets of larger
Australian cities. Pie carts and street vendors sold foods like meat pies and
pastries and offered an affordable alternative to eating out. Coffee stalls
originated in the late 1870s in larger Australian cities to meet the popular
demand of the freshly roasted brew. Coffee consumption continues to
exceed that of tea in this region and is wildly popular, as is fast food.
In general, the fast-food culture of this region resembles the United
States and United Kingdom. American fast-food outlets such as KFC and
McDonald’s (called “mackas” in Australia) have a presence, along with
fast-food chains based in the region. Georgie Pie, a former fast-food chain
based on meat pies, kept its doors open from 1977 until the mid-1990s.
Another Australia-based fast-food chain called Jester’s sells these nostalgic
pies across the region.

CENTRAL AMERICA AND THE CARIBBEAN

This region includes countries that are not landlocked and thereby are
popular tourist destinations. Countries like Barbados, Belize, Costa Rica,
Cuba, Jamaica, and the Dominican Republic are a few of the 20 countries
144 Filling Up

that comprise the Central American and Caribbean region. Like the other
regions, food is diverse but reflects a variety of cultures and use of different
spices. There are clear influences on cuisine brought from the original
Native Americans as well as the European, African, and Asian groups
who have migrated to the region. Foods tend to be based on corn-
centered dishes like tortillas, tamales, and tacos and may use sauces such
as pico de gallo, mole, and guacamole. Sweet desserts, such as flan and tres
leches cake, are popular throughout the region and made be created with
fresh ingredients like local pineapple and papaya. A popular staple dish,
particularly in Costa Rica and Belize, is rice and beans, which can be found
in some color variation throughout the region. For example, Cuban cook-
ing prefers black beans, whereas red beans are preferred by Puerto Ricans.
Breakfasts are hearty and may include beans, rice, and pork.

Fried Plantain
The snack food, fried plantain, is prepared using local plantains in Central
America and resembles the American version of banana chips. A plantain
is similar to a banana but much firmer. The plantains are best if overly ripe
but are caramelized on both sides and sliced. The snack or appetizer is
naturally very sweet in taste.

Pepper Pot
The pepper pot dish originated in Guyana but is extremely popular in
Barbados. The rich purple stew referred to as “pepper pot” is a delicacy
cooked in earthenware jars. The spicy stew has just about every ingredient
imaginable, but common meat additions include pork, mutton, and beef.
This stew is often served with rice or bread and butter. Measures are taken
to preserve pepper pot by adding the juice of the cassava root.

Curry Goat
A popular dish that originated in South Asia and has spread throughout
Caribbean is curry goat. Curry goat, a popular Jamaican specialty, refers
to a curry dish that consists of goat meat. Generally, salt, black pepper,
curry powder, onions, scallions, and garlic are added to the meat for
taste, and then it is marinated for several hours in the refrigerator. In the
past, curry goat was enjoyed at special events like weddings. However, this
dish is now popular throughout the year for those who can afford it. Goat
meat is considered to be a low-fat alternative to red meat.
Where: Eating around the World 145

Jerk Chicken
A style of cooking that is popular in the Caribbean is called “jerk”
and refers to when the meat is dry-rubbed with a hot-spice mixture.
This Jamaican jerk spice provides seasoning to meats like pork and chicken
and is served in a variety of ways. A traditional way to serve a jerk chicken
plate is with plantains and rice.

Tres Leches Cake

A popular cake known as tres leches cake is spongy in texture. The dessert is
prepared with three (or “tres”) kinds of milk (“leche”): evaporated milk, con-
densed milk, and heavy cream. This type of sponge cake is popular through-
out Central America and the Caribbean; however, its origin is a point of
debate. It is possible that the cake came from medieval Europe and was then
brought over to Central America. Modern versions may have different layers
and can be topped with fresh fruit and candies.

Fast Food
Central America is covered with every fast-food chain you can imagine.
Subway, McDonald’s, and KFC are all located throughout Central
America and the Caribbean. Pizza Hut, Papa John’s, Taco Bell, and others
continue to expand throughout this region and are widely popular with
natives and tourists alike. In fact, Costa Rica has been likened to a minia-
ture version of the United States with its proliferation of the fast-food
industry and propensity for burgers.

EUROPE
Europe represents a rich history of diverse cuisines that have influenced
tastes and the evolution of the food industry around the globe. When
you think about traveling to France or Italy, chances are that your mouth
begins to water as you imagine the tasty food items you will be sampling
during your visit. For this region, food is not just a way of getting the
daily caloric intake needed to survive; eating represents an experience.
Some areas in this region have been credited for shaping certain
health-oriented diets, such as the Mediterranean Diet discussed in
Chapter 3. While it is impossible to cover all of the delicacies that
have originated in Europe, this section will provide a few sumptuous
highlights.
146 Filling Up

Cornish Pasty
The national dish of Cornwall, United Kingdom, is the Cornish pasty.
This dish consists of a baked pastry that is typically filled with meat and
root vegetables and can be served hot or cold. The dish originated as a
lunch food for workers in the mining region of Cornwall. Meat pies have
been documented in medieval England from the 1300s.

Bratwurst
Germany is well known for making homemade sausages such as bratwurst.
Bratwurst is made from pork, beef, or veal and consists of finely chopped
meat that is worked into the natural casing of a sausage. These are now
available in the United States and can be bought at a local butcher shop
or grocery store. Bratwursts are prepared on the grill or fried in a pan.
Throughout Germany there are more than 50 types of bratwurst varieties,
specific to each region of the country.

Pierogi
In Poland, a common staple is the pierogi. The typical pierogi is fried, but
it can be baked or steamed. These doughy pockets are usually stuffed with
meat, but may be filled with other items like potatoes, sauerkraut, or vege-
tables. They are often sprinkled with roasted onions. A vegetarian version
of the pierogi, consisting of cabbage and mushrooms, is served for
Christmas Eve dinner. For dessert, the pierogi is stuffed with a Polish curd
cheese to create a sweet taste.

Goulash
The Hungarian specialty “goulash” is named for the Hungarian word for
shepherd’s soup (“gulya leves”). This European hot soup can be served as
a thick stew, but traditional Hungarian goulash is a clear broth loaded with
beef, onions, potatoes, tomatoes, paprika, and vegetables like green
pepper.

Pizza
Italy has two dishes that are famous around the world—pasta and pizza.
Have you thought about where pizza really comes from? Pizza is wildly
popular around the globe, but authentic pizza is said to originate in
Naples, Italy. The basic ingredients of dough, tomato sauce, and cheese
Where: Eating around the World 147

divinely come together to create a delightfully simple meal. The word

“pizza” came from the Latin word for flatbread, “pinsa.” The original pizza
was merely a seasoned flatbread with a very thin crust. Tomatoes were
introduced and accepted into Italian cuisines. The use of tomatoes, origi-
nally thought to be harmful and poisonous in the 1500s, expanded to pizza
dishes in the late 1700s. Pizza Margherita was named after Queen
Margherita, who visited Pizzeria Brandi in Naples. The pizza was created
in three colors to represent the Italian flag: red, white, and green.
The red was represented by tomatoes, white by mozzarella, and green by
the fresh basil. The trend of pizza has spread around the globe and includes
many versions of both thick and thin styles of crust. Toppings are diverse,
ranging from the traditional ingredients like anchovies to an assortment of
meats, vegetables, and fruits.

Schnitzel
A food that can be readily found during a trip to Europe is schnitzel.
This dish, which originated in Austria and is popular in Germany, refers
to meat (traditionally veal) that has been thinned and flattened. The thin-
ner meat is then breaded and fried. Meats selected for a schnitzel may
include veal, mutton, pork, reindeer, chicken, beef, or turkey. The term
“wienerschnitzel” is a protected term limited to Germany and Austria
and refers only to schnitzel made there with veal. This main course is often
served with potato salad, French fries, or spätzle (a noodle dish).

Swedish Meatballs
“Kottbullar” is the Swedish word for meatballs, a typical main course that
is included in the “smorgasbord” buffet. Prior to their popularity from the
widely distributed IKEA stores, Swedish meatballs were a traditional part
of dinner for Swedes. Swedish meatballs are smaller in size than Italian
ones and are typically served with a homemade gravy, cooked potatoes,
and lingonberry.

Fast Food
Although there are certain regions of Europe that have actively fought the
“fast-food” movement, it is not difficult to find American chains. There are
also several European-based fast-food chains found here, such as Telepizza
and Teremok. Telepizza serves pizzas with all different toppings, whereas
Teremok specializes in pancakes (blinis) that are made from buckwheat
flour.
148 Filling Up

If we consider that McDonald’s is the number one fast-food chain, it is

safe to assume that the American-grown business has earned some degree
of respect around the globe. Many of the usual suspects in the fast-food
industry can be found across this region, including but not limited to
Starbucks, Krispy Kreme, Pizza Hut, Taco Bell, and Cinnabon. However,
not all menu items are created equal across franchises. When comparing
McDonald’s in the United Kingdom and United States, for example, the
differences are stark. In the United Kingdom, organic milk is served, along
with carrot sticks and pineapple slices. The list of ingredients for French fry
preparation is substantially shorter in the United Kingdom, with no pre-
servatives found in any of the food items. Although the name and logo
may be the same, the recipes are also vastly different depending on the
region.

MIDDLE EAST
Many people in the United States have had the chance to sample some
type of Middle Eastern cuisine. Foods such as pitas, hummus, and kebabs
have gained popularity in restaurants throughout the world. Early food
sources in the Middle East included the use of wheat, barley, figs, and
dates. This region’s recipes have been influenced by surrounding areas of
Europe, Asia, and Africa. For example, spices from the Orient and India
have been used to produce a unique flavor palate for Middle Eastern food.
Because religion has historically played such a strong role in this region,
the protein of choice has been lamb. Neither Muslims nor Jews eat pork,
and alcohol is forbidden. The one exception has been Lebanon, which at
one time hosted the region’s only brewery and has been world renowned
for wines.

Wheat and Rice

Staples found in Middle Eastern diets include some type of starch, whether
it be rice, couscous, or burghul (which we know as bulgur). Burghul is the
Arabian term for a kind of cracked wheat that is made by drying wheat
grains in the oven or sun. Once dry, the resulting hardened substance is
broken into smaller pieces before cooking like rice. This unique starch
has been infused in the preparation of meat pies and salads. One popular
dish that has made its way to some parts of the United States is tabbouleh,
an Arabian dish created from a mixture of burghul, tomatoes, onion, and
freshly chopped herbs such as mint or parsley. Other common ingredients
used in the preparation of Middle Eastern dishes include olive oil, lemon,
Where: Eating around the World 149

and butter, but vegetables are a mainstay for most dishes throughout the
region.

Vegetarian Cuisine
Vegetarians will appreciate Middle Eastern cuisine for its focus on vegeta-
bles as the “star” of most meals. Vegetables are prepared in a variety of
ways, including grilled, cooked, stewed, and stuffed with various goodies.
For example, grape leaves or cabbage may be stuffed with rice, pine nuts,
meat, spices, and other variations. Vegetables such as spinach, onion,
and carrots are widely used in dishes. The tomato is a particular favorite
for locals, who use it in everything from salads to kebabs. Eggplants are
another popular menu choice in the Middle East. Preparation involves fry-
ing long slices and serving them with a yogurt and garlic dressing. Another
option is roasting the eggplant and providing a tahini dressing for the dis-
tinct taste of a sesame paste. Beans are also widely consumed in Middle
Eastern diets throughout the day. Falafel, a dish that can be found on
Israeli streets and also readily in the United States and Europe, refers to
fried balls made from dried fava beans or chickpeas that may be folded into
fresh pita bread.

Dairy and Meat

Milk, yogurt, and cheese are commonly consumed alone or in cooking.
Yogurt dressings may be created to accompany vegetable dishes or as a
drink. The most popular cheeses in the region tend to be of the white vari-
ety, such as Greek feta. As previously mentioned, vegetables are empha-
sized in the Middle Eastern diet; however, certain types of meat are still
enjoyed. Lamb, mutton, and chicken are the most frequently prepared, as
grilled dishes or served as kebabs on skewers. Kebabs represent a menu
option for street food or at restaurants rather than in home kitchens.
Meats may also be prepared in stews or served over rice.

Turkish Coffee
Although alcoholic beverages are not common in this region, Turkish cof-
fee is a delicacy that has gained notoriety around the globe. This hot bev-
erage is made by boiling coffee grounds in water and letting them settle, an
unfiltered process that results in a thicker version of coffee than is con-
sumed in the United States. Sugar or spices such as cinnamon or carda-
mom can be added for taste.
150 Filling Up

Fast Food
The demand for American fast-food outlets exceeds the supply in the
Middle East. Fast-food franchises are opened as family businesses and
include the likes of KFC, Papa John’s Pizza, the Cheesecake Factory,
International House of Pancakes, and Subway. Some of the American
chains that heavily emphasize forbidden foods like pork barbeque have
had to adapt their marketing plans and growth to the culture. For example,
Famous Dave’s has eased into development across this region by beginning
in Dubai, a place that offers their international visitors an eclectic array of
cuisines for every palate.

NORTH AMERICA
Foods in the North American region are incredibly diverse depending on
geographical locations within the United States, Canada, and Mexico as
well as Greenland. This section will provide some highlights and interest-
ing food trends in the region. Because the rest of the book has been written
from a largely U.S. perspective, this section will make a special point to
highlight other regions within North America. Interestingly, it is difficult
to think of a specific food or style when it comes to Canadian cuisine.
There are some unique foods that are offered that have developed some
notoriety in this country, however, and they are highlighted here, as well
as specialties from Mexico such as chilaquiles and elote.
Greenlandic cultures tend to favor seafood due to the natural terrain
being covered almost entirely by glaciers. Popular dishes in Greenland
include mussels, smoked fish of all varieties, and shrimp, as well as artic
sea mammals like seals and smaller whales. Coffee, both with and without
something stronger, is enjoyed after dinner. Another popular beverage in
Greenland is ice beer.

Ice Beer
Although Greenland is not known for many food items, the water is
famous for its purity, coming directly from the polar ice cap. The water is
bottled and sold for a profit around the world. This extremely pure water
is also used to create other beverages. Local breweries produce a variety
of beer types from this exceptionally pure water, derived from cutting slabs
of ice from glaciers, which is believed to contribute to better-tasting brews
than anywhere else in the world.
Where: Eating around the World 151

Whale Meat
Marine mammals, like smaller whales and seals, are considered a delicacy
in Greenland. The skin and fat from a whale can be used to make an
exotic soup. The meat can be marinated, cured, or processed into jerky
form. Eating whale meat originated with the Inuit people of Greenland,
who were indigenous to the region, but has generated some controversy
around the globe with the commercialization of whale meat in Japan and
other countries.

Poutine
The Canadian dish poutine consists of French fries topped with a light
brown gravy and cheese curds. The original dish was found in Quebec
but has spread across the country and is considered a French-Canadian
classic. Different variations of these same three ingredients can be found
in restaurants and home kitchens as well as American fast-food chains
throughout the country.

BeaverTails
An interesting dessert option in Quebec, Canada, originated at the
BeaverTails Pastry in the late 1970s. BeaverTails, which now have home-
made versions, consist of fried dough that resembles a rodent’s tail.
The dough is coated with Nutella, chocolate sauce, bananas, crushed
Oreos, candy, or caramel. Another Canadian dessert is the butter tart, a
small, bite-sized pastry with sweet filling. Typically, the flaky pastries are
topped with walnuts, pecans, or raisins.

Bloody Caesar
A noteworthy cocktail in Canada is the Bloody Caesar. Clamato, which is
a combination of clam and tomato juices, replaces the tomato juice found
in a traditional Bloody Mary drink. This drink is popular in Calgary.
Looking for a snack in Canada? How about the well-known ketchup chips
found in a variety of brands? Although ketchup chips have not taken off in
the United States, Canadians enjoy this snack by the handful.

Elote
A popular snack or street food in Mexico is “elote,” which is corn on
the cob. The corn is typically boiled and served on a stick or in cubes.
152 Filling Up

The corn is flavored with some combination of salt, lime, butter, cheese,
mayonnaise, chili powder, and sour cream.

Chilaquiles
The Mexican breakfast dish chilaquiles is popular with the locals and
includes corn tortillas that have been lightly fried and then covered with
green or red salsa, depending on one’s preference for spicy. Pulled chicken
and eggs (scrambled or fried) are added, then topped with cheese and sour
cream. This dish, like many other Mexican specialties, is usually accompa-
nied by refried beans.

Fast Food
Fast-food restaurant chains can be found throughout North America.
Canadian fast-food chains have some of their own versions of the country
favorites, like poutine. In addition to gravy and cheese curds on French
fries at McDonald’s, it is also possible to find “cheesy beef poutine pizza”
at Pizza Hut. Lobster sandwiches, aka “McLobster” at McDonald’s in
Northern Canada, can also be found at Subway. American and other
fast-food chains can be found all over Mexico. Greenland boasts more
diner-style fast-food options than typical American chains.

SOUTH AMERICA
Like the other regions covered in this chapter, South American cuisine
varies widely across the region. The native populations were forward-
thinking and developed advanced irrigation systems to support sustainable
vegetation. As a result, they were able to cultivate plants such as lima
beans, potatoes, corn, chile peppers, sweet potatoes, avocados, peanuts,
and cacao. They also raised animals such as llamas and guinea pigs in the
Old World. The influence of the European settlers resulted in a rich array
of cuisines. Foods drawing from Spanish, Italian, and Portuguese cultures
arrived and were incorporated into a South American diet. These tradi-
tional dishes were blended to create some unique culinary traditions for
the region. For Argentine culture, beef remains a central focus for many
dishes and is prepared in a variety of ways. Brazil’s national dish, “feijoada,”
represents a stewed version of pork, beans, and beef. A few of the high-
lights and more unusual dishes are described in this section.
Where: Eating around the World 153

Alpaca Meat
A delicacy in the South American region, alpaca meat, which has been
referred to as “the other red meat,” is considered lean and tender.
Typically, it is best served medium to medium rare to avoid becoming
too dry from overcooking. It can be purchased as ground meat, already
formed in patties, or in chunks for stew meat. Prime cuts in the form of
steaks and loin cutlets are also sold fresh or frozen. Secondary cuts can pro-
duce sausages and hot dogs. Generally, from a nutritional standpoint this
meat is high in protein while being low in fat and cholesterol. Some sour-
ces claim that alpaca meat is the most flavorful and healthy form of meat;
however, this form of meat has not yet caught on in the mainstream
United States. Popularity for this type of meat is growing in other places
in the world, like Australia, which has the second-largest alpaca market
after South America.

Empanadas
Although Chile does not claim a particular national dish, empanadas
would likely be considered a logical choice, as they are a regional specialty.
Venezuela also serves specialties like empanadas along with other dishes
that have a distinct European flair (e.g., French croissants and a version
of lasagna). Empanadas resemble small pastries and are stuffed with a vari-
ety of sweet or savory fillings. They have sometimes been referred to as
“beef turnovers,” but fillings such as cheese, vegetables, and fruits can also
be used. The dough is usually made with wheat flour but can be infused
with almond flour, cinnamon, or chocolate for sweet varieties. The pastries
are either baked, deep fried, or cooked on a grill. A variety of sauces may
accompany this appetizer or treat, including a spicy version (i.e., olive oil
with chili powder) or avocado sauce for meat-based empanadas and sweet
cream or honey for the dessert empanadas.

Ceviche
Several countries within South America consider ceviche to be their
national dish. In fact, both Peru and Ecuador claim that they are the birth-
place of this increasingly popular dish. Ceviche is made from fresh raw fish
that is cured in citrus juices and spiced with chile peppers. It is served cold,
typically accompanied by a variety of garnishes influenced by both the region
and whether it is being served as a first or main course. In Ecuador, the dish is
served with nuts, popcorn, or corn nuts, while in Peru ceviche is served with
154 Filling Up

sweet potatoes or corn on the cob. The dish is also popular in countries out-
side of South America, such as Mexico, where it is popular to serve with
toasted tortillas and raw onions.

Fast Food
In South America, U.S. fast-food chains are widely available. As in Asia,
these restaurant chains have adapted their typical menu fare to include
local favorites. For example, can you imagine ordering an empanada at
McDonald’s or caramelized goat milk ice cream from Baskin Robbins?

CONCLUSION
This chapter provides a sampling of the diverse cultures related to food
around the world. As you can see, there are many unique foods represented
in the different geographical regions. It is also important that we avoid
making generalizations about people’s eating patterns in a particular part
of the globe due to the many cultural differences that exist across a country
or region. Further, as the food industry with businesses such as McDonald’s
expands around the globe, some eating experiences can seem more similar
than different across cultures.

BIBLIOGRAPHY
Barksdale, Nate. “Minders’ Delight: The History of the Cornish Pasty.”
History.com. Last modified October 10, 2014. http://www.history.com/
news/hungry-history/miners-delight-the-history-of-the-cornish-pasty.
Beuchelt, Tina D., and Detlef Virchow. “Food Sovereignty or the Human
Right to Adequate Food: Which Concept Serves Better as International
Development Policy for Global Hunger and Poverty Reduction?”
Agricultural Human Values 29 (2012): 259–73. doi: 10.1007/s10460-012
-9355-0.
Bhutta, Zulfiqar A., and Rehana A. Salam. “Global Nutrition Epidemiology
and Trends.” Annals of Nutrition & Metabolism 61, no. 1 (2012): 19–27.
doi: 10.1159/000345167.
Blazes, Marian. “An Introduction to South American Food.” About.com.
Accessed February 23, 2016. http://southamericanfood.about.com/od/
exploresouthamericanfood/a/history.htm.
Bloudoff-Indelicato, Mollie. “Kangaroo: The Next Alternative Meat?”
National Geographic. Last modified May 18, 2015. http://theplate
.nationalgeographic.com/2015/05/18/kangaroo-the-next-alternative
-meat/.
Where: Eating around the World 155

Boyfield, Keith. “Averting a Global Food Crisis.” World Economics 14, no.
1 (2013): 65–86. http://www.world-economics- journal.com/Averting
%20a%20Global%20Food%20Crisis.details?AID=544.
Brown, Ian J., Ioanna Tzoulaki, Vanessa Candeias, and Paul Elliott. “Salt
Intakes around the World: Implications for Public Health.”
International Journal of Epidemiology 38 (2009): 791–813. doi: 10.1093/
ije/dyp139.
Capaldi, Elizabeth D. “Conditioned Food Preferences.” In Why We Eat
What We Eat, edited by Elizabeth D. Capaldi, 53–80. Washington,
DC: American Psychological Association, 1996.
Chen, Tanya. “13 Canadian Fast Food Menu Items Americans Don’t
Have.” BuzzFeed.com. Last modified December 2, 2014. http://www
.buzzfeed.com/tanyachen/fast-food-items-only-in-canada#.waW4y8nmz.
Chopra, Mickey, Sarah Galbraith, and Ian Darnton-Hill. “A Global
Response to a Global Problem: The Epidemic of Overnutrition.”
Bulletin of the World Health Organization 80, no. 12 (2002): 952–58.
Accessed February 23, 2016. http://www.who.int/bulletin/archives/80
(12)952.pdf.
Crockett, Zachary. “When Americans Ate Horse Meat.” Priceonomics
.com. Last modified January 16, 2015. http://priceonomics.com/when
-americans-ate-horse-meat/.
D’Aluisio, Faith, and Peter Menzel (photographer). What the World Eats.
Berkeley, CA: Tricycle Press, 2008.
Darnton-Hill, I., and E. T. Coyne. “Feast and Famine: Socioeconomic
Disparities in Global Nutrition and Health.” Public Health Nutrition 1,
no. 1 (1997): 23–31. doi: 10.1079/PHN19980005.
Drewnowski, Adam, and Barry M. Popkin. “The Nutrition Transition:
New Trends in the Global Diet.” Nutrition Reviews 55, no. 2 (1997):
31–43. doi: 10.1111/j.1753-4887.1997.tb01593.x.
Gaskell, Katja. “Top 10 Foods to Try in Mexico.” BBCGoodFood.com.
Accessed February 23, 2016. http://www.bbcgoodfood.com/howto/
guide/top-10-foods-try-mexico.
The Global Alliance for Improved Nutrition (GAIN). Gainhealth.org.
Accessed February 23, 2016. http://www.gainhealth.org.
Golub, Alla A., Benjamin B. Henderson, Thomas W. Hertel, Pierre J.
Gerber, Steven K. Rose, and Brent Sohngen. “Global Climate Policy
Impacts on Livestock, Land Use Livelihoods, and Food Security.”
Proceedings of the National Academy of Sciences 110, no. 52 (2013):
20894–99. doi: 10.1073/pnas.1108772109.
Hamdan, Sara. “Midlevel U.S. Chains Move into Fast-Food Hungry
Gulf.” New York Times. Last modified September 12, 2012. http://
156 Filling Up

www.nytimes.com/2012/09/13/world/middleeast/midlevel-us-chains
-move-into-fast-food-hungry-gulf.html?_r=0.
“Hara Hachi Bu.” Okinawa-diet.com. Accessed February 23, 2016. http://
okinawa-diet.com/okinawa_diet/hara_hachi_bu.html.
“The History of Australian Food.” Australia.Angloinfo.com. Accessed
February 23, 2016. http://australia.angloinfo.com/lifestyle/food-and
-drink/food-history/.
“History of Pizza.” LifeinItaly.com. Last modified August 4, 2015. http://
www.lifeinitaly.com/food/pizza-history.asp.
Hojjat, Tahereh A. “Global Food Crisis—Food versus Fuels.” Competition
Forum 7, no. 2 (2009): 419–26. https://www.questia.com/library/
journal/1P3-1912955601/global-food-crisis-food-versus-fuels.
Hubbard, Kirsten. “Central American Food: The Very Best of Central
American Cuisine.” About.com. Last modified December 16, 2014.
http://gocentralamerica.about.com/od/restaurantsrecipes/tp/Central
-America_Food-and-Drink.htm.
Joy, Olivia, and Tatiana Nassar. “Fast Food Giants Want Pizza the Action
in Africa.” CNN.com. Last modified October 4, 2013. http://www.cnn
.com/2013/10/04/business/fast-food-giants-africa/.
Kolars, Emily. “10 European Fast Food Chains You’ll Have to Travel to
Enjoy.” TheDailyMeal.com. Last modified July 18, 2013. http://www
.thedailymeal.com/10-european-fast-food-chains-don-t-translate-us.
Kremer-Sadlik, Tamar, Alyah Morgenstern, Chloe Peters, Pauline
Beaupoil, Stéphanie Caët, Camille Debras, and Marine le Mené.
“Eating Fruits and Vegetables. An Ethnographic Study of American
and French Family Dinners.” Appetite 89 (2015): 84–92. doi: 10.1016/
j.appet.2015.01.012.
Loring, Philip A., and S. C. Gerlach. “Food, Culture, and Human Health
in Alaska: An Integrative Health Approach to Food Security.”
Environmental Science & Policy 12 (2009): 466–78. doi: 10.1016/
j.envsci.2008.10.006.
Lund, Thomas B., and Jukka Gronow. “Destructuration or Continuity?
The Daily Rhythm of Eating in Denmark, Finland, Norway and
Sweden in 1997 and 2012.” Appetite 82 (2014): 143–53. doi: 10.1016/
j.appet.2014.07.004.
Mattei, Josiemer, Vasanti Malik, Nicole M. Wedick, Hannia Campos,
Donna Spiegelman, Walter Willett, and Frank B. Hu. “A Symposium
and Workshop Report from the Global Nutrition and Epidemiologic
Transition Initiative: Nutrition Transition and the Global Burden of
Type 2 Diabetes.” British Journal of Nutrition 108 (2012): 1325–35.
doi: 10.1017/S0007114512003200.
Where: Eating around the World 157

McNeill, Shalene, and Mary E. Van Elswyk. “Red Meat in Global

Nutrition.” Meat Science 92 (2012): 166–73. doi: 10.1016/j.meatsci
.2012.03.014.
Menzel, Peter, and Faith D’Aluisio. Hungry Planet: What the World Eats.
Napa, CA: Ten Speed Press, 2007.
Menzel, Peter, and Faith D’Aluisio. What I Eat: Around the World in 80
Diets. Napa, CA: Ten Speed Press, 2010.
Morin, Karen H. “Global Health and Nutrition.” Nutrition for the Family
37, no. 5 (2012): 346. doi: 10.1097/NMC.0b013e318261919a.
Mozaffarian, Dariush. “Diets from around the World—Quality Not
Quantity.” The Lancet 378 (2011): 759. doi: 10.1016/S0140-6736(11)
61362-7.
Pirkle, Catherine M., Hélène Poliquin, Drissa Sia, Kouassi J. Kouakou,
and Tani Sagna. “Re-envisioning Global Agricultural Trade: Time for
a Paradigm Shift to Ensure Food Security and Population Health in
Low-Income Countries.” Global Health Promotion 22, no. 1 (2014):
60–63. doi: 10.1177/1757975914531029.
Popkin, Barry M., Linda S. Adair, and Shu W. Ng. “Global Nutrition
Transition and the Pandemic of Obesity in Developing Countries.”
Nutrition Reviews 70, no. 1 (2012): 3–21. doi: 10.1111/j.1753-4887
.2011.00456.x.
Rowland, Neil, and Emily Crews Splane. Psychology of Eating. Boston:
Pearson, 2014.
Rozin, Paul. “Food and Eating.” In Handbook of Cultural Psychology, edited
by Shiobu Kitayama and Dov Cohen, 391–416. New York: Guilford
Press, 2007.
Rubaum-Keller, Irene. “Hara Hachi Bu: Eat Until You Are 80% Full.”
Huffington Post. Last modified November 21, 2011. http://www
.huffingtonpost.com/irene-rubaumkeller-/not-overeating_b_969910
.html.
Schmitt, Kristen. “Alpaca: The Other Red Meat.” Modernfarmer.com.
Last modified May 30, 2014. http://modernfarmer.com/2014/05/
alpaca-red-meat/.
Spiegel, Alison. “ ‘What I Eat: Around the World in 80 Diets’ Shows
Stunning Portraits of Daily Meals.” Huffington Post. http://www
.huffingtonpost.com/2014/03/28/what-i-eat-around-the-world-in-80
-diets_n_5043024.html.
Swan, Samuel H., Sierd Hadley, and Bernardette Cichon. “Crisis behind
Closed Doors: Global Food Crisis and Local Hunger.” Journal of
Agrarian Change 10, no. 1 (2010): 107–18. doi: 10.1111/j.1471
-0366.2009.00252.x.
158 Filling Up

Webb, Patrick. “Medium- to Long-Run Implications of High Food

Prices for Global Nutrition.” The Journal of Nutrition 140, no. 1
(2010): 143–47. doi: 10.3945/jn.109.110536.
Willett, Walter C., Frank Sacks, Antonia Trichopoulou, Greg Drescher,
Anna Ferro-Luzzi, Elisabeth Helsing, and Dimitrios Trichopoulos.
“Mediterranean Diet Pyramid: A Cultural Model for Healthy Eating.”
American Journal of Clinical Nutrition 61 (1995): 1402S–6S. http://
ajcn.nutrition.org/content/61/6/1402S.short.
Woodall, Sarah. “Greenland Gastronomy.” Greenland.com. Accessed
February 23, 2016. http://www.greenland.com/en/things-to-do/
cultural-experiences/greenlandic- gastronomy/.
 Part II

Scenarios

In this part of the book, five separate scenarios will be presented that
demonstrate a person who is struggling with some aspect of eating.
Each case study will illustrate a particular situation as well as practical
responses and recommendations for which actions are likely to be the most
helpful based on information from nutrition experts and the literature.

Dieting Gone Wild: The Throes of Teenage Years

Daphne just entered ninth grade and has been exploring a whole new school and
friendships. A few months ago, she started hanging out with a group of tenth-
grade girls who have entered into a “diet pact.” Specifically, they have committed
to losing 50 pounds collectively. To this end, they get together in the afternoons
and talk about ways to lose weight and change their appearance. They cheer each
other on in their dieting mission, but they undermine their goals by binge-eating
foods such as chips and ice cream.
Unsurprisingly, instead of losing the desired amount of weight, Daphne has
actually gained five pounds. She experiences intense body dissatisfaction and neg-
ative feelings around her body shape and appearance. All of the girls in the group
discuss what they hate about their bodies and how they would give anything to
change this or that body part. The girls spend hours gazing at pictures of ultra-
thin models in fashion magazines and on websites that actually promote anorexia
160 Filling Up

nervosa (referred to as “pro-ana” websites) for inspiration and motivation to stay

the course.
The other girls in the group share their diet “secrets” with her, including the use
of diet pills, laxatives, and throwing up food that has been consumed. They also tell
her she might consider fasting after a certain time each evening or skipping lunch.
Daphne would rather not use these purging methods because she hates the thought
of vomiting on purpose or taking pills. However, she is embarrassed by the recent
weight gain and feeling frustrated. She believes that her body is cycling out of con-
trol. The more she thinks about food, the more she has a hard time resisting the
temptation of sugary snacks. She actually has started to dream about foods.
When Daphne sees her regular doctor for her annual visit, she confides that
she has gained weight. She reveals that she often eats too much and cannot
control her food consumption as well as her obsession with body shape and size.
Her doctor tells her that Daphne is likely developing a condition called binge eat-
ing disorder. This is news to Daphne, who just thought she was on a diet that was
failing miserably. What is she to do?

The literature suggests that disordered eating behaviors can be an out-

growth of dieting behavior. Daphne is a classic example of someone who
unwittingly entered into a dieting mind-set as a way to feel connected to
her peers and be part of the group. The pull of this dieting mentality can
be powerful. Unfortunately, as behaviors become more frequent and
severe, the consequences grow worse as well. It is important for Daphne
to receive treatment for her binge eating disorder symptoms.
Binge eating disorder is defined as having recurring episodes of overeat-
ing that happen at least once a week over a period of at least three months.
Amounts of food consumed are considered larger than what would be nor-
mal for the relatively short (less than two hours) period of time. These epi-
sodes are associated with feelings of being out of control. This overeating is
not linked with a subsequent purging method. Generally, these feelings are
associated with eating more rapidly, eating alone, and feeling a great deal
of stress. It is important to note that these binge eating episodes are not
associated with feeling physically hungry. Moreover, individuals with
binge eating disorder may experience depression, feelings of disgust, and
guilt following the binge eating episode.
Eating disorder clinicians recognize the need to treat the psyche behind
the behavior as well as address the binge eating episodes. Specifically,
Daphne will want to eliminate both the overeating events as well as the feel-
ings of compulsion to binge. She will talk these out with a therapist, who will
likely use a cognitive behavioral approach. Cognitive behavioral therapeutic
approaches examine how a person’s thoughts lead to certain behaviors.
Scenarios 161

Daphne will be asked to explore how her thoughts are tied to her feelings and
disordered eating behaviors. For example, the therapist may ask Daphne to
chart her thoughts and feelings leading up to a binge episode in an attempt
to better understand potential triggers. Once there is some understanding of
precipitating events, Daphne will be encouraged to extinguish these triggers
or to recognize them when they are present so they can be addressed.
Therapy sessions will help Daphne cope with her emotions in new ways
that do not include binge eating. Because her peers have played a role in
cultivating a food-focused and body-hating environment associated with
introducing dieting strategies and pro-ana websites (i.e., websites that
actually promote and reinforce eating disordered behaviors), she may be
discouraged from spending time with her friends as she works to address
her destructive relationship with food. However, she should also be per-
suaded to find alternative activities so that she has a productive way to
spend the time she was hanging out with her peers after school.
In additional to the psychology behind the eating, Daphne will likely
work with a dietitian on her eating plan. She will be able to receive some
guidance regarding ways to moderate her eating so that she eats regular and
healthy meals throughout the day. She will be encouraged to slow down
and eat mindfully in order to taste her food. She will also be trained to
notice her physiological cues of hunger and fullness that have been absent
from binge eating episodes. If certain foods are identified as triggering,
there will need to provide gradual exposure to them with guidance, train-
ing, and oversight. Exposure therapy is designed to help remove the power
that certain foods are believed to have over a person. For Daphne, it will
be important to reprogram her relationship with food and to discover a
sense of self-worth again.

Mindless Eater: The Daily Grind of TV Dinners

Brandon is a 26-year-old single man who works long hours as an insurance agent
for State Farm. His childhood was pretty normal, and he has never really thought
about food or what he eats. He is living in an apartment with a small kitchen and
does not have much time to prepare food. Before he leaves for work, he typically
has cereal for breakfast and some orange juice. Although his menu is not inven-
tive, these items prove easy to fix and are fast. On his way into the office, his rou-
tine is to stop at Starbucks for a grande mocha with caramel sauce and whipped
cream. He finds that the espresso shot makes him feel alert and ready for the day.
During the workday he usually grabs lunch with his coworkers or brings a
sandwich from home. Sometimes the office will order in Chinese food, Jimmie
162 Filling Up

John’s sandwiches, or pizza in the middle of the day. He might have a granola bar
or snack in the afternoon to get a little boost. At his office, candy is often sitting
out in the reception area or shared office kitchen, so he might grab a small candy
bar for a snack. By the time he gets home in the evening, he feels pretty wiped
out. His way to wind down is to turn on the television and watch games or his
favorite sitcoms.
Being way too tired to cook a meal, Brandon usually microwaves a frozen
dinner. Alternatively, Brandon will pour tortilla chips into a bowl and coat them
with salsa and cheese sauce from a jar. Sometimes he will have a pizza delivered
to his home to keep things simple and fast. Whatever he selects for his nightly
meal, Brandon finds that he scarfs it down without really tasting his food.
Being completely distracted by what he is watching on television, he finds he does
not really enjoy his meal or notice sensations of fullness at the end. He is pretty
exhausted but notices that he experiences feelings of dissatisfaction even after
the food is gone. What should he do?

Brandon is what nutrition experts would label a mindless eater. That is,
Brandon engages in other activities while he is eating rather than focusing
on the food during his meal. It is recommended that Brandon should make
a few changes in his daily dietary regimen. First of all, he can prepare for
his long workday by bringing healthy snacks to eat throughout the day.
His “pick-me-up” snacks may consist of food items like carrot sticks and
hummus dip, apples and peanut butter, or almonds, which will serve to
keep Brandon’s energy level constant. Eating more and smaller meals
should also help curb Brandon’s sharp dive in energy and prevent his appe-
tite from taking over when he gets home from work. This will allow him to
take time to make healthier choices.
When Brandon eats his nightly meal, he should be encouraged to con-
sume his food away from distractions. With the television off and sitting
at a designated area like the kitchen table, Brandon can begin to practice
mindful eating. Mindful eating refers to eating in a deliberate manner with
attention to tastes and textures of food. Brandon should slow down his eat-
ing and may benefit from using a timer to train himself. To this end,
Brandon should be encouraged to chew each bite slowly and as many times
as possible prior to swallowing. A common way to teach mindful eating is
called the “chocolate kiss activity.” Brandon should be given a Hershey’s
Kiss while being encouraged to spend time looking at the shape, color,
and texture of the chocolate candy. Then, once he has spent ample time
studying the piece of candy, he should smell the chocolate with his eyes
closed. He should conduct a mental inventory of what memories the smell
evokes. Finally, he should slowly slide the candy in his mouth while tasting
Scenarios 163

the candy. Rather than chewing the candy, Brandon should be encouraged
to experience the taste of the piece of chocolate for as long as possible.
Although it would not be practical to eat every bite of every meal in this
fashion, the chocolate-kiss activity can teach a different way of eating that
is more mindful. Practicing a mini-meditation prior to meals can help peo-
ple like Brandon bring their attention to the food they are about to
consume.
Before each meal, Brandon should take a deep breath and focus on the
food he is going to have. He should take the time to notice the smell of his
food. He should take an inventory of each item on his plate. What is the
color of each food? What does the texture look like? While he is eating
the food, he should give full attention to feeling the sensation of the food
in his mouth and to noticing the texture of the item. It may also be helpful
for Brandon to keep a food journal to chart when and what he eats during
the day along with his observations about smells, tastes, and textures that
come from a mindful approach to eating. That documentation will allow
him to track his progress toward becoming a more mindful and healthy eater.

Going Off to College

Chandra had always lived with her parents in Wisconsin before going out of state to
attend a university in Pennsylvania. She decides to live on campus in order to avoid
the need to own a car and commute to school. As part of the university arrange-
ments, Chandra is required to buy a meal plan since she is living in a university res-
idential hall. She selects the most inclusive meal plan in order to maximize the
flexibility of her food choices and the times of the day she can elect to get a meal.
At first, she feels elated about the opportunity to go to dinner with new friends
and other residents on campus. It is a great way to be social, and there seems to
be a wide selection of foods to choose from when they go through the lines.
She also has the option to order Domino’s Pizza delivery using her student ID
card as part of her meal plan or to get Pizza Hut takeout from a campus store.
The students will order pizza pies as they work in study groups or blow off steam,
especially late at night. She also finds that she hits up the residence hall vending
machines frequently for a “sugar boost.” She grabs a Mountain Dew or Kit
Kat candy bar for that much-needed jolt of energy even at three in the morning.
Breakfast is sumptuous and includes some of Chandra’s favorite foods. When
she can make it to the dining hall in time, she gets made-to-order waffles or
omelets along with her favorite sides of hash browns and oatmeal. She is often
in class during the lunch hour, but she can get an afternoon snack or “make up
for it” at dinner when she realizes she is ravenously hungry. At first, she could
164 Filling Up

not be happier to have the freedom to eat what she wants, when she wants. But
after several weeks, the meals start to feel monotonous. Foods that seemed excit-
ing are available each day and have lost their luster. She feels hooked on her
Mountain Dew rush to get through her study sessions, and her body feels out of
sync. As much as Chandra hates to admit it, she misses the predictability of her
family environment as well as the access to healthy foods. She knows she can
do better but is unsure of where to start. What should Chandra do?

What Chandra is experiencing with her transition from family to college

is a common stressor for first-year students. Some researchers have dubbed
the phenomenon of unhealthy eating by first-year college students that can
be associated with weight gain as the “Freshman 15.” Whether any weight
is gained, there are clearly some challenges associated with developing eating
patterns as an adult outside of the home. Chandra is now in a position to eat
what, when, and how much she wants. She has endless access to foods even
at the early hours of the morning. Unfortunately, many of these foods are
considered “junk foods” and may not provide her with the nutrients her body
needs to function at an optimal level.
Chandra can benefit from keeping a food log to discover what foods she
is eating and how much. She should determine how many fruits and vege-
tables she is getting throughout the day. There may be a dietitian on cam-
pus who can conduct a nutritional analysis of her food intake. This will
help her understand how many calories are consumed as well as how close
she is to meeting the United States Department of Agriculture (USDA)
guidelines of healthy eating. The USDA food plate is a good model for
Chandra to use when determining how many and what portions she
should reach for throughout the day.
Although Chandra has access to fast foods like pizza, she will likely
want to reduce her frequency of these choices in her diet. She might con-
sider examining what healthy options are available at the dining hall and
other outlets that will help her meet her daily nutritional needs. She
should be encouraged to get plenty of variety in her diet so that she main-
tains a balanced approach to eating. This will feel challenging to Chandra
at first, but once she gets the hang of it, she will develop some important
lifestyle habits related to eating the right kinds of food throughout the day.

Midlife Stress Eater: Eating to Fill the “Empty Nest”

Beverly is a 49-year-old homemaker who is feeling blue these days. After step-
ping out of the workforce to raise her children more than 25 years ago, she feels
Scenarios 165

like her identity has been that of “mother” first and foremost. Now that all of her
three children have grown into adulthood and are out of the house, Beverly is
feeling down and out. She is a self-described “stress eater” and can remember
eating any time she felt strong emotions in her life. Now that she is home alone
when her husband is off to work, Beverly has a lot of time to think and experience
intense emotions. She realizes that she “put her life on hold” for 25 years and
neglected to develop meaningful friendships or foster enjoyable hobbies. This
has left her with a deep sense of emptiness.
To fill her that emptiness, she now finds herself engaging in emotionally based
eating. She eats when she feels depressed. She eats when she experiences anxiety.
She consumes food when she feels sad or mad. Although Beverly is immensely
lonely, food is always there for her. Beverly recognizes her tendency to reach
for comfort foods in these moments. She suspects she learned these behaviors
from her mother, who used to binge on jelly beans when she would experience
disappointment. She realizes that by watching her mom, she understood food
could be helpful as a coping strategy.
She wants to use healthy ways to cope with her strong emotions, but her negative
behaviors feel programmed and automatic. She has read about “empty nesters” who
struggle with the transition. But she never expected herself to feel such a deep sense
of sadness and lack of purpose. She is no longer needed by her kids except for the
occasional laundry request. What is she, a Laundromat?
In addition to losing the daily connection with her children and their activities,
she realizes that she no longer knows her husband. The relationship they once had
has become stiff and strained. They seem to search for conversation topics over
dinner. Beverly remembers feeling like she and her husband at one time had so
much in common. Now the only common tie seems to be the experience of hav-
ing three children together. What happened to them?
Being an emotionally driven “stress eater” has created a negative cycle of
depression. She feels stressed and then reaches for food to soothe her feelings.
As a result of consuming the food, which is most likely fattening or creamy—
cookies, ice cream, or other sweet treats were common—Beverly experiences
intense guilt and feelings of self-hatred. Sometimes Beverly feels like she is
addicted to sugar because her desire to eat these high-calorie items is so strong.
Naturally, she feels sick to her stomach after eating the sugary foods, but the next
time she feels stressed, she tends to fall into the same pattern of emotional eating.
What should Beverly do?

The nutrition experts would say that what Beverly is experiencing is

natural given her circumstances. She has developed ingrained patterns of
“eating her emotions” over the years as her “modus operandi.” In fact,
she started the habit of reaching for food when she felt intense emotions
166 Filling Up

from a young age. As Beverly recalled from her early experiences, role
modeling is important for how individuals learn to cope with emotions.
Some of those so-called coping strategies are not necessarily healthy.
How does Beverly move away from her “stress eating” and being an emo-
tional eater? The literature suggests it will take some time for Beverly to
reprogram her relationship with food.
If Beverly visits a dietitian, she might be encouraged to learn about
intuitive eating. Intuitive eating refers to using internal biological cues
rather than emotions to drive eating behaviors. Beverly should ask herself
whether she feels hungry the next time she reaches for a sugary treat.
This will be challenging at first, given that she has likely suppressed genu-
ine feelings of hunger and fullness for so long. It is estimated that it takes
the average person around six months to shift his or her relationship with
food from being an emotional to an intuitive eater. To accomplish this
task, there are a few recommendations for Beverly to follow.
The intuitive eating philosophy underscores the need to honor your
hunger. For many people like Beverly, it can be important to get back in
touch with physiologically based hunger cues. Beverly can use what is
called a “Hunger Discovery Scale” to evaluate her level of hunger at a par-
ticular time. Beverly should ask questions like whether her tank is com-
pletely empty. Does she feel ravenous or is she at a more moderate place
on the range of the hunger and fullness scale? She can assign the score of
“0” to represent feeling starved (beyond empty) all the way to the score
of “10” for feeling too full. A score of “5” represents a neutral stance—
neither hungry nor full. Finally, she should check in with her feelings of
fullness at the end of the meal to determine her level of satiety. It may also
be helpful for Beverly to maintain a food journal to chart when and what
she eats during the day along with her scores for hunger and fullness.
That documentation will allow her to track her progress toward becoming
a more mindful and healthy eater.
In addition to changing her relationship with food, Beverly will need
to develop new coping strategies that are more healthy and adaptive.
She should be encouraged to try new activities and find some hobbies.
For example, she might consider taking a walk rather than consuming a
piece of cake the next time she feels lonely. She will also need to find a
way to express in words the types of emotions she is experiencing. It may
be helpful for her to see a mental health counselor to work through some
of her strong emotions and depressed mood associated with the “empty
nest” transition. She may also need to work on her marital relationship.
It will be important for her to get to know her husband again and rebuild
her support systems around her to cope with this transition period.
Scenarios 167

Pressure to Compete: An Athlete’s Obsession

with “Sucking Weight”

Travis is a collegiate wrestler who attends a large university in the Midwest.

He has been wrestling for 10 years and played football since he was in third
grade. He was a champion at his high school and has been highly successful
throughout his career. Wrestling techniques came easy to him. He never gave
much thought to which weight class he belonged to or competed in, because
the coaches always treated him like the “golden child.” He remembers other
athletes on his team wearing sweat suits and doing extra laps to lose weight.
These same athletes would also carry around spit cups to eliminate any extra
water weight before competitions. Travis wondered why they had to try so hard
to achieve their competitive weight, until now. He realizes that competing on a
Division I collegiate team means that everyone was a star at their respective
high school. The athletes who have already established themselves on the team
can claim the weight classes they desire. Everyone else is forced to find a place
on the team.
Travis has been encouraged by his coach to consider moving down a weight
class. This shift will require extensive changes in his eating behaviors and will
involve losing 20 pounds in a short period of time. He is not concerned with
how he looks in his clothes, but he feels strong pressure to “do what it takes” to
increase his likelihood of success in the sport. Travis also worries that his scholar-
ship may be in jeopardy if he does not heed his coach’s wishes regarding the lower
weight class. He feels that he does not have much of a choice in the matter.
Upon receiving the recommendation to drop into a lower weight category,
Travis initially sought a healthy route to meet his sport-related goals. He sched-
uled an appointment with a sport nutritionist whom he learned some of the ath-
letes had seen over the years. The sport nutritionist prescribed meal plans that
would support gradual weight loss in a healthy way. Travis decided that to
achieve his goals sooner, he could cut the meal plans he received in half. Pretty
soon, Travis was elated to find that he had dropped five pounds. He thought,
“That was easy!” and “If I decrease my plan even more, my weight loss will hap-
pen even faster. No sweat!” His teammates express being jealous of his ability to
“suck weight” quickly and drop a weight class. They decide to get together for
early morning rigorous exercise sessions. Travis and his teammates wear sweat
suits and run around the gym to burn calories and lose water weight. They avoid
drinking too much water for fear the water weight will show up on the scale, put-
ting them at risk for dehydration.
Travis begins to feel worn-out and tired. He notices that he is irritable around
his friends and teammates. Getting through gym workouts and practices has
168 Filling Up

become a struggle. He also notices that his sleep is all over the place. He feels
compelled to take naps during the day but also has trouble falling asleep at night.
When he does fall asleep, Travis wakes up dreaming of food and feeling rav-
enous. His hunger pangs are both reinforcing of his weight goals and a reminder
of how little he is putting in his body. He knows he cannot sustain his attempts to
lose weight while still continuing to perform well in his sport. In fact, his perfor-
mance and energy level have suffered, and he recognizes he needs to take action.
What should Travis do?

The experts would identify Travis’s restricting behavior and excessive

exercise that have been correlated with his desire to drop a weight class
in his sport as “disordered” eating. Engaging in these unhealthy behaviors
in attempts to lose weight for wrestling puts Travis at increased risk for
developing a full-blown, clinically diagnosable eating disorder. Travis can
still suffer from a negative impact on his health resulting from not consum-
ing enough calories and exercising in an excessive fashion.
Like many athletes, the pressure of the sport context has contributed to
the use of disordered behaviors in a misguided attempt to improve one’s
performance. Coaches, teammates, and judges have all been blamed
for linking weight changes to performance gains in a variety of sports.
The mentality of sculpting one’s body weight, size, or shape closer to the
ideal can be dangerous for athletes like Travis.
If Travis continues down this path, he will likely need to be confronted
by someone who cares for him. In fact, he should be encouraged to under-
stand how eating too little will negatively affect his performance and his
health. Unfortunately, behaviors that begin as a way to reduce one’s
weight or drop a weight category can spiral out of control. Psychiatrists
that specialize in eating disorders associate this tendency to be reinforced
by unhealthy weight loss with a “click” in the brain. Something “clicks”
and the feelings associated with weight loss are seen as positive.
Therefore it is important for Travis to receive immediate and comprehen-
sive support that involves a healthy eating plan.
Treatment professionals need to consider whether athletes like Travis
can continue participating in their sport. A variety of factors may influ-
ence this decision, such as the amount of social support for healthy recov-
ery and the role of the coach in reinforcing weight standards among
athletes. Sport identity can be important and will need to be replaced with
something beneficial if the athlete drops out of the sport. A comprehensive
treatment approach for addressing disordered eating in an athlete should
include a physician, dietitian, and mental health professional at a mini-
mum. Ideally, the athletic trainer and other sport personnel are engaged
Scenarios 169

in supporting the treatment process. If problems are addressed early and

Travis recognizes the problem, he will be able to work on developing a
healthy meal plan. Recovery from disordered eating and eating disorders
is possible, but it will take time and trained professionals.

BIBLIOGRAPHY
Allison, Kelly C., Scott G. Engel, Ross D. Crosby, Martina de Zwaan, John
O’Reardon, Stephen A. Wonderlich, James E. Mitchell, Delia Smith
West, Thomas A. Wadden, and Albert J. Stunkard. “Evaluation of
Diagnostic Criteria for Night Eating Syndrome Using Intern Response
Theory Analysis.” Eating Behaviors 9 (2008): 398–407. doi: 10.1016/
j.eatbeh.2008.04.004.
Augustus-Horvath, Casey L., and Tracy L. Tylka. “A Test and Extension
of Objectification Theory as It Predicts Disordered Eating: Does
Women’s Age Matter?” Journal of Counseling Psychology 56, no. 2
(2009): 253–65. doi: 10.1037/a0014637.
Avalos, Laura C., and Tracy L. Tylka. “Exploring a Model of Intuitive
Eating with College Women.” Journal of Counseling Psychology 53,
no. 4 (2006): 486–97. doi:10.1037/0022-0167.53.4.486.
Berge, Jerica M., Katie Loth, Carrie Hanson, Jillian Croll-Lampert, and
Dianne Neumark-Sztainer. “Family Life Cycle Transitions and the
Onset of Eating Disorders: A Retrospective Grounded Theory
Approach.” Journal of Clinical Nursing 21, nos. 9–10 (2012): 1355–63.
doi: 10.1111/j.1365-2702.2011.03762.x.
Capaldi, Elizabeth D. “Conditioned Food Preferences.” In Why We Eat
What We Eat, edited by Elizabeth D. Capaldi, 53–80. Washington,
DC: American Psychological Association, 1996.
de Sampaio, Fernanda Tapajóz P., Sebastian Soneira, Alfredo Aulicino,
and Ricardo Francisco Allegri. “Theory of Mind in Eating Disorders
and Their Relationship to Clinical Profile.” European Eating Disorders
Review 21, no. 6 (2013): 479–87. doi: 10.1002/erv.2247.
de Sampaio, Fernanda Tapajóz P., Sebastian Soneira, Alfredo Aulicino,
Graciela Martese, Monica Iturry, and Ricardo Francisco Allegri.
“Theory of Mind and Central Coherence in Eating Disorders:
Two Sides of the Same Coin?” Psychiatry Research 210, no. 3 (2013):
1116–22. doi: 10.1016/j.psychres.2013.08.051.
Grave, Riccardo D. Multistep Cognitive Behavioral Therapy for Eating
Disorders: Theory Practice, and Clinical Cases. Lanham, MD: Jason
Aronson, 2013.
170 Filling Up

Louis, Winnifred R., Marc K.-H. Chan, and Seth Greenbaum. “Stress
and the Theory of Planned Behavior: Understanding Healthy and
Unhealthy Eating Intentions.” Journal of Applied Social Psychology 39,
no. 2 (2009): 472–93. doi: 10.1111/j.1559-1816.2008.00447.x.
McKenzie, James F., Brad L. Neiger, and Rosemary Thackeray. “Theories
and Models Commonly Used for Health Promotion.” In Planning,
Implementing, and Evaluating Health Promotion Programs: A Primer,
162–204. Boston: Pearson, 2013.
Ogden, Jane. “An Integrated Model of Diet.” In The Psychology of Eating:
From Healthy to Disordered Behavior, 2nd ed., 276–87. Malden, MA:
Wiley-Blackwell, 2010.
Piquero, Nicole Leeper, Kristan Fox, Alex R. Piquero, George Capowich,
and Paul Mazerolle. “Gender, General Strain Theory, Negative
Emotions, and Disordered Eating.” Journal of Youth and Adolescence 39,
no. 4. (2010): 380–92. doi: 10.1007/s10964-009-9466-0.
Rowland, Neil, and Emily Crews Splane. Psychology of Eating. Boston:
Pearson, 2014.
Rozin, Paul. “Food and Eating.” In Handbook of Cultural Psychology, edited
by Shiobu Kitayama and Dov Cohen, 391–416. New York: Guilford
Press, 2007.
Tiggemeann, Marika. “Objectification Theory: Of Relevance for Eating
Disorder Researchers and Clinicians?” Clinical Psychologist 17, no. 2
(2013): 35–45. doi:10.1111/cp.12010.
Williamson, Donald A., Marney A. White, Emily Yorke-Crowe, and
Tiffany M. Stewart. “Cognitive-Behavioral Theories of Eating
Disorders.” Behavior Modification 28, no. 6 (2004): 711–38. doi:
10.1177/0145445503259853.
 Part III

Controversies and Debates

In part III several debate essays about controversial issues surrounding food
and eating in our society are presented. The first essays will focus on fad
diets like the Paleo Diet and whether they have any validity for a healthy
diet and lifestyle choice or whether dieting should be avoided at all costs.
The second debate will dissect whether sugar addiction exists or is a myth.
It is common to hear about people experiencing strong cravings around
sweet food items, and it is important to determine whether sugar addiction
is a scientifically supported medical condition. Finally, the third debate in
this part of the book will explore whether the “Freshman 15” is a myth or if
there is documented evidence for weight gain during the first year in
college.

Controversy #1: Is the Paleo Diet an Effective Meal Plan?

INTRODUCTION
Trends related to eating and food consumption have changed over time
and reflect a variety of factors. For example, the availability of certain food
sources along with the socioeconomic level both influence the types of
foods consumed. The beauty ideal for a particular time period may range
from extremely thin to rotund or plump. Fasting (depriving oneself of
food) and feasting (eating large amounts of food) have occurred since the
172 Filling Up

Middle Ages and were often synonymous with the instability of food sup-
plies. Fasting behavior has also been tied to religious beliefs. For example,
giving up a particular food item or engaging in fasting behavior has been
customary for certain religious groups. Another motivation for fasting or
dietary restraint has been associated with an attempt to alter one’s body
weight, shape, or appearance. In times where food is relatively inexpensive
and widely available, the appearance ideal has been thin and lean, which
has been thought to represent discipline.
Dietary restraint has been defined as consciously restricting calories or
specific kinds of forbidden foods and has been tied to the development of
disordered eating or clinical eating disorders such as anorexia nervosa.
Dieting, which is hugely popular and normalized in U.S. culture, can
include the restriction of overall consumption of food throughout the
day or can represent the elimination of certain foods from one’s diet.
Dieting trends wax and wane as new types of diets become popular and
replace old styles of eating. Dieting trends can develop a cult-like follow-
ing or may be embraced by entire peer groups. For mainstream diets (e.g.,
gluten-free diets), certain manufacturers create foods that carry a label rec-
ognizing a food as being appropriate for the particular diet. Furthermore,
some diets are endorsed by members of the medical community. For exam-
ple, the South Beach Diet was created in 2003 by a cardiologist as a way to
prevent heart disease. This diet has been promoted on the Mayo Clinic
website as a way to live healthily.
The following debate essays by Drs. Lisa Sprod and Christy Greenleaf
address the issue of how dieting can serve as a controversial choice to eat
a particular way based on a current fad. A recent dieting trend, the Paleo
Diet, will be examined by Dr. Sprod for its potential merit as a medically
safe way of eating healthy. The ways that this diet incorporates healthy
food groups and eating choices will be discussed, along with how this diet
can be part of a healthy, sustainable lifestyle. Conversely, this debate will
focus on whether dieting should be avoided altogether in favor of a well-
rounded and diverse diet that includes many foods. The argument that
there are no “good or bad” foods will be forwarded to support this side of
the debate. Dr. Greenleaf will suggest that healthy eaters are intuitive
and listen to their bodies for the types of food that should be consumed
rather than following a prescribed diet such as the Paleo Diet.

BIBLIOGRAPHY
Fleig, Lena, Rudolf Kerschreiter, Ralf Schwarzer, Sarah Pomp, and Sonia
Lippke. “ ‘Sticking to a Healthy Diet Is Easier for Me When I Exercise
Controversies and Debates 173

Regularly’: Cognitive Transfer between Physical Exercise and Healthy

Nutrition.” Psychology and Health 29, no. 12 (2013): 1361–72. doi:
10.1080/08870446.2014.930146.
Gattellari, Melina, and Gail Huon. “Restrained and Unrestrained Females’
Positive and Negative Associations with Specific Foods and Body Parts.”
International Journal of Eating Disorders 21, no. 4 (1997): 377–83. doi:
10.1002/(SICI)1098-108X(1997)21:4<377::AID-EAT11>3.0.CO;2-W.
Goldfield, Gary S., and Andrew Lumb. “Effects of Dietary Restraint and
Body Mass Index on the Relative Reinforcing Value of Snack Food.”
Eating Disorders 17 (2009): 46–62. doi: 10.1080/10640260802570106.
Gonzalez, Vivian M. M., and Kelly M. Vitousek. “Feared Food in Dieting
and Non-Dieting Young Women: A Preliminary Validation of the
Food Phobia Survey.” Appetite 43 (2004): 155–73. doi: 10.1016/
j.appet.2004.03.006.
Radtke, Theda, Daphne Kaklamanou, Urte Scholz, Rainer Hornung, and
Christopher J. Armitage. “Are Diet Specific Compensatory Health
Beliefs Predictive of Dieting Intentions and Behaviour?” Appetite 76
(2014): 36–43. doi: 10.1016/j.appet.2014.01.014.
Rothgerber, Hank. “Can You Have Your Meat and Eat It Too?
Conscientious Omnivores, Vegetarians, and Adherence to Diet.”
Appetite 84 (2015): 196–203. doi:10.1016/j.appet.2014.10.012.
“South Beach Diet.” Mayo Clinic. Accessed June 15, 2015. http://www
.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/south-beach-diet/
art-20048491.
Stroebe, Wolfgang, Wendy Mensink, Henk Aarts, H. A. W. Schut, and
Arie W. Kruglanski. “Why Dieters Fail: Testing the Goal Conflict
Model of Eating.” Journal of Experimental Social Psychology 44 (2008):
26–36. doi: 10.1016/j.jesp.2007.01.005.

RESPONSE #1: THE POSITIVE SIDE

OF THE PALEO DIET
The Paleo Diet, as well as other diets, can be part of a healthy, sustainable
lifestyle. Given that the Paleo Diet mimics the diet of our ancestors from
10,000 years ago, it represents a truly “natural” way to eat. More recently,
humans began to consume a “civilized” diet as a result of new food-
producing and -preservation practices. For example, humans could ingest
highly processed foods out of a can as a major part of their diet. A strong
argument for the Paleo Diet relates to the inability of human metabolic
processes to evolve as quickly as our food has changed. It is believed that
the modern diet is leading to the increase in chronic diseases. By contrast
174 Filling Up

to the modern diet, the Paleo Diet emphasizes the consumption of lean ani-
mals, ideally wild or free range, grass-fed animals, eggs and honey, fish and
seafood, fresh fruits and vegetables, raw nuts and seeds, and oils such as olive,
walnut, flaxseed, macadamia, avocado, and coconut oils. Foods excluded
from the Paleo Diet include grains, dairy products, legumes, potatoes, refined
sugar, refined vegetable oils, salt, and processed foods. Due to this food pro-
file, the Paleo Diet includes many healthy food choices while excluding
many foods without any nutritional benefit that serve as empty calories.
The typical American diet has changed considerably in the past century
and now consists of an excessive amount of total calories, saturated fats, proc-
essed foods, and refined sugars while including fewer fresh fruits and vegeta-
bles. This has led to a steady but drastic increase in the number of
overweight and obese Americans, many of whom will develop chronic con-
ditions such as cardiovascular disease, type 2 diabetes, and cancer, to name
a few. Although the typical American diet has resulted in a negative impact
on the health of Americans, our fast-food culture is spreading to the rest of
the world, and a shift in body composition, from healthy to overweight and
obese, is occurring worldwide. The World Health Organization now reports
that the obesity pandemic has spread from the United States to not just the
world’s other rich nations but now to even the world’s poorest countries.
The consequences of this shift not only are impacting the health and well-
being of individuals but have systemic effects including threatening the sta-
bility of economies due to ever-increasing health care costs.
A shift away from a diet consisting of processed foods, often high in
saturated fat, refined sugar, and total calories, toward a whole-foods diet,
is a healthy option. Following a Paleo Diet can lead to the consumption
of fewer additives, preservatives, and chemicals, which are common in
processed foods. Fruits, vegetables, oils, nuts, and seeds contain anti-
inflammatory properties. Moreover, people following the Paleo Diet may
face reduced risk for anemia due to consuming increased amounts of red
meat. The Paleo Diet food choices are typically higher in fat, protein,
and fiber, all of which increase satiety, or that feeling of fullness, so over-
eating during a meal is less likely and the feeling of fullness will last longer.
Additionally, the limited food choices do tend to result in fewer calories
consumed throughout the day.
Diets containing less sugar, saturated fat, and excess calories can lead to
many beneficial outcomes. Research shows that a Paleo Diet in particular
leads to a number of positive health outcomes. A Paleo Diet can lead to
a reduction in total calories consumed, which can in turn lead to a
reduction in body weight. Excess body weight has been linked to
chronic-disease risk, so maintaining a healthy body weight is important.
Controversies and Debates 175

Other short-term improvements have been found in systolic blood pres-

sure, blood lipid profiles, and glucose control. The blood lipids of greatest
interest include low-density lipoproteins and high-density lipoproteins.
Low-density lipoproteins are considered dangerous because they deposit
cholesterol in the arteries. Cholesterol deposited in the arteries can restrict
blood flow and lead to cardiovascular disease and stroke. High-density lip-
oproteins are beneficial because they remove cholesterol from the arteries.
The Paleo Diet has been found to decrease low-density lipoproteins and
increase high-density lipoproteins, both of which reduce the risk of cardio-
vascular disease and stroke. Additionally, glucose control is important for
the prevention and treatment of type 2 diabetes.
Although it is not easy to completely remove certain foods from the
diet, strict diets, such as a Paleo Diet, are possible to follow and may result
in beneficial health outcomes. The Paleo Diet may be a wise choice for
individuals wishing to eat whole foods while avoiding processed foods rich
in refined sugar, saturated fat, preservatives, and chemicals. The Paleo Diet
can lead to many beneficial health outcomes, especially when compared to
a typical American diet.

Lisa Sprod

BIBLIOGRAPHY
Caballero, Benamin. “The Global Epidemic of Obesity: An Overview.”
Epidemiologic Reviews 29 (2007): 1–5. doi: 10.1093/epirev/mxm012.
Eaton, Stanley B., Loren Cordain, and Staffan Lindeberg. “Evolutionary
Health Promotion: A Consideration of Common Counterarguments.”
Preventive Medicine 34, no. 2 (2002): 119–23. doi: 10.1006/pmed
.2001.0966.
Eaton, Stanley B., and Stanley B. Eaton III. “Paleolithic vs. Modern Diets
—Selected Pathophysiological Implications.” European Journal of
Nutrition 39, no. 2 (2000): 67–70.
Forman, John P., Meir J. Stampfer, and Gary C. Curhan. “Diet and
Lifestyle Risk Factors Associated with Incident Hypertension in
Women.” Journal of the American Medical Association 302, no. 4
(2009): 401–11. doi: 10.1001/jama.2009.1060.
Frassetto, Linda A., Monique Schloetter, Michele Mietus-Snyder, R.
Curtis Morris Jr., and Anthony Sebastian. “Metabolic and Physiologic
Improvements from Consuming a Paleolithic, Hunter-Gatherer Type
Diet.” European Journal of Clinical Nutrition 63, no. 8 (2009): 947–55.
doi:10.1038/ejcn.2009.4.
176 Filling Up

Guthrie, Joanne F., Bing-Hwan Lin, and Elizabeth Frazao. “Role of Food
Prepared Away from Home in the American Diet, 1977–78 versus
1994–96: Changes and Consequences.” Journal of Nutrition Education and
Behavior 34, no. 3 (2002): 140–50. doi: 10.1016/S1499-4046(06)60083-3.
James, W. Philip T. “WHO Recognition of the Global Obesity Epidemic.”
International Journal of Obesity 32, Suppl. 7 (2008): S120–126. doi:
10.1038/ijo.2008.247.
Leis, Harry P., Jr. “The Relationship of Diet to Cancer, Cardiovascular
Disease and Longevity.” International Journal of Surgery 76, no. 1
(1991): 1–5.
Lindeberg, Staffan. “Paleolithic Diets as a Model for Prevention and
Treatment of Western Disease.” American Journal of Human Biology
24, no. 2 (2012): 110–15. doi: 10.1002/ajhb.22218.
Lindeberg, Staffan, Tommy Jonsson, Yvonne Granfeldt, E. Borgstrand, J.
Soffman, Karin Sjöström, and Bo Ahrén. “A Palaeolithic Diet
Improves Glucose Tolerance More than a Mediterranean-Like Diet in
Individuals with Ischaemic Heart Disease.” Diabetologia 50, no. 9
(2007): 1795–807. doi: 10.1007/s00125-007-0716-y.
Masharani, Umesh, Prativa Sherchan, Monique C. Schloetter, Suzanne
Stratford, Ai-Jiao Xiao, Anthony Sebastian, Nolte Kennedy, and
Lynda A Frassetto. “Metabolic and Physiologic Effects from
Consuming a Hunter-Gatherer (Paleolithic)-Type Diet in Type 2
Diabetes.” European Journal of Clinical Nutrition 69, no. 8 (2015):
944–48. doi: 10.1038/ejcn.2015.39. Accessed June 22, 2015. http://
www.nature.com/ejcn/journal/vaop/ncurrent/full/ejcn201539a.html.
Prentice, Andrew M. “The Emerging Epidemic of Obesity in Developing
Countries.” International Journal of Epidemiology 35, no. 1 (2006): 93–
99. doi: 10.1093/ije/dyi272.
van Dam, Rob M., Eric B. Rimm, Walter C. Willett, Meir J. Stampfer, and
Frank B. Hu. “Dietary Patterns and Risk for Type 2 Diabetes Mellitus in
U.S. Men.” Annals of Internal Medicine 136, no. 3 (2002): 201–9. doi:
10.7326/0003-4819-136-3-200202050-00008.

RESPONSE #2: THE NEGATIVE SIDE

OF THE PALEO DIET
According to the Paleo Diet philosophy, modern humans are sick, fat, and
tired because we no longer eat like our cave-dwelling ancestors who
hunted and gathered food. The idea is that if we returned to a more primi-
tive type of eating, most health problems would be alleviated. As is
common in many diets, a central tenet of the Paleo Diet is that certain
Controversies and Debates 177

foods, such as legumes, grains, and dairy products, are “bad” and to be
avoided. This approach to food and eating, where some foods are “good”
and others are “bad,” is problematic for a number of reasons.
The Paleo Diet has been presented to consumers as a “cure-all” for ill
health. In reality, health is multifaceted and influenced by numerous fac-
tors that interact with one another. Moreover, the idea that there is one
“correct” way to eat for good health is fundamentally flawed. People’s food
consumption was (and is today) largely influenced by culture, and thus the
concept of there being one Paleolithic diet is illogical. Today, people in
different cultures around the world have different diets, many of which
are associated with good health. In the Mediterranean region, for example,
people eat a diet heavy in whole grains and legumes (which is contrary to
the recommendation of the Paleo Diet) along with fruits, vegetables, and
lean meats and fish. Further, restricting or eliminating food groups is
troublesome. Specifically, there is strong empirical evidence supporting
the positive physical health effects of eating whole grains on cardiovascu-
lar disease and consuming dairy products on bone health; yet the Paleo
Diet calls for avoiding these food groups.
Probably most concerning, from a psychological perspective, is the
tendency of diets like the Paleo Diet to classify certain foods as “bad.”
This approach of placing so-called evil foods on the “do not eat” list can
contribute to disturbed eating attitudes and behaviors. Clinical eating dis-
orders, such as anorexia nervosa and bulimia nervosa, are life-threatening
psychological disorders. Subclinical eating disorders involve health-
damaging eating-, food-, and weight-related attitudes and behaviors that
can lead to more serious clinical conditions. Clinical and subclinical eat-
ing disorders are characterized by self-imposed strict rules for eating, a
strong influence of body weight and body image on self-concept, and
pathogenic eating behaviors such as caloric restriction. Diets, such as the
Paleo Diet, that promote the mentality that certain foods should not be
eaten set people up to feel guilt and shame if, and when, they “fail” to fol-
low the rules by eating pasta, bread, cereal, ice cream, or beans. The cycle
of “failing” followed by intense negative feelings is troublesome because
unhealthy compensatory behaviors are often used to make up for “cheat-
ing.” Health-damaging behaviors such as excessive exercise, fasting, and
self-induced vomiting may be used as self-punishment as part of this
unhealthy eating cycle. Dieters often engage in self-blame, believing that
they lack willpower, self-control, and motivation—that their failure to fol-
low the diet is a failure due to flawed personal character. The diet industry,
as well as the health and medical professions, typically emphasize personal
responsibility and “sell” the message that weight, body shape and size, and
178 Filling Up

health are completely and solely dependent upon a person’s ability to con-
trol their cravings, urges, and desires—ignoring the influence of biology
and environment. When people “fail” to do so, they are to blame for being
weak willed. Unfortunately, these types of beliefs and feelings do little to
motivate health-promoting behaviors—rather, binge eating and avoid-
ance of physical activity are common coping strategies when people feel
guilt and shame associated with their eating, body weight, and body image.
Thus the Paleo Diet (and all diets) should be avoided.
In conclusion, the reality is that it is unrealistic to believe that a diet
that restricts complete food groups is one that can (or should) be sustained.
The glorified health benefits of eating like our cave-dwelling ancestors
should be tempered with the fact that few people lived beyond the age of
25 during Paleolithic times; thus the actual effect of their eating on long-
term health is unknown. Moreover, there are many variations of eating
that promote good health and eating approaches; those that are restrictive
are rarely sustainable and often are associated with pathogenic attitudes
toward food and unhealthy eating behaviors. Therefore individuals should
be encouraged to be intuitive eaters so that they listen to their bodies for
cues of hunger and fullness rather than restrict their bodies to a limited
group of foods.

Christy Greenleaf

BIBLIOGRAPHY
Bortz, Walter M. “Biological Basis of Determinants of Health.” American
Journal of Public Health 95, no. 3 (2005): 389–92. doi: 10.2105/
AJPH.2003.033324.
Freeland-Graves, Jeanne H., and Susan Nitzke. “Position of the Academy
of Nutrition and Dietetics: Total Diet Approach to Healthy Eating.”
Journal of the Academy of Nutrition and Dietetics 113, no. 2 (2013):
307–17. doi: 10.1016/j.jand.2012.12.013.
Gibbons, Ann, and Matthieu Paley (photographer). “The Evolution of
Diet.” National Geographic 226, no. 3 (2014): 30–53.
Heaney, Robert P. “Dairy and Bone Health.” Journal of the American
College of Nutrition 28, Suppl. 1 (2009): 82S–90S. doi: 10.1080/
07315724.2009.10719808.
Hernandez, Lyla M., and Dan German Blazer. Genes, Behavior, and the
Social Environment: Moving Beyond the Nature/Nurture Debate.
Washington, DC: National Academies Press, 2006. http://site.ebrary
.com/id/10156539.
Controversies and Debates 179

Imamura, Fumiaki, Renata Micha, Shahab Khatibzadeh, Saman Fahimi,

Peilin Shi, John Powles, Dariush Mozaffarian, and Global Burden of
Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE).
“Dietary Quality among Men and Women in 187 Countries in 1990
and 2010: A Systematic Assessment.” The Lancet Global Health 3,
no. 3 (2015): e132–42. doi: 10.1016/S2214-109X(14)70381-X.
Kuijer, Roeline G., Jessica A. Boyce, and Emma M. Marshall. “Associating
a Prototypical Forbidden Food Item with Guilt or Celebration:
Relationships with Indicators of (Un)Healthy Eating and the
Moderating Role of Stress and Depressive Symptoms.” Psychology &
Health 30, no. 2 (2015): 203–17. doi: 10.1080/08870446.2014.960414.
Mellen, Philip B., Thomas F. Walsh, and David M. Herrington. “Whole
Grain Intake and Cardiovascular Disease: A Meta-analysis.” Nutrition,
Metabolism and Cardiovascular Diseases 18, no. 4 (2008): 283–90. doi:
10.1016/j.numecd.2006.12.008.
Meyer, C., J. Blissett, R. Alberry, and A. Sykes. “Beliefs about Exercise:
Relationship to Eating Psychopathology and Core Beliefs among
Young Female Exercisers.” Eating Behaviors 14, no. 1 (2013): 79–82.
doi: 10.1016/j.eatbeh.2012.10.003.
Nestle, Marion. “Paleolithic Diets: A Sceptical View.” Nutrition Bulletin
25, no. 1 (2000): 43–47. doi: 10.1046/j.1467-3010.2000.00019.x.
Palascha, Aikaterini, Ellen van Kleef, and Hans C. M. van Trijp. “How
Does Thinking in Black and White Terms Relate to Eating Behavior
and Weight Regain?” Journal of Health Psychology 20, no. 5 (2015):
638–48. doi: 10.1177/1359105315573440.
Smith-Jackson, TeriSue, Justine J. Reel, and Rosemary Thackeray.
“Coping with ‘Bad Body Image Days’: Strategies from First-Year Young
Adult College Women.” Body Image 8, no. 4 (2011): 335–42. doi:
10.1016/j.bodyim.2011.05.002.

Controversy #2: Is Sugar Addiction a Myth or a Reality?

INTRODUCTION
Have you ever had a craving for a particular food? Food cravings have been
described as an intense longing for a particular type of food that comes on
suddenly and needs to be satisfied immediately. Many cravings are
believed to be associated with one’s mood, psychological triggers, or when
180 Filling Up

certain emotions are present. People commonly report that these addic-
tions to food are real and can be dealt with only by the consumption of
the targeted food that has become the object of one’s craving. There is evi-
dence that having a food craving or strong urge to consume a particular
food item is linked to the tendency for binge episodes.
Feeling stressed or experiencing strong emotions like sadness or anger
can trigger the desire for certain kinds of food that tend to be sweet and fat-
tening such as ice cream or pizza. Moreover, women are believed to expe-
rience food cravings more often than men. Typical food cravings are
brought on by changes in mood and thought to be psychological in nature.
However, there are some valid biological explanations for sugar cravings
that are linked to carbohydrate consumption.
Looking at this psychological versus biological debate about sugar
addiction parallels the study of drug abuse as an addiction. The object of
one’s addiction is desired as a way to soothe emotions or feel comfort.
There may be pleasant feelings associated with a particular food that stem
back to childhood memories. For example, an adult may have fond memo-
ries of candy associated with Halloween trick-or-treating in the neighbor-
hood. In an attempt to “get back” those positive feelings, candy may
become the object for craving. However, the question becomes whether
the craving or so-called addiction is that simple?
Let us take chocolate, which is the most popularly reported food craving
in Western society. Its popularity as an object of craving makes sense given
that chocolate is dense in carbohydrates (aka sugar) but also has fat and pro-
tein. However, chocolate also contains cacao, which is thought to induce
mood-enhancing neurotransmitters within the brain. But is the real culprit
for the source of addictive qualities the caffeine also found in the chocolate?
The idea that food can be addictive and that certain people have a food
addiction or sugar addiction has been the center of many debates in the
scientific community. Although the push has been to identify eating
behaviors as a “food addiction” and to provide a psychiatric diagnosis,
understanding eating patterns related to psychological (or physical)
cravings may be useful from a health care perspective. Given that self-
reported food cravings have been strongly predictive of overeating behav-
ior, there are concerns that experiencing a food or sugar addiction will
directly lead to being overweight or obese.
Drs. Christy Greenleaf and Noell Rowan will dissect whether the con-
cept of food addiction has scientific and clinical merit in the following
debate essays. While Dr. Rowan will argue that food addiction has its place
in the addiction treatment community, Dr. Greenleaf will show evidence
that food addiction (and specifically sugar addiction) can be considered a
Controversies and Debates 181

myth. Dr. Greenleaf will argue that there is not sufficient evidence to sup-
port food as an addiction in the way that drug abuse has been defined in
the medical community.

BIBLIOGRAPHY
Foddy, Bennett. “Addicted to Food, Hungry for Drugs.” Neuroethics 4
(2011): 79–89. doi: 10.1007/s12152-010-9069-1.
Gearhardt, Ashley N., Marney A. White, Robin M. Masheb, and Carolos
M. Grilo. “An Examination of Food Addiction in a Racially Diverse
Sample of Obese Patients with Binge Eating Disorder in Primary Care
Settings.” Comprehensive Psychiatry 54 (2013): 500–505. doi: 10.1016/
j.comppsych.2012.12.009.
Mason, Susan M., Alan J. Flint, Alison E. Field, S. Bryn Austin, and Janet
W. Rich-Edwards. “Abuse Victimization in Childhood or Adolescence
and Risk of Food Addiction in Adult Women.” Obesity 21 (2013):
E775–81. doi: 10.1002/oby.20500.
Steenhuis, Ingrid. “Guilty or Not? Feelings of Guilt about Food among
College Women.” Appetite 52 (2009): 531–34. doi:10.1016/j.appet
.2008.12.004.
Tryon, Matthew S., Cameron S. Carter, Rashel R. DeCant, and Kevin D.
Laugero. “Chronic Stress Exposure May Affect the Brain’s Response to
High Calorie Food Cues and Predispose to Obesogenic Eating Habits.”
Physiology and Behavior 120 (2013): 233–42. doi: 10.1016/j.physbeh
.2013.08.010.
Vilija, Maulinauskiene, and Malinauskas Romualdas. “Unhealthy Food in
Relation to Posttraumatic Stress Symptoms among Adolescents.”
Appetite 74 (2014): 86–91. doi: 10.1016/j.appet.2013.12.002.
Wagner, Heather S., Britt Ahlstrom, Joseph P. Redden, Zata Vickers, and
Traci Mann. “The Myth of Comfort Food.” Health Psychology 33, no. 12
(2014): 1552–57. doi: 10.1037/hea0000068.
Wallis, D. J., and M. M. Hetherington. “Emotions and Eating. Self-
Reported and Experimentally Induced Changes in Food Intake Under
Stress.” Appetite 52 (2009): 355–62. doi: 10.1016/j.appet.2008.11.007.

RESPONSE #1: SUGAR ADDICTION IS A REALITY

Many scholars have argued that food addiction is a real phenomenon and
relates to a distorted relationship with food. Some scholars claim that
including food addiction as a type of eating disorder would assist in
182 Filling Up

prevention and educational efforts. Given that addictions are usually con-
sidered to be negative, addressing food as an addiction can be complicated.
First, some researchers and clinicians argue that food and sugar addictions
are a myth. Second, addictions are often dealt with by extinguishing the
unwanted behavior; however, food is necessary in everyday life and repre-
sents a basic need.
Anecdotal evidence for a legitimate “addiction” to sugar or another
type of food has been widely available in doctor’s offices across the country.
The sense of having an unbearable urge to eat chocolate or some other
sugary substance has been well documented in clinical cases. Certain foods
were associated with a reported “high” or sense of euphoria. In attempts to
measure this potential for food addiction in a systematic way, the Yale
Food Addiction Scale was developed, lending additional credibility to
the concept. Kirrilly Pursey and colleagues recently reviewed 25 well-
respected scientific studies using the Yale Food Addiction Scale to estab-
lish the prevalence of food addiction, and findings indicated the mean
prevalence was 19.9 percent, with food addiction higher in adult females
aged 35 and older and overweight/obese. While there is controversy in
the literature about whether the increase in obesity is explained by food
addiction, there is a documented pattern of behavior associated with signs
of addiction including binge eating, food cravings, compulsive overeating,
and withdrawal in animals and humans that provides evidence to further
study the phenomenon of food addiction.
The plausibility of food addiction is further supported by work demon-
strating that brain pathways responding to natural rewards are also acti-
vated with addictive drugs, and the dependence was particularly linked
to sugar. More specifically, ingestion of sugar with an immediate sweet
reward can substitute for addictive drugs and can be more rewarding with
a high that can be stronger than using cocaine. In fact, researchers have
found that when humans deprive themselves of food and then eat sugar,
there is a tendency for binge behavior of sugary foods to be triggered,
resulting in sustained and elevated sensitivity to amphetamine. In addi-
tion, researchers have shown that sugar releases opioids and dopamine in
the brain, and rats can become dependent on sugar, which may translate
to humans. Brain chemistry plays a critical role in addiction, and neuro-
scientists have been actively investigating the neural pathways and what
happens when animals and humans ingest certain foods like sugar and
other drugs for many years. Therefore the growing body of research and
the interest in sugar addiction over several decades tells the story of pos-
sible chemical dependence on sugar, which supports the creation of an
appropriate clinical diagnosis for sugar addiction.
Controversies and Debates 183

Furthermore, prior research repeatedly shows a translation of substance

dependence to eating behaviors and that new study is needed to examine
the contribution of biological, psychological, and behavioral factors involved
in problematic eating behaviors. In conclusion, even with some controversy,
there is substantial evidence showing that sugar addiction is a reality, and
multiple treatment centers across the United States are providing treatment
for eating disorders and a variety of addictions. Support groups such as Food
Addicts Anonymous and Overeaters Anonymous have been freely available
for anyone struggling with issues of food and problematic eating behaviors for
many years. Other resources include the National Eating Disorders
Association, the Binge Eating Disorder Association, and the International
Association of Eating Disorders Professionals Foundation.

Noell L. Rowan

BIBLIOGRAPHY
Ahmed, Serge H., Karine Guillem, and Youna Vandaele. “Sugar
Addiction: Pushing the Drug-Sugar Analogy to the Limit.” Clinical
Nutrition and Metabolic Care 16, no. 4 (2013): 434–39. doi: 10.1097/
MCO.0b013e328361c8b8.
American Psychiatric Association. Diagnostic and Statistical Manual of
Mental Disorders, 5th ed. Washington, DC: American Psychiatric
Association, 2013.
Avena, Nicole M., and Bartley G. Hoebel. “A Diet Promoting Sugar
Dependency Causes Behavioral Cross-Sensitization to a Low Dose of
Amphetamine.” Neuroscience 122, no. 1 (2003): 17–20. doi: 10.1016/
S0306-4522(03)00502-5.
Avena, Nicole. M., Pedro Rada, and Bartley G. Hoebel. “Evidence for
Sugar Addiction: Behavioral and Neurochemical Effects of
Intermittent, Excessive Sugar Intake.” Neuroscience and Biobehavioral
Reviews 32 (2008): 20–39. doi: 10.1016/j.neubiorev.2007.04.019.
Colantuoni, Carlo, Pedro Rada, Joseph McCarthy, Caroline Patten,
Nicole M. Avena, Andrew Chadeayne, and Bartley G. Hoebel.
“Evidence that Intermittent, Excessive Sugar Intake Causes Endogenous
Opioid Dependence.” Obesity Research 10 (2002): 478–88. doi: 10.1038/
oby.2002.66.
Corsica, Joyce. A., and Marcia L. Pelchat. “Food Addiction: True or
False?” Gastroenterology 26, no. 2 (2010): 165–69. doi: 10.1097/
MOG.ob013e328336528d.
184 Filling Up

Gold, Mark S., Cynthia R. Johnson, and K. Stennie. “Eating Disorders.” In

Substance Abuse: A Comprehensive Textbook, edited by J. H. Lowinson,
P. Ruiz, R. Millman, and J. G. Langrod, 319–37. Baltimore: Williams
& Wilkins, 1997.
Meule, Adrian, and Ashley N. Gearhardt. “Food Addiction in the Light of
DSM-5.” Nutrients 6, no. 9 (2014): 3653–71. doi: 10.3390/nu6093653.
Pursey, Kirrilly M., Peter Stanwell, Ashley N. Gearhardt, Clare E. Collins,
and Tracy L. Burrows. “The Prevalence of Food Addiction as Assessed
by the Yale Food Addiction Scale: A Systemic Review.” Nutrients 6
(2014): 4552–90. doi: 10.3390/nu6104552.
Salamone, John D., and Mercè Correa. “Dopamine and Food Addiction:
Lexicon Badly Needed.” Biological Psychiatry 73 (2013): e15–24. doi:
10.1016/j.biopsych.2012.09.027.
van Wormer, Katherine, and Diane Rae Davis. Addiction Treatment: A
Strengths Perspective. Pacific Grove, CA: Brooks/Cole-Thomson, 2003.
Wideman, Cyrilla H., G. R. Nadzam, and Helen M. Murphy.
“Implications of an Animal Model of Sugar Addiction, Withdrawal,
and Relapse for Human Health.” Nutritional Neuroscience 8, nos. 5–6
(2005): 269–76. doi: 10:1080/10284150500485221.

RESPONSE #2: SUGAR ADDICTION IS A MYTH

Although sugar addiction has often been cited in the popular press, and
more recently debated in the scientific literature, it is a myth. Sugar cer-
tainly makes food and drinks pleasurable to consume, but pleasure does
not equate with addiction. Addiction, which involves maladaptive use of
a substance resulting in significant distress and impairment, is defined by
the following characteristics: impaired control, social impairment, risky
use, and pharmacological dependence. A definitive argument for sugar as
an addictive substance fails across all four characteristics. First, impaired
control of sugar use would involve using more than intended, being unable
to stop or reduce use, spending a lot of time getting, using, and recovering
from use, and strong cravings for sugar. Research with humans indicates
that after fasting, there is a decrease in reported cravings for high-sugar/
sweet foods and that reported cravings typically are indicated later in the
day, both of which contradict the addiction model. It is also interesting
to consider that people rarely desire pure sugar; rather, people develop a
preference for palatable food that is sweet and high in fat. Further, evi-
dence from binge eating research documents that people eat a variety of
foods during binges that extend well beyond sweet foods. For example,
Controversies and Debates 185

salty snacks like potato chips are easily consumed and represent a common
food craving.
In terms of social impairment and risky use, the sugar addiction model
also falls short. There is little evidence that because of a need to obtain
and use sugar people fail to take care of major responsibilities, continue
to use sugar regardless of problems, give up important activities, or use
sugar in hazardous environments. Keep in mind that the idea of sugar
addiction is predicated on the assumption that it is the specific substance
of sugar that causes problems, which may be different from the concept
of unregulated eating or eating addiction. There may be people with disor-
dered eating conditions who avoid social situations where eating is
involved; however, it is unlikely that the reason for avoidance is an addic-
tion to sugar. It is difficult to measure this particular aspect of the sugar
addiction hypothesis in humans for a number of reasons. The fact that peo-
ple rarely eat pure sugar is one. Another is that there are few measurement
instruments that capture this particular concept. The Yale Food Addiction
Scale, for example, likely captures addictive-like eating behaviors, in part
associated with the avoidance of important activities, rather than physical
addiction to a specific food substance.
It should be noted that despite the popularity of sugar as an addiction,
there is no clinical diagnosis for food addictions of any kind. Although
other substances are recognized to be addictive and are associated with
diagnostic criteria and treatment approaches, sugar addiction has not been
included in the evidence-based work of mental health clinicians. Sugar
addiction has also not been considered a medical condition by physicians.
Finally, the human evidence for pharmacological dependence on sugar,
including tolerance to the effects of sugar and physical and psychological
symptoms of withdrawal, is weak. Sugar consumption actually decreases
from childhood into adulthood, and although humans are born with a prefer-
ence for sweet-tasting foods, this preference declines into adulthood. If sugar
were addictive, the preference would increase over time. Research does show
that sugar activates pleasure and reward centers in the brain similar to those
activated by drugs, yet it is important to note that many stimuli activate
pleasure and reward centers of the brain. Johannes Hebebrand and colleagues
from the Integrated Neurobiology of Food Intake, Addiction, and Stress con-
cluded that there is “insufficient scientific evidence to label any common
food, ingredient, micronutrient, standard food additive or combination of
ingredients as addictive” (2014, 299).
In conclusion, based on current scientific evidence, sugar as an addic-
tive substance is a myth. Much of the research suggesting sugar is addictive
186 Filling Up

is flawed in that it does not isolate sugar but rather assumes sugar is the key
substance in people’s food preference. Additionally, recent rodent research
raises questions about whether results are due to substance (sugar) or
behavior (eating) and indicates that rodents, when given access to sweet
food, still maintain a stable weight, thus making the link between what is
assumed to be sugar addiction and obesity unlikely. Addiction, as currently
defined, does not seem to accurately capture human preference for sweet
foods and drinks.

Christy Greenleaf

BIBLIOGRAPHY
American Psychiatric Association. Diagnostic and Statistical Manual of
Mental Disorders, 5th ed. Washington, DC: American Psychiatric
Association, 2013.
Benton, David. “The Plausibility of Sugar Addiction and Its Role in
Obesity and Eating Disorders.” Clinical Nutrition 29, no. 3 (2010):
288–303. doi: 10.1016/j.clnu.2009.12.001.
Brownell, Kelly D., and Mark S. Gold. Food and Addiction:
A Comprehensive Handbook. New York: Oxford University Press, 2012.
Buscemi, Joanna, James G. Murphy, Kristoffer S. Berlin, and Hollie A.
Raynor. (2014). “A Behavioral Economic Analysis of Changes in
Food-Related and Food-Free Reinforcement during Weight Loss
Treatment.” Journal of Consulting and Clinical Psychology 82, no. 4
(2014): 659–69. doi: 10.1037/a0036376.
Drewnowski, A., and F. Bellisle. “Is Sweetness Addictive?” Nutrition Bulletin
32, no. S1 (2007): 52–60. doi: 10.1111/j.1467-3010.2007.00604.x.
Haedt-Matt, Alissa A., Pamela K. Keel, Sarah E. Racine, S. A. Burt, Jean
Y. Hu, Steven Boker, Michael Neale, and Kelly L. Klump. “Do
Emotional Eating Urges Regulate Affect? Concurrent and Prospective
Associations and Implications for Risk Models of Binge Eating.”
International Journal of Eating Disorders 47, no. 8 (2014): 874–77. doi:
10.1002/eat.22247.
Hebebrand, Johannes, Özgür Albayrak, Roger Adan, Jochen Antel, Carlos
Dieguez, Johannes de Jong, Gareth Leng, John Menzies, Julian G.
Mercer, Michelle Murphy, Geoffrey van der Plasse, and Suzanne L.
Dickson. “ ‘Eating Addiction’, Rather than ‘Food Addiction’, Better
Captures Addictive-Like Eating Behavior.” Neuroscience &
Biobehavioral Reviews 47 (2014): 295–306. doi: 10.1016/j.neubiorev
.2014.08.016.
Controversies and Debates 187

Meule, Adrian, and Ashley N. Gearhardt. “Five Years of the Yale Food
Addiction Scale: Taking Stock and Moving Forward.” Current Addiction
Reports 1, no. 3 (2014): 193–205. doi: 10.1007/s40429-014-0021-z.
Virtue, Doreen. Constant Craving: What Your Food Cravings Mean and How
to Overcome Them. Carson, CA: Hay House, 1995.

Controversy #3: Is the “Freshman 15”

a Myth or a Reality?

INTRODUCTION
Have you ever heard of the dreaded “Freshman 15”? There has been a lot
of publicity in the media leading to intense fear around this anticipated
weight gain. The “Freshman 15” is the belief that college students will gain
significant body weight, that is, 15 pounds, in their freshman year.
Interestingly, many college students and scientists accept the weight
gain associated with the “Freshman 15” as inevitable or something that
just happens along with the college experience. This assumption is sup-
ported by assertions that eating habits and food choices change in the col-
lege environment for a variety of reasons. Dorm living and cafeteria food
may differ from meals at home in nutrient content and calories. There is
also the perception that some college students will go “hog wild”—eating
large meals and unhealthy snacks from vending machines and coffee
shops. Late-night pizza deliveries to accompany study groups can also con-
tribute to poor dietary choices. Moreover, the excess consumption of alco-
hol can do a number on a college student’s waistline.
With all of the explanations for potential weight gain in the first year of
college, one might ask where is the debate? In reality, the concept of the
“Freshman 15” is controversial among health educators and researchers.
Despite the logical rationale for the potential weight gain that can be tied
to a transition in food availability and access to unhealthy choices as well
as changing dietary habits, researchers have not substantiated this
assumption. Therefore it seems appropriate to better understand both sides
of the argument for and against the idea of the “Freshman 15.” Drs. Lynn
Hunt Long and Michaela Howells will provide debate essays for this topic.
First, Dr. Long will provide surrounding support for weight gain in the first
year due to a variety of well-documented factors. Next, Dr. Howells will
argue against the assumption that gaining weight (namely 15 pounds) in
one’s freshman year is inevitable. She will take the position that the
“Freshman 15” is, in fact, a myth.
188 Filling Up

BIBLIOGRAPHY
Hoffman, Daniel J., Peggy Policastro, Virginia Quick, and Soo-Kyung Lee.
“Changes in Body Weight and Fat Mass of Men and Women in the First
Year of College: A Study of the Freshman 15.” Journal of American
College Health 55, no. 1 (2006): 41–45. doi: 10.3200/JACH.55.1.41-46.
Jasinka, Agnes J., Marie Yasuda, Charles F. Burant, Nicolette Gregor, Sara
Khatri, Matthew Sweet, and Emily B. Falk. “Impulsivity and Inhibitory
Control Deficits Are Associated with Unhealthy Eating in Young
Adults.” Appetite 59, no. 3 (2012): 738–47. doi: 10.1016/j.appet
.2012.08.001.
Jung, Mary Elizabeth, Steven Russell Bray, and Kathleen Anne Martin
Ginis. “Behavior Change and the Freshman 15: Tracking Physical
Activity and Dietary Patterns in 1st-Year University Women.” Journal
of American College Health 56, no. 5 (2008): 523–30. doi: 10.3200/
JACH.56.5.523-530.
Small, Meg, Lisa Bailey-Davis, Nicole Morgan, and Jennifer Maggs.
“Changes in Eating and Physical Activity Behaviors across Seven
Semesters of College: Living On or Off Campus Matters.” Health
Education & Behavior 40, no. 4 (2012): 435–41. doi: 10.1177/10901981
12467801.

RESPONSE #1: THE “FRESHMAN 15” AS REALITY

The “Freshman 15” is the term used to describe the 15 pounds (6.8 kilo-
grams) that students seemingly gain during their first year of college. It
should be argued that the “Freshman 15” is a real phenomenon. With
newfound independence, lifestyle behaviors are often challenged and
change, including behaviors that affect weight gain. Behaviors resulting
in an increase in weight may include the types of food and beverages con-
sumed. Pizza becomes a popular meal during late nights of studying or
socializing. Vending machines may provide a much-needed energy
“boost,” but the snack foods are typically calorically dense and devoid of
nutrients. Alcohol intake may begin or increase during the freshman year
as college students gain access to freedom and experience pressures to par-
ticipate in social activities. To this end, college student diets do not typi-
cally meet nutritional guidelines. The students neglect to consume the
recommended fruit and vegetable intake while exceeding sugar, fat, and
sodium recommendations. Other relevant behaviors include eating pat-
terns such as skipping breakfast and late-night eating, sleep deprivation,
emotional eating, stress, and a decline in physical activity. For example,
Controversies and Debates 189

one study reported that almost 70 percent of university students did not
meet the recommended physical activity guidelines of 150 minutes of
moderate-intensity aerobic activity per week with muscle-strengthening
activities two or more days per week working major muscle groups.
While a number of studies have been conducted on the topic of the
“Freshman 15,” the results vary regarding the exact amount of weight gain.
Several studies have shown that freshmen gain as much as 15 pounds.
One study found that almost two-thirds of freshmen gained weight during
their first year of college, with about 5 percent of students gaining the well-
known “Freshman 15.” Other studies have shown the average weight gain
ranged from 2.6 pounds to 7.8 pounds. During the first year of college,
women experience greater weight gain than their male peers, and one
study found that students living on-campus gained more weight than their
peers who lived off-campus.
Of concern with weight gain during the first year of college is the likeli-
hood of continuing to increase weight throughout the college experience.
An increase in weight of 1.2 pounds per semester may seem small, but this
slight uptick may equate to a weight gain of 9.6 pounds by graduation date.
This concept is termed “creeping obesity,” which refers to small increases
in weight by month or semester that add up over time. Considering this
idea of sneaky weight gain, several studies have reported that students
have an increased risk for becoming obese, gaining between 9.6 and 27
pounds by graduation. One study followed students over four years of col-
lege and found that 70 percent of them added pounds by graduation, with
an average of 12, and up to 37 pounds. The overall percentage of students
found to be overweight increased from 18 to 31 percent. Accompanying
weight gain during the first semester, first year, or across the college expe-
rience, researchers have noted unhealthy changes in waist circumference,
absolute body fat, and BMI, which are risk factors for other negative health
outcomes.
College is an appropriate time for students to develop a lifelong plan for
healthful living. Many universities require students to complete a physical
activity and wellness course during their freshman year, which has been
effective in teaching about adoption of healthful behaviors. Topics of
these university wellness courses often include behavior change for opti-
mal wellness, understanding fitness principles, cardiorespiratory endur-
ance, muscular fitness, flexibility, nutrition, weight management, stress
management, and avoiding substance use, abuse, and addiction. Other
opportunities or courses that present information about health behaviors
affecting college freshmen include a university orientation and a first-year
experience course.
190 Filling Up

Weight gain is a problem for most students during the freshman year,
and the weight gain may go well beyond the first-year experience and con-
tribute to overweight and obesity in adulthood. Due to the negative health
and psychosocial outcomes associated with overweight and obesity, it is
important to develop educational and prevention programs for college
freshmen as they enter this time of high risk for weight gain in adulthood.

Lynn Hunt Long

BIBLIOGRAPHY
Freedman, Marjorie, and Jennifer Waldrop. “Freshman Orientation
Sessions Can Teach Incoming Students about Healthful Lifestyles.”
Journal of Nutrition Education and Behavior 43, no. 1 (2011): 68–70.
doi: 10.1016/j.jneb.2010.07.008.
Gow, Rachel, Sara Trace, and Suzanne Mazzeo. “Preventing Weight Gain
in First Year College Students: An Online Intervention to Prevent the
Freshman Fifteen.” Eating Behaviors 11 (2010): 33–39. doi: 10.1016/
j.eatbeh.2009.08.005.
Gropper, Sareen, Karla Simmons, Alisha Gaines, Kelly Drawdy, Desiree
Saunders, Pamela Ulrich, and Lenda Jo Connell. “The Freshman 15—
A Closer Look.” Journal of American College Health 58, no. 3 (2009):
223–31. doi: 10.1080/07448480903295334.
Hertzler, Ann, and Robert Frary. “Food Behavior of College Students.”
Adolescence 24, no. 94 (1989): 349–56.
“How Much Physical Activity Do Adults Need?” Centers for Disease
Control and Prevention. Accessed June 29, 2015. http://www.cdc.gov/
physicalactivity/basics/adults/index.htm.
Jung, Mary, Steven Bray, and Kathleen Ginis. “Behavior Change and the
Freshman 15: Tracking Physical Activity and Dietary Patterns in
1st-Year University Women.” Journal of American College Health 56,
no. 5 (2008): 523–30. doi: 10.3200/JACH.56.5.523-530.
Mihalopoulos, Nicole, Peggy Auinger, and Jonathan Klein. “The
Freshman 15: Is It Real?” Journal of American College Health 56, no. 5
(2008): 531–34. doi: 10.3200/JACH.56.5.531-534.
Morrow, Michelle, Kristiann Heesch, Mary Dinger, Holly Hull, Allen
Kneehans, and David Fields. “Freshman 15: Fact or Fiction?”Obesity
14, no. 8 (2006): 1438–43. doi: 10.1038/oby.2006.163.
Muth, Natalie. “Help Fight Freshman Weight Gain.” IDEA Fitness Journal
5 (2008): 76–80. http://www.ideafit.com/fitness-library/help-fight
-freshman-weight-gain.
Controversies and Debates 191

O’Connor, Amy. “70% of Students Gain Weight During College: Study.”

Time Inc. Network. Accessed June 29, 2015. http://news.health.com/
2012/09/26/college-gain-weight/.
Smith-Jackson, TeriSue, and Justine Reel. “Freshmen Women and the
‘Freshman 15’: Perspectives on Prevalence and Causes of College
Weight Gain.” Journal of American College Health 60, no. 1 (2012):
14–20. doi: 10.1080/07448481.2011.555931.
Thomas, Jack. “Weight Gain Awareness, The Freshman 15: A Nutrition
Student Public Speaking Project.” Journal of Nutrition Education and
Behavior 38 (2006): 383–85. doi: 10.1016/j.jneb.2006.05.018.
Vella-Zarb, Rachel, and Frank Elgar. “Predicting the ‘Freshman 15”’:
Environmental and Psychological Predictors of Weight Gain in First-
Year University Students.” Health Education Journal 69, no. 3 (2010):
321–32. doi: 10.1177/0017896910369416.

RESPONSE #2: THE “FRESHMAN 15” AS A MYTH

There are a tremendous number of physiological and emotional effects
associated with the transition from high school to college. However,
the media have primarily focused on the weight gain of students during
their freshman year. In Australia and New Zealand, this experience is
referred to as “First-Year Fatties,” the “Fresher Spread,” and the
“Fresher Five.” In the United States, it is referred to as the “Freshman
15.” The “Freshman 15” refers to the assumed 15 pounds of weight gain
associated with changes in diet and physical activity in first-year univer-
sity students.
The term “Freshman 15” was popularized in the August 1989 edition of
Seventeen magazine. The phrase was quickly picked up by other magazines
and newspapers, and was rapidly embedded in pop culture. Frequently, sto-
ries associated with the “Freshman 15” are meant to warn soon-to-be fresh-
man of significant weight gain and offer tips that may or may not be
grounded in science. Today, this lore is firmly entrenched, with the major-
ity of first-year college students reporting familiarity with this concept and
expressing concern over their predicted fate. This concern has real eco-
nomic impact, as evidenced by large sums of money being spent on expan-
sive recreation centers with extravagant amenities like inside rock walls,
cutting-edge group exercise classes, and luxuries like pools. These fitness
facilities act as a “selling point” to incoming college students and are often
promoted during campus tours and in glossy brochures. The “Freshman 15”
also adds an additional pressure on new students to maintain their high
school body sizes and shapes. Regardless of its powerful presence in pop
192 Filling Up

culture and seemingly prophetic value, there is little scientific evidence

supporting the “Freshman 15.”
There are three arguments against the “Freshman 15.” First, it ignores
the weight loss experienced by a significant number of freshman. Second,
this level of weight gain experienced by freshman is uncommon and
instead represents an overestimation by popular media. Finally, it neglects
to account for normal growth of individuals between 17 and 20 years old
who are completing the final stages of puberty.
Although there is intense pressure to look a particular way and strong
body dissatisfaction is reported among people in college, not all freshmen
gain weight, and many students even lose weight. Although the public
eye has focused on freshman weight gain, multiple studies have reported
weight loss within an average of 30 percent of their college freshmen.
Those studies that reported weight gain found significantly lower increases
than the predicted 15 pounds. For instance, multiple studies found only a
2-pound average weight gain, although others described up to a 6-pound
increase. In addition, weight gain is more likely in freshman men than
freshman women. This is particularly surprising because of the media’s
focus on the weight gain of young women. For instance, a 2015 Google
search found more than 1.2 million more hits for “Freshman 15 women”
then “Freshman 15 men.”
Starting college is commonly recognized as an important step to social
adulthood in the United States. However, few people recognize that the
majority of freshmen’s bodies have not finished physically maturing. In
the same way that babies gain weight as they grow into toddlers and chil-
dren, late teens continue to gain weight in their final stages of puberty.
Both females and males finish puberty in their early 20s—well beyond
the age of the typical freshman. This final stage of puberty is marked by
growth of bone, muscle, and other tissues in both sexes and a reduction
in adipose tissue. As a result, freshman weight gain may be associated with
this physical transition and be unrelated to changing diets or physical
activity levels.
Unfortunately, this normal transition of young adults’ bodies may be
misinterpreted by individuals and family members as a warning sign of
creeping weight gain associated with poor diet or exercise habits. Fear
of the “Freshman 15” may trigger young adults who are experiencing
normal body transitions to take unhealthy steps to avoid weight gain,
including skipping meals, undereating, and overexercising. On the
opposite end of the spectrum, some freshmen may treat the “Freshman
15” as a self-fulfilling prophecy and overindulge in high-calorie foods
and drinks.
Controversies and Debates 193

In conclusion, pop culture places a high value on the maintenance of

slim bodies. The creation of the “Freshman 15” concept reinforces this
emphasis on appearance. The “Freshman 15” ignores the weight loss by
as many as 30 percent of freshmen, and is a dramatization of the actual
average weight gain. In addition, the myth of the “Freshman 15” ignores
the normal transitions associated with the final stages of puberty and may
make young adults unnecessarily anxious about their bodies. By develop-
ing healthy eating and activity habits, incoming freshmen can transition
into being healthy adults with positive body images.

Michaela Howells

BIBLIOGRAPHY
Bogin, Barry. The Growth of Humanity. New York: Wiley-Liss. 2001.
Butler, Scott M., David R. Black, Carolyn L. Blue, and Randall J.
Gretebeck. “Change in Diet, Physical Activity, and Body Weight in
Female College Freshman.” American Journal of Health Behavior 28,
no. 1 (2004): 24–32. doi: 10.5993/AJHB.28.1.3.
Gropper, Sareen S., Karla P. Simmons, Alisha Gaines, Kelly Drawdy,
Desiree Saunders, Pamela Ulrich, and Lenda Jo Connell. “The
Freshman 15—A Closer Look.” Journal of American College Health 58,
no. 3 (2009): 223–31. doi: 10.1080/07448480903295334.
Hertzler, Ann A., and Robert B. Frary. “Food Behavior of College
Students.” Adolescence 24, no. 94 (1989): 349–56.
Hovell M. F., C. R. Mewborn, Y. Randle, and S. Fowler-Johnson. “Risk of
Excess Weight Gain in University Women: A Three-Year Community
Controlled Analysis.” Addictive Behaviors 10, no. 1 (1985): 15–28. doi:
10.1016/0306-4603(85)90049-8.
Jung, Mary Elizabeth, Steven Russell Bray, and Kathleen Anne Ginis.
“Behavior Change and the Freshman 15: Tracking Physical Activity
and Dietary Patterns in 1st-Year University Women.” Journal of
American College Health 56, no. 5 (2008): 523–30. doi: 10.3200/
JACH.56.5.523-530.
Khazan, Olga. “The Origin of the ‘Freshman 15’ Myth.” The Atlantic.
September 5, 2014. http://www.theatlantic.com/health/archive/2014/
09/the-freshman-15-is-a-myth/379587/.
Mihalopoulos, Nicole L., Peggy Auinger, and Jonathan D. Klein. “The
Freshman 15: Is It Real?” Journal of American College Health 56, no. 5
(2008): 531–34. doi: 10.3200/JACH.56.5.531-534.
194 Filling Up

Morrow, Michelle L., Kristiann C. Heesch, Mary K. Dinger, Holly R. Hull,

Allen W. Kneehans, and David A. Field. “Freshman 15: Fact or Fiction?”
Obesity 14, no. 8 (2006): 1438–43. doi: 10.1038/oby.2006.163.
Muth, Natalie Digate. “Help Fight Freshman Weight Gain: How to Assist
First-Year College Students So They Don’t Pack on the Dreaded
‘Freshman 15.’ ” IDEA Fitness Journal 5, no. 9 (2008): 76–80.
Accessed June 26, 2015. http://www.ideafit.com/fitness-library/help
-fight-freshman-weight-gain.
Smith-Jackson, TeriSue, and Justine J. Reel. “Freshman Women and the
‘Freshman 15’: Perspectives on Prevalence and Causes of College
Weight Gain.” Journal of American College Health 60, no. 1 (2012):
14–20. doi: 10.1080/07448481.2011.555931.
Thomas, Jack R. “Weight Gain Awareness, The Freshman 15:
A Nutrition Student Public Speaking Project.” Journal of Nutrition
Education Behavior 38, no. 6 (2006): 383–85. doi: 10.1016/j.jneb
.2006.05.018.
Vadeboncoeur, Claudia, Nicholas Townsend, and Charlie Foster.
“A Meta-analysis of Weight Gain in First Year University Students: Is
the Freshman 15 a Myth?” BMC Obesity 2, no. 22 (2015): 1–9. doi:
10.1186/s40608-015-0051-7.
Vella-Zarb, Rachel A., and Frank J. Elgar. “The ‘Freshman 5’: A Meta-
analysis of Weight Gain in the Freshman Year of College.” Journal of
American College Health 58, no. 2 (2009): 161–66. doi: 10.1080/
07448480903221392.
Vella-Zarb, Rachel A., and Frank J. Elgar. “Predicting the ‘Freshman 15’:
Environmental and Psychological Predictors of Weight Gain in First-
Year University Students.” Health Education Journal 69, no. 3 (2010):
321–32. doi: 10.1177/0017896910369416.
 Directory of Resources

BOOKS AND JOURNALS

Eating Disorders: The Journal of Treatment & Prevention
Publisher: Routledge
Website: http://www.tandfonline.com/loi/uedi20#.VfbBx9JVhBc

Full of Ourselves: A Wellness Program to Advance Girl Power, Health,

and Leadership
Publisher: Teachers College Press ISBN: 0-8077-4631-2
Website: http://catherinesteineradair.com/books/full-of-ourselves/

International Journal of Eating Disorders (IJED)

Publisher: Wiley
Website: http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1098-108X

Intuitive Eating: A Revolutionary Program That Works

Publisher: St. Martin’s Griffin ISBN: 0-312-32123-6
Website: https://www.intuitiveeating.com/

Journal of Clinical Sport Psychology (JCSP)

Publisher: Human Kinetics ISSN: 1932-9261 eISSN: 1932-927X
Website: http://journals.humankinetics.com/JCSP
196 Directory of Resources

Journal of Nutrition (JN)

Publisher: American Society for Nutrition
Website: http://jn.nutrition.org/

Psychology of Eating: From Healthy to Disordered Behavior,

Second Edition
Publisher: Wiley-Blackwell ISBN: 978-1-4051-9120-3
Website: http://www.wiley.com/WileyCDA/WileyTitle/productCd
-1405191201.html

ORGANIZATIONS
American Nutrition Association (ANA)
Website: http://americannutritionassociation.org/
Nutrition professionals and students who promote nutrition and wellness
in the community

American Society for Nutrition (ASN)

9650 Rockville Pike, Bethesda, MD 20814
(301) 634-7050
Website: http://www.nutrition.org/
Nutrition scientists who conduct nutrition research and translate findings
into practice.

Binge Eating Disorder Association (BEDA)

Emerson Place, Severna Park, MD 21146
Phone: (855) 855-BEDA (2332)
Website: http://bedaonline.com/
Provides research and resources for binge eating.

Families Empowered and Supporting Treatment of Eating Disorders

(F.E.A.S.T.)
Phone: (855)-50-FEAST (33278)
Website: Feast-ed.org
Provides information and support for parents and caregivers.

Food and Nutrition Service: USDA (United States Department

of Agriculture)
3101 Park Center Drive, Alexandria, VA 22302
Phone: (703) 305-2062
Website: http://www.fns.usda.gov/
Directory of Resources 197

International Association of Eating Disorder Professionals (iaedp)

PO Box 1295, Pekin, IL 61555-1295
Phone or Fax: 1-800-800-8126
Email: iaedpmembers@earthlink.net
Website: http://www.iaedp.com/
Members and resources for international multidisciplinary groups and
professionals working in the eating disorder field.

National Eating Disorders Association (NEDA)

165 West 46th Street, Suite 402, New York, NY 10036
Phone: 1-800-931-2237
Website: http://www.nationaleatingdisorders.org/
Organization with resources for individuals and supporting families
affected by an eating disorder.

School Nutrition Association

120 Waterfront Street, Suite 300, National Harbor, MD 20745
Phone: (301) 686-3100
Website: https://schoolnutrition.org/
School nutrition professionals focused on improving the quality of school
meals through education and advocacy.

SHAPE America (Society of Health and Physical Educators)

1900 Association Drive, Reston, VA 20191
Phone: (800) 213-7193 Fax: (703) 476-9527
Website: http://www.shapeamerica.org/
Organization of professionals involved in physical education, physical
activity, dance, school health, and sport.

USDA (United States Department of Agriculture)

1400 Independence Avenue SW, Washington, DC 20250
Phone: (202) 720-2791
Website: http://www.usda.gov

World Health Organization (WHO)

Website: http://www.who.int/topics/en/
Organization and resources about projects, initiatives, and activities on
health and development topics.
198 Directory of Resources

OTHER RESOURCES
Centers for Disease Control and Prevention (CDC): Physical Activity/
Healthy Living
1600 Clifton Road, Atlanta, GA 30333
Phone: 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348
Website: http://www.cdc.gov/physicalactivity/
Website: http://www.cdc.gov/HealthyLiving/
Information on exercise and health.

EDReferral.com (Eating Disorder Referral and Information Center)

Website: http://edreferral.com/
Provides names of eating disorder professionals across the country by
region that can take referrals.

Food Addicts Anonymous

529 NW Prima Vista Boulevard, #301A, Port St. Lucie, FL 34983
Phone: (772) 878-9657
Website: http://www.foodaddictsanonymous.org/
Resources for individuals with a food addiction.

National School Lunch Program (NSLP)

Food and Nutrition Service: USDA (United States Department of
Agriculture)
3101 Park Center Drive, Alexandria, VA 22302
Phone: (703) 305-2062
Website: http://www.fns.usda.gov/nslp/national-school-lunch-program-nslp
Resources for a federally assisted meal program.

Overeaters Anonymous (OA)

Mailing address: PO Box 44020, Rio Rancho, NM 87174-4020
Street Address: 6075 Zenith Court NE, Rio Rancho, NM 87144-6424
Phone: (505) 891-2664 Fax: (505) 891-4320
Website: https://www.oa.org/
Resources for individuals with overeating problems.

Promoting Active & Healthy Lifestyles (PE Links 4 U)

Website: http://www.pelinks4u.org/
Resources for healthy lifestyles.
 Glossary

addiction: Involves the maladaptive use of a substance, resulting in signifi-

cant distress and impairment. Addiction is characterized by impaired
control, social impairment, risky use, and pharmacological dependence.

anorexia nervosa: A mental disorder frequently referred to as “self-

starvation syndrome” in which individuals are underweight and restrict
their dietary intake in a way that nutrient demands are no longer met,
which negatively affects a variety of bodily systems.

associative learning: Refers to the development of a particular response to

food based on diverse factors that may positively or negatively reinforce
the consumption of that food item.

behavioral theories: A theoretical approach that focuses on specific

behaviors such as physical activity and nutritional patterns that contrib-
ute to one’s body weight, size, and shape.

binge eating disorder (BED): Defined as recurring episodes of binge eat-

ing, and one of the clinical eating disorders found in the current version
of the Diagnostic and Statistical Manual of Mental Disorders.
200 Glossary

board: An “American plan” that included meals (i.e., board) when the
food was literally served on a plank.

boundary model of overeating: Proposed in 1984, this model implies that

a “dietary boundary” exists to determine control for eating types or
amounts of food among restrained eaters.

buffet: This is actually a piece of furniture and relates to people serving

themselves. The “all you can eat” style of buffet was introduced in
1956 by Las Vegas businessman Herbert McDonald.

bulimia nervosa: A mental disorder classified as one type of clinical eating

disorder that is characterized by negative body image, binge episodes,
and compensatory methods.

cognitive models of food choice: These approaches to understanding food

preferences tend to focus on cognitions or thoughts around food that
predict or explain one’s eating behavior.

developmental models of food choice: Focus on the process of learning

and how eventual food preferences evolve for human beings.

dietary restraint: Consciously restricting calories or specific kinds of for-

bidden foods; this has been tied to the development of disordered eating
or clinical eating disorders such as anorexia nervosa.

dieting: Includes the restriction of overall consumption of food throughout

the day, selective consumption of certain foods, or can represent the
elimination of specific foods or food groups from one’s diet.

emotional eating: Eating patterns triggered by intense emotions rather

than biological cues of hunger and fullness.

emotional hunger: An individual’s appetite or feelings of hunger triggered

by a specific event or situation associated with a feeling or emotion.
Emotional hunger appears suddenly in contrast to the more gradual
building over time as found with a more physical type of hunger.

escape theory: Focuses on the role of self-awareness and criticism of self

with regard to eating behavior.
Glossary 201

exposure hypothesis: Identified in 1968 by Robert Zajonc, refers to a pas-

sive type of learning related to food choice.

fast food: The fast-food movement became popularized in the 1950s but has
exploded in the present day to a multibillion-dollar industry. Some exam-
ples of current fast-food restaurants include, but are not limited to,
McDonald’s, Burger King, Wendy’s, Taco Bell, Pizza Hut, and Bojangles.

fasting: Depriving oneself of food.

feasting: Eating large amounts of food.

flavor-flavor associative learning: Type of associative learning that takes

into account the tendency of human beings to have an innate food pref-
erence for sweet and salty items from an early age.

flavor-nutrient associative learning: This type of associative learning,

described as using a flavor with a required substance such as calories,
minerals, or vitamins, can lead to increased food preferences.

food addiction: The sense of being drawn to a particular food and feeling
out of control about one’s eating patterns.

food cravings: Typically independent of any physiological need and con-

sidered to be psychological in nature.

Freshman 15: The belief that college students will gain significant body
weight in their first year of college, the “15” referring to the number of
pounds gained.

grazing behavior: Consists of continuous snacking throughout the day.

health belief model: Developed in the 1950s and popularly used to explain
health behaviors, this theory argues that people tend to behave in
response to what they perceive as consequences for their actions.

healthy diet: A balanced meal plan or diet.

homeostasis: The regulation of eating within certain limits, usually around

our experience of hunger.
202 Glossary

intuitive eating: An approach to eating that focuses on moving individ-

uals away from having a highly emotionally charged relationship with
food to one that involves listening to one’s physiological cues of hunger
and fullness.

liquid diet: Nutrients obtained from food beverages such as carbonated

beverages, smoothies, and specialty coffees.

meals: Human need to nourish the body to eat and drink frequently
throughout the day in a particular pattern.

mindful eating: Involves focusing on the food itself and slowing down while
eating, incorporating the senses of sight and smell to fully enjoy the meal.

mindless eating: Refers to being absentminded about what food is being

consumed and not really noticing the taste and texture of the food.

neophobia: Defined as the fear and avoidance associated with trying novel
food items, this has also been referred to as the “omnivore’s paradox.”

obesity and overweight: A possible result if consuming an excess of

calories throughout the day over an extended period of time.

Paleo Diet: Mimics the diet of our ancestors from 10,000 years ago and rep-
resents a truly “natural” way to eat. It emphasizes the consumption of lean
animals, ideally wild or free range, grass-fed animals, eggs and honey, fish
and seafood, fresh fruits and vegetables, raw nuts and seeds, and oils such
as olive, walnut, flaxseed, macadamia, avocado, and coconut.

physical hunger: Is experienced throughout the day in between meals and

is accompanied by body signals such as growling.

protection motivation theory: A theory devised to understand the effects

that scare tactics may have on influencing health-related attitudes and
associated behaviors.

psychological hunger: Involves emotions, and overeating is common.

psychophysiological models of food choice: Another theoretical perspec-

tive related to eating behavior, which focuses on the concepts of hunger
and fullness (satiety).
Glossary 203

restraint theory of dieting: Developed in the late 1970s in attempts to

explain the relationship between dieting and body weight. Initially this
theory was used to predict food intake rather than body weight.

social learning theory: Also called observational learning, this theory is

characterized by the tendency of children to observe others in order to
learn certain types of behaviors.

South Beach Diet: Created in 2003 by a cardiologist as a way to prevent

heart disease.

sugar Addiction: The object of one’s addiction is desired as a way to

soothe emotions or feel comfort.

“supper”: Resembled bedtime snacks rather than a full meal given that it
was served later at night.

theory of planned behavior: Extends the theory of reasoned action by

including another construct, the influence of intention as it relates to
perceived behavioral control.

theory of reasoned action: Developed in the late 1960s to explain all

behaviors that are selected voluntarily, including health-related
decisions.

transtheoretical model: Another popular approach for understanding

behavior change related to health behaviors, the transtheoretical model
is a framework developed to understand how individuals begin to move
toward positive health behaviors.

TV dinner: In the 1970s, it became popular to move families from the

dining room to the living room for meals in the evenings.

yo-yo dieting: Involves periods of liberal eating alternated with highly

restrictive eating periods, and may lead to psychological hunger and
inability to rely on physical cues for hunger.
 About the Author and Contributors

Justine J. Reel, PhD, LPC, CC-AASP, is a Professor and Associate Dean

of Research and Innovation at the University of North Carolina
Wilmington. Prior to UNCW she was an Associate Professor and
Director of Graduate Studies in the Department of Health Promotion
and Education at the University of Utah. She received her bachelor’s
degree from North Carolina State University, and her master’s and doc-
toral degrees from the University of North Carolina Greensboro. She is
currently a certified applied sport psychology consultant and a Licensed
Professional Counselor. She has treated eating disorder clients across inpa-
tient, residential, partial, intensive outpatient, and outpatient settings.
Dr. Reel has written several books and monographs, including Working
Out: The Psychology of Sport and Exercise; The Hidden Faces of Eating
Disorders and Body Image; Eating Disorders: An Encyclopedia of Causes,
Treatment, and Prevention; and The Female Athlete Triad.

Robert A. Bucciere, MSW, LCSW, is a mental health and health care

consultant who resides in North Carolina. Prior to being a consultant, he
was a Hospital Manager for the Department of Clinical Social Work and
Chaplaincy Program at the University of Utah: Health Care. Prior to his
position as a manager, he was the Lead Licensed Clinical Social Worker
at the University Health Care: Neurobehavior HOME Program. He gradu-
ated from the University of Maryland at Baltimore and the University of
206 About the Author and Contributors

North Carolina at Greensboro. He has published and presented on the

topic area while providing individual, couples, and group psychotherapy
to thousands of individuals in a variety of populations across the life span.
He served as the Editorial Assistant for this book project.

Christy Greenleaf, PhD, is a Professor in the College of Health Sciences

at the University of Wisconsin–Milwaukee. Prior to her position in
Wisconsin, she was an Associate Professor in the Department of
Kinesiology, Health Promotion, and Recreation at the University of
North Texas. She received her bachelor of arts degree in psychology from
Bowling Green State University, her master of science degree in sport
studies from Miami University (Ohio), and her doctor of philosophy
degree in exercise and sport science from the University of North
Carolina–Greensboro. Dr. Greenleaf’s research focuses on psychosocial
aspects of weight, physical activity, body image, and disordered eating.

Michaela Howells, PhD, is an Assistant Professor in the Department

of Anthropology at the University of North Carolina Wilmington.
She received her doctoral degree from the University of Colorado at
Boulder. She earned her master’s and bachelor’s degrees from Iowa State
University and Central Washington State University. Her interests
include reproductive health, body image, and growth and development.

Lynn Hunt Long, EdD, is the Assistant Director of Academic and Student
Affairs with the State University System of Florida Board of Governors.
Prior to her current position, she was an Assistant Professor and
Coordinator for the Physical Activity and Wellness program in the
School of Health and Applied Human Sciences at the University of
North Carolina Wilmington. She holds degrees from Florida State
University, Auburn University, and the University of North Florida.

Noell L. Rowan, PhD, MSW, is Professor and BSW Program Coordinator

in the School of Social Work at the University of North Carolina
Wilmington. She earned BSW and MSW degrees from the University of
Georgia, and her PhD in social work from the University of Louisville.
She is a Hartford Geriatric Faculty Scholar and is licensed in clinical social
work. She is a clinical addictions specialist in North Carolina, holds the
ACSW credential, and has practiced social work in the areas of mental
health and addictions for over 20 years.
About the Author and Contributors 207

Lisa Sprod, PhD, MPH, is an Assistant Professor in Exercise Science at the

University of North Carolina Wilmington. She earned her postdoctoral
degree at the University of Rochester. She teaches courses in research
methods and exercise and assessment and prescription for clinical popula-
tions. Her research is focused on utilizing exercise to reduce the side effects
of cancer treatment.
 Index
Addiction, 11, 29, 37–38, 47, 52, 171,
179–86, 189; a myth, 179–81,
184–86; a reality, 179–83. See also
food; sugar
Adolescents, 33, 36, 71, 92, 113;
nutritional concerns for children
and, 117–22
Adulthood, 113–14, 118, 120, 165,
185, 190, 192; nutritional concerns
in, 122–23
Africa, 43–44, 135–38, 148
African, 44, 136, 141, 144
Age of elegance, 9
Agromafia, 70; olive oils and, 70–71
Alcohol, 101–2, 113, 115–16, 124,
148, 187–88. See also alcoholic;
alcoholism
Alcoholic, 106, 149
Alcoholism, 65
Algae, 62
“All you can eat,” 8, 18–19. See also
buffet
American diet, 8, 10, 23, 34, 53, 152,
174–75; plan, 8
Americans, 4–10, 12, 17, 43, 53, 60,
62, 102, 139, 144, 174
Amnestic shellfish poisoning, 69. See
also seafood toxicity; shellfish
poisoning
Anorexia nervosa, 32, 36, 105–6, 122,
172, 177. See also bulimia nervosa;
binge eating disorder; eating
disorder
Antibiotics, 66; and hormones, 68–70
Anxiety, 32, 45, 52, 71, 77, 102, 165
Artificial flavors, 67;
“natural flavors,” and chemicals in
foods, 74–75
Asia, 43, 135, 138–39, 141,
144, 148, 154. See also Asian;
Japan
Asian, 18, 44, 138–40, 144
Associative learning, 89, 92–95;
flavor-flavor, 94; flavor-nutrient,
94–95. See also developmental
models of food choice; models
Athletes, 51, 54–55, 167–68
Atkins Diet, 12, 56
210
Australia, 68, 135, 141–43, 153, 191;
and Oceania, 135, 141
Babies, 65, 114, 116, 192
Bacteria, 62, 65, 69. See also food-
borne pathogens
Barbecue(s), 143; barbecued, 137
Basashi, 139–40. See also Asia
Beavertails, 151
Behavioral theories, 108–9;
limitations of, 109; of obesity,
108–9. See also theories
Bible, 23, 113
Biblical times, 113
Binge eating disorder, 106, 122, 160,
183. See also anorexia nervosa;
bulimia nervosa; eating disorder
Birthday, 5, 7, 21, 22, 42, 46–47, 120;
cake, 22; history and social
meaning of the, cake, 22–23
Bloody Caesar, 151
Body mass index (BMI), 71, 189
Boundary model of overeating, 104–5.
See also models
Bovine spongiform encephalopathy
(BSE), 62
Bratwurst, 146
Breakfast, 4, 7, 9, 18, 42–43, 45, 53,
92, 114, 120–21, 124, 136, 144,
152, 161, 163, 188
Breastfeeding, 114, 116. See also infant
nutrition
British, 8, 11, 66, 141. See also Great
Britain
British Columbia, 66
Brunch, 9, 139
Buffet(s), 8, 17–19, 147. See also “all
you can eat”
Bulimia nervosa, 106, 122, 177. See
also anorexia nervosa; binge eating
disorder; eating disorder
Caffeine, 102, 115–16, 118, 180
Calcium, 114, 116, 125
Index
California, 13–15, 19, 43, 59, 63;
cuisine, 59
Caloric, 11, 31–32, 37–38, 54, 59, 77,
95, 108, 116, 119–21, 125,
145, 177
Camembert cheese, 66
Canada, 66, 68, 150–52
Carb-loading, 55
Carbohydrate, 12, 53–54, 57, 101,
180
Carhops, 13–14, 16
Caveman, 56
Celebrating customs, 46; and special
occasions, 46–47
Central America, 135, 143–45; and
the Caribbean, 135, 143–45
Centers for Disease Control and
Prevention, 66
Ceviche, 153–54. See also South
America
Chemicals, 52, 66–68, 70, 74–75,
102, 174–75;
“natural flavors,” artificial flavors, and,
in foods, 74–75. See also antibiotics
and hormones; pesticides
Chilaquiles, 150, 152
China, 31, 138–39
Chinatowns, 138
Chocolate, 10, 22, 35–37, 40, 102–3,
108, 115, 118, 142, 151, 153,
162–63, 180, 182; do coffee and,
have an effect on mood, 102–3. See
also coffee; mood
Cholecystokinin, 101
Chronic diseases, 52, 55, 72, 97, 103,
173–74; food as a protective factor
against, 55–56
Christmas, 7, 21, 23, 42, 46,
120, 142, 146
Chuck wagons, 20
Coffee, 20, 23–25, 30, 42–43, 53, 56,
94, 102, 115, 118, 120, 124, 140,
143, 149–50, 187; do, and
chocolate have an effect on mood,
Index
102–3; Turkish, 149. See also
chocolate; mood; Starbucks
Coffeehouse, 24–25
Cognitive models of food choice, 96,
100, 102; limitations of, 100. See
also models
Comfort foods, 56–57, 120, 165
Convenient, 6, 25, 52, 72
Cornish pasty, 146
Costco, 121
Cragel, 58
Creeping obesity, 189. See also obesity
Croissant, 58, 153
Cronut, 58
Culinary adventure, 51; foods as a,
60–62
Cupcakes, 21–22, 57–58
Cupcake Wars, 58
Curry goat, 144
Dairy, 34, 43, 53, 55, 65, 68, 70, 74,
117, 174, 177; and meat, 149
Deluca, Frederick, 16
Depression, 10, 32, 57, 77, 102–3,
160, 165
Desserts, 8, 11, 58, 94, 142, 144
Developmental disabilities, 114
Developmental models of food choice,
89–96, 109. See also associative
learning; exposure hypothesis; food;
models; social learning
Diabetes, 32, 52, 55–56, 65, 71–72,
97, 99, 114, 117–19, 174–75;
obesity and, 119–22
Diarrheal, 69. See also seafood toxicity
Dietary, 10, 32, 54, 72, 74, 95–96,
104–5, 113–14, 117, 119–21, 124,
162, 187; behaviors, 100; restraint,
36, 104, 172; supplement, 114
Diethylstilbestrol, 68
Diet industry, 77
Dieting, 5, 11, 38, 41, 73, 76–77, 92,
104–6, 109, 116, 118, 122, 124,
159–61, 171–72; mentality, 41,
211
76–77, 160. See also theories of
dieting
Dieting mentality, 41, 76–77, 160
Dietitian, 54, 56–57, 161, 164, 166,
168
Dim sum, 138–39
Dinner, 4, 6–7, 9, 12, 18, 35, 40,
44–45, 53, 60–61, 121, 137, 141,
146–47, 150, 161–63, 165
“Dirty Dozen,” 67
Disney, 22
Doughnuts, 58, 118
Drive-in, 13–15; -through, 6, 25; -up, 13
Duffin, 58
E. coli (Escherichia coli), 52, 62–64, 66
Easter, 21, 42, 44, 46, 120
Eating disorder, 71, 105–6, 117, 122,
160, 168–69, 172, 177, 181, 183;
eating disorders, 71, 106, 117, 122,
168–69, 172, 177, 183. See also
anorexia nervosa; bulimia nervosa;
binge eating disorder
Economy, 63; eating for the
environment and the, 59
Eggo, 11
Electrolytes, 54
Elote, 150–52
Emotional eating, 36–39, 41, 103,
109, 119–20, 123, 165, 188
Empanadas, 153
Empty calories, 54, 121, 174
English colonists, 7
Enhance performance, 54–55; sport
nutrition to, 54–55
Environment, 30, 33, 45, 72, 75, 93,
95, 98, 104, 107–9, 118, 121, 123,
161, 164, 178, 185, 187; eating for
the, and the economy, 59–60
Environmental, 55, 75, 107–8
Environmental Protection Agency, 67
Environmental Working Group, 67
Escape theory, 104–6. See also
theories; theories of dieting
212
Escargot, 6
Estrogen, 68
Ethnic, 4, 6, 10, 20–21, 30, 35, 42–44,
141; differences in food
preferences, 43
Europe, 18, 24, 73, 135, 139, 145,
147–49
European Union, 68
Exposure hypothesis, 90–91. See also
developmental models of food
choice; models
F-Plan Diet, 92
Farm-to-fork, 59
Farm-to-table, 59–60
Fast food, 4–5, 10, 12–17, 19, 23–25,
35, 38, 46, 52, 59, 72, 74, 119–21,
123, 135, 138, 141, 143, 145,
147–48, 150–52, 154, 164, 174
Fasting, 4, 30, 44, 72–73, 160,
171–72, 177, 184
Feasting, 72, 171
Fetus, 113, 115; fetuses, 70
Fish, 8, 34, 43, 53, 55, 69–70, 114–17,
136, 138, 140–43, 150, 153,
174, 177
Flavor-flavor associative learning, 94.
See also associative learning
Flavor-nutrient associative learning,
94–95. See also associative learning
Folate, 114–15
Food addiction, 37–38, 47,
180–82, 185
Food-borne pathogens, 62–64, 66
Food cravings, 29, 37, 47, 56–57, 103,
108, 179–80, 182; during
pregnancy, 115
Food desert, 72
Food Network, 58
Food pyramid, 53
Food stamps, 73; Act of 1964, 73
Food swamps, 72
Food trucks, 3, 23; history of, 19–21
Football, 54–55, 167
Index
Forever cheese, 66
Forkner, Tom, 16
France, 23–24, 31, 74, 145
French cuisine, 9–10, 61; influence of,
on food in America, 9–10
“Freshman 15,” 164, 171; college
nutrition and the, 123; a myth or a
reality, 187–93
Fried plantain, 136–37, 144
Frozen yogurt, 66
Fruits, 7–8, 20, 22, 36, 43, 46, 52–53,
64, 67, 72, 77, 91–93, 97, 98–99,
109, 116–18, 121, 123–25, 136,
147, 153, 164, 174, 177
“Funeral potatoes,” 35, 44. See also
Mormon
Genetically modified organisms
(GMOs), 75–76
Germany, 22, 24, 146–47
Glutton, 60
Goodnight, Charlie, 20
Goulash, 146
Grains, 10, 53, 77, 116, 136,
148, 174, 177
Grazing behavior, 31, 119
Great Britain, 8, 22, 24. See also
British
Great Depression, 10
Greece, 22, 55
Greeks, 22
Green leafy vegetables, 114
Guilt, 29, 36–37, 39, 52, 57, 76, 103,
106, 122, 160, 165, 177–78; when
food becomes a, trip, 76
Halloween, 120, 180
Health belief model, 96–97. See also
cognitive models of food choice;
models
Healthy diet, 53, 55–56, 62, 71, 99,
116, 171
Heart, 56, 69, 103; disease, 55–56, 97,
140, 172
Index 213

High-fiber diet, 92 Local farmers’ markets, 59; county

Hormones, 68–70; antibiotics and, farmers’ markets, 60
68–69 London, 11, 56
Hunger, 4, 36–41, 56, 73, 76–77, Lunch, 4–7, 18, 20, 40, 45–46, 53, 93,
100–105, 109, 113, 118, 121, 123, 98–99, 119, 137, 146, 160–61, 163
161, 166, 168, 178. See also
physical hunger; psychological Mad cow disease, 66
hunger Mardi Gras, 21, 23, 47
Hurricane Katrina, 47 Master Chef, 62
Hypothalamus, 101 Maternal, 113; nutrition, 114, 123
Mayo Clinic, 172
Ice beer, 150 McDonald, Herbert, 18
Ice cream, 15, 19, 35, 37, 38–39, McDonald, Richard and Maurice,
53–54, 56, 66, 139, 154, 14–15
159, 165, 177, 180 Meals, 3–4, 7–10, 12, 20–21, 23, 25,
Infant, 114; infants, 5, 31, 36, 66, 90, 29–31, 38, 45, 51, 53, 57, 59,
95, 116; nutrition, 116 61–62, 71, 73–74, 77, 103, 116–17,
Insecurity issues, 72; poverty and, 119, 121, 123, 136–38, 149,
72–73 161–64, 187, 192
Intuitive eating, 41, 166 Mediterranean Diet, 55, 145
Italy, 17, 24, 55, 60, 70, 145–46; Menopause, 123–24
southern, 55 Mercury, 67, 69–70, 115, 117;
poisoning, 69–70
Japan, 43, 68, 138–41, 151 Mexico, 20, 42, 150–52, 154
Jell-O, 11 Middle Ages, 22, 172
Jellyfish, 139 Middle-class, 7, 9, 61
Jerk chicken, 145 Middle East, 135, 148–50
Junk food, 10, 119, 164 Mindful eating, 39–41, 162
Mindless eating, 4–5, 39–40, 103,
Kangaroo, 141–42 120; mindful versus, 40
Karcher, Carl, 13–14 Miscarriage, 114–15
King cake, 23, 47; history and social Models, 12, 17, 89, 91–93, 95–96, 98,
meaning of the, 23 100–102, 109, 118, 159. See also
Kitchen Nightmares, 62 boundary model of overeating;
Korean, 141; BBQ, 20 cognitive models of food choice;
developmental models of food
Latter-Day Saints (LDS), 44. choice; health belief model;
See also Mormon psychophysiological models of food
Life cycle, 113, 123–25 choice; transtheoretical model
Life span, 72, 113 Molds, 62
Lifestyle choice, 171 Mood, 56–57, 102–3, 105–6, 166,
Liquid diet, 23 179–80; do coffee and chocolate
Listeria, 62, 65–66 have an effect on, 102–3;
Liver, 115; disease, 56 enhancer, 56–57
214
Mormon, 44. See also Latter-Day
Saints (LDS)
Mother, 45, 92, 113–16, 165
National School Lunch Act, 45
National School Lunch Program, 45
Native American, 7–8, 144
“Natural flavors,” 70; artificial flavors,
and chemicals in foods, 74
Neophobia, 90
Netherlands, 74
Neuropeptide Y, 101
Neurotoxic shellfish poison, 69. See
also seafood toxicity; shellfish
poisoning
Neurotransmitters, 101, 107, 180
New Orleans, 23, 47, 61
New York, 6, 18, 20, 24, 61, 66, 142
New Zealand, 68, 141–43, 191
Norepinephrine, 101
Norovirus, 62–66
North America, 51, 135, 150, 152
Nutritionist, 10, 54–55, 167
Obesity, 5, 32–33, 40, 46, 52, 71–72,
89, 97, 106–9, 117–21, 174, 182,
186, 189–90; battle against, and
diabetes, 71–72 excessive food
intake and the relationship to,
32–33; theories for the cause of,
106–9
Observational learning; 91–92, 97.
See also social learning theory;
theories
Obsession, 11–12, 71, 122, 160, 167;
an athlete’s, with “sucking weight,”
167; when eating healthy becomes
an, orthorexia nervosa, 71
Oceania, 135, 141; Australia and,
135, 141
Official Foodie Handbook, 61
Older adults, 64–66, 123–25
Olive oil, 22, 52, 55, 70–71, 136, 148,
153. See also Agromafia
Index
Omega-3, 114–15, 140
Omega-6, 140
Oregon, 58, 63
Orthorexia nervosa, 71
Overeating, 18, 38–40, 52, 57, 72, 76,
89, 97, 103–6, 109, 120–22, 160,
174, 180, 182
Overweight, 5, 11, 32–33, 40, 52,
71–72, 91–92, 97, 103, 107–9,
119–21, 174, 180, 182, 189–90
Paleo Diet, 12, 33, 56, 76, 92, 171–72;
an effective meal plan, 171–72;
negative side of the, 176–78;
positive side of the, 173–75
Paralytic types of shellfish poisoning,
69. See also seafood toxicity;
shellfish poisoning
Parasites, 62
Parkinson’s disease, 56
Pâté, 65, 115
Pathogens, 52, 62–64, 69. See also
food-borne pathogens
Peking duck, 139
Pepper pot, 144
Pesticides, 66–68, 70. See also
chemicals
Physical hunger, 38–39, 41;
characteristics of psychological
versus, 38–40. See also hunger;
psychological hunger
Pierogi, 146
Pig stand, 13
Pima Indians, 107
Pizza, 12, 17, 42, 117–18, 123, 138,
145–48, 150, 152, 162–64, 180,
187–88
Plate, 53, 94, 123, 140, 145, 163–64;
approach, 53
Poutine, 151–52
Poverty, 45, 72–73, 138; and
insecurity issues, 72–73
Pregnancy, 123; eating during, and
prenatal nutrition, 113–16
Index
Prenatal, 113, 125; eating during
pregnancy and, nutrition, 113–16
Preschool children, 90, 117–18
President Abraham Lincoln, 21
President Johnson, 73
Primary-school-age children,
117–18
Protection motivation theory (PMT),
96–97. See also theories
Psychological hunger, 38–40;
characteristics of, versus physical,
38–40. See also hunger, physical
hunger
Psychologists, 57, 71, 89
Psychophysiological models of food
choice, 100–104. See also models
Pumped breast milk, 116
Recombinant bovine growth
hormone, 68
Religion, 21, 47, 96, 148; the
influence of, and cultural attitudes
on food choices, 43–44
Religious holidays, 42, 120
Republic of Porkdom, 8
Restraint theory of dieting, 104–5;
limitations of, 106. See also theories;
theories of dieting
Retinol, 115
Roach coaches, 20
Rogers, Joe, 16
Roman, 21–23, 44, 46
Salmonella, 62–64, 69, 92
Sanders, Harland, 16
Schnitzel, 147
Schools, 47, 65; meaning of food in,
45–46
Schultz, Howard, 24
Scott, Walter, 20
Scruffin, 58
Seafood toxicity, 69–70. See also
shellfish poisoning
Self-medication, 57
215
Self-service, 14–15; history of buffets
as a, style of eating, 18–19
Serotonin, 57, 101
Seventeen, 191
Sex in the City, 58
Shellfish, 64, 69–70, 115
Shellfish poisoning, 69. See also
amnestic shellfish poisoning;
diarrheal shellfish poisoning;
neurotoxic shellfish poisoning;
paralytic shellfish poisoning;
seafood toxicity
Social influences on eating,
42, 104
Social learning theory, 91–92. See also
theories
Socioeconomic, 45, 52, 72–73, 96,
114, 171
Soft drinks, 53, 74, 102, 115, 118,
120, 124
South America, 135, 152–54
South Beach Diet, 12, 56, 172
Special dishes, 137
Speedee Service System, 14
Sport nutrition, 53–55; to enhance
performance, 54–55
Starbucks, 6, 148, 161; phenomenon,
24–25. See also coffee
Stress, 33, 37, 55, 57, 101, 160, 185,
188–89; eating paradox, 103;
midlife, eater, 164–66; relationship
between, and eating, 103
Sugar addiction, 171; a myth or a
reality, 179–86
Supper, 7, 137. See also dinner
Sur La Table, 61
Survivor, 44
Sushi, 115, 140
Swedish, 18; meatballs, 147
Take-out, 7, 17
Tang, 74
Tea, 53, 102, 115, 118, 124,
140–41, 143
216
Television, 40, 44–45, 58, 92, 103,
108, 120–21, 123, 162; eating
while driving, watching, and
working, 4–5
Texas, 13, 19–20, 66
Theories, 89–109. See also behavioral
theories; escape theory;
observational learning; protection
motivation theory; restraint theory
of dieting; social learning theory;
theories of dieting; theory of
planned behavior; theory of
reasoned action
Theories of dieting, 104–6. See also
escape theory; restraint theory of
dieting
Theory of planned behavior, 96,
98–99. See also theories
Theory of reasoned action, 96, 98. See
also theories
Thomas, Dave, 15–16
Toddlers, 90, 117, 192
Tofu, 114, 140
Top Chef, 62
Townies, 58
Transtheoretical model, 96, 99. See
also models
Tres leches cake, 144–45
Triathlon, 55
Index
Turkey, 24
Turkish, 24; coffee, 149
Turtle soup, 6
Upper-class, 9–10, 24, 61
U.S. Department of Agriculture
(USDA), 53
U.S. Secretary of Agriculture, 73
Vegan, 34, 59, 116, 119
Vegetarian, 34, 59, 106, 140; cuisine,
149
Vitamin D, 114, 116, 125
Wagyu, 140
Washington, 60, 63
Wedding cake, 46; history and social
meaning of the, 21–22
Whale meat, 151
Wheat, 8, 21–22, 34, 92, 148, 153;
and rice, 148–49
Williams-Sonoma, 61–62
Working-class, 9, 15, 17
World Health Organization, 174
World War II, 10, 14
Wrestling, 54, 167–68
Yale Food Addiction Scale, 182, 185
Yo-yo dieting, 38, 76–77